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Biomedical subjects

K Widhalm

Publications and source records attributed to K Widhalm.

At least 91 records · Page 5Linked to original sources
PubMed1989

[Follow-up study of severely overweight adolescents 4 years following inpatient weight loss with a low calorie protein-carbohydrate diet].

Very low calorie protein/carbohydrate diets have proved to be efficient and safe in the treatment of obesity in childhood and early adolescence. The follow-up study at issue shows that subsequent to short-term therapy no further reduction in weight is to be expected without adequate care following the diet. Between 1980 and 1983, 27 adolescent patients were treated for severe obesity (78.12% +/- 18.3% overweight, mean +/- s.e.m.) at the metabolic ward of the department of pediatrics, University of Vienna. The administration of a very low calorie protein/carbohydrate diet (VLCD) for 26 (+/- 7) days led to a considerable reduction in overweight (8.1 +/- 2.9 kg). On dismission the percentual overweight had decreased to 59.4 (+/- 24)%. After 4.4 (+/- 0.7) years the weight of 11 of the 27 patients could be controlled, 10 patients refused further cooperation and the remaining 6 could not be addressed. The body mass index (weight/height) had risen from 29.4 (+/- 1.2) to 43.0 (+/- 6.0) with 10 of 11 patients, corresponding to a percentual overweight of 88.2 (+/- 18.1)% at the follow-up date. Only one girl had reduced overweight by 45%, the BMI had fallen from 33.9 to 27.1. Furthermore, our data suggest that obesity induces a significant increase in blood pressure in adolescents. This rise is apparently independent of the age related increase in blood pressure and revertible by weight loss. The results we have to hand show that long-term weight reduction has only been achieved in 1 of 11 cases, with none of the adolescents having participated regularly in an outpatient after-care program.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Platelet viability (aggregation, migration, recovery) after radiolabelling from hypercholesterolemics using various tracers (oxine, oxine-sulphate, tropolone, MPO).

Earlier results indicated a diminished labelling efficiency and recovery negatively linked to actual cholesterol and lipoprotein values in hyperlipoproteinemics. This study was designed to examine whether other alternative tracers exhibit similar results and to study the influence on platelet viability in the presence or absence of PGI2. We demonstrate that no substantial difference occurs between the four tracers concerning labelling efficiency and recovery in normo- and hypercholesterolemics. Cholesterol severely affects the labelling parameters for all the tracers to a comparable extent. The absolute platelet function varies considerably, however, the percent changes in normo- and hypercholesterolemics seen before and after the labelling procedure do not differ significantly. PGI2 improves recovery in general, however, without affecting labelling efficiency or in vitro viability testing. As prolonged incubation further increases labelling efficiency, the presence and extent of hyperlipoproteinemia should be known in order to avoid poor labeling and viability and subsequently poor clinical results.

Adult↗
PubMed1988

Apolipoprotein A-I (Glu 198----Lys): a mutant of the major apolipoprotein of high-density lipoproteins occurring in a family with dyslipoproteinemia.

To detect genetic mutants of apo A-I, the major structural protein of human HDL, we screened 530 unrelated Austrian probands (168 children, 362 adults). An apo A-I mutant characterized by an exchange of the acidic amino acid Glu in position 198 with the basic amino acid Lys was identified in the serum of the mother of a hyperlipoproteinemic girl. So far only two patients with this mutant, referred to as apo A-I (Glu 198----Lys) have been described. We detected six new patients (two children and four adults) with apo A-I (Glu 198----Lys) among 20 members in three generations of the affected family. An autosomal codominant inheritance of the apolipoprotein variant could be established. All affected individuals were heterozygous for the mutant. Among the six new subjects with apo A-I (Glu 198----Lys) two children and one adult presented with high-density lipoprotein (HDL) cholesterol concentrations below the fifth percentile for age and sex and with low serum apo A-I and A-II. Although there was no consistent relationship of the mutant with low serum HDL in this family, a moderate effect of apo A-I (Glu 198----Lys) on HDL levels cannot be ruled out. Hyperlipoproteinemia of types IIa, IIb, and IV was observed in eight of the 20 family members studied, but did not cosegregate with the mutant apo A-I. There was no association of apo A-I (Glu 198----Lys) with premature clinical manifestations of atherosclerosis. The mutation occurred in a part of the apo A-I molecule, which is thought to be involved in lipid binding.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Blood pressure and excretion of sodium, potassium, calcium and magnesium in 8- and 9-year old boys from 19 European centres.

We have measured systolic and diastolic blood pressure and excretions of sodium, potassium, calcium and magnesium in groups of about 50 8- and 9-year-old boys from 19 European centres using standardized methods for the measurement of blood pressure and collection of urine, and by carrying out all analyses in one laboratory. Weight, height, pulse rate and environmental temperature were also studied. Mean systolic blood pressure ranged from 91 to 105 mm Hg and diastolic blood pressure from 51 to 66 mm Hg. Mean 24-h excretion of sodium was between 91 and 146 mmol/d, that of potassium between 29 and 60 mmol/d, that of calcium between 1.5 and 2.6 mmol/d and that of magnesium between 2.7 and 4.2 mmol/d. Mean sodium excretion tended to be lower and potassium excretion tended to be higher in the boys from the north-western parts of Europe. Relations between either systolic or diastolic blood pressure and electrolyte excretions were generally weak or absent. Most remarkable is that only the association between mean diastolic blood pressure and 24-h magnesium excretion (partial regression coefficient (b +/- s.e., -5.04 +/- 2.08 mm Hg/mmol/d) was statistically significant after adjusting for differences in creatinine excretion and environmental temperature. Mean systolic blood pressure was not significantly related with any of the variables measured. The partial regression coefficient (b +/- s.e.) for diastolic blood pressure on weight was 0.186 +/- 0.062 mm Hg/kg, on height 0.165 +/- 0.056 mm Hg/cm, on pulse rate 0.364 +/- 0.100 mm Hg/beats per min and on outside temperature -0.25 +/- 0.07 mm Hg/degrees C.

Blood Pressure↗
PubMed1987

Analysis of fluorescent low density lipoprotein uptake by lymphocytes. Paradoxical increase in the elderly.

Uptake of dioctadecylindocarbocyanine (DiI)-labelled low density lipoproteins (LDL) by peripheral blood lymphocytes (PBL) from young healthy donors has been characterized by flow cytometric analysis. The receptor positive cells were primarily (greater than 70%) T cells. Saturation and competition studies were performed with freshly isolated PBL as well as after a 2-3-day incubation in cholesterol-free medium. In both cases uptake was specific for LDL and not high density lipoprotein. It was also abrogated by chemical modification of apo B, and was not shown by PBL from a patient with familial hypercholesterolemia. DiI-LDL-uptake by cells from elderly donors was compared with that of PBL from young donors. There was a clear increase in uptake by freshly isolated PBL from aged donors which was shown not to stem from underlying "sickness". In contrast, uptake by pre-incubated cells was very variable, in terms of percentage receptor-positive cells and the level of uptake by those cells. However, LDL rescued mevinolin-suppressed mitogen responses from both old and young donors indicating that there is no impairment of uptake or degradation of LDL by PBL from the elderly.

Adult↗
PubMed1987

Potential life-threatening cardiac arrhythmias associated with a conventional hypocaloric diet.

Nine obese children (mean age 12.7 years, mean overweight 74.2%) were treated for 3 weeks with a very low calorie diet containing high quality protein. Eight patients (patients A) received a commercially available diet (240 kcal/1004 kJ/day) and 1 patient (patient B) a homemade dietary regimen (500 kcal/2100 kJ/day). Both preparations were supplemented with micronutrients; however, the daily intake of minerals was significantly less in patient B. All patients were monitored for the appearance of cardiac arrhythmias by frequent 24-hour Holter recordings. In patients A the mean loss of body weight was 9.4 +/- 2.4 kg, patient B lost 8.7 kg. The mean daily nitrogen balance was negative (patients A: 10.2 g/day, patient B: 6.8 g/day). Frequent blood chemistry evaluations were unremarkable. On the 14th day of treatment patient B developed arrhythmias (ventricular couplets, non-sustained ventricular tachycardias); in patients A no ventricular dysrhythmias were observed. Our data suggest that very low calorie diets containing protein of high biologic value can be associated with potentially dangerous arrhythmias.

Adolescent↗
PubMed1987

Paediatric guidelines for lipid reduction.

Due to the fact that atherogenesis starts even in early childhood there is no doubt that the primary prevention of atherosclerotic diseases is a paediatric problem and therefore must start as early as possible in childhood. Thus, there is now indeed strong support for increasing efforts toward identifying those subjects with elevated total cholesterol or low density lipoprotein (LDL)-cholesterol levels and for providing appropriate treatment in order to achieve a substantial and pertinent reduction of those levels. Based on the data from the Lipid Research Clinics Program, the diagnosis of hypercholesterolaemia during infancy and childhood can easily be made, using the 95th percentiles for total cholesterol and for LDL-cholesterol. Today there is no doubt that elevated plasma cholesterol levels should be lowered first by dietary modification even in early childhood, beginning at the age of two years. Most authors report an average cholesterol reduction of about 10-15% by a low cholesterol-low fat diet. Our group had the opportunity to study 11 hypercholesterolaemic children consuming a type II diet containing 15-20 g soybean-protein, which resulted in a reduction of 32% in total cholesterol and 37% in LDL-cholesterol. In an individual patient who does not respond adequately to diet, drug treatment should be started. Bile acid-binding resins in a dose of 4-8 g are the drugs of choice at this time. A further 15-20% reduction of total plasma cholesterol can be achieved in most children. It is concluded that detection and adequate treatment of disorders of lipoproteins should be carried out early in childhood, in particular in families with a cardiovascular history.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1987

Increase of serum lipids and serum lipoproteins in girls under therapy with estrogen and norethisteron for height reduction.

The effect of a combined treatment with ethinyl estradiol and norethisteron for height reduction on serum lipids and lipoproteins was investigated in 23 excessively tall girls (greater than 97th percentile). Serum cholesterol, triglycerides, HDL-C and LDL-C were determined before and 3, 6, 9 and 12 months after the onset and 3 to 12 months after cessation of therapy. Treatment with ethinyl estradiol and norethisteron resulted in significant (p less than 0.01) mean increases in serum cholesterol, triglycerides, HDL-C, and LDL-C of 20.6%, 95.5%, 23.6%, and 22.2% above pretreatment values, respectively. This increase occurred during the first 3 months of therapy and thereafter no further significant change was observed. After cessation of therapy elevated levels returned to pretreatment levels within 3 to 12 months in all but two patients. The results obtained suggest an influence of ethinyl estradiol and norethisteron on serum lipids and lipoproteins. Whether these reversible changes of serum lipids and lipoproteins are associated with an increased risk for developing atherosclerosis has to be evaluated in long term investigations.

Adolescent↗
PubMed1987

[Peculiarities of perioperative nutritional therapy in children].

There is a well known correlation between postoperative morbidity and mortality and the preoperative nutritional status. Due to this fact perioperative nutritional therapy has gained growing importance. In newborns, children, and adolescents several metabolic facts have to be taken into account in the perioperative management which are the topics of this review. Differences in electrolyte, fluid, and nutrient requirements are discussed. The article presents a summary of possibilities in parenteral and enteral nutritional therapy, recommendations and practical guidelines for the treatment of children and adolescents.

Child↗