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Skrabal F, Heymsfield SB, Skrabal K, Weber T, Fruhwald F, Windhaber J, Mady S. Sizing and mending of appendicular muscle mass for hydration during the 12-lead electrocardiogram: True incidence of sarcopenia in heart failure. J Cachexia Sarcopenia Muscle 2024; 15:575-586. [PMID: 38275200 PMCID: PMC10995443 DOI: 10.1002/jcsm.13423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 11/30/2023] [Accepted: 12/09/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Our aim was to develop and evaluate a method for the measurement of muscle mass during the 12-channel electrocardiogram (ECG), to determine the incidence of sarcopenia in patients with overhydration and to correct it for congestion. METHODS A 12-channel ECG that simultaneously provided multifrequency segmental impedance data was used to measure total body water (TBW), extracellular water (ECW), ECW/TBW ratio and appendicular muscle mass (AppMM), validated by whole-body dual-energy X-ray absorptiometry. The mean ECW/TBW ratio was 0.24 ± 0.018 (SD) and 0.25 ± 0.016 for young (age range 20-25 years) healthy males (n = 77) and females (n = 88), respectively. The deviation of the ECW/TBW ratio from this mean was used to correct AppMM for excess ECW ('dry AppMM') in 869 healthy controls and in 765 patients with chronic heart failure (CHF) New York Heart Association classes II-IV. The association of AppMM and dry AppMM with grip strength was also examined in 443 controls and patients. RESULTS With increasing N-terminal pro-brain natriuretic peptide (NT-proBNP), a continuous decline of AppMM indices is observed, which is more pronounced for dry AppMM indices (for males with NT-proBNP < 125 pg/mL: AppMM index mean = 8.4 ± 1.05, AppMM index dry mean = 8.0 ± 1.46 [n = 201, P < 0.001]; for females with NT-proBNP < 150 pg/mL: AppMM index mean = 6.4 ± 1.0, AppMM index dry mean = 5.8 ± 1.18 [n = 198, P < 0.001]; for males with NT-proBNP > 1000 pg/mL: AppMM index mean = 7.6 ± 0.98, AppMM index dry mean = 6.2 ± 1.11 [n = 137, P < 0.001]; and for females with NT-proBNP > 1000 pg/mL: AppMM index mean = 5.9 ± 0.96, AppMM index dry mean = 4.8 ± 0.94 [n = 109, P < 0.001]). The correlation between AppMM and upper-body AppMM and grip strength (r-value) increased from 0.79 to 0.83 (P < 0.001) and from 0.80 to 0.84 (P < 0.001), respectively, after correction (n = 443). The decline of AppMM with age after correction for ECW is much steeper than appreciated, especially in males: In patients with CHF and sarcopenia, the incidence of sarcopenia may be up to 30% higher after correction for ECW excess according to the European (62% vs. 57%, for males, and 43% vs. 31%, for females) and Foundation for the National Institutes of Health (FNIH) (56% vs. 46%, for males, and 54% vs. 38%, for females) consensus guidelines. CONCLUSIONS The incidence of sarcopenia in CHF as defined by the European Working Group on Sarcopenia and FNIH consensus may be up to 30% higher after correction for ECW excess. This correction improves the correlation between muscle mass and strength. The presented technology will facilitate, on a large scale, screening for sarcopenia, help identify mechanisms and improve understanding of clinical outcomes.
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Affiliation(s)
- Falko Skrabal
- Institute of Cardiovascular and Metabolic MedicineGrazAustria
| | | | | | - Thomas Weber
- Department of CardiologyKlinikum Wels‐GrieskirchenWelsAustria
| | | | - Jana Windhaber
- Department of Paediatric and Adolescent SurgeryMedical University GrazAustria
| | - Samy Mady
- Institute of Cardiovascular and Metabolic MedicineGrazAustria
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Flucher C, Windhaber J, Gasparella P, Castellani C, Tschauner S, Mittl B, Wolfschluckner V, Singer G, Till H. Long-term motor activity, cardiopulmonary performance and quality of life in abdominal wall defect patients. Pediatr Res 2024; 95:1101-1109. [PMID: 38052863 PMCID: PMC10920181 DOI: 10.1038/s41390-023-02900-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/17/2023] [Accepted: 11/05/2023] [Indexed: 12/07/2023]
Abstract
AIM To assess whether patients born with an abdominal wall defect (AWD) have impaired cardiorespiratory performance capacity, motor skills, core stability or quality of life in a long-term follow up. METHODS Patients diagnosed with AWD between 2002 and 2013 were invited to participate in the study, which included clinical examination, spirometry, cardiopulmonary exercise performance testing, assessment of motor activity, ultrasound, electromyography of the abdominal wall and assessment of the Gastrointestinal Quality of Life Index (GIQLI). The results were compared to a healthy control group matched for age, sex, BMI, and physical activity levels. RESULTS In total, 18 AWD patients (mean age 12.6 ± 3.5 years) were included and there were no significant differences in anthopometric data compared to the control group (n = 18). AWD patients had a significantly lower GIQLI score (AWD mean 137.2 ± 6.8 vs. control mean 141.4 ± 4.9; p = 0.038) and were affected by decreased motor abilities with significantly higher Dordel-Koch-Test values (AWD median 3.54/IQR 1 vs. control median 2.8/IQR 1; p = 0.005). CONCLUSION Follow-up examinations of AWD patients revealed decreased motor abilities and GIQLI scores while cardiopulmonary function was not different compared to healthy controls. The clinical impact of these findings remains to be elucidated. IMPACT Clinical examination, assessment of the gastrointestinal quality of life, sport medical testing, electromyography and abdominal wall ultrasound were performed in patients with congenital abdominal wall defect and compared to an age and sex matched healthy control group. Results of spirometry and spiroergometry, ultrasound or electromyography did not significantly differ between the groups. Significantly decreased locomotor function and gastrointestinal quality of life were found in patients with abdominal wall defect. However, the clinical impact of these findings remains to be elucidated.
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Affiliation(s)
- Christina Flucher
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
| | - Jana Windhaber
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
| | - Paolo Gasparella
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
| | - Christoph Castellani
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
| | - Sebastian Tschauner
- Division of Paediatric Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Barbara Mittl
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
| | - Vanessa Wolfschluckner
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
| | - Georg Singer
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria.
| | - Holger Till
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
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Vähä-Ypyä H, Bretterhofer J, Husu P, Windhaber J, Vasankari T, Titze S, Sievänen H. Performance of Different Accelerometry-Based Metrics to Estimate Oxygen Consumption during Track and Treadmill Locomotion over a Wide Intensity Range. Sensors (Basel) 2023; 23:s23115073. [PMID: 37299803 DOI: 10.3390/s23115073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/20/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023]
Abstract
Accelerometer data can be used to estimate incident oxygen consumption (VO2) during physical activity. Relationships between the accelerometer metrics and VO2 are typically determined using specific walking or running protocols on a track or treadmill. In this study, we compared the predictive performance of three different metrics based on the mean amplitude deviation (MAD) of the raw three-dimensional acceleration signal during maximal tests performed on a track or treadmill. A total of 53 healthy adult volunteers participated in the study, 29 performed the track test and 24 the treadmill test. During the tests, the data were collected using hip-worn triaxial accelerometers and metabolic gas analyzers. Data from both tests were pooled for primary statistical analysis. For typical walking speeds at VO2 less than 25 mL/kg/min, accelerometer metrics accounted for 71-86% of the variation in VO2. For typical running speeds starting from VO2 of 25 mL/kg/min up to over 60 mL/kg/min, 32-69% of the variation in VO2 could be explained, while the test type had an independent effect on the results, except for the conventional MAD metrics. The MAD metric is the best predictor of VO2 during walking, but the poorest during running. Depending on the intensity of locomotion, the choice of proper accelerometer metrics and test type may affect the validity of the prediction of incident VO2.
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Affiliation(s)
- Henri Vähä-Ypyä
- The UKK Institute for Health Promotion Research, 33500 Tampere, Finland
| | - Jakob Bretterhofer
- Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria
| | - Pauliina Husu
- The UKK Institute for Health Promotion Research, 33500 Tampere, Finland
| | - Jana Windhaber
- Sports Medicine Performance and Movement Analysis, Medical University of Graz, 8010 Graz, Austria
| | - Tommi Vasankari
- The UKK Institute for Health Promotion Research, 33500 Tampere, Finland
| | - Sylvia Titze
- Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria
| | - Harri Sievänen
- The UKK Institute for Health Promotion Research, 33500 Tampere, Finland
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Warncke G, Singer G, Windhaber J, Schabl L, Friehs E, Miekisch W, Gierschner P, Klymiuk I, Eber E, Zeder K, Pfleger A, Obermüller B, Till H, Castellani C. Volatile Organic Compounds, Bacterial Airway Microbiome, Spirometry and Exercise Performance of Patients after Surgical Repair of Congenital Diaphragmatic Hernia. Molecules 2021; 26:molecules26030645. [PMID: 33530644 PMCID: PMC7865878 DOI: 10.3390/molecules26030645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 01/22/2021] [Accepted: 01/22/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to analyze the exhaled volatile organic compounds (VOCs) profile, airway microbiome, lung function and exercise performance in congenital diaphragmatic hernia (CDH) patients compared to healthy age and sex-matched controls. A total of nine patients (median age 9 years, range 6-13 years) treated for CDH were included. Exhaled VOCs were measured by GC-MS. Airway microbiome was determined from deep induced sputum by 16S rRNA gene sequencing. Patients underwent conventional spirometry and exhausting bicycle spiroergometry. The exhaled VOC profile showed significantly higher levels of cyclohexane and significantly lower levels of acetone and 2-methylbutane in CDH patients. Microbiome analysis revealed no significant differences for alpha-diversity, beta-diversity and LefSe analysis. CDH patients had significantly lower relative abundances of Pasteurellales and Pasteurellaceae. CDH patients exhibited a significantly reduced Tiffeneau Index. Spiroergometry showed no significant differences. This is the first study to report the VOCs profile and airway microbiome in patients with CDH. Elevations of cyclohexane observed in the CDH group have also been reported in cases of lung cancer and pneumonia. CDH patients had no signs of impaired physical performance capacity, fueling controversial reports in the literature.
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MESH Headings
- Acetone/analysis
- Adolescent
- Bacteria/classification
- Bacteria/genetics
- Bacteria/isolation & purification
- Child
- DNA, Bacterial/genetics
- DNA, Ribosomal/genetics
- Exercise
- Female
- Hernias, Diaphragmatic, Congenital/metabolism
- Hernias, Diaphragmatic, Congenital/physiopathology
- Hernias, Diaphragmatic, Congenital/surgery
- Herniorrhaphy/methods
- Humans
- Male
- Microbiota
- Pentanes/analysis
- Phylogeny
- RNA, Ribosomal, 16S/genetics
- Spirometry
- Vital Capacity
- Volatile Organic Compounds/analysis
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Affiliation(s)
- Gert Warncke
- Department of Paediatric and Adolescent Surgery, Medical University Graz, 8036 Graz, Austria; (G.W.); (J.W.); (L.S.); (E.F.); (B.O.); (H.T.); (C.C.)
| | - Georg Singer
- Department of Paediatric and Adolescent Surgery, Medical University Graz, 8036 Graz, Austria; (G.W.); (J.W.); (L.S.); (E.F.); (B.O.); (H.T.); (C.C.)
- Correspondence: ; Tel.: +43-316-385-83722
| | - Jana Windhaber
- Department of Paediatric and Adolescent Surgery, Medical University Graz, 8036 Graz, Austria; (G.W.); (J.W.); (L.S.); (E.F.); (B.O.); (H.T.); (C.C.)
| | - Lukas Schabl
- Department of Paediatric and Adolescent Surgery, Medical University Graz, 8036 Graz, Austria; (G.W.); (J.W.); (L.S.); (E.F.); (B.O.); (H.T.); (C.C.)
| | - Elena Friehs
- Department of Paediatric and Adolescent Surgery, Medical University Graz, 8036 Graz, Austria; (G.W.); (J.W.); (L.S.); (E.F.); (B.O.); (H.T.); (C.C.)
| | - Wolfram Miekisch
- Department of Anesthesiology and Intensive Care Medicine, Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Rostock University Medical Centre, 18057 Rostock, Germany; (W.M.); (P.G.)
| | - Peter Gierschner
- Department of Anesthesiology and Intensive Care Medicine, Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Rostock University Medical Centre, 18057 Rostock, Germany; (W.M.); (P.G.)
| | - Ingeborg Klymiuk
- Core Facility Molecular Biology, Center for Medical Research, Medical University of Graz, 8036 Graz, Austria;
| | - Ernst Eber
- Department of Paediatrics and Adolescent Medicine, Division of Paediatric Pulmonology and Allergology, Medical University of Graz, 8036 Graz, Austria; (E.E.); (K.Z.); (A.P.)
| | - Katarina Zeder
- Department of Paediatrics and Adolescent Medicine, Division of Paediatric Pulmonology and Allergology, Medical University of Graz, 8036 Graz, Austria; (E.E.); (K.Z.); (A.P.)
| | - Andreas Pfleger
- Department of Paediatrics and Adolescent Medicine, Division of Paediatric Pulmonology and Allergology, Medical University of Graz, 8036 Graz, Austria; (E.E.); (K.Z.); (A.P.)
| | - Beate Obermüller
- Department of Paediatric and Adolescent Surgery, Medical University Graz, 8036 Graz, Austria; (G.W.); (J.W.); (L.S.); (E.F.); (B.O.); (H.T.); (C.C.)
| | - Holger Till
- Department of Paediatric and Adolescent Surgery, Medical University Graz, 8036 Graz, Austria; (G.W.); (J.W.); (L.S.); (E.F.); (B.O.); (H.T.); (C.C.)
| | - Christoph Castellani
- Department of Paediatric and Adolescent Surgery, Medical University Graz, 8036 Graz, Austria; (G.W.); (J.W.); (L.S.); (E.F.); (B.O.); (H.T.); (C.C.)
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Skrabal F, Weber T, Skrabal K, Windhaber J, Ehsas H, Stockinger N, Boyer J. Measurement of aortofemoral volume wave velocity during the routine 12-channel ECG: relation to age, physiological hemoglobin A 1C, triglycerides and SBP in healthy individuals. J Hypertens 2020; 38:1989-1999. [PMID: 32890275 DOI: 10.1097/hjh.0000000000002493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Measurements of pulse wave velocity are generally thought to be too impractical for clinical routine. This study aimed to develop a method that can be performed during routine 12-channel ECG. METHODS A 12-channel ECG simultaneously supplies arterial impedance plethysmographic signals from the extremities beside segmental multifrequency impedance measurements for obtaining body composition. The origin of the plethysmographic signal (volume wave) at the arms and legs was determined at the level of the elbows and the knees. The volume wave velocity (VWV) at the aorta and femoral arteries was calculated from the time difference of the plethysmographic signals between arms and legs. RESULTS Automated measurement of VWV was highly reproducible (r = 0.96). In 107 participants in perfect health, VWV in different models was positively related to age, physiological hemoglobin A 1C, triglycerides, normal standardized unattended blood pressure, but not to physiological low-density lipoprotein-cholesterol and high-density lipoprotein-cholesterol. Aortofemoral VWV was significantly higher in patients with established coronary artery disease than in healthy controls of the same age group (18.1 ± 5.8 vs. 11.9 ± 1.7 m/s, P < 0.001). VWV in study participants was higher than tonometrically determined pulse wave velocity as muscular arteries are included (13.2 ± 5.81 vs. 8.8 ± 2.98 m/s, n = 115, P < 0.001). CONCLUSION These background arterial impedance plethysmographic measurements for the measurement of VWV made simultaneously during 12-channel ECG show promise for large-scale, routine clinical assessment of large artery function.
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Affiliation(s)
- Falko Skrabal
- Institute of Cardiovascular & Metabolic Medicine, Graz
| | - Thomas Weber
- Cardiology Department, Klinikum Wels-Grieskirchen, Wels
| | | | - Jana Windhaber
- Department of Paediatric and Adolescent Surgery, Medical University Graz, Auenbruggerplatz, Graz, Austria
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Dantendorfer K, Windhaber J, Maierhofer D. Jackson seizure and panic disorder relieved by carbamazepine. Eur Psychiatry 2020; 10:370-1. [DOI: 10.1016/0924-9338(96)80338-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/1995] [Accepted: 04/11/1995] [Indexed: 11/26/2022] Open
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Windhaber J, Steinbauer M, Castellani C, Singer G, Till H, Schober P. Do Anthropometric and Aerobic Parameters Predict a Professional Career for Adolescent Skiers? Int J Sports Med 2019; 40:409-415. [PMID: 30887483 DOI: 10.1055/a-0858-9860] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim of this study was to evaluate whether spiroergometry performance in adolescent alpine ski racers can predict later advancement to a professional career. Over 10 consecutive years, adolescent skiers of the regional Austrian Youth Skier Squad (local level) underwent annual medical examinations, including exhaustive bicycle spiroergometry. The performance was determined at fixed (2 and 4 mmol/l serum lactate) and individual (individual anaerobic threshold (IAT) and lactate equivalent (LAE)) thresholds. Data from the last available test were compared between skiers who later advanced to the professional level (Austrian national ski team) and those who did not. Ninety-seven alpine skiers (n=51 male; n=46 female); mean age 16.6 years (range 15-18) were included. Of these, 18 adolescents (n=10 male; n=8 female) entered a professional career. No significant differences were found for maximum oxygen uptake (VO2max). Athletes advancing to the professional level had significantly higher performance and VO2 at LAE. Additionally, male professionals had significantly higher performances at fixed thresholds and the IAT. The performance and VO2 at the LAE, and thus the ability to produce power at a particular metabolic threshold, was the most relevant spiroergometric parameter to predict a later professional career.
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Affiliation(s)
- Jana Windhaber
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
| | - Monica Steinbauer
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
| | - Christoph Castellani
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
| | - Georg Singer
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
| | - Holger Till
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
| | - Peter Schober
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
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Gersak MM, Sorantin E, Windhaber J, Dudea SM, Riccabona M. The influence of acute physical effort on liver stiffness estimation using Virtual Touch Quantification (VTQ). Preliminary results. Med Ultrason 2016; 18:151-156. [PMID: 27239647 DOI: 10.11152/mu.2013.2066.182.vtq] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM Food intake and acutely decompensated cardiac failure may impair liver stiffness estimations, mainly because these methods are influenced by liver blood flow variation encountered in these conditions. It is well known that also during physical effort liver blood flow changes, due to the redistribution of blood flow mainly to the skeletal muscles. The aim of this study is to assess the change of liver shear- wave velocities immediately after cessation of an acute physical effort. A secondary aim was to find the proper timing for accurate liver stiffness estimation after physical exhaustion. MATERIAL AND METHODS Liver shear-wave velocities were measured using virtual touch quantification (VTQ) in seven apparently healthy volunteers, in fasting conditions. All subjects underwent a complete abdominal ultrasound study, including the liver VTQ. Then, all subjects performed a spiroergometry and thereafter, another series of three liver shear-wave velocity measurements were performed: immediately after spiroergometry, five min, and ten min after spiroergometry, respectively. RESULTS Before spiroergoemetry, the mean liver shear-wave velocity was 1.05+/-0.12 m/sec. Immediately after spiroergometry, mean liver shear-wave velocities increased significantly, measuring 1.34+/-0.16 m/sec (p <0.01). The mean liver shear-wave velocities at five and ten minutes after exhausting were 1.23+/-0.14 m/sec and 1.05+/-0.11 m/sec respectively. CONCLUSIONS Liver stiffness estimation using VTQ was influenced by acute physical exercise in our study group. Despite the small number of subjects, the preliminary results show that if patients had done physical effort before VTQ elastography, they should rest at least ten minutes before reliable liver stiffness estimations can be performed.
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Affiliation(s)
- Mariana M Gersak
- Department of Radiology, Cluj County Emergency Hospital, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.
| | - Erich Sorantin
- Department of Radiology, Division of Pediatric Radiology, Medical University of Graz, Austria
| | - Jana Windhaber
- Department of Pediatric and Adolescent Surgery, Medical University of Graz, Austria
| | - Sorin M Dudea
- Department of Radiology, Cluj County Emergency Hospital, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Michael Riccabona
- Department of Radiology, Division of Pediatric Radiology, Medical University of Graz, Austria
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Windhaber J, Schober P. Leistungsmedizinische Ergometrie im Kindes- und Jugendalter. Monatsschr Kinderheilkd 2014. [DOI: 10.1007/s00112-013-3012-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Castellani C, Windhaber J, Schober PH, Hoellwarth ME. Exercise performance testing in patients with pectus excavatum before and after Nuss procedure. Pediatr Surg Int 2010; 26:659-63. [PMID: 20532529 DOI: 10.1007/s00383-010-2627-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/20/2010] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the changes in lung function and exercise performance due to minimal invasive pectus repair. METHODS Fifty-nine patients with an average age of 16 years were included in this prospective investigation. After determination of body mass index (BMI) and body fat patients were subjected to pre-OP, post-OP and post-implant removal spirometry and bicycle ergospirometry. Forced vital capacity (FVC), performance capacity (PC) and relative oxygen uptake were determined. RESULTS Post-OP FVC significantly decreased from 91% of normal value to 79%, but again increased to 88% after implant removal. PC showed a significant reduction (105-97% of normal value). Likewise, the relative oxygen uptake showed a significant decrease (43.8-42.2 ml/kg per min). These findings correlated to a significant increase of BMI and body fat. When calculating oxygen uptake per kilogram lean body weight, there were no significant changes (49.8 to 49.8 ml/kg per min). CONCLUSIONS Pectus repair resulted in a temporary reduction of FVC, which resolved after implant removal. The drop in oxygen uptake and PC could be related to a significant increase of BMI and body fat. According to our data pectus repair is not followed by improvements in lung function and exercise performance.
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Affiliation(s)
- Christoph Castellani
- Department of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036, Graz, Austria.
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Mangge H, Sargsyan K, Almer G, Nemet A, Spindelboeck W, Dolinar U, Hiden M, Rosenkranz A, Horejsi R, Möller R, Windhaber J, Schober P, Truschnig-Wilders M. PO21-684 PREATHEROSCLEROSIS AND METABOLIC ABNORMALITIES IN OBESE JUVENILES DURING LIFESTYLE INTERVENTION - THE IMPACT OF SAT DISTRIBUTION. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71694-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Schalamon J, Pokall S, Windhaber J, Hoellwarth ME. Minimally invasive correction of pectus excavatum in adult patients. J Thorac Cardiovasc Surg 2006; 132:524-9. [PMID: 16935105 DOI: 10.1016/j.jtcvs.2006.04.038] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2005] [Revised: 03/29/2006] [Accepted: 04/20/2006] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The repair of pectus excavatum by minimally invasive surgery (Nuss procedure) is well established among pediatric surgeons. Studies on adult patients are rare. We analyzed the efficacy of minimally invasive pectus repair in a series of adult patients. METHODS We prospectively included all adult patients with minimally invasive repair of funnel chest treated from 2000 to 2005. The pectus bar was inserted under thoracoscopic control. On the right side a stabilizer was used to prevent bar displacement. Postoperative pain control was provided by epidural catheters. Clinical checks were performed 2 weeks, 3 months, and then annually after discharge. RESULTS Forty-three adult patients (39 men, 4 women) with a mean age of 22 years (range 18-39 years) were included. Mean duration of the operative procedures was 70 minutes (range 29-125 minutes); mean length of hospital stay was 9.3 days. Bars were removed from 15 patients 3 years after implantation. Minor complications occurred in 8 patients (19%), with intrapleural effusions being most frequent (n = 5). Three patients (7%) had major complications: drainage of a pneumothorax (n = 2) and bar displacement (n = 1). The cosmetic results were excellent and patient satisfaction was high. CONCLUSIONS We conclude that the Nuss procedure was beneficial in adult patients. Dislocation of the pectus bar can be prevented by submuscular placement. The use of corticosteroids may be helpful in case of repeated, uncontaminated pleural effusions. Patient satisfaction and the acceptable number and kind of complications are encouraging.
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Abstract
BACKGROUND The purpose of this study was to assess the naturalistic long-term course of panic disorder over a period of 11 years. METHOD Thirty DSM-III-R panic disorder patients, who had suffered from panic disorder for 6 years on average and who had taken part in an 8-week multicenter drug trial, were included in the intent-to-follow-up group to be reinterviewed 11 years after the end of the trial. At baseline and at follow-up the same instruments were used to assess frequency of panic attacks, level of phobic avoidance, and disabilities. Treatments received during the follow-up period and attempted suicides were assessed with a structured interview. Periods of well-being during the follow-up period were elicited retrospectively with a specifically designed longitudinal chart. RESULTS Twenty-four patients could actually be reinterviewed after 11.3 years. While at baseline all patients had suffered from panic attacks and had been severely disabled on a number of measures, 66.7% had no panic attack during the year before follow-up. During the month before follow-up 87.5% had no panic attack, and 54% showed no or only mild phobic avoidance. In the areas of work and family life 90% showed no or only mild disabilities, whereas in the area of social life this percentage was lower (67%). Thirty-three percent of the patients were completely remitted according to a composite remission criterion. CONCLUSIONS Panic disorder is not a uniformly chronic and progressing disorder. Over a period of 11 years there is a good chance of recovery from panic attacks and disabilities, and full remission is also possible.
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Affiliation(s)
- Hemma Swoboda
- Department of Psychiatry, Section of Social Psychiatry and Evaluative Research, University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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15
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Abstract
Several studies reported that in non-psychiatric hospital departments mentally ill patients have a longer length of hospital stay than mentally well. But their methods are often limited because other predictors of length of stay were excluded from statistical analyses. Using the Clinical Interview Schedule, research psychiatrists interviewed 993 patients of medical, surgical, gynecological, and rehabilitation departments in Austria. Using several multiple regression analyses, the influence of psychiatric comorbidity and other variables on length of stay was analyzed. 32.2% of all patients suffered from psychiatric morbidity. Of all psychiatric cases, 6.2% received more than one psychiatric diagnosis. Presence of psychiatric disorders, age, a diagnosis of neoplasms, number of all somatic diagnoses, and the number of previous non-psychiatric hospital admissions predicted length of stay. Patients with dementia, with substance abuse disorders, and with alcohol- and drug-related psychiatric disorders showed a significantly increased length of stay, while other psychiatric diagnoses did not differ from the mentally well. Even after controlling for confounding variables, dementia and substance related diagnoses increase the length of hospital stay. It is important to investigate interventions for early recognition and treatment of these disorders.
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Affiliation(s)
- J Wancata
- University of Vienna, Department of Psychiatry, Vienna, Austria.
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16
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Eher R, Windhaber J, Rau H, Schmitt M, Kellner E. [Styles of interpersonal conflict in patients with panic disorder, alcoholism, rheumatoid arthritis and healthy controls: a cluster analysis study]. Psychiatr Prax 2000; 27:189-94. [PMID: 17195512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
OBJECTIVE Conflict and conflict resolution in intimate relationships are not only among the most important factors influencing relationship satisfaction but are also seen in association with clinical symptoms. Styles of conflict will be assessed in patients suffering from panic disorder with and without agoraphobia, in alcoholics and in patients suffering from rheumatoid arthritis. METHODS 176 patients and healthy controls filled out the Styles of Conflict Inventory and questionnaires concerning severity of clinical symptoms. RESULTS A cluster analysis revealed 5 types of conflict management. Healthy controls showed predominantely assertive and constructive styles, patients with panic disorder showed high levels of cognitive and/or behavioral aggression. Alcoholics showed high levels of repressed aggression, and patients with rheumatoid arthritis often did not exhibit any aggression during conflict. CONCLUSIONS 5 Clusters of conflict pattern have been identified by cluster analysis. Each patient group showed considerable different patterns of conflict management.
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Affiliation(s)
- R Eher
- Klinische Abteilung für Sozialpsychiatrie, Universitätsklinik für Psychiatrie, Wien, Osterreich.
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17
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Windhaber J, Urbanits S, Grisold W. Neurologic side effects in neuroleptic-naïve patients treated with haloperidol or risperidone. Neurology 2000; 54:1543-4. [PMID: 10751282 DOI: 10.1212/wnl.54.7.1542-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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18
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Abstract
OBJECTIVE Although many studies have reported that many psychiatric cases are missed by their nonpsychiatric physicians, their methods are often limited because ward physicians' recognition has been assessed from potentially unreliable sources such as medical notes. The aim of the present study was to assess recognition by using direct questions to ward physicians. METHODS Five hundred five (505) nonpsychiatric in-patients were interviewed using the Clinical Interview Schedule. Ward physicians' recognition of psychiatric disorders was assessed using a rating form for every patient. RESULTS The psychiatric prevalence of the total sample was 37.3%. Overall, ward physicians' diagnostic sensitivity was 54.5%, but their sensitivity varied for the different diagnoses (31.3-89.5%). In addition to psychiatric symptoms and abnormalities, intake of psychotropics before admission significantly predicted identification of psychiatric disorders. CONCLUSIONS In our study, physicians' sensitivity was higher than that reported from surveys based on medical notes. The fact that nearly half of all psychiatric disorders were missed by ward physicians suggests that better psychiatric training for nonpsychiatric doctors is necessary.
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Affiliation(s)
- J Wancata
- Department of Psychiatry, University of Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria.
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19
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Wancata J, Benda N, Meise U, Windhaber J. [Does psychiatric comorbidity increase length of stay in medical, surgical and gynecological departments?]. Nervenarzt 1999; 70:810-6. [PMID: 10522249 DOI: 10.1007/s001150050516] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Several studies from Anglo-American countries indicate that in non-psychiatric hospital departments mentally ill patients have a longer length of hospital stay than mentally well, while in Austria and Germany, until now, no studies concerning this question exist. Therefore, we investigated the influence of psychiatric comorbidity on the length of stay in 608 patients of medical, surgical and gynecological departments in Vienna and Tyrol. Based on the Clinical Interview Schedule, 28.1% of the patients in this sample suffered from psychiatric disorders. The presence of psychiatric disorders, as well as type of hospital department (medical department), higher age, more previous non-psychiatric treatment periods, and more somatic diagnoses predicted a longer duration of inpatient treatment. To avoid the influence of cofounding variables, psychiatric cases were matched with psychiatric non-cases. The mentally ill group was treated for a markedly longer period as inpatients than the mentally well. Patients with a diagnosis of dementia or of substance abuse showed a significantly increased length of stay, while we could not confirm this for other psychiatric diagnoses.
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Affiliation(s)
- J Wancata
- Universitätsklinik für Psychiatrie Wien
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20
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Abstract
Smoking has been discussed both as a risk factor for panic disorder and as a contributing factor to elevated cardiovascular risk in panic disorder patients. Smoking habits and their association with panic disorder were studied in a sample of 102 panic disorder patients. Both for female and for male patients, rates of smokers and of exsmokers were substantially higher than in the general population. However, a surprisingly high number of patients had succeeded in reducing or quitting cigarette smoking because of their panic disorder, although they experienced little benefit in regard to panic symptoms from doing so. We conclude that the motivation for changing smoking habits is high in this population with elevated smoking prevalence and should be taken into consideration by therapists.
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Affiliation(s)
- M Amering
- Department of Social Psychiatry and Evaluative Research, University of Vienna, Austria
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21
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Windhaber J, Dantendorfer K, Maierhofer D. [Panic disorder and/or epilepsy?]. Psychiatr Prax 1998; 25:205-6. [PMID: 9738254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- J Windhaber
- Universitätsklinik für Psychiatrie Klin. Abt. für Sozialpsychiatrie u. Evaluationsforschung, Wien
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Windhaber J, Eher R. Treatment of paraphilia with an analogue of gonadotropin-releasing hormone. N Engl J Med 1998; 338:1923; author reply 1923-4. [PMID: 9643990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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23
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Etzersdorfer E, Wancata J, Fischer P, Windhaber J, Eichberger G, Katschnig H. [Patient suitability for discharge from psychiatric hospitals]. Psychiatr Prax 1998; 25:149-53. [PMID: 9653785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To assess the possibility of discharging psychiatric inpatients of two large Mental Hospitals in Lower Austria. METHODS A point prevalence study was performed in 1992. Treating psychiatrists were asked to evaluate the possibility to discharge patients under the hypothetical assumption that a broad range of residential facilities were available. RESULTS The inpatient proportion had decreased from 2179 in 1974 to 1032 in 1992. Of the 1992 population 75.7% might be discharged. Most patients (41.5%) were regarded as needing a permanently staffed home. CONCLUSIONS Although the inpopulation of the two large Mental Hospitals studied had decreased over a period of 18 years already by over 50 percent, the results of this study show that there is a large potential for further reform. Since the evaluation was carried out by the treating psychiatrists in the hospital, who might have been in a conflict of interests or might have preferred the treatment they are providing themselves, this finding is particularly remarkable.
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Affiliation(s)
- E Etzersdorfer
- Universitätsklinik für Tiefenpsychologie und Psychotherapie, Wien
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Windhaber J, Berger P, Amering M, Maierhofer D, Sachs G, Bankier B, Holzinger A, Dantendorfer K, Katschnig H. Catastrophic cognitions and avoidance behavior in panic disorder patients. Eur Psychiatry 1998. [DOI: 10.1016/s0924-9338(99)80541-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Windhaber J, Wancata J, Bankier B, Amering M, Katschnig H. Who are those relatives of acutely admitted psychiatric patients who feel guilty? Eur Psychiatry 1998. [DOI: 10.1016/s0924-9338(99)80437-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Amering M, Katschnig H, Berger P, Windhaber J, Baischer W, Dantendorfer K. Embarrassment about the first panic attack predicts agoraphobia in panic disorder patients. Behav Res Ther 1997; 35:517-21. [PMID: 9159975 DOI: 10.1016/s0005-7967(96)00126-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In order to find out whether contextual variables of the first panic attack and the person's reaction to it predict the development of agoraphobia in panic disorder patients, 60 patients with a DSM-III-R diagnosis of panic disorder with agoraphobia and 30 patients suffering from panic disorder without agoraphobia were interviewed about their first panic attack. Single comparisons between groups of agoraphobic and non-agoraphobic patients were carried out and a logistic regression model was applied. Occurrence of the first panic attack in public and the feeling of embarrassment were found to be significantly associated with the development of agoraphobia. It is concluded that eliciting this specific form of social concern at an early stage might help to identify patients at risk for later agoraphobia, which could, in turn, help to further specify early therapeutic interventions and concentrate therapeutic efforts on a high-risk group of panic disorder patients.
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Affiliation(s)
- M Amering
- Department of Psychiatry, University of Vienna, Austria
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30
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Amering M, Berger P, Dantendorfer K, Windhaber J, Katschnig H. [The first panic attack: a missed chance for prevention of panic disorder and its complications]. Psychiatr Prax 1997; 24:65-8. [PMID: 9190611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Assessment and analysis of first medical consultations and their significance in panic disorder patients. METHODS 90 panic disorder patients were interviewed concerning their experiences with the medical system at the time of their first panic attack. RESULTS Panic disorder patients contacted mostly non-psychiatric medical services at the time of their first panic attack. The correct diagnosis was established in only 4 cases (5.6%). CONCLUSIONS An important chance for secondary prevention of the development of panic disorder is missed, probably due to the poor education of physicians on panic attacks.
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Affiliation(s)
- M Amering
- Klinische Abteilung für Sozialpsychiatrie und Evaluationsforschung, Universitätsklinik für Psychiatrie, Wien
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Dantendorfer K, Prayer D, Kramer J, Amering M, Baischer W, Berger P, Schoder M, Steinberger K, Windhaber J, Imhof H, Katschnig H. High frequency of EEG and MRI brain abnormalities in panic disorder. Psychiatry Res 1996; 68:41-53. [PMID: 9027932 DOI: 10.1016/s0925-4927(96)03003-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The frequency and quality of brain abnormalities in panic disorder (PD) were assessed with magnetic resonance imaging (MRI). The use of electroencephalography (EEG) to detect PD patients with a high probability of morphologic brain abnormalities was also explored. Consecutive PD patients (n = 120) were screened with routine EEG examinations and were divided into the following subgroups on the basis of their EEG findings: patients with non-epileptic EEG abnormalities (EEG-A group, n = 28), matched patients with normal EEG results (EEG-N group, n = 28) and matched healthy controls (n = 28). PD patients showed a higher than expected rate of non-epileptic EEG abnormalities (29.2%; 35 of 120). EEG screening was effective in identifying patients with a high probability of morphologic brain abnormalities. MRI abnormalities were found in 60.7% of the EEG-A patients, 17.9% of the EEG-N patients, and only 3.6% of the controls. A high frequency of septo-hippocampal abnormalities was found. Further research should focus on attempts to subtype PD on the basis of neuroanatomic and functional brain abnormalities.
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Dantendorfer K, Amering M, Baischer W, Berger P, Steinberger K, Windhaber J, Katschnig H. Is there a pathophysiological and therapeutic link between panic disorder and epilepsy? Acta Psychiatr Scand 1995; 91:430-2. [PMID: 7676842 DOI: 10.1111/j.1600-0447.1995.tb09804.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Relations between panic disorder (PD) and epilepsy (E) have repeatedly been discussed. Three patients with juvenile E who had been free of seizures under anticonvulsant medication for many years and developed PD are presented. Increasing anticonvulsant medication resulted in complete and stable remission of PD. It is hypothesized that, in a subgroup of patients with PD, there is a pathophysiological relation to E. Further research into the usefulness of anticonvulsants in the treatment of PD, especially in therapy-refractory cases, is suggested.
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