Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “NETHERLANDS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 937 records · Page 52Linked to original sources
PubMed2005

Analysis of health factors as predictors for the functioning of military personnel: study of the factors that predict fitness for duty and medical costs of soldiers of the Royal Netherlands Army.

In 1998, the Royal Netherlands Army introduced a new examination system, which is based on the "workload-capability" model, to replace the old system, which focused on diagnosis and was solely based on the detection of diseases and infirmities. In a randomized controlled study, we found that soldiers recruited under the new system displayed a statistically significant higher number of days fit-for-duty and incurred lower medical costs than solders recruited under the old system. To gain a better understanding of the reasons for these differences, we studied the association between these results and information collected about the soldiers. In the course of the study, we collected various types of information about the study participants (e.g., education, deployment). During the study, soldiers were asked to complete a questionnaire twice a year, its content based in part on a periodic occupational health examination questionnaire commonly used in The Netherlands. We found that the following factors influenced fitness for duty and medical consumption: education, injuries, actual operational deployment, and the examination system itself. The superior performance of the new RNLA Basic Medical Requirements (BMEKL) system seems partly attributable to the assessment of the ability to meet the task-specific requirements. The primary mechanism is as yet undiscovered.

Adult↗
PubMed1998

[Genetic diagnosis of IVF embryos: preliminary results from 'preimplantation genetic diagnoses' in the Netherlands].

Preimplantation genetic diagnosis (PGD) is a very early form of genetic testing. It involves testing one or two cells taken from a recent embryo of eight cells produced by in vitro fertilization, and selective transfer of genetically normal embryos. So far in the Academic Hospital Maastricht, the Netherlands, 20 couples have undergone PGD, resulting in 6 ongoing pregnancies (one twin pregnancy). In three women the indications for PGD were: cystic fibrosis, sex-linked Pelizaeus-Merzbacher disease and chromosomal translocation, respectively. In the Netherlands PGD is only allowed if there is a high risk of a serious genetic disease. PGD can be carried out in Maastricht for: cystic fibrosis, sex-linked diseases, chromosomal abnormalities, fragile X syndrome, spinal muscular atrophy and myotonic dystrophy. The advantage of PGD is that it excludes the necessity of a therapeutic abortion. Disadvantages ages are the requirement of in vitro fertilization, which has only a 15-20% pregnancy rate, and the experimental nature of the PGD procedure. To date, about 200 children have been born worldwide following PGD.

Adult↗
PubMed1999

Transmission of tuberculosis between people of different ages in The Netherlands: an analysis using DNA fingerprinting.

SETTING: In the period 1950 to 1980 the risk of tuberculous infection in the Netherlands declined more steeply than tuberculosis incidence. This study aimed at determining whether this might be explained by preferential transmission within age groups. METHODS: Using restriction fragment length polymorphism (RFLP) typing on all Mycobacterium tuberculosis isolates in the Netherlands from 1993 to 1996, clusters with identical fingerprints were identified. The correlation between the ages of people in clusters of two Dutch patients was determined. RESULTS: The mean difference in age between the two people, in 81 clusters of two, was 13.9 years, while the mean age difference between all possible pairs of individuals in this data set was 25.5 years. Fisher's intraclass correlation coefficient was 0.62 (95% confidence interval [CI] 0.46-0.74). CONCLUSION: It is concluded that sources of tuberculosis may preferentially transmit infection to people close to their own age. As the average age of cases has increased in the period 1950-1980, sources may have become less likely to infect children in whom the risk of infection has been measured. The annual risk of infection measured in children and young adults in countries with low levels of tuberculosis may not apply to older members of the population.

Adolescent↗
PubMed1999

[Teenage pregnancy distribution by ethnicity in the Netherlands, 1990-1993].

OBJECTIVE: To determine and compare the obstetrical results of teenage pregnancies among the main ethnic groups in the Netherlands. DESIGN: Retrospective cohort study. METHODS: From the cohorts 1990-1993 of the Landelijke Verloskundige Registratie (LVR, National Obstetrical Registration) the data were analysed concerning primiparae aged 14-19 years with a single pregnancy. RESULTS: During the period 1990-1993, 14.9% of the women whose parturitions were recorded in the LVR were allochtonous, of the teenage pregnancies recorded 55.2% occurred in an allochtonous population group. The numbers (percentages) of teenage pregnancies (primiparae, singles) in the various ethnic groups were 4742 (2.2%) in the autochtonous group, 3974 (25.9%) in the (Muslim) mediterraneous, 340 (7.8%) in the non-Dutch European, 588 (14.9%) in the Afro-allochtonous, 316 (9.7%) in the Hindustani, 263 (5.5%) in the Asian (excluding Hindustani and Asian Turkish) and 360 (10.4%) in the remaining ethnic groups. Hindustani and orthodox Muslims regard teenage pregnancy positively. The perinatal mortality was higher among Afro-allochtonous than among autochtonous teenagers (odds ratio: 2.89 (95% confidence interval: 1.89-4.40)), and the same was true of premature and immature parturition. Both findings occurred significantly more often in the autochtonous, Afro-allochtonous and Asian population parts than among women of the same ethnic groups aged 20-24 years. In relation to autochtonous women aged 20-24, the odds ratios for perinatal mortality and premature and immature parturition among Afro-allochtonous women were 3.64 (2.50-5.30) and 2.02 (1.59-2.55), respectively; after correction for pre- and immature parturition the odds ratio for perinatal mortality decreased to 2.35 (1.51-3.66). Low birth weight was less frequent among the Mediterraneans and more frequent among the Afro-allochtonous and Hindustani than among the autochtonous. Induced vaginal deliveries were less frequent among allochtonous teenagers, the risk of caesarean section was lower among Mediterranean teenagers but higher among Afro-allochtonous, Hindustani and other ethnic teenagers than among autochtonous teenagers. All groups of teenagers had lower frequencies of induced delivery than women of the same ethnic groups aged 20-24 years. CONCLUSIONS: Teenage pregnancy in the Netherlands occurs much more often among allochtonous than among autochtonous women and is encountered most often among (Muslim) mediterranean and Afro-allochtonous groups. Obstetrical results vary greatly from one ethnic teenage group to another; they are poorest among the Afro-allochtonous, best among the Hindustani group. Among the mediterranean teenagers, they are similar to those among the autochtonous group.

Adolescent↗
PubMed1986

Development and current status of partial hospitalization in The Netherlands.

In order to assess the development and current status of partial hospitalization in The Netherlands, a survey was conducted among the 85 Dutch institutions active in this field. The response rate to a carefully formulated questionnaire was 100%. The 85 institutions included in the study offered 1914 places at which 2995 patients per week received treatment. This kind of facility in The Netherlands has apparently developed differently from those in the United States and Great Britain. The Dutch version of the partial-hospitalization program (php) has two main functions: it serves (1) as an alternative to ambulant treatment and (2) as a continuation, or extension, of inpatient treatment. The functions of day care and php as an alternative to inpatient treatment have not yet been fully developed. This study also includes data on facilities, staffing, contraindications and selection, patient population and diagnoses, therapeutic activities, and costs.

Aftercare↗
PubMed1999

[Report of the Health Council on the use of benzodiazepines. The Netherlands Health Council].

The Netherlands Health Council has issued a report on the appropriate use of benzodiazepines, detailing current knowledge on mode of action, indications for use, adverse effects and the prescribed volume in the Netherlands. About 3% of the adult population are chronic users of benzodiazepines. Chronic use is complicated by the risk of falling; the relative risk of hip fractures in chronic benzodiazepine users in about 1.7. Chronic use should be discouraged. However, most chronic users are fragile elderly people for whom a good night's sleep implies temporary escape from a sorry existence with somatic or psychic symptoms. Such circumstances should be kept in mind when treating individual patients.

Adult↗
PubMed1999

[No consensus on the definition, diagnosis and treatment of habitual abortion in the Netherlands].

OBJECTIVE: To review the current policy in diagnosis and treatment of recurrent miscarriage in the Netherlands. DESIGN: Cross-sectional survey. METHOD: A printed questionnaire was sent in 1996 to all 125 departments of gynaecology in the Netherlands with questions about definition, investigation and therapy of recurrent miscarriage. RESULTS: The response rate was 90% (n = 112). Twenty-nine per cent of the respondents defined recurrent miscarriage as having two or more abortions and 71% as three or more abortions. In 42% of the departments a diagnostic protocol for recurrent miscarriage was present. Diagnostic investigations most frequently performed were vaginal ultrasound (79%), parental chromosome analysis (78%), thyroid-stimulating hormone (72%), lupus anticoagulant (69%), blood glucose (65%), hysterosalpingography (56%) and anticardiolipin antibodies (IgG, IgM) (56%). Therapy most frequently applied was prescription of folic acid (53%). CONCLUSION: The definition of recurrent miscarriage differed. Uncertainty about a rational diagnostic approach was evident from the large number of tests requested by 20-50% of the respondents. Some diagnostic tests like immunological investigation and search for infectious factors were not followed by a therapeutical intervention.

Abortion, Habitual↗
PubMed1999

[Utilization of middle ear ventilatory tubes for children, ages 0-12 years, in the Netherlands during 1990-1994].

OBJECTIVE: To explore the incidence of treatment with ventilation tubes in the Netherlands in children from birth to 12 years of age in the period from 1990 to 1994. DESIGN: Secondary data analysis. METHODS: Data on bilateral treatment with ventilation tubes in 1990-1994 in the Netherlands were obtained from the National Medical Register of SIG Health Care Information. Incidence rates of the treatment in children aged 0-12 years were calculated using population estimates issued by the National Department of Statistics. RESULTS: Whereas from 1990 to 1992 the total number of bilateral inserted tubes increased from 39.923 to 51.615, a decrease to 48.635 was observed in 1994. The average incidence rate of treatment with ventilation tubes was 1.97% (range: 0.12%-5.08%) in children from birth to 12 years. Peak incidences were found around 2 years and 6 years of age. Prevalence rates of otitis media with effusion as found in the literature were higher, especially during infancy.

Age Factors↗
PubMed1999

[Trends in cancer incidence and cancer mortality in Netherlands: good and bad news].

Since 1990 age-standardized cancer mortality in men has decreased by about 1% per year. This decrease is due to a decrease in the mortality from lung cancer, stomach cancer, pancreatic cancer and bladder cancer. The mortality from melanoma, prostate cancer and oesophageal cancer in men has increased. After a slight increase in age-standardized cancer mortality in women, the rate has remained constant since 1990 in spite of the rapid increase in lung cancer mortality. Mortality due to cancers of the stomach, pancreas, cervix and ovary has decreased. Total cancer incidence in both men and women didn't change much during 1989-1994. In men the incidence of prostate cancer strongly increased. For women both the incidence of lung cancer and breast cancer increased. In the south-east of the Netherlands cancer incidence has been registered since 1973. In this area, the incidence increased before 1989. Therefore, it is likely that the national cancer incidence rates have also increased. Despite this increase, the age-standardized overall cancer mortality in the Netherlands did not increase during recent years.

Age Distribution↗
PubMed1999

Familial clustering and risk analysis for fragmented coronoid process and elbow joint incongruity in Bernese Mountain Dogs in The Netherlands.

OBJECTIVE: To analyze familial clustering and genetic risk for various forms of elbow dysplasia (ED) in Bernese Mountain Dogs (BMD) in The Netherlands and define possible means to select against ED. ANIMALS: 98 BMD born in 1992 and 64 BMD born in 1995. PROCEDURE: Dogs were examined radiographically when 12 to 18 months old. The population was resolved into familial clusters, and distribution of ED for the clusters was analyzed. Common ancestors associated with each form of ED were identified, and risk for having ED in the 64 offspring born in 1995 was calculated by relatedness to common ancestors. Risk was compared with radiographic outcome. RESULTS: The 2 forms of ED identified were fragmented coronoid process (FCP) and elbow joint incongruity (INC). Incidence of ED decreased from 63/98 (64%) in 1992 to 29/64 (45%) in 1995. None of the familial clusters was free of FCP or INC. Common ancestors associated with FCP differed from those associated with INC. There was more potential variation in risk for FCP and INC in the 64 offspring than was achieved by breeders, indicating a decrease in population heterogeneity. CONCLUSIONS AND CLINICAL RELEVANCE: FCP and INC had differing familial sources; thus, they most likely are different genetic traits. Although incidence of ED decreased from 1992 through 1995, we did not detect variation among pedigrees in genetic risk for ED remaining in the offspring born in 1995; thus, selection among families cannot further improve ED health status of BMD in The Netherlands. Phenotypic selection within families remains the only alternative.

Animals↗
PubMed1999

[Hyperthermic intra-peritoneal chemotherapy (HIPEC) in patients with peritoneal pseudomyxoma or peritoneal metastases of colorectal carcinoma; good preliminary results from the Netherlands Cancer Institute].

OBJECTIVE: To apply (HIPEC) using mitomycin in patients with peritoneal carcinomatosis. DESIGN: Descriptive. METHOD: The HIPEC treatment includes cytoreductive surgery and subsequent peritoneal lavage with exposure of the superficial tumour residues to a high concentration of a cytostatic drug at an intra-abdominal temperature of 40-42 degrees C. The HIPEC treatment was given to 24 patients with pseudomyxoma peritonei and to 29 patients with peritoneal carcinomatosis of colorectal origin. The adequate dose of mitomycin was determined in the Netherlands Cancer Institute in 26 patients: doses of 15 mg/m2 (n = 8), 25 mg/m2 (n = 3), 35 mg/m2 (n = 7) and 40 mg/m2 (n = 8) were administered. RESULTS: The maximal tolerable dose of mitomycin appeared to be 35 mg/m2, while unacceptable toxicity was recorded at a dose of 40 mg/m2. Therefore 35 mg/m2 was used in subsequent cases. Among the patients with pseudomyxoma peritonei 8 developed severe complications, two of which were fatal. After a median follow-up of 12 months, 21 patients were alive of whom 18 were free of disease. Among the patients with peritoneal carcinomatosis of colorectal origin one patient died from a treatment-related complication. After a median follow-up of 18 months, 18 patients were alive of whom 11 were free of disease. The actuarial 2 year survival was 59%. CONCLUSION: In the Netherlands Cancer Institute HIPEC treatment is considered the treatment of choice for pseudomyxoma peritonei. The results in cases of peritoneal carcinomatosis of colorectal origin are promising, but the results of a randomized trial are awaited.

Antibiotics, Antineoplastic↗
PubMed2000

[Alterations of stage distribution for breast cancer since the implementation of national screening program in the Netherlands during 1989-1995].

OBJECTIVE: To determine the results of the nation-wide breast cancer screening on the basis of the stage distribution of diagnosed breast cancer 1989-1995. DESIGN: Descriptive, inventory. METHOD: At the University of Nijmegen data concerning the numbers of diagnosed breast cancer cases and age and stage at diagnosis were obtained from the Netherlands Cancer Registry for the years 1989-1995. Population data were provided by Statistics Netherlands. With these data incidence figures were calculated. RESULTS: The number of invasive breast cancers rose from almost 8,000 in 1989 to almost 10,500 in 1994. In 1995, a small decrease was visible. The increase was largest in women aged 50-69 years, the target population of the screening programme (introduced in 1988), and less in older women. In women aged 50-69 years, the incidence of stage I tumours doubled, stage II tumours increased but had returned to original levels in 1995, whereas stage III and IV had decreased by more than 24%. The number of carcinomas in situ rose from 336 in 1989 to 829 in 1995 in all age categories, but most in women aged 50-69 years. CONCLUSION: When the implementation scheme of the national screening programme is taken into account, the results are indicative of a reduction in breast cancer mortality. Whether such a mortality reduction actually will follow, has to be awaited.

Adult↗
PubMed2000

[Psychiatric research in Southern Netherlands; most studies get completed, social-scientific ones more often than pharmacotherapeutical trials].

OBJECTIVE: To describe the nature and the course of scientific studies in psychiatry that have been reviewed by the Research Ethics Committee in the South Netherlands (Toetsingscommissie Zuid-Nederland (TCZ)). DESIGN: Exploratory, retrospective. METHOD: Scientific studies in psychiatry that were submitted for review in the period 1 January 1988-31 December 1998 by TCZ, were investigated to determine their progress and to find out what study features were prognostic for completion. RESULTS: In this research project 131 psychiatric studies, which were expected to be completed towards the end of 1998, were considered for inclusion. Approximately 2/3 of all studies had a social-scientific character, 1/3 being pharmacotherapeutical. 116 cases were reviewed and 114 selected. From the 88 studies started, 77 had been completed. Out of these 77 completed studies 75 have been presented and/or published. Seven patients were involved in four studies that were stopped prematurely; they were possibly incorrectly burdened. Studies described as experimental, painful, pharmacotherapeutical, externally initiated, externally financed or multicentered ran a greater risk of not being completed than studies without these characteristics. Topics such as a limited number of subjects, a large burden or a long duration also jeopardized the successful completion of a study. A multivariate analysis showed that the pharmacotherapeutical nature of studies was the most important predictor. CONCLUSION: In the psychiatric hospitals of the South Netherlands scientific research has been carried out. Many of the studies that were approved by the TCZ were started and completed. Pharmacotherapeutical research ran a greater risk of non-completion than social-scientific research.

Clinical Trials as Topic↗
PubMed2001

[Limited effect of Health Council guideline on outpatient preoperative evaluation clinics in the Netherlands: an inventory].

OBJECTIVE: To investigate the current status of preoperative evaluation in the Netherlands and the implementation of the Health Council recommendations. DESIGN: Cross-sectional study. METHOD: All Dutch anaesthesiologic partnerships and their hospital managers in February 2000 received a structured questionnaire about the existence of an outpatient evaluation clinic, possible problems in creating such a clinic and the contents of preoperative evaluation. RESULTS: We received responses of 101 (80%) and 111 (87%) from anaesthesiologists and managers, respectively. From 119 hospitals (94%) we received at least one useful questionnaire. On January 1, 2000, 24 (20%) hospitals had a complete and 36 (30%) a partial outpatient clinic. Within one year, 44% of the hospitals without a preoperative outpatient clinic expected to create one. The most common problem concerned financing this clinic. In hospitals with a complete clinic, anaesthesiologists were more often in employment (odds ratio (OR): 2.5; 95% confidence interval (95% CI): 1.0-10.0) and a routinely performed physical examination by the anaesthesiologist (or under his or her responsibility) was also conducted more often (OR: 5.0; 95% CI: 1.6-15.0). Not every patient saw an anaesthesiologist before entering the operating room in 70% of all hospitals. In hospitals without outpatient clinic, 57% of the day-surgery patients contacted the anaesthesiologist in the operating room. CONCLUSION: The recommendations of the Health Council of the Netherlands with respect to contents and organisation of the preoperative evaluation had, 3 years after being published, limited effect.

Adult↗
PubMedDate not supplied

Search for enterotoxin gene in Bacteroides fragilis strains isolated from clinical specimens in Poland, Great Britain, The Netherlands and France.

BACKGROUND: Bacteroides fragilis is a member of normal human flora and well known pathogenic agent. This bacterium produces many virulence factors. In 1984 new virulence factor--enterotoxin was described. The aim of the study was to search for enterotoxin gene in B. fragilis strains isolated from clinical specimens. MATERIAL AND METHODS: Strains isolated in Poland, Great Britain, France and the Netherlands were cultured on BBE medium. For DNA isolation Genomic DNA PREP PLUS isolation kit manufactured by A&A Biotechnology (Poland) was used. In order to detect enterotoxin (fragilysin) gene, polymerase chain reaction (PCR) was applied utilizing the following primers: 404 (GAG CGG AAG ACG GTG TAT GTG ATT TGT) and 407 (TGC TCA GCG CCC AGT ATA TGA CCT AGT). DNA obtained from bacterial cells was amplified in thermocycler Techne. The amplification products were detected by the electrophoresis in 1% agarose gel. RESULTS: Among 65 investigated B. fragilis strains, the enterotoxin gene was detected in DNA isolated from 12 strains. CONCLUSION: The enterotoxin producing B. fragilis strains were detected among strains isolated from different clinical specimens in Poland, Great Britain, the Netherlands and France.

Bacterial Toxins↗
PubMed2001

[Blueprint 2000 Education of dentists in the Netherlands. Objectives of undergraduate dental education. A summary].

Blueprint 2000 Education of dentists in the Netherlands includes nationally developed objectives for the dentist at graduation. The changing state of oral health of the population and oral health care require a dentist trained in a broad range of dental subjects. Intellectual and scientific training should be an important aspect of undergraduate education. Developments in teaching methods support these requirements. The differences in the implementation of educational developments in the three Dutch dental schools made a uniform description of objectives not yet possible. The actual objectives therefore are presented in four different ways: (1) the profile of the dentist in broad terms, (2) general objectives by way of competencies, (3) discipline-based objectives and (4) a list of problems. These problems are derived from every day practice and can serve as starting point in the learning process of the student. It is expected, that Blueprint 2000 Education of dentists in the Netherlands will be used as a basis for curriculum development. What type of objectives, or combinations, will be used will be seen in the future.

Adult↗
PubMed2001

Training of occupational physicians in The Netherlands with regard to occupational health services delivered to the population.

In the Netherlands, the need for a basically new approach to education and training in occupational medicine was felt by professionals, students, schools and occupational health services (OHS) in the early 1990s. After an inventory of the problems and shortcomings of the traditional curriculum, the Netherlands School of Occupational Health defined the framework for a new curriculum. In this article the background, principles and structure of the new curriculum are described. Three principles shape the curriculum: the needs of OHS; professional standards; and the state-of-the-art. The characteristics of the new curriculum are: interaction between theory and practice; students' self-management of the learning process; co-makership with OHS; and multidisciplinarity. The curriculum consists of a course/theory and a practical part. Most of the theoretical part is presented to so called core group of 12 students, which is to be maintained during the full course period of 4 years. The adage for the practical part to be spent in a certified OHS institution is: "the best teaching OHS are learning OHS". In 1999, the first group of students entered the renewed curriculum. First impressions of the experience gained are presented.

Curriculum↗
PubMed2001

[HIV-1 therapy in the Netherlands; virological and immunological response to antiretroviral therapy].

OBJECTIVE: To evaluate the effect of treatment of HIV-1 infection with combination therapy consisting of since 1996 in the Netherlands available protease and reverse transcriptase inhibitors. DESIGN: Prospective cohort study. METHODS: In an observational clinical cohort of HIV-1-infected individuals, the short-term successful treatment end point of antiviral therapy including at least one antiretroviral drug licensed in the Netherlands since July 1, 1996 (protease inhibitors and reverse transcriptase inhibitors), was HIV-1 RNA plasma levels < or = 500 copies/ml (virological success). Cox proportional hazard models were used to identify prognostic markers for therapy success. The study included 2,148 infected individuals with a median follow-up of 135 weeks of treatment; 1,049 had been pre-treated with antiretroviral drugs before starting their new regimen and 1,099 were treatment naive. RESULTS: Plasma HIV-1 RNA levels < or = 500 copies/ml at 24 weeks of treatment were seen in 61% of all patients. The chance of therapy success for naive patients was twice that for pre-treated patients (relative risk: 1.8; p < or = 0.001). Following the first 24 weeks, the chance of virological success was higher in the naive group (78% versus 63%; p < or = 0.001), and the number of naive patients failing therapy after initial success was smaller compared to pre-treated patients (22% versus 45%; p < or = 0.001). In the naive group, the CD4+ T-cell number increased from 239 to 440 (x 10(6) cells/l) in case of success, and decreased from 150 to 320 in case of treatment failure. HIV-1 related morbidity declined from 0.26 to 0.05 and mortality dropped from 0.07 to 0.03 per person-year of follow-up. Regimens were changed at least once in 76% of patients. Toxicity and therapy failure were the main reasons for regimen changes in naive and pre-treated patients, respectively. CONCLUSION: A combination of antiretroviral drugs, including at least one of the drugs licensed since 1996, led to a drop in HIV-1 plasma concentrations. Morbidity and mortality also decreased. The chance of a better immunological and virological response to the new drug regimens was greatest in therapy-naive patients.

Acquired Immunodeficiency Syndrome↗