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Biomedical subjects

K Widhalm

Publications and source records attributed to K Widhalm.

At least 127 records · Page 7Linked to original sources
PubMed1983

Lipid metabolism in acute renal failure.

Plasma lipid and lipoprotein composition was investigated in acute renal failure (ARF). Forty-seven percent of the patients showed hypertriglyceridemia, whereas serum cholesterol was slightly reduced. Triglyceride (TG) content, predominantly of LDL and to a lesser degree of VLDL, was elevated. Cholesterol concentrations of HDL and LDL fractions were markedly reduced. HDL-TG and VLDL-cholesterol were in the normal range. Forty percent of the patients had a type IV hyperlipoproteinemia. Post-heparin lipolytic activity (PHLA) was reduced owing to an inhibition of hepatic-TG-lipase (HTGL) activity, whereas protamine-inactivated LPL was in the normal range. Fractional elimination (K2) of parenterally administered fat emulsions, determined by an intravenous fat tolerance test (IVFTT) was reduced to 2.44% min, about half of normal. The fat elimination rate increased but did not normalize during parenteral nutrition with amino acids and glucose, suggesting enhanced lipid deposition. Alterations of lipid metabolism develop early in ARF (by 4 days) and, in general, are not influenced by residual renal function, urinary output, or duration of renal failure.

Acute Kidney Injury↗
PubMed1983

[Current status of parenteral feeding with fat emulsions. Clinical experience in children].

Total parenteral nutrition with lipid emulsions is considered to be a standard regimen in Europe treating pediatric diseases since more than 10 years. Due to the high energy requirements during childhood only by administration of fat emulsions the adequate input of energy can be guaranteed. It should be emphasized that i.v. administration of lipid emulsion must be performed continuously (by means of a bypass or with mixed solutions) in a dosage up to 2 g/kg/day. In order to control the function of fat elimination from the vessel system the daily estimation of serum triglycerides, which should not exceed values higher than 150-200 mg/dl during the infusion regime is highly recommended. Parenteral nutrition with fat should be performed according to strict indications; contraindications against administration of fat are severe shock, severe coagulation disturbances and rare forms of lipid disorders (with inability to metabolize fats, such as the inborn Apolipoprotein-C-II-deficiency). Observing all rules including strict sterile cautions, parenteral nutrition with fat serves as a valuable well-experienced tool treating pediatric patients. Beside the known problems with the catheter no problems should be expected.

Child↗
PubMed1983

[Metabolic changes in a 3-week treatment with a low calorie protein-carbohydrate diet in massively obese adolescents].

8 massively obese adolescents (2 girls, 6 boys, mean age 12.6 +/- 2.1 years, mean overweight 74 +/- 14%) were treated for 3 weeks with a very low calory diet (VLCD), containing 240 kcal, 33 g protein, 25.5 g carbohydrates and 0.7 g fat. Mean weight loss after 3 weeks was 9.47 +/- 2.8 kg. The mean loss of total nitrogen was 232.4 +/- 73.2 g. Great individual variations in regard to the amounts of nitrogen loss occurred. The mean nitrogen loss over the period of 21 days was 113.3 +/- 71.2 g. Three patients reached positive nitrogen balance in the third week. No pathological changes could be shown for serum electrolytes and enzymes as well as for glucose, urea and creatinine. At the end of the first week serum uric acid values were elevated, but reached normal values at the end of the diet period. 3 patients were treated with Allopurinol 200 mg for 7 to 14 days. Serum protein concentrations fell significantly from 7.64 +/- 0.3 to 7.0 +/- 0.2 g/dl, whereas serum albumin concentrations remained constant. Cholesterol and LDL-cholesterol fell significantly (p less than 0.001) to "supranormal" values, HDL-cholesterol and triglycerides remained almost constant. 24-h-ECG investigations before, during and after the diet did not reveal any pathological findings.

Adolescent↗
PubMed1983

[Effect of the amount of food as a visible external stimulus on the eating behavior of obese children].

In our study we investigated the influence of different amounts of food, offered to obese children. We compared the food intake of 15 obese children (8 girls, 7 boys mean overweight: 41 +/- 7%) aged 10 to 12 years (mean age: 11,3 +/- 0,8) with matched normal weight children: Obese children consumed significantly more food than the control group, independently of the amount of food offered. Offering higher amounts of food, obese children tended to eat more and increased their food intake significantly. Therefore we suggest, that obese children are more dependent on external stimulus concerning the amounts of offered food than normal weight children.

Appetite↗
PubMed1982

[Platelet half-life in patients with primary hyperlipoproteinemia type IIa, IIb, and IV according to Fredrickson with and without clinical signs of atherosclerosis].

It is generally accepted that platelet half-life is shortened in atherosclerotic vascular disease. Concerning changes due to hyperlipoproteinemia (HLP), however, there exist only few data. Therefore, we examined the platelet-half life in 60 patients with recently discovered HLP type IIa, IIb and IV according to Fredrickson before treatment in comparison to 60 controls. 33 of the HLP-patients had no clinical symptoms of angiopathy, 27 patients suffered from peripheral vascular disease or from coronary heart disease as verified by angiography. The labelling of autologous platelets was performed with 100 microCi of 111Indium-oxine-sulfate at 37 degrees C for 5 minutes. The mean labelling efficiency was 90%, the recovery after 2 hours about 70%. Serum lipoproteins were estimated by means of ultracentrifugation and polyanionprecipitation according to Lipid Research Clinic Methods. In the patients with HLP platelet half-life was significantly shortened in comparison to the control group (p less than 0.01). These changes were most pronounced in patients with HLP-type IIa and with atherosclerotic lesions, respectively. In patients with HLP-type IIa a very close correlation could be demonstrated between platelet half-life and LDL-cholesterol (r = -0.72; p less than 0.001) as well as total cholesterol (r = -0.73; p less than 0.001). These data prove that in HLP in-vivo platelet function as measured by platelet survival is significantly influenced even before the occurrence of clinically relevant symptoms of atherosclerosis.

Adult↗
PubMed1982

Fat elimination in acute renal failure.

Lipid metabolism and elimination of parenterally administered fat were investigated in 15 patients with acute renal failure (ARF). The mean triglyceride level was elevated to 2.56 +/- 1.43 mmol/l and the mean cholesterol level was 3.32 +/- 0.66 mmol/l, which is slightly below the normal range. A type IV hyperlipoproteinaemia was present in 47 per cent of the patients. The triglyceride content of LDL and VLDL was elevated and the cholesterol concentration of HDL and of LDL was reduced markedly. The fractional removal rate of triglycerides (K2) evaluated by an intravenous fat tolerance test using a bolus technique was reduced to 2.44 +/- 1.56 per cent/min which is about half of normal and correspondingly the elimination half life was prolonged to 28.4 min. No correlation could be demonstrated between the impairment of fat elimination and residual renal function, basal and VLDL triglyceride concentration or HDL cholesterol content.

Journal Article↗
PubMed1982

[Transient vitamin-D dependent rickets? a case report differential diagnosis (author's transl)].

The clinical course of a 9-month-old boy with Vit. D resistant rickets receiving treatment course 1-Alpha-hydroxycholecalciferol is described. Patient's response to therapy was excellent, after regression of bone changes and normalization of serum parameters drug treatment was discontinued for differential diagnostic considerations. Even several months later no relapse occurred. Due to this fact and the high concentration of serum 1,25-dihydroxycholecalciferol concentration during therapy the very rare pseudovitamin-D-deficiency type II, which is characterized by a bone receptor defect, was assumed. In contrast, successful treatment with low-dose 1 Alpha-OHCCF indicates that the underlying defect is pseudovitamin-D-deficiency rickets type I, however this form would require lifelong therapy. The differential diagnosis based on recent knowledge of Vitamin-D-metabolism is discussed.

Calcifediol↗
PubMed1982

[Quantitative-histomorphological study of the abdominal aorta in children and adolescents].

127 abdominal aortas of children and adolescents aged 0-20 years were examined histomorphologically. The quantitative analysis gave the following results: (1) The intimal thickness increases continuously with age. The maximal intimal growth can be observed between the 1st and 3rd and the 12th and 19th year of age, respectively. (2) The media exhibits a similar increase in thickness with a maximal growth between the 1st and 3rd and in the 12th year. (3) The intima-media index rises rapidly from birth until the 3rd year, with a plateau thereafter, and then increases again between the 14th and 18th year. (4) The mean values for these measurements were higher in males than in females in all the age groups except for the 1st year.

Adolescent↗
PubMed1982

[Diagnosis, clinical features and treatment of hyperlipidemias in children].

Hyperlipidemias represent one of the most important risk factors for the development of premature atherosclerotic disease. If prevention of ischaemic cardiovascular disease, which is responsible for about 50% of the deaths in Western Europe, should be successful, diagnosis and treatment of hyperlipidemic states should start as early as possible. A short overview concerning the composition and the metabolism of the lipoproteins is given and theoretical and practical aspects for the classification of the different forms of hyperlipoproteinemia during childhood are pointed out. Laboratory determinations are described and therapeutic approaches of the main pediatric hyperlipidemias are given: polygenetic and combined familial hyperlipidemias should be treated by diet alone, whereas familial hypercholesterolemias request drug treatment: cholestyramine, given in doses between 4 and 8 g seems to be the drug of choice. Possible future aspects of drug treatment are discussed, even those who are shown to increase the number of LDL-receptors, which are blocked in that disease. Finally, efforts are emphasized to screen all children of families, in which premature heart disease or hypercholesterolemia occur.

Adolescent↗
PubMed1981

Value of platelet sensitivity to antiaggregatory prostaglandins (PGI2, PGE1, PGD2) in 50 patients with myocardial infarction at young age.

Based upon earlier findings of our group that not only the synthesis of antiaggregatory prostaglandins by the vessel wall is altered in atherosclerotic vascular tissue of patients, but also the sensitivity of their platelets to these prostaglandins is changed, we examined a well defined group of 50 patients with myocardial infarction before the age of 40 years. In all patients the coronary heart disease was verified by angiography. The sensitivity of the platelets was examined in relation ot the smoking habit, the type and presence of hyperlipoproteinemia, one, two and three vessel disease and familial history. Except for hyperlipoproteinemia and smoking, all the patients were free of any additional risk factor. It is demonstrated that the platelet sensitivity to the antiaggregatory prostaglandins is significantly diminished in hyperlipoproteinemics in comparison to a control group.

Adult↗
PubMed1981

[Lipid and lipoprotein metabolism in acute pancreatitis].

In 10 patients with acute pancreatitis the lipid- and lipoprotein-metabolism was studied. In all patients blood samples were drawn for estimation of the fasting concentration of the lipoproteins. In 7 patients the postheparinlipasesystem was testet by an intravenous heparintest. Afterwards, 0.2 g fat/kg bodyweight were injected intravenously in 2 min. Before, 5, 10, 30 and 40 min after injection blood was drawn. Lipids were estimated by means of full encymatic methods, lipoproteins were determined according to the lipid research clinics method, NIH, using a combination of ultracentrifuge and polyanion precipitation. In comparison with healthy people the cholesterol, specially the LDL fraction was low. Additionally the triglycerides were elevated in 3 patients, caused by elevation of the VLDL fraction. After injection of heparin in all patients the triglyceride concentrations fell. That shows a functionating lipoprotein lipase system. Intravenously injected fat was eliminated in all patients with an elimination rate between 1 and 2 %/min. From these results it is concluded that exogenous fat is eliminated sufficiently from serum in acute pancreatitis. There is no sign for disturbed fat metabolism in these patients. Therefore the contraindication for fat emulsions in acute pancreatitis does not seem to be justified. Due to the fact of glucose intolerance in these patients fat emulsions could be used for an adequate supply of energy. Patients with a hyperlipoproteinemia should be excluded from this therapy by daily detection of triglycerides.

Acute Disease↗
PubMed1981

[Effect of body weight reduction on platelet function and serum lipoproteins in obese children (author's transl)].

In 11 obese children aged 11,9 +/- 1,3 years total cholesterol (C), triglycerides (TG), HDL-C, LDL-C and apolipoprotein B (Apo B) were estimated in serum after 3 weeks of hypocaloric diet (800 kcal, kJ). In vitro platelet function was evaluated using the tests of ADP-induced aggregation and platelet sensitivity to prostacyclin. The in vivo platelet activity was judged by estimating plasma levels of beta-thromboglobuline (beta-TG) and platelet factor 4 (PF4). A mean weight loss of 5,7 +/- 1,8 kg was observed. Before diet, serum-C, TG and lipoprotein-C concentrations were found to be within the so called "normal range". After three weeks of diet we observed a significant decrease of total-C, which could be accounted for by a decline in the atherogenic LDL-C; furthermore Apo B levels significantly decreased. Concerning the tests of platelet function only for beta-TG and PF 4 a marked decline (to about 50% of the initial values) could be seen. These preliminary results and changes in the lipoprotein are discussed in connection with a possible reduction of the risk for the development of atherosclerotic lesions.

Adolescent↗
PubMed1980

Glycosylated hemoglobin (HbAtc) and plasma lipoproteins in juvenile onset diabetes mellitus.

Plasma lipid and lipoprotein levels and hemoglobin Atc estimates of diabetic control were measured in 19 juvenile-onset diabetics (8 girls and 11 boys) upon admission (day 1) and at the end (day 25) of a 4-week summer camp, where the patients were put on a controlled diet with a daily linoleic acid intake of about 16g. Lipoproteins were also measured in 64 healthy controls. When values on day 25 were compared with those of day one, a slight but significant decrease in mean hemoglobin Atc (10.4 +/- 0.3 vs. 9.8 +/- 0.4% of total Hb; M +/- S.E.M.; p < 0.05) was noted, as well as in increase in mean high density lipoprotein cholesterol (1.0 +/- 0.07 vs. 1.3 +/- 0.1 mmol/l; M +/- S.E.M.; p < 0.02) and a decrease in mean triglycerides (1.2 +/- 0.1 vs. 0.7 +/- 0.04 mmol/l; M +/- S.E.M.; p < 0.001). A linear correlation was found between hemoglobin AIc on day 25 and urine glucose excretion during the camping period (p < 0.01). However, no relationship was noted between hemoglobin AIc and either lipids or lipoproteins. Other factors, e.g. the controlled intake of saturated fat or physical activity could have responsible for the changes in triglycerides and high-density lipoprotein cholesterol levels noted by the end of the camp.

Child↗
PubMed1980

Childhood obesity: serum lipoproteins, glucose and insulin concentrations after an oral glucose load.

In 15 grossly obese children (10 boys, 5 girls, age: 13,1 +/- 2,4 years, mean overweight 71 +/- 13%) an oral glucose load (45 g/m2) was performed. Blood glucose was determined by means of hexokinase method and serum insulin was estimated by radioimmunoassay. According to the criteria of Rosenbloom our results show, that 5 out of the 15 children must be considered to have abnormal glucose tolerance tests. In comparison to reference values basal serum insulin values were slightly elevated, the corespondending concentrations after the oral glucose load were markedly increased in all children. Furthermore, serum lipoprotein determinations were performed using the Lipid-Research-Clinics-Method, NIH, Bethesda: Comparing the mean LDL-cholesterol and HDL-cholesterol concentrations with those of age and sex matched controls no statistical differences could be found. However, the HDL-cholesterol values showed a tendency towards lower concentrations. Our data suggest that disturbances of carbohydrate metabolism in grossly obese children could be only detected after the performance of an oral glucose tolerance test.

Adolescent↗