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Epidemiology of Amyotrophic Lateral Sclerosis in the Pays de la Loire, France: A 20-Year Study from a Centralized Diagnostic Center
No full textInternational audienceINTRODUCTION: Amyotrophic lateral sclerosis (ALS) is a fatal motor neurons disease with multifactorial etiology. The epidemiology of ALS in France is mainly documented through the Limousin regional registry (FRALim). We aimed to determine the incidence and clinical characteristics of ALS cases over a 20-year period in another French region, the Pays de la Loire, served by a single centralized diagnostic center. METHODS: All patients diagnosed with ALS at the Angers University Hospital reference center between 2003 and 2023 were retrospectively included. Demographic and clinical data were extracted from medical records, and incidence rates were calculated using annual population estimates from the National Institute of Statistics and Economic Studies. Spatial analyses were performed to identify over-incidence areas and potential environmental or occupational determinants. RESULTS: A total of 1,316 patients were diagnosed with ALS during the study period, corresponding to a crude incidence rate of 1.88 cases per 100,000 person-years (95% CI: 1.78-1.98), with no significant variation over time. The standardized incidence rate was 1.73 (95% CI: 1.63-1.83). The mean age at symptom onset was 63.6 ± 11.2 years, 58.7% of patients were male. The mean disease duration was 3.7 ± 3.5 years. ALS onset was spinal in 70.3%, bulbar in 27.9%, and respiratory in 1.7% of cases. Familial or genetic forms accounted for 6% of patients. Four geographical over-incidence areas were identified, with no correlation found with pesticide use, air pollution, or other environmental indicators. One occupational cluster was observed among farmers in a specific commune, prompting a dedicated investigation. CONCLUSION: This 20-year retrospective study provides the first epidemiological data on ALS in western France. The incidence and clinical features are consistent with national and European data. The identification of spatial and occupational clusters underlines the importance of continued regional surveillance and of prospective, registry-based studies to clarify environmental and occupational risk factors for ALS
Standardized method for evaluating plant extracts for anemia treatment in public health nutrition: using a rat model of chemically induced anemia
No full textInternational audienceAnemia remains a major global public health concern, underscoring the need for innovative nutritional and therapeutic strategies. Indigenous food plants such as Carica papaya (pawpaw) have attracted attention as potential remedies; however, their claimed benefits require rigorous scientific confirmation through well-designed experimental models prior to clinical consideration. This study was designed to formulate and demonstrate a validated, two-stage experimental framework for the systematic assessment of plant-based anti-anemic activity, with C. papaya leaf and seed extracts used as a representative model. Anemia was experimentally induced in Wistar rats using aluminum chloride (AlCl₃) administered orally at 0.5 mg/kg daily for 14 days. The evaluation protocol consisted of two consecutive phases. In Stage 1, crude methanol extracts were screened at graded doses of 100, 300, and 500 mg/kg. Stage 2 focused on the most active extract identified in Stage 1, from which alkaloid and flavonoid fractions were isolated and tested at 75 and 150 mg/kg. Key hematological indices red blood cell count (RBC), hemoglobin concentration (Hb), packed cell volume (PCV), and full blood count were assessed throughout the 14-day treatment period. Administration of AlCl₃ produced marked anemia, evidenced by a decline in RBC from 7.15 to 5.05 × 10¹²/L and a reduction in Hb from 13.65 to 8.55 g/dL in untreated anemic controls. During Stage 1, methanol extracts of C. papaya leaves at 300 and 500 mg/kg demonstrated the strongest hematological recovery, significantly improving RBC, Hb, and PCV values toward normal ranges. In Stage 2, the leaf-derived alkaloid fraction at 150 mg/kg emerged as the most potent intervention, surpassing flavonoid fractions and exhibiting a clear dose-responsive effect. Overall, this work introduces a reliable and reproducible two-stage experimental approach for screening and characterizing plant-derived anti-anemic agents. The results highlight C. papaya leaf methanol extract, particularly its alkaloid fraction, as a promising candidate for anemia management and provide a standardized methodological framework for future studies in this area
From policy to practice in cervical cancer prevention in Reunion Island
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Approche intégrée de la surveillance des pesticides dans l'air : usages, pratiques et contexte local
No full textInternational audiencePesticides in ambient air pose significant public health concerns, yet no specific regulatory framework exists in France. This study investigates pesticide concentrations measured in Brittany (2021-2022) and their relationship with local agricultural practices, substance physicochemical properties, and meteorological conditions. Data was sourced from the national monitoring network, the national sales database, and a local farmer survey. Herbicides dominate both usage (~12 t/year) and detections, with seasonal peaks for prosulfocarb and pendimethalin (1.88 and 0.62 ng/m³). Conversely, S-metolachlor, despite high sales, was less frequently detected (less than 0,01 ng/m³). Substances not applied locally, including triallate and banned lindane, were also found, highlighting contaminant mobility and persistence. Additionally, 54 locally identified substances are absent from the national monitoring program, revealing a gap between surveillance and regional practices. These findings emphasize the need to adapt monitoring strategies to better reflect local agricultural realities.La présence de pesticides dans l'air soulève des questions sanitaires et sociales majeures, alors qu'aucune réglementation spécifique n'existe à ce jour. Cette étude analyse les concentrations atmosphériques mesurées en Bretagne (2021-2022) en lien avec les pratiques agricoles locales, les propriétés physico-chimiques des substances et les conditions météorologiques. Les données proviennent du réseau national de surveillance, de la Banque nationale des ventes et d'une enquête locale. Les herbicides dominent les usages (~12 t/an) et les détections, avec des pics saisonniers pour le prosulfocarbe et la pendiméthaline (1,88 et 0,62 ng/m³). À l'inverse, le S-métolachlore, pourtant largement vendu, reste peu présent (inférieur à 0,1ng/m³). Des substances non appliquées localement, dont le lindane (interdit), ont été détectées, illustrant la mobilité et la persistance de certains contaminants. Enfin, 54 substances identifiées localement ne figurent pas dans le programme national, soulignant la nécessité d'adapter la surveillance aux spécificités régionales
Who are the healthcare professionals involved in interprofessional team meetings in French multidisciplinary primary care centres? A quantitative analysis of eight centres
No full textInternational audienceBACKGROUND: Interprofessional collaboration is crucial for providing high-quality care to patients with complex conditions in primary care. In France, multidisciplinary primary care centres (MPCC) receive funding if they organise at least 6 interprofessional team meetings (ITM) per year to discuss complex patient situations and collectively define care strategies. It remains unclear how ITM have been implemented in France. This study analyses healthcare professionals’ involvement in ITMs within MPCCs.METHOD: A multicenter retrospective quantitative study in 8 French MPCCs based on the analysis of ITM reports for the period from 2018 to 2019 was conducted. RESULTS: 1733 patients’situations (n = 1733 cases) discussed during ITMs were analysed. The 8 MPCCs were heterogeneous in terms of geographical location, creation date, and size (3 MPCCs with > 20,000 patients followed by more than 60 professionals and 3 MPCCs with < 20 professionals). On average, five healthcare professionals attended each ITM, with huge variations among MPCCs. The nurse-general practitioner (GP) pair was central. At least one GP was present at 89% (n = 1469) and nurses at 38.15% (n = 630) of ITMs. Participation of other professionals was less frequent and varied according to the MPCC. Physiotherapists were present at 7.8% of ITMs, and other healthcare professionals were present at < 6% of ITMs, including pharmacists (3% of ITMs). In some cases, healthcare professionals external to MPCC, particularly those related to mental health, were also involved in ITMs.CONCLUSIONS: Depending on the MPCC, the professionals involved in ITM vary widely, with the nurse-GP pair at the centre. The relative absence of certain professionals needs to be analysed in order to encourage interprofessional working
Erasmus + et le retour du Royaume-Uni : choix politique ou décision pragmatique ?
No full texthttps://theconversation.comCinq ans après avoir quitté Erasmus +, le Royaume-Uni s’apprête à réintégrer le programme d’échanges européen, à l’horizon 2027. Au-delà du signal politique, cette décision résulte de réajustements pragmatiques qui éclairent les conditions de possibilité de coopérations universitaires stables à l’échelle internationale
Long-term air pollution exposure and mental health in French adults of the CONSTANCES cohort: Role of black carbon independently of PM2.5
No full textInternational audienceAmbient air pollution could be associated with poor mental health. Black carbon (BC) has been highlighted as a crucial component of particulate matter; however, its isolated role independent from the total particulate matter mass has been poorly studied. Our study aimed to examine the associations between long-term exposure to particulate matter with a diameter <2.5 μm (PM2.5), BC and nitrogen dioxide (NO2) and psychological distress in the French CONSTANCES cohort and to assess the role of BC independently of PM2.5. This cross-sectional study included 104,146 adults. Psychological distress was assessed in 2019 using the General Health Questionnaire-12 (GHQ-12). Annual concentrations of PM2.5, BC, and NO2 estimated from land-use regression models at each participant's residential address. Negative binomial models with different covariate adjustments were used. A residuals method was used to assess the independent role of BC. Incident rate ratios (IRR) per an interquartile range (IQR) increase in exposure to each pollutant were calculated. Stratified analyses by age, sex, education and season were also conducted. Mean exposures were 9.38 μg/m3 for PM2.5 (IQR = 2.6), 1.15 × 10−5/m for BC (IQR = 0.5) and 19.1 μg/m3 for NO2 (IQR = 11.5). Exposure to each pollutant was significantly associated with higher psychological distress (IRR (95 % CI): 1.052 (1.014–1.092) for PM2.5, 1.078 (1.055–1.101) for BC, and 1.082(1.057–1.109) for NO2). Stronger associations were found for men, elderly, lower-educated, and during warm season. BC residuals were significantly associated with higher psychological distress when regressed on PM2.5 (1.055 (1.039–1.071)) and when regressed on NO2 (1.067(1.041–1.093)). Exposure to ambient air pollution was associated with psychological distress, with BC showing a deleterious role independently of PM2.5 and NO2
Preconception Generational Impacts on Male Reproduction
No full textCeci est une mise à jour d’Aurore Gely-Pernot, Preconception Generational Impacts Male, Editeur(s) : Michael K. Skinner, Encyclopedia of Reproduction (Second Edition), Academic Press, 2018, Pages 642–648, ISBN 9780128151457International audienceAlthough mammalian development is directly affected by maternal exposure to environmental stressors during pregnancy, there has been over the last decade increasing evidence of the effect of paternal preconceptional exposure on the health of future generations. This chapter give an overview of the main physical, chemical and socio-cultural agents able to impact offspring health after male preconceptional exposure. It give also an overview of epigenetic mechanisms possibly involved in paternal inheritance
