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Biomedical subjects

D Charpin

Publications and source records attributed to D Charpin.

At least 163 records · Page 9Linked to original sources
PubMed1987

[Pulmonary localization of Kaposi's sarcoma].

The authors describe a case of a 61 year old man suffering from Kaposi's sarcoma with pulmonary involvement associated with a hairy cell leukaemia. The numerous associations with Kaposi's sarcoma are reviewed and the circumstances of the unexpected appearance of this disease, placing it in the group of opportunistic diseases. The prognosis is totally different according to whether it is an isolated Kaposi's sarcoma without visceral localisation or to a form with polyvisceral involvement and associated with another neoplasm or immunodepression.

Humans↗
PubMed1986

[A national survey: the respiratory specialist and allergology].

In June 1984 we wrote to all 1,594 Registered French Respiratory Specialists in the medical directory, with a questionnaire to determine their diagnostic and therapeutic activity in the field of allergy. In September 1984 a second letter with the same questionnaire was sent to these Physicians who had not replied to the first. Finally in October 1984 a random sample of 21 Physicians who had not replied to the two letters were contacted by telephone. Among the 1,594 letters initially, 232 were to people not involved in the field of inquiry (Deceased doctors, those retired or not thoracic Physicians) or had not reached the address. After excluding this group, the level of response was established at 74% for the first delivery and 33% for second or 84% overall. Among 1,114 respondents overall, 79% admitted to activity in allergy varying from 55% in the Paris Region to a maximum of 92% in the South-East. The differences were less pronounced when the age of the physicians was allowed for. The most used diagnostic means are skin tests (90%), total IgE (68.6%) and specific IgE (57%) far ahead of non-specific bronchial provocation tests (20%) and specific tests (14.6%). Two hundred and sixty thoracic Physicians had no activity in the field of allergy.

Adult↗
PubMed1986

Bilateral pleural plaques in Corsica: a non-occupational asbestos exposure marker.

The North-East quarter of Corsica being rich in asbestos deposits, we checked the chest radiographs of 1721 patients born in North Corsica, without occupational exposure to asbestos, in order to show an excess of asbestos pleural plaques in those born in the N.E. quarter. Of the 56/1710 patients with bilateral plaques, 53 were born in N.E., and three in N.W. The incidence of plaques was thus respectively 3.7% and 1.2% (p less than 0.05). The site of birth of these 56 patients was compared to that of 213 matched control patients without plaques, born in North Corsica. The percentage of patients with plaques born in villages with asbestos deposits was 94.6 per cent, versus 58.2 per cent for the control patients; the relative risk index is 12.7. This work is the first report of environmental asbestos plaques in Western Europe.

Aged↗
PubMed1985

[Epidemiological approach to the relationship between bronchiectasis and sterility].

In recent years associations have been reported between male infertility and chronic pulmonary infections. These disorders include immotile-cilia syndrome, cystic fibrosis and Young's syndrome. For each disorder, case reports or small groups of patients have been described. However, it remains to be determined if these congenital disorders play a significant role in primary bronchiectasis (P.B). To do this, we compared the fertility rate of 35 patients (24 males, 11 females) with clinical and radiological evidence of P.B. and of 71 patients (54 males, 17 females) with secondary bronchiectasis (S.B) due to a defined chest disease (mainly tuberculosis and chronic bronchitis with emphysema). We abstracted the clinical records of this group of 106 patients, hospitalized between 1966 and 1983 for: age at the time of hospitalization, sex, diagnosis (P.B. vs. S.B.), association with sinusitis and situs inversus, socio-economic status, ethnic group, marital status and fertility (graded as 0 or 1+). The crude association between P.B. and infertility is strong (p greater than 0.10). However age may represent a confounding factor as patients with P.B. are younger (p less than 0.01) than patients with S.B., and more often single (p less than 0.01). Initially we restricted the analysis to married patients of both groups, and still got a significant association. Then we compared mean age in childless married people of both groups and observed a non-significant difference. Moreover, when we compared fertility in older patients, for example in people over 30 years old, the association still persists (p less than 0.03). In conclusion, the congenital disorders associating bronchiectasia and infertility must be looked for in the check up of P.B., all the more so as some can be cured of their infertility.

Adult↗
PubMed1983

Deep-inspiration induced bronchoconstriction: a mechanism for beclomethasone aerosol intolerance.

We studied 17 asthmatic patients complaining of coughing attacks, with or without asthma, when inhaling beclomethasone dipropionate aerosol (Becotide). Specific airway resistance (SRaw) was measured immediately after a maximal inspiration (MI) and after Becotide inhalation. The effect of a second inhalation of Becotide was measured 10 min after inhalation of salbutamol. MI and Becotide induced large, but transient, SRaw increases in all patients; in addition, the latter induced coughing reactions. After salbutamol pretreatment, Becotide inhalation did not increase SRaw but coughing usually persisted. In 6 patients only, the increase in SRaw after Becotide was larger than that observed after MI. In those patients, placebo and Aldecine (similar to Becotide except for the metering valve) aerosols induced SRaw increases similar to that observed after Becotide. These data suggest that Becotide-induced bronchoconstriction is mainly related to the deep breath required for the inhalation. Non-specific irritation of the airways was probably responsible for the additional bronchoconstriction noticed in some patients.

Aerosols↗
PubMed1981

[Host factors in asbestos-associated disease. A study in twins (author's transl)].

Observations in two pairs of identical twins illustrate the importance of genetic factors in determining the outcome of exposure to asbestos in relation to pleural plaques and bronchogenic carcinoma. The first pair of twins, laggers with french railroad (S.N.C.F.), were discovered fortuitously, after only several years exposure, to have bilateral pleural plaques and calcification at the same site on the axillary and diaphragmatic surfaces. The second set of twins developed epidermoïd bronchial carcinoma : one at the right hilum, the other postero-basally on the right in 1969 and 1977 respectively. Both were in ship-building and each had been exposed to asbestos in the same yard for 20 years between 1945 and 1965. Radiographs showed left sided pleural calcification and reticular shadowing at the bases in the two cases. These observations show the role of the host in the generation of asbestos disease. They are in keeping with studies on the presence of certain tissue types (HLA B27, and HLA B8) in those with asbestosis and of non-specific auto-antibodies (anti-nuclear factor, rheumatoid factor) in asbestosis, silicosis and the idiopathic pulmonary fibrosis. The relation between genetic factors and asbestos-induced cancer is suggested by the variable susceptibility of different kinds of animals to carcinogenesis in response to asbestos and by the increased inductibility of the enzyme system Aryl-hydrocarbon-hydroxylase in subjects exposed to this air-born contaminant who develop pleural tumours and/or bronchitis. There are only two other publications of bronchial carcinoma in twins in the literature.

Adult↗
PubMed1979

Bronchodilator effects of antiasthmatic cigarette smoke (Datura stramonium).

In 12 asthmatic patients with mild airway obstruction we have measured the effect on specific airway resistance (sRaw) of inhaling the smoke of one Datura stramonium cigarette. In 11 patients sRaw decreased substantially after the cigarette, the mean maximal decrease being 40% at the 30th minute. In seven patients the subsequent inhalation of 200 micrograms salbutamol caused no further decrease in sRaw. In the remaining four patients salbutamol induced a larger decrease in sRaw than the cigarette smoke. The inhalation, however, of a synthetic anticholinergic agent (SCH 1000, 600 micrograms) proved as effective as salbutamol in these patients. In one patient the cigarette smoke and SCH 1000 produced only a negligible amount of bronchodilatation whereas the bronchial obstruction was reversible with salbutamol. Minor side effects were observed in six patients after the cigarette.

Adult↗
PubMed1978

Long term follow-up of aneurysmectomy for recurrent ventricular tachycardia or fibrillation.

The success of aneurysmectomy in abolishing recurrent ventricular tachycardia or ventricular fibrillation has not been clearly defined. Ten patients who underwent aneurysm resection to control ventricular arrhythmias were studied before and an average of 19 (4 to 42) months following operation. All patients had moderate to large aneurysms and four had asynergy in adjacent segments. Of four patients with significant stenosis in vessels not supplying the aneurysm, three had aortocoronary bypass grafts in addition to their resection. Ambulatory Holter monitoring and a graded exercise test were performed in all patients postoperatively. There was no operative mortality. Two patients who did not have associated revascularization procedures died suddenly 1.5 and 7 months postoperatively. Of the eight survivors, despite clinical improvement, the Holter ECG revealed runs of ventricular tachycardia in three patients and frequent multifocal ventricular extrasystoles in the other five patients. No correlation was found between recurrence of the ventricular arrhythmias and aneurysm size, contraction pattern of other myocardial segments, extent of coronary disease, or the presence of congestive heart failure. In conclusion, aneurysmectomy does not abolish ventricular tachyarrhythmias and probably should be reserved for patients who remain symptomatic despite an adequate medical trial. The persistence of complex arrhythmias following operation warrants a close follow-up in these patients.

Adult↗
PubMed1978

[Mitral prolapse syndrome. Simple diagnosis of forms with severe arrhythmia].

The mitral valve prolapse syndrome encompasses a wide clinical spectrum with a majority of patients presenting with a benign course while a few present with severe arrhythmias. Nineteen patients with a systolic click and angiographic mitral valve prolapse were studied to determine which of several simple tests identified the subgroup with severe ventricular arrhythmias. The incidence and type of ventricular arrhythmias, documented by a 24 hour recording (Holter), were correlated with: 1) cardiac size assessed by the cardiothoracic ratio; 2) echocardiographic indices: end-diastolic septal and posterior wall thickness and left ventricular end-diastolic dimension; 3) a ten minute rhythm strip (mini-Holter). Only patients with ventricular hypertrophy (5 patients) or dilatation (7 patients) had frequent and severe arrhythmias. In these two subgroups, the cardiothoracic ratio was larger than in patients with a normal echocardiogram (7 patients). The ten minute rhythm strip was abnormal in all those patients with severe ventricular arrhythmias (ventricular tachycardia). Thus, in patients with mitral valve prolapse, the presence of an abnormal cardiothoracic ratio, echocardiogram and ten minute rhythm strip identifies patients with potentially severe ventricular arrhythmias. The mechanism of these arrhythmias is still poorly understood; however, a certain number of them may be related to a dysfunction of the autonomic nervous system.

Adult↗
PubMedDate not supplied

Respiratory symptoms and air pollution changes in children: the Gardanne Coal-Basin Study.

The influence of daily changes in sulfur dioxide (SO2) levels on the induction of respiratory symptoms was studied during the 1983-1984 winter in 450 children, aged 9 to 11 yr, living in the Gardanne coal-basin, France. In this area, SO2 originates mainly from a coal-fueled power plant. The mean SO2 level during the winter was 22 micrograms/m3 in low-pollution areas and 93 micrograms/m3 in polluted areas, with daily SO2 levels up to 356 micrograms/m3. Children completed a daily diary about respiratory symptoms. In the polluted communities only we demonstrated a significant association between daily SO2 levels (after controlling for temperature and respirable particle variations) and prevalence of upper and lower respiratory symptoms. However, in each polluted town, and for each respiratory symptom, there was no evidence for either a latency period or a delay in the effects of pollutants. Mean daily temperature was also closely correlated with upper and lower respiratory symptoms in most of the polluted and some low-pollution communities. In a second step, the prevalence of respiratory symptoms in each town was compared, during two 2-wk periods, with air pollution levels; higher prevalences were found during the pollution period. In conclusion, moderate daily changes in SO2 levels induce a significant but transient increase in the prevalence of respiratory symptoms in children.

Air Pollutants↗
PubMedDate not supplied

Visits to the emergency room for asthma attacks and short-term variations in air pollution. A case-crossover study.

BACKGROUND: The 'case-crossover' design is a strategy fitted to studying transient effects of intermittent exposure on acute-onset disease occurring shortly after exposure. It has the important advantage of eliminating most confounding variables, allowing a stronger causality inference. OBJECTIVES: The objective of the study was to evaluate the relationships between emergency room (ER) visits for asthma attacks and gaseous air pollution changes. METHODS: The study included 549 individuals, 3-49 years old, visiting the ER during 1 year. Exposure to gaseous air pollutants (SO2, NO2, O3) on the same day and up to 4 days before was computed according to the patient's address. The statistical analysis included meteorological data as potential confounding variables. RESULTS: No association could be shown between ER visits and SO2 or NO2 levels. In contrast, there was a statistically significant association between ER visits and mean O3 levels, on the day of admission and also on D -2 and D -3. For an increase of 10 microg/m3, the risk of requiring an ER admission increased by 6-10%. CONCLUSIONS: Using this new strategy, we confirmed that ozone changes lead to a moderate increase in risk of requiring an ER admission in asthmatic subjects.

Adolescent↗