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Biomedical subjects

O Mickisch

Publications and source records attributed to O Mickisch.

8 recordsLinked to original sources
PubMed2006

Budesonide foam versus budesonide enema in active ulcerative proctitis and proctosigmoiditis.

BACKGROUND: Rectal budesonide is an effective treatment of active ulcerative proctitis or proctosigmoiditis. AIM: To compare the therapeutic efficacy, tolerability and safety, and patient's preference of budesonide foam vs. budesonide enema. METHODS: Patients with active ulcerative proctitis or proctosigmoiditis (clinical activity index > 4 and endoscopic index > or = 4) were eligible for this double-blind, double-dummy, randomized, multicentre study. They received 2 mg/25 mL budesonide foam and placebo enema (n = 265), or 2 mg/100 mL budesonide enema and placebo foam (n = 268) for 4 weeks. Primary endpoint was clinical remission (clinical activity index < or = 4) at the final/withdrawal visit (per protocol). RESULTS: A total of 541 patients were randomized--533 were evaluable for intention-to-treat analysis and 449 for per protocol analysis. Clinical remission rates (per protocol) were 60% for budesonide foam and 66% for budesonide enema (P = 0.02362 for non-inferiority of foam vs. enema within a predefined non-inferiority margin of 15%). Both formulations were safe and no drug-related serious adverse events were observed. Because of better tolerability and easier application most patients preferred foam (84%). CONCLUSION: Budesonide foam is as effective as budesonide enema in the treatment of active ulcerative proctitis or proctosigmoiditis. Both budesonide formulations are safe, and most patients prefer foam.

Administration, Rectal↗
PubMed2002

[Long-term management of anemia in chronic inflammatory bowel disease].

The development of a stepwise therapy, as detailed below, can be administered to the mostly young patients with Crohn's disease and ulcerative colitis on an out-patient basis and appropriate to their needs. This is true not only for the activity of the disease, but also for extraintestinal manifestations. The numerous variations in the stepwise anti-inflammatory therapy of chronic inflammatory bowel disease, but also in the substitution therapy of deficiency states and the therapy of accompanying extraintestinal diseases provide the gastroenterologist with the possibility of a long-term treatment tailored to the needs of the individual patient.

Anemia, Iron-Deficiency↗
PubMed1992

[An interesting case--endoscopic hemostasis of an actively bleeding sigmoid diverticulum--a case report].

A pulsating arterial bleeding from a diverticulum, situated in the colon sigmoideum, was identified and stopped during video-documentation in a 70 year-old man. After injection with a solution of suprarenin, the diverticulum was turned out like a balloon into the colon and didn't show any signs of further bleeding until the patient was prepared for a semi-elective resection of the sigmoid. This case demonstrates that emergency endoscopy is an effective method for diagnosis and even therapy of massive lower intestinal bleeding which eventually has to be supplemented by radiological techniques like scintigraphy and arteriography.

Aged↗
PubMed1992

[Esophageal perforation in attempted ERCP].

In this report we refer to a 88-years old female patient who was admitted to our hospital under the diagnosis of cholecysto- and choledocholithiasis. Due to clinical symptoms, general performance status and sonographically proven dilated bile ducts emergency-ERCP was performed by an experienced endoscopist. Unfortunately esophageal perforation occurred due to subsequently diagnosed hiatus hernia. Potential pitfalls during examination as well as a concept of problem management during endoscopies with side-view optics will be discussed.

Aged↗
PubMed1988

[Calcium antagonists in chronic renal failure. Undesirable effects on glomerular hemodynamics?].

Seven patients with glomerular proteinuria and hypertension (six with biopsy confirmation of glomerulonephritis, one with proteinuria after unilateral nephrectomy) were randomly given, for 14 days each, a calcium antagonist and then a conversion enzyme inhibitor, or vice versa, following a 14-day pause of all medication. Fractional albuminuria rose significantly during administration of calcium antagonists (P less than 0.05), while it decreased significantly during administration of converting enzyme inhibitor (P less than 0.05). The explanation for this finding may be that calcium antagonists raise glomerular capillary pressure by dilating the afferent arterioles, while converting enzyme inhibitors predominantly cause dilatation of the efferent arterioles.

Adult↗
PubMed1984

Multicystic transformation of kidneys in chronic renal failure.

With real-time sonography, 120 nondialyzed uremic patients prior to hemodialysis, 108 patients on maintenance hemodialysis and 9 patients postdialysis after successful homotransplantation were examined for the presence of renal cysts. Even in incipient renal failure, multiple cysts were demonstrable in some patients (at a serum creatinine of 3 mg/dl in 22% of patients), particularly in patients with analgesic nephropathy. When hemodialysis was started (serum creatinine approximately 10 mg/dl), 35% of the patients had multiple cysts. On hemodialysis, the prevalence, number and size of cysts rose progressively with time. After 8 years of hemodialysis, 92% of the patients had multiple cysts. However, enlargement of the kidneys was observed in only 2/108 patients. No major clinical complications were noted with the possible exception of 1 case of renal cell carcinoma. No correlation was noted between hematocrit and presence or extent of cystic transformation, but the 2 patients with cystic enlargement of the kidneys were polyglobulic. In 8/9 patients after transplantation, cysts were demonstrable in the patient's own kidneys after a median follow-up of 16 months. On light microscopy, cysts were lined by cuboidal or columnar epithelial cells with frequent papillary or adenomatous proliferations. The cyst lumen was filled with amorphous or lamellated organic material, which exhibited microfibrillar structure on electron microscopy. One kidney examined after ex vivo perfusion fixation showed multiple interconnected cavities on scanning electron microscopy. Ultrastructural studies showed epithelia with either the characteristics of proximal tubular cells (i.e. numerous microvilli, interdigitations and abundant lysosomes or mitochondria) or distal tubular cells (i.e. highly interdigitating processes) or finally collecting duct cells (i.e. no interdigitations and few microvilli).

Acute Kidney Injury↗