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Publisher: Springer-Verlag (Total: 2350 journals)

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Showing 1 - 200 of 2350 Journals sorted alphabetically
3D Printing in Medicine     Open Access  
3D Research     Hybrid Journal   (Followers: 20, SJR: 0.214, h-index: 10)
4OR: A Quarterly J. of Operations Research     Hybrid Journal   (Followers: 10, SJR: 1.073, h-index: 25)
AAPS J.     Hybrid Journal   (Followers: 21, SJR: 1.192, h-index: 74)
AAPS PharmSciTech     Hybrid Journal   (Followers: 7, SJR: 0.718, h-index: 54)
Abdominal Imaging     Hybrid Journal   (Followers: 14, SJR: 0.723, h-index: 60)
Abhandlungen aus dem Mathematischen Seminar der Universitat Hamburg     Hybrid Journal   (Followers: 4, SJR: 0.447, h-index: 12)
Academic Psychiatry     Full-text available via subscription   (Followers: 23, SJR: 0.492, h-index: 32)
Academic Questions     Hybrid Journal   (Followers: 8, SJR: 0.135, h-index: 6)
Accreditation and Quality Assurance: J. for Quality, Comparability and Reliability in Chemical Measurement     Hybrid Journal   (Followers: 26, SJR: 0.378, h-index: 30)
Acoustical Physics     Hybrid Journal   (Followers: 11, SJR: 0.355, h-index: 20)
Acoustics Australia     Hybrid Journal  
Acta Analytica     Hybrid Journal   (Followers: 7, SJR: 0.387, h-index: 6)
Acta Applicandae Mathematicae     Hybrid Journal   (Followers: 1, SJR: 0.624, h-index: 34)
Acta Biotheoretica     Hybrid Journal   (Followers: 4, SJR: 0.419, h-index: 25)
Acta Diabetologica     Hybrid Journal   (Followers: 17, SJR: 1.318, h-index: 46)
Acta Endoscopica     Hybrid Journal   (Followers: 1, SJR: 0.113, h-index: 8)
acta ethologica     Hybrid Journal   (Followers: 4, SJR: 0.465, h-index: 23)
Acta Geochimica     Hybrid Journal   (Followers: 6)
Acta Geodaetica et Geophysica     Hybrid Journal   (Followers: 2, SJR: 0.294, h-index: 13)
Acta Geotechnica     Hybrid Journal   (Followers: 7, SJR: 1.818, h-index: 22)
Acta Informatica     Hybrid Journal   (Followers: 5, SJR: 0.524, h-index: 32)
Acta Mathematica     Hybrid Journal   (Followers: 12, SJR: 8.021, h-index: 47)
Acta Mathematica Hungarica     Hybrid Journal   (Followers: 2, SJR: 0.53, h-index: 29)
Acta Mathematica Sinica, English Series     Hybrid Journal   (Followers: 6, SJR: 0.406, h-index: 30)
Acta Mathematica Vietnamica     Hybrid Journal   (SJR: 0.451, h-index: 5)
Acta Mathematicae Applicatae Sinica, English Series     Hybrid Journal   (SJR: 0.22, h-index: 20)
Acta Mechanica     Hybrid Journal   (Followers: 21, SJR: 0.898, h-index: 52)
Acta Mechanica Sinica     Hybrid Journal   (Followers: 5, SJR: 0.426, h-index: 29)
Acta Metallurgica Sinica (English Letters)     Hybrid Journal   (Followers: 7, SJR: 0.525, h-index: 18)
Acta Meteorologica Sinica     Hybrid Journal   (Followers: 3, SJR: 0.524, h-index: 14)
Acta Neurochirurgica     Hybrid Journal   (Followers: 6, SJR: 0.833, h-index: 73)
Acta Neurologica Belgica     Hybrid Journal   (Followers: 1, SJR: 0.348, h-index: 27)
Acta Neuropathologica     Hybrid Journal   (Followers: 5, SJR: 6.61, h-index: 117)
Acta Oceanologica Sinica     Hybrid Journal   (Followers: 3, SJR: 0.295, h-index: 17)
Acta Parasitologica     Hybrid Journal   (Followers: 10, SJR: 0.581, h-index: 28)
Acta Physiologiae Plantarum     Hybrid Journal   (Followers: 2, SJR: 0.551, h-index: 39)
Acta Politica     Hybrid Journal   (Followers: 13, SJR: 0.658, h-index: 20)
Activitas Nervosa Superior     Hybrid Journal  
adhäsion KLEBEN & DICHTEN     Hybrid Journal   (Followers: 6, SJR: 0.103, h-index: 4)
ADHD Attention Deficit and Hyperactivity Disorders     Hybrid Journal   (Followers: 22, SJR: 0.871, h-index: 15)
Adhesion Adhesives & Sealants     Hybrid Journal   (Followers: 9)
Administration and Policy in Mental Health and Mental Health Services Research     Partially Free   (Followers: 15, SJR: 0.795, h-index: 40)
Adsorption     Hybrid Journal   (Followers: 4, SJR: 0.774, h-index: 52)
Advances in Applied Clifford Algebras     Hybrid Journal   (Followers: 4, SJR: 0.319, h-index: 15)
Advances in Atmospheric Sciences     Hybrid Journal   (Followers: 36, SJR: 0.959, h-index: 44)
Advances in Computational Mathematics     Hybrid Journal   (Followers: 19, SJR: 1.255, h-index: 44)
Advances in Contraception     Hybrid Journal   (Followers: 3)
Advances in Data Analysis and Classification     Hybrid Journal   (Followers: 51, SJR: 1.113, h-index: 14)
Advances in Gerontology     Partially Free   (Followers: 8, SJR: 0.141, h-index: 3)
Advances in Health Sciences Education     Hybrid Journal   (Followers: 27, SJR: 1.397, h-index: 42)
Advances in Manufacturing     Hybrid Journal   (Followers: 3, SJR: 0.2, h-index: 4)
Advances in Polymer Science     Hybrid Journal   (Followers: 43, SJR: 0.637, h-index: 89)
Advances in Therapy     Hybrid Journal   (Followers: 5, SJR: 0.79, h-index: 44)
Aegean Review of the Law of the Sea and Maritime Law     Hybrid Journal   (Followers: 6)
Aequationes Mathematicae     Hybrid Journal   (Followers: 2, SJR: 0.882, h-index: 23)
Aerobiologia     Hybrid Journal   (Followers: 3, SJR: 0.511, h-index: 36)
Aesthetic Plastic Surgery     Hybrid Journal   (Followers: 9, SJR: 0.821, h-index: 49)
African Archaeological Review     Hybrid Journal   (Followers: 16, SJR: 0.612, h-index: 24)
Afrika Matematika     Hybrid Journal   (Followers: 1, SJR: 0.248, h-index: 6)
AGE     Hybrid Journal   (Followers: 7, SJR: 1.358, h-index: 33)
Ageing Intl.     Hybrid Journal   (Followers: 7, SJR: 0.337, h-index: 10)
Aggiornamenti CIO     Hybrid Journal   (Followers: 1)
Aging Clinical and Experimental Research     Hybrid Journal   (Followers: 3, SJR: 0.529, h-index: 55)
Agricultural Research     Hybrid Journal   (Followers: 4)
Agriculture and Human Values     Hybrid Journal   (Followers: 14, SJR: 1.197, h-index: 49)
Agroforestry Systems     Hybrid Journal   (Followers: 19, SJR: 0.64, h-index: 56)
Agronomy for Sustainable Development     Hybrid Journal   (Followers: 11, SJR: 1.732, h-index: 59)
AI & Society     Hybrid Journal   (Followers: 8, SJR: 0.171, h-index: 19)
AIDS and Behavior     Hybrid Journal   (Followers: 13, SJR: 2.006, h-index: 71)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 4, SJR: 0.706, h-index: 19)
Akupunktur & Aurikulomedizin     Full-text available via subscription   (Followers: 1)
Algebra and Logic     Hybrid Journal   (Followers: 5, SJR: 0.566, h-index: 18)
Algebra Universalis     Hybrid Journal   (Followers: 2, SJR: 0.388, h-index: 22)
Algebras and Representation Theory     Hybrid Journal   (Followers: 1, SJR: 0.868, h-index: 20)
Algorithmica     Hybrid Journal   (Followers: 8, SJR: 0.898, h-index: 56)
Allergo J.     Full-text available via subscription   (Followers: 1, SJR: 0.183, h-index: 20)
Allergo J. Intl.     Hybrid Journal   (Followers: 2)
Alpine Botany     Hybrid Journal   (Followers: 5, SJR: 0.729, h-index: 20)
ALTEX : Alternatives to Animal Experimentation     Open Access   (Followers: 3, SJR: 1.392, h-index: 32)
AMBIO     Hybrid Journal   (Followers: 11, SJR: 1.094, h-index: 87)
American J. of Cardiovascular Drugs     Hybrid Journal   (Followers: 16, SJR: 0.864, h-index: 39)
American J. of Community Psychology     Hybrid Journal   (Followers: 27, SJR: 1.237, h-index: 83)
American J. of Criminal Justice     Hybrid Journal   (Followers: 8, SJR: 0.634, h-index: 13)
American J. of Cultural Sociology     Hybrid Journal   (Followers: 15, SJR: 0.283, h-index: 3)
American J. of Dance Therapy     Hybrid Journal   (Followers: 4, SJR: 0.175, h-index: 13)
American J. of Potato Research     Hybrid Journal   (Followers: 2, SJR: 0.558, h-index: 35)
American J. of Psychoanalysis     Hybrid Journal   (Followers: 20, SJR: 0.293, h-index: 13)
American Sociologist     Hybrid Journal   (Followers: 12, SJR: 0.18, h-index: 13)
Amino Acids     Hybrid Journal   (Followers: 8, SJR: 1.362, h-index: 83)
AMS Review     Partially Free   (Followers: 4)
Analog Integrated Circuits and Signal Processing     Hybrid Journal   (Followers: 7, SJR: 0.21, h-index: 37)
Analysis and Mathematical Physics     Hybrid Journal   (Followers: 5, SJR: 0.665, h-index: 7)
Analysis in Theory and Applications     Hybrid Journal   (Followers: 1)
Analysis of Verbal Behavior     Hybrid Journal   (Followers: 5)
Analytical and Bioanalytical Chemistry     Hybrid Journal   (Followers: 32, SJR: 1.096, h-index: 123)
Anatomical Science Intl.     Hybrid Journal   (Followers: 2, SJR: 0.301, h-index: 26)
Angewandte Schmerztherapie und Palliativmedizin     Hybrid Journal  
Angiogenesis     Hybrid Journal   (Followers: 3, SJR: 2.212, h-index: 69)
Animal Cognition     Hybrid Journal   (Followers: 18, SJR: 1.122, h-index: 55)
Annales françaises de médecine d'urgence     Hybrid Journal   (Followers: 1, SJR: 0.156, h-index: 4)
Annales Henri Poincaré     Hybrid Journal   (Followers: 3, SJR: 1.377, h-index: 32)
Annales mathématiques du Québec     Hybrid Journal   (Followers: 4)
Annali dell'Universita di Ferrara     Hybrid Journal   (SJR: 0.504, h-index: 14)
Annali di Matematica Pura ed Applicata     Hybrid Journal   (Followers: 1, SJR: 1.167, h-index: 26)
Annals of Biomedical Engineering     Hybrid Journal   (Followers: 18, SJR: 1.182, h-index: 94)
Annals of Combinatorics     Hybrid Journal   (Followers: 4, SJR: 0.849, h-index: 15)
Annals of Data Science     Hybrid Journal   (Followers: 11)
Annals of Dyslexia     Hybrid Journal   (Followers: 10, SJR: 0.857, h-index: 40)
Annals of Finance     Hybrid Journal   (Followers: 29, SJR: 0.686, h-index: 14)
Annals of Forest Science     Hybrid Journal   (Followers: 7, SJR: 0.929, h-index: 57)
Annals of Global Analysis and Geometry     Hybrid Journal   (Followers: 1, SJR: 1.136, h-index: 23)
Annals of Hematology     Hybrid Journal   (Followers: 16, SJR: 1.117, h-index: 62)
Annals of Mathematics and Artificial Intelligence     Hybrid Journal   (Followers: 12, SJR: 0.593, h-index: 42)
Annals of Microbiology     Hybrid Journal   (Followers: 10, SJR: 0.402, h-index: 26)
Annals of Nuclear Medicine     Hybrid Journal   (Followers: 4, SJR: 0.68, h-index: 45)
Annals of Operations Research     Hybrid Journal   (Followers: 10, SJR: 1.186, h-index: 78)
Annals of Ophthalmology     Hybrid Journal   (Followers: 12)
Annals of Regional Science     Hybrid Journal   (Followers: 7, SJR: 0.405, h-index: 42)
Annals of Software Engineering     Hybrid Journal   (Followers: 13)
Annals of Solid and Structural Mechanics     Hybrid Journal   (Followers: 9, SJR: 0.553, h-index: 8)
Annals of Surgical Oncology     Hybrid Journal   (Followers: 14, SJR: 1.902, h-index: 127)
Annals of Telecommunications     Hybrid Journal   (Followers: 9, SJR: 0.315, h-index: 25)
Annals of the Institute of Statistical Mathematics     Hybrid Journal   (Followers: 1, SJR: 0.931, h-index: 31)
Antonie van Leeuwenhoek     Hybrid Journal   (Followers: 5, SJR: 0.992, h-index: 87)
Apidologie     Hybrid Journal   (Followers: 4, SJR: 1.14, h-index: 57)
APOPTOSIS     Hybrid Journal   (Followers: 8, SJR: 1.554, h-index: 87)
Applicable Algebra in Engineering, Communication and Computing     Hybrid Journal   (Followers: 2, SJR: 0.354, h-index: 27)
Applications of Mathematics     Hybrid Journal   (Followers: 2, SJR: 0.274, h-index: 20)
Applied Biochemistry and Biotechnology     Hybrid Journal   (Followers: 42, SJR: 0.575, h-index: 80)
Applied Biochemistry and Microbiology     Hybrid Journal   (Followers: 16, SJR: 0.267, h-index: 26)
Applied Cancer Research     Open Access  
Applied Categorical Structures     Hybrid Journal   (Followers: 2, SJR: 0.361, h-index: 21)
Applied Composite Materials     Hybrid Journal   (Followers: 49, SJR: 0.705, h-index: 35)
Applied Entomology and Zoology     Partially Free   (Followers: 3, SJR: 0.554, h-index: 34)
Applied Geomatics     Hybrid Journal   (Followers: 3, SJR: 0.323, h-index: 9)
Applied Geophysics     Hybrid Journal   (Followers: 8, SJR: 0.541, h-index: 13)
Applied Intelligence     Hybrid Journal   (Followers: 11, SJR: 0.777, h-index: 43)
Applied Magnetic Resonance     Hybrid Journal   (Followers: 4, SJR: 0.358, h-index: 34)
Applied Mathematics & Optimization     Hybrid Journal   (Followers: 6, SJR: 0.955, h-index: 33)
Applied Mathematics - A J. of Chinese Universities     Hybrid Journal   (SJR: 0.275, h-index: 8)
Applied Mathematics and Mechanics     Hybrid Journal   (Followers: 5, SJR: 0.37, h-index: 26)
Applied Microbiology and Biotechnology     Hybrid Journal   (Followers: 63, SJR: 1.262, h-index: 161)
Applied Physics A     Hybrid Journal   (Followers: 9, SJR: 0.535, h-index: 121)
Applied Physics B: Lasers and Optics     Hybrid Journal   (Followers: 24, SJR: 0.983, h-index: 104)
Applied Psychophysiology and Biofeedback     Hybrid Journal   (Followers: 8, SJR: 0.677, h-index: 47)
Applied Research in Quality of Life     Hybrid Journal   (Followers: 11, SJR: 0.288, h-index: 15)
Applied Solar Energy     Hybrid Journal   (Followers: 18, SJR: 0.251, h-index: 6)
Applied Spatial Analysis and Policy     Hybrid Journal   (Followers: 4, SJR: 0.351, h-index: 9)
Aquaculture Intl.     Hybrid Journal   (Followers: 22, SJR: 0.613, h-index: 40)
Aquarium Sciences and Conservation     Hybrid Journal   (Followers: 1)
Aquatic Ecology     Hybrid Journal   (Followers: 33, SJR: 0.646, h-index: 44)
Aquatic Geochemistry     Hybrid Journal   (Followers: 4, SJR: 0.764, h-index: 39)
Aquatic Sciences     Hybrid Journal   (Followers: 13, SJR: 1.172, h-index: 53)
Arabian J. for Science and Engineering     Hybrid Journal   (Followers: 5, SJR: 0.345, h-index: 20)
Arabian J. of Geosciences     Hybrid Journal   (Followers: 2, SJR: 0.417, h-index: 16)
Archaeological and Anthropological Sciences     Hybrid Journal   (Followers: 20, SJR: 1.056, h-index: 15)
Archaeologies     Hybrid Journal   (Followers: 12, SJR: 0.397, h-index: 13)
Archiv der Mathematik     Hybrid Journal   (Followers: 1, SJR: 0.597, h-index: 29)
Archival Science     Hybrid Journal   (Followers: 58, SJR: 0.804, h-index: 22)
Archive for History of Exact Sciences     Hybrid Journal   (Followers: 8, SJR: 0.28, h-index: 15)
Archive for Mathematical Logic     Hybrid Journal   (Followers: 2, SJR: 0.946, h-index: 23)
Archive for Rational Mechanics and Analysis     Hybrid Journal   (SJR: 4.091, h-index: 66)
Archive of Applied Mechanics     Hybrid Journal   (Followers: 5, SJR: 0.865, h-index: 40)
Archives and Museum Informatics     Hybrid Journal   (Followers: 140)
Archives of Computational Methods in Engineering     Hybrid Journal   (Followers: 5, SJR: 2.841, h-index: 40)
Archives of Dermatological Research     Hybrid Journal   (Followers: 7, SJR: 0.9, h-index: 65)
Archives of Environmental Contamination and Toxicology     Hybrid Journal   (Followers: 14, SJR: 0.846, h-index: 84)
Archives of Gynecology and Obstetrics     Hybrid Journal   (Followers: 16, SJR: 0.695, h-index: 47)
Archives of Microbiology     Hybrid Journal   (Followers: 8, SJR: 0.702, h-index: 85)
Archives of Orthopaedic and Trauma Surgery     Hybrid Journal   (Followers: 8, SJR: 1.039, h-index: 56)
Archives of Osteoporosis     Hybrid Journal   (Followers: 2, SJR: 1.092, h-index: 13)
Archives of Sexual Behavior     Hybrid Journal   (Followers: 10, SJR: 1.198, h-index: 74)
Archives of Toxicology     Hybrid Journal   (Followers: 17, SJR: 1.595, h-index: 76)
Archives of Virology     Hybrid Journal   (Followers: 5, SJR: 1.086, h-index: 90)
Archives of Women's Mental Health     Hybrid Journal   (Followers: 14, SJR: 1.264, h-index: 50)
Archivio di Ortopedia e Reumatologia     Hybrid Journal  
Archivum Immunologiae et Therapiae Experimentalis     Hybrid Journal   (Followers: 2, SJR: 1.2, h-index: 42)
ArgoSpine News & J.     Hybrid Journal   (SJR: 0.102, h-index: 3)
Argumentation     Hybrid Journal   (Followers: 5, SJR: 0.295, h-index: 18)
Arid Ecosystems     Hybrid Journal   (Followers: 2)
Arkiv för Matematik     Hybrid Journal   (Followers: 1, SJR: 0.948, h-index: 22)
Arnold Mathematical J.     Hybrid Journal   (Followers: 1)
Arthropod-Plant Interactions     Hybrid Journal   (Followers: 2, SJR: 0.797, h-index: 17)
Arthroskopie     Hybrid Journal   (Followers: 1, SJR: 0.145, h-index: 8)
Artificial Intelligence and Law     Hybrid Journal   (Followers: 11, SJR: 0.288, h-index: 25)
Artificial Intelligence Review     Hybrid Journal   (Followers: 14, SJR: 0.948, h-index: 48)
Artificial Life and Robotics     Hybrid Journal   (Followers: 9, SJR: 0.231, h-index: 14)
Asia Europe J.     Hybrid Journal   (Followers: 5, SJR: 0.247, h-index: 9)
Asia Pacific Education Review     Hybrid Journal   (Followers: 11, SJR: 0.371, h-index: 17)
Asia Pacific J. of Management     Hybrid Journal   (Followers: 16, SJR: 1.676, h-index: 50)
Asia-Pacific Education Researcher     Hybrid Journal   (Followers: 12, SJR: 0.353, h-index: 13)
Asia-Pacific Financial Markets     Hybrid Journal   (Followers: 2, SJR: 0.19, h-index: 15)
Asia-Pacific J. of Atmospheric Sciences     Hybrid Journal   (Followers: 19, SJR: 1.006, h-index: 14)
Asian Business & Management     Hybrid Journal   (Followers: 9, SJR: 0.41, h-index: 10)
Asian J. of Business Ethics     Hybrid Journal   (Followers: 9)
Asian J. of Criminology     Hybrid Journal   (Followers: 5, SJR: 0.263, h-index: 8)
AStA Advances in Statistical Analysis     Hybrid Journal   (Followers: 2, SJR: 0.681, h-index: 15)
AStA Wirtschafts- und Sozialstatistisches Archiv     Hybrid Journal   (Followers: 5, SJR: 0.195, h-index: 5)
ästhetische dermatologie & kosmetologie     Full-text available via subscription  

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Journal Cover Zeitschrift fur Rheumatologie
  [SJR: 0.166]   [H-I: 33]   [11 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0340-1855 - ISSN (Online) 1435-1250
   Published by Springer-Verlag Homepage  [2350 journals]
  • Treatment of adult idiopathic inflammatory myopathies with conventional
           immunosuppressive drugs
    • Authors: G. Keyßer; S. Zierz; M. Kornhuber
      Abstract: Objectives To gain information about the efficacy of immunosuppressive drugs as first-, second-, and third-line treatment of idiopathic inflammatory myopathies (IIM). Methods 112 treatment cycles of 63 patients with dermatomyositis (n = 23), polymyositis (n = 33), overlap syndromes (n = 4), and undifferentiated connective tissue diseases (n = 3) were analyzed by retrospective chart analysis. Data regarding muscle strength, muscle enzymes, treatment duration, and treatment discontinuation were collected. Results Azathioprine (38 cycles) and methotrexate (MTX; 24 cycles) were applied significantly longer than glucocorticoid monotherapy (9 cycles; 25 ± 21, 26 ± 29 and 7 ± 4 months, respectively; p < 0.05). MTX and azathioprine achieved a significant reduction of serum creatine kinase (CK), with MTX showing more marked effects. Treatment cycles with immunosuppressants other than MTX or azathioprine (n = 22) or with combinations of immunosuppressive drugs (n = 19) were mostly applied as third-line therapy, indicating their application in more refractory cases. Significant improvement of muscle strength was confined to MTX and azathioprine and to the first-line treatment. 8% of MTX patients withdrew due to the lack of efficacy, compared with 29% of patients taking azathioprine and 6 of 9 patients taking glucocorticoid monotherapy. In the 12 patients with Jo-1 syndrome, MTX treatment was effective for a longer time than azathioprine (44 ± 21 months vs. 27 ± 24 months, p < 0.05). Conclusion Our data confirm the effectiveness of MTX and azathioprine in the treatment of inflammatory myopathies and stress the importance of a potent first-line therapy.
      PubDate: 2018-04-30
      DOI: 10.1007/s00393-018-0471-0
       
  • Erfolgsquote bei Übungsfragen zum Fach Rheumatologie zur Vorbereitung auf
           das schriftliche Staatsexamen an deutschen Hochschulen von 2012 bis 2016
    • Authors: R. Sengewein; R. Brinks; G. Pongratz
      Abstract: Zusammenfassung Das Fach Rheumatologie ist mit nur 7 weisungsfreien Lehrstühlen in der deutschen Hochschullehre unterrepräsentiert. Das Lehrangebot weisungsfreier und nicht-weisungsfreier Standorte geht mit einer unterschiedlichen Quantität der Lehre einher. Unklar ist der Effekt des Lehrangebotes auf die Qualität der Lehre und auf die Ausbildung deutscher Medizinstudenten. Um sich der Beantwortung dieser Frage zu nähern, haben wir 2.610.217 Examensfragen von 32.166 Studierenden über einen Zeitraum von 4 Jahren nach Standort und Weisungsfreiheit ausgewertet, welche auf der Lernplattform AMBOSS dokumentiert worden sind. Insgesamt schneiden die Studierenden zum größten Teil mit einer gerade mal als „ausreichend“ bewerteten Examensleistung im Fach Rheumatologie ab. Standorte mit Weisungsfreiheit schneiden zwar signifikant besser ab, in Bezug auf das gesamte Staatsexamen haben diese Unterschiede allerdings keine Relevanz. Der Prüfungsdruck auf den deutschen Medizinstudenten, für das Examensfach Rheumatologie zu lernen, ist wohl eher gering einzuschätzen.
      PubDate: 2018-04-30
      DOI: 10.1007/s00393-018-0474-x
       
  • Älterwerden mit rheumatoider Arthritis – brennt die Erkrankung
           aus'
    • Authors: J. Bauhammer; C. Fiehn
      Abstract: Zusammenfassung Die rheumatoide Arthritis (RA) ist eine chronisch entzündliche Systemerkrankung mit im Vordergrund stehender gelenkdestruierender Synovitis. Immer wieder ist davon die Rede, dass sie mit der Zeit „ausbrennt“. Gemeint ist die Annahme, dass die Entzündung nach langem, meist schwerem Verlauf spontan nachlässt und auch ohne Therapie inaktiv bleibt. Dafür haben wir die Evidenz in der wissenschaftlichen Literatur analysiert. In historischen Langzeitkohorten mit Patienten, die keine antirheumatische Medikation erhalten haben, und ebenso mit Patienten unter konventioneller DMARD(„disease-modifying antirheumatic drug“)-Therapie, zeigt sich dabei, dass die Mehrheit der Patienten entzündlich aktiv bleibt und eine anhaltende radiologische Progression aufweist. Allenfalls Übergänge in mildere Verläufe oder aber Inaktivität nach besonders gutem Therapieansprechen sind beschrieben, nicht aber das Sistieren der Entzündung nach langjährigem aggressivem Verlauf. Der Verzicht auf eine DMARD-Therapie in dieser Situation birgt die Gefahr einer unterschwellig fortschreitenden Gelenkzerstörung, des Auftretens extraartikulärer Manifestationen und einer Erhöhung des kardiovaskulären Risikos. In der modernen RA-Therapie nach dem Treat-to-target-Prinzip mit dem Ziel einer Remissionsinduktion, Remissionserhaltung und Besserung der Langzeitprognose sollte der Begriff des „Ausbrennens“ nicht mehr verwendet werden.
      PubDate: 2018-04-30
      DOI: 10.1007/s00393-018-0465-y
       
  • Komplextherapien in der Rheumatologie und Geriatrie – Herausforderungen
           – Unterschiede – Chancen
    • Authors: H.-J. Lakomek; W. Fiori
      Abstract: Zusammenfassung Mit Einführung des fallpauschalierten Entgeltsystems ab 2003 in Deutschland wurden auch für die Fachbereiche Rheumatologie und Geriatrie fächerbezogene Diagnosis Related Groups (DRGs) eingeführt. Für die akutstationäre Rheumatologie wurden u. a. datengestützt die multimodale rheumatologische Komplexbehandlung (OPS [Operationen- und Prozedurenschlüssel] 8-983) ab 2005 und die zugehörige DRG I97Z (Rheumatologische Komplexbehandlung bei Krankheiten und Störungen an Muskel‑, Skelett-System und Bindegewebe) ab 2006 in das G‑DRG(German Diagnosis Related Group)-System aufgenommen. Einen Baustein für ältere Rheumapatienten stellt die geriatrische frührehabilitative Komplexbehandlung (OPS 8-550) dar. Es werden die Herausforderungen der Umsetzung von Komplexbehandlungen an den Beispielen OPS 8-983 und OPS 8-550 aufgezeigt. Auch die strukturellen und prozessualen Unterschiede dieser Komplexbehandlungen werden erörtert. Die akutstationäre Versorgung von Rheumapatienten mit entsprechender Fallschwere wie auch multimorbider geriatrischer Rheumapatienten wird durch die Umsetzung der jeweiligen Komplexbehandlung unterstützt.
      PubDate: 2018-04-30
      DOI: 10.1007/s00393-018-0470-1
       
  • Jung sein mit Rheuma
    • Authors: K. Baltruschat
      PubDate: 2018-04-27
      DOI: 10.1007/s00393-018-0452-3
       
  • Osteoimmunologie – IMMUNOBONE
    • Authors: M. Rauner; F. Buttgereit; J. Distler; A. I. Garbe; M. Herrmann; L. Hofbauer; M. Hoffmann; R. Jessberger; U. Kornak; G. Krönke; S. Mundlos; C. Spies; J. Tuckermann; J. Zwerina
      PubDate: 2018-04-24
      DOI: 10.1007/s00393-018-0455-0
       
  • Rheumatologie im Spiegel der Kunst
    • Authors: A. G. Aeschlimann; F. A. Aeschlimann; B. A. Michel
      PubDate: 2018-04-24
      DOI: 10.1007/s00393-018-0462-1
       
  • Älter werden mit axialer Spondyloarthritis
    • Authors: U. Kiltz; X. Baraliakos; B. Buehring; J. Braun
      Abstract: Zusammenfassung Die physiologischen Altersveränderungen wie Verlust von Muskelmasse und -funktion, Reduzierung von Organfunktionen und degenerative Gelenkveränderungen treffen bei Patienten mit ankylosierender Spondylitis (AS) auf krankheitsspezifische Veränderungen, die ältere AS-Patienten vulnerabel für andere Erkrankungen machen. Verschiedene Prozesse führen bei solchen Patienten zu einer reduzierten körperlichen Funktionsfähigkeit, zu einer veränderten Körperhaltung, zu verminderter Knochendichte und Sarkopenie, was zu vermehrter Fallneigung und Wirbelkörperfrakturen führen kann. Die Mortalität ist bei Patienten mit AS v. a. bei Männern insbesondere aufgrund der erhöhten kardiovaskulären Mortalität erhöht. Die standardisierte Erfassung kardiovaskulärer Risikofaktoren bei Patienten mit entzündlich rheumatischen Erkrankungen wird zwar seit Jahren empfohlen (unabhängig vom Alter der Patienten), dies wird jedoch kaum umgesetzt. Insgesamt liegen hinsichtlich Komorbiditäten und Risikofaktoren fast ausschließlich Untersuchungen bei AS-Patienten und nicht anderen Spondyloarthritiden vor.
      PubDate: 2018-04-24
      DOI: 10.1007/s00393-018-0446-1
       
  • Associations between interleukin-23R polymorphisms and ankylosing
           spondylitis susceptibility: an updated meta-analysis
    • Authors: Y. H. Lee; G. G. Song
      Abstract: Objective The aim of this study was to determine whether interleukin-23R (IL-23R) polymorphisms are associated with susceptibility to ankylosing spondylitis (AS). Methods Meta-analyses were conducted to determine the associations between IL-23R polymorphisms and AS susceptibility in Europeans, Asians, and all subjects combined. Results A total of 17 studies (21 separate comparisons) were included in this meta-analysis. The meta-analysis revealed a significant association between AS and the two alleles of the rs11209032 polymorphism in all study subjects (odds ratio [OR] = 1.160, 95% confidence interval [CI] = 1.091–1.204, P < 0.001). Stratification by ethnicity identified a significant association between this polymorphism and AS in Europeans (OR = 1.234, 95% CI = 1.159–1.313, P < 0.001), but not in Asians (OR = 1.003, 95% CI = 0.920–1.219, P = 0.942). Meta-analyses of the rs1004819, rs10489629, rs1343151, rs1495965, rs7517847, and rs11465804 polymorphisms showed the same pattern as shown for rs11209032. The meta-analysis also revealed a significant association between the two alleles of the rs2201841 and rs11209026 polymorphisms and the risk of developing AS in Europeans, but not in Asians. Interestingly, the rs10889677 polymorphism was not found to be associated with AS susceptibility in either Europeans or Asians. Conclusions This meta-analysis showed that several IL-23R polymorphisms are associated with the development of AS in Europeans.
      PubDate: 2018-04-24
      DOI: 10.1007/s00393-018-0472-z
       
  • Adherence and health literacy as related to outcome of patients treated
           for rheumatoid arthritis
    • Authors: J. G. Kuipers; M. Koller; F. Zeman; K. Müller; J. U. Rüffer
      Abstract: Background Disabilities in daily living and quality of life are key endpoints for evaluating the treatment outcome for rheumatoid arthritis (RA). Factors possibly contributing to good outcome are adherence and health literacy. Methods The survey included a representative nationwide sample of German rheumatologists and their patients with RA. The physician questionnaire included the disease activity score (DAS28) and medical prescriptions. The patient questionnaire included fatigue (EORTC QLQ-FA13), health assessment questionnaire (HAQ), quality of life (SF-12), health literacy (HELP), and patients’ listings of their medications. Adherence was operationalized as follows: patient-reported (CQR5), behavioral (concordance between physicians’ and patients’ listings of medications), physician-assessed, and a combined measure of physician rating (1 = very adherent, 0 = less adherent) and the match between physicians’ prescriptions and patients’ accounts of their medications (1 = perfect match, 0 = no perfect match) that yielded three categories of adherence: high, medium, and low. Simple and multiple linear regressions (controlling for age, sex, smoking, drinking alcohol, and sport) were calculated using adherence and health literacy as predictor variables, and disease activity and patient-reported outcomes as dependent variables. Results 708 pairs of patient and physician questionnaires were analyzed. The mean patient age (73% women) was 60 years (SD = 12). Multiple regression analyses showed that high adherence was significantly associated with 5/7 outcome variables and health literacy with 7/7 outcome variables. Conclusion Adherence and health literacy had weak but consistent effects on most outcomes. Thus, enhancing adherence and understanding of medical information could improve outcome, which should be investigated in future interventional studies.
      PubDate: 2018-04-24
      DOI: 10.1007/s00393-018-0449-y
       
  • Neue Einblicke in die Funktion des Knochenmarks
    • Authors: G. Schett; A. Bozec; I. Bekeredjian-Ding; H.-D. Chang; J.-P. David; T. Dörner; S. Grässel; M. Gunzer; R. Manz; H. Mei; D. Mielenz; U. Müller-Ladner; E. Neumann; A. Radbruch; W. Richter; R. H. Straub
      PubDate: 2018-04-24
      DOI: 10.1007/s00393-018-0456-z
       
  • Biomarker und Bildgebung zur Diagnose und Stratifizierung der rheumatoiden
           Arthritis und Spondylarthritis im BMBF-Verbund ArthroMark
    • Authors: T. Häupl; A. Skapenko; B. Hoppe; K. Skriner; H. Burkhardt; D. Poddubnyy; S. Ohrndorf; P. Sewerin; U. Mansmann; B. Stuhlmüller; H. Schulze-Koops; G.‑R. Burmester
      Abstract: Zusammenfassung Rheumatische Erkrankungen gehören zu den häufigsten chronisch entzündlichen Krankheiten. Neben ausgeprägter Schmerzhaftigkeit und progredienter Gelenkzerstörung reduzieren die rheumatoide Arthritis (RA), die Spondyloarthritiden (SpA) und die Psoriasisarthritis (PsA) die Arbeitsfähigkeit, die Lebensqualität und bei unzureichender Behandlung auch die Lebenserwartung. Seit der Einführung der Biologika zur Therapie dieser Erkrankungen hat die Suche nach geeigneten Biomarkern zur Frühdiagnostik und Vorhersage des Therapieerfolgs zunehmend an Bedeutung gewonnen. Das Hauptziel des Verbundes ArthroMark ist, neue Biomarker zu identifizieren und moderne Bildgebungsverfahren einzusetzen mit dem Ziel, die Diagnose, die Verlaufskontrolle und die Stratifizierung von Patienten mit RA, SpA und PsA zu verbessern. Mit der Entwicklung geeigneter Biomarker für diese Erkrankungen trägt dieses Vorhaben zur Gesundheitsforschung im Bereich chronischer Erkrankungen des Bewegungsapparates bei. Durch die Zusammenarbeit verschiedener nationaler Zentren sollen standortspezifische Ressourcen wie Probenbanken und klinische Studien gemeinsam nutzbar gemacht werden und individuelle Schwerpunkte in der Biomarkeranalyse mit einem entsprechenden Mehrwert vernetzt werden. Gemeinsames Datenmanagement und Vereinheitlichung der Datenerhebung sowie bestmögliche Charakterisierung der Patienten durch neue Bildgebungsmethoden sollen die Qualität der Markerprüfung optimieren.
      PubDate: 2018-04-24
      DOI: 10.1007/s00393-018-0458-x
       
  • Besonderheiten der Pharmakotherapie des älteren Rheumapatienten
    • Authors: H.‑J. Lakomek; Christian Schulz
      Abstract: Zusammenfassung Die zunehmende Lebenserwartung von Menschen mit einer entzündlich rheumatischen Erkrankung durch den medizinischen Fortschritt wie auch aufgrund der verfügbaren immunsuppressiven Therapie ist Anlass, die Behandlungssituation des älteren Menschen mit Rheuma zu betrachten. Geriatrische Patienten (Definition: Lebensalter > 70 Jahre bei gleichzeitig vorliegender geriatrietypischer Multimorbidität) erhalten in Deutschland z. B. bei Vorliegen einer rheumatoiden Arthritis häufiger Kortikosteroide und seltener bDMARDs („biological disease-modifying antirheumatic drugs“) und cDMARDs („conventional disease-modifying antirheumatic drugs“), was u. a. mit zusätzlich bestehenden Komorbiditäten wie auch Polypharmazie begründet wird. Unter Anwendung von geriatrietypischen Assessments wie auch eines umfassenden Medikationsplans lässt sich das Therapierisiko für b‑ und cDMARDs sachgerecht bewerten. Die Datenlage zur Biologikatherapie im Alter bei Rheuma unterstützt die Empfehlung eines häufigeren Einsatzes. Die jeweils 5 benannten Positiv- und Negativempfehlungen zur Pharmakotherapie beim älteren Rheumapatienten (z. B. RA[rheumatoide Arthritis]-Patienten) wurden von den Autoren in Anlehnung an die „Klug-entscheiden-Initiative“ der DGIM (Deutsche Gesellschaft für Innere Medizin) zusammengestellt, um den Weg einer b‑ wie auch cDMARD-Therapie bei geriatrischen RA-Patienten sicherer zu machen.
      PubDate: 2018-04-24
      DOI: 10.1007/s00393-018-0460-3
       
  • Gegenseitige Beeinflussung von Immunsystem und Knochen
    • Authors: T. Kamradt; M. Amling; B. Dankbar; A. Dudeck; M. Gunzer; A. Ignatius; G. Krönke; K. Kubatzky; T. Pap; I. Prinz; G. Schett; T. Schinke; J. Tuckermann; A. Waisman
      PubDate: 2018-04-19
      DOI: 10.1007/s00393-018-0454-1
       
  • Forschungsnetzwerke – Rheumaforschungsgruppe Ruhr
    • Authors: J. Braun; X. Baraliakos; U. Kiltz; E. Schmitz-Bortz; L. Kalthoff; D. Krause
      PubDate: 2018-04-17
      DOI: 10.1007/s00393-018-0457-y
       
  • Myeloablative autologe Stammzelltransplantation zur Behandlung der
           schweren Systemsklerose
    • Authors: J. C. Henes
      PubDate: 2018-04-13
      DOI: 10.1007/s00393-018-0448-z
       
  • Forschungsverbund Neuroimmunologie und Schmerz (Neuroimpa) im
           Forschungsnetz Muskuloskelettale Erkrankungen
    • Authors: H.-G. Schaible; H.-D. Chang; S. Grässel; H. Haibel; A. Hess; T. Kamradt; A. Radbruch; G. Schett; C. Stein; R. H. Straub
      Abstract: Zusammenfassung Hintergrund Der Forschungsverbund Neuroimmunologie und Schmerz (Neuroimpa) untersucht die Bedeutung der Beziehungen zwischen dem Immunsystem und dem Nervensystem bei muskuloskeletalen Erkrankungen für die Entstehung von Schmerzen und für den Verlauf von Frakturheilung und Arthritiden. Methodik Das Methodenspektrum umfasst Untersuchungen an Einzelzellen, In-vivo-Modelle von Arthritis und Frakturheilung, bildgebende Verfahren zum Studium von Gehirnfunktionen an Tier und Mensch sowie die Analyse von Patientendaten. Ergebnisse Proinflammatorische Zytokine tragen über neuronale Zytokinrezeptoren signifikant zur Entstehung von Gelenkschmerzen bei. Immunzellen sezernieren Opioidpeptide, die über Opioidrezeptoren peripherer Nozizeptoren hypoalgetisch wirken. Die Knochenneubildung nach Fraktur wird durch das Nervensystem signifikant unterstützt. Das sympathische Nervensystem fördert die Entwicklung immunologisch induzierter Arthritiden. Die Studien zeigen ein bedeutsames analgetisches Potenzial der Neutralisierung von proinflammatorischen Zytokinen und von selektiv peripher wirkenden Opioiden. Ferner zeigen sie, dass die Modulation neuronaler Mechanismen muskuloskeletale Krankheitsverläufe günstig beeinflussen kann. Diskussion Eingriffe in die Interaktionen zwischen dem Immunsystem und dem Nervensystem bergen ein großes therapeutisches Potenzial für die Behandlung von muskuloskeletalen Erkrankungen und Schmerzen.
      PubDate: 2018-04-13
      DOI: 10.1007/s00393-018-0459-9
       
  • Rheumatologie im Spiegel der Medien und Werbung am Beispiel des
           Rheumazentrum Rhein-Ruhr
    • Authors: O. Sander; W. Korfmacher; B. Ostendorf; M. Schneider
      PubDate: 2018-04-13
      DOI: 10.1007/s00393-018-0461-2
       
  • Nocturnal blood pressure dipping is similar in rheumatoid arthritis
           patients as compared to a normal population
    • Authors: O. Turgay Yildirim; E. Gonullu; F. Aydin; E. Aksit; A. Huseyinoglu Aydin; E. Dagtekin
      Abstract: Objective Rheumatoid arthritis (RA) is a systemic autoimmune inflammatory disorder which further doubles the risk of developing cardiovascular disease. Some studies suggest that in RA patients, the prevalence of hypertension increases due to prednisolone use, clinical status, genetic factors, and physical inactivity. On the other hand, dipper and non-dipper status in RA patients compared to non-RA subjects has not been investigated to our knowledge. Purpose of the study is to investigate whether non-dipper status is more deteriorated in RA patients. Methods Sixty-five RA patients and 61 age-sex-matched control patients were evaluated in this cross-sectional study. Patients were classified according to 24-h ambulatory blood pressure monitoring results. Patients with previous hypertension diagnosis, coronary artery disease, and abnormal kidney function were excluded. Results Mean age of the study sample was 53.7 ± 12.3 years and 40.5% were male. There was no significant difference between groups in terms of basic demographic characteristics. Leukocyte counts (p = 0.001), neutrophil counts (p = 0.001), and red cell distribution width (p = 0.000) were significantly higher in the RA group. ABPM results indicate no significant difference between RA patients and the control group in terms of daytime systolic and diastolic blood pressure, nighttime systolic and diastolic blood pressure, and average systolic and diastolic blood pressure results (p > 0.05). There was no statistical difference regarding the non-dipper status of patient groups (p = 0.412). Nocturnal blood pressure dipping was significantly similar between groups (p = 0.980). Conclusion In conclusion, RA patients have similar values in terms of nocturnal blood pressure dipping and hypertension diagnosis as compared to normal population.
      PubDate: 2018-04-12
      DOI: 10.1007/s00393-018-0451-4
       
  • Metabolic syndrome in systemic lupus erythematosus patients
    • Authors: N. Hammam; S. M. Rashad; A. A. A. Mohamed
      Abstract: Objective The study aims to evaluate the presence of metabolic syndrome (MetS) among Egyptian systemic lupus erythematosus (SLE) patients. Additionally, we intended to determine the association of MetS with disease activity, clinical and laboratory features. Patients and methods This cross-sectional study included adult SLE patients diagnosed and followed in rheumatology outpatient clinics. The demographic data, clinical and laboratory parameters were assessed for all patients. Disease activity was measured using SLE Disease Activity Index (SLEDAI-2k). Patients were diagnosed to have MetS according to The National Cholesterol Education Program Adult Treatment Panel III (NCEP). The characteristics of SLE patients and their disease status were compared between those with and without MetS. Results A total of 74 SLE patients were included; mean age was 32.1 ± 10.9 years and 87.8% were females. Twenty-five (33.8%) SLE patients had neuropsychiatric lupus (NPSLE), with headache the most common manifestation. MetS was diagnosed in 45.9% of the SLE group. Patients with MetS had significantly older age, delayed age of diagnosis and higher SLEDAI-2k scores (p = 0.015, p = 0.014 and p = 0.019, respectively) compared to those without MetS. NPSLE was significantly correlated with MetS (r = 0.32, p = 0.006) and in particular with higher central obesity (r = 0.43, p < 0.001). In the multivariate analysis, NPSLE remained independently associated with MetS (OR = 4.9, p = 0.004, 95% CI = 1.7–14.4). Conclusion Metabolic syndrome is present in a significant proportion of Egyptian patients with adult SLE. Delayed disease diagnosis and higher disease activity are SLE-related factors that may contribute to increase the risk of MetS. Data suggest that neuropsychiatric lupus may underlie some of the increased risk for MetS and central obesity.
      PubDate: 2018-04-12
      DOI: 10.1007/s00393-018-0447-0
       
 
 
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