Sammelsurium (96)

Gegröle
Der Eine grölt: „ Das war nicht meine Schuld!“ Der Andere leicht nasal: „Hehe, ha ha!“ und nochmals: „Hehe, ha ha!“

Schweigen
Der Mensch neigt nicht zum Schweigen. Wo nichts zu sagen ist, kann doch nicht geschwiegen werden. Egal wo. Nah dabei ist auch die mangelnde Fähigkeit zur Kontemplation.

Wieder GeGröle
Amon und Vinzent sind mit ihren Müttern gekommen, die sich unter anderem über die Mieten in Starnberg ausTauschen: „6-700 musst Du schon bezahlen.“ „Der Arzt hat gesagt, das ist normal, Kinder müssen krank werden.“ „Das kann doch nicht schmecken. Der Amon ißt ganz viel Sand.“
Wahrscheinlich war es die Rache des Standesbeamten, dass er Amon als Namen durchGehen ließ.
Ja, Vinzent wird sich normal entwickeln, aber Amon kann nur ein Arsch bleiben. (Fazit einer ungewollten BeobachtungsStudie, einer FeldStudie)

Im Schatten
Ich sitze im Schatten, in einem Meer von Grün -: keine Politiker, keine AmokSchützen, keine FlutKatastrophe, kein Handy. ... Kein Handy.

Fibromyalgia and Pregabalin - some ideas on an old study

The pregabalin study by Crofford was looking at subjective outcome parameters like pain (primary endpoint of the study has been a reduction on the pain numeric rating scale [range 0-10] of at least 50%), but the study didn't adjust for the subjective, confounding parameters like dizziness. 15% of the placebo group patients suffered from dizziness, in the 450 mg verum group of patients (only group that had significantly more patients on a reduction of 50% in the pain scale) about 65% suffered from dizziness, however.

I see an enhanced placebo effect, that the statistics used, cannot detect. Moreover, even in the significant verum group only less than 30% reached the 50% improvement level.

(Somehow I worked ideas out that I already told you about on this blog: http://rheumatologe.blogspot.de/2011/12/what-is-lacking-in-fibromyalgia-studies.html )

04.04.2014:
I've just took the data of the study and put it in chart to compare efficacy with just one side effect (dizziness - in the chart "Schwindel"). Schwindel is the German word for dizziness/vertigo, but it also means fraud. Efficacy rises slowly with increasing the dosage of pregabalin, but the percentage of dizziness rises dramatically.

FreitagsGedichte

Die alten Stimmen

Wo sind die alten Stimmen?
Sie hallten in den Fluren
Sie flüsterten in Winkeln
Sie gaben Halt dem Haus
Sie segneten das Volk
Bisweilen riefen sie zum Krieg

Wo ihr auch seid
Ihr alten Stimmen
Wagt nicht
ZurückZuKommen


Gedanken

Ich will Gedanken sammeln
Wie sie herunterFallen
In Worten und Wörtern
In Silben und Zeichen

Ich werde sie messen
Und ich wähle aus

Timbuktu und Sansibar
StreichelEinheit und Liebe
Tod und Erkenntnis

Tocilizumab Monotherapy vs. Humira Monotherapy

In a head to head study tocilizumab monotherapy  has been studied against humira monotherapy. Tocilizumab showed significantly better results.
Here a link, ‏@RonanTKavanagh supplied: http://www.biospace.com/News/roches-actemra-beats-abbott-laboratories-drug-in/262875/Source=TopBreaking  
I'll put on the abstract, later.
One question in a pre EULAR session to this study has been, if one should discontinue methotrexate. Most agreed that one shouldn't introduce methotrexate at the same time, when you switch to tocilizumab, but not to discontinue methotrexate if the patient already is treated with methotrexate and toloerates it. There has to come a study, but until then one can only extrapolate.
Another problem might be the stronger reduction of inflammatory lab parameters. It was suggested to look at CDAI to rule out any interference by a stronger influende on these parameters by tocilizumab compared to humira.

Fibromyalgia - German Guidelines

W. Haeussler presented the revision of the German guidelines on Fibromyalgia. It's a S3 guideline. In the new version you will find lots of negative recommendations, therapies that didn't show efficacy, that could harm patients, that are off-label. All and all the guidelines show more profile. Interestingsly the great German self help organisations have worked on these guidelines as fully equal members.
Lots of what my colleagues and I have told before, I find now in these guidelines.\

I'll go into detail and supply the link to the guidelines after the EULAR meeting.

Link to the German Guidelines for FMS: http://www.awmf.org/leitlinien/detail/ll/041-004.html

Tweetup EULAR 2012 - social event

Our social event has been a great success. People didn't have problems showing up in a restaurant in one of Berlin's nice quarters. Nice restaurant, nice atmosphere, great talks. Needs to be repeated at the next meeetings. Somehow I wonder, how Ronan guessed the right number of participants.
Here's the link to the picture Ronan just has put on Twitpic:
https://twitter.com/RonanTKavanagh/status/210661744723509248/photo/1 
He removed the flag from my face - I wonder how he did it! :-)

And here is one more by Michiel @zandbelt: http://twitpic.com/9uy7wd 

Great Post on his blog! Irwin ‏@_connectedcare on his Berlin rheumination
http://bjcconnectedcare.com/2012/06/eular-2012-my-berlin-rheumination/


Another picture supplied by Francis Berenbaum ‏@Larhumato

https://twitter.com/Larhumato/status/214807655166902272/photo/1

And Chetan Narshi ‏@rheumi_  shared the following picture:

https://twitter.com/rheumi_/status/214793895349993474/photo/1 

Will be continued as time goes by.

Concerning our social meeting at:


Gugelhof, 37 Knaackstrasse, 10435 Berlin
Wednesday 19:00 / 7 pm /
Link to the map: https://maps.google.de/maps?q=Gugelhof,+Knaackstra%C3%9Fe,+Berlin&hl=de&ie=UTF8&sll=50.488025,6.535442&sspn=0.017338,0.034847&oq=gugelho&t=h&hq=Gugelhof,+Knaackstra%C3%9Fe,+Berlin&z=15


If you are at the congress, like I am now 15:00 / 3 pm sharp, you can take the S-Bahn S5 (direction Strausberg Nord) to station (Alexander Platz) and change there to line U2 (direction Pankow) to station Senefelder Platz, Gugelhof is about 150 m away.

 Concerning our scientific meeting at:


2nd floor between halls 3 (EULAR village) and 4 (Exhibition / Posters), where it's marked a on the map
Thursday 12:00-13:00
Maybe we can go then to the Cyber Village to sit down.