Angouleme

This research aims to understand the risks of complications in patients without a spleen asplenic patients in France. These patients may have lost spleen function due to surgery for trauma, cancer, autoimmune disease, or diagnostic reasons, or due to treatments like radiotherapy or splenic artery embolism. The study focuses on evaluating the risks of infections, cancer, and blood clot diseases in this group, as these complications are not well understood. The study observes patients with asplenia caused by splenectomy, splenic artery embolization, or radiotherapy. It plans a long-term follow-up to assess how splenic function and immunity change over time among different patient groups. New tools to assess residual spleen function will be used to improve patient management and better estimate the rates of infectious and non-infectious complications. Participants will be followed prospectively with evaluations over a period of three years. Researchers will monitor and assess complications and risk factors during this time. The main outcome measured is the assessment of complication risk factors related to asplenia. This observational study does not involve treatments but focuses on detailed follow-up of health outcomes and splenic function.

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 involving prolonged or repeated seizures that can cause lasting impairments and high rates of death and disability. This research follows patients who survived SE requiring intensive care to better understand their long-term cognitive, physical, and mental health challenges, including anxiety, depression, and post-traumatic stress. The study aims to provide a deeper look at patient-reported outcomes and experiences, along with the burden on their families after SE. This observational study continues from a previous cross-sectional investigation by collecting detailed data over time to track changes in health-related quality of life and functional abilities up to one year after intensive care. It includes assessments of cognitive function, physical dependency, emotional health, social support, and the ability to return to work. The study also evaluates patients and their relatives experiences with the healthcare system at 3 and 12 months post-discharge. Participants will be followed through questionnaires and assessments at 3 and 12 months after ICU discharge. Researchers will measure overall quality of life impairments, cognitive and physical disabilities, mental health symptoms, social support satisfaction, and family burden. This longitudinal approach aims to improve understanding of post-ICU outcomes and guide future care. The study is led by Versailles Hospital and involves adults who survived ICU treatment for SE at least three months ago.

Researchers are studying the long-term effects and progression of HIV infection in people treated with antiretroviral therapy ART. The study focuses on understanding the development of health problems and complications related to HIV and its treatments, including effects on the immune system, cardiovascular health, cancer risks, and aging. It also addresses psychiatric, neurological, and social factors impacting overall health in people living with HIV. The study observes about 7,200 patients infected with HIV-1 who are receiving ART. Participants are followed according to national guidelines, with data collected at each hospital visit using a standard questionnaire. This includes demographic, clinical, biological, and treatment information. Additionally, a biobank is created from consenting participants at the start and every two years afterwards. Participants will have their health and treatment data recorded regularly, including socio-demographic information, HIV infection details, co-infections, comorbidities, therapeutic use, and virological responses. These outcomes are assessed annually for four years. The study prospectively registers all clinical events using a standardized classification system. This long-term monitoring helps researchers understand the evolving health needs of people living with HIV.

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.