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Biomedical subjects

W Biewer

Publications and source records attributed to W Biewer.

5 recordsLinked to original sources
PubMed2004

[Fibromyalgia].

Within clinical practice fibromyalgia is diagnosed according to the classification criteria of the American College of Rheumatology. The examination of the tender points is still to be standardized. By using additional diagnostic criteria fibromyalgia changes into a polysymptomatic syndrom with multiple functional and psychic symptoms. The prevalence of FMS is estimated to range between 1,3-4,8% in the general population. Relative hypocortisolism, sensory hypervigilance, adverse life experiences and psychiatric disorders are discussed as main pathophysiological mechanisms. There are no evidence-based guidelines of scientific societies for the management of fibromyalgia available. Patient education, medical training therapy, physical therapy (heat or cold) and relaxation therapy are recommended. There is a moderate evidence for the effectiveness of tricyclic antidepressants and aerobic training. The effectiveness of multicomponent therapy in fibromyalgia is still to be demonstrated.

Diagnosis, Differential↗
PubMed1997

[Pain management in patients with chronic rheumatic pain--a model for primary medical care].

A rheumatologist and a medical psychotherapist collaborate in offering periodically a cognitive behavioral treatment program for pain control for the patients of a rheumatological practice. The program consists of a biopsychosocial model of chronic pain, individualized relaxation training combining progressive muscle relaxation and some elements of autogenous training and meditation, several attention-related techniques and cognitive restructuring. From 1993 to 1995, 50 patients took part in five training courses. The compliance of the patients was satisfactory and the drop-out rate low (8%). In a post hoc interview 4 weeks later and another 2 years after the end of the training most of the patients assessed the program as useful for reduction of pain, increase of activity and enhancement of mood. Psychotherapeutic experience in group therapy or special training for non-psychotherapeutic physicians with continuous supervision is necessary in order to conduct a qualified treatment program. Within medical primary care, rheumatologists can motivate their patients towards active pain management, which can help to prepare patients for further psychotherapy in cases with psychiatric disorders and/or severe psychosocial strains.

English Abstract↗
PubMed1991

[Helicobacter pylori colonization of the gastric mucosa in rheumatic patients].

This study examines whether infections with Helicobacter pylori are more frequent in patients suffering from rheumatoid arthritis than in patients with non-inflammatory rheumatic diseases. The study furthermore examines whether the colonisation by H. pylori is favoured by antiphlogistic-antirheumatic treatment. For this purpose gastric biopsies obtained by endoscopy from 123 patients were histologically evaluated for the presence of H. pylori. 85 patients with rheumatoid arthritis were compared with 38 patients with non-inflammatory rheumatic diseases. Although an increased susceptibility for infections can be expected in persons with rheumatoid arthritis undergoing long-term antirheumatic treatment, this could not be confirmed by our results for the colonisation of the stomach by H. pylori. It is therefore statistically confirmed that rheumatoid arthritis itself and treatment with short-term effective antirheumatic drugs has no significant influence on the colonisation rate. Still it is doubtful whether any lesion associated with NSAR and H. pylori must necessarily be considered an NSAR-"induced". Future studies will have to elaborate whether NSAR in H. pylori infected mucosa will lead to higher incidence of damage.

Adult↗
PubMed1988

[Ranitidine in the treatment of non-steroidal anti-inflammatory agent-induced damage of the stomach and duodenal mucosa. Results of a randomized, placebo-controlled double-blind study in patients with rheumatic diseases].

46 patients with rheumatic diseases suffering from dyspepsia and endoscopically proven gastroduodenal lesions entered a double-blind placebo-controlled study with ranitidine 150 mg b.i.d. over 4-8 weeks. The patients had to be treated for at least 3 months with the non-steroidal antiinflammatory drugs (NSAID) Diclofenac, Indomethacin, and Piroxicam before entering the study. During the trial all patients had to continue on NSAID. At entry patients in the placebo group (n = 23) had a total number of 33 gastrointestinal lesions of grade 1-3. In the ranitidine group (n = 23) a total number of 28 gastrointestinal lesions had been counted. After 4 weeks of treatment the number of lesions had been reduced in the placebo group to 20 and in the ranitidine group to 6 (p less than 0.05). The total damaging score at entry averaging 2.0 under placebo and 1.0 under ranitidine had been reduced to 1.3 (placebo) and 0.3 (ranitidine). (p less than 0.05). Our results underline the efficacy of ranitidine in the treatment of NSAID-induced gastroduodenal mucosal lesions.

Anti-Inflammatory Agents, Non-Steroidal↗