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Biomedical subjects

E Ernst

Publications and source records attributed to E Ernst.

At least 217 records · Page 12Linked to original sources
PubMed2001

Neurological complications of cervical spine manipulation.

To obtain preliminary data on neurological complications of spinal manipulation in the UK all members of the Association of British Neurologists were asked to report cases referred to them of neurological complications occurring within 24 hours of cervical spine manipulation over a 12-month period. The response rate was 74%. 24 respondents reported at least one case each, contributing to a total of about 35 cases. These included 7 cases of stroke in brainstem territory (4 with confirmation of vertebral artery dissection), 2 cases of stroke in carotid territory and 1 case of acute subdural haematoma. There were 3 cases of myelopathy and 3 of cervical radiculopathy. Concern about neurological complications following cervical spine manipulation appears to be justified. A large long-term prospective study is required to determine the scale of the hazard.

Adult↗
PubMed2001

Interactions between herbal medicines and prescribed drugs: a systematic review.

Despite the widespread use of herbal medicines, documented herb-drug interactions are sparse. We have reviewed the literature to determine the possible interactions between the seven top-selling herbal medicines (ginkgo, St John's wort, ginseng, garlic, echinacea, saw palmetto and kava) and prescribed drugs. Literature searches were performed using the following databases: Medline (via Pubmed), Cochrane Library, Embase and phytobase (all from their inception to July 2000). All data relating to herb-drug interactions were included regardless of whether they were based on case reports, case series, clinical trials or other types of investigation in humans. In vitro experiments were excluded. Data were extracted by the first author and validated by the second author. 41 case reports or case series and 17 clinical trials were identified. The results indicate that St John's wort (Hypericum perforatum) lowers blood concentrations of cyclosporin, amitriptyline, digoxin, indinavir, warfarin, phenprocoumon and theophylline; furthermore it causes intermenstrual bleeding, delirium or mild serotonin syndrome, respectively, when used concomitantly with oral contraceptives (ethinylestradiol/desogestrel), loperamide or selective serotonin-reuptake inhibitors (sertaline, paroxetine, nefazodone). Ginkgo (Ginkgo biloba) interactions include bleeding when combined with warfarin, raised blood pressure when combined with a thiazide diuretic and coma when combined with trazodone. Ginseng (Panax ginseng) lowers blood concentrations of alcohol and warfarin, and induces mania if used concomitantly with phenelzine. Garlic (Allium sativum) changes pharmacokinetic variables of paracetamol, decreases blood concentrations of warfarin and produces hypoglycaemia when taken with chlorpropamide. Kava (Piper methysticum) increases 'off' periods in Parkinson patients taking levodopa and can cause a semicomatose state when given concomitantly with alprazolam. No interactions were found for echinacea (Echinacea angustifolia, E. purpurea, E. pallida) and saw palmetto (Serenoa repens). In conclusion, interactions between herbal medicines and synthetic drugs exist and can have serious clinical consequences. Healthcare professionals should ask their patients about the use of herbal products and consider the possibility of herb-drug interactions.

Drug Interactions↗
PubMed2001

Effects of heat and cold application on turns and amplitude in surface EMG.

The purpose of this study was to investigate the effects of cooling and heating of muscles on parameters of surface EMG (SEMG) under various well defined grades of isometric muscle contraction. In 32 healthy volunteers, aged 20-30 years, turns and amplitude (RMS) analysis was done in SEMG from the hand extensors. Muscle strength was defined by a new developed hand dynamometer. Values for RMS and turns in case of maximal voluntary contraction (MVC) over periods of 20 sec were determined for each volunteer and subsequently RMS and turns were measured during isometric contractions of 10%, 30%, 50% and 80% of MVC, interrupted each by rest periods. This procedure was repeated after cooling and warming the forearm with thermo packs. For control purposes the same investigations with three measurement periods of SEMG were done following the same time schedule without thermic stimuli. With increasing isometric contractions turns increased after heat application and decreased after ice application, compared to the values achieved without thermic stimuli. The differences were significant from a level of 30% of MVC (p < 0.05). No corresponding changes were seen for RMS. In the control experiment values of turns and RMS did not differ in the three measurement periods. It is concluded, that the amplitude in SEMG tracings seems to be a reliable parameter of muscle force, whereas turns are sensitive to temperature. They might be useful markers for therapeutic approaches targeted at the muscle.

Adult↗
PubMed2001

Effect of Cr(VI) exposure on sperm quality: human and animal studies.

The semen status of male workers occupationally exposed to hexavalent chromium(VI) was investigated. Sperm counts from exposed workers were 47.05+/-2.13 x 10(6)/ml and those from control group 88.96+/-3.40 x 10(6)/ml. Sperm motility decreased from 81.92+/-0.41% for the control group to 69.71+/-0.93% for the exposed workers. The levels of zinc, lactate dehydrogenase (LDH), and lactate dehydrogenase C4 isoenzyme (LDH-x) in seminal plasma for the exposed workers were 1.48+/-0.07 micromol/ml, 1.05+/-0.02 x 10(3) U, and 0.47+/-0.01 x 10(3) U, respectively, which were significantly lower than those of 5.72+/-0.15 micromol/ml, 1.49+/-0.02 x 10(3) U, and 0.78+/-0.15 x 10(3) U for the control group, respectively. Follicle stimulating hormone (FSH) (7.34+/-0.34 x 10(-3) IU/ml) in serum from the exposed workers was significantly higher than that (2.41+/-0.08 x 10(-3) IU/ml) from the control group. On the other hand, there were no significant differences in semen volume, semen liquefaction time, luteinizing hormone (LH) level in serum, and Cr concentration in both serum and seminal plasma between the exposed workers and the control group. Feeding Cr(VI) to rats significantly reduced the epididymal sperm counts from 87.40+/-3.85 x 10(6)/g epididymis in control group to 21.40+/-1.20 x 10(6)/g epididymis at a CrO(3) dose of 10 mg/kg body weight and to 17.48+/-1.04 x 10(6)/g epididymis at a CrO(3) dose of 20 mg/kg body weight. Exposure of rats to Cr(VI) also significantly increased the sperm abnormality from 2.75+/-0.06% in the control group to 6.68+/-0.32% in the exposed group at a CrO(3) dose of 10 mg/kg body and to 7.6+/-0.15% at a CrO(3) dose of 20 mg/kg body weight. In exposed rats, there was visible disruption in germ cell arrangement near the walls of the seminiferous tubules. The diameters of seminiferous tubules in exposed rats were smaller. These results suggest that occupational exposure to chromium(VI) leads to alteration of semen status and may affect the reproductive success of exposed workers.

Animals↗
PubMed2000

Garlic for treating hypercholesterolemia. A meta-analysis of randomized clinical trials.

PURPOSE: To investigate the effect of garlic on total cholesterol level in persons with elevated levels by conducting a meta-analysis of randomized, double-blind, placebo-controlled trials. DATA SOURCES: Systematic literature searches were conducted on the MEDLINE, EMBASE, BIOSIS, Cochrane Library, AMED, and CISCOM databases. Manufacturers of commercial garlic preparations and experts in the field were asked about published or unpublished trials. STUDY SELECTION: Selected trials were required to state that they were randomized, double-blind, and placebo-controlled; use garlic monopreparations; include persons with mean total cholesterol levels of at least 5.17 mmol/L (200 mg/dL); and report total cholesterol level as an end point. There were no language restrictions. DATA EXTRACTION: Two reviewers, blinded to key identifiers of each paper, independently extracted data in a standardized manner and assessed methodologic quality by using the Jadad scale. Discrepancies were settled through discussion. DATA SYNTHESIS: In the 13 trials included in the meta-analysis, garlic reduced total cholesterol level from baseline significantly more than placebo (P < 0.01); the weighted mean difference was -0.41 mmol/L (95% CI, -0.66 to -0.15 mmol/L) (-15.7 mg/dL [CI, -25.6 to -5. 7 mg/dL]). Six diet-controlled trials with the highest scores for methodologic quality revealed a nonsignificant difference between garlic and placebo groups; the weighted mean difference was -0.11 mmol/L (CI, -0.30 to 0.08 mmol/L) (-4.3 mg/dL [CI, -11.7 to 3.1 mg/dL]). CONCLUSIONS: The available data suggest that garlic is superior to placebo in reducing total cholesterol levels. However, the size of the effect is modest, and the robustness of the effect is debatable. The use of garlic for hypercholesterolemia is therefore of questionable value.

Chi-Square Distribution↗
PubMed2000

[Stress and fertility. A follow-up study among couples planning the first pregnancy].

Mental distress has often been suggested as a cause of unexplained infertility. However, the causal direction may well be from infertility to distress, and prospective data are needed. We therefore followed 393 couples, who were planning their first pregnancy, with prospective collection of information on distress from termination of birth control until pregnancy for a maximum of six menstrual cycles. The analyses included 1,475 menstrual cycles, and mental distress was measured in each cycle by the General Health Questionnaire (GHQ). Urine samples from each period of vaginal bleeding were analyzed for human chorionic gonadotrophic hormone, indicating early embryonal loss. We found that for cycles with the highest distress score (GHQ score above the 80 percentile) the probability of conception per cycle was 12.8% compared to 16.5% in other cycles (adjusted OR 0.6; 95% CI 0.4-1.0). The effect of distress was almost exclusively found among women with long menstrual cycles (OR 0.1; 95% CI 0.01-0.4 and OR 0.9; 0.5-1.4 for women with cycles > or = 35 and < 35 days, respectively). An increased incidence of early embryonal loss was also found among highly distressed women with long cycles, but was based on a small number of observations. It is concluded that psychological distress may be a risk factor for reduced fertility in women with long menstrual cycles.

Adult↗