Identification of abdominal muscles co-contraction patterns in motion from sEMG for physiotherapy rehabilitation: A pilot study

International audienceCurrent technologies are unable to identify the simultaneous contraction of deep and superficialmuscles when the subject is in motion. In this contribution, we propose a method to identify the co-contraction patterns of four muscles of the abdominal wall, namely the rectus abdominis, obliquus externus, obliquus internus and transversus abdominis, with only two pairs of surface electrodes. Surface electromyography (EMG) signals are acquired from two bipolar leads placed on the lower abdomen of the volunteers. Following the extraction of features, a principal component analysis is conducted to optimize the data representation, and a random forest classifier is employed to classify the co-contraction patterns. Our method achieves up to 86.30% accuracy, which demonstrates the possibility of identifying fourteen co-contraction patterns of four different muscles of the abdominal wall, either surface or deep muscles. Conclusion: This method does not need to be adapted to a new patient, which is better suited to the physiotherapists’s practice. Moreover, it opens a field of research regarding the role of deep muscles in motion either during exercises or daily life tasks as well as in pathologies with complex etiology. EMG research will benefit from this method, which provides a better understanding of muscle co-contractions, but also reduces the number of sensors needed to acquire relevant information, while remaining non-invasive. The clinical interest lies in the improvement of the physiotherapeutic management. Indeed, a better knowledge of the patient’s co-contractions patterns makes it easier to adapt the physiotherapist’s treatment plan to the patient’s needs

On the Use of Kernel Fisher Discriminant Analysis as a Reduction Method for the Classification of EMG Signals

International audienc

Evaluation of the performance of the Blueback Physio® medical device in the management of patients suffering from chronic low back pain

International audienceEvaluation of the performance of the Blueback Physio® medical device in the management of patients suffering from chronic low back pai

Chromosomal instability in the prediction of pituitary neuroendocrine tumors prognosis

International audienceAbstract The purpose of this study was to analyze the impact of copy number variations (CNV) on sporadic pituitary neuroendocrine tumors (PitNETs) prognosis, to identify specific prognosis markers according to the known clinico-pathological classification. CGH array analysis was performed on 195 fresh-frozen PitNETs (56 gonadotroph, 11 immunonegative, 56 somatotroph, 39 lactotroph and 33 corticotroph), with 5 years post-surgery follow-up (124 recurrences), classified according to the five-tiered grading classification (invasion, Ki-67, mitotic index and p53 positivity). Effect of alterations on recurrence was studied using logistic regression models. Transcriptomic analysis of 32 lactotroph tumors was performed. The quantity of CNV was dependent on tumor type: higher in lactotroph (median(min–max) = 38% (0–97) of probes) compared to corticotroph (11% (0–77)), somatotroph (5% (0–99)), gonadotroph (0% (0–10)) and immunonegative tumors (0% (0–17). It was not predictive of recurrence in the whole cohort. In lactotroph tumors, genome instability, especially quantity of gains, significantly predicted recurrence independently of invasion and proliferation (p-value = 0.02, OR = 1.2). However, no specific CNV was found as a prognostic marker. Transcriptomic analysis of the genes included in the CNV and associated with prognosis didn’t show significantly overrepresented pathway. In somatotroph and corticotroph tumors, USP8 and GNAS mutations were not associated with genome disruption or recurrence respectively. To conclude, CGH array analysis showed genome instability was dependent on PitNET type. Lactotroph tumors were highly altered and the quantity of altered genome was associated with poorer prognosis though the mechanism is unclear, whereas gonadotroph and immunonegative tumors showed the same ‘quiet’ profile, leaving the mechanism underlying tumorigenesis open to question

Vancomycin-Associated Cast Nephropathy

International audienceVancomycin is a widely prescribed antibiotic, but the exact nature of vancomycin-associated nephrotoxicity is unclear, in particular when considering the frequent coadministration of aminoglycosides. We describe here the initial case of a 56-year-old woman with normal renal function developing unexplained ARF without hypovolemia after administration of vancomycin without coadministration of aminoglycosides. Studying the patient’s renal biopsy specimen, we ascertained that obstructive tubular casts composed of noncrystal nanospheric vancomycin aggregates entangled with uromodulin explained the vancomycin-associated ARF. We developed in parallel a new immunohistologic staining technique to detect vancomycin in renal tissue and confirmed retrospectively that deleterious vancomycin-associated casts existed in eight additional patients with acute tubular necrosis in the absence of hypovolemia. Concomitant high vancomycin trough plasma levels had been observed in each patient. We also reproduced experimentally the toxic and obstructive nature of vancomycin-associated cast nephropathy in mice, which we detected using different in vivo imaging techniques. In conclusion, the interaction of uromodulin with nanospheric vancomycin aggregates represents a new mode of tubular cast formation, revealing the hitherto unsuspected mechanism of vancomycin-associated renal injury

Diagnosis and management of children and adult craniopharyngiomas: a French Endocrine Society/French Society for Paediatric Endocrinology & Diabetes Consensus Statement

International audienceCraniopharyngiomas are rare hypothalamic-pituitary tumors found in young children, adolescents and adults, and their multidisciplinary management required, calls for consistent practices for practicioners, patients and families. The French Endocrine Society and French Society for Pediatric Endocrinology & Diabetes enlisted and coordinated adult and paediatric endocrinologists, neurosurgeons, pathologists, radiotherapists as well as psychologists, dieticians and a patient association, to draft a reference document on this severe disease.The management of craniopharyngiomas remains complex due to their aggressive nature, invasive behavior, and propensity for recurrence, requiring a sequential and measured therapeutic approach and follow-up in expert centers. Although patient survival rates are high, the consequences of both the tumor and its treatment can lead to serious comorbidities and impaired quality of life, particularly in those patients with lesional hypothalamic syndrome. Recent advances have allowed the two described tumor types - papillary and adamantinomatous - to be associated with distinct molecular signatures, specific pathophysiological mechanisms and ipso facto, distinct therapeutic approaches, including innovative medications for hyperphagia, that will continue to evolve. This consensus statement covers all stages in the management of patients with craniopharyngioma, from diagnosis to therapeutic strategies including the long-term follow-up