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M Grosclaude

Publications and source records attributed to M Grosclaude.

At least 19 recordsLinked to original sources
PubMed2003

A double-blind placebo-controlled evaluation of sublingual immunotherapy with a standardized ragweed extract in patients with seasonal rhinitis. Evidence for a dose-response relationship.

BACKGROUND: There is a growing consensus on the benefits of sublingual-swallow immunotherapy in the treatment of allergic diseases. METHODS: This randomized, double-blind placebo-controlled study was undertaken to assess the efficacy and safety of sublingual immunotherapy with standardized ragweed pollen extract tablets, in patients with an allergic rhinitis. A total of 110 outpatients were randomized (immunotherapy [I]: 55; placebo [P]: 55), of whom 99 were analyzable for efficacy (I: 48; P: 51) and 106 analyzable for safety (I: 53; P: 53). After a 28-day progression phase, the patients received a maintenance treatment during 6.5 months. Efficacy variables included a global assessment of efficacy (patient/ investigator), symptoms and medication scores as well as the frequency of asthma attacks. RESULTS: In the active treatment group, 43 patients completed the study, versus 49 on placebo. During the whole period of pollination, the difference favoring immunotherapy was highly significant for the global assessment by the patient (p = 0.004) and by the investigator (p = 0.005). Adverse reactions were reported more often in the active treatment but mild or moderate, and they abated after dose adjustment. A subgroup analysis of those patients receiving the highest dose of immunotherapy (3 tablets 3 times a week) showed a highly significant response for rhinitis and conjunctivitis total scores by comparison to lower dosages. CONCLUSION: This study confirms the efficacy and safety of sublingual immunotherapy and strongly suggests a dose-response relationship.

Administration, Sublingual↗
PubMed2003

[A fixed combination of fluticasone and salmeterol permits better control of asthma than a beclomethasone dipropionate and montelukast combination].

It is now recommended to add an inhaled long-acting beta 2-agonist, or as an alternative, to add a leukotriene-antagonist, in patients whose asthma is insufficiently controlled with an inhaled corticosteroid alone. A randomised, multicentre, open-label, parallel-group study was carried out in 246 patients of at least 15 years, whose asthma was not adequately controlled with a medium dose of an inhaled corticosteroid. They received either fluticasone/salmeterol combination 250/50 micrograms one inhalation twice daily or CFC beclomethasone dipropionate 250 micrograms two puffs twice daily plus montelukast 10 mg in the evening for 12 weeks. The mean morning PEFR (main criterion) was significantly (p = 0.017) more improved with fluticasone/salmeterol (+44.2 L/min) than with beclomethasone dipropionate plus montelukast (+31.0 L/min). Other outcomes showed significantly better improvements (p 0.022 Pound) with fluticasone/salmeterol than with beclomethasone plus montelukast. The two treatments were well tolerated. Fluticasone/salmeterol provided a better asthma control than beclomethasone dipropionate plus montelukast in patients insufficiently controlled with an inhaled corticosteroid alone.

Acetates↗
PubMed2002

Effects of budesonide and fluticasone propionate in a placebo-controlled study on symptoms and quality of life in seasonal allergic rhinitis.

BACKGROUND: Intranasal glucocorticosteroids are effective in seasonal allergic rhinitis. This study compared the efficacy of budesonide (Rhinocort Turbuhaler) and fluticasone propionate (Flixonase) in this respect. METHODS: Patients (n = 280) were randomized to receive budesonide, 140 microg (delivered dose) once daily, fluticasone, 200 microg once daily, or matching placebos for 5 weeks. The primary efficacy variable was the change in combined nasal symptom (nasal blockage, runny nose, sneezing) scores. Quality of life was measured in 121 patients by means of the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and the Short-form Health Survey (SF-36). RESULTS: Both steroids significantly reduced combined nasal symptoms, compared with placebo. There was no significant difference between the two treatments. Substantial or total symptom control was achieved in 89.9% of the budesonide-treated patients, compared with 88.7% with fluticasone and 42.7% with placebo. Four of the five domains of the RQLQ were significantly improved with budesonide, whereas with fluticasone only two domains were improved. Budesonide significantly improved scores in five out of eight domains of the SF-36, whereas no domains were improved with fluticasone. CONCLUSION: There was no significant difference in efficacy between budesonide and fluticasone in this study. However, greater improvements in quality of life were seen with budesonide than with fluticasone.

Adolescent↗
PubMed2002

Safety of various dosage regimens during induction of sublingual immunotherapy. A preliminary study.

BACKGROUND: Sublingual immunotherapy (SLIT) has been demonstrated to be a viable alternative to injection immunotherapy. Administration of high doses of allergens to ensure efficacy has been shown to be well tolerated. The aim of the present study was the first step to address the issue of fast-induction regimens using various induction SLIT regimens in paediatric and adult patients. METHODS: Sixty-four patients (age range 5-46 years) with grass pollen rhinoconjunctivitis were enrolled in an 8-month double-blind, placebo-controlled trial of SLIT. Sixty-three patients were randomized to four groups and evaluated at the end of the study. One group received placebo (n = 16) and the other three groups (n = 47) received five grass pollen extracts according to three different induction regimens: regimen 1 starting with 3 IR tablets (n = 15), regimen 2 starting with 10 IR (n = 16) and regimen 3 starting with 30 IR (n = 16). The maintenance phase was made with sublingual-swallow drops at the same concentration of 300 IR/ml for all the patients. Adverse events were recorded on diary cards. RESULTS: During induction phase, 25/47 patients in the SLIT groups had adverse reactions in comparison to 2/16 patients in the placebo group (p < 0.05). The rate of adverse reactions was 33.3% (11.8-61.6) (95% CI) for regimen 1, 31.3% (11.0-58.7) for regimen 2, 43.8% (19.8-70.1) for regimen 3 and 12.5% (1.6-38.3) for placebo. Fifty-seven reactions were local reactions involving the oral region (54 SLIT, 3 placebo) and 13 were systemic reactions (all in the SLIT groups). 11/13 reactions were mild (gastrointestinal disorders, rhinoconjunctivitis), 1/13 consisted of moderate asthma and 1/13 consisted of severe abdominal pain. No urticaria, angioedema or life-threatening events were observed. CONCLUSIONS: These preliminary data showed that various induction regimens for SLIT are generally well tolerated and could allow a fast build-up phase of SLIT.

Administration, Sublingual↗
PubMed1997

Cetirizine and pseudoephedrine retard, given alone or in combination, in patients with seasonal allergic rhinitis.

We compared the efficacy and safety of cetirizine (5 mg), pseudoephedrine retard (120 mg), and the combination of cetirizine (5 mg) with pseudoephedrine retard (120 mg), each given twice daily for two weeks to subjects with pollen-associated allergic rhinitis. The study was multicentre and of randomized, double-blind, parallel-group design. Five rhinitis symptoms were rated according to severity on a scale of 0 - 3, daily by patients and at each clinic visit by investigators. A total of 687 patients, aged 9 - 66 years (mean: 32 years) was randomised to treatment (cetirizine: 231; pseudoephedrine: 226; combination: 230). On entry, the three groups were comparable in relevant respects. The primary outcome measure was based on the five symptoms assessed by the patients over the 2-week treatment period. The combination was more effective, providing at least 20% more "comfortable days" (symptoms absent or at most mild) than cetirizine or pseudoephedrine given alone (median values: 53.3%, 30.8%, and 33.3%, respectively; p < 0.001). For nasal obstruction, the combination (mean score: 1.19) was more effective than cetirizine (mean score: 1.43; p = 0.0005), but there was little difference between the combination and pseudoephedrine (mean score: 1.22; not significant). Sneezing, rhinorrhoea, nasal and ocular pruritus were better controlled by combination (mean 4-symptom score: 0.77) than by pseudoephedrine alone (mean 4-symptom score: 1.12; p < 0.001) and also better than by cetirizine alone (mean 4-symptom score: 0.93; p < 0.001). No unexpected adverse reactions were observed. A combination of cetirizine and pseudoephedrine retard is well tolerated and superior to each given alone for moderate to severe allergic seasonal rhinitis, especially when nasal obstruction is a predominant symptom.

Adolescent↗
PubMed1995

Leukotriene B4 production by blood neutrophils in allergic rhinitis--effects of cetirizine.

BACKGROUND: Mucosal inflammatory processes in late phase of allergic diseases involve cytokine production, cell adhesion molecule overexpression and release of inflammatory mediators with chemotactic activity, such as leukotriene B4 (LTB4). We had previously observed increased production of LTB4 by neutrophils in patients with allergic rhinitis and discussed the role of granulocyte macrophage-colony stimulating factor (GM-CSF) priming. Some antihistaminic compounds were shown to diminish the production of leukotrienes by neutrophils. OBJECTIVES: In a first step, we evaluated in ex vivo and in vitro studies, the effects of cetirizine on LTB4 production by blood neutrophils from allergic and healthy subjects. In a second step, we studied the in vitro effect of cetirizine on LTB4 production by neutrophils from healthy subjects during GM-CSF priming of these cells. METHODS: Neutrophils from both populations were purified from venous blood and LTB4 production was measured using high performance liquid cromatography (HPLC) method. RESULTS: In ex vivo studies, cetirizine treatment induced a decreased LTB4 production by neutrophils in allergic rhinitis. This effect of decreased LTB4 production was reproduced in vitro with 10(-8)-10(-6)M cetirizine. Nevertheless, this anti-H1 compound had no effect on neutrophil priming with GM-CSF. CONCLUSION: As LTB4 is an important chemotactic factor, Cetirizine could act on inflammatory cell recruitment by inhibiting LTB4 production by neutrophils.

Adult↗
PubMed1993

[Is awakening only a dream?].

"It's a dream ..." is the frequent definition of Intensive Care and Coma Experience proposed by patients. Does this word, so insistent and often heard in our research and those of many colleagues, correspond to the objective terms (onirism, confusion, delirium) qualifying clinical awakening or coma (as patients do assert it)? Or doesn't it rather point to a specific status of an other psychical experience? That is the author's hypothesis here developed, through specific aspects of awakening state and therapeutical implications.

Coma↗
PubMed1992

Leukotriene B4 level in stimulated blood neutrophils and alveolar macrophages from healthy and asthmatic subjects. Effect of beta-2 agonist therapy.

Leukotriene B4 levels were measured after stimulation by calcium ionophore A23187: (i) in peripheral, neutrophils (PMN) from allergic asthmatics, rhinitis and healthy subjects; (ii) in macrophages collected by bronchoalveolar lavage. LTB4 levels in PMNs were significantly higher in non-treated allergic asthmatics and non-treated subjects with rhinitis compared to controls. Beta-2 agonist-treated asthmatics showed a significantly decreased LTB4 production which was not different from those of controls. In vitro, LTB4 production decreased significantly after PMN incubation with Salbutamol (10(-6) mol l-1). LTB4 produced by AM collected by BAL was measured in non-treated (n = 5) and treated (n = 11) asthmatics with inhaled beta-2 agonist. AM collected from all controls and non-treated asthmatics produced LTB4. By contrast, no production of LTB4 was observed in the treated group. LTB4 production decreased when normal AM were incubated in vitro with Salbutamol (10(-8) mol l-1). These results suggest that biochemical differences occur in PMN and macrophages from subjects treated with beta-2 agonist, presumably in changing the 5-lipoxygenase pathway.

Adult↗
PubMed1991

Leukotriene B4 levels from stimulated neutrophils from healthy and allergic subjects: effect of platelets and exogenous arachidonic acid.

Leukotriene B4 (LTB4) levels were measured in peripheral blood neutrophils from allergic and healthy donors after stimulation by calcium ionophore A 23187. This level was higher in neutrophils from allergic subjects than in neutrophils from healthy subjects in the presence as well as in the absence of exogenous arachidonic acid. Platelets from allergics increased LTB4 levels from neutrophils from allergics but not levels in those from healthy donors. Moreover, platelets from healthy subjects reduced LTB4 in neutrophils from both groups. These results suggest that biochemical differences exist in neutrophils and platelets from allergics which contribute to changes in arachidonic acid metabolism via the 5-lipoxygenase pathway. In addition, they support the concept that platelets may play an important role in the regulation of neutrophil LTB4 levels, possibly by affecting the 5-lipoxygenase activity during the course of allergic inflammatory reactions.

Adolescent↗
PubMed1990

[Memory of intensive care in children. Onset of research, first results of a survey].

This document presents results about research by children (3 to 10 years old) who passed in Intensive care Unit, 1 to 7 years before. This research concerns subjective experience memories, and follows from the work we drive for some years by grown-up people which showed how those experience were near from states, psychical contents, hypothesis and constructions about early child experiences that psychological and psychoanalysis literature do describe too, but also difficult or impossible to explore. This new research props up our first hypothesis with new, surprising, observations: mnesic traces, psychological, material are the same by children or grown-up. Some clinical, theoretical and therapeutical aspects may be surrounded.

Child↗
PubMed1990

[Post-surgical resuscitation facts].

Intensive care fact, especially patients subjective experiences, can be approached as a specific object, a particular stakes and states model, beyond varied peculiarities of clinical fields which are concerned (head traumas, grafts etc..). Intensive care psychical aspects concern psychical trauma ("intensive care hole"); archaic, original, psychotic and distress experiences by grown-up and infants; persecution; unexpected memory; those who "get over far from". They have therapeutic implications with patients and with nursing team.

Adolescent↗
PubMed1990

[Consequences on the nursing team of the information of spinal cord injured patients].

For spine-wounded people, an early information about lesions forecast is as necessary as difficult. At the beginning, patients have'nt still realized their state seriousness, and diagnosis stays uncertain. This retrospective work tries to explore how early information is remembered and the consequences about hospital experience, in intensive care unit and in rehabilitation. It shows that early information does'nt modify this experience, but that relations between nurses and patients become better.

Adaptation, Psychological↗
PubMed1989

[Challenge provocation tests and non-specific bronchial hyperactivity in occupational asthma].

The aim of the study is to determine the interest of realistic challenge (nasal and bronchial) in occupational respiratory symptoms appearing during work. 75 patients were included in the study. The protocol included prick tests, measuring total and specific IgE, spirometry and metacholine test to assess bronchial hyperreactivity (BHR), realistic challenge by rhinomanometry and plethysmography measuring NR (nasal resistance) and RWA (Airway resistance). The test was considered positive if the RWA and/or NR were increased by 100%. 68% of the tests were positives in rhinomanometry and/or plethysmography. There is an BHR in 68% cases of occupational asthma. There is a quite strong correlation between the positivity of the realistic tests and the existence of a non specific BHR.

Asthma↗
PubMed1989

[Occupational asthma and rhinitis: challenge tests and nasal hyperactivity: present practice and future perspectives].

Nasal hypersensitivity is defined by an exaggerated response to certain specific stimuli such as a work-related agent, non-specific stimuli (irritant effect), or to allergic or inflammation mediators. The study of nasal hypersensitivity always involves provocation tests with other practical assays. In the occupational context, the provocation test most routinely used are "challenge tests", carried out with suspected substances provided by the patient, and non-specific tests with mediators (histamine and carbachol). Three complementary techniques-rhinomanometry, intranasal expiratory flow, and nasal lavage with cell and mediator studies, aim at three objectives. These are principally diagnostic and physiopathological, but are also possibly therapeutic. The authors describe in detail the technique of passive anterior rhinomanometry, nasal challenge tests and cholinergic challenges leading to a better understanding of non-specific nasal hypersensitivity. Future prospects concern the establishment of dose-response reactivity curves, exploration of the intranasal expiratory flows and research into nasal lavages with the study of cells and mediators released.

Asthma↗
PubMed1989

[Early informing of patients with spinal cord injuries].

Early information to patients on the prognosis of acute spinal injuries is an important and uneasy task. This retrospective study was undertaken to assess the consequences of this information. It appears that early information involves easier and more confident relationships between patient, nurses and medical staff in the ICU. This early information, despite its difficulty, seems beneficial.

Adolescent↗