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PubMedDate not supplied

Fumonisin B1 in maize for food production imported in The Netherlands.

Sixty-two samples of maize imported in The Netherlands and intended for human consumption were screened for the presence and concentration of fumonisin B1. Sixty-one of those samples contained fumonisin B1 with concentrations ranging from 30 to 3350 micrograms kg-1, 11 maize samples contained > 1000 micrograms kg-1. The average fumonisin B1 concentration was 640 micrograms kg-1 for the positive samples and 620 micrograms kg-1 for all samples. Medians were 600 micrograms kg-1 and 550 micrograms kg-1 for positive and all samples, respectively. The results obtained were comparable to results from other studies in maize from various countries.

Carboxylic Acids↗

PubMed2000

Long-term survival of prostate cancer in southeastern Netherlands.

With the increase in detection at an early stage, only a few and conflicting results have been reported on the long-term outcome for prostate cancer beyond 10 years. The vast majority of prostate cancer patients diagnosed between 1955 and 1984 in southeastern Netherlands, with a population of almost one million inhabitants, did not receive any curative treatment. We calculated the prognosis for 10-year survivors of prostate cancer diagnosed in the era preceding prostate-specific antigen (PSA) testing to determine how long these patients exhibited excess mortality. All patients under age 70 diagnosed with prostate cancer and registered in the population-based Eindhoven Cancer Registry between 1955 and 1984 were included in the study. Relative survival was calculated for those who survived for at least 10 years (n = 174). Initially, these patients still exhibited an almost 25% excess mortality risk, but this decreased with time and no excess mortality was found after 15 years.

Adult↗

PubMed2004

Performance of gross lesions at postmortem for the detection of outbreaks during the avian influenza A virus (H7N7) epidemic in The Netherlands in 2003.

A total of 123 submissions (on average, five birds per submission) from poultry flocks with a suspicion of an infection with highly pathogenic avian influenza virus were investigated at postmortem during the 2003 epidemic in The Netherlands. A total of 86 of these submissions were from infected flocks (positive submissions), and 37 submissions were from non-infected flocks (negative submissions). Peritonitis was the most frequently (62%) recorded pathological finding in positive submissions, followed by tracheitis (43%), oedema of the neck and/or wattles (12%) and (petechial) haemorrhages in the proventriculus (4%). A total of 17% of the positive submissions consisted of birds without any macroscopic lesion. The pathological lesions observed in our study do not fully comply with descriptions in literature, especially the lack of haemorrhagic changes in tissues and low prevalence of oedema of the neck, comb and wattles. It is recommended that if peritonitis, or tracheitis, or oedema of the neck and/or wattles or (petechial) haemorrhages in the proventriculus is observed at postmortem examination, especially if accompanied by an anamnesis describing acute and high mortality in a flock, this should consistently result in follow-up action to exclude highly pathogenic avian influenza in the differential diagnosis as cause of the disease problems by testing tissue samples with an avian influenza-specific laboratory test at the avian influenza reference laboratory.

Animals↗

PubMed2001

Prosthetic management of children in The Netherlands with upper limb deficiencies.

The aim of the study was to assess which children with congenital and acquired upper limb deficiencies were fitted with prostheses, what types of prostheses were prescribed as first, second and third prostheses, at what age prostheses were first prescribed and how long the children wore their prostheses. The design was a retrospective chart review at De Hoogstraat Rehabilitation Centre, Utrecht (The Netherlands). Medical files of all patients with congenital or acquired upper limb deficiencies who visited the outpatient clinic between 1972 and 1996 were reviewed, collecting data on patient characteristics, prosthesis prescription and use of prostheses. The group included 224 children, of whom 206 (92%) had congenital deficiencies. Of all children with unilateral congenital deficiencies, 54% had been fitted with prostheses, against 3% of all children with bilateral congenital deficiencies and 67% of all children with acquired deficiencies. In the congenital group, it was children with transverse defects of one-third or two-thirds of the forearm who had most frequently had prostheses fitted (85% of the children). Most of the children with unilateral congenital deficiencies had received passive prostheses as their first prostheses (80 of the 90 prescribed prostheses); children with acquired defects usually had active prostheses (8 of the 12 prescribed prostheses). Body-powered prostheses were most commonly prescribed as the second type of prosthesis. In the group of 119 children who had been seen before the age of 4 years and had been followed for at least three years, 63 had been fitted with one or more prostheses at a mean age of 2.6 (SD 2.5) years. Of the 46 children with congenital defects, 30 had been fitted with prostheses, and at the age of 12, two-thirds of them still used their prostheses (63%, 19/30). "De Hoogstraat" rehabilitation centre uses a restrained prosthesis prescription policy, depending on the type of deficiency and the expected functional benefits. Data on prosthesis use are encouraging, although a follow-up study is required to determine the functional outcome for prosthesis users and non-users.

Adolescent↗

PubMed2004

Prosthetic prescription in the Netherlands: an interview with clinical experts.

In the process of guideline development for prosthetic prescription in the Netherlands the authors made a study of the daily clinical practice of lower limb prosthetics. Besides the evidence-based knowledge from literature the more implicit knowledge from clinical experts is of importance for guideline development. In order to obtain this information the authors performed both an observational study of clinical practice and an interview study with 11 clinical experts from the three key disciplines in this field. The latter study is presented here as a descriptive and qualitative study. The combination of the opinions on prescription criteria given in these semi-structured interviews appeared divided with regard to various options in the prescription of a lower limb prosthesis. However, the implicit knowledge is considered by the authors of importance for the consensus procedure on guideline development. Prosthetic prescription criteria seem to be based on local experience and partly on assumptions. A consensus procedure can lead to improvement of the knowledge about prosthetic prescription.

Artificial Limbs↗

PubMedDate not supplied

Relatives' perspective on the terminally ill patients who died after euthanasia or physician-assisted suicide: a retrospective cross-sectional interview study in the Netherlands.

This study used retrospective interviews with 87 relatives to describe the experiences of patients who died by euthanasia or physician-assisted suicide (EAS) in the Netherlands. Most of the patients suffered from cancer (85%). The relatives were most often a partner (63%) or a child (28%) of the patient. Before explicitly requesting EAS most patients (79%) had spoken about their wishes concerning medical end-of-life decisions to be made at a later date. Hopeless suffering, loss of dignity, and no prospect of recovery were the most prevalent reasons for explicitly requesting EAS. According to the relative, in 92% of patients EAS had contributed favourably to the quality of the end of life, mainly by preventing or ending suffering.

Activities of Daily Living↗

PubMed2001

Reluctance to continue breastfeeding in The Netherlands.

UNLABELLED: A prospective cohort study of breastfeeding practice (0-4 mo) was carried out in well-baby clinics. The cohort included 4438 newborns brought to a clinic for the first time between 1 April and 1 July 1998. The odds ratios of demographic and gestational variables connected with the start and duration of breastfeeding were measured. The frequency of the reasons why breastfeeding was interrupted was determined. At birth 71% of the infants included in this study were exclusively breastfed. After 4 mo the percentage had dropped to 21%. Breast milk was replaced directly by formula (23%) or by a mixture of breast milk and formula (77%). Exclusive breastfeeding was given irrespective of the mother's cultural background. Higher education appeared to be the most decisive factor for the initiation of exclusive breastfeeding; higher parity was found to be the most decisive factor for continuation. In 46% of cases the infant's health and behaviour caused mothers to stop exclusive breastfeeding; in 38% the reasons were mother related; in 17% both mother- and infant-related motives were mentioned. CONCLUSION: Mothers' perception of hunger and crying colics were the main infant-related reasons for cessation of breastfeeding, whereas physical problems, return to work, doubt about the sufficiency of breast milk and the feeling of being restricted by breastfeeding were the main mother-related reasons. The decision to abandon exclusive breastfeeding was made primarily by mothers (71%). In The Netherlands more babies are breastfed at birth than was the case 10 y ago, but the duration of the breastfeeding period has become shorter.

Adolescent↗

PubMed1986

A cancer education study in The Netherlands based on the AACE/NCI Cancer Education Survey.

A Dutch Cancer Education Study demonstrated that the data collection instruments developed for the U.S. AACE/NCI Cancer Education Survey could also be used for the same kind of studies in foreign countries. Where needed, the data collection instruments were modified to the Dutch national situation. In this way, an impression was obtained on several aspects concerning undergraduate cancer education in the Dutch medical schools. Based on the combined findings of the U.S. Cancer Education Survey and the Dutch Cancer Education Study, a number of recommendations can be made for application to student cancer education in The Netherlands.

Education, Medical, Undergraduate↗

PubMed1991

Role of the general practitioner in breast cancer screening in The Netherlands.

Following the advice of the Dutch National Health Council, a national screening program for breast cancer was started in 1990 in the Netherlands. All women aged 50-70 will be invited for screening by mammography in fixed or (semi)mobile screening units every 2 years. The role of the general practitioner in screening for breast cancer is described in the Dutch protocol (Standard) published in 1990 by the Dutch College of General Practitioners. Because of the role of the general practitioner/family doctor as a gatekeeper and because of the list system, every Dutch woman is known by her own general practitioner. In any given year the general practitioner will see 70% of his population. So the general practitioner is in the position to play an important role in practice and patient-centered support of breast cancer screening. The general practitioner also has an important role in the support of women with positive results. The general practitioner receives the "abnormal" results and has to explain to the woman what this means and what further investigations are necessary. There are teaching programs on screening for breast cancer for the vocational training of general practitioners and for postgraduate training.

Aged↗

PubMed2006

A local and regional Alcohol and Drugs Monitor in the Netherlands: a tale of three cities.

Local and regional policymakers, care providers and prevention workers involved in addiction and addiction care need timely and reliable information. As few data on substance use are available at a local or regional level, an integrated local or regional monitoring system for alcohol and drugs (MAD) was developed. The MAD consists of four modules: a local social and information map, analyses of registration data of (addiction) care organisations, a local/regional survey among the general population and a community-based drug monitoring system aimed at collecting data on hard drug users. Both quantitative and qualitative research methods are used. This paper presents an overview of the MAD results with respect to alcohol and illicit drug use. Both quantitative and qualitative results show a substantial variation between regions, even in a country as small as the Netherlands. The study shows that a monitoring system can be an important source of information for local addiction policy, care and prevention.

Adolescent↗

PubMed2000

Health care utilization by people with multiple sclerosis in The Netherlands: results of two separate studies.

PURPOSE: For chronically ill persons it is assumed that they make heavy demands on health care services. In the literature one hardly finds any publications to substantiate or refute this assumption. The main purpose of our study is to describe the health care utilization of people with multiple sclerosis (MS) in the Netherlands and its relationships with severity and duration of the disease. METHODS: Two different samples of persons with MS were used. In the first sample (University Hospital Groningen) severity of MS was based on medical judgement, while in the second sample (Dutch Multiple Sclerosis Society) severity was self-reported. In both samples, use of health care facilities was assessed with a mail questionnaire. RESULTS: The methods for determining severity resulted in different distributions for severity of MS. However, the results were quite similar with respect to health care utilization. It appeared that the severity of MS was related to the number of professional caretakers MS-patients had contact with during one year. Duration of MS seemed not to be related to the number of caretakers. Only for specific caretakers, most notably GP, physiotherapist, home help and ergotherapist, the contact frequency increased with severity of MS. No such relationship was found between the frequency of contact with the neurologist and severity of MS. CONCLUSIONS: People with MS do not make a heavy demand on health care facilities in general but only on certain health care provisions. This is in contrast with the general notion that all chronically ill make a heavy demand on health care facilities in general.

Adult↗

PubMed2005

Health problems of persons with spinal cord injury living in the Netherlands.

PURPOSE: To investigate the prevalence of health problems among persons with spinal cord injury (SCI) living in the Netherlands, to identify the problems experienced as most important, and to analyse the experienced impact of these most important problems on daily activities and social life. METHOD: Postal survey among all members of the Dutch Association of Patients with SCI. The questionnaire focused on 26 health problems: 13 secondary impairments, 8 problems of daily living and 5 psychosocial problems. RESULTS: The respondents (response rate 45.5%, 454 persons) experienced an average of 8 health problems. The most frequently occurring problems regarded bladder and bowel regulation, spasms, pain, oedema and sexuality. Except for oedema, these problems were also most often cited as the most important. The most disabling condition for both daily and social activities was pain. Few significant relationships were found between the prevalence of health problems and the level, completeness and duration of the injury or gender. CONCLUSION: Persons with SCI living in the community experience many health problems and limitations in daily activities and social life due to these problems. The occurrence of these problems does not diminish with increasing time after injury. This strongly emphasises the need for follow-up care.

Activities of Daily Living↗

PubMed2003

Analysis of 127 stem cell donations of the regional Bone Marrow Donor Bank Europdonor Nijmegen, The Netherlands.

In December 2000, the Bone Marrow DonorBank Europdonor Nijmegen in The Netherlands celebrated its tenth anniversary. We describe the organisation and activities in the first 10 years of this regional bone marrow donor bank. A concise inquiry was sent to all transplant centres who had received a graft from our donors. Response rate was 88% and data were available from 127 recipients. Three donors donated twice to different patients. Median age of the 124 donors (42 females and 82 males) was 37 years and 30 years for the 127 recipients (48 females and 79 males). Time interval between first request of a blood sample and collection of bone marrow varied from 13 to 695 days (median, 113 days). All but two donors received general anaesthesia for 25-120 min (median; 60 min). Hospital stay has been reduced to 24 h. Most donors experienced pain from the collection sites for 3-5 days. However, 9 donors (7%) suffered from pain for 2-3 weeks. All but two donors (98%) were willing to donate a second time for the same patient and 119 (96%) donors wished to remain in the register. The number of nucleated cells (NC) in the collected marrow varied from 0.2 to 8.3 x 10(8)/kg body weight of the recipient (median, 3.5 x 10(8)/kg) with 6.4-470.0 x 10(4) CFU-GM/kg body weight of the recipient (median, 18.0 x 10(4)/kg body weight). The 3-year projected probability of survival of the 127 recipients transplanted with marrow from donors provided by Bone Marrow Donor Bank Europdonor Nijmegen was 27 +/- 9% (+/-95% CI).

Adult↗

PubMed2000

Daily mortality and air pollution in The Netherlands.

We studied the association of daily mortality with short-term variations in the ambient concentrations of major gaseous pollutants and PM in the Netherlands. The magnitude of the association in the four major urban areas was compared with that in the remainder of the country. Daily cause-specific mortality counts, air quality, temperature, relative humidity, and influenza data were obtained from 1986 to 1994. The relationship between daily mortality and air pollution was modeled using Poisson regression analysis. We adjusted for potential confounding due to long-term and seasonal trends, influenza epidemics, ambient temperature and relative humidity, day of the week, and holidays, using generalized additive models. Influenza episodes were associated with increased mortality up to 3 weeks later. Daily mortality was significantly associated with the concentration of all air pollutants. An increase in the PM10 concentration by 100 micrograms/m3 was associated with a relative risk (RR) of 1.02 for total mortality. The largest RRs were found for pneumonia deaths. Ozone had the most consistent, independent association with mortality. Particulate air pollution (e.g., PM10, black smoke [BS]) was not more consistently associated with mortality than were the gaseous pollutants SO2 and NO2. Aerosol SO4(-2), NO3-, and BS were more consistently associated with total mortality than was PM10. The RRs for all pollutants were substantially larger in the summer months than in the winter months. The RR of total mortality for PM10 was 1.10 for the summer and 1.03 for the winter. There was no consistent difference between RRs in the four major urban areas and the more rural areas.

Adolescent↗

PubMed2000

Treatment of impending and actual pathological femoral fractures with the long Gamma nail in The Netherlands.

OBJECTIVE: To compare the results of stabilising impending and actual pathological femoral fractures using the long Gamma nail with the published results of other methods. DESIGN: Retrospective study. SETTING: 20 hospitals throughout The Netherlands. PATIENTS: 101 patients with metastases in 110 femurs, which were stabilised with a long Gamma nail. MAIN OUTCOME MEASURES: Functional results and complications. RESULTS: Minimum follow-up was 1.5 years or until death, Mean survival was 12 months (range 0-82). 14 patients died in hospital; 5 had technical complications and fat embolism was suspected in 3 patients. 92% of the patients became mobile and pain was absent or acceptable in 93%. CONCLUSION: The use of the long Gamma nail produces better functional results, fewer technical complications, and an incidence of general complications no different from those reported for other methods.

Aged↗

PubMed2002

Bodypacking--an increasing problem in The Netherlands: conservative or surgical treatment?

OBJECTIVE: Evaluation of diagnostic work-up and treatment of bodypackers. Identification of predictive factors for surgical treatment. DESIGN: Retrospective descriptive study. SETTING: Teaching hospital, The Netherlands. PATIENTS: All 40 consecutive patients, admitted during the period 1995-99 inclusive to the surgical department with the diagnosis of "bodypacker". MAIN OUTCOME MEASURES: Age, sex, medical history, additional diagnostic investigation, treatment, morbidity, and mortality. RESULTS: There were 36 men and 4 women, the reason for whose visit to the emergency department was the persistence of cocaine packages in the body. 24 had abdominal pain and 15 patients were vomiting. In all cases packages were identified on an abdominal radiograph taken supine. The cocaine concentration in the urine was raised in 8/13 patients. During admission 18/40 patients (45%) were operated on, and in 9 patients (23%) a previously unsuspected lesion was found, which was causing the obstruction. Factors predictive of the need for surgical treatment were: abdominal history (p = 0.01), abdominal pain while in the emergency department (p = 0.001), location of the packages of cocaine in the stomach and small intestine on the abdominal radiograph (p = 0.05), and a high concentration of cocaine in the urine (p = 0.03). 9 of the patients operated on developed complications; no patient died. CONCLUSION: The number of bodypackers admitted to the surgical department increases. More than half the patients could be treated conservatively. Factors predictive of the need for surgery are: abdominal history, pain, high obstruction, and cocaine in the urine. In 9 of the patients operated on an unsuspected disease was found that was causing the obstruction.

Abdomen↗

PubMed2004

Methodological problems related to alcohol research among Turks and Moroccans living in the Netherlands: findings from semi-structured interviews.

OBJECTIVES: To identify factors related to alcohol use among Turks and Moroccans living in the Netherlands. Furthermore, to reveal methodological problems related to research among Turks and Moroccans in general and to alcohol research among these groups in particular. DESIGN: Individual face-to-face interviews were carried out with Dutch researchers (n = 9), Turkish and Moroccan (health) practitioners working in the field with Turks (n = 4) or Moroccans (n = 2), and members of the target population with a Turkish (n = 3) or a Moroccan background (n = 2). Furthermore, focus-group interviews were held with Turkish women (n = 4), Turkish men (n = 3), Moroccan women (n = 4) and Moroccan men (n = 3) working as health professionals. RESULTS: Alcohol use seems prevalent particularly among second-generation Turks and Moroccans and is related to: upbringing, influence of peer groups, integration and the degree in which Islamic rules are practised. Written questionnaires seem more appropriate for second-generation Turks and Moroccans, because they have fewer language problems and are more familiar with Western bureaucratic society. However, both generations may prefer face-to-face interviews since both groups fear that 'written' answers about the sensitive subject 'alcohol use' may somehow become known among community members. Similarly, an interviewer with a Dutch background may elicit more reliable answers about alcohol use than an interviewer with a Turkish or Moroccan background. CONCLUSION: In alcohol research special attention should be paid to second-generation Turks and Moroccans. Although it is probably easier to conduct alcohol studies in this group than in first-generation Turks and Moroccans, quantitative research is needed to test the hypothesis that written questionnaires elicit more reliable answers about alcohol use than face-to-face interviews. Furthermore, the influence of ethnic matching on response and data quality should be tested further.

Alcohol Drinking↗

PubMed2006

Internalising and externalising behaviours in young adults: Dutch natives and Turkish migrants in the Netherlands.

OBJECTIVE: To compare the prevalence of internalising and externalising behaviour of Dutch and Turkish migrant young adults in the Netherlands. We will also assess associations with socio-economic position. METHOD: Dutch natives (1,236) and Turkish migrants (438), age 18-28, completed the Young Adult Self-Report. Scores above the 90th percentile of the distribution of the Dutch sample were defined as deviant. RESULTS: Turkish migrants more often reported deviant scores than natives for internalising problems, especially for the Anxious/Depressed syndrome. For externalising problems, Turkish migrants less often had deviant scores for Intrusive Behaviour, whereas Turkish women more often had deviant scores for Aggressive and Delinquent Behaviour. Similar results were found for comparison between mean scores. After adjustment for socio-economic position, the disparities in men remained, whereas disparities in women largely disappeared. CONCLUSION: Compared with Dutch young adults, Turkish migrant young adults reported more problems. Ethnic disparities were strongly associated with socio-economic disparities among women, but not among men.

Adolescent↗