Saint Lo

Researchers are evaluating different antimicrobial therapies for infections caused by difficult-to-treat Pseudomonas aeruginosa, a type of bacteria resistant to many common antibiotics. This study focuses on comparing new beta-lactambeta-lactamase inhibitor combinations, cefiderocol, and older treatments like aminoglycosides and colistin to understand their effectiveness in real-life settings for patients facing these challenging infections. The study is a prospective, multicenter cohort involving patients who require intravenous antibiotic treatment for their P. aeruginosa infections. Participating patients will receive one of the available antimicrobial options, and their bacterial samples will be analyzed centrally to assess susceptibility and resistance mechanisms. The study collects clinical data throughout treatment and monitors outcomes such as cure rates, resistance development, adverse events, and mortality. Participants will be followed until hospital discharge and up to 28 days after treatment completion. Researchers will track clinical cures, microbiological eradication, adverse events, emergence of resistance, and acquisition of other multidrug-resistant bacteria. Data collection includes electronic case reports and laboratory testing on bacterial isolates. The total participation duration varies according to hospital stay and follow-up schedules, with rigorous monitoring of safety and treatment outcomes.

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 studying ICU Acquired Weakness by evaluating whether early sitting out of bed in an arm-chair position improves functional recovery in patients who are ventilated in intensive care. This trial compares this early armchair positioning to a conservative strategy of sitting in bed, aiming to clarify if the armchair is essential for improving muscle and functional outcomes, as current guidelines do not strongly recommend this practice. Participants who have been awake with a certain alertness level RASS score between -1 and 1 for over 12 hours are randomly assigned to either daily chair sessions lasting at least 30 minutes or to no chair positioning. The chair sessions continue until ICU discharge or day 28, with careful monitoring of tolerance and a maximum session duration of 4 hours. The study follows patients through their ICU stay to assess recovery. During the study, researchers assess functional levels at ICU discharge or day 28, along with mobility scales, muscle strength scores, length of ICU and hospital stays, ventilator-free days, and mortality rates up to six months. Patients are monitored closely for safety and recovery progress throughout their ICU stay, with data collected to understand the impact of early armchair positioning on their health and function.

This research aims to better understand how pregnancy affects women with multiple sclerosis MS and related neurological conditions, including neuromyelitis optica and myelin oligodendrocyte glycoprotein antibody-related disorders. The study focuses on important questions about the use of disease-modifying drugs during pregnancy, the effects on the mothers health and disability, the childs health, breastfeeding, and pain management during delivery. It is a national, prospective, observational study conducted within the French MS cohort called Observatoire Franais de la Sclrose en Plaque OFSEP. Women with MS or related disorders who are pregnant will be followed throughout their pregnancy and for one year after giving birth. Their children will also be monitored until they reach six years of age. There is no intervention or treatment given as part of this study instead, it collects detailed information on the course of MS during pregnancy and postpartum, including any use or discontinuation of disease-modifying drugs and other pregnancy-related factors. Participants will have regular follow-ups during pregnancy and postpartum to assess their health and any treatment-related side effects. Researchers will collect data on relapses, disability progression, breastfeeding, and use of pain relief during delivery. Children born to these women will be observed for up to six years to evaluate long-term outcomes. The main outcomes measured include the number of treatment-related adverse events during pregnancy and postpartum, helping to improve knowledge for neurologists and families regarding MS and pregnancy.

Researchers are studying advanced cancer of the stomach and the gastro-esophageal junction, a serious disease with low survival rates. The trial focuses on patients whose cancer has progressed after two or three prior treatments. The study aims to evaluate whether combining the oral drug trifluridinetipiracil with the anti-angiogenic drug fruquintinib can improve survival compared to trifluridinetipiracil alone. This international Phase III trial builds on recent advances in immunotherapy and targeted therapies for this cancer type. Participants are randomly assigned to one of two groups. One group receives trifluridinetipiracil alone in 28-day cycles, taking the drug by mouth twice daily on Days 1 to 5 and Days 8 to 12 with rest days in between, repeated every 4 weeks. The other group receives the same trifluridinetipiracil schedule plus fruquintinib by mouth once daily for 21 days each cycle. Treatment continues until the cancer progresses, unacceptable side effects occur, or the participant chooses to stop. During the study, participants undergo regular assessments to monitor overall survival up to 18 months after starting treatment. Researchers will also measure progression-free survival during this period. Patients will have tumor evaluations, laboratory tests, and monitoring for treatment side effects. Participants must meet specific health criteria and agree to biological studies. The study provides close follow-up to evaluate the effects of the treatments over time.