A study has been conducted in general practice comparing two brands of lozenges, Merocaine (Merrell) and Tyrozets, (M.S.D.), in the management of acute sore throat and pharyngitis. Eighty-eight patients entered the between-patient study and each completed a diary card covering symptoms experienced and dosage used for each of the two drugs. The doctor reported upon the appearance of the throat and added antibiotics in cases of necessity, which was approximately for one-third of patients. Merocaine proved to be significantly superior to Tyrozets in producing rapid pain relief (within 15 minutes) and reduction of faucial and pharyngeal injection.
Forty patients in general practice with rheumatoid arthritis or osteoarthritis were identified as suffering from moderate pain and tenderness and moderate stiffness in excess of 30 minutes. After discontinuation of non-steroidal anti-inflammatory drugs for 2 weeks, a crossover study was conducted comparing the benefits of flufenamic acid, 100 mg, four times daily with placebo. At the same time, paracetamol at a dose up to 8 x 500 mg daily, could be used for pain which the patient judged to be unrelieved. Thirty-four patients completed the two 3-week test periods and twenty-one patients were improved in relation to morning stiffness and pain by flufenamic acid and twelve patients by placebo--a difference greater than would have occurred by chance (p = 0.05). At the same time, paracetamol consumption was reduced significantly fron a mean of 91.29 tablets to 60.68 tablets for each 3-week period. Side-effects occurred in ten patients on placebo and fifteen patients on flufenamic acid. One patient on each medication had to discontinue for multiple side-effects. Diarrhoea occurred in two patients on flufenamic acid and in one patient on placebo. Flufenamic acid is clearly effective and side-effects do not occur more often than would be expected by chance when compared with placebo.
A double-blind study of terfenadine and placebo in 110 patients suffering from hay fever (confirmed by skin tests) was conducted. A novel technique was applied using an escape envelope containing a reference drug which could be taken under controlled conditions if, after 48 hours, the patient experienced no relief. Significantly more patients on placebo opened the envelope than patients taking the active drug. Terfenadine was demonstrated to be an effective drug in hay fever and produced no more drowsiness than placebo.
Summary. A comparison of calcium-47 kinetics and biochemical measurements has been made in 25 previously untreated patients with Paget's disease. The rate of disappearance of 4rCa into bone with a turnover time of more than 5 days was measured as A5, and the pool size with a turnover time of less than 5 days as E5. In moderately active disease the reductions in A5 and E5 to be anticipated from treatment seem to be offset by an increase in exchangeability due to remineralization of osteoid. In more active disease the effect of calcitonin may be to shift bone formation from a woven to a lamellar pattern as well as to reduce turnover, Under these circumstances both A5 and E5 are reduced by treatment more in keeping with the biochemical changes.Key words: Paget's disease --Calcitonin kinetics.Paget's disease is a common skeletal disorder characterized by an increase in bone turnover. Changes in disease activity during treatment are most conveniently monitored using serum alkaline phosphatase (SAP) and urinary hydroxyproline excretion (HYPRO) as indices of osteoblastic and osteoclastic activity. The uptake of calcium isotopes into bone is also increased in this disease [1][2][3][4][5][6][7][8], and studies using 47Ca have analyzed plasma activity curves in terms of exchangeable pool and the internal and external disappearance of isotope [1,[9][10][11]. Although it may be difficult to translate kinetic data into absolute rates of bone formation and resorption [12], the measurements are a useful index and represent an independent parameter by which the response to treatment can be assessed. However, there have been relatively few detailed studies which have related tracer uptake into bone, "accretion" or "exchangeable pool," to other parameters of bone turnover during treatment [1,[6][7][8]. Such an exercise is important because it may provide additional information about the pathophysiological basis of Paget's disease. Materials and MethodsTwenty-five patients with previously untreated Paget's disease were studied before and at 6-month intervals during a course of treatment with salmon calcitonin (SCT) given in a dose of 100 MRC units 3 times a week by subcutaneous injection. Four patients received supplements of phosphate (Phosphate, Sandoz; 0.5 g elemental phosphorus every 8 h), and ten patients were given vitamin D (calcium and vitamin D BPC 1000 IU (25 p.g) daily).All patients were admitted to the metabolic ward and stabilized on a low-gelatin diet with a constant calcium content adjusted to usual intake. SCT therapy was withdrawn 3 days before the start of biochemical and kinetic studies. Serum alkaline phosphatase was measured by the Hausemen technique [13] (normal range 46-190 IU L '), and total urinary hydroxyproline by the method of Prockop and Udenfriend [14] (normal range <300/xmol.24 h '). Values shown in the illustrations represent the mean of at least 5 determinations in the first week of the study which began after a 3-day equilibration period. Kinetic measurements were made at the same time following an...
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