Saint Paul

This research aims to evaluate the use of digital tools in dentistry to improve the detection of dental conditions in adults. It compares the standard real-life examination by practitioners, which combines clinical and radiographic assessments, with examinations based on imaging results from digital devices. The study follows up on previous research that provided recent insights into adult patients oral health and care needs. The study involves digital imaging technologies such as intraoral scanners optical impression cameras, panoramic radiography orthopantomogram, and Cone Beam Computed Tomography CBCT. These tools provide 3D images and detailed views of dental structures, potentially offering more systematic and rapid clinical data collection. Radiographs are only performed when medically justified, and there are no deviations from standard care. Participants attend a single study visit where data is collected through clinical examination and imaging results. Researchers will assess various dental conditions, including the number of decayed, missing, or filled teeth, the extent and location of carious and wear lesions, dental restorations, periodontal involvement, and endodontic status. The study focuses on improving the quality and completeness of diagnostic information to support better treatment planning.

Large-cell neuroendocrine carcinomas LCNECs of the lung are rare, aggressive tumors with poor prognosis and limited treatment options. Researchers are evaluating the combination of durvalumab with etoposide and platinum chemotherapy as a first-line treatment to improve the progression-free rate at 12 months in patients with advanced LCNEC confirmed by expert pathologist review. This phase II, multicenter, open-label study aims to assess the efficacy and safety of this combination compared to historical data. Participants will receive durvalumab combined with etoposide and either cisplatin or carboplatin. Treatment includes an induction phase with cycles every three weeks for 12 weeks four cycles, followed by a maintenance phase with durvalumab every four weeks for up to 24 months. This prospective study uses an external control arm for comparison and focuses on first-line treatment of advanced LCNEC. During the study, patients will be closely monitored through scheduled visits and assessments, including radiological evaluations to measure disease progression. Researchers will track the progression-free rate at 12 months as the primary outcome and also evaluate objective response rates, disease control rates, overall survival, and safety profiles over a period of up to 63 months. Participants will be followed for adverse events and treatment-emergent effects for up to 27 months and 90 days post-treatment, ensuring comprehensive safety and efficacy evaluation.

Researchers are exploring the potential benefits of a respiratory training program called cardiac coherence in people who have acute stress disorder after experiencing a traumatic event. This pilot study aims to see if this method can help prevent chronic post-traumatic stress disorder from developing after three months. The study also seeks to understand how feasible and acceptable the program is for patients. Participants will learn how to practice cardiac coherence with guidance from a trained practitioner during their first visit. They will receive a smartphone app to guide their breathing and a diary to track their adherence. The training involves performing six respiratory cycles per minute, with specific inhale and exhale durations, for five minutes, three times a day at home over three months. During the study, patients will be monitored through questionnaires and heart rate variability measurements at the start and after three months. Compliance with the breathing exercises will be tracked monthly. Researchers will assess the proportion of patients who do not develop post-traumatic stress disorder by month three, as well as any complications related to the disorder. The total participation lasts at least three months, including ongoing support and evaluation.

People with mental disorders tend to smoke more than the general population, which contributes to a significant reduction in their life expectancy by 10 to 20 years, mainly due to heart and lung diseases such as bronchial cancers. Despite this, smoking cessation efforts tailored for psychiatric patients are limited, as smoking is often overlooked or accepted in mental health care settings. This study aims to assess a smoking cessation program called Tabapsy designed with input from mental health users, professionals, and general practitioners, focusing on adult patients receiving outpatient psychiatric care. The Tabapsy intervention includes a campaign promoting smoking cessation within psychiatric medical psychological centers CMPs and a series of supportive activities. These activities involve an initial information meeting to boost motivation, an assessment workshop to evaluate nicotine dependence and create personalized quitting plans, five thematic workshops covering nicotine replacement, emotional management, weight control, physical activity, and manual tasks, and peer support groups for shared experiences. A dedicated facilitator will lead these sessions, supported by an online resource website. The study compares the intervention against usual care in a national cluster-randomized trial involving psychiatric sectors. Participants who smoke regularly and consent will complete questionnaires via a web app at the start, 3 months, and 6 months, with additional surveys for those in the intervention group. The questionnaires cover smoking habits, dependence, motivation, cessation aid use, mental and physical well-being, and knowledge about tobacco. The main outcome is smoking cessation lasting at least 7 days at 3 months. Secondary outcomes include cost-effectiveness, implementation, quit attempts, and satisfaction. A total of 6,250 participants will be enrolled over 12 months across 22 sectors.

This research aims to evaluate the effect of music therapy combined with standard care compared to standard care alone on psychological pain in patients with suicidal thoughts or after a suicide attempt. The study involves patients admitted to a psychiatric hospitalization unit who continue to experience suicidal mood despite emergency somatic management lasting less than 48 hours. The trial is randomized and controlled, designed to assess changes in psychological pain over a short period. Participants are divided into two groups one receives usual care plus music therapy, and the other receives usual care only. Music therapy involves four sessions, each lasting 30 minutes, conducted over 48 hours using the Music Care tool. Standard care includes medical and paramedical interviews lasting 20 to 30 minutes, prescription of anxiolytics or hypnotics if needed, hospitalization, and regular psychological status evaluations during hospitalization. During the study, psychological pain is measured before and after each music therapy session using an analogical visual scale. Participants undergo repeated interviews to monitor their psychological state and drug treatment effects. The primary outcome is the change in psychological pain 48 hours after inclusion. The total duration of hospital stay for study participation ranges from 48 to 60 hours, with informed consent and social security affiliation required for enrollment.