Wednesday, January 18, 2017


Fußreflexzonen-Pflaster - die gibt es noch nicht und wird es hoffentlich auch nie geben, da ich jetzt gerade hier die Idee für diesen Schwachsinn aufgestellt habe; denn alle Dummheit, die denkbar ist, wird auch durchgeführt.

Ich hatte bereits mehrfach über die Foot patches geschrieben, wie z.B. hier (1) oder hier (2). Oder ich habe über die Fußreflexzonenmassage geschrieben (39. „Die Reflexologie beruht auf einer absurden Theorie und es wurde nicht nachgewiesen, dass sie den Verlauf einer Krankheit beeinflusst.“ [Quackwatch]

Bisher ist noch niemand auf die Idee gekommen, diese beiden überflüssigen Methoden zu verbinden. Es gibt dann ein Fußreflexzonen-Pflaster, das genau auf den Fuß geklebt werden muss, denn an den verschiedenen Stellen sind unterschiedliche Stoffe in das Pflaster eingebracht worden, damit ganz spezifisch die Gifte aus den einzelnen Organen eliminiert werden können. Das wird teuer – das kann ich Ihnen versprechen.

„Das ist unmöglich!“ werden Sie sagen und damit haben Sie Recht. Natürlich ist das unmöglich, aber ein windiger Geschäftsmann hätte dummerweise auf so eine Idee kommen können, um vielen Menschen Enttäuschungen zu bereiten bzw. das Geld aus der Tasche zu ziehen. 

Bleiben Sie wachsam gegen Abzocke! 

Ups! Da bin ich jetzt mit meinen Fußreflexzonen-Pflaster ganz schön ins Fettnäpfchen getreten. So etwas wird bereits verhökert.
Ich lese z.B.:
„Die Fußreflexzonen - unser zweites Herz
Die Fußsohlen des Menschen gelten in Asien als das "zweite Herz des Körpers". Denn an der Fußsohle sind alle Organe mit ihren Reflexpunkten vertreten. Die Traditionell Chinesische Medizin kennt dieses Prinzip seit 5000 Jahren und betrachtet die Fußsohlen auch als "Spiegel des Körpers" sowie als "dritte und vierte Niere".“ Ja, was denn nun Herz oder Niere? 5000 Jahre sind ziemlich hochgegriffen. Etwas über 2000 Jahre ist wahrscheinlicher (4). Die TCM kennt keine Reflexpunkte. Sie kennt Meridiane (besser gesagt
經絡 oder Flussbahnen, denn dort soll das Qi fließen) und Therapie- oder Akupunkturpunkte (穴位). Ich lese über die Vorzüge von „organischem Germanium“, allerdings warnen Behörden und nicht die Pharmaindustrie vor dem Verzehr von Germanium (5), weshalb es auch nicht in Nahrungsergänzungsmitteln zulässig ist.

Bei aller Wellness! Bleiben Sie kritisch! 




Haiku after the Frost

Winter is playing
With the sky in grey and blue
Unaware of sprouts

A cold and drab day
Snow in the weather forecast
But Vivaldi’s Winter

The ice flowers
On the windshield disappear
With warm music

Scarecrow in snow
Nothing left to guard
Two foxes passing

Winter, snow
First pollination though
Antihistamine again

Moon isn’t waning
Just looking somewhere else
Syria’s Winter

Coughing and sneezing
Shivering in a blanket
Mum’s hot chicken soup


Tuesday, January 17, 2017

Palindromic Rheumatism

There still is quite a lot of uncertainty about palindromic rheumatism, but it’s an accepted diagnosis and is classified in ICD-10 as M12.3. It is a form of episodic inflammatory arthritis. One or even multiple joints swell, may be red, and are painful - and then go back to normal. Unlike other forms of arthritis palindromic rheumatism doesn’t damage the joints permanently. Some scientists say that half the patients develop rheumatoid arthritis, but that’s a rough estimation as we lack longitudinal data to confirm this number. Time intervals between attacks vary a lot.

The term palindromic rheumatism was coined in 1941 by P.S. Hench and E.F. Rosenberg. The description is purely clinical as then rheumatoid factor (RF) or even ACPA [anticitrullinated protein antibody] weren’t known or waited for lab tests to be developed. They used palindromic as the symptoms appear and disappear in a similar way.
The cause is still unknown. It is uncertain, if it is a condition, which might lead to what we call early arthritis nowadays and/or rheumatoid arthritis.
Apart from clinical examination lab tests and X-rays are used to rule out rheumatoid arthritis, but there is no test, which could be used to diagnose palindromic arthritis. If ACPA or RF are present, rheumatoid arthritis might develop later. Sometimes palindromic rheumatism is the first presentation of M. Whipple.  The rheumatologist diagnoses palindromic rheumatism by the patient’s history and his finding of acute arthritis. And he has to rule out other forms of arthritis like gout (or the ones already mentioned).
Therapy should focus on treating acute attacks. The mainstays for this are NSAIDs. Sometimes antimalarials are prescribed, but robust data for this indication doesn’t exist.  

G. Salvador and colleagues asked if palindromic rheumatism could be a an abortive form of rheumatoid arthritis in a study (1). They looked at 63 patients with palindromic rheumatism: 33 were defined as pure or persistent and 30 as associated palindromic rheumatism. They concluded: “AntiCCP [ACPA] and, to a lesser extent, AKA [antikeratin antibodies], were found in a high proportion of patients with PR [palindromic rheumatism], suggesting that this syndrome is an abortive form of RA [rheumatoid arthritis]. The predictive value of these antibodies in PR, as markers of progression to an established RA, remains uncertain.” I think these findings are very valuable, but the conclusion is premature as there might be an admission bias.

S. Cabrera-Villalba and colleagues looked at subclinical synovitis in patients with palindromic rheumatism in the intercritical period (2). The study used ultrasound and clinical examination. The authors concluded: “Some differences emerged in the clinical phenotype of PR [palindromic rheumatism] according to ACPA [anticitrullinated protein antibody] status. Most patients with PR do not have US [ultrasound] subclinical synovitis in the intercritical period, even those who are ACPA-positive.”

Y. Emad and colleagues studies, if hand joint involvement and positive ACPA [anticitrullinated protein antibodies] in palindromic rheumatism predict development of rheumatoid arthritis after one year of follow-up (3). The authors concluded: “Early hand joint involvement and positive anti-CCP at disease onset are good predictors for progression to RA in this domain.” Interestingly they had already treated 43 patients with hydroxychloroquine, and the authors think that this had led to remission. Really? The study can’t tell and it muddies the outcome of the original study. Cabrera-Villalba and colleagues voiced their concerns in a letter to the editor (4). CRP levels were high or measurements were made in mg/l and quoted in mg/dl. I think that CRP levels were high, but that patients rather belong to an early arthritis cohort than to a palindromic rheumatism in intercritical period cohort.

R. Sanmartí and colleagues published: “Palindromic rheumatism with positive anticitrullinated peptide/protein antibodies is not synonymous with rheumatoid arthritis. A longterm followup study.” In results we read: “Seventy-one patients (54 women/17 men) with a PR diagnosis were included. Serum ACPA were positive in 52.1%. After a mean followup of 7.6 ± 4.7 years since the first ACPA measurement, 24 patients (33.8%) progressed to chronic disease: 22% RA, 5.6% systemic lupus erythematosus, and 5.6% other diseases. […] Progression to RA was more frequently seen in ACPA-positive than in ACPA-negative patients (29.7% vs 14.7%), but the difference was not significant. […]”. The authors concluded: “ACPA are frequently found in the sera of patients with PR, and a significant proportion of these patients do not progress to RA in the long term.”

To sum it up, palindromic rheumatism still is a challenging diagnosis. We have to make clear distinctions between palindromic rheumatism and early arthritis. I would like to see these patients regularly to make sure that they don’t progress to rheumatoid arthritis.


Monday, January 16, 2017

Exhibition „Into the Blue“ by Liz Walinski at Munich Airport Terminal 2

Liz Walinski is exhibiting paintings and cyanotypes right now at Munich Airport Terminal 2 Level 04 Check-in Area. The exhibition started on January the 2nd and terminates at the 22nd of January.
As my favorite color is blue, I might be called prejudiced in talking about this exhibition (that’s all there has to be as disclaimer).

But let’s start with Liz Walinski, who currently lives and works in Munich. She holds a Master’s degree in Art by the Ludwig-Maximilian University of Munich and has been exhibiting art works and projects in galleries since 2008.
Liz Walinski is fascinated by clouds and water. “Cyanotype is a photographic technic invented in 1843, which can work without film, camera and darkroom.”

Let’s have a look at the art that started fascinating me two days ago.

The first set is a triptych. You can make out a netherworld, in which water leads down into the ice, like Dante’s deepest hell. In the middle you can see our world, which is snowed upon as winter demands. On the side you see God’s realm, the paradise, much like Mount Fuji (富士山). And I feel reminded of some of Ando Hiroshige’s (安藤 ) Thirty-six Views of Mount Fuji (富士三十六).

The next cyanotype reminds me of glaciers in gloomy weather, when they emit lots of blue. And with this picture I also started reminiscing a painting by the late Rudolf-Werner Ackermann of which I can produce a photograph. 

The last of the cyanotypes that attracted me the most is this one:

It reminds me of chaos theory, of bifurcations that make out our lives. The more bifurcations the easier they lead us into chaos. We can watch it in good crime movies, when the killer ends up in a chaos of lies, each being the wrong choice at a bifurcation. So the picture could well be titled “Bifurcations”.

Want to know more about Liz Walinski? Here’s her web page:
If you are travelling through Munich these days, don’t miss her exhibition at the airport.