Saint Didier Au Mont D Or

Researchers are evaluating laryngeal transplantation in adults aged 18 to 60 who have lost permanent laryngeal function due to trauma or injury not treatable by conventional methods. This study focuses on patients who are severely disabled and face social isolation from their impaired ability to speak, breathe, and swallow. The trial aims to analyze three patients receiving this transplant to determine whether it improves function and quality of life when other surgeries have failed. The treatment involves laryngeal transplantation using a specific nerve re-innervation technique designed to improve functional outcomes and enable patients to be decannulated. A dual immunosuppressive therapy regimen will be applied and adjusted based on the patients condition and the type of tissue transplanted. This pilot study will observe three patients receiving this procedure, with each patient serving as their own control for before-and-after comparisons. Participants will be assessed over three years after transplantation through measures including swallowing ability using the Deglutition Handicap Index, voice quality by patient questionnaires, breathing evaluated by decannulation status, and graft survival. Psychological evaluations, informed consent, and health status assessments are part of participant involvement. The study includes long-term monitoring of functional outcomes and graft viability to better understand the benefits and challenges of this novel transplant approach.

Researchers are evaluating whether active cycling supported by functional electrical stimulation FES improves cardiovascular fitness better than active cycling alone in adults who have hemiparesis following a stroke. This randomized, controlled trial takes place in a neurologic rehabilitation unit and includes patients with hemiparesis between 3 months and 1 year after their first stroke. The study seeks to understand how FES affects physical and cognitive recovery compared to placebo stimulation. Participants are randomly assigned to one of two groups one group receives 30 minutes of active leg cycling with FES applied to specific leg muscles, and the other group receives 30 minutes of cycling with sham FES. Both groups perform their sessions three times a week for eight weeks while seated on a specialized FES-Cycle device combining a cyclo-ergometer and an electrical stimulator. All participants continue their usual rehabilitation programs alongside the study intervention. Before starting, after completing training, and at a three-month follow-up, participants undergo evaluations including cardiovascular fitness measured by peak oxygen uptake VO2 peak, muscle thickness, walking ability, cerebral blood flow during exercise, and cognitive function. The research team monitors these outcomes to assess the impact of FES-cycling on recovery. Total involvement spans initial assessment, an eight-week treatment period, and a subsequent follow-up visit.

Researchers are investigating whether adding local vibration sessions to the dorsiflexor muscles of the affected leg can improve neuromotor recovery in patients who are in the subacute phase after a stroke. This study compares two groups of stroke patients one receiving vibration therapy alongside standard rehabilitation and the other receiving sham vibration with standard rehabilitation. The main goal is to see if this vibration program can help patients walk faster. The treatment involves 40 sessions over 8 weeks during hospitalization, with five sessions per week. One group receives actual vibration therapy at a frequency of 100Hz on the dorsiflexor muscles, while the other group receives sham vibration without effective stimulation. Both groups also continue with the usual rehabilitation program for stroke recovery. Participants will undergo various assessments including walking speed measured by a 10-meter walk test at 2 months, and other walking performance tests over several months. Additional evaluations include motor function, spasticity, autonomy in walking, muscle strength, and neuromuscular fatigue using tools like electromyograms and gait analysis. These tests occur at different timepoints up to 4 months to monitor recovery and treatment effects.

Researchers are investigating how an educational intervention tailored to patients with low health literacy can reduce medication errors and misuse after hospital discharge in those who have experienced acute myocardial infarction or acute decompensated heart failure. Low health literacy affects many people in Europe and is linked to poor health outcomes, increased hospital readmissions, and higher healthcare costs. This study focuses on patients hospitalized for these acute cardiovascular events, as they face increased risks due to complex medication regimens and short hospital stays. The study compares usual care with an interventional educational toolkit designed specifically for patients with low health literacy. This toolkit involves three interviews with a trained health advisor two before discharge and one telephone follow-up within three weeks after leaving the hospital. The nurse provides detailed, personalized information about the discharge prescription, illness, and actions to take in high-risk situations. Additionally, two telephone interviews by a clinical research assistant occur at 30 and 90 days post-discharge to assess understanding and adherence through questionnaires. Participants will be closely followed during the study with assessments focusing on medication errors or misuse within 30 days after hospital discharge. The study measures how well patients understand and take ownership of their discharge prescriptions, aiming to improve adherence. The trial runs until December 2027, and participants receive monitoring through interviews and questionnaires to track outcomes and support medication safety after leaving the hospital.