Determinants of participation in colonoscopic screening by siblings of colorectal cancer patients in France

International audienceBACKGROUND: Targeted colonosocopic screening is recommended for first-degree relatives of colorectal cancer patients diagnosed before the age of 60 and offers the possibility of reducing morbidity and mortality, but participation remains too low. The objective of this study was to determine in a French population the factors that affect siblings' participation in screening, notably those relating to the individuals, their medical care, their family and their social network. METHODS: A cross sectional survey was conducted in siblings of index patients having undergone surgery for colorectal cancer between 1999 and 2002 in two French counties. Siblings were contacted during 2007 and 2008 through the index patient. The factors affecting participation in colonoscopic screening were studied by logistic regression taking into account family cluster effect. RESULTS: 172 siblings of 74 index cases were included. The declared rate of undergoing at least one colonoscopy among siblings was 66%; 95%CI 59-73%. Five variables were independently associated with colonoscopic screening: perceiving fewer barriers to screening (OR = 3.2; 95%CI 1.2-8.5), having received the recommendation to undergo screening from a physician (OR = 4.9; 1.7-13.7), perceiving centres practising colonoscopy as more accessible (OR = 3.2, 1.3-7.8), having discussed screening with all siblings (OR = 3.9; 1.6-9.6) and being a member of an association (OR = 2.6; 1.0-6.6). CONCLUSIONS: The factors independently associated with participation in CRC screening by an individual at increased risk belonged to each of four dimensions relating to his individual psychosocial characteristics, to his relationship with a physician, within the family and social environment. The relevance of these results to clinical practice may help to improve compliance to recommendations in a global preventive strategy including all stages of the information pathway from the physician to the index patient and his relatives

Quality of life in patients with hereditary haemorrhagic telangiectasia (HHT)

Background: There are very few studies about general quality of life parameters, standards for the description of health status and comparison with general population data on patients with Hereditary hemorrhagic telangiectasia (HHT), a rare disease in which epistaxis is a cardinal symptom. Purpose: To assess the quality of life in a population of Spanish patients with HHT and compare it with the general population. Design and methods: Between January 1st 2005 and December 31st 2013, 187 adult patients diagnosed with HHT who were admitted to the HHT Unit of the Hospital Sierrallana, completed on their first visit, the EuroQol 5D-3L (five dimensions and three levels) quality of life descriptive test and the visual analog scale (VAS). The numerical social index value was also determined and the subjective effect of the nasal epistaxis on their quality of life was estimated classified as mild, moderate or severe. Results: Patients with HHT had greater problems than the general population in the five dimensions of the EuroQol 5D-3L, particularly considering pain/discomfort and anxiety/depression. In the VAS and the social index value, patients with HHT also scored lower than the general population, particularly older patients, males, and patients with HHT2. They also had values similar to those of populations with chronic illnesses. The subjective perception of the severity of epistaxis correlated strongly with the VAS and social index values. Conclusions: The quality of life of patients with HHT, estimated using the EuroQol 5D-3L scale, is affected across all dimensions. The scores are similar to those seen in cases of other chronic diseases. Older patients, males and the carriers of the ACVRL1 mutation generally have worse scores on these scales. The VAS and the social index value are index that correlate well with the severity of the clinical symptoms associated mainly with epistaxis

Enantiomeric fractionation of metoprolol and its major transformation products for quantitative biodegradation measurement and elucidation of biodegradation mechanisms

International audienceEnantiomeric fractionation of metoprolol and its major transformation products for quantitative biodegradation measurement and elucidation of biodegradation mechanism

Microplastics in Toulon area:occurrence and efficiency of wastewater treatment plants

The occurrence of microplastics in the environment is a growing concern. Their presence in the ocean and in sea water has been documented since the early 1970s. The sources of microplastics emissions are numerous and related to human activities. Wastewater treatment plants (WWTPs) are sometimes reported as sources of microplastics while a growing number of studies demonstrate high removal performances of microplastics during wastewater treatment. The first studies focused on microplastics above 300 μm that could be analyzed by simple techniques (optical microscopy in particular) commonly used in laboratories. The development of more powerful analytical tools has led to a lower detection limit of a few micrometers. However, the lack of harmonized analytical protocols (sampling strategy, sample preparation, etc.) still renders the comparison of results from different studies difficult. The MEDIPLAST project studies the occurrence of microplastics in the water cycle of the Toulon metropolitan area using a robust and reproducible analytical method on all the samples. Microplastics down to 10 μm are qualified and quantified in four WWTPs composed with different treatment processes. Measurement campaigns were also carried out in the marine environment at six locations in Toulon bay to assess the impact of discharge from WWTPs or harbor activities. Results show a very good performance of WWTPs with a removal of microplastics higher than 99.4%. The primary treatment is the most efficient step but biofilters and disc filters enable an additional elimination of the remaining microplastics up to 69%. Offshore measurements do not show a significant increase of microplastics at the WWTPs discharge points compared to the aquatic environment not impacted by the discharges