Fortschritte der Medizin. Originalien最新文献

{"title":"[Immunomodulation by herbal agents. A double-blind study in a medical university hospital involving a hepatitis B vaccine adjuvant model].","authors":"H C Bostelmann,&nbsp;R H Bödeker,&nbsp;W Dames,&nbsp;H H Henneicke-von Zepelin,&nbsp;C P Siegers,&nbsp;U Stammwitz","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aims: </strong>Using the hepatitis B vaccination as a model, to investigate the extent to which the herbal immunomodulator, Esberitox N, supports seroconversion.</p><p><strong>Method: </strong>346 medical students participated in the placebo-controlled, randomized double-blind study. They took 3 x 2 tablets of the test substances daily, beginning 3 days prior to the injection and ending two weeks after it. The target outcomes were seroconversion and the level of the anti-HBs titer.</p><p><strong>Results: </strong>The data of 157 volunteers treated with the test substance, and 161 treated with placebo were analysed. After the first injection, the seroconversion rate was 22% in both test substance and placebo groups, and showed no advantage for the volunteers receiving the test substance. After the second injection, 89% of all members of each group revealed seroconversion. After the first injection, anti-HBs titers were appreciably higher in the test substance group (n = 34) than in the placebo group (n = 36; PWilcoxon = 0.003). The respective median values were 37.0 IU/L (95% CI: 18-68) and 15.5 IU/L (95% CI: 8-30).</p><p><strong>Conclusion: </strong>The immunomodulator tested has negligible influence on seroconversion, but does enhance the immune response of subjects experiencing seroconversion.</p>","PeriodicalId":12358,"journal":{"name":"Fortschritte der Medizin. Originalien","volume":"120 4","pages":"119-23"},"PeriodicalIF":0.0,"publicationDate":"2002-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22268272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Therapy of cardiac arrhythmias. Clinical significance of potassium- and magnesium aspartate in arrhythmias].","authors":"M Manz,&nbsp;R Susilo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Unlabelled: </strong>Potassium and magnesium deficiencies usually coexist and represent a risk factor for cardiac arrhythmias. Serum levels--in particular of magnesium--are inconclusive for establishing a possible electrolyte deficiency. Basic treatment of arrhythmia should therefore include the administration of potassium and magnesium, since the benefit is great, and the possible side effects is negligible. A placebo-controlled study involving patients with cardiac arrhythmias revealed that appreciably fewer ventricular asystoles occurred after three weeks of treatment with potassium and magnesium aspartate, even when serum levels were within the normal range prior to initiating treatment. Patients older than 50, and those with previous coronary heart disease and/or myocardial infarction derived particular benefit from this form of treatment.</p><p><strong>Conclusion: </strong>These results underscore the key role played by potassium and magnesium in the treatment of cardiac arrhythmias.</p>","PeriodicalId":12358,"journal":{"name":"Fortschritte der Medizin. Originalien","volume":"120 1","pages":"11-5"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40831105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Pain modification by the 5-HT3 receptor antagonist tropisetron in secondary fibromyalgias].","authors":"Th Stratz,&nbsp;W Müller","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and methods: </strong>The 5-HT3-receptor antagonist tropisetron has a favourable effect on the pain, not only of primary but also of secondary fibromyalgia. In an open study, ten women with clinical and serological evidence of secondary fibromyalgia were treated with tropisetron. Treatment comprised a single daily injection of 5 mg tropisetron on five consecutive days. Prior to, and 7 and 14 days after, treatment, the patients rated their pain on the visual analog pain (VAP) scale.</p><p><strong>Results: </strong>Nine patients experienced a substantial reduction in pain, with the mean VAP score decreasing from 64.3 initially, to 31.9 on the 7th day. After 14 days, the average score was 33.3, that is, roughly the same as that recorded after 7 days; however, 3 patients indicated the reappearance of substantially greater pain.</p><p><strong>Conclusion: </strong>On the basis of these preliminary results, it would appear to be worth initiating a double-blind study to investigate the effects of short-term i.v. treatment with tropisetron in a large, clearly defined patient population with secondary fibromyalgia.</p>","PeriodicalId":12358,"journal":{"name":"Fortschritte der Medizin. Originalien","volume":"120 1","pages":"17-20"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40831106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Observational study of the tolerance and effectiveness of cefpodoxim-proxetil in general practice].","authors":"K Hanke, S P F Blum","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>BACKGROUND, OUTCOME AND METHODS: Observational study of the clinical efficacy and tolerance of the cefpodoxime proxetil preparation, Podomexef. The study was conducted from August 1996 to April 1997. A total of 549 practitioners participated, 2,734 patients were recruited, and the data of 2714 patients were analyzed.</p><p><strong>Dosage: </strong>Podomexef 200 film tablets, 2x daily.</p><p><strong>Indication: </strong>Bacterial infections of the upper and lower airways and ENT infections.</p><p><strong>Results: </strong>Global clinical efficacy was assessed by the physicians to be \"very good\" and \"good\" in 96.4% of the cases. With regard to tolerance, the physicians' assessment was \"very good\" and \"good\" in 96.3%. In 51 patients (1.9%), 70 adverse drug reactions involving the gastrointestinal tract, CNS and skin occurred.</p><p><strong>Conclusion: </strong>Under day-to-day doctor's office conditions, Podomexef 200 film tablets are both effective and well tolerated in the treatment of bacterial infections of the airways and ENT infections.</p>","PeriodicalId":12358,"journal":{"name":"Fortschritte der Medizin. Originalien","volume":"120 1","pages":"21-8"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40831107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Tilidine/naloxon retard in long-term administration in chronic pain and multimorbidity. Multicenter study of long-term tolerance and effectiveness in 2 years observation].","authors":"Th Flöter,&nbsp;U Brunnmüller","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and method: </strong>335 patients (51% female, 49% male, mean age 56 years) with chronic pain and multimorbidity have been included in a multi-center 2-years' study with slow release Tilidine/Naloxone for efficacy and safety which included detailed laboratory examinations. 316 patients had already been treated with analgesics. 159 patients (47.5%) finished the study as planned, 176 patients finished the study earlier.</p><p><strong>Results: </strong>Parameters of quality of life such as persistent pain, sleep, mood and activity have improved. Tolerance has not been observed. In 85 patients (25%) adverse events had occurred (nausea, vomiting, dizziness) which are related to the study-medication. Constipation was documented in only 4 patients. After 2 years of therapy with Tilidine/Naloxone there has been no relevant changes in laboratory findings. There has been no sign of organ damage or interactions with concomitant medication.</p><p><strong>Conclusion: </strong>Tilidine/Naloxone is an effective and safe analgesic (WHO II) suitable for the longterm treatment of patients with chronic pain.</p>","PeriodicalId":12358,"journal":{"name":"Fortschritte der Medizin. Originalien","volume":"120 1","pages":"29-35"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40831108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Therapeutic characteristance and tolerance of topical comfrey preparations. Results of an observational study of patients].","authors":"R Koll,&nbsp;S Klingenburg","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>To analyze the anti-inflammatory and analgetic properties of the topical comfrey, preparations Kytta-Salbe f, Kytta-Plasma f and Kytta-Balsam f applied to bruises, sprains and distortions and painful conditions of the muscles and joints.</p><p><strong>Method: </strong>A prospective open multicentric observational study complying with paragraph 67(6) of the AMG and involving 162 general practitioners. During the two-week period of observation, the patients received an average of one to three applications of the comfrey preparation per day. All 492 questionnaires were evaluated. Efficacy and tolerability were assessed by both physician and patient.</p><p><strong>Results: </strong>Pain at rest and on movement, as also tenderness, improved in the overall observation group by an average of 45-47%. The duration of morning joint stiffness decreased from 20 minutes initially to 3 minutes. During the course of treatment with comfrey, more than two-thirds of the patients were able to reduce or even discontinue their intake of non-steroidal anti-inflammatory drugs and other specific concomitant medication. In most of the cases, both effectiveness and tolerability were assessed to be excellent or good.</p><p><strong>Conclusion: </strong>The results of the study confirm the effectiveness and tolerability of the topical comfrey preparation investigated in the treatment of bruises, sprains and distortions as well as painful conditions affecting muscles and joints.</p>","PeriodicalId":12358,"journal":{"name":"Fortschritte der Medizin. Originalien","volume":"120 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40831104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Pancreatic exocrine insufficiency in patients with diabetes mellitus. Current state of our knowledge and practical consequences].","authors":"M L Richter,&nbsp;T Wagner","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In recent years, a number of studies have been carried out, the results of which suggest that the exocrine function of the pancreas is significantly more frequently impaired than is the case in healthy controls. In particular when a patient presents with gastrointestinal complaints of unclear origin, unexplained fluctuations in blood sugar, or loss of weight, the possibility of pancreatic exocrine insufficiencyshould be included in differential diagnostic considerations. Abnormal stools and intolerance of dietary fat can be clarified on the basis of a careful history. The diagnosis is confirmed with the aid of simple laboratory tests, for example the chemotrypsin test or the detection of elastase 1 in the stools. By way of treatment, pancreatic enzyme replacement can be applied.</p>","PeriodicalId":12358,"journal":{"name":"Fortschritte der Medizin. Originalien","volume":"119 Suppl 2 ","pages":"77-9"},"PeriodicalIF":0.0,"publicationDate":"2001-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24952913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The path to pain management on WHO. Step III. Towards a better understanding of the treatment of severe chronic pain].","authors":"W Sohn","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Many patients with severe chronic pain continue to receive inadequate treatment. The reason is often a lack of proper communication between patient and physician. In order to ensure adequate pain therapy, it is essential to gain the patient's cooperation and also to involve the patient's relatives. Following comprehensive history-taking and a physical examination, the treatment is established individually on the basis of a stepped approach. The stepped schema advocated by the WHO is applied both to tumor-related and to non-tumor-related pain.</p>","PeriodicalId":12358,"journal":{"name":"Fortschritte der Medizin. Originalien","volume":"119 Suppl 2 ","pages":"81-9"},"PeriodicalIF":0.0,"publicationDate":"2001-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24952914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The alpha-glucosidase inhibitor miglitol for the treatment of type 2 diabetes mellitus in the doctor's office].","authors":"H C Fehmann","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and method: </strong>An observational study was carried out according to and 67 (6) AMG from october 1999 until august 2000. 2654 patients with diabetes mellitus type 2 were treated by 766 physicians for 3 months with alpha-glucosidase inhibitor miglitol. The aim of the study \"DiaLife\" was to obtain data regarding the effectiveness and safety of miglitol in the daily practice. Pre- and postprandial glucose levels, HbA1c, triglycerides, urin glucose, microalbuminuria and body weight were used as parameters of effectiveness. Also an increasing treatment scheme was used. Side effects were documented by the care providing physicians and evaluated by the global tolerability analysis.</p><p><strong>Results: </strong>Males and females showed a balanced distribution. The average age was 62 years and the average duration of diabetes was 5 years. Concomitant diseases were described for 82% of patients: 62% of patients suffered from hypertension, 43% from hyperlipidemia and 22% from coronary heart disease. 64% of patients were already on treatment for diabetes. The mostly prescribed drugs were sulfonylureas and biguanides. Miglitol was gradually increased (first week 1 x 50 mg daily, second week 2 x 50 mg daily, until the third week 3 x 50 mg daily) and the final dosages were 3 x 50 mg or 3 x 100 mg miglitol daily. HbA1c, pre- and postprandial glucose levels were strongly reduced. The HbA1c decreased from 8.4% to 7,1%. Pre- and postprandial glucose levels were reduced minus 46 mg/dl and minus 59 mg/dl. The average decrease of body weight was 1,9 kg; the effect was augmented in individuals with higher BMI. Adverse effects were reported in 47 patients and occured mainly in the GI tract. There were no problems in the combination of miglitol with other pharmacological substance groups.</p><p><strong>Conclusion: </strong>The alpha-glucosidase inhibitor miglitol is an efficient and safe drug for the treatment of diabetes mellitus type 2. It is an ideal tool for mono- and combination therapy. It reduces remarkably the body weight. 90% of physicians judged miglitol's efficiency and safety as \"very good\" or \"good\".</p>","PeriodicalId":12358,"journal":{"name":"Fortschritte der Medizin. Originalien","volume":"119 Suppl 2 ","pages":"55-61"},"PeriodicalIF":0.0,"publicationDate":"2001-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24952910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Prevention of pneumococcal infection by vaccination].","authors":"H Bertz","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and objective: </strong>Infections with pneumococcus have a high morbidity and mortality rate. The elderly and patients with an immunodeficiency are at particular risk. The increasing resistance of Streptococcus pneumoniae to antibiotics impairs effective treatment. Prophylactic vaccination is possible since 1977. The currently available 23-valent polysaccharide vaccine is effective against more than 90% of the most common pneumococcal serotypes. Although the STIKO (Ständige Impfkommission am Robert-Koch-Institut, Berlin) has been recommending vaccination for the elderly and at risk patients since 1995, only 6% of the elderly are vaccinated.</p><p><strong>Patients and methods: </strong>In 1999 in a prospective observational study involving 4347 vaccinations, in addition to demographic and anamnestic data, the tolerability of Pneumovax 23 was documented by the physician on the basis of a score (very good/good/moderate/ poor). Adverse events (AE) were recorded on the questionnaire of the Paul Ehrlich Institute. 83.5% of the patients were older than 60 years and 44% had at least one additional chronic disease. Influenza vaccinationwas given simultaneously in 23%.</p><p><strong>Results: </strong>In 95.9% of the 4271 evaluable patients local, and in 97.3% systemic tolerability was assessed to be very good/good. Only in 1.4% (n = 60) of the patients were local and/or systemic adverse events seen.</p><p><strong>Conclusion: </strong>Pneumococcal vaccination--also in combination with influenza vaccine, is safe and cost-effective.</p>","PeriodicalId":12358,"journal":{"name":"Fortschritte der Medizin. Originalien","volume":"119 Suppl 2 ","pages":"71-5"},"PeriodicalIF":0.0,"publicationDate":"2001-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24952912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}