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  1. Article ; Online: Endoscopic management of duodenal adenomatosis in familial adenomatous polyposis-A case-based review.

    Soons, E / Bisseling, T M / van Kouwen, M C A / Möslein, G / Siersema, P D

    United European gastroenterology journal

    2021  Volume 9, Issue 4, Page(s) 461–468

    Abstract: Adenomatous polyposis (AP) diseases, including familial adenomatous polyposis (FAP), attenuated FAP (AFAP), and MUTYH-associated polyposis (MAP), are the second most common hereditary causes of colorectal cancer. A frequent extra-colonic manifestation of ...

    Abstract Adenomatous polyposis (AP) diseases, including familial adenomatous polyposis (FAP), attenuated FAP (AFAP), and MUTYH-associated polyposis (MAP), are the second most common hereditary causes of colorectal cancer. A frequent extra-colonic manifestation of AP disease is duodenal polyposis, which may lead to duodenal cancer in up to 18% of AP patients. Endoscopic surveillance is recommended at 0.5- to 5-year intervals depending on the extent of polyp growth and histological progression. Although the Spigelman classification is traditionally used to determine surveillance intervals, it lacks information on the (peri-)ampullary site, where 50% of duodenal carcinomas are located. Hence, information on the papilla has recently been added as a prognostic marker. Patients with duodenal adenoma(s) ≥10 mm and ampullary adenomas of any size are suggested to be referred to an expert center for endoscopic therapy, particularly endoscopic mucosal resection and endoscopic ampullectomy. Nonetheless, despite the logic of this approach, the long-term efficacy of endoscopic therapy is still to be demonstrated.
    MeSH term(s) Adenomatous Polyposis Coli/diagnosis ; Adenomatous Polyposis Coli/pathology ; Adenomatous Polyposis Coli/surgery ; Duodenal Neoplasms/diagnosis ; Duodenal Neoplasms/pathology ; Duodenal Neoplasms/surgery ; Duodenoscopy ; Endoscopic Mucosal Resection ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Patient Compliance ; Prognosis ; Time Factors
    Language English
    Publishing date 2021-05-07
    Publishing country England
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 2728585-6
    ISSN 2050-6414 ; 2050-6406
    ISSN (online) 2050-6414
    ISSN 2050-6406
    DOI 10.1002/ueg2.12071
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Laboratory variation in the grading of dysplasia of duodenal adenomas in familial adenomatous polyposis patients.

    Soons, E / Siersema, P D / van Lierop, L M A / Bisseling, T M / van Kouwen, M C A / Nagtegaal, I D / van der Post, R S / Atsma, F

    Familial cancer

    2022  Volume 22, Issue 2, Page(s) 177–186

    Abstract: To prevent duodenal and ampullary cancer in familial adenomatous polyposis (FAP) patients, a diagnosis of high grade dysplasia (HGD) plays an important role in the clinical management. Previous research showed that FAP patients are both over- and ... ...

    Abstract To prevent duodenal and ampullary cancer in familial adenomatous polyposis (FAP) patients, a diagnosis of high grade dysplasia (HGD) plays an important role in the clinical management. Previous research showed that FAP patients are both over- and undertreated after a misdiagnosis of HGD, indicating unwarranted variation. We aimed to investigate the laboratory variation in dysplasia grading of duodenal adenomas and explore possible explanations for this variation. We included data from all Dutch pathology laboratories between 1991 and 2020 by retrieving histology reports from upper endoscopy specimens of FAP patients from the Dutch nationwide pathology databank (PALGA). Laboratory variation was investigated by comparing standardized proportions of HGD. To describe the degree of variation between the laboratories a factor score was calculated. A funnel plot was used to identify outliers. A total of 3050 specimens from 25 laboratories were included in the final analyses. The mean observed HGD proportion was 9.4%. The top three HGD-diagnosing laboratories diagnosed HGD 3.9 times more often than the lowest three laboratories, even after correcting for case-mix. No outliers were identified. Moderate laboratory variation was found in HGD diagnoses of duodenal tissue of FAP patients after adjusting for case-mix. Despite the fact that no outliers were observed, there may well be room for quality improvement. Concentration of these patients in expertise centers may decrease variation. To further reduce unwarranted variation, we recommend (inter)national guidelines to become more uniform in their recommendations regarding duodenal tissue sampling and consequences of HGD diagnoses.
    MeSH term(s) Humans ; Ampulla of Vater/pathology ; Laboratories ; Common Bile Duct Neoplasms ; Adenomatous Polyposis Coli/diagnosis ; Adenoma/pathology ; Duodenal Neoplasms/pathology
    Language English
    Publishing date 2022-11-19
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1502496-9
    ISSN 1573-7292 ; 1389-9600
    ISSN (online) 1573-7292
    ISSN 1389-9600
    DOI 10.1007/s10689-022-00320-1
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  3. Article ; Online: Inulin significantly improves serum magnesium levels in proton pump inhibitor-induced hypomagnesaemia.

    Hess, M W / de Baaij, J H F / Broekman, M / Bisseling, T M / Haarhuis, B / Tan, A / Te Morsche, R / Hoenderop, J G J / Bindels, R J M / Drenth, J P H

    Alimentary pharmacology & therapeutics

    2016  Volume 43, Issue 11, Page(s) 1178–1185

    Abstract: Background: Proton pump inhibitors (PPI) are among the most widely prescribed drugs to treat gastric acid-related disorders. PPI-induced hypomagnesaemia, a defect in intestinal absorption of Mg(2+) , can be a severe side effect of chronic PPI use.: ... ...

    Abstract Background: Proton pump inhibitors (PPI) are among the most widely prescribed drugs to treat gastric acid-related disorders. PPI-induced hypomagnesaemia, a defect in intestinal absorption of Mg(2+) , can be a severe side effect of chronic PPI use.
    Aim: To restore serum Mg(2+) concentrations in PPI-induced hypomagnesaemia patients by dietary supplementation with inulin fibres.
    Methods: Eleven patients with PPI-induced hypomagnesaemia and 10 controls were treated with inulin (20 g/day). Each trial consisted of two cycles of 14-day inulin treatment followed by a washout period of 14 days. Patients continued to use their PPI. Serum Mg(2+) levels served as the primary endpoint.
    Results: Inulin significantly enhanced serum Mg(2+) levels from 0.60 to 0.68 mmol/L in PPI-induced hypomagnesaemia patients, and from 0.84 to 0.93 mmol/L in controls. As a consequence 24 h urinary Mg(2+) excretion was significantly increased in patients with PPI-induced hypomagnesaemia (0.3-2.2 mmol/day). Symptoms related to hypomagnesaemia, including muscle cramps and paraesthesia, were reduced during intervention with inulin.
    Conclusion: Inulin increases serum Mg(2+) concentrations under PPI maintenance in patients with PPI-induced hypomagnesaemia.
    MeSH term(s) Adult ; Aged ; Case-Control Studies ; Female ; Humans ; Intestinal Absorption ; Inulin/administration & dosage ; Magnesium/blood ; Magnesium Deficiency/blood ; Male ; Middle Aged ; Muscle Cramp/drug therapy ; Proton Pump Inhibitors/adverse effects ; Proton Pump Inhibitors/therapeutic use ; Young Adult
    Chemical Substances Proton Pump Inhibitors ; Inulin (9005-80-5) ; Magnesium (I38ZP9992A)
    Language English
    Publishing date 2016-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 639012-2
    ISSN 1365-2036 ; 0269-2813 ; 0953-0673
    ISSN (online) 1365-2036
    ISSN 0269-2813 ; 0953-0673
    DOI 10.1111/apt.13619
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  4. Article: CT colonography to visualise the whole colon can be complementary to incomplete colonoscopy.

    Bisseling, T M / Dekker, H M / Cools, B / Nagengast, F M

    The Netherlands journal of medicine

    2006  Volume 64, Issue 10, Page(s) 389–390

    MeSH term(s) Adenomatous Polyposis Coli/diagnostic imaging ; Adenomatous Polyposis Coli/pathology ; Adult ; Colonography, Computed Tomographic ; Colonoscopy ; Humans ; Male
    Language English
    Publishing date 2006-11
    Publishing country Netherlands
    Document type Case Reports ; Journal Article
    ZDB-ID 193149-0
    ISSN 1872-9061 ; 0300-2977
    ISSN (online) 1872-9061
    ISSN 0300-2977
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  5. Article ; Online: Clinical risk factors of colorectal cancer in patients with serrated polyposis syndrome: a multicentre cohort analysis.

    IJspeert, J E G / Rana, S A Q / Atkinson, N S S / van Herwaarden, Y J / Bastiaansen, B A J / van Leerdam, M E / Sanduleanu, S / Bisseling, T M / Spaander, M C W / Clark, S K / Meijer, G A / van Lelyveld, N / Koornstra, J J / Nagtegaal, I D / East, J E / Latchford, A / Dekker, E

    Gut

    2017  Volume 66, Issue 2, Page(s) 278–284

    Abstract: Objective: Serrated polyposis syndrome (SPS) is accompanied by an increased risk of colorectal cancer (CRC). Patients fulfilling the clinical criteria, as defined by the WHO, have a wide variation in CRC risk. We aimed to assess risk factors for CRC in ... ...

    Abstract Objective: Serrated polyposis syndrome (SPS) is accompanied by an increased risk of colorectal cancer (CRC). Patients fulfilling the clinical criteria, as defined by the WHO, have a wide variation in CRC risk. We aimed to assess risk factors for CRC in a large cohort of patients with SPS and to evaluate the risk of CRC during surveillance.
    Design: In this retrospective cohort analysis, all patients with SPS from seven centres in the Netherlands and two in the UK were enrolled. WHO criteria were used to diagnose SPS. Patients who only fulfilled WHO criterion-2, with IBD and/or a known hereditary CRC syndrome were excluded.
    Results: In total, 434 patients with SPS were included for analysis; 127 (29.3%) were diagnosed with CRC. In a per-patient analysis ≥1 serrated polyp (SP) with dysplasia (OR 2.07; 95% CI 1.28 to 3.33), ≥1 advanced adenoma (OR 2.30; 95% CI 1.47 to 3.67) and the fulfilment of both WHO criteria 1 and 3 (OR 1.60; 95% CI 1.04 to 2.51) were associated with CRC, while a history of smoking was inversely associated with CRC (OR 0.36; 95% CI 0.23 to 0.56). Overall, 260 patients underwent surveillance after clearing of all relevant lesions, during which two patients were diagnosed with CRC, corresponding to 1.9 events/1000 person-years surveillance (95% CI 0.3 to 6.4).
    Conclusion: The presence of SPs containing dysplasia, advanced adenomas and/or combined WHO criteria 1 and 3 phenotype is associated with CRC in patients with SPS. Patients with a history of smoking show a lower risk of CRC, possibly due to a different pathogenesis of disease. The risk of developing CRC during surveillance is lower than previously reported in literature, which may reflect a more mature multicentre cohort with less selection bias.
    MeSH term(s) Adenoma/diagnosis ; Adenoma/epidemiology ; Adenoma/pathology ; Adenomatous Polyposis Coli/epidemiology ; Adenomatous Polyposis Coli/pathology ; Adult ; Aged ; Aged, 80 and over ; Colonoscopy ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/epidemiology ; Colorectal Neoplasms/pathology ; Female ; Humans ; Male ; Middle Aged ; Netherlands/epidemiology ; Population Surveillance ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Smoking/epidemiology ; United Kingdom/epidemiology ; World Health Organization ; Young Adult
    Language English
    Publishing date 2017-02
    Publishing country England
    Document type Journal Article ; Multicenter Study
    ZDB-ID 80128-8
    ISSN 1468-3288 ; 0017-5749
    ISSN (online) 1468-3288
    ISSN 0017-5749
    DOI 10.1136/gutjnl-2015-310630
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  6. Article: A patient with prolonged vague pain in the lower abdomen following a three-day period with diarrhoea and vomiting.

    Bisseling, T M / Op den Akker, J W / Janssen, M / Strijk, S P

    The Netherlands journal of medicine

    2005  Volume 63, Issue 7, Page(s) 278, 285

    MeSH term(s) Abdominal Pain/diagnosis ; Abdominal Pain/etiology ; Acute Disease ; Aged ; Colon, Sigmoid/blood supply ; Diagnosis, Differential ; Diarrhea/diagnosis ; Diarrhea/etiology ; Diverticulum, Colon/complications ; Diverticulum, Colon/diagnosis ; Female ; Humans ; Magnetic Resonance Imaging ; Mesenteric Vascular Occlusion/complications ; Mesenteric Vascular Occlusion/diagnosis ; Mesenteric Veins ; Tomography, X-Ray Computed ; Vomiting/diagnosis ; Vomiting/etiology
    Language English
    Publishing date 2005-07
    Publishing country Netherlands
    Document type Case Reports ; Journal Article
    ZDB-ID 193149-0
    ISSN 1872-9061 ; 0300-2977
    ISSN (online) 1872-9061
    ISSN 0300-2977
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  7. Article ; Online: Low Incidence of Advanced Neoplasia in Serrated Polyposis Syndrome After (Sub)total Colectomy: Results of a 5-Year International Prospective Cohort Study.

    Bleijenberg, A G C / IJspeert, J E G / Carballal, S / Pellise, M / Jung, G / van Herwaarden, Y J / Bisseling, T M / Nagtegaal, I D / van Leerdam, M E / Spaander, M C W / van Lelyveld, N / Bessa, X / Rodríguez-Alcalde, D / Bastiaansen, B A J / de Klaver, W / Bemelman, W A / Bujanda, L / Koornstra, J J / Rivero, L /
    Rodríguez-Moranta, F / Balaguer, F / Dekker, E

    The American journal of gastroenterology

    2019  Volume 114, Issue 9, Page(s) 1512–1519

    Abstract: Introduction: Serrated polyposis syndrome (SPS) is accompanied by a substantially increased colorectal cancer (CRC) risk. To prevent or treat CRC in patients with a very high polyp burden, (sub)total colectomy with ileorectal or ileosigmoidal ... ...

    Abstract Introduction: Serrated polyposis syndrome (SPS) is accompanied by a substantially increased colorectal cancer (CRC) risk. To prevent or treat CRC in patients with a very high polyp burden, (sub)total colectomy with ileorectal or ileosigmoidal anastomosis is regularly performed. The CRC risk after (sub)total colectomy might be decreased, but evidence is lacking. We aimed to assess the yield of endoscopic surveillance in patients with SPS who underwent (sub)total colectomy.
    Methods: For this post hoc analysis, we used prospectively collected data from a large international prospective cohort study. We included patients diagnosed with SPS (World Health Organization type I and/or III) who underwent (sub)total colectomy. Primary endpoint was the cumulative 5-year incidence of CRC and advanced neoplasia (AN).
    Results: Forty-eight patients (mean age 61 [±7.8]; 52% men) were included and followed up for a median of 4.7 years (interquartile range 4.7-5.1). None of the patients developed CRC during follow-up. Five patients developed AN, corresponding to a cumulative 5-year AN incidence of 13% (95% confidence interval 1.2-23). In 4 patients, AN was diagnosed at the first surveillance endoscopy after study inclusion, and in 1 patient, AN was detected during subsequent rounds of surveillance. The risk of AN was similar for patients with ileorectal and ileosigmoidal anastomosis (logrank P = 0.83).
    Discussion: (Sub)total colectomy mitigates much of the excess risk of CRC in patients with SPS. Advanced neoplasms are mainly detected at the first endoscopy after (sub)total colectomy. Based on these results, after the first surveillance, intervals might be extended beyond the currently recommended 1-2 years.
    MeSH term(s) Adenomatous Polyps/pathology ; Adenomatous Polyps/surgery ; Aged ; Carcinoma/epidemiology ; Cohort Studies ; Colectomy/methods ; Colonic Polyps/surgery ; Colonoscopy ; Colorectal Neoplasms/pathology ; Colorectal Neoplasms/surgery ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Recurrence, Local/pathology ; Neoplasms, Multiple Primary/surgery ; Prospective Studies
    Language English
    Publishing date 2019-09-06
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 390122-1
    ISSN 1572-0241 ; 0002-9270
    ISSN (online) 1572-0241
    ISSN 0002-9270
    DOI 10.14309/ajg.0000000000000339
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  8. Article: Nitric oxide-mediated vascular tone in the fetal placental circulation of patients with type 1 diabetes mellitus.

    Bisseling, T M / Wouterse, A C / Steegers, E A / Elving, L / Russel, F G / Smits, P

    Placenta

    2003  Volume 24, Issue 10, Page(s) 974–978

    Abstract: Endothelium-derived nitric oxide (NO) plays a key role in the regulation of vascular tone in health and disease. The present study addresses the contribution of NO to the baseline vascular tone in the fetal placental circulation of type 1 diabetic women. ...

    Abstract Endothelium-derived nitric oxide (NO) plays a key role in the regulation of vascular tone in health and disease. The present study addresses the contribution of NO to the baseline vascular tone in the fetal placental circulation of type 1 diabetic women. To this end, we performed ex-vivo dual perfusions of isolated cotyledons from seven women with type 1 diabetes mellitus and 24 healthy women. The fetal arterial pressure was considered to be a measure of fetal vascular resistance. The contribution of NO to the baseline vascular tone of the fetal placental circulation was quantified by addition of the NO-synthase inhibitor N(G)-nitro-arginine-methylester (L-NAME). Apart from the diabetic state, we studied the influence of exogenous insulin on the response to L-NAME. Mean (+/-SEM) baseline fetal arterial pressure was higher in diabetes (25.7+/-3.4 mm Hg vs 18.0+/-1.7 mm Hg, P<0.05). Maximum perfusion pressure after L-NAME was 87.9+/-7.1 mm Hg in diabetes vs 58.9+/-4.5 mm Hg in controls (P<0.01). The net L-NAME-induced increase in fetal arterial pressure was higher in diabetes (62.2+/-9.1 mm Hg vs 40.9+/-3.5 mm Hg, P<0.05). Although insulin induced a shift to the left of the L-NAME-curve, the net L-NAME-induced increase in fetal arterial pressure was not affected. We conclude that diabetes is associated with an increased baseline vascular tone of the fetal placental vascular bed. This can not be explained by attenuated NO-mediated effects. In contrast, the activity of the NO-pathway seems to be increased in diabetes. The latter observation seems not to be caused by high insulin levels.
    MeSH term(s) Adult ; Blood Pressure/physiology ; Diabetes Mellitus, Type 1/complications ; Diabetes Mellitus, Type 1/metabolism ; Diabetes Mellitus, Type 1/physiopathology ; Female ; Fetus/blood supply ; Humans ; Muscle, Smooth, Vascular/physiopathology ; NG-Nitroarginine Methyl Ester/pharmacology ; Nitric Oxide/physiology ; Nitric Oxide Synthase/antagonists & inhibitors ; Placenta/blood supply ; Placenta/chemistry ; Placental Circulation ; Pregnancy ; Signal Transduction
    Chemical Substances Nitric Oxide (31C4KY9ESH) ; Nitric Oxide Synthase (EC 1.14.13.39) ; NG-Nitroarginine Methyl Ester (V55S2QJN2X)
    Language English
    Publishing date 2003-11
    Publishing country Netherlands
    Document type Comparative Study ; Journal Article
    ZDB-ID 603951-0
    ISSN 1532-3102 ; 0143-4004
    ISSN (online) 1532-3102
    ISSN 0143-4004
    DOI 10.1016/s0143-4004(03)00171-1
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  9. Article: Collagen synthesis in rat skin and ileum fibroblasts is affected differently by diabetes-related factors.

    Verhofstad, M H / Bisseling, T M / Haans, E M / Hendriks, T

    International journal of experimental pathology

    1998  Volume 79, Issue 5, Page(s) 321–328

    Abstract: Untreated diabetes reduces wound strength: a concomitant reduction in collagen deposition has been found in cutaneous wounds but not in intestinal anastomoses. This raises the question if collagen synthesis in fibroblasts from skin and intestine reacts ... ...

    Abstract Untreated diabetes reduces wound strength: a concomitant reduction in collagen deposition has been found in cutaneous wounds but not in intestinal anastomoses. This raises the question if collagen synthesis in fibroblasts from skin and intestine reacts differently to the diabetic state. Fibroblast lines were established from healthy rat skin and ileum. Diabetic rat serum was collected from hyperglycaemic rats 3 days after intravenous injection of streptozotocin (200 mg/kg). Fibroblast cultures were grown to confluency in foetal calf serum and maintained in various concentrations of glucose, insulin, normal or diabetic rat serum. Collagen synthesis was measured by incorporation of [3H]-proline into Collagenase-Digestible-Protein. Collagen synthesis in fibroblasts from both skin and ileum was not affected by increasing glucose concentrations. Insulin strongly and specifically stimulated collagen synthesis in skin fibroblasts whereas in ileum fibroblasts only a nonspecific increase of total protein synthesis was observed. In skin fibroblasts, diabetic rat serum stimulated collagen synthesis to a significantly lesser extent than normal rat serum, whereas in ileum fibroblasts stimulation by serum was far less explicit and no difference was observed between normal and diabetic serum. The fact that ileum fibroblasts respond less strongly to culture in diabetic serum than skin fibroblasts may explain our prior finding that would collagen accumulation in intestinal anastomoses is virtually unaffected during diabetes and supports the existence of tissue-specific healing responses.
    MeSH term(s) Animals ; Cell Culture Techniques ; Collagen/biosynthesis ; Diabetes Mellitus, Experimental/blood ; Diabetes Mellitus, Experimental/metabolism ; Dose-Response Relationship, Drug ; Fibroblasts/drug effects ; Fibroblasts/metabolism ; Glucose/pharmacology ; Ileum/metabolism ; Insulin/pharmacology ; Male ; Rats ; Rats, Wistar ; Skin/metabolism
    Chemical Substances Insulin ; Collagen (9007-34-5) ; Glucose (IY9XDZ35W2)
    Language English
    Publishing date 1998-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 1016006-1
    ISSN 1365-2613 ; 0959-9673 ; 0958-4625 ; 0007-1021
    ISSN (online) 1365-2613
    ISSN 0959-9673 ; 0958-4625 ; 0007-1021
    DOI 10.1046/j.1365-2613.1998.t01-1-780407.x
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  10. Article: Dysfunction of the cyclo-oxygenase pathway in the foetoplacental circulation in Type 1 diabetes mellitus.

    Bisseling, T M / Wouterse, A C / Steegers, E A P / Elving, L / Russel, F G M / Smits, P

    Diabetic medicine : a journal of the British Diabetic Association

    2005  Volume 22, Issue 4, Page(s) 503–506

    Abstract: Aim: In diabetes, perinatal morbidity is significantly increased. This may partly be related to functional changes in the foetoplacental vascular bed. In diabetes models, a defect in the cyclo-oxygenase pathway is a common observation. Therefore, we ... ...

    Abstract Aim: In diabetes, perinatal morbidity is significantly increased. This may partly be related to functional changes in the foetoplacental vascular bed. In diabetes models, a defect in the cyclo-oxygenase pathway is a common observation. Therefore, we hypothesized that the human foetoplacental circulation of diabetic patients is characterized by dysfunction of the cyclo-oxygenase pathway, as well.
    Methods: We performed ex-vivo perfusions of isolated placental cotyledons from healthy women (n = 14) and from patients with Type 1 diabetes (n = 9). The contribution of cyclo-oxygenase products to foetoplacental vascular tone was quantified by measuring the response to the cyclo-oxygenase inhibitor indomethacin.
    Results: Baseline foetoplacental arterial pressure was comparable between controls and diabetic women (mean +/- sem, 21.7 +/- 1.2 vs. 24.4 +/- 2.0 mmHg). Maximum foetoplacental arterial pressure at highest dose of indomethacin was 32.8 +/- 3.0 mmHg in controls vs. 27.3 +/- 2.3 mmHg in diabetic women. The indomethacin-induced increase in pressure was reduced in diabetes (2.9 +/- 0.7 vs. 11.2 +/- 2.4 mmHg in controls, P = 0.01).
    Conclusions: Under baseline conditions, the net effect of all cyclo-oxygenase products in the foetoplacental vascular bed is vasodilation. In diabetes, this vasodilator effect seems significantly impaired.
    MeSH term(s) Adult ; Blood Pressure/drug effects ; Cyclooxygenase Inhibitors ; Diabetes Mellitus, Type 1/enzymology ; Diabetes Mellitus, Type 1/physiopathology ; Female ; Humans ; In Vitro Techniques ; Indomethacin ; Placental Circulation/drug effects ; Pregnancy ; Pregnancy in Diabetics/enzymology ; Pregnancy in Diabetics/physiopathology ; Prostaglandin-Endoperoxide Synthases/physiology ; Signal Transduction/drug effects ; Vasoconstriction/drug effects
    Chemical Substances Cyclooxygenase Inhibitors ; Prostaglandin-Endoperoxide Synthases (EC 1.14.99.1) ; Indomethacin (XXE1CET956)
    Language English
    Publishing date 2005-04
    Publishing country England
    Document type Journal Article
    ZDB-ID 605769-x
    ISSN 1464-5491 ; 0742-3071 ; 1466-5468
    ISSN (online) 1464-5491
    ISSN 0742-3071 ; 1466-5468
    DOI 10.1111/j.1464-5491.2005.01437.x
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