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Schmidt T, Spahiu F, Zacher J, Bjarnason-Wehrens B, Predel H, Reiss N. Physical Activity After Heart Transplantation: Characteristics, Motifs, Barriers, and Influence of COVID-19 Pandemic. J Heart Lung Transplant 2022. [PMCID: PMC8988573 DOI: 10.1016/j.healun.2022.01.1409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose After heart transplantation (HTX), regular physical activity (PA) is crucial to counteract transplant-related alterations and improve functional performance. Not much is known about the long-term implementation of PA and potential problems that may occur. The potential influence of COVID-19 pandemic is unknown. Methods Online questionnaire survey: 158 patients (53±14 yrs, 65% male, 8±7 yrs after HTX) were included. Recruitment was carried out via HTX outpatient departments, transplant sport associations, self-aid groups and social media. The questionnaire included 77 to 138 items divided into 6 categories and 3 time points (pre heart failure, after HTX before COVID-19, after HTX during COVID-19). The survey was approved by the local ethics committee. Results 88% reported regular PA after HTX (before COVID-19) and 75% had taken up PA within the first year. Patients stated higher level of PA after HTX, compared to the pre heart failure period (p<0.05). Patients who completed cardiac rehabilitation (70%), started leisure-time PA significantly earlier (p<0.05) and with higher frequency (p<0.05). Figure 1 shows the most important motifs/barriers for regular PA and changes over the reported period. Satisfaction with sports facilities was moderate and 39% complained about the need for improvement (e.g. exercise education). 61% performed exercise training without a professional supervision. Exercise monitoring was mostly done using heart rate respond (52%), but frequently no monitoring was used (32%). During COVID-19, patients were more dissatisfied with their level of regular PA (p<0.01) or physical condition (p<0.05) and emphasized the beneficial effect of PA on their mental balance. Conclusion After HTX, most patients try to integrate regular PA in their leisure-time behavior, but complain about a lack of detailed exercise education and appropriate sports facilities. Participation in a cardiac rehabilitation after HTX may have positive long-term impact on PA levels.
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Abstract
Damage to health caused by complications and errors is part of the reality of medical treatment. In order to avoid further negative consequences in the event of legal claims as a result of excessive processing times or unjustified refusals, a good cooperation between the physician and claims management in the clinic and the legal processor in liability insurance is required. In order to avoid false assumptions in claims processing, a critical analysis of the facts of the case is necessary. In addition, findings from claims management must be recorded and effectively implemented in the clinical practice.
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Affiliation(s)
- A Meyer
- Risikomanagement/Versicherungen, Helios Kliniken GmbH, Friedrichstr. 136, 10117, Berlin, Deutschland.
| | - J Zacher
- Risikomanagement/Versicherungen, Helios Kliniken GmbH, Friedrichstr. 136, 10117, Berlin, Deutschland.,Helios Kliniken GmbH, Friedrichstr. 136, 10117, Berlin, Deutschland
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Nimptsch U, Bolczek C, Spoden M, Schuler E, Zacher J, Mansky T. Mengenentwicklung bei stationären Behandlungen im Wirbelsäulenbereich – Analyse der bundesweiten Krankenhausabrechnungsdaten von 2005 – 2014. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- U Nimptsch
- TU Berlin, Strukturentwicklung und Qualitätsmanagement im Gesundheitswesen, Berlin
| | - C Bolczek
- TU Berlin, Strukturentwicklung und Qualitätsmanagement im Gesundheitswesen, Berlin
| | - M Spoden
- TU Berlin, Strukturentwicklung und Qualitätsmanagement im Gesundheitswesen, Berlin
| | - E Schuler
- Helios Kliniken GmbH, Zentraler Dienst Medizin, Berlin
| | - J Zacher
- Helios Kliniken GmbH, Zentraler Dienst Medizin, Berlin
| | - T Mansky
- TU Berlin, Strukturentwicklung und Qualitätsmanagement im Gesundheitswesen, Berlin
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Krahwinkel W, Schuler E, Liebetrau M, Meier-Hellmann A, Zacher J, Kuhlen R. The effect of peer review on mortality rates. Int J Qual Health Care 2016; 28:594-600. [DOI: 10.1093/intqhc/mzw072] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 05/12/2016] [Accepted: 06/14/2016] [Indexed: 11/13/2022] Open
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Berenbaum F, Grifka J, Brown JP, Zacher J, Moore A, Krammer G, Dutta D, Sloan VS. Efficacy of Lumiracoxib in Osteoarthritis: A Review of Nine Studies. J Int Med Res 2016; 33:21-41. [PMID: 15651713 DOI: 10.1177/147323000503300102] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Lumiracoxib is a cyclooxygenase-2 selective inhibitor in development for the treatment of osteoarthritis (OA), rheumatoid arthritis and acute pain. We reviewed nine clinical studies of 1 − 52 weeks' duration demonstrating the efficacy of lumiracoxib in OA. Male and female patients aged ≥ 18 years with primary OA of the hand, hip or knee received lumiracoxib, placebo or active comparators (diclofenac, celecoxib or rofecoxib). Lumiracoxib provided consistent reductions in OA pain intensity and improvements in the patient's global assessment of disease activity and functional status (assessed using the Western Ontario and McMaster Universities Osteoarthritis Index questionnaire or the Australian/Canadian OA Hand Index). These results were superior to placebo and similar to the active comparators tested. In addition, lumiracoxib was consistently superior to placebo and generally similar to active comparators in terms of the new Outcome Measures in Clinical Trials and Osteoarthritis Research Society International criteria. These were used to provide a single measure of response to treatment, taking into account pain, the patient's global assessment of disease activity and functional status.
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Affiliation(s)
- F Berenbaum
- Department of Rheumatology, Pierre and Marie Curie University-Saint-Antoine Hospital, Paris, France.
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Zacher J. [Not Available]. Orthopade 2016; 45:180-182. [PMID: 26754655 DOI: 10.1007/s00132-015-3221-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- J Zacher
- Zentrum für Orthopädie und Unfallchirurgie, HELIOS Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Deutschland.
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Zacher J. [Joint space measurement as a predictor for joint replacement after hip arthroscopy ]. Orthopade 2015; 44:315. [PMID: 26042235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Zacher J. [Falls/fractures dependent on pain management]. Orthopade 2015; 44:315. [PMID: 26042234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Zacher J. [Importance of inflammation in the pathogenesis of osteoarthritis]. Orthopade 2015; 44:314. [PMID: 26042233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Affiliation(s)
- J Zacher
- HELIOS Klinikum Berlin-Bruch Zentrum für Orthopädie und Unfallchirurgie Schwanebecker, Chaussee 50, 13125, Berlin, Heidelberg,
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Zacher J. [Efficacy of intra-articular injection of PRP]. Orthopade 2014; 43:940-2. [PMID: 25273877 DOI: 10.1007/s00132-014-3018-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- J Zacher
- HELIOS Klinikum Berlin-Bruch, Zentrum für Orthopädie und Unfallchirurgie, Schwanebecker Chaussee 50, 13125, Berlin, Deutschland,
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Kirollos R, Allison R, Zacher J, Guterman PS, Palmisano S. Perception of smooth and perturbed vection in short-duration microgravity. J Vis 2013. [DOI: 10.1167/13.9.702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Renner B, Walter G, Strauss J, Fromm MF, Zacher J, Brune K. Preoperative administration of etoricoxib in patients undergoing hip replacement causes inhibition of inflammatory mediators and pain relief. Eur J Pain 2011; 16:838-48. [PMID: 22337568 PMCID: PMC3437501 DOI: 10.1002/j.1532-2149.2011.00062.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2011] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Administering cyclooxygenase-2 inhibitors preoperatively appears attractive since these drugs reduce post-operative pain, but do not increase the risk of post-operative bleeds, asthmatic attacks and stress-related gastrointestinal ulcers. In a former investigation, we could show that post-operative administration of etoricoxib reduces prostaglandin production in wound fluid, but the onset of action is variable due to delayed post-operative absorption. METHODS In this study, we investigated the preoperative administration of etoricoxib in patients undergoing hip replacement. They received 120 mg etoricoxib or placebo 2 h before surgery and 1 day after in a double-blinded, randomized, parallel group design. RESULTS A total of 11 patients were randomized (placebo n = 5; verum n = 6). We found high and constant levels of the drug in blood, central nervous system and wound fluid already at the end of surgery (t(max) < 2 h). This was accompanied by inhibition of prostaglandin production in the wound tissue (treatment p < 0.05), suppression of interleukin 6 increase in plasma (treatment p < 0.01), and - despite existing standard pain relief procedures - higher satisfaction with analgesics (time vs. treatment p < 0.05) and less demand for opioids (treatment p < 0.01) and intrathecal bupivacaine (treatment p = 0.05) administration. CONCLUSION Administration of etoricoxib 2 h before surgery allows for an effective drug concentration in critical tissues, a reduction of the production of pro-inflammatory mediators and for better pain relief.
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Affiliation(s)
- B Renner
- Institute of Experimental and Clinical Pharmacology and Toxicology, University of Erlangen-Nürnberg, Erlangen, Germany.
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Adams S, Gloy S, Zacher J, Spuler A, Spuler S. P3.27 The amazing regenerative potency of human satellite cells - analysis in single fibers. Neuromuscul Disord 2010. [DOI: 10.1016/j.nmd.2010.07.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ungethuem U, Haeupl T, Witt H, Koczan D, Krenn V, Huber H, von Helversen TM, Drungowski M, Seyfert C, Zacher J, Pruss A, Neidel J, Lehrach H, Thiesen HJ, Ruiz P, Bläss S. Molecular signatures and new candidates to target the pathogenesis of rheumatoid arthritis. Physiol Genomics 2010; 42A:267-82. [PMID: 20858714 DOI: 10.1152/physiolgenomics.00004.2010] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Rheumatoid arthritis (RA) is a chronic, inflammatory joint disease of unknown etiology and pronounced interpatient heterogeneity. To characterize RA at the molecular level and to uncover pathomechanisms, we performed genome-wide gene expression analysis. We identified a set of 1,054 genes significantly deregulated in pair-wise comparisons between RA and osteoarthritis (OA) patients, RA and normal donors (ND), or OA and ND. Correlation analysis revealed gene sets regulated identically in all three groups. As a prominent example secreted phosphoprotein 1 (SPP1) was identified to be significantly upregulated in RA compared with both OA and ND. SPP1 expression was found to correlate with genes expressed during an inflammatory response, T-cell activation and apoptosis, suggesting common underlying regulatory networks. A subclassification of RA patients was achieved on the basis of proteoglycan 4 (PRG4) expression, distinguishing PRG4 high and low expressors and reflecting the heterogeneity of the disease. In addition, we found that low PRG4 expression was associated with a more aggressive disease stage, which is in accordance with PRG4 loss-of-function mutations causing camptodactyly-arthropathy-coxa vara-pericarditis syndrome. Altogether we provide evidence for molecular signatures of RA and RA subclasses, sets of new candidate genes as well as for candidate gene networks, which extend our understanding of disease mechanisms and may lead to an improved diagnosis.
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Affiliation(s)
- U Ungethuem
- Department of Vertebrate Genomics, Max Planck Institute for Molecular Genetics, CharitéUniversitätsmedizin Berlin, Germany.
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Dyde R, Jenkin M, Jenkin H, Zacher J, Harris L. The effect of lunar gravity on perception: Ambient visual cues have less effect on orientation judgements than they do under normal gravity. J Vis 2010. [DOI: 10.1167/9.8.700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Jenkin H, Zacher J, Dyde R, Harris L, Jenkin M. How do SCUBA divers know which way is up? The influence of buoyancy on orientation judgements. J Vis 2010. [DOI: 10.1167/9.8.716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Zacher J. Wie erzielen wir Verbesserungen im klinischen Alltag? Dtsch Med Wochenschr 2009. [DOI: 10.1055/s-0029-1242670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zacher J, Pauly T. Ehrenmitglieder der ARO im Jahr 2008. Z Rheumatol 2008. [DOI: 10.1007/s00393-008-0410-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Niethard M, Rogalski M, Deja M, Zacher J. Partielle epiphyseale Brückenbildung mit zunehmendem Genu varum bei kortikalem Enchondrom – ein Fallbericht. Z Orthop Unfall 2008; 146:725-9. [DOI: 10.1055/s-2008-1038999] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zacher J. Auswirkungen der Peer-Review-Verfahren: Veränderungen der Fehlerkultur und der internen Abläufe in den Fachgruppen und Kliniken. Dtsch Med Wochenschr 2008. [DOI: 10.1055/s-0028-1085592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Heller G, Günster C, Swart E, Mansky T, Nimptsch U, Krahwinkel W, Rink O, Waldmann D, Zacher J, Robra BP. Weiterentwicklung des Projektes Qualitätssicherung der stationären Versorgung mit Routinedaten (QSR). Gesundheitswesen 2008. [DOI: 10.1055/s-0028-1086271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zacher J, Altman R, Bellamy N, Brühlmann P, Da Silva J, Huskisson E, Taylor RS. Topical diclofenac and its role in pain and inflammation: an evidence-based review. Curr Med Res Opin 2008; 24:925-50. [PMID: 18279583 DOI: 10.1185/030079908x273066] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Topical diclofenac is widely used in the treatment of pain and inflammation. This comprehensive review assesses the safety and efficacy of topical diclofenac in a range of painful and inflammatory disorders. METHODS Double-blind, randomized, placebo- or active-controlled trials (RCT) evaluating topical diclofenac in soft-tissue injuries, soft-tissue rheumatic disorders and osteoarthritis were identified through detailed literature searches. In addition, non-RCT evidence from publications evaluating the pharmacologic characteristics of topical diclofenac were also included in this review to obtain a more complete picture of the drug's profile, its efficacy and safety. RESULTS Studies demonstrate that the drug preferentially distributes to the target tissues in sufficient concentrations to produce a therapeutic effect. A total of 19 double-blind RCTs in more than 3000 patients, supported by single-blind or open trials, consistently show that topical diclofenac significantly reduces pain and inflammation in acute and chronic conditions compared with placebo and is comparable to other topical non-steroidal anti-inflammatory drugs (NSAIDs) and some oral NSAIDs (diclofenac, ibuprofen, naproxen). Improvements have also been observed in patients' functional capacity and mobility. Topical diclofenac is well tolerated, resulting mostly in mild, easily resolved local skin irritation, and is associated with fewer side-effects than other topical NSAIDs and a lower rate of gastrointestinal complications than oral NSAIDs (diclofenac, ibuprofen, naproxen). CONCLUSION This evidence-based review shows topical diclofenac to be an effective and well tolerated treatment in painful and inflammatory conditions, at least in the short-term. However, only published RCT studies have been included in this analysis, which may exclude some interesting data from non-RCT studies. Future trials of topical diclofenac need to be of longer duration, be better reported and consider a broader spectrum of acute and chronic pain indications.
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Affiliation(s)
- J Zacher
- Department of Orthopedic Surgery and Orthopedic Rheumatology, HELIOS Hospital Group, Berlin, Germany
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Zacher J, Wessinghage D, Kisslinger E. Die krankengymnastische Nachbehandlung ausgedehnter Eingriffe bei entzündlichen und degenerativen Kniegelenksveränderungen. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1047388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zacher J, Goethe S, Wessinghage D. Zur Differentialdiagnose der Coxitis beim Kind: Abrißfraktur des Trochanter major. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1048070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zacher J, Dittrich P, Wessinghage D, Kukovetz W. Indometacinkonzentration in Blut, Synovia, Synovialis sowie Haut,Unterhautfettgewebe und Muskulatur nach mehrmaliger kutaner Applikation einer alkoholischen Indometacinlösung*. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1047991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sell S, Zacher J, Lack S, Goethe S. Kniegelenkspropriozeption bei der chronischen Polyarthritis. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1047369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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König S, Sell S, Zacher J. Sonographie des Hüftgelenkes bei chronisch-entzündlichen Gelenkerkrankungen. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1047344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hartwig C, Beyer J, Zacher J. Das Miller-Galante-Knieendoprothesensystem ohne alloarthroplastischen Ersatz der Kniescheibenrückfläche - erste klinische Ergebnisse. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1043702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sell S, Gutsche I, Konermann W, Zacher J. Sonographisch gesteuerte Punktionen bei chronisch entzündlichen Gelenkerkrankungen. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1047314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zacher J, Reiser M. Ergebnisse der Kernspintomographie bei chronisch-entzündlichen Gelenkerkrankungen - Korrelation mit intraoperativen Befunden. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1048058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sell S, Zacher J, Konermann W. Die sonographische Untersuchung der periartikulären Strukturen des Schultergelenkes bei Patienten mit entzündlichen rheumatischen Erkrankungen. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1047395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zacher J, Kißlinger E, Wessinghage D, Bambach T. Sonographischer und makroskopischer Befund am rheumatisch veränderten Gelenk. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1047523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zacher J, Hohenadel J, Herr G. Einfluß synovialisverödender Substanzen vom Natrium-Morrhuat-Typ auf die Monolayer-Zellkultur synovialer Fibroblasten. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1047415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wessinghage D, Mohr W, Zacher J. Makroskopische und mikroskopische Untersuchungsergebnisse bei rheumatischen Tenosynovitiden*. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1051212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wessinghage D, Zacher J. Probleme mit der Verankerung gelockerter GSB-Ellbogenprothesen bei mutilierender cP. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1047939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wetzel R, Wessinghage D, Zacher J. Handgelenksarthrodese bei chronisch-entzündlichen Gelenkerkrankungen*. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1048035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Martini F, Horstmann T, Knak J, Mayer F, Zacher J. Die Bedeutung der präoperativen Physiotherapie vor einer Hüfttotalendoprothesenversorgung bei Coxarthrose. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1043632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sell S, Hintzenstern K, Willms R, Zacher J. Radiolunäre Arthrodese - ein präventiver Eingriff bei der Handgelenksbeteiligung der chronischen Polyarthritis. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1043683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sell S, Zacher J, Küsswetter W. Sonographische Untersuchung der Hand bei Patienten mit entzündlich-rheumatischen Gelenkerkrankungen - sinnvolle Ergänzung des Untersuchungsganges oder diagnostische Spielerei? AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1047340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zacher J, Wessinghage D. Makropathologische Kniegelenksveränderungen bei der chronischen Polyarthritis. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1051111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zacher J, Wessinghage D, Wetzel R, Späth S. Behandlung des akuten Lendenwirbelsäulensyndroms durch die Kombination von Krankengymnastik, physikalisch-balneologischen Maßnahmen mit der Applikation eines parenteral verabreichten nichtsteroidalen Antiphlogistikums*. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1048061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
Pain and loss of function are the clinical signs of osteoarthritis (OA). Conventional x-rays confirm the diagnosis or provide important hints for differential diagnosis. In the natural course of OA, x-rays are performed at longer intervals when pain increases or therapy is without effect, especially if more invasive therapies, or even surgery, becomes necessary. The advantages of x-rays are worldwide availability, cost effectiveness, very long experience with this imaging method and the possibility of storing the images for long periods of time. The typical findings of OA can be detected only roughly by quantitative methods. In many patients, grading of OA does not correlate well with the clinical symptoms. X-ray changes are part of the American College of Rheumatology (ACR) classification criteria for OA of the hand, hip and knee. Ordinary s-rays can depicting bone with a higher local resolution than any other imaging technique. Soft tissues and cartilage can be visualized only indirectly. In OA, ultrasound is the method to depict intra-articular effusion at an early stage. Osteophytes or the degree of synovitis are also visible. Concomitant changes in tendons, bursae or cartilage, such as structures in the hip, shoulder and knee, can be evaluated. MRI is an appropriate tool for describing changes in cartilage volume and concomitant soft-tissue alterations. For qualitative cartilage imaging, MRI has, to date, not been fully validated. Bone scans (bone scintigraphy) allow the differentiation of inflammatory from degenerative joint affections and may add information on the activity of the subchondral bone, which may develop to a prognostic marker of OA. This survey represents recommendations of the Commission "Imaging Techniques" of the German Rheumatology Society regarding the technical and individual conditions, indications, practical guidance and the typical findings of imaging in OA.
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Affiliation(s)
- J Zacher
- Klinik für Orthopädie und Orthopädische Rheumatologie, HELIOS-Klinikum Berlin-Buch, Hobrechtsfelder Chaussee 96, 13125 Berlin.
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Zacher J, Gursche A. Results of Elbow Joint Replacement in Rheumatoid Destruction. AKTUEL RHEUMATOL 2005. [DOI: 10.1055/s-2005-858816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Zacher J, Gursche A. Ergebnisse des Ellbogengelenkersatzes bei rheumatischer Destruktion. AKTUEL RHEUMATOL 2005. [DOI: 10.1055/s-2005-858574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Brune K, Zacher J. [Cardiovascular risk: a class effect of coxibs? How to manage patients taking Vioxx?]. MMW Fortschr Med 2004; 146:10, 12. [PMID: 15536697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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