De Korenwolf, de witte neushoorn maar ook de klinisch onderzoeker

Als u enigszins het ecologisch nieuws van de afgelopen jaren heeft gevolgd, dan zal de titel van mijn verhaal u duidelijk maken dat het hier gaat om zeldzaamheden. Immers, de korenwolf ofwel de cricetus cricetus is ongeveer 25/30 cm groot. Er is nog een andere korenwolf soort die circa 5 cm breed is en krap 20 cm hoog. Deze zogenaamde cricetus gulpenensis, oftewel de Gulpener Korenwolf is echter een meergranen luxe witbier van hoge gisting. De hamsterachtige korenwolf waar ik het over wil hebben heeft een zwarte buik, wat, en dat moet u maar van mij aannemen, erg opvallend is. Bij de meeste hamsters is de onderkant van het lichaam namelijk juist lichter dan de rug. De korenwolf komt voor in Midden-, Zuid-, en West-Europa. In Nederland komt hij alleen in Zuid-Limburg voor. Het aantal korenwolfen daalt echter en daarom zijn er allerlei groepen actief geweest om het leven van de korenwolf weer makkelijker te maken in Zuid-Limburg. De korenwolf graaft veel en leeft in grote holenstelsels, daarom is het belangrijk dat de bodem van zijn omgeving vruchtbaar, droog en matig hard is. Doordat de korenwolf zo zeldzaam is geworden de laatste jaren, zijn er veel acties geweest. Zo hielpen o.a. Natuurmonumenten, Vereniging Das en Boom en Staatsbosbeheer de Korenwolf. In mei 1999 waren er zelfs maar (vermoedelijk) 3 korenwolfen over, maar vooral de vereniging Das en Boom is met een succesvol fokprogramma bezig het aantal weer uit te breiden.Rede, In verkorte vorm uitgesproken ter gelegenheid van het aanvaarden van het ambt van hoogleraar Inwendige geneeskunde en in het bijzonder de endocrinologie aan het Erasmus MC, faculteit van de Erasmus Universiteit Rotterdam op 15 september 200

Aspects of medical therapy of neuroendocrine disorders

Treatment of pituitary diseases bas changed considerably over the last 35 years. Apart from the introduction of transspbenoidal surgery the development of dopaminergic drugs, as well as of the somatostatin analog octreotide have been major steps forward towards the control of the growth and hormonal byperproduction by pituitary adenomas. The improved understanding of the interaction between hormones and their receptors, the knowledge about hypothalamic releasing factors and hormones, as well as the development of RIA- and ELISA techniques for the measurement of circulating hormone and growth factor levels have also contributed to this progress in treatment. This thesis is dealing with some aspects of the medical treatment of neuroendocrine disorder

KETOgenic diet therapy in patients with HEPatocellular adenoma:Study protocol of a matched interventional cohort study

INTRODUCTION: Hepatocellular adenoma (HCA) is an uncommon, solid and benign liver lesion, mainly occurring in women using oral contraceptives. Patients are advised to stop using oral contraceptives (OC) and, as overweight is frequently observed, dietary restrictions. Metabolic changes are assumed to play a role and it has been suggested that diet may help to reduce tumour size. A low-calorie ketogenic diet (LCKD) has been shown to induce weight loss and multiple metabolic changes, including the reduction of portal insulin concentrations, which downregulates hepatic growth hormone receptors. Weight reduction and an LCKD can potentially reduce the size of HCAs. METHODS AND ANALYSIS: We designed a matched, interventional cohort study to determine the effect of an LCKD on the regression of HCA. The study population consists of female subjects with an HCA, 18–50 years of age, body mass index>25 kg/m(2), who are entering a surveillance period including cessation of OC. A historical control group will be matched. The intervention consists of an LCKD (approximately 35 g carbohydrate/1500 kcal/day) for 3 months, followed by a less strict LCKD for 3 months (approximately 60 g carbohydrate/1500 kcal/day). Main study endpoint is the diameter of the HCA after 6 months, as compared with the historic control group. Secondary endpoints include adherence, quality of life, change in physical activity, liver fat content, body weight, body composition and resting energy expenditure. ETHICS AND DISSEMINATION: The medical ethical committee has approved the study protocol, patient information files and consent procedure and other study-related documents and procedures. TRIAL REGISTRATION NUMBER: NL75014.078.20; Pre-results. https://www.trialregister.nl/trial/909

Supplementary data for: Missed Diagnoses and Health Problems in Adults With Prader-Willi Syndrome: Recommendations for Screening and Treatment

Context: Prader-Willi syndrome (PWS) is a complex hypothalamic disorder, combining hyperphagia, hypotonia, intellectual disability, and pituitary hormone deficiencies. Annual mortality of patients with PWS is high (3%). In half of the patients, the cause of death is obesity related and/or of cardiopulmonary origin. Health problems leading to this increased mortality often remain undetected due to the complexity and rareness of the syndrome. Objective: To assess the prevalence of health problems in adults with PWS retrospectively. Patients, Design, and Setting: We systematically screened 115 PWS adults for undiagnosed health problems. All patients visited the multidisciplinary outpatient clinic for rare endocrine syndromes at the Erasmus University Medical Center, Rotterdam, Netherlands. We collected the results of medical questionnaires, interviews, physical xaminations, biochemical measurements, polygraphy, polysomnography, and radiology. Main outcome measures: Presence or absence of endocrine and nonendocrine comorbidities in relation to living situation, body mass index, genotype, and demographic factors. Results: Seventy patients (61%) had undiagnosed health problems, while 1 in every 4 patients had multiple undiagnosed health problems simultaneously. All males and 93% of females had hypogonadism, 74% had scoliosis, 18% had hypertension, 19% had hypercholesterolemia, 17% had type 2 diabetes mellitus, and 17% had hypothyroidism. Unfavorable lifestyles were common: 22% exercised too little (according to PWS criteria) and 37% did not see a dietitian. Conclusions: Systematic screening revealed many undiagnosed health problems in PWS adults. Based on patient characteristics, we provide an algorithm for diagnostics and treatment, with the aim to prevent early complications and reduce mortality in this vulnerable patient group