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C Wäscher

Publications and source records attributed to C Wäscher.

4 recordsLinked to original sources
PubMed2005

Immunoadsorption patients with multiple sclerosis: an open-label pilot study.

BACKGROUND: Immunoadsorption (IA) is occasionally applied in patients with acute relapses of multiple sclerosis (MS). This pilot study was undertaken to determine whether IA might help in secondary progressive and relapsing-remitting multiple sclerosis. DESIGN: IA was performed at 1-week intervals in 12 patients with secondary progressive or relapsing-remitting MS. These patients had an extended disability status scale (EDSS) score of 4.5-7 and an EDSS increase of 0.5 within 6 months before inclusion in the study despite conventional drug therapy. The change in the EDSS and that in the MS functional composite (MSFC) score, which consisted of quantitative tests of arm function, ambulation, visual acuity and cognition, served as the primary outcome variables, which were measured at baseline and at 3, 6 and 12 months. Changes in quality of life and cerebral lesions by magnetic resonance imaging (MRI) were also assessed at baseline and after the last immunoadsorption (month 3). RESULTS: A significant reduction of the median EDSS change was observed after the treatment period, which reversed 3 months after the immunoadsorptions had been stopped. Ten of 12 patients remained stable during the first year of follow-up with no significant changes of the MSFC scores. No significant changes in magnetic resonance imaging T2-hyperintense brain lesions or in the number of gadolinium-positive lesions and in the patients' quality of life were observed. Western blot analyses demonstrated a reduction of serum myelin-specific antibodies, which were collected in the adsorber eluates. CONCLUSIONS: Removal of immunoglobulins, including myelin-specific antibodies by immunoadsorption, seems to delay disease progression as defined by EDSS, MSFC and MRI, while the patients' quality of life did not deteriorate.

Adult↗
PubMed2004

Introductory experience with the continuous glucose monitoring system (CGMS; Medtronic Minimed) in detecting hyperglycemia by comparing the self-monitoring of blood glucose (SMBG) in non-pregnant women and in pregnant women with impaired glucose tolerance and gestational diabetes.

OBJECTIVE: To assess the detection rate of hyperglycemia with a continuous glucose monitoring system compared to a self-monitoring blood glucose profile in non-pregnant, non-diabetic pregnant women, and patients with impaired glucose tolerance or gestational diabetes.. METHODS: Eight non-pregnant (NP) and 56 pregnant women (17 dietary-treated gestational diabetics (GDM), 15 women with impaired glucose tolerance (IGT), and 24 non-diabetic pregnant women (NDP)) underwent a 72-hour measurement with the CGMS (Medtronic Minimed, Northridge, CA, USA). Self-monitored blood glucose measurements, performed 30 minutes before and 120 minutes after each meal, were compared to the duration of hyperglycemia monitored by the continuous glucose monitoring system. RESULTS: No clinically observable infection was found at the subcutaneous tissue where the electrode was placed. A statistically significant difference was found between the groups in body mass index, HbA1c, and in gestational age, but not in age or parity. Using the self-monitored blood glucose (SMBG), 88 % (7/8) of the NP and 54 % (13/24) of the NDP had no measurement above 6.7 mmol/l. However, 17 % (4/24) of the NDP and 40 % (6/15) of the IGT showed more than two measurements above 6.7 mmol/l compared to 24 % (4/17) of the dietary-treated GDM. The differences between these groups were not significant (p = 0.21). The mean durations (+/- SD) of hyperglycemia above 6.7 mmol/l/24 h were: NP 111 +/- 120 min, NDP 138 +/- 120 min, IGT 381.8 +/- 295 min, and GDM 190 +/- 155 min, p = 0.017; above 7.8 mmol/l/24 h NP 24 +/- 49 min, NDP 38 +/- 47 min, IGT 170.7 +/- 190 min, and GDM 64 +/- 88 min, p = 0.016; and above 8.9 mmol/l/24 h NP 9.3 +/- 25 min, NDP 7.5 +/- 14 min, IGT 59 +/- 77 min, and GDM 14 +/- 21 min, p = 0.026. There was no significant difference in the fetal outcome or rate of birth percentiles using the sensor data. CONCLUSIONS: The use of the sensor in pregnant women is unproblematic. a) The CGMS detected more frequent and longer durations of hyperglycemia in GDM compared to non-diabetic pregnant women than the SMBG. b) Women with an IGT exhibited higher glucose levels than patients with gestational diabetes. c) The clinical importance of these hyperglycemic intervals, e.g. with respect to the risk for macrosomia, must be assessed in larger trials.

Blood Glucose Self-Monitoring↗
PubMedDate not supplied

[Supply of iodine during pregnancy--an inventory in Berlin, Germany].

BACKGROUND: Iodised salt was introduced in Germany in the early 1980s. A nation-wide study in 1996 showed that iodine levels among the population had improved since the introduction of the supplementation. The study did not separately investigate the iodine status of pregnant women. In our prospective study, we used three parameters to assess the iodine levels among pregnant women. PATIENTS AND METHODS: Between October 1999 and February 2000, we asked 109 German-speaking patients seeking prenatal care in our clinic to participate. Following informed consent, we measured goiter volume by ultrasound and collected venous blood (serum) and urine samples. We asked patients about any history of thyroid gland illnesses and about iodine supplementation which is generally given to pregnant patients in Germany. The blood and urine samples were stored at -18 degrees C until measurement. We used the iodine-creatinine-ratio to measure ioduria. Iodine was measured using the Cer-Arsenite-method (Dade-Behring). The thyroglobulin concentration in serum was measured using RIA. RESULTS: The mean iodine-creatinine ratio was 181 +/- 109 microg/g, 20.4 % of the patients had a ratio between 50 and 100 microg/g which is defined as iodine deficiency I degrees (WHO). 8.7 % of the patients had thyreoglobulin levels above the cut-off value of 50 ng/ml. 12.6 % of the patients had a goiter (volume > 18 ml). 58 % of the patients were taking iodine supplements. These patients had significantly higher iodine-creatinine ratio levels (204 microg/g vs. 148 microg/g, P = 0.007) and lower serum thyroglobulin levels (38.4 vs. 34.1 pmol/l, P = 0.06) than non-supplemented patients. CONCLUSIONS: The prevalence of goiter reflects an extended period of iodine deficiency. Using laboratory methods, up to 20.4 % of pregnant women were identified as having an iodine deficiency which indicates the need for a general iodine supplementation during pregnancy.

Adult↗