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[Tetanus in the Netherlands: a retrospective study].
To evaluate the availability and effectiveness of tetanus prophylaxis in the Netherlands, the use of tetanus toxoid (TT) immunisation for pregnant women, and the implementation of the Dutch guidelines for tetanus prophylaxis, and to compare this with current international practice. Retrospective study. All medical records of admitted patients with tetanus were collected at the Erasmus University Medical Centre in Rotterdam from January 1999 to December 2005. The charts were evaluated for availability of, and adherence to, tetanus prophylaxis. In addition, the guidelines for tetanus prophylaxis were studied in detail. During the study period, 189 cases of tetanus were recorded in the Netherlands. Most patients (n=178, 93%) had received TT vaccination, in compliance with the national and international recommendations. There was no trend for less compliance over the study period. In compliance with international guidelines, prophylaxis was initiated in 117 (63%) cases. On multivariate analysis, failure to initiate prophylaxis was associated with the Netherlands, with patients having a temporary residence permit being less likely to receive prophylaxis. Although most patients in the Netherlands are immunised against tetanus, the prophylaxis offered to patients with known risk factors is suboptimal. The guidelines for the implementation of prophylaxis were found to be insufficiently implemented.In an effort to replicate the most recent successful replicable results, a meta-analysis of “Discovery” participants in the large multi-site, placebo-controlled, double blind study of CPAP treatment for OSA was performed. The study was published in the Feb. 27, 2008 issue of the Journal of the American Medical Association (JAMA) and is a publication of the National Heart, Lung and Blood Institute (NHLBI). The article’s authors included Steven N. Katz, PhD, of the Mayo Clinic in Rochester, Minn. and James G. Meigs, MD, PhD, of the University of Colorado School of Medicine. This investigation was funded by NHLBI. The investigators found that CPAP treatment for OSA can reduce the risk of death in patients of any age, independent of age, gender, BMI, and baseline AHI. These findings support the conclusion that CPAP treatment should be
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