Epidemiology of Parkinson's Disease: The Rotterdam Study

At present, Parkinson's disease (PO), after Alzheimer's disease, is generally considered to be the most frequent progressive neurodegenerative disease in the elderly. Due to the growing proportion of elderly in many populations, more and more persons will be affected by this disabling disease which constitutes a large burden to man and society. Since the publication of James Parkinson's essay, almost two centuries have elapsed and, in spite of numerous efforts to unravel the nature of the disease, the etiology of PO is still unknown. Yet, the neuropathologic and biochemical changes that cause the signs of the disease seem to be settled, based on knowledge that was mainly accumulated in only the past three decades. Neuropathologically, PO is defined by selective degeneration of pigmented neurons of the pars compacta of the substantia nigra and other brainstem ganglia, with cytoplasmic inclusions, called Lewy bodies, in the surviving neurons as the hallmark. These lesions lead to a deficiency of striatal dopamine. It is now considered that parkinsonian signs only become clinically overt after dopaminergic cell loss of approximately 50% and that at that moment the endogeneous dopamine content is depleted by 80%

APOE and the risk of PD with or without dementia in a population-based study.

OBJECTIVE: To study the association between APOE genotype and PD with or without dementia. METHODS: The study formed part of the Rotterdam Study, a prospective, population-based cohort study on the frequency, etiology, and prognosis of chronic diseases. The cohort examined for PD consisted of 6,969 independently living or institutionalized i

Case ascertainment uncertainties in prevalence surveys of Parkinson's disease

Using unpublished data from five completed prevalence surveys of Parkinson's disease (PD), we investigated case ascertainment uncertainties that potentially have a direct effect on prevalence. These uncertainties arise from the choice of diagnostic criteria, the choice of screening method, and the amount of information lost because of nonresponse. The surveys were conducted in Argentina, India, China, Italy, and the Netherlands. Our analyses consisted of simple comparisons of prevalence results, positive predictive values (a screening measure), and nonresponse percentages. We found that (a) prevalence comparisons between surveys have diminished value if the surveys used different diagnostic criteria for PD; (b) screening performance may be affected adversely if symptom questions are answered by one family member for the entire family living together rather than by each family member individually; and (c) nonresponse from refusal or unavailability does not necessarily lead to bias, but special caution may be appropriate with prevalence results pertaining to elderly women

68Ga-PSMA Uptake in Angiolipoma

Item does not contain fulltextGa-PSMA PET/CT is an imaging technique used in staging and detection of prostate cancer. However, enhanced uptake on Ga-PSMA PET/CT scan has also been ascribed to other malignant and benign lesions. We report on a case of a 56-year-old man with treated prostate carcinoma who had a Ga-PSMA PET/CT scan for restaging. Ga-PSMA uptakes in the prostatic bed and in multiple subcutaneous lesions were seen. Histopathology of a subcutaneous lesion revealed angiolipoma. It is important to be aware of the existence of the growing amount of reports on enhanced Ga-PSMA uptake unrelated to prostate cancer

Ontwikkeling van een serious game voor multidisciplinaire samenwerking in zorg en welzijn

Gemeenten en zorgorganisaties kijken steeds vaker over grenzen van sectoren heen vanwege de decentralisatie van ondersteuning aan langdurig zieken en ouderen. De samenwerking bij een dergelijke integrale aanpak kent verschillende uitdagingen, die in opleiding en training kunnen worden geoefend. Dit artikel beschrijft het proces om te komen tot een serious game voor het oefenen van de belangrijkste uitdagingen bij complexe multidisciplinaire samenwerking in zorg en welzijn. Op basis van literatuuronderzoek en interviews met professionals zijn vier leerdoelen opgesteld: het onderscheiden van de meerwaarde van de verschillende professionals, het communiceren met de verschillende professionals, het ontwikkelen van en het handelen naar een teamgerichte focus en het reflecteren op de samenwerking en de eigen rol hierin. In een prototype van de serious game combineerden we deze leerdoelen met gaming elementen, zoals tijdsdruk, het omgaan met tegenstrijdige belangen, het uitwisselen van unieke informatie, cross-training en stapsgewijze spelacties. De game is in drie pilotsessies gespeeld met professionals uit zorg en welzijn. Direct na het spelen werd met behulp van een evaluatieprotocol de game geëvalueerd en aangepast. De leerdoelen werden herkend en de spelvorm sluit aan bij de wensen van de praktijk. Deze studie biedt inzicht in de bouwstenen om multidisciplinaire samenwerking te optimaliseren en laat zien hoe een laagdrempelige, praktijkgerichte simulatietraining kan worden ontwikkeld

High detection rate of adenomas in familial colorectal cancer

Item does not contain fulltextBACKGROUND AND AIMS: Subjects with one first-degree relative (FDR) with colorectal cancer (CRC) 1) adenomas. Men were more often found to have an adenoma than women (24% vs 14.3%; p=0.01). Adenomas were more frequent in group B compared with group A (22.0% vs 15.6%; p=0.09). CONCLUSION: The yield of colonoscopic surveillance in familial CRC is substantially higher than the yield of screening reported for the general population

Adorno, der sport und die kritische sporttheorie

PURPOSE: Colonoscopic surveillance is recommended for individuals with familial colorectal cancer (CRC). However, the appropriate screening interval has not yet been determined. The aim of this randomized trial was to compare a 3-year with a 6-year screening interval. PATIENTS AND METHODS: Individuals between ages 45 and 65 years with one first-degree relative with CRC age < 50 years or two first-degree relatives with CRC were selected. Patients with zero to two adenomas at baseline were randomly assigned to one of two groups: group A (colonoscopy at 6 years) or group B (colonoscopy at 3 and 6 years). The primary outcome measure was advanced adenomatous polyps (AAPs). Risk factors studied included sex, age, type of family history, and baseline endoscopic findings. RESULTS: A total of 528 patients were randomly assigned (group A, n = 262; group B, n = 266). Intention-to-treat analysis showed no significant difference in the proportion of patients with AAPs at the first follow-up examination at 6 years in group A (6.9%) versus 3 years in group B (3.5%). Also, the proportion of patients with AAPs at the final follow-up examination at 6 years in group A (6.9%) versus 6 years in group B (3.4%) was not significantly different. Only AAPs at baseline was a significant predictor for the presence of AAPs at first follow-up. After correction for the difference in AAPs at baseline, differences between the groups in the rate of AAPs at first follow-up and at the final examination were statistically significant. CONCLUSION: In view of the relatively low rate of AAPs at 6 years and the absence of CRC in group A, we consider a 6-year surveillance interval appropriate. A surveillance interval of 3 years might be considered in patients with AAPs and patients with >/= three adenomas