Biomedical subjects

M Wildner

Publications and source records attributed to M Wildner.

58 records · Page 4Linked to original sources

PubMedDate not supplied

[Inpatient health care utilization for musculoskeletal disorders and injuries: a forecast study for Germany up to 2010].

BACKGROUND: The study is part of the project "Orthopaedics 2010 -- evaluation of the demand for the orthopaedic work force in the year 2010", initiated by the professional association of orthopaedists (BVO). The aim is to estimate the prospective number of orthopaedists for the sufficient medical care of musculoskeletal disorders and injuries. METHODS: The main data source was the official statistics of discharge rates from 1994 to 1999 and the German population forecasts from 1994 to 2010 of the Federal Office of Statistics, Wiesbaden, Germany. An univariate forecasting analysis was done using the Granger and Newbold method. RESULTS: All diagnostic categories of musculoskeletal disorders (arthropathies, dorsopathies, rheumatism, osteopathies) will increase up to four-fold from 1994 to 2010. Three of the four diagnostic categories of injuries (dislocations, sprains and strains; contusion; injuries and open wounds) will decrease by up to 15 percent, the diagnostic category of fractures will increase (10 percent). The stratified analyses by gender and age reveal that women and persons over 65 years old are more often affected by musculoskeletal disorders and injuries. CONCLUSIONS: Both demographic changes and changes in the utilization of inpatient care will lead to a substantial increase of hospital cases up to 2010. The presented results should be looked at together with their confidence limits as interval estimations. In addition, there are independent external factors such as the new prospective payment system (G-DRGs) that will influence the hospital admission rates as well.

Age Distribution↗

PubMedDate not supplied

[Regional mortality differences in Bavaria].

OBJECTIVE: In completion of a decision of the Bavarian Parliament we examined the regional mortality differences within Bavaria. DATA: The analysis was based on the number of deaths in Bavaria in the years of 2000-2002. Data on regional demographic and socioeconomic indicators were used to identify potential associations. METHODS: Deaths were analysed by cause of death and region. Crude and age standardised mortality rates were calculated. Additionally, we assessed the potential years of life lost in order to obtain some indication of the potential effects of preventive action. The association with likely explanatory factors was investigated on an ecological level. RESULTS: The regional mortality differences in Bavaria show a northeast-southwest gradient favouring the southwest, which reflects the socioeconomic situation within Bavaria. This may be due to the economic disadvantage northeast Bavaria had to endure as a result of its marginal location within a divided Europe. We found strong bivariate correlations of the mortality rate with individual socioeconomic factors (e. g. with available income: -0.582; with unemployment: +0.416; with the immigration rate: -0.473). Exploratory analysis suggest that about 50 % of the regional variation in mortality could be explained by socioeconomic factors. DISCUSSION: The results for cause of death indicate that behavioural factors in relation to socioeconomic aspects may well play a role in the mortality gradient. This will be the focus of a future piece of research of our unit.

Adolescent↗

PubMedDate not supplied

[Validation of the North American Spine Society Instrument for assessment of health status in patients with chronic backache].

BACKGROUND: Pain and functional limitations are the chief symptoms in patients with back pain. However, standardized assessment of these domains are still not commonplace in clinical practice. The objective of this study was the cultural adaptation and validation of the North American Spine Society (NASS) Lumbar Spine Outcome Assessment Instrument for German speaking patients with back pain. METHODS: Translation and backtranslation of the NASS instrument was performed according to international recommendations. 56 consecutive inpatients with a confirmed diagnosis of dorsopathia completed a German version of the NASS instrument, the SF-36 and an established German instrument for back patients (FFbH-R). All patients completed the questionnaires 48 hours apart to assess test-retest reliability. Validity was assessed through correlation with corresponding subscales of the SF-36, the FFbH-R and a 0-10 pain numeric rating scale. Internal consistency and item-to-scale correlation served as statistics of reliability. RESULTS: The two subscales of the NASS Instrument for cervical and lumbar problems correlate significantly with the corresponding subscales of the FFbH-R and the SF-36 (r = 0.28-0.83, p < 0.05) and 0.39-0.68 (p < 0.05) with a pain numeric rating scale. Test-retest reliability demonstrated intraclass correlation coefficients between 0.82 to 0.89. CONCLUSION: The German version of the NASS Cervical and Lumbar Spine Outcome Assessment Instrument allows the standardized assessment of pain, functional limitations and neurogenic symptoms in patients with back pain and the international comparison of health states and therapeutic outcomes.

Activities of Daily Living↗

PubMedDate not supplied

[Results with Garth's modified roentgen exposures].

With the apical oblique view of Garth, a modified ap-projection of the shoulder, the postero-lateral aspect of the humeral head (Hill-Sachs defect) and the antero-inferior glenoidal rim (Bankart lesion) are well demonstrated. Additionally a posterior dislocation of the shoulder can be detected and an orthograde view of the glenohumeral joint can be obtained at the same time. The affected arm is kept close to the body which is advantageous in case of a fresh trauma. The apical oblique view has worked well at the radiological follow-up of 56 patients 10-23 years after the Eden-Hybbinette-Lange operation for chronic shoulder instability for an assessment of a Hill-Sachs lesion and of the fate of the bone block antero-inferiorly. The results are described. Disadvantages of the apical oblique view are a geometrical distortion and an exposure to radiation which is three times that of a standard ap x-ray picture.

Adolescent↗