• Sacral neuromodulation versus personalized conservative treatment in patients with idiopathic slow-transit constipation: study protocol of the No.2-trial, a multicenter open-label randomized controlled trial and cost-effectiveness analysis.

      Heemskerk, S C M; Rotteveel, A H; Benninga, M A; Baeten, C I M; Masclee, A A M; Melenhorst, J; van Kuijk, S M J; Dirksen, C D; Breukink, S O (2018-02-22)
      The evidence regarding the (cost-)effectiveness of sacral neuromodulation (SNM) in patients with therapy-resistant idiopathic slow-transit constipation is of suboptimal quality. The Dutch Ministry of Health, Welfare and Sports has granted conditional reimbursement for SNM treatment. The objective is to assess the effectiveness, cost-effectiveness, and budget impact of SNM compared to personalized conservative treatment (PCT) in patients with idiopathic slow-transit constipation refractory to conservative treatment.
    • Safety and immunogenicity of fractional dose intradermal injection of two quadrivalent conjugated meningococcal vaccines.

      Jonker, Emile F F; van Ravenhorst, Mariëtte B; Berbers, Guy A M; Visser, Leo G (2018-05-16)
      Vaccination with conjugated meningococcal vaccines is the best way to prevent invasive meningococcal disease. Changes in serogroup epidemiology have led to the inclusion of quadrivalent vaccines in the national immunization programs of several countries, but vaccines are frequently in short supply. Intradermal administration has the potential to increase vaccine availability through dose reduction, without sacrificing efficacy. It has never before been investigated for glycoconjugate meningococcal vaccines.
    • Safety distances for hydrogen filling stations

      Matthijsen, A J C M; Kooi, E S (Elsevier, 2006-06-30)
      In the context of spatial planning the Dutch Ministry of Housing, Spatial Planning and the Environment asked the Centre for External Safety of the National Institute for Public Health and the Environment (RIVM) to advice on safe distances pertaining to hydrogen filling stations. The RIVM made use of failure modeling and parameters for calculating the distance in detail. An imaginary hydrogen filling station for cars is used in the determination of ‘external safety’ or third party distances for the installations and the pipe work for three different sizes of hydrogen filling stations. For several failure scenarios ‘effect’ distances are calculated for car filling at 350 and 700 bar. Safe distances of filling stations from locations where people live and work appear to be similar for compressed hydrogen, gasoline/petrol and compressed natural gas. Safe distances for LPG are greater. A filling unit for hydrogen can be placed at gasoline/petrol-filling stations without increasing safety distances
    • The safety of dental amalgam and alternative dental restoration materials for patients and users.

      Rodríguez-Farre, Eduardo; Testai, Emanuela; Bruzell, Ellen; De Jong, Wim; Schmalz, Gottfried; Thomsen, Mogens; Hensten, Arne (2016-08)
    • The safety of medical devices containing DEHP plasticized PVC or other plasticizers on neonates and other groups possibly at risk (2015 update).

      Testai, Emanuela; Hartemann, Philippe; Rastogi, Suresh Chandra; Bernauer, Ulrike; Piersma, Aldert; De Jong, Wim; Gulliksson, Hans; Sharpe, Richard; Schubert, Dirk; Rodríguez-Farre, Eduardo (2016-04)
    • The safety of the use of bisphenol A in medical devices.

      Testai, Emanuela; Hartemann, Philippe; Rodríguez-Farre, Eduardo; Rastogi, Suresh Chandra; Bustos, Juana; Gundert-Remy, Ursula; Hensten, Arne; Kopperud, Hilde Molvig; Olea, Nicolás; Piersma, Aldert; De Jong, Wim (2016-08)
    • Salmonella enterica Prophage Sequence Profiles Reflect Genome Diversity and Can Be Used for High Discrimination Subtyping.

      Mottawea, Walid; Duceppe, Marc-Olivier; Dupras, Andrée A; Usongo, Valentine; Jeukens, Julie; Freschi, Luca; Emond-Rheault, Jean-Guillaume; Hamel, Jeremie; Kukavica-Ibrulj, Irena; Boyle, Brian; Gill, Alexander; Burnett, Elton; Franz, Eelco; Arya, Gitanjali; Weadge, Joel T; Gruenheid, Samantha; Wiedmann, Martin; Huang, Hongsheng; Daigle, France; Moineau, Sylvain; Bekal, Sadjia; Levesque, Roger C; Goodridge, Lawrence D; Ogunremi, Dele (2018)
      Non-typhoidal Salmonella is a leading cause of foodborne illness worldwide. Prompt and accurate identification of the sources of Salmonella responsible for disease outbreaks is crucial to minimize infections and eliminate ongoing sources of contamination. Current subtyping tools including single nucleotide polymorphism (SNP) typing may be inadequate, in some instances, to provide the required discrimination among epidemiologically unrelated Salmonella strains. Prophage genes represent the majority of the accessory genes in bacteria genomes and have potential to be used as high discrimination markers in Salmonella. In this study, the prophage sequence diversity in different Salmonella serovars and genetically related strains was investigated. Using whole genome sequences of 1,760 isolates of S. enterica representing 151 Salmonella serovars and 66 closely related bacteria, prophage sequences were identified from assembled contigs using PHASTER. We detected 154 different prophages in S. enterica genomes. Prophage sequences were highly variable among S. enterica serovars with a median ± interquartile range (IQR) of 5 ± 3 prophage regions per genome. While some prophage sequences were highly conserved among the strains of specific serovars, few regions were lineage specific. Therefore, strains belonging to each serovar could be clustered separately based on their prophage content. Analysis of S. Enteritidis isolates from seven outbreaks generated distinct prophage profiles for each outbreak. Taken altogether, the diversity of the prophage sequences correlates with genome diversity. Prophage repertoires provide an additional marker for differentiating S. enterica subtypes during foodborne outbreaks.
    • Salt Reductions in Some Foods in The Netherlands: Monitoring of Food Composition and Salt Intake.

      Temme, Elisabeth H M; Hendriksen, Marieke A H; Milder, Ivon E J; Toxopeus, Ido B; Westenbrink, Susanne; Brants, Henny A M; van der A, Daphne L (2017-07-22)
      High salt intake increases blood pressure and thereby the risk of chronic diseases. Food reformulation (or food product improvement) may lower the dietary intake of salt. This study describes the changes in salt contents of foods in the Dutch market over a five-year period (2011-2016) and differences in estimated salt intake over a 10-year period (2006-2015).
    • Samenwerken aan gezondheid in de wijk: Een rol voor de huisarts? Ervaringen uit het project preventie in de buurt

      Drenthen, T; van den Brekel-Dijkstra, K; Leijen, M W; Monden-Oosterveld, H P (2017)
      There are two reasons why general practitioners (GPs) should collaborate with others in their neighbourhood: social problems that translate into physical symptoms and addressing healthy lifestyles and prevention.
    • Samenwerking tussen JGZ en het voortgezet onderwijs: tips en trucs uit de praktijk

      Blokstra, A.; Pieter, R.; Opten, R.; Bemelmans, W. (2017-04-25)
    • The sample of choice for detecting Middle East respiratory syndrome coronavirus in asymptomatic dromedary camels using real-time reversetranscription polymerase chain reaction.

      Mohran, K A; Farag, E A B; Reusken, C B E; Raj, V S; Lamers, M M; Pas, S D; Voermans, J; Smits, S L; Alhajri, M M; Alhajri, F; Al-Romaihi, H E; Ghobashy, H; El-Maghraby, M M; Al Dhahiry, S H S; Al-Mawlawi, N; El-Sayed, A M; Al-Thani, M; Al-Marri, S A; Haagmans, B L; Koopmans, M P G (2016-12)
      The newly identified Middle East respiratory syndrome coronavirus (MERS-CoV), which causes severe respiratory disease, particularly in people with comorbidities, requires further investigation. Studies in Qatar and elsewhere have provided evidence that dromedary camels are a reservoir for the virus, but the exact modes of transmission of MERS-CoV to humans remain unclear. In February 2014, an assessment was made of the suitability and sensitivity of different types of sample for the detection of MERSCoV by real-time reverse-transcription polymerase chain reaction (RT-PCR) for three gene targets: UpE (upstream of the E gene), the N (nucleocapsid) gene and open reading frame (ORF) 1a. Fifty-three animals presented for slaughter were sampled. A high percentage of the sampled camels (79% [95% confidence interval 66.9-91.5%, standard error 0.0625]; 42 out of 53) were shown to be shedding MERS-CoV at the time of slaughter, yet all the animals were apparently healthy. Among the virus-positive animals, nasal swabs were most often positive (97.6%). Oral swabs were the second most frequently positive (35.7%), followed by rectal swabs (28.5%). In addition, the highest viral load, expressed as a cycle threshold (Ct) value of 11.27, was obtained from a nasal swab. These findings lead to the conclusion that nasal swabs are the candidate sample of choice for detecting MERS-CoV using RT-PCR technology in apparently healthy camels.
    • Scabiës-PCR bij uitbraken binnen zorgorganisaties

      Fanoy E; Pattiepeilohy J; Braks M; van Drunen K; Igloi Z; Morroy G; van de Water J; Sigurdsson V; Wintermans B (2017-10)
    • Screening for HIV, hepatitis B and syphilis on dried blood spots: A promising method to better reach hidden high-risk populations with self-collected sampling.

      van Loo, Inge H M; Dukers-Muijrers, Nicole H T M; Heuts, Rosalie; van der Sande, Marianne A B; Hoebe, Christian J P A (2017)
      Many people at high risk for sexually transmitted infections (STIs), e.g., men who have sex with men (MSM), are not optimally reached by current sexual health care systems with testing. To facilitate testing by home-based sampling or sampling in outreach setting we evaluated dried blood spots (DBS), a method for self-collected blood sampling for serological screening of HIV, hepatitis B (HBV) and syphilis. The aims of this study were to assess the acceptability and feasibility of self-collected DBS and to compare the test results for screening of HIV, HBV and syphilis from DBS with blood drawn by venous puncture.
    • Seasonality and geographical spread of respiratory syncytial virus epidemics in 15 European countries, 2010 to 2016

      Broberg, Eeva K; Waris, Matti; Johansen, Kari; Snacken, René; Penttinen, Pasi; European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden; Turku University Hospital, Turku, Finland; European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden; European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden; European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden (2018-02-01)
    • Self-rated health and all-cause and cause-specific mortality of older adults: Individual data meta-analysis of prospective cohort studies in the CHANCES Consortium.

      Bamia, Christina; Orfanos, Philippos; Juerges, Hendrik; Schöttker, Ben; Brenner, Hermann; Lorbeer, Roberto; Aadahl, Mette; Matthews, Charles E; Klinaki, Eleni; Katsoulis, Michael; Lagiou, Pagona; Bueno-de-Mesquita, H B As; Eriksson, Sture; Mons, Ute; Saum, Kai-Uwe; Kubinova, Ruzena; Pajak, Andrzej; Tamosiunas, Abdonas; Malyutina, Sofia; Gardiner, Julian; Peasey, Anne; de Groot, Lisette Cpgm; Wilsgaard, Tom; Boffetta, Paolo; Trichopoulou, Antonia; Trichopoulos, Dimitrios (2017-09)
      To evaluate, among the elderly, the association of self-rated health (SRH) with mortality, and to identify determinants of self-rating health as "at-least-good".
    • Sensory analysis of characterising flavours: evaluating tobacco product odours using an expert panel.

      Krüsemann, Erna J Z; Lasschuijt, Marlou P; de Graaf, C; de Wijk, René A; Punter, Pieter H; van Tiel, Loes; Cremers, Johannes W J M; van de Nobelen, Suzanne; Boesveldt, Sanne; Talhout, Reinskje (2018-05-23)
      Tobacco flavours are an important regulatory concept in several jurisdictions, for example in the USA, Canada and Europe. The European Tobacco Products Directive 2014/40/EU prohibits cigarettes and roll-your-own tobacco having a characterising flavour. This directive defines characterising flavour as 'a clearly noticeable smell or taste other than one of tobacco […]'. To distinguish between products with and without a characterising flavour, we trained an expert panel to identify characterising flavours by smelling.
    • Separate and combined associations of obesity and metabolic health with coronary heart disease: a pan-European case-cohort analysis.

      Lassale, Camille; Tzoulaki, Ioanna; Moons, Karel G M; Sweeting, Michael; Boer, Jolanda; Johnson, Laura; Huerta, José María; Agnoli, Claudia; Freisling, Heinz; Weiderpass, Elisabete; Wennberg, Patrik; van der A, Daphne L; Arriola, Larraitz; Benetou, Vassiliki; Boeing, Heiner; Bonnet, Fabrice; Colorado-Yohar, Sandra M; Engström, Gunnar; Eriksen, Anne K; Ferrari, Pietro; Grioni, Sara; Johansson, Matthias; Kaaks, Rudolf; Katsoulis, Michail; Katzke, Verena; Key, Timothy J; Matullo, Giuseppe; Melander, Olle; Molina-Portillo, Elena; Moreno-Iribas, Concepción; Norberg, Margareta; Overvad, Kim; Panico, Salvatore; Quirós, J Ramón; Saieva, Calogero; Skeie, Guri; Steffen, Annika; Stepien, Magdalena; Tjønneland, Anne; Trichopoulou, Antonia; Tumino, Rosario; van der Schouw, Yvonne T; Verschuren, W M Monique; Langenberg, Claudia; Di Angelantonio, Emanuele; Riboli, Elio; Wareham, Nicholas J; Danesh, John; Butterworth, Adam S (2018-02-01)
      The hypothesis of 'metabolically healthy obesity' implies that, in the absence of metabolic dysfunction, individuals with excess adiposity are not at greater cardiovascular risk. We tested this hypothesis in a large pan-European prospective study.
    • Sequencing of the variable region of rpsB to discriminate between Streptococcus pneumoniae and other streptococcal species.

      Wyllie, Anne L; Pannekoek, Yvonne; Bovenkerk, Sandra; van Engelsdorp Gastelaars, Jody; Ferwerda, Bart; van de Beek, Diederik; Sanders, Elisabeth A M; Trzciński, Krzysztof; van der Ende, Arie (2017-09)
      The vast majority of streptococci colonizing the human upper respiratory tract are commensals, only sporadically implicated in disease. Of these, the most pathogenic is Mitis group member, Streptococcus pneumoniae Phenotypic and genetic similarities between streptococci can cause difficulties in species identification. Using ribosomal S2-gene sequences extracted from whole-genome sequences published from 501 streptococci, we developed a method to identify streptococcal species. We validated this method on non-pneumococcal isolates cultured from cases of severe streptococcal disease (n = 101) and from carriage (n = 103), and on non-typeable pneumococci from asymptomatic individuals (n = 17) and on whole-genome sequences of 1157 pneumococcal isolates from meningitis in the Netherlands. Following this, we tested 221 streptococcal isolates in molecular assays originally assumed specific for S. pneumoniae, targeting cpsA, lytA, piaB, ply, Spn9802, zmpC and capsule-type-specific genes. Cluster analysis of S2-sequences showed grouping according to species in line with published phylogenies of streptococcal core genomes. S2-typing convincingly distinguished pneumococci from non-pneumococcal species (99.2% sensitivity, 100% specificity). Molecular assays targeting regions of lytA and piaB were 100% specific for S. pneumoniae, whereas assays targeting cpsA, ply, Spn9802, zmpC and selected serotype-specific assays (but not capsular sequence typing) showed a lack of specificity. False positive results were over-represented in species associated with carriage, although no particular confounding signal was unique for carriage isolates.
    • Seroprevalence of hantaviruses and Leptospira in muskrat and coypu trappers in the Netherlands, 2016.

      Friesema, Ingrid H M; Bakker, Jacinta; Maas, Miriam; Goris, Marga G A; van der Giessen, Joke W B; Rockx, Barry H G (2018)
      Aims: Seoul orthohantavirus (SEOV) and Leptospira spp. are zoonotic pathogens with rats as main reservoir. Recently, the presence of SEOV in brown rats was reported in one region in the Netherlands. Brown rats are a frequent bycatch in traps placed to catch muskrats (Ondatra zibethicus) and coypus (Myocastor coypus), and thus are a potential health risk for trappers. It was our aim to determine the seroprevalence of orthohantavirus, specifically SEOV, and Leptospira spp in Dutch trappers. Methods and results: Participating trappers provided serum samples and completed an online questionnaire. The serum was tested for the presence of antibodies against six orthohantaviruses and eight Leptospira serovars. Two hundred-sixty trappers completed the online questionnaire (65%), and 246 (61%) and 162 (40%) serum samples were tested for relevant orthohantaviruses and Leptospira spp., respectively. The seroprevalence of Puumala orthohantavirus in Dutch trappers was 0.4% (95% CI: 0.1-2.3%). None of the participants tested positive for SEOV. The seroprevalence of leptospirosis was 1.2% (95% CI: 0.3-4.4%), although Leptospira spp. are present in brown rats in the Netherlands.Significance of study: The results indicate that the infections with orthohantaviruses and leptospires is low for muskrat and coypu trappers.