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Background: In outpatient settings diagnostic classification of depressive symptoms is mostly descriptive based on ICD-10. Depending on clinical experience and consultation time, diagnosis can be verified by validated scales. However, physicians working in primary care are familiar with ICD-10 criteria. Therefore, the aim of the present study was to examine the feasibility of the validation of an ICD-10-derived symptom scale for depression., Methods: For this preliminary trial we generated a symptom scale derived 1:1 from the diagnostic criteria for depression given in the ICD-10 with 10 items. The Hamilton Rating Scale for Depression (HAMD-17) was used as reference in a population of 226 outpatients suffering from depressive symptoms. Correlation between scales as well as sensitivity and specificity of the ICD-10 scale were calculated., Results: The generated ICD-10 symptom scale for depression could be analyzed in 219 patients and showed a significant and strong correlation with the HAMD-17 (p < 0.0001; ρ = 0.75). The best tradeoffs between specificity and sensitivity of the ICD-10 score were found at 10 points for the lower and 14 points for the upper cut-off. Overall sensitivity and specificity was 76.7 and 88.6%. Almost two thirds (i.e. 65.3%) of the patients were correctly classified by the ICD-10 scale., Conclusion: The ICD-10 symptom scale examined in the current population was found to have fair correlation with the HAMD-17 as well as, in face of the limited variance of the patients' condition, acceptable sensitivity and specificity. Therefore, this preliminary study showed that the ICD-10-derived symptom scale seems appropriate to be investigated in a thorough validation trial., (Copyright © 2012 S. Karger AG, Basel.)

Background: Treatment of rheumatic or musculoskeletal disorders (MD) is multi-disciplinary and includes herbal analgesics. Although already reviewed, no quantitative evaluation of efficacy and safety of the herbal combination Phytodolor® (STW1) is available., Methods: We searched in databases and contacted authors and the manufacturer to identify randomized controlled trials (RCTs) examining STW1 in patients with MD. We made a reanalysis of raw data of eligible published and unpublished RCTs and pooled the results for meta-analysis according to Cochrane guidelines and intention-to-treat. Primary outcome measure was patient global assessment of efficacy, secondary outcome measure was pain at rest and on movement. Results were stratified according to treatment groups., Results: Patient data of 11 RCTs were eligible for pooling. In the entire population, STW1 was significantly superior compared to placebo in patients' global assessment of efficacy (group difference for rating very good/good: 20%; placebo 48.9% and STW1 69.1%; p < 0.001; OR 0.43; 95% CI 0.28-0.65) and in the subpopulation 'other rheumatic diseases' (placebo 45.4%; STW1 72.3%; p < 0.001; OR 0.32; 95% CI 0.2-0.52), but not in the subpopulation 'gonarthrosis'. STW1 did not differ significantly compared to non-steroidal anti-inflammatory drugs (NSAIDs), neither in the entire population nor the subpopulations. Similar results were found for pain at rest and on movement. No serious adverse events (AE) but minor AE were reported (placebo 8.1%; STW1 14.2%; NSAIDs 18.9%)., Conclusion: According to the analysed data, STW1 showed a better pain reduction than placebo in patients with pain due to MD, probably equivalent to NSAIDs, and was well tolerated., (Copyright © 2011 S. Karger AG, Basel.)

Background and Objective: Data from a randomized trial in hepatitis C infected Egyptian patients suggest that the oral intake of the enzyme preparation Phlogenzym results in a significant reduction of aminotransferase levels and is equally effective to the therapy with interferon alpha. In our study, we investigated whether comparable effects can be found in daily practice in German patients., Patients and Methods: We retrospectively evaluated the aminotransferase levels of all patients with chronic hepatitis C who were treated with Phlogenzym at a dose of 6 tablets/day in our outpatient department between 1998 and 2003. Inclusion criteria for the study were treatment duration >3 weeks and elevated alanine-aminotransferase (ALT)levels 6 months prior to and at the beginning of the treatment with Phlogenzym. Liver cirrhosis Child B or C, interferon therapy within the last 3 months before treatment with Phlogenzym and alcohol intake >30 g/day were exclusion criteria., Results: 22 patients were included into the analyses. The mean duration of treatment with Phlogenzym was 77 +/- 41 days. ALT, aspartate-aminotransferase (AST) and gamma glutamyl transpeptidase (GGT) levels did not change significantly during treatment. Fitting a generalized linear model, we estimated that a hypothetical patient who started with a baseline value of 50 U/I after 90 days of treatment ends up in an ALT level of 52 U/I (95%-CI:27-77 U/I), an AST level of 51 U/I (35-67 U/I) and a GGT level of 42 U/I (22-61 U/I). 5 out of 22 patients had to stop treatment because of side effects., Conclusion: 6 tablets Phlogenzym per day do not seem to reduce permanently elevated aminotransferases in patients with chronic hepatitis C.