Influence of clinical and gait analysis experience on reliability of observational gait analysis (Edinburgh Gait Score Reliability)

AbstractObjectivesTreatment complexity of cerebral palsy (CP) patients imposes outcome evaluation studies, which may include objective technical analysis and more subjective functional evaluation. The Edinburgh Gait Score (EGS) was proposed as an additive or alternative when complex instrumented three-dimensional gait analysis is not available. Our purposes were to apply a translated EGS to standard video recordings of independent walking spastic diplegic CP patients, to evaluate its intraobserver and interobserver reliability with respect to gait analysis familiar and not familiar observers.MethodsTen standard video recordings acquired during routine clinical gait analysis were examined by eight observers gait analysis interpretation experienced or not, out of various specialities, two times with a two weeks interval. Kappa statistics and intraclass correlation coefficient were calculated.ResultsBetter reliability was observed for foot and knee scores than in proximal segments with significant differences between stance and swing phase. Significantly better results in gait analysis trained observers underlines the importance to either be used to clinical gait analysis interpretation, or to benefit of video analysis training before observational scoring.ConclusionVisual evaluation may be used for outcome studies to explore clinical changes in CP patients over time and may be associated to other validated evaluation tools

How do French nuclear physicians deal with ethical aspects of ă communication results to patients after PET performed for oncological ă indications? A national french survey

Annual Congress of the European-Association-of-Nuclear-Medicine (EANM), ă Barcelona, SPAIN, OCT 15-19, 2016International audienceno abstrac

Polysialic acid neural cell adhesion molecule (PSA-NCAM) is an adverse prognosis factor in glioblastoma, and regulates olig2 expression in glioma cell lines

International audienceBackground: Glioblastoma multiforme (GBM) is the most aggressive and frequent brain tumor, albeit without cure. Although patient survival is limited to one year on average, significant variability in outcome is observed. The assessment of biomarkers is needed to gain better knowledge of this type of tumor, help prognosis, design and evaluate therapies. The neurodevelopmental polysialic acid neural cell adhesion molecule (PSA-NCAM) protein is overexpressed in various cancers. Here, we studied its expression in GBM and evaluated its prognosis value for overall survival (OS) and disease free survival (DFS).Methods: We set up a specific and sensitive enzyme linked immunosorbent assay (ELISA) test for PSA-NCAM quantification, which correlated well with PSA-NCAM semi quantitative analysis by immunohistochemistry, and thus provides an accurate quantitative measurement of PSA-NCAM content for the 56 GBM biopsies analyzed. For statistics, the Spearman correlation coefficient was used to evaluate the consistency between the immunohistochemistry and ELISA data. Patients' survival was estimated by using the Kaplan-Meier method, and curves were compared using the log-rank test. On multivariate analysis, the effect of potential risk factors on the DFS and OS were evaluated using the cox regression proportional hazard models. The threshold for statistical significance was p = 0.05.Results: We showed that PSA-NCAM was expressed by approximately two thirds of the GBM at variable levels. On univariate analysis, PSA-NCAM content was an adverse prognosis factor for both OS (p = 0.04) and DFS (p = 0.0017). On multivariate analysis, PSA-NCAM expression was an independent negative predictor of OS (p = 0.046) and DFS (p = 0.007). Furthermore, in glioma cell lines, PSA-NCAM level expression was correlated to the one of olig2, a transcription factor required for gliomagenesis.Conclusion: PSA-NCAM represents a valuable biomarker for the prognosis of GBM patients

Résultats de la thoracoscopie dans les pleurésies purulentes : une expérience monocentrique de 33 cas.

Le but de ce travail était d’évaluer les résultats de la vidéothoracoscopie dans les pleurésies purulentes à travers notre pratique courante. De 2005 à 2013, notre étude rétrospective a permi de colliger 33 patients pris en charge chirurgicalement par vidéothoracoscopie. Les patients ont été répartis en deux groupes, ceux qui ont achevé la procédure par vidéothoracoscopie et ceux qui ont eu une conversion en thoracotomie. Trente trois patients ayant été l’objet d’une vidéothoracoscopie pour pleurésies purulentes après échec du traitement médical, avec une prédominance masculine (ratio 3,71) et un âge moyen de (58 16,27), ont été répartis entre le stade II et stade III avant la chirurgie (23 cas soit 69,7% et 10 cas soit 30,3%) et au moment de la chirurgie (16 cas soit 48,5% et 17 cas soit 51,5%). Le taux de conversion en thoracotomie a été de 30,3%. En comparant le groupe thoracoscopie seule et le groupe conversion en thoracotomie, il est apparu que seul le stade de la pleurésie purulente a constitué un facteur déterminant dans la conversion (p<0,001). Nous avons également trouvé une discordance entre la classification pré-opératoire et la classification post-opératoire de la pleurésie. Trois (3) patients de stade II ont été opérés par thoracoscopie seule et trois (3) ont eu une re-intervention pour récidive ; la mortalité était nulle. La vidéothoracoscopie a été une technique performante dans la prise en charge des pleurésies purulentes, tant sur le plan diagnostique que sur le plan thérapeutique avec une morbidité et une mortalité faibles.Mots clés : pleurésies purulentes, vidéothoracoscopie, conversion.English AbstractTo evaluate the results of videothoracoscopy approach in thoracic empyema through our practice. From 2005 to 2013, our retrospective study with prospective collection of data allowed to record 33 patients who underwent surgery by taking videothoracoscopy. We have divided the patients into two groups, those who have completed the procedure videothoracoscopy and those who needed a conversion to thoracotomy. 33 patients underwent videothoracoscopy for empyema after failure of medical treatment, with a male predominance (ratio 3.71) and an average age (58 16.27); divided between stage II and stage III before surgery (23 cases or 69.7%, and 10 cases or 30.3%) and at the time of surgery (16 cases or 48.5%, and 17 cases or 51.5%). The conversion rate to thoracotomy is (30.3%). Thoracoscopic group versus conversion group to thoracotomy, it appears that only the stage of empyema was the sole factor in the conversion (p <0.001). We also found a difference between the preoperative classification and the classification postoperatively. Three patients with stage II operated by thoracoscopy alone and three had a reoperation for recurrence, mortality was null. The videothoracoscopy approach seems to be effective in the management of empyema, both diagnostic and therapeutic terms with a low morbidity and mortality.Key words: empyema, videothoracoscopy, conversio