Med Klin
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Comment Randomized Controlled Trial Clinical Trial
[Cost effectiveness of captopril after myocardial infarct; comment].
In Germany approximately 88,000 people died as a result of acute myocardial infarction and approximately 300,000 people suffered from acute myocardial infarction in 1992. These data demonstrate the socioeconomic impact of coronary disease. In the SAVE-(Survival-and-Ventricular-Enlargement) study, Pfeffer et al. demonstrated a reduction of morbidity and mortality due to therapy with captopril in patients after myocardial infarction. In a retrospective, incremental cost-effectiveness-analysis, from the perspective of German statutory insurance fund, the economic impact of captopril after myocardial infarction has been analysed. ⋯ The treatment with captopril after acute myocardial infarction is not only a clinically efficacious treatment, but also cost-effective in patients after acute myocardial infarction.
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Case Reports Randomized Controlled Trial Multicenter Study Clinical Trial
[Quality of life in patients with acute myeloid leukemia].
In oncology, quality of life has become an essential criterion for evaluating the effects of therapy in clinical trials. So far, in adult patients suffering from acute leukemia assessment of quality of life has not been considered possibly due to poor prognosis and the acute course of the disease. Advances in chemotherapy significantly prolong survival of patients with acute myeloid leukemia and may cure a subset of patients. Therefore, the assessment of quality of life of patients undergoing treatment is of growing interest. ⋯ Preliminary results show the psychooncological relevance of the study for the clinician.
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Randomized Controlled Trial Multicenter Study Clinical Trial
[Mexiletine in treatment of painful diabetic neuropathy].
The objective of this double-blind placebo controlled multicenter study was to prove the efficacy of mexiletine in painful diabetic neuropathy. Treatment was provided for in three dosages. For pain measurements a visual analogue scale (VAS) and McGill's verbal rating scale were chosen. 95 patients were included. ⋯ Mexiletine proved a very safe therapy with negligible side effects at the medium dose range, even less than placebo. There were no cardiovascular side effects. Further investigations should pay more attention to the variety of the complaints and include the quality of life.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
[Treatment of migraine attacks: combination of dihydroergotamine tartrate and paracetamol in comparison with individual drugs and placebo].
In a multi-center, double-blind, placebo-controlled crossover study safety and efficacy of oral dihydroergotamine tartrate (DHE) 2 mg, paracetamol 1000 mg, and a fixed combination of these two agents was compared for the relief of migraine attacks. The effect of the four different treatments on severity and duration of migraine headache was assessed pretreatment and at one and two hours post-treatment in the patient diary (10 point numerical rating scale 0 = no pain, 9 = unbearable pain). Nausea, vomiting, photophobia, phonophobia, and adverse events were also recorded in the patient diary. ⋯ The oral combination of 2 mg DHE and 1000 mg paracetamol is safe and effective in the treatment of acute migraine attacks and should be first choice of therapy in patients who do not respond to mild analgesics like paracetamol alone.
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Randomized Controlled Trial Multicenter Study Clinical Trial
[Recurrence of Hodgkin's disease after advanced primary stages. German Hodgkin's Study Group].
In a multicentre study on the treatment of Hodgkin's disease, 88 out of 297 patients with primary advanced stages IIIB/IV failed to respond to alternating COPP/ABVD chemotherapy +/- radiotherapy. They may be broken down as follows: tumour progression under current therapy (PD) 23/28, partial remission at the end of treatment (PR) 28/88, early nodal recurrence 13/88, late nodal recurrence 15/88, extranodal recurrence 7/88, unclear localisation 1/88. Thirty-six months after noting failure of treatment, 45% of all patients were still alive. ⋯ These data would not appear to be appreciably poorer than those reported in the literature for comparable patients receiving HDC/ABMT. Only a randomized comparison would be capable of showing whether HDC/ABMT is superior to high-dose conventional chemotherapy with haematopoietic growth factors. It is proposed that such a therapeutic trial should be initiated as soon as possible.