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Johns E, Alkanj A, Beck M, Dal Mas L, Gourieux B, Sauleau EA, Michel B. Using machine learning or deep learning models in a hospital setting to detect inappropriate prescriptions: a systematic review. Eur J Hosp Pharm 2023:ejhpharm-2023-003857. [PMID: 38050067 DOI: 10.1136/ejhpharm-2023-003857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/07/2023] [Indexed: 12/06/2023] Open
Abstract
OBJECTIVES The emergence of artificial intelligence (AI) is catching the interest of hospital pharmacists. A massive collection of health data is now available to train AI models and hold the promise of disrupting codes and practices. The objective of this systematic review was to examine the state of the art of machine learning or deep learning models that detect inappropriate hospital medication orders. METHODS A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. MEDLINE and Embase databases were searched from inception to May 2023. Studies were included if they reported and described an AI model intended for use by clinical pharmacists in hospitals. Risk of bias was assessed using the Prediction model Risk Of Bias ASsessment Tool (PROBAST). RESULTS 13 articles were selected after review: 12 studies were judged to have high risk of bias; 11 studies were published between 2020 and 2023; 8 were conducted in North America and Asia; 6 analysed orders and detected inappropriate prescriptions according to patient profiles and medication orders; and 7 detected specific inappropriate prescriptions, such as detecting antibiotic resistance, dosage abnormality in prescriptions, high alert drugs errors from prescriptions or predicting the risk of adverse drug events. Various AI models were used, mainly supervised learning techniques. The training datasets used were very heterogeneous; the length of study varied from 2 weeks to 7 years and the number of prescription orders analysed went from 31 to 5 804 192. CONCLUSIONS This systematic review points out that, to date, few original research studies report AI tools based on machine or deep learning in the field of hospital clinical pharmacy. However, these original articles, while preliminary, highlighted the potential value of integrating AI into clinical hospital pharmacy practice.
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Affiliation(s)
- Erin Johns
- Direction de la Qualité, de la Performance et de l'Innovation, Agence Régionale de Santé Grand Est Site de Strasbourg, Strasbourg, Grand Est, France
- IMAGeS, Laboratoire des Sciences de l'Ingénieur de l'Informatique et de l'Imagerie, Illkirch, Grand Est, France
| | - Ahmad Alkanj
- Laboratoire de Pharmacologie et de Toxicologie Neurocardiovasculaire, Université de Strasbourg, Strasbourg, Grand Est, France
| | - Morgane Beck
- Direction de la Qualité, de la Performance et de l'Innovation, Agence Régionale de Santé Grand Est Site de Strasbourg, Strasbourg, Grand Est, France
| | - Laurent Dal Mas
- Direction de la Qualité, de la Performance et de l'Innovation, Agence Régionale de Santé Grand Est Site de Strasbourg, Strasbourg, Grand Est, France
| | - Benedicte Gourieux
- Laboratoire de Pharmacologie et de Toxicologie Neurocardiovasculaire, Université de Strasbourg, Strasbourg, Grand Est, France
- Service Pharmacie - Stérilisation, Les Hopitaux Universitaires de Strasbourg, Strasbourg, Grand Est, France
| | - Erik-André Sauleau
- IMAGeS, Laboratoire des Sciences de l'Ingénieur de l'Informatique et de l'Imagerie, Illkirch, Grand Est, France
- Département de Santé Publique - Groupe Méthodes Recherche Clinique, Les Hopitaux Universitaires de Strasbourg, Strasbourg, Grand Est, France
| | - Bruno Michel
- Laboratoire de Pharmacologie et de Toxicologie Neurocardiovasculaire, Université de Strasbourg, Strasbourg, Grand Est, France
- Service Pharmacie - Stérilisation, Les Hopitaux Universitaires de Strasbourg, Strasbourg, Grand Est, France
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Fabacher T, Sauleau EA, Leclerc Du Sablon N, Bergier H, Gottenberg JE, Coulet A, Névéol A. Evaluating the Portability of Rheumatoid Arthritis Phenotyping Algorithms: A Case Study on French EHRs. Stud Health Technol Inform 2023; 302:768-772. [PMID: 37203492 DOI: 10.3233/shti230263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Previous work has successfully used machine learning and natural language processing for the phenotyping of Rheumatoid Arthritis (RA) patients in hospitals within the United States and France. Our goal is to evaluate the adaptability of RA phenotyping algorithms to a new hospital, both at the patient and encounter levels. Two algorithms are adapted and evaluated with a newly developed RA gold standard corpus, including annotations at the encounter level. The adapted algorithms offer comparably good performance for patient-level phenotyping on the new corpus (F1 0.68 to 0.82), but lower performance for encounter-level (F1 0.54). Regarding adaptation feasibility and cost, the first algorithm incurred a heavier adaptation burden because it required manual feature engineering. However, it is less computationally intensive than the second, semi-supervised, algorithm.
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Affiliation(s)
- Thibaut Fabacher
- University hospital of Strasbourg, France
- ICube Laboratory, Strasbourg, France
- Inria Paris, France
- Centre de Recherche des Cordeliers, Inserm, Université Paris Cité, France
| | - Erik-André Sauleau
- University hospital of Strasbourg, France
- ICube Laboratory, Strasbourg, France
| | | | | | | | - Adrien Coulet
- Inria Paris, France
- Centre de Recherche des Cordeliers, Inserm, Université Paris Cité, France
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Collinet A, Ntilikina Y, Romani A, Schuller S, Sauleau EA, Charles YP. Psychopathological profile and sagittal alignment in low-back pain. Orthop Traumatol Surg Res 2023; 109:103474. [PMID: 36347460 DOI: 10.1016/j.otsr.2022.103474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 04/13/2022] [Accepted: 05/09/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Low-back pain requires comprehensive care using a biopsychosocial model. The psychologic dimension plays an important role, but the link between sagittal alignment and a given psychopathological profile is little studied. The aim of this study was to analyze the psychopathological profiles and sagittal parameters of a population with low-back pain and to assess the link. MATERIAL AND METHODS 205 patients, with a mean age of 49.6 years (range, 18-70 years), presenting chronic common low-back pain without radicular involvement, were included prospectively. Mood scores comprised: the self-administered "Hospital Anxiety and Depression Scale" (HAD), Hamilton Anxiety Scale (HAM-A), Hamilton Depression Scale (HAM-D) and Young Mania Rating Scale (YMRS). Radiological parameters, measured on lateral full-spine radiographs, included: L1-S1 lordosis, T1-T12 kyphosis, pelvic incidence, pelvic tilt, sacral slope, sagittal vertical axis (SVA), T1 slope, and Roussouly type. RESULTS Mean HAM-A score was 16.1; 54% of patients had scores ≥14, indicating anxiety disorder. Mean HAM-D score was 10.8; 55% of patients had scores ≥10, indicating depressive disorder. Mean YMRS score was 2.6; only 1 patient had a score ≥20, indicating manic disorder. The 112 patients with HAM-A score >14 showed mean 51.6° L1-S1 lordosis (p=0.356), 48.3° T1-T12 kyphosis (p=0.590), -4.3mm C7 SVA (p=0.900), and 29.3° T1 slope (p=0.451). In case of HAM-A <14, there were no significant differences. The 113 patients with HAM-D score >10 showed significant differences in T1-T12 kyphosis (mean 49.0°; p<0.05) and T1 slope (30.2°; p<0.05); mean L1-S1 lordosis was 50.5° (p=0.861) and C7 SVA 1.6mm (p=0.462). In case of HAM-D <10, T1-T12 kyphosis was 45.5° (p<0.05) and T1 slope 26.2° (p<0.05); mean lordosis was 50.9° (p=0.861) and mean C7 SVA -7.1mm (p=0.259). Multivariate analysis found no significant link between Roussouly type and psychiatric scores: HAD (p=0.715), HAM-A (p=0.652), and HAM-D (p=0.902). CONCLUSION More than 50% of patients with common low-back pain presented a mood disorder. Depressive disorder was associated with greater T1-T12 kyphosis and T1 slope. There was no relationship between psychiatric scores and overall sagittal alignment. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Arnaud Collinet
- Service de chirurgie du rachis, hôpitaux universitaires de Strasbourg, université de Strasbourg, hôpital Hautepierre 2, 1, avenue Molière, 67200 Strasbourg, France.
| | - Yves Ntilikina
- Service de chirurgie du rachis, hôpitaux universitaires de Strasbourg, université de Strasbourg, hôpital Hautepierre 2, 1, avenue Molière, 67200 Strasbourg, France
| | - Aude Romani
- Service de chirurgie du rachis, hôpitaux universitaires de Strasbourg, université de Strasbourg, hôpital Hautepierre 2, 1, avenue Molière, 67200 Strasbourg, France
| | - Sébastien Schuller
- Service de chirurgie du rachis, hôpitaux universitaires de Strasbourg, université de Strasbourg, hôpital Hautepierre 2, 1, avenue Molière, 67200 Strasbourg, France
| | - Erik-André Sauleau
- Pôle santé publique, hôpitaux universitaires de Strasbourg, université de Strasbourg, Strasbourg, France
| | - Yann Philippe Charles
- Service de chirurgie du rachis, hôpitaux universitaires de Strasbourg, université de Strasbourg, hôpital Hautepierre 2, 1, avenue Molière, 67200 Strasbourg, France
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Mandja BA, Handschumacher P, Bompangue D, Gonzalez JP, Muyembe JJ, Sauleau EA, Mauny F. Environmental Drivers of Monkeypox Transmission in the Democratic Republic of the Congo. Ecohealth 2022; 19:354-364. [PMID: 36029356 DOI: 10.1007/s10393-022-01610-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
Monkeypox (MPX) is an emergent severe zoonotic disease resembling that of smallpox. To date, most cases of human MPX have been reported in the Democratic Republic of the Congo (DRC). While the number of cases has increased steadily in the DRC over the last 30 years, the environmental risk factors that drive the spatiotemporal dynamics of MPX transmission remain poorly understood. This study aimed to investigate the spatiotemporal associations between environmental risk factors and annual MPX incidence in the DRC. All MPX cases reported weekly at the health zone level over a 16-year period (2000-2015) were analyzed. A Bayesian hierarchical generalized linear mixed model was conducted to identify the spatiotemporal associations between annual MPX incidence and three types of environmental risk factors illustrating environment as a system resulting from physical, social and cultural interactions Primary forest (IRR 1.034 [1.029-1.040]), economic well-being (IRR 1.038 [1.031-1.047]), and temperature (IRR 1.143 [1.028-1.261]) were positively associated with annual MPX incidence. Our study shows that physical environmental risk factors alone cannot explain the emergence of MPX outbreaks in the DRC. Economic level and cultural practices participate from environment as a whole and thus, must be considered to understand exposure to MPX risk Future studies should examine the impact of these factors in greater detail.
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Affiliation(s)
- Bien-Aimé Mandja
- Département des Sciences de Base, Service d'Écologie et Contrôle des Maladies Infectieuses, Faculté de Médecine, Université de Kinshasa, Quartier Lemba, BP 834 KIN XI, Kinshasa, Democratic Republic of the Congo.
- Laboratoire Chrono-Environnement, UMR 6249 CNRS, Université de Bourgogne Franche-Comté, Besançon, France.
| | | | - Didier Bompangue
- Département des Sciences de Base, Service d'Écologie et Contrôle des Maladies Infectieuses, Faculté de Médecine, Université de Kinshasa, Quartier Lemba, BP 834 KIN XI, Kinshasa, Democratic Republic of the Congo
- Laboratoire Chrono-Environnement, UMR 6249 CNRS, Université de Bourgogne Franche-Comté, Besançon, France
| | - Jean-Paul Gonzalez
- Department of Microbiology and Immunology, Division of Biomedical Graduate Research Organization, Georgetown University School of Medicine, 4000 Reservoir Road, Washington, DC, 20057, USA
| | - Jean-Jacques Muyembe
- Département des Sciences de Base, Service d'Écologie et Contrôle des Maladies Infectieuses, Faculté de Médecine, Université de Kinshasa, Quartier Lemba, BP 834 KIN XI, Kinshasa, Democratic Republic of the Congo
- Institut National de Recherche Biomédicale, Gombe, Kinshasa, Democratic Republic of the Congo
| | - Erik-André Sauleau
- Laboratoire de Biostatistique et Informatique Médicale, Faculté de Médecine, Laboratoire ICube UMR CNRS 7357, Université de Strasbourg, Strasbourg, France
| | - Frédéric Mauny
- Laboratoire Chrono-Environnement, UMR 6249 CNRS, Université de Bourgogne Franche-Comté, Besançon, France
- Centre Hospitalier Universitaire de Besançon, uMETh Inserm CIC 1431, Besançon, France
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Risser C, Tran Ba Loc P, Binder-Foucard F, Fabacher T, Lefèvre H, Sauvage C, Sauleau EA, Wolff V. COVID-19 Impact on Stroke Admissions during France's First Epidemic Peak: An Exhaustive, Nationwide, Observational Study. Cerebrovasc Dis 2022; 51:663-669. [PMID: 35358979 PMCID: PMC9058998 DOI: 10.1159/000523685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/13/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction The coronavirus disease 2019 (COVID-19) pandemic continues to have great impacts on the care of non-COVID-19 patients. This was especially true during the first epidemic peak in France, which coincided with the national lockdown. The aim of this study was to identify whether a decrease in stroke admissions occurred in spring 2020, by analyzing the evolution of all stroke admissions in France from January 2019 to June 2020. Methods We conducted a nationwide cohort study using the French national database of hospital admissions (Information Systems Medicalization Program) to extract exhaustive data on all hospitalizations in France with at least one stroke diagnosis between January 1, 2019, and June 30, 2020. The primary endpoint was the difference in the slope gradients of stroke hospitalizations between pre-epidemic, epidemic peak, and post-epidemic peak phases. Modeling was carried out using Bayesian techniques. Results Stroke hospitalizations dropped from March 10, 2020 (slope gradient: −11.70), and began to rise again from March 22 (slope gradient: 2.090) to May 7. In total, there were 23,873 stroke admissions during the period March–April 2020, compared to 29,263 at the same period in 2019, representing a decrease of 18.42%. The percentage change was −15.63%, −25.19%, −18.62% for ischemic strokes, transient ischemic attacks, and hemorrhagic strokes, respectively. Discussion/Conclusion Stroke hospitalizations in France experienced a decline during the first lockdown period, which cannot be explained by a sudden change in stroke incidence. This decline is therefore likely to be a direct, or indirect, result of the COVID-19 pandemic.
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Affiliation(s)
- Clémence Risser
- Public Health Department, Strasbourg University Hospital, Strasbourg, France
| | - Pierre Tran Ba Loc
- Public Health Department, Strasbourg University Hospital, Strasbourg, France
| | | | - Thibaut Fabacher
- Public Health Department, Strasbourg University Hospital, Strasbourg, France.,ICube, UMR7357, University of Strasbourg, Strasbourg, France
| | - Hassina Lefèvre
- Public Health Department, Strasbourg University Hospital, Strasbourg, France
| | - Claire Sauvage
- Public Health Department, Strasbourg University Hospital, Strasbourg, France
| | - Erik-André Sauleau
- Public Health Department, Strasbourg University Hospital, Strasbourg, France.,ICube, UMR7357, University of Strasbourg, Strasbourg, France
| | - Valérie Wolff
- Stroke Unit Department, Strasbourg University Hospital, Strasbourg, France.,Mitochondria, Oxidative Stress and Muscle Protection Research Unit (MSP) UR3072, Biomedicine Research Center of Strasbourg (CRBS), Strasbourg, France
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Albrecht P, Perisse J, Sauleau EA, Blanc F. Cognitive reserve as one of the determinants of the progression of Alzheimer disease. Geriatr Psychol Neuropsychiatr Vieil 2022:pnv.2021.1000. [PMID: 35031531 DOI: 10.1684/pnv.2021.1000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
To assess the validity of Yaakov Stern's theory, which postulates that the first cognitive deficits of Alzheimer disease are delayed in patients with high cognitive reserve, compared to those with low cognitive reserve, but this is subsequently associated with faster cognitive decline when cerebral lesions have reached a certain degree of severity. A retrospective study of 318 patients with Alzheimer disease without associated cerebral disorders, was performed at the Memory Clinic of the University Hospital of Strasbourg. The patients were divided into five groups according to their degree of cognitive reserve, as assessed by their level of education (primary, middle school, intermediate, high school and higher education). Cognitive status was assessed by scores on the Mini Mental Status Examination (MMSE) at the first examination and during follow-up lasting four years or longer. Slopes of cognitive decline were computed and compared between groups using ß linear regression. Patients in the higher education group had higher MMSE scores than those in the other groups at the first consultation, but a statistically significant steeper slope during the follow-up. Our results are consistent with Stern's theoretical model, which assumes that high cognitive reserve is accompanied by compensation mechanisms which hinder the onset of clinical cognitive decline in patients with Alzheimer disease, but that is then associated with a faster decline at a later stage when the reserve is exhausted.
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Affiliation(s)
- Pierre Albrecht
- Pôle de gériatrie, CM2R, Hôpitaux universitaires de Strasbourg, France
| | - Jérémie Perisse
- Pôle de gériatrie, CM2R, Hôpitaux universitaires de Strasbourg, France
| | - Erik-André Sauleau
- Département de Santé publique, Groupe méthode en recherche clinique (GRMC), Hôpitaux universitaires de Strasbourg, France, Laboratoire ICube, UMR 7357, Université de Strasbourg et CNRS, Strasbourg, France
| | - Frédéric Blanc
- Pôle de gériatrie, CM2R, Hôpitaux universitaires de Strasbourg, France, Laboratoire ICube, UMR 7357, Université de Strasbourg et CNRS, Strasbourg, France
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Alizada U, Sauleau EA, Krummel T, Moranne O, Kazes I, Couchoud C, Hannedouche T. Effect of emergency start and central venous catheter on outcomes in incident hemodialysis patients: a prospective observational cohort. J Nephrol 2021; 35:977-988. [PMID: 34817835 DOI: 10.1007/s40620-021-01188-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 10/21/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Unfavorable conditions at hemodialysis inception reduce the survival rate. However, the relative contribution to outcomes of predialysis follow-up, symptoms, emergency start or central venous catheter (CVC) is unknown. METHODS We analyzed the determinants of survival according to dialysis initiation conditions in the nationwide REIN registry, using two methods based either on clinical classification or data mining. We divided patients into four groups according to dialysis initiation (emergency vs planned, symptoms or not, previous follow-up). "Followed planned starters" began dialysis as outpatients and with an arteriovenous fistula (AVF). "Followed symptomatic non-urgent starters" were patients who started earlier because of any non-urgent symptomatic event. "Followed urgent starters" had seen a nephrologist before inception but started dialysis in an emergency condition. "Unknown urgent starters" were patients without any follow-up and who had a CVC at inception. RESULTS "Followed urgent" starters had the lowest 2-year survival rate (66.8%) compared to "followed planned" (77.3%), "followed symptomatic non urgent" (79.2%), and "unknown urgent" (71.7%). Compared to other groups, the risk of mortality was lower in followed symptomatic non urgent (HR 0.86 95% CI 0.75-0.99) and higher in followed urgent starters (HR 1.05 (95% CI 0.94-1.18). In data mining Classification And Regression Tree regrouping in five categories, the lowest 2-year survival (52.3%) was in over 70-year-old starters with a CVC. The survival was 93.2% in under 57-year-old patients without active cancer, 82.5% in 57-70-year-old individuals without cancer, 72.4% in over 70-year-old patients without CVC and 61.4% in under 70-year-old subjects with cancer. The hazard ratio of data mining categories varied between 2.12 (95% CI 1.73-2.60) in 57-70-year-old subjects without cancer and 4.42 (95% CI 3.64-5.37) in over 70-year-old patients with CVC. Therefore, regrouping incident patients into five data mining categories, identified by age, cancer, and CVC use, could discriminate the 2-year survival in patients starting hemodialysis. CONCLUSIONS Although each classification captured different prognosis information, both analyses showed that starting hemodialysis on a CVC has more dramatic outcomes than emergency start per se.
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Affiliation(s)
- Ulviyya Alizada
- Public Health Departments, Group Methods in Clinical Research, University Hospital of Strasbourg, Strasbourg, France
| | - Erik-André Sauleau
- Public Health Departments, Group Methods in Clinical Research, University Hospital of Strasbourg, Strasbourg, France.,School of Medicine, University of Strasbourg, Strasbourg, France
| | - Thierry Krummel
- Department of Nephrology, University Hospital of Strasbourg, Strasbourg, France
| | - Olivier Moranne
- Department of Nephrology, University Hospital of Nimes, Nimes, France
| | - Isabelle Kazes
- Department of Nephrology, Regional Coordination of Champagne-Ardenne for Rein Registry, University Hospital of Reims, Reims, France
| | - Cécile Couchoud
- Agency of Biomedicine, National Coordination REIN Registry, Paris, France
| | - Thierry Hannedouche
- School of Medicine, University of Strasbourg, Strasbourg, France. .,Department of Nephrology, University Hospital of Strasbourg, Strasbourg, France.
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Quesnel-Barbet A, Soula J, Sauleau EA, Parrend P, Bazile P, Dufossez F, Maignant G, Staccini P, Albert F, Hansske A. PoleSat's Modelling a Reorganization of Vascular Catheterization Provision at the Territorial Hospital Grouping Level. Stud Health Technol Inform 2020; 270:1353-1354. [PMID: 32570655 DOI: 10.3233/shti200438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Since a French organization (2016) has defined "the territorial hospital groupings", public hospitals must share medical-economic knowledge and decision-makers expect prospective analyses. PoleSat aims, quick hospital-catchment area modellings, completed by population analyses. Modellings are based on "diagnostic and interventional vascular catheterizations" acts and Nouvelle-Aquitaine, and they are carried out 3 times, through the graphical user interface's main-setting values, coupled with 3 activity-scenarios. Scenario results cannot confirm the NA02-Atlantique's H0. The experts have approved PoleSat's method as a robust help-tool; therefore they project to repeat its usages.
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Affiliation(s)
- Anne Quesnel-Barbet
- Lille University Hospital (CHU), MRRC, Public Health, Lille, Nord, France
- RETINES Lab - IRIS Dept - Medical Faculty of Nice University, Nice, PACA, France
| | - Julien Soula
- CERIM Lab - EA 2694-Medical Faculty of Lille University, Lille, Nord, France
| | - Erik-André Sauleau
- ICube Lab - CNRS - CSDC-UNESCO-Unitwin, Strasbourg University, B-R, France
| | - Pierre Parrend
- ICube Lab - CNRS - CSDC-UNESCO-Unitwin, Strasbourg University, B-R, France
| | - Pierre Bazile
- Geographic Information Association (AFIGEO), Saint-Mandé, Val de Marne, France
| | - François Dufossez
- Medical Information Dept, Béthune Hospital Center, Béthune, Pas-de-Calais, France
| | - Gilles Maignant
- RETINES Lab - IRIS Dept - Medical Faculty of Nice University, Nice, PACA, France
| | - Pascal Staccini
- RETINES Lab - IRIS Dept - Medical Faculty of Nice University, Nice, PACA, France
| | - Frédéric Albert
- Care Supply General Direction - DGOS, Ministry of health, Paris, IdF, France
| | - Arnaud Hansske
- KASHMIR-DataReuse Lab, Catholic Lille University (UCL), Lille, Nord, France
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Mroueh FM, Noureldein M, Zeidan YH, Boutary S, Irani SAM, Eid S, Haddad M, Barakat R, Harb F, Costantine J, Kanj R, Sauleau EA, Ouhtit A, Azar ST, Eid AH, Eid AA. Unmasking the interplay between mTOR and Nox4: novel insights into the mechanism connecting diabetes and cancer. FASEB J 2019; 33:14051-14066. [DOI: 10.1096/fj.201900396rr] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Fatima Mohsen Mroueh
- Department of Anatomy, Cell Biology, and Physiological Sciences, Faculty of Medicine and Medical Center, American University of Beirut, Beirut, Lebanon
| | - Mohamed Noureldein
- Department of Anatomy, Cell Biology, and Physiological Sciences, Faculty of Medicine and Medical Center, American University of Beirut, Beirut, Lebanon
| | - Youssef H. Zeidan
- Department of Anatomy, Cell Biology, and Physiological Sciences, Faculty of Medicine and Medical Center, American University of Beirut, Beirut, Lebanon
- Department of Radiation Oncology, Faculty of Medicine and Medical Center, American University of Beirut, Beirut, Lebanon
| | - Suzan Boutary
- Department of Anatomy, Cell Biology, and Physiological Sciences, Faculty of Medicine and Medical Center, American University of Beirut, Beirut, Lebanon
| | - Sara Abou Merhi Irani
- Department of Anatomy, Cell Biology, and Physiological Sciences, Faculty of Medicine and Medical Center, American University of Beirut, Beirut, Lebanon
| | - Stéphanie Eid
- Department of Anatomy, Cell Biology, and Physiological Sciences, Faculty of Medicine and Medical Center, American University of Beirut, Beirut, Lebanon
| | - Mary Haddad
- Department of Anatomy, Cell Biology, and Physiological Sciences, Faculty of Medicine and Medical Center, American University of Beirut, Beirut, Lebanon
| | - Rasha Barakat
- Department of Anatomy, Cell Biology, and Physiological Sciences, Faculty of Medicine and Medical Center, American University of Beirut, Beirut, Lebanon
| | - Frederic Harb
- Department of Life and Earth Sciences, Faculty of Sciences, Lebanese University, Fanar, Lebanon
| | - Joseph Costantine
- Department of Electrical and Computer Engineering, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Rouwaida Kanj
- Department of Electrical and Computer Engineering, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Erik-André Sauleau
- Department of Biostatistics, Centre National de la Recherche Scientifique (CNRS) Unité Mixte de Recherche (UMR) 7357 ICube, University of Strasbourg, Strasbourg, France
| | - Allal Ouhtit
- Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Sami T. Azar
- Department of Internal Medicine, Faculty of Medicine and Medical Center, American University of Beirut, Beirut, Lebanon
- American University of Beirut (AUB) Diabetes, Faculty of Medicine and Medical Center American University of Beirut, Beirut, Lebanon
| | - Ali H. Eid
- Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, Doha, Qatar
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Assaad A. Eid
- Department of Anatomy, Cell Biology, and Physiological Sciences, Faculty of Medicine and Medical Center, American University of Beirut, Beirut, Lebanon
- American University of Beirut (AUB) Diabetes, Faculty of Medicine and Medical Center American University of Beirut, Beirut, Lebanon
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10
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Quesnel-Barbet A, Soula J, Sauleau EA, Parrend P, Bazile P, Dufossez F, Hansske A. Polesat-Web-2018: A Simulation IT Tool with Immediate Prospective and Strategic Views of Hospital Spatial Planning. Stud Health Technol Inform 2019; 264:1757-1758. [PMID: 31438329 DOI: 10.3233/shti190633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Medical geo-informatics allows the Health world to address major challenges thanks to attractive concepts, methods and user-friendly IT. PoleSat-web-2018 presents a decision support system - a modelling "variable geometry" IT tool for simulation of hospital spatial planning. The outputs enable quasi-instantaneous analytic visualization at several geographic levels. PoleSat-web-2018 provides prospective views of hospital catchments (by grouping, closing) and proves to be relevant for the French planners of the Ministry of Health.
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Affiliation(s)
- Anne Quesnel-Barbet
- Regional Home of Clinical Research (MRRC) - Public Health Pole, the University Hospital Center (CHU), Lille, Nord, France.,Geographic Information Association (AFIGEO), 73 avenue de Paris, Saint-Mandé, Val de Marne, France
| | - Julien Soula
- CERIM-Medical Informatics Lab - EA 2694: Public Health, Medical Faculty of Lille University, Lille, Nord, France
| | - Erik-André Sauleau
- Public Health Department - Clinical Research Methods, the University Hospital Center (CHU), Strasbourg, Bas-Rhin, France.,ICube-Bioinformatics & System complex - CNRS - CSDC-UNESCO-Unitwin, Strasbourg University, Strasbourg, Bas-Rhin, France
| | - Pierre Parrend
- High School of ECAM Strasbourg-Europe, Schiltigheim, Bas-Rhin, France.,ICube-Bioinformatics & System complex - CNRS - CSDC-UNESCO-Unitwin, Strasbourg University, Strasbourg, Bas-Rhin, France
| | - Pierre Bazile
- Geographic Information Association (AFIGEO), 73 avenue de Paris, Saint-Mandé, Val de Marne, France
| | - François Dufossez
- Medical Information Department (DIM), Béthune Hospital Center (CH), Béthune, Pas-de-Calais, France
| | - Arnaud Hansske
- Medical Information & Hospital Information System Departments (DIM-SIH), Catholic Hospitals (GHICL), Lille, Nord, France.,KASHMIR-DataReuse Lab, Catholic Lille University (UCL), Lille, Nord, France
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11
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Chahoud M, Chahine R, Salameh P, Sauleau EA. Reliability, factor analysis and internal consistency calculation of the Insomnia Severity Index (ISI) in French and in English among Lebanese adolescents. eNeurologicalSci 2017; 7:9-14. [PMID: 29260018 PMCID: PMC5721555 DOI: 10.1016/j.ensci.2017.03.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 01/25/2017] [Accepted: 03/15/2017] [Indexed: 11/29/2022] Open
Abstract
Objectives Our goal is to validate and to verify the reliability of the French and English versions of the Insomnia Severity Index (ISI) in Lebanese adolescents. Study design A cross-sectional study was implemented. Methods 104 Lebanese students aged between 14 and 19 years participated in the study. The English version of the questionnaire was distributed to English-speaking students and the French version was administered to French-speaking students. A scale (1 to 7 with 1 = very well understood and 7 = not at all) was used to identify the level of the students' understanding of each instruction, question and answer of the ISI. The scale's structural validity was assessed. The factor structure of ISI was evaluated by principal component analysis. The internal consistency of this scale was evaluated by Cronbach's alpha. To assess test–retest reliability the intraclass correlation coefficient (ICC) was used. Results The principal component analysis confirmed the presence of a two-component factor structure in the English version and a three-component factor structure in the French version with eigenvalues > 1. The English version of the ISI had an excellent internal consistency (α = 0.90), while the French version had a good internal consistency (α = 0.70). The ICC presented an excellent agreement in the French version (ICC = 0.914, CI = 0.856–0.949) and a good agreement in the English one (ICC = 0.762, CI = 0.481–890). The Bland–Altman plots of the two versions of the ISI showed that the responses over two weeks' were comparable and very few outliers were detected. Conclusion The results of our analyses reveal that both English and French versions of the ISI scale have good internal consistency and are reproducible and reliable. Therefore, it can be used to assess the prevalence of insomnia in Lebanese adolescents. Principal component analysis found two factors in the English version and three in the French version of the ISI. The English version of the ISI showed an excellent internal consistency (α = 0.90). Almost a perfect agreement was obtained with the French version of ISI where ICC = 0.914 (CI = 0.856–0.949). The Bland–Altman plots of the two versions of ISI showed that the responses over two weeks’ time were comparable. Both English and French versions of the ISI are reproducible and reliable.
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Affiliation(s)
- M Chahoud
- Doctoral School of Science and Technology, Lebanese University, Hadath, Lebanon and Doctoral School of Life and Health Sciences - ED 414, University of Strasbourg, France
| | - R Chahine
- Faculty of Medical Science, Lebanese University, Hadath, Lebanon
| | - P Salameh
- Faculty of Medical Science, Lebanese University, Hadath, Lebanon.,Laboratory of Clinical and Epidemiology Research, Faculty of Pharmacy, Lebanese University, Hadath, Lebanon
| | - E A Sauleau
- Department of Biostatistics, CNRS UMR 7357 ICube, University of Strasbourg, France
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Denis B, Broc G, Sauleau EA, Gendre I, Gana K, Perrin P. Tailored telephone counselling to increase participation of underusers in a population-based colorectal cancer-screening programme with faecal occult blood test: A randomized controlled trial. Rev Epidemiol Sante Publique 2017; 65:17-28. [PMID: 28089385 DOI: 10.1016/j.respe.2016.06.336] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 05/28/2016] [Accepted: 06/21/2016] [Indexed: 01/22/2023] Open
Affiliation(s)
- B Denis
- Association for colorectal cancer screening in Alsace, 68024 Colmar, France.
| | - G Broc
- Psychology Laboratory EA 4139, Bordeaux Segalen University, 33076 Bordeaux, France
| | - E A Sauleau
- Biostatistics Laboratory, Medicine University, 67085 Strasbourg, France
| | - I Gendre
- Association for colorectal cancer screening in Alsace, 68024 Colmar, France
| | - K Gana
- Psychology Laboratory EA 4139, Bordeaux Segalen University, 33076 Bordeaux, France
| | - P Perrin
- Association for colorectal cancer screening in Alsace, 68024 Colmar, France
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13
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Paternostre F, Charles YP, Sauleau EA, Steib JP. Cervical sagittal alignment in adult hyperkyphosis treated by posterior instrumentation and in situ bending. Orthop Traumatol Surg Res 2017; 103:53-59. [PMID: 27889355 DOI: 10.1016/j.otsr.2016.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 07/14/2016] [Accepted: 10/12/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND In the normal adult spine, a link between thoracolumbar and cervical sagittal alignment exists, suggesting adaptive cervical positional changes allowing horizontal gaze. In patients with thoracic hyperkyphosis, cervical adaptation to sagittal global alignment might be different from healthy individuals. However, this relationship has not clearly been reported in hyperkyphotic deformity. PURPOSE The purpose of this study was to identify cervical sagittal alignment types observed on radiographs in young adults with thoracic hyperkyphosis. The relationship between cervical and thoracolumbar alignment as well as the effect of posterior instrumentation and adaptive positional changes of the mobile cervical segment were retrospectively analyzed. PATIENTS AND METHODS Twenty-three patients (32.7 years; 5-year follow-up) were included. Full spine radiographic measurements were: T1 slope, T1-T4 kyphosis, T4-T12 kyphosis, L1-S1 lordosis, pelvic incidence, pelvic tilt, sacral slope, SVA C7, SVA C2, lordosis between C0-C2, C2-C7, C2-C4 and C4-C7. A Bayesian model and Spearman correlation were used. RESULTS Two alignment types existed: cervical lordosis (group A) and cervical kyphosis (group B). Preoperatively, T4-T12 kyphosis and L1-S1 lordosis were significantly higher in group A: 76.6° versus 59.4° and -72.8° versus -65.8° (probability of>5° difference P (β>5)>0.95). Pelvic incidence was higher in group A (49.8° versus 44.2°) and C0-C2 lordosis in group B (-29.4° versus -21.6°). A significant correlation existed between: T4-T12 kyphosis and C2-C7 lordosis, L1-S1 lordosis and pelvic incidence, C2-C7 lordosis and T1 slope, C2-C7 lordosis and T1-T4 kyphosis. Postoperatively, T4-T12 kyphosis decreased by 33.1° P (β>5)=0.9995), L1-S1 lordosis decreased by 17.7° (P (β>5)=0.961), T1-T4 kyphosis increased by 14.1° (P (β>5)=0.973). SVA C2 (translation) increased by 13.8mm. C0-C2 lordosis (head rotation) remained unchanged. Six patients changed cervical alignment. PJK occurred in 15 patients, unrelated to cervical alignment or proximal instrumentation level. DISCUSSION Two cervical alignment types, lordotic or kyphotic, were observed thoracic hyperkyphosis patients. This alignment was mainly triggered by the amount of thoracic kyphosis and lumbar lordosis, linked to pelvic incidence. Moreover, the inclination of the C7-T1 junctional area plays a key role in the amount of cervical lordosis. The correction of T4-T12 kyphosis induced compensatory modifications at adjacent segments: T1-T4 kyphosis increase (PJK) and L1-S1 lordosis decrease. Global spino-pelvic alignment and head position did not change in the sagittal plane. The cervical spine tented to keep in its preoperative position in most patients. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- F Paternostre
- Service de chirurgie du rachis, fédération de médecine translationnelle (FMTS), université de Strasbourg, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France
| | - Y P Charles
- Service de chirurgie du rachis, fédération de médecine translationnelle (FMTS), université de Strasbourg, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France.
| | - E A Sauleau
- Service de santé publique, fédération de médecine translationnelle (FMTS), université de Strasbourg, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, BP 426, 67091 Strasbourg, France
| | - J-P Steib
- Service de chirurgie du rachis, fédération de médecine translationnelle (FMTS), université de Strasbourg, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France
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14
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Charles YP, Pelletier H, Hydier P, Schuller S, Garnon J, Sauleau EA, Steib JP, Clavert P. Pullout characteristics of percutaneous pedicle screws with different cement augmentation methods in elderly spines: An in vitro biomechanical study. Orthop Traumatol Surg Res 2015; 101:369-74. [PMID: 25755067 DOI: 10.1016/j.otsr.2015.01.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 09/18/2014] [Accepted: 01/05/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND Vertebroplasty prefilling or fenestrated pedicle screw augmentation can be used to enhance pullout resistance in elderly patients. It is not clear which method offers the most reliable fixation strength if axial pullout and a bending moment is applied. The purpose of this study is to validate a new in vitro model aimed to reproduce a cut out mechanism of lumbar pedicle screws, to compare fixation strength in elderly spines with different cement augmentation techniques and to analyze factors that might influence the failure pattern. MATERIALS AND METHODS Six human specimens (82-100 years) were instrumented percutaneously at L2, L3 and L4 by non-augmented screws, vertebroplasty augmentation and fenestrated screws. Cement distribution (2 ml PMMA) was analyzed on CT. Vertebral endplates and the rod were oriented at 45° to the horizontal plane. The vertebral body was held by resin in a cylinder, linked to an unconstrained pivot, on which traction (10 N/s) was applied until rupture. Load-displacement curves were compared to simultaneous video recordings. RESULTS Median pullout forces were 488.5 N (195-500) for non-augmented screws, 643.5 N (270-1050) for vertebroplasty augmentation and 943.5 N (750-1084) for fenestrated screws. Cement augmentation through fenestrated screws led to significantly higher rupture forces compared to non-augmented screws (P=0.0039). The pullout force after vertebroplasty was variable and linked to cement distribution. A cement bolus around the distal screw tip led to pullout forces similar to non-augmented screws. A proximal cement bolus, as it was observed in fenestrated screws, led to higher pullout resistance. This cement distribution led to vertebral body fractures prior to screw pullout. CONCLUSION The experimental setup tended to reproduce a pullout mechanism observed on radiographs, combining axial pullout and a bending moment. Cement augmentation with fenestrated screws increased pullout resistance significantly, whereas the fixation strength with the vertebroplasty prefilling method was linked to the cement distribution.
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Affiliation(s)
- Y P Charles
- Groupe d'étude de biomécanique ostéo-articulaire de Strasbourg (GEBOAS), fédération de médecine translationnelle de Strasbourg (FMTS), université de Strasbourg, 4, rue Kirschleger, 67085 Strasbourg cedex, France; Service de chirurgie du rachis, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France.
| | - H Pelletier
- Institut national des sciences appliquées (INSA), université de Strasbourg, 24, boulevard de la Victoire, 67000 Strasbourg, France; Institut Charles-Sadron, UPR 22 CNRS, université de Strasbourg, 23, rue du Loess, 67000 Strasbourg, France
| | - P Hydier
- Institut national des sciences appliquées (INSA), université de Strasbourg, 24, boulevard de la Victoire, 67000 Strasbourg, France
| | - S Schuller
- Groupe d'étude de biomécanique ostéo-articulaire de Strasbourg (GEBOAS), fédération de médecine translationnelle de Strasbourg (FMTS), université de Strasbourg, 4, rue Kirschleger, 67085 Strasbourg cedex, France; Service de chirurgie du rachis, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France
| | - J Garnon
- Service de radiologie interventionnelle, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France
| | - E A Sauleau
- Département de santé publique, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France
| | - J-P Steib
- Groupe d'étude de biomécanique ostéo-articulaire de Strasbourg (GEBOAS), fédération de médecine translationnelle de Strasbourg (FMTS), université de Strasbourg, 4, rue Kirschleger, 67085 Strasbourg cedex, France; Service de chirurgie du rachis, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France
| | - P Clavert
- Groupe d'étude de biomécanique ostéo-articulaire de Strasbourg (GEBOAS), fédération de médecine translationnelle de Strasbourg (FMTS), université de Strasbourg, 4, rue Kirschleger, 67085 Strasbourg cedex, France; Institut national des sciences appliquées (INSA), université de Strasbourg, 24, boulevard de la Victoire, 67000 Strasbourg, France; Institut d'anatomie normale, faculté de médecine, université de Strasbourg, 4, rue Kirschleger, 67085 Strasbourg cedex, France
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Desandes E, Lacour B, Belot A, Molinie F, Delafosse P, Tretarre B, Velten M, Sauleau EA, Woronoff AS, Guizard AV, Ganry O, Bara S, Grosclaude P, Troussard X, Bouvier V, Brugieres L, Clavel J. Cancer incidence and survival in adolescents and young adults in France, 2000-2008. Pediatr Hematol Oncol 2013; 30:291-306. [PMID: 23363314 DOI: 10.3109/08880018.2012.762569] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study aimed to describe cancer incidence (2000-2008) and survival (2000-2004) in France in adolescents and young adults (AYA). All cases of cancer diagnosed in 15-24 years, recorded by all French population-based registries (14% of the French population), over the 2000-2008 period, were included. Incidence change over time was described with the conventional annual percentage change (cAPC). The survival of cases diagnosed (2000-2004) was estimated using Kaplan-Meier method. A total of 1022 in adolescents and 1396 in young adults were diagnosed. Overall incidence rates were 219.4/10(6) in 15-19 year olds and 293.1/10(6) in 20-24 year olds. The most frequently diagnosed cancers in male AYA were malignant gonadal germ-cell tumors and Hodgkin's disease, and were melanoma, thyroid carcinoma, and Hodgkin's disease in females. The age-standardized rates appeared stable over time in AYA, with a cAPC of +2.0% (P = 0.68). The 5-year overall survival for all cancers was different between genders and age groups, with 78.8% (95%CI: 75.6-82.0) for males and 85.2% (95%CI: 82.2-88.1) for females (P = 0.01), and 78.5% (95%CI: 75.0-82.1) in 15-19 year olds and 84.3% (95% CI: 81.6-87.0) in 20-24 year olds (P = 0.02). Noteworthy, the frequency and the distribution of tumor types in AYA are unique and different from the observed at any other age group. Survival in French AYA has improved over time. Epidemiological data might reflect major trends in the risk factors and preventive interventions. Thus, further research into etiology of cancers affecting AYA should become key priorities for cancer control among AYA.
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Affiliation(s)
- Emmanuel Desandes
- Registre National des Tumeurs Solides de l'Enfant, CHU Nancy, Faculté de Médecine, 9 Avenue de la Forêt de Haye, Vandoeuvre lès-Nancy cedex, France.
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Gaudineau A, Sauleau EA, Nisand I, Langer B. Obstetric and neonatal outcomes in a home-like birth centre: a case–control study. Arch Gynecol Obstet 2012; 287:211-6. [DOI: 10.1007/s00404-012-2553-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2012] [Accepted: 09/03/2012] [Indexed: 10/27/2022]
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18
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Fromont A, Binquet C, Sauleau EA, Fournel I, Despalins R, Rollot F, Weill A, Clerc L, Bonithon-Kopp C, Moreau T. National estimate of multiple sclerosis incidence in France (2001–2007). Mult Scler 2012; 18:1108-15. [DOI: 10.1177/1352458511433305] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: In France, the incidence of multiple sclerosis (MS) is not well known, and MS is one of the 30 long-term illnesses for which patients are covered for 100% of their health care costs. Objective: To estimate the incidence of MS in France and its geographic variations. Methods: We estimated the national rate for notification of MS to the main French health insurance system, and its confidence interval (CI), between November 2000 and October 2007, which covers 87% of the population. We analysed geographic variations using a Bayesian approach. Results: Between November 2000 and October 2007, among a covered population of 52,449,871, some 28,682 individuals were registered as having MS. After age standardization according to the European population, the notification rate for MS was 6.8 per 100,000 (6.7–6.9), 9.8 (9.7–10.0) in women and 3.7 (3.6–3.8) in men. When the under-notification rate (11.5% and 29%) was taken into account, the notification rate per 100,000 inhabitants was estimated between 7.6 and 8.8. The notification rate was higher in north-eastern France, and lower on the Atlantic coast and in the Alps as well as on both sides of the Rhône River. Conclusions: This study, conducted on a representative French population, provides for the first time national estimates of MS incidence between November 2000 and October 2007.
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Affiliation(s)
- A Fromont
- Department of Neurology, University Hospital of Dijon, France
- Burgundy University, Centre of Epidemiology of the Populations EA 4184, France
| | - C Binquet
- INSERM, CIE1, France; Dijon University Hospital, Clinical Investigation Centre – Clinical Epidemiology / Clinical Trials, France; Burgundy University, France
| | - EA Sauleau
- Strasbourg University Hospitals, Public Health Department, Biostatistics and Methodology Unit, France
| | - I Fournel
- INSERM, CIE1, France; Dijon University Hospital, Clinical Investigation Centre – Clinical Epidemiology / Clinical Trials, France; Burgundy University, France
| | - R Despalins
- INSERM, CIE1, France; Dijon University Hospital, Clinical Investigation Centre – Clinical Epidemiology / Clinical Trials, France; Burgundy University, France
| | - F Rollot
- INSERM, CIE1, France; Dijon University Hospital, Clinical Investigation Centre – Clinical Epidemiology / Clinical Trials, France; Burgundy University, France
| | - A Weill
- French Public Health Insurance, Paris, France
| | - L Clerc
- French Public Health Insurance, Direction of the Medical Department, Dijon, France
| | - C Bonithon-Kopp
- INSERM, CIE1, France; Dijon University Hospital, Clinical Investigation Centre – Clinical Epidemiology / Clinical Trials, France; Burgundy University, France
| | - T Moreau
- Department of Neurology, University Hospital of Dijon, France
- Burgundy University, Centre of Epidemiology of the Populations EA 4184, France
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Matern O, Sauleau EA, Tschill P, Perrin-Schmitt F, Grollemund B. Left-sided predominance of hypodontia irrespective of cleft sidedness in a French population. Cleft Palate Craniofac J 2011; 49:e1-5. [PMID: 21905908 DOI: 10.1597/11-025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE Individuals with oral clefts exhibit considerably more dental anomalies than do individuals without clefts. Our aim was to evaluate the prevalence of tooth agenesis in a sample composed of 124 children (81 boys and 43 girls, mean age 12.5 years) with clefts registered with the Cleft Palate Center in Strasbourg (France). DESIGN Cleft types and dental agenesis were assessed by clinical and radiographic examination. Cleft types were divided into four groups according to the clinical extent of the cleft (cleft lip only [CL, 12.9%], cleft lip and alveolus [CLA, 4%], cleft lip and palate [CLP, 49.2%], and cleft palate only [CP, 33.9%]). RESULTS Of the subjects 63% had evidence of hypodontia: maxillary lateral incisors (54%) and upper and lower premolars (32%) were the most common missing teeth. The number of dental ageneses associated with CP (54%) and CLP (79%) was significantly higher than that with CL (33%). All these anomalies were found in proportionately higher frequencies as the severity of the cleft increased, and we found left side predominance for hypodontia (p < .01) irrespective of cleft sidedness. CONCLUSIONS Both right-sided and left-sided clefts were more frequently correlated with left-sided dental agenesis. This left-sided prevalence suggests that common signaling malfunctions might be involved, both in dental development anomalies and cleft genesis.
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Affiliation(s)
- Olivier Matern
- Pôle de médecine et Chirurgie bucco-dentaires, Unité Fonctionnelle d'Orthopédie Dento-Faciale, 1, Place de l'Hôpital - 67091 Strasbourg, France.
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Viel JF, Daniau C, Goria S, Fabre P, de Crouy-Chanel P, Sauleau EA, Empereur-Bissonnet P. Risk for non Hodgkin's lymphoma in the vicinity of French municipal solid waste incinerators. Environ Health 2008; 7:51. [PMID: 18959776 PMCID: PMC2587460 DOI: 10.1186/1476-069x-7-51] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2008] [Accepted: 10/29/2008] [Indexed: 05/19/2023]
Abstract
BACKGROUND Dioxin emissions from municipal solid waste incinerators are one of the major sources of dioxins and therefore are an exposure source of public concern. There is growing epidemiologic evidence of an increased risk for non-Hodgkin's lymphoma (NHL) in the vicinity of some municipal solid waste incinerators with high dioxin emission levels. The purpose of this study was to examine this association on a larger population scale. METHODS The study area consisted of four French administrative departments, comprising a total of 2270 block groups. NHL cases that had been diagnosed during the period 1990-1999, and were aged 15 years and over, were considered. Each case was assigned a block group by residential address geocoding. Atmospheric Dispersion Model System software was used to estimate immissions in the surroundings of 13 incinerators which operated in the study area. Then, cumulative ground-level dioxin concentrations were calculated for each block group. Poisson multiple regression models, incorporating penalized regression splines to control for covariates and dealing with Poisson overdispersion, were used. Five confounding factors were considered: population density, urbanisation, socio-economic level, airborne traffic pollution, and industrial pollution. RESULTS A total of 3974 NHL incident cases was observed (2147 among males, and 1827 among females) during the 1990-1999 time period. A statistically significant relationship was found at the block group level between risk for NHL and dioxin exposure, with a relative risk (RR) of 1.120 (95% confidence interval [CI] 1.002 - 1.251) for persons living in highly exposed census blocks compared to those living in slightly exposed block groups. Population density appeared positively linked both to risk for NHL and dioxin exposure. Subgroup multivariate analyses per gender yielded a significant RR for females only (RR = 1.178, 95% CI 1.013 - 1.369). CONCLUSION This study, in line with previous results obtained in the vicinity of the incinerator located in Besançon (France), adds further evidence to the link between NHL incidence and exposure to dioxins emitted by municipal solid waste incinerators. However, the findings of this study cannot be extrapolated to current incinerators, which emit lower amounts of pollutants.
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Affiliation(s)
- Jean-François Viel
- CNRS n° 6249 "Chrono-Environment", Faculty of Medicine, 2, place Saint Jacques, 25030 Besançon cedex, France
| | - Côme Daniau
- National Institute for Public Health Surveillance, "Health and Environment" Department, 12, rue du Val d'Osne, 94415 Saint-Maurice Cedex, France
| | - Sarah Goria
- National Institute for Public Health Surveillance, "Health and Environment" Department, 12, rue du Val d'Osne, 94415 Saint-Maurice Cedex, France
| | - Pascal Fabre
- National Institute for Public Health Surveillance, "Health and Environment" Department, 12, rue du Val d'Osne, 94415 Saint-Maurice Cedex, France
| | - Perrine de Crouy-Chanel
- National Institute for Public Health Surveillance, "Health and Environment" Department, 12, rue du Val d'Osne, 94415 Saint-Maurice Cedex, France
| | - Erik-André Sauleau
- Haut-Rhin Cancer Registry, and French network of cancer registries (FRANCIM), 87, avenue d'Altkirch, 68051 Mulhouse, France
| | - Pascal Empereur-Bissonnet
- National Institute for Public Health Surveillance, "Health and Environment" Department, 12, rue du Val d'Osne, 94415 Saint-Maurice Cedex, France
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21
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Desandes E, Lacour B, Belot A, White-Koning M, Velten M, Tretarre B, Sauleau EA, Maarouf N, Guizard AV, Delafosse P, Danzon A, Cotte C, Boutreux S, Brugières L. [Cancer incidence and survival among adolescents and young adults in France (1978-1997)]. Bull Cancer 2007; 94:331-7. [PMID: 17449435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Malignancies are rare young French adults but represent the third significant cause of death in the cohort of 15-24 years of age. The aim of this study was to investigate incidence and survival rates of French adolescents and young adults with cancer. All cases of cancer occuring over a 20-year period (1978-1997) in the cohort of patients aged 15 to 24, were obtained from nine population-based registries (10 % of the French population). Basal cell carcinomas of the skin were excluded. 1161 and 1884 cases were recorded in adolescents and young adults, respectively. Overall incidence rates (IR) were 161.4/10(6) in adolescents aged 15-19 years (M/F ratio = 1.3), and 252.6/10(6) in young adults aged 20-24 years (M/F ratio : 1.2). During the 1978-97 period, the IRs appeared stable over the years, +0.4 % [CI95 % = -2.3 ; +3.1] (p = 0.79) for adolescents and +1.7 % [CI95 % = -4.0 ; +7.3] (p = 0.57) for young adults. Five-year overall survival rates were 69.1 % [CI95 % = 66.4-71.8] for adolescents and 74.5 % [CI95 % = 72.3-76.7] for young adults. The 5-year survival rate for patients 15-24 years improved from 62.0 % (CI95 % = 57.5-66.5) in 1978-82 to 80.2 % (IC95 % = 77.7-82.8) in 1993-97. Noteworthy, results in adolescents and young adults are poor compared to the ones from their younger counterparts, especially in patients with acute lymphoblastic leukemia, non-Hodgkin lymphoma, Ewing's sarcoma, osteosarcoma, rhabdomyosarcoma, and astrocytoma. Further studies are warranted to elucidate whether these differences are due to intrinsic biological properties of the tumor or to differences in clinical practices in the two populations.
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Affiliation(s)
- Emmanuel Desandes
- Registre national des tumeurs solides de l'enfant, Université Henri Poincaré Nancy 1, Faculté de Médecine, 9, avenue de la Forêt-de-Haye, BP 184, 54505 Vandoeuvre-lès-Nancy Cedex.
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22
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Dejardin O, Remontet L, Bouvier AM, Danzon A, Trétarre B, Delafosse P, Molinié F, Maarouf N, Velten M, Sauleau EA, Bourdon-Raverdy N, Grosclaude P, Boutreux S, De Pouvourville G, Launoy G. Socioeconomic and geographic determinants of survival of patients with digestive cancer in France. Br J Cancer 2006; 95:944-9. [PMID: 16969351 PMCID: PMC2360549 DOI: 10.1038/sj.bjc.6603335] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2006] [Revised: 07/26/2006] [Accepted: 07/26/2006] [Indexed: 11/09/2022] Open
Abstract
Using a multilevel Cox model, the association between socioeconomic and geographical aggregate variables and survival was investigated in 81 268 patients with digestive tract cancer diagnosed in the years 1980-1997 and registered in 12 registries in the French Network of Cancer Registries. This association differed according to cancer site: it was clear for colon (relative risk (RR)=1.10 (1.04-1.16), 1.10 (1.04-1.16) and 1.14 (1.05-1.23), respectively, for distances to nearest reference cancer care centre between 10 and 30, 30 and 50 and more than 90 km, in comparison with distance of less than 10 km; P-trend=0.003) and rectal cancer (RR=1.09 (1.03-1.15), RR=1.08 (1.02-1.14) and RR=1.12 (1.05-1.19), respectively, for distances between 10 and 30 km, 30 and 50 km and 50 and 70 km, P-trend=0.024) (n=28 010 and n=18 080, respectively) but was not significant for gall bladder and biliary tract cancer (n=2893) or small intestine cancer (n=1038). Even though the influence of socioeconomic status on prognosis is modest compared to clinical prognostic factors such as histology or stage at diagnosis, socioeconomic deprivation and distance to nearest cancer centre need to be considered as potential survival predictors in digestive tract cancer.
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Affiliation(s)
- O Dejardin
- Cancers & Populations, ERI 3 INSERM, Faculty of Medicine, Avenue de la Côte de Nacre 14032 Caen Cedex, France.
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23
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Abstract
The aim of this paper is to present a paradigm for combining ordinal expert ratings with exposure measurements while accounting for a between-worker effect when estimating exposure group (EG)-specific means for epidemiological purposes. Expert judgement is used to classify the EGs into a limited number of exposure levels independently of the exposure measurements. The mean exposure of each EG is considered to be a random deviate from a central exposure rating-specific value. Combining this approach with the standard between-worker random effect model, we obtain a nested two-way model. Using Gibbs sampling, we can fit such models incorporating prior information on components of variance and modelling options to the rating-specific means. An approximate formula is presented estimating the mean exposure of each EG as a function of the geometric mean of the measurements in this EG, between and within EG standard deviations and the overall geometric mean, thus borrowing information from other EGs. We apply this paradigm to an actual data set of dust exposure measurements in a steel producing factory. Some EG-specific means are quite different from the estimates including the ratings. Rating-specific means could be estimated under different hypotheses. It is argued that when setting up an expert rating of exposures it is best done independently of existing exposure measurements. The present model is then a convenient framework in which to combine the two sources of information.
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Affiliation(s)
- P Wild
- INRS, Department of Epidemiology, BP 23, 54501 Vandoeuvre Cedex, Paris, France.
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24
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Bohadana AB, Peslin R, Megherbi SE, Teculescu D, Sauleau EA, Wild P, Pham QT. Dose-response slope of forced oscillation and forced expiratory parameters in bronchial challenge testing. Eur Respir J 1999; 13:295-300. [PMID: 10065671 DOI: 10.1034/j.1399-3003.1999.13b13.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In population studies, the provocative dose (PD) of bronchoconstrictor causing a significant decrement in lung function cannot be calculated for most subjects. Dose-response curves for carbachol were examined to determine whether this relationship can be summarized by means of a continuous index likely to be calculable for all subjects, namely the two-point dose response slope (DRS) of mean resistance (Rm) and resistance at 10 Hz (R10) measured by the forced oscillation technique (FOT). Five doses of carbachol (320 microg each) were inhaled by 71 patients referred for investigation of asthma (n=16), chronic cough (n=15), nasal polyposis (n=8), chronic rhinitis (n=8), dyspnoea (n=8), urticaria (n=5), post-anaphylactic shock (n=4) and miscellaneous conditions (n=7). FOT resistance and forced expiratory volume in one second (FEV1) were measured in close succession. The PD of carbachol leading to a fall in FEV1 > or = 20% (PD20) or a rise in Rm or R10 > or = 47% (PD47,Rm and PD47,R10) were calculated by interpolation. DRS for FEV1 (DRSFEV1), Rm (DRSRm) and R10 (DRSR10) were obtained as the percentage change at last dose divided by the total dose of carbachol. The sensitivity (Se) and specificity (Sp) of DRSRm, DRS10 delta%Rm and delta%R10 in detecting spirometric bronchial hyperresponsiveness (BHR, fall in FEV1 > or = 20%) were assessed by receiver operating characteristic (ROC) curves. There were 23 (32%) "spirometric" reactors. PD20 correlated strongly with DRSFEV1 (r=-0.962; p=0.0001); PD47,Rm correlated significantly with DRSRm (r=-0.648; p=0.0001) and PD47,R10 with DRSR10 (r=-0.552; p=0.0001). DRSFEV1 correlated significantly with both DRSRm (r=0.700; p=0.0001) and DRSR10 (r=0.784; p=0.0001). The Se and Sp of the various FOT indices to correctly detect spirometric BHR were as follows: DRSRm: Se=91.3%, Sp=81.2%; DRSR10: Se=91.3%, Sp=95.8%; delta%Rm: Se=86.9%, Sp=52.1%; and delta%R10: Se=91.3%, Sp=58.3%. Dose-response slopes of indices of forced oscillation technique resistance, especially the dose-response slope of resistance at 10Hz are proposed as simple quantitative indices of bronchial responsiveness which can be calculated for all subjects and that may be useful in occupational epidemiology.
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Affiliation(s)
- A B Bohadana
- Institut National de la Santé et de la Recherche Médicale, Unité 420, Epidémiologie Santé Travail, Vandoeuvre-lès-Nancy, France
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25
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Teculescu DB, Sauleau EA, Massin N, Bohadana AB, Buhler O, Benamghar L, Mur JM. Sick-building symptoms in office workers in northeastern France: a pilot study. Int Arch Occup Environ Health 1998; 71:353-6. [PMID: 9749975 DOI: 10.1007/s004200050292] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
STUDY OBJECTIVES To verify that sick building symptoms are present in north-eastern France office workers; to try to identify new confounding factors. METHODS The design was that of a cross-sectional study with control group. We studied with the same methods the personnel of an air-conditioned building (n=425), and of a naturally ventilated building (n=351). Air temperature and humidity, bacterial and fungal densities were measured by the same technical staff in the two buildings. A standard questionnaire on irritative and respiratory symptoms, personal and family history, and lifestyle was completed by the participants. RESULTS In univariate analysis, exposure to air-conditioning was associated with an increased prevalence of symptoms (odds ratios-OR-between 1.54 and 2.84). A significant increase in sickness absence was also found among subjects working in air-conditioned offices. As a series of factors were suspected to interfere with these associations, logistic regression was applied. This method confirmed exposure to be an independent determinant of 7 symptoms, and also identified two determinants not previously described: a family history of respiratory diseases and "do-it-yourself' activities. IN CONCLUSION we found the sick building symptoms to be present in a group of French office workers exposed to air-conditioning. We confirmed the influence of a number of confounding factors and described two further confounders - do-it-yourself activities at home and a history of familial respiratory disease.
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Affiliation(s)
- D B Teculescu
- Institut National de la Santé et de la Recherche Médicale, Vandoeuvre, France.
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