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At least 217 records · Page 12Linked to original sources
PubMed1994

[Incidence and prevalence of genetically-determined disorders in The Netherlands; a literature study].

OBJECTIVE: To analyse if data now available on frequencies of genetic disorders are sufficient to be used in future as indicators when an evaluation of new developments is desired for policy-making purposes. DESIGN: Literature study. SETTING: The Netherlands. METHOD: Using automated literature search systems, papers published before October 1991 were surveyed and an inventory of incidence and prevalence of genetic disorders in the Netherlands was made. RESULTS: Depending on the pattern of heredity differences in available data and their validity were found. Valid data on most of the II congenital anomalies investigated were available from the EUROCAT registration in the northern Netherlands. This method of data collecting is also suitable for the evaluation of prevalence development. On the 29 multifactorial diseases occurring later in life that were investigated many data were available, although the varying sources made comparison difficult. These data were often out of date and had a highly varying validity. Of 3 chromosomal abnormalities the prevalence at birth was known. Of only 22 out of 650 monogenic disorders, described in the Netherlands up to 1991, the prevalence at birth and(or) in the population was known. CONCLUSION: Data on frequency of genetic disorders can be collected but the information now available is insufficient to serve as an indicator for government policy. Frequencies should also be considered in relation to the impact of the disease on the individual, his environment and society.

Adolescent↗
PubMed1996

Mortality trends in Belgium and The Netherlands. Closing the gap.

Mean life expectancy at birth (1967-1992) increased for both sexes combined with 5.6 years in Belgium and 3.6 years in The Netherlands. Age adjusted mortality from all causes and cardiovascular diseases has been followed up from 1968 onwards to 1989 in Belgium and The Netherlands and in Flanders and Wallonia from 1971 to 1989 for each sex and two age classes, 45-74 y and 75-85 + y. Flanders and Wallonia were selected because of differences in mortality and life-style. Total mortality decreased faster in Belgium, especially in the period 1980-89, for almost all comparisons in each sex and age class and for most cardiovascular diseases. A comparison of mortality trends in the period 1980-89 among 35 countries worldwide showed a better performance in Belgium than in The Netherlands for 10 different causes of death. The mortality gap between both countries is closing, especially between The Netherlands and Flanders. The decreasing slope in mortality from all causes is explained mostly by the change in cardiovascular mortality. Medical treatment and care, which are not better in Belgium, do not explain the differences in mortality trends Observed changes in life-style, including saturated and polyunsaturated fat intake, smoking habits and salt intake are consistent with the observed mortality changes.

Adolescent↗
PubMed1996

[Diagnosis and treatment of extrauterine pregnancy in The Netherlands].

OBJECTIVE: To inventory current policy in the diagnosis and treatment of ectopic pregnancy (EP) in the Netherlands. DESIGN: Questionnaire. SETTING: Academic Medical Centre, Amsterdam, the Netherlands. METHODS: A questionnaire was sent to all I30 departments of gynaecology in the Netherlands. RESULTS: The response rate was 94% (n = 122). Transvaginal ultrasonography was very widely used, whereas results of serum hCG measurements were only available within 24 h in 75% of the departments. Eighty-three per cent of the respondents screen for EP in high-risk patients. Laparoscopic surgery was used in 62% of the departments, open surgery in 9%, whereas in 28% the surgical technique depended upon the skills of the operating gynaecologist. If desire for pregnancy was present, 53% of the departments operated always conservatively, 2% always radically, whereas in 43% conservative surgery was performed only in case of a healthy ipsilateral tube. Methotrexate was used in 38% of the departments for persistent trophoblast, in 16% as primary treatment of interstitial pregnancies and in 13% as primary treatment for tubal pregnancy. CONCLUSION: Diagnostic strategies for EP in the Netherlands are homogeneous and in conformity with the state of the art in the literature. For treatment, laparoscopic techniques are widely used. In almost all departments, conservative surgery is the treatment of choice. Use of methotrexate is so far limited to treatment of persistent trophoblast after a failure of conservative surgery.

Chorionic Gonadotropin↗
PubMed1996

[Reports of suspected side effects of selective serotonin reuptake inhibitors in Belgium and The Netherlands].

OBJECTIVE: To study the adverse drug reaction (ADR) profile of selective serotonin re-uptake inhibitors (SSRI) in Belgium and the Netherlands. DESIGN: Descriptive study. SETTING: The Belgian Pharmacovigilance Centre and the Dutch Drug Safety Unit. METHOD: All adverse reactions of fluoxetine, fluvoxamine, paroxetine and sertraline, reported between the moment of registration of these drugs and January 1st 1995, were assessed for causality. Possible, probable and certain adverse reactions were counted per drug and per country. RESULTS: At the national monitoring centres of Belgium and of the Netherlands adverse reactions were reported 78 and 537 times, respectively. Approximately 30% of the adverse reactions were well-established. Approximately 60% of the reactions were poorly documented or not serious. Less than 1% of the adverse reactions reported in Belgium and approximately 13% of the reactions reported in the Netherlands, were less established and/or serious. These reactions were: movement disorders and extrapyramidal reactions, convulsions, galactorrhoea, hyponatraemia and syndrome of inappropriate antidiuretic hormone secretion, and purpura. CONCLUSION: The ADR profile was compatible with the ADR profile in the medical literature, but not all ADR were similarly represented in the product information of the different SSRI. More adverse reactions were reported in the Netherlands than in Belgium.

1-Naphthylamine↗
PubMed1996

[Transmission of sensitive and resistant strains of Mycobacterium tuberculosis in The Netherlands, 1993-1995, studied by means of DNA fingerprinting].

OBJECTIVE: Determination of the contribution of recent transmission of both sensitive and drug-resistant Mycobacterium tuberculosis strains to the number of tuberculosis cases in the Netherlands. DESIGN: Descriptive study. SETTING: National Institute for Public Health and Environment, Bilthoven, the Netherlands. METHODS: Since 1993 all isolates of M. tuberculosis in the Netherlands are sent to the national reference laboratory for surveillance purposes. The strains with IS6110 DNA fingerprint, isolated from January 1993 to July 1995, were analysed for clustering of DNA patterns (clustering of identical DNA patterns was assumed to represent recent transmission of tuberculosis). A transmission index was calculated from the ratio of the number recently infected tuberculosis patients and the number of source patients. RESULTS: Among 2,217 M. tuberculosis isolates, 1,313 unique DNA fingerprints were observed, while 264 DNA patterns occurred more than once. 904 (41%) DNA fingerprints were part of a cluster of identical fingerprints. The mean cluster size was 3.42. The 232 resistant strains showed significantly less clustering (33% versus 42%, p < 0.02) and a smaller transmission index (0.27 versus 0.42, p < 0.02) compared with sensitive strains. CONCLUSION: Recent transmission contributes to the magnitude of the tuberculosis problem in the Netherlands. The epidemiological situation would, however, lead to gradual elimination of the disease were it not for introduction of tuberculosis from other countries. Transmission of resistant strains is relatively limited. Micro-epidemics caused by resistant M. tuberculosis strains were not observed.

DNA Fingerprinting↗
PubMed1997

[Prevalence of chronic fatigue syndrome and primary fibromyalgia syndrome in The Netherlands].

OBJECTIVE: To determine the prevalence of chronic fatigue syndrome (CFS) and of primary fibromyalgia syndrome (PFS) in the Netherlands. DESIGN: Questionnaire. SETTING: Department of Medical Psychology, University Hospital Nijmegen, the Netherlands. METHOD: A questionnaire was mailed to all the 6657 general practitioners in the Netherlands in order to inform them of the existence of CFS and to ask them if they had any CFS or PFS patients in their practices. RESULTS: Sixty percent (n = 4027) of the general practitioners returned the questionnaire. Of all the general practitioners, 27% said they had no CFS patients, 23% said they had 1 CFS patient, while 21% had 2 CFS patients, and 29% said they had 3 or more CFS patients in their practice. Concerning PFS the results were 17% (no PFS patients), 18%, 18% and 47%, respectively. With a mean practice of 2486 patients per general practice, the estimated prevalence of CFS was 112 per 100,000 and that of PFS 157 per 100,000 persons. Of the CFS patients 81% were women and 55% were 25-44 years old; for PFS these figures were 87% and 48% respectively. CONCLUSION: Extrapolation of the study results indicates that there are at least 17,000 CFS patients and 24,000 PFS patients in the Netherlands. The found prevalence is probably an under-estimation.

Adult↗
PubMed1997

[Epidemiology of prenatal diagnosis and selective pregnancy termination because of fetal neural tube defects in The Netherlands in comparison to other European countries].

OBJECTIVE: To describe the epidemiological impact of prenatal diagnosis and selective abortion on the frequency of neural tube defects (NTD) in the period 1980-1992 in the Northern Netherlands in comparison with data from other European regions. DESIGN: Descriptive. SETTING: 17 'European registration of congenital anomalies' (EUROCAT) registrations, localized in 10 European countries. METHOD: Data were collected actively and retrospectively from multiple sources fed by voluntary registration of congenital anomalies in live births, stillbirths and pregnancies terminated because of congenital anomalies. RESULTS: In Europe the total birth prevalence of NTD in the period 1980-1992 ranged from 5.3 per 10,000 in Switzerland to 29.0 per 10,000 in Glasgow, a difference of a factor 5.5. In live births the difference was ninefold: ranging from 2.0 per 10,000 in Paris to 18.8 per 10,000 in Dublin. The Netherlands had a conspicuously high prevalence among live births, higher than in other regions in continental Europe. For spina bifida the live birth prevalence both in other continental regions and in Glasgow was also lower than in the Netherlands. In Glasgow serum alpha-foetoprotein screening apparently led to frequent early prenatal diagnosis of NTD and to frequent termination of pregnancy. In Paris the use of ultrasound screening appears to lead to frequent later prenatal diagnosis, as well as frequent termination of pregnancy. CONCLUSION: In the Netherlands the impact of prenatal diagnosis and selective abortion is limited, so that primary prevention (periconceptional use of folic acid) is more important than in some other European countries.

Abortion, Therapeutic↗
PubMed1998

Origin and management of primary and acquired drug-resistant tuberculosis in The Netherlands: the truth behind the rates.

SETTING: The Netherlands, May 1994 to May 1996. OBJECTIVE: 1) To estimate to what extent drug-resistant tuberculosis was acquired or recently transmitted in The Netherlands, 2) to assess the relevance of drug resistance data as routinely collected, and 3) to describe case management. DESIGN: Prospective descriptive study. Patients diagnosed with drug-resistant tuberculosis were interviewed. Information on patient management and contact tracing was collected. IS6110 restriction fragment length polymorphism (RFLP) patterns of all strains were compared with those of the National RFLP library and clusters were analyzed. RESULTS: In total 193 cases were included in the study. Acquired drug resistance (ADR) was rare. Dutch ADR patients reported receiving treatment a long time previously (mean age 58, mean treatment interval 23 years). Most foreign ADR patients had been treated recently in their country of origin. Of 151 primary drug-resistant (PDR) cases, 129 (85%) were foreign-born, of whom few (8%-19%) had been infected in The Netherlands. Few Dutch PDR cases had been infected recently (mean age 49 years). Rifampicin resistance was more frequently observed in foreign ADR cases than in foreign PDR cases (28% vs 5%; P < 0.001). One third of cases had not been treated according to treatment guidelines. CONCLUSION: Only a small proportion of drug-resistant cases resulted from recent infection or treatment in The Netherlands. General rates of ADR and PDR do not reflect current Dutch programme performance. For programme monitoring, ADR/PDR rates and their trends must be reported and evaluated in Dutch and foreign patients separately.

Adult↗
PubMed1998

[Preconception screening of parents and carrier state of cystic fibrosis in the Netherlands: expenses and savings].

OBJECTIVE: To evaluate effects, costs and savings for a preconceptional couple screening programme for cystic fibrosis (CF) carriers. SETTING: State University Groningen, the Netherlands. DESIGN: Prospective theoretical evaluation. METHOD: A decision tree and an arithmetic model were constructed for two different strategies of preconceptional CF screening of couples: 'single entry two step' (SETS; start by testing one partner), and 'double entry two step' (DETS; test both partners). The difference between costs of screening and costs of CF illness prevented by screening was determined. RESULTS: DETS couple screening with the assumptions used for e.g. sensitivity and use of options can detect 81.5% of carrier couples in the Netherlands (against 70% for SETS), but results in twice as many positive/negative couples as SETS couple screening. The maximum number of carrier couples identified when screening 100,000 couples would be 88, resulting in a decrease of the number of children with CF of 25 each year. The costs of screening equal the savings if approximately 8,000 couples are screened yearly in the Netherlands. CONCLUSIONS: There are no financial objections to preconceptional couple screening in the Netherlands, even with an uptake ratio of around 10%. Whether screening for CF carriers should be offered or not should be decided on the basis of non-financial arguments.

Adult↗
PubMed1998

[Leptospirosis in the Netherlands, 1991-1995].

OBJECTIVE: To determine all cases of leptospirosis in the Netherlands in 1991-1995 that were confirmed by serological investigation or culturing. DESIGN: Descriptive, retrospective. SETTING: Department of Biomedical Research, Royal Tropical Institute, Amsterdam, the Netherlands, and Department of Internal Medicine, Academic Medical Centre, Amsterdam, the Netherlands. METHOD: Using data of the Reference Laboratory for Leptospirosis, the number of leptospirosis cases in 1991-1995 was determined and compared with the data of 1986-1990. Additional information was obtained about patients with confirmed leptospirosis or who had been hospitalized because of leptospirosis. RESULTS: The number of confirmed cases dropped from 229 in 1986-1990 to 159 in 1991-1995. This decrease could be attributed mainly to a marked decrease of the number of dairy farm fever (hardjo) cases. There was a clear increase of the number of infections acquired during travel in foreign countries, notably outside Europe. Thus, leptospirosis in the Netherlands shifted from an occupational disease towards a disease due to recreational activities. In about 10% of the patients the disease ran a severe course with Weil's syndrome (icterus, renal failure, and haemorrhages). Eight patients (5%) died. Clinical data of 5 of these 8 patients indicated that they had suffered from Weil's syndrome.

Demography↗
PubMed1998

[The epidemiology of hepatitis A in the Netherlands, 1957-1998].

OBJECTIVE: To describe the incidence of hepatitis A in the Netherlands, 1957-1997 to find an explanation for the increase in 1998. DESIGN: Descriptive. SETTING: National Institute of Public Health and Environment (RIVM), Bilthoven, the Netherlands. METHOD: Following an increase of the number of hepatitis A notifications in 1998 the national notification data over the period 1957-1997 were examined. The impact of waning natural immunity in the Dutch population and of the annual influx from high-endemic countries on the epidemiology of hepatitis A was studied. RESULTS: The number of notifications declined considerably in the early sixties and stabilised in the seventies at 5-7 notifications per 100,000 inhabitants. The age distribution over time showed that the proportion of cases in children is still the largest, although the proportion of notifications of adult cases increased slightly over time. A seasonal fluctuation was demonstrated by a steep increase in the number of notifications among non-Dutch children in autumn, with the infection acquired abroad, probably in Morocco or Turkey, followed by an increase among children and adults who acquired their infection in the Netherlands. The number of notifications doubled in the early months of 1998 compared with 1997. The present epidemic increase can be explained by increased transmission in subgroups who contributed similarly in the same months in the past 5 years and may result from secondary infections related to the relatively high peak in autumn in 1997. CONCLUSION: In 1975-1997 a stable but low incidence of hepatitis A was observed in the Netherlands; the number of cases among adults did not increase over time. The present epidemic increase underlines the potential risk of epidemics and the role of importation of the virus from high-endemic countries.

Adolescent↗
PubMed1998

Closure of Disputes in Assessments of Climate Change in The Netherlands

/ This paper presents an analysis of the closure of visible disputes in the assessments of climate change in the Netherlands. We focus primarily on two key constituents of the assessments: the estimate of climate sensitivity and the inclusion of non-CO2 greenhouse gases in assessment studies. For the cases studied, we identify variability in the assessment reports in the Netherlands during the pre-IPCC period. In the Netherlands arena, the assessments in this period can be seen as exponents of two different lines, a Netherlands line and an international line. We seek to identify what factors were decisive in the selection processes that resulted in the closure of visible disputes (visible in or across the assessment reports) for both cases. Our analysis reveals a remarkable difference in the adoption behavior of two Dutch assessment groups despite a large overlap in membership. We provide evidence that it is not the paradigmatic predisposition of the experts in the committee that was decisive for the closure of visible disputes, but it was the context in which the experts operated and the commitments they had made in each setting.

Science for policy↗
PubMed1991

[HIV-2 in The Netherlands].

By comparing data from the HIV confirmation laboratories it could be established that in the period prior to February 1991 a HIV-2 infection was demonstrated in at least 18 persons in the Netherlands. Consequently, use of combined HIV-1/2 tests is urgently recommended for screening in diagnostic and blood bank laboratories in the Netherlands. A suspicion of presence of HIV-2 antibodies may arise in the interpretation of a combined HIV-1/2-ELISA, a specific HIV-1-ELISA and the pattern of HIV-1 western immunoblot. Confirmation of the presence of HIV-2 antibodies should be obtained by means of western blots of viral lysates of both HIV-1 and HIV-2 and peptide tests from the transmembranous region. Most persons with a HIV-2 infection originated from Africa south of the Sahara or the Cape Verdean Islands or had had a sexual relationship with a person from these areas. The vast majority was heterosexual and 13 of the 18 infected persons were women. This differs greatly from the epidemiological pattern of HIV-1 infections in the Netherlands. The possibility of further spread of HIV-2 in the Netherlands via heterosexual contacts should be seriously taken into account.

Adolescent↗
PubMed1986

Aliens in the Netherlands on January 1st 1985.

"The increase in the number of aliens in the Netherlands has slowed down considerably since 1980. Nevertheless, we can still speak of significant changes in the alien population. This article gives a brief description of these changes in 1984 and looks at differences with the recent past.... Some preliminary figures on changes in the alien population in the first half of 1985 are also given. The article concludes with a summary of the (annually) available figures on aliens in the Netherlands." Data are included on people born in Suriname or the Netherlands Antilles who have Dutch nationality.

Americas↗
PubMed1988

[Number of Surinam- and Antillean-born children in the Netherlands].

"A multivariate analysis of the 1985 Quality of Life-Survey among Surinam and Antillean born persons in the Netherlands reveals some telling results about their fertility. For both groups a low current number of children is associated with a high educational level, no religion, a long stay in the Netherlands, an urban environment and--only in the case of females--employment. To a lesser extent, the same holds true for education attended (partly) in the Netherlands and having a Dutch partner." (SUMMARY IN ENG)

Americas↗
PubMed1997

Clear cell adenocarcinoma of the vagina and cervix. An update of the central Netherlands registry showing twin age incidence peaks.

BACKGROUND: The objective of this study was to update the registry of women in the Netherlands with clear cell adenocarcinoma (CCAC) of the cervix or vagina with or without intrauterine exposure to diethylstilbestrol (DES). METHODS: From a nationwide search in PALGA, the automated pathology registry in the Netherlands, data were gathered on women with CCAC born after 1947. Information obtained from the clinical files of the patients included reported exposure to DES, patterns of complaints previous to diagnosis, the current status of the patients, and the results of cytopathologic examinations previous to histopathologic diagnosis. After review of the histopathologic slides, the specific pathologic characteristics of CCAC were determined. The age distribution of women born after 1947 was compared with that of women born before 1947. RESULTS: Information about possible exposure to DES during pregnancy was available for 73 of 88 women with CCAC born after 1947. Exposure to DES was reported for 47 (64%) of these women. The DES medication was most often reported as having started before the 18th week of pregnancy. Cytopathologic examination was informative in 81% of the cases of CCAC of the cervix, but only in 41% of the cases of CCAC of the vagina. Most patients had Stage I or II tumors at diagnosis. Tumor Stage III and IV and a high grade of nuclear atypia were related to unfavorable outcome. The age distribution of all patients with CCAC showed two distinct peaks; one at young age, (a mean age of 26 years), and one at older age (a mean age of 71 years). This bimodal age distribution still applied when the cases in which DES exposure was reported had been excluded. CONCLUSIONS: Despite the fact that DES has not been prescribed to pregnant women in the Netherlands in the last 20 years, CCAC is still relevant in our times. It is important to stay alert and periodically to update and evaluate the data of this registry, including data on women born outside the DES exposure period. The bimodal age distribution in this study of women without intrauterine exposure to DES suggests a carcinogenesis-promoting role of menarche and menopause and/ or the existence of a subpopulation with genetic risk factors or exogenous risk factors other than exposure to DES. Postmenopausal observation of women exposed to DES must be encouraged for clinical reasons and may help facilitate differentiation between these two hypotheses. If these risk factors of CCAC were better documented and their interrelationships better defined, CCAC could become an important model of multistep carcinogenesis in tissues sensitive to sex hormones.

Adenocarcinoma, Clear Cell↗
PubMed1995

Socioeconomic variation in cancer survival in the southeastern Netherlands, 1980-1989.

BACKGROUND: The survival rates of patients with cancer by socioeconomic status (SES) has never been investigated in the Netherlands, a country characterized by good general access to health care services. The association between socioeconomic status and survival from cancer of the lung (n = 4591), breast (n = 3928), colorectum (n = 3558), prostate (n = 1484), and stomach (n = 1455) was studied, and the impact of some prognostic factors (stage at diagnosis, histologic type, and treatment) on this association was assessed. METHODS: Subjects were patients who were diagnosed from 1980 to 1989 and included in the population-based Eindhoven Cancer Registry in the Southeastern Netherlands. The patients were classified by socioeconomic status based on their postal code of residence at the time of diagnosis (3 or 5 categories). The follow-up ended July 1, 1991, at which time relative survival rates and hazard ratios were calculated. RESULTS: A more favorable relative survival for patients living in high SES areas was found for those with cancer of the lung, breast, colorectum, and prostate, whereas for those with stomach cancer, lower survival was found for patients living in high SES areas. For cancer of the lung, colorectum, and prostate, the socioeconomic variation in survival could not be explained by the distribution of the prognostic factors stage, histologic type, and treatment. For patients with breast and stomach cancer, the socioeconomic variation in survival could be ascribed mainly to differences in the percentage of patients diagnosed with a metastasis. CONCLUSIONS: Socioeconomic variation in survival from a number of common cancer sites exists in the Netherlands, despite the fairly equal access to health care services for different socioeconomic groups. Most of the variation could not be explained by the differential distribution of stage, histologic type, and treatment across SES categories.

Aged↗
PubMed2006

Multi-centre first-trimester screening for Down syndrome in the Netherlands in routine clinical practice.

OBJECTIVES: This is the first report on the results of a first-trimester combined-test screening programme in the Netherlands in a multi-centre routine clinical setting. METHODS: Between July 2002 and May 2004, blood samples were taken from subjects in 44 centres in the Netherlands and sent to our laboratory to assay for maternal serum concentrations of fbeta-hCG and PAPP-A. Fetal nuchal translucency (NT) was measured in the participating centres at a gestational age (GA) of 10-14 weeks. Results of those pregnancies for which a combined biochemical and NT risk was calculated were included in the epidemiological analysis of this study. RESULTS: A total of 4033 singleton pregnancies were included in the analysis. The median maternal age of the analysed group was 36.5 years. The distribution of GA was biphasic, with median GA of 10.3 and 12.1 weeks, respectively. The detection rate using the combined ultrasound and serum screening at a cut-off level of 1 in 250 was 71% (15/21), with a screen-positive rate of 4.7%. CONCLUSION: The results of this study show that the first-trimester combined test is suitable as a prenatal screening test in a multi-centre routine clinical setting in the Netherlands. Strict performance evaluation should identify weaknesses in the organisation that impair the performance of the test. Here, the performance of NT was especially identified as a candidate for improvement.

Adolescent↗