Women in rheumatology: major contributions and key discoveries of the twentieth century.

In the twentieth century, rheumatology saw an exponential growth. Discoveries in the pathophysiology of rheumatic diseases, progress in research methodology and novel treatments cardinally changed the natural course of rheumatic diseases and revolutionized patient management. Although underrepresented in this field, women have made considerable input in advancing our specialty towards the new era. In this article we acknowledge key scientific discoveries and major contributions made by 18 brilliant women scientists that shaped the field of rheumatology in the twentieth century. We hope that the achievements of these remarkable women will inspire young rheumatologists and researchers.

The 70th anniversary of glucocorticoids in rheumatic diseases: the second youth of an old friend.

Seventy years ago, the first administration of cortisone in a patient with RA marked a milestone in the treatment of inflammatory diseases. However, the initial enthusiasm rapidly vanished as the administration of high doses for lengthy periods revealed worrisome adverse effects. It has taken several decades to overcome the (sometimes excessive) mistrust and to achieve a more differentiated evaluation of the benefit-risk profile and the adequate usage of glucocorticoids (GCs). Today, GCs remain indispensable for the treatment of many inflammatory conditions and their usefulness in RA as a disease-modifying low-dose co-medication is widely acknowledged. Recent studies show promising results concerning both traditional GCs and new formulations. Still, decades of relatively little scientific attention have resulted in a continuing lack of detailed evidence. Hence there is an ongoing need for further research regarding mechanisms of GC actions, the further optimization of treatment parameters for traditional GCs and new formulations.

A Picture is Worth a Thousand Words: Art and Medicine.

BACKGROUND: Medical practice is a form of art, with each complex detail essential to the welfare of the individuals in the care of the physician. Art and medicine have shared a close relationship in a variety of ways for centuries, as demonstrated by anatomical drawings and textbooks from the 16th century. Leonardo da Vinci, driven by his fascination with the details of the human body and how it functioned, succeeded in creating an anatomical model of the cerebral ventricles and the aorta using molten wax and a glass structure, respectively (Heart and Its Blood Vessels). By using water that contained grass seeds, this experiment enabled him to study blood flow. da Vinci's engrossment with the complexity of the human body is reflected in many of his drawings, including the famous depiction of the human physique in his drawing of the Vitruvian Man. This drawing, which defines the ideal proportions of the human body and their correlation with geometry, is an example of how artistic and scientific objectives integrate with each other.

Did King Herod suffer from a rheumatic disease?

Herod the Great was appointed "king of Jews," to govern Judea, by the Roman Emperor and Senate. He lived from 73/74 BCE to 4 CE. He died with an illness and symptoms that have been the source of considerable speculation. Richard Strauss depicted Herod in his classic opera, "Salome." That opera was derived from a play of the same name by Oscar Wilde, which was based on an 1876 painting, "Salome Dancing Before Herod," by Gustave Moreau. The operatic Herod was afflicted with an illness characterized by dementia, hallucinations, paranoia, alcoholism (from drinking the Emperor's wine), violence, twitches, and sterility; different interpretations showed him also with falls, chills, shaking, thirst, forgetfulness, and sleepiness, for which we suggest the novel diagnosis of chronic lead intoxication (which can manifest to rheumatologists as saturnine gout). He had compatible symptoms (encephalopathy and neuromuscular abnormalities) and consumed excessive quantities of imperial wine, known to be highly contaminated with lead and likely associated with similar symptoms among Roman aristocracy. Herod's demented cruelties-an oppressive reign which including the beheading of John the Baptist-exacerbated the political climate and may have contributed to the subsequent violent 7-year revolt culminating in the destruction of the second temple. How different might history have been if Herod the Great had been abstemious?

Did Father Cicero suffer from rheumatism?

Father Cicero Romao Batista is probably the most famous Ceará character of all time. An important protagonist of the Cariri region, situated in the south of Ceara State, in the late nineteenth century and the first third of the twentieth century, Father Cicero had great political and religious activity, as well as other less well-known achievements, for instance, his ecological teachings that led him to be awarded the title of "Patron of Forests", besides an enormous effort and personal sacrifice for the improvement of the conditions of human life. Inspired by reading his biography, we find that the "Padim Ciço" could have inflammatory spondyloarthropathy. In this article, we present the plausibility of this diagnostic hypothesis, seeking to emphasize that an attentive ear and clinical observation, albeit indirectly and without the privilege of a personal contact with the patient, are unparalleled tools for bringing forth a diagnosis.

[Kurt Seidel (1914-1990) : Between medicine and politics]. / Kurt Seidel (1914-1990) : Zwischen Medizin und Politik.

Prof. Dr. med. Kurt Seidel played an outstanding role in the post-war history of rheumatology in eastern Germany. This is documented by the textbook articles and review articles written by him, by the foundation and leadership over many years of the working and research group of rheumatology in Jena, by his role in the formation of the divided society of the German Democratic Republic (GDR) and by the preparation of its chronical in 1984. An appreciation of his achievements against the background of the scientific political circumstances prevailing at that time is documented through a dissertation.

Causas de mortalidad por enfermedades reumáticas en Jerez de los Caballeros (Badajoz) durante el siglo xix / Causes of mortality due to rheumatic diseases in Jerez de los Caballeros (Badajoz) during the 19th century

Se han recopilado 26.203 defunciones en Jerez de los Caballeros (Badajoz) durante el siglo xix, agrupándolas según la clasificación de Bertillon, para estudiar las causas de muerte por enfermedades reumáticas, mediante el análisis de los Libros de Defunción del Archivo Parroquial y legajos del Archivo Municipal. Se halla un total de 31 fallecidos, siendo el segmento entre 65-74 años el que presenta las mayores cifras. La escasez de registros puede ser debida a la inexactitud de los diagnósticos. El mes con mayor mortalidad es septiembre (AU)

A total of 26,203 of the deaths in Jerez de los Caballeros (Badajoz) during the 19th century were collected and grouped according to the Bertillon's Classification, in order to study the causes of death from rheumatic diseases. An analysis was made using the Death Registers, those located in the Parish Archives, and files of the Municipal Archives. There were a total of 31 deaths due to rheumatic diseases, with the 65-74 years age group being most frequent. The lack of records may be due to the inaccuracy of the diagnoses. September was the month of increased mortality (AU)

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Causes of mortality due to rheumatic diseases in Jerez de los Caballeros (Badajoz) during the 19th century.

A total of 26,203 of the deaths in Jerez de los Caballeros (Badajoz) during the 19th century were collected and grouped according to the Bertillon's Classification, in order to study the causes of death from rheumatic diseases. An analysis was made using the Death Registers, those located in the Parish Archives, and files of the Municipal Archives. There were a total of 31 deaths due to rheumatic diseases, with the 65-74 years age group being most frequent. The lack of records may be due to the inaccuracy of the diagnoses. September was the month of increased mortality.

[Chateaubriand and contemporary medicine]. / Chateaubriand et la médecine de son temps.

The author reviews the situation of medicine in the time of Chateaubriand, then his attitude toward this art and its practitioners, then his own pathology, psychological as well as somatic.