Urinary tract infection in male general practice patients: uropathogens and antibiotic susceptibility.

Objectives: To evaluate uropathogens and their antibiotic susceptibility in male general practitioner (GP) patients presenting with an uncomplicated urinary tract infection (UTI).

Material And Methods: A population-based study was conducted among males, 18 years and older, general practice patients, who had symptoms indicative of an uncomplicated UTI. A UTI was defined as >/=10(3) colony-forming units/mL (CFU/mL).

Evaluation of the nitrite and leukocyte esterase activity tests for the diagnosis of acute symptomatic urinary tract infection in men.

For 422 male patients with symptoms indicative of a urinary tract infection, nitrite and leukocyte esterase activity dipstick test results were compared with results of culture of urine samples. The positive predictive value of a positive nitrite test result was 96%. Addition of results of the leukocyte esterase test did not improve the diagnostic accuracy of the nitrite test.

Risk factors for acute respiratory tract infections in general practitioner patients in The Netherlands: a case-control study.

Background: Acute respiratory tract infections (ARTI) are an important public health problem. Improved identification of risk factors might enable targeted intervention. Therefore we carried out a case-control study with the aim of identifying environmental risk factors for ARTI consultations in the Dutch general population.

Urbanisation and the incidence of eating disorders.

The link between degree of urbanisation and a number of mental disorders is well established. Schizophrenia, psychosis and depression are known to occur more frequently in urban areas. In our primary care-based study of eating disorders, the incidence of bulimia nervosa showed a dose-response relation with degree of urbanisation and was five times higher in cities than in rural areas.

Internet-based monitoring of influenza-like illness (ILI) in the general population of the Netherlands during the 2003-2004 influenza season.

Background: An internet-based survey of influenza-like illness (ILI)--the Great Influenza Survey or GIS--was launched in the Netherlands in the 2003-2004 influenza season. The aim of the present study was to validate the representativeness of the GIS population and to compare the GIS data with the official ILI data obtained by Dutch GPs participating in the Dutch Sentinel Practice Network.

Method: Direct mailings to schools and universities, and repeated interviews on television and radio, and in newspapers were used to kindle the enthusiasm of a broad section of the public for GIS.

General practitioner practices in requesting laboratory tests for patients with gastroenteritis in the Netherlands, 2001-2002.

Background: The objective of this study was to estimate the (selective) proportion of patients consulting their GP for an episode of gastroenteritis for whom laboratory tests were requested. In addition adherence of GPs to the guidelines for diagnostic test regime was ascertained.

Methods: Data were collected from a GP network in the Netherlands.

Time trends in the incidence of eating disorders: a primary care study in the Netherlands.

Objective: This Dutch epidemiological study used primary care-based data to examine changes in the incidence of eating disorders in the 1990s compared to the 1980s.

Method: A nationwide network of general practitioners, serving a representative sample of the total Dutch population, recorded newly diagnosed patients with anorexia nervosa (AN) and bulimia nervosa (BN) in their practices during 1985-1989 and 1995-1999.

Results: The overall incidence of AN was stable (from 7.

Urinary tract infections in general practice patients: diagnostic tests versus bacteriological culture.

Objectives: Urinary tract infections (UTIs) are common bacterial infections encountered in general practice. For the optimal treatment the general practitioner (GP) should rely on the results of diagnostic tests and recent antimicrobial susceptibility of uropathogens.

Patients And Methods: In total 1993 female patients (11-70 years) with complaints of an acute uncomplicated UTI were included.

Antibiotic treatment and resistance of unselected uropathogens in the elderly.

A population-based study was conducted among women over the age of 70 years with complaints of uncomplicated urinary tract infections (UTIs). The positive predictive value of the nitrite test alone or in combination with the leukocyte esterase test ranged between 83% and 99%. The nitrofurantoin prescription rate decreased whereas fluoroquinolone and amoxicillin/clavulanic acid prescriptions increased with increasing age.

[The influenza season 2004/'05 in the Netherlands with the largest epidemic of the last 5 years caused by the virus variant A/California and the composition of the vaccine for the season 2005/'06].

In the Netherlands, the influenza epidemic of the 2004/'05 season started late. The background value of 3 cases of an influenza-like illness per 10,000 inhabitants per week was exceeded from week 1 until week 14 of 2005. The magnitude of the epidemic was the largest of the last 5 years, namely 104 per 10,000 inhabitants.

A case-control study of acute respiratory tract infection in general practice patients in The Netherlands.

Background: Acute respiratory tract infections (ARTIs) are responsible for considerable morbidity in the community, but little is known about the presence of respiratory pathogens in asymptomatic individuals. We hypothesized that asymptomatic persons could have a subclinical infection and thus act as a source of transmission.

Methods: During the period of 2000-2003, all patients with ARTI who visited their sentinel general practitioner had their data reported to estimate the incidence of ARTI in Dutch general practices.

Erythromycin resistance in the commensal throat flora of patients visiting the general practitioner: a reservoir for resistance genes for potential pathogenic bacteria.

The prevalence and mechanism of erythromycin resistance in commensal throat streptococci was determined from October 2000 until December 2002 as part of an ongoing study of the NIVEL in general practice patients (N=678). Resistance prevalence for 1mg/L and 16 mg/L erythromycin was 57% and 20%, respectively. The percentage of total commensal flora resistant within each patient ranged from 1% to 100% (median, 1%).

The consistency of shingles and its significance for health monitoring.

Accurate estimation of monitored populations is essential for epidemiological study. Many countries do not have systems of patient registration and routine disease surveillance is thereby hindered. We studied the incidence of shingles over time and investigated the hypothesis that the incidence is consistent and could be used as a proxy for estimating the monitored population.

[The 2003/2004 influenza season in the Netherlands with a limited epidemic of the virus variant A/Fujian, and the vaccine composition for the 2004/2005 season].

In contrast to the three previous influenza seasons, the influenza epidemic of the 2003/2004 season started early in week 49 of 2003. The epidemic was predominantly caused by influenza-A viruses of the H3N2 subtype. All isolated influenza-A viruses were antigenically related to influenza virus A/Fujian/411/02, which was already detected in the influenza season 2002/2003 and that deviated from the vaccine-reference strain A/Moscow/10/99 to a certain extent.

Are influenza surveillance data useful for mapping presentations?

Geographical information system (GIS) based on mappings of influenza data are rare (http://www.b3e.jussieu.

[The 2002/2003 influenza season in the Netherlands and the vaccine composition for the 2003/2004 season].

As in the 2000/2001 and 2001/2002 seasons, the influenza epidemic in the 2002/2003 season started late (week 7 of 2003) and was only moderate in size. Influenza A (H3N2) and B viruses were detected in equal numbers among patients of general practitioners and these two viruses were therefore equally responsible for the epidemic. However, H3N2 viruses dominated isolates taken from hospitals.

Surveillance of respiratory pathogens and influenza-like illnesses in general practices - The Netherlands, winter 1997-98.

The Netherlands Institute of Primary Health Care (NIVEL) has coordinated the activities of a sentinel surveillance network of 43 general practices since 1970. These practices care for 1% of the Dutch population, a sample representative of the national pop

[The 2001/2002 influenza season and the vaccine composition for the 2002/2003 season].

The epidemic in the influenza season 2001/2002 was of moderate activity just like in 2000/2001. The influenza epidemic started in week 2 of 2002 when the clinical influenza activity reported by the general practitioner network of the Netherlands Institute of Primary Health Care (NIVEL) increased. This was caused by influenza A viruses of the H3N2 subtype in particular.

Unexplained severe chronic pain in general practice.

The aim of this study was to estimate the prevalence of unexplained severe chronic pain (USCP) in general practice and to report medical as well as psychological descriptions of patients suffering from this condition.A total of 45 GPs in 35 different practices included patients throughout the year 1996. Patients were included according to the following criteria: between 18 and 75 years of age; pain which had lasted at least 6 months; pain is the most prominent aspect in the clinical presentation; pain is serious enough to justify clinical attention; pain has led to obvious discomfort and disability in daily life for at least for 1 month.

A comparison of gastroenteritis in a general practice-based study and a community-based study.

We compared gastroenteritis cases that consulted a general practitioner (GP) with those who did not in a community-based study and also with those in a GP-based study. We aimed to identify factors associated with consultation, and with inclusion of cases by GPs, and secondly to study the effects on the frequency of detection of pathogens. Furthermore, we estimated the under-ascertainment by GPs.

[2000/01 influenza season and the vaccine composition for the season 2001/'02].

In the 2000/01 season, the size of the influenza epidemic in the Netherlands was exceptionally small. Since the start of the Continuous Morbidity Registration of the Netherlands Institute of Primary Health Care (NIVEL) in 1970, the peak incidence of influenza-like illnesses has never been so low. The aetiology of the epidemic was also unusual.

Sensor, a population-based cohort study on gastroenteritis in the Netherlands: incidence and etiology.

A prospective population-based cohort study with a nested case-control study was conducted to estimate the incidence of gastroenteritis and the associated pathogens in the general Dutch population. Follow-up of two consecutive cohorts was performed by weekly reporting cards from December 1998 to December 1999. Cases and controls in the case-control study supplied a questionnaire and stool samples.