Soil contamination following an industrial accident : towards efficient investigations and assessment

International audienceWhen an industrial accident occurs, e.g. the explosion or the fire of a chemical facility, soil investigations and subsequent risk mitigation generally need to be decided and performed rapidly. This requires specific organisation and tools: Procedures for an immediate and coordinated intervention of relevant actors: industrials, administrations for industrial facilities, emergency and health, local authorities, environmental consultants and laboratories, NGOs. Models and input data on emission, atmospheric transfer and deposition on soil, for an accidental source; investigation plans and adequate soil quality references, guidelines... But the European Seveso legislation, and its application in France and probably in Europe, is focused on the prevention of immediate impacts on health and constructions; and the Integrated Pollution Prevention and Control (IPPC) legislation deals with the chronic impacts of operating facilities. Thus, post-accidental impacts of industrial accidents are hardly dealt with, the specific organisation and tools are lacking, and when accidents occur, the industrials and administrations concerned are largely unprepared for managing their delayed impacts, first of them on soils

Spontaneous Dissection of Right Coronary Artery Manifested with Acute Myocardial Infarction

Spontaneous coronary artery dissection is a rare cause of acute ischemic coronary events and sudden cardiac death. It usually occurs in young women without traditional risk factors for coronary artery disease during pregnancy or postpartum period. However, it has also been reported in patients with atherosclerotic coronary disease. We present a case of spontaneous right coronary artery dissection in a 48-year male with recent myocardial infarction and previous percutaneous coronary intervention

Effects of statins on plaque rupture assessed by optical coherence tomography in patients presenting with acute coronary syndromes: insights from the optical coherence tomography (OCT)-FORMIDABLE registry

Aims Chronic pre-treatment with statins may reduce mortality and morbidity in patients experiencing acute coronary syndromes (ACS), but mechanisms accounting for these findings are not completely understood. Methods and results The optical coherence tomography (OCT)-Formidable registry retrospectively enrolled 285 consecutive patients with ACS undergoing OCT in 9 European centres. Mean age was 60.4 ± 12.8 years, 148 (51.9%) patients had hyperlipemia, 45 (15.8%) diabetes mellitus and 142 (49.8%) presented with ST Segment Elevation Myocardial Infarction (STEMI). Patients were stratified according to statin prescription: 150 (52.6%) were on chronic pre-treatment with statins before ACS and were more likely to present with non-ST segment elevation acute coronary syndromes (NSTE-ACS) at admission (111, 74%) rather than STEMI, while the opposite was observed for patients not on statins. The primary end-point of ruptured plaque at OCT occurred significantly less frequently in the patients on chronic pre-treatment with statins [odds ratio (OR) 0.375, 95% confidence interval (CI) 0.185-0.759, P = 0.006]. The secondary end-point of thin-cap fibro-atheroma (TCFA) at any site was significantly less frequent in the statin group (OR 0.423, 95%CI 0.213-0.840, P = 0.014). No differences were observed for the secondary end-point of not-ruptured TCFA as the culprit lesion. Pre-specified sensitivity analysis was conducted according to the pattern of ACS: the reported differences were confirmed for NSTE-ACS patients, with a trend towards less plaque rupture and a significant reduction of TCFA at any site with statins, but not for STEMI. Conclusions Chronic pre-treatment with statins is associated with a reduced prevalence of ruptured plaques in patients presenting with ACS, particularly in those with NSTE-ACS. Statins bear hence the potential to reduce morbidity during the acute phase of ACS

Association of the PHACTR1/EDN1 genetic locus with spontaneous coronary artery dissection

Background: Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndromes (ACS) afflicting predominantly younger to middle-aged women. Observational studies have reported a high prevalence of extracoronary vascular anomalies, especially fibromuscular dysplasia (FMD) and a low prevalence of coincidental cases of atherosclerosis. PHACTR1/EDN1 is a genetic risk locus for several vascular diseases, including FMD and coronary artery disease, with the putative causal noncoding variant at the rs9349379 locus acting as a potential enhancer for the endothelin-1 (EDN1) gene. Objectives: This study sought to test the association between the rs9349379 genotype and SCAD. Methods: Results from case control studies from France, United Kingdom, United States, and Australia were analyzed to test the association with SCAD risk, including age at first event, pregnancy-associated SCAD (P-SCAD), and recurrent SCAD. Results: The previously reported risk allele for FMD (rs9349379-A) was associated with a higher risk of SCAD in all studies. In a meta-analysis of 1,055 SCAD patients and 7,190 controls, the odds ratio (OR) was 1.67 (95% confidence interval [CI]: 1.50 to 1.86) per copy of rs9349379-A. In a subset of 491 SCAD patients, the OR estimate was found to be higher for the association with SCAD in patients without FMD (OR: 1.89; 95% CI: 1.53 to 2.33) than in SCAD cases with FMD (OR: 1.60; 95% CI: 1.28 to 1.99). There was no effect of genotype on age at first event, P-SCAD, or recurrence. Conclusions: The first genetic risk factor for SCAD was identified in the largest study conducted to date for this condition. This genetic link may contribute to the clinical overlap between SCAD and FMD

N° 85. — Interactions interfaciales entre l’acide désoxycholique, le cholestérol et la lécithine

L’interaction interfaciale entre l’acide désoxycholique, le cholestérol et la lécithine a été étudiée par la méthode des films mixtes étalées à l’interface eau/air. De plus, la théorie, élaborée récemment par l’un d’entre nous, permettant de décrire le comportement superficiel d’un mélange de tensides a été appliquée à l’interface solution/phase huileuse (heptane ou tétrachlorure de carbone). Ces expériences faites aux interfaces eau/air et eau/heptane ou tétrachlorure de carbone indiquent si les interactions sont dues aux forces Van der Waals ou non. Il en suit que l’interaction entre les films étalés de la lécithine et l’acide désoxycholique en absence des ions calciques, observée à l’interface eau/air, serait due aux forces de Van der Waals. En présence des ions calciques, pourtant une interaction se manifeste aussi à l’interface eau/phase huileuse indiquant que les ions calciques forment un complexe entre les groupes carboxyliques et phosphorylés. L’interaction entre le cholestérol et l’acide désoxycholique se manifeste aussi bien à l’interface eau/air qu’à l’interface eau/phase huileuse. Il y a aussi un effet de pH, mais le rôle des ions calciques est peu important

Attentats de novembre 2015 à Paris : impact sur les relations parents–enfants et sur les enfants des professionnels et bénévoles mobilisés au secours des victimes

International audienceIntroduction : After the attacks in Paris and Saint-Denis in November 2015, Santé publique France launched the November 2015 Post-Attacks Public Health Survey (ESPA November 13) open to people exposed as well as to professionals and volunteers (first responders) came to the rescue of civilians on the night of the attacks or in the weeks that followed. these victims could be people directly threatened or witnesses. Among the questions of the survey, one of them concerns the effect of the attacks on parent–child relations and on the children. This article discusses the responses of the first responders. Method : Carried out via the Internet, the survey takes place in two phases carried out in 2016 and 2020. It consists of closed-ended and open-ended questions, including the question of interest for this article: “If you have children, can you tell us if you think the experience you had had an effect on them, or on the relationship with them? Can you explain to us?” The answers are analyzed according to a thematic analysis with comparison of the answers collected in 2016 and 2020. Results : Five main themes show that a part of the first responders did not notice any change in their children or in their relationships with their children. For the others, they identify factors of psychic contagion which raise questions about their ability to have been able to protect their children. Parent–child relationships are modified, and some children have developed a strong concern for their parents or even various disorders. Conclusion : The attacks had a psychological impact for some children and modified the parent–child attachment ties (more fusional attachment ties), highlighting a strong feeling of insecurity for both parents and children, at the risk of impeding the process of empowerment of children.Introduction : Après les attentats de Paris et Saint-Denis en novembre 2015, Santé publique France a lancé l’Enquête de Santé publique postattentats de novembre 2015 (ESPA 13 novembre) ouverte aux personnes exposées ainsi qu’aux professionnels et bénévoles (intervenants) venus au secours des civils. Parmi les questions de l’enquête, l’une d’elles porte sur l’effet des attentats sur les relations parents–enfants et sur les enfants. Cet article traite des réponses des intervenants. Méthode : Réalisée par Internet, l’enquête se déroule en deux phases réalisées en 2016 et 2020. Elle se compose de questions fermées et ouvertes dont la question d’intérêt de cet article : « Si vous avez des enfants, pouvez-vous nous dire si vous pensez que l’expérience que vous avez vécue a eu un effet sur eux, ou sur la relation avec eux ? Pouvez-vous nous expliquer ? ». Les réponses sont traitées selon une analyse thématique avec comparaison des réponses recueillies en 2016 et 2020. Résultats : Cinq thèmes principaux apparaissent montrant qu’une partie des intervenants n’ont constaté aucun changement chez leurs enfants ou dans leurs relations avec leurs enfants. Pour les autres, ils identifient des facteurs de contagion psychique qui les interrogent sur leur capacité à avoir su protéger leurs enfants. Les relations parents–enfants sont modifiées et certains enfants ont développé une forte inquiétude pour leurs parents voire des troubles divers. Conclusion : Les attentats ont eu un impact psychique pour certains enfants et ont modifié les liens d’attachements, mettant en avant un fort sentiment d’insécurité des membres de la famille, au risque d’empêcher le processus d’autonomisation des enfants

Simulation du déploiement de stents à partir d’éléments «poutres» élasto-plastiques

International audienc