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Biomedical subjects

C Lucke

Publications and source records attributed to C Lucke.

At least 19 recordsLinked to original sources
PubMed2004

[Effectiveness and efficiency of stationary geriatric treatment of old and very old patients].

In this study we compared characteristics and treatment results in patients of 60 to 79 (group I, n = 682) and of 80 to 100 years of age (group II, n = 593) treated in a geriatric hospital. Neurologic diseases (mainly stroke) predominated in group I (38%), and patients with fractures in group II (53%). Diabetes mellitus and hyperlipidemia were less frequent in patients of group II, but overt cardial insufficiency was more frequent than in group I. While the effectiveness of geriatric treatment was identical in both groups, the efficiency-defined as progress per day-was in some parts slightly higher in group II. There are three independent variables strongly related to the decision of transfer into a nursing home: 1) Barthel Index on discharge; 2) Household-Size (living alone/living not allone); 3) Age.

Accidental Falls↗
PubMed1998

[How does subjective well-being of elderly patients during inpatient geriatric rehabilitation change?].

During rehabilitation of patients suffering from a recent hip fracture, we evaluated the development of several aspects of their subjective well-being (n = 87, age: 70 to 94)). In most cases, a deterioration of subjective well-being due to the consequences of the hip fracture could be prevented; the well-being improved in most cases. When discharged, the subjective well-being of our patients was comparable to the well-being of similar-aged people living at home.

Activities of Daily Living↗
PubMed1998

Infrared thermography in the diagnosis of Raynaud's phenomenon in vibration-induced white finger.

BACKGROUND: Frequent use of vibrating tools over several years may lead to a neurovascular disturbance of finger circulation with the development of typical Raynaud's phenomenon, attacks being triggered by vibration and/or cold exposure. The condition is recognized as an occupational disease and known as vibration-induced white finger (VWF). Aim of the present study was to evaluate the usefulness of infrared thermography (IRT) with a cold provocation test in the diagnosis of Raynaud's phenomenon in VWF. PATIENTS AND METHODS: 24 patients with the diagnosis of VWF, previously established by other methods, were compared with 12 matched control subjects. We carried out IRT-measurements simultaneously on both hands before, directly after and 5, 10, 15, 20, and 30 mins following a 3 min exposure of both hands to a waterbath of 12 degrees C. The results of temperature measurements of all fingers were analyzed and the time to complete rewarming of all fingers was recorded. RESULTS: The basal thermograms did not differ between both groups, whereas the mean finger temperatures after cold exposure were significantly lower in VWF-patients compared to controls, with a considerable individual overlap between both groups. Therefore, determination of absolute finger temperature reveals not to be a useful diagnostic tool in individual cases, but might be helpful for pharmacological studies (group-analysis). In contrast to absolute finger temperatures, the parameter of rewarming time after cold exposure revealed to be diagnostic on an individual basis: a complete rewarming after 15 min indicates a normal vascular reactivity and an incomplete rewarming 30 min following the cold provocation points to an impaired vascular reactivity due to VWF. CONCLUSIONS: IRT revealed to be a useful tool in the diagnosis of Raynaud's phenomenon in VWF, and provides a sufficient documentation suitable for further follow-up examination.

Adult↗
PubMed1997

[Experience in applying legal conditions according to the nursing insurance regulation--ambulatory rehabilitation, nursing aids and nursing care eligibility].

UNLABELLED: The Statutory Health Care (Nursing) Insurance in Germany, called "Pflegeversicherung (PVG)", financially supports nursing care at home and in nursing homes. If suggested by an authorized examining person (MDK), it provides access to ambulatory rehabilitation and to various aids to facilitate nursing care of patients cared for at home. Also, the PVG mandatory requires the visit by a nurse every three to six months (nursing care checkup) if the patient is cared for by family members without support of professional nursing services. Little is known about the realisation of the suggestions given by the examining person from MDK and about the realisation of the nursing care checkup in actual practice. Our study tried to find answers to these questions. For this purpose, we visited 150 patients at home and asked them about rehabilitation efforts, whether the recommended additional aids had been supplied, and whether nursing care checkups had been successfully performed. RESULTS: For 41 patients, rehabilitatory exercises were suggested, but only 7 were actually realised. 89 patients were supposed to receive various aids, but only 31 were actually delivered. Whenever rehabilitation was performed, it was nearly without exception thanks to the initiative of relatives supported by their private doctor. Nursing care checkups should have been performed in 80 patients, but had been realised in only 11 cases. The care providing relatives considered such "care checkups" to be ineffective, costly and useless. CONCLUSION: The nonfinancial services granted by the PVG were not translated into reality in most instances, and if so, it was due to efforts of relatives and private doctors, not to efforts of the statutory bodies. Apparently this task was more than these bodies could handle during this early phase of services by the PVG. Therefore, the private doctors (family doctors) should be informed of the results of the examination done by MDK. The need for the nursing care checkup should be reconsidered.

Aged↗
PubMed1996

[Surgical outcome in subtrochanteric fractures. A study over 15 years].

During the past 15 years new methods for the surgical approach to subtrochanteric fractures have been developed, e.g. the dynamic hip screw (DHS) and the gamma-nail (GN). Reviewing the results of this change in methods, we report on 102 patients after subtrochanteric fractures of the femur. We divided them into three groups according to the time of operation (1980-1984, period I; 1986-1989, period II; 1991-1993, period III). During period I, 74% of the fractures were stabilized using angle plates. During period III, more than 30% were operated on using the DHS and nearly 50% using the GN. The total hospital stay (department of surgery as well as geriatric hospital) decreased from 107.5 +/- 46.5 days to 78.9 +/- 24.3 days (P < 0.001). During period I, 86.2% of patients could be discharged home, during period III, 100%. Serious complications decreased during these 15 years. In conclusion, as observed in pertrochanteric fractures, the introduction of new operative techniques for the treatment of subtrochanteric fractures in the elderly was followed by a shortened hospital stay, a decreased complication rate and an increased rate of discharge home.

Activities of Daily Living↗
PubMed1996

[Experiences in realization of guidelines of the nursing care insurance regulation--outcome in home care service after expert assessment by medical service personnel].

The German Pflegeversicherung is a new kind of insurance system for dependence on nursing care (Nursing Care Insurance). Grading into groups according to the intensity of help required, effected by physicians and nurses of the Medical Service of the statutory insurance bodies, as well as the grading system itself have been subjected to severe criticism. However, the emotions in this regard have recently calmed down considerably. The questions are: Do the benefits of the Pflegeversicherung result in improving the financial situation at home? Does it signify increase professional nursing at home? The purpose of our study is to find an answer to these and other questions. We interviewed 150 nursing care dependent persons receiving benefits according to the new system. Senile dementia was the most frequent diagnosis in groups II and III of the official grading scale. Despite of the financial support, a change to more professional nursing care was rarely observed; on the contrary, at times the costly professional services were no longer requested. Deterioration of physical health was seen in every second patient since the first rating by the Medical Service 4 to 6 months ago. Notification of grading and payments to the families took place without delay except in cases of "Kombinationsleistung" (financial support plus financing ambulatory professional nursing-care). We observed major deficits in the counselling of patients or their relatives; there were mostly no courses in nursing care for relatives. Patients and their care-providing relatives usually were satisfied by the benefits provided; relatives felt the financial benefits as an acknowledgement of their engagement. In summary, most care-providing relatives were satisfied by the benefits, but the lack of nonfinancial services (counselling, courses in nursing care, payments for social security) showed up major deficiencies.

Adolescent↗
PubMed1995

[Surgical results of pertrochanteric fractures. A 15-year study].

During the last 15 years new methods for the surgical treatment of pertrochanteric fractures have been developed [e.g. the dynamic hip screw (DHS) and the gamma-nail (GN)]. We report on the results obtained in 450 patients operated on between 1979 and 1984 (period I), from 1986 to 1989 (period II), and between 1991 and 1993 (period III); we reviewed the results with the intension of finding whether application of the new methods led to better results, shorter stay in hospital and fewer complications. The mean age of all patients was 79 years and was 4 years higher in period I to than in period III (77.5 +/- 9.2 vs 81.5 +/- 8.4). During period I, 65% of the fractures were stabilized using Ender rods, while during period III the DHS was used in nearly 60% and the GN, in 22%. The total hospital stay (department of surgery and geriatric hospital) decreased from 80.4 +/- 31.7 in period I to 66.6 +/- 24 days in period III (P < 0.001). Serious complications decreased by 80% during this time. During period I 86.2% of patients could be discharged home, as against 89.0% in period II and 94.7% during period III. The introduction of new operative techniques for the treatment of pertrochanteric fractures in the elderly was followed by a dramatic shortening of hospital stay, a reduced incidence of complications, early weight-bearing and an increased rate of discharge home.

Aged↗
PubMed1995

[Current aspects of secondary and tertiary prevention from the viewpoint of the clinical gerontologist].

Prevention is of importance when the patient is already suffering from a serious disease, e.g., from arterial obstructive disease causing a stroke or an amputation, from a hip fracture or other diseases that might threaten his independence. Prevention covers a wide field of topics. Most importantly, the patient must recover from his acute disease. It is important to avoid complications which are not specific for the disease but are typical for a bedridden old person (decubital ulcer, dehydration etc.). Prevention also means to avoid recurrence of the same disease as well as complications that frequently occur during the clinical course and may influence the outcome (spasticity in stroke patients, muscular calcification following hip replacement).

Activities of Daily Living↗
PubMed1995

[Surgical results of per- and subtrochanteric femoral fractures. An overview of 15 years].

During the last 15 years, new methods for the surgical approach to pertrochanteric and subtrochanteric fractures were developed (eg. the dynamic hip screw (DHS) and the gamma-nail (GN)). Reviewing the results of this change in methods, we report on 450 patients with pertrochanteric fractures and 102 patients after subtrochanteric fractures of the femur. According to different surgical techniques, the patients were allocated into three periods (1980-1984, period I: 1986-1989, period II; 1991-1993, period III). During period I. 65% of the pertrochanteric fractures were stabilized using Ender-rods, during period III nearly 60% were operated using the DHS and 22% using the gamma-nail. The total hospital stay (department of surgery as well as the geriatric hospital) decreased from 80.4 +/- 31.7 days to 66.6 +/- 24 days (p < 0.001). Serious complications decreased by 80% during this time. During period I, 86.2% of patients with pertrochanteric fractures could be discharged at home, but in 89% in period II and 94.7% during period III. During period I, 74% of the subtrochanteric fractures were stabilized using an angle plate. During period III, more than 30% were operated by using the DHS and nearly 50% by using the gamma-nail. The total hospital stay (department of surgery as well as the geriatric hospital) decreased from 107.5 +/- 46.5 to 78.9 +/- 24.3 days (p < 0.001). During period I, 86.2% of patients with subtrochanteric fractures could be discharged at home, but 100% during period III. Serious complication as well as discharges to nursing home decreased during these 15 years.

Aged↗
PubMed1994

[Walking ability and independence in old age].

Physiological changes associated with aging and their influence on the activities of daily living (ADL) in old and very old persons are discussed. Degenerative diseases of the spine and of weight-bearing joints may affect the ability to walk and may thus endanger independent living. Treatment of orthopedic disease in the elderly should include efforts at rehabilitation aimed at enabling the patient to return home. For this, patients should be able to walk, or if this goal seems to be inaccessible, independence in ADL should be aimed for. Special aspects of rehabilitation are discussed for old patients following hip replacement or lower leg amputation.

Activities of Daily Living↗
PubMed1984

[Cricopharyngeal achalasia in stroke patients].

A 68-year-old man developed severe swallowing difficulties after a cerebrovascular accident: he was unable to take food. Nutrition was assured via a gastrostomy ( Witzel fistula). Nonetheless there was steady weight loss. A cricopharyngeal achalasia was finally discovered to be the cause of the swallowing problem. Myotomy of the cricopharyngeal muscle completely abolished it.

Aged↗
PubMed1983

[Hyperthyroidism in the aged].

Clinical symptoms in elderly patients with hyperthyroidism are atypical and uncharacteristic. In 13 patients with overt hyperthyroidism a goiter was found in only half the patients, eye signs in just three of them. Tachycardias, sometimes even paroxysmal tachycardias, predominate. In old people the diagnosis of hyperthyroidism is frequently missed, in 11 of 13 patients the disease was diagnosed following transfer to the rehabilitation center. About 50% of patients were iodine contaminated and this may have contributed to the disease. Data are presented to demonstrate that hyperthyroidism in old age may be a life threatening disease.

Age Factors↗
PubMed1977

Studies on circadian variations of plasma TSH, thyroxine and triiodothyronine in man.

To evaluate the existence of circadian variations in thyroid hormone and TSH levels, blood was drawn every 20 min for 24 h in four and for 14 h in one volunteer. Hormones were measured by sensitive radioimmunoassays. TSH: A diurnal rhythmicity could be demonstrated with peaks from 8 p.m. to 2 a.m and a nadir from 7 a.m. to 2 p.m. Superimposed on the diurnal rhythm multiple shortlived fluctuations were observed. Thyroxine: Pooled data showed peak values from 8 a.m. to 12 a.m. and lowest levels from 11 p.m. to 3 a.m. Again, shortlived fluctuations were superimposed on the diurnal rhythm in all instances. Triiodothyronine: Hormone levels were highest from 7 a.m. to 1 p.m. and lowest from 11 p.m. to 3 a.m. Fluctuations in T3 levels were less marked than those of T4. Diurnal variations in hormone levels can be demonstrated in most, but not in all instances. Fluctuations are minor and do not exceed the normal range. Therefore these changes are of no relevance in routine testing of these hormones.

Adult↗
PubMed1976

[Somatostatin -- a review (author's transl)].

Somatostatin, a peptide isolated from ovine hypothalami, prevents growth hormone secretion in vivo and in vitro. Moreover, somatostatin interferes with the secretion of various other hormones: TSH insulin, glucagon, gastrin, VIP and GIP. Under certain conditions a blunting effect on the secretion of prolactin and ACTH can be demonstrated.

Acromegaly↗