Psychiatric morbidity among adults in The Netherlands: the NEMESIS-Study. I. Objectives, design and methods. Netherlands Mental Health Survey and Incidence Study

OBJECTIVE: To determine prevalence, incidence and course of psychiatric disorders in non-institutionalised Dutch adults. DESIGN: Prospective and cross-sectional. SETTING: Trimbos Institute, Utrecht, the Netherlands. METHOD: A multistage, stratified random sampling procedure was used to obtain a sample of 7076 adults (18-64 years). Respondents were interviewed throughout 1996 in their homes. The main diagnostic instrument was the 'Composite international diagnostic interview' (CIDI), designed to assess lifetime prevalence of mental disorders according to Diagnostic and statistical manual of mental disorders, 3rd revised edition (DSM-III-R). The diagnostic categories were: affective disorders, anxiety disorders, eating disorders, schizophrenia and other non-affective psychoses, and substance use disorders (dependence and abuse). The sample was weighted towards national census data on sex, age, marital status and urbanicity. RESULTS: The results of the first measurement (1996) will be described in the next article (1997:2353-60). The response rate was 64.2%. There were no indications that the psychiatric morbidity of non-respondents differed from respondents. The same respondents will be interviewed again after 12 (1997) and after 36 months (1999).     

Liver transplantation. I. Its history. The indications. Clinical efficacy]

The aim of this study is to present the actual indications of the liver transplantation in adult as well as in children patients. A multicenter comparative study based on the already published reports in Europe and in the United States has been done in order to analyse the survival rates for different liver diseases subjected to liver transplantation, as well as the prevalence of these nosologic entities in different hepato-biliary centers. Such an analysis is badly needed in Romania, where the prevalence of liver diseases is relatively high, and in the context of the initiation of transplantation in our country.     

Inflammatory bowel disease: Part I. Clinical features and diagnosis

Familial and epidemiologic studies of inflammatory bowel disease indicate a strong genetic predisposition that is modified by certain environmental factors. Abnormal submucosal immune activation may be important in the etiology of the disease. Yersinia enterocolitica infection, various "gay bowel syndromes" and other recently described enteric infections often mimic Crohn's disease. An initial barium study is useful in documenting the extent of disease and complications. Endoscopic biopsy confirms the surface appearance and histologic features of inflammatory bowel disease. Newer photodocumentation techniques are expected to improve the comparability of endoscopic observations. Complications of inflammatory bowel disease occur frequently, may involve any organ system and may precede the onset of bowel symptoms.     

The Health Maintenance Organization: I. Historical perspective and current status.

Discusses the history of health maintenance organizations and presents a modal program with special focus on the management of psychotherapy and psychopharmacology. The clinical demands of managed group practice are compared with fee-for-service care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Guideline 'Radiotherapy in non-small-cell lung carcinoma. Working Group, National Organization for Quality Assurance in Hospitals, Netherlands

8000-9000 new patients with lung cancer are diagnosed yearly in the Netherlands. Of these 10-30% can be treated by surgery, which because of co-morbidity or the extent of the disease is impossible in the others. There is agreement on the terms 'curative', 'radical' and 'palliative' radiotherapy: curative radiotherapy aims at cure through destruction of all tumour cells, on the assumption that the neoplasia has not metastasized (this applies to patients with tumours in stage I and II and sometimes in stage III); radical radiotherapy aims at postponement of locoregional tumour growth; this has a positive effect on the patient's duration of survival and quality of life, but it is to be expected that the patient will die from distant metastases (this treatment is indicated for patients with stage IIIA disease); palliative radiotherapy aims at improvement of the quality of life rather than on prolonging the duration of survival. Patients with a stage III tumour (locoregional invasion making surgical treatment impossible but without distant metastases) without complaints should receive radiotherapy, because these patients are candidates for prolonged survival. In the future the best therapy for these patients could be a combined modality (chemotherapy in combination with radiotherapy). Lung cancer patients with an irresectable tumour should be included as often as possible in clinical trials. During treatment checking quality of life, taking into account the objective and the side effects of the treatment, is important. All medical experts who look after the patient, should inform each other on the actual state of health of the patient and any appointments made. A personal file with this information, kept by the patient himself, has been advocated for this purpose.     

Role of the laboratory in the diagnosis and treatment of lead poisoning]

In an experimental canine model, topical application of phenylephrine hydrochloride (Neo-Synephrine) to the urethral mucosa was demonstrated to cause a rise of intraurethral pressure which persisted for over 2 h without any rise of arterial pressure. There was no intraurethral pressure change after the topical application of phentolamine (Regitine) or phenoxybenzamine (Dibenzyline). No effect was observed on the intraurethral pressure following isoprenaline (Isuprel) application, but a marked fall in arterial pressure was observed.     

Cytokines, their receptors and inhibitors. Importance in laboratory diagnosis of rheumatoid arthritis

The present paper reviews the literature on biological activities of human cytokines in homeostasis, as modulated by their secretion, expression of membrane-bound and soluble receptors as well as by means of other cytokines and specific inhibitors, respectively. The role of structure and properties of interleukins 1, 2, 6 and their receptors in pathophysiology and laboratory diagnostics of rheumatoid arthritis, is discussed. Methods of quantitative determination of cytokines are described.     

Dental problems in rabbits and rodents. I. Anatomy, physiology, symptomatology, diagnosis

Anatomy and physiology of the different dentition, the common symptoms and the clinical diagnosis are discussed in the first part of the article on dental and oral problems in rodents and rabbits. In this article (the second part) prognosis, treatment plan, treatment and prevention are described.     

One hundred years of orthopedics in the Netherlands. I. Introduction

One hundred years ago, on 1 May 1898, the Netherlands Orthopaedic Association was founded. This was prompted by the view that general surgeons paid insufficient attention to the treatment of the locomotor system; they were permitted to join the new association, however, at any rate until 1947. It was especially in the last 30 years that orthopaedic surgery underwent major changes. The most striking novelty was arthroplastic surgery. There have also been developments in the treatment of spinal abnormalities, rheumatological surgery, sports medicine, oncology and traumatology.     

Huntington's chorea: clinical aspects, genetics and current diagnosis

Huntington's disease is a late manifesting autosomal dominant neurodegenerative disorder. It is characterized by motor disturbance, loss of cognitive functions and psychiatric manifestations. The disease causing mutation, an unstable DNA sequence in the coding region of the Huntington gene on chromosome 2p, has recently been identified. A trinucleotide [CAG] repeat is expanded over the normal range and can be easily detected by standard laboratory methods. Accurate genetic testing can now be offered in clinically questionable cases and to presymptomatic subjects at risk for Huntington's disease. Furthermore, there is a correlation between the size of the expanded CAG repeat and the age of onset in affected individuals. The predictive value of this correlation, however, is limited due to the range of onset ages found at a given repeat length in large series of patients. Expanded triplet repeats exhibit a marked instability especially in male meiosis with a tendency to further increase during transmission over the generations. This is likely to be the molecular mechanism explaining anticipation, as well as the occurrence of juvenile cases and new mutations.     

Progress in treatment and diagnosis of renal diseases. I. Primary glomerular diseases. 2. Chronic glomerulonephritis]

The formation of dinitrophenylglutathione (DNP-SG) in human colon adenocarcinoma cells was identified and quantified by an HPLC-UV method, following exposure to 1-chloro-2,4-dinitrobenzene (CDNB) at 10 degrees for 40 min. The rate of efflux of DNP-SG at 37 degrees likewise, was measured by monitoring the DNP-SG content in the extracellular medium. Among the polyphenols examined for their action on DNP-SG export, butein was the most potent inhibitor with an IC50 value of 15 microM. The others, in order of decreasing potencies, were quercetin, tannic acid, 2'-hydroxychalcone, 2-hydroxychalcone anIIC50 values in the micromolar range. These polyphenols did not affect the ATP or the glutathione content of the cells. Mg(2+)-ATPase extracted from the plasma membrane of the cells was activated by DNP-SG in a concentration-dependent manner, and the reaction showed saturation kinetics with K(m) and Vmax values of 110 microM and 12.3 nmol/min/mg protein, respectively. However, the six polyphenols mentioned above had negligible effects on the Mg(2+)-ATPase activity, suggesting that this was probably not the target of their inhibitory action. Probenecid, p-trifluoromethoxy-phenylhydrazone (FCCP) and chlorambucil also showed varying degrees of inhibition of the export of DNP-SG.     

Clinical and laboratory indices that enhance the diagnosis of postural tachycardia syndrome

OBJECTIVE: To identify clinical and laboratory indices that improve the diagnosis of the postural tachycardia syndrome (POTS). DESIGN: We assessed associations of orthostatic intolerance by using multivariate regression analysis. MATERIAL AND METHODS: We evaluated autonomic symptoms and autonomic function in 30 patients with POTS, 30 patients with mild orthostatic intolerance, and 19 age- and gender-matched control subjects. Indices of parasympathetic and sympathetic functions were analyzed on the basis of (1) autonomic function tests (head-up tilt), (2) oscillations at respiratory and nonrespiratory frequencies (0.01 to 0.09 Hz) in R-R interval and blood pressure (Wigner distribution), and (3) deterministic component (rescaled range analysis). RESULTS: The four clinical and laboratory indices that independently supported the diagnosis of POTS are as follows: (1) orthostatic heart rate during the first minute of head-up tilt, (2) autonomic deficit (adrenergic autonomic score), (3) loss of spectral powers in R-R interval during head-up tilt at the fifth minute, and (4) severity of orthostatic dizziness, fatigue, palpitations, and shortness of breath. CONCLUSION: Enhancing the sensitivity and specificity of the diagnosis of POTS should be possible by using these four indices. A hyperadrenergic state and distal neuropathy, affecting adrenergic sympathetic cardiovagal fibers, seem to be involved in the pathophysiology of POTS. Certain features suggest brain-stem dysregulation.