Demographic and behavioral predictors of knowledge and HIV seropositivity: results of a survey conducted in three anonymous and free counselling and testing centers.

This paper deals with subjects seeking counselling and testing for human immunodeficiency virus (HIV); it analyses which sociodemographic and behavioral characteristics are related to beliefs concerning HIV infection and to HIV seropositivity. A one month survey among individuals who attended HIV testing in three anonymous and free centers (CIDAGs) was carried out in Paris city, on March 1994. 2059 subjects completed a self-administered questionnaire.

[From first symptom to diagnosis and from diagnosis to treatment of tuberculosis: still a long delay].

Objective: The aim of this investigation was to determine the delay between the first symptom and diagnosis of pulmonary tuberculosis and onset of treatment.

Study Design: Fifty-two consecutive patients presenting with confirmed pulmonary tuberculosis over an 18 month period (June 1, 1991 to December 31, 1992) at the Cochin Hospital in Paris.

Results: The mean delay between first symptom and diagnosis was 2 weeks in 14 patients (27%), 3 to 4 weeks in 10 patients (19%) and over 4 weeks in 28 patients (54%).

HIV prevalence and risk behaviour among intravenous drug users attending HIV counselling and testing centres in Paris.

This study was designed to analyse sexual and drug use behaviour, to determine whether increased awareness can lead to behaviour change, and to evaluate the association between HIV seropositivity and potential risk factors. A 4-month survey was carried out on 147 IVDUs attending three HIV counselling and testing centres, 98% of whom had been using heroin for an average of 7 years, 85% in association with other drugs. Two-thirds of injectors reported having used "safer" injecting practices in the previous year.

[Symptomatology of tuberculosis].

First described long before the beginning of our era, the clinical presentation of tuberculosis has not really changed much over the course of ages. Although early diagnosis and the introduction of bacteriocidal antibiotics have led to a decline in the most severe forms, at least in developed countries, the general and functional symptomatology, characteristic of chronic tuberculosis, remains unchanged in non-immunodeficient patients. Inversely, in patients with and immunodeficiency syndrome, the distribution and clinical course of the fundamental signs and symptoms have undergone a considerable modification as a result of intercurrent clinical signs of other opportunistic diseases involving both the lung and extrapulmonary organs.

Long-term results of monthly inhaled pentamidine as primary prophylaxis of Pneumocystis carinii pneumonia in HIV-infected patients.

Purpose: To evaluate the long-term efficacy and safety of inhaled pentamidine as primary prophylaxis against Pneumocystis carinii pneumonia (PCP) in patients infected with human immunodeficiency virus (HIV).

Patients: Two hundred thirty-two HIV-infected patients with a CD4 cell count below 20% of the total lymphocyte count were given aerosolized pentamidine once every 4 weeks for more than 3 months. Pentamidine aerosols were administered at the hospital under medical supervision.

[Urban asthma and habitat].

This study examines in urban area the housing conditions in asthma patients who called a first-aid association of doctors (SOS Médecins) and their relationships to symptoms. The patient population is compared with the non asthmatic population who called SOS Medecins during the same period. During the first six months of 1989, among 102,791 calls, 701 were related to acute asthma symptoms, and 100 non asthma patients were sorted at random as a control group.

[Asthma, urban atmospheric pollution and the weather].

The aim of this study, which was carried out in an urban environment, was to research in to a possible relationship between temporal variations in the level of atmospheric pollution in the centre of Paris, compared to the frequency of acute dyspnoeic crises in which asthmatic patients had requested the emergency service (SOS Médecins). This study began in the first half of 1989; during this period there were 701 cases of acute asthma recorded within the Paris city boundary by "SOS Médecins". The pollutants recorded were sulphur dioxide (SO2), an index of black smoke (FN), oxides of nitrogen (NOx), ozone (O3) and soluble sulphate particles (SO4).

Combined chemotherapy including rifabutin for rifampicin and isoniazid resistant pulmonary tuberculosis. G.E.T.I.M. (Group for the Study and Treatment of Resistant Mycobacterial Infection).

A prospective multicentre open study has been conducted in France in order to assess the efficacy and tolerability of an antimycobacterial regimen including rifabutin in the treatment of patients with pulmonary tuberculosis due to rifampicin and isoniazid resistant bacilli. Patients were treated with daily rifabutin (450-600 mg), associated with companion drugs to which the organisms remained susceptible; in most cases the regimen included a fluoroquinolone. The duration of treatment was initially scheduled for a minimum period of 12 months after sputum culture conversion.

[Health effects of chronic exposure to tobacco smoke on a non-smoker population].

A study devised to evaluate the effects of chronic exposure to tobacco smoke on the health of a population of non-smokers was conducted in a prison. Fourteen volunteers among male, non-smoking prisoners in good health and without history of lung disease were put for thirty days in a cell that was already occupied by three smokers. These subjects were examined on arrival and on the 30th day of their imprisonment.

[Cough and bronchial obstruction induced by citric acid in smokers, occasional smokers and non-smokers].

We have studied cough and bronchial constriction induced by inhaling citric acid in 15 smokers with baseline airflow obstruction, in 13 occasional smokers and 13 non smokers. The threshold for cough was significantly higher in occasional smokers in relation to smokers and non smokers. Citric acid produced the same degree of bronchial constriction at the same time in smokers and occasional smokers: the maximum fall in forced expired volume (FEV1-VEMS) was recorded five seconds after inhalation of the citric acid (dose threshold) and there was no significant difference between the two groups.

Treatment compliance and self-medication in asthma in France.

A study was carried out among asthmatic patients in order to determine their compliance to treatment and self-medication. Data collection used a self-administered postal questionnaire as tested in a previous study. The population under study included 450 asthmatic patients; 370 answered; their mean age was 47 +/- 16 yrs and 44% were men.

[Opinions and behavior of asthmatic patients towards treatment using aerosols].

An ever increasing number of drugs prescribed in the treatment of asthma are presented as aerosols, so that patients may be requested to inhale many puffs every day. In this study, the opinion of asthmatic patients was sought and their behaviour towards aerosols during attacks and in long-term treatment was recorded by means of a questionnaire. The answers confirmed that asthmatics liked aerosols and found them usually effective, but 60% of these patients exceeded the stated dose, and if the drug failed to bring the expected relief, 30% waited 24 hours before calling for a doctor.

[Bronchoceles. Apropos of a case].

Bronchoceles form bronchial cul-de-sacs in normal or destroyed walls, post-stenotic or secondary to congenital bronchial atresia or infections in infancy. Because of their rarity they frequently go unrecognised. A precise history may sometimes reveal the cause as post-infectious.

[Evaluation of the medical costs of asthma in adults during a l-year follow-up in a hospital environment].

The medical cost of asthma is difficult to measure because this syndrome is generally studied in amongst a large group of patients with chronic respiratory disease. The aim of this study was to assess the theoretical cost of the medical treatment of asthma in a group of young adults who are free from any other disease; the study lasted for one year of follow up and the treatment was given in the public hospital service. Four particular situations are identified corresponding to four stages of severity of the disease and each of these stages was given a treatment selected as the usual therapeutic regime given in a respiratory service in a public hospital.

[Aerosol therapy in asthma].

Today there is a general use of aerosols in the treatment of asthma. To understand their importance it is necessary to know the make-up of an aerosol, physical and chemical factors as well as anatomical factors that influence its deposition and clearance in the tracheo-bronchial tree. In the therapy of asthma, small, easy-to-handle and reliable inhalers are prescribed.

[Can weight gain during weaning from smoking be limited using nicotine gum?].

One hundred subjects smoking more than 20 cigarettes per day were divided into two groups allocated at random to either nicotine gum or a placebo gum. Forty-eight subjects stopped smoking, irrespective of the treatment received. The magnitude of weight gain after given up smoking and the benefits of nicotine gum were evaluated.

[Smoking among nursing students].

The aim of this work is to study smoking habits in young adults in a particularly sensitive environment. The data were collected in 28 nursing schools of the Public Hospital System in Paris by means of anonymous self-administered questionnaire. The questions focused on smoking habits, knowledge of risks and student attitudes.

[Critical study of the indications for long-term oxygen therapy. Chronic obstructive bronchopneumopathies].

Numerous studies have shown that longterm oxygen therapy in hypoxaemic patients with chronic airflow obstruction (BPCO) is capable of improving the prognosis and decreasing the risk of cardio-respiratory decompensation; in addition sometimes physical capacity and intellectual capacity is improved. Another result often noted is a reduction in the mean hospital stay which corresponds to an improvement in the quality of life. A PaO2 constantly below 55 mmHg (7.

Superinfection by Aspergillus fumigatus of a pulmonary lesion caused by Mycobacterium xenopi.

A 36-year-old man had a pulmonary infection with a cavity in the right upper lobe caused by Mycobacterium xenopi. A superinfection by Aspergillus fumigatus occurred 1 year later. Both organisms were found in the resected lung specimen.