A. Taytard

Increased prevalence of asthma and allied diseases among active adolescent tobacco smokers after controlling for passive smoking exposure. A cause for concern

Background Whereas effects on allergic and respiratory health have been established for passive tobacco smoking, contradictory results still exist for active tobacco smoking.

Smoking exposure and allergic sensitization in children according to maternal allergies

BACKGROUND Although the negative impact of environmental tobacco smoke (ETS) on airway diseases in children is well known, the effect of ETS on allergic sensitization is still debated. OBJECTIVE To evaluate how maternal allergies modulate the effect of tobacco exposure on allergic sensitization in childhood. METHODS Of 9000 children in grades 4 and 5 selected in 6 cities in France, 7798 participated in a survey that consisted of an epidemiologic questionnaire, skin prick testing to common allergens, and skin examination for eczema. Tobacco exposure was obtained from parent questionnaires. RESULTS Twenty-five percent of the children had allergic sensitization, 25.2% had eczema, 11.6% had allergic rhinitis, 9.9% had asthma, and 8.3% had exercise-induced asthma. Twenty percent of the children were exposed to tobacco in utero. Maternal exposure had a greater impact than paternal exposure on childrens allergic sensitization. Prenatal exposure was more associated with sensitization than postnatal exposure. Children with maternal allergies and exposure to maternal ETS during pregnancy were at higher risk for sensitization to house dust mite (25.7% vs. 14.0%; odds ratio, 1.95; 95% confidence interval, 1.19-3.18; P = .006). In contrast, sensitization to food allergens was not associated with tobacco exposure. CONCLUSIONS Children exposed to maternal smoking had a higher risk of sensitization to house dust mite, especially when the mothers were allergic.

Unexpected effects of inhaled fluticasone in an HIV patient with asthma.

International guidelines recommend prescription of inhaled corticosteroïds to improve asthma control. Chronic secondary adrenal suppression due to inhaled corticosteroids has been described. We report a case of acute adrenal suppression due to drug interaction between Fluticasone and antiretroviral therapy in a HIV patient. Seeing an increased prevalence of hyperresponsiveness among HIV‐infected men, we conclude that coprescription of Fluticasone and highly active antiretroviral therapy must be carefully controlled.

Désensibilisation aux bêta-lactamines et à l'imipenem-cilastatine chez une patiente affectée d'une infection par le VIH

Abstract The authors report a case of beta-lactamin allergy in a HIV + patient. They performed a desensitization to imipenem-cilastatin using a protocol similar to that used for penicillin-allergic patient.

Acute asphyxia caused by Gerhardt's syndrome associated with asthma.

Vocal cord dysfunction (VCD) has been frequently discussed as confounding the diagnosis of asthma, and it is recommended to examine vocal cord function in cases of difficult asthma. However, there is also strong evidence that asthma may be associated with VCD, sometimes masquerading as exercise-induced asthma. Gerhardts syndrome frequently induces severe acute respiratory distress requiring ventilatory support, and this condition might be mistaken for a severe acute asthma attack. Here, a case of bilateral paralysis of the vocal cords, which was associated with asthma, is described.

082 Does tobacco smoke exposure influence allergie sensitization in children, according to maternal atopy?

Introduction The negative impact of environmental tobacco smoke (ETS) on airway diseases in children is well known, however the effect of ETS on sensitization is still debated. The aim of the study was to evaluate whether if environmental tobacco exposure was associated with higher risk of sensitization, according to maternai atopy. Methods Out of 9,000 children of 4th and 5th grade selected in six cities of France, 7,798 participated into the survey that included an epidemiological questionnaire (ISAAC-II), a medical examina-tion including skin prick test positivity to common allergens, skin examination for eczema, and run test to assess exercise-induced asthma (EIA). Results 25.2% had eczema, 12.9% rhinitis, 9.9% asthma and 25% had atopy. 21.7% had maternai atopy (MA). 21.6% of children were exposed to maternai ETS during pregnancy. In utero ETS was associated with SPT positivity to HDM (22.2% vs 15.4% ; p Conclusions Smoking exposure seems to have a different effect on children sensitization, according maternai atopy and the time widow exposure.

Allergie et désensibilisation aux quinolones

The authors report a case of fluoroquinolone allergy. They performed a desensitization to ofloxacine using a protocol similar to that used for beta-lactamin-allergic patients.