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Biomedical subjects

M J Müller

Publications and source records attributed to M J Müller.

At least 73 records · Page 4Linked to original sources
PubMed2000

No effect of gender on different components of daily energy expenditure in free living prepubertal children.

BACKGROUND: There are limited and controversial data on the influence of gender on metabolic rate in prepubertal children. OBJECTIVE: To assess the effect of gender on resting energy expenditure (REE), activity-related energy expenditure (AEE), total energy expenditure (TEE) and physical activity level (PAL) in free-living prepubertal children. DESIGN: Cross-sectional study. SUBJECTS: 40 prepubertal children (24 boys, 16 girls, 4-11 y old (mean age: 7.0 +/- 1.2 y), BMI 13.1-32.0 kg/m2). MEASUREMENTS: Energy expenditure was measured by the combination of indirect calorimetry and individually calibrated 24 h heart rate monitoring. Body composition was assessed by anthropometrics and bioelectrical impedance analysis. Socio-cultural and socio-economic factors, as well as activities of daily living, were estimated by questionnaire for the parents. Boys and girls were matched for fat-free mass (FFM, boys: 25.9 +/- 8.5 kg; and girls: 24.4 +/- 4.5 kg, n.s.) and fat mass (FM, boys: 11.6-5.9 kg; and girls: 10.8 +/- 3.3 kg, n.s.). RESULTS: We found no sex difference in REE, AEE and TEE. PAL was 1.4 +/- 0.3 for boys and 1.2 +/- 0.4 for girls. REE and TEE were significantly related to FFM (r=0.62, r=0.81, r=0.60). FFM was found to be the most significant determinant of REE (r2=0.70). REE accounted for the largest part of the variance in TEE (r2=0.46). Gender had no significant effect. CONCLUSIONS: There is no effect of gender on energy expenditure in prepubertal children.

Basal Metabolism↗
PubMed2000

Metabolically active components of fat free mass and resting energy expenditure in nonobese adults.

Resting energy expenditure (REE) and components of fat-free mass (FFM) were assessed in 26 healthy nonobese adults (13 males, 13 females). Detailed body composition analyses were performed by the combined use of dual-energy X-ray absorptiometry (DEXA), magnetic resonance imaging (MRI), bioelectrical impedance analysis (BIA), and anthropometrics. We found close correlations between REE and FFM(BIA) (r = 0.92), muscle mass(DEXA) (r = 0.89), and sum of internal organs(MRI) (r = 0.90). In a multiple stepwise regression analysis, FFM(BIA) alone explained 85% of the variance in REE (standard error of the estimate 423 kJ/day). Including the sum of internal organs(MRI) into the model increased the r(2) to 0.89 with a standard error of 381 kJ/day. With respect to individual organs, only skeletal muscle(DEXA) and liver mass(MRI) significantly contributed to REE. Prediction of REE based on 1) individual organ masses and 2) a constant metabolic rate per kilogram organ mass was very close to the measured REE, with a mean prediction error of 96 kJ/day. The very close agreement between measured and predicted REE argues against significant variations in specific REEs of individual organs. In conclusion, the mass of internal organs contributes significantly to the variance in REE.

Absorptiometry, Photon↗
PubMed2000

Reliability and validity of the German version of the European Addiction Severity Index (EuropASI).

OBJECTIVE: This study provides data on the psychometric characteristics of the German version of the European Addiction Severity Index (EuropASI). The ASI is a frequently used clinical and research instrument that measures problem severity among people with substance dependence. METHOD: The German ASI was used in a sample of 112 consecutively admitted male psychiatric inpatients seeking treatment for severe alcohol problems. The conceptual structure of the German ASI subscales was investigated by analyzing the intercorrelations of the severity ratings and composite scores. Internal consistency, interrater reliability and concurrent validity in terms of correlations with other assessment instruments were evaluated. RESULTS: The German ASI subscales proved to be independent or moderately correlated (-0.17 < r < 0.34). Each correlation coefficient between corresponding severity ratings and composite scores was significant (p < .0005), ranging from r = 0.47 to r = 0.93. Reliability measures indicated moderate to good internal consistency (Cronbach's alpha: 0.69-0.92) and moderate to excellent interrater reliability (intraclass correlation coefficient: 0.62-0.99). Validity was supported by significantly higher ratings in the alcohol section in alcohol dependent patients compared to patients without dependence (t = 2.99, 108 df, p = .004). Significant correlations (p < .001) were found between the alcohol use section and the Michigan Alcoholism Screening Test (r = 0.34 composite score and r = 0.44 severity rating) and between psychiatric status and the Symptom Checklist-90-revised (r = 0.55/0.51), supporting concurrent validity. CONCLUSIONS: The German version presented evidence of acceptable psychometric properties and its applicability in German-speaking countries could be confirmed.

Adult↗
PubMed2000

Carbohydrate-deficient transferrin (CDT) and HDL cholesterol (HDL) are highly correlated in male alcohol dependent patients.

BACKGROUND: Serum levels of total HDL cholesterol (HDL) are reportedly influenced by recent alcohol intake. We examined the correlation between HDL cholesterol and widely used markers of excessive alcohol intake, such as carbohydrate-deficient transferrin (CDT), gamma-glutamyl-transferase (GGT), or mean corpuscular volume of erythrocytes (MCV), of which CDT is thought to be the most specific. METHODS: Several serological markers [i.e., CDT, GGT, aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), MCV, and HDL] were determined in 100 actively drinking male patients with alcohol dependence (DSM-IV) and in 27 non-alcohol-dependent controls, according to routine procedures. Spearman's rank correlation coefficients were calculated. RESULTS: We found a highly significant positive correlation between HDL and CDT (r(s) = 0.55; p < 0.0005) in patients, but not in controls (r(s) = 0.13;p = 0.51). HDL was also positively correlated with GGT, ALAT, ASAT, and MCV only in patients. CONCLUSIONS: HDL cholesterol, as a widely determined parameter, may represent a useful routine marker for recent excessive alcohol intake. High HDL cholesterol levels should alert clinicians to investigate a patient's recent pattern of alcohol consumption.

Adolescent↗
PubMed1999

Antipsychotic effects and tolerability of the sigma ligand EMD 57445 (panamesine) and its metabolites in acute schizophrenia: an open clinical trial.

Antipsychotic efficacy and side effects of the selective sigma ligand EMD 57445 (panamesine) were investigated in 12 patients (6 males, 6 females) who met DSM-III-R criteria for schizophrenia. A 4-week open clinical study revealed only modest effects of EMD 57445 and its metabolites on positive and negative symptoms of schizophrenia. Extrapyramidal and other side effects were moderate, although a significant increase in mild dyskinetic movements was found. Five patients, four of whom were females, completed the trial. Dropouts were mainly due to treatment failure. Antipsychotic effects were significantly greater in female than male patients.

Acute Disease↗
PubMed1999

Occupancy of striatal D(2)-like dopamine receptors after treatment with the sigma ligand EMD 57445, a putative atypical antipsychotic.

RATIONALE: EMD 57445 (panamesine) is a high affinity sigma ligand with the profile of an atypical antipsychotic in animal studies. It has been reported recently to have antipsychotic activity in schizophrenia. However, its metabolite, EMD 59983, binds also to D(2) and D(3) dopamine (DA) receptors. OBJECTIVES: The aim of this study was to test, using single photon emission computed tomography (SPECT) and [(123)I]iodobenzamide (IBZM) as the radiotracer, whether EMD 59983 would pass the blood-brain barrier and to what extent it would contribute to the effects of EMD 57445 in schizophrenia. METHODS: Two IBZM SPECT-scans were performed in five neuroleptic-free schizophrenic patients (DSM IV), one before and one after treatment with 60 mg panamesine daily for a treatment duration of 12-26 days. RESULTS: A high occupancy of striatal D(2)-like DA receptors similar to that induced by typical neuroleptics was observed in all patients treated with EMD 57445. CONCLUSIONS: Our results suggest that a possible antipsychotic activity of EMD 57445 in schizophrenia is not necessarily attributable to its affinity for sigma receptors, but could be simply due to the potent antidopaminergic effects of EMD 59983, its main metabolite.

Adult↗
PubMed1999

Physical activity and diet in 5 to 7 years old children.

OBJECTIVE: To assess the possible associations between physical activity, diet, social state and overweight in children. DESIGN: Cross-sectional study on 1468 children aged between 5 and 7 years old in Kiel, northwest Germany. METHODS: Assessment of physical activity and social factors by a questionnaire, food frequency record, body composition analysis by anthropometrics and bioelectrical impedance analysis. RESULTS: 23% of our children were overweight or obese. Low levels of physical activity (as assessed by TV viewing time) were associated with increased body mass index and a higher prevalence of overweight. TV-viewing of more than 1 h per day was associated with a high consumption fast food, sweets, chips and pizza whereas fruits and vegetables were less frequently consumed. Overweight, inactivity and unhealthy eating habits were seen more frequently in families with a low social status. CONCLUSIONS: In 5 to 7 years old children, overweight is associated with physical inactivity, unhealthy eating habits and a low social status. Primary prevention efforts should be directed to low income families.

Child↗
PubMed1999

Increased lipid utilization in weight losing and weight stable cancer patients with normal body weight.

OBJECTIVE: Cachexia and weight loss are frequently seen in cancer patients. We investigated lipid metabolism to elucidate a metabolic basis for adequate nutrition of cancer patients. DESIGN: Lipid metabolism was assessed by indirect calorimetry and triglyceride clearance rates after randomised injection of a lipid bolus (long-chain triglycerides (LCT) or medium-chain triglycerides (MCT) during an euglycemic clamp protocol in cancer patients. SETTING: Rudolf-Virchow Krankenhaus, Berlin, Germany. SUBJECTS: Eighteen patients were included. Twelve patients had upper gastrointestinal cancer: a weight stable cancer group (Caws, n = 6) with a body mass index (BMI) of 22.9 +/- 1.7 kg/m2 and a weight losing cancer group (Cawl, n = 6) with a mean weight loss of 7.4 +/- 3.1 kg or 11% of the initial body weight during the previous three months (present BMI 21.8 +/- 0.8 kg/m2). The data were compared with six control patients with benign gastrointestinal diseases (BMI = 25.0 +/- 0.8 kg/m2). MAIN OUTCOME: Cancer patients had an increased basal lipid oxidation rate that was more pronounced in Cawl (+92% vs +42% in Caws; P < 0.01 and 0.05 vs controls, respectively). Utilisation of LCT was increased in cancer patients, this was most pronounced in Cawl (+150 vs +65% in Caws; P < 0.01 and 0.05, respectively). Metabolically, there were no differences in the utilisation of LCT and MCT/LCT containing lipid emulsions. CONCLUSIONS: Cancer patients have an increased lipid oxidation and an enhanced utilisation of exogeneous lipids. This is most pronounced in Cawl. To prevent further weight loss or to increase body weight, they should increase their fat intake. In contrast, fat-reduced or prudent diets seem to be inadequate for the nutrition of cancer patients.

Area Under Curve↗
PubMed1999

Hypermetabolism in clinically stable patients with liver cirrhosis.

BACKGROUND: Hypermetabolism has a negative effect on prognosis in patients with liver cirrhosis. Its exact prevalence and associations with clinical data, the nutritional state, and beta-adrenergic activity are unclear. OBJECTIVE: We investigated resting energy expenditure (REE) in 473 patients with biopsy-proven liver cirrhosis. DESIGN: This was a cross-sectional study with a controlled intervention (beta-blockade) in a subgroup of patients. RESULTS: Mean REE was 7.12 +/- 1.34 MJ/d and correlated closely with predicted values (r = 0.70, P < 0.0001). Hypermetabolism was seen in 160 patients with cirrhosis (33.8% of the study population). REE was > 30% above the predicted value in 41% of the hypermetabolic patients with cirrhosis. Hypermetabolism had no association with clinical or biochemical data on liver function. REE correlated with total body potassium content (TBP; r = 0.49, P < 0.0001). Hypermetabolic patients had lower than normal body weight and TBP (P < 0.05). About 47% of the variance in REE could be explained by body composition whereas clinical state could maximally explain 3%. Plasma epinephrine and norepinephrine concentrations were elevated in hypermetabolic cirrhotic patients (by 56% and 41%, respectively; P < 0.001 and 0.01). Differences in REE from predicted values were positively correlated with epinephrine concentration (r = 0.462, P < 0.001). Propranolol infusion resulted in a decrease in energy expenditure (by 5 +/- 3%; P < 0.05), heart rate (by 13 +/- 4%; P < 0.01), and plasma lactate concentrations (by 32 +/- 12%; P < 0.01); these effects were more pronounced in hypermetabolic patients (by 50%, 33%, and 68%, respectively; each P < 0.05). CONCLUSIONS: Hypermetabolism has no association with clinical data and thus is an extrahepatic manifestation of liver disease. Increased beta-adrenergic activity may explain approximately 25% of hypermetabolism.

Adult↗
PubMed1999

[Alcohol and body weight].

Alcohol intake contributes to energy balance. Chronic and moderate alcohol consumption (i.e. 20-40 g/day) plus a high fat intake (i.e. > 40% of energy intake) favor a positive energy balance and thus weight gain. By contrast a high alcohol intake (i.e. > 20% of energy intake) may lead to malnutrition depending on the concomitant nutrient intake. It is evident that alcohol cannot be considered as an "empty" calorie. Energy wasting mechanisms, which have been proposed by some authors, are unlikely to contribute to energy balance in healthy subjects. Our present knowledge on the energetic value of alcohol mainly depend on physiologic data based on the measurements of energy and substrate balances. By contrast epidemiologic data on the effect of alcohol intake on body weight are contradictory. This is explained by the limitations of epidemiological studies as well as by the possible contributions of other life style-related factors. It is evident that many studies on the effect of alcohol on body weight are uncontrolled studies. It is surprising that although 100 years of research have gone in this area we still have no definite answer to the question.

Alcohol Drinking↗
PubMed1999

[Sexual dissatisfaction and somatic complaints in male infertility].

Several relevant sociodemographic and psychological variables were assessed in addition to clinical and andrological examinations in order to find predictors for sexual satisfaction and somatisation in 68 infertile men of involuntarily childless couples. Subjects reported relatively high average levels of both sexual satisfaction and somatisation, with considerable variance between subjects. Multiple regression analyses revealed that neither age, attitudes towards sexuality, nor andrological findings had an influence on sexual satisfaction. However, an inverse relationship between sexual satisfaction and somatisation was found. Furthermore, a short-lasting partnership and high sexual dissatisfaction prior to the diagnosis of infertility could be unveiled as risk factors for somatisation in infertile men. These results propose state and trait characteristics of sexual satisfaction and suggest a buffering role of longer lasting and sexually satisfying partnerships with respect to the distress of infertility. The promising results need confirmation by repeated investigation. Other possible influences, e.g. styles of coping, should be included in future studies.

Adult↗
PubMed1998

Evaluation of standardized rater training for the Positive and Negative Syndrome Scale (PANSS).

The Positive and Negative Syndrome Scale (PANSS) is employed increasingly for the evaluation of therapeutic outcome in studies on schizophrenia. Rater training is important to improve the concordance and accuracy of ratings; however, there are no established guidelines for carrying out such training. We conducted rater training, under clinical conditions, of psychiatrists and clinical psychologists who were rather unfamiliar with the PANSS. Based on videotapes of PANSS interviews, all participants were trained during five successive standardized weekly sessions. The results were analyzed with respect to conventional criteria of concordance with standard expert ratings and interrater reliability. The main objective was to evaluate the number of training sessions which are necessary and sufficient to achieve acceptable PANSS rating results. Additionally, differences in training outcome for positive, negative and general psychopathological symptoms and between subgroups of different clinical and PANSS experience were considered. After three weekly sessions, satisfactory concordance of about 80% of clinicians on the PANSS total scale was obtained. However, in comparison with the positive and general psychopathological subscales, the PANSS negative-symptom subscale yielded somewhat less satisfactory results, with about 70% of the raters achieving sufficient accuracy. Intraclass correlations corroborated these findings. No substantial differences in training outcome were found between subgroups of different clinical and PANSS experience. We conclude that at least three standardized PANSS training sessions are recommended to obtain satisfactory accuracy of ratings.

Adult↗
PubMed1998

Lipoprotein-X in patients with cirrhosis: its relationship to cholestasis and hypercholesterolemia.

Lipoprotein-X (Lp-X) is an abnormal low-density lipoprotein frequently found in liver disease. It is regarded as the most sensitive and specific biochemical parameter for the diagnosis of intra- and extrahepatic cholestasis. Moreover, Lp-X is supposed to contribute to the development of hypercholesterolemia in cholestatic liver disease, because it fails to inhibit de novo cholesterol synthesis. This investigation will focus on the relationship between the presence of Lp-X and serum lipid concentrations in cirrhosis. The significance of Lp-X in the diagnosis of cholestasis, compared with alkaline phosphatase (AP), gamma-glutamyl transferase (GGT), and bilirubin levels, will be assessed as well. The present cross-sectional study includes 212 patients with histopathologically proven cirrhosis. The detection of Lp-X and the quantification of -, beta-, and pre-beta-cholesterol was based on agar gel electrophoresis and polyanion precipitation. For the characterization of liver function, the concentrations of albumin and bilirubin, the activities of liver enzymes, and coagulation times were assessed. In a subgroup of 40 individuals, liver biopsies were re-evaluated to confirm or exclude intrahepatic cholestasis. As a result, there was no association between the appearance of Lp-X and total cholesterol concentrations. While all patients with Lp-X showed intrahepatic cholestasis (predictive value of the positive test = 1), only 16 of 28 patients with cholestasis formed Lp-X (sensitivity = 0.57). The activities of AP and of GGT, as well as the concentrations of bilirubin, were strongly elevated in most patients, with and without cholestasis. The predictive values of AP, GGT, and bilirubin were 0.77, 0.69, and 0.74 for the positive test and 0.5, 0, and 0.6 for the negative test, respectively. We conclude that Lp-X is not related to hypercholesterolemia in cirrhosis. The positive, but not the negative, Lp-X test has high predictive value for the diagnosis of cholestasis in cirrhosis. The biochemical parameters traditionally used for the assessment of extrahepatic cholestasis, AP, GGT, and bilirubin, do not support the diagnosis of intrahepatic cholestasis caused by cirrhosis.

Adult↗