Monday, December 19, 2016

The Very Basic Guide to Yiddish




Yiddish isn’t a dead language. In fact there are about 0.5-1.0 speakers. The book “Unorthodox” by Deborah Feldman encouraged me to write this very basic guide to Yiddish. Yiddish has been the lingua franca of the Ashkenazim (ashkenazic Jews) in middle and Eastern Europe. Like modern German Yiddish has its roots in medieval German. But it has an own grammar and lots of word come from Hebrew and other languages. Yiddish is considered a language of its own, being part of the continental West Germanic branch of Germanic languages like Afrikaans, Dutch, German, Letzebuergisch (Luxemburgish language). Some loan words from Yiddish are still in use in nowadays German. Yiddish has several dialects, with which we won’t concern ourselves in the very basic guide.

Thank you – a dank (pronounced donk) [German: Danke]
Thank you very much – a sheynem dank [German: Schönen Dank]
You’re welcome – nishto farvos
Yes – yo [German: Ja]
No – neyn [German: Nein]
Do you speak English? – redt ir English? (formal) redstu English? (informal) [German: would prefer sprechen to reden, but still correct is: Reden Sie Englisch? Redest Du Englisch?]
Please – zayt asoy gut [German: Bitte, but „Seien Sie so gut“ would still be possible]
Excuse me – entshuldik (for getting attention) [German: Entschuldigung?!]
Sorry – zay moykh
You’re welcome – nishto farvos
Good morning – gutn morgn [German: Guten Morgen]
Good evening – gutn ovend [German: Guten Abend]
Good night – a gute nakht [German: Gute Nacht]
Hello – sholem aleykhem
Hello (answer) – aleykhem sholem
See you later – biz shpeter [German: Bis später]
Goodbye – zay gezunt
Good luck! – zol zayn mit mazel!
How are you? – vi geyt es? [German: Wie geht’s?]
I’m fine! Thanks! – es geyt gut, a dank! [German: Mir geht’s gut. Danke!]
I would like to buy ... – ikh volt vi tsu koyfn ...
How much is it? – vi tayer iz dos? [German: Wie teuer ist das? But preferably: Wieviel kostet das?]
I like – mir gefelt [German: mir gefällt]
Please write it down – shrayb es on, ikh bet dikh
I don’t know – ikh vis nit [German: ich weiß nicht]
I don’t understand this – ikh farstey dos nit [German: ich verstehe das nicht]
Where is – vu iz [German: wo ist]
Where is the bathroom? – vu iz dos bodtsimer? [German: Wo ist das Badezimmer?]
I'm lost – ikh bin farloyrn
What is your name? – vi heystu? [German: Wie heisst Du?]
My name is LMK – ikh heys LMK [German: ich heisse LMK]
Mr, Mrs, Ms – her, froy, fraylin [German: Herr, Frau, Fräulein, but Fräulein hardly in use anymore]
Left – links [German: links]
Right – rekhts [German: rechts]
I need a doctor – ikh darf a doktor

Please blame any mistakes on me.

Links for Yiddish:

Links for more Basic Guides:
The Very Basic Guide to Turkmenian, Uzbek and Kyrgyz http://rheumatologe.blogspot.de/2014/10/the-very-basic-guide-to-languages-of.html

Winter to arrive soon




Abandoned seashore
Driftwood waiting in the wind
For geese to return


Window shopping
Huge stacks of calendars
Sparrow dashes off

Red morning
Red traffic lights
Coffee to go

Neon lights
Steps in the hallway
A welcome fly

Vicissitudes
Vacuity and vainness
A Ferris wheel
 
Frosty night
The moons shivers
And the fox


Out in the open
The wanderer is happy
Leaving steps in snow

 
Leave by leave
Rotting on the ground
But the white crane

Sunday, December 18, 2016

Im Oberbergischen ohne Navi




Ich besitze kein Navi. Und normalerweise ist das völlig egal. Ich brauche es nicht und finde es störend. Aber vor einigen Tagen war ich im Dunkeln im Oberbergischen unterwegs und hatte mich verfahren. Da dachte ich, wie toll es wäre, ein Navi zu haben.

Ein Freund hatte mich zu seiner Geburtstagsfeier eingeladen. Ich bin direkt nach der Arbeit vom Niederrhein losgefahren und hatte die Strecke gut im Kopf, wie ich meinte. Einige Zeit nach der Autobahn fuhr ich in Richtung Wiehl und habe eine sehr kleine Abzweigung verpasst. Einen Kilometer später war ich mir sicher, dass ich falsch gefahren war, fuhr aber weiter, um mich neu orientieren zu können. Da war ich in Wiehl. Und da war die Bahnhofstraße. Da wieder dachte ich, ich wäre doch richtig, denn auf der Bahnhofstraße hatte ich vorgehabt zu parken. Ich suchte die Bielsteiner Straße und fand sie nicht. Stattdessen war ich in eine unbelebte Fußgängerzone geraten. Und traf auf ein älteres Ehepaar.

Ich sprach die beiden an. Und nach kurzem Überlegen erfuhr ich, dass es hier keine Bielsteiner Straße gäbe. Die Konfusion hätte bestimmt mit den Eingemeindungen zu tun. Da bemerkte ich plötzlich, dass ich den Namen des Restaurants zwei Orte weiter vergessen hatte. Aber schon fiel der Name Kranenberg. Da erinnerte ich mich wieder, denn Kranenberg ist so ähnlich wie Kranenburg. Wenn man in Köln Leitungswasser trinkt, nennt man es gerne Kranenburger. Nun in Kranenburg am Niederrhein war ich auch schon und ebenfalls zum Essen. Es stellte sich heraus, dass der Weg zum Restaurant kompliziert ist. Der ältere Herr war Architekt und hatte zudem den Umbau des Hauses Kranenberg früher durchgeführt. Netterweise fuhr er mit seiner Gattin vor mir her und lieferte mich vor dem Restaurant ab, wo sogar ein Parkplatz frei war. Ich kam nicht sehr zu spät.

Ich besitze kein Navi. Werde ich mir nun ein Navi zulegen? Ganz bestimmt nicht. Ich werde mir doch nicht die Chance verbauen, so nette und hilfsbereite Menschen kennenzulernen.


Friday, December 16, 2016

Biologics in Relapsing Polychondritis




Relapsing polychondritis is a rare, often severe, and untreated fatal connective tissue disease. The inflammation of the ear cartilage is often the initial symptom, at least in the patients, who had been referred to our center. We’re still lacking a specific lab test for relapsing polychondritis. We have different diagnostic criteria by McAdam, Damiani and Michet. I’ve already written about the disease on this blog, less than I should have considering the fact that I treat patients with this disease. There have been four abstracts at the 2016 ACR Annual Meeting. I’ll also talk about the abstracts/studies, which doesn’t concern biologics.

Guillaume Moulis and his more than 20 co-authors presented [#1329]: “Efficacy and Safety of Biologics in Relapsing Polychondritis: A National Multicenter Study in France”. Conclusion: “Overall, biologics are an interesting option for RP treatment. “ You might call this statement laconic, but there’s lots of work included. The authors saw 41 patients and had to try several drugs until one worked. The rate of partial and complete remission is about 60-70%, with anakinra and abatacept being lowest at 50-53%. The authors looked at all TNF alpha inhibitor, anakinra, abatacept, tocilizumab, and rituximab.

Marcela Ferrada and colleagues presented [#1330]: “Clinical Presentations of Relapsing Polychondritis: More Than a Swollen Ear”. The authors acquired data via an internet-based questionnaire to catalogue the variety of possible clinical presentations of relapsing polychondritis. They could evaluate 180 questionnaires. In results the authors point out: “Common initial symptoms included dizziness, eye inflammation, constochondritis, and shortness of breath, nose pain, and voice changes. Some patients also reported fatigue, flu-like symptoms, fever and difficulty swallowing as initial symptoms. Complications of RP included disability (25%), tracheomalacia (16%) and intubation related to RP (12%).”  The study has limitations as you can’t validate the diagnosis and there’s a recall bias. But still, I think the study is very valuable.

Chee Ken Cheah and collegues presented [#1331]: “Disease Patterns and Long Term Outcome Amongst Patients with Relapsing Polychondritis – Single Centre Experience”. Conclusions: “Our study revealed higher number of initial organ presentation, and younger age of disease onset correlated with potential diagnosis delay. Male gender with airway involvements correlated with higher number of organ damages and poorer outcome. Multicenter registries may lead to a better understanding of this disease.”

Toshiki Nakajima and colleagues looked at 33 patients with relapsing polychondritis in this study [#1332]: “Severe Complications and Immunosuppressive Treatments in 33 Patients with Relapsing Polychondritis”. In results the authors inform us about HLA haplotypes, which are associated with relapsing polychondritis: “Positivity of HLA-DQB1 05:02 was 17.6% (3/17), higher than 2.6% in healthy Japanese.” [The authors recently reported an association of disease onset and 3 HLA haplotypes (DQB1*05:02, B*67:01 and DRB1*16:02 in linkage disequilibrium) in C. Terao et al.: Rheumatology (Oxford) doi: 10.1093/rheumatology/kew233]. “Methotrexate (MTX), azathioprine (AZP), intravenous cyclophosphamide (IVCY), infliximab (IFX) and tocilizumab (TCZ) were used along with glucocorticoid ….” Conclusion: “The linkage with certain haplotypes of HLA and the positivity of autoantibodies (~30%) consolidate that RP is an autoimmune disease. IVCY showed a good response in patients with TB lesions in the present study. The prognosis of patients with CNS lesions was poor. Further collection of cases is required to elucidate pathophysiology and improve treatments.”

So we have different approaches according to disease severeness, organ involvement, and activity. Immunosuppressants as well as biologics are used. As the disease is rare there won’t be any randomized controlled trials and any drug will be off label. Anyway, a partial remission of 50-70% is feasible with biologics. Hopefully one can speed up approval proceedings with insurance companies because of the off label use.

Links:


Moulis G, Pugnet G, Costedoat-Chalumeau N, Mathian A, Leroux G, Boutemy J, Bouillet L, Berthier S, Gaultier JB, Jeandel PY, Konaté A, Mékinian A, Solau-Gervais E, Terrier B, Wendling D, Garnier C, Cathebras P, Arnaud L, Cacoub P, Amoura Z, Piette JC, Arlet P, Palmaro A, Lapeyre-Mestre M, Sailler L. Efficacy and Safety of Biologics in Relapsing Polychondritis: A National Multicenter Study in France [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). http://acrabstracts.org/abstract/efficacy-and-safety-of-biologics-in-relapsing-polychondritis-a-national-multicenter-study-in-france/. Accessed December 15, 2016.

Ferrada M, Choudhury SD, Newman K, Sinaii N, Guma M, Christie T, Katz JD. Clinical Presentations of Relapsing Polychondritis: More Than a Swollen Ear [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). http://acrabstracts.org/abstract/clinical-presentations-of-relapsing-polychondritis-more-than-a-swollen-ear/. Accessed December 15, 2016.

Cheah CK, Sangle (Joint First Author) S, D'Cruz D. Disease Patterns and Long Term Outcome Amongst Patients with Relapsing Polychondritis – Single Centre Experience [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). http://acrabstracts.org/abstract/disease-patterns-and-long-term-outcome-amongst-patients-with-relapsing-polychondritis-single-centre-experience/. Accessed December 15, 2016.

Nakajima T, Yoshifuji H, Terao C, Murakami K, Kuramoto N, Nakashima R, Imura Y, Tanaka M, Ohmura K, Mimori T. Severe Complications and Immunosuppressive Treatments in 33 Patients with Relapsing Polychondritis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). http://acrabstracts.org/abstract/severe-complications-and-immunosuppressive-treatments-in-33-patients-with-relapsing-polychondritis/. Accessed December 15, 2016.