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In Germany, clomethiazole (CLO) and benzodiazepines are predominantly used as therapeutic agents in the treatment of the alcohol withdrawal syndrome (AWS). These agents have disadvantages such as sedation, risk of respiratory insufficiency, and cardiovascular complications as well as addictive potential. Alternatively, it could be demonstrated that both tiapride (TIA) and carbamazepine (CBZ) are efficient in the treatment of AWS with less toxicity. However, they seem to be less effective in AWS than CLO as single agents. But no systematic comparison of the combination of TIA and CBZ against an established therapeutic standard can be found in the literature. Therefore, we compared the combination of TIA and CBZ with CLO in two open exploratory studies with matched samples. Outcome parameters were heart rate, blood pressure, complications, withdrawal symptoms (CIWA-Ar scale), and general clinical state (CGI scale). A retrospective evaluation of medical records (30 TIA+CBZ, 30 CLO) was followed by an open prospective study (40 TIA+CBZ, 40 CLO). Both studies revealed similar efficacy in terms of psychopathologic and vegetative symptoms. Vegetative recovery seems to be faster with TIA+CBZ. Results of this exploratory study have to be confirmed by a controlled double-blind study with severity of AWS as an experimental factor.

ObjectivesSUSTAIN is a prospective, multi-center non-interventional study in Germany to observe long term efficacy and safety, quality of life and further patient reported outcomes in patients with active psoriatic arthritis under treatment with Ustekinumab in routine clinical care.MethodsIn this study treatment with Ustekinumab is according to the label (Stelara®). It is planned to observe 400 patients at 75 centers for 160 weeks with documentation intervals at week 0 and 4 and then every 12 weeks. Besides demographic data, the following data will be documented: Amount of swollen and tender joints, tender entheses, skin symptoms (BSA and PASI), patient reported outcome concerning disease activity and pain, Health Assessment Questionnaire (HAQ), quality of life (SF-12), sleep quality (VAS), satisfaction with therapy of patient and physician, safety (adverse events [AE]/serious adverse events [SAE]), pharmacoeconomic aspects, number of patients with “Minimal Disease Activity” (MDA), number of patients with MDA at week 28 und 52.ResultsOverall, there have been 189 patients (56% women) at 59 centers documented after 11 months. At week 4 154 patients and at week 16 112 patients. At baseline, the patients had a mean age of 56 years (29–85), body weight 87 kg (50–147), BMI 30 (19–47), showed arthritis at small (68.8%) and/or big (51.3%) joints, skeletal involvement (19%), enthesitis (13.2%). The number of tender joints improved from a mean of 8,6 (CI 95% 7.1/10.2) to 4.7 (3.1/6.3) at week 16, number of swollen joints from 3,4 (2,6/4,2) to 1,4 (0.9/1.9). The patient reported global disease activity (0–100) decreased from 55.1 to 38.6 at week 16. Further improvements were documented for enthesitis, PSA, BSA, PASI, and pain. Efficacy of the therapy with Ustekinumab after 16 weeks was assessed as “very good” by 32.3% and as “good” by 44.8% of the treating physicians and by 34% and 40.2%, respectively, of the patients. In total, 60 adverse events were reported, of which four were serious. All in all safety of therapy with Ustekinumab after 16 weeks was assessed as “very good” by 51% and as “good” by 43.8% of the treating physicians, and by 55% and 37%, respectively, of the patients.ConclusionsThe non-interventional study SUSTAIN showed relevant improvements with elevated therapy satisfaction and good safety in patients with active psoriatic arthritis after 16 weeks under real world condition.Disclosure of InterestJ. Wendler Consultant for: Janssen-Cilag GmbH, Speakers bureau: Janssen-Cilag GmbH, I. Schwarze: None declared, H. Schwenke: None declared, J. Behrens Employee of: Janssen-Cilag GmbH, T. Gruppe Employee of: Janssen-Cilag GmbH, F. Behrens Consultant for: Janssen-Cilag GmbH, Speakers bureau: Janssen-Cilag GmbH

Leaf stages of Ribes cv., which differ in their susceptibility to American gooseberry mildew (Sphaerotheca mors-uvae), also differ in the quantity of cytoplasm in their epidermal cells. The complete asexual life cycle of the fungus appears to be linked to epidermal cells completely filled with cytoplasm, while partially vacuolized cells allow only limited fungal development. This phenomenon is considered to be the basis for the horizontal resistance of Ribes cv. to Sphaerotheca mors-uvae. Blattstadien von Ribes cv., die unterschiedlich anfällig gegenüber dem Amerikanischen Stachelbeermehltau sind, unterscheiden sich auch im Cytoplasmagehalt ihrer Epidermiszellen. Der vollständige asexuelle Lebenszyklus des Pilzes scheint nur an Epidermiszellen möglich zu sein, die vollständig mit Cytoplasma angefüllt sind. Teilweise vakuolisierte Zellen erlauben nur eine begrenzte Pilzentwicklung. Dieses Phänomen wird als Grundlage der horizontalen Resistenz von Ribes cv. gegenüber Sphaerotheca mors-uvae angesehen.

Development of American gooseberry mildew (Sphaerotheca mors-uvae) differed on leaves and shoots of susceptible and resistant cultivars of Ribes nigrum. Besides qualitative differences there were also considerable deviations in regard to the percentage of the various fungal structures which developed on leaves of resistant plants. Die Entwicklung des Amerikanischen Stachelbeermehltaus (Sphaerotheca mors-uvae) auf Blättern und Trieben von anfälligen und resistenten Sorten von Ribes nigrum war deutlich verschieden. Neben qualitativen Unterschieden waren auch erhebliche quantitative Abweichungen im Prozentsatz der einzelnen Pilzstrukturen auf Blättern resistenter Pflanzen zu verzeichnen.