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1. Management of acute mesenteric ischaemia: Results of a worldwide survey

Author

Hess, B, Cahenzli, M, Forbes, A, Burgos, R, Coccolini, F, Corcos, O, Holst, M, Irtun, Ø, Klek, S, Pironi, L, Rasmussen, H, Serlie, M, Thibault, R, Gabe, S, Reintam Blaser, A, Akin, E, Ali, S, Argenio, G, Atici, S, Augustin, G, Baili, E, Bains, L, Bala, M, Baldini, E, Baraket, O, Barone, M, Biloslavo, A, Roberto, B, Bombardini, C, Brisinda, G, Buonomo, L, Catena, F, Ceresoli, M, Chiarello, M, Chouliaras, C, D'Acapito, F, Damaskos, D, De Simone, B, Delogu, D, Demetrashvili, Z, Di Carlo, I, D'Oria, M, Durán-Muñoz-Cruzado, V, Forget, P, Fortuna, L, Fransvea, P, Frey, C, Gapejeva, O, Garcon, P, Gass, J, Teixeira Gonsaga, R, Griffiths, E, Gundogan, K, Gurjar, M, Hamid, H, Silesky Jiménez, J, Kase, K, Hussain Kazmi, S, Kechagias, A, Khokha, V, Kobe, Y, Korkolis, D, Litvin, A, Lostoridis, E, Mahendran, H, Marino, F, Martinuzzi, A, Mesina, C, Neri, V, Panisic, M, Paolillo, C, Pararas, N, Perrone, G, Pesce, A, Picardi, B, Pither, C, Podda, M, Poskus, T, Poullenot, F, Przemyslaw, M, Sartelli, M, Sasia, D, Scheiterle, M, Seretis, F, Søreide, K, Sydorchuk, R, Szczepanek, K, Bodnar, Z, Tamion, F, Tarasconi, A, Teraa, M, Tolonen, M, Vanuytsel, T, Veroux, M, Vinter-Jensen, L, Visconti, D, Widmer, L, Zakaria, A, Zubareva, N, Endorsing International, S, Hess B., Cahenzli M., Forbes A., Burgos R., Coccolini F., Corcos O., Holst M., Irtun Ø., Klek S., Pironi L., Rasmussen H. H., Serlie M. J., Thibault R., Gabe S., Reintam Blaser A., Akin E., Ali S. M., Argenio G., Atici S. D., Augustin G., Baili E., Bains L., Bala M., Baldini E., Baraket O., Barone M., Biloslavo A., Roberto Bini, Bombardini C., Brisinda G., Buonomo L., Catena F., Ceresoli M., Chiarello M. M., Chouliaras C., D'Acapito F., Damaskos D., De Simone B., Delogu D., Demetrashvili Z., Di Carlo I., D'Oria M., Durán-Muñoz-Cruzado V. M., Forget P., Fortuna L., Fransvea P., Frey C., Gapejeva O., Garcon P., Gass J. M., Teixeira Gonsaga R. A., Griffiths E., Gundogan K., Gurjar M., Hamid H. K. S., Silesky Jiménez J. I., Kase K., Hussain Kazmi S. S., Kechagias A., Khokha V., Kobe Y., Korkolis D. P., Litvin A., Lostoridis E., Mahendran H. A., Marino F., Martinuzzi A., Mesina C., Neri V., Panisic M., Paolillo C., Pararas N., Perrone G., Pesce A., Picardi B., Pither C., Podda M., Poskus T., Poullenot F., Przemyslaw M., Sartelli M., Sasia D., Scheiterle M., Seretis F., Søreide K., Sydorchuk R., Szczepanek K., Bodnar Z., Tamion F., Tarasconi A., Teraa M., Tolonen M., Vanuytsel T., Veroux M., Vinter-Jensen L., Visconti D., Widmer L., Zakaria A. D., Zubareva N., Endorsing International Societies, Hess, B, Cahenzli, M, Forbes, A, Burgos, R, Coccolini, F, Corcos, O, Holst, M, Irtun, Ø, Klek, S, Pironi, L, Rasmussen, H, Serlie, M, Thibault, R, Gabe, S, Reintam Blaser, A, Akin, E, Ali, S, Argenio, G, Atici, S, Augustin, G, Baili, E, Bains, L, Bala, M, Baldini, E, Baraket, O, Barone, M, Biloslavo, A, Roberto, B, Bombardini, C, Brisinda, G, Buonomo, L, Catena, F, Ceresoli, M, Chiarello, M, Chouliaras, C, D'Acapito, F, Damaskos, D, De Simone, B, Delogu, D, Demetrashvili, Z, Di Carlo, I, D'Oria, M, Durán-Muñoz-Cruzado, V, Forget, P, Fortuna, L, Fransvea, P, Frey, C, Gapejeva, O, Garcon, P, Gass, J, Teixeira Gonsaga, R, Griffiths, E, Gundogan, K, Gurjar, M, Hamid, H, Silesky Jiménez, J, Kase, K, Hussain Kazmi, S, Kechagias, A, Khokha, V, Kobe, Y, Korkolis, D, Litvin, A, Lostoridis, E, Mahendran, H, Marino, F, Martinuzzi, A, Mesina, C, Neri, V, Panisic, M, Paolillo, C, Pararas, N, Perrone, G, Pesce, A, Picardi, B, Pither, C, Podda, M, Poskus, T, Poullenot, F, Przemyslaw, M, Sartelli, M, Sasia, D, Scheiterle, M, Seretis, F, Søreide, K, Sydorchuk, R, Szczepanek, K, Bodnar, Z, Tamion, F, Tarasconi, A, Teraa, M, Tolonen, M, Vanuytsel, T, Veroux, M, Vinter-Jensen, L, Visconti, D, Widmer, L, Zakaria, A, Zubareva, N, Endorsing International, S, Hess B., Cahenzli M., Forbes A., Burgos R., Coccolini F., Corcos O., Holst M., Irtun Ø., Klek S., Pironi L., Rasmussen H. H., Serlie M. J., Thibault R., Gabe S., Reintam Blaser A., Akin E., Ali S. M., Argenio G., Atici S. D., Augustin G., Baili E., Bains L., Bala M., Baldini E., Baraket O., Barone M., Biloslavo A., Roberto Bini, Bombardini C., Brisinda G., Buonomo L., Catena F., Ceresoli M., Chiarello M. M., Chouliaras C., D'Acapito F., Damaskos D., De Simone B., Delogu D., Demetrashvili Z., Di Carlo I., D'Oria M., Durán-Muñoz-Cruzado V. M., Forget P., Fortuna L., Fransvea P., Frey C., Gapejeva O., Garcon P., Gass J. M., Teixeira Gonsaga R. A., Griffiths E., Gundogan K., Gurjar M., Hamid H. K. S., Silesky Jiménez J. I., Kase K., Hussain Kazmi S. S., Kechagias A., Khokha V., Kobe Y., Korkolis D. P., Litvin A., Lostoridis E., Mahendran H. A., Marino F., Martinuzzi A., Mesina C., Neri V., Panisic M., Paolillo C., Pararas N., Perrone G., Pesce A., Picardi B., Pither C., Podda M., Poskus T., Poullenot F., Przemyslaw M., Sartelli M., Sasia D., Scheiterle M., Seretis F., Søreide K., Sydorchuk R., Szczepanek K., Bodnar Z., Tamion F., Tarasconi A., Teraa M., Tolonen M., Vanuytsel T., Veroux M., Vinter-Jensen L., Visconti D., Widmer L., Zakaria A. D., Zubareva N., and Endorsing International Societies

Abstract

Background: Acute mesenteric ischaemia (AMI) is a condition with high mortality. This survey assesses current attitudes and practices to manage AMI worldwide. Methods: A questionnaire survey about the practices of diagnosing and managing AMI, endorsed by several specialist societies, was sent to different medical specialists and hospitals worldwide. Data from individual health care professionals and from medical teams were collected. Results: We collected 493 individual forms from 71 countries and 94 team forms from 34 countries. Almost half of respondents were surgeons, and most of the responding teams (70%) were led by surgeons. Most of the respondents indicated that diagnosis of AMI is often delayed but rarely missed. Emergency revascularisation is often considered for patients with AMI but rarely in cases of transmural ischaemia (intestinal infarction). Responses from team hospitals with a dedicated special unit (14 team forms) indicated more aggressive revascularisation. Abdominopelvic CT-scan with intravenous contrast was suggested as the most useful diagnostic test, indicated by approximately 90% of respondents. Medical history and risk factors were thought to be more important in diagnosis of AMI without transmural ischaemia, whereas for intestinal infarction, plasma lactate concentrations and surgical exploration were considered more useful. In elderly patients, a palliative approach is often chosen over extensive bowel resection. There was a large variability in anticoagulant treatment, as well as in timing of surgery to restore bowel continuity. Conclusions: Delayed diagnosis of AMI is common despite wide availability of an adequate imaging modality, i.e. CT-scan. Large variability in treatment approaches exists, indicating the need for updated guidelines. Increased awareness and knowledge of AMI may improve current practice until more robust evidence becomes available. Adherence to the existing guidelines may help in improving differences in treatment an

Published
2023

6. Characteristics of adult patients with chronic intestinal failure due to short bowel syndrome: An international multicenter survey

Author

Pironi, L, Steiger, E., Joly, F., Jeppesen, P.B., Wanten, G.J.A., Sasdelli, A.S., Chambrier, C., Aimasso, U., Mundi, M.S., Szczepanek, K., Jukes, A., Theilla, M., Kunecki, M., Daniels, J., Serlie, M., Poullenot, F., Cooper, S.C., Rasmussen, H.H., Compher, C., Seguy, D., Crivelli, A., Santarpia, L., Guglielmi, F.W., Kozjek, N.R., Schneider, S.M., Ellegard, L., Thibault, R., Matras, P., Matysiak, K., Gossum, A. van, Forbes, A., Wyer, N., Taus, M., Virgili, N.M., O'Callaghan, M., Chapman, B., Osland, E., Cuerda, C., Udvarhelyi, G., Jones, L., Lee, A.D. Won, Masconale, L., Orlandoni, P., Spaggiari, C., Díez, M.B., Doitchinova-Simeonova, M., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Czako, L., Kekstas, G., Sanz-Paris, A., Jáuregui, M.E.P., Murillo, A.Z., Schafer, E., Arends, J., Suárez-Llanos, J.P., Youssef, N.N., Brillanti, G., Nardi, E., Lal, S., Pironi, L, Steiger, E., Joly, F., Jeppesen, P.B., Wanten, G.J.A., Sasdelli, A.S., Chambrier, C., Aimasso, U., Mundi, M.S., Szczepanek, K., Jukes, A., Theilla, M., Kunecki, M., Daniels, J., Serlie, M., Poullenot, F., Cooper, S.C., Rasmussen, H.H., Compher, C., Seguy, D., Crivelli, A., Santarpia, L., Guglielmi, F.W., Kozjek, N.R., Schneider, S.M., Ellegard, L., Thibault, R., Matras, P., Matysiak, K., Gossum, A. van, Forbes, A., Wyer, N., Taus, M., Virgili, N.M., O'Callaghan, M., Chapman, B., Osland, E., Cuerda, C., Udvarhelyi, G., Jones, L., Lee, A.D. Won, Masconale, L., Orlandoni, P., Spaggiari, C., Díez, M.B., Doitchinova-Simeonova, M., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Czako, L., Kekstas, G., Sanz-Paris, A., Jáuregui, M.E.P., Murillo, A.Z., Schafer, E., Arends, J., Suárez-Llanos, J.P., Youssef, N.N., Brillanti, G., Nardi, E., and Lal, S.

Abstract

Item does not contain fulltext, BACKGROUND AND AIMS: The case-mix of patients with intestinal failure due to short bowel syndrome (SBS-IF) can differ among centres and may also be affected by the timeframe of data collection. Therefore, the ESPEN international multicenter cross-sectional survey was analyzed to compare the characteristics of SBS-IF cohorts collected within the same timeframe in different countries. METHODS: The study included 1880 adult SBS-IF patients collected in 2015 by 65 centres from 22 countries. The demographic, nutritional, SBS type (end jejunostomy, SBS-J; jejuno-colic anastomosis, SBS-JC; jejunoileal anastomosis with an intact colon and ileocecal valve, SBS-JIC), underlying disease and intravenous supplementation (IVS) characteristics were analyzed. IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorized as <1, 1-2, 2-3 and >3 L/day. RESULTS: In the entire group: 60.7% were females and SBS-J comprised 60% of cases, while mesenteric ischaemia (MI) and Crohn' disease (CD) were the main underlying diseases. IVS dependency was longer than 3 years in around 50% of cases; IVS was infused ≥5 days/week in 75% and FE in 10% of cases. Within the SBS-IF cohort: CD was twice and thrice more frequent in SBS-J than SBS-JC and SBS-JIC, respectively, while MI was more frequent in SBS-JC and SBS-JIC. Within countries: SBS-J represented 75% or more of patients in UK and Denmark and 50-60% in the other countries, except Poland where SBS-JC prevailed. CD was the main underlying disease in UK, USA, Denmark and The Netherlands, while MI prevailed in France, Italy and Poland. CONCLUSIONS: SBS-IF type is primarily determined by the underlying disease, with significant variation between countries. These novel data will be useful for planning and managing both clinical activity and research studies on SBS.

Published
2021

10. Home parenteral nutrition provision modalities for chronic intestinal failure in adult patients: An international survey

Author

Pironi, L, Steiger, E., Brandt, C, Joly, F., Wanten, G.J.A., Chambrier, C., Aimasso, U., Sasdelli, A.S., Zeraschi, S., Kelly, D., Szczepanek, K., Jukes, A., Caro, S. Di, Theilla, M., Kunecki, M., Daniels, J., Serlie, M., Poullenot, F., Wu, J., Cooper, S.C., Rasmussen, H.H., Compher, C., Seguy, D., Crivelli, A., Pagano, M.C., Hughes, S.J., Guglielmi, F.W., Kozjek, N.R., Schneider, S.M., Gillanders, L., Ellegard, L., Thibault, R., Matras, P., Zmarzly, A., Matysiak, K., Gossum, A. van, Forbes, A., Wyer, N., Taus, M., Virgili, N.M., O'Callaghan, M., Chapman, B., Osland, E., Cuerda, C., Sahin, P., Jones, L., Lee, A.D. Won, Masconale, L., Orlandoni, P., Izbéki, F., Spaggiari, C., Bueno, M., Doitchinova-Simeonova, M., Garde, C., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Czako, L., Kekstas, G., Sanz-Paris, A., Jáuregui, E.P., Murillo, A.Z., Schafer, E., Arends, J., Suárez-Llanos, J.P., Lal, S., Pironi, L, Steiger, E., Brandt, C, Joly, F., Wanten, G.J.A., Chambrier, C., Aimasso, U., Sasdelli, A.S., Zeraschi, S., Kelly, D., Szczepanek, K., Jukes, A., Caro, S. Di, Theilla, M., Kunecki, M., Daniels, J., Serlie, M., Poullenot, F., Wu, J., Cooper, S.C., Rasmussen, H.H., Compher, C., Seguy, D., Crivelli, A., Pagano, M.C., Hughes, S.J., Guglielmi, F.W., Kozjek, N.R., Schneider, S.M., Gillanders, L., Ellegard, L., Thibault, R., Matras, P., Zmarzly, A., Matysiak, K., Gossum, A. van, Forbes, A., Wyer, N., Taus, M., Virgili, N.M., O'Callaghan, M., Chapman, B., Osland, E., Cuerda, C., Sahin, P., Jones, L., Lee, A.D. Won, Masconale, L., Orlandoni, P., Izbéki, F., Spaggiari, C., Bueno, M., Doitchinova-Simeonova, M., Garde, C., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Czako, L., Kekstas, G., Sanz-Paris, A., Jáuregui, E.P., Murillo, A.Z., Schafer, E., Arends, J., Suárez-Llanos, J.P., and Lal, S.

Abstract

Contains fulltext : 220087.pdf (Publisher’s version ) (Closed access), BACKGROUND & AIMS: The safety and effectiveness of a home parenteral nutrition (HPN) program depends both on the expertise and the management approach of the HPN center. We aimed to evaluate both the approaches of different international HPN-centers in their provision of HPN and the types of intravenous supplementation (IVS)-admixtures prescribed to patients with chronic intestinal failure (CIF). METHODS: In March 2015, 65 centers from 22 countries enrolled 3239 patients (benign disease 90.1%, malignant disease 9.9%), recording the patient, CIF and HPN characteristics in a structured database. The HPN-provider was categorized as health care system local pharmacy (LP) or independent home care company (HCC). The IVS-admixture was categorized as fluids and electrolytes alone (FE) or parenteral nutrition, either commercially premixed (PA) or customized to the individual patient (CA), alone or plus extra FE (PAFE or CAFE). Doctors of HPN centers were responsible for the IVS prescriptions. RESULTS: HCC (66%) was the most common HPN provider, with no difference noted between benign-CIF and malignant-CIF. LP was the main modality in 11 countries; HCC prevailed in 4 European countries: Israel, USA, South America and Oceania (p < 0.001). IVS-admixture comprised: FE 10%, PA 17%, PAFE 17%, CA 38%, CAFE 18%. PA and PAFE prevailed in malignant-CIF while CA and CAFE use was greater in benign-CIF (p < 0.001). PA + PAFE prevailed in those countries where LP was the main HPN-provider and CA + CAFE prevailed where the main HPN-provider was HCC (p < 0.001). CONCLUSIONS: This is the first study to demonstrate that HPN provision and the IVS-admixture differ greatly among countries, among HPN centers and between benign-CIF and cancer-CIF. As both HPN provider and IVS-admixture types may play a role in the safety and effectiveness of HPN therapy, criteria to homogenize HPN programs are needed so that patients can have equal access to optimal CIF care.

Published
2020

11. A free-choice high-fat diet modulates the effects of a sucrose bolus on the expression of genes involved in glucose handling in the hypothalamus and nucleus accumbens

Author

Koekkoek, L L, Unmehopa, U A, Eggels, L, Kool, T, Lamuadni, K, Diepenbroek, C, Mul, J D, Serlie, M J, la Fleur, S E, Koekkoek, L L, Unmehopa, U A, Eggels, L, Kool, T, Lamuadni, K, Diepenbroek, C, Mul, J D, Serlie, M J, and la Fleur, S E

Abstract

The consumption of saturated fat and sucrose can have synergistic effects on the brain that do not occur when either nutrient is consumed by itself. In this study we hypothesize that saturated fat intake modulates glucose handling in the hypothalamus and nucleus accumbens, both brain areas highly involved in the control of food intake. To study this, male Wistar rats were given a free-choice high fat diet (fcHFD) or a control diet for two weeks. During the last seven days rats were given a daily bolus of either a 30% sucrose solution or water. Rats were sacrificed on day eight, 30 minutes after the onset of drinking. mRNA and protein levels of genes involved in glucose handling were assessed in the hypothalamus and nucleus accumbens. We found increased Glut3 and Glut4 mRNA in the hypothalamus of fcHFD-fed rats without an additional effect of the sucrose bolus. In the nucleus accumbens, the sucrose bolus increased Glut3 mRNA and decreased Glut4 mRNA independent of prior diet exposure. The ATP-sensitive potassium channel subunit Kir6.1 in the nucleus accumbens tended to be affected by the synergistic effects of a fcHFD and a sucrose bolus. These data suggest that acute glucose handling in the hypothalamus and nucleus accumbens may be affected by prior high fat exposure.

Published
2020

17. Patterns of Co-occurring Comorbidities in People Living With HIV

Author

De Francesco, Davide, Verboeket, Sebastiaan O, Underwood, Jonathan, Bagkeris, Emmanouil, Wit, Ferdinand W, Mallon, Patrick W G, Winston, Alan, Reiss, Peter, Sabin, Caroline A, Study group members AMC, Reiss, P., Wit, F. W. N. M., Kooij, K. W., van Zoest, R. A., Verheij, E., Verboeket, Sebastiaan O., Prins, M., Kootstra, N. A., Harskamp-Holwerda, A. M., Maurer, Irma, Mangas Ruiz, M. M., Boeser-Nunnink, B. D. M., Geerlings, S. E., Goorhuis, A., Hovius, J. W. R., Nellen, F. J. B., van der Poll, Tom, Prins, J. M., Wiersinga, W. J., van Vugt, M., de Bree, G. J., Postema, P. G., Bisschop, P. H. L. T., Serlie, M. J. M., Dekker, E., van der Velde, N., Willemsen, J. M. R., Vogt, L., Portegies, P., Schmand, B. A., Geurtsen, G. J., Verbraak, F. D., Visser, I., Nieuwkerk, P. T., Majoie, C. B. L. M., Caan, M. W. A., van Lunsen, H. W., van den Born, B. J. H., Stroes, E. S. G., Intensive care medicine, Anatomy and neurosciences, Medical psychology, Internal medicine, APH - Aging & Later Life, Elderly care medicine, Amsterdam Neuroscience - Systems & Network Neuroscience, Ophthalmology, Psychiatry, APH - Mental Health, Radiology and nuclear medicine, ACS - Atherosclerosis & ischemic syndromes, Graduate School, Center of Experimental and Molecular Medicine, Global Health, Infectious diseases, APH - Global Health, Experimental Immunology, APH - Quality of Care, Cardiology, Endocrinology, Gastroenterology and Hepatology, Geriatrics, Nephrology, APH - Health Behaviors & Chronic Diseases, Neurology, Medical Psychology, APH - Societal Participation & Health, Adult Psychiatry, APH - Personalized Medicine, Radiology and Nuclear Medicine, Obstetrics and Gynaecology, Vascular Medicine, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, APH - Methodology, ACS - Microcirculation, ACS - Heart failure & arrhythmias, and ACS - Diabetes & metabolism

Subjects
0301 basic medicine, patterns of comorbidities, medicine.medical_specialty, multimorbidity, comorbidities, Major Articles, 03 medical and health sciences, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), Interquartile range, Internal medicine, Health care, medicine, Medical history, 030212 general & internal medicine, Pathological, business.industry, Metabolic disorder, HIV, medicine.disease, 030112 virology, Comorbidity, Mental health, Infectious Diseases, Oncology, Pharmacokinetic and Clinical Observations in PeoPle Over fiftY (POPPY) study and the AGEhIV Cohort Study, business
Abstract

Background The aims of this study were to identify common patterns of comorbidities observed in people living with HIV (PLWH), using a data-driven approach, and evaluate associations between patterns identified. Methods A wide range of comorbidities were assessed in PLWH participating in 2 independent cohorts (POPPY: UK/Ireland; AGEhIV: Netherlands). The presence/absence of each comorbidity was determined using a mix of self-reported medical history, concomitant medications, health care resource use, and laboratory parameters. Principal component analysis (PCA) based on Somers’ D statistic was applied to identify patterns of comorbidities. Results PCA identified 6 patterns among the 1073 POPPY PLWH (85.2% male; median age [interquartile range {IQR}], 52 [47–59] years): cardiovascular diseases (CVDs), sexually transmitted diseases (STDs), mental health problems, cancers, metabolic disorders, chest/other infections. The CVDs pattern was positively associated with cancer (r = .32), metabolic disorder (r = .38), mental health (r = .16), and chest/other infection (r = .17) patterns (all P < .001). The mental health pattern was correlated with all the other patterns (in particular cancers: r = .20; chest/other infections: r = .27; both P < .001). In the 598 AGEhIV PLWH (87.6% male; median age [IQR], 53 [48–59] years), 6 patterns were identified: CVDs, chest/liver, HIV/AIDS events, mental health/neurological problems, STDs, and general health. The general health pattern was correlated with all the other patterns (in particular CVDs: r = .14; chest/liver: r = .15; HIV/AIDS events: r = .31; all P < .001), except STDs (r = –.02; P = .64). Conclusions Comorbidities in PLWH tend to occur in nonrandom patterns, reflecting known pathological mechanisms and shared risk factors, but also suggesting potential previously unknown mechanisms. Their identification may assist in adequately addressing the pathophysiology of increasingly prevalent multimorbidity in PLWH.

Published
2018

20. Cross-sectional Comparison of the Prevalence of Age-Associated Comorbidities and Their Risk Factors Between HIV-Infected and Uninfected Individuals: The AGEhIV Cohort Study

Author

Schouten, Judith, Wit, Ferdinand W., Stolte, Ineke G., Kootstra, Neeltje A., van der Valk, Marc, Geerlings, Suzanne E., Prins, Maria, Reiss, Peter, Kooij, K. W., van Zoest, R. A., Elsenga, B. C., Stolte, I. G., Martens, M., Moll, S., Berkel, J., Möller, L., Visser, G. R., Welling, C., Zaheri, S., Gras, L. A. J., van Leeuwen, E., Godfried, M. H., Goorhuis, A., van der Meer, J. T. M., Nellen, F. J. B., van der Poll, T., Prins, J. M., Wiersinga, W. J., Postema, P. G., Bisschop, P. H. L. T., Serlie, M. J. M., Dekker, E., de Rooij, S. E. J. A., Vogt, L., Portegies, P., Schmand, B. A., Geurtsen, G. J., van Eck-Smit, B. L. F., de Jong, M., Richel, D. J., Verbraak, F. D., Demirkaya, N., Ruhé, H. G., Nieuwkerk, P. T., van Steenwijk, R. P., Majoie, C. B. L. M., Caan, M. W. A., van Lunsen, H. W., van den Born, B. J. H., Stroes, E. S. G., Graduate School, AII - Amsterdam institute for Infection and Immunity, Global Health, Experimental Immunology, Infectious diseases, APH - Amsterdam Public Health, Other departments, Other Research, Obstetrics and Gynaecology, General Internal Medicine, Center of Experimental and Molecular Medicine, ACS - Amsterdam Cardiovascular Sciences, Cardiology, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, AMS - Amsterdam Movement Sciences, Endocrinology, CCA -Cancer Center Amsterdam, ANS - Amsterdam Neuroscience, Geriatrics, Nephrology, Neurology, Medical Microbiology and Infection Prevention, Oncology, Biomedical Engineering and Physics, Ophthalmology, Adult Psychiatry, Medical Psychology, Pulmonology, Radiology and Nuclear Medicine, Vascular Medicine, and Pharmacy

Subjects
Male, Microbiology (medical), medicine.medical_specialty, HIV Infections, Disease, Cohort Studies, Risk Factors, Internal medicine, Prevalence, Humans, Medicine, Family history, Prospective cohort study, Immunodeficiency, Aged, business.industry, Odds ratio, Middle Aged, medicine.disease, Comorbidity, Cross-Sectional Studies, Infectious Diseases, Cardiovascular Diseases, Hypertension, Immunology, Female, Ritonavir, business, Cohort study, medicine.drug
Abstract

Human immunodeficiency virus (HIV)-infected individuals may be at increased risk of age-associated noncommunicable comorbidities (AANCCs). Cross-sectional analyses of AANCC prevalence (including cardiovascular, metabolic, pulmonary, renal, bone, and malignant disease) and risk factors in a prospective cohort study of HIV type 1-infected individuals and HIV-uninfected controls, who were aged ≥45 years and comparable regarding most lifestyle and demographic factors. HIV-infected participants (n = 540) had a significantly higher mean number of AANCCs than controls (n = 524) (1.3 [SD, 1.14] vs 1.0 [SD, 0.95]; P < .001), with significantly more HIV-infected participants having ≥1 AANCC (69.4% vs 61.8%; P = .009). Hypertension, myocardial infarction, peripheral arterial disease, and impaired renal function were significantly more prevalent among HIV-infected participants. Risk of AANCC by ordinal logistic regression was independently associated with age, smoking, positive family history for cardiovascular/metabolic disease, and higher waist-to-hip ratio, but also with HIV infection (odds ratio, 1.58 [95% confidence interval, 1.23-2.03]; P < .001). In those with HIV, longer exposure to CD4 counts

Published
2014

22. Infusion of fluoxetine, a serotonin reuptake inhibitor, in the shell region of the nucleus accumbens increases blood glucose concentrations in rats

Author

Diepenbroek, C, Rijnsburger, M, Eggels, L, van Megen, K M, Ackermans, M T, Fliers, E, Kalsbeek, A., Serlie, M J, La Fleur, S.E., Diepenbroek, C, Rijnsburger, M, Eggels, L, van Megen, K M, Ackermans, M T, Fliers, E, Kalsbeek, A., Serlie, M J, and La Fleur, S.E.

Abstract

The brain is well known to regulate blood glucose, and the hypothalamus and hindbrain, in particular, have been studied extensively to understand the underlying mechanisms. Nuclei in these regions respond to alterations in blood glucose concentrations and can alter glucose liver output or glucose tissue uptake to maintain blood glucose concentrations within strict boundaries. Interestingly, several cortico-limbic regions also respond to alterations in glucose concentrations and have been shown to project to hypothalamic nuclei and glucoregulatory organs. For instance, electrical stimulation of the shell of the nucleus accumbens (sNAc) results in increased circulating concentrations of glucose and glucagon and activation of the lateral hypothalamus (LH). Whether this is caused by the simultaneous increase in serotonin release in the sNAc remains to be determined. To study the effect of sNAc serotonin on systemic glucose metabolism, we implanted bilateral microdialysis probes in the sNAc of male Wistar rats and infused fluoxetine, a serotonin reuptake inhibitor, or vehicle after which blood glucose, endogenous glucose production (EGP) and glucoregulatory hormones were measured. Fluoxetine in the sNAc for 1 hour significantly increased blood glucose concentrations without an effect on glucoregulatory hormones. This increase was accompanied by a higher EGP in the fluoxetine infused rats compared to the controls. These data provide further evidence for a role of sNAc-serotonin in the regulation of glucose metabolism.

Published
2017

26. Prostaglandin profiling reveals a role for haematopoietic prostaglandin D synthase in adipose tissue macrophage polarisation in mice and humans

Author

Virtue, S., Masoodi, M., de Weijer, B. A. M., van Eijk, M., Mok, C. Y. L., Eiden, M., Dale, M., Pirraco, A., Serlie, M. J., Griffin, J. L., Vidal-Puig, A., Griffin, Julian [0000-0003-1336-7744], Vidal-Puig, Antonio [0000-0003-4220-9577], Apollo - University of Cambridge Repository, Other departments, AII - Amsterdam institute for Infection and Immunity, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Medical Biochemistry, and Endocrinology

Subjects
Inflammation, Adipogenesis, Prostaglandin D2, Macrophages, Mice, Obese, Lipid Metabolism, Diet, Mice, Inbred C57BL, Disease Models, Animal, Mice, Endocrinology & Metabolism, Adipose Tissue, Animals, Eicosanoids, Humans, Obesity, 13 Education, 11 Medical and Health Sciences, Chromatography, Liquid
Abstract

BACKGROUND/OBJECTIVES: Obesity has been associated with both changes in adipose tissue lipid metabolism and inflammation. A key class of lipid-derived signalling molecules involved in inflammation are the prostaglandins. In this study, we aimed to determine how obesity affects the levels of prostaglandins within white adipose tissue (WAT) and determine which cells within adipose tissue produce them. To avoid the effects of cellular stress on prostaglandin levels, we developed a multivariate statistical approach in which metabolite concentrations and transcriptomic data were integrated, allowing the assignment of metabolites to cell types. SUBJECTS/METHODS: Eicosanoids were measured by liquid chromatography-tandem mass spectrometry and mRNA levels using real-time PCR. Eicosanoid levels and transcriptomic data were combined using principal component analysis and hierarchical clustering in order to associate metabolites with cell types. Samples were obtained from C57Bl/6 mice aged 16 weeks. We studied the ob/ob genetically obese mouse model and diet-induced obesity model. We extended our results in mice to a cohort of morbidly obese humans undergoing bariatric surgery. RESULTS: Using our modelling approach, we determined that prostglandin D₂ (PGD₂) in adipose tissue was predominantly produced in macrophages by the haematopoietic isoform of prostaglandin D synthase (H-Pgds). Analysis of sub-fractionated WAT confirmed that H-Pgds was expressed in adipose tissue macrophages (ATMs). Furthermore, H-Pgds expression in ATMs isolated from lean and obese mice was consistent with it affecting macrophage polarisation. Functionally, we demonstrated that H-PGDS-produced PGD₂ polarised macrophages toward an M2, anti-inflammatory state. In line with a potential anti-inflammatory role, we found that H-PGDS expression in ATMs was positively correlated with both peripheral insulin and adipose tissue insulin sensitivity in humans. CONCLUSIONS: In this study, we have developed a method to determine the cellular source of metabolites within an organ and used it to identify a new role for PGD₂ in the control of ATM polarisation.

Published
2014

27. One-week exposure to a free-choice high-fat high-sugar diet does not disrupt blood–brain barrier permeability in fed or overnight fasted rats.

Author

Rijnsburger, M., Unmehopa, U. A., Eggels, L., Serlie, M. J., and la Fleur, S. E.

Subjects
BLOOD-brain barrier, HIGH-fat diet, PERMEABILITY, GLUCOSE transporters, RATS, OCCLUDINS, NEUROPEPTIDES
Abstract

Objectives: The hypothalamus lies adjacent to the third ventricle and is in close proximity with the median eminence (ME), a circumventricular organ with an incomplete blood–brain barrier (BBB) which controls direct entry of nutrients into the brain. The blood–CSF barrier of the hypothalamus shows dynamic changes upon neuroendocrine events and adjusts permeability with the tight junction (TJ) complex. It has been shown that chronic exposure to a high-fat diet (HFD) affects BBB permeability. HFD also induces leptin resistance and alters neuropeptide expression in the arcuate nucleus (Arc) of the hypothalamus starting early during overnutrition. We hypothesized altered integrity of the BBB to occur after exposing rats to a free-choice high-fat high-sugar (fcHFHS) diet for 1 week. Methods: We measured diffusion of Evans blue dye over the ME and assessed expression of the TJ proteins ZO-1, claudin-5, and occludin in the tanycytic wall of the third ventricle. Furthermore, we assessed protein expression of glucose transporter 1 (GLUT-1), which is highly expressed in the Arc-ME complex and facilitates glucose transport over the BBB. Results: fcHFHS-fed rats increased caloric intake compared to control, however, there was no effect of the fcHFHS diet on permeability of the BBB, nor changes in protein expression of tight TJ proteins or GLUT-1. Fasting acutely affects the BBB and we hypothesized that exposure to the fcHFHS diet affects the BBB differently compared to chow after fasting. We did not, however, find any differences in Evans blue diffusion nor protein expression between chow- and fcHFHS-fed rats when fasted overnight. Conclusions: We conclude that short-term consumption of a fcHFHS diet does not change permeability or diffusion in the hypothalamus barrier in ad libitum fed or fasted rats. [ABSTRACT FROM AUTHOR]

Published
2019
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28. Brain dopamine and serotonin transporter binding are associated with visual attention bias for food in lean men

Author

Koopman, K. E., Koopman, K. E., Roefs, A., Elbers, D. C. E., Fliers, E., Booij, J., Serlie, M. J., la Fleur, S. E., Koopman, K. E., Koopman, K. E., Roefs, A., Elbers, D. C. E., Fliers, E., Booij, J., Serlie, M. J., and la Fleur, S. E.

Abstract

Background. In rodents, the striatal dopamine (DA) system and the (hypo) thalamic serotonin (5-HT) system are involved in the regulation of feeding behavior. In lean humans, little is known about the relationship between these brain neurotransmitter systems and feeding. We studied the relationship between striatal DA transporters (DAT) and diencephalic 5-HT transporters (SERT), behavioral tasks and questionnaires, and food intake. Method. We measured striatal DAT and diencephalic SERT binding with [I-123] FP-CIT SPECT in 36 lean male subjects. Visual attention bias for food (detection speed and distraction time) and degree of impulsivity were measured using response-latency-based computer tasks. Craving and emotional eating were assessed with questionnaires and ratings of hunger by means of VAS scores. Food intake was assessed through a self-reported online diet journal. Results. Striatal DAT and diencephalic SERT binding negatively correlated with food detection speed (p = 0.008, r = -0.50 and p = 0.002, r = -0.57, respectively), but not with food distraction time, ratings of hunger, craving or impulsivity. Striatal DAT and diencephalic SERT binding did not correlate with free choice food intake, whereas food detection speed positively correlated with total caloric intake (p = 0.001, r = 0.60), protein intake (p = 0.01, r = 0.44), carbohydrate intake (p = 0.03, r = 0.39) and fat intake (p = 0.06, r = 0.35). Conclusions. These results indicate a role for the central 5-HT and DA system in the regulation of visual attention bias for food, which contributes to the motivation to eat, in non-obese, healthy humans. In addition, this study confirms that food detection speed, measured with the latency-based computer task, positively correlates with total food and macro-nutrient intake.

Published
2016

30. Serotonin, a possible intermediate between disturbed circadian rhythms and metabolic disease

Author

Versteeg, R I, Serlie, M J, Kalsbeek, A, la Fleur, S E, Versteeg, R I, Serlie, M J, Kalsbeek, A, and la Fleur, S E

Abstract

It is evident that eating in misalignment with the biological clock (such as in shift work, eating late at night and skipping breakfast) is associated with increased risk for obesity and diabetes. The biological clock located in the suprachiasmatic nucleus dictates energy balance including feeding behavior and glucose metabolism. Besides eating and sleeping patterns, glucose metabolism also exhibits clear diurnal variations with higher blood glucose concentrations, glucose tolerance and insulin sensitivity prior to waking up. The daily variation in plasma glucose concentrations in rats, is independent of the rhythm in feeding behavior. On the other hand, feeding itself has profound effects on glucose metabolism, but differential effects occur depending on the time of the day. We here review data showing that a disturbed diurnal eating pattern results in alterations in glucose metabolism induced by a disrupted circadian clock. We first describe the role of central serotonin on feeding behavior and glucose metabolism and subsequently describe the effects of central serotonin on the circadian system. We next explore the interaction between the serotonergic system and the circadian clock in conditions of disrupted diurnal rhythms in feeding and how this might be involved in the metabolic dysregulation that occurs with chronodisruption.

Published
2015

31. Hepatic and peripheral insulin sensitivity do not improve 2 weeks after bariatric surgery

Author

de Weijer, B. A., Aarts, E., Janssen, I. M. C., Berends, F. J., van de Laar, A., Kaasjager, K., Ackermans, M. T., Fliers, E., Serlie, M. J., Other departments, Other Research, Laboratory for Endocrinology, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam Neuroscience, and Endocrinology

Subjects
nutritional and metabolic diseases
Abstract

Bariatric surgery has rapid metabolic effects on glucose metabolism before the occurrence of clinically significant weight loss. This suggests an acute effect of the surgery itself, e.g., resulting from bypassing the nutrient flow from the proximal gastrointestinal tract. Rapid effects of Roux-en-Y gastric bypass surgery (RYGB) on glucose metabolism were defined. Glucose metabolism and total triglyceride hydrolysis in the basal state and during a hyperinsulinemic euglycemic clamp using stable isotopes 2 weeks were studied before and after RYGB. Eighteen pre-menopausal women scheduled for RYGB were included. 2 weeks after RYGB median weight loss was 7.8 kg. Basal insulin and glucose levels decreased after surgery. Endogenous glucose production (EGP) was lower after surgery. In addition, insulin levels were lower during the clamp after surgery, suggesting enhanced clearance. Hepatic and peripheral insulin sensitivity did not change. Free fatty acid (FFA) levels increased after surgery both in the basal state and during the first step of the clamp. Total triglyceride hydrolysis did not change in the basal state and tended to be higher during hyperinsulinemia. Within 2 weeks, RYGB reduces basal EGP as well as insulin and glucose levels without an acute beneficial effect on hepatic or peripheral insulin sensitivity. The latter may be explained by higher rates of lipolysis and exposure to FFA induced by the hypocaloric state

Published
2013

34. Glycosphingolipids and insulin resistance

Author

Aerts, J. M., Boot, R. G., van Eijk, M., Groener, J., Bijl, N., Lombardo, E., Bietrix, F. M., Dekker, N. [=Nick], Groen, A. K., Ottenhoff, R., van Roomen, C., Aten, J., Serlie, M., Langeveld, M., Wennekes, T., Overkleeft, H. S., Cowart, A., Amsterdam Cardiovascular Sciences, Amsterdam Gastroenterology Endocrinology Metabolism, Medical Biochemistry, Amsterdam institute for Infection and Immunity, Other departments, Vascular Medicine, Pathology, and Endocrinology

Published
2010

36. Systematic review: pharmacotherapy for high-output enterostomies or enteral fistulas.

Author

Vries, F. E. E., Reeskamp, L. F., Ruler, O., Arum, I., Kuin, W., Dijksta, G., Haveman, J. W., Boermeester, M. A., and Serlie, M. J.

Subjects
ENTEROSTOMY, INTESTINAL fistula, DRUG therapy, PROTON pump inhibitors, ANTIHISTAMINES, THERAPEUTICS
Abstract

Background High-output enterocutaneous fistula or enterostomies can cause intestinal failure. There is a wide variety of options in medical management of patients with high output. Aim To systematically review the literature on available pharmacotherapy to reduce output and to propose an algorithm for standard of care. Methods Relevant databases were systematically reviewed to identify studies on pharmacotherapy for reduction in (high-) output enterostomies or fistula. Randomised controlled trials and within subjects controlled prospective trials were included. An algorithm for standard of care was generated based on the outcomes of the systematic review. Results Two studies on proton pump inhibitors, six on anti-motility agents, three on histamine receptor antagonists, one on an α2- receptor agonist and eight on somatostatin (analogues) were included. One study examined a proton pump inhibitor and a histamine receptor antagonist within the same patients. Overall, we found evidence for the following medical therapies to be effective: omeprazole, loperamide and codeine, ranitidine and cimetidine. On the basis of these outcomes and clinical experience, we proposed an algorithm for standard of care which consists of high-dose proton pump inhibitors combined with high-dose loperamide as the first step followed by addition of codeine in case of insufficient output reduction. So far, there is insufficient evidence for the standard use of somatostatin (analogues). Conclusions The available evidence on the efficacy of medication to reduce enterostomy or enterocutaneous fistula output is hampered by low quality studies. We propose an algorithm for standard of care output reduction in these patients. [ABSTRACT FROM AUTHOR]

Published
2017
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37. Meal timing effects on insulin sensitivity and intrahepatic triglycerides during weight loss

Author

Versteeg, R I, Ackermans, M T, Nederveen, A J, Fliers, E, Serlie, M J, and la Fleur, S E

Abstract

Background:Several human and rodent studies suggest that in addition to the amount of energy consumed, timing of food intake contributes to body weight regulation. Consuming most energy in the morning has favorable effects on weight loss and weight maintenance. Whether this also affects glucose metabolism and liver fat independently from weight loss is unknown.Objective:We hypothesized that during weight loss, consuming most energy in the morning improves insulin sensitivity and reduces hepatic fat content more than consuming most energy in the evening.Methods:Twenty-three obese insulin resistant men (age 59.9±7.9 years, body mass index 34.4±3.8 kg m−2) followed a 4-week hypocaloric diet intervention with either 50% of daily energy consumed in the morning (BF group) or evening (D group). Insulin sensitivity, measured with a two-step hyperinsulinemic euglycemic clamp using a glucose tracer, intrahepatic triglycerides (IHTG), measured using magnetic resonance spectroscopy, and resting energy expenditure (REE) were assessed before and after the diet intervention.Results:Meal macronutrient composition and weight loss (6.5±1.5% vs 6.2±1.9%, respectively, P=0.70) did not differ between the BF and D groups. Endogenous glucose production (P⩽0.001), hepatic and peripheral insulin sensitivity (P=0.002; P=0.001, respectively) as well as IHTG content (P⩽0.001) all significantly improved with weight loss, but were not different between the BF and D groups. In addition, both groups decreased REE and respiratory quotient equally.Conclusions:During weight loss, consuming most energy in the morning instead of the evening does not have additional beneficial effects on insulin sensitivity and IHTG content. These results do not support weight independent effects of meal timing on glucose metabolism and IHTG in hypocaloric conditions in obese men.

Published
2018
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38. Endocrinologische Aandoeningen Inleiding

Author

Fliers, E., Bisschop, P. H. L. T., Serlie, M. J. M., Willems, J. H. B. M., Croon, N. H. T. H., Koten, J. W., Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam Neuroscience, Endocrinology, and Amsterdam Movement Sciences

Published
2002

39. Endocrinologische Aandoeningen; De bijnier

Author

Fliers, E., Bisschop, P. H. L. T., Serlie, M. J. M., Willems, J. H. B. M., Croon, N. H. T. H., Koten, J. W., Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam Neuroscience, Endocrinology, and Amsterdam Movement Sciences

Published
2002

40. Endocrinologische Aandoeningen; De Schildklier

Author

Fliers, E., Bisschop, P. H. L. T., Serlie, M. J. M., Willems, J. H. B. M., Croon, N. H. T. H., Koten, J. W., Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam Neuroscience, Endocrinology, and Amsterdam Movement Sciences

Published
2002

41. Endocrinologische Aandoeningen; De hypofyse

Author

Fliers, E., Bisschop, P. H. L. T., Serlie, M. J. M., Willems, J. H. B. M., Croon, N. H. T. H., Koten, J. W., Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam Neuroscience, Endocrinology, and Amsterdam Movement Sciences

Published
2002

42. Differences in fluid and solute transport between diabetic and nondiabetic patients at the onset of CAPD

Author

Serlie, M. J., Struijk, D. G., de Blok, K., Krediet, R. T., and Other departments

Subjects
urologic and male genital diseases
Abstract

Loss of transcapillary ultrafiltration (TCUF) can occur during continuous ambulatory peritoneal dialysis (CAPD) and may be caused by exposure to the high glucose concentrations in the dialysate, leading to glycation of water channels in the endothelial cells of the peritoneal microvessels. If this hypothesis is correct, diabetic patients should have lower TCUF rates at the onset of CAPD than nondiabetic controls. Such a difference should disappear during longer-duration CAPD because of the continuous glucose exposure in both groups, induced by the high glucose concentrations in the dialysate. Therefore, the standard peritoneal permeability analysis of 11 diabetic (mean age 48 years, range 33-70 years) and 11 nondiabetic patients (mean age 49 years, range 36-69 years) matched for sex, age, and duration of CAPD were studied shortly after the onset of CAPD treatment (mean duration 162 vs 131 days) and one year later. No differences were found in solute transport or protein clearances between the two groups at the onset of CAPD. The TCUF rate was lower in the diabetic patients: 0.9 mL/min (0.09-2.25) versus 1.51 mL/min (0.97-2.44), p = 0.01. The other parameters of fluid transport were not different. The mean osmotic pressure gradient, exerted by albumin and glucose, was 1.72 mmHg in the diabetic patients and 5.44 mmHg in the controls (p = 0.0004). No differences were found in peritoneal permeability, including TCUF, after one year between the two groups. In conclusion, the TCUF rate was lower in diabetic patients compared to nondiabetics only shortly after the onset of CAPD. These results suggest that long-term exposure to high glucose concentrations in diabetics prior to CAPD may cause changes in capillary wall aquaporins, similar to long-term exposure to high glucose concentrations in the dialysate in CAPD

Published
1997

46. Low-dose glucocorticoid treatment affects multiple aspects of intermediary metabolism in healthy humans: a randomised controlled trial.

Author

Raalte, D., Brands, M., Zijl, N., Muskiet, M., Pouwels, P., Ackermans, M., Sauerwein, H., Serlie, M., and Diamant, M.

Abstract

im/hypothesis: To assess whether low-dose glucocorticoid treatment induces adverse metabolic effects, as is evident for high glucocorticoid doses. Methods: In a randomised placebo-controlled double-blind (participants and the investigators who performed the studies and assessed the outcomes were blinded) dose-response intervention study, 32 healthy men (age 22 ± 3 years; BMI 22.4 ± 1.7 kg/m) were allocated to prednisolone 7.5 mg once daily ( n = 12), prednisolone 30 mg once daily ( n = 12), or placebo ( n = 8) for 2 weeks using block randomisation. Main outcome measures were glucose, lipid and protein metabolism, measured by stable isotopes, before and at 2 weeks of treatment, in the fasted state and during a two-step hyperinsulinaemic clamp conducted in the Clinical Research Unit of the Academic Medical Centre, Amsterdam, the Netherlands Results: Prednisolone, compared with placebo, dose dependently and significantly increased fasting plasma glucose levels, whereas only prednisolone 30 mg increased fasting insulin levels (29 ± 15 pmol/l). Prednisolone 7.5 mg and prednisolone 30 mg decreased the ability of insulin to suppress endogenous glucose production (by 17 ± 6% and 46 ± 7%, respectively, vs placebo). Peripheral glucose uptake was not reduced by prednisolone 7.5 mg, but was decreased by prednisolone 30 mg by 34 ± 6% ( p < 0.0001). Compared with placebo, prednisolone treatment tended to decrease lipolysis in the fasted state ( p = 0.062), but both prednisolone 7.5 mg and prednisolone 30 mg decreased insulin-mediated suppression of lipolysis by 11 ± 5% and 34 ± 6%, respectively. Finally, prednisolone treatment increased whole-body proteolysis during hyperinsulinaemia, which tended to be driven by prednisolone 30 mg (5 ± 2%; p = 0.06). No side effects were reported by the study participants. All participants completed the study and were analysed. Conclusions/interpretation: Not only at high doses but also at low doses, glucocorticoid therapy impaired intermediary metabolism by interfering with the metabolic actions of insulin on liver and adipose tissue. These data indicate that even low-dose glucocorticoids may impair glucose tolerance when administered chronically. Trial registration:: ISRCTN83991850 Funding:: The study was funded by the Dutch Top Institute Pharma T1-106. [ABSTRACT FROM AUTHOR]

Published
2011
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47. Evaluation of endocrine tests. C: Glucagon and clonidine test in phaeochromocytoma

Author

Bisschop, P. H., Corssmit, E. P. M., Baas, S. J., Serlie, M. J., Endert, E., Wiersinga, W. M., Eric Fliers, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam Movement Sciences, Endocrinology, Laboratory for Endocrinology, and Amsterdam Neuroscience

Subjects
endocrine system, endocrine system diseases
Abstract

Background: The diagnosis of phaeochromocytoma is based on the demonstration of catecholamine excess. Urine and plasma metanephrine measurements are highly sensitive tests for the diagnosis of phaeochromocytoma, but moderate elevations in metanephrines lack optimal specificity. In this study we aimed to evaluate the diagnostic value of additional tests, i.e. glucagon stimulation and clonidine suppression test, in patients with moderately elevated catecholamines and/or metanephrines. Methods: Patients with suspected phaeochromocytoma with moderately elevated catecholamines and/or metanephrines in plasma or urine were subjected to the glucagon stimulation and clonidine suppression test. The presence of phaeochromocytoma was confirmed by histology and the absence by a disease-free extended follow-up. Results: Fifty-five patients were included. Phaeochromocytoma was diagnosed in II patients. The follow-up period in patients without phaeochromocytoma was 56 (19 to 154) months. The sensitivity of the glucagon test was 30% and the specificity 100%. The clonidine test had no discriminative power, because the area under the ROC curve was not significantly different from 0.5. Conclusion: The clonidine suppression test without normetanephrine measurements and the glucagon stimulation test are not sensitive enough to safely exclude phaeochromocytoma in patients with mildly elevated plasma or urine catecholamines

48. Obesity: Is evolution to blame?

Author

Serlie, M. J., La Fleur, S. E., Eric Fliers, Amsterdam Gastroenterology Endocrinology Metabolism, Endocrinology, and Amsterdam Neuroscience

Abstract

No abstract available

49. Management of acute mesenteric ischaemia: Results of a worldwide survey

Author

Benjamin Hess, Martin Cahenzli, Alastair Forbes, Rosa Burgos, Federico Coccolini, Olivier Corcos, Mette Holst, Øivind Irtun, Stanislaw Klek, Loris Pironi, Henrik Højgaard Rasmussen, Mireille J. Serlie, Ronan Thibault, Simon Gabe, Annika Reintam Blaser, Emrah Akin, Syed Muhammad Ali, Giulio Argenio, Semra Demirli Atici, Goran Augustin, Efstratia Baili, Lovenish Bains, Miklosh Bala, Edoardo Baldini, Oussama Baraket, Mirko Barone, Alan Biloslavo, null Roberto Bini, Cristina Bombardini, Giuseppe Brisinda, Luis Buonomo, Fausto Catena, Marco Ceresoli, Maria Michela Chiarello, Christos Chouliaras, Fabrizio D'Acapito, Dimitrios Damaskos, Belinda De Simone, Daniele Delogu, Zaza Demetrashvili, Isidoro Di Carlo, Mario D'Oria, Virginia María Durán-Muñoz-Cruzado, Patrice Forget, Laura Fortuna, Pietro Fransvea, Christian Frey, Olga Gapejeva, Pierre Garcon, Jörn-Markus Gass, Ricardo Alessandro Teixeira Gonsaga, Ewen Griffiths, Kursat Gundogan, Mohan Gurjar, Hytham K.S. Hamid, Juan Ignacio Silesky Jiménez, Karri Kase, Syed Sajid Hussain Kazmi, Aristotelis Kechagias, Vladimir Khokha, Yoshiro Kobe, Dimitrios P. Korkolis, Andrey Litvin, Eftychios Lostoridis, Hans Alexander Mahendran, Fabio Marino, Andres Martinuzzi, Cristian Mesina, Vincenzo Neri, Marina Panisic, Ciro Paolillo, Nikolaos Pararas, Gennaro Perrone, Antonio Pesce, Biagio Picardi, Charlotte Pither, Mauro Podda, Tomas Poskus, Florian Poullenot, Matras Przemyslaw, Massimo Sartelli, Diego Sasia, Maximilian Scheiterle, Fotios Seretis, Kjetil Søreide, Ruslan Sydorchuk, Kinga Szczepanek, Zsolt Bodnar, Fabienne Tamion, Antonio Tarasconi, Martin Teraa, Matti Tolonen, Tim Vanuytsel, Massimiliano Veroux, Lars Vinter-Jensen, Diego Visconti, Lukas Widmer, Andee Dzulkarnaen Zakaria, Nadezhda Zubareva, null Endorsing International Societies, null ESICM (European Society of Intensive Care Medicine), null WSES (World Society of Emergency Surgery), null WSACS (The Abdominal Compartment Society), null In-principle support, null WFICC (World Federation of Intensive and Critical Care), Endocrinology, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Lucerne Cantonal Hospital [Luzern, Switzerland], University of Tartu, Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Aalborg University [Denmark] (AAU), Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology (MCMCC), Alma Mater Studiorum Università di Bologna [Bologna] (UNIBO), Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Universiteit van Amsterdam (UvA), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), None, Hess, B, Cahenzli, M, Forbes, A, Burgos, R, Coccolini, F, Corcos, O, Holst, M, Irtun, Ø, Klek, S, Pironi, L, Rasmussen, H, Serlie, M, Thibault, R, Gabe, S, Reintam Blaser, A, Akin, E, Ali, S, Argenio, G, Atici, S, Augustin, G, Baili, E, Bains, L, Bala, M, Baldini, E, Baraket, O, Barone, M, Biloslavo, A, Roberto, B, Bombardini, C, Brisinda, G, Buonomo, L, Catena, F, Ceresoli, M, Chiarello, M, Chouliaras, C, D'Acapito, F, Damaskos, D, De Simone, B, Delogu, D, Demetrashvili, Z, Di Carlo, I, D'Oria, M, Durán-Muñoz-Cruzado, V, Forget, P, Fortuna, L, Fransvea, P, Frey, C, Gapejeva, O, Garcon, P, Gass, J, Teixeira Gonsaga, R, Griffiths, E, Gundogan, K, Gurjar, M, Hamid, H, Silesky Jiménez, J, Kase, K, Hussain Kazmi, S, Kechagias, A, Khokha, V, Kobe, Y, Korkolis, D, Litvin, A, Lostoridis, E, Mahendran, H, Marino, F, Martinuzzi, A, Mesina, C, Neri, V, Panisic, M, Paolillo, C, Pararas, N, Perrone, G, Pesce, A, Picardi, B, Pither, C, Podda, M, Poskus, T, Poullenot, F, Przemyslaw, M, Sartelli, M, Sasia, D, Scheiterle, M, Seretis, F, Søreide, K, Sydorchuk, R, Szczepanek, K, Bodnar, Z, Tamion, F, Tarasconi, A, Teraa, M, Tolonen, M, Vanuytsel, T, Veroux, M, Vinter-Jensen, L, Visconti, D, Widmer, L, Zakaria, A, Zubareva, N, Endorsing International, S, Institut Català de la Salut, [Hess B, Cahenzli M] Department of Intensive Care Medicine, Lucerne Cantonal Hospital, Lucerne, Switzerland. [Forbes A] Department of Anaesthesiology and Intensive Care, University of Tartu, Tartu, Estonia. [Burgos R] Unitat de Suport Nutricional, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Coccolini F] General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy. [Corcos O] Intestinal Vascular Emergencies Structure (SURVI), Beaujon Hospital/Assistance Publique, Hopitaux de Paris, France, and Vall d'Hebron Barcelona Hospital Campus

Subjects
Investigative Techniques::Epidemiologic Methods::Data Collection::Surveys and Questionnaires [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Occlusive intestinal ischaemia, Nutrition and Dietetics, Acute mesenteric ischaemia, [SDV]Life Sciences [q-bio], Endocrinology, Diabetes and Metabolism, NOMI (Non-occlusive mesentericandnbsp, enfermedades del sistema digestivo::enfermedades gastrointestinales::enfermedades intestinales::isquemia mesentérica [ENFERMEDADES], Otros calificadores::/diagnóstico [Otros calificadores], Isquèmia intestinal - Tractament, 610 Medicine & health, técnicas de investigación::métodos epidemiológicos::recopilación de datos::encuestas y cuestionarios [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Acute mesenteric infarction, Intestinal failure, Enquestes, Treatment, Isquèmia intestinal - Diagnòstic, Other subheadings::/diagnosis [Other subheadings], NOMI (Non-occlusive mesenteric ischaemia), Survey, Digestive System Diseases::Gastrointestinal Diseases::Intestinal Diseases::Mesenteric Ischemia [DISEASES], ischaemia)
Abstract

Background: Acute mesenteric ischaemia (AMI) is a condition with high mortality. This survey assesses current attitudes and practices to manage AMI worldwide.Methods: A questionnaire survey about the practices of diagnosing and managing AMI, endorsed by several specialist societies, was sent to different medical specialists and hospitals worldwide. Data from individual health care professionals and from medical teams were collected.Results: We collected 493 individual forms from 71 countries and 94 team forms from 34 countries. Almost half of respondents were surgeons, and most of the responding teams (70%) were led by surgeons. Most of the respondents indicated that diagnosis of AMI is often delayed but rarely missed. Emergency revascularisation is often considered for patients with AMI but rarely in cases of transmural ischaemia (intestinal infarction). Responses from team hospitals with a dedicated special unit (14 team forms) indicated more aggressive revascularisation. Abdominopelvic CT-scan with intravenous contrast was suggested as the most useful diagnostic test, indicated by approximately 90% of respondents. Medical history and risk factors were thought to be more important in diagnosis of AMI without transmural ischaemia, whereas for intestinal infarction, plasma lactate concentrations and surgical exploration were considered more useful. In elderly patients, a palliative approach is often chosen over extensive bowel resection. There was a large variability in anticoagulant treatment, as well as in timing of surgery to restore bowel continuity.Conclusions: Delayed diagnosis of AMI is common despite wide availability of an adequate imaging modality, i.e. CT-scan. Large variability in treatment approaches exists, indicating the need for updated guidelines. Increased awareness and knowledge of AMI may improve current practice until more robust evidence becomes available. Adherence to the existing guidelines may help in improving differences in treatment and outcomes. Background: Acute mesenteric ischaemia (AMI) is a condition with high mortality. This survey assesses current attitudes and practices to manage AMI worldwide.Methods: A questionnaire survey about the practices of diagnosing and managing AMI, endorsed by several specialist societies, was sent to different medical specialists and hospitals worldwide. Data from individual health care professionals and from medical teams were collected.Results: We collected 493 individual forms from 71 countries and 94 team forms from 34 countries. Almost half of respondents were surgeons, and most of the responding teams (70%) were led by surgeons. Most of the respondents indicated that diagnosis of AMI is often delayed but rarely missed. Emergency revascularisation is often considered for patients with AMI but rarely in cases of transmural ischaemia (intestinal infarction). Responses from team hospitals with a dedicated special unit (14 team forms) indicated more aggressive revascularisation. Abdominopelvic CT-scan with intravenous contrast was suggested as the most useful diagnostic test, indicated by approximately 90% of respondents. Medical history and risk factors were thought to be more important in diagnosis of AMI without transmural ischaemia, whereas for intestinal infarction, plasma lactate concentrations and surgical exploration were considered more useful. In elderly patients, a palliative approach is often chosen over extensive bowel resection. There was a large variability in anticoagulant treatment, as well as in timing of surgery to restore bowel continuity.Conclusions: Delayed diagnosis of AMI is common despite wide availability of an adequate imaging modality, i.e. CT-scan. Large variability in treatment approaches exists, indicating the need for updated guidelines. Increased awareness and knowledge of AMI may improve current practice until more robust evidence becomes available. Adherence to the existing guidelines may help in improving differences in treatment and outcomes.

Published
2023

50. Definition and diagnostic criteria for sarcopenic obesity: ESPEN and EASO consensus statement

Author

Lorenzo M. Donini, Luca Busetto, Stephan C. Bischoff, Tommy Cederholm, Maria D. Ballesteros-Pomar, John A. Batsis, Juergen M. Bauer, Yves Boirie, Alfonso J. Cruz-Jentoft, Dror Dicker, Stefano Frara, Gema Frühbeck, Laurence Genton, Yftach Gepner, Andrea Giustina, Maria Cristina Gonzalez, Ho-Seong Han, Steven B. Heymsfield, Takashi Higashiguchi, Alessandro Laviano, Andrea Lenzi, Ibolya Nyulasi, Edda Parrinello, Eleonora Poggiogalle, Carla M. Prado, Javier Salvador, Yves Rolland, Ferruccio Santini, Mireille J. Serlie, Hanping Shi, Cornel C. Sieber, Mario Siervo, Roberto Vettor, Dennis T. Villareal, Dorothee Volkert, Jianchun Yu, Mauro Zamboni, Rocco Barazzoni, Unité de Nutrition Humaine (UNH), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Clermont Auvergne (UCA), Endocrinology, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Donini, L. M., Busetto, L., Bischoff, S. C., Cederholm, T., Ballesteros-Pomar, M. D., Batsis, J. A., Bauer, J. M., Boirie, Y., Cruz-Jentoft, A. J., Dicker, D., Frara, S., Fruhbeck, G., Genton, L., Gepner, Y., Giustina, A., Gonzalez, M. C., Han, H. -S., Heymsfield, S. B., Higashiguchi, T., Laviano, A., Lenzi, A., Nyulasi, I., Parrinello, E., Poggiogalle, E., Prado, C. M., Salvador, J., Rolland, Y., Santini, F., Serlie, M. J., Shi, H., Sieber, C. C., Siervo, M., Vettor, R., Villareal, D. T., Volkert, D., Yu, J., Zamboni, M., and Barazzoni, R.

Subjects
Sarcopenia, Health (social science), Nutrition and Dietetics, Sarcopenic obesity, Skeletal, [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, Critical Care and Intensive Care Medicine, Body Mass Index, Obesity, Adiposity, Body Composition, Humans, Muscle, Skeletal, Prospective Studies, obesity, sarcopenia, sarcopenic obesity, Physiology (medical), Muscle, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition
Abstract

Introduction: Loss of skeletal muscle mass and function (sarcopenia) is common in individuals with obesity due to metabolic changes associated with a sedentary lifestyle, adipose tissue derangements, comorbidities (acute and chronic diseases) and during the ageing process. Co-existence of excess adiposity and low muscle mass/function is referred to as sarcopenic obesity (SO), a condition increasingly recognized for its clinical and functional features that negatively influence important patient-centred outcomes. Effective prevention and treatment strategies for SO are urgently needed, but efforts are hampered by the lack of a universally established SO definition and diagnostic criteria. Resulting inconsistencies in the literature also negatively affect the ability to define prevalence as well as clinical relevance of SO for negative health outcomes. Aims and Methods: The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) launched an initiative to reach expert consensus on a definition and diagnostic criteria for SO. The jointly appointed international expert panel proposes that SO is defined as the co-existence of excess adiposity and low muscle mass/function. The diagnosis of SO should be considered in at-risk individuals who screen positive for a co-occurring elevated body mass index or waist circumference, and markers of low skeletal muscle mass and function (risk factors, clinical symptoms, or validated questionnaires). Diagnostic procedures should initially include assessment of skeletal muscle function, followed by assessment of body composition where presence of excess adiposity and low skeletal muscle mass or related body compartments confirm the diagnosis of SO. Individuals with SO should be further stratified into stage I in the absence of clinical complications or stage II if cases are associated with complications linked to altered body composition or skeletal muscle dysfunction. Conclusions: ESPEN and EASO, as well as the expert international panel, advocate that the proposed SO definition and diagnostic criteria be implemented into routine clinical practice. The panel also encourages prospective studies in addition to secondary analysis of existing data sets, to study the predictive value, treatment efficacy and clinical impact of this SO definition.

Published
2022

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