Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Jan 1997
Randomized Controlled Trial Comparative Study Clinical Trial[Double-blind comparative study of the effectiveness and tolerance of 900 mg dexibuprofen and 150 mg diclofenac sodium in patients with painful gonarthrosis].
In this randomized double-blind, parallel-group study the efficacy of 300 mg oral dexibuprofen three times daily and 50 mg oral diclofenac sodium three times daily was tested for equivalence in 110 patients with painful osteoarthritis of the knee. During the 15-day treatment period the functional index for knee osteoarthritis according to Lequesne was improved under dexibuprofen by a mean of 7.4 and by a mean of 7.3 under treatment with diclofenac sodium. ⋯ The descriptive analysis of secondary criteria such as intensity of pain, rest pain, pain at beginning, nocturnal pain, tenderness, restriction of movement, handicap, subjective estimation of disease progression, as well as global judgement of efficacy and tolerance by investigator and patient confirm equivalence of both preparations. The pooled analysis of all parameters, tolerability included, by a Mann-Whitney-statistic of 0.520 with the lower boundary of the 95% confidence interval of 0.467 shows equivalence of both drugs with a trend to superiority of dexibuprofen due to its better tolerability. 7.3% of the patients on dexibuprofen and 14.5% of the patients on diclofenac sodium dropped out because of side-effects.
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Wien. Klin. Wochenschr. · Jan 1997
Review[The heart in infection and MODS (multiple organ dysfunction syndrome)].
Dysfunctioning of the heart forms part of the multiple organ dysfunction syndrome (MODS) in sepsis and SIRS. This acute septic cardiomyopathy is often underestimated in degree and relevance, although yet in fact 10% of all sepsis fatalities are due to intractable heart failure. This potentially reversible cardiomyopathy is characterized by a considerable pump failure, is not primarily ischemic, coronary blood flow being normal or even enhanced; left and right ventricle are enlarged as a consequence of an increased ventricular compliance. ⋯ SIRS-cardiomyopathy in non-infectious MODS has common traits with acute septic cardiomyopathy. The pathogenesis of heart disease in sepsis and SIRS is multifactorial, the endotoxin/TNF-alpha/NO/cGMP-cascade representing a main negative inotropic axis. Therapy of acute septic cardiomyopathy and SIRS-cardiomyopathy at present still is mainly symptomatic (volume substitution, inotropic/vasoactive agents), causal therapeutic principles are, however, put to test in the context of a comprehensive concept of causal sepsis treatment.