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Objective: To assess the diagnostic accuracy of existing clinical criteria and to develop prediction tools for iron deficiency in 2-year-old children., Study Design: In a national cross-sectional study conducted in primary care pediatricians' practices throughout France, 2-year-old children were consecutively included (2016-2017). Multivariable logistic regression modeling and bootstrapping were used to develop several clinical models to predict iron deficiency (serum ferritin <12 μg/L). These models used the best criteria and combinations among the American Academy of Pediatrics' (AAP) criteria adapted to the European context (n = 10), then all potential predictors (n = 19). One model was then simplified into a simple prediction tool., Results: Among 568 included infants, 38 had iron deficiency (6.7%). In univariable analyses, no significant association with iron deficiency was observed for 8 of the 10 adapted AAP criteria. Three criteria (both parents born outside the European Union, low weight at 1 year old, and weaning to cow's milk without supplemental iron) were retained in the AAP model, which area under the receiver operating characteristic curve, sensitivity, and specificity were 0.62 (95% CI, 0.58-0.67), 30% (95% CI, 22%-39%), and 95% (95% CI, 92%-97%), respectively. Four criteria were retained in a newly derived simple prediction tool (≥1 criterion among the 3 previous plus duration of iron-rich formula consumption <12 months), which area under the receiver operating characteristic curve, sensitivity, and specificity were 0.72 (95% CI, 0.65-0.79), 63% (95% CI, 47%-80%), and 81% (95% CI, 70%-91%), respectively., Conclusions: All prediction tools achieved acceptable diagnostic accuracy. The newly derived simple prediction tool offered potential ease of use., Trial Registration: ClinicalTrials.gov NCT02484274., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background & Aims: Iron deficiency (ID) is considered the most frequent micronutrient deficiency in industrialized countries where strategies for its primary prevention vary widely and are insufficiently evaluated. We aimed to study the effectiveness for iron status of a national iron deficiency prevention strategy based on recommendations for young-child formula (YCF) use after age 12 months, taking into consideration other sources of iron and the family's socio-economic status., Methods: In a cross-sectional observational study conducted in primary care pediatrician offices throughout France from 2016 to 2017, infants aged 24 months were consecutively included for a food survey and blood sampling. Associations between YCF consumption and serum ferritin (SF) level were studied by multivariable regression after adjustment on sociodemographic, perinatal and dietary characteristics, notably other intakes of iron., Results: Among the 561 infants analyzed, the ID prevalence was 6.6% (37/561; 95% confidence interval [CI] 4.7-9.0). Daily iron intake excluding YCF and total daily iron intake including YCF were below the 5-mg/day recommended average requirements for 63% and 18% of children, respectively. ID frequency was significantly decreased (or SF level was independently higher) with any YCF consumption after age 10 months (odds ratio 0.15, 95% CI 0.07-0.31), current YCF consumption at age 24 months (median SF level 29 vs 21 μg/L if none), prolonged YCF consumption (28 μg/L if >12 months vs 17 μg/L if none), and increasing daily volume of YCF consumed at age 24 months from a small volume (e.g., 29 μg/L if <100 mL/day vs 21 μg/L if none)., Conclusions: Current or past YCF use was independently associated with a better iron status at age 24 months than non-use. The strategy recommending YCF use at weaning after age 12 months seems effective in the general population. CLINICALTRIALS., Gov Identifier: NCT02484274., Competing Interests: Conflict of interest The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors have no patents, products in development or marketed products to declare., (Copyright © 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Although iron deficiency (ID) is considered the most frequent micronutrient deficiency in industrialized countries and is associated with impaired neurodevelopment when occurring in early years, accurate recent estimations of its prevalence are lacking. Our objective was to estimate ID prevalence and associated sociodemographic markers in young children in France. The Saturn-Inf national cross-sectional hospital-based survey recruited 3,831 French children <6 years old between 2008 and 2009 to assess lead poisoning prevalence and to establish a biobank. This secondary analysis measured serum ferritinemia (SF) in sera kept frozen at -80 °C for children with sufficient serum aliquots and C-reactive protein <10 mg/L. For the 657 participating children (17% of the Saturn-Inf study), the median age was 3.9 years (interquartile range: 2.2-5.1); 52% were boys. The median SF was 44 μg/L (interquartile range: 28-71). ID prevalence was 2.8% (95% confidence interval [1.7, 4.7]) and 3.2% (95% confidence interval [2.0, 5.1]) with an SF threshold of 10 and 12 μg/L, respectively. Low SF was significantly associated (p < .05) with mother being a migrant (32 vs. 45 μg/L for a mother born in France) or unemployed (37 vs. 50 μg/L for a mother employed). In this first national cross-sectional hospital-based study in France, ID prevalence was much lower than that in other French and European studies performed in underprivileged populations but close to the lowest values observed in other population-based studies in Europe., (© 2017 John Wiley & Sons Ltd.)

Introduction: Since the introduction of targeted therapies, specific lymphoma mortality has decreased. Possible long-term toxicities, however, are not known yet. This article describes the implementation of the SIMONAL study that investigates the hypothesis of an overconsumption of care after lymphoma treatment with a 10-year follow-up., Methods: After the mandatory regulatory steps (CCTIRS and CNIL) the vital status and address of 5247 patients treated in 131 French centers were retrieved using a secure web portal, in order to send a quality of life after lymphoma questionnaire. After an additional vital status validation request at the center for epidemiologic research and population health (CESP), the questionnaires were sent. Double data entry was performed on the collected data and a request to access data from France's public health insurance scheme information system (SNIIRAM) was formulated., Results: Retrieval of the addresses via the portal has been slow and multiple reminders were needed. The CESP identified 9.4 % additional deaths not known by the treatment centers. Of the 3391 questionnaires sent, the response rate was 50%. A comparison between the responders and non-responders revealed no demographic differences but showed that the responders were more often treated with targeted drugs as they were included in more recent trials., Discussion: Logistic and information technology (IT) aspects rendered the implementation of the SIMONAL study more complex, time consuming and costly. However, using the collected data, many future research questions will be addressed., (Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Background: Fruit and vegetable consumption is a marker of higher-quality diets; less is known about the contribution of 100% fruit and vegetable juices (FVJ) to diet quality., Objective: To explore FVJ consumption patterns in relation to dietary nutrient density among French children (aged 3-14 years old) and adults (≥21 years old)., Methods: Analyses were based on the nationally representative 2013 CCAF (Comportements et Consommations Alimentaires en France) survey of 1930 respondents, stratified by age group, FVJ consumption, and socioeconomic status (SES). Dietary nutrient density was based on the Nutrient Rich Food (NRF9.3) index, adjusted for gender and age., Results: Mean total consumption of fruits and vegetables was 2.6 servings/day for children and 3.8 servings/day for adults. Mean population consumption of FVJ was 83 mL/day for children and 54.6 mL/day for adults, equivalent to 0.4 servings/day and 0.3 servings/day respectively. FVJ consumers had higher quality diets than did non-consumers, after adjusting for covariates. The respective NRF9.3 values were 486.4 ± 4.3 vs. 428.7 ± 7.5 for children and 460.7 ± 4.4 vs. 435.4 ± 4.4 for adults. FVJ consumers had similar or higher intakes of fruits and vegetables than did non-consumers. The socioeconomic gradient for FVJ consumption was much weaker (p < 0.046) than for whole fruit (p < 0.01)., Conclusions: In a nationally representative sample of French children and adults, fruit and vegetable consumption fell short of recommended values. Higher FVJ consumption was associated with higher-quality diets and better compliance with the French National Plan for Nutrition and Health (PNNS).

Purpose: To compare (1) fluid, food and nutrient intake obtained with a paper versus an online version of a 7-day food record and (2) user's acceptability of both versions of the food record., Methods: A cross-over study was carried out in 2010 in France. A total of 246 participants aged 18-60 years reported their food and fluid intake using both versions of the 7-day food record, separated by a 7- to 14-day washout period. To help participants in estimating consumed portions, both versions of the food record were supported by a photographic booklet of standard portions and containers. At the end of the study protocol, participants completed a questionnaire designed to assess the acceptability of the two questionnaires., Results: The reported water intake of fluids was significantly higher with the online version compared with the paper version (respectively 1348 ± 36 and 1219 ± 34 mL/day, p < 0.0001). No difference was found between methods in terms of energy intake and the consumption of most food categories, macro- and micronutrients. Furthermore, 77 % of the participants preferred the online method to the paper version., Conclusions: Fluid intake, but not food intake, reported with the online 7-day food record was higher in comparison with the paper version. In addition, the online version was preferred by users. In population surveys, the online record is therefore a relevant alternative, and even a preferred alternative in the case of fluid intake, to the paper record.

There is a profound relation between human health and well being from the one side and air pollution levels from the other. Air quality in South of France and more specifically in Nice, is known to be bad, especially in summer. The non-parametric Mann-Kendall test has been developed for detecting and estimating monotonic trends in the time series and applied in our study at annual values of pollutants air concentrations and mortality. An important objective of many environmental monitoring programs is to detect changes or trends in pollution levels over time. Over the period 1990-2005, concerning the emissions of main pollutants, we obtained significant decreasing trends. By considering the ozone mean values in urban areas over the 1997-2005 period, an increase of 3.0% year(-1) was obtained with annual averages and 3.9% year(-1) with median values. A clear increasing trend for PM(10) ambient concentrations is obtained. In addition, we observed an increase of the Olea (and Grass) pollination season. Over the same period, an annual change rate of +0.31% year(-1) for "airway diseases" and of +2.50% year(-1) for "unknown causes" were identified in the "Alpes Maritimes" county. To see the results, there seems to be a short-term link between the levels of these pollutants and mortality for respiratory causes. The other pollutants concentration showed a downward trend reflecting the reduction policy of the emissions. In addition, we obtained significant decreasing trends concerning the "ischemic heart diseases" (-1.20% year(-1)) and "asthma" (-4.03% year(-1)) categories. No significant gender-related difference was identified for these groups.

In laparoscopic fenestration of lymphoceles after kidney transplantation, identification of the correct site of incision is sometimes difficult. We developed a new technique, using diaphanoscopy in 3 patients. After ultrasound-guided puncture and dilation, the correct incision site is identified by white light with a cystoscope inserted into the lymphocele cavity.

Introduction: The aim of this study is to assess the efficiency of extracorporeal shock wave lithotripsy (ESWL) as initial therapy for isolated lower pole kidney stones smaller than 20 mm., Patients and Methods: During a 24-month period 116 patients with previously untreated single stones under 20 mm in diameter were treated with a Dornier lithotripter S. They were analyzed with regard to stone site and size, number of ESWL sessions, auxiliary measures, retreatment rates, complications and the time taken for stone clearance., Results: 76 patients (65.5%) became stone free, 50 of them (43.1%) within 3 months after ESWL. Depending on stone size the stone-free rates were 67.1% for patients with a stone diameter of <10 mm (59 of 88 patients), and 60.7% for stone diameters between 10 and 20 mm (17 of 28 patients). Complications during and after treatment were rare, i.e. the necessity of ureteral stent insertion due to colic (n = 10), endoscopic stone removal (n = 2), acute pyelonephritis (n = 1), stonestreet (n = 1) and 1 case of hematoma not requiring intervention. The recurrence rate during follow-up (13.2-36.9, mean 25.0 months) was low: 16 patients (13.8%) had recurrent or persistent stones, and 74 patients (63.8%) had no evidence of urolithiasis., Conclusions: ESWL is a safe and efficient first-line therapy for treatment of isolated small lower pole kidney stones with acceptable stone-free rates, low morbidity, few complications and a low stone recurrence rate., (Copyright 2003 S. Karger AG, Basel)

Background: The aim of the study was to compare preoperative transrectal ultrasound findings with final histopathological stage after radical prostatectomy to determine the value of TRUS in preoperative staging of prostate cancer., Methods: The evaluation was performed as a retrospective study. In 114 radical prostatectomy specimens the histopathological, ultrasound and rectal digital findings were correlated. Mean age of patients was 63 years and in all patients a radical retropubic prostatectomy was performed., Results: Organ confined PC was found correctly with TRUS in 68% and capsular penetration in 32%. Corresponding findings with digital rectal examination (DRE) were 68% and 17% respectively. Sensitivity of TRUS in organ confined PC (T1-2) was 66.1% (DRE 68.5%), specificity 32.6% (DRE 20%) and positive predictive value 55.7% (DRE 49.3%). Sensitivity, specificity and positive predictive value of TRUS for stage T3 (a,b,c) were 32.6%, 68.4% and 45.5% respectively. A separate evaluation of stage T3c revealed for TRUS: sensitivity 41.2%, specificity 81.8% and positive predictive value 36.8%., Conclusion: On the basis of this retrospective analysis, and due to the low sensitivity and specificity, TRUS is not suitable for adequate preoperative staging of prostatic cancer.

In this paper, we try to understand the motivations and characteristics of people susceptible to be volunteers for the SU.VI.MAX study. The objective of this study will be to recruit and to follow during 8 years, a cohort of 15,000 subjects at a national level, for an intervention trial in the field of nutritional prevention. A short media campaign has been organised to recruit "1,000 volunteers to help to test and to validate tools specifically developed for the SU.VI.MAX study". In total, 15,789 subjects matching selection criteria answered to our invitation. All received a short questionnaire; 10,984 sent back correctly filled up questionnaires (70%) and 1005 were selected at random for a complete analysis. A lexical analysis of motivations disclosed 6 different groups organised in two poles. The pole of true altruists with a speech relative to notions such as "volunteers-benevolent" (7% of subjects), wishes to participate to a "humane task" (9% of subjects) or to progress of medical research (27% of subjects). The other pole corresponds to people interested personally by the theme of the project with 3 kinds of speech: personal past history (13% of subjects), interest for foods fortified with vitamins and/or minerals (19% of subjects) or for relationships between food consumption and health (22% of subjects).