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Biomedical subjects

E Ernst

Publications and source records attributed to E Ernst.

At least 649 records · Page 36Linked to original sources

Dose-response studies on the effect of n-3 polyunsaturated fatty acids on lipids and haemostasis.

We have studied the dose-response effects of dietary supplementation with n-3 polyunsaturated fatty acids (n-3 PUFA's) on lipids and haemostasis. Ten healthy males were each given 1.3 g, 4 g or 9 g of n-3 PUFA's daily for 6-week periods. Bleeding time, HDL-cholesterol and plasminogen activator inhibitor increased with the dose of n-3 PUFA. Plasma fibrinogen and triglyceride levels were reduced in a dose-dependent fashion. After ingestion of 1.3 g of n-3 PUFA's plasma fibrinogen decreased from 9 to 7 mumol/l and HDL-cholesterol increased from 1.2 to 1.3 mmol/l. The bleeding time was prolonged from 5 to 6.5 min while triglyceride levels decreased from 1.2 to 0.9 mmol/l after ingestion of 4 g of n-3 PUFA's. Dietary supplementation with the highest daily dose (9 g) reduced plasma levels of triglycerides, fibrinogen and von Willebrand factor, while bleeding time, plasminogen activator antigen, plasminogen activator inhibitor and the ratio of HDL-cholesterol to total cholesterol increased.

Adult↗

[Modification of blood flow properties by physical stimuli].

The pharmacological modification of blood rheology is an accepted means of therapy for circulatory diseases. In the search for modes of physical treatment which induce similar rheological changes, various physical stimuli were tested under differing experimental conditions. Some show no rheological effects; others induce negative, or in some cases positive rheological changes. At present it seems premature to draw clinical conclusions from most of these observations. As regards regular physical training, however, the emerging picture is clearer. Training seems to enhance blood flow in ischaemic diseases partly due to its positive effects on blood rheology.

Arterial Occlusive Diseases↗

Plasma atrial natriuretic peptide in elite runners.

Plasma atrial natriuretic peptide (ANP) was measured in relation to a 5-km race in 11 elite mid- and long-distance runners. Plasma ANP, measured in relation to the race, was compared with the relative changes in plasma volume and the physical fitness of the runners. Relative changes in plasma volume were estimated by changes in hemoglobin and hematocrit, and physical fitness was evaluated by a cycle ergometer test, running time, and resting heart-rate. In connection with the race, plasma ANP increased in all the runners. Median plasma ANP was 4.7 pmol.l-1 before the race and 12.9 pmol.l-1 immediately after the race. No correlation was found between the changes in ANP and the relative changes in plasma volume or the measurements of physical fitness. A volume expansion of the red blood cells was found immediately after the race. We conclude that well-conditioned subjects have a prominent rise in plasma ANP, in spite of a high maximal cardiac output.

Adult↗

A double-blind trial of Dextran-haemodilution vs. placebo in claudicants.

Haemodilution is often recommended for peripheral arterial disease, yet little data is available to support its clinical efficacy. This study was designed to prove or disprove the effectiveness of Dextran-haemodilution in intermittent claudication. Twenty claudicants with long, well-collateralized arterial occlusions were randomized into groups 1 and 2. Group 1 received isovolemic haemodilution with Dextran 40 (500 ml per session) during 3 weeks, which was followed by a wash-out period, followed by placebo treatments for 3 weeks. In group 2 this sequence was reversed. Pain-free and maximal walking distances were measured by standardized treadmill tests along with plethysmographic blood flow, Doppler pressures, haematocrit, blood and plasma viscosity as well as fibrinogen. Walking distances increased significantly by about 50% during haemodilution in both groups. This was paralleled by a fall in haematocrit and blood viscosity. All other variables remained constant. During placebo treatments there were no significant changes of any variable. The treatment was tolerated without complications. Thus Dextran-haemodilution seems safe and effective in selected peripheral occlusive arterial disease (POAD) patients. Potential responders might be identifiable before the start of therapy by angiographic investigations. The clinical effectiveness of Dextran 40 is comparable to that of hydroxyethyl starch 200 as reported in the literature.

Adult↗

Plasma fibrinogen--an independent cardiovascular risk factor.

Apart from being an acute phase reactant, fibrinogen appears to play an important although not widely recognized role in athero-/thrombogenesis. Arteriosclerotic diseases are associated with elevated levels of plasma fibrinogen. Strategies that lower the cardiovascular risk also lower fibrinogen levels. Virtually all accepted risk factors are associated with hyperfibrinogenaemia, while low risk populations usually have low fibrinogen levels. Epidemiological studies show that fibrinogen is a predictor of arteriosclerotic diseases. Its predictive power seems to be as high as or higher than accepted risk factors. These findings and other circumstantial, as well as experimental, evidence suggest that fibrinogen is a powerful, independent cardiovascular risk factor.

Animals↗

Effect of physical exercise on cytokines and lymphocyte subpopulations in human peripheral blood.

To examine the effect of intensive physical exercise on interleukin 2 (IL-2), tumor necrosis factor alpha (TNF alpha) and lymphocyte subsets, eleven elite and well-conditioned runners were tested in relation to a five-kilometer race. IL-2 was significantly decreased (p less than 0.01) immediately after the exercise and significantly increased after 24 hours (p less than 0.05), compared to the pre-exercise values taken at steady state. TNF alpha was significantly increased after 2 hours (p less than 0.05), and returned to habitual values after 24 hours. In the steady state at rest, elevation of HLA-DR+ cells was observed in all runners compared with control subjects (p less than 0.05), indicating a persistent activation of lymphoid cells. In connection with exercise a significant increase in NK cells (CD16+) was observed (p less than 0.01). The T-helper/T-suppressor (CD4+/CD8+) ratio was significantly reduced in connection with physical activity (p less than 0.01). In seven runners the ratio was reduced to a value of less than one. This decrease was observed immediately after the exercise, followed by increased ratios 2 hours later (p less than 0.01), due to oppositely directed quantitative changes of the CD4+ and CD8+ cell populations. After 24 hours the ratios returned to habitual levels. Furthermore, we confirmed an increase in the total number of granulocytes in connection with exercise (p less than 0.01), and observed a decrease in absolute numbers of lymphocytes two hours after exercise (p less than 0.01). We emphasize the importance of obtaining information about physical activity within the previous 24 hours before measuring white blood cell parameters.

Adult↗

Does blood rheology revert to normal after myocardial infarction?

After myocardial infarction there is an acute deterioration of the flow properties of blood. The present study was designed to test whether the abnormality persists. Blood and plasma viscosity, red cell aggregation and deformability, haematocrit, erythrocyte sedimentation rate, white cell count, cholesterol, and triglycerides were measured in 51 patients who had had a myocardial infarction 5.4 (mean) years before. Results in patients and controls were compared and matched pairs with identical cardiovascular risk factors were also selected. Blood viscosity and red cell aggregation were increased and red cell deformability was decreased in the 51 patients. The abnormalities were independent of the interval since infarction and persisted for years. The rheological abnormalities present after myocardial infarction are at least partly independent of the acute event and acute phase reactions. They contribute to the reduced perfusion of the microcirculation of the heart.

Adult↗

A review of stroke rehabilitation and physiotherapy.

Most of the members of the therapeutic team in stroke rehabilitation take the effectiveness of physical treatments after stroke for granted. Yet, published data show that the evidence is not so straightforward or easy to evaluate. The majority of the hard evidence, however, does imply that stroke patients benefit from rehabilitation with physiotherapy. This benefit may be statistically small, but for a given individual, it could mean the difference between living at home or in an institution. Few studies address the question of the optimal physiotherapy in stroke rehabilitation. The evidence available today suggests that it does not matter which form of treatment is chosen and that any of the available approaches will improve the patient's functional status. In other words, if an optimal treatment exists, we have, so far, failed to identify it. Until further evidence emerges, we should therefore select therapies that are most cost-effective and that can be given to the largest number of patients. Well-planned clinical trials aimed at finding the best approach and discriminating potential responders from nonresponders are urgently needed.

Aged↗

Regular sauna bathing and the incidence of common colds.

The high morbidity of common colds means that their economic importance is considerable, with colds causing more loss of productivity than any other infection. As no effective prophylaxis is available, this trial was to test the hypothesis that sauna bathing can reduce the incidence of common colds. Twenty-five volunteers were submitted to sauna bathing, with 25 controls abstaining from this or comparable procedures. In both groups the frequency, duration and severity of common colds were recorded for six months. There were significantly fewer episodes of common cold in the sauna group. This was found particularly during the last three months of the study period when the incidence was roughly halved compared to controls. The mean duration and average severity of common colds did not differ significantly between the groups. It is concluded that regular sauna bathing probably reduces the incidence of common colds, but further studies are needed to prove this.

Adult↗

The effects of calcium channel blockers on blood fluidity.

Although vasodilation, direct cardiac actions, or both represent the main properties of calcium channel blockers, there are further pharmacologic effects that may be therapeutically relevant. For example, hemorrheological effects, which have been demonstrated for a variety of calcium antagonists, have received relatively little attention to date. Hemorrheology describes the mechanics of blood and its components. It is of particular interest in the context of cardiovascular disease, as it has been shown that under certain conditions (reduced pump function, impaired vasomotor reserve), parameters of blood fluidity may be crucial for tissue perfusion. Whole-blood viscosity is the dominating factor in large arteries. For geometrical reasons, plasma viscosity and the rheological properties of blood cells may become of paramount importance at the microcirculatory level. In ischemic states, erythrocytes may be depleted of ATP, which they need for maintenance of normal shape and for transformation. This results in rigidification of the red blood cell and hindrance of its passage in the microcirculatory bed. Hence, blood flow deteriorates with the consequence of further unfavorable changes of the "milieu interieur," leading to the induction of a vicious cycle. Although effects on several hemorrheological parameters, for example, whole-blood viscosity, plasma viscosity, and red cell aggregation, can be demonstrated for various calcium channel blockers, the main rheological effects of these compounds are believed to consist in the improvement of erythrocyte deformability. When the ATP-dependent calcium pump is impaired in ischemia, calcium channel blockers may inhibit the slow inward transmembrane calcium flux and prevent the accumulation of intracellular calcium.

Blood Viscosity↗

Reduction of complement activation in rheumatoid arthritis by steroid treatment.

Patients with severe active active rheumatoid arthritis (RA) have higher than normal plasma concentrations of the complement C3 split-product C3d, indicating increased complement activation. Treatment with steroids reduced plasma C3d levels in these patients. Ten patients with classic or definite RA and high disease activity were studied during six days of treatment with steroids. The C3d plasma concentrations declined in a dose-related manner with an increase in daily prednisolone dosage. However the statistical significance of this relationship did not seem to be high enough to validate the use of serial C3d estimations to monitor changes in disease activity in RA patients during short-term steroid treatment.

Arthritis, Rheumatoid↗

[Erythrocyte sedimentation rate. History and importance today].

ERS-related methods have been used since ancient times. Its scientific basis was disclosed in the 18th century, subsequently forgotten and rediscovered in the 19th century. Fahraeus and his scholar Westergren finally popularized the method. The ESR is a simple test which is determined by a complex interaction of various factors. It is suited predominantly as a screening method for inflammatory diseases. Tests that are easier to interpret, like plasma viscosity, have (so far?) not substituted ESR in German speaking countries.

Blood Sedimentation↗