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An increasing number of patients with the zoonosis tularemia have been reported in the last few years in Europe. Tularemia can be divided into different forms depending on its appearance. Tularemia must be considered in the differential diagnosis of diseases that present with an ulcer and regional lymphadenopathy. The diagnosis can be confirmed by culturing Francisella tularensis. With effective antibiotic intervention, the prognosis is favorable. Typically tularemia develops after outdoor activities; it is generally transferred by blood-sucking arthropods from infected wild animals to humans., (© The Authors • Journal compilation © Blackwell Verlag GmbH, Berlin.)

In the past few years the therapeutic options for non-seminomatous germ-cell tumors of the testis have evolved rapidly. Until recently it was usual practice with patients in clinical stage I to perform lymphadenectomy or retroperitoneal radiotherapy after orchidectomy. However, for 60-80% of these patients this therapy was not necessary, since they were already cured by orchidectomy alone. With the improvement of clinical staging and the success of modern chemotherapy, it seems to be possible to follow up stage I patients clinically. The various aspects which justify this "wait-and-see" strategy are discussed. Further, the question is discussed whether all patients in clinical stage I may be treated in this way, or whether specific groups at severe risk of metastatic disease at the time of orchidectomy should be excluded.

In the course of a randomized double blind trial conducted by 7 Swiss urological centres, 51 patients with advanced, not pretreated carcinoma of the prostate were included. Following orchiectomy the patients were either administered 300 mg Anandron daily (Roussel RU 23908) or Placebo. Twelve months later the Anandron-group shows a slightly better objective response whereas there is no difference in survival rates. The adverse effects of Anandron-treatment are described.