Fortschritte der Medizin. Originalien最新文献

{"title":"[Five days ceftibuten versus 10 days penicillin in the treatment of 2099 patients with A-streptococcal tonsillopharyngitis].","authors":"D Adam,&nbsp;H Scholz,&nbsp;M Helmerking","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Unlabelled: </strong>Group A Streptococci have remained sensitive to penicillins and other betalactam antibiotics, e. g. cephalosporins. Since the beginning of the 1950s oral penicillin V given three times daily in a dose of 50,000 IU daily has been the drug of choice against Group A streptococcal infection. The German Society for Pediatric Infectious Diseases (DGPI) undertook a large scale multicenter randomized study of culture-proven A-streptococcal tonsillopharyngitis to compare the efficacy and safety of a five day regimen of ceftibuten (9 mg/kg KG, once daily) with 10 days of penicillin V (50,000 I.E./kg KG, divided in three doses), testing for equivalence of clinical and bacteriological efficacy. A one year follow-up served to assess poststreptococcal sequelae like rheumatic fever or glomerulonephritis.</p><p><strong>Results: </strong>The clinical efficacy at the clinical end-point 7-9 days after end of treatment was 86.9% (419/482) for ceftibuten and 88.6% (1,198/1,352) for penicillin V. This result is statistically equivalent (P = 0.0152). Resolution of clinical symptoms was significantly faster in the ceftibuten group (P = 0.043/Fisher-Test) and compliance was significantly superior as well (P (0.001). Eradication of group A streptococci at an early control 2-4 days after end of treatment was not equivalent, 78.49% for ceftibuten and 84.42% for penicillin V (P = 0.5713). Both eradication rates were comparable 7-8 weeks after end of treatment (84.65%, 375/443 ceftibuten vs. 86.82%, 1,067/1,229 penicillin V), the difference not being significant. No cases of poststreptococcal sequelae, e.g. rheumatic fever or glomerulonephritis, attributable to either ceftibuten or penicillin were observed in the course of the study.</p>","PeriodicalId":12358,"journal":{"name":"Fortschritte der Medizin. Originalien","volume":"119 Suppl 2 ","pages":"63-70"},"PeriodicalIF":0.0,"publicationDate":"2001-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24952911","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":"[Improving textile sun protection by regular washing of clothing].","authors":"P Kaskel,&nbsp;H Rohwer,&nbsp;U Osterwalder,&nbsp;R U Peter","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The highest priority in the prevention of malignant tumors of the skin is given to the avoidance of sun-induced reddening of the skin and sunburn at any age. The usual recommendation is to keep out of the sun between 11 am and 3 pm, wear a sun-hat and appropriate clothing, and use a sun screen (UV-A and UV-B) that doesn't wash off on exposed skin and when in the water. With regard to the wearing of clothing protecting against UV radiation, compliance must be expected to be low, since just such protective clothing (in particularthick, densely-woven materials) is unsuitable for the summer. Using detergents containing a UV absorber in the home wash, even light summer wear can be made to offer good UV protection.</p>","PeriodicalId":12358,"journal":{"name":"Fortschritte der Medizin. Originalien","volume":"119 Suppl 2 ","pages":"91-4"},"PeriodicalIF":0.0,"publicationDate":"2001-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24951117","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":"[Lumbar lateral recess stenosis. Clinical symptoms, diagnostic modalities and surgical management].","authors":"B Wörner,&nbsp;M Lange,&nbsp;U Fink,&nbsp;R Oeckler","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>In spite of its importance for lumbar radicular syndroms only a few reports about lumbar lateral recess stenosis exist in literature. Most important clinical symptom is radicular pain, which may be exercise-dependent. Confirmation of diagnosis and differentiation from disc herniation requires imaging like CT, MRI or post-myelo-CT. Surgical treatment options include selective decompression techniques like foraminotomy, medial facettectomy and undercutting as well as hemilaminectomy, laminotomy and wide laminectomy or fusion.</p><p><strong>Method: </strong>We treated 35 patients with selective decompression techniques.</p><p><strong>Results: </strong>In the follow-up 5 up to 18 months after surgery 25 patients for themselves described the results as good or excellent. Therefore, individually tailored selective microsurgical decompression is an appropriate and successful treatment strategy for lumbar lateral recess stenosis, if conservative treatment fails.</p>","PeriodicalId":12358,"journal":{"name":"Fortschritte der Medizin. Originalien","volume":"119 Suppl 2 ","pages":"51-4"},"PeriodicalIF":0.0,"publicationDate":"2001-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24952909","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":"[Nebivolol, a third generation beta blocker: the modern treatment of hypertension. Results of a multicentric observational study].","authors":"J von Fallois,&nbsp;H D Faülhaber","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Nebivolol represents a new therapeutic class of beta blockers with high beta1 selectivity and the ability to modu late the direct vascular reactions through the liberation of nitric oxide (NO) by the endothelial cell. Its antihypertensive action develops at a once-daily dosage. The main aim of the study was to determine the tolerability and antihypertensive efficacy of nebivolol in hypertensives with or without concomitant diseases.</p><p><strong>Methods and results: </strong>The observational study was carried out in 1529 centers on 6376 patients with hypertension over a period of 6 weeks. The initial daily dosage was 5 mg or 2.5 mg in patients older than 65. Under treatment, the systolic blood pressure decreased by a mean (+/- 1 standard deviation) of 29 mmHg (+/- 17 mmHg) from 173 mmHg (+/- 18 mmHg) initially, to 144 mmHg (+/- 14 mmHg) by the end of the observation period. The diastolic blood pressure decreased by a mean of 16 mmHg (+/- 10 mmHg) from 101 mmHg (+/- 9 mmHg) initially to 85 mmHg (+/- 8 mmHg) by the end of the observation period (p < 0.001). Normalization of the diastolic blood pressure (< 90 mmHg) was achieved in 62.2% of the patients. The mean heart rate at the start of the study was 84 (+/- 12) vs. 73 (+/- 8) beats per minute by the end of the study (reduction: 10.6 +/- 10.3 beats per minute). The decrease in blood pressure and heart rate depended on the baseline values, that is, higher blood pressure and higher heart rates initially showed a greater reduction (both parameters) in comparison with moderately elevated initial values. Cholesterol, triglycerides and blood sugar decreased significantly (p < 0.001) duringthe observation period. For triglycerides the decrease was 13%, for cholesterol 8%. Diabetics benefited most (reduction in triglycerides 18%, in cholesterol 9%); here, the glucose concentration decreased by 16%. Physician-assessment of the efficacy of nebivolol was 93%, tolerability 97% (very good or good).</p><p><strong>Conclusion: </strong>In this large multicentric observational study, the substance nebivolol proved to be a safe, largely side effect-free antihypertensive. Its favorable metabolic properties must be considered positive, in particular with regard to the possible development of coronary heart disease.</p>","PeriodicalId":12358,"journal":{"name":"Fortschritte der Medizin. Originalien","volume":"118 Suppl 2 ","pages":"77-82"},"PeriodicalIF":0.0,"publicationDate":"2000-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24949173","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":"[Treatment of type 2 diabetes mellitus with the alpha-glucosidase inhibitor Miglitol in the doctor's office].","authors":"H C Fehmann","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and method: </strong>In an observational study carried out in accordance with paragraph 67 (6) of the AMG and beginning in May 1998, 846 patients with type 2 diabetes mellitus were followed for a period of three months by general practitioners and internists. The aim was to acquire data on the efficacy and tolerability of the alpha-glucosidase inhibitor, Miglitol, used in the doctor's office setting. A major point of interest was to determine the feasibility of using a regimen of gradually increasing doses in daily practice. The parameters investigated were HbA1c, fasting blood glucose and changes in the patient's weight. Any side effects were recorded by the care-providing physician and evaluated in the global tolerability analysis.</p><p><strong>Results: </strong>The demographic data showed a balanced distribution of male and female patients. The average age of the men was 62 years, of the women 65 years. At the start of the observation, 62% of the patients had polyneuropathy, 35% retinopathy, and 25% nephropathy. 620 patients (73.3%) had received prior antidiabetic treatment. Depending on tolerability, the dose of Miglitol was increased individually from an initial 3 x 50 mg to 3 x 100 mg. 63.8% of the patients remained at the initial dose of 3 x 50 mg. A clear decrease in both HbA1c and fasting blood glucose was observed under treatment. During the course of the three months, the BMI decreased slightly by an average of 0.4 kg/m2, a desirable side effect in this patient group. Adverse reactions occurred in 39 ofthe 846 patients in the form of flatulence, diarrhea and enterospasm.</p><p><strong>Conclusion: </strong>Treatment with the alpha-glucosidase inhibitor Miglitol proved to be highly effective and readily combinable with other antidiabetics. Its efficacy was assessed to be \"very good\" or \"good\" by 86.5% of the physicians, and more than 90% assessed its tolerability to be \"very good\" or \"good\".</p>","PeriodicalId":12358,"journal":{"name":"Fortschritte der Medizin. Originalien","volume":"118 Suppl 2 ","pages":"55-61"},"PeriodicalIF":0.0,"publicationDate":"2000-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24948648","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":"[Moxifloxacin in the treatment of chronic bronchitis--clinical evaluation and assessment by patients].","authors":"J Lorenz,&nbsp;W Busch,&nbsp;I M Thate-Waschke","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and method: </strong>The aim of this trial conducted in the offices of pneumologists was to evaluate the clinical success of a 5-day course of oral moxifloxacin administered once daily at a dose of 400 mg in 328 patients with acute exacerbation of chronic bronchitis (Anthonisen type 1). In this non-comparative study, the results of treatment were assessed not merely on the basis of the clinical parameters, but also, for the first time, by the surrogate marker of patient satisfaction and the improvement in cough, dyspnea, chest pain and sputum, the severity of which was scored daily by the patient himself.</p><p><strong>Results: </strong>Cough, chest pain and the purulence of the sputum improved rapidly within the first five days of treatment. At least 90% of the patients reported their satisfaction with the antibiotic. The clinical success rate (cure and improvement) for all the patients involved (ITT analysis) was 90.5%. The most common side effect was diarrhea, while the other side effects showed no specific pattern.</p>","PeriodicalId":12358,"journal":{"name":"Fortschritte der Medizin. Originalien","volume":"118 Suppl 2 ","pages":"63-70"},"PeriodicalIF":0.0,"publicationDate":"2000-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24948651","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":"[Doxazosin in the gastrointestinal therapeutic system (GITS) and doxazosin standard in patients with benign prostatic hyperplasia. Double-blind trial of efficacy and tolerability].","authors":"P Gratzke,&nbsp;R S Kirby","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and method: </strong>This randomized, doubleblind, multicenter, parallel-group, placebo-baseline study compared the effects of doxazosin GITS 4 mg or 8 mg once daily with doxazosin standard 1 mg to 8 mg once daily in 678 men with benign prostatic hyperplasia (BPH). Following a 2-week washout period and a 2-week, single-blind, placebo run-in phase, patients were randomized to 13 weeks of double-blind treatment with doxazosin GITS, initiated at 4 mg once daily and titrated to 8 mg once daily after 7 weeks, if needed, and doxazosin standard, initiated at 1 mg once daily, titrated to 2 mg after 1 week, to 4 mg at 3 weeks, and to 8 mg at 7 weeks if needed. The primary outcome measures were mean changes from baseline to the final visit for International Prostate Symptom Score (I-PSS) and maximum urinary flow rate in the per-protocol analysis (PPA) population. Secondary outcomes included other aspects of BPH symptoms and urinary flow; and assessment of sexual function in the PPA and intent-to-treat populations, as measured by the International Index of Erectile Function (IIEF).</p><p><strong>Results: </strong>Doxazosin GITS and doxazosin standard produced clinically and statistically significant equivalent reductions in BPH symptoms, including least-square mean decreases in total I-PSS of -8.1 +/- 0.3 and -7.9 +/- 0.3 from baseline, respectively (p < 0.001 vs baseline for each). Both therapies significantly improved maximum urinary flow rates by 2.7 +/- 0.3 ml/s (least-squares mean change from baseline, p < 0.001). The beneficial effects of both therapies on secondary parameters of symptoms and urinary flow were consistent with these findings. Significant improvements in sexual function were observed with both therapies among individuals with sexual dysfunction at baseline. Nearly half of patients on doxazosin GITS achieved BPH symptom relief at the initial 4-mg dose.A similar number of patients in both doxazosin groups were titrated to the maximum dose of 8 mg for both formulations. While both agents were well tolerated, the incidence of at least one treatment-emergent adverse event was significantly lower among patients treated with doxazosin GITS (p = 0.003).</p><p><strong>Conclusions: </strong>Doxazosin GITS and doxazosin standard produced comparable significant reductions in BPH symptoms and improvements in maximum urinary flow rates. A therapeutic effect equivalent to that of doxazosin standard was achieved with doxazosin GITS with fewer titration steps and enhanced tolerability. Both formulations of doxazosin improved sexual function in individuals with dysfunction at baseline.</p>","PeriodicalId":12358,"journal":{"name":"Fortschritte der Medizin. Originalien","volume":"118 Suppl 2 ","pages":"83-92"},"PeriodicalIF":0.0,"publicationDate":"2000-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24949174","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":"[Diagnosing magnesium deficiency. Current recommendations of the Society for Magnesium Research].","authors":"L Spätling,&nbsp;H G Classen,&nbsp;W R Külpmann,&nbsp;F Manz,&nbsp;P M Rob,&nbsp;H F Schimatschek,&nbsp;W Vierling,&nbsp;J Vormann,&nbsp;A Weigert,&nbsp;K Wink","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The cardiovascular risk increases with decreasing serum levels of magnesium, and this already at concentrations within the previous reference range (0.70-1.10 mmol/L). For this reason, the Society for Magnesium Research has updated its 1986 recommendations for the diagnosis of magnesium deficiency. The diagnosis is based on the patient's history, his clinical symptoms, and the results of clinical-chemical investigations of plasma/serum and urine. Further diagnostic methods used include the determination of ionized serum magnesium and the magnesium retention test. The optimal serum magnesium concentration is > 0.80 mmol/L.</p>","PeriodicalId":12358,"journal":{"name":"Fortschritte der Medizin. Originalien","volume":"118 Suppl 2 ","pages":"49-53"},"PeriodicalIF":0.0,"publicationDate":"2000-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24948647","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":"[Environmental pollution--assessment of environmental medicine questionnaires and data in Schleswig-Holstein from 1995-1997].","authors":"A Bauer,&nbsp;C Alsen-Hinrichs","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Physicians qualified in environmental medicine due to their participation in special training courses in the federal state Schleswig-Holstein (Germany) may use a standardized questionnaire to report on their environmental medicine-related cases. The course of the illness and recovery, respectively, if known, is to be documented on a separate data sheet. During a three year period from 1995 to 1997 716 cases and 216 courses of illness and recovery, respectively, have been reported. The relevant environmental factors/toxicants of exposure most frequently documented by these physicians and found to be related to symptoms of illness were biocides (mainly insecticides used indoors for pest control, 31%) molds (30%), dental amalgam (28%), solvents or volatile organic compounds (VOC, 23%) and formaldehyde (17%), respectively. In 47% of the documented cases an exposure to more than one environmental factor/toxicant was registered. Age distribution as well as the symptoms of illness of the patients were found to be dependent on the type of exposure. After the physicians diagnosis of an environmental medicine-related illness the exposure was stopped completely in 57% of those cases of whom the course of the illness was known. Recovery was reported in 62% of these patients, and additional 30% had improved but had not recovered completely at the time of data-assessment. From these results it may be concluded that research work in the field of environmental medicine should be enforced in order to prevent unnecessary illness and to lower the costs of the public health system.</p>","PeriodicalId":12358,"journal":{"name":"Fortschritte der Medizin. Originalien","volume":"118 Suppl 2 ","pages":"93-6"},"PeriodicalIF":0.0,"publicationDate":"2000-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24949175","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":"[Asthma training in children and adolescents].","authors":"O Laub","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In Germany, asthma training courses have been available for a number of years now. The efficacy of these courses in terms of quality of life improvement and the economics of such training has been demonstrated unequivocally. In the present study, the development of asthma training in Germany is discussed. In recent years, in particular, it has been shown that the involvement of the patient's family is of considerable importance. In addition, in the practical work of the asthma trainer, instruments for quality testing and quality control of presently established concepts have been developed, which guarantee a high standard of most pediatric training programs. The interdisciplinary aspect has an eminently important role to play: the cooperation on equal footing of various occupational groups enables the team to adopt a number of different options with regard to their pupils and their families. A model providing a description of coping with the disease on a number of different levels has been worked out (8-level model). In the concept developed by the pediatric hospital in Osnabrück, the social aspect in relation to the child takes pride of place.</p>","PeriodicalId":12358,"journal":{"name":"Fortschritte der Medizin. Originalien","volume":"118 Suppl 2 ","pages":"71-5"},"PeriodicalIF":0.0,"publicationDate":"2000-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24948653","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}