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Biomedical subjects

E Brunner

Publications and source records attributed to E Brunner.

At least 73 records · Page 4Linked to original sources
PubMed1996

[Not Available].

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History, 19th Century↗
PubMed1995

Psychological factors in the relationship between alcohol and cardiovascular morbidity.

Most major studies have found a U-shaped relationship between the level of alcohol consumption and all cause mortality, largely as a consequence of lower death rates from coronary heart disease (CHD) amongst moderate drinkers. Previous attempts to unravel the significance of this observation have focused on controlling for possible confounders, such as smoking, social class and the existence of previous ill-health in the group of abstainers. Our analysis of data from the Whitehall II study of British Civil Servants sought to determine whether psychological factors (GHQ, Hostility, Affect Balance, Social Supports) may be influencing the observed relationships between levels of alcohol consumption and some of the established risk factors for CHD. We found evidence of weak confounding only with respect to levels of apolipoprotein B (APoB) and as such have failed to provide compelling evidence that the U-shaped relationship between alcohol and CHD mortality could be easily explained by psychosocial confounding. At the same time we would not claim that the measures we have used are either flawless or exhaust the range of psychological variables that might plausibly influence physiological mediators of cardiovascular disease.

Adult↗
PubMed1994

Plagiarism or protecting public health?

Is milk produced using recombinant bovine growth hormone hazardous to animal health? Despite wide publicity, the controversy remains unresolved. Rapid publication of all available data is essential if progress is to be made.

Animals↗
PubMed1994

Fat intake: implications of changes in distribution for setting dietary goals in the UK.

STUDY OBJECTIVE: To examine (a) changes in the shape of the distribution of dietary fat intake as the mean dietary fat intake of the population shifts and (b) implications for setting national dietary goals. DESIGN: Data on the percentage of energy from total fat, saturates, monounsaturates, polyunsaturates, and the P:S ratio were analysed for two dietary intervention trials and six cross sectional dietary surveys. The nutrient distributions from each study were described in terms of the mean, standard deviation (SD), coefficient of variation (CV), and skewness statistic. For the intervention trials statistical parameters were compared for groups who received and did not receive dietary advice. For the cross sectional studies, statistical parameters were compared across groups with different levels of mean fat intake. The implications of the results for setting dietary goals were considered using statistical models. MAIN RESULTS: For most fat fractions there was a positive association between the mean and the SD, and an inverse association between the mean and the CV, indicating that as the mean shifts upwards the SD increases but not in proportion to the mean. This is intermediate between a constant SD and a constant CV model. For a population nutrient goal of a maximum of 15% saturates, the estimated population mean for British women would be 8.4% using the constant SD model and 10.8% using the constant CV model. For saturates and the P:S ratio, a lower mean intake was associated with a greater positive skew in the distribution of reported intakes. For saturates, this is consistent with a group of high fat consumers who fail to reduce their intake as the population mean shifts downwards: a "rearguard effect". Findings for the P:S ratio are consistent with a group of consumers who produced a strong positive skew at low mean intakes, which reduced in size as the mean population intake increases: a "vanguard effect". CONCLUSIONS: These findings provide evidence that the distribution of fat intake may change with the mean to a degree that the setting and monitoring of nutritional goals may need to take account of changes in variance and shape of the intake distribution.

Adult↗
PubMed1993

Gender differences in occupational mobility and structure of employment in the British Civil Service.

In all industrialized societies health status in adults has been found to vary with social position. Attempts to explain this are usually grouped under headings of artefact, material, lifestyle and selective mobility of the healthiest. Such attempts have to date been unsuccessful in fully accounting for this relationship, and whilst they have merit have left unconsidered the effects of the process whereby social stratification occurs. The present study is a prelude to subsequent studies that will endeavour to distinguish between three separate influences on health--the effects of current social position, the long term effects stemming from one's initial class position, and the effects of the processes governing mobility. The purpose of our present investigation is to describe patterns of occupational mobility, that will enable us to identify possible predictors of subsequent mobility and therefore to indicate to what extent mobility might be a process governed by social rules. The work presented in this paper comprises part of the Whitehall II study of occupational, social and lifestyle influences upon health in a Civil Service population. Using multiple regression techniques almost half the variation in mobility is modelled in terms of educational level, fathers' social class, gender, marital status, age on entry into the Civil Service, length of time in Civil Service employment and grade of entry into the Civil Service. Using estimates derived from this model it is suggested that a number of sub-groups within the Civil Service suffer adverse mobility (mobility appears particularly restricted for women and for those entering the Civil Service above 30 years of age). The results obtained suggest that the issue of obstructed opportunity at the workplace could become a focus for fruitful investigation, linking issues of personal autonomy, expectations and control to health. A number of methodological problems in this kind of work are considered together with discussion of how the model can be used to increase our understanding of mobility.

Adult↗
PubMed1991

Health inequalities among British civil servants: the Whitehall II study.

The Whitehall study of British civil servants begun in 1967, showed a steep inverse association between social class, as assessed by grade of employment, and mortality from a wide range of diseases. Between 1985 and 1988 we investigated the degree and causes of the social gradient in morbidity in a new cohort of 10,314 civil servants (6900 men, 3414 women) aged 35-55 (the Whitehall II study). Participants were asked to answer a self-administered questionnaire and attend a screening examination. In the 20 years separating the two studies there has been no diminution in social class difference in morbidity: we found an inverse association between employment grade and prevalence of angina, electrocardiogram evidence of ischaemia, and symptoms of chronic bronchitis. Self-perceived health status and symptoms were worse in subjects in lower status jobs. There were clear employment-grade differences in health-risk behaviours including smoking, diet, and exercise, in economic circumstances, in possible effects of early-life environment as reflected by height, in social circumstances at work (eg, monotonous work characterised by low control and low satisfaction), and in social supports. Healthy behaviours should be encouraged across the whole of society; more attention should be paid to the social environments, job design, and the consequences of income inequality.

Adult↗
PubMed1991

Fluoxetine versus placebo: a double-blind study with bulimic inpatients undergoing intensive psychotherapy.

In a double-blind trial 40 patients with bulimia nervosa according to DSM III-R criteria were randomly assigned either to a 60 mg fluoxetine group or to a placebo control group. Fluoxetine or placebo was given over a period of 35 days. Parallel to the drug trial, patients participated in an intensive inpatient behavioral psychotherapy program. There were no dropouts at all in the study. Fluoxetine was well tolerated and had only minor adverse effects. In self-ratings and expert ratings concerning attitudes towards eating, eating behavior, and general psychopathology, significant improvements over time were observed in both groups. Using analysis of variance (ANOVA), however, there were no statistically significant "group by time" differences. Results show that the intensive inpatient-care and psychotherapy program was highly effective in changing eating behavior and attitudes as well as general psychopathology. Fluoxetine showed a significant reduction in body weight, especially during the first three weeks of fluoxetine treatment. It was not possible to demonstrate a statistically significant improvement in eating attitudes, eating behavior, and general psychopathology beyond that elicited by intensive inpatient psychotherapy and general inpatient care. These results can possibly be explained by the existence of a "ceiling effect".

Adult↗
PubMed1991

A nonparametric estimator of the shift effect for repeated observations.

In a nonparametric two-sample model for independent observations with repeated measurements, a new point estimator and a new distribution-free confidence interval for the difference in means are introduced. The method is based on some ideas in Hodges and Lehmann (1963, Annals of Mathematical Statistics 34, 598-611). The asymptotic theory in Brunner and Neumann (1983, Biometrical Journal 24, 373-389; 1986; Biometrical Journal 28, 394-402) and the results for small sample sizes in Brunner and Compagnone (1988, Statistical Software Newsletter 14, 36-42) are used. The new estimators are applied to a problem in morphometry.

Animals↗
PubMed1990

Disturbances in the hypothalamo-pituitary-adrenal and other neuroendocrine axes in bulimia.

Disturbances in the hypothalamo-pituitary-adrenal (HPA) and other endocrine axes were assessed in 24 women with bulimia and healthy controls. Overnight blood samples for measuring nocturnal plasma cortisol, prolactin (PRL), growth hormone (GH), luteinizing hormone (LH), and follicle stimulating hormone (FSH) were obtained at 30-min intervals. A 1.5 mg dexamethasone suppression test (DST) and a TRH-test were performed. Patients were monitored closely while their nutritional intake was recorded over 21 days. Compared with healthy controls, nocturnal cortisol plasma levels were not elevated in the bulimics. There was a trend toward insufficient cortisol suppression in the DST in patients with bulimia, which was most pronounced in patients with signs of restricted caloric intake. Plasma dexamethasone levels were significantly reduced in bulimics compared with healthy controls. There was a trend for blunted thyrotropin stimulating hormone (TSH) responses to thyrotropin releasing hormone (TRH) in bulimia. The prolactin response to TRH was significantly reduced in bulimics with a history of anorexia nervosa. Plasma LH and plasma FSH were significantly reduced in bulimics with signs of reduced caloric intake [low T3, high levels of beta-hydroxy-butyric acid (BHBA), reduced daily caloric intake, high number of fasting days] as compared with healthy controls. Bulimics with high BHBA levels had significantly reduced nocturnal prolactin plasma levels. Results show that multiple neuroendocrine disturbances exist in bulimia in a milder form than in anorexia nervosa. Evidence for the impact of caloric intake on endocrine functions is presented. Endocrine dysfunctions in our bulimic sample did not show a positive association with the presence of depressive symptoms.

Adult↗
PubMed1989

General anesthetics modulate GABA receptor channel complex in rat dorsal root ganglion neurons.

The effects of halothane, isoflurane, and enflurane on ionic currents induced by bath application of gamma-amino-butyric acid (GABA) were studied with the rat dorsal root ganglion neurons maintained in primary culture. The whole-cell patch clamp technique was used to record the current. In normal neurons before exposure to anesthetics, GABA at low concentrations (1-3 x 10(-6) M) induced a small sustained inward current. At higher concentrations (3 x 10(-5) M-1 x 10(-3) M), GABA induced a large inward current, which decayed to a steady-state level (desensitization). Halothane (0.86 mM), isoflurane (0.96 mM), and enflurane (1.89 mM), each equivalent to the respective 2 minimum alveolar concentration (MAC) units, augmented the sustained current evoked by 3 x 10(-6) M GABA to 330-350% of control and the peak current evoked by 3 x 10(-5) M of GABA to 136-145% of control. The decay phase of the current was accelerated by the anesthetics, the time for the current to decline to 70% of the peak being reduced to 23-39% of control. In contrast, the densitized steady-state current evoked by high concentrations of GABA was decreased by anesthetics. In conclusion, general anesthetics exert a dual effect on the GABA receptor channel complex: to potentiate the nondesensitized (both peak and sustained) current and to suppress the desensitized steady-state current. The potentiation of the GABA receptor channel response may be a primary action of anesthetics leading to surgical anesthesia.

Anesthetics↗
PubMed1989

Desensitization to trimethoprim sulfamethoxazole in patients with acquired immune deficiency syndrome and Pneumocystis carinii pneumonia.

In three of eight patients with the acquired immune deficiency syndrome the Pneumocystis carinii pneumonia treated with intravenous trimethoprim sulfamethoxazole, drug-related reactions occurred 9, 10, and 13 days after therapy. The symptom complex consisted of a maculopapular eruption, fever, eosinophilia, and leukopenia. Oral desensitization with graded doses of trimethoprim sulfamethoxazole was successfully achieved in two of the three patients.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Determination of the diameter of erythrocytes in the urine in urologic diseases and so-called asymptomatic microhematuria].

In a blind-study with 96 patients analysis of erythrocyte diameters permits to differentiate between renal-parenchymatous and post-renal microhaematuria in 89.9% of the cases. Erythrocytes on renal-parenchymatous microhaematuria are distinctly smaller (Average diameter 3.2 microns-5.6 microns) than those on post-renal microhaematuria (average diameter 5.4 microns-8.8 microns). In addition to the evaluation of erythrocyte morphology erythrocyte morphometry represents further possibility in diagnosis.

Adolescent↗
PubMed1988

[Radiodiagnosis of temporal bone anomalies].

The X-ray findings in temporal bone anomalies are reviewed. Radiological procedure and examination technique are presented, as are symptoms of important anomalies. The methods available are plain film X-ray of temporal bone, multi-directional tomography, and high-resolution CT. Although some of the abnormalities are visible even in plain films, consistent use of conventional tomography or CT is necessary for correct diagnosis. This procedure is indicated not only when an abnormality is clinically obvious, but also in all cases of unexplained hearing loss without evidence of acquired disease. The advantage of CT over conventional tomography is that soft tissue anomalies, such as primary cholesteatoma or tumor simulating vascular abnormalities, can be demonstrated. In these cases CT is obligatory.

Cochlea↗