Les difficultés d’un suivi épidémiologique longitudinal dans les services de santé au travail

INTRODUCTION: This study was designed to describe the difficulties of epidemiological follow-up of employees by occupational health services. METHODS: This study was based on two transverse studies conducted by the Pays de la Loire musculoskeletal disorders (MSD) surveillance network. Eighty-three occupational health physicians included 3,710 employees between 2002 and 2005 and had to review them between 2007 and 2009. Thirteen of these physicians changed jobs and 7 changed geographical sector in the same occupational health service. RESULTS: Another 94 physicians were contacted and 85 agreed to participate in the network. The follow-up rate was 43%: 1,044 employees were reviewed by the physician who saw them on inclusion and 567 employees were reviewed by another physician of the network. The other employees were distributed as follows: 25% were lost to follow-up and their occupational status remained unknown; 23% were still employed with an identified occupational health physician but had not attended a medical visit during the follow-up study; 5% had left the occupational health surveillance system. Only 23 employees refused to participate in the follow-up and 105 employees had a physician who refused to participate. DISCUSSION: There is therefore a considerable mobility of occupational health physicians, which interfered with follow-up despite their good mobilization and a high percentage of employee are lost to follow-up after having left their jobs. More appropriate systems must be set up to follow populations of employees, such as new collaborations with general practitioners

Integrative data mining highlights candidate genes for monogenic myopathies

Inherited myopathies are a heterogeneous group of disabling disorders with still barely understood pathological mechanisms. Around 40% of afflicted patients remain without a molecular diagnosis after exclusion of known genes. The advent of high-throughput sequencing has opened avenues to the discovery of new implicated genes, but a working list of prioritized candidate genes is necessary to deal with the complexity of analyzing large-scale sequencing data. Here we used an integrative data mining strategy to analyze the genetic network linked to myopathies, derive specific signatures for inherited myopathy and related disorders, and identify and rank candidate genes for these groups. Training sets of genes were selected after literature review and used in Manteia, a public web-based data mining system, to extract disease group signatures in the form of enriched descriptor terms, which include functional annotation, human and mouse phenotypes, as well as biological pathways and protein interactions. These specific signatures were then used as an input to mine and rank candidate genes, followed by filtration against skeletal muscle expression and association with known diseases. Signatures and identified candidate genes highlight both potential common pathological mechanisms and allelic disease groups. Recent discoveries of gene associations to diseases, like B3GALNT2, GMPPB and B3GNT1 to congenital muscular dystrophies, were prioritized in the ranked lists, suggesting a posteriori validation of our approach and predictions. We show an example of how the ranked lists can be used to help analyze high-throughput sequencing data to identify candidate genes, and highlight the best candidate genes matching genomic regions linked to myopathies without known causative genes. This strategy can be automatized to generate fresh candidate gene lists, which help cope with database annotation updates as new knowledge is incorporated

Occupational outcome in 2007-2008 of workers suffering from musculoskeletal disorders in the French Pays de la Loire region

Aims: A French program of epidemiological surveillance implemented in 2002 in the Pays de la Loire region revealed a prevalence of 13% for the 6 most frequent upper extremity musculoskeletal disorders (UEMSDs) among a sample of salaried workers: rotator cuff syndrome, lateral epicondylitis, flexor-extensor peritendinitis of the hands and fingers, De Quervain’s disease, carpal tunnel syndrome and ulnar tunnel syndrome. The aim of this study is to describe the occupational outcome of these workers a few years later. Methods: From 2002 to 2004, 83 occupational physicians examined 3,710 workers randomly selected [1], following the recommendations of the European consensus Saltsa [2]. 3 groups were constituted: Group 1: workers with no upper limb pain during the past 7 days (49% of the sample) Group 2: workers with pain during the past 7 days but without any clinical diagnosed form of UEMSDs (38%), Group 3: workers with at least one clinically diagnosed UEMSD (13%) In 2007 and 2008, they received by mail a questionnaire about their occupational activities. Results: 2,332 people responded. Workers were older in group 3. After adjusting for age, we found as many retired people in the 3 groups. Among the non-retired workers (table), those who were not working were more numerous in group 3 and less numerous in group 1 (p=0.0007). Among those still at work, the percentage of workers who have changed their working station since 2002-2004 differed between groups (p=0.04): 24% have changed their working station in the same company in group 2 (vs 19% in group 1 and 21% in group 3), and 16% have moved to another company in group 2 (vs 14% and 10%, respectively). Conclusion: This study shows that the occupational outcome varies according to the previous UEMSDs status

Formation and interactions of cold and ultracold molecules: new challenges for interdisciplinary physics

Progress on researches in the field of molecules at cold and ultracold temperatures is reported in this review. It covers extensively the experimental methods to produce, detect and characterize cold and ultracold molecules including association of ultracold atoms, deceleration by external fields and kinematic cooling. Confinement of molecules in different kinds of traps is also discussed. The basic theoretical issues related to the knowledge of the molecular structure, the atom-molecule and molecule-molecule mutual interactions, and to their possible manipulation and control with external fields, are reviewed. A short discussion on the broad area of applications completes the review.Comment: to appear in Reports on Progress in Physic

Fibroblast growth factor signalling controls nervous system patterning and pigment cell formation in Ciona intestinalis

During the development of the central nervous system (CNS), combinations of transcription factors and signalling molecules orchestrate patterning, specification and differentiation of neural cell types. In vertebrates, three types of melanin-containing pigment cells, exert a variety of functional roles including visual perception. Here we analysed the mechanisms underlying pigment cell specification within the CNS of a simple chordate, the ascidian Ciona intestinalis. Ciona tadpole larvae exhibit a basic chordate body plan characterized by a small number of neural cells. We employed lineage-specific transcription profiling to characterize the expression of genes downstream of fibroblast growth factor signalling, which govern pigment cell formation. We demonstrate that FGF signalling sequentially imposes a pigment cell identity at the expense of anterior neural fates. We identify FGF-dependent and pigment cell-specific factors, including the small GTPase, Rab32/38 and demonstrated its requirement for the pigmentation of larval sensory organs

The Nutritional Impact of Milk Beverages in Reducing Nutrient Inadequacy among Children Aged One to Five Years in the Philippines: A Dietary Modelling Study

Around half of Filipino children are not consuming any dairy products on a given day, which has shown to be associated with increased risk of inadequate nutrient intakes. The current study applies dietary modelling to assess the nutritional impact of meeting dairy recommendations in reducing nutrient inadequacy in children aged one to five years in the Philippines. Dietary intake data of Filipino children aged one to five years (n = 3864) were analyzed from the 8th National Nutrition Survey 2013. Children who did not meet national dairy recommendations were identified. Two scenarios were applied, based on two types of commonly consumed milk products by the survey participants. In scenario one, one serving of powdered milk was added to the diet of these children. In scenario two, one serving of a young children milk (YCM) or preschool children milk (PCM) was added to the diet of children aged one to two years and three to five years, respectively. Mean nutrient intakes and percentages of children with inadequate intakes were estimated before and after applying modelling scenarios. Scenario one demonstrated improvement in calcium, phosphorus, sodium, vitamin A and riboflavin intakes, while in scenario two, further improvement of intakes of a wider range of nutrients including iron, selenium, zinc, magnesium, potassium, vitamins C, D, E, thiamin, niacin, vitamins B6, and B12 was observed. In both scenarios, if all children would meet their dairy recommendations, theoretical reductions in population nutrient inadequacy would be observed for all micronutrients, for example, only 20% of children aged one to two years would be inadequate in vitamin A instead of the current 60%, iron inadequacy would see a 5% reduction, and approximately 10% reduction for calcium and 20% reduction for folate. The present study is the first to apply dietary modelling to assess the theoretical impact of meeting dairy recommendations on nutrient inadequacy in children in the Philippines. Dairy consumption should be encouraged as part of the strategy to reduce nutrient inadequacies. Calcium, iron, vitamins D, E, and folate are of concern in the Philippines as the level of inadequacies are extremely high in early years, YCM and PCM can help increase the intake of these nutrients

Une épilepsie… pas très salée!

International audienc

Relations entre facteurs organisationnels et jobstrain/déséquilibre efforts récompenses dans des centres d'appels téléphoniques en France

Objectifs : A l’initiative de l’InVS, un réseau de surveillance épidémiologique des troubles musculosquelettiques en milieu de travail a été mis en place en 2002 dans les Pays-de-la-Loire. L’objectif de ce travail est d’identifier les facteurs individuels et professionnels associés au syndrome de la coiffe des rotateurs (SCR) et aux douleurs à l’épaule. Méthodes : Au total, 3710 salariés (58 % d’hommes et âge moyen de 38,7 # 10,3 ans) ont été inclus dans le réseau entre 2002 et 2004. Le SCR a été diagnostiqué par 83 médecins du travail selon un examen clinique standardisé. Les facteurs individuels, organisationnels, biomécaniques, et psychosociaux potentiellement associés au SCR et aux douleurs ont été recueillis par autoquestionnaire. Des régressions logistiques binaires ont été utilisées afin de modéliser les facteurs associés au SCR et aux douleurs à l’épaule. Ensuite, une régression multinomiale a été utilisée, la variable à expliquer comportant trois catégories : ne pas avoir de douleur à l’épaule (référence), avoir une douleur à l’épaule sans SCR et avoir un SCR. Seules les variables significatives au seuil de 5 % ont été retenues dans le modèle final. Résultats : La prévalence des douleurs à l’épaule dans l’échantillon était de 29,3 % celle du SCR de 7,4 %, et 63,3 % n’ont pas souffert à l’épaule. Les facteurs associés aux douleurs et au SCR sont le genre féminin (respectivement OR = 1,3 IC 95 % [1,1–1,5]) et 1,4 [1,1–1,9]), l’âge (1,6 [1,1–2,2] et 7,0 [4,1–12,2] chez les plus de 55 ans comparé aux moins de 35 ans), l’épicondylite (1,7 [1,0–2,9] et 3,6 [2,0–6,6]), le syndrome du canal carpien (1,9 [1,2–3,0] et 2,7 [1,5–4,9]), la répétitivité du geste (1,3 [1,1–1,6] et 1,7 [1,3–2,3] pour une durée de plus de 4 h/j comparé à jamais), la forte demande physique (1,4 [1,1–1,6]) et 1,7 [1,3–2,3]) et le faible soutien social hiérarchique (1,4 [1,2–1,6] et 1,5 [1,1–2,0]). L’abduction des bras comprise entre 608 et 908 (plus de 2 h/j) est associée seulement aux douleurs (1,4 [1,1–1,8]), l’abduction des bras à plus de 908 est associée au SCR (1,8 [1,1–2,7]) tandis que l’abduction des bras réunissant les 2 dernières conditions est associée aux douleurs et au SCR (1,5 [1,1–2,1]) et 2,7 [1,7–4,4]). Enfin, le rythme de travail imposé par la cadence automatique d’une machine est associé aux douleurs (1,5 [1,2–1,9]). Conclusion : Ces résultats confirment le caractère plurifactoriel des douleurs et du SCR, associant des facteurs individuels à des facteurs organisationnels, biomécaniques et psychosociaux