A Feasibility Study of Virtopsy With Tissue Sampling in Besancon University Hospital
Stillbirth and Fetal DeathTermination of Pregnancy1 moreThe aim of this project is to assess the feasibility of a new local post mortem procedure at Besançon University Hospital : Virtopsy+, magnetic resonance (MR) imaging with tissue sampling of the fetus and newborns.
Prediction on Time to Death in Potential Controlled Donation After Circulatory Death (cDCD) Donors...
Tissue and Organ ProcurementA considerable number of potential cDCD donors do not convert into actual organ donors because circulatory arrest does not occur within the predefined timeframe of warm ischemia after withdrawal of life-sustaining treatment. The main objective of this study is to determine parameters predicting time to death in potential cDCD patients.
Efficacy of Risk Assessment for Sudden Cardiac Death in Patients With Hypertrophic Cardiomyopathy...
Hypertrophic CardiomyopathyHypertrophic cardiomyopathy (HCM) is a heart disease characterized by hypertrophy of the left ventricular myocardium and is most often caused by mutations in sarcomere genes. The structural and functional abnormalities cannot be explained by flow-limiting coronary artery disease or loading conditions. The disease affects at least 0,2% of the population worldwide and is the most common cause of sudden cardiac death (SCD) in young people and competitive athletes due to fatal ventricular arrhythmia, but in most patients, however, HCM has a benign course. Therefore, it is of utmost importance to properly evaluate patients and identify those who would benefit from a cardioverter-defibrillator (ICD) implantation.
Impact of Interprofessional Training and Co-ordination on Early Identification and Proactive Approach...
Interprofessional RelationsEnd-of-life SituationsMore than 300,000 people die each year in France from a disease that may require palliative care. Nevertheless, only a small proportion of these patients are able to access this care, in particular because of a too late identification. While several factors may hinder access to specialized palliative care resources, one of the major barriers to the initiation of palliative care, and particularly to the implementation of quality end-of-life care, Remains the failure to recognize that patients with advanced chronic illness are actually approaching the end of their lives. However, it is now clearly established that early integration of palliative care in the care of people living with a serious, incurable and progressive disease: has an impact on the quality (and sometimes the expectation) of life of these people, avoids aggressive treatments and unplanned hospitalizations, is associated with lower health costs than other end-of-life patients. Primary health care providers have a major role to play in facilitating access to palliative care, but their practice has been hampered in our country by the fragmented and poorly coordinated nature of primary care and Negligible in terms of training. However, they remain the first contact of the patients with the system of care, and are also structuring for the continuation of the patient's journey within the health system. The first hypothesis is that the work of genuine interprofessional primary care teams in multi-professional health centers (MSPs), coupled with adequate training in the use of simple tools, can contribute to the early identification of patients approaching End of life, to meet their palliative care needs. However, various European programs (Gold Standards Framework in the UK, NECPAL in Catalonia, RADPAC in the Netherlands) have shown that identification alone is not enough to increase access to specialized palliative care. The second hypothesis is that it must be articulated for this with a training of the professionals to carry out conversations of anticipated planning of the care with their patients.
Decision Making in End of Life as Individual Preferences
Terminal DiseasesIt is not universal that terminally ill patients choose surrogate in the event of disagreement between the treating physician and the surrogate at the end of their lives. There are several factors that influence the terminally ill patient's decision to choose a decision maker at the end of his / life.
Adequate Definition of Delayed Graft Function in Living and Deceased Donor Kidney Transplantation...
Deceased Donor Kidney TransplantationLiving Donor Kidney TransplantationIt is required to establish an adequate definition of delayed graft function in deceased donor kidney transplantation. We attempt to compare various definitions of delayed graft function and find the definition that can predict graft function survival best in deceased donor kidney transplantation.
A Cohort Study for Occupational Stress Induced Early Embryonic Death
EtiologyCohort Study3 moreOccupation stress can be the risk factors of early embryonic death
Measuring Depth of Unconsciousness at the End of Life Using Bispectral Index (BIS)
Loss of Consciousness at End of LifeThe purpose of this study is to use the BIS monitor to assess the degree of consciousness in pre-terminal palliative patients admitted to our palliative care unit and to ascertain if this tool provides a more accurate assessment of consciousness in this specific group of patients than clinical observation of consciousness and the use of sedation scales. We hypothesize that the measured BIS results provide a more accurate assessment of the patient's level of consciousness than routine clinical observation or the use of sedation scales.
DF4 Connector System Post-Approval Study
Ventricular TachycardiaVentricular Fibrillation2 moreThe purpose of this study is to evaluate long-term performance of the DF4 Connector System. This evaluation is based on the number of DF4 lead-related complications occurring during the study compared to the number of leads enrolled in the study. The DF4 systems will be followed for 5 years after implant. This study is required by FDA as a condition of approval of the DF4 Connector Systems. This study is conducted within Medtronic's post-market surveillance platform.
Implantable Cardioverter Defibrillators - Improving Risk Stratification
Sudden Cardiac DeathImplantable Defibrillator User3 moreWorldwide three million people a year die from sudden cardiac death (SCD). In most cases there is no warning and the heart is stopped by a sudden arrhythmia. We know that some people are at high risk of sudden cardiac death and can prevent their deaths with an implantable cardioverter defibrillator (ICD) that is implanted in a minor operation. However, most people who die from sudden cardiac death are not found to be at high risk by our current risk markers and 40% of the people who have ICDs do not have therapy within the first 4 years after implant. We need new and better ways of identifying people who are at high risk of sudden cardiac death so that we can prevent their deaths with ICDs. Our understanding of the electrical signals in the heart has increased considerably in recent years; in no small part this is due to our Principal Investigator Professor Andre Ng's basic science work. This study aims to take the understanding of action potential duration (APD) restitution gained through our work and other studies in humans and in computer simulations and translate it into a fresh way of assessing risk of sudden cardiac death. This study will carefully examine electrical activity, using APD restitution, in the hearts of patients who are having ICDs fitted because of their high risk of sudden cardiac death and combine this with a detailed heart scan, assessment of autonomic nervous system and gene expression data. We will then follow these patients up to see who benefits from their ICD. This wide ranging information will give us as complete a picture as possible of the factors that cause sudden cardiac death. We hope to use this to identify better predictors of sudden cardiac death. The study hypotheses are as follows: Primary Regional Restitution Instability Index (R2I2) will be significantly higher in patients reaching the endpoint of ventricular endpoint / sudden cardiac death than in those not. An R2I2 cut-off of 1.03 will partition patients into high and low risk groups. Secondary Peri-infarct zone mass in grams will be significantly higher in patients reaching the endpoint of ventricular endpoint / sudden cardiac death than in those not.