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Background: This study was aimed to develop a sensitive and rapid assay for the determination of glial fibrillary acidic protein (GFAP) in serum and to evaluate the clinical applicability in serum samples from patients with acute stroke., Methods: The two-site chemiluminometric immunoassay, intended to use in a near-patient setting with a single incubation step (20 min), was used to measure serum samples from healthy blood donors and from patients with brain injury and correlated to serum S100B levels., Results: The GFAP assay covered a concentration range up to 18 microg/L with an analytical sensitivity of 0.014 microg/L. The intra-assay precision was 3.5% at 1.55 microg/L (n=20) and 4.1% at 0.39 microg/L (n=20). The inter-assay precision was 3.8% at 9.1 microg/L (n=10) and 10.3 % at 0.21 microg/L (n=9). Normal controls (n=46) showed non-detectable GFAP with a 99% upper limit of <0.04 microg/L. GFAP values were associated with progression and severity of the illness in acute stroke patients., Conclusions: We have developed an improved assay for the measurement of GFAP levels in serum. Serum GFAP is a potential marker for prognosis and outcome in patients with central nervous system disorders.

Both the Netherlands College of Urologists (NVU) and the Dutch General Practice College (NHG) in recent years published guidelines for the management of benign hypertrophy of the prostate (BPH). The two differ in a number of respects and are not always consistent. The differences between the GP's and urologists' guidelines are mostly to be attributed to the difference in the patient populations visiting the GP and the urologist, respectively. In order to arrive a better adjustment concerning BPH patients between general practice and specialists, a team composed of NVU and NHG has drawn up 'Recommendations for transmural care'. These recommendations concern four subjects: diagnosis of micturition abnormalities, indication for examination of cancer of the prostate, drug treatment, indications for referring and re-referring of patients with micturition problems.

The Dutch College of General Practitioners recently updated its guideline 'Gastric complaints'. The main change concerns Helicobacter pylori infection diagnosis and treatment. In cases of functional dyspepsia with Helicobacter infection antibiotic eradication treatment is not advised. In patients with gastric complaints, three working diagnoses are presented: aspecific gastric complaints, ulcer complaints, reflux complaints. Endoscopy is given a more prominent role than in the previous version of the guideline. Criteria are given for discontinuation of unmotivated long-term use of antacid medication.