Angouleme

This research focuses on patients without a functioning spleen, a condition known as asplenia, which can be congenital or acquired through surgery, radiotherapy, or splenic artery embolization. The study aims to assess the risk factors for complications such as infections, cancer, and blood clots in French patients with asplenia. Researchers want to better understand how the immune system and splenic function change over time in these patients. Participants include adults aged 18 and older who have asplenia due to splenectomy, embolization, or radiotherapy. The study is observational and follows patients prospectively over time to monitor complications. It seeks to implement new diagnostic tools to evaluate residual splenic function and improve patient management. The study distinguishes three groups based on the cause of asplenia to examine differences in infection risks. During the study, participants will be followed longitudinally for at least three years to assess complication risk factors. Researchers will use new and existing tools to monitor splenic function and immune status. The main measurement is the incidence of infectious and non-infectious complications. This long-term follow-up aims to provide detailed data on risks faced by asplenic patients to guide better care.

This research aims to improve genetic counseling by classifying gene variants found in families with a history of hereditary cancers, especially breast and ovarian cancer. Initially focused on BRCA1 and BRCA2 genes, the study now includes multiple genes from a large French oncogenetics database, covering thousands of families and variants. The goal is to better understand which gene variants are linked to cancer risk and to refine how these variants are classified for clinical use. Participants include index cases carrying specific gene variants and their family members. The study collects saliva samples from relatives to test for the presence of these variants, particularly those classified as uncertain significance class 3, likely pathogenic class 4, or hypomorphic pathogenic class 5. Genetic analyses are performed by specialized laboratories, and data from multiple families is combined to assess how these variants co-segregate with cancer occurrence. Throughout the study, researchers analyze genetic data using statistical models to estimate the likelihood that certain variants cause cancer. They use anonymous results for overall variant classification and share findings with families when variants are found to be pathogenic. This helps guide genetic counseling, possible preventive measures, and clinical management. The study spans up to 15 years and continuously updates classification methods and clinical recommendations based on new data.

Researchers are evaluating how an early and extended rehabilitation program that combines personalized nutritional therapy, physiotherapy, and physical activity can improve long-term outcomes for patients who have undergone invasive mechanical ventilation and vasopressor therapy in the ICU. This trial compares the effects of this tailored rehabilitation program to usual care, aiming to support recovery from critical illness. The study is a multicenter randomized controlled trial led by Nantes University Hospital. Participants will be assigned randomly to either the rehabilitation group or the usual care group. Those in the rehabilitation group receive a customized program starting early in the ICU and continuing through the post-ICU ward and at home for 12 weeks. This program involves goal-directed nutrition and physical activities adjusted to each patients progress, with support from dieticians, physiotherapists, and physical activity instructors. The usual care group receives standard nutritional support and physiotherapy based on local practices from day 0 to day 180. Throughout the study, participants will undergo various assessments including walking distance measured by a 6-minute walk test at 6 months, muscle strength, muscle mass, physical activity levels, calorie and protein intake, body weight, mortality rates, blood glucose monitoring, and quality of life surveys. These evaluations occur at multiple time points during and after hospitalization, up to one year. The study includes careful monitoring of mechanical ventilation duration, infections, hospital stay lengths, and other safety outcomes. Participant involvement spans from ICU admission through long-term follow-up.

Status epilepticus SE is a serious neurological emergency marked by prolonged or multiple seizures that can cause lasting impairments and has a high risk of death and complications. Despite advances, mortality remains about 20% overall and up to 40% in refractory cases. Many survivors experience cognitive, physical, and mental difficulties, but the long-term impact on quality of life after intensive care treatment is not well understood. This study aims to continue observing these effects over time, focusing on patient-reported outcomes and experiences following SE requiring ICU care. This observational study follows adults who survived ICU management for SE, assessing their health and well-being more than 3 months but less than 5 years after ICU discharge. It builds on previous registry data and collects detailed information on cognitive function, physical disability, mental health, social support, and family burden. The study includes repeated assessments at 3 and 12 months to track changes and experiences over time. Participants will be evaluated through questionnaires and patient-reported measures to capture their quality of life, cognitive and physical impairments, anxiety, depression, and post-traumatic stress disorder. The study also assesses social support and experiences of both patients and their relatives with the healthcare system. Researchers aim to better understand the long-term effects of SE and ICU care, with the study lasting until March 2027.

Researchers are collecting detailed data on adults experiencing convulsive and non-convulsive status epilepticus SE or pseudo status epilepticus. This observational study aims to understand the circumstances, treatment, and outcomes of SE in critically ill patients by gathering extensive clinical and demographic information. The study is sponsored by the Ictal Group and tracks patient progress up to one year after SE onset. Participants with SE are observed without intervention, focusing on data collection such as seizure onset, treatment timing, EEG monitoring results, and seizure characteristics. The study includes both convulsive and non-convulsive SE cases, as well as pseudo SE, using standardized forms to document pre-hospital and hospital care details. Outcome evaluations are scheduled at ICU and hospital discharge, and follow-ups occur at 90 days and one year after SE. During the study, participants vital status and neurological outcomes are assessed using the Glasgow Outcome Scale at multiple timepoints. Researchers also monitor seizure recurrence, total seizure duration, and length of hospital stay. The study tracks mortality rates at ICU and hospital discharge and up to ten years in secondary measures. Data collection includes patient chart reviews and phone interviews to ensure comprehensive follow-up over time.