màj : 23/07/98 |
Asthmology :
from basic science to management Monday morning September 1st, 1997
... |
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màj : 23/07/98 |
Asthmology :
from basic science to management Monday morning September 1st, 1997
... |
||||||||||||||||||||||||||||
In VITRO DIAGNOSIS SGO Johansson
Objective of the course :
1. Speificity and sensitivity of immunoassays for IgE antibody
2. Correlation to in vivo testing
3. Position in allergy diagnosis workings
| 1- In order to evaluate the responsibility of an allergen in the severity of asthma, what is the best method ? | Before course | After course | Expert |  |
| a- quantify the level of specific IgE | 35% | 22% | 31% | |
| b- evaluate the area of the skin prick test | 26% | 33% | b=yes | 16% |
| c- check histamine release in vitro | 15% | 14% | 9% | |
| d- perform an inhalation challenge test | 32% | 31% | 22% | |
| e- check any clinical exacerbation in relation to allergen exposure | 41% | 33% | e=yes | 38% |
| 2- Total IgE level can be high in what of the following diseases: | Before course | After course | Expert | |
| a- Intrinsic asthma | 29% | 42% | a=yes | 38% |
| b- Extrinsic asthma | 97% | 94% | b=yes | 84% |
| c- Smoking habit | 29% | 36% | c=yes | 19% |
| d- Hodgking disease | 65% | 86% | d=yes | 53% |
| e- Lung cancer | 6% | 19% | 3% |
| 3- High affinity IgE receptors have been described on the following cells : | Before course | After course | Expert | |
| a- bronchial epithelial cells | 12% | 0% | a=yes | 0% |
| b- eosinophils | 9% | 34% | b=yes | 15% |
| c- mast cells | 59% | 69% | c=yes | 56% |
| d- macrophages | 6% | 14% | 0% | |
| e- all of them | 47% | 40% | 35% |
FROM BRONCHOSPASM TO REMODELLING J. Bousquet
Objective of the course : Asthma is a chronic inflammatory disease of the airways involving the activation of many different cell types. A process of healing and repair follows on from inflammation and this leads to a variable degree of remodelling of the airways. The treatement of asthma should take into account that the disease is associated with short-lived symptoms that can be prevented or reversed by bronchodilators, exacerbations which can be treated or reversed by anti-inflammatory drugs and remodelling of the airways, for which no definite treatement has been yet validated?
| 1- Chronic inflammation | Before course | After course | Expert | |
| 1 - Is associated with nonspecific bronchial hyperreactivity | 55% | 65% | 38% | |
| 2 - May be induced by allergen exposure | 52% | 70% | 41% | |
| 3 - Is present in asthma and in chronic bronchitis | 64% | 73% | 3=yes | 47% |
| 4 - Eosinophilic inflammation is only present in asthma | 9% | 14% | 4=yes | 13% |
| 5 - All the above are correct | 39% | 38% | 38% |
| 2- Bronchospasm | Before course | After course | Expert | |
| 1 - Is the only cause of bronchial osbstruction | 0% | 0% | 1=yes | 0% |
| 2 - is the major cause of death in asthma | 48% | 62% | 2=yes | 31% |
| 3 - Is due to the release of vaso-active mediators | 67% | 70% | 3=yes | 63% |
| 4 - Is associated with mucus secretion in asthma exacerbations | 70% | 68% | 63% | |
| 5 - All the above are correct. | 12% | 14% | 19% |
| 3- Remodeling of the airways | Before course | After course | Expert | |
| 1 - Has been demonstrated in asthma | 28% | 36% | 21% | |
| 2 - Is associated with subepithelial fibrosis | 28% | 28% | 27% | |
| 3 - Is associated with collagen deposition beneath the basement menbrane | 22% | 22% | 27% | |
| 4 - Is associated with progressive impairment of airflow | 31% | 28% | 24% | |
| 5 - All the above are correct. | 66% | 86% | 5=yes | 79% |
SMOOTH MUSCLE AND BRONCHOSPASM J. Mercier
Objective of the course :
1. to understand the mechanisms of smootth muscle contractility
involved in bronchospasm.
2. to understand how sensitization alters the contractility of
airway smooth muscle.
| 1- Sensitization | Before course | After course | Expert | |
| 1 - Has no effect on the shortening velocity of smooth muscle | 14% | 3% | 0% | |
| 2 - Reduces the photosphorylation of the myosin light chains | 38% | 33% | 35% | |
| 3 - Afters mainly the early phase of contraction | 52% | 72% | 3=yes | 53% |
| 4 - Facilitates smooths muscle contraction by increasing sodium influx | 48% | 28% | 4=yes | 12% |
| 2- In airway smooth muscle : | Before course | After course | Expert | |
| 1 - The velocity of shortening is constant during contraction | 4% | 11% | 15% | |
| 2 - The control of contraction depends on troponin, as in skeletal muscle | 15% | 14% | 15% | |
| 3 - Mediators released by inflammatory cells may activate the contraction | 100% | 97% | 3=yes | 82% |
| 4 - Sympathetic innervation is very poor | 35% | 25% | 15% | |
| 5 - There are many muscarinic receptors | 35% | 50% | 35% |
| 3- In the airways : | Before course | After course | Expert | |
| 1 - 60-75% of smooth muscle shortening takes place during the first third of the contraction | 34% | 61% | 1=yes | 56% |
| 2 - The control of smooth muscle contraction depends on myosin phophorylation | 52% | 61% | 2=yes | 63% |
| 3 - Histamine release and its linkage on the H1 receptor may activate the smooth muscle contraction | 45% | 64% | 3=yes | 41% |
| 4 - The activation of b adrenoceptors induces strong relaxation, which in turn decreases the airways resistance | 69% | 53% | 4=yes | 44% |
| 5 - The muscarinic receptors are mainly located in the smooth muscle of small caliber airways. | 24% | 28% | 13% |
| 4- In sensitized smooth muscle : | Before course | After course | Expert | |
| 1 - The velocity of shortening during the early phase of contraction is 40% less than in non-sensitized smooth muscle | 6% | 27% | 13% | |
| 2 - The increased in myosin light chain phosphorylation is involved in the increased ATPase activity | 76% | 77% | 2=yes | 80% |
| 3 - The quantity of type I myosin heavy chains is greater than in non-sensitized smooth muscle | 24% | 33% | 27% | |
| 4 - The total concentration of myosin light chain kinase is increased | 6% | 47% | 4=yes | 30% |
REMODELLING M. Vignola
Objective of the course :
1. To evaluate whether asthma is characterized by airways
remodelling
2. To evaluate the biological mechanisms underlying airways
remodelling in asthma
3. To evaluate the clinical, functional and radiographic
consequences of airways remodelling in asthma.
| 1- Do you think that the following growth factors are involved in bronchial asthma ? | Before course | After course | Expert | |
| a- TGFb | 44% | 69% | 52% | |
| b- GMCSF | 41% | 67% | 64% | |
| c- LTD4 | 9% | 6% | 15% | |
| d- Il-10 | 6% | 11% | 9% | |
| e- all of them | 56% | 25% | 5=yes | 21% |
| 2- Among the following features, what are those which indicate any evidence of airways remodeling ? | Before course | After course | Expert | |
| a- basal membrane thickening | 24% | 50% | 1=yes | 42% |
| b- presence of macrophages within the airways | 3% | 17% | 16% | |
| c- presence of fibroblasts within the airways | 32% | 25% | 29% | |
| d- desquamation of the bronchial epithelial cells | 15% | 19% | 6% | |
| e- all of them | 56% | 61% | 42% |
| 3- From a clinical point of view, how is it possible to assess airways remodeling ? | Before course | After course | Expert | |
| a- FEV1 decline | 53% | 72% | a=yes | 71% |
| b- High resolution tomography | 19% | 36% | b=yes | 32% |
| c- b 2-induced reversibility of FEV1 | 34% | 28% | c=yes | 26% |
| d- Presence of hyaluronic acid in induced sputum | 6% | 8% | d=yes | 0% |
| e- Bronchial biopsy | 59% | 56% | e=yes | 39% |
An expert system for Asthma management Ph Godard
Objective of the course :
1. To know what an expert system is
2. To understand how it can be used in daily clinical practice.
3. To use it as an interactive device for a better understanding
of asthma management.
| 1- Could you define what is an expert system ? | Expert | |
| a- a commercial software | 6% | |
| b- an assistance for diagnosis | 35% | |
| c- a kind of computer | 3% | |
| d- a method for clinical research | 19% | |
| e- a software based on artificial intelligence | e=yes | 71% |
| 2- Do you think that expert system exist for: | Expert | |
| a- the diagnosis of pneumonia | 0% | |
| b- the evaluation of pulmonary function tests | 9% | |
| c- the follow-up of asthmatic patients | 73% | |
| d- the diagnosis of coin lesios | 3% | |
| e- all of them | e=yes | 24% |
| 3- If an expert system is available for the management of asthma, are you interested to have it | Expert | |
| a- to evaluate it ( kind of b test) | 0% | |
| b- to use it in daily practice, either for research or clinical practice | 73% | |
| c- no | 3% | |
| d- to use it for teaching | 30% | |
| e- to understand how it works | 30% |
.
EAACICongrès Conçue et réalisée
par: Michel Godard (at) Top
Date de création: 1997- Dernière mise à jour: 23/07/98
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