Monastir

Acute heart failure AHF is a major cause of hospital stays and is linked to high rates of rehospitalization or death within 30 days after discharge. Current risk assessments mainly focus on blood flow congestion in large vessels, but they do not fully capture small vessel and tissue-level problems that can continue despite clinical improvement. Lung ultrasound scores LUS help assess lung congestion, while blood lactate levels indicate tissue oxygen delivery and usage. Combining these two measures may better predict early complications after hospital discharge. This observational study includes adults hospitalized for acute heart failure who are clinically stable and expected to be discharged within 24 hours. At discharge, participants undergo lung ultrasound using a standardized 8-zone method to measure lung congestion, and blood lactate levels are measured at rest. Researchers collect clinical data including patient demographics, heart failure type, vital signs, lab tests, treatments, and hospitalization details to classify patients based on combined lung congestion and tissue perfusion scores. Participants are followed for 30 days after discharge through phone interviews and medical record review to track outcomes such as heart failure readmission, emergency visits, and death. The main outcome is a combined measure of rehospitalization or all-cause mortality within 30 days. Secondary outcomes include time to first event and all-cause readmission. This follow-up helps evaluate if the combined lung ultrasound and lactate score better predicts early adverse events compared to lung ultrasound alone.

This research aims to evaluate the CardioStory device in adult patients who come to the emergency department with new shortness of breath, also known as dyspnea. The study focuses on distinguishing heart failure from other causes of dyspnea by collecting data from routine medical assessments and device measurements. The study is observational and involves adults aged 18 years and older. Participants will undergo non-invasive cardiac assessments using the CardioStory device, which quickly measures cardiac filling pressure using fiber-optic sensors and advanced algorithms without invasive procedures. Measurements with the device take about 2 minutes and are compared to standard clinical assessments including medical history, physical exams, laboratory tests, and echocardiography. The study collects data only during the emergency visit. During participation, patients will have routine clinical data recorded alongside the device measurements. Researchers will assess the diagnostic performance, sensitivity, specificity, and time efficiency of the CardioStory device in identifying heart failure. They will also monitor for any adverse events related to device use. The primary and secondary outcomes are measured on the first day of the emergency visit, with no long-term follow-up mentioned.

Researchers are evaluating the use of intravenous magnesium sulfate compared to a placebo for treating adults with non-traumatic acute headaches in the emergency department. This phase 3 randomized trial aims to assess how effective magnesium sulfate is when added to paracetamol for relieving headache pain. The study is led by the University of Monastir and focuses on patients aged 18 to 85 years presenting with acute headache symptoms not caused by trauma. Participants receive either 1 gram of paracetamol combined with a 20-minute infusion of 2 grams of magnesium sulfate in saline or 1 gram of paracetamol with a 20-minute infusion of saline alone as a placebo. The trial uses triple blinding to ensure unbiased results. The treatment is given intravenously in the emergency department setting. During the study, participants are closely monitored for headache relief over one day following treatment. Researchers will measure the primary outcome of headache response to magnesium sulfate within 24 hours. Secondary outcomes include comparing placebo effects. The study excludes individuals with certain medical conditions or medication use to ensure safety and accuracy. Participation duration includes the treatment and short-term observation period within the emergency setting.

Researchers are evaluating the effects of olive leaf extracts atherolive on adults with type 2 diabetes. This study is conducted in emergency departments and external endocrinology and diabetology consultations at two hospitals. The trial compares atherolive to a placebo to better understand its impact on blood sugar control and related health markers. Participants will be randomly assigned to receive either atherolive or a placebo, both given as a 400 mg dose once daily for three months. Before treatment, patients undergo biological assessments including lipid profiles, blood sugar, creatinine levels, HbA1c for diabetics, and inflammatory markers like C-reactive protein. Continuous blood glucose monitoring using an iPro device is performed at the start to measure blood sugar variability. During the study, researchers will track continuous glucose monitoring results and Hemoglobin A1c levels over 90 days. Additional outcomes include changes in lipid balance and hospitalizations due to cardiovascular disease or adverse effects. Participants will be monitored for three months, with assessments to evaluate treatment effects and safety throughout.

Renal colic is a common cause of severe abdominal pain leading to many emergency department visits. Researchers are evaluating whether oral non-steroidal anti-inflammatory drugs NSAI, specifically piroxicam, are beneficial as a second line treatment for patients discharged after initial renal colic treatment. This study compares the effects of piroxicam with acetaminophen and placebo to investigate pain recurrence, reconsultation rates, and hospital admissions. Participants are randomly assigned to one of three groups one receives 20 mg of piroxicam daily, another takes 1000 mg of acetaminophen daily, and the third group takes a placebo pill each day. All treatments last for five days. Patients will be contacted by telephone on the seventh day to assess the effectiveness and any side effects experienced. During the study, participants will be monitored through follow-up phone calls to evaluate pain recurrence, safety, and overall treatment impact within seven days. The main outcome measured is the efficacy of the oral NSAI within this one-week period. The study aims to provide clearer guidance on outpatient treatment options for renal colic. The total duration of participation includes the five-day treatment and follow-up contact on day seven.

The trial investigates treatments for patients who have experienced an acute attack of renal colic and have been successfully treated in the Emergency Department. It is a prospective, randomized, single-blind study comparing the effects of oral paracetamol combined with tramadol, oral paracetamol combined with caffeine, and a placebo. The goal is to evaluate these treatments during the emergency discharge phase for renal colic patients. Participants are randomly assigned to one of three groups upon discharge one group receives two tablets daily of paracetamol-tramadol 325 mg paracetamol 37.5 mg tramadol for 7 days, another group takes three tablets daily of paracetamol-caffeine 65 mg caffeine 500 mg paracetamol for 7 days, and the last group receives three placebo tablets daily for 7 days. All tablets are identically packaged to maintain blinding. Throughout the study, data such as temperature, blood pressure, heart rate, pain intensity measured by visual analog scale, abdominal tenderness, and specific signs related to renal colic are collected. Additional tests like ultrasound, urine culture, renal ultrasound, creatinine levels, and blood sugar are performed based on clinical context. Researchers monitor recurrence of renal colic and emergency department readmissions within 7 days after inclusion, along with side effects up to 30 days. The total participation duration includes the 7-day treatment and follow-up assessments.

Heart failure HF is a major cause of hospitalization, rehospitalization, and death in adults over 65 years old. This research evaluates death and hospital readmission rates at 30 days and one year after hospital discharge among patients admitted to the emergency department with acute heart failure. It compares patients with heart failure with reduced ejection fraction HFrEF to those with preserved ejection fraction HFpEF. The study observes adult patients aged 18 to 80 admitted with acute heart failure to the emergency department of Monastir. It does not involve specific treatments but tracks outcomes such as death or readmission after discharge. The study period covers both short-term 30 days and long-term one year follow-up to understand prognosis in different types of heart failure. Participants will be monitored through their hospital records to record death or readmission within the specified timeframes. The research team collects data to measure these outcomes after discharge, with no investigational treatments administered. The total participation duration depends on the timing of discharge and follow-up up to one year after discharge.

Heart failure is a common and serious condition that leads to many hospital visits and deaths worldwide. Access to specialized heart failure clinics is limited, although such care can improve patient outcomes. This international, multicenter randomized controlled trial called VICTORY-HF is studying whether adding a virtual heart failure clinic to routine care can improve medication use and health outcomes for patients recently discharged after hospitalization or urgent care for heart failure. Participants will be randomly assigned to receive either 90 days of virtual heart failure clinic care plus routine care or routine care alone. The virtual clinic offers structured remote follow-up, monitoring of physiological measures, and optimization of guideline-directed medical therapies. The trial will evaluate the effects of this intervention on medication use, patient-reported health status, mortality, hospital readmissions, and emergency visits. Participants will be followed for 90 days during the virtual clinic intervention, with co-primary outcomes measured at 90 and 180 days. Assessments include monitoring of clinical events, medication optimization, and healthcare utilization. The follow-up period includes clinic visits and data collection to evaluate the impact of virtual care on recovery and health status after heart failure hospitalization.