Rapport 2013 rédigé par l’ARS et l’INVS suite à une saisie par le maire de Preignac (Gironde)
En février 2013, l’Agence régionale de santé (ARS) d’Aquitaine est sollicitée au sujet d’épandages de pesticides à proximité d’une école et d’une suspicion d’agrégat spatio-temporel de cancers pédiatriques dans une commune viticole de Gironde. Une investigation est mise en place afin d’objectiver la fréquence des cancers pédiatriques et évaluer la plausibilité d’un lien avec les épandages viticoles de pesticides. La recherche des cas a été réalisée via les registres nationaux pédiatriques des hémopathies malignes (1990-2012) et des tumeurs solides (2000-2012) pour la commune et celles limitrophes, caractérisées également par une forte activité viticole.
9 cas de cancers pédiatriques ont été enregistrés par les registres de cancer sur la commune et celles limitrophes
5 hémopathies malignes de 1990 à 2012,
2 tumeurs cérébrales,
et 1 neuroblastome de 2000 à 2012,
soit un léger excès de cas pour les 14 dernières années (8 observés pour 5,7 attendus). Sur la commune seule, cet excès est faible (4 cas observés pour 0,8 attendu).
Hormis une forte activité viticole au niveau de la zone d’étude avec des épandages à proximité de l’école, aucune autre source majeure de pollution n’a été identifiée. Les méthodes épidémiologiques ne peuvent déterminer si l’excès de cas de cancer, qui reste faible, est lié à un facteur de risque environnemental commun. Par ailleurs, il existe d’autres facteurs, notamment individuels, pouvant expliquer la survenue de ces pathologies et qui n’ont pas été investigués. La contribution des pesticides au risque cancer ne pouvant être exclue, il a été recommandé de mettre en place des actions visant à diminuer les expositions ainsi qu’une surveillance sanitaire sur la commune.
La recherche des cas a été réalisée via les registres nationaux pédiatriques des hémopathies malignes (1990-2012) et des tumeurs solides (2000-2012) pour la commune et celles limitrophes, caractérisées également par une forte activité viticole. https://t.co/pwXk7wSTKd
BACKGROUND AND OBJECTIVES:
Although opioid pain relievers are commonly prescribed in pregnancy, their association with neonatal outcomes is poorly described. Our objectives were to identify neonatal complications associated with antenatal opioid pain reliever exposure and to establish predictors of neonatal abstinence syndrome (NAS).
We used prescription and administrative data linked to vital statistics for mothers and infants enrolled in the Tennessee Medicaid program between 2009 and 2011. A random sample of NAS cases was validated by medical record review. The association of antenatal exposures with NAS was evaluated by using multivariable logistic regression, controlling for maternal and infant characteristics.
Of 112 029 pregnant women, 31 354 (28%) filled ≥1 opioid prescription. Women prescribed opioid pain relievers were more likely than those not prescribed opioids (P < .001) to have depression (5.3% vs 2.7%), anxiety disorder (4.3% vs 1.6%) and to smoke tobacco (41.8% vs 25.8%). Infants with NAS and opioid-exposed infants were more likely than unexposed infants to be born at a low birth weight (21.2% vs 11.8% vs 9.9%; P < .001). In a multivariable model, higher cumulative opioid exposure for short-acting preparations (P < .001), opioid type (P < .001), number of daily cigarettes smoked (P < .001), and selective serotonin reuptake inhibitor use (odds ratio: 2.08 [95% confidence interval: 1.67–2.60]) were associated with greater risk of developing NAS.
Prescription opioid use in pregnancy is common and strongly associated with neonatal complications. Antenatal cumulative prescription opioid exposure, opioid type, tobacco use, and selective serotonin reuptake inhibitor use increase the risk of NAS.
Sources and More Information
Pill-pushing doctors endanger babies by prescribing opioid painkillers to pregnant women, naturalnews, August 15, 2015.
Prescription Opioid Epidemic and Infant Outcomes, American Academy of Pediatrics, (doi: 10.1542/peds.2014-3299), February 10, 2015.
Drug addict babies: Common pregnancy pain drugs leave newborns suffering horrific withdrawal symptoms, mirror, 14 April 2015.
Opioids During Pregnancy Put Babies at Risk, medpagetoday, 04.13.2015.
Pregnant Women Prescribed Opioids Have Babies More Likely To Suffer Complications, Withdrawal Symptoms, medicaldaily, Apr 14, 2015.
Hypomethylation of miR-142 promoter and upregulation of microRNAs that target the oxytocin receptor gene in the autism prefrontal cortex
2015 Study Abstract
MicroRNAs are small RNA molecules that regulate the translation of protein from gene transcripts and are a powerful mechanism to regulate gene networks. Next-generation sequencing technologies have produced important insights into gene transcription changes that occur in the brain of individuals diagnosed with autism spectrum disorder (asd). However, these technologies have not yet been employed to uncover changes in microRNAs in the brain of individuals diagnosed with asd.
Small RNA next-generation sequencing was performed on RNA extracted from 12 human autism brain samples and 12 controls. Real-time PCR was used to validate a sample of the differentially expressed microRNAs, and bioinformatic analysis determined common pathways of gene targets. MicroRNA expression data was correlated to genome-wide DNA methylation data to determine if there is epigenetic regulation of dysregulated microRNAs in the autism brain. Luciferase assays, real-time PCR, and Western blot analysis were used to determine how dysregulated microRNAs may regulate the expression and translation of an autism-related gene transcript.
We determined that miR-142-5p, miR-142-3p, miR-451a, miR-144-3p, and miR-21-5p are overexpressed in the asd brain. Furthermore, the promoter region of the miR-142 gene is hypomethylated in the same brain samples, suggesting that epigenetics plays a role in dysregulation of microRNAs in the brain. Bioinformatic analysis revealed that these microRNAs target genes that are involved in synaptic function. Further bioinformatic analysis, coupled with in vitro luciferase assays, determined that miR-451a and miR-21-5p can target the oxytocin receptor (OXTR) gene. OXTR gene expression is increased in these same brain samples, and there is a positive correlation between miR-21-5p and OXTR expression. However, miR-21-5p expression negatively correlates to production of OXTR protein from the OXTR transcript. Therefore, we suggest that miR-21-5p may attenuate OXTR expression in the human autism brain.
Our data suggests that dysregulation of microRNAs may play a biological role in the brain of individuals of autism. In addition, we suggest an interaction between epigenetic mechanisms and microRNA dysregulation in the brain. Overall, this data adds an important link in our understanding of the molecular events that are dysregulated in the brain of individuals diagnosed with autism.
Sources and More Information
Hypomethylation of miR-142 promoter and upregulation of microRNAs that target the oxytocin receptor gene in the autism prefrontal cortex, NCBI PubMed PMID: 26273428, Mol Autism. 2015 Aug 14;6:46. doi: 10.1186/s13229-015-0040-1. eCollection 2015.
DES usage review buttress the need for adequate and rigorous research into the use of drugs in pregnancy and ensure that they do more good than harm before being introduced for consumption
1988 Study Abstract
We conducted an incidence study to determine the occurrence rates of clear cell adenocarcinoma (CCAC) of the vagina and cervix in young women (born in 1940 and thereafter), and a case-series analysis, focusing on the maternal history of pregnancy and delivery and in-utero exposure to diethylstilbestrol (DES).
Overall, 10 cases of CCAC had been listed in the files of the Connecticut State Tumor Registry prior to the study, and each of the 10 cases were confirmed as valid. In addition, another 10 cases, all previously undetected, were found after the tissue slides of young women listed as having other cancers of the vagina and cervix were reviewed by expert pathologists, suggesting that prior estimates of the incidence rate for CCAC must be misleading unless special efforts are taken to identify undetected cases. The incidence rates of vaginal CCAC (11 cases total) were highest in 1975-1979, and decreased slightly during 1980-1982. In the cervix (nine cases total), the rate increased consistently since 1970. History of in-utero exposure to diethylstilbestrol was obtained for five of eight vaginal cases and four of eight cervical cases of CCAC. In all nine cases, exposure to diethylstilbestrol was associated with a history of bleeding during the pregnancy or prior miscarriage.
We conclude that the finding of stable (or rising) incidence rates for CCAC occurring nearly 30 years after the marked decrease in diethylstilbestrol sales emphasizes the need for continued clinical and epidemiologic studies of the etiology and clinical course of CCAC.
Sources and more information
Clear cell adenocarcinoma of the vagina and cervix: incidence, undetected disease, and diethylstilbestrol, NCBI PMID: 3385459, J Clin Epidemiol. 1988;41(6):593-7.
Sabrina McCormick weaves the story of one survivor with no family history into a powerful exploration of the big business of breast cancer. As drugs, pink products, and corporate sponsorships generate enormous revenue to find a cure, a growing number of experts argue that we should instead increase focus on prevention reducing environmental exposures that have contributed to the sharp increase of breast cancer rates. But the dollars continue to pour into the search for a cure, and the companies that profit, including some pharmaceutical and cosmetics companies, may in fact contribute to the environmental causes of breast cancer. No Family History shows how profits drive our public focus on the cure rather than prevention, and suggests new ways to reduce breast cancer rates in the future.
During the 6 years from the initial survey, 830 young women exposed to DES in utero were periodically screened.
1979 Study Abstract
The physician population delivering obstetric care in Philadelphia between 1950 and 1970 was contacted to ascertain their use of diethylstilbestrol (DES) during pregnancy. Of the 31.8% of the physicians who responded to the questionnaire, 71.8% used DES during pregnancy and 12.7% desired assistance in review of their records.
During the 6 years from the initial survey, 830 young women exposed to DES in utero were periodically screened for cervicovaginal abnormalities and clear cell adenocarcinoma. Of these 830 patients 61.7% were found to have cervicovaginal abnormalities, and 65.9% of the patients showed either adenosis or evidence of the prior existence of vaginal adenosis. Eight patients were treated for clear cell adenocarcinoma. Two cases were detected while asymptomatic. Seven of the patients are living with no evidence of cancer, and two of these have survived over 5 years.
Sources and more information
Six years’ experience with screening of a diethylstilbestrol-exposed population, NCBI PMID: 463989, Am J Obstet Gynecol. 1979 Aug 15;134(8):860-5.