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PubMed2000

Antimicrobial resistance in the subgingival microflora in patients with adult periodontitis. A comparison between The Netherlands and Spain.

BACKGROUND: The widespread use of antibiotics for prophylaxis and treatment of bacterial infections has lead to the emergence of resistant human pathogens. Great differences have been documented between European countries in the use of systemic antibiotics. In parallel, significant differences in levels of resistant pathogens have been documented. AIM: To investigate whether differences in antibiotic use influence the level of antimicrobial resistance of the subgingival microflora of untreated patients with adult periodontitis in The Netherlands and Spain. METHOD: Blood agar plates containing breakpoint concentrations of penicillin, amoxicillin, amoxicillin and clavunalate, metronidazole, erythromycin, azithromycin, clindamycin and tetracycline were used to determine the proportion of bacteria from the subgingival plaque that was resistant to these antibiotics. In the Spanish patients, statistically significant higher mean levels of resistance were found for penicillin, amoxicillin, metronidazole, clindamycin and tetracycline. The mean number of different bacterial species growing on the selective plates was higher in the Spanish patients, as was the % of resistant strains of most periodontal pathogens. A striking difference was observed in the frequency of occurrence of tetracycline-resistant periodontal pathogens. In Spain, 5 patients had > or =3 tetracycline resistant periodontal pathogens, whereas this was not observed in any of the Dutch patients. CONCLUSIONS: The widespread use of antibiotics in Spain is reflected in the level of resistance of the subgingival microflora of adult patients with periodontitis.

Adult↗
PubMed2000

Beta-lactamase producing bacteria in the subgingival microflora of adult patients with periodontitis. A comparison between Spain and The Netherlands.

BACKGROUND/AIMS: Countries with a high per capita antibiotic use frequently demonstrate a high level of drug resistance. The aim of this study was to compare the prevalence and levels of beta-lactamase producing bacteria in the subgingival microflora in adult patients with periodontitis in Spain and The Netherlands, and to characterise beta-lactamase producing bacteria in both patient samples. METHOD: Patients with moderate to severe periodontitis were consecutively selected and asked to report on: current systemic disorders and medications, history of use of antibiotics, and smoking habits. Clinical variables included probing pocket depth, clinical attachment level, plaque, bleeding on probing, and suppuration. Pooled subgingival samples of 4 selected sites were anaerobically cultured in blood agar plates with and without amoxicillin, and amoxicillin/clavulanate. Bacterial colonies growing on amoxicillin plates but not on amoxicillin/clavulanate plates were tested for beta-lactamase production. beta-lactamase producing bacteria were isolated and identified. RESULTS: 31 patients were studied in the Spanish group and 30 in the Dutch group. Comparable mean gender and ages were found. Evaluation of previous antibiotic use revealed that, in the previous 12 months, 54.8% of patients in the Spanish group and 10% in the Dutch group reported antibiotic use (p<0.001). The prevalence of beta-lactamase producing bacteria was 87.1% in the Spanish group and 73.3% in the Dutch group. Total counts of beta-lactamase producing bacteria on amoxicillin plates (p<0.01), the mean number of different beta-lactamase producing colonies per patient (p<0.001), and the number of amoxicillin resistant colonies (p<0.001) were significantly higher in the Spanish group. 74 beta-lactamase producing strains in the Spanish group and 33 in the Dutch group were isolated for identification. 23 out of 35 identified strains in the Spanish group, and 32 out of 33 in the Dutch group belonged to Prevotella genus. CONCLUSIONS: A high prevalence of beta-lactamase producing bacteria has been evaluated in two distinct populations, belonging to two European countries with clear differences in antibiotic usage policy. A higher prevalence and a more complex beta-lactamase producing microflora, were found in the Spanish group, associated with a higher antibiotic consumption. This study shows that a higher use of beta-lactam antibiotics is reflected in the % of beta-lactamase producing bacteria in the subgingival microflora of patients with periodontitis. This information may be important in the treatment of severe periodontitis.

Adult↗
PubMed2000

Differences in the composition of the subgingival microbiota of two periodontitis populations of different geographical origin. A comparison between Spain and The Netherlands.

The purpose of this study was to compare the subgingival microbiota of two geographically distinct patient populations using identical clinical and bacteriological methods. Adult patients with a diagnosis of periodontitis were consecutively selected according to pre-defined clinical criteria. Microbiological samples were taken from the deepest four sites with bleeding. The samples were plated on blood agar plates, for the determination of the total anaerobic counts and identification of specific bacterial pathogens, and on TSBV and McConkey for isolation of Actinobacillus actinomycetemcomitans and enteric rods, respectively. Thirty-one patients in Spain and 30 patients in The Netherlands were selected. Both patient groups showed similar clinical characteristics, both in terms of age, gender and periodontal clinical variables. A. actinomycetemcomitans was significantly more prevalent (23.3% vs. 3.2%) in the Dutch group, while Porphyromonas gingivalis was significantly more prevalent (64.5% vs. 36.7%) in the Spanish group. Bacteroides forsythus and most commensal periodontal pathogens showed similar prevalences, except Peptostreptococcus micros that was significantly more frequent in the Dutch group (96.7% vs. 74.2%). In summary, the subgingival microbiota from the Spanish group was characterised by a high prevalence of P. gingivalis and low of A. actinomycetemcomitans, while the flora from the Dutch group was characterised by a high prevalence of A. actinomycetemcomitans and P. micros.

Aggregatibacter actinomycetemcomitans↗
PubMed2003

Culture moderates the self-regulation of shame and its effects on performance: the case of salespersons in The Netherlands and the Philippines.

In this study, the authors investigated how salespeople within an interdependent-based culture (the Philippines) and an independent-based culture (the Netherlands) experience and self-regulate shame. Filipino and Dutch employees were found to experience shame as a consequence of customer actions in largely similar ways (i.e., for both, shame is a painful self-conscious emotion with unique physiological/behavioral urges, self-focused attention, and felt threat to the core self) but have different responses to their felt shame. Specifically, shame is self-regulated dissimilarly in the 2 cultures and leads to opposite effects on performance, namely, enhanced customer relationship building and civic virtue and helping occur for Filipino employees, and diminished sales volume, communication effectiveness, and relationship building transpire for Dutch employees. The positive effects experienced by Filipino employees occur through direct responses to felt shame and as a result of adaptive resource utilization. The negative effects experienced by Dutch employees occur as a result of the dysfunctional (from the firm's point of view) discharge of protective actions.

Affect↗
PubMed2001

Birth of the life sciences in The Netherlands and Belgium.

Small countries can seldom compete in science with larger, more powerful nations. The Netherlands and Belgium, however, are excellent examples of centres that fertilized scientific activity in neighbouring countries for over 400 years.

Anatomy↗
PubMed1983

Incidence of childhood leukaemia in The Netherlands (1973-1980).

The childhood leukaemia incidence rate for the Netherlands was estimated at 3.11 per 100.000 children (aged 0-15 year) per year, based on a complete nation-wide childhood leukaemia registry comprising the period 1973-1980. Acute lymphocytic leukaemia (ALL) accounted for 82.4% of the patients, acute non-lymphocytic leukaemia for 13.6% and chronic myeloid leukaemia for 2.9%. ALL occurred more frequently in boys (sex ratio 1.2). The highest ALL rate was observed in the 3-4 year age group. These figures corresponded with the data of the Manchester Children's Tumour Registry. Neither the incidence rates according to year of diagnosis nor the incidence rates according to year of birth showed a significant trend with time. The total leukaemia incidence rate in urban areas was somewhat higher than in rural areas. While the direct comparison of the incidence rate between these areas is not significant, the trend over the three categories of urbanisation is significant.

Adolescent↗
PubMed1989

Childhood leukaemia in The Netherlands, 1973-1986: temporary variation of the incidence of acute lymphocytic leukaemia in young children.

The incidence of childhood leukaemia in The Netherlands in the period 1973-1986 was studied by means of the DCLSG nationwide register, which lists all patients according to bone marrow slides classified in the DCLSG central laboratory. Acute lymphocytic leukaemia (ALL) accounted for 81% of cases, acute non-lymphocytic leukaemia (ANLL) for 13%, chronic myelocytic leukaemia (CML) for 2.5%, and acute unclassifiable leukaemia (AUL) for 3%. The peak incidence of ALL was at age 3, common-ALL and pre B-ALL comprising about 95% of the immunophenotypes at this age. Incidence rates for ALL remained stable between 1973 and 1978 at 2.85 cases per 10(5) children per year, exhibited a temporary increase between 1979 and 1984 to 3.60 and dropped back to the lower, previous level in 1985 and 1986. This rise was seen mainly among children in the 1-4 year age group, especially at age 3, and those with common-ALL and an initial WBC less than 5.0 x 10(9) l-1. Cumulative incidence rates per year of birth were fairly homogeneous up to age 6, except for the 1978 birth cohort which exhibited higher rates. Incidence rates for ANLL, CML and AUL remained stable over time. Changes in ascertainment, declining birth rates and a 50% decrease in childhood mortality, e.g. from infectious diseases, could not explain this temporary variation. Moreover, incidence rates in this survey appeared to be similar to those reported in various developed countries for the same period. As far as the aetiology of childhood common-ALL is concerned, therefore, the Dutch data appear to support the hypothesis of 'random mutation' as well as that of a limited role of environmental factors.

Adolescent↗
PubMed1994

Improved prognosis of breast cancer since 1970 in south-eastern Netherlands.

Despite many new advances in breast cancer therapy since the 1970s, there are only few reports on improved prognosis in a general population. A follow-up of more than 10 years is rarely reported, and a differentiation according to stage of the disease or between follow-up intervals is seldom made. Our purpose was to assess whether prognosis of primary breast cancer improved in patients diagnosed between 1970 and 1984 in south-eastern Netherlands, and to distinguish between different stages and follow-up intervals. Data from 4,467 breast cancer patients diagnosed between 1970 and 1984 were derived from the population-based Eindhoven Cancer Registry. Follow-up was attained up to 1 July 1991. Relative survival rates, as the ratio of the observed to the expected rates, were calculated. In a multivariate analysis a change in prognosis over time was computed with adjustment for age and stage; this was done separately for 5 year follow-up intervals. The relative survival rates were 69% after 5 years, 55% after 10 years and 50% after 20 years. Relative survival, after adjustment for age, was strongly related to the stage of the disease in the first 5 years of follow-up, less markedly between 5 and 10 years, and to a small, borderline significant, extent after 10 years of follow-up. Relative survival rates increased markedly over time, during the whole interval of follow-up. This increase was apparent in all age groups and in all stages, except for those with distant disease at diagnosis. The observed improvement in survival is unlikely to be explained by the increased use of adjuvant chemo- and hormonal therapy. Other factors, such as a change in the natural history of the disease in this period, cannot be ruled out.

Adult↗
PubMed1996

Rehabilitation of patients with spinal cord lesions in The Netherlands: an epidemiological study.

Very little is known about the occurrence of spinal cord lesions and results of the rehabilitation of patients with such lesions in the Netherlands. This study was conducted to describe the process of rehabilitation in the Dutch situation, to assess the incidence of spinal cord lesions in a regional rehabilitation centre and to characterise differences between traumatic and non-traumatic spinal cord lesions regarding age, level and extent of lesion. In this study 293 patients were included who were admitted to the rehabilitation centre between 1982 and 1993. Sixty-six per cent of this group came from the university hospital. The mean length of stay in the rehabilitation centre was 154 days. After completing the rehabilitation programme 94% of patients went home. Sixteen new SCI patients per million per year were admitted to the rehabilitation centre. Of our group 52% had a non-traumatic lesion, which concerned older patients with more incomplete lesions. In our opinion close collaboration between the university hospital and the rehabilitation centre is needed for optimal rehabilitation. Attention to independent living programmes and appropriate housing facilities can shorten the length of stay and increase the number of discharges of patients to their own environment. For patients with non-traumatic spinal cord lesions special programmes should be made available.

Adult↗
PubMed1993

Orthodontics in The Netherlands.

In October 1992 I visited the Netherlands and spent time at both university training centres and a number of selected specialist orthodontic practices. Holland has a population of nearly 15 million and the highest population density of any European country. There are about 6,000 GDPs in Holland and about 300 dentists who have undergone specialty training in orthodontics.

Humans↗
PubMed2004

Decreased rates of advanced breast cancer due to mammography screening in The Netherlands.

The effect of the implementation of the Dutch breast cancer screening programme during 1990-1997 on the incidence rates of breast cancer, particularly advanced breast cancer, was analysed according to stage at diagnosis in seven regions, where no screening took place before 1990. The Netherlands Cancer Registry provided detailed data on breast cancer incidence in 1989-1997 by tumour stage, age and region. Annual age-adjusted incidence rates of all breast cancers and advanced cancers, defined as large tumours T2+ with lymph node and/or distant metastases, were compared with rates in 1989. In general, breast cancer incidence rose strongly in the early 1990s, especially in the age category 50-69 years (estimated annual percentage change (EAPC) 4.25; 95% CI 1.70, 6.86). The increase was mainly due to the increase in small T1 cancers and ductal carcinoma in situ. However, in women aged 50-69, advanced cancer incidence rates showed a significant decline by 12.1% in 1997 compared with 1989 (EAPC -2.14, 95% CI -3.47, -0.80), followed by a breast cancer mortality reduction of similar size after approximately 2 years. We confirm that breast cancer screening initially leads to a temporary strong increase in the breast cancer incidence, which is followed by a significant decrease in advanced diseases in the women invited for screening. It is evident that breast cancer screening contributes to a reduction in advanced breast cancers and breast cancer mortality.

Adult↗
PubMed2004

Mammography screening in the Netherlands: delay in the diagnosis of breast cancer after breast cancer screening.

In a prospective study we determined the frequency and causes of delay in the diagnosis of breast cancer after suspicious screening mammography. We included all women aged 50-75 years who underwent biennial screening mammography in the southern breast cancer screening region of the Netherlands between 1 January 1996 and 1 January 2002. Clinical data, breast imaging reports, biopsy results and breast surgery reports were collected of all women with a positive screening result with a minimum of 2-year follow-up. Of 153 969 mammographic screening examinations, 1615 (1.05%) were positive screens. Breast cancer was diagnosed in 770 (47.9%) of 1607 women for whom follow-up information was available, yielding a cancer detection rate of 5.0 per 1000 women screened. Breast cancer was diagnosed within 3 months following a positive screen in 722 cases (93.8%). The diagnostic delay was 4-6, 7-12 and 13-24 months, respectively, in 11 (1.4%), 24 (3.1%) and nine (1.2%) patients. In four other patients (0.5%), breast cancer was diagnosed after a repeat positive screen, resulting in a diagnostic delay of 25-27 months. Reasons for a diagnostic delay >3 months were erroneous mammographic interpretation of suspicious lesions as benign or probably benign lesions (33 cases), benign biopsies from a malignant lesion (10), and omission to biopsy or remove a lesion that was suspicious at breast imaging (4) or core biopsy (1). We conclude that there is room for improvement in the workup of patients with a positive screening mammography, as seen from data in this screening region. To improve the workup, we suggest that other breast cancer screening programmes also identify delay in breast cancer diagnosis after a positive screen.

Aged↗
PubMed2005

Meat consumption and K-ras mutations in sporadic colon and rectal cancer in The Netherlands Cohort Study.

Case-cohort analyses were performed on meat and fish consumption in relation to K-ras mutations in 448 colon and 160 rectal cancers that occurred during 7.3 years of follow-up, excluding the first 2.3 years, and 2948 subcohort members of The Netherlands Cohort Study on diet and cancer. Adjusted incidence rate ratios and 95% confidence intervals were computed for colon and rectal cancer and for K-ras mutation status subgroups. Total fresh meat, most types of fresh meat and fish were not associated with colon or rectal cancer, neither overall nor with K-ras mutation status. However, several weak associations were observed for tumours with a wild-type K-ras, including beef and colon tumours, and an inverse association for pork with colon and rectal tumours; for meat products, an increased association was observed with wild-type K-ras tumours in the colon and possibly with G>A transitions in rectal tumours.

Aged↗
PubMed1999

Animal products, calcium and protein and prostate cancer risk in The Netherlands Cohort Study.

Prostate cancer risk in relation to consumption of animal products, and intake of calcium and protein was investigated in the Netherlands Cohort Study. At baseline in 1986, 58,279 men aged 55-69 years completed a self-administered 150-item food frequency questionnaire and a questionnaire on other risk factors for cancer. After 6.3 years of follow-up, 642 prostate cancer cases were available for analysis. In multivariate case-cohort analyses adjusted for age, family history of prostate cancer and socioeconomic status, no associations were found for consumption of fresh meat, fish, cheese and eggs. Positive trends in risk were found for consumption of cured meat and milk products (P-values 0.04 and 0.02 respectively). For calcium and protein intake, no associations were observed. The hypothesis that dietary factors might be more strongly related to advanced prostate tumours could not be confirmed in our study. We conclude that, in this study, animal products are not strongly related to prostate cancer risk.

Aged↗
PubMed2004

Drug use during breastfeeding. A survey from the Netherlands.

OBJECTIVE: To survey drug use by breastfeeding women, and to compare this with nonbreastfeeding women. In addition, we were interested whether drug use was of influence on the decision to give breastfeeding, and the other way around. DESIGN AND SETTING: During a 6-week period in 2002, a questionnaire was handed out to all women with a child not older than 6 months, who visited a Well-Baby Clinic in the province of Friesland, the Netherlands, eventually resulting in 549 returned questionnaires (response 43%). RESULTS: In all, 82.1% of the participants breastfed their baby at least at any time during the first 6 months after birth. More than half (65.9%) of all breastfeeding women had used drugs; however, they used drugs less frequently than nonbreastfeeding women (79.6%). The pattern of drug use differed: oral contraceptives, iron preparations, drugs for peptic ulcer, and several psychotropic drugs were more frequently used by nonbreastfeeding women, while vitamins were more frequently used by breastfeeding women. Drugs play an important role in women's decision to start or continue breastfeeding: women frequently hesitated to use drugs during breastfeeding, stopped either breastfeeding or drug use to avoid combining the two, took a measure to minimise exposure to the child, did not use any drug because of breastfeeding, or did not breastfeed because of drug use. CONCLUSIONS: Drugs are frequently though reluctantly used during breastfeeding, and play an important role in the decision to start and stop breastfeeding. Information how to deal with drugs seems therefore indispensable in efforts to promote breastfeeding.

Adult↗
PubMed2006

Dietary intake in asylum seeker children in The Netherlands, strongly related to age and origin.

OBJECTIVE: To monitor the dietary intake of energy, macro- and micronutrients in asylum seeker children. DESIGN AND SETTING: Cross-sectional study in three asylum seeker centres in The Netherlands. SUBJECTS: Hundred and sixteen children 2-12 years old (86% of the study cohort) provided a dietary history. METHOD: The dietary intake was estimated by 24 h recall, and the origin of the children was classified in three geographic regions: African (n=45), Central Asia (n=34) or Eastern Europe (n=37). RESULTS: The total energy intake from fat was in 24% of the children above 40En%. Seventy per cent of the children above 4 year of age had a saturated fat intake above 10En%. The children from Eastern Europe had a higher intake of fat and disaccharides than the children from the other regions. Among the children, an intake less than 80% of the recommended daily allowances of micronutrients was found for calcium (42%), iron (49%), vitamin A (45%) and vitamin D (80%). An inadequate dietary intake of iron and vitamin D was significantly more seen among the youngest children, whereas an inadequate intake of calcium and vitamin A was found more among the elder children. CONCLUSIONS: The dietary intake of a prominent proportion of these children contains too much fat and insufficient amounts of calcium, iron, vitamin A and vitamin D. The low micronutrient intake of the asylum seeker children can be considered as a nutritional risk. Nutritional education and strategies to improve the macro- and micronutrient intake of asylum seeker children is indicated.

Africa↗
PubMed2003

Carrier frequency of the V377I (1129G>A) MVK mutation, associated with Hyper-IgD and periodic fever syndrome, in the Netherlands.

Hyper-IgD and periodic fever syndrome (HIDS) and mevalonic aciduria (MA) are two autosomal recessive disorders that both are caused by a deficient activity of the enzyme mevalonate kinase (MK) due to mutations in the encoding gene (MVK). The most frequently occurring MVK mutation, V377I (1129G>A), has been identified exclusively in HIDS patients. Other common mutations have been associated with both HIDS and MA. To estimate the incidence of MK deficiency in the Netherlands, we determined the carrier frequency of the V377I mutation in genomic DNA extracted from anonymised newborn screening cards by PCR-RFLP. We found 14 carriers among 2138 analysed samples (1 : 153). Based on the V377I allele frequency of 42% in patients diagnosed with MK deficiency, the carrier frequency of any MVK mutation in the Dutch population can be calculated as 1 : 65. This predicts a disease incidence between 1 in 5196 and 1 in 53 656, which is far more than actually observed. Although under-diagnosis of patients with MK deficiency remains possible, this discrepancy probably is due to a reduced penetrance of V377I homozygosity. Analysis of the distribution of the V377I allele within patients carrying MVK mutations revealed that this was not according to the Hardy-Weinberg equilibrium principle, most probably due to an under-representation of V377I homozygotes in HIDS. Homozygotes for V377I might exhibit a much milder phenotype of MK deficiency or no disease-phenotype at all.

Familial Mediterranean Fever↗
PubMed2006

New mutations in the NHS gene in Nance-Horan Syndrome families from the Netherlands.

Mutations in the NHS gene cause Nance-Horan Syndrome (NHS), a rare X-chromosomal recessive disorder with variable features, including congenital cataract, microphthalmia, a peculiar form of the ear and dental anomalies. We investigated the NHS gene in four additional families with NHS from the Netherlands, by dHPLC and direct sequencing. We identified an unique mutation in each family. Three out of these four mutations were not reported before. We report here the first splice site sequence alteration mutation and three protein truncating mutations. Our results suggest that X-linked cataract and NHS are allelic disorders.

Abnormalities, Multiple↗