Rheumatology through the ages. Dr Laurel Young Consultant Rheumatologist Royal Berkshire Hospital

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Transcription:

Rheumatology through the ages Dr Laurel Young Consultant Rheumatologist Royal Berkshire Hospital

Outline of talk History of rheumatology Old therapies History of rheumatology in Reading

Water therapy

History of Rheumatology 400 BC - rheuma = flowing 1200s gutta = drop 1600s gout used for most joint problems 1642 Rheumatism = joint problems

History of Rheumatology 1808 Rheumatic fever recognised 1858 Garrod identified rheumatoid arthritis (RA) 1890s Pierre-Auguste Renoir (1841-1919) diagnosed with RA

History of Rheumatology 1969 Paget s disease described

History of Rheumatology 1909 Nichols and Richardson differentiated osteoarthritis and rheumatoid arthritis

History of Rheumatology 1932 International Committee on Rheumatism formed (became American Rheumatism Association and then American College of Rheumatology)

History of Rheumatology 1959 Charnley hip replacement

History of Rheumatology 1963 Ankylosing spondylitis term adopted

Drugs in Rheumatology 1899 aspirin developed by Bayer 1935 gold salts used in RA (chrysotherapy/aurotherapy) 1940s sulphasalazine developed as anti-inflammatory with antibiotic

Drugs in Rheumatology 1949 Philip Hench and Edward Kendall first used cortisone in autoimmune diseases

Drugs in Rheumatolgoy 1950s penicillamine used 1956 paracetamol developed

Drugs in Rheumatology NSAIDs (Non-steroidal antiinflammatory drugs) 1962 ibuprofen (naproxen, indomethacin, diclofenac) 1991 COX-II inhibitors discovered 1998 celecoxib 2004 rofecoxib (Vioxx) recalled

Drugs in Rheumatology 1980 methotrexate trialled in 32 patients with RA (approved 1988)

Drugs in Rheumatology 1998 Leflunomide (Arava) approved 1998 First Anti-tumour necrosis factor (anti-tnf) agent approved, Etanecept (Enbrel) 1999 - Infliximab

The local story.

Rheumatology at Battle Hospital 1949 Oxford Regional Hospital Board appointed Dr L M Jennings as physician for the treatment of chronic rheumatism 1953 Dr R I (Ian) Meanock appointed as Chairman of the Area Department of Accident and Orthopaedic Surgery (rehabilitation) - introduced active remedial therapy - fought for water support campaigned for hydrotherapy pool 1965 Dr Patrick Chesterman appointed as Consultant orthopaedic surgeon (hand specialist) 1966 Dr Francis M Andrews appointed as Consultant in Rheumatology/Physical Medicine 1969 Rheumatology and rehabilitation moved to Thames block ward and offices, gymnasium

1969 Rheumatology and rehabilitation moved to Thames block ward and offices, gymnasium

Rheumatology Battle Hospital 1971 Abbey block opens

Rheumatology Battle Hospital 1977 Hydrotherapy pool opened

Rheumatology Battle Hospital 1978 Kathryn Murphy started as trainee 1985 Ian Meanock retired 1985 Dr Anthony Bradlow appointed 25 beds in Cookham and 7 beds Caversham

Rheumatology Battle Hospital 1989 Rheumatology joins general medicine 1991 Dr Francis Andrews leaves to become priest 1992 Dr Joel David appointed 1997 Rheumatology beds in Redlands ward

Rheumatology RBH and Battle 2001 Dr Jeremy McNally replaces Dr David 2004 Dr Laurel Young appointed as 3 rd consultant 2005 Moved to Royal Berkshire Hospital as Battle closes 2009 Dr Antoni Chan appointed as 4 th consultant

History of Rheumatology