Hugo Smeets - Academia.edu (original) (raw)

Papers by Hugo Smeets

United European Gastroenterology Journal, 2016

Mesenchymal stem cells (MSCs) have been reported to be a valuable cell source in regenerative med... more Mesenchymal stem cells (MSCs) have been reported to be a valuable cell source in regenerative medicine, and bone marrow represents a major source of MSCs. Recently, it has been shown that MSC can be easily isolated from human amnion, which is generally discarded after delivery, and a large amount of cells can be obtained. We have previously reported that intravenous administration of human amnion-derived MSCs (hAMSCs) provided significant improvement in rats with colitis induced by dextran sulfate sodium or girradiation. In addition, conditioned medium (CM) obtained from MSCs contains a variety of humoral factors to improve damaged tissues. In this study, we investigated the effects of hAMSCs and CM in rats with 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced colitis. Aims & Methods: hAMSCs were isolated and expanded by digestion with collagenase, followed by culturing in uncoated plastic dishes. CM was collected by culturing subconfluent hAMSCs with serum-free MEMa for 48 hrs. CM gel was prepared by mixing CM with 2% carboxymethyl cellulose. On day 0, 200 l of TNBS (15 mg/rat) in 30% ethanol was intrarectally administered to the ten-week-old male Sprague-Dawley (SD) rats. One-million hAMSCs were intravenously administered 3 hrs after TNBS treatment, and rats were sacrificed on day 7 for histological examination and quantitative PCR. In another experiment, 400 l of CM gel was intrarectally administered 3 hrs after TNBS treatment, and day 1 and day 2. Results: hAMSC transplantation and CM gel enema significantly improved the endoscopical score, and tended to improve the histological score. Quantitative PCR demonstrated that the expression levels of TNF-, CXCL1 and CCL2 tended to be decreased by hAMSC transplantation and CM gel enema. Infiltrations of CD68-positive macrophages and myeloperoxidase-positive neutrophils were significantly decreased by hAMSC transplantation and CM gel enema. Conclusion: Transplantation of hAMSCs and CM gel enema provided significant improvement in rats with colitis induced by TNBS. hAMSCs or CM from hAMSCs may be new therapeutic strategies inflammatory bowel disease. Disclosure of Interest: All authors have declared no conflicts of interest.

Epidemiology and Infection, 2013

SUMMARYA prospective cohort study using electronic medical records was undertaken to estimate the... more SUMMARYA prospective cohort study using electronic medical records was undertaken to estimate the relative risk (RR) of irritable bowel syndrome (IBS) following acute gastroenteritis (GE) in primary-care patients in The Netherlands and explore risk factors. Patients aged 18–70 years who consulted for GE symptoms from 1998 to 2009, met inclusion/exclusion criteria and had at least 1 year of follow-up data were included. Patients with non-GE consultations, matched by age, gender, consulting practice and time of visit, served as the reference group. At 1 year, 1·2% of GE patients (N = 2428) had been diagnosed with IBS compared to 0·3% of the reference group (N = 2354). GE patients had increased risk of IBS [RR 4·85, 95% confidence interval (CI) 2·02–11·63]. For GE patients, concomitant cramps and history of psycho-social consultations were significantly associated with increased risk. GE patients had increased risk of IBS up to 5 years post-exposure (RR 5·40, 95% CI 2·60–11·24), sugges...

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Gastroenterology, 2011

ABSTRACT Background and aims: Transplant recipients who receive thiopurines (azathioprine and 6- ... more ABSTRACT Background and aims: Transplant recipients who receive thiopurines (azathioprine and 6- mercaptopurine) are at an increased risk of developing non-melanoma skin cancer (NMSC). Patients with inflammatory bowel disease (IBD) are increasingly being treated with thiopurines. The risk of NMSC in this patient group is largely unknown. We investigated the association between thiopurine use and NMSC risk in a large cohort of IBD patients in the Netherlands. Methods: Patients with IBD were identified in an anonymized computerized database of one of the Dutch health insurance companies, including 1.2 million policyholders. From this database, information regarding type of drugs and number of dosages provided to patients were collected between January, 2001 and December, 2009. Each IBD patient was linked to the Dutch nationwide pathology archive (PALGA) to verify the IBD diagnosis and to determine whether a patient had developed NMSC. Cox proportional hazard regression analysis was used to calculate the risk of NMSC in patients with and without thiopurine use, adjusted for type of IBD, gender, age and duration of IBD. Results: A total of 2887 patients with a confirmed IBD diagnosis were included in this study. Of these, 819 patients (28%) used thiopurines. No statistically significant differences were found for type of IBD, gender, age and extent of IBD between thiopurine users and non-users. Disease duration was significantly shorter in users compared to non-users (34 months (SD 45) versus 38 months (SD 48), p=0.03). Eighty-six patients (3%) developed NMSC during 18,727 person years of follow-up. Of these patients, 24 (28%) had used thiopurines. Mean age at NMSC diagnosis was 64 years (SD 12) in thiopurine users compared to 63 years (SD 13) in nonusers (p=0.68). Increasing age and duration of IBD were associated with a higher risk of developing NMSC (adjusted hazard ratio (HR) 1.06, 95% Confidence Interval (CI) 1.04- 1.08 and adjusted HR 1.007, 95% CI 1.002-1.011, respectively). A diagnosis of ulcerative colitis and female gender were associated with a decreased risk of NMSC (adjusted HR 0.62, 95% CI 0.40-0.98) and adjusted HR 0.47, 95% CI 0.30-0.74). Thiopurine use was not associated with an increased risk of developing NMSC (adjusted HR 0.85, 95% CI 0.51- 1.41). Conclusion: In contrast to transplant recipients, thiopurine use in IBD patients is not associated with an increased risk of developing NMSC

Digestive Diseases and Sciences, 2015

Background Microbiotical dysbiosis induced by a Western diet seems to be associated with an incre... more Background Microbiotical dysbiosis induced by a Western diet seems to be associated with an increased risk of developing colorectal cancer (CRC). Few other factors with an effect on the colonic microbiota and their association with CRC have been evaluated. Aim We investigated whether the use of antibiotics is associated with CRC risk. Methods Data on the use of antibiotics and comedication were extracted from a health insurance database for subjects with a diagnostic-related group for CRC between 2006 and 2011 and four age-and sex-matched controls. Antibiotic use was categorized according to the number of prescriptions during a 5-year follow-up period (1-6 years prior to CRC). Multivariable conditional binary logistic regression analysis was used to estimate odds ratios (ORs) and 95 % confidence intervals (95 % CIs) for different levels of use. Results A total of 4029 cases (47 % male, mean age at diagnosis 71 ± 11 years) and 15,988 controls were included. Antibiotics had been prescribed to 2630 (65.3 %) cases and 10,234 (64.0 %) controls (p = 0.13). An increasing use of antibiotics was associated with an increasing risk of CRC [multivariable OR for high (C8 prescriptions) vs. no prescriptions: 1.26, 95 % CI 1.11-1.44, p-trend \0.01]. For each increase of 5 prescriptions, the OR for CRC was 1.05 (95 % CI 1.01-1.09). Conclusion We found an association between the use of antibiotics, especially when used frequently, and the risk of developing CRC. Further studies are needed to establish under which conditions the use of antibiotics increases the risk of developing CRC.

Gut, 2011

Previous studies have suggested a chemopreventive effect of 5-aminosalicylic acid (5-ASA) therapy... more Previous studies have suggested a chemopreventive effect of 5-aminosalicylic acid (5-ASA) therapy in patients with inflammatory bowel disease (IBD). This effect has not been reported in IBD patients using thiopurines. We investigated the association between thiopurine or 5-ASA use and the risk of advanced neoplasia (AN), including high-grade dysplasia and colorectal cancer, in a large cohort of patients with IBD in the Netherlands. PALGA, the nationwide network and registry of histo- and cytopathology in The Netherlands was linked to an anonymised computerised database of a Dutch health insurance company to identify patients with IBD with or without AN. Pharmaceutical data, including type and duration of medication use, were collected between January 2001 and December 2009. Cox proportional hazard regression analysis was used to calculate risk of AN in patients with and without thiopurine or 5-ASA use. A total of 2578 patients with IBD were included. Of these, 973 patients (38%) used 5-ASA, 314 (12%) thiopurines, 456 (18%) both 5-ASA and thiopurines and 835 (32%) none of these drugs. Twenty-eight patients (1%) developed AN during 16,289 person-years of follow-up. Of these, 11 patients (39%) had used 5-ASA, two (7%) thiopurines and one (4%) both drugs. Thiopurine use was associated with a significantly decreased risk of developing AN (adjusted HR 0.10, 95% CI 0.01 to 0.75). 5-ASA therapy also had a protective effect on developing AN, but this was not statistically significant (adjusted HR 0.56, 95% CI 0.22 to 1.40). Thiopurine use protects IBD patients against the development of AN. The effect of 5-ASA appeared to be less pronounced.

Gastroenterology, 2010

Gastroenterology, Volume 138, Issue 5, Pages S-202, May 2010, Authors:Fiona van Schaik; Hugo M. S... more Gastroenterology, Volume 138, Issue 5, Pages S-202, May 2010, Authors:Fiona van Schaik; Hugo M. Smeets; Geert J. van der Heijden; Bas Oldenburg.

Clinical Gastroenterology and Hepatology, 2011

Psychosomatics, 2013

Background: There is a large mortality gap between patients with a nonaffective psychotic disorde... more Background: There is a large mortality gap between patients with a nonaffective psychotic disorder and those in the general population, is associated with both natural and nonnatural death causes. Objective: This study aims to assess whether mortality risks vary for different causes of death according to the duration since diagnosis and age in a large sample of patients with nonaffective psychotic disorder. Methods: Data of patients with nonaffective psychotic disorder (n ¼ 12,580) from 3 Dutch psychiatric registers were linked to the cause of death register of Statistics Netherlands and compared with personally matched controls (n ¼ 124,143) from the population register. Death rates were analyzed by duration since the date of the registered diagnosis of the (matched) patient and their age using a Poisson model. Results: Among patients, the rates of all-cause death decreased with longer illness duration. This was explained by lower suicide rates. For example, among those between 40 and 60 years of age, the rate ratios (RR) of suicide during 2-5 and 4 5 years were 0.52 and 0.46 (p ¼ 0.002), respectively, when compared with the early years after diagnosis. Compared with controls, patients experienced higher rates of natural death causes during all stages and in all age categories, rate ratios 2.35-5.04; p o 0.001-0.025. There was no increase in these rate ratios with increasing duration or increasing age for patients when compared with controls. Conclusions: The high risk of natural death causes among patients with nonaffective psychotic disorder is already present at a comparatively young age. This suggests caution in blaming antipsychotics or the accumulating effects of adverse lifestyle factors for premature death. It is better to proactively monitor and treat somatic problems from the earliest disease stages onward.

Authors' original file for figure 2

Administration and Policy in Mental Health and Mental Health Services Research, 2015

BMC Health Services Research, 2007

Background Evaluation of evidence for the effectiveness of implementation strategies aimed at red... more Background Evaluation of evidence for the effectiveness of implementation strategies aimed at reducing prescriptions for the use of acid suppressive drugs (ASD). Methods A systematic review of intervention studies with a design according to research quality criteria and outcomes related to the effect of reduction of ASD medication retrieved from Medline, Embase and the Cochrane Library. Outcome measures were the strategy of intervention, quality of methodology and results of treatment to differences of ASD prescriptions and costs. Results The intervention varied from a single passive method to multiple active interactions with GPs. Reports of study quality had shortcomings on subjects of data-analysis. Not all outcomes were calculated but if so rction of prescriptions varied from 8% up to 40% and the cost effectiveness was in some cases negative and in others positive. Few studies demonstrated good effects from the interventions to reduce ASD. Conclusion Poor quality of some studies...

Background: The Psychiatric Case Register Middle Netherlands (PCR-MN) registers the mental health... more Background: The Psychiatric Case Register Middle Netherlands (PCR-MN) registers the mental healthcare consumption of over Dutch 760,000 inhabitants in the centre of the Netherlands. In 2010 the follow-up period was over ten years. In this paper we describe the content, aims and research potential of this case register. Description: All mental healthcare institutions in the middle-western part of the province of Utrecht participate in the PCR-MN case register. All in- and out-patients treated in these institutions have been included in the database from the period 2000 to 2010. Diagnosis according to DSM-IV on axis I to IV, visits to in- and out-patient clinics and basic demographics are recorded. A major advantage of this register is the possibility to link patients anonymously from the PCR-MN cohort to other databases to analyze relationships with determinants and outcomes, such as somatic healthcare consumption, mortality, and demographics, which further increases the research pot...

Journal of Global Health, 2020

Nederlands Tijdschrift Voor Geneeskunde, Mar 24, 2014

The Journal of emergency medicine, Jan 21, 2015

Acute involuntary psychiatric admissions (AIPA) tend to be applied more often in urban areas. The... more Acute involuntary psychiatric admissions (AIPA) tend to be applied more often in urban areas. The current study aims to describe AIPA prevalence differences between the subdistricts in an urban area, and to identify which district characteristics are associated with a higher AIPA district density. Information was collected on consecutive AIPAs over a 64-month period (2005-2010) in 49 subdistricts in and around the city of Utrecht, the Netherlands, including 1098 AIPAs. District characteristics included several demographic and economical factors and health care characteristics such as number of sheltered living facilities. The AIPA density (mean 4.4/10,000 inhabitants/y) was four to five times higher in the most urbanized subdistrict (around 12) compared to the suburban subdistricts (2.5-3). On the district level, the main correlates with AIPA density per district were unemployment rate and small household size. Other correlates were percentage of non-Western immigrants and number of...

ABSTRACT While there are consistent reports of a high psychosis rate among certain groups of migr... more ABSTRACT While there are consistent reports of a high psychosis rate among certain groups of migrants in Europe, there is little information on their risk for mood disorders. The aim of this study was to investigate the risk of receiving psychiatric treatment for mood disorders or psychotic disorders, comparing migrants and Dutch nationals in an ethnically mixed catchment area. A second aim was to calculate 1-year prevalence rates of psychotic disorders for first-generation migrants. A retrospective cohort study. A psychiatric registry provided information on treatments at all in- and out-patient facilities. Statistics Netherlands provided annual population figures. The risk of receiving treatment for unipolar depressive disorder was increased for the Turkish-Dutch (first and second generation combined; age- and sex-adjusted Relative Risk 4.9; 95% CI: 4.4-5.5), Moroccan-Dutch (RR= 3.6; 3.3-4.0) and Surinamese-Dutch (RR=1.8; 1.5-2.2). The risk of being treated for bipolar disorder was not significantly increased for any group, except for the Turkish-Dutch of the second generation. The risk of treatment for non-affective psychotic disorder was very high for the Turkish-Dutch, Moroccan-Dutch and Surinamese-Dutch of the second generation. There was a large difference in Relative Risk of this disorder between the Turkish-Dutch of the first (RR= 1.3; 1.0-1.8) and the second generation (RR= 8.7; 5.5-13.9). The 1-year prevalence rates of treated psychotic disorders were highest for Surinamese-Dutch (2.1%) and Moroccan-Dutch males (1.2%) of the first generation. Migrants from Western-European countries were not at increased risk for any of these disorders. The mental-health status of non-Western immigrants in the Netherlands is poorer than that of Dutch nationals.

European journal of gastroenterology & hepatology, 2014

Chronic constipation is a common condition, but the exact impact on healthcare budgets in Western... more Chronic constipation is a common condition, but the exact impact on healthcare budgets in Western Europe is poorly documented. The aim of this study was to (a) investigate chronic constipation-related direct medical costs in patients with newly diagnosed chronic constipation and (b) study differences in costs according to natural history. We identified 16 887 patients newly diagnosed with chronic constipation in a Dutch health insurance database (∼1.3 million patients) in 2006-2009. Individuals with chronic constipation were selected on the basis of chronic laxative use (≥90 days/year) and diagnostic related groups for chronic constipation. On the basis of the episodes of laxative use and diagnostic related groups, individuals were categorized as having persistent, episodic, and nonrecurrent disease. Unadjusted costs for laxatives and hospital care for chronic constipation and constipation-related comorbidities were assessed and compared between patients with nonrecurrent, episodic,...

Social Psychiatry and Psychiatric Epidemiology, 2014