Les Sables D Olonne

This research aims to evaluate the effectiveness of Non-Invasive Ventilation using Continuous Positive Airway Pressure CPAP compared to oxygen supply by face mask for treating acute respiratory failure caused by drowning. The study is an open-label, multicenter, prospective, cross-over cluster randomized trial conducted in 16 emergency medical centers in France. It addresses the urgent need for clearer treatment guidelines, as no national or international consensus currently exists for managing drowning-related acute respiratory failure. Participants receive one of two treatments the experimental group receives non-invasive ventilation with CPAP set between 8 to 10 cm H2O starting from the pre-hospital setting through to intensive care unit admission and continuing until 6 hours after the start of drowning care. The control group receives oxygen supply by face mask at 15 liters per minute for the same time period. Both treatments are continued in the intensive care unit until the respiratory failure improves, with gradual weaning based on maintaining oxygen saturation levels. During the study, participants are closely monitored for oxygen saturation, neurological status using the Glasgow Coma Scale, blood pressure, occurrence of cardiac arrest, and aspiration within the first 6 hours after treatment begins. The emergency medical teams may decide on mechanical ventilation if needed. The trial aims to observe the ability to improve oxygen saturation above 92% and maintain a stable neurological and cardiovascular status. The total involvement includes pre-hospital care and intensive care monitoring during the critical early hours following drowning.

This research investigates patients who have experienced pulmonary embolism PE and focuses on the risk of PE recurrence, which can be fatal in about 10% of cases. Patients with PE are grouped by recurrence risk into very low, high, or intermediate categories, with limited knowledge about those at intermediate risk. The study aims to explore how residual pulmonary vascular obstruction RPVO, measured more accurately by a new 3-dimensional imaging method called VentilationPerfusion Single Photon Emission Computed Tomography VQ SPECTCT, may predict recurrence in these intermediate-risk patients. Participants are patients who had an objectively confirmed PE and were treated with anticoagulant therapy continuously for 3 to 6 months without plans to continue anticoagulation. All participants will undergo a VQ SPECTCT scan at the start of the study to assess RPVO. The study will observe these patients for 24 months to track symptomatic recurrent venous thromboembolism VTE events, including nonfatal PE, deep vein thrombosis, or fatal PE. During the study, researchers will collect data on various predictors of PE recurrence and assess patients quality of life and breathing difficulty using specific questionnaires at the start and after 6 months. They will also monitor mortality, chronic pulmonary hypertension, and other health outcomes over 24 months. This follow-up will help determine if RPVO measured by VQ SPECTCT is a valuable tool to predict recurrence risk in this patient group.

Researchers are evaluating the long-term outcomes of various shoulder replacement systems sold by FX SHOULDER SOLUTIONS. This observational study follows patients who have undergone shoulder arthroplasty, including total anatomical, hemi anatomical, or reversed procedures. The main goal is to measure the rate of revision surgeries over a 10-year period after the initial operation. Secondary goals include assessing shoulder movement, pain, function scores, implant positioning, complications, and surgeon feedback throughout follow-up visits. The study plans to include 1004 patients treated with one of 11 different shoulder implant types, covering a range of indications such as trauma, degenerative conditions, and revisions. Patients may be enrolled retrospectively or prospectively, with a preference for prospective recruitment. Participants are followed at scheduled intervals after surgery 6 weeks, 3 or 6 months, 1 year, 2 years, 3 years, 5 years, 7 years, and finally 10 years post-operation. During the study, patients will attend regular postoperative visits where their shoulder function is evaluated using standardized scores like QuickDASH, Constant-Murley, ASES, and Subjective Shoulder Value. Pain levels and radiological assessments of implant positioning are also performed at each visit. Researchers will monitor for any complications and collect qualitative feedback on the surgical instruments used. The study offers long-term monitoring of shoulder implant performance in real-life conditions over a decade.