Mri Guided Percutaneous Abdominal Biopsy in a Closed Magnet: Assessment in an Animal Study

peer reviewedMRI guided percutaneous abdominal biopsy was evaluated in an animal model, using a closed magnet and different types of needles. Thirty-six single pass biopsies were performed in 6 piglets with 6 types of MR compatible needles. Virtual targets of a diameter of 2 cm were drawn on the images of the right and left lobe of the liver and the upper and lower poles of both kidneys. FMPSPGR sequences were applied during an apnea of 19 to 23 seconds in axial, sagittal, coronal or axial oblique planes using a closed 1.0 T magnet and the body coil. Piglets were autopsied 1 hour after the procedure. Mean duration of the procedure was 16.9 (11-37) minutes; mean number of acquisitions per procedure was 5.9 (3-12); mean number of redirections of the needle was 0.6 (0-4). Pathological samples from the liver and kidneys of good quality were obtained in 22/36 (72.2%) cases. A subcapsular hematoma was observed in 18/24 (75.0%) cases of renal biopsies and in 1/12 (8.3%) of hepatic biopsies. No statistically significant correlation could be established between duration of the procedure and site of biopsy and between the type of biopsy needle and complication (p = 0.18 to 0.85). In conclusion, MRI guided percutaneous needle biopsy in the abdomen is a reliable technique in piglets using a closed magnet

Screening for balance disorders in mildly affected multiple sclerosis patients

Multiple sclerosis (MS) patients often complain about balance problems when Romberg's test and tandem gait are normal. The aim of the study was to determine if measures of trunk sway taken during a battery of stance and gait tasks could be used to detect subclinical balance disorders. We recorded trunk angular sway in the pitch and roll directions from 20 MS patients (EDSS 1.4 +/- 0.5) and 20 age- and gender-matched healthy controls (HCs), during 12 stance and gait tasks. We filmed 22 subjects simultaneously. Two neurologists assessed the videos, deciding whether task performance was pathological. Sway measures were significantly different between patients and HCs in eight out of 12 balance tasks. The most significant differences between MS patients and HCs were pitch angle range standing on one leg with eyes open on a firm surface (mean 3.13 degrees vs. 2.09 degrees , p = 0.005), and on a foam support surface (mean 6.24 degrees vs. 2.96 degrees , p = 0.006), pitch velocity range walking 8 m with eyes closed (mean 75.5 vs. 50.2 degrees /s, p > 0.001) and pitch velocity range walking 3 m on heels (mean 85.37 vs. 60.9 degrees /s, p = 0.002). Multivariate analysis revealed a model with three tasks which detected balance disorders in 84% of the MS patients and 90% of the HCs correctly. The neurologists achieved accuracies of 30% for the MS patients and 82% for the HCs. Using trunk sway measures during stance and gait tasks is a sensitive screening method for balance problems in MS patients, and is more accurate than assessment by trained neurologists

The Accuracy of the Detection of Body Postures and Movements Using a Physical Activity Monitor in People after a Stroke

Background: In stroke rehabilitation not only are the levels of physical activity important, but body postures and movements performed during one’s daily-life are also important. This information is provided by a new one-sensor accelerometer that is commercially available, low-cost, and user-friendly. The present study examines the accuracy of this activity monitor (Activ8) in detecting several classes of body postures and movements in people after a stroke. Methods: Twenty-five people after a stroke participated in an activity protocol with either basic activities or daily-life activities performed in a laboratory and/or at home. Participants wore an Activ8 on their less-affected thigh. The primary outcome was the difference in registered time for the merged class “upright position” (standing/walking/running) between the Activ8 and the video recording (the reference method). Secondary analyses focused on classes other than “upright position”. Results: The Activ8 underestimated the merged class “upright position” by 3.8% (775 s). The secondary analyses showed an overestimation of “lying/sitting” (4.5% (569 s)) and of “cycling” (6.5% (206 s)). The differences were lowest for basic activities in the laboratory and highest for daily-life activities at home. Conclusions: The Activ8 is sufficiently accurate in detecting different classes of body postures and movements of people after a stroke during basic activities and daily-life activities in a laboratory and/or at home

Studenten, docenten en opleiders "innoleren" in de minor Innovatief beroepsonderwijs

Bij Fontys Hogescholen zijn met ingang van het lopende studiejaar studenten actief in minoren. Voor de studenten van de lerarenopleidingen is er een aanbevolen minor 'Innovatief beroepsonderwijs'. Uitgangspunt van de minor is de synergie die ontstaat wanneer activiteiten worden ontplooid waarbij Schoolontwikkeling, Opleiding van nieuwe docenten, praktijknabij Onderzoek en Professionalisering van zittende docenten hand in hand gaan (SOOP; zie Van der Sanden, 2004). Studenten werken en denken mee aan innovatieve SOOP-projecten ('innoleren') op scholen voor vmbo en mbo. Bovendien zijn kringen gevormd waarin studenten, docenten en opleiders samen kennis maken rond de thema's die in de projecten aan de orde zijn: A. Competentiegericht leren en opleiden; B. Competentiegericht toetsen; C. Algemene pedagogische aspecten; D. Leerlingen met speciale hulpvragen; E. De loopbaan centraal en F. De school als lerende organisatie. In september is een groep van 38 studenten (PTH; tweedejaars) gestart. De themakringen zijn wat later van start gegaan (november). Uit eerste indrukken van betrokkenen kan worden opgemaakt dat er in deze opzet een nieuwe balans ontstaat tussen betrokken partijen en personen die een positieve bijdrage levert aan de constructie en uitwisseling van praktijkgerichte kennis. Een interessante vraag voor de nabije toekomst is hoe de veelheid van kennis uit de themakringen zijn weg kan vinden naar (andere) scholen en opleidingen

Objectively measured arm use in daily life improves during the first 6 months poststroke: a longitudinal observational cohort study

Background: It is unclear how arm use in daily life changes after stroke since studies investigating the change in arm use poststroke are scarce. The aim of this study was to investigate the change in arm use during the first six months poststroke. Secondary aim was to compare arm use changes between arm recovery clusters. Methods: Arm use was measured during week 3, 12, and 26 poststroke with accelerometers on the wrists and the nonaffected leg. Outcomes were the amount of affected and nonaffected arm use during sitting and standing per day and per sit/stand hour, and the daily ratio between arms. Arm function was measured with the Fugl-Meyer Upper Extremity Scale to identify recovery clusters (poor/moderate/excellent). Generalized estimating equations compared arm use outcomes between time points and between recovery clusters. Results: Thirty-three stroke patients participated. Affected arm use per day increased between week 3 and 12 (30 %; p = 0.04) and it increased per sit/stand hour between week 3–12 (31 %; p < 0.001) and between week 3 and 26 (48 %; p = 0.02). Nonaffected arm use per day decreased between week 3 and 12 (13 %; p < 0.001) and between week 3 and 26 (22 %; p < 0.001) and it decreased per sit/stand hour between week 3 and 26 (18 %; p = 0.003). The daily ratio increased between week 3 and 12 (43 %; p < 0.001) and between week 3 and 26 (95 %; p < 0.001). Changes in arm use did not differ significantly between recovery clusters (p = 0.11–0.62). Affected arm use was higher in the excellent recovery cluster (p < 0.001). Conclusions: Affected arm use and the ratio between arms increase during the first 26 weeks poststroke especially in patients with excellent arm recovery