Ibandronate treatment decreases the effects of tumor-associated lesions on bone density and strength in the rat.

Bisphosphonate treatment is beneficial against symptoms of metastatic bone disease, although less is known about the effect of preventative treatment schedules. We investigated the effect of various treatment regimens of the bisphosphonate, ibandronate (IB), on the preservation of bone quality in a rat model of tumor-induced osteolysis. Osteolytic Walker 256 (W256) carcinosarcoma cells were implanted into the left femur of female Sprague-Dawley rats, resulting in a 10% reduction in bone mineral density (BMD), a 16% reduction in bone density (BD), and a 26% reduction in failure load compared with the right femur 28 days after implantation. IB was administered subcutaneously in five different treatment schedules: (1) IB PRE-POST received IB for 26 days, prior to implantation of W256 cells in the medullary canal of the femur, and for 28 additional days after surgery; (2) IB PRE-POST SHAM received the same IB administration, but with a sham operation; (3) IB PRE received IB injections before W256 cell insertion only; (4) IB PRE-0 received IB injections for 26 days and was then killed to serve as a time zero control; and (5) IB POST received sham injection with saline before W256 cell insertion, and then received IB injections for 28 days until killing. Controls (TUMOR ONLY) received sham injections with saline prior to W256 cell insertion, and then for 28 additional days until killing. We used dual-energy X-ray absorptiometry (DXA) to measure distal femur BMD and bone mineral content (BMC), peripheral quantitative computed tomography (pQCT) to measure distal femur BD, and torsion testing to obtain torsional failure load. Combined preventative and interventional IB treatment best preserved bone mass and strength, although all treatment schedules resulted in significant improvement compared with untreated controls (TUMOR ONLY). The possibility of reducing or even preventing skeletal morbidity in cancer patients with a high risk of developing metastatic spreading to bone is exciting, and warrants further exploration.

Treatment with ibandronate preserves bone in experimental tumour-induced bone loss.

Cancer-induced bone diseases are often associated with increased bone resorption and pathological fractures. In recent years, osteoprotective agents such as bisphosphonates have been studied extensively and have been shown to inhibit cancer-related bone resorption in experimental and clinical studies. The third-generation bisphosphonate, ibandronate (BM 21.0955), is a potent compound for controlling tumour osteolysis and hypercalcaemia in rats bearing Walker 256 carcinosarcoma. We have studied the effect of ibandronate given as an interventional treatment on bone strength and bone loss after the onset of tumour growth in bone. Our results suggest that it is capable of preserving bone quality in rats bearing Walker 256 carcinosarcoma cells. Since other bisphosphonates have produced comparable results in man after their success in the Walker 256 animal models our findings suggest that ibandronate may be a powerful treatment for maintaining skeletal integrity in patients with metastatic bone disease.

[Treatment of acute cerebral ischaemia with low-molecular dextran: results of a retrospective study (author's transl)]. / Behandlung der akuten zerebralen Mangeldurchblutung mit niedermolekularem Dextran Therapie-Ergebnisse einer retrospektiven Studie

Between 1968 and 1970, 226 patients with acute cerebral ischaemia were treated with vasodilator drugs. In the subsequent three years (1971 to 1973) 202 patients were instead treated with dextran (Rheomacrodex) infusions. tin the latter period the death-rate was 35%, 19% less than during the preceding period of vasodilator treatment. In the dextran group among patients over 65 years the death-rate was 42%, 21% less than in the vasodilator group of the same age. Dextran treatment caused complete disappearance of neurological signs in 25%, compared with 7.5% in the vasodilator group. Dividing patients into those with normal blood pressure, hypertension and diabetes gave corresponding differences among the two groups. The death-rate during the period of dextran treatment was significantly less in all the sub-groups than in the vasodilator years. The results of this retrospective study provide important pointers to the effectiveness of dextran infusion in the treatment of acute cerebral ischaemia.

[Visceral leishmaniasis (kala-azar), an important disease not only in the tropics (author's transl)]. / Kala-Azar (viszerale Leishmaniose)-eine wichtige Krankheit nicht nur der Tropen

A 39-year-old woman contracted visceral leishmaniasis on a 14-day visit to southern Italy and died of staphylococcal septicaemia before specific treatment could be effective, diagnostic efforts over four months having failed to make the diagnosis until four weeks before death. Eight further cases reported in German-speaking medical journals illustrate similar diagnostic difficulties. The disease is accompanied by septic temperatures, frequently with two daily spikes, hepato- and splenomegaly, normochromic anaemia and leucocytopenia. But diagnosis can only be made by specific tests. The organisms can be discovered in sternal puncture and organ biopsies only if the Giemsa stain is used. Complement-fixation reaction for leishmania should be tried repeatedly, in case the disease is suspected.