[Regional electro-hyperthermia--technical principles, clinical results and health insurance aspects]. / Die regionale Elektrohyperthermie--technische Grundlagen, klinische Resultate und versicherungsmedizinische Aspekte.

The method of electro-hyperthermia is based on the production of alternating currents from capacitive coupled electrodes. Because of the associated heating of body tissues, the electro-hyperthermia is promoted as an alternative to the more sophisticated methods of scientific hyperthermia, which find use in oncologic diseases. The analysis of technical data, however, reveals that the electro-hyperthermia is not qualified for a focused, effective and therapeutically useful heating of circumscribed target areas. Data from clinical studies demonstrating efficacy for defined indications are not available. The application of electro-hyperthermia is excluded form the German system of public health insurance. As proof of medical necessity cannot be provided, there is also no claim for reimbursement from private health insurance. According to legal regulations in Germany, an invoice as hyperthermia treatment is usually not possible. Rather, an item from the electrotherapy section of the official provision of medical fees (GOA) has to be chosen.

[Proteolytic enzymes as an alternative in comparison with nonsteroidal anti-inflammatory drugs (NSAID) in the treatment of degenerative and inflammatory rheumatic disease: systematic review]. / Proteolytische Enzyme als therapeutische Alternative zu nichtsteroidalen Antirheumatika (NSAR) in der antiphlogistischen Therapie degenerativer und entzündlich-rheumatischer Erkrankungen. Systematischer Review.

BACKGROUND AND PURPOSE: The comparably high number of severe side effects due to treatment with nonsteroidal anti-inflammatory drugs (NSAID) calls for better tolerated substances. One possible alternative is seen in the systemic treatment with proteolytic enzyme preparations for oral administration. The aim of this study was to determine whether the results from controlled randomized trials on enzyme therapy prove equal anti-inflammatory effectiveness compared to NSAID in the treatment of degenerative or inflammatory rheumatic disease. METHODS: All drug preparations registered in Germany as having anti-inflammatory properties were listed. Among these preparations, a systematic search was carried out for randomized clinical therapeutic trials giving evidence for the anti-inflammatory effectiveness of enzyme preparations or their components. RESULTS: The anti-inflammatory effectiveness of three out of eight registered enzyme preparations was investigated in randomized trials. In total, seven trials were judged to be sufficiently documented and to allow valuation. All studies show severe methodical deficits, and the standard trial design (clinical trials during inpatient rehabilitation in combination with extensive accompanying treatment) does not allow clear-cut conclusions. CONCLUSION: According to the present state of knowledge, oral proteolytic enzyme treatment does not offer a justified alternative in comparison with NSAID in the anti-inflammatory treatment of rheumatic disease.