Zeitschrift für Rheumatologie
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To investigate a new bone densitometric technology based on digital radiogrammetry (DXR) with respect to its ability to measure severity-dependent variations of bone mineral density (BMD) in patients with rheumatoid arthritis and to differentiate between corticoid-induced and periarticular bone mineral density loss. ⋯ The DXR-based BMD calculation can distinguish severity and progress of disease-related periarticular demineralization in contrast to those of DXA. In this context, DXA primarily measures the systemic (corticoid-induced) osteoporosis and pQCT partially estimates disease-related bone mineral density loss, whereas DXR can predominantly analyze and quantify the periarticular demineralization, which often shows a manifestation at an early stage of rheumatoid arthritis. Therefore DXR seems to be a diagnostic tool in the course of rheumatoid arthritis.
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Depending on its severity the fixed flexion deformity of the spine in patients with ankylosing spondylitis leads to significant disturbance in the activity of daily living. The surgical correction of such a deformity requires a special knowledge in the context of spinal surgery. ⋯ Considering the rate of complications it is necessary to select carefully the patients undergoing these procedures. The surgeon must be familiar in handling these patients and these special surgical procedures.
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Biography Historical Article
[Scleroderma and Paul Klee: Metamorphosis of life and art?].
Paul Klee was born in 1879 in Münchenbuchsee, not far from Bern, and died at the age of 60 in Switzerland due to severe scleroderma, which was diagnosed in 1936. From this time on, this connective tissue disease had followed him continuously and had strongly influenced his enjoyment of life, personal development and creative power in art work, before finally causing his death in 1940. Based on diaries, letters, personal remarks and notes, his case history was reconstructed from the first symptoms to the date of diagnosis up until his death and an analysis was made of the influence his illness had on his art work in aura, color, figure and productivity.
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There are a number of common aspects between rheumatology and neurology. First, many systemic rheumatic diseases also affect the central and peripheral nervous system as well as muscle causing characteristic symptom complexes. Second, there are similarities between neurological and rheumatological autoimmune diseases in terms of underlying pathomechanisms. Here the most important neurological aspects of rheumatological disorders including their diagnosis and therapy are highlighted.
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Multicenter Study Clinical Trial
[Rheumatologic treatment in the G-DRG system].
On June 27 2000, the German Self-Administration and lately the German Ministry of Health set the general conditions for a new reimbursement system for the inpatient hospital sector which is based nearly exclusively on lump-sum payments. The Association of Acute Rheumatology Hospitals (VRA) and the DRG-Research-Group, Münster University Hospital, conducted a multi-center trial which included 7266 cases from 22 different hospitals. The data were used to analyze how well the not yet German healthcare adjusted G-DRG system (version 1.0) accounts for rheumatologic diagnostics and treatment as well as problems of specialized hospitals. 7 Adjacent-DRGs covered 91% of all cases, 68% of all cases were grouped into only two different Adjacent-DRGs (169 Bone Diseases and Specific Arthropathies and 166 Other Connective Tissue Disorders). ⋯ The results strongly supported the assumption that an accurate reimbursement of rheumatologic cases in the current G-DRG system 1.0 would not have been possible. Adaptations made in the new G-DRG Version 2004 can only partly solve these problems, despite an improved construction of the DRGs. In order to guarantee an appropriate reimbursement of rheumatology clinics from 2005 on, the G-DRG system must be adapted to specific rheumatological pathways and/or alternative or additional reimbursement systems have to be found.