René R. W. J. van der Hulst

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Parenteral glutamine dipeptide improves nitrogen balance in postoperative patients on total parenteral nutrition (TPM). Animal studies show that the structure and function of the gut is preserved by glutamine. It is not known if this is the case in human beings. 20 patients admitted to hospital for total parenteral nutrition were randomly allocated to(More)
BACKGROUND Recurrent thoracic empyema in the presence of residual lung tissue can be treated with an open window thoracostomy (OWT). Vacuum-assisted closure (VAC) of these large thoracic defects is a novel option. METHODS Nineteen patients with residual lung tissue received an OWT for treatment of recurrent thoracic empyema. In this retrospective case(More)
Forty-one (impending) fractures were reviewed in 39 patients with metastatic bone disease. Thirty-one lesions were located in the femur, and the remaining ten lesions were located in the humerus. In 22 cases there were multiple lesions in the affected bone. All patients were treated with intramedullary nailing, 21 times because of a pathologic fracture and(More)
Continuous enteral feeding (CEF) has been associated with decreased gastric acidity, thereby stimulating gastric colonization and ventilator-associated pneumonia (VAP). Intermittent enteral feeding (IEF) could induce a temporary increase in gastric acidity and decrease the risk of VAP. We studied the influence of IEF (18 h/d) and CEF (24 h/d) on gastric and(More)
BACKGROUND Current noninvasive tests to confirm the eradication of Helicobacter pylori must be performed 4 weeks or more after eradication therapy is completed. OBJECTIVE To determine whether the stool antigen test, a relatively new noninvasive test for H. pylori, administered at various times after eradication therapy correctly identifies persons with(More)
In this study, we compared one hundred patients with autoimmune/inflammatory syndrome induced by adjuvants (ASIA) due to silicone implant incompatibility syndrome diagnosed in 2014 in Maastricht, the Netherlands, with one hundred historical patients with adjuvant breast disease diagnosed in the Baylor College of Medicine, Houston, USA, between 1985 and(More)
BACKGROUND Total parenteral nutrition (TPN) is associated with depletion of intestinal immune cells and increased gut permeability (GP). Adding glutamine (GLN) to TPN preserves GP by an unknown mechanism. Intestinal immune cells situated between the enterocytes (intraepithelial lymphocytes, [IEL]) influence GP in vitro. To obtain insight into the underlying(More)
When there is not sufficient local tissue available for reconstruction of one or multiple digital defects, distant flap reconstructions are required. Available thin flaps with defined arterial inflow and venous outflow are limited and require the sacrifice of an arterial pedicle. In addition, a functional limitation can occur at the donor site. During the(More)
Ischaemia-reperfusion injury is the mechanism underlying (partial) flap loss. This is not only a traumatic event for the patient, it also causes increased patient morbidity [Kerrigan CL, Stotland MA. Ischemia reperfusion injury: a review. Microsurgery 1993;14:165-75] as well as prolonged hospitalisation, increasing medical consumption and costs. For(More)
Glutamine serves as a shuttle of useful nontoxic nitrogen, supplying nitrogen from glutamine-producing (eg, muscle) to glutamine-consuming tissues. True production rates of glutamine are difficult to measure, but probably are less than 60 to 100 g/d for a 70-kg man. During catabolic stress increased amounts of glutamine are released from muscle, consisting(More)