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Biomedical subjects

W Brückle

Publications and source records attributed to W Brückle.

At least 19 recordsLinked to original sources
PubMed2001

Short-term treatment of primary fibromyalgia with the 5-HT3-receptor antagonist tropisetron. Results of a randomized, double-blind, placebo-controlled multicenter trial in 418 patients.

We investigated the efficacy and tolerability of short-term treatment with tropisetron, a selective, competitive 5-HT3-receptor antagonist in fibromyalgia. The trial was designed as a prospective, multicenter, double-blind, parallel-group, dose-finding study. We randomly assigned 418 patients suffering from primary fibromyalgia to receive either placebo, 5 mg, 10 mg or 15 mg tropisetron once daily for 10 days. Clinical response was measured by changes in pain score, visual analog scale, tender point count and ancillary symptoms. Responders were prospectively defined as patients showing a 35% or higher reduction in pain score. Treatment with 5 mg tropisetron resulted in a significantly higher response rate (39.2%) than placebo (26.2%) (p < 0.05). In the visual analog scale, the group administered 5 mg tropisetron showed a significant improvement (p < 0.05) and the group administered 10 mg tropisetron showed a nonsignificant clinical benefit. The number of painful tender points was significantly reduced (p = 0.002) in the 5 mg tropisetron group. Regarding ancillary symptoms, the 5 mg tropisetron group showed a significant improvement (p < 0.05) in sleep and dizziness. The patients' overall assessment of efficacy was significantly higher for 5 mg (p = 0.016) and 10 mg (p = 0.002) tropisetron than for placebo. The safety and tolerability of tropisetron was good; gastrointestinal tract symptoms were the most frequently reported adverse events. Short-term treatment of fibromyalgia patients with 5 mg tropisetron for 10 days proved to be efficacious and well tolerated. In this study a bell-shaped dose-response curve was seen.

Adolescent↗
PubMed2000

Efficacy and tolerability of tropisetron in primary fibromyalgia--a highly selective and competitive 5-HT3 receptor antagonist. German Fibromyalgia Study Group.

OBJECTIVE: Based on a potential role for serotonin receptors in fibromyalgia, we investigated the efficacy and tolerability of treatment with tropisetron, a highly selective, competitive inhibitor of the 5-HT3 receptor. METHODS: In this prospective, multicenter, double-blind, parallel-group, dose-finding study, 418 patients suffering from primary fibromyalgia (ACR criteria) were randomly assigned to receive either placebo, 5 mg, 10 mg or 15 mg tropisetron once daily, respectively. The duration of treatment was 10 days. The clinical response was measured by changes in pain-score, visual analog scale (VAS), and the number of painful tender-points. RESULTS: Treatment with 5 mg tropisetron resulted in a significantly higher response rate (39.2%) when compared with placebo (26.2%) (p=0.033). The absolute reduction in pain-score was -13.5% for 5 mg tropisetron, -13.0% for 10 mg tropisetron, and -6.3% for placebo (p<0.05). The effects of 15 mg tropisetron were similar to placebo, thus suggesting a bell-shaped dose-response curve. Compared with placebo, treatment with 5 mg tropisetron led to a significant improvement (p<0.05) in VAS, while a clear trend in terms of clinical benefit was seen with 10 mg tropisetron. The number of painful tender-points was also reduced significantly (p=0.002) in the 5 mg tropisetron group. Of interest, during the 12-month follow-up period, pain intensity of responders on 5 mg and 10 mg tropisetron was still markedly below baseline. The treatment was well tolerated, with gastro-intestinal complaints being the most frequently reported side effects, in keeping with the known safety profile for 5-HT3 receptor antagonists. CONCLUSIONS: This study demonstrates the efficacy of short-term treatment with 5 mg tropisetron once daily in primary fibromyalgia. Treatment was well tolerated and prolonged clinical benefits were seen.

Adolescent↗
PubMed1997

Tissue oxygen measurement and 31P magnetic resonance spectroscopy in patients with muscle tension and fibromyalgia.

Muscle tissue oxygen tension was measured by a polarographic oxygen fine-needle probe, and inorganic phosphate and creatine phosphate spectra were recorded using magnetic resonance spectroscopy in patients with chronic low back pain and in patients with fibromyalgia. Results were compared with healthy controls. The tissue oxygen tension was markedly higher in those with tense muscles than in normal subjects. Magnetic resonance spectra for inorganic phosphate were higher in patients demonstrating muscle contraction, and intracellular pH was shifted in the alkaline direction in cases with increased muscle tension. Results show that hypoxia is not the result of increased muscle tension, as was thought previously, but results from oversupply of oxygen demanded by the muscle, leading to increased capillary perfusion and rising oxygen tension.

Adult↗
PubMed1994

Treatment of psoriatic arthritis with auranofin and gold sodium thiomalate.

Forty-two patients with psoriatic arthritis were included in a multicenter, double-blind trial comparing auranofin and gold sodium thiomalate (GST) for 6 months, followed by a 6-month open treatment. Fifty-two percent of the patients on auranofin and 33% on GST were able to complete the 1-year course of therapy. As a result of the study we conclude that both gold compounds are effective agents in the treatment of psoriatic arthritis. Degree of improvement of arthritis was better in the GST group, but the number of improved patients was greater in the auranofin group. Two patients on auranofin were withdrawn for side effects (one diarrhoea, one worsening of psoriasis) and 5 on GST (rash 2, total loss of appetite 1, exacerbation of psoriasis 2). Comparing the side effects of both compounds, auranofin is less likely to aggravate the psoriatic condition or result in withdrawal of patients for adverse reactions.

Adult↗
PubMed1992

[Generalized tendomyopathy].

Generalised tendomyopathy (fibromyalgia) is characterised by diffuse localized pain involving the locomotory system, tenderness in the regions of the tendon insertions and muscles, loss of muscular power, sleep disorders and other vegetative functional and psychological disorders. In many cases, the diagnosis is delayed, often being made only after comprehensive superfluous diagnostic procedures, sometimes invasive, and inappropriate treatment. Age at disease onset is about 35 years, and initially involves, usually localized, the cervical or lumbar region of the spine. The condition is usually progressive over years. Pathogenesis is multifactorial; for generalization and persistence of the disease, psychosocial factors and civilization-related phenomena appear to play a decisive role. Treatment of generalized tendomyopathy is, for the most part, symptomatic and, overall, unsatisfactory. By way of medical treatment, only antidepressants seem to have a certain positive effect in some of the patients. Of importance is a good doctor--patient relationship and successful motivation of the patient to undergo active physiotherapeutic--in some cases also psychotherapeutic--treatment. With an eye to instituting more successful therapeutic measures and avoiding unnecessary diagnostic and therapeutic procedures, and, last but not least, for socioeconomic reasons, early diagnosis is of great importance.

Adult↗
PubMed1992

Cerebral involvement in adult onset Still's disease.

Still's disease was diagnosed in a 40-year-old patient as a cause of psycho-organic syndrome with complete disorientation and stupor, sensory and motor aphasia. There were no signs of a tumour, cerebrovascular accident, bacterial or viral infection. The patient recovered quickly from the cerebral disturbances under treatment with corticosteroids. Similar symptoms in adult patients with Still's disease are seldom found in the literature.

Adrenal Cortex Hormones↗
PubMed1991

[The course and topography of pain in generalized tendomyopathies].

The generalized tendomyopathy (fibromyalgia) is characterized by the characteristic picture of multilocular pain symptoms, severe pressure-type pain in the tendon insertions and muscles, vitality deficiency, sleep disturbance and other vegetative disorders as well as functional complaints and is often also characterized by an altered psychological condition. Nevertheless, the disease is often not recognized, resulting in extensive superfluous diagnostic procedures and sometimes invasive and useless therapeutic measures. The disorder develops on average in the 37th year of life and initially affects, mostly monolocular, the cervical and lumbar region. The further course of the disease is progressive or recurrent and extends over years, often over decades. The patients' quality of life is markedly impaired and in many cases they are no longer able to carry out their occupational and household work. The socioeconomic significance of the generalized tendomyopathy probably exceeds that of chronic polyarthritis. One problem is the still poor therapeutic possibilities and also the assessment of the treatment. It is, therefore, of great importance to follow the course of the disease and the pain course via hand measurement methods, so as to enable the evaluation of new, but also known therapies. Measuring instruments, which record the intensity and the topography of the pain, such as dolorimetry and the pain score, will be presented and discussed. One of the newest possibilities is the computerized recording of the current symptoms, which is made by the patient himself by means of an electronic pain diary.

Fibromyalgia↗
PubMed1990

[Soft tissue rheumatism. Frequent disease picture in the framework of non-systemic inflammatory soft tissue rheumatism].

The term nonarticular rheumatism covers a hetereogeneous group of diseases affecting the fatty tissue, periarticular tissue and muscles that often also appears, combined, in the form of peri-arthropathies. Without a doubt, the greatest importance attaches to the tendomyoses, which are characterized by spontaneous pain, in particular tenderness to touch, that appears at classical localisations. The most common causes are misalignment, microtrauma, overstraining, and occasionally internistic diseases. In many cases, the genesis is multifactorial, psychological factors also being involved. With respect to therapy, once noxae have been excluded, a range of predominantly physical and drug treatments are available, depending upon the acute nature of the disorder.

Bursitis↗
PubMed1988

Benign hypergammaglobulinemic purpura in a patient with ulcerative colitis and peripheric arthritis.

A 32-year-old patient is described presenting with ulcerative colitis and oligoarthritis who later developed benign hypergammaglobulinemic purpura. This diagnosis was confirmed by clinical investigation, immunological findings as well as by histological and immunofluorescent examination. He was successfully treated with steroids and azathioprin. The relevant literature is reviewed.

Adult↗
PubMed1987

[Spontaneous splenorenal shunt in liver cirrhosis].

A 52 year old patient was admitted to the hospital for further clarification of a cystic structure in the region of the spleen hilus noticed in the upper abdominal sonogram. The investigations revealed a spontaneous splenorenal shunt in hepatic cirrhosis.

Arterio-Arterial Fistula↗