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Sepsis and its severe form, septic shock, pose significant health challenges involving organ failure and acute circulatory failure. Despite early treatment, many patients still experience worsening conditions and high mortality. This research aims to evaluate whether measuring small blood vessel function in emergency patients can improve outcomes by guiding early fluid treatment. The study compares the usual monitoring of circulation with additional assessments by nurses of peripheral perfusion index and skin mottling. If these measurements indicate poor microcirculation, a first fluid infusion of 500 mL over 30 minutes will be given after medical approval. Patients will be followed for seven days to assess their recovery and health status. Participants will be monitored closely during emergency care, with nurses measuring microcirculation parameters alongside standard tests. Researchers will track clinical deterioration within 24 hours after inclusion, using these data to see if early intervention based on microcirculation improves patient prognosis. The total follow-up period for each participant is seven days.

Researchers are evaluating the effectiveness of two surgical methods for treating pelvic organ prolapse in women aged 50 and older. Pelvic organ prolapse, often caused by loss of pelvic support, affects about half of women over 50 and can significantly impact quality of life. This study compares the vaginal patch plastron surgery to anterior colporraphy, focusing on a combined definition of success that includes both anatomical and functional outcomes at one year. The study involves two surgical procedures: anterior colporraphy and vaginal patch plastron. Anterior colporraphy includes creating a vaginal strip isolated from the anterior colpocele and repairing tendinous arches with lateral stitches. The vaginal patch plastron involves making a midline incision on the anterior vaginal wall, separating the vaginal epithelium from underlying tissue, and plicating the fibromuscular layer with stitches before closing the vaginal wall. Patients will be blinded to which surgery they receive. Participants will have a follow-up visit 45 days after surgery to assess complications, with additional phone calls at 4 and 8 months to check for any issues. A final follow-up visit occurs one year after surgery, conducted by an independent assessor unaware of the treatment type, to evaluate the primary outcome measuring anatomical and functional success. The main outcome is the rate of prolapse surgery success at one year.