Congress Sponsors Search Write About màj 23/07/98

ENFUMOSA (courriel: Chanez (at) montp.inserm.fr ) The European Network For Understanding Mechanisms of Severe Asthma BIOMED 2 Program - European Commission 4th quaterly meeting, with the support of INSERM and Merck Sharp & Dohme Laboratory February 13-14th 1998 in Montpellier- France (see programm, abstracts and experts comments ) Report by Philippe Tarodo on the following session : Vendredi 13 Février 1988 Présentateurs/Speakers Modérateurs Experts 8h30-10h00 Aspects cliniques Clinical aspects P. Godard (Montpellier) B. Wallaert (Lille) T. Perez (Lille) Discussion 15' 15' 15' 45' P. Duroux (Paris) C. Pison (Grenoble) E. Bel (Leiden, NL) S. Johnston (Southampton, UK) N. Siafakas (Heraklion, G)

PH. GODARD COMMUNICATION:
Clinical aspects on the severity of bronchial asthma

The first question from P. Duroux and L. Fabbri was to define the exacerbation of asthma. Is it possible to assess the exacerbation of the disease with the intensity or the duration of the loss of the control disease?

Ph. Godard: It is a difficult problem to define the exacerbation. The evaluation of the start of the exacerbation is particularly difficult and the assessement of the intensity of the exacerbation is impossible because patients need an educator to understand theit symptoms and to record them.

I think that the assessment of the exacerbation result in an increase of symptoms and recourse of anti-inflammatory drugs.

D. Dusser: Is there correlation between the severity of the disease assessed with expert system and the occurance of the number of exacerbation?

Ph. Godard: This question was not yet evaluated.

P. Duroux: The differential diagnosis between asthma and acute heart failure is frequently difficult. Is there some discriminant factors stemming from the analysis of the data to expert-system?

Ph. Godard : It is effectively often difficult to make distinction between asthma and acute heart failure, even more difficult when there is a diastolic ventricular failure.

Only the histology study of the basal membrane can make this distinction.

B. WALLAERT COMMUNICATION:
Long-term follow-up of severe asthmatic patients requiring mechanical ventilation

L Fabbri: 12% of the patients were still smokers after the first episode of near-fatal asthma requiring mechanical ventilation. How could you differenced asthmatic and the COPD patients?

B. Wallaert: Asthma was diagnosed according to the criteria of the ATS. Patient with a clinical history of COPD were excluded from the study.

Ph. Godard: One method to differentiate these two populations was to assess the number of eosinophils in serum or BAL-fluid.

P. Duroux: An other method was to evaluate the reversibility of the bronchial obstruction after the exacerbation occuring during the follow-up.

B. Wallaert: We have not assess the number of eosinophils in blood or BAL fluid, but the reversibility of bronchial obstruction was always evaluated and all of the patients had a complete reversibility of lung fonction.

S. Johnston: Is there a relationship between the lung function and the risk to death?

B. Wallaert: It's difficult to assess a relationship between this two variables because of the large heterogeneity of the patient caracteristics.

T. PEREZ COMMUNICATION:
Respiratory Myopathy In Steroid Dependent Asthma

P. Duroux: What is the biochemical mechanisms of the corticosteroids deleterious effect on inspiratory muscle endurance?

T. Perez: The main determinant of inspiratory muscle dysfunction during obstructive lung disease is hyperinflation. The role of corticosteroids on inspiratory muscle dysfunction was probably linked to a disease-related difference in adaptation of inspiratory muscles to airway obstruction and hyperinflation.

The biochemical mechanism is uncompletely know but it was probably due to the atrophy of muscle fibers.

G. Pauli: Can theophylline increased the muscular mass and then prevented the occurence of inspiratory muscle dysfonction?

T. Perez: It is true that theophylline might improve diaphragm contractility. But in clinical practice, this point is very debated. In our study, no difference about inspiratory muscle function was found between treated and untreated patients.

. Enfumosa Congrès   Conçue et réalisée par: Michel Godard (at) Top
Date de création: 12 Février 1998 -Dernière mise à jour: 23/07/98
Le secret des correspondances transmises sur le réseau Internet n'est pas garanti.
Toute personne citée dispose d'un droit d'accès, de modification, de rectification et de suppression des données le concernant (art. 34 de la loi "Informatique et Libertés" n° 78-17 du 6 janvier 1978). Pour l'éxercer adressez-vous à Michel Godard (at)