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Purpose: Identification of patient-related influencing factors on access to follow-up rehabilitation METHODS: Partially standardized, written survey of patients between the ages of 18 and 65 in 3 acute hospitals in Hanover, who were assigned to one of the following six defined indication groups on the basis of their diagnosis: (1) surgically treated bone fractures, (2) knee and hip endoprosthesis, (3) malignant disease from visceral surgery, (4) heart disease without surgical intervention, (5) heart disease with surgical intervention, and (6) stroke. In addition to personal information (such as age and gender) personal rehabilitation goals, rehabilitation motivation, disease processing, functioning, state of health, the knowledge of right to request and suffrage and the personal desire to start a follow-up rehabilitation were raised., Results: Of the 1,227 patients surveyed, 42.5% received follow-up rehabilitation. The percentages between the groups of diagnoses varied widely and were lowest after conservatively treated heart disease (3.2%) and highest after knee and hip joint replacement (98.1%). Including cases with a follow-up rehabilitation relevant diagnosis (n=1,000), the proportion of persons with rehabilitation increased to 51.7% (p<0.001). Reasons for an untreated follow-up rehabilitation were in rare cases the rejection by the payer (0.7%), the rejection by the patient (1.6%) or the lack of rehabilitation ability (3.3%). However in most cases the application remained without further differentiation (28.5%). The most important factor influencing follow-up rehabilitation access were diagnosis. Compared to knee- and hip endoprosthesis, the patients from other relevant diagnosis groups had a much lower chance to start a follow-up rehabilitation (OR from 0,01 up to 0,07; p<0,001). The desire of the patient showed the second most and significant influence to get follow-up rehabilitation (OR=8.18; p<0.001)., Conclusions: The diagnosis was identified as the most important criterion for follow-up rehabilitation access. No measurable factors of functioning seem to have a big influence. Therefore, the individual doctor's decision to submit an application is of particular importance. Especially because of the low level of medical knowledge on the indication catalog of the German pension insurance, the medical treatment based on professional experience as well as the lack of further education possibilities (Gottschling-Lang, 2016), it can be assumed that the follow-up rehabilitation is less standardized and systematic. In order to ensure a need-based patient care, assessment procedures should be established and the training and continuing education of physicians should be supplemented with the topic of follow-up rehabilitation., Competing Interests: Die Studie wurde finanziell gefördert durch die Deutsche Rentenversicherung Braunschweig-Hannover., (© Georg Thieme Verlag KG Stuttgart · New York.)

Objectives: Fibromyalgia syndrome (FMS) patients have multiple symptoms, including mental symptoms such as depression. Natural killer T (NKT) cells have shown to be correlated with depression. However, up to now there is no information regarding the role of CD3+CD56+NKT cells in FMS patients, especially in the intensity of mental symptoms. The present study aimed to observe the role of CD3+CD56+NKT cells level in FMS patients in relation to the intensity of depression., Methods: Ninety-six female patients who matched definition of FMS were divided into subgroups of depressions according to Hospital Anxiety and Depression Scale (HADS) score (HADS-Depression <8; 8-10; and >10). CD3+CD56+NKT cells from peripheral blood were measured by fluorescence-activated cell sorting methods., Results: ANOVA test in the subgroup of depression of FMS patient showed significant differences. Additionally, the differences were observed in HADSD <8 and >10. The use of antidepressant significantly altered the level of CD3+CD56+NKT cells. A blocking variable ANCOVA with antidepressant as covariate showed main effects in the subgroup of depression, however, the interaction of antidepressant and the subgroup of depression did not influence the level of CD3+CD56+NKT cells., Conclusions: These results suggest that CD3+CD56+NKT cells could play a role as a mediator in mental symptom such as depression in FMS patients. It seems the role of antidepressant in the mood intensity is not mediated by CD3+CD56+NKT cells in FMS patients. Additionally, subgrouping FMS patients based on the intensity of mental symptoms may help to optimise the treatments.