Linear association between maternal age and spontaneous breech presentation in singleton pregnancies after 32 weeks gestation

Purpose—To investigate the association between maternal age and spontaneous breech presentation. Material and methods—Fifteen-year observational study over (2001–2015). All consecutive singleton births delivered at the Centre Hospitalier Universitaire Sud Reunion’s maternity. The only single exclusion criterion was uterine malformations (N = 123) women. Results—Of the 60,963 singleton births, there was a linear association (χ2 for linear trend, p\u3c0.0001) between maternal age and spontaneous breech presentation. Overall rate of breech presentation was 2.7% in deliveries over 32 weeks gestation, while it was 1.9% in women aged 15 to 19 years and 4.0% in women aged 45+, with a linear progression for each 5-year age category. This linearity remained significant controlling for early prematurity (\u3c33 weeks) and severe fetal malformations (χ2 for linear trend = 64, p \u3c0.0001). Controlling in a multiple logistic regression model for other major risk factors gestational age, female sex, primiparity, maternal age remained significantly an independent risk factor, p \u3c0.0001. Conclusion—Maternal age (x) is an independent factor for breech presentation in singleton pregnancies after 32 weeks gestation with a linear association that may be approximated at y = 0.1x. (y: incidence, percent)

Impact of management on mortality in patients with invasive cervical cancer in Reunion Island

Objective: In Reunion Island, the standardized mortality rate for cervical cancer is 4.8/100,000 women, twice higher than in Metropolitan France. For locally advanced disease, the standard of care includes a treatment by brachytherapy. Nevertheless, brachytherapy was not available on the Island before 2016. The objective of this study was to assess the impact of the management of patients with invasive cervical cancer on mortality in Reunion. Methods: We have identified all the women hospitalized in one of the health care centers of the Island diagnosed with invasive cervical cancer between 01/01/2010 and 31/12/2015. The guidelines of the French Society of Gynecological Oncology (FSGO) were considered as the reference to evaluate professional practices. The characteristics that had an influence on global survival after log-rank test were included in a multivariate analysis according to the Cox Model. Results: Retrospective analysis identified 303 women meeting inclusion criteria. The assessment of professional practices showed that the decisions on 11.6% of the patients discussed during multidisciplinary meetings, were not applied, consequentially leading to a decrease in survival (p = 0.001). A total of 156 patients (51.5%) were administered a treatment in accordance with the guidelines of the FSGO and had a better survival, even after multivariate analysis (HR 2.53 [CI 95% 1.55-4.14], p < 10(-3)). Nonconformity was associated with the lack of access to brachytherapy on the Island. Women on the Island presented low rates of screening tests (cover rates 53.2%). Conclusion: The absence of treatment in accordance with the guidelines and decisions taken during multidisciplinary meetings and the absence of brachytherapy were associated to a higher mortality among patients with invasive cervical cancer in Reunion Island. We hope that the implementation of brachytherapy in Reunion will address these deficiencies. (C) 2017 Elsevier B.V. All rights reserved

Interactions entre Aspergillus fumigatus et les cellules épithéliales bronchiques

International audienc

Comment je fais… pour utiliser le vert d’indocyanine pour contrôler la viabilité des lambeaux en reconstruction vaginale

International audienceNo abstract availabl

Chemical modification of olive pomace by various esters and silane

International audienceThe olive pomace was modified chemically to improve the interface between the polymer matrix and the cellulosic fillers. The modification was done using various ester types having the same nature, however, with different chain lengths and one silane. Before the surface treatment, the olive pomace was extracted with acetone to remove contaminants on the surface, using Soxhlet apparatus. The transesterification of olive pomace with the different ester components, i.e., vinyl acetate, vinyl propanoate, and vinyl butanoate, and the condensation reaction with dichlorodimethylsilane was confirmed by Fourier transform infrared (FTIR) analysis. Moreover, the treatment of olive pomace with vinyl acetate improves the thermal stability and the sample records higher onset temperature of degradation as measured by thermogravimetric analysis (TGA). The results obtained indicated also that the reaction between the hydroxyl groups of waste flour and the acetyl, propionyl, pivalyl, and silane groups have occurred. The modified wood flours exhibited a decrease in the hydrophilicity as supported by the lower moisture content

Effect of surface treatment on the physicomechanical and thermal properties of high-density polyethylene/olive husk flour composites

International audienceIn this study, a particular interest was focused on the recovery of lignocellulosic waste of olive husk flour (OHF) by its incorporation as filler in manufacturing composite materials based on high-density polyethylene (HDPE) matrix with various filler contents (10, 20, and 30 wt %). The problem of incompatibility between the hydrophilic filler and the hydrophobic matrix was treated with two methods: the first method consists of using maleic anhydride-grafted polyethylene (MAPE) as compatibilizer in HDPE/OHF composites. The second method, was focused on the chemical modification of OHF by vinyl-triacetoxy-silane (VTAS). Fourier transform infrared spectroscopy is used to analyze both grafting and silanization reactions involved. Scanning electron microscopy was used to show the morphology of the flour surface. Furthermore, the physicomechanical and thermal characteristics of the various composite samples were investigated as a function of filler contents and treatment types. The results showed that the properties of the composite materials are positively affected by the silanization treatment of OHF and also by MAPE addition. However, better mechanical and thermal properties with less moisture absorption were obtained for the composite materials compatibilized with MAPE

Synthesis and characterization of rubbery epoxy/organoclay hectorite nanocomposites

International audienceThe present research investigates the morphology, the mechanical, and the viscoelastic properties of rubbery epoxy/clay nanocomposites synthesized by in situ polymerisation of a prepolymer diglycidyl ether of bisphenol-A crosslinked with an aliphatic diamine based on a polyoxypropylene backbone. The inorganic phase was hectorite, exchanged with octadecylammonium ions in order to give organophilic properties to the phyllosilicate. An ultrasonicator was used to disperse the silicate clay layer into epoxy-amine matrix. The morphology of epoxy-hectorite nanocomposites examined by transmission electron microscopy (TEM) showed that mixed delamination or intercalation or microdispersion could occur depending on type of organoclay. Moreover, the mechanical and viscoelastic properties were found to be improved with only the treated hectorite

Linear association between maternal age and need of medical interventions at delivery in primiparae: a cohort of 21,235 singleton births

Published Online 26 June 2017Objectives: We sought to investigate the potential association between maternal age and the need for active obstetrical intervention intrapartum in primiparas. Study design: Observational study over 14 years (2001–2014) of all consecutive primiparous singleton births having delivered at the Centre Hospitalier Universitaire Hospitalier Sud Reunion’s maternity (French overseas department, Indian Ocean). Results: Of the 21,235 singleton primiparous births, there were three significant linear associations between maternal age from 12 years of age to 42 + (all χ2 for linear trend, p 3.5 kg), and ethnicity. Using maternal age remained significantly an independent risk factor (p < .0001), after controlling for the major confounders: maternal BMI, maternal height, birthweight ≥3500 g, p < .0001. Conclusions: Increasing maternal age has a linear association with vaginal deliveries without any medical intervention, rate of cesarean sections, and rate of operative vaginal procedures. These associations are independent of maternal BMI and maternal height. We currently do not have a specific explanation why younger women appear to be protected from requiring intrapartum obstetric intervention. Nevertheless, these strong facts deserve acknowledgement and further research.Pierre-Yves Robillard, Thomas C. Hulsey, Malik Boukerrou, Francesco Bonsante, Gustaaf Dekker and Silvia Iacobell

Evaluation of physicians’ practice patterns in France concerning fertility preservation in women with endometriosis

International audienc