[Pregnancy and delivery of teenagers: Is the obstetrical prognosis worst between 13-15years old?] / Grossesse et accouchement de l'adolescente : le pronostic obstétrical est-il plus défavorable entre 13 et 15 ans ?

OBJECTIVE: To assess the prognosis of pregnancy and delivery of 13-15years old patients compared to teenagers aged of 16-17. METHODS: Single-center retrospective study of a continuous series of 13-15 teenagers followed in a public maternity between 1996 and 2012 compared to a series of patients aged of 16-17 matched on the day of the delivery (two controls for a case). RESULTS: Seventy-three teens 13-15 were followed during the study period, and 146 adolescents aged 16-17 were included and matched. The two groups did not differ regarding size, weight or medical history. Younger patients were more often educated than older ones (46.6 vs 27.4%, P<0.01). The incidence of congenital malformations was high but substantially identical in the two groups (9.6 vs 11.0%, NS), as well as prematurity concerned that almost one third of patients (27.4 vs 30.1%, NS). The Caesarean section rate was low (11.0 vs 10.3%, NS). The frequency of birth weight below the 10th percentile did not differ between groups (15.1 vs 19.9%, NS). CONCLUSION: Teenage girls of 13-15years old have high perinatal risk (prematurity, congenital malformation), and frequently delivery vaginally. These risks do not seem superior to those of adolescent girls aged of 16-17years old.

[Pulmonary diffusion test to NO and CO time course during thoracic radiotherapy for lung cancer: the CONORT prospective study protocol]. / Évolution de la double diffusion au CO et au NO au cours de la radiothérapie pulmonaire pour cancer bronchique : présentation du protocole de l'étude prospective Conort.

Thoracic radiotherapy is a usual treatment for lung cancer. Early-stages may be treated in stereotactic mode while locally advanced stages are usually treated with conventional radiotherapy mode. Pulmonary function tests show that thoracic irradiation has no impact on lung volume such as forced expiratory volume in one second (FEV1) or forced vital capacity (FCV). However, some studies found that CO (carbon monoxide) diffusing capacity (TLCO) may be altered under thoracic radiotherapy. DLCO alteration is usually symptomatic of either a lesion in the alveolar membrane or a pulmonary capillary alteration. Pulmonary diffusion may be also appreciated by the NO (azote monoxide) diffusion capacity. Moreover, using a double measurement of NO and CO diffusing capacities permit to assess which lung compartment (capillary or membrane) is affected. CONORT is an observational prospective monocentric study, aiming to assess the CO and NO diffusing capacity (as well as other pulmonary function tests) during thoracic radiotherapy. Inclusion criteria are patients with lung cancer, treated by thoracic radiotherapy (conformational or stereotactic), who signed consent. Pulmonary function tests are performed before, during, at the end and six weeks and six months after thoracic irradiation. To estimate a difference of 15% in diffusing capacity test, we have to include 112 patients with a 90% power and a 5% alpha risk. Four months after beginning, 36 patients were included. Preliminary data will be presented at the SFRO meeting.

Air pollution and atopy.

Relationships between air pollutants and atopy can be studied within 3 different settings. In vitro, exposure of pollen to air pollutants induce morphological changes and seems to facilitate extrusion on allergenic material out of the pollen grain. In animal as well as in human experiments, air pollutants, especially diesel exhaust particulates, are able to trigger an IgE-response. Epidemiological surveys also show that air pollutants trigger symptoms in patients. In contrast, whether or not air pollutants can induce de novo allergic diseases is still a matter of debate. Some surveys suggest that, in humans also, air pollutants, especially diesel-exhaust particulates, could trigger allergic sensitization and development of atopic diseases. At home, other pollutants can be involved: volatile organic compounds have pro-inflammatory properties and favour T-cell sensitization. Relationship between exposure to secondhand tobacco smoke or occupational hazards and atopic sensitization have led to discordant results.