[Does radiotherapy help against painful arthrosis?].
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Biomedical subjects
Publications and source records attributed to E J Valtonen.
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42 patients with osteoarthrosis with inflammation were included in the study. After randomization and with single-blind technique, they were given intra-articularly in the knee joint either 20 mg of triamcinolonehexacetonide (TH) or 6 mg of the combination betamethasone acetate and betamethasone disodiumphosphate (BM). The patients were studied up to six months after the injection. Initially, week one, two, four and at the time for a possible new injection; pain, local tenderness and joint range were evaluated. At the control in week one, two and four, a general evaluation of effect was also performed. Duration of effect was defined as patient's need of a new injection or other therapy during a six-month period. Results. In the evaluation of effect in local tenderness and pain, TH gave a significant better result already after one week. The improvement in joint range was more pronounced with TH. Also in the general evaluation significantly better results were shown with TH. In general evaluation all patients with TH were considered to improve with two weeks treatment. The duration of effect was significantly longer with TH. After three months five patients in the TH group respectively 12 patients in the BM group needed new therapy. The reported side-effects were not considered to be serious. The investigation has shown that TH gives a pronounced effect and long duration which has resulted in that TH is a preferable drug when long effect is needed in the treatment of osteoarthrosis with concomitant inflammation.
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The objective of the study was to compare efficacy and safety of Fenbufen and Aspirin in osteoarthritis. The study was a double-blind, randomized trial with crossover. The test subjects were treated for 4 weeks with 600 mg Fenbufen and for 4 weeks with 3.6 g Aspirin per day. 35 patients with osteoarthritis of the knee and 18 patients with osteoarthritis of the hip participated in the study. The physical measurements of osteoarthritis activity showed significant improvement with both Fenbufen and Aspirin. The drugs were comparable with respect to: 1) improvement of physical m-easurements, 2) investigator's assessments, and 3) patients' assessments. A smaller number of patients reported drug-related side effects with Fenbufen than with Aspirin. 57% of the patients reported side effects during treatment with Aspirin and 40% during treatment with Fenbufen. There were no abnormalities discovered in haematologic or biochemical tests performed during the course of the trial.
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The author reports the results of a placebo controlled trial of Celestone Chronodose in the treatment of supraspinatus tendinitis involving a total of 180 patients. The results after local injection and deep gluteal injection are also compared.
Sixty hospital out-patients between 18 and 67 years of age entered this double-blind parallel study set up to compare ibuprofen 1200 mg daily with indomethacin 75 mg daily. Both groups of patients received one capsule three times daily. Ten patients withdrew from the trial because of side effects and a further 3 were excluded--one because of an incorrect diagnosis and 2 because of incomplete assessments--leaving the statistical analysis to be performed on 47 patients. Assessments made after one and two weeks showed significant improvement for the parameters of pain and tenderness at each examination in both treatment groups. Restriction of movement also showed improvement, though not reaching statistical significance. Although there was no statistically significant difference beteen the two drug groups the mean improvement in all three parameters was consistently better with ibuprofen than with indomethacin. The commonest side effects were related to the gastrointestinal tract. Altogether, 10 patients withdrew because of side effects--4 on ibuprofen and 6 on indomethacin. The gastric symptoms occurring with indomethacin appeared to be generally more severe and usually occurred early, within 3 or 4 days of commencing treatment, whereas patients on ibuprofen withdrew usually after 7 or 8 days.
In a double-blind study, diclofenac sodium (Voltaren)--administered for 14 days in a dosage of 25 mg t.i.d.--was compared with naproxen (250 mg b.i.d. for 14 days) in the treatment of 120 patients with soft-tissue rheumatism. Assessment of the efficacy of the two treatments was based upon changes, recorded once a week, in the following parameters: pain at rest and on movement, swelling, local tenderness, functional impairment, limitation of movement, and sleep disturbances. The incidence of unwanted effects was also recorded, and the effects themselves were classified according to the probability of their being causally related to the trial preparations. Both drugs appeared to be effective in relieving symptoms associated with soft-tissue rheumatism. In most indications the therapeutic efficacy of the two preparations was similar. In patients suffering from diseases affecting the shoulder region, however, diclofenac sodium was significantly more effective. Unwanted effects rarely occurred with either drug.
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A questionnaire which allowed anonymous answering and which also included many other questions besides those dealing with sexual life was sent to 302 patients suffering from multiple sclerosis (MS). Sexual life had changed for 91% of males and 72% of females. About half of the patients replied that their sexual life was unsatisfactory or had ceased altogether. These patients were as a rule in a relative poor physical condition. In males, disturbances in erection (62%) were the most common problem, erection was normal in only 20%. In females the essential figures were: loss of orgasm in 33%, loss of libido in 27% and spasticity in 12%. There was no correlation between the incidence of sexual disturbances and the duration of the MS. It seems that the neurological disturbances in sexual life depend simply on the location of the plaques in the central nervous system.
This statistical report describes a clinical trial on 60 patients with supraspinal tendinitis for the comparison of triamcinolone hexacetonide (in a 20 mg/cc suspension in 1 cc ampoules) with methylprednisolone acetate (in a 40 mg/cc suspension in 1 cc ampoules). The objective of the study was to determine the therapeutic activity, including onset and duration of relief, of triamcinolone hexacetonide as a subacromial injection, and to compare these results with those obtained with similar injections of methylprednisolone acetate. The following results were obtained. Triamcinolone hexacetonide reduced pain, local tenderness and functional impairment to a greater degree than did methylprednisolone acetate. A significantly smaller proportion of patients needed a second injection of triamcinolone hexacetonide (33%) than needed a second injection of methylprednisolone acetate (63%). Triamcinolone hexacetonide appears to have longer duration of activity than does methyl-prednisolone acetate, judging by the percentage of patients still getting relief from their first injection at the end of the study period. The drugs were similar as regards side effect incidence rates and time to onset of action.
Some factors influencing the comfort of old people (mean age 73 years) in a modern home for the aged were studied. Most (76 percent) of the old persons were satisfied with their living conditions. Only one-fourth (24 percent) of the inmates were dissatisfied. The most important factors causing dissatisfaction were discomfort due to illnesses, and disagreement with other residents. On the whole, the old people were more satisfied with their life at home for the aged than is ofter supposed.
A double-blind trial of methocarbamol versus placebo was carried out in 59 matched pairs of patients suffering from painful muscle spasm. Methocarbamol (1500 mg. q.d.s.) was found to be effective in approximately 60% of patients compared with 30% of patients receiving placebo (p less than 0.01). Side-effects were of almost equal incidence in the two groups.