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Background/objective: Tacrolimus HEXAL®/Crilomus® is an approved generic immunosuppressant for the prevention and treatment of rejection following renal transplantation. For safe and socioeconomically efficient conversion of the innovator into a generic formulation, high- -quality data are necessary, in view of the different and country-specific comorbidities and pharmacokinetics in kidney transplant recipients., Patients and Methods: From 2014 to 2017, we enrolled 32 kidney transplant recipients, receiving newly prescribed Tacrolimus HEXAL®/Crilomus® in 5 German centers. Efficacy and safety data were collected over 6-8 months and retrospectively compared to the period prior to conversion., Results: The mean tacrolimus trough level was 4.91 ng/mL Standard Deviation (SD) (SD ±1.7) before and 5.06 ng/mL (SD ±1.97) after conversion. Mean tacrolimus trough concentration-dose-ratio (+/- SD) was 187.1 ng/mL/mg/kg/day (SD 99.2) for the reference and 205.1 ng/mL/mg/kg/day (SD 133) for the generic product, resulting in a non-significant difference of 18.0 ng/mL/mg/kg/day (SD 71.8) (p=0.84, Wilcoxon V=180). Overall, dosing had to be changed in 4 (14.8%) patients. Graft function remained stable and no rejections occurred., Conclusion: In conclusion, conversion to the generic tacrolimus formulation can be considered safe and feasible in long-term kidney transplant recipients in Germany. As suggested by guidelines, vigilant therapeutic drug monitoring is recommended to account for possible tacrolimus concentration variability on the individual patient level., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background and Aims: Physical activity is beneficial in several chronic disorders including Crohn's disease, but the preferred type of exercise is unknown. Our study aimed to examine and compare the safety, feasibility and potential beneficial effects of individual moderate endurance and moderate muscle training in patients with Crohn's disease., Methods: Quiescent or mildly active (Crohn's disease activity index <220) patients with Crohn's disease were randomly allocated to either a control, endurance, or muscle training group. Participants exercised individually for 3 months three times per week. Endpoints included dropout rate, disease activity, inflammatory parameters including faecal calprotectin, anthropometric data, quality of life, physical activity and strength., Results: A total of 45 patients with Crohn's disease were randomly allocated. In the endurance group ( n  = 17), the dropout rate was significantly higher (47% vs. 13%) compared with the muscle group ( n  = 15). In both groups the maximal and average strength in the upper and lower extremities increased significantly (all P  < 0.04). In the endurance group emotional function was significantly improved ( P  = 0.03). Statistically significant changes of disease activity and other outcome parameters were not observed in this pilot cohort., Conclusion: Both individual moderate endurance and muscle training can be safely performed in patients with mild or quiescent Crohn's disease. Muscle training appears more feasible and may be favoured. Both forms of exercise have beneficial effects on strength. Quality of life increased in both intervention groups, although statistical significance was only reached in one subgroup.

A case of listeriosis in a patient undergoing long-term hemodialysis is reported. The 69-year-old man with chronic renal failure due to polycystic renal dysplasia had received hemodialysis treatment for 10 years. Renal anemia and iron overload developed within this time. In the course of a hemodialysis the patient presented with malaise, chills and fever to 38.7 degrees C. Blood culture specimens were obtained and the patient received ampicillin-sulbactam. Blood culture specimens subsequently showed growth of Listeria monocytogenes. During therapy the patient improved rapidly and was free from fever on day 5. The relation of iron overload and Listeria infection is discussed.