[Parathyroid carcinoma]. / Beobachtungen zum Epithelkörperchencarcinom.

The parathyroid carcinoma is a rare cause of primary hyperparathyroidism. It deserves special attention in regard to diagnosis and treatment. Within a period of 10 years we observed 117 patients with primary hyperparathyroidism (pHPT) at the University Hospitals of Ulm and Heidelberg. In five patients a parathyroid carcinoma was found, corresponding to an incidence of 4.4%. In four of five patients no clinical signs were evident preoperatively indicating a parathyroid malignancy.

[Falciparum malaria in East African tourists in spite of fansidar prevention. A contribution on increased chloroquine and pyrimethamine-sulfadoxine resistance in areas of East Africa]. / Falciparum-Malaria bei Ostafrika-Touristen trotz Fansidar-Prophylaxe. Ein Beitrag zur wachsenden Chloroquin- und Pyrimethamin-Sulfadoxin-Resistenz in Gebieten Ostafrikas.

A decreased chloroquine (Resochin) sensitivity of strains of Plasmodium falciparum in certain areas of East Africa has given rise to an inappropriate change of chemoprophylaxis to pyrimethamine-sulfadoxine (Fansidar). Falciparum malaria occurred in five tourists during or after Fansidar prophylaxis. A therapeutic chloroquine-R2-resistance was observed in one seriously ill patient. In some patients the course of disease was prolonged to such an extent that the diagnosis could be established only after as much as 4 months after the end of the journey. This was in part surely caused by intake of anti-plasmodial drugs such as sulfonamides, tetracyclines and co-trimoxazol. The high mortality of falciparum malaria of nearly 10% in this country does not depend on the choice of drug prophylaxis or on problems of resistance, but still on a missed or delayed diagnosis.

[Tourism and risk of infection (author's transl)]. / Tourismus und Infektionsrisiko

Great streams of tourists flow every year from the Federal Republic to southern countries. The danger of infection with serious tropical diseases such as smallpox, cholera or leprosy is fairly small, statistically speaking. Even exotic parasitoses merit only individual medical interest in the majority of cases. Of greater importance are the cosmopolitan infectious diseases such as typhoid fever, paratyphoid, salmonella enteritis, poliomyelitis, viral hepatitides which are transmitted orally and altogether are imported in no small numbers. The alteration of the mode of living caused by the holiday and frequently a false confidence in the hygienic conditions favor the infection. Almost independent of the behavior of the tourists are the infections produced by insect bites, such as malaria or the leishmaniases, which often end fatally for lack of recognition. Here, a better enlightment of the travelers, the use of prophylactic agents and improvement of diagnosis must be instituted.