Exploring the Factors That Influence Pain Relief and Bone-marrow Suppression When Strontium Chloride Is Administrated

Aim: The usefulness and safety of strontium chloride (89Sr), a radiopharmaceutical agent for painful bone metastasis, varies from patient to patient, but the reasons for why the usefulness and safety vary have not been elucidated. The purpose of this study is to explore the background factors of patients who experienced pain relief or bone-marrow suppression after 89Sr was administrated. Methods: In the cases of pain relief, we divided the results from a numeric rating scale (NRS) before and after 89Sr administration into effective and ineffective groups as outcomes. In the cases of bone-marrow suppression, we analyzed neutrophil cells, blood platelets, and hemoglobin levels, respectively, before and after 89Sr administration as outcomes. Then, we performed statistical analyses on both case groups. Results: The results showed that the background factors associated with pain relief were weight, the 89Sr dosage amount, NRS, eGFR, SCr, and Ca levels before 89Sr administration and the area of bone metastasis (number of sites reached). We found that background factors associated with bone-marrow suppression have a moderate significant correlation with hemoglobin, NRS, and SCr levels before 89Sr administration after investigating factors which influence neutropenia. In the case of thrombocytopenia, there was a moderate significant correlation with platelet counts before 89Sr administration. In the case of hypochromia, there was a moderate significant correlation with hemoglobin levels before 89Sr administration. Discussion: Our study could elucidate patient background factors associated with pain relief and bone-marrow suppression after 89Sr administration.

Clinical efficacy of four interventions in the reduction of dentinal hypersensitivity: A 2-month study.

Background and Aim: Dentinal hypersensitivity is a relatively common problem experienced in clinical dental practice and is characterized by short, sharp pain in response to stimuli such as tactile, thermal, evaporative, osmotic, or chemical. Several agents and treatment modalities have been used in the treatment of this condition. This study was conducted to compare the efficacy of four commercially available toothpastes in the reduction of dentinal hypersensitivity (DH), based on the hypothesis that calcium sodium phosphosilicate (CSPS) group had a better efficacy of the four. Settings and Design: This study design was a prospective, single-blind, randomized, parallel clinical design. Subjects and Methods: A total of 160 cases (93 males and 67 females; aged 20-60 years) were randomly divided into four groups: Group 1 - toothpaste containing 5% potassium nitrate; Group 2 - toothpaste containing 5% CSPS (NovaMin); Group 3 - toothpaste containing 10% strontium chloride; and Group 4 - a herbal formulation. The patients' DH scores for tactile, thermal, and evaporative stimuli were recorded on a visual analog scale at baseline, 2 weeks, 1 month, and 2 months. Statistical Analysis Used: The data were analyzed with Wilcoxon signed-rank test, Kruskal-Wallis test, and Mann-Whitney U-test (P < 0.05). Results: The four desensitizing kinds of toothpaste containing different active agents were effective in relieving dentinal hypersensitivity. However, CSPS group showed a better clinical response at the end of 2 months. Conclusions: The CSPS group showed a better reduction in the symptoms of DH.