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Search Results: 1 - 10 of 799 matches for " Sandrine Katsahian "
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Attitudes of Medical Students towards Conflict of Interest: A National Survey in France
Bruno Etain, Lydia Guittet, Nicolas Weiss, Vincent Gajdos, Sandrine Katsahian
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0092858
Abstract: Following recent health scandals in France, the French parliament adopted law n°2011-2012 to regulate ties between physicians and the pharmaceutical industry. The law also requires pharmaceutical companies to publicize financial and other benefits given to medical students. In this context, we administered a survey to medical students in France, in an effort to identify priorities for future education regarding conflicts of interest (COI). This web-based survey encompassed knowledge about, training on, personal exposure to, and opinions on COI among preclinical and clinical students as well as residents. Two thousand one hundred and one (2,101) students participated. Although most students (64.6%) believed that they are able to define what a COI is, they failed to correctly identify several situations as COI (receiving a gift, being offered a meal, being invited to a conference). Most students reported feeling inadequately educated about COI (85.2%). Compared to other class levels, residents were more exposed to pharmaceutical sales representatives. This exposure is highly associated to receipt of gifts (OR 14.51, 95% CI 11.67–18.05). Medical students were aware of potential bias induced by COI with respect to drug prescriptions and research, but felt personally immune towards COI. In our survey, personal research performed by students was more likely to be associated with perception of potential bias on prescription for self (but not for others) than attending a lecture on COI. Promulgating laws that regulate ties between physicians/students and the pharmaceutical industry is a mandatory first step. However, complementary strategies should be implemented within medical schools, in particular, specific training about COI in early medical education.
Effects of discontinuing or continuing ongoing statin therapy in severe sepsis and septic shock: a retrospective cohort study
Armand Mekontso Dessap, Islem Ouanes, Nerlep Rana, Beatrice Borghi, Christophe Bazin, Sandrine Katsahian, Anne Hulin, Christian Brun-Buisson
Critical Care , 2011, DOI: 10.1186/cc10317
Abstract: We retrospectively compared patients with severe sepsis and septic shock in whom statin therapy had been discontinued or continued. The primary endpoint was the number of organ failure-free days at day 14. Secondary end-points included hospital mortality and safety. The association of statin continuation with outcome was evaluated for crude analysis and after propensity score matching and adjustment. We also measured plasma atorvastatin concentrations in a separate set of ICU septic patients continuing the drug.Patients in whom statin therapy had been continued in the ICU (n = 44) had significantly more organ failure-free days (11 [6-14] vs. 6 [0-12], mean difference of 2.34, 95%CI from 0.47 to 5.21, P = 0.03) as compared to others (n = 32). However, there were important imbalances between groups, with more hospital-acquired infections, more need for surgery before ICU admission, and a trend towards more septic shock at ICU admission in the discontinuation group. The significant association of statin continuation with organ failure free days found in the crude analysis did not persist after propensity-matching or multivariable adjustment: beta coefficients [95% CI] of 2.37 [-0.96 to 5.70] (P = 0.20) and 2.24 [-0.43 to 4.91] (P = 0.11) respectively. We found particularly high pre-dose and post-dose atorvastatin concentrations in ICU septic patients continuing the drug.Continuing statin therapy in ICU septic patients was not associated with reduction in the severity of organ failure after matching and adjustment. In addition, the very high plasma concentrations achieved during continuation of statin treatment advocates some caution.Statins are effective lipid-lowering agents that have been shown to improve survival in the primary and secondary prevention of atherosclerosis in several large randomized clinical trials [1]. Many experimental models have also shown pleiotropic activity of statins (including anti-inflammatory, anti-oxidative, and immunomodulatory effects)
Orosomucoid, a New Biomarker in the Association between Obesity and Periodontitis
Hélène Rangé, Christine Poitou, Adrien Boillot, Cécile Ciangura, Sandrine Katsahian, Jean-Marc Lacorte, Sébastien Czernichow, Olivier Meilhac, Philippe Bouchard, Catherine Chaussain
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0057645
Abstract: Epidemiological data indicate an association between periodontitis and obesity. The biological mechanisms of this relationship remain unclear. A cross-sectional study was conducted to evaluate the relationship between periodontitis and the common systemic inflammatory markers in 32 morbidly obese patients recruited in a Clinical Nutrition department. Periodontal condition was evaluated using pocket depth (PD) measurement, a classical clinical marker of ongoing periodontitis. Major periodontal risk factors were recorded (age, gender, diabetes and smoking status), as well as plasma levels of inflammatory markers (CRP, orosomucoid, IL-6) and adipokines (adiponectin, leptin). All patients included in the sample exhibited evidence of periodontitis, 16 of whom were diagnosed as having severe disease. Adjusted logistic regression analysis indicated that the severity of periodontitis was associated with the plasma level of orosomucoid (p<0.04) after adjustment for age, gender and smoking. Our study thus suggests that the severity of periodontitis, in morbidly obese patients, is associated with the increase of orosomucoid levels.
Treatment for Stable Coronary Artery Disease: A Network Meta-Analysis of Cost-Effectiveness Studies
Thibaut Caruba, Sandrine Katsahian, Catherine Schramm, Ana?s Charles Nelson, Pierre Durieux, Dominique Bégué, Yves Juillière, Olivier Dubourg, Nicolas Danchin, Brigitte Sabatier
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0098371
Abstract: Introduction and Objectives Numerous studies have assessed cost-effectiveness of different treatment modalities for stable angina. Direct comparisons, however, are uncommon. We therefore set out to compare the efficacy and mean cost per patient after 1 and 3 years of follow-up, of the following treatments as assessed in randomized controlled trials (RCT): medical therapy (MT), percutaneous coronary intervention (PCI) without stent (PTCA), with bare-metal stent (BMS), with drug-eluting stent (DES), and elective coronary artery bypass graft (CABG). Methods RCT comparing at least two of the five treatments and reporting clinical and cost data were identified by a systematic search. Clinical end-points were mortality and myocardial infarction (MI). The costs described in the different trials were standardized and expressed in US $ 2008, based on purchasing power parity. A network meta-analysis was used to compare costs. Results Fifteen RCT were selected. Mortality and MI rates were similar in the five treatment groups both for 1-year and 3-year follow-up. Weighted cost per patient however differed markedly for the five treatment modalities, at both one year and three years (P<0.0001). MT was the least expensive treatment modality: US $3069 and 13 864 after one and three years of follow-up, while CABG was the most costly: US $27 003 and 28 670 after one and three years. PCI, whether with plain balloon, BMS or DES came in between, but was closer to the costs of CABG. Conclusions Appreciable savings in health expenditures can be achieved by using MT in the management of patients with stable angina.
Effectiveness of Chest Physiotherapy in Infants Hospitalized with Acute Bronchiolitis: A Multicenter, Randomized, Controlled Trial
Vincent Gajdos ,Sandrine Katsahian,Nicole Beydon,Véronique Abadie,Lo?c de Pontual,Sophie Larrar,Ralph Epaud,Bertrand Chevallier,Sylvain Bailleux,Alix Mollet-Boudjemline,Jean Bouyer,Sylvie Chevret,Philippe Labrune
PLOS Medicine , 2010, DOI: 10.1371/journal.pmed.1000345
Abstract: Background Acute bronchiolitis treatment in children and infants is largely supportive, but chest physiotherapy is routinely performed in some countries. In France, national guidelines recommend a specific type of physiotherapy combining the increased exhalation technique (IET) and assisted cough (AC). Our objective was to evaluate the efficacy of chest physiotherapy (IET + AC) in previously healthy infants hospitalized for a first episode of acute bronchiolitis. Methods and Findings We conducted a multicenter, randomized, outcome assessor-blind and parent-blind trial in seven French pediatric departments. We recruited 496 infants hospitalized for first-episode acute bronchiolitis between October 2004 and January 2008. Patients were randomly allocated to receive from physiotherapists three times a day, either IET + AC (intervention group, n = 246) or nasal suction (NS, control group, n = 250). Only physiotherapists were aware of the allocation group of the infant. The primary outcome was time to recovery, defined as 8 hours without oxygen supplementation associated with minimal or no chest recession, and ingesting more than two-thirds of daily food requirements. Secondary outcomes were intensive care unit admissions, artificial ventilation, antibiotic treatment, description of side effects during procedures, and parental perception of comfort. Statistical analysis was performed on an intent-to-treat basis. Median time to recovery was 2.31 days, (95% confidence interval [CI] 1.97–2.73) for the control group and 2.02 days (95% CI 1.96–2.34) for the intervention group, indicating no significant effect of physiotherapy (hazard ratio [HR] = 1.09, 95% CI 0.91–1.31, p = 0.33). No treatment by age interaction was found (p = 0.97). Frequency of vomiting and transient respiratory destabilization was higher in the IET + AC group during the procedure (relative risk [RR] = 10.2, 95% CI 1.3–78.8, p = 0.005 and RR = 5.4, 95% CI 1.6–18.4, p = 0.002, respectively). No difference between groups in bradycardia with or without desaturation (RR = 1.0, 95% CI 0.2–5.0, p = 1.00 and RR = 3.6, 95% CI 0.7–16.9, p = 0.10, respectively) was found during the procedure. Parents reported that the procedure was more arduous in the group treated with IET (mean difference = 0.88, 95% CI 0.33–1.44, p = 0.002), whereas there was no difference regarding the assessment of the child's comfort between both groups (mean difference = ?0.07, 95% CI ?0.53 to 0.38, p = 0.40). No evidence of differences between groups in intensive care admission (RR = 0.7, 95% CI 0.3–1.8, p = 0.62), ventilatory
Social Representations and Public Policy: Influence of the Distance from the Object on Representational Valence  [PDF]
Jimmy Bordarie, Sandrine Gaymard
Open Journal of Social Sciences (JSS) , 2015, DOI: 10.4236/jss.2015.39038
Abstract:

Theory: Our research is based on the social representations theory (Moscovici, 1961) [1] as an interpretation grid to understand reality. These representations constitute a way to defend social positions towards a social object. We are interested in the concept of distance from the object (Abric, 2001) [2] to study individuals’ feelings towards a social object. People can feel concerned and close to it, or not concerned and distant from it. We assume this link impacts the representational elements’ valence. By applying it to the urban mobility public policy of 30 kph, we inscribe it into an applied approach with the aim of helping urban planners, politicians and associations to understand social acceptability of this measure. Method: 129 young French drivers (mean age: 22.4; SD: 3.8; 78% are women and 22% are men) replied to a questionnaire to determine the individuals’ distance from the object and the social representation of 30 kph. Results: A T test highlights the significant influence of the distance from the object on the representational elements’ valence. Depending on individuals’ feelings, social representation is focused upon pro-social or negative aspects. Gender seems to have a minor impact, whereas the regular mode of transport seems to influence the representation. Applications: Our results clearly give information to build efficient awareness campaigns (Bordarie & Gaymard, 2015) [3]. They can also provide indications for urban planners to implement 30 kph zones, highlighting the flexibility of practices (Bordarie & Gaymard, 2015) [4].

Drought Effects on Early Growth and Mortality of Three Oak Species in the Upper Rhine Valley  [PDF]
Sandrine Brèteau-Amores
American Journal of Climate Change (AJCC) , 2018, DOI: 10.4236/ajcc.2018.72020
Abstract: Pedunculate oak and sessile oak are important natural species in the Upper Rhine Valley. The increasing mortality of these oak species has been observed since the 1980s in this region, mainly due to severe droughts. Turkey oak is known to be highly productive and drought-resistant. The goal of this article is therefore to investigate the adaptability to drought of these three young oak species growing at the same site, and to show to what extent Turkey oak can be substituted for these native oak species. Stand measurements and retrospective analyses of radial growth were performed within the framework of the eight-year-old “Mooswald” afforestation experiment in order to determine stand volume, mortality and resistance/resilience to drought for each species. Turkey oak shows significantly higher stand volume and significantly lower mortality than sessile oak. Values of these two parameters for Turkey oak and sessile oak are not significantly different from those of pedunculate oak. However, Turkey oak is not more resistant to drought than the other oak species. Sessile oak has the highest mortality and the smallest stand volume, while pedunculate oak is the least resilient to drought. These results are only a trend that must be confirmed in older stand stages and investigation in young stands must continue, supported by better monitoring and improved tools.
Superoxide Flashes in Mouse Skeletal Muscle Are Produced by Discrete Arrays of Active Mitochondria Operating Coherently
Sandrine Pouvreau
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0013035
Abstract: Reactive Oxygen Species (ROS) constitute important intracellular signaling molecules. Mitochondria are admitted sources of ROS, especially of superoxide anions through the electron transport chain. Here the mitochondria-targeted ratiometric pericam (RPmt) was used as a superoxide biosensor, by appropriate choice of the excitation wavelength. RPmt was transfected in vivo into mouse muscles. Confocal imaging of isolated muscle fibers reveals spontaneous flashes of RPmt fluorescence. Flashes correspond to increases in superoxide production, as shown by simultaneous recordings of the fluorescence from MitoSox, a mitochondrial superoxide probe. Flashes occur in all subcellular populations of mitochondria. Spatial analysis of the flashes pattern over time revealed that arrays of mitochondria work as well-defined superoxide-production-units. Increase of superoxide production at the muscle fiber level involves recruitment of supplemental units with no increase in per-unit production. Altogether, these results demonstrate that superoxide flashes in muscle fibers correspond to physiological signals linked to mitochondrial metabolism. They also suggest that superoxide, or one of its derivatives, modulates its own production at the mitochondrial level.
Aquello que no se conmemora: ?Democracias sin un pasado compartido?
Lefranc,Sandrine;
Revista de ciencia política (Santiago) , 2003, DOI: 10.4067/S0718-090X2003000200011
Abstract: abstract democratic societies, both the "old" and the "new" ones, that were confronted to a violent past, today don't seem to share but a fragmented and conflictive memory of this past. the measures of transitional justice that democratic governments took in the southern cone and in south africa (amnesties, "truth" and reparations) didn't allow the invention of a united memory. this article tries to take stock of these experiences, from the point of view of four different goals targeted by the governments. transitional justice contributed to the stabilization of the democratic regime, but did not put an end to the misunderstanding.
Passer les frontières des registres en fran ais : un pas à l’école
Sandrine Wachs
Synergies France , 2005,
Abstract:
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