Reported adverse drug reactions during the use of inhaled steroids in children with asthma in the Netherlands

Objective: Inhaled corticosteroids (ICS) are widely used in the treatment of asthma. We studied the suspected adverse drug reactions (sADRs) reported during the use of ICS in the Netherlands. Methods: In the Netherlands, health professionals and patients can report suspected ADRs to the Pharmacovigilance Centre Lareb. All reported sADRs on ICS were categorised and assessed as to whether these were likely to be associated with use of the steroid. Age and gender adjusted Reported Odds Ratios (RORs) and Naranjo Scores (NS) were computed for sADRs reported more than 3 times. Results: Since 1984, sADRs of ICS were reported in 89 children (mean age 6 years), 48 (54%) were boys. Suspected drugs were fluticasone in 46 children (52%), budesonide in 21 (24%), and beclomethasone in 22 cases (24%). Psychiatric symptoms were reported in 19 children (21%; ROR 3.8, NS 3.6), growth retardation in 6 children (7%; ROR 47.8, NS 3.0) and rashes in 6 cases (7%; ROR 0.7, NS 2.4). There were 7 reports (8%; ROR 2.1, NS 3.4) concerning abnormalities of the teeth, 4 reports of alopecia (4%; ROR 3.3, NS 3.5), and 3 reports of hirsutism and hypertrichosis (NS 4.0). Non-fatal adrenal insufficiency was reported once. Conclusion: Alteration of behaviour was the most frequently reported sADR. There are more indications that alterations of behaviour could be a real sADR of ICS. Non-fatal adrenal insufficiency was the only reported possible life threatening sADR. The association of hypertrichosis and teeth abnormalities after ICS in children has not been reported in the literature before

Antibiotic usage, dosage and course length in children between 0 and 4 years

Antibiotic drugs are most frequently used by 0- to 4-year-old children. We performed a cross-sectional study in the Netherlands using a pharmacy prescription database to investigate the use, dose and course length of antibiotic drugs in 0- to 4-year-olds. We used a database with pharmacy drug-dispensing data. We investigated all prescriptions of systemic antibiotics prescribed in the years 2002-2006 for children of 0-4 years of age. Prescriptions for children under the age of 3 months were excluded. Children of 9-12 months of age received more antibiotics than children in other age groups. In the 3- to 6-month-olds, amoxicillin was prescribed in 75.2% of the cases. This percentage was 50.4% in the 4-year-olds. The contribution of other broad-spectrum antibiotics increased with age (clarithromycin and amoxicillin/clavulanic acid). Small-spectrum penicillins were prescribed less often than the broad-spectrum antibiotics. From the prescriptions of the five most used drugs, 97.6% were within the recommended dose range. Most course lengths corresponded with the guidelines. Of the prescriptions, 3.9% were unlicensed or off-label. Within the group of 0- to 4-year-old children, most antibiotics were used by 9- to 12-month-olds. The doses and course lengths were mostly correct, but the choice of antibiotics was not according to the guidelines. Young children received unlicensed and off-label prescribed antibiotics

Inadequate folic acid intake around the time of conception, particularly among less highly educated women

Objective. To describe the knowledge and use of folic acid by women in the North of the Netherlands who wish to become pregnant, in relation to their social-economic status. Design. Descriptive. Method. Pregnant women who were attending one of 3 gynaecological and 7 midwifery practices for their first or second pregnancy check-up in October or November 2000 in the provinces Groningen, Friesland and Drenthe were asked to complete a questionnaire about their knowledge, sources of information and use of folic acid. Four hundred and sixty-one of the 473 women were prepared to take part. The highest level of education achieved was used as an indicator of social-economic status. Results. Three hundred and fifty-seven (77%) respondents had heard about folic acid before becoming pregnant, 289 (63%) knew about its protective effect in terms of neural-tube defects, and 151 (33%) knew the full length of the advised period of folic acid intake. Two hundred and sixty-five (61%) respondents had taken folic acid for some part of the advised period and 164 (36%) had taken it for the entire duration of the advised period. More women with a higher education than women with lower levels of education knew about folic acid and had used it. Conclusion. Three quarters of the respondents had heard about folic acid before their pregnancy, and less than half took it during the advised period around the time of conception. Women with a higher education were more likely to follow the advice.</p

Inadequate folic acid intake around the time of conception, particularly among less highly educated women

Objective. To describe the knowledge and use of folic acid by women in the North of the Netherlands who wish to become pregnant, in relation to their social-economic status. Design. Descriptive. Method. Pregnant women who were attending one of 3 gynaecological and 7 midwifery practices for their first or second pregnancy check-up in October or November 2000 in the provinces Groningen, Friesland and Drenthe were asked to complete a questionnaire about their knowledge, sources of information and use of folic acid. Four hundred and sixty-one of the 473 women were prepared to take part. The highest level of education achieved was used as an indicator of social-economic status. Results. Three hundred and fifty-seven (77%) respondents had heard about folic acid before becoming pregnant, 289 (63%) knew about its protective effect in terms of neural-tube defects, and 151 (33%) knew the full length of the advised period of folic acid intake. Two hundred and sixty-five (61%) respondents had taken folic acid for some part of the advised period and 164 (36%) had taken it for the entire duration of the advised period. More women with a higher education than women with lower levels of education knew about folic acid and had used it. Conclusion. Three quarters of the respondents had heard about folic acid before their pregnancy, and less than half took it during the advised period around the time of conception. Women with a higher education were more likely to follow the advice.</p

Inadequate folic acid intake around the time of conception, particularly among less highly educated women

Objective. To describe the knowledge and use of folic acid by women in the North of the Netherlands who wish to become pregnant, in relation to their social-economic status. Design. Descriptive. Method. Pregnant women who were attending one of 3 gynaecological and 7 midwifery practices for their first or second pregnancy check-up in October or November 2000 in the provinces Groningen, Friesland and Drenthe were asked to complete a questionnaire about their knowledge, sources of information and use of folic acid. Four hundred and sixty-one of the 473 women were prepared to take part. The highest level of education achieved was used as an indicator of social-economic status. Results. Three hundred and fifty-seven (77%) respondents had heard about folic acid before becoming pregnant, 289 (63%) knew about its protective effect in terms of neural-tube defects, and 151 (33%) knew the full length of the advised period of folic acid intake. Two hundred and sixty-five (61%) respondents had taken folic acid for some part of the advised period and 164 (36%) had taken it for the entire duration of the advised period. More women with a higher education than women with lower levels of education knew about folic acid and had used it. Conclusion. Three quarters of the respondents had heard about folic acid before their pregnancy, and less than half took it during the advised period around the time of conception. Women with a higher education were more likely to follow the advice.</p

Inadequate folic acid intake around the time of conception, particularly among less highly educated women

Objective. To describe the knowledge and use of folic acid by women in the North of the Netherlands who wish to become pregnant, in relation to their social-economic status. Design. Descriptive. Method. Pregnant women who were attending one of 3 gynaecological and 7 midwifery practices for their first or second pregnancy check-up in October or November 2000 in the provinces Groningen, Friesland and Drenthe were asked to complete a questionnaire about their knowledge, sources of information and use of folic acid. Four hundred and sixty-one of the 473 women were prepared to take part. The highest level of education achieved was used as an indicator of social-economic status. Results. Three hundred and fifty-seven (77%) respondents had heard about folic acid before becoming pregnant, 289 (63%) knew about its protective effect in terms of neural-tube defects, and 151 (33%) knew the full length of the advised period of folic acid intake. Two hundred and sixty-five (61%) respondents had taken folic acid for some part of the advised period and 164 (36%) had taken it for the entire duration of the advised period. More women with a higher education than women with lower levels of education knew about folic acid and had used it. Conclusion. Three quarters of the respondents had heard about folic acid before their pregnancy, and less than half took it during the advised period around the time of conception. Women with a higher education were more likely to follow the advice.</p

Inadequate folic acid intake around the time of conception, particularly among less highly educated women

Objective. To describe the knowledge and use of folic acid by women in the North of the Netherlands who wish to become pregnant, in relation to their social-economic status. Design. Descriptive. Method. Pregnant women who were attending one of 3 gynaecological and 7 midwifery practices for their first or second pregnancy check-up in October or November 2000 in the provinces Groningen, Friesland and Drenthe were asked to complete a questionnaire about their knowledge, sources of information and use of folic acid. Four hundred and sixty-one of the 473 women were prepared to take part. The highest level of education achieved was used as an indicator of social-economic status. Results. Three hundred and fifty-seven (77%) respondents had heard about folic acid before becoming pregnant, 289 (63%) knew about its protective effect in terms of neural-tube defects, and 151 (33%) knew the full length of the advised period of folic acid intake. Two hundred and sixty-five (61%) respondents had taken folic acid for some part of the advised period and 164 (36%) had taken it for the entire duration of the advised period. More women with a higher education than women with lower levels of education knew about folic acid and had used it. Conclusion. Three quarters of the respondents had heard about folic acid before their pregnancy, and less than half took it during the advised period around the time of conception. Women with a higher education were more likely to follow the advice.</p

Морфология и трехмерные изображения рудника-пещеры Кан-и-Гут

Путём сравнительного анализа и компьютерной обработки данных чертежей и схем из разных источников впервые получена пространственная (3D) модель одного из самых сложных в морфологическом отношении подземелий смешанного типа – рудника-пещеры Кан-и-Гут (Кыргызстан). Описана методика перевода графических данных в цифровой формат. Найдены основные морфометрические параметры полости, представлены трехмерные изображения основных его отделов, обсуждается их морфология. В ряде полостей рудника-пещеры выявлены существенные изменения, произошедшие за последние 50 лет вследствие масштабных обрушений.Шляхом порівняльного аналізу і комп’ютерної обробки даних креслень і схем з різних джерел вперше отримана просторова (3d) модель одного з найскладніших в морфологічному відношенні підземель змішаного типа – копальні-печери Кан-і-Гут (Киргизстан). Описана методика переведення графічних даних в цифровий формат. Знайдені основні морфометричні параметри порожнини, представлені тривимірні зображення основних його відділів, обговорюється їх морфологія. У ряді порожнин копальні-печери виявлені істотні зміни, події за останніх 50 років унаслідок масштабних обвалень.Kan-i-Gut mined cave, located in Kyrgyzstan, is one of the most morphologically complex cavities of mixed genesis. For the first time, a 3D model was developed for this cave by comparative analyses and computer processing of cave maps and mine surveyor plan and profile, obtained from different sources. The methodology of transferring graphical data into digital format is described. Primary morphometric parameters of the mined cave are gathered, and 3D images of its main parts are presented. Essential morphological changes due to vast collapses during the last 50 years were discovered

Classifying Back Pain and Peripheral Joint Complaints in Inflammatory Bowel Disease Patients: A Prospective Longitudinal Follow-up Study

Development and application of statistical models for medical scientific researc