Verdun

Researchers are evaluating the diagnostic use of two biomarkers, Glutathion S-Transferase-c0 (GST-c0) and Peroxyredoxin 1 (PRDX1), to identify patients who have experienced cerebral infarction (stroke) within a critical window of less than 4.5 hours. The study includes patients with neurological symptoms lasting less than 12 hours and aims to improve detection for timely treatment decisions, especially for those with unknown stroke onset times. Participants will have blood samples taken to measure GST-c0 and PRDX1 levels. These blood samples will be used for biological assessments and stored in a biobank. The study groups are defined by whether the blood sample is obtained within 4.5 hours or after 4.5 hours from stroke onset. Magnetic resonance imaging (MRI) must be performed within 30 minutes after blood collection to support diagnostic evaluation. During the study, participants will be evaluated for stroke symptoms and severity using the National Institute of Health Stroke Score. Researchers will collect detailed timing information about symptom onset and perform blood tests and MRI scans accordingly. The main outcomes measured are the time between stroke onset and blood sampling, assessing how well GST-c0 and PRDX1 levels identify strokes occurring within 4.5 hours. The study ensures participants are socially insured and monitors safety by excluding those with recent serious conditions or legal and psychiatric restrictions.

Researchers are investigating the best length of prednisone treatment to prevent relapses in patients with granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA). These conditions can be controlled with immunosuppressive therapy, particularly with rituximab, but many patients experience recurring relapses that cause damage and require repeated treatments. While rituximab is used to maintain remission, the ideal duration of prednisone use remains unclear, with US studies favoring early withdrawal (6-12 months) and European studies supporting longer use (>18 months) due to lower relapse rates. Participants will be randomly assigned to receive either prednisone 5 mg/day orally for an additional 12 months with weekly tapering or a placebo after an initial tapering period. Both groups receive maintenance rituximab treatment. The study compares the effects of extended prednisone use versus early withdrawal on relapse rates to determine the best approach to maintenance therapy for these patients. During the study, participants will be monitored for relapse-free survival over 30 months, with relapse defined by a Birmingham Vasculitis Activity Score (BVAS) greater than zero. Researchers will track disease activity, medication adherence, and safety throughout the trial. The study includes assessments at screening and regular follow-up visits to evaluate the benefits and risks of prolonged prednisone treatment in combination with rituximab.

Researchers are evaluating whether an early, personalized rehabilitation program that combines nutritional therapy, physiotherapy, and physical activity can improve long-term outcomes for adults who have been critically ill and required mechanical ventilation and vasopressor therapy in the ICU. This trial compares the effects of this extended rehabilitation approach to usual care given during and after ICU stay. The study includes patients starting invasive mechanical ventilation recently and aims to support recovery from critical illness through tailored interventions. Participants are assigned to either the rehabilitation group or the control group. The rehabilitation group receives a customized program beginning early in the ICU and continuing through the post-ICU hospital stay and then at home for a total of 12 weeks. This program uses goal-directed nutrition and physical activity adjusted over time by specialists including dieticians, physiotherapists, and physical-activity instructors. The control group receives the usual care available at each ICU from day 0 to day 180. Throughout the study, participants will be monitored to assess their recovery progress, with the primary outcome measuring the distance walked in 6 minutes at 6 months. Researchers will gather data on physical function and health improvements during and after the rehabilitation period. The study includes follow-up assessments up to 180 days to evaluate the long-term effects of the rehabilitation program compared to usual care.

Researchers are evaluating the benefits of remote monitoring using the Bora Care solution for patients with chronic obstructive pulmonary disease (COPD) who experience frequent exacerbations. The study aims to show whether this remote monitoring approach can reduce the total number of hospital days due to respiratory deterioration compared to traditional clinical follow-up over a 12-month period. The main question is whether remote monitoring can lower the average annual hospitalization time for COPD flare-ups. Participants are assigned to either a control group receiving usual care, which includes regular visits with a general practitioner and pulmonologist, or an experimental group that receives the same conventional care plus remote monitoring using the Bora Care system. This system involves wearing a BoraBand wristband at home to measure vital signs daily, data visualization through the Bora Connect platform for caregivers, and an early detection score (BVS3) to identify exacerbations. Trained nurses (Case Managers) monitor patients remotely and communicate alerts to pulmonologists who decide on hospitalizations or treatment adjustments. Throughout the study, participants will have scheduled consultations and be monitored for symptoms and vital signs. Case Managers will follow up with patients by phone if alerts occur and coordinate with pulmonologists for care decisions. Patients in the remote monitoring group may also access their data through a patient interface. The study will measure the effectiveness of remote monitoring in reducing hospital stays over one year, with safety and adherence tracked during this time.

Researchers are evaluating maternal-fetal transfers (MFTs) across eight maternity units in the Lorraine and Champagne-Ardenne regions. This observational, descriptive, prospective study aims to compare the percentage of "avoidable" maternal-fetal transfers, which are transfers where delivery ultimately meets the acceptance criteria of the sending maternity unit. The study is motivated by concerns about the human and logistical resources involved in transfers that may not benefit the patient, especially when patients transferred for threatened premature delivery with a cervix longer than 15 mm often return home without giving birth at the receiving unit. The study involves the prospective and consecutive inclusion of all maternal-fetal transfers during the study period. Teams at both the sending and receiving maternity units complete questionnaires describing the transfer conditions and pregnancy outcomes. The study does not change the care provided to the mothers but collects data to better understand the transfer process and its complexity. Participants will be involved through their maternity units, where data will be collected via questionnaires about the transfer and pregnancy results. Researchers will measure the percentage of avoidable maternal-fetal transfers after delivery, tracking outcomes up to six weeks post-transfer. The study focuses on logistical and human resource implications, aiming to improve future maternal-fetal transfer practices while monitoring safety and outcomes throughout the follow-up period.