[Skin sensitisation profiles of outpatients with symptoms of respiratory allergies]. / Profils de sensibilisation cutanée aux pneumallergènes des patients consultant pour allergie respiratoire.

AIM: The main objective of the survey was to determine the frequency of the mono and polysensitizations in patients consulting for respiratory allergy, rhinitis or/and asthma. The secondary objectives were to evaluate the severity, the number and the type of the sensitizations, the frequency of the asthma or rhinitis as a function of the sensitizations, the evolution of the sensitizations with age, and identify the principal responsible pneumallergens. PATIENTS AND METHODS: The multicentric survey included a patient questionnaire allowing the collection and anonymous treatment of data on socio-demographic characteristics, clinical symptoms, cutaneous tests and sensitizations. RESULTS: A sample of 505 patients, mean age 24 years, consulting for rhinitis or asthma, monosensitized (36%) or polysensitized (64%), was evaluated. The percentage of polysensitized patients was similar in asthmatics, patients with rhinitis, and patients with both asthma and rhinitis (60%, 65%, and 63%, respectively). The mean number of the sensitizations was 2.4 for patients with asthma, 2.6 for those with rhinitis, and 2.6 for patients with both asthma and rhinitis. The greater the severity of the rhinitis or asthma, the higher the number of the sensitizations. Sensitizations to acarids, gramineae and cat were the most frequent. When practioners were asked about their intention to undertake desensitization in polysensitized patients, 52% of them replied positively. CONCLUSION: Data collected during this survey showed that a large proportion of the patients who consulted for rhinitis or asthma were monosensitized (36%). Sensitization to acarids was the most frequent. Even in polysensitized patients, more than half the practioners said they would use desensitization.

Favorable survival observed after carboplatin, paclitaxel, and concurrent accelerated hyperfractionated radiotherapy for treatment of locally advanced head and neck carcinoma.

PURPOSE: Several trials have demonstrated the superiority of simultaneous chemoradiotherapy compared with radiation alone for patients with locally advanced head and neck cancers. However, the optimal regimen remains to be defined. This study assessed the safety and activity of combined carboplatin (C), paclitaxel (P), and twice-daily radiotherapy (RT) in a community based, multicenter, phase II trial. MATERIALS AND METHODS: Eligible patients (N = 52) had ECOG PS 0-2 and previously untreated, stage III or IV (M0), unresectable, squamous cell cancers of the head and neck. Treatment consisted of 6 weekly courses of C (AUC = 1), P (40 mg/m(2)/1-h) and twice-daily radiation (120 cGy BID; total dose of 6,960 cGy). Subsequently, patients with N2/N3 disease were permitted neck dissection. RESULTS: Median follow-up was 61 months. Sixty-seven percent (67%) of patients had stage IV (M0) disease at baseline. Fifty-five percent (55%) of treated patients experienced NCI Grade 3-4 dysphagia, stomatitis, or mucositis; 80% had > or = Grade 3 toxicity of any organ system. Median weight loss was 7.1 lbs; 35% of patients experienced 10% or more weight loss. Of 43 patients evaluable for response, responses were: 29 CR (67%), 7 PR (16%), 1 MR (2%), 4 SD (9%), and 2 PD (5%); the overall response rate (CR+PR) was 84%. For the entire cohort of 52 patients, the estimated overall survival at 36 months was 60%; progression-free survival was 50%. CONCLUSIONS: We conclude that weekly C + P and concurrent twice-daily hyperfractionated radiotherapy is tolerated and highly active in patients with unresectable, locally advanced squamous cell carcinoma of the head and neck.

[Pulmonary eosinophilia in asthmatic patients: after radiography, bronchoalveolar lavage]. / Eosinophilie pulmonaire de l'asthmatique: après la radiographie, le lavage broncho-alvéolaire.

The technique of broncho-alveolar lavage (BAL) can be used without difficulty in asthmatic patients. The authors studied 17 patients with high eosinophil counts (greater than 20 p. 100) and followed them up for 6 to 12 months. An increase in total cell counts in BAL was observed which was in direct correlation with the percentage of eosinophils; chest X-ray showed no evidence of pulmonary infiltration in any of the cases; 9 patients were steroid dependent. These observations indicate that radiological pulmonary infiltrates in asthmatic patients which is a real disease entity does not cover the whole spectrum of deep pulmonary changes in this condition. Broncho-alveolar lavage is a valuable mean of assessing the degree of local eosinophilia to compare the inflammatory disease of the distal airways with the rest of the asthmatic changes. It may contribute to a better understanding of the asthmatic syndrome; many facets of which are indeed still obscure.

[Effect of SCH 1000 on bronchial hyperreactivity compared to that of fenoterol]. / Effet du SCH 1000 sur l'hyperréactivité bronchique comparé à celui du fénotérol.

The hyperreactivity-modulating effect of SCH 1000 and fenoterol was tested in two groups of 10 patients. The drugs were administered at random, in simple blind fashion. Baseline pulmonary function was in the range of predicted values for all patients. One group received 80 micrograms of SCH 1000. When the drug was inhaled after carbachol challenge, pulmonary function returned to normal values in all patients. When the drug was inhaled before challenge, a shift to the right of the dose-effect curves was observed in all patients but 1. The other group received 800 micrograms of fenoterol. When the drug was administered after carbachol challenge, all 10 patients returned to baseline within 10 min. When it was given before carbachol challenge, a shift to the right of the dose-effect curves was observed in 9 patients out of 10. SCH 1000 and fenoterol induced an effective protection against carbachol, increasing the PD20 and shifting the dose-effect curves to the right in most of the asthmatics. In 2 patients, 80 micrograms of SCH 1000 or 800 micrograms of fenoterol seemed too low in order to achieve a complete protective effect.