Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
INTRODUCTION:The frequency, the clinical characteristics, and the prognosis of dengue is highly variable. Dengue fever is associated with a range of neurological manifestations. The objective of the present study was to determine the incidence of neurological signs and their predictive factors using data from cases of dengue seen and followed in Cayenne Hospital during the Dengue 2 epidemic in 2013.METHODS:In 2013, a longitudinal study using data from all cases of dengue seen in Cayenne hospital was collected. Medical records used a standardized form to collect demographic information, clinical signs and biological results and the date at which they were present. The analysis used Cox proportional modeling to obtain adjusted Hazard ratios.RESULTS:A total of 1574 patients were included 221 of whom developed central nervous system signs. These signs were spontaneously resolutive. There were 9298person days of follow-up and the overall incidence rate for central nervous system signs was 2.37 per 100 person-days. The variables independently associated with central nervous system anomalies were headache, Adjusted Hazard ratio (AHR) = 1.9(95%CI = 1.4-2.6), bleeding AHR = 2 ((95%CI = 1.3-3.1), P = 0.001, abdominal pain AHR = 1.9 ((95%CI = 1.4-2.6), P<0.001, aches AHR = 2.1 ((95%CI = 1.5-2.9), P<0.001, and fatigue AHR = 1.5 ((95%CI = 1.3-1.7), P<0.001.DISCUSSION:Overall, the present study suggests that neurological signs of dengue are not exceptional even in patients without the most severe features of dengue. These manifestations were spontaneously resolutive. Here it was not possible to distinguish between encephalitis or encephalopathy. Further studies would require more in depth exploration of the patients.
ISSN: 1932-6203

inserm-01421218
http://www.hal.inserm.fr/inserm-01421218
http://www.hal.inserm.fr/inserm-01421218/document
http://www.hal.inserm.fr/inserm-01421218/file/2016%2C%20Djossou%20-%20Incidence%20and%20Predictive%20Factors%20of%20Central%20Nervous%20System%20Dysfunction%20in%20Patients%20Consulting.pdf
DOI : 10.1371/journal.pone.0150828.t003

Éditeur(s) : HAL CCSD
Résumé : Point processes are often used as spatial or spatio-temporal distribution models of occurrences. In this PhD dissertation, we focus first on Cox processes driven by a hidden process associated with a Dirichlet process. This model corresponds to hidden occurrences influencing the stochastic intensity of observed occurrences. We generalize the notion of "Shot noise Cox process" introduced by M{o}ller and develop its bayesian analysis by a Gibbs sampler combined with a Metropolis-Hastings algorithm. We show that our MCMC method is a reversible jump one. The model takes into account a random number of hidden contributions producing effects on the observed point process intensity. Therefore the parameter space has a variable dimension. We focus the statistical inference on the estimation of the hidden contribution expected value, the hidden contribution expected number, the spatial influence and correlation parameters. The contribution equality test and contribution independence test are proposed. Applications in epidemiology and ecology are shown from extit{Rubus fruticosa} data, extit{Ibicella lutea} data and death number data in counties of Georgia, USA. Two situations are considered with respect to available data~: firstly, the spatial positions of occurrences are observed between several pairs of consecutive dates; secondly, counts are carried out over a fixed time interval in several spatial sampling units. Secondly, we focus on point processes with memory introduced by Kagan, Ogata and Vere-Jones, pioneers in statistical seismology. In fact, spatio-temporal point processes play an important role in the studies of earthquake catalogs since they consist of seismic events with their dates and spatial locations. We studied an ETAS (Epidemic Type Aftershock Sequence) model with time independent background intensity and several triggering functions taking into account previous events. We illustrate our approach with a seismicity study of the Lesser Antilles arc. A comparaison study of Gamma, Weibull, Log-Normal and modified Omori law triggering function models is also carried out. We show that the modified Omori law does not fit the Lesser Antilles seismic data and the best adjusted triggering function is the Weibull model. Consequently, the waiting time between aftershocks is weaker in the Lesser Antilles zone compared to the one in regions with seismicity described by the modified Omori law. In other words, aftershock aggregativity is higher in the Lesser Antilles region. The stochastic background intensity following a Dirichlet process centered on a spatial log-normal process is discussed.
Les processus ponctuels sont souvent utilisés comme modèles de répartitions spatiales ou spatio-temporelles d'occurrences. Dans cette thèse, nous nous intéressons tout d'abord à des processus de Cox dirigés par un processus caché associé à un processus de Dirichlet. Ce modèle correspond à des occurrences cachées influençant l'intensité stochastique des occurrences observées. Nous généralisons la notion de " Shot noise Cox process " introduite par Moller et développons le traitement bayésien par un échantillonneur de Gibbs combiné à un algorithme de Metropolis-Hastings. Nous montrons que cette méthode MCMC est à sauts réversibles. Le modèle prend en compte, en effet, un nombre aléatoire de contributions cachées influençant l'intensité du processus ponctuel observé donc a un espace paramétrique de dimension variable. Nous focalisons l'inférence statistique sur l'estimation de la valeur espérée de chaque contribution cachée, le nombre espéré de contributions cachées, le degré d'influence spatiale de ces contributions et leur degré de corrélation. Le test d'égalité des contributions et celui de leur indépendance sont ainsi développés. L'utilité en épidémiologie et en écologie est alors démontrée à partir de données de Rubus fruticosa, Ibicella lutea et de mortalité dans les cantons de Georgia, USA. En termes de données observées, deux situations sont considérées: premièrement, les positions spatiales des occurrences sont observées entre plusieurs paires de dates consécutives; deuxièmement, des comptages sont effectués, au cours d'une période fixée, dans des unités d'échantillonnage spatiales. D'autre part, nous nous intéressons aux processus ponctuels à mémoire introduits par Kagan, Ogata et Vere-Jones, précurseurs de la statistique sismologique. En effet, les processus ponctuels spatio-temporels ont une place importante dans l'étude des catalogues sismiques puisque ces derniers sont généralement constitués d'événements sismiques datés et géo-référencés. Nous avons étudié un modèle ETAS (Epidemic Type Aftershock Sequence) avec une intensité d'arrière-plan indépendante du temps et plusieurs fonctions déclenchantes permettant d'intégrer les événements antérieurs récents. Cette approche est utilisée pour étudier la sismicité de l'arc des Petites Antilles. Une étude comparative des modèles Gamma, Weibull, Log-Normal et loi d'Omori modifiée pour les fonctions déclenchantes est menée. Nous montrons que la loi d'Omori modifiée ne s'ajuste pas aux données sismiques des Petites Antilles et la fonction déclenchante la plus adaptée est le modèle de Weibull. Cela implique que le temps d'attente entre répliques dans la zone des Petites Antilles est plus faible que celui des régions à sismicité décrite par la loi d'Omori modifiée. Autrement dit, l'agrégation des répliques après un événement majeur est plus prononcée dans la zone des Petites Antilles. La possibilité d'inclure une intensité d'arrière-plan suivant un processus de Dirichlet centré sur un processus spatial log-gaussien est discutée.
https://tel.archives-ouvertes.fr/tel-00841146

Droits : info:eu-repo/semantics/OpenAccess
NNT : 2012AGUY0555
tel-00841146
https://tel.archives-ouvertes.fr/tel-00841146
https://tel.archives-ouvertes.fr/tel-00841146/document
https://tel.archives-ouvertes.fr/tel-00841146/file/these_VALMY.pdf

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
A retrospective cohort study was conducted on 1541 HIV-infected patients to determine variables associated with the incidence of herpes zoster. A single failure Cox model showed that herpes zoster incidence increased following the first 6 months of antiretroviral treatment adjusted hazard ratio (AHR)=5 (95%CI=2.6-9.2), P<0.001; in the >60 years age group AHR=2 (95%CI=1-4), P=0.04; in patients in the top CD8 quartile AHR=2.1 (95%CI=1.3-3.6), P<0.001; and in patients previously reported to use crack cocaine AHR=5.9, (95%CI=1.4-25), P=0.02. Herpes zoster incidence increased in patients with CD4 counts<500 per mm(3) and gradually declined since 1992-1996, with AHR=0.3 (95%CI=0.2-0.5), P<0.001 for the 1997-2002 period and AHR=0.24 (95%CI=0.14-0.4), P<0.001 for the 2002-2008 period. Contrary to what has been described elsewhere, there was no specific effect of protease inhibitors on herpes zoster incidence. The present study is the first to suggest that crack cocaine is associated with an increased incidence of herpes zoster. The neurological or immunological effects of crack are discussed.
ISSN: 1932-6203

inserm-00921158
http://www.hal.inserm.fr/inserm-00921158
http://www.hal.inserm.fr/inserm-00921158/document
http://www.hal.inserm.fr/inserm-00921158/file/2013_Nacher_-_Predictive_factorssur herpes_zoster.pdf
DOI : 10.1371/journal.pone.0080187

Éditeur(s) : HAL CCSD
Résumé : International audience
Background: Guadeloupe is the region of France with the second highest prevalence of HIV. Methods: To determine the risk factors for being lost to follow-up (LFU), a retrospective cohort study of 2,732 patients followed between 1988 and 2009 was conducted, and determined which variables were related to being LFU, i.e. permanently disappearing from HIV clinics or coming back after more than one year of missed appointments. Results: The incidence rate for permanent follow-up interruption was 9 per 100 person-years (8.3-9.7 personyears). The median time of LFU was 6.4 years (interquartile range 3-16.9 years). Cox modelling showed that the younger age groups (HR: 1.60[1.30-2.10], p=0.000) and patients diagnosed before 1997 (HR: 4.80[3.50-6.50], p=0.000) were significantly more likely to be permanently LFU. However, patients treated with HAART had a lower risk of being LFU (HR: 0.63[0.51-0.80], p=0.000). Conclusion: These results suggest that some patients may have died. They also allow to quantify the magnitude of a major yet often under-recognized problem and to identify its predictors in the context of Guadeloupe. This could help clinicians improve patient retention.
J AIDS Clin Res

inserm-00915235
http://www.hal.inserm.fr/inserm-00915235
http://www.hal.inserm.fr/inserm-00915235/document
http://www.hal.inserm.fr/inserm-00915235/file/2013_Elenga_-_Incidence_and_Risk_Factors_for_Follow-Up_Interruptionsur HIV-Infected_patients_guadeloupe.pdf
DOI : 10.4172/2155-6113.1000238

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
ISSN: 0020-7292

inserm-01065103
http://www.hal.inserm.fr/inserm-01065103
http://www.hal.inserm.fr/inserm-01065103/document
http://www.hal.inserm.fr/inserm-01065103/file/Figure.pdf
http://www.hal.inserm.fr/inserm-01065103/file/2013_Douine_-_Survival_cervical.pdf

Éditeur(s) : HAL CCSD BMJ Publishing Group
Résumé : International audience
Objective The potential impact of environmental exposure to pyrethroid insecticides on child neurodevelopment has only just started to receive attention despite their widespread use. We investigated the associations between prenatal and childhood exposure to pyrethroid insecticides and behavioural skills in 6-year-olds. Methods The PELAGIE cohort enrolled 3421 pregnant women from Brittany, France between 2002 and 2006. 428 mothers were randomly selected for the study when their children turned 6, and 287 (67%) agreed to participate. Children's behaviour was assessed using the Strengths and Difficulties Questionnaire (SDQ). Three subscales (prosocial behaviour, internalising disorders and externalising disorders) were considered. Five pyrethroid metabolites were measured in maternal and child urine samples collected between 6 and 19 gestational weeks and at 6 years of age, respectively. Logistic regression and reverse-scale Cox regression models were used to estimate the associations between SDQ scores and urinary pyrethroid metabolite concentrations, adjusting for organophosphate metabolite concentrations and potential confounders. Results Increased prenatal cis-3-(2,2-dichlorovinyl)-2,2dimethylcyclopropane carboxylic acid (DCCA) concentrations were associated with internalising difficulties (Cox p value=0.05). For childhood 3phenoxybenzoic acid (PBA) concentrations, a positive association was observed with externalising difficulties (Cox p value=0.04) and high ORs were found for abnormal or borderline social behaviour (OR 2.93, 95% CI 1.27 to 6.78, and OR 1.91, 95% CI 0.80 to 4.57, for the intermediate and highest metabolite categories, respectively). High childhood trans-DCCA concentrations were associated with reduced externalising disorders (Cox p value=0.03). Conclusions The present study suggests that exposure to certain pyrethroids, at environmental levels, may negatively affect neurobehavioral development by 6 years of age.
ISSN: 1351-0711

hal-01519255
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01519255
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01519255/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01519255/file/Behavioural%20disorders%20in%206-year-old%20children_JFViel_HAL.pdf
DOI : 10.1136/oemed-2016-104035

Éditeur(s) : HAL CCSD Lippincott, Williams & Wilkins
Résumé : International audience
BACKGROUND: People in developed countries are widely exposed to low levels of organochlorine pesticides, polychlorinated biphenyls (PCBs), and polybrominated diphenyl ethers (PBDEs). Seafood is a major contributor to PCB exposure. Toxicity of those various pollutants to reproductive and endocrine functions raises questions about possible effects on fertility. We explored whether serum levels of these pollutants and seafood consumption were associated with the fertility of couples enrolled in a French birth cohort (PELAGIE). METHODS: Time-to-pregnancy was investigated in 3,421 pregnant women by asking how many months they had taken to conceive. Levels of 14 organochlorine pesticides, 12 PCBs, and 10 PBDE compounds were measured in cord blood serum from a random subcohort (n = 394). Mercury concentrations measured in maternal hair were considered as a potential coexposure. Fecundability odds ratios (ORs) were estimated from multivariate discrete-time Cox proportional hazard models. RESULTS: Shellfish consumption was associated with longer time-to-pregnancy (fecundability OR ≥twice/week vs. 0.410 µg/L vs. <0.266 µg/L, fecundability OR = 0.46 [0.32-0.66]). In multiple sensitivity analyses, reduced fecundability was most consistently associated with shellfish consumption, p,p'-DDE, total PCBs, PCB153, and PCB187. Models that simultaneously included multiple coexposure factors led to similar conclusions. CONCLUSIONS: Our findings were robust in sensitivity analyses, including analysis restricted to primiparous women. These results suggest that PCBs, p,p'-DDE, and other shellfish contaminants may impair human fertility.
ISSN: 1044-3983

inserm-00826533
http://www.hal.inserm.fr/inserm-00826533
DOI : 10.1097/EDE.0b013e31827f53ec
PUBMED : 23348067

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Purpose: Active surveillance is a treatment option for favorable risk prostate cancer. However, data are missing on populations of African descent. We evaluated the safety and benefit of active surveillance in an African Caribbean cohort with favorable risk prostate cancer. Materials and Methods: Between 2005 and 2016, a single center, prospective cohort study was performed in Guadeloupe, French West Indies, including patients on active surveillance who had low risk prostate cancer (prostate specific antigen 10 ng/ml or less and Gleason score 6 or less) or favorable intermediate risk prostate cancer (prostate specific antigen 10 to 20 ng/ml, Gleason score 3 + 4 or less and life expectancy less than 10 years). Treatment was recommended in case of grade progression, increased tumor volume, prostate cancer doubling time less than 36 months or patient wish. Overall survival, disease specific survival and duration of active surveillance were calculated with the KaplanMeier method. Multivariate analysis was performed using the Cox proportional hazards model to identify predictors of active surveillance termination. Results: A total of 234 patients with a median age of 64 years were enrolled in study. Median followup was 4 years (IQR 2.3-5.5). Overall survival at 30 months, 5 years and 10 years was 99.5%, 98.5% and 90.7%, respectively. Disease specific survival at 30 months, and 5 and 10 years was 100%. At 30 months, 5 years and 10 years 72.7%, 52.6% and 40.4% of patients, respectively, remained untreated and on active surveillance. Age (HR 0.96 per additional year, 95% CI 0.93-0.99) and prostate specific antigen density (HR 1.52 per additional 0.1 ng/ml, 95% CI 1.20-1.89) were found to be independent predictors of active surveillance termination. Conclusions: Active surveillance is safe and beneficial for highly selected African Caribbean patients. It seems to be feasible for patients at low risk and intermediate favorable risk. Prostate specific antigen density could help better select these patients.
ISSN: 0022-5347

hal-01519251
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01519251
DOI : 10.1016/j.juro.2016.12.047
PUBMED : 27993665

Résumé : Les processus ponctuels sont souvent utilisés comme modèles de répartitions spatiales ou spatio-temporelles d'occurrences Dans cette thèse, nous nous intéressons à des processus de Cox dirigés par un processus caché associé à un processus de Dirichlet. Ce modèle correspond à des occurrences cachées influençant l'intensité stochastique des occurrences observées. Nous généralisons la notion de Shot noise Cox process et développons le traitement bayésien. Nous focalisons l'inférence statistique sur l'estimation de la valeur espérée de chaque contribution cachée, leur nombre espéré, degré d'influence spatiale et degré de corrélation L'utilité en épidémiologie et en écologie est démontrée à partir de données de Rubus fruticosa, lbicella lutea et de mortalité dans les cantons de Georgie, USA. En termes de données observées, deux situations sont considérées: d'abord, les positions spatiales des occurrences sont observées entre plusieurs paires de dates consécutives; puis, des comptages sont effectués dans des unités d'échantillonnage spatiales. D'autre part, nous nous intéressons aux processus ponctuels à mémoire introduits par Kagan, Ogata et Vere-Jones. En effet, les processus ponctuels ont une place importante dans l'étude des catalogues sismiques. Nous avons étudié un modèle Epidemie Type Aftershock Sequence avec une intensité d'arrière-plan indépendante du temps et plusieurs fonctions déclenchantes permettant d'intégrer les événements antérieurs récents. Cette approche est utilisée pour étudier la sismicité des Petites Antilles. Une étude comparative des modèles Gamma, Weibull, Log-Normal et loi d'Omori modifiée pour les fonctions déclenchantes est menée.
Point processes are often used as spatial or spatio-temporal distribution models of occurrences. In this Phd dissertation, we focus first on Cox processes driven by a hidden process associated with a Dirichlet process. This model corresponds to hidden occurrences influencing the stochastic intensity of observed occurrences. We generalize the notion of Shot noise Cox process and develop its bayesian analysis. We focus the statistical inference on the estimation of the hidden contribution expected value, the hidden contribution expected number, the spatial influence and correlation parameters. Applications in epidemiology and ecology are shown from Rubus fruticosa data, Ibicella lutea data and death number data in counties of Georgia, USA. Two situations are considered with respect to available data: firstly, the spatial positions of occurrences are observed between several pairs of consecutive dates; secondly, counts are carried out over a fixed time interval in several spatial sampling units. Secondly, we focus on point processes with memory intr oduced by Kagan, Ogata and Vere-Jones. Spatio-temporal point processes play an important role in the studies of earthquake catalogs since they consist of seismic events with their dates and spatial locations. We studied an Epidemic Type Aftershock Sequence model with time independent background intensity and several triggering functions taking into account previous events. We illustrate our approach with a seismicity study of the Lesser Antilles arc. A comparaison study of Gamma, Weibull, Log-Normal and modified Omori law triggering function models is also carried out

http://www.theses.fr/2012AGUY0555/document

Éditeur(s) : HAL CCSD International Medical Press
Résumé : International audience
BACKGROUND: Psychiatric disorders are relatively common among HIV-infected patients. However, there are few studies about their potential risk factors. This analysis aimed to measure the incidence of severe psychiatric events (PE) among patients receiving combination antiretroviral therapy (cART) of the French APROCO-COPILOTE (ANRS CO8) cohort, and to identify the medical and socio-behavioural correlates of their first episode of depression, suicide or suicide attempt (D/S/SA). METHODS: APROCO-COPILOTE is a cohort of patients started on a protease inhibitor regimen between 1997 and 1999, with prospective medical standardized records and self-administered questionnaires collecting socio-demographic and socio-behavioural data. This analysis included all 11-year follow-up visits for 1,095 patients having completed baseline self-administered questionnaires. A proportional hazard Cox model was used to identify the correlates of a first D/S/SA event. RESULTS: The overall prevalence of severe PE remained low: 50 patients experienced 67 events (incidence rate [95% CI] =1.04 [0.82, 1.32] per 100 person-years). Depression (n=16), suicides (n=5) and suicide attempts (n=14) were the most frequently diagnosed PE (0.54 [0.39, 0.76] per 100 person-years) among 25 patients. Multivariate results showed that unemployment, unstable housing, detectable viral load and smoking more than 20 cigarettes/day were independently associated with D/S/SA. CONCLUSIONS: Although the incidence of severe PE remained relatively low among the patients of APROCO-COPILOTE cohort, this study's results underline a clinically important problem in HIV-infected patients receiving cART. Furthermore, our findings not only emphasize the importance of comprehensive care, especially for socially vulnerable patients, but may also help future studies designed to assess the effectiveness of interventions in reducing the risk of PE during cART.
ISSN: 1359-6535

hal-00875183
https://hal.archives-ouvertes.fr/hal-00875183
DOI : 10.3851/IMP2102
PUBMED : 22544079

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 IJCA
Résumé : International audience
International Journal of Computer Applications

hal-01010081
https://hal.archives-ouvertes.fr/hal-01010081
DOI : 10.5120/16691-6825

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Introduction: The selection of patients with metastatic clear cell renal cell carcinoma (ccRCC) who may benefit from targeted tyrosine kinase inhibitors has been a challenge, even more so now with the advent of new therapies. Hilar fat infiltration (HFI) is a validated prognostic factor in nonmetastatic ccRCC (TNM 2009 staging system) but has never been studied in metastatic patients. We aimed to assess its phenotype and prognostic effect in patients with metastatic ccRCC treated with first-line sunitinib.Materials and methods: In a multicentric study, we retrospectively included 90 patients and studied the corresponding ccRCC at the pathological, immunohistochemical, and molecular levels. Patient and tumor characteristics were compared using univariate and multivariate analysis. All the features were then studied by Cox models for prognostic effect.Results: HFI was found in 42 patients (46.7%), who had worse prognosis (Heng criteria) (P = 0.003), liver metastases (P = 0.036), and progressive diseases at first radiological evaluation (P = 0.024). The corresponding ccRCC was associated with poor pathological prognostic factors that are well known in nonmetastatic ccRCC. For these patients, median progression-free survival was 4 months vs. 13 months (P = 0.02), and median overall survival was 14 months vs. 29 months (P = 0.006). In a multivariate Cox model integrating all the variables, only poor prognosis, according to the Heng criteria and HFI, remained independently associated with both progression-free survival and overall survival.Conclusion: HFI was demonstrated for the first time to be an independent poor prognostic factor. Its potential role in predicting resistance to antiangiogenic therapy warrants further investigation.
ISSN: 1078-1439

hal-01632553
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01632553
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01632553/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01632553/file/Hilar%20fat%20infiltration_accepted.pdf
DOI : 10.1016/j.urolonc.2017.05.015

Éditeur(s) : HAL CCSD National Institute of Environmental Health Sciences
Résumé : International audience
BACKGROUND: Glycol ethers are present in a wide range of occupational and domestic products. Animal studies have suggested that some of them may affect ovarian function. OBJECTIVE: To study the relation between women's exposure to glycol ethers and time to pregnancy. METHODS: Urine from randomly selected women in the PELAGIE mother-child cohort who had samples collected before 19 weeks of gestation was tested to measure eight glycol ether metabolites by chromatography coupled to mass spectrometry. Time to pregnancy was collected at the beginning of the pregnancy by asking women how many months they took to conceive. Associations between metabolite levels and time to pregnancy were estimated in 519 women with complete data using discrete-time Cox proportional hazards models to adjust for potential confounders. RESULTS: Glycol ether metabolites were detected in 6% (for ethoxyacetic acid) to 93% (for phenoxyacetic and butoxyacetic acids) of urine samples. Phenoxyacetic acid was the only metabolite with a statistically significant association with longer time to pregnancy (fecundability OR 0.82; 95% CI: 0.63, 1.06 for the second and third quartile combined; fecundability OR 0.70; 95% CI: 0.52, 0.95 for a fourth-quartile (≥1.38 mg/L) vs. first-quartile concentration (<0.14 mg/L)). This association remained stable after multiple sensitivity analyses. CONCLUSION: Phenoxyacetic acid, which was present in most of the urine samples tested in our study, was associated with increased time to pregnancy. This metabolite and its main parent compound, 2-phenoxyethanol, are plausible causes of decreased fecundability, but may also be surrogates for potential co-exposures frequently present in cosmetics.
ISSN: 0091-6765

hal-00866023
https://hal-univ-rennes1.archives-ouvertes.fr/hal-00866023
https://hal-univ-rennes1.archives-ouvertes.fr/hal-00866023/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-00866023/file/Urinary_Glycol_Ether-accepted.pdf
DOI : 10.1289/ehp.1206103

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Long-term exposure to air pollution (AP) has been shown to have an impact on mortality in numerous countries, but since 2005 no data exists for France. We analyzed the association between long-term exposure to air pollution and mortality at the individual level in a large French cohort followed from 1989 to 2013. The study sample consisted of 20,327 adults working at the French national electricity and gas company EDF-GDF. Annual exposure to PM10, PM10–2.5, PM2.5, NO2, O3, SO2, and benzene was assessed for the place of residence of participants using a chemistry-transport model and taking residential history into account. Hazard ratios were estimated using a Cox proportional-hazards regression model, adjusted for selected individual and contextual risk factors. Hazard ratios were computed for an interquartile range (IQR) increase in air pollutant concentrations. The cohort recorded 1967 non-accidental deaths. Long-term exposures to baseline PM2.5, PM10-25, NO2 and benzene were associated with an increase in non-accidental mortality (Hazard Ratio, HR = 1.09; 95% CI: 0.99, 1.20 per 5.9 μg/m3, PM10-25; HR = 1.09; 95% CI: 1.04, 1.15 per 2.2 μg/m3, NO2: HR = 1.14; 95% CI: 0.99, 1.31 per 19.3 μg/m3 and benzene: HR = 1.10; 95% CI: 1.00, 1.22 per 1.7 μg/m3).The strongest association was found for PM10: HR = 1.14; 95% CI: 1.05, 1.25 per 7.8 μg/m3. PM10, PM10-25 and SO2 were associated with non-accidental mortality when using time varying exposure. No significant associations were observed between air pollution and cardiovascular and respiratory mortality. Long-term exposure to fine particles, nitrogen dioxide, sulfur dioxide and benzene is associated with an increased risk of non-accidental mortality in France. Our results strengthen existing evidence that outdoor air pollution is a significant environmental risk factor for mortality. Due to the limited sample size and the nature of our study (occupational), further investigations are needed in France with a larger representative population sample.
ISSN: 0160-4120

hal-01187145
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01187145
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01187145/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01187145/file/Association%20between%20long-term%20exposure%20to%20air%20pollution%20and%20mortality_accepted.pdf
DOI : 10.1016/j.envint.2015.08.006

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
UNLABELLED: ABSTRACT: BACKGROUND: Malaria is a major health issue in French Guiana. Amerindian communities remain the most affected. A previous study in Camopi highlighted the predominant role of environmental factors in the occurrence of malaria. However, all parameters involved in the transmission were not clearly identified. A new survey was conducted in order to clarify the risk factors for the presence of malaria cases in Camopi. METHODS: An open cohort of children under seven years of age was set up on the basis of biologically confirmed malaria cases for the period 2001-2009. Epidemiological and observational environmental data were collected using two structured questionnaires. Data were analysed with a multiple failures multivariate Cox model. The influence of climate and the river level on malaria incidence was evaluated by time-series analysis. Relationships between Anopheles darlingi human biting rates and malaria incidence rates were estimated using Spearman's rank correlation. RESULTS: The global annual incidence over the nine-year period was 238 per 1,000 for Plasmodium falciparum, 514 per 1,000 for Plasmodium visa and 21 per 1,000 for mixed infections. The multivariate survival analysis associated higher malaria incidence with living on the Camopi riverside vs. the Oyapock riverside, far from the centre of the Camopi hamlet, in a home with numerous occupants and going to sleep late. On the contrary, living in a house cleared of all vegetation within 50 m and at high distance of the forest were associated with a lower risk. Meteorological and hydrological characteristics appeared to be correlated with malaria incidence with different lags. Anopheles darlingi human biting rate was also positively correlated to incident malaria in children one month later. CONCLUSIONS: Malaria incidence in children remains high in young children despite the appearance of immunity in children around three years of age. The closeness environment but also the meteorological parameters play an important role in malaria transmission among children under seven years of age in Camopi.
ISSN: 1475-2875

inserm-00633771
http://www.hal.inserm.fr/inserm-00633771
http://www.hal.inserm.fr/inserm-00633771/document
http://www.hal.inserm.fr/inserm-00633771/file/1475-2875-10-246.pdf
DOI : 10.1186/1475-2875-10-246

Éditeur(s) : HAL CCSD
Résumé : International audience
Les processus ponctuels temporel, spatial et spatio-temporel permettent de décrire divers phénomènes consistant en des distributions d'événements : on peut citer les occurrences d'infection en épidémiologie, les épicentres en sismologie, ou les décharges électriques en neurologie. Dans le cadre de la détection de la résurgence de maladies, nous considérons un processus doublement stochastique (Cox) défini par son processus intensité spatio-temporel. Il s'agit d'un modèle hiérarchique spatio-temporel à trois composantes pour la fonction d'intensité : un effet spatial, une tendance temporelle et un effet spatio-temporel. Des études par simulations numériques sont menées afin de vérifier la performance des estimateurs proposés
41èmes Journées de Statistique, SFdS, Bordeaux
Bordeaux, France, France

inria-00386679
https://hal.inria.fr/inria-00386679
https://hal.inria.fr/inria-00386679/document
https://hal.inria.fr/inria-00386679/file/p118.pdf

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
BACKGROUND: Socioeconomic inequalities in cancer mortality have been observed in different European countries and the US until the end of the 1990s, with changes over time in the magnitude of these inequalities and contrasted situations between countries. The aim of this study is to estimate relative and absolute educational differences in cancer mortality in France between 1999 and 2007, and to compare these inequalities with those reported during the 1990s. METHODS: Data from a representative sample including 1% of the French population were analysed. Educational differences among people aged 30--74 were quantified with hazard ratios and relative indices of inequality (RII) computed using Cox regression models as well as mortality rate difference and population attributable fraction. RESULTS: In the period 1999--2007, large relative inequalities were found among men for total cancer and smoking and/or alcohol related cancers mortality (lung, head and neck, oesophagus). Among women, educational differences were reported for total cancer, head and neck and uterus cancer mortality. No association was found between education and breast cancer mortality. Slight educational differences in colorectal cancer mortality were observed in men and women. For most frequent cancers, no change was observed in the magnitude of relative inequalities in mortality between the 1990s and the 2000s, although the RII for lung cancer increased both in men and women. Among women, a large increase in absolute inequalities in mortality was observed for all cancers combined, lung, head and neck and colorectal cancer. In contrast, among men, absolute inequalities in mortality decreased for all smoking and/or alcohol related cancers. CONCLUSION: Although social inequalities in cancer mortality are still high among men, an encouraging trend is observed. Among women though, the situation regarding social inequalities is less favourable, mainly due to a health improvement limited to higher educated women. These inequalities may be expected to further increase in future years.
ISSN: 1471-2458

inserm-00868759
http://www.hal.inserm.fr/inserm-00868759
http://www.hal.inserm.fr/inserm-00868759/document
http://www.hal.inserm.fr/inserm-00868759/file/1471-2458-13-823.pdf
DOI : 10.1186/1471-2458-13-823

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

Éditeur(s) : HAL CCSD Oxford University Press (OUP)
Résumé : International audience
OBJECTIVES: To compare virological effectiveness in patients who continued on a virologically successful first-line boosted protease inhibitor (PI)-containing combination antiretroviral therapy (cART) regimen or who switched to a PI-free cART including efavirenz, nevirapine or abacavir. METHODS: From the French Hospital Database on HIV, we selected 439 patients with undetectable viral load (VL) on a first-line boosted PI-containing cART regimen who switched to a PI-free combination including efavirenz, nevirapine or abacavir. Each of these patients was matched with three patients who continued to take their first-line cART regimen, on the basis of gender, age, CD4 cell count, VL, date of cART initiation and the duration of VL undetectability. Time to virological failure (VF) was analysed with Kaplan-Meier curves and Cox models. RESULTS: The 12 month probabilities of VF were 3.7% and 5.7% in non-switch and switch patients, respectively, and 3.9%, 7.2% and 9.0% in patients switching to efavirenz-, nevirapine- and abacavir-containing cART, respectively. After adjustment, only patients switching to abacavir-containing cART had a higher risk of VF than non-switch patients (adjusted hazard ratio, 1.99; 95% confidence interval, 1.05-3.79). CONCLUSIONS: Switching from a virologically successful first-line boosted PI-containing cART regimen to a non-nucleoside reverse transcriptase inhibitor-containing cART regimen containing either efavirenz or nevirapine is virologically safe, while switching to abacavir-containing cART should be avoided.
ISSN: 0305-7453

hal-00875284
https://hal.archives-ouvertes.fr/hal-00875284
DOI : 10.1093/jac/dkr208
PUBMED : 21636583