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The relationship between host factors of allergic nature and respiratory symptoms.

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.

Air Pollution

Double-blind trial of a long-acting bronchodilator preparation ("Nethaprin Dospan") in bronchospastic disease.

A double-blind, placebo-controlled, crossover study was carried out in 48 patients with bronchospastic disease to assess the efficacy of a long-acting bronchodilator preparation ("Nethaprin Dospan") containing etafedrine hydrochloride, bufylline, doxylamine succinate and phenylephrine. Patients received 1 tablet nightly, with an extra dose in the morning if necessary, of active drug or placebo for 1 week, and were then crossed over to the alternative medication for a further week. All patients had marked disability, apparent on initial clinical examination and on respiratory function tests. The results showed that FEV1 and VC were significantly improved with the active medication, and patients slept better, had improved appetite and suppression of cough.

Asthma

A series of patients infected with the emerging tick-borne Yezo virus in China: an active surveillance and genomic analysis.

BACKGROUND: Yezo virus (YEZV) is an emerging tick-borne pathogen, which was initially reported in Japan in 2021. Only one patient had been reported in China so far. We aimed to describe the epidemiological, clinical, and laboratory findings of a series of patients, and to characterise the viral genomes of YEZV. METHODS: In this active surveillance and genomic analysis, we conducted active surveillance at Mudanjiang Forestry Central Hospital, Heilongjiang Province of northeast China. Participants were eligible for inclusion if they sought medical care for a recent tick bite between May 1 and July 31, in 2022 and 2023, and between May 1 and July 10, in 2024. We collected sera from participants to detect YEZV infection by meta-transcriptomic sequencing, real-time RT-PCR, and indirect immunofluorescence assay. We isolated YEZV by cell culture and characterised the pathogen by morphological and phylogenetic analyses. FINDINGS: A series of 18 patients with YEZV infection (12 male and six female; median age 53 years, IQR 45-60) were identified among 988 participants. The patients presented with fever (18 patients, 100%), headache (ten patients, 56%), dizziness (nine patients, 50%), malaise (three patients, 17%), lumbago (three patients, 17%), and cough (three patients, 17%). Nine (50%) patients had rash around the tick bite site and four (22%) had lymphadenopathy. Nine (50%) patients had gastrointestinal symptoms, and five (28%) had neurological symptoms. We observed leukopenia in ten (63%) and thrombocytopenia in five (31%) of 16 assessed patients. Elevated hepatic transaminase concentrations were identified in 13 (72%) of all 18 patients, lactate dehydrogenase or α-hydroxybutyric dehydrogenase in nine (50%), serum amyloid protein A in 13 (72%), and hypersensitive C-reactive protein in ten (56%). Eight (7%) of 119 Ixodes persulcatus ticks removed from participants were positive for YEZV. Three YEZV strains were isolated from the sera of patients. Ten viral genomes were obtained from five patients, a blood-sucking I persulcatus removed from a participant, and four host-questing tick samples collected in the areas where patients were identified or in the adjacent region. Phylogenetic analyses revealed that YEZVs in either patients or ticks were divided into two clades, each with distinct mutations. INTERPRETATION: Awareness of YEZV infection is important and clinicians should consider the virus when diagnosing patients with suitable symptoms. FUNDING: National Key Research and Development Program of China. TRANSLATION: For the Chinese translation of the abstract see Supplementary Materials section.

Humans

Fatal pulmonary reaction from low doses of bleomycin. An idiosyncratic tissue response.

There were two cases of fatal interstitial pneumonia secondary to bleomycin sulfate administration. Although bleomycin pulmonary toxicity is generally thought to be dose-related and occurs infrequently with a total cummulative dose less than 300 to 400 units, the two reactions reported here occurred with doses of 105 and 165 units. Fatal bleomycin-induced pneumonia has been previously reported at these low dosages, and physicians should be aware that this toxic reaction may occur as an idiosyncratic response. Previous thoracic irradiation may be a predisposing factor. Patients receiving bleomycin should be meticulously monitored by interrogation for cough, dyspnea, and chest pain; by auscultation for rales; by serial chest roentgenograms; and by determinations of vital capacity and single-breath carbon monoxide diffusing capacity.

Adenocarcinoma

Pulmonary infiltrates with eosinophilia and urinary symptoms during disodium cromoglycate treatment. A case report.

A 64-year-old asthmatic woman began to suffer from urinary irritation after 5 months' treatment with disodium cromoglycate. After 10 months she contracted, additionally, a dry, hacking cough and gradually increasing exercise-induced dyspnoea. Chest X-ray revealed scattered, micronodular infiltrations in both lungs, and her spirogram was clearly restrictive. Peripheral blood showed eosinophilia of 23.5%. Urine was clean. When DSCG was withdrawn, her urinary symptoms and cough disappeared overnight, and her dyspnoea improved within weeks, as did her chest X-ray. Inhalation provocation test with DSCG 2 months later resulted in an immediate asthmatic reaction followed by a possible delayed-type reaction 9 hours later. Disodium cromoglycate is regarded as the possible aetiologic agent.

Cromolyn Sodium

Respiratory disease of workers harvesting grain.

The incidence of respiratory symptoms caused by grain dust during harvesting was surveyed in a group of Lincolnshire farmers. A quarter complained of respiratory distress after working on combine harvesters or near grain driers and elevators, with cough, wheezing, and breathlessness, sometimes so severe as to prevent work. The airborne dust around combine harvesters contained up to 200 million fungus spores/m3 air with Cladosporium predominant while drivers were exposed to up to 20 million spores/m3 air. Verticillium/Paecilomyces type spores, mostly from Verticillium lecanii, Aphanocladium album, and Paecilomyces bacillosporus, were abundant in the dust. Extracts of these species produced immediate weal reactions in skin tests, precipitin reactions with sera, and rapid decreases in FEV1 when inhaled by affected workers. There was no delayed reactions. Results suggest type I immediate hypersensitivity to the spores although the physical effect of a heavy dust deposit could be important. Drivers could be protected by cabs ventilated with filtered air.

Agricultural Workers' Diseases

Immunologically mediated lung diseases. Extrinsic allergic alveolitis and allergic bronchopulmonary aspergillosis.

Early recognition and treatment of immunologically mediated diseases of the lung are vital to prevent irreparable damage. Extrinsic allergic alveolitis and allergic bronchopulmonary aspergillosis are often confused but should not be difficult to distinguish. The former is nonatopic and is marked by chills, fever, chest pains, cough, dyspnea, and restrictive pulmonary function. The immunologic hallmark is the presence of precipitating antibody to the suspected antigen. Allergic bronchopulmonary aspergillosis is atopic and is marked by low-grade fever, obstructive pulmonary function, markedly elevated serum IgE levels, and positive immediate and late response on skin tests. Both diseases respond well to early corticosteroid therapy. Prophylactic measures are also important in controlling extrinsic allergic alveolitis.

Animals

A respiratory survey of cedar mill workers. II. Influence of work-related and host factors on the prevalence of symptoms and pulmonary function abnormalities.

The influence of certain work-related and host factors on the prevalence of respiratory symptoms and pulmonary function abnormalities in 405 red cedar workers and 187 control workers was examined. In cedar workers, but not in controls, the prevalence of chest symptoms increased with duration of exposure. The decline in pulmonary function with increasing duration of exposure was also more marked in cedar workers, but in both groups smoking was a more important determinant. Substantial proportions of cedar workers and, to a lesser extent, controls noted improvement of cough and wheeze, and particularly of conjunctivitis and rhinitis, when away from work. No deterioration, however, was found in pulmonary function during the work week in either exposure group. Atopic status was unrelated to the prevalence of chest symptoms or pulmonary function abnormalities; it was more common in workers with conjunctivitis and rhinitis, particularly in the cedar group. Similarly, Pi phenotype did not appear to influence the occurrence of either symptoms or lung function abnormalities.

Adult

[Comparison between two types of pertussis vaccines].

We have produced pertussis vaccines with laboratory and industrial methods. The characteristic of laboratory cultivation of microorganisms is, in this context, growth on Hornibrook medium in low form flask and in stationary culture. Industrial cultivation is done in homogenous culture on a B-2 medium in fermentor. The strains utilized were isolated from whooping-cough cases in the Montreal region. The yield (org. x 10(9)/ml) obtained with an industrial cultivation of B. pertussis was 4 to 7 times higher than that reached with a laboratory cultivation of this microorganism. The non-toxicity as expressed in weight gain of mice was shown for both types of vaccine. The vaccines produced in fermentor were less histamino sensibilizing for mice than the one produced in stationary flash culture. The quality of the vaccines achieved by industrial method is easily reproducible due to the fact that enough variables can be measured.

Bordetella pertussis

Health hazards to timber and forestry workers from the Douglas fir tussock moth.

A heavy infestation of the tussock moth caterpillar (Orgyia pseudotsugata McDonnough) in forested areas of Oregon was associated with itching of the skin and eyes, nasal discharge, cough, and, at times, respiratory difficulty, Personal interviews and inspection of forty-one occupationally exposed persons were supplemented by a questionnaire administered to 428 individuals, composing three groups at various degrees of risk and a control group. There was a cause and effect relationship between the adverse symptoms and the exposure to tussock moth larvae. The specific etiologic agent was not identified, but it was felt that the secretion, hairs, or other substances in the larvae or cocoons of the moth acted as a potent allergenic substance and, for some persons, was also a primary skin irritant.

Animals

Comparison of respiratory variables in grain elevator workers and civic outside workers of Thunder Bay, Canada.

We compared respiratory variables in 441 grain elevator workers with 180 civic outside laborers in Thunder Bay. The grain handlers had a lower frequency of both positive skin reactions to pollens and molds and a family history of asthma, which suggests that they may have been self-selected for a decreased tendency to develop allergic respiratory disease. There was a higher frequency of cough and rales and a small decrease in forced vital capacity and forced expiratory volume in one sec among the grain handlers, as compared to the civic workers matched for smoking. However, these differences between grain and nongrain workers were small in comparison to those between smokers and nonsmokers. There was no clear indication of a worsening of respiratory functions that could be attributed specifically to duration of employment as a grain elevator worker.

Adult

A respiratory survey of cedar mill workers. I. Prevalence of symptoms and pulmonary function abnormalities.

A respiratory-occupational questionnaire and spirometry were used to compare the prevalence of symptoms and pulmonary function abnormalities in 405 workers exposed to red cedar dust and 252 control workers exposed to other wood dusts. Compared with controls, the cedar workers were found to have a significantly higher prevalence of respiratory symptoms, cough, phlegm, wheeze and breathlessness, as well as more rhinitis and conjunctivitis. While, as expected, there was a clear relationship between respiratory symptoms and cigarette smoking, there was also evidence to suggest a synergistic effect between exposure to cedar dust and smoking. There was no difference in the lung function between cedar workers and controls. Sixty-five workers in the control group previously had worked in red cedar mills; they had a higher prevalence of respiratory symptoms than other workers in this group. Red cedar asthma was found in only 1.1% of the cedar workers. This condition usually develops in the early months of exposure, and workers who are affected tend to leave the industry. The probable incidence of red cedar asthma was estimated to be higher, around 4-5%.

Adult

Toluene diisocyanate pulmonary disease: immunopharmacologic and mecholyl challenge studies.

Selected workers exhibiting clinical "sensitivity" to toluene diiosocyanate (TDI) (wheezing, cough, and dyspnea upon entering a TDI-containing area) were studied for : (1) in vitro TDI-induced leukocyte histamine release; (2) determination of cyclic 3',5' adenosine monophosphate (cAMP) levels of lymphocytes exposed to TDI; (3) effect of TDI on the isoproterenol-induced increase of lymphocyte cAMP levels: and (4) acetyl-beta-methylcholine (mecholyl) inhalation challenge. TDI did not induce histamine release from leukocytes of "sensitive" or "nonsensitive" individuals, nor were lymphocyte cAMP levels affected by in vitro TDI exposure, TDI did, however, diminish in vitro stimulation of cAMP by isoproterenol. This effect, seen with cells of "sensitive" and "nonsensitive" individuals, appeared to be dose-dependent; there were no significant differences between the two groups. When challenged with mecholyl, 7 of 10 "sensitive" but only 1 of 10 "nonsensitive" individuals showed a greater than 20% decrease in FEV1. These results suggest that TDI-induced obstructive airways disorders may be associated with altered beta-adrenergic function.

Administration, Intranasal