Publications by authors named "F B Joosten"

65 Publications

Correction to: Prediction of total body electrical resistance normal values based on limb muscle thickness assessed by ultrasound.

Eur J Clin Nutr 2021 Mar 5. Epub 2021 Mar 5.

Department of Internal Medicine, Rijnstate Hospital, Arnhem, The Netherlands.

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March 2021

Prediction of total body electrical resistance normal values based on limb muscle thickness assessed by ultrasound.

Eur J Clin Nutr 2021 Jan 18. Epub 2021 Jan 18.

Department of Internal Medicine, Rijnstate Hospital, Arnhem, The Netherlands.

Background: Recently, a new model has been proposed to assess hydration in patients by measurement of total body electrical resistance (TBER), with results expressed in ohm rather than in liter body water. According to this approach, hydration is considered to be normal if TBER is within the normal range. As TBER is inversely related to the size of the limb muscle compartment, this relationship can be used to calculate the patient-specific TBER normal value (TBER). The present study investigates whether the prediction of TBER can be improved by the use of ultrasound (US) instead of anthropometrically derived parameters of limb muscularity.

Methods: In total, 129 healthy subjects (60 men and 69 women) ranging in age from 18 to 75 yr, and in BMI from 17.4 to 52.0 kg/m were included in the study. Arm muscle cross-sectional area assessed by anthropometry (AMA) was compared with mean muscle thickness (MMT) of arm and leg assessed by B-mode US.

Results: MMT correlated stronger with TBER than AMA, and reduced the standard error of the estimate (SEE) by 15% in men and by 26% in women. Muscularity was overestimated by AMA due to a systematic error directly proportional to subcutaneous fat layer thickness. The gender independent relation between MMT and TBER is described by the equation: TBER = 705-75.4⋅MMT (R = 0.85, SEE = 22.3 Ω/m, P < 0.001).

Conclusions: US-based measurement of limb muscularity provides a more precise prediction of TBER, in particular in obese subjects, and is recommended as the method of choice.
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January 2021

Hyperactive thyroid nodules treated by radiofrequency ablation: a Dutch single-centre experience.

Neth J Med 2020 03;78(2):64-70

Departments of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands.

Background: Hyperactive thyroid nodules (HTN) are usually treated with radioactive iodine (RAI). However, as RAI is associated with a 30-60% long-term risk of permanent hypothyroidism, radiofrequency ablation (RFA) may be a good alternative. Primary aim of this study was to assess the percentage of patients achieving euthyroidism after RFA.

Patients And Methods: Patients with a symptomatic HTN were treated by ultrasound-guided RFA, using the trans-isthmic approach and moving-shot technique, in an outpatient setting under local anaesthesia.

Results: Twenty-one patients were included, ranging in age from 37-75 years. Follow-up was at least one year. All patients had a suppressed serum thyroid-stimulating hormone (TSH), with free thyroxine (FT4) and free triiodothyronine (FT3) concentrations mildly elevated in 33% and 43% of cases, respectively. RFA was not associated with clinically meaningful adverse effects. TSH normalisation was achieved in 11/21 patients (52%) after first RFA. A partial response, defined as a normalisation of FT4 and FT3, but incomplete improvement of TSH, was observed in 6/21 patients (29%). Three patients had no response (14%), and one patient developed mild, asymptomatic subclinical hypothyroidism. Five patients underwent a second RFA and this led to TSH normalisation in four, thereby raising the rate of complete remission to 71%. Recurrence of TSH suppression did not occur during the study period.

Conclusion: These data suggest that RFA is a safe and promising treatment for symptomatic hyperactive thyroid nodules, with a low risk of permanent hypothyroidism. Long-term studies are needed to identify the recurrence risk of hyperthyroidism.
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March 2020

A Shared Decision Approach to Chronic Abdominal Pain Based on Cine-MRI: A Prospective Cohort Study.

Am J Gastroenterol 2018 08 27;113(8):1229-1237. Epub 2018 Jun 27.

Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands. Rijnstate Hospital Department of Radiology, Arnhem, The Netherlands. These authors jointly supervised: Harry van Goor H, Richard PG ten Broek.

Objectives: Chronic abdominal pain develops in 11-20% of patients undergoing abdominal surgery, partly owing to post-operative adhesions. In this study we evaluate results of a novel diagnostic and therapeutic approach for pain associated with adhesions.

Methods: Prospective cohort study including patients with a history of abdominal surgery referred to the outpatient clinic of a tertiary referral center for the evaluation of chronic abdominal pain. Subgroups were made based on outcome of adhesion mapping with cine-MRI and shared decision making. In operatively managed cases, anti-adhesion barriers were applied after adhesiolysis. Long-term results for pain were evaluated by a questionnaire.

Results: A total of 106 patients were recruited. Seventy-nine patients had adhesions on cine-MRI, 45 of whom underwent an operation. Response rate to follow-up questionnaire was 86.8%. In the operative group (Group 1), the number of negative laparoscopies was 3 (6%). After a median of 19 (range 6-47) months follow-up, 80.0% of patients in group 1 reported improvement of pain, compared with 42.9% in patients with adhesions on cine-MRI who declined surgery (group 2), and 26.3% in patients with no adhesions on cine-MRI (group 3), P = 0.002. Consultation of medical specialists was significantly lower in group 1 compared with groups 2 and 3 (35.7 vs. 65.2 vs. 58.8%; P = 0.023).

Conclusion: We demonstrate long-term pain relief in two-thirds of patients with chronic pain likely caused by adhesions, using cine-MRI and a shared decision-making process. Long-term improvement of pain was achieved in 80% of patients who underwent surgery with concurrent application of an anti-adhesion barrier.
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August 2018

A novel diagnostic aid for intra-abdominal adhesion detection in cine-MRI: pilot study and initial diagnostic impressions.

Br J Radiol 2017 Aug 14;90(1077):20170158. Epub 2017 Jul 14.

Medical Physics, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK.

Objective: A non-invasive diagnostic technique for abdominal adhesions is not currently available. Capture of abdominal motion due to respiration in cine-MRI has shown promise, but is difficult to interpret. This article explores the value of a complimentary diagnostic aid to facilitate the non-invasive detection of abdominal adhesions using cine-MRI.

Method: An image processing technique was developed to quantify the amount of sliding that occurs between the organs of the abdomen and the abdominal wall in sagittal cine-MRI slices. The technique produces a "sheargram" which depicts the amount of sliding which has occurred over 1-3 respiratory cycles. A retrospective cohort of 52 patients, scanned for suspected adhesions, made 281 cine-MRI sagittal slices available for processing. The resulting sheargrams were reported by two operators and compared with expert clinical judgment of the cine-MRI scans.

Results: The sheargram matched clinical judgment in 84% of all sagittal slices and 93-96% of positive adhesions were identified on the sheargram. The sheargram displayed a slight skew towards sensitivity over specificity, with a high positive adhesion detection rate but at the expense of false positives.

Conclusion: Good correlation between sheargram and absence/presence of inferred adhesions indicates quantification of sliding motion has potential to aid adhesion detection in cine-MRI.

Advances In Knowledge: This is the first attempt to clinically evaluate a novel image processing technique quantifying the sliding motion of the abdominal contents against the abdominal wall. The results of this pilot study reveal its potential as a diagnostic aid for detection of abdominal adhesions.
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August 2017