Med Klin
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Randomized Controlled Trial Clinical Trial Controlled Clinical Trial
[Iodine therapy for iodine deficiency goiter and autoimmune thyroiditis. A prospective study].
There is epidemiological and clinical evidence that iodine may induce or promote the manifestation of autoimmune thyroiditis. For this reason it is important to know if substitution of alimentary iodine deficiency or iodine treatment of endemic goitre can cause formation of thyroid antibodies. On the other hand the practical importance of this phenomenon should be evaluated. ⋯ Possible antibody reactions have no clinical importance at all. Individual cases must be observed. Low iodine doses should be preferred. Combined iodine/T4 treatment seems to have an advantage regarding immunological thyroidal reactions.
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NATURAL HISTORY OF HEPATITIS C-INFECTION AND VIRAL CHARACTERISTICS: Hepatitis C-virus (HCV) infection is a major cause of non-A, non-B-hepatitis and, additionally, is associated with liver cirrhosis and hepato-cellular carcinoma. The high degree of chronificity of HCV-infection is reasonable due to antigenic variability of neutralizing epitopes leading to incomplete immunoresponse with subsequent virus persistence. Besides genetic variants of HCV within a virus population (quasispecies nature of HCV), different genotypes are classified being genetically and phenotypically distinct, and geographically restricted in part. ⋯ In this context, variations of interferon therapy should be evaluated (e.g. higher and daily doses, longer duration of interferon therapy, "retarded" interferon (PEG-IFN). In addition, new therapeutical concepts should be performed including a combination of interferon with other known antiviral agents (amantadine), a combination with immunomodulators (GM-CSF, thymosin alpha 1), the development of new antiviral agents (inhibitors of viral proteases, helicases and polymerases) and the exploration of anti-viral, molecular strategies (specific ribozymes, antisense oligonucleotides and DNA-vaccination). Nevertheless, the development of an effective vaccination should be the most important challenge for the future.
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Multicenter Study Comparative Study
[Community-acquired respiratory tract infections. Current data on the efficacy of various classes of antibiotics and antibiotic resistance of the main prevalent bacteria species].
The American Thoracic Society regards fluoroquinolones together with macrolides and doxycycline as first choice antibiotics in the empirical treatment of community acquired pneumoniae in non-hospitalized patients, while the Deutsche Gesellschaft für Pneumology only recommends macrolides and doxycycline for these patients. ⋯ These susceptibility data and the known prevalence of other respiratory tract pathogens such as Chlamydia pneumoniae and Mycoplasma pneumoniae which are sensitive to erythromycin and tetracycline therefore support the recommendations of the Deutsche Gesellschaft für Pneumology. However, newer fluoroquinolones with increased activity against pneumococci may be a helpful alternative for patients with persistent and recurrent exacerbations of respiratory infections and patients with relevant underlying diseases or relevant risk factors.