Mammography screening attendance: meta-analysis of the effect of direct-contact invitation.

Background: Personal or telephone contact methods are often used to increase attendance for mammography screening. A meta-analysis of the literature was performed to assess the overall effect of direct-contact recruitment on mammography participation.

Methods: Two independent reviewers conducted two different search strategies.

Geographical differences in cancer incidence in the Belgian province of Limburg.

Correctly addressing the questions of worried citizens with respect to possible clusters of cancer occurrence requires a risk communication strategy that is informed by a previously established analytical procedure. The aim of this study was to analyse cancer registration data in order to identify municipalities or clusters of municipalities with an increased incidence of one or more cancer types, adjusted for background characteristics at the same level. Ideally, the approach is proactive, straightforward, and easy for untrained citizens to follow and imprecision effects are taken into account.

Registration of stroke through the Belgian sentinel network and factors influencing stroke mortality.

Introduction: Stroke is one of the leading causes of death. Belgian stroke mortality rates are only available from the death certificates notification.

Objectives: To estimate stroke incidence, mortality and case fatality, to compare our figures with those available from the death certificates notification and from neighboring countries, and identifying factors influencing survival.

The diagnostic value of macroscopic haematuria for the diagnosis of urological cancer in general practice.

Background: The diagnostic value and the impact of some signs and symptoms in most diseases in primary care have only been studied incompletely.

Aim: To assess the diagnostic value of macroscopic haematuria for the idagnosis of urological cancer (bladder, kidney) in a general practice setting, as well the influence of age, sex, and some additional signs and symptoms.

Design Of Study: Diagnostic study.

Questionnaires are better than laboratory tests to screen for current alcohol abuse or dependence in a male inpatient population.

Objective: To assess the diagnostic performance of the CAGE and AUDIT (Alcohol Use Disorder Identification Test) and its derivatives, and laboratory tests for screening alcohol abuse or dependence in a male medical hospital population.

Design: A diagnostic cross-sectional prevalence study.

Setting: Three general hospitals and one university hospital.

Cardiovascular risk in white-coat and sustained hypertensive patients.

We compared cardiovascular outcome between patients with white-coat and sustained hypertension who had previously participated in the Ambulatory Blood Pressure Monitoring and Treatment of Hypertension (APTH) trial. Baseline characteristics, including office and ambulatory blood pressure (BP), were measured during the 2-month run-in period of the APTH trial. During follow-up, information on the occurrence of major cardiovascular events (death, myocardial infarction, stroke and heart failure), achieved office BP and treatment status was obtained.

Evaluation of Charlson's comorbidity index in elderly living in nursing homes.

The object of this article was to validate the predictive value of Charlson's comorbidity index for the prediction of short-term mortality or morbidity in elderly people. The design was a cohort study comparing survival and hospitalization in institutionalized elderly people with different levels of comorbidity at baseline. The setting was 16 Flemish nursing homes for the elderly.

Higher attack rates for left motor deficit among men with cerebrovascular events.

The authors report the findings of a prospectively collected database of stroke and TIA recorded from 1998 through 1999 by the 178 family physicians of the Belgian sentinel network. The yearly age-adjusted attack rate per 100,000 men was estimated as 109 (95% CI = 86 to 137) for left motor deficit and 75 (95% CI = 56 to 99) for right motor deficit (p = 0.011).

Prostate-specific antigen screening coverage and prostate cancer incidence rates in the Belgian province of Limburg in 1996-1998.

According to the 1996-1998 cancer incidence report of the cancer registry of the Belgian province of Limburg (LIKAR), prostate cancer is the most common cancer in men with a crude invasive cancer incidence rate of 123.7 per 100000 person-years (125.4 and 81.

Is there an increased risk of dying after depression?

Although a lot of research has been performed on the relation between depression and subsequent mortality, the results show contradictory findings. In this study, the authors investigated mortality in depressed people compared with nondepressed people in a large-scale retrospective cohort study based in general practice in the province of Limburg, the Netherlands. All subjects diagnosed with depression between 1975 and 1990 were included and compared with subjects matched on birth year who never were diagnosed with depression.

Habitual caffeine consumption and its relation to memory, attention, planning capacity and psychomotor performance across multiple age groups.

The present study evaluated the association between habitual caffeine intake via coffee and tea and cognitive performance. This was done as part of a larger research programme into the determinants of cognitive ageing (the Maastricht Aging Study: MAAS). Possible withdrawal effects that may have explained in part the positive association between performance and intake in an earlier study were controlled for.

The incidence of stroke and transient ischaemic attacks is falling: a report from the Belgian sentinel stations.

Background: Increasing as well as decreasing trends in stroke incidence have been described.

Aim: To examine time trends associated with the incidence of stroke and transient ischaemic attacks (TIAs) within an ongoing registration network.

Design Of Study: Analysis of data from a network of sentinel practices.

Molecular epidemiology of methicillin-resistant Staphylococcus aureus in nursing homes: a cross-sectional study.

A cross-sectional study of methicillin-resistant Staphylococcus aureus carriage in 2,857 nursing home residents showed an overall prevalence of 4.9%. The three clones identified by genetic analysis were identical to those in the acute care facilities; only their relative prevalence differed.

The relation between alcohol abuse or dependence and academic performance in first-year college students.

A large-scale study (N = 3,518) was designed to assess the academic performance of college freshmen in relationship to alcohol abuse or dependence. Alcohol abuse or dependence was identified in 501 (14%) students; of these, 128 (3.6%) were alcohol-dependent.

Management of hepatitis C virus infections in intravenous drug users.

Intravenous drug use is a major route of hepatitis C virus (HCV) transmission. In Belgium, more than 70% of the intravenous drug users (IVDUs) are HCV seropositive. In the past, medical treatment of HCV-positive IVDUs has been controversial.

Conducting systematic reviews of diagnostic studies: didactic guidelines.

Background: Although guidelines for critical appraisal of diagnostic research and meta-analyses have already been published, these may be difficult to understand for clinical researchers or do not provide enough detailed information.

Methods: Development of guidelines based on a systematic review of the evidence in reports of systematic searches of the literature for diagnostic research, of methodological criteria to evaluate diagnostic research, of methods for statistical pooling of data on diagnostic accuracy, and of methods for exploring heterogeneity.

Results: Guidelines for conducting diagnostic systematic reviews are presented in a stepwise fashion and are followed by comments providing further information.

Increased risk of Parkinson's disease after depression: a retrospective cohort study.

Background: Depression has been linked to the occurrence of a number of somatic diseases. There are no data for PD.

Objective: To determine if depression is associated with a subsequent risk for PD.

Seroprevalence of hepatitis C markers among intravenous drug users in western European countries: a systematic review.

Currently, the most important risk factor for hepatitis C virus (HCV) infection in Europe is intravenous drug use. To establish a better insight into the epidemiology of hepatitis C among intravenous drug users (IVDUs) in western European countries a systematic review on the prevalence of hepatitis C markers and their determinants was performed. Reports were identified by searches on Medline and on the internet and by screening reference lists of selected papers.

Chest pain in the emergency department: the broad spectrum of causes.

We performed a prospective study to describe the broad spectrum of causes of chest pain in patients presenting to the emergency department and to compare the diagnoses in referred patients, self-referred patients and patients rushed in by ambulance. The final diagnosis in a consecutive case series of 578 chest pain patients was established after discharge from the hospital. The underlying disorders were grouped into cardiac, respiratory, gastro-oesophageal disorders, musculoskeletal pathology, somatization disorders, other diseases and unknown.

Dietary habit profile in European communities with different risk of myocardial infarction: the impact of migration as a model of gene-environment interaction. The IMMIDIET Study.

The risk of myocardial infarction (MI) is lower in southern than in northern European countries. The lower rate of MI in the Mediterranean regions of Europe suggested a potential role of the traditional Mediterranean diet in the prevention of MI. Unfortunately, in the last 20 years, a tendency to adopt Westernised food habits even in southern regions of Europe is reflected by an increase in the prevalence of obesity.

Predictors of attrition in a longitudinal cognitive aging study: the Maastricht Aging Study (MAAS).

A large sample of older participants of the Maastricht Aging Study (MAAS) were compared to drop-outs at the 3-year follow-up with respect to socio-demographic, health, and cognitive characteristics. In addition, the impact of selective drop-out on measures of cognitive change was examined. To this end, hypothetical scores were estimated for drop-outs by using single and multiple imputation methods.

Systematic reviews of diagnostic research. Considerations about assessment and incorporation of methodological quality.

The aim of this paper is to provide a theoretical background for performing and reading systematic reviews of diagnostic studies. We first discuss items for assessment of methodological quality in diagnostic studies and then present methods on how to incorporate these quality measures in systematic reviews. The items of internal validity determine whether the presented results of the individual studies are unbiased and can be trusted.

Chest pain in general practice or in the hospital emergency department: is it the same?

Objective: The aim of the present study was to provide a description of the impact of setting on the diagnostic case mix that is identified in consecutive patients presenting with chest pain.

Methods: A cross-sectional study was carried out of patients presenting with chest pain according to setting: general practice, self-referred, referred or arriving by ambulance at the hospital emergency department (ED). GPs from 25 general practices situated in the Flemish part of Belgium were recruited, and the hospital involved was a major teaching hospital in the same area.