There are about 36633 clinical studies being (or have been) conducted in France. The country of the clinical trial is determined by the location of where the clinical research is being studied. Most studies are often held in multiple locations & countries.
Patient's discharge from hospital is associated with iatrogenic events for 12 to 17% of patients. This risk may be linked with discontinuity of care between hospital physicians and Primary Care Physician (PCP). The investigators aim to assess in this study the impact of medication reconciliation at discharge associated with a patient's counseling session, both provided by a pharmacist, on patient's care after discharge. To demonstrate the interest of medication reconciliation at discharge we expect a reduction by 15% of the number of prescription changes not maintained by the PCP after discharge.
Sepsis represents a serious public health issue characterized by a complex inflammatory response. In addition to their hemostatic role, platelets display inflammatory functions by secreting a variety of immunomodulatory factors and interacting with circulating immune cells. The investigators postulate that, in severe sepsis, platelets become activated and release amounts of different soluble inflammatory molecules that contribute to sepsis-associated inflammation. First, the investigators propose to assess whether severe sepsis impairs the ability of platelets to release soluble CD40L (sCD40L), an powerful platelet-derived immunomodulatory molecule, in ICU patients with S. aureus documented infection, ICU patients with documented infection involving other bacterial species, compared to ICU patients with inflammation of noninfectious origin and healthy blood donors. Then, the investigators wish to assess whether the bacterial species affects the release of platelet sCD40L and by an extensive screening of platelet soluble factors, the investigators propose to set up profiles of inflammatory molecules associated with the type of infection. Finally, the investigators will analyze platelets' activation state and their association with circulating immune, according to the type of infection. Therefore, this project is expected to assess to which extent the platelet inflammatory function is super-activated in severe sepsis and to identify new platelet-related biomarkers of sepsis.
In the recent context of deinstitutionalization and longitudinal studies pointing to a large number of positive long-term outcommes for people affected by a psychiatric disorder (schizophrenia, bipolar disorder, eating disorder, severe personality disorder, etc.), the possibility of overcoming the consequences of a psychiatric pathology emerges as a solid fact. Therefore, the existence of this possibility calls for the identification of the determinants underlying of the various outcomes over time of those affected by a severe psychiatric disorder, in particular those likely to underpin the most positive developments. While it is well known from a medical point of view that certain dimensions affect the prognosis of persons affected by a severe psychiatric disorder (such as the persistence of negative symptoms or cognitive disorders in schizophrenic disorders), prognosis from a purely medical perspective (and putting aside the role of the person and his environment) seems to be able to account only for a modest proportion of the prognosis of people affected by a serious psychiatric disorder. It is this fact that has gradually led to the emergence of complementary models capable of enriching the understanding of the determinants of the future of people affected by a severe psychiatric disorder, in particular models inviting to separate "becoming of the person" from the " psychiatric disorder "to take into account the" personal role of the person "in his or her own healing. This perspective is the "recovery" perspective. Recovery process is defined as a personal trajectory which includes the person's experiences and the reactions of his / her environment following the installation of a psychiatric disorder, which can support a mode of release of the status of "psychiatric patient". Recovery thus implies an "approach underpinned by the understanding of the human response to pathology" (Noiseux) and, one might add, of its environment. However, while these studies point to a number of crucial dimensions involved in the recovery of a severe psychiatric disorder, one of the important limitations of these studies is the distance from any psychopathological consideration, thus setting aside the possibility of specific processes of recovery depending of the pathology. The identification of recurrent experiential logics specific to the various psychiatric disorders therefore appears to be an important field of investigation. It would potentially be able to guide the development of new therapeutic devices based on the recovery model.
Prospective, double-blind, randomized assessment of the efficacy, safety and pharmacokinetic of Aerucin® as adjunct treatment (in addition to standard of care antibiotics) for pneumonia caused by P. aeruginosa.
the aim is to study skeletal muscle metabolism alterations métaboliques associated with weight loss in women with ovarian and/or endometrial cancer according to BMI.
Pneumonia is the most frequent infection in critically ill patients and remains a significant challenge to intensivists world-wide due to persisting high mortality and morbidity. Compelling evidence suggests that appropriate antibiotic therapy remains the most important intervention to improve patients' outcome, including the administration of a suitable molecule at an optimized dosage regimen. A vast array of pathophysiological changes can occur in critically ill patients that can complicate antibiotic dosing. Knowledge of the pharmacokinetic and pharmacodynamic properties of the antibiotics used for the management of critically ill patients is essential for selecting the antibiotic dosing regimens, which will optimize patient outcomes. Changes in volume of distribution (Vd) and clearance (CL) of antibiotics have been noted in these patients, which may affect the antibiotic concentration at the target site. It follows that the pharmacodynamic parameters that determine antibiotic efficacy, which can vary between antibiotic classes, may also be affected. Optimization of these parameters is necessary to maximize the rate of response through patient recovery and minimized antibiotic resistance. In a multicenter observational study in critically ill patients with normal plasma renal indices at admission, about 65% of patients manifested augmented creatinine clearance on at least one occasion in the first seven study days. Augmented creatinine clearance may significantly impact drug pharmacokinetics for a variety of renally eliminated pharmaceuticals (such as low-molecular weight heparins, aminoglycosides, glycopeptides, and β-lactams), leading to subtherapeutic concentrations and potentially adverse clinical outcomes. Currently little data exist that describe the consequences of augmented creatinine clearance on antibiotics PK. Ceftaroline (600 mg bid) is a cephalosporin with expanded gram-positive activity, including MRSA and penicillin-resistant streptococcus, which was approved by the US Food and Drug Administration (FDA) on October 29, 2010 for the treatment of acute bacterial SSSIs and community-acquired bacterial pneumonia. Ceftaroline showed also good activity against some of the common gram-negative respiratory pathogens (eg, Haemophilus influenzae, Moraxella catarrhalis, Neisseria meningitidis, and Pasteurella multocida). However, it does not display clinically relevant activity against Pseudomonas aeruginosa, Stenotrophomonas maltophilia, or Acinetobacter baumannii. Ceftaroline also lacks activity against gram-negative organisms with extended-spectrum β-lactamases. Importantly, because ceftaroline appears to induce AmpC β-lactamases despite MIC values in susceptible range, ittheoretically should be avoided in gram-negative bacteria known to harbor inducible AmpC β-lactamases (eg, Serratia, Proteus, Citrobacter, Morganella, Enterobacter, Providencia, and P. aeruginosa). In patients, ceftaroline is given as a prodrug, ceftaroline fosamil. After intravenous administration, the prodrug is rapidly transformed by plasma phosphatase enzymes to its bioactive metabolite. The pharmacokinetics of ceftaroline has been evaluated in single and multiple dose studies in healthy volunteers, in subjects with various degrees of renal impairment and in healthy elderly subjects. The volume of distribution is equal to 20.3 L, which corresponds to extracellular fluid volume. The protein binding is low (20%). The main route of elimination is via renal excretion, with a clearance estimated to160 mL/min close to the creatinine clearance. The elimination half-live is 2.6 h in adults with normal renal function. Unfortunately, no PK study has been performed in infected critically ill patients with augmented creatinine clearance. The best PK-PD index predicting drug efficacy is %Time>CMI. A bacteriostatic effect is achieved when free drug concentrations exceed the MIC for 30 to 40% of the dose administration interval (30 to 40%T>MIC). Near maximum organism kill is achieved at 50 to 60%T>MIC (30%T>MIC for Staphylococcus aureus). This project aims to characterize ceftaroline PK in patients with early-onset pneumonia and augmented creatinine clearance. The choice of ceftaroline is justified by its spectrum suitable for micro-organisms commonly encountered in early onset pneumonia, including methicillin-resistant Staphylococcus aureus. Secondary main objective is to predict the probably of reaching PK-PD targets using Monte Carlo simulations under various scenario in order to identify optimal ceftaroline administration schemes in critical care patients with various degrees of renal impairment.
The purpose of this study is to evaluate the antiatherogenic and anti-inflammatory potential of an adequate intake of alpha-linolenic acid in elderly.
This is an exploratory, single-centre, investigator blinded, randomized, controlled, intra-individual study, involving subjects with psoriasis vulgaris. The objective is to evaluate, in a modified Dumas-Scholtz psoriasis mini-zone test, the safety and efficacy of CD10367 solution at 1% and 3% after a 3-week treatment period of once daily application.
When the kidneys are perfused on perfusion machines before transplantation, the resistance parameters as well as the histological score on the pre-implantation biopsy participate in the evaluation of the quality of the graft. The metabolomic profile of the infusion fluid could provide additional evidence.
A phase 2, multicenter, open-label, single arm clinical trial in adults with newly diagnosed aggressive high-risk DLBCL.