[Evaluation of the working capacity of patients with tumors in the otorhinolaryngologic region].
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A study is presented of 80 patients with ischemic heart disease (IHD): 37 patients with a low reaction of the cardiac rhythm to physical load--chronotropic insufficiency (CHI) and 43 patients with an adequate reaction of the cardiac rhythm to loads. Physical working capacity was evaluated by the strength of threshold load, pulsepressure double product, rest quotient, oxygen pulse, oxygen consumption per 1 kgm of work. Interval between the 1 and 2 examination--6.5 years. It was shown that CHI in IHD does not influence the prognosis of the disease and does not reflect the grade of its severity. They are, however, the marker of involvement of the atria. Chronic insufficiency in ischemic heart disease makes it difficult to objectively evaluate the physical working capacity.
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In a case-control study 49 consecutive post-coronary artery bypass grafting (CABG) patients (10 f, 39 m) participating in a comprehensive rehabilitation programme were compared with 98 individually matched double control patients, receiving standard care. The rehabilitation programme, starting 6 weeks after surgery, consisted of follow-up at a coronary clinic, repeated health education, and physical training in out-patient groups. During the first year after CABG, fewer study group patients were readmitted to hospital (14% vs 32%, p less than 0.01) and on fewer occasions (1.1 vs 2.9, p less than 0.05). Fewer patients used anxiolytic drugs (0% vs 15%, p less than 0.01). At the one year post-CABG exercise test we found in the study group a tendency to a greater increase in work capacity, as compared with the values obtained at the preoperative exercise test (33 vs 25 W ns). There were no differences in the rates of returning to work (59% vs 64%). In a long-term follow-up study (av. 38 months post-CABG) the patients were asked to fill in a questionnaire evaluating perceived physical work capacity and training habits. The study group patients rated their physical work capacity higher, and more patients had continued with regular physical training (66% vs 46%, p = 0.05). There were fewer patients using anxiolytic drugs (9% vs 30%, p less than 0.01). Although the programme did not influence the return to work we conclude that it improved the quality of life of our patients as it entailed fewer readmissions and reduced the use of anxiolytic medication; in addition it promoted physical fitness and training habits.
Lung diseases are one of the most frequent causes of permanent occupational disability. The assessment of the insured person's remaining ability to work by evaluating the respiratory parameters is by no means trivial. Nevertheless, no clear overview has been published yet. In this paper tables and evaluation schemes are presented for the quick and reliable assessment of the degree of the occupational disability of persons with respiratory diseases.
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