[Prevalence and significance of carbohydrate craving in Austria]. / Prävalenz und Bedeutung der Kohlenhydratsucht in Osterreich.

Among disorders of appetite and eating frequent craving of carbohydrate containing snacks between meals is well known. Excessive carbohydrate consumption causes increased caloric intake and may lead to overweight and risks of obesity regarding metabolism and vascular remodelling. Up to now prevalence and consequences of that disorder have never been studied in the Austrian population. Hence we investigated by questionnaires and interviews eating habits in samples of 1058 women and 942 men of the Austrian population. Evaluation showed that carbohydrate craving is a more or less serious problem for about 30% of Austrians. Women, especially those with overweight, were affected more frequently than men. In the whole population sample investigated there was a seasonal variation with a tendency to increased carbohydrate craving in fall and winter. This was, however, not significant for overweight women, they probably eat their snacks over the whole year. A subgroup of males reported craving of snacks containing sausage or meat instead of carbohydrate. Craving of carbohydrate is considered the consequence of a decrease of serotonin in appetite regulating neurons and centers of the brain. Treatment of craving by drugs inhibiting the re-uptake of serotonin into afferant neurons is discussed. Medication of this type is, however, hampered by cardiovascular side effects observed with fenfluramines.

[Effect of dexfenfluramine on eating behavior and body weight of obese patients: results of a field study of Isomeride in Austrian general practice]. / Der Einfluss von Dexfenfluramin auf Essverhalten und Körpergewicht von Adipösen: Ergebnisse einer Anwendungsstudie von Isomeride in österreichischen Arztpraxen.

In a multicenter study by 243 practicing physicians in Austria 819 severely obese subjects of both sexes without overt disease were encouraged to keep a calorie-restricted diet to reduce weight. After a run-in period of more than two weeks of dieting patients started taking 15 mg dexfenfluramine (Isomeride) twice daily for three month. While their weight was fairly stable during the run-in period progressive weight loss occurred during taking dexfenfluramine due to obvious changes in eating habits and appetite allowing to keep the reducing diet more strictly. Females lost 7.7 +/- 3.9 kg while obese men lost 9.32 +/- 4.6 kg. Laboratory tests obtained before starting dexfenfluramine and after 3 months at termination of medication showed blood glucose, cholesterol, LDL and triglycerides to decrease while HDL-cholesterol increased moderately. Dexfenfluramine was well tolerated by the majority of patients. Side effects such as fatigue, sedation, flatulence or diarrhea occurred in only 7.9% of the probands initially and dropped to 2.1% during the third month of the medication. It is concluded that Dexfenfluramine modifies eating habits and appetite thus making weight reducing diets easier acceptable and resulting in weight loss. It is suggested that Dexfenfluramine has a role in treatment regimes for morbid and refractory obesity.

Constitutional delay of growth and puberty: do they really reach their target height?

We compared the final adult height (FH) of patients with classic constitutional delay of growth and puberty with their target height (TH) and with the height prediction by the Bayley-Pinneau method (BP). 20 patients and their parents were included in our study: 6 females (mean age 19.1 years) and 14 males (mean age 20.6 years). No significant difference could be detected between TH, FH and BP prognosis. This is in contrast to recent studies using height data partly obtained by self-estimation. We measured our patients and their parents ourselves and were accurately able to calculate their genetically determined TH. This proceeding could explain our results. Our study shows that adolescents with true constitutional delay do not need treatment and that height prediction seems to be accurate.

[Listeria meningoencephalitis in a 2-year-old boy]. / Listerienmeningoenzephalitis bei einem 2jährigen Knaben.

We report the unusual case of a two year old boy with encephalomeningitis caused by Listeria monocytogenes. The patient was hospitalized with the classical signs of severe bacterial meningitis. The microbiological investigations gave proof of Listeria monocytogenes as causative agent 36 hours later. Antibiotic treatment with ampicillin and gentamicin resulted in a prompt improvement of the boy's condition. The boy was discharged four weeks later.

The effect of cyproheptadine on plasma growth hormone (GH) and on somatostatin response to GH-releasing hormone in man.

Cyproheptadine (CPH)--a putative serotonin antagonist--is known to inhibit growth hormone (GH) response to various pharmacological stimuli, as well as during sleep. To elucidate the possible site at which this drug takes effect, we examined plasma GH and somatostatin response to i.v. GHRH1-44 (1 microgram/kg body wt.) before and after CPH treatment in 10 healthy volunteers. The oral administration of CPH (8-12 mg daily for 5 days; total dose 56 mg) significantly curbed GH response to GHRH as expressed in peak plasma GH values (32.0 +/- 6.1 micrograms/l vs. 12.6 +/- 3.2 micrograms/l; P less than 0.01) and in integrated GH response area (2368 +/- 517 micrograms x l-1 x 2 h vs. 744 +/- 172 micrograms x l-1 x 2 h; P less than 0.01). Plasma somatostatin levels did not change in response to GHRH.

DNA-grading of prostatic carcinoma: prognostic validity and reproducibility.

The prognostic significance of the DNA-Malignancy-Grade (DNA-MG) was tested in 52 prostatic carcinoma patients in comparison with a cytomorphological grading system and the clinical staging. Papanicolaou- or MGG stained smears from transrectal aspiration biopsies were automatically restained according to Feulgen in a modified Shandon staining machine. The DNA-MG, based on the variation of the nuclear DNA content of tumor cells around the normal DNA peak, ranges on a continuous scale from 0.01 to 3.0. It was determined with a TV-image analysis system (Leitz, TAS plus), combined with an automatic microscope. The DNA-MG revealed a high prognostic validity, the clinical stage showed only a minor influence on the survival time and the cytopathologic grading system was of insufficient prognostic information. Significant differences in survival time could be demonstrated between patients with DNA-MGs of 0.01-1.5 and 1.5-3.0, as well as with DNA-MGs 1.0-2.0 and 2.0-3.0. The intra- and interobserver variations of the DNA grading system were found to be sigma = 0.014 and sigma = 0.036 respectively. The reproducibilities were 86.7% for intra- and interobserver measurements, when the continuous DNA-MG scale was divided in three groups.