The prevalence of musculoskeletal complaints in professional musicians is higher compared to the general population (Odds ratio 2.3): point prevalences in the literature range between 9% and 68%;... Show moreThe prevalence of musculoskeletal complaints in professional musicians is higher compared to the general population (Odds ratio 2.3): point prevalences in the literature range between 9% and 68%; year prevalences range between 41% and 93%. Female gender is the most important risk factor. Also among amateur musicians musculoskeletal complaints are frequent, the year prevalence of playing-related is 68%. Female gender, a sudden increase in playing time and playing a string instrument were the main risk factors. Among professional musicians with musculoskeletal complaints, the impact of these complaints on daily functioning is appreciated as more severe, compared non-musicians with musculoskeletal complaints. Also, healthcare usage is higher among musicians with these complaints. Musicians with complaints report worse illness perceptions compared to non-musicians with musculoskeletal complaints. In the last part of this thesis biomechanical aspects of violin playing are evaluated: Violinists with complaints show more activity of the superficial neck and shoulder muscles while playing the instrument, which is hypothesized to be the result of co-contraction. From a biomechanical point of view, playing without a shoulder rest, or with a shoulder rest with minimal height seems favourable, the latter being subjectively most comfortable by the violinists. Show less
Minten, M.J.M.; Leseman-Hoogenboom, M.M.; Kloppenburg, M.; Kortekaas, M.C.; Leer, J.W.; Poortmans, P.M.P.; ... ; Ende, C.H.M. van den 2018
Clostridium difficile infection (CDI) was discovered in 1978 as an important cause of antibiotic-associated diarrhoea. CDI became the most common healthcare-associated infection in Northern-America... Show moreClostridium difficile infection (CDI) was discovered in 1978 as an important cause of antibiotic-associated diarrhoea. CDI became the most common healthcare-associated infection in Northern-America and Europe during the antibiotic era, especially after global spread of a fluoroquinoloneresistant ribotype 027 strain in 2003. The rise of CDI urged the use of epidemiological surveillance systems to monitor disease dynamics and rapidly detect outbreaks. However, valid estimations of the infection burden of CDI in Europe were hampered by the heterogeneity and insufficiency of diagnostic algorithms for CDI, lack of standardised typing systems and incomplete surveillance methodologies. This thesis includes two studies conducted within a project named ‘the European CDI Surveillance Network’ focussing on enhancement of CDI surveillance and laboratory capacity for CDI in Europe. In the Netherlands, a sentinel surveillance system monitors the incidence of CDI in hospitals. This thesis describes (spatial) trends in the epidemiology of CDI in the Netherlands, in particular for children and the potentially zoonotic C. difficile ribotype 078. Data of a community-based case-control study was used to apply spatial scan statistics to detect CDI clustering beyond the hospital setting. Finally, this thesis provides directions for future epidemiological surveillance systems of CDI, both in the Netherlands and Europe. Show less
Bandelj, P.; Harmanus, C.; Blagus, R.; Cotman, M.; Kuijper, E.J.; Ocepek, M.; Vengust, M. 2018
Worldwide, there is an strong rise of cardiometabolic disorders, which mainly comprise obesity, cardiovascular disease (CVD) and type 2 diabetes. Therefore, the development and improvement of... Show moreWorldwide, there is an strong rise of cardiometabolic disorders, which mainly comprise obesity, cardiovascular disease (CVD) and type 2 diabetes. Therefore, the development and improvement of preventive and curative strategies for cardiometabolic disease is eagerly warranted. With the studies describes in this thesis, we aimed to disentangle the interwoven physiological, environmental and genetic factors that determine cholesterol and energy metabolism to increase our understanding of their contribution to cardiometabolic disease risk. The first part of this thesis focussed on the cholesteryl ester transfer protein (CETP). The lipid transfer properties of CETP induce a proatherogenic lipoprotein profile. Therefore, CETP inhibitory molecules have been developed and tested in clinical trials for their capability to improve the lipoprotein profile and reduce CVD risk. To fully understand the role of CETP in CVD, its physiology and biological function should be fully unravelled. The focus of the second part of this thesis was on the role of energy metabolism in cardiometabolic health. Specifically, we aimed to study the association of environmental and genetic factors, which were previously described to influence brown adipose tissue (BAT) activity, with energy expenditure and disease outcomes. Show less
In this thesis the risk factors of venous thrombosis will be discussed in the general and particularly the elderly population. The goal of this thesis is to provide insights on risk factors of... Show moreIn this thesis the risk factors of venous thrombosis will be discussed in the general and particularly the elderly population. The goal of this thesis is to provide insights on risk factors of thrombosis in the elderly population, in order to advance our basic understanding of physiological age-related changes that increase the risk of venous thrombosis and which may ultimately lead to improved personalized interventions. In this chapter firstly background information will be provided on risk factors for venous thrombosis, focussing specifically on age as a risk factor. Secondly, the role of veins and venous valves in the development of venous thrombosis will be discussed and thirdly, global assays as a potential tool to identify patients at high risk for venous thrombosis will be considered. The study populations used in this thesis will discussed, and an outline of this thesis will be provided. Show less
Older women with breast cancer are underrepresented in the available evidence. Therefore, there is no solid evidence on how to treat older women with breast cancer. This thesis has three main... Show moreOlder women with breast cancer are underrepresented in the available evidence. Therefore, there is no solid evidence on how to treat older women with breast cancer. This thesis has three main conclusions: 1. There are large international differences in the treatment strategy of breast cancer among older women. These differences are not associated with a significant difference in prognosis. 2. The presence of comorbidity has an important impact on the general prognosis of older women with breast cancer. We did not show an important association between specific comorbidities or the use of co-medications and the breast cancer specific prognosis. 3. Concerning older women with breast cancer for research, there are very important methodological issues to take into account, including to avoidance of selection bias and the proper methodologies to take in to account the chance of dying from another cause of cancer: the competing risk of mortality. Future research should be done to create a tool which can assist in identifying the individualised treatment strategy for each older woman with breast cancer. This will have to take into consideration patient’s and tumour’s information, as well as the endpoints for each individual patient. Show less
Molnos, S.; Wahl, S.; Haid, M.; Eekhoff, E.M.W.; Pool, R.; Floegel, A.; ... ; Hart, L.M. 't 2018
Spondyloarthritis comprises a heterogeneous group of distinct disorders including ankylosing spondylitis, non-radiographic axial spondyloarthritis, psoriatic arthritis, arthritis related to... Show moreSpondyloarthritis comprises a heterogeneous group of distinct disorders including ankylosing spondylitis, non-radiographic axial spondyloarthritis, psoriatic arthritis, arthritis related to inflammatory bowel disease and reactive arthritis. Spondyloarthritis is the second most prevalent form of chronic inflammatory arthritis, with an estimated prevalence of about 0.5-1.5%. The studies presented in this thesis cover many aspects related to Spondyloarthritis in Colombia. The following topics were addressed. First, the analyses and performance of the different classification criteria and the factors important in the decision of the rheumatologist to order an MRI or HLA-B27 test in the diagnostic work-up of spondyloarthritis in the context of the clinical rheumatology setting. Second, a better insight was obtained with regard to the presence of comorbidities and risk factors of patients with spondyloarthritis. This included also a case control study to evaluate the relationship between periodontitis and spondyloarthritis. Third, the translation and cross-cultural adaptation to Spanish of the ASAS-HI was performed. Adittionally, the implementation of the domains and instruments of the ASAS core set in clinical trials have been evaluated. Finally, we discuss the potential unmet needs in the field of rheumatology in Colombia and we propose a research agenda for the upcoming years. Show less
