[Accumulation of Metformin-associated Lactic Acidosis].

 Lactic acidosis has been associated with the use of metformin since its introduction. The cause, however, is highly controversial. The incidence of metformin-associated lactic acidosis (MALA) is quoted at 3,0 to 16,7 cases per 100 000 patient-years according to current studies.

[Pericardial empyema as a rare complication of pneumococcal pneumonia].

The case histories of 3 patients hospitalised for severe pneumococcal pneumonia are reported. Electrocardiography showed generalized ST-segment elevations and echocardiography revealed pericardial effusion. Pericardiocentesis was performed and analysis of the punctate fluid was consistent with empyema.

[Morphine poisoning in chronic kidney failure. Morphine-6-glucuronide as a pharmacologically active morphine metabolite].

History And Admission Findings: A 57-year-old woman with metastasizing ovarian cancer and chronic renal failure was admitted for morphine treatment of an acute lumbospinal pain syndrome, ambulant treatment with analgesics having failed provide adequate pain relief. On admission due to pain the conscious patient presented with reduced general condition and lumbal pain sensitive to tapping. Lasègue's sign was positive on both sides, no other disturbed neurological functions were found.