Repository hosted by TU Delft Library

The Social Medical Survey of Children attending Child Health Clinics (SMOCC) was initiated to obtain reference data on morbidity in children in their first two years of life. During 1988 and 1989, the staff of 21 Child Health Clinics recorded data on the pre- and perinatal period, and on the first two years of life, of infants born in the geographically defined catchment areas of these clinics. The cohort is representative of the newborn population of the Netherlands with respect to mother's age at delivery, parity and, to a somewhat lesser extent the level of maternal education and degree of urbanization of residential area. The incidence of preterm birth and of very preterm birth in the sample was 6.8% and 0.66%, respectively. Incidence of low birthweight and of very low birthweight was 6.0% and 0.71%, respectively. Birthweights of singleton infants were in accordance with the national standard (the Amsterdam intrauterine growth charts).

It remains unclear if patients with different types of common mental disorders, such as adjustment, anxiety and depressive disorders, have the same irrational ideas. The aim of this prospective cohort study (n = 190) is to investigate differences in level and type of irrational beliefs among these groups and to examine whether a change in irrational beliefs is related to symptom recovery. Irrational beliefs (IBI) and symptoms were measured at four points in time: at baseline, after 3, 6 and 12 months. Results showed that diagnostic groups differed in their level of irrational beliefs and this effect remained over time. Highest levels of irrationality were observed in the double diagnosis group, followed by the anxiety disorder group and the depression group. Participants with adjustment disorders showed the lowest levels of irrationality, comparable to a community sample. We did not find differences in the type of irrational beliefs between diagnostic groups. The level of irrationality declined over time for all diagnostic groups. No differences in decrease were observed between diagnostic groups. The magnitude and direction of change in irrational beliefs were related to the magnitude of recovery of depressive, anxiety and stress symptoms over time. These results support the application of general cognitive interventions, especially for patients with a depressive or an anxiety disorder. © The Author(s) 2007.

Often developmental psychologists see children only after referral from physicians. Do pediatricians recognize which children in a known risk group are in need of a cognitive evaluation? A judgment by pediatricians, based on an assessment using a parent questionnaire, the Denver Developmental Screening Test (DDST) and the overall impression during a systematic examination, was compared in 368 very preterm children, not yet diagnosed with cognitive impairments, to the results of an intelligence test. The pediatric assessment moderately identified preterm children with cognitive developmental problems. A low score on the DDST part of the pediatric assessment and information on extra assistance at school or grade retention, best indicated which children should be referred. Preterm born children known to need extra assistance at school at 5 years of age, should be referred for cognitive assessment by a child psychologist, in view of their risk for difficulties in cognitive functioning and associated problems. © 2007 Springer Science+Business Media, LLC.

The evolution of bone lesions in transplantable C57BL/KaLwRij 5T mouse myeloma (MM) has been followed in vivo. Mice were anaesthetised and a radiograph of the pelvis and hind legs was performed by a radiograph dedicated for mammography. This is the first description of an in vivo technique under experimental conditions whereby the development of bone lesions owing to the MM growth was demonstrated.

Background. Narrative reviews have concluded that there is a small association between coffee consumption and an increased risk of urinary tract cancer, possibly due to confounding by smoking. No association for tea consumption has been indicated. This systematic review attempts to summarize and quantify these associations both unadjusted and adjusted for age, smoking and sex. Method. Thirty-four case-control and three follow-up studies were included in this systematic review. Summary odds ratios (OR) were calculated by meta-regression analyses. Results. The unadjusted summary OR indicated a small increased risk of urinary tract cancer for current coffee consumers versus non-drinkers. The adjusted summary OR were: 1.26 (95% CI : 1.09-1.46) for studies with only men, 1.08 (95% CI : 0.79-1.46) for studies with only women and 1.18 (95% CI : 1.01-1.38) for studies with men and women combined. Neither unadjusted nor adjusted summary OR provided evidence for a positive association between tea consumption and urinary tract cancer. Even though studies differed in methodology, the results were rather consistent. We did not perform dose-response analyses for coffee and tea consumption due to sparse data. Conclusions. In accordance with earlier reviews, we found that coffee consumption increases the risk of urinary tract cancer by approximately 20%. The consumption of tea seems not to be related to an increased risk of urinary tract cancer.

Background. Disasters are believed to have large effects on the mental health of adolescents but the lack of prospective pre- and post-disaster data on affected and control populations have limited our knowledge on the validity of these claims. We examined the medium-term, 12 months' effects of a severe disaster on the mental health of adolescents, and compared them to effects after 5 months. Method. A café fire in The Netherlands injured 250 adolescents and killed 14. We obtained data 15 months before and 12 months after the disaster about behavioural and emotional problems (using the Youth Self-Report) and substance misuse, in 124 students of an affected school of whom 31 were present at the fire (response 77.5 %) and 830 other students (56.4 %); mean age at baseline, 13-8 years. Results. We found differences between students from the affected school and others for excessive use of alcohol (odds ratio 3.42, 95% confidence interval 2.00-5.85, p<0.0001), but not for behavioural and emotional problems and use of other substances. Effects had decreased compared to those after 5 months. Conclusions. In the long run, the effects of disaster decrease regarding self-reported behavioural and emotional problems, but they remain regarding alcohol misuse among those present at the disaster, and their peers. © 2004 Cambridge University Press.

Published trends and geographical differences in cryptorchidism rates are almost exclusively derived from, hospital-based birth defect registers, which are sensitive to selection bias and incomplete reporting. This study aimed to accurately assess the cryptorchidism prevalence in the general population of Rotterdam. Of 7652 consecutive male live births, 7292 (95%) were examined for cryptorchidism at Child Healthcare Centres around the age of 1 month. In a subgroup of cases, the persistence of cryptorchidism was re-assessed during a follow-up examination by expert specialists. The cryptorchidism rate at the median age of 35 days was 1.2% (89/7292). In the reexamined subgroup (median age 95 days) 69% of the boys (24/35) had persistent cryptorchidism, of which 20 were unilateral and four bilateral. The population rate of 1.2% falls within the range of 0.9-9% reported by others. Differences in case ascertainment and population characteristics probably explain part of the differences between studies. Our cross-sectional design does not allow for analysis of a temporal trend, but provides a baseline for future trend studies. To study cryptorchidism rates, trends, and risk factors, a systematic case ascertainment is warranted. © 2005 Blackwell Publishing Ltd.

The apolipoprotein E4 allele (APOEε4) and atherosclerosis are risk factors for cognitive decline. We investigated whether the effects of APOEε4 and atherosclerosis on cognitive decline are independent. A population-based follow-up study was performed on 838 subjects who were non-demented at baseline. The Mini Mental State Examination (MMSE) score at follow-up was studied as a function of APOEε4 and atherosclerosis. Mild, non-significant effects on the MMSE score were found for atherosclerosis in the absence of APOEε4 and for APOEε4 in the absence of atherosclerosis. APOEε4 carriers with two or more indicators of atherosclerosis positive, had a significantly lower MMSE score at follow-up (mean difference -0.7 points; 95% confidence interval -1.1 to -0.2) relative to non-APOEε4 carriers with no evidence of atherosclerosis. Our findings suggest that the consequences of APOEε4 and atherosclerosis are not independent, and that particularly APOEε4 carriers with atherosclerosis are at increased risk of cognitive decline.

Background: Evidence on the relation between trans fatty acid intake and coronary heart disease is limited. We investigated this relation in a Dutch population with a fairly high trans fatty acid intake, including trans fatty acids from partly hydrogenated fish oils. Methods: We prospectively studied 667 men of the Zutphen Elderly Study aged 64-84 years and free of coronary heart disease at baseline. We used dietary surveys to establish the participants' food consumption patterns. Information on risk factors and diet was obtained in 1985, 1990, and 1995. After 10 years of follow-up from 1985-95, there were 98 cases of fatal or non-fatal coronary heart disease. Findings: Between 1985 and 1995, average trans fatty acid intake decreased from 4·3% to 1·9% of energy. After adjustment for age, body mass index, smoking, and dietary covariates, trans fatty acid intake at baseline was positively associated with the 10-year risk of coronary heart disease. The relative risk for a difference of 2% of energy in trans fatty acid intake at baseline was 1·28 (95% CI 1·01-1·61). Interpretation: A high intake of trans fatty acids (all types of isomers) contributes to the risk of coronary heart disease. The substantial decrease in trans fatty acid intake, mainly due to industrial lowering of trans contents in Dutch edible fats, could therefore have had a large public-health impact. Chemicals/CAS: Fatty Acids; Fish Oils

Objectives: Coffee, tea, and fluid consumption have been thought to influence bladder cancer incidence. In a large prospective study, these associations were investigated. Methods: In 1986, cohort members (55-69 years) completed a questionnaire on cancer risk factors. Follow-up was established by linkage to cancer registries until 1992. The multivariable case-cohort analysis was based on 569 bladder cancer cases and 3123 subcohort members. Results: The incidence rate ratios (RR) for men consuming < 2 cups of coffee/day was 0.89 (95% CI 0.51-1.5) using the median consumption category (4-< 5 cups/day) as reference. This RR increased to 1.3 (95% CI 0.94-1.9) for men consuming ≥7 cups/day, although no clear dose-response association was found. The RRs decreased from 1.2 (95% CI 0.56-2.7) for women consuming <2 cups of coffee/day to 0.36 (95% CI 0.18-0.72) for women consuming ≥5 cups/day compared to the median consumption category (3-<4 cups/day). Men and women who abstained from drinking tea had a RR of 1.3 (95% CI 0.97-1.8) compared to those consuming 2-<3 cups of tea per day (median consumption c category). The RR for men and women comparing highest to lowest quintile of total fluid consumption was 0.87 (95% CI 0.63-1.2). Conclusion: The data suggest a possible positive association between coffee consumption and bladder cancer risk in men and a probable inverse association in women. Tea consumption was inversely associated with bladder cancer. Total fluid consumption did not appear to be associated with bladder cancer.

The association between the consumption of onions and leeks (vegetables belonging to the Allium genus), garlic supplements, and the risk of lung carcinoma was investigated in a large-scale prospective cohort study on diet and cancer in the Netherlands. The Netherlands Cohort Study was started in 1986 among 120,852 men and women, ages 55-69 years, by collecting information on usual diet and important life-style characteristics. After 3.3 years of follow-up, 550 incident lung carcinoma cases were observed. Information on Allium vegetable consumption was available for 484 lung carcinoma cases and 3123 members of a randomly sampled subcohort. In stratified analysis, a lower lung carcinoma risk was observed in the highest onion intake category [rate ratio (RR) = 0.65; 95% confidence interval, 0.45-0.95] compared to the lowest consumption category. After including other, dietary and nondietary, determinants of lung carcinoma in the multivariable models and using pack years for past and current smoking, instead of using smoking status categorized as never, ex-, and current smoking, the rate ratio in the highest intake category increased to 0.80 and was no longer significantly different from unity (95% confidence interval, 0.52-1.24). Leek consumption was not associated with risk for lung carcinoma (RR = 1.08; 95% confidence interval 0.80-1.45 in the highest intake category, compared to the lowest). No statistically significant trends in the rate ratios associated with increasing consumption of these vegetables were detected for lung carcinoma or the four histological subtypes. A higher lung carcinoma risk was observed for those subjects who used exclusively garlic supplements (RR = 1.78; 95% confidence interval, 1.08-2.92), compared to those not taking dietary supplements. A lower lung carcinoma risk was seen for those using garlic supplements together with any other supplement (RR = 0.93; 95% confidence interval 0.46-1.86) compared to those using any other supplement. In conclusion, we found no evidence of a relation between the consumption of onions or leeks and the risk of lung carcinoma or any of the histological subtypes. Garlic supplement use seems not associated with a lower risk of lung carcinoma.

Background Data on long-term consequences of preterm birth on pain coping later in life are limited. Aim The aim of this study was to assess whether gestational age, birth weight and neonatal disease severity have an effect on the pain coping strategy in adolescents born preterm or with low birth weight. Study design Observational, longitudinal study. Subjects We analyzed data of 646 children aged 19 years, who were born at a gestational age < 32 weeks or with a birth weight < 1500 g in the year 1983 in the Netherlands. Outcome measures Participants were asked to complete a validated questionnaire that assesses pain coping strategies in eight subscales: information seeking, problem solving, seeking social support, positive self-statement, behavioral distraction, cognitive distraction, externalizing and internalizing. In total, 537 children also completed an IQ test. Results Out of the eight subscales, only behavioral distraction was used more often with increasing gestational age (linear regression analysis, b 0.05, confidence interval CI 0.02–0.08). Behavioral distraction was employed more often by small-for-gestational-age adolescents in comparison with their appropriate-for-gestational age peers (b 0.26, CI 0.09–0.42). However, this effect disappeared when adjusted for gestational age. Intelligence at the age of 19 was significantly correlated with increased use of adaptive strategies (problem solving, positive self-statement, behavioral and cognitive distraction) and less use of maladaptive strategies (internalizing). Conclusions Characteristics at birth and neonatal disease history did not influence pain coping strategy in adolescence. Intelligence, however, moderated pain coping strategy in adolescents born preterm or with low birth weight.

Adults born preterm at very low birth weight (VLBW; <1500 g) have higher blood pressure than those born at term. It is not known whether all VLBW adults are at risk or whether higher blood pressure could be attributed to some of the specific conditions underlying or accompanying preterm birth. To identify possible risk or protective factors, we combined individual-level data from 9 cohorts that measured blood pressure in young adults born at VLBW or with a more stringent birth weight criterion. In the absence of major heterogeneity, we performed linear regression analysis in our pooled sample of 1571 adults born at VLBW and 777 controls. Adults born at VLBW had 3.4 mm Hg (95% confidence interval, 2.2–4.6) higher systolic and 2.1 mm Hg (95% confidence interval, 1.3–3.0) higher diastolic pressure, with adjustment for age, sex, and cohort. The difference in systolic pressure was present in men (1.8 mm Hg; 95% confidence interval, 0.1–3.5) but was stronger in women (4.7 mm Hg; 95% confidence interval, 3.2–6.3). Among the VLBW group, blood pressure was unrelated to gestational age, maternal smoking, multiple pregnancy, retinopathy of prematurity, or bronchopulmonary dysplasia. Blood pressure was higher than that of controls among VLBW adults unexposed to maternal preeclampsia. Among those exposed, it was even higher, especially if born appropriate for gestational age. In conclusion, although female sex and maternal preeclampsia are additional risk factors, the risk of higher blood pressure is not limited to any etiologic subgroup of VLBW adults, arguing for vigilance in early detection of high blood pressure in all these individuals.

Background: Randomised controlled trials (RCTs) are the gold standard to estimate treatment effects. When patients receive effective treatment over time they may reach the limit of a certain measurement scale. This phenomenon is known as censoring and leads to skewed distributions of the outcome variable with an excess of either low (floor effect) or high values (ceiling effect). Applying traditional methods such as linear mixed models to analyse these kind of longitudinal RCT data may result in bias of the regression coefficients. To deal with floor effects due to censoring, a tobit mixed model can be used. The objective of this study was to compare the results of longitudinal linear mixed model analyses with longitudinal tobit mixed model analyses. Methods: A simulation study was performed in which several situations of RCTs with floor effects were simulated. From the simulated datasets, which were set up to estimate the interaction between treatment and time, the regression coefficient for this interaction and for the overall treatment effect were estimated. Additionally, data from an empirical RCT were analysed with both methods. Results: Regarding the interaction between treatment and time, the results of the tobit mixed model analysis were the same as the true values in all conditions, while the linear mixed model analysis revealed highly underestimated regression coefficients. However, the overall treatment effect with an increasing number of follow-up measurements in combination with a strong floor effect showed that the estimates from the tobit mixed model were also not accurate. Conclusion: Tobit mixed model analysis should be used to estimate treatments effects in longitudinal RCTs with floor effects due to censoring. © 2018, Prex S.p.A. All rights reserved.

Human colorectal carcinogenesis has been shown previously to be associated with impressive changes in the tissue levels of plasminogen activators and their inhibitors, exemplified by an increase in the urokinase-type plasminogen activator (u-PA) and the inhibitors PAI-1 and PAI-2, and a decrease in tissue-type plasminogen activator (t-PA). In the present study we evaluated the prognostic significance of these parameters to the overall survival of patients with colorectal cancer, in conjunction with several major clinicopathological parameters like age, gender, differentiation grade, and Dukes' stage. Univariate analyses revealed that a low t-PA antigen level, low t-PA activity, and high u-PA/t-PA antigen ratio in normal mucosa and a high u-PA and PAI-2 antigen level in carcinomas are prognostic for a poor overall survival of patients with colorectal cancer. The prognostic value of t-PA antigen and activity in normal mucosa, the antigen ratio of u-PA in carcinoma (C) and t-PA in corresponding normal (N) mucosa [u-PA(C)/t-PA(N) antigen ratio], and PAI-2 antigen in carcinomas was found to be independent from clinicopathological parameters by multivariate analyses. These observations illustrate the clinical importance of the plasminogen activation cascade at the tissue level in colorectal cancer invasion, metastasis, and survival.

Perinatal mortality in very preterm infants has decreased by up to 50% during the last decades. Studies of changes of long-term outcome are inconclusive. We studied the visual, auditory, neuromotor, cognitive and behavioural development of two geographically defined populations of very preterm, singleton infants, born in 1983 and in 1993, and analysed the relationship between perinatal risk factors and outcomes. The incidence of disabling cerebral palsy increased from 6.0% to 11.1% (OR 2.45 [95% CI 1.11, 5.38]). Impaired vision and strabismus decreased significantly, presumably by continuous monitoring of pO2. Hearing problems, the need for special education and the incidence of behavioural problems did not change over time. The proportion of children who showed optimal performance in every developmental domain increased from 29.5% in 1983 to 43.2% in 1993. Cerebral palsy was associated with male gender in 1983, with low Apgar score and intraventricular haemorrhage in 1993, and with seizures both in 1983 and in 1993. The intensiveness of neonatal treatment has increased, leading to the survival of many more healthy infants, but at the cost of more infants with cerebral damage. Modern perinatal care is no longer limited by the devastating effects of pulmonary problems as it was in the past, but fails to safeguard cerebral integrity in very preterm infants. © 2007 The Authors.

OBJECTIVE. Mass screening for celiac disease is controversial. The objective of this study was to determine whether detection of childhood celiac disease by mass screening improves long-term health status and health-related quality of life. METHODS.We conducted a prospective 10-year follow-up study of 32 children who were aged 2 to 4 years, had celiac disease identified by mass screening, and had a gluten-free diet (19) or a normal gluten-containing diet (13). The follow-up included assessments of general health status, celiac disease-associated symptoms, celiac disease-associated serum antibodies, and health-related quality of life. RESULTS. Ten years after mass screening, 81% of the children were adhering to a gluten-free diet. The health status improved in 66% of the treated children: in 41% by early treatment and in 25% by prevention of the gluten-dependent symptoms that they developed after diagnosis. For 19% of the children, treatment after screening would not have improved their health status, because they had no symptoms at screening and have remained symptom-free while consuming gluten. The healthrelated quality of life of the children with symptoms improved significantly after 1 year of gluten-free diet. Ten years after screening, the health-related quality of life of the children with celiac disease was similar to that of the reference population. CONCLUSION. Identification by mass screening led 10 years later to health improvement in 66% of children without deterioration of generic health-related quality of life. There is a good compliance after mass screening. In a research setting, delaying treatment for children without symptoms seems to be an option after a positive screening test. Long-term follow-up studies are needed to assess possible long-term complications in untreated, nonsymptomatic celiac disease. Copyright © 2009 by the American Academy of Pediatrics.

JGZ