The aims of this study were to determine whether subjects with stable asthma perceive acute bronchoconstriction differently when it is induced by histamine, exercise, and antigen, and to determine whether the perception that follows histamine and exercise is altered when these are carried out after antigen challenge. We have also compared perception during the early and late asthmatic responses in two subjects with a dual response. Methods SUBJECTSEight non-smokers with asthma (five of them female), aged 18 to 38 (mean 26) years took part in the study (table 1). They were recruited from the respiratory clinic at Laval Hospital, Quebec City. Subjects were studied while taking part in a study on the influence of exposure to antigen on the pattern of response to non-specific stimuli.The subjects had mild stable asthma, controlled by a beta2 agonist on an "as required" basis only. None was taking sodium cromoglycate, theophylline, inhaled corticosteroids or an oral antihistamine. All had a history of exercise induced asthma and all were atopic, with at least one positive skinprick reaction (weal diameter over 2 mm) on being tested with 26 common aeroallergens. The study was approved by the local ethics committee and all subjects gave written informed consent to the procedures.

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Coxiella burnetiiappears to be endemic in animals in the Mauricie region of Quebec, and causes some human cases of Q fever annually. Unlike in other rural areas, patients in this study experienced few respiratory symptoms. To determine whetherC burnetiipneumonia is underdiagnosed, adults admitted to hospital for community acquired pneumonia were included in a one-year serological study. Significant immunofluorescent antibody (IFA) titres in four of 118 patients with pneumonia (fewer than 4%) were studied. Clinical presentation, standard laboratory tests and epidemiological data did not allow identification of these cases; however, Q fever increased during the warm months. There were no detectable complement fixing (CF) antibodies in these four cases.C burnetiicauses few cases of pneumonia in Mauricie. IFA seems to be a more sensitive test than CF.

Short-term oxygen therapy (STOT) is often prescribed to allow patients with chronic obstructive pulmonary disease (COPD) to be discharged safely from hospital following an acute illness. This practice is widely accepted without being based on evidence. Purpose: Our objective was to describe the characteristics and outcomes of patients with COPD who received STOT. Patients and Methods:The study was a secondary analysis of the INOX trial, a 4-year randomised trial of nocturnal oxygen in COPD. The trial indicated that nocturnal oxygen has no significant effect on survival or progression to LTOT, allowing our merging of patients who received nocturnal oxygen and those who received placebo into a single cohort to study the predictors and outcomes of STOT regardless of the treatment received during the trial. Results: Among the 243 participants in the trial, 60 required STOT on at least one occasion during follow-up. Patients requiring STOT had more severe dyspnoea and lung function impairment, and lower PaO 2 at baseline than those who did not. STOT was associated with subsequent LTOT requirement (hazard ratio [HR]: 4.59; 95% confidence interval [CI]: 2.98-7.07) and mortality (HR: 1.93; 95% CI: 1.15-3.24). The association between STOT and mortality was confounded by age, disease severity and comorbidities. Periods of STOT of more than one month and/or repeated prescriptions of STOT increased the probability of progression to LTOT (OR: 5.07; 95% CI: 1.48-18.8). Conclusion: Following an acute respiratory illness in COPD, persistent hypoxaemia requiring STOT is a marker of disease progression towards the requirement for LTOT.