Randomized Pragmatic, Cluster, Stepped-wedge Trial of Early Detection and Referral for Autism and Neurodevelopmental Disorders At the Maternal and Child Protection Services for Care Before 1 Year of Follow-up

This study aims to compare two screening strategies for identifying infants with a potential risk of Autism Spectrum and Neurodevelopmental Disorders to provide early access to care and increase the likelihood of a favorable outcome

开始日期2024-12-01

申办/合作机构

Centre Hospitalier Intercommunal Créteil

NCT06527456 / Not yet recruitingN/AIIT

Intervention With General Practitioners to Improve Women's Participation in Cervical Cancer Screening

In France, cervical cancer is the 12th most common female cancer with nearly 3,000 new cases per year.
Since 2018, a national Organized Cervical Cancer Screening program (DOCCU) has been set up and concerns all asymptomatic women aged 25 to 65.
This program, managed by the Regional Cancer Screening Coordination Centers (CRCDC), invites women who have not taken a sample within the recommended time frame to consult for screening. However, only 59% of patients participated.
The intervention of the general practitioner, an essential player in prevention, could allow for better awareness.
The objective of the INDIGO study is to evaluate the effectiveness of the intervention of a general practitioner on the participation rate in the DOCCU of patients who are not up to date with their screening.

开始日期2024-12-01

申办/合作机构

Centre Hospitalier Intercommunal Créteil

NCT06263816 / Not yet recruiting临床3期IIT

Effect of Long-term Carvedilol to Prevent Decompensation or Death in Patients With Asymptomatic Child-Pugh A5 to B8 Cirrhosis and Clinically Significant Portal Hypertension: a Multicenter Double-blind Randomized Control Trial

Decompensation of cirrhosis is a turning point in cirrhosis course, as associated with a marked decrease in life expectancy. Thus, prevention of decompensation is crucial.
The usefulness of carvedilol to prevent decompensation of cirrhosis in patients with TE-LSM ≥ 25 kPa as a surrogate marker for clinically significant portal hypertension, has never been evaluated in a clinical trial.

开始日期2024-11-15

申办/合作机构

Assistance Publique des Hôpitaux de Paris SA

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2024-12-01·American Journal of Ophthalmology Case Reports

Macular telangiectasia type 2 in a patient with Down syndrome: A possible association

Article

作者: Halouani, Safa ; Souied, Eric H. ; Souied, Eric H ; Le, Hoang Mai ; Herda, Nabil ; Miere, Alexandra ; Cirneanu, Alina

PurposeDown syndrome (DS) is one of the most prevalent genetic diseases associated with a variety of ophthalmic disorders, including reported retinal abnormalities. Macular telangiectasia type 2 (MacTel 2) is a late-onset neurodegenerative retinal disease with a substantial genetic component. We hereby describe a case of a female with DS who presented with MacTel 2, and we discuss the possible pathways associating both entities.ObservationWe report the case of a 49-year-old female with a medical history of DS and hydroxychloroquine (HCQ) intake. She was referred for HCQ retinal toxicity screening. The multimodal imaging revealed a temporal perifoveal gray area with crystal deposits on multicolor fundoscopy with parafoveal outer retinal atrophy and ellipsoid zone loss with inner retinal cavitations in both eyes on the optical Coherence Tomography (OCT) B scan. The corresponding swept-source OCT angiography confirmed the presence of bilateral macular telangiectasia.Conclusion and importanceMetabolic pathways including serine/glycine and sphingolipids are incriminated in both entities' pathogenesis suggesting a possible association, hence, the importance of raising awareness of this association. More cases are likely to be found since DS patients currently have a nearly normal lifespan. Additional retinal examination of DS adults is then necessary to look for signs of MacTel 2.

2024-11-01·Ophthalmology Science

Artificial Intelligence-Based Disease Activity Monitoring to Personalized Neovascular Age-Related Macular Degeneration Treatment: A Feasibility Study

Article

作者: Aslam, Tariq ; De Salvo, Gabriella ; Stahl, Andreas ; Sahni, Jayashree ; Wei Ting, Daniel Shu ; Somfai, Gábor Márk ; Mulyukov, Zufar ; Lujan, Brandon J ; Lorand, Daniel ; Keane, Pearse A. ; Hatz, Katja ; Gallego-Pinazo, Roberto ; Keane, Pearse A ; Lujan, Brandon J. ; Gemmy Cheung, Chui Ming ; Semoun, Oudy ; Liakopoulos, Sandra

PurposeTo evaluate the performance of a disease activity (DA) model developed to detect DA in participants with neovascular age-related macular degeneration (nAMD).DesignPost hoc analysis.ParticipantsPatient dataset from the phase III HAWK and HARRIER (H&H) studies.MethodsAn artificial intelligence (AI)-based DA model was developed to generate a DA score based on measurements of OCT images and other parameters collected from H&H study participants. Disease activity assessments were classified into 3 categories based on the extent of agreement between the DA model's scores and the H&H investigators' decisions: agreement ("easy"), disagreement ("noisy"), and close to the decision boundary ("difficult"). Then, a panel of 10 international retina specialists ("panelists") reviewed a sample of DA assessments of these 3 categories that contributed to the training of the final DA model. A panelists' majority vote on the reviewed cases was used to evaluate the accuracy, sensitivity, and specificity of the DA model.Main Outcome MeasuresThe DA model's performance in detecting DA compared with the DA assessments made by the investigators and panelists' majority vote.ResultsA total of 4472 OCT DA assessments were used to develop the model; of these, panelists reviewed 425, categorized as "easy" (17.2%), "noisy" (20.5%), and "difficult" (62.4%). False-positive and false negative rates of the DA model's assessments decreased after changing the assessment in some cases reviewed by the panelists and retraining the DA model. Overall, the DA model achieved 80% accuracy. For "easy" cases, the DA model reached 96% accuracy and performed as well as the investigators (96% accuracy) and panelists (90% accuracy). For "noisy" cases, the DA model performed similarly to panelists and outperformed the investigators (84%, 86%, and 16% accuracies, respectively). The DA model also outperformed the investigators for "difficult" cases (74% and 53% accuracies, respectively) but underperformed the panelists (86% accuracy) owing to lower specificity. Subretinal and intraretinal fluids were the main clinical parameters driving the DA assessments made by the panelists.ConclusionsThese results demonstrate the potential of using an AI-based DA model to optimize treatment decisions in the clinical setting and in detecting and monitoring DA in patients with nAMD.Financial DisclosuresProprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

2024-10-01·Transfusion and Apheresis Science

Position paper on advancing sickle cell disease management in France by bridging the clinical practices and guidelines through expert insights

Review

作者: Bernaudin, F. ; Benmoussa, K ; Joseph, L ; Héquet, O. ; Joseph, L. ; Héquet, O ; Connes, P. ; Beraud, M. ; Bah, A ; Bah, A. ; Connes, P ; Benmoussa, K. ; Beraud, M ; Bernaudin, F

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