[Dexketoprofen-trometamol and tramadol in acute lumbago]. / Dexketoprofen-Trometamol und Tramadol bei akuter Lumbago.

UNLABELLED: BACKGROUND, METHOD: The analgesic efficacy and tolerability of dexketoprofen-trometamol (DKPT) was compared with tramadolhydrochloride (TRAM) in a multicentre, randomised, double-blind, clinical trial in 192 Patients with acute low back pain. The initial pain at rest and on movement should be at least 50 mm on a 100 mm visual analogue scale. The daily dose during the 7 days' treatment was 50 mg TRAM t.i.d. (n = 95) or 25 mg DKPT t.i.d. (n = 97). The patients were allowed to take additional Paracetamol up to 4 x 500 mg per day as rescue medication. RESULTS: From the 4th day of treatment pain on movement decreased significantly (p = 0.044) in the DKPT-group in comparison with the TRAM-group. The nocturnal pain decreased during the treatments with a difference in therapies of 22.9% in favour of DKPT. Within the DKPT-group the patients required additional Paracetamol more often only during the 1st day of treatment whereas the patients of the TRAM-group required the additional rescue medication mainly during the first 3 days of treatment. This difference was statistically significant (p = 0.011). Under DKPT treatment patients experienced significantly less adverse events (with an at least "possible" causal relationship; p = 0.026). This can be explained by central nervous disturbances that occurred only in the TRAM group. The distribution of gastro-intestinal disorders was identical in both treatment groups. CONCLUSION: With this results DKPT in comparison with TRAM also showed to be a strong analgesic drug with a better risk-benefit relation due to its better tolerability.

Report of a case with giant condyloma (Buschke-Löwenstein tumor) localized in the bladder.

Giant condyloma is a variation of condylomata acuminata caused by a sexually transmitted virus infection. Although it is a benign disease, it carries a risk of malignant transformation. Primary locations of giant condyloma are the perianal region and the external genitalia. Bladder involvement is rare. We report on a patient with multiple sclerosis in whom a giant condyloma developed in the bladder. Systemic immunosuppression for the treatment of multiple sclerosis and/or chronic cystitis as a result of neurogenic bladder dysfunction might be a risk factor for the development of giant condyloma of the bladder.

[Therapy of rheumatic disease with a hydroxyethylsalicylate gel. Results of 2 clinical studies of effectiveness and bioavailability]. / Rheumatherapie mit einem Hydroxyethylsalicylat-Gel. Ergebnisse zweier klinischer Untersuchungen zur Wirksamkeit und Bioverfügbarkeit.

Two clinical studies were carried out to investigate the efficacy and safety as well as the local and systemic availability of a hydroxyethylsalicyclate gel. A double blind, multicenter trial, involving 113 patients with nonarticular rheumatic back pain, revealed statistically significant relief of pain as compared with placebo. Local and systemic tolerance was excellent. An open study of bioavailability after local application in 16 patients showed a mean salicylate concentration of 0.93 +/- 0.5 microgram/ml in the synovial fluid and 0.40 +/- 0.23 microgram/ml in the synovial membrane, compared with 0.14 +/- 0.04 microgram/ml in the serum. Genetisinic acid was not detected, while OH-hippuric acid was detected only in the serum and synovial fluid.

[Experiences with continent ileostomy (Kock pouch) as bladder substitute in a general hospital]. / Erfahrungen mit der kontinenten Ileostomie (Kock-Pouch) als Harnblasenersatz in einem Krankenhaus der Basisversorgung.

It is reported on the experiences with 13 patients who received in the Urological Department of the Marienhospital Gelsenkirchen after radical cysto-prostatectomy a continent anti-reflux ileostomy (Kock pouch). After a short literature review and a presentation of the operative technique modified by Skinner the indications of a radical cystectomy with construction of a Kock pouch in the treatment of local invasively bladder cancer are described. The survival rates and the perioperative complications are presented.

Plastic surgery in hydronephrosis (Indications and follow-up. Isotope nephrographic studies).

Surgical interventions for the reconstruction of the renal pelvis were performed in 108 cases between 1962 and 1974. On follow-up, 3 to 6 months after operation the results were found good or satisfactory in 54 cases (50%). Isotope nephrography revealed a good or satisfactory fall of the curve in the excretion phase in 49 out of the 54 cases (94%), distinct retention curves having been found in the remaining 6%. In 35% of these cases isotope nephrography showed a far more complete urinary drainage than it had been assumed on the ground of radiography. In 63% of the cases the results of the two diagnostic methods were congruent.

Scintigraphical examinations in kidney trauma.

Thirty-three patients with acute renal trauma and 9 others sent to us for a specialist's opinion were examined radiologically and scintigraphically in the years 1971-1973. Scintigraphy proved to be an important complementary examination to the radiological procedures for the estimation of the impaired functional status of the damaged kidney. In half of the cases X-ray alone did not yield an exact assessment of the extent of the damage to the kidney as did the combination with scintigraphy and under some circumstances with isotope nephrography. Sometimes the X-ray picture allowed an under- or overestimation of the renal damage. Both radiological procedures are without risk and simple to carry out. In some instances this nuclear-medical complemntary examination can more exactly answer the question whether kidney trauma is involved.