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Biomedical subjects

M Huisman

Publications and source records attributed to M Huisman.

At least 19 recordsLinked to original sources
PubMed2005

Socioeconomic status and ischaemic heart disease mortality in 10 western European populations during the 1990s.

OBJECTIVE: To assess the association between socioeconomic status and ischaemic heart disease (IHD) mortality in 10 western European populations during the 1990s. DESIGN: Longitudinal study. SETTING: 10 European populations (95,009,822 person years). METHODS: Longitudinal data on IHD mortality by educational level were obtained from registries in Finland, Norway, Denmark, England/Wales, Belgium, Switzerland, Austria, Turin (Italy), Barcelona (Spain), and Madrid (Spain). Age standardised rates and rate ratios (RRs) of IHD mortality by educational level were calculated by using Poisson regression. RESULTS: IHD mortality was higher in those with a lower socioeconomic status than in those with a higher socioeconomic status among men aged 30-59 (RR 1.55, 95% confidence interval (CI) 1.51 to 1.60) and 60 years and over (RR 1.22, 95% CI 1.21 to 1.24), and among women aged 30-59 (RR 2.13, 95% CI 1.98 to 2.29) and 60 years and over (RR 1.36, 95% CI 1.33 to 1.38). Socioeconomic disparities in IHD mortality were larger in the Scandinavian countries and England/Wales, of moderate size in Belgium, Switzerland, and Austria, and smaller in southern European populations among men and younger women (p < 0.0001). For elderly women the north-south gradient was smaller and there was less variation between populations. No socioeconomic disparities in IHD mortality existed among elderly men in southern Europe. CONCLUSIONS: Socioeconomic disparities in IHD mortality were larger in northern than in southern European populations during the 1990s. This partly reflects the pattern of socioeconomic disparities in cardiovascular risk factors in Europe. Population wide strategies to reduce risk factor prevalence combined with interventions targeted at the lower socioeconomic groups can contribute to reduce IHD mortality in Europe.

Adult↗
PubMed2005

Inequalities in the prevalence of smoking in the European Union: comparing education and income.

BACKGROUND: The aim of the study was to determine whether education or income was more strongly related to smoking in the European Union at large, and within the individual countries of the EU, at the end of the 1990s. METHODS: We related smoking prevalence to education and income level by analyzing cross-sectional data on a total of 48,694 men and 52,618 women aged 16 and over from 11 countries of the European Union in 1998. RESULTS: Both education and income were related to smoking within the European Union at large. After adjustment of the other socioeconomic indicator, education remained related to smoking in the EU at large, but income only remained so among men. Educational inequalities were larger than income-related inequalities among younger and middle-aged men and women. Educational inequalities were larger than income-related inequalities among men in all individual countries, and among women in Northern Europe. For women from Southern European countries, the magnitude of education- and income-related inequalities was similar. CONCLUSIONS: Education is a strong predictor of smoking in Europe. Interventions should aim to prevent addiction to smoking among the lower educated, by price policies, school-based programs, and smoking cessation support for young adults.

Adolescent↗
PubMed2005

Education level inequalities and transportation injury mortality in the middle aged and elderly in European settings.

OBJECTIVE: To study the differential distribution of transportation injury mortality by educational level in nine European settings, among people older than 30 years, during the 1990s. METHODS: Deaths of men and women older than 30 years from transportation injuries were studied. Rate differences and rate ratios (RR) between high and low educational level rates were obtained. RESULTS: Among men, those of low educational level had higher death rates in all settings, a pattern that was maintained in the different settings; no inequalities were found among women. Among men, in all the settings, the RR was higher in the 30-49 age group (RR 1.46, 95% CI 1.32 to 1.61) than in the age groups 50-69 and > or = 70 years, a pattern that was maintained in the different settings. For women for all the settings together, no differences were found among educational levels in the three age groups. In the different settings, only three had a high RR in the youngest age group, Finland (RR 1.33, 95% CI 1.01 to 1.74), Belgium (RR 1.38; 95% CI 1.13 to 1.67), and Austria (RR 1.49, 95% CI 0.75 to 2.96). CONCLUSION: This study provides new evidence on the importance of socioeconomic inequalities in transportation injury mortality across Europe. This applies to men, but not to women. Greater attention should be placed on opportunities to select intervention strategies tailored to tackle socioeconomic inequalities in transportation injuries.

Accidents, Traffic↗
PubMed2005

Educational inequalities in smoking among men and women aged 16 years and older in 11 European countries.

OBJECTIVE: To determine those groups who are at increased risk of smoking related diseases, we assessed in which male and female generations smoking was more prevalent among lower educated groups than among the higher educated, in 11 European countries. DESIGN: Cross sectional analysis of data on smoking, covering the year 1998, from a social survey designed for all member states of the European Union. SUBJECTS: Higher and lower educated men and women aged 16 years and older from 11 member states of the European Union. OUTCOME MEASURES: Age standardised prevalence rates by education and prevalence odds ratios of current and ever daily smoking comparing lower educated groups with higher educated groups. RESULTS: A north-south gradient in educational inequalities in current and ever daily smoking was observed for women older than 24 years, showing larger inequalities in the northern countries. Such a gradient was not observed for men. A disadvantage for the lower educated in terms of smoking generally occurred later among women than among men. Indications of inequalities in smoking in the age group 16-24 years were observed for all countries, with the exception of women from Greece and Portugal. CONCLUSIONS: Preventing and reducing smoking among lower educated subgroups should be a priority of policies aiming to reduce inequalities in health in Europe. If steps are not taken to control tobacco use among the lower educated groups specifically, inequalities in lung cancer and other smoking related diseases should be anticipated in all populations of the European Union, and both sexes.

Adolescent↗
PubMed2004

Socioeconomic inequalities in mortality among elderly people in 11 European populations.

STUDY OBJECTIVE: To describe mortality inequalities related to education and housing tenure in 11 European populations and to describe the age pattern of relative and absolute socioeconomic inequalities in mortality in the elderly European population. DESIGN AND METHODS: Data from mortality registries linked with population census data of 11 countries and regions of Europe were acquired for the beginning of the 1990s. Indicators of socioeconomic status were educational level and housing tenure. The study determined mortality rate ratios, relative indices of inequality (RII), and mortality rate differences. The age range was 30 to 90+ years. Analyses were performed on the pooled European data, including all populations, and on the data of populations separately. Data were included from Finland, Norway, Denmark, England and Wales, Belgium, France, Austria, Switzerland, Barcelona, Madrid, and Turin. MAIN RESULTS: In Europe (populations pooled) relative inequalities in mortality decreased with increasing age, but persisted. Absolute educational mortality differences increased until the ages 90+. In some of the populations, relative inequalities among older women were as large as those among middle aged women. The decline of relative educational inequalities was largest in Norway (men and women) and Austria (men). Relative educational inequalities did not decrease, or hardly decreased with age in England and Wales (men), Belgium, Switzerland, Austria, and Turin (women). CONCLUSIONS: Socioeconomic inequalities in mortality among older men and women were found to persist in each country, sometimes of similar magnitude as those among the middle aged. Mortality inequalities among older populations are an important public health problem in Europe.

Adult↗
PubMed2001

Derivated fetal haemoglobin as a marker for red cell age in the human fetus reflecting stimulated or impaired red blood cell production.

We have determined whether derivated fetal haemoglobin (dHbF, consisting of glycated and acetylated HbF) can be used as a cell age marker for fetal red blood cells (RBCs). Cord blood was obtained between 19 and 39 weeks of gestation from 28 alloimmunised anaemic fetuses (23 RhD+ and 5 Kell) and from 20 non-anaemic fetuses and newborns (controls). Density gradient centrifugation was applied to 36 samples (20 RhD+, 15 controls and 1 Kell) to obtain fractions of increasing cell age. Blood samples were used for measurements of mean cellular volume (MCV), mean cell haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), pyruvate kinase activity (PK) and derivated fetal haemoglobin (dHbF) by cation-exchange HPLC. Reticulocytes were counted only in the whole blood samples. In all density gradient separated RBC fractions, the values for MCV, MCH and PK activity decreased and those of MCHC and dHbF increased with increasing density (equivalent to increasing cell age). The mean density was lower for RBCs of the anaemic RHD group (1.072+/-0.007 g/ml) than for the non-anaemic controls (1.077+/-0.005 g/ml) (p<0.05) The RBC density of the Kell sensitised fetus did not differ from those of the controls. In the control group, the values of the cell age markers in whole blood changed significantly with the gestational age, showing an increase of mean age of the erythrocyte population. The best linear relationship was found for dHbF (y=6.28+0.17*weeks; r=0.84; p<0.001). In the anaemic RhD+ fetuses, the RBC age markers did not change with gestational age; the dHbF percentages were lower, and the MCV, MCH, PK values and the reticulocyte counts were higher than in the controls (0.05<p<0.001). The dHbF values of the Kell sensitised fetuses were above (p<0.01) and the reticulocyte counts were below normal (p<0.05) for gestational age. For the anaemic fetuses, a significant number of the dHbF values (86%) and of the reticulocyte counts (78%) differed from the values of the controls (p<0.01). The dHbF percentages in RhD+ fetuses showed the best correlation with the Hb deficit, which is a measure for anaemia (r=-0.81, p<0.0001). We conclude that the percentage derivated HbF may indicate whether the RBC production is normal for gestational age. It may in that sense reflect stimulated or impaired erythropoiesis in alloimmunised haemolytic anaemia.

Anemia, Hemolytic↗
PubMed2000

"Shake hands"; diagnosing a floppy infant--myotonic dystrophy and the congenital subtype: a difficult perinatal diagnosis.

Myotonic dystrophy is a multi-organ disease inherited in a complicated way. Congenital myotonic dystrophy is a distinct entity with severe symptoms leading to a high rate of perinatal morbidity and mortality. The occurrence of congenital myotonic dystrophy often allows a subsequent diagnosis in the mother with important implications for her life, her further pregnancies and offspring. Genetic principles of anticipation and somatic mosaicism are involved and hamper the prenatal diagnostic possibilities. A family is presented in which maternal myotonic dystrophy and congenital myotonic dystrophy were diagnosed after the third pregnancy. The key features leading to the diagnosis were obstetric history, neonatal hypotonia and asphyxia, facial abnormalities in the mother together with the inability to bury eyelashes and delayed release of grip after shaking hands. The disorder is reviewed with respect to clinical symptoms, pathogenesis and genetics.

Adult↗
PubMed1998

Rapid molecular mass and structural determination of plant cell wall-derived oligosaccharides using off-line high-performance anion-exchange chromatography/mass spectrometry.

A method has been developed for the rapid molecular mass determination and structural elucidation of mixtures of oligosaccharides derived from plant cell walls. The oligosaccharides were fractionated using gel permeation chromatography and 'analytical' high-performance anion-exchange chromatography (HPAEC), neutralized, dried and the mixtures of eluent salt and oligosaccharides were per-O-acetylated directly. The derivatized oligosaccharides were isolated by dissolution in dichloromethane and the salts were removed by aqueous partitioning. The per-O-acetylated oligosaccharides were analysed using electrospray (ES) and matrix-assisted laser desorption/ionization time of flight mass spectrometry (MS). Exploiting the fact that acid-catalysed per-O-acetylation of oligosaccharides can be achieved even under the extremely salty conditions that are found in post-column neutralized HPAEC fractions, and combining this derivatization step with off-line ESMS, allow rapid screening for molecular mass and thus yield information on the composition of the various oligosaccharides in these complex mixtures. Subsequent per-O-methylation of the per-O-acetylated, salt-free fractions and collision-induced dissociation tandem mass spectrometric analysis was used for additional sequence and branching determination of the oligosaccharides.

Carbohydrate Sequence↗
PubMed1998

Determinants of polychlorinated biphenyl levels in plasma from 42-month-old children.

We report on the PCB levels in plasma from 42-month-old children and the factors that determine these levels. We measured the levels of the PCB congeners 118 (2,4,5-3'4' pentachlorobiphenyl (CB)), 138 (2, 3,4-2'4'5'hexaCB), 153 (2,4,5-2'4'5'hexaCB), and 180 (2,3,4, 5-2'4'5'heptaCB) in cord plasma, breast milk, and plasma from 42-month-old children (n = 126) living in the Groningen area, The Netherlands. The sum of the levels of these four congeners was calculated for cord plasma (SigmaPCBcord), breast milk (SigmaPCBmilk), and 42-month plasma (SigmaPCB42mo). SigmaPCBcord was used as a measure of prenatal exposure. Postnatal exposure was assessed in terms of the SigmaPCBmilk and the duration of lactation. In addition, maternal factors including age, body weight and height, parity, and formal education were recorded. In 42-month-old children who have been fully breast-fed for at least six weeks as babies, the median SigmaPCB42mo was 4.5 times as high as that in formula-fed children (0.81 microg/L vs. 0.18 microg/L). The PCB levels in cord blood and human milk and the duration of breast-feeding predict the plasma PCB level at 42 months. Each additional week of full breast-feeding is estimated to result in an increase of 0.3% of the milk PCB level. We concluded that lactation is a major source for the child's PCB body burden at 42 months.

Animals↗
PubMed1998

Polychlorinated biphenyls in adipose tissue, liver, and brain from nine stillborns of varying gestational ages.

We analyzed polychlorinated biphenyls (PCBs) in s.c. adipose tissue, liver, and brain of nine fetuses who died in utero. Their median (range) gestational ages and birth weights were 34 (17-40) wk and 2050 (162-3225) g. Three fetuses were small for gestational age. The levels of PCB congener nos. 118, 138, 153, and 180, and the sum of these (sigmaPCB), were calculated in terms of tissue total fat content (ng/g fat). The median (range) sigmaPCB (in ng/g fat) amounted to adipose tissue 235 (97-768), liver 198 (67-362), and brain 50 (22-122). Median (range) sigmaPCB levels in liver and brain were 0.8 (0.4-0.9) and 0.2 (0.1-0.3) times, respectively, as high as the sigmaPCB levels in adipose tissue. There were strong relations between sigmaPCB in adipose tissue and sigmaPCB in liver (r=0.98; p < 0.01), and between sigmaPCB in adipose tissue and sigmaPCB in brain (r=0.91; p < 0.01). Adipose tissue, liver, and brain did not show differences in the distribution of congeners 118, 138, 153, and 180, and there was no statistically significant association between tissue PCB levels and gestational age (r varied between 0.22 and 0.47). Median sigmaPCB levels in fetal adipose tissue proved to be comparable with our previously established sigmaPCB levels in mature breast milk of 93 Dutch women (median 414; range 158-969 ng/g of fat). The PCB congeneric distribution of fetal adipose tissue was not different from that of human milk. We conclude that maternal PCBs have a tendency to accumulate notably in fetal tissues with high triglyceride contents. They are easily transferred across the placenta and seem to become equilibrated among the apolar parts of maternal and fetal lipids.

Adipose Tissue↗
PubMed1997

Nicotine and caffeine. Influence on prenatal hemodynamics and behavior in early twin pregnancy.

OBJECTIVE: To evaluate the effect of nicotine and caffeine in early multiple pregnancies. STUDY DESIGN: Ten women with twin pregnancies volunteered to take part in the study. Five mothers smoking > 5 cigarettes/d were investigated before and after smoking. Five women were investigated before and after drinking coffee. Maternal hemodynamics, umbilical blood flow, fetal heart rate and twin behavior were longitudinally documented during a 30-minute session from 8 to 16 gestational weeks. Fetal behavior was analyzed from videotapes using a one-minute window. RESULTS: The mean increase in maternal heart rate after smoking was 10 bpm (P < .005). After drinking coffee, it was 8 bpm (P < .01). The pulsatility index of the umbilical artery showed a significant increase after smoking (P < .01). After coffee the increase was also significant (P < .05). Two of five behavioral parameters (swallowing and breathing) demonstrated significant changes after the consumption of coffee (P < .001). CONCLUSION: This pilot study demonstrated significant effects of nicotine and caffeine consumption on maternal and fetal hemodynamics. It seems worthwhile to study the influences of smoking and coffee consumption on early twin behavior in larger samples.

Adult↗
PubMed1996

Estimation of 24-hour polyamine intake from mature human milk.

It has been suggested that milk polyamines stimulate GI tract proliferation and maturation in newborns. We determined human milk polyamine concentrations and estimated 24-h outputs on days 16 +/- 4 (n = 98), 44 +/- 3 (n = 97) and 91 +/- 6 (n = 25) after delivery. Median concentrations in micromolars were, respectively, putrescine 0.77, 0.63, and 0.63; spermidine 4.54, 3.07, and 2.73; spermine 3.76, 2.90, and 2.22; and total polyamines 9.82, 6.83, and 5.71. Concentrations of spermidine, spermine, and total polyamines decreased during the observation period. Putrescine, spermidine, and spermine milk/maternal plasma ratios were estimated to be 16-19, 14-24, and 44-75, respectively. It would appear that milk polyamines are derived from the high polyamine contents in the mammary gland and that they may be important in infant nutrition.

Female↗
PubMed1996

Measurement of transepidermal water loss in Tanzanian cot-nursed neonates and its relation to postnatal weight loss.

In healthy cot-nursed Tanzanian neonates (n = 92, gestation 26-42 weeks) measurements of trans-epidermal water loss (TEWL) and weight change were performed during the first 24 h after birth at an average ambient humidity of 70% and an environmental temperature of 32 degrees C. Urine production on day 1 (ml/kg per 24 h) was documented for a subgroup of 13 preterm and 8 term infants. In a limited group of preterm infants (n = 5) TEWL measurements, weight and 24 h urine volume measurements were repeated daily for 7 days. Maximum weight loss was determined in 7 preterm (gestational age 30-36 weeks) and 6 term infants. TEWL was estimated by measuring the evaporation rate at three sites of the body using the water vapour pressure gradient method. On day 1, TEWL was highest in the most preterm infants, whereas TEWL and urine production were higher in large for gestational age infants as compared to appropriate for gestational age (AGA) infants of the same gestational age (31-36 weeks). For the whole group, weight loss on day 1 was correlated with TEWL (r = 0.49, p < 0.05). At follow-up TEWL in preterm infants remained almost constant during the first 4 days and decreased after the fourth day, at which time weight gain commenced. Preterm AGA infants (gestational age 24-37 weeks) showed a mean postnatal weight loss of 4.4% of the birth weight, while in term infants this loss was only 2.6%. A reduced postnatal weight loss as compared to Caucasian infants may be explained by a lower water loss during the first days after birth, through both skin evaporation and urine excretion.

Body Water↗
PubMed1996

Triglycerides, fatty acids, sterols, mono- and disaccharides and sugar alcohols in human milk and current types of infant formula milk.

OBJECTIVE: To investigate differences in the fatty acid composition, sterols, minor carbohydrates and sugar alcohols between human and formula milk. DESIGN: We analyzed the concentrations of triglycerides, sterols, di- and monosaccharides and sugar alcohols, as well as the fatty acid composition of 10 currently available types of formula milk for term babies. Results were compared with mature human milk from 99 exclusively breast-feeding Dutch women, who collected 24-hour samples in the second week (n = 99), sixth week (n = 99) and 3 months (n = 25) after delivery. Infant formula milk data were considered different if they fell outside the mean +/- 2s.d. range of corresponding human milk data. RESULTS: The triglyceride concentrations in human milk were lower than those of the formula milk, possibly due to an incomplete collection of fat-rich hindmilk. Formula milks tended towards a higher proportion of medium chain fatty acids and lower proportions of longer-chain polyunsaturated fatty acids. Formulas had cholesterol concentrations 3-35 times lower, and much higher phytosterol concentrations, compared with the human milk. In the formula milk types the glucose, sorbitol and myoinositol concentrations were generally lower, whereas the fucose and erythreitol concentrations were in the lower mean +/- 2s.d. human milk range. The galactose concentrations in the formulas were generally higher. CONCLUSIONS: Formula milk and human milk differ considerably in fatty acid composition and concentrations of cholesterol, phytosterols, monosaccharides and sugar alcohols. The biological consequences of these differences in composition are uncertain.

Carbohydrates↗
PubMed1995

Neurological condition in 18-month-old children perinatally exposed to polychlorinated biphenyls and dioxins.

The neurological optimality of 418 Dutch children was evaluated at the age of 18 months, in order to determine whether prenatal and breast milk mediated exposure to polychlorinated biphenyls (PCBs) and dioxins affected neurological development. Half of the infants were breast-fed, the other half were formula-fed. PCB concentrations in cord and maternal plasma were used as a measure of prenatal exposure to PCBs. To measure postnatal exposure, PCB and dioxin congeners were determined in human milk and in formula milk. After adjusting for covariates, transplacental PCB exposure was negatively related to the neurological condition at 18 months. Although greater amounts of PCBs and dioxins are transferred via nursing than via placental passage, an effect of lactational exposure to PCBs and dioxins could not be detected. We even found a beneficial effect of breast-feeding on the fluency of movements. We conclude that transplacental PCB passage has a small negative effect on the neurological condition in 18-month-old toddlers.

Dioxins↗
PubMed1995

Perinatal exposure to polychlorinated biphenyls and dioxins and its effect on neonatal neurological development.

Polychlorinated biphenyls (PCBs) and dioxins (polychlorinated dibenzo-p-dioxins (PCDDs), and dibenzofurans (PCDFs)) are widespread environmental contaminants which are neurotoxic in animals. Perinatal exposure to PCBs, PCDDs, and PCDFs occurs prenatally via the placenta and postnatally via breast milk. To investigate whether such an exposure affects the neonatal neurological condition, the neurological optimality of 418 Dutch newborns was evaluated with the Prechtl neurological examination. Half of the infants were breast-fed, the other half were formula-fed, representing a relatively high against a relatively low postnatally exposed group, respectively. As an index of prenatal exposure, four non-planar PCBs in cord and maternal plasma were used. These PCB levels were not related to neurological function. As measures of combined pre- and early neonatal exposure, 17 dioxin congeners, three planar, and 23 non-planar PCB congeners were determined in human milk in the second week after delivery. Higher levels of PCBs, PCDDs, and PCDFs in breast milk were related to reduced neonatal neurological optimality. Higher levels of planar PCBs in breast milk were associated with a higher incidence of hypotonia. This study confirms previous reports about the neurotoxic effects of these compounds on the developing brain of newborn infants.

Benzofurans↗