Formaldehyde Exposure and Lower Respiratory Infections in Infants: Findings from the PARIS Cohort Study

Background: Certain chemical pollutants can exacerbate lower respiratory tract infections (LRIs), a common childhood ailment. Although formaldehyde (FA) is one of the most common air pollutants found in indoor environments, its impact on infant health is uncertain

Oral and oropharyngeal cancer surgery with free-flap reconstruction in the elderly: Factors associated with long-term quality of life, patient needs and concerns. A GETTEC cross-sectional study

Objectives: To assess the factors associated with long-term quality of life (QoL) and patient concerns in elderly oral or oropharyngeal cancer (OOPC) patients after oncologic surgery and free-flap reconstruction. Methods: Patients aged over 70 years who were still alive and disease-free at least 1 year after surgery were enrolled in this cross-sectional multicentric study. Patients completed the EORTC QLQ-C30, -H&N35 and -ELD14 QoL questionnaires, and the Hospital Anxiety and Depression Scale (HADS). Patient needs were evaluated using the Patient Concerns Inventory (PCI). Factors associated with these clinical outcomes were determined in univariate and multivariate analysis. Results: Sixty-four patients were included in this study. Long-term QoL, functioning scales and patient autonomy were well-preserved. Main persistent symptoms were fatigue, constipation and oral function-related disorders. Salivary and mastication/swallowing problems were the main patient concerns. The mean number of patient concerns increased with the deterioration of their QoL. Psychological distress (HADS score ≥ 15) and patient frailty (G8 score < 15) were significantly associated with poor QoL outcomes. Conclusions: We found a negative correlation between the number of patient concerns and QoL. Dental rehabilitation and psychological and nutritional supportive measures are of critical importance in the multidisciplinary management of elderly OOPC patients

Prognostic impact of epidermal growth factor receptor (EGFR) expression on loco-regional recurrence after preoperative radiotherapy in rectal cancer

BACKGROUND: Epidermal growth factor receptor (EGFR) represents a major target for current radiosensitizing strategies. We wished to ascertain whether a correlation exists between the expression of EGFR and treatment outcome in a group of patients with rectal adenocarcinoma who had undergone preoperative radiotherapy (RT). METHODS: Within a six-year period, 138 patients underwent preoperative radiotherapy and curative surgery for rectal cancer (UICC stages II-III) at our institute. Among them, 77 pretherapeutic tumor biopsies were available for semi-quantitative immunohistochemical investigation evaluating the intensity and the number (extent) of tumor stained cells. Statistical analyses included Cox regression for calculating risk ratios of survival endpoints and logistic regression for determining odds ratios for the development of loco-regional recurrences. RESULTS: Median age was 64 years (range: 30–88). Initial staging showed 75% and 25% stage II and III tumors, respectively. RT consisted of 44-Gy pelvic irradiation in 2-Gy fractions using 18-MV photons. In 25 very low-rectal-cancer patients the primary tumor received a boost dose of up to 16 Gy for a sphincter-preservation approach. Concomitant chemotherapy was used in 17% of the cases. All patients underwent complete total mesorectal resection. Positive staining (EGFR+) was observed in 43 patients (56%). Median follow-up was 36 months (range: 6–86). Locoregional recurrence rates were 7 and 20% for EGFR extent inferior and superior to 25%, respectively. The corresponding locoregional recurrence-free survival rate at two years was 94% (95% confidence interval, CI, 92–98%) and 84% (CI 95%, 58–95%), respectively (P = 0.06). Multivariate analyses showed a significant correlation between the rate of loco-regional recurrence and three parameters: EGFR extent superior to 25% (hazard ratio = 7.18, CI 95%, 1.17–46, P = 0.037), rectal resection with microscopic residue (hazard ratio = 6.92, CI 95%, 1.18–40.41, P = 0.032), and a total dose of 44 Gy (hazard ratio = 5.78, CI 95%, 1.04–32.05, P = 0.045). CONCLUSION: EGFR expression impacts on loco-regional recurrence. Knowledge of expression of EGFR in rectal cancer could contribute to the identification of patients with an increased risk of recurrences, and to the prediction of prognosis

Evaluation de l'environnement domestique de nouveau-nés franciliens

L objectif de notre travail a été de documenter les niveaux intérieurs de différents aérocontaminants et d en identifier les déterminants. Nous avons mené une étude environnementale dans 196 logements de nouveau-nés issus d une cohorte francilienne, combinant des questionnaires avec des mesurages répétés d aérocontaminants biologiques et chimiques. S agissant de la contamination biologique (endotoxines, moisissures, acariens) de nos logements de nouveau-nés, elle s avère faible et proche du bruit de fond. Quant à la pollution chimique par les aldéhydes, elle est omniprésente et apparaît comparable à celle retrouvée dans des études antérieures. A côté des paramètres de confort et d aération, les principales sources intérieures des aldéhydes, continues (type et âge des matériaux d ameublement et de revêtement) ou discontinues (combustions, produits ménagers, bricolage) ont bien été identifiées par le questionnaire. L extrapolation des modèles construits à l ensemble des logements des nouveau-nés recrutés ne semble pas envisageable pour les aérocontaminants biologiques, mais le serait pour les aldéhydesThe aim of our study was to estimate the levels of biological contaminants and chemical pollutants in the indoor air and then to identify their determinants. We carried out an environmental study in 196 dwellings of newborn babies recruited from a birth cohort, combining questionnaire and repeated measurements. Biological contaminants concentrations (endotoxins, fungi, house dust mites) were low, close to background level. As for aldehydes, levels were in line with previous studies. Analysis also helped to highlight the housing factors associated with aldehyde concentrations in homes: apart from comfort and aeration parameters, the main indoor aldehyde sources were either continuous (age and type of building materials and coverings), or discontinuous (smoking, use of air fresheners and cleaning products, DIY...). However not possible for airborne biological contaminants, the extrapolation of theses models to the whole infants cohort may be interesting for aldehydesPARIS-BIUP (751062107) / SudocSudocFranceF

Améliorer la qualité de l'air dans les écoles

National audienc

On-line coupling of thermal extraction with gas chromatography / tandem mass spectrometry for the analysis of semivolatile organic compounds in a few milligrams of indoor dust

International audienceAn original multiresidue method based on thermal extraction (TE) and gas chromatography/tandem mass spectrometry (GC/MS/MS) was developed to simultaneously quantify, from a very small amount of sample (a few milligrams), a wide range of concerning SVOCs, including polycyclic musks, organochlorines (OCs), organophosphates (OPs), oxadiazolones, polycyclic aromatic hydrocarbons (PAHs), polybromodiphenylethers (PBDEs), polychlorobiphenyls (PCBs), phthalates and pyrethroids, in indoor settled dust. Method limits of quantification (LOQs) ranged from 5 ng g for PCBs, oxadiazon, 4,4'-DDE and 4,4'-DDT to 2000 ng g for DEHP for a 2 mg sample of sieved dust. The proposed method was successfully validated in terms of accuracy and precision via replicate analysis of four different standard reference materials (SRMs 1649b (Urban Dust), 2585 (Organic Contaminants in House Dust), 2786 and 2787 (Fine Atmospheric Particulate Matter)) supplied by the National Institute of Standards and Technology (NIST) and was applied to five real indoor settled dust samples collected in French schools. In addition, its performance was compared to that of a previously published method based on pressurized liquid extraction (PLE) and GC/MS/MS. The different results obtained demonstrate the advantages of the proposed method over conventional methods and illustrate its two main features i) its ease of use and very rapid implementation in only three steps (sieving, weighing and analysis), which make it particularly appropriate for environmental monitoring programs and large-scale studies, and ii) its ability to precisely and accurately quantify a wide range of SVOCs from trace (a few ng g) to highly concentrated (several mg g) compounds from only 2 mg of sieved dust

Exposure Assessment of Allergens and Metals in Settled Dust in French Nursery and Elementary Schools

The aim of this study was to characterise the contamination in settled dust in French classrooms and to provide an overview of the influencing factors of dust contamination. Cat, dog and dust mite allergens and metals were measured in 51 classrooms at 17 schools. The concentrations of pet allergens in settled dust were generally low (mean value of 0.1 µg·g−1), with carpeted and rug-covered floors presenting higher dust and cat allergen concentrations. The highest metal loadings in dust were observed for manganese (Mn) and copper (Cu), while the lead (Pb) loadings were lower (16 ± 19 µg·m−2) and fell below the French guideline. Higher metal leachability was found for cadmium (Cd), Cu, Pb and strontium (Sr) at values of approximately 80%, which suggest that, in cases of dust ingestion by children, a large proportion should be assimilated through the gastro-intestinal tract. The intra-classroom and intra-school variabilities of the metal concentrations in settled dust were lower than the variability between schools. Classrooms with tiled floors had higher Pb loadings than classrooms with wood or vinyl floors. In addition, wet cleaning less than once a week resulted in greater loadings of Cu and Pb in the settled dust. Lastly, enrichment factors showed that metals in settled dust of classrooms were not only from the contribution of the natural background concentrations in soils