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Filter by:In 2019, the lack of studies about mental health of the detained population at retention centers in France is pointed out by the report of Controller-General for Places of Deprivation of Liberty. The aim of this study is to contribute to this relatively untouched field by describing which psychiatric pathologies are encountered in this population who went through migration and retention. Having a clearer picture of the situation can help to provide a more adapted psychiatric care in retention centers. The results are expected to show a higher rate of psychiatric disease than in the general population including addiction to substance, anxiety disorder and post-traumatic stress disorder (PTSD).
Hypertrophic Obstructive cardiomyopathy (HOCM) is the most common genetic cardiomyopathy, heterogeneous in phenotype and clinical course. The genotype-phenotype relationship and associated molecular mechanisms are still incompletely understood. In the HOCM milieu, increased energy cost of force production, impairing performance and mitochondrial function, may be associated to patients' genotype and/or phenotype
Iron demand: The average daily demand to fit the cell biological metabolism is balanced between intake and lost which about 1-2 mg.
Iron demand: The average daily demand to fit the cell biological metabolism is balanced between intake and lost which about 1-2 mg.
This clinical trial aims to investigate the efficacy of Calcipotriol ointment combined with 5-fluorouracil cream as an immunotherapy for actinic keratosis in Organ Transplant Recipients (OTRs) before transplantation and determine whether it can prevent cutaneous squamous cell carcinoma (SCC) in OTRs post-transplant.
Evaluate the role of color Doppler ultrasonography (CDUS) in detection of active sacroiliitis in Ankylosing Spondylitis patients using MRI of the sacroiliac joints as a gold standard. Evaluate the relation of active sacroiliitis detected by color Doppler ultrasonography (CDUS) with disese activity in patients with ankylosing spondylitis
Patients with Chronic Kidney Disease (CKD) have impaired psycho-cognitive functions in parallel with deteriorating kidney function. The pathophysiology of cognitive impairment in CKD is poorly understood and there is currently no therapy to limit cognitive decline. As kidney function deteriorates, uremic toxins accumulate in the patient's body. Their cerebral toxicity, whether direct or indirect through cerebral endothelial dysfunction, is a hypothesis that may explain the cognitive abnormalities, as well as the increased severity of strokes in patients with CKD. Among uremic toxins, indoxyl sulfate (IS) is an indolic toxin that is poorly purified by dialysis and whose high levels have already been shown to be associated with an increased cardiovascular risk in patients with CKD. Our hypothesis is that the psycho-cognitive disorders observed in patients with CKD are linked to cerebral endothelial dysfunction associated with high levels of IS. In two models of CKD in rats, found impaired cognitive performance and increased blood-brain barrier (BBB) permeability, as assessed by brain scintigraphy with 99mTc-DTPA, compared to healthy control rats. Impaired cognitive performance was correlated with BBB permeability and circulating IS levels. Rats receiving an IS-enriched diet had higher BBB permeability and more impaired cognitive performance than MRC rats without an IS-enriched diet, suggesting a central role of IS. The 99mTc-DTPA brain scintigraphy has already been used in clinical research to assess the BBB disruption after stroke, outside the context of CKD, and the tracer is available in human nuclear medicine. Our hypothesis is that patients with CKD would have increased permeability of the BBB compared to healthy age- and sex-matched controls, and that this permeability would correlate with circulating levels of IS as in our preclinical animal models. The main objective of this project is to evaluate the permeability of the BBB by brain scintigraphy with 99mTc-DTPA in patients with end-stage CKD and compare it to healthy age- and sex-matched controls. A 18-month inclusion period will allow us to recruit 15 patients with end-stage CKD and 15 healthy volunteers matched in age and gender, as an important number of patients with end-stage CKD are followed in our department. If we confirm the results obtained in animal models, we will be able to propose the analysis of BBB disruption in isotope imaging as a criterion for evaluating therapeutic approaches modulating the toxicity of indolic uremic toxins in order to limit cognitive decline.
Upper Gastrointestinal (UGI) symptoms are among the commonest complaints for which patients seek medical attention, with the annual prevalence of dyspepsia approximating 25% . Endoscopy holds an important place in the diagnosis of UGI conditions by enabling visualization, photography, ultrasonography, and biopsying of suspicious lesions . It gives a better diagnostic yield over radiology particularly in the investigation of upper gastrointestinal bleeding, inflammatory conditions of the upper gastro-intestinal track like esophagitis, gastritis and duodenitis as well as the diagnosis of Mallory Weiss tears and vascular malformations .Dyspepsia in the absence of any other symptom was the indication for UGIE in the vast majority of patients. Close to 80% of our patients presented with dyspepsia not associated with any other symptom and in 50% of the patients the endoscopic findings were normal [4]. Other common reasons for UGIE were GERD symptoms, recurrent vomiting, dyspepsia associated with weight loss and patients with symptoms of UGI bleeding . Gastritis was the most frequent endoscopic finding in our patients, followed by duodenitis .Gastric ulcer was diagnosed more frequently than duodenal ulcers . Taking a biopsy is very helpful in diagnosis in our study. H. pylori colonization of the gut is the main cause of chronic gastritis and the principal etiological agent of gastric cancer and peptic ulcer disease . Gastric cancer was diagnosed, by endoscopy, about eight times more frequently in patients presenting with an alarm symptom like recurrent vomiting, dyspepsia together with weight loss or UGI bleeding .
To assess the prevalance of non_alcoholic fatty liver diseases in inflammatory bowel disease patients and its relation to type of treatment given and disease severity
Since the end of 2018, the Care and Orientation Center (CASO)of Marseille corridnated by Medecins du Monde has been investigated an innovative program aimed at direct referrals to primary care for vulnerable and precarious population with access barriers to healthcare system (no being coveraged at time of the study). Patients consulting at the CASO MDM in Marseille are accompanied and were received, free of charge, by primary care professionals (general practitioners, specialists, pharmacy, analysis laboratory, etc). This is an observational, comparative study, with two arms: the CASO MDM in Marseille for the intervention site and the CASO MDM in Bordeaux for the control site (where the innovative program does not exist). A total of 610 patients will be included (305 in the innovative group / 305 in the control group). The main objective is to evaluate the effectiveness of the innovative programm (PASS de ville) compared to the standard of care by assessing the rate of emergency departement visits at one year in each group. Duration of inclusion: 12 months; Duration of follow-up: 18 months; Total duration of the study: 36 months. Both quantitative and qualitative analyses will be conducted to address overall outcomes. Univariate and multivariate analyzes will be performed on the primary outcome as well as the secondary outcomes in order to highlight significant differences between the two groups and to identify predictive factors for improved effectiveness. The analysis will be conducted in accordance with Good Epidemiological Practices, and the final report will be written according to the CONSORT (Consolidated Standards of Reporting Trials) recommendations. An intention to treat analysis will be conducted.