[Two patients with mitochondrial respiratory chain disease].

A 23-year-old woman and a 13-year-old boy were diagnosed with mitochondrial respiratory chain disease. The woman had muscle pain, fatigue and bilateral ophthalmoplegia--symptoms consistent with Kearns-Sayre syndrome. The boy had aspecific symptoms; eventually, reduced activity of complex 1 was found to be the cause of the mitochondrial respiratory chain disease in the boy and his mother, who had suffered from unexplained fatigue and muscle pain for 15 years.

Comparison of 11C-methionine PET and 18F-fluorodeoxyglucose PET in differentiated thyroid cancer.

Background: The purpose of this prospective study is to evaluate the possibility of 11C-methionine (Met) PET compared with 18F-fluorodeoxyglucose (FDG) PET for the detection of recurrent or metastatic disease in patients with differentiated thyroid cancer (DTC).

Materials And Methods: Twenty patients with clinical suspicion of recurrent DTC but negative posttreatment 131I-whole body scans were included in the study. Both 11C-Met PET and 18F-FDG PET were performed within 1 week.

High prevalence of morphometric vertebral deformities in patients with inflammatory bowel disease.

Background: Earlier studies have documented that the prevalence of decreased bone mineral density (BMD) is elevated in patients with inflammatory bowel disease. The objective of this study was to investigate the prevalence of vertebral deformities in inflammatory bowel disease patients and their relation with BMD and bone turnover.

Methods: One hundred and nine patients with Crohn's disease (CD) and 72 with ulcerative colitis (UC) (age 44.

Haemoglobin A1c goal attainment in relation to dose in patients with diabetes mellitus taking metformin: a nested, case-control study.

Background And Objective: Conclusions from clinical trials suggest possible therapeutic advantages for once-daily agents over twice-daily agents in the treatment of type 2 diabetes mellitus. This study set out to investigate the relationship between metformin dosing frequency and glycosylated haemoglobin (HbA1c)-goal attainment in daily practice.

Methods: This was a nested case-control study.

[Efficient and improved diagnosis of osteoporosis by simultaneous bone density measurement and spinal morphometry].

Objective: As the vertebral fracture status is an important and independent parameter for the prediction of future fractures, we aimed to determine the added value of spinal morphometry performed in combination with bone density measurement in the determination of vertebral fracture status in patients referred for conventional bone density measurement.

Design: Prospective, observational.

Method: Consecutive patients referred to our university medical centre department for bone mineral density measurement also underwent spinal morphometry at the same session.

Quantitative ultrasound does not identify patients with an inflammatory disease at risk of vertebral deformities.

Background: Previous studies from our group have shown that a high prevalence of vertebral deformities suggestive of fracture can be found in patients with an inflammatory disease, despite a near normal bone mineral density (BMD). As quantitative ultrasound (QUS) of the heel can be used for refined assessment of bone strength, we evaluated whether QUS can be used to identify subjects with an inflammatory disease with an increased chance of having a vertebral fracture.

Methods: 246 patients (mean age: 44 +/- 12.

Type 2 diabetes mellitus: prevention of macrovascular complications.

Type 2 diabetes mellitus is a disease that affects a rapidly increasing number of patients. Most patients with Type 2 diabetes will develop vascular complications. This may be microvascular disease, such as nephropathy, retinopathy or polyneuropathy, and also macrovascular disease, such as coronary heart disease, stroke or peripheral artery disease.

Progressive vertebral deformities despite unchanged bone mineral density in patients with sarcoidosis: a 4-year follow-up study.

Unlabelled: To evaluate the incidence of new and/or progressive vertebral deformities and changes in bone mineral density, we re-examined 66 patients with sarcoidosis after a follow-up period of four years. In 17 subjects (26%) new and/or progressive vertebral deformities were found, though BMD did not change significantly.

Introduction: Previous studies from our group have shown that morphometric vertebral deformities suggestive of fractures can be found in 20% of patients with sarcoidosis, despite a normal bone mineral density (BMD).

Cross-sectional versus sequential quality indicators of risk factor management in patients with type 2 diabetes.

Background: The fairness of quality assessment methods is under debate. Quality indicators incorporating the longitudinal nature of care have been advocated but their usefulness in comparison to more commonly used cross-sectional measures is not clear.

Aims: To compare cross-sectional and sequential quality indicators for risk factor management in patients with type 2 diabetes.

The ability of plasma to stimulate fibroblast cholesterol efflux is associated with the -629C-->A cholesteryl ester transfer protein promoter polymorphism: role of lecithin: cholesterol acyltransferase activity.

A recent population-based study showed that cholesteryl ester transfer protein (CETP) gene variations, which relate to lower plasma CETP, may predict increased cardiovascular risk, in spite of higher HDL cholesterol. Among other functions, CETP activity contributes to cellular cholesterol efflux, an early step in the anti-atherogenic reverse cholesterol transport (RCT) process. We hypothesized that cellular cholesterol efflux stimulating capacity of plasma could be associated with CETP gene variation.

The diagnostic value of 124I-PET in patients with differentiated thyroid cancer.

Background: The purpose of this prospective study was to evaluate the clinical diagnostic value of iodine-124 (124I)-positron emission tomography (PET) in patients with advanced differentiated thyroid carcinoma (DTC) and to compare the 124I-PET imaging results with the 131I whole-body scan (WBS).

Materials And Methods: Twenty patients with histologically proven advanced DTC (including T4, extra-nodal tumour growth, or distant metastases) underwent diagnostic 131I-WBS, 124I-PET scan, and post-treatment 131I-WBS 4 months after ablation. The findings on the 124I-PET were compared with the findings on the diagnostic and post-therapeutic 131I-WBS and were also correlated with radiologic and/or cytological investigations.

The follow-up of patients with differentiated thyroid cancer and undetectable thyroglobulin (Tg) and Tg antibodies during ablation.

Objective: This retrospective study describes the role of serum thyroglobulin (Tg) in relation to tumor characteristics in the prediction of persistent/recurrent disease in patients with differentiated thyroid cancer (DTC) with negative Tg at the time of ablation.

Design: Between 1989 and 2006, 94 out of 346 (27%) patients with DTC had undetectable Tg at the time of 131I ablation and were included in this evaluation. The group of 94 patients consisted of 15 males and 79 females in the age range of 16-89 years with a median follow-up of 8 years (range 1-17).

Universal risk factors for multifactorial diseases: LifeLines: a three-generation population-based study.

The risk for multifactorial diseases is determined by risk factors that frequently apply across disorders (universal risk factors). To investigate unresolved issues on etiology of and individual's susceptibility to multifactorial diseases, research focus should shift from single determinant-outcome relations to effect modification of universal risk factors. We present a model to investigate universal risk factors of multifactorial diseases, based on a single risk factor, a single outcome measure, and several effect modifiers.

Influence of elevated cardiometabolic risk factor levels on treatment changes in type 2 diabetes.

Undertreatment of risk factors in patients with type 2 diabetes is common. We assessed the influence of elevated levels of blood pressure, total cholesterol, and A1C on decisions of Dutch general practitioners to change drug treatment in a cohort of 3,029 patients during a 1-year period. Respectively, 58, 71, and 21% of patients remained untreated despite poor blood pressure, lipid levels, and glycemic control.

Bone turnover and hip bone mineral density in patients with sarcoidosis.

Background And Aim Of The Work: Sarcoidosis is a chronic inflammatory T-cell-driven disease that can also affect bone. We evaluated bone remodelling and bone mineral density (BMD) in patients with sarcoidosis and their dependency of disease-related and treatment-related factors.

Methods: In 124 patients BMD of the hip (DXA) and markers of bone resorption (ICTP) and formation (PINP) were evaluated.

[The prevalence of the metabolic syndrome in the Netherlands: increased risk of cardiovascular diseases and diabetes mellitus type 2 in one quarter of persons under 60].

Objective: To estimate the prevalence of the metabolic syndrome in the Netherlands in two populations in the age category 28-59 years and to compare this with the prevalence of hypercholesterolaemia in these populations.

Design: Descriptive.

Method: Data from two Dutch population based studies were used: the 'Monitoring risicofactoren en gezondheid Nederland' (MORGEN) study ['Monitoring risk factors and health in the Netherlands' study] (1993-1995) and the 'Prevention of renal and vascular end-stage disease' (PREVEND) study (1998-1999).

Cyclic Cushing's syndrome: a clinical challenge.

Cyclic Cushing's syndrome (CS) is a rare disorder, characterized by repeated episodes of cortisol excess interspersed by periods of normal cortisol secretion. The so-called cycles of hypercortisolism can occur regularly or irregularly with intercyclic phases ranging from days to years. To formally diagnose cyclic CS, three peaks and two troughs of cortisol production should be demonstrated.

A sensitive Tg assay or rhTSH stimulated Tg: what's the best in the long-term follow-up of patients with differentiated thyroid carcinoma?

Sensitivity of thyroglobulin (Tg) measurement in the follow-up of differentiated thyroid carcinoma (DTC) can be optimized by using a sensitive Tg assay and rhTSH stimulation. We evaluated the diagnostic yield of a sensitive Tg assay and rhTSH stimulated Tg in the detection of recurrences in the follow-up of DTC. Additionally the value of imaging techniques for the localization of recurrences was evaluated.

Detection of bone metastases in thyroid cancer patients: bone scintigraphy or 18F-FDG PET?

Background: Similar to the situation in other tumour types, it is currently unclear whether fluorodeoxyglucose (FDG) positron emission tomography (PET) is adequate in the detection of bone metastases of thyroid cancer. The purpose of this retrospective study was to evaluate the performance of bone scans in comparison with FDG PET in the detection of bone metastases in patients with differentiated thyroid cancer (DTC).

Materials And Methods: Twenty-four patients had undergone both FDG PET and bone scans within 6 months because of suspected bone metastases.

[Assessment of renal function according to the NHG protocol 'Diabetes mellitus type 2': risk of overestimating the number of diabetes patients with renal dysfunction].

Objective: To evaluate the consequences of the new Dutch College of General Practitioners (NHG) protocol 'Diabetes mellitus type 2', which recommends using either the Cockcroft-Gault (CG) formula or the 'Modification of diet in renal disease' (MDRD) study formula to determine the estimated glomerular filtration rate (eGFR) as an indicator of renal function, in a cohort of patients with type-2 diabetes.

Design: Inventory.

Method: The eGFR was calculated using the CG formula, the body-mass index (BMI-)corrected CG formula and the MDRD formula in 6224 patients with type-2 diabetes who entered the 'Zwolle outpatient diabetes project integrating available care' (ZODIAC) study in 2005.

Locoregional control in patients with palpable medullary thyroid cancer: results of standardized compartment-oriented surgery.

Background: Extent of neck dissection is controversial in patients with palpable medullary thyroid cancer (MTC).

Methods: We evaluated 64 MTC patients (19 hereditary, 45 sporadic) with palpable thyroid nodules (group 1, n = 35) or palpable lymph node metastases (group 2, n = 29). Standard surgery included total thyroidectomy, central compartment dissection, and additional neck dissection on indication.

High plasma cholesteryl ester transfer protein levels may favour reduced incidence of cardiovascular events in men with low triglycerides.

Aims: High cholesteryl ester transfer protein (CETP) concentrations are associated with increased risk of cardiovascular disease (CVD) in subjects with high triglycerides. We determined the relationship of plasma CETP with incident CVD in a population with relatively low triglycerides.

Methods And Results: A nested case-control study was performed in men participating in the prospective PREVEND study, after exclusion of CVD, diabetes mellitus, and lipid-lowering drugs use at baseline.