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W Müller

Publications and source records attributed to W Müller.

At least 37 records · Page 2Linked to original sources
PubMed2005

[Do both the public health service and public health have a future despite developing in different directions?].

In the United Kingdom and the United States the public health services have always been considered as being an integral part of public health. The mission, tasks and objectives are the same. In Germany pub-lic health research and public health initiatives on behalf of the universities started in the 1990s. Before that terms and disciplines such as "hygiene" and "social medicine" prevailed. The public health service -- related to these disciplines -- had also been established previously. At the start of the debate on public health issues, however, the pub-lic health service did not play an important role. It was criticized for its conventional organization and its lack of population-based strategies. This article describes the conceptual development of both public health and the public health service over the last 15 ye-ars and the importance of public health politics in achieving a joint strategy aimed at im-proving the health of the population including different population groups.

Education, Medical, Graduate↗
PubMed2005

Individual flight styles in ski jumping: results obtained during Olympic Games competitions.

From the physics point of view, the jump length in ski jumping depends on: the in-run velocity v(0), the velocity perpendicular to the ramp v(p0) due to the athlete's jumping force, the lift and drag forces acting during take-off and during the flight, and the weight of the athlete and his equipment. The aerodynamic forces are a function of the flight position and of the equipment features. They are a predominant performance factor and can largely be influenced by the athlete. The field study conducted during the Olympic Games competitions 2002 at Park City (elevation: 2000 m) showed an impressive ability of the Olympic medallists to reproduce their flight style and remarkable differences between different athletes have been found. The aerodynamic forces are proportional to the air density. Elite athletes are able to adapt their flight style to thin air conditions in order to maximise jump length and to keep the flight stable. The effects of flight position variations on the performance have been analysed by means of a computer model which is based on the equations of motion and on wind tunnel data corresponding to the flight positions found in the field. Athletes have to solve extremely difficult optimisation problems within fractions of a second. The computer simulation can be used as a reliable starting point for the improvement of training methods and gives an insight into the "implicit" knowledge of physics that the ski jumping athlete must have available for a good performance.

Air Movements↗
PubMed2005

Rehospitalisations for respiratory disease and respiratory syncytial virus infection in preterm infants of 29-36 weeks gestational age.

BACKGROUND: To evaluate rates of rehospitalisation due to respiratory illness in preterm infants of 29-36 weeks gestation without chronic lung disease. PATIENTS AND METHODS: Retrospective single centre cohort study including infants from 1998 to 1999 with follow-up over two respiratory syncytial virus (RSV) seasons. RESULTS: Of 435 infants included 61 infants (14%) experienced 78 rehospitalisations. The overall RSV attack rate was 4.4% over two consecutive RSV seasons for infants below 6 months of age at onset of RSV season (7.7 and 1.1%, respectively, p=0.015), with significant differences between infants of 29-32 and 33-36 weeks gestational age (10.5% vs. 2.3%, p=0.008). None of the infants needed mechanical ventilation or admission to the intensive care unit. Infants with RSV infection were younger of age (mean 4.2 vs. 8.2 months; p=0.015), had longer stays at the hospital (11.5 vs. 7.0 days; p=0.006), and more severe courses of disease (score 3.0 vs. 1.8; p<0.001). Additional risk factors for RSV infection were multiple gestation (OR 5.5; CI 95% 1.439-21.028) and congenital heart disease (OR 4.2; CI 95% 1.005-17.669). CONCLUSION: The total burden of respiratory disease and RSV infection in this population was low. A lower gestational age, multiple gestation, and congenital heart disease were associated with increased risk of RSV infection.

Austria↗
PubMed2005

Chlamydia pneumoniae, herpes simplex virus and cytomegalovirus in symptomatic and asymptomatic high-grade internal carotid artery stenosis. Does infection influence plaque stability?

BACKGROUND: Current debates are focused on inflammatory processes in atherosclerotic lesions as a possible pathomechanism for destabilization and thrombembolism. In this prospective study the role of systemic and local infection in patients with high-grade internal carotid artery stenosis (ICA) was evaluated. PATIENTS AND METHODS: Serum antibody titers of 109 consecutive patients, who underwent surgery for ICA stenosis (asymptomatic n = 40, symptomatic n = 69) were prospectively measured for Chlamydia pneumoniae (Cpn) (IgA and IgG), Herpes simplex virus (HSV) (IgG, IgM) and Cytomegalovirus (CMV) (IgG, IgM) respectively. 53 carotis plaques of this group (asymptomatic n = 17, symptomatic n = 36) could be analyzed by polymerase chain reaction (PCR) for Cpn-, HSV- and CMV-DNA presence. RESULTS: Seropositivity was found in 61,5% for Cpn, 91,7% for HSV and 72,5% CMV respectively. No significant relation was found between symptomatic and asymptomatic patients as well as no difference was seen for presence of IgA antibodies against Cpn comparing both groups. Plaque-PCR revealed Cpn in 7 cases (13,2%), HSV in 2 cases (3,8%) and no CMV had been detected. Again, no significant relationship was found concerning symptomatic and asymptomatic patients. All 9 PCR-positive plaques displayed lesions of "complicated atherosclerosis" as central fibrous necrosis and calcification or plaque bleeding and surface thrombosis. CONCLUSIONS: Our results do not support the hypothesis that systemic Cpn, HSV or CMV- infection or evidence of Cpn-, HSV- or CMV-DNA in carotid plaques causes plaque destabilization and cerebral thromboembolism. Plaque infection could only be observed in cases with advanced atherosclerosis.

Carotid Stenosis↗
PubMed2005

Within clutch co-variation of egg mass and sex in the black-headed gull.

Female birds of several species have control over the production of daughters and sons. However, most studies failed to find a relationship between egg size and sex. This is intriguing as adjustment of egg size would constitute a powerful tool for the female to meet different resource demands of the sexes, particularly in size dimorphic species. Our results show that, within clutches of black-headed gulls (Larus ridibundus) the proportion of males was positively associated with egg mass. This applied for all three laying positions, independently of the absolute egg mass. There was a significant relationship between the distribution of the sexes over the laying sequence and the egg mass change. When egg mass decreased over the sequence, first-laid eggs were male biased and last-laid eggs female biased, and vice versa. The potential adaptive value of this allocation strategy is evaluated with regard to male sensitivity to egg quality and competitive differences between the sexes.

Animals↗
PubMed2004

Correlation between invasion of Caco-2 eukaryotic cells and colonization ability in the chick gut in Campylobacter jejuni.

In an in vitro cell culture model using Caco-2 cells the adhesion and invasion properties of 11 Campylobacter (C.) jejuni isolates of different origin were studied. Additionally, we investigated the colonization ability of the strains in a chick model. Virtually, all C. jejuni showed cell adherence in the in vitro assay, but there were large differences in the invasion frequencies among the Campylobacter isolates. The colonization ability in the chick gut also differed markedly and enabled the formation of three groups: non-colonizing, weak or delayed colonization and strong colonization ability. On this occasion, we found a putative correlation between invasion of Caco-2 cells and colonization in the chick gut. Non-colonizers are not invasive or only have small invasion indexes. Strains which colonize weakly or exhibit delayed colonization have a medium invasion index and strong colonizers show markedly higher values of this parameter. The characterization of the flagellin gene of the used C. jejuni strains resulted in eight flaA types. There was no association between flaA type and invasion or colonization ability in the chick gut.

Animals↗
PubMed2004

Copper-induced hepatotoxicosis with hepatic stellate cell activation and severe fibrosis in North Ronaldsay lambs: a model for non-Wilsonian hepatic copper toxicosis of infants.

Copper-sensitive North Ronaldsay sheep represent a possible model for certain hepatic-overload syndromes of infancy and childhood that are clinically, pathologically and genetically distinct from Wilson's disease. The purpose of this study was to simulate in artificially reared lambs the syndrome produced by copper exposure in susceptible human infants. Twenty four North Ronaldsay lambs were assigned to three groups of eight animals, namely, an unsupplemented control group and two trial groups given milk replacer to which copper (CuSO4) had been added at the rate of 5 mg/litre and 10 mg/litre. Four lambs from each group were killed at 40 or 69 days. Livers were fixed in 10% formalin and analysed for copper by mass spectrometry. Paraffin wax-embedded sections were stained with rhodanine for copper and labelled immunohistochemically for alpha smooth muscle actin (ASMA). At 40 days the maximum amounts of copper in the livers of both copper-supplemented groups was 1466-1605 microg/g dry weight (control group 172-201 microg/g Cu dry weight). Histochemically, copper was demonstrated within hepatocytes, together with marked apoptosis. At 69 days there was a florid pericellular fibrosis complemented by strong ASMA immunolabelling, confirming phenotypic modulation of hepatic stellate cells. Such primary copper-induced fibrogenesis confirms the unique status of this animal model in respect of childhood copper toxicosis.

Animals↗
PubMed2004

[Bone ablation using ultrashort laser pulses. A new technique for middle ear surgery].

OBJECTIVES: Laser applications within the tympanic cavity area are widely accepted. Commonly used systems are CO(2), argon, KTP and erbium devices. The disadvantages are heat development and/or acoustic load of the inner ear. A new laser with ultra short pulses was examined concerning its ablation characteristics and tested for possible applications in the tympanic cavity. METHODS: Investigations on human ossicles and porcine compacta were performed with a femtosecond laser in order to determine the ablation parameters. This included measurements of the dependency of the threshold energy on the pulse duration and the determination of the ablation ratio using different pulse energy levels. On the basis of histological slices the thermal damages of the bone were examined. Additionally, the processed samples were analyzed with an optical microscope and with a scanning electron microscope in order to evaluate the quality of the perforations. RESULTS: The measurements showed that the threshold energy has a lower level than the threshold energy of the conventional laser systems. At a pulse duration of 180 fs the smallest fluence, with which an erosion can be achieved, is below 1 J/cm(2). With increasing pulse duration the necessary threshold energy also rises. Due to the low energy level necessary for ablation and the extremely short pulse duration, less thermal damage is induced to the surrounding bone tissue as compared to conventional laser systems. The analysis of the scanning electron microscope demonstrates the extreme precision of this laser system. The achieved accuracy of the incisions and drillings ranges in the microm-area. CONCLUSIONS: The fs laser represents a new surgical tool for middle ear surgery. It works efficiently and in a touch-free procedure. Due to its high precision and the reduced side effects an advantage in the handling of bony structures is to be expected in relation to other laser systems. Apart from the perforation of the stapes footplate, in particular the handling and modelling of the incus, a further field of applications includes enhanced coupling, e. g. for implantable hearing aids and ossicular chain replacement prosthesis.

Animals↗
PubMed2004

Efficacy and tolerability of intravenous tropisetron in the treatment of fibromyalgia.

OBJECTIVE: To determine the efficacy of a serotonin receptor (5-HT(3)) antagonist in the treatment of fibromyalgia (FM) in a prospective, randomized, double-blind, placebo-controlled, multicentre trial. METHODS: Twenty-one female patients (age 21-63 years) with FM according to the American College of Rheumatology classification criteria for FM were assigned randomly to either a placebo group or to receive a daily intravenous bolus injection of 5 mg tropisetron for 5 days. RESULTS: In patients receiving tropisetron, the visual analogue scale (VAS) score for pain decreased by 28.9 compared with a decrease of 6.8 in the placebo group [probability (p)=0.063; effect size: 0.794]. Similar results were obtained using a body diagram pain score as a secondary efficacy parameter: mean pain reduction was 27.2 in the tropisetron group, versus 2.8 in the placebo group (p=0.038; effect size: 0.902). CONCLUSION: 5-HT(3) receptor antagonists provide significant pain relief for a group of FM patients.

Adult↗
PubMed2004

The influence of the 5-HT3 receptor antagonist tropisetron on pain in fibromyalgia: a functional magnetic resonance imaging pilot study.

OBJECTIVE: Central pain processing is altered in patients with fibromyalgia syndrome (FMS). The serotonin metabolism, especially the 5-HT3 receptor, seems to play an important role. METHODS: We investigated the effect of the local injection of the 5-HT3 receptor antagonist tropisetron on the perception and central processing of pain in FMS patients using painful mechanical stimulation and functional magnetic resonance imaging (fMRI) within the framework of a pre-/posttreatment double-blind design. RESULTS: In the contralateral primary somatosensory cortex, contralateral posterior insula, and anterior cingulate cortex, we found that the activation was significantly reduced after treatment. On average, patients rated the stimulation-induced pain intensity as stronger in the session after treatment compared to before treatment, although the individual data revealed a heterogeneous pattern. All patients showed sensitisation during the painful stimulation, which was not influenced by the treatment. CONCLUSIONS: Both the sensory-discriminative and motivational-affective components of pain as measured by fMRI were altered by tropisetron.

Brain↗
PubMed2004

Influence of tropisetron on the serum substance P levels in fibromyalgia patients.

BACKGROUND: Substance P is found at an elevated level in the cerebrospinal fluid of fibromyalgia (FM) patients. Treatment with tropisetron leads in a subgroup of FM patients to pain reduction. The question arises of whether the substance P level in the serum can be changed by tropisetron treatment. METHOD: Twenty patients with FM diagnosed according to the ACR criteria were treated for 5 days with a 5 mg tropisetron intravenous (i.v.) bolus injection daily. Before the first injection, 3 h later, and before and 3 h after the last injection, the serum levels of substance P were determined. The determination of this substance was carried out by means of an immunoassay from Assay Design Biotrend, Cologne. To evaluate the success of the tropisetron treatment, patients made a global assessment as 'clearly better', 'better', 'unchanged', or 'poor'. Patients who answered 'clearly better' and 'better' were regarded as responders. RESULTS: Of the 20 patients, ten reported a good or very good influence on their pain (responders). In these responders, the means of the serum substance P levels were elevated in comparison with the non-responders, though the difference was not significant. In responders, the 5-HT3 receptor antagonist tropisetron produced a significant decrease in the serum substance P levels, while this did not occur in the non-responders. CONCLUSION: It is possible that the responders to tropisetron represent a subgroup of FM patients for whom substance P and 5-HT3 receptors play key roles in the development of the pain symptoms.

Female↗
PubMed2004

Treatment of systemic sclerosis with the 5-HT3 receptor antagonist tropisetron.

BACKGROUND: There is no known disease-modifying therapy for progressive systemic sclerosis. OBJECTIVES: It was shown that a patient with secondary fibromyalgia syndrome for whom the development of systemic sclerosis was suspected because of a Raynaud's phenomenon and the presence of SCL-70 antibodies in the serum had experienced a clear pain reduction under treatment with tropisteron, which is the reason why this drug was also used with established systemic sclerosis. METHOD: Two patients with progressive systemic sclerosis and positive SCL-70 antibodies were treated for 6 weeks with 5 mg tropisetron daily. Both patients had clear skin symptoms, functional impairments of the locomotor system, and a secondary fibromyalgia syndrome. The skin score and joint motion were checked before, during, and after treatment. In addition, the patients filled in the visual analog scale for pain at these times. At the end of the 6 weeks, the patients showed a clear improvement of the skin score and the movability of various joints as well as a clear reduction of pain. The medication was well-tolerated. Constipation developed in the patients; it could be controlled with laxatives. Follow-up questioning of the patients after 3 months showed that their condition had remained stable. CONCLUSION: Two patients with progressive systemic sclerosis showed an improvement of various symptoms under a blockade of the 5-HT3 receptors via tropisetron. The long-lasting effect pointed to immunomodulation. The two cases give cause for clarifying this by means of clinical studies, which should also investigate the question of dosage (possibly 5 mg tropisetron twice daily).

Adult↗
PubMed2004

Intravenous treatment of fibromyalgia with the 5-HT3 receptor antagonist tropisetron in a rheumatological practice.

In 223 fibromyalgia (FM) patients in a rheumatology practice, a follow-up postal survey was carried out 0.5-2 years after a 5-day intravenous (i.v.) treatment with 5 mg of the 5-HT3 receptor antagonist tropisetron daily on the effect of this treatment. 121 patients returned the completed questionnaire. After subtraction of 22 undeliverable questionnaires, this represented 60.2% of patients contacted for whom an assessment of the tropisetron treatment was possible. A good to very good effect of the treatment on the pain was reported by 45% of the patients, and only 25% reported an unsatisfactory effect. The effect of tropisetron IV lasted between one day and 12 weeks (mean 8.6 +/- 13.6 d). Sleep and general condition were also assessed as good or very good by almost half of the patients. The tolerance of tropisetron was generally good. In comparison with the current treatment and the best treatment with other drugs ever received, tropisetron was rated as more efficacious in almost half of the cases, though an unsatisfactory effect of tropisetron compared to other treatments was reported in 30% of the cases. Considered in comparison to less or at most equally efficacious alternatives, according to this open respective study, IV tropisetron treatment represents a promising option for the treatment of FM even though the study design incorporated many imponderables. Particularly the question of whether the success of treatment can be improved further with a longer lasting treatment or a selection of the patients still needs to be settled.

Female↗
PubMed2004

Treatment of chronic low back pain with tropisetron.

BACKGROUND: Various pathophysiological processes can lead to chronic back pain, which necessitates a differentiated therapeutic approach. In addition, psychic and psychosocial processes may influence the clinical picture. METHOD: Twenty-five patients with chronic back pain were enrolled in the study. Patients suffering from psychosocial stresses and depressions were excluded from the study. The patients with painful tendinopathies and myofascial pain syndromes were treated with local injections of 5-10 mg tropisetron, and patients with degenerative processes were treated for 5 days with an intravenous (i.v.) bolus injection of 5 mg tropisetron (Navoban). Before treatment and 7 and 14 days later, the visual analog pain scale was filled in. The long-term drug therapy could be continued. RESULTS: There was a highly significant pain reduction with a very potent effect both in the locally treated group and in the intravenously treated group. Most of the patients could discontinue or reduce their long-term therapy with non-steroidal anti-inflammatory drugs or analgesics. CONCLUSION: A marked improvement in pain could be achieved in an open study by treating back pain of a primarily somatic nature with the 5-HT3 receptor antagonist tropisetron. A reduction in pain of > or =50% was reported by 76% of the patients. These results should be substantiated by the corresponding randomized, placebo-controlled, double blind studies that are needed to investigate the true benefit of treating back pain with 5-HT3 receptor antagonists.

Adult↗
PubMed2004

Effect of tilting on cerebral haemodynamics in preterm infants with periventricular leucencephalomalacia.

AIM: Measurement of cerebral haemodynamics to detect impaired cerebral blood flow and impaired cerebral autoregulation might make prevention of brain lesions and especially periventricular leucencephalomalacia (PVL) achievable. METHODS: Changes in cerebral blood volume (CBV) and the cerebral haemoglobin oxygenation index (cHbD) following tilting up and down in 10 preterm infants with PVL and 25 preterm infants without PVL, measured by near infrared spectroscopy (NIRS), were analysed. Tilting manoeuvres were recorded with a polysomnographic system in combination with NIRS. CBV and cHbD of the baseline phase (1 min before tilting) were compared with data from the post-tilting phase (1 min after tilting). RESULTS: Changes in CBV and cHbD after tilting were significantly pronounced in infants with PVL compared with infants without PVL. CBV decreased in infants with PVL, by -0.099 +/- 0.081 ml 100 g(-1) brain (mean +/- SD) after tilting up, and increased by 0.106 +/- 0.104 ml 100 g(-1) brain after tilting down. CBV decreased in infants without PVL, by -0.041 +/- 0.068 ml 100 g(-1) brain after tilting up, and increased by 0.020 +/- 0.096 ml 100 g(-1) brain after tilting down. cHbD showed similar changes after tilting. CONCLUSION: Changes in CBV and cHbD after tilting were pronounced in preterm infants with PVL and this may indicate reduced cerebral autoregulatory capacity.

Cerebrovascular Circulation↗
PubMed2004

[Prognosis of preterm infants with a birth weight <1,501 g].

The prognosis of very low birth weight infants (birth weight <1,501 g) is correlated with gestational age. Mortality is between 10 and 16%, showing high numbers in infants < or = 26 weeks of gestation. Looking at the low-term outcome, cerebral palsy is the most prevalent major disability with an incidence of 8%. Similar to mortality, the incidence of cerebral palsy is inversely proportional to gestational age. A clinically verified chorioamnionitis increases the risk of developing cerebral palsy by a factor of up to 4.

Bronchopulmonary Dysplasia↗