Angouleme

This research focuses on patients without a functioning spleen, known as asplenic patients, which can result from surgical removal due to trauma, cancer, auto-immune diseases, or diagnostic purposes, as well as from treatments like radiotherapy or splenic artery embolization. These patients face increased risks of infections caused by encapsulated bacteria, cancer, and thromboembolic diseases. The study aims to assess the complications that occur in French asplenic patients and to introduce new diagnostic tools for better follow-up and management. The study observes different groups of asplenic patients including those who underwent splenectomy, splenic artery embolization, or radiotherapy. It seeks to understand how splenic function and immunity change over time in these patients, recognizing that infectious risks may vary among these groups. The research emphasizes the limitations of current tools that assess splenic function and aims to implement new methods to accurately evaluate residual splenic function. Participants will be followed over time to monitor infectious and non-infectious complications. The study includes assessments of complication risk factors over a period of three years. Researchers will collect data on patient health outcomes to better estimate the incidence of complications and improve understanding of these risks. This longitudinal follow-up helps in advancing care for asplenic patients through improved diagnostic and management strategies.

Researchers are studying gene variants of uncertain significance (VUS) found in genes linked to hereditary breast, ovarian, and other cancers. The goal is to better classify these VUS using data from a large French genetic database to improve genetic counseling and help guide clinical decisions, including preventive surgeries. The study originally focused on BRCA1 and BRCA2 genes but now includes multiple cancer-related genes identified through ongoing genetic testing in French families. Participants include index cases who carry specific VUS classified as uncertain or likely causal, along with their selected family members. Saliva samples are collected from these relatives to test for the presence of the variants. The study uses co-segregation analysis, which examines how the variant tracks with disease within families, applying a Bayesian model alongside other genetic and clinical data to estimate the likelihood that a variant causes cancer. Participants provide informed consent and saliva samples for genetic testing. Researchers compile data from multiple families to strengthen the classification of variants. The primary outcome is to perform co-segregation analysis over a period of up to 15 years. This long-term study aims to refine the clinical relevance of genetic variants to support personalized cancer risk assessment and counseling for affected families.

Researchers are evaluating whether an early, personalized rehabilitation program that combines nutritional therapy, physiotherapy, and physical activity can improve long-term outcomes for adults who have been critically ill and required mechanical ventilation and vasopressor therapy in the ICU. This trial compares the effects of this extended rehabilitation approach to usual care given during and after ICU stay. The study includes patients starting invasive mechanical ventilation recently and aims to support recovery from critical illness through tailored interventions. Participants are assigned to either the rehabilitation group or the control group. The rehabilitation group receives a customized program beginning early in the ICU and continuing through the post-ICU hospital stay and then at home for a total of 12 weeks. This program uses goal-directed nutrition and physical activity adjusted over time by specialists including dieticians, physiotherapists, and physical-activity instructors. The control group receives the usual care available at each ICU from day 0 to day 180. Throughout the study, participants will be monitored to assess their recovery progress, with the primary outcome measuring the distance walked in 6 minutes at 6 months. Researchers will gather data on physical function and health improvements during and after the rehabilitation period. The study includes follow-up assessments up to 180 days to evaluate the long-term effects of the rehabilitation program compared to usual care.

Status epilepticus (SE) is a serious neurological emergency involving prolonged or repeated seizures that can cause long-term impairments. Despite advances in care, SE still leads to significant death and disability, with about 20% of patients dying in the hospital and nearly half experiencing lasting functional problems. These impairments include cognitive, physical, and mental health issues, but their impact on quality of life after intensive care for SE has not been well studied. This study aims to further understand these outcomes by continuing previous patient-reported outcome research in a longitudinal way, also including patient experiences and family burden. The study does not involve specific treatments or interventions but focuses on adults who survived SE requiring intensive care and were previously enrolled in a related registry. Participants are assessed more than 3 months and less than 5 years after their ICU discharge. The study collects detailed information about their long-term health and quality of life, as well as their experiences and the challenges faced by their families. Participants will be involved through follow-up evaluations that include patient-reported outcomes and experiences, aiming to assess the overall impact of SE on their lives. The main measurement is the percentage of global impairment in health-related quality of life at 3 and 12 months. This approach helps capture the cognitive, physical, and mental effects of SE from the patient’s perspective and monitors how these change over time.

Researchers are studying the long-term health outcomes of people living with HIV who are treated with antiretroviral therapy (ART). While ART has helped make HIV a chronic condition with survival rates close to the general population, those living with HIV still face higher risks of other health problems, including immune system issues, cardiovascular disease, cancer, and complications from aging. The study also looks at psychiatric, neurological, and social factors affecting these individuals, aiming to better understand overall health beyond just physical symptoms. Participants in this study receive follow-up care based on national guidelines, where demographic, clinical, biological, and treatment data are collected at each hospital visit using a standardized questionnaire. All health events are recorded according to the International Classification of Diseases (ICD-10). Additionally, a biobank of samples is collected from consenting participants at entry and every two years thereafter to support further research. People in the study will be monitored for up to four years, with annual assessments of socio-demographic characteristics and health status. The study tracks the development of new health problems, monitors the effectiveness and side effects of ART regimens, and gathers comprehensive data on participants’ clinical management. This long-term observation aims to provide a detailed understanding of morbidity and mortality risks in treated HIV patients.

Researchers are collecting detailed information about adults who experience convulsive or non-convulsive status epilepticus, a serious condition involving prolonged or repeated seizures. This registry study records data on the circumstances of seizure onset, clinical features, treatments given before and during hospital care, diagnostic test results, and causes of the seizures. The study aims to track outcomes for these patients over time to better understand this condition and its management. Participants in this study are adults aged 18 years or older diagnosed with status epilepticus lasting 5 minutes or more, either as continuous seizures or repeated seizures without full recovery between them. Data collection involves standardized forms capturing demographic details, timing of seizures and treatments, EEG monitoring results, and other clinical information. The study includes follow-up assessments at ICU and hospital discharge, as well as at 90 days and one year after the seizure event. Throughout the study, researchers gather clinical findings, laboratory and EEG results, and treatment information from hospital and pre-hospital sources. They evaluate patient outcomes using measures like vital status and the Glasgow Outcome Scale at multiple time points, including up to one year after the seizure. This comprehensive data helps monitor recovery and long-term effects of status epilepticus in critically ill patients.