Caffeine dose-dependently potentiates the antitumor effect of cisplatin on osteosarcomas.

BACKGROUND: Caffeine-assisted chemotherapy has been used in the treatment of osteosarcomas. However, there is little in vivo evidence for this treatment, and thus we sought to verify the dose and effect of caffeine in combination with cisplatin in osteosarcoma-bearing rats. MATERIALS AND METHODS: Seven-week-old male Fischer rats were transplanted with chemical carcinogen-induced osteosarcoma, selected lung metastatic lesions tumor block. The osteosarcoma-bearing rats were treated with saline, caffeine, cisplatin or cisplatin and caffeine. RESULTS: The most growth inhibition was observed in the co-administration group. When three different dosing schedules of caffeine were given, the extent of tumor inhibition was closely correlated with the average plasma concentration of caffeine. The cisplatin concentration in the tumor was significantly increased when caffeine was co-administered. CONCLUSION: This study confirms that a high concentration of caffeine (about 0.4 mM) is effective in enhancing the antitumor effects of cisplatin.

Relationship between the type of urinary incontinence and falls among frail elderly women in Japan.

Urinary incontinence and falls are serious problem among elderly people, because of restriction of the Activities of Daily Living (ADL) and Quality of Life. Previous studies have examined the association between urinary incontinence and falls. However, results have been inconsistent. In Japan, with the rapid aging of the society, the number of elderly women who have urinary incontinence and are at risk of falling is increasing. We investigated the relationship between type of urinary incontinence and risk of falls among elderly users of day-care services in a long-term care system. Our study population comprised 118 ambulatory women. At baseline, we evaluated incontinent status, lower extremity muscle strength, balance ability, ADL, and Instrumental ADL. We asked subjects about number of falls every 4 months during a year. In univariate analysis, lower extremity muscle strength (p = 0.001) and mixed incontinence (p = 0.050) differed significantly according to the fall status. Stress and urge incontinence were not significantly associated with falls. In logistic regression analysis, subjects who had mixed incontinence were 3.05 (95% confidence interval 1.01-10.2) times more likely to fall than those without. These results suggest that mixed incontinence have independent associations with falls. Incontinent status should be considered to prevent falls among elderly persons who are partially dependent and need support.

Lower-extremity muscle forces measured by a hand-held dynamometer and the risk of falls among day-care users in Japan: using multinomial logistic regression analysis.

PURPOSE: To assess the relationship between the lower extremity muscle forces and risk of falls among the elderly who were using day-care services in the long-term care insurance system. METHOD: The study population comprised 96 women aged 69 - 91 years. At baseline, we assessed ADL, functional capacity, isometric muscle forces of knee extension and ankle dorsiflexion obtained with a hand-held dynamometer. After 1 year, we asked subjects about falls during the follow up period. RESULTS: In univariate analysis, only the knee extensor strength (p = 0.003) and ankle dorsiflexor strength (p = 0.02) differed significantly according to the fall status. After adjustment for age using multinomial logistic regression analysis, the weak quadriceps group was 7.50 times more likely than the strong group to fall once (p = 0.02), and 5.00 times more likely to fall twice or more (p = 0.02). The weakest ankle dorsiflexor group was 5.09 times more likely than the strongest group to fall twice or more (p = 0.05). CONCLUSIONS: Our results indicated that the forces of knee extensor and ankle dorsiflexor were strongly associated with falls among day-care users. Physiotherapy should focus on the lower-extremity muscle strength to prevent falls and deterioration of physical ability among elderly persons who are partially dependent and need support.