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Biomedical subjects

E Baumgartner

Publications and source records attributed to E Baumgartner.

At least 19 recordsLinked to original sources
PubMed2004

Fibromyalgia: a randomised, controlled trial of a treatment programme based on self management.

OBJECTIVE: To evaluate the efficacy of a treatment programme for patients with fibromyalgia (FM) based on self management, using pool exercises and education. METHODS: Randomised controlled trial with a 6 month follow up to evaluate an outpatient multidisciplinary programme; 164 patients with FM were allocated to an immediate 6 week programme (n = 84) or to a waiting list control group (n = 80). The main outcomes were changes in quality of life, functional consequences, patient satisfaction and pain, using a combination of patient questionnaires and clinical examinations. The questionnaires included the Fibromyalgia Impact Questionnaire (FIQ), Psychological General Well-Being (PGWB) index, regional pain score diagrams, and patient satisfaction measures. RESULTS: 61 participants in the treatment group and 68 controls completed the programme and 6 month follow up examinations. Six months after programme completion, significant improvements in quality of life and functional consequences of FM were seen in the treatment group as compared with the controls and as measured by scores on both the FIQ (total score p = 0.025; fatigue p = 0.003; depression p = 0.031) and PGWB (total score p = 0.032; anxiety p = 0.011; vitality p = 0.013,). All four major areas of patient satisfaction showed greater improvement in the treatment than the control groups; between-group differences were statistically significant for "control of symptoms", "psychosocial factors", and "physical therapy" No change in pain was seen. CONCLUSION: A 6 week self management based programme of pool exercises and education can improve the quality of life of patients with FM and their satisfaction with treatment. These improvements are sustained for at least 6 months after programme completion.

Adult↗
PubMed2003

Neurophysiologic evidence for a central sensitization in patients with fibromyalgia.

OBJECTIVE: To determine whether abnormalities of peripheral and central nociceptive sensory input processing exist outside areas of spontaneous pain in patients with fibromyalgia (FM) as compared with controls, by using quantitative sensory testing (QST) and a neurophysiologic paradigm independent from subjective reports. METHODS: A total of 164 outpatients with FM who were attending a self-management program were invited to participate in the study. Data for 85 patients were available and were compared with those for 40 non-FM controls matched for age and sex. QST was performed using thermal, mechanical, and electrical stimuli at locations of nonspontaneous pain. Pain assessment was 2-fold and included use of subjective scales and the spinal nociceptive flexion reflex (NFR), a specific physiologic correlate for the objective evaluation of central nociceptive pathways. Questionnaires regarding quality of life and the impact of FM were available. RESULTS: Participants were mainly middle-aged women, with a mean disease duration of 8 years. Between-group differences were significant for neurophysiologic, clinical, and quality of life measures. In patients with FM, peripheral QST showed significantly altered cold and heat pain thresholds, and tolerance to cold pain was radically reduced. The median NFR threshold in patients with FM (22.7 mA [range 17.5-31.7]) was significantly decreased compared with that in controls (33 mA [range 28.1-41]). A cutoff value of <27.6 mA for NFR provided sensitivity of 73% and specificity of 80% for detecting central allodynia in the setting of FM. CONCLUSION: Our results strongly, although indirectly, point to a state of central hyperexcitability of the nociceptive system in patients with FM. The NFR can be used to assess central allodynia in FM. It may also help discriminate patients who may benefit from use of centrally acting analgesics.

Female↗
PubMed2002

A six year prospective study of a cohort of patients with fibromyalgia.

OBJECTIVES: To examine the long term prognosis in patients with fibromyalgia (FM). METHODS: Forty five of 70 patients who had participated in a three week trial six years earlier completed again the same questionnaires used previously. RESULTS: Most symptoms had remained stable. Pain had increased, but some aspects of quality of life had improved over time. CONCLUSION: Symptoms of FM persisted over the six years, but patients appeared better able to cope with them.

Adaptation, Psychological↗
PubMed1998

[Precautionary maternity leave in Tirol].

Under Austrian law, precautionary maternity leave is a decree issued by the district public health physician. It forbids a pregnant woman to work and mandates immediate maternity leave. Regular maternity leave for all women employed in all jobs begins at 32 weeks of gestation. Women who work in workplaces deemed dangerous and women with a history of obstetric problems such as premature or growth-retarded babies from previous pregnancies are regularly 'sent' into precautionary maternity leave. The public health physicians of Tirol's nine administrative districts were interviewed and supplied data on precautionary maternity leave from their districts. In 100 women who attended the clinic for pregnancies at risk of the Obstetrics/Gynecology Department of Innsbruck University Hospital and who had already obtained precautionary maternity leave, the medical/administrative procedure was studied in each case and correlated with pregnancy outcome. The town district of Innsbruck and the district that comprises the suburbs of the provincial capital had the highest rates of precautionary maternity leave. The town district of Innsbruck had a rate of 24.3% of all pregnant women (employed and not employed) in precautionary maternity leave in 1997, whereas the whole province of Tirol had 13.4%. More than 80% of decrees for precautionary maternity leave are issued by district public health physicians on the basis of written recommendations from gynecologists. One third of women who are sent into precautionary maternity leave are issued the decree prior to 12 weeks of gestation - mostly cases of multiple pregnancies and women with previous miscarriages. The present system of precautionary maternity leave appears to work in the sense that most working pregnant women with risk factors are correctly identified - with most errors on the side of caution. As the system also helps employers - the employee's pay is paid from the federal family support fund and state insurance once she is in precautionary maternity leave - little effort is made to find a low-risk workplace for a pregnant employee.

Austria↗
PubMed1997

[Current approach to low back pain].

Despite advances in medical knowledge and available methods of treating spinal problems, the costs these problems generate are growing in a constant and exponential manner in western countries. Back pain is not different, commoner or more severe than in the past. This raises the question whether present-day management, which often runs counter to current scientific evidence, is appropriate. Practically speaking, so-called specific back pain is to be distinguished from nonspecific or common back pain. The former arises from a precise lesion (infectious, tumoral, inflammatory or traumatic), while the latter has no obvious underlying cause. Fortunately this preliminary differentiation is usually possible on the basis of the history and clinical workup alone. In this paper we deal solely with common back pain, as being by far the most frequent in everyday practice. Once a specific origin has been ruled out, the chief aim should be earliest possible resumption of the patient's normal activities. Various methods, embracing drug treatment, physiotherapy, and in appropriate cases ergotherapy, are available for this purpose. If this fails, the physician must react as rapidly as possible to prevent the condition becoming chronic. Regard should be had for the various psychosocial factors which interfere with the healing process, and a method should be adopted which is no longer based on the classic biomedical model but on a bio-psycho-social approach as proposed by Waddell. If necessary the patient should be referred to a specialist (rheumatologist, rehabilitation, orthopedist etc). Back pain is extremely widespread in the population at large and is a frequent reason why people consult a physician. On these grounds the primary care physician has a key role to play in the initial workup and also in the acute, subacute or chronic stage of the evolution. This review of the principles which should guide the practical approach to the back-pain patient is intended to aid the practitioner in his tasks of diagnosis and therapy.

Combined Modality Therapy↗
PubMed1993

A novel technique for the detection of DNA single-strand breaks in human white blood cells and its combination with the unscheduled DNA synthesis assay.

A modified assay for the detection of DNA single-strand breaks (SSBs) in human mononucleated white blood cells (MWBCs) based on the nick translation (NT) reaction was developed and combined with the test for unscheduled DNA synthesis (UDS). Both assays were performed on disposable 96-well filtration plates and therefore allowed rapid and sensitive examination of SSBs and UDS. Only 5-8 ml of heparinized blood is required for an eightfold determination in both assays. The uptake of radioactive nucleotide precursors was demonstrated to depend linearly upon the NT reaction time and in both assay systems on the number of investigated cells. The best results and the lowest signal to noise ratio were obtained when the NT assay was performed at 25 degrees C for 20 min. The test was standardized for 150,000 MWBCs/well and a polymerase I concentration of 20 U/ml. The same number of cells were used to measure UDS during a 4-h incubation at 37 degrees C. We observed a dose-dependent increase in SSBs after in vitro incubation with N-methyl-N-nitrosoguanidine (MNNG), with a detection limit of 50 microM when MNNG was present for 1 h and of 5 microM after 20-h incubation period. UDS in MWBCs was increased after treatment for 1 h with MNNG (200 microM) only if poly(ADP)ribose synthesis was inhibited by 3-aminobenzamide. UDS was induced by 320 microM methyl methanesulfonate, but SSBs could only be detected after inhibition of UDS by 100 microM hydroxyurea.(ABSTRACT TRUNCATED AT 250 WORDS)

Chromosome Aberrations↗
PubMed1993

Detection of DNA single-strand breaks in lymphocytes of smokers.

In a controlled study, ten male volunteers (five smokers and five nonsmokers) were subjected to different smoking conditions and compared to five nonsmokers, not exposed to cigarette smoke. During the 4 days of the study, nonsmoking periods were strictly controlled. On the first day the ten subjects were sham exposed. On the second day the five smokers smoked 24 cigarettes in 8 h, while the five nonsmokers were exposed to the environmental tobacco smoke. After another day of sham exposure the smoke exposure was repeated under the same conditions. Blood was drawn before and after exposure and DNA single-strand breaks (SSBs) were analyzed in lymphocytes immediately (1 h) after isolation of cells and after 4 h incubation at 37 degrees C, using a modified assay based on the nick translation reaction. Base levels of unscheduled DNA synthesis (UDS) and UDS levels were determined after 1 h incubation with methyl methanesulfonate. Duplicate analysis using the same method was performed in a second laboratory after transportation of blood samples at 0 degree C on a train from Munich to Hamburg. Tobacco smoke exposure of the subjects increased COHb and plasma cotinine levels. SSBs could be detected in all probands with some interindividual day-to-day and morning-to-evening variations. In four of five active smokers, SSB increases were found after smoking. In nonsmokers exposed to tobacco smoke no exposure-related variation in SSB levels could be detected.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Neurological manifestations of Lyme disease].

Lyme's disease, transmitted by Borrelia Burgdorferi (BB), is a polymorphic and multisystemic illness. Its neurological manifestations are encountered in 10-50% of cases and occur in the acute disseminated stage as well as in the late stage. This article initially reviews the principal clinical pictures of the neuroborreliosis and distinguishes them from neurological disorders whose association with BB infection is not proven. The paper then discusses the relative usefulness of the different ancillary tests in the diagnostic workup. We hope to stimulate interest in the research of intrathecal specific antibody production (especially in the early central nervous system diseases), instead of measuring levels of anti-BB antibodies in the serum and in the cerebrospinal fluid. Finally, a treatment plan is proposed, whose efficiency constitutes another argument in favor of the correct diagnosis but whose failure may reflect a diagnostic error.

Aged↗
PubMed1991

[Computerized tomography of the female thorax after mastectomy: the most important topometric data from the viewpoint of radiation].

The author analysed postoperative CT images of 77 patients operated on carcinoma of the breast and performed topometric measurements on the level of sternoclavicular joints parasternal, and in the centre line of the sternum in the height of the second and sixth intercostal space as well as on the thorax wall medioclavicular and on the forepart of the axillar line. The values measured corresponded to the literary data in general except those of the second intercostal space and of the axilla. The author stresses the necessity of CT series when making radiation planning of breast cancer.

Breast Neoplasms↗
PubMed1990

[The radiation reaction of the lung following the treatment of breast carcinoma with telecesium--the correlation with the dose-time relationship].

51 mamma carcinoma patients underwent postoperative telecaesium irradiation (50 Gy). Chest radiograms were taken preceding the treatment and following it by eight to ten weeks. By reason of the results it can be supposed, that the unavoidable lung reaction due to radiotherapy can be decreased and partly avoided by adequate fractionation.

Breast Neoplasms↗
PubMed1986

[Detection of wheat gliadins in heated food by reversed-phase high-pressure liquid chromatography].

To recognize and determine the wheat gliadins in unheated gluten-free food for coeliac patients the immunological methods such as ELISA can be used. In heated food (above 80 degrees-90 degrees C) these methods fail wholly or in part to achieve the quantitative determination of wheat gliadin. The changes in protein patterns after heat treatment are also revealed by the RP-HPLC of wheat gliadins and some peaks appear, which are characteristic for heat treated wheat flour. Using these peaks, about 2% admixture of wheat flour (T. aestivum, T. durum) as well as of rye flour can be detected. In foods which contain more than 50% skim milk the addition of only at least 5% of these flours can be detected. The ethanolic extracts of foods were concentrated by freeze-drying prior to analysis by HPLC. The ethanol-soluble non-dialysable food components affect the quantitative determination of wheat or rye proteins by means of peak areas. Selective enrichment is a possibility. The RP-HPLC-analysis of ethanol-soluble proteins makes it possible to detect heated flours of wheat and rye (cooked, roller-dried, extrusion-cooked) in glutenfree food.

Animals↗
PubMed1985

[Determination of wheat gliadins in food with ELISA].

Two Sandwich-ELISA methods suitable for quantitative determination of wheat alpha-gliadin and whole gliadin (i.g. alpha-, beta-, and gamma-gliadin) in unheated gluten-containing and gluten-free foods are described. An optimal method for extraction of gliadin from foods was developed. Foods are extracted with 70% ethanol except those containing cocoa, where 3 M-urea and 10% casein were added prior to extraction. Wheat flours are extracted at room temperature or at 40 degrees C, gluten-free foods at 40 degrees C. The recovery of added gliadin (0.1% wheat flour) is at least 80% in foods without cocoa, at least 70% in cocoa-containing foods (1% wheat flour added). Both methods are highly specific for wheat, cross-reactions e.g. with rye are insignificant. The sensitivity assay of the assay in buffer is 0.5 ng/ml alpha-gliadin an 10 ng/ml whole gliadin and it can be decreased by prolonged incubation with sample. The unspecific effect of food components is discussed; it can be eliminated to a large extent.

Animals↗
PubMed1985

[Analysis of whole gliadin from untreated and heat-treated flour with phase inversion high pressure liquid chromatography].

The gliadins from various wheat flours either untreated or heated (baking, cooking, roller-drying, extrusion-cooking) were extracted with 70% ethanol and analysed by RP-HPLC. When flours are heated below 80 degrees C the chromatograms showed no significant change. At temperatures about 80-90 degrees C a peak appeared in all samples (with the exception of durum wheat) at a retention time of 35 min (peak 35) or, if already present, become more pronounced. A further increase in temperature or treatment time resulted in an increase in this peak whereas the peaks of the more strongly bound gliadins slowly disappeared. In the gliadins of the bread crust the amount of peak 35 decreased again. Similarly, changes were observed in the distribution of the apparent molecular weights of gliadins from heated flours by using gel electrophoresis (SDS-PAGE). At temperatures about 80-90 degrees C the bands between 50-62 kD (under reducing conditions) appeared or become stronger. Their intensity increased with increasing time and treatment temperature whereas the lower molecular weight bands slowly disappeared. Peak 35 may be useful as an indicator of gliadin in heat-treated "gluten-free" foods.

Bread↗
PubMed1985

[Determination of staphylococcal enterotoxins A, B and C in foods using ELISA with labeled antigen].

The competitive ELISA (polystyrene balls) with labeled antigen according to Stiffler-Rosenberg and Fey (1978) was applied to the analysis of Staphylococcal enterotoxins (SE) A, B and C in food to see if the enterotoxin concentration corresponding to maximum limit for SEA and SEB (1 ng/g food and 10 ng/g food respectively) could be measured. The effect of various food ingredients on the quantitative determination of SE in single-step and two-step variants of competitive ELISA was investigated. Generally, the effect of food was the lowest in extracts of cheeses and the highest in extracts of meats and pasta products. All enterotoxins were equally affected. However, within the same type of food significant differences in binding of both labeled and unlabeled antigen were found. The effect of food components often depended on the assay variant; the extracts of cheese gave better results in the two-step and the extracts of pasta better results in the single-step ELISA. In some weak-positive extracts, false positive results could not be excluded. In the samples of cheese which were involved in food poisoning exclusively the enterotoxin type A was found (up to 30 ng/g). The recovery of added SE (1-10 ng/g food) ranged from 50-70% in cheese and was about 70% in pasta foods. The assay sensitivity in buffer ranged from 0.2 ng/ml for enterotoxins A and B and 0.3 ng/ml for enterotoxin C (20 ml sample) to 0.5 ng/ml for A and B and 0.6 ng/ml for C (5 ml sample) to 1 ng/ml for A and B and 2 ng/ml for C (1 ml sample). In food, especially in meat and pasta the detection limit was often higher. With some exceptions the required sensitivity for enterotoxin A (1 ng/g) could only be reached in cheese.

Cheese↗
PubMed1985

[Determination of staphylococcal enterotoxins A, B, C and D in foods using sandwich ELISA with labeled antibody].

The noncompetitive Sandwich-ELISA (polystyrene balls) with labelled antibody for staphylococcal enterotoxins (SE) A, B, C, and D according to Fey et al. (1984), which have recently been introduced commercially, was applied to analysis of foods. The effect of various food ingredients on the quantitative determination and recovery of SE was investigated. The unspecific effect of food components which, in some cases, caused false-positive results in the competitive ELISA was less frequent. Nevertheless, the differences in binding of unlabeled antigen between buffer and food were still observed. Using ELISA microtiter plates the effect of food components was less pronounced. Enterotoxin type A or a mixture of A and D were dominant in foods which were involved in food poisoning (about 150 samples). In meat the recovery of SE added (1-10 ng/g) ranged from 30-60%. The assay sensitivity in buffer ranged from 0.1 ng/ml for enterotoxins A, B, C and D (5 ml sample) to 0.2 ng/ml for enterotoxins A-D (1 ml sample) using polystyrene balls and was 1 ng/ml for enterotoxins A-D using ELISA plates. In foods the detection limit was occasionally higher. The required sensitivity for enterotoxin A (maximum limit 1 ng/g) could mostly be reached. Because of the differences in antigen binding in buffer and in various food extracts the determination of the enterotoxin content in this range is laborious.

Cheese↗