[New inventory of moulds of the atmosphere of Paris. Comparison of the results on Petri boxes and on slides in 1966 and 1967].
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Biomedical subjects
Publications and source records attributed to J Charpin.
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In this study, we evaluated the prevalence of systemic reactions to hymenoptera stings in an adult general population, 20-60 years old. The protocol included a standardized questionnaire, skin tests to venom in subjects reporting a history of systemic reaction, and in subjects reporting a history of severe local and systemic reactions, as well as in a control group, a radioallergosorbent test (RAST) to hymenoptera venoms. According to the questionnaire, 1.2% of the study population had a history of systemic reactions. Only 0.85% had both such a history and a positive skin test to venoms. RASTs were positive, for at least one venom, in 57% of subjects with a history of systemic reaction, 15.8% of subjects with a history of severe local reactions, and 6.0% of the control group. In conclusion, this study shows that systemic reactions are not uncommon in the general population. RASTs tests are not sensitive or specific enough to be considered, per se, for indications of allergy to venoms.
In ten allergic patients, the effect of inhaltion of increasing quantities of grass pollen on specific airways resistance (SRaw, measured by plethysmography) was estimated after preliminary inhalation of a placebo and of a synthetic anticholinergic drug (SCH 10000). After placebo, the inhalation of grass pollen induced in all cases a bronchoconstriction (mean increase of SRaw : 170 %). After SCH 1000, and for the same quantity of pollen inhaled, seven patients were entirely protected against the bronchoconstrictor effect of the allergen ; for the whole group, the observed bronchoconstriction was significantly lower (p less than 0.01, mean increase of SRaw : 60 %). The possible mechanisms of this protection are discussed. The results suggest that SCH 1000 could be used as a preventive drug in pollinic asthma.
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In a group of 140 asthmatic children (6-15 years old) followed up for six months, the authors compared : (1) the daily transcription of asthmatic symptoms, of their intensity and of the use of antibiotics or corticosteroids ; (2) the peak expiratory flow rate measured daily at nine a.m. ; (3) the clinical history, coded every fifth day. A clinical score was computed by multiple linear correlation between (1) and (3), with a correlation coefficient of 0.84 (p less than 0.001), showing that the propounded quantification of symptoms and treatments was very good for estimating the clinical history. The coefficient of simple linear correlation between peak expiratory flow rate and score (r = --0.41) and between peak expiratory flow rate and clinical history (r = --0.65) was statistically significant ; however a further computation by stepwise multiple linear correlation showed that the peak expiratory flow rate was essentially correlated to the intensity of the symptoms, and to a lesser degree to the presence of breathlessness and prescription of corticosteroids. The correlation coefficient was -- 0.55 (p less than 0.01). Thus the peak expiratory flow rate does not very well account for the clinical state of asthmatics ; useful for the fast but superficial monitoring of patients, it cannot replace the daily transcription of symptoms and treatments : both methods are complementary.
The relationship between bronchial asthma and the beta adrenergic system is considered both from the physiopathologic and therapeutic point of view. A brief analysis of the sympathetic system is performed. The sympathetic nervous system is responsible for bronchodilation mediated through its beta-receptors. To evaluate this activity, beta adrenergic blockers such as propanolol are used. When this agent is administered, a descent of conductance is observed. On this condition, vagal stimulation brings about bronchoconstriction. At bronchial level, it seems that the beta-adrenergic system antagonizes vagal effect. From the physiopathologic point of view, Szentivanyi (1968) suggested a spontaneous beta block in the asthmatic. Other theories refer to a pathologic sensitivity of the peripheral bronchial receptors. The natural beta-adrenergics and the beta-adrenergic drugs enhance the synthesis of cAMP by stimulating the adenil cyclase system. This effect brings about relaxation of the bronchial smooth muscle. Considering the therapeutic effects, a comparative study of bronchodilators is performed. From all, Salbutamol has an intense broncholytic effect with little effect on heart dynamics. When sympathomimetics are bound to use in asthma, drugs such as Salbutamol and Terbutalina should be preferred because of its low cardiogenic effects. Its administration per os has rendered doubtful results.
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This paper is relating the study of 164 patients with primary and proved bronchial carcinoma. A thrombocytosis superior to 400,000/mm3 was observed in 36.6 p. cent of cases. But no statistic relation was found between the histological type of tumor, a biological inflammatory state, the existence of metastasis and thrombocytosis. However thrombocytosis was more frequently observed among anaemic and hyposideremic patients. No significantly changes of paO2 and paCO2 were noted in patients with thrombocytosis. The systematic platelet count could be of an interest in the interpretation of some thoracic radiography.
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In 14 asthmatic subjects with bronchial obstruction reversible by beta-sympathomimetic drug inhalation (salbutamol), the effect of intravenous injections of placebo and of 2, 4 and 8 mg/kg of hemisuccinate hydrocortisone (HSHC) has been measured by determining the forced expiratory volume in one second (FEV1) every two hours for eight hours. In four patients, FEV1 was not significantly altered by HSHC injection. It was improved in the ten other patients. The latency period lasted at least four hours and the peak action was observed between the sixth and the eighth hour. These two factors were related to the HSHC dose. The improvement obtained with 8 mg/kg HSHC was similar to that of salbutamol. The effect of the latter was potentiated by 8 mg/kg HSHC. These results suggest that HSHC should not be used when a fast reaction is wanted, on the one hand, and that the efficacy of the product must be controlled by objective measurements, on the other hand since not every subject is responsive.
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