The objectives of this study are: (a) to determine the occurrence of permanent work disability (PWD) in early rheumatoid arthritis (RA); (b) to identify prognostic groups of patients; (c) to assess the employment rates for these groups over time. Seventy-three gainfully employed consecutive out-patients with early RA (> or = 5 ARA 1958 criteria, disease duration < or = 12 months) at time one (T1) were re-examined at time two (T2) after a mean follow-up of 6 yr (S.D. +/- 2 yr). Potential risk factors, identified at T1, for PWD at T2 were entered in a tree structured survival analysis using RECPAM (RECursive Partition and AMalgamation). Cumulative 3 yr employment rates (3-yrER +/- S.E.M.) were computed from the resulting Kaplan-Meier curves. At T2, PWD occurred in 27 of the 73 patients (37%). The fastest decline in the employment rate was found within the first 3 yr of the disease onset, with a 3-yrER reduced to 73 +/- 5%. The group with the poorest prognosis (n = 14; 3-yrER 14 +/- 9%) was defined by age > or = 50 yr with either ESR > or = 60 mm/h or the combination of modified functional class (1-7) > or = 4 with a disease duration > or = 7 months. An intermediate group (n = 38; 3-yrER 79 +/- 6%) was defined by (a) age > or = 50 yr and low or moderate disease activity, (b) age < 50 yr and more strenuous job-related physical requirements, (c) age < 50 yr and less strenuous work, but joint count > or = 15. No case of PWD occurred in 21 individuals aged < 50 yr with a joint count < 15 and less physically demanding jobs. PWD occurs early in a substantial number of patients with RA. RECPAM defines risk profiles that can readily be applied in actual clinical situations and allow an estimation of the risk of PWD at different time points using the resulting Kaplan-Meier curves.

Bildgebende Diagnostik der Osteitis Szintigraphie, PET oder MRT? Diagnostik der Osteitis Im deutschsprachigen Raum wird der Begriff Osteomyelitis für die hämatogene (endogene) Form der Knochen-und Knochenmarkentzündung verwendet. Ätiologisch wird hiervon die Osteitis abgegrenzt, bei der die Knochenentzündung posttraumatisch, also durch eine exogene Keimbesiedlung, bedingt ist [31]. Akute Osteitis. Häufigste Ursache für eine Osteitis ist eine offene Fraktur, wobei die Tibia der meist betroffene Knochen ist [10, 19]. Begünstigende Faktoren für die Entstehung einer Osteitis sind ausgedehnte Verletzungen mit schlecht durchbluteten Knochenfragmenten und Weichteilnekrosen. Auch eine Schwächung des Immunsystems, z. B. im Rahmen eines Diabetes mellitus, wirkt sich ungünstig aus [31]. Die Infektionsrate liegt, auch in Abhängigkeit von Menge und Virulenz der inokulierten Keime, bei bis zu 15% [10, 19].

Summary: In order to improve endurance by exercise on a bicycle ergometer, both the interval method (I) (exertion and recovery phases alternate each minute) and the continuous method (constant exertion) can be employed. We examined the effects of both methods on the following parameters: heart rate, blood pressure, rate-pressure product, glucose, lactate, and catecholamine levels, and physical performance. Two groups of nine male patients were trained daily on a bicycle ergometer for 3.5 weeks. These patients had undergone coronary bypass surgery 24 and/or 26 days before the training started. The training heart rate was set at 86% of the individual maximum heart rate. In the last week of training, the exercise intensity in both patient groups, following either I or C regimen, was 20: 121 W and 83 W respectively. The exercise training lasted 20 minutes with the following findings: ( I ) there were no significant differences in blood pressure, ratepressure product, rates of glucose and catecholamines. and (2) there was a significantly higher rate of lactate in the second ten minutes of the I training. Before and after the training period, the patients were subjected to a multistage bicycle ergometer exercise test (sitting). The following results obtained after the training favor the I method: ( I ) patients' physical performance increased ( +0.63 vs. +0.26 W/kg; p

The present study extends previous observations by the finding that carriers of the N5,N10-methylenetetrahydrofolate reductase C677T TT genotype with various coronary high risk profiles had clearly higher coronary heart disease scores than individuals with at least one C677T C allele.

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Qualitlitssieherung der Rehabilitation Herzkranker: retrospektive Pilotstudie zur Evaluation kardiologischer Parameter der Effizienz von Anschlussheilbehandlungen (AHB) dargestellt in 2 Kapiteln: Leistungsspektrum und Wiedereingliederung I Hermann Weidemann (Hrsg.). Von H.