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PubMed1992

The effects of mate removal on pregnancy success in prairie voles (Microtus ochrogaster) and meadow voles (Microtus pennsylvanicus).

The effects of removing the stud male have not been controlled in many studies relating pregnancy block to the presence of an unfamiliar male. We examined the effects of removing the male on pregnancy success in prairie voles and meadow voles, two species that differ in degree of paternal investment. Whereas prairie vole males provide extensive care to offspring and accelerate pup development, meadow vole males display little or no care and delay development of pups. We predicted that removal of the stud male would decrease pregnancy success in prairie voles and either have no effect or increase success in meadow voles. In experiment 1, females were in male-induced estrus, and their mates were either left with them or were removed 4 h, 1 day, 2 days, or 8 days after mating. In experiment 2, females were in postpartum estrus, and their mates were either left with them or were removed 1 day, 2 days, or 8 days after birth of their first litter. Removal of the male soon after mating in postpartum estrus decreased pregnancy success in prairie voles and increased success in meadow voles. Thus, although removal of the stud male influenced litter production, the direction of the effect varied with species.

Animals↗

PubMedDate not supplied

Physical limitations are not required for chronic pain rehabilitation success.

A high performance, active duty fitness requirement group rehabilitated equally to a low performance needs civilian group, both suffering from disabling chronic pain. The purpose of this prospective study was to determine whether higher physical performance requirements adversely affected outcome in a chronic pain rehabilitation program. Twenty-three active duty, chronic pain patients were treated along with 22 civilian chronic pain sufferers in a behavior modification, including positive, verbal reinforcement for performance, stress management and family counseling, physical reconditioning, including stretching, strengthening and aerobic conditioning in a slowly progressive fashion to required needs, and narcotic and muscle relaxant detoxification program at a major military medical center. Eighteen patients in each group, representing, respectively, 78 and 82% of the military and civilian participants, successfully completed the inpatient program. Success was defined by (1) elimination of all narcotics and minor tranquilizers, (2) elimination of all physical restrictions that precluded any desired work or play, which required much higher levels for the active duty patients that included: (3) elimination of all physical profile restrictions and (4) objectively passing annual aerobics field test requirements before the program's end. Review of military disability separation records, averaging 24 mo posttreatment, showed that no formerly successful active duty patients had later been discharged because of physical impairments. Of individuals responding to mail questionnaires at an average of 19 mo postprogram, 12 of 14 (86%) initially successful military patients reported continued unrestricted maintenance of physical abilities, whereas 10 of 14 (71%) of the initially successful civilians reported no restrictions in desired activities.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗

PubMed1993

Decreased mortality rate and length of hospital stay in surgical intensive care unit patients with successful selective decontamination of the gut.

OBJECTIVE: Current studies concerning selective decontamination of the digestive tract have failed to demonstrate a decrease in the length of hospital stay and mortality rate, despite the finding of a significantly lower number of infections. To evaluate this issue in more detail, the relationship between the mortality rate and length of stay with respect to colonization and infections was studied within a group of patients receiving selective decontamination. Special attention was given to the efficacy of decontamination within each patient. The main question addressed was whether an effect on mortality rate was present, and if so, why this effect was not apparent until now. DESIGN: Prospective observational cohort study. SETTING: Surgical intensive care unit (ICU) in a university hospital. PATIENTS: Ninety-seven patients primarily admitted into the surgical ICU who received selective decontamination. Transferred patients were excluded. The majority of the surgeries were elective, and all patients completed the follow-up. INTERVENTIONS: All patients received polymyxin E, amphotericin B, and norfloxacin four times a day in a 2% solution of Orabase orally and enterally as suspensions of 200, 500, and 50 mg, respectively. Assessment of the efficacy of selective decontamination was done by identification of Gram-negative microorganisms in surveillance cultures from the oropharynx and rectum. Predicted mortality rates for each patient were calculated with a logistic regression formula. MEASUREMENTS AND MAIN RESULTS: A possible benefit of selective decontamination of the digestive tract would be expressed by lower actual mortality rates compared to predicted mortality rates. Since we expected the efficacy of decontamination to have an influence on infection and mortality rates, we evaluated these rates in terms of successful or unsuccessful decontamination. Most patients (n = 72) were successfully decontaminated. Actual death rates in these patients were significantly lower than the expected rates (as calculated by the Acute Physiology and Chronic Health Evaluation [APACHE] II scoring system) (18% vs. 40%, p = .006), whereas no difference was found in those patients with failed decontamination (n = 25, death rate 44%). The patients with unsuccessful selective decontamination had significantly longer hospital (52 vs. 34 days) and ICU lengths of stays (23 vs. 9 days; p = .002) and higher mortality rates (44% vs. 18%, p = .020) when compared with those patients who were successfully decontaminated. CONCLUSIONS: These results indicate that selective decontamination is beneficial in terms of mortality rate and length of stay in surgical patients only when successful decontamination has been achieved. The subgroup of patients for whom decontamination is not successful might be responsible for the obscurity in mortality effects of selective decontamination in studies until now. It is expected that identification and subsequent elimination of possible risk factors that cause a failure of selective decontamination can result in lower morbidity and mortality rates in critically ill, surgical patients admitted to the ICU.

Anti-Bacterial Agents↗

PubMed2003

The significance of needle deflection in success of the inferior alveolar nerve block in patients with irreversible pulpitis.

The purpose of this prospective, randomized, blinded study was to compare the anesthetic efficacy of the conventional inferior alveolar nerve block, administered with the needle bevel oriented away from the mandibular ramus, to the bidirectional-needle-rotation technique, administered using the computer-assisted Wand II anesthesia system, in patients diagnosed with irreversible pulpitis. Sixty-four emergency patients diagnosed with irreversible pulpitis of a mandibular posterior tooth randomly received, in a blinded manner, 2.8 ml of 2% lidocaine with 1:100,000 epinephrine using either a conventional inferior alveolar nerve block or a bidirectional-needle-rotational technique using the Wand II injection system. The conventional inferior alveolar nerve block was administered with the needle bevel oriented away from the mandibular ramus so the needle would deflect inward toward the mandibular foramen. The bidirectional-needle-rotation technique was administered by rotating the Wand handpiece assembly in a clockwise-counterclockwise movement (like an endodontic hand file) to minimize needle deflection. Endodontic access was begun 17 min after solution deposition, and all patients were required to have profound lip numbness. Success was defined as none or mild pain (VAS recordings) on endodontic access or initial instrumentation. The results of this study showed no significant differences (p > 0.05) between the success rates of the two techniques. The conventional inferior alveolar nerve block, with the needle bevel oriented away from the mandibular ramus, had a 50% success rate. The bidirectional-needle-rotation technique with the Wand II had a 56% success rate. Neither technique resulted in an acceptable rate of anesthetic success in patients with irreversible pulpitis.

Adult↗

PubMed2006

Succession planning: multilevel organizational strategies for the new workforce.

Succession planning for staff and managers starts with a clear vision and strategic plan. It includes hiring, developing, and coaching all employees to meet new competencies. The implementation of succession planning requires commitment, vigilance, and engagement by all members of the nursing department. Partnerships with human resources and the education department are key for success. The author shares one medical center's experience with succession planning and ongoing strategies for success.

Career Mobility↗

PubMed1976

Apical bearing and success with the Bausch and Lomb Soflens (polymacon) contact lens.

Thirty-three patients (63 eyes) were fitted with Bausch and Lomb soflens (polymacon) contact lenses. The initial lenses were selected with the mean posterior apical radius 0.45 mm flatter than the flat keratometer reading of the cornea (S.D. = +/-0.31 MM). Forty-eight eyes (76%) were successfully fitted and 15 eyes (25%) were unsuccessfully fitted. Among the successfully fitted eyes, 31 were fitted with the initial lens, 12 required steeper lenses, and 5 required flatter lenses. The final successfully fitted lenses were on the average 0.40 mm flatter (S.D. = +/-0.32 mm) than the flat keratometer reading of the cornea. The unsuccessfully fitted lenses were not significantly different than the successfully fitted lenses, being 0.47 mm flatter (S.D. = +/-O.32 mm) than the flat keratometer reading of the cornea. Although the central lens-cornea relationship is helpful in fitting the Soflens, the number of successful results are increased significantly by changing to a lens with different parameters when lens performance and patient response are not optimal.

Adolescent↗

PubMed1989

Correction of presbyopia with contact lenses: comparative success rates with three systems.

In a study designed to compare subjective success rates of three presbyopic contact lens systems, 200 presbyopes were fitted with monovision (MV), a pair of concentric center-near lenses (CN pair), or a combination of center-near/center-distance concentric lenses (CNCD). Overall, 112 subjects (56% of those fitted) successfully wore at least one lens system for a minimum of 3 months. MV was the most successful system (67% success); disrupted stereopsis was not a significant reason for failure with this system. The lower success rates with the two concentric bifocal systems (CN pair 42%, CNCD 37%) could be attributed to the greater visual compromise required with these lenses.

Adult↗

PubMed1989

The impact of a didactic session on the success of feline endotracheal intubation by paramedics.

Clinical reports of endotracheal (ET) intubation of infants by paramedics suggest suboptimal success rates. Methods to improve the performance of paramedics in ET intubation should be explored. The small, anesthetized cat may be utilized to evaluate infant ET intubation performance. By determining success rates and complications of ET intubation in the cat model, analysis of the current skills and the impact of a short didactic session is described. Unprepared paramedics (n = 36) were randomized to an educational (experimental) or control group. Supervisory personnel evaluated ET tube placement and complications. There was no significant difference in the percent of successfully intubated cats, 67% and 57%, respectively, between experimental and control groups. Fifteen percent of successful ET intubations exceeded 30 seconds of intubation time. The experimental group chose appropriate equipment more frequently. Serious complications occurred in 50% of attempted intubations. There was a poor correlation between performance and measures of paramedic experience. Development of educational methods is required to improve infant ET intubation success and reduce complications.

Allied Health Personnel↗

PubMed1988

Spinal pedicle fixation: reliability and validity of roentgenogram-based assessment and surgical factors on successful screw placement.

The increased popularity of pedicle fixation prompted research to address two issues: the reliability and validity of roentgenograms as a technique for evaluating the success of pedicle fixation, and the effects of surgical factors on successful fixation. Thus, does approach--the point and angle of screw insertion, surgeon experience, practice, level of the spine involved, and screw size--effect success of pedicle fixation? Eight fresh thoracolumbar spines were harvested and cleaned of all soft tissues. Two surgeons, one more experienced in pedicle fixation than the other, used two pedicle fixation approaches (Weinstein and Roy-Camille) on both the left and right sides at levels T11-S1 of each specimen. All screws were placed under anteroposterior (AP) and lateral c-arm control. For specimens 1 to 3, 5.5 mm screws were used at T11-L1, and 7.0 mm screws at L2-S1. Unacceptable failure rates at L2 and L3 for the first three specimens resulted in a change of instrumentation for the remaining specimens, with 5.5 mm screws used at T11-L3 and 7.0 mm screws at L4-S1. When surgeons completed the fixations for a specimen, AP and lateral roentgenograms were taken and both surgeons independently evaluated the films to assess the success of each fixation. Failure was defined as evidence of any cortical perforation on any side of the pedicle in or outside of the spinal canal. After completing the roentgenogram evaluation, the specimen was transected in the midline, and the success of each pedicle fixation was evaluated by visual/tactile inspection. There were no disagreements between surgeons on the visual/tactile evaluations of the specimens.(ABSTRACT TRUNCATED AT 250 WORDS)

Bone Screws↗

PubMed2001

Bone graft incorporation in radiographically successful human intervertebral body fusion cages.

STUDY DESIGN: Biopsies were obtained from within radiographically successful human intervertebral body fusion cages to document the histology of remodeling bone graft. OBJECTIVES: The purpose of this study is to describe the tissue within successful human interbody cages with special reference to the viability of bone and the presence or absence of debris particles. SUMMARY OF BACKGROUND DATA: The use of interbody fusion cages is gaining rapid acceptance, but there is little histologic documentation of the nature of tissue within successful human interbody fusion cages. METHODS: Needle biopsies were obtained of tissue within radiographically successful intervertebral body fusion cages at the time of pedicle screw removal for back pain or fusion of adjacent spinal level in nine spinal levels of eight patients. Preoperative diagnoses of these eight adult patients included disease conditions in the sagittal plane: spondylosis (5), degenerative disc disease (6), failed laminectomy and discectomy (2), radiculopathy (1), and spondylolisthesis (1). In all cases the cages had been packed with autograft (iliac crest 7, local 1) at the time of insertion. Cage implantation was performed with anterior (anterior lumbar interbody fusion 4, corpectomy and plate fixation 1), and posterior (posterior lumbar interbody fusion 4), segmental instrumentation (plate 1, or pedicle screws 8). All cases except one cervical case had posterolateral fusion or bilateral facet fusion. The cages were composed of carbon fiber-reinforced polymer (Brantigan cage; DePuy AcroMed, Raynham, MA, n = 5) or titanium mesh (Harms Cage; DePuy AcroMed, Raynham, MA, n = 4). Cages had been in situ from 8 to 72 months (mean 28 months). All nine biopsies from eight patients were obtained from within the center of the cages. Specimens were decalcified, routinely embedded in paraffin, stained with hematoxylin and eosin, and viewed qualitatively with transmitted and polarized light. RESULTS: All needle biopsies were obtained from within the center of the cages, and no patient developed spinal instability after the biopsy. All nine biopsies showed small fragments of necrotic bone associated with viable bone and restoration of hematopoietic bone marrow. Numerous cement lines demarcated the edges of previous cycles of remodeling. The ratio of necrotic to viable bone varied greatly among cases. Small particles of debris were associated with four of the five carbon-fiber cages and one of the four specimens from titanium cages, but there was no visible bone resorption or inflammation. CONCLUSIONS: Autogenous bone graft was incorporated in these radiographically successful human intervertebral body fusion cages. A few debris particles were observed, but there was no histologic evidence of particle-induced bone resorption or inflammation.

Adult↗

PubMedDate not supplied

Succession planning: valuable process or pointless exercise?

Succession planning is the process of identifying people who could presently move into key positions or could do so after specifically targeted development occurs. The process identifies the better people in the organization and takes a consistent approach to assembling, analyzing, and retaining information about potential leaders and planning for their further development. At its simplest level, it is the development of a backup and potential successor to each manager; at its most formal, it is a documented plan for management succession at all levels in the organization. Strongly supportive of a policy of development and promotion from within the organization, succession planning also represents a proactive posture in respect to inevitable management turnover. In these days of rapid change in health care, no modern organization that expects to keep up with increasing competition can afford to drift-or even let a single department drift-although replacements are recruited for managers who resign, retire, or otherwise leave. On numerous occasions, however, all of the effort expended in succession planning seems wasted when potential successors either leave the organization or fail to live up to expectations, prompting one to wonder whether succession planning is little more than a pointless exercise.

Career Mobility↗

PubMed2005

The effect of prematurity on vaginal birth after cesarean delivery: success and maternal morbidity.

OBJECTIVE: We sought to compare vaginal birth after cesarean (VBAC) success and uterine rupture rates between preterm and term gestations in women with a history of one prior cesarean delivery. Our hypothesis was that preterm women undergoing VBAC were more likely to be successful and have a lower rate of complications than term women undergoing VBAC. METHODS: We reviewed medical records of women with a history of a cesarean delivery who either attempted a VBAC or underwent a repeat cesarean delivery from 1995 through 2000 in 17 community and university hospitals. We collected information on demographics, medical and obstetric history, complications, and outcome of the index pregnancy. The primary analysis was limited to women with singleton gestations and one prior cesarean delivery. Statistical analysis consisted of bivariate and multivariable techniques. RESULTS: Among the 20,156 patients with one prior cesarean delivery, 12,463 (61%) attempted a VBAC. Mean gestational ages for the term and preterm women were 39.2 weeks and 33.9 weeks of gestation, respectively. The VBAC success rates for the term and preterm groups were 74% and 82%, respectively (P < .001). Multivariable analysis showed that the VBAC success was higher (adjusted odds ratio 1.54, 95% confidence interval 1.27-1.86) in preterm gestations. A decreased risk of rupture among preterm gestations was suggested in these results (adjusted odds ratio 0.28, 95% confidence interval 0.07-1.17; P = .08). CONCLUSION: Preterm patients undergoing a VBAC have higher success rates when compared with term patients undergoing a VBAC. Preterm patients undergoing VBAC may have lower uterine rupture rates.

Cesarean Section, Repeat↗

PubMed2005

Predictors of successful long-term blood pressure control in type 2 diabetic patients: data from the Swedish National Diabetes Register (NDR).

BACKGROUND: Hypertension in patients with diabetes is a well recognized cardiovascular risk factor for which the benefits of treatment are strongly evidence based. Less is known about predictors for successful long-term blood pressure control in these patients, including the potential role of body mass index (BMI), glycaemic control, microalbuminuria and smoking. MATERIAL AND METHODS: We used longitudinal data on risk factor levels from repeated clinical surveys of 1759 type 2 diabetic patients in the Swedish National Diabetes Register (NDR), a nationwide annual registration of quality indicators in diabetes care. Subjects with successful blood pressure (BP) control (systolic BP < 135 mmHg and diastolic BP < 85 mmHg) at baseline in 1997, in 2001, and at follow-up in 2003, were compared to subjects with BP control >or= 135/85 mmHg. RESULTS: Logistic regression analysis disclosed that successful BP control during the study period was predicted by lower BMI (P < 0.001), a lower frequency of microalbuminuria (P = 0.002), and lower age (P < 0.001) at baseline in 1997, and was still associated with lower BMI (P < 0.001), a lower frequency of microalbuminuria (P = 0.01) and lower age (P < 0.001) at follow-up. Successful BP control was also associated at follow-up with a lower frequency of the metabolic syndrome (30 versus 75%) and lower predicted 10-year risks [United Kingdom Prospective Diabetes Study (UKPDS) Risk Engine] of coronary heart disease (14 versus 29%) and stroke (10 versus 22%) (all P < 0.001). CONCLUSION: A lower BMI and absence of microalbuminuria were strong independent predictors of long-term successful BP control in type 2 diabetic patients, also characterized by a lower frequency of the metabolic syndrome and lower 10-year risk of cardiovascular disease. This implies the long-term benefits on BP control of lifestyle measures as well as control of microalbuminuria.

Adult↗

PubMed2003

Predictive factors for applicability and success with endoscopic treatment of upper tract urothelial carcinoma.

PURPOSE: We report on endoscopic treatment outcomes for upper tract urothelial carcinoma and identify predictive factors for success. MATERIALS AND METHODS: A total of 61 renal units were referred for endoscopic treatment of an upper tract tumor, 69% of which did not have a traditional indication for nephron sparing approaches. Tumor pathology and operative findings were assessed retrospectively for treatment outcomes and influential factors. RESULTS: Initial ureteroscopic inspection was undertaken in 53 renal units with resection attempted in 18 (34%) resulting in an 89% success rate with 16 treated. A percutaneous approach in 19 renal units (11 after ureteroscopy) was 100% successful in achieving tumor-free status, for a total of 35 renal units successfully treated endoscopically. Surveillance then began on 27 renal units with a recurrence rate of 88% and mean time to recurrence of 5.8 months (range 2 to 20). Of patients undergoing surveillance (31% of whom had high grade disease), 54% remain or have died of unrelated disease, during a mean followup of 21.0 months (range 3 to 48). Higher tumor grade, larger size, renal pelvis location (all p <0.01) and multifocality (p = 0.05) significantly correlated with decreased recurrence-free survival, but did not predict failure of local control by endoscopic surveillance. CONCLUSIONS: Although endoscopic techniques can render most patients tumor-free, there is a high associated recurrence rate and many need repeat procedures. Recurrence-free survival is greater in patients with low grade, solitary or less bulky disease. However, rigorous surveillance after endoscopic resection can lead to success even in patients with high grade, multifocal or large volume disease, resulting in preservation of renal units.

Aged↗

PubMed2004

Successful outpatient management of the nonpalpable intra-abdominal testis with staged Fowler-Stephens orchiopexy.

PURPOSE: Previous reports of orchiopexies have shown an 85.9% success rate for staged Fowler-Stephens orchiopexy (FSO). We review our experience with nonpalpable testes (NPTs). MATERIALS AND METHODS: A total of 119 patients with 128 NPTs were treated at our institution between 1994 and 2001. Atrophic testes or "nubbins" were removed. Once an intra-abdominal testis was identified the peritoneum was opened and firm traction was placed on the gonad. If feasible, primary orchiopexy was completed. Otherwise, staged Fowler-Stephens orchiopexy was performed. RESULTS: Primary orchiopexy was performed in 28 testes in 27 patients without division of the spermatic vessels. An atrophic nubbin was removed in 45 patients. All children with bilateral NPTs had at least 1 viable intra-abdominal testis found at surgery. Staged FSO was performed in 55 testes in 47 children. The second stage was performed at a median of 3.5 months after initial ligation of the spermatic vessels. Median followup was 1 year and mean followup was 9 months. Five patients were lost to followup. Successful surgery was defined as a dependent scrotal location and testis size equivalent to the contralateral mate. The overall success rate for the primary orchiopexy group was 100%. In the staged FSO group 1 patient had an atrophic testis at 1-year followup, yielding an overall success rate of 98%. CONCLUSIONS: A high degree of success can be obtained for children with intra-abdominal testes. Mobility of the testis on exploration is a good indicator that the testis can be managed with primary orchiopexy without division of the vessels. If primary orchiopexy cannot be performed, excellent results are achieved with a staged FSO.

Ambulatory Surgical Procedures↗

PubMed2005

Success of multiple, sequential, free tissue transfers to the head and neck.

INTRODUCTION: Free tissue transfer has become the primary reconstructive modality for significant ablative defects in the head and neck. The overall success rate is high, approaching 95% in most centers. The success rate of multiple sequential free flaps has been thought to be lower, based on the absence of optimal vessel availability and the presence of significant scar tissue in the previously operated patient. We evaluated a series of patients who underwent multiple free flaps at different time points to determine the overall success rate and to identify pitfalls encountered in this population. METHODS: Retrospective review, tertiary care medical center. RESULTS: From 1995 to 2002, 377 free flaps were performed by our reconstructive service. Of this group, 36 underwent multiple free flaps at different time points. Thirty-two had two flaps, and four had three flaps. Reasons for performing sequential free flap procedures were as follows: recurrent disease/new primary (18), need for further augmentation (10), failed previous flap (6), delayed mandibular reconstruction after plate fracture (2), mandibular osteoradionecrosis (3), and delayed pharyngoesophageal stenosis (1). The overall failure rate on the second and third flap was 2 of 32 and 0 of 4, respectively, with an overall success rate of 94%. CONCLUSION: Multiple, sequential, free tissue transfer for reconstruction of head and neck defects is a safe and reliable procedure with success rates equal to that in patients undergoing initial free flap reconstruction. Careful preoperative planning can result in optimal outcomes even in this difficult patient population.

Adult↗

PubMed2004

Influence of 131I diagnostic dose on subsequent ablation in patients with differentiated thyroid carcinoma: discrepancy between the presence of visually apparent stunning and the impairment of successful ablation.

BACKGROUND: In the management of patients with differentiated thyroid carcinoma, direct comparison of the presence of scintigraphic stunning after a diagnostic dose of 131I with subsequent successful ablation has not been evaluated. METHODS: This study included 245 patients who received a dose of 2775-3700 MBq of 131I for thyroid remnant ablation. In all patients, the thyroid-stimulating hormone (TSH) level before ablation was more than 30 microlU x ml. One hundred and twenty-six patients (Group A) were given a 185 MBq diagnostic scan (Dscan) 4-11 days before 131I ablation, and 119 patients (Group B) received 131I ablation directly after thyroidectomy. Scintigraphic stunning was considered to be present on any post-ablation scan that revealed either fewer foci or obviously less prominent uptake compared with the earlier corresponding Dscan. Successful ablation was defined as no visible uptake in the neck region or anywhere else on a follow-up Dscan 6-12 months later. RESULTS: Our results revealed that only 13 of the 126 patients (10.3%) in Group A had visually apparent thyroid stunning. Successful ablation was obtained in 56 of 126 cases (44.4%) in Group A, compared with 86 of 119 cases (72.2%) in Group B (P<0.001). In Group A, the success rate of ablation in patients with stunning (5/13) was not statistically different from that in those without (51/113) (odds ratio, 0.76; 95% CI, 0.23-2.47). Multiple logistic regression analysis revealed that the independent determinants of successful ablation were the use of Dscan before ablation (odds ratio, 0.23; 95% CI, 0.10-0.56) and the ablation dose of 131I (odds ratio, 1.05; 95% CI, 1.00-1.10). CONCLUSIONS: Visually apparent stunning is infrequent and may not be sufficiently sensitive to detect the influence of a 185 MBq Dscan on subsequent ablation outcome. For patients with differentiated thyroid carcinoma, we recommend that ablation should be performed directly after thyroidectomy.

Adult↗

PubMed2006

Patients' expectations, motivation and multi-dimensional subjective and objective socio-medical success in medical rehabilitation measures.

This report describes the subjective and objective socio-medical rehabilitation success of a cohort of patients with a primary musculoskeletal or cardiovascular diagnosis 1 year after medical rehabilitation. Furthermore, the predictive value of patients' motivation, expectations and subjective need for rehabilitation, at time of application, on rehabilitation success are examined. Data were derived from a German study, comparing different methods of social medical assessments for the selection of patients for inpatient medical rehabilitation. The results discussed refer to a sample of 352 patients with primary orthopaedic or cardiovascular disease who replied to the 1-year follow-up survey. Rehabilitation subjectively had positive effects for the majority and a positive socio-medical outcome (for at least 80% of the participants); although there was lower subjective success concerning job-related problems and working ability. Multiple regression analysis showed that somatic impairments, functional disabilities in general life as well as health and coping-related expectations/motivation are significant predictors of rehabilitation success. Generally, the explained variance by the regression model was low and further potential criteria of rehabilitation success should be investigated.

Adolescent↗