calcitonin and Chronic-Disease

The analgesic properties of salmon calcitonin for the treatment of atypical facial pain (AFP) were investigated. An initial open-label trial of salmon calcitonin in subjects with refractory AFP was followed with a randomized, double-blind, placebo-controlled crossover trial of salmon calcitonin in the management of AFP. Salmon calcitonin (100 IU in 1 mL saline) was administered in an open-label fashion to 13 subjects with refractory AFP five times per week for 6 weeks. In the subsequent randomized investigation, salmon calcitonin (100 IU in 1 mL saline) or placebo (1 mL saline) was delivered three times per week for 3 weeks, with a 1-week washout prior to crossover. The percentage of subjects dropping out (57%) exceeded that reported in other pain studies using calcitonin. Therefore, it was imperative to halt the study for ethical reasons. There was no difference in outcome measures (P > .05) in subjects administered either active drug or placebo, and a high incidence of side effects led to dropout in subjects taking salmon calcitonin. Although salmon calcitonin may have analgesic properties, it is not efficacious for AFP, largely because of the side effects.

Topics: Adult; Aged; Analgesics; Calcitonin; Chronic Disease; Double-Blind Method; Facial Pain; Female; Humans; Male; Middle Aged; Nausea; Pain Measurement; Vomiting

We present a case of chronic mandibular suppurative osteomyelitis after a routine extraction that required surgical and prolonged antimicrobial treatment. We also report the use of calcitonin as an adjunct to resolve symptoms of pain and possibly induce bony healing.

Topics: Anti-Bacterial Agents; Bone Density Conservation Agents; Calcitonin; Chronic Disease; Female; Humans; Mandibular Diseases; Mandibular Fractures; Middle Aged; Osteomyelitis; Tooth Extraction

We report on a 29-year-old motorcyclist, who had suffered a traumatic right side arm plexus lesion. The myelo-CT image showed a avulsion of the cervical roots C7/C8. Five days after the accident the patient complained of phantom pain in the right plegic arm and was presented to our acute pain service (APS). The patient complained of lancinating attacks of severe phantom pain in the right arm (visual analogue scale intensity of 80-100 pts.). The initial pain treatment was performed with PCA (piritramide), and because of the lancinating pain character carbamazepine treatment was introduced. The pain intensity increased under carbamazepine (VAS = 100 pts.), and after treatment with five cycles of salmon-calcitonin infusion the pain intensity decreased (VAS = 10 pts). After withdrawal of the infusion therapy with salmon calcitonin the pain intensity increased up to VAS = 70 pts. TENS therapy five times per day showed no analgetic effect. We repeated the calcitonin-infusion therapy and after five i.v. cycles we continued with 200 I.U. salmon calcitonin intranasal per day. The initial phantompain intensity decreased (VAS = 40 pts.), but showed no long term analgesia. The additional psychological treatment with relaxation techniques (Jacobson/Bensen) showed the desired phantom pain relief. An interdisciplinary and multimodal cooperation between anesthesiologists, trauma surgeons, neurosurgeons and psychologists is needed for successful phantom pain treatment after traumatic brachial plexus lesion. Intravenous salmon calcitonin showed only short-term analgetic effect.

Topics: Adult; Brachial Plexus; Calcitonin; Chronic Disease; Combined Modality Therapy; Humans; Male; Patient Care Team; Phantom Limb; Radiculopathy; Radiography; Relaxation Therapy

Experimental and clinical evidence testifies to an antinociceptive action of salmon calcitonin (sCT), administered in different ways, on the central nervous system. These studies were performed almost exclusively in acute pain models. The purpose of the present study was to investigate the effects of sCT, injected directly into the lateral cerebral ventriculi, on the firing of single nociceptive thalamic neurons, detected by electrophysiological techniques in an experimental model of prolonged or chronic pain, such as rats rendered arthritic by injection of Freund's adjuvant into the left hindfoot. The noxious test stimuli used were either extension or flexion of the ankle or mild lateral pressure on the heel. With increasing doses of sCT (5, 10, 20, 40 micrograms, 5 microliters/i.c.v.) it was possible to observe correspondingly increasing inhibitory and long-lasting effects on the evoked firing, with a significant dose-effect relationship. In agreement with electrophysiological findings, preliminary data, obtained with a patch clamp technique, on depression of calcium fluxes through neuronal membrane, induced by sCT, oriented the attention to a direct action of sCT on CNS.

Topics: Analgesics; Animals; Arthritis, Experimental; Calcitonin; Chronic Disease; Disease Models, Animal; Electrophysiology; Injections, Intraventricular; Male; Movement; Nociceptors; Pain; Physical Stimulation; Pressure; Rats; Rats, Sprague-Dawley; Thalamus

23 patients with algodystrophy, 28 up to 82 years of age, were treated with calcitonin during the period 1978-1988 and the effect of the treatment is discussed. The treatment was carried out with the drug Myacalcic "Sandoz" in a daily dose of 100 IU, administered intramuscularly every day in the course of 10 days. The following clinical parameters were followed up: pain, swelling, functional capacity, skin (dystrophic) changes. The patients are classified in 2 groups in relation to the results: I. group--acute stage and II. group--chronic stage of the disease. The pain was favourably influenced in both groups by the Myacalcic treatment. In the acute stage the swelling was favourably influenced in 81% of the patients, the skin changes in 89%, the functional capacity was improved 1.64 times. In the chronic stage the swelling was reduced in 25% of the patients, there was no effect on the dystrophic changes and the functional capacity decreased in spite of the treatment.

Topics: Adult; Aged; Aged, 80 and over; Calcitonin; Chronic Disease; Drug Evaluation; Female; Humans; Male; Middle Aged; Reflex Sympathetic Dystrophy

Prednisone-induced osteoporosis is very frequent in the long-term treatment of sarcoidosis (sarcoidosis 4:45-48, 1987). The aim of this work is to evaluate if salmon Calcitonin (sCT) is able to prevent osteopenia in the long-term. We have studied 53 patients with chronic histologically-proven sarcoidosis, all needing steroids, in a follow-up of 15 months; 20 of them were protected with sCT (100 I.U. i.m. daily for one month, then every two days for all the time of the study), 33 were unprotected. The two groups were matched for age, sex and total dose of prednisone. In order to overcome the differences of Vertebral Cancellous Mineral Content (VCMC) due to age and sex, we express VCMC in terms of Z score, i.e. the number of standard deviations above or below our normal means: initial Z score was -1.77 +/- 0.16 in the sCT group and -0.99 +/- 0.17 in the other group (P less than .05). For each subject we calculated the Mineral Loss (ML) in % of the initial value. At the end of the study ML% averaged -2.15(+/- 2.27) in the sCT protected group, and -14.11(+/- 2.08) in the unprotected group (P less than .001). We have also analysed the results limited to pts with initial Z score under -1 (19 sCT protected pts vs 18 unprotected). In these subgroups the ML% after 15 months averaged -13.62(+/- 2.9) in the unprotected group and -2.80(+/- 2.29) in the protected one (P less than .01). Finally we have studied another subgroup, i.e. 21 postmenopausal females: 9 were sCT protected, 12 were unprotected.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Calcitonin; Chronic Disease; Female; Humans; Male; Menopause; Middle Aged; Minerals; Osteoporosis; Prednisone; Sarcoidosis; Spine