[Is morphine indicated in patients with cardiac asthma? Indications for negative effects from the use of morphine].

According to current Dutch and European guidelines, morphine has a place in the treatment of patients with cardiac asthma. There are no studies showing an improvement in objective parameters with the use of morphine in patients with cardiac asthma. Recent large retrospective cohort studies indicate an increased mortality risk among patients given morphine in the treatment of cardiac asthma, even after correction for confounders.

Results of sling surgery in a non-selected population.

Objective: To evaluate sling surgery in terms of effectiveness and quality of life, and describe the effects of confounding variables on outcomes.

Methods: A retrospective cohort study using multiple validated questionnaires was conducted in a specialized pelvic floor center in the Netherlands. Women were enrolled after undergoing sling surgery between January 1, 2010, and January 31, 2012.

The entirely subcutaneous implantable cardioverter-defibrillator: initial clinical experience in a large Dutch cohort.

Objectives: The purpose of the study was to evaluate the efficacy and safety of the entirely subcutaneous implantable cardioverter-defibrillator (S-ICD).

Background: A new entirely S-ICD has been introduced, that does not require lead placement in or on the heart. The authors report the largest multicenter experience to date with the S-ICD with a minimum of 1-year follow-up in the first 118 Dutch patients who were implanted with this device.

Daytime triglyceride variability in men and women with different levels of triglyceridemia.

Background: Triglyceride (TG) levels measured in either the fasting or non-fasting state predict the risk of cardiovascular disease (CVD). Since CVD risk assessment is affected by variability in TG, the aim of the study was to investigate intra-individual variability of non-fasting TG.

Methods: Capillary triglyceride (cTG) levels were measured in 246 free-living individuals at six time-points during the day on three separate occasions.

Mannose binding lectin deficiency and triglyceride-rich lipoprotein metabolism in normolipidemic subjects.

Mannose binding lectin (MBL) is one of the three initiators of complement activation and is therefore closely linked to inflammation. MBL deficiency has been associated with the generation of atherosclerosis. Since atherosclerosis, the complement system and postprandial lipemia are linked to inflammation, we studied postprandial lipoprotein metabolism in MBL deficiency.

Comparison of different methods to investigate postprandial lipaemia.

Postprandial hyperlipidaemia has been associated with coronary artery disease (CAD). We investigated which of the generally used methods to test postprandial lipaemia differentiated best between patients with premature CAD (50+/-4 years, n=20) and healthy controls. Furthermore, the effects of rosuvastatin 40 mg/day on postprandial parameters were assessed.

Leukocyte activation by triglyceride-rich lipoproteins.

Objective: Postprandial lipemia has been linked to atherosclerosis and inflammation. Because leukocyte activation is obligatory for atherogenesis, leukocyte activation by triglyceride-rich lipoproteins (TRLs) was investigated.

Methods And Results: The expression of CD11b and CD66b after incubation with glucose and native and artificial TRLs (NTRL and ATRL) in vivo and in vitro was evaluated by flowcytometry.

Effects of a stanol-enriched diet on plasma cholesterol and triglycerides in patients treated with statins.

Background: Plant stanols have been recommended in combination with individualized dietary interventions to reduce plasma cholesterol concentrations. It is unclear whether plant stanols in combination with dietary guidance in patients already using optimal doses of statins will further reduce fasting and postprandial lipids compared with standard care.

Study Design: This single-blind, randomized study investigated the effect of plant stanols in margarines, combined with a lipid-lowering dietary intervention, in patients already on lipid-lowering medications at maximal doses not reaching their target lipid levels.

The metabolic syndrome in relation to complement component 3 and postprandial lipemia in patients from an outpatient lipid clinic and healthy volunteers.

We investigated the relationship between complement component 3 (C3), fasting and postprandial lipemia and the metabolic syndrome (MetabS). Herefore fasting and postprandial samples after an acute oral fat load were obtained in 40 MetabS+ (50+/-8 years) and 70 MetabS- (48+/-7 years) subjects. Fasting C3 was higher in MetabS+ (1.

Effects of rosuvastatin on postprandial leukocytes in mildly hyperlipidemic patients with premature coronary sclerosis.

We investigated whether pro-inflammatory aspects of the postprandial phase can be modulated by rosuvastatin in premature coronary artery disease (CAD) patients. Herefore standardized 8 h oral fat loading tests were performed off-treatment and after rosuvastatin 40 mg/d in 20 male CAD patients (50 +/- 4 years). The expression of leukocyte activation markers CD11a, CD11b, CD62L and CD66b was studied using flowcytometry.

Lipaemia, inflammation and atherosclerosis: novel opportunities in the understanding and treatment of atherosclerosis.

Atherosclerosis is the major cause of death in the world. Fasting and postprandial hyperlipidaemia are important risk factors for coronary heart disease (CHD). Recent developments have undoubtedly indicated that inflammation is pathophysiologically closely linked to atherogenesis and its clinical consequences.

Increased expression of activation markers on monocytes and neutrophils in type 2 diabetes.

Background: Activation of leukocytes is obligatory for adherence to the endothelium and atherogenesis. Since leukocyte activation by triglycerides (TG) and glucose has been described in vitro, we hypothesised higher leukocyte activation in patients with type 2 diabetes.

Methods: Using flow cytometry, we studied the expression of the leukocyte activation markers CD11A, CD11B, CD62L and CD66B in 15 patients with type 2 diabetes without clinical evidence of atherosclerosis (55+/-7 years) and in 15 healthy controls (53+/-2 years).

Daylong triglyceridaemia in healthy Mediterranean and northern European subjects.

Background: A Mediterranean eating pattern and diet enriched in monounsaturated fatty acids may result in a favourable daylong lipid profile.

Methods: 19 Spanish males (aged 32 +/- 8 years) and 28 females (34 +/- 8 years) were matched to Dutch subjects on the basis of fasting capillary triglycerides (TGc), gender and age. TGc were self-measured at six fixed time points over three days.

Activation of leukocytes by postprandial lipemia in healthy volunteers.

Activation of leukocytes is obligatory for inflammation and atherogenesis by adhering to the endothelium via specific ligands. Although in vitro studies have shown that triglycerides (TG) can activate leukocytes, it is unknown whether this occurs in vivo. Using flowcytometry, we studied the expression of leukocyte activation markers CD11A, CD11B, CD62L (all involved in endothelium adhesion) and CD66B (a neutrophil degranulation marker) during a 6 h fat challenge (50 g/m2) and a water test in 10 healthy males (52 +/- 3 years).

Addition of glucose to an oral fat load reduces postprandial free fatty acids and prevents the postprandial increase in complement component 3.

Background: Elevated fasting plasma concentrations of complement component 3 (C3) are associated with elevated fasting and postprandial triacylglycerol concentrations, insulin resistance, obesity, and coronary artery disease. C3 is the central component of the complement system and the precursor of acylation-stimulating protein (ASP). Insulin and ASP are principal determinants of free fatty acid (FFA) trapping by adipose tissue.

Normal ranges of non-fasting triglycerides in healthy Dutch males and females.

Background: Increased triglycerides (TG) are associated with atherosclerosis. We determined free-living non-fasting TG concentrations in healthy Dutch subjects.

Methods: Capillary TG (TGc) was self-measured by 109 males and 104 females during 3 days, on six fixed time-points each day; fasting, before and 3 h after lunch, before and 3 h after dinner and at bedtime.

Postprandial leukocyte increase in healthy subjects.

Atherosclerosis is an inflammatory disorder involving leukocytes and lipids. To study the relationship between leukocytes and lipids in vivo, leukocyte changes were determined in 14 healthy males (age, 23 +/- 3 years; body mass index [BMI], 21.9 +/- 1.

Postprandial recruitment of neutrophils may contribute to endothelial dysfunction.

Atherosclerosis is a low-grade inflammatory disease involving leukocytes, lipids, and glucose leading to endothelial dysfunction. Since activation of neutrophils by triglycerides and glucose has been described in vitro, we hypothesized that the postprandial phase is an inflammatory state affecting leukocytes, possibly contributing to endothelial dysfunction. We measured postprandial blood leukocyte counts, cytokines, hydroperoxides (HPOs), and flow-mediated vasodilation (FMD) in eight healthy males (age 23 +/- 2 years) after a FAT (50 g/m2) and GLUCOSE challenge (37.

Insulin resistance and vessel endothelial function.

IRS is a complex disease consisting of a clustering of metabolic disorders, of which hyperglycaemia, hyper-insulinaemia and dyslipidaemia are the most important. Endothelial dysfunction plays an important role in the pathogenesis of atherosclerosis. The effects of hyperinsulinaemia seem to depend on lipidaemia and glycaemia.

Diurnal triglyceride profiles: a novel approach to study triglyceride changes.

Fasting plasma triglycerides (TG) show a high intra-individual variability, and therefore, repeated measurements and alternative methodology are necessary when studying TG metabolism. In search for novel approaches to study TG changes, we evaluated the feasibility of determining ambulatory capillary TG. In addition, well-known characteristics (e.

Diurnal triglyceride profiles in healthy normolipidemic male subjects are associated to insulin sensitivity, body composition and diet.

Background: Elevated fasting and postprandial triglycerides (TG) are established risk factors for Coronary Heart Disease (CHD). Usually, fasting plasma TG are measured, although TG are mainly produced in a postprandial state. Our objective was to investigate diurnal TG profiles using serial capillary TG measurements, in normolipidemic healthy males.