Salouel

Septic shock is a life-threatening condition with high mortality rates. Researchers are studying how left and right atrial strain LAS and RAS measurements, obtained through speckle tracking echocardiography, can help evaluate heart function in these patients. This observational study focuses on comparing two echocardiographic software programs, ECHOPAC and UWS, to understand differences in their LAS and RAS measurements, and to test a new AutoStrain technology for measurement reproducibility among observers. The study uses retrospective data from adult patients treated for septic shock who had transthoracic echocardiography TTE as part of their care. It compares variations in several atrial strain measurements between the two software tools, including analyses from different heart views and measurement modes. The study also assesses how consistent the measurements are when performed manually or with AutoStrain, across different observers. Participants are adults over 18 treated for septic shock with available echocardiographic data. Researchers review existing echocardiograms and collect various atrial strain measurements over one year. They evaluate measurement differences, reproducibility, and the effectiveness of AutoStrain technology. This non-interventional study involves no new treatments or procedures and will contribute to improving heart function assessment in critically ill patients.

Researchers are studying the effects of clozapine, a second-generation antipsychotic drug used to treat psychosis in Parkinsons disease PD patients. The study focuses on clozapine-related immunodeficiency, which may cause decreased immune function and increased infection risk over time. This research aims to explore changes in immune system markers in PD patients treated with clozapine, as current data mainly involve psychiatric patients with schizophrenia. Participants will undergo blood tests to measure serum immunoglobulin levels and lymphocyte subpopulations B, T, NK cells at the start of clozapine treatment, six months later, and again at one year. The study involves regular monitoring of blood counts weekly for the first 18 weeks and then monthly while on treatment, continuing for four weeks after stopping clozapine. Additional immunological assays are added during these scheduled blood tests. Participants will be monitored through blood tests and clinical assessments during the study. Researchers will evaluate changes in serum IgG levels after six months as the primary outcome. The study will also track immune cell populations over time. Safety monitoring includes regular blood count checks to detect potential risks like neutropenia. The total follow-up extends at least one year after treatment initiation, allowing thorough observation of immune changes.

Researchers are evaluating a new care pathway called RAUC designed for adults who visit the emergency room with digestive problems requiring surgery. This study focuses on patients treated without a pre-established optimization program and aims to reduce unplanned hospital readmissions within 30 days after emergency digestive surgery. The study highlights the complexity of emergency digestive surgeries involving elderly patients and those with other health issues, addressing a gap in personalized care and research in this area. The study compares patients following the RAUC pathway, which includes Enhanced Recovery After Surgery ERAS and various e-health tools for home monitoring, with those receiving standard care. The RAUC pathway incorporates several technologies a teleexpertise solution ROFIM connecting hospital and extra-hospital practitioners, a virtual reality headset DEEPSEN to reduce anxiety, a patch RDS for continuous home monitoring of physiological parameters, a digital home management solution Get ready, home CRP testing Lumiradx, and digital recording of surgery times Digital Surgery. Patients are divided into groups receiving either this experimental care or standard care, with additional comparison to patients identified from health records. Participants will be monitored at several points, including at surgery and up to 30 days afterward, measuring outcomes such as unscheduled hospital readmissions, complication severity Clavien-Dindo score, hospitalization duration, quality of life, anxiety levels, emergency transitions without hospitalization, and cost-effectiveness. The study uses these assessments to evaluate the impact of the RAUC pathway and its tools on patient recovery and healthcare use. Follow-up and data collection continue until at least 30 days post-surgery to assess safety and effectiveness.

Polycystic ovary syndrome PCOS is a common condition linked to metabolic problems, including insulin resistance and a higher risk of developing type 2 diabetes. PCOS has four different phenotypes A-D, and some may have less risk of insulin resistance. This research aims to study glucose levels continuously to see how glucose profiles differ among these PCOS phenotypes using new monitoring technology. Participants in this study will use a Free-style Libre Pro sensor device to continuously monitor glucose levels for 14 days. The study compares four PCOS phenotypes based on combinations of symptoms such as irregular menstrual cycles, hyperandrogenism, and ovarian morphology or AMH levels. Additionally, an Age Reader device will analyze glycation end products related to glucose control. Women in the trial will be monitored over two weeks, with continuous glucose data collected through the sensor. Researchers will assess time spent within glucose target ranges, average blood sugar levels, variability, and presence of low blood sugar. Other tests include HbA1C, oral glucose tolerance, insulin resistance evaluation, and glycation product measurement. The study is non-randomized and open-label, with participation starting in January 2026 and ending in July 2027.

Researchers are studying patients in critical care who require continuous renal replacement therapy CRRT to manage fluid overload. The study aims to evaluate whether using bioelectrical impedance analysis BIA to guide fluid removal improves the reduction of total body water TBW compared to standard care. Excess fluid can cause organ problems and raise the risk of death, so finding the right fluid removal method is important. This is a pilot, randomized, controlled, open-label study comparing two approaches to fluid removal during a 72-hour CRRT period. Participants are randomly assigned to one of two groups. In the standard group, fluid removal rates are set by the physician based on clinical and hemodynamic assessments. In the experimental group, fluid removal is guided by the extracellular to total body water ratio ECWTBWat measured by BIA, aiming to keep this ratio below 0.400 during treatment. Measurements are taken with specialized devices to calculate the ratio, and the physician adjusts fluid removal accordingly. This process continues throughout the 72-hour CRRT session. During the study, patients will receive CRRT and have their fluid balance monitored closely. Researchers will assess total body water levels, fluid removal rates, and various clinical parameters such as blood pressure stability, arrhythmias, and blood chemistry at multiple time points up to 72 hours. Outcomes like filter use, norepinephrine dosage, ventilation duration, mortality, and hospital stay length will also be recorded. Patient safety and fluid status will be carefully tracked to compare the two fluid removal strategies over the treatment period.

Researchers are investigating how pesticide exposure and changes in the gut and genital microbiomes relate to endometriosis, a condition affecting womens reproductive health. This study aims to measure oxidative stress by analyzing circulating cell-free DNA cfDNA and to explore epigenetic changes. By comparing women with confirmed advanced endometriosis to women with infertility due to male factors, the study seeks to identify unique microbiome signatures and chemical exposures linked to the condition. Participants will be divided into two groups women aged 18 to 43 with confirmed stage 3 or 4 endometriosis, and women of the same age range with male-factor infertility and no endometriosis. Biological samples including blood, vaginal swabs, endometrial rinses, fecal samples, and hair will be collected to analyze cfDNA, microbiota profiles, and exposure to endocrine disruptors. Some procedures, like the endometrial rinse, are performed only after informed consent by a gynecologist. The study will follow participants for up to two years. During the study, researchers will quantify cfDNA levels, assess variations in vaginal, endometrial, and intestinal microbiota, evaluate exposure to endocrine disruptors through questionnaires and hair samples, and analyze DNA methylation. Participants will provide samples and complete questionnaires as part of the biological and environmental assessments. The study includes monitoring to ensure safety and adherence, with the total duration of participant involvement lasting two years.

Researchers are investigating the use of MRI-Guided Laser Interstitial Thermal Therapy MRIg-LITT to treat medically intractable tremors caused by Parkinsons disease or essential tremor. This study focuses on patients who cannot undergo deep brain stimulation due to medical, diagnostic, or social reasons, or who refuse that treatment. MRIg-LITT is a minimally invasive surgical method previously shown to be effective and safe for epilepsy and brain tumors, but its use for tremor treatment has not yet been studied. The study involves implanting a laser electrode surgically into the ventral and intermediary nucleus of the thalamus VIM to perform unilateral thalamotomy using MRIg-LITT. This procedure aims to reduce tremors in patients resistant to medical therapy. The trial is an interventional study without masking or placebo, focusing on patients 18 years or older with Parkinsons or essential tremor who have contraindications to or refuse deep brain stimulation. Participants will be monitored for changes in total body weight and cumulative fluid balance 72 hours after the procedure. The study will assess the safety and effects of the MRIg-LITT thalamotomy treatment. Researchers will carefully evaluate any adverse events and overall treatment outcomes during this period. The trial is sponsored by Centre Hospitalier Universitaire, Amiens, and is expected to continue until April 2026.

Researchers are studying adults with multiple myeloma MM who have secondary immunodeficiency SID and are receiving treatment with HyQvia. This observational study aims to understand how HyQvia is used in real-world clinical settings, focusing on the details of the infusion process. The study plans to enroll about 100 participants across multiple centers in Europe and South America. Participants with MM and SID will be treated with HyQvia as part of their regular medical care. The study will track their treatment from the start of HyQvia through 12 months of follow-up. During this time, researchers will observe infusion parameters such as dose, infusion volume, rate, duration, and infusion site details. There will be no additional intervention, as the study is observational. Participants will attend multiple clinic visits over the 12 months following enrollment for follow-up assessments. Data will be collected from routine clinic visits and voluntary patient-reported outcomes. Researchers will measure various infusion characteristics and treatment outcomes, including treatment intervals, needle specifications, use of infusion pumps, caregiver support, reasons for any changes in infusion, and overall participant health status. Safety events and hospitalizations will also be monitored throughout the study period.

This research aims to observe patients in France with HER2-negative early breast cancer who are treated with olaparib, a medication chosen by their doctors. The study focuses on understanding how often patients complete the full course of olaparib treatment and gathers information on related genetic factors and medical history. It is a national, multicenter, prospective observational study without experimental treatment assignment. Participants in this study receive adjuvant olaparib treatment as part of their usual care under their physicians discretion. The study does not assign treatments but follows patients who start olaparib, tracking their treatment progress for up to 18 months after inclusion. There are no additional interventions or placebo groups. Throughout the study, researchers collect data on treatment completion rates, types of BRCA mutations, variant types, medical history, and the time until olaparib treatment stops. Participation involves observational follow-up, with no extra treatment visits beyond routine care. The overall participation lasts 18 months after a patients enrollment, focusing on real-world treatment experiences and outcomes.

Premature ventricular complexes PVC are common, affecting about 20% of people. They may appear unexpectedly on an electrocardiogram ECG or cause symptoms like palpitations, chest pain, or fainting. Initial tests such as Holter ECG monitoring, echocardiography, and exercise stress tests help exclude structural heart disease, but sometimes subtle heart abnormalities may be missed. Cardiac magnetic resonance CMR imaging is the best way to assess heart function and detect issues like swelling, fatty replacement, or scarring in the heart muscle, but its exact role in patients with PVC is still unclear. This observational study aims to find out when CMR should be used to provide additional diagnosis or prognostic information beyond initial tests for patients referred for PVC by their cardiologists. The study will observe patients who have already had ECG, Holter ECG, and CMR scans, focusing on identifying myocardial abnormalities using CMR. Participants will be adults with PVC who have undergone these heart assessments. Researchers will review CMR results to count detected heart abnormalities and analyze factors that predict these findings. The main measurement is the number of myocardial abnormalities identified by CMR on the first day. This study will help clarify the value of CMR in evaluating PVC and guide future heart care for these patients.