Implementation of additional targeted vaccinations to prevent infectious diseases in the elderly ... more Implementation of additional targeted vaccinations to prevent infectious diseases in the elderly is under discussion in different countries. When considering the added value of such preventive measures, insight in the current disease burden will assist in prioritization. The aim of this study was to estimate the disease burden in adults aged 50 years and over for influenza, pertussis, pneumococcal disease and herpes zoster. The average annual disease burden for these four diseases in the Netherlands was calculated for the period 2010-2013 using the disability-adjusted life years (DALY) measure. Disease models and parameters were obtained from previous research. Where possible we adapted these models specifically for older adults and applied age-specific parameters derived from literature. The disease burden based on these adapted models and parameters was compared with the disease burden based on the general population models. The estimated average annual disease burden was from hig...
SamenvattingDiagnostiek is een stapsgewijs proces. Al vroeg tijdens een consult schiet ons een aa... more SamenvattingDiagnostiek is een stapsgewijs proces. Al vroeg tijdens een consult schiet ons een aantal diagnoses te binnen, de ene wat waarschijnlijker dan de andere. Hoe waarschijnlijk een diagnose in die fase is, hangt samen met het vóórkomen van de aandoening. Hoe vaker een aandoening voorkomt, hoe groter de voorafkans. Zo is bij een patiënt die met diarree bij de huisarts komt de voorafkans op een endocriene tumor zeer klein; de voorafkans op een virale enteritis is echter groot. In de spreekkamer van de internist zullen die kansen heel anders verdeeld zijn.
Canadian family physician Médecin de famille canadien, 2008
To review the evidence regarding the treatment and prevention of herpes labialis. The evidence re... more To review the evidence regarding the treatment and prevention of herpes labialis. The evidence relating to treatment and prevention of herpes labialis is derived from randomized controlled trials (level I evidence). Treatment with an indifferent cream (zinc oxide or zinc sulfate), an anesthetic cream, or an antiviral cream has a small favourable effect on the duration of symptoms, if applied promptly. This is also the case with oral antiviral medication. If antiviral medicine (cream or oral) is started before exposure to the triggering factor (sunlight), it will provide some protection. Research on sunscreens has shown mixed results: some protection has been reported under experimental conditions that could not be replicated under natural conditions. In the long term, the number of relapses of herpes labialis can be limited with oral antiviral medication. Only prompt topical or oral therapy will alleviate symptoms of herpes labialis. Both topical and oral treatment can contribute to...
Nederlands tijdschrift voor geneeskunde, Jan 27, 2008
The first revision of the guideline 'Influenza and influenza vaccination' from the Dutch ... more The first revision of the guideline 'Influenza and influenza vaccination' from the Dutch College of General Practitioners contains the new indications for influenza vaccination. The most important revisions are: the minimum age has been lowered from 65 to 60 years, the indication for furunculosis patients and their families has been removed, and vaccination is recommended to healthcare professionals who have regular and intensive contact with patients. The purpose of vaccinating healthcare professionals against influenza is to reduce the transmission of the influenza virus to patients at very high risk of complications from influenza and reduce sick leave among healthcare professionals. The use of antiviral agents should only be considered for patients with a very high risk of complications from influenza.
Our systematic review summarizes the evidence about the accuracy of those tests. We performed a l... more Our systematic review summarizes the evidence about the accuracy of those tests. We performed a literature search of MEDLINE (1966-1999) and EMBASE (1988-1999) with additional reference tracking. Articles written in English, French, German, or Dutch, that addressed the accuracy of at least one physical diagnostic test for meniscus injury with arthrotomy, arthroscopy, or magnetic resonance imaging as the gold standard were included. We excluded studies if no reference group or only test-positives had been included, if the study pertained to cadavers only, or if only physical examination under anesthesia was considered. Two reviewers independently selected studies, assessed the methodologic quality, and abstracted data using a standardized protocol. We calculated sensitivity, specificity, and likelihood ratios for each test, and summary estimates when appropriate and possible. Of 402 identified studies, 13 met the inclusion criteria. The results of the index and reference tests were a...
SamenvattingBegin jaren ’60 bleek het slaapmiddel thalidomide, dat ook gepropageerd werd als medi... more SamenvattingBegin jaren ’60 bleek het slaapmiddel thalidomide, dat ook gepropageerd werd als medicijn tegen ochtendmisselijkheid, ernstige teratogene bijwerkingen te hebben: foto’s van pasgeboren kinderen met onderontwikkelde of afwezige ledematen haalden de wereldpers en het middel werd internationaal in de ban gedaan. Dit Softenondrama versnelde de oprichting van een toezichthoudende geneesmiddelenautoriteit, het College ter Beoordeling van Geneesmiddelen (CBG). Anno 2008 is, gesteund door hetzelfde CBG, het verguisde middel weer beschikbaar; niet als slaapmiddel, maar onder bijzondere omstandigheden voor de behandeling van onder andere de ziekte van Kahler en lepra. Een betere illustratie van het spanningsveld van werkzaamheid en veiligheid van geneesmiddelen is niet denkbaar.
Implementation of additional targeted vaccinations to prevent infectious diseases in the elderly ... more Implementation of additional targeted vaccinations to prevent infectious diseases in the elderly is under discussion in different countries. When considering the added value of such preventive measures, insight in the current disease burden will assist in prioritization. The aim of this study was to estimate the disease burden in adults aged 50 years and over for influenza, pertussis, pneumococcal disease and herpes zoster. The average annual disease burden for these four diseases in the Netherlands was calculated for the period 2010-2013 using the disability-adjusted life years (DALY) measure. Disease models and parameters were obtained from previous research. Where possible we adapted these models specifically for older adults and applied age-specific parameters derived from literature. The disease burden based on these adapted models and parameters was compared with the disease burden based on the general population models. The estimated average annual disease burden was from hig...
SamenvattingDiagnostiek is een stapsgewijs proces. Al vroeg tijdens een consult schiet ons een aa... more SamenvattingDiagnostiek is een stapsgewijs proces. Al vroeg tijdens een consult schiet ons een aantal diagnoses te binnen, de ene wat waarschijnlijker dan de andere. Hoe waarschijnlijk een diagnose in die fase is, hangt samen met het vóórkomen van de aandoening. Hoe vaker een aandoening voorkomt, hoe groter de voorafkans. Zo is bij een patiënt die met diarree bij de huisarts komt de voorafkans op een endocriene tumor zeer klein; de voorafkans op een virale enteritis is echter groot. In de spreekkamer van de internist zullen die kansen heel anders verdeeld zijn.
Canadian family physician Médecin de famille canadien, 2008
To review the evidence regarding the treatment and prevention of herpes labialis. The evidence re... more To review the evidence regarding the treatment and prevention of herpes labialis. The evidence relating to treatment and prevention of herpes labialis is derived from randomized controlled trials (level I evidence). Treatment with an indifferent cream (zinc oxide or zinc sulfate), an anesthetic cream, or an antiviral cream has a small favourable effect on the duration of symptoms, if applied promptly. This is also the case with oral antiviral medication. If antiviral medicine (cream or oral) is started before exposure to the triggering factor (sunlight), it will provide some protection. Research on sunscreens has shown mixed results: some protection has been reported under experimental conditions that could not be replicated under natural conditions. In the long term, the number of relapses of herpes labialis can be limited with oral antiviral medication. Only prompt topical or oral therapy will alleviate symptoms of herpes labialis. Both topical and oral treatment can contribute to...
Nederlands tijdschrift voor geneeskunde, Jan 27, 2008
The first revision of the guideline 'Influenza and influenza vaccination' from the Dutch ... more The first revision of the guideline 'Influenza and influenza vaccination' from the Dutch College of General Practitioners contains the new indications for influenza vaccination. The most important revisions are: the minimum age has been lowered from 65 to 60 years, the indication for furunculosis patients and their families has been removed, and vaccination is recommended to healthcare professionals who have regular and intensive contact with patients. The purpose of vaccinating healthcare professionals against influenza is to reduce the transmission of the influenza virus to patients at very high risk of complications from influenza and reduce sick leave among healthcare professionals. The use of antiviral agents should only be considered for patients with a very high risk of complications from influenza.
Our systematic review summarizes the evidence about the accuracy of those tests. We performed a l... more Our systematic review summarizes the evidence about the accuracy of those tests. We performed a literature search of MEDLINE (1966-1999) and EMBASE (1988-1999) with additional reference tracking. Articles written in English, French, German, or Dutch, that addressed the accuracy of at least one physical diagnostic test for meniscus injury with arthrotomy, arthroscopy, or magnetic resonance imaging as the gold standard were included. We excluded studies if no reference group or only test-positives had been included, if the study pertained to cadavers only, or if only physical examination under anesthesia was considered. Two reviewers independently selected studies, assessed the methodologic quality, and abstracted data using a standardized protocol. We calculated sensitivity, specificity, and likelihood ratios for each test, and summary estimates when appropriate and possible. Of 402 identified studies, 13 met the inclusion criteria. The results of the index and reference tests were a...
SamenvattingBegin jaren ’60 bleek het slaapmiddel thalidomide, dat ook gepropageerd werd als medi... more SamenvattingBegin jaren ’60 bleek het slaapmiddel thalidomide, dat ook gepropageerd werd als medicijn tegen ochtendmisselijkheid, ernstige teratogene bijwerkingen te hebben: foto’s van pasgeboren kinderen met onderontwikkelde of afwezige ledematen haalden de wereldpers en het middel werd internationaal in de ban gedaan. Dit Softenondrama versnelde de oprichting van een toezichthoudende geneesmiddelenautoriteit, het College ter Beoordeling van Geneesmiddelen (CBG). Anno 2008 is, gesteund door hetzelfde CBG, het verguisde middel weer beschikbaar; niet als slaapmiddel, maar onder bijzondere omstandigheden voor de behandeling van onder andere de ziekte van Kahler en lepra. Een betere illustratie van het spanningsveld van werkzaamheid en veiligheid van geneesmiddelen is niet denkbaar.
Uploads
Papers