Chalons En Champagne

Researchers are evaluating a new ultrasound algorithm called EMERALD-US designed to diagnose acute dyspnea causes in emergency department patients. Acute dyspnea occurs twice as often as chest pain and has a higher mortality rate. The study highlights the importance of quick and accurate diagnosis to improve treatment outcomes for conditions like heart failure, pneumonia, and obstructive pulmonary disease exacerbation. Current ultrasound methods lack formal validation in emergency settings, so this study aims to fill that gap. The study uses the EMERALD-US algorithm, which applies lung, heart, and vascular ultrasound within the first hour after the patient's arrival in the emergency department. The ultrasound exams are performed by a physician not directly caring for the patient, and the results are kept separate from the treating physician. This approach helps assess the algorithm's diagnostic accuracy for the main causes of acute dyspnea, as well as less common causes like pulmonary embolism and pleural effusion. Participants with acute non-traumatic dyspnea will undergo ultrasound scans, with images reviewed blindly by a core lab. The study will compare the ultrasound diagnosis to the final hospital discharge diagnosis made by a team of senior physicians. Researchers will also examine the algorithm's feasibility, its correlation with other tests, and its impact on improving diagnosis and patient survival at 30 days. The main outcome measured is the discharge diagnosis averaged over about two weeks from emergency admission to hospital discharge.

Researchers are conducting a French prospective observational study to understand how patients aged 18 years and older with moderate to severe atopic dermatitis (AD) are managed when eligible for or currently receiving systemic therapy. The study aims to describe treatment patterns, including previous and current therapies, and monitor drug survival and compliance over time. Experienced dermatologists in hospital and office settings will participate, ensuring treatment decisions reflect real-world clinical practice. Patients will be followed for one year under routine care, with systemic treatment decisions made solely by their physicians independent of study enrollment. The study does not involve specific interventions or changes in treatment but observes the use and management of systemic therapies for AD, including topical corticosteroid use and other systemic options. Participants will complete questionnaires and undergo assessments at baseline, six months, and twelve months. Researchers will collect data on previous and current treatments, therapeutic management of atopic comorbidities, drug survival changes, and treatment adherence. The study focuses on gathering real-life information on systemic therapy use and patient outcomes over the 12-month follow-up period.

Colorectal cancer mainly affects elderly patients, with over half of new cases in France occurring in those aged 70 or older. Adjuvant chemotherapy has shown benefits in disease-free and overall survival after stage III colon cancer surgery, but its use in elderly patients remains limited. This phase III randomized study explores whether adjuvant chemotherapy improves disease-free survival in elderly patients and which chemotherapy regimen is most effective, addressing concerns about benefits for both unfit and fit elderly patients. Participants will be divided into two groups based on a multidisciplinary evaluation including a geriatrician. One group will receive fluoropyrimidine-based chemotherapy (LV5FU2 or capecitabine), and the other will receive oxaliplatin-based chemotherapy (FOLFOX4 or XELOX). Some patients may be assigned to observation only. Treatments will begin within 12 weeks after surgery. The study also evaluates specific biological markers common in elderly tumors, such as mismatch repair deficiency. During the study, participants will undergo assessments including geriatric questionnaires and medical monitoring. Researchers will track disease-free survival over three years following the last patient's enrollment. Safety and treatment effects will be monitored, with exclusion of patients expected to live less than four years or those unable to comply with follow-up. The study aims to better understand chemotherapy benefits in an elderly population after colon cancer surgery.

Researchers are evaluating maternal-fetal transfers (MFTs) across eight maternity units in the Lorraine and Champagne-Ardenne regions. This observational, descriptive, prospective study aims to compare the percentage of "avoidable" maternal-fetal transfers, which are transfers where delivery ultimately meets the acceptance criteria of the sending maternity unit. The study is motivated by concerns about the human and logistical resources involved in transfers that may not benefit the patient, especially when patients transferred for threatened premature delivery with a cervix longer than 15 mm often return home without giving birth at the receiving unit. The study involves the prospective and consecutive inclusion of all maternal-fetal transfers during the study period. Teams at both the sending and receiving maternity units complete questionnaires describing the transfer conditions and pregnancy outcomes. The study does not change the care provided to the mothers but collects data to better understand the transfer process and its complexity. Participants will be involved through their maternity units, where data will be collected via questionnaires about the transfer and pregnancy results. Researchers will measure the percentage of avoidable maternal-fetal transfers after delivery, tracking outcomes up to six weeks post-transfer. The study focuses on logistical and human resource implications, aiming to improve future maternal-fetal transfer practices while monitoring safety and outcomes throughout the follow-up period.