Time to fitness for work (TFW) was measured as the number of days that were paid as compensation for work disability during the 4 years after discharge from the rehabilitation clinic in a population ...of patients hospitalised for rehabilitation after orthopaedic trauma. The aim of this study was to test whether some psychological variables can be used as potential early prognostic factors of TFW.
A Cox proportional hazards model was used to estimate the associations between predictive variables and TFW. Predictors were global health, pain at hospitalisation and pain decrease during the stay (all continuous and standardised by subtracting the mean and dividing by two standard deviations), perceived severity of the trauma and expectation of a positive evolution (both binary variables).
Full data were available for 807 inpatients (660 men, 147 women). TFW was positively associated with better perceived health (hazard ratio HR 1.16, 95% confidence interval CI 1.13-1.19), pain decrease (HR 1.46, 95% CI 1.30-1.64) and expectation of a positive evolution (HR 1.50, 95% CI 1.32-1.70) and negatively associated with pain at hospitalisation (HR 0.67, 95% CI 0.59-0.76) and high perceived severity (HR 0.72, 95% CI 0.61-0.85).
The present results provide some evidence that work disability during a four-year period after rehabilitation may be predicted by prerehabilitation perceptions of general health, pain, injury severity, as well as positive expectation of evolution.
Biopsy needle susceptibility artifacts Ladd, Mark E.; Erhart, Peter; Debatin, Jörg F. ...
Magnetic resonance in medicine,
October 1996, Volume:
36, Issue:
4
Journal Article
Peer reviewed
Understanding the appearance of thin metallic structures in magnetic resonance imaging is important for evaluating the potential role of MRI in guiding and monitoring percutaneous interventions. As ...most MR compatible instruments are made from materials with a susceptibility different from water, their visibility is enhanced beyond what is expected on the grounds of displaced water alone. Unfortunately, this artifactually enhanced visibility is not constant, but instead depends on a variety of factors. This article presents computer simulations of the image distortion resulting from magnetic susceptibility differences between a needle and the surrounding tissue. The simulations show not only an artifact size that is dependent on needle composition, orientation, and pulse sequence, but also a corresponding shift of the artifact center away from the actual center of the needle. These effects place limits on the accuracy of MRI‐guided needle tip placement.
Purpose
This study aimed to identify self-perception variables which may predict return to work (RTW) in orthopedic trauma patients 2 years after rehabilitation.
Methods
A prospective cohort ...investigated 1,207 orthopedic trauma inpatients, hospitalised in rehabilitation, clinics at admission, discharge, and 2 years after discharge. Information on potential predictors was obtained from self administered questionnaires. Multiple logistic regression models were applied.
Results
In the final model, a higher likelihood of RTW was predicted by: better general health and lower pain at admission; health and pain improvements during hospitalisation; lower impact of event (IES-R) avoidance behaviour score; higher IES-R hyperarousal score, higher SF-36 mental score and low perceived severity of the injury.
Conclusion
RTW is not only predicted by perceived health, pain and severity of the accident at the beginning of a rehabilitation program, but also by the changes in pain and health perceptions observed during hospitalisation.
Erhart Peter. «Carta ista amalfitana est et nescitur legere». The charters of Cava dei Tirreni and St Gall and their evidence for early medieval archival practice. In: Gazette du livre médiéval, ...n°50. Printemps 2007. pp. 27-39.
Introduction
Vocational rehabilitation (VR) emphasizes a need for medical support, rehabilitation and biopsychosocial approach to enable individuals to successfully participate in the workforce. ...Optimal rehabilitation management relies on an in-depth knowledge of the typical spectrum of problems encountered of patients in VR. The International Classification of Functioning, Disability and Health (ICF) is based on a universal conceptual model and provides a holistic view of functioning of the lived experience of people such as those undergoing VR. The objectives of this study are to describe the functioning and health of persons undergoing VR and to identify the most common problems around work and in VR using the ICF as the reference framework.
Methods
An empirical cross-sectional multicenter study was conducted using convenience sampling from March 2009 to March 2010. Data were collected using a Case Record Form rated by health professionals which was based on an extended version of the ICF Checklist containing 292 ICF categories and sociodemographic information.
Results
152 patients with various health conditions participated. We identified categories from all four ICF components: 24 for
body functions
, six for
body structures
, 45 for
activities and participation,
and 25 for
environmental factors
.
Conclusions
Our study identified a multitude of ICF categories that describe functioning domains and which represent the complexity of VR. Such a comprehensive approach in assessing patients in VR may help to understand and customize the process of VR in the clinical setting and to enhance multidisciplinary communication.
Guidewire antennas for MR fluoroscopy Ladd, Mark E.; Erhart, Peter; Debatin, Jörg F. ...
Magnetic resonance in medicine,
June 1997, Volume:
37, Issue:
6
Journal Article
Peer reviewed
Before MRI can be used for guiding vascular interventions, the problem of dependably visualizing guidewires must be solved. Ideally, the position and curvature of the tip of the guidewire should be ...visible to facilitate steering through the vascular system. In this paper, various antennas are described that can be incorporated into a guidewire tip. These antennas allow the guidewire to be visualized with high contrast. Computer simulation and experimental evidence are presented showing the value of adding a passive MR signal source, with a short T1, internal to the coil. The internal source increases the available signal, narrows the apparent width of the guidewire, and allows the use of fast imaging sequences.
To assess the potential role of intravascular magnetic resonance (MR) imaging with receiver coils mounted to an inflatable balloon in characterizing atherosclerotic plaque.
Twelve human harvested ...segmental femoral arteries with atherosclerotic changes were studied with a 5-F imaging balloon catheter equipped with a single-loop wire receiver coil. Imaging was performed with an open-configuration 0.5-T (n = 6) or a 1.5-T (n = 6) MR system, with T1- and T2-weighted sequences. Histologic analysis was the reference standard, and MR images were analyzed with regard to vessel wall thickness, plaque area, and components.
Images acquired at 1.5 T were characterized by better in-plane resolution (117 x 104 microm). Resolution at 0.5 T (234 x 178 microm) was sufficient to discriminate the wall layers. On T2-weighted images, adventitia, media, and thickened intima could be discriminated. T1-weighted images did not permit differentiation between wall layers. There was good correlation between MR and histologic measurements of wall thickness (r = .97) and plaque area (r = .98). Plaque characterization was possible on T2-weighted images. Calcified plaque was identified as areas of low signal intensity (134 +/- 98) and could be differentiated from fibrous structures containing collagen (1,968 +/- 680) or fatty components (762 +/- 394).
Intravascular MR imaging on the basis of the balloon catheter design enables differentiation of wall layers and plaque components.
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