Influence de la teneur en ciment sur les propriétés thermomécaniques des blocs d’argile comprimée et stabilisée

Ce travail vise à déterminer la résistance à la compression et la conductivité thermique des blocs à base d’argile comprimée et stabilisée au ciment d’une part et à étudier la variation de ces propriétés en fonction de la teneur en ciment d’autre part. Les mesures réalisées indiquent que la résistance des blocs sans ciment est de 3,7 MPa par « voie sèche » pour une conductivité thermique de 0,91 Wm-1K-1 (déterminée à l’aide d’un fluxmètre). L’incorporation de ciment entraine une variation de ces deux propriétés. Ainsi on note d’abord une baisse de la résistance suivie d’une augmentation au delà de 4% de ciment. Toutefois la conductivité thermique des blocs ayant les teneurs en ciment les plus importantes reste proche de celle des blocs sans ciment.Mots-clés: bloc d’argile, ciment portland, stabilisation, résistance en compression, conductivité thermique. Influence of cement content on the thermomechanical properties of compressed and stabilized clay blocks This work aims to determine the compressive strength and the thermal conductivity of clay compressed blocks and stabilized with cement and to study the influence of the cement ratio on these characteristics of the blocks. The resistance of blocks without cement is (determined at dry state) is 3.7 MPa and measurements made with a fluxmeter show that the thermal conductivity of these blocks is 0,91 Wm-1 K-1. The results show also that the thermal conductivity and the compressive strength of the blocks vary according to the cement ratio. However the thermal conductivity of the blocks with high cement ratio is close to that of the blocks without cement.Keywords: clay blocks, Portland cement, stabilization, compressive strength, thermal conductivity

Safety and Efficacy of Sildenafil for Group 2 Pulmonary Hypertension in Left Heart Failure

Pulmonary hypertension (PH) is a multifactorial, progressive disease with poor outcomes. Group 2 PH is defined by pulmonary vascular disease with elevated pulmonary capillary wedge pressure including both left-sided obstructive lesions and diastolic heart failure (HF). Sildenafil was historically discouraged in this population as pulmonary vasodilation can lead to pulmonary edema. However, evidence suggests that sildenafil can help to treat the precapillary component of PH. This is a single center, retrospective pilot study of pediatric PH patients with left-sided HF who were treated with sildenafil for ≥ 4 weeks. HF patients without mechanical support (HF group) and HF patients with a left ventricular assist device (HF-VAD) were analyzed. The exploratory analysis described the safety and side effects of the drug. Echocardiographic parameters were compared before and after sildenafil treatment in a paired analysis. The changes in medical therapy during treatment, mechanical support, and mortality was reported; 19/22 patients tolerated sildenafil. Pulmonary edema in two patients resolved upon discontinuation of sildenafil. In the HF group, both the right atrial volume and right ventricular diastolic area decreased, and the tricuspid regurgitation (TR) S/D ratio decreased after therapy (p = 0.02). Across both the groups, four patients weaned off milrinone and seven weaned off inhaled nitric oxide. Of the thirteen HF patients, four received a transplant, and all of the nine HF-VAD patients received a transplant. Sildenafil can be safely used in carefully selected patients with HF and mixed pre/postcapillary PH with judicious titration and inpatient surveillance, with patients showing improvements in echocardiographic parameters

Safety and Efficacy of Sildenafil for Group 2 Pulmonary Hypertension in Left Heart Failure

Pulmonary hypertension (PH) is a multifactorial, progressive disease with poor outcomes. Group 2 PH is defined by pulmonary vascular disease with elevated pulmonary capillary wedge pressure including both left-sided obstructive lesions and diastolic heart failure (HF). Sildenafil was historically discouraged in this population as pulmonary vasodilation can lead to pulmonary edema. However, evidence suggests that sildenafil can help to treat the precapillary component of PH. This is a single center, retrospective pilot study of pediatric PH patients with left-sided HF who were treated with sildenafil for ≥ 4 weeks. HF patients without mechanical support (HF group) and HF patients with a left ventricular assist device (HF-VAD) were analyzed. The exploratory analysis described the safety and side effects of the drug. Echocardiographic parameters were compared before and after sildenafil treatment in a paired analysis. The changes in medical therapy during treatment, mechanical support, and mortality was reported; 19/22 patients tolerated sildenafil. Pulmonary edema in two patients resolved upon discontinuation of sildenafil. In the HF group, both the right atrial volume and right ventricular diastolic area decreased, and the tricuspid regurgitation (TR) S/D ratio decreased after therapy (p = 0.02). Across both the groups, four patients weaned off milrinone and seven weaned off inhaled nitric oxide. Of the thirteen HF patients, four received a transplant, and all of the nine HF-VAD patients received a transplant. Sildenafil can be safely used in carefully selected patients with HF and mixed pre/postcapillary PH with judicious titration and inpatient surveillance, with patients showing improvements in echocardiographic parameters