Search PubMed⌕ Search

Biomedical subjects

M Schattenkirchner

Publications and source records attributed to M Schattenkirchner.

At least 73 records · Page 4Linked to original sources
PubMed1988

Auranofin and gold sodium thiomalate in the treatment of rheumatoid arthritis: a one-year, double-blind, comparative multicenter study.

In a 48-week, double-blind trial, 122 patients were randomly assigned to treatment with auranofin (60) and gold sodium thiomalate (GST) (62) at five centers. Both groups showed significant improvement (P less than 0.05) from baseline in parameters of disease activity. Results of the covariance analysis for all patients who completed the trial showed no significant differences (P less than 0.05) in efficacy between the two groups. The proportions of patients showing 50% or greater improvement in tender joints, swollen joints, activity index, severity of pain, general health rating, and erythrocyte sedimentation rate (ESR) were similar for both auranofin-treated and GST-treated patients who completed the 48-week trial. When all patients who entered the trial were evaluated, a slightly greater proportion of patients on auranofin had improved. Diarrhea occurred more frequently with auranofin (32%) compared to GST (19%), whereas rash and pruritus were twice as common in those patients treated with GST compared to those treated with auranofin. The withdrawal rate due to adverse reactions was 10% for auranofin vs 26% for GST. It was concluded that the efficacy of auranofin was comparable to that of injectable gold and was better tolerated, as evidenced by the lower withdrawal rate from adverse events for the auranofin patients.

Adult↗
PubMed1988

Molecular biology of the HLA-B27 locus.

The molecular biology of the HLA-B27 locus is reviewed. The HLA-B27 gene itself does not differ between healthy individuals and ankylosing spondylitis patients. Several unique features of the HLA-B27 molecule have been identified and one epitope was proposed to cross-react with bacterial proteins.

Amino Acid Sequence↗
PubMed1987

Natural course and prognosis of HLA-B27-positive oligoarthritis.

A long-term follow-up of 119 patients with the descriptive diagnosis of B27-positive oligoarthritis showed that after a time between months to several years about half of the patients with this condition develop a definite disease of the seronegative spondarthritis group, especially ankylosing spondylitis. Another great part of the patients go into a complete and presumably persistent remission of their arthritis. After a follow-up time of 8 to 12 years, about 10% present a recurrent B27-associated oligoarthritis with some special clinical features. It is to be discussed whether this condition is a separate disease entity or still an abortive form of a well-known disease of the seronegative spondarthritis group.

Arthritis, Reactive↗
PubMed1987

Diagnostic methods for evaluation of activity in inflammatory rheumatic disease.

Inflammation is one of the cardinal clinical signs of rheumatic disease, although the pathogenesis of inflammation may differ from one such disease to another. The role played by inflammation in the diverse irreversible changes in the structure of the musculoskeletal system is probably also quite different. Despite this proviso, one of the prime tasks of clinical rheumatology is precise measurement of inflammation, because the information so acquired makes it possible to draw conclusions about the activity of the disease and assess the effect of therapeutic measures. Measurement of inflammation consists, fundamentally, of quantifying the classic symptoms of pain, swelling, heat, redness and limitation of movement. All attempts to measure inflammation by means of a single parameter, for instance of a humoral type (acute phase proteins), or by a single method (scintiscanning with radionuclides or thermography) have failed sooner or later. The only practical approach is to measure a number of subjective and objective parameters. With all these methods, sensitivity and reproducibility are crucial to success. In rheumatoid arthritis, the major rheumatic disease, various authors have compiled indices on the basis of individual parameters: number of painful joints, number of swollen joints, grip strength, duration of morning stiffness, a number of function tests, erythrocyte sedimentation rate (or other humoral inflammation parameters), a special pain measurement (pain scale) and subjective evaluation of the rheumatic condition by the physician and the patient.

Humans↗
PubMed1987

Rheumatology--past, present, and future.

From ancient times until the middle of the last century--the beginning of the modern scientific era--the description, classification, and study of rheumatologic phenomena played an important role in medicine. There are numerous examples in the literature, beginning with Hippocrates' observations on gout through the discoveries of Sydenham and Heberden. The detection of uric acid as "materia peccans" in gouty arthritis and the differentiation of the chronic arthritides by Garrod in 1853 marked the start of research into the aetiology and pathogenesis of rheumatic diseases. After Garrod's discovery, observation and description of rheumatic diseases lagged, and the only treatment in common usage was symptomatic and left to spas. In the last few decades, interest in the classification of rheumatic disease revived, and the union of clinical rheumatology with basic research provided the basis of a period of rapid progress in the knowledge of pathogenesis and in the development of symptomatic therapies, including non-steroidal anti-inflammatory drugs (NSAIDs). Two major therapeutic goals mark the future of rheumatology: the search for optimum treatment to halt the manifestations of rheumatic diseases and the search for the aetiology, which would lead eventually to prevention and cure.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1986

Lyme arthritis: clinical features, serological, and radiographic findings of cases in Germany.

The clinical manifestations, serological data, and radiographic findings of ten cases of Lyme arthritis in Germany are summarized. Qualitative assessment shows that the characteristics of the disease in Germany do not differ fundamentally from those reported in the USA. However, since a serological test for antibodies to the causative spirochete is now available, the great variety of the clinical features of Lyme arthritis can be described more precisely. The cases of chronic Lyme arthritis without prior erythema chronicum migrans, hitherto the most important diagnostic hallmark of the disease, may have been underestimated. One of the cases reported provides evidence that the disease was transmitted via a fly bite. Radiographic abnormalities consisting of marked juxta-articular osteoporosis and osseous erosions were found in two patients with chronic arthritis. Three patients were treated with high-dose intravenous penicillin, two did not respond to the therapy.

Adolescent↗
PubMed1986

Postmarketing experience with auranofin in the Federal Republic of Germany.

Data about adverse events can be particularly useful when assessing newly marketed drugs. However, spontaneous reporting of adverse events does not generally provide sufficient or highly accurate data on incidence and prevalence. In order to provide the most complete and accurate data, a postmarketing surveillance program (PMSP) for auranofin (AF) oral gold therapy for rheumatoid arthritis (RA) was conducted in the Federal Republic of Germany (FRG) from December 1982 through December 1985. The objectives of the program were to observe a large population treated with AF for more than a year; to compare the safety profile of AF with experience from clinical trials; and to register rare or previously unknown adverse events. The program included 2,777 patients with RA from 928 test centers. Disease duration was less than 2 years in 29%. 2-5 in 23.2%, 5-10 in 32.5%, and more than 10 in 13.3% (no data for 2%); disease was mild or moderate in 67.4% and severe in 29.9% (no data for 2.7%). Auranofin was given 6 mg/day as either two 3-mg tablets at breakfast or 1 tablet at breakfast and 1 at the evening meal. Laboratory studies and efficacy, as indicated by increase in grip strength and decrease in number of tender and swollen joints, were monitored regularly. A total of 1,595 patients completed 1 year of treatment with AF. Withdrawals included 12.9% for adverse events, 4.2% for insufficient therapeutic effect, and 33.1% for a variety of administrative or technical reasons. The most common adverse event was alteration in stool pattern, which occurred in 22.5% of patients, compared with 46.6% in worldwide AF clinical trials. Other gastrointestinal symptoms occurred in 17.4%, compared with 22.4% worldwide. The occurrence of most adverse events in the PMSP was much less than in worldwide studies, for example: skin rash 7.3% vs. 24.2% worldwide, pruritus 4.2% vs. 16.6%, proteinuria 1.0% vs. 5.0%, and leukopenia 0.7% vs. 1.9%. These discrepancies may be explained by the method of monitoring employed in the postmarketing study, which favored the reporting of only clinically relevant adverse events. The pattern of occurrence of adverse events was similar to that seen during other AF trials, indicating that any intolerance to AF occurs primarily within the first 6 months of treatment. However, hematologic or nephrologic adverse events appear to be independent of time on therapy, with a constant monthly prevalence of about 0.1-0.2%.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1986

[Rheumatology].

Explore the source record for details and available documents.

Arthritis, Rheumatoid↗
PubMed1985

[Changes in the cervical spine in chronic polyarthritis].

In 93 patients with classical chronic polyarthritis (rheumatoid arthritis) (at least five ARA-criterias) there were inflammatory lesions of dens epistropheus in 48.4%, ventral atlantoaxial subluxations in 25.8%, lateral atlantoaxial dislocations in 14% and pseudobasilary invagination in 5.4%. Step-ladder-subluxation between C 2/C 7 was found in 31.2%, discitis in 12.5% and spondylarthritis in 38% of cases. Inflammatory signs of the cervical spine were correlated to the Steinbrocker-Grade IV, ANA level 1:40 and the degree of Waaler-Rose. The correlation between long standing steroid-therapy and signs of cervical involvement during c.p.--specially in C1/C2--is found to be proven. There are connections between the duration of c.p. (more than 10 years) and manifestation of cervical spine lesions, further, in a protective sense between longstanding gold therapy and cervical spine lesions.

Adult↗
PubMed1985

HLA-DR4 in ankylosing spondylitis with different patterns of joint involvement.

Fifty patients with ankylosing spondylitis (AS) confined to the spine and sacroiliac joints were compared with 50 cases of AS complicated by various patterns of non-axial joint involvement. Radiological and clinical features were evaluated and HLA-DR4 typing was carried out. This antigen was found in 16% of 200 normal individuals in 18% of patients suffering from exclusively axial AS, and in 54% of patients with additional purely peripheral joint involvement (wrist, finger, ankle, toe). The possibility that HLA-DR4 represents a non-specific marker for peripheral arthritis in patients with ankylosing spondylitis is discussed.

Adult↗
PubMed1984

Different synovial fluid fibronectin levels in rheumatoid variants.

A circulating high-molecular-weight glycoprotein called fibronectin plays a part in cell adhesion and migration before phagocytosis and in morphology, differentiation, and metabolism in inflammatory synovial effusions of patients with rheumatic diseases. A technique of nephelometric immunoassay, based on the measurement of an antigen-antibody reaction, was applied to the analysis of fibronectin concentrations in synovial fluids from 20 patients with rheumatoid arthritis (RA) and other diseases (non-RA). RA synovial fluids have a significantly higher concentration than the specimens obtained from Yersinia arthritis patients (n = 12). The mean concentration of other synovial fluids, from 12 patients with osteoarthritis of the knees, did not significantly differ from the synovial fluids of control values obtained from patients who underwent meniscectomy. There was a considerably negative correlation between fibronectin levels and overall indices of inflammatory activity, such as Ritchie articular indices or a whole number of painful rheumatoid arthritis joints. However, a particularly distinct correlation was obtained when raised fibronectin levels were compared with the inflammatory activity of the knee joint, from which the specimen was aspirated. Thus, these findings suggest that the measurements of fibronectin in synovial fluid may be of some differential-diagnostic value in rheumatoid variants, but may only serve as an indicator of inflammatory activity if the joint, from which the specimen is obtained, is taken into account.

Adult↗
PubMed1984

[Ankylosing spondylitis with and without peripheral joint involvement. The significance of HLA-DR4 in the diagnosis, disease risk and pathogenesis].

50 patients with ankylosing spondylitis without any peripheral arthritis are compared with 50 cases of ankylosing spondylitis complicated by arthritis of different kind. Radiological and clinical features were evaluated and assessed. HLA-DR4 typing was carried out. This antigen was found in 16% of 200 normal individuals, in 18% of all patients with ankylosing spondylitis confined to the spinal column, and in 54% of patients with only peripheral arthritis (wrist, finger, ankle, toe joints). The conclusion that HLA-DR4 represents nonspecific evidence for peripheral arthritis in patients with ankylosing spondylitis is discussed.

Adult↗
PubMed1984

[Indications and contraindications for systemic gold therapy].

At the current state of the art a comparison of gold salts and other therapeutic modalities in terms of their risk-benefit ratios clearly shows chrysotherapy to have a place in the treatment of active rheumatoid arthritis. Factors supporting the use of gold salts as base-line drugs for active rheumatoid arthritis include the extensive experience accumulated with chrysotherapy as a basic antirheumatoid treatment and the potential of gold salts to halt joint destruction. The application of gold salts in the treatment of juvenile chronic polyarthritis and psoriatic arthritis rests on the same rationale. Further studies are needed to establish the place of gold salts in ankylosing spondylitis and chronic Reiter's syndrome. Contraindications include diseases of organs likely to be the site of disastrous side effects on gold administration as well as disseminated lupus erythematosus and arthritis in the presence of colitis. Experiences with systemic gold therapy will, no doubt, be expanded in many a respect by the availability of an oral dosage form. Whatever the indication of gold salts a thorough understanding of clinical rheumatology, a complete mastery of the technique and consistent, meticulous patient monitoring are paramount if treatment is to be beneficial.

Anti-Inflammatory Agents↗
PubMed1983

[Reactive arthritis--clinical aspects and course].

Post-enteritis reactive arthritis-mainly caused by Yersinia enterocolitica-has succeeded rheumatic fever as the most frequent postinfection arthritis in Northern and Central Europe. Aetiologically important are infective diseases-produced by "arthritogenic" bacteria--as a trigger, and genetic predisposition, indicated by a high incidence of HLA-B27 (80%). Over a period of 5 years 51 cases of post-enteritis reactive arthritis were diagnosed in our clinic; the patients--after the first examination--were followed up for several years. The typical clinical findings initially were an asymmetric oligoarthritis, mainly affecting knees, ankles and toes. Transitory low-back pain and heel pain were the most important concomitant findings. Transient liver involvement was indicated by pathological laboratory tests in 12 cases. Acute primary disease was determined at latest within one year (average duration 6.5 months). In the follow-up period 7 patients developed symptoms of a chronic seronegative spondylarthritis. Thus, post-enteritis reactive arthritis may often represent the first manifestation of a chronic disease of the seronegative spondylarthritis group, e.g. Reiter's syndrome.

Adolescent↗