The main aim of the Leucémies de l’Enfant et l’Adolescent (LEA) project (Childhood and Adolescen... more The main aim of the Leucémies de l’Enfant et l’Adolescent (LEA) project (Childhood and Adolescent Leukaemia) is to study the determinants (medical, socioeconomic, behav-ioural and environmental) of medium- and long-term outcomes of patients treated for childhood acute leukaemia (AL). The LEA study began in 2004 and is based on a French multicentric prospective cohort. Included are children treated for AL since January 1980 (incident and prevalent cases), surviving at month 24 for myeloblastic AL and lympho-blastic AL grafted in first complete remission or at month 48 for lymphoblastic AL not grafted in first complete remission. Information is collected during specific medical visits and notably includes the following data: socioeconomic data, AL history, physical late effects (such as fertility, cardiac function and metabolic syndrome) and quality of life.
Presse médicale (Paris, France : 1983), Jan 24, 2001
Since 1986, quantification of G6PD activity has been a routine test for all babies born at the pu... more Since 1986, quantification of G6PD activity has been a routine test for all babies born at the public maternity hospitals of Marseilles. The objective of our study was to determine the prevalence of G6PD deficiency in the population tested and to evaluate the relative risk of neonatal jaundice in newborns with G6PD deficiency. Neonatal screening is performed on cord blood by spectrophotometric measurements of G6PD activity. A group of 7779 newborns was studied retrospectively. The occurrence of neonatal jaundice was evaluated in 85 children with G6PD deficiency and compared to 85 children with normal G6PD activity. The incidence of G6PD deficiency in male newborns was found to be 2.1%. The relative risk for neonatal jaundice in the G6PD deficient population compared to the non-deficient population is estimated to be 2.6. Neonatal jaundice with pathological hyperbilirubinemia develops more frequently in cases of G6PD deficiency. The early characterization of G6PD activity provides an...
Six percent of the French population is foreign. Paradoxically, there are in France few recent da... more Six percent of the French population is foreign. Paradoxically, there are in France few recent data about the health of these communities. Because a lot of different foreign communities are living in Marseille, it seemed important for us to examine the health of one of these populations. The difficulties encountered in studying the health status in the general population allow us to propose a measure based on perceived health opinion. Our first objective was to state that perceived health status of one community differs between its original country and its emigration country, taking into account the level of morbidity. Our second objective was to show that the perceived health status in the emigration population was close to the one observed in France. Two cross-sectional studies were performed in the Comoro Islands and in Marseille, a French south eastern city. The perceived health was assessed with the Duke Health Profile (DHP); the objective health was assessed by a specific ques...
There has been a considerable amount of debate in Europe on the use of the human embryo in resear... more There has been a considerable amount of debate in Europe on the use of the human embryo in research, a key point in the ongoing examination of bioethics laws. The French Academy of Medicine, the National Consultative Committee on Ethics, the State Council and the Parliamentary Office for the evaluation of scientific and technologic decisions have all made formal statements. An examination of these opinions discloses that there is a critical agreement concerning the Laws of July 1994 and on the requirement for a better text regulating research on the human embryo. It is becoming very clear that an international harmonization will probably not be possible on this point. In this context, where research on the human embryo is authorized in the United States, it is reasonable to expect fundamental discoveries which will be of fundamental importance for all scientific disciplines, emphasizing the need for further thought on our protectionist legal position.
Presse médicale (Paris, France : 1983), Jan 18, 2000
The tragic HIV contamination of hemophilics and transfusion recipients between 1980 and 1985 in F... more The tragic HIV contamination of hemophilics and transfusion recipients between 1980 and 1985 in France led to low court proceeding the same events. In addition, last June a state minister was arraigned for not recalling transfused patients before 1985. This involves later events and announces other court actions. France is the only country where these dramatic events have take on the dimension of a major political scandal. Based on the scientific elements (reactions and articles in the international medical literature) and an analysis of the decisions made by France, a chronological examination of the disease and the risks for hemophiliacs and transfusion recipients offers helpful insight into possible options for reducing these risks. The interval between these the court proceeding allows time for further thought focusing on a serious deviation of public health in France.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2012
To describe the health-related quality of life (HRQL) of a cohort of children aged 6-10 years who... more To describe the health-related quality of life (HRQL) of a cohort of children aged 6-10 years who were born preterm; and to determine whether sociodemographic factors, neonatal features and neurocognitive status were affecting their HRQL. All singleton infants born between 24 and 32 weeks of gestation between January 1997 and December 2001 at the study hospital, who were still alive in 2007 (age 6-10 years), and who had undergone complete clinical paediatric follow-up were included in the study. Maternal and perinatal data were obtained by chart review and regular clinical examination. The 'Battery for Rapid Evaluation of Cognitive Functions' (BREV) was used for cognitive evaluation when children were aged 4-8 years. HRQL data were collected in 2007 using the 'Vécu et Santé Perçue de l'Adolescent et de l'Enfant' (VSP-A) questionnaire (parent version). The HRQL of the preterm children was compared with that of a French reference population. Of 202 children who fulfilled the inclusion criteria, 82 children participated in the study. Their mean age was 7.9 years [standard deviation (SD) 1.4], mean birth weight was 1130.0 g (SD 361.4), 23 children were born before 28 weeks of gestation, 46 were female and 11 had major neurocognitive disorders. These data were not significantly different for the non-respondents (n=120). Parents of preterm children reported a significantly lower perception of HRQL of their child compared with parents of children in the reference population, as reflected by VSP-A global index scores and scores for the 'body image', 'vitality', 'psychological well-being' and 'school performance' dimensions. In multivariate analyses, three factors were found to be significantly associated with at least one dimension in the VSP-A scale in the preterm children: presence of major neurocognitive disorders, negatively correlated with 'vitality', 'relationships with friends', 'physical well-being' and 'school performance' dimensions; maternal parity, positively correlated with the 'psychological well-being' dimension; and socio-economic status of family, positively correlated with the 'relationships with friends' dimension. The maximum R(2) was 15%. In addition to neurocognitive disorders, other variables such as socio-economic status of the family have a significant impact on the HRQL of preterm children at 6-10 years of age. Given the low proportion of variability in HRQL explained by the models, there is a need to explore other factors (e.g. environmental).
The purpose of this multicenter study was to compare the long-term impact of a preparative regime... more The purpose of this multicenter study was to compare the long-term impact of a preparative regimen with either BUBU or TBI on health status and quality of life (QoL) in childhood acute leukemia survivors treated with hematopoietic SCT (HSCT). Two-hundred and forty patients were included. Sixty-six had received BU, while 174 had received TBI. Median follow-up from HSCT was 10.1 years. Multivariate analyses were performed to assess the occurrence of late effects according to treatment. QoL was assessed in 130 adults using SF-36 questionnaires. Patients developed fewer late complications after BU (2.35 vs 3.01, P=0.03) while the risk to present with at least one complication was equivalent in both groups (87.9% after BU and 93.1% after TBI, P=0.66). Detailed multivariate analyses revealed a lower risk of height growth failure (OR=0.2), cataract (OR=0.1) and iron overload (OR=0.2) after BU, and an increased risk of overweight (OR=3.9) and alopecia (OR=11.2). SF-36 mental and physical composite scores were similar in both treatment groups and proved significantly lower than French norms. Late effects induced by BU might differ from those experienced after TBI. Although less frequent, they are still of considerable importance and may affect patients' QoL.
... 25 Similarly, Balkau et al in 2003 26 found the prevalence to be 4% and 5.6%, respectively, f... more ... 25 Similarly, Balkau et al in 2003 26 found the prevalence to be 4% and 5.6%, respectively, forwomen and men between 30 and 39 years of age. ... 10,12,16,2933 GHD caused by CNS irradiation is considered to play a major role for the development of the MS parameters. ...
Canadian journal of psychiatry. Revue canadienne de psychiatrie, 1999
The psychometric properties of the French version of the Positive and Negative Syndrome Scale (PA... more The psychometric properties of the French version of the Positive and Negative Syndrome Scale (PANSS) were studied in a population of 85 patients diagnosed with schizophrenia in accordance with Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) criteria. The results of the study of the properties (internal consistency and principal-component analysis) of the initial structure with 3 scales (positive, negative, and general psychopathology) led us to investigate other factorial structures. We thus isolated a 5-factor structure (negative, hostility, positive, disorganization, and anxiety), explaining 54.7% of the total variance. The internal consistency of the 5 factors isolated was good (0.79, negative factor; 0.71, hostility factor; 0.77, positive factor; 0.66, disorganization factor; and 0.61, anxiety factor). The 3-subscale structure of the PANSS is discussed.
A population of 512 adults (men: 266, 52%, women: 246, 48%) with mean age 41.4 years (S.D. 10.7) ... more A population of 512 adults (men: 266, 52%, women: 246, 48%) with mean age 41.4 years (S.D. 10.7) was investigated. This population was subdivided into five groups: Marseilles city, Manosque a small town in a prealpine area, the area surrounding the Etang de Berre, a rural area in Northern Bouches du Rhône and Chateaurenard, a small town in an intensive agricultural area. RASTs to a panel of eight allergens (Lolium perenne, Parietaria officinalis, Cupressus sempervirens, Olea europea, Cat dander, Alternaria tenuis, Dermatophagoides pteronyssinus, and Castor bean seed) were done. 99 subjects were found to have a RAST positive to one or several allergens. The main positives found by RAST were a grass pollen (Lolium perenne) and the mite Dermatophagoides pteronyssinus with respectively 10.1% and 11.3% of the results followed by the pollens of Olea Europea 4.4%, Parietaria officinalis 3.1% and Cupressus sempervirens 1.9%, Castor bean seed 1.7% Cat dander 0.9% and Alternaria tenuis 0.9%. ...
Appropriate assessment of ankle injuries in children and adolescents is a common emergency room p... more Appropriate assessment of ankle injuries in children and adolescents is a common emergency room problem. Many imaging techniques have been proposed, but with no consensus on the reality of anatomic lesions in ankles free of fractures, complicating the therapeutic decision. We analyzed the lesions observed with magnetic resonance imaging (MRI) in a large number of acute ankles in children. This prospective study was conducted in a pediatric emergency room. The study population included all children aged eight to 15 years who presented an isolated injury of the ankle without fracture on the plain x-ray. History taking and physical examination were standardized. MRI was performed within three days of the initial physical examination. All the radiographic documents were examined by an experienced radiologist blinded to the results of the physical examination. During the study period, 116 patients were included. One hundred two MRI series were examined. Minor ligament injury was noted in 20 patients and ligament tear in five, including three with a closed distal tibial growth plate. Minor bone injury was noted in 42 patients and fracture in seven. None of these fractures were visible on the plain x-ray, even after knowledge of the MRI. Injuries were more frequent in boys. Injuries were more frequent when the pain was localized on the lateral aspect of the ankle and when there was an edema. Despite an abundant literature on ankle sprains, prospective studies are scarce in the pediatric population. We have found that MRI is particularly well-adapted for children because it allows a complete examination of anatomic lesions involving the bone or ligaments without the inconveniences of injections, pain, or radiation. Our clinical and imaging findings show that ankle sprains are real in children. We were however unable to identify any clinical factors predictive of ligament and/or bone injury. Other studies should be conducted to better understand the nosological context of ankle sprain in children and adolescents. Further study will enable a better evidence-based approach to individually adapted therapy.
The main aim of the Leucémies de l’Enfant et l’Adolescent (LEA) project (Childhood and Adolescen... more The main aim of the Leucémies de l’Enfant et l’Adolescent (LEA) project (Childhood and Adolescent Leukaemia) is to study the determinants (medical, socioeconomic, behav-ioural and environmental) of medium- and long-term outcomes of patients treated for childhood acute leukaemia (AL). The LEA study began in 2004 and is based on a French multicentric prospective cohort. Included are children treated for AL since January 1980 (incident and prevalent cases), surviving at month 24 for myeloblastic AL and lympho-blastic AL grafted in first complete remission or at month 48 for lymphoblastic AL not grafted in first complete remission. Information is collected during specific medical visits and notably includes the following data: socioeconomic data, AL history, physical late effects (such as fertility, cardiac function and metabolic syndrome) and quality of life.
Presse médicale (Paris, France : 1983), Jan 24, 2001
Since 1986, quantification of G6PD activity has been a routine test for all babies born at the pu... more Since 1986, quantification of G6PD activity has been a routine test for all babies born at the public maternity hospitals of Marseilles. The objective of our study was to determine the prevalence of G6PD deficiency in the population tested and to evaluate the relative risk of neonatal jaundice in newborns with G6PD deficiency. Neonatal screening is performed on cord blood by spectrophotometric measurements of G6PD activity. A group of 7779 newborns was studied retrospectively. The occurrence of neonatal jaundice was evaluated in 85 children with G6PD deficiency and compared to 85 children with normal G6PD activity. The incidence of G6PD deficiency in male newborns was found to be 2.1%. The relative risk for neonatal jaundice in the G6PD deficient population compared to the non-deficient population is estimated to be 2.6. Neonatal jaundice with pathological hyperbilirubinemia develops more frequently in cases of G6PD deficiency. The early characterization of G6PD activity provides an...
Six percent of the French population is foreign. Paradoxically, there are in France few recent da... more Six percent of the French population is foreign. Paradoxically, there are in France few recent data about the health of these communities. Because a lot of different foreign communities are living in Marseille, it seemed important for us to examine the health of one of these populations. The difficulties encountered in studying the health status in the general population allow us to propose a measure based on perceived health opinion. Our first objective was to state that perceived health status of one community differs between its original country and its emigration country, taking into account the level of morbidity. Our second objective was to show that the perceived health status in the emigration population was close to the one observed in France. Two cross-sectional studies were performed in the Comoro Islands and in Marseille, a French south eastern city. The perceived health was assessed with the Duke Health Profile (DHP); the objective health was assessed by a specific ques...
There has been a considerable amount of debate in Europe on the use of the human embryo in resear... more There has been a considerable amount of debate in Europe on the use of the human embryo in research, a key point in the ongoing examination of bioethics laws. The French Academy of Medicine, the National Consultative Committee on Ethics, the State Council and the Parliamentary Office for the evaluation of scientific and technologic decisions have all made formal statements. An examination of these opinions discloses that there is a critical agreement concerning the Laws of July 1994 and on the requirement for a better text regulating research on the human embryo. It is becoming very clear that an international harmonization will probably not be possible on this point. In this context, where research on the human embryo is authorized in the United States, it is reasonable to expect fundamental discoveries which will be of fundamental importance for all scientific disciplines, emphasizing the need for further thought on our protectionist legal position.
Presse médicale (Paris, France : 1983), Jan 18, 2000
The tragic HIV contamination of hemophilics and transfusion recipients between 1980 and 1985 in F... more The tragic HIV contamination of hemophilics and transfusion recipients between 1980 and 1985 in France led to low court proceeding the same events. In addition, last June a state minister was arraigned for not recalling transfused patients before 1985. This involves later events and announces other court actions. France is the only country where these dramatic events have take on the dimension of a major political scandal. Based on the scientific elements (reactions and articles in the international medical literature) and an analysis of the decisions made by France, a chronological examination of the disease and the risks for hemophiliacs and transfusion recipients offers helpful insight into possible options for reducing these risks. The interval between these the court proceeding allows time for further thought focusing on a serious deviation of public health in France.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2012
To describe the health-related quality of life (HRQL) of a cohort of children aged 6-10 years who... more To describe the health-related quality of life (HRQL) of a cohort of children aged 6-10 years who were born preterm; and to determine whether sociodemographic factors, neonatal features and neurocognitive status were affecting their HRQL. All singleton infants born between 24 and 32 weeks of gestation between January 1997 and December 2001 at the study hospital, who were still alive in 2007 (age 6-10 years), and who had undergone complete clinical paediatric follow-up were included in the study. Maternal and perinatal data were obtained by chart review and regular clinical examination. The 'Battery for Rapid Evaluation of Cognitive Functions' (BREV) was used for cognitive evaluation when children were aged 4-8 years. HRQL data were collected in 2007 using the 'Vécu et Santé Perçue de l'Adolescent et de l'Enfant' (VSP-A) questionnaire (parent version). The HRQL of the preterm children was compared with that of a French reference population. Of 202 children who fulfilled the inclusion criteria, 82 children participated in the study. Their mean age was 7.9 years [standard deviation (SD) 1.4], mean birth weight was 1130.0 g (SD 361.4), 23 children were born before 28 weeks of gestation, 46 were female and 11 had major neurocognitive disorders. These data were not significantly different for the non-respondents (n=120). Parents of preterm children reported a significantly lower perception of HRQL of their child compared with parents of children in the reference population, as reflected by VSP-A global index scores and scores for the 'body image', 'vitality', 'psychological well-being' and 'school performance' dimensions. In multivariate analyses, three factors were found to be significantly associated with at least one dimension in the VSP-A scale in the preterm children: presence of major neurocognitive disorders, negatively correlated with 'vitality', 'relationships with friends', 'physical well-being' and 'school performance' dimensions; maternal parity, positively correlated with the 'psychological well-being' dimension; and socio-economic status of family, positively correlated with the 'relationships with friends' dimension. The maximum R(2) was 15%. In addition to neurocognitive disorders, other variables such as socio-economic status of the family have a significant impact on the HRQL of preterm children at 6-10 years of age. Given the low proportion of variability in HRQL explained by the models, there is a need to explore other factors (e.g. environmental).
The purpose of this multicenter study was to compare the long-term impact of a preparative regime... more The purpose of this multicenter study was to compare the long-term impact of a preparative regimen with either BUBU or TBI on health status and quality of life (QoL) in childhood acute leukemia survivors treated with hematopoietic SCT (HSCT). Two-hundred and forty patients were included. Sixty-six had received BU, while 174 had received TBI. Median follow-up from HSCT was 10.1 years. Multivariate analyses were performed to assess the occurrence of late effects according to treatment. QoL was assessed in 130 adults using SF-36 questionnaires. Patients developed fewer late complications after BU (2.35 vs 3.01, P=0.03) while the risk to present with at least one complication was equivalent in both groups (87.9% after BU and 93.1% after TBI, P=0.66). Detailed multivariate analyses revealed a lower risk of height growth failure (OR=0.2), cataract (OR=0.1) and iron overload (OR=0.2) after BU, and an increased risk of overweight (OR=3.9) and alopecia (OR=11.2). SF-36 mental and physical composite scores were similar in both treatment groups and proved significantly lower than French norms. Late effects induced by BU might differ from those experienced after TBI. Although less frequent, they are still of considerable importance and may affect patients' QoL.
... 25 Similarly, Balkau et al in 2003 26 found the prevalence to be 4% and 5.6%, respectively, f... more ... 25 Similarly, Balkau et al in 2003 26 found the prevalence to be 4% and 5.6%, respectively, forwomen and men between 30 and 39 years of age. ... 10,12,16,2933 GHD caused by CNS irradiation is considered to play a major role for the development of the MS parameters. ...
Canadian journal of psychiatry. Revue canadienne de psychiatrie, 1999
The psychometric properties of the French version of the Positive and Negative Syndrome Scale (PA... more The psychometric properties of the French version of the Positive and Negative Syndrome Scale (PANSS) were studied in a population of 85 patients diagnosed with schizophrenia in accordance with Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) criteria. The results of the study of the properties (internal consistency and principal-component analysis) of the initial structure with 3 scales (positive, negative, and general psychopathology) led us to investigate other factorial structures. We thus isolated a 5-factor structure (negative, hostility, positive, disorganization, and anxiety), explaining 54.7% of the total variance. The internal consistency of the 5 factors isolated was good (0.79, negative factor; 0.71, hostility factor; 0.77, positive factor; 0.66, disorganization factor; and 0.61, anxiety factor). The 3-subscale structure of the PANSS is discussed.
A population of 512 adults (men: 266, 52%, women: 246, 48%) with mean age 41.4 years (S.D. 10.7) ... more A population of 512 adults (men: 266, 52%, women: 246, 48%) with mean age 41.4 years (S.D. 10.7) was investigated. This population was subdivided into five groups: Marseilles city, Manosque a small town in a prealpine area, the area surrounding the Etang de Berre, a rural area in Northern Bouches du Rhône and Chateaurenard, a small town in an intensive agricultural area. RASTs to a panel of eight allergens (Lolium perenne, Parietaria officinalis, Cupressus sempervirens, Olea europea, Cat dander, Alternaria tenuis, Dermatophagoides pteronyssinus, and Castor bean seed) were done. 99 subjects were found to have a RAST positive to one or several allergens. The main positives found by RAST were a grass pollen (Lolium perenne) and the mite Dermatophagoides pteronyssinus with respectively 10.1% and 11.3% of the results followed by the pollens of Olea Europea 4.4%, Parietaria officinalis 3.1% and Cupressus sempervirens 1.9%, Castor bean seed 1.7% Cat dander 0.9% and Alternaria tenuis 0.9%. ...
Appropriate assessment of ankle injuries in children and adolescents is a common emergency room p... more Appropriate assessment of ankle injuries in children and adolescents is a common emergency room problem. Many imaging techniques have been proposed, but with no consensus on the reality of anatomic lesions in ankles free of fractures, complicating the therapeutic decision. We analyzed the lesions observed with magnetic resonance imaging (MRI) in a large number of acute ankles in children. This prospective study was conducted in a pediatric emergency room. The study population included all children aged eight to 15 years who presented an isolated injury of the ankle without fracture on the plain x-ray. History taking and physical examination were standardized. MRI was performed within three days of the initial physical examination. All the radiographic documents were examined by an experienced radiologist blinded to the results of the physical examination. During the study period, 116 patients were included. One hundred two MRI series were examined. Minor ligament injury was noted in 20 patients and ligament tear in five, including three with a closed distal tibial growth plate. Minor bone injury was noted in 42 patients and fracture in seven. None of these fractures were visible on the plain x-ray, even after knowledge of the MRI. Injuries were more frequent in boys. Injuries were more frequent when the pain was localized on the lateral aspect of the ankle and when there was an edema. Despite an abundant literature on ankle sprains, prospective studies are scarce in the pediatric population. We have found that MRI is particularly well-adapted for children because it allows a complete examination of anatomic lesions involving the bone or ligaments without the inconveniences of injections, pain, or radiation. Our clinical and imaging findings show that ankle sprains are real in children. We were however unable to identify any clinical factors predictive of ligament and/or bone injury. Other studies should be conducted to better understand the nosological context of ankle sprain in children and adolescents. Further study will enable a better evidence-based approach to individually adapted therapy.
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Papers by P. Auquier