Biomedical subjects
Publications and source records attributed to A Minette.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
One of the authors observed an excess of dyspnea complaints in coalminers without bronchitis, massive fibrosis or emphysema in different epidemiological surveys. An abnormally high prevalence of dyspnea complaints in coalminers has also been reported by other investigators in different countries. It seems therefore necessary to study whether the type of complaints observed in our country can be validated by appropriate functional investigations. A research on this problem is in progress in our laboratory. In this preliminary publication a review of the literature concerning the mechanisms of dyspnea is presented. Such a study was necessary in order to make an adequate choice of the functional measurements usable for our validation study.
Explore the source record for details and available documents.
The changes in FEV1 and in specific conductance induced by 200 micrograms oxitropium bromide given as pressurized aerosol were measured at 8 time intervals during 7 hours after inhalation in a group of 19 patients with reversible broncho-obstruction. The working of the drug was compared to the functional values observed at the same time intervals after placebo, 40 micrograms ipratropium bromide and 400 micrograms fenoterol. Both oxitropium and ipratropium were definitely and significantly superior to placebo at all time intervals. Oxitropium was superior to ipratropium at the 7th hour. At this time interval the difference was significant At the 7th hour oxitropium gave higher mean results than fenoterol, but this difference was not significant. The drug was also compared to its competitors regarding its subjective and cardiovascular tolerance. No unfavourable side-effects were observed.
We compared the effects of almitrine and doxapram on the arterial blood gases and ventilation of patients with chronic respiratory insufficiency and chronic hypercapnia and hypoxemia. Sixteen long-term in-patients were randomly allocated to one of the following treatment groups: the first group (8 patients) received IV almitrine 0.5 mg/kg and the second group (8 patients) IV doxapram 1 mg/kg by IV perfusion during 30 min. All gave their informed consent. Arterial blood gases and ventilation were measured 10 min and 5 min before treatment, at the 5th, 15th and 25th min of perfusion time, and 5, 10 and 15 min after infusion. There was a marked increase in paO2 in almitrine-treated patients, which was maximum at the 25th min of infusion (+ 14.6 mm Hg, p < 0.001), but only a slight improvement was observed in the doxapram group (+ 3.3 mm Hg, p < 0.05). After almitrine the maximum mean paCO2 decrease was at the 10th min after perfusion (-6.9 mm Hg, p < 0.001); after doxapram the maximum decrease, although highly significant, was much less (-2.8 mm Hg, p < 0.01). Thus, at the presently used and well-tolerated doses, almitrine is much more efficient than doxapram in improving gas exchange in patients with chronic hypoxemia and hypercapnia. However, complementary studies using higher dosage of doxapram are warranted.
Two epidemiological surveys were made by the same research team on the prevalence and the aetiological factors of chronic bronchitis symptoms in coalminers. The first study was made in a coalminers' community of Belgian Limburg, the other one in a representative sample of coalminers regularly at work. In both surveys an excess of dyspnea complaints was observed in comparison to the prevalence of this symptom in controls. These dyspnea complaints often presented themselves as isolated symptoms, without chronic cough or phlegm production. Dyspnea in excess could not be explained by massive fibrosis. The prevalence of the symptom was not linked, neither to the spirometric values, nor to the results of respiratory challenge tests with acetylcholine, tobacco use, or the length of exposure at the coalface. When dyspnea was associated with cough and phlegm production there was on the contrary a statistically significant relation with the spirometric values and the effect of acetylcholine. It seems therefore reasonable to explain at least partially the isolated dyspnea complaints in coalminers by specific mechanisms not related to bronchitis but resulting from the pathological lesions characteristic of simple pneumoconiosis. Complaints of cough and phlegm production appear as a rule later in the coalminer's life. In the groups taken into consideration in the study they were linked with cigarette smoking which appeared as the predominant aetiological factor for these complaints; in a subgroup a synergic action of coaldust, tobacco use and air pollution could be discussed in this respect. Notwithstanding the pathogenic independence of some dyspnea complaints versus cough and expectoration, it is quite clear that when productive bronchitis develops and causes broncho-obstruction, it may aggravate pre-existing dyspneic patterns.
The results observed with talampicilline in our clinical study confirmed the observations made by others regarding the activity and the improved tolerance for this drug versus ampicilline. The use of a high daily dosage of 3 g per day was neither a cause of more frequent nor more severe side-effects than the usually smaller posology used in other studies published in the literature.
RG 033 is a compound consisting of betametasone in resinic microcapsules which allow a slow and continuous dialysis of the active drug through the membrane in the digestive tract. The drug was studied with regard to its effects on the distribution of alveolar air and its gastric tolerance. In a preliminary study the drug release from the capsules in the pH-conditions of the digestive tract was studied by means of a physico-chemical model. Two groups of 15 patients with broncho-obstruction reversed by salbutamol, a potent beta 2-sympathomimetic, were included in the trial. One group received 1 mg and the other 2 mg of the drug. An alternate scheme was used for the treatments. The functional methods used to assess the ventilatory results were chosen according to the conclusions of a previous comprehensive study by one of the authors [7] [8]. The ventilatory results of both dosages were quite similar. This observation suggests that a maximum effect on alveolar air distribution was obtained with 1 mg. No unfavourable side-effect on the gastric mucosa was observed.
The usefulness of mucolytics for clinical purposes remains controversial. Although many authors agree with the opinion that some of these drugs, above all aerosols of acetylcysteine at convenient dosages, provided they are associated with beta 2-sympathomimetics, may be useful in the treatment of bronchial obstruction due to inspissated mucus in excess in the lumens, many specialists remain reluctant concerning the activity of mucolytics given by mouth. It seemed therefore interesting to organize an international meeting on this topic. First of all, I would like to pay honour to the initiative of the Zambon Laboratories who organized this symposium. I would also like to express my gratitude for having been involved in the preparation of the programme of these days and having been asked to present the general conclusions of the meeting. The following pages are devoted to these conclusions. We shall repeatedly make reference to the works which were presented in extenso during the meeting. The general report of the symposium will shortly appear in a special supplement of the European Journal of Respiratory Diseases. It seems however useful to give at the end of our text the complete list of the presented lectures.
Explore the source record for details and available documents.
The results are in agreement with the hypothesis that 900 mg oral bamifylline, as a unique dose, should produce slight and temporarily bronchodilating effects. This phenomen may be discussed from the 30th minute after intake. It was significant after 2 hours and remained significant till the 4th hour. It is interesting to stress that this conclusion is in agreement with some isolated observations we could make before in our laboratory by means of injections or suppositories with the same product [9]. We did not observe facts suggesting a possible cumulative effect of the drug, when taken at a dosage of 3 times 900 mg regularly spread over the day. The drug seems to be perfectly tolerated. A 10 days' treatment with the above mentioned posology did not produce neither haematological, haepatic, renal, nor vascular side-effects which could be identified by the techniques classically used in these respective fields.
By bringing the aerosols in a spirometrical bell from which a constant volume aerosol was thereafter inhaled by each subject through a bi-directional valve, we observed more consistent and reproducible ventilatory results than by giving the aerosols by means of a classical device via a face mask. Moreover the results were significantly higher with the first technique; this fact suggests that the quantity of inhaled broncho-active drug with suitable granulometry would have been on the average greater per minute with the first method.
Explore the source record for details and available documents.
Epidemiological surveys of coal workers' pneumoconiosis are only possible by means of periodic X-ray examinations, repeated with a reasonable frequency in order to allow an identification of the first X-ray anomalies of simple pneumoconiosis in exposed workmen. Incidence studies to detect simple pneumoconiosis at its first stages and its progressive increase in cohorts of coal-miners whose dust exposure is known are indeed theoretically the best way to approach these problems. For many reasons, discussed in this paper, such incidence studies are nowadays impossible in Belgium. The survey technique used in our country is based on repeated transversal surveys. Its results are illustrated and commented.
The prevalence of virus warts of the hands among butchers has been determined in three industrial butcheries by examining 536 meat-workers at their places of work. A prevalance of 23-8% has been found, which is significantly higher than the 8-5% prevalance found in 965 control adult subjects examined in different firms where manipulation of food does not occur. Further, the prevalence of virus warts of the hands has been found significantly higher in the 199 workers of one butchery (32-1%) than in 199 control subjects (10-1%) strictly matched for age and sex, and belonging to the same industrial area. In butchers, warts of the dorsal aspects of the hands are statistically less frequent than in control subjects when three localizations are considered (dorsal, palmar, dorsal plus palmar). No significant difference is observed when single localizations (dorsal or palmar) are considered. A definite explanation of the high prevalence of virus warts of the hands among butchers has not been found so far; some hypotheses are discussed in the light of the presnt study.
In a first chapter the author reviews the mechanisms of action of corticoids in respiratory diseases. Moreover the causes and the prevalence of unwanted side-effects are discussed. The advantages of synthetic glucocorticoids with short half-life time in pneumology are stressed. In the following chapters, the rationale of long-term corticoid treatments of asthma, in non allergic obstructive chronic lung diseases, in sarcoidosis and in the thoracic localisations of some collagen diseases is presented in detail. Regarding the treatment of asthma the author discusses the advantages of the alternate-day therapy, the use of corticoids in aerosols and the ratioale of ACTH. The usefulness of alternate-day therapy in sarcoidosis is also advocated.
Respiratory symptoms and personal history of allergy were examined in 1659 children, including the entire elementary school population of four villages of the Belgian Ardennes. Levels of atmospheric pollution were monitored during the survey and proved to be very low. It is suggested that socio-economic factors produce a small increase in respiratory symptoms, particularly in cough symptoms. A personal history of eczema and of hay fever was highly associated with dyspnea and wheezing.