Comparison of phosphor screen autoradiography and micro-pattern gas detector based autoradiography for the porosity of altered rocks.

This study aims to further develop the 14C-PMMA porosity calculation method with a novel autoradiography technique, the Micro-pattern gas detector autoradiography (MPGDA). In this study, the MPGDA is compared with phosphor screen autoradiography (SPA). A set of rock samples from Martinique Island exhibiting a large range of connected porosities was used to validate the MPGDA method. Calculated porosities were found to be in agreement with ones from the SPA and the triple-weight method (TW). The filmless nature of MPGDA as well as straightforward determination of C-14 radioactivity from the source rock makes the porosity calculation less uncertain. The real-time visualization of radioactivity from C-14 beta emissions by MPGDA is a noticeable improvement in comparison to SPA.

[Occupational dermatitis in cleaning and maintenance workers. Analysis of 769 cases declared to the Caisse Nationale d'Assurance Maladie des Travailleurs Salariés between 2004 and 2007]. / Les eczémas professionnels chez les travailleurs du secteur du nettoyage et de l'entretien. Étude de 769 déclarations à la Caisse nationale d'assurance maladie des travailleurs salariés entre 2004 et 2007.

BACKGROUND: Employees active in the cleaning and maintenance industry (CMI) are particularly exposed to occupational eczema (OE), which affects the hands in 80 to 90% of cases. This risk of OCE in France was evaluated using data collected by the Occupational Risks Division of the French National Health Insurance Fund for Salaried Workers (CNAMTS). PATIENTS AND METHODS: All cases of OE among CMI employees declared to and recognized by the CNAMTS between 1st January 2004 and 31st December 2007 were selected. The following parameters were noted in each case: age, gender, trade in question, National Health Insurance Office of residence, causal agent and number of days of sick leave. The incidence per 100,000 employees could be determined from the total number of employees followed up by occupational medicine and the numbers working in the CMI. RESULTS: For the 4 years studied, 769 cases of OE were reported in CMI workers representing 2.6% of the salaried employee population. The annual incidence of OE was 43.5 per 100,000 employees. There was a marked female predominance (75.7%). OE led to loss of 32,714 workdays. CONCLUSION: This is the first study conducted in France about OE among NIS employees. It highlights the socioeconomic impact of OE. The difficulties of interpretation show the limits of recognition of occupational disease. Analysis of cases of OE in France and monitoring require the development of a specific database to clarify risk situations and identify priority regional and national preventive actions.

Occupational contact dermatitis in 10,582 French patients reported between 2004 and 2007: a descriptive study.

BACKGROUND: Limited epidemiological data are available in France for occupational contact dermatitis (OCD), a non- infectious inflammatory skin condition arising from direct skin contact with substances used in the workplace. OBJECTIVE: To estimate the occurrence of, and number of workdays lost to, OCD in France. METHODS: Descriptive study of all OCD declared by salaried workers and recognised as occupational disease in France over a 4-year period. RESULTS: 10,582 OCD cases were reported, representing 9.6% of all occupational diseases recognised. The estimated annual incidence of OCD recognised was 15.72/100,000 salaried workers (i.e. 146.87/100,000 employees for all occupational diseases). OCD cases were mainly in the construction and public works industries with 3,057 (36.7%) salaried workers affected. In the services sector, OCD predominantly affected employees aged less than 30 years (41%), particularly hairdressers (69%). OCD accounted for the loss of 395,069 working days. CONCLUSION: OCD represents a significant public health problem in France, particularly for construction workers and hairdressers.

Recent trends in breast cancer incidence rates in the Loire-Atlantique, France: a decline since 2003.

BACKGROUND: A recent decline in breast cancer incidence rates has been reported in the United States and in Europe. This decrease has been partly attributed to the reduced use of hormone replacement therapy (HRT). No study in Europe has detailed recent breast cancer incidence trends both by hormonal receptor status and mode of detection at an individual level. METHODS: We examined trends in breast cancer incidence rates in the French administrative area of Loire-Atlantique between 1991 and 2007, by age, mode of detection, histological subtype, estrogen/progesterone receptor (ER/PR) status and grade. Annual age-standardized breast cancer incidence rates were estimated using the Loire-Atlantique and Vendée Cancer Registry data. Annual percentage changes (APCs) were estimated using an age-adjusted Poisson regression model. RESULTS: Incidence rates of breast cancer increased 3.5% per year in 1991-2003, dropped -4.3% per year in 2003-2006 and increased in 2007 (9.1%). Stratified analyses by age groups showed that the decrease concerned predominantly women aged 50-64 years, whereas an increasing proportion of cancers detected by organized screening was observed in this age group. Among these women, the decline of incidence particularly concerned positive estrogen and progesterone receptor tumors, lobular subtype tumors, and low-grade tumors. CONCLUSION: The drop in breast cancer incidence rates observed between 2003 and 2006 in women 50-64 years old was greater for ER+PR+ tumors. During the same period, the incidence of breast cancers diagnosed by organized screening increased. These patterns appear consistent with an impact of the reduced use of HRT.

Modulation of phenotypic expression of APOA5 Q97X and L242P mutations.

OBJECTIVE: To provide phenotypic and functional data in new patients with APOA5 mutations and to identify genetic and metabolic factors influencing their phenotypic expression. METHODS AND RESULTS: By sequencing APOA5 gene in a cohort of 286 hyperchylomicronemic subjects, free of LPL or APOC2 mutations, we identified 4 unrelated carriers of the Q97X mutation (3 heterozygotes and 1 homozygote) and one heterozygote with a new L242P mutation. Postheparin LPL activity level was reduced by about 50% in Q97X heterozygotes and more than 90% in the Q97X homozygote, but was normal in the L242P patient after resolution of hyperchylomicronemia. Plasma apoAV was undetectable in the Q97X homozygote and in the normal range in the L242P and Q97X heterozygous carriers. In Western blot studies, the association of apoAV with plasma lipoproteins was altered in Q97X heterozygous carriers but not in the L242P carrier. Hyperchylomicronemic heterozygotes for both mutations carried an additional APOA5 variant haplotype and/or APOE variant (E2 or E4). Type 2 diabetes or metabolic syndrome were not a major phenotypic determinant. CONCLUSIONS: The L242P mutation was present in a hyperchylomicronemic proband but its causal involvement remains to be established. The Q97X mutation was clearly involved in hyperchylomicronemia with evidence of concomitant altered intravascular lipolysis, and a complete apoAV deficiency in the homozygote. The phenotypic expression variability of APOA5 mutations was mostly influenced by compound heterozygosity with APOA5 variant haplotypes plus additional genetic factors, and in a lesser extent by the metabolic environment.

Ecological association between indoor radon concentration and childhood leukaemia incidence in France, 1990-1998.

The objective of this study was to evaluate the ecological association between indoor radon concentration and acute leukaemia incidence among children under 15 years of age in the 348 geographical units (zones d'emploi, ZE) of France between 1990 and 1998. During that period, 4015 cases were registered by the French National Registry of Childhood Leukaemia and Lymphoma. Exposure assessment was based on a campaign of 13 240 measurements covering the whole country. The arithmetic mean radon concentration was 85 Bq/m (range, 15-387 Bq/m) and the geometric mean, 59 Bq/m (range: 13-228 Bq/m). A positive ecological association, on the borderline of statistical significance (P=0.053), was observed between indoor radon concentration and childhood leukaemia incidence. The association was highly significant for acute myeloid leukaemia (AML) (P=0.004) but not for acute lymphocytic leukaemia (ALL) (P=0.49). The standardized incidence ratio (SIR) increased by 7, 3 and 24% for all acute leukaemia, ALL and AML, respectively, when radon concentration increased by 100 Bq/m. In conclusion, the present ecological study supports the hypothesis of a moderate association between indoor radon concentration and childhood acute myeloid leukaemia. It is consistent with most previous ecological studies. Since the association is moderate, this result does not appear inconsistent with the five published case-control studies, most of which found no significant association.

French population exposure to radon, terrestrial gamma and cosmic rays.

In France, natural sources account for most of the population exposure to ionising radiation. This exposure varies widely with area. Radon and gamma-ray exposure data come from national measurement campaigns; cosmic doses were calculated from city altitude. These data were corrected for season of measurement, housing characteristics and population density to study their relationship with health indicators. The crude average of indoor radon concentrations was 89 Bq m(-3), and the average corrected for season and housing characteristics was 83 Bq m(-3) (range over districts: 19-297). Weighting by district population density yielded a national average of 63 Bq m(-3). Gamma-ray dose rates averaged 55 nSv h(-1) (23-96) indoors and 46 nSv h(-1) (25-85) outdoors; corrections did not change the means. Corrected cosmic annual doses averaged 0.28 mSv (0.27-0.38). These corrections estimated the radiation exposure of the French population more accurately and represented its distribution well, thereby allowing its study as a cofactor in ecological studies.

Seasonal correction factors for estimating radon exposure in dwellings in France.

Indoor radon concentrations are subject to seasonal variation with a maximum in winter and a minimum in summer. Procedures to correct for seasonal variation are necessary in order to get an unbiased estimate of the annual average radon concentration from data based on short-period radon measurements. To obtain correction factors, we apply the model developed by Pinel et al to the French database of indoor radon measurements (measurements performed as part of the indoor radon case-control study and of the national radon measurement campaign). For 6-month measurements, the correction factors vary from 0.87 to 1.17 and agree with those previously published. These results might be applicable when assessing indoor radon concentrations with regard to recommended action levels.

Family resemblance in breakfast energy intake: the Stanislas Family Study.

BACKGROUND: There seems to be a consensus that family influences on dietary habits are important. However, no data relative to breakfast have been published yet. OBJECTIVE: To investigate whether and how breakfast energy intake aggregates within French families. DESIGN: A total of 398 families of the Stanislas Family Study who filled in a 3 day food consumption diary were selected. Absolute and relative breakfast energy intakes (BEI in kcal/day and RBEI in percentage of daily intake, respectively) were both studied. RESULTS: By using a variance component analysis, no genetic influence was shown in family aggregation of both BEI and RBEI. Intra-generation common environmental contribution to total phenotypic variance of BEI and RBEI was higher than inter-generation; both were increased with frequency of sharing breakfast. Furthermore frequency of sharing breakfast contributed to increase family resemblance in breakfast energy intake, particularly in offspring for BEI and RBEI, and in spouses for RBEI. Smoking habits, alcohol consumption, BMI or physical activity were related to family resemblance, but after adjustment on each factor degrees of resemblance were almost unchanged. CONCLUSION: General findings of this study were that family aggregation in breakfast absolute and relative energy intakes was significant within Stanislas families. Family resemblance depended on inter- and intra-generation components and was modified by the number of shared breakfasts. Our study confirmed that familial habits act on family resemblance in both absolute and relative breakfast energy intakes, so that family should be a favorite unit for health and diet promotion programs. SPONSORSHIP: Kellogg's PA, France.

The use of recombinant factor VIIa (NovoSeven) in a patient with a factor XI deficiency and a circulating anticoagulant.

A 75-year-old female known to have a chronic myelomonocytic leukaemia and an acquired FXI deficiency (FXI level, 5%) related to a FXI inhibitor (38 Bethesda units) was admitted to the hospital for acute pneumonia associated with a bulky pleural effusion. A therapeutic puncture was found to be essential for the patient. But, such a procedure is a haemostatic challenge which requires adequate preparation. A first treatment composed of intravenous immunoglobulins and immunosuppressive therapy failed to eradicate the inhibitor and to restore a normal FXI level. In this context, steroids or FXI concentrates were not recommended. Thus, small doses of recombinant activated factor VII were used to achieve haemostasis. The procedure was successful, the tolerance was good and no adverse events occurred.

A case of chronic myelomonocytic leukaemia and factor XI deficiency with a circulating anticoagulant.

Inhibitors against factor XI (FXI) have been frequently described in patients who acquired inhibitors (due to auto-immune disorders, malignancies or infections), but less often in those with a congenital deficiency of this factor, who had received plasma infusions. The present report concerns one such inhibitor found in the plasma of a patient with chronic myelomonocytic leukaemia and infected by B19 parvovirus, who was neither a heterozygote nor a homozygote for FXI deficiency, and who had no bleeding tendency despite a very low FXI level. Taking this case into account, we discuss and present the clinical and biological features of acquired FXI deficiency caused by an inhibitor.

Evaluation of the American Academy of Dermatology's National Skin Cancer Early Detection and Screening Program.

BACKGROUND: Increasing incidence and mortality rates from cutaneous melanoma are a major public health concern. As part of a national effort to enhance early detection of melanoma/skin cancer, the American Academy of Dermatology (AAD) has sponsored an annual education and early detection program that couples provision of skin cancer information to the general public with almost 750,000 free skin cancer examinations (1985-1994). OBJECTIVE: To begin to evaluate the impact of this effort, we determined the final pathology diagnosis of persons attending the 1992-1994 programs who had a suspected melanoma at the time of examination. METHODS: We directly contacted all such persons by telephone or mail and received pathology reports from those who had a subsequent biopsy. RESULTS: We contacted 96% of the 4458 persons with such lesions among the 282,555 screenings in the 1992-1994 programs. We obtained a final diagnosis for 72%, and the positive predictive value for melanoma was 17%. Three hundred seventy-one melanomas were found in 364 persons. More than 98% had localized disease. More than 90% of the confirmed melanomas with known histology were in situ or "thin" lesions (< or = 1.50 mm thick). The median thickness of all melanomas was 0.30 mm. The 8.3% of AAD cases with advanced melanoma (metastatic disease, regional disease, or lesions > or = 1.51 mm) is a lower proportion than that reported by the 1990 Surveillance, Epidemiology and End Result Registry. The rate of thickest lesions (> or = 4 mm) and late-stage melanomas among all participants was 2.83 per 100,000 population. Of persons with a confirmed melanoma, 39% indicated (before their examination) that without the free program, they would not have considered having a physician examine their skin. CONCLUSION: The 1992-1994 free AAD programs disseminated broad skin cancer educational messages, enabled thousands to obtain a free expert skin cancer examination, and found mostly thin, localized stage 1 melanomas (usually associated with a high projected 5-year survival rate). Because biases impose possible limitations, future studies with long-term follow-up and formal control groups should determine the impact of early detection programs on melanoma mortality.

Twenty cases of persistent sore nipples: collaboration between lactation consultant and dermatologist.

The nipple and surrounding area, like other areas of skin, are subject to irritation, inflammation, and infection. Twenty women with persistent sore nipples were first seen by a lactation consultant and later referred to a dermatologist. The dermatologist successfully treated 18 of the 20 mothers. A lactation consultant should be able to identify those women who will benefit from evaluation and treatment by a dermatologist.