[Intricated asthma tracheomalacia: diagnosis and therapeutic aspects]. / Asthme et trachéomalacie associés: aspects diagnostiques et thérapeutiques.

An asthmatic girl was first hospitalized at age 2(9/12) years because of dyspnoea, lung consolidations and/or atelectasis, and rattling. Between ages 2(9/12) and 6(2/12) years, she required three hospitalizations in ICU out of nine hospitalizations for the same symptoms. Differential diagnosis of this difficult to treat asthma disclosed severe tracheomalacia and persistent asthma. Treatments given according to the clinical, radiological and functional findings failed to decrease frequency and severity of acute respiratory episodes. Eventually, positive pressure ventilation delivered at airway opening (via a mouthpiece) associated to active respiratory physiotherapy succeeded in removing atelectasis and quickly cured the five following acute episodes without any further hospitalization. This case report is about diagnosis procedure, intricate asthma and tracheomalacia, and open mind to unusual therapeutics that may disclose potential help.

How to better define the characteristics of dispersion of results in liquid chromatographic analyses through an interlaboratory study. Example of collaborative studies on ketoprofen and spiramycin.

The aim of this study was to use statistical tools, especially the analysis of variance (ANOVA), to improve knowledge of the characteristics of the dispersion of results in high-performance liquid chromatography (HPLC) methods for quantitative analysis. It is in this regard that two interlaboratory studies have been carried out in collaboration with Rhône-Poulenc Rorer. The first concerned the analysis of a single drug product (ketoprofen) and was typically a "simple analysis". The second one involved a complex mixture of drug products and related substances (spiramycin), requiring far more constraining analysis conditions. Preliminary studies of the analyses were carried out to develop an optimized protocol. Statistical exploitation of the data for ketoprofen showed that there was no significant influence of the factors "laboratory" and "preparation", under the conditions of the study. On the other hand, in the case of spiramycin, a significant influence of the factors "laboratory" and "preparation" was observed under the conditions of the collaborative study, indicating that the latter factor must be taken into account to establish certified assays. Results of these two studies will help to determine the factors that have a significant influence, depending on the product and the chromatographic method used. By completing the statistical data base, interlaboratory studies will also contribute in the near future to the elaboration of more rigorous protocols for analytical transfers.