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PubMed2006

Extrapulmonary tuberculosis by nationality, The Netherlands, 1993-2001.

This study describes the epidemiology of extrapulmonary tuberculosis (TB) in the Netherlands from 1993 through 2001. We assessed whether the increasing numbers of inhabitants with a non-Western ethnic background had an effect on the number of extrapulmonary patients. We used data from the Netherlands Tuberculosis Register and included all cases of TB diagnosed in the Netherlands between January 1, 1993, and December 31, 2001. Information on age, sex, nationality, year of diagnosis, culture result, anatomic location of the site of disease, and HIV status was retrieved from the register. Of 13,258 patients with TB, 8216 (62%) had pulmonary TB, and 5042 (38%) had extrapulmonary TB. Non-Dutch nationals were more likely to have most types of extrapulmonary TB. The growth of the number of inhabitants with a non-Western ethnic background in the Netherlands explains the proportional growth of extrapulmonary TB. Physicians need to be aware of the changing clinical picture of TB.

AIDS-Related Opportunistic Infections↗
PubMed1999

[Plague in southern Netherlands during the Middle Ages and modern times. Complaint about the status of the disease in its socioeconomic context].

In this contribution the latest insights with regard to the demographic impact of plague in the Netherlands are discussed, although is remains difficult to clearly distinguish this factor from other causes of mortality. When, how and why did the plague reappear in Europe after several centuries of absence to become endemic for the next three centuries? When and why did it disappear in Western Europe in the seventeenth century? The first epidemics of plague probably were not as catastrophic in the Netherlands as they were in many other parts of Europe, which is remarkable since the Netherlands was, together with Northern Italy, the most populous region of Europe. The explanation is to be found in the general socioeconomic context, that was in many regards better than in the neighbouring regions. The 'crisis of the late Middle Ages' was not as deep in the Netherlands as elsewhere: a relationship demography--economy is therefore probable. Nevertheless, mortality was high, partly because of plague, but also because of other diseases--for which the common term pestilentia was in use. Some unique statistical data for Flanders illustrate this mortality from the late Middle Ages onward. The succession of mortality leading to a high average mortality rate was more important than accidental mortality, that could have a spectacular but often not long-lasting impact.

Disease Outbreaks↗
PubMed1999

Different profiles of allelic losses in cervical carcinoma cases in Surinam and The Netherlands.

BACKGROUND: Cervical carcinoma is the second most common malignancy among women worldwide. The highest incidence rates are observed in developing countries. The increased susceptibility to cervical carcinoma in high incidence populations may result from several factors including human papillomavirus exposure and both inherited and acquired genetic traits. Using comparative molecular analysis of cervical carcinomas from Surinam, a high incidence area, and the Netherlands, a low incidence area, distinct molecular genetic profiles were studied in two populations with contrasting risk for the disease. METHODS: In the two populations, the authors compared allelic loss as a marker for the involvement of putative tumor suppressor genes in 40 and 67 carcinoma specimens from Surinam and the Netherlands, respectively. Loss of heterozygosity (LOH) analysis was performed using polymorphic microsatellite markers at sites of known tumor suppressor genes (17p [p53], 13q [Rb, BRCA2], 16q [E-cadherin], and 17q [BRCA1]) and at chromosomes 3p, 6p, 6q, and 11q, which frequently are lost in cervical carcinoma. RESULTS: Remarkable differences in LOH were found between both populations. The most prominent observation was the extremely high frequency of LOH, up to 72%, in the region of the major histocompatibility complex on chromosome 6p in specimens from Surinam. In the group of specimens from the Netherlands, only 45% of LOH was observed at this locus. In addition, LOH was detected significantly more frequently at 6q and 13q in the cases from Surinam whereas LOH was found more frequently at 17p in cases from the Netherlands. CONCLUSIONS: The results of the current study show that heterogeneity exists in tumor-associated somatic genetic alterations between these two populations that may be indicative of the existence of multiple genetic pathways in cervical tumorigenesis.

Adult↗
PubMed2001

Risks of fracture of Björk-Shiley 60 degree convexo-concave prosthetic heart valves: long-term cohort follow up in the UK, Netherlands and USA.

BACKGROUND AND AIM OF THE STUDY: Approximately 82,000 Björk-Shiley convexo-concave (BSCC) 60 degree prosthetic heart valves were implanted in patients worldwide between 1979 and 1986. Outlet strut fractures (OSF) of some of the valves were first reported shortly after their introduction. Here, the determinants of OSF are examined, and the between-country variation and long-term risk are assessed. METHODS: Cohorts of patients in the UK, Netherlands and USA with 15,770 BSCC 60 degree heart valves were followed up to 18 years for the occurrence of OSF. RESULTS: Crude rates of OSF were highest in the UK (0.18% per year), intermediate in the Netherlands (0.13%), and lowest in the USA (0.06%), although risk factor adjustment reduced the inter-country differences. Furthermore, in the UK and Netherlands, OSF rates (particularly for mitral valves) declined with time since implantation, and between-country differences were considerably diminished 10 or more years post implantation. The risk of OSF decreased steadily with advancing patient age. Fracture rates were lower among women than men, and also varied significantly with valve size and position and OSF status of other valves in the same shoporder. CONCLUSION: This long-term follow up of BSCC 60 degree heart valve patients indicates that risk factors for valve fracture are generally similar in the UK, Netherlands and USA. It also identifies a strong association between fracture risk and age, newly reveals gender-related differences, and shows that the risk of valve fracture persisted, albeit at a reduced rate, into the 1990s.

Adult↗
PubMed2001

[Sero-monitoring of notifiable diseases in wild boar in the Netherlands 1999-2001].

Within the framework of a sero-monitoring system, in operation since 1996. blood samples from wild boar shot during the hunting seasons 1999-2000 and 2000-2001 in The Netherlands were screened for the presence of antibodies against classical swine fever virus (CSFV), swine vesicular disease virus (SVDV), and Anjeszky's disease virus (ADV). The results indicate that CSFV, SVDV, and ADV are uncommon in the wild boar population in the Netherlands. Because of the recent foot-and-mouth disease (FMD) epidemic in the Netherlands in 2001, blood samples (approximately 200 samples) from wild boar shot in the Netherlands during the hunting season 2001/2002 were examined for antibodies against FMD. To date, antibodies against FMD have not been detected.

Animals↗
PubMed2002

[The risk of variant Creutzfeldt-Jakob disease in the Netherlands and the effect of preventive measures].

Variant Creutzfeldt-Jakob disease (vCJD) is a fatal and untreatable neurological disease, in which pathogenic prions (PrPSc) are involved. There is convincing epidemiological and experimental evidence that vCJD is a human expression of bovine spongiform encephalopathy (BSE). The risk of transmission of pathogenic prions which cause vCJD to humans is influenced by the species barrier, genetic susceptibility of the host, dose of infection and route of exposure. Transmission of pathogenic prions from bovines to humans is possible through meat products containing nerve and lymphatic tissue, and through medical products derived from bovine material. Human to human transmission is, in principle, also possible via blood and blood-derived products, human organs and tissues for transplantation, and through surgical instruments. Preventive measures to reduce transmission from bovines to humans have been introduced step by step in the Netherlands since 1989. With proper implementation, the current risk of becoming infected by Dutch meat products is small. It is very likely, however, that in the past decade BSE-infected bovines have entered the food chain. The Dutch population has also been exposed to foreign infected meat products. Measures to prevent human to human transmission are currently being improved in the Netherlands. It is expected that cases of vCJD will occur in the Netherlands in the future, but the number cannot be estimated accurately. The presence of PrPSc in both the livestock and in the human population in the Netherlands constitutes a permanent public health threat and is a reason for continued vigilance and active prevention.

Animals↗
PubMed1984

[The reliability of birth expectations in the Netherlands].

This study is concerned with the reliability of birth expectations in the Netherlands. The data are from four nationwide surveys: the National Survey on Fertility of 1969, the Netherlands Survey on Fertility and Parenthood Motivation of 1975, and the Netherlands Fertility Surveys of 1977 and 1982. These data permit the reliability of birth expectations data to be evaluated at the aggregate level only. Variations in the reliability of the data among the four surveys, and in the reliability of short- and long-term expectations, are analyzed. The results suggest that "asking for birth expectations in surveys in the Netherlands makes sense in so far that birth expectations can be used in...hypotheses for population forecasts." The precise ways of doing this are currently being studied at the Central Bureau of Statistics. (summary in ENG)

Attitude↗
PubMed2002

[Positron emission tomography in the Netherlands: need to expand the capacity].

Positron emission tomography with 18fluor-2-deoxy-D-glucose (FDG-PET) is increasingly used in clinical practice, especially in oncology. However, in the Netherlands, guidelines for its routine use are lacking, probably due to the limited availability and costs of PET technology. The increasing demand for evidence of a positive effect on patient management (and outcome) following the introduction of new diagnostic tests, also plays an important role. For non-small cell lung cancer (NSCLC) such evidence is now available. In a prospective randomised multicentre study performed in the Comprehensive Cancer Centre in Amsterdam, FDG-PET reduced the number of futile thoracotomies in patients with suspected NSCLC by 50%. This and other studies resulted in a regional guideline (formulated by pulmonologists, surgeons, radiotherapists, radiologists and nuclear medicine physicians) for the use of FDG-PET in patients with (suspected) NSCLC. Several, predominantly multicentre, studies to evaluate the effectiveness of FDG-PET in subgroups of patients with colorectal cancer, breast cancer, oesophageal cancer, ENT tumours, non-Hodgkin's lymphoma and NSCLC (early in the diagnostic workup), are currently being undertaken in the Netherlands. The results of these might facilitate a cost-effective positioning of PET technology for routine patient care in the Netherlands. A recent report from the Comprehensive Cancer Centre in the south of the Netherlands, based on scenarios in Belgium and the United States, indicates that the availability of PET facilities should increase substantially over the next decade, so as to ensure access to all patients who may benefit from this technology.

Cost-Benefit Analysis↗
PubMed2002

Sex differences in physician burnout in the United States and The Netherlands.

OBJECTIVE: to determine if there are sex differences in physician burnout in the Netherlands and, if not, to explore why they are present in the United States. METHODS: Separate physician surveys were conducted in the United States (n=2326) and the Netherlands (n=1426). Thirty-three percent of US respondents were female (adjusted response rate 52%); 18% of Dutch respondents were female (adjusted response rate 63%). Standardized mean sex differences (effect sizes) in burnout variables were calculated and compared crossnationally. RESULTS: US women experienced more burnout than US men did (28% v 21%, p<.01), but the sex difference in burnout among Dutch physicians was not significant. Women in both countries worked fewer hours than men did (48 v 56 US, 44 v 56 NL, difference in effect sizes of sex differences between US and NL, p<.001). Although women in both countries described less work control than men, the effect size of the sex difference in the United States was more than twice that in the Netherlands (.34 US v .15 NL, p<.01). Children, home support, and work-home interference were comparable between sexes in the United States. CONCLUSIONS: Gender parity in physician burnout in the Netherlands may be due to fewer work hours and greater work control of women compared to those in the United States.

Adult↗
PubMed2002

Dutch perspectives on palliative care in the Netherlands.

This study reports data gathered via extensive interviews with some of the leading authorities on the euthanasia policy that were conducted in the Netherlands. They were asked: It has been argued that the policy and practice of euthanasia in the Netherlands is the result of undeveloped palliative care. What do you think? I also mentioned the fact that there are only a few hospices in the Netherlands. The responses were different and contradictory. Many interviewees agreed with the statement. Almost all of those agreeing with it said that only during the late 1990s were people beginning to admit that there was a need to improve palliative care. Some interviewees insisted that doctors first need to explore other options for helping the patient prior to choosing the course of euthanasia. Other interviewees thought that palliative care is well developed in the Netherlands and that euthanasia has actually paved the way for calling more attention to palliative care.

Attitude to Death↗
PubMedDate not supplied

[A comparative study of the euthanasia laws of Belgium and the Netherlands].

Recently, laws on euthanasia have been adopted in the Netherlands and Belgium. In both countries the legality of euthanasia is conditioned by adherence to strict conditions and by confirmation after a notification procedure. Although both laws are rather similar, the Belgian law is more fastidious on the requirements of prudent practice. The Belgian law does and the Dutch law does not distinguish between terminal conditions and non-terminal or slowly evolutive chronic conditions. In Belgium, the law only applies to adults, whereas in the Netherlands, minors over 12 years of age may under certain conditions receive euthanasia. However, the Belgian National Medical Disciplinary Board has recently mitigated differences by drafting guidelines which reflect a broad interpretation of the law. A major difference between the two countries is that in the Dutch society the norm setting on euthanasia developed more through jurisprudence and endorsement by the Medical Association than through legislation. We anticipate that the implementation of the new law and the notification procedure may be more difficult in Belgium than in the Netherlands. In order to promote the quality of the euthanasia practice, the euthanasia notification procedure in the Netherlands is followed by systematic feedback to the physicians. The strict anonymity of the Belgian notification procedure will be broken only when the control commission finds some anomaly or deficiency in the declaration. Therefore, unless the Evaluation and Control Commission makes ample use of its prerogative to contact the physician, the Belgian physicians may be less supported by the notification procedure to improve their knowledge and skills in euthanasia.

Belgium↗
PubMed2004

[Dentistry and health system in Netherlands].

This study was aimed to introduce the dental education, practice and the health care system in Netherlands. The quality of dental education in Netherlands is quite high. There are three dental schools and recruit about 300 new students per year. Currently there are about 7623 dentists, 283 orthodontists, 203 oral surgeons, 8500 dental assistants and 2000 dental hygienists. In order to be a dentist, one needs to be registered in Individual Health Care Professions Act (BIG). Netherlands is also one of the leading countries in research on professional stress and burn-out in dentistry. This study summarized the main findings of research in this field. The refinement of the health care system in recent years in Netherlands has provided some insight and reference for the ongoing reformation and revolution of the public health system in China.

Delivery of Health Care↗
PubMed2004

[Health Council of the Netherlands advisory report 'Vaccination against pertussis'--time for a new vaccine].

An advisory report on vaccination against pertussis by the National Vaccination Programme Review Committee of the Health Council of the Netherlands makes recommendations on improving pertussis vaccination in the Netherlands. Since 1996, between 4000 and 8000 cases of pertussis have been reported each year, mainly in young children who have already been vaccinated. The main cause of this increase, apart from decreasing immunity in older children and adults, seems to be diminished vaccine effectiveness due to the occurrence of non-vaccine related strains of the pertussis bacterium in the Netherlands. The cellular vaccine used in the Netherlands contains low levels of the major antigens pertussis toxin and pertactin. The Health Council recommends the fastest possible transition to the use of an acellular combination vaccine. Such a vaccine will be effective and will have considerably fewer side effects than the one currently in use. The Committee recommends that research is done into the sources of pertussis infections in young infants.

Humans↗
PubMed2004

[High perinatal mortality in the Netherlands compared to the rest of Europe].

In the Peristat-project, a European collaborative study, a set of indicators has been defined for monitoring perinatal health outcomes. For a group of 10 core indicators, with variables for subgroup analysis, national registry data from 15 European member states were collected and compared. The Netherlands was found to have the highest perinatal mortality in Europe: the foetal and neonatal mortality amounted to 7.4 and 3.5 per 1000 births, respectively. European countries differ in registration practices. Some countries do not register perinatal deaths occurring before a duration of amenorrhoea of 28 weeks. Therefore, the Peristat mortality data should be compared with 28 weeks of gestation as a cut-off point. With this cut-off point, The Netherlands has the second highest perinatal mortality. A number of factors may have contributed to this relatively high mortality, such as differences in registration practices, the profile of the Dutch childbearing population and the characteristics of Dutch perinatal care. The Netherlands has a relatively high proportion of older mothers, multiple births and mothers belonging to an ethnic minority. Also, Dutch neonatologists are known to be conservative in their treatment of premature newborns, which reduces their chances of survival. There is also less prenatal screening for congenital abnormalities in The Netherlands than in many other European countries. Further analysis of the Dutch data, as well as continued monitoring at the European level, can serve as a basis for future policy decisions to enhance the health of Dutch mothers and newborns.

Data Collection↗
PubMed1991

The point of view of a low prevalence country: The Netherlands.

The elimination of tuberculosis in the Netherlands is not envisaged before 2025. The evidence presented in this paper suggests that the elimination phase asks for a revision of existing control strategies. In the Netherlands a new role is identified for a voluntary tuberculosis organisation like the Royal Netherlands Tuberculosis Association (KNCV) in the areas of expert consultation, surveillance, post-graduate education and consensus and protocol development. A major challenge for a low prevalence country is the existence of high prevalence countries; KNCV's contribution to the success of the Mutual Assistance Programme of the IUATLD in Tanzania, Malawi, Benin, Kenya and Mali is discussed. A major role is identified for the IUATLD and voluntary organisations like KNCV in WHO's new global programme against tuberculosis. The involvement of a Dutch voluntary organisation, the Medical Committee The Netherlands-Vietnam (MCNV) in support of the national tuberculosis programme in Vietnam illustrates this development.

Adolescent↗
PubMed2006

[Suicide among migrant populations and native Dutch in The Netherlands].

OBJECTIVE: To determine the differences in suicide mortality between native Dutch and migrant groups in the Netherlands from different countries and regions of origin, taking the differences in age structure into account. DESIGN: Retrospective. METHODS: Data from the statistics on causes of death from the Dutch Central Bureau of Statistics, Statistics Netherlands (CBS), based on the causes of death given in the certificates from the doctor or forensic pathologist, were coupled to the reports of death from the Municipal Population Registration (GBA). In this way, the country of origin of the deceased could be determined. The confidentiality of these data is regulated by law. For the period 1996-2004, all 13,737 persons were selected who had committed suicide (International classification of diseases (ICD)-10-codes X60-X84). The country of origin was determined on the basis of data on the country of birth of the deceased and his or her parents. Someone is a 'migrant' ('foreign') according to the definition of the CBS if at least one of the parents was born outside the Netherlands. RESULTS: There were substantial differences in suicide mortality between migrant groups in the Netherlands. These differences reflected, to some extent, suicide mortality patterns in the countries and regions of origin. On the whole, migrants originating from western countries showed suicide mortality rates that were well above the average rate for native Dutch. High suicide rates were seen in male migrants from southern and eastern Europe. On the other hand, suicide mortality was significantly lower among Turks and Moroccans than among native Dutch. Only young adult males of non-western origin, with the exception of Moroccans, were much more likely to commit suicide than native Dutch. CONCLUSION: Although much attention has recently been paid to the elevated rates of attempted suicide among young women from Surinam, their suicide mortality was increased less than that of men from Surinam up to middle age. These increased suicide rates may reflect high levels of mental illness, identity problems, disappointments related to the process of migration, high expectations with respect to education, work and income, and the responsibilities for a family.

Adolescent↗
PubMedDate not supplied

Contraception and fertility in the Netherlands.

At the beginning of the 1960s, the Netherlands was basically a conservative society, in which there was little public discussion of birth control or of any sex-related topic. Then, beginning in the 1960s, a series of revolutionary changes in attitudes transformed the Netherlands. The pill was introduced in 1964, and within four years, four out of 10 Dutch women between the ages of 21 and 34 had used it. In 1971, the pill and sterilization were both made available free of charge through the national health insurance plan. By 1974, three-quarters of currently married women 20-42 years of age had ever used the pill, and by 1981, more than 700,000 men and women of reproductive age had had voluntary sterilizations, so that approximately 20 percent of all Dutch couples of reproductive age were protected from pregnancy by sterilization. As might be expected, the wide use of effective contraceptive methods during the late 1960s and the 1970s produced an unprecedented fertility downturn in the Netherlands: The crude birthrate fell from about 20 births per 1,000 population in 1965 to 13 per 1,000 in 1975; the total fertility rate fell from 3.1 births per woman in 1960 to 1.7 in 1975. The birthrate and the abortion rate among teenagers both declined during the 1970s; since sexual activity among teenagers was far more common at the end of the decade than at the start of it, the decline suggests that teenagers used modern contraceptive methods, especially the pill, effectively. At present, contraceptives are widely available, usually at no cost, throughout the Netherlands.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

[Leprosy in The Netherlands in the period 1970-1991].

OBJECTIVE: To inventory the changes in leprosy epidemiology in the Netherlands. DESIGN: Retrospective. SETTING: Academic Medical Centre (Amsterdam) and University Hospital Dijkzigt (Rotterdam), the Netherlands. METHOD: The medical records of all new leprosy patients in the period 1970-1991 were analysed. RESULTS: Between 1970 and 1991, 622 new leprosy patients were registered; 371 men (59.6%) and 251 women (40.4%). Most patients came from Surinam (73.3%) and Indonesia (7.2%). The mean time lapse between onset and treatment in the Netherlands was 10.1 years. Switching from monotherapy to combination therapy (1979) had no effect on the incidence of reversal reactions (cellular hypersensitivity in immunologically unstable patients), but did affect the incidence of erythema nodosum leprosum during the treatment. CONCLUSION: Leprosy in the Netherlands is an important disease, mainly from Surinam. The main advantage of combination therapy is the shortened duration of treatment. The treatment of choice is the one recommended by the WHO, the combination therapy with rifampicin administration once a month, because of the few adverse effects.

Adult↗