222 results match your criteria: "French Clinical Research Infrastructure Network[Affiliation]"

Introduction: The project, funded by the Agence Nationale de la Recherche, aims to evaluate the long-term outcomes of patients with oesophageal atresia (OA) between 13 and 14 years old and establish multiomics profiles using data from the world's biggest OA registry.

Methods And Analysis: is a national multicentre population-based cohort study recruiting participants from all qualified French centres for OA surgery at birth. The primary objective is to assess the prevalence of gastro-oesophageal reflux disease in adolescence among patients with OA, with several secondary objectives including the identification of risk factors and multiomic profiles from oesophageal biopsies and blood samples collected between 13 and 14 years old, compared with a control group.

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Background: Several methods for measuring IMR derived from angiography have been developed. AngioIMR is a novel method for the assessment of angiography-derived IMR with no requirement for a wire and hyperemia. The prognostic value of AngioIMR is unknown in STEMI patients.

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Mineralocorticoid Receptor and Sleep Quality in Chronic Kidney Disease.

Int J Mol Sci

November 2024

Unidad de Excelencia Instituto de Biología y Genética Molecular (IBGM), Universidad de Valladolid-CSIC, 47003 Valladolid, Spain.

The classical function of the mineralocorticoid receptor (MR) is to maintain electrolytic homeostasis and control extracellular volume and blood pressure. The MR is expressed in the central nervous system (CNS) and is involved in the regulation of the hypothalamic-pituitary-adrenal (HPA) axis as well as sleep physiology, playing a role in the non-rapid eye movement (NREM) phase of sleep. Some patients with psychiatric disorders have very poor sleep quality, and a relationship between MR dysregulation and this disorder has been found in them.

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Article Synopsis
  • Most patients with acute ischemic stroke and large vessel occlusion are initially evaluated at non-thrombectomy centers before being transferred to specialized facilities for treatment, leading to potential delays and worse outcomes.
  • The review highlights that changes in clinical and radiological status during transfers vary among patients and can affect their recovery, emphasizing the need for better care during this critical time.
  • It also explores potential strategies, like penumbral protection, to minimize damage during transfer and outlines important factors to consider when designing clinical trials aimed at improving patient outcomes.
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  • * Of the women surveyed, 63% responded, revealing a postpartum depression prevalence of 16.4% when using a specific scoring scale (EPDS score of 13 or higher), which rose to 23.1% with a slightly lower cutoff (score of 11 or higher).
  • * Key risk factors identified included younger maternal age and being born in a non-European country, highlighting the need for tailored support and interventions for at-risk populations after cesarean delivery.
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Aims: Biomarkers associated with asymptomatic ventricular dysfunction might improve risk stratification and identify pathways leading to heart failure (HF). We explored the association between proteomic biomarkers and left ventricular hypertrophy (LVH), diastolic dysfunction (DD) and incident HF in three population-based cohorts.

Methods And Results: A chip was used to measure 92 protein biomarkers in blood samples from >1500 Malmö Preventive Project (MPP) participants, of whom 514 had LVH (34%), 462 had DD (32.

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Background: Cognitive impairment is common in patients with heart failure and preserved ejection fraction but its clinical correlates and prognostic associations are poorly understood.

Methods: We analyzed cognitive function, using the Mini-Mental State Examination (MMSE), in patients with heart failure and preserved ejection fraction enrolled in a prespecified substudy of the PARAGON-HF trial (Prospective Comparison of Angiotensin Receptor Neprilysin Inhibitor With Angiotensin Receptor Blocker Global Outcomes in Heart Failure With Preserved Ejection Fraction). Logistic regression analyses were performed to determine the variables associated with lower MMSE scores at baseline and postbaseline decline in MMSE scores at 48 weeks.

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  • - Patients with chronic kidney disease (CKD) are at increased risk for heart-related issues, and medications like SGLT2 inhibitors (Dapagliflozin) and MRAs (Eplerenone) can help with cardiovascular problems, especially in diabetic cases.
  • - A study tested the effects of Dapagliflozin and Eplerenone together on heart and kidney functions in rats with non-diabetic CKD, revealing that both drugs reduced kidney fibrosis and improved heart pressure and perfusion.
  • - The combined treatment of Dapagliflozin and Eplerenone not only improved heart function but also showed a synergetic effect in reducing heart muscle damage compared to using each drug alone.
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Antibody Persistence and Risk of COVID-19 Infection: Insights from Modeling.

Vaccines (Basel)

September 2024

Assistance Publique Hôpitaux de Paris (APHP), Hôpital Cochin, CIC Cochin Pasteur, Inserm, 75014 Paris, France.

Background: In this post hoc exploratory study of the APHP-COVIBOOST trial (NCT05124171), we used statistical modeling to describe the evolution of neutralizing antibody (nAb) titers over time, asses its impact on SARS-CoV-2 infection, and explore potential differences between three booster vaccine formulations (D614, B.1.351, and BNT162b2).

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  • Endotracheal intubation (ETI) is crucial for critically ill patients
  • , but it has risks like hypoxemia; preoxygenation is used to enhance safety but can have unreliable monitoring through standard pulse oximeters (SpO2).
  • The Oxygen Reserve Index (ORI)
  • is proposed as a more reliable continuous measure during preoxygenation, targeting an ORI value of at least 0.6 over one minute instead of the standard SpO2 100% goal to improve outcomes.
  • A trial with 950 critically ill adults
  • will compare ORI monitoring against standard SpO2 monitoring during ETI; outcomes include the lowest SpO2 during intubation and cognitive
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  • * Conducted across 40 hospitals in France, the trial involved 2,222 patients who were randomly assigned to either keep using RASIs until surgery or stop them 48 hours prior.
  • * The results showed no significant difference in all-cause mortality or major complications within 28 days after surgery between the two groups, suggesting that either strategy can be safely applied.
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Is coronary artery disease screening by imaging in patients with chronic kidney disease necessary?

Arch Cardiovasc Dis

September 2024

Department of Cardiology, University Hospital, 38000 Grenoble, France; University Grenoble Alpes, INSERM, CHU Grenoble Alpes, LRB, 38000 Grenoble, France; French Clinical Research Infrastructure Network, 75018 Paris, France. Electronic address:

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Performance of the ERC/ESICM-recommendations for neuroprognostication after cardiac arrest: Insights from a prospective multicenter cohort.

Resuscitation

September 2024

AfterROSC Network Group, Paris, France; Université de Paris Cité, Inserm, Paris Cardiovascular Research Center, Paris, France; Ramsay Générale de Santé, Hôpital Privé Jacques Cartier, Massy, France.

Article Synopsis
  • The study aimed to evaluate the effectiveness of the 2021 ERC/ESICM algorithm in predicting neurological outcomes for cardiac arrest survivors in intensive care.
  • A total of 337 patients were examined, with the algorithm successfully identifying all 175 patients predicted to have poor neurological outcomes and showing high specificity for various predictive tools like EEG and clinical examination.
  • For patients with uncertain outcomes, favorable indicators could help predict positive recovery, providing valuable guidance in prognosis and treatment decisions.
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Excessive activation of the mineralocorticoid receptor (MR) is implicated in cardiovascular and renal disease. Decreasing MR activation with MR antagonists (MRA) is effective to slow chronic kidney disease (CKD) progression and its cardiovascular comorbidities in animal models and patients. The present study evaluates the effects of the MR modulator balcinrenone and the MRA eplerenone on kidney damage in a metabolic CKD mouse model combining nephron reduction and a 60% high-fat diet.

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Aerosolized Antibiotic Therapy in Mechanically Ventilated Patients.

Am J Respir Crit Care Med

September 2024

Division of Respiratory Care, Department of Cardiopulmonary Sciences, Rush University, Chicago, Illinois.

Delivering antibiotics directly to the respiratory tract through inhalation to address lung infections has garnered clinical and scientific interest for decades, given the potential favorable pharmacokinetic profile of this administration route. Among critically ill patients, the burden of healthcare-associated pulmonary infections particularly drove continued interest in delivering inhaled antibiotics to intubated patients. We present a concise overview of the existing rationale and evidence and provide guidance for implementing inhaled antibiotics among ventilated critically ill patients, emphasizing insights from recent literature.

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Article Synopsis
  • Randomised controlled trials often use surrogate endpoints instead of direct outcomes to enhance efficiency and reduce costs, but this can lead to increased uncertainty regarding treatment effects and intervention harms.
  • A new guideline, known as CONSORT-Surrogate, provides a checklist for reporting trials that utilize surrogate endpoints, ensuring better clarity and transparency in the results.
  • The recommended checklist, tailored for all stakeholders involved in clinical trials, aims to improve the reporting quality of these studies and ultimately reduce wasted research efforts.
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  • Randomised controlled trials often use surrogate endpoints instead of direct outcomes to save time, cost, and ethical concerns, but this can create uncertainty about the actual treatment effects and potential harms.
  • The SPIRIT-Surrogate is a new guideline to enhance the reporting standards for trial protocols that use surrogate endpoints, building on the existing SPIRIT checklist.
  • This guideline includes nine modified items, encouraging all stakeholders to adopt it, which aims to improve trial design, transparency, and ultimately reduce wasted research efforts.
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Office- versus home-based evaluation of quality of life in heart failure with reduced ejection fraction: A randomized study.

Int J Cardiol

October 2024

Cardiovascular Research and Development Center (UnIC@RISE), Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal; Internal Medicine Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal; Institut National de la Santé et de la Recherche Médicale U1116, Centre Hospitalier Régional Universitaire, French Clinical Research Infrastructure Network, Investigation Network Initiative-Cardiovascular and Renal Clinical Trialists, Nancy, France. Electronic address:

Background: Heart failure (HF) patients often experience poor health-related quality-of-life (HR-QoL). The Kansas City Cardiomyopathy Questionnaire (KCCQ) is frequently used for assessing HR-QoL in HF. Whether KCCQ scores vary in a clinical meaningful manner according to the setting (home vs office) where patients respond to the questionnaire is currently unknown.

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Background: The mineralocorticoid receptor plays a significant role in the development of chronic kidney disease (CKD) and associated cardiovascular complications. Classic steroidal mineralocorticoid receptor antagonists are a therapeutic option, but their use in the clinic is limited due to the associated risk of hyperkalemia in patients with CKD. Finerenone is a nonsteroidal mineralocorticoid receptor antagonist that has been recently investigated in 2 large phase III clinical trials (FIDELIO-DKD [Finerenone in Reducing Kidney Failure and Disease Progression in Diabetic Kidney Disease] and FIGARO-DKD [Finerenone in Reducing Cardiovascular Mortality and Morbidity in Diabetic Kidney Disease]), showing reductions in kidney and cardiovascular outcomes.

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Use of the French National Health Data System (SNDS) in pharmacoepidemiology: A systematic review in its maturation phase.

Therapie

November 2024

Réseau de recherche en épidémiologie clinique et en santé publique/French Clinical Research Infrastructure Network (RECaP F-CRIN) Inserm network, 54500 Vandoeuvre-lès-Nancy, France; Sorbonne Université, INSERM, institut Pierre-Louis d'épidémiologie et de Santé publique, AP-HP, hôpital Pitié-Salpêtrière, département de Santé publique, centre de pharmacoépidémiologie (Cephepi), CIC-1901, 75000 Paris, France.

Article Synopsis
  • The study analyzes the use of the French National Health Data System (SNDS), which provides healthcare data for nearly the entire population of France, focusing on the trends in pharmacoepidemiological research based on this data.
  • A systematic review of articles from 2012 to 2018 revealed an upward trend in published studies, with the majority focusing on drug utilization, safety, and effectiveness, and a notable concentration on medications for the nervous and cardiovascular systems.
  • The findings suggest that while the SNDS is increasingly valuable for drug safety research, there is a need for more studies involving specific populations such as children, pregnant women, and the elderly, who are usually not represented in clinical trials.
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Coronary microvascular dysfunction and atrial reservoir function.

Cardiovasc Ultrasound

May 2024

Department of Cardiology, University Hospital, Grenoble, 38000, France.

Background: Coronary microvascular dysfunction (CMD) refers to structural and functional abnormalities of the coronary microcirculation, which may be diagnosed using invasive coronary physiology. CMD is responsible for impaired diastolic cardiac function. It has recently been suggested that left atrial strain (LASr) represents a highly sensitive tool for detecting cardiac diastolic function abnormalities.

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Mineralocorticoid Receptor Antagonists in Patients With Heart Failure and Impaired Renal Function.

J Am Coll Cardiol

June 2024

British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom. Electronic address:

Background: Kidney dysfunction often leads to reluctance to start or continue life-saving heart failure (HF) therapy.

Objectives: This study sought to examine the efficacy and safety of mineralocorticoid receptor antagonists (MRAs) in patients with HF with reduced ejection fraction experiencing significant kidney dysfunction.

Methods: We pooled individual patient data from the RALES (Randomized Aldactone Evaluation Study) and EMPHASIS-HF (Eplerenone in Mild Patients Hospitalization and Survival Study in Heart Failure) trials.

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Article Synopsis
  • The French Ministry of Health gives money each year for medical research projects, focusing more on primary care since 2013.
  • A study looked at 1,796 funded projects from 2013 to 2019 to find out how many were about primary care.
  • They found only 49 primary care projects, which is just 2.7% of all projects, and this number hasn’t changed much over the years.
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Serum and Salivary IgG and IgA Response After COVID-19 Messenger RNA Vaccination.

JAMA Netw Open

April 2024

INSERM, U1111, CNRS, UMR 5308, CIRI-GIMAP, Université Claude Bernard Lyon 1, Université Jean Monnet, Immunology and Immunomonitoring Laboratory, iBiothera, CIC 1408, Saint-Étienne, France.

Importance: There is still considerable controversy in the literature regarding the capacity of intramuscular messenger RNA (mRNA) vaccination to induce a mucosal immune response.

Objective: To compare serum and salivary IgG and IgA levels among mRNA-vaccinated individuals with or without previous SARS-CoV-2 infection.

Design, Setting, And Participants: In this cohort study, SARS-CoV-2-naive participants and those with previous infection were consecutively included in the CoviCompare P and CoviCompare M mRNA vaccination trials and followed up to day 180 after vaccination with either the BNT162b2 (Pfizer-BioNTech) vaccine or the mRNA-1273 (Moderna) vaccine at the beginning of the COVID-19 vaccination campaign (from February 19 to June 8, 2021) in France.

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Background: The prevalence and risk factors of posttraumatic stress disorder after cesarean delivery, outside high-risk contexts, remain unclear.

Objective: This study aimed to assess posttraumatic stress disorder prevalence and risk factors at 2 months postpartum among a general population of women with cesarean delivery.

Study Design: This was a prospective ancillary cohort study of the Tranexamic Acid for Preventing Postpartum Hemorrhage after Cesarean Delivery (TRAAP2) trial, conducted in 27 French hospitals from 2018 to 2020, enrolling women expected to undergo cesarean delivery before or during labor at ≥34 weeks of gestation.

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