Prevalence of beryllium sensitization in patients diagnosed with sarcoidosis

Occupational exposure to beryllium (Be) may lead to development of Be-specific CD4+ T-cell immune response and occurrence of a granulomatous disorder called chronic beryllium disease (CBD). Due to similar clinical pictures, CBD may be misdiagnosed as sarcoidosis if Be exposure (BeE) and Be sensitization (BeS) are not looked for. To determine whether some patients diagnosed as sarcoidosis may have undetected CBD, we screened a retrospective cohort of patients with sarcoidosis for BeE and BeS. BeE was assessed through a self-administered questionnaire and a standardized occupational health interview. BeS was assessed using CFSE flow cytometry developed as an alternative to the classical Be lymphocyte proliferation test (BeLPT). 159 patients recorded in a Swiss interstitial lung disease registry with a diagnosis of sarcoidosis were enrolled through their pulmonary physician and received a screening questionnaire. 68 filled questionnaires were returned. 28/68 patients had positive screening. 24/28 underwent an occupational health interview. BeE was considered probable in 6/24 and possible in 18/24. Using CFSE flow cytometry, BeS was detected in 7/24 of these patients (4/6 with probable BeE and 3/18 with possible BeE). BeS testing by CFSE flow cytometry was positive in 5/6 controls with proven CBD and positive BeLPT, and negative in 10 healthy subjects. Conclusions: the minimal rate of BeE and BeS in an unselected population of patients with sarcoidosis was 7/159 (4.4%), suggesting misdiagnosed CBD. A screening questionnaire could help to detect BeE in patients diagnosed with sarcoidosis, and prompt investigations in search of CBD. CFSE flow cytometry may be an alternative to BeLPT to document BeS.

Évaluation de la Pensée Constructive chez les adolescents délinquants: une approche pour comprendre les réponses inadaptées au stress

Objective: This pilot study aims at assessing Constructive Thinking in a sample of adolescent offenders and in a normative sample of adolescents. Method: 66 adolescent offenders (12-18 years) were compared to 540 control adolescents on the different subscales of the "Constructive Thinking Inventory". Results and Conclusion: Adolescent offenders show a less efficient Constructive Thinking: they show cognitive styles that may hamper their ability to take appropriate decisions when facing stressful situations, increasing self-defeating behaviors. Interventions may focus on improving adequate coping with stress.

Comparison of potential adjustment variables representing primary intellectual level in epidemiological studies on neurotoxicity

BACKGROUND: Primary intellectual abilities (PIA) are a confounder in epidemiological studies on neurotoxicity. A good measure of this confounder should be independent of age as PIA is an intrinsic ability. Furthermore, as PIA is related to health endpoints, any measure of PIA should reveal this association. This study is aimed at comparing vocabulary test, diploma and age at end of schooling properties as measures of PIA in a non-exposed population of workers. METHODS: The design was a cross-sectional study of 413 non-exposed workers (203 women and 210 men) selected from a health check-up center. The effect of age on the vocabulary score was assessed using an analysis of covariance adjusted for diploma. Relationships between neuropsychological performances and vocabulary score, diploma and end of schooling age were, respectively, assessed using multiple linear regressions adjusted for age and gender. RESULTS: Vocabulary score increased significantly with age, both for men and women. The increase was 0.14 word per year for women, and 0.18 word per year for men. The explained variance of the models evaluating the relationships between age at end of schooling, diploma, vocabulary test, and neuropsychological performances was quite similar for the three measures of PIA. CONCLUSIONS: Vocabulary score was found to be age-related, even after adjustment for diploma. No difference was found between these three variables in terms of their relationship to neuropsychological endpoints. Moreover, the literature shows that vocabulary test performances are influenced by exposure to neurotoxic agents. These results suggest that vocabulary score could be of interest for participants of similar ages and similar diplomas. Otherwise, the other two variables would be better PIA measures in neurotoxicology studies.