PubMed Health⌕ Search

Biomedical subjects

E Mur

Publications and source records attributed to E Mur.

At least 19 recordsLinked to original sources
PubMed2006

[Sonography of synovial and erosive inflammatory changes].

High-frequency sonography enables excellent detection of early erosions and synovial proliferations. Power Doppler sonography (PDUS) allows for an improved characterization of articular and peritendinous augmented volume, because detection of hypervascularity correlates with inflammatory activity and further is helpful in differentiation from effusion and inactive pannus. The use of contrast media improves the sensitivity of vascularity detection, because they allow for a delineation of vessels at the microvascular level. This is of increased interest, as the development of new therapeutic options targeting the microvascular level calls for earlier diagnosis and optimal assessment of disease activity. Because of good availability, cost effectiveness, and patient acceptance, sonography facilitates early diagnosis of synovial proliferations and erosions as well as therapy follow-up.

Arthritis, Rheumatoid↗
PubMed2006

Cosmetic outcome of breast conservative treatment for early stage breast cancer.

PURPOSE: To evaluate the cosmetic outcome of breast conservative therapy and to examine the degree of agreement between the patients' and oncologists' ratings. We also analyze the influence of several factors on cosmesis. METHODS AND MATERIALS: We retrospectively evaluated 145 patients with primary breast cancer treated by local excision and radiotherapy between January 2000 and May 2001. Cosmetic outcome was evaluated by doctors and patients and was scored as excellent, good, fair or poor. RESULTS: 73% of patients rated cosmesis as excellent or good while the percentage was 71% when rated by radiation oncologists. The degree of cosmesis concordance evaluated by oncologists and patients was low (kappa = 0.3). In our study the variables which significantly influence on the cosmetic outcome were concomitant adjuvant chemotherapy (p = 0.04) and radiation therapy boost, either by electron beam or brachytherapy (p = 0.013). CONCLUSION: The cosmetic outcome of breast conserving therapy was good. There was a similar rating by the patient and radiation oncologist, but the level of concordance between patients and doctors was low. Factors that significantly influence the cosmesis appear to be concomitant adjuvant chemotherapy and radiation therapy boost.

Adult↗
PubMed2004

In vitro effects of two extracts and two pure alkaloid preparations of Uncaria tomentosa on peripheral blood mononuclear cells.

In the traditional Peruvian medicine, hot aqueous extracts of Uncaria tomentosa have been used for the treatment of a wide range of health problems, particularly digestive complaints and arthritis. Some of the beneficial effects observed in patients suggest an immunomodulatory capacity of Uncaria tomentosa extracts. In this study, the effects of two extracts and two mixtures of tetracyclic and pentacyclic oxindole alkaloids of Uncaria tomentosa were investigated in freshly isolated human peripheral blood mononuclear cells (PBMC) stimulated with the mitogens phytohaemagglutinin (PHA) and concanavalin A (Con A) in vitro. Neopterin production and tryptophan degradation were monitored in culture supernatants to determine the effects of the test substances on immunobiochemical pathways induced by interferon-gamma. Compared to unstimulated cells PHA and Con A increased the production of neopterin and degradation of tryptophan (p < 0.01). HCl and ethanol extracts and mixtures of alkaloids of Uncaria tomentosa inhibited both effects in a dose-dependent manner, the lowest effective concentrations of the extracts were 500 - 1000 microg/mL and of the alkaloid mixtures 100 - 175 microg/mL (p < 0.05 and < 0.01). With the highest concentrations of extracts and mixtures complete suppression of mitogen-induced neopterin production and tryptophan degradation was observed. These data demonstrate that Uncaria tomentosa extracts and mixtures of alkaloids modulate the immunobiochemical pathways induced by interferon-gamma. The findings imply a potential application of the extracts as immunoregulators and would be in line with observations in patients using these extracts.

Adjuvants, Immunologic↗
PubMed2003

[Quality assurance in the teaching of medical students illustrated by the example of spa therapy for rheumatic diseases].

BACKGROUND: The currently employed methods for quality assurance in student education are frequently considered as being inadequate. In the present study the request to plan a budget for the treatment of patients with ankylosing spondylitis is presented as an additional method to assess the influence of a teaching course on the student's attitude towards certain interventions. How would medical students distribute financial resources for the treatment of patients with ankylosing spondylitis? Does a course 'Excursion to a Spa' lead to changes in budgeting by the student? MATERIAL AND METHODS: Before and after a 4-day excursion to Bad Gastein (health resort primarily for patients with rheumatic diseases) to become better acquainted with the local treatment modalities medical students in semester 8.4 +/- 3.8 (5th year in medical school) were asked how they would distribute a fixed sum of EUR 5,000.- (= 100%) for a prospective period of 5 years over 9 given forms of treatment in a patient with ankylosing spondylitis in order to provide optimal improvement of the disease and quality of life. RESULTS: Before the excursion the students distributed the budget as follows: drug therapy 15%, spa therapy 17%, physical therapy 14%, exercise therapy 19%, massage therapy 11%, unconventional therapies 5%, psychological therapy 7%, changes in the household environment 8%, private pleasure 4%. After the excursion to the spa the medical students assigned more financial means on spa therapy (p = 0.024, Wilcoxon test) and unconventional therapies (p = 0.015). CONCLUSION: Creating a budget for a defined disease appears to be a useful instrument for assessing the influence of a teaching course on medical students' attitude towards certain interventions and for detecting imbalances in the presentation of therapy procedures or discrepancies between the presentation and the aims of teaching.

Complementary Therapies↗
PubMed2002

[Retained and discontinued conventional and unconventional measures by patients with Bechterew disease for modifying the course of illness].

BACKGROUND: Patients with chronic rheumatic disease often seek relief in unconventional treatments, but many of them do not share this information with their physician. OBJECTIVE: To explore which conventional and unconventional interventions are used by patients with ankylosing spondylitis. Which of these do they continue to use and which do they give up? PATIENTS: One-hundred fifty patients (36 female, 114 male) with ankylosing spondylitis, who presented for radon thermal treatment at the Gasteiner Heilstollen Hospital (mean age 50 +/- 11 years; disease duration 24 +/- 11 years). METHOD: A previous investigation identified 75 interventions used by patients with AS to influence their disease. In a face-to-face, structured interview all these interventions (terms used by the patients) were now presented to 150 other patients with AS. They were asked to state whether they had already used (and given up) the respective intervention or whether they intend to continue using it and intend to use it in future. RESULTS: A summary of all interventions previously and still used by patients showed conventional interventions (67%) to out-number unconventional (33%) interventions. Of the 150 patients, 20 stated that they use or have used more than 15 different unconventional interventions. In addition to health resort medicine (interview at a health resort!), massage therapy, physiotherapy and physical exercise were the most commonly used of the conventional interventions. Of the unconventional interventions warm climate, sea bathing, self-applied psychotherapy, vitamin pills, repression, showering with alternating cold and warm water, and self-help groups were named most frequently. CONCLUSION: Some patients with ankylosing spondylitis use many different (33% unconventional) interventions. In the patient's view, even rather general interventions such as warm climate or sea bathing are regarded as relevant to the disease. An open doctor-patient discussion of unconventional interventions used by the patient appears reasonable. The results confirm that most patients suffering from chronic and incurable disease seek relief in unconventional therapies.

Adult↗
PubMed2001

[Influence of reflex zone therapy of the feet on intestinal blood flow measured by color Doppler sonography].

OBJECTIVE: An influence on organ-associated blood flow is considered as a possible mechanism of action of reflex zone massage of the feet (FRZM) therapy. In the present study we investigated whether changes in intestinal blood flow can be achieved by FRZM. MATERIAL AND METHODS: 32 healthy adults (19 women and 13 men) were randomly assigned to the treatment or the placebo group. Subjects of the treatment group received foot massage on the zones assigned to the intestines and those of the placebo group received massage on zones unrelated to the intestines. Before, during and after FRZM, the blood flow velocity, the peak systolic and the end diastolic velocities in the superior mesenteric artery as well as the resistive index as a parameter of vascular resistance were calculated. RESULTS: During FRZM, in the subjects of the treatment group there was a significant reduction in the resistive index (p = 0.021), suggesting an increase in the blood flow in the superior mesenteric artery and the subordinate vascular system. In contrast, there were no significant changes in the resistive index in the subjects of the placebo group. CONCLUSION: The reduction in the resistive index observed in the treatment group supports the assumption that FRZM improves blood flow in the organs considered to be associated with the specific foot zones, at least during the therapy process.

Adult↗
PubMed2001

Prospective controlled evaluation of the influence of an excursion to a health resort on medical students' opinion about chances for outpatient rehabilitation at a health resort.

OBJECTIVE: To assess the influence of an excursion to a health resort on students' opinion on the chances for outpatient rehabilitation at a health resort for cardiac and rheumatic diseases. METHODS: A group of 17 medical students went on a 1-day excursion to Bad Orb (near Frankfurt/M.) where mainly patients with heart diseases are treated. Another group of 44 students went on a 5-day excursion to Bad Gastein (Austria) where mainly patients with rheumatic diseases are treated. Before and after the excursion students completed a questionnaire asking their opinion on the chances for outpatient rehabilitation at a health resort for acute and chronic cardiac and rheumatic diseases. RESULTS: Students judged the chances for beneficial effects of outpatient rehabilitation at a health resort for chronic rheumatic diseases to be significantly better after the excursion to Bad Gastein than before, whereas there was no difference after the excursion to Bad Orb. CONCLUSION: Students' opinion of chances for outpatient rehabilitation at a health resort can be influenced by an excursion to a spa, but a single 1-day excursion may not be sufficient.

Adult↗
PubMed2000

Microemulsion formulation of cyclosporin (Sandimmun Neoral) vs Sandimmun: comparative safety, tolerability and efficacy in severe active rheumatoid arthritis. On behalf of the OLR 302 Study Group.

OBJECTIVE: To compare the safety, tolerability and efficacy of the new oral microemulsion formulation of cyclosporin A (CyA; Sandimmun Neoral) and the original CyA formulation (Sandimmun), in patients with severe active rheumatoid arthritis (RA), over a 12-month period. METHODS: In this double-blind, multicentre study, patients were randomized to treatment with Neoral or Sandimmun, starting with 2.5 mg/kg/day, with dose adjustments after 4 weeks. Primary efficacy criteria included patients' assessment of disease activity. Pharmacokinetic and safety assessments were performed at regular intervals. RESULTS: Compared with Sandimmun, Neoral showed a consistent trend towards greater clinical efficacy from week 12 onwards, including a significant difference in patients' assessment of disease activity at the study end-points. A significantly lower increase in dose from baseline was observed with Neoral at week 24. Pharmacokinetic assessments at week 24 showed increased absorption and decreased variability with Neoral. No differences in safety were found between treatment groups. CONCLUSION: These observations indicate that Neoral is as safe and at least as effective as Sandimmun and have important implications for patient management given the increasing role for CyA in the treatment of severe, active RA.

Antirheumatic Agents↗
PubMed1999

Aspergillus osteoarthritis in acute lymphoblastic leukemia.

We report an unusual case of arthritis of the right wrist due to Aspergillus fumigatus without evidence for a generalized infection, following chemotherapy for acute lymphoblastic leukemia. The diagnosis was made by surgical biopsy. Amphotericin-B (Am-B) was not tolerated by the patient. Liposomal preparations of Am-B penetrate poorly into bone and cartilage. Therefore, oral itraconazole was given; the arthritis improved and chemotherapy was continued without infectious complications. Two weeks after complete hematopoietic recovery, an intracranial hemorrhage from a mycotic aneurysm of a brain vessel occurred, although the patient was still receiving itraconazole. We emphasize the importance of prompt and thorough efforts to identify the causative agent in immunocompromised patients with a joint infection. Itraconazole is effective in Aspergillus osteoarthritis but, due to its poor penetration into the brain, the combination with a liposomal formulation of Am-B is recommended.

Antifungal Agents↗
PubMed1999

[Changes of renal blood flow during organ-associated foot reflexology measured by color Doppler sonography].

Using colour Doppler sonography blood flow changes of the right kidney during foot reflexology were determined in a placebo-controlled, double-blind, randomised study. 32 healthy young adults (17 women, 15 men) were randomly assigned to the verum or placebo group. The verum group received foot reflexology at zones corresponding to the right kidney, the placebo group was treated on other foot zones. Before, during and after foot reflexology the blood flow of three vessels of the right kidney was measured using colour Doppler sonography. Systolic peak velocity and end diastolic peak velocity were measured in cm/s, and the resistive index, a parameter of the vascular resistance, was calculated. The resistive index in the verum group showed a highly significant decrease (p </= 0.001) during and an increase (p = 0.001) after foot reflexology. There was no difference between men and women and no difference between smokers and non-smokers. Verum and placebo group significantly differed concerning alterations of the resistive index both between the measuring points before versus during foot reflexology (p = 0.002) and those during versus after foot reflexology (p = 0.031). The significant decrease of the resistive index during foot reflexology in the verum group indicates a decrease of flow resistance in renal vessels and an increase of renal blood flow. These findings support the hypothesis that organ-associated foot reflexology is effective in changing renal blood flow during therapy.

Adult↗
PubMed1999

[Electromyography biofeedback therapy in fibromyalgia].

Nineteen patients with fibromyalgia underwent a course of treatment with EMG-biofeedback (EMG-BFB) technique. On completion of treatment, there was a statistically significant lowering of sensitivity to pain at pressure points typical for fibromyalgia (p = 0.017), which could be observed also 2 months after completion of treatment. In addition, there was a reduction both in the affective (p = 0.04) and in the sensory (p = 0.007) components of pain. Furthermore, there was a statistically significant improvement in the accompanying disease parameters of sleep disturbance (p = 0.004) and head ache (p = 0.031). Since EMG-BFB training might contribute not only to a reduction of pain and muscle tension but also to an improvement of quality of life, it can be recommended as part of a multimodal pain therapy in fibromyalgia patients.

Adult↗
PubMed1997

The presence of secretoneurin in human synovium and synovial fluid.

Secretoneurin is a neuropeptide formed from the proprotein secretogranin II. It is found in afferent nerve fibres and has chemotactic activity for monocytes, neutrophils and fibroblasts. We investigated the presence of secretoneurin in synovial fluid and synovium from patients with osteoarthritis and rheumatoid arthritis. The secretoneurin immunoreactive material found in synovial fluid was identified by high performance liquid chromatography as the free peptide secretoneurin. Its level in hip joints was 15.6, in knee joints of osteoarthritis patients 17.3 and in rheumatoid patients significantly lower (8.6 fmol/ml). Immunocytochemistry provided evidence for the presence of sub-intimal secretoneurin-immunoreactive nerve fibres in knee synovium in osteoarthritic patients. In rheumatoid synovium, only very few immunoreactive fibres were found these being mostly localised in deep stroma. The results show that secretoneurin is present in osteoarthritic joint and suggest that secretoneurin levels are down-regulated in rheumatoid joint. Therefore, secretoneurin may participate in acute or mild phases of inflammation but is unlikely to have a major role when more severe inflammation is present such as that seen in rheumatoid joint.

Antibody Specificity↗
PubMed1997

The safety profile of low-dose cladribine in refractory rheumatoid arthritis. A pilot trial.

Cladribine (2-chlorodeoxyadenosine, 2-CdA) is a newer purine analog with specific toxicity to lymphocytes. As lymphocytes play a major role in rheumatoid arthritis (RA), we assessed the safety profile of low-dose 2-CdA in patients who were refractory to more than three disease-modifying drugs. Five patients were given a subcutaneous dosage of 0.05 mg/kg 2-CdA weekly over a period of 8 weeks. Of the lymphocyte subsets, both T and B cells decreased below the normal range, whereas natural killer cells remained stable. These changes were the only side-effects noted during treatment and 4 weeks afterwards. In one patient a pacemaker was implanted for reasons unlikely to be related to 2-CdA administration. We conclude that even low-dose 2-CdA (0.05 mg/kg) can decrease T and B cell populations in patients with refractory RA, but other side-effects are unlikely. For assessing the possible clinical efficacy of low-dose 2-CdA further studies are warranted.

Aged↗
PubMed1994

Technetium-99m human immunoglobulin scintigraphy in psoriatic arthropathy: first results.

Standard bone scintigraphy [using technetium-99m methylene diphosphonate (MDP)] is widely held to be the most sensitive method for the early detection of psoriatic arthropathy. Preliminary results of this study reveal that 99mTc human immunoglobulin (HIG) scintigraphy demonstrates a typical premature pattern of extradermal psoriatic disease in digits indicative of the early stage of psoriatic arthritis. This pattern was also found in a rare case of psoriatic arthropathy without skin lesions. 99mTc-HIG scintigraphy appears to reveal the initial inflammatory characteristics of later bone lesions. In the advanced stage of psoriatic arthritis, 99mTc-MDP and 99mTc-HIG scans were found to be equally sensitive in the detection of the affected joints. Thus 99mTc-HIG scintigraphy seems to be useful in the early detection of psoriatic arthropathy and also in advanced psoriatic arthritis, as well as for the detection of psoriatic arthropathy without skin lesions.

Arthritis, Psoriatic↗
PubMed1994

Fibromyalgia--the effect of relaxation and hydrogalvanic bath therapy on the subjective pain experience.

In the present study, two established non-medicinal treatment methods are compared with regard to their effect on various psychological pain parameters in patients with fibromyalgia. Twelve patients underwent hydrogalvanic baths, 13 patients the Jacobson relaxation training. Statistical evaluation showed only one significant difference in the different dimensions of pain measured at the beginning and end of the therapy. In comparison with patients receiving Jacobson-therapy, there is a significantly higher decrease in pain intensity in the period from breakfast till lunch in patients receiving bath-therapy. Apart from this, no differences between the two treatment groups could be found, either in the quality of pain, the psychological symptoms accompanying it, in sleep quality or in pain behaviour.

Adult↗
PubMed1994

Stress coping of patients with ankylosing spondylitis.

Seventy-six male patients with ankylosing spondylitis (SA) and sixteen healthy controls were assessed for their stress coping mechanisms. As compared to healthy controls, the coping behaviour of the patients with SA was characterized by a significantly higher degree of playing down the stressful situation through comparison with others and by more substitutive gratification; they also showed less self-accusation and resignation. These coping mechanisms apparently do not change significantly in the course of the illness, as in our study we found that patients with different durations of illness did not differ from each other with regard to the coping strategies they used. When comparing the different strategies of coping the subjective intensity of pain, we found at a low intensity of pain a significant positive correlation with the strategies of 'playing down the stressful situation through comparison with others' and 'positive self-instruction', and a negative correlation with 'self-accusation'.

Adaptation, Psychological↗