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Het RIVM brengt elk jaar in kaart hoeveel mensen in Nederland griep en andere luchtweginfecties hebben gehad. Sinds 2020 doen we dat ook voor het aantal mensen in Nederland dat het coronavirus hadden. Coronavirus Tijdens de zomer van 2021, van juli tot en met september, hadden heel weinig mensen een positieve coronatest. In het najaar en de winter nam het aantal weer toe, door de opkomst van de delta- en omikronvariant. Tussen mei 2021 en mei 2022 zijn 6.448.170 mensen positief getest op corona. Van hen zijn 44.990 mensen opgenomen in het ziekenhuis, en 5756 op de intensive care. Van 3482 mensen is bekend dat ze zijn overleden aan COVID-19. Griepepidemie De griepepidemie in het griepseizoen 2021/2022 begon later dan eerdere seizoenen en duurde 13 weken. Ongeveer 127.378 mensen gingen naar de huisarts met griepachtige klachten. Dit waren er minder dan normaal: veel mensen met deze klachten lieten zich testen op het coronavirus en gingen niet naar de huisarts. Naar schatting hebben tussen oktober 2021 en mei 2022 ongeveer 795.000 mensen griep gehad. Mensen zijn vooral ziek geworden van het type A(H3N2) griepvirus. RS-virus Sinds het voorjaar van 2021 melden ziekenhuizen hoge aantallen infecties met het RS-virus, vooral in de zomer van dat jaar. Deze infecties komen vooral bij kinderen onder de vier jaar voor. De meesten hebben milde klachten, maar de infectie kan soms zo ernstig verlopen dat ze in het ziekenhuis moeten worden opgenomen. Na de zomer van 2021 daalde het aantal infecties, maar bleef het nog wel zo hoog dat het de omvang van een epidemie heeft. Deze epidemie duurt al meer dan een jaar. In totaal meldden de ziekenhuizen 4504 infecties met het RS-virus tussen mei 2021 en mei 2022. Meldingsplichtige luchtweginfecties Sommige luchtweginfecties moeten bij de GGD worden gemeld. De GGD kan dan zo nodig actie nemen om te voorkomen dat ze zich verder verspreiden. Het aantal meldingen van legionella (658) is in 2021 sterk gestegen. Het aantal meldingen van tuberculose was in 2021 hoger (680) dan in 2020, maar nog wel lager dan de jaren daarvoor. Het aantal meldingen van psittacose (papegaaienziekte, 55) was in 2021 aanzienlijk lager dan vorige jaren. Het aantal meldingen van Q-koorts (6) was vergelijkbaar met 2020, maar lager dan de jaren daarvoor. Deze ziekten, met uitzondering van tuberculose, uiten zich meestal in de vorm van longontstekingen. Omdat de oorzaak daarvan vaak niet wordt onderzocht, zullen meer mensen deze ziekten hebben gehad dan is gemeld.

In 1973 LeVeen et al. described a new technique for extensive, retroperitoneal disobliteration of the aorto-bifemoral tract using the arterial disobliteration device (ADD). In Europe this technique was first described in 1981 by Widdershoven and Willekens. Later on more publications from Spain, Poland, Belgium and the Netherlands appeared. At the Groot Ziekengasthuis in 's-Hertogenbosch (the Netherlands) the new procedure was introduced in 1984. Until 1991, 158 patients were operated. The results were analysed. The average follow-up time was 44 months (range 3-84). In 44.5% of these patients intermittent claudication was the reason for operation. In 40.5% of the cases there was untreatable ischemic rest pain and in 15% there was also ischemic gangrene of one or both legs. Aorto-bi-iliac disobliteration was performed in 55 patients, aorto-bi-femoral disobliteration in 31 patients and unilateral disobliteration in another 48 patients. In 24 patients we performed an unilateral aorto-femoral with a contralateral aorto-iliac desobstruction. Both the operation technique and the results are described. Five patients died in the early postoperative period and in 16 patients early reintervention i.e. within 6 hours after the initial operation was necessary for hemorrhage or acute vascular occlusion. During the follow-up 15 patients died. Recurrent occlusion was seen six times while in two patients restenosis developed. In conclusion; in selected patients with aorto-femoral occlusive disease the ADD-procedure can replace the up to now usual procedures.

The relatively rare Hypothenar Hammer Syndrome is presented and discussed, illustrated by two cases. Percutaneous blockage of the stellate ganglion is suggested in order to prevent the amputation of the affected finger or fingers.

In 1978 Leveen et al. described an original technique for extended aortobifemoral disobliteration using a retroperitoneal approach. This technique was introduced to Europe by Widdershoven and Willekens in 1977 and was adopted in Belgium by Suy and Nevelsteen in 1982 and in Spain by Cuesta and Bengoechea in 1984. A group of 228 patients treated by the Leveen's method from 1982 to 1987 were followed-up for a mean of 21 months (1–54). Disabling claudication (66%) or more advanced ischaemia (34%) was the indication for treatment. An aorto-bifemoral endarterectomy was performed in 124 patients. Aorto-biiliac endarterectomy in 39, unilateral aortofemoral endarterectomy with a contralateral aorto-iliac endarterectomy in 17 and unilateral iliofemoral endarterectomy in 48 cases. There were seven postoperative deaths (3%) and an early thrombectomy had to be performed in 8 patients. There were 14 late deaths. Occlusion occurred in 11 patients giving a 3-year-patency rate of 97%. There were no late complications related to the technique. It is concluded that disobliteration using the Leveen technique compares well with prosthetic grafting. Since this method does not require the use of foreign material the patient is protected from the complications sometimes seen after the insertion of prosthetic grafts.

The authors present a series of 98 patients, who underwent an aorto-ilio-femoral endarterectomy according to the technique of LeVeen. The operative mortality was 1% with an adjusted early patency rate of 99%. For a total of 52 documented cases, erectile function was lost in 25%. Ejaculatory disorders were seen in 35 patients. With a mean follow-up period of 22 months (range 1 to 60 months) there were no occlusions in the aortoiliac group. Patency in the aortofemoral group decreased to 92.5% after 4 years. It is concluded that the results support continued use of the reported technique. A longer period of follow-up however is recommended to define its exact role in reconstructive surgery for aortoiliac occlusive disease.

The aorto-iliac disobliteration technique using the LeVeen plaque cracker is described and the results in 70 patients (operated on at the Elisabeth Hospital, Sluiskil, The Netherlands), are presented. The early mortality rate for the series was 4.3%. There were two cases of haemorrhage due to adventitial damage, within two weeks of the operation. The 5 year patency rate was 100%. The LeVeen disobliteration technique is a considerable improvement in the conventional open or half closed endarterectomy. The operation is shorter, and simpler. Also it is ideally suited for combination with the retroperitoneal approach. The technique can be easily combined with disobliterations distal to the groin. The relative advantages and disadvantages of the closed disobliteration and synthetic graft methods are discussed together with the reasons why the closed disobliteration technique seems to be the method of choice in those patients without aneurysms or excessive calcification.