Le canal lombaire étroit chez la personne âgée de plus de 75 ans. Facteurs déterminants du résultat fonctionnel

Introduction: lumbar spinal stenosis is a common pathology. When symptomatic, an intermittent radicular claudication appears. The stenosis seen most commonly develops focally, at the intervertebral junction, as a result of a complex process of ligamentum flavum hypertrophy, facet arthropathy, disc herniation, and sometimes spondylolisthesis. Degenerative lumbar spinal stenosis is the most frequent indication for functional spine neurosurgery in the elderly. Aging population in developed countries lives with significant comorbidities wich complicates patient management. The screening of patient's eligibility for surgery implies the knowledge of all issues including the prognosis factors related to functional improvement. Objectives: This retrospective study aims to discuss the effectiveness of surgery, in terms of pain/satisfaction, for 73 patients aged 75 years and above suffering from a lumbar canal stenosis, treated between 2006 and 2014. Patients and methods: We reviewed all files information: demographic, pre- and postoperative clinical, non-clinical therapeutic and surgical data. Results: seventy-three patients met the study criteria. The median level of satisfaction was 85%. No deterioration after surgery or deaths occured. Statistical analysis using multiple linear regression indicates that analgesic intake before (pConclusion: functional outcome of surgery for lumbar spinal stenosis is very good, despite advanced age. Elderly should not be a contraindication for decompressive lumbar spine surgery, however, since this high-risk population is more likely to suffer operative complications, special precautions are required. Factors associated with post-operative satisfaction are painkilling medication use and persistence of the radicular pain. A prospective study using patient-satisfaction standardised questionnaire would allow us to consolidate and potentially complete our results.Introduction : le canal lombaire étroit est une pathologie fréquente. Lorsqu'il est symptomatique, il se manifeste par une claudication radiculaire intermittente. La sténose acquise se développe préférentiellement au niveau de la jonction entre deux vertèbres par des phénomènes dégénératifs complexes associant une hypertrophie du ligament jaune, une altération des facettes articulaires, des protrusions discales et parfois un spondylolisthésis. C'est la première indication en neurochirurgie fonctionnelle rachidienne chez les personnes âgées. La population vieillissante des pays industrialisés, est accablée par de nombreuses comorbidités qui compliquent sa prise en charge. La sélection des patients éligibles à une chirurgie nécessite de connaître les enjeux d'un tel traitement et notamment les facteurs pronostiques liés à l'amélioration fonctionnelle. Objectifs: cette étude rétrospective a pour but de rechercher des déterminants du résultat fonctionnel dans la chirurgie du canal lombaire étroit chez des patients âgés de plus de 75 ans, en terme de satisfaction postopératoire. Patients et méthodes: il s'agit d'une étude rétrospective, monocentrique sur dossiers médicaux. Les patients inclus ont été opérés entre octobre 2006 et décembre 2014 d'une laminectomie lombaire et avaient au moins 75 ans lors de l'intervention. Des données démographiques, cliniques, para-cliniques, thérapeutiques, chirurgicales et de suivi ont été recueillies. Résultats : soixante-treize patients ont pu être sélectionnés avec une médiane de satisfaction de 85%. Aucun patient de notre étude n'a présenté d'aggravation secondaire à la chirurgie et aucun n’est décédé. L'analyse par modèle de régression linéaire montre que la prise d'antalgiques en pré- (pConclusion : les résultats fonctionnels de la chirurgie du canal lombaire étroit restent très bons malgré un âge avancé. L'âge ne doit pas être un frein à la chirurgie, mais des précautions particulières à la population vieillissante s'imposent. Les facteurs liés à la satisfaction postopératoire sont la consommation d'antalgiques et la persistance d'une radiculalgie. Une étude prospective utilisant des questionnaires de satisfaction standardisés nous permettrait de conforter et éventuellement de compléter nos résultats

Towards the understanding of the cocoa transcriptome: Production and analysis of an exhaustive dataset of ESTs of Theobroma cacao L. generated from various tissues and under various conditions

Theobroma cacao L., is a tree originated from the tropical rainforest of South America. It is one of the major cash crops for many tropical countries. T. cacao is mainly produced on smallholdings, providing resources for 14 million farmers. Disease resistance and T. cacao quality improvement are two important challenges for all actors of cocoa and chocolate production. T. cacao is seriously affected by pests and fungal diseases, responsible for more than 40% yield losses and quality improvement, nutritional and organoleptic, is also important for consumers. An international collaboration was formed to develop an EST genomic resource database for cacao. Fifty-six cDNA libraries were constructed from different organs, different genotypes and different environmental conditions. A total of 149,650 valid EST sequences were generated corresponding to 48,594 unigenes, 12,692 contigs and 35,902 singletons. A total of 29,849 unigenes shared significant homology with public sequences from other species. Gene Ontology (GO) annotation was applied to distribute the ESTs among the main GO categories. A specific information system (ESTtik) was constructed to process, store and manage this EST collection allowing the user to query a database. To check the representativeness of our EST collection, we looked for the genes known to be involved in two different metabolic pathways extensively studied in other plant species and important for T. cacao qualities: the flavonoid and the terpene pathways. Most of the enzymes described in other crops for these two metabolic pathways were found in our EST collection. A large collection of new genetic markers was provided by this ESTs collection. This EST collection displays a good representation of the T. cacao transcriptome, suitable for analysis of biochemical pathways based on oligonucleotide microarrays derived from these ESTs. It will provide numerous genetic markers that will allow the construction of a high density gene map of T. cacao. This EST collection represents a unique and important molecular resource for T. cacao study and improvement, facilitating the discovery of candidate genes for important T. cacao trait variation. (Résumé d'auteur

Deciphering the genome structure and paleohistory of _Theobroma cacao_

We sequenced and assembled the genome of _Theobroma cacao_, an economically important tropical fruit tree crop that is the source of chocolate. The assembly corresponds to 76% of the estimated genome size and contains almost all previously described genes, with 82% of them anchored on the 10 _T. cacao_ chromosomes. Analysis of this sequence information highlighted specific expansion of some gene families during evolution, for example flavonoid-related genes. It also provides a major source of candidate genes for _T. cacao_ disease resistance and quality improvement. Based on the inferred paleohistory of the T. cacao genome, we propose an evolutionary scenario whereby the ten _T. cacao_ chromosomes were shaped from an ancestor through eleven chromosome fusions. The _T. cacao_ genome can be considered as a simple living relic of higher plant evolution

A new insight in the nuclear and cytoplasmic diversity of T.Cacao: Consequences for the T. Cacao classification

An extended diversity study was carried out on a collection of 650T. cacao accessions representing the different geographic origins of native cocoa populations as well as cultivated populations. These populations were genotyped with 837 SNP markers defined in genes with a putative known function. Classical genetic parameters were calculated to characterize the diversity existing inside and between populations, highlighting a classification of the T. cacao species in three main genetic groups. SNP alleles, specific to some populations could be identified. A cytoplasmic diversity, based on SNP identified in chloroplastic and mitochondrial genomes, also allowed for a refinement of the T. cacao classification. An estimation of linkage disequilibrium, reflecting the extend of physical linkage conserved between markers and genetic mixing was made in each population. In parallel with the exploitation of linkage disequilibrium as a genome mapping approach, the detection of outlying loci concerning genetic differentiation provides a complementary strategy for identifying genome regions and candidate genes related to adaptive traits. This strategy was applied to the set of SNP presented in this study considering the genetic structure previously highlighted. Some SNP markers located in the vicinity of annotated genes, exhibited diversity patterns consistent with evidence of selection events, suggesting their potential interest to monitor breeding efforts for adaptive traits suchas disease resistance or environmental changes. (Résumé d'auteur

Discovery and mapping of a new expressed sequence tag-single nucleotide polymorphism and simple sequence repeat panel for large-scale genetic studies and breeding of Theobroma cacao L.

Theobroma cacao is an economically important tree of several tropical countries. Its genetic improvement is essential to provide protection against major diseases and improve chocolate quality. We discovered and mapped new expressed sequence tag-single nucleotide polymorphism (EST-SNP) and simple sequence repeat (SSR) markers and constructed a high-density genetic map. By screening 149 650 ESTs, 5246 SNPs were detected in silico, of which 1536 corresponded to genes with a putative function, while 851 had a clear polymorphic pattern across a collection of genetic resources. In addition, 409 new SSR markers were detected on the Criollo genome. Lastly, 681 new EST-SNPs and 163 new SSRs were added to the pre-existing 418 co-dominant markers to construct a large consensus genetic map. This high-density map and the set of new genetic markers identified in this study are a milestone in cocoa genomics and for marker-assisted breeding. The data are available at http://tropgenedb.cirad.fr

QTL detection and marker assisted selection for the resistance to Phytophthora palmivora using a F2 Theobroma cacao L. progeny

Background. Obtain sustainable varieties resistant to disease is one of the main goals of genetic improvement of cocoa. In partnership between CEPLAC (Comissão Executiva do Plano da Lavoura Cacauiero) and CIRAD (Centre International de Recherche Agronomique pour le Développement), studies to detect and characterize QTLs for resistance to witches' broom (Moniliophthora perniciosa) and to pod rot (Phytophthora .palmivora), are conducted. QTL detection for resistance to Phytophthora. palmivora, were carried out from a segregating F2 progeny (172 ind) resulting from the cross between Scavina-6 (resistant Forastero clone) and ICS1 (susceptible Trinitario clone) . Phenotic symptoms were revealed seven days after inoculation by a P. palmivora strain (CEPLAC phytopathology laboratory collection) . A drop of 0.2ml of a concentrated solution of zoospores was deposited on leaf discs. Phenotypic analyses on necrosis severity (note 0 :without penetration point until note 5 :total necrosis) were obtained from sixty discs per genotype. QTL analyses were carried out using a genetic map established with 202 markers (SNPs and SSRs). The remaining par of the F2 population (972 individuals excluding plants used for the QTL analysis), was genotyped with the SSR markers associated with QTLs detected. The 972 genotypes were classified according to the presence of favorable QTL-allele or unfavorable QTL-allele. Phenotypic analyses on necrosis severity were carried under the same conditions as for the QTL analysis and two sets of thirty seven selected genotypes with favorable QTLs and unfavorable QTLs, were inoculated. Results. The remaining par of the F2 population (972 individuals) was genotyped with the SSR markers : mTcCIR91, mTcCIR175 et mTcCIR430, respectively associated with the three QTLs detected in the linkage groups 10, 3 and 2, explaining 25% of the total variation. Statistical analysis results presented here, show a significative difference between both sets of plants, showing a very efficiency selection for Phytophthora resistance only with these markers close to QTLs. Conclusion. Scavina-6 is also an important source of resistance to witches' broom (Moniliophthora perniciosa) The same approach using this same F2 population Scavina-6 by ICS1, is underway to select resistant plants. (Résumé d'auteur

Sequencing the Cocoa criollo genome : An international initiative of the ICGS (International Cocoa Genome Sequencing) consortium (P050)

Theobroma cacao L., is a diploid tree fruit species (2n = 2x = 20), originated from the South American rainforests. A criollo genotype, providing a high quality chocolate and highly homozygous, has been choosing by the ICGS to sequence the cocoa genome. A combination of Sanger and NGS technologies was chosen for sequencing the criollo genotype, with a genome coverage of 16,7 X. The assembly corresponds to 76% of the estimated genome size of the criollo genotype (430 Mb) and appears to cover a very large proportion of the euchromatin of the T. cacao genome, allowing to recover 97.8% of the transcriptome unigene resource. Annotations revealed 28,798 protein-coding genes. This first cocoa genome sequence was the support to inventory in the cocoa genome important gene families potentially involved in resistance and quality traits. Their localisation in the genome and their comparison with QTLs involved in these traits provide a large set of candidate genes. The inferred paleohistory of the T. cacao genome has highlighted the close evolutionary relationship of the T. cacao genome to the eudicot putative ancestor, as was also observed in grape. We propose an evolutionary scenario whereby the ten T. cacao chromosomes were shaped from an ancestor through only eleven chromosome fusions. It represents a new and simple model to study evolutionary processes, gene functions, genetics and biochemistry of tree fruit crops. A genome browser allows to access freely to the cocoa sequence data at the following website : http://cocoagendb.cirad.fr. (Texte intégral

Deciphering the genome structure of Theobroma cacao (W107)

Theobroma cacao L., is a diploid tree fruit species, originated from the South American rainforests, and constitutes an important source of incomes for farmers of tropical countries. We produced a high quality draft genome sequence corresponding to a 16,7X genome coverage of a criollo genotype. The assembly corresponds to 76% of the estimated genome size of the T. cacao genotype B97-61/B2 (430 Mbp). This assembly appears to cover a very large proportion of the euchromatin of the T. cacao genome, allowing to recover 97.8% of the unigene resource (38,737 unigenes assembled from 715,457 EST sequences) in the genome assembly. Annotations revealed 28,798 protein-coding genes among which 82% could be anchored in a high density genetic map. Only 20% of the genome consisted in transposable elements, a significantly lower percentage compared to other genome of similar size. This first cocoa genome sequence was the support for several genome analyses revealing specific extension of some gene families. The comparative mapping of genes involved in disease resistance and quality traits, localised in the genome sequence, and QTLs related to these traits highlighted several co-localisations between them and candidate genes potentially involved in useful cocoa trait variations. This genome sequence will facilitate a better understanding of trait elaboration and will accelerate T. cacao breeding through efficient marker assisted selection and exploitation of genetic resources. A genome browser allows to access freely to the cocoa sequence data at the following website : http://cocoagendb.cirad.fr. (Texte intégral