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Biomedical subjects

H Müller-Fassbender

Publications and source records attributed to H Müller-Fassbender.

At least 19 recordsLinked to original sources

[Radiologic findings in gout].

Radiological gout manifestations are detectable in the early stage, but also especially in the chronic stage of gout. Whereas in the early stage only soft tissue mutations (bursitis inflammation) and light calcium deposits are usually discernible, chronic gout leads to asymmetrical, diverse forms of osseous destruction, favouring smaller joints, but also affecting larger ones, which are caused by the intra-articular and extra-articular deposit of tophus material, corresponding to the progression and degree of severity of the illness. Radiologically-detectable changes in other organs, such as the kidneys, will be addressed. The high number of, and to some extent very characteristic, osseous mutations are compared with those mutations which are very similar to the diagnoses of other syndromes affecting the joints. Specifically, problems in differentiating diagnosis of rheumatoid arthritis, arthritis psoriatica, chondrocalcinosis, and other diseases of the joints will receive special mention. Reference is also made to the extreme diagnostic difficulties resulting from the rare but nevertheless conceivable influence of gout on the spine or sacroiliac joints. The method of magnetic resonance imaging for gout shows a characteristic signal behaviour of the tophus material. It has been determined that, through magnetic resonance tomography, interosseous tophi can be detected earlier and in a more widespread manner than with the aid of native X-ray images, such that an increase in the use of this method is to be expected.

Arthritis, Gouty↗

Glucosamine sulfate compared to ibuprofen in osteoarthritis of the knee.

Glucosamine sulfate is able to stimulate proteoglycan synthesis by chondrocytes and has mild anti-inflammatory properties. In clinical trials, glucosamine sulfate was more effective than placebo in controlling the symptoms of osteoarthritis (OA). In order to better characterize this therapeutic activity, we conducted a randomized, double-blind, parallel-group study of glucosamine sulfate 500 mg t.i.d. vs ibuprofen 400 mg t.i.d., orally for 4 weeks. The study included 200 hospitalized patients with active OA of the knee, symptoms for at least 3 months and a Lequesne's index of at least 7 points. Patients were evaluated weekly. Response was defined as a reduction in the Lequesne's index by at least 2 points if the enrollment value was higher than 12 points, or by at least 1 point if the enrollment value was 12 or less points, together with a positive overall assessment by the investigator. The improvement tended to be sooner under ibuprofen (48% responders vs 28% after the 1st treatment week; P = 0.06, Fisher's Exact test), but there was no difference from the 2nd week onward, with a success rate of 52% in the ibuprofen group and of 48% in the glucosamine group (P = 0.67) at the end of treatment. The average Lequesne's index at enrollment was around 16 points and decreased by over 6 points in both groups, again with the above described trend. On the other hand, 35% of patients on ibuprofen reported adverse events, mainly of gastrointestinal origin, vs 6% adverse events with glucosamine (P < 0.001, Fisher's Exact test). The number of adverse event related drop-outs was different between the two groups (7% vs 1%, respectively; P = 0.035). Glucosamine sulfate was therefore as effective as ibuprofen on symptoms of knee OA. These data confirm glucosamine sulfate as a safe symptomatic Slow Acting Drug for OA.

Administration, Oral↗

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↗

Double-blind clinical trial of S-adenosylmethionine versus ibuprofen in the treatment of osteoarthritis.

Thirty-six subjects with osteoarthritis of the knee, the hip, and/or the spine were enrolled in a randomized double-blind study. Patients received a daily oral dose of 1,200 mg of S-adenosylmethionine (SAMe) or 1,200 mg of ibuprofen for four weeks. Morning stiffness, pain at rest, pain on motion, crepitus, swelling, and limitation of motion of the affected joints were assessed before and after treatment. The total score obtained by the evaluation of all the individual clinical parameters improved to the same extent in patients treated with SAMe or ibuprofen. Both treatments were well tolerated and no patient from either group withdrew from the study.

Adult↗

[Comparative study of piroxicam and indomethacin retard in arthroses].

Indomethacin retard and piroxicam (Felden) were compared in an open, randomized parallel study in the treatment of osteoarthritis. Improvement of the symptoms of the disease was highly significant for both drugs. A statistical difference in the efficacy was not proved. Number and duration of the side effects were significantly lower with piroxicam than with indomethacin retard. Piroxicam was only applied once a day. Indomethacin retard was always (43% of the cases) or sometimes (14%) applied twice daily.

Arthritis, Rheumatoid↗

Tizanidine (DS 103-282) in the treatment of acute paravertebral muscle spasm: a controlled trial comparing tizanidine and diazepam.

In a double-blind trial tizanidine (DS 103-282: 5-Chloro-4-(2-imidazolin-2-yl-amino)-2,1,3-benzothiadiazole), a new muscle relaxant, was compared with diazepam in twenty in-patients suffering from acute paravertebral muscle spasm. All the patients had suffered from degenerative spinal disease for some years. Ten patients received tizanidine and the other ten received diazepam. Both drugs were administered t.i.d. for a period of 7 days. Significant improvements were reported in eight of the sixteen variables. Tizanidine was significantly superior to diazepam for two of these variables (lateral flexion of the lumbar spine, right and left). A centrally mediated blood-pressure-lowering effect was observed with both drugs. Tizanidine was generally better tolerated, only two patients reporting transient side-effects compared with five patients in the diazepam group. Like diazepam, tizanidine is a suitable drug for the treatment of acute paravertebral muscle spasm.

Acute Disease↗

[Prevention of re-occlusion after recanalisation of occluded arteries by the catheter method (author's transl)].

In a double-blind study, prevention of re-thrombosis was tested on 101 patients in whom stenosis or segmental occlusion of a large artery of the lower limbs had been successfully removed by the intraluminal catheter method. The combination of 75 mg dipyridamol and 330 mg acetylsalicylic acid, three times daily by mouth, proved to be slightly more effective than acetylsalicylic acid alone at the same dosage. In the group with the combined treatment 84% of the arteries remained open, compared with 70% on acetylsalicylic acid alone.

Arterial Occlusive Diseases↗

[Sjögren's syndrome with pulmonary fibrosis. A case report (author's transl)].

The case is pointing to two remarkable facts: 1. Sjögren's syndrome may also be proceeding--without demonstrating any inflammatory rheumatic symptoms--with an isolated pulmonary fibrosis, as it had been evident in another case mentioned. 2. In certain circumstances, it may be considerably difficult to differentiate, with reliable certainty, the morphological changes in the salivary gland from those of a malignant lymphoma. Besides, also in literature there are reports concerning malignant degeneration turning into malignant lymphomata [1,8] in cases of Sjögren's syndrome.

Adult↗

A long-term study of benorylate in patients with rheumatoid arthritis.

The analgesic and anti-inflammatory efficacy and adverse effects of benorylate were studied over a period of 6 months in 33 patients suffering from definite or classical rheumatoid arthritis. The average dose used was 6 g daily and examinations were made before treatment and at regular intervals during treatment to assess the clinical status of the patient, tolerance to the drug and any effect on blood, liver or renal function. Benorylate had a satisfactory effect in 28 patients. Additional treatment was requried in 3 cases and treatment discontinued in 2 cases. Distinct improvement of grip strength, morning stiffness and E.S.R. in 25 cases indicates the anti-inflammatory efficacy of benorylate. There were no signs of toxicity to bone marrow, liver or kidney. Severe side effects such as stomch ulcers, gastrointestinal bleeding and severe allergic complications were not observed. Side effects such as constipation and tinnitus that occurred at the beginning of treatment were mainly of a a passing nature and disappeared without a need to change therapy. Benorylate is suitable for the treatment of recent rheumatoid arthritis of a low to moderate activity as well as for long-term treatment.

Arthritis, Rheumatoid↗