Dreux

Researchers are studying adults with community-acquired pneumonia who need oxygen therapy due to acute respiratory failure meeting acute respiratory distress syndrome (ARDS) criteria. This condition often leads to tracheal intubation and poor outcomes. Previous studies showed that prone positioning reduces mortality in invasively ventilated ARDS patients and improves oxygenation in non-intubated patients with viral pneumonia, including COVID-19 cases. This trial focuses on patients with non-COVID community-acquired pneumonia using nasal high flow therapy, aiming to see if awake prone positioning can reduce the need for intubation and related treatments like sedation and muscle relaxation. Participants will be encouraged to spend as much time as possible in the prone position, ideally 4 to 8 hours per session, with a goal of up to 16 hours or more within each 24-hour period, depending on their tolerance. This intervention is compared to usual care without prone positioning. The study excludes patients with recent COVID-19 infection or those requiring immediate intubation. During the study, researchers will monitor patients for up to 28 days after randomization, focusing on whether they require intubation. Participants will be admitted to an intensive care or intermediate care unit, and their oxygen levels will be closely assessed using the PaO2/FiO2 ratio or equivalent SpO2/FiO2 measurements. Consent and social security affiliation are required. Safety and effectiveness of awake prone positioning in reducing intubation needs will be evaluated throughout the study period.

Schizophrenia is a condition affecting about 0.7% of people and often involves poor insight, which can lead to poor medication adherence, relapse, and rehospitalization, negatively impacting quality of life. Psychoeducation has shown potential to improve treatment compliance and the therapeutic relationship. This trial evaluates an individual early psychoeducation program called PEPITS, designed to support patients during the initial hospitalization phase to improve insight, medication adherence, and reduce relapse. The PEPITS program is delivered by nurses and consists of three main phases: an introduction phase, a pathology and care phase, and a recovery and "stepping stone" phase. Each phase involves several sessions that provide patients with information, key knowledge, and new skills related to their illness and recovery process. Participants in the study will either receive the PEPITS program alongside usual psychiatric care or just the usual care without PEPITS. Participants will be followed for one year after randomization. Researchers will assess changes in patients' insight over this period as the primary outcome. Throughout the study, patient progress, relapse, and medication adherence will be monitored to evaluate the program's impact. The total participation lasts up to one year, allowing detailed observation of the program's long-term effects.

Researchers are investigating the effects of continuing oral intake versus fasting in adult patients with acute respiratory failure who are hospitalized in intensive care units but are not intubated. The study addresses a gap in current ICU nutrition guidelines, as fasting is commonly practiced despite limited scientific evidence, and patients often suffer from caloric deficits and discomfort such as hunger and thirst. The trial explores whether allowing oral intake before potential intubation increases risks such as aspiration or the need for intubation. Participants will be assigned to one of two groups: those allowed to eat and drink freely according to their tolerance, and those who will fast without any oral intake of liquids or solid foods. This approach aims to compare the safety and outcomes of maintaining nutritional support versus fasting in this specific patient population at risk of intubation. Throughout the study, researchers will monitor the percentage of patients who require intubation or die without intubation within 96 hours after randomization. Patient well-being, risk of aspiration, and respiratory status will be closely evaluated. The trial includes detailed assessments and continuous monitoring during the ICU stay to understand the impact of oral intake continuation on clinical outcomes and patient comfort.

Researchers are conducting an ambispective, observational, multicenter, and multicohort study focusing on patients with non-small cell lung cancer (NSCLC) who are starting treatment with approved drugs developed by AstraZeneca (AZ) or as part of an AZ alliance. The study includes three groups based on NSCLC stage: resectable, unresectable, and metastatic. This modular study design allows assessment of each new drug indication once it receives European marketing authorization and becomes available in the participating countries. Patients will be enrolled if they have received, are receiving, or will receive approved AZ or AZ alliance drugs either alone or in combination, at any disease stage. Treatment decisions are made by the patients' own doctors before joining the study. The study follows these patients in three cohorts: resectable NSCLC, unresectable NSCLC, and metastatic NSCLC, to evaluate outcomes related to drug effectiveness in real-world settings. Participants will be followed for up to three years to measure outcomes such as disease-free survival, event-free survival, and time to treatment failure, depending on their cohort. Data collection includes retrospective and prospective information on treatment start and patient progress. The study emphasizes real-world evidence by observing patients receiving standard care without intervention from the study team.