Differential response effectiveness is examined for patients during multiple episodes of methadone maintenance (MM) treatment. Subjects were 251 narcotics addicts who were divided into three groups based on their dail...
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Differential response effectiveness is examined for patients during multiple episodes of methadone maintenance (MM) treatment. Subjects were 251 narcotics addicts who were divided into three groups based on their daily narcotics use pattern during their first two MM treatment periods: (1) a "stabilizing group"-showing no daily use for both periods, (2) a "cumulative group"-showing a lower level of daily use during the second period compared to the first, and (3) a "deteriorating group"-showing higher daily use during the second period. Behavioral measures for various narcotics-related variables were plotted over 4 time periods (pre-MM, during first MM, between first and second episodes, and during second MM) were compared. Results indicated several individual differences related to patients' response to multiple episodes of MM. Clinical, research, and policy implications are discussed.
H.1. symptom modifying drugs The primary outcome variable is a specific aspect of joint pain, although a ‘signal’ symptom or some measure of function may also be studied. Trials of drugs with a rapid onset of effect...
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H.1. symptom modifying drugs The primary outcome variable is a specific aspect of joint pain, although a ‘signal’ symptom or some measure of function may also be studied. Trials of drugs with a rapid onset of effect can be as short as 1–4 weeks but may be as long as 12 weeks. Longer trials (up to 2 years) may be needed to evaluate longer-term toxicity, determine optimal long-term dosing regimens, or establish long-term benefit. Supplemental escape analgesia should be minimized, monitored and discontinued prior to evaluation of efficacy. Some agents that provide symptom relief may not provide benefit until weeks after initiation of therapy. Under these circumstances, trials will vary from 3–12 months in length. If the agent is administered in courses, episodic readministration of the drug may be needed in long-term trials. Longer trials (up to 2 years) may be required to exclude toxicity or establish long-term benefit. H.2. structure modifying drugs These drugs are intended to prevent, retard, stabilize or reverse development of the morphologic changes of OA. Although this has been called ‘chondroprotection’, the term is misleading and should be avoided, because all structures of the joint are involved in OA, not articular cartilage alone. The benefits of disease modifying therapy may not be apparent until years after the onset of treatment. The selection of high-risk groups may shorten the time of investigation. Improvement in symptoms (i.e., joint pain) is not a requisite for the efficacy of a drug in this category. In these studies, it may be necessary to permit concomitant use of drugs for relief of symptoms (NSAIDs, analgesics). The confounding effects of glucocorticoids and NSAIDs in these trials is not yet understood and very restricted use of IA depocorticosteroids is recommended. Demonstration of structure modification will require the use of direct measures of joint anatomy, such as radiography, particularly measurement of the radiographic joint space. As s
Thirty patients with hormone-refractory prostate cancer were treated with cycles of oral cyclophosphamide (100 mg/m2/day for 14 days, with a 14-day gap). Eighteen patients had a significant improvement in symptoms of ...
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Thirty patients with hormone-refractory prostate cancer were treated with cycles of oral cyclophosphamide (100 mg/m2/day for 14 days, with a 14-day gap). Eighteen patients had a significant improvement in symptoms of advanced disease, 6 had objective partial remissions and 13 had stabilisation of disease (criteria of National Prostatic Cancer Project). The median survival from the time of diagnosis was 33.3 months, and from the commencement of cyclophosphamide 12.7 months. The treatment was well tolerated. Oral cyclophosphamide is active in the treatment of advanced hormone-refractory prostate cancer and yields symptomatic and objective remissions without undue side effects. This observation requires validation, with further testing of its impact on survival in randomised clinical trials.
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