Johannes C van der Wouden

..Influenza vaccination was found to have a moderately beneficial effect on quality of life in influenza-positive weeks of illness in children with asthma...

..Many options are available for preventing people from getting infected by influenza virus, with vaccination being the most widely used...

..Lasagna's Law states that medical investigators overestimate the number of patients available for a research study. We aimed to assess factors related to success or failure of recruitment in general practice research...

..Although the epidemiology is relatively unknown it is becoming a major health problem in some countries. We determine the incidence and management of dermatophytosis in Dutch general practice in 1987 and 2001...

..CONCLUSION: Dutch children make essential mistakes related to inhaler use that are easy to avoid. We recommend a better explanation and demonstration of the technique, and recommend involvement of the parents during instruction...

..The aim of this study is to evaluate the relationship between prescribing of asthma medication and doctor-diagnosed asthma in children age 0-17...

..Our aim was to describe the clinical management of young children's UTIs in Dutch primary care and to compare this to the national guideline recommendations...

..Further, the preliminary data showed an effect on pain and quality of life in the expected direction. The results underline the need for a definitive study with a larger sample size and a random controlled design...

..This study compares HRQOL among subgroups of infants with asthma-like symptoms to a subgroup without such symptoms and examines independent associations between asthma-like symptoms during the first year of life and HRQOL at age 12 months...

..If our hypothesis is true the GP could reduce the risk of sepsis or bacteraemia by managing skin diseases appropriately...

..The duration of exposure to an aspect of organizing cardiovascular care was the key determinant to success...

..CONCLUSION: In the Netherlands, childhood morbidity has changed. Skin diseases have become more important in general practice and respiratory problems are declining...

..The risks of influenza vaccination in asthmatic children are still being discussed. Especially, the risk that influenza vaccination may exacerbate asthma is an issue in this debate...

..GPs are often consulted for respiratory tract symptoms in children...

..Teamwork in the practices proved to be related to both follow-up and record-keeping. Younger and female GPs were further predictors of adequate record-keeping...

..We aimed to investigate incidence rates of urinary tract infections in Dutch general practice and their association with gender, season and urbanisation level, and to analyse prescription and referral in case of urinary tract infections...

..Described here are the methodology, recruitment phases, and main characteristics of the recruited children...

..CONCLUSIONS: This process evaluation demonstrated that the intervention was usually carried out as planned and achieved a high satisfaction rating from the participating practice members...

..However, the efficacy of SLIT with house dust mite extract is not well established...

..This study examined hospital admissions in relation to the preceding consultations in general practice in this age group...

..The aim was to explore prescription patterns in children with physician-diagnosed asthma and its determinants in general practice...

..This discrepancy calls for a better understanding of NSAP in family practice...

..Early detection and counselling is expected to reduce the prevalence of asthma symptoms and improve health-related quality of life at age 6 years...

..CONCLUSIONS: Chronic benign pain in childhood and adolescence is common, and seems to persist in a considerable proportion (30-45%), although pain generally does not deteriorate over time...

..Only limited information is available about the frequency of specific skin diseases. We aimed to compare incidence rates of skin diseases in children in general practice between 1987 and 2001...

..To assess changes in antibiotic prescribing patterns for children between 1987 and 2001, and to identify general practice characteristics associated with higher antibiotic prescribing rates...

..67-0.73). In conclusion, disease severity and disease-related quality of life are different aspects of AD and must be taken into consideration when evaluating treatment or investigating new dermatological therapies in trials...

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..Because musculoskeletal problems can influence physical activity, we compared the frequency of musculoskeletal problems in overweight and obese children with that in normal-weight children...

..In recent decades, studies on the management of common foot problems in children have suggested that in many cases, there is no indication for treatment. It is not known whether these studies have changed daily practice...

..For allergy and eczema no such trend was observed. In conclusion, birth order is inversely related to the risk of allergy, independent of the size of the sibship...

..CONCLUSION: Presently, Dutch general practitioners tend to manage more health problems themselves and refer less young people to specialists...

..be influenced by the type of complaint? What is the activity level of overweight children compared to non-overweight children? And is (sustained) overweight of children associated with parameters related to the energy balance equation?..

..04 (CI95%: 0.76-1.42), 0.79 (CI95%: 0.55-1.12), 0.87 (CI95%: 0.66-1.14) and 1.13 (CI95%: 0.71-1.81). CONCLUSION: The DTP-IPV vaccination was not related to reported atopic disorders at primary school age...

..The identification of these microbial genetic markers, which are predictive of the severity and the course of the disease, will facilitate guided individualized antimicrobial therapy in the future...

..Additional studies are warranted to justify routine influenza vaccination of children with asthma...

..CONCLUSIONS. This study showed remarkably stable trends in incidence rates, antibiotic prescribing, and referrals of common ENT problems. The low proportion of antibiotic treatment in ENT problems did not show negative consequences...

..This study examined whether there is a relationship with the numbers of bovines, pigs, sheep, and poultry per km2, and temperature, which could explain the observed regional gradient in the incidence of impetigo...

..Treatment options include many different oral and topical antibiotics as well as disinfectants. This is an updated version of the original review published in 2003...

..The results show an increased incidence in the past decades of allergic rhinitis in children in Dutch general practice. The shift to a smaller spectrum of prescriptions in 2001 may be a result of the 1996 clinical guideline...

..Most febrile children contacting a GP cooperative are seen by a GP, although the incidence of serious illness is low. The guidelines for triage might not be suitable in primary care...

..Furthermore, we also found evidence that gender differences have to be taken into account...

..Although more reviews have become available, the methodological quality could be improved. SLIT for children could be promising, but methodological flaws in the reviews and individual studies are too serious to draw definite conclusions...

..Patients: Children aged 3 months to 6 years with fever as the main reason for contact...

..In conclusion, in the Dutch population, there is no indication for a higher risk of reported physician-diagnosed atopic disorders at primary schools age after Hib vaccination in the first year of life, in addition to other vaccinations...

..Longer duration of fever has been related to increased risk for serious bacterial infections (SBI). However, the evidence for this association remains controversial. We assessed the predictive value of duration of fever for SBI...

..Meanwhile, clinicians and patients should aim for an optimal treatment with the currently available asthma medication...

..The aim of this study was to compare parent-reported wheezing or shortness of breath among infants as assessed by questionnaire and physician-interview...

..This study shows no evidence for any protective effects from MMR diseases for the development of atopy and therefore supports conclusions found elsewhere that childhood vaccinations do not cause atopy...

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..Because appropriate treatment starts with the correct perception of overweight, health care professionals should be aware of the frequent parental misperception of the overweight status of their children...

..Most textbooks recommend supination of the forearm, as opposed to pronation and other approaches. It is unclear which manoeuvre is most successful. This is an update of a Cochrane review first published in 2009...

..There was a positive association between pertussis infection and atopic disorders in the pertussis vaccinated group only. From the present study, it cannot be concluded whether this association is causal or due to reverse causation...

..Due to clinical and non-clinical factors, considerable variation exists in the prescribing of antibiotics for respiratory tract infections (RTIs) by GPs based in the Netherlands...

..CONCLUSIONS: This study showed that a comprehensive intervention implemented by outreach visitors was effective in improving organization of cardiovascular preventive care in general practice...

..Reserve radiography for uncertain cases in which you need to exclude more severe injuries. Consider reducing nursemaid's elbow by rapid pronation of the forearm, which has been shown to be less painful and more effective than supination...

..Studies need to increase follow-up time to estimate the sustainability of the intervention effects found...

..In conclusion, the TIS is an easy and fast method to score AD. Because of the moderate to good interobserver agreement and the high correlation with the SCORAD, we recommend the TIS to determine the severity of AD in general practice...

..CONCLUSIONS There is a small positive effect 6 weeks after high-dose vitamin D(3) on persistent nonspecific musculoskeletal pain. Future research should focus on longer follow-up, higher supplementation doses, and mental health...

..Because of the low rate of cure and high rate of adverse events in the placebo group, the value of povidone-iodine in impetigo can be questioned...

..Longitudinal research should determine whether shifts occur in pain experience and locations from childhood and adulthood and in different dimensions of functional status and, more broadly, in quality of life resulting from pain...