Biomedical subjects

Thomas Stoll

Publications and source records attributed to Thomas Stoll.

11 recordsLinked to original sources

PubMed2006

Bone loss after total hip arthroplasty.

The aim of the present study is to evaluate periprosthetic bone loss and to compare it with the bone loss in other areas of the body. We also aim to shed light on the course of bone mineral density (BMD) in patients with cemented femoral prosthesis in comparison with those with uncemented ones. We analyzed the BMD using dual-energy X-ray absorptiometry (DEXA) in a consecutively recruited convenience sample of 50 patients with cemented and uncemented total hip arthroplasty (THA). BMD was measured within the first month after surgery as well as 1 year later. In ten of the patients (20%) previously undiagnosed osteoporosis was revealed. Osteoporosis was significantly more frequently detected in patients with cemented compared to those with uncemented femoral stem. We found a significant loss in BMD in the periprosthetic femoral region compared with no losses in other body regions (lumbar spine, radius, contralateral hip). The magnitude of this loss was the highest in Gruen-Zone 7 (mean 15.2% per year). We found no BMD loss difference between patients with cemented and uncemented prosthesis in the Gruen-Zone 2-7. In conclusion these periprosthetic losses may be due to local factors such as periprosthetic bone remodeling, as they contrast with the course of BMD in the lumbar spine, radius and not operated hip.

Absorptiometry, Photon↗

PubMed2004

Validity and sensitivity to change of the NASS questionnaire for patients with cervical spine disorders.

STUDY DESIGN: Study of two cohorts with a differing severity of disease before and after treatment. OBJECTIVES: The aim of this study was to examine the validity and sensitivity to change of the German version of the cervical NASS patient questionnaire. SUMMARY OF BACKGROUND DATA: To the authors' best knowledge, there are no data revealing the psychometric properties of the cervical NASS patient questionnaire. PATIENTS AND METHODS: The validity and sensitivity in patients with cervical spine disorders who were referred by their physician either to an inpatient rehabilitation program or to an outpatient physiotherapy were examined. They were consecutively recruited. Their functioning and health status were assessed when entering the study and after the treatment by the NASS questionnaire and the Medical Outcome Survey Short Form-36 (SF-36). RESULTS: Criterion validity was demonstrated by the statistically significant correlations between the NASS subscores and all subscores of SF-36. As expected, the SF-36 subscores Physical Function and Pain showed the strongest associations to the NASS subscore Pain and Disability (rho = 0.75 and 0.65, respectively), demonstrating construct validity of the latter. Discriminative validity of NASS subscores was shown in two ways. First, a statistically significant difference was found between functional and health status of the two cohorts with better scores in the patients referred to outpatient physiotherapy as compared with those sent to an inpatient rehabilitation program. Second, statistically significant and clinically important improvements recorded by the NASS subscores were demonstrated in both patient groups after the treatment in accordance with improved SF-36 subscores. Moreover, the NASS subscores demonstrated good sensitivity to change (Pain and Disability with a standard response mean ranging from 0.64 to 1.24). CONCLUSIONS: The German version of the cervical NASS patient questionnaire (NASS) is a valid instrument for patients with cervical spine health problems. As this instrument is also sensitive to change, it is recommended for use. Moreover, the present study gives evidence for the validity of the original cervical NASS questionnaire in English.

Cervical Vertebrae↗

PubMed2004

ICF Core Sets for osteoporosis.

OBJECTIVE: To report on the results of the consensus process integrating evidence from preliminary studies to develop the first version of a Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set and a Brief ICF Core Set for osteoporosis. METHODS: A formal decision-making and consensus process integrating evidence gathered from preliminary studies was followed. Preliminary studies included a Delphi exercise, a systematic review, and an empirical data collection. After training in the ICF and based on these preliminary studies, relevant ICF categories were identified in a formal consensus process by international experts from different backgrounds. RESULTS: The preliminary studies identified a set of 239 ICF categories at the second, third and fourth ICF levels with 72 categories on body functions, 41 on body structures, 81 on activities and participation, and 45 on environmental factors. Fifteen experts from 7 different countries attended the consensus conference on osteoporosis. Altogether 67 second-level and 2 third-level categories were included in the Comprehensive ICF Core Set with 15 categories from the component body functions, 7 from body structures, 21 from activities and participation, and 26 from environmental factors. The Brief ICF Core Set included a total of 22 second-level categories with 5 on body functions, 4 on body structures, 6 on activities and participation, and 7 on environmental factors. CONCLUSION: A formal consensus process integrating evidence and expert opinion based on the ICF framework and classification led to the definition of ICF Core Sets for osteoporosis. Both the Comprehensive ICF Core Set and the Brief ICF Core Set were defined.

Activities of Daily Living↗

PubMed2004

ICF Core Sets for chronic widespread pain.

OBJECTIVE: To report on the results of the consensus process integrating evidence from preliminary studies to develop the first version of a Comprehensive ICF Core Set and a Brief ICF Core Set for chronic widespread pain. METHODS: A formal decision-making and consensus process integrating evidence gathered from preliminary studies was followed. Preliminary studies included a Delphi exercise, a systematic review and an empirical data collection. After training in the ICF and based on these preliminary studies relevant ICF categories were identified in a formal consensus process by international experts from different backgrounds. RESULTS: The preliminary studies identified a set of 365 ICF categories at the second, third and fourth ICF levels with 143 categories on body functions, 45 on body structures, 125 on activities and participation and 125 on environmental factors. Thirty experts attended the consensus conference on chronic widespread pain (16 physicians with at least a specialization in physical and rehabilitation medicine, 4 rheumatologists, 2 psychiatrists, 5 physical therapists, one psychologist, one occupational therapist and 1 social worker). Altogether 65 second-level and 2 third-level categories were included in the Comprehensive ICF Core Set with 23 categories from the component body functions, one from body structures, 27 from activities and participation and 16 from environmental factors. The Brief ICF Core Set included a total of 24 second-level categories and 2 third-level categories with 10 on body functions, 10 on activities and participation and 6 on environmental factors. No body structures were included in the Brief ICF Core Set. CONCLUSION: A formal consensus process integrating evidence and expert opinion based on the ICF framework and classification led to the definition of ICF Core Sets for chronic widespread pain. Both the Comprehensive ICF Core Set and the Brief ICF Core Set were defined.

Activities of Daily Living↗

PubMed2004

ICF Core Sets for obstructive pulmonary diseases.

OBJECTIVE: To report on the results of the consensus process integrating evidence from preliminary studies to develop the first version of the Comprehensive ICF Core Set and a Brief ICF Core Set for obstructive pulmonary diseases. METHODS: A formal decision-making and consensus process integrating evidence gathered from preliminary studies was followed. Preliminary studies included a Delphi exercise, a systematic review and an empirical data collection. After training in the ICF and based on these preliminary studies relevant ICF categories were identified in a formal consensus process by international experts from different backgrounds. RESULTS: The preliminary studies identified a set of 287 ICF categories at the second, third and fourth ICF levels with 97 categories on body functions, 33 on body structures, 104 on activities and participation, and 53 on environmental factors. Seventeen experts from 8 different countries attended the consensus conference on obstructive pulmonary diseases. Altogether 67 second-level and 4 third-level categories were included in the Comprehensive ICF Core Set with 19 categories from the component "body functions", 5 from "body structures", 24 from "activities and participation" and 23 from "environmental factors". The Brief ICF Core Set included a total of 17 second-level categories with 5 on "body functions", 3 on "body structures", 5 on "activities and participation" and 4 on "environmental factors". CONCLUSION: A formal consensus process integrating evidence and expert opinion based on the ICF framework and classification led to the definition of ICF Core Sets for obstructive pulmonary diseases. Both the Comprehensive ICF Core Set and the Brief ICF Core Set were defined.

Activities of Daily Living↗

PubMed2003

Quantitative determination of saturated oligogalacturonic acids in enzymatic digests of polygalacturonic acid, pectin and carrot pomace by on-line LC-ESI-MS.

A method for the quantitative determination of oligogalacturonic acids (OGAs) by on-line high-performance liquid chromatographic (HPLC) separation and mass spectrometric detection via an electrospray interface (ESI-MS) without additional desalting steps was developed. Saturated OGAs up to a degree of polymerization (dp) of 3 were quantified by comparison with reference compounds. The calibration plots showed high linearity (R(2)>0.99), and the detection limits for dp 1, 2, and 3 were 11, 28, and 6 ng per injection, respectively. Non- and partially methyl-esterified OGAs with a dp of 3 and 4 were calculated semi-quantitatively as dp 3. The analytical system was used for the quantification of OGAs of digests obtained by incubation of polygalacturonic acid, pectin, and carrot pomace with commercial enzyme preparations. Furthermore, methyl-esterified OGAs up to a dp of 12 containing up to 4 methyl esters were detected in a pectin digest.

Cellulases↗

PubMed2003

Subclinical disease activity in systemic lupus erythematosus: immunoinflammatory markers do not normalize in clinical remission.

OBJECTIVE: To correlate various laboratory measures in systemic lupus erythematosus (SLE) with the British Isles Lupus Assessment Group (BILAG) disease activity index, to search for organ-specific laboratory patterns and to compare with a control population. METHODS: A cohort of 57 Caucasian outpatients fulfilling the American College of Rheumatology criteria for SLE and a control population of 17 patients admitted for coronarography were examined. Disease activity was assessed with BILAG index. Plasma samples were investigated for sCD44, interleukin 6 (IL-6), IL-10, IL-12, tumor necrosis factor-a (TNF-a), soluble TNF receptor-55 (sTNFR-55), sTNFR-75, IL-1-receptor antagonist, soluble intercellular adhesion molecule (sICAM), soluble vascular cell adhesion molecule (sVCAM), E-selectin, and neopterin as well as for C3, C4, dsDNA, and other conventional indicators. RESULTS: Thirty-nine patients had inactive disease (total BILAG score < or = 5), 18 patients had active SLE. Surprisingly, except for C-reactive protein (p < 0.001), no statistically significant difference of the laboratory indicators was found between patients with active and those with inactive SLE. However, there was a significant difference between SLE patients and controls for sTNFR-75 (p < 0.008). We found significant correlations between laboratory markers and some BILAG organ system scores, such as between IL-1ra and the musculoskeletal score (p < 0.003) and between sTNFR-55/sTNFR-75 and renal BILAG (p < 0.001, p < 0.004, respectively). Significant nonparametric correlations were revealed between C3 and C4 (p < 0.0001), and between sTNFR-75 and dsDNA, neopterin, sVCAM, sICAM and sTNFR-55 concentrations (p < 0.0001 for all), and between sTNFR-75 and IL-1ra (p < 0.006). CONCLUSION: Patients with SLE in clinical remission show ongoing systemic immunoinflammatory activity measured with a variety of cytokines, adhesion molecules, and other inflammatory markers. This indicates that laboratory measures may provide qualitatively different additional information to validated disease activity indexes such as the BILAG. Different laboratory markers correlate with disease activity in different organ systems. This suggests differences in pathogenic mechanisms in SLE depending on the organ system involved.

Adult↗

PubMed2002

High-performance liquid chromatographic separation and on-line mass spectrometric detection of saturated and unsaturated oligogalacturonic acids.

A method for the simultaneous determination of saturated and unsaturated oligogalacturonic acids up to degree of polymerization (dp) of 7 by high-performance liquid chromatography (HPLC) is presented. For this purpose, a Cyclobond I 2000 column and a volatile mobile phase consisting of ammonium formate and methanol were used, allowing direct coupling of HPLC to a mass spectrometer via an electrospray interface (ESI-MS) without additional desalting. The analytical system was used for the characterization of digests obtained by incubation of polygalacturonic acid with commercial enzyme preparations.

Chromatography, High Pressure Liquid↗

PubMedDate not supplied

ICF Core Set for patients with musculoskeletal conditions in the acute hospital.

PURPOSE: The aim of this consensus process was to decide on a first version of the ICF Core Set for patients with musculoskeletal conditions in the acute hospital. METHODS: The ICF Core Set development involved a formal decision-making and consensus process integrating evidence gathered from preliminary studies including focus groups of health professionals, a systematic review of the literature and empiric data collection from patients. RESULTS: Twenty-one experts selected a total of 47 second-level ICF categories. The largest number of categories was selected from the ICF component Body Functions (17 categories or 36%). Nine (19%) of the categories were selected from the component Body Structures, 11 (23%) from the component Activities and Participation, and 10 (21%) from the component Environmental Factors. CONCLUSION: The Acute ICF Core Set for patients with musculoskeletal conditions provides all professionals with a clinical framework to comprehensively assess patients in the acute hospital. This first ICF Core Set will be further tested through empiric studies in German-speaking countries and internationally.

Activities of Daily Living↗

PubMedDate not supplied

ICF Core Set for patients with musculoskeletal conditions in early post-acute rehabilitation facilities.

PURPOSE: The aim of this consensus process was to decide on a first version of the ICF Core Set for patients with musculoskeletal conditions in early post-acute rehabilitation facilities. METHODS: The ICF Core Set development involved a formal decision-making and consensus process integrating evidence gathered from preliminary studies including focus groups of health professionals, a systematic review of the literature and empiric data collection from patients. RESULTS: Fifteen experts selected a total of 70 second-level categories. The largest number of categories was selected from the ICF component Body Functions (23 categories or 33%). Seven (10%) of the categories were selected from the component Body Structures, 22 (31%) from the component Activities and Participation, and 18 (26%) from the component Environmental Factors. CONCLUSION: The Post-acute ICF Core Set for patients with musculoskeletal conditions is a clinical framework to comprehensively assess patients in early post-acute rehabilitation facilities, particularly in an interdisciplinary setting. This first ICF Core Set will be further tested through empiric studies in German-speaking countries and internationally.

Activities of Daily Living↗

PubMedDate not supplied

Preliminary validation of PRISM (Pictorial Representation of Illness and Self Measure) - a brief method to assess suffering.

BACKGROUND: Alleviation of suffering is widely acknowledged as one of the main goals of medicine. However, no measure to assess this crucial aspect of illness has been developed to date. AIMS: To validate PRISM (Pictorial Representation of Illness and Self-Measure) as a simple quantitative method of assessing the perceived burden of suffering due to illness. METHODS: Validity and reliability studies to date have involved over 700 patients with a variety of chronic physical illnesses. RESULTS: Reliability of PRISM is good (test-retest reliability r = 0.95; p < or = 0.001, interrater reliability r = 0.79; p < or = 0.001). Qualitative data indicate that the interpretation of the PRISM task is not only consistent among patients, but also consistent with that expected from existing literature on suffering. As expected, PRISM shows strong correlations with psychological variables (notably depression and coping resilience) and also correlates with SF-36 subscale scores. Prospective longitudinal data demonstrate that PRISM is sensitive to therapeutic change. It is very acceptable to patients and takes less than 5 min to administer. CONCLUSION: In the absence of a 'gold standard' measure of suffering, our validation data must be interpreted with caution. However, the performance of PRISM is entirely consistent with what would be expected of a measure of suffering, based on current published work.

Adult↗