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Biomedical subjects

G Arnold

Publications and source records attributed to G Arnold.

At least 19 recordsLinked to original sources

New risk assessment approach for systemic insecticides: the case of honey bees and imidacloprid (Gaucho).

The procedure to assess the risk posed by systemic insecticides to honey bees follows the European Directives and depends on the determination of the Hazard Quotient (HQ), though this parameter is not adapted to these molecules. This paper describes a new approach to assess more specifically the risk posed by systemic insecticides to honey bees with the example of imidacloprid (Gaucho). This approach is based on the new and existing chemical substances Directive in which levels of exposure (PEC, Predicted Exposure Concentration) and toxicity (PNEC, Predicted No Effect Concentration) are compared. PECs are determined for different categories of honey bees in relation to the amounts of contaminated pollen and nectar they might consume. PNECs are calculated from data on acute, chronic, and sublethal toxicities of imidacloprid to honey bees, to which selected assessment factors are applied. Results highlight a risk for all categories of honey bees, in particular for hive bees. These data are discussed in the light of field observations made on honey bee mortalities and disappearances. New perspectives are given to better determine the risk posed by systemic insecticides to honey bees.

Animals↗

The use of radiolabelled human serum albumin and SPECT/MRI co-registration to study inflammation in the cavernous sinus of cluster headache patients.

A sterile inflammation in the cavernous sinus was hypothesized to underlie cluster headache (CH). Neurogenic inflammation is accompanied by the extravasation of plasma proteins in the surrounding tissue. We tested the hypothesis of an inflammatory process in the cavernous sinus in CH patients using 99mTc-human serum albumin (HSA) and single photon emission computed tomography (SPECT). Six patients with episodic CH were enrolled. After baseline imaging, CH attacks were induced by IV injection of nitroglycerin. The patients remained untreated for 20 min. A second SPECT was performed after successful treatment. Region of interest (ROI) analysis was performed on the basis of coregistered MRI/SPECT data. There was no statistical difference between the 99mTc-HSA uptake in the ipsilateral cavernous sinus before and after induction of an acute CH attack. There was no evidence for 99mTc-HSA extravasation in the cavernous sinus during the active episode as compared with the remission phase. Our results do not support the hypothesis of an inflammation in the cavernous sinus.

Adult↗

Osmosensitive mechanisms contribute to the water drinking-induced pressor response in humans.

BACKGROUND: Water drinking elicits a sympathetically mediated pressor response in multiple-system atrophy patients through an unknown mechanism. We reasoned that gastrointestinal distention, hyposomotic stimulation, or both contribute to the water-induced pressor response. METHODS: We compared the response to normal saline and water on blood pressure in 10 patients with probable multiple-system atrophy. Patients featured moderate to severe autonomic dysfunction. EKG and finger arterial blood pressure were recorded continuously, and 500 mL normal saline and distilled water were each given in a single-blinded fashion. Fluids were applied through a previously inserted nasogastric tube within a 5-minute period. RESULTS: Blood pressure began to increase within 10 minutes after water administration and reached a maximum after 20 minutes. Blood pressure did not change after saline administration. The blood pressure change after 20 minutes was 8 +/- 9/2 +/- 5 mmHg with water and -1 +/- 11/-1 +/- 7 mmHg with normal saline administration (p = 0.02 between interventions). Heart rate did not change with either intervention. CONCLUSION: Ingestion of water elicits a greater pressor response than the ingestion of normal saline. Thus, gastric distention is probably not the crucial mechanisms for the water-induced pressor response. Instead, the response may be mediated through osmosensitive afferent structures in the gastrointestinal tract, portal vein, and liver.

Autonomic Nervous System Diseases↗

["Progressive" hypothenar hammer syndrome Indication for operative treatment].

Hypothenar hammer syndrome (HHS) is ischemia of the distal ulnar artery caused by injury to the ulnar part of the palmar arch. This disease often involves workers who frequently use the hypothenar part of the hand as a hammer. The aneurysmatic form of HHS represents an indication for operative treatment; the thrombotic form is treated mainly conservatively. In our opinion, the symptomatic thrombotic form represents an indication for operation if symptoms persist during conservative therapy, particularly if symptoms progress. In fresh embolic occlusions, regional thrombolysis is usually successful. We present here the symptomatic treatment and course in two patients with complaints increasing during conservative therapy. The patients reported progressive Raynaud's phenomenon of the fingers. Angiography confirmed corkscrew-like aneurysmatic configuration of the distal ulnar artery and subsequent embolization of digital arteries. In both cases, we removed the source of the embolism with resection of the involved arterial segment and anastomosis with autologous vein grafts.

Adult↗

CGRP release and c-fos expression within trigeminal nucleus caudalis of the rat following glyceryltrinitrate infusion.

Neuropeptide release and the expression of c-fos like immunoreactivity (c-fos LI) within trigeminal nucleus caudalis neurons (TNC) are activation markers of the trigeminal nerve system. Glyceryltrinitrate (GTN) is believed to stimulate the trigeminal nerve system, thereby causing headache. We examined the effects of a 30 min NO-donor infusion on CGRP release in jugular vein blood and c-fos LI within TNC of the rat. GTN (2 and 50 microg/kg/min) or NONOate infusion (25 nmol/kg/min) did not cause any CGRP release during and shortly after infusion, whereas administration of capsaicin resulted in strongly increased CGRP levels. GTN infusion (2 microg/kg/min for 30 min) did not lead to enhanced c-fos LI after 2 h and 4 h, whereas capsaicin infusion caused a time- and dose-dependent expression of c-fos LI within laminae I and II of the TNC. Surprisingly, GTN attenuated capsaicin-induced c-fos expression by 64%. The nitric oxide synthase (NOS) inhibitor L-NAME (5 and 50 mg/kg) reduced capsaicin-induced c-fos LI dose dependently (reduction by 13% and 59%). We conclude that GTN may lead to headaches by mechanisms independent of CGRP release from trigeminal nerve fibres. GTN doses comparable to those used in humans did not activate or sensitize the trigeminal nerve system. Both GTN and L-NAME reduced capsaicin-induced c-fos LI. This is most likely due to a feedback inhibition of nitric oxide synthases, which indicates that the c-fos response to capsaicin within TNC is mediated by NO dependent mechanisms.

Animals↗

Multiple cerebral aneurysms as delayed complication of left cardiac myxoma: a case report and review.

Left cardiac myxoma and also consecutive embolization into the brain is well documented, whereas the association of myxomas with multiple fusiform cerebral aneurysms is rare. We analyze 33 previously reported patients and present a case of a 43-year-old woman with multiple cerebral infarctions 2 years after resection of a recurrent myxoma in the left atrium. Cerebral angiography displayed multiple fusiform aneurysms of several cerebral arteries, including a giant aneurysm of the basilar artery. Serum level of interleukin-6 (IL-6) was highly elevated. The clinical, radiological and pathological features of these aneurysms are summarized. The pathogenesis, including the role of IL-6 in the formation of myxomatous aneurysms, is discussed.

Adult↗

Combined 123I-FP-CIT and 123I-IBZM SPECT for the diagnosis of parkinsonian syndromes: study on 72 patients.

72 consecutive patients with suspected parkinsonian syndromes (PS) were studied by dopamine transporter (DAT) and D2 receptor SPECT in order to evaluate the accuracy of combined SPECT imaging. In the follow-up, the patients were diagnosed as having Parkinson's disease (PD, n = 25), dementia with Lewy bodies (DLB, n = 6), multiple system atrophy (MSA, n = 13), progressive supranuclear palsy (PSP, n = 8), corticobasal degeneration (CBD, n = 9), and essential tremor (ET, n = 11). Using the iteratively estimated optimal cutoffs, DAT was reduced in 57/61 PS patients, whereas all ET patients were identified as "normal". Reduced D2 receptor binding had 7/13 patients with MSA, 6/8 patients with PSP, 2/9 patients with CBD and no ET, PD or DLB patients. FP-CIT SPECT allows an accurate detection of nigrostriatal affection in neurodegenerative PS. IBZM SPECT is useful to approve the diagnosis of PSP and MSA although a normal finding cannot exclude an atypical PS. IBZM SPECT seems to be of restricted value in CBD.

Aged↗

Improvement of motor function in early Parkinson disease by safinamide.

A median safinamide (SAF) dose of 70 mg/day (range 40 to 90 mg/day) increased the percentage of parkinsonian patients improving their motor scores by > or =30% from baseline (responders) after 3 months from 21.4% (placebo) to 37.5% (p < 0.05, calculated by logistic regression analysis). In a subgroup of 101 patients under stable treatment with a single dopamine agonist, addition of SAF magnified the response (47.1% responders, mean 4.7-point motor score decrease; p > or = 0.05). These results suggest that doses of SAF exerting ion channel block and glutamate release inhibition add to its symptomatic effect and warrant exploration of higher doses.

Adult↗

[Migrainous vertigo].

Migrainous vertigo is one of the commonest cause of episodic vertigo and is increasingly recognized among neurootologists and migraine specialists. The clinical presentation is heterogeneous with spontaneous and positional vertigo lasting seconds to days and inconsistent temporal relationship to headache and other migrainous features. Findings during the acute episode suggest that several pathophysiological mechanisms can be involved. There are no evidence-based guidelines for therapy available. Presently, migrainous vertigo is not included in the classification of the International Headache Society (IHS). We propose that the diagnosis of definite migrainous vertigo can be made in a patient with migraine according to the IHS with at least two attacks of vestibular vertigo accompanied by migrainous symptoms when other causes are excluded.

Diagnosis, Differential↗

High-dose riboflavin treatment is efficacious in migraine prophylaxis: an open study in a tertiary care centre.

The aim of this study was to investigate the efficacy of riboflavin for the prevention of migraine. An open label study was performed in a specialized outpatient clinic. Patients received 400 mg riboflavin capsules per day. Headache frequency, duration, intensity and the use of abortive drugs were recorded at baseline and 3 and 6 months after treatment. Headache frequency was significantly reduced from 4 days/month at baseline to 2 days/month after 3 and 6 months (P < 0.05). The use of abortive drugs decreased from 7 units/month to 4.5 units/month after 3 and 6 months of treatment (P < 0.05). In contrast, headache hours and headache intensity did not change significantly. We could demonstrate a significant reduction of headache frequency following riboflavin treatment. In addition, the number of abortive anti-migraine tablets was reduced. In line with previous studies our findings show that riboflavin is a safe and well-tolerated alternative in migraine prophylaxis.

Adult↗

A randomized trial of botulinum toxin A for treatment of drooling.

The authors compared the efficacy of three different doses (18.75, 37.5, and 75 MU per parotid gland) of botulinum toxin A (BTX-A; Dysport, Ipsen Pharma, Germany) injections vs vehicle in patients with sialorrhea (n = 32) using a single-center, prospective, double-blind, placebo-controlled dose-finding study. The primary endpoint was achieved with 75 MU BTX-A without treatment-related adverse events, suggesting BTX-A is a safe and effective treatment for patients with sialorrhea.

Botulinum Toxins, Type A↗

The effects of frequency in pallidal deep brain stimulation for primary dystonia.

The effect of stimulation frequency for pallidal deep brain stimulation in five patients with either generalized or segmental dystonia was evaluated three to twelve months postoperatively via a randomized, double-blind paradigm. The quality of life and the severity of dystonic symptoms improved by approximately 60% and 43% respectively using a frequency of 130 Hz. Compared with 130 Hz a significant further clinical improvement was observed at frequencies of 180 and 250 Hz, which contrasted with a significant deterioration at lower frequencies (5, 50 Hz) compared to 130 Hz.

Adolescent↗

The German Cardiac Society from its foundation as the German Society for Circulation Research to the present: its history, structure and targets.

The "Deutsche Gesellschaft für Kardiologie--Herzund Kreislaufforschung" (German Cardiac Society) was founded as "Deutsche Gesellschaft für Kreislaufforschung" on June 6, 1927, in Bad Nauheim by B. Kisch, Cologne, and A. Weber, Bad Nauheim. They were actively supported by F.M. Groedel, Bad Nauheim, who later in 1950--together with B. Kisch, now both of New York--was co-founder of the American College of Cardiology (ACC). Thus, our Society is the oldest society of cardiology in Europe. The first meeting of the Society was held in Cologne in 1928, with H. E. Hering as president. From that year on there was an annual meeting of the Society until the last one during WWII in 1941 in Bad Nauheim. After WWII the first meeting of the Society was held again in Bad Nauheim in 1949. The Society met there annually until 1982. From 1983 onwards--the Society now called "Deutsche Gesellschaft für Herz- und Kreislaufforschung"--the (spring) meeting has taken place in Mannheim. In 1974 an additional annual autumn meeting was established, taking place at alternating locations. The emphasis of these autumn meetings is placed on continuous medical education on a high level, contrary to the spring meetings focussing on the scientific aspects. In 1950 the Society joined the International Society and Federation of Cardiology (ISFC)--now the World Heart Federation (WHF)--in Paris, and in 1952 the European Society of Cardiology (E.S.C.) in London. According to its statutes, in 1994 the Society changed its name to "Deutsche Gesellschaft für Kardiologie--Herz- und Kreislaufforschung". The Society, which brings together cardiologists, clinicians in universities, community hospitals and in private practice, and researchers working in the field of cardiology, cardiac surgeons and pediatric cardiologists, has more than 4900 members, including 10 honorary members, and 13 corresponding members. The Society has 4 committees, 9 project groups and 10 clusters with 29 working groups, and sponsors 13 prizes and awards as well as 14 national and international grants.

Cardiology↗