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Biomedical subjects

E Ernst

Publications and source records attributed to E Ernst.

At least 541 records · Page 30Linked to original sources
PubMed1993

[Conservative therapy of backache. Part 4: Manual therapy].

The literature on the clinical effectiveness of manipulation in low back pain is extensive, although scientific studies that are free from flaws are much rarer. Most of the studies so far done show--with some reservations--a positive effect for manipulation. Given the proper indication, and with care being taken to observe contraindications, this modality can thus be recommended if performed by an experienced manipulator. However, this should not blind us to the fact that further investigations are necessary, and that the technique has no unequivocal advantages over exercise.

Contraindications↗
PubMed1993

[Conservative therapy of backache. Part 3: Physical therapy].

Physical exercise is accepted by many as the first line of treatment of low back pain. Nevertheless, hard data published so far have failed to demonstrate its benefit as clearly as we would wish. A wealth of exercise programs is available that escape systematic classification. The authors differentiate between general endurance training, and stretching, flexion and extension exercises. Whether endurance training is of benefit has not yet been unequivocally established. In contrast, stretching exercises have been shown to be effective. Flexion exercises have both proponents and opponents, while most randomized studies on extension exercises appear to demonstrate their effectiveness. Thus, physical exercise may be considered, at least in part, an effective form of treatment. Further research is needed to define the optimal exercise program for the individual patient as accurately as possible.

Exercise Therapy↗
PubMed1993

[Conservative therapy of low back pain. 2: Drug therapy].

Drug treatment of back pain is a useful adjunct to initial bedrest. A number of groups of drugs have proved effective. Analgesics and non-steroidal anti-inflammatory drugs can be recommended for short term treatment of acute cases. The effectiveness of muscle relaxants is unclear and, if prescribed they should be given only over the short term. Tricyclic antidepressants should be given only to patients with chronic pain complicated by a depressive component. A number of injection techniques are available for the treatment of refractory severe pain.

Anesthesia, Conduction↗
PubMed1993

[Conservative therapy of low back pain. Part 1: Immobilization].

The most common treatment for low back pain is bedrest, the purpose of which is to minimize pain caused by movement. Randomized studies have shown that this form of treatment is of use only over the short term. Whenever possible, the patient should be mobilized again after only 2 days. Long-term immobilization has a number of disadvantages. Lumbar corsets may be considered a form of partial immobilization, and are usually not recommended for unspecific back pain. As initial treatment of acute back pain, short term bedrest with proper positioning of the sufferer, possibly in combination with drug treatment can be employed.

Aged↗
PubMed1993

Fibrinogen as a cardiovascular risk factor: a meta-analysis and review of the literature.

PURPOSE: To evaluate the possibility that fibrinogen represents a cardiovascular risk factor. DATA IDENTIFICATION: A computerized literature search (1980 to 1992) identified all published epidemiologic studies on fibrinogen and cardiovascular disease. Clinical and basic research data were found by separate searches. References of all papers thus obtained were studied and relevant papers included. STUDY SELECTION: Six prospective epidemiologic studies were included in a meta-analysis (one study was excluded because the study population was non-representative). Clinical papers were reviewed separately for other evidence of causation. DATA EXTRACTION: The correlation of fibrinogen levels on the subsequent incidence of myocardial infarction, stroke, and peripheral arterial occlusive disease was assessed and the causality of the association was analyzed. Calculations were made to examine fibrinogen level (in tertiles) versus cardiovascular risk. Odds ratios of high versus low tertile were computed. RESULTS OF DATA ANALYSIS: All prospective studies showed that fibrinogen was associated with subsequent myocardial infarction or stroke. A total of 92,147 person-years was covered by these investigations. Odds ratios varied between 1.8 (95% CI, 1.2 to 2.5) in the Framingham and 4.1 (CI, 2.3 to 6.9) in the GRIPS study, with a summary odds ratio of 2.3 (CI, 1.9 to 2.8). Associations existed between fibrinogen and other cardiovascular risk factors, but after multivariate analysis, only the association between fibrinogen and cardiovascular events remained. The majority of the preconditions for causality were fulfilled, indicating that fibrinogen is pathophysiologically related to cardiovascular events. CONCLUSIONS: Fibrinogen can be considered a major cardiovascular risk factor. Future studies of cardiovascular morbidity and death should include this variable.

Cardiovascular Diseases↗
PubMed1993

[Low-dose laser therapy: critical analysis of clinical effect].

Low dose laser therapy (LDLT) has been available for the treatment of various diseases for almost two decades. The aim of therapy is usually to reduce pain. The literature offers a plethora of reports, some negative and some positive. This review discusses the relatively few placebo-controlled, double-blind trials on the subject, in an attempt to provide an evaluation of the clinical effectiveness of LDLT. The majority of these studies suggest that LDLT is not clinically effective. There is no particular disease or symptom which seems to respond to LDLT. The same can be said of the type of laser light or its intensity. Based on this collective data, LDLT does not seem to be a scientifically proven therapy.

Analgesia↗
PubMed1993

[Blood sedimentation--hemorheology in general practice].

AIMS: To describe the principle, measuring procedures and clinical information yield of the erythrocyte sedimentation rate with particular consideration of hemorrheological aspects. MAJOR POINTS CONSIDERED: ESR is a well established procedure with a checkered past which continues to be of considerable importance for screening purposes. Although the ESR is easy to carry out, the physical phenomena on which it is based are highly complicated. The measured value obtained is determined by a number of interacting factors. What is not well known is the fact that, in principle, it is a hemorrheological procedure. Numerous sources of error capable of affecting the ESR value must be taken into account. CONCLUSION: More recent developments suggest that ESR will continue to be of considerable value as a simple and inexpensive screening procedure.

Blood Cell Count↗
PubMed1993

Mercury in the rat hypothalamic arcuate nucleus and median eminence after mercury vapor exposure.

A histochemical technique has been used to reveal mercury deposits in the hypothalamic arcuate nucleus and median eminence of adult male rats. After exposure to long-term, low-level or short-term, high-level mercury vapor, silver-enhanced mercury grains were found in neurons of the arcuate nucleus. In addition mercury deposits were found in tanycytes, ciliated ependymal cells, and in the walls of capillaries. The mechanisms underlying uptake and possible induction of toxic effects are discussed.

Administration, Inhalation↗
PubMed1993

Detection of mercury in rat spinal cord and dorsal root ganglia after exposure to mercury vapor.

Adult male Wistar rats were exposed to mercury vapor, 50 micrograms Hg/m3, 6 hr/day, 5 days/week, over 1-, 2-, 3-, 4-, 6-, and 8-week periods. Sections from the spinal cord and dorsal root ganglia from spinal levels C1, C5, T6, and L1 were stained with the autometallographical technique and the distribution of mercury deposits described at light and electron microscopical levels. A quantitative analysis of the amount of mercury in blocks of the spinal cord was performed using cold vapor atomic absorption spectrophotometry. After an exposure period of 2 weeks, silver-enhanced mercury grains could be observed in spinal cord neurons located in Rexed laminae IV-X. Ventral horn motoneurons were heavily stained in all of the spinal cord segments. Ependymal cells and glial cells of both the spinal gray and white matter contained cytoplasmatic mercury accumulations in rats exposed to mercury vapor for 4 weeks. In the dorsal root ganglia, only ganglion cells showed a faint mercury staining and the amount of staining was notably less than that seen in the ventral horn motoneurons. At the ultrastructural level, mercury was seen primarily within lysosomes of target cells. The quantitative mercury measurements demonstrated that spinal cords from rats exposed to mercury vapor for 6 or 8 weeks contained a significantly higher concentration of mercury than those from control animals.

Administration, Inhalation↗
PubMed1993

Differentiation of silver-enhanced mercury and gold in tissue sections of rat dorsal root ganglia.

Autometallography was used in conjunction with light and electron microscopy to detect traces of gold and mercury in the dorsal root ganglia of rats treated with sodium aurothiomalate and mercuric chloride. In order to differentiate between gold and mercury in tissue sections, the gold accumulations were removed by potassium cyanide, leaving mercury sulphides/selenides as the only possible catalysts for autometallographic development. With this technique, it is now possible to differentiate between all tissue metals capable of initiating the autometallographic process, i.e. gold, vesicular zinc, and sulphides and selenides of mercury and silver.

Animals↗
PubMed1993

The role of fibrinogen as a cardiovascular risk factor.

Several epidemiological studies have produced longitudinal data identifying fibrinogen as a major cardiovascular risk factor. Cross-sectional results show strong associations between fibrinogen and a variety of demographic variables, cardiovascular risk factors, or diseases. Clinical cohort studies demonstrate that fibrinogen might also be a risk factor for the sequelae of cardiovascular disease. Knowledge about the determinants of the plasma level of fibrinogen in health and disease is as yet incomplete. Understanding of the mechanisms leading to the atherothrombogenic action of fibrinogen is also fragmentary. Fibrinogen strongly affects blood coagulation, blood rheology and platelet aggregation; in addition fibrinogen and its metabolites have direct effects on the vascular wall. Finally, fibrinogen is a prominent acute phase protein. All of these phenomena might provide some insight into the pathophysiological mechanisms involved. It is concluded that fibrinogen represents a major, independent risk factor that should now be included into the cardiovascular risk profile.

Arteriosclerosis↗