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Saint-Sauveur-en-Rue, France

Richard P.,Association de Protection de la Sante des Habitants APSH | Coquart J.,Center Hospitalier Of Bethune | Cicolella A.,INERIS
Pollution Atmospherique

Bisphénol A (BPA) is a ubiquitous disruptor. It has been shown, that after exposure during gestation, BPA can induce several chronic diseases (cancer, reproductive troubles, behavioral troubles, diabetes and obesity). The aim of the study was to analyze whether éviction from BPA sources in food could diminish population exposure. 48 volunteers have given urinary samples before and after a one week éviction. The population imprégnation levels are significantly high, as 87.5 % of the studied population, which corroborâtes other biomonitoring surveys. Contrary to ail expectations, such a decrease following food withdrawal has not been systematically achieved. Several hypotheses have been cited to account for this resuit ant to more specifically account for the numerous other possible sources of poisoning. It is therefore essential that BPA levels should be clearly indicated on ail products containing the substance with an aim to identifying the best way of securing withdrawal for the population, pending enforcement of October 12, 2011 law banning BPA in plastic food packagings. Source

Dekeyser S.,Center hospitalier Bethune | Beclin E.,Unite dhygiene et de lutte contre les infections nosocomiales | Nguyen S.,Unite dinfectiologie | Dufossez F.,Center Hospitalier Of Bethune | Descamps D.,Center hospitalier Bethune
Pathologie Biologie

Objective: An outbreak of vancomycin-resistant Enterococcus faecium (E. faecium) occurred in the Bethune Hospital since March 2008 (two consecutive waves). To control this outbreak, two-point prevalence surveys were conducted in May 2008 and January 2009 in inpatients hospitalised more than 24. hours on previously non-affected wards. Methods: In each ward, information was given to inpatients, administrative and medical data were collected, rectal swabs or stool samples were performed and cultured on chromogenic media. Data were anonymised, and Epidata software was used for the analysis. Results: In May 2008, nine patients were found to be colonized with vancomycin-resistant E. faecium among the 239 patients evaluated (prevalence: 3,76%), and three new wards were affected: neurology ward, general surgical ward, and emergency department observation unit. In January 2009, only one patient, hospitalised in cardiac intensive care unit, was colonised among the 157 patients evaluated (prevalence 0,63%). Conclusions: These two-point prevalence surveys identified the reservoir of vancomycin-resistant E. faecium carriage, and were thus helpful to contain the two epidemic waves at the Bethune Hospital. A cohorting of the colonised inpatients was performed. Five secondary colonisation cases were detected among the 181 contact patients in May 2008, and no secondary case among 32 contact patients in January 2009. © 2009 Elsevier Masson SAS. Source

Lesesve J.-F.,Nancy University Hospital Center | Crepin O.,Center Hospitalier Of Bethune | Crepin O.,College de France | Siest J.-P.,Association Biologie Prospective | And 2 more authors.
Annales de Biologie Clinique

The schistocytes are fragmented red blood cells mainly observed in the setting of hemolytic anemias and particularly among the thrombotic microangiopathies. The presence of schistocytes is an important criterion for the diagnosisofmechanical anemias, though the identificationofthese cells remains problematic. As a high variability of the morphologic identification criteria of the schistocytes among morphologists has been observed, some guidelines have been proposed after workshops (French and Italian groups). The International council for standardization in hematology published a consensus in November, 2011. The French group of cellular hematology (GFHC) aimed to recover the opinion of French biologists directly confronted to schistocytes measurements. 169 out 500 (34%) answered 10 questions dealing with the identification and measurements of schistocytes as proposed by the ICSH guidelines. A consensus was reached for the urgent need of guidelines documents, moreover in the current background of the European accreditation NF EN ISO 15189 rules. A traduction in native (French) language aswarmly wished in order to facilitate the diffusion of the information. New fragmented red cell parameter recently provided by 2 manufacturers of automated blood cell counters remained doubtfull for routine use for half of the biologists. Source

Bouras A.F.,Center Hospitalier Of Bethune | Marin H.,Lille University Hospital Center | Bouzid C.,Center Pierre et Marie Curie | Pruvot F.-R.,Lille University Hospital Center | And 2 more authors.
Langenbeck's Archives of Surgery

Background: Life-threatening postoperative pancreatic fistula (LTPOPF) is the most feared complication after pancreatoduodenectomy (PD). Although completion pancreatectomy (CP) is usually performed when radiological management fails, the associated morbidity and mortality rates remain high. Here, we reviewed pancreas-preserving alternatives to CP. Methods: The PubMed database was systematically searched for publications between 1983 and 2014, describing pancreas-preserving surgical treatment of the pancreas remnant (PR) after reintervention in a context of post-PD LTPOPF. Results: A total of 12 articles including 140 patients were reviewed. Six different types of pancreas-preserving treatment were described: external wirsungostomy, simple drainage of the PF, closure of pancreatic stump, internal wirsungostomy, partial CP, and salvage pancreatogastrostomy after major leakage of a pancreatojejunostomy. The overall median survival rate was 75 % but rose to 83 % when patients undergoing only surgical drainage of the fistula were excluded. The median complication rate was 75 %, and the median length of hospital stay was 41.5 days. Further reintervention was required for 25 % of the patients. The median incidence of late diabetes was 22.5 %. The incidence of exocrine insufficiency ranged from 0 to 100 % depending on the intervention. Conclusion: Pancreas-preserving surgical management of the PR after LTPOPF can be performed with acceptable mortality and morbidity. These data suggest that CP should have a more precisely specified role in the management algorithm and should not be performed systematically. © 2015, Springer-Verlag Berlin Heidelberg. Source

Goeb V.,University of Picardie Jules Verne | Ardizzone M.,Service de Rhumatologie | Arnaud L.,Service de Medecine Interne | Avouac J.,French Institute of Health and Medical Research | And 16 more authors.
Joint Bone Spine

The use of TNFα antagonists must follow specific guidelines to ensure optimal effectiveness and safety. The French Society for Rheumatology (SFR) and Task Force on Inflammatory Joint Diseases (CRI), in partnership with several French learned societies, asked the French National Authority for Health (HAS) to develop and endorse good practice guidelines for the prescription and monitoring of TNFα antagonist therapy by physicians belonging to various specialties. These guidelines were developed, then, validated by two multidisciplinary panels of experts based on an exhaustive review of the recent literature and in compliance with the methodological rules set forth by the HAS. They pertain to the initial prescription of TNFα antagonists and to a variety of clinical situations that can arise during the follow-up of patients receiving TNFα antagonists (infections, malignancies, pregnancy, vaccination, paradoxical adverse events, surgery, use in older patients, and vasculitides). © 2013 Société française de rhumatologie. Source

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