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Biomedical subjects

L Kullmann

Publications and source records attributed to L Kullmann.

At least 19 recordsLinked to original sources

[Observations on real drug need of hospitals].

Authors indicate that a considerable share of the inpatient drug supply "gets out" of the institution, another remarkable share is administrated to patients due to polypragmasia. Consequently, in-patient drug-costs might be reduced by large amounts without jeopardizing the quality of care. Authors made attempts to measure the first of the two mentioned losses by repeated systematic observation of patients' clinical charts, while the second one was assessed by several peer-reviews. Illegal drug losses were tackled by involving an external ordinary drugstore, to deliver hospital staff members prescription drugs, while polypragmasia was successfully reduced by introducing changes derived from reports of peer-reviews, over the past three years. Additionally, since the most costly group of drugs is that of the antibiotics, an internal treatment protocol system was set up based on collective knowledge and consensus of all doctors. Authors recommend that once all listed management activities are introduced and conducted in a hospital, department-specific daily drug-cost rationing can be created fairly based on the average drug consumption of the respective department.

Drug Costs

[Results of amputation and rehabilitation].

Authors report on a questionnaire study of amputees having been rehabilitated in three departments of the National Institute of Medical Rehabilitation in 1988. The study was conducted one and a half years (average) after amputation. In comparison to an earlier study on a similar population the ratio of distal amputations has increased and the prosthetic fitting has improved. From these points results are well comparable with international standards. The feeling of isolation of the amputees has decreased since the earlier study. Their chance to get a job has deteriorated essentially, their subsistence problems have increased.

Adolescent

[Treatment and rehabilitation of dysmelic children].

It is reasonable to make the plan of treatment and rehabilitation of dysmelic children in infancy and to realize it after an agreement with the parents, if possible in a care system. A careful operative indication considering the possibilities of orthetic-prothetic supply from every respect is necessary. The supply of the orthopaedic apparatus is generally individually planned and it succeeds only rarely to use standard prosthesis and orthesis. It is worthwhile to strive that the rehabilitation procedure should enable the child to go to the general school in the usual time. Based on the presentation of a few cases the author describes the ground principles of treatment-rehabilitation summarized in the paper.

Artificial Limbs

Hip disarticulation in peripheral vascular disease.

The authors had to perform hip disarticulation on vascular patients in an increasing number - in spite of the general amputation principles. In the majority of the cases hip disarticulation followed other, more distal amputations of the same lower limb. Results of wound-healing, prosthetic fitting and mortality are poor, nevertheless this operation may lengthen life, relieve pain and lead to a tolerable life, usually bound to wheel-chair.

Adult

Rehabilitation of hemiplegic amputees.

The authors report on results of rehabilitation of their 49 hemiplegic amputee cases. Most of the patients had vascular disease. A majority of them had also other conditions with negative effects on rehabilitation. 29 patients achieved walking, 14 used a wheelchair, three remained bedridden and another three died during the hospitalization. The influence of different factors on mobility has been studied. Below-knee amputation had significant effect on mobility, and the time interval between amputation and hemiplegia was also of importance. Other correlations need further studies and more experience.

Activities of Daily Living

Evaluation of disability and of results of rehabilitation with the use of the Barthel index and Russek's classification.

At a rehabilitation medicine unit for mainly vascular lower-limb amputees the use of simple and comparable methods of evaluation of gait performance (Russek's classification) and activities of daily living (the Barthel index) have been studied. Results of the two methods correlate and both have prognostic value concerning rehabilitation outcome.

Activities of Daily Living

Polytenosynovitis caused by Toxoplasma gondii.

Two cases are reported of polytenosynovitis involving the wrists and ankles and caused by toxoplasmosis, together with the investigations that led to the diagnosis. Medical and surgical treatment of the first patient and medical treatment only of the second patient gave satisfactory results.

Female