Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Infective endocarditis is defined by a focus of infection within the heart and is a feared disease across the field of cardiology. It is frequently acquired in the health care setting, and more than one-half of cases now occur in patients without known heart disease. Despite optimal care, mortality approaches 30% at 1 year. The challenges posed by infective endocarditis are significant. It is heterogeneous in etiology, clinical manifestations, and course. Staphylococcus aureus, which has become the predominant causative organism in the developed world, leads to an aggressive form of the disease, often in vulnerable or elderly patient populations. There is a lack of research infrastructure and funding, with few randomized controlled trials to guide practice. Longstanding controversies such as the timing of surgery or the role of antibiotic prophylaxis have not been resolved. The present article reviews the challenges posed by infective endocarditis and outlines current and future strategies to limit its impact. (C) 2017 by the American College of Cardiology Foundation.
ISSN: 0735-1097

hal-01489511
https://hal.archives-ouvertes.fr/hal-01489511
DOI : 10.1016/j.jacc.2016.10.066

Éditeur(s) : HAL CCSD Publisher : Baltimore : Williams & Wilkins, c1950-. Latest Publisher : Bethesda, MD : American Association of Immunologists
Résumé : International audience
Schistosome infection is a major public health concern affecting millions of people living in tropical regions of Africa, Asia, and South America. Schistosomes cause mild clinical symptoms in most subjects, whereas a small proportion of individuals presents severe clinical disease (as periportal fibrosis (PPF)) that may lead to death. Severe PPF results from an abnormal deposition of extracellular matrix proteins in the periportal spaces due to a chronic inflammation triggered by eggs and schistosome Ags. Extracellular matrix protein production is regulated by a number of cytokines, including IFN-gamma. We have now screened putative polymorphic sites within this gene in a population living in an endemic area for Schistosoma mansoni. Two polymorphisms located in the third intron of the IFN-gamma gene are associated with PPF. The IFN-gamma +2109 A/G polymorphism is associated with a higher risk for developing PPF, whereas the IFN-gamma +3810 G/A polymorphism is associated with less PPF. The polymorphisms result in changes in nuclear protein interactions with the intronic regions of the gene, suggesting that they may modify IFN-gamma mRNA expression. These results are consistent with the results of previous studies. Indeed, PPF is controlled by a major locus located on chromosome 6q22-q23, closely linked to the gene encoding the alpha-chain of the IFN-gamma receptor, and low IFN-gamma producers have been shown to have an increased risk of severe PPF. Together, these observations support the view that IFN-gamma expression and subsequent signal transduction play a critical role in the control of PPF in human hepatic schistosome infection (S. mansoni).
ISSN: 0022-1767

Droits : http://creativecommons.org/licenses/by-nc-nd/
hal-01211760
https://hal.archives-ouvertes.fr/hal-01211760
https://hal.archives-ouvertes.fr/hal-01211760/document
https://hal.archives-ouvertes.fr/hal-01211760/file/J%20Immunol-2003-Chevillard-5596-601.pdf
DOI : 10.4049/jimmunol.171.10.5596

Éditeur(s) : HAL CCSD Oxford University Press (OUP)
Résumé : International audience
Persistent organic pollutants have not been conclusively associated with length of gestation or with preterm birth. Chlordecone is an organochlorine pesticide that has been extensively used to control the banana root borer population in the French West Indies. Data from the Timoun Mother-Child Cohort Study conducted in Guadeloupe between 2004 and 2007 were used to examine the associations of chlordecone concentrations in maternal plasma with the length of gestation and the rate preterm birth in 818 pregnant women. Data were analyzed using multivariate linear regression for length of gestation and a Cox model for preterm birth. The median plasma chlordecone concentration was 0.39 µg/L (interquartile range, 0.18-0.83). No correlation was observed with plasma concentrations of p,p'-dichlorodiphenyl dichloroethene (ρ = 0.017) or polychlorinated biphenyl 153 (ρ = -0.016), the other main organochlorine compounds detected. A 1-log10 increase in chlordecone concentration was associated with a decreased length of gestation (-0.27 weeks; 95% confidence interval: -0.50, -0.03) and an increased risk of preterm birth (60%; 95% confidence interval: 10, 130). These associations may result from the estrogen-like and progestin-like properties of chlordecone. These results are of public health relevance because of the prolonged persistence of chlordecone in the environment and the high background rate of preterm births in this population.
ISSN: 0002-9262

hal-01010740
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01010740
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01010740/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01010740/file/Chlordecone%20Exposure%20final.pdf
DOI : 10.1093/aje/kwt313

Résumé : Cette étude a pour missions essentielles de comprendre et d’expliquer comment le passage d’une langue à une autre voire le mélange des deux codes langagiers qui se côtoient au sein de la population de la Guadeloupe, département français d’outre-mer, le français et le créole, peuvent, dans le cadre des échanges médicaux éducatifs, influencer la compréhension des mécanismes de la maladie par le patient, son acceptation et sa gestion.La justification de cette étude tient du constat que la prévalence de cette maladie chronique en Guadeloupe, l’asthme bronchique, est relativement importante, que la prise en charge reste perfectible malgré les recommandations de bonnes pratiques édictées par les sociétés savantes, et que certains patients ont du mal à comprendre les termes utilisés en français par leur médecin lors de l’annonce du diagnostic, ainsi que par les éducateurs chargés de leur apporter les outils de bonne gestion de cette maladie, ce qui n’est pas sans incidents en termes de morbidité et de mortalité.L’auteur décompose sa recherche autour de cinq grands thèmes :- La description du territoire d’étude, sur le plan géographico-climatique, historico-économique, sanitaire et social, la naissance d’une ère culturelle nouvelle générant une langue partagée par plus de 95% de la population et transmise au sein des familles et dans la communauté.- La présentation de l’éducation thérapeutique, démarche considérée par la communauté scientifique comme essentielle pour améliorer la prise en charge du patient et l’autogestion de la maladie, les plans gouvernementaux successifs traitant de cette matière.- L’état des connaissances sur l’asthme bronchique en France, dans le monde et en Guadeloupe plus particulièrement.- L’impact de la langue créole dans le processus de compréhension de la maladie à travers la relation soignant-soigné, et ses conséquences chez les natifs bilingues en termes d’acquisitions des outils d’autogestion en comparaison à l’utilisation du français.- La formulation de propositions de contextualisation didactique, tant en termes de formation des professionnels de santé par la préconisation de l’utilisation de la langue créole, par l’adaptation des outils psychopédagogiques au contexte local, que d’encouragement du patient à utiliser sa langue maternelle dans l’expression de ses ressentis.La recherche montre que la langue créole, utilisée autant au cours de la consultation par le médecin traitant et par le malade que pendant les séances d’éducation thérapeutique par les éducateurs et le public, influence les indicateurs de gestion de cette maladie.En conclusion, l’auteur défend l’hypothèse selon laquelle l’utilisation de la langue créole dans les échanges médicaux éducatifs chez les adolescents asthmatiques bilingues français-créole favoriserait la compréhension des mécanismes de la maladie asthmatique, la prise de conscience de sa gravité et la nécessité de se soigner pour éviter les complications, corollaire d’une bonne qualité de vie.
In Guadeloupe, a French Overseas Territory, the population uses French and Creole linguistic codes. The main goals of this thesis are to understand and to explain how a better use of French and Creole, within the framework of educational medical exchanges, can improve the understanding of the mechanisms of the disease by the patient, its acceptance and its management.The bronchial asthma is a chronic disease, which affects an important part of the Guadeloupian population. In spite of the recommendations promulgated by the medical scholars, the care of the patients can be improved in Guadeloupe. Certain patients have difficulty understanding the terms used in French by their doctor during the announcement of the diagnosis, as well as by the educators in charge of bringing them the tools of good management of this disease what is not without incidents in terms of morbidity and mortality.The author elaborates his research around five main themes:- The thorough description of the space studied in this thesis; the geography of the land, the history of the population, the impact of the economic; the presentation of the social and health care infrastructures; and furthermore the birth of a new cultural era generating a language shared by more than 95 % of the population and passed on within families and communities.- The presentation of the therapeutic education, the approach considered by the scientific community as essential to improve the management of the patient and the self-management of the disease, the successive governmental plans dealing with this subject.- The state of the knowledge on the bronchial asthma in France, in the world and in Guadeloupe more particularly.- The impact of the Creole language in the process of understanding of the disease within the healthcare relationships and its consequences at the bilingual natives in terms of acquisitions of the tools of self-management in comparison to the use of French.- The formulation of proposals of didactic contextualization regarding the training of the healthcare professionals; the recommendation to the healthcare workers to use the Creole language; the adaptation of the psycho-pedagogical tools to the local context; the encouragement to the patients to use their native language in the expression of their feelings.- Researches show that the Creole language used during the consultation by the regular doctor, but also during the educational sessions therapeutics by the educators influence the indicators of management of this disease. In conclusion, the author defends the hypothesis according to which, the use of the Creole language in the educational medical exchanges at the bilingual asthmatic teenagers French-Creole would favor the understanding of the mechanisms of the asthmatic disease, the awareness of its gravity and the necessity of looking after oneself to avoid the complications, corollary of a good quality of life.

http://www.theses.fr/2015AGUY0827/document

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Ciguatera Fish Poisoning (CFP) is a non-bacterial seafood poisoning well characterized in the remote archipelagos of French Polynesia, yet poorly documented in the Society archipelago, most notably on Moorea, the second most populated island in French Polynesia, which counts a high proportion of fishermen fishing on a regular basis. To address this knowledge gap, a holistic study of the ciguatera issue was conducted on Moorea. First, ciguatera risk was analysed in terms of incidence rate, fish species most commonly involved and risk stratification in Moorea lagoon based on 2007–2013 epidemiological data. A mean incidence rate of 8 cases per 10,000 inhabitants for the study period and an average under-reporting rate of 54% were found. Taking into account hospitalization and medication fees, and loss of productive days, the health-related costs due to CFP were estimated to be USD $1613 and $749 for each reported and unreported case, respectively, with an overall cost of USD $241,847 for the study period. Comparison of the present status of CFP on Moorea with a risk map established in the late 1970’s showed that the spatial distribution of the risk has stayed relatively stable in time, with the north shore of the island remaining the most prone to ciguatera. Evaluation of the current knowledge on CFP among different populations groups, i.e. fishermen, residents and visitors, was also conducted through direct and indirect interviews. About half of the fishermen interviewed were actually able to identify risky fishing areas. While, overall, the CFP risk perception in the fishing community of Moorea seemed accurate, although not scientifically complete, it was sufficient for the safe practice of their fishing activities. This may be due in part to adaptive responses adopted by 36% of the fishermen interviewed, such as the avoidance of either high-risk fishing sites or toxic species. At the residents and visitors’ level, the study points out a striking lack of awareness of the CFP issue among visitors, as compared to local residents. Indeed, less than 25% of Moorea visitors vs. an average of 98% in residents were aware of CFP or of its presence on the island. Interestingly, evaluation of the fish consumption preferences showed that 70% of visitors do not consume lagoon fish during their stay, not for fear of CFP, but mainly due to the lack of availability of these species in recreational facilities or because they have nutritional preference for pelagic fish. This lack of awareness, along with the report by several CFP patients of the consumption of fish species yet banned for sale, stress the need for improved communication efforts on this critical issue among both residents and visitors on Moorea. The implementation of a public outreach strategy is proposed, based on both existing information networks and low-cost communication actions through information displays at various strategic locations, e.g. Tahiti-Faa’a international airport, the ferry boat station, recreational facilities, as well as the major trading points on Moorea Island.
ISSN: 1568-9883

hal-01391648
https://hal-univ-perp.archives-ouvertes.fr/hal-01391648
DOI : 10.1016/j.hal.2016.10.003

Éditeur(s) : HAL CCSD Springer Verlag (Germany)
Résumé : International audience
Today, there is increasing concern regarding the capacity ofScleractinian corals to sustain the growing number of insultsassociated with global and local changes (e.g. global warming,ocean acidification, pollution). If corals are to exist, there is anurgent need to use indicators of coral health that provide insightinto early sub lethal shifts in corals before the irreversibleeffects of exposure manifest at the population and communitylevels. This paper will provide an overview of the most relevantand appropriate indicators of coral health currently usedin traditional monitoring programs (traditional approach) orthose that could be used in a near future to improve assessmentof coral health (new and proactive approach). In addition, byusing French Polynesia coral reefs as a study case, this paperwill present how coral health was assessed in the past and howit will be in a near future.
ISSN: 0948-4280

hal-01342777
https://hal-univ-perp.archives-ouvertes.fr/hal-01342777
DOI : 10.6119/JMST-013-0813-2

Éditeur(s) : HAL CCSD
Résumé : International audience
Direct examinations of blood and serologic tests were used to assess the intensity of the filarial endemicity in Gabon. Both methods revealed that the prevalence of filariasis with microfilaremia (Loa loa and Dipetalonema perstans) is presently very elevated. The areas that are more involved are the forest regions as well as the highest ones (ogoue, Lolo, Ngounie). Women appeared to be suffering from loasis to a lesser extent than men. On the other hand, the prevalence was identical for Dipetalonema perstans. For the gabonese population one can approximately say that 3 out of 5 adults patients have filariasis, two being D. perstans and one L. loa. Consequently these affections represent a major public health problem. Finally one must note that no case of lymphatic filariasis has been identified.
Bull Soc Pathol Exot Filiales

hal-00717069
https://hal.univ-antilles.fr/hal-00717069
PUBMED : 6936082

Éditeur(s) : HAL CCSD
Résumé : International audience
The aim of this study is to perform a simulation of large scale Wireless Sensor Networks (WSN) working on medical diagnosis. The main feature of this WSN is its density and the fact that all sensors are in the same radio range. Our approach helps medical staff to diagnose diseases in an automatic way. In this context, each patient is equipped to a set of sensors. Each sensor is connected to a transducer dedicated to measure a specific health parameter . This WSN will perform some computations and run an alarm when some diseases are suspected. This technique is based on the population protocol to handle data exchanged between sensors. This approach is in fact an efficient distributed algorithm which implies that the diagnose may be done by any sensor dealing with the disease detection. The main result of this paper is: the method supports large scalability which proves its practicability for real cases.
Computers and Communications (ISCC), 2010 IEEE Symposium on Computers and Communications.
Riccione, Italy

hal-00519595
https://hal.archives-ouvertes.fr/hal-00519595

Éditeur(s) : HAL CCSD Cambridge University Press (CUP)
Résumé : International audience
Cervical cancer is the second most frequent cancer in women in French Guiana. Studies have shown that populations living in the remote areas of the interior have early sexual debut and that multiple sexual partnerships are common. The objective of the present study was thus to determine the prevalence of human papillomavirus (HPV) infection in these areas. A study was conducted in women aged 20-65 years with previous sexual activity. Women were included on a voluntary basis after using local media and leaders to inform them of the visit of the team. HPV infection was defined by the detection of HPV DNA using the Greiner Bio-One kit. In addition to HPV testing cytology was performed. The overall age-standardized prevalence rate was 35%. There was a U-shaped evolution of HPV prevalence by age with women aged >50 years at highest risk for HPV, followed by the 20-29 years group. Twenty-seven percent of women with a positive HPV test had normal cytology. Given the high incidence of cervical cancer in French Guiana and the high prevalence of HPV infections the present results re-emphasize the need for screening for cervical cancer in these remote areas. Vaccination against HPV, preferably with a nonavalent vaccine, also seems an important prevention measure. However, in this region where a large portion of the population has no health insurance, this still represents a challenge.
ISSN: 0950-2688

inserm-01476015
http://www.hal.inserm.fr/inserm-01476015
http://www.hal.inserm.fr/inserm-01476015/document
http://www.hal.inserm.fr/inserm-01476015/file/High%20prevalence%20HPV%20infection%20in%20women%20living%20in%20the%20remote%20territories%20of%20French%20Guiana%20STD.pdf
http://www.hal.inserm.fr/inserm-01476015/file/Table%203.pdf

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Herbicides are generally the most extensively used of the pesticides applied to agricultural crops. However, the literature contains little evidence useful in assessing the potential sources of the general population's exposure to herbicides, including by residential proximity to crops. The objective of this study was to take advantage of data from the PELAGIE mother-child cohort to identify the main determinants of the body burden of exposure to the chloroacetanilide and triazine herbicides commonly used on corn crops in Brittany, France, before 2006. Urine samples from a randomly selected subcohort of women in the first trimester of pregnancy (n=579) were assayed for herbicide metabolites. The residential exposure resulting from proximity to corn crops was assessed with satellite-image-based scores combined with meteorological data. Data on diet, drinking tap water (from the public water supply), occupations, and household herbicide use were collected by questionnaires. Herbicides were quantified in 5.3% to 39.7% of urine samples. Alachlor and acetochlor were found most frequently in the urine of women living in rural areas. The presence of dealkylated triazine metabolites in urine samples was positively associated with residential proximity to corn crops (OR=1.38, 95% CI: 1.05-1.80). Urinary metabolites of both atrazine and dealkylated triazine were correlated with tap water consumption (OR=2.94, 1.09-7.90, and OR=1.82, 1.10-3.03, respectively); hydroxylated triazine metabolites were correlated with fish intake (OR=1.48, 1.09-1.99). This study reinforces previous results that suggest that environmental contamination resulting from agricultural activities may contribute to the general population's exposure to herbicides.
Environment International

hal-00966842
https://hal.archives-ouvertes.fr/hal-00966842
https://hal.archives-ouvertes.fr/hal-00966842/document
DOI : 10.1016/j.envint.2013.10.010
PUBMED : 24246238

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
OBJECTIVES:Blood rheology plays a key role in the pathophysiology of sickle cell anaemia (SS) and sickle cell haemoglobin C disease (SC), but its evolution over the lifespan is unknown.MATERIALS AND METHODS:Blood viscosity, red blood cell (RBC) deformability and aggregation, foetal haemoglobin (HbF) and haematocrit were measured in 114 healthy individuals (AA), 267 SS (161 children + 106 adults) and 138 SC (74 children + 64 adults) patients.RESULTS:Our results showed that 1) RBC deformability is at its maximal value during the early years of life in SS and SC populations, mainly because HbF level is also at its peak, 2) during childhood and adulthood, hydroxycarbamide treatment, HbF level and gender modulated RBC deformability in SS patients, independently of age, 3) blood viscosity is higher in older SS and SC patients compared to younger ones and 4) haematocrit decreases as SS patients age.CONCLUSION:The hemorheological changes detected in older patients could play a role in the progressive development of several chronic disorders in sickle cell disease, whose prevalence increases with age. Retarding these age-related haemorheological impairments, by using suitable drugs, may minimize the risks of vaso-occlusive events and chronic disorders.
ISSN: 1932-6203

Droits : http://creativecommons.org/licenses/by/
hal-01669747
https://hal.univ-antilles.fr/hal-01669747
DOI : 10.1371/journal.pone.0158182
PUBMED : 27355589
PUBMEDCENTRAL : PMC4927160

Éditeur(s) : HAL CCSD Intech
Résumé : International audience
The socio-economic status (SES) of populations has an influence on the incidence or mortality rates of numerous health outcomes, among which respiratory diseases (Prescott et al., 2003; Ellison-Loschmann et al., 2007). Considering asthma, the possible contribution of SES to overall prevalence –regardless of asthma severity-, remains controversial in industrialized countries. Several studies indicate that allergic asthma is more prevalent in more well-off populations whereas the non-allergic forms of asthma are more common in the deprived ones (Cesaroni et al., 2003; Blanc et al., 2006). On the other hand, severe asthma whatever its etiology appears to be more frequent in the latter populations, as compared to the more affluent (Basagana et al., 2004). Risk factors for exacerbations (e.g., passive smoking (Wright Subramanian, 2007), psychosocial stress (Gold & Wright, 2005), cockroach allergens (Kitch et al., 2000), and suboptimal compliance with anti-inflammatory medication (Gottlieb et al., 1995)) are generally more common among people with asthma and low SES than their better-off counterparts. These observations support the hypothesis that some factors more present in deprived populations contribute to asthma exacerbation (Mielck et al., 1996).
Air Pollution

Droits : http://creativecommons.org/licenses/by-nc-nd/
ISBN : 978-953-307-143-5
hal-01118620
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01118620
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01118620/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01118620/file/Ambient%20aire-%20chapter.pdf

Éditeur(s) : Elsevier
Résumé : Shrimp farming is a small but growing industry in New Caledonia. Since 1993, "Syndrome 93" has been affecting New Caledonian shrimp farming industry every cold season, causing severe epizootic mortalities in grow-out ponds and significant losses. Highly pathogenic strains of Vibrio penaeicida are considered the etiological agent of the disease in Litopenaeus stylirostris. On one hand, studies demonstrated that healthy shrimp may carry V penaeicida for weeks with a high overall prevalence, regardless of any seasonal pattern or temperature conditions. On the other hand, larvae are free of V penaeicida and are also resistant to experimental infection. V penaeicida is frequently detected in incoming water pumped from the bays, which was shown, by a molecular typing study, to be the infectious source. This particular epidemiological pattern highlights the major role of the factors that trigger and aggravate the disease in grow-out ponds, where shrimp populations carry the pathogen all year round. In order to gain a better understanding of "Syndrome 93" epidemiology, quantification of V penaeicida both in shrimp and the shrimp farm ecosystem is necessary. This article describes the steps in the successful development of a real-time PCR quantification assay of V penaeicida in shrimp haemolymph, seawater (from ponds or bays) and sediment pore water, including the choice of an accurate extraction technique. The entire detection method; including sample processing, DNA extraction and real-time PCR amplification, can be completed within 4 h. (c) 2006 Elsevier B.V All rights reserved.
Journal of Microbiological Methods (0167-7012) (Elsevier), 2006-10 , Vol. 67 , N. 1 , P. 27-35

Droits : 2006 Elsevier
http://archimer.ifremer.fr/doc/2006/publication-1903.pdf
DOI:10.1016/j.mimet.2006.02.013
http://archimer.ifremer.fr/doc/00000/1903/

Éditeur(s) : HAL CCSD Wiley
Résumé : International audience
Background Although the French eating model may differ from those of other countries, no studies to date have investigated dietary patterns in a wide age range of adults and at the national level. We aimed to identify dietary patterns (DP) of French adults and assess their associations with demographic, socio-economic and behavioural factors. Methods The present study included 2624 adults (1087 men, 1537 women) aged 18–79 years from the cross-sectional national French INCA2 dietary survey. Dietary data were collected using a 7-day estimated food record. Clusters of DP were derived using principal component analysis and clustering, conjointly. Age-adjusted logistic regression analyses were used to investigate the association between DP and correlates. Results Five DP were identified, namely ‘traditional’, ‘prudent’, ‘diversified’, ‘processed’ and ‘sandwiches’. Men were more likely to follow a traditional diet and women the ‘prudent’ pattern. Members of the ‘processed’ and ‘sandwiches’ patterns were younger compared to non-members. Healthier dietary patterns were overall positively associated with a higher socio-economic position, healthier behaviours (in terms of sedentary behaviours and smoking status) and lower body mass index. Under-reporting of energy intake, restrictive diet to lose weight and dietary supplement consumption were also related to specific DP, although differentially in men and women. Associations with contextual factors (i.e. household composition, agglomeration size and region) were also observed. Conclusions The identification of adults’ dietary patterns and associated behaviours (all modifiable) is important for the conceptualisation of multi-behavioural programs. The additional information on social and environmental correlates is also essential for targeting the most vulnerable population groups in the context of such public health interventions
ISSN: 0952-3871

hal-01299975
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01299975
DOI : 10.1111/jhn.12315
PUBMED : 25233099

Éditeur(s) : HAL CCSD IOS Press
Résumé : International audience
Patients with hemoglobin C disease (CC) usually do not develop severe complications in comparison with individuals with sickle cell anemia (SS) or with sickle cell hemoglobin C disease (SC). The present study compared the hematological, biochemical, hemorheological and clinical characteristics of CC patients to those of SS, SC and healthy individuals (AA). Blood viscosity was measured at 225 s(-1) with a cone plate viscometer. The hematocrit-to-blood viscosity ratio (HVR), i.e. an index of red blood cell (RBC) oxygen transport effectiveness, was calculated. RBC deformability was determined at 30 Pa by ektacytometry, and RBC aggregation properties by syllectometry. CC and SC had higher blood viscosity and lower HVR than AA. Nevertheless, HVR was higher in CC compared to SS and tended to be higher than in SC. The CC group exhibited very rigid hyperchromic RBC compared to the three other groups. RBC aggregation abnormalities were observed in CC: low RBC aggregation index and high RBC aggregates strength. Despite these hemorheological abnormalities, CC never had hospitalized painful vaso-occlusive crisis or acute chest syndrome. In contrast, all of them had splenomegaly. Of note, 2 out of 7 CC developed retinopathy or otologic disorders. Whether the blood hyperviscosity and decreased RBC deformability are responsible for these complications is unknown. The higher oxygen transport effectiveness (i.e., HVR) of CC compared to SS is probably at the origin of the very low risk of medical complication in this population.
ISSN: 1386-0291

hal-01668336
https://hal.univ-antilles.fr/hal-01668336
DOI : 10.3233/CH-141906

Éditeur(s) : HAL CCSD
Résumé : International audience
OBJECTIVES: To detect new hazards ("signals"), occupational health monitoring systems mostly rest on the description of exposures in the jobs held and on reports by medical doctors; these are subject to declarative bias. Our study aims to assess whether job-exposure matrices (JEMs) could be useful tools for signal detection by improving exposure reporting. METHODS: Using the French national occupational disease surveillance and prevention network (RNV3P) data from 2001 to 2011, we explored the associations between disease and exposure prevalence for 3 well-known pathology/exposure couples and for one debatable couple. We compared the associations measured when using physicians' reports or applying the JEMs, respectively, for these selected diseases and across non-selected RNV3P population or for cases with musculoskeletal disorders, used as two reference groups; the ratio of exposure prevalences according to the two sources of information were computed for each disease category. RESULTS: Our population contained 58,188 subjects referred with pathologies related to work. Mean age at diagnosis was 45.8 years (95% CI 45.7; 45.9), and 57.2% were men. For experts, exposure ratios increase with knowledge on exposure causality. As expected, JEMs retrieved more exposed cases than experts (exposure ratios between 12 and 194), except for the couple silica/silicosis, but not for the MSD control group (ratio between 0.2 and 0.8). CONCLUSIONS: JEMs enhanced the number of exposures possibly linked with some conditions, compared to experts' assessment, relative to the whole database or to a reference group; they are less likely to suffer from declarative bias than reports by occupational health professionals.
International Archives of Occupational and Environmental Health

hal-01560279
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01560279
DOI : 10.1007/s00420-017-1215-1
PUBMED : 28299449

Éditeur(s) : EDP Sciences
Résumé : The diversity of reef ecosystems, the multiplicity of reef resource uses and the breadth of the range of the island socio-cultural contexts concerned make coral reef fisheries (CRF) management in the South Pacific a complex task. The health and state of the targeted resources depend both on ecosystem characteristics (as determined by ecological and biological factors) and on fishing pressure, whose effects are only partly known. Increasing harvests from commercial and recreational fishing increasingly overlap with traditional Subsistence activity, creating an important CRF management challenge. This paper presents a new approach to CRF assessment and monitoring by providing a set of multidisciplinary indicators. The fisheries system is assessed from three different viewpoints: ecology of targeted populations, exploitation and the broader socio-econornic fishery context. The use of complementary indicators chosen from each of these fields could balance the chronic lack of human and financial resources for the management of these fisheries. We suggest the use of these indicators through an assessment grid or an indicator dashboard specifically adapted to given situations and management objectives determined through a participatory approach. The operational efficiency of this dashboard depends on i) dialogue between users, ii) the objectivity of the proposed monitoring, iii) the Visual transcription of divergent/convergent interests amongst stakeholders, and iv) stakeholder involvement in the decision-making process. The use and constraints of such a tool are described with reference to Ouvea atoll (New-Caledonia, South Pacific) for which an analysis of available indicators for assessing fisheries status is presented.
La diversité des écosystèmes coralliens, la multiplicité des modalités d'exploitation de leurs ressources et l'hétérogénéité des contextes socio-culturels insulaires rendent complexe la gestion des pêcheries récifo-lagonaires du Pacifique sud. La santé et l'évolution de ces ressources dépendent, d'une part, des caractéristiques propres de l'écosystème (obéissant à des facteurs biologiques et écologiques) et, d'autre part, de la pression de pêche dont certains effets seulement sont établis. La pêche traditionnelle aux fins de subsistance est aujourd'hui concurrencée par des activités à visées commerciales et récréatives, qui accroissent les prélèvements et soulèvent de nouveaux enjeux de gestion. L'article propose une approche pour l'évaluation et le suivi de ces pêcheries basée sur un ensemble d'indicateurs pluridisciplinaires. Le système « Pêche » est analysé de trois points de vue complémentaires : l'écologie des peuplements exploités, l'exploitation halieutique sensu stricto et le contexte économique et social plus large des pêcheries. La mise en place d'indicateurs issus de ces trois domaines vise à compenser le manque chronique de moyens financiers et humains pour la gestion des pêcheries coralliennes des îles du Pacifique sud. Nous suggérons que leur utilisation s'effectue au travers d'une grille d'évaluation ou tableau de bord répondant à des situations précises et des objectifs de gestion définis lors d'une approche participative. La portée opérationnelle de ce tableau de bord de gestion de la pêche repose sur i) la concertation engagée entre les usagers, ii) l'objectivité du suivi préconisé, iii) la transcription visuelle des intérêts convergents et/ou divergents des acteurs, et iv) leur implication dans le processus de décision. Les modalités et contraintes d'application de cet outil sont décrites sur l'exemple de l'atoll d'Ouvéa (Nouvelle-Calédonie, Pacifique Sud), pour lequel une analyse des indicateurs disponibles pour décrire l'état des pêcheries a été réalisée.
Aquatic Living Resources (0990-7440) (EDP Sciences), 2005-07 , Vol. 18 , N. 3 , P. 199-213

Droits : 2005 EDP Sciences, IFREMER, IRD
http://archimer.ifremer.fr/doc/2005/publication-716.pdf
DOI:10.1051/alr:2005026
http://archimer.ifremer.fr/doc/00000/716/

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Background: Despite intensive research over several decades, the etiology of multiple sclerosis (MS) remains poorly understood, although environmental factors are supposedly implicated. Our goal was to identify spatial clusters of MS incident cases at the small-area level to provide clues to local environmental risk factors that might cause or trigger the disease. Methods: A population-based and multi-stage study was performed in the French Brittany region to accurately ascertain the clinical onset of disease during the 2000-2004 period. The municipality of residence at the time of clinical onset was geocoded. To test for the presence of MS incidence clusters and to identify their approximate locations, we used a spatial scan statistic. We adjusted for socioeconomic deprivation, known to be strongly associated with increased MS incident rates, and scanned simultaneously for areas with either high or low rates. Sensitivity analyses (focusing on relapsing-remitting forms and/or places of residence available within the year following clinical onset) were performed. Results: A total of 848 incident cases of MS were registered in Brittany, corresponding to a crude annual incidence rate of 5.8 per 100,000 inhabitants. The spatial scan statistic did not find a significant cluster of MS incidence in either the primary analysis (p value >= 0.56) or in the sensitivity analyses (p value >= 0.16). Conclusion: The findings of this study indicate that MS incidence is not markedly affected across space, suggesting that in the years preceding the first clinical expression of the disease, no environmental trigger is operative at the small-area population level in the French Brittany region.
ISSN: 1476-072X

hal-01616063
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01616063
DOI : 10.1186/s12942-017-0108-6
PUBMED : 28934989

Éditeur(s) : HAL CCSD Presses université de Laval
Résumé : International audience
This article aims to specify the challenges related to adapting the Disability Creation Process (DCP) model to the experience of chronic disease, specifically Human immunodeficiency virus (HIV). In this perspective, a conceptual clarification is proposed because the DCP is mainly used to study populations in situations of disability due to motor, sensory, mental or behavioral disabilities. However, this model seems to be able to adequately read the specific experience of HIV, and help to understand differently life trajec-tories of people living with HIV (PLHIV). Indeed, HIV infection, despite its status as a "chronic disease", continues to contribute to the risk of social isolation. Body modifications induced by the disease or its treatment has an impact on how others view PLHIV. They expose the visibility of HIV status and, ultimately, the fear of social exclusion. In this respect, the analysis of the DCP may allow us to understand the varia-tions in the quality of social participation and identify the phases of vulnerability by focusing on body image in particular induced by the infection or treatments. This approach provides the opportunity for new insight into the influence of social environments (particularly health management or community support) with re-gards to the lifestyle and the daily experiences of socially disadvantaged people.
Cet article tente de spécifier les enjeux d’une adaptation du modèle du Processus de production du handicap (PPH) au vécu de la maladie chronique, et plus spécifiquement du virus de l’immunodéfi-cience humaine (VIH). Dans cette perspective, un éclaircissement conceptuel est proposé, car le PPH a principalement été utilisé pour étudier les populations vivant des situations de handicap liées à des incapa-cités motrices, sensorielles, intellectuelles ou comportementales. Ce modèle semble toutefois en mesure de renouveler la lecture de l’expérience spécifique du VIH, et d’aider à saisir autrement les trajectoires de vie des personnes vivant avec le VIH (PVVIH). En effet, l’infection au VIH, malgré son statut de « maladie chronique », demeure associée à un risque d’isolement social. Les modifications corporelles induites par la maladie ou par son traitement confronte les PVVIH au regard de l’autre. Elles exposent à la visibilité du statut sérologique et, in fine, à la peur de l’exclusion sociale. Dans ce cadre, l’analyse du Processus de production du handicap peut permettre de comprendre les variations de la qualité de la participation sociale et d’identifier les phases de vulnérabilité en s’intéressant notamment au rapport au corps induit par l’infection et les traitements. Cette approche offre l’opportunité d’un nouvel éclairage sur le poids des envi-ronnements sociaux (notamment des dispositifs de prises en charge sanitaire ou d’accompagnement communautaire) sur les habitudes de vie et l’expérience quotidienne d’un public fragilisé socialement.
ISSN: 1499-5549

hal-01681423
https://hal.archives-ouvertes.fr/hal-01681423

Résumé : La tuberculose, maladie très ancienne, est plus que jamais présentée sur la scène sanitaire mondiale avec 9 millions de nouveaux cas par an. Cette maladie, qui demeure une cause majeure de mortalité, est un des problèmes les plus difficiles à résoudre en santé publique et à échelle internationale. Les diverses programmes de lutte, lancés par l’Organisation Mondiale de la Santé (OMS), pour prévenir et garantir la guérison des patients tuberculeux, se heurtent à des difficultés qui hypothèquent leur efficacité. En effet, l'expansion du virus de rinimunodéficience humaine (VIII) et son influence néfaste sur la susceptibilité à la tuberculose, l'accroissement rapide de la tuberculose multirésistante, la pauvreté ainsi que la croissance démographique, sont un ensemble de facteurs préjudiciables à l'application des mesures préventives et curatives. Les contextes économiques difficiles conduisant indubitablement au cumul de ces facteurs, ont fait une césure entre les pays riches et les pays pauvres quant à l'incidence et la révolution de la tuberculose à échelle mondiale. Pour atténuer la disparité des résultats des luttes antituberculeuses, les méthodologies employées en épidémiologie de la tuberculose doivent s'inscrire dans une démarche d'efficacité. Les marqueurs moléculaires, indispensables à l'identification et à la classification des souches appartenant au complexe Mycobacterium tuberculosis (MTC) ont chacun des potentialités qui leur sont propres dont il convient de cerner pour une utilisation adéquate dans les études épidémiologiques et phylogénétiques. Le but de cette thèse consiste à extraire des connaissances nouvelles des résultats de génotypage stockées dans les bases de données, connaissances relatives au polymorphisme du support génomique pour estimer la contribution de chaque marqueur dans la classification de MTC. Le recours à différentes méthodes de reconstruction phylogénétique et de modélisation des données fut indispensable. A la lumière des résultats obtenus, cette thèse propose une nouvelle méthodologie de classification, pour rétablissement d'une phylogéographie robuste de MTC en relation avec l'histoire des migrations humaines qui aurait débutée en Afrique subsaharienne. Chaque méthode de génotypage ayant une efficience et un cout propres, qu'il convient de mesurer par rapport aux moyens disponibles et aux résultats escomptes, il est donc intéressant de renforcer la connaissance des marqueurs et de proposer différentes alternatives menant à la classification des mycobactéries. Ainsi, les résultats obtenus dans cette thèse apportent plus de cohérence aux solutions proposées pour la caractérisation des clones de MTC circulant dans le monde.
Tuberculosis, very old disease, is more than ever presented on the global health scene with 9 million new cases per year. This disease, which remains a major cause of mortality is one of the most intractable public health and international issues. The various control programs, launched by the World Health Organization (WHO) to prevent and guarantee the cure of tuberculosis patients face difficulties that undermine their effectiveness. Indeed, the expansion of human virus rinimunodéficience (VIII) and its negative influence on susceptibility to tuberculosis, the rapid growth of multidrug-resistant tuberculosis, poverty and population growth, are a set of factors detrimental to application of preventive and curative measures. The difficult economic circumstances undoubtedly leading to accumulation of these factors have a break between rich and poor countries about the impact and the revolution of tuberculosis worldwide. To address the disparity of the results of tuberculosis struggles, the methodologies used in epidemiology of tuberculosis must be part of a process efficiency. Molecular indispensable to the identification and classification of strains belonging to the Mycobacterium tuberculosis complex (MTC) markers each have their own potentials that need to be identified for proper use in epidemiological and phylogenetic studies. The purpose of this thesis is to extract new knowledge of the results of genotyping data stored in databases, knowledge of the polymorphism of genomic carrier to estimate the contribution of each marker in the classification of TCM. The use of different methods of phylogenetic reconstruction and modeling data was essential. In light of the results obtained, the thesis proposes a new classification methodology for a robust recovery phylogeography of TCM in connection with the history of human migration have started in sub-Saharan Africa. Each genotyping method with cost efficiency and equity, should be measured in relation to the resources available and discounts results, it is interesting to strengthen the knowledge of markers and propose alternatives leading to the classification of mycobacteria. Thus, the results obtained in this thesis bring more coherence to the proposed characterization of clones MTC circulating worldwide solutions.

http://www.theses.fr/2012AGUY0518/document