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G. Reuter – One of the best experts on this subject based on the ideXlab platform.

  • Real-time mobile teledermoscopy for skin cancer screening targeting an Agricultural Population: An experiment on 289 patients in France
    Journal of the European Academy of Dermatology and Venereology : JEADV, 2015
    Co-Authors: L. Hue, S. Makhloufi, P. Sall N’diaye, C. Blanchet-bardon, L. Sulimovic, F. Pomykala, M. Colomb, M. Baccard, F. Lassau, G. Reuter

    Abstract:

    Background The incidence of skin cancer has reached epidemic proportions in the white Population and is significantly elevated in Agricultural Populations, who are exposed to ultraviolet radiation during their professional activities. In 2014, the Agricultural Social Insurance Mutual Benefit Fund (MSA) offered its customers who work in agriculture and live in rural areas with reduced access to dermatologists the ability to participate in a one-day teledermoscopic (TDS) screening event. Objective This study’s aim was to assess the feasibility of real-time mobile TDS triage of a large number of Agricultural workers by trained medical officers and occupational physicians. Methods Fifteen TDS screening centres were located in different areas of France. Individuals older than 18 years who worked in agriculture and lived in a rural area near a TDS screening centre were invited to participate in a one-day screening event and were examined by an MSA physician. In cases of suspicious skin lesions, clinical and dermoscopic images were obtained and transferred immediately to four dermatologists who were simultaneously present at the tele-platform for diagnosis and decision-making. Low-quality images were retaken. Results Two hundred eighty-nine patients underwent skin cancer screening. Among 199 patients (69%), 390 suspicious lesions were identified and generated 412 pictures. All lesions were analysed by dermatologists. For 105 patients (53%), no follow-up was required. Seventeen patients were referred to local dermatologists for rapid examination, including 12 cases of suspected malignant melanocytic lesions. Among the 12 patients with suspected melanoma, face-to-face visits were conducted within ten days for 11 of them, and 1 case of melanoma was confirmed by histopathology. Conclusions Our study suggests that teledermoscopy performed in the context of occupational medicine and targeted to Agricultural Populations is feasible and could be useful for improving skin cancer screening in at-risk Populations while avoiding face-to-face examinations by a dermatologist in 53% of cases.

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Carmen Freire – One of the best experts on this subject based on the ideXlab platform.

  • Thyroid and reproductive hormones in relation to pesticide use in an Agricultural Population in Southern Brazil.
    Environmental research, 2019
    Co-Authors: Ramison Dos Santos, Camila Piccoli, Cleber Cremonese, Carmen Freire

    Abstract:

    Abstract This study aimed to assess the association of short- and long-term exposure to pesticides with circulating levels of thyroid and reproductive hormones in an Agricultural Population in the South of Brazil. Serum specimens from 122 male and female adults residing in small Agricultural properties were sampled both in the low and high pesticide use season. A comprehensive questionnaire was used to collect detailed information on recent and cumulative lifetime use of pesticides and other Agricultural-related exposures. The difference in serum hormone levels between seasons was assessed by the T-test and Wilcoxon test for paired samples, and associations between pesticide exposure-related variables and hormone values were explored by multivariate linear regression analysis. Levels of total thyroxine (T4) and male testosterone were significantly reduced from the low to high pesticide use season. In the high exposure season, recent use of dithiocarbamate fungicides, not using full personal protection equipment, and use of manual equipment was associated with reduced levels of thyroid-stimulating hormone (TSH). Moreover, recent use of lambda-cyhalothrin (pyrethroid) was associated with reduced total T4 and increased male luteinizing hormone (LH), use of paraquat (herbicide) with reduced free triiodothyronine (T3), and use of phthalamide (fungicide) with increased male LH. We also found associations of lifetime years of Agricultural work with reduced total T4 and increased male testosterone; and of lifetime Agricultural work and use of various pesticide classes (i.e. insecticides, herbicides, organophosphate insecticides, dithiocarbamate fungicides, and pyrethroids), mancozeb (fungicide), and paraquat with slight changes in free or total levels of T4 and/or T3. Findings suggest that both short- and long-term exposure to Agricultural pesticides may alter thyroid hormones and male testosterone levels among farm residents.

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  • Pesticide exposure and thyroid function in an Agricultural Population in Brazil.
    Environmental research, 2016
    Co-Authors: Camila Piccoli, Cleber Cremonese, Rosalina Jorge Koifman, Sergio Koifman, Carmen Freire

    Abstract:

    Although numerous pesticides may interfere with thyroid function, however, epidemiological evidence supporting this relationship is limited, particularly regarding modern non-persistent pesticides. We sought to evaluate the association of Agricultural work practices, use of contemporary-use pesticides, and OC pesticides residue levels in serum with circulating thyroid hormone levels in an Agricultural Population. A cross-sectional study was conducted with a random sample of 275 male and female farm residents in Farroupilha, South of Brazil. Information on sociodemographics, lifestyle and Agricultural work was obtained through questionnaire. Blood samples were collected on all participants and analyzed for cholinesterase activity, serum residues of OC pesticides, and levels of free T4 (FT4), total T3 (TT3) and TSH. Non-persistent pesticides exposure assessment was based on questionnaire information on current use of pesticides, and frequency and duration of use, among others. Associations were explored using multivariate linear regression models. Total lifetime years of use of fungicides, herbicides and dithiocarbamates in men was associated with increased TSH accompanied by decrease in FT4, with evidence of a linear trend. In addition, there was an association between being sampled in the high pesticide-use season and increased TSH levels. Conversely, farm work and lifetime use of all pesticides were related with slight decrease in TSH and increased TT3 and FT4, respectively. In general, pesticide use was not associated with thyroid hormones in women. Subjects with detected serum concentrations of β-hexachlorocyclohexane, endrin, dieldrin, heptachlor epoxide B, γ-chlordane, transnonachlor, heptachlor, p,p’-dichlorodiphenylethane and endosulfan II experienced slight changes in TT3; however, associations were weak and inconsistent. These findings suggest that both cumulative and recent occupational exposure to Agricultural pesticides may affect the thyroid function causing hypothyroid-like effects, particularly in men.

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L. Hue – One of the best experts on this subject based on the ideXlab platform.

  • Real-time mobile teledermoscopy for skin cancer screening targeting an Agricultural Population: An experiment on 289 patients in France
    Journal of the European Academy of Dermatology and Venereology : JEADV, 2015
    Co-Authors: L. Hue, S. Makhloufi, P. Sall N’diaye, C. Blanchet-bardon, L. Sulimovic, F. Pomykala, M. Colomb, M. Baccard, F. Lassau, G. Reuter

    Abstract:

    Background The incidence of skin cancer has reached epidemic proportions in the white Population and is significantly elevated in Agricultural Populations, who are exposed to ultraviolet radiation during their professional activities. In 2014, the Agricultural Social Insurance Mutual Benefit Fund (MSA) offered its customers who work in agriculture and live in rural areas with reduced access to dermatologists the ability to participate in a one-day teledermoscopic (TDS) screening event. Objective This study’s aim was to assess the feasibility of real-time mobile TDS triage of a large number of Agricultural workers by trained medical officers and occupational physicians. Methods Fifteen TDS screening centres were located in different areas of France. Individuals older than 18 years who worked in agriculture and lived in a rural area near a TDS screening centre were invited to participate in a one-day screening event and were examined by an MSA physician. In cases of suspicious skin lesions, clinical and dermoscopic images were obtained and transferred immediately to four dermatologists who were simultaneously present at the tele-platform for diagnosis and decision-making. Low-quality images were retaken. Results Two hundred eighty-nine patients underwent skin cancer screening. Among 199 patients (69%), 390 suspicious lesions were identified and generated 412 pictures. All lesions were analysed by dermatologists. For 105 patients (53%), no follow-up was required. Seventeen patients were referred to local dermatologists for rapid examination, including 12 cases of suspected malignant melanocytic lesions. Among the 12 patients with suspected melanoma, face-to-face visits were conducted within ten days for 11 of them, and 1 case of melanoma was confirmed by histopathology. Conclusions Our study suggests that teledermoscopy performed in the context of occupational medicine and targeted to Agricultural Populations is feasible and could be useful for improving skin cancer screening in at-risk Populations while avoiding face-to-face examinations by a dermatologist in 53% of cases.

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