[Epidemiology and therapy of pain and depression during HIV and AIDS]. / Epidemiologie und Therapie von Schmerzen und Depression bei HIV und Aids.

Pain is one of the most common reasons for admission to hospital for patients suffering from AIDS. Pain and other symptoms very often cover depressive episodes. Pain induced by AIDS therapy represents a progressive problem and induces the necessity to alter the highly active antiretroviral therapy (HAART). Of HIV-infected people 90% complain of headaches. Headache may result from opportunistic infections, from side-effects of HAART or from the HIV in the CNS itself but also the high burden of idiopathic headaches must be considered. Up to 20% of all neuropathies in HIV-infected people are caused by HAART. In most cases changing of HAART is necessary. Problems of interactions between HAART and the substances used for pain therapy via the cytochrome P450 system represents a special therapeutic problem during HAART in order to avoid development of resistance by the HIV.

[Highly active antiretroviral therapy of neuro-AIDS. Side effects on the nervous system and interactions]. / Hochaktive antiretrovirale Therapie bei Neuro-AIDS. Nebenwirkungen auf das Nervensystem und Interaktionen.

Highly active antiretroviral therapy (HAART) has increased the mean survival time in the AIDS stage to sometimes more than 10 years. Five different groups of antiretroviral medications are known, of which integrase inhibitors and CCR5 antagonists represent the newest and most modern substances. The long AIDS survival time implies that side effects and interactions become relatively more important and must be differentiated from the symptoms of HIV itself. Side effects of HAART concern the central and peripheral nervous system and the muscles. The neurotoxicity of the components in HAART varies considerably and depends on the substance itself. Knowledge of side effects and interactions of HAART with antiepileptics, antidepressants, and analgetics are essential for the treatment of patients with neuro-AIDS.

[Primary CNS lymphoma in azathioprine therapy for autoimmune diseases: review of the literature and case report]. / Primäres ZNS-Lymphom während der Behandlung von Autoimmunerkrankungen mit Azathioprin. Kasuistik und Literaturübersicht.

We present a 31-year-old female patient with primary non-Hodgkin's lymphoma of the CNS after immunosuppressive therapy. Colitis ulcerosa had been diagnosed 2 years previously. Prophylactic therapy with azathioprine over 9 months was stopped after the development of listeria meningitis which was treated successfully with antibiotics. At this time native CCT was normal. Three months later the patient developed an epileptic seizure and multiple cerebral lesions were detected in CCT and MRI. Although antibiotic therapy was started, the cerebral lesions showed no regression. Stereotactic biopsy revealed immunochemical and histologic high-grade malignant B cell lymphoma. The risk of primary CNS lymphoma under azathioprine treatment for an autoimmune disease with a possible congenital immunodeficiency is presented and the literature is reviewed.

[Synthesis of carbazole derivatives. 1. The reaction of 3-(2-nitroethenyl)-indole-2-malonic acid esters with Michael acceptors]. / Uber die Reaktion von 3-(2-Nitroethenyl)indol-2-malonestern mit Michael-Akzeptoren.

Michael-type reaction of compounds of type 9 were studied. Addition reactions with acrolein and methyl vinyl ketone, respectively, lead--depending on the conditions--to pyridoindoles of type 16 and 14 and/or to tetrahydrocarbazoles of type 17 and 15. With Triton B compounds 15 undergo retro-Michael-type elimination of the nitromethyl group, followed by hydrolysis/decarboxylation and dehydrogenation, leading to the disubstituted carbazoles 20. In the case of 17a, the primary elimination product 18 could be isolated. The synthetic potential of these reaction types is discussed. Some of the described compounds and derivatives of them show antimycobacterial activity.