Combs La Ville, France

Origin and Function of Eosinophilic Polynuclear During DRESS Syndrome

A Trial COmparing staNdard of Care Versus Treat to Target With telemonitoRing and Patient Education in Patients With Ulcerative cOlitis Initiating Adalimumab

NUMBER OF PATIENTS : 238 patients in 20 sites in France RECRUITMENT PERIOD : The trial duration for each patient will be 144 weeks MAIN ENDPOINT : At week 48 success defined by: Endoscopic remission defined by an endoscopic Mayo score 0 SECONDARY ENDPOINTS: At W48 - Clinical remission (Clinical remission is defined as a total Mayo score ≤2 points, with no individual sub score >1, and a Mayo endoscopy sub score of 0 or 1) - Remission without steroids - Endoscopic healing rate with Mayo score 0 or 1 - UCEIS score - Histological healing (Nancy score) - Remission rate and remission rate without steroids at study visits and W48 - Quality of life evolution (evaluate visit W0 vs W14, W26, W38 and W48) - Patients satisfaction - Continuous response - Safety and tolerability - Anti-TNF pharmacokinetics - Number of visits in trial - Number of UC related hospitalizations - Number of colectomies - Treatment compliance (questionnaire) - Patient adhesion (questionnaire) - Medico-economic analysis

A Study in Participants With Major Depressive Disorder (MDD) With Anhedonia and Inadequate Response to Current Antidepressant Therapy Including a Selective Serotonin Reuptake Inhibitor (SSRI) or Serotonin Norepinephrine Reuptake Inhibitor (SNRI)

ZNN Bactiguard Cephalomedullary Nails PMCF Study

This study is a multicentre, prospective, post-market clinical follow-up study on the Zimmer Natural Nail (ZNN) Bactiguard Cephalomedullary Nails. The primary endpoint for this study is the assessment of performance by analyzing fracture/osteotomy healing within 12 months after fracture fixation. Radiological fracture healing is defined as bridging callus on at least three of the four cortices on the AP and lateral radiographs and clinically as full weight-bearing without pain. The secondary endpoint is the assessment of safety, clinical benefit, and postop fracture-related infection (FRI). Safety will be evaluated by recording and analyzing the incidence and frequency of complications and adverse events. Relation of the events to implant, instrumentation and/or procedure should be specified. Clinical benefit will be assessed by recording patient-reported outcome measures (PROMs). FRIs will be classified according to the updated diagnostic algorithm defined by the FRI Consensus Group. Data will be collected at 6 weeks, 3 months, 6 months and 1 year after fracture fixation. The study will enroll patients implanted with the Zimmer Natural Nail Bactiguard Cephalomedullary Nail according to the approved/cleared indications. The sample size for this study is 150 study cases, and up to 10 sites in EMEA will participate.

Predictability of the Clinical Global Impression Scale (CGI) in Post Immediate in Psychotraumatic Impact

A functional unit of Urgent Medical Aid Service (SAMU), Medical-psychological emergency cell (CUMP) is an emergency medical device and provides immediate and post-immediate medico-psychological care for mentally injured people in psychotraumatic situations. CUMP also ensures immediate post follow-up of these patients, as well as departmental organization of psychotrauma consultation. During the course of the treatment, victims are oriented, with a telephone callback which can be decided, allowing a remote reassessment of any psychotraumatic sequelae of the event. This phone reminder is part of routine practice following a CUMP intervention. The objective is then early detection of sequelae allowing rapid orientation on specific care pathways, in particular on the consultation of psychotrauma. Post-traumatic stress disorder is a syndromic entity reactive to experience of a traumatogenic event (defined by the brutal, sudden and unexpected confrontation with death, or the loss of physical or psychological integrity), bringing together intrusive symptoms of reliving, behavioral avoidance of stimuli related to the traumatic event, persistent negative alterations in cognitions and mood, and neurovegetative hyperactivity, causing clinically significant distress and impaired the usual functioning of the subject. Experiencing a psychotraumatic event in one's life is a frequent experience. Epidemiological data show a lifetime prevalence of around 30%. During and/or in the hours following a psychotraumatic event, people experience psychological, physiological and emotional upheavals called peritraumatic distress. Although most people recover on their own, a portion (8.3%) develop post-traumatic stress disorder. However, one of the main characteristics of post-traumatic stress disorder is the presence of avoidance symptoms. Avoidance can take different forms such as non-confrontation with all the evocative clues of the traumatic event such as places, people and situations related to the traumatic event, but also the avoidance of thoughts, memories, conversations related to the traumatic event. This avoidance of thoughts and conversations can be a barrier to entry into trauma-focused psychotherapy. Indeed, talking about the traumatic event goes against this avoidance. A proactive approach at a distance from the event to re-evaluate the symptomatology of the people involved and thus propose an orientation towards specialized care in the field of psychotrauma in order to counter avoidance would seem entirely relevant. Indeed, studies show the interest of a telephone follow-up by the Medical-Psychological Unit 15 days before an emergency repatriation of French people during the Lebanon war in 2016. On the one hand, remote telephone reminder of event is experienced positively by the people involved in the event and was able to highlight the presence of post-traumatic stress symptoms in 23% of cases. On the other hand, 56% of people were able to be referred to appropriate medio-psychological care following this telephone interview. However, depending on the situation, all of the subjects involved in a psychotraumatic event cannot be reassessed, especially when event involves too many people. On the other hand, a significant proportion of subjects will not present psychotraumatic sequelae. Under these conditions, it seems appropriate to be able to define the proportion of psychotraumatized subjects most at risk of developing post-traumatic stress disorder (PTSD). Data from literature find that a high level of peritraumatic distress is largely associated with severity of post-traumatic stress symptoms . Thus, peritraumatic distress reactions would be a good indicator of risk of developing a subsequent post-traumatic stress disorder. Several questionnaires exist to assess this peritraumatic distress. However, in a disaster situation and in view of the large number of victims potentially involved, it may be interesting to use a rapid and global assessment tool. To do this, the severity item of the global clinical impression scale would respond to this clinical reality. Research hypothesis Hypothesis is that the severity item of the global clinical impression scale evaluated immediately after in a subject who has experienced a psychotraumatic event is a predictor of post-traumatic stress symptoms at 1 month and 6 months. Investigators expect a correlation between the scores of the PDI and the severity item of the global clinical impression while controlling the socio-demographic characteristics of the worker as well as his clinical experience. Patients included will have similar profiles and will be confronted with the same type of traumatic event. Brief Protocol - Inclusion visit : psychiatric assessment, socio-demographic data, questionnaire (CGI and Peritraumatic Distress Inventory scale(PDI)) - Follow-up visit: M1 and M6 : phone call (Post traumatic stress disorder Checklist Scale questionnaire (PCL 5), Mini International Neuropsychiatric Interview (MINI) : major depressive episod, alcohol consumption disorder, substance-related disorder (non-alcoholic). Expected results Investigators expect this work to confirm the prediction between the initial score on the CGI and the score at M1 and M6 on the PCL5. This result will make it possible to define an initial threshold for the CGI allowing the occurrence of a constituted post-traumatic stress disorder to be predicted, defined by a score greater than or equal to 33 on the PCL5. The objective is to set up a systematic recall protocol for subjects presenting with a state of acute stress for which an initial CGI score will be higher than the determined threshold, in order to be able, depending on the subsequent symptomatology, to offer early management. and focus of post traumatic stress disorder. This reminder protocol will be integrated into routine practices and deployed on the emergency reception service of Hospital.

Diagnostic Accuracy of the "LLIFT", a Novel Non-invasive Biomarker for the Diagnosis of Non Alcoholic Fatty Liver (NAFL) and SteatoHepatitis (NASH) in a Population With High Risk of Metabolic Syndrome"

Oral Switch During Treatment of Left-sided Endocarditis Due to Multi-susceptible Staphylococcus

The RODEO 1 study is designed to determine the safety and efficacy of partial oral treatment of IE compared with traditional full-length parenteral treatment. Our primary objective is to demonstrate that in patients with left-sided multi-susceptible Staphylococcus who have received at least 10 days of IV antibiotic treatment with or without valvular surgery, a switch to an oral combination of rifampicin and fluoroquinolones between Day 10 and Day 28 after initiation of the IV antibiotic treatment, is not inferior to the continuation of the conventional IV antibiotic treatment regarding to treatment failure within 3 months after the end of antibiotic treatment. Nationwide, noninferiority, multicenter, randomized, controlled, open-label trials. Randomisation will only be offered to patients who have received at least 10 days of IV conventional antibiotic treatment of IE, and fulfil the inclusion criteria. Randomisation will take place between Day 10 and Day 28 after initiation of parenteral antibiotic therapy or valvular surgery, thus ensuring to have at least 14 days of oral therapy in the experimental group. Patients will be eligible whether they have undergone valvular surgery or not. This will imply that surgery procedure prior to randomisation will be heterogeneous, but randomisation will be stratified on the requirement of valvular surgery as part of the treatment of the current episode of IE or not.

Oral Switch During Treatment of Left-sided Endocarditis Due to Multi-susceptible Streptococcus

The RODEO 2 study is designed to determine the safety and efficacy of partial oral treatment of IE compared with traditional full-length parenteral treatment. Our primary objective is to demonstrate that in patients with left-sided multi-susceptible Streptococcus-Enterococcus IE who have received at least 10 days of IV antibiotic treatment with or without valvular surgery, a switch to an oral combination of amoxicillin between Day 10 and Day 28 after initiation of the IV antibiotic treatment, is not inferior to the continuation of the conventional IV antibiotic treatment regarding to treatment failure within 3 months after the end of antibiotic treatment. Nationwide, noninferiority, multicenter, randomized, controlled, open-label trials. Randomisation will only be offered to patients who have received at least 10 days of IV conventional antibiotic treatment of IE, and fulfil the inclusion criteria. Randomisation will take place between Day 10 and Day 28 after initiation of parenteral antibiotic therapy or valvular surgery, thus ensuring to have at least 14 days of oral therapy in the experimental group. Patients will be eligible whether they have undergone valvular surgery or not. This will imply that surgery procedure prior to randomisation will be heterogeneous, but randomisation will be stratified on the requirement of valvular surgery as part of the treatment of the current episode of IE or not.

Frequency of Hemorrhages Associated With the Functional Anomalies of Willebrand Factor in Emergency Patients

Utility of Sodium Lactate Infusion During Septic Shock

ULIS-1 consists in three arms of treatment during the first 24hrs of septic shock treatment. - normal saline - sodium lactate 2.5ml/kg in 60min then - either 0.25 or 0.5ml/kg/h during 24hrs Main criteria is fluid balance at 48hrs