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Biomedical subjects

E Ernst

Publications and source records attributed to E Ernst.

At least 289 records · Page 16Linked to original sources

Male-mediated spontaneous abortion among spouses of stainless steel welders.

OBJECTIVES: Male-mediated spontaneous abortion has never been documented for humans. The welding of stainless steel is associated with the pulmonary absorption of hexavalent chromium, which has genotoxic effects on germ cells in rodents. Clinical and early subclinical spontaneous abortions were examined among spouses of stainless-steel welders. METHODS: A cohort of first-pregnancy planners was recruited from members of the union of metal workers and 3 other trade unions. The cohort was followed for 6 menstrual cycles from the cessation of contraceptive use. Altogether, 280 pregnancies were conceived, of which 35 were detected by human chorionic gonadotrophic hormone analysis and did not survive to a clinically recognized pregnancy. Information on exposure was collected prospectively in relation to the outcome and was available for all cycles resulting in a pregnancy. Information on pregnancy outcome was collected for all 245 clinically recognized pregnancies. RESULTS: Increased risk of spontaneous abortion was found for pregnancies with exposure to paternal stainless-steel welding (adjusted relative risk 3.5, 95% confidence interval 1.3-9.1). The results were consistent in analyses of both biochemically and clinically recognized abortions. There was no increased risk for spontaneous abortion in pregnancies with paternal exposure to the welding of metals other than stainless steel. CONCLUSIONS: Male welding of stainless steel was associated with an increased risk of spontaneous abortion in spouses. A mutagenic effect of hexavalent chromium has been found previously in both somatic and germ cells, and the findings could be due to mutations in the male genome.

Abortion, Spontaneous↗

Semen quality and sexual hormones in greenhouse workers.

OBJECTIVES: This study focused on determining the testicular function of greenhouse workers exposed to pesticides. METHODS: Semen was examined for 122 of 199 eligible men (61%) from 30 ornamental flower greenhouses. Sperm concentration, morphology, and viability were measured according to World Health Organization guidelines, and the curvilinear sperm velocity was determined by a computer-assisted analysis of video recordings. Three groups were formed according to expert judgment of current exposure to pesticides from cultures, pesticide formulations, and the transfer of pesticide residues from leaves to hands, and also ranked according to years of work in a greenhouse. The risk estimates were adjusted for the effects of sexual abstinence and other potentially confounding factors. RESULTS: According to current exposure the median values of sperm concentration and the proportion of normal spermatozoa were 60% and 14% lower, respectively, in the high-level exposure group (N=13) than in the low-level group (N=44), and the values of the intermediate group fell in between. The adjusted differences between the high-level and low-level exposure groups were statistically significant, while no differences were observed for the viability and velocity of sperm and sexual hormones. The median sperm concentration was 40% lower for the men with > 10 years' experience in a greenhouse than for those with < 5 years' experience. The age-adjusted testosterone/sex-hormone-binding globulin ratio declined 1.9% (95% confidence interval 0.4-3.4%) per year of work. CONCLUSIONS: The results are compatible with the hypothesis that male fecundity may be at risk from exposure to pesticides in the manual handling of cultures in greenhouses.

Adolescent↗

Prevalence of use of complementary/alternative medicine: a systematic review.

Reported are the results of a systematic review of the prevalence of use of complementary/alternative medicine. Computerized literature searches were carried out in four databases. Twelve surveys thus found were selected because they dealt with the utilization of complementary/alternative medicine in random or representative samples of the general population. Data were extracted in a predefined, standardized way. Prevalence of use of complementary/alternative medicine ranged from 9% to 65%. Even for a given form of treatment such as chiropractic, as used in the USA, considerable discrepancies emerged. The data suggest that complementary/alternative therapies are used frequently and increasingly. Prevalence of use seemed to depend critically on factors that were poorly controlled in surveys of complementary/alternative medicine. The true prevalence of use of complementary/alternative medicine in the general population remains uncertain.

Complementary Therapies↗

The BBC survey of complementary medicine use in the UK.

INTRODUCTION: Recent data about the use of complementary and alternative medicine (CAM) by the general population exist for Australia and the USA, but not for the UK. This study aimed at providing such data. DESIGN: Nationally representative random telephone survey. SETTING AND PARTICIPANTS: 1204 British adults were interviewed. RESULTS: 20% of the sample used CAM in the previous year. Herbalism, aromatherapy, homoeopathy, acupuncture/acupressure, massage and reflexology were the most popular treatment modalities. The main reasons for trying CAM were its perceived effectiveness, a positive inclination towards it, and its relaxing effects. On average, users spent 13.62 +/- 1.61 Pounds on CAM per month, which extrapolates to an annual expenditure of 1.6 billion Pounds for the whole nation. CONCLUSIONS: It is concluded that CAM is prevalent in the UK. Therefore, its scientific validation has become an ethical imperative.

Adult↗

Aromatherapy: a systematic review.

Aromatherapy is becoming increasingly popular; however there are few clear indications for its use. To systematically review the literature on aromatherapy in order to discover whether any clinical indication may be recommended for its use, computerised literature searches were performed to retrieve all randomised controlled trials of aromatherapy from the following databases: MEDLINE, EMBASE, British Nursing Index, CISCOM, and AMED. The methodological quality of the trials was assessed using the Jadad score. All trials were evaluated independently by both authors and data were extracted in a pre-defined, standardised fashion. Twelve trials were located: six of them had no independent replication; six related to the relaxing effects of aromatherapy combined with massage. These studies suggest that aromatherapy massage has a mild, transient anxiolytic effect. Based on a critical assessment of the six studies relating to relaxation, the effects of aromatherapy are probably not strong enough for it to be considered for the treatment of anxiety. The hypothesis that it is effective for any other indication is not supported by the findings of rigorous clinical trials.

Anxiety↗

[Semen quality and fertility in a population-based follow-up study].

Little is known about the importance of semen quality in male infertility. We followed 430 first pregnancy planners with no previous reproductive experience recruited among more than 50,000 cohabiting trade-union members. The couples were consecutively enrolled into the study as they discontinued contraception and were followed up for six month menstrual cycles or until a pregnancy was verified. Each man provided a semen sample at enrollment. Women kept daily record of vaginal bleeding and sexual activity. The probability of conception increased with increasing sperm concentration up to 40 x 10(6)/ml, but any higher sperm density was not associated with additional likelihood of pregnancy. The proportion of sperm with normal morphology was strongly related to likelihood of pregnancy, independently of sperm concentration. In conclusion, sperm concentration and morphology are valuable biological markers of male fecundity. Reference values for semen quality based on biological knowledge can be established.

Biomarkers↗