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PubMed2006

[Health-related fitness of sedentary elderly in the Netherlands].

The assessment of fitness is a component of a national project aimed at the enhancement of physical avtivity among sedentary older adults, aged 55-65 year in the Netherlands. Deterioration in physical functioning may be improved through an exercise programme. Research showed that enhancement of physical activity results in improved fitness, increased functional ability and health-related quality of life. Scientific results of the association between exercise and physical fitness in older adults is not sufficiently evidence-based in the Netherlands. In order to support health policy interventions 5.584 fitness tests of sedentary older adults were analyzed. The fitness was assessed by the Groninger Fitnesstest for Elderly (GFE). The analysis of physical fitness in sedentary older adults showed a lower fitness status among the age group 55-65 of age and women. Health risk factors such as overweight and having a chronic disease explained 88% of the variance between a low fitness and a high fitness profile.

Activities of Daily Living↗
PubMed2006

End of life decisions in newborns in The Netherlands: medical and legal aspects of the Groningen protocol.

The international press has been full of blood chilling accounts concerning a supposedly new practice in the Netherlands of terminating the life of severely defective newborn babies with a protocol. Our aim is to give insight into the medical and legal aspects of this protocol and to describe its contents. The legal developments concerning termination of life in newborns in the Netherlands are being discussed.

Advisory Committees↗
PubMed2006

Development of out-of-hours primary care by general practitioners (GPs) in The Netherlands: from small-call rotations to large-scale GP cooperatives.

BACKGROUND: Over the last 10 years, care outside office hours by primary care physicians in The Netherlands has experienced a radical change. While Dutch general practitioners (GPs) formerly performed these services in small-call rotations, care is nowadays delivered by large-scale GP cooperatives. METHODS: We searched the literature for relevant studies on the effect of the out-of-hours care reorganization in The Netherlands. We identified research that included before- and afterintervention studies, descriptive studies, and surveys. These studies focused on the consequences of reorganizing several aspects of out-of-hours care, such as patient and GP satisfaction, patient characteristics, utilization of care, and costs. RESULTS: Various studies showed that the reorganization has successfully addressed many of the critical issues that Dutch GPs were confronted with delivering these services. GPs' job satisfaction has increased, and patients seem to be satisfied with current out-of-hours care. DISCUSSION: Several aspects of out-of-hours care are discussed, such as telephone triage, self referrals, and future expectations, which should receive extra attention by researchers and health policy makers in the near future.

After-Hours Care↗
PubMed2006

[Bluetongue in The Netherlands; description of the first clinical cases and differential diagnosis. Common symptoms just a little different and in too many herds].

For the first time Bluetongue (BT) has been diagnosed in the Netherlands. The clinical symptoms of BT on five farms during the first outbreak ever in the Netherlands are described. Fever and swollen sensitive coronets leading to reluctance to stand and walk were sometimes the first symptoms. Later lesions in the mouth occurred with foamy salivation and respiratory problems. In other cases a swollen head with swollen lips and foamy salivation were the first clinical signs. Also sudden death occurred. In the first sixteen confirmed cases morbidity and mortality were lower than described in outbreaks in other countries. Good collaboration between practitioners, specialists of the Animal Health Service (GD-Deventer), and specialists of the Food and Consumer Product Safety Authority (VWA) and CIDC-Lelystad (Wageningen UR) led to a rapid notification and ultimately confirmation of the suspected diagnosis BT.

Animals↗
PubMedDate not supplied

[Contagiousness of yellow fever in the Netherlands between 1820 and 1825. Medical and sanitary aspects of a polymorphic disease].

Shortly after 1800, the question of the contagiousness of yellow fever was quite a topic. In the Netherlands, as was the case in France, the government feared the introduction of contagious diseases, especially of the yellow fever. This growing fear was prompted by the increasing number of yellow fever appearances in the mediterranean ports of France, Spain and Italy, as well as in some French Atlantic ports. In 1821, Thomassen ai Thuessink (a leading expert on epidemic diseases in the Netherlands), Bernard and Van Stipriaan Luïscius were invited by the Royal Dutch Academy of Sciences, Literature and Arts (Amsterdam) to assess two treatises on yellow fever, written by Jean Devkze. Devhze's treatises were meticulously analysed. After careful considerations they took the side of Devhze's opponents, and so was the character of their advice to the Dutch government. As a result, already existing sanitary laws were maintained and were even laid down more strictly. Not until several decades later, the senselessness of the distinction between infectious and contagious (as being used by early nineteenth-century scientists) would be generally admitted, although the earliest rumours were already heard shortly after 1800.

Communicable Disease Control↗
PubMed2006

[Proximal femur fractures in the elderly in The Netherlands during the period 1991-2004: incidence, mortality, length of hospital stay and an estimate of the care capacity needed in the future].

OBJECTIVE: To assess the incidence of operations for neck and pertrochanteric femur fractures during the last 15 years and to estimate the future demand for such operations in The Netherlands. DESIGN: Retrospective. METHOD: For the years 1991, 1995, 2000 and 2004, the following anonymised data were collected in the National Medical Registry of Prismant for all patients admitted to Dutch hospitals for a hip fracture: age-group, gender, length of pre- and postoperative hospital stay, destination after discharge and hospital mortality. These data were related to demographic data for the Dutch population from Statistics Netherlands (CBCS) and to estimates for the Dutch population in the future from Primos Prognostic Data. RESULTS: The average absolute increase in the period 1991-2004 was linear, with 230 fractures per year. Women were operated for a hip fracture 1.5-2 times as often as men in the same age range. The age-specific incidence remained constant over the years but the absolute number of elderly persons per age group increased. The average length of pre- and postoperative hospital stay was reduced by half during the period under investigation. The postoperative hospital mortality decreased from 8.1% in 1991 to 5.6% in 2004, and was 1.5 times as high for men aged 70 years or over as for women of the same age group. In 2004 as compared to 1991, 2.5 times as many patients were discharged to a nursing home. In view of the increasing age of the population, the total number of operated hip fractures can be expected to be 20,200 in the year 2010 and 23,900 in the year 2020. CONCLUSION: In the period 1991-2004 there was an annual increase of 230 operations for proximal femur fractures that was closely related to the ageing of the Dutch population. During the years under investigation, the incidence in the same age range was higher in women, but men had a higher hospital mortality. It is estimated that the decreasing hospital mortality and the decrease in the length of hospital stay will increase the need for nursing-home care for this category of patients.

Accidental Falls↗
PubMed2006

[Screening the population for colorectal cancer: the background to a number of pilot studies in the Netherlands].

Colorectal cancer is one of the most common cancers in the Netherlands, where it is now the second most commonly-occurring cancer in terms of both incidence (10,000 new cases each year) and mortality rate (4,400 each year). - In 40% of all cases the disease is diagnosed at a late stage, which is associated with a poor outcome. - Research has shown that screening of the general population for colorectal cancer by means of the faecal occult blood test (FOBT) results in a reduction in mortality of approximately 16%. Whether endoscopic screening will result in a greater reduction in the mortality rate is currently under investigation. - This year, the first pilot study on implementation of screening for colorectal cancer using two different types of FOBT will start in the Netherlands.

Colorectal Neoplasms↗
PubMed1991

[Prevalence of Lyme borreliosis in The Netherlands].

In the autumn of 1989 a seroepidemiological study was carried out among 440 owners of hunting dogs and 1052 blood donors from different regions in the Netherlands. To detect IgG antibodies to Borrelia burgdorferi an enzyme-linked immunosorbent assay was performed. The prevalence of antibodies to B. burgdorferi in owners of hunting dogs was 15%, which was significantly higher than in blood donors (9%). In both groups the prevalence of seropositivity increased with age. There was no difference between men and women. The prevalence of antibodies to B. burgdorferi in blood donors from different regions varied significantly, ranging from 2% to 17%. Only 3% of the owners of hunting dogs could recall having had symptoms most likely to be due to Lyme borreliosis. Of the 68 seropositive hunters 64 (94%) were asymptomatic. The results of this study indicate that in the Netherlands asymptomatic infections with B. burgdorferi are common in individuals highly exposed to ticks and that there is considerable variation in the prevalence of seropositivity in the general population. Hence caution is called for in the clinical interpretation of IgG test results.

Adolescent↗
PubMed1991

Drug utilization studies and drug monitoring in The Netherlands.

Drug utilization research is a research area of increasing importance, as well in the Netherlands as elsewhere. In this article on overview is given of the situation in the Netherlands. Three types of studies are distinguished, descriptive studies, studies of the determinants of drug use and studies of the impact of drug use. Descriptive studies are needed to understand the present situation and to detect problems. If these problems are to be solved it is important to understand the factors that determine drug use. By looking what the impact is, the value of drug use for health care can be assessed. It is also an important tool for developing systems for drug monitoring at a patient level. At present community pharmacists play an important role in drug monitoring at the patient level. A problem still awaiting a solution is how to implement such systems effectively.

Adverse Drug Reaction Reporting Systems↗
PubMed1991

[Congenital hypoplastic anemia in The Netherlands (1963-1989)].

Congenital hypoplastic anemia (CHA; syn: Diamond-Blackfan syndrome) is a rare disorder with one of two patients a year in the Netherlands. To get a better understanding of this disorder in the Netherlands we conducted a national retrospective study over a 25-year period (1963 till 1989). The medical reports of 19 patients who fulfilled the diagnostic criteria for CHA were studied. Almost all patients were diagnosed during the first three months of life. Dysmaturity was found in 50% of the patients and in 25% physical anomalies were observed. In 17 patients the bone marrow showed a hypoplastic erythropoiesis, but in 2 patients erythropoiesis was quantitatively normal. All patients were treated with prednisone and 74% of them responded initially. Five of these patients (26%) had a complete remission and 4 of them (21%) are in remission on low dose prednisone maintenance-treatment. Remarkably one patient went only into remission at the age of 17 years. Nine patients (47%) are transfusion-dependent and one patient has a stable hemoglobin level of about 5.0 mmol/l without treatment. This study further shows that the chance of achieving a remission was positively correlated with an early start of prednisone treatment and negatively with the manifestation of symptoms on the first day of life.

Clinical Laboratory Techniques↗
PubMed1991

Mortality and morbidity from respiratory diseases in childhood in The Netherlands, 1980-1987.

National mortality and hospitalization data from the Netherlands were analysed for asthma (International Classification of Diseases) (ICD 493), acute bronchi(oli)tis (ICD 466), pneumonia and influenza (ICD 480-487), and other chronic obstructive pulmonary diseases (ICD 490 + 491 + 492 + 496) in children aged 0-14 yrs for 1980-1987. No trends were seen in the mortality in age groups 0-4 yrs and 5-14 yrs, which actually concerned small numbers. In general a tendency towards increasing hospital admission rates for respiratory diseases was observed in both sexes in age groups 0-4 yrs and 5-9 yrs but not in age group 10-14 yrs, and significant increases were found for asthma in males and females aged 0-4 yrs and in males aged 5-9 yrs, and for acute bronchitis in females aged 5-9 yrs. Hospital admission rates in the Netherlands for asthma appeared to be low compared to other countries. The average length of stay, however, for both asthma and the other respiratory diseases was substantial though declining. Clinical information is required on possible causal factors of the apparent need for hospitalization for reactive airway disorders in young children, and on the management of asthma in particular.

Adolescent↗
PubMed1991

The prevention of suicide among older people in The Netherlands: interventions in community mental health care.

About one third of all suicides in the Netherlands are committed by elderly people. Yet, until recently no discernible initiatives have been taken to prevent suicide among the elderly. One of the possibilities that has not yet been considered is the use of mass media. In this article some thoughts are presented on the use of television and other media for communicating messages designed to identify depressive symptoms and to counter suicidal tendencies by mobilizing relatives and friends. Epidemiological findings on suicide among elderly persons in the Netherlands are presented, along with data on the role of the general practitioner and the mental health care system in suicide prevention. It is stressed that because of a number of unfortunate circumstances many depressed elderly people do not receive adequate treatment: Because they survived many major life events, their relatives wrongly consider them to be strong enough to cope with yet another major life event, loss or threatening condition. Relatives may think of depressed symptoms as a natural reaction, and may not consider these to be alarming. If they are alarmed, relatives may not know that depression is a treatable condition, or where they may be able to seek psychological assistance. Depressed elderly people might not be willing to share depressed feelings or thoughts concerning death and dying, or admit having suicidal ideation. Symptoms of depression may be confused with the normal aging process, both by the person him- or herself and by his or her relatives and friends.

Adolescent↗
PubMed1991

Trends in obesity in young adults in The Netherlands from 1974 to 1986.

Data from two screening projects on cardiovascular risk factors were used to investigate trends in body mass index (BMI; weight(kg)/height(m)2) and in the prevalence of obesity in The Netherlands between 1974 and 1986. In the period 1974-80 about 30,000 men and women aged 37-43, with a mean age of 40, were screened. In the period 1981-6 about 80,000 men aged 33-37, with a mean age of 35, were examined. In men, an increase in mean BMI of about 0.5 kg/m2 was observed between 1974 and 1980, which was reflected in an increase in the prevalence of a BMI between 27 and 30 kg/m2 of about 4 percentage points. In the period 1981-6, no change in mean BMI was observed in men, although there was a slight decrease in the percentage of men with a BMI between 25 and 27 kg/m2 (about 2 percentage points). In women, no change in mean BMI or in the prevalence of different grades of obesity was observed in the period 1974-80. The prevalence of grade I obesity (BMI 25-29.9 kg/m2) was 40-45 per cent in men aged 40 and 25-30 per cent in women aged 40 in the period 1974-1980. The prevalence of grade II obesity (BMI greater than or equal to 30 kg/m2) during that period was 5-6 per cent in men and 7-8 per cent in women. The prevalence of grade I and grade II obesity in men aged 35 was 35-40 per cent and 5-6 per cent respectively during the period 1981-6. The prevalence of grade II obesity in The Netherlands is comparable with that in some other Western European countries, but much lower than in the United States and Canada.

Adult↗
PubMed1991

[Prevalence at birth of more than 30 congenital disorders in Northern Netherlands].

For birth years 1981-1986, 1251 children/foetuses with congenital anomalies were reported to the regional EUROCAT registration of the northern Netherlands (2.5% of all live and stillbirths). In this article the total birth prevalence for over 30 individual congenital anomalies is presented for the first time in the Netherlands. The prevalence registered for neural tube defects is higher than in EUROCAT-centres elsewhere in continental Europe. The prevalence of cleft lip with or without cleft palate is, as in Denmark, higher than in other EUROCAT-centres.

Cleft Lip↗
PubMed1991

[Course and distribution of mortality of pleural mesothelioma in The Netherlands, 1970-1987].

In this article the sex- and age-specific trends and geographical distribution of asbestos related pleural mesothelioma mortality in the Netherlands between 1970 and 1987 are investigated. For men total mortality increased from 10.8 per million during 1970-1978 to 20.9 per million during 1979-1987. The highest mortality occurred with 147.7 per million in 1987 in the age group between 65 and 74 years. Mortality rates for the age group between 55 and 64 years amounted to 96.5 per million in 1987. The geographical distribution over the country showed a strong concentration of male mesothelioma cases in the regions with many harbours, shipyards and heavy industries round Amsterdam, IJmuiden, Rotterdam, Dordrecht and Walcheren. Using linear regression techniques, it was calculated that several thousands new mesothelioma cases will occur in the Netherlands during the next two decades. A significant decrease in mesothelioma mortality can not be expected before 2010.

Adult↗
PubMed1990

Antibiotic prophylaxis in biliary tract surgery--current practice in The Netherlands.

A questionnaire about the current practice of antibiotic prophylaxis in biliary tract surgery was sent to the chairmen of the departments of surgery of 175 hospitals in The Netherlands. The Dutch hospitals are classified into three categories depending on the type of residency in general surgery. Overall, 80 per cent replied. Antibiotic prophylaxis in elective cholecystectomy is given in 76 per cent of the clinics (100/132), and single-dose prophylaxis is employed in 28 per cent of the clinics (28/100). In patients with acute cholecystitis, emergency surgery is the treatment of choice in 108 hospitals (82%). Differences in antibiotic prophylaxis between the three categories of hospitals include the omission of prophylaxis in elective cholecystectomy in 31 per cent of the C-clinics (vs. 10% in A-clinics and 16% in B-clinics), and the use of single-dose prophylaxis in 13 per cent of the B-clinics (vs. 30% of the A-clinics and 31% of the C-clinics). Since prophylaxis for more than 24 hours has no additional effect and peri-operative prophylaxis in acute cholecystitis is mandatory, antibiotic prophylaxis in biliary tract surgery is inappropriate in at least 31 hospitals in The Netherlands (23%).

Aged↗
PubMed1990

[Multiple births in The Netherlands, 1900-1988].

There are an estimated 120,000 twins and other multiples (all still alive) in The Netherlands. The age of this population (i.e. a quarter of a million persons, 1.6% of the total population) is slightly lower compared with The Netherlands as a whole. Alterations in the structure of mother's age and birth order can only partly explain the observed changes in multiple birth frequencies. The recent increase may be due to medical treatment of women with fertility problems. In addition dizygotic twin births appear to be largely responsible for the total development in multiple births. The changes in birth patterns which relate to the demographic variables age of mother and birth order, are hardly responsible for the decline of stillbirths, perinatal and infant mortality among twins and other multiples. This improvement can be ascribed mainly to progress in medical care. In spite of this improvement, the differences compared with singles are still considerable: the stillbirth rate for twins and other multiples is 2.5 times that for singles; the perinatal mortality rate and the infant mortality rate are about four times as high. However, in the first few years of life of twins and other multiples the age-specific mortality risk declines at such a rate that as early as the third year after birth there is hardly any difference with respect to the singles.

Adolescent↗
PubMed1990

[Prognosis concerning HIV-infection and AIDS epidemic in The Netherlands based on mathematical analysis].

In the Netherlands by the 1st of January 1990 1074 AIDS patients have been reported to the Department of the Chief Medical Officer. In the last few years the proportion of intravenous drug users increased and the proportion of homo/bisexual men decreased. After adjustment for the effect of delay in reporting the total number of AIDS patients by 1st January 1990 is estimated to be 1173. It appears that the reporting delay outside Amsterdam is longer than in this city. The time required for doubling of the half-yearly incidence of new AIDS patients (doubling time, dt) increased from 9 months in the beginning of the epidemic to 34 months. It is expected on the assumption of constant dt that 1120 new AIDS patients will be diagnosed in 1990 and 1991 together. The present growth among the homo/bisexual men (dt 34 months) is smaller than the one among the intravenous drug users (dt 23 months). The growth in Amsterdam (dt 36 months) is less than that in the rest of the Netherlands (dt 32 months). Based on the course of the AIDS epidemic the number of HIV infected (including the AIDS patients) is estimated as 9,000-12,000 by the 1st of January 1990.

Acquired Immunodeficiency Syndrome↗