[Occupational asthma caused by a coloring reagent]. / Asthme et rhinite professionnels à un colorant réactif.

A case of occupational asthma associated with rhinitis and conjunctivitis occurred in a patient working in a textile factory and exposed to different coloring reagents is reported. Symptoms appeared in phases correlated with changes in the use of the coloring reagents. Prick tests were carried out with the different coloring reagents and were positive for the yellow color. The test was followed by a clear increase in bronchial hyperreactivity to methacholine. Some individual preventive measures, such as wearing a face mask, led to reduction then disappearence of the symptoms.

Interspecies scaling of tolcapone, a new inhibitor of catechol-O-methyltransferase (COMT). Use of in vitro data from hepatocytes to predict metabolic clearance in animals and humans.

1. In the present study, in vivo pharmacokinetic data in animals were combined with in vitro metabolic data from animal and human hepatocytes to predict the human systemic plasma clearance and the kinetic profile of tolcapone, a compound metabolized by phase II reactions. 2. The integration of in vitro metabolic data from hepatocytes into allometric scaling gave satisfactory predictions of metabolic clearance in humans for tolcapone (74.2 ml/min predicted versus 118 ml/min observed). 3. Using combined time transformations and in vitro metabolic rates, the range of values predicted from the various animal species (90.4 to 242 ml/min, 0.60 to 2.2 h and 7.3 to 121 for clearance, half-life and volume of distribution, respectively) were in good agreement with the observed values in humans (118 ml/min, 1.3 h and 8.6 h, respectively). 4. Compared to the conventional correction factors (e.g. maximum life span, brain weight), in vitro metabolic data provide a more rational basis for extrapolating the metabolic clearance in humans.

[Study by questionnaire of the influence of weather conditions, particularly fog, on the symptomatology of asthmatic subjects]. / Etude par questionnaire de i'influence des conditions météorologiques, en particulier du brouillard sur la symptomatologie des sujets asthmatiques.

The role of fog in the symptomatology in asthmatic subjects has been assessed by a questionnaire concerning respiratory complaints linked to meteorological conditions and to non-specific irritant factors. In a population of 121 asthmatics (59 men and 62 women) 74.4% complained that fog was a factor aggravating their symptoms while only 3% of a group of 30 non-asthmatic subjects expressed discomfort during episodes of fog. The chemical analysis of fog during 32 episodes of local fog (pH, chloride, nitrate, sulphate, sodium, ammonia, potassium, magnesium, calcium) has shown a greater concentration of pollutants and greater acidity in the smaller particles (2-6 microns) which are able to penetrate the bronchial tree. This acidity could explain the role of fog in respiratory physiology. Certain authors have suggested that the aggravation of respiratory symptoms observed during peaks of pollution could be induced by aerosols containing sulphuric acid while others have described effects on respiratory function at the time of exposure to acid aerosols in asthmatic subjects but the results of the different studies have not all been concordant. Putting aside the role of the susceptible individual, other factors may intervene at the time inhalation of pollutants, notably the ambient humidity, the neutralising effect of endogenous ammonia and the synergystic effect between acid aerosols and atmospheric pollutants.

[Asthma due to isocyanates in a theoretically non-exposed worker]. / Asthme aux isocyanates à un poste théoriquement non exposé.

We report a case of isocyanate induced asthma in a patient who had been previously exposed to isocyanate and had become a porter in a factory producing polyurethene foam. The test for exposure to TDI was positive. The recognition of occupational asthma was nevertheless challenged and the patient was not considered to be carrying out work involving exposure to the inhalation of isocyanates. The effect of a change of job in the development of occupational asthma, and the risk of asthma induced by isocyanates despite inhaled concentrations inferior to the VME, the difficulty of obtaining a recognition of occupational asthma when the working conditions fulfilled do not exactly correspond to those labelled in the schedule for occupational diseases, are discussed in this paper.

[Long-term efficacy of high-dose aerosol corticotherapy in the treatment of severe asthma]. / Efficacité au long cours d'une corticothérapie en aérosol fortement dosé dans le traitement de l'asthme sévère.

Forty-five patients with severe, poorly controlled asthma, including 23 corticosteroid-dependent patients, were treated with a preparation of beclomethasone dipropionate aerosol delivering 250 mcg per puff. The daily dose ranged from 1000 to 2000 mcg. The mean follow-up period was 14 +/- 7 months, and 11 patients have now been followed up for more than 2 years. Forty-two patients were improved, and total withdrawal of continuous steroid therapy could be achieved in 13 cases. Treatment remained effective in long term use, provided a minimum of 1000 mcg/day was given. However, despite clinical improvement the obstructive syndrome persisted in 65% of the patients.

[Mechanism of action and mode of administration of high-dose inhaled corticotherapy in the treatment of asthma]. / Mécanisme d'action et mode d'administration d'une corticothérapie inhalée à forte dose dans le traitement de l'asthme.

The commercial availability of high-dose inhaled corticosteroid preparations for the treatment of asthma offers an occasion for reviewing the different mechanisms of action of glucocorticoids notably glucocorticoids, notably their interference with lipocortin protein synthesis and arachidonic acid metabolism. A favourable effect on bronchial hyper-reactivity and on delayed hypersensitivity reactions has also been observed. The problems raised by the various preparations responsible for varying degrees of systemic activity, the difficulties inherent in the use of inhalers and the side-effects of these products are discussed. The effectiveness and safety of the current high-dose inhaled preparations are emphasized.

Iron-binding proteins, hepatitis B virus, and mortality in the Solomon Islands.

The hypothesis that serum levels of ferritin and transferrin are associated with subsequent mortality was tested in a population of Solomon Islanders who had been followed over an 8-12-year period beginning in 1966. A case-control analysis of 105 matched pairs showed that 1966-1970 levels of ferritin were higher and levels of transferrin were lower in Solomon Islanders who had died by 1978 than in matched controls who were alive in 1978. These findings support the hypothesis and, in addition, are consistent with the view that increased iron stores are associated with increased mortality. Among females, the association of ferritin with mortality was more pronounced in chronic carriers of hepatitis B virus than in noncarriers.