Among all laboratory parameters used today in the assessment of activity and progression of rheumatoid arthritis erythrocyte sedimentation rate (ESR) can only be recommended reservedly. ESR is influenced by anemia, reduction of plasma fibrinogen, dysproteinemia and by the concentration of acute phase proteins. Quantification of acute phase proteins especially of the C-reactive protein (CRP) correlates best with activity and progression of early forms of rheumatoid arthritis as well as with malignant courses. During the administration of alkylating agents - rise of ESR in spite of clinical improvement and decrease of CRP - and during antimalarials - clinical improvement, decrease of CRP and constant, unchanged ESR - the quantification of CRP turns out to be superior to ESR.

Acute-Phase Proteins↗

PubMedDate not supplied

[P-phenomenon in the synovial fluid].

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Animals↗

PubMedDate not supplied

[Effect of cyclophosphamide (Endoxan) on experimental arthritis in rabbits].

The experimental investigation is divided into 3 parts: Firstly, it was assessed that cyclophosphamide (Cp) in different dosages was well tolerated locally when injected into the knee joint of normal rabbits as compared to saline controls on the basis of histology and cell count determination of the injected joints. In a second series of experiments a hyperimmune arthritis (HIA) was produced in rabbits by systemic administration of albumin, complete Freund's adjuvant and intraarticular stimulus by ovalbumin. Histological examination of synovial membranes reveal alterations similar to those of human rheumatoid arthritis on the 7th day after stimulus. Further experiments were aimed at assessing if Cp exerted an inhibitory effect on the 7 day old HIA. Cp in a dosage of 10 mg has been applied intraarticularly in various intervals prior, simultaneously and after the elicitation of HIA. It could be demonstrated that Cp led to a reduction of the number of lymphocytes, plasma cells and fibroblasts in the synovial membrane, the inhibitory effect on fibroblasts was bound to its administration around the point of HIA elicitation, an even stronger inhibition of lymphocytes and plasma-cells was only to be expected when Cp was applied 48 hours after ovalbumin challenge. Unwanted reactions in the course of Cp administration such as superficial and deep necrosis as well as damage of blood vessels in the synovial membrane combined with minor inhibition of lymphocytes and plasma cells were encountered when Cp was injected 120 hours after HIA elicitation. These new experimental results lead to the conclusion that efficacy and unwanted reactions during Cp administration are related to a local activation of the substance in the inflammatory milieu of HIA. Furthermore we were able to demonstrate that even the sole application of Cp if injected shortly before immigration of lymphocytes into the synovial tissue led to a marked suppression of almost all histological parameters of HIA. Our experimental findings strongly support the importance of lymphocytes and plasma cells being inactivated for the successful treatment of adult rheumatoid arthritis. They grow to consider the formation of necrosis and damage of blood vessels as sequelae of too fast a local activation of Cp in the inflammatory tissue.

Animals↗

PubMedDate not supplied

[Interactions between diclofenac and glibenclamide].

24 diabetic patients, well controlled on Glibenclamid and a standard diet, were randomised for a doubleblind study with Diclofenac und placebo. After 3 days during which the fasting blood sugar and urine sugar were determined, 12 patients received Diclofenac, 12 patients placebo. Determinations of blood and urine sugar of the following 4 days and comparison of the two groups did not reveal any differences. Mean values of blood sugar of the first three days compared with the blood sugar of days of medication did not show significant changes. Considering this investigation it can be assumed that there is no interaction between Glibenclamid and Diclofenac.

Adult↗

PubMedDate not supplied

[Treatment of osteoporosis with a delayed-action sodium fluoride preparation].

40 patients with various types of osteoporosis, aged 17 to 76 years, were treated for 12 months with a new NaF-drug (Ossiplex-Retard, film tbl. 25 mg NaF plus 200 mg vitamine C). Daily dosage was 50-100 mg. Clinical symptoms, X-ray-status of the axial skeleton, alkaline serum phosphatase and the consumption of analgetics were used for assessment. 2/3 of the patients with presenile and steroid induced osteoporosis responded well to treatment, while those with osteogenesis imperfecta, idiopathic osteoporosis and plasmocytosis did not show clinical or radiological improvement. In senile osteoporosis, a physiological process of aging, should only be given NaF-treatment, if fractures without callus formation are present. Harmless side effects, (gastrointestinal intolerance in 15% and a painful tendoperiostosis syndrome in 12.5%), necessitated discontinuation of treatment in 3 cases. The NaF-drug with added vitamine C has less side effects than other NaF-containing compounds and should therefore be included as part of the therapeutical regimen of certain types of osteoporosis.

Adolescent↗