Éditeur(s) : HAL CCSD Massachusetts Medical Society
Résumé : International audience
o abstract
ISSN: 0028-4793

hal-01390975
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01390975
DOI : 10.1056/NEJMoa1515319
PUBMED : 27626530

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
This study aimed to identify factors associated with virological response (VR) to raltegravir (RAL)-containing regimens in 468 treatment-experienced but integrase inhibitor-naive HIV-1 patients receiving a RAL-containing regimen. VR was defined at Month 6 (M6) as HIV-1 RNA viral load (VL) <50 copies/mL. The impacts on VR of baseline integrase mutations, VL, CD4 count, genotypic sensitivity score for nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors and protease inhibitors, and the number of new antiretrovirals used for the first time associated with RAL were investigated. For patients with VL >50 copies/mL at M6, integrase mutations selected were characterised. Median baseline VL was 4.2 log(10)copies/mL (IQR 3.3-4.9 log(10) copies/mL) and CD4 count was 219 cells/mm(3) (IQR 96-368 cells/mm(3)). At M6, 71% of patients were responders. In multivariate analysis, baseline VL and CD4 count and ≥ 2 new antiretrovirals among darunavir, etravirine, maraviroc and enfuvirtide were associated with VR to RAL. Neither HIV-1 subtype nor baseline integrase polymorphisms were associated with VR to RAL. Among 63 failing patients at M6, selection of ≥ 1 change in the integrase gene was observed in 49 (77.8%), and 27/63 (42.9%) were considered as RAL-associated resistance mutations. Factors independently associated with the occurrence of ≥ 1 RAL-associated resistance mutation were VL at failure >3 log(10) and having no new drugs associated with RAL. RAL showed great potency in treatment-experienced patients. The number of new drugs associated with RAL was an important factor associated with VR. HIV-1 subtype and baseline integrase polymorphisms do not influence the RAL VR.
ISSN: 0924-8579

hal-00875083
https://hal.archives-ouvertes.fr/hal-00875083
DOI : 10.1016/j.ijantimicag.2013.02.016
PUBMED : 23562640

Éditeur(s) : HAL CCSD Human Kinetics
Résumé : International audience
OBJECTIVE: The aim was to examine the relationship between physical activity pattern and dietary profile. Although some clustering of the variables related to these major determinants of cardiovascular risk has been demonstrated, they have not been extensively studied together. PARTICIPANTS, DESIGN, AND SETTING: Two hundred two female university students from the main Guadeloupe (French West Indies) campus participated. They self-administered a validated Food Frequency Questionnaire and the 1-yr recall Modifiable Activity Questionnaire. Principal-component analysis was performed on the scores and the variables related to the physical activity pattern and dietary profile. RESULTS: A model including 10 variables explained 84.9% of the total variance. The physical activity pattern was not associated with the dietary profile, apart from fruit intake. The physical activity level was homogeneously low (median 1.58, first and last quartile cutoffs 1.54 and 1.66, respectively). There was no correlation between the physical activity level and the Food Frequency Questionnaire score (r=-.005). CONCLUSIONS: The absence of a strong relationship between the food and physical activity profiles is interpreted as a possible reflection of a dysregulation of the quality of food intake in this population with a sedentary lifestyle.
ISSN: 1526-484X

hal-00748203
https://hal.archives-ouvertes.fr/hal-00748203
DOI : 10.1123/ijsnem.20.5.401
PUBMED : 20975108

Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : International audience
The diagnosis of some infectious diseases is sometimes difficult to make and new diagnostic tools have been regularly assessed to that end. 18fluoro-deoxyglucose ((18)FDG) positron-emission tomography (PET) coupled with computed tomography (CT) is one of these new procedures. It has been evaluated for numerous infectious diseases with uneven results. A literature review allowed drawing some conclusions. First, (18)FDG-PET/CT is not currently a first-line procedure for infectious diseases. Second, it has proved useful for the evaluation of patients presenting with fever of unknown origin (FUO). Its negative predictive value is 100%: the symptoms of patients experiencing FUO with negative first-line investigations and a negative (18)FDG-PET/CT will almost always spontaneously disappear. Third, (18)FDG-PET/CT also seems to be contributive for the diagnosis of vascular prosthesis infections or osteomyelitis. Fourth, it has promising results for patients presenting with infective endocarditis, especially for secondary infectious foci, or for patients presenting with suspected infection of pacemakers or implanted defibrillator; but results are still preliminary and must be confirmed. Finally(18)FDG-PET/CT cannot be recommended yet for other infectious diseases due to lack of published data.
ISSN: 0399-077X

hal-01064982
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01064982
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01064982/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01064982/file/Contributionsur 18Fluoro_deoxyglucose_PETCT_accepted.pdf
DOI : 10.1016/j.medmal.2014.04.007

Éditeur(s) : HAL CCSD Wiley
Résumé : International audience
ISSN: 0007-1048

hal-01679026
https://hal.univ-antilles.fr/hal-01679026
DOI : 10.1111/bjh.14693

Éditeur(s) : HAL CCSD SAGE Publications
Résumé : International audience
The French overseas territories in the Americas are the French territories most affected by HIV. Crack cocaine users are particularly impacted. The objective of this study was to describe sexual risk behaviors and inconsistent condom use among crack cocaine users. A total of 640 crack cocaine users were interviewed. The sampling method was non-probabilistic. An anonymous standardized questionnaire of 110 questions was used. Over a third of persons did not use condoms systematically with casual sex partners (36.2%) or commercial sex partners (32.3%), and 64% did not use condoms systematically with regular sex partners. In a context of multiple sexual partnerships, frequent forced sex, and insufficient HIV testing, the lack of systematic condom use may favor the spread of HIV. Different predictive factors of inconsistent condom use were identified, depending on the type of partner, with a log binomial regression. However, among the predictor variables identified, two predictive factors frequently occur among the different type of sex partners: high perceived risk of HIV and self-perceived capacity to persuade a sex partner to use condom. These results pointed towards interventions improving access to rights and raising perceived self-efficacy.
ISSN: 0956-4624

inserm-01566193
http://www.hal.inserm.fr/inserm-01566193
http://www.hal.inserm.fr/inserm-01566193/document
http://www.hal.inserm.fr/inserm-01566193/file/2017%2C%20Parriault%20-%20Sexual%20risk%20behaviors.pdf
DOI : 10.1097/COH.0b013e3283536ab2

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
ABSTRACT: BACKGROUND: The amount of lead in the environment has decreased significantly in recent years, and so did exposure. However, there is no known safe exposure level and, therefore, the exposure of children to lead, although low, remains a major public health issue. With the lower levels of exposure, it is becoming more difficult to identify lead sources and new approaches may be required for preventive action. This study assessed the usefulness of lead isotope ratios for identifying sources of lead using data from a nationwide sample of French children aged from six months to six years with blood lead levels (B-Pb) [greater than or equal to] 25 ug/L. METHODS: Blood samples were taken from 125 children, representing about 600,000 French children; environmental samples were taken from their homes and personal information was collected. Lead isotope ratios were determined using quadrupole ICP-MS (inductively coupled plasma - mass spectrometry) and the isotopic signatures of potential sources of exposure were matched with those of blood in order to identify the most likely sources. RESULTS: In addition to the interpretation of lead concentrations, lead isotope ratios were potentially of use for 57% of children aged from six months to six years with blood lead level [greater than or equal to] 25 ug/L (7% of overall children in France, about 332,000 children), with at least one potential source of lead and sufficiently well discriminated lead isotope ratios. Lead isotope ratios revealed a single suspected source of exposure for 32% of the subjects and were able to eliminate at least one unlikely source of exposure for 30% of the children. CONCLUSIONS: In France, lead isotope ratios could provide valuable additional information in about a third of routine environmental investigations.
ISSN: 1476-069X

inserm-00624817
http://www.hal.inserm.fr/inserm-00624817
http://www.hal.inserm.fr/inserm-00624817/document
http://www.hal.inserm.fr/inserm-00624817/file/1476-069X-10-75.pdf
DOI : 10.1186/1476-069X-10-75

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
ABSTRACT: Eclipsed by the debates about malaria incidence and severity in individual patients, malaria transmission in helminth-infected persons has so far received very little attention. Studies in humans have shown increased malaria incidence and prevalence, and a trend for a reduction of symptoms in patients with malaria. This suggests that such patients could possibly be less likely to seek treatment thus carrying malaria parasites and their gametocytes for longer durations, therefore, being a greater potential source of transmission. In addition, in humans, a study showed increased gametocyte carriage, and in an animal model of helminth-malaria co-infection, there was increased malaria transmission. These elements converge towards the hypothesis that patients co-infected with worms and malaria may represent a hub of malaria transmission. The test of this hypothesis requires verifying, in different epidemiological settings, that helminth-infected patients have more gametocytes, that they have less symptomatic malaria and longer-lasting infections, and that they are more attractive for the vectors. The negative outcome in one setting of one of the above aspects does not necessarily mean that the other two aspects may suffice to increase transmission. If it is verified that patients co-infected by worms and malaria could be a transmission hub, this would be an interesting piece of strategic information in the context of the spread of anti-malarial resistance and the malaria eradication attempts.
ISSN: 1475-2875

inserm-00758017
http://www.hal.inserm.fr/inserm-00758017
http://www.hal.inserm.fr/inserm-00758017/document
http://www.hal.inserm.fr/inserm-00758017/file/1475-2875-11-376.pdf
DOI : 10.1186/1475-2875-11-376

Éditeur(s) : HAL CCSD Centers for Disease Control and Prevention
Résumé : International audience
To assess the prevalence of malaria among illegal gold miners in the French Guiana rainforest, we screened 205 miners during May-June 2014. Malaria prevalence was 48.3%; 48.5% of cases were asymptomatic. Patients reported self-medication with artemisinin-based combination therapy. Risk for emergence and spread of artemisinin resistance among gold miners in the rainforest is high.
ISSN: 1080-6040

Droits : http://creativecommons.org/licenses/by/
pasteur-01305106
https://hal-pasteur.archives-ouvertes.fr/pasteur-01305106
https://hal-pasteur.archives-ouvertes.fr/pasteur-01305106/document
https://hal-pasteur.archives-ouvertes.fr/pasteur-01305106/file/15-1957.pdf
DOI : 10.3201/eid2205.151957.

Éditeur(s) : HAL CCSD
Résumé : National audience
Introduction Le chikungunya (CHIKV) est un alphavirus ré-émergent depuis 10 ans responsable de nombreuses épidémies. Chez certains patients, il est à l'origine de troubles musculo-squelettiques et de polyarthropathies inva-lidants et persistants plus de 3 mois, définissant la forme chronique du chikun-gunya (CHIKC). Afin de déterminer la prévalence du CHIKC, nous avons mené une cohorte prospective de patients ambulatoires lors de la dernière épi-démie en outre-mer. Secondairement, nous avons recherché les facteurs de risques associés.
Médecine et maladies infectieuses 46 (2016) 15-16
Lille, France

inserm-01413489
http://www.hal.inserm.fr/inserm-01413489
http://www.hal.inserm.fr/inserm-01413489/document
http://www.hal.inserm.fr/inserm-01413489/file/2016%2C%20Thioune%20-%20COL%207-01%20%281%29.pdf
http://www.hal.inserm.fr/inserm-01413489/file/2016%2C%20Thioune%20-%20COL%207-01.pdf

Éditeur(s) : HAL CCSD INVS
Résumé : National audience
Context – Cervical cancer is the second most frequent cancer of women in French Guiana. Studies have shown that populations living in remote villages in the interior of the territory have early sexual relations and that multiple sexual partnerships are frequent. Hence, the main objective of the study was to determine the prevalence of Human Papilloma Virus (HPV) in these areas.Methods – This multicentric cross sectional study was conducted in women aged 20 to 65 years, living in theremote villages along the Maroni and Oyapock rivers. Women were included on a voluntary basis after beinginformed of the study team schedule through radio address and key opinion leaders.The search for HPV and cytologic examinations were performed on each sample. HPV infection was defined bythe detection of viral DNA using the Greiner Bio One® kit. Cytologic analyses were performed using the 2001Bethesda classification.Results – Overall, 643 women were included in the study. Age-standardized HPV prevalence was 35%. Theprevalence curve by age group showed a U-shaped pattern: women over 50 years had the highest risk of being infected by HPV, followed by women aged 20-29 years. In addition, 26.1% of women with a normal smear test had HPV infection. The most frequent genotypes were HPV52, HPV58, and HPV16. On interpretable smears 1.16% of women had high grade superficial intra-epithelial (HSIL) lesions.Conclusions – The standardized prevalence of HPV in French Guiana is among the highest in the world. HSILcytological lesions were nearly 4 times more frequent than in the Île-de-France region. Given the importance of the incidence of cervical cancer in French Guiana, these results suggest it may be preferable to use HPV testing than cytology. Vaccination against HPV, preferably with the new nonavalent vaccine seems an appropriate prevention measure. However, this intervention will be a challenge to implement in this region where a significant proportion of the population is not covered by health insurance.
Contexte – Le cancer du col de l’utérus est le deuxième cancer féminin le plus fréquent en Guyane française.Des études ont montré que les populations résidant dans les communes isolées de l’intérieur du départementdébutent leur vie sexuelle de façon précoce et que le multipartenariat sexuel y est fréquent. Dans ce contexte, l’objectif principal de cette étude était de déterminer la prévalence de l’infection à papillomavirus humains (HPV) dans ces zones.Méthodes – Cette étude transversale multicentrique a été conduite auprès des femmes âgées de 20 à 65 ansrésidant dans les communes isolées des fleuves Maroni et Oyapock. Les femmes étaient incluses sur la basedu volontariat après avoir été informées du passage de l’équipe de l’étude via la radio locale et par les leadersd’opinion. La recherche d’infection à HPV et les analyses cytologiques ont été réalisées sur chaque prélèvement. L’infection à HPV était définie par la détection d’ADN viral par le kit de dépistage Greiner Bio One®. Les analyses cytologiques ont été décrites selon la classification de Bethesda 2001.Résultats – Au total, 643 femmes ont été incluses. La prévalence de l’infection à HPV, standardisée sur l’âge,était de 35%. La courbe de prévalence par classe d’âge présentait une forme en U : les femmes de plus de50 ans avaient le plus haut risque d’être infectées par HPV, suivies par les femmes âgées de 20 à 29 ans.Par ailleurs, 26,1% des femmes ayant un frottis normal étaient infectées par le HPV. Les génotypes les plusfréquents étaient HPV52, HPV58 et HPV16. Sur les frottis interprétables, 1,16% des femmes avaient des lésions de haut grade (type HSIL).Conclusions – Le taux standardisé de prévalence de l’infection par le HPV en Guyane est parmi les plus élevésau monde. Les lésions cytologiques de type HSIL étaient près de 4 fois plus fréquentes qu’en Île-de-France.Étant donné l’importance de l’incidence du cancer du col de l’utérus en Guyane, ces résultats montrent qu’il est peut être préférable d’utiliser le test HPV plutôt que la cytologie. La vaccination anti-HPV, de préférence avec le nouveau vaccin nonavalent, semble être une mesure de prévention appropriée. Pour autant, cela reste un challenge de mettre en oeuvre ces interventions dans cette région où une part importante de la population n’a pas d’assurance maladie.
ISSN: 1953-8030

Droits : info:eu-repo/semantics/OpenAccess
inserm-01407222
http://www.hal.inserm.fr/inserm-01407222
http://www.hal.inserm.fr/inserm-01407222/document
http://www.hal.inserm.fr/inserm-01407222/file/2016%2C%20Dufit%20et%20al.pdf

Éditeur(s) : HAL CCSD
Résumé : National audience
Une Brésilienne de 39 ans est adressée à l’hôpital de Cayenne pour des céphalées, une confusion fébrile et une altération de l’état général. Six mois plus tôt, une infection par le VIH avait été révélée (charge virale de 147 615 copies/ ml ; CD4 à 56/ mm3), au Brésil, par un tableau de tuberculose pleuro-pulmonaire non documentée. Elle suit depuis un traitement antirétroviral et une quadrithérapie antituberculeuse, sans cotrimoxazole, traitement toujours en cours à son entrée.
La Lettre de l'Infectiologue

Droits : info:eu-repo/semantics/OpenAccess
inserm-01423104
http://www.hal.inserm.fr/inserm-01423104
http://www.hal.inserm.fr/inserm-01423104/document
http://www.hal.inserm.fr/inserm-01423104/file/2015%2C%20Epelboin%20-%20M%C3%A9ningo-enc%C3%A9phalite%20%C3%A0%20histoplasma%20capsulatum.pdf

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Fungi are major contributors to the opportunistic infections that affect patients with HIV/AIDS. Systemic infections are mainly with Pneumocystis jirovecii (pneumocystosis), Cryptococcus neoformans (cryptococcosis), Histoplasma capsulatum (histoplasmosis), and Talaromyces (Penicillium) marneffei (talaromycosis). The incidence of systemic fungal infections has decreased in people with HIV in high-income countries because of the widespread availability of antiretroviral drugs and early testing for HIV. However, in many areas with high HIV prevalence, patients present to care with advanced HIV infection and with a low CD4 cell count or represent with persistent low CD4 cell counts because of poor adherence, resistance to antiretroviral drugs, or both. Affordable, rapid point-of-care diagnostic tests (as have been developed for cryptococcosis) are urgently needed for pneumocystosis, talaromycosis, and histoplasmosis. Additionally, antifungal drugs, including amphotericin B, liposomal amphotericin B, and flucytosine, need to be much more widely available. Such measures, together with continued international efforts in education and training in the management of fungal disease, have the potential to improve patient outcomes substantially.
ISSN: 1473-3099

inserm-01574426
http://www.hal.inserm.fr/inserm-01574426
http://www.hal.inserm.fr/inserm-01574426/document
http://www.hal.inserm.fr/inserm-01574426/file/2017%2C%20Limper%20-%20Fungal%20infections%20in%20HIV%20AIDS.pdf
DOI : 10.1016/S1473-3099(17)30303-1

Éditeur(s) : HAL CCSD American Society for Microbiology
Résumé : International audience
Human leishmaniasis are widely spread diseases with different clinical forms caused by about 20 species within the Leishmania genus. Leishmania species identification is relevant for therapeutic management and prognosis, especially for cutaneous and muco-cutaneous forms. Several methods are available to identify Leishmania species from culture, but they have not been standardized for the majority of the currently described species, with the exception of MultiLocus Enzyme Electrophoresis. Moreover, these techniques are expensive, time-consuming and not available in all laboratories. Within the last decade, mass spectrometry (MS) has been adapted for microorganism identification, including Leishmania However, no commercial reference mass spectral database is available. In this study, a reference mass spectral library (MSL) for Leishmania isolates, accessible through a free web-based application (mass spectral identification, MSI), was constructed and tested. It includes mass spectral data for 33 different Leishmania species, including species that infect humans, animals and phlebotomine vectors. Four laboratories on two continents evaluated MSI performance using 268 samples of which 231 were Leishmania strains. All Leishmania strains, but one, were correctly identified at least at the complex level. A risk of species misidentification within the L. donovani, L. guyanensis and L. braziliensis complexes was observed, as already reported with other techniques. The tested application was reliable, with identification results comparable to those obtained with reference methods, but with a more favorable cost-efficiency ratio. This free online identification system relies on a scalable database and can be implemented directly in the user's computers.
ISSN: 0095-1137

hal-01571305
https://hal.archives-ouvertes.fr/hal-01571305
DOI : 10.1128/JCM.00845-17
PUBMED : 28724559

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
AbstractBackgroundSuicide rates in prison are high and their risk factors are incompletely understood. The objective of the present study is to measure the risk of suicide and its predictors in the only prison of multicultural French Guiana.MethodsAll new prisoners arriving between September 2013 and December 2014 were included. The Mini International Neuropsychiatric Interview (MINI) was used and socio-demographic data was collected. In order to identify the predictors of suicide risk multivariate logistic regression was used.ResultsOf the 707 prisoners included 13.2% had a suicidal risk, 14.0% of whom had a high risk, 15.1% a moderate risk and 41.9% a low risk. Predictive factors were depression (OR 7.44, 95% CI: 3.50–15.87), dysthymia (OR 4.22, 95% CI: 1.34–13.36), panic disorder (OR 3.47, 95% CI: 1.33–8.99), general anxiety disorder (GAD) (OR 2.19, 95% CI: 1.13–4.22), men having been abused during childhood (OR 21.01, 95%, CI: 3.26–135.48), having been sentenced for sexual assault (OR 7.12, 95% CI: 1.98–25.99) and smoking (OR 2.93, 95%, CI 1.30–6.63).ConclusionThe suicide risk was lower than in mainland France, possibly reflecting the differences in the social stigma attached to incarceration because of migrant populations and the importance and trivialization of drug trafficking among detainees. However, there were no differences between nationalities. The results reemphasize the importance of promptly identifying and treating psychiatric disorders, which were the main suicide risk factors.
ISSN: 1471-244X

inserm-01517176
http://www.hal.inserm.fr/inserm-01517176
http://www.hal.inserm.fr/inserm-01517176/document
http://www.hal.inserm.fr/inserm-01517176/file/12888_2017_Article_1320.pdf
DOI : 10.1186/s12888-017-1320-4

Éditeur(s) : HAL CCSD American Society of Hematology
Résumé : International audience
ISSN: 0006-4971

inserm-00919490
http://www.hal.inserm.fr/inserm-00919490
http://www.hal.inserm.fr/inserm-00919490/document
http://www.hal.inserm.fr/inserm-00919490/file/2013_Lemonne_-_Does_increased_red_blood_cell_deformability_raise_the_risk_for_osteonecrosis_in_sickle_cell_anemia.pdf
http://www.hal.inserm.fr/inserm-00919490/file/inserm-00919490_edited.pdf

Éditeur(s) : HAL CCSD
Résumé : International audience
This study investigated the possibility of there being differences in respiratory muscle strength and endurance in elite and competition triathletes who have similar maximal oxygen uptakes (V_O2max) and ventilatory thresholds (Thvent). Five internationally-ranked elite, [mean (SD) age 23.8 (1.4) years] and six nationallyand regionally-ranked competition [age 21.1 (1.1) years] male triathletes performed two successive trials: first an incremental cycle test to assess V_O2max and Thvent and second 20 min of cycling followed by 20 min of running (C-R) at intensities higher than 85% V_O2max. Cardioventilatory data were collected every minute during the two trials, using an automated breath-by-breath system. Maximal expiratory and inspiratory (PImax) strength were assessed before and 10 min after C-R from the functional residual capacity. Respiratory muscle endurance was assessed 1 day before and 30 min after C-R by measuring the time limit (tlim). The results showed firstly that during C-R, the competition triathletes had significantly (P<0.05) higher minute ventilation [mean (SEM) 107.4 (3.1) compared to 99.8 (3.7) lÆmin-1], breathing frequency [44.4 (2.0) compared to 40.2 (3.4) Æmin-1] and heart rate [166 (3) compared to 159 (4) beatsÆmin-1] and secondly that after C-R, they had significantly lower PImax [127.1 (4.2) compared to 130.7 (3.0) cmH2O] and tlim [2:35 (0:29) compared to 4:12 (0:20) min] than the elite triathletes. We conclude that, despite similar V_O2max and Thvent, the competition triathletes showed less extensive adaptive mechanisms, including those in the respiratory muscles, than did the elite triathletes. This led to higher ventilation, which appeared to be the cause of the faster development of fatigue in the inspiratory muscles in this group.
EUROPEAN JOURNAL OF APPLIED PHYSIOLOGY

hal-00720562
https://hal.univ-antilles.fr/hal-00720562
https://hal.univ-antilles.fr/hal-00720562/document
https://hal.univ-antilles.fr/hal-00720562/file/BoussanaEJAP02_2_.pdf

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Lead in homes is a well-known source of childhood lead exposure, which is still of concern due to the health effects of low lead doses. This study aims to describe lead contamination in the homes of children aged 6 months to 6 years in France (without overseas). Between October 2008 and August 2009, 484 housing units were investigated. Lead in tap water and total and leachable lead levels from floor dust, outdoor soils and paint chips were measured. X-ray fluorescence measurements were carried out on non-metallic and metallic substrates. Nationwide results are provided. The indoor floor dust lead (PbD) geometric mean (GM) was 8.8 μg/m² (0.8 μg/ft²) and 6.8 μg/m² (0.6 μg/ft²) for total and leachable lead respectively; 0.21% of homes had an indoor PbD loading above 430.5 μg/m² (40 μg/ft²). The outdoor play area concentration GM was 33.5 mg/kg and 21.7 mg/kg in total and leachable lead respectively; 1.4% of concentrations were higher than or equal to 400 mg/kg. Outdoor floor PbD GM was 44.4 μg/m² (4.1 μg/ft²) that was approximately 3.2 times higher than the GM of indoor PbD. Lead-based paint (LBP) was present in 25% of dwellings, LBP on only non-metallic substrates was present in 19% of homes and on metallic substrates in 10% of dwellings. The GM of lead concentrations in tap water was below 1 μg/L; 58% of concentrations were lower than 1 μg/L and 2.9% were higher than or equal to 10 μg/L. The age cut-off for homes with lead would be 1974 for paint and 1993 for indoor floor dust. This study provides, for the first time, a look at the state of lead contamination to which children are exposed in French housing. Moreover, it provides policy makers an estimate of the number of French dwellings sheltering children where abatement should be conducted.
ISSN: 0013-9351

hal-00732138
https://hal.archives-ouvertes.fr/hal-00732138
DOI : 10.1016/j.envres.2012.04.005
PUBMED : 22551852

Éditeur(s) : HAL CCSD Ferrata Storti Foundation
Résumé : International audience
BACKGROUND: Little is known about the effects of blood rheology on the occurrence of acute chest syndrome and painful vaso-occlusive crises in children with sickle cell anemia and hemoglobin SC disease. DESIGN AND METHODS: To address this issue, steady-state hemorheological profiles (blood viscosity, red blood cell deformability, aggregation properties) and hematologic parameters were assessed in 44 children with sickle cell anemia and 49 children with hemoglobin SC disease (8-16 years old) followed since birth. Clinical charts were retrospectively reviewed to determine prior acute chest syndrome or vaso-occlusive episodes, and rates of these complications were calculated. RESULTS: Multivariate analysis revealed that: 1) a higher steady-state blood viscosity was associated with a higher rate of vaso-occlusive crises in children with sickle cell anemia, but not in children with hemoglobin SC disease; 2) a higher steady-state red blood cell disaggregation threshold was associated with previous history of acute chest syndrome in children with hemoglobin SC disease and boys with sickle cell anemia. CONCLUSIONS: Our results indicate for the first time that the red blood cell aggregation properties may play a role in the pathophysiology of acute chest syndrome in children with hemoglobin SC disease and boys with sickle cell anemia. In addition, whereas greater blood viscosity is associated with a higher rate of vaso-occlusive crises in children with sickle cell anemia, no association was found in children with hemoglobin SC disease, underscoring differences in the etiology of vaso-occlusive crises between sickle cell anemia and hemoglobin SC disease.
ISSN: 0390-6078

inserm-00849038
http://www.hal.inserm.fr/inserm-00849038
http://www.hal.inserm.fr/inserm-00849038/document
http://www.hal.inserm.fr/inserm-00849038/file/inserm-00849038.pdf
DOI : 10.3324/haematol.2012.066670

Éditeur(s) : HAL CCSD Wiley
Résumé : International audience
Sickle cell anemia (SS) is characterized by a reduced cerebral microvascular oxygen saturation (cerebral TOI), which is not associated with hemoglobin concentration. Cerebral TOI has never been studied in sickle cell-hemoglobin C disease (SC). We focused on the relationships between hemorheological alterations and cerebral TOI in sickle cell patients with no cerebral vasculopathy and on the usefulness of TOI variability to assess the cerebral vasomotion activity. The blood rheological profile, the level of cerebral TOI (spatial resolved spectroscopy) and the cerebral TOI variability, which reflects vasomotion activity, were compared between 20 healthy subjects (AA), 21 SC patients, and 21 SS patients. Cerebral TOI exhibited the following order: AA > SC > SS. The low cerebral TOI in SS patients was related to red blood cell aggregation and deformability properties. The cerebral TOI variability of SS and SC patients was increased above healthy values and vasomotion activity was negatively associated with the reduced cerebral TOI in SS patients. We demonstrated that (1) blood rheology could be involved in the reduced cerebral TOI in SS patients but not in SC patients; (2) vasomotion activity is increased in SS and SC patients to compensate for the reduced cerebral TOI.
ISSN: 0361-8609

inserm-00838966
http://www.hal.inserm.fr/inserm-00838966
http://www.hal.inserm.fr/inserm-00838966/document
http://www.hal.inserm.fr/inserm-00838966/file/2013_Waltz_American_Journalsur Hematology.pdf
DOI : 10.1002/ajh.23318