Latest database descriptions

To improve national epidemiological monitoring of mesothelioma.

General objective: to identify retired workers that were exposed to carcinogens throughout their professional life; to inform them of their right to post-occupational medical monitoring and to support them throughout their efforts.
Secondary objective: to conduct an epidemiological (cohort) study to describe the long-term health effects of the considered exposures, and to assess the benefits of post-occupational monitoring in terms of health and social awareness.

The main objective of Brest Stroke Registry is to regroup all confirmed cases of stroke over a defined geographical zone in order to calculate an incidence.

There are three prospective medium-term goals:

- In respect with public health epidemiology:

1- To obtain incidence data and evaluate the regional and international divergences
This is about obtaining confirmed incidence data given that there are only two French data bases in Dijon and Lille. Our results put forward a high stroke incidence rate in the region of Brest. The rates of combined standardized attacks for 2008-2010 in 1 00 000 people were:
For men: 356.7 (IC95%: 317,5-396.0); 445.5 (IC95%: 414.7-476.3) and 464.1 (IC95%: 415.0-513.2) for Dijon, Brest and Lille respectively. (Cf registry comparison)
For women: 244.8 (IC95%: 219.7-269.8); 300.9 (IC95%: 282.9-319.0) and 362.4 (IC95%: 331.8-393.1) for Dijon, Brest and Lille respectively. (Cf registry comparison)

To date, there is no explanation for this high divergence of data.

2- To obtain the mortality data in short and long term.
Since the onset of the registry, we have implemented a study on the mortality of stroke patients of Brest Registry. This study has been realized independently for both types of stroke, i.e. ischemic and hemorrhagic, with different caused mortality. This mortality was studied at medium-term (≤ 28 days) as well as at long-term (> 28 days). Currently, we have followed all collected data in 2008 for a maximum of 6 years. There will be a collaboration project between InVS, Brest CHU and Rennes network on all causes of death.

3- Pharmaco-epidemiology

In clinical terms, the registry offers an opportunity to do an inventory of all current practices (diagnosis, therapies and the subsidiaries) and propose in this manner the best management of stroke. This strategy is in line with the pilot programs deployed by the HAS (French High Health Authority) for improvement of quality and safety of the health care. We have a project to analyse the bleeding risk associated with anticoagulants and anti-platelet agents in people of Brest as well as that of Dijon and Lille (in collaboration with their respective registry).
This study has gained a particular characteristic since 2012 with emerging new oral anticoagulants (OAC) which have shown less associated bleeding risks compared with vitamin K antagonists (randomized controlled trials). Hospital Project Call for Funding will be submitted in 2015.

- In terms of clinical researc we have initiated several projects:
1- Study the impactand consequences of stroke by socio-economic characteristics of the territories in the Pays de Brest (SOCAVAC)
2- Identify short and long term clinical predictors of mortality in patients who have had a hemorrhagic stroke.
3- To identify clinical predictors of mortality in the short and long-term patients with ischemic stroke.
4- To identify genetic predictors of mortality and long-term recurrence of patients with ischemic stroke
5- Identify stroke identification algorithm from existing databases

General objective: to monitor variations in weight and body composition as well as metabolic, cardiovascular and pulmonary comorbidities introduced by surgery for obesity. Secondary objective: to study tissue, vitamin, cellular and systemic physiopathological changes (metabolic and inflammatory phenomena, insulin resistance) induced by bariatric surgery.