Uric acid lowering effect of oxipurinol sodium in hyperuricemic patients - therapeutic equivalence to allopurinol.

OBJECTIVE: Oxipurinol has been shown to be sufficiently absorbed after oral administration as a rapid release preparation of oxipurinol sodium. We compared the uric acid lowering affect of allopurinol and oxipurinol. METHODS: In a multicenter, randomized, double blind crossover trial in 99 hyperuricemic patients with normal renal function we investigated the uric acid lowering effect of oxipurinol sodium (O) in daily amounts equimolar to 300 mg allopurinol (A). Mean pretreatment plasma uric acid concentrations in groups A/O and O/A were 8.3 +/- 1.4 and 8.7 + /- 1.4 mg/dl, respectively. RESULTS: In group A/O the mean plasma uric acid decreased to 5.4 +/- 1.2 mg/dl with allopurinol treatment, and increased slightly to 5.7 + /- 1.3 mg/dl during the consecutive oxipurinol period. In group O/A plasma uric acid declined to 6.0 +/- 1.4 mg/dl with oxipurinol and was 5.6 + /- 1.3 mg/dl at the end of the allopurinol period. The overall average reduction compared to baseline was 3.0 mg/dl with allopurinol and 2.6 mg/dl with oxipurinol. The difference between the 2 treatments was small but significant (multiple p=0.027,2 tailed). The corresponding mean plasma oxipurinol concentrations were 9.24 mu g/dl at the end of the allopurinol period and 9.9 mu g/dl after treatment with oxipurinol (NS). CONCLUSION: Oxipurinol is well absorbed and sufficiently effective in hyperuricemic patients when administered as a rapid release preparation of oxipurinol sodium. Oxipurinol sodium could be a substitute for allopurinol in hyperuricemic patients and possibly also with new uses for allopurinol.

[An extended health surveillance program for mentally stressed employees--results and experiences]. / Ein erweitertes Dispensairebetreuungsprogramm für neuropsychisch stark belastete Werktätige--Ergebnisse und Erfahrungen.

One-week physical and psychic fitness training courses are held for nomenclature and management personal annually. Undergoing exercise bouts, they are tested for their cardiocirculatory capacity and given specific information on the type of continuous physical endurance training they should carry out. A follow-up course one year later reviews the level of fitness reached. The follow-up course focuses on a psychologically oriented manager training group talks and concentrative relaxation. Other groups of working people, including shift workers and mothers with several children are given the opportunity to undergo a four-week physical fitness training during preventive spa treatment courses. 140 persons attend this type of treatment every year. For the purpose of objectifying treatment results and reviewing the cardiocirculatory capacity random samples were taken of 20 persons exercising on a fitness machine before, immediately after and six months after the treatment course. Biochemical parameters were also determined. Physical fitness was up between 25 and 50 watts in 72 per cent of the test persons. Under exercise, the blood pressure and the heart rate fell significantly. The LPTT, cholesterol and uric-acid levels in serum were below the initial values. The improved fitness persisted only in 27 per cent of the test persons after six months, with the biochemical parameters equalling the initial values. Preventive measures in the form of physical fitness should be extended at enterprise and local levels. However, working people should be more aware of the possibilities available for physical fitness training.

[Decreasing blood pressure in essential hypertension with physical training]. / Untersuchungen zur Blutdrucksenkung durch physisches Training Bei patienten mit essentieller Hypertonie.

Eighty-eight patients with the stage 1 hypertension according to the WHO classification exercised on a bicycle ergometer for 30 min daily at the heart rate 130-140 beats/min for 28 days. In 42% of the patients the systolic pressure at rest, during exercise, and in the recovery period decreased significantly; in 58% of them the systolic pressure did not sink. The diastolic pressure during exercise sank in those patients whose systolic pressure was reduced by the effect of the exercise, whereas in those patients who did not respond to exercise by a reduction of the systolic pressure, the diastolic pressure did not change, either. The following indicators differentiated the responders and non-responders to exercise: height of systolic pressure during exercise and recovery period, height of diastolic pressure at rest, disturbed glycide metabolism, presence of hypertension in the family history, sports in anamnesis and cardiac index.

[Non-drug modification of high blood pressure]. / Nichtmedikamentöse Beeinflussung des Hochdruckes.

Arterial essential patients with hypertension of the clinical degrees of severity I and II are treated either with physical training or with a psychophysiologically orientated therapy, in the centre of which stands the application of a breath-induced relaxation training. After a 4-week daily application the physical training led in 42% of the cases to a significant reduction of the blood pressure. These concerning the blood pressure trainable patients differed from the non-trainable patients among others by the following signs: higher systolic stress and recreation values before the beginning of the training, lower diastolic values, smaller familiar load by hypertension and more frequent disturbances of carbohydrate metabolism. After a 3-month psychophysiologic therapy 80% of the patients exhibited normotonic or borderline values in self-measurements of the blood pressure and at first a medicamentous treatment could not be continued. Follow-up examinations for testing the long-term effect of the two methods are necessary.