Archive for August, 2011


Thursday, August 25th, 2011

The mighty Leaf that gives relief

By Margaret McCartney

Published: January 16 2010 00:04 | Last updated: January 16 2010 00:04

Cannabis and the law have a clear relationship; to take the former is to break the latter. For years, pressure has been mounting on the government to change this position. And not just for recreational reasons, but medical ones too. It is often claimed, for example, that cannabis improves the lives of multiple sclerosis sufferers.

A recent systematic review of the evidence in BMC Neurology found that cannabis did help alleviate spasticity, the uncomfortable cramp that can become constant in MS, making affected limbs hard to use. But while patients reported an improvement following treatment, objective measurements did not show any significant change.

Spasticity may not be affected by cannabis; the drug may instead be treating muscle tension and discomfort. That doesn’t mean cannabis is not useful. Indeed, another review published last year in Pain Medicine found that “cannabis treatment is moderately efficacious for the treatment of chronic pain”. But it also noted that “beneficial effects may be partially (or completely) offset by potentially serious harms”.

We can hardly boast that the legitimate medicine cabinet is untainted by side-effect-free drugs. In cannabis, the most obvious side-effect is sluggishness – more commonly known as being “stoned”. This is a real problem, but it may possibly be no worse than the sedation delivered by strong analgesics  that may be prescribed or administered.

There are more worrying risks with cannabis, notably psychosis. A review in the Lancet in 2007 suggested there was a dose-related risk – the more cannabis, the greater the danger. Some studies have also indicated the risk is highest for young people, and those with a personal or family history of psychosis. So how many people are likely to be affected? A paper in Addiction last year found that the number of men who would have to stop heavy use of cannabis to prevent one case of psychosis would approach 2,800 in the 20-24 age group and 4,700 among those aged 35-39.

For many doctors and potential patients, addiction is an even bigger concern. Should it become available on prescription, cannabis would join other legitimate drugs which have dependence as a potential harm – from diazepam to morphine. The truth is that cannabis may well end up being just as useful as any of these drugs and, just like them, require careful prescription and informed consent.

Margaret McCartney is a GP in Glasgow.

Sourced & published by Henry Sapiecha


Thursday, August 25th, 2011

August 24, 2011 11:43 pm

Botox obtains US approval

for use as a bladder treatment

Botox, the drug best known for filling in brow wrinkles, received approval from US health regulators on Wednesday for the treatment of overactive bladders, boosting the shares of Allergan, its manufacturer.

The US Food and Drug Administration said Botox can be used by people with neurological conditions, such as spinal cord injuries or multiple sclerosis, to alleviate urinary incontinence.

Morgan Stanley analysts estimate the approval could provide Allergan with $59m in annual revenues by 2015. It could generate an additional $457m a year if, as expected, the drug is approved to treat patients with overactive bladders for non-neurological reasons.

Shares of Allergan rose 3.02 per cent to $77.90 on Wednesday.

This month, the Irish Medicines Board issued a similar approval for Botox, opening the door for its use as a bladder drug in Europe.

When injected into the bladder through a cystoscope, Botox decreases incontinence by relaxing the organ and increasing its storage capacity. The effect of the drug lasts for about nine months. Possible side-effects include urinary tract infections and problems retaining urine.

Allergan estimates that about 340,000 people in the US suffer from urinary incontinence due to neurological conditions.

David Pyott, chief executive of Allergan, said this month that he expects the company to boost its sales force to promote the drug.

Botox generates about $1.3bn in annual sales for Allergan, with half of that coming from cosmetic uses. In spite of a weak US economy, cosmetic Botox sales were up 16 per cent year on year in the the second quarter.

Allergan has said that although Botox is widely known for smoothing wrinkles, sales for therapeutic purposes will eventually outpace sales of the drug for cosmetics reasons. It has aggressively promoted the drug for various conditions.

Last year, Allergen paid $600m to settle cin court over  illegally promoting and selling Botox for unapproved uses until 2005. The company also pleaded guilty to a misdemeanour “misbranding” charge.

Botox, first approved 21 years ago for treatment of eye muscle twitches, has been a boon for Allergan and now has seven different approved uses. Doctors use the drug to treat chronic migraine headaches, muscle stiffness and severe armpit sweat.

Allergan said Botox has also been studied and evaluated for about 100 different purposes.

“It’s like an entire pipeline in one drug,” said Les Funtleyder, analyst and fund manager at Miller Tabak.

Sourced & published by Henry Sapiecha


Saturday, August 13th, 2011


FOR years, women have been labelled ”too posh to push” for choosing caesarean births without medical reasons, but a controversial new study suggests they may be picking a better path for themselves and their babies.

Dr Stephen Robson, an associate professor of obstetrics at Australian National University, is recruiting 1000 pregnant women to test the long-held view that vaginal deliveries are better than caesareans for healthy women with uncomplicated pregnancies.

The study, which requires 500 women choosing a caesarean and 500 planning a vaginal birth, will look at psychological and physical outcomes for the women and their babies, including depression and breastfeeding rates.

Dr Robson said that although an estimated 10,000 Australian women chose to have caesareans each year without medical reasons, no one had ever comprehensively studied their outcomes because research tended to focus on women with problems. ”From a medical point of view, it’s difficult to counsel people because no one can give a reasonable comparison of what the risks are for women who are otherwise healthy,” he said.

Dr Robson said a study published in The Lancet in 2000, which compared caesareans with vaginal deliveries for babies in the breech position unexpectedly found that women in the caesarean group did slightly better overall than women in the vaginal group. The results left doctors around the world wondering if surgical deliveries could be better for healthy women.

”It dawned on people, what if it turns out to be safer to have a caesarean birth if you’re a healthy mother? … What would that mean? How would that affect society? The topic led to great discussion at a meeting I was at recently where one cheeky guy said, ‘Maybe we could do away with labour wards forever and save hundreds of millions of dollars,’ ” he said.

”Depending on what we find, there is a profound sense that maybe this will lead to an unanticipated and staggering finding.”

Current research cited by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists says caesareans in healthy women may reduce the chance of injuries that lead to incontinence and difficulty with sex while also reducing the risk of their baby dying or getting cerebral palsy.

On the other hand, the college says it may slightly increase the risk of death for mothers while also increasing their risk of placenta accreta in future pregnancies – a serious complication that can cause significant blood loss. The recovery time is also longer compared with a vaginal delivery.

President of the college, Dr Rupert Sherwood, encouraged women to take part in the study.

Sourced & published by Henry Sapiecha


Thursday, August 4th, 2011

The West Australian government has orders an independent audit

into management of state housing tenants after the skeletal remains of an elderly man were discovered in a unit up to two years after his death.

Seventy-five-year-old Robert Roll’s corpse went undetected until July 7, despite neighbours urging housing department officials to check on him.

Housing Minister Troy Buswell said he was not satisfied with the explanation provided by the Department of Housing, whose records incorrectly stated that Mr Roll’s home had been inspected in 2010.

“The information I received contained discrepancies in regard to the last contact the department had with Mr Roll, and my main concern is that the department’s systems showed that an inspection was undertaken in 2010, when an inspection did not actually occur,” Mr Buswell said.

“Whether this was caused due to human error or improper actions, we need to make sure this doesn’t happen again.

“The audit will examine the circumstances around the discovery of Mr Roll’s body, as well as the department’s tenancy management actions throughout the history of Mr Rolls’ tenancy.

“It will also look at the actions taken to identify and test safety devices in Mr Roll’s unit, and overall tenancy management at the complex at 601 Wellington Street.”

The audit will also consider the extent to which the department has implemented the recommendations of the Auditor General’s 2010 report into the fitting and maintenance of safety devices, records systems and procedures such as property inspections.

“While the department is finalising a report on its own response to the Auditor General’s report, it seems logical to have an independent body also scrutinise this response, particularly when we are engaging someone to look at similar issues relating to Mr Roll’s case,” he said.

“I expect the audit will identify any key concerns or weaknesses in the department’s management of Mr Roll’s tenancy and any continuing issues around systems and procedures, with recommendations as to how these may be improved.”

The audit will be undertaken by KPMG. It will commence this month and is expected to take eight weeks.

Police said last month that it appeared Mr Roll had cancer and died of natural causes. A report has been prepared for the WA coroner.

They have since established Mr Roll was a former boilermaker, believed to be from Newcastle in England’s north but had moved to Australia several decades ago.

Residents in the same apartment block began to grow concerned when Mr Roll’s mail began piling up.

Sourced & published by Henry Sapiecha


Tuesday, August 2nd, 2011

Death knell sounds for needles

August 2, 2011 – 2:59PM

If the sight of a needle-wielding doctor heading your way freaks you out, take heart. The nanopatch is coming.

The needle-free vaccine delivery system is a step closer to reality after a consortium of investors put up $15 million to aid its development.

The money will enable Australian Institute for Bioengineering and Nanotechnology Professor Mark Kendall to continue his work.

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The nanopatch is a needle-phobe’s Holy Grail.

It has thousands of small projections to deliver vaccines to abundant immune cells in the skin, doing away with needles plunged into muscle where there are few immune cells.

Early stage testing in animals has shown a nanopatch-delivered flu vaccine is effective with only 1/150th of the dose compared with a syringe.

The nanopatch is also expected to cut needle stick injuries and cross contamination. And it does not need refrigeration like traditional vaccines.

Professor Kendall said the new technology would cut costs dramatically and make transportation easier.

“In Africa about half of vaccines aren’t working properly because of a breakdown in the cold chain,” he said in a statement today.

“The nanopatch also offers a way to stop needle-stick injuries during vaccination which again is a particularly important problem in Africa; with a third of vaccines affected by other complications brought about through cross contamination needle stick injury.”


Sourced & published  by Henry Sapiecha