[Severe intestinal diseases caused by aerobic bacterial spores].
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Together with gastroenterologists rheumatologists describe diagnostically significant disturbances of the supporting apparatus and the locomotor system which frequently occur in ulcerous colitis, enterocolitis regionalis Crohn, Whipple's disease and non-tropical sprue. Important conclusion for the diagnostic approach supplement the description.
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The age incidence curve of chronic inflammatory bowel diseases follows a bimodal type with a second peak after the age of 60. In some epidemiological studies there is a female predominance in Crohn's disease of the aged. There are no old-age-specific modifications in the clinical course and the complications of the chronic inflammatory bowel disease. Postoperative recurrencies of Crohn's disease may be less common in the older age group. Ischemic bowel diseases and colonic cancer must be considered most often in the differential diagnosis of chronic inflammatory bowel diseases of the aged.
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The bioavailability of digoxin and beta-methyl-digoxin (BMD) was tested with a single dose on the grounds of peak serum concentration, tmax, area under the serum concentration-time curve and the cumulative 24 hour urinary excretion on one group of patients with liver disease (n = 20) and one with gastrointestinal disease (n = 10). Despite the smaller dose (0.5 mg BMD against 0.75 mg digoxin), peak serum concentration was significantly higher with BMD in both groups and was also reached earlier than with digoxin. The extent of absorption was also higher in both groups with BMD than with digoxin. A comparison of the results on hand with the results obtained in corresponding tests on healthy persons showed no significant differences with BMD. The excellent bioavailability of BMD was therefore also proved on patients with gastrointestinal diseases, whereas with digoxin the absorption in these patients was retarded, compared with healthy persons, but the extent of absorption was not reduced either. In gastrointestinal diseases with unknown conditions of absorption, the better bioavailability of BMD is probably of advantage, when compared with digoxin. According to medical literature, t/2 of BMD may be prolonged in liver diseases, so that in such cases the dose of BMD has to be adjusted or the use of digoxin is recommended.
Epidemiological studies proved a clear increase of the frequency of ulcerous colitis and Crohn's disease in highly industrialised countries. Ethnic particularities and familiar accumulation are to be emphasized. The stationary morbidity is determinable in the GDR for both diseases, however, it is not suitable for the establishment of incidence and prevalence. Issuing from the patients of a defined population treated with salazopyrin the prevalence of ulcerous colitis was established with 26.1 for the female sex and 23.6 for the male sex on 10(5) inhabitants. With 3.4 diseases in females and 2.2 in males Crohn's disease is unequivocally less frequent, though not all patients may established.
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