Effect of monomeric immunoglobulin G (IgG) on the clearance of soluble aggregates of IgG in man

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Prednisone treatment of elderly-onset rheumatoid arthritis: Disease activity and bone mass in comparison with chloroquine treatment

Objective. Prednisone is frequently used in the treatment of elderly-onset rheumatoid arthritis (RA), but the balance between efficacy and toxicity, including the effect on bone mass, has not been investigated in long-term studies. This prospective, randomized study was undertaken to compare disease activity and bone mass during long-term treatment with prednisone versus chloroquine in this patient population. Methods. Patients with active RA diagnosed at age ≥ 60 were randomized to receive prednisone (15 mg/day for 1 month, with the dosage tapered as low as possible thereafter) (n = 28) or chloroquine (n = 28). Patients who did not show a response received other second-line drugs as an adjunct to prednisone or as a replacement for chloroquine. Bone mass was measured by dual-energy x-ray absorptiometry. The study duration was 2 years. Results. During the 2 years, treatment with other second-line drugs was needed for 12 patients in the prednisone group (43%) and 8 in the chloroquine group (29%). Functional capacity and disease activity improved significantly in both groups and did not differ significantly between the groups, except for a greater improvement in the prednisone group at 1 month. Radiographic scores for joint destruction progressed similarly in both groups. There was a nonsignificant excess bone loss of 1.8% in the spine and 1.5% in the hip in the prednisone group, compared with the chloroquine group. Conclusion. Neither treatment was entirely satisfactory since a significant number of patients needed an additional second-line drug over the 2-year period

Is quantitative analysis superior to visual analysis of planar thallium 201 myocardial exercise scintigraphy in the evaluation of coronary artery disease? - Analysis of a prospective clinical study

Quantitative analysis of myocardial exercise scintigraphy has been previously reported to be superior to visual image interpretation for detection of the presence and extent of coronary artery disease. Computer analysis of perfusion defects and washout rate of thallium 201 was performed on scintigrams from a group of 131 consecutive patients (prospective group), using criteria defined from a previous group of 72 patients (initial group), and compared with visual interpretation of scintigrams for detection and evaluation of coronary artery disease. The sensitivity of the quantitative technique with regard to overall detection of coronary artery disease was not significantly different from the visual method (69% and 74%, respectively), whereas the specificity was higher (86% and 68%). Quantitative analysis did not increase the sensitivity of thallium imaging over the visual method in the left anterior descending artery (46% vs 65%) and the right coronary artery (51% vs 72%) but did increase sensitivity in the left circumflex artery (75% vs 47%). Whereas in the initial group quantitative analysis resulted in a better identification of multivessel disease (sensitivity 81 % vs 57%), in the prospective group sensitivity decreased (54% vs 67%) without significant loss of specificity. The initial group had a 40% incidence of three-vessel disease and the prospective group, 22% (P < 0.05). One-vessel disease was higher in the prospective group (32% vs 11%, P < 0.05). Thus, assessing the quantitative technique in a larger prospective patient population, there was no improvement of detection of the presence and extent of coronary artery disease when compared with visual interpretation

Radiation Dose Features and Solid Cancer Induction in Pediatric Computed Tomography

Imaging- and therapeutic targets in neoplastic and musculoskeletal inflammatory diseas

Cancer induction caused by radiation due to computed tomography: a critical note

Imaging- and therapeutic targets in neoplastic and musculoskeletal inflammatory diseas

TREATMENT OF DIFFERENTIATED THYROID CANCER: NEW PLAYERS ON AN OLD FIELD

Imaging- and therapeutic targets in neoplastic and musculoskeletal inflammatory diseas

MOLECULAR IMAGING WITH SPECT AND PET IN EXPLORATORY INVESTIGATIONAL NEW DRUG STUDIES

Imaging- and therapeutic targets in neoplastic and musculoskeletal inflammatory diseas

MOLECULAR IMAGING WITH SPECT AND PET IN EXPLORATORY INVESTIGATIONAL NEW DRUG STUDIES

The phase O microdosing concept was introduced recently by the FDA in order to shorten the timeline for drug development and to reduce the overall cost of the process. The aim of this approach is to provide drug pharmacokinetic and pharmacodynamic data using subpharmacological doses of prospective drug candidates in a small number of human volunteers at the earliest stages of drug development. A microdose is defined as 1/100th of the pharmacological dose or a maximum of 100 mu g, which requires ultrasensitive analytical methods for measuring such a small amount of drug. Molecular imaging plays a fundamental role in this process. Radionuclide-based imaging modalities such as single-photon emission computed tomography (SPECT) and positron emission tomography (PET) allow the noninvasive visualization and quantitative assessment of physiological and biochemical processes occurring at cellular and subcellular levels within the human body Due to the high sensitivity of such techniques it is possible to evaluate in vivo the biodistribution and pharmacokinetics of drug candidates in the nano- to picomolar concentration range. This information obtained in the earlier phases of drug development might have a tremendous impact on the success rate of agents entering clinical trials and on the overall efficiency of the process. In this article we provide an overview of the basic principles of molecular imaging with SPECT and PET and explain how these techniques can be implemented in exploratory IND studies and used to accelerate new drug approvals.Imaging- and therapeutic targets in neoplastic and musculoskeletal inflammatory diseas

Microdosing in early lead discovery

Microdosing provides a tool to enhance drug development by initiating human studies prior to Phase I studies. The purpose is to assist in the go versus no-go decision-making process and to eliminate early ineffective compounds from the drug pipeline. Selection of multiple potential leads can be performed at the clinical stage instead of in preclinical studies. The microdosing approach can be easily used for a molecularly targeted potential drug compound with a known mechanism of action. It provides useful data regarding accessibility and biodistribution that can be used in many estimations benefiting the development of the molecule. In addition, steady state and genetic investigations are becoming possible. Microdosing has a sparing effect on timelines and costs, however, the real importance is not yet known because, although it is known to be widely performed, only a few original reports have been published.Radiolog