Gluten-Free Diet in Co-Existent Celiac Disease and Type 1 Diabetes Mellitus: Is It Detrimental or Beneficial to Glycemic Control, Vascular Complications, and Quality of Life?

Celiac disease (CeD) is associated with type 1 diabetes mellitus (T1DM), and both have the same genetic background. Most patients with T1DM who develop CeD are either asymptomatic or have mild CeD-related gastrointestinal symptoms. Therefore, children affected by T1DM should undergo screening for asymptomatic CeD.

Effects of intravenous thyrotropin-releasing hormone on F-fluorodeoxyglucose uptake in human brown adipose tissue: a randomized controlled trial.

Objective: Brown adipose tissue (BAT) activity in humans is stimulated by cold and by a limited number of pharmacological agents, including β3-adrenergic agonists and bile acids. Although thyrotropin-releasing hormone (TRH) is known to activate BAT in several mammals, this has not been reported in humans.

Design: A randomized, placebo-controlled, double-blind, cross-over trial.

Hormonal control of metabolism by the hypothalamus-autonomic nervous system-liver axis.

The hypothalamus has long been appreciated to be fundamental in the control and coordination of homeostatic activity. Historically, this has been viewed in terms of the extensive neuroendocrine control system resulting from processing of hypothalamic signals relayed to the pituitary. Through these actions, endocrine signals are integrated throughout the body, modulating a vast array of physiological processes.

Energy Homeostasis and Body Weight before and after Cessation of Block and Replacement Therapy in Euthyroid Patients with Graves' Disease.

Patients with Graves' hyperthyroidism (GH) treated with a combination of thyrostatic drugs and T(4), that is, block and replacement therapy (BRT), often report body weight (BW) gain. We aimed to determine changes in BW and energy metabolism upon cessation of BRT in these patients, and to identify possible endocrine determinants. We analysed 22 patients with GH (i) during BRT, and (ii) 12 weeks after BRT cessation.

Re-operations for aortic allograft root failure: experience from a 21-year single-center prospective follow-up study.

Objective: The study aims to report results of re-operations after aortic allograft root implantation.

Methods: All consecutive patients in our prospective allograft database, who underwent aortic allograft root implantation, were selected for analysis, and additional information for patients who subsequently underwent re-operation was obtained from hospital records.

Results: From 1989 to 2009, 262 aortic allograft root implantations were performed.

Aortic root reoperations after pulmonary autograft implantation.

Objective: To report the results of aortic root reoperations after pulmonary autograft implantation.

Methods: All consecutive patients in our prospective Ross research database were selected for analysis, and additional information for patients requiring reoperation was obtained from the hospital records.

Results: From 1988 to 2009, 155 pulmonary autograft operations were performed.

Hypothalamic control of energy metabolism via the autonomic nervous system.

The hypothalamic control of hepatic glucose production is an evident aspect of energy homeostasis. In addition to the control of glucose metabolism by the circadian timing system, the hypothalamus also serves as a key relay center for (humoral) feedback information from the periphery, with the important role for hypothalamic leptin receptors as a striking example. The hypothalamic biological clock uses its projections to the preautonomic hypothalamic neurons to control the daily rhythms in plasma glucose concentration, glucose uptake, and insulin sensitivity.

An online solid-phase extraction-liquid chromatography-tandem mass spectrometry method to study the presence of thyronamines in plasma and tissue and their putative conversion from 13C6-thyroxine.

Thyronamines are exciting new players at the crossroads of thyroidology and metabolism. Here, we report the development of a method to measure 3-iodothyronamine (T(1)AM) and thyronamine (T(0)AM) in plasma and tissue samples. The detection limit of the method was 0.

Novel neural pathways for metabolic effects of thyroid hormone.

The relation between thyrotoxicosis, the clinical syndrome resulting from exposure to excessive thyroid hormone concentrations, and the sympathetic nervous system remains enigmatic. Nevertheless, beta-adrenergic blockers are widely used to manage severe thyrotoxicosis. Recent experiments show that the effects of thyrotoxicosis on hepatic glucose production and insulin sensitivity can be modulated by selective hepatic sympathetic and parasympathetic denervation.

Surgical treatment of active native aortic valve endocarditis with allografts and mechanical prostheses.

Background: Surgical intervention for persistent active native aortic valve endocarditis (NVE) remains challenging. We analyzed our combined experience with allografts and mechanical prostheses (MP) in NVE operations.

Methods: Between 1980 and 2002, 138 patients (81% males) underwent aortic valve replacement for NVE in 2 centers (106 allografts; 32 MPs).

Thyroid hormone effects on whole-body energy homeostasis and tissue-specific fatty acid uptake in vivo.

The effects of thyroid hormone (TH) status on energy metabolism and tissue-specific substrate supply in vivo are incompletely understood. To study the effects of TH status on energy metabolism and tissue-specific fatty acid (FA) fluxes, we used metabolic cages as well as (14)C-labeled FA and (3)H-labeled triglyceride (TG) infusion in rats treated with methimazole and either 0 (hypothyroidism), 1.5 (euthyroidism), or 16.

Impact of the definition of renal dysfunction on EuroSCORE performance.

Aim: Renal dysfunction is an important variable in the EuroSCORE (European System for Cardiac Operative Risk Evaluation) model and is currently defined as creatinine >200 mmol/L. The aim of this study was to examine whether using other definitions of renal dysfunction could improve the predictive ability of the EuroSCORE.

Methods: Between January 2004 and January 2006, 1 205 patients underwent cardiac surgery.

Thyroid hormone modulates glucose production via a sympathetic pathway from the hypothalamic paraventricular nucleus to the liver.

Thyrotoxicosis increases endogenous glucose production (EGP) and induces hepatic insulin resistance. We have recently shown that these alterations can be modulated by selective hepatic sympathetic and parasympathetic denervation, pointing to neurally mediated effects of thyroid hormone on glucose metabolism. Here, we investigated the effects of central triiodothyronine (T(3)) administration on EGP.

Central effects of thyronamines on glucose metabolism in rats.

Thyronamines are naturally occurring, chemical relatives of thyroid hormone. Systemic administration of synthetic 3-iodothyronamine (T(1)AM) and - to a lesser extent - thyronamine (T(0)AM), leads to acute bradycardia, hypothermia, decreased metabolic rate, and hyperglycemia. This profile led us to hypothesize that the central nervous system is among the principal targets of thyronamines.

The Ross procedure: a systematic review and meta-analysis.

Background: Reports on outcome after the Ross procedure are limited by small study size and show variable durability results. A systematic review of evidence on outcome after the Ross procedure may improve insight into outcome and potential determinants.

Methods And Results: A systematic review of reports published from January 2000 to January 2008 on outcome after the Ross procedure was undertaken.

Plasma insulin concentrations during a hyperinsulinaemic clamp: what do we measure?

Background: The aim of this study is to compare the performance of three commonly used insulin assays with respect to the detection of exogenous human and porcine insulin added to human or rat plasma.

Methods: The DPC Immulite human insulin assay, the Mercodia rat insulin enzyme-linked immunosorbent assay and the Linco rat insulin radioimmunoassay were tested.

Results: The mean cross-reactivity of exogenous insulin ranged from 25% to 92%.

Autograft or allograft aortic valve replacement in young adult patients with congenital aortic valve disease.

Aims: We analysed the outcome of young adults with congenital aortic valve disease who underwent allograft or autograft aortic valve or root replacement in our institution and evaluated whether there is a preference for either valve substitute.

Methods And Results: Between 1987 and 2007, 169 consecutive patients with congenital aortic valve disease aged 16-55, participating in our ongoing prospective follow-up study, underwent 63 autograft and 106 allograft aortic valve replacements (AVRs). Mean age was 35 years (SD 10.

Effects of thyrotoxicosis and selective hepatic autonomic denervation on hepatic glucose metabolism in rats.

Thyrotoxicosis is known to induce a broad range of changes in carbohydrate metabolism. Recent studies have identified the sympathetic and parasympathetic nervous system as major regulators of hepatic glucose metabolism. The present study aimed to investigate the pathogenesis of altered endogenous glucose production (EGP) in rats with mild thyrotoxicosis.

Outcome of pregnancy in women after pulmonary autograft valve replacement for congenital aortic valve disease.

Background And Aim Of The Study: The pulmonary autograft has been recommended as the valve of choice for aortic valve replacement (AVR) in young women contemplating pregnancy. However, current information on maternal and perinatal outcome of pregnancy in women with pulmonary autograft valve replacement is limited.

Methods: Using a nationwide Dutch registry (CONCOR) and a local Belgian tertiary care center database, 17 women (age range: 18 to 45 years) with pulmonary autograft valve replacement were enrolled into the study.

Allografts for aortic valve or root replacement: insights from an 18-year single-center prospective follow-up study.

Objective: Whether allografts are the biological valve of choice for AVR in non-elderly patients remains a topic of debate. In this light we analyzed our ongoing prospective allograft AVR cohort and compared allograft durability with other biological aortic valve substitutes.

Methods: Between April 1987 and October 2005, 336 patients underwent 346 allograft AVRs (95 subcoronary, 251 root replacement).

The Ross operation: a Trojan horse?

Aims: The Ross operation is the operation of choice for children who require aortic valve replacement (AVR) and may also provide a good option in selected adult patients. Although the autograft does not require anticoagulation and has a superior haemodynamic profile, concern regarding autograft and allograft longevity has risen. In this light, we report the 13-year results of our prospective autograft cohort study.