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Biomedical subjects

H E Langer

Publications and source records attributed to H E Langer.

At least 19 recordsLinked to original sources
PubMed2003

Kineret: efficacy and safety in daily clinical practice: an interim analysis of the Kineret response assessment initiative (kreative) protocol.

Data from 166 patients who had completed 6 months of anakinra (Kineret, r-metHuIL-1Ra) therapy under the conditions of daily clinical practice showed an efficacy and safety profile comparable to the data known from clinical trials. Patients significantly responded as early as 1 month following initiation of therapy. The data suggest that anakinra may also be effective in patients who have failed tumor necrosis factor (TNF)-blocking agents. Injection-site reactions were reported less frequently than in clinical trials, indicating that these reactions seem to require less therapeutic attention under non-clinical trial conditions.

Antirheumatic Agents↗
PubMed1990

[Viruses and arthritis].

A number of virus infections can induce acute, non-erosive arthritis. A thorough exploration of the patient's history and serological testing for viral infections are crucial to the diagnosis of virus-induced arthritis. Musculoskeletal involvement in infection with the HIV-virus is not a rare feature and will have to be considered more often in cases of acute arthritis, as the prevalence of HIV-infection is increasing. Whether chronic arthritis, like rheumatoid arthritis, is induced by viral infection, is still a subject of intensive research efforts.

Arthritis, Infectious↗
PubMed1990

[Practical differential diagnosis in acute arthritis].

The most common cause for acute arthritis are crystal arthropathies, sero-negative spondarthritides and reactive inflammatory arthritis. In any case, the possibility of a purulent-septic arthritis must be excluded because of the prognostic consequences. Precise rheumatological case history and careful examination are relevant tools in providing a differential diagnosis; laboratory findings may be of great help as well. A flow-chart is suggested for rational diagnosis.

Acute Disease↗
PubMed1990

[New classification criteria of chronic polyarthritis].

The criteria for the classification of the rheumatoid arthritis were defined more precisely, reduced and simplified in 1987 by the American Rheumatism Association. The more detailed specification was achieved at the cost of sensitivity. We find the revision positive as the classification criteria are supposed to mainly serve the purpose of systematic organisation and as a base for multicentered studies. Only then they can give a little help in diagnostic orientation. Never the criteria can take the place of the individual differential diagnosis and the observation of the development of the disease.

Arthritis, Rheumatoid↗
PubMed1990

[Long-term drug treatment of chronic polyarthritis: current status and perspectives].

The therapeutic repertoire for the treatment of rheumatoid arthritis has been expanded to new disease-modifying antirheumatic drugs (DMARDs), like Auranofine, Sulfasalazine, and Methotrexate. Rheumatoid arthritis is not only a highly disabling disease but is now recognized to be related with increased mortality. Therefore, the aim of therapeutic strategies is the early induction of remission. The strategy for treatment of rheumatoid arthritis should be based on an analysis of the individual risk of a patient to develop severe illness. A concept of "risk-oriented DMARD-therapy" of rheumatoid arthritis is proposed.

Analgesics↗
PubMed1990

[Progress in therapy of spondylarthritis].

An update of the wide spectrum of therapeutic measures in the spondarthritides is presented with the example of ankylosing spondylitis. Most important is a life style adjusted to the disease with daily exercises and complementary physiotherapy. The most significant measures of physiotherapy, drug treatment, operation, and radiotherapy are discussed. Preliminary results indicate a long-term effect of sulfasalazine in ankylosing spondylitis. Peculiarities in the treatment of psoriatic arthritis and of entheropathic arthritides are pointed out.

Anti-Inflammatory Agents↗
PubMed1990

[Patient education in rheumatology].

Most of the patients with rheumatic diseases do not know enough about their disease and its treatment. This may influence patient's satisfaction and compliance. Patient education is a useful approach to reduce the negative consequences of the lack of knowledge and non-compliance. Rheumatologists have recognized patient education as an important part of the long-term management of rheumatic diseases.

Arthritis, Rheumatoid↗
PubMed1990

[Rheumatologic emergencies].

Contrary to the widely assumed opinion there exist rheumatological emergency situations that affect patients hazardously. These cover complications of the antirheumatic therapy as well as complications of the disease itself. The paper gives an overview of rheumatological emergency situations and tries a systemic approach to a rheumatological emergency medicine.

Anti-Inflammatory Agents↗
PubMed1990

[Clinical study on rheumatoid arthritis of the TMJ].

256 individuals with inflammatory rheumatic diseases and 117 individuals of two control groups returned their questionnaires in a survey of subjective symptoms of the masticatory system. Subjective symptoms of the temporomandibular joint (tmj) were reported by 41% of the patients with rheumatoid arthritis, 29% of the patients with psoriatic arthritis, 20% of the patients with ankylosing spondylitis and 23% of the patients with other rheumatic diseases (such as Reiter's syndrome). Statistically significant differences (p less than 0.05) regarding the occurrence of "difficulties in opening the mouth wide" and "crepitus from the tmj" were found between the various types of rheumatic arthritis. In 40 patients with rheumatic diseases and tmj-symptoms the tmj was examined clinically, by orthopantomography and lateral tomography. Radiographic abnormalities were found in 68% of the patients and classified by a new radiographic index, according to the index of Steinbrocker. There were no indications for a relationship between a loss of posterior support and extensive radiographic changes of the tmj. The most common objective symptoms were pain on chewing, crepitus in the tmj and tenderness to palpation of the masticatory muscles and neck.

Adult↗
PubMed1990

[Diagnosis of lung function in patients with ankylosing spondylitis].

In a group of 55 men of 18 to 58 years of age who were suffering from ankylosing spondylitis, changes in lung function were analysed by measuring the static parameters and by differentiating between the thoracic and abdominal parts in breathing at rest and under stress, using CO2 rebreathing. In accordance with the reduction in vital capacity, the thoracic share is restricted already at rest. At rest, there is compensation via the abdominal compartment, in contrast to the stress in CO2 rebreathing in which the abdominal part does not compensate.

Adolescent↗
PubMed1989

Reactive fibromatosis in pustulotic arthro-osteitis.

Sterno-costo-hyperostosis is an inflammatory rheumatic disease which is associated to pustulosis palmaris et plantaris. The origin of this disorder is unknown. We described the appearance as a "reactive" fibromatosis in connection with a hyperostosis of a clavicle, which could be demonstrated in a biopsy-probe and by NMR-technique.

Adult↗
PubMed1987

Human dirofilariasis with reactive arthritis--case report and review of the literature.

A 43-year-old German man suffered from an insect bite, which was followed by a severe local inflammation and lymphadenitis. A year later, he developed dry cough, chest pain, and an oligoarthritis of the ankle and knee joints. While other causes of the symptoms could be excluded, serologic findings suggested a dirofilarial infection with reactive arthritis due to the parasite. The observation points out, that in cases of unclassifiable mono- or oligoarthritis, reactive arthritis due to parasites should be considered in the spectrum of differential diagnoses. The disease is rare at present, but its frequency might be underestimated because of the diagnostic difficulties. Dirofilarial infection should be borne in mind after a stay abroad. The present case, however, shows, that the disease also occurs in patients who had not travelled to regions of risk in recent years.

Antibodies↗
PubMed1987

Gold colitis induced by auranofin treatment of rheumatoid arthritis: case report and review of the literature.

A case of ulcerative colitis occurred during treatment of rheumatoid arthritis with the new oral gold preparation auranofin after a cumulative dose of 2160 mg. A barium enema showed loss of mucosal pattern and a rectal biopsy disclosed deep erosions, mucosal inflammation, and crypt abscesses. Precipitates of gold were seen in the periglandular stroma. On electron microscopy the gold deposits seemed to be identical to granules described in gold nephropathy. As the extrapolated serum gold level was within the normal range at the onset of the complication, the morphological findings suggested a local toxicity of the drug. The patient recovered within 14 days of withdrawal of auranofin and the start of therapy with sulphasalazine and steroids. A review of the published work shows that the previously reported mortality in gold colitis of 40% has decreased in recent years. The causes of this decrease may be both the earlier diagnosis of gold colitis and the improved intensive care of its severe complications.

Arthritis, Rheumatoid↗
PubMed1985

[Synovitis in familial Mediterranean fever].

Arthroscopy done on a 24-year-old turkish male with familial Mediterranean fever (FMF) and arthritis of the knee joint provided morphological data during the acute stage of FMF-arthritis. Main finding is a heavy granulocytic infiltration of the subsynovial stratum, similar to that seen in non-specific purulent inflammation, accompanied by marked ectasis and hyperaemia of the synovial vessels. In the microbiologically sterile synovial fluid cell counts and lactate values are found as in bacterial arthritis. The typical history and the characteristic course of the disease are indicators for the diagnosis. Serological, immunological and radiological findings are non-specific. The efficacy of prophylactic colchicine in symptomatic therapy could be verified but it is essential that the drug is taken regularly and that the patient is instructed accordingly. Investigation of other members of the family showed a high frequency of intermarriages and the presence of this autosomal-recessive inherited disease in three generations.

Adult↗