The intestinal absorption of orally administered hydrolytic enzymes and their effects in the treatment of acute herpes zoster as compared with those of oral acyclovir therapy.

Oral enzymes are known as therapy of herpes zoster for more than 30 years. Nevertheless, today's standard treatment of herpes zoster in immunocompetent patients is oral acyclovir. Other therapies are no longer customary because of their insufficient efficacy and frequent side effects. The positive results obtained in earlier studies with an orally administered enzyme combination preparation has led to the assumption that this might definitely represent an alternative therapy. The purpose of this study was to determine whether the enzyme combination differs from acyclovir with regard to efficacy and tolerance in the treatment of acute herpes zoster. In this double-blind, controlled, multicenter trial, immunocompetent patients with herpes zoster were randomly assigned to receive one of the two test drugs for 7 days. The parameters of pain and skin lesions were measured over 14-21 days. Forty-four patients were enrolled in the enzyme therapy (ET) group and 46 in the acyclovir thérapie (AT) group. Following entry into the study, patients demonstrated no significant differences with respect to anamnestic or clinical data. Significant differences regarding the statistically evaluated parameters of efficacy were not seen either. Paracetamol use and total pain over 14 days also failed to reveal any notable differences between the two groups. Side effects were observed in four patients of the ET group and in three of the AT group. Results suggest that the therapy of herpes zoster with an orally applied enzyme combination preparation is a valid and even cheaper alternative to therapy with acyclovir.

Comparative trial in volunteers to investigate possible ethanol-ranitidine interaction.

OBJECTIVE: To assess the effect of ranitidine on ethanol absorption after ethanol 0.5 g/kg is given in three single doses of 0.167 g/kg to simulate normal social drinking. DESIGN: A double-blind, placebo-controlled, crossover trial was performed in 16 healthy men. Ethanol serum concentrations were measured on day 6 of each of the three treatment periods (placebo, ranitidine 150 mg bid, or ranitidine 300 mg bid). METHODS: Ethanol 0.167 g/kg was administered followed by a standard meal at 1700. The last tablet of the test medication was given 15 minutes later. Thirty and 60 minutes after the first intake, the same amount of ethanol was given again. Serum ethanol concentrations were measured multiple times during the four-hour period following oral ingestion of the first dose. RESULTS: Comparison of median serum ethanol concentrations, the areas under the curve, peak and time to peak serum ethanol concentrations showed no significant differences during medication with placebo, ranitidine 150 mg bid, or ranitidine 300 mg bid. Peak ethanol concentrations (median values) were 153, 140, and 155 mg/L, respectively. CONCLUSIONS: This study shows that treatment with ranitidine, in a dose up to 300 mg bid, has no significant effect on serum ethanol concentrations, even when ethanol was given in divided doses to simulate normal patterns of social drinking. This implies that concomitant dosing with ranitidine will not increase the adverse effects of moderate doses of ethanol on concentration and psychomotor function.

[Syndrome of the painful external tibial bone]. / Das Syndrom des schmerzhaften Os tibiale externum.

The tuberosity ossis naviculare rises from a separate apophyseal nucleus normally fusing with the os naviculare. In 10% of the cases it remains autonomous during life as os tibiale external. This variance of evolution is dominantly inherited. By statically false position of the foot, but also by traumata the loosening of the synchondrosis may cause sharp pain of the os tibiale external. As to X-rays the accessory tarsal bone may be mistaken for fractures. Normally conservative treatment is successful; if not the operative removal is advisable.