Gehandicapten wel geteld : lichamelijk gehandicapten 1971/1972

In this publication are assembled the most important results of a survey carried out in 1971/1972 by the Central Bureau of Statistics as to the number of physically handicapped in the Netherlands, their social circumstances and the use made of and demand for services and facilities. For the purpose of this survey a sample was drawn from the Netherlands population of 5 years of age and older (both institutionalized and non-institutionalized) registered in the municipal civil registers as of 28th February 1971. In the first instance these persons received a questionnaire by mail. Of those who responded (83%), those who claimed to have physical complaints were approached by means of an interview survey. Co-operation was 95%. In the framework of this survey by physically handicapped is understood: = anyone who has one or more functional disorders to at least a certain degree. Disorders in the following are regarded as functional disorders: function of legs, function of arms/hands, sight, hearing, speech, endurance (heart, lungs), micturition, defecation, balance (including epilepsy), other functions. With respect to each function it was determined to what degree of severity the disorder must at least be present for the individual to be considered physically handicapped. 3 to 4 degrees of severity were distinguished for each functional disorder.The results of the study are published in Dutch in six parts. The first part, containing the key figures, appeared at the end of 1974. It is expected that parts 2 and 3 will appear in the course of 1976. This part (7) is an English language synopsis of the first three parts. In addition to a general description of definitions and research methods the following subjects are dealt with:- demographic data (age, sex, degree of urbanization, province, civil status);- physical data (nature of functional disorder, cause, diagnosis groups, physical defects, location of accident, age at which functional disorder became manifest, degree of severity);- special aids (prostheses, wheel chairs, hearing-aids etc.), use and demand;- medical services (general practitioner, rehabilitation treatment), use and demand;- social services, contact and demand.For each of these subjects some of the most salient results are given.Of the Netherlands population of 5 years of age and older 8.7% are found to be physically handicapped on the basis of the definition employed in the survey. This is equivalent to over a million persons. The chance of becoming physically handicapped increase sharply with increase of age. Of young people of 5 -24 years of age approximately 2% are handicapped. Among persons of 75 years of age and older this percentage is 35. Till the age of 55 differences between men and women are not large. After this age differentiations are to be found. Differences in mortality patterns and in physical burden are probably responsible for this. The sharp increase among men up to the age of 65 and the decrease after this age is striking. Even when the factor age is eliminated it is found that the percentage of physically handicapped in rural areas is significantly lower than in urban municipalities. After elimination of the age factor, differences between the provinces are found to disappear. Only the province of Limburg, which encompasses the former mining area, is found to have a significantly higher percentage.Disorders in endurance and in function of legs play a very large role. Of all physically handicapped (of 5 years and older) 21% have only a disorder in endurance and 18% a disorder in function of legs. in addition to this there are a large number of physically handicapped persons with a disorder in endurance and/or function of legs in combination with other functional disorders. This results in there being a disorder in endurance among 45% of all physically handicapped and a disorder in function of legs among 42%. Slightly more than 80% of handicapped persons are handicapped simply as a result of illness (including old age). After this in order of frequency follow "due to accident" and "from birth". In the case of disorders due to accident, traffic is found to account for the largest number, followed closely by accidents at work and at home. In the diagnosis groups heart and vascular diseases and rheumatic conditions are the most widespread.For the purpose of moving around approximately 56% of persons with disorders in function of legs make use of special aids such as canes and orthopaedic aids, while nearly 10% move around with the assistance of others. It is estimated that 8.9% of all physically handicapped with a disorder in function of legs, or 0.3% of the Netherlands population, makes use of some form of special transport such as a wheel chair, invalid car, push chair etc. Approximately 87% of all physically handicapped had consulted a general practitioner or specialist in the year preceding the survey and 12.3% had at some time received rehabilitation treatment.Of the physically handicapped of 5 - 64 years of age, 22% had contact with social services in some form.In conclusion it should be stated that in many instances a lack of information was found to exist as to aids, services and the channels to obtaining these. Though it is possible that resistance and bash fulness play a role it does appear desirable that more attention should be devoted to the aspect "information". more information in general, but in particular to the physically handicapped, to persons in their immediate surroundings and to their potential helpers should be considered.In view of the fact that a high percentage of the physically handicapped fairly regularly come into contact with some form of medical services, co-operation with this sector to further information and to point the way to the appropriate institutions is to be advocated.<p/

Effect of long-term voluntary exercise wheel running on susceptibility to bacterial pulmonary infections in a mouse model

Regular moderate exercise has been suggested to exert anti-inflammatory effects and improve immune effector functions, resulting in reduced disease incidence and viral infection susceptibility. Whether regular exercise also affects bacterial infection susceptibility is unknown. The aim of this study was to investigate whether regular voluntary exercise wheel running prior to a pulmonary infection with bacteria (P. aeruginosa) affects lung bacteriology, sickness severity and phagocyte immune function in mice. Balb/c mice were randomly placed in a cage with or without a running wheel. After 28 days, mice were intranasally infected with P. aeruginosa. Our study showed that regular exercise resulted in a higher sickness severity score and bacterial (P. aeruginosa) loads in the lungs. The phagocytic capacity of monocytes and neutrophils from spleen and lungs was not affected. Although regular moderate exercise has many health benefits, healthy mice showed increased bacterial (P. aeruginosa) load and symptoms, after regular voluntary exercise, with perseverance of the phagocytic capacity of monocytes and neutrophils. Whether patients, suffering from bacterial infectious diseases, should be encouraged to engage in exercise and physical activities with caution requires further research

Investigation of the presence of human or bovine respiratory syncytial virus in the lungs of mink (Neovison vison) with hemorrhagic pneumonia due to Pseudomonas aeruginosa

<p>Abstract</p> <p>Background</p> <p>Hemorrhagic pneumonia is a disease of farmed mink (<it>Neovison vison</it>) caused by <it>Pseudomonas aeruginosa</it>. The disease is highly seasonal in Danish mink with outbreaks occurring almost exclusively in the autumn. Human respiratory syncytial virus (RSV) has been shown to augment infection with <it>P. aeruginosa</it> in mice and to promote adhesion of <it>P. aeruginosa</it> to human respiratory cells.</p> <p>Findings</p> <p>We tested 50 lung specimens from mink with hemorrhagic pneumonia for bovine RSV by reverse transcriptase polymerase chain reaction (PCR) and for human RSV by a commercial real-time PCR. RSV was not found.</p> <p>Conclusions</p> <p>This study indicates that human and bovine RSV is not a major co-factor for development of hemorrhagic pneumonia in Danish mink.</p

Structural/mechanistic insights into the efficacy of non-classical β-lactamase inhibitors against extensively drug resistant Stenotrophomonas maltophilia clinical isolates

Clavulanic acid and avibactam are clinically deployed serine β-lactamase inhibitors, important as a defence against antibacterial resistance. Bicyclic boronates are recently discovered inhibitors of serine and some metallo β-lactamases. Here we show that avibactam and a bicyclic boronate inhibit L2 (serine β-lactamase) but not L1 (metallo β-lactamase) from the extensively drug resistant human pathogen Stenotrophomonas maltophilia. X-ray crystallography revealed that both inhibitors bind L2 by covalent attachment to the nucleophilic serine. Both inhibitors reverse ceftazidime resistance in S. maltophilia because, unlike clavulanic acid, they do not induce L1 production. Ceftazidime/inhibitor resistant mutants hyper-produce L1, but retain aztreonam/inhibitor susceptibility because aztreonam is not an L1 substrate. Importantly, avibactam, but not the bicyclic boronate is deactivated by L1 at a low rate; the utility of avibactam might be compromised by mutations that increase this deactivation rate. These data rationalize the observed clinical efficacy of ceftazidime/avibactam plus aztreonam as combination therapy for S. maltophilia infections and confirm that aztreonam-like β-lactams plus non-classical β-lactamase inhibitors, particularly avibactam-like and bicyclic boronate compounds, have potential for treating infections caused by this most intractable of drug resistant pathogens

Challenging and emerging pathogens in cystic fibrosis

Bacterial pathogens and especially Pseudomonas aeruginosa play an important role in cystic fibrosis (CF). Increased microbiological monitoring, improved detection techniques but also improved antibiotic treatment of classic CF pathogens, have led to a changing epidemiology of pathogens. In this thesis we show that although some emerging pathogens are associated with adverse clinical outcome upon cross- sectional analysis, the individual effects on the course of lung disease are often minimal when performing longitudinal follow-up and taking into account possible confounding factors. Apart form their individual effects interactions between pathogens can occur: we showed that RSV can facilitate P. aeruginosa infection in a mouse model. This suggests that not only the individual effects of pathogens should be investigated but also pathogen interactions. Another important change in infection epidemiology for CF patients was the occurrence of highly prevalent P. aeruginosa clones. Several reports have described the occurrence of such clones and an association with adverse clinical outcome. Recently a highly prevalent clone was found in the Dutch CF population. We showed that infection with this clone is not associated with worse lung function or a stronger lung function decline. There was also no association with increased mortality or chance of lung transplantation. However, this clone was better able to persist within patients and patients with this clone were more likely to use antibiotics. Thus, continuing prospective monitoring of the clinical impact of this clone is necessary, to study the long term effects and to evaluate the current infection control policy. Finally, we investigated the occurrence of resistant P. aeruginosa and found that the long-term use of inhaled tobramycin significantly increased this risk. This warrants the search and application of new and improved antibiotic treatment strategies, to prevent the long-term monotherapeutic use of tobramycin and the associated risk of antibiotic resistance