Les populations du monde, le monde des populations. La place de l'expert en sciences sociales dans le débat public : actes de la table ronde pour l'inauguration de l'Ined, du lundi 14 septembre 1998

L'Ined a deux missions qui consistent : * à faire progresser la connaissance scientifique, * à mettre ces progrès au service des pouvoirs publics et du public, pour une meilleure vie en société, pour un progrès social, culturel, économique, etc. L'Ined n'est donc pas seulement un organisme de recherche à l'état pur, il tente de mettre sa recherche à la disposition de la collectivité. C'est sur cette articulation entre les deux missions de l'Ined que nous sommes amenés à réfléchir aujourd'hui : comment faire passer le message scientifique du chercheur au décideur (l'homme politique en particulier, mais pas exclusivement)? Le débat d'aujourd'hui réunit donc des chercheurs, des administrateurs, des politiques qui ont tous en commun le fait d'avoir exercé leur action autour des questions de populations

Mai et juin 1968 : un cahier photographique

Le cahier photographique présente quelques photographies professionnelles et amateures, commentées par des sociologues ou des non-sociologues, afin d’organiser avec une certaine rigueur les souvenirs et la réalité des mois de mai et juin 1968 en France. Ces mois ne se résument pas aux affrontements parisiens, car ils ont mis en mouvement, sous des formes et selon des logiques de solidarités collectives parfois étonnantes, tous les secteurs et toutes les dimensions de la société. Le cahier ne prétend pas à l’exhaustivité : il montre, de façon partielle, comment la photographie et la sociologie peuvent contribuer à rendre compte, 50 ans plus tard, d’un des évènements les plus importants du xxe siècle.This photographic notebook features professional and amateur photographs - commented by sociologists and non-sociologists alike – in a rigorous bid to organise the memories and realities of the social turbulence that France witnessed in May and June 1968. The upheavals experienced during these months went beyond Paris to affect all different sectors and parts of society, sometimes in forms and pursuing a logic characterised by a surprising amount of collective solidarity. The notebook does not claim to be exhaustive but offers a partial demonstration of how 50 years on photography and sociology help account for one of the 20th century’s most important events.El cuaderno fotográfico ofrece algunas fotografías profesionales y de aficionados, comentadas por sociólogos o no sociólogos, con la finalidad de organizar con cierto rigor la memoria y la realidad de los meses de mayo y junio de 68 en Francia. Esos meses no pueden resumirse en los enfrentamientos parisinos, ya que pusieron en movimiento a todos los sectores y a todas las dimensiones de la sociedad, bajo formas y según lógicas de solidaridad colectiva en ocasiones sorprendentes. El cuaderno no pretende ser exhaustivo : muestra, de manera parcial, cómo la fotografía —y la sociología— pueden contribuir a poner de manifiesto, 50 años más tarde, uno de los acontecimientos más importantes del siglo XX

Predictive value of electrophysiologic studies during treatment of ventricular tachycardia with the beta-blocking agent nadolol

AbstractSixty patients with recurrent inducible sustained ventricular tachycardia were prospectively treated with nadotol (40 or 80 mg/day). Old myocardial infarction was present in 43 patients and dilated cardiomyopathy in 12. In group I (n = 36), nadolol was given alone, whereas in group II (n = 24), previously ineffective treatment with amiodarone was continued in combination with nadolol. Left ventricular ejection fraction was higher in patients in group I (0.40 ± 0.12) than in group II (0.30 ± 0.10, p < 0.01) patients. Electro-physiologic study was repeated after short-term treatment with nadolol, which was continued regardless of the results of this test, according to the scheme of the parallel approach.Recurrence of spontaneous tachycardia or sudden death occurred in 21 patients after 10 ± 9.2 months; sustained tachycardia was inducible in 19 on nadolol therapy. The remaining 39 patients (of whom 21 had inducible tachycardie while taking the drug) have had no recurrence of tachycardia after 27.8 ± 9.3 months of follow-up study. Sensitivity, specificity and predictive value of a positive and negative test were 90.5%, 46%, 47.5% and 90%, respectively. The results diner between group I and group II patients, the latter having a high percent of false positive responses. This difference is even more obvious with respect to left ventricular ejection fraction: the predictive value of a positive test was 86% when ejection fraction was >0.40 and 39% when it was < 0.40. A long (>400 ms) cycle length of the induced ventricular tachycardia seems more predictive of recurrence or sudden death (11 of 14 compared with 9 of 26 faster tachycardias, p < 0.01).Electrophysiologic studies are suitable for evaluation of the antiarrhythmic effect of a beta-blocker on the ventricular tachycardia substrate, with the same restrictions as for other drugs in patients with low left ventricular ejection fraction. A beta-blocker should be included in serial drug testing in patients with sustained ventricular tachycardia

Evolution de la structure familiale

La France a connu, au cours des trente dernières années, des changements profonds dans la structure et les fonctions de la famille. Avec le recul de la vieillesse et de la mort, l'espérance de vie en couple stable n'a jamais été si longue. Pourtant le mariage et la famille se sont fragilisés. Au total, le nombre de personnes seules n'a jamais été aussi grand. Parallèlement, la famille a perdu progressivement sa position économique centrale au sein de la société, prise par l'"État providence". Dans ces conditions, le mariage a perdu de ses avantages. Il n'est plus un passage obligé pour socialiser les enfants. Ainsi, des formes de la famille, autrefois marginales et réprouvées, ont gagné en importance numérique, affirmation et reconnaissance juridique

Reverse electrical remodeling by cardiac resynchronization therapy: prevalence and clinical impact.

International audienceBACKGROUND: Cardiac resynchronization therapy (CRT) improves left ventricular ejection fraction (LVEF) in patients with congestive heart failure, LV systolic dysfunction, and a wide QRS complex. Previous reports suggest that CRT may also induce electrical remodeling but the impact on clinical outcome remains unknown. Objective: We sought to determine (1) if chronic CRT induces a relevant shortening of the intrinsic QRS (iQRS), (2) whether changes in the native conduction system correlate with clinical or echocardiographic response to CRT, and (3) to identify predictors of iQRS width shortening. METHODS: We prospectively included 85 consecutive patients with left bundle-branch block who received a CRT device in 3 French centers. NYHA class, iQRS duration, LVEF, and left ventricular volumes were assessed before and 1 year after CRT implantation. Clinical and echocardiographic CRT responders were defined respectively as NYHA class improvement >1 class without heart failure hospitalization and an increase of LVEF by ≥10% and/or a decrease in LVESV by ≥15%. Electrocardiographic responders were defined as a decrease in iQRS duration by ≥20 ms. RESULTS: Baseline and 1-year follow-up mean iQRS durations were, respectively, 168.0 ± 19.7 ms and 149.6 ± 31.6 ms (P < 0.0001). Electrocardiographic response, observed in 43/85 patients (51%), was associated with a greater rate of clinical (P = 0.035) and echocardiographic (P = 0.023) response. Younger age, male gender, and longer baseline QRS width were independent predictors of electrocardiographic response. CONCLUSION: CRT decreases iQRS duration. A reduction of at least 20 ms in iQRS duration is associated with better clinical and echocardiographic response

La société russe depuis la Perestroïka : rupture, crise ou continuité ?

La Russie a connu au cours des quinze dernières années d'importants bouleversements : implosion politique de l'URSS, libéralisation et crise profonde de l'économie, transformations sociales rapides... L'objectif de ce séminaire est de contribuer à donner des clés de compréhension des aspects socio-économiques et démographiques en Russie aujourd'hui. A travers des contributions sur des thèmes variés, la question d'une interprétation en termes de transition, de ruptures, de crises ou de continuités servira de fil conducteur, alors même que les rythmes de transformations et les dates marquantes peuvent être très différents suivant qu'il s'agit de l'économie, du social ou de la démographie. Évolution du marché du travail, transformation du système de protection sociale, développement de la pauvreté et nouvelles stratifications sociales, évolution de la famille, analyse des tendances démographiques récentes, et notamment de la natalité et de la mortalité, travail de la société russe sur le rapport à son histoire... autant de sujets qui permettront d'esquisser un état des lieux de la société russe en ce début de troisième millénaire

A novel method for localization and ablation of conduction gaps after wide antral circumferential ablation of pulmonary veins

International audienceBackground - Atrial fibrillation ablation is often performed by achieving pulmonary vein isolation using the "wide antral circumferential ablation" (WACA) technique, but many pulmonary veins remain connected because of conduction gaps in the ablation line. Aim - To analyse the efficacy of a novel technique based on pacing manoeuvres to detect gaps in an initial WACA lesion. Methods - Patients referred for radiofrequency atrial fibrillation ablation were enrolled prospectively. A WACA lesion set was performed, isolating ipsilateral pulmonary veins together. If pulmonary vein isolation was not achieved, the atria were paced using an ablation catheter. For each pacing site, "activation delay" and "activation sequence" were analysed using a circular mapping catheter positioned at the pulmonary vein ostium. Results - Twenty-one patients were included. A total of 25 non-isolated WACA lesion sets were studied. Three patterns were identified: (1) the activation delays converged towards one point with the shortest delay; no modification of the activation sequence (indicating one gap); (2) the activation delays converged towards at least two close locations; no change in the activation sequence (indicating at least two close gaps); (3) the activation delays converged towards at least two remote locations; modification of the activation sequence (indicating at least two remote gaps). Pacing manoeuvres and effect of ablation allowed precise localization of gaps, ultimately leading to pulmonary vein isolation in all patients. Conclusion - This simple pacing method accurately detected the location of residual connections after WACA lesion sets performed for atrial fibrillation ablation, allowing pulmonary vein isolation to be achieved

Cinacalcet reverses short QT interval in Familial Hypocalciuric Hypercalcemia type 1

Context: Familial hypocalciuric hypercalcemia type 1 (FHH-1) defines an autosomal dominant disease, related to mutations in the CASR gene, with mild hypercalcemia in most cases. Cases of FHH-1 with a short QT interval have not been reported to date.Objective: Three family members presented with FHH-1 and short QT interval (50% within two hours, and decreases in serum calcium and increases in serum phosphate occurred within 8 hours, with rectification of the QT interval, which remained normal after 3 months of cinacalcet treatment. Conclusion: Our results indicate that FHH-1 patients should be assessed for a short QT interval, and a cinacalcet test used to select patients who are likely to benefit from this treatment