Population‐based study on the seroprevalence of parvovirus B19 in Amsterdam

A study was undertaken to estimate the seroprevalence of parvovirus B19 infection in the general adult population of Amsterdam, The Netherlands. To our knowledge this is the first study testing parvovirus B19 in a random sample of the Dutch adult population. The study was a cross‐sectional survey, and the study sample was stratified by age and ethnicity, with deliberate oversampling of minority ethnic groups. Serum samples obtained from 1,323 residents in 2004 were tested for antibodies to parvovirus B19. Basic demographic data (gender, age, country of birth, and number of children) were also available. Sixty‐two percent of the participants were seropositive; corrected for the oversampling the estimated prevalence in the Amsterdam adult population was 61%. No specific predictors or risk groups for seropositivity were identified. In our urban adult study population no positive correlation with increasing neither age, nor significant differences between age groups were found. These results imply that almost 40% of the adult Amsterdam population is susceptible to infection. J. Med. Virol. 81:1305–1309, 2009. © 2009 Wiley‐Liss, Inc.     

The utility of online panel surveys versus computer-assisted interviews in obtaining substance-use prevalence estimates in the Netherlands

Aims   Rather than using the traditional, costly method of personal interviews in a general population sample, substance-use prevalence rates can be derived more conveniently from data collected among members of an online access panel. To examine the utility of this method, we compared the outcomes of an online survey with those obtained with the computer-assisted personal interviews (CAPI) method.
Design   Data were gathered from a large sample of online panellists and in a two-stage stratified sample of the Dutch population using the CAPI method.
Setting   The Netherlands.
Participants   The online sample comprised 57 125 Dutch online panellists (15–64 years) of Survey Sampling International LLC (SSI), and the CAPI cohort 7204 respondents (15–64 years).
Measurements   All participants answered identical questions about their use of alcohol, cannabis, ecstasy, cocaine and performance-enhancing drugs. The CAPI respondents were asked additionally about internet access and online panel membership. Both data sets were weighted statistically according to the distribution of demographic characteristics of the general Dutch population.
Findings   Response rates were 35.5% ( n  = 20 282) for the online panel cohort and 62.7% ( n  = 4516) for the CAPI cohort. The data showed almost consistently lower substance-use prevalence rates for the CAPI respondents. Although the observed differences could be due to bias in both data sets, coverage and non-response bias were higher in the online panel survey.
Conclusions   Despite its economic advantage, the online panel survey showed stronger non-response and coverage bias than the CAPI survey, leading to less reliable estimates of substance use in the general population.     

Priorities in obstetrics and gynaecology in the developing world

Every minute of every day a woman in the developing world dies of an avoidable cause of death. For every woman dying there are at least another 20 women who are left with severe morbidity. These deaths can be prevented. The interventions required are clear, inexpensive and effective. Yet they are not universally available or accessible. The call for action has been made, yet the speed of progress is slow.     

Methotrexate effects in patients with rheumatoid arthritis with cardiovascular comorbidity

Methotrexate, an antirheumatic drug that may increase serum homocysteine, significantly increases mortality in patients with rheumatoid arthritis and cardiovascular comorbidity.     

Local administration of PF-3512676 CpG-B instigates tumor-specific CD8+ T-cell reactivity in melanoma patients

PURPOSE: Impaired immune effector functions in the melanoma sentinel lymph node (SLN) may allow for early metastatic events. Local administration of PF-3512676 (formerly known as CpG 7909) has shown immunostimulatory effects of both dendritic cell and T-cell subsets in the melanoma SLN. Here, we set out to ascertain whether these PF-3512676-induced immunostimulatory effects translate into higher frequencies of melanoma-specific CD8(+) T cells. EXPERIMENTAL DESIGN: Twenty-four stage I to III melanoma patients were randomized to preoperative local administration of either PF-3512676 or saline. CD8(+) T cells from SLN and peripheral blood were tested for reactivity by IFN-gamma ELISPOT assay against several HLA-A1/A2/A3-restricted epitopes derived from various melanoma-associated antigens (MAA) in 21 of 24 enrolled patients. Frequencies of natural killer (NK) cells and frequencies and maturation state of dendritic cell subsets in the SLN were determined by flow cytometry. RESULTS: Melanoma-specific CD8(+) T-cell response rates against >1 MAA epitope in the SLN were 0 of 11 for the saline group versus 5 of 10 for the PF-3512676-administered group (P = 0.012). Of these 5 responding patients, 4 also had a measurable response to >1 MAA epitope in the blood. Increased frequencies in the SLN of both MAA-specific CD8(+) T cells and NK cells correlated to CpG-induced plasmacytoid dendritic cell maturation. CONCLUSIONS: These data show an increase in melanoma-specific CD8(+) T-cell frequencies as well as an increased effector NK cell rate after a single dose of PF-3512676 and thus support the utility of local PF-3512676 administration as adjuvant treatment in early-stage melanoma to try and halt metastatic spread.     

Gender-related differences in the organization and provision of services among general practitioners in Europe: a signal to health care planners

BACKGROUND: The number of women entering general practice is rising in many countries. Thus, gender differences in work situation preferences and practice activities are important for future planning. OBJECTIVES: This article describes the differences between male and female general practitioners (GPs) in 32 European countries. It examines gender differences in curative and preventive services and relates these to features of the health care system and the practice. METHODS: The data were collected in 1993 and 1994 in the European Study of Task Profiles of General Practitioners. In 32 countries, 8,183 GPs answered standardized questionnaires written in their own languages on their self-reported involvement in curative and preventive services, as well as how their practice was organized and managed. Because the independent variables in this study were on both the national 1 and individual practice levels, the data were subjected to multilevel analysis. RESULTS: Regardless of the type of health care system, the female GPs were younger than the male GPs and more often worked part time in groups or partnerships and in cities, although not in deprived areas. They made fewer house calls and did less work outside office hours. Differences between men and women regarding workload diminished considerably after controlling for part-time work. When other characteristics of the person and the practice were taken into account, female GPs proved to be less involved in several curative services, except as the first contact for gynecological problems, but more involved in health education. Some differences were found in only certain types of health care systems. CONCLUSIONS: The results may have important implications for working arrangements, training, education, and planning of resources for general practice in the future.