Biomedical subjects

Christine Payan

Publications and source records attributed to Christine Payan.

7 recordsLinked to original sources

PubMed2005

A prospective study of the psychological effects of "person under train" incidents on drivers.

Previous studies have shown that person under train (PUT) accidents cause psychological distress to drivers during the first year following the incident. Our aims were to assess the psychological consequences of PUT accidents on drivers prospectively, and to identify risk factors for psychological effects. In this prospective, one-year, follow-up study, a consecutive series of PUT drivers (n=202) were compared with a group of matched control drivers (n=186). Psychological state was assessed 15 days, 3 months and 1 year after the event, using the GHQ-28 questionnaire and a standardised diagnostic interview (the v4.4 MINI). Fifteen days after the event, PUT drivers had significantly higher GHQ-28 scores (p<0.0001) and more acute stress disorder (p=0.008) than control drivers. No significant differences were found 3 months and 1 year after the accident. Significant explicative variables were the presence of acute and chronic psychosocial stressors (OR=3.30 and 3.68) and the availability of immediate help (OR=0.46). We thus confirm previous findings that train drivers who have experienced a PUT accident experience acute psychological disturbances. Our results also highlight the utility of the systematic prevention programme provided.

Accidents, Traffic↗

PubMed2005

A motor function measure for neuromuscular diseases. Construction and validation study.

A new scale for motor function measurement has been developed for neuromuscular diseases. The validation study included 303 patients, aged 6-62 years. Seventy-two patients had Duchenne muscular dystrophy, 32 Becker muscular dystrophy, 30 limb-girdle muscular dystrophy, 39 facio-scapulo-humeral dystrophy, 29 myotonic dystrophy, 21 congenital myopathy, 10 congenital muscular dystrophy, 35 spinal muscular atrophy and 35 hereditary neuropathy. The scale comprised 32 items, in three dimensions: standing position and transfers, axial and proximal motor function, distal motor function. Agreement coefficients for inter-rater reliability were excellent (kappa=0.81-0.94) for nine items, good (kappa=0.61-0.80) for 20 items and moderate (kappa=0.51-0.60) for three items. High correlations were found between the total score and other scores: Vignos (r=0.91) and Brooke (r=0.85) grades, Functional Independence Measure (r=0.91), the global severity of disability evaluated with visual analog scales by physicians (r=0.88) and physiotherapists (r=0.91). This scale is reliable, does not require any special equipment and is well-accepted by patients. Its sensitivity to change is being assessed to permit its use in clinical trials of neuromuscular diseases.

Adolescent↗

PubMed2004

Phase I study of dystrophin plasmid-based gene therapy in Duchenne/Becker muscular dystrophy.

Nine patients with Duchenne or Becker muscular dystrophy were injected via the radialis muscle with a full-length human dystrophin plasmid, either once with 200 or 600 microg of DNA or twice, 2 weeks apart, with 600 microg of DNA. In the biopsies taken 3 weeks after the initial injection, the vector was detected at the injection site in all patients. Immunohistochemistry and nested reverse transcription-polymerase chain reaction indicated dystrophin expression in six of nine patients. The level of expression was low (up to 6% weak, but complete sarcolemmal dystrophin staining, and up to 26% partial sarcolemmal labeling). No side effects were observed, nor any cellular or humoral anti-dystrophin responses. These results suggest that exogenous dystrophin expression can be obtained in Duchenne/Becker patients after intramuscular transfer of plasmid, without adverse effects, hence paving the way for future developments in gene therapy of hereditary muscular diseases.

Adolescent↗

PubMed2002

Current protocol of a research phase I clinical trial of full-length dystrophin plasmid DNA in Duchenne/Becker muscular dystrophies. Part II: clinical protocol.

A phase I open clinical study on gene therapy in Duchenne and Becker muscular dystrophy, without direct individual benefit for the patient, is being performed at the Pitié-Salpêtrière Hospital, Paris. The aims of this project are: (a) to determine the tolerance and the safety of the intramuscular administration of dystrophin cDNA and (b) to study the quality of the gene transfer in vivo in human patients affected by Duchenne and Becker muscular dystrophy. This clinical trial is conducted sequentially and includes three cohorts of three patients each. Patients must be at least 15 years of age. Diagnosis of Duchenne and Becker muscular dystrophy was confirmed by molecular analysis of the dystrophin gene and for each patient the abnormal expression of dystrophin was confirmed, in skeletal muscle, with antibodies directed against the deleted part of the dystrophin. This phase I study is scheduled to be completed by the end of 2002.

Adult↗

PubMed2002

Amisulpride does not prevent relapse in primary alcohol dependence: results of a pilot randomized, placebo-controlled trial.

BACKGROUND: Few medications have been proved to be effective in preventing relapse in alcoholism. The mesolimbic dopamine system is known to play an important role in alcohol dependence. Amisulpride, a substituted benzamide, seems to facilitate dopaminergic neurotransmission at low doses. METHODS: After short-term, inpatient detoxification, 71 patients participated in a randomized, double-blind, placebo-controlled study to evaluate the efficacy of amisulpride in relapse prevention. Patients received amisulpride 50 mg/day or placebo for 6 months. RESULTS: There were no differences between the two groups of treatment for time to first drink, length of time before dropout, number of drinking days, and number of heavy drinking days. However, significantly more patients who were treated with amisulpride than those who were treated with placebo were nonabstinent and had relapsed at each visit. Craving for alcohol was significantly higher in the amisulpride than in the placebo group. Transaminases, gamma-glutamyl-transferase, and mean erythrocyte corpuscular volume were regularly higher in the amisulpride group than in the placebo group. CONCLUSIONS: The results indicate that treatment with amisulpride was not effective in preventing relapse to drinking in detoxified, alcohol-dependent patients. The significance of this finding is discussed, particularly in terms of the effects of neuroleptics on alcohol consumption.

Adult↗

PubMed2002

Magnetic resonance imaging criteria for distinguishing between inclusion body myositis and polymyositis.

OBJECTIVE: To develop diagnostic imaging criteria for polymyositis (PM) and sporadic inclusion body myositis (sIBM). METHODS: We investigated 220 patients with suspected inflammatory myopathies by magnetic resonance imaging (MRI). Findings were compared with the results of clinical and biological examinations and muscle biopsy. PM and IBM were diagnosed in 25 patients each. Quantitative and qualitative MRI analysis of the 3 muscle groups of the 2 thighs included fatty infiltration, atrophy, inflammation, and the type and distribution of the lesions. RESULTS: MRI was abnormal in all patients. Fatty infiltration and atrophy were more frequent in patients with sIBM (p < 0.05). Inflammation as the sole abnormality was preferentially encountered in PM (p = 0.05). Widespread abnormalities were more frequent in sIBM (p < 0.01). Abnormalities in PM tended to be distributed along the fascia. Involvement of the anterior group, an asymmetrical distribution, and a distal predominance were all more frequent in sIBM (p < 0.001). CONCLUSION: Despite some overlap in MRI findings between the 2 diseases, MRI was useful for distinguishing PM from sIBM.

Adult↗

PubMed1999

Serum thyroid-stimulating-hormone concentration as an index of severity of major depression.

Alterations in thyroid axis are common in depression and subclinical hypothyroidism may predispose to recurrent depressive episodes and resistance to antidepressants. The same normal reference ranges are used in both depressive and non-psychiatric patients to detect hypothyroidism. We hypothesized that in depressive patients, serum TSH (thyrotropin) elevation within the normal reference range (>/= upper 25th percentile) may be related to patients' characteristics reflecting the severity of the depressive illness. We analysed, in a cross-sectional study, the relationship between serum TSH and serum-free thyroxine (T4) concentrations and different demographic and psychiatric characteristics in 94 depressive in-patients with DSM-III-R criteria for major depression. The frequency of subclinical hypothyroidism (normal serum T4, higher than normal serum TSH) was 5.3 %. In univariate analyses patients who had serum TSH concentrations >/= upper 25th percentile of the normal range were more likely to have recurrent depression, longer disease duration, higher number of episodes of major depression, higher number of previous suicide attempts and higher body mass index than those patients who had serum TSH concentrations < upper 25th percentile of the normal range (age-adjusted p<0.05). Stepwise logistic regression analysis showed that serum TSH >/= upper 25th percentile of the normal range was positively associated with recurrent depression (p=0.0001), presence of somatic disease condition (p=0.04), marital status (p=0.06) and number of suicide attempt (p=0.1). On the other hand, significantly higher serum TSH concentrations were observed in patients with recurrent depression, melancholia and associated somatic disease conditions. Correspondence analysis showed that serum TSH in the higher 25th percentile of the normal reference range projected together with the presence of melancholia, psychiatric and somatic disease conditions, severe major depressive episodes, recurrence of depressive episodes, prescription of at least two antidepressants or non-response to two antidepressants, and previous suicide attempts. Our study suggests that serum TSH concentration in the upper 25th percentile of the normal reference range may be associated with characteristics of severe major depression. Further prospective studies are needed to establish whether serum TSH concentration in the upper 25th percentile of the normal reference range is a contributory causal factor or a consequence of the severity of major depression.

Journal Article↗