Veertig jaar epidemiologie aan de Erasmus Universiteit 1969-2009

Waarschijnlijk telt geen land ter wereld per hoofd van de bevolking zoveel epidemiologen als Nederland. De Nederlandse Vereniging van Epidemiologen is een van de grootste in Europa. Elke maand verschijnen in de beste internationale wetenschappelijke tijdschriften resultaten van Nederlands epidemiologisch onderzoek. En het zijn artikelen die ertoe doen. In de top 25 van meest geciteerde Nederlands onderzoekers zijn er alleen al zes gelieerd aan het ERGO-onderzoek: een cohort van inmiddels ruim 15.000 Rotterdammers dat nu al bijna 20 jaar loopt. Om kort te gaan: epidemiologie is hot in Holland. Deze bundel bevat afscheidsredes en oraties uit de afgelopen veertig jaar, Tot slot bevat dit boek een opsomming van promovendi die vanuit de afdeling Epidemiologie hun proefschrift verdedigden aan de Erasmus Universiteit, en van alle medewerkers, oud-medewerkers en gasten met een formele aanstelling bij de afdeling Epidemiologie

Incidence and risk factors of open-angle glaucoma : the Rotterdam study

__Abstract__ Glaucoma is one of the poorest understood and defined eye diseases among those known since our era. Despite two millennia of writing about glaucoma, a straightforward and clear-cut definition is not available worldwide. In essence, glaucoma is an eye disease characterized by loss of retinal ganglion cells and their axons. Clinically, this loss becomes apparent by cupping, also called excavation, of the optic disc and concomitant visual field loss. There are many subgroups of glaucoma, separated by causes, genetics, or morphology, and within each group there may be tens of different glaucoma types. From the start, I would like to point out that this thesis focuses on primary open-angle glaucoma. This is glaucoma in which the persons have open angles in their anterior eye chamber, through which the intraocular fluid leaves the eye. Moreover, all causes of secondary glaucoma, such as inflammation, medication, and systemic disorders, should have been eliminated with a reasonable amount of certainty. Since open-angle glaucoma cases with pseudoexfoliation were not specifically excluded at baseline of the Rotterdam study, we prefer to refer to open-angle glaucoma instead of primary open-angle glaucoma although during follow-up, no pseudoexfoliation was observed

Detection superiority of 7 T MRI protocol in patients with epilepsy and suspected focal cortical dysplasia

In 11 adult patients with suspicion of Focal cortical dysplasia (FCD) on 1.5 T (n = 1) or 3 T (n = 10) magnetic resonance imaging (MRI), 7 T MRI was performed. Visibility, extent, morphological features and delineation were independently rated and subsequently discussed by three observers. Additionally, head-to-head comparisons with corresponding 3 T images were made in the eight patients with a previous 3 T MRI and sustained suspicion of FCD. Comparison with histopathology was done in the five patients that underwent surgery. All lesions, seen at 1.5 and 3 T, were also recognized on 7 T. At 7 T FLAIR highlighted the FCD-like lesions best, whereas T2 and T2* were deemed better suited to review structure and extent of the lesion. Image quality with the used 7 T MRI setup was higher than the quality with the used 3 T MRI setup. In 2 out of 11 patients diagnosis changed, in one after re-evaluation of the images, and in the other based on histopathology. With the used 7 T MRI setup, FCD-like lesions can be detected with more confidence and detail as compared to lower field strength. However, concordance between radiologic diagnosis and final diagnosis seems to be lower than expected

Compactification of M(atrix) theory on noncommutative toroidal orbifolds

It was shown by A. Connes, M. Douglas and A. Schwarz that noncommutative tori arise naturally in consideration of toroidal compactifications of M(atrix) theory. A similar analysis of toroidal Z_{2} orbifolds leads to the algebra B_{\theta} that can be defined as a crossed product of noncommutative torus and the group Z_{2}. Our paper is devoted to the study of projective modules over B_{\theta} (Z_{2}-equivariant projective modules over a noncommutative torus). We analyze the Morita equivalence (duality) for B_{\theta} algebras working out the two-dimensional case in detail.Comment: 19 pages, Latex; v2: comments clarifying the duality group structure added, section 5 extended, minor improvements all over the tex

Evaluation of community-wide interventions: The ecologic case-referent study design

In a setting of long-standing, community-wide and generally accepted prevention activities like youth health care services in The Netherlands, evaluative research in the form of experimental studies is hardly possible. Furthermore, as most interventions will bear fruit only after several years and the effects are often described in rather vague terms, even nonexperimental study designs are fraught with possible difficulties. Although a study design using aggregate data is generally considered inferior or 'incomplete', in many cases, especially in health services research, this approach can be the only one feasible to evaluate the effectiveness of preventive programmes and interventions. In this article we present the ecologic case-referent design as a potentially expedient and valid method for estimating the ecologic effect of a population-wide intervention on the outcome rate in those populations. In this case-referent design, many variables are measured at the individual level, whereas the main exposure variable is measured at an aggregate or ecologic level. Using recently published studies as an example, the advantages and drawbacks of the design are discussed using the randomised controlled trial design as the referent study design

Serum levels of interleukin-6 are not elevated in patients with Alzheimer's disease

Serum levels of interleukin-6 (IL-6) were determined in 97 patients with clinically diagnosed Alzheimer's disease and 79 age- and sex-matched control subject. Median serum levels of IL-6 did not differ significantly between Alzheimer patients (8.6 U/ml) and controls (8.2 U/ml). Median levels of serum IL-6 were similar for sporadic and familial patients. The concentration of IL-6 was not associated with the severity of the dementia or the duration of the disease since first symptoms. According to these observations there is no evidence for a significant elevation in serum IL-6 in Alzheimer's disease

Blood pressure in childhood : epidemiological probes into the aetiology of high blood pressure

High arterial blood pressure takes a heavy toll in western populations (1 ). Its causes are still largely unknown, but its sequelae, a variety of cardiovascular and renal diseases, have been referred to as "a modern scourge" (2). High blood pressure of unknown cause, or essential hypertension, is considered by most to be a quantitative deviation from the norm (3). Thus, the study of the distribution, determinants and development of blood pressure may provide knowledge about the aetiology and pathogenesis of high blood pressure. The basic idea of this thesis is, that it is possible to learn something about the causes of essential hypertension by inquiries of the correlates and the course of blood pressure in early life, long before the consequences of high blood pressure have occurred and early enough to prevent them. From this idea the questions follow naturally. What is the level of blood pressure in childhood? Does the level in childhood tell us something about the level in adulthood, when the diseases that are related to high blood pressure occur? What are the determinants, or correlates, of the level of blood pressure? Which factors predict change in blood pressure during childhood? And finally, can future hypertensives be detected early in life? These questions will be dealt with in the following chapters, where reports of various studies are given. The piece de resistance of this thesis are investigations performed as part of the EPOZ study, the Epidemiological Preventive Organisation Zoetermeer. Further studies have been carried out in other populations. The different designs of these studies illustrate that an epidemiologist has many options as a student of disease aetiology. One study is experimental - a randomised trial of sodium intake and blood pressure in newborns. As the experiment serves as the 'gold standard' for any scientific research in epidemiology as well as elsewhere ( 4), I am glad that an experimental study in the open population could be part of this thesis. The other investigations have been non-experimental, observational. Some studies were cross-sectional, others were planned according to a longitudinal research design. The longitudinal studies were of the case-control type and of the follow-up type. And finally, the follow-up studies have been retrospective and prospective. An overview of the various studies, with their design, population and type is given in the Table

An Integrated View on the Future of Logistics and Information Technology

In this position paper, we present our vision on the future of the logistics business domain and the use of information technology (IT) in this domain. The vision is based on extensive experience with Dutch and European logistics in various contexts and from various perspectives. We expect that the vision also holds for logistics outside Europe. We build our vision in a number of steps. First, we make an inventory of the most important trends in the logistics domain - we call these mega-trends. Next, we do the same for the information technology domain, restricted to technologies that have relevance for logistics. Then, we introduce logistics meta-concepts that we use to describe our vision and relate them to business engineering. We use these three ingredients to analyze leading concepts that we currently observe in the logistics domain. Next, we consolidate all elements into a model that represents our vision of the integrated future of logistics and IT. We elaborate on the role of data platforms and open standards in this integrated vision.Comment: 22 pages, 7 figures, 3 table