Colorectal cancer (CRC) has a high incidence worldwide, especially in high-income countries. In France, a national CRC screening program targeting residents aged 50–74 years has been in place since 2009. Little is known about CRC screening practices in cancer survivors, even though some have an increased risk of developing a second cancer in the colorectum. This study aims to identify the barriers to CRC screening among cancer survivors.
Methods
This cross-sectional study based on the French national VICAN survey included individuals diagnosed in 2010 with a cancer in 1 of 11 locations other than the colorectum and interviewed 5 years after diagnosis about various health-related issues. Binary logistic regression was used to identify the factors associated with lack of up-to-date CRC screening in cancer survivors without cancer progression.
Results
Of the 2935 cancer survivors included in the study, 35.3% reported undergoing a screening test in the previous 2 years. The rate of up-to-date CRC screening rose to 49.3% in survivors aged 51–75 years. Among these, lack of CRC screening in the recommended time frame was associated with obesity, current smoking, non-use of complementary medicine, perceived financial difficulties, and poor access to general practitioners.
Conclusions
Barriers to CRC screening can be personal and/or institutional.
To examine the genetic diversity in Morocco, the polymorphism at the HLA-DRB1 locus was investigated in two populations: the Metalsa group consisting of Berbers from north Morocco (who speak the Tarifit language and live in the Nador area), and the Chaouya group who are Arabic-speaking people from west Morocco (Atlantic coast) living in the Settat area. The DRB1 alleles of 197 healthy unrelated individuals were identified by direct DNA sequencing of exon 2 using fluorescently-labeled primers. A total of 28 and 29 alleles at DRB1 locus were identified in the Metalsa and Chaouya groups, respectively. The most frequent alleles in the Metalsa group are DRB1*03011 (20.2%), DRB1*0701 (12.12%), and DRB1*1302 (11.11%). In the Chaouya group, DRB1*0701 (16.33%), DRB1*15011 (12.76%), and DRB1*03011 (11.73%) are most common. Each population exhibits some specific variants and some uncommon alleles. The frequency of the DRB1*03011 allele differs significantly between the two populations (p = 0.0311). The DRB1 frequency distributions in the two groups suggest the effects of balancing selection. The interpopulation analysis highlighted a strong relatedness, based on genetic distances, between the two Moroccan groups and the other north Africans (the Moroccans from El Jadida area, Moroccan Souss Berbers, Algerians, and Tunisians), and to a lesser extent with the Iberians, French, and Ethiopians. 相似文献
No data are available on thromboprophylaxis use in Morocco. Our aim was to characterize patients at risk of venous thromboembolism and assess the rate of appropriate thromboprophylaxis.
Materials and Methods
This was a national, observational, multicentre survey of venous thromboembolism risk and thromboprophylaxis use in hospitalized patients. Data were collected on a predefined date in three university hospitals in Morocco using a standardized pre-printed form. Thromboembolic risk was assessed according to the American College of Chest Physicians (ACCP) 2008 guidelines. Patients were classified as “thromboprophylaxis indicated” or “thromboprophylaxis not indicated”.
Results
784 patients were analysed: 307 (39.2%) medical and 477 (60.8%) surgical. 421 (53.7%) were female. Medical patients were older than surgical patients (57.6 ± 11.5 vs. 46.2 ± 16.9 years, p < 0.0001) and were more likely to have risk factors for thromboembolism (50.5% vs. 45.7% of patients, p = NS). 57% of patients without contraindications or bleeding risk were at risk of thromboembolism according to ACCP guidelines and thromboprophylaxis was prescribed to 42.8% of these patients. In contrast, 7.4% of patients with no thromboembolic risk also received thromboprophylaxis (proportion agreement: 61.0%; Kappa = 0.296). Over half (54.5%) of medical patients at risk of thromboembolism did not receive thromboprophylaxis whereas 6.3% of those with no risk did receive it (proportion agreement: 76.4%; Kappa = 0.433). These figures were 57.9% and 9.2%, respectively, for surgical patients (proportion agreement: 52.7%; Kappa = 0.191). Thromboprophylaxis was given to 19.2% of patients with contraindications or a bleeding risk.
Conclusions
Educational initiatives are imperative to inform doctors about appropriate thromboprophylaxis. 相似文献
Despite the increasing impact of rhabdoviruses in European percid farming, the diversity of the viral populations is still
poorly investigated. To address this issue, we sequenced the partial nucleoprotein (N) and complete glycoprotein (G) genes
of nine rhabdoviruses isolated from perch (Perca fluviatilis) between 1999 and 2010, mostly from France, and analyzed six of them by immunofluorescence antibody test (IFAT). Using two
rabbit antisera raised against either the reference perch rhabdovirus (PRhV) isolated in 1980 or the perch isolate R6146,
two serogroups were distinguished. Meanwhile, based on partial N and complete G gene analysis, perch rhabdoviruses were divided
into four genogroups, A-B-D and E, with a maximum of 32.9% divergence (G gene) between isolates. A comparison of the G amino
acid sequences of isolates from the two identified serogroups revealed several variable regions that might account for antigenic
differences. Comparative analysis of perch isolates with other rhabdoviruses isolated from black bass, pike-perch and pike
showed some strong phylogenetic relationships, suggesting cross-host transmission. Similarly, striking genetic similarities
were shown between perch rhabdoviruses and isolates from other European countries and various ecological niches, most likely
reflecting the circulation of viruses through fish trade as well as putative transfers from marine to freshwater fish. Phylogenetic
relationships of the newly characterized viruses were also determined within the family Rhabdoviridae. The analysis revealed a genetic cluster containing only fish viruses, including all rhabdoviruses from perch, as well as
siniperca chuatsi rhabdovirus (SCRV) and eel virus X (EVEX). This cluster was distinct from the one represented by spring
viraemia of carp vesiculovirus (SVCV), pike fry rhabdovirus (PFRV) and mammalian vesiculoviruses. The new genetic data provided
in the present study shed light on the diversity of rhabdoviruses infecting perch in France and support the hypothesis of
circulation of these viruses between other hosts and regions within Europe. 相似文献
A survey of the presence of aflatoxin M1 (AFM1) was carried out on eight traditional dairies belonging to four sectors of Fez city situated in the northern center of Morocco. Raw milk samples were collected between October 2009 and September 2010, and analyzed by LC-fluorescence detection after immunoaffinity purification. AFM1 was detected in 13 out of 48 samples (27%) at concentrations ranged between 10 and 100 ng/l. Within these positive samples, four (∼8% of the total) were above the European legislation limit of 50 ng/l. This study revealed a variation of contamination from one sector to another with a higher incidence in milk samples collected in autumn compared to those collected in other seasons suggesting a link between feeding practices, such as the use of silage and AFM1 contamination. This is the first report on AFM1 contamination in raw milk directly collected from Moroccan traditional dairies. The levels of contamination found justify more detailed and continuous monitoring to assess the public health implication and reduce consumers’ exposure to AFM1. 相似文献