Showing papers by "Martijn Poeze published in 2009"
TL;DR: Citrulline production is severely low in patients with sepsis and is related to diminished de novo arginine and NO production, and these findings warrant further studies of therapeutic nutritional interventions to restore arginin metabolism in sepsi.
177 citations
TL;DR: There is poor public awareness about the existence of a syndrome known as sepsis, and results of this questionnaire underscore the challenges in early management and treatment of infected patients at risk for developing sepsi syndrome.
Abstract: Background: Sepsis is a common cause of death throughout the world. Early treatment improves outcome; however, treatment may be delayed if the patient does not present himself/herself for medical care until late in the disease process. Lack of knowledge about the syndrome may contribute to delay in presenting for medical care. However, we need to acknowledge the complexity of sepsis. General awareness of sepsis by the public may increase political pressure for research funding. Increased public awareness of acute myocardial infarction has contributed to reduced mortality over the last 50 yrs. This example provides a rationale for future efforts to increase the public awareness of sepsis. Objective: The survey was designed to gain insight into public perceptions and attitudes regarding sepsis. Design: Prospective, international survey performed using structured telephone interviews. Subjects: A total of 6021 interviewees, 5021 in Europe and
93 citations
TL;DR: It is hypothesized that deficient amino acid concentrations, especial ly ARG, at the fracture site lead to the development o f atrophic non-union during fracture healing due to insufficient callus formation.
Abstract: INTRODUCTION Overall five to 10 percent of all patients wit h a fracture develop an insufficient healing process resulting in a non-uni on formation. Malnutrition, drug therapy, inadequate stabilizatio n and fixation of the fracture parts, disturbed mechanical loading, inade quate blood supply and metabolic disorders are several causes for incr eased risk of fracture non healing. Previous experimental studies showed t h importance of sufficient nitric oxide (NO) availability during no rmal fracture healing. A strong regulation of NO is essential, since th NO effect appears to have a dual effect on bone metabolism with high NO concentrations being detrimental and low-normal NO concentrations beneficial. There is evidence that arginine (ARG), as the primary pre cu sor for NO synthesis, is essential during NO-regulated fractur e healing in experimental settings. ARG is a nonessential amino acid derived from protein breakdown, food intake, and from endogenous conversion of citrulline (CIT) into ARG and degraded into ornithi ne (ORN) and urea by arginase or into CIT and NO, through NOS-synthas es enzymes. During conditions of stress, such as wound healing a d inflammation, arginine metabolism changes and ARG availability is probably limited. ARG may therefore become rate-limiting for the pro duction of NO. We hypothesize that deficient amino acid concentrations, especial ly ARG, at the fracture site lead to the development o f atrophic non-union during fracture healing due to insufficient callus formation.