BackgroundIn breast cancer patients routine thromboprophylaxis is not recommended but individualized risk assessment is encouraged. The incorporation of hypercoagulability biomarkers could increase the sensitivity of risk assessment models (RAM) to identify patients at VTE risk. To this aim we investigated the impact of cancer-related characteristics on hypercoagulability biomarkers.MethodsThrombin generation (TG) assessed with the Thrombogramme-Thrombinoscope®, levels of platelet derived microparticles (Pd-MP) assessed with flow cytometry, procoagulant phospholid dependent clotting time (PPL-ct) measured with a clotting assay and D-Dimers (were assessed in a cohort of 62 women with breast cancer and in 30 age matched healthy women.ResultsPatients showed significantly higher TG, Pd-MP, D-Dimers levels and shortened PPL-ct compared to the controls. The PPL-ct was inversely correlated with the levels of Pd-MP, which were increased in 97% of patients. TG and D-Dimers were increased in 76% and 59% of patients respectively. In any stage of the disease TG was significantly increased as compared to the controls. There was no significant difference of TG in patients with local, regional of metastatic stage. There was no significant difference in Pd-MP or Pd-MP/PS+ between the subgroups of patients with local or regional stage of cancer. Patients with metastatic disease had significantly higher levels of Pd-MP and Pd-MP/PS+ compared to those with regional stage. The D-Dimers increased in patients with metastatic stage. In patients on chemotherapy with less than 6 months since diagnosis TG was significantly higher compared to those on chemotherapy who diagnosed in interval > 6 months. Patients with metastatic disease had significantly higher levels of Pd-MP and D-Dimers compared to those with non-metastatic disease.ConclusionIn breast cancer patients the stage, the time elapsed since the diagnosis and the administration of chemotherapy are determinants of cellular and plasma hypercoagulability. The levels and the procoagulant activity of Pd-MP are interconnected with the biological activity and the overall burden of cancer. TG reflects the procoagulant properties of both breast cancer and chemotherapy in the initial period of cancer diagnosis. Thus the weighted incorporation of the biomarkers of cellular and plasma hypercoagulabilty in RAM for VTE might improve their predictive value.
Au Mali, l'usage des pesticides sur la culture de coton constitue un réel problème de santé publique et pour l'environnement. Cette étude porte sur les risques potentiels correspondant à la « dangerosité » des matières actives présentes dans les pesticides distribués pour le coton. Nous avons recensé 174 pesticides homologués par le Comité sahélien des pesticides (CSP) destinés à la culture du coton, dont 106 insecticides et fongicides et 68 herbicides. Ils sont formulés à partir de 50 matières actives ; 10 sont interdites en Europe et se retrouvent dans 35 produits homologués (soit 20 % des produits disponibles). Un indice de risque de toxicité (IRT) sur la santé des utilisateurs a été calculé pour chacune des 50 matières actives tenant compte de leurs toxicités aiguë et chronique. Il montre que la pendiméthaline et la bifenthrine ont les IRT les plus élevés respectivement pour les herbicides et les insecticides. Un indicateur de contamination des sols et des eaux de surface et souterraine par ces matières actives a été calculé. Il montre qu'une matière active peut présenter un risque important pour la santé et avoir un fort niveau de toxicité pour l'environnement ou avoir un faible impact sur la santé mais présenter un risque élevé pour l'environnement. Une sensibilisation des différents acteurs sur les risques encourus par les pesticides permettrait de réduire leurs impacts sur la santé humaine et l'environnement. Mots clés : coton / pesticides / santé publique / environnement / MaliAbstract -Assessing potential risks regarding pesticides used in cotton production in Mali. In Mali, pesticides used on cotton crops are a real public health and environmental problem. This study presents an analysis of potential risks corresponding to the "dangerousness" of active ingredient present in these pesticides for cotton. We identified 174 pesticides registered by the Sahel Pesticides Committee (CILSS-CSP) for cotton, including 106 insecticides and fungicides and 68 herbicides. They are formulated from 50 active ingredients; 10 are banned in Europe and are found in 35 registered products (20% of available products). For each active ingredient present in these pesticides, a Health Risk Index was calculated for the health of users. This indicator takes into account the acute and chronic toxicities of the different active ingredient. The results of our work show that, for herbicides, pendimethalin has the highest Health Risk Index; for insecticides, it is bifenthrin. We have also identified an indicator of soil, surface water and groundwater contamination by these active ingredients. The results show that an active ingredient could have a significant risk for health and have a high level of toxicity to the environment or have a low impact on health but have a high risk for the environment. Rising awareness among stakeholders about the risks of pesticides would reduce their impact on human health and environment.
Land-use-change-induced increases in shallow groundwater levels across parts of the Sahel in recent years have coincided with expanded use of groundwater for irrigation. This study was conducted to assess the potential linkages and livelihood implications based on a field survey of nine villages building on previous hydrological studies. The results show that irrigators lack effective means of production and mostly rely on manual methods. Borehole usage is more profitable and reliable than shallower wells. Overall incomes from irrigation are relatively small and severely constrained by the limited field scale due to high establishment and operating costs. (Résumé d'auteur
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