Publications (7)21.82 Total impact
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Article: Risk factors and characteristics of respiratory and allergic phenotypes in early childhood.
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ABSTRACT: Unsupervised approaches can be used to analyze complex respiratory and allergic disorders. We investigated the respiratory and allergic phenotypes of children followed in the Pollution and Asthma Risk: An Infant Study (PARIS) birth cohort. Information on respiratory and allergic disorders, medical visits, and medications was collected during medical examinations of children at 18 months of age; biomarker data were also collected (total and allergen-specific IgE levels and eosinophilia). Phenotypes were determined by using latent class analysis. Associated risk factors were determined based on answers to questionnaires about environmental exposures. Apart from a reference group, which had a low prevalence of respiratory symptoms or allergies (n=1271 [69.4%]), 3 phenotypes were identified. On the basis of clinical signs of severity and use of health care resources, we identified a mild phenotype (n=306 [16.7%]) characterized by occasional mild wheeze and 2 severe phenotypes separated by atopic status. The atopic severe phenotype (n=59 [3.2%]) included 49 (83%) children with wheezing and was characterized by a high prevalence of atopy (61% with allergenic sensitization) and atopic dermatitis (78%). In contrast, atopy was rare among children with the nonatopic severe phenotype (n=195 [11%]); this group included 88% of the children with recurrent wheezing. Risk factors for respiratory disease included parental history of asthma, male sex, siblings, day care attendance, exposure to tobacco smoke or molds, indoor renovations, and being overweight, although these factors did not have similar affects on risk for all phenotypes. Atopy should be taken into account when assessing the risk of severe exacerbations (that require hospital-based care) in wheezing infants; precautions should be taken against respiratory irritants and molds and to prevent children from becoming overweight.The Journal of allergy and clinical immunology 08/2012; 130(2):389-96.e4. · 9.17 Impact Factor -
Article: Can early household exposure influence the development of rhinitis symptoms in infancy? Findings from the PARIS birth cohort.
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ABSTRACT: Allergic rhinitis (AR) has become the most prevalent chronic allergic disorder in childhood, and the role of environment has been questioned, particularly in early life. To investigate the risk factors for rhinitis symptoms in infants included in the PARIS (Pollution and Asthma Risk: an Infant Study) birth cohort. Infants were invited to participate at age 18 months in a health examination conducted by a pediatrician. Allergic rhinitis was defined as the presence of rhinitis symptoms (runny nose, blocked nose, sneezing in the absence of a cold) combined with biological atopy (elevated total immunoglobulin E [IgE], specific IgE, or eosinophilia) and nonallergic rhinitis (NAR) as symptoms without biological atopy. Information about indoor exposures and lifestyle was collected during a telephone interview when the child was 1 month of age. Risk factors for AR and NAR were studied by using a polytomous regression model. The prevalence of AR and NAR was 70/1,850 (3.8%) and 99/1,850 (5.4%), respectively. Allergic rhinitis and NAR did not share similar risk factors. Male sex (odds ratio [OR] = 1.99 [1.19-3.32]), parental history of AR (OR = 1.89 [1.16-3.08]), low socioeconomic class (OR = 2.23 [1.05-4.72] for low vs high level), and the presence of cockroaches in the home (OR = 3.15 [1.67-5.96]) were risk factors for AR. Conversely, the presence of particle-board furniture less than 12 months old in the child's bedroom was associated with an increased risk of NAR (OR = 1.87 [1.21-2.90]). This study should raise awareness about the impact of indoor exposures, particularly with regard to cockroaches and particle-board furniture, because they could influence the occurrence of noninfectious rhinitis.Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology 10/2011; 107(4):303-9. · 2.83 Impact Factor -
Article: Coverage and compliance of Human Papilloma Virus vaccines in Paris: demonstration of low compliance with non-school-based approaches.
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ABSTRACT: To evaluate the coverage and compliance of the Human Papilloma Virus (HPV) vaccine in Paris. We selected a female population living in Paris, between the ages of 14 and 23 years (French recommendations) on December 31st, 2008, that was affiliated to social security (n = 77,744). We evaluated the dynamic of HPV vaccine dose reimbursement between July 2007 and April/May 2009 for this population. The coverage rate in the study population with at least one dose of the vaccine was 17%. A complete vaccination scheme (three doses) was observed in less than 43% of affiliates, whereas two doses have been reimbursed to 26% of the affiliates and only one dose to 31%. Higher rates of coverage and compliance were observed among girls between 15 and 17 years of age. Coverage and compliance rates corresponding to the French HPV vaccine program appear to be lower than those observed in countries with different recommendations and implementation strategies, and particularly school-based program. Our study suggests that health authorities should modify current recommendations.Journal of Adolescent Health 09/2010; 47(3):237-41. · 3.33 Impact Factor -
Article: Prevalence of hepatitis B and hepatitis C virus infections in France in 2004: social factors are important predictors after adjusting for known risk factors.
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ABSTRACT: To monitor the prevalence of hepatitis B and hepatitis C a cross-sectional survey was conducted in 2004 among French metropolitan residents. A complex sampling design was used to enroll 14,416 adult participants aged 18-80 years. Data collected included demographic and social characteristics and risk factors. Sera were tested for anti-HCV, HCV-RNA, anti-HBc and HBsAg. Data were analyzed with SUDAAN software to provide weighted estimates for the French metropolitan resident population. The overall anti-HCV prevalence was 0.84% (95% CI: 0.65-1.10). Among anti-HCV positive individuals, 57.4% (95% CI: 43.2-70.5) knew their status. Factors associated independently with positive anti-HCV were drug use (intravenous and nasal), blood transfusion before 1992, a history of tattoos, low socioeconomic status, being born in a country where anti-HCV prevalence >2.5%, and age >29 years. The overall anti-HBc prevalence was 7.3% (95%: 6.5-8.2). Independent risk factors for anti-HBc were intravenous drug use, being a man who has sex with men, low socioeconomic status, a stay in a psychiatric facility or facility for the mentally disabled, <12 years of education, being born in a country where HBsAg prevalence >2%, age >29 and male sex. The HCV RNA and HBsAg prevalence were 0.53% (95% CI: 0.40-0.70) and 0.65% (95% CI: 0.45-0.93), respectively. Among HBsAg positive individuals, 44.8% (95% CI: 22.8-69.1) knew their status. Anti-HCV prevalence was close to the 1990s estimates whereas HBsAg prevalence estimate was greater than expected. Screening of hepatitis B and C should be strengthened and should account for social vulnerability.Journal of Medical Virology 02/2010; 82(4):546-55. · 2.82 Impact Factor -
Article: FEV1/FVC and FEV1 for the assessment of chronic airflow obstruction in prevalence studies: do prediction equations need revision?
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ABSTRACT: Little is known on the long-term validity of reference equations used in the calculation of FEV(1) and FEV(1)/FVC predicted values. This survey assessed the prevalence of chronic airflow obstruction in a population-based sample and how it is influenced by: (i) the definition of airflow obstruction; and (ii) equations used to calculate predicted values. Subjects aged 45 or more were recruited in health prevention centers, performed spirometry and fulfilled a standardized ECRHS-derived questionnaire. Previously diagnosed cases and risk factors were identified. Prevalence of airflow obstruction was calculated using: (i) ATS-GOLD definition (FEV(1)/FVC<0.70); and (ii) ERS definition (FEV(1)/FVC<lower limit of normal) with European Community for Coal and Steel (ECCS) reference equations and with predicted values derived from the presumably normal fraction of the studied population. A total of 5008 subjects (4764 adequate datasets) were studied. Prevalence of airflow obstruction was 8.71% with ATS-GOLD definition and 6.40% with ERS definition and ECCS predicted values. The ERS definition with predicted values derived from the studied population provided a 7.96% prevalence. Severity distribution of airflow obstruction was also influenced by the equation used to calculate predicted values of FEV(1). Prevalence and severity of chronic airflow obstruction are influenced not only by the definition used but also by equations used to calculate predicted FEV(1)/FVC and FEV(1) values. These equations likely need to be periodically revised.Respiratory medicine 11/2008; 102(11):1568-74. · 2.33 Impact Factor -
Article: [Colorectal cancer: assessment of two-yearly screening of the population in health care examination centres].
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ABSTRACT: To present the first assessment of the two-yearly faecal occult blood test used to screen patients attending health care centres for examinations. Method The Hemoccult II test was proposed by correspondence to 26 530 subjects aged 52-74 years, having exhibited a negative test during their periodical check-up 2 years before. The test was performed by 20 590 subjects and the corrected participation rate, taking into account unjustified sending, was of 83.1%. The positivity rate was 3.5%. In the 519 colonoscopies performed (71% of positive Hemoccult II), 23 cancers and 91 adenomas (31 larger than 1 cm) were observed (positive predictive value=22%). In 213 subjects, the information on the follow-up of the positive Hemoccult II were unavailable or unexploitable (lost to follow-up, coloscopy refused, inappropriate examinations). These results show that the two-yearly screening for colorectal cancer in an informed population after a periodical check-up results in a good participation rate. The follow-up rate of positive subjects, fundamental for the assessment of the program, is lower than during the regular check-up but remains relatively satisfactory.La Presse Médicale 11/2003; 32(32):1496-9. · 0.67 Impact Factor -
Article: [Mammography use among women aged 35 to 75 years].
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ABSTRACT: The aim of the study was to evaluate mammography use and indications (diagnosis or screening) among 19,253 women aged 35 to 75 attending a health screening centre. The data were collected by a self-administered questionnaire completed after by an interview with a nurse. Mammography use is frequent in women attending a health screening centre, even before the age of 50: 79.1% had undergone at least one mammography during their life and for 47.3% a screen had been performed within the last three years. Nevertheless mammography was only used by 65.2% of the women aged 50-69 years, target age group of the screening programme. A logistic regression model adjusting for multiple variables was used to examine factors associated with women who underwent a screen within the last three years. Women more likely to be screened were aged 50-69 (vs age 35-49: OR=3.1), used regular gynaecological care (OR=4.5), had a family history of breast cancer (OR=1.45), had in their district a breast cancer screening campaign (OR=1.93). The study indicated that women under 50 years of age with a family history of breast cancer and women aged 70 and over were under-screened. When a campaign for breast cancer screening was organised in the district the screening rates were higher in the target population (71,4% vs 60,1%) although only 64% of the women reported having attended. Current recommendations for breast cancer screening should be reviewed in the light of these results.Bulletin du cancer 12/2002; 89(11):957-62. · 0.67 Impact Factor
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2010
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Hôpital Tenon – Hôpitaux universitaires Est Parisien
Paris, Ile-de-France, France
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