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159 results on '"van den Donk M"'

8. NHG-Standaard Pijn

Author

de Jong, L., Janssen, P.G.H., Keizer, D., Köke, A.J.A., Schiere, S., van Bommel, M., van Coevorden, R.S., van de Vusse, A., van den Donk, M., van Es, A., Veldhoven, C.M.M., Verduijn, M.M., Revalidatiegeneeskunde, RS: CAPHRI School for Public Health and Primary Care, and RS: CAPHRI - R1 - Ageing and Long-Term Care

Published
2015

9. Computerized decision support systems in primary care for type 2 diabetes patients only improve patients' outcomes when combined with feedback on performance and case management: a systematic review

Author

Cleveringa, F.G.W., Gorter, K.J., van den Donk, M., Gijsel, J., and Rutten, G.E.H.M.

Subjects
Econometric and Statistical Methods: General, Geneeskunde (GENK), Bescherming en bevordering van de menselijke gezondheid, Geneeskunde(GENK), Medical sciences, General [Econometric and Statistical Methods]
Published
2013

13. Cost-effectiveness of the diabetes care protocol, a multifaceted computerized decision support diabetes management intervention that reduces cardiovascular risk

Author

Cleveringa, F.G.W., Welsing, P.M.J., van den Donk, M., Gorter, K.J., Niessen, L.W., Rutten, G.E.H.M., and Redekop, W.K.

Subjects
Econometric and Statistical Methods: General, Geneeskunde (GENK), Bescherming en bevordering van de menselijke gezondheid, Geneeskunde(GENK), Medical sciences, General [Econometric and Statistical Methods]
Published
2010

14. Towards a more efficient diabetes control in primary care: six-monthly monitoring compared with three-monthly monitoring in type 2 diabetes - The EFFIMODI trial. Design of a randomised controlled patient-preference equivalence trial in primary care

Author

Wermeling, P.R., van den Donk, M., Gorter, K.J., de Wit, G.A., van der Graaf, Y., and Rutten, G.E.H.M.

Subjects
Econometric and Statistical Methods: General, Geneeskunde (GENK), Bescherming en bevordering van de menselijke gezondheid, Geneeskunde(GENK), Medical sciences, General [Econometric and Statistical Methods]
Published
2010

15. Cognition in the early stage of type 2 diabetes

Author

Ruis, C., Biessels, G.J., Gorter, K.J., van den Donk, M., Kappelle, L.J., Rutten, G.E.H.M., Neuropsychology, psychopathology and cognition, and Afd Psychologische functieleer

Subjects
International (English)
Published
2009

19. The role of B-vitamins - gene interactions in colorectal carcinogenesis: A molecular epidemiological approach

Author

van den Donk, M., Wageningen University, Frans Kok, Ellen Kampman, and Jaap Keijer

Subjects
Global Nutrition, Wereldvoeding, Nutrition and Disease, vitamine b complex, vitamin b complex, RIKILT - Business Unit Veiligheid & Gezondheid, foliumzuur, Biochemie, colorectal cancer, Biochemistry, folic acid, Voeding en Ziekte, genetic variation, RIKILT - Business Unit Safety & Health, colorectaal kanker, genetische variatie, carcinogenesis, carcinogenese, VLAG
Abstract

Folate deficiency can affect DNA methylation and DNA synthesis. Both factors may be operative in colorectal carcinogenesis. Many enzymes, like methylenetetrahydrofolate reductase (MTHFR), thymidylate synthase (TS), methionine synthase (MTR), and serine hydroxymethyltransferase (SHMT), are needed for conversions in folate metabolism. Flavin adenine dinucleotide, a metabolite of vitamin B2, is a cofactor for MTHFR; vitamin B6 is a cofactor for SHMT; and vitamin B12 is a cofactor for MTR. Polymorphisms exist in most of the genes encoding the enzymes that play a role in folate metabolism. Therefore, genetic variation might influence DNA methylation and synthesis processes and thus colorectal carcinogenesis. This thesis describes studies that have been conducted to clarify the role of folate, related B-vitamins, and genetic variation in colorectal carcinogenesis.In a meta-analysis of human observational studies on the association between folate intake and risk of colorectal adenomas, includingdata from 4 cohort studies and 10 case-control studies, pooled relative risks (95% confidence interval (CI)) for highestvs.lowest exposure category of 0.85 (0.71;1.01) for dietary folate intake and 0.75 (0.61;0.93) for total folate intake were found.In a Dutch case-control study, including data of colorectal adenoma cases (n=768) and endoscopy controls with no history colorectal polyps (n=709), a slightly positive association between folate and colorectal adenoma risk (odds ratio (OR) highest vs. lowest tertile 1.32, 95% CI 1.01;1.73), and an inverse association between vitamin B2 intake and colorectal adenoma risk (OR highestvs.lowest tertile 0.51, 95% CI 0.36;0.73) was found, especially among those withMTHFR 677 TTgenotype. A null association was found for vitamin B6 and vitamin B12. Furthermore, the combined intake of B-vitamins might be important: the positive association between folate intake and colorectal adenomas seemed to be more pronounced among those with low vitamin B2 intakes. The polymorphisms in the folate metabolism studied (MTHFR, TSandSHMT1) did not seem to influence colorectal adenoma risk when dietary factors were not taken into account. Furthermore, relatively high folate intake (>212μg/day) was mildly inversely associated with promoter methylation of six selected tumor suppressor and DNA repair genes in adenoma tissue as compared with low folate intake (

Published
2005

20. Effect of early intensive multifactorial therapy compared with routine care on self-reported health status, general well-being, diabetes-specific quality of life and treatment satisfaction in screen-detected type 2 diabetes mellitus patients (ADDITION-Europe): a cluster-randomised trial

Author

van den Donk, M, Griffin, SJ, Stellato, RK, Simmons, RK, Sandbaek, A, Lauritzen, T, Khunti, K, Davies, MJ, Borch-Johnsen, K, Wareham, NJ, Rutten, GEHM, van den Donk, M, Griffin, SJ, Stellato, RK, Simmons, RK, Sandbaek, A, Lauritzen, T, Khunti, K, Davies, MJ, Borch-Johnsen, K, Wareham, NJ, and Rutten, GEHM

Abstract

AIMS/HYPOTHESIS: The study aimed to examine the effects of intensive treatment (IT) vs routine care (RC) on patient-reported outcomes after 5 years in screen-detected diabetic patients. METHODS: In a pragmatic, cluster-randomised, parallel-group trial, 343 general practices in Denmark, Cambridge and Leicester (UK) and the Netherlands were randomised to screening for type 2 diabetes mellitus plus IT of multiple risk factors in people 40-69 years without known diabetes (n = 1,678 patients) or screening plus RC (n = 1,379 patients). Practices were randomised in a 1:1 ratio according to a computer-generated list. Diabetes mellitus was diagnosed according to WHO criteria. Exclusions were: life expectancy <1 year, housebound, pregnant or lactating, or psychological or psychiatric problems. Treatment targets for IT were: HbA1c <7.0% (53 mmol/mol), BP ≤135/85 mmHg, cholesterol <5 mmol/l in the absence of a history of coronary heart disease and <4.5 mmol/l in patients with cardiovascular (CV) disease; prescription of aspirin to people taking antihypertensive medication and, in cases of CV disease or BP >120/80 mmHg, ACE inhibitors were recommended. After 2003, the treatment algorithm recommended statins to all patients with cholesterol of ≥3.5 mmol/l. Outcome measures were: health status (Euroqol 5 Dimensions [EQ-5D]) at baseline and at follow-up; and health status (36-item Short Form Health Survey [SF-36] and Euroquol Visual Analogue Scale [EQ-VAS]), well-being (12-item Short Form of the Well-Being Questionnaire), diabetes-specific quality of life (Audit of Diabetes-Dependent Quality of Life) and satisfaction with diabetes treatment (Diabetes Treatment Satisfaction Questionnaire) at follow-up. At baseline, standardised self-report questionnaires were used to collect information. Questionnaires were completed at the same health assessment visit as the anthropometric and biochemical measurements. The patients and the staff assessing the outcomes were unaware of the group assi

Published
2013

21. Computerized decision support systems in primary care for type 2 diabetes patients only improve patients' outcomes when combined with feedback on performance and case management: a systematic review

Author

Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Cancer, General Practice & Nursing Science, Cleveringa, F.G.W., Gorter, K.J., van den Donk, M., Gijsel, J., Rutten, G.E.H.M., Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Cancer, General Practice & Nursing Science, Cleveringa, F.G.W., Gorter, K.J., van den Donk, M., Gijsel, J., and Rutten, G.E.H.M.

Published
2013

22. Belangrijke wijzigingen in de NHG-standaard ‘Atriumfibrilleren

Author

Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, JC onderzoeksprogramma Infectieziekten, General Practice & Nursing Science, van den Donk, M., Geersing, G.J., Rutten, F.H., NHG-Werkgroep Atriumfibrilleren, x, Opstelten, W., Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, JC onderzoeksprogramma Infectieziekten, General Practice & Nursing Science, van den Donk, M., Geersing, G.J., Rutten, F.H., NHG-Werkgroep Atriumfibrilleren, x, and Opstelten, W.

Published
2013

24. Intensive multifactorial treatment and cognitive functioning in screen-detected type 2 diabetes - The ADDITION-Netherlands study: A cluster-randomized trial

Author

Helmholtz Institute, Experimental Psychology (onderzoeksprogramma PF), Afd Psychologische functieleer, Leerstoel Dijkerman, Leerstoel Postma, Koekkoek, P.S., Ruis, C., van den Donk, M., Biessels, G.J., Gorter, K.J., Kappelle, L.J., Rutten, G.E.H.M., Helmholtz Institute, Experimental Psychology (onderzoeksprogramma PF), Afd Psychologische functieleer, Leerstoel Dijkerman, Leerstoel Postma, Koekkoek, P.S., Ruis, C., van den Donk, M., Biessels, G.J., Gorter, K.J., Kappelle, L.J., and Rutten, G.E.H.M.

Published
2012

25. Does early intensive multifactorial treatment reduce total cardiovascular burden in individuals with screen-detected diabetes? Findings from the ADDITION-Europe cluster-randomized trial

Author

Simmons, RK, Sharp, SJ, Sandbaek, A, Borch-Johnsen, K, Davies, MJ, Khunti, K, Lauritzen, T, Rutten, GEHM, van den Donk, M, Wareham, NJ, Griffin, SJ, Simmons, RK, Sharp, SJ, Sandbaek, A, Borch-Johnsen, K, Davies, MJ, Khunti, K, Lauritzen, T, Rutten, GEHM, van den Donk, M, Wareham, NJ, and Griffin, SJ

Abstract

AIMS: To describe the total cardiovascular burden (cardiovascular morbidity or mortality, revascularization or non-traumatic amputation) in individuals with screen-detected diabetes in the ADDITION-Europe trial and to quantify the impact of the intervention on multiple cardiovascular events over 5 years. METHODS: In a pragmatic, cluster-randomized, parallel-group trial in four centres (Denmark; Cambridge, UK; the Netherlands; and Leicester, UK), 343 general practices were randomized to screening plus routine care (n = 1379 patients), or screening and promotion of target-driven, intensive treatment of multiple risk factors (n = 1678). We estimated the effect of the intervention on multiple cardiovascular events after diagnosis of diabetes using the Wei, Lin and Weissfeld method. RESULTS: Over 5.3 years, 167 individuals had exactly one cardiovascular event, 53 exactly two events, and 18 three or more events. The incidence rates (95% CI) of first events and any event per 1000 person-years were 14.6 (12.8-16.6) and 20.4 (18.2-22.6), respectively. There were non-significant reductions in the risk of a first (hazard ratio 0.83, 95% CI 0.65-1.05) and second primary endpoint (hazard ratio 0.70, 95% CI 0.43-1.12). The overall average hazard ratio for any event was 0.77 (95% CI 0.58-1.02). CONCLUSIONS: Early intensive multifactorial treatment was not associated with a significant reduction in total cardiovascular burden at 5 years. Focusing on first events in cardiovascular disease prevention trials underestimates the total cardiovascular burden to patients and the health service.

Published
2012

26. Screening for Type 2 diabetes. Lessons from the ADDITION-Europe study

Author

Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, General Practice & Nursing Science, van den Donk, M., Sandbaek, A., Borch-Johnson, K., Lauritzen, T., Simmons, R.K., Wareham, N.J., Griffin, S.J., Davies, M.J., Khunti, K., Rutten, G.E.H.M., Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, General Practice & Nursing Science, van den Donk, M., Sandbaek, A., Borch-Johnson, K., Lauritzen, T., Simmons, R.K., Wareham, N.J., Griffin, S.J., Davies, M.J., Khunti, K., and Rutten, G.E.H.M.

Published
2011

30. Computerized decision support, task delegation and feedback on performance in type 2 diabetes care : the diabetes care protocol

Author

Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, General Practice & Nursing Science, Rutten, Guy, Gorter, KJ, van den Donk, M., Cleveringa, F.G.W., Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, General Practice & Nursing Science, Rutten, Guy, Gorter, KJ, van den Donk, M., and Cleveringa, F.G.W.

Published
2010

31. Insulin therapy in type 2 diabetes patients : balancing between evidence and experience

Author

Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, General Practice & Nursing Science, Rutten, Guy, Gorter, KJ, van den Donk, M., van Avendonk, M.J.P., Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, General Practice & Nursing Science, Rutten, Guy, Gorter, KJ, van den Donk, M., and van Avendonk, M.J.P.

Published
2010

32. Towards a more efficient diabetes control in primary care: six-monthly monitoring compared with three-monthly monitoring in type 2 diabetes - The EFFIMODI trial. Design of a randomised controlled patient-preference equivalence trial in primary care.

Author

Brain, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, JC onderzoeksprogramma Methodologie, General Practice & Nursing Science, Healthcare Innovation & Evaluation, Epidemiology & Health Economics, Wermeling, P.R., van den Donk, M., Gorter, K.J., de Wit, G.A., van der Graaf, Y., Rutten, G.E.H.M., Brain, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, JC onderzoeksprogramma Methodologie, General Practice & Nursing Science, Healthcare Innovation & Evaluation, Epidemiology & Health Economics, Wermeling, P.R., van den Donk, M., Gorter, K.J., de Wit, G.A., van der Graaf, Y., and Rutten, G.E.H.M.

Published
2010

33. Cost-effectiveness of the diabetes care protocol, a multifaceted computerized decision support diabetes management intervention that reduces cardiovascular risk

Author

Brain, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Other research (not in main researchprogram), Cancer, General Practice & Nursing Science, Epidemiology & Health Economics, JC onderzoeksprogramma Methodologie, Cleveringa, F.G.W., Welsing, P.M.J., van den Donk, M., Gorter, K.J., Niessen, L.W., Rutten, G.E.H.M., Redekop, W.K., Brain, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Other research (not in main researchprogram), Cancer, General Practice & Nursing Science, Epidemiology & Health Economics, JC onderzoeksprogramma Methodologie, Cleveringa, F.G.W., Welsing, P.M.J., van den Donk, M., Gorter, K.J., Niessen, L.W., Rutten, G.E.H.M., and Redekop, W.K.

Published
2010

34. Opsporing van het metabool syndroom door mensen zelf hun middelomtrek te laten meten

Author

Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, General Practice & Nursing Science, den Engelsen, C., van den Donk, M., Gorter, K.J., Salomé, P.L., Bobbink, I.W., Rutten, G.E.H.M., Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, General Practice & Nursing Science, den Engelsen, C., van den Donk, M., Gorter, K.J., Salomé, P.L., Bobbink, I.W., and Rutten, G.E.H.M.

Published
2010

35. No negative effects of a multi-factorial, intensified treatment on self-reported health status, treatment satisfaction, and diabetes-related distress in screen-detected type 2 diabetes patients. The ADDITION-Netherlands study.

Author

Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, General Practice & Nursing Science, van den Donk, M., Gorter, K.J., Rutten, G.E.H.M., Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, General Practice & Nursing Science, van den Donk, M., Gorter, K.J., and Rutten, G.E.H.M.

Published
2010

36. Diabetes Care Protocol: effects on patient-important outcomes. A cluster randomized, non-inferiority trial in primary care

Author

Brain, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Cancer, General Practice & Nursing Science, Cleveringa, F.G.W., Minkman, M.H., Gorter, K.J., van den Donk, M., Rutten, G.E.H.M., Brain, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Cancer, General Practice & Nursing Science, Cleveringa, F.G.W., Minkman, M.H., Gorter, K.J., van den Donk, M., and Rutten, G.E.H.M.

Published
2010

37. Cognition in the early stage of type 2 diabetes

Author

Neuropsychology, psychopathology and cognition, Afd Psychologische functieleer, Ruis, C., Biessels, G.J., Gorter, K.J., van den Donk, M., Kappelle, L.J., Rutten, G.E.H.M., Neuropsychology, psychopathology and cognition, Afd Psychologische functieleer, Ruis, C., Biessels, G.J., Gorter, K.J., van den Donk, M., Kappelle, L.J., and Rutten, G.E.H.M.

Published
2009

38. Identifying people with metabolic syndrome in primary care by screening with a mailed tape measure: A survey of 14,000 people in the Netherlands

Author

Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, General Practice & Nursing Science, van den Donk, M., Bobbink, W.G., Gorter, K.J., Salome, Ph.L, Rutten, G.E.H.M., Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, General Practice & Nursing Science, van den Donk, M., Bobbink, W.G., Gorter, K.J., Salome, Ph.L, and Rutten, G.E.H.M.

Published
2009

39. Insulin therapy in type 2 diabetes is no longer a secondary care activity in the Netherlands.

Author

Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, General Practice & Nursing Science, van Avendonk, M.J.P., Gorter, K.J., van den Donk, M., Rutten, G.E.H.M., Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, General Practice & Nursing Science, van Avendonk, M.J.P., Gorter, K.J., van den Donk, M., and Rutten, G.E.H.M.

Published
2009

40. The association between erectile dysfunction and cardiovascular risk in men with Type 2 diabetes in primary care: it is a matter of age.

Author

Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, General Practice & Nursing Science, Cleveringa, F.G.W., Meulenberg, M.G., Gorter, K.J., van den Donk, M., Rutten, G.E.H.M., Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, General Practice & Nursing Science, Cleveringa, F.G.W., Meulenberg, M.G., Gorter, K.J., van den Donk, M., and Rutten, G.E.H.M.

Published
2009

41. The role of B-vitamins - gene interactions in colorectal carcinogenesis: A molecular epidemiological approach

Author

Kok, Frans, Kampman, Ellen, Keijer, Jaap, van den Donk, M., Kok, Frans, Kampman, Ellen, Keijer, Jaap, and van den Donk, M.

Abstract

Folate deficiency can affect DNA methylation and DNA synthesis. Both factors may be operative in colorectal carcinogenesis. Many enzymes, like methylenetetrahydrofolate reductase (MTHFR), thymidylate synthase (TS), methionine synthase (MTR), and serine hydroxymethyltransferase (SHMT), are needed for conversions in folate metabolism. Flavin adenine dinucleotide, a metabolite of vitamin B2, is a cofactor for MTHFR; vitamin B6 is a cofactor for SHMT; and vitamin B12 is a cofactor for MTR. Polymorphisms exist in most of the genes encoding the enzymes that play a role in folate metabolism. Therefore, genetic variation might influence DNA methylation and synthesis processes and thus colorectal carcinogenesis. This thesis describes studies that have been conducted to clarify the role of folate, related B-vitamins, and genetic variation in colorectal carcinogenesis.In a meta-analysis of human observational studies on the association between folate intake and risk of colorectal adenomas, includingdata from 4 cohort studies and 10 case-control studies, pooled relative risks (95% confidence interval (CI)) for highestvs.lowest exposure category of 0.85 (0.71;1.01) for dietary folate intake and 0.75 (0.61;0.93) for total folate intake were found.In a Dutch case-control study, including data of colorectal adenoma cases (n=768) and endoscopy controls with no history colorectal polyps (n=709), a slightly positive association between folate and colorectal adenoma risk (odds ratio (OR) highest vs. lowest tertile 1.32, 95% CI 1.01;1.73), and an inverse association between vitamin B2 intake and colorectal adenoma risk (OR highestvs.lowest tertile 0.51, 95% CI 0.36;0.73) was found, especially among those withMTHFR 677 TTgenotype. A null association was found for vitamin B6 and vitamin B12. Furthermore, the combined intake of B-vitamins might be important: the positive association between folate intake and colorectal adenomas seemed to be more pronounced among those with low vitamin B2 i

Published
2005

43. Diagnostic accuracy for different strategies of image-guided breast intervention in cases of nonpalpable breast lesions

Author

JC onderzoeksprogramma Kanker, Radiologie, Epidemiology & Health Economics, Pijnappel, R.M., van den Donk, M., Holland, R., Mali, W.P.T.M., Peterse, J.L., Hendriks, J.H.C.L., Peeters, P.H.M., JC onderzoeksprogramma Kanker, Radiologie, Epidemiology & Health Economics, Pijnappel, R.M., van den Donk, M., Holland, R., Mali, W.P.T.M., Peterse, J.L., Hendriks, J.H.C.L., and Peeters, P.H.M.

Published
2004

44. Intensive multifactorial treatment and cognitive functioning in screen-detected type 2 diabetes - The ADDITION-Netherlands study: A cluster-randomized trial

Author

Koekkoek, P.S., Ruis, C., van den Donk, M., Biessels, G.J., Gorter, K.J., Kappelle, L.J., Rutten, G.E.H.M., Helmholtz Institute, Experimental Psychology (onderzoeksprogramma PF), Afd Psychologische functieleer, Leerstoel Dijkerman, and Leerstoel Postma

Subjects
Male, Complications, Smoking Prevention, Type 2 diabetes, Neuropsychological Tests, Cognitive functioning, law.invention, Executive Function, Mental Processes, Randomized controlled trial, law, Risk Factors, Attention, Cluster randomised controlled trial, Cognitive decline, Netherlands, Intelligence Tests, education.field_of_study, Econometric and Statistical Methods: General, Neuropsychology, Middle Aged, Intensive multifactorial therapy, Neurology, International (English), Educational Status, Female, Cohort study, medicine.medical_specialty, Population, Clinical Neurology, Motor Activity, Medical sciences, Diabetes Complications, Memory, Diabetes mellitus, Internal medicine, medicine, Humans, Bescherming en bevordering van de menselijke gezondheid, Geneeskunde(GENK), education, Life Style, Aged, Glycated Hemoglobin, business.industry, medicine.disease, Diet, Diabetes Mellitus, Type 2, Socioeconomic Factors, Physical therapy, Neurology (clinical), business, Cognition Disorders
Abstract

article i nfo Type 2 diabetes Cognitive functioning Intensive multifactorial therapy Randomized controlled trial Cohort study Complications Aim: To assess whether an intensive multifactorial treatment can reduce cognitive decrements and cognitive decline in screen-detected type 2 diabetes. Methods: The multinational ADDITION-study, a cluster-randomized parallel group trial in patients with screen- detected type 2 diabetes, compared the effectiveness of intensive multifactorial treatment (IT; lifestyle advice and strict regulation of metabolic parameters) with routine care (RC) on cardiovascular outcome. In The Netherlands randomization was stratified according to practice organization. Allocation was concealed from patients. The present study assessed the effect of IT on cognition through two neuropsychological assessments (NPA) on two occasions. The assessments took place three and six years after the start of the intervention. Non- diabetic controls served as reference group. The first NPA was performed in 183 patients (IT: 97; RC: 86) and 69 controls. The second NPA was performed in 135 patients (IT: 71; RC: 64) and 55 controls. Primary outcome was a composite score, including the domains memory, information-processing speed and attention and executive function. Comparisons between the treatment groups were performed with multi-level analyses. Results: The first NPAshowed no differences between the treatment groups(mean differencecomposite z-score: 0.00; 95%-CI −0.16 to 0.16; IT vs RC). Over the next three years cognitive decline in the diabetic groups was within the range of the reference group and did not differ between the treatment arms (difference decline between diabetic groups −0.12; −0.24 to 0.01; IT vs RC). Conclusions: Six years of IT in screen-detected type 2 diabetes had no benefit on cognitive functioning over RC.

Published
2012

45. Diagnostic strategies in non-palpable breast lesions.

Author

Pijnappel, R.M., Peeters, P.H.M., van den Donk, M., Holland, R., Hendriks, J.H.C.L., Deurloo, E.E., Mali, W.P.T.M., Pijnappel, R.M., Peeters, P.H.M., van den Donk, M., Holland, R., Hendriks, J.H.C.L., Deurloo, E.E., and Mali, W.P.T.M.

Published
2002

46. Diagnostic strategies in non-palpable breast lesions.

Author

JC onderzoeksprogramma Kanker, Radiologie, Epidemiology & Health Economics, Pijnappel, R.M., Peeters, P.H.M., van den Donk, M., Holland, R., Hendriks, J.H.C.L., Deurloo, E.E., Mali, W.P.T.M., JC onderzoeksprogramma Kanker, Radiologie, Epidemiology & Health Economics, Pijnappel, R.M., Peeters, P.H.M., van den Donk, M., Holland, R., Hendriks, J.H.C.L., Deurloo, E.E., and Mali, W.P.T.M.

Published
2002

48. Identifying people with metabolic syndrome in primary care by screening with a mailed tape measure. A survey in 14,000 people in the Netherlands.

Author

van den Donk M, Bobbink IWG, Gorter KJ, Salomé PL, and Rutten GEH

Abstract

Objectives. To determine the feasibility of population-based screening for metabolic syndrome (MetS) in primary care with self-measurement of waist circumference (WC) as first step, and the prevalence of MetS in a Dutch city. Methods. Survey in 14,000 people on the list of primary care physicians in the city of IJsselstein. All adults between 20 and 70 years on July 1st, 2006 were asked to measure their WC using a mailed tape measure. Participants with a high WC (>88/102 cm for women/men) were invited for assessment of other factors defining MetS. For patients already known with cardiovascular risk factors, these data were collected from medical records. Results. 11,862 subjects were invited, of whom 6,843 (58%) measured their WC. 2,004 had a WC>88/102 cm and 1,721 participated in all examinations. In 473 MetS was detected. The sensitivity of the screening was 77%, the negative predictive value 96%. The prevalence of MetS, including patients known with cardiovascular risk factors, was 15.5%. Conclusions. A primary care physician-driven population screening with self-measurement of WC can identify adults with MetS. The estimated prevalence of MetS is 15.5%. This procedure creates possibilities for targeted screening, prevention and treatment of people who are at increased cardiovascular risk. Copyright © 2009 by Elsevier Inc. [ABSTRACT FROM AUTHOR]

Published
2009
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49. Combined task delegation, computerized decision support, and feedback improve cardiovascular risk for type 2 diabetic patients: a cluster randomized trial in primary care.

Author

Cleveringa FGW, Gorter KJ, van den Donk M, Rutten GEH, Cleveringa, Frits G W, Gorter, Kees J, van den Donk, Maureen, and Rutten, Guy E H M

Abstract

Objective: The Diabetes Care Protocol combines task delegation (a practice nurse), computerized decision support, and feedback every 3 months. We studied the effect of the Diabetes Care Protocol on A1C and cardiovascular risk factors in type 2 diabetic patients in primary care.Research Design and Methods: In a cluster randomized trial, mean changes in cardiovascular risk factors between the intervention and control groups after 1 year were calculated by generalized linear models.Results: Throughout the Netherlands, 26 intervention practices included 1,699 patients and 29 control practices 1,692 patients. The difference in A1C change was not significant, whereas total cholesterol, LDL cholesterol, and blood pressure improved significantly more in the intervention group. The 10-year coronary heart disease risk estimate of the UK Prospective Diabetes Study improved 1.4% more in the intervention group.Conclusions: Delegation of routine diabetes care to a practice nurse combined with computerized decision support and feedback did not improve A1C but reduced cardiovascular risk in type 2 diabetes patients. [ABSTRACT FROM AUTHOR]

Published
2008
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50. Remission of screen-detected metabolic syndrome and its determinants: an observational study

Author

den Engelsen Corine, Gorter Kees J, Salomé Philippe L, van den Donk Maureen, and Rutten Guy E

Subjects
Metabolic syndrome, Abdominal obesity, Screening, Cardiovascular risk, Primary care, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Early detection and treatment of the metabolic syndrome may prevent diabetes and cardiovascular disease. Our aim was to assess remission of the metabolic syndrome and its determinants after a population based screening without predefined intervention in the Netherlands. Methods In 2006 we detected 406 metabolic syndrome cases (The National Cholesterol Education Program’s Adult Treatment Panel III (NCEP ATP III) definition) among apparently healthy individuals with an increased waist circumference. They received usual care in a primary care setting. After three years metabolic syndrome status was re-measured. We evaluated which baseline determinants were independently associated with remission. Results The remission rate among the 194 participants was 53%. Baseline determinants independently associated with a remission were the presence of more than three metabolic syndrome components (OR 0.46) and higher levels of waist circumference (OR 0.91), blood pressure (OR 0.98) and fasting glucose (OR 0.60). Conclusions In a population with screen-detected metabolic syndrome receiving usual care, more than half of the participants achieved a remission after three years. This positive result after a relatively simple strategy provides a solid basis for a nation-wide implementation. Not so much socio-demographic variables but a higher number and level of the metabolic syndrome components were predictors of a lower chance of remission. In such cases, primary care physicians should be extra alert.

Published
2012
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