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Biomedical subjects

E Schober

Publications and source records attributed to E Schober.

At least 19 recordsLinked to original sources
PubMed2006

Obesity among female adolescents in Vienna, Austria--the impact of childhood weight status and ethnicity.

OBJECTIVE: The objective of the study was to analyse prevalence of overweight and obesity among migrant girls in Vienna, Austria, starting at the age of 6 years up to the age of 15 years. DESIGN: In a longitudinal study, the prevalence of overweight and obesity among migrant girls from Turkey and former Yugoslavia was documented and compared with that among Austrian girls in Vienna. SETTING: Medical investigation of medical school authority in Viennese schools. SAMPLE: Seven hundred and ninety girls of low socio-economic status were included in the study. METHODS: Anthropometric data were collected at the age of 6, 10 and 15 years. Body mass was estimated by means of the body mass index (BMI), and percentile curves were used for determining the weight status. MAIN OUTCOME MEASURE: Stature, body weight, BMI, weight status. RESULTS: The prevalence of overweight and obesity was significantly higher among migrant girls at all age groups. The highest percentage of overweight was found among 10-year-old girls from Yugoslavia (nearly 35%) and the lowest percentage of overweight was exhibited in 6-year-old Austrian girls (20%). Being overweight or obese at the age of 6 years increased the risk of being overweight at 10 and 15 years significantly (P < 0.001). Among migrants, this risk was significantly higher than among Austrian girls (P < 0.001). Only 64.8% of Austrian girls, who were overweight/obese at the age of 6 years, were still classified as overweight at the age of 15 years. Among migrant girls, who were overweight at the age of 6 years, 72.0% (Turkish girls) and 78.3% (Yugoslavian girls) remained overweight until the age of 15 years. CONCLUSIONS: Especially girls from former Yugoslavia but also Turkish girls exhibited high rates of overweight and obesity. Prevention should start as early as possible since overweight tends to persist from childhood into adolescence.

Adolescent↗
PubMed2006

Beta-cell autoantibodies in children with type 2 diabetes mellitus: subgroup or misclassification?

BACKGROUND: In adults, a fraction of diabetic individuals with beta-cell autoantibodies has initially non-insulin requiring diabetes clinically appearing as type 2 diabetes mellitus (T2DM), named latent autoimmune diabetes in adulthood (LADA). The occurrence of beta-cell autoantibodies in European children and adolescents with T2DM has not been reported so far. METHODS: The frequency of beta-cell autoantibodies (anti-GAD, anti-IA-2, and anti-ICA) was determined in 7050 diabetic children and adolescents. The type of diabetes was classified by paediatric diabetic specialists based on the clinical presentation. Children with non-insulin dependent T2DM over a one year period were studied separately. RESULTS: A total of 6922 children were clinically classified as having type 1 diabetes (T1DM) and 128 children as having T2DM. Thirty six per cent of the children with T2DM had at least one detectable beta-cell autoantibody. These children did not differ significantly from the children with T2DM and without autoantibodies in respect of age, gender, weight status, lipids, blood pressure, C-peptide, glucose, and HbA1c at manifestation, as well as frequency of anti-thyroidal antibodies and insulin treatment during follow up. In the subgroup of the 38 children with T2DM without insulin requirement over a one year period, autoantibodies occurred in 32%. These 12 children were predominantly obese (67%), female (67%), and in the pubertal age range. CONCLUSION: beta-cell autoantibodies were detectable in a subgroup of initially non-insulin dependent diabetic children and adolescents with the clinical appearance of T2DM. Following the terminology "latent autoimmune diabetes in adulthood (LADA)", this subgroup might be classified as "LADY" (latent autoimmune diabetes in youth).

Adolescent↗
PubMed2006

Evaluation of different DNA sampling techniques for the application of the real-time PCR method for the quantification of cyanobacteria in water.

AIMS: To evaluate different types of sample storage and DNA extraction techniques for the real-time PCR quantification of cyanobacteria in water. METHODS AND RESULTS: Two different filter types for the cell harvest of Microcystis sp. and Planktothrix spp. that were either freeze-dried or stored frozen, and two different methods for DNA extraction were compared. DNA extraction was achieved by standard phenol-chloroform extraction or by a faster commercially available purification kit (DNeasy, QIAGEN). In general there was good agreement between the cell number equivalents of phycocyanin (PC) genotypes that were estimated using the Taq nuclease assay (TNA) between both filter types and the storing of samples. The standard DNA extraction procedure gave higher numbers of PC genotypes when compared with the DNeasy procedure. TNA results obtained from Planktothrix from natural samples extracted with the standard procedure revealed a significant correlation with the cell numbers estimated via the microscope. CONCLUSIONS: Freeze-drying of samples gives quantifiable data. The standard DNA extraction is considered to be the most reliable and accurate, although the DNeasy procedure is useful for early warning monitoring. SIGNIFICANCE AND IMPACT OF THE STUDY: Application of quantitative genotype analysis in cyanobacteria from freeze-dried samples collected during recent and past sampling programmes.

Colony Count, Microbial↗
PubMed2006

Thyroid autoimmunity in children with coexisting type 1 diabetes mellitus and celiac disease: a multicenter study.

BACKGROUND: Children with type 1 diabetes mellitus (DM1) are more prone to developing thyroid autoimmunity (TAI); TAI also occurs more frequently in patients with celiac disease (CD). AIM: To determine whether TAI occurs more frequently in children with coexisting DM1 and CD compared to children with DM1 only, and whether the clinical course of DM1 is influenced by concomitant TAI. PATIENTS AND METHODS: We performed a multicenter retrospective case-control study comparing data from 84 diabetic children with CD (group 1) to 167 diabetic children without CD (group 2), matched by age at DM1 onset, duration of DM1 and center. Markers of TAI, thyroid function and HbA1c were recorded. The TAI follow-up lasted 4.9 +/- 2.8 years. RESULTS: TAI was diagnosed in 13% of children in group 1 and 19% of children in group 2 (ns). Diabetes control was not influenced by TAI in either group. CONCLUSIONS: Occurrence of TAI in diabetic children is not related to coexisting CD. TAI does not lead to worsening of metabolic control in children with DM1.

Adolescent↗
PubMed2005

The 'accelerator hypothesis': relationship between weight, height, body mass index and age at diagnosis in a large cohort of 9,248 German and Austrian children with type 1 diabetes mellitus.

AIMS/HYPOTHESIS: The aim of this study was to investigate whether either increased weight or BMI are associated with the earlier manifestation of type 1 diabetes mellitus in children. METHODS: We evaluated anthropometric measurements in a large cohort of 9,248 patients of European extraction who were diagnosed in the years 1990-2003 in 116 pediatric clinics throughout Germany and Austria. RESULTS: Patients were divided into four groups according to age (0-4.9 years, 5-9.9 years, 10-14.9 years and 15-20 years). Significantly higher standard deviation scores (SDSs) for weight and BMI at diabetes onset were found for both boys and girls in the three younger age groups (up to 14.9 years of age) compared with the reference population (p<0.00001). In addition, the BMI SDS and the weight SDS were significantly higher in the 0-4.9-years age group than in all other groups (p<0.00001), and BMI SDS at onset gradually decreased with increasing age at manifestation (p<0.0001). Over the >10-year study period, there was a continuous rise in the weight-SDS and the BMI-SDS in the cohort (p<0.0001), especially in the 5-9.9-years and the 10-14.9-years age groups. Multivariate analysis revealed a significant influence of male sex and of year of manifestation on BMI SDS (p<0.0001) and demonstrated a negative association between the patients' BMI SDS and age at diagnosis, with a mean annual decrease in BMI SDS of -0.0248 (95% CI -0.0294 to -0.0202, p<0.0001). CONCLUSIONS/INTERPRETATION: A higher BMI was associated with a younger age at diabetes onset. Increased weight gain could therefore be a risk factor for the early manifestation of type 1 diabetes.

Adolescent↗
PubMed2004

[Evaluation of a portable ultrasound device immediately after spiral computed tomography].

AIM: Portable ultrasound devices are an established diagnostic tool. They are frequently used in trauma and emergency wards. Multidetector computed tomography (MD-CT) represents the standard imaging method for many diagnostic questions. In some patients, however, there are findings on CT which remain unspecific. In these cases, a complementary ultrasound (US) examination may help to obtain a specific diagnosis. Aim of this study is the evaluation of a portable US device immediately after MD-CT for further work-up of unclear lesions. METHODS: 257 MD-CT examinations were performed during a 3-week period. A portable US device (LogiqBook, GE Medical Systems, Solingen, Deutschland) was used when a lesion found at MD-CT remained unclear. Time intervals between CT and US as well as US examination times were registered. RESULTS: US was used in 23 of 257 CT examinations (8.9 %), but 3 of these examinations had to be terminated due to unfavourable US conditions. Thus, there remained 19 questions regarding parenchymal lesions in the liver (n = 13), kidney (n = 1) or suprarenal gland (n = 2). Pleural empyema was suspected in the 4 remaining patients. In all of the 20 patients, US helped to narrow down the differential diagnosis of MD-CT results. The mean time span between CT and US was 2.5 min, and the mean US examination time was 6.5 min. CONCLUSION: Portable US immediately after MD-CT helps to narrow down the differential diagnosis of hepatic and pleural lesions with minimal additional effort in time and organization.

Adrenal Gland Diseases↗
PubMed2004

Prevalence of overweight and obesity in male adolescents in Austria between 1985 and 2000. A population based study.

OBJECTIVE: To analyse the prevalence of overweight and obesity in young Austrian men, to describe a possible time trend during the observation period 1985-2000 and to define regional differences within the country. DESIGN: Epidemiological population based investigation (conscript health investigation) comparing aggregated data of four cross-sectional studies. SUBJECTS: Four cohorts of 18 year-old males (1985: n = 50,475, 1990: n = 47,463, 1995: n 39,275, 2000: n = 43,503), in total n = 180,716. METHODS: Measurements of height and weight were performed during the nationwide conscript health investigation. BMI was calculated and overweight was defined as BMI > or = 25.00 kg/m2 and obesity as BMI > or = 30.00 kg/m2. Besides height and weight data, information on place of residence of the young men was used for the study. Chi-squared and Student's t-test were calculated to test group differences with respect to their statistical significance. RESULTS: The prevalence of overweight increased from 10.9% to 15.5% and of obesity from 1.8% to 4.9% during the observation period. A significant regional trend was found with the highest prevalence of overweight and obesity in the Eastern part of Austria (p < 0.001). BMI was 22.12 +/- 0.34 kg/m2 (mean +/- SD) in 1985 and showed a significant increase (p < 0.001) during the study period to 22.71 +/- 0.25 kg/m2. CONCLUSION: Overweight and obesity increased remarkably in young males in Austria between the years 1985 and 2000. The steepest increase was found in the prevalence of obesity and in the Western part of Austria. A significant regional difference could be documented during the whole study period.

Adolescent↗
PubMed2003

Eating disorders and type 1 diabetes mellitus in adolescence.

One of the main difficulties in managing type 1 diabetes mellitus (T1DM) in the young is nutritional treatment. Studies have shown that adolescents (particularly adolescent girls and young women) have an increased risk for clinical and sub-clinical eating disorders. Adjustment to the nutritional regimen and, consequently, to the management of the disease in adolescence seems to involve a complex interplay of various psychosocial and biological aspects. The aim of this review is to consider the relationship between T1DM and eating disorders in adolescence in the light of some important biological psychological and familial factors. Further research is required in order to detect the degree of the interactions between these factors in adolescents with T1DM.

Adaptation, Psychological↗
PubMed2003

["Disappearance" of retroperitoneal vessels - a case report].

We report the ultrasound findings in a case of pneumo-retroperitoneum. The 74-year-old patient was admitted because of severe dyspnoea. Chest X-ray revealed a left-sided pleural effusion, and a drainage was performed. Later on the patient for the first time complained about severe pain in the lower abdomen. Ultrasound of the abdomen was performed. Sonographically, it was remarkably difficult to obtain images of the right kidney and the retroperitoneal vessels, as massive reverberation artifacts in the retroperitoneum were present. Plain radiography of the abdomen revealed free retroperitoneal and intraabdominal gas. At laparotomy a perforated diverticulitis of the sigma was discovered. Postoperative follow-up was uneventful, but the recurrent pleural effusion was later confirmed to be due to a malignant mesothelioma. This article discusses the characteristic sonomorphologic features of pneumo-retroperitoneum and its differential diagnosis. Although free retroperitoneal air is a rare condition, it is crucial for the examiner to be aware of the characteristic sonographic findings in order to initiate appropriate therapy.

Aged↗
PubMed2003

European Union diabetes indicators: fact or fiction?

Diabetes mellitus is one of the major causes of morbidity and mortality in EU/EFTA countries. Monitoring risk factors for diabetes and its complications will offer the possibility to evaluate the development in time as well as the influence of possible interventions. In this investigation a list with core and secondary indicators is proposed. Availability of these indicators and their data sources is discussed. An important variability of data sources is used in EU/EFTA countries, interfering with the comparability of the outcome. Further harmonisation as well as continuous evaluation of data sources will be necessary to provide reliable tools to monitor diabetes mellitus and its outcome on a routine basis.

Comorbidity↗
PubMed2003

Prevalence of celiac disease and follow-up of EMA in children and adolescents with type 1 diabetes mellitus.

BACKGROUND: The prevalence of celiac disease (CD) in children with diabetes mellitus type 1 (DM) is significantly higher than in the nondiabetic population. Most patients with DM and associated CD do not experience typical gastrointestinal symptoms of CD. There is no agreement on the necessity of screening and management of silent CD for patients with DM or on the time scale for screening. Only few data on follow-up evaluation of children with DM and CD-related antibodies are available. METHODS: One hundred fifty-seven patients with DM (mean age, 14.8 years; range, 4-21 years; male, 83) were screened with endomysial antibodies (EMA) between 1993 and 2001. A follow-up period of at least 3 years, with at least 2 EMA measurements, was possible. Group 1 comprised 37 patients whose first measurement was at the onset of DM. Group 2 comprised 120 patients whose first measurement was during the course of the disease. In patients with positive EMA, small bowel biopsy was performed. Thyroid peroxidase (TPO), thyroglobulin (TgA), glutamate decarboxylase (GAD), antiinsulin (IAA), and islet cell antibodies (IA2) were measured in all patients. RESULTS: EMA was positive in 16 patients, in 5 at onset of DM and in 11 during the course of DM (mean duration, 33.6 months; range, 11-105 months). Biopsy results showed normal mucosa in seven patients, increased intraepithelial lymphocyte counts in one, and flat mucosa in eight. There was no significant difference between EMA-positive and EMA-negative patients regarding height, weight, HbA1c level, frequency of hypoglycemia or hyperglycemia, TPO, TgA, GAD, IAA, or IA2. CONCLUSION: This study emphasizes the high prevalence of CD in patients with DM. Although several patients already had positive EMA titers at the onset of DM, seroconversion may also occur during the course of the disease. Screening for CD with EMA or tissue transglutaminase should be included in the initial investigation of DM, but should also be repeated over time to detect late seroconversion.

Adolescent↗
PubMed2002

Enteroclysis in adult celiac disease: diagnostic value of specific radiographic features.

The purpose of this study was to compare the diagnostic accuracy of various radiographic findings at enteroclysis in adult patients with untreated celiac disease. Twenty-seven adult patients underwent enteroclysis because of unspecific intestinal symptoms before definitive biopsy proof of celiac disease. Enteroclysis of 123 subjects with similar clinical presentation, including abdominal pain, diarrhea, occult intestinal bleeding, and weight loss, who had a definitive diagnosis other than celiac disease, served as controls. The radiographic features previously described in the literature as indicative of adult celiac disease (i.e., fold thickening, decrease of jejunal folds, increase of ileal folds, small bowel dilatation, flocculation) were evaluated in blinded fashion in all studies and the subjective likelihood of diagnosis of celiac disease was assessed. Assessing every finding separately, each feature proved to have a high specificity (78-100%) but low sensitivity (19-59%) for celiac disease. Reversal of jejunoileal fold pattern was the single best feature (specificity 100%, 95% CI 97-100%; sensitivity 59%, 95% CI 40-78%); however, combination of criteria enables establishment of the diagnosis of celiac disease quite accurately (specificity 100%, 95% CI 98-100%; sensitivity 78%, 95% CI 58-91%). Reversal of jejunoileal fold pattern as a single finding as well as combination at least three of the following features, i.e., fold thickening, decrease of jejunal folds ("colonization"), increase of ileal folds ("jejunization"), dilatation, and flocculation, make enteroclysis an accurate tool for diagnosis of celiac disease in adult patients with suspected intestinal disease.

Adult↗
PubMed2001

Incidence of Type I diabetes mellitus in children and young adults in the province of Upper Austria, 1994-1996.

AIM/HYPOTHESIS: The aim of our study was to determine the incidence rate of Type I (insulin-dependent) diabetes mellitus in the 15-30 years age group in a well-defined province in Austria and to compare this with the incidence rate of childhood-onset diabetes mellitus in the age group 0-15 over a 3-year period. METHODS: Incident cases of Type I diabetes were reported by the local departments of medicine and paediatrics prospectively to the Austrian Diabetes incidence registry. Completeness of ascertainment was calculated by the capture-recapture method. RESULTS: The incidence rates per 100,000 person-years for Type I diabetes in the Austrian province of Upper Austria were 8.99 (7.02-11.4, 95%-CI) for the 0-15 years age group and 7.1 (5.5-9.0, 95%-CI) for the 15-30 years age group. The estimated completeness of ascertainment was 93 % (89.0-97.1%, 95%-CI) for children and 87% (84.1-89.9%, 95%-CI) for young adults. Sex differences were evident in young adults, with a 1.6-fold increased risk in males older than 15 years and 2.2-fold increased risk in men over 20 years of age. CONCLUSION/INTERPRETATION: Our study shows that the incidence rate of Type I diabetes in Austria after the age of 15 years is similar to the incidence rate in childhood. An unexplained male predominance in patients older than 20 years could be observed as in sevc ral other countries.

Adolescent↗
PubMed2001

Ultrasound with Levovist in the diagnosis of suspected calf vein thrombosis.

Diagnosing calf vein thrombosis (CVT) by color Doppler ultrasound (US) is often a difficult task because of swelling or obesity. The purpose of this study was to assess if IV infusion of Levovist can improve the accuracy and reduce the rate of indeterminate examinations. A total of 20 patients with suspected CVT underwent color Doppler US without and with Levovist followed by ascending venography as the "gold standard," which detected calf clots in 7 patients (35%). Compared to routine noncontrast sonography, Levovist examination reduced the rate of indeterminate scans from 55% to 20% and improved the specificity for the detection of CVT from 25% to 67% without compromising sensitivity (100% to 86%) notably. Image quality was improved in 13 (65%) of 20 scans. In conclusion, we can say that Levovist improves the quality of duplex examination of the calf veins, especially in cases with difficult conditions due to obesity or swelling.

Contrast Media↗
PubMed2001

Normalization of pregnancy outcome in pregestational diabetes through functional insulin treatment and modular out-patient education adapted for pregnancy.

AIM: To investigate whether modular out-patient group education for flexible, Functional Insulin Treatment (FIT) adapted for pregnancy can eliminate diabetes-associated neonatal complications in pregestational diabetes. RESEARCH DESIGN AND METHODS: Outcome analysis of the modular out-patient group education and FIT based on separate insulin dosages for fasting, eating or correcting hyperglycaemia in 76 consecutive pregnancies (in 20 cases first after conception) of 59 patients with pregestational diabetes (Type 1 diabetes, n = 54). CONTROLS: (a) diabetic pregnancies: historical controls; (b) non-diabetic pregnancies: retrospective case-controlled study; (c) population-based data of all Austrian newborns registered within the respective time period. RESULTS: HbA1c of 113 +/- 18% of mean value (= 100%) of non-diabetic, non-pregnant population (103 +/- 14% during the last pregnancy trimester), and self-monitored blood glucose of 5.6 +/- 0.7 mmol/l (5.3 +/- 0.7 mmol/l during the last trimester) was achieved throughout all FIT pregnancies. Severe hypoglycaemia occurred in 14 pregnancies. The gestational age at delivery was 39.2 +/- 1.5 weeks (four cases (5.4%) < 37 weeks) with a birth weight of 3305 +/- 496 g. Four newborns (5.3%) were above the 90th, and nine (11.8%) below the 10th percentile for weight of reference population-based data. Hypoglycaemia was recorded in six newborns (8%). Malformations were found in two infants whose mothers booked for diabetes FIT education only after conception. The caesarean delivery rate was 25%. In comparison with historical diabetic pregnancy controls we demonstrated a reduction in major complications, and compared with non-diabetic women, a lowering of diabetes-related neonatal complication rates to general population levels. CONCLUSIONS: Structured, comprehensive, modular out-patient group education promoting self-choice of insulin dose for flexible, normal eating prior to conception normalizes pregnancy outcome in diabetes.

Adult↗
PubMed2001

Influence of a beta-glucan-enriched bedtime snack on nocturnal blood glucose levels in diabetic children.

BACKGROUND: The high prevalence of low nocturnal blood glucose levels is a major problem in the treatment of children with diabetes. METHODS: The effect of a beta-glucan-enriched bedtime snack on nocturnal blood glucose levels was examined in comparison with an equicaloric conventional snack in 38 children with diabetes during a 12-night study period. RESULTS: A significant influence of the type of bedtime snack on the blood glucose course until 2 AM could be observed (P < 0.05). However, there was no difference in the prevalence of nocturnal hypoglycemic blood glucose levels, which was 27% at 2 AM. CONCLUSION: Silent nocturnal hypoglycemia is common in children with diabetes. The introduction of a fiber-enriched bedtime snack may flatten the blood glucose curve before midnight but cannot prevent low 2 AM blood glucose. Other therapeutic strategies that reduce the risk of asymptomatic and symptomatic nocturnal hypoglycemia would be beneficial to many children with diabetes.

Blood Glucose↗