PubMed Health⌕ Search

Biomedical subjects

C Brill

Publications and source records attributed to C Brill.

9 recordsLinked to original sources
PubMed2001

Comparison of results of core decompression and intertrochanteric osteotomy for nontraumatic osteonecrosis of the femoral head using Cox regression and survivorship analysis.

Different surgical procedures have been recommended for osteonecrosis of the femoral head to prevent or delay the need for arthroplasty. Core decompression is a commonly used treatment in the early stages of the disease, but the published efficacy has varied markedly. Only a few comparisons of different techniques have been reported. The aim of this study was to evaluate and compare the results of 2 commonly used procedures, core decompression and intertrochanteric osteotomy, using Cox regression and survivorship analysis. A total of 177 cases with a mean age of 41 years at surgery were treated for osteonecrosis (94 core decompressions, 83 osteotomies). Any further surgery was defined as failure and endpoint. Significant risk factors for treatment failure were age > 40 years at surgery (P = .022), corticosteroid intake (P < .001), advanced stage of necrosis (Steinberg stage > or =III, P=.04), and core decompression (P = .084). To analyze the influence of the surgical procedure, patients with corticosteroid treatment were excluded, and survival analysis was performed. This analysis revealed survival rates of 74% after osteotomy and 78% after core decompression 6 years postoperatively in early, precollapse stages (P = .819). In advanced stages, the rate of survival for hips after core decompression was lower (56%) than in hips after osteotomy (76%) (P = .056). Our results indicate that core decompression may be as effective as intertrochanteric osteotomy in precollapse stages but is less traumatizing and is cost-effective. For postcollapse hips, intertrochanteric osteotomy should be considered.

Adolescent↗
PubMed2000

Teleradiology requirements and aims in Germany and Europe: status at the beginning of 2000.

Specific radiological requirements have to be considered for realization of telemedicine. In this article the goals and requirements for an extensive implementation of teleradiology are defined from the radiological user's point of view. Necessary medical, legal and professional prerequisites for teleradiology are presented. Superior requirements, such as data security and privacy or standardization of communication, must be realized. Application specific requirements, e. g. quality and extent of teleradiological functions as well as technological alternatives, are discussed. Each project must be carefully planned in relation to one's own needs, extent of functions and system selection. Topics like legal acceptance of electronic documentation, reimbursement of teleradiology and liability must be clarified in the future.

Europe↗
PubMed2000

Decrease in restraint use in a study of a geropsychiatric unit.

1. Traditional and nontraditional interventions were used in this study. 2. There was a reduction in the number of times restraints were used, as well as in the number of patient placed in restraints. 3. Further research is needed to find more humane ways to help older adults through acute crisis episodes.

Aged↗
PubMed1998

Teleradiology: results of a questionnaire of German radiologists.

A questionnaire was sent by mail to 4400 radiologists (i.e. to at least 1000 radiological institutions). The response rate was about 5%. The results showed that 47% of respondents felt well informed about teleradiology, 49% not enough and 3% not at all. Image and report transfer as well as interfaces to reference databases, educational applications, technical quality surveillance and product support (maintenance) were considered to be increasingly important areas. Smaller institutions (1-3 doctors) judged expert consultation as more important than bigger institutions. Standardization, system stability and data security were demanded as well as guidelines, for example concerning the linking of report and image, correct documentation and required image quality. Technically most demands can be fulfilled today but this technology is not yet commonly included in teleradiology systems.

Attitude of Health Personnel↗
PubMed1997

Development and validation of a disease-specific questionnaire on the quality of life of patients with chronic venous insufficiency.

BACKGROUND: Recording of Quality of Life (QoL) is taking on increasing importance in medicine. Although QoL cannot be measured directly, numerous methods studies have demonstrated that important areas of QoL can be addressed by validated questionnaires. The present study was designed to examine a new disease-specific, German-language questionnaire, the Freiburger Questionnaire of QoL in venous diseases (FLQA), with respect to reliability, validity and patient acceptance-among patients with chronic venous insufficiency (CVI). PATIENTS AND METHODS: The FLQA consists of 83 items and differentiates between limitations in QoL in 7 scales: physical complaints, everyday life, social life, emotional status, therapy, satisfaction, occupation. Data were collected from 246 patients with CVI stage I (n = 107), II (n = 75) and III (venous ulcer, n = 64) in the Widmer classification. RESULTS: In the psychometric test, the majority of scales showed little or no top or bottom effect. The internal consistency of the scales was generally high (Cronbach's Alpha in all scales more than alpha = .70 and in 4 scales above alpha = .90). The convergent validity with the Nottingham Health Profile and the ALLTAG was high in several scales. The FLQA showed good discriminant validity and significantly differentiated between the clinical CVI stages in several areas of QoL. The change sensitivity during the course of therapy was also good. In a feasibility test, the acceptance values among patients were high with respect to ease of understanding and description of the QoL areas relevant to them. The mean time to fill out the questionnaire was 21 +/- 6 minutes. CONCLUSION: Overall, the FLQA appears suitable to reliably record characteristics of QoL in patients with CVI in both course and cross-sectional studies.

Activities of Daily Living↗
PubMed1995

Examining the impact of Validation Therapy on the elderly.

With the growing number of elderly people in this country, there is a concomitant growth in demented old, old people being admitted to nursing homes. This research examined the impact of their use of Validation Therapy in a group setting on eight such people. The findings of the project generated four common themes that were exhibited across the 10 sessions and all eight participants. The incorporation of social behaviors, family roles, music and the opportunity to socialize with peers into the daily care of demented old, old people could have a positive impact on the quality of life for each individual. Interventions or approaches based on these four themes could be considered as approaches to teach to individuals caring for old people with Alzheimer's-like dementia. The foundation of the profession of nursing is that of caring (Watson, 1988). Based on the concept of caring, the common themes identified through this project become important for nursing to recognize. With these new clients (the old, old), new approaches to care need to be defined. It is the premise of these nurse researchers that understanding and applying the interventions used with VT in a caring way will enhance the lives of the demented elderly in nursing homes in this country.

Aged↗