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Improving the vaccinal policy has become a major stake in France as in many other developed countries. The neglect of vaccination strategies by citizens has complex and multiple causes. Some are directly linked with recent media controversies about vaccination and with a global lack of confidence toward producers and regulators. Other causes are directly linked with individual behaviors, professional practices and primary care organization. Community pharmacists have a good observing position of this phenomenon, as they are prepositioned on the territory, in constant contact with both outpatients and healthy people. Pharmacist's sociological and technical observations appear to be useful in designing new approaches for improving vaccinal strategies. While the 2012-2017 "vaccine policy" should emphasize the central role of general practitioners in France, these observations invite to develop innovative collaboration with pharmacists in the search of a better vaccine coverage., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

New European Directive 2006/7/EC concerning the management of bathing water quality introduces the concept of 'active management of bathing water sanitary quality' which could lead to a temporary bathing prohibition in case of short term pollution. For the last three bathing seasons, Veolia has carried out in experimental mode this 'active management' concept at more than one hundred bathing sites with various characteristics. Results confirm the high level of microbiological pollution observed in sewer overflows during rainy periods, which is the main cause of bathing water quality deterioration. An on-line treatment solution has been successfully tested. This solution may be used in dense urban areas.

The main causes of cancer of the larynx and hypopharynx are smoking cigarettes and drinking alcohol. However, for these as well as for other cancers of the upper aerodigestive tract, some dietary components, mainly low consumption of fruit and vegetables, have been observed to be associated with increased cancer risk. We report results from a multicenter case-control study carried out in six regions of Europe located in northern Spain, northern Italy, Switzerland, and France. A total of 1,147 males with cancer (cases) and 3,057 population controls were interviewed on usual diet, lifelong drinking and smoking habits, and occupational history. Cancer cases had histologically verified epidermoid carcinomas. The cancers were classified in two anatomic sub-entities: the epilarynx (hypopharynx and upper part of the larynx), which enters into contact with the bolus and the air; and the endolarynx, through which air and tobacco smoke pass, but not the bolus. A previous report from this study found that alcohol drinking presents a greater risk factor for cancer of the epilarynx than for cancer of the endolarynx. The main results regarding diet indicate that high intake of fruit, vegetables, vegetable oil, fish, and low intake of butter and preserved meats were associated with reduced risk of both epilaryngeal and endolaryngeal cancers, after adjustment for alcohol, tobacco, socioeconomic status, and non-alcohol energy intake. Among nutrients, a reduced risk was found for high intake of vitamins C and E and for a high polyunsaturated/saturated fatty acids (P/S) ratio. While these variables are relevant in scoring nutritional behaviour, it remains unresolved whether the biologic properties of these nutrients play a role in the apparent protective effect.

From the data collected in the Cancer Registry of Calvados, a screening program for neoplastic lesions of the whole upper digestive and respiratory tract was performed in a canton where esophageal cancer incidence is very high. 137 men underwent this examination for mouth, pharyngo-larynx and esophagus. None neoplastic lesion was revealed but histologic and cytologic swabs showed some abnormalities that are now being studied.

The measurement of ionized calcium has evolved in the last decade, and can now be easily performed by clinical laboratories using direct potentiometric analyzers available from a number of manufacturers. An original protocol for a comparison of the analyzers was used through a parallel multicenter evaluation in France. Using newly developed aqueous buffered solutions, this study focused not only on the analytical performance and operational handling of analyzers, but also on possible interferences in biological samples and the clinical relevance of the measurement with respect to the techniques of sample collection. All the instruments exhibited good precision and linearity, and were easy to handle and robust for daily use. However, not all the models gave identical results on the same patient's specimen. The utility of some Ca2+ analyzers has been further enhanced by the ability to "correct" the results to pH 7.40, although care must be taken in the interpretation of these results. While there are a number of clear-cut situations in which Ca2+ measurement is more relevant than total calcium, it seems that chemical activity of Ca2+ in blood may sometimes be considered with great caution under pathological conditions. The role of Ca2+ measurement in routine will be discussed in relation to the potential benefits of the instruments in laboratories.

A case-control study on larynx and hypopharynx cancer was carried out in 6 populations including the city of Turin and the province of Varese (Italy), the provinces of Navarra and Zaragoza (Spain), the canton of Geneva (Switzerland), and the département of Calvados (France). This report presents an analysis of the risk associated with alcohol and tobacco consumption based on 1,147 male cases and 3,057 male population controls. Special attention was given to the study of the risk at various sites of larynx and hypopharynx. The effect of tobacco is similar for all sites and the risk associated with ever smoking is on the order of 10. The risks from alcohol drinking depend on site. They are similar for epilarynx and hypopharynx (RR = 4.3, for more than 80 g/day) and lower for endolarynx (RR = 2.1, for more than 80 g/day). For all sites the risk decreases after quitting (RR = 0.3 after 10 years); exclusive use of filter cigarettes is protective (RR = 0.5 relative to smokers of plain cigarettes only) as is exclusive use of blond tobacco (RR = 0.5 relative to smokers of black tobacco only). Inhalation increases the risk of endolaryngeal cancer but not that of hypopharynx or epilarynx. The relative risks for joint exposure to alcohol and tobacco are consistent with a multiplicative model.