Publications scientifiques de l'Université de Reims Champagne-Ardenne
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Tracheobronchial Replacement Using Cryopreserved Aortic Allografts: Results in 50 Patients (TRITON-01 Registry)
No full textInternational audienceAbstract Objectives Tracheal replacement remains a major challenge in thoracic surgery. We report the outcomes of the TRITON-01 registry, which includes 50 patients who underwent tracheal replacement using a cryopreserved aortic allograft performed by our surgical team. Methods Prospective data were collected for each patient, including indication for surgery, operative details, postoperative mortality and morbidity, late complications, stent management, and patient status at last follow-up on January 2, 2025. Results Between October 2009 and January 2025, 50 patients (25 females) with a mean age of 55.1 years (range, 20-79 years) underwent tracheal replacement. Extensive tracheobronchial lesions were malignant in 41 cases and benign in 9 cases. Veno-venous extracorporeal membrane oxygenation (ECMO) was used intraoperatively in 13 patients. Tracheobronchial reconstructions were classified as type 1, 2, 3, and 4 in 20, 15, 4, and 11 patients, respectively. Additional lung resections (lobectomy, bilobectomy, or pneumonectomy) were performed in 12 cases. Incomplete (R1) resection was observed in 3 patients. Thirty-day postoperative mortality was 4% (n = 2). Major complications occurred in 15 patients (30%). At the last follow-up (ranging from 1 month to 14 years), 74% of patients (n = 37) were alive. Stent-related granuloma formation was the most common late complication (n = 26), and stent removal was successfully achieved in 15 (30%) patients due to the development of functional neocartilage. Conclusions Tracheal replacement with cryopreserved aortic allografts appears to be an effective and sustainable technique, with acceptable mortality and morbidity rates. Ongoing investigations aim to optimize cartilage regeneration and enhance the bioavailability of grafts. Clinical registration number Clinicaltrials.gov Identifier: NCT04263129
Triterpenoids from Astragalus armatus subsp. numidicus and their chemotaxonomic significance
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Thermal, rheological and mechanical behavior of PLA and PP biocomposites filled with Brewer’s spent grain (BSG): A comparative analysis of polymer-filler interactions
No full textInternational audienceThis work is focused on composites based on Brewer’s spent grain (BSG), a by-product from beer production, with two thermoplastic polymers with different properties, Polylactic Acid (PLA) and Polypropylene (PP). The effects of BSG concentration were evaluated using Thermogravimetric analysis (TGA), Differential Scanning Calorimetry (DSC), melt dynamic rheology, tensile testing, and Scanning Electron Microscopy (SEM). TGA showed that BSG tend to interact with PLA, particularly at high temperatures during compounding, thereby accelerating PLA degradation and promoting chain cleavage as evidenced by size exclusion chromatography. This interaction affects the thermal transitions of the composites and mechanical properties, as evidenced by the ductile behavior observed in the micrographs. Conversely, BSG seems to act as an inert filler in the case of PP matrix. Rheological analysis suggested particle flocculation when PLA is mixed with above 30% (wt./wt.). In contrast, PP demonstrated consistent flow behavior with increasing BSG content, which is highly advantageous for extrusion and injection molding. PP appears to promote a good dispersion of the BSG particles, likely due to its sufficiently high viscosity. The tensile strength of both polymers was negatively affected by BSG, likely due to poor interfacial adhesion, as indicated by the microvoids in the SEM images. However, a steady elastic modulus with increasing BSG content for both polymers demonstrated their potential to maintain mechanical integrity when subjected to stress. This study provides a better understanding of BSG-filled PP and PLA composites, with opposite behavior, also contributing for the development of sustainable materials for packaging, home furniture, or automotive applications
Aorto-mesenteric space reduction in women with anorexia nervosa: retrospective audit and analysis
No full textInternational audienceAbstract Background and aims Superior mesenteric artery syndrome (SMAS) is a rare condition favored by weight loss, with nonspecific digestive complaints that may hinder weight recovery in anorexia nervosa. This study aimed to examine the radiological features of aorto-mesenteric (A-M) space reduction in anorexia nervosa and their association with digestive complaints. Methods Female patients with anorexia nervosa and a history of computerized tomography angiography for digestive complaints were included. Clinical data were retrospectively collected and computerized tomography scans were reviewed by an independent, experienced radiologist to identify signs of SMAS and of Nutcracker syndrome. Adipose tissue surfaces were also calculated from the scans. Some patients were reassessed after nutritional recovery. Results On the 51 female patients included (mean age 27.7 ± 12.3 years) from a cohort of 202 female anorexia nervosa patients, 48 met radiological criteria for SMAS (A-M angle < 25° or distance ≤ 8 mm). A duodenal dilation was present in 35 patients (68.6%) and a left renal vein dilation in 39.2%. The type of digestive complaints did not differ significantly between patients with and without duodenal dilation, although gastroesophageal reflux approached statistical significance ( p = 0.06). Body mass index and visceral adipose tissue did not correlate significantly with A-M measurements. Following nutritional recovery in ten patients, there was a significant increase in A-M measurements and a decrease in both duodenal dilation and digestive symptoms. Conclusion Radiological features of A-M space reduction are common in anorexia nervosa. Left renal vein compression and its upstream dilation, as well as left dilated ovarian vein and pelvic varicose veins, are frequently associated with radiological signs of SMAS. Nutritional support alleviates digestive complaints related to SMAS
Rapport technique : Définition d'un plan de simulation STICS à échelle européenne, dans le cadre du projet SLAM-B et identification des unités pédoclimatiques pertinentes: Travail préparatoire à l’extension du modèle STICS à l’échelle de l’Europe sur la période 1990-2050
No full textThis work is part of the SLAM-B project which aims to design and evaluate the bioeconomy trajectories of territories towards carbon neutrality. This report proposes a robust method for constructing homogeneous spatial units for agri-environmental simulation at the European scale. It aims to reconcile the diversity and heterogeneity of data sources (soil, climate, land use) with the constraints of spatial homogeneity and computational efficiency to feed STICS crop model.Several datasets are mobilized, including SoilGrids, ESDB, LUCAS and climate data associated with the Agri4Cast grid.Ce travail s'inscrit dans le projet SLAM-B qui vise à concevoir et évaluer les trajectoires de bioéconomie des territoires vers la neutralité carbone. Ce rapport propose une méthode robuste de construction d’unités spatiales homogènes pour la simulation agro-environnementale à l’échelle européenne. Il vise à concilier la diversité et l’hétérogénéité des sources de données (sol, climat, occupation des sols) avec les contraintes d'homogénéité spatial et d'efficacité computationnelle pour alimenter modèle de culture STICS.Plusieurs jeux de données sont mobilisés, dont SoilGrids, ESDB, LUCAS et les données climatiques associées à la grille Agri4Cast.Une classification non supervisée (k-moyennes) est ensuite mobilisée afin d’identifier des groupes homogènes de contextes pédo-climatiques, réduisant ainsi le nombre d’unités à simuler tout en limitant la perte d’information.L’ensemble de la démarche est évalué à travers des analyses zonales et azonales permettant de quantifier les effets des choix méthodologiques sur la distribution des surfaces et la représentativité des sols agricoles. Une attention particulière est portée aux arbitrages entre précision locale et soutenabilité computationnelle, ainsi qu’aux conséquences des opérations de rognage spatial et de filtrage des occurrences minoritaires
Regards croisés sur la santé bucco-dentaire : prévention en France, défis au Vietnam et interventions sur le terrain
No full textCe travail compare la santé bucco-dentaire en France et au Vietnam en évaluant les besoins des populations, la prévalence des pathologies orales et l’efficacité des actions menées pour lutter contre ces affections. Les résultats mettent en évidence un manque de connaissances en hygiène orale ainsi qu’un accès limité aux soins, particulièrement dans les zones rurales vietnamiennes. L’étude souligne l’importance de la prévention bucco-dentaire, la nécessité de programmes préventifs adaptés, réguliers et intégrés aux politiques locales de santé publique, ainsi que la mise en place de mesures préventives dites communautaires, au plus près des besoins des populations. Ces résultats ouvrent des perspectives pour le développement de stratégies de prévention bucco-dentaire durables, adaptées aux contextes locaux et aux besoins spécifiques des populations, tant à l’échelle locale qu’internationale
Obésité : quelle influence sur la fertilité et le pronostic obstétrical ?
No full textL’obésité est une maladie chronique de plus en plus fréquente, reconnue pour ses multiples répercussions sur le système métabolique et hormonal, en particulier sur la santé reproductive. Souvent sous-estimée comme maladie, elle représente néanmoins un facteur majeur d’altération de la fertilité, tant chez les femmes que chez les hommes. Elle impacte également le pronostic obstétrical en augmentant le risque de complications maternelles (hypertension gravidique, prééclampsie, diabète gestationnel, thromboses et infections postpartum) et fœtales (macrosomie, malformations congénitales, retard de croissance intra-utérin et mortalité périnatale) pouvant compliquer l’accouchement. Cette thèse propose une analyse des données actuelles relatives à l’impact de l’obésité sur la fertilité du couple, les mécanismes physiopathologiques impliqués, et les conséquences obstétricales. Ce travail s’intéresse également à la place du pharmacien d’officine en tant que professionnel de santé dans la prévention et la prise en charge de l’obésité et de l’infertilité. Par son rôle de conseil, de dépistage et d’accompagnement, le pharmacien participe à l’éducation hygiéno-diététique, à l’orientation des patients et à l’amélioration du suivi pré-conceptionnel, contribuant ainsi à l’amélioration de la santé reproductive et périnatale
Head and neck radiotherapy after reconstructive flap surgery: Results of the multicentric XFLAP1 study
No full textInternational audienceBackground and purpose:Postoperative target delineation after reconstructive surgery in head and neck cancer (HNC) is heterogeneous; whether to include the flap or focus on the native tissue–flap junction is debated. We quantified patterns of relapse relative to flaps and summarized practice, toxicity and function.Materials and methods:in the retrospective XFLAP1 cohort (2018–2023), patients with HNC underwent tumor resection with flap reconstruction and postoperative radiotherapy (PORT) ± concurrent chemotherapy. Competing-risks (Fine-Gray) estimated locoregional relapse (LRR) and metastases; overall survival (OS) used Kaplan-Meier. Flaps were contoured a posteriori on planning CTs, when available.Results:Of 355 patients across eight centres, free flaps were used in 239 (67%) and regional pedicled flaps in 69 (33%). The entire flap body was encompassed in the CTVs in 66% of plans; median flap-body dose was 65.3 Gy and pedicle Dmax 67.5 Gy for the delineated flaps (N = 153). Median follow-up was 32.9 months, 120/355 (34%) patients relapsed, including 68 (19%) LRR and 71 (20%) metastases. Median time to LRR was 7.35 months; only 3 (1%) of relapses arose within the flap body. Two-year cumulative incidence was 15.8% for LRR and 16.7% for metastases; two-year OS was 74.6%. On multivariable analysis, pN2–3 predicted metastases; LRR, metastases, and ECOG ≥ 1 were associated with worse OS.Conclusions:relapses in the flap-body epicentre were rare; most local failures involved the native tissue–flap junction or non-flap sites. These data support junction-focused CTVs with reduced emphasis of the flap body to limit morbidity, pending prospective validation
