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 microg/m2 (0.8 microg/ft2) and 6.8 mmicrog/m2 (0.6 mg/ft2) for total and leachable lead respectively; 0.21% of homes had an indoor PbD loading above 430.5 microg/m2 (40 microg/ft2). The outdoor play area concentration GM was 33.5microg/kg and 21.7microgkg in total and leachable lead respectively; 1.4% of concentrations were higher than or equal to 400microg/kg. Outdoor floor PbD GM was 44.4 mg/m2 (4.1 mg/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 microg/L; 58% of concentrations were lower than 1 microg/L and 2.9% were higher than or equal to 10 mg/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.
Environmental Research

hal-00714516
https://hal.archives-ouvertes.fr/hal-00714516

Éditeur(s) : HAL CCSD Oxford University Press (OUP)
Résumé : International audience
Introduction: Most studies on nematode-malaria interactions were conducted outside of the Americas. The objective of the present study was thus to study the relation between malaria and nematodes in a cohort of children in an Amazonian village. Methods: Odds ratios for intestinal nematode infections as an explanatory variable to malaria resistant vs. malaria sensitive were computed. Results: Ascaris lumbricoides was significantly more frequent in the ‘resistant’ malaria group than in the ‘sensitive’ one. Conclusions: Despite its low statistical power, the present results find that Ascaris was associated with less malaria, as observed by a number of studies.
ISSN: 0142-6338

inserm-01410100
http://www.hal.inserm.fr/inserm-01410100
http://www.hal.inserm.fr/inserm-01410100/document
http://www.hal.inserm.fr/inserm-01410100/file/worms%20malaria%20camopi%20j%20trop%20pediatrics.pdf
http://www.hal.inserm.fr/inserm-01410100/file/GI%20nematodes%20tab%20aurelia%29.pdf

Éditeur(s) : HAL CCSD Oxford University Press (OUP)
Résumé : International audience
Background: The objective of the study was to determine the incidence of transaminase elevation during dengue, and its predictive factors. Methods: In 2013, a longitudinal study was performed using data from all cases of dengue seen in Cayenne Hospital. Cox proportional modeling was used. Signs of major transaminase elevation were defined as an increase in aspartate amino transferase (AST) or alanine amino transferase (ALT) concentration over 10 times the normal value (10N). Results: There were 1574 patients and 13 249 person-days of follow-up. The incidence rate for signs of trans-aminase elevation (10N) was 0.55 per 100 person-days. Six patients had major transaminase elevation with AST.1000 units (0.43 per 1000 patient-days), and 73 patients (4.6%) developed transaminase elevation with AST .10N. The variables independently associated with major transaminase elevation were hyponatremia, low platelets, dehydration, hematocrit increase, food intolerance, positive nonstructural protein 1 (NS1), age over 15 years and the notion of paracetamol intake. Conclusions: Although very frequent, the incidence of major transaminase elevation was lower than reported elsewhere perhaps because of good access to care, or of the particular serotype causing this epidemic. The patients with transaminase elevation tended to be older, more severe and taking paracetamol.
ISSN: 0035-9203

inserm-01475594
http://www.hal.inserm.fr/inserm-01475594
http://www.hal.inserm.fr/inserm-01475594/document
http://www.hal.inserm.fr/inserm-01475594/file/2016%2C%20Djossou%20-%20Incidence%20and%20predictive%20factors%20of%20transaminase.pdf
DOI : 10.1093/trstmh/trv117

Éditeur(s) : HAL CCSD Wiley
Résumé : International audience
Background: Squamous cell carcinoma (SCC) is considered the most frequent skin cancer in black people. Its incidence is not known in the Afro-Caribbean population.Objective: To assess the incidence of SCC in Guadeloupe, the largest island of the Lesser Antilles (405 000 inhabitants, mostly black people of African and European descent). The second objective was to characterize clinical and histological patterns of SCC occurring in the Afro-Caribbean community.Methods: This retrospective study was conducted over an 11-year period (2000-2010). Data regarding 723 histological confirmed cases of SCC identified using the three Guadeloupean pathology laboratories computerized databases were retrieved from the records of 551 patients. Private practice dermatologists and general practitioners were contacted to obtain any missing data. Results: The annual age-adjusted incidence of SCC was 15 per 100.000 residents in Guadeloupe. In the Afro-Caribbean community, SCC had a greater size (i.e.: 2.8±2.8 cm versus 1.5±1.0 cm, p<0.001), was more often located on the anogenital area (i.e. :48/79-60.8% versus 14/320-4.4%, p<0.001) in association with an underlying dermatosis due to HPV infection (15/71- 21.1% versus 3/366, 0.8%, p<0.001) and led more frequently to metastasis (13/84-15.5% versus 10/366-2.7%, p<0.001) and/or fatal evolution (11/83-13.3% versus 7/365-1.9%, p<0.001). Conclusions: The results of this original study, which first estimated the incidence of SCC in West Indies, suggest that anogenital examination should be routinely performed in skin cancer screening of Afro-Caribbean people in order to detect the presence of SCC at an early stage.
ISSN: 0926-9959

inserm-01513116
http://www.hal.inserm.fr/inserm-01513116
http://www.hal.inserm.fr/inserm-01513116/document
http://www.hal.inserm.fr/inserm-01513116/file/2017%2C%20Cordel%20-%20Squamous%20cell%20carcinoma%20in%20the%20Afro-Caribbean%20community.pdf
http://www.hal.inserm.fr/inserm-01513116/file/CordeletalJ%20Eur%20Acad%20Dermatol%20Venereol2017.pdf

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Background: Influenza is an important cause of serious illness and death, particularly in elderly and high-risk groups. Objectives Aim of this study was to identify factors associated with poor outcomes among adults hospitalized in France for laboratory-confirmed seasonal influenza. Study design Patients hospitalized for influenza were identified in a prospective, multicenter study carried out in French hospitals during three consecutive influenza seasons (2012–2015). Influenza virus infection was confirmed by reverse transcription polymerase chain reaction. Sociodemographic and clinical variables were compared according to the virus type and subtype. Risk factors for complications, intensive care unit (ICU) admission and death were analyzed by backward stepwise logistic regression. Results The study population consisted of 566 patients, of whom 56% were older than 65 years and 82% had underlying chronic illnesses. Type A influenza viruses infected 422 patients (75%), including subtype H3N2 in 239 patients (57%). The prior vaccine coverage rate was 38%. Complications occurred in 255 patients (45%), consisting mainly of pneumonia (n = 143, 30%) and respiratory failure (n = 116, 20%). Eighty-three patients (15%) were admitted to an ICU, and the in-hospital mortality rate was 4% (n = 21). Sixty-six patients (12%) received oseltamivir. Age over 65 years was the only identified risk factor for complications. Risk factors for ICU admission were an absence of vaccination, no oseltamivir administration before admission, pre-existing chronic respiratory disease, and current smoking. Age over 65 years and ICU admission were risk factors for death. Conclusions Older individuals and patients with underlying conditions are most at risk of influenza complications. Vaccination and early oseltamivir administration, both of which are recommended for these patients, appear to reduce ICU admissions
ISSN: 1386-6532

hal-01302409
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01302409
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01302409/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01302409/file/Factors%20associated%20with%20poor%20outcomes.pdf
DOI : 10.1016/j.jcv.2016.04.005

Éditeur(s) : HAL CCSD Springer
Résumé : International audience
Diabetologia
Stockholm, Sweden

hal-01204766
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01204766
DOI : 10.1007/s00125-015-3687-4

Éditeur(s) : HAL CCSD
Résumé : International audience
Up-to-date estimates of the health outcomes of preterm children are needed for assessing perinatal care, informing parents, making decisions about care, and providing evidence for clinical guidelines. To determine survival and neonatal morbidity of infants born from 22 through 34 completed weeks' gestation in France in 2011 and compare these outcomes with a comparable cohort in 1997. The EPIPAGE-2 study is a national, prospective, population-based cohort study conducted in all maternity and neonatal units in France in 2011. A total of 2205 births (stillbirths and live births) and terminations of pregnancy at 22 through 26 weeks' gestation, 3257 at 27 through 31 weeks, and 1234 at 32 through 34 weeks were studied. Cohort data were collected from January 1 through December 31, 1997, and from March 28 through December 31, 2011. Analyses for 1997 were run for the entire year and then separately for April to December; the rates for survival and morbidities did not differ. Data are therefore presented for the whole year in 1997 and the 8-month and 6-month periods in 2011. Survival to discharge and survival without any of the following adverse outcomes: grade III or IV intraventricular hemorrhage, cystic periventricular leukomalacia, severe bronchopulmonary dysplasia, retinopathy of prematurity (stage 3 or higher), or necrotizing enterocolitis (stages 2-3). A total of 0.7% of infants born before 24 weeks' gestation survived to discharge: 31.2% of those born at 24 weeks, 59.1% at 25 weeks, and 75.3% at 26 weeks. Survival rates were 93.6% at 27 through 31 weeks and 98.9% at 32 through 34 weeks. Infants discharged home without severe neonatal morbidity represented 0% at 23 weeks, 11.6% at 24 weeks, 30.0% at 25 weeks, 47.5% at 26 weeks, 81.3% at 27 through 31 weeks, and 96.8% at 32 through 34 weeks. Compared with 1997, the proportion of infants surviving without severe morbidity in 2011 increased by 14.4% (P < .001) at 25 through 29 weeks and 6% (P < .001) at 30 through 31 weeks but did not change appreciably for those born at less than 25 weeks. The rates of antenatal corticosteroid use, induced preterm deliveries, cesarean deliveries, and surfactant use increased significantly in all gestational-age groups, except at 22 through 23 weeks. The substantial improvement in survival in France for newborns born at 25 through 31 weeks' gestation was accompanied by an important reduction in severe morbidity, but survival remained rare before 25 weeks. Although improvement in survival at extremely low gestational age may be possible, its effect on long-term outcomes requires further studies. The long-term results of the EPIPAGE-2 study will be informative in this regard.
ISSN: 2168-6211

hal-01258705
http://hal.univ-brest.fr/hal-01258705
PUBMED : 25621457
DOI : 10.1001/jamapediatrics.2014.3351

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
AbstractBackground The intensive use of chlordecone (an organochlorine insecticide) in the French West Indies until 1993 resulted in a long-term soil and water contamination. Chlordecone has known hormonal properties and exposure through contaminated food during critical periods of development (gestation and early infancy) may affect growth. Objectives We aimed to assess the impact of prenatal and postnatal exposure to chlordecone on the growth of children from the TIMOUN mother–child cohort. Methods Chlordecone was determined in cord plasma at birth (N=222) and in breast milk samples (at 3 months). Dietary chlordecone intake was estimated at 7 and 18 months, with food-frequency questionnaires and food-specific contamination data. Anthropometric measurements were taken at the 3-, 7- and 18-month visits and measurements reported in the infants' health records were noted. Structured Jenss–Bayley growth models were fitted to individual height and weight growth trajectories. The impact of exposure on growth curve parameters was estimated directly with adjusted mixed non-linear models. Weight, height and body mass index (BMI), and instantaneous height and weight growth velocities at specific ages were also analyzed relative to exposure. Results Chlordecone in cord blood was associated with a higher BMI in boys at 3 months, due to greater weight and lower height, and in girls at 8 and 18 months, mostly due to lower height. Postnatal exposure was associated with lower height, weight and BMI at 3, 8 and 18 months, particularly in girls. Conclusion Chlordecone exposure may affect growth trajectories in children aged 0 to 18 months
ISSN: 0013-9351

hal-01169790
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01169790
DOI : 10.1016/j.envres.2015.06.023
PUBMED : 26133809

Éditeur(s) : HAL CCSD John Libbey Eurotext
Résumé : National audience
The most recent data on prevalence of chronic hepatitis B and C in the French Overseas Territories (FOT) show great variability among these territories with a prevalence rising from 0.46 to 3.4% for HBs Antigen and from 0.02 to 0.67%for anti HCV antibodies. The modes of transmission rely mainly for HBV on sexual or materno-fetal exposure, especially among people from non-French border endemic areas, and for HCV on blood or nosocomial route. Good adhesion of the treating physicians and pediatricians to vaccination has significantly reduced the prevalence of HBV in the ten past years, with an estimated coverage of 75 to 85%depending on the territories. Although there is still a high prevalence of HBV in some FOT, the screening policy and management are based on those carried out inmetropolitan France, which seems insufficient and inadequate to the situation of these territories. Regarding the therapeutic management of HCV, the means attributed to FOT have been identical to those of metropolitan France but the small number of specialist practitioners and remoteness contributed to provision of new molecules later in certain territories. Medical pluridisciplinary sessions have been implemented and based on the universitary or regional hospitals. Copyright © 2017 John Libbey Eurotext.
ISSN: 2115-3310

hal-01485859
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01485859
DOI : 10.1684/hpg.2016.1379

Éditeur(s) : HAL CCSD Mary Ann Liebert
Résumé : International audience
Little information is available on the molecular epidemiologic profile of HIV-1 in French Guiana, the French department with the highest HIV/AIDS incidence. To follow the evolution of HIV-1 diversity, we carried out a molecular analysis of HIV-1 isolates from 305 treatment-naive patients between 2006 and 2012. Protease and reverse-transcriptase sequences were obtained for subtype characterization, polymorphism analysis, and identification of drug resistance mutations. Of 305 HIV-1 strains, 95.1% were subtype B viruses. The overall prevalence of transmitted drug-resistance mutations (TDRMs) was 4.6% (14/305), ranging from 1.9% to 7.1% depending on the year. This study shows a low level of HIV-1 genetic diversity and a moderate prevalence of TDRMs with no evidence of an increasing trend over the study period. Nevertheless, the strong genetic polymorphism observed on both genes may be of concern for long-term treatment of people living with HIV-1 and thus deserves continuous monitoring.
ISSN: 0889-2229

pasteur-01583613
https://hal-riip.archives-ouvertes.fr/pasteur-01583613
https://hal-riip.archives-ouvertes.fr/pasteur-01583613/document
https://hal-riip.archives-ouvertes.fr/pasteur-01583613/file/2016%20Darcissac%20et%20al.%20ARHR.pdf
DOI : 10.1089/aid.2016.0048

Éditeur(s) : HAL CCSD Ferrata Storti Foundation
Résumé : International audience
Lionnet et al. recently reported a high prevalence of retinopathy (RET) and otologic disorders (OTD) in patients with sickle cell-hemoglobin C disease (SC), while a significant number of patients had renal diseases (mainly glomerulopathy; GLO) and osteonecrosis (OST). The pathophysiological processes of these complications in SC are not well defined, although blood hyperviscosity has been suspected, but never tested to the best of our knowledge, as responsible for several chronic complications in SC disease1,2. The aim of this study was to analyze the associations between hematological and hemorheological parameters and chronic complications in adult SC patients.
ISSN: 0390-6078

inserm-01081709
http://www.hal.inserm.fr/inserm-01081709
http://www.hal.inserm.fr/inserm-01081709/document
http://www.hal.inserm.fr/inserm-01081709/file/2014%2C%20Lemonne%20-%20Impaired%20blood%20rheology%20plays%20a%20role%20in%20the%20chronic%20disorders%20associated%20with%20sickle%20cell-hemoglobin%20C%20disease.pdf
PUBMED : 24633868

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
ABSTRACT: In the past decade, there has been an increasing number of studies on co-infections between worms and malaria. However, this increased interest has yielded results that have been at times conflicting and made it difficult to clearly grasp the outcome of this interaction. Despite the heterogeneity of study designs, reviewing the growing body of research may be synthesized into some broad trends: Ascaris emerges mostly as protective for malaria and its severe manifestations, whereas hookworm seems to increase malaria incidence. As efforts are made to de-worm populations in malaria endemic areas, there is still no clear picture of the impact these programmes have in terms of quantitative and qualitative changes in malaria.
ISSN: 1475-2875

inserm-00632065
http://www.hal.inserm.fr/inserm-00632065
http://www.hal.inserm.fr/inserm-00632065/document
http://www.hal.inserm.fr/inserm-00632065/file/1475-2875-10-259.pdf
DOI : 10.1186/1475-2875-10-259

Éditeur(s) : Orléans : G. Luzeray Paris : Maison du livre français
Extrait de : Trois siècles de vie française

Droits : Domaine public
Provenance : Université de Nantes. Service commun de la documentation
Permalien : http://www.manioc.org/patrimon/NAN13042
NAN13042

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Plasmodium vivax malaria is an important public health issue in the Amazon region, and it accounts for approximately 84 % of cases of the disease. Migration across the border between Brazil and French Guiana contributes to the maintenance of the disease. The aim of this study was to evaluate the therapeutic and parasitological responses of patients with P. vivax malaria treated with chloroquine and primaquine in the socio-environmental context of cross-border interactions between Brazil and French Guiana. The factors controlled were diagnostic agreement, adherence, adjustment of primaquine doses for patient weight, and quality of the drugs used. A prospective study was conducted in 2011 with 103 individuals aged 10-60 years with a positive diagnosis of P. vivax treated with chloroquine (10 mg base/kg on the first day, followed by 7.5 mg/kg on the second and third days) and primaquine for 7 days, who were followed for 28 days. The primaquine doses were adjusted for the patients' weight. A number of factors were determined: epidemiological characteristics, origin of patients, signs and symptoms, initial parasitaemia and parasitaemia clearance time, blood concentrations of chloroquine and primaquine, quality of anti-malarial drugs and diagnostic agreement. Ninety-five patients were followed for 28 days. There was a 100 % agreement in microscopic diagnosis between field laboratory and reference centre. The adhesion to the treatment was 100 %. Of these patients, 32.6 % received a weight-adjusted dose of primaquine. The chloroquine and primaquine tablets were consistent with the optimal quality limits for human consumption. The investigated patients achieved optimal blood exposure to anti-malarial drugs. The parasitological and therapeutic response was adequate in 99.0 % of cases. In the municipality of Oiapoque, the therapeutic regime used for the treatment of P. vivax malaria using chloroquine combined with primaquine remains effective, when external factors are controlled, such as the quality of anti-malarial drugs, the adhesion to the treatment prescribed, the correct diagnostic and the adjustment of primaquine dose for patient body weight.
ISSN: 1475-2875

Droits : http://creativecommons.org/licenses/by/
pasteur-01229355
https://hal-pasteur.archives-ouvertes.fr/pasteur-01229355
https://hal-pasteur.archives-ouvertes.fr/pasteur-01229355/document
https://hal-pasteur.archives-ouvertes.fr/pasteur-01229355/file/s12936-015-0925-7.pdf
PUBMEDCENTRAL : PMC4600333

Éditeur(s) : HAL CCSD Wiley
Résumé : International audience
ObjectivesTo compare the efficacy, in current clinical practice, of ă first regimens containing abacavir with lamivudine (ABC/3TC) or ă tenofovir with emtricitabine (TDF/FTC) in patients with baseline viral ă load 100000 HIV-1 RNA copies/mL. ă MethodsUsing a prospective cohort, we selected all patients starting a ă first HIV regimen based either on ABC/3TC or on TDF/FTC. The propensity ă score (PS) method was used to limit the indication bias due to the ă observational nature of the data. Adjusting and weighting methods via PS ă were used to compare the effectiveness of a first regimen containing ă ABC/3TC or TDF/FTC. The primary outcome was treatment failure by month ă 12 (M12). ă ResultsOverall, 2781 patients started an antiretroviral (ARV) regimen ă with ABC/3TC or TDF/FTC each in combination with efavirenz, boosted ă atazanavir or boosted darunavir. Among the 2472 uncensored patients ă before M12, 962 (39%) had a baseline viral load 100000 copies/mL of ă whom 294 were in treatment failure at or before M12. Our analyses showed ă no difference between ABC/3TC and TDF/FTC in the risk of treatment ă failure at M12 in patients starting an ARV regimen with a high viral ă load (100000 copies/mL). ă ConclusionsUsing a large prospectively collected cohort of patients ă seeking care in France, we found no evidence that ABC/3TC based regimens ă led to more failures than TDF/FTC based ones in patients with high ă baseline viral loads.
ISSN: 1464-2662

hal-01482656
https://hal.archives-ouvertes.fr/hal-01482656
DOI : 10.1111/hiv.12306

Description : Alexandre Moreau de Jonnés traite dans cet ouvrage de la fièvre jaune, maladie meurtrière du Nouveau monde. Il propose dans une première partie, un historique de la maladie remontant pour cela jusqu'au XVème siècle ; dans une deuxième partie, des observations médicales effectuées dernièrement ; et dans une troisième partie, les résultats de recherches concernant le développement et la propagation de la fièvre jaune.
Siècle(s) traité(s) : 19
Droits : Domaine public
Provenance : Collectivité territoriale de Guyane. Bibliothèque Alexandre-Franconie
Permalien : http://www.manioc.org/patrimon/HASHe8fa1ddaabdbaa8342e7d6
HASHe8fa1ddaabdbaa8342e7d6

Éditeur(s) : HAL CCSD
Résumé : International audience
A prospective study on randomized patients was conducted to determine how morphokinetic parameters are altered in embryos grown in sequential versus global culture media. Eleven morphokinetic parameters of 160 single embryos transferred were analyzed by time lapse imaging involving two University-affiliated in vitro fertilization (IVF) centers. We found that the fading of the two pronuclei occurred earlier in global (22.56±2.15 hpi) versus sequential media (23.63±2.71 hpi; p=0.0297). Likewise, the first cleavage started earlier at 24.52±2.33 hpi vs 25.76±2.95 hpi (p=0.0158). Also, the first cytokinesis was shorter in global medium, lasting 18±10.2 minutes in global versus 36±37.8 minutes in sequential culture medium (p <0.0001). We also observed a significant shortening in the duration of the 2-cell stage in sequential medium: 10.64 h±2.75 versus 11.66 h±1.11 in global medium (p=0.0225) which suggested a faster progression of the embryos through their first mitotic cell cycle. In conclusion, morphokinetic analysis of human embryos by Time lapse imaging reveals significant differences in five kinetic variables according to culture medium. Our study highlights the need to adapt morphokinetic analysis accordingly to the type of media used to best support human early embryo development.
Annales de Biologie Clinique

hal-01579406
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01579406
DOI : 10.1684/abc.2017.1259
PUBMED : 28751285

Éditeur(s) : HAL CCSD
Résumé : International audience
o abstract
Journal of Thoracic Disease

hal-01319894
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01319894
DOI : 10.21037/jtd.2016.03.34
PUBMED : 27162684
PUBMEDCENTRAL : PMC4842784

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Background Experimental evidence suggests that developmental exposure to persistent organic pollutants (POP) and to some non persistent pesticides may disrupt metabolic regulation of glucose metabolism and insulin secretion, and thereby contribute to the current epidemic of obesity and metabolic disorders. Quasi-experimental situations of undernutrition in utero have provided some information. However, the evidence in humans concerning the role of the prenatal environment in these disorders is contradictory, and little is known about long-term outcomes, such as type 2 diabetes, of prenatal exposure. Objectives Our aim was to evaluate the effects of prenatal exposure to POP and organophosphate pesticides on fetal markers of glucose metabolism in a sample of newborns from the Pelagie mother–child cohort in Brittany (France). Methods Dialkylphosphate (DAP) metabolites of organophosphate pesticides were measured in maternal urine collected at the beginning of pregnancy. Cord blood was assayed for polychlorinated biphenyl congener 153 (PCB153), p,p′-dichlorodiphenyl dichloroethene (DDE) and other POP. Insulin and adiponectin were determined in cord blood serum (n=268). Results A decrease in adiponectin and insulin levels was observed with increasing levels of DDE, but only in girls and not boys. Adiponectin levels were not related to the concentrations of other POP or DAP metabolites. Decreasing insulin levels were observed with increasing PCB153 concentrations. Insulin levels increased with DAP urinary levels. Additional adjustment for BMI z-score at birth modified some of these relations. Conclusions Our observations bring support for a potential role of organophosphate pesticides and POP in alterations to glucose metabolism observable at birth
ISSN: 0013-9351

hal-01259218
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01259218
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01259218/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01259218/file/Prenatal%20exposure%20to%20persistent%20organic%20pollutants%20and%20organophosphate%20pesticides%2C%20and%20markers%20of%20glucose%20metabolism%20at%20birth.pdf
DOI : 10.1016/j.envres.2016.01.005

Éditeur(s) : HAL CCSD American Society of Tropical Medicine and Hygiene
Résumé : International audience
Histoplasmosis is the first cause of acquired immunodeficiency syndrome (AIDS) and AIDS-related deaths in French Guiana. Cohort data were used to determine whether primary prophylaxis with 100 mg itraconazole for patients with CD4 counts < 150/mm(3) was cost-effective with different scenarios. For a scenario where 12% of patients died, 60% were aware of their human immunodeficiency virus (HIV) infection and adherence was only 50%, primary prophylaxis would prevent 1 death and 9 cases of histoplasmosis for a cost of 36,792 Euros per averted death, 1,533 per life-year saved, 4,415 Euros per averted case, when only counting the costs of itraconazole prophylaxis. Taking into account the total costs of hospitalization showed that primary prophylaxis would allow a savings of 185,178 Euros per year. Even in a scenario of low adherence, primary prophylaxis would be cost-effective in French Guiana, and presumably in the rest of the Guianas and the Amazon.
ISSN: 0002-9637

inserm-00913886
http://www.hal.inserm.fr/inserm-00913886
http://www.hal.inserm.fr/inserm-00913886/document
http://www.hal.inserm.fr/inserm-00913886/file/2013_Nacher_-_Primary_prophylaxissur disseminated_histoplasmosis_in_HIV_patients_in_French_Guiana_a_cost_effectiveness_study.pdf
DOI : 10.4269/ajtmh.13-0082