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Thouvenin J, Van Marcke C, Decoster L, Raicevic G, Punie K, Vandenbulcke M, Salgado R, Van Valckenborgh E, Maes B, Joris S, Steichel DV, Vranken K, Jacobs S, Dedeurwaerdere F, Martens G, Devos H, Duhoux FP, Rasschaert M, Pauwels P, Geboes K, Collignon J, Tejpar S, Canon JL, Peeters M, Rutten A, Van de Mooter T, Vermeij J, Schrijvers D, Demey W, Lybaert W, Van Huysse J, Mebis J, Awada A, Claes KBM, Hebrant A, Van der Meulen J, Delafontaine B, Bempt IV, Maetens J, de Hemptinne M, Rottey S, Aftimos P, De Grève J. PRECISION: the Belgian molecular profiling program of metastatic cancer for clinical decision and treatment assignment. ESMO Open 2022; 7:100524. [PMID: 35970014 PMCID: PMC9434164 DOI: 10.1016/j.esmoop.2022.100524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/24/2022] [Accepted: 05/30/2022] [Indexed: 11/29/2022] Open
Abstract
PRECISION is an initiative from the Belgian Society of Medical Oncology (BSMO) in collaboration with several stakeholders, encompassing four programs that aim to boost genomic and clinical knowledge with the ultimate goal to offer patients with metastatic solid tumors molecularly guided treatments. The PRECISION 1 study has led to the creation of a clinico-genomic database. The Belgian Approach for Local Laboratory Extensive Tumor Testing (BALLETT) and GeNeo studies will increase the number of patients with advanced cancer that have comprehensive genotyping of their cancer. The PRECISION 2 project consists of investigator-initiated phase II studies aiming to provide access to a targeted drug for patients whose tumors harbor actionable mutations in case the matched drug is not available through reimbursement or clinical trials in Belgium.
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Affiliation(s)
- J Thouvenin
- Hospices Civils de Lyon, Medical Oncology, Lyon, France; Institut Jules Bordet, Medical Oncology Clinic, Brussels, Belgium
| | | | - L Decoster
- UZ Brussel, Medical Oncology, Brussels, Belgium
| | | | - K Punie
- KU Leuven University Hospitals Leuven, General Medical Oncology, Leuven, Belgium
| | | | - R Salgado
- GasthuisZusters Antwerpen, Pathology, Antwerp, Belgium
| | | | - B Maes
- Laboratory of Molecular Diagnostics, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium
| | - S Joris
- UZ Brussel, Medical Oncology, Brussels, Belgium
| | | | - K Vranken
- Pediatric Oncology, WIV-ISP, Leuven, Belgium
| | | | | | - G Martens
- Laboratoriumgeneeskunde, AZ Delta, Roeselare, Belgium
| | - H Devos
- Laboratoriumgeneeskunde, AZ Sint-Jan, Bruges, Belgium
| | - F P Duhoux
- UCLouvain, Ottignies-Louvain-la-Neuve, Belgium
| | - M Rasschaert
- Universitair Ziekenhuis Antwerpen, Medical Oncology, Antwerpen, Belgium; Medical Oncology, AZ Monica, Deurne, Belgium
| | - P Pauwels
- Universitair Ziekenhuis Antwerpen, Pathology, Antwerpen, Belgium
| | - K Geboes
- Division of Digestive Oncology, Department of Gastroenterology, UZ Gent, Gent, Belgium; Department of Internal Medicine and Pediatrics, UZ Gent, Gent, Belgium
| | - J Collignon
- Medical Oncology, CHU de Liege - Hospital Sart Tilman, Liège, Belgium
| | | | - J-L Canon
- Grand Hôpital de Charleroi Site Notre Dame, Service d'Oncologie-Hématologie, Charleroi, Belgium
| | - M Peeters
- Universitair Ziekenhuis Antwerpen, Oncology, Antwerpen, Belgium
| | - A Rutten
- GZA Ziekenhuizen Campus Sint-Vincentius, Medical Oncology, Antwerpen, Belgium
| | - T Van de Mooter
- GZA Ziekenhuizen Campus Sint-Vincentius, Medical Oncology, Antwerpen, Belgium
| | - J Vermeij
- ZNA Middelheim, Medical Oncology, Antwerpen, Belgium
| | | | - W Demey
- AZ Klina, Medical Oncology, Brasschaat, Belgium
| | - W Lybaert
- GZA Ziekenhuizen Campus Sint-Vincentius, Medical Oncology, Antwerpen, Belgium
| | - J Van Huysse
- AZ Sint-Jan Brugge-Oostende, Pathology, Brugge, Belgium
| | - J Mebis
- Laboratory of Molecular Diagnostics, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium
| | - A Awada
- Institut Jules Bordet, Medical Oncology Clinic, Anderlecht, Belgium
| | | | | | | | | | | | | | | | - S Rottey
- Medical Oncology Department, UZ Gent, Gent, Belgium
| | - P Aftimos
- Institut Jules Bordet, Medical Oncology Clinic, Anderlecht, Belgium
| | - J De Grève
- UZ Brussel, Medical Oncology, Brussels, Belgium.
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Hoang I, Paire-Ficout L, Derollepot R, Perrey S, Devos H, Ranchet M. Increased prefrontal activity during usual walking in aging. Int J Psychophysiol 2022; 174:9-16. [DOI: 10.1016/j.ijpsycho.2022.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 10/10/2021] [Accepted: 01/24/2022] [Indexed: 10/19/2022]
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Hoang I, Ranchet M, Cheminon M, Derollepot R, Devos H, Perrey S, Luauté J, Danaila T, Paire-Ficout L. An intensive exercise-based training program reduces prefrontal activity during usual walking in patients with Parkinson’s disease. Clin Park Relat Disord 2022; 6:100128. [PMID: 34988428 PMCID: PMC8704467 DOI: 10.1016/j.prdoa.2021.100128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 12/08/2021] [Accepted: 12/09/2021] [Indexed: 11/28/2022] Open
Abstract
Patients with Parkinson’s disease have increased prefrontal activity during usual walking. After SIROCCO training, prefrontal activity decreased and gait performance improved in patients. An intensive exercise-based training program increased automaticity of gait in patients with PD. Findings highlight the potential of neuroplasticity in PD after exercise.
Introduction Parkinson’s disease (PD) leads to a progressive loss of locomotor automaticity. Consequently, PD patients rely more on executive resources for the control of gait, resulting in increased prefrontal activity while walking. Exercise-based training programs may improve automaticity of walking and reduce prefrontal activity in this population. This study aimed to assess the effect of an intensive multidisciplinary exercise-based training program on prefrontal activity and gait performance during usual walking in PD patients. Method Fourteen patients (mean age: 67 ± 9; disease duration: 6 ± 5 years; Hoehn and Yahr score: 1.9 ± 0.6) were included in this study. They were assessed in ON stage at three different times at 5-week intervals: two times before the training program (T0 and T1) and once after the training program (T2). Gait performance (stride time, speed, stride length, cadence, and their respective coefficient of variation) and cortical activity in the dorsolateral prefrontal cortex (DLPFC) using functional near infrared spectroscopy (fNIRS) were measured during usual walking. Results Patients had reduced cortical activity of the DLPFC at T2 compared to T1 (p = 0.003). Patients had shorter stride time at T2 compared to T1 (p = 0.025) and tended to have longer stride length at T2 than at T1 (p = 0.056). Conclusion The training program led to positive effects on prefrontal activity and gait performance. Reduced prefrontal activity during usual walking after training program suggests that patients may have a greater reserve capacity to face more challenging walking conditions. Further studies will investigate the effect of this training on cortical activity during dual-task walking..
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Affiliation(s)
- I. Hoang
- TS2-LESCOT, Univ Gustave Eiffel, IFSTTAR, Univ Lyon, F-69675 Lyon, France
- Corresponding author at: Université Gustave Eiffel, TS2-LESCOT, Cité des Mobilités, 25, Avenue François Mitterrand, Case 24, F-69675 Bron Cedex, France.
| | - M. Ranchet
- TS2-LESCOT, Univ Gustave Eiffel, IFSTTAR, Univ Lyon, F-69675 Lyon, France
| | - M. Cheminon
- Service de Rééducation Neurologique, Hôpital Henry-Gabrielle, Hospices Civils de Lyon, Lyon, France
| | - R. Derollepot
- TS2-LESCOT, Univ Gustave Eiffel, IFSTTAR, Univ Lyon, F-69675 Lyon, France
| | - H. Devos
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, School of Health Professions, The University of Kansas Medical Center, Kansas City, KS, USA
| | - S. Perrey
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Alès, Montpellier, France
| | - J. Luauté
- Service de Rééducation Neurologique, Hôpital Henry-Gabrielle, Hospices Civils de Lyon, Lyon, France
- Inserm UMR-S 1028, CNRS UMR 529, ImpAct, Centre de Recherche en Neurosciences de Lyon, université Lyon-1, 16, avenue Lépine, 69676 Bron, France
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - T. Danaila
- Centre de Neurosciences Cognitives, Service de Neurologie C, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Université Claude Bernard Lyon I, Lyon, France
| | - L. Paire-Ficout
- TS2-LESCOT, Univ Gustave Eiffel, IFSTTAR, Univ Lyon, F-69675 Lyon, France
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Tsugu T, Tanaka K, Belsack D, Devos H, Nagatomo Y, Michiels V, Argacha JF, Cosyns B, Buls N, De Mey J. Effects of left ventricular mass index on computed tomography derived fractional flow reserve in significant obstructive coronary artery disease. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In significant obstructive coronary artery disease (SOCAD), a mismatched assessment of the severity of coronary artery stenosis may occur between invasive coronary angiography and computed tomography (CT) derived fractional flow reserve (FFRCT). The exact mechanisms of unexpected underestimation of FFRCT remain unknown.
Purpose
The aims of this study are (1) to clarify the mechanisms of underestimation on FFRCT; and (2) to identify the predictive factors of FFRCT underestimation above the value of 0.80 in SOCAD vessels.
Methods
A total of 1160 outpatients who underwent CT angiography (CTA) with FFRCT analysis for suspected coronary artery disease (CAD) between January 2017 and June 2020 were evaluated. Among them, 141 consecutive patients who had both CTA coupled to FFRCT analysis and invasive angiogram showing >75% coronary stenosis were included for analysis. Vessels were divided into two groups according to FFRCT at the distal vessel: FFRCT >0.80 (n=12) and FFRCT ≤0.80 (n=153). Vessel-related parameters, including vessel morphology (vessel length and lumen volume) and plaque components (non-calcified plaque volume and calcified plaque volume) and left ventricular (LV) myocardial-related parameters, including LV wall thickness at each site of the myocardium, and LV mass were evaluated semi-automatically.
Results
Vessel morphology and plaque components did not differ between FFRCT >0.80 and ≤0.80, whereas LV wall thickness (average; 10.7±2.7 vs. 8.4±1.6 mm, and maximal; 13.5±3.0 vs. 10.6±1.8 mm, all p value <0.001), LV mass (136.4±38.4 vs. 98.8±26.8 g, p<0.001), and LV mass index (73.8±22.6 vs. 51.8±12.2 g/m2, p<0.001) were significantly higher in FFRCT >0.80. Next, we investigated the parameters that correlated with FFRCT. Of all, vessel morphology and plaque components were not related to FFRCT, whereas maximal LV wall thickness, r=0.24, p=0.01; LV mass, r=0.19. p=0.04; and LV mass index, r=0.30, p=0.001) correlated with FFRCT. In the vessels showing FFRCT >0.80, only LV mass (r=0.84, p=0.005) and LV mass index (r=0.67, p=0.047) correlated with FFRCT. (Figure 1). LV mass index was the strongest predictor of a distal FFRCT of >0.80 with the area under curve (AUC) 0.81, 95% CI 0.62 – 1.00, P<0.0001 and an optimal cut-off value of 66.5 g/m2 sensitivity 77.8%, specificity 89.6% (Figure 2).
Conclusions
FFRCT is affected not by vessel-related parameters but LV myocardial-related parameters in SOCAD. The presence of an excessive LV mass is a major predictor of underestimation of FFRCT in SOCAD vessels. LV myocardial-related parameters should be considered when interpreting numerical values of FFRCT to avoid the possibility of overlooked SOCAD.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- T Tsugu
- Universitair Ziekenhuis Brussel, Department of Radiology, Brussels, Belgium
| | - K Tanaka
- Universitair Ziekenhuis Brussel, Department of Radiology, Brussels, Belgium
| | - D Belsack
- Universitair Ziekenhuis Brussel, Department of Radiology, Brussels, Belgium
| | - H Devos
- Universitair Ziekenhuis Brussel, Department of Radiology, Brussels, Belgium
| | - Y Nagatomo
- National Defense Medical College Hospital, Department of Cardiology, Tokorozawa, Japan
| | - V Michiels
- Universitair Ziekenhuis Brussel, Cardiology, Centrum voor Hart- en Vaatziekten, Brussels, Belgium
| | - J F Argacha
- Universitair Ziekenhuis Brussel, Cardiology, Centrum voor Hart- en Vaatziekten, Brussels, Belgium
| | - B Cosyns
- Universitair Ziekenhuis Brussel, Cardiology, Centrum voor Hart- en Vaatziekten, Brussels, Belgium
| | - N Buls
- Universitair Ziekenhuis Brussel, Department of Radiology, Brussels, Belgium
| | - J De Mey
- Universitair Ziekenhuis Brussel, Department of Radiology, Brussels, Belgium
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Tsugu T, Tanaka K, Belsack D, Devos H, Nagatomo Y, Michiels V, Argacha JF, Cosyns B, Buls N, De Mey J. Impact of vascular morphology and plaque characteristics on computed tomography derived fractional flow reserve in early stage coronary artery disease. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
FFRCT gradually decreases from the proximal to the distal part of a vessel and reach the pathological threshold for significant ischemia even in the absence of obstructive coronary artery disease (CAD). The exact mechanisms of such gradual FFRCT decline remain unknown.
Purpose
The aims of this study are (1) to clarify the mechanisms of the gradual decline of computed tomography (CT) derived fractional flow reserve (FFRCT); and (2) to identify the predictive factors of an FFRCT decline below the pathological value of 0.80 in no apparent CAD vessels.
Methods
A total of 1058 outpatients with suspected CAD and who underwent CT angiography (CTA) with FFRCT analysis between January 2017 and December 2019 were evaluated. Among them, 150 consecutive patients who had both a CTA coupled to an FFRCT analysis and an invasive angiogram showing <25% coronary stenosis were included for analysis. Vessels were divided into two groups according to FFRCT at the distal vessel: FFRCT >0.80 (n=317) and FFRCT ≤0.80 (n=114). ΔFFRCT was defined as the magnitude of the change in FFRCT from the proximal to the distal vessel. Plaque characterization and vessel morphology measurements were performed semi-automatically. Vessel constituents were characterized based on Hounsfield units (HU) into lumen volume (<−50 HU), non-calcified plaque (NCP) (−50–150 HU), and calcified plaque (>150 HU).
Results
FFRCT decreased continuously from the proximal to distal across the three major vessels in both FFRCT>0.80 and FFRCT ≤0.80 groups (Figure 1). Compared to FFRCT>0.80 group, NCP volume was significantly higher in all three major vessels in FFRCT ≤0.80 group (210.2±83.6 mm3 vs. 140.9±139.3 mm3 for the RCA, p=0.01; 177.5±150.2 mm3 vs. 133.2±112.2 mm3 for the LAD, p=0.04; 127.6±91.5 mm3 vs. 58.7±57.7 mm3 for the LCX, p<0.01). Next, we investigated the vessel parameters that correlated with ΔFFRCT. ΔFFRCT was correlated with lumen volume in FFRCT>0.80 group (r=−0.24, p<0.0001), whereas ΔFFRCT was correlated with NCP volume in FFRCT ≤0.80 group (r=0.42, p<0.001) (Figure 2). An NCP volume above 44.8 mm3 was the strongest predictor of distal FFRCT of ≤0.80 (area under the curve 0.69, p<0.0001, sensitivity 95%, specificity 39%).
Conclusions
FFRCT is affected by vascular morphology and plaque characteristics even in the early stage of coronary artery disease. Our study highlights that subclinical coronary artery disease strongly influences FFRCT by effects unrelated to coronary stenosis. The presence of NCP is a major predictor of the gradual decrease of FFRCT toward pathological values. Anatomical findings as vessel morphology and plaque characteristics should be taken into consideration when interpreting numerical values of FFRCT to avoid unnecessary referrals for invasive coronary angiography or percutaneous coronary intervention.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- T Tsugu
- Universitair Ziekenhuis Brussel, Department of Radiology, Brussels, Belgium
| | - K Tanaka
- Universitair Ziekenhuis Brussel, Department of Radiology, Brussels, Belgium
| | - D Belsack
- Universitair Ziekenhuis Brussel, Department of Radiology, Brussels, Belgium
| | - H Devos
- Universitair Ziekenhuis Brussel, Department of Radiology, Brussels, Belgium
| | - Y Nagatomo
- National Defense Medical College Hospital, Department of Cardiology, Tokorozawa, Japan
| | - V Michiels
- Universitair Ziekenhuis Brussel, Cardiology, Centrum voor Hart- en Vaatziekten, Brussels, Belgium
| | - J F Argacha
- Universitair Ziekenhuis Brussel, Cardiology, Centrum voor Hart- en Vaatziekten, Brussels, Belgium
| | - B Cosyns
- Universitair Ziekenhuis Brussel, Cardiology, Centrum voor Hart- en Vaatziekten, Brussels, Belgium
| | - N Buls
- Universitair Ziekenhuis Brussel, Department of Radiology, Brussels, Belgium
| | - J De Mey
- Universitair Ziekenhuis Brussel, Department of Radiology, Brussels, Belgium
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Abstract
Objective: To examine the symptoms experienced and the change in driving habits in individuals with concussion.Materials and methods: A survey was created by a team of rehabilitation professionals who see persons with concussion in their clinics. The survey captured demographics, mechanism of injury, date of injury, symptoms experienced during driving, if drivers felt safe when driving, and changes in driving habits since the concussion. Non-parametric tests were used to compare symptoms experienced and driving habits across three groups which were created based on time since injury.Results: Of the 140 participants, 74% (104/140) had resumed driving after concussion; of these 27% (28/104) reported that they felt unsafe while driving. Forty-four per cent (46/104) experienced symptoms while driving, of which headache, and difficulty concentrating were the most common symptoms experienced throughout the concussion spectrum (acute to chronic phase). Most drivers (78/104, 75%) with concussion had changed their driving habits by driving less often and shorter distances, and by avoiding nighttime driving and heavy traffic areas.Conclusions: Headache and concentration problems were experienced by drivers regardless of the time since injury. Most drivers had made changes to their driving habits. Clinicians should consider the symptom burden patients experience and discuss driving restrictions to ensure driving safety.
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Affiliation(s)
- L D'Silva
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas, USA
| | - H Devos
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas, USA
| | - S L Hunt
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas, USA
| | - J Chen
- Center for Concussion Management, University of Kansas Health System, Kansas City, Kansas, USA
| | - D Smith
- Center for Concussion Management, University of Kansas Health System, Kansas City, Kansas, USA
| | - M A Rippee
- Center for Concussion Management, University of Kansas Health System, Kansas City, Kansas, USA
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Hsieh KL, Mirelman A, Shema-Shiratzky S, Galperin I, Regev K, Shen S, Schmitz-Hübsch T, Karni A, Paul F, Devos H, Sosnoff JJ, Hausdorff JM. A multi-modal virtual reality treadmill intervention for enhancing mobility and cognitive function in people with multiple sclerosis: Protocol for a randomized controlled trial. Contemp Clin Trials 2020; 97:106122. [PMID: 32858229 DOI: 10.1016/j.cct.2020.106122] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/25/2020] [Accepted: 07/06/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Gait and cognitive impairments are common in individuals with Multiple Sclerosis (MS) and can interfere with everyday function. Those with MS have difficulties executing cognitive tasks and walking simultaneously, a reflection of dual-task interference. Therefore, dual-task training may improve functional ambulation. Additionally, using technology such as virtual reality can provide personalized rehabilitation while mimicking real-world environments. The purpose of this randomized controlled trial is to establish the benefits of a combined cognitive-motor virtual reality training on MS symptoms compared to conventional treadmill training. METHODS This study will be a single-blinded, two arm RCT with a six-week intervention period. 144 people with MS will be randomized into a treadmill training alone group or treadmill training with virtual reality group. Both groups will receive 18 sessions of training while walking on a treadmill, with the virtual reality group receiving feedback from the virtual system. Primary outcome measures include dual-task gait speed and information processing speed, which will be measured prior to training, one-week post-training, and three months following training. DISCUSSION This study will provide insight into the ability of a multi-modal cognitive-motor intervention to reduce dual-task cost and to enhance information processing speed in those with MS. This is one of the first studies that is powered to understand whether targeted dual-task training can improve MS symptoms and increase functional ambulation. We anticipate that those in the virtual reality group will have a significantly greater increase in dual-task gait speed and information processing speed than those achieved via treadmill training alone.
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Affiliation(s)
- K L Hsieh
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Illinois Multiple Sclerosis Research Collaborative, Interdisciplinary Health Science Institute, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - A Mirelman
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Department of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S Shema-Shiratzky
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - I Galperin
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - K Regev
- Neuroimmunology and Multiple Sclerosis Unit of the Neurology Division, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - S Shen
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - T Schmitz-Hübsch
- NeuroCure, Charité - Universitaetsmedizin Berlin, Berlin, Germany; Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitaetsmedizin Berlin, Berlin, Germany
| | - A Karni
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Department of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Neuroimmunology and Multiple Sclerosis Unit of the Neurology Division, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - F Paul
- NeuroCure, Charité - Universitaetsmedizin Berlin, Berlin, Germany; Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitaetsmedizin Berlin, Berlin, Germany; Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - H Devos
- Laboratory for Advanced Rehabilitation Research in Simulation, Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - J J Sosnoff
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Illinois Multiple Sclerosis Research Collaborative, Interdisciplinary Health Science Institute, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - J M Hausdorff
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
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Ranchet M, Morgan JC, Akinwuntan AE, Devos H. Visual search and target detection during simulated driving in Parkinson's disease. Accid Anal Prev 2020; 134:105328. [PMID: 31639583 DOI: 10.1016/j.aap.2019.105328] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 09/04/2019] [Accepted: 10/15/2019] [Indexed: 06/10/2023]
Abstract
Patients with Parkinson's Disease (PD) often exhibit difficulties with visual search that may impede their ability to recognize landmarks and cars while driving. The main objective of this study was to investigate visual search performances of both billboards and cars in patients with PD using a driving simulator. A second objective was to examine the role of cognitive functions in performing the visual search task while driving. Nineteen patients with PD (age: 68 ± 8yo, sex (Men/Women): 15/4) and 14 controls (age: 60 ± 11yo, sex: 7/7) first performed a battery of cognitive tests. They then drove in a simulator and were instructed to follow a lead vehicle while searching for billboards with the letter A (stationary target) or red cars (moving target) among other distractors. Accuracy and response times of visual search were the main outcome variables. Standard deviation of lateral position (SDLP) was the secondary outcome. During driving, patients were less accurate in identifying the targets, particularly for the stationary billboards located in the outer periphery. Within the group of patients, significant correlations were found between several measures of cognitive tests and simulator-based visual search accuracy. By contrast, only the score on the MOCA test correlated significantly with visual search accuracy in controls. Findings suggest that patients with PD have impaired visual search for more eccentric stationary targets while driving a simulator, which is likely due to cognitive deficits. Difficulties identifying objects in the outer periphery may have implications for driving safety. Decreased functional field of view under increased cognitive load may have attributed to the difficulties identifying these landmarks. This may impact the ability to identify, anticipate, and respond to important information (e.g., pedestrians, navigation signs, landmarks), especially in complex driving situations (e.g. urban driving or intersections).Future studies should be conducted in a larger sample size to determine whether a visual search task on a driving simulator may predict on-road driving performances.
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Affiliation(s)
- M Ranchet
- Univ Lyon, F-69000 Lyon, France; IFSTTAR, TS2, LESCOT, F-69500, Bron, France.
| | - J C Morgan
- Parkinson's Foundation Center of Excellence, Movement and Memory Disorder Programs, Department of Neurology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - A E Akinwuntan
- Dean's Office, School of Health Professions, The University of Kansas Medical Center, Kansas City, KS, USA
| | - H Devos
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, The University of Kansas Medical Center, Kansas City, KS, USA
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Schmidt JD, Lynall RC, Lempke LB, Devos H. Post-concussion Driving Management Practices Among Certified Athletic Trainers. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz026.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Purpose
To describe post-concussion driving management practices and opinions among athletic trainers (ATs) and to compare practices across highest earned degree, setting, and years certified.
Methods
A survey weblink was emailed to a convenience sample of 8,723 ATs (10.8% response rate [945/8723]; years certified=14.5±10.7; years worked clinically=12.4±9.4). The validated survey captured AT driving management practices and opinions (agreement on a seven-point Likert scale). We compared the percentage of patients instructed to refrain from driving across highest earned degree, setting, and years certified using Kruskal-Wallis tests (alpha=0.05).
Results
When asked whether they recommended concussed patients refrain from driving, 58.5% of ATs responded “sometimes” (n=553/945), 37.9% responded “always” (n=358/945), and 3.6% responded “never” (n=34/945). ATs most commonly: recommended patients refrain from driving until symptom resolution (44.7%, n=399/892); utilized their clinical exam to determine readiness to return-to-drive (64.9%, n=579/892); and provided instructions verbally (94.2%, n=840/892). ATs agreed that “patients that are impaired by a concussion are a danger on the road”, but only somewhat agreed that “patients with suspected concussion should not drive a motor vehicle until cleared to do so by a medical professional” (median=5). High school (60.5±37.6%) and clinic-based ATs (66.5±31.2%) trended towards higher percentages of patients instructed to refrain from driving relative to college (52.3±38.2%; H(2)=5.92,p=0.052). No other differences observed.
Conclusion
ATs recommend driving restrictions to some, but not all, concussed patients. ATs recognize post-concussion driving dangers, but do not strongly endorse refraining from driving after concussion. High school and clinic-based ATs may manage more adolescent novice drivers and, therefore, act more conservatively.
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Ranchet M, Morgan J, Akinwuntan A, Devos H. Cognitive determinants of visual search in patients with Parkinson's disease. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Akinwuntan AE, Backus D, Grayson J, Devos H. Validation of a short cognitive battery to screen for fitness-to-drive of people with multiple sclerosis. Eur J Neurol 2018; 25:1250-1254. [PMID: 29802779 DOI: 10.1111/ene.13690] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/22/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Some symptoms of multiple sclerosis (MS) affect driving. In a recent study, performance on five cognitive tests predicted the on-road test performance of individuals with relapsing-remitting MS with 91% accuracy, 70% sensitivity and 97% specificity. However, the accuracy with which the battery will predict the driving performance of a different cohort that includes all types of MS is unknown. METHODS Participants (n = 118; 48 ± 9 years of age; 97 females) performed a comprehensive off-road evaluation that lasted about 3 h and a standardized on-road test that lasted approximately 45 min over a 2-day period within the same week. Performance on the five cognitive tests was used to predict participants' performance on the standardized on-road test. RESULTS Performance on the five tests together predicted outcome of the on-road test with 82% accuracy, 42% sensitivity and 90% specificity. CONCLUSIONS The accuracy of predicting the on-road performance of a new MS cohort using performance on the battery of five cognitive tests remained very high (82%). The battery, which was administrable in <45 min and cost ~$150, was better at identifying those who actually passed the on-road test (90% specificity). The sensitivity (42%) of the battery indicated that it should not be used as the sole determinant of poor driving-related cognitive skills. A fail performance on the battery should only imply that more comprehensive testing is warranted.
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Affiliation(s)
- A E Akinwuntan
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - D Backus
- MS Rehabilitation and Wellness Program, Shepherd Center, Atlanta, GA, USA
| | - J Grayson
- Department of Business Administration, Augusta University, Augusta, GA, USA
| | - H Devos
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA
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Gils S, Cauwelier B, Devos H, Vanlaere I, Roggeman S, Emmerechts J. Evaluation of two automated cell counters for the analysis of hematopoietic progenitor cell apheresis products. Int J Lab Hematol 2017; 39:243-250. [PMID: 28444843 DOI: 10.1111/ijlh.12617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 11/21/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Routine hematology parameters in hematopoietic progenitor cell apheresis products (HPC-A) are usually determined using automated cell counters. These instruments, however, are designed to analyze whole blood samples, that differ considerably from HPC-A in blood cell composition. This study evaluates the performance of two automated cell counters for the analysis of HPC-A. METHODS Routine hematology parameters [red blood cells (RBC), hematocrit (HCT), mean corpuscular volume (MCV), white blood cells (WBC), WBC differentiation, and platelets (PLT)] were determined on the Unicel DxH 800 instrument (Beckman Coulter) and the XN-350 instrument (Sysmex). Correlations with the reference methods, intrarun precision, and linearity of the analyses were studied. RESULTS Good correlations were found for almost all parameters. However, RBC count was overestimated by XN-350, using the impedance technique, as was neutrophil percentage using DxH 800. Coefficients of variation for intrarun precision were below 10% on both analyzers for all parameters, except for neutrophil percentage (14.7%) and PLT (10%) on DxH 800. Both instruments showed good linearity for all parameters, except for RBC and HCT on DxH 800. CONCLUSION With the exception of the measurement of neutrophils on DxH 800 and RBC by the impedance technique on the XN-350, routine hematology parameters in HPC-A can safely be determined using automated cell counters.
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Affiliation(s)
- S Gils
- AZ Sint-Jan hospital, Bruges, Belgium
| | | | - H Devos
- AZ Sint-Jan hospital, Bruges, Belgium
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Ranchet M, Orlosky J, Morgan J, Qadir S, Akinwuntan AE, Devos H. Pupillary response to cognitive workload during saccadic tasks in Parkinson's disease. Behav Brain Res 2017; 327:162-166. [PMID: 28366772 DOI: 10.1016/j.bbr.2017.03.043] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 03/24/2017] [Accepted: 03/27/2017] [Indexed: 11/17/2022]
Abstract
The relationship between cognitive workload and cognitive impairments in Parkinson's disease (PD) is currently not well known. This study compared cognitive workload during saccadic tasks between patients with PD and controls. Sixteen controls, 11 patients with no obvious cognitive impairment (PD-NCI) (MOCA score≥26), and 10 PD patients with cognitive impairment (PD-CI) (MOCA score<26) performed prosaccade and antisaccade tasks. Cognitive workload, extracted via pupil recording, and other eye metrics were compared between the three groups. PD-NCI patients exhibited greater cognitive workload than controls in the prosaccade task. PD-CI patients also showed more cognitive workload in the prosaccade task than PD-NCI patients and controls. No other differences in eye metrics were found between the three groups. Cognitive workload could be used to differentiate between different cognitive states in PD. The causal relationship between increased cognitive workload and cognitive decline in PD-NCI should be the focus of future studies.
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Affiliation(s)
- M Ranchet
- Department of Physical Therapy, College of Allied Health Sciences, Augusta University, Augusta, GA, USA; University of Lyon, F-69000 Lyon, France; French Institute of Science and Technology for Transport, Development and Networks (IFSTTAR), TS2, LESCOT, F-69500 Bron, France.
| | - J Orlosky
- Cybermedia Center, Toyonaka Educational Research Center 5F, Osaka University, 1-32 Machikaneyama, Toyonaka, Osaka 560-0043, Japan
| | - J Morgan
- Movement and Cognitive Disorders Center, Department of Neurology, Augusta University, GA, USA
| | - S Qadir
- Medical College of Georgia, Augusta University, GA, USA
| | - A E Akinwuntan
- Department of Physical Therapy, College of Allied Health Sciences, Augusta University, Augusta, GA, USA; Dean's Office, School of Health Professions, The University of Kansas Medical Center, Kansas City, KS, USA
| | - H Devos
- Department of Physical Therapy, College of Allied Health Sciences, Augusta University, Augusta, GA, USA; Department of Physical Therapy and Rehabilitation Science, School of Health Professions, The University of Kansas Medical Center, Kansas City, KS, USA
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Ranchet M, Akinwuntan AE, Tant M, Salch A, Neal E, Devos H. Fitness-to-drive agreements after stroke: medical versus practical recommendations. Eur J Neurol 2016; 23:1408-14. [DOI: 10.1111/ene.13050] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 04/21/2016] [Indexed: 01/25/2023]
Affiliation(s)
- M. Ranchet
- Department of Physical Therapy; College of Allied Health Sciences; Augusta University; Augusta GA USA
| | - A. E. Akinwuntan
- Department of Physical Therapy; College of Allied Health Sciences; Augusta University; Augusta GA USA
- Dean's Office; School of Health Professions; The University of Kansas Medical Center; Kansas City KS USA
| | - M. Tant
- CARA; Belgian Road Safety Institute; Brussels Belgium
| | - A. Salch
- Department of Physical Therapy; College of Allied Health Sciences; Augusta University; Augusta GA USA
| | - E. Neal
- Department of Physical Therapy; College of Allied Health Sciences; Augusta University; Augusta GA USA
| | - H. Devos
- Department of Physical Therapy; College of Allied Health Sciences; Augusta University; Augusta GA USA
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Criel M, Godefroid M, Deckers B, Devos H, Cauwelier B, Emmerechts J. Evaluation of the Red Blood Cell Advanced Software Application on the CellaVision DM96. Int J Lab Hematol 2016; 38:366-74. [DOI: 10.1111/ijlh.12497] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 03/14/2016] [Indexed: 12/16/2022]
Affiliation(s)
- M. Criel
- Department of Laboratory Hematology; AZ Sint-Jan; Bruges Belgium
| | - M. Godefroid
- Department of Laboratory Hematology; AZ Sint-Jan; Bruges Belgium
| | - B. Deckers
- Department of Laboratory Hematology; AZ Sint-Jan; Bruges Belgium
| | - H. Devos
- Department of Laboratory Hematology; AZ Sint-Jan; Bruges Belgium
| | - B. Cauwelier
- Department of Laboratory Hematology; AZ Sint-Jan; Bruges Belgium
| | - J. Emmerechts
- Department of Laboratory Hematology; AZ Sint-Jan; Bruges Belgium
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Devos H, Baker K, Phillips K, Akinwuntan A. Improvement of driving skills in persons with relapsing-remitting multiple sclerosis. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Vercruysse S, Vandenberghe W, Münks L, Nuttin B, Devos H, Nieuwboer A. Effects of deep brain stimulation of the subthalamic nucleus on freezing of gait in Parkinson's disease: a prospective controlled study. J Neurol Neurosurg Psychiatry 2014; 85:871-7. [PMID: 24396010 DOI: 10.1136/jnnp-2013-306336] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Freezing of gait (FOG) is a debilitating gait disorder in Parkinson's disease (PD) with partial responsiveness to dopaminergic medication. To date, notions about the effects of subthalamic deep brain stimulation (STN-DBS) on FOG remain controversial. OBJECTIVES To compare the effects of bilateral STN-DBS and continued best medical treatment (BMT) on FOG occurrence, FOG severity and clinical outcomes in PD patients at 6 and 12 months follow-up. METHODS In this prospective, controlled study, 41 PD patients with at least 5 years disease duration participated. Twenty-four subjects (20 with FOG) were treated with STN-DBS and seventeen (15 with FOG) continued BMT. The primary outcome was the New Freezing of Gait Questionnaire (NFOGQ) at 6 months postsurgery. Other outcomes were the NFOGQ at 12 months and clinical outcomes (Unified Parkinson's Disease Rating Scale III (UPDRS III), timed gait, falls and quality of life) at both time points. RESULTS STN-DBS increased the likelihood to convert from being a freezer to a non-freezer at 6 and 12 months follow-up (relative risk reduction=0.4). However, 45% of baseline freezers still experienced FOG 6 and 12 months postsurgery although with reduced severity. Three baseline non-freezers (1/2 BMT-treated, 2/4 STN-DBS-treated) developed FOG during follow-up. STN-DBS-induced benefits on FOG were mostly mediated by baseline levodopa equivalent dose, altered medication-intake and reduced motor fluctuations. CONCLUSIONS In contrast to continued BMT, STN-DBS reduced FOG occurrence and severity at 6 months postsurgery with largely sustained effects at 12 months follow-up. Longer follow-up periods are needed to test whether FOG improvements after STN-DBS persist with disease progression.
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Affiliation(s)
- S Vercruysse
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - W Vandenberghe
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - L Münks
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - B Nuttin
- Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium
| | - H Devos
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - A Nieuwboer
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
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Wit L, Putman K, Devos H, Brinkmann N, Dejaeger E, Weerdt W, Jenni W, Lincoln N, Schuback B, Schupp W, Lesaffre E. Five-year mortality and related prognostic factors after inpatient stroke rehabilitation: A European multi-centre study. J Rehabil Med 2012; 44:547-52. [DOI: 10.2340/16501977-0991] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Devos H, Akinwuntan AE, Nieuwboer A, Truijen S, Tant M, De Weerdt W. Screening for fitness to drive after stroke: A systematic review and meta-analysis. Neurology 2011; 76:747-56. [DOI: 10.1212/wnl.0b013e31820d6300] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Lemoyne S, Van Leemput J, Smet D, Desmedt E, Devos H, Van Schaeren J, Jeurissen A. Pelvic inflammatory disease due to Streptococcus pneumoniae: a usual pathogen at an unusual place. Acta Clin Belg 2008; 63:398-401. [PMID: 19170357 DOI: 10.1179/acb.2008.082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
We report three cases of pelvic inflammatory disease (PID) due to Streptococcus pneumoniae in previously healthy young women. S. pneumoniae frequently causes bacteremia, meningitis and respiratory infections, but it very rarely infects the genital tract. All our patients presented with an acute onset of severe abdominal pain and had an intrauterine device (IUD) present. No abnormal sexual behavior was noticed. Although the relation between PID due to S. pneumoniae and the use of an IUD has been a topic for discussions, culture of IUD in all our patients and blood culture in 2 of 3 of our patients revealed S. pneumoniae. All patients recovered well with intravenous antibiotic treatment and removal of the IUD.
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Affiliation(s)
- S Lemoyne
- Department of Intensive Care Medicine, GZA Sint-Augustinus, Wilrijk, Belgium
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Devos H, Van Schaeren J, Jeurissen A. Resistance of Campylobacter spp. to ciprofloxacin and erythromycin in a Belgian peripheral hospital. Acta Clin Belg 2007; 62:444-5. [PMID: 18351190 DOI: 10.1179/acb.2007.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Abstract
OBJECTIVE To develop an efficient clinical screening battery to accurately predict the fitness to drive in people with Parkinson disease (PD). METHODS This prospective study included 80 participants: 40 patients with PD and 40 healthy age- and sex-matched control subjects. All participants were assessed using a driving simulator, a driving history survey, and the Clinical Dementia Rating. The patients with PD also underwent a clinical test battery and an evaluation of fitness to drive performed by an official center, which included visual, cognitive, and on-road tests. A two-class decision from this driving assessment center was the main outcome measure. RESULTS A screening battery assessing four clinical variables (disease duration, contrast sensitivity, Clinical Dementia Rating, and motor part of the Unified Parkinson's Disease Rating Scale) provided the best model (R(2) = 0.52) to predict the fitness to drive and correctly classified 36 (90%) of the patients with PD as pass or fail (sensitivity = 91%, specificity = 90%). The Test Ride for Investigating Practical fitness to drive (TRIP) driving simulator score discriminated significantly between drivers with PD and their healthy peers (p = 0.0008). When the TRIP driving simulator score was added to the clinical model, the total explained variance increased (R(2) = 0.60) and correctly classified 39 (97.5%) of drivers with PD into the pass/fail category (sensitivity = 91%, specificity = 100%). CONCLUSIONS A short clinical screening battery that measures disease duration, contrast sensitivity, cognitive and motor functions can predict fitness to drive in people with Parkinson disease with a high degree of accuracy.
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Affiliation(s)
- H Devos
- Katholieke Universiteit Leuven, Faculty of Kinesiology and Rehabilitation Sciences, Department of Rehabilitation Sciences, Tervuursevest 101, BE-3001 Leuven, Belgium.
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Devos H, Rodd C, Gagné N, Laframboise R, Van Vliet G. A search for the possible molecular mechanisms of thyroid dysgenesis: sex ratios and associated malformations. J Clin Endocrinol Metab 1999; 84:2502-6. [PMID: 10404827 DOI: 10.1210/jcem.84.7.5831] [Citation(s) in RCA: 105] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Permanent primary congenital hypothyroidism (CH) can be caused by abnormal thyroid differentiation (athyreosis), migration (ectopy), or function (leading to goiter). Goiters follow an autosomal recessive pattern of inheritance, whereas ectopy and athyreosis are considered as a single sporadic entity with a female preponderance. On the other hand, a high prevalence of extrathyroidal malformations has been reported in CH, but without linking specific defects to specific types of CH. On the basis of TSH screening, 273 newborns were referred to an academic pediatric endocrinology clinic in the province of Quebec between 1988 and 1997. Of 230 patients with permanent primary CH who had scintigraphy at diagnosis, 141 had ectopy (104 girls), 36 had athyreosis (21 girls), 42 had goiter (18 girls), 10 (3 girls) had a normal scan, and 1 girl had hemiagenesis. Only in the ectopies was the proportion of girls significantly higher than 0.5 (P<0.001). Isolated cardiac malformations were observed in 7 patients (3.0%), a prevalence 5-fold higher than that in the general population; this was largely due to atrial and ventricular septal defects, which were only observed in ectopy and athyreosis. Our data suggest that the molecular mechanisms that lead to complete absence of thyroid differentiation or defective thyroid migration 1) may be similar, but are modulated by the genetic makeup of the embryo and/or the hormonal milieu of the fetus; and 2) may also be involved in septation of the embryonic heart.
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Affiliation(s)
- H Devos
- Department of Pediatrics, McGill University, Quebec, Canada
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Devos M, Devos H, Spileers W, Arden GB. Quadrant analysis of peripheral colour contrast thresholds can be of significant value in the interpretation of minor visual field alterations in glaucoma suspects. Eye (Lond) 1995; 9 ( Pt 6):751-6. [PMID: 8849544 DOI: 10.1038/eye.1995.189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Peripheral colour contrast thresholds were investigated in glaucoma suspects with no or minor visual field alterations, determining the average colour contrast threshold at 12.5 degrees off axis. The technique was introduced as a rapid screening test for pre-glaucomatous visual loss. Using this 'ring' test, all definite glaucoma patients in the initial study had elevated colour contrast thresholds. In our experience, however, a substantial proportion of early glaucoma patients were found to have normal thresholds. The peripheral colour contrast threshold determined by the ring test is an average threshold in the entire annular zone at 12.5 degrees eccentricity. We therefore modified the test procedure without a major increase in test duration. An arcade subtending 45 degrees at 12.5 degrees eccentricity was used to determine colour contrast thresholds in four quadrants of the visual field separately ('quadrant' test). We present here the first results of this novel procedure, investigating peripheral colour contrast thresholds in glaucomatous patients. The quadrant test is shown to be more sensitive than the ring test in the detection of functional loss.
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Affiliation(s)
- M Devos
- Universitaire Ziekenhuizen, Dienst Oogheelkunde, Leuven, Belgium
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Pacolet J, Van Dender K, Devos H. [The riches of old age. Socioeconomic status of elderly persons]. Rev Med Liege 1994; 49:99-108. [PMID: 8146524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- J Pacolet
- HIVA (Hoger Instituut voor de Arbeid), Section Economie
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Peteghem TV, Devos H. Toxicity study of lead naphthenate. Occup Environ Med 1974. [DOI: 10.1136/oem.31.3.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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