@unpublished{BaumannWillaschekKertessSzlaninkaetal.2017,
  author    = {Baumann, Christoph and Willaschek, Christian and Kertess-Szlaninka, Tuende and Lang, Johanna and Buchhorn, Reiner},
  title     = {Implementing high energy liquid nutrition, omega-3 fatty acids and nutritional supplements for the treatment of anorexia nervosa},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-150430},
  year      = {2017},
  abstract  = {Objective: To examine the effects of two different treatment approaches on the course of anorexia nervosa (AN) over time. Methods: The subjects were 27 hospitalized AN patients (mean age: 14.91 years; mean BMI: 14.58; mean height: 163.56) . In our retrospective analysis we compared weight gain in two groups. While one group was treated with a standard oral refeeding protocol (historical control) through January 2013 (N=16), the second group (highly standardized refeeding protocol) received a high energy liquid nutrition and nutritional supplements including omega-3 fatty acids (N=11). Results: On admission, the two groups were comparable in terms of height, weight, age and heart rate. At the end of our monitoring time frame of 25 days, weight gain was 121.4\% higher in the highly standardized refeeding protocol group than in the historical control group (66.5 ±52.4 vs 147.3 ±55.7 grams/day; t-Test p=0.004; CI95\%: 29.3-132.2). About 45\% of our patients stated they were vegetarians at admission. However, we could not identify a vegetarian diet as a statistically significant negative prognostic factor for weight gain. Discussion: The highly standardized refeeding protocol seems to be helpful in malnourished AN patients to improve weight gain without enhancing the risk of a refeeding syndrome. Because of an increasing energy turnover, caloric intake should be adjusted during refeeding.},
  subject      = {Anorexia nervosa},
  language  = {en}
}
@article{BuchhornBaumannWillaschek2021,
  author    = {Buchhorn, Reiner and Baumann, Christoph and Willaschek, Christian},
  title     = {Pathophysiological mechanisms of bradycardia in patients with anorexia nervosa},
  series = {Health Science Reports},
  volume    = {4},
  journal   = {Health Science Reports},
  number    = {3},
  doi       = {10.1002/hsr2.331},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-244724},
  year      = {2021},
  abstract  = {Background The purpose of this investigation was to examine heart rate variability (HRV), interbeat interval (IBI), and their interrelationship in healthy controls, bradycardic hyperpolarization-activated cyclic nucleotide-gated channel 4 (HCN4) mutation carriers, and patients with anorexia nervosa (AN). We tested the hypothesis that neural mechanisms cause bradycardia in patients with AN. Therefore, we assumed that saturation of the HRV/IBI relationship as a consequence of sustained parasympathetic control of the sinus node is exclusively detectable in patients with AN. Methods Patients with AN between the ages of 12 and 16 years admitted to our hospital due to malnutrition were grouped and included in the present investigation (N = 20). A matched-pair group with healthy children and adolescents was created. Groups were matched for age and sex. A 24-hour Holter electrocardiography (ECG) was performed in controls and patients. More specifically, all patients underwent two 24-hour Holter ECG examinations (admission; refeeding treatment). Additionally, the IBI was recorded during the night in HCN4 mutation carriers (N = 4). HRV parameters were analyzed in 5-minute sequences during the night and plotted against mean corresponding IBI length. HRV, IBI, and their interrelationship were examined using Spearman's rank correlation analyses, Mann-Whitney U tests, and Wilcoxon signed-rank tests. Results The relationship between IBI and HRV showed signs of saturation in patients with AN. Furthermore, signs of HRV saturation were present in two HCN4 mutation carriers. In contrast, signs of HRV saturation were not present in controls. Conclusions The existence of HRV saturation does not support the existence of parasympathetically mediated bradycardia. Nonneural mechanisms, such as HCN4 downregulation, may be responsible for bradycardia and HRV saturation in patients with AN.},
  language  = {en}
}