1†Retreatment for reactivation of ROP following initial anti-VEGF injections. A 5-year retrospective study.

To present the retreatment rates and the characteristics of ROP reactivation, as well as the differences between bevacizumab and ranibizumab injections in premature babies treated in our department over the past 5 years.A retrospective analysis of babies with treated ROP was performed. 89 babies who required treatment from 2017 to 2022 were examined. We studied the severity of their disease with regards to their gestational age, treatment time and type and the need of further treatment. We also focused on the comparison of anti-VEGF agents for ROP.22 out of 89 babies (14 boys and 8 girls) with aggressive posterior retinopathy of prematurity (APROP) and mean gestational age of 25+3w received initially anti-VEGF injections. 16 of those (11 boys and 5 girls) required retreatment with diode laser. 9 out of these 16 babies were treated with ranibizumab (Lucentis) and 7 with bevacizumab (Avastin). It is also of note that only 2 out of 67 babies who initially received laser treatment needed a complementary laser session.The majority of babies with aggressive ROP who receive anti-VEGF agents will most probably require further laser treatment. At an equal level of retinal damage, it seems that their response to ranibizumab and bevacizumab is similar.

Asthma and allergy to house-dust mites in populations living in high altitudes.

Do subjects living in high altitude where house-dust mites are known to be uncommon exhibit a lower prevalence of asthma and allergy to house-dust mites? To answer this question, we compared the prevalence rates of asthma and skin reactions to house-dust mites in two towns with contrasted environments: Marseille, located on the seashore, and Briançon, 1350 m in altitude. The study population consisted of a random sample of 4,008 people in Marseille and 1,055 people in Briançon. All subjects received a home questionnaire, and a sample of patients and asymptomatic subjects had a skin-prick test evaluation. The cumulative prevalence of asthma was equal to 4.1 percent in Marseille and 2.4 percent in Briançon, a difference which was significant (p = 0.01). The prevalence of positive skin tests to housedust mites in asymptomatic subjects was equal to 27.5 percent in Marseille and 10.2 percent in Briançon (p less than 0.001). This study supports the hypothesis that exposure to environmental factors may have a major influence on developing allergic diseases.

A comparison of the bronchodilatory effect of 50 and 100 microg salbutamol via Turbuhaler and 100 microg salbutamol via pressurized metered dose inhaler in children with stable asthma.

AIM: The aim of the study was to compare the efficacy of single doses of salbutamol Turbuhaler (50 and 100 microg), salbutamol pressurized metered dose inhaler (pMDI) (100 microg) and placebo in children with stable chronic reversible airway obstruction. Primary efficacy variable (FEV1-av) was calculated as the area under the curve of forced expiratory volume in one second (FEV1) (AUC, 0-4 h) and divided by the observed time. DESIGN: The study was of a randomized, single-dose, crossover and double-blind design. Seven centres participated. FEV1 was measured pre-dose and at 15 min, 0.5, 1, 1.5, 2, 3 and 4 h post study dose. PATIENTS: Forty asthmatic children (9 girls) with a mean age of 9 years (range: 6-12), mean FEV1 of 1.6 l (range: 0.9-2.4) and a mean FEV1 in percentage of predicted normal value of 80% (range: 61-109) were randomized into the study. The mean reversibility 30 min after inhaling 2x100 microg salbutamol from pMDI was 20% (range: 9-45) or 15% (range: 8-27) in percentage of predicted normal value. RESULTS: The mean FEV1-av was 1.63 l for placebo, 1.71 l for 50 microg salbutamol Turbuhaler, 1.76 l for 100 microg salbutamol Turbuhaler and 1.76 for 100 microg salbutamol pMDI. Corresponding values for maximum FEV1 were 1.76, 1. 85, 1.87 and 1.87 l, respectively. There were no statistically significant differences between the active treatments in FEV1-av or maximum FEV1. All active treatments were significantly better than placebo. CONCLUSION: No significant differences in bronchodilating effect between 50, 100 microg salbutamol Turbuhaler and 100 microg salbutamol pMDI in children, aged 6-12 years, with stable asthma could be demonstrated. All active treatments were significantly better than placebo.

[Respiratory allergy and domestic animals. Survey in a sample of the general population]. / Allergie respiratoire et animaux domestiques. Enquêtes réalisées en population générale.

To evaluate the role of exposure to furred pets on respiratory allergic disorders, we interviewed 10,338 adults, selected at random from communities of South-East France. All subjects answered a standardized questionnaire related to asthma and perennial rhinitis and to present or past exposure to furred pets and respiratory symptoms related to this exposure. Besides, a sample of the population had a blood analysis for detection of specific IgE directed against common aero-allergens (Phadiatop). Overall, more than half of the households had a pet, more often in rural than urban communities. Among asthmatics 9.3% acknowledged respiratory symptoms when exposed to pets and 5.9% had parted from their pets because of respiratory symptoms; among patients with chronic rhinitis, those figures were 5.1% and 2.6%, respectively. However, these subjects with respiratory symptoms had pets as often as the whole population. In atopic subjects (positive Phadiatop test), exposed to cats, the prevalence of perennial rhinitis was higher than in atopic subjects not exposed to cats and in non-atopic subjects. Thus furred pets have a deleterious influence on patients with asthma or rhinitis, especially in the atopic subgroup. Pet avoidance is an important factor in the management of these diseases.

[Poaceae pollens. Comparison of Poaceae pollens in 1999 among Marseille, Gap, and Briançon 2000 meters]. / Comparaison des pollens de Poaceae en 1999 à Marseille, Gap, Briançon et Briançon 2000 mètres.

Pollens of Poaceae remain the major concern of all those which are concerned with the allergies. The grasses in question are ubiquitaires, but the variations due to climate and the relief influence much on the statements. Our country, from its geographical richness and by the number of sites of collecting, allows an interesting synthesis and a better comprehension of the metabolism of the plant. We are interesting here in the sites of Nimes, Aixen-Provence, Gap and Briançon, included in the National Network. Moreover, one sensor placed temporarily at 2,000 meters of altitude, meadows of Briançon, gives one further information.

Relationship between spontaneous dyspnoea and lability of airway obstruction in asthma.

1. As marked lability of bronchial obstruction is a risk factor for asthma severity, it may influence dyspnoea, the most common subjective complaint in asthma. We therefore studied the relationship between spontaneous dyspnoea and the degree of bronchial lability, as assessed by the daily variability in peak expiratory flow rate and the bronchial responsiveness to either carbachol or salbutamol, in 33 stable symptomatic asthmatic patients. 2. Three times daily, for 10 consecutive days, the patients rated the intensity of their dyspnoea on a visual analogue scale and immediately afterwards recorded their peak expiratory flow rate. Within the next 5 days, we determined the bronchial response by measuring the forced expiratory volume in 1 s and the specific resistance of airways to either carbachol or salbutamol according to baseline airway obstruction. 3. We characterized dyspnoea for each patient by using two parameters: (1) the relationship with underlying airway obstruction, as assessed by the correlation coefficient r between dyspnoea scores and corresponding values of peak expiratory flow rate (r DSc-PEFR), and (2) the intensity, as assessed by the mean visual analogue scale dyspnoea score adjusted for comparable airway obstruction. Bronchial lability was characterized by (1) variability in mean daily peak expiratory flow rate and (2) bronchial responsiveness to either carbachol (as assessed by the threshold dose and the slope of the dose-response curve) or salbutamol (as assessed by the threshold dose and maximal response). We assessed the relationship between dyspnoea and bronchial lability by correlating each of their respective characteristics. 4. We found large inter-subject differences in both characteristics of dyspnoea.(ABSTRACT TRUNCATED AT 250 WORDS)

[beta2-Microglobulin and pulmonary tuberculosis (author's transl)]. / beta2-Microglobuline et tuberculose pulmonaire.

Serum beta2-microglobulin levels, determined in 29 healthy adults were found to be 1,3 mg/l with an upper confidence limit (95%) of 2,0 mg/ml. In contrast, serum values in 101 patients with pulmonary tuberculosis were 2,1 mg/l with an upper confidence limit of 3,2 mg/l. The latter value is therefore to be taken into consideration if serum beta2m is to be used for discriminating between lung carcinoma and other pulmonary diseases.

Influence of the menstrual cycle on theophylline pharmacokinetics in asthmatics.

The effect of menstrual cycle on the pharmacokinetics of theophylline has been studied in 9 female asthmatic patients. At three different times during the cycle (first, tenth and twentieth days) each subject received an i.v. infusion of 240 mg theophylline. Significant changes were found in the kinetics of theophylline according to the menstrual cycle. The maximum plasma drug concentration, minimum mean residence time, and minimum elimination half-life were observed at mid-cycle. The lowest clearance was observed at D 20. The AUC and volume of distribution did not vary significantly during the cycle.

Manufacturer's information insert and subjective theophylline side-effects.

In Western Europe medicine packages contain an insert prepared by the manufacturer which enumerates the drug side-effects. We investigated the influence of this insert on alleged theophylline side-effects. Forty literate adult asthmatics were randomly allocated into two groups (n = 20 each): theophylline packages contained the manufacturer's insert in group A but not in group B. Theophylline was prescribed (10 mg.kg-1 body weight qd) for one week. During this period the patients filled a diary grading 13 different symptoms from 0 to 3; 5 of these symptoms were listed on the insert as theophylline side-effects. On the eighth day the patients were interviewed and theophylline blood levels measured. Theophylline side-effects were significantly more marked in group A than in group B, whereas the other symptoms were of similar magnitude. Eight patients prematurely stopped their treatment in group A vs 3 in group B, because of alleged intolerance. Theophylline blood levels did not differ significantly in the two groups; neither did they in the subgroup which stopped treatment and in the one which complied to prescription. We conclude that side-effects were suggested to the patients by the insert and/or that the insert increased their awareness of side-effects, with a subsequent detrimental influence upon compliance to therapy.