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Biomedical subjects

J D Dewitte

Publications and source records attributed to J D Dewitte.

At least 19 recordsLinked to original sources
PubMed1995

[Chronic hyperventilation syndrome].

Hyperventilation syndrome is a frequent, but poorly understood clinical entity. The clinical expression is a rich combination of respiratory, cardiac and neurological signs which can simulate various organic diseases. Hypocapnia remains the primum movens for most authors although the relationship with psychiatric situations, in particular in anxious patients, is increasingly emphasized. The diagnosis is currently based on the elimination of diseases associated with hyperventilation, then on Nijmegen's questionnaire and is confirmed by the reproduction of the same clinical picture in a voluntary hyperventilation test. Respiratory function tests offer little information. Treatment is based on combining rehabilitation therapy focused on the diaphragm and on relaxation. Specialized care may be needed in psychiatric patients.

Chronic Disease↗
PubMed1994

Respiratory symptoms and bronchial reactivity among pig and dairy farmers.

OBJECTIVES: This study assessed the prevalence of respiratory manifestations among French pig and dairy farmers and determined the relationship between bronchial reactivity and respiratory manifestations. METHODS: The pig farmers included 102 men working more than half-time inside swine confinement buildings. There were 51 male dairy farmers and 81 male referents. The demographic characteristics of the three groups were similar except for more smokers among the referents. Each subject completed a standardized questionnaire. Pulmonary function tests were performed before and after a methacholine challenge (cumulative doses 80, 240, and 560 micrograms). Airborne dust, ammonia, and carbon dioxide were measured inside 28 swine confinement buildings. RESULTS: The pig farmers were exposed to a total dust level of 2.41 mg.m-3. The respirable particle concentration was low. The pig and dairy farmers had a significantly higher prevalence of cough and morning phlegm than the referents. Before the methacholine challenge, the dairy farmers had nonsignificantly lower mean lung function values than the other groups. Among the subjects with no history of asthma, nonspecific bronchial hyperreactivity was significantly higher among the pig and dairy farmers than among the referents. There was a fall in the forced expiratory volume in 1 s (FEV 1.0) that was greater than 10% in 6.7% of the referents, 17.9% of the swine workers, and 35.6% of the dairy farmers. This result was unchanged after adjustment for the initial FEV1.0. CONCLUSIONS: The prevalence of respiratory symptoms was significantly higher among the pig farmers without base-line lung function impairment. However, both the pig and the dairy farmers had increased bronchial reactivity.

Adult↗
PubMed1994

Medicolegal and compensation aspects of occupational asthma.

The medicolegal aspects (primary prevention, secondary prevention or surveillance) and the system of compensation (tertiary prevention) for occupational asthma are reviewed in this article. Due to the significant medical, medicolegal, social and financial consequences, it is of the utmost importance that the diagnosis of occupational asthma be proved by objective means, whenever feasible. Compensation for temporary and permanent disability/impairment should be offered to workers. Attempts to retain subjects rapidly and efficiently are preferable, as occupational asthma generally affects young workers. The evaluation of permanent asthma and the awarding of relative permanent disability compensation should be effected 2 yrs after exposure to the causative agent has ended, as asthma generally persists even after exposure to the causative agent ceases. A tabulated review of prevailing medicolegal compensation systems in various countries is presented. Data on an evaluative assessment of the Quebec system of compensation are included.

Asthma↗
PubMed1993

Quality of life of subjects with occupational asthma.

BACKGROUND: The aim of the study was to assess the quality of life in subjects with occupational asthma after removal from exposure to the offending agent by comparison with a group of subjects paired for clinical and functional indices in order to show the separation between the two groups of subjects with a hypothesized different quality of life and relate the impairment in quality of life to anthropometric, clinical, and functional variables. METHODS: A previously described asthma quality of life questionnaire (Juniper EF, et al. Thorax 1992;47:76-83) was administered to two groups of subjects in a prospective manner. Information on the clinical and functional severity of asthma was obtained from each subject. Two groups of subjects were assessed: group 1, 134 subjects with occupational asthma who were seen more than 2 years after the diagnosis was confirmed, and group 2, 91 subjects who were seen in specialized asthma clinics of tertiary care hospitals for treatment of nonoccupational asthma and matched with 91 of the 134 subjects with occupational asthma from group 1 according to need for medication and (when available), baseline forced expiratory volume in 1 second (FEV1), and level of bronchial responsiveness. RESULTS: A statistically significant difference was seen in the four domains (asthma symptoms, limitation of activities, emotional dysfunction, environmental stimuli) and in the total score of the quality of life questionnaire between the two groups of matched subjects; the mean difference in the total score was 0.6 on a scale of 1 (no limitation or none of the time) to 7 (severe limitation or all the time). A weak but statistically significant correlation between the total score and several indices (FEV1, bronchial responsiveness and asthma severity) was generally obtained. CONCLUSION: The quality of life of subjects with occupational asthma is slightly less satisfactory than that of subjects paired for clinical and functional indices, although the magnitude of the difference is small; and quality of life is weakly correlated with clinical and functional indices.

Adult↗
PubMed1993

Mesenchymal cystic hamartoma of the lung.

We report the case of an asymptomatic 51-year-old man, presenting with chest X-ray abnormalities consisting in multiple pulmonary nodules; the diagnosis of mesenchymal cystic hamartoma of the lung was made by an open lung biopsy, revealing both nodules of mesenchymal cells and cysts with a lining of normal or metaplastic epithelium. Clinical and pathological characteristics of this rare entity are reviewed.

Cysts↗
PubMed1993

[The Quebec system of indemnification for occupational asthma. Description, efficacy, and costs].

This study describes the Quebec system of compensation for occupational asthma, assessing the functional and social outcome of claimants and estimating the efficiency and cost. Information was obtained on the clinical, functional and social outcome as well as the estimated costs for 134/211 subjects (participation rate of 64%), who received compensation between 1986 and 1988. At the time of assessment (2 years and more after the diagnosis), 93% of participants still demonstrated significant bronchial hyperresponsiveness and 84% required anti-asthma medication. None of the participants remained exposed to the offending agent: 67% were working for the same or another employer, 16% were retired, 8% were retraining for a new job and 8% were still unemployed. Quality of life was mildly affected, more so than for a control group of subjects. The mean interval between the time claims were addressed and the first medicolegal decision was 8.1 months. The mean total cost (including temporary and permanent disability indemnities, medical and technical costs) was $CAN 49,200 (minimum and maximum values of $2,100 and $330,900). We conclude that for subjects with occupational asthma in Quebec: 1) the mean interval for a medicolegal decision to be made is eight months: 2) a minority is still unemployed two to four years after being assessed; 3) the quality of life is more affected than in a control group; 4) the mean cost is close to $CAN 50,000.

Activities of Daily Living↗
PubMed1989

[Value of ipratropium (Atrovent) in the treatment of chronic obstructive lung diseases in myasthenic patients treated with anticholinesterase agents. Apropos of a case].

We report a case of myasthenia gravis occurring in a 70-year old patient with old chronic bronchitis. Anticholinesterase therapy led to an increase in respiratory symptoms, but relief was obtained with inhaled ipratropium. The activity of this drug was confirmed by spirography. This clinical finding is compared with similar data found in the literature.

Aged↗
PubMed1989

[Mucoviscidosis: current diagnostic possibilities. Applications in perinatology].

The gene of cystic fibrosis is localised on the long arm of chromosome 7. DNA probes placed close to the gene enable a study of restriction polymorphism to follow the transmission of the gene in index families. It is now possible to counsel those families, who already have an affected child, with an early antenatal diagnosis at ten weeks after the last period. In our personal experience, based on a study of the genotype of 48 families, 70% were informative when they were studied by two probes corresponding to the local pJ3.11 and met. When the latter probes Km19-XV2c were studied concurrently useful information was achieved in 96%. DNA analysis non enables the detection of the chromosome carrying the deleterious gene in practically every family where there is a child suffering from the disease.

Chromosomes, Human, Pair 7↗
PubMed1988

[Malignant endobronchial melanoma, apparently primary. Apropos of a case].

This case concerns a 48 year-old patient whose endobronchial malignant melanoma was discovered on the occasion of a haemoptysis. A search for primary localization remained negative, suggesting a primary endobronchial lesion. Only a few cases of endobronchial malignant melanoma have been published, and several assumptions can be raised to explain the possibility of their primary origin.

Bronchial Neoplasms↗
PubMed1987

Improved HPLC determination of urinary neopterin.

In order to improve the urinary neopterin measurement, the reversed-phase HPLC method has been reevaluated. The parameters which influence the chromatographic behavior of 12 pteridines were studied: nature of buffer, pH, ionic strength, addition of organic modifier to the mobile phase. Accordingly, an isocratic HPLC method is described which offers a good compromise between specificity and analysis time. This method is well-suited to automation in routine clinical laboratory use. Using this HPLC method, urinary neopterin related to creatinine was determined in lung diseases (neoplasm, sarcoïdosis and bronchial asthma) and in kidney allografts. This method was shown to be useful in the diagnosis and in the monitoring of treatment of rejection episodes.

Asthma↗
PubMed1986

Predictive value of T-cell subset derangements in lung cancer.

The proportions of T-lymphocytes, T-lymphocyte subsets, NK cells, DR determinant and interleukin-2 receptor-bearing T-lymphocytes were enumerated in 39 patients with lung cancer prior to any chemotherapy. T-lymphocytes, suppressor/cytotoxic T-cells and interleukin-2 receptor-bearing T-cells were found to be significantly higher in patients responding than in those not responding to chemotherapy. Such mononuclear cell subset analysis by monoclonal antibodies might be additional information to consider before undertaking treatment.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

[Lack of T lymphocytes expressing CD4 antigen during pollenosis].

T lymphocyte subpopulations by monoclonal antibodies have been studied in 17 atopic asthmatics and 17 normal subjects age and sex matched, we found a significant decrease of total T lymphocytes with significant decrease of CD4 antigen bearing cells in the patients, the pollenogenic asthmatics being responsible for this difference with the controls. We did not find any study of the literature evaluating T lymphocyte subpopulations in atopic patients with regard to allergen type. The pathogenic hypothesis are discussed.

Adolescent↗
PubMed1985

Immunological effect of silica dust analyzed by monoclonal antibodies.

We found a significant decrease of OKT8 + ve cells in silicosis patients (18.1%), but also in unaffected exposed workers (19.0%), when compared with sex- and age-matched controls (22.8%). The proportion of OKT8 + ve cells was significantly lower in subjects with antinuclear antibodies (15.7%) and in those with IgG-rheumatoid factors (16.3%).

Adult↗