ABSTRACT
Fifty-five patients with hormone refractory prostate cancer and painful bone metastases were randomised either to placebo or to clodronate 300 mg i.v. for 3 days, followed by oral clodronate 3200 mg for four weeks. Pain intensity was assessed using Visual Analogue Scales (VAS). Mean overall pain as well as mean pain during the best and worst periods were recorded. Forty-six patients were evaluable for efficacy. No significant differences were found between the two treatments. As regards mean worst pain a substantial numerical fall was registered for the treatment group, 21 mm, but the improvement was not significant compared to that of the placebo group. This was probably due to the limited number of patients (the study was prematurely ended due to problems recruiting patients). In conclusion, no significant differences were found between the treatment arm and the controls, in contrast to results from previous studies. Possible explanations are that the doses in this study were generally lower than in previous studies, the mean baseline pain was substantially lower and that the current study was placebocontrolled. Our data indicate that if clodronate is to be used for the alleviation of bone pain in prostate cancer, patients with high baseline should be selected and high intravenous doses should be given at start of the treatment.
Subject(s)
Analgesics, Non-Narcotic/therapeutic use , Bone Neoplasms/secondary , Clodronic Acid/therapeutic use , Pain/drug therapy , Prostatic Neoplasms/physiopathology , Aged , Aged, 80 and over , Bone Neoplasms/physiopathology , Double-Blind Method , Humans , Male , Middle Aged , Pain/etiology , Pain Measurement , Placebos , Prostatic Neoplasms/pathology , Reproducibility of ResultsABSTRACT
Polymorphonuclear leukocyte (PMN) migration and chemotaxis were studied by a modified Boyden chamber technique in 100% autologous serum with casein as attractant. PMN chemotaxis was induced by increasing the top gradient concentration of casein to 20 mg/ml. Under non-gradient condition, casein 20 mg/ml inhibited PMN migration, which was thought to be due to chemotactic deactivation. Vinblastine 0.01 microgram/ml partially inhibited PMN migration in a casein gradient with a top gradient concentration of 20 mg casein/ml. It is suggested that PMN migration in the casein gradient was composed of both vinblastine-sensitive chemotaxis and vinblastine-resistant chemotaxis.
Subject(s)
Caseins/pharmacology , Chemotaxis, Leukocyte/drug effects , Vinblastine/pharmacology , HumansABSTRACT
Normally the kidneys respond to an acid load by increased ammonia production. In six patients with adult-type diabetes this response was reduced by a mean 50% after a therapeutic dose of phenformin. The reduced ability to compensate for acid loads may be one factor leading to metabolic acidosis and lactoacidosis sometimes associated with phenformin therapy.
