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In contrast to the majority of allergic or hypersensitivity conditions, worldwide anaphylaxis epidemiological data remain sparse with low accuracy, which hampers comparable morbidity statistics. Data can differ widely depending on a number of variables. In the current document we reviewed the forms on which anaphylaxis has been defined and classified; and how it can affect epidemiological data. With regards to the methods used to capture morbidity statistics, we observed the impact of the anaphylaxis coding utilizing the World Health Organization's International Classification of Diseases. As an outcome and depending on the anaphylaxis definition, we extracted the cumulative incidence, which may not reflect the real number of new cases. The new ICD-11 anaphylaxis subsection developments and critical view of morbidity statistics data are discussed in order to reach new perspectives on anaphylaxis epidemiology. © 2018 The Author(s).

Retinitis pigmentosa (RP) represents a group of clinically heterogeneous retinal degenerations in which all modes of inheritance have been described. We have previously found two different clinical profiles in X linked RP as a function of age and mode of onset. The first clinical form has very early onset with severe myopia. The second form starts later with night blindness with mild myopia or none. At least two genes have been identified in X linked forms, namely RP2 (linked to DXS7, DXS255, and DXS14) and RP3 (linked to DXS84 and OTC) on the short arm of the X chromosome. In order to contribute to phenotype-genotype correlations in X linked RP, we tested the hypothesis that the two clinical profiles could be accounted for by the two different gene loci. The present study provides evidence for linkage of the clinical form with early myopia as the onset symptom with the RP2 gene (pairwise linkage to DXS255: Z = 3.13 at theta = 0), while the clinical form with later night blindness as the onset symptom is linked to the RP3 gene (pairwise linkage to OTC: Z = 4.16 at theta = 0).

Objectives This study investigated the role of maternal exposures at work during pregnancy in the occurrence of oral clefts. Methods The occupational exposures of 851 women (100 mothers of babies with oral clefts and 751 mothers of healthy referents) who worked during the first trimester of pregnancy were studied. All the women were part of a multicenter European case-referent study conducted using 6 congenital malformation registers between 1989 and 1992. In each center, the mother's occupational history, obtained from an interview, was reviewed by industrial hygienists who were blinded to the subject's status and who assessed the presence of chemicals and the probability of exposure. Odds ratios (OR) were estimated by a multivariate analysis including maternal occupation or occupational exposures during the first trimester of pregnancy and possible confounding factors such as center of recruitment, maternal age, urbanization, socioeconomic status, and country of origin. Results After adjustment for confounding factors, cleft palate only was significantly associated with maternal occupation in services such as hairdressing [OR 5.1, 95% confidence interval (95% CT) 1.0-26.0] and housekeeping (OR 2.8, 95% CI 1.1-7.2). The analysis suggests that the following occupational exposures are associated with orofacial clefts: aliphatic aldehydes (OR 2.1, 95% CI 0.8-5.9) and glycol ethers (OR 1.7, 95% CI 0.9-3.3) for cleft lip with or without cleft palate and lead compounds (OR 4.0, 95% CI 1.3-12.2), biocides (OR 2.5, 95% CI 1.0-6.0), antineoplastic drugs (OR 5.0, 95% CI 0.8-34.0), trichloroethylene (OR 6.7, 95% CI 0.9-49.7), and aliphatic acids (OR 6.0, 95% CI 1.5-22.8) for cleft palate only. Conclusions Due to the limited number of subjects, these results must be interpreted with caution. However, they point out some chemicals already known or suspected as reproductive toxins.

Objectives. This study examined the relationship between maternal tobacco and alcohol consumption during the first trimester of pregnancy and oral clefts. Methods. Data were derived from a European multicenter case-control study including 161 infants with oral clefts and 1134 control infants. Results. Multivariate analyses showed an increased risk of cleft lip with or without cleft palate associated with smoking (odds ratio [OR]= 1.79, 95% confidence interval [CI]= 1.07, 3.04) and an increased risk of cleft palate associated with alcohol consumption (OR = 2.28, 95% CI = 1.02, 5.09). The former risk increased with the number of cigarettes smoked. Conclusions. This study provides further evidence of the possible role of prevalent environmental exposures such as tobacco and alcohol in the etiology of oral clefts.

Glycol ethers are found in a wide range of domestic and industrial products, many of which are used in women's work environments. Motivated by concern about their potential reproductive toxicity, we have evaluated the risk of congenital malformations related to glycol ether exposure during preg nancy as part of a multicenter case-control study, conducted in six regions in Europe. The study comprised 984 cases of major congenital malformations and 1,134 controls matched for place and date of birth. Interviews of the mothers provided information about occupation during pregnancy, sociodemographic variables, and other potential risk factors (medical history, tobacco, alcohol, drugs). A chemist specializing in glycol ethers evaluated exposure during pregnancy, using the job description given by the mother, without knowledge of case or control status. We classified malformations into 22 subgroups. The overall odds ratio (OR) of congenital malformation associated with glycol ether exposure was 1.44 [95% confidence interval (CI) = 1.10-1.90], after adjustment for several potential confounders. The association with exposure to glycol ethers appeared particularly strong in three subgroups: neural tube defects (OR = 1.94; 95% CI = 1.16-3.24), multiple anomalies (OR = 2.00; 95% CI = 1.24-3.23), and cleft lip (OR = 2.03; 95% CI = 1.11-3.73). In this last subgroup, risk, especially of an isolated defect, tended to increase with level of exposure.

The authors report a retrospective study of therapeutic abortions for antenatally diagnosed abnormalities, 146 fetuses are concerned during a five years period, an anatomo-pathological examination have been performed in all cases, malformations of central nervous system are the most frequent (62). 26 urologic abnormalities are especially detailed. There are 10 isolated urologic abnormalities, and 16 abnormalities multiples. All fetuses had renal lesions which could justified an intervention but the declaration at registration of congenital birth defects is not obligatory. A multidisciplinary approach to prenatal diagnosis and congenital birth must still developed for a better understanding.

The high incidence of chromosomal anomalies at birth and the severity of the resulting handicap led to examining their detectability by amniocentesis. With current indications for amniocentesis, the detection rate did not excede 30%. Consequently, it seems necessary to estimate the importance of other known risk factors and to calculate the resulting impact this would have on eventually broadening the indications for amniocentesis. A review of the literature led the authors to discuss the relative importance of each known risk factor and its role in public health.

French health professionals are now required to provide relevant information on the test screening for Down syndrome and its possible implications when making the test available to pregnant women. A questionnaire was designed to assess prescription modalities, explanation of results, opinion on the information received when test was offered and test results were given, and likely decision after screening.The response rate was 39% (1473 questionnaires analyzed). In 90.5% of the answers, women declared that an interview had preceded test prescription. 61.2% of women were satisfied with both the clarity and quantity of explanations provided and 57.6% considered that the information had helped them decide to undergo or refuse screening. 54.1% were satisfied with the explanations of test results. Amniocentesis was proposed to 125 women, 79.2% of which decided to undergo the procedure. Their opinion concerning explanations of test results was similar to that of women who refused amniocentesis or had not yet made up their minds.Such results demonstrate the necessity to improve and adapt the information delivered by health professionals, keeping in mind that in this type of situation, decision making requires the rapid integration of complex information.

European Workshop on Genetic Testing Offer in Europe, 19-20/11/2012 The workshop was designed with the aim of bringing together experts and stakeholders in the field of genetic testing to discuss the (future) organization of genetic testing in Europe. Obviously since it will not be possible to adequately deal with all aspects of genetic testing within the framework of one workshop, a limited number of issues have been selected. The selection was based on the importance and urgency of the matter and the need and opportunity for action at the European level, and the likelihood for successful intervention. Primary deliverables of this workshop are planned as to be able to define a vision on the use, value and integration of genomic medicine into clinical practice and to prepare a briefing note to highlight the specific points that deserve the Commission’s interest. Quality of genetic testing and organization of genetic testing services were the two main themes of the scope of the workshop. To warrant the quality of the genetic diagnostic laboratories the way forward is to make accreditation the norm, i.e. the diagnostic laboratories in Europe should be accredited. To further guarantee equity, the regulation should include the requirement for all tests to be within the scope accreditation. The embedding of genetic testing in a healthcare setting can ensure a context where due emphasis is being provided on the individualized medical supervision of patients, the presence of pre-test and post-test counseling, psychological follow-up if appropriate and quality assurance of the tests performed. In light of growing number of companies selling and advertising genetic tests, it is crucial that information is available for healthcare professionals and the general public that gives background on genetic testing and describes the provision of genetic testing services., JRC.I.3-Molecular Biology and Genomics