[Effect of the weather on platelet adhesiveness in man].
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Biomedical subjects
Publications and source records attributed to E Jacobi.
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In order to evaluate the objectivity and validity of radiographic parameters in rheumatoid arthritis (RA) we studied 56 patients with definite RA. Inter-observer variation was assessed comparing the scorings (Larsen classification) of two independent experienced observers. Total radiographic scores were highly significantly correlated (r = 0.89). Yet, we could not find relevant associations between radiographic findings and clinical outcome parameters (pain, morning stiffness, dexterity, grip strength, and patient's overall assessment). Thus, hand radiographs in RA provide highly reproducible results. Its validity concerning patient outcome, however, has to be interpreted very carefully.
Low back-pain is one of the most frequent symptoms and its chronicity causes considerable socioeconomic costs in many countries. To evaluate the efficiency of therapeutic approaches in low back-pain we need reliable information concerning patient health status in its physical and psychosocial dimensions. After adapting the MOPO-scales, which have proven a reliable instrument in other rheumatic diseases, to special requirements in low back-pain, we assessed patient outcome using eight scales and calculating a summated health score. Statistical analysis yielded evidence our instrument to be reliable, valid, sensitive and practicable in assessing patient outcome in low back-pain.
A pain management program is presented which enables patients to reduce pain by means of relaxation and attention-diversion, etc. The problems arising from applying a psychological training to organic diseases, and the most favourable therapist's behaviour in facing these difficulties are elucidated. Finally, controlled studies are cited showing that pain can be reduced and the emotional state improved by pain management techniques.
A registry for the documentation of rheumatic diseases has been developed at the University of Düsseldorf. For 3 years more than 450 parameters for each patient have been documented, checked, and stored in a data bank. The registry has made a definite improvement in the diagnosis and long-term follow-up of rheumatic diseases. The use of special statistical procedures to study the frequency of various parameters in different diseases has allowed independent diagnostic criteria to be established.
Because of their considerable socioeconomic costs rheumatic symptoms are a major concern in industrialized nations. Our study provides data on the prevalence of rheumatic symptoms in the general population and on their physical and psychosocial impact. We performed a survey of 1814 randomly selected non institutionalized persons, aged 40 to 69 years, living in the Federal Republic of Germany. The selected subjects were asked whether they had pain in one or more of the following sites: neck/back, joints of upper extremities, joints of lower extremities. Physical and psychosocial disability was assessed using a multidimensional questionnaire that included a German version of the Arthritis Impact Measurement Scales (AIMS) and validated instruments concerning psychosocial dimensions of health status. The prevalence of rheumatic symptoms increases between 40 and 59 years and decreases thereafter. Rheumatic symptoms are more frequent in women than in men. The predominant pain localization is the back. Individuals reporting pain in one region (back, upper and lower extremities) often feel pain in other areas as well and often suffer from additional symptoms such as weakness and sleep disturbance. We found significant disabilities in physical (mobility, activities of daily living, physical activities) and psychosocial (depression, anxiety, exhaustion, family problems) dimensions of health status in subjects reporting rheumatic symptoms.