Biomedical subjects

V Thijs

Publications and source records attributed to V Thijs.

7 recordsLinked to original sources

PubMed2006

Embolization of pulmonary arteriovenous malformations and decrease in prevalence of migraine.

OBJECTIVE: To determine if embolization of pulmonary arteriovenous malformations (PAVMs) decreases the occurrence of migraine. METHODS: All 105 patients with hereditary hemorrhagic telangiectasia (HHT), minimum age 16 years, who underwent an embolization of PAVM in our hospital between June 1995 and April 2004, were included in this study. A structured headache questionnaire was sent to all patients and focused on two periods: 1 year before and at least 6 months after embolization. Two independent neurologists diagnosed migraine according to the International Headache Society criteria. RESULTS: Eighty-four patients (80%) sent back the questionnaire (mean age 47.8 +/- 15.1 years, 51 female). Median follow-up time was 48 months (first quartile: 23 months; third quartile: 66 months). The overall prevalence of migraine decreased from 45.2% before to 34.5% after embolization (p = 0.01). The prevalence of migraine with aura decreased from 33.3% before to 19.0% after embolization (p = 0.002). The severity of headache attacks decreased in patients who still had migraine (p = 0.15) or migraine with aura after embolization (p = 0.11). CONCLUSION: Embolization of pulmonary arteriovenous malformations in patients with hereditary hemorrhagic telangiectasia seems to be related to a decrease in prevalence of migraine, suggesting that the presence of a right-to-left shunt rather than the localization of this shunt plays a causative role in the pathogenesis of migraine.

Adult↗

PubMed2006

Risk of thromboembolism after cerebral venous thrombosis.

The outcome of cerebral venous thrombosis (CVT) has been studied infrequently. We assessed the frequency of recurrence of cerebral or systemic thromboembolism and factors influencing recurrence. We performed a retrospective study of consecutive patients with CVT in the period 1985-2002 who were admitted to the University Hospital Gasthuisberg. We performed a chart review and a semi-standardized telephone interview that focused on recurrent CVT or systemic thromboembolism. Fifty-four CVT patients with a mean age of 42 years were followed up for a mean of 3.5 years. Eighty percent were women. Coagulation disorders were found in 17 patients (31%). One patient (1.9%) had recurrent CVT and seven patients (12.9%) suffered systemic thromboembolism after a median of 2.5 months. Patients with recurrent thromboembolism more often had coagulopathies (P = 0.04) or a history of deep venous thrombosis (P = 0.007). Patients with early recurrent venous thromboembolism often were not treated with oral anticoagulants (P < 0.001). It was evident from the above study that a substantial number of patients suffer recurrent thromboembolism after CVT.

Adult↗

PubMed2006

Body temperature and outcome after stroke thrombolysis.

AIMS: We studied whether baseline body temperature and temperature increases after stroke adversely affect outcome after thrombolysis with intravenous tissue plasminogen activator (IV tPA). METHODS: The evolution of body temperature in the first 24 h after treatment with IV tPA was described by calculating the area under the curve of the temperature over time plot relative to temperature at admission (AUCBL) and relative to a standard value of 37 degrees C (AUC37). Temperature parameters were related to functional outcome. RESULTS: The median baseline National Institutes of Health Stroke Scale of 100 consecutive patients was 16 (interquartile range 11-21) and 34 patients had a favourable response to tPA. Patients with an unfavourable outcome had a more important temperature elevation than patients who had a favourable outcome after tPA (+1 degrees C vs +0.6 degrees C, P=0.02), despite similar baseline T and had a higher AUCBL (9.79 vs 5.36, P=0.027) and more frequently showed hyperthermia relative to baseline (82% vs 56%, P=0.011). After adjustment for baseline characteristics, the presence of hyperthermia relative to baseline was associated with a reduced odds of good outcome after thrombolysis (OR 0.34, 95% CI 0.10-0.95, P=0.040). CONCLUSION: Hyperthermia relative to baseline temperature in the 24 h after intravenous thrombolysis is associated with an unfavourable outcome.

Aged↗

PubMed2005

Discriminant ability of the Trunk Impairment Scale: A comparison between stroke patients and healthy individuals.

PURPOSE: The Trunk Impairment Scale (TIS) is a standardized scale to evaluate the trunk function in stroke patients. It was the aim of this study to determine the discriminant ability of the TIS by comparing stroke patients with healthy individuals. Further, the variables that had an influence on obtaining a high score on the TIS in healthy subjects were examined. METHOD: Forty stroke patients and 40 age- and sex-matched healthy individuals were included in the study. TIS scores from the stroke patients and healthy individuals were compared using the Wilcoxon ranked sum test. RESULTS: Sub-scale and total TIS scores showed significant differences between stroke patients and healthy individuals (P < 0.0001). Univariate analysis and logistic regression analysis further revealed that younger persons, women and people who are more active in daily life have a higher chance of obtaining a high score on the TIS. CONCLUSIONS: The TIS discriminates between stroke patients and healthy individuals. A submaximal score on the TIS was found in 45% of the healthy subjects suggesting that a lower score on the TIS still indicates normal trunk function and full participation in daily life.

Abdomen↗

PubMed2003

Coexistence of CADASIL and Alzheimer's disease.

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL) is caused by point mutations in the Notch3 gene. Presenilins are proteins involved in the cleaving of both Notch and the amyloid precursor protein (APP). In cases of early onset Alzheimer's disease mutations of the presenilin genes (PSEN 1 and PSEN 2) and APP can be found. A 64 year old patient with CADASIL (R169C-mutation) is reported, who, in addition to subcortical infarcts and granular osmiophilic deposits, had numerous senile plaques and neurofibrillary tangles on pathological examination. Mutations in the APP, PSEN1, and PSEN2 genes were not identified. Neuropathological findings of Alzheimer's disease may be found in CADASIL patients.

Alzheimer Disease↗

PubMed2000

Demographic characteristics and prognosis in a Flemish amyotrophic lateral sclerosis population.

We describe the genetic and demographic characteristics of patients with amyotrophic lateral sclerosis (ALS) in Flanders, Belgium. Prognostic factors related to survival are examined. ALS was familial in 8.6% of all MND patients. In 6 of 8 apparently unrelated families, an SOD1 mutation was found. In sporadic ALS, mean age at onset was 57.1 years. There was a male preponderance (1.2:1) and the disease had a bulbar onset in 19%. Median survival was 32 months (95% CI 26-46). The presence of an APOE-epsilon 4 allele was not associated with a bulbar onset of ALS, an earlier age at onset or a shorter median survival. Variables examined in a multivariate analysis included age, sex, site of onset, delay from onset to diagnosis, and % forced vital capacity. Shorter survival was independently associated with higher age, bulbar onset, a short diagnostic delay, and a lower percent-predicted vital capacity at study entry. Simple clinical baseline characteristics can assist the clinician in estimating prognosis in ALS. The demographic characteristics of the Flemish ALS population do not seem to differ from those described in other parts of the world.

Adult↗

PubMedDate not supplied

Intermediate short-term outcomes after brain computed tomography and magnetic resonance imaging in neurology outpatients.

OBJECTIVE: The purpose of this study was to assess and compare the impact of magnetic resonance imaging (MIR) and computed tomography (CT) on diagnostic and therapeutic decision making, taking into account the real cost of both techniques at the authors' institution. METHOD: Brain CT and routine and rapid MRI were compared, and case files were prepared with either the CT or the MRI findings. These files were separately presented to a neurologist, and different questions were asked about further management. The real cost of CT and MRI was calculated. A questionnaire was sent to the patients 3 months after imaging. RESULTS: More lesions were detected on MRI than on CT Routine and rapid AIRI were comparable. The analysis of the CT case files revealed an additional request for MRl in 33% of the patients. An analysis of the MRI case files revealed that 20% more technical examinations were requested after MRI than after CT In the majority of the patients (90%), neuroimaging had no impact on therapy except by means of reassurance of the physician. The scan was considered useful for therapeutic planning by excluding the presence of a space-occupying lesion. The real cost of the MP! strategy was 9% higher than that of the CT strategy. CONCLUSION: In this patient population, neuroimaging was normal in the majority of the patients. Undergoing an imaging examination was of benefit to the patients and improved their sense of well-being mainly by the reassurance they experienced, as reported by 91% of the patients. At the authors' institution, the real cost of MMI in this patient population was only slightly higher than the real cost of CT The statistical analysis favors the use of MRI as a 1st imaging examination.

Adolescent↗