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Biomedical subjects

R A Hirasing

Publications and source records attributed to R A Hirasing.

At least 73 records · Page 4Linked to original sources
PubMed1995

[Prevalence of chronic diseases in school children reported by their parents].

OBJECTIVE: To establish the prevalence of chronic diseases reported by parents among a random population of Dutch children. Furthermore, to establish how often these children visited a physician because of a chronic disease, and used drugs for its treatment. SETTING: Dordrecht and environs. DESIGN: Descriptive. METHOD: In the school year 1990-1991, all 8689 parents of school children summoned for a periodical health check by the school doctor or school nurse were sent a questionnaire together with the notification. With the aid of a list of criteria it was determined for every child during the periodical health check if the diseases, if any, were serious, if the children were being treated for them and if they used medication. RESULTS: The response to the questionnaire amounted to 98.3%. Of the children examined, 21.3% according to the parents suffered from one or more chronic diseases, 3.7% to a major extent. Of the group with one or more chronic diseases, 25.2% were monitored by the family doctor, 10.5% by the paediatrician, 18.6% by various other specialists and 4.5% by a homeopathist. Of the population as a whole, 10.1% used medication because of one or several of the chronic diseases; this accounted for 47.4% of the group with one or several chronic diseases. CONCLUSION: The prevalence of chronic diseases in school children reported by the parents is so high that it should be given attention in post-graduate education and public health information.

Child↗
PubMed1995

[Pediatric surveillance of invasive infections caused by Haemophilus influenzae type b in children in the period following introduction of vaccination].

OBJECTIVE: Evaluation of the effect of vaccination against Haemophilus influenzae type b (Hib) on the occurrence of invasive Hib infections in children since its introduction into the national immunization programme in April 1993. DESIGN: Observational study. SETTING: Nationwide investigation. METHOD: Data collected through active surveillance of invasive Hib infections by paediatricians for the period from October 1993 to September 1994 (11 months) were compared with data from the meningitis surveillance by the Netherlands Reference Laboratory for Bacterial Meningitis. RESULTS: A total of 139 paediatric reports of invasive disease by H. influenzae concerned 57 cases of only meningitis, 35 of meningitis with sepsis, 2 of meningitis with arthritis, one of meningitis with arthritis and osteomyelitis, 34 of epiglottitis including one case with sepsis, 8 of only sepsis and 2 of only arthritis. All proven infections by Hib occurred in children who had not or incompletely been vaccinated. One child with sepsis had had three vaccinations and became ill five months later; the isolated bacterial strain was not serotyped. Typing was performed in only 80% of the isolates, of which 98% were of type b. Appropriate culturing and typing was often omitted in case of epiglottitis. CONCLUSION: The effect of vaccination against Hib became apparent in a small number of cases of invasive Hib disease reported by paediatricians; the peak incidence of meningitis no longer occurred in children under one year of age but in children aged one year. The paediatric surveillance described offers possibilities for monitoring Hib epidemiology.

Child↗
PubMed1995

[Use of the pill by adolescents for contraception or as therapy].

OBJECTIVE: To describe frequency of oral contraceptive (OAC) use, indications for OAC use and influence of calender age, gynaecological age (age minus age at menarche) and level of education on OAC use among ninth grade secondary school girls. SETTING: Secondary schools in Amstelland-de Meerlanden, a combined urban and rural region to the south of Amsterdam. METHOD: By questionnaire and individual interview on menstrual cycle pattern and OAC use, school girls were asked about duration and reasons for OAC use and what preparation they used. RESULTS: The response to the questionnaire was 92%, that to the interview 83%. Of the 2248 responders 248 (11%; mean age 15.3 years (SD: 0.6)) used OAC: 74% used low dose 'sub 50' preparations, 3% pills with 50 micrograms oestrogen, 3% 3-phase preparations and 17% pills with antiandrogens. Of girls aged 14, 15 and 16 years 4%, 12% and 28%, respectively, used OAC. Of the 15-year-olds 36% mentioned contraception as most important reason, 20% menstrual cycle irregularity, 28% dysmenorrhoea, 12% acne and 5% other reasons. With multiple logistic regression analysis age, gynaecological age and level of education were independent variables for OAC use in general and for OAC use for contraception or dysmenorrhoea, but less so for OAC use for menstrual cycle irregularity or acne. CONCLUSION: During adolescence low dose OACs are frequently used. Of adolescent OAC users 36% mentioned contraception as most important reason. OAC use in the Netherlands among girls aged 15 and 16 years doubled in comparison with 1982. Gynaecological age and calender age (determinants of biological maturation), and level of education (a determinant of life style) were associated with OAC use.

Acne Vulgaris↗
PubMed1994

[Bicycle accidents in children in The Netherlands in 1990/1991; time for bicycle helmets].

OBJECTIVE: To assess the possibility of preventing consequences of bicycle accidents. DESIGN: Retrospective study. SETTING: The Netherlands. MATERIAL AND METHOD: The data on mortality and hospital admissions of children aged 0-14 years were analysed. The data on traffic accident fatalities were obtained from the Traffic Accidents Registration (for 1991) and those on admissions from the Dutch Centre for Health Care Information (for 1990). RESULTS: In 1991, 82 children (1-14 years) died from the consequences of a traffic accident. Most died after a bicycle accident. The number of hospital admissions because of traffic accidents in the age group 0-14 years in 1990 amounted to 2839, of which 46% were due to a bicycle accident. Most of the children aged 0-14 years admitted because of bicycle accidents had head and skull injuries. In 69% of the bicycle accidents no motor vehicle was involved. CONCLUSION: Because of the high frequency of head injuries, wearing a bicycle helmet should be promoted strongly, legal obligation giving the fastest and best results. Several prevention strategies are discussed.

Accidents, Traffic↗
PubMed1994

[Smoking in the presence of infants; a survey among parents attending well-baby clinics].

OBJECTIVE: To determine the exposure to cigarette smoke of infants aged 0-14 months. DESIGN: Cross-sectional. SETTING: The area of Westfriesland, the Netherlands. METHOD: All parents of infants 8 days, 3, 5, 9, and 14 months old who visited the infant welfare centre in 1992 were asked to fill in a questionnaire. RESULTS: The questionnaire was filled in by 75% of the parents. Smoking before pregnancy was reported by 38% of the mothers, 25% smoked for more than 12 weeks during pregnancy. Almost 50% of all infants were exposed to cigarette smoke at home: 31% of the fathers, 27% of the mothers and 21% others smoked at home. The number of parents who smoked > or = 16 cigarettes a day at home was significantly higher in the weekend than on working days. Nobody smoked in the bedroom of the infant, 42% smoked in the living room, 21% smoked during nursing the infant and 11% smoked in the car in the presence of the infant. CONCLUSION: Infants are often exposed to cigarette smoke at home, during nursing and in the car.

Adult↗
PubMed1994

[Good long-term results of dry bed training in children with nocturnal enuresis].

OBJECTIVE: To determine the long-term effect of dry bed training in a youth health care setting. SETTING: Haarlemmermeer, the Netherlands. DESIGN: Descriptive. METHOD: Parents of 36 children (mean age 9 year) subjected to dry bed training in 1987-1989, were asked in 1993 if their child had wet his or her bed in the past 4 weeks. The parents were instructed in the training in group sessions in the youth health care setting. RESULTS: In 1993, that is 4-6 years after the training, 83% slept dry. In the other 17% the number of wet nights dropped from 6 times to twice a week. CONCLUSION: We can conclude that the long-term success rate of dry bed training is high. Group dry bed training is a suitable method for children with nocturnal enuresis from age 8 when other methods are unsuccessful. The training is feasible outside the hospital.

Adolescent↗
PubMed1994

Increasing incidence of type I diabetes in The Netherlands. The second nationwide study among children under 20 years of age.

OBJECTIVE: A nationwide retrospective study was conducted to assess the incidence of type I diabetes in The Netherlands among children < 20 years of age in 1988-1990. The first study with a similar design covered 1978-1980. RESEARCH DESIGN AND METHODS: The capture-recapture census method was chosen for analysis of the data. A questionnaire was sent to all Dutch pediatricians and internists, and for the ascertainment, a similar questionnaire was sent out separately to members of the Dutch Diabetes Association, which is the national patient association. RESULTS: The average achieved ascertainment rate was 81%. The ascertainment-adjusted annual incidence was 13.2/100,000 for 0- to 19-year-old children, indicating an increase of 23% compared with the 1978-1980 survey; for 0- to 14-year-olds, the increase amounted to 17%. CONCLUSIONS: This study suggests a sustained increase of type I diabetes in The Netherlands because the cumulative incidence studied previously in the 1960-1970 birth cohorts of male army conscripts 18 years of age was also found to rise. In contrast to Northern European countries, an increase in incidence for the age category 0-4 years could not be found.

Adolescent↗
PubMed1991

[National testis registration].

In order to gain an impression of the documentation of the testes position in the first few days after delivery an inquiry was held among all clinical paediatricians. The response was 62%. Figure I shows where the localisation of the testes is registered systematically and where it is not. Between 1982 and 1988 the number of operations for undescended testes according to figures from the Dutch Centre for Health Care Information (SIG) decreased from 5928 to 2889. The expected number of operations per year is approximately 800. The number of unilateral orchidopexy operations per 1000 boys of 0-19 years old per year shows considerable geographic variation: in 1982 it ranged from 1.1 to 4.8 and in 1988 from 0.5 to 2.4. The documentation of the position of the testes in the first few days after delivery is important to prevent unnecessary operations.

Adolescent↗
PubMed1991

[Dry bed training in nocturnal enuresis].

In order to determine the prevalence of bedwetting, in the period September 1987-June 1989 an investigation was conducted among 1882 pupils of 15 primary schools in a rural area of the Netherlands. The investigation coincided with the periodical medical examination for which all pupils of these groups were invited and for which over 99% reported. In addition to this epidemiological study, a study was made of the effect of dry bed training, as a part of youth health care, in 36 children with nocturnal enuresis. Of the children examined, 8% wet their beds at least once a week, boys twice as often as girls. The secondary form of nocturnal enuresis occurred mostly in those aged 7-8 (44%) and mostly after certain events such as start of the school year, family problems or hospitalization. The proportion of bedwetting children with a parent with a history of nocturnal enuresis in youth was large: 56%. Of the girls with nocturnal enuresis, 25% had had a urinary tract infection as against 0.4% of the control group. Nocturnal enuresis often caused emotional stress in child and parents. The success rate of the dry bed training was 86%. Most children were dry within two months; 32% had a--frequently transient--relapse. After six months, 75% of the children who had had dry bed training remained dry at night. Group dry bed training appears a suitable method for children with nocturnal enuresis from age 8 when other methods (including the pad and buzzer) are unsuccessful. The training is feasible outside hospital and is an appropriate part of the tasks of youth health care.

Adolescent↗