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PubMed1976

Studies on the structural abnormality of fibrinogen Paris I.

The structural properties of an inherited fibrinogen abnormality designated fibrinogen Paris I were investigated. Dodecyl sulfate gel electrophoresis of unreduced samples revealed no discernible differences in molecular weight from normal; this implied that in fibrinogen Paris I, the normal fibrinogen architecture of six covalently linked chains per molecule is preserved. Examination of dithiothreitol reduced samples before and after treatment with Reptilase or thrombin revealed that the Aalpha- and Bbeta-chains could release the A and B peptides, respectively. A mutant chain (mol wt 52,500, termed gammaParis I) which replaces a large proportion of gamma-chains (mol wt 49,400) was shown, like normal gamma-chains, to lack thrombin- and Reptilase-sensitive sites. The gamma-chains and alpha-chains of Paris I fibrin underwent Factor XIIIa-catalyzed cross-linking slowly; this behavior was not attributable to an intrinsic abnormality of these chains themselves but rather to the inhibitory effect of the mutant gammaParis I chains on this process. Results of DEAE-cellulose gradient elution chromatography of Paris I fibrinogen preparations revealed the presence of small amounts of normal fibrinogen molecules and also indicated that the gammaParis I chains possessed structural overlap with gamma-chains. Unlike gamma-chains however, the gammaParis I chains did not incorporate dansylcadaverine in the prescence of Factor XIIIa, nor, as previously reported, did they undergo cross-linking. The observations indicate that the amine acceptor site found in the COOH-terminal region of the gamma-chain is either not present on the gammaParis I chain or is unavailable for cross-linking. Further support for localization of the abnormality in the COOH-terminal region of the molecule was obtained from the observation that during plasmic hydrolysis of Paris I fibrinogen, at least one unique form of core Fragment D (DParis I) was evolved, whereas Fragment E did not differ from normal.

Amines↗
PubMed2000

[Nicolas Houel and Michel Dusseau, apothecaries of the XVIth century in Paris].

These two apothecaries of the XVIth century of Pharmacy in Paris were outstanding personalities. Nicolas Houel founded a charity in the south of Paris at Saint-Marcel suburb: The House of Christian Charity. It was a philanthropic organization composed of a chapel, an orphanage, a hospital, an apothecary's shop and a medicinal plants garden called Le Jardin des apothicaires. This institution is at the origin of the future Paris Pharmacy College (1777) and of the Paris School of Pharmacy (1803). This apothecary was also an artist, a poet, the author of artistic and scientific works. He wrote three pharmaceutical books between 1571 and 1573. The first one Pharmaceutices libri duo is about laxative and purgative medicines in accordance with Mésué's concepts, the second is a Plague Treatise and the third a Theriac and Mithridat Treatise. Michel Dusseau is the author of the first pharmaceutical book written in French prose. It was published in Lyon in 1561: l'Enchirid ou Manipul des miropoles. The life of Michel Dusseau had remained quite unknown but we recently managed to identify four generations of Dusseaus: Christofle, the ancestor, who lived in the XVth century and was not an apothecary, Michel a juror of the Paris apothecaries community and the author of the Enchirid, Pierre, Michel's son, also an apothecary, and lastly, Pierre's children who were the 4th generation. L'Enchirid is a "Manual for myrrh sellers ", a galenic pharmacy book divided into three parts. The first part shows how to prepare medicines, the second deals with pharmaceutical operations, the third is dedicated to the preparations of galenic forms. This book was well appreciated by French apothecaries in the XVIth-XVIIth centuries but sank into oblivion because of obsolescence.

France↗
PubMed1998

Prevalence of asthma or respiratory symptoms among children attending primary schools in Paris.

The objectives of this study were to determine the prevalence of chronic respiratory symptoms and asthma in 8- to 9-year-old children in Paris, and to analyze their medical management. This cross-sectional study was carried out in 1994 on a randomized sample of 3,756 pupils attending Paris public primary schools. The response rate by parents to an initial standardized self-administered questionnaire was 94.8%. This questionnaire identified 601 children (17%) as having recurrent respiratory symptoms. Of these children, 555 (92.3%) agreed to participate in a follow-up survey that evaluated their medical management; these children were examined by 73 school doctors of the city of Paris. Prevalence of parent-reported doctor-diagnosed asthma was 6.1%. In addition to these 211 children with asthma, 344 other children had recurrent respiratory symptoms: 120 children were "wheezers," and the remaining 224 children were "coughers." Among "chesty" pupils not identified as asthmatics, physical education teachers reported exercise-induced cough or respiratory discomfort in 13.7%, and nearly 14% had a peak expiratory flow 20% lower than the predicted values for age and height. In children identified as asthmatic, 25.3% were not under medical supervision, 55.5% had never performed lung function tests, 63.7% did not receive any prophylactic treatment, and 59.7% were receiving no treatment. Bronchodilator prophylactic medication before exercise was used by only 7% of asthmatics, although physical training teachers noted chest discomfort on exercise in 30.4% of these pupils. These results confirm that children with asthma and participating in this study were less than optimally investigated, were underdiagnosed and undertreated, and their medical management was not optimal. In addition to its epidemiologic value, the study has helped Paris school doctors to advise parents to refer their children to their general practitioner when asthma was suspected or undertreated.

Asthma↗
PubMed1991

Vecuronium is more potent in Montreal than in Paris.

This study was undertaken to compare the potency of vecuronium in patients anaesthetized in Montreal or Paris. Anaesthesia was induced with thiopentone and maintained with N2O, and intermittent boluses of thiopentone and fentanyl in 18 patients in Paris and 19 in Montreal. Neuromuscular blockade was measured using train-of-four stimulation of the ulnar nerve. The force of contraction of the adductor pollicis muscle was measured. Single doses of vecuronium, 20, 30, or 40 micrograms.kg-1 were given by random allocation. Dose response curves were constructed by obtaining the linear regression of the logit of the first response (T1) neuromuscular blockade versus log dose. The patients in Paris required 27% more vecuronium (95% confidence limits 5-53%; P = 0.01) for the same intensity of blockade. In Montreal, the ED50 and ED90 (+/- SEE for the mean) values were 26.0 +/- 1.4 and 44.2 +/- 2.5 micrograms.kg-1 compared with 33.0 +/- 3.3 and 71.9 +/- 7.2 micrograms.kg-1 in Paris respectively. The patients were comparable with respect to age, sex, height and weight. These results confirm, for vecuronium, the transatlantic difference in potency of neuromuscular blocking drugs which was previously observed with d-tubocurarine between London and New York.

Adult↗
PubMed2005

[Activities of parentality teams in Paris: patient demands and staff responses].

In application of public policy, parentality teams were created in Paris in June 1998. All ten maternity units of the Paris Hospital Group (AP-HP) participated in developing these teams but staff implications varied between the institutions. Other maternity units in Paris have also instituted parentality teams which are still operating. The Paris Maternal and Infantile Protection administration together with INSERM Unit 149 were charged with the evaluation of these teams. The first phase of "active monitoring" terminated 2001, and discussions between the different teams in October 2004 allowed an analysis of the current situation.

Female↗
PubMed2002

Trends in opiate and opioid poisonings in addicts in north-east Paris and suburbs, 1995-99.

AIMS: (1). To assess the trends in the number, mortality and the nature of severe opiate/opioid poisonings from 1995 to 1999 in north-east Paris and adjacent suburbs and (2). to examine the effects of the introduction of high-dose buprenorphine on these parameters. DESIGN: Retrospective, 5-year study with review of pre-hospital, hospital and post-mortem data. SETTING AND PARTICIPANTS: Eighty patients from the toxicological intensive care unit (TICU) in north-east Paris, 421 patients from the pre-hospital emergency medical service in a north-east suburb of Paris (SAMU 93) and 40 deaths from the coroner's office in Paris. MEASUREMENTS AND RESULTS: We found that the number of pre-hospital opiate/opioid poisonings and deaths decreased over 5 years. During the same time frame, opiate/opioid poisoning admissions to our TICU remained steady, but the number of deaths declined. From 1995 to 1999, the detection of buprenorphine among opiate/opioid-poisoned TICU patients increased from two to eight occurrences per year while detection of opiates diminished from 17 to 10 occurrences per year. Increased buprenorphine detection correlated directly with increasing sales over this time period. In spite of the increased use of buprenorphine, the mortality associated with opiate/opioid poisonings has diminished in the pre-hospital environment from 9% in 1995 to 0% in 1999, and in the TICU from 12% in 1995 to 0% in 1997 and thereafter. We found a high frequency of multiple opiate/opioid use in severe poisonings, as well as the frequent association of other psychoactive drugs including ethanol. CONCLUSIONS: The number and the mortality of opiate/opioid poisonings appear to be stable or decreasing in our region. The association of multiple opiates/ opioids appears nearly as common as the association with other psychoactive drugs. The introduction of high-dose buprenorphine coincides with a decrease in opiate/opioid poisoning mortality. Further study will be necessary to clarify this observation.

Adult↗
PubMed1988

Epidemiology of toxoplasmosis among pregnant women in the Paris area.

A survey was performed using a sample of pregnant women selected at one of the biggest test centres in the Paris area. These women were serologically screened for toxoplasmosis between October 1981 and September 1983 (according to the prevention protocol for congenital toxoplasmosis established by the French health ministry). The prevalence rate of specific antibodies for toxoplasmosis was estimated from the 1074 women who were tested for the first time during the study. The prevalence rate among pregnant women in the Paris area was derived by direct standardization according to age and geographical origin. A standardized prevalence rate of 71% +/- 4% among French women, of 51.4% +/- 5% among immigrant women and a global adjusted prevalence rate of 67.3% +/- 3% for pregnant women in the Paris area was found. An incidence rate of 1.6% was estimated for the 2216 non-immune pregnant women included in the sample. There is no significant difference between the probabilities of seroconversion among French and immigrant women (2.3% +/- 1% and 1.6% +/- 0.8% respectively). Comparison of the data with previous study results show a decrease in the prevalence rate of specific antibodies for toxoplasmosis in the Paris area over the last 20 years that cannot be explained by changes in age and geographical origin. No data were available to support an aetiological hypothesis for a decrease in toxoplasma transmission to humans. Since immigration and a decrease in toxoplasma transmission to humans has led to a larger population of women at risk of infection during pregnancy in France, it is therefore important to perform studies to investigate risk factors and markers of acquired toxoplasmosis during pregnancy in order to improve the prevention of congenital toxoplasmosis.

Adolescent↗
PubMed2001

HIV incidence estimates among women of childbearing age in the area around Paris, France: no evidence for any effect of age or time.

OBJECTIVE: To explore whether there are any age or time effects on the HIV incidence rate among women of childbearing age in the area around Paris (France). DESIGN: Three seroprevalence surveys were conducted among pregnant women in the Paris area (PREVAGEST) during three periods (1990-1991, 1992-1993, 1994-1995); their data were used to derive HIV incidence estimates with Ades and Medley's method. To assess the power of our study, data were also simulated with a demographic model under different assumptions for HIV-incidence rates. RESULTS: No age or time effect was detected on HIV incidence in the Paris area during the period from 1990 to 1995. Analysis of simulated surveys showed that with the sample size of the PREVAGEST surveys, the method was able to detect an age or time effect with a relative risk of about 2.5 between age groups or periods. CONCLUSION: We conclude that the method is applicable to our data. If any existed, age or time effect was quite likely no higher than 2.5. As we previously reported using another method, incidence of HIV infection among women of childbearing age in the Paris area can be estimated at 0.74/1,000 per year (95% confidence interval, 0.62-0.87) from 1990 through 1995.

Adolescent↗
PubMed1999

Single clonal origin of a high proportion of Legionella pneumophila serogroup 1 isolates from patients and the environment in the area of Paris, France, over a 10-year period.

Arbitrarily primed PCR with three primers and pulsed-field gel electrophoresis were used to characterize a set of 75 clinical Legionella pneumophila serogroup 1 isolates, with no apparent epidemiological link, obtained from 24 hospitals in Paris, France, from 1987 to 1997. Unexpectedly, 25 clinical isolates from 15 hospitals had an identical profile (termed type A) by both methods. The same profile was subsequently found in 16 of 64 randomly selected environmental L. pneumophila serogroup 1 isolates from 15 different sites in the Paris area. There was no evidence of geographic clustering or a peak incidence of type A isolation. Type A has not been found in France outside the Paris area, suggesting that a particular type of L. pneumophila serogroup 1 is specifically present in the Paris water distribution network.

Bacterial Typing Techniques↗
PubMed1998

Homicide followed by suicide: Paris and its suburbs, 1991-1996.

Homicide-suicides (HS) are relatively infrequent events. Yet, they are of great concern because they often result in the death of family members, young children, and cause additional morbidity, family disruption and childhood psychological trauma. The aims of our study were (a) to examine the sociodemographic, clinical, and autopsy characteristics of HS in Paris and its suburbs from 1991 through 1996, and (b) to analyze the psychodynamic determinants leading up to the onset of HS. Our findings are compared with those obtained in other international studies. For the purpose of the present study. HS was defined as a violent event in which an individual committed homicide and subsequently committed suicide within a few hours. The main results are as follows. During the six-year study period, 56 HS involving 133 victims were investigated at the Institute of Forensic Medicine of Paris. Seventeen events occurred in Paris and 39 in its suburbs. Paris has a population of approximately 2,200,000 while its suburbs are home to another 8,5000,000. Of the 56 offenders, 48 (85%) were males. The mean age of offenders was 51 years in males (range, 24 to 83) and 40.5 years in females (range, 33 to 56). In 45 events (80%), the offenders used a gun for both the homicide and suicide. A knife was used in only 4 murders, strangulation in 4 other cases, with poisoning, arson, or beating occurring in one case each. In 9 cases, the offender used a different weapon for homicide and suicide. Among firearms, handguns were more likely to be used (26 cases) than shotguns (6 cases) or rifles (13 cases). In 40 cases the offender killed one victim, in 11 cases 2 victims, and in 5 cases 3 victims. The homicide victims consisted of 34 children (21 boys), mean age 8 years (range, 1 to 16), 29 spouses (26 females), 2 girlfriends, 10 strangers, and 2 relatives. Five pets were killed. HS were most likely to be committed in the home. A suicide note was found near the victims in 29 cases (50% of events). In 42 cases the offender was found to be severely depressed. Familial HS were the most frequent events followed by suicidal pacts. When male sexual proprietariness and amorous jealousy were involved, the HS perpetrators acted often impulsively in carrying out the HS. There had been a chronically chaotic relationship and frequent physical violence and verbal threats. The triggering event was often the female withdrawal or estrangement. Only in a few cases, other motivations such as occupational or money problems were involved. Chronic alcoholism was found in 16 cases. In conclusion, the offender was more likely to be a male, severely depressed, violent and jealous who killed his spouse, and often his children, with impulsiveness, but after numerous threats. Our findings suggest that HS differ from both homicide and suicide and thus occupy a distinct epidemiological domain requiring specific prevention programs.

Adolescent↗
PubMed1977

Parent Attitude Research Instrument (PARI): clinical vs. statistical inferences in understanding abusive mothers.

Attitudes toward child rearing and early experiences in childhood traditionally have been regarded as psychodynamic factors that influence adult behavior. The present study assessed the capacity of the Parent Attitude Research Instrument (PARI) to differentiate between court-identified abusive mothers and a control sample of nonabusive, well-baby clinic mothers of comparable socioeconomic status. While univariate t-tests showed statistical significance for 3 of the 23 PARI scales, more sophisticated and appropriate multivariate tests (Discriminant Function Analysis) demonstrated that the PARI correctly classified the experimental and control Ss only 65% of the time. It appears that the PARI alone should not be used to identify potentially abusive mothers. Even more important, the results caution and alert non-statistically informed clinicians and researchers to the pitfall of over-interpreting clinical data that are based on the more simple univariate tests of statistical significance.

Attitude↗
PubMed1996

Quality assurance of interstitial brachytherapy technique in lip cancer: comparison of actual performance with the Paris System recommendations.

This study takes a quality assurance approach to assessing staff application of Paris System recommendations for brachytherapy. Between 1988 and 1992, 72 patients were treated with brachytherapy for cancer of the lip at Hospital Clinic in Barcelona. Because of the relatively high number of total local recurrences (11%) and the fact that several radiotherapists had come from other hospitals to join the staff, we analysed the technique actually used compared with the recommendations of the Paris System. Results indicate our staff did not, in fact, use the active length prescribed by the Paris System in 71% of cases but that the discrepancies had no observable impact on the actuarial local control in the short follow-up period (28 +/- 15 months). When we compared, in time sequence, the first 35 patients treated between 1988 and 1989 (Early group) with the last 37 treated between 1990 and 1992 (Later group), we saw that staff members had improved their application of the therapy by more often using the recommended length of active lines. Staff performance in the Later group was still far from ideal, however, as the actual length used differed from the length recommended in 51% of the cases. At present we are insisting on stricter application of the Paris System guidelines for lip brachytherapy. Our study suggests that auditing performance is worthwhile and we recommend that radiotherapists apply this analytical quality assurance method, especially when several new physicians join a department.

Aged↗
PubMed1984

Single and double plane implants: a comparison of the Manchester System with the Paris System.

A comparison between the Manchester System and the Paris System of interstitial dosimetry has been made in the case of single and double plane implants. The rules of both systems are reviewed. A brief description of the Paris System is presented in an appendix. Dose distributions for two different examples are presented in two orthogonal planes. The Paris System uses considerably fewer sources than the Manchester System. It results in a larger volume of high dose than the Manchester System. The use of Iridium-192 sources strength and source length can be adjusted represents a significant advantage. The Paris System attempts to adapt the implant configuration to the clinical situation as the target thickness is used to define the source separation and the target length is used to define the source length. The differences in the dose definition are discussed.

Brachytherapy↗
PubMed2002

Apolipoprotein A-I(Milano) and apolipoprotein A-I(Paris) exhibit an antioxidant activity distinct from that of wild-type apolipoprotein A-I.

Apolipoprotein A-I(Milano) (apoA-I(Milano)) and apoA-I(Paris) are rare cysteine variants of apoA-I that produce a HDL deficiency in the absence of cardiovascular disease in humans. This paradox provides the basis for the hypothesis that the cysteine variants possess a beneficial activity not associated with wild-type apoA-I (apoA-I(WT)). In this study, a unique antioxidant activity of apoA-I(Milano) and apoA-I(Paris) is described. ApoA-I(Milano) was twice as effective as apoA-I(Paris) in preventing lipoxygenase-mediated oxidation of phospholipids, whereas apoA-I(WT) was poorly active. Antioxidant activity was observed using the monomeric form of the variants and was equally effective before and after initiation of oxidative events. ApoA-I(Milano) protected phospholipid from reactive oxygen species (ROS) generated via xanthine/xanthine oxidase (X/Xo) but failed to inhibit X/Xo-induced reduction of cytochrome c. These results indicate that apoA-I(Milano) was unable to directly quench ROS in the aqueous phase. There were no differences between lipid-free apoA-I(Milano,) apoA-I(Paris), and apoA-I(WT) in mediating the efflux of cholesterol from macrophages, indicating that the cysteine variants interacted normally with the ABCA1 efflux pathway. The results indicate that incorporation of a free thiol within an amphipathic alpha helix of apoA-I confers an antioxidant activity distinct from that of apoA-I(WT). These studies are the first to relate gain of function to rare cysteine mutations in the apoA-I primary sequence.

Animals↗
PubMed1995

The application of dose-volume histograms to the Paris and Manchester systems of brachytherapy dosimetry.

When the geometry of an implant does not exactly follow a system of dosimetry problems arise in choosing a treatment dose rate. This study has investigated the use of natural dose-volume histograms (DVHs) as a means for choosing the treatment dose level in these cases. A number of ideal geometrical cases have been investigated. For these, where appropriate, the Paris or Manchester dose rates have been calculated and compared with the peak position of the natural DVH. The dose rate at the peak of the DVH was found to agree with the basal dose rate calculated according to the Paris rules. For implants that completely obeyed the Paris rules the mean ratio was 1.009 +/- 4%. A series of clinical implants was also examined. For these the mean ratio was 1.002 +/- 2.5%. It is concluded that the peak position of a DVH can be used to predict the Paris basal dose rate of an implant. There was no systematic relationship found between the Manchester dose rate and the peak position of the DVH. The mean ratio between the Manchester dose rate and the peak dose rate position of the DVH was 0.82 +/- 13% for a series of implants.

Brachytherapy↗
PubMed1996

[Women and the practice of health in the "Register of counsels' speeches in the Parlement of Paris, 1346-1427"].

The study of women in medieval medical practice is a recent area of research plagued by method, sources, and interpretation problems. The main obstacle is probably the paucity of the documentation, the underrepresentation of women in the sources. Studying the judiciary sources of fourteenth- and fifteenth-century Paris reveals women tried by the highest court of justice in France for illicit practice of medicine. Of 34 trials pertaining to health in the "Registre des plaidoiries du Parlement de Paris 1364-1427," eight cases involve women. Two of these trials are particularly instructive because they give many details on certain aspects of women's practice in the Middle Ages. Perette la Pétone is brought to justice by the "corporation des chirurgiens de Paris" for illicit practice of surgery and Jeanne Pouquelin is tried by the "communauté des barbiers de la ville de Paris" for illicit practice of "barbery." This article includes a transcript of the unpublished sources used for the study of these two cases. They shed some light on questions such as: What is the place and role of women in the medical guilds? How do they acquire the expertise required for these crafts? How are they perceived by their peers and society in general? And what is the extent of their medical knowledge?

France↗
PubMed1995

[Zoeros Pasha's report presented to the Sultinate on his return from Paris].

The Ottoman Empire dispatched a committee consisting of Zoeros Pasha, the president, Dr. Hüseyin remzi and veterinarian Hüseyin Hüsnü, who were members sent to learn how the method of the vaccination of rabies was practiced in Paris in 1886. Zoeros Pasha relates their studies in Paris, as well as his idea on the novelties he observed there and comments on the advantages of them in case of application in the Empire, in his report dated December 29th of 1886, prepared on his return from Paris. Zoeros Pasha and Hüseyin Hsnü Bey learned the vaccination practice, attending Pasteur's laboratory. Zoeros Pasha studied bacteriology for three months and Hüseyin Remzi attended the laboratory of "Jardin des Plantes" in order to do some zoological researches. When Pasteur went on vacation, Zoeros Pasha provided for Hüsnü Bey to attend the Veterinary School of Paris and directed his attention to the anthrax vaccination found by Pasteur. Hüseyin Hsnü Bey and Dr. Hüseyin Remzi Bey composed a book based on their translations on the subject Zoeros Pasha also mentions in his report the following topics on which he says he could report, if desired: 1. New methods of treatment applied for heart and lung diseases. 2. The most effective prophylactic methods and sanitary precautions on the epidemic and infectious diseases. 3. Improvement planned for the Imperial School of Medicine. 4. Use of anatomy in finding out criminals, in order to help the police forces.

Bacteriology↗
PubMedDate not supplied

[Tribute to the hospital staff for their courage during the Liberation of Paris (19-27 August 1944)].

The lecture given by P. Brocq on "The Hotel-Dieu from August 19th to 27th 1944" and P. Canlorbe's doctoral dissertaion on "The Medical Services in the French Resistance" have not received the attention they deserve. I was present at the Hotel-Dieu during that period and I wish to pay a just tribute to the personnel of the Paris hospitals. Historical events such as the beginning of the insurrection in the Police Headquarters on Saturday August 19th and the reaction of the German troups still in Paris are presented in this paper, along with some medical data, the rapid organization of a complete surgical unit similar to those deployed in wartime, including fearless volunteers who picked up casualties and dispatched them to the appropriate treatment centres composed of eight surgical teams. A message of hope was dropped over the Police Headquarters at around 6 p.m. on Thursday August 24th, more than five hours before Captain Dronne's detachment reached the Hotel-de-Ville and Place Notre-Dame. On Friday August 25th, the tactical group led by Colonel P. Billotte was triumphally acclaimed when it reached the wide space in front of the church. The number of casualties indicates how fierce was the confrontation: 822 wounded (398 Frenchs and 424 Germans) were admitted to the Hotel-Dieu, of which 283 died (78 French and 205 Germans). In the other Paris hospitals of the Assistance Publique, 3,083 patients were admitted for wounds and 567 died. The personnel of those hospitals was extremely performing during this period and also paid a heavy tribute. Three members of the Hotel-Dieu died and 10 were killed at the Bichat Hospital during the Lufwaffe air raid during the night of August 26-27th 1994. Time has come, more than fifty-three years later, to commemorate the courage of the personnel of those hospitals who effectively and generously fulfilled their mission during Paris Liberation.

France↗