Grezac

Viral hepatitis are primarily human systemic infections caused by viruses hepatic diseases which cause damage to the liver by hepatocyte infection of the virus and/or a host immune response to the virus. (1) Hepatitis is grouped into five types (A, B, C, D, E) and is mainly transmitted by parenteral, sexual and fetomaternal. (2) Hepatitis B virus (HBV) was discovered in 1965 in the United States.(3)It is a DNA virus that belongs to the family Hepadnaviridae. (4) Hepatitis B infection is characterized by signs clinical conditions such as jaundice, asthenia, anorexia but in the vast majority of cases (98% of infections). The course of hepatitis B is not serious; Nine out of ten people will clear the virus thanks to their immune defenses: they heal spontaneously and are immune because they made antibodies against HBV.(5) In 10% of infected people (15% in men, 5% in women), the hepatitis virus B will remain in the liver where it will be more or less active. This activity leads to chronic hepatitis. Approximately 316 million people are chronic carriers of HBV worldwide (1-3) and approximately 887,000 deaths are linked to the hepatitis B virus each year. Appropriate support for carrying Chronic HBV reduces the risk of transmission. The WHO has set the goal of elimination of viral hepatitis B and C in 2030.(5) The biomarkers specifically associated with this infection are: Hbs antigen (HbsAg), antibodies anti-Hbs, anti-HBc antibodies, Hbe antigen, anti-HBe antibodies, virus DNA in plasma. Chronic hepatitis B is defined by the maintenance of HBs antigen in the blood beyond 6 months.(6) The diagnosis of acute hepatitis B is based on the combination of a clinical picture such as acute febrile state. accompanied or followed by jaundice or an increase in hepatic transaminases (AST, ALT, gammaGT) and the presence of HBs antigen and anti-HBc IgM and viral DNA in the blood.(6) Treatment monitoring of chronic hepatitis B is carried out by monitoring the viral load of hepatitis B in the blood. Furthermore, quantification of viral load during hepatitis monitoring Chronic B is essential in order to be able to assess and anticipate the risk of progression towards fibrosis.(6) On the European market, quantitative determination of hepatitis B viral load as part of Diagnosis and monitoring of the disease is done by real-time PCR which is the reference technique.(7) As part of routine care, there are several diagnostic PCR kits that can be used on plasma or serum. Today, there are no CE approved PCR kits that allow the quantification of viral DNA at the both serum and plasma. Our study will make it possible to evaluate the performance of the Bioneer kit PCR kit AccuPower® Quant Kit Bioneer ExiStation™FA 96/384 on serum and plasma from patients with hepatitis B.

Researchers are conducting a pilot phase of a long-term observational study focused on family clusters that include a patient with Alzheimer's disease (AD), their informal caregiver, and at least one first-degree relative. The study aims to explore risk and prognostic factors such as blood-based biomarkers in patients and their relatives, as well as to understand caregivers' health, challenges, and needs. This study addresses gaps in knowledge about biomarker trajectories, newly identified risk factors like hearing impairment, and caregiver experiences over time, using a motivated population at increased risk for dementia. The study will recruit 150 family clusters, each consisting of 2 to 5 people: an AD patient, a caregiver, and one to three first-degree relatives. Participants will be followed for 2 years through visits at specialized memory centers and online questionnaires. Medical examinations will be conducted at the start, 12 months, and 24 months, while caregivers and relatives will answer regular questionnaires about their health and caregiving experiences, either in person or via secure internet and postal methods. Participants will be assessed for recruitment and retention rates over 18 and 24 months, respectively. Data collection includes medical exams, health questionnaires, and tracking of caregiver burden and patient disease progression. The study will monitor the feasibility of a larger-scale investigation, with ongoing evaluations conducted at expert centers and remotely to capture comprehensive longitudinal data from all family members involved.

Liver transplantation involves significant changes in blood flow and heart function during various stages of surgery, which makes monitoring vital for adjusting treatments. This research compares two monitoring methods: transpulmonary thermodilution and transesophageal echocardiography, to understand their accuracy in measuring cardiac index during liver transplantation. Participants will have their cardiac index measured using both transpulmonary thermodilution and transesophageal echocardiography at four key surgical moments: after anesthesia starts, during the anhepatic phase, at reperfusion, and during the surgical connection of bile ducts. The study includes an end-expiratory occlusion test to assess cardiac function before and after the test. Throughout the surgery, researchers will record and compare cardiac index variations from both monitoring techniques. Transesophageal echocardiography will also be used to visualize the surgical connection, checking for issues like narrowing or blood flow changes. The study focuses on how these measurements vary at different surgery phases to evaluate the reliability of thermodilution compared to echocardiography.

Researchers are evaluating the efficacy and safety of dalbavancin (DAL) as suppressive therapy for acute or chronic infections caused by Gram-positive bacteria. Dalbavancin is a semi-synthetic antibiotic derived from teicoplanin that has structural differences improving its ability to bind staphylococcal bacteria and extending its half-life. It penetrates various tissues including skin, bones, joints, lungs, and peritoneal space, maintaining effective concentrations against susceptible pathogens. The study aims to assess how well DAL controls infections over time and to monitor its safety when used as ongoing treatment. Participants in this study have received suppressive antibiotic therapy with dalbavancin for infections that were not fully eradicated by prior antibiotic or surgical treatments. The study collects baseline demographic and clinical data such as sex, age, comorbidities, septic history, and prior antibiotic use. Dalbavancin’s bactericidal action involves blocking bacterial cell wall synthesis and enhancing immune cell killing of MRSA. It also has activity against bacterial biofilms. The study period covers patients treated between July 2019 and December 2024. Participants are followed for up to one year, with the main outcome measuring the proportion of infections that remain stable during this time. If participants are lost to follow-up or observed for less than one year, their last visit date is used in survival analyses. Researchers track the infection status and assess the safety of dalbavancin treatment throughout the follow-up period. This allows evaluation of the long-term effectiveness and tolerability of dalbavancin as suppressive therapy.

Researchers are evaluating the effectiveness of a 30 microgram sublingual sufentanil tablet compared to the standard pain management protocol in adults with moderate to severe pain from isolated trauma to the upper or lower limbs. The study focuses on patients admitted to the emergency department with a pain rating of 4 or higher on the Numerical Rating Scale. This Phase 3 trial aims to address challenges in emergency pain treatment, such as long delays and resource limitations, by exploring a non-invasive analgesic option. Participants are randomly assigned to receive either the sublingual sufentanil tablet or the standard of care analgesic treatment used in the Clermont-Ferrand emergency department. The sublingual tablet offers a potentially faster and easier-to-administer alternative to intravenous opioids, which require more resources and longer wait times. The study compares pain score changes on a scale from 0 to 10 between the two groups at the time of treatment and 60 minutes later. During the study, patients will have their pain levels assessed using the Numerical Rating Scale at Hour 0 and again 60 minutes after treatment. Researchers will monitor safety and effectiveness by tracking pain score variations and observing any adverse effects. The trial includes adult patients with normal oxygen saturation and full consciousness, ensuring that participants meet specific health criteria. The goal is to confirm whether sublingual sufentanil provides effective pain relief in emergency settings while potentially improving workflow and patient experience.

This research aims to understand the brain's response during the first week after an acute brain injury such as subarachnoidal hemorrhage, intracranial hypertension, or acute trauma brain injury. It focuses on exploring how different brain monitoring indices relate to each other and identifying changes in brain electrical activity and heart-lung function during this critical period. The study seeks to investigate the underlying biological processes and discover useful biomarkers by using advanced monitoring techniques. Participants will be monitored using multiple tools including brain oxygen consumption, metabolic disorder assessments, and electrical activity measurements. The study evaluates correlations between various cerebral autoregulation indices like PRx, ORx, and Cox, and also analyzes quantitative EEG changes. Monitoring takes place from 1 to 15 days following the acute brain injury, using the CNS MOBERG® monitoring system to gather comprehensive data. During the study, participants will undergo continuous multimodal neurological monitoring to track brain function and detect early signs of delayed brain injury. Researchers will collect data on brain oxygen levels, metabolic changes, and electrical activity patterns. The main outcome measured is the correlation between different cerebral autoregulation indices over the first 15 days post-injury. Safety and progression are closely observed throughout the monitoring period, which lasts up to two weeks after injury onset.