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Biomedical subjects

K Sievers

Publications and source records attributed to K Sievers.

At least 19 recordsLinked to original sources
PubMed2006

[Structure, methodology and ethics of German commissions on living organ donation].

Living organ donation is a medically established and morally acceptable method of transplantation. According to German Transplantation Law, an expert review by a local "Commission on Living Donation" (Lebendspendekommission, LSK) is required before transplantation. The legal task of this review is to ensure a voluntary decision by the donor and to rule out illegal trading of organs. Results from a national survey among all LSKs show that the process of review and assessment varies considerably among German LSKs. Most of them carry out a compulsory hearing of every potential donor, but this is omitted by some LSKs in a number of cases. Only 60% of all LSKs feel confident to determine donors' free will and protect their self-determination. Only 33% claim to be able to recognise illegal trading of organs. The LSKs even disagree on the exact borderline between legal incentives and illegal commerce. An expansion of living donation by financial incentives, pool-donation or crossover donation is supported only by a minority of German LSKs. The article argues in favour of establishing national standards for the process of LSK-reviews in order to foster procedural ethics and trustworthiness in the field of living organ donation.

Data Collection↗
PubMed1993

Evaluation of tumor blood perfusion by dynamic MRI and CT in patients undergoing thermoradiotherapy.

In 18 patients who were treated with combined regional hyperthermia and radiation for recurrent pelvic tumors, blood flow related data were obtained using dynamic computed tomography and dynamic magnetic resonance imaging. The enhancement of contrast material (delta HU) and Gadolinium DTPA (delta SI) over baseline in the early phase (15-30 s) after bolus injection is dependent upon perfusion. With both methods significant differences in global perfusion have been observed between tumor center and tumor periphery. With regard to the mean perfusion values we are able to separate high, medium and low perfused pelvic tumors. Flow rates expressed as delta HU for dynamic CT and delta SI for dynamic MRI show a significant inverse correlation with the achieved steady state temperatures above baseline. Values of enhancement of contrast material higher than 15-35 delta HU or 300-700 delta SI indicate flow rates which were limiting in achieving steady state temperatures higher than 3 degrees C above baseline (core temperature).

Combined Modality Therapy↗
PubMed1993

Musculoskeletal disorders as determinants of disability in Finns aged 30 years or more.

The relationship between disability and various musculoskeletal disorders was investigated in 7217 men and women representative of the Finnish population aged 30 years or more. They participated in the Mini-Finland Health Survey and were first screened by interview and questionnaire about limitations in daily activities. The outcome variables were reduced working capacity, an occasional need for assistance in daily activities, and a regular need for assistance in daily activities. In a two-phase medical examination, all cases fulfilling predetermined diagnostic criteria of musculoskeletal, cardiovascular, respiratory and mental disorders and diabetes were recorded independently. In multivariate logistic regression analyses, inflammatory arthritis was the strongest determinant of all forms of disability. Osteoarthritis, especially in the hip, was a strong determinant of both occasional and regular need for assistance, and chronic low back pain was a strong determinant of reduced working capacity and occasional need for assistance among those aged 30-64 years. Other musculoskeletal disorders also determined the prevalence disability, but these relationships were reduced by taking comorbidity into account. A low level of education and a low (less than 20 kg/m2) or very high (at least 35 kg/m2) body mass index represented independent determinants of all forms of disability, and a history of physically strenuous work an independent determinant of reduced working capacity, when disabling illness was adjusted for. The proportion of all forms of disability attributable to musculoskeletal disorders, in models including, age, sex, other disabling illness and significant non-medical determinants of disability, was close to 20%. The disorders with the highest community impact were chronic low back pain among those aged 30-64, osteoarthritis of the hips and knees and inflammatory arthritis.

Adult↗
PubMed1993

Association of overweight, trauma and workload with coxarthrosis. A health survey of 7,217 persons.

In a population sample health survey, body mass, previous trauma and physical stress were studied for associations with coxarthrosis. A sample of 8,000 persons representative of the Finnish population aged 30 or over was invited for examination, and 90 percent participated. On the basis of a standardized clinical examination, a physician diagnosed coxarthrosis in 6 percent of the women and 4 percent of the men. The prevalence rose with age. In persons with a past traumatic lower-limb injury, the odds ratio of unilateral coxarthrosis was 2.1 and of bilateral coxarthrosis 1.5, as adjusted for sex, age and other determinants using logistic regression. The sum index reflecting self-reported features of physical stress in present or previous occupations was directly proportional to the prevalence of coxarthrosis. Body mass index (kg/m2) was closely associated with bilateral coxarthrosis; the adjusted odds ratio (95 percent confidence intervals) for indices > 35, compared to those < 25, was 2.8 (1.4-5.7). In terms of the population attributable fraction, prior trauma, physical stress and body mass were estimated to explain 59 percent of the prevalence of coxarthrosis. The potential for primary prevention may be great, but longitudinal population studies are necessary to elucidate causal significance of the risk factors.

Adult↗
PubMed1993

[Localization of frontobasal traumatic cerebrospinal fluid fistulas. Comparison of radiologic and surgical findings].

Computed tomographic and surgical findings were compared in 30 patients with traumatic frontobasal cerebrospinal fluid fistula. Radiological signs were extension of fractures of the rhinobasis, localized opacification of paranasal sinuses, and localized intracranial air collections. Exact localization of dural tears was only possible in about half of all patients (16 of 30). In conclusion there must be surgical inspection of all fractures of the skull base, and only isolated injuries could be treated by selective surgery.

Adult↗
PubMed1992

Clinical investigations on blood perfusion in human malignancies of the pelvis and abdomen: significance for tumor therapy.

Blood flow of deep pelvic and abdominal tumors was investigated with the thermal clearance method, dynamic CT and dynamic MRI. There are good correlations between the measurement values obtained by these methods. A low flow was observed in rectal cancer and soft tissue sarcoma in contrast to pancreatic cancer and hypernephroma. The temperature increase induced by regional hyperthermia was dependent on the individual tumor blood flow. Dynamic CT can be used pretherapeutically and predict the quality of a heat treatment, which is important with regard to concepts consisting in radiotherapy or chemotherapy plus hyperthermia.

Abdominal Neoplasms↗
PubMed1991

Prevalence, determinants, and consequences of chronic neck pain in Finland.

Chronic neck pain is a relatively mild musculoskeletal condition, but common enough to be a possible public health problem. The distribution, determinants, and consequences of chronic neck pain have hitherto been described inadequately. In the Mini-Finland Health Survey, a representative population sample of 8,000 Finns aged greater than or equal to 30 years was invited to participate in a comprehensive health examination comprising an interview and a clinical examination; 90.2% complied. Predetermined criteria were used to diagnose major cardiovascular, musculoskeletal, respiratory, mental, and other disorders, regardless of other simultaneous disorders. Chronic neck syndrome was diagnosed in 9.5% of the men and 13.5% of the women. When adjusted for age and sex, the prevalence of the neck syndrome was associated with a history of injury to the back, neck, or shoulder and with mental and physical stress at work. Among those aged 30 to 64 years, overweight and parity were also significant determinants. Other musculoskeletal and mental disorders were associated with neck syndrome, and the association persisted after working conditions, injuries, overweight, and parity were adjusted for. There was some independent association between neck syndrome and disabilities, use of physician services, and use of pain killers.

Adult↗
PubMed1991

Angioplasty of renal arteries: a report of ten year's experience.

Report of PTA of renal arteries in 288 patients. Primary results show good to optimal dilatation of the arteries (60.6% to 78.6%). One third of all cases achieved optimal blood pressures. In about 40% antihypertensive drugs had to be administered, in about 30% blood pressure remained unchanged although PTA was effective. PTA of renal arteries is the best method of treating renal hypertension, also because of the low rate of complications.

Angioplasty, Balloon↗
PubMed1991

Back pain and arthrosis in Finland. How many patients by the year 2000?

Four Finnish interview surveys from the years 1964, 1968, 1976, and 1987 show a rapid increase in the occurrence of self-reported chronic musculoskeletal disorders. The expected number of such patients by the year 2000 will be one fifth more than in 1987 when the changes in the age structure of the population are taken into consideration. This would amount to 850,000 cases in the year 2000, the total population at that time being 5 million inhabitants. This would be a relative increase of 131 percent as compared with 1964. Half of the cases suffer from back disorders and one quarter from arthrosis. Musculoskeletal disorders now make up the most prevalent group of chronic diseases in the Finnish adult population.

Age Factors↗
PubMed1990

[Computed tomographic assessment of orbital fractures in traumatic damage of the optic nerve].

Ten patients with orbital fractures and optic nerve trauma are reported. Fractures of the optic canal could be demonstrated by computed tomography in six cases and fractures of the orbital apex in another three cases. Surgical decompression of the optic canal was performed in seven cases. Computed tomography enhanced decision for surgery in cases of intraorbital haematoma with exophthalmus and narrowing of the canal by bony fragments, especially in those patients presenting with incomplete or progressive visual disturbance.

Emergencies↗
PubMed1989

Clinical arthritis associated with positive radiological and serological findings in Finnish adults.

The Mini-Finland Health Survey was designed to analyse the epidemiology of major public health problems. The study covered a representative sample of the Finnish population aged 30 years or over, and initially comprised 8,000 people. Serum rheumatoid factor was determined in 7,124 cases (89%). There were 138 cases of clinical arthritis in the series, corresponding to a prevalence of 1.9% (1.0% in males and 2.7% in females). Fifty-nine of the cases (0.8% of the population) were seropositive, and 50 cases (0.7%) had in their hand radiographs changes characteristic of rheumatoid arthritis. Twelve of the X-ray positive cases were seronegative. One-half of these proved to be seroconversion cases or rheumatoid variants typically seronegative, such as early-onset juvenile rheumatoid arthritis.

Adult↗
PubMed1989

Descriptive epidemiology and public health aspects of low back pain.

The prevalence of low back syndrome and its consequences in terms of disability, handicap, and need for medical care were studied as part of "the Mini-Finland Health Survey". A sample of 8000 persons representative of the Finnish population aged 30 or over was invited for examination, and 7217 (90%) participated. At interview 75% of the participants reported that they had experienced at least one episode of low back pain. Six or more episodes were reported by half of the population, and about 20% had suffered from pain during the previous month. On the basis of a standardised clinical examination, a physician diagnosed low back syndrome in 17.5% of men and 16.3% of women. The prevalence was highest in those aged 55-64 years. The use of health services was frequent among those suffering from low back pain. Nevertheless, their need for care was commonly unmet. Some disability was found in almost 60% of the subjects with low back pain, although severe functional limitations were rare. It was estimated that of the work disability the reduced capacity for everyday duties apart from work, and the reduced capacity for leisure time activities, in the population 18%, 16%, and 17%, respectively, were attributable to the low back syndrome. Thus low back syndrome has a strong impact on individuals and on society as a whole.

Adult↗
PubMed1987

Lumbar disc syndrome in Finland.

The prevalence of lumbar disc syndrome (herniated disc or typical sciatica) and its consequences in terms of disability, handicap, and need for medical care were studied as part of the Mini-Finland Health Survey. A sample of 8000 persons representative of the Finnish population aged 30 or over was asked to come for examination, and 7217 (90%) participated. A diagnosis of lumbar disc syndrome based on medical history, symptoms, and standardised physical examination was made for 5.1% of the men and for 3.7% of the women. Half of these patients were assessed to be in need of medical care, over 80% of which was considered to be adequately met. One third of all patients with lumbar disc syndrome had been previously hospitalised for that syndrome, and one fifth of the patients had undergone lumbar surgery. At least slight disability was found in almost 60% of the patients, though severe functional limitations were rare. About 6% of the population's work disability was estimated to be attributable to lumbar disc syndrome.

Adult↗
PubMed1987

[Day clinic treatment of substance-dependent patients].

The authors are of the opinion that not enough use is being made of the possibility to treat patients suffering from various kinds of dependence, in special day hospitals or departments. Two different models are reported: briefly, the possibility of day hospital treatment instead of inpatient care, and in detail the type of treatment practised in Bremen following short-term inpatient treatment. The article describes the indications for admission, course of treatment, and handling of relapses, as well as the results of catamnestic follow-up questioning. The results encourage continuation of day hospital facilities and their increased utilisation.

Adult↗