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Biomedical subjects

C Ring

Publications and source records attributed to C Ring.

At least 19 recordsLinked to original sources
PubMed2006

[Improvement of anxiety and depression in women with breast cancer during inpatient oncological rehabilitation-- results of a prospective study].

PURPOSE: Investigation of the influence of an oncological inpatient rehabilitation programme on anxiety and depression in women with breast cancer. PATIENTS AND METHOD: 198 women with breast cancer, aged 25 to 75 years, filled in the Hospital Anxiety and Depression Scale (HADS) German version at the beginning and end of inpatient rehabilitation. Focus was set on the frequency of anxiety and depression. Therefore proportions with 95 % confidence intervals (CI) were built. The before-after comparison of HADS-scores was made using the signed rank test with two-sided level of significance of alpha = 5 %. In addition effect sizes were calculated. Possible relations between the scores at the beginning of rehabilitation and the patients' age or the interval since diagnosis were analysed by calculating correlation coefficients. RESULTS: At the beginning of rehabilitation a state of anxiety was probable in 23.2 % (CI [17.3 %; 29.1 %] of the women and one of depression in 9.1 % (CI [5.8 %; 13.9 %]). In other words, they reached a level of >or= 11 score points on each scale. No correlation was found with the age of the patients or the time interval since diagnosis (|r| <or= 0.192). At the end of rehabilitation 67.5 % (CI [61.0 %; 74.0 %]) and 60.9 % (CI [54.1 %; 67.7 %]), respectively, of the women showed an improvement of anxiety and depression. The before-after difference was a median + 2 points (anxiety) and + 1 point (depression), resp., with a positive value representing an improvement. The changes after rehabilitation were statistically significant with p < 0.0001. The effect sizes ranged from 0.37 to 0.50. CONCLUSIONS: After the end of primary therapy, women with breast cancer frequently suffer from anxiety or depressive disorders, with no correlation to the patients' age or time since diagnosis. By an inpatient oncological rehabilitation programme both anxiety and depression can be improved very successfully. Whether these results represent a long-term effect is currently being evaluated in a randomised prospective study.

Adult↗
PubMed2005

Increased C reactive protein in response to acute stress in patients with rheumatoid arthritis.

OBJECTIVE: To assess the effects of acute stress on inflammatory, haemostatic, rheological, and haemodynamic activity in patients with rheumatoid arthritis (RA) in comparison with patients with osteoarthritis (OA). METHODS: 21 patients with RA and 10 with OA underwent a brief mental stress task while standing. Inflammatory, haemostatic, rheological, and haemodynamic variables were measured at baseline, during the task, and at recovery. RESULTS: At baseline, erythrocyte sedimentation rate and fibrinogen were higher in RA than OA. White blood cell count, fibrinogen, blood pressure, and pulse rate increased, whereas prothrombin time and plasma volume decreased during the task in both patient groups. The stress task increased C reactive protein (CRP) only in patients with RA, and more specifically in those patients with RA with high disease activity. CONCLUSIONS: The increase in the inflammatory marker CRP, which was specific to patients with RA, combined with the haemostatic, rheological, and haemodynamic reactions to the stress task, over and above the already high baseline levels, could underlie the increased risk for myocardial infarction in this vulnerable patient group.

Acute Disease↗
PubMed2005

A randomized trial of Korodin Herz-Kreislauf-Tropfen as add-on treatment in older patients with orthostatic hypotension.

In a randomized, double-blind, placebo-controlled, parallel group, phase III clinical trial efficacy and safety of Korodin, a combination of natural D-camphor and an extract from fresh crataegus berries, was investigated in patients 50 years and older with orthostatic hypotension. At visit 1 eligibility of patients was checked and a placebo medication was given to all patients. At visit 2 orthostatic hypotension had to be reconfirmed, then the patient was randomized either to Korodin or placebo, study medication (25 drops) was applied once and then outcome was measured. After 7 days of home treatment with daily 3 x 25 drops outcome was measured at visit 3. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were documented 10, 5, 2 and 0 min before as well as 1, 3, 5, 8, and 10 min after getting in the upright position at visit 1, at visit 2 before and after application of study medication and at visit 3. Primary outcome was the change of mean arterial blood pressure (MAP) from just before standing up to the nadir within the first 3 min after standing up. Secondary outcome variables were SBP, DBP, HR, quality of life (SF-12) and seven typical signs and symptoms of orthostatic hypotension. The study was performed in a rehabilitation clinic and in two doctor's practices in Germany from November 2002 to May 2003. During this time, 57 patients were admitted to the study, 39 patients were eligible and randomized, 38 patients were treated according to protocol and evaluated, 21 patients with Korodin and 17 patients with placebo. After a single application the median decrease of MAP was 11.4 mmHg for Korodin and 14.0 mmHg for placebo. Compared to baseline, the median MAP improved 4.3 mmHg for Korodin and 0.3 mmHg for placebo. After 1 week of treatment the decrease of median MAP after standing up was 9.3 mmHg for Korodin and 13.3 mmHg for placebo. Compared to baseline, the improvement was 5.9 mmHg for Korodin and 1.6 mmHg for placebo. Efficacy of 1 week treatment was significant. For the single application a superiority of Korodin over placebo was seen; however, it was not significant. All secondary outcome variables confirmed these findings, except for the physical summary score in the quality of life evaluation (SF-12 questionnaire). Only one adverse event occurred, but this was not serious and without relationship to the study medication. The other safety variables (SBP, DBP, HR, ECG, physical examination) did not show any problems. This study demonstrates that Korodin is efficacious for orthostatic hypotension in patients over 50 years.

Aged↗
PubMed2005

[Prediction of premature pension after stationary rehabilitation due to adipositas--a prognostic model based on routinely collected data of the State Insurance Institution of Baden-Württemberg].

Up to 60 % of the German population can be marked as obese. Due is to its frequency and its associated diseases like cardiovascular disorders and disorders of the musculoskeletal system adipositas is a severe burden on the German health care system. This burden is caused by costs of the disease and costs due to premature pensioning. In this study logistic regression modelling has been performed by means of routinely collected data of patients of the regional statutory pension insurance institute Landesversicherungsanstalt Baden-Württemberg (LVA-BW) rehabilitated due to adipositas (n = 599). The aim was to detect influential variables for the prognosis of premature pensioning (n = 135). The data of the patients were obtained from a research database of the "RehaNet" project which includes data of the standardized discharge report of the Federation of German Pension Insurance Institutes and quality assurance questionnaires of the LVA-BW. Three variables remain in the model after a step-down procedure for modelling by logistic regression. The selected variables are age (in years), the physician's statement about the patients limitations of movement after rehabilitation (yes/no) and about the patients ability to work in future (more/less than half-day). After internal validation of the model by bootstrap methods the model achieves a sensitivity of 73 %, a specificity of 87 %, a positive and a negative predictive value of 57 and 93 % respectively. The area under the curve (AUC) of the ROC analysis is 0.87, so the model achieves a good prognostic value. Thus, this model is a valuable test for the exclusion of possible premature pension while or after rehabilitation due to adipositas. It was found that the situation of "no premature pensioning" of patients rehabilitated due to adipositas can be predicted quite accurately with little information (three variables). This reveals a perspective for further research in the possibility of an early, risk-adapted and individualised intervention after stationary rehabilitation for adipositas to keep employment.

Databases, Factual↗
PubMed2003

Elevated heels and adaptation to new shoes in frail elderly women.

Footwear is supposed to have influence on postural control and is a potential aspect to address in the prevention of falls in the elderly. This study aimed to show whether measurements of static balance and gait are different with habitual shoes compared to new special senior shoes with different heel height and whether these results change after adaptation. In a randomized controlled intervention study, 26 subjects (median age 87 years) were recruited from two nursing homes and one facility of assisted living. Measurements of static balance and gait were performed with habitual shoes and two types of new special senior shoes differing in heel height. Measurements were repeated after five weeks. There was no difference in static balance and gait with habitual shoes compared to either of the new footwear offered. Results of performance with higher heels were not different compared to lower heels. No further effect of adaptation after wearing a new shoe over five weeks could be demonstrated. With respect to static and dynamic balance, there seems to be a wide range of acceptable footwear as long as the heel height is below a critical value. A standardized shoe can be used in the assessment of balance because the effect of adaptation can be neglected.

Accidental Falls↗
PubMed2003

[Osteoporosis in inflammatory bowel disease - results of a survey among members of the German Crohn's and Ulcerative Colitis Association].

INTRODUCTION: Osteoporosis is a frequent and clinically important complication in inflammatory bowel disease (IBD). Prevalence and risk factors have been examined in small numbers of patients. With a nationwide survey of members of the German Crohn's and Ulcerative Colitis Association (DCCV) we wanted to evaluate the situation in a larger group of patients. METHODS: Questionnaires were sent with the autumn issue of the members journal to approx. 14,620 affected members of the DCCV. Items covered osteoporosis, clinical symptoms, anamnesis and sociodemographic topics. Results are presented as descriptive analysis and in a logistic regression analysis of factors contributing to the osteoporosis risk. RESULTS: 2,536 questionnaires could be used (17.3 %). Mean age and distribution concerning diagnosis and gender were comparable to the DCCV members in total. The prevalence of pathologic bone density was 62.3 % in those 1,265 patients (50.1 %) who underwent bone densitometry in the course of their disease. The analysis led to the following possible risk factors: disease activity (high chronic activity or more than 1 acute flare annually vs. remission, p < 0.001), lifetime steroid dosage > 10 g (p = 0.002), Crohn's disease vs. ulcerative colitis (p = 0.02), multiple bowel resection (p = 0.032), age (p = 0.018) and low body mass index (p = 0.034). 83.4 % of the patients with pathologic bone density received specific therapy, but most of those (63.5 %) were solely substituted with calcium and vitamin D. CONCLUSION: This is the first study looking at epidemiology and risk factors of osteoporosis in a large study population of patients with inflammatory bowel disease. Although the prevalence may be overestimated due to selection bias in our study, osteoporosis is confirmed as a frequent and clinically relevant complication in IBD. Bone densitometry is recommended in those patients with one or more risk factors.

Adolescent↗
PubMed2001

Prevalence of Staphylococcus aureus and staphylococcal enterotoxins in raw pork and uncooked smoked ham--a comparison of classical culturing detection and RFLP-PCR.

In many countries Staphylococcus aureus is considered to be the second or third most common pathogen causing outbreaks of food poisoning, only outnumbered by Salmonella spp. and in competition with Clostridium perfringens. Often the consumption of ham or meat containing staphylococcal enterotoxins (SE) is identified as cause of the illness. Thus, to gain an insight into the prevalence of S. aureus and its emetic enterotoxins in raw pork and uncooked smoked ham and to investigate how the prevalence of the pathogen is influenced during the fabrication process, a total of 135 samples of raw pork, salted meat and ready-for-sale uncooked smoked ham were examined for the prevalence of S. aureus and staphylococcal enterotoxins A to D (SEA-SED). To this means classical cultural methods were employed as well as molecular biological techniques (PCR) and the results were compared. In 25.9% of all samples S. aureus was detected by culture whereas 51.1% of the samples showed a positive result when PCR was used for the detection of the pathogen. Fresh meat was contaminated most often. By PCR, 62.2% were identified as being S. aureus positive compared to 57.7% positive samples using the cultural technique. The detection rate during the fabrication process declined significantly. The pathogen was cultivated from 8.9% of the salted meat samples. Here, 55.6% of the samples reacted positively in the PCR, and finally, in approximately a third of the ready-for-sale smoked hams, S. aureus genes were found. From 11.1% of these samples, the pathogen could be isolated by culture. From these results, we conclude that the PCR used in this study is more sensitive than the classical cultural method. By PCR, one or more staphylococcal enterotoxin genes were found in 24 of the 135 examined samples. This means that 34.8% of the staphylococcal strains identified using the PCR technique were enterotoxigenic. Using the SET-RPLA, a percentage of 28.6% enterotoxigenic isolates was ascertained. No staphylococcal enterotoxin formation was detected by the SET-RPLA in ready-for-sale ham, although SE-genes were found by PCR. The detection of SE-genes by PCR is faster and easier to perform than the SET-RPLA.

Animals↗
PubMed2001

Predictors of attendance at cardiac rehabilitation after myocardial infarction.

OBJECTIVE: The purpose of this study was to determine predictors of attendance at cardiac rehabilitation after myocardial infarction (MI). METHODS: Various demographic, behavioural, and clinical variables were measured during hospitalisation in 288 MI patients. Of these, 263 were available to attend outpatient-based cardiac rehabilitation: 108 actually attended. RESULTS: Multiple logistic regression analyses indicated that nonattenders lived in more deprived areas and were less likely to have paid employment. Nonattenders also registered more symptoms of depression and anxiety and exercised less frequently prior to their MI, although only the last of these variables were predicted in a multivariate model. In terms of clinical status, whether patients had been thrombolysed or not was the strongest predictor of attendance. CONCLUSIONS: Attendance at cardiac rehabilitation is not an arbitrary matter. Strategies should be developed for encouraging greater attendance among those not in paid employment, those from deprived areas, and those who exercise infrequently.

Aged↗
PubMed2001

Quality assurance in mental health-care: a case study from social work.

The quality of health and social care is now a high priority for government, professionals, and the public. This is particularly true of mental health, where explicit standards lie at the centre of current policy, demanding the development of reliable means for quality assurance. These need to allow for the multiplicity of stakeholders in mental health-care, and their different constructions of "quality". The challenges presented are illustrated by this account of an action research programme, which was developed to improve social work practice in a multidisciplinary mental health service, and evaluated using a case study design. An action research approach was chosen in preference to an "off-the-shelf" quality assurance system, because it possessed features that appeared to match the context of the work. It involved feeding back the findings of a baseline assessment of service quality to four teams of social workers, who used the information to select priority areas for improvement. An action plan was developed with them, and its implementation and impact were examined. Substantial improvements were observed in only one of the chosen target areas--the quality of case recording. For the other--securing the clients' full involvement in their care plan--very limited improvements occurred. Interview data suggested that this was due to the presence of extensive organisational support for the first objective, but not the second. These findings suggest that while some features of action research can contribute to quality improvement, these must be incorporated into a more comprehensive programme of change, which commands the support of all the stakeholders involved.

Feedback↗
PubMed2001

Changes in limb stiffness under conditions of mental stress.

In 2 experiments, the effects of mental stress on limb stiffness were investigated. The relative contribution to arm stiffness of individual muscle activity, co-contraction, muscle reflexes, and postural adjustments were examined. In each experiment, participants (N = 24, Experiment 1; N = 16, Experiment 2) held their supinated hand under a tray that they were required to return to horizontal after it had been suddenly released. Electromyographic activity in the biceps and triceps muscles was recorded, as were elbow and wrist angles and tray displacement. In Experiment 1, mental arithmetic stress was shown to lead to decreased tray displacement (i.e., increased resistance) compared with displacements under the control, unstressed condition, as well as to increased elbow flexion before tray release. In Experiment 2, the increased resistance to perturbation caused by mental stress was found to be independent of initial elbow angle, but to vary as a function of the amount of upward force exerted before tray release. The authors conclude that stress-induced increases in limb stiffness result from changes in the initial position of the elbow, specified by its angle, together with the initial force exerted by participants to counteract the mechanical perturbations.

Adult↗
PubMed2001

Cardiac coping style, heartbeat detection, and the interpretation of cardiac events.

OBJECTIVES: Vigilance to, and avoidance of, cardiac sensations and symptoms were explored in three studies. DESIGN AND METHODS: In the first study, a self-report measure of cardiac vigilance and cardiac avoidance, the Cardiac Coping Inventory (CCI), was administered to 453 students, and its factor structure, internal consistency, and test-retest reliability were established. In the second, 31 undergraduates completed the CCI, and their cardioceptive sensitivity was measured on a heartbeat detection task. In a third study of 91 patients with suspected myocardial infarction, the role of coping styles in symptom interpretations was analysed. RESULTS: Cardiac avoidance and vigilance were independent of general symptom reporting tendencies. Cardiac vigilance was negatively correlated with heartbeat detection. Among the patients, delay in seeking treatment was predicted by the perceived importance of chest pain, which was influenced by the intensity of chest pain and cardiac vigilance. CONCLUSIONS: Although individuals high in cardiac vigilance do not seem to be good detectors of their heartbeats in the laboratory, they appear to attach importance to heart symptoms in real life, resulting in a health-protective behaviour.

Journal Article↗
PubMed2001

The effects of competition and competitiveness on cardiovascular activity.

Cardiovascular activity was measured at resting baseline and in response to a car racing game, undertaken in competition or in cooperation with an experimenter, or individually. Competitiveness and win and goal orientations were assessed by questionnaire. Competition provoked increases in blood pressure and heart rate, and a significant shortening of the preejection period, an index of enhanced beta-adrenergic influences on the heart. The cooperation task was largely without effect, and although the solo task affected cardiovascular activity, it did so to a lesser extent and much less consistently than did the competition task. The three task conditions, then, were largely distinguishable by their capacity to activate beta-adrenergic processes. Participants high in competitiveness and desire to win showed higher blood pressure reactions and greater shortening of the preejection period to competition than those low in these characteristics.

Adult↗
PubMed2001

Modulation of the human nociceptive flexion reflex across the cardiac cycle.

Carotid baroreceptor stimulation has been shown to dampen pain. This study tested, in 40 normotensive adults, the hypothesis that pain is lower during systole when arterial baroreceptor stimulation is maximal than diastole when stimulation is minimal. The sural nerve was stimulated electrocutaneously to obtain a nociceptive flexion reflex (NFR) threshold, and then stimulation was delivered for 28 trials at 100% NFR threshold at seven intervals after the R-wave. Nociceptive responding was indexed by electromyographic (EMG) activity elicited in the biceps femoris. Significant variations in EMG activity occurred across the cardiac cycle, with less activity midcycle, indicating that the NFR response was attenuated during systole compared to diastole. Stimulation of baroreceptors by natural changes in blood pressure during the cardiac cycle dampened nociception, and accordingly, the data support the arterial baroreflex mechanism of hypertensive hypoalgesia.

Adult↗
PubMed2000

The effects of an oral multivitamin combination with calcium, magnesium, and zinc on psychological well-being in healthy young male volunteers: a double-blind placebo-controlled trial.

RATIONALE: Vitamin and mineral supplements may be associated with improved psychological status. OBJECTIVE: The present study tested the effects of a multivitamin and mineral supplement (Berocca) on psychological well-being. METHODS: In a double-blind randomised-control trial, 80 healthy male volunteers were assigned to either Berocca or placebo. Questionnaires measuring psychological state were completed and a blood sample taken to determine plasma zinc concentration on day 1 (pre-treatment) and again on day 28 (post-treatment), following 28 days of treatments, which were administered at a dosage of one tablet daily. At the end of the study, the acceptability of the treatment and participants' awareness of treatment condition were assessed, as was habitual dietary behaviour. RESULTS: Relative to placebo, treatment with Berocca was associated with consistent and statistically significant reductions in anxiety and perceived stress. Participants in the Berocca group also tended to rate themselves as less tired and better able to concentrate following treatment. In addition, participants registered more somatic symptoms following placebo than following Berocca. These effects cannot be attributed to differences in the acceptability of the two treatments or to participants guessing what treatment they received. CONCLUSION: These findings demonstrate that Berocca significantly reduces anxiety and perceived stress.

Adolescent↗
PubMed2000

Effects of depression and anxiety on mortality and quality-of-life 4 months after myocardial infarction.

OBJECTIVE: The purpose of this study was to determine the impact of depression and anxiety on mortality and quality-of-life in patients hospitalized for an acute myocardial infarction (MI). METHODS: Questionnaire measures of depression and anxiety were completed during hospitalization by 288 MI patients. The main outcomes were mortality and quality-of-life, assessed by the Dartmouth COOP charts, at 4 months. RESULTS: A total of 25 patients died, 22 from cardiac causes, during the 4-month follow-up. Symptoms of depression and anxiety did not predict either cardiac or all-cause mortality. Severity of infarction, extent of heart failure, and a longer stay in hospital predicted mortality. Symptoms of depression and anxiety predicted 4-month quality-of-life among survivors, as did gender, partner status, occupational status, living alone, previous exercise behaviour, length of hospital admission, and Peel Index scores. In a multiple regression model, depression emerged as the strongest predictor of quality-of-life. State anxiety, severity of infarction, and partner status also entered the model. CONCLUSION: Neither depression nor anxiety predicted mortality 4 months after MI. Both depression and anxiety predicted quality-of-life at 4 months among survivors.

Adult↗
PubMed2000

Secretory immunoglobulin A and cardiovascular activity during mental arithmetic: effects of task difficulty and task order.

Secretory immunoglobulin A (sIgA) in saliva and cardiovascular activity were measured at rest and during mental arithmetic. Task difficulty was manipulated by presenting easy, hard, and impossible versions of the mental arithmetic task in counterbalanced order, while task novelty was operationalised as order of presentation (i.e. first, second, third). Mental arithmetic elicited significant increases in sIgA concentration and sIgA secretion rate, as well as significant cardiovascular effects. Performance decreased and rated difficulty increased with increasing task difficulty. However, sIgA and cardiovascular activity, with the exception of diastolic blood pressure, were insensitive to variations in task difficulty. In contrast, sIgA concentration and a broad range of cardiovascular variables were influenced by task novelty, with more pronounced activity characterising the task version presented first, irrespective of its level of difficulty. Task novelty would seem to be a more important determinant of sIgA and cardiovascular activity than task difficulty.

Adult↗
PubMed2000

Cardiovascular and secretory immunoglobulin A reactions to humorous, exciting, and didactic film presentations.

Secretory immunoglobulin A (sIgA) in saliva and cardiovascular activity were measured at rest and in response to three film extracts varying in affective content. Subjective ratings of film impact confirmed a priori assumptions; the humorous film was rated as funnier than the other two films, the didactic film as more boring than the other two films, and the exciting film as more exciting and more stressful than the other two films. The films elicited distinct patterns of cardiovascular autonomic activity. The exciting film provoked changes characteristic of beta-adrenergic activation: increased systolic blood pressure (SBP); heart rate (HR); cardiac output (CO); and shortened pre-ejection period (PEP). The didactic film had little impact on cardiovascular activity. While an increase in total peripheral resistance (TPR) occurred, the humorous film was largely notable for a reduction in beta-adrenergic drive, as evidenced by reduced CO and a lengthening of PEP. In contrast to previous research reporting a rise in sIgA particular to humorous exposures, the sIgA secretion rate, although enhanced by exposure to the films, did not vary with film content.

Adult↗