Plummer, Mark P* Dotaz Zobrazit nápovědu
Critical illness is associated with a disturbed regulation of gastrointestinal hormones resulting in functional and metabolic anomalies. Fibroblast growth factor 19 (FGF19) is an ileum-derived metabolic hormone induced by bile salts upon gallbladder emptying after enteral nutrient stimulation. Our aim was to study the nutrient-stimulated FGF19 response in 24 patients admitted to the intensive care unit (ICU) compared with 12 healthy controls. All subjects received intraduodenal high-lipid nutrient infusion for 120 minutes. Blood was collected every 30 minutes until 1 hour after infusion, and gallbladder emptying was studied by ultrasound. Serum levels of bile salts and FGF19 were assessed. ICU patients had significantly higher fasting bile salt serum levels compared with controls, whereas FGF19 serum levels were similar. In both groups, nutrient infusion elicited substantial bile salt elevations (P < 0.001), peaking at 90 minutes, albeit with a significantly lower peak in the ICU patients (P = 0.029). In controls, FGF19 was significantly elevated relative to baseline from 120 minutes onward (P < 0.001). In ICU patients, the FGF19 response was blunted, as reflected by significantly lower FGF19 elevations at 120, 150, and 180 minutes (P < 0.05) and significantly lower area under the curve (AUC) values compared with controls (P < 0.001). Gallbladder dysmotility was associated with the impaired FGF19 response in critical illness. The gallbladder ejection fraction correlated positively with FGF19 AUC values (ρ = +0.34, P = 0.045). In 10 of 24 ICU patients, gallbladder emptying was disturbed. These patients had significantly lower FGF19 AUC values (P < 0.001). Gallbladder emptying and the FGF19 response were respectively disturbed or absent in patients receiving norepinephrine. Conclusion: The nutrient-stimulated FGF19 response is impaired in ICU patients, which is mechanistically linked to gallbladder dysmotility in critical illness. This may contribute to disturbed liver metabolism in these patients and has potential as a nutritional biomarker.
- MeSH
- dospělí MeSH
- dyskineze žlučových cest krev MeSH
- fibroblastové růstové faktory krev MeSH
- kritický stav MeSH
- lidé středního věku MeSH
- lidé MeSH
- postprandiální období * MeSH
- senioři MeSH
- studie případů a kontrol MeSH
- žlučové kyseliny a soli krev MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
Pizzala, A. P. Baldry, P. Richelmi, A. Bianchi, P. Micheletti and F. Anderson -- A Computer Literacy Course For Private Practitioners .343 -- Lyn A. Hanmer, P. Pozzi -- Experiences With A Postgraduate Training Programme In The -- German National Professional Society Plummer, and Ann Warnock-Matherson -- CML Implementation For A Diploma Nursing Program 419 -- C. Delafaye, P.H. Maurain, G. Palmer, S. Combe, B. Tissot, C. Alluson, -- P. Brochet, S. Maurice, P.
xxvi, 632 stran : ilustrace, tabulky ; 28 cm
Papillon, G. Lavoie, P. Durant and J.-P. Cléret, P.H. Thoreux, P. Denier and P. Plummer, Jr., T.R. Edens, M.J. Stroud, B.B. Swindell, -- A.R Wheeler and G.R. of Oral Cancer using Principle Component Analysis for Feature Selection -- Mark E. Quality Auditing Protocols -- Aneel Advani, Neil Jones, Yuval Shahar, Mary Goldstein, Mark A.
IFIP world conference series on medical informatics Studies in health technology and informatics
sv. ; 27 cm
- MeSH
- informační systémy MeSH
- lékařská informatika MeSH
- lékařství MeSH
- Publikační typ
- kongresy MeSH
- sborníky MeSH
- Konspekt
- Lékařské vědy. Lékařství
- NLK Obory
- lékařská informatika
Mark Smithers and lain Thomson -- PART SEVEN -- Esophageal Cancer -- 35 Epidemiology, Risk Factors, and PART ONE -- Pancreas -- 90 Anatomy, Physiology, and Embryology of the Pancreas 1062 -- Joseph Fusco, Michael Millis -- 105 Prevention and Management of Complications of Pancreatic Surgery 1239 -- Mark P Pointer Jr. and Douglas P. Plummer, and -- Lawrence L.
Eighth edition 2 svazky ; (xxxii, 2193, I-74 stran) : ilustrace, tabulky ; 28 cm
With comprehensive coverage of all aspects of GI surgery, the 8th Edition offers lavishly illustrated, authoritative guidance on endoscopic, robotic, and minimally invasive procedures, as well as current medical therapies. It’s your one-stop resource for proven, systematic approaches to all relevant adult and pediatric GI disorders and operations. Nakladatelská anotace. Kráceno.
- Konspekt
- Patologie. Klinická medicína
- NLK Obory
- chirurgie
- NLK Publikační typ
- kolektivní monografie
