University Hospital Maastricht Research Articles

The impact of microbiological cultures on antibiotic prescribing in general internal medicine wards: microbiological evaluation and antibiotic use

Antibiotics are frequently prescribed because of a clinical suspicion of infection while results of microbiological analysis are still pending. Empirical therapy may be influenced by microbiological culture results, either by discontinuation of therapy in the case of negative cultures, or by broadening or narrowing (streamlining) the spectrum of antibiotics. Several strategies have been suggested to improve antibiotic prescribing, such as surveillance of antibiotic resistance, monitoring and auditing of antibiotics use, the use of consensus guidelines or computer decision support and improving multidisciplinary co-operation [1–3]. Although appropriateness of antibiotic prescribing has been investigated by some [4–6], the impact of microbiological culture results on antibiotic prescribing has not been analysed frequently [7,8]. In two longitudinal studies in internal medicine wards, microbiological analyses were performed in about 70% of all episodes of infection, relevant micro-organisms were isolated in about 50% of episodes and this resulted in modification of antibiotic therapy in about 50% of the cases [7,9]. In another study, Arbo et al. reported that cultures obtained within the first 7 days after admission, and the isolation of Staphylococcus aureus or Gramnegative bacteria were associated with modification of antibiotic therapy [8]. We prospectively investigated the impact of microbiological analyses on antibiotic prescribing in three general internal medicine wards of a Dutch university hospital. Therapeutic antibiotic prescribing in the general internal medicine wards (69 beds) at the Maastricht University Hospital in the Netherlands was prospectively monitored over a 12month period, between June 1996 and June 1997. Patients with HIV-infections and kidney or marrow transplantation were excluded from the study. Demographic characteristics, types, dose and route of administration were monitored daily for all patients receiving antibiotics. The results of microbiological tests (growth of bacteria and susceptibility testing) and its impact on antibiotic prescribing was evaluated. The following definitions were employed. Infection episode and antibiotic episode: an episode of infection was defined as a documented or suspected episode of

Single Domain Human Immunoglobulin Fold-Based Biomolecules

Single domain human immunoglobulin fold-based biomolecules Simon E. Hufton Target Quest B.V., University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands We have developed human immunoglobulin fold containing proteins as alternative binding ligands to antibodies. Firstly, we have evaluated cytotoxic T lymphocyte associated antigen 4 (CTLA-4) as a protein scaffold. CTLA-4 is an important regulator of cellular immunity and is transiently expressed on the surface of T cells. To have a suitable library selection system we have displayed the extracellular domain of CTLA-4 in 1A subsidiary of Dyax Corp. a functional form on the surface of filamentous phage. We have generated both engineered CTLA-4 variants and repertoires of CTLA-4 variants from which binding ligands to somatostatin receptors and αvβ3 integrin have been isolated. We have also investigated the potential of single VL domains as binding ligands From a naive repertoire, single VL domains were isolated which were able to bind to B7-1 and B7-2 which are important costimulatory molecules on antigen presenting cells. We believe that these monomeric immunoglobulins may present certain advantages over classical antibodies for certain applications. Disease Markers 16 (2000) 37 ISSN 0278-0240 / $8.00  2000, IOS Press. All rights reserved

Predictive value of parent-reported symptoms in the assessment of otitis media with effusion during infancy

Objective - To determine the predictive value of parent-reported symptoms in the assessment of otitis media with effusion (OME) during infancy. Design - Prospective longitudinal study that compared the results of questionnaire-based parental reports with the state of the middle ear assessed by otoscopy and tympanometry at 3-month intervals from birth to the age of 2 years. Setting - Outpatient Department, University Hospital Maastricht, The Netherlands. Subjects - One hundred and fifty healthy-born infants. Main outcome measures - Sensitivity, specificity, positive and negative predictive values of parent-reported ear infection, hearing loss, mouth breathing, snoring and common cold. Results - Prevalence rates showed the following ranges: OME, 39%-53%, parent-reported ear infection, 2%-20%, hearing loss 2%-7%, mouth breathing, 30%-41%, snoring, 31%-41% and common cold, 65%-81%. Common cold demonstrated the highest sensitivity (83%) with a low specificity of 36%. Hearing loss gave the highest positive predictive value (PPV) (70%) with a moderate negative predictive value (NPV) (54%). PPV increased with the number of anamnese questions answered positively. Conclusions - The diagnostic value of parent-reported ear infection, hearing loss and common cold was found to be limited. Combinations of positively-reported symptoms gives increased diagnostic validity while the absence of parent-reported symptoms does not necessarily indicate the absence of OME.

Repetitive asphyxia does not enhance leukocyte-vessel wall interactions in the immature fetal intestine

Department of Surgery1, University Hospital Maastricht, Departments of Physiology and Biophysics, Maastricht University, the Netherlands, Departments of Surgery and Pediatrics, University of Auckland, New Zealand

Outcome of peroneal neuropathies in patients with systemic malignant disease

Rubin et al. recently published an article in Cancer on the relation between peroneal neuropathy and systemic malignant disease.1 We would like to present some comments and additional data, based on our own experience,2 that were not referred to in their article. Our point of departure was a retrospective review of patients presenting with peroneal neuropathy. Peroneal neuropathy was diagnosed in 372 persons within a 5-year period (1988–1992) at 2 general neurology clinics. Seventy-four of these patients also had cancer. In 56 cases, the cancer was believed to be associated with the peroneal neuropathy, as based on temporal relation and progression of the tumor. As both clinics are situated in a relatively isolated area of The Netherlands (between Belgium and Germany), where there is hardly any outflow to other clinics, epidemiologic data could be used to obtain relative risks. The catchment population of the clinics consisted of 433,142 people, and 8766 new cancer patients were diagnosed. The relative risk, corrected for age and gender, for peroneal neuropathy in cancer patients compared with patients without cancer was 3.4. The relative risk of cancer for patients with peroneal neuropathy compared with people without peroneal neuropathy was 2.8. Cancer was found particularly more often in elderly men who had peroneal neuropathy. Rubin et al. found 58 patients (0.05%) with peroneal neuropathy among 115,081 patients with systemic malignant disease. We found 56 (0.64%) among 8766 cancer patients. Part of this difference may be explained by the selection criteria Rubin et al. applied. Lung carcinoma was the most frequently occurring tumor in our group (22/56), followed by digestive tract (10/56), urogenital tract (9/56), and hematologic (8/56) tumors. Another noteworthy difference concerns the median time to diagnosis of peroneal neuropathy following the diagnosis of malignant disease, which was 5 months in the study of Rubin et al., whereas most patients were found to have been diagnosed within 1 month in our study. We excluded patients in whom peroneal neuropathy was diagnosed more than 6 months after the diagnosis of systemic malignant disease, if stable and nonprogressive. Weight loss was found in 35 of 58 patients in the study of Rubin et al. and in 35 of 56 patients in ours. We assume that factors other than weight loss (metabolic factors, for instance) may play a role in the development of peroneal neuropathy in cancer patients. It is unlikely that chemotherapeutic agents were causative factors in our patients, as only four patients received potentially neurotoxic drugs. A temporal relation with the occurrence of the peroneal neuropathy in these four patients made a correlation unlikely. We did not look at outcome figures for our patients. Rubin et al. reported relatively good outcomes. In conclusion, the findings of both studies confirm the relation between systemic malignant disease and the occurrence of peroneal neuropathy. In patients with peroneal neuropathy, cancer should be added to the list of associated conditions, particularly in elderly men. On the other hand, measures to prevent the occurrence of peroneal neuropathy during surgery and in bedridden cancer patients should be taken, particularly if weight loss has occurred. Pete J. Koehler M.D., Ph.D.*, Albert Twijnstra M.D., Ph.D. , * Department of Neurology, Atrium Medical Center, Heerlen, The Netherlands, Department of Neurology, University Hospital Maastricht, Maastricht, The Netherlands

Atrophie blanche.

International Journal of DermatologyVolume 38, Issue 3 p. 161-172 Atrophie blanche M. Birgitte Maessen-Visch MD, M. Birgitte Maessen-Visch MD From the Departments of Dermatology and Hematology, University Hospital Maastricht, and Department of Dermatology, Zwolle, The NetherlandsSearch for more papers by this authorM. Iuo Koedam MD, M. Iuo Koedam MD From the Departments of Dermatology and Hematology, University Hospital Maastricht, and Department of Dermatology, Zwolle, The NetherlandsSearch for more papers by this authorKarly Hamulyák MD, Karly Hamulyák MD From the Departments of Dermatology and Hematology, University Hospital Maastricht, and Department of Dermatology, Zwolle, The NetherlandsSearch for more papers by this authorH. A. Martino Neumann MD, PhD, H. A. Martino Neumann MD, PhD From the Departments of Dermatology and Hematology, University Hospital Maastricht, and Department of Dermatology, Zwolle, The NetherlandsSearch for more papers by this author M. Birgitte Maessen-Visch MD, M. Birgitte Maessen-Visch MD From the Departments of Dermatology and Hematology, University Hospital Maastricht, and Department of Dermatology, Zwolle, The NetherlandsSearch for more papers by this authorM. Iuo Koedam MD, M. Iuo Koedam MD From the Departments of Dermatology and Hematology, University Hospital Maastricht, and Department of Dermatology, Zwolle, The NetherlandsSearch for more papers by this authorKarly Hamulyák MD, Karly Hamulyák MD From the Departments of Dermatology and Hematology, University Hospital Maastricht, and Department of Dermatology, Zwolle, The NetherlandsSearch for more papers by this authorH. A. Martino Neumann MD, PhD, H. A. Martino Neumann MD, PhD From the Departments of Dermatology and Hematology, University Hospital Maastricht, and Department of Dermatology, Zwolle, The NetherlandsSearch for more papers by this author First published: 25 December 2001 https://doi.org/10.1046/j.1365-4362.1999.00581.xCitations: 51 M.B. Maessen-Visch, md, University Hospital Maastricht, Department of Dermatology, P. Debeyelaan 25, Postbus 5800, 6202 AZ Maastricht, The Netherlands Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume38, Issue3March 1999Pages 161-172 RelatedInformation

A treatment algorithm for the overactive bladder.

BJU InternationalVolume 83, Issue S2 p. 29-30 A treatment algorithm for the overactive bladder PH.E.V. Van Kerrebroeck, PH.E.V. Van Kerrebroeck Department of Urology, University Hospital Maastricht, The NetherlandsSearch for more papers by this author PH.E.V. Van Kerrebroeck, PH.E.V. Van Kerrebroeck Department of Urology, University Hospital Maastricht, The NetherlandsSearch for more papers by this author First published: 27 May 2002 https://doi.org/10.1046/j.1464-410X.83.s2.6.xCitations: 3AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume83, IssueS2March 1999Pages 29-30 RelatedInformation

Patient satisfaction with clinical trial participation.

To assess satisfaction of patients who participate in clinical trials requiring informed consent and to analyse factors determining patient satisfaction. The survey took place in 26 clinical trials at the University Hospital Maastricht (azM), The Netherlands. A personal interview and telephone questionnaire were used consecutively (n= 135; 135 out of 172=78.5% response rate) to measure patient's expectancies before starting the trial during the informed consent procedure and to evaluate aspects of trial participation. An additional control group of 34 patients was interviewed only by telephone (100% response). Satisfaction was assessed in two distinct ways: first, by measuring the patient's subjective evaluation of several aspects of trial participation; secondly, by comparing prior expectations and subsequent evaluations. Patient satisfaction was subdivided with respect to medical-technical, interpersonal and organizational aspects of trial participation. Changes in patient's health and illness perceptions were regarded as confounding factors in the relationship between satisfaction and its possible causes. Although patient satisfaction was quite high, dissatisfaction with aspects of trial participation became apparent when both prior expectations and subsequent evaluations were compared with each other. Prior expectations and general attitudes towards medical care and research before entering the trial have an impact on satisfaction with aspects of trial participation (10-20% explained variance). No linear relationship was found between perceived improvements in health and illness conditions and patient satisfaction with trial participation.

Changes in Microcirculation in Patients with Atrophie Blanche Visualized by Laser Doppler Perfusion Imaging and Transcutaneous Oxygen Measurements

Objective: To quantify differences in microcirculation in atrophie blanche (AB) in patients with chronic venous insufficiency (CVI) and in healthy controls before and after venous occlusion. Design: Prospective study in a single patient group. Setting: Department of Dermatology, University Hospital Maastricht, The Netherlands. Patients and methods: Sixteen patients with CVI and large lesions of AB, 10 patients with CVI without AB and 10 healthy controls were enrolled in the study. Laser Doppler perfusion imaging (LDPI) measurements were performed in and outside large lesions of AB and in healthy controls. Transcutaneous oxygen (Tc Po2) measurements were performed in patients with CVI with and without AB and in healthy controls. Results: Median basal resting flow was higher in AB than in healthy controls (0.67 mV versus 0.21 mV, p = 0.002). The venoarteriolar response (VAR was increased significantly in AB (58% versus 43%, p = 0.04). A significant decrease in Tc Po2 values occurred in AB lesions with 40 mmHg, in CVI skin with 60 mmHg and in healthy controls with 80 mmHg. Conclusion: Basic resting flux in AB measured with LDPI is increased compared with clinically normal skin. The decrease in flux on venous occlusion is larger in AB than in healthy controls.

O.12 Isokinetic upper leg muscle strength as a functionalparameter of nutritional status in patients with inflammatory bowel disease

O.12 Isokinetic upper leg muscle strength as a functional parameter of nutritional status in patients with inflammatory bowel disease B. J. Geerling, R. W. StockbrElgger and R.-J. M. Brummer Dept of Gastroenterology, University Hospital Maastricht, Maastricht, The Netherlands. Introduction: Malnutrition is observed in patients with Inflammatory Bowel Disease (IBD). Functional parameters are often omitted in the assessment of nutritional status. The aim of this study was to assess the muscle strength as a functional parameter of nutritional status in IBD patients comprising Crohn's disease (CD) and ulcerative colitis (UC). Methods: In 37 IBD patients at time of diagnosis (IBD-new: 11CD, 26UC) age and sex matched with healthy controls and in 32 patients with longstanding CD in remission (CD-Iong) age and sex matched with healthy controls, muscle strength of the quadriceps and hamstrings was measured using an isokinetic dynamometer (Cybex II) with angular velocities of 60 and 180.s -~. Peak torques (PT's) and work capacities (WC) of muscle strength were determined. Fat-free mass (FFM) was assessed using Dual-energy X-ray absorptiometry. Paired t-tests were used for statistical analysis. Results: Hamstrings PT's (60, 180.s -1) were significantly reduced (P < 0.05) in CD-Iong (71.6 Nm __ 22.2 and 45.6 Nm _+ 15.2, respectively) compared with controls (87.6 Nm _+ 33.4 and 59.3 Nm + 31.9, respectively). WC of the hamstrings (180.s -1) was significantly decreased (P< 0.05) in CD-Iong (210.0J _+ 119.1) compared with controls (298.4J _+ 212.4). However, the PT's and WC of the quadriceps in CD-Iong were preserved compared to controls. The correlation between hamstrings PT's and FFM was significant (P < 0.001) in both IBD-new and the control-groups, but not in CD-Iong. Conclusion: Muscle strength of the hamstrings in patients with longstanding CD was significantly reduced while the strength of the quadriceps was preserved. Muscle strength was not decreased in IBD patients at time of diagnosis. The pathophysiology of the reduced muscle strength of the hamstrings needs to be elucidated.

Neurogenic Impotence and Lower Urinary Tract Symptoms Due to Vitamin B1 Deficiency in Chronic Alcoholism

No AccessJournal of UrologyClinical Urology: Case Report1 Mar 1997Neurogenic Impotence and Lower Urinary Tract Symptoms Due to Vitamin B1 Deficiency in Chronic Alcoholism Bernard S. Tjandra and Rudi A. Janknegt Bernard S. TjandraBernard S. Tjandra More articles by this author and Rudi A. JanknegtRudi A. Janknegt More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)65098-5AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Neurogenic Impotence and Lower Urinary Tract Symptoms Due to Vitamin B1 Deficiency in Chronic Alcoholism." The Journal of Urology, 157(3), pp. 954–955 References 1 : Studies on metabolism of pyruvic acid in normal and vitamin B1-deficient states; accumulation of pyruvic acid and other carbonyl compounds in beri-beri and effect of vitamin B1. Biochem. J.1939; 33: 1525. Google Scholar 2 : Vasculogenic impotence evaluated by high-resolution ultrasonography and pulsed Doppler spectrum analysis. Radiology1985; 155: 777. Google Scholar 3 : Sacral signal tracing: the electrophysiology of the bulbocavernosus reflex. J. Urol.1978; 122: 661. Google Scholar 4 : Evoked responses from the pudendal nerve. J. Urol.1982; 128: 974. Link, Google Scholar 5 : Comparison of Hoffmann reflex with quantitative assessment of cutaneous sensation in diabetic neuropathy. Acta Neurol. Scand.1986; 74: 121. Google Scholar 6 Tjandra, B. S., Van de Beek, C. and Janknegt, R. A.: Treatment of impotency with thiamine point-puncture. Proceedings of the 2nd Asian Congress of Urology, Bangkok, Thailand, December 1993. Google Scholar Departments of Urology, University of Indonesia, Djakarta, Indonesia, and University Hospital Maastricht, Maastricht, The Netherlands© 1997 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 157Issue 3March 1997Page: 954-955 Advertisement Copyright & Permissions© 1997 by American Urological Association, Inc.MetricsAuthor Information Bernard S. Tjandra More articles by this author Rudi A. Janknegt More articles by this author Expand All Advertisement PDF downloadLoading ...

Detrusor Activity Index: Quantification of Detrusor Overactivity by Ambulatory Monitoring

Ambulatory urodynamic monitoring has been developed and evaluated during the last decade, and its appreciation is growing rapidly. We investigated the usefulness of this technique to quantify detrusor activity, and developed a parameter to quantify the grade of detrusor overactivity. We investigated 167 female patients with lower urinary tract symptoms and 61 asymptomatic volunteers. Detrusor behavior was classified according to the medical history findings and independently based on urodynamic investigation. The possible categories were termed overactive or not overactive. Subjects who were classified consistently formed the 2 reference groups, which were used in the statistical analysis of logistic regression. By logistic regression a scoring rule was developed. The individual score (detrusor activity index 0 to 1) is a measure of detrusor activity during the filling phase. At a cutoff point of 0.41 the sensitivity equaled specificity of 85% in our patient and volunteer groups. The scoring rule can be applied clinically as a test to detect and quantify detrusor overactivity in patients with urinary incontinence.

Expression of E-selectin, intercellular adhesion molecule (ICAM)-1 and vascular cell adhesion molecule (VCAM)-1 in non-small-cell lung carcinoma: Staal-van den Brekel AJ, Thunnissen FBJM, Buurman WA, Wouters EFM. Department of Pulmonology, University Hospital Maastricht, PO Box 5800, NL-6202 AZ Maastricht Virchows Arch 1996;428:21–27

Expression of E-selectin, intercellular adhesion molecule (ICAM)-1 and vascular cell adhesion molecule (VCAM)-1 in non-small-cell lung carcinoma: Staal-van den Brekel AJ, Thunnissen FBJM, Buurman WA, Wouters EFM. Department of Pulmonology, University Hospital Maastricht, PO Box 5800, NL-6202 AZ Maastricht Virchows Arch 1996;428:21–27

Construction of diabody phage display repertories for the selection of large numbers of bispecific antibody fragments [Abst. 217] : Brian T. McGuinnessa, General Walterb, Kevin Fitzgeralda, Alexander Duncana, Paula Mahoney-Schulerc, Walt Mahoneyc, Hennie Hoogenboomd, aCambridge Antibody Technology Ltd., The Science Park, Melbourn, Cambridge, Mabridgeshire, SG8 6JJ, UK, bMax Planck Institut fur Molekulare Genetik, Ihnestr. 73, D-14195 Berlin-Dahlem, Germany, cBoehringer Mannheim

Construction of diabody phage display repertories for the selection of large numbers of bispecific antibody fragments [Abst. 217] : Brian T. McGuinnessa, General Walterb, Kevin Fitzgeralda, Alexander Duncana, Paula Mahoney-Schulerc, Walt Mahoneyc, Hennie Hoogenboomd, aCambridge Antibody Technology Ltd., The Science Park, Melbourn, Cambridge, Mabridgeshire, SG8 6JJ, UK, bMax Planck Institut fur Molekulare Genetik, Ihnestr. 73, D-14195 Berlin-Dahlem, Germany, cBoehringer Mannheim

Anti EGP-2 phage antibodies as a tool for identifying novel colon tumor antigens. [Abst. 223] : Rob C. Rooversa, Adriaan de Bruinea, Bart-Jan Kroesenb, Wijnand Helfrichb, Loe de Leijb, Jan-Willem Arendsa, Hennie R. Hoogenbooma, aCESAME at the Department of Pathology, University Hospital Maastricht, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands, bDepartment of Clinical Immunology, University Hospital Groningen, Oostersingel 59,

Anti EGP-2 phage antibodies as a tool for identifying novel colon tumor antigens. [Abst. 223] : Rob C. Rooversa, Adriaan de Bruinea, Bart-Jan Kroesenb, Wijnand Helfrichb, Loe de Leijb, Jan-Willem Arendsa, Hennie R. Hoogenbooma, aCESAME at the Department of Pathology, University Hospital Maastricht, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands, bDepartment of Clinical Immunology, University Hospital Groningen, Oostersingel 59,

Future directions in research of endogenous production of N-nitroso compounds

Future directions in research of endogenous production on N-nitroso compounds. Stockbrugger RW. Department of Gastroenterology/Hepatology, University Hospital Maastricht, The Netherlands. Publication Types: Review Review, Tutorial

Severely impaired fetal growth is preceded by maternal hemodynamic maladaptation in very early pregnancy.

To test the hypothesis that in pregnancies complicated by intrauterine growth retardation (IUGR) maternal cardiovascular adaptation is already abnormal in the first weeks of pregnancy. University Hospital Maastricht, Maastricht, The Netherlands. Fourteen healthy pregnant women, recruited from the subfertility clinic. Ten pregnancies were uneventful and four pregnancies resulted in the birth of growth retarded infants. Maternal cardiovascular status was followed longitudinally by combined M-mode and Doppler echocardiography. Studies were performed weekly between the fifth and 10th week, at 14, 25 and 35 weeks and postpartum. Differences between the two groups were analyzed by nonparametric tests. In early pregnancy, the IUGR group differed from the normal group by a consistently smaller left atrial diameter and a cardiac output that failed to increase. Postpartum the subjects in the IUGR group had a significantly smaller left atrial diameter and faster mean circumferential fiber shortening. Maternal hemodynamic adaptation in the first weeks of pregnancy is defective in IUGR pregnancies, presumably associated with a concomitant inadequacy of the vascular filling state.

A 3‐month double‐blind study of doxazosin as treatment for benign prostate bladder outlet obstruction

British Journal of UrologyVolume 75, Issue 6 p. 809-810 A 3-month double-blind study of doxazosin as treatment for benign prostate bladder outlet obstruction A.H.P. Meier, A.H.P. Meier Department of Urology De Wever Hospital PO Box 4446 C401 CX HeerlenSearch for more papers by this authorE.S.C. van Waalwijk van Doom, E.S.C. van Waalwijk van Doom *Department of Urology University Hospital Maastricht Rijksuniversiteit Limburg Po Box 5800 6202 AZ Maastricht The NetherlandsSearch for more papers by this authorK.P.J. Delaere, K.P.J. Delaere Department of Urology De Wever Hospital PO Box 4446 C401 CX HeerlenSearch for more papers by this author A.H.P. Meier, A.H.P. Meier Department of Urology De Wever Hospital PO Box 4446 C401 CX HeerlenSearch for more papers by this authorE.S.C. van Waalwijk van Doom, E.S.C. van Waalwijk van Doom *Department of Urology University Hospital Maastricht Rijksuniversiteit Limburg Po Box 5800 6202 AZ Maastricht The NetherlandsSearch for more papers by this authorK.P.J. Delaere, K.P.J. Delaere Department of Urology De Wever Hospital PO Box 4446 C401 CX HeerlenSearch for more papers by this author First published: June 1995 https://doi.org/10.1111/j.1464-410X.1995.tb07405.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume75, Issue6June 1995Pages 809-810 RelatedInformation

Decrease of mucosal glutamine concentration in the nutritionally depleted patient

A diminished glutamine delivery by peripheral tissues is suggested to play an important role in the etiology of postoperative complications of nutritionally depleted patients. Decreased glutamine supply to the gut mucosa in these nutritionally depleted patients may have important consequences for the integrity of the gut mucosa barrier. To evaluate whether glutamine concentration in the gut mucosa of depleted patients is altered, patients with either a fat-free mass index below 90% or percentage ideal body weight below 90% as a result of weight loss were studied. 22 patients admitted to the University Hospital Maastricht and 14 controls were studied. After an overnight fast, venous blood was sampled and duodenal biopsies were obtained by endoscopy. Plasma and tissue amino acids were measured. Fat-free mass was determined by bioelectrical impedance measurement. In 10 depleted patients glutamine concentration in the duodenal mucosa was 2883 ± 250 μmol/kg dry weight. Concentration of alanine was 2570 ± 263 μmol/kg dry weight. In the non-depleted patients glutamine and alanine concentrations were respectively 3463 ± 171 μmol/kg dry weight and 3540 ± 315 μmol/kg dry weight. Concentrations in controls were 3296 ± 176 μmol/kg dry weight for glutamine and 3682 ± 372 μmol/kg dry weight for alanine. Concentrations for alanine and glutamine were significantly lower in depleted patients compared to non-depleted patients (p < 0.05). Also, alanine and glutamine concentrations were significantly correlated with percentage ideal body weight (r=0.43, p < 0.005 for glutamine and r=0.62, p < 0.001 for alanine) and fat-free mass index (r=0.42, p < 0.05 for glutamine and r=0.48, p < 0.01 for alanine) This study suggests that in patients depletion appears to be related to decreased plasma and mucosa glutamine and alanine concentrations.

Bicarbonate Dialysis: A Review and Future Perspectives

Seminars in DialysisVolume 7, Issue 3 p. 186-191 Bicarbonate Dialysis: A Review and Future Perspectives K M L Leunissen, Corresponding Author K M L Leunissen Department of Nephrology, University Hospital Maastricht, The Netherlands*Department of Nephrology, University Hospital Maastricht, P.O. Box 5800, NL/6202 AZ Maastricht, The Netherlands pp 186–191Search for more papers by this authorJ. P. Kooman, J. P. Kooman Department of Nephrology, University Hospital Maastricht, The NetherlandsSearch for more papers by this authorW.H. M. van Kuijk, W.H. M. van Kuijk Department of Nephrology, University Hospital Maastricht, The NetherlandsSearch for more papers by this authorJ. P. van Hooff, J. P. van Hooff Department of Nephrology, University Hospital Maastricht, The NetherlandsSearch for more papers by this author K M L Leunissen, Corresponding Author K M L Leunissen Department of Nephrology, University Hospital Maastricht, The Netherlands*Department of Nephrology, University Hospital Maastricht, P.O. Box 5800, NL/6202 AZ Maastricht, The Netherlands pp 186–191Search for more papers by this authorJ. P. Kooman, J. P. Kooman Department of Nephrology, University Hospital Maastricht, The NetherlandsSearch for more papers by this authorW.H. M. van Kuijk, W.H. M. van Kuijk Department of Nephrology, University Hospital Maastricht, The NetherlandsSearch for more papers by this authorJ. P. van Hooff, J. P. van Hooff Department of Nephrology, University Hospital Maastricht, The NetherlandsSearch for more papers by this author First published: May 1994 https://doi.org/10.1111/j.1525-139X.1994.tb00835.xCitations: 4AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Citing Literature Volume7, Issue3May 1994Pages 186-191 RelatedInformation