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Biomedical subjects

T Kohlmann

Publications and source records attributed to T Kohlmann.

48 records · Page 3Linked to original sources
PubMed1994

[The current backache epidemic].

All available data presented show that we are confronted with a back-pain (BP) epidemic; it affects numerous industrialized countries. More severe forms of BP make up one fifth of the prevalence. The greater part of BP seems to be mild, especially among persons aged 25 to 54. The social insurance statistics, too, show an alarming trend. Cases of work incapacity and medical rehabilitation have increased drastically: one sixth of all cases of work incapacity as well as one third of all medical rehabilitations are to be accounted to BP. It is not easy to interpret the data. Do they represent an increasing BP epidemic? A long-term secular trend towards higher BP prevalences at the population level is to be assumed but cannot be proven at the moment. Is there any evidence that BP-related risk factors have increased? To our knowledge there are no reliable data. It is also to be considered that the 'natural' course of BP may have changed. Is the epidemic a consequence of an increasing 'chronification' of BP due to physical, psychosocial or medical influences? Do 'back-schools' and other factors regarding the BP business have only health-promoting effects? Does the date represent a changing perception and appraisal of pain and/or a changing 'pain-reporting behaviour'? Is 'pain' today what would have been 'discomfort' in former times? Does one complain about BP today when one would have been silent in former times? There are no valid data for these hypotheses, either. Finally, has the transition probability from pain to disability and to social benefits changed?(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Grading of backache].

Back pain is occurring in a broad spectrum of severity; therefore, a grading procedure which is derived from a sound conceptual basis and can be easily applied is of crucial importance in clinical research and in epidemiologic studies. Following a grading procedure which has been developed in epidemiologic studies in the U.S., a hierarchical model for grading is proposed. This comprises pain intensity and functional limitation as basic criteria as well as aspects of time, pain-related cognitions/emotions and concomitant complaints. An application of a simple grading procedure is used to illustrate the predictive utility of the proposed model.

Activities of Daily Living↗
PubMed1985

[Clinico-psychologic studies on the problem of functional psychotic deterioration in schizophrenia].

Our concept of the functional-psychotic mental deterioration of schizophrenia approximately characterizes the same point of view as Kraepelin's terminus "Dementia praecox". The first result of our psychological examination on 225 schizophrenic persons with defect psychotic symptoms was the statement of the deficit in achievement between the former school education (average IQ of the school-type) and the results of examination of intelligence during our research. The functional-psychotic mental deterioration as well appears as a decrease of memory and psychomotoric speed deficiency, furthermore as mental deconcentration and increase of psychoorganic signs in the Rorschach-Test. The psychometric results of this research were statisticly significant.

Adolescent↗
PubMed1975

[Clinical psychological studies on adolescent and adult mongols (author's transl)].

A group of 20 mongol adolescents and adults with an average age of 19 years was strictly parallelized with a group of 20 brain-damaged adolescents and adults of other diagnostic groups with respect to age and intelligence level (average age 19 and average intelligence 50.65--52.90). The hypothesis of a possible deterioration of performance and personality was checked with the following battery of tests: Hamburg-Wechsler intelligence test for adults, the motoricity test according to Walther and the Rorschach experiment. The average difference in the sub-tests of HAWIE primarily emphasize the psycho-organic disturbance in visual-motor coordination, which is seen to a much greater extent in mongols than in non-mongols. The significant difference in completing pictures indicates an intensification of psycho-organicity. In agreement with the observations of WUNDERLICH, the psychomotoricity of the mongols is significantly slower and less adroit than the psychomotoricity of non-mongol oligophrenias. Non-significant differences in the psycho-organic sign (P%, F+%) in disfavor the mongols were seen in the Rorschach experiment. Factorial analysis distinguished the two groups very clearly. In the three most important factors, the mongol group showed stronger signs of psycho-organicity and weak mental performance associated with an intensified neuroticism factor compared with the brain-damage oligophrenia group of other diagnostic origin.

Adolescent↗
PubMed1975

[Correlations of the Personal Sphere Model and Rorschach Projection tests. (A factorial examination of the validity of the Personal Sphere Model using the Rorschach Test)].

The most important results of the factor analysis of 11 variables of the Personal Sphere Model and 14 variables of the Rorschach-Test have shown in both tests common radicals appearing in the evaluation as well of the structure of personality as of the behaviour of man. Both tests emphasize the possibility of objectivating pathological traits of personality: the difference consisting in the fact, that this traits are coming out more distinctly in the Rorschach-Test, while in the Personal Sphere Model the psychodynamic factors of the ability of building object relationships of overcoming seperations are appearing more clearly. The most relevant conformity of both tests is the possibility of distinctly projecting the defense mechanism of aggression.

Aggression↗
PubMedDate not supplied

[Comparative evaluation of a German version of the Health Assessment Questionnaire and the Hannover Functional Capacity Questionnaire].

OBJECTIVE: To translate the Health Assessment Questionnaire Disability Index (HAQ) into a German version, to validate and to compare its properties with two different versions of the Hannover Functional Ability Questionnaire (HFAQ) in a German speaking population. METHODS: The test-retest reliability was tested by Pearson correlation in 32 outpatients of the Department of Rheumatology of the Medizinische Hochschule Hannover. For retesting, the questionnaire was mailed to them 1 week later. To validate the questionnaire it was administered to 110 inpatients in three different hospitals. All patients fulfilled the American College of Rheumatology 1987 revised criteria of rheumatoid arthritis (RA) or the Rome criteria of definitive inactive RA. The internal consistency was measured by Cronbach's coefficient alpha (CCA). To assess criterion validity we compared the HAQ and the two versions of the HFAQ with Keitel's test (KT) and the modified Steinbrocker classification (mSC). Construct validity was assessed by comparing these instruments with different clinical and laboratory variables. A multivariate analysis was used to identify the most important factors that are influencing the HAQ- and HFAQ-scores. RESULTS: Test-retest reliability of the HAQ was r = 0.94. CCA was 0.91 (HAQ), 0.90 (HFAQ-P) and 0.93 (HFAQ-PR). The KT Pearson correlation coefficients reached r = -0.73 (HAQ), r = +0.74 (HFAQ-P) and r = +0.71 (HFAQ-PR). The mSC correlated r = +0.75 (HAQ), r = -0.72 (HFAQ-P) and r = -0.70 (HFAQ-PR). The correlation coefficients of HAQ/HFAQ-P was r = -0.87 and of HAQ/HFAQ-PR r = -0.88. The correlations between other clinical and laboratory variables reached from r = +/-0.58 (pain/HAQ) to r = +/-0.11 (number of swollen joints/HFAQ-PR). In backward multiple regression analysis 59-64% of the variance of disability measured by the questionnaires was explained predominantly by pain (32-33%) and by range of motion (16-21%). CONCLUSION: The German version of the HAQ presented here and the two versions of the HFAQ are reliable and valid instruments for measuring functional disability in a German-speaking population with RA. The construct measured by the HAQ and both versions of the HFAQ showed a high degree of correspondence.

Activities of Daily Living↗
PubMedDate not supplied

["Interface problems" in medical rehabilitation: development of a brief questionnaire for assessing the need for information and communication among general practitioners].

Against the background of current and future demographic changes the relevance of medical rehabilitation in the German health care system is generally acknowledged. It is a central element of treatment programmes especially for elderly and chronically ill patients. In recent years, problems due to lack of co-operation and communication as well as insufficient links between acute care and rehabilitation treatment have found increasing attention. Previous attempts to increase involvement especially of general practitioners in the rehabilitation process were only slightly successful. In a pilot study conducted by the Rehabilitationswissenschaftlicher Arbeitskreis Schleswig-Holstein a new procedure was tested to increase involvement of general practitioners. A brief questionnaire was attached to the report of discharge of rehabilitation patients and was sent to 130 practitioners. With this questionnaire the general attitude and need for information of the practitioners should be analysed. Knowledge about these variables should help to improve communication and co-operation. The response rate was quite high: about 75% of the contacted practitioners answered the questionnaire. All practitioners described medical rehabilitation as important and also had a quite positive attitude toward the same. Two-thirds of the physicians were interested in more intensive contacts and requested further information.

Aged↗
PubMedDate not supplied

[What do we know about the symptoms of back pain? Epidemiological results on prevalence, incidence, progression and risk factors].

AIMS: This paper provides an overview of epidemiological findings concerning the prevalence and incidence of back pain, the underlying risk factors and health care utilization due to back pain. METHODS: Besides epidemiological studies, data from health care statistics and cost-of-illness studies were included in the systematic search. Relevant publications were identified using electronic literature databases (in particular Medline). RESULTS: Back-related disorders, classified according to the ICD-10 M40-M54 key are the major cause for receiving disability benefits. While back pain leads to a frequent demand for medical services, loss of production because of temporal sick leave is the major economic factor. In total, the estimated annual costs caused by back pain range between 16 and 22 billion euros. The life-time prevalence corresponds to the immense costs: 80 % report having ever experienced back pain. The point prevalence lies between 30 and 40 %. Approximately one-fourth to one-third of those affected suffer from clinically significant back pain. Recurrent as well as incident back pain is best predicted by prior back pain. The wide spectrum of other risk factors (depression, psychosocial distress, somatization, catastrophizing, dissatisfaction at work and sociodemographic as well as socioeconomic variables) underscores the multifaceted etiology of this symptom. CONCLUSION: Back pain belongs to the major individual and societal health problems in Germany. While extensive epidemiological evidence exists for the prevalence of back pain, its severity, course and associated risk factors, little systematic knowledge is available about the medical treatment of back pain.

Age Distribution↗
PubMedDate not supplied

Non-palpable breast lesions in asymptomatic women: diagnostic value of initial ultrasonography and comparison with mammography.

AIM: This prospective double-blind study was designed to assess (i) if primary breast screening by ultrasonography is capable of detecting breast cancer independent of tissue density and (ii) if the rate of unnecessary biopsies remains acceptable when diagnostics are based on ultrasonography. PATIENTS AND METHODS: Bilateral breast ultrasonography was performed in 448 asymptomatic women as the initial diagnostic method. Sonograms were interpreted using a set of standardized diagnostic criteria. Subsequently, mammograms were obtained. The radiologists reading the mammograms were blinded to the sonographic results. RESULTS: Overall, 3 non-palpable breast cancers were detected by ultrasound and mammography. All 3 ultrasonographically detected breast cancers were smaller than 1 cm (0.7, 0.7, 0.6 cm). All 3 carcinomas were correctly detected by both methods. For ultrasonography, the false positive rate was 1.1% (n=5) and for mammography 0.6% (n=3). When both methods were combined, the rate of unnecessary open biopsies was 1.6% (n=7). The ratio of benign to malignant lesions was 3.7/1. CONCLUSION: Without prior mammography, primary high-resolution breast ultrasonography is capable of detecting non-palpable breast carcinomas in asymptomatic women at an early stage. The rate of unnecessary open biopsies is low and the ratio of benign to malignant biopsies acceptable.

Adult↗
PubMedDate not supplied

[Change in functional capacity and pain intensity of 81 cP patients treated with Azulfidine RA or aurothioglucose. Preliminary statistical assessment of the German multicenter study of the treatment of chronic polyarthritis with Azulfidine RA].

A 36 week treatment with either salazosulfapyridine or aurothioglucose on 81 patients with definite and active rA, most of them from outpatient clinics, did not lead to significant differences in disability and pain intensity. Under both medications 40% were able to reach a statistically significant and clinically relevant improvement, while 25% remained in an unsatisfactory state.

Activities of Daily Living↗