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Biomedical subjects

E Ernst

Publications and source records attributed to E Ernst.

At least 559 records · Page 31Linked to original sources
PubMed1993

Smoking, a cause of back trouble?

Epidemiological studies strongly imply that smoking may be a risk factor for back problems. It has been speculated that this is due to frequent coughing, unhealthy life style or osteoporosis in smokers. All of these hypotheses, however, do not accord with the experimental evidence. A new theory is therefore proposed. It suggests that smoking leads to malnutrition of the disc which in turn renders it more vulnerable to mechanical stress. Malnutrition can be brought about by carboxyhaemoglobin formation, nicotine-induced vasoconstriction, arteriosclerotic vessel wall changes, impairment of fibrinolytic activity and changes in the flow properties of blood. The evidence supporting these pathomechanisms is discussed. Future studies should test the above hypothesis experimentally.

Back Pain↗
PubMed1993

Regular exercise reduces fibrinogen levels: a review of longitudinal studies.

Fibrinogen can be considered as a major cardiovascular risk factor. Therefore there is a growing interest in methods to lower its plasma level. This paper is aimed at reviewing the data investigating the effects of regular exercise on plasma fibrinogen levels. Cross-sectional studies strongly suggest that regular exercise will reduce fibrinogen levels, and longitudinal data confirm this. The average decrease achieved by regular endurance exercise over several months is around 0.4 g/l. It can be extrapolated that this corresponds to a substantial decrease in risk of coronary heart disease. It is concluded that regular exercise is the most practicable approach known to date to lower plasma fibrinogen levels.

Coronary Disease↗
PubMed1993

Asymptomatic varicocele testis.

The incidence of asymptomatic varicocele among 542 unselected military conscripts in Denmark was 9%. Semen from 39 of the 49 men with varicocele was compared with findings in age-matched, varicocele-free controls. The overall quality of the semen was reduced in the varicocele group (p < 0.001), with significantly lower parameters of sperm concentration, total sperm count, qualitative motility and sperm motility after 24 hours. There was also significant difference in morphology, with more amorphous spermatozoa and more with tail defects (p < 0.05) in the varicocele group. The study indicated an association between asymptomatic varicocele and compromised sperm quality. The advisability of surgical treatment was not clarified, but the two groups of men will be further observed with special regard to this question.

Adult↗
PubMed1993

[The cervical spine whiplash trauma].

The whiplash injury is a classical injury of the upper spine following a car crash. It results from hyperextension and hyperflexion of the upper spine. In most cases no morphological changes can be verified. Thus the diagnosis has to be clinical, based on subjective symptoms. The prognosis is often good; the true problem are those few patients who develop chronic complaints. Therapy consists of initial immobilisation, analgetics and physiotherapy. Reasonable driving, safe cars and head rests should help to prevent whiplash injuries.

Animals↗
PubMed1993

Fibrinogen as a cardiovascular risk factor--interrelationship with infections and inflammation.

Epidemiological evidence suggests that fibrinogen represents a major cardiovascular risk factor. Clinical data is in full agreement with this hypothesis. As fibrinogen also represents an acute phase protein, its association with atherosclerosis could be linked to infection or inflammation of other organs. Moreover, it could be connected to the inflammatory phenomena of atherosclerosis itself. These two possible explanations for the link between fibrinogen and atherosclerosis are discussed in detail. On balance, the evidence for either is not fully convincing. Therefore the most likely explanation for the striking association between fibrinogen and cardiovascular events is that hyperfibrinogenaemia is causally related to atherothrombosis, independent of its role as an acute phase protein. Several plausible pathophysiological pathways exist which would explain how fibrinogen leads to major cardiovascular disease. It is concluded that fibrinogen is a cardiovascular risk factor in its own right; its measurement should be included in future cardiovascular risk profiles.

Acute-Phase Reaction↗
PubMed1993

Identification of different target glycoproteins for bovine herpes virus type 1-specific cytotoxic T lymphocytes depending on the method of in vitro stimulation.

Vaccinia virus recombinants expressing the three major bovine herpes virus-1 (BHV-1) glycoproteins gI, gIII and gIV were used to identify the major target antigens for BHV-1-specific CTL isolated from immune cattle. Peripheral blood mononuclear cells (PBMC) expanded in vitro in the presence of interleukin-2 (IL-2) and lysed both gIII- and gIV-infected target cells. Secondary in vitro stimulation of PBMC was also performed in the presence of either fixed BHV-1-infected autologous fibroblasts or ultraviolet (UV)-inactivated virus. Both methods of antigen presentation allowed the proliferation of BHV-1-specific CTL but the target glycoprotein for these CTL differed depending on the method of stimulation. Vaccinia-gIV-infected targets were lysed predominantly when PBMC were stimulated by fixed infected fibroblasts, whilst PBMC stimulated by UV-inactivated virus lysed mostly vaccinia-gIII-infected targets. This observation could be explained by a different processing pathway of BHV-1 antigens in each cell type involved.

Animals↗
PubMed1993

[Disk hernia, operate or not?].

There is often a high degree of uncertainty concerning the treatment of disc hernias. In cases with uncertain indication for operation only few hard data are available to base therapeutic decisions on. According to the few available controlled studies, which are discussed in detail, surgery yields better results only in the first year after surgery. There is no difference in the longer-term prognosis between surgery and physiotherapy. The need for further controlled trials using modern imaging techniques is obvious.

Cauda Equina↗
PubMed1993

[Is prevention really better than healing? A discussion contribution to prevention of spinal diseases].

Primary, secondary and tertiary prevention are usually differentiated. All preventive measures have to prevail against criteria of effectiveness and efficiency. In the case of primary prevention, the search for risk factors is particularly important. The present limits of prevention of back pain are discussed in some detail; these exist mainly because at present our knowledge is incomplete. In the long run, prevention in the absence of a solid scientific basis is counter-productive. The only successful way of identifying effective preventive measures for back pain is to intensify research.

Back Pain↗
PubMed1993

[An analysis of the clinical effectiveness of manual therapy in cervical vertebrae syndrome].

The aim of this review was to evaluate the clinical effectiveness of manipulation techniques as a therapy for cervical pain syndromes. Only few randomized trials have been published on this matter. They come to contradictory conclusions. In this unclear situation, the prescribing physician should note that there is no scientific evidence to suggest that manipulations are superior to other forms of treatment, for instance exercise therapy. Further research in this area seems therefore mandatory.

Cervical Vertebrae↗
PubMed1992

[TENS: fiction and fact].

TENS (transcutaneous electrical nerve stimulation) is a widely used therapeutic principle that is aimed at ameliorating pain of various genesis. Its effectiveness had been more or less accepted, when a study denying this very point was published and gave rise to considerable international uncertainty. The result was general rejection of TENS (at least in the USA). This reaction is, however, certainly not justified. An analysis of the international literature shows that most original data are favorable to TENS. It is to be hoped that the matter will again receive intensive international research and that within a few years we will have identified the indications for this form of therapy.

Humans↗
PubMed1992

Fibrinogen and viscosity as risk factors for subsequent cardiovascular events in stroke survivors.

OBJECTIVE: To investigate whether abnormalities in blood viscosity predict a poor prognosis for subsequent cardiovascular events in stroke survivors. DESIGN: Nested case-control study among a cohort of survivors of a first stroke, followed for an average of 2 years. Patients with a second stroke, myocardial infarction, or cardiovascular death were matched with patients who did not have such events (control patients). SETTING: Buchberg-Klinik, Bad Tölz, Germany, a specialized center for stroke rehabilitation. PATIENTS: A total of 625 consecutive patients. Twenty-one patients (3.5%) were lost to follow-up. Sixty pairs were matched. MEASUREMENTS: Native and hematocrit-standardized blood viscosity at three shear rates, hematocrit, plasma viscosity, fibrinogen, erythrocyte sedimentation rate, total leukocyte count, and the matching variables. RESULTS: Eighty-five patients had a second stroke, myocardial infarction, or died due to a cardiovascular event. Patients with re-events had higher blood viscosity and fibrinogen levels than the control patients. In the 60 matched pairs, the mean of the paired differences between patients with re-events and control patients was 5.03 mPa.s (95% CI, 1.262 to 8.941; P = 0.01) for native blood viscosity at shear rate 0.7 s-1, for plasma viscosity, 0.044 mPa.s (CI, 0.006 to 0.083; P greater than 0.02), and for fibrinogen, 0.056 g/L (CI, 0.010 to 0.101; P greater than 0.02). Odds ratios were significantly increased only for plasma viscosity (odds ratio, 2.86; CI, 1.06 to 8.43) and fibrinogen (odds ratio, 3.67; CI, 1.31 to 11.69). CONCLUSIONS: Hyperfibrinogenemia is an independent risk factor for cardiovascular events in stroke survivors. Intervention trials with fibrinogen lowering measures may be warranted.

Aged↗
PubMed1992

Reviewer bias.

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Observer Variation↗