A randomised double-blind comparison of intravenous pamidronate and clodronate in the hypercalcaemia of malignancy

In conjunction with rehydration, the bisphosphonates are the treatment of choice for hypercalcaemia of malignancy. Single infusions of either pamidronate or clodronate are usually effective, but a direct comparison of the two agents given at the highest doses commonly used has not been performed. Forty-one patients (15 breast, 12 squamous carcinomas, four lymphomas, four bladder, two prostate and four others) with hypercalcaemia of malignancy (corrected serum calcium > 2.7 mmol l-1) persisting after 48 h of saline rehydration were randomly allocated to receive a 4 h intravenous (i.v.) infusion of either pamidronate 90 mg or clodronate 1500 mg. No other systemic anti-cancer treatment was prescribed. There were no significant differences in the post-hydration serum calcium values (mean 3.17 mmol l-1 for pamidronate and 3.06 mmol l-1 for clodronate), tumour type or frequency of bone metastases between the two treatments. One patient on each treatment died within 2 days and was not assessable for response. A total of 19/19 (100%) patients achieved normocalcaemia following pamidronate and 16/20 (80%) with clodronate. The median time to achieve normocalcaemia was 4 days (range 2-14) for pamidronate and 3 days (range 2-6) with clodronate. The median duration of normocalcaemia was 28 days (range 10-28+ days) after pamidronate and 14 days after clodronate (range 7-21 days) (P 28 days respectively. Two patients experienced fever after pamidronate but no significant toxicity was observed with either treatment. We conclude that both agents are effective in the management of hypercalcaemia of malignancy. At the doses studied, the effects of pamidronate are more complete and longer lasting than those of clodronate

Ten-year follow-up of a patient with metastatic Ewing's sarcoma of the pelvis.

PATIENT: We report a 32-year-old women with a pelvic Ewing's sarcoma, who developed skeletal metastases within 20 months of diagnosis but following treatment remains disease-free at 10 years. DISCUSSION: Ewing's sarcoma is a highly malignant tumour of bone. Presentation of a pelvic tumour over the age of 30 years is extremely rare and associated with a poor prognosis. Early recurrence is also associated with an extremely grave prognosis. In our patient there was little or no response to salvage chemotherapy, but, against the odds, remission was induced with pamidronate and palliative radiotherapy to some but not all sites of disease.This remission has been maintained without additional therapy for a further 5 years

Antidepressant and skeletal muscle relaxant effects of the aqueous extract of the Prosopis cineraria

The aqueous leaves extract of Prosopis cineraria (AEPC) is used traditionally for the treatment of various CNS disorder. The purpose of this study was to evaluate the extract for antidepressant and skeletal muscle relaxant activity. The antidepressant effect of the extract was evaluated using Forced swim test (FST). The immobility periods of control and treated mice were recorded. The antidepressant-like effect of tested compound was compared to that of imipramine (15 mg/kg. p.o). Muscle relaxant property was studied using rotarod apparatus and total fall off time for standard and control group was recorded. Phytochemical screening revealed the presence of saponins, flavonoids, alkaloids, glycosides, tannins and phenolic compounds. The leaf extract at doses of 200 mg/kg significantly decreased the duration of immobility time in FST. The efficacy of tested extract was found to be comparable to that of imipramine. Our results suggested that the aqueous extract of Prosopis cineraria leaves exerts antidepressant-like effect.O extrato aquoso de folhas de Prosopis cineraria (AEPC) é utilizado, tradicionalmente, para o tratamento de várias disfunções do SNC. O propósito desse estudo foi avaliar o extrato quanto às atividades antidepressiva e relaxante muscular esquelética. O efeito antidepressivo do extrato foi avaliado usando o teste do nado forçado (FST). Registraram-se os períodos de imobilidade dos camundongos controle e dos tratados. O efeito antidepressivo do composto testado foi comparado com a imipramina ((15 mg/kg. p.o). A propriedade relaxante muscular foi estudada usando o cilindro giratório e o tempo total de queda para os grupos padrão e controle foram registrados. A triagem fitoquímica revelou a presença de saponinas, flavonoides, alcaloides, glicosídeos, taninos e compostos fenólicos. O extrato da folha em doses de 200 mg/kg diminui significativamente a duração do tempo de imobilidade no FST. A eficácia do extrato testado foi comparável àquela da imipramina. Nossos resultados sugeriram que o extrato aquoso das folhas da Prosopis cineraria exerce efeito semelhante ao antidepressivo