F. Lebargy

Marie Kraïm-Leleu; François-Xavier Lesage; Moustapha Dramé; F. Lebargy; F. Deschamps

Objectives The aim of this research was to examine the occupational risk factors for Chronic Obstructive Pulmonary Diseases (COPD) in a range of occupations. Methods Eleven occupations involving different types of exposure were observed in this multicenter case-control study. Controls and cases were matched for sex, age and smoking. Multiple logistic regression analyses were used to estimate odds ratios (ORs). Results A total of 1,519 participants were initially recruited between September 2004 and September 2012. After matching, 547 pairs were obtained. The mean age was 56.3 +/- 10.4 years. Smelter workers were the only ones with an increased risk of COPD in this study (OR = 7.6, p < 0.0001, 95% CI [4.5, 12.9]). Physical activity was protective (OR = 0.7), while living in the city was a risk (OR = 1.6). The main used metals were cast iron, aluminum and alloys. Molds and cores were mainly made from sand and synthetic resins. Machine maintenance (65.2%), molding (49.6%), finishing (41.1%) and casting (41.0%) were the most common activities. Almost all workers (95.1%) cleaned the floors and machines with a brush or compressed air. Conclusions This study demonstrates the importance of occupational factors in the genesis of COPD, especially among smelter workers. As with the fight against smoking-related disease, the removal or substitution of recognized hazardous agents is the best way of preventing the onset of COPD. This is why it is essential to continue research on its occupational risk factors.

Shahryar Alipour; F. Deschamps; François-Xavier Lesage; F. Lebargy

Estimation of Annual Incidence of Lung Cancer Associated with Work Place Exposure to Passive Smoking in France: Shahryar Alipour, et al. Department of Occupational Health, Faculté de Médecine, France—This study attempted to estimate the number of annual new cases of lung cancer from workplace exposure to Environmental Tobacco Smoke (ETS) in France. The number of new lung cancer cases attributable to workplace ETS exposure in France was estimated with regard to the following factors: excess risk of lung cancer from workplace ETS exposure, incidence of lung cancer in non‐exposed non‐smokers, and number of French workers exposed to passive smoking. The excess risk of lung cancer from workplace ETS exposure was estimated as from 0.12 to 0.39 by different references. The French workforce, regularly exposed to ETS in their workplace is about 3.2 millions. The incidence of lung cancer of non‐smokers without exposure to ETS is between 3.7 to 10 per hundred thousand. If these three factors are combined, it is estimated that exposure to workplace passive smoking causes around 14 to 125 new cases of lung cancer each year in France. New lung cancer cases from workplace exposure to ETS represent a few percent of all occupational lung cancers, and a minuscule number in regards to the whole lung cancer annual incidence (14 to 125 for 23,000 lung cancers in France=0.06% to 0.54%)

F. Lavaud; F. Deschamps; Paul-Michel Mertes; Jean F Fontaine; F. Lebargy

Resume La prevention de l’allergie au latex en milieu professionnel et/ou domestique repose sur un faisceau de mesures complementaires. Le remplacement du latex naturel demeure delicat a realiser en raison des qualites techniques difficilement retrouvees dans un autre materiel d’origine synthetique. La prevention secondaire pose parfois des problemes complexes de reconversion professionnelle. Les groupes a risques sont maintenant bien definis mais leur depistage doit etre fait en fonction du contexte. Globalement, les strategies preventives consistent en l’utilisation, chaque fois que c’est possible, de materiaux synthetiques et pour les gants, en l’utilisation de gants en latex non poudres a faible teneur allergique lorsque le latex demeure necessaire. L’amelioration des systemes de ventilation associee a des regles d’hygiene simples et de bon sens doivent aussi faire partie d’une procedure informative et regulierement actualisee.

Louis Boissière; Jeanne-Marie Perotin-Collard; Eric Bertin; Isabelle Gaubil; Ana Diaz Cives; Coralie Barbe; Sandra Dury; Julie Nardi; F. Lebargy; Gaëtan Deslée; Claire Launois

Objectives To assess the effects of bariatric surgery in patients with obesity on dyspnea and to analyze the relationships between improvement of dyspnea after bariatric surgery and changes in pulmonary function, especially Expiratory Reserve Volume (ERV) which is the lung volume abnormality most frequently associated with obesity. Methods Forty-five patients (5 males/40 females, mean Body Mass Index = 46.2 ± 6.8 kg/m2) were evaluated before and 6 to 12 months after bariatric surgery. Dyspnea was assessed by the modified Medical Research Council (mMRC) scale. Pulmonary function tests, arterial blood gases and six-minute walk test were performed. Laboratory parameters including C-Reactive Protein (CRP) were analyzed. Results Ninety percent of patients were dyspneic before surgery (mMRC scale ≥ 1) versus 59% after surgery (p<0.001). Mean mMRC score improved after bariatric surgery (1.5 ± 0.9 vs 0.7 ± 0.7, p<0.0001). Among patients with dyspnea before surgery (n = 38), a more marked increase in ERV after surgery was observed in patients with improvement of dyspnea compared to patients with no improvement of dyspnea (+0.17 ± 0.32 L vs +0.49 ± 0.35 L, p = 0.01). Multivariate analysis including age, variation of BMI, variation of CRP, variation of Total Lung Capacity and variation of ERV demonstraded that ERV was the only variable associated with improvement of the mMRc score after bariatric surgery (p = 0.04). Conclusion Weight loss associated with bariatric surgery improves dyspnea in daily living. This improvement could be partly related to increased ERV.

Gonçalo Boleto; Jeanne-Marie Perotin; Claire Launois; Emmanuelle Uro-Coste; Philippe Birembaut; Sandra Dury; Hervé Vallerand; F. Lebargy; Gaëtan Deslée; Juliette Vella-Boucaud

BackgroundNuclear protein in testis carcinoma is a rare and very aggressive undifferentiated cancer which characteristically arises in the midline of the head, neck, and mediastinum.Case presentationWe describe the case of a 46-year-old white woman admitted for superior vena cava syndrome revealing a mediastinal tumor. Pathological examination of specimens obtained by mediastinoscopy revealed an undifferentiated tumor with solid growth and positive immunoreactivity for p40 and negative immunoreactivity for cytokeratin markers. Immunohistochemical staining was positive for nuclear protein in testis, allowing the diagnosis of nuclear protein in testis midline carcinoma of the mediastinum.ConclusionsWe present a rare case of mediastinal nuclear protein in testis carcinoma with diagnosis based on nuclear protein in testis protein positivity and atypical immunohistochemical features including p40 positivity and anti-cytokeratin negativity. Physicians must remain aware of the possibility of nuclear protein in testis carcinoma especially in young patients with thoracic symptoms and suspicion of neoplasm.

F. Lavaud; A.C. Jonvel; Jean F Fontaine; Dominique Sabouraud; F. Lebargy

A Charles; Dominique Sabouraud; F. Lavaud; F. Lebargy; J Motte

Louis Boissière; Eric Bertin; I. Gaubil-Kaladjian; A. Diaz Cives; J. Perotin Collard; Sandra Dury; F. Lebargy; J. Nardi; Gaëtan Deslée; Claire Launois

Y. Ammar; J. Vella-Boucaud; Claire Launois; H. Vallerand; Sandra Dury; F. Lebargy; Gaëtan Deslée; Jeanne M Perotin

F. Lavaud; Jean F Fontaine; G. Deslee; Dominique Sabouraud; F. Lebargy