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Objective: Thermal spring waters (TSW) are commonly used as active ingredients in cosmetics. Their biological activities directly depend on the ionic composition of the spring. However, in order to exhibit beneficial properties, the minerals need to reach viable skin layers. The present study addresses the incorporation of marketed TSW in model cosmetic formulations and the impact of the formulation on skin absorption of magnesium and calcium ions that are known to improve skin barrier function. Methods: Marketed TSW was introduced into five formulations. Liposomes were prepared using saturated or unsaturated phospholipids mixed with cholesterol by the thin layer evaporation technique. Emulsions water‐in‐oil (W/O), oil‐in‐water (O/W) or double: water‐in‐oil‐in‐water (W/O/W) were prepared by high‐shear mixing. Skin absorption of Mg2+ and Ca2+ from those formulations was studied in vitro using static Franz diffusion cells under infinite dose condition and under occlusion of the apparatus. Results: Mg2+ and Ca2+ penetrate skin samples from TSW. Encapsulating TSW into double emulsion (TSW/O/W) increased skin absorption of both cations of interest and kept the Ca2+/Mg2+ ratio equal to that of TSW in each skin layer. The dermal absorption of Mg2+ from the double emulsion departs from both single emulsions. Application of liposome suspension improved the skin absorption of Ca2+ while keeping constant that of Mg2+, leading to unbalanced Ca2+/Mg2+ ratio inside skin. Conclusion: The beneficial effects of TSW are not only due to their action on the skin surface. Their active components, especially Ca2+ and Mg2+ cations, reach viable skin layers in a formulation‐dependent manner. The distribution of ions inside skin depends on the type of formulation. [ABSTRACT FROM AUTHOR]

Objective: In vitro assessments of skin absorption of xenobiotics are essential for toxicological evaluations and bioavailability studies of cosmetic and pharmaceutical ingredients. Since skin metabolism can greatly contribute to xenobiotic absorption, experiments need to be performed with skin explants kept viable in suitable survival media. Existing protocols for non‐viable skin are modified to consider those conditions. The objective was to design a survival medium used as an acceptor fluid in Franz cells for testing cutaneous penetration of hydrophilic or lipophilic molecules. Their metabolism inside skin may be investigated under the same conditions. The determining factors involved in survival mechanisms in vitro are discussed. The consequences of short‐term skin preservation at 4°C were also evaluated. Methods: The metabolic activity of fresh skin samples mounted in Franz cells was studied by measurement of lactate release over 24 h in order to assess the impacts of pH, buffering, osmolality, ionic strength, initial glucose supply and the addition of ethanol or non‐ionic surfactant in the acceptor part of Franz cells. Conclusion: Survival media must maintain physiological pH (>5.5) be isotonic with skin cells (300 mOsm kg−1) and contain at least 0.5 g L−1 glucose. Several compositions able to preserve skin metabolism are reported. Storage of skin explants overnight at 4°C impairs skin metabolic activity. The present work provides guidelines for designing survival media according to constraints related to the scientific requirements of the experiments. [ABSTRACT FROM AUTHOR]

Abstract: The transport of caffeine to the hypodermis by an alcohol-free o/w microemulsion was investigated and compared with an aqueous gel and an o/w emulsion. The microemulsion was well characterized and in vitro diffusion measurements through pig skin having the hypodermis either kept or removed were performed in static Franz cells. The microemulsion allowed delivery of a large fraction of the caffeine in the hypodermis: 23% of caffeine reached the hypodermis after 24h diffusion, 1.3-fold larger than from the emulsion and gel dosage forms. Half this amount was stored in the hypodermis, the other half continuing its diffusion to the receptor compartment of the Franz cell. [Copyright &y& Elsevier]

Aims and objective. To study the impact of postnatal depression on the quality of life of young French mothers and to evaluate if the gender of their child influences this. Background. Postnatal depression (PND) constitutes a major public health problem considering its high prevalence and consequences upon quality of life and parental skills. Design. This research is a cross-sectional study during the postnatal period. Methods. This study was carried out during a two-month period. Data were collected by interview and questionnaires. The authors compared the prevalence rate of PND and life quality in a cohort of 181 women and measured the short-term impact of the child's birth. Results. Postnatal depression strongly negatively influences all dimensions of life quality explored through the SF36, e.g. physical functioning (PF), physical Role (RP), bodily pain (BP), mental health (MH), emotional role (RE), social functioning (SF), vitality (VT), general health (GH), standardized physical component (PCS) and standardized mental component (MCS). The baby's gender (having a boy) also significantly reduces quality of life, irrespective of depressive state. There is a relationship between baby gender and PND. Conclusion. This research is the first to show that the birth of a boy reduces several dimensions of the mothers' quality of life. Relevance to clinical practice. The importance of the impairment of quality of life in case of PND, as well as its effects on mother-child interaction, could justify prevention programs and early psychotherapeutic care. Further research needs to explore the effectiveness of programmes targeting the construction of parenting skills as a preventative measure against PND, especially for parents of boys. [ABSTRACT FROM AUTHOR]

In order to protect a hydrophilic drug and to prolong its further delivery, the formulation of multiple emulsions could be worthy. However, the double emulsions are not stable, their structure can change, leading to the formation of a single emulsion as the destruction of the system, and the drug can release easily from the globules in liquid state. The freeze-drying technology could be used to produce dry emulsion, the powder form being much more stable. The aim of this work was to study the influence of a cryoprotectant and a freeze-drying process on the stability of W/O/W emulsions. Samples were frozen at two different freezing rate (νf = 0.55°C/min and 1.25°C/min) and successively dried at two different sublimation temperature (Ts = - 10°C and - 20°C). The particle size distributions were measured by granulometer and UV spectrophotometer was performed to investigate the leakage of internal constituent. The glass transition temperature (Tg) of the double emulsions was analyzed by DSC. The particle sizes became even smaller after freeze drying, except when κ-carrageenan is used as a cryoprotectant. In that case, the particles became aggregated after freeze drying, whatever the process conditions. The mean size is considerably reduced when the globules are diluted at low concentration in glucose and trehalose solution. When the concentration is increased, the size distribution is not significantly affected. The leakage of the internal aqueous phase to the external one during freeze drying was measured as an indicator of the structure stability. It is affected by the nature of the cryoprotectant and the conditions of the freeze-drying process. The leakage of the internal phase was smaller when cycle III (νf = 1.25°C/min, Ts = - 10°C) was processed. From our experiments, we suppose that the water transfer from the inner phase to the outer aqueous phase results in the diminution of the globules size in double emulsion. The Tg of the double emulsions diluted with trehalose and glucose were determined at - 33.8°C and - 47.1°C. In contrast, the Tg of double emulsion with κ-carrageenan and HES did not appear. [ABSTRACT FROM AUTHOR]

Abstract: Formulation of nanocapsules based on polyureas and polyamides have been tested using a patented process. This method based on polycondensation reaction of two complementary monomers and spontaneous formation of oil in water emulsion, is an alternative concept to the known technique based on the same type of reaction used for the formulation of microcapsules, and in which the lipophilic monomer was emulsified in the organic phase before the formation of the polymeric membrane. Nanocapsules can be prepared from different monomers. Wall based on cross-linked polymer contributes to the stability of nanocapsules during and after formulation. The permeability of the polymeric wall is related to its crystallinity and contributes to the growth of nanocapsule membrane by the diffusion of the hydrophilic monomers to get stable colloidal suspensions. [Copyright &y& Elsevier]

Abstract: Sub-micrometric particles having an oil core and a polymer shell (nanocapsules) have been prepared by combining in a single stage the emulsification process and an interfacial polymerization reaction. The spontaneous emulsification produced very fast a dispersion of oil droplets of 100–400 nm mean diameter at the surface of which the subsequent polycondensation reaction took place. The process has been optimized with respect to the choice of α-tocopherol as the oil and made robust regarding the presence of monomers in the aqueous and oil phases and their conversion into polymers. The major cause of troubles was the large concentration of diol or diamine monomers in the aqueous phase that made the oil droplets unstable with respect to aggregation immediately after their formation. Once the emulsifier has adsorbed and the polymerization has completed, the final suspensions of nanocapsules were quite stable over long periods. A secondary population of micrometric particles that coexisted with the nanocapsules was present in several cases, which was unfavourable regarding their application as a drug delivery system for cosmetic applications. [Copyright &y& Elsevier]

Nano-emulsions consist of fine oil-in-water dispersions, having droplets covering the size range of 100–600 nm. In the present work, nano-emulsions were prepared using the spontaneous emulsification mechanism which occurs when an organic phase and an aqueous phase are mixed. The organic phase is an homogeneous solution of oil, lipophilic surfactant and water–miscible solvent, the aqueous phase consists on hydrophilic surfactant and water. An experimental study of nano-emulsion process optimisation based on the required size distribution was performed in relation with the type of oil, surfactant and the water–miscible solvent. The results showed that the composition of the initial organic phase was of great importance for the spontaneous emulsification process, and so, for the physico-chemical properties of the obtained emulsions. First, oil viscosity and HLB surfactants were changed, α-tocopherol, the most viscous oil, gave the smallest droplets size (171 ± 2 nm), HLB required for the resulting oil-in-water emulsion was superior to 8. Second, the effect of water–solvent miscibility on the emulsification process was studied by decreasing acetone proportion in the organic phase. The solvent–acetone proportion leading to a fine nano-emulsion was fixed at 15/85% (v/v) with EtAc–acetone and 30/70% (v/v) with MEK–acetone mixture. To strength the choice of solvents, physical characteristics were compared, in particular, the auto-inflammation temperature and the flash point. This phase of emulsion optimisation represents an important step in the process of polymeric nanocapsules preparation using nanoprecipitation or interfacial polycondensation combined with spontaneous emulsification technique. [Copyright &y& Elsevier]

Polyurethane polymers and poly(ether urethane) copolymers were chosen as drug carriers for α-tocopherol. This active ingredient is widely used as a strong antioxidant in many medical and cosmetic applications, but is rapidly degraded, because of its light, heat and oxygen sensitivity. Polyurethane and poly(ether urethane)-based nanocapsules were synthesized by interfacial reaction between two monomers. Interfacial polycondensation combined with spontaneous emulsification is a new technique for nanoparticles formation. Nanocapsules were characterized by studying particle size (150–500 nm), pH, yield of encapsulation and morphologies. Polyurethanes (PUR) were obtained from the condensation of diisocyanate (isophorone diisocyanate: IPDI) and polyol: 1,2-ethanediol (EG), 1,4-butanediol (BD), 1,6-hexanediol (HD). Poly(ether urethane) copolymers were obtained by replacing diols by polyethylene glycol oligomers (PEG) Mw 200, 300, 400 and 600. Molecular weights of di- and polyols have a considerable influence on nanocapsules characteristics cited above. The increase of molecular weight of polyols tends to increase the mean size of nanocapsules from (232±3) nm using EG to (615±39) nm using PEG 600, and led to the apparition of a population of agglomerate particles. We also noted that the yield of encapsulation increases with the increase of polyol length (from 85.6 to 92.2% w/w). Microscopic observations confirmed particle size analysis, but cannot predict the membrane structure owing the small size of the particles. [Copyright &y& Elsevier]

The purpose of this study was to optimize the freeze-drying processes of nanoparticles in order to improve their end-used properties and their stability. Polycaprolactone (PCL) nanoparticles were prepared by the emulsification-diffusion method and then were frozen at different freezing rates. Finally, the nanoparticles were freeze-dried under different operating conditions by using a laboratory-made freeze-dryer. Then, the average particle size was analyzed by using a Coulter® LS 230 apparatus firstly after the freezing step and finally after the sublimation step. The surface morphology and the thermophysical characteristics of the nanoparticles were determined by SEM and by DSC, respectively. It was observed that, the freezing process can break the nanoparticles and cause the leakage of their contents during the freeze-drying step. The higher the freezing rate, the larger the size of nanoparticles during the freezing process. From the results DSC data, it could be assumed that the nanoparticles in the nanosuspensions may have been broken not by water crystallization in the external phase, but by the solidification of the oil (miglyol) in the internal phase. [ABSTRACT FROM AUTHOR]

In the field of pharmaceutical applications relying on encapsulation of drug by polymer coating, capsules based on biodegradable polymers with mean size of about 500 nm have been obtained by a patented emulsion–diffusion method. The morphology, size and structure of the nanocapsules (NC) control their pharmaceutical properties, especially release of the drug. Here is reported a decisive contribution of transmission electron microscopy (TEM) in revealing the controlled form and size of the NC: mean size values measured by TEM do agree with data obtained by laser granulometry. Moreover, the TEM magnification allows an estimation of the membrane thickness. [Copyright &y& Elsevier]

Identifies the factors associated with satisfaction on patients receiving medical and surgical care in France. Prevalence of older age and better self-perceived health status of inpatient satisfaction; Importance of respecting the needs of patients in humane health care system; Need for understanding patients' characteristics for the betterment of patient care and satisfaction.

Introduction et but de l’étude Une stratégie de dépistage et prise en charge structurée a conduit à une diminution de la prévalence du surpoids chez l’adolescent (AJPM 2013). L’augmentation de la fréquence de la surcharge pondérale avec le statut socioéconomique est documentée. Les interventions universelles peuvent augmenter les inégalités de santé en profitant davantage aux plus favorisés. L’essai Pralimap-Inès a été mis en œuvre entre 2012 et 2015 pour évaluer si un dépistage en milieu scolaire avec prise en charge adaptée pouvait produire, chez les adolescents de faible statut socioéconomique, un effet équivalent à celui observé chez ceux de statut socioéconomique plus élevé avec une intervention standard. Matériel et méthodes Dans 36 établissements scolaires vosgiens, 8735 adolescents entrant en classe de troisième et de seconde ont été mesurés (poids, taille, tour de taille). Ceux éligibles (2113) ont renseigné leur position sociale, comportements, modes de vie et santé perçue (Family Affluence Scale FAS ; EAT-26 ; IPAQ ; fréquence alimentaire ENNS, Kidscreen, tec.). Parmi eux, 1639 en surcharge pondérale (seuils IMC IOTF) et/ou adiposité abdominale (seuils de tour de taille McCarthy) ont été retenus et 1418 ont été inclus (il y a eu 221 refus parentaux écrits). Tous avaient accès à cinq séances collectives d’éducation thérapeutique animées par des professionnels de l’Association vosgienne des réseaux de santé. Six cent dix adolescents étaient moins favorisés (FAS ≤ 5) et ont été assignés à une groupe témoin ou à un groupe intervention adaptée (Ines ; n = 414) visant à surmonter les obstacles liés aux inégalités de santé : réunions de concertation pluridisciplinaire, entretiens motivationnels, ateliers alimentation, coaching d’activité physique, soutien financier pour le sport, accompagnement par les pairs et, éventuellement, une prise en charge en charge en service spécialisé en hospitalisation de jour. Résultats L’analyse d’équivalence en intention de traiter a été utilisée pour comparer le groupe favorisé et le groupe Inès. À l’inclusion, la corpulence moyenne était significativement plus forte dans le groupe Inès (IMC 27,0 contre 26,4 kg/m 2 ; IMC Z-score 1,7 contre 1,6 ; tour de taille 89,9 contre 87,9 cm ; obésité 26 % contre 19,5 %). À la fin de l’année scolaire, après les interventions, les différences étaient moins marquées. Comparé au groupe favorisé, le changement dans le groupe Inès était non inférieur (IMC, tour de taille, dépense énergétique globale hebdomadaire mesurée par l’Ipaq, score de boulimie) ou équivalent (IMC Z-score, score de restriction et HAD), voire supérieur (consommation de fruits et légumes). Conclusion Les différences sociales de surcharge pondérale sont marquées dès l’adolescence. L’intervention proportionnée en milieu scolaire est faisable, acceptée par les adolescents défavorisés, et peut permettre une atténuation des inégalités de santé. Le milieu scolaire est un environnement favorable pour améliorer la santé sans aggraver les inégalités sociales de santé. [ABSTRACT FROM AUTHOR]

Background: In patients with congestive heart failure (CHF), clinical trials have demonstrated the benefit of a number of drugs on morbidity and mortality. Nevertheless so far, there is no published controlled study of long-term antithrombotic therapy in patients with CHF. The aim of this work was to identify the relationship between cardiovascular drug use, especially antithrombotic therapy, and survival of CHF patients in current clinical practice, using an observational, population-based database.Methods: The EPICAL study (Epidémiologie de l'Insuffisance Cardiaque Avancée en Lorraine) has identified prospectively all patients with severe CHF in the community of Lorraine. Inclusion criteria were age 20-80 years in 1994, at least one hospitalisation for cardiac decompensation, NYHA III/IV HF, ventricular ejection fraction < or =30% or cardiothoracic index > or =60% and arterial hypotension or peripheral and/or pulmonary oedema. A total of 417 consecutive patients surviving at hospital discharge were included in the database. The average follow-up period was 5 years. Univariate Cox models were used to test the relationship of baseline biological and clinical factors to survival. Cardiovascular drug prescriptions were tested in a multivariate Cox model adjusted by other known predictive factors.Results: Duration of disease >1 year, renal failure, serum sodium > or =138 mmol/l, old age, serious comorbidity, previous decompensation, high doses of furosemide and vasodilators use were independently associated with poor prognosis at 1 and 5 years. Oral anticoagulants, aspirin, lipid lowering drugs and beta-blockers use were associated with better survival. There was no interaction between aspirin and angiotensin converting enzyme inhibitor use on survival.Conclusion: Antithrombotic therapy was associated with a better long-term survival in our study population of severe CHF. These results together with other previously published circumstantial evidence urge for a prospective, controlled and randomised trial specifically designed to evaluate optimal oral anticoagulants and aspirin in patients with congestive heart failure. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effectiveness of proportionate universalism intervention to reduce the slope of the nutritional social gradient in adolescents. A mixed (experimental and quasi-experimental) multicentre trial. Data from 985 adolescents of the PRALIMAP-INÈS trial (North-eastern France, 2012–2015) were analysed. For this, adolescents were split into five social classes according to the Family Affluence Scale: Highly Less Advantaged (H.L.Ad ; n = 33), Less Advantaged (L.Ad ; n = 155), Intermediate (Int; n = 404), Advantaged (Ad; n = 324) and Highly Advantaged (H.Ad; n = 69). The overweight care management was a standard care for all and a strengthened one adapted to the social class of adolescents. The main outcome was the 1-year change of the body mass index z-score (BMIz) slope. Other nutritional outcomes were BMI, ΔBMI p95 (BMI minus 95th percentile of the WHO reference), %BMI p95 (percent of 95th percentile of the WHO reference), leisure-time sport, consumption of fruits and vegetables and consumption of sugary foods and drinks. The inclusion data confirmed a weight social gradient expressed by a significant BMIz linear regression coefficient (β = −0.09 [−0.14 to −0.04], P < 0.0001). The higher the social class, the lower the BMIz. The 1-year BMIz linear regression coefficient was −0.07 [−0.12 to −0.02], corresponding to a significant weight social gradient reduction of 23.3% (β = 0.021 [0.001 to 0.041]; P = 0.04). Consistent results were found for other nutritional outcomes. PRALIMAP-INÈS shows that proportionate universalism intervention is effective to reduce the adolescents' nutritional social gradient and suggests that equitable health programmes and policies are a realistic goal. [ABSTRACT FROM AUTHOR]

This study aimed to provide cost-effectiveness and budget impact analyses of a school-based overweight/obesity screening and care prevention strategy among adolescents. Cost-effectiveness and budget impact analyses. Data from 3538 adolescents who participated in a school-based randomised controlled trial in the Northeast of France were used. Costs (from a public payer's perspective) included screening for overweight and obesity and subsequent care. Effectiveness was measured as the change in body mass index (kilogram per square metre), prevalence of overweight/obesity, moderate physical activity energy expenditure, duration and frequency and total sitting time. The incremental cost-effectiveness ratio was calculated, and a budget impact analysis was conducted. The screening and care strategy resulted in an incremental cost-effectiveness ratio of €1634.48 per averted case of overweight/obesity and €255.43 per body mass index unit decrease. The costs for increasing moderate physical activity by 1000 metabolic equivalent of task-min/week, duration by 60 min/week and frequency 1 day/week were €165.28, €39.21 and €93.66 per adolescent, respectively. Decreasing total sitting time by 60 min/week had a cost of €8.49 per adolescent. The cost of implementing the strategy nationally was estimated to be €50.1 million with a payback period from 3.6 to 7.3 years. The screening and care strategy could be an efficient way to prevent overweight and obesity among adolescents. Future studies should investigate how the current results could be achieved in schools with different settings and thus justify its relevance for overweight and obesity prevention to policy-makers. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To review physical activity questionnaires designed for children and/or adolescents and to present their psychometric properties. Topics: In epidemiological studies, questionnaire is the most often used method to measure physical activity. Most of the proposed questionnaires were validated in English. Perspectives: Questionnaires validated in French are essential to fill the lack of such instrument available in France. Conclusion: Best psychometric properties were found for the Physical Activity Questionnaire for Children (PAQ-C), Previous Day Physical Activity Recall (PDPAR), Physical Activity Questionnaire for Adolescent (PAQ-A) and Modified Activity Questionnaire for Adolescent (MAQA). [Copyright &y& Elsevier]

Abstract: Aims: To elaborate a physical activity questionnaire for school children aged between 6 and 10 years (QAPE-semaine) and to study the psychometric properties (face validity, acceptability, test-retest reproducibility, criterion validity). Methods: The questionnaire measures physical activities at school, during leisure-time and other activities. Three scores are calculated: variety of physical activities, intensity and sedentary. The questionnaire was pre-tested to study the content validity, and was administered twice to 185 children from two elementary schools. The validity was studied by comparing the results of the questionnaire outcomes with a one day-recall (QAPE-hier) filled out in two occasions (to measure activities during a non school-day and a school-day). The statistic used was the intraclass correlation coefficient (ICC). Results: The QAPE-semaine was acceptable. The ICC for the reproducibility of variety of physical activities, intensity and sedentary scores were 0.54, 0.47 and 0.68, respectively; and 0.54, 0.56 and 0.64 for the criterion validity of variety of physical activities, intensity and sedentary scores, respectively. All the ICC were significant (P <0.0001). Conclusion: The psychometric properties of the QAPE-semaine are satisfactory (moderate to good). Its administration in classes with school professor''s help seems however essential. [Copyright &y& Elsevier]

Lung cancer is the most frequent cause of cancer deaths worldwide, and non-small-cell lung cancer (NSCLC) accounts for approximately 80% of all cases. Stage at diagnosis is the most important indicator of survival. Various non-invasive and invasive procedures are available for NSCLC staging. However, the precise indications for performing these procedures remain controversial. There is no evidence about the level of variability in practice of imaging and invasive procedures used for NSCLC staging. Their high costs contribute to the controversy about their use. We performed a literature search on the MEDLINE database to identify studies reporting practice of staging for a nonselected group of patients with NSCLC. Only seven studies enrolling between 185 and 2071 patients reported NSCLC staging practices. These studies were reviewed to identify patterns in practice of staging work-up and consecutive treatment. Lack of detailed reporting limits the interpretation of the results. Based on our review, future investigations should be conducted to determine the extent of variation in patterns of physician practices of NSCLC staging and their impact on the treatment practice or patient survival. [ABSTRACT FROM AUTHOR]

BACKGROUND: Enhancement of the results obtained by scaling and planing is most often sought by using antimicrobial therapies. Laser beams have been shown to be bactericidal and could possibly target pathogens more effectively and with fewer compliance problems than antiseptic solutions. METHODS: Thirty subjects 20-60 years old presenting periodontal pockets at least 5 mm deep in each quadrant received initial periodontal treatment. The study had a split-mouth design. The control side (SRP) only received scaling and planing, and the test side (SRP+laser) was treated by both SRP and Nd:Yap (yttrium aluminum perovskite doped with neodym) laser. Clinical conditions were evaluated at day 0 and day 90 using the plaque index, gingival index, bleeding on probing, pocket probing depth, and clinical attachment level. Microbial sampling was also performed on days 0 and 90, and the presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythensis, and Treponema denticola was analysed by polymerase chain reaction in a commercial laboratory. Post-operative pain or discomfort was measured by the patient using a linear visual scale. Pearson's chi-squared test was used to compare bacterial presence. RESULTS: There was no statistically significant difference concerning clinical data between test and control groups at baseline. Both treatments enhanced the clinical situation compared to baseline; however, results were not significantly different between the two groups. T. forsythensis was the organism most numerous in both groups. Though initial treatment diminished the numbers of all the pathogens it did not do so statistically significantly. Differences between test and control groups were very small and bore no significance. Evaluation of the post-operative pain did not reveal any differences between the groups. CONCLUSIONS: Scaling and root planing was effective in reducing levels of plaque, inflammation, and bleeding upon probing. No additional advantage was achieved by using the Nd:Yap laser. [ABSTRACT FROM AUTHOR]

Abstract: This study shows an original method to follow the blending of two powders and of these two powders and one viscous liquid in a classical reactor, under different agitation conditions. This technique takes a series of images and analyses them. It is a non-intrusive method which avoids sampling and therefore process interruption and sample preparation necessary otherwise. However, the image analysis is not evident and needs several steps. The simple application of the box-counting method on the synthetic on real images did not lead to good results because of the lack of variation of the fractal dimension between different images with a variable homogeneity. The box-counting method was then associated with an erosion treatment, leading to a useful parameter to characterise the mixture homogeneity. This parameter is the variation of the fractal dimension of the image, from the initial crude image to the final completely eroded one. The first results showed that the mixing is completely homogeneous after 100 s of agitation. In fact, a pseudo-homogeneity is achieved much more rapidly (t &#60;40 s) but subsequent images show that aggregates still remain in the reactor. The method is then applied to the mixing of the two powders under different operating conditions and also to the blend of the two powders and one viscous liquid to simulate the chemical reaction evolution. The results obtained are satisfactory. They allow determination of the mixing time and quantification of the degree of homogeneity of the blend. For the solid/liquid mixture, the poor affinities between oil and solid have modified the characteristics of the mixture and made it difficult to produce. The final aim is to link these results on the mixing homogeneity and the solid/solid contact times with the reaction kinetics. [Copyright &y& Elsevier]

To assess the relationships between socio-demographic factors, quality of life and attitudes towards psychotropic drugs and dependency and to compare those relationships in continuous consumers (CC), occasional consumers (OC) and non-consumers (NC) of those drugs.Quality of life (SF36) and attitudes (14 statements) were measured in 601 subjects (45–60 years old) from the SUVIMAX cohort (SUpplémentation en VItamines et en sels Minéraux AntioXydants). Data were obtained on 334 NC, 142 CC, 125 OC from the inclusion questionnaire and the monthly consumption report notebooks kept by subjects between 1994 and 1998. Dichotomous and polychotomous logistic regressions were used for the analysis.The lower the quality of life score the more frequent was consumption. NC tended to be men, with high quality of life scores. They entertained negative attitudes towards psychotropics and dependency. OC tended to be women reporting a chronic pathology, with fairly high social status. They had intermediate quality of life and denied dependency. CC tended to be men with no professional activity and low quality of life scores in particular for mental health and perceived health. They had positive attitudes towards psychotropics and accept dependency.Assessment of patients’ quality of life and understanding of their attitudes towards psychotropics can provide essential information for those in charge of health promotion programmes and may help in identifying new intervention strategies. Preventive education and follow-up of therapy may be better suited to the needs of patients. [ABSTRACT FROM AUTHOR]

The authors have compared prenatal depression prevalence in France (Lorraine and outside Lorraine: 221 women) and in Switzerland and Scotland using Cox EPDS. Results show depression percentage are higher in France than in Scotland (Evans et al., 2001) and comparable to those observed in Switzerland (Manzano et al., 1997). Besides, coping strategies evaluated with French adaptation (Mulller and Spitz, 2003) of Carver’s BriefCope, differentiate significantly depressive and non depressive women during pregnancy. It appears very urgent to develop preventive perspective to face that important public health problem. [Copyright &y& Elsevier]

Purpose: To evaluate the association between obesity phenotypes and health-related quality of life (HRQoL) in non-dialysis-dependent CKD patients.Methods: Data from the national CKD-REIN cohort which included 3033 patients with stage 3-4 CKD were used. Patients were divided into three groups: non-obese (NO) patients (BMI < 30 kg/m2), metabolically healthy obese (MHO) (BMI ≥ 30 kg/m2 and ≤ 1 criterion NCEP/ATP III), and metabolically unhealthy obese (MUO) (BMI ≥ 30 kg/m2 and ≥ 2 criteria NCEP/ATP III). HRQoL was measured by the KDQOL-36™ which comprised three disease-specific dimensions: symptoms, effects, and burden and two summaries scores: physical (PCS) and mental (MCS). We used a mixed effect model with adjustment on sociodemographic characteristics and comorbidities.Results: A total of 2693 patients completed the self-administered questionnaires. MHO patients accounted for 3.4% of the cohort and for 12% of obese patients. In the NO group, average HRQoL scores were 77.2 ± 15.9 for symptoms, 83.5 ± 16.5 for effects, 76.8 ± 22.7 for burden, 43.5 ± 9.7 for PCS, and 47.9 ± 7.0 for MCS. In the multivariate analysis, scores were similar in MHO and NO patients, but significantly different with those in MUO patients: symptoms (- 0.7; p = 0.71 vs. - 3.0; p = 0.0025), effects (+ 1.2; p = 0.57 vs. - 4.3; p < 0.0001), burden (+ 2.7; p = 0.31 vs. - 3.6; p = 0.0031), and PCS (- 0.6; p = 0.58 vs. - 4.3; p < 0.0001). MCS was not associated with obesity phenotypes.Conclusions: This study demonstrated an association between obesity phenotypes and QoL in non-dialysis-dependent CKD patients. MUO patients had worse QoL than NO and MHO patients even after adjustment on comorbidities. [ABSTRACT FROM AUTHOR]

In this work, our goal was to study the capability of a single metallic oxide to neutralize a chemical agent and to exhibit an antibacterial effect. We tested two types of magnesium oxides, MgO. The first MgO sample tested, which commercial data size characteristic was −325 mesh (MgO-1) destroyed in 3 h, 89.7% of paraoxon and 93.2% of 4-nitrophenol, the first degradation product. The second MgO sample, which commercial data size was <50 nm (MgO-2) neutralized in the same time, 19.5% of paraoxon and 10.9% of 4-nitrophenol. For MgO-1 no degradation products could be detected by GC-MS. MgO-1 had a bactericidal activity on Escherichia coli (6 log in 1 h), and showed a decrease of almost 3 log on a Staphylococcus aureus population in 3 h. MgO-2 caused a decrease of 2 log of a E.coli culture but had no activity against S. aureus . Neither of these two products had an activity on Bacillus subtilis spores. Analytical investigations showed that the real sizes of MgO nanoparticles were 11 nm for MgO-1 and 25 nm for MgO-2. Moreover, their crystalline structures were different. These results highlighted the importance of the size of the nanoparticles and their microscopic arrangements to detoxify chemical products and to inhibit or kill microbial strains. [ABSTRACT FROM AUTHOR]

Les inégalités sociales de surpoids et d'obésité résultent d'une multitude de facteurs, notamment d'inégalités territoriales d'accès à des services et des soins. Les interventions à distance offrent la possibilité d'acquérir des connaissances et de développer des compétences en tout temps et en tous lieux. Elles contribuent à limiter les obstacles liés aux déplacements et par conséquent les coûts. Le programme PRALIMAP-CINECO propose un e-Coaching santé à des adultes en situation de surpoids ou d'obésité, et vise des changements de conduites alimentaires et de pratiques d'activité physique et de sédentarité, ainsi que le renforcement des compétences d'auto-régulation. Le modèle ADDIE (Analysis Design Development Implementation Evaluation) a été utilisé pour la conception pédagogique du e-coaching santé. Des entretiens et focus group ont été menés pour identifier et analyser les besoins et les caractéristiques du public cible. Une veille sur les méthodologies de prise en charge à distance du surpoids a été réalisée. La scénarisation des contenus a été développée par des experts (médecins spécialistes de l'obésité, professionnels de l'activité physique adaptée, de l'alimentation, de la psychologie, du numérique...) à partir du référentiel d'éducation thérapeutique du patient de prise en charge de l'obésité chez l'adulte. Divers outils de production ont été utilisés tels que Prezi, Genially, Canva, des outils de tournage et du montage audiovisuel. Après la passation de questionnaires socio-économiques et de comportements de santé en ligne, les adultes en excès de poids réalisent un bilan éducatif partagé initial (BEP) en distanciel. Ce BEP initial permet notamment de définir des objectifs, des priorités et un programme structuré. Une plateforme en ligne met à disposition des patients des activités asynchrones et synchrones autour de quatre thèmes : généralités concernant la santé, activité physique/sédentarité, alimentation et dimension psychologique. Au total, plus de 80 activités ludiques, interactives et participatives ont été créées : web série, tutoriels, jeux sérieux, témoignages, quizz... Les activités ont été réparties au sein de 12 modules. En parallèle du suivi des activités, un accompagnement individuel adapté aux besoins est proposé avec des professionnels tels que des diététiciens, enseignants en activité physique adaptée et psychologues, sous la forme de séances à distance régulières sur une période pouvant aller de quelques mois à 1 an. Un journal de suivi interactif ainsi qu'un forum est mis à disposition des patients. Les professionnels ont accès aux dossiers des patients qu'ils accompagnent sur une plateforme de données de santé sécurisée et y partagent leurs comptes-rendus afin d'optimiser le parcours du patient. Le patient reçoit des synthèses qu'il peut partager avec son médecin traitant. Un BEP intermédiaire réalisé en distanciel permet de faire le point sur l'atteinte des objectifs et le réajustement du programme avec le patient si nécessaire. Afin de maintenir la motivation du patient à participer, plusieurs stratégies ont été développées. Le patient peut obtenir des badges virtuels grâce à sa progression dans le e-coaching santé. Il peut aussi se repérer facilement sur la plateforme grâce à une navigation facilitée, des codes couleurs, des pictogrammes, l'affichage d'un calendrier des évènements à venir et à une visibilité sur sa progression dans le e-coaching santé. Ce dispositif innovant d'e-coaching santé permet une prise en charge pluridisciplinaire et personnalisée du surpoids et de l'obésité. Il permet d'atteindre une population nombreuse et notamment ceux pour qui l'accès aux soins est complexe car trop éloignés. Cet e-coaching santé contribue à la réduction des inégalités sociales de santé et accorde une place au patient en tant qu'acteur de sa santé, en l'accompagnant vers une autonomie à adopter des comportements favorables à sa santé. [ABSTRACT FROM AUTHOR]

Abstract: The chemical warfare agents such as VX represent a threat for both military and civilians, which involves an immediate need of effective decontamination systems. Since human scalp is usually unprotected compared to other body regions covered with clothes, it could be a preferential site of exposure in case of terrorist acts. The purpose of this study was to determine if skin decontamination could be efficient when performed more than 1h after exposure. In addition, the impact of hairs in skin contamination was investigated. By using in vitro skin models, we demonstrated that about 75% of the applied quantity of VX was recovered on the skin surface 2h after skin exposition, which means that it is worth decontaminating even if contamination occurred 2h before. The stratum corneum reservoir for VX was quickly established and persistent. In addition, the presence of hairs modified the percutaneous penetration of the nerve agent by binding of VX to hairs. Hair shaft has thus to be taken into account in the decontamination process. Reactive Skin Decontamination Lotion (RSDL) and Fuller’s Earth (FE) were active in the skin decontamination 45min post-exposure, but RSDL was more efficient in reducing the amount of VX either in the skin or in the hair. [Copyright &y& Elsevier]

Abstract: The use of chemical warfare agents such as VX in terrorism act might lead to contamination of the civilian population. Human scalp decontamination may require appropriate products and procedures. Due to ethical reasons, skin decontamination studies usually involve in vitro skin models, but human scalp skin samples are uncommon and expensive. The purpose of this study was to characterize the in vitro permeability to VX of human scalp, and to compare it with (a) human abdominal skin, and (b) pig skin from two different anatomic sites: ear and skull roof, in order to design a relevant model. Based on the VX skin permeation kinetics and distribution, we demonstrated that (a) human scalp was significantly more permeable to VX than abdominal skin and (b) pig-ear skin was the most relevant model to predict the in vitro human scalp permeability. Our results indicated that the follicular pathway significantly contributed to the skin absorption of VX through human scalp. In addition, the hair follicles and the stratum corneum significantly contributed to the formation of a skin reservoir for VX. [Copyright &y& Elsevier]

Abstract: The main objective of this investigation is to characterize several industrial pressure sensitive adhesives (PSA) for their microencapsulation. The adhesive selected must remain stable within the variations of the microencapsulation conditions. Thanks to its encapsulation, the adhesive will be self protected into the microcapsule''s shell, and its release will be then controlled applying a light pressure. First, physicochemical microencapsulation processes were selected, and three industrial water-based acrylic adhesives were consequently chosen. The adhesive main characteristics (composition, particle size distribution and peel strength) were determined. Then, particle size stability was tested under ranges of pH (from 2 to 9), temperature (from 5 to 85°C) and electrical conductivity variations (up to 12mS/cm), within an interval of values encountered in the physicochemical processes of microencapsulation. Finally, the compatibility with various solvents (acetone, ethanol and ethyl acetate) was also tested. [Copyright &y& Elsevier]

Summary: Introduction: The objective was to assess the efficacy of adapted physical activity on quality of life of hospitalized children and adolescents with cancer. Facts: Thirty children were included in the APOP study (mean age 13.6±2.9 years; 18 males). Cross-over analysis revealed no effect of period or interaction between physical activity and period. Quality of life was higher when children practiced than when they did not practice physical activity during their hospitalization, as reported by both children and parents, for the dimensions of physical functioning (P <0.0001), role/social-physical limitations (P =0.001), self-esteem (P <0.0001) and mental health (P <0.0001). Physical activity had a significant effect on the general behavior dimension (P =0.01), as reported by children, and on the bodily pain dimension (P =0.0004), as reported by parents. Conclusion: Physical activity practiced during hospitalization for children with cancer was associated with better health-related quality of life. [Copyright &y& Elsevier]

Abstract: Myoglobin (Mb)-loaded poly(ε-caprolactone) (PCL) microparticles were prepared by multiple emulsion with solvent extraction/evaporation method under more or less deleterious operating conditions. The protein integrity was monitored using both UV/Vis absorbance ratio method at specific wavelengths and a conductometric bi-enzymatic biosensor based on proteinase K and pronase. Under standard operating conditions, Mb remained in native conformation, while different degrees of protein denaturation were observed by changing the encapsulation conditions. It was shown that solvent elimination under reduced pressure and in a lower extent addition of a higher molecular weight PCL led to protein alteration. In the first case, the loss of protein integrity can be attributed to residual solvent entrapped in particles whose solidification was accelerated. In the second case, denaturation may be explained by an increase in the protein exposure time at water/organic solvent interface due to an increase in organic phase viscosity. [Copyright &y& Elsevier]

Background/Aims: Stratum corneum (SC) removal is needed in biopharmaceutical studies or in evaluating the barrier function. The most common technique is the tape stripping method. However, it results in neither a homogeneous nor a complete removal. Methods: The removal qualities of tape stripping, cyanoacrylate skin surface biopsy and trypsinization were estimated in vitro via histological imaging and confocal Raman microspectroscopy (CRM) and compared. In addition, the potential of the noninvasive CRM as a replacement method is discussed. Results: Comparison between the 3 methods showed, as expected, that the tape stripping method did not result in a uniform removal over the whole surface even after 28 strips. The trypsinization and cyanoacrylate skin surface biopsies allowed a complete and uniform removal of the SC after defining a standard protocol (2 cyanoacrylate strips with a polymerization time of 15 min). Conclusion: The feasibility of CRM to control SC removal was demonstrated in vitro. Tape stripping is a simple method, but it is influenced by many extrinsic factors and axial drug quantification is difficult. With trypsinization and cyanoacrylate methods, the entire SC is removed so that quantification over the whole SC is possible but not an axial drug screening. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Abstract: The aim of the present study was to evaluate the percutaneous penetration of five common radiopharmaceuticals (99mTc, 67Ga, 125I, 111In and 51Cr) and to evaluate the effect of decontamination by a detergent solution dedicated to hospital institutions for that purpose. The skin kinetic profiles were established by using the in vitro Franz cell method over 24h. The skin distribution in each skin layer was quantified after 6h exposure time and the efficacy of the detergent solution to remove radionuclides was evaluated also after 6h. The most striking result was the repartition into two classes of kinetic profiles: 125I and 99mTc permeated quickly (∼60% of applied activity after 24h) while the 3 other radionuclides permeated slowly (from ∼2.75% for 67Ga to ∼10% of applied activity for 111In). The lag times, i.e. the time necessary to cross the skin varied from 20min for 99mTc to 5h for 51Cr, which accumulated in skin compartments. Skin washings with the detergent solution were particularly efficient for this radionuclide, contrary to the others for which the washing procedure should be applied earlier. The permeation of ions was dependent on their chemical and physical forms and on their salting-in or salting-out effects (coordination state and Hofmeister series). [ABSTRACT FROM AUTHOR]

An optimized process for protein encapsulation was applied to formulate epidermal growth factor (rhEGF)-poly-ℇ-caprolactone microspheres. Microparticles mean size was 3.8 µm ± 0.2 and the encapsulation efficiency was 41.9% ± 2.6. rhEGF recovery after the encapsulation process was ∼70% (41.9% inside the microspheres and 30% still active in the external phase). In vitro release experiments in McIlvaine buffered solution showed a rhEGF sustained release over 4 days. Skin absorption studies conducted on full-thickness human skin using the Franz cell method showed that 20% rhEGF was released from the microspheres after 24 h exposure. Microspheres accumulated in the stratum corneum where they may act as a rhEGF reservoir. Therefore, rhEGF-PCL microparticles seemed to be promising systems due to their ability to provide locally a sustained release of rhEGF in skin layers. [ABSTRACT FROM AUTHOR]

Abstract: The evolution of regulation on chemical substances (i.e. REACH regulation) calls for the progressive substitution of toxic chemicals in formulations when suitable alternatives have been identified. In this context, the method of Hansen solubility parameters was applied to identify an alternative solvent less toxic than methylene chloride used in a microencapsulation process. During the process based on a multiple emulsion (W/O/W) with solvent evaporation/extraction method, the solvent has to dissolve a polymer, poly(ɛ-caprolactone) (PCL), which forms a polymeric matrix encapsulating or entrapping a therapeutic protein as the solvent is extracted. Therefore the three partial solubility parameters of PCL have been determined by a group contribution method, swelling experiments and turbidimetric titration. The results obtained allowed us to find a solvent, anisole, able to solubilize PCL and to form a multiple emulsion with aqueous solutions. A feasibility test was conducted under standard operating conditions and allowed the production of PCL microspheres. [Copyright &y& Elsevier]

Background Although parent-child agreement is widely studied in the paediatric clinical sample, no study has compared parent-child agreement during home and hospital stays. We aimed to determine the level of agreement in reports of health-related quality of life (HRQoL) between parents of children with cancer and the children themselves during a stay in the hospital and a stay at home. Methods The sample consisted of 28 children, aged 9-18 years old, hospitalized and treated for cancer in a Children's University Hospital in France. The child's HRQoL was assessed by the parent and child versions of the Child Health Questionnaire. Parent-child agreement was estimated by the intraclass correlation coefficient. Potential predictors influencing the parent-child agreement were investigated. Results For both locations of stay, parent scores from the HRQoL survey were lower than those for their children for all domains, except for the general behaviour during the home stay. Scores for both parents and children, for all domains, were lower during the hospital than the home stay. The parent-child agreement was better for mental health, self-esteem, general health and family activities during the hospital stay (range 0.32-0.66), but was better for physical function, role/physical and general behaviour during the home stay (range 0.45-0.71). Few predictors of parent-child agreement were found. Conclusions Agreement between parents and their children who have cancer in reporting the child's HRQoL differed by location of stay. For the home stay, the agreement was better for domains related to the child's physical life, but for the hospital stay, it was better for domains related to the child's behaviour/psychological life. [ABSTRACT FROM AUTHOR]

Abstract: The first objective of this study was to prepare microspheres containing a model protein by double emulsion-solvent evaporation/extraction method. This method was modified to consider the fragile nature of proteins. These modifications related to the reduction of polymer loss, of agitation duration and of contact time between protein and solvent. The polymer used was poly(ɛ-caprolactone) and the model protein was bovine serum albumin. The control of the microsphere properties constituted a second objective of this project. A screening design methodology was used to evaluate the effects of the process and formulation variables on microsphere properties. Twelve operating factors were retained, and the particle properties considered were the mean size, the encapsulation efficiency, and the surface state. The statistical analysis of the results allowed determining the most influent factors. Considering the whole results, it appeared that the polymer concentration, the osmotic pressure equilibrium and the volume of the inner, outer and organic phases were the most important parameters. Following this screening study, it was possible to produce particles of small size with high entrapment efficiency (near to 80%) and smooth surface. A good batch to batch reproductibility was obtained. [Copyright &y& Elsevier]

Background. Although antibiotic prophylaxis for infective endocarditis (IE) has been recommended for persons with predisposing cardiac conditions (PCCs) for many years, its efficacy, which has not been demonstrated, has been recently challenged. To assess its usefulness, we estimated the risk of developing IE after undergoing a dental procedure for which subjects would be eligible for prophylaxis, both in subjects having (protected procedure) or not having (unprotected procedure) received antibiotic prophylaxis. Methods. The number of French persons with PCCs, the annual number of dental procedures in which subjects would be eligible for antibiotic prophylaxis, and the number of procedures that were unprotected were estimated on the basis of a survey performed on a sample of 2805 subjects aged 25-84 years. The annual number of IE cases possibly due to an unprotected procedure was estimated on the basis of a 1-year epidemiological study of IE conducted in an area inhabited by 16 million people. Results. After standardization, extrapolation of results to the age-equivalent general population (39 millions subjects) indicated the following: first, 3.3% (95% confidence interval [CI], 2.6%-4%) of the subjects had PCC, 2.7 million (95% CI, 2.3-3.2 million) of whom had undergone at least 1 at-risk dental procedures within the survey year, and the procedures were unprotected in 62% of cases; second, 37 (95% CI, 18-68; 2.7%) of the 1370 annual IE cases in France were possibly related to unprotected procedures. Thus, the risks of developing IE were estimated to be 1 in 46,000 for unprotected procedures (1 in 10,700 and 1 in 54,300 for subjects with prosthetic and native valve PCC, respectively) and 1 in 150,000 for protected procedures. Conclusions. A huge number of prophylaxis doses would be necessary to prevent a very low number of IE cases. [ABSTRACT FROM AUTHOR]

Background: Iron has been suggested to play a role in the development of cardiovascular disease (CVD) through its pro-oxidant properties. However, epidemiological studies on iron status and the risk of CVD have yielded conflicting results. We therefore carried out a prospective study to evaluate the relationship between iron status and CVD in a middle-aged French population.Methods: In total, 9917 subjects (3223 men aged 45-60 years and 6694 women aged 35-60 years) included in the SU.VI.MAX (SUpplementation en VItamines et Minéraux AntioXydants) cohort were followed prospectively for 7.5 years. All cases of ischaemic heart disease (IHD) were identified and validated. CVD risk factors, haemoglobin and serum ferritin concentrations were measured at baseline.Findings: Of men 4.3%, and of women 37.8%, presented at baseline a serum ferritin concentration <30 microg l(-1). During the follow-up, 187 subjects (148 men, 39 women) developed IHD. Serum ferritin was positively associated with total cholesterol, serum triglycerides, systolic and diastolic blood pressure, body mass index and haemoglobin. No linear association was found between serum ferritin and IHD risk in men or in women.Conclusion: Our data do not support a major role of iron status in the development of IHD in a healthy general population. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Non-carious cervical lesions (NCCL), also termed abfractions, have long been thought to be produced by excessive brushing. Nearly 20 years ago an occlusal etiology was proffered (Lee & Eagle 1984). Controversy still exists concerning these two concepts. The present work was carried out to verify the occurrence of signs of excessive brushing or occlusal disturbances associated with abfractions. MATERIAL AND METHODS: All first consultants were screened for the presence of abfractions during one trimester. NCCL were found in 61 patients who consequently received a thorough examination searching for clinical evidence of excessive brushing or occlusal disturbances. The presence of plaque, calculus, periodontitis, or mobility was also noted. Simple frequency and percentage were used to describe the occurrence of different clinical signs in association with the presence of abfractions. RESULTS: Abfractions often exist in mouths presenting plaque (40.1%), calculus (41.7%), or periodontitis (20.4%). Ulceration of the gingiva is a rare finding (1.6%). However, subgingival apical limits were frequent (32.5%). NCCL coexist almost systematically with occlusal wear facets (94.5%). Lack of canine disclusion (77.2%) was also closely associated with the presence of abfractions. Conversely, mobility was seldom found (1.9%). CONCLUSIONS: Clinical signs of excessive brushing were lacking, whereas signs of occlusal disturbance were very consistent with the presence of abfractions. [ABSTRACT FROM AUTHOR]

Summary Objectives: The use of psychotropic drugs has increased continuously over recent years in industrialized countries. In Europe, France has the highest consumption of such drugs. The aim of this study was to identify the sociodemographic and medical factors associated with the use of psychotropic agents. Methods: Data, collected as part of the SUVIMAX (SUpplementation en VItamines et sels Mineraux AntioXydants) prevention trial, from a self- administered questionnaire involving 7299 subjects aged 45–60 years, were subjected to logistic regression analysis. Results: A total of 467 subjects used psychotropic drugs (8·4% of the women, 4·6% of the men). Use of psychotropic drugs increased in subjects of both sexes with past history of depression, perception of poor health and use of other drug treatments. Widowhood in men [odds ratio (OR) = 3·4; 95% CI = 1·6–7·3] and divorce in women (OR = 2; 95% CI = 1·2–3·2) were also associated with an increased use of psychotropic drugs. Interaction was demonstrated between educational level and occupational satisfaction in men (OR = 2·9; 95% CI = 1·5–5·8) and between perception of health status and use of other types of medication in women (OR = 6·5; 95% CI = 4·6–9·5). Conclusion: The results of our study are consistent with those of others in demonstrating that specific socio-occupational factors in men and specific medical factors in women influence extent of use of psychotropic drugs. [ABSTRACT FROM AUTHOR]

The iron status of a national sample of adults living in France and participating in the SU.VI.MAX cohort, was assessed using serum ferritin and hemoglobin concentrations. Complete data were obtained for 6648 women 35-60 y old and for 3283 men 45-60 y old. Assessment of iron dietary intakes was realized on a subsample of 3111 women and 2337 men who reported six 24 h dietary records during a one-year period; 22.7% of menstruating women and 5.3% of post-menopausal women presented a total depletion of iron stores (serum ferritin < 15 microg/l). Iron-deficient anemias were found in, respectively, 4.4% and less than 1% of these women. Three-quarters of the anemias were related to iron deficiency in menstruating women. In men, iron depletion and iron deficiency anemia were very rare. Post-menopausal women had much higher serum ferritin levels than menstruating women. In menstruating women, those using intrauterine devices had significantly lower serum ferritin levels than those without contraception, and much lower than those using oral contraception. The frequency of iron depletion reached 28.1% in women using intrauterine devices, but only 13.6% in those using oral contraceptives. The mean iron intake was 16.7 +/- 5.7 mg/d in men and 12.3 +/- 3.4 mg/d in women. Heme iron represented respectively, 11.1 and 10.4% of iron intake. Ninety-three percent of menstruating women had dietary iron intakes lower than recommended dietary allowances (RDA); 52.6% consumed less than two thirds of these RDA. In post-menopausal women and men, respectively 27.7% and 3.6% had dietary intakes lower than RDA. Serum ferritin was positively correlated with meat, fish and total iron intake, and negatively correlated with dietary products consumption, calcium and fiber intake. [ABSTRACT FROM AUTHOR]

Introduction et but de l’étude La prévalence du surpoids et de l’obésité continue de croître dans les catégories les moins favorisées, mais se stabilise, voire régresse dans les catégories les plus favorisées contribuant à aggraver les inégalités sociales. Cette situation justifie leur prise en compte lors d’intervention à visée préventive ou thérapeutique. Cette étude a pour objectif de mesurer les inégalités sociales de corpulence chez les adolescents et leurs évolutions après la mise en place d’une intervention en milieu scolaire. Matériel et méthodes Mille quatre cent dix-huit adolescents (âgés de 13 à 18 ans) issus des classes de troisième et de seconde de 36 établissements scolaires du département des Vosges ont été inclus dans l’étude Pralimap-Ines, dont 1142 avec un suivi à la fin de l’année scolaire. À l’entrée et à la fin de l’année scolaire, ils ont été pesés et mesurés (poids, taille, périmètre abdominal) et ont répondu à des questionnaires sur leur milieu social (score selon la FAS : Family Affluence Scale, de 0 à 9), leur alimentation, leur activité physique et leur état de santé général. Le score selon la FAS a été catégorisé en cinq classes : très défavorisés [0–2], défavorisés [3–4], intermédiaires [5], favorisés [6–7] et très favorisé [8–9]. Les interventions ont consisté en une prise en charge standard pour les adolescents de milieux favorisés (FAS > 5) et en une prise en charge adaptée pour les adolescents de milieu défavorisés (FAS ≤ 5). Le gradient social correspond à une relation linéaire entre le niveau social et l’état de santé. Des modèles de régression linéaire (analyse de pente et test de tendance linéaire) ont été utilisés pour décrire le GS. Résultats À l’inclusion, plus le milieu social était élevé, plus la corpulence était basse traduisant un gradient social : β = −0,6 kg/m 2 , p < 0,0001 pour l’IMC ; β = −0,08, p = 0,0009 pour le Z-score de l’IMC et β = −5 %, p = 0,002 pour la prévalence de l’obésité. Ce gradient social était en cohérence avec plusieurs déterminent de l’excès pondéral comme la pratique d’une activité physique ( β = +190 MET.min par semaine, p < 0,0001), la fréquence de consommation de fruits et légumes ( β = +2 par semaine, p < 0,0001), la fréquence de consommation de produits sucrés ( β = −1 par semaine, p = 0,006) et la perception d’un état de santé bon/excellent ( β = +4 %, p < 0,0001). À la fin des interventions, il y avait une réduction, voire une disparition du gradient social, avec une réduction de corpulence plus importante chez les adolescents défavorisés : β = −0,4 kg/m 2 , p < 0,0008 pour l’IMC ; β = −0,05, p = 0,02 pour le Z-score de l’IMC ; β = +138 MET.min par semaine, p = 0,01 pour l’activité physique ; β = +1 par semaine, p < 0,006 pour la consommation de fruits et légumes, β = −0,4 par semaine, p = 0,2 pour la consommation de produits sucrés et β = +2 %, p = 0,2 la perception d’un état de santé bon/excellent. Conclusion Ces données confirment l’existence d’un réel gradient social de corpulence chez les adolescents qui est cohérent avec les déterminants du surpoids. Une intervention ciblée à partir du milieu scolaire et tenant compte du milieu social paraît efficace sur l’atténuation de ce gradient. [ABSTRACT FROM AUTHOR]

Introduction L’objectif était de décrire le vécu du parcours du don, ses déterminants et son retentissement sur la qualité de vie (QV), un an après le don de rein. Patients et méthodes Cinq cents donneurs vivants (DV) prélevés ont été inclus entre octobre 2009 et janvier 2012 pour une évaluation avant don (T0) puis suivis à 3 (T1) et 12 mois après don (T2). Leur vécu du parcours, la QV (SF-36 et Euroqol), l’anxiété et la dépression (HAD) et l’estime de soi ont été analysés par questionnaires envoyés au domicile. Les données médicales provenaient du registre CRISTAL. Résultats Trois cents quatre-vingt-quatre DV ont répondu aux 3 temps de mesure soit 68 % de taux de participation complète de la cohorte. Le parcours avant don a été en moyenne de 11 mois, jugé trop long par 1 donneur sur 5, opaque et stressant par un sur 3. Cinquante-sept déclarent au moins une complication après don (douleurs 73 %, complications sévères 3 %). Le prélèvement par cœlioscopie (80 %) est associé à moins de complications pulmonaires, d’HTA, de douleurs et à une meilleure récupération physique et QV. Ils ont repris le travail après une durée d’arrêt médiane de 63 jours (9/10) ; tous n’ont pas complétement récupéré (3/10) et ressentent encore des douleurs (3/10). Ils ont retrouvé le niveau d’estime de soi pré-don (3/4), avec un sentiment de fierté (2/3). Avant le don, un donneur de 75 ans a la même QV physique qu’un homme de 35 ans en population générale. Un an après, ils n’ont pas tous retrouvé leur niveau de QV physique (4/10) et mentale (1/2) restant supérieurs à ceux de la population générale. Les donneurs regrettent un suivi médical et psychologique insuffisant et déclarent un préjudice financier (3/10), influençant l’évolution à un an. Le parcours est lourd et l’expérience jugée stressante mais positive et enrichissante. Ils seraient prêts à le refaire (98,2 %) et à le conseiller (96 %). Conclusion Cette étude nationale met en lumière le fort engagement des DV et confirme leur bon état physique et mental mais met en lumière les difficultés rencontrées même si l’expérience vécue n’altère ni l’élan initial, ni le sens attribué au don. Elle conduit à des recommandations visant à améliorer les facteurs potentiellement modifiables : développement de la cœlioscopie, mieux préparer et informer sur le geste chirurgical et ses suites, les obligations et la longueur du parcours, assurer une prise en charge complète de la douleur, anticiper le besoin de soutien et détecter le risque de survenue d’anxiété/dépression, informer clairement sur les aspects professionnels et financiers. [ABSTRACT FROM AUTHOR]

Introduction et but de l’étude Les études relatives à l’obésité de l’enfant et l’adolescent et ses conséquences montrent de nombreuses inégalités d’accès à la prévention et aux soins. Le programme PRALIMAP-INES vise à montrer l’efficacité d’interventions adaptées pour les adolescents issus de milieux moins favorisés. Cette stratégie a montré sa faisabilité pour les adolescents en surpoids et des insuffisances pour les sujets obèses. L’objectif est de développer et tester une stratégie de coordination des acteurs de santé permettant un accompagnement adapté à destination des adolescents obèses de milieu social moins favorisés. Matériel et méthodes Le surpoids est dépisté à l’école en début d’année scolaire. Le statut social «Favorisé» ou «Moins favorisé» est déterminé. Un accompagnement de 5 séances collectives est proposé à tous les adolescents dépistés. S’il est moins favorisé, l’adolescent reçoit éventuellement des interventions supplémentaires adaptées à ses besoins. Le parcours de prise en charge des adolescents, affectés au groupe bénéficiant d’interventions supplémentaires, est construit lors d’une réunion de concertation pluridisciplinaire. Différentes activités sont proposées dans l’établissement: entretiens motivationnels et en activité physique, ateliers alimentation… et d’autres au centre spécialisé de l’obésité (CSO): bilan biomédical, initiation d’un parcours personnalisé d’éducation thérapeutique. Résultats et Analyse statistique Sur 4324 adolescents pesés et mesurés, 202 adolescents (4,7 %) avaient un IMC supérieur au seuil IOTF de 30 kg/m 2 à 18 ans. 192 ont été inclus dans le programme PRALIMAP-INES dont 95 issus de milieu social moins favorisé. Parmi les 69 affectés au bras bénéficiant d’interventions supplémentaires, 58 se sont vus proposer une prise en charge médicale de recours et 22 sont venus au CSO. Conclusion La 1 re étape pour l’adolescent, consistant à la réalisation d’un bilan médical au CSO a pu être réalisée grâce à la coordination assurée par une infirmière. Elle a contacté en 1 er l’adolescent et les parents pour proposer et organiser le bilan mais également le médecin traitant, l’infirmier de l’éducation nationale, la sécurité sociale, les taxis... en fonction des besoins et des difficultés rencontrées. La continuité de la prise en charge médicale et la coordination du parcours de soins doivent être travaillées pour permettre un suivi et un maintien sur le long terme avec tous les acteurs. [ABSTRACT FROM AUTHOR]