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Biomedical subjects

E Ernst

Publications and source records attributed to E Ernst.

At least 667 records · Page 37Linked to original sources
PubMed1990

Short time dialysis with continuous blood volume control.

Continuous measurement of haemoglobin concentration is used to control changes of blood volume during haemodialysis. Ultrafiltration is either kept constant throughout the session or after starting with a rate (1.5 to 2 l/h), is manually controlled in order to limit blood volume reduction to a pre-set percentage. Ultrafiltration is step-wise decreased (a) or switched on and off (b) accordingly. Blood volume decrease with constant ultrafiltration is compared with method (a) and (b) in 4 stable haemodialysis patients. Constant ultrafiltration rate and the same total amount of ultrafiltrate causes a nearly 3% (mean) greater volume reduction as compared with method (a) and (b). No difference was observed in blood pressure and heart rate. We conclude that ultrafiltration in stable haemodialysis patients can be completed in short time without consequences for cardiovascular stability.

Blood Pressure↗
PubMed1989

[Therapeutic consequences of hemorheologic research].

One of the possibilities to ameliorate blood perfusion is the modification of the rheological properties of blood. Hemodilution, enzymatic defibrinogenation and oral drugs are available at present to achieve this aim. Hemodilution is clinically successful with certain indications. The efficacy of enzymatic defibrinogenation cannot be judged finally. Within the group of rheologically active drugs a variety of substances are of proven effectiveness. Yet it is open whether this is brought about exclusively by hemorheological mechanisms.

Arterial Occlusive Diseases↗
PubMed1989

Influence of cilazapril on blood rheology in healthy subjects. A pilot study.

This study attempted to determine whether the autohemodilution that has repeatedly been shown to be induced by nitrates and other vasodilators is also produced by cilazapril. Fifteen healthy male volunteers were given 2.5 mg oral cilazapril daily for two weeks. Blood rheology was quantified by measuring blood and plasma viscosity, hematocrit count, red blood cell aggregation and deformability, and white blood cell clogging at baseline, four hours after first dose and four and 24 hours after the last dose. No acute or chronic changes were observed except for a significant increase in red blood cell deformability and a decrease in white blood cell clogging. It is concluded that hemodilution secondary to vasodilation may occur but be offset by hemoconcentration induced by aldosterone inhibition and decrease of anti-diuretic hormone levels. The changes in deformability and clogging may benefit microcirculatory function, a hypothesis that would need further investigation in controlled trials.

Adult↗
PubMed1989

The effect of n-3 fatty acids on lipids and haemostasis in patients with type IIa and type IV hyperlipidaemia.

Plasma lipids and haemostasis were investigated in 17 patients with hyperlipidaemia before and after 6 weeks supplementation with 6 g n-3 fatty acids. Nine of the patients had type IIa and 8 had type IV hyperlipidaemia. No effect on plasma cholesterol, LDL- or HDL-cholesterol were seen, but plasma triglycerides decreased after n-3 supplementation. Apolipoprotein B increased and apolipoprotein A1 decreased after the oil supplement. The bleeding time was prolonged, but platelet aggregation was unaltered by n-3 fatty acids. Protein C activity increased in type IIa and decreased in type IV after the supplement. Fibrinolysis was markedly depressed while von Willebrand factor antigen was reduced after intake of n-3 fatty acids.

Adult↗
PubMed1989

Hemorheological effects of oral contraceptives.

To determine the hemorheological effects of oral contraceptives, 50 healthy young women took no medication for 3 cycles. Subsequently they were randomized into group A and B. Group A took Diane-35, B took Microgynon each for 6 cycles. Finally 3 cycles without medication followed. Blood viscosity was quantified by ex vivo measurements of hematocrit, blood and plasma viscosity, red cell filterability, fibrinogen and colloid oncotic pressure. In group A fibrinogen rose at the end of the medication phase. In group B fibrinogen, blood and plasma viscosity increased on medication. The former 2 variables remained elevated even after discontinuation of the oral contraceptive. The data combined with those from the literature suggest that low-dose oral contraceptives lead to no biologically meaningful changes in blood rheology while higher doses induce limitations of blood fluidity which could be involved in the increment of cardiovascular risk by these medications.

Adult↗
PubMed1989

Leucocyte aggregation in burned patients.

Leucocyte aggregation describes one type of biophysical behaviour of white cells. To test whether this parameter is changed in burned patients, 15 burn victims were investigated immediately after admission into hospital. Cell counts and aggregation were measured and related to the prognosis of the injury. Compared with normal controls, burning injury is associated with higher white cell counts and enhanced leucocyte aggregation. Fatal injuries showed a (non-significant) tendency for higher aggregation values than survivors. There are significant positive correlations between white cell counts, maximal aggregation values and the burned body surface area. The results suggest that leucocyte aggregation is pathologically enhanced in response to burns. Possibly this alteration is of prognostic importance.

Adult↗
PubMed1989

Effects of n-3 fatty acids on blood rheology.

In spite of the recent flurry of interest in n-3 fatty acids, haemorheological effects have been somewhat neglected. When quantifying blood rheology by means of blood viscosity, plasma viscosity, haematocrit, red cell deformability and red cell aggregation measurements, it is observed that all these parameters (except for haematocrit) are altered significantly when an increasing dose of n-3 fatty acids is given to volunteers. In patients with hyperlipoproteinaemias similar effects are seen during an 8-week medication period. n-3 fatty acids seem to increase blood fluidity by at least two independent mechanisms: changing red cell deformability possibly by altering the cell membrane composition, and lowering plasma viscosity possibly by altering the protein pattern of the plasma. The therapeutic potential of the observed changes lies in increasing blood flow in ischaemic tissues and needs to be explored more thoroughly.

Adult↗
PubMed1989

Is increased plasma viscosity a risk factor for high blood pressure?

Data from several epidemiologic studies have suggested that, among other variables, hematocrit and fibrinogen may constitute risk factors for high blood pressure. As part of a population survey for cardiovascular risk factors, plasma viscosity and hemoglobin were measured. Blood pressure was determined under standardized conditions according to the recommendations of the AHA. A two-stage age-sex-stratified cluster sample of 5,312 persons, aged twenty-five to sixty-four years, was selected from a mixed urban/rural target population of 282,279 (total population approximately 533,000). A net response of 79.3% was achieved. Multiple logistic regression analyses including plasma viscosity, hemoglobin, body mass index, alcohol consumption, smoking behavior, and total serum cholesterol as independent variables were run controlling for both age and sex. Plasma viscosity appeared as a significant main effect in all analyses and demonstrated the strongest association with high blood pressure next to body mass index. Whether this association implies a causal relationship cannot be answered from cross-sectional data. However, even if plasma hyperviscosity represents a secondary phenomenon in hypertension, it might be of prognostic relevance. There is evidence that increased plasma viscosity may contribute to myocardial hypertrophy. Therefore hypertensives with impaired blood fluidity might constitute a subgroup at particular risk for cardiovascular complications. When antihypertensive drugs are selected, their influence on blood viscosity should be taken into account.

Adult↗
PubMed1989

Placebo-controlled, double-blind trial of hemodilution in peripheral occlusive arterial disease.

A number of uncontrolled trials has suggested that hemodilution is effective in peripheral occlusive arterial disease. This study was aimed at proving or disproving the efficacy of hemodilution by using a randomized, placebo-controlled, double-blind crossover design. Twenty-four stable claudicants with long, collateralized femoropopliteal obstructions were treated with isovolemic hemodilution with 500 mL of 10% hydroxyethyl starch 200 and sham dilutions. Three weeks of hemodilution lowered blood and plasma viscosity, as well as hematocrit, and increased resting blood flow and pain-free walking distance. Placebo treatments produced no such favorable changes. It is concluded that hemodilution therapy can be clinically effective in patients with arterial obstructions in the lower extremities. Hemodilution seems particularly promising under hemodynamic condition of low shear stresses in vivo.

Blood Viscosity↗
PubMed1989

The fibrinolytic system during short-term treatment with tenoxicam.

The effect of 20 mg tenoxicam once daily for 7 days on various components of the fibrinolytic system was studied in 10 healthy volunteers. Plasma plasminogen, antithrombin 3, and prekallikrein decreased significantly while plasma plasminogen activator inhibitor increased significantly. The medication did not affect fibrin plate lysis area or the plasma level of plasminogen activator, alpha-2-antiplasmin, alpha-2-macroglobulin, C1 inactivator or Factor XII. It is suggested that these changes may be caused by interference with hepatic enzyme systems. The reduction in plasma prekallikrein may indicate that tenoxicam exerts its anti-inflammatory effect by more than one mechanism.

Adult↗
PubMed1989

Changes in PMN leukocyte migration activity and complement C3d levels in RA patients with high disease activity during steroid treatment.

We have investigated chemotaxis of polymorphonuclear granulocytes (PMN) from 7 well characterized RA patients with intense disease activity, before and after steroid treatment. Increased spontaneous and directed granulocyte migration was observed in 6 out of 7 patients before steroid treatment. In 5 patients these parameters were reduced after treatment. In contrast to this, decreased chemotaxis of polymorphonuclear granulocytes (PMN) from patients with Rheumatoid Arthritis (RA), have been reported earlier. This has been suggested as a partial explanation of the increased morbidity of these patients. Plasma levels of Complement C3d were initially increased in all patients and were slightly reduced following treatment. PMN migration in highly active RA cases is increased and responds markedly to steroid treatment, in contrast to the complement activation. The mainly unaffected, increased levels of plasma C3d might, in part, explain the early recurrence of symptoms often seen when steroid medication is withdrawn. Our results contrast with earlier findings and need to be confirmed in further studies.

Acute Disease↗
PubMed1989

[Hemorheologic effects of calcium antagonists in comparison with beta receptor blockers].

Normalizing rheological deficits may enhance perfusion. Both betablockers and calcium antagonists induce such effects in various populations due to differing mechanisms. In the case of calcium antagonists, this could synergistically contribute to a reduction of the peripheral resistance, predominantly caused by vascular changes. This hypothesis requires experimental testing.

Adrenergic beta-Antagonists↗
PubMed1989

Changes in blood rheology of grossly obese individuals during a very low calorie diet.

A group of grossly obese individuals were put on a 300 kcal diet for 15 days. Blood rheology was quantified by measuring blood and plasma viscosity, haematocrit, red cell aggregation and deformability, fibrinogen and ESR. After 15 days blood viscosity had decreased and red cell deformability increased. The results suggest that the rheological deficit in obesity can be partly normalized by low calorie diets.

Blood Viscosity↗