The 4th JEPE (journees d’echanges avec les pays de l’est) one model of pneumological exchange of two medicine schools

On 10–12 May 2019, the 4th JEPE conference with the APGS (Association Pneumologique de Grande Sud) and APPEN (Association des Pneumologues de Pays de L’Est du Nord Pas de Calais) was organized. At the same time, it was the first Franco-Italian meeting of the APGS association which took place during the 4th JEPE in Stresa, Italy. The theme of the congress was “The management of Chronic Respiratory Diseases (Asthma, COPD, SAOS) in France and Italy” with the contribution of “Association Asthme et Allergies, OSPL, Apnee de Sommeil.” This support was done in France as well as in Italy based on scientific data, recommendations of practices, and health and social organizations. Many practical recommendations were realized, and diagnostic and therapeutic management in structures and at home were compared to demonstrate the significant difference between France and Italy. At the same time, the meeting was a unique opportunity to put these different points into perspective to improve the practices in both the countries.

First day was marked by the opening ceremony with short speech of Dr Bruno Stach, president of APPEN; Dr Herve Pegliasco, president APGS; and also of Professor Stefano Nava from the Italian part. After we assist at a critical analysis of the “Impact in health in the picture (example of impressionists)” made by Marc Stemmagna and Herve Pegliasco proving once again that lung physicians have also other hobbies not only the science one.

The second day was organized surrounding of three major diseases: chronic obstructive pulmonary disease (COPD), asthma, and interstitial lung diseases. We had the opportunity to see how it looks the dynamic of epidemiological evidence of asthma and COPD (Chantal RAHERISSON–SEMJEN– Bordeaux) and what are the recommendations on COPD in France and Italy (Nicolas ROCHE–Paris President of SPLF). Both presentations demonstrate that the prevalence of COPD is increasing but the other disease like asthma remains stable as prevalence. On the other part, in all the countries, it is an excess of topic corticoids and the way of step down is quite long with resistant from the part of the patients and current practitioner.

For non-invasive ventilation (NIV), we had here the two recognized “Manitou” on ventilation, Professor Nicolino Ambrosino and Professor Stefano Nava. First presentation was a pleading for the physiological benefits of NIV in COPD patients and also a detailed intromission in the quality of life of this sample of patients. Another important subject as prevalence, among burning diseases, focused on the meeting, was idiopathic pneumonitis fibrosis (IPF). Michaela ROMAGNOLI (Treviso), living and working in both the countries, demonstrates the benefits and the limits of crio-biopsy in comparison with the surgical biopsy and the progress in the therapeutically algorithm for this disease. Professor Stefano Nava (Bologna) had a bird eye view on the epidemiological evidences concerning NIV and after Bruno HOUSSET (Creteil) had a very attractive speech on COPD and artificial intelligence showing how important it will become in the future the functional capacity of patients checking and the screening and monitoring patients at home. Another interesting presentation was about “Homecare organization on Italy” (Erico CLINI – Modena). Here, the benefits of self-management, video presentation, and rehabilitation at home with important advantages on cost– benefits reports were seen. Finally, we had, in the same area of expertise, an exposure of Dr Bruno Stach (Valenciennes) on “The place of novel technologies for the patients with CPAP and NIV at home.” The importance of telemedicine and the responsibilities of the specialist who is treating the patient and of the company assisting this patient was emphasized.

The second day was the moment of workshops and here all important east countries brought their own contribution. The Romanian team spoke about obstructive sleep apnea (OSA), obesity hipoventilation syndrome (OHS), and central sleep apnea (Florin Mihaltan, Marius Balint) and the polish experts about lung cancer in women (Joanna Domagala Kulawiki and Monica Swierczynska Krepa) and lung post-transplant homecare of patients (Monika Szaj and Piotr Gutowski).

This first meeting with experts from two important countries, France and Italy, demonstrates once again the importance and the advantages of confronting the epidemiological, clinical, and surveillance data for changing the health politics in the future. For the invited guests coming from Poland, Romania, and Czech Republic, it was another occasion to see how the pneumological networking is progressing. It was practical with many lessons again for all, experts and participants.