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2009 | 56 | 4 |

Tytuł artykułu

Measurement of functional independence level and falls-risk in individuals with ungiagnosed phenylketonuria

Warianty tytułu

Języki publikacji

EN

Abstrakty

EN
 The aim of the study was to determine the level of functional independence in adult patients with previously undiagnosed or untreated phenylketonuria (PKU). The study was conducted among 400 intellectually impaired adult residents of Social Welfare Homes in South-Eastern Poland born prior to the introduction of neonatal PKU screening programs. PKU was screened by filter paper test using tandem mass spectrometry methods, and confirmed by gas chromatography-mass spectrometric analysis of PKU organic acids in urine. Degree of functional independence included the assessment of activities of daily living (Barthel Index) and measures of balance and gait (Tinetti scale). Eleven individuals with previously untreated PKU were identified whereby eight presented with moderate disability and three with mild disability. Six had a high risk of falls and five had a moderate risk of falls. This study indicates that there is considerable number of undiagnosed PKU patients within the Polish population who require assessment and management in order to reduce the impact of the neurological and neuropsychiatric problems associated with the condition. Appropriate therapy for those with undiagnosed PKU should, in particular, address the risk of falls.

Wydawca

-

Rocznik

Tom

56

Numer

4

Opis fizyczny

p.613-618,fig.,ref.

Twórcy

autor
  • University of Rzeszow, Warszawska 26a, 35-205 Rzeszow, Poland
autor
autor

Bibliografia

  • Brown MCJ, Guest JF (1999) Economic impact of feeding a phenylalanine restricted diet to adults with previously untreated phenylketonuria. J Intellect Disabil Res 43: 30-37. 
  • Chalmers RA, Lawson AM (1975) Human metabolic diseases. Chem Brit 11: 290-295.
  • Collin C, Wade DT, Davies S, Horne V (1988) The Barthel ADL Index: a reliability study. Int Disabil Stud 10: 61-63. 
  • Dalek B, Czernicki J (1999) Tests on the evaluation of elderly patient's functional fitness. Physiotherapy 7: 47-51 (in Polish).
  • Fitzgerald B, Morgan J, Keene N, Rollinson R, Hodgson A, Dalrymple-Smith J (2000) An investigation into diet treatment for adults with previously untreated phenylketonuria and severe intellectual disability. J Intellect Disabil Res 44: 53-59. 
  • Franssen EH, Souren LE, Torossian CL, Reisberg B (1999) Equilibrium and limb coordination in mild cognitive impairment and mild Alzheimer's disease. J Am Geriatr Soc 47: 463-469. 
  • Giżewska M (2006) PKU as a cause of intellectual disability in the adult before the era of newborns screening tests-phenylalanine neurotoxic mechanism. Family Med Primar Care Rev 2: 386-391.
  • Giżewska M, Ołtarzewski M, Sendecka E (2003) Patients with PKU born before introducing screening tests: various faces of the same disease. Adv Pediatrics 2: 24-32 (in Polish).
  • Hsueh J-P, Lin J-H, Jeng J-S, Hsieh (2002) Comparison of the psychometric characteristics of the functional independence measure, 5 item Barthel index, and 10 item Barthel index in patients with strokes. J Neurol Neurosurg Psychiatr 73: 188-190. 
  • Ishimaru K, Tamasawa N, Baba M, Matsunaga M, Takeg K (1993) Phenyloketonuria with adult-onset neurological manifestation. Clin Neurol 33: 961-965. 
  • Kasim S, Moo LR, Zschocke, Jinnah HA (2001) Phenylketonuria presenting in adulthood as progressive spastic paraparesis with dementia. J Neurol Neurosurg Psychiatr 71: 795-797. 
  • Lee PJ, Amos A, Robertson L, Fitzgerald B, Hoskin R, Lilburn M, Weetch E, Murphy G (2009) Adults with late diagnosed PKU and severe challenging behavior: a randomized placebo-controlled trial of phenylalanine - restricted diet. J Neurol Neurosurg Psychiatr 80: 631-635. 
  • Mahoney FI, Barthel D (1965) Functional evaluation: the Barthel Index. Maryland State Med J 14: 61-65. 
  • Merrick J, Aspler S, Schwarz G (2003) Phenylalanine-restricted diet should be life-long. A case report on long-term follow-up of an adolescent with untreated phenylketonuria. Int J adolesc Med Health 15: 165-168. 
  • Robertson L (2006) The National Society for Phenylketonuria (NSPKU)  http://www.nspku.org/Documents/Conf_abstracts/Conference_Abstracts_2006.pdf
  • Rolling J (1984) The discovery of phenylketonuria. Acta Paediatr (Suppl) 407: 4-10.
  • Sansom C (1999) Tandem mass spectrometry: the tool of choice for diagnosing inborn errors of metabolism. Mol Med Today 5: 95-96. 
  • Tinetti ME (1986) Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc 34: 119-126.  
  • Twardowska-Rajewska J (2006) Short programme of making efforts to streamline seniors in order to minimize balance disturbances. Preliminary reports. Polish Gerontology 1: 41-45 (in Polish).
  • Yannicelli S, Ryan A (1995) Improvements in behavior and physical manifestations in previously untreated adults with phenylketonuria using a phenylalanine-restricted diet: national survey. J Inherit Metab Dis 18: 131-134. 
  • Weglage J, Oberwrittler C, Marguardt T, Schellscheidt J, von Teeffelen-Heithoff A, Koch G, Gerding H (2000) Neurological deterioration in adult phenylketonuria. J Inherit Metab Dis 23: 83-84. 
  • Williams K (1998) Benefits of normalizing plasma phenyloalanine: Impact on behaviour and health. A case report. J Inherit Metab Dis 21: 785-790. 
  • Sansom C (1999) Tandem mass spectrometry: the tool of choice for diagnosing inborn errors of metabolism. Mol Med Today 5: 95-96. 
  • Zekanowski C, Perez B, Desviat LR, Wiszniewski W, Ugarte M (2000) In vitro expression analysis of R68G and R68S mutations in phenylalanine hydroxylase gene. Acta Biochim Polon 47: 365-369. 

Typ dokumentu

Bibliografia

Identyfikatory

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