[Repeat mass screening for fecal occult blood for the diagnosis of colorectal neoplasms in a rural district. Results of an informational campaign]. / Wiederholte Massenscreeninguntersuchung auf okkultes Blut im Stuhl zur Erfassung kolorektaler Neoplasien in einem ländlichen Bezirk. Ergebnisse einer Informationskampagne.

In 1987/88 and 1988/89 we tested the population (aged greater than or equal to 40) of the district of Oberpullendorf in 2 series for faecal occult blood by means of the Hemdetect Test. In the first test series the test was offered to 18,233 persons and 8235 (45%) persons completed the test; 187 (2.3%) were positive. In the second series 6512 (36%) out of 18,241 completed the test and 472 (7.2%) persons were positive. The persons with positive results were examined by colonoscopy, gastroscopy, and abdominal sonography, in combination with routine investigations. Secondary compliance in these investigations was 92%. The screening method revealed 34 colorectal cancers with the favourable pathological staging: Dukes A 18 (53%), Dukes B 6 (18%), Dukes C 10 (29%), Dukes D 0. 11 polyps showing carcinoma in situ and 174 polyps (70% of which were adenomas) in 124 patients were treated by colonoscopy. In the meantime we have detected 14 "interval" cancers among people with a false negative test result, also at a favourable staging: Dukes A 6 (43%), Dukes B 4 (29%), Dukes C 4 (29%), Dukes D 0. In the non-responders we found 30 colorectal cancers at a much worse staging: Dukes A 7 (23%), Dukes B 10 (33%), Dukes C 8 (27%), and Dukes D 5 (17%). Screening for faecal occult blood in combination with the necessary investigations of the positive persons by colonoscopy is able to detect symptomless colorectal cancers at a less advanced pathological stage and enables the treatment of precancerous adenomatous polyps. An improvement in cumulative sensitivity is expected on annual repetition of screening for faecal occult blood.

[Treatment of Amanita phalloides poisoning with silybin in combination with penicillin and cortisone]. / Therapie der Knollenblätterpilzvergiftung mit Silibinin in Kombination mit Penicillin und Cortison.

A report is presented of Amanita phalloides poisoning in a family of 3 members admitted with acute gastrointestinal symptoms after eating a meal of various self-picked mushrooms. A latent period of 11 hours preceded the onset of symptoms, a typical feature of this form of poisoning. There was an enormous increase in liver-specific enzymes in two of the cases. The clinical picture was markedly mitigated by the early initiation of silybin therapy, in combination with penicillin and cortisone. The patients made a rapid symptomatic recovery and the liver parameters were sufficiently improved by the 12th day so that the patients could be discharged.

[A severe case of acute malaria tropica--haemolysis and disseminated intravascular coagulopathy (author's transl)]. / Ein Fall von akuter Malaria tropica mit schwerem Verlauf. Hämolyse und intravasale Gerinnungsaktivierung.

The case is reported of a 24-year old male patient, who was infected with Plasmodium falciparum during prolonged touch-down at Maputo and Dar-es-Salaam on returning from Lesotho (South Africa), a non-endemic areas. Severe haemolysis, anaemia, myocardiopathy, renal insufficiency, disseminated intravascular coagulopathy and mild encephalopathy occurred. The patient's condition was very serious, but he responded rapidly to chloroquine, heparin, fibrinogen and other intensive medication and was soon discharged, fully cured.