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PubMed1993

A comparison of retirement migration from Paris and London.

"Retirement migration from Paris and London [is] compared by means of data from the OPCS Longitudinal Study for London and from the Echantillon Demographique Permanent for Paris. The levels of retirement migration for men and women from different zones of each capital city are examined and the social class differences in retirement migration in London and Paris and the different role which housing tenure plays in the two cities are highlighted. The authors go on to examine the regions to which Londoners and Parisians move on retirement and the type of housing which they take. In all cases, marked differences are found in migration behaviour between newly retired men and women in Paris and London, linked to urban structures and cultural differences."

Culture↗
PubMed2002

[Prosecution of Mélanie Hahnemann in 1847 at the court of Paris: illegal practise of pharmacy and medicine].

Recently married, the Hahnemanns came to Paris in 1835. The great man, 80, was authorised to practice in France. His wife Mélanie always assisted him in writing prescriptions, and in recruiting patients. When he died in 1843, she was continuing to practise assisted or not by a physician, Deleau or Croserio. A young pharmacist, Charles LeThiére, lived close to her as her adoptive son, grandson of the famous painter Guillaume Guillon-LeThière who was the director of the French Academy of Fine Arts of Rome at the Villa Medici, grandson as well of the Roman pharmacist Giuseppe Meli. Early Charles remained orphan and was educated by Mélanie. In 1844, he obtained his pharmaceutical graduation at the Ecole supérieure de Pharmacie de Paris. In 1847, she was accused of illegal practising of medicine and pharmacy. She claimed that she held the degree of doctor in homeopathy granted to her by the Academy of Pennsylvania. The court condemned her on the medical side considering that she earned money without legal certification in medicine. But as the drugs were prepared by a pharmacist, and delivered free of charge to the patients, no sentence was pronounced against her neither against LeThière. However, the court tempted to object that LeTière did not meet all the legal requirements for practising his pharmaceutical activity, especially aruging that he did not own an open shop of pharmacy, and that he did not declare his activity to the authorities in Paris. This point underline the fact that during the XIXth century the French law (21 germinal An XI- 1803), obliged the starting drug industry to be in dependence of the shops of pharmacy opened to the public, owned by a graduated pharmacist. As defender Mrs. Hahnemann chose the quite known solicitor Chaix d'Estange. Many testimonies came for justifying her capability of medical prescribing from artists, officers, writers and several aristocrats. From abroad came the supports of American doctors, Hempel, Hering and Hull. But the core question motivating her sentence came from the medical lobby acting in Paris led by the professor Orfila. Among the adepts of the homeopathy themselves, raised division and rivalry, but all considering that Mélanie Hahnemann's behavior was criticable. The court fined her for hundred francs that she paid. Then, she kept the circle of her friends and continued in medical counselling.

Ethics, Pharmacy↗
PubMed2003

[The foundation of the School of Pharmacy in Paris].

The Parisian School of Pharmacy originates from the Jardin des apothicaires created by the Parisian apothecaries community located rue de l' Arbalète to the suburb St Marcel in Paris in the early 17th century. It expenced on this site and was successively named the Collège de pharmacie (1777), the Société libre des pharmaciends de Paris and the Ecole gratuite de pharmacie (1796). The 11 April 1803 law as well as the government decrees of the same year organised the official training education of pharmacists in France with the creation of three schools in Montpellier, Paris and Strasbourg. The first director of the Parisian School was the well-known Louis-Nicolas Vauquelin. The development of this School imposed a new location in Paris, avenue de l' Observatoire, in 1882. The School of Pharmacy became Faculté de pharmacie in 1920.

France↗
PubMed1982

Antibiotic loaded plaster of Paris pellets: an in vitro study of a possible method of local antibiotic therapy in bone infection.

Plaster of Paris is an effective ancillary treatment in the surgery of infected cavities in bone. It is well tolerated and spontaneously absorbed over a period of weeks to months, being replaced by bone of normal architecture. It effectively obliterates much of the dead space, leaving little room for hematoma formation. It would appear logical to treat local infection, especially involving rigid walled cavities, by a locally diffused antibiotic. When incorporated into plaster of Paris pellets, two antibiotics, Fucidin and gentamicin, are capable of prolonged local release in bacteriocidal concentrations. On the basis of in vitro observations on bacterial cultures, it is proposed that antibiotic-plaster of Paris pellets might be a simple adjuvant technique to good surgical debridement in the treatment of bone infection. Plaster of Paris has the practical advantage over acrylic cement beads containing antibiotics in that it is resorbed and would not need a subsequent operation to be moved.

Anti-Bacterial Agents↗
PubMed1993

[Plaster of Paris: a carrier for antibiotics in the treatment of bone infections].

Local antibiotherapy by diffusion from plaster of Paris is a promising method in orthopedic surgery. Nevertheless, the characteristics of this matrix have not yet been extensively studied with respect to regulation of drug-carrier capacity. From the careful comparative investigation of five commercialized plasters of Paris, it appears that the material must be constituted of fine homogeneous crystals devoid of any additive in order to obtain reproducible implants which are sufficiently hard. This condition determines their use as a biodegradable filler of bone cavities. Because of the antimicrobial spectrum, diffusion velocity and synergistic effect of sodium fusidate, amoxicillin trihydrate and sodium amoxicillin, this association of antibiotics with the plaster of Paris appears to be a useful sterilizing delivery system. The plaster of Paris allows a significant release of sodium amoxicillin during the first 3 days. This is followed by an important sustained liberation of sodium fusidate and amoxicillin trihydrate for one week. Finally, the local release of sodium fusidate for at least 2 weeks at concentrations higher than the minimum inhibition concentrations (MIC) of the most frequently infecting pathogens in osteomyelitis, will allow the sterilization of bone cavities.

Anti-Bacterial Agents↗
PubMed1996

[Epidemiology of Crohn disease in Public Assistance-Hospitals in Paris. Data of hospitalizations 1981-1992].

OBJECTIVES: The aim of this study was to describe the epidemiological features of hospitalizations for Crohn's disease in Public Hospitals of Paris ("Assistance Publique-Hôpitaux de Paris") between 1981 and 1992. METHODS: Data concerning hospital stays were obtained from the OTARIE file, containing for each hospitalization descriptive data about the patient (including sex, birth date and locality, residence locality) and the hospital (including the identity of hospital department, the route of admission into the department and discharge from the department, the main medical diagnosis). RESULTS: There was a 2.5-fold increase of the number of hospital stays for Crohn's disease from the beginning to the end of the study period. Concomitantly, the women/men sex-ratio increased from 0.99 to 1.39. The rate of hospital stays lasting less than 24 hours increased at the end of the study period, reaching 10.6% in 1992. Among the patients born out of the area of Paris, there was a significantly higher proportion of patients native from the North of France. CONCLUSION: The prominent epidemiological features concerning the hospital stays for Crohn's disease in Public Hospitals of Paris between 1981 and 1992 were: a) a 2.5-fold increase of the number of patients hospitalized per year between 1981 and 1992; b) a concomitant increase of the sex-ratio in favour of women; c) the existence of a significant higher proportion of patients originary from the North of France.

Adolescent↗
PubMed1979

Creutzfeldt-Jakob disease in France: I. Retrospective study of the Paris area during the ten-year period 1968-1977.

A systematic search for cases of Creutzfeldt-Jakob disease occurring in the ten-year period 1968 through 1977 was conducted in the city of Paris and surrounding departments which comprise the greater Paris area. Fifty-six cases were found among the total population of approximately 10 million inhabitants, with a maximum incidence of 1.1 cases per year per million people in the densely populated city of Paris and a progressively lower incidence in the less heavily populated suburban and rural areas of the region. There was no temporal or geographic clustering of disease. Attention is drawn to the often rapid onset and short duration of illness (nearly two-thirds of the patients died within five months of onset) and the frequent early occurrence of symptoms such as asthenia, diaphoresis, and disturbances of sleep and appetite.

Adult↗
PubMed1998

Bicycle safety behavior in Paris and Boston.

Concerns about bicycle-related deaths and injuries have led to extensive injury prevention efforts in the United States, yet these concerns are not universal. For instance, in France attitudes toward bicycle safety are quite different. To understand more about variation in urban bicycle safety behavior, we observed passing bicyclists in Paris and Boston. In addition to helmet use, we looked at use of lights at night. Among 5,808 passing bicyclists, there were large differences in helmet and light use: only 2.2% of Paris bicyclists wore helmets compared to 31.5% in Boston. In contrast, 46.8% of nighttime Paris bicyclists had working head or tail lights compared to only 14.8% in Boston. These large and seemingly contradictory percentages are the result of different laws and public health priorities, types of bicycle riding, and perceived risks. Suggestions for further research and practical ways to improve U.S. bicycle safety behavior are discussed.

Accidents, Traffic↗
PubMed2001

The relationship between introduction of American society of clinical oncology guidelines and the use of colony-stimulating factors in clinical practice in a Paris university hospital.

BACKGROUND: Clinical practice guidelines are issued periodically by professional medical societies or committees to assist practitioners in clinical decision making. However, it is unclear whether such guidelines have any lasting impact on clinical practice. OBJECTIVE: The purpose of this study was to assess the impact of the American Society of Clinical Oncology (ASCO) guidelines regarding use of hematopoietic colony-stimulating factors (CSF) on cancer care in a university hospital in Paris. METHODS: The study was performed at Hĵpital Tenon, an 830-bed university hospital in Paris, in 1996 and 1997, both before and after the ASCO guidelines were implemented. The guidelines were first disseminated as a continuing medical education program and then actively implemented using a CSF prescription order form summarizing the guidelines. This form had to be used during the patient consultation and was sent to the Hĵpital Tenon pharmacy for CSF dispensation. Even if CSF use did not comply with the ASCO guidelines, the pharmacy filled the prescription. Seven other university hospitals in Paris, where the ASCO guidelines were not actively implemented, comprised the control group. The main outcome measure was the proportion of prescriptions in compliance with the 1996 update of the ASCO guidelines. Secondary outcome measures were the proportions of prescriptions in compliance with ASCO guidelines regarding primary prophylactic, secondary prophylactic, and therapeutic CSF administration. RESULTS: Before implementation of the ASCO guidelines, CSF use in compliance with the guidelines was 39% (41/105) at the study site and 31% (16/51) at the control sites (P > 0.05). Six months after dissemination and implementation of the guidelines, the proportion of CSF prescriptions complying with ASCO guidelines increased significantly versus baseline (P = 0.003) in the study group, to 61% (50/82). However, even after the guidelines were implemented, compliance with guidelines on primary prophylactic CSF administration did not change significantly versus before implementation in the study group (12% [5/41] before implementation vs 6% [2/33] after implementation; P > 0.05). CONCLUSIONS: The results suggest an association between the active implementation strategy (continuing medical education and CSF prescription reminder form) and physician compliance with the ASCO guidelines. Implementation of the ASCO guidelines appears to have had some impact on medical practice.

Colony-Stimulating Factors↗
PubMedDate not supplied

[Retrospective study of 594 HIV-1 seropositive patients seen in 8 hospitals of western Paris].

This multicenter retrospective study concerns 594 cases of HIV-1 positive patients. The majority were asymptomatic. Some had Aids-related complex and some had AIDS. They were all seen in seven hospitals of the western outskirts of Paris and in one Paris hospital between 1983 and 1988. There was a predominance of homosexuals and of cases of AIDS in the center of Paris. Intravenous (IV) drug users and asymptomatic cases were more numerous in the city outskirts, a reflection of the populations at risk around each hospital. The proportion of cases of AIDS was lower among IV drug users than among homosexuals or bisexuals probably due to the fact that the viral infection was discovered at an earlier stage in a population contaminated at a later date or to the tendency to ask for the test "systematically" in drug addicts. 22% of the cases were women with a sex ratio of 3.5. HIV infection was attributed to use of intravenous drugs in 51% and to heterosexual transmission in 18% of the women. But the incidence of heterosexual transmission increased significantly, essentially in women. Overall, the incidence of infection by the HIV 1 has decreased since 1986. A number of recent publications seem to indicate the same tendency. But this fundamental observation remains to be validated by further studies. The yearly incidence of AIDS increases. The 5 year calculated actuarial rate of probability of remaining asymptomatic decreased to 40% in 385 initially asymptomatic patients.

Adult↗
PubMed2006

Excess deaths during the August 2003 heat wave in Paris, France.

BACKGROUND: During the August 2003 heat wave in France, almost 15,000 excess deaths were recorded. Paris was severely affected, with an excess death rate of 141%. This study had two aims: to identify individual factors associated with excess deaths during a heat wave in an urban environment and to describe the spatial distribution of deaths within the French capital. METHODS: The study population included all people who died at home between August 1st and 20th, 2003 (N=961). We identified factors associated with excess deaths by comparing the sociodemographic characteristics of the study population with those of people who died at home during the same period in reference years (2000, 2001, 2002) (N=530). Spatial differences were analysed by calculating comparative mortality rates within Paris during August 2003. Mortality ratio was determined to demonstrate temporal variations in mortality between the heat wave period and reference years. RESULTS: The major factors associated with excess death were: age over 75 years (adjusted OR=1.44 (1.10-1.90), being female (adjusted OR=1.43 (1.11-1.83)), not being married (adjusted OR=1.63 (1.23-2.15)), particularly for men. Being a foreigner appeared to be a protective factor for women. Comparative mortality rates by neighbourhood showed a gradient in excess deaths from North-West to South-East. The mortality ratio was 5.44 (5.10-5.79), with very high rates of excess death in the South (12th, 13th, 14th and 15th "arrondissement"). CONCLUSION: The August 2003 heat wave in Paris was associated with both an exceptional increase in mortality rates and changes in the characteristics of those dying and spatial distribution of mortality. Understanding the effects of a heat wave on mortality can probably be improved by an analysis of risk at two levels: individual and contextual.

Aged↗
PubMed2005

Mental health care in Paris.

AIM: Characterised by its population density, cultural and ethnic diversity, familial fragmentation and high levels of HIV/AIDS, crime and homelessness, Paris poses specific problems with regard to mental healthcare. METHODS: Epidemiological studies show high rates of generalised anxiety and drug and alcohol abuse and dependence, greater use of psychoactive medication and, at the same time, apprehension about looking after mentally ill family members at home. RESULTS: Although the Greater Paris area has a much higher density of GPs and specialists than the national mean, there are considerable variations within the region itself, with the central area having up to four times as many GPs or psychiatrists as the outer suburbs. On the other hand, although the number of mental health medical acts and the number of people receiving mental health care have been rising dramatically over the last 15 years, Paris has considerably less adult psychiatry beds and day care places per head of population than the rest of France. DISCUSSION: Current planning targets include a more equitable distribution of mental health care service provision for the rapidly evolving urban population, early prevention of psycho-affective disorders, suicide and drug and alcohol misuse and the creation of low threshold services for adolescents in difficulty.

Adolescent↗
PubMed2001

[Acute diarrhea and rotavirus infection in the child: assessment of data from emergency care and and the microbiology laboratory of the Armand-Trousseau (Paris) Hospital between 1988 and 2001].

MATERIAL AND METHODS: Between October 1, 1988 and March 31, 2001, a longitudinal survey was conducted at the French pediatric hospital Armand-Trousseau in Paris. Following data were simultaneously collected: consultations and hospitalizations for acute diarrhea at the emergency room, and identifications of rotavirus from diarrheic stools at the laboratory. RESULTS: Acute diarrhea represented 9.3% to 11.1% of all consultations. The activity was continuous through the year with several epidemic peaks, the largest occurring during the winter months. The hospitalization rate was high and stable since 1989 (16.5% to 21%), reaching 22-26% at the winter peak. Overall, rotaviruses were identified in 22.4% of stool samples but the detection rate increased from 10% in 1989 to 31% in 1997. Rotaviruses were isolated mainly in winter, reaching the rate of 50-70% at the peak. DISCUSSION: Despite numerous biases of methodology and the fact that data were extracted from two different sources, acute diarrhea appeared as a major epidemic phenomenon in Paris, and rotaviruses were the main pathogens identified in diarrheic infants in winter. The extent of the winter epidemic increased each year since ten years, in parallel with the increase of the global activity of the emergency room. Despite attempts to develop ambulatory care, admission rates remained high in patients with acute diarrhea and searching for care at the emergency room of our hospital, especially in winter. CONCLUSION: These preliminary data were restricted to a single pediatric hospital in Paris. They need to be extended to a national level before considering a strategy for prevention using vaccination.

Child↗
PubMed2001

High seroprevalence to Bartonella quintana in homeless patients with cutaneous parasitic infestations in downtown Paris.

Bartonella quintana infections have recently been reported in homeless patients. We prospectively studied the prevalence of and the factors associated with a positive serology to B quintana in the homeless population of downtown Paris. The following data were recorded: ongoing cutaneous parasitic infestation, years of homelessness, living status, previous episodes of body pediculosis and scabies, alcoholism, intravenous drug use, known immunodepression (including undernutrition and known HIV infection), and contacts with animals. B quintana serology was performed in 57 patients and in 53 age- and sex-frequency-matched downtown Paris volunteer blood donors. Thirty-one patients (54%; 95% confidence interval [CI], 41%-68%) had a positive B quintana serology as compared with 2% in the control group (P <.0001); 8 of 57 patients (14%; 95% CI: 6%-26%) had a serologic profile of an evolving infection. Age and years of homelessness were independently associated with a positive B quintana serology with adjusted relative risks (RRs) of 2.9 (95% CI, 1.4-5.9) for age 40 years and older and 1.7 (95% CI, 1.1-2.7) for years of homelessness 3 or more. Our results suggest a high prevalence of past and recent infections with B quintana in the downtown Paris homeless population with cutaneous parasitic infestations.

Adult↗
PubMed2005

Infant mortality and income in 4 world cities: New York, London, Paris, and Tokyo.

OBJECTIVES: We investigated the association between average income or deprivation and infant mortality rate across neighborhoods of 4 world cities. METHODS: Using a maximum likelihood negative binomial regression model that controls for births, we analyzed data for 1988-1992 and 1993-1997. RESULTS: In Manhattan, for both periods, we found an association (.05% significance level) between income and infant mortality. In Tokyo, for both periods, and in Paris and London for period 1, we found none (5% significance level). For period 2, the association just missed statistical significance for Paris, whereas for London it was significant (5% level). CONCLUSIONS: In stark contrast to Tokyo, Paris, and London, the association of income and infant mortality rate was strongly evident in Manhattan.

Data Collection↗
PubMed2000

[Neurology in Paris hospitals, particularly the Salpêtrière before Charcot: Rostan on brain softening].

In the beginning of the 19th century, many studies were devoted to the diseases of the nervous system in France, long before the work of Charcot. The researches of Léon Rostan on the cerebral softening (1819, 1823) were based on the anatomoclinic method developed by the School of Paris whose most famous representatives were Corvisart and Laennec for the study of heart and lung diseases. The researches of Rostan were performed in the Salpêtrière hospital which was, at this time, an hospice for old women. Rostan was appointed Inspector of the Health service in the Salpêtrière hospital in 1812 then Head of a department in 1818. He was 28 year old when he published his book "Researches on the cerebral softening" in 1819. Rostan was the first to describe the spontaneous cerebral softening as a special anatomoclinic entity distinct from encephalitis and apoplexy. He compared this entity to the senile gangrene and stated that it was related to the ossification of cerebral arteries. He described the pathologic features of the brain softening and also its clinical symptomatology in opposition to that of apoplexy. The concept of brain softening according to Rostan was harshly fought by the followers of the Broussais's physiological medicine (from Lallemand, 1830 to Calmeil, 1859) who claimed that all brain softenings were due to the inflammation process and thus should be described as encephalitis. In opposite, the ideas of Rostan were accepted and developed by others such as Carswell in England (1835), Abercrombie in Scotland (1836) and Andral in France (1827, 1840). These authors agreed that some type of cerebral softening was related to a disease of the arterial system. Nevertheless, the modern concept of brain softening was not definitively accepted before the description of the thromboembolic mechanisms by Virchow in Germany (1856) with the help of the microscope, and the anatomoclinic studies of Proust, Laborde and Prevost and Cottard in France (1866). The book of Rostan was dedicated to the "Conseil Général des Hospices" which was created in 1801 to unify the administration of the hospitals in Paris and became the "Administration Générale de l'Assistance Publique à Paris" in 1849. One hundred and fifty years after its publication, the work of Léon Rostan was outstanding by its modernity of the form as well as the substance.

Cerebrovascular Circulation↗
PubMed2002

[Peritoneal tuberculosis: 27 cases in the suburbs of northeastern Paris].

SETTING: Peritoneal tuberculosis did not disappear from France during the 1990s. OBJECTIVE: To determine the characteristics of peritoneal tuberculosis in the north-eastern suburbs of Paris. METHOD: A retrospective study of cases diagnosed with peritoneal tuberculosis between 1990 and 1998 in five suburban hospitals in the north-east region of Paris. RESULTS: Twenty-seven cases of adult peritoneal tuberculosis were diagnosed. There were nine women and 18 men, with a mean age of 37.5 years, 88.9% of whom were foreign born. General and digestive symptoms--abdominal pain and/or ascites--were present in 96.3% of the cases. The mean delay in treatment was 30 days. Peritoneal involvement was isolated in 25.9% of cases, and associated with pulmonary tuberculosis in 40.7% or hepatic tuberculosis in 25.9%. Co-infection with HIV (human immunodeficiency virus) was present 14.8% of cases. Culture of ascites fluid, laparoscopy and/or laparotomy (n = 17), with directed biopsy, aided in the formal diagnosis of peritoneal tuberculosis in 59.2%. One relapse and one case of multiresistance were observed. The mean duration of treatment was 9 months (range 6-12 months). Three patients received treatment with corticosteroids, and 91.2% of the patients achieved cure without sequelae. CONCLUSION: Peritoneal tuberculosis is not rare in the Paris region. The diagnosis should be suspected in case with ascites and fever, and can be confirmed by laparoscopy with sampling for bacteriology and histology. The methods of treatment need to be standardised.

Abdominal Pain↗
PubMed2002

Impact of zinc roofing on urban runoff pollutant loads: the case of Paris.

Previous research on the Marais catchment in Paris demonstrated the very high zinc and cadmium contamination of runoff from zinc roofing. Thus further investigations were aimed at evaluating the relative importance of this type of roofing in Paris and its potential contribution to zinc and cadmium loads in wet weather flows. According to these results, about 40% of the surface of roofs in Paris is covered with rolled zinc (1016 ha), and this proportion is not likely to vary significantly in the next years, due to architectural rules. The Zn and Cd concentrations measured in runoff from these roofs are in accordance with literature

Construction Materials↗