• 【在2002-2003年流感季节期间,法国晚期AH1N2人类重配体的鉴定和鉴定。】 复制标题 收藏 收藏
    DOI:10.1016/j.virusres.2007.10.007 复制DOI
    作者列表:Al Faress S,Ferraris O,Moules V,Valette M,Hay A,Lina B
    BACKGROUND & AIMS: :We have previously shown a clear differential genetic evolution of the hemagglutinin (HA) of human AH1N1 and AH1N2 viruses, isolated in southern France between 2001 and 2004. However, our analysis revealed that one single AH1N2 isolate, detected in 2003 (A/Lyon/0838/2003), had its HA clustering within the HAs of the AH1N1 subtypes. To determine if this virus was a new reassortant, the nucleotide sequences of its eight RNA gene segments were compared with those of five representative strains of the AH1N1, AH1N2 and AH3N2 viruses, isolated during the same time-period. According to the sequences obtained, the neuraminidase (NA) gene segment of the A/Lyon/0838/2003 (H1N2) virus was genetically closely related to those of the AH1N2 viruses, whereas the six internal genes appeared to be clustering with those of the AH1N1 viruses. This suggested that the A/Lyon/0838/2003 (H1N2) virus was the result of a second reassortment event that had occurred during the winter of 2002-2003; the N2 gene segment of an AH1N2 virus being introduced into an AH1N1 genetic background. Subsequently, we analysed the extremities of each gene segment of the viruses from the different subtypes, and experimentally reproduced, in vitro, AH1N2 reassortant viruses through co-infection of Madin-Darby canine kidney (MDCK) cells with both AH1N1 and AH1N2 viruses, isolated in the 2002-2003 influenza season. While the comparison of the AH1N1 and the AH1N2 gene segment extremities revealed no major differences, we successfully reproduced an AH1N2 reassortant virus similar to the A/Lyon/0838/2003 (H1N2) virus. This result provided an experimental evidence of the compatibility between their respective surface H1 and N2 glycoproteins, and suggests that similar events may occur silently amongst human subtypes.
    背景与目标: :我们之前已经显示了在2001年至2004年之间在法国南部分离出的人类AH1N1和AH1N2病毒的血凝素(HA)的明显遗传差异。然而,我们的分析表明,在2003年检测到了一个单独的AH1N2分离株(A / Lyon / 0838/2003),其HA群集在AH1N1亚型的HA中。为了确定这种病毒是否是新的重配体,将其八个RNA基因区段的核苷酸序列与在同一时期分离出的五个代表性AH1N1,AH1N2和AH3N2病毒株的核苷酸序列进行了比较。根据获得的序列,A / Lyon / 0838/2003(H1N2)病毒的神经氨酸酶(NA)基因片段在遗传上与AH1N2病毒密切相关,而六个内部基因似乎与A1L2 AH1N1病毒。这表明A / Lyon / 0838/2003(H1N2)病毒是2002-2003年冬季发生的第二次重排事件的结果;将AH1N2病毒的N2基因片段引入AH1N1遗传背景。随后,我们分析了来自不同亚型的病毒的每个基因片段的末端,并通过联合感染Madin-Darby犬肾(MDCK)细胞与AH1N1和AH1N2病毒,在体外实验复制了AH1N2重配病毒在2002-2003流感季节。虽然AH1N1和AH1N2基因片段末端的比较没有发现主要差异,但我们成功地复制了类似于A / Lyon / 0838/2003(H1N2)病毒的AH1N2重配病毒。该结果提供了它们各自的表面H1和N2糖蛋白之间相容性的实验证据,并表明相似的事件可能在人类亚型中悄然发生。
  • 【1990年至2003年法国的儿童白血病和人口流动。】 复制标题 收藏 收藏
    DOI:10.1038/sj.bjc.6604141 复制DOI
    作者列表:Bellec S,Baccaïni B,Goubin A,Rudant J,Ripert M,Hémon D,Clavel J
    BACKGROUND & AIMS: :In a national study, we investigated the incidence of childhood leukaemia (CL) over a 14-year period in France in relation to several measures based on the proportion of individuals who changed address between the last two national censuses. A positive association was found with the proportion of migrants who came from a distant place. The further the migrants came, the higher was the incidence of leukaemia, particularly among children aged 0-4 years in 'isolated' communes at the time of diagnosis (RR=1.4, 95% CI: 1.1,1.8 in the highest category of migration distance). Although the role of the population density was less obvious, a more marked association was found above a certain threshold. No association with the proportion of commuters was observed.
    背景与目标: :在一项全国性研究中,我们根据最近两次国家人口普查之间更改住址的个人比例,调查了法国在14年内的儿童白血病(CL)发病率,并采取了多种措施。与来自遥远地方的移民比例呈正相关。移民越远,白血病的发病率就越高,尤其是在诊断时处于“孤立”社区的0-4岁儿童中(最高移民类别中RR = 1.4,95%CI:1.1,1.8)距离)。尽管人口密度的作用不太明显,但在一定阈值以上发现了更明显的关联。没有观察到与通勤者的比例相关。
  • 【法国里昂大学医院重症监护室耐甲氧西林金黄色葡萄球菌医院感染的发生率,2003-2006年。】 复制标题 收藏 收藏
    DOI:10.1086/533547 复制DOI
    作者列表:Moalla M,Baratin D,Giard M,Vanhems P
    BACKGROUND & AIMS: :We describe the trends in the incidence of methicillin-resistant Staphylococcus aureus nosocomial infection in intensive care units in Lyon hospitals from January 1, 2003, through December 31, 2006. The incidence rate decreased from 1.77 cases per 100 ICU patients in 2003 to 1.16 cases per 100 ICU patients in 2006, a reduction of 38.0% (P = .05).
    背景与目标: :我们描述了2003年1月1日至2006年12月31日里昂医院重症监护室耐甲氧西林金黄色葡萄球菌医院感染的发生趋势。发病率从2003年的每100 ICU患者1.77例下降到2003年的1.16 2006年,每100 ICU患者中有50例病例减少了38.0%(P = 0.05)。
  • 【生活无私捐赠的前提是“匿名”和“非定向”吗?法国和魁北克的移植医师的观点。】 复制标题 收藏 收藏
    DOI:10.1016/j.socscimed.2008.02.026 复制DOI
    作者列表:Fortin MC,Dion-Labrie M,Hébert MJ,Achille M,Doucet H
    BACKGROUND & AIMS: :It can be argued that living altruistic donors should remain anonymous and should not express preferences in the selection of organ recipients. This study aimed to describe the views of transplant physicians in France and Québec regarding these issues. A total of 27 French and 19 Québec renal transplant physicians took part in individual, semi-directed interviews. Almost all of the physicians agreed that anonymity is mandatory in living altruistic donation (LAD). Regarding the issue of directed donation, most of the French physicians (78%) were opposed to any form of the practice, compared to only a third of their Québec colleagues (32%). We found that these positions were embedded in their respective cultural, legal and social contexts. These results afford a better understanding of these complex issues in two different cultural contexts, and will be useful in the development of international guidelines for LAD.
    背景与目标: 可以说,无私的活体捐献者应该保持匿名,并且在选择器官接受者时不应该表现出偏好。这项研究旨在描述法国和魁北克的移植医师对这些问题的看法。共有27位法国人和19位魁北克肾移植医师参加了个别的,半定向的访谈。几乎所有的医生都同意匿名是生活利他捐赠(LAD)中的强制性要求。关于定向捐赠问题,大多数法国医生(78%)反对任何形式的实践,而魁北克同事中只有三分之一(32%)反对。我们发现这些职位被嵌入各自的文化,法律和社会环境中。这些结果使人们能够更好地理解两种不同文化背景下的这些复杂问题,并将有助于制定国际法援署的准则。
  • 【气候变化对法国大西洋沿岸近千年的重大风暴事件的影响。】 复制标题 收藏 收藏
    DOI:10.1038/s41598-020-69069-w 复制DOI
    作者列表:Pouzet P,Maanan M
    BACKGROUND & AIMS: :This paper reviews the climatological influences on major past storm events in the North-east Atlantic. Analyses are based on a millenary record of sedimentological and historical impacts affecting coastal societies. The effects of 20 past storms have been found from sedimentary deposits from the last 1,000 years. Historical archives confirmed these events. This paper highlights five major storms that have markedly impacted coastal populations. They date back to 1351-1352, 1469, 1645, 1711 and 1751 AD. The 1351-1352 AD event is defined as a millennium storm that was "likely apocalyptical", provoking serious damage and long lasting floods on much of the European coast. Major storm impacts have mostly been recorded during positive North Atlantic Oscillation phases. Four decreasing temperature phases are concomitant with 1300-1355, 1420-1470, 1560-1590 and 1690-1715 AD periods, during which much of the northern Atlantic coast of France underwent severe storm damages.
    背景与目标: :本文回顾了气候变化对东北大西洋过去重大风暴事件的影响。分析基于影响沿海社会的千年沉积学和历史影响的记录。从过去的1000年的沉积物中发现了20次过去的风暴的影响。历史档案馆证实了这些事件。本文重点介绍了五个严重影响沿海人口的大风暴。他们的历史可以追溯到公元1351-1352、1469、1645、1711和1751年。公元1351-1352年的事件被定义为“可能是世界末日”的千年风暴,在欧洲大部分地区造成了严重的破坏和长期的洪灾。在北大西洋涛动的积极阶段,主要记录了主要的风暴影响。四个温度下降阶段与公元1300-1355年,142​​0-1470年,1560-1590年和1690-1715年相伴,在此期间,法国北部大西洋沿岸的大部分地区遭受了严重的风暴破坏。
  • 【成人肺炎链球菌心内膜炎。法国在青霉素耐药性时代(1991-1998年)的一项多中心研究。肺炎球菌性心内膜炎研究组。】 复制标题 收藏 收藏
    DOI:10.1097/00005792-200009000-00006 复制DOI
    作者列表:Lefort A,Mainardi JL,Selton-Suty C,Casassus P,Guillevin L,Lortholary O
    BACKGROUND & AIMS: :To better define the overall characteristics and risk factors for dying of adult pneumococcal endocarditis (PE) focusing on the echocardiographic diagnosis, the impact of surgery, and emergence of penicillin resistance, the medical and microbiologic charts of adult PE cases observed between 1991 and 1998 in university and general hospitals were reviewed through a nationwide retrospective study in France. Thirty cases of PE (22 men, 8 women; median age, 53 yr; range, 27-87 yr) were collected and validated. Twenty patients (66.7%) had no known predisposing cardiopathy; 4 had a bioprosthetic valve. The primary focus of infection was pneumonia in 10 (33.3%), and meningitis was noted in 12 (40.0%). Half the patients suffered from chronic alcoholism. Echocardiography detected vegetation(s) in 29 cases (96.7%), valvular perforation in 6 (20.0%), and/or valve ring abscess in 4 (13.3%). The most frequent complications were congestive heart failure (n = 19), large arterial emboli (n = 8), and focal abscesses (n = 7). Five strains were penicillin-resistant. Twenty (66.7%) patients underwent valve replacement, 12 of them during the first month. The overall mortality rate was 24.1%. According to a multivariate analysis, the risk factors independently associated with dying were age > or = 65 yr and septic shock, while cardiac surgery was protective (p < 0.01). In conclusion, PE is usually fulminant and causes severe valve damage and embolic complications; its short-term prognosis might be improved by early valve replacement.
    背景与目标: :为更好地定义成人肺炎球菌性心内膜炎(PE)的总体特征和死亡因素,重点在于超声心动图诊断,手术的影响以及青霉素耐药性的出现,我们在1991年至1998年间观察了成人PE病例的医学和微生物学图表在法国,通过一项全国性回顾性研究对大学和综合医院的住院医师进行了回顾。收集并验证了30例PE(22例男性,8例女性;中位年龄53岁;范围27-87岁)。 20例患者(66.7%)没有已知的诱发性心脏病。 4个有生物修复瓣膜。感染的主要焦点是肺炎10例(33.3%),注意到脑膜炎的12例(40.0%)。一半的患者患有慢性酒精中毒。超声心动图检查发现29例(96.7%)的植被,6例(20.0%)的瓣膜穿孔和/或4例(13.3%)的瓣膜脓肿。最常见的并发症是充血性心力衰竭(n = 19),大动脉栓塞(n = 8)和局灶性脓肿(n = 7)。五株对青霉素具有抗性。二十例(66.7%)患者接受了瓣膜置换术,其中第一个月有12例。总死亡率为24.1%。根据多变量分析,与死亡相关的独立危险因素为年龄≥65岁和败血性休克,而心脏手术是保护性的(p <0.01)。总之,PE通常是暴发性的,会导致严重的瓣膜损伤和栓塞并发症。早期更换瓣膜可改善其短期预后。
  • 【在法国,一般麻醉剂用于年轻残障成年人的拔牙。】 复制标题 收藏 收藏
    DOI:10.1038/sj.bdj.4809068 复制DOI
    作者列表:Maestre C
    BACKGROUND & AIMS: The anaesthetic management of handicapped young adults is often difficult. However, few examples were found in the literature that attempted to specifically measure the frequency of general anaesthesia in the dental treatment of this group of patients. This paper focuses on the management of mentally or physically handicapped young patients undergoing extractions at a specialist dental service in Southern France. A survey of 184 young patients treated during a 39-month period, either under general (34 cases) or local (150 cases) anaesthesia was carried out. A minimum one-year follow-up period was used for each patient. The main characteristics of the patients who received general or local anaesthesia were compared and the factors which indicated the choice of general rather than local anaesthesia were assessed. This study attempts to define precise selection criteria, including dental and non-dental factors. Limited past treatment history was found to be a strong indicator of the need for general anaesthesia. The results of this study suggest that non-dental background factors were also important. The need for general anaesthesia was markedly increased in the groups with severe behavioural disturbances or low levels of contact with the general dental practitioner. If provision of regular dental services for disabled young patients can significantly reduce the need for general anaesthesia, care will have to be taken in developing the relationships between the hospital and general dental practitioner.

    背景与目标: 残疾年轻人的麻醉处理通常很困难。但是,在文献中发现很少有实例试图专门测量这一组患者在牙科治疗中全身麻醉的频率。本文重点研究在法国南部一家专科牙科诊所接受拔牙手术的弱智或弱智年轻患者的管理。对在39个月内接受全身麻醉(34例)或局部麻醉(150例)的184例年轻患者进行了调查。每位患者的随访时间最少为一年。比较了接受全身麻醉或局部麻醉的患者的主要特征,并评估了指示选择全身麻醉而非局部麻醉的因素。这项研究试图定义精确的选择标准,包括牙科和非牙科因素。发现有限的既往治疗史是需要全身麻醉的有力指标。这项研究的结果表明,非牙科背景因素也很重要。在行为严重障碍或与普通牙科医生接触水平低的组中,全身麻醉的需求明显增加。如果为残疾的年轻患者提供定期牙科服务可以大大减少全麻的需求,则必须注意建立医院与普通牙科医生之间的关系。

  • 【法国南部遗传性视网膜营养不良和视神经病变的相对频率:21年数据管理评估。】 复制标题 收藏 收藏
    DOI:10.3109/09286586.2012.737890 复制DOI
    作者列表:
    BACKGROUND & AIMS: PURPOSE:Inherited retinal dystrophies (IRDs) and inherited optic neuropathies (IONs) are rare diseases defined by specific clinical and molecular features. The relative prevalence of these conditions was determined in Southern France. METHODS:Patients recruited from a specialized outpatient clinic over a 21-year period underwent extensive clinical investigations and 107 genes were screened by polymerase chain reaction/sequencing. RESULTS:There were 1957 IRD cases (1481 families) distributed in 70% of pigmentary retinopathy cases (56% non-syndromic, 14% syndromic), 20% maculopathies and 7% stationary conditions. Patients with retinitis pigmentosa were the most frequent (47%) followed by Usher syndrome (10.8%). Among non-syndromic pigmentary retinopathy patients, 84% had rod-cone dystrophy, 8% cone-rod dystrophy and 5% Leber congenital amaurosis. Macular dystrophies were encountered in 398 cases (30% had Stargardt disease and 11% had Best disease). There were 184 ION cases (127 families) distributed in 51% with dominant optic neuropathies, 33% with recessive/sporadic forms and 16% with Leber hereditary optic neuropathy. Positive molecular results were obtained in 417/609 families with IRDs (68.5%) and in 27/58 with IONs (46.5%). The sequencing of 5 genes (ABCA4, USH2A, MYO7A, RPGR and PRPH2) provided a positive molecular result in 48% of 417 families with IRDs. Except for autosomal retinitis pigmentosa, in which less than half the families had positive molecular results, about 75% of families with other forms of retinal conditions had a positive molecular diagnosis. CONCLUSIONS:Although gene discovery considerably improved molecular diagnosis in many subgroups of IRDs and IONs, retinitis pigmentosa, accounting for almost half of IRDs, remains only partly molecularly defined.
    背景与目标: 目的:遗传性视网膜营养不良(IRD)和遗传性视神经病变(IONs)是由特定的临床和分子特征定义的罕见疾病。在法国南部确定了这些疾病的相对患病率。
    方法:从专科门诊诊所招募的患者在21年内进行了广泛的临床研究,并通过聚合酶链反应/测序筛选了107个基因。
    结果:共有1957例IRD病例(1481个家庭)分布在70%的色素性视网膜病病例中(56%为非综合征,14%综合征),20%为斑块状病变和7%为静止状态。色素性视网膜炎患者最常见(47%),其次是Usher综合征(10.8%)。在非综合征性色素性视网膜病患者中,有84%患有杆锥营养不良,8%的锥杆营养不良和5%的Leber先天性黑病。 398例发生黄斑营养不良(30%患有Stargardt病,11%患有Best病)。共有184例ION病例(127个家庭),其中以占优势的视神经病变分布为51%,具有隐性/散发性形式的占33%,具有Leber遗传性视神经病变的占16%。在417/609个带有IRD的家庭中获得了积极的分子结果(68.5%),在27/58个带有IONs的家庭中获得了积极的分子结果(46.5%)。 5个基因(ABCA4,USH2A,MYO7A,RPGR和PRPH2)的测序为417个IRD家族中的48%提供了阳性分子结果。除常染色体色素性视网膜炎(其中少于一半的家庭的分子结果为阳性)外,约75%患有其他形式视网膜疾病的家庭的分子诊断为阳性。
    结论:尽管基因发现大大改善了IRD和IONs的许多亚类的分子诊断,但占IRD几乎一半的色素性视网膜炎仍仅在分子上有部分定义。
  • 【[法国区域预防计划的评估:自杀预防的情况]。】 复制标题 收藏 收藏
    DOI:10.3917/spub.064.0585 复制DOI
    作者列表:Bellanger M,Jourdain A
    BACKGROUND & AIMS: :Since 1994, a new prevention policy has been introduced in France. Over that period, eleven regions have conducted suicide prevention programs. It is possible today to assess the effects of these programs in retrospect. We have compared mortality data of the experimental regions to those of the other regions. We observed a significant difference in favour of the regions with suicide prevention programs. Results are discussed in relation with the achieved program content.
    背景与目标: :自1994年以来,法国引入了新的预防政策。在此期间,有11个地区实施了自杀预防计划。今天有可能回顾这些计划的效果。我们将实验区域的死亡率数据与其他区域的死亡率数据进行了比较。我们观察到对自杀预防计划有利的地区存在显着差异。讨论结果与已实现的计划内容有关。
  • 【篇名[法国中枢神经系统肿瘤的发病率和死亡率:1978-2000年期间的趋势以及登记实践对结果的影响]。】 复制标题 收藏 收藏
    DOI:10.1016/s0398-7620(06)76738-4 复制DOI
    作者列表:Ménégoz F,Martin E,Danzon A,Mathieu-Daudé H,Guizard AV,Macé-Lesec'h J,Raverdy N,Pasquier B
    BACKGROUND & AIMS: BACKGROUND:In France, cancer incidence figures are produced by cancer registries covering only 13.5% to 16% of the whole population of the country. Thus, to produce national figures, estimates have to be computed. Registration disparities between registries concerning tumors of the Central Nervous System (CNS) could have biased these estimates. METHODS:National estimates are based on modelling of the incidence/mortality ratio. The most recent estimations for year 2000 were calculated by the French Cancer Registry Network (FRANCIM) and the department of biostatistics of Lyon University Hospital. Since benign tumors are not recorded in some cancer registries, a new estimate of the incidence of CNS tumors was produced by estimating the number of benign tumors in these registries. RESULTS:In 2000 in France, the number of estimated cases of CNS tumors was 2697 in men and 2602 in women, with incidence rates (World standard) of 7.4 and 6.4 per 100,000 respectively. The incidence increased between 1978 and 2000, on an average by 2.25% per year in men and 3.01% per year in women. However, these estimates do not provide a correct picture of CNS incidence. First of all, pathological diagnoses are not performed in 3.5%-27.5% of the patients with CNS tumors registered in French registries. Second, figures for benign tumors (mainly meningiomas) were provided by only two of nine cancer registries. If benign tumors had been registered by all cancer registries, computed incidence would have increased by 12% for men and 26% for women. CONCLUSION:Incidence of CNS tumors is increasing in France, as in many other countries. To improve comparability with other countries, French cancer registries should also collect data on benign tumors. The discrepancies observed between registries in the proportion of patients without information on histology show differences in diagnostic practices and should be the starting point for a survey on this topic.
    背景与目标: 背景:在法国,癌症登记机构仅记录了该国总人口的13.5%至16%的癌症发病率数据。因此,要产生国家数据,必须计算估计值。有关中枢神经系统(CNS)肿瘤的注册管理机构之间的注册差异可能会使这些估计数产生偏差。
    方法:国家估计数基于发病率/死亡率的模型。法国癌症注册网络(FRANCIM)和里昂大学医院生物统计学系计算了2000年的最新估计值。由于在某些癌症登记册中未记录良性肿瘤,因此通过估算这些登记册中良性肿瘤的数目可以得出有关中枢神经系统肿瘤发生率的新估计。
    结果:在法国,2000年CNS肿瘤的估计病例数为男性2697例,女性2602例,发病率(世界标准)分别为100,000例7.4和6.4。发病率在1978年至2000年之间增加,男性平均每年增加2.25%,女性平均每年增加3.01%。但是,这些估计不能提供中枢神经系统发病率的正确描述。首先,在法国注册处登记的CNS肿瘤患者中,没有进行病理诊断的占3.5%-27.5%。第二,良性肿瘤(主要是脑膜瘤)的数字仅由九个癌症登记处中的两个提供。如果所有癌症登记处都登记了良性肿瘤,那么男性的计算发病率将增加12%,女性将增加26%。
    结论:与许多其他国家一样,法国的中枢神经系统肿瘤发病率正在上升。为了提高与其他国家的可比性,法国癌症注册机构还应该收集有关良性肿瘤的数据。在没有组织学信息的患者中,注册表之间观察到的差异显示出诊断方法的差异,应该成为对此主题进行调查的起点。
  • 【法国多发性硬化症的地理变异。】 复制标题 收藏 收藏
    DOI:10.1093/brain/awq134 复制DOI
    作者列表:Fromont A,Binquet C,Sauleau EA,Fournel I,Bellisario A,Adnet J,Weill A,Vukusic S,Confavreux C,Debouverie M,Clerc L,Bonithon-Kopp C,Moreau T
    BACKGROUND & AIMS: :France is located in an area with a medium to high prevalence of multiple sclerosis, where its epidemiology is not well known. We estimated the national and regional prevalence of multiple sclerosis in France on 31 October 2004 and the incidence between 31 October 2003 and 31 October 2004 based on data from the main French health insurance system: the Caisse Nationale d'Assurance Maladie des Travailleurs Salariés. The Caisse Nationale d'Assurance Maladie des Travailleurs Salariés insures 87% of the French population. We analysed geographic variations in the prevalence and incidence of multiple sclerosis in France using the Bayesian approach. On the 31 October 2004, 49 417 people were registered with multiple sclerosis out of the 52 359 912 insured with the Caisse Nationale d'Assurance Maladie des Travailleurs Salariés. Among these, 4497 were new multiple sclerosis cases declared between 31 October 2003 and 31 October 2004. After standardization for age, total multiple sclerosis prevalence in France was 94.7 per 100,000 (94.3-95.1); 130.5 (129.8-131.2) in females and 54.8 (54.4-55.3) in males. The national incidence of multiple sclerosis between 31 October 2003 and 31 October 2004 was 7.5 per 100,000 (7.3-7.6); 10.4 (10.2-10.6) in females and 4.2 (4.0-4.3) in males. The prevalence and incidence of multiple sclerosis were higher in North-Eastern France, but there was no obvious North-South gradient. This study is the first performed among a representative population of France (87%) using the same method throughout. The Bayesian approach, which takes into account spatial heterogeneity among geographical units and spatial autocorrelation, did not confirm the existence of a prevalence gradient but only a higher prevalence of multiple sclerosis in North-Eastern France and a lower prevalence of multiple sclerosis in the Paris area and on the Mediterranean coast.
    背景与目标: 法国位于多发性硬化症的中度至高度流行地区,其流行病学尚未广为人知。我们根据法国主要健康保险体系:法国国民健康保险组织的数据,估计了2004年10月31日法国在全国和地区的多发性硬化症患病率,以及2003年10月31日至2004年10月31日的发病率。国民储蓄担保组织向萨拉瓦列人的萨拉迪埃人提供保险,使法国人口获得87%的保险。我们使用贝叶斯方法分析了法国多发性硬化症患病率和发病率的地理差异。在2004年10月31日,有52,359,912例因凯撒国民保险(Calasse Nationale d'Assurance Maladie des TravailleursSalariés)投保的52,359,912人中,有49,417人患有多发性硬化症。其中,有4497例是在2003年10月31日至2004年10月31日之间宣布的新的多发性硬化症病例。按照年龄标准化后,法国的多发性硬化症总患病率为每10万人中94.7(94.3-95.1);女性为130.5(129.8-131.2),男性为54.8(54.4-55.3)。在2003年10月31日至2004年10月31日期间,全国多发性硬化症的发病率是每100,000例7.5(7.3-7.6);女性为10.4(10.2-10.6),男性为4.2(4.0-4.3)。法国东北部多发性硬化症的患病率和发病率较高,但没有明显的南北梯度。这项研究是在法国有代表性的人群(87%)中首次使用相同的方法进行的。贝叶斯方法考虑了地理单位之间的空间异质性和空间自相关性,并未证实存在患病率梯度,而仅证实法国东北部多发性硬化症的患病率较高,而巴黎地区的多发性硬化症的患病率较低在地中海沿岸。
  • 【MIDTAL项目简介:其方法和样品来自法国阿尔卡雄湾。】 复制标题 收藏 收藏
    DOI:10.1007/s11356-012-1299-9 复制DOI
    作者列表:Kegel JU,Del Amo Y,Medlin LK
    BACKGROUND & AIMS: :Microalgae worldwide regularly cause harmful effects, considered from the human perspective, in that they cause health problems and economic damage to fisheries and tourism. Cyanobacteria cause similar problems in freshwaters. These episodes encompass a broad range of phenomena collectively referred to as "harmful algal blooms" (HABs). For adequate management of these phenomena, monitoring of microalgae is required. However, effective monitoring is time-consuming because cell morphology as determined by light microscopy may be insufficient to give definitive species and toxin attribution. In the European Union FP7 project MIDTAL (Microarrays for the Detection of Toxic Algae), we achieved rapid species identification using rRNA genes as the target. These regions can be targeted for probe design to recognise species or even strains. We also included antibody reactions to specific toxins produced by these microalgae because, even when cell numbers are low, toxins can be present and can accumulate in the shellfish. Microarrays are the state-of-the-art technology in molecular biology for the processing of bulk samples for detection of target RNA/DNA sequences. After 36 months, we have completed RNA-cell number-signal intensity calibration curves for 18 HAB species and the analysis of monthly field samples from five locations from year 1. Results from one location, Arcachon Bay (France), are reported here and compared favourably with cell counts in most cases. In general, the microarray was more sensitive than the cell counts, and this is likely a reflection in the difference in water volume analysed with the volume filtered for the microarray an order of magnitude greater.
    背景与目标: 从人类的角度来看,全世界的微藻类经常造成有害影响,因为它们会对渔业和旅游业造成健康问题和经济损失。蓝细菌在淡水中引起类似的问题。这些事件包含广泛的现象,统称为“有害藻华”(HABs)。为了适当处理这些现象,需要监控微藻。但是,有效的监视非常耗时,因为通过光学显微镜确定的细胞形态可能不足以提供确定的物种和毒素归因。在欧盟FP7项目MIDTAL(用于检测有毒藻类的微阵列)中,我们实现了以rRNA基因为目标的快速物种鉴定。这些区域可以作为探针设计的目标,以识别物种甚至菌株。我们还包括了针对这些微藻产生的特定毒素的抗体反应,因为即使细胞数量很少,毒素也可能存在并可以在贝类中积聚。微阵列是分子生物学中用于处理大量样品以检测目标RNA / DNA序列的最新技术。 36个月后,我们已经完成了针对18种HAB物种的RNA细胞数信号强度校准曲线,并从第一年开始对五个地点的月度田间样品进行了分析,在此处报告并比较了一个地点阿尔卡雄湾(法国)的结果在大多数情况下,细胞计数都非常有利。通常,微阵列比细胞计数更敏感,这很可能反映了用微阵列过滤的水量分析的水量差异大了一个数量级。
  • 【[在金融化时代重塑医疗体系。法国和巴西的教训]。】 复制标题 收藏 收藏
    DOI:10.1590/1413-81232018237.11422018 复制DOI
    作者列表:Cordilha AC,Lavinas L
    BACKGROUND & AIMS: :Since the post-War period, social protection systems have experienced continuous reforms, either extending or, more often, reducing the scope and the scale of public provision. This paper seeks to present how healthcare systems have evolved both in France and in Brazil recently, in order to comprehend mechanisms through which financialization has been reshaping public care provision. This comparative analysis unveils distinct financialization dynamics of healthcare systems, built upon universalism principles. After featuring both systems, underlying their private dimension - either complementary or supplementary - the article points out how the financial sector is broadening its share in the supply of healthcare services. In what follows, the sector's process of internationalization/centralization is analyzed and lastly the regulatory role of the State in strengthening private provision is defined. Despite radically different institutional paths, the findings corroborate that in both cases finance is a driving force in reshaping the healthcare sector. :Desde a segunda metade do século XX, reformas tornaram-se contínuas no âmbito dos sistemas de proteção social, ampliando ou, com mais frequência, restringindo o escopo e a escala da provisão pública. Neste artigo, cotejamos a evolução recente dos sistemas de saúde na França e no Brasil, de modo a apreender os mecanismos através dos quais a “financeirização” vem reformatando a provisão pública. Essa abordagem comparada tem por finalidade explicitar dinâmicas diferenciadas de penetração do capital financeiro em sistemas de saúde que se pautaram por princípios universalistas. Após caracterizar brevemente ambos os sistemas de saúde, destacando o alcance da provisão privada seja complementar, seja suplementar, o artigo mostra como o setor financeiro vem ampliando sua participação na oferta de serviços de saúde. Em seguida, analisa como se dá o processo de internacionalização/centralização do setor, e, finalmente, sintetiza o papel regulatório do Estado no fortalecimento da provisão privada. Os resultados indicam que, a despeito de trajetórias institucionais radicalmente opostas, a marcha da financeirização avança no setor de saúde.
    背景与目标: :自战后以来,社会保护体系经历了不断的改革,要么扩大,要么更经常地减少公共服务的范围和规模。本文旨在介绍最近在法国和巴西的医疗体系如何发展,以便理解金融化重塑公共医疗服务的机制。这项比较分析揭示了基于普遍主义原则的独特的医疗保健系统金融化动态。在对这两种系统进行了介绍之后,它们指出了它们的私有维度(互补的或补充的)的基础,并指出了金融部门如何扩大其在医疗服务供应中的份额。接下来,分析了该部门的国际化/集中化进程,最后定义了国家在加强私人供给方面的监管作用。尽管机构路径截然不同,但研究结果证实,在这两种情况下,金融都是重塑医疗保健行业的动力。
    :在XX世卫组织第二次世界大战期间,改革社会保护,两栖,两栖,后备队,再三队或后备队。sproculaséculoséculoséculoXX,séculoséculoséculoXX。巴西的Neste artigo,巴西的最近的发展机构,巴西的先例,后继的墨西哥人和西班牙人。通用金融公司与首都金融公司之间的最终对决萨尔瓦多地区发展银行,西班牙私有企业,塞维利亚超级企业,阿尔及利亚最普通的企业,西班牙金融服务公司。塞古达(Em seguida),国际定居点/定居点,定居点,圣帕特里克(sintetiza o papel)或私人户口(saledo no fortalecimento)。您可以在结果显示,在根本上解决问题的机构,在金融机构工作的人。
  • 【法国北部中风和急性冠状动脉事件发生率的比较。】 复制标题 收藏 收藏
    DOI:10.1177/2047487318788921 复制DOI
    作者列表:Cottel D,Montaye M,Marécaux N,Amouyel P,Dallongeville J,Meirhaeghe A
    BACKGROUND & AIMS: :Background Although stroke and acute coronary events share several risk factors, few studies have compared population-level epidemiological surveillance indicators of the two diseases in the same age range and in the same geographical area. Design The objective of the present study was to compare the rate of acute coronary events with that of stroke among inhabitants aged from 35-74 years in Northern France (Lille). Methods All incident and recurrent acute coronary events and stroke events occurring in men and women over 2008-2014 were recorded using two population-based registries with several overlapping sources of case ascertainment for hospitalised/non-hospitalised and fatal/non-fatal events. Log-linear Poisson regression models were used to compare the event and mortality rates. Results The results showed that the incident rates of acute coronary event and stroke were similar except under 60 years. In this group (35-59 years), the incident rate of acute coronary events was 1.6-fold higher than that of stroke. In contrast, the attack (incident and recurrent) rates were higher for acute coronary events than for stroke (1.5-fold; p < 0.0001) - especially in men (1.8-fold; p < 0.0001). The mortality rate was 2.2-fold higher for acute coronary events than for stroke, independent of sex and age group ( p < 0.0001), as was the case-fatality rate (1.5-fold, p < 0.0001). Conclusion In Lille, the overall acute coronary event rate was higher than the stroke rate - especially among men, due to a higher risk of incident acute coronary event under the age of 65 and a higher risk of recurrent acute coronary event in the 65-74 year-old age range. Further efforts should be devoted to primary and secondary prevention strategies after acute coronary events.
    背景与目标: 背景:尽管中风和急性冠状动脉事件具有多种危险因素,但很少有研究比较相同年龄范围和相同地理区域的两种疾病的人群水平流行病学监测指标。设计本研究的目的是比较法国北部(里尔)年龄在35-74岁之间的居民的急性冠脉事件发生率和中风发生率。方法使用两个基于人口的登记处记录了2008-2014年期间男性和女性的所有突发事件和复发性事件以及复发性事件和中风事件,其中有几个重叠的病例确定源,用于确定住院/非住院和致命/非致命事件。对数线性泊松回归模型用于比较事件和死亡率。结果结果表明,除了60岁以下,急性冠心病和中风的发生率相似。在这一组(35-59岁)中,急性冠状动脉事件的发生率比中风高1.6倍。相反,急性冠状动脉事件的发作(事件和复发)率比中风要高(1.5倍; p <0.0001),尤其是男性(1.8倍; p <0.0001)。与性别和年龄组无关(p <0.0001),急性冠脉事件的死亡率比中风高2.2倍(p <0.0001),病死率也是如此(1.5倍,p <0.0001)。结论在里尔,总体急性冠脉事件发生率高于中风发生率-特别是在男性中,这是由于65岁以下的急性冠脉事件的发生风险较高,而65-74岁的复发性急性冠脉事件的发生风险较高岁年龄段。急性冠状动脉事件后,应进一步努力进行一级和二级预防策略。
  • 【2020年3月,法国,与冠状病毒病(COVID-19)流行同步的类似流感样疾病的过量病例。】 复制标题 收藏 收藏
    DOI:10.2807/1560-7917.ES.2020.25.14.2000326 复制DOI
    作者列表:Boëlle PY,Souty C,Launay T,Guerrisi C,Turbelin C,Behillil S,Enouf V,Poletto C,Lina B,van der Werf S,Lévy-Bruhl D,Colizza V,Hanslik T,Blanchon T
    BACKGROUND & AIMS: :Several French regions where coronavirus disease (COVID-19) has been reported currently show a renewed increase in ILI cases in the general practice-based Sentinelles network. We computed the number of excess cases by region from 24 February to 8 March 2020 and found a correlation with the number of reported COVID-19 cases so far. The data suggest larger circulation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the French population than apparent from confirmed cases.
    背景与目标: :目前已报道了几个冠状病毒病(COVID-19)的法国地区,在以常规医疗为基础的Sentinelles网络中,ILI病例再次出现增加。我们计算了2020年2月24日至2020年3月8日各地区的超额病例数,发现与迄今报告的COVID-19病例数相关。数据表明,与确诊病例相比,法国人群中严重急性呼吸系统综合症冠状病毒2(SARS-CoV-2)的传播更大。

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