Les Sables D Olonne

Researchers are evaluating the use of Non-Invasive Ventilation combined with Continuous Positive Airway Pressure (CPAP) compared to oxygen supply by face mask in treating acute respiratory failure caused by drowning. This condition has a significant mortality rate, and no national or international consensus exists on its management. The study includes both children and adults and is conducted across 16 Emergency Medical Service centers in France. Previous observations suggest that improving oxygenation quickly helps maintain neurological status, and the clinical course is similar for saltwater and freshwater drowning cases. The study uses a cross-over cluster randomized design where emergency medical teams apply one of two strategies for four months each: either Non-Invasive Ventilation with CPAP set between 8 to 10 cm H2O or oxygen supply by face mask at 15 liters per minute. Treatments begin in the pre-hospital setting and continue until six hours after EMS arrival, then extend into the Intensive Care Unit where support is gradually reduced based on patient oxygen saturation. Mechanical ventilation is available if needed, at the discretion of practitioners. Participants undergo monitoring of oxygen saturation, neurological status via the Glasgow Coma Scale, blood pressure, and occurrences of cardiac arrest or aspiration within six hours of treatment start. The study tracks the ability to maintain oxygen saturation above 92% and other clinical signs of respiratory failure. Consent is required for adults, and parental authorization is needed for children. The total observation includes pre-hospital and intensive care phases up to respiratory failure resolution.

Researchers are studying patients who have had a pulmonary embolism (PE) to better understand the risk of the condition coming back, especially in those at intermediate risk. While anticoagulant treatments help prevent recurrence, it is unclear which patients in this intermediate group need ongoing treatment. This study focuses on the role of residual pulmonary vascular obstruction (RPVO), a condition found in 30-40% of PE patients, which may increase the chance of recurrence. A new imaging method, V/Q SPECT/CT, provides a more accurate 3-dimensional measurement of RPVO compared to older techniques. All participants will have a V/Q SPECT/CT scan when they join the study to measure RPVO. The study does not involve additional treatments but evaluates how well RPVO measured by this imaging predicts the return of venous thromboembolism (VTE) over time. Patients included will be those who had PE, completed 3 to 6 months of anticoagulant therapy, and will not continue anticoagulation beyond that period. During the 24-month follow-up, researchers will track any symptomatic recurrent VTE events, including fatal or nonfatal PE or deep vein thrombosis. The study involves regular monitoring of participants to assess these outcomes. The goal is to identify if RPVO quantified by V/Q SPECT/CT can help predict which patients are at higher risk for recurrence, potentially guiding future treatment decisions.

This research aims to monitor the long-term performance of the FX SHOULDER SOLUTIONS shoulder systems used for shoulder replacement surgeries. It includes patients with conditions such as proximal humeral fracture, glenohumeral osteoarthritis, avascular necrosis of the humerus head, rotator cuff tear or arthropathy, inflammatory arthritis, and revision of a shoulder prosthesis. The study's main goal is to assess the revision rate of these shoulder systems over a 10-year period after surgery, providing real-world data on their durability and outcomes. Participants undergo total anatomical, hemi anatomical, or reversed shoulder arthroplasties using the FX SHOULDER SOLUTIONS systems. The study includes 1004 cases divided into 11 implant groups based on range, indication, and implant constructs. Patients may be included retrospectively or prospectively, with a preference for prospective enrollment. Follow-up visits are scheduled at 6 weeks, 3 or 6 months, 1, 2, 3, 5, 7, and 10 years after surgery to monitor progress and outcomes. During the study, researchers collect data on revision rates, range of motion, various shoulder function scores (Quick Dash, Constant, ASES, SSV), pain levels, and radiological assessments of implant positioning at each visit. They also track complications and gather qualitative feedback from surgeons about the surgical instruments used. This comprehensive approach helps evaluate the long-term success and safety of the shoulder systems, with a total participation duration of 10 years post-surgery.