Metabolic syndrome and cognition in patients with manifest atherosclerotic disease: the SMART study.

Background: It is unclear whether the metabolic syndrome (MetS) increases risk of cognitive dysfunction beyond the level expected from its individual components. We examined the association of MetS with cognitive dysfunction and assessed whether MetS increased risk of cognitive dysfunction more than that of the sum of its individual components.

Methods: Data on 823 participants were used from the SMART-study, a cohort study among patients with atherosclerotic disease.

A long-term prospective study of the natural course of sporadic adult-onset lower motor neuron syndromes.

Objective: To determine the natural course of sporadic adult-onset lower motor neuron syndrome in a long-term prospective study of patients with the syndrome.

Design: Inception cohort with a follow-up of 72 months.

Setting: Three university hospitals in the Netherlands (referral centers for neuromuscular diseases).

Fish consumption, n-3 fatty acids, and subsequent 5-y cognitive decline in elderly men: the Zutphen Elderly Study.

Background: Indications have been seen of a protective effect of fish consumption and the intake of n-3 fatty acids on cognitive decline. However, studies are scarce and results inconsistent.

Objective: The objective of the study was to examine the associations between fish consumption, the intake of the n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) from fish and other foods, and subsequent 5-y cognitive decline.

Expected and unexpected gallstones in primary care.

Objective: The aim of this prospective cohort study was to assess the differences in signs and symptoms of primary-care patients with expected and those with unexpected gallstones referred for upper abdominal ultrasound (US).

Material And Methods: A total of 430 patients were referred by 76 general practitioners (GPs) for abdominal US to one of the three participating hospitals in The Netherlands. All GPs were asked to complete a standardized questionnaire before and after abdominal US.

Decline in cognitive functioning is associated with a higher mortality risk.

Objective: This study investigates the association between 5-year change in cognitive functioning and subsequent mortality.

Methods: Four hundred and ninety-three Dutch and Italian men from the Finland, Italy, and the Netherlands Elderly (FINE) Study, born between 1900 and 1920, participated in the present study between 1990 and 2000. Cognitive functioning was measured with the Mini-Mental State Examination in 1990 and 1995, and mortality data were obtained until the year 2000.

Depression and cardiovascular mortality: a role for n-3 fatty acids?

Background: Recent studies indicate that depression plays an important role in the occurrence of cardiovascular diseases (CVDs). The underlying mechanisms are not well understood.

Objective: We investigated whether dietary intake of the n-3 fatty acids (FAs) eicosapentaenic acid and docosahexaenoic acid could explain the relation between depressive symptoms and cardiovascular mortality.

Effect of non-invasive ventilation on survival, quality of life, respiratory function and cognition: a review of the literature.

Symptoms of nocturnal hypoventilation may negatively influence the quality of life (QoL) of ALS patients long before respiratory failure ensues. Non-invasive mechanical ventilation (NIV) is considered a treatment option for nocturnal hypoventilation. The primary objective of NIV is improving quality of life (QoL).

Coffee consumption is inversely associated with cognitive decline in elderly European men: the FINE Study.

Objective: To investigate whether coffee consumption is associated with 10-year cognitive decline in elderly men, as results of previous studies obtained hitherto have been controversial and prospective information on this association has been lacking.

Design, Subjects And Setting: Six hundred and seventy six healthy men born between 1900 and 1920 from Finland, Italy and the Netherlands participated in a 10-year prospective cohort study. Cognitive functioning was assessed using the Mini-Mental State Examination (0-30 points, with a higher score indicating better cognitive performance).

Chest radiography in general practice: indications, diagnostic yield and consequences for patient management.

Background: Chest radiography (CXR) is frequently performed in Western societies. There is insufficient knowledge of its diagnostic value in terms of changes in patient management decisions in primary care.

Aim: To assess the influence of CXR on patient management in general practice.

Marital status and living situation during a 5-year period are associated with a subsequent 10-year cognitive decline in older men: the FINE Study.

We investigate the association between marital status and living situation (over 5 years) on 10-year subsequent cognitive decline. The study population consisted of 1,042 men aged 70-89 years in 1990, who participated in the longitudinal Finland, Italy, the Netherlands Elderly (known as FINE) Study. We measured cognition by using the Mini-Mental State Examination, and we assessed marital status (married vs unmarried) and living situation (living with others vs living alone) with a standardized questionnaire.

Chest radiography and pneumonia in primary care: diagnostic yield and consequences for patient management.

The current prospective cohort study assessed the diagnostic yield of chest radiography (CXR) in primary-care patients suspected of pneumonia. In total, 192 patients with a clinical suspicion of pneumonia aged >/=18 yrs were referred by their general practitioner (GP) for CXR to one of the three participating hospitals in the Netherlands. All GPs were asked to complete a standardised form before and after CXR.

Upper abdominal ultrasound in general practice: indications, diagnostic yield and consequences for patient management.

Background: Abdominal ultrasound (US) is frequently performed in Western societies. There is insufficient knowledge of its diagnostic value in terms of changes in patient management decisions in primary care.

Objective: To assess the influence of upper abdominal US on patient management in general practice.

Axon loss is an important determinant of weakness in multifocal motor neuropathy.

Background: Multifocal motor neuropathy (MMN) is characterised by asymmetrical weakness and muscle atrophy, in the arms more than the legs, without sensory loss. Despite a beneficial response to treatment with intravenous immunoglobulins (IVIg), weakness is slowly progressive. Histopathological studies in MMN revealed features of demyelination and axon loss.

Homocysteine level and cognitive function in patients with arterial disease: the second manifestations of ARTerial Disease Study.

Objectives: To assess the relationship between total plasma homocysteine (tHcy) level and cognitive function in patients with manifest arterial disease.

Design: Cross-sectional.

Setting: Patients with symptomatic cerebrovascular disease, cardiovascular disease, peripheral arterial disease, or abdominal aortic aneurysm included in the Second Manifestations of ARTerial disease study, a single-center, longitudinal study with an extensive screening program at baseline.

Intake of polyunsaturated fatty acids and vitamin E reduces the risk of developing amyotrophic lateral sclerosis.

Background: To assess whether the premorbid dietary intake of fatty acids, cholesterol, glutamate or antioxidants was associated with the risk of developing amyotrophic lateral sclerosis (ALS).

Methods: Patients referred to our clinic during 2001-2002, who had definite, probable or possible ALS according to El Escorial criteria, without a familial history of ALS, were asked to participate in a case-control study (132 patients and 220 healthy controls). A food-frequency questionnaire was used to assess dietary intake for the nutrients of interest.

Long-term outcome in polymyositis and dermatomyositis.

Background: Although polymyositis and dermatomyositis are regarded as treatable disorders, prognosis is not well known, as in the literature long-term outcome and prognostic factors vary widely.

Aim: To analyse the prognostic outcome factors in polymyositis and adult dermatomyositis.

Methods: We determined mortality, clinical outcome (muscle strength, disability, persistent use of drugs and quality of life) and disease course and analysed prognostic outcome factors.

Depressive symptoms as risk factor of cardiovascular mortality in older European men: the Finland, Italy and Netherlands Elderly (FINE) study.

Background: Depressive symptoms have been suggested to increase the risk of cardiovascular diseases, but this may reflect reversed causality. We investigated to what extent depressive symptoms are a true risk factor for cardiovascular mortality in elderly men.

Design: The Finland, Italy and Netherlands Elderly (FINE) study is a prospective cohort study conducted in Finland, Italy and The Netherlands.

Dispositional optimism and the risk of cardiovascular death: the Zutphen Elderly Study.

Background: Dispositional optimism, defined in terms of life engagement and generalized positive outcome expectancies for one's future, may be related to lower cardiovascular mortality. We aimed to determine whether dispositional optimism is a stable trait over time and whether it is independently related to lower cardiovascular mortality in elderly men.

Methods: In a cohort study with a follow-up of 15 years, we included 545 (61.

Feasibility and cost efficiency of a diagnostic guideline for chronic polyneuropathy: a prospective implementation study.

Background: Extensive investigations are often performed to reveal the cause of chronic polyneuropathy. It is not known whether a restrictive diagnostic guideline improves cost efficiency without loss of diagnostic reliability.

Methods: In a prospective multicentre study, a comparison was made between the workup in patients with chronic polyneuropathy before and after guideline implementation.

Frequency of chest radiography and abdominal ultrasound in the Netherlands: 1999-2003.

Chest radiography and abdominal ultrasound are two widely used diagnostic imaging techniques in Western societies. However, little is known about the frequency of these examinations and its determinants. The aim of this descriptive study was to provide detailed information on the number of chest radiography and abdominal ultrasound examinations by age, gender, referring physician and ethnicity.

The meaning of distal sensory loss and absent ankle reflexes in relation to age: a meta-analysis.

Context: Polyneuropathy is a common disease and is more prevalent (at least 3 %) in elderly people. However, routine neurological examination of healthy elderly people may show distal sensory loss and absent tendon reflexes, which can obscure the distinction from polyneuropathy.

Objective: To investigate the relation between age and the prevalence of distal sensory loss, absent tendon reflexes, or muscle weakness, and to ascertain above which age these neurological signs could be considered as normal in ageing.

Multidisciplinary ALS care improves quality of life in patients with ALS.

Objective: To examine the effect of multidisciplinary ALS care on the quality-of-life (QoL) in patients with ALS and their caregivers.

Methods: In a cross-sectional study, 208 patients with ALS and their caregivers were interviewed. QoL was assessed using the 36-item Short Form Health Survey (SF-36) and two visual analogue scales (VAS).

CSF levels of angiogenesis-related proteins in patients with leptomeningeal metastases.

The authors determined the levels of vascular endothelial growth factor (VEGF) and urokinase-type plasminogen activator (uPA) in the CSF of patients with leptomeningeal metastases (LM; n = 53), cancer patients without LM (n = 18), and subjects without malignancy (n = 25). Median levels of uPA and VEGF were significantly higher in patients with LM, supporting the hypothesis that angiogenesis contributes to LM. VEGF was negatively correlated with survival in patients with LM, suggesting its use as a prognostic factor.