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Biomedical subjects

S Elsenbruch

Publications and source records attributed to S Elsenbruch.

18 recordsLinked to original sources
PubMed2006

Social support during pregnancy: effects on maternal depressive symptoms, smoking and pregnancy outcome.

BACKGROUND: The goal was to study the effects of social support during pregnancy on maternal depressive symptoms, quality of life and pregnancy outcomes. METHODS: Eight hundred ninety-six women were prospectively studied in the first trimester of pregnancy and following completion of the pregnancy. The sample was divided into quartiles yielding groups of low, medium and high social support based on perceived social support. RESULTS: Pregnant women with low support reported increased depressive symptoms and reduced quality of life. The effects of social support on pregnancy outcomes were particularly pronounced in women who had smoked during pregnancy, with significant main effects of social support in a two-way analysis of variance (smoking status and social support) for child body length (F = 4.26, P = 0.04; 50.43 +/- 2.81 cm with low support versus 51.76 +/- 2.31 cm with high support) and birthweight (F = 11.35, P = 0.001; 3175 +/- 453 g with low support versus 3571 +/- 409 g with high support). In smokers, pregnancy complications occurred more frequently when given low support {34 versus 10.3% with high support, chi(2) = 5.49, P = 0.019; relative risk (RR) = 3.3 [95% confidence interval (95% CI) = 1.1-10.2]}, and the proportion of preterm deliveries was greater given low support (10.0 versus 0% with high support, chi(2) = 3.84, P = 0.05, odds ratio = 8.1). CONCLUSIONS: Lack of social support constitutes an important risk factor for maternal well-being during pregnancy and has adverse effects on pregnancy outcomes.

Adult↗
PubMed2006

Disturbed in vitro adrenergic modulation of cytokine production in inflammatory bowel diseases in remission.

OBJECTIVE: Psychological stress has been implicated in the pathophysiology of both inflammatory and functional gastrointestinal (GI) diseases. The goal of this study was to address neuroendocrine modulation of cytokine production by peripheral blood cells in GI diseases. METHODS: We analyzed the in vitro effects of the beta-adrenergic agonist terbutaline and the glucocorticoid agonist dexamethasone on TNF-alpha and IL-10 production by LPS-stimulated monocytes in whole cell blood cultures in patients with inflammatory bowel diseases in remission (N=10), diarrhoea-predominant irritable bowel syndrome (IBS, N=12), patients with a recent gastroenteritis (post-infectious group, N=10), and healthy controls (N=15). RESULTS: In response to terbutaline, there was a significant increase in IL-10 production (concentration effect: p<0.05), which was diminished in IBD (group effect: p<0.01), comparable in IBS and controls, but enhanced in the post-infectious group (group x concentration effect: p<0.05). In contrast, terbutaline resulted in a concentration-dependent suppression of TNF-alpha production, which was comparable in all groups. Dexamethasone suppressed TNF-alpha production in a dose-dependent manner in all groups, but this effect was significantly more pronounced in post-infectious subjects (group effect: p<0.05). CONCLUSIONS: In IBD, disturbed adrenergic regulation of IL-10 could be part of the mechanism(s) underlying the modulation of disease activity by psychological stress. Diarrhoea-predominant IBS was not associated with altered adrenergic or glucocorticoid regulation of cytokine production by peripheral blood cells, whereas a recent history of gastroenteritis was associated with disturbed neuroendocrine modulation of cytokine production, which may play role in the pathophysiology of post-infectious IBS.

Adrenergic beta-Agonists↗
PubMed2006

Visceral pain and public speaking stress: neuroendocrine and immune cell responses in healthy subjects.

Whereas responses to psychological stressors are well-characterized, little is known regarding responses to painful visceral stimuli. We analyzed the emotional, cardiovascular, neuroendocrine, and cellular immune responses to painful rectal stimulation and psychological stress in healthy individuals. Eleven healthy subjects were studied in three conditions on separate days: painful rectal distension, public speaking stress, and rest. Blood was drawn for endocrinological and immunological analyses; heart rate and blood pressure were measured continuously; state anxiety was assessed with a questionnaire (STAI-S). Anxiety scores were highest in the rectal distension condition. This was evident following rectal distension (mean STAI-S scores: 44.2+/-3.5 post-distension vs. 36.6+/-3.8 post-speech, p<.05), but anxiety was also elevated at baseline (41.6+/-3.9 vs. 32+/-3.2 recovery, p<.01). This anticipatory effect was reflected by elevated baseline cortisol (p<.05) and baseline ACTH (p<.01) levels, as well as circulating lymphocytes and lymphocyte subsets, including decreased basal CD3+CD4+ cells (p<.05) and increased CD16+CD56+ cells (p=.06) compared to rest. Both public speech and rectal distension induced cardiovascular activation, but the effect was more pronounced following rectal distension (+63.8+/-9.4 mmHg in response to distension vs. +36.4+/-6.2 mmHg in response to speech for systolic BP, p<.05). Different response patterns were also observed in the distribution of circulating leukocytes and lymphocyte subsets, including CD16+CD56+ cells (p<.05). An acute visceral pain stimulus causes profound emotional, neuroendocrine, and immune cell responses, which are markedly affected by anticipatory anxiety. These findings may have implications for conditions associated with visceral hyperalgesia.

Adult↗
PubMed2005

Clinical and biochemical characterization of women with polycystic ovary syndrome in North Rhine-Westphalia.

Polycystic ovary syndrome (PCOS), defined as the combination of oligoanovulation and hyperandrogenism, affects more than 5% of women of reproductive age. Insulin resistance and hyperinsulinemia appear to play an important role in its pathogenesis. Here, we will present a characterization of a PCOS cohort from North Rhine-Westphalia in Germany. Clinical features, family history as well as endocrine and metabolic parameters were prospectively recorded from 200 successive patients. All patients were evaluated for insulin resistance and beta-cell-function by oral glucose tolerance test. Patient data were compared with those of 98 age-matched control women. PCOS patients showed significantly higher BMI, body fat mass and androgen levels as well as impaired glucose and insulin metabolism. A positive family history of PCOS and diabetes was more frequent in PCOS patients. Insulin resistance (71%) was the most common metabolic abnormality in PCOS patients followed by obesity (52%) and dyslipidemia (46.3%), with an incidence of 31.5% for the metabolic syndrome. C-reactive protein and other cardiovascular risk factors were frequently elevated even in young PCOS patients. While the clinical characteristics and endocrine parameters of this German PCOS cohort were heterogeneous, they were comparable to those from other Caucasian populations.

Adult↗
PubMed2004

[Metformin, an efficacious drug in the treatment of polycystic ovary syndrome].

BACKGROUND AND OBJECTIVE: Polycystic ovary syndrome (PCOS), with an incidence of 5% in women of reproductive age, is defined as the presence of oligo- or amenorrhea in combination with hyperandrogenism. Most patients also suffer from impaired insulin action (insulin resistance). PCOS thus resembles the metabolic syndrome (type 2 diabetes mellitus, hypertension, lipid disorders, atherosclerosis). International studies showed a beneficial effect of metformin treatment on biochemical and reproductive parameters in PCOS. The aim of our study is the evaluation of metformin treatment in a German PCOS sample. PATIENTS AND METHODS: 103 PCOS women (age 18-40) were treated, according to their body weight, with either 1000 mg or 1700 mg metformin per day after assessment of insulin resistance. Clinical features as well as endocrine and metabolic parameters were recorded at baseline and at 1, 6, and 12 months of treatment. Additionally, baseline data were compared with those of 98 control subjects (age 18-38). RESULTS: PCOS women showed significantly higher body mass index, body fat mass and androgen levels, as well as an impaired glucose- and insulin metabolism compared to controls. Metformin treatment ameliorated acne (36% to 4%), hirsutism-score (11.2 to 9.7) and restarted normal menstrual cycles in 66.7% of PCOS-women. Sixteen of 48 patients with unfulfilled wish to conceive became pregnant during therapy. Metformin restored menses in all previously amenorrheic women. Comparing post-metformin versus baseline levels, HOMA-IR (4.6 to 2.3), AUC-I (379 to 225) and 2-h glucose (117 to 90 mg/dl) decreased significantly. Furthermore, metformin decreased testosterone (2.9 to 1.8 nmol/l), free androgen index (9.1 to 5.3) and dehydroepiandrosterone levels (5.1 to 3.9 mg/l). CONCLUSION: Metformin improves significantly hyperandrogenism and insulin resistance in PCOS patients and appears to be an efficacious mode of therapy.

Adolescent↗
PubMed2004

Pseudo-affective visceromotor responses and HPA axis activation following colorectal distension in rats with increased cholinergic sensitivity.

We analysed visceromotor (VMR) and corticosterone responses to colorectal stimuli under control conditions and following acoustic stress in rats selectively bred for increased sensitivity to cholinergic agonists, the Flinders Sensitive Line (FSL) rats, compared with Flinders Resistant Line (FRL) rats. FSL rats demonstrated a significant VMR response at the smallest distension pressure, whereas no response was evident in FRL controls. FSL rats also demonstrated enhanced VMR responses at both larger distension levels compared with FRL rats. Colorectal distension (CRD) produced significant increases in serum corticosterone levels, which were comparable in FRL and FSL. Noise stress induced divergent corticosterone responses in FRL and FSL, but did not affect VMR to CRD in either group. These data suggest that FSL rats show altered VMR responses to CRD and disturbed hypothalamic-pituitary-adrenal axis responses to acute stress.

Acetylcholine↗
PubMed2003

Detection of gastric slow wave uncoupling from multi-channel electrogastrogram: validations and applications.

Current methodology of single channel electrogastrography is unable to detect coupling or uncoupling of gastric slow waves, which is crucial for gastric emptying. In this study, a new methodology, called cross-spectral analysis method, was established to compute the coupling percentage of multi-channel gastric slow waves recorded using serosal electrodes and electrogastrogram (EGG). Two experiments were performed to validate the method and demonstrate its applications in clinical research. In experiment 1, simultaneous recordings of gastric slow waves were made in five dogs from serosal electrodes and cutaneous electrodes. In experiment 2, four-channel fasting EGGs were made in 10 volunteers for 30 min during waking and 30 min during non-rapid eye movement (REM) sleep. The validation study (experiment 1) showed that the slow wave coupling calculated from the EGGs was correlated with that computed from the serosal recordings. The gastric slow wave coupling percentages detected from both serosal and cutaneous recordings were significantly impaired during vasopressin infusion (6.3 +/- 2.6 vs 62.4 +/- 6.3, P < 0.001 for serosal recordings; 6.7 +/- 3.0 vs 57.2 +/- 2.7, P < 0.001 for cutaneous recordings), and the coupling percentages respectively calculated from serosal and cutaneous recordings were significantly correlated during the baseline recording period (R = 0.922, P < 0.05) and vasopressin infusion period (R = 0.916, P < 0.05). In experiment 2, the gastric slow wave became less coupled when healthy volunteers fell asleep. The percentage of slow wave coupling calculated from the EGGs was 68.2 +/- 17.9% during waking but 41.9 +/- 20.8 during non-REM sleep (P < 0.05). The method developed in this study is reliable for the detection of slow wave uncoupling from multi-channel EGGs. Gastric slow wave coupling is impaired during vasopressin infusion and sleep. These data suggest that this method has potential applications in physiological and clinical studies.

Adult↗
PubMed2001

Diarrhea- and constipation-predominant IBS patients differ in postprandial autonomic and cortisol responses.

OBJECTIVE: As the primary link between brain and gut, autonomic and endocrine dysfunction may play a role in the pathophysiology of the irritable bowel syndrome (IBS). The aim of this study was to assess autonomic, endocrine, and symptomatic responses to food intake in diarrhea-predominant and constipation-predominant IBS patients, compared to normals. METHODS: Twelve women with diarrhea-predominant or alternating IBS (IBS-D), 12 women with constipation predominant IBS (IBS-C), and 20 healthy women participated. GI symptoms, saliva cortisol concentration, heart rate, and heart rate variability were assessed at baseline and after a meal. Spectral analysis of heart rate variability was used as a measure of the sympathovagal regulation of the heart rate. RESULTS: Both groups of IBS patients showed a significant postprandial increase in GI symptoms. IBS-D showed a significant increase in the low frequency/high frequency band ratio and a decrease in the high frequency band power during the first postmeal period, which was significantly different, not only from controls, but also from IBS-C. IBS-D also showed a significant postprandial increase in cortisol, which was not evident in controls or IBS-C. There was a significant correlation between the vagal response and the postprandial increase in GI symptoms in IBS-D (r = 0.6, p < 0.05). CONCLUSIONS: These findings support the notion that the IBS symptom groups are characterized by different physiological responses to visceral stimuli, and point to a role of autonomic pathways in IBS symptomatology.

Adult↗
PubMed2000

Time-frequency analysis of heart rate variability using short-time fourier analysis.

This study was done to introduce new parameters derived by time frequency analysis of heart rate variability data. Four simulation experiments were carried out to compare the short-time Fourier transform (STFT) analysis method to the traditional overall spectral analysis method. Sinusoidal signals were generated with identical total power in the high-frequency band, but varying time-frequency and time-amplitude information. The STFT method was also applied to heart rate variability data from the stages of normal human sleep. Data analysis included computation of the power in the high-frequency band by overall spectral analysis. The instability coefficients (ICs) of the frequency and power in the high-frequency band were derived by STFT analysis. The ICs derived by the STFT method were able to describe time-frequency and time-amplitude variations in sinusoidal signals which contained identical total power in a specified frequency range. The ICs of the frequency and power were able to differentiate variations in vagal activity between the stages of human sleep and waking. The ICs represent new parameters derived by the STFT method, and allow the detection and quantification of short-lasting time-frequency and time-amplitude variations that remain obscured by overall spectral analysis.

Adult↗
PubMed2000

Proximal migration of esophageal acid perfusions during waking and sleep.

OBJECTIVE: Proximal acid migration resulting from gastroesophageal reflux has been implicated in aerodigestive complaints and disorders. This study was designed to investigate the effects of acid volume, posture, and sleep on proximal esophageal acid migration (drop in pH to <4.0). METHODS: The study was performed in 15 healthy adults. A distal esophageal acid perfusion technique to simulate gastroesophageal reflux was used. Esophageal acid perfusions of 1 ml and 3 ml were accomplished at a site 5 cm above the proximal border of the lower esophageal sphincter in the upright and supine positions during waking, and during polysomnographically monitored sleep. Esophageal pH was recorded by two sensors located in the mid- and proximal esophagus at 10 and 15 cm above the lower esophageal sphincter. RESULTS: Acid volume clearly increased the incidence of migration to the mid and proximal sensors during both waking and sleep, and also significantly increased acid clearance time. Posture failed to significantly affect the incidence of acid migration and acid clearance. Sleep clearly enhanced migration to the proximal pH sensor of even those perfusions as small as 1 ml. For instance, 40% of 1 ml perfusions during sleep migrated to the proximal sensor compared with <1% during waking. Acid clearance times were significantly longer during sleep as measured by the mid- and proximal esophageal pH sensors. CONCLUSIONS: In healthy individuals, volume enhances the likelihood of migration to both mid- and proximal esophagus, and significantly prolongs clearance time in the waking state. Posture appears to be a less significant parameter with regard to both the incidence of acid migration and acid clearance. Sleep is a significant risk factor for acid migration to the proximal esophagus for even minute volumes, and markedly prolongs acid clearance.

Adult↗
PubMed2000

Autonomic regulation of cardiac function during sleep in patients with irritable bowel syndrome.

OBJECTIVE: Several studies have provided evidence of abnormal autonomic activity in irritable bowel syndrome (IBS), suggesting that abnormal central nervous system-autonomic nervous system arousal mechanisms may be part of its pathophysiology. The goal was to investigate cardiac sympatho-vagal balance during waking and the different stages of sleep using heart rate variability analysis in IBS patients compared to healthy controls. METHODS: A total of 15 IBS patients (13 female, two male, mean age 34.9 +/- 2.1 yr) and 15 controls (13 female, two male, mean age 36.2 +/- 2.3 yr) were studied during 1 h of pre-sleep quiet waking and during seven-hours of sleep. Polysomnography was used for the determination of state of consciousness. Electrocardiography provided the beat-to-beat intervals, which were then subjected to spectral analysis for determination of the percentage of energy in the low and high frequency bands, respectively. The low frequency/high frequency band ratio was also calculated. For each subject, heart rate variability analysis was performed using 15-min segments of waking, non-rapid eye movement sleep, and rapid eye movement sleep. RESULTS: The low frequency band power was significantly greater in IBS patients during waking. No group differences were found in high frequency band power during any state. The low frequency to high frequency band ratio was significantly greater in IBS patients during rapid eye movement sleep. CONCLUSIONS: IBS patients have greater sympathetic activity during waking and greater overall sympathetic dominance during rapid eye movement sleep. These results support the presence of autonomic abnormalities in patients with IBS. The possibility is discussed that sympathetic dominance during rapid eye movement sleep may play a role in sensitizing the gut to waking stimulation.

Adult↗
PubMed1999

Heart rate variability during waking and sleep in healthy males and females.

STUDY OBJECTIVES: The study goal was to investigate autonomic activity with heart rate variability analysis during different sleep stages in males and females. DESIGN: The study utilized a 2 Groups (males, females) x 4 States (waking, stage 2 sleep, stage 4 sleep, rapid-eye movement sleep) mixed design with one repeated, within-subjects factor (i.e., state). SETTING: The study was carried out in the sleep laboratory of the Thomas N. Lynn Institute for Healthcare Research. PARTICIPANTS: Twenty-four healthy adults (fourteen females and ten males). INTERVENTIONS: NA. MEASUREMENTS AND RESULTS: All participants underwent polysomnographic monitoring and electrocardiogram recordings during pre-sleep waking and one night of sleep. Fifteen-minute segments of beat-to-beat heart rate intervals during waking, stage 2 sleep, stage 4 sleep, and REM sleep were subjected to spectral analysis. Compared to NREM sleep, REM sleep was associated with decreased high frequency (HF) band power, and significantly increased low frequency (LF) to (HF) ratio. Compared to females, males showed significantly elevated LF/HF ratio during REM sleep. Males also demonstrated significantly decreased HF band power during waking when compared to females. No significant sleep- or gender-related changes in LF band power were found. CONCLUSIONS: The results confirmed changes in autonomic activity from waking to sleep, with marked differences between NREM and REM sleep. These changes were primarily due to stage-related alterations in vagal tone. REM sleep was characterized by increased sympathetic dominance, secondary to vagal withdrawal. The data also suggested gender differences in autonomic functioning during waking and sleep, with decreased vagal tone during waking and increased sympathetic dominance during REM sleep in the males.

Adult↗
PubMed1999

Disruption of normal gastric myoelectric functioning by sleep.

STUDY OBJECTIVES: The aim of this study was to assess the effects of sleep on gastric myoelectric activity as measured by electrogastrography in healthy individuals. The goal was to elucidate the role of central influences in the regulation of normal gastric functioning. DESIGN: Electrograstrogram (EGG) was recorded during polysomnographically monitored waking and sleep. SETTING: Sleep laboratory. PARTICIPANTS: 17 healthy volunteers. MEASUREMENTS AND RESULTS: EGG parameters were computed for 20-minute segments of pre-sleep waking, stage 2 sleep, stage 4 sleep, and REM sleep using both overall and running spectral analysis of EGG data. The dominant power decreased significantly from waking (31.4 +/- 1.4 dB) to all sleep stages (23.1 +/- 1.5 dB during stage 2; 24.7 +/- 1.4 dB during stage 4; 24.3 +/- 1.3 dB during REM sleep). The percentage of 2-4cpm activity decreased significantly during NREM sleep (64.6 +/- 7.6% during stage 2 sleep; 57.5 +/- 5.5% during stage 4 sleep) compared to its waking value (90.8 +/- 3.2%), but not compared to REM sleep (74.1 +/- 5.4%). The instability coefficient of the dominant frequency increased significantly from waking (0.19 +/- 0.03) to all sleep stages (0.36 +/- 0.05 during stage 2 sleep; 0.47 +/- 0.05 during stage 4; 0.34 +/- 0.05 during REM sleep). No significant differences between the sleep stages were found for any measure. CONCLUSIONS: Sleep is associated with increases in gastric dysrhythmia and instability of the gastric slow wave frequency when compared to waking. These findings suggest that the intrinsic electrical activity of the stomach is significantly influenced by central nervous system mechanisms, and support the notion of a brain-gut axis.

Adult↗
PubMed1999

Subjective and objective sleep quality in irritable bowel syndrome.

OBJECTIVE: The aim of this study was to compare subjective and objective measures of sleep quality in patients with irritable bowel syndrome (IBS) and controls. METHODS: The Pittsburgh Sleep Quality Index (PSQI) was used to measure subjective sleep quality, and polysomnography was performed during one night to obtain objective measures of sleep quality, including sleep efficiency, sleep latency, number of arousals, and percentage of slow-wave sleep. Participants were 15 IBS patients and 15 healthy controls. RESULTS: The results showed a significantly increased global PSQI score in patients, as well as significantly higher scores on several subcomponents of the PSQI (i.e., sleep quality, sleep latency, habitual sleep efficiency, and daytime dysfunction). Analysis of polysomnographic parameters revealed no significant group differences on any measure. CONCLUSIONS: Complaints of poor sleep quality in the absence of objective sleep abnormalities suggest altered sleep perception, and support that IBS involves exaggerated responses to normal internal or external stimuli.

Adult↗
PubMed1997

Meal composition and its effect on postprandial sleepiness.

Drowsiness is a commonly experienced phenomenon following food ingestion. The present two experiments were designed to assess separately the effects of a solid meal compared to a liquid meal and to an equal volume of water, and the effects of meal constituents (high-fat, high-carbohydrate, or mixed meal) on objective postprandial sleep latencies. Ten normal male subjects participated in each study. Both studies used identical protocols, differing only in the meals the subjects were fed. All subjects underwent a pre-meal baseline nap at 1600 hours. At 1700 hours, subjects consumed a test meal. Naps followed at 1730, 1800, 1900, and 2000 hours. Sleep onset latency was determined by standard polysomnographic measures. In both studies, a one-way repeated-measures ANOVA procedure revealed no significant difference in sleep latencies among the meal conditions for the nap at 1600 hours. However, for the postprandial naps at 1730, 1800, and 2000 hours, the solid meal demonstrated a significant decrease in postprandial sleep latency compared with an equivalent volume of water (control). No significant differences in sleep latency were found between the food constituents. Results indicate that in contrast to a liquid meal, a solid meal produces a decrease in sleep onset latency when compared to an equivalent volume of water. Further, it was demonstrated that meal constituents have no effect on postprandial sleepiness.

Adolescent↗
PubMedDate not supplied

Psychological and physiological responses to postprandial mental stress in women with the irritable bowel syndrome.

OBJECTIVE: To investigate the psychological (affective and symptomatic) and physiological (autonomic and cortisol) responses to postprandial mental stress in women with irritable bowel syndrome (IBS). It was hypothesized that patients with IBS would show exaggerated autonomic and cortisol responses to the psychological stressor and that the stressor would enhance gastrointestinal symptoms. METHOD: Twenty-four women with IBS and 20 healthy women participated in the two-day study protocol. Both days were identical, with the exception that on one day, a stressful mental task was completed after ingestion of a standard meal. Heart rate variability, cortisol, affective, and symptomatic responses were measured before and after application of the stressor. RESULTS: Patients with IBS demonstrated increased negative affect at baseline and in response to the stressor. Gastrointestinal symptoms were not affected by the stressor. Appraisal of the stressor by patients with IBS was not different from that of controls. There were no group differences in the autonomic response to the stressor. There was no overall cortisol response to the stressor in either group. CONCLUSIONS: Patients with IBS respond with greater negative affect to postprandial psychological stress as well as to food intake alone, and they can be distinguished from controls on the basis of self-report data. Patients with IBS cannot be differentiated from controls on the basis of the pattern of changes in sympathetic activation after the mental stressor. The stressor used in this study did not elicit a cortisol response in either group.

Adult↗