The contribution of alpha1-antitrypsin to the total antitrypsin activity of human serum. A study of two phenotype PI OO individuals.

Comparison of the levels of alpha1-AT, alpha2-M, inter alpha-AT, C1 inactivator and antiplasmin and global antitrypsin activity in a group of normal phenotype PI MM individuals, a group of normal individuals with phenotypes with intermediate alpha1 AT activities and alpha2-AT-deficient persons show that alpha1-AT contributes more than 90 percent of the total antitrypsin activity of normal plasma. AT III and fast reacting antiplasmin are shown to contribute to the remaining activity. It can be assumed that due to test conditions the antitrypsin activity of alpha2-M is not assessed. C1 inactivator and inter alpha1-AT do not contribute to a perceptible extent to the overall antitrypsin activity estimated according to the method of Eriksson (Eriksson, S. (1965) Acta Med. Scand. 177, 1).     

Comparison of serum IgE determination by radioimmunoassay and by single radial immunodiffusion

Two commercially available methods of total serum IgE determination have been evaluated, viz: the radioimmunosorbent test (RIST) and the assay by single radial immunodiffusion (RID). RIST was found a suitable and rapid method for the wide range of IgE concentrations to be expected in the sera of an allergic population. The RID method has a lower limit of detection of about 1000 I.U./ml; over this value, both techniques provided statistically correlated results. However, for technological reasons RID was considered less suitable for routine application.     

Frailty and Somatic Comorbidity in Older Patients With Medically Unexplained Symptoms

ObjectivesTo examine the level of frailty and somatic comorbidity in older patients with medically unexplained symptoms (MUS) and compare this to patients with medically explained symptoms (MES).DesignCross-sectional, comparative study.SettingCommunity, primary care, and secondary healthcare to recruit patients with MUS in various developmental and severity stages and primary care to recruit patients with MES.ParticipantsIn total, 118 patients with MUS and 154 patients with MES, all aged ≥60 years.MethodsFrailty was assessed according to the Fried criteria (gait speed, handgrip strength, unintentional weight loss, exhaustion, and low physical activity), somatic comorbidity according to the self-report Charlson comorbidity index, and the number of prescribed medications.ResultsAlthough patients with MUS had less physical comorbidity compared with patients with MES, they were prescribed the same number of medications. Moreover, patients with MUS were more often frail compared with patients with MES. Among patients with MUS, physical frailty was associated with the severity of unexplained symptoms, the level of hypochondriacal beliefs, and the level of somatisation.Conclusions and implicationsDespite a lower prevalence of overt somatic diseases, patients with MUS are more frail compared with older patients with MES. These results suggest that at least in some patients age-related phenomena might be erroneously classified as MUS, which may affect treatment strategy.     

Carotid Atherosclerosis Is Associated With Poorer Hearing in Older Adults

ObjectivesCardiovascular disease may be linked to hearing loss through narrowing of the nutrient arteries of the cochlea, but large-scale population-based evidence for this association remains scarce. We investigated the association of carotid atherosclerosis as a marker of generalized cardiovascular disease with hearing loss in a population-based cohort.DesignCross-sectional.SettingA population-based cohort study.Participants3724 participants [mean age: 65.5 years, standard deviation (SD): 7.5, 55.4% female].MethodsUltrasound and pure-tone audiograms to assess carotid atherosclerosis and hearing loss.ResultsWe investigated associations of carotid plaque burden and carotid intima-media thickness (IMT) (overall and side-specific carotid atherosclerosis) with hearing loss (in the best hearing ear and side-specific hearing loss) using multivariable linear and ordinal regression models. We found that higher maximum IMT was related to poorer hearing in the best hearing ear [difference in decibel hearing level per 1-mm increase in IMT: 2.09 dB, 95% confidence interval (CI): 0.08, 4.10]. Additionally, third and fourth quartile plaque burden as compared to first quartile was related to poorer hearing in the best hearing ear (difference: 1.06 dB, 95% CI: 0.04, 2.08; and difference: 1.55 dB, 95% CI: 0.49, 2.60, respectively). Larger IMT (difference: 2.97 dB, 95% CI: 0.79, 5.14), third quartile plaque burden compared to first quartile (difference: 1.24 dB, 95% CI: 0.14, 2.35), and fourth plaque quartile compared to first quartile (difference: 2.12 dB, 95% CI: 0.98, 3.26) in the right carotid were associated with poorer hearing in the right ear.Conclusions and ImplicationsCarotid atherosclerosis is associated with poorer hearing in older adults, almost exclusively with poorer hearing in the right ear. Based on our results, it seems that current therapies for the prevention of cardiovascular disease may also prove beneficial for hearing loss in older adults by promoting and maintaining inner ear health.     

Buruli Ulcer in Traveler from Suriname,South America,to the Netherlands

We report Buruli ulcer in a man in the Netherlands. Phenotyping of samples indicate the Buruli pathogen was acquired in Suriname and activated by trauma on return to the Netherlands. Awareness of this disease by clinicians in non–Buruli ulcer–endemic areas is critical for identification.     

The population impact of smoke-free workplace and hospitality industry legislation on smoking behaviour. Findings from a national population survey

Aims To study the impact of implementing smoke‐free workplace and hospitality industry legislation on smoking behaviour. Design, setting and participants A cross‐sectional population survey from 2001 to 2008 (n ≈ 18 000 per year) was used to assess trends and seasonal patterns in smoking and quitting, and to examine whether changes could be observed after the workplace smoking ban in the Netherlands in 2004 and the hospitality industry ban in 2008. Measurements Outcome measures were smoking prevalence, quit attempts and successful quit attempts. Interactions with educational level (socio‐economic status) and bar visiting (exposure to the hospitality industry ban) were tested. Findings The workplace ban was followed by a decrease in smoking prevalence (OR = 0.91, P < 0.001), but the hospitality industry ban was not (OR = 0.96, P = 0.127). Both bans, especially the workplace ban, were followed by an increase in quit attempts and successful quit attempts: workplace ban, OR = 1.31, P < 0.001; OR = 1.49, P < 0.001; hospitality industry ban, OR = 1.13, P = 0.013; OR = 1.44, P < 0.001. The workplace ban had a larger effect on successful quitting among higher‐educated (OR = 0.35, P < 0.001) than on lower‐educated respondents (OR = 0.74, P = 0.052). The hospitality industry ban had a larger effect on quit attempts among frequent bar visitors (OR = 1.48, P = 0.003) than on non‐bar visitors (OR = 0.71, P = 0.014). Conclusions A workplace smoking ban in the Netherlands was followed by more changes in smoking and quitting than a hospitality industry ban. The hospitality industry ban only appeared to have an impact on quit attempts, and not on smoking prevalence.     

The incidence of suspected myocardial infarction in Dutch general practice in the period 1978-1994

Aim To evaluate how the incidence of suspected myo-cardial infarctionhas developed from 1978 to 1994 and to study the incidence ofconfirmed acute myocardial infarction in Dutch general practicesduring the period 1991–1994. Methods In three periods (1978, 1983–1985 and 1991–1994)the incidence of suspected myocardial infarction has been registeredby the ‘Dutch Sentinel Practice Network’. This isa registration system that obtains data from general practitionerscovering about 150000 persons. During the period 1991–1994the incidence of confirmed myocardial infarction was also registered. Results For men, the incidence rate of suspected myo-cardial infarctiondecreased by 28% from 4·7 per 1000 in 1978 to 3·4per 1000 in the period 1991–1994. For women, the incidencefell by 23% from 2·6 per 1000 in 1978 to 2·0 per1000 in the period 1983–1985 and stabilized thereafter.The most pronounced decrease in the incidence of suspected myocardialinfarction during the period 1978—1994 occurred in bothmen and women aged 45–64. In the period 1991–1994,the standardized incidence rate of confirmed myocardial infarctionis 1·7 per 1000 for men and 0·9 per 1000 for women. Conclusions These data suggest that the incidence of suspected myocardialinfarction has declined substantially between 1978 and 1994both for men and for women; this decline is most pronouncedin the age group 45–64.     

Disease Detection or Public Opinion Reflection? Content Analysis of Tweets,Other Social Media,and Online Newspapers During the Measles Outbreak in the Netherlands in 2013

Background

In May 2013, a measles outbreak began in the Netherlands among Orthodox Protestants who often refuse vaccination for religious reasons.

Objective

Our aim was to compare the number of messages expressed on Twitter and other social media during the measles outbreak with the number of online news articles and the number of reported measles cases to answer the question if and when social media reflect public opinion patterns versus disease patterns.

Methods

We analyzed measles-related tweets, other social media messages, and online newspaper articles over a 7-month period (April 15 to November 11, 2013) with regard to topic and sentiment. Thematic analysis was used to structure and analyze the topics.

Results

There was a stronger correlation between the weekly number of social media messages and the weekly number of online news articles (P<.001 for both tweets and other social media messages) than between the weekly number of social media messages and the weekly number of reported measles cases (P=.003 and P=.048 for tweets and other social media messages, respectively), especially after the summer break. All data sources showed 3 large peaks, possibly triggered by announcements about the measles outbreak by the Dutch National Institute for Public Health and the Environment and statements made by well-known politicians. Most messages informed the public about the measles outbreak (ie, about the number of measles cases) (93/165, 56.4%) followed by messages about preventive measures taken to control the measles spread (47/132, 35.6%). The leading opinion expressed was frustration regarding people who do not vaccinate because of religious reasons (42/88, 48%).

Conclusions

The monitoring of online (social) media might be useful for improving communication policies aiming to preserve vaccination acceptability among the general public. Data extracted from online (social) media provide insight into the opinions that are at a certain moment salient among the public, which enables public health institutes to respond immediately and appropriately to those public concerns. More research is required to develop an automatic coding system that captures content and user’s characteristics that are most relevant to the diseases within the National Immunization Program and related public health events and can inform official responses.