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Background: Anastomotic complications are common after lung transplantation (1.4–33% of cases) and still associated with a high morbi-mortality. Methods: The current study is a monocenter retrospective analysis of symptomatic anastomotic complications (SAC) occurring after lung transplantation between 2010 and 2016, using the macroscopic, diameter, and suture (M-D-S) classification from consensus of French experts in bronchoscopy. The objectives were to determine incidence from surgery, risk factors, and impact of survival of SAC. We defined SAC as M-D-S abnormalities (stenosis ⩾ 50% or dehiscence) requiring bronchoscopic or surgical interventions. Results: A total of 121 patients were included. SAC occurred in 26.5% of patients ( n = 32), divided in symptomatic stenosis for 23.7% ( n = 29), and symptomatic dehiscence in 2.5% ( n = 3). In multivariate analysis, donor bacterial lung infection [HR 2.08 (1.04–4.17), p = 0.04] and age above 50 years [HR 3.26 (1.04–10.26), p = 0.04] were associated with SAC occurrence. Cystic fibrosis etiology was associated with better survival on Kaplan–Meier curve ( p < 0.001). SAC [HR 2.15 (1.07–4.32), p = 0.03] was independently associated with worst survival. The 29 symptomatic patients because of stenosis required endoscopic procedure, of whom 16 patients needed bronchial stent placement. Four patients underwent surgery: three patients because of dehiscence and one because of severe bilateral stenosis (re-transplantation). Discussion: SAC occurred in 26.5% of patients. Donor lung infection was the only alterable identified factors. The increase rate of SAC in older patients above 50 years of age encourages in regular endoscopic monitoring.

Patients with interstitial lung disease have been considered at high risk of complications of COVID-19 because of their underlying lung disease and use of immunosuppressive agents.1 However, data on COVID-19 in patients with sarcoidosis are scarce.2–4 Several reasons for an increased risk of severe forms of COVID-19 among sarcoidosis patients have been hypothesised: the involvement of the lung in almost 90% of patients with COVID-19, some of whom have reduced pulmonary function and comorbidities such as diabetes or hypertension, which are largely associated with the use of glucocorticosteroids for treating sarcoidosis; and the use of immunosuppressive agents in a subset of these patients.5 Recently, Gyorfi et al6 described the case of a patient with sarcoidosis who experienced a symptomatic SARS-CoV-2 infection with spontaneous clinical improvement, and a virological relapse after steroids treatment. This case illustrated the fact that immunosuppression with glucocorticoids may induce relapse of COVID-19 in patients with sarcoidosis. However, we lack data on the outcomes of patients with sarcoidosis affected by COVID-19. We retrospectively collected data for all patients with sarcoidosis and SARS-CoV-2 infection seen among 15 French centres between 1 March and 20 May 2020. The inclusion criteria were a sarcoidosis diagnosis based on the American Thoracic Society/European Respiratory Society/World Association for Sarcoidosis and other granulomatous diseases criteria7 and SARS-CoV-2 infection based on at least one of the following: nasopharyngeal or tracheal swab reverse transcription (RT)-PCR positive for SARS-CoV-2; SARS-CoV-2-positive serology; or typical clinical and radiological findings.

This paper describes an experimental measurement setup for the characterization of single-reed mouthpiece interaction under quasi-static conditions. Measurement leads to the estimation of the nonlinear characteristics, establishing the relation between pressure drop across the reed channel and the jet cross-section. Measurements with various lip forces show that the resultant nonlinear characteristics can be described by a single nonlinear characteristic linking the generalized pressure and the jet cross-section. This generalized pressure is the sum of the pressure drop and the lip pressure, defined as the lip force divided by an equivalent lip surface determined for each reed. The nonlinear characteristic is then modeled as a function depending on three parameters: the opening at rest, the linear stiffness for low pressures, and the “elbow pressure,” which allows to make the link between the two affine parts of the function. The characterization of 24 tenor saxophone reeds shows that the model fits the experimental characteristics with an inaccuracy that can be considered as a supplementary parameter for the reed. Finally, the reeds can be characterized with with only five parameters, the inaccuracy, the lip equivalent surface and the three parameters of the nonlinear model. First results suggest that equivalent lip surface and inaccuracy depends on the reed type while reed opening at rest and linear stiffness depends on the reed.

To investigate the relation between human immunodeficiency virus (HIV) antigenemia and clinical manifestations of HIV infections, we studied 96 patients with hemophilia who were positive for HIV antibody, for a median of 34 months. Every 4 to 10 months a clinical and laboratory examination was performed and serum samples were tested for three HIV markers: HIV antigen, antibody to p24, and antibody to gp41. Twenty-two subjects (23 percent) were found to be positive for HIV antigen: 8 were positive upon entry and remained so (Group 1), and 14 became positive during the study, 4 to 26 months after HIV antibody appeared (seroconversion), 13 of whom remained positive for HIV antigen (Group 2). Most subjects positive for HIV antigen had low or undetectable titers of antibody to p24, whereas the antibody titer to gp41 remained high. In Group 2, patients with low p24 antibody titers had further decreases in their titers before or at the time HIV antigen appeared. Once present, HIV antigen persisted and tended to increase in concentration. In contrast to Group 3 (negative for HIV antigen, low anti-p24 titer) and 4 (negative for HIV antigen, high anti-p24 titer), the groups positive for HIV antigen had significantly higher incidences of acquired immunodeficiency syndrome (P = 0.05), immunodeficiency-related infections (P<0.001), and immune thrombocytopenia (P = 0.001), and had more severe disease as measured by the Walter Reed staging system (P<0.001). In this study, HIV antigen appeared to be a better predictive marker of HIVrelated complications than the absolute T4+ count. These results suggest that HIV antigenemia indicates a poor clinical prognosis. (N Engl J Med 1987; 317:1114–21.) PERSONS with hemophilia constitute one of the populations that have a high prevalence of serologic markers of human immunodeficiency virus (HIV). A recent national study in France showed that 50 percent of patients with hemophilia A or B were positive for antibodies to HIV. 1 The primary infection syndrome described in homosexual men is seldom seen in hemophilia, 2 and most infected patients with hemophilia remain asymptomatic or acquire only persistent generalized lymphadenopathy over a period of two to three years. 3 4 5 The acquired immunodeficiency syndrome (AIDS) does develop in some, however; in a group of 51 Americans with hemophilia followed for three . . .