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Biomedical subjects

I Elomaa

Publications and source records attributed to I Elomaa.

At least 127 records · Page 7Linked to original sources
PubMed1988

Clodronate for osteolytic metastases due to breast cancer.

Breast-cancer patients with multiple osteolytic bone metastases were treated with clodronate (Cl2MDP) 1.6 g/day (17 patients) or placebo (17 patients) for 12 months. Bone pain, extension of bone metastases and formation of new osteolytic foci were reduced by Cl2MDP, and development of severe hypercalcaemia was prevented. After withdrawal of treatment, the patients were followed up for at least 12 months. New bone metastases developed in both groups. There were, however, less fractures and less hypercalcaemia in the Cl2MDP than in the placebo group. The survival rate was higher in the Cl2MDP group than in the placebo group. No side-effects were observed in the Cl2MDP group.

Aged↗
PubMed1987

The response evaluation of bone metastases in mammary carcinoma. The value of radiology, scintigraphy, and biochemical markers of bone metabolism.

The correlation between response of metastatic bone lysis and bone pain, various biochemical markers of bone metabolism, and radiological and scintigraphic findings was investigated in 49 women with breast cancer included in a calcitonin supportive therapy trial. All patients had dominant skeletal disease and were on stable systemic treatment (cytotoxic or hormonal) for a least 6 months before the first response evaluation. Bone pain correlated poorly with treatment response. Changes in sclerotic metastases did not show any apparent relation to changes in lytic lesions. A correlation between bone scans and lytic activity on radiographs was found. The absolute level of biochemical bone markers did not correlate with treatment response, but seemed instead to reflect the rate of bone turnover. The relative level of bone markers with respect to baseline showed better correlation to treatment response. The best conventional marker of disease activity was urinary hydroxyproline/creatinine. Propeptide of Type III procollagen (PIIINP), a novel marker reflecting collagen turnover, promises to be at least as sensitive as hydroxyproline. Stable and regressing patients had the same prognosis and significantly longer survival than progressors.

Biomarkers, Tumor↗
PubMed1987

Screening for colorectal carcinoma in cancer family syndrome kindreds.

Screening for colorectal carcinoma (CRC) was organized for 236 asymptomatic family members in 22 Finnish cancer family syndrome (CFS) kindreds, and 58% (137) of the subjects accepted the invitation. Double-contrast colonography and sigmoidoscopy or colonoscopy were used. In 137 subjects aged 20-65 years, with 3 or more first-degree relatives with CRC, one screening visit showed a colonic neoplasm in 12 (9%) subjects. Two had carcinoma (Dukes A and B), and 10 subjects one or more adenomas. Two of the subjects not attending screening (2%) developed Dukes C colon carcinoma during the study period, and one of them died of cancer. Continued screening of 34 patients with a previously identified CFS showed metachronous colorectal tumours in 12 (35%) cases: 9 operable carcinomas and 9 adenomas within 3 years. The preliminary result of screening on the basis of CFS was encouraging. Effective and continuous screening, however, requires centralized organization. The continued follow-up of identified CFS cases effectively revealed metachronous colorectal tumours at a curable stage, but its benefit was burdened by a high rate of advanced malignancies other than CRC.

Adenoma↗
PubMed1987

Mesalazine tolerance in patients with inflammatory bowel disease and previous intolerance or allergy to sulphasalazine or sulphonamides.

Fifty patients intolerant of or allergic to sulphasalazine (SASP) or sulphonamides were treated with mesalazine. Eighty per cent of patients continued treatment during the time of follow-up (mean, 8.4 months); 14% (7 of 50 patients) had to stop the treatment with mesalazine because of side effects. The patients with allergic reactions, including rash, fever, and systemic manifestations from SASP, were most likely to be intolerant of or allergic to mesalazine (four of seven patients); two of them developed a similar reaction from both SASP and mesalazine. Two patients (2 of 12) with previous haematologic side effects had to discontinue mesalazine treatment, one because of mild neutropaenia and one because of an elevation of liver enzyme values. One patient experienced gastrointestinal side effects from both mesalazine and SASP. Altogether, 4 (4 of 50) patients experienced gastrointestinal symptoms from mesalazine. Two of them had had a flare-up of the symptoms of the colitis when treated with SASP. All side effects were rapidly reversible after withdrawal of the drug. Patients with severe allergic reactions with systemic manifestations from SASP should be treated with caution with 5-aminosalicylic acid preparations.

Adolescent↗
PubMed1987

Unprocessed bran and intermittent thiazide therapy in prevention of recurrent urinary calcium stones.

Both urinary calcium excretion and renal stone episodes are increased during the summer in Finland. Since thiazide and unprocessed bran are known to decrease urinary calcium excretion, we treated 73 patients with recurrent urinary stone formation by giving them unprocessed bran and intermittent thiazide. Of the patients, 32 had absorptive hypercalciuria and 41 had normal urinary calcium values. All patients were on a low-calcium and low-oxalate diet and took 40 g bran daily. Fourteen of the hypercalciuric and 14 of the normocalciuric patients were randomly allocated to use hydrochlorothiazide 50 mg b.i.d. from May to September. Reduction of stone formation was seen in all groups. The combination of thiazide + bran was superior to the bran on its own in inhibition of stone formation. Only 3/11 (27%) stones passed through during the summer in the thiazide + bran group as compared with the 11/17 (65%) in the bran group.

Adult↗
PubMed1987

Cytogenetic investigations of patients on clodronate therapy for Paget's disease of bone.

In order to judge whether or not clodronate used for treatment of patients with Paget's disease of bone had an effect on the haematopoetic tissue, the frequency of chromosome/chromatid breaks in bone marrows and blood cells was evaluated. Seven patients were studied before treatment, after a few days of treatment and after greater than or equal to 2 months of treatment. Three additional patients were studied after exposure to clodronate for greater than or equal to 6 months. There was no significant increase in the occurrence of chromosomal aberrations induced by treatment. Thus no negative effect of clodronate on the haematopoetic tissue could be noted.

Aged↗
PubMed1987

Treatment of skeletal disease in breast cancer: a controlled clodronate trial.

Normocalcaemic breast cancer patients with progressive osteolytic bone metastases were treated with clodronate 1.6 g/day (17) or placebo (17) for 12 months. Bone pain, extension of bone metastases and formation of new osteolytic foci were reduced by clodronate, and development of severe hypercalcaemia was prevented. After withdrawal of treatment the patients were followed-up for at at least 12 months. New bone metastases developed in both groups. There were, however, less fractures and less hypercalcaemia in the clodronate than in the placebo group. The survival rate was higher in the clodronate group than in the placebo group. No haematological toxicity was observed in the clodronate group.

Bone Neoplasms↗
PubMed1986

The steady-state pharmacokinetics of tamoxifen and its metabolites in breast cancer patients.

The steady-state pharmacokinetics of tamoxifen and its metabolites was studied in sixteen patients with advanced mammary cancer. Patients were randomized to receive tamoxifen given as Tamofen, Leiras, or as Nolvadex, ICI, 20 mg twice daily for 16 weeks in a cross-over study. Plasma and urine samples were analyzed during one dose interval (12 h) after treatment for 8 and 16 weeks. The concentrations of tamoxifen, N-desmethyltamoxifen, N,N-desdimethyltamoxifen, and metabolite Y were determined in plasma and the areas under the plasma level curves were calculated. 4-Hydroxytamoxifen was not found in plasma. In urine samples only tamoxifen and N-desmethyltamoxifen were above the detection limits even though metabolite Y was also analyzed after acid hydrolysis. There were no statistically significant differences in the concentrations of tamoxifen and its metabolites between the two preparations. The results of nonresponders did not differ from those of responders. Liver metastases had no effect on the metabolism of tamoxifen.

Aged↗
PubMed1986

Aminoglutethimide as second line therapy in advanced breast cancer.

Seventy-two women with advanced breast cancer were treated with aminoglutethimide and hydrocortisone (AG). All patients were previously treated with hormones and 59 patients had also received cytotoxic agents. A partial response to AG with a mean duration of 9 months (range: 4-26 months) was achieved in 24 patients (33%), 10 patients (14%) had stable disease, and 32 patients (44%) were progressing during AG therapy. Response to previous treatment seemed to be correlated to response to AG, as 47% of patients having responded to the first hormonal treatment also responded to AG, while only 16% of the progressors responded to AG. The number of previous treatments influenced neither the frequency nor duration of response to AG. The median survival after start of AG was 13 months, and 31% of the patients lived more than 2 years. Side-effects led to discontinuation of therapy in 9 patients (13%). Three patients developed reversible agranulocytosis.

Adult↗
PubMed1984

Five years of experience with selective therapy in recurrent calcium nephrolithiasis.

We evaluated the efficacy of selective treatment in 126 patients with recurrent calcium urolithiasis who were chosen on the basis of ability to correct underlying physiochemical disturbances. Patients with hyperparathyroidism underwent an operation. Patients with renal hypercalciuria were treated with thiazide and those with absorptive hypercalciuria were given a low calcium, low oxalate diet with or without thiazide. The only treatment for normocalciuric patients was high fluid intake, which was suggested also to the other groups. A significant individual mean reduction in stone formation was observed in all groups after 5 years of treatment. However, only 48 per cent of the normocalciuric patients were in remission after 5 years of high fluid intake therapy and 45 per cent of those with absorptive hypercalciuria were free of recurrence with diet only. Thiazide treatment seemed to be effective despite the type of hypercalciuria. The effect of the treatment on stone formation was mediated through reduction of risk factors in the urine. Conversely, a high level of risk factors commonly predicted stone recurrence.

Adult↗
PubMed1984

Raynaud's phenomenon progressing to gangrene after vincristine and bleomycin therapy.

Vascular symptoms after vinca-alcaloids and bleomycin are known. We report a 50-year-old woman who was cigarette smoker and who had had the syndrome of Raynaud's phenomenon for two years before she developed non-Hodgkin lymphoma. She was treated with chemotherapy including vincristine and bleomycin. Immediately after the second course of chemotherapy she had severe vertigo, nystagmus, dysarthria and dysphagia. The fingers remained cyanotic and became extremely painful despite stellatum blockade, intra-arterial vasodilators and thoracic sympathectomy. Two digits of the left hand were partially amputated because of gangrenous areas on the fingertips. The cerebral symptoms disappeared.

Bleomycin↗
PubMed1984

Long-term effects of dichloromethylene diphosphonate in patients with osteolytic bone metastases and coincident primary hyperparathyroidism.

Dichloromethylene diphosphonate (Cl2MDP), an inhibitor of osteoclast-mediated bone resorption, lowers serum calcium in hypercalcemia associated with malignancies and with primary hyperparathyroidism. We have evaluated the effectiveness of Cl2MDP in three patients who had multiple osteolytic bone metastases due to breast cancer and coincident primary hyperparathyroidism and who refused neck exploration. Cl2MDP was added to the tamoxifen treatment and was given orally at a dose of 1600 mg/day for 12 months. All patients had a reduction in serum calcium level which was accompanied by a decline in the fasting urinary calcium and hydroxyproline excretion. Administration of Cl2MDP was not associated with any changes in parathyroid hormone levels. New bone metastases were observed neither during the treatment nor in the follow-up period. No side effects were observed.

Aged↗