For people suffering chronic pain, smoked cannabis reduces pain, improves mood and helps sleep, according to new research published in CMAJ (Canadian Medical Association Journal)

People who suffer from chronic neuropathic pain due to damage or dysfunction of the nervous system have few treatment options.

These options include opioids, anticonvulsants, antidepressants and local anesthetics, but efficacy varies and all have side effects which limit compliance.

Oral cannabinoids have shown success in treating some types of pain but may differ in effect and risks from smoked cannabis.

A team of researchers from McGill University Health Centre (MUHC) and McGill University conducted a randomized controlled trial to investigate the analgesic effect of inhaled cannabis in 21 participants 18 years and older with chronic neuropathic pain.

The researchers used three different potencies of active drug (THC levels of 2.5%, 6% and 9.4%) as well as a 0% placebo.

Patients reported better sleep quality as the THC content increased. Anxiety and depression also decreased in the 9.4% THC group compared with the placebo group.

“We found that 25 mg herbal cannabis with 9.4% THC, administered as a single smoked inhalation three times daily for five days, significantly reduces average pain intensity compared with a 0% THC cannabis placebo in adult subjects with chronic post traumatic/post surgical neuropathic pain,” reports lead author Dr. Mark Ware, Director of Clinical Research at the Alan Edwards Pain Management Unit of the MUHC. “We found statistically significant improvements in measures of sleep quality and anxiety.”

“To our knowledge, this is the first outpatient clinical trial of smoked cannabis ever reported,” the authors state. It is one of only a handful of studies on smoked cannabis and neuropathic pain. The authors recommend more studies with higher potencies of THC, longer duration of follow-up and flexible dosing. Long-term safety studies of smoked cannabis for medical purposes are also needed.

In a related commentary http://www.cmaj.ca/embargo/cmaj100799.pdf, Dr. Henry McQuay of Balliol College, Oxford University, UK, writes “the authors should be congratulated for tackling such a worthwhile question as: does cannabis relieve neuropathic pain?, particularly because the trial must have been a major nightmare to get through the various regulatory hurdles.

What makes it a worthwhile question is the continuing publicity that patients see, hear and read, suggesting analgesic activity of cannabis in neuropathic pain, and the paucity of robust evidence.” He concludes that “this trial adds to the trickle of evidence that cannabis may help some of the patients who are struggling at present.”

www.cmaj.ca

Male hypogonadism is a condition in which the body doesn’t produce enough of the hormone testosterone — the hormone that plays a key role in masculine growth and development during puberty.

You may be born with male hypogonadism, or it can develop later in life from injury or infection. The effects — and what you can do about them — depend on the cause and at what point in your life male hypogonadism occurs. Some types of male hypogonadism can be treated with testosterone replacement therapy.

In adult males, hypogonadism may alter certain masculine physical characteristics and impair normal reproductive function. Signs and symptoms may include:

* Erectile dysfunction
* Infertility
* Decrease in beard and body hair growth
* Decrease in muscle mass
* Development of breast tissue (gynecomastia)
* Loss of bone mass (osteoporosis)

Hypogonadism can also cause mental and emotional changes. As testosterone decreases, some men may experience symptoms similar to those of menopause in women. These may include:

* Fatigue
* Decreased sex drive
* Difficulty concentrating
* Hot flashes

When to see a doctor
See a doctor if you have any symptoms of male hypogonadism. Establishing the cause of hypogonadism is an important first step to getting appropriate treatment.

Risk factors for hypogonadism include:

* Kallmann syndrome
* Undescended testicles as an infant
* Mumps infection affecting your testicles
* Injury to your testicles
* Testicular or pituitary tumors
* HIV/AIDS
* Klinefelter syndrome
* Hemochromatosis
* Previous chemotherapy or radiation therapy

Hypogonadism can be inherited. If any of these risk factors are in your family health history, tell your doctor.

If tests confirm you have low testosterone, further testing can determine if a testicular disorder or a pituitary abnormality is the cause. Based on specific signs and symptoms, additional studies can pinpoint the cause. These studies may include:

* Hormone testing
* Semen analysis
* Pituitary imaging
* Genetic studies
* Testicular biopsy

Testosterone testing also plays an important role in managing hypogonadism. This helps your doctor determine the right dosage of medication, both initially and over time.

Types of testosterone replacement therapy
Several testosterone delivery methods exist. Choosing a specific therapy depends on your preference of a particular delivery system, the side effects and the cost. Methods include:

* Injection. Testosterone injections are safe and effective. Injections are given in a muscle about every two weeks. Your symptoms may come and go between doses. You or a family member can learn to give TRT injections at home. If you’re uncomfortable giving yourself injections, a nurse or doctor can give the injections.
* Patch. A patch containing testosterone (Androderm) is applied each night to your back, abdomen, upper arm or thigh. The site of the application is rotated to maintain seven-day intervals between applications to the same site to lessen skin reactions.
*

Gel. You rub testosterone gel (AndroGel, Testim) into your skin on your lower abdomen, upper arm or shoulder. As the gel dries, your body absorbs testosterone through your skin. Gel application of testosterone replacement therapy appears to cause fewer skin reactions than patches do. Don’t shower or bathe for several hours after a gel application to be sure it gets absorbed.

Low testosterone levels to blame for low libido, fatigue and weight gain

While most frequently associated with women’s health, age-related hormone changes, often dubbed menopause, can occur in men as well, causing symptoms of fatigue, mood swings, decreased desire for sex, hair loss, lack of concentration and weight gain.  Experts estimate that more than 5 million men are affected, yet worry the number may be considerably higher since symptoms are frequently ignored.

Male hypogonadism, as it’s referred to in the medical community, occurs when the testicles do not produce enough testosterone, the hormone that plays a key role in masculine growth and development.  When hormone levels drop, men can experience significant mental and physical changes.

“This is a highly prevalent disorder,” said Robert Brannigan, MD, urologist at Northwestern Memorial Hospital.  ”Unfortunately, we estimate that 95 percent of cases are undiagnosed and therefore untreated.  When ignored, symptoms can seriously disrupt one’s quality of life.”

“My body was telling me that something wasn’t right.  I was always tired, it didn’t matter how much sleep I got, I constantly wanted to take a nap,” said Michael Andruzzi, a 40-year-old man diagnosed with male hypogonadism and a patient at Northwestern Memorial.

Brannigan explains hormone variations are a normal aspect of getting older.  ”In females, ovulation comes to an end and hormone production declines in a relatively quick period of time, whereas men experience hormone shifts more slowly, with testosterone levels dropping around one percent each year beginning in a man’s late thirties,” adds Brannigan, who is also an associate professor of urology at the Northwestern University Feinberg School of Medicine.

Brannigan goes on to explain that by age seventy, the reduction in a male’s testosterone level could be as high as fifty percent or more compared to baseline levels, but notes that aging men are not the only ones at risk.  A number of genetic causes can impact males from birth and are usually diagnosed with failure to progress normally through puberty during the teenage years.

Treatment options for male hypogonadism include hormone replacement therapy (HRT) via absorbable pellet implants, topical gels, patches, and injections.  Through HRT, doctors can restore sexual function and muscle strength.  In addition, men often experience an increase in energy and an improved overall sense of well-being.

“Once I began treatment, I felt better very quickly,” said Andruzzi.  ”My energy level shot back up; I regained strength and felt I could concentrate much better.”

“We are seeing more men affected by male hypogonadism than we saw ten years ago,” said Brannigan.  ”However, many men continue to suffer in silence due to a lack of awareness surrounding the disorder.  Because male hypogonadism can significantly impact the quality of one’s life, it’s important that men pay attention to their body and openly discuss symptoms with their physician in order to prevent overlooking the cause and avoid missing an opportunity for appropriate therapy.”

Although research to determine the exact association continues, doctors also warn that male hypogonadism has been linked to chronic medical conditions such as high cholesterol, diabetes and cardiovascular disease.  It’s also closely associated with infertility.

“This disorder is not something that should be ignored,” said Brannigan, who is working to educate patients and physicians about the symptoms and treatments available in order to ensure therapies are made available to men in need.

Male hypogonadism is most commonly diagnosed through a simple blood test.  Brannigan notes hormone replacement therapy is not appropriate for all patients especially those with history of prostate and breast cancer and men trying to conceive.  He suggests consulting your doctor if you are experiencing symptoms.

For more information or to schedule an appointment call 312-926-8400.

About Northwestern Memorial HealthCare

Northwestern Memorial HealthCare is the parent corporation of Chicago’s Northwestern Memorial Hospital, an 854-bed academic medical center hospital and Northwestern Lake Forest Hospital, a 215-bed community hospital located in Lake Forest, Illinois.

Researchers explain how a facultative enzyme governs tumor growth

A kinase is a type of enzyme the body uses to regulate the functions of the proteins required for cell growth and maintenance, and researchers have discovered that one in particular plays a key role in developing prostate cancer.

“It’s known as Mnk, and although it appears not to be essential for normal cell maintenance, it’s important for cancer growth” said Dr. Luc Furic, a postdoctoral researcher working with Dr. Nahum Sonenberg at McGill University’s Goodman Cancer Research Centre and Department of Biochemistry.

This is a very significant finding because the body’s chemical processes are highly complex and interrelated, meaning that targeting one cause of cancer often involves affecting the body’s normal functions. An important part of cancer research is about trying to find processes that can be inhibited or stopped without causing damages to normal tissue.

The chemical process Mnk uses is known as phosphorylation, and this process activates or inactivates the body’s proteins, controlling mechanisms that can cause disease. In this case, Mnk works with a protein known as eIF4E to synthesize proteins in the cell.

Researchers at the Centre hospitalier de l’Université de Montréal Research Centre (CRCHUM), Université de Montréal and McGill University engineered mice that were able to block the phosphorylation process of this protein, and discovered that these mice became resistant to prostate cancer growth.

“The PTEN gene and its protein act as a tumour suppressor,” explained Dr. Fred Saad, researcher at the CRCHUM and at Université de Montréal’s Department of Surgery. “By removing this gene in the mouse prostate, we were able to study eIF4E’s effect on cell growth.”

The research is directly related to humans, because PTEN is frequently mutated in human prostate cancer. Studies on cancer patients have confirmed eIF4E’s involvement.

The task ahead will be to find a specific and selective pharmacological inhibitor of Mnks. Although some inhibitors are used for research purposes, these inhibitors are not highly specific to this kinase.

The research was published in the Proceedings of the National Academy of Sciences and received funding from the National Cancer Institute of Canada (Canada Cancer Society), the National Institutes of Health, Canada, the Knut and Alice Wallenberg foundation and the Fonds de la recherche en santé du Québec.

More Information: www.mcgill.ca

Step towards designing fats that are digested more slowly

Institute of Food Research scientists have discovered an unexpected synergy that helps break down fat. The discovery provides a focus to find ways to slow down fat digestion, and ultimately to create food structures that induce satiety.

“Much of the fat in processed foods is eaten in the form of emulsions such as soups, yoghurt, ice cream and mayonnaise,”" said Dr Peter Wilde from the Institute of Food Research, an institute of BBSRC. “We are unpicking the mechanisms of digestion used to break them down so we can design fats in a rational way that are digested more slowly.”

If the digestion of fat is delayed and fatty acids are able to reach the ileum, the final section of the small intestine, their presence stimulates satiety-inducing hormones.

IFR scientists have been experimenting with using protein layers to stabilise emulsions and delay fat digestion.

In this study, they found that a normally-stable whey protein is partially broken down when it is attached to the surface of an emulsion. When a surfactant is introduced, this acts synergistically with the fat, breaking down the protein layer even more effectively. With the barrier weakened, access is improved for the enzymes and bile salts that break down fat.

“We are now experimenting with heat and enzyme treatments to reduce the synergistic effect and make the protein barrier stronger,” said Dr Wilde.

The scientists at the Institute of Food Research are the only scientists seeking the precise mechanisms by which emulsions behave under different conditions and how they are digested so they can be used to control satiety.

This research was funded by the BBSRC and by the EU through a Marie Curie Fellowship.

Dr. Peter Wilde | Quelle: EurekAlert!

The world famous UV and Vitamin D researcher is receiving the research award of the University of Oslo for his pioneering achievements in the area of tanning.

Professor Johan Moan, one of the world’s most famous UV and vitamin D researchers, is receiving the renowned research prize of the University of Oslo (UiO).

Moan manages the research department for biophysics and photodynamic therapy at the University Clinic of Oslo and is a professor at the Institute of Physics of the University of Oslo.

He is in particular being awarded for his research concerning the effects of tanning on human health.

In one of his newest pieces of work, Moan recommends the use of solariums in particular in winter in order to ensure an equal provision of the human body with vitamin D. “During the winter months, the vitamin D level is significantly reduced as sunlight at this time naturally contains too little ultraviolet light to stimulate the vitamin D production in human skin. If you use solariums during this time, this can prevent the vitamin D level from dropping and can keep it at a constantly high level,” explains the designated UiO research award winner.

The presentation of the award shall take place on 2nd September of 2010 on the occasion of the annual reception of the University of Oslo. The UiO research prize is endowed with 250,000 Norwegian kroner.

The Sunlight Research Forum (SRF) is a non-profit organisation with headquarters in The Netherlands. Its aim is to make the newest medicinal and scientific results regarding the effects of moderate UV radiation on humans available to the wider public.

Information:
An abstract of the study “J han Moan, Zoya Lagunova, Emanuela Cicarma, Lage Aksnes, Arne Dahlback, William B. Grant, Alina o Carmen Porojnicu: Sunbeds as Vitamin D Sources” is available to download from www.sunlightresearchforum.eu

For men with advanced prostate cancer, a key goal of treatment is to reduce testosterone levels as low as possible.

This is often accomplished by hormone therapy. Although hormone therapy is used to reduce testosterone levels, it can sometimes initially increase testosterone through a surge instead.

A testosterone surge results from a type of hormone therapy known as Gonadotropin-releasing hormone (GnRH) agonists, including leuprolide. This surge, also called a flare, may stimulate tumor growth and cause painful and potentially dangerous symptoms in some men such as bone pain, urinary retention and neurological damage. I

n addition, the therapeutic benefits of GnRH treatment may be delayed.

Doctors take steps to counteract testosterone surge; risks may be reduced by prescribing an additional medication known as an antiandrogen, which blocks the negative effects of testosterone surge. While risks are reduced, though, they are not eliminated.

There is, however, a novel treatment option that reduces testosterone levels immediately, without any testosterone surge and without the need for an additional medication to block surges. FIRMAGON® (degarelix for injection) is a GnRH antagonist and gives men with locally advanced prostate cancer an important treatment alternative in their quest to beat advanced prostate cancer.

FIRMAGON provides surge-free reduction in testosterone in 96 percent of men by day three of treatment.

Prostate cancer is the second most common cancer, as well as the second leading cause of cancer death, in American men. About one man in six will be diagnosed with prostate cancer during his lifetime; one in 35 will die of the disease. For men with advanced prostate cancer, particularly metastatic disease, lowering testosterone levels is an important goal of treatment.

This is because testosterone affects the growth of the prostate and any cancer cells that may be present. One way to lower testosterone is hormonal therapy (HT).

For more information about prostate cancer, talk to your doctor and visit www.firmagon.com

Results underscore physiological impacts of ongoing situation

LSU Sociology Professors Matthew Lee and Troy Blanchard have conducted a survey to gain an understanding of the health impacts the ongoing Deepwater Horizon disaster is having on people living in Louisiana’s coastal communities.

“Louisiana’s coastal communities are the most geographically proximate human settlements to the actual disaster site,” said Lee.

“It is imperative that we begin work now to better understand the human impacts of this situation because the results are expected to be long-lasting and diverse.”

The researchers, in conjunction with LSU’s Public Policy Research Lab, or PPRL, conducted a telephone survey beginning June 17, less than 60 days after the onset of the Deepwater Horizon blowout. PPRL investigators conducted more than 900 interviews with coastal Louisiana residents near the spill site. Prominent findings include:

- Self-rated stress has more than doubled since the oil spill, as compared to a year ago.

- Nearly 60 percent of the sample population reported feeling almost constant worry about the oil spill during the week before being interviewed.

- More than eight out of 10 respondents worry over family, friends and community survival due to complications caused by the oil spill. Seven in 10 are worried about having to move because of it.

- More than 35 percent reported experiencing headaches or migraines or feeling sick to their stomach some of the time or almost constantly in the week before the interview because of their worry over the oil spill; nearly 43 percent reported being unable to focus on their usual jobs or tasks because of their worry over the situation in the Gulf.

“The indication is, at least at this point, that the human health impacts are real and substantial,” said Blanchard. “Right now, the data suggest that significant public health resources may be required to assist residents in the coastal parishes of Louisiana in dealing with the consequences of this disaster.”

To view the results, visit http://www.lsu.edu/pa/mediacenter/tipsheets/oilspill.shtml under “LSU Resources.”

More news and information can be found on LSU’s home page at www.lsu.edu

Adult circumcision has been proposed as a possible HIV prevention strategy for gay men, but a new study by the University of Pittsburgh Graduate School of Public Health presented at the XVIII International AIDS Conference suggests it would have a very small effect on reducing HIV incidence in the United States.

Circumcision is thought to reduce the risk of HIV transmission by removing cells in the foreskin that are most susceptible to infection by the virus. Clinical trials conducted in Africa have found it reduces the risk of HIV in heterosexual men, yet there is little evidence that it can reduce transmission among American gay men.

The study was based on surveys of 521 gay and bisexual men in San Francisco. Findings indicated that 115 men (21 percent) were HIV-positive and 327 (63 percent) had been circumcised.

Of the remaining 69 men (13 percent), only three (0.5 percent) said they would be willing to participate in a clinical trial of circumcision and HIV prevention, and only four (0.7 percent) were willing to get circumcised if it was proven safe and effective in preventing HIV.

The researchers extrapolated these findings to the entire gay and bisexual male population of San Francisco, an estimated 65,700 people, and determined that only 500 men would potentially benefit from circumcision.

“Circumcision in the U.S. already is very common, making it applicable to a limited number of men as a potential HIV prevention strategy in adulthood,” said Chongyi Wei, Dr.P.H., study author and post-doctoral associate, Pitt’s Graduate School of Public Health. “Our study indicates that any potential benefit may likely be too small to justify implementing circumcision programs as an intervention for HIV prevention.”

Study co-authors include H. Fisher Raymond, M.P.H., Willi McFarland, M.D., Ph.D., Susan Buchbinder, M.D., and Jonathan Fuchs, M.D., all of the San Francisco Department of Health. The study was funded by the Centers for Disease Control and Prevention.

The University of Pittsburgh Graduate School of Public Health (GSPH), founded in 1948 and now one of the top-ranked schools of public health in the United States, conducts research on public health and medical care that improves the lives of millions of people around the world.

GSPH is a leader in devising new methods to prevent and treat cardiovascular diseases, HIV/AIDS, cancer and other important public health issues. For more information about GSPH, visit the school’s Web site at http://www.publichealth.pitt.edu

Vivus Inc said a second late-stage study of its erectile dysfunction drug met the main goals of improving erectile function score across the two doses that were studied in the trial.

The trial, named REVIVE-Diabetes (TA-302), tested the safety and efficacy of the drug avanafil in 390 men with diabetes and erectile dysfunction.

The study showed statistically significant improvement in erectile function and successful intercourse in 15 minutes and beyond six hours after dosing, the company said in a statement.

Last November, data from the first late-stage study — named REVIVE (TA-301) — on the drug showed it met the main trial goals and was effective in 30 minutes or less. [ID:nN18109272]

Commonly reported side effects included headache, nasopharyngitis, flushing, sinus congestion, sinusitis and dyspepsia. There were no drug-related serious adverse events in the study.

The company is conducting two more trials on avanafil, one in men who have undergone radical prostatectomy and an open-label safety study.

In total, the late-stage avanafil clinical program will enroll about 1,300 patients, Vivus said.

Source: Reuters