[Documentation and computer-assisted evaluation of basic data in a geriatric clinic]. / Dokumentation und computergestützte Auswertung von Basisdaten einer geriatrischen Klinik.

We analyzed data of our clinic by a computer program for discharge letters developed by us. Structure of patients, types of diseases, and success in rehabilitation were recorded. The average age of our patients was 80 years. The biggest group have been the 80-85 years old ones. Two-thirds have been female. Our department is divided into three sections. Admissions made to the section treating patients with acute diseases were made in two-thirds of the cases from surgeries and in one-third from accidents. The section where patients are rehabilitated received only patients who had been admitted before. Two-thirds of them were suffering from surgical diseases (especially orthopedic/traumatic problems). One-third from medical or neurological diseases--especially stroke. In the section for long-term treatment we transferred patients with chronic diseases, mainly from our own sections for acute care and rehabilitation. Twenty percent came from other departments and other hospitals. Discharge: Fifty-one percent of patients treated in the section for acute care were discharged. More than one-fourth were transferred to the section for long-term treatment. Thirteen percent died. Two-thirds of the rehabilitated patients were discharged home. Sixteen percent were treated long-term; about seven percent died. From our section for long-term treatment one-third of the patients were discharged home. Nineteen percent were discharged to nursing homes or other homes for seniors. Forty-one percent died. Younger patients could more likely be discharged without home nursing care and to a household with other members. More than fifty percent of patients of 80 years and older lived alone and required homecare.(ABSTRACT TRUNCATED AT 250 WORDS)

[Extragenital endometriosis with multiple stenoses of the small intestine]. / Endometriosis extragenitalis mit multiplen Dünndarmstenosen.

This paper reports on the case of a 38-year-old woman with multiple stenoses in the proximal and middle section of the jejunum, as well as in the terminal ileum, who had been symptomatic for nine years, with symptoms progressively reflecting obstruction due to mechanical subileus. The cause was found to be extragenital endometriosis which, with the mucosa remaining intact, was associated with hormone-dependent bleeding with subsequent fibrosis leading to segmental thickening of the bowel wall and narrowing of the lumen. The diagnostic work-up included a radiological study of the small bowel as described by Sellingk, abdominal sonography and a CT exam; the X-ray study and the CT scan revealed stenosing of the bowel, while sonography and CT showed wall thickening. The treatment of this condition comprises resection of the affected bowel segment together with anti-estrogen treatment or ovariectomy, and in this respect differs notable from the more common Crohn's disease of the small bowel, from which it must be diagnostically differentiated.

Prokinetic drug treatment (cisapride) is as effective as H2-blocking agent (ranitidine) in the treatment of gastric ulcer.

A double-blind, randomized, parallel-group multicenter study was conducted in 120 patients with gastric ulcer to compare cisapride, 10 mg t.i.d., and ranitidine, 150 mg b.i.d., administered over 8 weeks. No significant differences between the results of the two treatments were found in terms of ulcer healing or symptomatic relief. Endoscopy showed that the incidence of medium-sized or large ulcers was reduced from 85% at the start to 11% and 4%, respectively, after 4 and 8 weeks in the ranitidine group, and from 98% to 15% and 4%, respectively, in the cisapride group. By week 8, the ulcer was healed in 89% of the ranitidine patients, and in 86% of the cisapride patients. Moderate to severe diurnal epigastric pain--the predominant symptom--was reported by about 80% of the patients in week 8, and by less than 15% from week 4 on. The response to nocturnal epigastric pain, epigastric pressure, sensation of fullness and other symptoms was similar. Except for gastrointestinal symptoms in the cisapride patients--nearly always indicative of enhanced bowel contractions--the occurrence of adverse effects was similar in the two groups. The improvement in gastrointestinal motility under cisapride, would appear to be as effective as suppression of acid secretion in the treatment of gastric ulcer disease.

[Duodenal ulcer - multicenter double-blind study with proglumide]. / Ulcera duodeni - multizentrische Doppelblind-Studie mit Proglumid.

In a randomised multicenter double blind study we investigated the healing-rate with proglumid and an antacid drug, studying 70 in- and outpatients with florid duodenal ulcer. We evaluated the size and depth of 59 chronic duodenal ulcers in 52 patients with endoscopic and x-ray-investigations before and after four-week-treatment. Inpatients of the proglumid-group had a significant higher healing-rate than inpatients in the antacid-group (95% against 70%, p less than 0.05). As found in endoscopy the outpatients in the proglumid-group had a higher healing-rate, but because of the smaller number of patients the difference was not significant. Summarized the in- and outpatients, the proglumid-group had a healing-rate of 83%, the antacid-group of 60% (p less than 0.05). Bigger ulcers with a size more than 120 mm2 at the beginning showed a significant better healing with proglumid than with the antacid-drug (t/2 = 14.6 resp. 24.6 days). With x-ray-examination we could not find differences of healing between the two groups, but younger patients often were not examined. The symptoms of patients did not show a significant difference during the healing-course. We could not find any side-effects. Proglumid is an effective drug for the healing of chronic duodenal ulcers.

[ECG changes and peripheral blood pressure during endoscopic study of the stomach]. / Ekg-Veränderungen und peripheres Blutdruckverhalten bei der endoskopischen Untersuchung des Magens.

It is reported on alterations of ECG and blood pressure appearing in 51 patients during endoscopic examination of the stomach. Above all, these alterations consisted of repolarisation disturbances with a partial preterminal negative T and isolated supraventricular extrasystoles. Atrioventricular blocks or spreading of the QRS-complex were not observed. In all patients a distinct increase in frequency was present while the endoscope was introduced. Since regression of all these alterations would occur after examination, a vegetative-functional stimulus might be the inducing factor. In endoscopic examinations the risk of any incidents appearing in connection with the system of coronary circulation is minimal. In patients with considerable previous damage of the heart caution is advised.