Arpajon

Researchers are evaluating the effectiveness of an integrative program called ADA, which combines physical activity, nutrition, and supportive care to improve the quality of life for women who have survived breast cancer. This pragmatic cluster randomized trial compares the ADA intervention to usual care and aims to provide evidence on how well such interventions work in real-life settings. The study particularly focuses on women who have completed most cancer treatments but may still be experiencing long-term effects affecting their physical and mental health. The ADA intervention consists of a 12-week program featuring one-hour adapted physical activity sessions combined with relaxation and deep breathing exercises. Participants receive short nutrition information sheets, attend workshops on mobility and nutrition, set personal motivational challenges, and receive follow-up calls for support and individualization. They also have access to an online space with helpful resources. The control group will receive usual care involving weekly adapted physical activity sessions based on current recommendations for cancer survivors. Participants will be involved for at least 12 months, with assessments at 3, 6, and 12 months after starting the intervention. Researchers will measure health-related quality of life as the primary outcome at 12 months, along with secondary outcomes including physical activity levels, fatigue, motivation, sedentary behavior, relationship to food, and self-efficacy. The study includes group activities, questionnaires, and motivational check-ins to monitor progress and adherence throughout the trial.

Lower limb trauma that requires immobilization is common and raises the risk of venous thromboembolism VTE. The TRiPcast score helps identify patients at high risk score 7 who need preventive anticoagulant treatment. While low molecular weight heparins LMWH are standard, recent studies suggest they may not fully prevent VTE in high-risk patients. This trial compares rivaroxaban, a direct oral anticoagulant, with LMWH to assess which is more effective and easier to use for preventing blood clots in these patients. Participants with lower limb trauma and a TRiPcast score of 7 or higher are randomly assigned to receive either rivaroxaban 10 mg orally once daily or LMWH injections during the period of immobilization, until they can bear weight on the limb again. Treatment begins in the emergency department and continues at home, with dosing for LMWH following local guidelines and rivaroxaban fixed at 10 mg daily. Throughout the study, participants are monitored at 45 and 90 days after treatment start to track symptomatic blood clots and bleeding events. Their satisfaction with the treatment is also assessed. Researchers measure the rate of symptomatic venous thromboembolic events primarily at 45 days and evaluate safety, treatment satisfaction, and cost-effectiveness at 90 days. The total follow-up lasts up to 90 days to fully capture outcomes and treatment impact.