Static and elevated pollen traps do not provide an accurate assessment of personal pollen exposure.

SUMMARY: Background. Volumetric pollen traps are commonly used to assess pollen exposure. These traps are well suited for estimating the regional mean airborne pollen concentration but are likely not to provide an accurate index of personal exposure. In this study, we tested the hypothesis that hair sampling may provide different pollen counts from those from pollen traps, especially when the pollen exposure is diverse. Methods. We compared pollen counts in hair washes to counts provided by stationary volumetric and gravimetric pollen traps in 2 different settings: urban with volunteers living in short distance from one another and from the static trap and suburban in which volunteers live in a scattered environment, quite far from the static trap. Results. Pollen counts in hair washes are in full agreement with trap counts for uniform pollen exposure. In contrast, for diverse pollen exposure, .individual pollen counts in hair washes vary strongly in quantity and taxa composition between individuals and dates. These results demonstrate that the pollen counts method (hair washes vs. stationary pollen traps) may lead to different absolute and relative contributions of taxa to the total pollen count. Conclusions. In a geographic area with a high diversity of environmental exposure to pollen, static pollen traps, in contrast to hair washes, do not provide a reliable estimate of this higher diversity.

[Severe bronchial stenosis with upstream bronchiectasis in an arc welder: causal relation or epiphenomenon?]. / Sténose bronchique serrée avec bronchectasies d'amont chez un soudeur à l'arc: relation causale ou épiphénomène?

This case concerns an arc welder who presented suppurative bronchiectasis and episodes of purulent left side pleurisy in relation to cystic bronchiectasis of the left lower lobe and a very severe stenosis at the origin of the main left bronchus. The medicolegal problem was to assess the causal relationship between these lesions and occupational exposure. They do not come under the heading of table 44 of the General List and we made this the aim of discretionary award in front of a regional committee of compensation for occupational disease.

Assessment of the severity of asthma by an expert system. Description and evaluation.

Asthmaexpert, an expert system (ES), was produced at the special request of several clinicians in order to better understand the medical decisions made clinical experts in managing an asthmatic patient. We describe and evaluate this knowledge base, focusing mainly on assessment of the severity of asthma. After compiling data from a patient, Asthmaexpert assesses the severity of the disease and identifies the trigger factors involved, suggests any further investigations that may be required, and offers a treatment strategy. Implemented with Nexpert and Hypercard, it runs on a MacIntosh personal computer. The validation stage involved eight clinical experts who provided 20 case report forms (CRF) with their conclusions about management of asthma. The CRF were then programmed into the ES, which provided its own conclusions about the same subjects. Afterward, all the experts evaluated the conclusions given by ES or by their colleagues in a double-blind manner. One hundred twenty-seven CRF were available. The reliability of the experts' opinions was good, with a substantial consensus between them when assessing severity scores (kappa = 0.27 to 0.54). There was no difference in concordance of opinions on severity scores either between the experts who designed the system and ES or between the other experts and ES (weighted kappa = 0.72 and 0.69, respectively). Experts judged that the severity scores given by ES were as good as those proposed by their colleagues, and that the overall conclusions given by ES were as good as or better than those given by their colleagues. The conclusions drawn by ES were given a good rating.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of castration and testosterone on Fel dI production by sebaceous glands of male cats: II--Morphometric assessment.

A morphometric study of cat sebaceous glands was performed to evaluate the effects of castration and testosterone treatments. Skin biopsies were taken in six cats before castration, after castration and after the testosterone injections administered after castration (total number of biopsies: 18). Ninety 8 microns thick sections of each biopsy were assessed for image analysis processing (SAMBA 2005, ALCATEL TITN). The variations in glands and cells size were evaluated on digitized microscopic images by morphometric parameters included in the SAMBA software package. An original software was developed for the analysis of the spacial gland structure. The best morphometric parameters were selected in a first step of the study, and included the nuclear surface (NS), the cell surface (CS) and the nuclear/cellular surface ratio (N/C). These three parameters were then compared in each group of samples for the six cats. It was shown that after castration the N/C (21%) significantly increased compared with prior to castration (12.6%). This 59.8% increase was mainly due to cell cytoplasm shrinking reflecting a decrease of the cell activity. The testosterone administered after castration produced a reverse effect with a N/C ratio back to normal (11.4%) and a significant cell cytoplasm and gland enlargement as shown by the three dimension constructions. This morphometric data correlated with the measurement of sebum and Fel dI productions. The negative effects of castration and the positive effects of testosterone on the sebaceous cells and glands volume favour the hypothesis that cat sebaceous cells are subject to hormonal control this is also likely to apply to the Fel dI production.

Effects of castration and testosterone on Fel dI production by sebaceous glands of male cats: I--Immunological assessment.

Fel dI is produced by salivary and sebaceous glands. Hormonal control of sebum production is clearly established. The influence of cat castration and supplementary treatment with testosterone on the production of sebum and Fel dI in cat skin have been researched in this study. On day 1, 12 male cats were anaesthetized and three skin areas carefully shaven. Then the level of lipids on skin surface was measured by means of a photometric method. Finally, the three areas of skin were washed with 5ml of distilled water through a plastic cylinder. Fel dI collected in the washes was measured with a two-site monoclonal antibody based ELISA. On day 2, six cats were castrated, the other six were used as a control group. Two and 4 weeks later, the levels of lipids and Fel dI in skin washes were measured again in all cats. On day 30, the six castrated cats were injected intramuscularly with prolonged-action testosterone. Two weeks later, quantification of lipids and Fel dI in all animals was repeated. Sebum and Fel dI levels decreased in all castrated animals. Injecting the castrated cats with testosterone led to a significant increase in sebum and Fel dI production. Our findings indicate that Fel dI production is influenced by the production of hormones.

[Underestimation of cases of occupational asthma in Provence-Alpes-Côte d'Azur and Corse region]. / Sous-déclaration des cas d'asthme professionnel dans la région Provence-Alpes-Côte d'Azur et la Corse.

To evaluate a possible underestimation of disability claims for occupational asthma in the Provence-Alpes-Côte d'Azur-Corse area, we compared the actual figures collected from 1986 to 1988 to the predicted figures. The latter were computed from the number of exposed subjects in at-risk industries and the prevalence of occupational asthma reported in the literature for each exposure category. From 1986 to 1988, only 44 disability claims were submitted and 25 of them were accepted. These disability claims represent about 2% of the occupational asthma cases which would be expected. The reasons for such a large discrepancy could be a selection bias leading disabled subjects to leave the occupation at risk, a failure by the patient and/or the physician to identify the disease, or a poor compensation system which is not an incentive for performing a disability claim.

[A national survey: the respiratory specialist and allergology]. / Enquête nationale: le pneumologue et l'allergologie.

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.