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Biomedical subjects

F Musial

Publications and source records attributed to F Musial.

At least 19 recordsLinked to original sources

[Mind-body medicine as a part of German integrative medicine].

Mind-body medicine (MBM) as a holistic approach to health and healing has been shaped by research into stress physiology and stress psychology, by psychoneuro(endocrino)immunology and by Antonovsky's salutogenetic paradigm. MBM seeks to acknowledge physical, psychological as well as social and spiritual aspects of human beings. MBM constitutes one of the traditions, which the emerging field of integrative medicine in Germany draws upon, others being mainstream medicine, traditional European naturopathy and non-European methods like traditional Chinese medicine. The article outlines historical aspects of MBM, gives a brief review of research evidence, and introduces clinical MBM institutes in Germany. Especially the Clinic and Chair of Complementary and Integrative Medicine, Alfried Krupp von Bohlen und Halbach Foundation at the University Duisburg-Essen has been integrating MBM into the concept of integrative medicine. Considering that a growing number of health issues arises due to maladaptive lifestyles, MBM is being identified as a development that supports a shift from increasingly expensive treatments to more cost-effective preventive approaches.

Delivery of Health Care, Integrated↗

[Psychophysiology of visceral pain].

This paper reviews the most important research strategies in the context of the psychophysiology of visceral pain. These are disturbed gastrointestinal motility, visceral hypersensitivity and central nervous system mechanisms such as response bias, attentional bias and affective evaluation. The most prominent research methods and results are reviewed and methodological problems are discussed. From a psychophysiological perspective, visceral pain remains a complex and heterogeneous syndrome in which stress and coping may be etiologically as important as pathophysiological mechanisms of peripheral origin and central nervous system mechanisms like attentional bias.

Central Nervous System↗

[Therapy of fecal incontinence in elderly patients: Study of a home biofeedback training program].

UNLABELLED: The increased prevalence of urinary and fecal incontinence is one of the most important factors in the loss of independence and mobility in the elderly population. It is also one of the major reasons for elderly people to give up their household and move into a nursing home. Anorectal biofeedback therapy is a very effective treatment for fecal incontinence. However, due to the increased immobility of elderly people, ambulatory biofeedback training programs which require the participants to leave their homes and travel to the next available outpatient clinic on a regular basis, especially when depending on public transportation, may prove particularly difficult for elderly, incontinent subjects. Supervised home biofeedback training programs may offer an alternative for those patients, who are motivated enough and not mentally impaired. Two different age groups of women (between 49 and 63; and between 65 and 78 years old) suffering from fecal incontinence due to external anal sphincter impairment, received a supervised home biofeedback program, after extensive anorectal diagnostics including manometry. The program focused on improving voluntary sphincter contraction. After an average of 9 months, anorectal manometry was repeated, and anal resting and squeeze pressure as well as minimal rectal perception threshold were determined. There was no effect on anal resting pressure and rectal perception. However, anal maximum squeeze pressure as well as squeeze pressure over 10 s was substantially increased with no difference between the age groups. CONCLUSION: Supervised home biofeedback for sphincter insufficiency was effective in improving the voluntary contraction of the anorectum in both age groups. Therefore, biofeedback home training programs may offer an alternative to ambulatory programs for those individuals, who are not mobile enough to regularly attend an outpatient clinic.

Aged↗

Influence of continuous, isobaric rectal distention on smooth muscle tone and cardiovascular activation in healthy volunteers.

UNLABELLED: Interactions between visceral, intestinal stimulation and autonomic cardiovascular function have received increasing attention over the last years. The aim of the study was to investigate the effect of long-term continuous rectal distention on rectal tone and cardiovascular function at the threshold for first sensation of distention and moderate urge to defecate compared to a resting period without distention. Continuous isobaric rectal distention was performed in 13 healthy volunteers with a ten minute pressure tracking procedure at each subject's predetermined individual threshold for either moderate urge or first sensation, separated by a ten minute resting period. Rectal volume, heart rate, systolic and diastolic blood pressure were determined continuously. RESULTS: Rectal tone decreased significantly over time at the threshold for moderate urge and first sensation. Cardiovascular measures remained stable over the distention procedures, except for a significant increase in systolic blood pressure at the threshold for moderate urge. DISCUSSION: The previously reported rectal accommodation response to rectal distention was confirmed. The increase in systolic blood pressure is most likely mediated through sympathetic efferent pathways.

Adaptation, Physiological↗

Temporal analysis of feeding behavior in miniature pigs.

The feeding behavior of four Munich miniature pigs (29-43 kg) housed in pairs of two, was observed for two consecutive weeks. Pigs were conditioned to operate a computer-controlled recording system equipped with feeders delivering a precise food release per response and were then fed ad libitum. In addition to the descriptive analysis of feeding behavior, Walsh-Fourier Spectral Analysis was utilized to investigate the temporal patterns of food ingestion and the synchronisation of feeding patterns between the animals housed together. The pigs had up to 48% of their daily energy intake during the dark cycle and there was a substantial reduction of food intake from the first to the second week. Furthermore, pigs housed together synchronized feeding behavior from week 1 to week 2. The recording system has been shown to be highly reliable and valid and provides an excellent tool for the investigation of ingestive behaviors in miniature pigs.

Animals↗

Rectal adaptation to distention: implications for the determination of perception thresholds.

Chronic changes in rectal compliance and perception are often associated with constipation, but the mechanisms responsible for these changes are not known. These studies evaluated the dynamic response of the rectal wall to distention and, in a separate investigation, the influence of adaptive relaxation on perception thresholds. In Study 1, seven healthy volunteers were evaluated using a computer-controlled barostat to maintain continuous isobaric distention of the rectum at urge threshold over a 25-min period. Changes in intrabag volume were evaluated at minutes 1, 5, and 25. Study 2 investigated changes in perception thresholds with different interstimulus intervals (30 s vs. 60 s) in 16 healthy subjects. Pressure was incremented in steps of 2 mmHg up to discomfort threshold. The mean intrabag volume, pressure, and the compliance index for the first and second 5-s intervals were compared to the last 5 s interval. Statistical analyses were performed using the Wilcoxon Sign-Rank test with Bonferonni corrections. Study 1 showed a significant relaxation of the rectal wall in response to balloon distention with volumes consistently increasing from minute 1 to minute 25. Study 2 showed a significant change in the compliance index at the threshold for moderate urge and intense urge during the 60-s distention that resulted from progressive relaxation of the rectal wall. Study 1 showed an adaptive response of the rectum to distention. Study 2 confirmed these findings and implied a role for this adaptive response in the determination of rectal sensory thresholds.

Adult↗

Nutrient ingestion increases rectal sensitivity in humans.

To determine the effect of nutrient ingestion on rectal perception thresholds (first sensation, consistent urge to defecate, pain), rectosigmoid balloon distentions were performed with a computerized automated pump in eight healthy volunteers (four males, four females, 31.6 +/- 6.02 years). Two measurements of rectal balloon distention were performed on 2 separate days. Day 1 served as a control condition with no meal. On day 2 the subjects received a 600 kcal liquid meal. On the control day, determination of perception thresholds was performed two times with a 10-min break between measurements. On the experimental day, threshold determinations were made before and after the ingestion of the liquid standard meal. The order of the experimental days was counterbalanced. Distention volumes at the urge to defecate and the pain threshold (maximum tolerable volume) were significantly reduced following the meal. The average change from pre- to postprandial measurements of the threshold for urge to defecate was -20.55 +/- 4.22% and for the maximum tolerable volume it was -16.09 +/- 4.4%. These results extend data previously reported from animal studies using similar experimental methods.

Adult↗

Effect of rectal distention and feeding on cecal tone in pigs.

The effects of eating and rectal distention on cecal tone were evaluated. Cecal tone was measured using a computer-controlled barostat in four female 30 to 40 kg Yucatan Micropigs fitted with cecal fistulas. Each pig underwent two separate trials of pre and postprandial measurements of cecal tone, either with or without continuous rectal distention with a 30 ml water-filled balloon. Cecal tone was measured 10 min prior to, during, and 10 min following a high-fat (60%) liquid meal (473 ml). Cecal tone significantly increased (intrabag volume decreased) after feeding (119.6 +/- 9.1 ml vs. 81.2 +/- 7.9 ml; p = 0.008). Rectal distention tended to reduce the postprandial change in cecal tone (142.8 +/- 11.5 vs. 130.9 +/- 12.6 ml; p = 0.196). There was also a strong tendency for cecal volumes to be higher (decreased tone) with rectal distention preprandially (142.8 +/- 11.5 ml vs. 119.6 +/- 9.1 ml; p = 0.024). Nutrient ingestion significantly increased cecal tone and rectal distention abolished this effect. These findings may indicate a regulatory pathway that allows additional storage of fecal material in the event that the output of the system is disturbed.

Animals↗

Monitoring radio programs and time of day affect simulated car-driving performance.

Whether radio monitoring, task difficulty, and time of day affect driving performance was examined in a computer-controlled, simulated driving task. Driving performance was defined as the absolute deviation of the car position from road midline as displayed on the computer monitor. We found for 12 men and 8 women (i) an expected, marked deterioration of performance with increasing task difficulty, (ii) a deterioration of performance in the morning, and (iii) a deterioration of performance when subjects concurrently listened to radio programs except for the easy task conducted in the morning. The latter is supposed to be caused by a reactive increase of effort, which is induced by the concurrent radio monitoring and stimulated through a perceived impairment of attention.

Adult↗

Prevalence of gastrointestinal symptoms in obese and normal weight binge eaters.

OBJECTIVES: Disturbances in gastrointestinal function may result from disordered eating and may lead to increases in gastrointestinal (GI) symptoms. We compared GI symptoms in obese and non-obese binge eaters and non-binge eaters. METHODS: One hundred nineteen obese and 77 normal-weight females completed a questionnaire on bowel symptoms and binge eating behaviors for the previous 3 months. Based on binge behaviors and body mass index (> 30 kg/m2), individuals were grouped as obese binge eaters (n = 73), obese non-binge eaters (n = 43), non-obese binge eaters (n = 14), and normal-weight controls (n = 61). RESULTS: Obese binge eaters reported more upper GI symptoms than normal controls or obese non-binge eaters (p < 0.001). Compared with normal controls, nausea, vomiting, and bloating was 2-4 times more prevalent in both binge eating groups. Indigestion was more prevalent in both obese groups. Obese binge eaters reported more lower GI symptoms than normal-weight controls (p < 0.05). Binge eating in both weight groups was associated with more frequent abdominal pain and dyschezia. Obesity was associated with more frequent constipation, diarrhea, straining, and flatus, whether or not subjects reported binge eating. Chi-square showed a significant association between obesity, binge eating, and symptoms of irritable bowel syndrome, using the Manning criteria. CONCLUSIONS: Specific GI symptoms were associated with binge eating and obesity. Overall, symptoms were more prevalent and more severe in obese binge eaters. The high prevalence of GI symptoms in obese patients who indulge in binge eating should be considered in their evaluation and treatment.

Analysis of Variance↗

Eating lowers defecation threshold in pigs through cholinergic pathways.

The effect of atropine on defecation threshold was compared to placebo pre- and postprandially in four 20- to 30-kg pigs. Stepwise balloon distention was performed 10 cm from the anal verge with a 5-cm latex balloon. Volume was increased in steps of 10 ml up to 200 ml of air or until the balloon was defecated (defecation threshold). Dependent measures were balloon volume, rectal pressure, rectal compliance, and an index of distention-induced contractile activity. Under placebo conditions, the volume and pressure to elicit defecation were significantly lower after feeding (p < 0.05). The distention-induced contractile activity significantly increased near the defecation threshold, but pre- and postprandial conditions were not different. No differences were seen between pre- and postprandial rectal compliance curves. Atropine abolished the postprandial decrease in defecation threshold, but did not affect rectal compliance. The increase in contractile activity at defecation threshold seen with placebo was abolished by atropine. These results show that eating lowers the defecation threshold in terms of distention volume and rectal pressure, and demonstrate that these changes are mediated through cholinergic pathways.

Animals↗

The effect of feeding on defecation behaviour in pigs.

The effect of eating on defecation behaviour was investigated in four 20-30 kg pigs. Rectal distention stimulation was performed pre- and postprandially at 10 cm from the anus with a 5 cm latex balloon. Volume was increased in steps of 10 ml up to 200 ml of air or until balloon defecation. Dependent measures were volume, rectal pressure, determined with a solid state pressure transducer inside the balloon probe, rectal compliance, and an index of distention induced contractile activity. The volume and pressure required to elicit defecation was significantly lower after feeding (p less than 0.01). Distention induced contractile activity was significantly increased near defecation threshold, but pre- and postprandial conditions were not different. There was no difference in rectal compliance pre- and postprandially. These results suggest that eating lowers defecation threshold in terms of distention volume and rectal pressure, and that these changes are not dependent on altered rectal compliance or changes in distention induced motor activity.

Animals↗

Prolonged ambulatory monitoring of colonic motor activity in the pig.

The aim of this study was to develop a chronic model suitable for repeated, long-term studies of the interaction of behavior and colonic function in unrestrained pigs. Cecostomies were created in three 20-30 kg micropigs under general anesthesia. Fistulas were created by suturing the bowel to the abdominal wall. Recordings were made by passing a small (8F) solid-state pressure transducer through the fistula into the proximal bowel and connecting it to a battery-operated data logger worn in a vest on the pig's back. Cecostomies have remained patent and trouble-free for over 18 months. No serious infections have occurred. Preliminary data from a total of thirteen 24-h recording sessions showed 54% of all contractile activity to be in the 2-4 cpm frequency range. Increased motility was seen following meals and upon morning awakening. Motility was minimal during the night. Infrequent (10.31 +/- 2.05/24 h; mean +/- SD) propagated contractions were also noted. These contractions were generally of low amplitude (33.24 +/- 3.81 mmHg). These techniques allow prolonged, intraluminal recordings to be made from the colon of the unrestrained pig.

Animals↗

Effect of prolonged, continuous rectal distention on mouth-to-cecum and colonic transit time in pigs.

The effect of prolonged (6 h), continuous rectal distention on mouth-to-cecum and colonic transit time was studied in four unrestrained pigs. Mouth-to-cecum transit time was determined from samples of cecal efflux using the phenol red dye technique. Colonic transit time was assessed with radiopaque markers that were injected into the cecum before each trial. Rectal distention was applied 2-1/2 h before feeding, during feeding, and 3-1/2 h after feeding. No distention was applied during control conditions. Stools were collected for 48 h after marker application. Rectal distention increased mouth-to-cecum transit time (p < 0.05). Colonic transit time was also prolonged by rectal distention as shown by a significant decrease in the number of markers excreted within 36 h (p < 0.05). Rectal distention for 6 h increased colonic transit time up to 30 h following distention and prolonged mouth-to-cecum transit of a high fat liquid meal.

Animals↗

The effect of loperamide on anorectal function in normal healthy men.

Loperamide improves anorectal functioning in patients with diarrhea and incontinence. Loperamide reduces sensitivity of the recto-anal inhibitory reflex and increases internal anal sphincter tone. Additionally, it has an effect on rectal compliance in incontinent patients with diarrhea. We studied the effect of loperamide versus placebo at different distances from the anal verge in 18 healthy male volunteers, using standard anorectal manometry was a double-blind, two-factorial design. We found that the recto-anal inhibitory reflex is most pronounced when stimulated in regions close to the anal canal and that distention stimuli are also perceived best in that region. Both effects are counteracted by loperamide. We found no effect on internal sphincter tone or rectal compliance. These results imply a gradient of sensitivity for rectal perception and the recto-anal inhibitory reflex in healthy volunteers. Loperamide action on both mechanisms suggests a common mediator for both effects.

Adult↗

[Sex behavior and knowledge about AIDS among students].

604 out of 700 students (330 females, 274 males; mean age 23.3 [19-64] years) completed a questionnaire, which was handed out by their teachers and consisted of 26 questions concerning sexual practices and knowledge about AIDS. 285 subjects were studying natural sciences, 134 arts and 185 medicine. There were significant differences between the sexes (P less than 0.01) in drug use (alcohol, cannabis), use of condoms, promiscuity and with respect to discussion of AIDS. Fewer females than males said that they occasionally used intoxicants before sex (14% vs 25%). Women also used condoms less frequently than men (23% vs 44%), although more insisted on their use if their partner declined (68% vs 58%). 55% of the men and 72% of the women were living within a stable relationship. More women (70%) than men (56%) said they would discuss AIDS before having sex with a new partner. There were significant differences between students from individual disciplines (P less than 0.01) with regard to their knowledge, use of condoms, promiscuity, and discussion of AIDS: arts students were less well informed and changed sexual partners more frequently. The same was true of students more than 30 years old. There are important differences between students with regard to their knowledge about AIDS and sexual behaviour risk factors. Educational programmes need to take this fact into account.

Acquired Immunodeficiency Syndrome↗

Facial EMG responses to auditory stimuli.

Three studies were performed to investigate the effects of auditory stimuli (pure tones and environmental noise) of different intensities on surface EMG activity recorded over five facial muscle regions (M. frontalis lateralis, M. corrugator supercilii, M. orbicularis oculi, M. zygomaticus major, M. depressor anguli oris). The results show that with presentation of tones and noises of high intensity (> 85 dB) strong facial EMG reactions over muscles of the upper face (M. frontalis lateralis, M. corrugator supercilii, M. orbicularis oculi) were evoked. Among environmental noises of different valence but the same intensity, baby's crying evoked EMG reactions over facial muscles in the mouth region, possibly indicating that the subjects demonstrated expressions of dislike during this particular stimulation. It is also discussed whether facial EMG reactions to auditory stimulation of different intensities could be connected to changes in muscle tone of the middle ear muscles. The contraction of these muscles modulates sensitivity to auditory stimulation. Thus, facial EMG activity of the muscles of the upper face could serve as an indicator of sensitivity to external auditory stimuli. However, the evaluation of pleasant and unpleasant emotional reactions in response to auditory stimulation seems to be impossible.

Acoustic Stimulation↗