The data suggest that tetrahydroaldosterone is the most reliable screening test for PA. Tetrahydroaldosterone determination in combination with aldosterone-18-glucuronide and free aldosterone increases diagnostic specificity for PA. Potassium, renin, plasma aldosterone, and basal PARR are inadequate screening procedures because they are subject to high rates of false-positive and false-negative results.

During phase-II studies monitored by Hoechst AG (Germany) and Daiichi (Japan) and phase-III/IV studies of Hoechst AG 577 adverse drug reactions were recorded among 13,717 patients treated with ofloxacin. Treatment was stopped in about 40% of the patients with adverse drug reactions. Most of the adverse reactions concerned the gastrointestinal tract. 124 adverse reactions concerned the central nervous system, mostly headache and sleep disturbances (n = 84). For the rare occurrences of other symptoms of the central nervous system, such as hallucinations (n = 1), nightmares (n = 1), confusion (n = 1), and depression (n = 2) the data are inadequate to appraise the relative importance of possible contributing factors.

Since 1976, various activity indices for Crohn's disease have been developed but none has been suitable for use in the paediatric age group. Therefore, the German‐Swiss Study Group on Crohn's Disease in Children and Adolescents decided to develop their own paediatric Crohn's disease activity index (PCDAI) by multiple regression analysis of prospectively collected data. The result was a simple index consisting of two clinical (appetite, number of stools/week) and four laboratory variables (erythrocyte sedimentation rate, serum iron and α2‐globulin concentrations and bands as percentage of white blood cells). Applying the index to patients who were followed‐up, it could be demonstrated that the changes in PCDAI inversely reflected the changes in weight and that the surgical removal of the inflamed parts of the gut reduced the disease activity index to levels comparable to those obtained in patients after successful, exclusively conservative, treatment. Low disease activity was maintained for at least three years.

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Ofloxacin is a new quinolone-carboxylic acid derivative with a broad spectrum of activity, excellent bioavailability after oral administration and insignificant metabolisation. The serum elimination half-life is six to eight hours. 879 patients were treated with ofloxacin in therapeutic comparative studies monitored by the Department of Clinical Research, Hoechst AG. Of the original isolates 91 to 100% were susceptible to ofloxacin, 67 to 84% to co-trimoxazole, 73 to 98% to a fixed combination of amoxycilline plus clavulanic acid (AMC), 74% to nalidixic acid, 77% to nitrofurantoin, and 79% to pipemidic acid in previous in vitro tests. In the therapeutic studies which included only patients with pathogens susceptible to the antimicrobial agent used, the following cure rates (clinical and bacteriological) were obtained for uncomplicated infections of the lower urinary tract: ofloxacin (single dose treatment) 78% and 83%, co-trimoxazole 62%, nalidixic acid 72%. A three-day course with ofloxacin compared to a three to four-day treatment with co-trimoxazole or seven-day treatment with the other comparative compounds resulted for lower urinary tract infections in the following cure rates: ofloxacin 89%, co-trimoxazole 84%; ofloxacin 71%, AMC 33%; ofloxacin 64%, nitrofurantoin 56%; ofloxacin 56%, pipemidic acid 36%. The unfavourable results after treatment with AMC or pipemidic acid were caused by a high rate of superinfections. The combined cure rate in infections of the upper urinary tract was 73% for ofloxacin and 65% for co-trimoxazole or 81% for ofloxacin and 57% for AMC, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

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