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1. Antibody status and cumulative incidence of SARS-CoV-2 infection among adults in three regions of France following the first lockdown and associated risk factors: a multicohort study

Author: Marie Zins, Jerome Nicol, Florence Jusot, Cindy Lai, Adeline Renuy, Sofiane Kab, Toscane Fourié, Xavier de Lamballerie, Nathalie Bajos, Fabien Szabo de Edelenyi, Laurence Meyer, Fanny Artaud, Nathalie Lydié, Younes Esseddik, Mathilde Touvier, Gianluca Severi, Stéphane Priet, Fabrice Carrat, Paola Mariela Saba Villarroel, Alexandra Rouquette, Jean-Marie Gagliolo, Nathalie Druesne-Pecollo, Clovis Lusivika-Nzinga, Pierre-Yves Ancel, Marie-Aline Charles, Nathanael Lapidus, Hélène Blanché, Delphine Rahib, Stephane Legot, Jean-François Deleuze, Demarquay, Sandrine, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Sorbonne Université - Département de santé publique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Unité des Virus Emergents (UVE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Santé publique France - French National Public Health Agency [Saint-Maurice, France], Fondation Jean Dausset CEPH, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Institut Gustave Roussy (IGR), Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité), Université Paris Cité (UPCité), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Service de santé publique et d'épidémiologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Etude longitudinale française depuis l'enfance (UMS : Ined-Inserm-EFS) (ELFE), Institut national d'études démographiques (INED)-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC - Mère Enfant Necker Cochin Paris Centre (CIC 1419), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Laboratoire d'Economie de Dauphine (LEDa), Institut de Recherche pour le Développement (IRD)-Université Paris Dauphine-PSL, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS), Institut national de la santé publique (INSP), INSTITUT THEMATIQUE - SANTE PUBLIQUE (IT7 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherche Interdisciplinaire sur les enjeux Sociaux - sciences sociales, politique, santé (IRIS), École des hautes études en sciences sociales (EHESS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Sorbonne Paris Nord, ANR [#ANR-20-COVI-000, #ANR-10-COHO-06]- Fondation pour la Recherche Médicale [#20RR052-00]- Inserm [#C20-26], and ANR-20-COVI-0009,SAPRIS,Santé, perception, pratiques, relations et inégalités sociales en population générale pendant la crise COVID-19(2020)
Subjects: Adult, 0301 basic medicine, medicine.medical_specialty, Adolescent, Epidemiology, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), [SDV]Life Sciences [q-bio], Seroprevalence, SARS-COV-2, Antibodies, Viral, Serology, 03 medical and health sciences, 0302 clinical medicine, Seroepidemiologic Studies, Internal medicine, medicine, Humans, AcademicSubjects/MED00860, Cumulative incidence, 030212 general & internal medicine, Child, biology, business.industry, Incidence, Cohort, COVID-19, General population, General Medicine, Odds ratio, Middle Aged, Corrigenda, Confidence interval, [SDV] Life Sciences [q-bio], 030104 developmental biology, Risk factors, Communicable Disease Control, biology.protein, Original Article, France, Antibody, business
Abstract: Background We aimed to estimate the seropositivity to anti-SARS-CoV-2 antibodies in May–June 2020 after the first lockdown period in adults living in three regions in France and to identify the associated risk factors. Methods Between 4 May 2020 and 23 June 2020, 16 000 participants in a survey on COVID-19 from an existing consortium of three general adult population cohorts living in the Ile-de-France (IDF) or Grand Est (GE) (two regions with high rate of COVID-19) or in the Nouvelle-Aquitaine (NA) (with a low rate) were randomly selected to take a dried-blood spot for anti-SARS-CoV-2 antibodies assessment with three different serological methods (ClinicalTrial Identifier #NCT04392388). The primary outcome was a positive anti-SARS-CoV-2 ELISA IgG result against the spike protein of the virus (ELISA-S). Estimates were adjusted using sampling weights and post-stratification methods. Multiple imputation was used to infer the cumulative incidence of SARS-CoV-2 infection with adjustments for imperfect tests accuracies. Results The analysis included 14 628 participants, 983 with a positive ELISA-S. The weighted estimates of seropositivity and cumulative incidence were 10.0% [95% confidence interval (CI): 9.1%, 10.9%] and 11.4% (95% CI: 10.1%, 12.8%) in IDF, 9.0% (95% CI: 7.7%, 10.2%) and 9.8% (95% CI: 8.1%, 11.8%) in GE and 3.1% (95% CI: 2.4%, 3.7%) and 2.9% (95% CI: 2.1%, 3.8%) in NA, respectively. Seropositivity was higher in younger participants [odds ratio (OR) = 1.84 (95% CI: 1.79, 6.09) in Conclusions Seropositivity to anti-SARS-CoV-2 antibodies in the French adult population was ≤10% after the first wave. Modifiable and non-modifiable risk factors were identified.
Published: 2021

2. Effet du traitement parodontal chez des patients atteints de polyarthrite rhumatoïde : essai clinique randomisé ESPERA

Author: Elise Arrivé, Thierry Schaeverbeke, Alain Cantagrel, Cathy Nabet, Groupe Espera, Arnaud Constantin, Paul Monsarrat, Thomas Barnetche, Jean-Noel Vergnes, Gabriel Fernandez de Grado, Nadia Mehsen-Cetre, Michel Sixou, Claire Willmann, Faculté de chirurgie dentaire, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, CHU Toulouse [Toulouse], Service de rhumatologie, Centre Hospitalier Universitaire de Nice (CHU Nice)-Hôpital l'Archet, Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de santé publique et d'épidémiologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, and Université de Bordeaux (UB)
Subjects: 030203 arthritis & rheumatology, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, [SDV]Life Sciences [q-bio], 030212 general & internal medicine, 3. Good health
Abstract: Resume Objectifs Evaluer l’effet du traitement parodontal sur les parametres cliniques et biochimiques de la polyarthrite rhumatoide (PR) et la qualite de vie chez des patients atteints d’une PR moderement active et d’une parodontite. Methodes Dans cet essai ouvert, randomise et controle, des sujets atteints de PR (n = 22) ont ete affectes a un traitement parodontal « immediat » ou « differe » (detartrage et debridement radiculaire non chirurgical complet, antibiotherapie par voie systemique et instructions d’hygiene orale). Le critere de jugement principal a ete le changement du DAS28 (avec vitesse de sedimentation) a 3 mois. La qualite de vie generale et la qualite de vie relative a la sante bucco-dentaire ont ete evaluees. Resultats La sante parodontale s’est considerablement amelioree apres le traitement parodontal (surface enflammee de la gencive, p = 0,03). Le traitement parodontal n’a entraine ni evenement indesirable ni amelioration de DAS28 (difference moyenne ajustee avec un intervalle de confiance a 95 % de −0,03[−0,98 ; 0,92]). Aucune amelioration de la qualite de vie generale n’a ete constatee apres le traitement parodontal ni aucun effet significatif sur la qualite de vie bucco-dentaire, malgre une tendance positive dans le domaine « impacts psychologiques » (0,13[− 0,07 ; 0,33], p = 0,20). Conclusions Bien qu’aucun effet du traitement parodontal sur les parametres de la PR n’ait ete identifie, cet essai fournit des donnees importantes pour recommander les soins parodontaux chez les patients atteints de PR. Le traitement parodontal est sur et reduit l’inflammation orale avec un effet possible sur la qualite de vie bucco-dentaire. Comme la parodontite et la PR sont des maladies chroniques complexes et multifactorielles, il est probable que les approches centrees sur le patient impliquant a la fois les professionnels de la sante bucco-dentaire et les rhumatologues contribueront a optimiser les soins aux patients.
Published: 2020

3. Validation of the French version of the Functional, Communicative and Critical Health Literacy scale (FCCHL)

Author: Virginie Ringa, Anne-Déborah Bouhnik, Laurent Rigal, Allan Ben Smith, Alexandra Rouquette, Youssoufa M. Ousseine, Julien Mancini, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de santé publique et d'épidémiologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre for Oncology Education and Research Translation [Liverpool, NSW, Australia] (CONCERT), University of New South Wales [Sydney] (UNSW)-Ingham Institute for Applied Medical Research [Liverpool, NSW, Australia]-South Western Sydney Clinical School [Liverpool, NSW, Australia], Psycho-Oncology Co-operative Research Group [Sydney, Australia] (School of Psychology - PoCoG), The University of Sydney, Biostatistique et technologies de l'information et de la communication (BioSTIC) - [Hôpital de la Timone - APHM] (BiosTIC ), Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), The project leading to this publication has received funding from Excellence Initiative of Aix-Marseille University - A*MIDEX, a French 'Investissements d’Avenir' program. This work was supported by the French National Cancer Institute (grant number INCA_8102), IRESP (grant number RINGA-AAP16-HSR-13) for French teams collaboration, the funding partners of the IRESP in the framework of the '2016 call for general project Health services'., Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Ingham Institute for Applied Medical Research [Liverpool, NSW, Australia]-University of New South Wales [Sydney] (UNSW)-South Western Sydney Clinical School [Liverpool, NSW, Australia], Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), and Dupuis, Christine
Subjects: Psychometrics, [SDV]Life Sciences [q-bio], Applied psychology, Short Report, Health Informatics, Health literacy, Computer-assisted web interviewing, 03 medical and health sciences, 0302 clinical medicine, Health Information Management, 030212 general & internal medicine, Asset (economics), Association (psychology), Health communication, Reliability (statistics), Cancer, Measurement, lcsh:Public aspects of medicine, lcsh:RA1-1270, 3. Good health, [SDV] Life Sciences [q-bio], Validation studies, 030220 oncology & carcinogenesis, Scale (social sciences), France, Psychology
Abstract: Background Health literacy is a key asset, defined as the capacity to acquire, understand and use information in ways which promote and maintain good health. Objectives To assess the reliability and validity of the French translation of the Functional, Communicative and Critical Health Literacy (FCCHL) scale. Methods/participants A cross-sectional survey using an online questionnaire was proposed to all members of Seintinelles association. Exploratory and confirmatory factorial analyses were conducted. Results Data from 2342 respondents (45.8% had cancer history) were analysed. The FCCHL scale was well-accepted (missing value by item ≤0.7%). Factor analysis revealed an acceptable fit of three-factor model (comparative fit index = 0.922, root mean square error of approximation = 0.065 and standardized root mean square residual = 0.052). The FCCHL showed satisfactory reliability (α = 0.77) and scalar invariance was reached for education and deprivation, but not for age. Known group validity was verified as mean scale scores differed according to education, deprivation and age, as expected. Conclusion The French version of the FCCHL provides a brief reliable and valid measure to explore the dimensions of health literacy. It could be used by health professionals to screen for health literacy level in order to develop this skill and to tailor health communication. Electronic supplementary material The online version of this article (10.1186/s41687-018-0027-8) contains supplementary material, which is available to authorized users.
Published: 2018

4. A Subset of Extreme Human Immunodeficiency Virus (HIV) Controllers Is Characterized by a Small HIV Blood Reservoir and a Weak T-Cell Activation Level

Author: Christine Rouzioux, Nicolas Noel, Faroudy Boufassa, Véronique Avettand-Fenoel, Olivier Lambotte, Etienne Canouï, Camille Lécuroux, Asier Sáez-Cirión, Laurence Meyer, Marine Gousset, Immunologie des Maladies Virales et Autoimmunes (IMVA - U1184), Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Hôpital Bicêtre, Hôpital Bicêtre-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11), Institut des Maladies Emergentes et des Thérapies Innovantes (IMETI), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, Infection à VIH, réservoirs, diversité génétique et résistance aux antirétroviraux (ARV) (EA 7327), Université Paris Descartes - Paris 5 (UPD5), Laboratoire de Virologie [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), HIV, Inflammation et persistance, Institut Pasteur [Paris], Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de santé publique et d'épidémiologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, The ANRS Codex cohort is funded by ANRS., Saez-Cirion, Asier, Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), HIV, Inflammation et persistance - HIV, Inflammation and Persistence, Institut Pasteur [Paris] (IP), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: 0301 basic medicine, [SDV.IMM] Life Sciences [q-bio]/Immunology, T cell, [SDV]Life Sciences [q-bio], Human leukocyte antigen, Peripheral blood mononuclear cell, Immunoglobulin G, immune activation, 03 medical and health sciences, Immune system, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, ultrasensitive plasma HIV-RNA load, Major Article, Medicine, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, biology, business.industry, HIV controllers, Virology, HIV-DNA in PBMC, 3. Good health, [SDV] Life Sciences [q-bio], HLA, 030104 developmental biology, Infectious Diseases, medicine.anatomical_structure, Oncology, Immunology, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, biology.protein, [SDV.IMM]Life Sciences [q-bio]/Immunology, Antibody, business, Viral load, CD8, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Background Human immunodeficiency virus controllers (HICs) form a heterogeneous group of patients with regard to formal definitions, immunologic characteristics, and changes over time in viral load. Patients and Methods The HICs with undetectable viral load ([uHICs] ie, for whom a viral load had never been detected with routine assays; n = 52) were compared with 178 HICs with blips during the follow up (bHICs). Clinical characteristics, ultrasensitive HIV-ribonucleic acid (RNA) and HIV-deoxyribonucleic acid (DNA) loads, HIV1-Western blot profiles, and immune parameters were analyzed. Results Relative to bHICs, uHICs had significantly lower ultrasensitive plasma HIV-RNA loads (P < .0001) and HIV-DNA levels in peripheral blood mononuclear cells (P = .0004), higher CD4+ T-cell count (P = .04) at enrollment, and lower T-cell activation levels. Between diagnosis and inclusion in the cohort, the CD4+ T-cell count had not changed in uHICs but had significantly decreased in bHICs. Twenty-one percent of the uHICs lacked specific anti-HIV immunoglobulin G antibodies, and these individuals also had very low levels of HIV-DNA. Half of the uHICs had a protective human leukocyte antigen (HLA) allele (-B57/58/B27), a weak CD8+ T-cell response, and very small HIV-DNA reservoir. Conclusions We suggest that an interesting HIC phenotype combines protective HLA alleles, low level of HIV blood reservoirs, and reduced immune activation. Prospective studies aimed at evaluating the benefit of combined antiretroviral therapy in HICs might take into account the identification of uHICs and bHICs.
Published: 2017

5. Zika emergence in the French Territories of America and description of first confirmed cases of Zika virus infection on Martinique, November 2015 to February 2016

Author: Elise, Daudens-Vaysse, Martine, Ledrans, Noellie, Gay, Vanessa, Ardillon, Sylvie, Cassadou, Fatiha, Najioullah, Isabelle, Leparc-Goffart, Dominique, Rousset, Cécile, Herrmann, Raymond, Cesaire, Marianne, Maquart, Olivier, Flusin, Séverine, Matheus, Patricia, Huc-Anaïs, Josiane, Jaubert, Anne, Criquet-Hayot, Bruno, Hoen, Felix, Djossou, Corinne, Locatelli-Jouans, Alain, Blateau, Anne-Marie, McKenzie, Mathilde, Melin, Patrick, Saint-Martin, Frédérique, Dorléans, Claudine, Suivant, Luisiane, Carvalho, Marion, Petit-Sinturel, Audrey, Andrieu, Harold, Noël, Alexandra, Septfons, Anne, Gallay, Marie-Claire, Paty, Laurent, Filleul, André, Cabié, Agence régionale de santé (ARS) de Martinique (ARS Martinique), Cellule Inter Régionale d'Epidémiologie des Antilles - Guyane, Institut de Veille Sanitaire (INVS), Laboratoire de Virologie-Immunologie, Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], French National Reference Centre for Arboviruses, Institut de Recherche Biomédicale des Armées (IRBA), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), CHU Pointe-à-Pitre/Abymes [Guadeloupe], Laboratoire d'Analyses Médicales, Clinique Saint Paul, URML Martinique, Dermatologie et Maladies infectieuses [Pointe-à-Pitre], CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre de Gestion du Risque Infectieux Nosocomial [Pointe-à-Pitre] (CGRIN), Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Agence Régionale de Santé Guyane (ARS Guyane), Agence Régionale de la Santé (ARS), Agence régionale de santé Guadeloupe (ARS), Cellule Inter Régionale d'Epidémiologie Océan Indien, the Zika Surveillance Working Group, ADENIS, ANTOINE, IRBA Armed Forces Biomedical Research Institute, Agence Régionale de Santé de Guyane, Institut National de Veille Sanitaire, Institut national de veille sanitaire, Animal, Santé, Territoires, Risques et Ecosystèmes (UMR ASTRE), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut National de la Recherche Agronomique (INRA), Département Systèmes Biologiques (Cirad-BIOS), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad), Cellule interrégionale d'épidémiologie Antilles-Guyane [CIRE], CIRE Antilles-Guyane - Gourbeyre, CHU de la Martinique [Fort de France], Unité de Virologie, Institut de Médecine Tropicale du Service de Santé des Armées, Institut pluridisciplinaire de recherche appliquée dans le domaine du génie pétrolier (IPRADDGP), Université de Pau et des Pays de l'Adour (UPPA)-Centre National de la Recherche Scientifique (CNRS), Service de Maladies Infectieuses et Tropicales [Fort-de-France, Martinique], CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France]-Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Centre de Recherche et de Veille sur les Maladies Émergentes dans l'Océan Indien (CRVOI), Université de La Réunion (UR), Institut de Recherche Biomédicale des Armées [Antenne Marseille] (IRBA), Université Henri Poincaré - Nancy 1 (UHP), Unité des Maladies Infectieuses et Tropicales (UMIT), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Cellule Interrégionale d'Epidémiologie Antilles-Guyane, Service de santé publique et d'épidémiologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Bicêtre, Cellule Interrégionale d'Epidémiologie, and CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG)
Subjects: 0301 basic medicine, Pediatrics, Pathology, Epidemiology, vector-borne infections, location.country, medicine.disease_cause, Communicable Diseases, Emerging, Disease Outbreaks, Zika virus, Dengue fever, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Maculopapular rash, Medicine, 030212 general & internal medicine, Chikungunya, Guadeloupe, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, biology, Reverse Transcriptase Polymerase Chain Reaction, Zika Virus Infection, Rash, French Guiana, 3. Good health, Population Surveillance, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, RNA, Viral, medicine.symptom, Martinique, medicine.medical_specialty, 030106 microbiology, 03 medical and health sciences, location, Zika, Virology, Humans, business.industry, Public Health, Environmental and Occupational Health, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Sequence Analysis, DNA, Zika Virus, biology.organism_classification, medicine.disease, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Martinique island, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract: International audience; Following of the emergence of Zika virus in Brazil in 2015, an epidemiological surveillance system was quickly implemented in the French overseas Territories of America (FTA) according to previous experience with dengue and chikungunya and has detected first cases of Zika. General practitioners and medical microbiologists were invited to report all clinically suspectedcases of Zika, laboratory investigations were systematically conducted (RT-PCR). On 18 December, the first autochthonous case of Zika virus infection was confirmed by RT-PCR on French Guiana and Martinique, indicating introduction of Zika virus inFTA. The viral circulation of Zika virus was then also confirmed on Guadeloupe and Saint-Martin. We report here early findings on 203 confirmed cases of Zika virus infection identified by RT-PCR or seroneutralisation on Martinique Island between 24 November 2015 and 20 January 2016. All cases were investigated. Common clinical signs were observed (maculopapularrash, arthralgia, fever, myalgia and conjunctival hyperaemia) among these patients, but the rash, the foundation of our case definition, may be absent in a significant proportion of patients (16%). These results are important for the implementation of a suspected case definition, the main tool for epidemiological surveillance, in territories that may be affected by ZIKV emergence, including Europe.
Published: 2016

6. Long-term outcomes and predictors of disabling disease of a population-based cohort of incident Crohn's disease diagnosed between 1995 and 1997

Author: Rabilloud, M.-L., Bretagne, J.-F., Bajeux, E., Siproudhis, L., Viel, J.-F., Tron, I., Robaszkiewicz, M., Bouguen, G, CHU Pontchaillou [Rennes], Service des Maladies de l'Appareil Digestif, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Foie, métabolismes et cancer, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de santé publique et d'épidémiologie, Service des Maladies de l'Appareil Digestif [CHU Rennes], and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: [SDV]Life Sciences [q-bio], ComputingMilieux_MISCELLANEOUS
Abstract: International audience; Meeting Abstract: P705
Published: 2016

7. Predictive factors of surgery and bowel damage during the course of Crohn's disease: A population-based study

Author: Rabilloud, M.-L., Bretagne, J.-F., Bajeux, Emma, Siproudhis, L., Viel, J.-F., Tron, I., Bouguen, G, CHU Pontchaillou [Rennes], Service des Maladies de l'Appareil Digestif, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Foie, métabolismes et cancer, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de santé publique et d'épidémiologie, Service des Maladies de l'Appareil Digestif [CHU Rennes], and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: [SDV]Life Sciences [q-bio], ComputingMilieux_MISCELLANEOUS
Abstract: International audience; Meeting Abstract: P199
Published: 2016

8. Seroprevalence of Asian Lineage Chikungunya Virus Infection on Saint Martin Island, 7 Months After the 2013 Emergence

Author: Noellie Gay, Dominique Rousset, Patricia Huc, Séverine Matheus, Martine Ledrans, Jacques Rosine, Sylvie Cassadou, Harold Noël, Animal, Santé, Territoires, Risques et Ecosystèmes (UMR ASTRE), Institut National de la Recherche Agronomique (INRA)-Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad), Département Systèmes Biologiques (Cirad-BIOS), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad), Institut pluridisciplinaire de recherche appliquée dans le domaine du génie pétrolier (IPRADDGP), Université de Pau et des Pays de l'Adour (UPPA)-Centre National de la Recherche Scientifique (CNRS), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Institut National de Veille Sanitaire, Institut national de veille sanitaire, Cellule Inter Régionale d'Epidémiologie des Antilles - Guyane, Institut de Veille Sanitaire (INVS), CIRE Antilles-Guyane - Gourbeyre, Service de santé publique et d'épidémiologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut National de la Recherche Agronomique (INRA), Institut Pluridisciplinaire de recherche appliquée en génie pétrolier (IPRA), and Université de Pau et des Pays de l'Adour (UPPA)
Subjects: Male, Time Factors, Attack rate, medicine.disease_cause, L73 - Maladies des animaux, Virus de chikungunya, 0302 clinical medicine, Seroepidemiologic Studies, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, 030212 general & internal medicine, Chikungunya, Child, ComputingMilieux_MISCELLANEOUS, education.field_of_study, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Articles, Middle Aged, 3. Good health, Infectious Diseases, Geography, Child, Preschool, S50 - Santé humaine, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Female, medicine.symptom, Chikungunya virus, Adult, Adolescent, West Indies, 030231 tropical medicine, Population, education, Asymptomatic, Virus, 03 medical and health sciences, Young Adult, Virology, medicine, Seroprevalence, Humans, Outbreak, Infant, SAINT, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Morbidité, Chikungunya Fever, Parasitology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Demography
Abstract: At the end of 2013, chikungunya virus (CHIKV) emerged in Saint Martin Island, Caribbean. The Asian lineage was identified. Seven months after this introduction, the seroprevalence was 16.9% in the population of Saint Martin and 39.0% of infections remained asymptomatic. This moderate attack rate and the apparent limited size of the outbreak in Saint Martin could be explained by control measures involved to lower the exposure of the inhabitants. Other drivers such as climatic factors and population genetic factors should be explored. The substantial rate of asymptomatic infections recorded points to a potential source of infection that can both spread in new geographic areas and maintain an inconspicuous endemic circulation in the Americas.
Published: 2016

9. Hospitalisations et mortalité des jeunes vivant avec une pathologie chronique en France : analyse à partir de l’échantillon généraliste des bénéficiaires

Author: Josiane Warszawski, A. Rachas, Philippe Tuppin, Albert Faye, Laurence Meyer, E de La Rochebrochard, Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de santé publique et d'épidémiologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Département des études sur les pathologies et les patients [Paris] (CNAM), Caisse Nationale de l'Assurance Maladie [Paris] (CNAM), Institut national d'études démographiques (INED), Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Robert Debré, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Bicêtre, Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris]-Université Paris Diderot - Paris 7 (UPD7), and Hôpital Bicêtre-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)
Subjects: 03 medical and health sciences, Base de l'Assurance Maladie, 030505 public health, 0302 clinical medicine, Adolescent, Pathologies chroniques, Epidemiology, Public Health, Environmental and Occupational Health, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 030212 general & internal medicine, [SHS.DEMO]Humanities and Social Sciences/Demography, 0305 other medical science, 3. Good health
Abstract: International audience; INTRODUCTION. Avec l’amélioration du pronostic des pathologies chroniques à début pédiatrique, un nombre grandissant de patients atteignent l’âge adulte. Cependant, l’adolescence et l’entrée dans la vie adulte s’accompagnent de multiples changements et de crises, pouvant entraîner des ruptures avec le système de soins et des complications médicales. Nous avons estimé la prévalence des pathologies chroniques graves à 14 ans puis comparé les incidences des hospitalisations et des décès avec celles de la population générale.MÉTHODES. Une cohorte rétrospective de jeunes ayant atteint 14 ans entre 2005 et 2013, issue de l’échantillon généraliste des bénéficiaires, a permis d’estimer la prévalence des antécédents de déclaration en affection de longue durée (ALD) avant 14 ans, les taux de mortalité, et les probabilités d’hospitalisation en court séjour avant 19 ans (méthode de Kaplan-Meier). L’évolution de l’incidence des hospitalisations par âge a été décrite entre 14 et 21 ans.RÉSULTATS. Parmi 54 098 sujets de 14 ans, 3,2 % (intervalle de confiance à 95% : 3,0–3,3, n = 1811) avaient un antécédent d’ALD. Le taux demortalité pour 10 000 personnes-années entre 14 et 19 ans était de 21,2 (13,0–34,6) chez les sujets ayant une ALD et 1,6 (1,2–2,2) chez les sujets sans ALD, avec une surmortalité masculine chez les sujets sans ALD uniquement. Les probabilités d’hospitalisation à cinq ans étaient de 56,4% et 36,6 %, respectivement, et 20,8% et 11,6% pour les hospitalisations par les urgences. Entre 14 et 21 ans, l’incidence des hospitalisations augmentait chez les jeunes sans ALD, mais chutait à 19 ans chez ceux ayant une ALD. En revanche, l’incidence des hospitalisations par les urgences ne diminuait pas.DISCUSSION/CONCLUSION. Des études investiguant les stratégies d’évitement des situations à risque permettraient de mieux comprendre l’absence de surmortalité masculine chez les malades. La chute de l’incidence des hospitalisations à 19 ans peut refléter l’atténuation de certaines pathologies avec l’âge, mais aussi des modifications de prise en charge lors du transfert en service d’adultes (discontinuité du suivi, soins préférentiellement ambulatoires …).
Published: 2017

10. Mother-to-child HIV transmission despite antiretroviral therapy in the ANRS French Perinatal Cohort

Author: Marianne Burgard, Stéphane Blanche, Christine Rouzioux, Catherine Dollfus, Roland Tubiana, Jean-Paul Teglas, Jérôme Le Chenadec, Anrs French Perinatal Cohort, Albert Faye, Laurent Mandelbrot, Josiane Warszawski, Santé reproductive, sexualité, infection à VIH - épidémiologie, démographie, sciences sociales, Institut national d'études démographiques (INED)-Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de santé publique et d'épidémiologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Immunologie cellulaire et tissulaire, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Infections à Vih, Réservoirs, Pharmacologie des Antirétroviraux et Prévention de la Transmission Mère Enfant, Université Paris Descartes - Paris 5 (UPD5), Service d'immuno-hématologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'hématologie-immunologie-oncologie pédiatrique [CHU Trousseau], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Service de pédiatrie générale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 (UPD7), Service de bactériologie, virologie, parasitologie et hygiène, Service de gynécologie et obstétrique [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Louis Mourrier, Institut national d'études démographiques ( INED ) -Université Paris-Sud - Paris 11 ( UP11 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Bicêtre, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Université Pierre et Marie Curie - Paris 6 ( UPMC ) -IFR113-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paris Descartes - Paris 5 ( UPD5 ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Service d'hématologie-immunologie-oncologie pédiatrique, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 ( UPD7 ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Louis Mourrier, Warszawski, Josiane, Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière], Service de bactériologie, virologie, parasitologie et hygiène [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and CHU Trousseau [APHP]
Subjects: Male, medicine.medical_specialty, Anti-HIV Agents, Immunology, Population, HIV Infections, Drug Administration Schedule, Cohort Studies, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), Pregnancy, Antiretroviral Therapy, Highly Active, medicine, Humans, Immunology and Allergy, 030212 general & internal medicine, Pregnancy Complications, Infectious, Prospective cohort study, education, education.field_of_study, 030219 obstetrics & reproductive medicine, Obstetrics, business.industry, Infant, Newborn, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Odds ratio, Viral Load, medicine.disease, Infectious Disease Transmission, Vertical, Bottle Feeding, 3. Good health, Surgery, Infectious Diseases, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Cohort, HIV-1, Premature Birth, Regression Analysis, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, business, Sentinel Surveillance, Viral load, Cohort study
Abstract: International audience; OBJECTIVE: To identify factors associated with mother-to-child HIV-1 transmission (MTCT) from mothers receiving antenatal antiretroviral therapy. DESIGN: The French Perinatal Cohort (EPF), a multicenter prospective cohort of HIV-infected pregnant women and their children. METHODS: Univariate analysis and logistic regression, with child HIV status as dependent variable, were conducted among 5271 mothers who received antiretroviral therapy during pregnancy, delivered between 1997 and 2004 and did not breastfeed. RESULTS: The MTCT rate was 1.3% [67/5271; 95% confidence interval (CI), 1.0-1.6]. It was as low as 0.4% (5/1338; 95% CI, 0.1-0.9) in term births with maternal HIV-1 RNA level at delivery below 50 copies/ml. MTCT increased with viral load, short duration of antiretroviral therapy, female gender and severe premature delivery: 6.6% before 33 weeks versus 1.2% at 37 weeks or more (P < 0.001). The type of antiretroviral therapy was not associated with transmission. Intrapartum therapy was associated with four-fold lower MTCT (P = 0.04) in case of virological failure (> 10 000 copies/ml). Elective cesarean section tended to be inversely associated with MTCT in the overall population, but not in mothers who delivered at term with viral load < 400 copies/ml [odds ratio (OR), 0.83; 95% CI, 0.29-2.39; P = 0.37]. Among them, only duration of antenatal therapy was associated with transmission (OR by week, 0.94; 95% CI, 0.90-0.99; P = 0.03). CONCLUSIONS: Low maternal plasma viral load is the key factor for preventing MTCT. Benefits in terms of MTCT reduction may be expected from early antiretroviral prophylaxis. The potential toxicity of prolonged antiretroviral use in pregnancy should be evaluated.
Published: 2008

11. Socioeconomic Disparities in Adverse Birth Outcomes in Urban and Rural Contexts: a French Mother-Child Cohort

Author: Bertin, Mélanie, Viel, Jean-François, Monfort, Christine, Cordier, Sylvaine, Chevrier, Cécile, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de santé publique et d'épidémiologie, CHU Pontchaillou [Rennes], and Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: Adult, Rural Population, Maternal-Child Health Services, Urban Population, [SDV]Life Sciences [q-bio], Mothers, Health Services Accessibility, urban-rural context, Pregnancy, Residence Characteristics, Risk Factors, neighbourhood deprivation, adverse birth outcomes, Odds Ratio, Birth Weight, Humans, spatial accessibility of prenatal care, Poverty, Infant, Newborn, Pregnancy Outcome, Prenatal Care, Health Status Disparities, Socioeconomic Factors, Infant, Small for Gestational Age, Female, France
Abstract: International audience; BACKGROUND: Although adverse birth outcomes have been associated with neighbourhood deprivation in urban areas, few studies have addressed this issue in rural zones. This study examines whether associations between neighbourhood deprivation and adverse birth outcomes differ in urban and rural contexts, while taking individual characteristics and spatial accessibility of prenatal care (SAPC) into account. METHODS: Pregnant women from a French mother-child cohort were recruited from 2002 to 2006 in Brittany. Their residential addresses were geocoded into their census blocks (the finest geographical resolution available). Deprivation was assessed at the same neighbourhood level. Models to assess the associations of deprivation, stratified by urban/rural status, with preterm delivery (PTD), with small for gestational age birth weight (SGA) and with small for gestational age head circumference at birth (SHC), estimated odds ratios (ORs), adjusted for maternal socioeconomic characteristics and SAPC. RESULTS: This study considered 2929 liveborn singleton pregnancies from 780 census blocks. Neighbourhood deprivation was associated with increased risks of SGA and SHC (P trend \textless 0.01 and 0.03 respectively), only among mothers residing in rural areas. Neighbourhood deprivation had statistically significantly heterogeneous effects on SGA and SHC according to the urban/rural status of maternal residence. CONCLUSION: These findings suggest that neighbourhood deprivation affects fetal growth differentially in urban and rural areas and that SAPC does not seem to be responsible for this difference. Comparison of these findings with the literature requires caution in the conceptualisation of urban and rural settings
Published: 2015

12. Combined ART started during acute HIV infection protects central memory CD4+ T cells and can induce remission

Author: Cheret , Antoine, Bacchus-Souffan , Charline, Avettand-Fenoël , Véronique, Mélard , Adeline, Nembot , Georges, Blanc , Catherine, Samri , Assia, Saez-Cirion , Asier, Hocqueloux , Laurent, Lascoux-Combe , Caroline, Allavena , Clotilde, Goujard , Cécile, Valantin , Marc Antoine, Leplatois , Anne, Meyer , Laurence, Rouzioux , Christine, Autran , Brigitte, Group , OPTIPRIM ANRS-147 Study, Centre Hospitalier de Tourcoing, Infection à VIH, réservoirs, diversité génétique et résistance aux antirétroviraux (ARV) ( EA 7327 ), Université Paris Descartes - Paris 5 ( UPD5 ), Laboratoire de Virologie [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Immunité et Infection, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -IFR113-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de santé publique et d'épidémiologie, Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Bicêtre, Plateforme Cytométrie Pitié-Salpêtrière ( CyPS ), Unité Mixte de Service d'Imagerie et de Cytométrie ( UMS LUMIC ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Assistance publique - Hôpitaux de Paris (AP-HP), Régulation des Infections Rétrovirales, Institut Pasteur [Paris], Centre Hospitalier Régional d'Orléans ( CHR ), Service de maladies infectieuses et tropicales [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Service de maladies infectieuses et tropicales [Nantes], Université de Nantes ( UN ) -Hôtel-Dieu-Centre hospitalier universitaire de Nantes ( CHU Nantes ), Médecine interne [CHU Bicêtre], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Service de Maladies Infectieuses [Nice], These trials were funded by the French National Agency for Research on AIDS and Viral Hepatitis (ANRS) and conducted with the support of MSD, Janssen, ViiV Healthcare and GILEAD Laboratories., OPTIPRIM ANRS-147 Study Group, Infection à VIH, réservoirs, diversité génétique et résistance aux antirétroviraux (ARV) (EA 7327), Université Paris Descartes - Paris 5 (UPD5), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR113-Université Pierre et Marie Curie - Paris 6 (UPMC), Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Plateforme Cytométrie Pitié-Salpêtrière (LUMIC-CYPS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Unité Mixte de Service d'Imagerie et de Cytométrie (UMS LUMIC), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional d'Orléans (CHRO), Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Nantes (UN)-Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière], Institut Pasteur [Paris] (IP), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Microbiology (medical), Male, Adult, CD4-Positive T-Lymphocytes, T cell, Human immunodeficiency virus (HIV), Antiretroviral Therapy, HIV Infections, reservoirs, Biology, medicine.disease_cause, Immunophenotyping, 03 medical and health sciences, Young Adult, 0302 clinical medicine, HIV DNA, Antiretroviral Therapy, Highly Active, medicine, Secondary Prevention, Humans, [ SDV.IMM ] Life Sciences [q-bio]/Immunology, Pharmacology (medical), Highly Active, 030212 general & internal medicine, Young adult, 030304 developmental biology, Pharmacology, 0303 health sciences, post-treatment controllers, T lymphocyte, Middle Aged, 3. Good health, Peripheral, Infectious Diseases, medicine.anatomical_structure, Treatment Outcome, Viral replication, Anti-Retroviral Agents, Immunology, primary HIV infections, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Off Treatment
Abstract: BackgroundTherapeutic control of HIV replication reduces the size of the viral reservoir, particularly among central memory CD4+ T cells, and this effect might be accentuated by early treatment.MethodsWe examined the effect of ART initiated at the time of the primary HIV infection (early ART), lasting 2 and 6 years in 11 and 10 patients, respectively, on the HIV reservoir in peripheral resting CD4+ T cells, sorted into naive (TN), central memory (TCM), transitional memory (TTM) and effector memory (TEM) cells, by comparison with 11 post-treatment controllers (PTCs).ResultsBetween baseline and 2 years, CD4+ T cell subset numbers increased markedly (P ConclusionsEarly prolonged ART thus limits the size of the HIV reservoir, protects long-lived cells from persistent infection and may enhance post-treatment control.
Published: 2015

13. Decreased Cardiovascular and Extrahepatic Cancer-Related Mortality In Treated Patients with Mild HFE Hemochromatosis

Author: Edouard Bardou-Jacquet, Fabrice Lainé, Romain Moirand, Dominique Guyader, Jean-François Viel, Ghislain Manet, Jeff Morcet, Michèle Perrin, Anne-Marie Jouanolle, Yves Deugnier, Foie, métabolismes et cancer, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de génétique moléculaire, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes], Service de santé publique et d'épidémiologie, CHU Pontchaillou [Rennes], Cadieu, Muriel, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Laboratoire de génétique moléculaire et génomique médicale [CHU Rennes]
Subjects: medicine.medical_specialty, Survival, Population, Cardio-vascular disease, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Diabetes mellitus, medicine, Iron overload, education, Hemochromatosis, Cancer, education.field_of_study, Hepatology, business.industry, Hazard ratio, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, medicine.disease, Confidence interval, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, 3. Good health, Surgery, Standardized mortality ratio, 030220 oncology & carcinogenesis, Cohort, 030211 gastroenterology & hepatology, HFE, business
Abstract: International audience; Background & aims - Mortality studies in patients with hemochromatosis give conflicting results especially with respect to extrahepatic causes of death. Our objective was to assess mortality and causes of death in a cohort of patients homozygous for the C282Y mutation in the HFE gene, diagnosed since the availability of HFE testing. Methods - We studied 1085 C282Y homozygotes, consecutively diagnosed from 1996 to 2009, and treated according to current recommendations. Mortality and causes of death were obtained from death certificates and compared to those of the general population. Standardized mortality ratios (SMRs) were used to assess specific causes of death and the Cox model was used to identify prognostic factors for death. Results - Patients were followed for 8.3±3.9 years. Overall the SMR was the same as in the general population (0.94 CI: 0.71-1.22). Patients with serum ferritin⩾2000 μg/L had increased liver-related deaths (SMR: 23.9 CI: 13.9-38.2), especially due to hepatic cancer (SMR: 49.1 CI: 24.5-87.9). Patients with serum ferritin between normal and 1000 μg/L had a lower mortality than the general population (SMR: 0.27 CI: 0.1-0.5), due to a decreased mortality, related to reduced cardiovascular events and extrahepatic cancers in the absence of increased liver-related mortality. Age, diabetes, alcohol consumption, and hepatic fibrosis were independent prognostic factors of death. Conclusions - In treated HFE hemochromatosis, only patients with serum ferritin higher than 2000 μg/L have an increased mortality, mainly related to liver diseases. Those with mild iron burden have a decreased overall mortality in relation to reduced cardiovascular and extrahepatic cancer-related events. These results support a beneficial effect of early and sustained management of patients with iron excess, even when mild.
Published: 2015

14. Ten-year prognosis in multiple sclerosis: a better outcome in relapsing-remitting patients but not in primary progressive patients

Author: Gilles Edan, J. Yaouanq, Anne Kerbrat, Emmanuelle Leray, I Tron, Stéphanie Hamonic, Vision, Action et Gestion d'informations en Santé (VisAGeS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Inria Rennes – Bretagne Atlantique, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-SIGNAUX ET IMAGES NUMÉRIQUES, ROBOTIQUE (IRISA-D5), Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS), Service de Neurologie [Rennes] = Neurology [Rennes], CHU Pontchaillou [Rennes], Service de santé publique et d'épidémiologie, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), API 09-41, PHRC, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-Université de Rennes 1 (UR1), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Edan, Gilles, Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Université de Bretagne Sud (UBS)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-Télécom Bretagne-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-CentraleSupélec-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Université de Rennes (UNIV-RENNES)-CentraleSupélec-Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Université de Bretagne Sud (UBS)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Rennes (ENS Rennes)-Télécom Bretagne-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-CentraleSupélec, Service de Neurologie [Rennes], and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes]
Subjects: Male, Pediatrics, Time Factors, MESH: Multiple Sclerosis, Relapsing-Remitting, Disease, multiple sclerosis, 0302 clinical medicine, cohort studies, Recurrence, MESH: Child, Epidemiology, Medicine, demyelinating diseases, 10. No inequality, Child, MESH: Aged, 0303 health sciences, education.field_of_study, Clinically isolated syndrome, MESH: Middle Aged, MESH: Follow-Up Studies, Middle Aged, Multiple Sclerosis, Chronic Progressive, 3. Good health, Natural history, Neurology, MESH: Young Adult, Cohort, Disease Progression, Female, epidemiology, MESH: Disease Progression, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Cohort study, Adult, medicine.medical_specialty, Adolescent, Population, MESH: Prognosis, 03 medical and health sciences, Young Adult, Multiple Sclerosis, Relapsing-Remitting, Humans, [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], MESH: Multiple Sclerosis, Chronic Progressive, education, 030304 developmental biology, Aged, MESH: Adolescent, MESH: Humans, business.industry, Multiple sclerosis, MESH: Time Factors, MESH: Adult, medicine.disease, MESH: Male, MESH: Recurrence, clinically isolated syndrome, Physical therapy, Neurology (clinical), prognosis, business, MESH: Female, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract: International audience; Background and purpose - Multiple sclerosis (MS) prognosis remains a challenge for both patients and physicians. Complementary to natural history studies, updated population-based data from the first event suggestive of MS, at the time of the first approved disease modifying drug (DMD), are needed. Our objective was to provide a 10-year history of MS from clinical onset at time of first approved DMDs in a population-based cohort. Methods - A population-based cohort of patients whose first clinical event suggestive of MS had occurred in Brittany between 2000 and 2001 was prospectively selected. History of relapses, treatments and disability up to 10 years after onset were collected. Results - In all, 278 patients with either attack-onset (n = 244) or progressive-onset (n = 34) were recruited. Amongst attack-onset patients, 30% remained as clinically isolated syndrome and 70% had a second relapse after a median time of 1.7 years (95% confidence interval 1.2-2.4). 80% of relapsing-remitting MS patients received DMDs for at least 6 months. 29% reached disability status scale (DSS) 3 and 8% DSS 6. Amongst progressive-onset patients, 100% reached DSS 3 and 59% DSS 6. Conclusion(s) - Our population-based study reports a lower risk of disability progression at 10-year follow-up in the relapsing-remitting MS group than previously reported. This better prognosis was not observed in the progressive-onset MS group. This finding impacts the prognosis given to patients in clinical practice.
Published: 2015

15. Étude AIRBAg : résultats préliminaires après un an de dépistage de la BPCO agricole [AIRBAg study: Preliminary results after one year of screening for COPD in dairy farmers]

Author: Jouneau, S., Pinault, M., Gouyet, T., Brinchault, G., Guillot, S., Viel, J.-F., Presle, J.-C., Desrues, B., Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre de Ressource et de Compétences de la Mucoviscidose, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes], Service de santé publique et d'épidémiologie, CHU Pontchaillou [Rennes], Service de pneumologie, Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail, AIRB, CHU de Rennes, Service de pneumologie [Rennes] = Pneumology [Rennes], Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and Centre de Ressource et de Compétences de la Mucoviscidose [CHU Rennes]
Subjects: Agriculteur, Dépistage, Chronic obstructive pulmonary disease, [SDV]Life Sciences [q-bio], Screening, Obstruction bronchique, Bronchopneumopathie chronique obstructive, Mini-spiromètre électronique, Obstructive lung disease, Farmer, Electronic mini-spirometer, respiratory tract diseases
Abstract: National audience; Introduction - The AIRBAg study screens for bronchial obstruction in dairy farmers. We present the preliminary results after one year. Methods - A prospective screening study based on questionnaires and electronic mini-spirometry (Néo-6(®)) that includes a representative sample of dairy farmers from the departments of Morbihan and Île-et-Vilaine in Brittany. The dairy farmers had an occupational medicine appointment and, if they demonstrated at least one marker of possible bronchial obstruction (chronic cough, chronic bronchitis, dyspnoea, wheezing, FEV1/FEV6
Published: 2015

16. Intensive five-drug antiretroviral therapy regimen versus standard triple-drug therapy during primary HIV-1 infection (OPTIPRIM-ANRS 147): a randomised, open-label, phase 3 trial

Author: Chéret, A, Nembot, G, Mélard, A, Lascoux, C, Slama, L, Miailhes, P, Yeni, P, Abel, S, Avettand-Fenoel, V, Venet, A, Chaix, Ml, Molina, Jm, Katlama, C, Goujard, C, Tamalet, C, Raffi, F, Lafeuillade, A, Reynes, J, Ravaux, I, Hoën, B, Delfraissy, Jf, Meyer, L, Rouzioux, C, Group, Optiprim Anrs Study, Infection à VIH, réservoirs, diversité génétique et résistance aux antirétroviraux (ARV) (EA 7327), Université Paris Descartes - Paris 5 (UPD5), Médecine interne [CHU Bicêtre], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Centre Hospitalier de Tourcoing, Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des maladies infectieuses et tropicales [CHU Tenon], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service de maladies infectieuses et tropicales, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Service de Maladies Infectieuses et Tropicales [Fort-de-France, Martinique], CHU Fort de France-CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France], Régulation de la réponse immune, infection VIH-1 et autoimmunité, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Infections à Vih, Réservoirs, Pharmacologie des Antirétroviraux et Prévention de la Transmission Mère Enfant, Laboratoire de virologie, Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service des Maladies Infectieuses et Tropicales [CHU Saint Louis], Génétique et Ecologie des Virus, Génétique des Virus et Pathogénèse des Maladies Virales, Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de santé publique et d'épidémiologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Virology, Hôpital de la Timone [CHU - APHM] (TIMONE), Maladies infectieuses et tropicales, Department of Infectious Diseases, General Hospital, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Service des Maladies Infectieuses et Tropicales [Hôpital de la Conception] (SMIT), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), CHU Pointe-à-Pitre/Abymes [Guadeloupe], France REcherche Nord & sud Sida-hiv Hépatites (FRENSH), Inserm–ANRS, Gilead Sciences, Janssen Pharmaceuticals, Merck, and ViiV Laboratories, Asier Saez-Cirion collabore dans le groupe OPTIPRIM ANRS Study Group, Infection à VIH, réservoirs, diversité génétique et résistance aux antirétroviraux (ARV) ( EA 7327 ), Université Paris Descartes - Paris 5 ( UPD5 ), Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques, Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service des maladies infectieuses et tropicales, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Tenon [APHP], Centre de Recherche en Cancérologie de Lyon ( CRCL ), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 ( UPD7 ), CHU Fort de France-CHU de la Martinique-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique, Université Paris-Sud - Paris 11 ( UP11 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Centre de recherche en épidémiologie et santé des populations ( CESP ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Bicêtre, Hôpital de la Timone [CHU - APHM] ( TIMONE ), Recherches Translationnelles sur le VIH et les maladies infectieuses ( TransVIHMI ), Université de Montpellier ( UM ) -Universtié Yaoundé 1 [Cameroun]-Université Cheikh Anta Diop ( UCAD ) -Université Montpellier 1 ( UM1 ) -Institut de Recherche pour le Développement ( IRD ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service des Maladies Infectieuses et Tropicales [Hôpital de la Conception] ( SMIT ), Assistance Publique - Hôpitaux de Marseille ( APHM ) -Hôpital de la Conception [CHU - APHM] ( LA CONCEPTION ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), and Diallo, Ousseynatou
Subjects: Cart, Adult, Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Population, Mononuclear, Antiretroviral Therapy, HIV Infections, Emtricitabine, 03 medical and health sciences, chemistry.chemical_compound, immune system diseases, Internal medicine, Antiretroviral Therapy, Highly Active, medicine, Leukocytes, [ SDV.IMM ] Life Sciences [q-bio]/Immunology, Humans, Highly Active, education, Darunavir, ComputingMilieux_MISCELLANEOUS, 030304 developmental biology, Maraviroc, 0303 health sciences, education.field_of_study, 030306 microbiology, business.industry, virus diseases, Middle Aged, Viral Load, Raltegravir, 3. Good health, Surgery, [SDV] Life Sciences [q-bio], Regimen, Infectious Diseases, Treatment Outcome, chemistry, Anti-Retroviral Agents, HIV-1, Leukocytes, Mononuclear, [SDV.IMM]Life Sciences [q-bio]/Immunology, Ritonavir, Female, France, business, medicine.drug
Abstract: International audience; BACKGROUND: Early combination antiretroviral therapy (cART) initiation at the time of primary HIV-1 infection could restrict the establishment of HIV reservoirs. We aimed to assess the effect of a cART regimen intensified with raltegravir and maraviroc, compared with standard triple-drug cART, on HIV-DNA load. METHODS: In this randomised, open-label, phase 3 trial, we recruited patients from hospitals across France. Inclusion criteria were primary HIV-1 infection (an incomplete HIV-1 western blot and detectable plasma HIV-RNA), with either symptoms or a CD4+ cell count below 500 cells per μL. Patients were randomly assigned (1:1) to an intensive, five-drug cART regimen (raltegravir 400 mg and maraviroc 150 mg twice daily, and a fixed-dose combination of tenofovir disoproxil fumarate 300 g plus emtricitabine 200 g, darunavir 800 g, and ritonavir 100 g once daily) or a standard triple-drug cART regimen (tenofovir disoproxil fumarate 300 g plus emtricitabine 200 g, darunavir 800 g, and ritonavir 100 g once daily) using a predefined randomised list generated by randomly selected variable block sizes. The primary endpoint was the median number of HIV-DNA copies per 10(6) peripheral blood mononuclear cells (PBMC) at month 24, analysed in the modified intention-to-treat population, defined as all patients who started their assigned treatment. This study is registered with ClinicalTrials.gov, number NCT01033760. FINDINGS: Between April 26, 2010, and July 13, 2011, 110 patients were enrolled, of whom 92 were randomly assigned and 90 started treatment (45 in each treatment group). Six (13%) patients in the intensive cART group and two (4%) in the standard cART group discontinued before month 24. At month 24, HIV-DNA loads were similar between groups (2·35 [IQR 2·05-2·50] log₁₀ per 10(6) PBMC in the intensive cART group vs 2·25 [1·71-2·55] in the standard cART group; p=0·21). Eight grade 3-4 clinical adverse events were reported in seven patients in the intensive cART group and seven grade 3-4 clinical adverse events were reported in seven patients in the standard cART group. Three serious clinical adverse events occurred: two (pancreatitis and lipodystrophy) in the standard cART group, which were regarded as treatment related, and one event (suicide attempt) in the intensive cART group that was unrelated to treatment. INTERPRETATION: After 24 months, cART intensified with raltegravir and maraviroc did not have a greater effect on HIV blood reservoirs than did standard cART. These results should help to design future trials of treatments aiming to decrease the HIV reservoir in patients with primary HIV-1 infection. FUNDING: Inserm-ANRS, Gilead Sciences, Janssen Pharmaceuticals, Merck, and ViiV Laboratories.
Published: 2015

17. Pyrethroid insecticide exposure and cognitive developmental disabilities in children: The PELAGIE mother–child cohort

Author: Gwendolina Limon, Sylvaine Cordier, Gaël Durand, Florence Rouget, Cécile Chevrier, Jean-François Viel, Agnès Lacroix, Christine Monfort, Gaïd Le Maner-Idrissi, Charline Warembourg, Service de santé publique et d'épidémiologie, CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Laboratoire de Psychologie Expérimentale (LPE), Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Université de Rennes 2 (UR2), LABOCEA, This study was supported by the French National Research Agency (ANR-2010-PRSP-007), the French Pfizer Foundation and the French Research Institute for Public Health (AMC11004NSA-DGS)., ANR-10-PRSP-0007,PEPSY(2010), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)
Subjects: Adult, Insecticides, Metabolite, Developmental Disabilities, [SDV]Life Sciences [q-bio], Neurodevelopment, Mothers, 010501 environmental sciences, Pharmacology, 01 natural sciences, 03 medical and health sciences, chemistry.chemical_compound, Cognition, Organophosphorus Compounds, Pregnancy, Environmental health, Nitriles, Pyrethrins, parasitic diseases, Pyrethroid pesticides, Medicine, Humans, Child, lcsh:Environmental sciences, 030304 developmental biology, 0105 earth and related environmental sciences, General Environmental Science, Wechsler Intelligence Scale for Children, 2. Zero hunger, Intelligence Tests, lcsh:GE1-350, 0303 health sciences, Pyrethroid, business.industry, Cognitive abilities, Neuropsychology, Agriculture, Organophosphates, 3. Good health, Deltamethrin, chemistry, Child, Preschool, Cohort, Linear Models, Female, France, business, Neurocognitive
Abstract: Pyrethroid insecticides are widely used in agriculture and in homes. Despite the neurotoxicity of these insecticides at high doses, few studies have examined whether lower-level exposures could adversely affect children's neurodevelopment.The PELAGIE cohort included 3421 pregnant women from Brittany, France between 2002 and 2006. When their children reached their sixth birthday, 428 mothers from the cohort were randomly selected, successfully contacted and found eligible. A total of 287 (67%) mothers agreed to participate with their children in the neuropsychological follow-up. Two cognitive domains were assessed by the Wechsler Intelligence Scale for Children: verbal comprehension and working memory. Five pyrethroid and two organophosphate insecticide metabolites were measured in maternal and child first-void urine samples collected between 6 and 19 gestational weeks and at 6 years of age, respectively. Linear regression models were used to estimate associations between cognitive scores and urinary pyrethroid metabolite concentrations, adjusting for organophosphate metabolite concentrations and potential confounders.Maternal prenatal pyrethroid metabolite concentrations were not consistently associated with any children's cognitive scores. By contrast, childhood 3-PBA and cis-DBCA concentrations were both negatively associated with verbal comprehension scores (P-trend = 0.04 and P-trend
Published: 2015

18. Late Antiretroviral Therapy (ART) Initiation Is Associated with Long-Term Persistence of Systemic Inflammation and Metabolic Abnormalities

Author: Corinne Vigouroux, Jean-Philippe Bastard, Laurence Meyer, Laurence Gérard, Jacqueline Capeau, Soraya Fellahi, Mathilde Ghislain, Anne Simon, Thierry May, Cécile Goujard, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Centre de Recherche Saint-Antoine (UMRS893), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de santé publique et d'épidémiologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Service d'Immunopathologie [Hôpital Saint-Louis, Paris], Université Paris Diderot - Paris 7 (UPD7)-Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Pitié-Salpêtrière [AP-HP], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de biochimie et hormonologie [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Service de médecine interne [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Laboratoire commun de biologie et génétique moléculaires [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Lipopolysaccharide Receptors, lcsh:Medicine, Systemic inflammation, Zidovudine, Insulin resistance, Internal medicine, Diabetes mellitus, Humans, Receptors, Tumor Necrosis Factor, Type II, Medicine, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, Prospective Studies, Prospective cohort study, lcsh:Science, Immunodeficiency, Inflammation, Acquired Immunodeficiency Syndrome, Multidisciplinary, biology, Interleukin-6, business.industry, Insulin, C-reactive protein, lcsh:R, Middle Aged, medicine.disease, CD4 Lymphocyte Count, 3. Good health, C-Reactive Protein, Endocrinology, Anti-Retroviral Agents, HIV-1, biology.protein, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, lcsh:Q, medicine.symptom, business, Biomarkers, Research Article, medicine.drug
Abstract: International audience; ObjectivesHIV-induced immunodeficiency is associated with metabolic abnormalities and systemic inflammation. We investigated the effect of antiretroviral therapy (ART) on restoration of insulin sensitivity, markers of immune activation and inflammation.MethodsImmunological, metabolic and inflammatory status was assessed at antiretroviral therapy initiation and three years later in 208 patients from the ANRS-COPANA cohort. Patients were compared according to their pre-ART CD4+ cell count (group 1: ≤ 200/mm3, n = 66 vs. group 2: > 200/mm3, n = 142).ResultsMedian CD4+ cell count increased in both groups after 3 years of successful ART but remained significantly lower in group 1 than in group 2 (404 vs 572 cells/mm3). Triglyceride and insulin levels were higher or tended to be higher in group 1 than in group 2 at ART initiation (median: 1.32 vs 0.97 mmol/l, p = 0.04 and 7.6 vs 6.8 IU, p = 0.09, respectively) and remained higher after three years of ART (1.42 vs 1.16 mmol/L, p = 0.0009 and 8.9 vs 7.2 IU, p = 0.01). After adjustment for individual characteristics and antiretroviral therapy regimens (protease inhibitor (PI), zidovudine), insulin levels remained significantly higher in patients with low baseline CD4+ cell count. Baseline IL-6, sCD14 and sTNFR2 levels were higher in group 1 than in group 2. Most biomarkers of immune activation/inflammation declined during ART, but IL-6 and hsCRP levels remained higher in patients with low baseline CD4+ cell count than in the other patients (median are respectively 1.4 vs 1.1 pg/ml, p = 0.03 and 2.1 vs 1.3 mg/ml, p = 0.07).ConclusionAfter three years of successful ART, low pretreatment CD4+ T cell count remained associated with elevated insulin, triglyceride, IL-6 and hsCRP levels. These persistent metabolic and inflammatory abnormalities could contribute to an increased risk of cardiovascular and metabolic disease.
Published: 2015

19. Prenatal pesticide exposure and otitis media during early childhood in the PELAGIE mother-child cohort

Author: Sylvaine Cordier, Tania Serrano, Christine Monfort, Cécile Chevrier, Camille Buscail, Jean-François Viel, Fabienne Pelé, Département d'Information Médicale, Centre Hospitalier Universitaire [Rennes]-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de santé publique et d'épidémiologie, CHU Pontchaillou [Rennes], Service de l'information médicale [CHU Rennes], and Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: Adult, Male, Insecticides, [SDV]Life Sciences [q-bio], Subgroup analysis, 010501 environmental sciences, Logistic regression, 01 natural sciences, Cohort Studies, Toxicology, 03 medical and health sciences, Pregnancy, Surveys and Questionnaires, Environmental health, Humans, Medicine, Pesticides, 030304 developmental biology, 0105 earth and related environmental sciences, 2. Zero hunger, 0303 health sciences, Herbicides, business.industry, Public Health, Environmental and Occupational Health, Infant, Environmental Exposure, Environmental exposure, medicine.disease, 3. Good health, Otitis Media, Otitis, Child, Preschool, Prenatal Exposure Delayed Effects, Cohort, Gestation, Female, medicine.symptom, business, Biomarkers, Cohort study
Abstract: International audience; OBJECTIVE: Contemporary pesticides, such as triazines or organophosphates, possess immunotoxic properties. We aimed to determine whether prenatal environmental exposure to these current-use pesticides was associated with otitis media (OM) during the first 2 years of life among children from the PELAGIE mother-child cohort. METHODS: The PELAGIE cohort enrolled 3421 women at the beginning of pregnancy in Brittany (France). At the 2-year follow-up, 1505 families completed a self-administered questionnaire, including the domestic use of pesticides and consumption of organic diet during pregnancy and occurrences of OM in the child. Two health outcomes were considered: at least one OM and recurrent OM (at least three). Multivariate logistic regression models that adjusted for known risk factors of OM were performed. Metabolites of triazine herbicides and organophosphate insecticides measured in urine collected before the 19th week of gestation (248 mothers) were considered in a subgroup analysis. Multiple imputation was used to handle missing values for the covariates. RESULTS: Children whose mothers reported an organic diet during pregnancy had a reduced risk of OM (at least one episode, p trend=0.01). No association was found between any outcome and residential proximity to crops. The presence in maternal urine of dealkylated triazine metabolites (OR=2.12 (1.01 to 4.47)) was positively associated with recurrent OM. CONCLUSIONS: To the best of our knowledge, this is the first work to suggest a positive association between prenatal exposure to current-use pesticides and the occurrence of parent-reported OM in young children
Published: 2015

20. Oral versus intravenous high-dose methylprednisolone for treatment of relapses in patients with multiple sclerosis (COPOUSEP)

Author: Le Page, Emmanuelle, Veillard, David, Laplaud, David A, Hamonic, Stéphanie, Wardi, Rasha, Lebrun, Christine, Zagnoli, Fabien, Wiertlewski, Sandrine, Deburghgraeve, Véronique, Coustans, Marc, Edan, Gilles, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de santé publique et d'épidémiologie, Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche en Transplantation et Immunologie (U1064 Inserm - CRTI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Centre hospitalier Saint-Brieuc, Hôpital Pasteur [Nice] (CHU), Service de Neurologie [Brest], Hôpital d'Instruction des Armées 'Clermont-Tonnerre' (HIA), Service de Neurologie, Centre hospitalier universitaire de Nantes (CHU Nantes)-Hôpital Guillaume-et-René-Laennec [Saint-Herblain], Hôpital Laennec, Vision, Action et Gestion d'informations en Santé (VisAGeS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Inria Rennes – Bretagne Atlantique, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-SIGNAUX ET IMAGES NUMÉRIQUES, ROBOTIQUE (IRISA-D5), Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS), Service de Neurologie [Rennes] = Neurology [Rennes], We thank E Leray (EHESP, Rennes, France), M Madigand (General Hospital, St Brieuc, France), and K Coat (Unversity Hospital Rennes, France) for advice and monitoring, F Lublin and R Gross (Mount Sinai Hospital, New York, NY, USA) for advice in manuscript editing, and S Calmanti (University Hospital Rennes) for assisting the manuscript editing and submission., Jonchère, Laurent, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CentraleSupélec-Télécom Bretagne-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de Recherche en Informatique et en Automatique (Inria)-École normale supérieure - Rennes (ENS Rennes)-Université de Bretagne Sud (UBS)-Centre National de la Recherche Scientifique (CNRS)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-CentraleSupélec-Télécom Bretagne-Université de Rennes 1 (UR1), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École normale supérieure - Rennes (ENS Rennes)-Université de Bretagne Sud (UBS)-Centre National de la Recherche Scientifique (CNRS)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), and Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)
Subjects: [SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio]
Abstract: International audience; SummaryBackground High doses of intravenous methylprednisolone are recommended to treat relapses in patients with multiple sclerosis, but can be inconvenient and expensive. We aimed to assess whether oral administration of high-dose methylprednisolone was non-inferior to intravenous administration. Methods We did this multicentre, double-blind, randomised, controlled, non-inferiority trial at 13 centres for multiple sclerosis in France. We enrolled patients aged 18–55 years with relapsing-remitting multiple sclerosis who reported a relapse within the previous 15 days that caused an increase of at least one point in one or more scores on the Kurtzke Functional System Scale. With use of a computer-generated randomisation list and in blocks of four, we randomly assigned (1:1) patients to either oral or intravenous methylprednisolone, 1000 mg, once a day for 3 days. Patients, treating physicians and nurses, and data and outcome assessors were all masked to treatment allocation, which was achieved with the use of saline solution and placebo capsules. The primary endpoint was the proportion of patients who had improved by day 28 (decrease of at least one point in most affected score on Kurtzke Functional System Scale), without need for retreatment with corticosteroids, in the per-protocol population. The trial was powered to assess non-inferiority of oral compared with intravenous methylprednisolone with a predetermined non-inferiority margin of 15%. This trial is registered with ClinicalTrials.gov, number NCT00984984. Findings Between Jan 29, 2008, and June 14, 2013, we screened 200 patients and enrolled 199. We randomly assigned 100 patients to oral methylprednisolone and 99 patients to intravenous methylprednisolone with a mean time from relapse onset to treatment of 7·0 days (SD 3·6) and 7·4 days (3·9), respectively. In the per-protocol population, 66 (81%) of 82 patients in the oral group and 72 (80%) of 90 patients in the intravenous group achieved the primary endpoint (absolute treatment difference 0·5%, 90% CI −9·5 to 10·4). Rates of adverse events were similar, but insomnia was more frequently reported in the oral group (77 [77%]) than in the intravenous group (63 [64%]). Interpretation Oral administration of high-dose methylprednisolone for 3 days was not inferior to intravenous administration for improvement of disability scores 1 month after treatment and had a similar safety profile. This finding could have implications for access to treatment, patient comfort, and cost, but indication should always be properly considered by clinicians. Funding French Health Ministry, Ligue Française contre la SEP, Teva
Published: 2015

21. In the Heat of the Summer

Author: Emmanuelle Cadot, Alfred Spira, Victor G. Rodwin, Cadot, Emmanuelle, Service de santé publique et d'épidémiologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, World Cities Project, International Longevity Center, New York University [New York] (NYU), and NYU System (NYU)-NYU System (NYU)-Wagner College
Subjects: Male, Gerontology, Paris, medicine.medical_specialty, Hot Temperature, Health (social science), Urban Population, Climate, Poison control, Climate change, Disaster Planning, 010501 environmental sciences, 01 natural sciences, Suicide prevention, Article, Occupational safety and health, Disease Outbreaks, Disasters, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Risk Factors, Injury prevention, Humans, Medicine, 030212 general & internal medicine, Socioeconomics, Aged, 0105 earth and related environmental sciences, Aged, 80 and over, Emergency management, business.industry, Public health, Age Factors, Urban Health, Public Health, Environmental and Occupational Health, 3. Good health, Urban Studies, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, 13. Climate action, Preparedness, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract: Climate change and human health are intertwined.1 The heat waves in Chicago, in 1995, and in Paris, in 2003, followed by Hurricane Katrina’s destruction of New Orleans, raised awareness of the risks faced by vulnerable older people. Many cities have responded by announcing emergency preparedness plans; some of these plans have already been tested. Last summer, from July 27 to August 5, New York City suffered a mild heat wave with temperatures reaching 100°F. Paris, as well, was hit by another heat wave from July 17 to July 29, with maximum temperatures reaching 104°F, which was considerably milder than in 2003 when they often exceeded 110°F. In New York, there were 100 “excess deaths,” an increase of 8% over past trends.2 In Paris, the number of excess deaths in 2006 (42), also an increase of 8%, was considerably lower than the 1,294 deaths registered in 2003—an increase of 190% compared to the preceding three-year average. Given existing surveillance capacity, it is impossible to know whether the reduction in excess deaths in Paris was due, partly, to its enhanced preparedness or whether it reflects no more than the effects of a far milder heat wave. Nevertheless, the milder heat wave of 2006 does provide an opportunity to examine the actual implementation of the heat wave preparedness plan. In light of ongoing efforts to develop such plans in cities worldwide and completed studies on the effects of the 2003 heat wave in Paris, what may be learned to promote urban health and improve understanding of the factors that put vulnerable older people at greatest risk?
Published: 2007

22. Interendoscopist variability in proximal colon polyp detection is twice higher for serrated polyps than adenomas

Author: Jean-François Bretagne, Christine Piette, Jean-François Viel, Guillaume Bouguen, Stéphanie Hamonic, Foie, métabolismes et cancer, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service des Maladies de l'Appareil Digestif [CHU Rennes], CHU Pontchaillou [Rennes], Service de santé publique et d'épidémiologie, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service des Maladies de l'Appareil Digestif, and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes]
Subjects: Male, Databases, Factual, Proximal polyp, Colorectal cancer, population, Colonoscopy, Gastroenterology, lesions, 0302 clinical medicine, Risk Factors, endoscopist, Medicine, Early Detection of Cancer, risk, Observer Variation, medicine.diagnostic_test, Serrated polyp, pathological conditions, signs and symptoms, General Medicine, Middle Aged, 3. Good health, surgical procedures, operative, 030220 oncology & carcinogenesis, Female, Quality performance, 030211 gastroenterology & hepatology, withdrawal time, Colorectal Neoplasms, Observer variation, Adenoma, medicine.medical_specialty, prevalence, Colonic Polyps, screening colonoscopy, detection rates, 03 medical and health sciences, Internal medicine, otorhinolaryngologic diseases, Humans, Retrospective Cohort Study, Proximal colon, neoplasms, Aged, Quality of Health Care, Retrospective Studies, [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, business.industry, polypectomy, colorectal-cancer, Reproducibility of Results, Detection rate, Endoscopy, Retrospective cohort study, medicine.disease, digestive system diseases, Cross-Sectional Studies, Logistic Models, business
Abstract: International audience; AIM To assess the interendoscopist variability in the detection of colorectal polyps according to their location and histological type. METHODS This study was a retrospective analysis of prospectively collected data from a regional colorectal cancer (CRC) screening program; 2979 complete colonoscopies from 18 endoscopists were included. Variability in performance between endoscopists for detection of at least one adenoma (A), one proximal adenoma (PA), one distal adenoma (DA), and one proximal serrated polyp (PSP) was assessed by using multilevel logistic regression models. RESULTS The observed detect ion rates among the 18 endoscopists ranged from 24.6% to 47.6% (mean = 35.7%) for A, from 19.1% to 39.0% (mean = 29.4%) for DA, from 6.0% to 22.9% (mean = 12.4%) for PA, and from 1.3% to 19.3% (mean = 6.9%) for PSP. After adjusting for patient-level variables (sex, age), the interendoscopist detection rates variability achieved a significant level for A, PA, and PSP but not for DA (P = 0.03, P = 0.02, P = 0.02 and P = 0.08, respectively). This heterogeneity, as measured by the variance partition coefficient, was approximately threefold higher for PA (6.6%) compared with A (2.1%), and twofold higher for PSP (12.3%) compared with PA. CONCLUSION These results demonstrate significant interendoscopist variability for proximal polyp particularly for serrated polyps, but not for distal adenoma detection. These findings contribute to explain the decreased effectiveness of complete colonoscopies at preventing proximal CRCs and the need to carefully assess the proximal colon during scope procedure.
Published: 2016

23. Acute Plasma Biomarkers of T Cell Activation Set-Point Levels and of Disease Progression in HIV-1 Infection

Author: Isabelle Girault, Marie-Anne Rey-Cuille, Alain Venet, Yasmine Zitoun, Camille Lécuroux, Beatrice Jacquelin, Gaël Petitjean, Anne-Sophie Liovat, Françoise Barré-Sinoussi, Pierre Lebon, Michaela Müller-Trutwin, Martine Sinet, Laurence Meyer, Régulation des Infections Rétrovirales, Institut Pasteur [Paris] (IP), Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Régulation de la réponse immune, infection VIH-1 et autoimmunité, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de santé publique et d'épidémiologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Descartes - Paris 5 (UPD5), Hôpital Cochin [AP-HP], This work was supported by grants from the French National Agency for AIDS Research (ANRS), Institut Pasteur and the AREVA Foundation. G.P. and C.L. received a fellowship from ANRS. A-S.L. received fellowhips from the 'Ministère de l’Enseignement Supérieur et de la Recherche', 'Université Paris VII-Denis Diderot' and from Sidaction., The authors are grateful to the patients and clinicians from the participating centers of the French PRIMO cohort (ANRS CO06) for their participation and efficient collaboration. We thank Y. Madec for helpful discussions. We are thankful to M.J. Ploquin, A. Saez-Cirion and M.C. Saleh for critical reading of the manuscript and to M.E. Laird for precious support in editing. We would like to acknowledge the 'Centre d’Immunologie Humaine' (CIH) of the Institut Pasteur for access to the Luminex machine., Institut Pasteur [Paris], Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université (HESAM)-HESAM Université (HESAM)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), and HESAM Université (HESAM)-HESAM Université (HESAM)
Subjects: Male, Time Factors, MESH: CD4 Lymphocyte Count, [SDV]Life Sciences [q-bio], T-Lymphocytes, HIV Infections, Lymphocyte Activation, MESH: HIV-1, Cohort Studies, MESH: Transforming Growth Factor beta1, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Blood plasma, Pathology, 030212 general & internal medicine, Young adult, MESH: Cohort Studies, MESH: Aged, 0303 health sciences, MESH: Cytokines, Multidisciplinary, MESH: Middle Aged, T Cells, Interleukin-18, MESH: Enzyme-Linked Immunosorbent Assay, MESH: HIV Infections, Middle Aged, Viral Load, Blood proteins, 3. Good health, medicine.anatomical_structure, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, MESH: Young Adult, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Disease Progression, [SDV.IMM]Life Sciences [q-bio]/Immunology, Medicine, Infectious diseases, Cytokines, Interleukin 18, MESH: Disease Progression, Female, MESH: Interleukin-18, Inflammation Mediators, MESH: Viral Load, Viral load, MESH: Chemokine CXCL10, Research Article, Adult, Adolescent, Science, T cell, Immune Cells, MESH: Inflammation Mediators, Immunology, Retrovirology and HIV immunopathogenesis, Viremia, Enzyme-Linked Immunosorbent Assay, Viral diseases, Biology, Microbiology, Transforming Growth Factor beta1, 03 medical and health sciences, Young Adult, Acquired immunodeficiency syndrome (AIDS), Diagnostic Medicine, Virology, medicine, Humans, MESH: Lymphocyte Activation, 030304 developmental biology, Aged, MESH: Adolescent, MESH: Humans, MESH: Time Factors, HIV, MESH: Adult, medicine.disease, MESH: Male, CD4 Lymphocyte Count, Chemokine CXCL10, MESH: T-Lymphocytes, MESH: Biomarkers, HIV-1, Clinical Immunology, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Biomarkers, General Pathology
Abstract: International audience; T cell activation levels, viral load and CD4 + T cell counts at early stages of HIV-1 infection are predictive of the rate of progression towards AIDS. We evaluated whether the inflammatory profile during primary HIV-1 infection is predictive of the virological and immunological set-points and of disease progression. We quantified 28 plasma proteins during acute and post-acute HIV-1 infection in individuals with known disease progression profiles. Forty-six untreated patients, enrolled during primary HIV-1 infection, were categorized into rapid progressors, progressors and slow progressors according to their spontaneous progression profile over 42 months of follow-up. Already during primary infection, rapid progressors showed a higher number of increased plasma proteins than progressors or slow progressors. The plasma levels of TGF-b1 and IL-18 in primary HIV-1 infection were both positively associated with T cell activation level at set-point (6 months after acute infection) and together able to predict 74% of the T cell activation variation at set-point. Plasma IP-10 was positively and negatively associated with, respectively, T cell activation and CD4 + T cell counts at set-point and capable to predict 30% of the CD4 + T cell count variation at set-point. Moreover, plasma IP-10 levels during primary infection were predictive of rapid progression. In primary infection, IP-10 was an even better predictor of rapid disease progression than viremia or CD4 + T cell levels at this time point. The superior predictive capacity of IP-10 was confirmed in an independent group of 88 HIV-1 infected individuals. Altogether, this study shows that the inflammatory profile in primary HIV-1 infection is associated with T cell activation levels and CD4 + T cell counts at set-point. Plasma IP-10 levels were of strong predictive value for rapid disease progression. The data suggest IP-10 being an earlier marker of disease progression than CD4 + T cell counts or viremia levels.
Published: 2012

24. Mapping heatwave health risk at the community level for public health action

Author: Jean-François Viel, Erika Upegui, Camille Buscail, Service de santé publique et d'épidémiologie, Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Institut de recherche, santé, environnement et travail ( Irset ), Université d'Angers ( UA ) -Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -École des Hautes Études en Santé Publique [EHESP] ( EHESP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) -Université des Antilles ( UA ), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), BMC, Ed., Laboratoire Chrono-environnement (UMR 6249) (LCE), and Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: Land cover, 010504 meteorology & atmospheric sciences, General Computer Science, Business, Management and Accounting(all), Urban heat island, Vulnerability, Vulnerable populations, Geographic Mapping, Spatial risk assessment, 010501 environmental sciences, lcsh:Computer applications to medicine. Medical informatics, 01 natural sciences, Risk Assessment, Normalized Difference Vegetation Index, Residence Characteristics, 11. Sustainability, Humans, Land surface temperature, 0105 earth and related environmental sciences, Public health, Research, Public Health, Environmental and Occupational Health, Extreme Heat, Regression analysis, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, 15. Life on land, Remote sensing, General Business, Management and Accounting, Hazard, Geography, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, 13. Climate action, Public Health Practice, lcsh:R858-859.7, Regression Analysis, Heatwave health risk, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Spatial variability, France, Risk assessment, Cartography, Computer Science(all), Environmental Monitoring
Abstract: Background Climate change poses unprecedented challenges, ranging from global and local policy challenges to personal and social action. Heat-related deaths are largely preventable, but interventions for the most vulnerable populations need improvement. Therefore, the prior identification of high risk areas at the community level is required to better inform planning and prevention. We aimed to demonstrate a simple and flexible conceptual framework relying upon satellite thermal data and other digital data with the goal of easily reproducing this framework in a variety of urban configurations. Results The study area encompasses Rennes, a medium-sized French city. A Landsat ETM + image (60 m resolution) acquired during a localized heatwave (June 2001) was used to estimate land surface temperature (LST) and derive a hazard index. A land-use regression model was performed to predict the LST. Vulnerability was assessed through census data describing four dimensions (socio-economic status, extreme age, population density and building obsolescence). Then, hazard and vulnerability indices were combined to deliver a heatwave health risk index. The LST patterns were quite heterogeneous, reflecting the land cover mosaic inside the city boundary, with hotspots of elevated temperature mainly observed in the city center. A spatial error regression model was highly predictive of the spatial variation in the LST (R 2 = 0.87) and was parsimonious. Three land cover descriptors (NDVI, vegetation and water fractions) were negatively linked with the LST. A sensitivity analysis (based on an image acquired on July 2000) yielded similar results. Southern areas exhibited the most vulnerability, although some pockets of higher vulnerability were observed northeast and west of the city. The heatwave health risk map showed evidence of infra-city spatial clustering, with the highest risks observed in a north–south central band. Another sensitivity analysis gave a very high correlation between 2000 and 2001 risk indices (r = 0.98, p -12). Conclusions Building on previous work, we developed a reproducible method that can provide guidance for local planners in developing more efficient climate impact adaptations. We recommend, however, using the health risk index together with hazard and vulnerability indices to implement tailored programs because exposure to heat and vulnerability do not require the same prevention strategies.
Published: 2012

25. Does the site of magnetic resonance imaging abnormalities match the site of recent-onset inflammatory back pain? The DESIR cohort

Author: Florence Canoui-Poitrine, Valérie Farrenq, M. Blachier, Cécile Poulain, Pascal Claudepierre, Bertrand Coutanceau, Bijan Ghaleh, Sylvie Bastuji-Garin, Alain Saraux, Philippe Le Corvoisier, Salah Ferkal, Maxime Dougados, Service de rhumatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, Laboratoire d'Investigation Clinique (LIC), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle Recherche Clinique-Santé Publique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Centre de référence des Neurofibromatoses, CIC - CHU Henri Mondor, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, Service de rhumatologie [CHU Henri Mondor], Université Paris-Est Marne-la-Vallée (UPEM), Service de santé publique et d'épidémiologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Assistance publique - Hôpitaux de Paris (AP-HP) - CHU Cochin [AP-HP], Université de Brest (UBO) - Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Brest (UBO) - IFR148, Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Henri-Mondor, Institut National de la Santé et de la Recherche Médicale (INSERM) - Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut National de la Santé et de la Recherche Médicale (INSERM) - IFR10 - Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Henri Mondor, and Université Paris-Sud - Paris 11 (UP11) - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Bicêtre
Subjects: musculoskeletal diseases, Adult, Male, medicine.medical_specialty, Immunology, Lumbar vertebrae, General Biochemistry, Genetics and Molecular Biology, Thoracic Vertebrae, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Lumbar, Rheumatology, Spondylarthritis, Back pain, Immunology and Allergy, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, 030203 arthritis & rheumatology, Sacroiliac joint, Ankylosing spondylitis, Lumbar Vertebrae, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, Buttock Pain, Sacroiliac Joint, Middle Aged, medicine.disease, Low back pain, Magnetic Resonance Imaging, 3. Good health, Surgery, Radiography, medicine.anatomical_structure, Cross-Sectional Studies, Logistic Models, Back Pain, Thoracic vertebrae, Female, Radiology, medicine.symptom, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: ObjectivesTo assess whether the site of axial pain (thoracic spine, lumbar spine or buttock(s)) was associated with the site of MRI lesions in patients with recent inflammatory back pain (IBP) suggesting spondyloarthritis.MethodsWe conducted a cross-sectional study of baseline data in 708 patients with recent IBP from the DESIR cohort. Radiographs of the sacroiliac joints (SIJs) and MRI scans of the SIJs and thoracic and lumbar spine were obtained routinely. Associations between pain sites and sites of inflammatory and structural MRI changes were evaluated using separate multivariate logistic regressions.ResultsOf the 648 patients with complete data, 61% had thoracic pain, 91.6% lumbar pain and 79.2% buttock pain. MRI inflammation was seen in 19%, 21% and 46% of patients at the thoracic, lumbar and SIJ sites, respectively. By multivariate analysis, pain was significantly associated with MRI inflammation only at the same site (adjusted OR (aOR)thoracicpain1.71; 95% CI 1.09 to 2.67; p=0.02; aORlumbar pain2.53; 95% CI 1.03 to 6.20; p=0.04; aORbuttock pain2.86; 95% CI 1.84 to 4.46; pbuttock pain1.89; 95% CI 1.22 to 2.90; p=0.004). The association between pain site and site of MRI inflammation persisted in the subgroups with normal or doubtful SIJ radiographs or with Assessment of SpondyloArthritis international Society criteria for axial spondyloarthritis.ConclusionsThe site of pain (thoracic spine, lumbar spine or buttock(s)) is associated with MRI inflammation at the same site in patients with recent IBP.
Published: 2012

26. Le bien-être et ses paysages comme territoires des infrastructures de transport terrestre. Conflits d'acteurs, enjeux de valeurs et savoirs paysagers [rapport final pour le MEDDE]

Author: Faburel, Guillaume, Altaber, Cécile, Chevallier, Karen, Meyer, Laurence, Gageonnet, Claire, Triangle : action, discours, pensée politique et économique (TRIANGLE), École normale supérieure - Lyon (ENS Lyon)-Université Lumière - Lyon 2 (UL2)-Sciences Po Lyon - Institut d'études politiques de Lyon (IEP Lyon), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Centre National de la Recherche Scientifique (CNRS), Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de santé publique et d'épidémiologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, MEDDE, Ministère de l'Ecologie, du Développement Durable et de l'Energie, Programme scientifique Infrastructures de Transport Terrestre Ecologie Paysages (ITTECOP), Faburel, Guillaume, École normale supérieure de Lyon (ENS de Lyon)-Université Lumière - Lyon 2 (UL2)-Sciences Po Lyon - Institut d'études politiques de Lyon (IEP Lyon), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Centre National de la Recherche Scientifique (CNRS), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS)-Sciences Po Lyon - Institut d'études politiques de Lyon (IEP Lyon), and Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Université Lumière - Lyon 2 (UL2)-École normale supérieure - Lyon (ENS Lyon)
Subjects: transports, infrastructures, [SHS.SCIPO] Humanities and Social Sciences/Political science, environnement, [SHS.SCIPO]Humanities and Social Sciences/Political science, territoires
Abstract: Ministère de l'Ecologie, du Développement Durable et de l'Energie (MEDDE), 196 p.; Rapport final pour le Ministère de l'Ecologie, du Développement Durable et de l'Energie Faburel G. (coord.), Altaber Cécile, Chevallier Karen, Meyer Laurence et Gageonnet Claire
Published: 2012

27. Should we consider Dupuytren's contracture as work-related? A review and meta-analysis of an old debate

Author: Yves Roquelaure, Annette Leclerc, Alexis Descatha, Pénélope Jauffret, Jean-François Chastang, Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de santé publique et épidémiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Laboratoire d'Ergonomie et d'Épidémiologie en Santé au Travail (LEEST), Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Institut de Veille Sanitaire (INVS), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), and BMC, Ed.
Subjects: medicine.medical_specialty, lcsh:Diseases of the musculoskeletal system, Population, Dupuytren contracture, Risk Assessment, Vibration, Work related, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Risk Factors, Occupational Exposure, Epidemiology, Odds Ratio, medicine, Humans, Orthopedics and Sports Medicine, 030212 general & internal medicine, occupational, Dupuytren's contracture, education, observational studies, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, 030222 orthopedics, education.field_of_study, business.industry, medicine.disease, 3. Good health, Occupational Diseases, meta-analysis, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Meta-analysis, Physical therapy, Observational study, Contracture, medicine.symptom, lcsh:RC925-935, business, Research Article, Cohort study
Abstract: Background In view of the conflicting opinions published, a meta-analysis was undertaken on epidemiological studies in order to assess any association between Dupuytren's contracture and work exposure. Methods Using the key words: "occupational disease", "work" and "Dupuytren contracture" without limitation on language or year of publication, epidemiological studies were selected from four databases (Pub-Med, Embase, Web of science, BDSP) after two rounds (valid control group, valid work exposure). A quality assessment list was constructed and used to isolate papers with high quality methodological criteria (scores of 13 or above, HQMC). Relevant associations between manual work, vibration exposure (at work) and Dupuytren's contracture were extracted from the articles and a metarisk calculated using the generic variance approach (meta-odds ratios, meta-OR). Results From 1951 to 2007, 14 epidemiological studies (including 2 cohort studies, 3 case-control studies, and 9 cross-sectional studies/population surveys) were included. Two different results could be extracted from five studies (based on different types of exposure), leading to 19 results, 12 for manual work (9 studies), and 7 for vibration exposure (5 studies). Six studies met the HQMC, yielding 9 results, 5 for manual work and 4 for vibration exposure. Five studies found a dose-response relationship. The meta-OR for manual work was 2.02[1.57;2.60] (HQMC studies only: 2.01[1.51;2.66]), and the meta-OR for vibration exposure was 2.88 [1.36;6.07] (HQMC studies only: 2.14[1.59;2.88]). Conclusion These results support the hypothesis of an association between high levels of work exposure (manual work and vibration exposure) and Dupuytren's contracture in certain cases.
Published: 2011

28. Decrease of prefrontal metabolism after subthalamic stimulation in obsessive-compulsive disorder: a positron emission tomography study

Author: Julie Anne Peron, Mircea Polosan, Florence Le Jeune, Denys Fontaine, Sophie Tezenas du Montcel, Marie-Odile Krebs, Antoine Pelissolo, Aurélie Bourguignon, Dominique Drapier, Nicolas Baup, Bertrand Devaux, Paul Sauleau, Bruno Millet, Sylvie Raoul, Nematollah Jaafari, Isabelle Chereau, Etienne Garin, Marc Vérin, Emmanuelle Leray, Luc Mallet, K. N’Diaye, Jérôme Yelnik, Département de médecine nucléaire [Rennes], CRLCC Eugène Marquis (CRLCC), Comportement et noyaux gris centraux = Behavior and Basal Ganglia [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes (INCR), Service de Neurologie [Rennes] = Neurology [Rennes], CHU Pontchaillou [Rennes], Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière (CRICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de psychiatrie, CHU Pontchaillou [Rennes]-Hôpital Guillaume Régnier, Service de santé publique et d'épidémiologie, Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Hôpital Sainte-Anne, CIC AP-HP (pitie-Salpetriere)/inserm, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), ANTE-INSERM U836, équipe 11, Fonctions cérébrales et neuromodulation, CHU Grenoble-CHU Grenoble, Service de Neurochirurgie, Centre Hospitalier Universitaire de Nice (CHU Nice), CHU Clermont-Ferrand, Service de physiologie, Service de neurochirurgie, CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), This study was supported by a grant from Medtronic to Dr. Millet., French Stimulation dans le trouble obsessionnel compulsif (STOC) study group, Pollak, Pierre, David, Olivier, Université de Rennes (UR)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes (INCR), Laboratoire de psychologie cognitive et sociale (LPCS), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA), The French Stimulation dans le trouble obsessionnel compulsif (STOC) study group, CHU Pontchaillou [Rennes]-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université européenne de Bretagne - European University of Brittany (UEB)-Institut des Neurosciences Cliniques de Rennes (INCR), Recherche en Pharmaco-épidémiologie et Recours aux Soins (REPERES), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP), EA Management des Organisations de Santé (EA MOS), École des Hautes Études en Santé Publique [EHESP] (EHESP)-PRES Sorbonne Paris Cité, École des Hautes Études en Santé Publique [EHESP] (EHESP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de psychiatrie adulte [CHU Pitié-Salpêtière], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Psychiatrie, CHU Grenoble, Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Descartes - Paris 5 (UPD5), Service de neurochirurgie [Rennes] = Neurosurgery [Rennes], Microenvironnement et remodelage, Service de médecine nucléaire [Rennes], CRLCC Eugène Marquis (CRLCC)-CRLCC Eugène Marquis (CRLCC)-Foie, métabolismes et cancer, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Guillaume Régnier (CHGR), CH Régnier, Université de Rennes (UR)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes = Institute of Clinical Neurosciences of Rennes (INCR), CRLCC Eugène Marquis ( CRLCC ), Comportement et noyaux gris centraux [Rennes], Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Université européenne de Bretagne ( UEB ) -CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes (INCR), Service de Neurologie [Rennes], Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière ( CRICM ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Service d'informatique médicale, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Descartes - Paris 5 ( UPD5 ) -Hôpital Sainte-Anne, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), CHU Nice, Université de Poitiers-Centre hospitalier universitaire de Poitiers ( CHU Poitiers ) -Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut des Neurosciences Cliniques de Rennes (INCR)-CHU Pontchaillou [Rennes]-Université européenne de Bretagne - European University of Brittany (UEB)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5)-Hôpital Sainte-Anne, Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-CHU Pitié-Salpêtrière [APHP], Service de neurochirurgie [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: Male, Obsessive-Compulsive Disorder, Deep Brain Stimulation, medicine.medical_treatment, MESH : Prefrontal Cortex, Severity of Illness Index, 0302 clinical medicine, obsessive compulsive disorder, MESH : Obsessive-Compulsive Disorder, MESH : Gyrus Cinguli, MESH: Treatment Outcome, subthalamic nucleus, MESH: Middle Aged, MESH: Image Processing, Computer-Assisted, 3. Good health, MESH: Adult Brain Mapping Cross-Over Studies Deep Brain Stimulation Double-Blind Method Female Gyrus Cinguli/radionuclide imaging Humans Image Processing, Computer-Assisted Male Middle Aged Obsessive-Compulsive Disorder/radionuclide imaging* Obsessive-Compulsive Disorder/therapy* Positron-Emission Tomography Prefrontal Cortex/radionuclide imaging* Severity of Illness Index Statistics, Nonparametric Subthalamic Nucleus/surgery* Treatment Outcome, MESH : Image Processing, Computer-Assisted, medicine.medical_specialty, Deep brain stimulation, behavioral disciplines and activities, Statistics, Nonparametric, 03 medical and health sciences, MESH: Severity of Illness Index, MESH: Gyrus Cinguli, MESH : Double-Blind Method, Humans, MESH : Middle Aged, [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Biological Psychiatry, MESH: Subthalamic Nucleus, MESH: Obsessive-Compulsive Disorder, MESH: Humans, MESH : Deep Brain Stimulation, MESH : Humans, MESH : Positron-Emission Tomography, MESH: Adult, nervous system diseases, 030227 psychiatry, Subthalamic Nucleus/surgery, nervous system, Positron-Emission Tomography, MESH: Deep Brain Stimulation, orbitofrontal cortex, Gyrus Cinguli/radionuclide imaging, Neuroscience, MESH: Female, 030217 neurology & neurosurgery, Cingulate cortex, 18FDG-PET, MESH : Brain Mapping, Gyrus, Image Processing, Computer-Assisted, MESH : Female, MESH: Double-Blind Method, Prefrontal cortex, MESH: Brain Mapping, Brain Mapping, MESH: Statistics, Nonparametric, Cross-Over Studies, Putamen, MESH : Adult, Middle Aged, MESH: Positron-Emission Tomography, deep brain stimulation, Subthalamic nucleus, surgical procedures, operative, Treatment Outcome, medicine.anatomical_structure, Cingulate gyrus, Cardiology, MESH : Severity of Illness Index, Female, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Internal capsule, Psychology, therapeutics, Adult, MESH : Male, MESH : Subthalamic Nucleus, Prefrontal Cortex, MESH : Treatment Outcome, Gyrus Cinguli, MESH: Cross-Over Studies, Double-Blind Method, Internal medicine, medicine, MESH : Statistics, Nonparametric, Prefrontal Cortex/radionuclide imaging, Postcentral gyrus, [SCCO.NEUR]Cognitive science/Neuroscience, MESH : Cross-Over Studies, MESH: Male, ddc:616.8, [ SDV.NEU ] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Orbitofrontal cortex, MESH: Prefrontal Cortex, Obsessive-Compulsive Disorder/radionuclide imaging/therapy
Abstract: International audience; Background:High-frequency bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) is a promising treatment in refractory obsessive-compulsive disorder (OCD). Method Using the crossover, randomized, and double-blind procedure adopted by the STOC study, 10 patients treated with high-frequency bilateral STN DBS underwent am 18-fluorodeoxyglucose positron emission tomography (PET) investigation to highlight the neural substratum of this therapeutic approach. Results The median YaleBrown Obsessive Compulsive Scale (Y-BOCS) scores for all 10 patients were 31 (minimum = 18, maximum = 36) with "Off-Stimulation" status and 19 (minimum = 0, maximum = 30) with "On-Stimulation" status (p = .05). The OCD patients in Off-Stimulation status showed a hypermetabolism in the right frontal middle and superior gyri, right parietal lobe, postcentral gyrus, and bilateral putamen compared with healthy control subjects. A significant decrease in cerebral metabolism was observed in the left cingulate gyrus and the left frontal medial gyrus in On-Stimulation conditions compared with Off-Stimulation conditions. In addition, the improvement assessed by Y-BOCS scores during the On-Stimulation conditions was positively correlated with PET signal changes at the boundary of the orbitofrontal cortex and the medial prefrontal cortex, between PET signal changes and the Y-BOCS scores modifications in On-Stimulation status. Conclusion This study suggests that the therapeutic effect of STN DBS is related to a decrease in prefrontal cortex metabolism. © 2010 Society of Biological Psychiatry.
Published: 2010

29. Trauma symptoms inventory scale, return to work, and atypical complex regional pain syndrome type 1?

Author: Bertand Pichon, Alexis Descatha, Service de médecine physique et de réadaptation, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de santé publique et épidémiologie, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), and Kaniewski, Nadine
Subjects: 030222 orthopedics, medicine.medical_specialty, MESH: Humans, Rehabilitation, MESH: Disability Evaluation, Physical Therapy, Sports Therapy and Rehabilitation, medicine.disease, Return to work, MESH: Absenteeism, 03 medical and health sciences, MESH: Reflex Sympathetic Dystrophy, 0302 clinical medicine, Complex regional pain syndrome, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Scale (social sciences), medicine, Physical therapy, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Trauma symptoms, Psychology, 030217 neurology & neurosurgery, ComputingMilieux_MISCELLANEOUS, MESH: Physical Therapy Modalities
Abstract: International audience; no abstract
Published: 2010

30. Expected and unexpected adverse effects H1N1 vaccination for health care workers in a university hospital

Author: Aurélien Dinh, Jérôme Salomon, Christine Lawrence, Alexis Descatha, Services des maladies infectieuses, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Equipe Hygiène, Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé, Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de santé publique et épidémiologie, Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Kaniewski, Nadine
Subjects: medicine.medical_specialty, Health Personnel, 030204 cardiovascular system & hematology, Hospitals, University, MESH: Influenza A Virus, H1N1 Subtype, MESH: Influenza Vaccines, 03 medical and health sciences, Influenza A Virus, H1N1 Subtype, 0302 clinical medicine, Surveys and Questionnaires, Influenza, Human, Health care, medicine, Humans, 030212 general & internal medicine, Adverse effect, ComputingMilieux_MISCELLANEOUS, MESH: Hospitals, University, MESH: Humans, General Veterinary, General Immunology and Microbiology, business.industry, MESH: Influenza, Human, MESH: Questionnaires, Vaccination, Public Health, Environmental and Occupational Health, Influenza a, MESH: Vaccination, medicine.disease, University hospital, 3. Good health, Infectious Diseases, Immunization, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Influenza Vaccines, Emergency medicine, Molecular Medicine, MESH: Health Personnel, Disease prevention, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Medical emergency, business
Abstract: International audience; no abstract
Published: 2010

31. Influence of job seniority, hand hygiene education, and patient-to-nurse ratio on hand disinfection compliance

Author: Sylvie Buffet-Bataillon, Michel Cormier, Christian Michelet, Emmanuelle Leray, Magali Poisson, Martine Bonnaure-Mallet, Brébion, Alice, Microbiologie : Risques Infectieux, Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de santé publique et d'épidémiologie, Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service de Parasitologie-Mycologie [Rennes], Université de Rennes (UR)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Faculté d'Odontologie-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes - UFR d'Odontologie (UR Odontologie), and Université de Rennes (UR)-Université de Rennes (UR)
Subjects: Microbiology (medical), medicine.medical_specialty, Multivariate analysis, Audits, media_common.quotation_subject, MESH: Education, Medical, education, Psychological intervention, Nurses, 030501 epidemiology, MESH: Handwashing, Compliance (psychology), Education, 03 medical and health sciences, 0302 clinical medicine, Nursing, Hygiene, Health care, medicine, Humans, 030212 general & internal medicine, Seniority, Health Workforce, [SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology, media_common, MESH: Humans, Education, Medical, business.industry, Public health, General Medicine, 3. Good health, Infectious Diseases, MESH: Nurses, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, MESH: Health Manpower, MESH: Guideline Adherence, Health education, Guideline Adherence, 0305 other medical science, business, Hand hygiene, Hand Disinfection
Abstract: International audience; Hand hygiene compliance was evaluated by direct observation in 2006 and 2007. In 2007, data on characteristics such as job seniority, hand hygiene education, and patient-to-nurse ratio during direct observations were collected. A hand hygiene promotional programme was performed between the two evaluations. Univariate and multivariate analysis identified factors associated with improved hand hygiene compliance. Between 2006 and 2007, from 761 hand hygiene opportunities, overall and partial compliance improved from 44.9% to 58% (P
Published: 2010

32. La fertilité est-elle en danger ?

Author: Jégou, Bernard, Jouannet, Pierre, Spira, Alfred, Groupe d'Etude de la Reproduction Chez l'Homme et les Mammiferes ( GERHM ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -IFR140-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de biologie de la reproduction-CECOS, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP]-Université Paris Descartes - Paris 5 ( UPD5 ) -EA1752, Service de santé publique et d'épidémiologie, Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Bicêtre, Groupe d'Etude de la Reproduction Chez l'Homme et les Mammiferes (GERHM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-EA1752, Hôpital Bicêtre-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-IFR140-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP]-Université Paris Descartes - Paris 5 (UPD5)-EA1752, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Bicêtre, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre
Subjects: [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: La fertilité humaine est-elle en danger ? Cette question alimente un vif débat, aussi bien dans la communauté scientifique qu'auprès du grand public, des médias, du monde industriel et des décideurs politiques. Que les activités humaines - industrielles, agricoles ou même individuelles - puissent constituer de graves menaces pour le climat et la biodiversité est un constat désormais largement partagé. Mais qu'elles puissent nuire à la capacité des individus à se reproduire suscite de nombreuses inquiétudes, car il s'agit, symboliquement, de la perpétuation de l'espèce humaine. Dès les années 1990, les auteurs de ce livre, spécialistes de renommée internationale, se sont trouvés associés autour d'une préoccupation commune quant à l'évolution de la santé reproductive humaine. Aujourd'hui, dans cet ouvrage qui constitue la synthèse la plus actuelle des connaissances sur le sujet, ils dressent un état des lieux clair et accessible au plus grand nombre, avec le désir d'alimenter le débat et d'aider à faire des choix collectifs raisonnés en matière de développement et de santé publique.
Published: 2009

33. Should a person who wants to die always be considered a patient?

Author: Descatha, Alexis, SAMU 92-SMUR, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé, Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de santé publique et épidémiologie, Kaniewski, Nadine, and Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Attitude to Death, MESH: Humans, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Attitude to Death, Right to Die, MESH: Professional Practice, Humans, Professional Practice, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Right to Die, ComputingMilieux_MISCELLANEOUS, MESH: Male
Abstract: International audience; no abstract
Published: 2009

34. Is Dr House is a good diagnostics teacher for medical students?

Author: Descatha, Alexis, Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé, Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de santé publique et épidémiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], and SAMU 92-SMUR
Subjects: likelihood ratio, MESH: Humans, diagnosis, MESH: Diagnosis, MESH: Education, Medical, Undergraduate, MESH: Television, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, medical education, ComputingMilieux_MISCELLANEOUS
Abstract: International audience; no abstract
Published: 2009

35. Frequency and predictors of renal artery stenosis in patients with coronary artery disease

Author: Hervé Le Breton, Stéphane Mock, Marc Bedossa, Romain Ollivier, David Veillard, Dominique Boulmier, Guillaume Leurent, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de santé publique et d'épidémiologie, Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Coronary angiography, Male, MESH: Logistic Models, 030204 cardiovascular system & hematology, Renal artery stenosis, Logistic regression, MESH: Risk Assessment, Severity of Illness Index, Coronary artery disease, MESH: Hypertension, 0302 clinical medicine, MESH: Aged, 80 and over, [INFO.INFO-TS]Computer Science [cs]/Signal and Image Processing, Risk Factors, MESH: Risk Factors, Prevalence, MESH: Renal Insufficiency, 030212 general & internal medicine, Prospective Studies, Aged, 80 and over, MESH: Aged, MESH: Middle Aged, General Medicine, Middle Aged, 3. Good health, MESH: Renal Artery Obstruction, medicine.anatomical_structure, Creatinine, Hypertension, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, medicine.symptom, Cardiology and Cardiovascular Medicine, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, Artery, Adult, medicine.medical_specialty, Renal function, MESH: Creatinine, Renal Artery Obstruction, Risk Assessment, Lesion, 03 medical and health sciences, Sex Factors, MESH: Sex Factors, MESH: Coronary Stenosis, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, MESH: Severity of Illness Index, medicine, Humans, In patient, Renal insufficiency, MESH: Prevalence, Aged, MESH: Humans, business.industry, Coronary Stenosis, MESH: Adult, medicine.disease, MESH: Male, MESH: Prospective Studies, MESH: Coronary Angiography, Logistic Models, Renal arteriography, business, MESH: Female
Abstract: International audience; BACKGROUND: Renal artery stenosis (RAS) remains underdiagnosed because of nonspecific clinical manifestations, including in patients with coronary artery disease (CAD). AIMS: To estimate the prevalence and identify predictors of RAS in patients with CAD undergoing coronary angiography. SETTING: University-based medical centre. METHODS: We enrolled 650 consecutive patients (mean age=67+/-10 years, 80% men) with confirmed CAD. All patients underwent selective renal arteriography in the same procedure. We estimated the prevalence of RAS, defined as a >50% lesion. Multiple variable analysis of factors associated with presence of RAS was carried out using a logistic regression model. Variables that emerged as predictors by single-variable analysis were included in the model, along with variables that were tentatively associated with RAS, based on a literature review. RESULTS: RAS was detected in 94 patients (14.5%, 95% CI: 11.8-17.2%), including 20 (3.1%) with bilateral lesions. By single-variable analysis and presence and number of coronary artery stenoses (P
Published: 2009

36. Comparison of epidemiological, clinical, and biological features of invasive aspergillosis in neutropenic and nonneutropenic patients: a 6-year survey

Author: Jean-Pierre Gangneux, Sylvie Caulet-Maugendre, Emmanuelle Leray, M. Faucheux, Virginie Gandemer, C. Meunier, Bernard Lelong, A. Cornillet, C. Lebert, Chantal Belleguic, Christophe Camus, Claude Guiguen, Stanislas Nimubona, Pierre Tattevin, Sylviane Chevrier, M. Aupee, CHU Pontchaillou [Rennes], Service des urgences [Rennes] = Emergency [Rennes], Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], Service d'hématologie-oncologie pédiatrique, Service de pneumologie, Service de Parasitologie-Mycologie [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Génétique et évolution des maladies infectieuses (GEMI), Centre National de la Recherche Scientifique (CNRS)-Université Montpellier 1 (UM1)-Institut de Recherche pour le Développement (IRD [France-Sud]), Signalisation et Réponses aux Agents Infectieux et Chimiques (SeRAIC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Service d'hématologie clinique, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou, Centre de recherches (CRT), Société Lafarge, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], Comportement et noyaux gris centraux = Behavior and Basal Ganglia [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes (INCR), Service de santé publique et d'épidémiologie, Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Université de Rennes (UR)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Université Montpellier 1 (UM1)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud]), Université de Rennes (UR), Université de Rennes (UR)-Hôpital Pontchaillou, and Université de Rennes (UR)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes = Institute of Clinical Neurosciences of Rennes (INCR)
Subjects: Male, Antifungal Agents, Time Factors, Opportunistic infection, Aspergillosis, law.invention, 0302 clinical medicine, law, Risk Factors, MESH: Risk Factors, MESH: Child, 030212 general & internal medicine, Child, MESH: Aged, 0303 health sciences, Leukopenia, MESH: Middle Aged, Mortality rate, Middle Aged, Intensive care unit, 3. Good health, Infectious Diseases, Fungal, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Child, Preschool, Female, medicine.symptom, Microbiology (medical), Adult, medicine.medical_specialty, Antigens, Fungal, Neutropenia, Adolescent, MESH: Neutropenia, Antibodies, 03 medical and health sciences, Internal medicine, medicine, Humans, MESH: Aspergillosis, Antigens, Preschool, Antibodies, Fungal, Mycosis, Aged, MESH: Antigens, Fungal, MESH: Adolescent, MESH: Humans, 030306 microbiology, business.industry, MESH: Time Factors, MESH: Antibodies, Fungal, MESH: Child, Preschool, MESH: Adult, medicine.disease, MESH: Antifungal Agents, MESH: Male, Surgery, Pneumonia, business, MESH: Female
Abstract: International audience; BACKGROUND: Invasive aspergillosis is an opportunistic infection that occurs mainly among patients with prolonged neutropenia. Few data are available on invasive aspergillosis in nonneutropenic patients. METHODS: The aim of this survey was to compare neutropenic and nonneutropenic patients who had received a diagnosis of invasive aspergillosis at our institution during a 6-year period. RESULTS: Among the 88 cases of invasive aspergillosis analyzed here, 12 were histologically proven, 52 were probable, and 24 were possible. Forty-seven percent of cases were diagnosed in the intensive care unit, and 40% were diagnosed in hematology units. Neutropenia was a risk factor for 52 patients (59%), most of whom had hematological or solid malignancies. Among the 36 nonneutropenic patients (41%), the main underlying conditions were steroid-treated chronic obstructive pulmonary disease, asthma, rheumatoid arthritis, giant-cell arteritis, and microvascular disorders; 10 patients were recipients of solid-organ transplants, and 1 patient was seropositive for human immunodeficiency virus. The distribution of proven and probable invasive aspergillosis was similar for neutropenic and nonneutropenic patients. The mortality rate was 71.5% overall and was significantly higher among nonneutropenic patients than among neutropenic patients (89% vs. 60%; P
Published: 2006

37. Offre de soins et expansion urbaine, conséquences pour l'accès aux soins. L'exemple de Ouagadougou

Author: Cadot, Emmanuelle, Harang, Maud, Service de santé publique et d'épidémiologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Laboratoire Espace, Santé et Territoire (LEST), Université Paris Nanterre (UPN), and Cadot, Emmanuelle
Subjects: dynamiques spatiales, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SHS.GEO] Humanities and Social Sciences/Geography, étalement urbain, Burkina Faso, distribution spatiale, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, accès aux soins, Ouagadougou, [SHS.GEO]Humanities and Social Sciences/Geography, offre de soins
Abstract: Accès au texte intégral : http://eps.revues.org/index1739.html; National audience; Ouagadougou, capitale exemplaire d'un processus d'urbanisation d'un pays africain, donne lieu par sa croissance spatiale rapide et peu contrôlée à un mode original de production de l'espace s'accompagnant du développement de vastes zones d'habitat spontané. Dans ce contexte d'étalement spatial, les autorités sanitaires ont tenté de répondre à la demande de soins par la mise en place de politiques planificatrices ayant des impacts sur l'agencement du territoire. Notre objectif est de confronter la croissance spatiale et l'évolution du nombre et du type de structures de soins modernes dans la ville. Cette étude repose, dans un premier temps, sur des recherches bibliographiques et d'archives qui ont permis de retracer les différentes étapes de la croissance spatiale de la ville depuis le début du vingtième siècle. Dans un second temps, nous avons appréhendé les différents éléments qui composent le système de soins (CSPS, hôpitaux, cabinets privés de soins infirmiers, etc.) comme un semis de points. Un indicateur simple et synthétique de concentration a été utilisé pour caractériser les formes des distributions spatiales des établissements de soins dans la ville. Les infrastructures publiques sont régulièrement réparties dans la ville ; leur distribution témoigne de la volonté des pouvoirs publics d'assurer à l'ensemble de la population une forme d'équité dans l'accès physique aux soins. La répartition spatiale des établissements de soins privés, caractérisée par des zones de concentration au centre de la ville et autour des plus grands axes de communication, souligne la logique marchande de leur implantation. Ces recompositions de l'espace sanitaire de la ville ne sont pas sans conséquences sur l'accès aux soins et se traduisent par un accroissement des inégalités physiques d'accès aux soins, notamment pour les populations des quartiers périphériques, plus particulièrement des quartiers non lotis.
Published: 2006

38. Excess deaths during the August 2003 heat wave in Paris, France

Author: Canoui-Poitrine, Florence, Cadot, Emmanuelle, Spira, Alfred, Service de santé publique et d'épidémiologie, and Hôpital Bicêtre-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)
Subjects: Paris, Mortality ratio, Heat wave, Standardized mortality ratio, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Excess deaths
Abstract: BACKGROUND: During the August 2003 heat wave in France, almost 15,000 excess deaths were recorded. Paris was severely affected, with an excess death rate of 141%. This study had two aims: to identify individual factors associated with excess deaths during a heat wave in an urban environment and to describe the spatial distribution of deaths within the French capital. METHODS: The study population included all people who died at home between August 1st and 20th, 2003 (N=961). We identified factors associated with excess deaths by comparing the sociodemographic characteristics of the study population with those of people who died at home during the same period in reference years (2000, 2001, 2002) (N=530). Spatial differences were analysed by calculating comparative mortality rates within Paris during August 2003. Mortality ratio was determined to demonstrate temporal variations in mortality between the heat wave period and reference years. RESULTS: The major factors associated with excess death were: age over 75 years (adjusted OR=1.44 (1.10-1.90), being female (adjusted OR=1.43 (1.11-1.83)), not being married (adjusted OR=1.63 (1.23-2.15)), particularly for men. Being a foreigner appeared to be a protective factor for women. Comparative mortality rates by neighbourhood showed a gradient in excess deaths from North-West to South-East. The mortality ratio was 5.44 (5.10-5.79), with very high rates of excess death in the South (12th, 13th, 14th and 15th "arrondissement"). CONCLUSION: The August 2003 heat wave in Paris was associated with both an exceptional increase in mortality rates and changes in the characteristics of those dying and spatial distribution of mortality. Understanding the effects of a heat wave on mortality can probably be improved by an analysis of risk at two levels: individual and contextual.
Published: 2005

39. Excess deaths during the August 2003 heat wave in Paris, France

Author: F. Canouï-Poitrine, E. Cadot, A. Spira, Service de santé publique et d'épidémiologie, and Hôpital Bicêtre-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)
Subjects: Male, Gerontology, Paris, Standardized mortality ratio, Urban Population, Epidemiology, Heat exhaustion, Heat Exhaustion, Excess deaths, Heat wave, Humans, Medicine, Aged, High rate, business.industry, Mortality rate, Public Health, Environmental and Occupational Health, medicine.disease, Mortality ratio, Population study, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Urban environment, Demography
Abstract: Background During the August 2003 heat wave in France, almost 15,000 excess deaths were recorded. Paris was severely affected, with an excess death rate of 141%. This study had two aims: to identify individual factors associated with excess deaths during a heat wave in an urban environment and to describe the spatial distribution of deaths within the French capital. Methods The study population included all people who died at home between August 1st and 20th, 2003 (N=961). We identified factors associated with excess deaths by comparing the sociodemographic characteristics of the study population with those of people who died at home during the same period in reference years (2000, 2001, 2002) (N=530). Spatial differences were analysed by calculating comparative mortality rates within Paris during August 2003. Mortality ratio was determined to demonstrate temporal variations in mortality between the heat wave period and reference years. Results The major factors associated with excess death were: age over 75 years (adjusted OR=1.44 (1.10-1.90), being female (adjusted OR=1.43 (1.11-1.83)), not being married (adjusted OR=1.63 (1.23-2.15)), particularly for men. Being a foreigner appeared to be a protective factor for women. Comparative mortality rates by neighbourhood showed a gradient in excess deaths from North-West to South-East. The mortality ratio was 5.44 (5.10-5.79), with very high rates of excess death in the South (12th, 13th, 14th and 15th “arrondissement”). Conclusion The August 2003 heat wave in Paris was associated with both an exceptional increase in mortality rates and changes in the characteristics of those dying and spatial distribution of mortality. Understanding the effects of a heat wave on mortality can probably be improved by an analysis of risk at two levels: individual and contextual.
Published: 2005

40. Vulnérabilité sociale des personnes âgées à Paris, les leçons à tirer de l'épisode caniculaire d'Août 2003

Author: Cadot, Emmanuelle, Canoui-Poitrine, Florence, Alarcon, Flora, Noel, Harold, Spira, Alfred, Service de santé publique et d'épidémiologie, Hôpital Bicêtre-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11), Chauvin P, Parizot I, Cadot, Emmanuelle, and Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre
Subjects: [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
Published: 2005

41. Causality and Emergency Medicine?

Author: Alexis Descatha, Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé, Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de santé publique et épidémiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], SAMU 92-SMUR, Kaniewski, Nadine, and Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: medicine.medical_specialty, MESH: Humans, business.industry, MESH: Causality, 030204 cardiovascular system & hematology, medicine.disease, Causality, 03 medical and health sciences, 0302 clinical medicine, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Acute Disease, Emergency medicine, Emergency Medicine, medicine, Humans, MESH: Acute Disease, MESH: Emergency Medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 030212 general & internal medicine, Medical emergency, business, ComputingMilieux_MISCELLANEOUS
Abstract: International audience; no abstract
Published: 2011

42. The Prognostic Value of Olfactory Dysfunction in Patients with COVID-19: The COVIDORA Study.

Author: Hamel AL, Delbos L, Natella PA, Radulesco T, Alexandru M, Bartaire E, Bartier S, Benoite G, Bequignon E, Castillo L, Canouï-Poitrine F, Carsuzaa F, Corré A, Coste A, Couloigner V, Daveau C, De Boissieu P, De Bonnecaze G, De Gabory L, Debry C, Deraedt S, Dufour X, El Bakkouri W, Gilain L, Hans S, Hautefort C, Hermann R, Jankowski R, La Croix C, Lecanu JB, Malard O, Michel J, Nguyen Y, Nevoux J, Papon JF, Patron V, Prigent M, Pruliere-Escabasse V, Renaud M, Rumeau C, Salmon D, Saroul N, Serrano E, Nhung Tran Khai C, Tringali S, Truy E, Vandersteen C, Verillaud B, Veil R, and Fieux M
Abstract: Background: Among all studies describing COVID-19 clinical features during the first wave of the pandemic, only a few retrospective studies have assessed the correlation between olfac-tory dysfunction (OD) and the evolution of disease severity. The main aim was to assess whether OD is a predictive factor of COVID-19 severity based on the patient's medical management (outpa-tient care, standard hospital admission, and ICU admission)., Methods: A national, prospective, mul-ticenter cohort study was conducted in 20 public hospitals and a public center for COVID-19 screen-ing. During the first wave of the pandemic, from 6 April to 11 May 2020, all patients tested positive for COVID-19 confirmed by RT-PCR underwent two follow-up ENT consultations within 10 days of symptom onset. The main outcome measures were the evolution of medical management (out-patient care, standard hospital admission, and ICU admission) at diagnosis and along the clinical course of COVID-19 disease., Results: Among 481 patients included, the prevalence of OD was 60.7%, and it affected mostly female patients (74.3%) under 65 years old (92.5%), with fewer comor-bidities than patients with normal olfactory function. Here, 99.3% (290/292) of patients with OD presented with non-severe COVID-19 disease. Patients reporting OD were significantly less hospi-talized than the ones managed as outpatients, in either a standard medical unit or an ICU. Conclu-sions: As regards the clinical course of COVID-19 disease, OD could predict a decreased risk of hospitalization during the first wave of the pandemic.
Published: 2024
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43. Validity of the French version of Catquest-9SF and use of an electronic notepad for entering patient-reported outcome measures.

Author: Katz G, Rouquette A, Lignereux F, Mourgues T, Weber M, and Lundström M
Abstract: Background: The Catquest-9SF questionnaire is a patient reported outcome measure that quantifies the visual benefits from cataract surgery. The purpose of this study was to translate and adapt the Catquest-9SF questionnaire for France, to assess its psychometric properties via Rasch analysis, and to assess its validity when completed using an electronic notepad., Methods: The Catquest-9SF questionnaire was translated following the guidelines of the International Society for Pharmacoeconomics and Outcomes Research. Catquest-9SF and clinical data were collected from patients before and after routine cataract surgery. All questionnaire data were collected via an electronic notepad. Rasch analysis was performed to assess psychometric properties, and sensitivity to change was analysed for patients with complete paired pre- and post-operative questionnaires., Results: A complete filled-in preoperative questionnaire was obtained for 848 patients. Rasch analysis showed good precision (person separation: 2.32, person reliability: 0.84), ordered category probability curves, no item misfit, and unidimensionality. The respondents were slightly more able than the level of item difficulty (targeting: -1.12 logits). Sensitivity was analysed on 211 paired questionnaires, and the postoperative questionnaires showed a clear ceiling effect. The effect size was 2.6. The use of an electronic notepad for completing the questionnaire worked out very well after some adjustments., Conclusions: The French version of Catquest-9SF has good psychometric properties and is suitable for use in French-speaking patients. The use of the Catquest-9SF questionnaire in an electronic format showed good validity.
Published: 2021
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44. A training program for fibromyalgia management: A 5-year pilot study.

Author: Bodéré C, Cabon M, Woda A, Giroux-Metges MA, Bodéré Y, Saliou P, Quinio B, Misery L, and Le Fur-Bonnabesse A
Abstract: We studied the effects of a specific cardio training program lasting 5 years on pain and quality of life in fibromyalgia patients., Method: An observational longitudinal pilot study was conducted in 138 fibromyalgia women. Fibromyalgia women recruited were asked to carry out three sessions per week, each lasting 45 min, of moderate-intensity continuous training (64%-75% Maximal Heart rate [HRmax]). During the first year, the patients progressively increased their training intensity. During the last 2 years, the patients were asked to associate moderate-intensity continuous training and high-intensity interval training (85%-90% HRmax). Pain on a visual analog scale, anxiety and depression state on the Hospital Anxiety and Depression Scale, impact of fibromyalgia on daily life using the Fibromyalgia Impact Questionnaire, heart rate and sleep quality (visual analog scale) were assessed at baseline and each year for 5 years., Results: Forty-nine patients dropped out in the first year. Depending on their training status, the remaining 89 patients were retrospectively assigned to one of the three groups: Active (moderate-intensity continuous training), Semi-Active (one or two sessions, low-intensity continuous training <60% HRmax) and Passive (non-completion of training), based on their ability to comply with the program. Alleviation of all symptoms ( p < 0.0001) was observed in the Active group. Increasing exercise intensity enhanced the effects obtained with moderate-intensity continuous training. Significant change in the Fibromyalgia Impact Questionnaire ( p < 0.0001) and depression (Hospital Anxiety and Depression Scale; p < 0.0001), and no significant decrease in pain were noted in the Semi-Active group. No effect of the training was observed in the Passive group., Conclusion: The study intervention associated with multidisciplinary care alleviated pain, anxiety and depression, and improved both quality of life and quality of sleep, in fibromyalgia patients., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2020.)
Published: 2020
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45. [ANCA-vasculitis with renal impairment treated by intravenous versus oral cyclophosphamide: Multicentric analysis of relapse free survival (VaReCyS)].

Author: Gouin JB, Dhalluin T, Perrichot R, Vigneau C, and Michel A
Subjects: Administration, Intravenous, Administration, Oral, Aged, Disease-Free Survival, Female, Humans, Male, Middle Aged, Retrospective Studies, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis complications, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis drug therapy, Cyclophosphamide administration & dosage, Immunosuppressive Agents administration & dosage, Kidney Diseases complications
Abstract: Introduction: ANCA-vasculitis are associated with high morbidity and mortality. Large use of cyclophosphamide as induction immunosuppressive therapy is limited by its side effects. All recent literature trends in decreasing cumulative dose while optimizing maintenance therapy., Methods: This retrospective multicentric analysis included ANCA-vasculitis patients with renal impairment and de novo diagnose followed in Rennes and Vannes hospitals for 2 years minimum. The primary endpoint was to analyze relapse free survival comparing oral and intravenous administration of cyclophosphamide., Results: From 01/01/2003 to 01/03/2016, 91 patients were included (45 oral and 46 intravenous group). Patients in oral group were 10 years younger (P<0,001), with higher maintenance therapy (P<0,001) and steroids (P<0,001) duration. With a Cox model adjusted on age, steroid and maintenance therapy duration, oral cyclophosphamide showed no benefice in decreasing relapse free survival (OR 0,80; 95%IC 0,38-1,66; P=0,55). No difference was observed on either mortality or renal survival. Oral group at 1-year trends to achieve more leucopenia (40 vs 24%) and infection (30 vs 22%) episodes, but less hospitalization (40 vs 65%), without reaching statistical significance., Conclusion: In this retrospective multicentric analysis, oral cyclophosphamide induction was not associated with better relapse free survival after adjustment with age, steroid and maintenance therapy duration. Maintenance therapy duration is believed to better prevent ANCA-vasculitis relapse., (Copyright © 2020 Société francophone de néphrologie, dialyse et transplantation. Published by Elsevier Masson SAS. All rights reserved.)
Published: 2020
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46. Ultrasensitive Doppler as a tool for the diagnosis of testicular ischemia during the Valsalva maneuver: a new way to explore varicoceles?

Author: Rocher L, Gennisson JL, Baranger J, Rachas A, Criton A, Izard V, Bertolloto M, Bellin MF, and Correas JM
Subjects: Adult, Humans, Male, Prospective Studies, Reproducibility of Results, Varicocele pathology, Testis diagnostic imaging, Testis pathology, Ultrasonography, Doppler methods, Valsalva Maneuver, Varicocele diagnostic imaging
Published: 2019
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47. Biomarker cruises in sepsis: who is the CAPTAIN? Discussion on "Circulating biomarkers may be unable to detect infection at the early phase of sepsis in ICU patients: the CAPTAIN prospective multicenter cohort study".

Author: Briassoulis G, Briassoulis P, Miliaraki M, Ilia S, Parlato M, Philippart F, Rouquette A, Moucadel V, Cavaillon JM, and Misset B
Subjects: Biomarkers, Cohort Studies, Humans, Intensive Care Units, Prospective Studies, Sepsis
Published: 2019
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48. Developmental patterns of fetal fat and corresponding signal on T1-weighted magnetic resonance imaging.

Author: Blondiaux E, Chougar L, Gelot A, Valence S, Audureau E, Ducou le Pointe H, Jouannic JM, Dhombres F, and Garel C
Subjects: Birth Weight, Female, Gestational Age, Humans, Infant, Newborn, Pregnancy, Pregnancy Trimester, Second, Pregnancy Trimester, Third, Retrospective Studies, Fetus diagnostic imaging, Magnetic Resonance Imaging methods, Subcutaneous Fat diagnostic imaging
Abstract: Background: Evaluation of subcutaneous fetal fat layer thickness on T1-weighted sequences can be used to predict birth weight. Little is known about normal MR signal patterns of subcutaneous tissue throughout pregnancy., Objective: To establish developmental patterns of subcutaneous fetal fat signal on T1-weighted sequences during the 2nd and 3rd trimesters., Materials and Methods: We retrospectively examined T1-weighted images of 110 fetal MRI scans. We measured signal intensity of subcutaneous fat on thighs, buttocks, trunk, nuchal region, chin and scalp. We then calculated the ratios of the obtained values with fetal muscle, amnios and maternal fat signal, and compared the results with those of immunohistochemical examination of adipose tissue extracted from the abdominal wall of fetuses as part of standard autopsy protocol., Results: We included 60 MRI scans in fetuses without intra-uterine growth restriction or macrosomia of non-diabetic mothers (range 23-37 weeks of gestation). Fat T1 intensity of all anatomical regions was low in all fetuses before 26 weeks of gestation. It became more hyperintense with increasing gestational age, in the following order: chin and nuchal region, then buttocks, thighs and trunk, and eventually the scalp at 33 weeks of gestation. After 33 weeks of gestation, all fetal subcutaneous tissues demonstrated overall hyperintense signal. This progression followed the conversion at immunohistochemistry of fetal adipose tissue composition from predominant brown to white adipose cells in 19 fetuses (19-41 weeks of gestation)., Conclusion: Between 26 weeks and 33 weeks of gestation, subcutaneous fetal fat signal changed in an orderly pattern from chin to buttocks and scalp. This may reflect the conversion from predominant brown to white adipose tissues in subcutaneous fetal fat.
Published: 2018
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49. An update systematic review of fetal death, congenital anomalies, and fertility disorders among health care workers.

Author: Warembourg C, Cordier S, and Garlantézec R
Subjects: Adult, Congenital Abnormalities etiology, Female, Fetal Death etiology, Humans, Infant, Newborn, Infertility epidemiology, Infertility etiology, Male, Occupational Diseases etiology, Pregnancy, Pregnancy Complications etiology, Pregnancy Outcome, Prenatal Exposure Delayed Effects epidemiology, Prenatal Exposure Delayed Effects etiology, Congenital Abnormalities epidemiology, Health Personnel statistics & numerical data, Occupational Diseases epidemiology, Occupational Exposure adverse effects, Pregnancy Complications epidemiology
Abstract: Background: Health care workers (HCWs) are occupationally exposed to various hazards, some associated with adverse pregnancy outcomes in previous reviews. This systematic review aims at synthesizing the recent literature on occupational exposures among HCWs related to fetal death, congenital anomalies, and fertility disorders., Methods: We searched the Medline database from 2000 to 2015 for articles about all potential occupational exposures of women and men working in this sector., Results: We retained 32 studies, most of them (n = 30) among women HCWs. Studies based on job title reported excess risks of some congenital anomalies (especially nervous and musculoskeletal systems) among HCWs compared to non-HCWs but no evidence about fetal death. Excess risks associated with specific exposures includes reports of some congenital anomalies for women exposed to anesthetic gases. Exposure to some sterilizing agents and, with less evidence, to antineoplastic drugs and to ionizing radiation, is associated with increased risks of miscarriage but not stillbirth. Strenuous work schedules appear to be associated with fertility disorders, but the evidence is limited. Only a few studies have been published since 2000 about non-ionizing radiation, or about fertility disorders related to chemical or physical agents, or about male HCWs., Conclusions: Despite the establishment of recommendations to limit exposures of HCWs, some excess risks of adverse pregnancy outcomes are still reported and need to be explained., (© 2017 Wiley Periodicals, Inc.)
Published: 2017
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50. [Febrile exanthema in French Guyana].

Author: Morin F, de Laval F, and Morand JJ
Subjects: Adolescent, Adult, Diagnosis, Differential, Exanthema pathology, Exanthema virology, Face pathology, Female, Fever ethnology, Fever virology, French Guiana ethnology, Humans, Remission, Spontaneous, Time Factors, Torso pathology, Exanthema ethnology
Published: 2017
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