PubMed · 6563219
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K Shibusawa. 1983. [Katacalcin].. https://pubmed.ncbi.nlm.nih.gov/6563219/
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The author presents late results of treating 60 patients with posttraumatic Sudeck's dystrophy of upper extremity. The treatment was conducted by 3 methods: 30 patients were receiving mannitol for 1 month, 15 subjects were given calcitonin intramuscularly for 1 month, and programmed rehabilitation according to Mucha's scheme was applied in 15 patients. The results were estimated within the period of 1/2--2 years since the commencement of therapy. The evaluation of the results was accomplished by 3-degree classification namely: good, fair, poor. Main attention was focussed on the rest pain regression and improvement of the hand grasping function. In the total group of 60 patients under treatment, there were 38 persons with good results (62%), in 16 the result was fair (27%) and in 6 persons the outcome was poor (11%). It has been recorded that the treatment during the I stage of disease by all the three methods used was uniformly effective. In the treatment of the II stage the most efficacious was mannitol (statistically significant). Mannitol best influenced the improvement of hand grasping strength after the treatment, as well as regression of DS typical changes in RTG and bone scan. It has been also ascertained that for achievement of good results--regardless of the therapeutic method--the greatest influence was exerted by: the time shorter than 3 months elapsing from the trauma to the onset of the treatment, initial deficit in flexion of the fingers smaller than 3 cm, the presence of typical for DS changes in bone scintigraphy as well as I stage of the disease.
Osteoporosis is the most important metabolic bone disease and places an increasing burden on the healthcare system. The condition can be prevented by the early introduction of hormone replacement therapy. The role of bisphosphonates in achieving the same result is being actively explored. The attraction of preventing bone loss is that it preserves the micro-architecture of bone, and therefore its mechanical integrity. The great problem of treating the established condition is that substantial bone loss is accompanied by architectural disintegration. Replacing lost bone may not necessarily restore mechanical integrity and protect against fractures. The management of Paget's disease has been quite revolutionised by the introduction of the bisphosphonates. The condition is a result of a primary increase in osteoclastic bone resorption which can be corrected by bisphosphonates, with considerable symptomatic improvement. The increasing potency and safety margin of the newer agents has meant that the threshold for treatment has fallen. There is now potential for long term control of bone turnover with the hope of preventing late complications. Hypercalcaemia of malignancy is usually the result of both increased bone destruction and decreased urinary calcium excretion. These two components of hypercalcaemia demand different approaches to management. The general availability of an ever-expanding range of increasingly potent bisphosphonates has resulted in a dramatic improvement in the treatment of increased bone resorption associated with malignancy. Many types of tumour, either directly or indirectly, compromise the ability of the kidney to eliminate a calcium load derived from increased bone destruction. Calcitonin is the only agent which is currently available to counter this process.