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Biomedical subjects

H Van Loon

Publications and source records attributed to H Van Loon.

7 recordsLinked to original sources
PubMed2000

Quality of life and effectiveness of diabetes care in three different settings in Leuven.

BACKGROUND: The new diabetes protocol, formulated in Belgium as a consensus between the National Institution of Health Insurance and diabetologists, implicitly assumes the care of type 1 diabetic patients to be more efficient at the specialist level (SP) in hospital, although GPs frequently are involved in diabetes care. OBJECTIVES: A study was carried out in order to highlight differences in diabetes care between three different treatment settings (SP alone, combined SP-GP and GP alone) METHODS: Out of a group of known diabetics, 325 patients were selected according to a stratified cluster sampling technique, in such a way that the three types of diabetes (formerly called type 1, type 2a and type 2b) occurred sufficiently in the three above-defined treatment settings. Outcome data on co-morbidity and diabetes health profile as well as output data on laboratory results were collected for each patient and compared between the different subgroups. RESULTS: On the basis of a response rate of 47.9%, equally distributed over the different levels, we demonstrated that GPs and SPs score equally low on the different measures and that a better follow-up is indicated in all settings. CONCLUSION: Diabetes care in Flanders can be upgraded significantly. There is no evidence that specialists are performing better. Therefore, one could argue for better follow-up of diabetes care in a primary health care setting.

Adolescent↗
PubMed1989

Reliability and reproducibility of the larval paralysis test as an in vitro method for the detection of anthelmintic resistance of nematodes against levamisole and morantel tartrate.

In order to study the reliability of the larval paralysis test as an in vitro assay for the detection of resistance of nematodes to levamisole and morantel tartrate, the influence of different parameters was evaluated using resistant and susceptible Ostertagia ostertagi strains. The operator, the sample (10% of the larvae present in the suspension), the incubation time (24, 48 or 72 h), the incubation temperature (20 or 25 degrees C) and the observation period of the larvae (5 or 15 s) had no statistically significant influence on the test results. Statistical differences were obtained only when L3 larvae of different ages (1 or 2 months) were used. Reversibility of the paralysis did not occur when concentrations of levamisole of less than or equal to 200 micrograms ml-1 or morantel tartrate of less than 2000 micrograms ml-1 were used. The reproducibility of the test was fairly good, with a mean standard deviation of 21.3% for the LC50 values. Morantel resistance in a strain of O. ostertagi was not confirmed as such by the larval paralysis test. The resistance factor was less than or equal to 1, in spite of an efficacy of morantel of 77.4% as shown in vivo.

Animals↗
PubMed1987

Screening for marasmus: a discriminant analysis as a guide to choose the anthropometric variables.

In a cross-sectional study, children 0-6 yr of age from eight different population groups in Africa and Asia were examined. Clinical assessment defined 8750 children as being well nourished and 194 as having marasmus. Height, weight, arm circumference (AC), and triceps skinfold thickness were measured; the latter two measurements and the clinical assessment were done by the same observer. Based on data from normal children, local growth curves were computed for each group. Each child's growth was expressed in standard deviation scores (SDS) of his own group. On the basis of the results of a discriminant analysis, all variables were ranked by their decreasing power to discriminate between normal and marasmic children. For 83% of the children one measurement (AC/age) is sufficient to classify them definitely; for the others several variables are needed. This strategy yields an overall sensitivity of 80%, a specificity of 97%, and a positive predictive value of 38%.

Africa↗
PubMedDate not supplied

Local versus universal growth standards: the effect of using NCHS as universal reference.

Lack of local references has brought many fieldworkers to use the NCHS reference or other Western standards to assess the nutritional status of children in different developing countries. Cross-sectional data from 6631 children between 0 and 6 years of age, without signs of protein-energy malnutrition, were collected by the same observer in four different geographical areas in Africa and Asia. For each of the four geographical areas, local growth curves were drawn and compared with the NCHS reference. The local curves shows clear heterogeneity, and the values at different ages are not a constant proportion of the NCHS. These observations are in favour of using local standards in the nutritional screening of children in order to develop efficient and effective nutritional programmes.

Arm↗
PubMedDate not supplied

Growth of children in a iodine-deficient area in northern Zaïre.

In a case-control study all preschool children of 50 villages in an iodine-deficient area in northern Zaïre were examined for the absence or presence of a goitre. Children with goitre but without obvious signs of cretinism (cases) were maximally matched with a goitre-free child of the same ethnic group, village, sex and age (controls). Anthropometry of cases and controls was compared in order to investigate if endemic goitre is associated with any growth impairment. Surprisingly, between ages 2 and 4 years, children with goitre are taller and heavier, and have a smaller triceps skinfold thickness. Arm circumferences did not differ between cases and controls. Stunting is more prevalent in controls. If manifest cretinism is excluded, goitre is not associated with growth retardation. The higher anthropometric figures in goitrous children remain unexplained. In the absence of any data on the hormonal status of these two groups of children, it can only be surmised that, in iodine-deficient areas, some degree of hypothyroidism negatively influencing growth might be more frequent in non-goitrous children than in goitrous ones.

Age Factors↗
PubMedDate not supplied

Retrospective estimate of the nursing cost of autonomy impairment and cost benefit in clinical trials: feasibility and application of piracetam in demented elderly patients.

The aims of this study were to determine whether the nursing costs of functional disability could be assessed retrospectively and, if so, whether this method was sensitive enough to show the influence of a treatment on economic costs. Four studies were available for this purpose: three randomized, double-blind, placebo-controlled, clinical trials measuring, among others, the influence of piracetam on activities of daily living (ADL) of elderly demented patients in Italy, Austria, and Belgium, and one large population-based survey measuring the costs of providing basic nursing, hygienic, and therapeutic needs to 6000 elderly according to ADL scores. The items on the different ADL scales used in each trial were recoded to a common denominator, and an overall dependency score was calculated for each patient. The survey data showed a highly significant linear correlation between ADL status and nursing expenses. Nursing costs of noninstitutionalized patients were calculated by assigning each patient the average nursing cost of all persons from the survey who matched by sex, age, and dependency score. Retrospective economic assessment was possible for ambulatory patients when there were functional assessments and a survey with nursing costs gauged according to those functional assessments. Objective classification criteria for hospital or retirement home patients are needed for the level of reimbursement of nursing costs. Piracetam treatment decreased dependency, compared with placebo. The economic improvement continued over the entire duration of all three clinical trials, lasting up to 6 months in the Italian trial in both ambulatory and residential settings. The decrease in nursing costs remained stable during the same period for patients treated with piracetam, whereas nursing costs of placebo patients steadily increased. After 6 months this difference increased a monthly average of 820 Belgian francs (BF {35 BF = 1 US $}) for ambulatory patients in favor of piracetam, 1650 BF for residential patients, and 2580 BF for hospitalized individuals.

Activities of Daily Living↗