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.
Eclectic is a strategy trial; once the class of treatment (endocrine therapy or chemotherapy) has been allocated according to 16α-18F-fluoro-17β-oestradiol (18F-FES) Positron Emission Tomography/Computed Tomography (PET/CT) results and circulating tumor biomarkers, clinicians will decide which treatment to use.
Objectives: The main drawback of the hook-wire technique for locating ground glass nodules before video assisted thoracoscopic surgery (VATS) resection is the risk of the hook dislodging during single lung ventilation as the lung collapses. In order to reduce the friction of the thread in the wall, the investigators modified the technique by first positioning a catheter in the chest wall and introducing the carrying needle through the catheter. The objective was to evaluate the success rate and complications of this technique. Material and Methods : the investigators retrospectively included all patients undergoing VATS resection of solitary lung nodules after localization using the sliding wire technique.
Lower limb trauma requiring immobilization is a very frequent condition that is associated with an increased risk of developing venous thromboembolism (VTE). The TRiP(cast) score has been developed to provide individual VTE risk stratification and help in thromboprophylactic anticoagulation decision. The recent CASTING study had confirmed that patients with a TRiP(cast) score <7 have a very low risk of VTE and could be safely manage without prophylactic treatment. Conversely, patients with a score ≥ 7 have a high-risk of VTE and require a prophylactic anticoagulant treatment. Low molecular weight heparins (LMWH) have been shown to be effective in this indication. However, in the CASTING study, the 3-month symptomatic VTE rate was 2.6% in this subgroup despite LMWH prophylactic treatment. This result suggests that LMWH are not sufficiently effective in this particular subgroup of high-risk patients. Direct oral anticoagulants, and in particular rivaroxaban, may be an effective and safe alternative to LMWH. In the PRONOMOS study, comparing LMWH with rivaroxaban in patients who had undergone non-major lower limb surgery, the relative risk of symptomatic VTE was 0.25 (95% CI = 0.09 - 0.75) in favor of rivaroxaban 10mg. No significant increase in bleeding was found. In addition, as LMWH treatment requires subcutaneous daily injections, the use of rivaroxaban may positively impact patients' quality of life as well as being effective in medico-economic terms. The aims of this study are to demonstrate that rivaroxaban is at least as effective, easier to use and more efficient than LMWH in patients with trauma to the lower limb requiring immobilisation and deemed to be at risk of venous thromboembolism (TRiP(cast) score ≥ 7). High-risk patients are randomized to receive either rivaroxaban or LMWH. They are followed up at 45 days and 90 days to assess the occurrence of thrombotic events or bleeding, as well as their satisfaction with the treatment received.
Solid cancers and their therapeutic management remain a major public health problem due to their increasing prevalence and associated mortality. Among solid cancers, lung cancer ranks 4th among incident cancers. The prognosis remains poor, 33,117 deaths were recorded in France in 2018. Two histological forms of bronchopulmonary cancer are distinguished: non-small cell lung cancers (NSCLC), which represent 85% of bronchopulmonary cancer, and small cell lung cancers. The most common forms of NSCLC are adenocarcinoma, squamous cell carcinoma and large cell carcinoma. The emergence of new so-called targeted therapies has considerably modified the management and prognosis of oncology patients and in particular of patients with NSCLC. These new molecules were developed following the molecular characterization of tumors on the one hand and on the other hand the characterization of the role of immunity in anti-tumor defense, particularly the Programmed Death receptor pathway 1 (PD-1). Blocking this pathway restores the anti-tumor potential of these lymphocytes. Pembrolizumab is a humanized monoclonal antibody that binds to the PD-1 receptor and blocks its interaction with the Programmed Death Ligand-1 (PDL1) and Programmed Death Ligand-2 (PDL2), expressed by tumor cells but also by cells in the microenvironment. tumor and by antigen-presenting cells. Pembrolizumab thus potentiates T cell responses, including anti-tumor responses, by blocking the binding of PD-1 with PDL1 and PDL2. Pembrolizumab currently has marketing authorization (MA) for the treatment of NSCLC. Despite therapeutic progress due, among other things, to the emergence of anti-PD-1 antibodies including pembrolizumab, the prognosis of NSCLC remains poor and the use of pembrolizumab is sometimes limited by the occurrence of adverse effects. The pharmacokinetics of pembrolizumab was studied pre-marketing in patients with melanoma, NSCLC or metastatic or unresectable carcinomas. However, there are no data relating to the pharmacokinetic (PK) / clinical response (pharmacodynamic / PD) relationship of pembrolizumab, in real life. No prospective pharmacological study has in fact been published to date, especially in patients treated as part of the management of NSCLC. The absence of such studies - in real life - constitutes a pitfall given the existence of a possible association between PK data and the clinical response and/or toxicity of pembrolizumab.
The purpose of the study is to determine the correlation between the diagnosis of Superficial endometriosis by the 3DT1 sequence on Magnetic resonance imaging and the histology obtained by laparoscopy.
Musculoskeletal disorders (MSDs) of the limbs and spine are painful conditions of the periarticular soft tissues (muscles, tendons, vessels, etc.) and peripheral nerves secondary to overuse of occupational origin. They can manifest as pain (the most common symptom), discomfort, stiffness, loss of precision in movements or loss of strength. The lumbar spine and upper limbs are the parts of the body most frequently affected by MSDs. MSDs have a multifactorial origin that can be separated into 2 categories: factors linked to the individual (age, sex, medical history) and factors linked to the work environment (biomechanical constraints, work organization, psychosocial risks). MSDs are the leading cause of compensated occupational illnesses in France (86% of occupational illnesses in 2021, according to the Health Insurance annual report), particularly in the agricultural sector to which the majority of professions in green spaces belong. . If, in the Grand Est of France, the prevalence of employees exposed to physical risks decreased in the majority of sectors of activity between 1994 and 2017, we note at the same time a slight increase in the prevalence in the agricultural sector over this period. same period (6% in 2017 compared to 3.7% in 1994, SUMER 2017 survey). Concerning the current context in France, the green spaces sector has undergone changes in recent years following the national implementation of the Ecophyto plan in 2008 (updated in 2015 then in 2018). This plan, the latest version of which is called Ecophyto 2+, aims to reduce the use of plant protection products by 50% by 2025. At the same time, the use of plant protection products for the maintenance of green spaces, forests, roads and walks have been prohibited by the Labbé law since January 1, 2017. In this context, and given the absence of recent data from the literature on this subject in France, the investigator wishes to carry out an inventory recent physical and organizational constraints, as well as the prevalence of MSDs, in the green space sector (targeting more particularly in its study the green spaces of the Territorial Civil Service of the Grand Est)
Idiopathic scoliosis surgery is a major surgery, causing significant post-operative pain which can have a significant impact, both for the patient and for society. Different analgesic strategies have emerged in recent years, within the framework of multimodal analgesia including systemic analgesics, but also axial or peripheral loco-regional anesthesia (LRA). These techniques are integrated into the recommendations of learned societies, aimed at optimizing the post-operative rehabilitation of patients. If intrathecal morphine injection (ITM) and spinal erector block (ESPB) have already shown their effectiveness in reducing postoperative pain, the combination of these techniques can have a real benefit in major spinal surgery. , and has not yet been studied.
The health of women who use drugs is a real public health issue where the midwife has an important role to play in the multidisciplinary support of the Center for Care, Support and Prevention in Addictology (CSAPA). The main objective is to identify the needs and expectations of the women received in terms of reducing risks and damage at the gynecological and obstetric level.
To date, studies have been carried out on emergency department revisits but most are studies carried out in Anglo-Saxon territories. The studies carried out in France, for their part, concern the elderly geriatric population, or populations with specific pathologies such as child psychiatrists or patients with acute heart failure, but not the general adult population. Nevertheless, these studies have shown that knowledge of the risk factors for early readmission of a patient makes it possible to carry out targeted prevention actions in order to reduce this early recourse rate. However, in a context of increasing emergency flow and increasing tension in the field with limited healthcare resources, returning home and outpatient care are increasingly favored. However, these strategies only make sense if outpatient follow-up is organized when early reconsultation is possible for certain indications that remain to be determined. In this context, it would be interesting to have information on the reasons for which patients return to the emergency room early after initial treatment. This would indeed make it possible to consider carrying out preventive actions in the long term in order to reduce this revisit rate on the one hand and on the other hand to identify the signs of seriousness which should bring the patient back to the emergency room as soon as possible.
With over 4 million people living with diabetes in France, i.e. 6% of the general population, it is necessary to consider both their physical and mental health. Indeed, recent studies have shown that with a good quality of life, patients have better disease management, improved physical health and social life, and reduced anxiety and depressive symptoms. Quality of life is at the heart of this research project. In order to improve it, several psychotherapies can be used, notably those that include mindfulness. Of all those proposed in the literature, Acceptance and Commitment Therapy (ACT), developed by Hayes, appears to be ideally suited to this objective. The aim of this psychotherapy is to improve the patient's psychological flexibility. According to the scientific literature, ACT therapy has been shown to improve the quality of life of patients living with diabetes, as well as their ability to manage their condition and reduce anxiety and depressive symptoms. This research project aims to: 1. To help patients cope better with their illness through learning the different dimensions of ACT therapy in order to obtain a toolbox to use on a daily basis, when necessary. 2. To offer professionals alternatives to the traditional care of diabetic patients with the toolbox cited above. 3. To enable health authorities to take advantage of this program and these different exercises to reduce complications in the medium and long term for people with diabetes and change health behaviors. In 2020, the French Diabetics Federation created the "Slow Diabetes" movement. The initial objective of which was to help people with diabetes to better cope with their isolation linked to the Covid-19 pandemic. Since its launch, this movement has taken the form of several programs lasting three or six weeks and developed to improve the general well-being of people with diabetes. The research proposed here seeks to improve the quality of life of diabetic patients through online ACT therapy, based on the "Slow Diabetes" model.