U Simeoni

Hôpital Armand-Trousseau (Hôpitaux Universitaires Est Parisien), Lutetia Parisorum, Île-de-France, France

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Publications (214)562.77 Total impact

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    ABSTRACT: Allergy has been on the rise for half a century and concerns nearly 30% of children; it has now become a real public health problem. The guidelines on prevention of allergy set up by the French Society of Paediatrics (SFP) and the European Society of Paediatric Allergology and Clinical Immunology (ESPACI) are based on screening children at risk through a systematic search of the family history and recommend, for children at risk, exclusive breastfeeding whenever possible or otherwise utilization of hypoallergenic infant formula, which has demonstrated efficacy. The AllerNaiss practice survey assessed the modes of screening and prevention of allergy in French maternity units in 2012. The SFP guidelines are known by 82% of the maternity units that took part in the survey, and the ESPACI guidelines by 55% of them. A screening strategy is in place in 59% of the participating maternity wards, based on local consensus for 36% of them, 13% of the units having a written screening procedure. Screening is based on the search for a history of allergy in first-degree relatives (99%) during pregnancy (51%), in the delivery room (50%), and after delivery (89%). A mode of prevention of the risk of allergy exists in 62% of the maternity units, most often in writing (49%). A hypoallergenic infant formula is prescribed for non-breastfed children in 90% of the units. The survey shows that there is a real need for formalization of allergy risk screening and prevention of allergy in newborns in French maternity units. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
    Archives de Pédiatrie 08/2015; DOI:10.1016/j.arcped.2015.06.014 · 0.41 Impact Factor
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    ABSTRACT: The survival of preterm babies has increased over the last few decades. However, disorders associated with preterm birth, known as oxygen radical diseases of neonatology, such as retinopathy, bronchopulmonary dysplasia, periventricular leukomalacia, and necrotizing enterocolitis are severe complications related to oxidative stress, which can be defined by an imbalance between oxidative reactive species production and antioxidant defenses. Oxidative stress causes lipid, protein, and DNA damage. Preterm infants have decreased antioxidant defenses in response to oxidative challenges, because the physiologic increase of antioxidant capacity occurs at the end of gestation in preparation for the transition to extrauterine life. Therefore, preterm infants are more sensitive to neonatal oxidative stress, notably when supplemental oxygen is being delivered. Furthermore, despite recent advances in the management of neonatal respiratory distress syndrome, controversies persist concerning the oxygenation saturation targets that should be used in caring for preterm babies. Identification of adequate biomarkers of oxidative stress in preterm infants such as 8-iso-prostaglandin F2α, and adduction of malondialdehyde to hemoglobin is important to promote specific therapeutic approaches. At present, no therapeutic strategy has been validated as prevention or treatment against oxidative stress. Breastfeeding should be considered as the main measure to improve the antioxidant status of preterm infants. In the last few years, melatonin has emerged as a protective molecule against oxidative stress, with antioxidant and free-radical scavenger roles, in experimental and preliminary human studies, giving hope that it can be used in preterm infants in the near future. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
    Archives de Pédiatrie 07/2015; DOI:10.1016/j.arcped.2015.05.019 · 0.41 Impact Factor
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    Clinical Infectious Diseases 06/2015; DOI:10.1093/cid/civ468 · 9.42 Impact Factor
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    ABSTRACT: In the epidemiologic context of maternal obesity and type 2 diabetes (T2D), the incidence of gestational diabetes has significantly increased in the last decades. Infants of diabetic mothers are prone to various neonatal adverse outcomes, including metabolic and hematologic disorders, respiratory distress, cardiac disorders and neurologic impairment due to perinatal asphyxia and birth traumas, among others. Macrosomia is the most constant consequence of diabetes and its severity is mainly influenced by maternal blood glucose level. Neonatal hypoglycemia is the main metabolic disorder that should be prevented as soon as possible after birth. The severity of macrosomia and the maternal health condition have a strong impact on the frequency and the severity of adverse neonatal outcomes. Pregestational T2D and maternal obesity significantly increase the risk of perinatal death and birth defects. The high incidence of maternal hyperglycemia in developing countries, associated with the scarcity of maternal and neonatal care, seriously increase the burden of neonatal complications in these countries.
    06/2015; 6(5):734-743. DOI:10.4239/wjd.v6.i5.734
  • Archives de Pédiatrie 04/2015; DOI:10.1016/j.arcped.2015.02.018 · 0.41 Impact Factor
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    ABSTRACT: Up-to-date estimates of the health outcomes of preterm children are needed for assessing perinatal care, informing parents, making decisions about care, and providing evidence for clinical guidelines. To determine survival and neonatal morbidity of infants born from 22 through 34 completed weeks' gestation in France in 2011 and compare these outcomes with a comparable cohort in 1997. The EPIPAGE-2 study is a national, prospective, population-based cohort study conducted in all maternity and neonatal units in France in 2011. A total of 2205 births (stillbirths and live births) and terminations of pregnancy at 22 through 26 weeks' gestation, 3257 at 27 through 31 weeks, and 1234 at 32 through 34 weeks were studied. Cohort data were collected from January 1 through December 31, 1997, and from March 28 through December 31, 2011. Analyses for 1997 were run for the entire year and then separately for April to December; the rates for survival and morbidities did not differ. Data are therefore presented for the whole year in 1997 and the 8-month and 6-month periods in 2011. Survival to discharge and survival without any of the following adverse outcomes: grade III or IV intraventricular hemorrhage, cystic periventricular leukomalacia, severe bronchopulmonary dysplasia, retinopathy of prematurity (stage 3 or higher), or necrotizing enterocolitis (stages 2-3). A total of 0.7% of infants born before 24 weeks' gestation survived to discharge: 31.2% of those born at 24 weeks, 59.1% at 25 weeks, and 75.3% at 26 weeks. Survival rates were 93.6% at 27 through 31 weeks and 98.9% at 32 through 34 weeks. Infants discharged home without severe neonatal morbidity represented 0% at 23 weeks, 11.6% at 24 weeks, 30.0% at 25 weeks, 47.5% at 26 weeks, 81.3% at 27 through 31 weeks, and 96.8% at 32 through 34 weeks. Compared with 1997, the proportion of infants surviving without severe morbidity in 2011 increased by 14.4% (P < .001) at 25 through 29 weeks and 6% (P < .001) at 30 through 31 weeks but did not change appreciably for those born at less than 25 weeks. The rates of antenatal corticosteroid use, induced preterm deliveries, cesarean deliveries, and surfactant use increased significantly in all gestational-age groups, except at 22 through 23 weeks. The substantial improvement in survival in France for newborns born at 25 through 31 weeks' gestation was accompanied by an important reduction in severe morbidity, but survival remained rare before 25 weeks. Although improvement in survival at extremely low gestational age may be possible, its effect on long-term outcomes requires further studies. The long-term results of the EPIPAGE-2 study will be informative in this regard.
    JAMA Pediatrics 01/2015; 169(3). DOI:10.1001/jamapediatrics.2014.3351 · 4.25 Impact Factor
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    ABSTRACT: Epigenetic changes have long-lasting effects on gene expression and are related to, and often induced by, the environment in which early development takes place. In particular, the period of development that extends from pre-conception to early infancy is the period of life during which epigenetic DNA imprinting activity is the most active. Epigenetic changes have been associated with modification of the risk for developing a wide range of adulthood, non-communicable diseases (including cardiovascular diseases, metabolic diseases, diseases of the reproductive system, etc.). This paper reviews the molecular basis of epigenetics, and addresses the issues related to the process of developmental programming of the various areas of human health. © 2014 Elsevier Ireland Ltd. All rights reserved.
    Early Human Development 09/2014; 90 Suppl 2:S23-4. DOI:10.1016/S0378-3782(14)50007-2 · 1.93 Impact Factor
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    ABSTRACT: Recent studies have shown that a low birth weight is a risk factor for increased systemic blood pressure (BP) in adulthood. Further, systemic BP and arterial stiffness (AS) are reported to be increased in adolescents born prematurely. The purpose of this study was to characterize systemic BP and AS in young adults born preterm. Systemic BP was measured using an automated oscillometric device. AS was assessed by measuring the right carotid-radial pulse wave velocity (PWV) using a validated non-invasive automated method. Systemic BP, pulse pressure, and PWV [mean (confidence intervals)] were compared between 16 adults (age 21 years) born preterm (age at birth 32 weeks of gestation) with a birth weight (1710 g) appropriate for their gestational age and 15 adults (21 years) born at term (40 weeks of gestation) with a birth weight (3430 g) appropriate for their gestational age. Adults born preterm had a significantly higher systolic BP [122 mmHg (114-144) v. 112 (106-127)], mean BP [89 mmHg (86-98) v. 84 (81-91)], diastolic BP [69 mmHg (66-76) v. 65 (62-78)], pulse pressure [54 mmHg (47-72) v. 47 (42-60)], and PWV [7 m/s (6.3-8.6) v. 6.4 (5.8-8)] than did those born at term. Our findings suggest that young adults with a low birth weight due to preterm birth have increased systemic BP and AS. Accordingly, preterm birth may predispose individuals to cardiovascular diseases in adulthood due to increased AS.
    Journal of Developmental Origins of Health and Disease 08/2014; 5(6):1-5. DOI:10.1017/S2040174414000385 · 0.77 Impact Factor
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    ABSTRACT: In the 1980s, David Barker and Colleagues proposed that the major causes of cardiovascular and metabolic diseases have their roots in early development. There is now robust evidence that an hyperglycemic intrauterine environment is responsible not only for significant short-term morbidity in the fetus and the neonate but also for an increased risk of developing diabetes as well as other chronic, noncommunicable diseases at adulthood. The risk is higher in pregestational diabetes, but unrecognized and/or poorly managed gestational diabetes (GDM) may have similar consequences. Although a relatively clear picture of the pathogenesis of the fetal and neonatal complications of maternal diabetes and of their interrelationship is available today, the intimate molecular mechanisms involved in the long term are far from being understood. While the rate of GDM is sharply increasing in association with the pandemic of obesity and of type 2 diabetes over the world, we review here the current understanding of short- and long-term outcomes of fetuses exposed to a diabetic environment.
    Bailli&egrave re s Best Practice and Research in Clinical Obstetrics and Gynaecology 08/2014; 29(2). DOI:10.1016/j.bpobgyn.2014.08.004 · 3.00 Impact Factor
  • U Simeoni · G H A Visser · H L Halliday
    Zeitschrift für Geburtshilfe und Neonatologie 08/2014; 218(4):177-8. DOI:10.1055/s-0034-1384585 · 0.46 Impact Factor
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    ABSTRACT: Abstract Background: After prenatal diagnosis of lethal fetal abnormality (LFA), some couples choose to continue the pregnancy rather than opt for termination of the pregnancy. This may result in the requirement for neonatal palliative care, which in France is prescribed by the Leonetti Law. These rare situations raise various questions about when and how palliative care is provided in cases of LFA. Objective: The main goal of the study was to clarify the place given to the concept of perinatal palliative care within the antenatal information provided by perinatal professionals. This work was specifically aimed at revealing caregivers' perceptions of and attitudes toward LFA, how it is managed, and procedures for decision making and providing information. Methods: This is a qualitative study using focus groups from two French Multidisciplinary Centers for Prenatal Diagnosis. All verbal production (individual statements, verbal exchanges, etc.) produced during the two focus groups was fully transcribed and the content analyzed. Results: Content analysis revealed four main themes: (1) defining LFA; (2) the source and nature of information about LFA and how it is communicated; (3) therapeutic options and decisions in the management of LFA; and (4) palliative care (limits and criteria) in the context of LFA. Conclusions: Consistency as regards the perceived intention of care among all members of the health care team is essential to support parents facing a possible fatal outcome. Attitudes and practices at Multidisciplinary Centers for Prenatal Diagnosis need to be shaped on a national basis.
    Journal of Palliative Medicine 05/2014; 17(8). DOI:10.1089/jpm.2014.0023 · 2.06 Impact Factor
  • Archives de Pédiatrie 05/2014; 21(5):904. DOI:10.1016/S0929-693X(14)72164-5 · 0.41 Impact Factor
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    ABSTRACT: Very early in life, sodium intake correlates with blood pressure level. This warrants limiting the consumption of sodium by children. However, evidence regarding exact sodium requirements in that age range is lacking. This article focuses on the desirable sodium intake according to age as suggested by various groups of experts, on the levels of sodium intake recorded in consumption surveys, and on the public health strategies implemented to reduce salt consumption in the pediatric population. Practical recommendations are given by the Committee on nutrition of the French Society of Pediatrics in order to limit salt intake in children.
    Archives de Pédiatrie 05/2014; DOI:10.1016/j.arcped.2014.02.007 · 0.41 Impact Factor
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    ABSTRACT: Lipids are an important source of energy for young children and play a major role in the development and functioning of nervous tissue. Essential fatty acids and their long-chain derivatives also fulfill multiple metabolic functions and play a role in the regulation of numerous genes. The Food and Agriculture Organization of the United Nations (FAO), the World Health Organization (WHO), and the French Agency for Food, Environmental and Occupational Health & Safety (Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail [ANSES]) have recently recommended a minimum daily intake in preformed long-chain polyunsaturated fatty acids (LC-PUFAs): arachidonic acid (ARA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). Mother's milk remains the only reference, but the large variability in its DHA content does not guarantee that breastfed children receive an optimal DHA intake if the mother's intake is insufficient. For children fed with infant formulas, ARA and DHA intake is often below the recommended intake because only one-third of infant formulas available on the market in France are enriched in LC-PUFAs. For all children, linoleic acid (LA) intake is on average higher than the minimal recommended values. The consequences of these differences between intake and recommended values are uncertain. A cautious attitude is to come close to the current recommendations and to advise sufficient consumption of DHA in breastfeeding women. For bottle-fed children, infant formulas enriched in LC-PUFAs and with moderate levels of LA should be preferred. LC-PUFA-rich fish should be consumed during breastfeeding, and adapted vegetable oils when complementary foods are introduced.
    Archives de Pédiatrie 04/2014; 21(4):424-38. DOI:10.1016/j.arcped.2013.12.026 · 0.41 Impact Factor
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    ABSTRACT: Very early in life, sodium intake correlates with blood pressure level. This warrants limiting the consumption of sodium by children. However, evidence regarding exact sodium requirements in that age range is lacking. This article focuses on the desirable sodium intake according to age as suggested by various groups of experts, on the levels of sodium intake recorded in consumption surveys, and on the public health strategies implemented to reduce salt consumption in the pediatric population. Practical recommendations are given by the Committee on nutrition of the French Society of Pediatrics in order to limit salt intake in children.
    Archives de Pédiatrie 03/2014; · 0.41 Impact Factor
  • M Saint-Faust · F Boubred · U Simeoni
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    ABSTRACT: The structural and functional development of the kidney is responsible for a significant impact on postnatal adaptation to extrauterine life. Prenatal or neonatal impairment of nephrogenesis may carry long term, lifelong consequences in terms of reduced nephron endowment, chronic kidney disease, and cardiovascular risks at adulthood. Intrauterine growth restriction, preterm birth, congenital renal, and urinary tract anomalies are for long widely incriminated. Neonatal administration of nephrotoxic drugs has been associated with short-term acute kidney injury and longer chronic kidney disease. This review attempts at offering a comprehensive understanding of the renal development, the neonatal renal transition to extrauterine life and subsequent maturation phase during early infancy. It also focuses on developmental and maturational changes that impact lifelong renal function and adult health.
    American Journal of Perinatology 03/2014; 31(9). DOI:10.1055/s-0033-1361831 · 1.60 Impact Factor
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    ABSTRACT: Background:Perinatal cerebral hypoxia-ischemia (HI) can lead to severe neurodevelopmental disorders. Studies in humans and in animal models mainly focused on cerebral outcomes and little is known about the mechanisms that may affect the brainstem and the spinal cord. Dysfunctions of neuromodulatory systems, such as the serotonergic (5-HT) projections, critical for the development of neural networks, have been postulated to underlie behavioral and motor deficits, as well as metabolic changes.Methods:The aim of this study was to investigate brainstem and spinal cord functions by means of plethysmography and sensorimotor tests in a neonatal Rice-Vanucci model of hypoxia-ischemia (HI) in mice. We also evaluated bioaminergic contents in central regions dedicated to the motor control of autonomic functions.Results:Mice with cerebral infarct expressed motor disturbances, had a lower body weight and a decreased respiratory frequency than SHAM suggesting defects of brainstem neural network involved in the motor control of feeding, suckling, swallowing and respiration. Moreover, our study revealed changes of monoamines and amino acids contents in the brainstem and the spinal cord of HI mice.Conclusions:Our results suggest that monoaminergic neuromodulation plays an important role in the physiopathology of HI brain injury that may represent a good therapeutic target.Pediatric Research (2014); doi:10.1038/pr.2014.42.
    Pediatric Research 03/2014; 11. DOI:10.1038/pr.2014.42 · 2.84 Impact Factor
  • U. Simeoni
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    ABSTRACT: La prematuridad, un importante desafío de salud pública, afecta al 7-14% de los nacimientos en todo el mundo. Aunque los considerables adelantos técnicos y científicos han hecho posible la supervivencia de niños cada vez más inmaduros, los casos más frecuentes se refieren a la prematuridad tardía. En condiciones de gran prematuridad (antes de las 33 semanas de amenorrea), el nacimiento se programa en un centro de nivel 3 y la madre es trasladada en el período prenatal. La asistencia médica es perinatal y se inicia con la corticoterapia prenatal para acelerar la maduración fetal ante una amenaza de parto prematuro. La estabilización en la sala de parto está relativamente exenta de dificultades. Sin embargo, una serie de complicaciones posibles en la unidad de reanimación neonatal puede alterar la estancia hospitalaria, con una mortalidad y morbilidad que por lo general son proporcionales al grado de inmadurez. Los cuidados se orientan hoy hacia una conducta menos agresiva, centrada en el desarrollo del niño de forma personalizada y con la estrecha cooperación de los padres. La etapa posthospitalaria y el seguimiento a largo plazo son claves para la calidad de la vida futura de estos niños, algunos de los cuales están expuestos a trastornos del desarrollo psicomotor e incluso a una mayor incidencia de enfermedades no transmisibles del adulto como la hipertensión arterial y la diabetes de tipo 2.
    03/2014; 18(1):1–7. DOI:10.1016/S1636-5410(14)66729-5
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    ABSTRACT: Epidemiological and experimental studies indicate that early vascular dysfunction occurs in low birth weight subjects, especially preterm infants (PT). We recently reported impaired angiogenic activity of endothelial colony forming cells (ECFCs) in this condition. We hypothesized that ECFCs dysfunction in PT might result from premature senescence and investigated the underlying mechanisms. Compared to ECFCs from term neonates (n=18), ECFCs isolated from PT (n=29) display an accelerated senescence sustained by growth arrest and increased senescence-associated β-galactosidase activity. Increased p16(INK4a) expression, in the absence of telomere shortening, indicates that premature PT-ECFCs ageing results from stress-induced senescence. SIRT1 level, a NAD-dependent deacetylase with anti-aging activities, is dramatically decreased in PT-ECFCs and correlated with gestational age. SIRT1 deficiency is subsequent to epigenetic silencing of its promoter. Transient SIRT1 overexpression or chemical-induction by resveratrol treatment reverses senescence phenotype, and rescues in vitro PT-ECFCs angiogenic defect in a SIRT1-dependent manner. SIRT-1 overexpression also restores PT-ECFCs capacity for neovessel formation in vivo. We thus demonstrate that decreased expression of SIRT1 drives accelerated senescence of PT-ECFCs, and acts as a critical determinant of PT-ECFCs angiogenic defect. These findings lay news grounds for understanding the increased cardiovascular risk in individuals born prematurely and open perspectives for therapeutic strategy.
    Blood 02/2014; 123(13). DOI:10.1182/blood-2013-02-484956 · 10.43 Impact Factor
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    ABSTRACT: Renal failure in neonates is associated with an increased risk of mortality and morbidity. But critical values are not known. To define critical values for serum creatinine levels by gestational age in preterm infants, as a predictive factor for mortality and morbidity. This was a retrospective study of all preterm infants born before 33 weeks of gestational age, hospitalized in Nantes University Hospital NICU between 2003 and 2009, with serum creatinine levels measured between postnatal days 3 to 30. Children were retrospectively randomized into either training or validation set. Critical creatinine values were defined within the training set as the 90(th) percentile values of highest serum creatinine (HSCr) in infants with optimal neurodevelopmental at two years of age. The relationship between these critical creatinine values and neonatal mortality, and non-optimal neural development at two years, was then assessed in the validation set. The analysis involved a total of 1,461 infants (gestational ages of 24-27 weeks (n=322), 28-29 weeks (n=336), and 30-32 weeks (803)), and 14,721 creatinine assessments. The critical values determined in the training set (n=485) were 1.6, 1.1 and 1.0 mg/dL for each gestational age group, respectively. In the validation set (n=976), a serum creatinine level above the critical value was significantly associated with neonatal mortality (Odds ratio: 8.55 (95% confidence interval: 4.23-17.28); p<0.01) after adjusting for known renal failure risk factors, and with non-optimal neurodevelopmental outcome at two years (odds ratio: 2.06 (95% confidence interval: 1.26-3.36); p=0.004) before adjustment. Creatinine values greater than 1.6, 1.1 and 1.0 mg/dL respectively at 24-27, 28-29, 30-32 weeks of gestation were associated with mortality before and after adjustment for risk factors, and with non-optimal neurodevelopmental outcome, before adjustment.
    PLoS ONE 12/2013; 8(12):e84892. DOI:10.1371/journal.pone.0084892 · 3.23 Impact Factor

Publication Stats

2k Citations
562.77 Total Impact Points

Institutions

  • 2015
    • Hôpital Armand-Trousseau (Hôpitaux Universitaires Est Parisien)
      Lutetia Parisorum, Île-de-France, France
  • 2014–2015
    • University of Lausanne
      Lausanne, Vaud, Switzerland
    • University Hospital of Lausanne
      Lausanne, Vaud, Switzerland
  • 2008–2015
    • Aix-Marseille Université
      • • Faculté de Pharmacie
      • • Faculté de Médecine
      Marsiglia, Provence-Alpes-Côte d'Azur, France
  • 2013
    • Paul Sabatier University - Toulouse III
      Tolosa de Llenguadoc, Midi-Pyrénées, France
  • 2008–2013
    • Hôpital Européen, Marseille
      Marsiglia, Provence-Alpes-Côte d'Azur, France
  • 2001–2013
    • Assistance Publique Hôpitaux de Marseille
      • Service de médecine néonatale
      Marsiglia, Provence-Alpes-Côte d'Azur, France
  • 2010
    • Centre Hospitalier Universitaire de Rennes
      Roazhon, Brittany, France
    • Assistance Publique – Hôpitaux de Paris
      Lutetia Parisorum, Île-de-France, France
  • 2004
    • Unité Inserm U1077
      Caen, Lower Normandy, France
  • 1993–2002
    • Hôpital Universitaire Necker
      Lutetia Parisorum, Île-de-France, France
  • 1993–2001
    • University of Strasbourg
      • • Institut de Bactériologie
      • • Faculty of Medicine
      Strasburg, Alsace, France
  • 1992
    • CHRU de Strasbourg
      Strasburg, Alsace, France