Publications by authors named "Alexy Tran Dinh"

Background: The waitlist deaths of transplantation candidates based on their time on the waiting list (TWL) have already been studied, but the short-term mortality and early complications of lung transplant (LT) recipients based on their TWL have not been specifically studied. The first aim of this study was to assess the relationship between increased TWL and short-term mortality in LT recipients.

Methods: In this observational, monocentric, retrospective study, all patients who underwent LT between January 2016 and August 2022 at Bichat Claude Bernard Hospital, Paris were analyzed.

View Article and Find Full Text PDF

Secondary prophylaxis using inhaled colistin (IC) was implemented to prevent recurrences of Pseudomonas aeruginosa or extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE) pneumonia during the postoperative intensive care unit (ICU) stay after lung transplantation (LT). We evaluated the risk of emergence of colistin resistance in the respiratory tract during secondary IC prophylaxis. We conducted a prospective, single-centre, observational study of all adult patients who underwent LT between 1 July 2018 and 30 June 2019.

View Article and Find Full Text PDF
Article Synopsis
  • A study was conducted to compare the outcomes of lung transplantation (LT) based on whether the surgery took place during the day or night.
  • The study included 253 patients between January 2015 and December 2020, with 66% undergoing surgery during the day and 34% at night.
  • Results showed that while mortality rates at 90 days and one year were similar for both groups, daytime procedures had a higher rate of one-year airway complications compared to nighttime surgeries.
View Article and Find Full Text PDF
Article Synopsis
  • The study emphasizes the under-researched role of myeloid cells, particularly monocytes and low-density neutrophils (LDNs), in COVID-19 disease and their impact on immune responses, especially against secondary bacterial infections.
  • Findings reveal that COVID patients show increased LDNs that damage type II alveolar cells and that monocytes in COVID patients exhibit reduced responsiveness to bacterial infections, indicating impaired immune function in severe cases.
  • Overall, the results suggest that COVID-19 alters the immune environment, leading to a biased T cell response and harmful functions of myeloid cells, which can exacerbate lung damage and hinder effective defenses against infections.
View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to evaluate the effectiveness of the Consultation And Relational Empathy (CARE) measure for assessing medical students' empathy during Objective and Structured Clinical Examinations (OSCEs), addressing the lack of a definitive tool for this purpose.
  • Researchers analyzed the CARE measure's psychometric properties and compared scores given by examiners and standardized patients (SPs) to 129 students, finding discrepancies in their evaluations.
  • Although the CARE measure had satisfactory overall properties, the inter-rater reliability was deemed poor, suggesting that the evaluators and the type of SP significantly impact the assessment of empathy in medical education.
View Article and Find Full Text PDF

In this work, we present a new approach to predict the risk of acute cellular rejection (ACR) after lung transplantation by using machine learning algorithms, such as Multilayer Perceptron (MLP) or Autoencoder (AE), and combining them with topological data analysis (TDA) tools. Our proposed method, named topological autoencoder with best linear combination for optimal reduction of embeddings (Taelcore), effectively reduces the dimensionality of high-dimensional datasets and yields better results compared to other models. We validate the effectiveness of Taelcore in reducing the prediction error rate on four datasets.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the effectiveness of Extended Focused Assessment with Sonography in Trauma (eFAST) for patients with stab wounds to the chest or abdomen, comparing it to CT scans.
  • Out of 200 patients, eFAST was particularly valuable in identifying urgent conditions like cardiac tamponade and haemothorax, with high sensitivity and specificity for these injuries.
  • However, eFAST showed lower sensitivity for diagnosing pneumothorax and haemoperitoneum, indicating a need for further research across multiple centers to validate these findings.
View Article and Find Full Text PDF

Background: Early diagnosis of acute mesenteric ischemia (AMI) is essential for a favorable outcome. Selection of patients requiring a dedicated multiphasic computed tomography (CT) scan remains a clinical challenge.

Methods: In this cross-sectional diagnostic study conducted from 2016 to 2018, we compared the presentation of AMI patients admitted to an intestinal stroke center to patients with acute abdominal pain of another origin admitted to the emergency room (controls).

View Article and Find Full Text PDF
Article Synopsis
  • - The study investigates the risk factors and incidence of prolonged mechanical ventilation (PMV) after lung transplantation (LT) in patients at Bichat Claude Bernard Hospital from 2016 to 2020, finding that 28% required PMV for an average of 34 days.
  • - Significant independent risk factors for PMV include higher body mass index (BMI), diabetes in the recipient, ECMO support during surgery, and receiving more than 5 red blood cell transfusions.
  • - One-year survival rates show a concerning increase in mortality for patients on PMV (44%) compared to those without it (15%), highlighting the need to consider preoperative risk factors like BMI and diabetes in recipient selection.
View Article and Find Full Text PDF
Article Synopsis
  • Objective structured clinical examinations (OSCE) help assess medical students' skills, and this study evaluated third-year students' roles as standardized patients in these exams.
  • In a pilot session, their OSCE scores were compared with third-year students who did not participate, revealing that those involved had significantly better scores (17 vs. 14.5 out of 20).
  • Most participating students felt that being standardized patients reduced their stress, enhanced their preparedness, and improved their communication skills, indicating the potential for broader implementation of this approach in medical education.
View Article and Find Full Text PDF

spp. are associated with respiratory infections in immunocompromised hosts. A link with bronchial complications after lung transplantation (LTx) has been suggested.

View Article and Find Full Text PDF

Pulmonary hypertension (PH) is associated with pulmonary vasoconstriction and endothelial dysfunction leading to impaired nitric oxide (NO) and prostacyclin (PGI) pathways. Metformin, the first line treatment for type 2 diabetes and AMP-activated protein kinase (AMPK) activator, has been recently highlighted as a potential PH treatment. AMPK activation has been reported to improve endothelial function by enhancing endothelial NO synthase (eNOS) activity and to have relaxant effects in blood vessels.

View Article and Find Full Text PDF

SARS-CoV-2 infection goes beyond acute pneumonia, as it also impacts lipid metabolism. Decreased HDL-C and LDL-C levels have been reported in patients with COVID-19. The lipid profile is a less robust biochemical marker than apolipoproteins, components of lipoproteins.

View Article and Find Full Text PDF
Article Synopsis
  • The study examined the presence and effects of culture-positive preservation fluid (PF) in lung transplant patients from 2015 to 2020, finding that 30.6% had PF that tested positive for microorganisms.
  • Common bacteria like Staphylococcus aureus and Escherichia coli were identified, and a significant portion of culture-positive samples were polymicrobial.
  • Patients with culture-positive PF experienced lower 30-day survival rates (85.5%) compared to those with culture-negative PF (94.7%), prompting the need for further research to understand the implications and management of culture-positive PF.
View Article and Find Full Text PDF

Efforts to understand the molecular mechanisms of COVID-19 have led to the identification of ACE2 as the main receptor for the SARS-CoV-2 spike protein on cell surfaces. However, there are still important questions about the role of other proteins in disease progression. To address these questions, we modelled the plasma proteome of 384 COVID-19 patients using protein level measurements taken at three different times and incorporating comprehensive clinical evaluation data collected 28 d after hospitalisation.

View Article and Find Full Text PDF

Background: The outcomes of lung transplantation (LT) recipients who received a graft from a brain-dead donor after successful resuscitation from cardiac arrest (CA donors) have been poorly described. This study compared the one-year survival of LT recipients depending on the CA status of the donor.

Methods: This prospective observational single-centre study analysed all consecutive patients who underwent LT at Bichat Claude Bernard Hospital, Paris, between January 2016 and December 2020.

View Article and Find Full Text PDF

High-density lipoproteins (HDLs), whose main role is the reverse transport of cholesterol, also have pleiotropic anti-inflammatory, antioxidant, anti-apoptotic and anti-infectious properties. During sepsis, HDL cholesterol (HDL-C) concentration is low, HDL particle functionality is altered, and these modifications are correlated with poor outcomes. Based on the protective effects of HDL, we hypothesized that HDL-C levels could be associated with lung transplantation (LT) outcome.

View Article and Find Full Text PDF

Background: Airway complications are frequent after lung transplantation (LT), as they affect up to 23% of recipients. The implication of perioperative extracorporeal membrane oxygenation (ECMO) support and haemodynamic instability has never been specifically assessed. The first aim of this study was to explore the impact of perioperative ECMO support on bronchial anastomotic dehiscence (BAD) at Day 90 after LT.

View Article and Find Full Text PDF

Background: Objective structured clinical examinations (OSCEs) are known to be a fair evaluation method. These recent years, the use of online OSCEs (eOSCEs) has spread. This study aimed to compare remote versus live evaluation and assess the factors associated with score variability during eOSCEs.

View Article and Find Full Text PDF

We aimed to describe the prevalence, risk factors, morbidity and mortality associated with the occurrence of bacteraemia during the postoperative ICU stay after lung transplantation (LT). We conducted a retrospective single-centre study that included all consecutive patients who underwent LT between January 2015 and October 2021. We analysed all the blood cultures drawn during the postoperative ICU stay, as well as samples from suspected infectious sources in case of bacteraemia.

View Article and Find Full Text PDF

We evaluated the contribution of artificial intelligence in predicting the risk of acute cellular rejection (ACR) using early plasma levels of soluble CD31 (sCD31) in combination with recipient haematosis, which was measured by the ratio of arterial oxygen partial pressure to fractional oxygen inspired (PaO/FiO) and respiratory SOFA (Sequential Organ Failure Assessment) within 3 days of lung transplantation (LTx). CD31 is expressed on endothelial cells, leukocytes and platelets and acts as a "peace-maker" at the blood/vessel interface. Upon nonspecific activation, CD31 can be cleaved, released, and detected in the plasma (sCD31).

View Article and Find Full Text PDF

Background: During the COVID-19 first wave in France, the capacity of intensive care unit (ICU) beds almost doubled, mainly because of the opening of temporary ICUs with staff and equipment from anaesthesia.

Objectives: We aim to investigate if the initial management in temporary ICU is associated with a change in ICU mortality and short-term prognosis.

Design: Retrospective single-centre cohort study.

View Article and Find Full Text PDF
Article Synopsis
  • The study explores how recipient B cells produce donor-specific antibodies after organ transplantation, traditionally thought to require help from the recipient's own CD4 T cells.
  • Researchers found that even without these T cells, recipient mice after heart transplantation produced antibodies against donor MHC I molecules due to help from donor CD4 T cells present in the graft.
  • Similar mechanisms were observed in human kidney and lung transplants, suggesting that a new form of T cell interaction may explain early antibody responses and potentially worse transplant outcomes.
View Article and Find Full Text PDF

Introduction: The maximum gain in quality of life after lung transplantation (LT) is expected between six months and one year after LT, as the occurrence of chronic lung allograft dysfunction may mask the beneficial effects beyond one year. Thus, the postoperative period could be the cornerstone of graft success. We sought to describe the factors present before postoperative admission to the ICU and associated with favorable, arduous or fatal pathway within 90 days of LT.

View Article and Find Full Text PDF