[How safe is short-term inpatient treatment after laparoscopic cholecystectomy]. / Wie sicher ist die stationäre Kurzzeitbehandlung nach laparoskopischer Cholecystektomie?

In 534 patients after laparoscopic cholecystectomy an earliest discharge was intended. The median day of discharge was day 3 postoperatively. The limitations to discharge were; normal physical findings, temperature back to normal and sonographic findings, which did not exceed the usual fluid accumulation in the gallbladder bed. Under strict application of these limitations no postoperative complication was missed. Due to outpatient pre-examination and operation on the day of admission the total length of stay could be limited to 2 days median. Also in this subgroup of 178 patients the chosen procedure was save.

Antihypertensive efficacy, tolerance, and safety of long-term treatment with ramipril in patients with mild-to-moderate essential hypertension.

A total of 555 hypertensive patients took part in a 2-year multicenter, open-label study to determine the efficacy, tolerance, and safety of long-term therapy with ramipril. In the beginning, all patients were to receive 5 mg of ramipril/day. The dosage was then adjusted in accordance with response to treatment and ranged from 1.25-20 mg of ramipril daily. Of these patients, 129 also received 25 mg of hydrochlorothiazide daily at some point during the trial. To evaluate whether tolerance to ramipril developed during long-term treatment, a subgroup of 202 patients was analyzed for efficacy maintenance. Prior to enrolling in the 2-year study, these patients had received ramipril monotherapy in a short-term, double-blind study and had been classified as responders, i.e., their diastolic blood pressure had been maintained at less than or equal to 90 mm Hg. At the end of 104 weeks of treatment, 45.9% of patients were on 2.5 mg of ramipril alone and 43.6% were on 5 mg of ramipril alone. Only four patients required the addition of 25 mg of hydrochlorothiazide. No clinically important changes occurred, and kidney function was well maintained. The most frequently reported adverse events excluding intercurrent illnesses were dizziness/vertigo (6%), asthenia (4%), nausea (3%), headache (2%), and abdominal pain, gastrointestinal disorder, rash, and increased cough (1% each). Ramipril was safe, effective, and well tolerated in the long-term treatment of patients with mild-to-moderate essential hypertension.