Ph-Metrie oesophagienne a double canal dans le diagnostic du reflux gastro-oesophagien Avec manifestations ORL

Objectif : Déterminer la fréquence du reflux proximal pathologique chez des patients présentant un reflux gastro-oesophagien (RgO) avec manifestations oto-rhino-laryngologiques (ORL) et explorés par une ph-métrie oesophagienne des 24 heures, utilisant une sonde à double canal, déterminer le taux de concordance entre les symptômes ORL et les épisodes de RgO proximal et enfin, rechercher des facteurs  épidémiologiques, cliniques et ph-métriques distaux associés à un plus grand risque de survenue de RgO proximal. : Nous avons revu tous les tracés et comptes rendus des phmétries oesophagiennes des 24 heures à double canal pratiquées entre 2008 et 2010, pour exploration de  manifestations ORL de RgO.Matériel et méthodes : Nous avons revu tous les tracés et comptes rendus des ph-métries oesophagiennes des 24 heures à double canal pratiquées entre 2008 et 2010, pour exploration de manifestations ORL de RgO.Résultats : il s’agissait de 33 patients, d’âge moyen de 43,2 ans (10-73 ans). Un reflux proximal pathologique a été retrouvé chez 27 patients. Il était associé à un reflux distal chez 16 patients et isolé chez 11 patients. Un reflux proximal nocturne pathologique a été retrouvé chez 13 patients. Une bonne concordance symptomatique a été retrouvée chez 9 malades. Concernant les facteurs prédictifs du reflux proximal pathologique, nous avons retrouvé une corrélation statistiquement significative avec l’existence d’un reflux distal associé et l’existence d’un reflux distal nocturne.Conclusion : en attendant le développement et la diffusion de   l’impédancemétrie oesophagienne, la ph-métrie oesophagienne utilisant une sonde à double canal doit être proposée à tous les patients souffrant d’un RgO avec manifestations ORL.Mots-clés : reflux gastro-oesophagien, ph-métrie oesophagienne des 24 heures, oto-rhino-laryngologie

Morbid Obesity with Achalasia: A Surgical Challenge

Achalasia is a relatively rare medical condition that is classically not associated with obesity. The surgical treatment of a simultaneous occurrence of these two diseases requires careful consideration, and only a few reports can be found in the literature combining a Heller myotomy with gastric bypass, duodenal switch, or gastric banding. We report the case of a 69-year-old female patient with early achalasia and obesity who underwent simultaneous laparoscopic gastric sleeve resection and robotic Heller myotomy. No intra- or postoperative complications occurred. A follow-up at 6 weeks showed a significant weight loss and resolved symptoms of achalasia. The case illustrates that a simultaneous gastric sleeve resection and robotic Heller myotomy might be an option for the treatment of concurrent obesity and achalasia

Piezoelectric cellular microstructure PDMS material for micro-sensors and energy harvesting

International audienc

Pre-stretch induced leakage current in VHB electroactive polymers

International audienceDielectric elastomers generators (DEGs) constitute promising systems due to their high energy density. This latter isinfluenced by viscoelasticity and the leakage current. An understanding of this leakage current and how it can beinfluenced by the stretch state of material is required to predict or optimize DEGs. In this context, our work consisted instudying the evolution of the leakage current in commercial electroactive polymer (3 M VHB4910) using silver grease aselectrodes. This analysis has been performed in order to evaluate the influence of three different factors: the biaxial prestretch(2 = 4, 9 and 16), the temperature (from 20°C to 80°C) and the high electric field (from 1MVm -1 to 20MVm-1).Main results are (i) the increase in the leakage current at higher pre-stretch due to the increase of the electric field, (ii) apredominant Schottky conduction mechanism (iii) a lower current at room temperature for asymmetric pre-stretchcompared to an equivalent area surface ratio with symmetric pre-stretch, (iv) the point iii fails when the material works attemperatures higher than room temperature. Probable changes in the molecular chains with strain explain these results

Pre-stretch induced leakage current in VHB electroactive polymers

International audienceDielectric elastomers generators (DEGs) constitute promising systems due to their high energy density. This latter isinfluenced by viscoelasticity and the leakage current. An understanding of this leakage current and how it can beinfluenced by the stretch state of material is required to predict or optimize DEGs. In this context, our work consisted instudying the evolution of the leakage current in commercial electroactive polymer (3 M VHB4910) using silver grease aselectrodes. This analysis has been performed in order to evaluate the influence of three different factors: the biaxial prestretch(2 = 4, 9 and 16), the temperature (from 20°C to 80°C) and the high electric field (from 1MVm -1 to 20MVm-1).Main results are (i) the increase in the leakage current at higher pre-stretch due to the increase of the electric field, (ii) apredominant Schottky conduction mechanism (iii) a lower current at room temperature for asymmetric pre-stretchcompared to an equivalent area surface ratio with symmetric pre-stretch, (iv) the point iii fails when the material works attemperatures higher than room temperature. Probable changes in the molecular chains with strain explain these results