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Non-muscle-invasive bladder cancer NMIBC is a type of bladder tumor that affects the inner lining of the bladder without invading the muscle layer. This research aims to collect and analyze real-world data on how NMIBC is managed and followed up in clinical practice across France. The study seeks to assess the performance of urine tests used to detect tumor recurrence and to understand variations in treatment and patient outcomes. The study is observational and involves collecting medical data from patients being monitored for NMIBC, including results from urine biomarker tests done before biopsies or resections. Urologists participating in the French Urology Association will record findings from regular bladder endoscopic exams and urine test results during routine care visits. Data analysis will focus on the accuracy of urine tests in predicting tumor recurrence and how this varies by tumor characteristics and prior treatments. Participants will have their medical history, treatments, and urine test results entered into a registry at enrollment. During follow-up visits scheduled as part of their personalized care, data on bladder exams and urine tests will be collected. Researchers will evaluate outcomes such as recurrence-free survival and the diagnostic value of urine biomarkers over a five-year period. The study plans to include around 8,000 patients over six years to improve understanding of NMIBC management and follow-up.

Small Bowel Obstruction SBO is a common emergency condition diagnosed mainly by abdominal CT scans, which help guide treatment including medical care or surgery. However, CT scans expose patients to radiation, increase costs, and extend emergency department stays. Researchers are evaluating the use of Point of Care Ultrasound POCUS combined with clinical judgment Gestalt probability to safely exclude SBO in patients with low or moderate risk, potentially reducing the need for CT scans. In this observational study, trained emergency physicians will perform POCUS on patients with suspected SBO who have low or moderate Gestalt clinical probability. The ultrasound will look for signs like dilated, fluid-filled intestinal loops in different abdominal zones. After POCUS, all patients will receive a CT scan to confirm SBO presence or absence, serving as the gold standard. The main goal is to assess how well POCUS can rule out SBO in this specific patient group. Participants will be followed for 28 days, with data collected on the accuracy of POCUS compared to CT, time from ultrasound to CT results, and any false positives or negatives. Physicians will also evaluate the ease and usefulness of POCUS. This study aims to show that POCUS can reduce unnecessary CT scans, lowering radiation exposure, costs, emergency department length of stay, and workload for radiologists.

Researchers are evaluating a new ultrasound algorithm called EMERALD-US to improve diagnosis of acute non-traumatic dyspnea in patients aged 50 and older admitted to emergency departments. The study aims to assess how accurately this ultrasound method can identify the three main causes of dyspnea heart failure, pneumonia, and obstructive pulmonary disease exacerbation. This is a prospective multicenter study focusing on the emergency setting where rapid and accurate diagnosis is critical for patient outcomes. The ultrasound exams include lung, cardiac, and vascular scans performed within the first hour after the patients initial medical contact in the emergency department. These exams are done by physicians who are not involved in patient care and are later reviewed blindly by a centralized core laboratory. The study also compares the ultrasound diagnosis with the clinical diagnosis made by emergency physicians. Additional laboratory and radiological tests are collected to assess the algorithms diagnostic accuracy for both common and less frequent causes of dyspnea. Participants will undergo ultrasound examinations lasting up to 30 minutes, alongside routine clinical, laboratory, and imaging assessments. The main outcome measured is the final discharge diagnosis determined by a panel of three senior physicians, based on all clinical data and hospital stay lasting about two weeks. The study also monitors patient management time in the emergency department and 30-day mortality. Researchers will examine the feasibility of using the ultrasound algorithm in emergency settings and its impact on improving diagnostic accuracy and patient survival.

This research aims to evaluate in adult patients who require emergency tracheal intubation due to vital distress the effect of a combined strategy designed to reduce complications related to intubation. The study assesses how using rocuronium as a paralytic agent, providing bag face-mask ventilation before intubation, and systematically applying the Gum Elastic Bougie GEB at the first intubation attempt may impact intubation-related morbidity. Previous studies showed individual benefits of these approaches, but their combined effect in emergencies has not been assessed. The trial compares two groups one group receives a combination rapid sequence intubation RSI strategy using rocuronium, bag-mask ventilation between induction and laryngoscopy, and systematic GEB use to aid intubation. The other group follows current recommendations using succinylcholine for RSI, no routine bag-mask ventilation before intubation, and GEB use only if intubation fails under direct laryngoscopy. Emergency physicians perform intubations and record outcomes. Participants will be monitored closely during and after intubation. Data collection includes medical history, vital signs such as arterial pressure, oxygen saturation, and heart rate. Researchers will track severe intubation-related complications occurring within the first hour and assess intubation difficulty using various measures on the day of intubation. Outcomes like mortality and use of sedatives or vasopressors are recorded up to 28 days after inclusion. The overall study period extends until September 2026.

Researchers are evaluating treatments for community-acquired pneumonia CAP, especially in patients admitted to intensive care units ICUs. This trial also adapts to study treatments for respiratory pandemics like COVID-19. The goal is to determine which treatment strategies improve outcomes for patients with severe pneumonia, using a flexible, ongoing approach that can test multiple therapies simultaneously and update as new information becomes available. Participants receive different treatment strategies based on random assignment to study groups. Treatments include various antibiotics, steroids, antivirals, immune modulators, anticoagulation methods, and ventilation strategies. Some treatment options have been closed to recruitment, reflecting the trials adaptive nature. The trial includes several domains targeting specific infections such as influenza and COVID-19, with dosing and duration guided by clinical practice and local guidelines. During the study, participants are monitored closely with assessments including survival up to 90 days, days alive without organ support in ICU, ICU and hospital length of stay, ventilator-free days, organ failure-free days, and quality of life up to 6 months. Researchers collect detailed data on patient outcomes, organ support needs, and hospital discharge status. The study runs until February 2028, with ongoing evaluation to improve pneumonia treatment strategies in ICU settings and during respiratory pandemics.

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.