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Biomedical subjects

G J Vaandrager

Publications and source records attributed to G J Vaandrager.

18 recordsLinked to original sources
PubMed1994

Increasing incidence of type I diabetes in The Netherlands. The second nationwide study among children under 20 years of age.

OBJECTIVE: A nationwide retrospective study was conducted to assess the incidence of type I diabetes in The Netherlands among children < 20 years of age in 1988-1990. The first study with a similar design covered 1978-1980. RESEARCH DESIGN AND METHODS: The capture-recapture census method was chosen for analysis of the data. A questionnaire was sent to all Dutch pediatricians and internists, and for the ascertainment, a similar questionnaire was sent out separately to members of the Dutch Diabetes Association, which is the national patient association. RESULTS: The average achieved ascertainment rate was 81%. The ascertainment-adjusted annual incidence was 13.2/100,000 for 0- to 19-year-old children, indicating an increase of 23% compared with the 1978-1980 survey; for 0- to 14-year-olds, the increase amounted to 17%. CONCLUSIONS: This study suggests a sustained increase of type I diabetes in The Netherlands because the cumulative incidence studied previously in the 1960-1970 birth cohorts of male army conscripts 18 years of age was also found to rise. In contrast to Northern European countries, an increase in incidence for the age category 0-4 years could not be found.

Adolescent↗
PubMed1992

The incidence of male childhood type 1 (insulin-dependent) diabetes mellitus is rising rapidly in The Netherlands.

This study evaluates the cumulative incidence of Type 1 (insulin-dependent) diabetes mellitus in male army conscripts 0-18 (inclusive) years of age in the Netherlands (birth cohorts) over 10 years. Data from 2136 cases were retrieved from files of the conscript registry of the Royal Dutch Army. Ascertainment was sought by the capture-recapture method, achieving an average ascertainment rate of 89.7%. Poisson regression modelling was used to determine the change in incidence over time. A significant non-linear increase in the incidence of insulin-dependency in the birth cohorts of 1960-1970 was found. The cumulative incidences of the early birth cohorts 1.85/1000 (1960), 1.76/1000 (1961), 1.11/1000 (1962) were considerably lower than of the later birth cohorts 1.96/1000 (1968), 2.11/1000 (1969), 2.12/1000 (1970). Overall the risk of Type 1 diabetes increased on the average 4.4% with each annual birth cohort. Only for the 1962 birth cohort was a significant dip in the incidence observed. The results indicate a rapidly increasing incidence of diabetes in males in the Netherlands consistent with the concurrent rapid rise in Northern Europe, found in both sexes.

Adolescent↗
PubMed1990

[15 years of national screening for phenylketonuria in The Netherlands; 4th Report of the National Commission for Management of Phenylketonuria].

In the period 1st September 1974 to 1st January 1989 2,511,000 infants (99.3% of all livebirths) were screened for PKU. Treatment was required in 158 of the 330 referred infants. The diagnosis of these 158 patients was PKU (137), hyperphenylalaninaemia (HPA) (19) and malignant HPA (2). Three cases had a false-negative screening result. The prevalence of PKU, treated HPA and malignant HPA in the Netherlands is 1:18,000, 1:132,000 en 1:1,300,000. Height adjusted for age was in 24% of the patients with PKU of Dutch parents and weight adjusted for height in 11% under the 10th centile. Ninety per cent of the patients with PKU of 5 years and older attended primary or secondary school, compared with 95% in the general population.

Community Participation↗
PubMed1985

[Preventive screening in Child Health Services].

Early detection in the framework of secondary prevention is an important task, although not the only one, of youth health care, 'the preventive and socio-medical complement of curative medicine'. The primary aim of youth health care is 'promoting and protecting health, growth and development of children and youths'. Periodic health examinations (PHE'S) are an effective and efficient mean to this end. Like all medical consultations PHE is characterised by the integration of its two components: the analysis which focuses on the individual child and its environment (history and physical examination) and the synthesis (general health education and specific counseling). Moreover PHE provides the basis for epidemiological research, collective health education and policy-planning. Complementary examination of a child, usually less extensive than PHE, is executed on the basis of an individual indication. For practical reasons groups of children may be examined in screening-programs. It is preferable to incorporate screening results in the total medical assessment, which is the result of a series of individual PHE'S. Fractionated and isolated screening-programs are not in accordance with the intrinsic value of youth health care. Therefore an integral approach of the child and its environment demands the maximum incorporation into the PHE of systematic and standardized methods of examination. The concept of the 'group at risk' threatens to supplant the search for the 'child at risk'. Collective health education programs are supplementary to individual counseling and health education, but cannot replace the latter.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Incidence of childhood diabetes in The Netherlands: a decrease from north to south over north-western Europe?

The incidence of childhood diabetes (0-19 years of age) in The Netherlands, where there is no nationalized health-care system, was investigated retrospectively in the years 1978 to 1980 inclusive. The method chosen was a questionnaire among all Dutch paediatricians and internal physicians acting as consultants. Ascertainment was by the same questionnaire held separately among the large Dutch membership of the Dutch Diabetes Association, employing the capture-recapture census method for calculation. For paediatricians the ascertainment was 94%, for specialists in internal medicine 75%. Before correction for ascertainment 1271 children were registered in the two surveys. The ascertainment-corrected annual incidence was 10.95/100000 for 0-19-year-old children, lower than in any other ascertained survey in north-western Europe published so far. The male:female ratio was the same as in other studies and no local geographical differences were found. Seasonal variation was absent in children 0-10 years old in the month the first insulin injection was administered. The data support the influence of unknown exogenous factors associated with the clinical onset of childhood diabetes.

Adolescent↗
PubMed1980

Increased blood pressure in schoolchildren related to high sodium levels in drinking water.

The relationship between sodium in drinking water and blood pressure was examined in 348 schoolchildren aged 7.7 to 11.7 years. They were born and living in three areas with different levels of sodium in the public drinking water. Sodium content of the water was either long-term low, long-term high, or short-term high. The three communities are closely comparable according to demographic characteristics. The mean values of systolic and diastolic blood pressure were higher in the high sodium areas. After adjustment for dissimilarities in distributions of weight, height, pulse rate, age, family history of hypertension, and time of blood pressure measurement, these differences remained constant, ranging from 1.8 to 4.0 mm Hg. Girls and boys showed essentially the same differences. Mean 24-hour sodium excretion was somewhat higher in the long-term low area; no differences were found in sodium-creatinine ratio. The regression coefficients between sodium excretion and blood pressure were not significant. The findings from this retrospective follow-up study support the hypothesis that sodium intake influences blood pressure. The association seems to be of a relatively short-term nature, as no differences in blood pressure levels were found between the long-term and short-term high areas.

Blood Pressure↗