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Walk training and drug treatment in patients with peripheral arterial occlusive disease stage II. A review.

On the basis of the present studies physical therapy is the most effective basis therapy of peripheral arterial occlusive disease stage II according to Fontaine. The consequent integration of the patients into widespread vascular training groups would be desirable. All present studies with so-called vasoactive drugs led to a statistically significant increase in pain-free walking distance. This is especially true for the substances naftidrofuryl, pentoxifylline, and buflomedil. Nevertheless, these studies do not fully meet the standards set by the GCP or the FDA guidelines. It must also be said that the increase in walking distance by vasoactive substances is less pronounced than the effect obtained by walk training alone. Both the vasoactive therapy and controlled walk training aim at an increase in pain-free walking distance. It is, however, still unclear whether the modes of therapy described influence the primary disease. Angiographically controlled studies are momentarily not available.

Arterial Occlusive Diseases↗

[An experience with the clinical use of halidor in the treatment of chronic lower limb ischemia].

The paper is concerned with a study into the effect of halidor on the results of conservative (17cases) and surgical (22 cases) treatment of patients suffering from chronic lower limb ischemia. The surgical treatment included revascularization interventions. The study groups were compared to the respective control groups of patients who did not receive halidor. As compared to the control group, the group undergoing surgical treatment demonstrated a significant increase in the ankle/brachial index after parenteral infusion of halidor administered in courses (p<0.05). Also, in the group undergoing conservative treatment, there was a significant increase in the distance of painless walking.

Bencyclane↗

[Halidor, 1-benzyl-1-(3'-dimethylaminopropoxy)-cyclohep tane fumarate as an uncoupler and inhibitor of the respiratory chain].

Halidor 1-benzyl-1-(3'-dimethylaminopropoxy)-cycloheptane fumarate, activates succinate oxidation in mitochondria and inhibits reverse electron transport from succinate to NAD+ in submitochondrial partides preparations at doses of 2-10(-5)--10(-3) M. At a dose of 5--7-10(-4) M halidor cause a swelling of mitochondria incubated in 0.1 M NH4NO3. At higher concentrations (10(-3)--10(-2) M) halidor practically completely inhibits NADH and succinate oxidase activity of mitochondria and submitochondrial particles. It is suggested that vasodilating effect of halidor is due to the uncoupling of oxidative phosphorylation, thus causing a deficiency of ATP for contracting function of blood vessel muscles.

Adenosine Triphosphate↗

Platelet-cancer cell interaction in metastasis formation: a possible therapeutic approcach to metastasis prophylaxis.

The mechanism of the early stage of metastasis formation by sticky blood-born cancer cells is discussed. Abnormal platelet aggregation to circulating and lodged cancer cells, as well as alterations of blood coagulation and fibrinolysis play an important role. The reducing effect of several platelet aggregation inhibitors on cancer cell stickiness and tumor embolism mortality has been investigated in rats after intravenous transplantation of 1 X 10(6) Walker-256 carcinosarcoma cells. The tested substances diminished platelet aggregation to circulating cancer cells, leading to a dose-dependent inhibition of cancer cell lodgment to the endothelium. Furthermore, some of the substances prevented lethal pulmonary tumor cell embolism which was observed in 60% of the controls. These results are interpreted by assuming an inhibition of disseminated intravascular coagulation which occured after intravenous transplantation of Walker-256 carcinosarcoma. On this basis a clinical long-term study for metastasis prophylaxis was started more than 4 years ago with one of the tested substances, the dipyridamole derivative RA 233, in 40 patients with sarcoma or malignant lymphoma of the head and neck region. The provisional results obtained in matched pairs are discussed.

Animals↗

[On the treatment of acute arterial circulatory disturbances of the retina and optic nerve (author's transl)].

After discussing basic therapeutic principles for the treatment of acute arterial occlusions of the retina and N. opticus (fibrinolysis, anticoagulation, corticoids, vasoactive drugs) the problems in employment of vasodilating drugs and the necessity of concomitant administration of strophanthine or digitalisglycosides are outlined. Results obtained after the administration of 3,7-Dimethyl-1-(5-oxo-hexyl)-xanthine (Pentoxifylline, Trental) in the treatment of 49 cases suffering from occlusion of the retinal vessels and 23 cases with vascular occlusion in the N. opticus are reported and commented with a view to the bad prognosis of these serious disorders, 55% of the patients showing definite improvement of visual acuity. Therapeutic guidelines resulting from these experiences are presented.

Acute Disease↗

[Clinical evaluation of fludilat in cerebrovascular insufficiency].

In order to evaluate the clinical efficacy of Fludilat, we studied 75 patients, 37 women (49.3 per cent) and 38 men (50.7 per cent), with ages between 36 and 98 years, during a period of 3 months. 50 of the patients received Fludilat at the dose of three tablets per day during 3 months. The remaining 25 patients received Placebo during the same period of time. We obtained very good results in 63.5 per cent, good in 20.4 per cent and poor in 16.1 per cent of the patients treated with Fludilat. The results with Placebo were very good 2.9 per cent, good 41.8 per cent and poor 55.3 per cent. We observed no side effects during the treatment. Therefore from our study we conclude that Fludilat is an effective drug in the treatment of the disturbances produced by the cerebral vascular insufficiency.

Adult↗

[Treatment of blood circulation disorders with a hemoactive-vasoactive drug].

The therapeutic activity of Fludilat in circulatory disorders was evaluated in 9 women and 11 men, with ages between 41 and 75 years. Three suffered atherosclerosis and 17 diabetic vascular disease. Elimination of the symptom was obtained in intermittent claudication in 71 per cent of the patients who suffered it, in 67 per cent in case of feeling of coldness, in 46 per cent in paraesthesias, in 73 per cent in feeling of heaviness and in 6 per cent in trophic changes. In the remaining patients there was a significative reduction in the intensity of the symptoms, except in trophic changes. This result are considered as excellents. The general result of the treatment was satisfactory. There was no significacative change in the blood pressure and no side effects were reported. A better response of the atherosclerotic patients was obtained. We found no influence of age, sex and blood pressure on the results. The study corroborates the efficacy of Fludilat in the treatment of circulatory disorders and its excellent tolerance.

Adult↗