Search PubMed⌕ Search

Biomedical subjects

E Ernst

Publications and source records attributed to E Ernst.

At least 631 records · Page 35Linked to original sources
PubMed1991

[Hemodilution in peripheral arterial occlusive disease. Placebo controlled randomized double-blind study with hydroxyethyl starch or dextran].

Hemodilution is often recommended for peripheral arterial occlusive disease, yet the ultimate proof of efficacy is lacking in two randomized, placebo-controlled, double-blind, crossover trials (one using Dextran 40 and the other 10% hydroxyethyl starch 200) it has been shown to clinically benefit claudicants. During the hemodilution phases of these trials, where a 500 ml volume was exchanged against 500 ml blood, there was a significant prolongation of the walking distances. With sham-hemodilution there were no beneficial effects. These studies suggest furthermore that responders and non-responders to hemodilution can be identified prior to therapy by angiogram. A theory is developed which implies that low shear forces in vivo are a precondition for the clinical effectiveness of hemodilution. The experimental evidence supporting this theory is reported. Dextran and hydroxyethyl starch do not seem to differ with respect to their clinical response. It is concluded that hemodilution is effective for peripheral arterial occlusive disease stage II and probably even more effective in more advanced stages.

Arterial Occlusive Diseases↗
PubMed1991

[Rehabilitation following myocardial infarct].

Today rehabilitation after myocardial-infarction is a routine measure in most countries, yet its effectiveness is still under discussion. Rehabilitation aims at ameliorating the quality of life and at preventing a cardiovascular reevent, in other words at prolonging life. The latter "hard" endpoints is best amenable to quantification. Only recent meta-analyses of pooled data were able to show that rehabilitation in fact does prolong life. The relative importance of physical exercise in mostly complex rehabilitation programs is even less clear. This analyses implies a benefit, yet the exact proof is still missing. If rehabilitation could be shown to improve quality of life, its application would, of course, be justified even if it did fail to prolong life. Important open questions relate to the optimizing of rehabilitation: duration, frequency, intensity as well as age and sex of responders. Answering these will be a challenge for tomorrow's rehabilitation medicine.

Combined Modality Therapy↗
PubMed1991

[Fibrinogen: a "new" cardiovascular risk factor].

There can be little doubt today that fibrinogen is a major cardiovascular risk factor. In spite of this clear message, many fundamental problems are as yet unsolved. We know too little at present about the determinants of the "normal" fibrinogen level, about the biochemical control of its synthesis, and about the mechanisms involved in harming the circulatory system. From a practical point of view we can use today's knowledge 1) to identify individuals at risk, 2) to normalize (within limits) their plasma fibrinogen levels. A precondition for the latter strategy would be that fibrinogen and the cardiovascular risk are causally related. Even though the published data does support this view, it has to be established more firmly in the future.

Austria↗
PubMed1991

[In what manner does regular training prolong life?].

Regular endurance exercise prolongs life mostly by reducing the cardiovascular risk. Many mechanisms might be involved and it is not possible to define their relative importance. Possibly, hemodynamic effects contribute to quality of life and the ability of exercise to influence classical cardiovascular risk factors eventually prolongs life. In any case, regular exercise is certainly an excellent means of primary prevention of atherosclerotic diseases.

Cardiovascular Diseases↗
PubMed1991

[Hemorheologic and clinical changes in ankylosing spondylitis during hyperthermia].

In this controlled study the short- and longterm effects of whole body hyperthermia in ankylosing spondylitis were investigated. Longitudinal and cross-sectional analyses show positive effects: reduction in blood and plasma viscosity, normalization of red cell deformability, reduction of analgetics' use, increase in motility and subjective improvement of well-being. Clinical and rheological changes correlate which might imply (but does not prove) a causal relationship between the two.

Adult↗
PubMed1991

A single blind randomized, controlled trial of hydrotherapy for varicose veins.

Sixty-one patients suffering from primary varicosity were divided into 2 groups, one receiving regular hydrotherapy, the other no such treatment for 31/2 weeks. Objective evaluation of the venous competence showed an apparently greater benefit in the control group in respect to light reflex rheographic venous filling time. The leg volume changes, however, indicated a stronger and more persistent reduction in the experimental group. The same applied for ankle and calf circumferences, which were reduced significantly only in patients treated with hydrotherapy. Furthermore some (but not all) of the subjective symptoms yielded significantly more frequent improvement in this group. In conclusion this controlled study implies that hydrotherapy may help patients suffering from primary varicose veins, a notion which was previously often stated but so far not scientifically verified.

Female↗
PubMed1991

[Physical medicine--a field between empiricism and science].

Physical Medicine is more deeply rooted in empiricism than most other medical fields. This causes problems and the demand for scientific testing of its methods. Selected examples are given relating to prevention, therapy and rehabilitation. They show that scientific testing is possible also in Physical Medicine and can lead to positive results.

Arterial Occlusive Diseases↗
PubMed1991

[Hyperviscosity. An independent risk factor after a survived stroke].

Several lines of evidence indicate that pathologic blood flow properties lead to a deterioration in the prognosis of patients with arteriosclerotic diseases, especially after a stroke. We tested this hypothesis in a prospective study including 625 patients with a first stroke that dated back less than five years (7.4 +/- 11.3 months, mean +/- sd). Investigated parameters were native and hematocrit standardized blood viscosity (at shear rates 0.7 s-1, 2.4 s-1 and 95.5 s-1) and its most important determinants (i.e. hematocrit, plasma viscosity, fibrinogen), erythrocyte sedimentation rate, leukocytes, cholesterol, triglycerides, blood pressure and BMI. For smoking patients were scored into four groups. Two years after these investigations a follow up was performed (response rate 96.3%). 71 patients with study endpoint (second stroke, heart attack or death due to the underlying cardiovascular disease) were identified. In 65 cases matching of a patient with and a patient without endpoint was possible. Criteria for matching were: cholesterol, triglycerides, diabetes, BMI, gender, age blood pressure, smoking, time interval between first stroke and rheologic measurements and concomitant diseases. Native blood viscosity was significantly higher in patients with endpoint (p less than 0.01) as compared to patients without (37.4 +/- 12.5 mPas vs 32.1 +/- 8.9 mPas at a shear rate of 0.7 s-1). All other variables did not differ significantly between both groups. It is concluded that in patients, who have survived a first stroke, high blood viscosity is a risk factor, independent from the accepted ones.

Blood Flow Velocity↗
PubMed1991

[Blood fluidity and omega-3 fatty acids].

Omega-3 fatty acids are highly unsaturated fatty acids with a first (counted from the methyl end) double bound at the third carbon atom. Their biological effects--mainly changes of blood lipids and of the eicosanoid pattern--are due to a competitive inhibition of omega-6 fatty acids within the prostaglandin metabolism. Hemorheological effects have also been described repeatedly. A placebo-controlled, double blind study shows that red cell deformability is raised and blood viscosity decreased by omega-3 fatty acids in stepwise increasing doses. When the dose is further increased there is a drop of plasma viscosity and red cell aggregation. An open study with hyperlipoproteinemic patients confirms these effects: After 21 days of 8 capsules Ameu per day there is a significant reduction of plasma viscosity. After 56 days treatment (same dosage) blood viscosity drops and red cell deformability increases significantly. At present the evidence is growing to suggest that omega-3 fatty acids can delay atherogenesis. The above data allow the hypothesis that hemorheology may be involved in this.

Adult↗
PubMed1990

[Hardening against the common cold--is it possible?].

The common cold has great socio-economic impact. To date, no prophylaxis has been scientifically shown to be effective. A number of older reports implied that visits to the sauna and other thermotherapeutic measures might provide a certain degree of protection. More recent data suggest that this supposition is probably true. Nevertheless, there are a number of important questions still to be answered in this area.

Cold Climate↗
PubMed1990

[Rheologic risk factors of apoplexy].

There can be no doubt about the relevance of various established risk factors of stroke, which therefore will not be discussed. When trying to manipulate factors as hypertension, hyperlipoproteinemia and smoking, in most cases an improvement of the flow properties of blood can be observed. This makes flow properties at least very likely to trigger cerebral ischaemia and stroke. Furthermore there is increasing evidence, that single factors, contributing to a deterioration of blood rheology (i.e. haematocrit, fibrinogen, plasma viscosity, red cell rigidity) may be considered risk factors of apoplexie depending on the quality of interaction. There seem to exist positive correlations to the extent of atherosclerotic alterations of the vessel system. Blood viscositiy and red cell aggregation can be interpreted as the respective state of different pathologic profiles of blood rheology and thus might reach pathologic levels already before it is notified by single factors. In conclusion there is a good chance for blood viscosity and red cell aggregation to play an independent role as risk factors of apoplexie derived from cerebral ischaemia.

Blood Viscosity↗
PubMed1990

[Physical therapy of rheumatoid arthritis].

Physiotherapy is an important component of the treatment regimen for rheumatoid arthritis, and is aimed mainly at reducing pain and preserving function. Depending on the severity of the disease and the clinical picture, physiotherapy, ergotherapy, hydrotherapy and heat treatment, as well as massage and electrotherapy may all be considered. When properly applied, these treatments have the advantage of being free of side effects. Scientific proof of effectiveness is often lacking in physical medicine, which clearly represents a challenge to the discipline in the years to come.

Arthritis, Rheumatoid↗