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Biomedical subjects

E Ernst

Publications and source records attributed to E Ernst.

At least 487 records · Page 27Linked to original sources
PubMed1995

[Garlic (Allium sativum)--a potent medicinal plant].

A good deal of evidence suggests beneficial effects of the regular dietary intake of garlic on mild hypertension and hyperlipidemia. Garlic seems to have anti-microbial and immunostimulating properties, enhance fibrinolytic activity, and exert favorable effects on platelet aggregation and adhesion. Standardised preparations guarantee exact dosing and minimize the problem of the strong odour of raw garlic. Thus, a traditional folk remedy has established its usefulness for many patients with less severe forms of cardiovascular disease as a medical drug with very few side effects. The available evidence gives rise to the hope that the list of indications may even be considerably extended in the future.

Cardiovascular Diseases↗
PubMed1995

A leading medical school seriously damaged: Vienna 1938.

Misguided by the notion that the decline of the German race would be prevented by purifying "Aryan blood" and eliminating foreign, particularly Jewish, influences, the Nazis evicted all Jews from universities within their growing empire during the Third Reich. The Medical Faculty of Vienna suffered more than any other European faculty from "race hygiene." Within weeks of the Nazi annexation of Austria in 1938, 153 of the Faculty's 197 members were dismissed. By far the most frequent reason for dismissal was Jewish origin. Most victims managed to emigrate, many died in concentration camps, and others committed suicide. The "cleansing" process encountered little resistance, and the vacant posts were quickly filled with persons known not for their medical expertise but for their political trustworthiness. It was in this climate that medical atrocities could be committed. After the collapse of the Third Reich, most members of the Faculty were burdened with a Nazi past. Most remained in office, and those who had to leave were reinstituted swiftly. The Jews evicted in 1938 were discouraged from returning. These events have significantly--and with long-lasting effects--damaged the quality of a once-leading medical school. This story needs to be told to honor its victims and to fortify us so that history does not repeat itself.

Austria↗
PubMed1995

Cloning and expression of carbonyl reductase from rat testis.

Carbonyl reductase is a cytosolic, monomeric, NADPH-dependent oxidoreductase with broad specificity for carbonyl compounds and a general distribution in human and many animal tissues. A carbonyl-reductase-like enzyme is exclusively expressed in rat reproductive tissues and adrenal glands. To understand the structural and functional relationships between the two enzymes, we cloned and sequenced the cDNA for the enzyme from rat testis and overexpressed the encoded protein in Escherichia coli. Three types of cDNA coding for the same protein but differing in their 5'-untranslated regions were isolated. The encoded protein had the same length as, and showed 86% positional identity with, carbonyl reductase from human placenta and liver. The recombinant enzyme exhibited the same substrate specificity and susceptibility to inhibitors as the enzyme isolated from rat testis, and also closely resembled human carbonyl reductase. Similar to the human enzyme, the recombinant rat enzyme catalyzed its own modification by pyruvate and 2-oxoglutarate, respectively. We conclude that carbonyl reductase from rat testis and human tissues represent species-specific forms of the same enzyme.

Alcohol Oxidoreductases↗
PubMed1995

[Proving the effectiveness of complementary therapy. Analysis of the literature exemplified by acupuncture].

At present, acupuncture may be considered one of the most popular forms of complementary medicine worldwide. However, in relation to the number of reviews on the subject, comparatively few controlled clinical trials have been reported so far. An analysis of all the controlled clinical trials listed in MEDLINE between 1987 and March 1994 (n = 39) that met certain basic requirements revealed that they addressed a wide variety of diseases and/or symptoms with no major focus (apart from the symptom of pain, which of course is highly complex in nature). In agreement with the findings of other meta-analyses, most of the more recent papers have been found to be still of indifferent quality. Besides the inherent problem that the term acupuncture subsumes within itself a substantial number of different techniques (and even philosophies), an obvious methodological deficit can be observed. Many groups seem to attach too little importance to choosing an appropriate control model, although seminal papers addressing this problem were already published in the early eighties. Similar remarks apply to inadequacies in study design, which should be at least single-blind. In summary, these findings may well help to explain why the effectiveness of acupuncture has still not been definitively demonstrated.

Acupuncture Therapy↗
PubMed1995

Complementary cancer treatments: hope or hazard?

Complementary therapies are frequently used by cancer patients, yet the area is a minefield of hazards and hopes. A distinction between cure and care seems helpful. There are no effective complementary cures and most options that are promoted carry a distinct and, in certain cases, fatal risk. Complementary cancer care is more acceptable and there are options that can be shown to ease suffering. Vis a vis the popularity of complementary cancer treatments, the lack of scientific evidence for most therapies seems unacceptable. The call for more rigorous research is loud and clear.

Complementary Therapies↗
PubMed1995

Therapeutic interventions to lower plasma fibrinogen concentration.

A causal link between plasma fibrinogen levels and the risk of cardiovascular disease is now reasonably well established. Therefore the therapeutic lowering of fibrinogen has become a relevant area of research. Several options to achieve this aim have been reported in the literature. Changes in lifestyle can affect the fibrinogen level, of which smoking cessation is by far the most effective; weight or stress reduction or an increase in regular physical activity may have less pronounced effects; dietary changes appear to have even less effect, though a regular, moderate alcohol consumption may result in a small reduction. Many oral drugs have been shown to lower fibrinogen; however, the data should be viewed critically. In particular, the clinical situation in which a drug is administered must be considered and risk:benefit analyses should be performed before a drug is recommended for this indication. Among the oral fibrinogen-lowering drugs, fibrates rank first (e.g. bezafibrate has been reported to reduce increased fibrinogen by as much as 40%, and ticlopidine can induce a reduction of about 15% if fibrinogen was elevated at baseline). Whether concentration within the normal range can be altered by oral medication is less clear. Finally (and obviously), intravenous fibrinolytic agents or heparin-induced extracorporeal low-density lipoprotein precipitation will lower fibrinogen dramatically; yet these procedures are rarely indicated for this purpose alone. All options to lower fibrinogen also have prominent effects on other cardiovascular functions; thus, an intervention trial may not be the most appropriate method of testing the validity of the hypothesis of fibrinogen as a cardiovascular risk factor.

Cardiovascular Diseases↗
PubMed1995

The "optional cross-over design" for randomized controlled trials.

In order to facilitate the performance of randomized controlled trials (RCT) in situations where no "hard" endpoints can be identified and the patient's subjective impressions about success of failure of a given treatment are paramount, the "optional cross-over design" is suggested. In this design, patients are randomised to receive either active medication or placebo during phase I. At its end the patient may choose to change to the other treatment arm, if therapy was felt to be unsuccessful (= optional cross-over). In phase II, treatment continues as in phase I except for those patients who have chosen the "optional cross-over". Further cross-over points may ensue depending on the particularities of the situation, however, two such options may be adequate for most studies. At the end of the trial period, the numbers of patients in each treatment arm are counted and evaluated statistically. If an optimally successful remedy is being tested, close to 100% of the study population could finish up in the active treatment arm. If, as in most instances, the remedy is not optimally successful, this percentage will be proportionally less. If an ineffective remedy is being tested, the distribution of the total sample within the two treatment arms approaches 50:50%. The "optional cross-over design" seems suited for RCT in areas where the complex, unmeasurable and subjective experience of the patient are considered to represent adequate endpoints.

Cross-Over Studies↗
PubMed1995

Lymphocyte redistribution in connection with physical activity in the rat.

Previous studies have demonstrated numerous immunobiological changes in connection with exercise. A decrease in peripheral blood mononuclear white cells (PBMC) 2 h after intense exercise has been shown. This lymphocytopenia in humans after exercise is thought to be of great importance regarding the morbidity to viral infection. We constructed an animal experimental set-up, previously published, to investigate the exercise-induced lymphocyte redistribution. The experimental set-up allowed us to draw blood from catheters implanted in the right carotid artery in rats. PBMC were isolated and labelled with In111 and reinfused before the exercise run on a treadmill to exhaustion. The runner and control rats were killed and dissection performed 1 h after the exercise. Tissue samples were weighed and measured in a gamma counter. Furthermore, blind microscopic examinations of selected tissues were performed to study a hypothesized accumulation of blood mononuclear cells in relation to muscle fibre lesions. We found that the total number of PBMC in the running rats was decreased (P = 0.018) and granulocytes increased, 1 h after the exercise (P = 0.028). Similar findings in humans in connection with physical activity have been observed. The percentage of total injected counts per minute per gram tissue (% c.p.m. g-1) showed significantly lower values in the liver and kidney from runners than from controls (P = 0.032 and P = 0.028). These findings might be the result of a visceral hypoflow in connection with exercise. Furthermore, a tendency to decreased % c.p.m. g-1 in the lungs were seen in the exercised rats (P = 0.083) indicating a possible redistribution from the lungs during the run. Light microscopy demonstrated an accumulation of PBMC around muscle fibre lesions, but there was no significant difference between runners and controls. Furthermore, no significant difference in % c.p.m. g-1 was found between working muscle groups in runner and control rats. In conclusion, the demonstration of the redistribution of PBMC from the liver and kidney in the exercised rats and the absence of any significant accumulation of PBMC in working muscles or other organs, do not explain the lymphocytopenia demonstrated here.

Adjuvants, Immunologic↗
PubMed1995

Haemorheological consequences of chronic cigarette smoking.

Smoking is a universally accepted major cardiovascular risk factor, but the mechanisms by which it promotes ischaemic vascular disease are not fully understood. The changes that chronic smoking exerts on the flow properties of blood might contribute to an explanation. It is well documented that smoking leads to a rise in haematocrit. It also alters the rheological behaviour of red blood cells and increases both plasma viscosity and fibrinogen levels. Finally, it increases the total white cell count and modifies leukocyte function. Together these changes cumulate in a significant deterioration of the flow properties of blood, as evidenced by a steep increase in whole blood viscosity. Alterations of blood rheology in turn can promote atherothrombogenesis in several ways. It seems possible, therefore, that one mechanism by which smoking increases the risk of vascular diseases operates through its complex effects on blood rheology.

Arteriosclerosis↗
PubMed1995

Mercury content in rat teeth after administration of organic and inorganic mercury. The effects of interrupted exposure and of selenite.

Rat molars are indicators of exposure concentration and target organ content in chronic mercury vapor exposure. We wished to study the accumulation and persistence of organic and inorganic mercury in rat teeth and the effect of selenium on mercury retention. Male Wistar rats received either inorganic or organic mercury (with or without addition of selenite), selenite only, or no mercury or selenite (controls) in the drinking water for 4 weeks. Group A was killed after exposure. Group B was killed 20 weeks later. The mercury content was measured by cold-vapor atomic absorption spectrophotometry. The mercury content in the molars in group B was 66% and 77% less than in group A after inorganic and organic exposure, respectively. In the incisors the corresponding reductions were 90% and 97%. Selenite had limited effect on mercury retention in group A and none in group B. We suggest that rat molars and, by inference, human deciduous teeth may serve as indicators of organic and inorganic mercury exposure.

Air Pollutants↗
PubMed1995

Complementary medicine: common misconceptions.

Complementary medicine (CM), defined as health care which lies for the most part outside the mainstream of conventional medicine, is gaining popularity in Britain and elsewhere. In the UK the most prevalent therapies are manipulation (used by 36% of the population), herbalism (24%) homoeopathy (16%) and acupuncture (16%). Due to the heterogeneity of CM, it is often problematic to generalize. The debate about the usefulness of CM is often regrettably emotional, and thus unproductive. In the pursuit of a more fruitful way ahead, the following highlights some of the main arguments from both 'sides' and tries to disguise them as misconceptions.

Attitude of Health Personnel↗
PubMed1995

[Clinical trials--methodological gold standard or naive reductionism?].

The methodological concept of the randomized controlled clinical trial is a relatively recent invention. It is widely accepted to be the only means of conclusively establishing a cause effect relationship between a given therapeutic intervention and an observed outcome. There are, however, numerous pitfalls. Ethical concerns and/or practical problems can seriously affect both proper randomisation as well as the use of a placebo treatment as the control intervention. Sometimes blinding of the patients or the therapist may be difficult or even impossible, depending on the availability of a similar treatment without the specific therapeutic effect, whereas a satisfactory investigator blinding can be achieved in most instances. Practical problems can be minimised by adapting the trial design to the given clinical situation. The fact that a number of drawbacks exist, must, however, not be used as an argument to abstain from performing such studies--simply because there is no better alternative.

Bias↗