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.
Paralysis of the recurrent (or inferior) laryngeal nerve (RLN or ILN) is one of the most common and most serious complications of thyroid surgery. Neuromonitoring of the inferior laryngeal nerve (ILN or recurrent) is a technique currently used during thyroidectomy to locate ILN during dissection. Detector electrodes are placed in contact with vocal muscle which is stimulated electrically at the location of ILN, producing an acoustic and visual signal. This is a basic electromyographic technique whose diagnostic and prognostic potential for the entire neuromuscular system has not yet been fully explored. The study of action potentials generated by the stimulation-detection of nerves ILN and vagal nerves at the beginning and end of dissection, notably the decrease in amplitude, could allow a diagnosis during the course of surgery making it possible to diagnose lesions of the nerve and guide the surgeon in his surgical decisions, thus avoiding the risk of bilateral recurrent paralysis. It could also enable the surgeon to give a prognosis for functional recovery.
Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death. Although there are several causes of fatal anaphylaxis, food allergy is one of the most common. Epinephrine is recommended as the initial treatment of choice for anaphylaxis. A delay in epinephrine administration may contribute to an increased risk of death. Therefore, the World Allergy Organization recommends that, for the treatment of anaphylaxis, epinephrine solution be administered intramuscularly in the mid-anterolateral thigh. In France 3 auto-injector pens are available: Anapen®, Epipen® and Jext®. For weight> 30 kg, the devices have a needle size respectively of 7.49 mm, 15.02 mm and 15.36 mm. For the weights between 15 and 30 kg needle size is 7.49 mm to 12.7 mm and Anapen® for Epipen® and Jext®. Several studies suggest that the needle length needle is sometim
The main objective of this study is to determine the capacity of a questionnaire to predict a normal balance sheet of haemostasis.
Three groups of patients will be considered: a control group (n = 10); a group of patients with paroxysmal or persistent AF with AF cryoablation procedure - within this group, MRI will replace CT-scan usually performed in routine before the procedure (n = 15); a group of patients with permanent AF (n = 15). MRI study will include pulmonary veins angiography with gadolinium injection (0.20 mmol/kg), 2D-cine imaging and late-enhancement imaging. A 3D gradient-echo sequence(Flash 3-D) will then be applied 20 minutes after the injection, with the following parameters : echo time 0.98 ms, repetition time 2.53 ms, angle 15°, resolution 2.0x1.3x1.0 mm. T1 map and two T2 sequences will be performed so as to determine LA relaxation times. Argus software will be used for post-treatment imaging. Quantitative data will be expressed in mean ± SD. A comparison of T1 and T2 values in LA will be performed between the three groups. Statistics will be performed with SPSS software in bilateral analysis and a value of p < 0.05 will be considered as significant.
The spinal cord is a common site for the development of several neurodegenerative neurological disorders (spinal muscular atrophy or SMA, amyotrophic lateral sclerosis or ALS, X-linked spinal bulbar muscular atrophy or SBMA). In different proportions, these diseases involve axonal loss in large funiculi of the spinal white matter, their demyelination, and loss of ventral horn motor neurons or motoneurones of the spinal gray matter. The lack of specific biomarkers of these macro and microscopic spinal damages, makes it difficult the differential diagnosis and monitoring of these diseases. Techniques to explore non-invasively the human central nervous system, such as magnetic resonance imaging (MRI) and electrophysiology, are potential tools to extract specific biomarkers of spinal damages. However, imaging techniques are still poorly developed at spinal level for technical (specific antennas), anatomical (size of the spinal cord, vertebrae) and physiological reasons (cardio-respiratory movements). However, recent advances in the field of spinal cord imaging allowed to extract quantitative data on neuron loss, axonal degeneration and demyelination in different spinal pathologies whether degenerative (ALS or SMA) or traumatic (SCI). Correlations were found with clinical data, and in ALS patients, the changes in MRI metrics over time paralleled the functional deterioration. The electrophysiological techniques are used since a long time, leading to a good knowledge of the neurophysiology of human spinal cord. In addition, electrophysiology indirectly provides data at a microscopic scale, providing information on the excitability of spinal neural networks and giving an estimate of the amount of functional neurons. By combining these techniques for the investigation of human spinal cord in vivo, the goal is to extract new biomarkers using as study models, diseases of the spinal cord affecting differentially the white and the gray matter (SMA, SBMA and ALS). At first, new methods of diffusion MRI and modelling will be performed in healthy subjects to assess the axonal density and diameter of the fibers in the white matter. The anatomical imaging T2 will measure the geometrical parameters of the spinal cord such as its surface and/or volume at a given vertebral level. Thanks to imaging, we will construct via methods of segmentation and image processing, an atlas of the spinal cord that will allow to locate spatially spinal atrophy in patients. After this phase of validation, A study of patients will be conducted using these new MRI techniques, in addition to those already developed in the laboratory. The contribution of electrophysiology will be to assess more accurately the microscopic damage. Quantitative data from imaging and electrophysiology will be correlated with clinical data in order to extract the most relevant biomarkers. This project has thus a methodological interest by proposing the development of new methods to assess the human spinal cord, at both macro and microscopic levels. These methods are based on the development of the techniques developed at spinal level and which are already applicable to human pathologies. The original combination of imaging and electrophysiology will also enable us to further analyze the human spinal cord, both anatomically and functionally. This project has an important clinical value for the extraction of biomarkers in diseases where there is an unmet need for diagnosis, monitoring, prognosis and evaluation of new therapies.
Abatacept disrupts T-cell coactivation signals in rheumatoid arthritis (RA). Its potential effects on B cells are not well described. This study will assess the effects of abatacept therapy on the phenotype and function of peripheral blood B cells in patients with RA.
The advantages of the celioscopy mini--trocar and monotrocar technical are recognized. There is however no forward-looking or retrospective study comparing the microcomputed-celioscopy (use of microphone) - trocar of 3mm of diameter in access celioscopic pluri--trocar) in the celioscopy monotrocar ( a single intra-umbilical section) in gynecological surgery. The objective of this preliminary study is to compare both surgical care in terms of morbidity died operating, in adnexa surgeries.
The strong relationship between falling and severity of cognitive impairment in the elderly is well established. The association premorbid gait and executive disorders suggests that they are under tension by the same mechanisms. The gait fortiori neurological are fall risk factors. Dysfunctions underlying disorders as Parkinson called march executive disorders are subcortical origin involving so the basal ganglia. This study is indeed based on the assumption that the dysfunction of the basal ganglia as observed in parkinsonian syndromes resulting in disorders of posture and walking, by dysexecutive syndrome, anxiety and the contrast vision disorders. These gait exposed to falls and dysexecutive these disorders with cognitive impairment and greater susceptibility to confusional states. The executive disorders, gait disorders, anxiety, disturbances of vision and especially saccadic eye movements, impaired vision contrasts are well established in the degenerative parkinsonian syndromes. This study proposes a new approach to assessing gait disorders to define a high risk of falling in the presence of parkinsonian walking in the elderly over 75 years.
The main objective of this study is to clarify prospectively prognosis of patients newly diagnosed as carriers of a LVNC (incident cases) (i.e. without the occurrence of a survival of the following events: death, heart transplantation or hospitalization for cardiovascular complications). In a second time, prognosis factors will be identify in these patients with LVNC.
Pain is a common symptom of Parkinson's disease (PD) but the physiology remains poorly understood. Recent work suggests that subthalamic nucleus deep brain stimulation (STN-DBS) could make a profit on the pain in PD. The investigator would drive a study with a follow up of PD patients before and after STN-DBS. The pain will be clinically explored by targeted questionnaires and electrophysiological through laser evoked potentials. The questionnaires are designed to quantify and characterize the pain in these patients. Laser evoked potentials will, through repetitive stimulation, study both the functional status of the afferent nociceptive pathways, their habituation to repetitive nociceptive stimuli, and so better understand any abnormalities of the central processing of nociceptive information.