Hospital Teaching Status and Patients' Outcomes After Colon Cancer Surgery.

Background And Objectives: It is increasingly accepted that quality of colon cancer surgery might be secured by combining volume standards with audit implementation. However, debate remains about other structural factors also influencing this quality, such as hospital teaching status. This study evaluates short-term outcomes after colon cancer surgery of patients treated in general, teaching or academic hospitals.

The association between ICU level of care and mortality in the Netherlands.

Purpose: The relationship between the number of patients admitted to an intensive care unit (ICU) volume and mortality is currently the subject of debate. After implementation of a national guideline in 2006, all Dutch ICUs have been classified into three levels based on ICU size, patient volume, ventilation days, and staffing. The goal of this study is to investigate the association between ICU level and mortality of ICU patients in the Netherlands.

Impact of hospital volume on breast cancer outcome: a population-based study in the Netherlands.

For low-volume tumours, high surgical hospital volume is associated with better survival. For high-volume tumours like breast cancer, this association is unclear. The aim of this study is to determine to what extent the yearly surgical hospital breast cancer volume is associated with overall survival.

Intersubject responsiveness of high-affinity growth hormone (GH)-binding protein (GHBP) to long-term GH replacement therapy.

In adult growth hormone deficiency (GHD) syndrome responsiveness to GH replacement therapy is reported to vary considerably. The underlying mechanisms, however, are not well understood. The aim of this study was to investigate which baseline variables determine the reported variable intersubject responsiveness of high-affinity GH-binding protein (GHBP) to GH replacement therapy.

High-affinity growth hormone (GH)-binding protein (GHBP), body fat mass, and insulin-like growth factor-binding protein-3 predict the GHBP response to GH therapy in adult GH deficiency syndrome.

The study objective was to investigate which baseline factors can accurately predict plasma high-affinity growth hormone (GH)-binding protein (GHBP) levels after GH replacement therapy in patients with GH deficiency (GHD). The study group consisted of 36 GHD patients (22 men and 14 women; mean age, 43.1 years; (range, 21 to 60) known to have adult-onset GHD for many years (range, 4 to 22).

Deuterium and bromide dilution, and bioimpedance spectrometry independently show that growth hormone-deficient adults have an enlarged extracellular water compartment related to intracellular water.

GH has a strong influence on body composition. However, the effects of GH deficiency in adults on water compartments are not well understood. Therefore, extracellular water (ECW) and total body water were independently determined by deuterium and bromide dilution and by bioimpedance spectrometry in GH-deficient (GHD) adults and compared to those in controls, matched for age, sex, body weight, and height.

Visceral adipose tissue is associated with circulating high affinity growth hormone-binding protein.

Recent data show that body fat distribution, specifically visceral fat accumulation, is associated with the regulation of GH secretion. To our knowledge no studies have been performed with regard to the relationship between plasma high affinity GH-binding protein (GHBP) levels and fat distribution in humans. To address this question, we measured plasma GHBP and insulin-like growth factor I levels as well as visceral, sc abdominal, and hip adipose tissue (AT) areas by using magnetic resonance imaging scanning in 12 patients with GH deficiency (GHD) and in 12 age- and sex-matched healthy subjects.

High-affinity growth hormone binding protein, insulin-like growth factor I and insulin-like growth factor binding protein 3 in adults with growth hormone deficiency.

The high-affinity growth hormone binding protein (GHBP) circulates in human blood and represents the extracellular domain of the growth hormone (GH) receptor. The effects of GH deficiency on GHBP in adults are not clear. The aim of this study was to evaluate serum GHBP levels in adults with GH deficiency and to assess whether GHBP measurement may contribute to the diagnosis of adult GH deficiency, based on a two-step model.

Magnetic resonance imaging-assessed adipose tissue and serum lipid and insulin concentrations in growth hormone-deficient adults. Effect of growth hormone replacement.

The visceral and subcutaneous abdominal adipose tissue (AT) areas and the subcutaneous hip AT area were assessed by magnetic resonance imaging (MRI) in relation to serum lipid and plasma insulin levels in 12 growth hormone-deficient (GHD) adults before and after 6 months of replacement therapy with recombinant human growth hormone (rhGH) and in 12 healthy control subjects. Compared with control subjects, GHD patients had a significantly increased amount of visceral AT, which was inversely related with plasma HDL cholesterol and positively correlated with plasma triglyceride levels. Visceral AT was not associated with plasma total and LDL cholesterol or plasma insulin concentrations.

Resting metabolic rate, body composition and related hormonal parameters in growth hormone-deficient adults before and after growth hormone replacement therapy.

The resting metabolic rate (RMR), and body composition were assessed in 30 growth hormone-deficient (GHD) adults before and after 3 and 6 months of replacement therapy with recombinant human growth hormone (rhGH). In addition, insulin-like growth factor I (IGF-I), IGF binding proteins (IGFBPs) and plasma insulin were measured at baseline and at 6 months in relation to RMR. During 6 months of rhGH replacement therapy, body fat decreased from 18.

Direct assessment of extracellular water volume by the bromide-dilution method in growth hormone-deficient adults.

Body composition and water content were assessed in 36 growth hormone deficient (GHD) patients (M:23, F:13) and 14 controls (M:7, F:7) using anthropometry, hydrodensitometry, bioelectrical impedance measurement and the bromide-dilution method, with which extracellular water volume can be measured directly. GHD patients, compared to controls, did not differ in extracellular water volume, in hydration state and water distribution. A higher BMI (P = 0.

Energy and macronutrient intake in growth hormone-deficient adults: the effect of growth hormone replacement.

Objective: To assess the energy intake and the macronutrient composition of the diet in 25 growth hormone-deficient (GHD) patients before, and after 3 and 6 months replacement with recombinant human growth hormone (rhGH).

Design: The study had a randomised double-blind placebo-controlled design. Energy intake was assessed by the 4-day food record and 24-h urine total nitrogen excretion was used as a check on the validity.

Adipose tissue assessed by magnetic resonance imaging in growth hormone-deficient adults: the effect of growth hormone replacement and a comparison with control subjects.

The visceral and subcutaneous abdominal adipose tissue (AT) area and the subcutaneous hip AT area were assessed by magnetic resonance imaging (MRI) in 12 growth hormone-deficient adults before and after 6 mo of replacement with recombinant human growth hormone (rhGH) and in 12 healthy control subjects. The data obtained by MRI were compared with circumference measurements of waist and hip. Growth hormone-deficient patients compared with control subjects had a higher visceral AT area (P = 0.

Validation of extracellular water determination by bioelectrical impedance analysis in growth hormone-deficient adults.

We validated the determination of extracellular water (ECW) by the bioelectrical impedance method (BIA), using the RJL manufacturer-supplied equation and the equation of Lukaski in 34 growth hormone-deficient (GHD) patients before and after replacement with recombinant human growth hormone (rhGH), using the bromide-dilution (Br-) method as the reference method. At baseline, paired comparisons showed no significant differences between mean ECW assessed by the Br- method and by BIA using both equations in the placebo and rhGH group. At 6 months, no significant difference was found between ECW assessed by the Br- method and by BIA using the manufacturer-supplied equation, both in the placebo and rhGH group.