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20 results on '"Van Boxem, Ton"'

8. An expert-supported monitoring system for patients with chronic obstructive pulmonary disease in general practice: results of a cluster randomized controlled trial

Author

van den Bemt, Lisette, Schermer, Tjard R.J., Smeele, Ivo J.M., Boonman-de Winter, Leandra J.M., van Boxem, Ton, Denis, Joke, Grootens-Stekelenburg, Joke G., Grol, Richard P.T.M., and van Weel, Chris

Subjects
Lung diseases, Obstructive -- Care and treatment, Physicians (General practice) -- Practice, Patient monitoring equipment -- Usage, Health
Abstract

A multicenter randomized controlled trial is conducted to determine the effectiveness of the monitoring system used for the management of patients with chronic obstructive pulmonary disease. The system is shown to be not completely effective and hence requires certain enhancements.

Published
2009

9. No apparent clinical value in maintaining regular checks of COPD patients by a GP laboratory over the years [Geen aanwijsbaar klinisch nut voor het jarenlang in stand houden van periodieke controles van COPD-patinten door een huisartsenlaboratorium]

Author

van den Bemt, Lisette, Schermer, Tjard R.J., Smeele, Ivo J, Boonman-de Winter, Leandra J.M., van Boxem, Ton, Denis, Joke, Grootens, Joke, Grol, Richard P.T.M., van Weel, Chris, van den Bemt, Lisette, Schermer, Tjard R.J., Smeele, Ivo J, Boonman-de Winter, Leandra J.M., van Boxem, Ton, Denis, Joke, Grootens, Joke, Grol, Richard P.T.M., and van Weel, Chris

Published
2010

10. Current clinical guideline definitions of airflow obstruction and COPD overdiagnosis in primary care

Author

Schermer, Tjard R. J, Smeele, Ivo J, Thoonen, Bart P, Lucas, A. E. M, Grootens-Stekelenburg, Joke G, van Boxem, Ton, Heijdra, Yvonne, van Weel, Chris, Schermer, Tjard R. J, Smeele, Ivo J, Thoonen, Bart P, Lucas, A. E. M, Grootens-Stekelenburg, Joke G, van Boxem, Ton, Heijdra, Yvonne, and van Weel, Chris

Abstract

The aim of the present study was to establish the agreement between two recommended definitions of airflow obstruction in symptomatic adults referred for spirometry by their general practitioner, and investigate how rates of airflow obstruction change when pre-bronchodilator instead of post-bronchodilator spirometry is performed. The diagnostic spirometric results of 14,056 adults with respiratory obstruction were analysed. Differences in interpretation between a fixed 0.70 forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) cut-off point and a sex- and age-specific lower limit of normal cut-off point for this ratio were investigated. Of the subjects, 53% were female and 69% were current or ex-smokers. The mean post-bronchodilator FEV1/FVC was 0.73 in males and 0.78 in females. The sensitivity of the fixed relative to the lower limit of normal cut-off point definition was 97.9%, with a specificity of 91.2%, positive predictive value of 72.0% and negative predictive value of 99.5%. For the subgroup of current or ex-smokers aged ≥50 yrs, these values were 100, 82.0, 69.2 and 100%, respectively. The proportion of false positive diagnoses using the fixed cut-off point increased with age. The positive predictive value of pre-bronchodilator airflow obstruction was 74.7% among current or ex-smokers aged ≥50 yrs. The current clinical guideline-recommended fixed 0.70 forced expiratory volume in one second/forced vital capacity cut-off point leads to substantial overdiagnosis of obstruction in middle-aged and elderly patients in primary care. Using pre-bronchodilator spirometry leads to a high rate of false positive interpretations of obstruction in primary care.

Published
2008

19. Exercise-induced spontaneous hemothorax insinuates trauma; yet unmasks a lament disorder

Author

Hadithi, Muhammed, van Boxem, Ton J.M, Giaccone, Giuseppe, and Postmus, Pieter E

Abstract

The investigation for a plausible explanation of the development of massive spontaneous hemothorax during exercise in two patients led to the disclosure of two different malignancies. The first patient (pleural fibrosarcoma) passed away shortly after diagnosis. The second patient is alive without signs of disease (peripheral neuro-ectodermal tumor, PNET) since the diagnosis was made 3 years before.

Published
2001
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20. Results of Two Years Expenience with Fluorescence Bronchoscopy in Detection of Preinvasive Bronchial Neoplasia

Author

J. W. Venmans, Ben, J. M. Van Boxem, Ton, F. Smit, Egbert, E. Postmus, Pieter, and G. Sutedja, Tom

Abstract

The aim of the study was to determine whether use of fluorescence bronchoscopy improves the detection of preinvasive neoplastic bronchial lesions. The data of all patients who underwent fluorescence bronchoscopy and in whom bronchial biopsies were taken, were analyzed. Most patients were at risk for preinvasive lesions. A total of 174 bronchoscopies were performed in 95 patients. Of the 681 representative biopsies, 31 were found to be moderate dysplastic, 39 were found to be severe dysplastic and 9 exhibited carcinoma in situ. These 79 preinvasive lesions were found in 34 patients. The respective results of fluorescence bronchoscopy in addition to conventional bronchoscopy and of conventional bronchoscopy alone for detection of preinvasive lesions were: sensitivity 85% (67/79) and 59% (47/79); specificity 60% (351/581) and 85% (493/581); positive predictive values of 23% (67/297) and 35% (47/135); negative predictive values of 97% (351/363) and 94% (493/525). A separate analysis of only the first bronchoscopy of each patient showed similar results. Results of fluoresence bronchoscopy were better in the second part of the patient group. We conclude that after a learning period fluorescence bronchoscopy can increase the yield of finding preinvasive neoplastic lesions when used in addition to conventional bronchoscopy.

Published
1999
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