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Bruck an der Mur, Austria

Mangge H.,Medical University of Graz | Schnedl W.J.,Practice for General Internal Medicine | Schrocksnadel S.,Innsbruck Medical University | Geisler S.,Innsbruck Medical University | And 2 more authors.
Pteridines | Year: 2013

Higher serum neopterin concentrations and kynurenine-to-tryptophan (Kyn/Trp) ratios are associated with increased mortality in patients with coronary artery disease (CAD). Preferentially, Th1-type cytokine interferon-γ stimulates tryptophan breakdown and neopterin production by GTP cyclohydrolase I (GCH-I) in parallel in monocyte-derived macrophages and dendritic cells. In other cells, activation of GCH-I leads to the formation of 5,6,7,8-tetrahydrobiopterin (BH4), the necessary cofactor of amino acid hydroxylases such as phenylalanine 4-hydroxylase (PAH) and nitric oxide synthases. In 31 CAD patients (70.3 ± 9.9 years; 21 males, 10 females), we determined serum concentrations of phenylalanine, tyrosine, and Kyn/Trp by HPLC, neopterin by ELISA, and nitrite by the colorimetric Griess assay. The phenylalanine-to-tyrosine ratio (Phe/Tyr) served as an estimate of PAH enzyme activity. Elevated Phe/Tyr concentrations were detected in a subgroup of CAD patients and correlated with Kyn/ Trp (r = 0.396, p < 0.05) and neopterin (r = 0.354, p < 0.05) and inversely with nitrite (r =-0.371, p < 0.05) concentrations. Higher Phe/Tyr in patients is associated with immune activation and indicates subnormal PAH activity that might be involved in the precipitation of neuropsychiatric symptoms in CAD patients. © 2013 Walter de Gruyter GmbH, Berlin/Boston.

Hoenigl M.,Medical University of Graz | Zollner-Schwetz I.,Medical University of Graz | Sill H.,Medical University of Graz | Linkesch W.,Medical University of Graz | And 3 more authors.
Mycoses | Year: 2011

Invasive fungal infections (IFIs) in patients with haematological malignancies are difficult to diagnose and outcome is often fatal. Over the 7-month study period, 117 cases with haematological malignancies receiving systemic antifungal treatment were included. Data regarding antifungal agents, dosage and reason for administration were recorded. Fungal infections in study patients were classified as possible, probable or proven according to recent European Organization for Research and Treatment of Cancer criteria. During the study period, 690 cases with haematological malignancies were admitted. A total of 117 cases received systemic antifungal therapy. Twenty-four of 117 patients (21%) had possible, six (5.1%) had probable and four (3.4%) had proven IFI. Seven of 10 probable and proven infections were caused by Candida spp., 2 by Aspergillus spp. and 1 by a fungus belonging to Zygomycetes. Fifty-two of 117 patients (44%) received antifungal prophylaxis, 81 of 117 (69%) received empirical (31/117; 26%) or pre-emptive (50/117; 43%) antifungal therapy and four of 117 patients (3.4%) directed antifungal therapy. Mostly, systemic antifungal therapy was administered empirically or pre-emptively. Twenty-nine per cent of cases receiving systemic antifungal treatment met the international consensus criteria of mostly possible IFI, whereas 71% did not. Proven invasive fungal infections were rare. © 2010 Blackwell Verlag GmbH.

Kruschitz R.,Medical University of Vienna | Kruschitz R.,Medical University of Graz | Kruschitz R.,SIPCAN Special Institute for Preventive Cardiology and Nutrition | Wallner-Liebmann S.J.,Medical University of Graz | And 5 more authors.
PLoS ONE | Year: 2013

We aimed to describe the relationship between BMI and the subcutaneous adipose tissue topography within young athletes and non-athletic controls, to comparatively evaluate the diagnostic powers of subcutaneous adipose tissue thicknesses at different body sites, furthermore to explore appropriate cut-offs to discriminate between athletes and controls. Measurements were determined in 64 males and 42 females, who were subsequently separated into two even groups (athletes and non-athletes). The optical device LIPOMETER was applied at standardised body sites to measure the thickness of subcutaneous adipose tissue layers. To calculate the power of the different body sites and the BMI to discriminate between athletes and non-athletes, receiver operating characteristic curve analysis was performed. In men, the neck (optimal cut-off value 2.3 mm) and trunk (optimal cut-off value 15.5 mm) provided the strongest discrimination power: with 90.6% (58 of 64) of the subjects being correctly classified into athletes or non-athletes. Discrimination power of the BMI values was 64.1% (41 of 64 were correctly classified). In women, the upper back (optimal cut-off value 3.3 mm) and arms (optimal cut-off value 15.9 mm) provided the strongest discrimination power with 88.1% (37 of 42 being correctly classified). When using BMI to discriminate between athletes and non-athletes only 52.4% (22 of 42) were correctly classified. These results suggest that compared to BMI levels, subcutaneous fat patterns are a more accurate way of discriminating between athletes and non-athletes. In particular the neck and the trunk compartment in men and the upper back and arms compartment in women, were the best sites to discriminate between young athletes and non-athletes on the basis of their fat patterns. © 2013 Kruschitz et al.

Schnedl W.J.,Practice for General Internal Medicine | Lipp R.W.,Medical University of Graz | Wallner-Liebmann S.J.,Medical University of Graz | Kalmar P.,Medical University of Graz | And 2 more authors.
European Journal of Clinical Nutrition | Year: 2014

Primary epiploic appendagitis (PEA) is a rare cause of abdominal acute or subacute complaints. Diagnosis of PEA is made when computed tomography (CT) reveals a characteristic lesion. We report on contrast-enhanced CT images of a patient with PEA and regression of inflammation and the reduction in size of the inflamed appendage over the time period of 4 months. Patients with PEA usually recover without medication or surgical treatment within a few weeks. However, due to continuing bloating and irregular bowel movements we investigated carbohydrate malabsorption and diagnosed a fructose malabsorption. Bloating and irregular bowel movements in this patient with PEA were correlated to carbohydrate malabsorption and were treated successfully with a diet free of culprit carbohydrates. © 2014 Macmillan Publishers Limited. All rights reserved.

Schnedl W.J.,Practice for General Internal Medicine | Kalmar P.,Medical University of Graz | Wallner-Liebmann S.J.,Medical University of Graz | Reiter G.,Siemens AG | And 2 more authors.
Phlebologie | Year: 2016

Patients with anomalies of the inferior vena cava (IVC) are rare, are usually asymptomatic and this developmental anomaly is detected during radiologic evaluation of deep vein thrombosis or incidentally during abdominal radiologic evaluation. We report on time resolved three-dimensional magnetic resonance angiography (4D MRA) in a patient with congenital anomaly of the IVC and nonspecific abdominal complaints. 4D MRA is shown for evaluation and detailed diagnosis in vascular venous anatomy. However, due to continuing bloating and irregular bowel movements we investigated carbohydrate malabsorption and a lactose malabsorption was diagnosed. The nonspecific abdominal complaints in this patient with IVC anomaly were due to lactose malabsorption and were treated successfully with a lactose-free diet. © Schattauer 2016.

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