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Biomedical subjects

Robert Forget

Publications and source records attributed to Robert Forget.

12 recordsLinked to original sources
PubMed2006

Excipient quantitation and drug distribution during formulation optimization.

An oral granules formulation experienced high drug content and increased variability when the process was scaled up from lab scale to clinical manufacturing scale. It was suspected that mannitol, due to its smaller particle size and lower density, was preferentially lost during the top spray granulation process, thereby causing active enrichment in the remaining granules. In order to troubleshoot the problem, rapidly evaluate solutions, and further optimize the formulation, a simple and rapid analytical technique was required. Since mannitol does not have a UV chromophore, conventional HPLC/UV analysis could not be used. Three alternative analytical techniques were evaluated in terms of ease of use, reproducibility, linear dynamic range and rapidity. The HPLC/RID (refractive index detector) and HPLC/ELSD (evaporative light scattering detector) provided rapid, reproducible alternate techniques to HPLC/UV, whereas LC/MS showed poor reproducibility. Analysis of the sieve samples of the granulations by HPLC/RID and HPLC/ELSD confirmed that poor active drug distribution was due to mannitol losses in the filter bag, as well as increased low size granules low in active drug content. The resultant formulation process was modified and a reduction in the initial air flow at start-up reduced losses of mannitol in the granulator filters.

Chemistry, Pharmaceutical↗
PubMed2006

Exploring the comparability of the Sensory Organization Test and the Pediatric Clinical Test of Sensory Interaction for Balance in children.

BACKGROUND AND PURPOSE: The Sensory Organization Test (SOT) and the Pediatric Clinical Test of Sensory Interaction for Balance (PCTSIB) quantify the ability to maintain balance in the presence of sensory conflicts. The purposes were to explore the concurrent validity of these two assessments by comparing the performance of healthy children on the tests and examine the relationship between age and assessment performances thereby exploring the construct validity of the measures. SUBJECTS: Sixteen healthy children (9.8 +/- 3.5 yr.). METHODS: Children were assessed with both tools during a single session. RESULTS: Only three conditions of the SOT were related to the corresponding PCTSIB conditions: eyes closed in tandem and single leg stance (SLS), and altered vision in SLS. None of the conditions involving altered support surfaces were related. All SOT conditions and four PCTSIB conditions in SLS, were significantly related to age as well as one condition in tandem. DISCUSSION AND CONCLUSION: Although both tests are associated with age, they do not measure sensory organization abilities in the same manner. As such, they each provide different and complementary information about healthy children's ability to maintain balance.

Adolescent↗
PubMed2005

Perception of local DC and AC electric fields in humans.

The goal of this study was to address some of the factors that contribute to the human ability to detect the presence of weak electric fields generated by direct current (DC) and alternating current (AC) sources. An exposure chamber allowed us to expose a limited surface of the body (forearm and hand) to DC fields of up to 65 kV/m and AC fields up to a maximum of 35 kV/m (frequency 60 Hz). Perception was examined using a staircase procedure and a rating procedure derived from signal detection theory. Sixteen subjects participated in the experiments, and none detected the local DC fields. In contrast, 9/16 subjects were sensitive to local AC electric fields, although detection thresholds (index of sensitivity, d' = 1.0) were widely variable between subjects. When regional exposure was limited to the dorsal forearm, performance was similar to that seen when the forearm and hand were exposed. In contrast, subjects did not reliably detect the AC electric fields when exposure was limited to the hand (either hairy or glabrous skin), although a minority of subjects (3/9) showed some evidence of detecting fields presented to the glabrous palm. Subjects were unable to detect AC electric fields when the hair was removed from the forearm and hand, suggesting that the evoked sensation is mainly dependent on movement of hair located in the exposed region.

Adult↗
PubMed2005

Bilateral changes in somatosensory sensibility after unilateral below-knee amputation.

OBJECTIVE: To evaluate possible alteration in proprioceptive and cutaneous sensibility in the nonamputated leg of unilateral transtibial amputees. DESIGN: Cross-sectional study with between-subjects (amputees vs controls) and within-subjects (nonamputated vs amputated leg) comparisons. SETTING: Canadian rehabilitation hospital research laboratory. PARTICIPANTS: Two groups of amputees (34 due to traumatic causes, 14 due to vascular causes), recruited more than 1 year after their prosthetic training; and 2 groups (n=34, n=14) of age-matched control subjects. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Threshold of movement detection and touch-pressure perception at the knee and foot levels. RESULTS: In the traumatic group, the sensory thresholds of the nonamputated leg were significantly higher than the control values in the 2 modalities tested. The movement detection was reduced at the knee and ankle levels, whereas a decrease in touch-pressure sensibility was observed only at the plantar site. As expected, a large proportion of the vascular amputees presented with severe sensory deficits in the nonamputated leg, particularly a loss in touch-pressure perception at the foot. The thresholds of movement detection were similar and correlated at both knees in the 2 groups of amputees. For the touch-pressure thresholds, no significant relationship was found between sides at the knee level. CONCLUSIONS: Sensory changes observed in the nonamputated leg suggest that central sensory adaptations occur after amputation. For movement detection, they were marked by a matching of perception on both sides of the body. Functional significance of these changes remains to be determined.

Adaptation, Physiological↗
PubMed2005

The utilization of activity-based cost accounting in hospitals.

Healthcare costs are being examined on all fronts. Healthcare accounts for 11% of the gross national product and will continue to rise as the "babyboomers" reach retirement age. While ascertaining costs is important, most research shows that costing methods have not been implemented in hospitals. This study is concerned with the use of costing methods; particularly activity-based cost accounting. A mail survey of CFOs was undertaken to determine the type of cost accounting method they use. In addition, they were asked whether they were aware of activity-based cost accounting and whether they had implemented it or were planning to implement it. Only 71.8% were aware of it and only 4.7% had implemented it. In addition, only 52% of all hospitals report using any cost accounting systems. Education needs to ensure that all healthcare executives are cognizant of activity-based accounting and its importance in determining costs. Only by determining costs can hospitals strive to contain them.

Accounting↗
PubMed2004

Children show decreased dynamic balance after mild traumatic brain injury.

OBJECTIVE: To compare the balance skills of children after mild traumatic brain injury (TBI) with that of noninjured children matched for age, sex, and premorbid level of physical activity. DESIGN: Cohort study. SETTING: Pediatric trauma center. PARTICIPANTS: Thirty-eight children aged 7 to 16 years (mean, 12.2+/-2.8 y) were recruited in each group. Children with mild TBI had a mean Glasgow Coma Scale score of 14.8 and were considered normal on a neurologic assessment at hospital discharge. Noninjured children were friends of those with mild TBI. INTERVENTION: Assessments of balance were conducted at 1, 4, and 12 weeks after mild TBI and at corresponding time intervals for the controls. MAIN OUTCOME MEASURES: The balance subtest of the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP), the Pediatric Clinical Test of Sensory Interaction for Balance (P-CTSIB), and the Postural Stress Test (PST) were used. RESULTS: Over the time interval of the study, analyses of variance revealed that children with mild TBI performed significantly worse than the noninjured group on the BOTMP balance subtest (P<.001) and on the PST (P=.031), as well as on the eyes-closed conditions in the P-CTSIB tandem position (P=.05). CONCLUSIONS: Children with a mild TBI still showed balance deficits at 12 weeks postinjury. These deficits should be taken into consideration when planning a return to physical activities, particularly to those that require subtle balance skills.

Adolescent↗
PubMed2002

Botulinum toxin improves lid opening delays in blepharospasm-associated apraxia of lid opening.

Lid movement and EMG of the orbicularis oculi (OOc) were analyzed in 10 patients with apraxia of lid opening associated with blepharospasm before and after botulinum toxin treatment. The latencies to onset and to complete the eye opening and the time during which eye opening was sustained were studied in relation to OOc activity and compared with control values obtained in 12 healthy subjects. Following treatment there was an improvement of all lid opening measurements, a decrease of the abnormally prolonged OOc activity, and a reduction of the functional disability.

Aged↗
PubMed2002

Effect of force-feedback treatments in patients with chronic motor deficits after a stroke.

OBJECTIVE: To assess the effects a motor reeducation approach based on static dynamometers used to provide feedback on the force produced. DESIGN: The study design was a single-blind, randomized, controlled trial. Chronic stroke subjects participated in a 6-wk, thrice-weekly, force-feedback program of either the upper paretic limb (n = 13) or the lower paretic limb (n = 12). Baseline and postintervention assessments of the performance of both the upper and the lower limb were measured for each subject, the untreated paretic limb of each group serving as a control for the other group. RESULTS: With the exception of the handgrip force, strength measurements of the treated limb increased after completion of the treatment. The outcome measurements of the upper limb of the subjects included in the upper paretic limb were not significantly different after treatment from those measured in the lower paretic limb. In contrast, gait velocity and the distance walked in 2 min increased after treatment in the lower paretic limb as compared with the upper paretic limb, whereas the scores in the Fugl-Meyer test for the lower limb and the timed up-and-go test did not increase for either group after treatment. CONCLUSION: The results indicate that treatment of the lower limb based on force feedback produces an improvement of gait velocity.

Adult↗
PubMed1998

Tactile, thermal and pain sensibility in burned patients with and without chronic pain and paresthesia problems.

Abnormal return of cutaneous sensibility is common after burn injuries and many patients complain of painful and/or paresthetic sensations in their healed wounds. However, little is known about the exact nature and severity of these problems. The present study was designed to provide a quantitative evaluation of the cutaneous sensibility in burned patients. Tactile, thermal and pain thresholds were measured in 121 patients with healed burns paired-matched to 121 control healthy subjects more than 18 months after the burns. Testing was confined to both upper limbs and was performed in a healed burn area and its contralateral burned or unburned counterpart. The tested sites were also divided into symptomatic and asymptomatic ones, depending on the presence or not of pain or paresthesia at the site. The results showed significantly higher sensory thresholds in burned patients than control subjects. Severity of the deficits of the various sensory modalities was, however, a function of burn depth. Deep burn injuries which had required skin grafts to heal were more seriously affected than superficial burns which had healed spontaneously. Significant sensory losses were found not only in burn sites but also in the non-injured areas suggesting changes in the central nervous system. When symptomatic and asymptomatic sites were compared, significant deficits were observed in the tactile modality (touch-pressure). Other significant predictors of chronic sensory problems were burn depth and patients' age. Pathophysiological mechanisms of diminished sensibility in burned and unburned skin as long as several years after the injury are discussed along with those implicated in pain and paresthesia problems reported by the patients.

Adolescent↗
PubMedDate not supplied

Visuomotor response time in children with a mild traumatic brain injury.

OBJECTIVE: Compare the visuomotor response times of children after a mild traumatic brain injury (mTBI) with those of noninjured children matched for age, sex, and premorbid level of physical activity. DESIGN: Prospective cohort study. SETTING: Pediatric trauma center. PARTICIPANTS: Thirty-eight children aged 7 to 16 years in each group. Children with mTBI had a mean Glasgow Coma Scale score of 14.8 and were considered normal on a neurological assessment carried out at the time of hospital discharge. Noninjured children were friends of those with mTBI. INTERVENTION: Assessments of response time were conducted at 1, 4, and 12 weeks after mTBI and at corresponding time intervals for the control children. MAIN OUTCOME MEASURES: The response speed subtest of the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP); reaction and movement time for upper and lower extremities, for simple, choice, and reversed choice response time paradigms. RESULTS: Over the assessment period, children with mTBI performed worse than the control group only on the response speed subtest of the BOTMP. The mTBI children however tended to have slower movement times 1 week postinjury for the reversed choice response time paradigm for the lower extremities. CONCLUSIONS: Some children with mTBI may have some problems in response time persisting until 12 weeks postinjury. Further research is required to better identify and understand the severity of these problems and determine their impact, if any, on participation in physical activities.

Adolescent↗
PubMedDate not supplied

Exploring children's self-efficacy related to physical activity performance after a mild traumatic brain injury.

OBJECTIVE: To evaluate children's self-efficacy related to their practice of physical activities prior to and after a mild traumatic brain injury (mTBI), and compare these to those of noninjured children matched for age, sex, and premorbid level of physical activity. PARTICIPANTS AND METHODS: Thirty-four children (mean age: 12 +/- 3 years) in each group. Children with mTBI were assessed 1 day postinjury (to document preinjury status) and at 12 weeks post-mTBI using a self-efficacy questionnaire, the Physical Activity Questionnaire, the Athletic Competence subscale of the Self-Perception Profile for Children or Adolescents, and the Rivermead Post-Concussion Symptoms Questionnaire. Noninjured children underwent the same assessments at a corresponding time interval. RESULTS: At 12 weeks postinjury, self-efficacy scores of children with mTBI were significantly lower than initial (ie, pretraumatic) values and those of noninjured children. The children with mTBI had, however, returned to their preinjury level of participation in physical activities and maintained their athletic competence. CONCLUSIONS: After mTBI, children appear to lack confidence in their ability to perform during physical activities as compared to before their injury. Intervention strategies such as information or counseling sessions targeting children and their parents may minimize the impact of the mTBI on children's confidence in their performance in physical activities.

Activities of Daily Living↗