Medical educational and functional determinants of employment after stroke.

To evaluate the medical educational and functional determinants of employment after stroke a total of 204 Patients were assessed for functional changes during rehabilitation and after one year. Additionally the educational and social background of each patient was documented. One year after discharge from the rehabilitation unit 11.3% of the patients worked full-time and 2.7% part time. Another 14.7% had the decision pension versus employment still pending and 0.5% were classified as unemployed. 70.8% received regular retirement plan payments or disability pensions. Generally a similar level of functional capabilities can be observed after one year for working and non-working patients except for manual dexterity. Early admission to rehabilitation (within the first 12 weeks) favours return to work. A high school degree qualifying for university entrance and a well paid and better qualified profession as well are correlated with a higher percentage of patients regaining their employment. An other determining factor of employment after CVA is the physical requirement of the former work. Most of the working patients (92%) had been either transferred onto a job suited for an handicapped people or their work plan had been restructured accordingly.

[Group specific improvements in activities of daily living in elderly stroke patients in the rehabilitation phase. A report from the study, "Rehabilitation in geriatrics--analysis and evaluation of rehabilitation procedures in over-60 stroke patients with reference to its epidemiologic aspects")]. / Gruppenspezifische Verbesserungen von Alltagsfähigkeiten bei älteren Schlaganfallpatienten während der Rehabilitationsphase. Ein Bericht aus der Studie "Rehabilitation in der Geriatrie--Analyse und Evaluation von Rehabilitationsverfahren bei über 60jährigen Schlaganfallpatienten unter Berücksichtigung epidemiologischer Aspekte").

Significant as well as non-significant but still distinct improvements in the average functional status of Activities of Daily Living (ADL), according to the Barthel Index and Rüstigkeitsskala as shown by the total patient group of two rehabilitation clinics are presented. The initial status and the time elapsed between stroke and rehabilitation are of great importance for the changes which can be attained. Patient groups which differ in factors such as age, sex, and family status also show clear differences in the average improvement of their functional status.

Influence of norepinephrine on vessel geometry of the intact femoral artery in juvenile insulin-dependent diabetics-evidence of early diabetic angiopathy in central arteries.

A modified M-mode ultrasound echo system had been employed to study blood-vessel geometry of the intact femoral artery before and after Norepinephrine (NE) infusion. 14 patients with juvenile IDDM aged below 35 years and 11 healthy subjects participated in the study. In the diabetic group, wall distensibility (delta D/delta P) was reduced (p less than 0.01) at control conditions. After NE infusion, wall distensibility decreased in both groups (p less than 0.01). The decrease of wall distensibility is due to an increase in pulse pressure (delta P) (p less than 0.002) in the diabetic group and a reduction of pulsatile diameter (delta D) (p less than 0.02) in the normal group. Increased stiffening of the arteriaL wall after NE infusion with progressive reduction of wall strain (delta D/Dd) is the typical finding in the normal group. No change of wall strain was observed in the diabetic group. The functional alteration of the diabetic femoral artery may be described as diminished resistance of the arterial wall to the distending force of rising blood pressure.

Plasma catecholamines in long-term diabetes.

To investigate a possible defect in sympathetic innervation of the blood vessels in diabetics, 18 normals, 13 normotensive juvenile diabetics without complications and 13 normotensive juvenile diabetics with complications were first treated with an increasing infusion of norepinephrine (NE) and subsequently given a two minutes' exercise with a 150 Watt load. Plasma catecholamines were measured under both conditions. In the infusion experiments diabetics were found to have higher NE levels than normals. In normals NE fells to starting levels 5 min. after completion of the work load. In diabetics this fall-back rate was slower. The reduction in the fall-back rate was correlated with the duration of the diabetes.