Saint Paul

Leptospirosis is a bacterial infection caused by contact with water or soil contaminated by animal urine. It is a significant health problem worldwide, with nearly one million cases annually and a mortality rate ranging from 5 to 10%, increasing up to 50% in severe cases. In Reunion Island, leptospirosis is common due to the climate, with many cases requiring hospitalization and intensive care. This research focuses on studying the long-term effects of leptospirosis beyond one year after infection, as some patients experience chronic symptoms such as fatigue, kidney issues, muscle weakness, and neurological or cardiac problems. The study involves biological sampling, including blood and urine collection, to analyze immune responses and detect ongoing infection. Samples are processed and stored for further testing. Patients who were hospitalized for confirmed leptospirosis within the last 12 to 18 months and are part of a prior cohort are invited to participate. The study includes clinical and biological data collection through questionnaires and medical follow-up. Participants will have medical visits and telephone interviews to assess their health status, quality of life, and use of alternative medicines. The main outcome measured is the proportion of patients experiencing chronic symptoms two years after infection. The study also collects information on health literacy and complementary health approaches. Participants are expected to be residents of Reunion and able to respond to phone questionnaires, with follow-up planned for up to one year after enrollment.

Researchers are evaluating community health actions aimed at women aged 30 to 65 who live in vulnerable situations in the outlying areas of Reunion Island. The study focuses on health awareness and improving cervical cancer screening rates among this group, especially related to HPV, a risk factor for anal cancer. This research uses a randomized controlled crossover design to assess methods of screening. The intervention includes cervical cancer screening awareness workshops held in small groups through focus groups. Participants who are not current with their cervical cancer screening are offered an HPV self-test using a vaginal self-swab during an individual consultation. This approach is compared to screening performed by a health professional. Participants attend sexual health awareness meetings and may undergo HPV testing. Researchers measure the rate of women who complete cervical cancer screening within three months after the community health intervention. The study tracks acceptability and concordance between self-screening and professional screening methods to better understand how to improve screening rates in this population.

Researchers are evaluating Trastuzumab deruxtecan (T-DXd) in adult patients with unresectable or metastatic HER2-low expressing breast cancer. This non-interventional study aims to assess the effectiveness of T-DXd, patients' demographic and clinical characteristics, treatment patterns, tolerability, management of adverse drug reactions, and patient experience. The study also collects data on conventional chemotherapy treatments in a disease registry to better understand treatment outcomes in this population. Participants will receive treatment with Trastuzumab deruxtecan or conventional chemotherapy drugs such as capecitabine, eribulin, gemcitabine, paclitaxel, or nab-paclitaxel according to the Summary of Product Characteristics and routine clinical practice. No study drug will be administered by the researchers, as treatments follow physicians' standard care decisions. This approach allows observation of real-world treatment use and outcomes. During the study, patients' treatment timelines and responses will be followed, focusing on the time to next treatment up to 31 months. Researchers will monitor tolerability, adverse drug reactions, and patient-reported experiences. Data collection includes clinical and demographic information, treatment patterns, and outcomes to provide a comprehensive understanding of T-DXd and conventional chemotherapy use in this patient group.

Large hiatal hernia (LHH) affects many patients undergoing laparoscopic antireflux surgery, with recurrence rates reported up to 30% after about two years. This trial evaluates whether adding a biosynthetic absorbable mesh to standard suture repair reduces the rate of hernia recurrence compared to repair without mesh. The study also aims to assess symptom improvement, quality of life, complication rates, and cost-effectiveness over a 2-year period. Participants will undergo laparoscopic primary repair for symptomatic LHH, defined as a hiatal hernia larger than 5 cm. They will be assigned to either receive a standardized herniorrhaphy with onlay biosynthetic absorbable mesh or the same repair without mesh. The laparoscopic approach is used to reduce hospital stay and complications. No emergency or repeat surgeries are included. During the study, participants will be monitored for hernia recurrence using radiologic exams at 24 months. Symptom changes, quality of life, and complications will be tracked and classified. Researchers will also analyze healthcare costs related to treatments. Patients will provide informed consent and must be covered by social security. The total participation involves follow-up assessments up to two years after surgery.

There is a wide variation in how rapid sequence induction is performed in operating rooms worldwide. This study aims to describe how French anesthesiologists prevent serious blood flow problems during rapid sequence anesthetic induction in adult patients. It focuses on the occurrence of major hemodynamic disorders, such as low or high blood pressure, sustained arrhythmias, or cardiac arrest within the first 10 minutes after anesthesia begins. Participants will undergo rapid sequence anesthetic induction, a process used to quickly induce general anesthesia for patients at high risk of lung fluid aspiration. The study will observe the clinical practices of pre-oxygenation, induction, and intubation, and check how well these practices follow the formal expert recommendations from 2017 and 2018. Data on the prevention of gastric fluid inhalation, equipment used, drugs administered, and clinical parameters will be collected during the induction process. Throughout the study, researchers will monitor neurological and cardio-respiratory signs and record any complications within the first 10 minutes after anesthesia induction. The main outcome measured is the occurrence of major hemodynamic disorders during this period. The study is observational and multicenter, involving adult patients undergoing rapid sequence induction in France.