RESUMEN
Objective: Effects of a combined orthopedic and psychosomatic rehabilitation (VOP) concept are evaluated in contrast to psychosomatic and orthopedic rehabilitation. Therefore both mental and physical health of rehabilitants are compared. Methods: A prospective case-control study was performed in order to gather psychic strain and bodily constitution. Covariance analysis was conducted to expose significant differences between groups. Results: An equal clinically relevant reduction of psychological distress could be achieved with psychosomatic rehabilitation (N=322) and VOP (N=511). Moreover, bodily constitution could be increased by the same amount through VOP and orthopedic rehabilitation (N=135). In conclusion the therapy concept is successful in patients with both somatic and psychic problems.
Asunto(s)
Procedimientos Ortopédicos/psicología , Procedimientos Ortopédicos/rehabilitación , Psicoterapia/estadística & datos numéricos , Estrés Psicológico/prevención & control , Estrés Psicológico/psicología , Adolescente , Adulto , Anciano , Estudios de Casos y Controles , Terapia Combinada/psicología , Terapia Combinada/estadística & datos numéricos , Comorbilidad , Femenino , Alemania/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Estrés Psicológico/epidemiología , Resultado del Tratamiento , Adulto JovenRESUMEN
DNA synthesis in cultures of PHA-stimulated blood mononuclear cells from patients with advanced malignant tumors of the ovary before treatment was significantly reduced and responses of lymphocytes alone were, on an average, 40% lower than in control subjects. Adherent cells were found to suppress the PHA response of autologous lymphocytes from 6/12 patients before treatment, 4/18 patients during chemotherapy and only in 2/19 control subjects. The net effects of adherent cell-lymphocyte interactions in autogeneic vs. allogeneic combinations were frequently discordant, which suggests shifts in lymphocyte subpopulations responsive, respectively, to suppressor- and helper-type mediators released by monocytes in patients. PHA responses of mononuclear blood cells from patients after the 1st and 2nd round of chemotherapy were usually higher than the mean in untreated patients, but declined rapidly after subsequent rounds of cytostatic drug treatment and were deeply impaired in a few cured patients examined many months after therapy. Previous radiotherapy appeared to have little effect on the magnitude and patterns of changes of blood mononuclear response to PHA during subsequent chemotherapy.