Etude pharmaco-économique des anti GPIIb/IIIa et de la bivalirudine utilisés dans la prise en charge des syndromes coronaires aigus

AIX-MARSEILLE2-BU Pharmacie (130552105) / SudocSudocFranceF

Inference of the pollen penetration and remanence into dwellings using seasonal variation of indoor/outdoor pollen counts

Humans now spent most of their time indoor where they can be exposed to various aerocontaminants, among which pollen. The question of remanence of pollen grains indoor is important because allergic patients could get symptoms from these indoor pollen far away from the pollination period but the temporal relationship between both phenomenons is poorly documented. In this study, we monitored pollen counts both in house dust samples and outdoor pollen traps during the whole pollen season in Southern France and computed the influx and remanence of various pollen species throughout the pollen season. Five families living in the same street volunteered to participate. Monitoring of indoor pollen counts was performed at four occasions through sampling of house dust from the living room. During the same period, outdoor pollen counts were monitored using a Burkard pollen trap. Pollens from 73 taxa were identified on the house dust samples collected indoor. For each pollen type, indoor pollen count dynamics were consistent with the observed pollen counts in Burkard traps over the whole pollination period. Two groups of pollen types can be defined on the basis of these results: the first group includes Platanus, Quercus and Cupressaceae which exhibit high remanence and a low penetration, and the second group contains species with high penetration but various remanence. Date of sampling was the main factor affecting penetration coefficients very low in winter, to moderate in spring and huge in summer. Pollen type, housing and sampling time period have bearing on penetration and remanence of pollen grains indoo

Survenue de symptômes tardifs après un test de provocation par la méthacholine

International audienceThere are few prospective studies available on the development of delayed symptoms following challenge tests with methacholine (MCT) at the currently recommended doses. The objective of this study was to describe the nature and frequency of respiratory symptoms suggestive of bronchospasm developing within 24 hours after a MCT. The study was offered to adult patients who underwent MCT seen consecutively between June and October 2015. Following the test, a questionnaire adapted from the GINA asthma control questionnaire bearing on diurnal and nocturnal symptoms (cough, dyspnoea, wheeze and tightness), was delivered to the patient and the replies collected by telephone 24 hours later. Of the 101 patients included (initial FEV1 2.82 ± 0.79 L), 46 (46 %) were MCT+ and 55 (54 %) MCT−. Among the MCT−, 4 (7 %) presented with immediate symptoms (S+) and 4 (7 %) with delayed symptoms. Among the MCT+ patients, 36 (78 %) presented with immediate symptoms (P < 0.001 compared with the MCT− patients), and 39 (85 %) with delayed symptoms (P < 0.001 compared with the MCT− patients). Delayed symptoms developed with a mean of 5 h 30 after the provocation test. Immediate and delayed symptoms were more frequent in subjects having significant non-specific bronchial hyper-reactivity. Informing patients of the risk of developing delayed symptoms seems useful and allows optimization of their management after a MCT.Peu d’études prospectives sur la survenue de symptômes tardifs (ST) aux doses actuellement recommandées pour les tests de provocation par la méthacholine (TPM) sont disponibles. L’objectif a été de décrire la nature et la fréquence des symptômes respiratoires évocateurs d’un bronchospasme 24 heures après un TPM. L’étude était proposée aux patients adultes adressés consécutivement de juin à octobre 2015 et ayant effectué un TPM. En post-test, un questionnaire, adapté de celui du contrôle de l’asthme du GINA visant au recueil des symptômes diurnes et nocturnes (toux, dyspnée, sibilant, oppression) était remis et les réponses recueillies par téléphone 24 heures après. Sur 101 patients inclus (VEMS initial 2,82 ± 0,79 L), 46 (46 %) étaient TPM+ et 55 (54 %) TPM−. Parmi les TPM−, 4 (7 %) ont présenté des symptômes immédiats (S+) et 4 (7 %) ont présenté des symptômes tardifs (ST+). Parmi les patients TPM+, 36 (78 %) ont présenté des symptômes immédiats (p < 0,001 contre les sujets TPM−) et 39 (85 %) ont présenté des symptômes tardifs (p < 0,001 contre les sujets TPM−). Les symptômes tardifs survenaient en moyenne 5 h 30 après le test de provocation. Les symptômes immédiats et tardifs étaient plus fréquents chez les sujets ayant une hyperréactivité bronchique non spécifique importante. Informer les patients sur le risque de survenue de symptômes respiratoires tardifs apparaît utile et permettra d’optimiser leur prise en charge après un TPM