[The influence of GAGPS on the viscosity of synovial fluid in activated arthrosis].
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Biomedical subjects
Publications and source records attributed to F Rainer.
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The case is presented of a female patient with rheumatoid arthritis, in whom a malignant non-Hodgkin lymphoma developed following long-term treatment with azathioprine. The possibility of an increased incidence of malignant lymphomas in immunological disorders, including rheumatoid arthritis, is discussed, as is the question of the extent to which azathioprine therapy might be involved in this. Some pathogenetic mechanisms of the development of malignant lymphomas are also considered.
In 60 patients (48 cases were evaluated) with primary gout a longterm therapy (5--10 years) with Allopurinol was performed. Without treatment 4.4 sudden onsets of gout per patient and year were registrated; under Allopurinol only 0.062 (p less than 0.001) onsets were observed. This resulted in a large decrease in hospitalisation time from 44 days to 0.62 days per patient and year. In the majority of cases involution or diminuation of the tophi was found. In 7 cases of nephrolithiasis no further renal colic took place. In 8.3% a skin rasch and in 12.5% a slight gastrointestinal side effect was observed. Together with the clinical results the socio-medical aspects are discussed and the importance of gout in respect to the socioeconomic point of view is pointed out.
272 patients with various rheumatic disorders were interviewed on the basis of a 28 points questionnaire concerning a possible self-medication with non prescribed remedies. A total of 272 patients (78%) had taken various non prescribed remedies and additionally 56 patients had kept self-made dietary restrictions. The parameters favouring an increased rate of self-medication were: female sex, increased age and a prolonged duration of the disease. However, the type of the rheumatic disorder did not play any significant role. The possible reasons of this high degree of self-medication with non prescribed remedies are discussed and improved patient-information by the physician is postulated.
45 patients wih degenerative joint diseases (osteoarthrosis of the hip or knee, Heberden's nodes) were treated for 5 weeks in an open controlled trial with Sulindac, a new nonsteroidal antirheumatic drug (300-400 mg daily). The effectiveness of the drug was evaluated by the following criteria: changes of pain intensity with active movements, pain at rest, night pain, duration of morning stiffness and limitation of movement. Analysis of the global data showed in 64,4% excellent results. In 9.9% the results were good, in 17,8% moderate and there was no response in 6.6%. Other side effects (epigastric pain 8,9%, dizziness 2,2%) were not serious and reversible during the treatment with Sulindac.
The rheological properties of synovial fluids from patients with different rheumatic diseases are discussed. Viscosities of 73 samples were determined and are compared to a standard of "healthy" human synovial fluid p. m. and to bovine synovia. Typical differences between "healthy", degenerative and inflammatory synovial fluids could be discerned. These differences can be characterized with several rheological parameters. The mechanism of lubrication in joints and the role of synovial fluid as a lubricant are discussed. Rheological properties of polymere solutions which could serve as a substitute for sick synovial fluids are described and compared to the properties of healthy synovia. Several possibilities for molecular changes which could account for the deterioration of synovial fluids in patients with different rheumatic diseases are discussed.
The study comprises 79 patients with rheumatoid arthritis and their death rate and causes of death in comparison to an age- and sex-matched conrol group. The patients had died in the years from 1952 till 1977 and an autopsy was done on all of them in the University Institute of Pathology. Infections turned out to be the most common cause of death (48%), second in rank were various cardiac diseases (20%) while the percentage of other causes of death never exceeded 10 per cent. Possible relations between infections and their importance as a cause of death are discussed.
The case histories and autopsy findings of 79 patients with rheumatoid arthritis (RA)--15 patients with and 64 patients without a history of long term corticoid treatment--who had died in the years 1952-1977 and who had been autopsied in the University Institute of Pathology of Graz were evaluated with respect to organic lesions caused by infections and were compared with an exactly matched control group. Both in the rheumatoid group material and in the 64 RA patients without steroid. long term treatment there was a highly significant accumulation of putrid bronchitis and pneumonia and a significant accumulation of pyelonephritis in comparison to the control group. As far as bronchiectases and pulmonary tuberculosis are concerned, there was an increased prevalence in the RA group, but this was beyond the range of statistical significance. Possible reasons that might account for the elevated susceptibility to infections in patients with RA are discussed.
Disturbances of immunoglobulin production have often been observed in preclinical multiple myeloma and have led to the question of a pattern of reactive formation of monoclonal gammopathies. In the documented rare case of coincidental Ig-G-myeloma and rheumatoid arthritis some possible similar pathogenetic mechanisms in both diseases are discussed.