Bouncing back to normalcy

Cette composition photographique réalisée et commentée par Jérôme Grimaud, délégué psychosocial de la Fédération Internationale des Sociétés de la Croix-Rouge et du Croissant-Rouge (IFCR), aborde le sujet du retour à la normalité comme étant le principal but des activités de soutien psychosocial réalisées auprès de la population victime du terrible séisme qui a affecté Haïti en janvier 2010. Ce thème est également commenté dans l'article précédent de cette revue, "Tout dÆun coup cÆest le retour à la normale pour eux" ou "All of a sudden they are back to normal" en anglais.

Revenir à la normale

Cette composition photographique réalisée et commentée par Jérôme Grimaud, délégué psychosocial de la Fédération Internationale des Sociétés de la Croix-Rouge et du Croissant-Rouge (IFCR), aborde le sujet du retour à la normalité comme étant le principal but des activités de soutien psychosocial réalisées auprès de la population victime du terrible séisme qui a affecté Haïti en janvier 2010. Ce thème est également commenté dans l'article précédent de cette revue, "Tout dÆun coup cÆest le retour à la normale pour eux" ou "All of a sudden they are back to normal" en anglais.

A new method for analyzing histograms of brain magnetization transfer ratios: comparison with existing techniques.

BACKGROUND AND PURPOSE: Previously reported quantitative parameters for the magnetization transfer ratio (MTR) do not give identical results, which can limit their ability to differentiate normal from diseased tissue and render them vulnerable to variations among MR systems. Our purpose was to systematically study different MTR metrics; propose a new MTR histogram parameter, AMTR(2/3); and compare AMTR(2/3) with existing parameters in a study of multiple sclerosis (MS). METHODS: Seven conventional MTR parameters were proposed: global and mean MTR; peak height and position of the histogram; and percentiles MTR25, MTR50, and MTR75. Additionally, we investigated a parameter, AMTR(2/3), to indicate the normalized pixel count (area under the histogram curve) inside the band size of two-thirds MTR histogram peak height. All parameters were measured in 10 patients with relapsing-remitting MS (group A), 10 healthy control subjects from the same imaging center as that of patients (group B), and four healthy control subjects from an outside institution (group C). Comparison of findings was performed between groups A and B to assess the discriminating ability of MTR parameters and groups B and C to evaluate intersystem variations. RESULTS: All MTR parameters differed between groups A and B, but the difference was significant for only global MTR, mean MTR, MTR25, and AMTR(2/3). With the exception of AMTR(2/3), all parameters differed significantly between the two control groups. CONCLUSION: AMTR(2/3) is less sensitive to MR imaging system variations than are other MTR parameters and was most effective in differentiating patients with MS from healthy control subjects. This finding supports the use of AMTR(2/3) in multicenter MT MR imaging studies of MS.

European validation of a standardized clinical description of multiple sclerosis.

OBJECTIVES: The EDMUS system is a clinical database specifically tailored to the description of multiple sclerosis (MS). The EVALUED (Evaluation of the EDMUS system) study is an European project with two objectives: 1) to assess the inter-examiner reliability of the whole EDMUS system; 2) to validate the EDMUS-Grading Scale (EGS),which is a simplified version of the Kurtzke Disability Status Scale (DSS). METHODS: The protocol included 12 neurologists working in pairs within six European centres (Bari, Basel, Florence, London, Lyon, Würzburg). They assessed independently 30 MS patients in their centre, filling in the EDMUS forms. The reliability of the system was assessed on selected key items in the history of the MS onset, the clinical course and the disease course classification. The clinical examination of the patients permitted an assessment of the Kurtzke Expanded Disability Status Scale (EDSS) and the EGS. Level of agreement was measured in terms of kappa and weighted kappa indexes whenever appropriate. RESULTS: The study included 180 patients with definite or probable MS of whom 37% were males. Age was 35.8+/-9.6 years (mean +/- SD), disease duration 7.8+/-5.7 years, and mean EDSS score 4.1+/-2.2. The disease course was relapsing-remitting in 67%, secondary progressive in 22%, and progressive from disease onset in 11%. For key items of the history, the inter-examiner reliability level ranged from moderate to excellent. Concerning the disability scales, perfect agreement was reached in 59 % for EDSS and 78% for EGS. The close correlation and linear association (r=0.94, p<0.0001) between both scales demonstrated EGS's construct validity. CONCLUSION: The EDMUS system allows a consistent clinical description of MS using a common language. This standardized follow-up of MS patients is valuable especially in studies requiring a critical mass of informative patients.