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Biomedical subjects

M Koning

Publications and source records attributed to M Koning.

8 recordsLinked to original sources
PubMed2005

Predictive factors for rapid loss on the mini-mental state examination in Alzheimer's disease.

OBJECTIVES: To seek predictors of rapid loss of cognition and to evaluate their frequency in a prospective study of patients suffering from Alzheimer's disease (AD). DESIGN: A one-year prospective study. METHODS: 312 AD patients from the memory clinic at Toulouse University Hospital, participants in the ELSA study, were enrolled. Rapid cognitive decline was defined as a 4-point or greater loss on the Mini-Mental State Examination (MMSE) in 6 months. Comprehensive geriatric and neuropsychological assessment was conducted at baseline, 6 months and one year. RESULTS: Seventy-nine (24.8%) patients presented rapid cognitive loss over 6 months. The majority were stable at one year whereas 15 experienced continued rapid cognitive loss. Multivariate analysis showed that only the Mini Nutritional Assessment score (MNA) was correlated with rate of decline. Patients with rapid cognitive decline were also significantly more dependent at 6 months. CONCLUSIONS: Our findings demonstrate that rapid cognitive loss is frequent in AD patients, probably indicating underlying frailty. Future studies should lead to a practical approach to detecting these frail patients and to increasing preventive interventions.

Activities of Daily Living↗
PubMed2003

Weight gain in patients after therapy for hyperthyroidism.

OBJECTIVE: To determine the prevalence of obesity following therapy for hyperthyroidism and to assess the contributing factors associated with an undesirable weight gain. DESIGN: A retrospective analysis was undertaken of clinical records for 160 hyperthyroid patients attending an endocrine clinic in Bloemfontein (1994-2001). RESULTS: Of the 160 patients, 143 had Graves' disease and 17 patients had multinodular goitre. Most of our patients (N = 147) were treated with radioiodine, 10 patients with carbimazole and 3 patients had thyroidectomy. The median weight gain 6 months after therapy was 5.0 kg, after 12 months 9.0 kg, and after 24 months 12 kg, whereafter body mass stabilised. Before therapy 27.5% of patients had a body mass index (BMI) of < 22 kg/m2, 29.4% were overweight (BMI > 25 kg/m2) and 19.3% were obese (BMI > 30 kg/m2). Two years after treatment only 8.7% of patients had a BMI of < 22 kg/m2, 27.5% had a BMI > 25 kg/m2, and 51.3% had become obese. The main factors associated with weight gain 24 months after therapy were poor control of thyroid function on replacement therapy, diagnosis of Graves' disease and need for thyroxine replacement. CONCLUSION: This study has shown a large increase (32%) in the prevalence of obesity following treatment for hyperthyroidism. The main weight gain was during the first 2 years after therapy. The main factors contributing to excessive weight gain were need for replacement therapy and poor control of thyroid function.

Antithyroid Agents↗
PubMed2000

Tracing the transformation of labelled [1-13C]phenanthrene in a soil bioreactor.

[1-(13)C]-labelled phenanthrene was incubated in a closed bioreactor to study the flux and biotransformation of polycyclic aromatic hydrocarbon (PAH) in contaminated soils on a bulk and molecular level. The degradation of extractable phenanthrene was observed by GC-MS measurements and the mineralisation was monitored by (13)CO(2) production. The transformation of the (13)C-label into non-extractable soil-bound residues was determined by carbon isotopic measurements. With these data we were able to calculate a carbon budget of the (13)C-label. Moreover, the chemical structure of non-extractable bound residues was characterised by applying selective chemical degradation reactions to cleave xenobiotic subunits from the macromolecular organic soil matrix. The obtained low molecular weight products yielded (13)C-labelled compounds which were identified using IRM (isotope ratio monitoring)-GC-MS and structurally characterised with GC-MS. Most of the (13)C-labelled products obtained by chemical degradation of non-extractable bound residues are well-known metabolites of phenanthrene. Thus, metabolites of [1-(13)C]phenanthrene formed during biodegradation appear to be reactive components which are subsequently involved in the bound residue formation. Hydrolysable amino acids of the soil residues were significantly labelled with (13)C as confirmed by IRM-GC-MS measurements. Therefore, phenanthrene-derived carbon was transformed by anabolic microbial processes into typical biologically derived compounds. These substances are likely to be incorporated into humic-like material after cell death.

Journal Article↗
PubMed1997

An audit of the assessment and management of adults admitted to Christchurch Hospital with community acquired pneumonia.

AIMS: To audit the management of adult patients admitted with community acquired pneumonia including the standards of clinical assessment, use of modified British Thoracic Society prognostic criteria and antibiotic therapy. METHODS: A prospective, 16 week, study of consecutive patients admitted to Christchurch Hospital with community acquired pneumonia. RESULTS: Ninety-six patients met the inclusion criteria. The median age was 70 years. A pathogen was identified in 28 (26%) patients. Forty two patients fulfilled the modified British Thoracic Society criteria for severe disease and all 9 deaths occurred in that subgroup. The management guidelines were followed without exception in only 15% of cases. Documentation of the prognostic criteria was often incomplete and therefore only 33% of those patients with severe disease were correctly identified. Seventy one percent of those with severe disease were treated with only one antibiotic and there was significant delay in administering the first dose in 44% of cases. A follow up chest radiograph was performed in 43 (51%) of those discharged. CONCLUSIONS: There was poor compliance with the management guidelines. There was a lack of awareness of the severity criteria leading to inadequate treatment in many cases. Further educational initiatives are indicated.

Adult↗
PubMed1996

Laparoscopically assisted transvaginal segmental resection of the rectosigmoid colon for endometriosis.

OBJECTIVE: To compare three methods of segmental lower colon resection for treatment of symptomatic intestinal endometriosis. DESIGN: Retrospective case study. SETTING: Private practice patients in a rural community hospital. PATIENTS: Patients with nodular, invasive rectosigmoid endometriosis requiring segmental resection and anastomosis for treatment. Laparotomy patients were matched with laparoscopy patients for severity of intestinal endometriosis. INTERVENTIONS: Segmental resection of the rectosigmoid colon by laparotomy, by a laparoscopic Intracorporeal technique or by a laparoscopically assisted transvaginal technique. MAIN OUTCOME MEASURES: Length of surgery, length of hospital stay, operating room charges and total hospital charges corrected to 1995 dollars. RESULTS: Compared with laparotomy segmental colon resection for endometriosis, laparoscopic transvaginal segmental resection resulted in a shorter length of stay, equivalent operating room charges, and significantly lower total hospital charges. The laparoscopic transvaginal technique is much faster, safer, and less fatiguing to the surgeon than a total intracorporeal technique. CONCLUSIONS: Laparoscopically assisted transvaginal segmental rectosigmoid resection for endometriosis is a promising technique that is simpler than a laparoscopic intracorporeal segmental resection technique and is less costly than a laparotomy segmental resection technique.

Colon, Sigmoid↗
PubMed1993

Variability of the main sequence.

PURPOSE: This study investigated the relationship between amplitude and peak velocity of saccadic eye movements (the so-called main sequence) and the intra-individual variability of the main sequence. METHODS: Saccadic amplitudes and peak velocities were measured twice in 58 healthy subjects with an infrared reflection technique. RESULTS: Considerable intra-individual variability was found between the first and second recordings. CONCLUSIONS: Intra-individual variability of saccadic peak velocity affects the interpretation of changes in repeated recordings of peak velocities, such as before and after medication is administered. Furthermore, considerable intra-individual variability decreases the probability that statistically significant differences between patients and control subjects can be detected, especially when groups are small. Calculating the intraclass correlation coefficient allows the number of subjects in comparative studies to be determined.

Adult↗