Heart disease in the Netherlands: A quantitative update

In this review we discuss cardiovascular mortality, incidence and prevalence of heart disease, and cardiac interventions and surgery in the Netherlands. We combined most recently available data from various Dutch cardiovascular registries, Dutch Hospital Data (LMR), Statistics Netherlands (CBS), and population-based cohort studies, to provide a broad quantitative update. The absolute number of people dying from cardiovascular diseases is declining and cardiovascular conditions are no longer the leading cause of death in the Netherlands. However, a substantial burden of morbidity persists with 400,000 hospitalisations for cardiovascular disease involving over 80,000 cardiac interventions annually. In the Netherlands alone, an estimated 730,000 persons are currently diagnosed with coronary heart disease, 120,000 with heart failure, and 260,000 with atrial fibrillation. These numbers emphasise the continuous need for dedicated research on prevention, diagnosis, and treatment of heart disease in our country

Target Site Recognition by a Diversity-Generating Retroelement

Diversity-generating retroelements (DGRs) are in vivo sequence diversification machines that are widely distributed in bacterial, phage, and plasmid genomes. They function to introduce vast amounts of targeted diversity into protein-encoding DNA sequences via mutagenic homing. Adenine residues are converted to random nucleotides in a retrotransposition process from a donor template repeat (TR) to a recipient variable repeat (VR). Using the Bordetella bacteriophage BPP-1 element as a prototype, we have characterized requirements for DGR target site function. Although sequences upstream of VR are dispensable, a 24 bp sequence immediately downstream of VR, which contains short inverted repeats, is required for efficient retrohoming. The inverted repeats form a hairpin or cruciform structure and mutational analysis demonstrated that, while the structure of the stem is important, its sequence can vary. In contrast, the loop has a sequence-dependent function. Structure-specific nuclease digestion confirmed the existence of a DNA hairpin/cruciform, and marker coconversion assays demonstrated that it influences the efficiency, but not the site of cDNA integration. Comparisons with other phage DGRs suggested that similar structures are a conserved feature of target sequences. Using a kanamycin resistance determinant as a reporter, we found that transplantation of the IMH and hairpin/cruciform-forming region was sufficient to target the DGR diversification machinery to a heterologous gene. In addition to furthering our understanding of DGR retrohoming, our results suggest that DGRs may provide unique tools for directed protein evolution via in vivo DNA diversification

Erratum to Heart disease in the Netherlands: A quantitative update (Neth Heart J, (2013), 22, (3-10), 10.1007/s12471-013-0504-x)

Cardiolog

Trends and outcomes of valve surgery: 16-year results of Netherlands Cardiac Surgery National Database

The aim was to describe procedural volumes, patient risk profile and outcomes of heart valve surgery in the past 16 years in Netherlands. The Dutch National Database for Cardio-Thoracic Surgery includes approximately 200 000 cardiac operations performed between 1995 and 2010. Information on all valve surgeries (56 397 operations) was extracted. We determined trends for changes in procedural volume, demographics, risk profile and in-hospital mortality of valve operations. Because of incomplete data in the first years of registration, the total number of operations in those years was estimated using Poisson regression. For a subset from 2007 to 2010, follow-up data were available. Survival status was obtained through linkage with the national Cause of Death Registry, and survival analysis was performed using Kaplan-Meier method. Information on discharge and readmissions was obtained from the National Hospital Discharge Registry. The annual volume of heart valve operations increased by more than 100% from an estimated 2431 in 1995 to 5906 in 2010. Adjusted for population size in Netherlands, the number of operations per 100 000 adults increased from 20 in 1995 to 43 in 2010. In 2010, frequently performed valve surgery included the following: 34.6% isolated aortic valve (AoV) replacement, 21.8% AoV replacement and coronary artery bypass grafting (CABG), 14.6% isolated mitral valve surgery (repair or replacement) and 9.1% mitral valve and CABG. In AoV surgery, an increasing use of bioprostheses in all age categories is observed. In mitral valve surgery, 75.4% was performed by repair rather than replacement in 2010. In-hospital mortality for all valve surgery decreased significantly from 4.6% in 2007 to 3.6% in 2010, whereas the mean logistic EuroSCORE remained stable (median 5.8, P = 1.000). Thirty-day mortality after all valve surgery was 3.9% and 120-day mortality was 6.5%. At 1 year, survival after all valve surgery was 91.6% and a reoperation had been performed in 1.6%. The median postoperative length of stay was 7 days (interquartile range (IQR) 5-11) in the primary hospital and 11 days (IQR 8-16), including subsequent stay, in the secondary hospital. The results of this study provide a comprehensive overview of valve surgery trends and outcomes in Netherlands. The number of heart valve operations performed in Netherlands has increased since 1995. The significant decrease in mortality and unchanged EuroSCORE between 2007 and 2010 might reflect a general improvement of the safety of valve surger

Värdetransportrån

Med denna rapport vill vi försöka att belysa ett brott som har blivit allt vanligare för varje dag som går, nämligen värdetransportrån. Gärningsmännen blir råare och deras metoder förfinas hela tiden. Rikskriminalpolisen fasar nu för att gärningsmännen går vidare och även försöker råna värdedepåer runt om i Sverige . Det som är skrämmande med dessa brott är att gärningsmannen inte drar sig för att använda vapen för att få det han vill. Ett stort problem för polisen är att det krävs stora resurser i spaningsarbete för att kunna lagföra de misstänkta gärningsmännen. Detta är ett väldigt tidsödande arbete och man kan anse att tidsåtgången inte är försvarlig mot den gällande straffsatsen. I dagsläget är inte förberedelse eller försök till rån i närheten av vad man döms till när det gäller fullbordat rån. En ändring i straffskalan när det gäller försök och förberedelse för grovt rån, skulle göra att dessa individer inte kan komma ut så snabbt för att fortsätta sin brottsliga bana efter avtjänat fängelsestraff. En annan typ av brott som är relativt vanligt, men mycket svårbevisat, är stämplingsbrott gällande grovt rån. Vissa individer har specialiserat sig på att ”samla” information gällande transporterna för att sedan anlita andra personer för att genomföra rånet. Man tar sedan procent på förtjänsten eller så säljer man en redan utarbetad plan. I rapporten tar vi upp ökningen av värdetransportrånen i Sverige och jämför med några andra länder i Europa och Skandinavien. Vi pekar även på att risken för upptäckt ställt i relation till de pengar som gärningsmännen kan komma åt vid brottet och det eventuella straff man kan tilldömas, inte avskräcker gärningsmännen från att begå brottet. Vi ger en redogörelse över vilka brott som kan bli aktuella vid förberedelse och genomförande av värdetransportrån, och vi avslutar med våra egna slutsatser när det gäller värdetransportrånen i Sverige