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The aim of the study is to compare, in coronary artery disease patients, physical activity (PA) assessed with the Dijon Physical Activity Questionnaire (DPAQ) and the true PA objectively measured using an accelerometer. Seventy patients wore an accelerometer (MyWellness Key actimeter) throughout 1 week after a cardiac rehabilitation program that included therapeutic education about regular PA. Patients completed the DPAQ at the end of the week. The mean weekly active energy expenditure was 619.9 [plus or minus] 374.6 kcal, and the mean DPAQ score was 21.3 [plus or minus] 3.1/30 points. There were low but significant correlations between total active energy expenditure and the DPAQ score ([rho]=0.4, P=0.009). There were no correlations between peak power output and total DPAQ score. The DPAQ significantly correlates with objective measures given by the MyWellness Key actimeter. The choice between these tools relies on the clinician's appreciation, taking into account patients' characteristics and goals as well as the cost of the method and availability of the tool. (Contains 2 tables.)

To cite this article: Defrance C, Bousquet P-J, Demoly P. Evaluating the negative predictive value of provocation tests with nonsteroidal anti-inflammatory drugs. Allergy 2011; 66: 1410-1414. Abstract Background: The nonsteroidal anti-inflammatory drugs (NSAIDs) hypersensitivity work-up is based on clinical history, skin tests, and drug provocation tests. The negative predictive value (NPV) of the latter is not established. Method: A cohort study was conducted in the Allergy Department in Montpellier to evaluate the NPV of the provocation test with NSAIDs in patients with clinical presentation suggestive of hypersensitivity, and negatively tested. Patients were contacted at least 6 months after the work-up. Patients who took NSAID and reacted were proposed a new allergy work-up, which included a provocation test with the culprit drug. Results: Among the 393 patients contacted, 279 (71.0%) were followed up. Two hundred and sixty (93.2%) patients had taken a NSAID at least once: 139 (53.5%) the same drug as the one tested and 215 (82.7%) an alternative (94, 33.7% taking both the tested NSAID and an alternative). Eight patients (3.1%) reported a reaction (five with the negatively tested NSAID and three with another NSAID). All the reactions occurred immediately after the first administration and were not severe. Among the five patients who reacted with the negatively tested NSAID, only three accepted a re-challenge, negative in two cases and positive in one, representing a NPV of 97.8% (95% CI: 95.4-100%). Three patients (3/215) reported a reaction when an alternative NSAID was taken, representing a NPV of 98.6% (95% CI: 97-100%). Conclusion: The NPV of NSAIDs drug provocation test is high. This should reassure physicians who might hesitate to prescribe NSAIDs, especially in patients with negative allergic work-ups. [ABSTRACT FROM AUTHOR]

We investigate the ability of a mesoscale model to reconstruct CO2 fluxes at regional scale. Formally, we estimate the reduction of error for a CO2 flux inversion at 8 km resolution in the South West of France, during four days of the CarboEurope Regional Experiment Strategy (CERES) in spring 2005. Measurements from two towers and two airplanes are available for this campaign. The lagrangian particle dispersion model LPDM was coupled to the nonhydrostatic model Meso-NH and integrated in a matrix inversion framework. Impacts of aircraft and tower measurements are quantified separately and together. We find that the configuration with both towers and aircraft is able to significantly reduce uncertainties on the 4-day averaged CO2 fluxes over about half of the 300×300 km2 domain. Most of this reduction comes from the tower measurements, even though the impact of aircraft measurements remains noticeable. Imperfect knowledge of boundary conditions does not significantly impact the error reduction for surface fluxes. We test alternative strategies to improve the impact of aircraft measurements and find that most information comes from measurements inside the boundary layer. We find that there would be a large improvement in error reduction if we could improve our ability to model nocturnal concentrations at tower sites. [ABSTRACT FROM AUTHOR]

Background Cypress allergy is a typical winter pollinosis and the most frequent one in the South of France. Main symptoms are rhinitis, conjunctivitis, and asthma. Peach allergy is common too in Southern Europe. Allergic cross-reactions between cypress and peach have been reported, including an oral allergy syndrome. We wanted to investigate whether a cross-reactive allergen between cypress and peach might be responsible for the observed clinical association. Methods We analyzed 127 patients included over a 3-month period, outside the pollen season, and we dosed specific Ig E levels, for selected, individual allergens. Results Patients sensitized to peach were mainly positive for the peach-nonspecific lipid-transfer protein. Conclusions Profilins or thaumatins could not explain the observed clinical association between cypress and peach. [ABSTRACT FROM AUTHOR]

An increasing focus on place based planning and adaptation processes brings to the fore the importance of understanding the situated experience of social and environmental change. Populations do not respond uniformly to environmental and social change, and given that consensus is needed to successfully achieve inclusive adaptation it is important to understand how and why people are more sensitive to certain changes and risks over others. Using a sense of place lens, we investigate how an individual's relationship with their property and their town shapes their sensitivity to a range of risks. To investigate this, we conducted a survey in towns in South Africa, UK and France (n = 707) to examine the relationship between multiple dimensions of sense of place with place-based risks. We find that relationship with place matters differently for perception of social, environmental and overdevelopment risk. In particular, we find that feeling safe in place correlates with reduced perceptions of social risks but increases the likelihood of perceiving environmental risk. The role of place in risk perception is stronger at the property scale than the town scale, and it is only at the property scale that place meaning is related to risk perception. Our findings contribute to theory on the subjective experience of place-based risks and has implications for how social and environmental change can be communicated and managed. • Surveys carried out in 4 coastal towns in 3 countries focused on multiple dimensions of sense of place and risk. • Sense of place explains variation in perceptions of environmental, overdevelopment and social risks. • Feelings of place related safety leads to lower perceptions of social risk but higher perceptions of environmental risk. • The meaning attached to place is significant for perception of risk at the property scale but not at the town scale. [ABSTRACT FROM AUTHOR]

The article focuses on the vaccination of the 2009-2010 influenza H1N1 to patients with egg allergy in France. It says that three vaccines were administered to 107 patients including egg-free vaccine Celvapan, Panenza, and Pandemrix. It says that 37.5% of the patients were subjected to an egg avoidance regime, while 38.5% have developed allergic reaction and 14.7% have showed gastrointestinal symptoms. A chart which shows the egg-allergy description of the patients is presented.

In order to assess the impact of tobacco smoking on nasal quality of life, a cross-sectional pilot study was carried out on 185 sales representatives from all regions of France during their yearly seminar. Tobacco smoking is thought to induce nasal symptoms which may impair quality-of-life but there is no study which has analyzed the impact of tobacco smoking in normal subjects or patients with allergic rhinitis. Thirty-eight subjects had a previous diagnosis of allergy made by a physician with skin tests and/or serum-specific Immunoglobulin E.

Megacities, with their large and complex infrastructures, are significant sources of methane emissions. To develop a simple, low-cost methodology to quantify these globally important methane sources, this study focuses on mobile measurements of methane (CH 4 ) and its isotopic composition in Paris. Data collected between September 2018 to March 2019 resulted in 17 days of measurements, which provided spatial distribution of street-level methane mixing ratios, source type identification, and emission quantification. Consequently, 90 potential leaks were detected in Paris sorted into three leak categories: natural gas distribution network emissions (63%), sewage network emissions (33%), and emissions from heating furnaces of buildings (4%). The latter category has not previously been reported in urban methane studies. Accounting for the detectable emissions from the ground, the total estimated CH 4 emission rate of Paris was 5000 L/min (190 t/yr), with the largest contribution from gas leaks (56%). This ranks Paris as a city with medium CH 4 emissions. Two areas of clusters were found, where 22% and 56% of the total potential emissions of Paris were observed. Our findings suggest that the natural gas distribution network, the sewage system, and furnaces of buildings are ideal targets for street-level CH 4 emission reduction efforts for Paris.

Objectives: Our aim was to confirm with a large panel of clinical isolates that class 2 integrons are highly prevalent in Proteae and to analyse their genetic characteristics., Methods: Proteae (Proteus spp., Morganella spp. and Providencia spp.) isolates were collected from clinical samples during 2013 at Limoges University Hospital, France. The presence of class 1, 2 and 3 integrons was investigated by quantitative PCR. The presence of a stop codon in the intI2 gene was determined by Sanger sequencing. The gene cassette arrays of class 2 integrons were determined by PCR-RFLP and Sanger sequencing or next-generation sequencing when needed., Results: Of the 327 Proteae collected, 103 (31.5%) harboured a class 2 integron and 45 (13.8%) a class 1 integron. No class 3 integrons were detected. One functional IntI2 integrase was detected in a Morganella morganii isolate. Six different gene cassette arrays were detected. Four had already been described in the literature: dfrA1-sat2-aadA1 (72 isolates), dfrA1-catB2-sat2-aadA1 (17), sat2-aadA1 (6) and lnu(F), dfrA1, aadA1 (1). We identified two new gene cassette arrays: (i) a new variant of the dfrA1 gene cassette (one isolate; the one with the functional IntI2); and (ii) the array dfrA1-gcu115-sat2 harbouring the new gcu115 gene cassette with two ORFs encoding proteins of unknown functions (five isolates)., Conclusions: We showed a high frequency of class 2 integrons, as well as a diversity of gene cassette arrays, among Proteae. This work highlights that the Proteae tribe plays an important role as a reservoir of class 2 integrons., (© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Study Design: Cross-sectional study of teaching general practitioners (TGPs) in the South of France., Objective: To determine what TGPs think about francophone Internet sites dedicated to chronic low back pain (CLBP)., Summary of Background Data: Patients with CLBP often seek medical information about their symptoms on the Internet. The quality of the information is usually poor. To date, the opinion of TGPs concerning the quality of CLBP Web sites remains unknown., Methods: We invited the 112 TGPs in the Southern region to participate. The participants used an assessment scale to evaluate 7 Web sites about CLBP in semicontrolled conditions. The quality and the importance of the different types of information (medical, nonmedical) and the design were measured on a visual analog scale (0-100) and with the point-sharing method (scale of 0-10)., Results: In total, 47 TGPs responded. The median quality score for the 7 Web sites was 50 (range 30-79). The score for medical information was 52.5 (10-80), for nonmedical information it was 60.4 (20-90), and for design it was 56.4 (30-85). For nonmedical information, the median relative weight was 4, and for both medical information and design it was 3., Conclusion: French TGPs believe that CLBP Web sites should focus on nonmedical, practical advice; they consider the design at least as important as the medical information. This viewpoint seems to conflict in part with patients' expectations. Good-quality and interactive Web sites could reduce this discordance. A list of approved sites should be available for general practitioners to recommend to their patients, to supplement information given during the consultation.

Background: Cupressaceae pollen allergy is a worldwide winter pollinosis. Exposure to cypress pollen has increased enormously during recent decades, and cypress pollen allergy has become a major health problem, especially in Mediterranean countries., Objectives: We aimed to evaluate the prevalence of cypress pollen sensitization and allergy in the Montpellier area and the symptoms presented by sensitized patients., Methods: We included all 6185 consecutive patients who were referred to our center for any allergic disorder during a 36-month period. For each patient, we evaluated skin prick test results, allergy symptoms, pulmonary function test results, and the need for allergen immunotherapy., Results: We found that 20.7% of patients were sensitized to cypress pollen and 46.4% presented symptoms during the pollen season. The main symptoms were rhinoconjunctivitis and asthma. Oral allergy syndrome to peach was detected in 4% of sensitized and symptomatic patients. Allergen immunotherapy was necessary to control symptoms in 57.9% of cases., Conclusions: Cypress pollen allergy is one of the leading causes of respiratory allergy in the Montpellier area. Symptoms are often severe and include pollen-induced asthma. Moreover,many patients need allergen immunotherapy in order to achieve better control of their symptoms.

In cases of malaria, rapid and accurate diagnosis of Plasmodium sp. is essential. In this study three different quantitative, real-time PCR methods were compared with routine methods used for malaria diagnosis. A comparative study was conducted prospectively in the laboratories of Montpellier and Nîmes University Hospitals. The methods used for routine diagnostic malaria testing consisted of microscopic examination of Giemsa-stained blood smears and rapid diagnostic tests. Three quantitative real-time PCR methods (qRT-PCR) were tested: qRT-PCR1 amplified a specific sequence on the P. falciparum Cox1 gene, qRT-PCR2 amplified a species-specific region of the multicopy 18S rDNA, and qRT-PCR3 amplified a mitochondrial DNA sequence. Among the 196 blood samples collected, 73 samples were positive in at least one of the five tests. Compared with the routine method, there were no false negatives for P. falciparum diagnosis in either qRT-PCR1 or qRT-PCR3. In all P. ovale, P. vivax and P. malariae infections diagnosed from blood smears, qRT-PCR1 was negative, as expected, whereas qRT-PCR2 and qRT-PCR3 were positive and concordant (simple kappa coefficient = 1). One negative sample from microscopy was positive with both qRT-PCR2 and qRT-PCR3. Together, qRT-PCR3 and the combined qRT-PCR1 and qRT-PCR2 were concordant with routine methods for malaria diagnosis (99% and 99.5%, respectively). These three rapid, molecular qRT-PCR methods, used alone or in association, showed excellent results, with high concordance, accuracy and reliability in malaria diagnosis.

Cervical spine injuries after diving into private swimming pools can lead to dramatic consequences. We reviewed 34 patients hospitalized in our center between 1996 and 2006. Data was collected from their initial admission and from follow-up appointments. The injuries were sustained by young men in 97% (mean age 27) and the majority happened during the summer (88%). Fractures were at C5-C7 in 70%. American Spinal Injury Association class (ASIA) on admission was A for 8 patients, B for 4, C for 4, D for 1, and E for 17. There were 23 surgical spine stabilizations. Final ASIA class was A for 6 patients, B for 1, C for 3, D for 5, and E for 18. The mean duration of hospitalization was 21.3 days in our neurosurgical center (mean overall cost: 36,000 Euros/patient) plus 10.6 months in rehabilitation center for the 15 patients admitted who had an ASIA class A to C. Mean overall direct cost for a patient with class A is almost 300,000 Euros, compared to around 10,000 Euros for patients with class D and E. In addition, a profound impact on personal and professional life was seen in many cases including 11 divorces and 7 job losses. Dangerous diving into swimming pools can result in spinal injuries with drastic consequences, including permanent physical disability and a profound impact on socio-professional status. Moreover, there are significant financial costs to society. Better prevention strategies should be implemented to reduce the impact of this public health problem.

Background: The Allergic Rhinitis and Its Impact on Asthma (ARIA) workshop proposes a classification of allergic rhinitis severity. It does not take into account impairment in quality of life and treatment should be adapted accordingly., Methods: Two cross-sectional surveys were designed:a spring survey, for which 1,321 practitioners enrolled 3,026 patients consulting for seasonal allergic rhinitis and an autumn-winter survey, for which 1,346 practitioners enrolled 3,507 patients consulting for perennial allergic rhinitis. Simple quality of life parameters were included and logistic regressions were performed in order to assess the impairment of quality of life., Results: The majority of the patients were experiencing an impairment on their quality of life (92.2%). Except for cough, these patients had significantly more nasal, lung and ocular symptoms. In a multivariate analysis, rhinorrhea, nasal itching, red eyes, dyspnea, change in voice, fatigue and headache were correlated to impairment of quality of life. Persistent rhinitis was associated only with subjects who expressed difficulties in reading, and intermittent rhinitis with those who had to blow their nose and who expressed an impact on their professional activities., Conclusions: The proposal of the ARIA expert panel defining the severity of allergic rhinitis based on quality of life parameters is likely to simplify daily physician practice.

A retrospective analysis without exclusion of 369 consecutive cases of myocardial infarction admitted between January 1988 and March 1992 studied the risk factors, previous medical history and treatment in this period during which medical practice seemed to be standardised with acknowledged benefits of thrombolysis, beta-blockade and aspirin therapy. The population observed is divided in three age groups (< 65, > 65 < 75 and > 75). A Cox model multivariate analysis for age, sex, diabetes, hypertension, hypercholesterolaemia, tobacco smoking, previous infarction, coronary artery disease and cardiac failure underlined the risk related to age which was 3.2 for patients 65-75 years of age and 4 for patients over 75 years of age. The risk was high in women (1.4), diabetes (1.5) and previous infarction (1.7). The excess mortality of the elderly age groups could also have been related to medical management as the most effective treatments were less commonly used. Thrombolysis was used in 44% of patients under 65 years of age but in only 9.7% of patients over 75 years; betablockers were prescribed in 77.6% of the younger but only in 27.4% of the older patients. The same tendency was observed in the administration of aspirin, with 81.6% receiving this drug in the younger patients compared to only 61% in older patients. Differences in survival at 6 months according to age (93.6%, 74% and 54.9%) show that there is a clearly defined therapeutic objective over 65 years of age with a large field of action and a probability of significant improvement in mortality and morbidity.