Neuropathic Pain in HIV Could Be Eased With Medicinal Marijuana (Cannabis)

In a double-blind, placebo-controlled clinical trial to assess the impact of smoked medical cannabis, or marijuana, on the neuropathic pain associated with HIV, researchers at the University of California, San Diego School of Medicine found that reported pain relief was greater with cannabis than with a placebo. The study, sponsored by the University of California Center for Medical Cannabis Research (CMCR) based at UC San Diego, will be published on line, August 6 in the journal Neuropsychopharmacology.

Led by Ronald J. Ellis, M.D., Ph.D., associate professor of neurosciences at UCSD School of Medicine, the study looked at 28 HIV patients with neuropathic pain not adequately controlled by other pain-relievers, including opiates. They took part in the controlled study as outpatients at the UCSD Medical Center. The proportion of subjects achieving pain reduction of 30 percent or more was greater for those smoking cannabis than those smoking the placebo.

“Neuropathy is a chronic and significant problem in HIV patients as there are few existing treatments that offer adequate pain management to sufferers,” Ellis said.

“We found that smoked cannabis was generally well-tolerated and effective when added to the patient’s existing pain medication, resulting in increased pain relief.”

Each trial participant participated in five study phases over seven weeks. During two five-day phases, randomly selected participants smoked either cannabis or placebo cigarettes made from whole plant material with cannabinoids (the psychoactive compound found in marijuana) removed, both provided by the National Institute on Drug Abuse. Outcome was tested by standardized tests measuring analgesia (lessened pain sensation), improvement in function and relief of pain-associated emotional distress.

Using verbal descriptors of pain magnitude, cannabis was associated with an average reduction of pain intensity from ‘strong’ ‘to mild-to-moderate’ in cannabis smokers, according to Ellis. Also, cannabis was associated with a sizeable (46% versus 18% for placebo) proportion of patients reporting clinically meaningful pain relief.

The study’s findings are consistent with and extend other recent research supporting the short-term efficacy of cannabis for neuropathic pain, also sponsored by the CMCR.

“This study adds to a growing body of evidence that indicates that cannabis is effective, in the short-term at least, in the management of neuropathic pain,” commented Igor Grant, M.D., professor of psychiatry and director of the CMCR.

The CMCR coordinates and supports cannabis research throughout the state of California. Research focuses on the potential medicinal benefits of cannabis for diseases and conditions as specified by the National Academy of Sciences, Institute of Medicine Report (1999) and by the Workshop on the Medical Utility of Marijuana, National Institutes of Health (1997).

Grant noted that this is the fourth CMCR sponsored study to provide convergent evidence that cannabis can help in relieving these types of pain. The previous studies were conducted with CMCR support by Donald I. Abrams, M.D., Professor of Clinical Medicine at UCSF, who reported efficacy in short-term treatment of HIV neuropathy (Neurology, 2007, 68:515-521); by Mark Wallace, M.D., Program Director for the UCSD Center for Pain Medicine, who found that normal volunteers subjected to chemically induced pain which mimics neuropathy also responded to medium doses of cannabis (Anesthesiology, 2007, 107(5):785-796); and by Barth Wilsey, M.D., Director of the UC Davis Analgesic Research Center, who also reported benefit from smoked cannabis in a group of patients with neuropathy of multiple origins (Journal of Pain, 2008 Jun;9(6):506-21).

Additional contributors to the study, all from the UCSD School of Medicine, include Will Toperoff, RN, FNP, Department of Neurosciences; Florin Vaida, Ph.D., Family and Preventive Medicine; Geoff van den Brande, RN, Medicine; J. Gonzales, Pharm.D., Pharmacy; Ben Gouaux, Heather Bentley, CCRA, and J. Hampton Atkinson, M.D., Psychiatry.

Tags: Medicinal Marijuana, Cannabis, HIV, Medical Research, HIV Drug, Pain Relief, Neuropsychopharmacology, San Diego School of Medicine, cannabinoids

Cranberry Juice Keeps Bacteria Away From Cells By Creating An Energy Barrier.

Results help explain how cranberry juice can prevent urinary tract infections

WORCESTER, Mass. – For generations, people have consumed cranberry juice, convinced of its power to ward off urinary tract infections, though the exact mechanism of its action has not been well understood. A new study by researchers at Worcester Polytechnic Institute (WPI) reveals that the juice changes the thermodynamic properties of bacteria in the urinary tract, creating an energy barrier that prevents the microorganisms from getting close enough to latch onto cells and initiate an infection.

The study, published in the journal Colloids and Surfaces: B, was conducted by Terri Camesano, associate professor of chemical engineering at WPI, and a team of graduate students, including PhD candidate Yatao Liu. They exposed two varieties of E. coli bacteria, one with hair-like projections known as fimbriae and one without, to different concentrations of cranberry juice. Fimbriae are present on a number of virulent bacteria, including those that cause urinary tract infections, and are believed to be used by bacteria to form strong bonds with cells.

For the fimbriaed bacteria, they found that even at low concentrations, cranberry juice altered two properties that serve as indicators of the ability of bacteria to attach to cells. The first factor is called Gibbs free energy of attachment, which is a measure of the amount of energy that must be expended before a bacterium can attach to a cell. Without cranberry juice, this value was a negative number, indicating that energy would be released and attachment was highly likely. With cranberry juice the number was positive and it grew steadily as the concentration of juice increased, making attachment to urinary tract cells increasingly unlikely.

Surface free energy also rose, suggesting that the presence of cranberry juice creates an energy barrier that repels the bacteria. The researchers also placed the bacteria and urinary tract cells together in solution. Without cranberry juice, the fimbriaed bacteria attached readily to the cells. As increasing concentrations of cranberry juice were added to the solution, fewer and fewer attachments were observed.

Cranberry juice had no discernible effect on E. coli bacteria without fimbriae, suggesting that compounds in the juice may act directly on the molecular structure of the fimbriae themselves. This reinforces previous work by the WPI team that showed that exposure to cranberry juice alters the shape of the fimbriae, causing them to become compressed. Using an atomic force microscope as a minute strain gauge, the team also showed that the adhesive force exerted by bacteria on urinary tract cells declined in direct proportion to the concentration of cranberry juice in the solution.

"Our results show that, at least for urinary tract infections, cranberry juice targets the right bacteria—those that cause disease—but has no effect on non-pathogenic organisms, suggesting that cranberry juice will not disrupt bacteria that are part of the normal flora in the gut," Camesano says. "We have also shown that this effect occurs at concentrations of cranberry juice that are comparable to levels we would expect to find in the urinary tract."

Camesano notes that unpublished work has shown that while cranberry juice has potent effects on disease-causing bacteria, those effects are transitory. "When we takes E. coli. bacteria that have been treated with cranberry juice and place them in normal growth media, they regain the ability to adhere to urinary tract cells," she says. "This suggests that to realize the antibacterial benefits of cranberry, one must consume cranberry juice regularly—perhaps daily."

For those watching calories, Camesano says other recent work in her lab has shown that the effects of regular cranberry juice cocktail and diet (sugar-free) cranberry juice are identical. "That's good news for people who do not like to consume a lot of sugary juice," she says.

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About Worcester Polytechnic Institute

Founded in 1865 in Worcester, Mass., WPI was one of the nation's first engineering and technology universities. WPI's 18 academic departments offer more than 50 undergraduate and graduate degree programs in science, engineering, technology, management, the social sciences, and the humanities and arts, leading to the BA, BS, MS, ME, MBA and PhD. WPI's world-class faculty work with students in a number of cutting-edge research areas, leading to breakthroughs and innovations in such fields as biotechnology, fuel cells, and information security, materials processing, and nanotechnology. Students also have the opportunity to make a difference to communities and organizations around the world through the university's innovative Global Perspective Program. There are more than 20 WPI project centers throughout North America and Central America, Africa, Australia, Asia, and Europe.

Contact: Michael Dorsey
mwdorsey@wpi.edu
508-831-5609
Worcester Polytechnic Institute

Tags: Medical Research, urinary tract infections, cranberry juice, Worcester Polytechnic Institute, Gibbs free energy

Let Go That Viagra, Pick Up A Watermelon.

The researchers have found that watermelon has found chemical properties that carry Viagra like capabilities, it relax the blood vessels. Citrulline is the culprit ingredient. Following is a part of the press release and follow the link at the end to read the complete article at Texas A&M.

COLLEGE STATION -- A cold slice of watermelon has long been a Fourth of July holiday staple. But according to recent studies, the juicy fruit may be better suited for Valentine’s Day.

That’s because scientists say watermelon has ingredients that deliver Viagra-like effects to the body’s blood vessels and may even increase libido.

“The more we study watermelons, the more we realize just how amazing a fruit it is in providing natural enhancers to the human body,” said Dr. Bhimu Patil, director of Texas A&M’s Fruit and Vegetable Improvement Center in College Station.

“We’ve always known that watermelon is good for you, but the list of its very important healthful benefits grows longer with each study.”

Beneficial ingredients in watermelon and other fruits and vegetables are known as phyto-nutrients, naturally occurring compounds that are bioactive, or able to react with the human body to trigger healthy reactions, Patil said.

In watermelons, these include lycopene, beta carotene and the rising star among its phyto-nutrients – citrulline – whose beneficial functions are now being unraveled. Among them is the ability to relax blood vessels, much like Viagra does.

Scientists know that when watermelon is consumed, citrulline is converted to arginine through certain enzymes. Arginine is an amino acid that works wonders on the heart and circulation system and maintains a good immune system, Patil said.

“The citrulline-arginine relationship helps heart health, the immune system and may prove to be very helpful for those who suffer from obesity and type 2 diabetes,” said Patil. “Arginine boosts nitric oxide, which relaxes blood vessels, the same basic effect that Viagra has, to treat erectile dysfunction and maybe even prevent it.”

While there are many psychological and physiological problems that can cause impotence, extra nitric oxide could help those who need increased blood flow, which would also help treat angina, high blood pressure and other cardiovascular problems.

“Watermelon may not be as organ specific as Viagra,” Patil said, “but it’s a great way to relax blood vessels without any drug side-effects.”

The benefits of watermelon don’t end there, he said. Arginine also helps the urea cycle by removing ammonia and other toxic compounds from our bodies.

AGNEWS

Tags: Medical Research, watermelon, viagra, Citrulline

Early Detection Of Osteoporosis Risk With Simple Ultrasound Exam Of Women's Heel.

OAK BROOK, Ill. – An ultrasound exam of the heel may be able to predict if a woman is at heightened risk for fractures due to osteoporosis, according to a new multicenter study being published in the July issue of the journal Radiology. Along with certain risk factors, including age or recent fall, radiation-free ultrasound of the heel may be used to better select women who need further bone density testing, such as a dual-energy x-ray absorptiometry (DXA) exam.

"Osteoporosis is a major public health issue expected to increase in association with worldwide aging of the population," said the study's lead author Idris Guessous, M.D., senior research fellow in the Department of Internal Medicine at Lausanne University Hospital in Switzerland. "The incidence of osteoporosis will outpace economic resources, and the development of strategies to better identify women who need to be tested is crucial."

Osteoporosis is a disease that is characterized by low bone mass and the deterioration of bone tissue and is a major public health threat. According to the National Osteoporosis Foundation, 10 million Americans currently have osteoporosis and approximately 34 million more are estimated to have low bone mass, increasing their risk of developing the disease. Eighty percent of those affected are women.

"Patients with osteoporosis are not optimally treated because of a lack of general awareness," Dr. Guessous said. "A simple prediction rule might be a useful clinical tool for healthcare providers to optimize osteoporosis screening."

In the three-year multicenter study, 6,174 women age 70 to 85 with no previous formal diagnosis of osteoporosis were screened with heel-bone quantitative ultrasound (QUS), a diagnostic test used to assess bone density. QUS was used to calculate the stiffness index, which is an indicator of bone strength, at the heel. Researchers added in risk factors such as age, history of fractures or a recent fall to the results of the heel-bone ultrasound to develop a predictive rule to estimate the risk of fractures. The results showed that 1,464 women (23.7 percent) were considered lower risk and 4,710 (76.3 percent) were considered higher risk.

Study participants where mailed questionnaires every six months for up to 32 months to record any changes in medical conditions, including illness, changes in medications or any fracture. If a fracture had occurred, the patients were asked to specify the fracture's precise location and trauma level and to include a medical report from the physician in charge.

In the group of higher risk women, 290 (6.1 percent) developed fractures whereas only 27 (1.8 percent) of the women in the lower risk group developed fractures. Among the 66 women who developed a hip fracture, 60 (90 percent) were in the higher risk group.

The results show that heel QUS is not only effective at identifying high-risk patients who should receive further testing, but also may be helpful in identifying patients for whom further testing can be avoided.

"Heel QUS in conjunction with clinical risk factors can be used to identify a population at a very low fracture probability in which no further diagnostic evaluation may be necessary," Dr. Guessous said.

Contact: Linda Brooks
lbrooks@rsna.org
630-590-7762
Radiological Society of North America

Tags: osteoporosis, Medical Research, ultrasound exam, RSNA

Yale Get Funded to Study Exercise for Women with Cancer

New Haven, Conn. — A Yale-developed exercise program designed to reduce bone loss and prevent weight gain in women with cancer is being funded with a $2.2 million grant from the National Cancer Institute.

The principal investigator, M. Tish Knobf, the American Cancer Society Professor at Yale University School of Nursing and a member of Yale Cancer Center, said there are more than 10 million cancer survivors in the United States, and 22 percent are women diagnosed with breast cancer.

“Cancer survivors face persistent physical symptoms as well as psychological distress when treatment ends,” Knobf said. “For long-term survivors, there are additional concerns related to late effects of cancer therapy, such as bone loss.”

She and her team conducted a pilot study to look at the effects of exercise and found that 88 percent of the women adhered to the program, maintained their weight, had no changes in bone mass, and improved psychologically.

“Weight gain, changes in body composition, decreased physical functioning, bone loss, and menopause in women treated for cancer may increase risks for cardiovascular disease, diabegtes, and osteoporosis,” Knobf said. “With an estimated 64 percent of cancer survivors now living longer than five years, interventions are needed to reduce the risk of cancer recurrence, secondary cancers, and health risks for other chronic illnesses.”

Co-investigators Lyndsay Harris, M.D., and Karl Insogna, M.D., will provide additional expertise to help monitor the women enrolled in the study. Harris, associate professor of medical oncology and director of the Yale Cancer Center Breast Cancer Program, studies the molecular classifications of breast cancer, particularly in minority women. Insogna, director of the Yale Bone Center and professor internal medicine, has clinical expertise on the disease-related causes of bone loss.

PRESS CONTACT
Jacqueline Weaver
203-432-8555

tag: Medical Research, bone loss, American Cancer Society, Yale Cancer Center, Weight gain, cardiovascular disease, diabegtes, osteoporosis, Breast Cancer Program,

Glaucoma Associated With Increased Risk of Cardiovascular Death In Black Patients, Stony Brook University Study

STONY BROOK, N.Y., March 11, 2008 – In a population of African origin, persons with diagnosed and treated glaucoma appeared to have an increased risk of death from cardiovascular causes, according to a study by Suh-Yuh Wu, and colleagues in the Departments of Preventive Medicine and Ophthalmology at Stony Brook University, the University of the West Indies, and the Cleveland Clinic Foundation. The study results are published in the March issue of Archives of Ophthalmology.

Glaucoma is one of the leading causes of visual impairment worldwide. The most common type, primary open-angle glaucoma, is especially prevalent in populations of African origin, including African-Americans, in which it is the foremost cause of blindness. According to Wu and coauthors, populations of African origin have higher rates of death from chronic disease than white populations and also tend to have and higher eye pressure (ocular hypertension).

Wu and colleagues studied 4,092 participants age 40 to 84 (average age 58.6) in the Barbados Eye Studies, which assessed a predominantly black population with similar ancestry to African-Americans. Initial visits occurred between 1987 and 1992. Height, weight and blood pressure were recorded. Interviews were conducted, and eye photographs and various eye measurements were taken, including eye pressure. Participants with specific findings were also referred for a comprehensive ophthalmologic examination.

At the beginning of the study, 300 participants had glaucoma, including 141 who had been diagnosed and treated. After nine years of follow-up, 764 (19 percent) of the participants had died. After adjusting for other factors, the researchers found that glaucoma was not associated with the risk of death overall. However, the risk of death from cardiovascular diseases was 38 percent higher in individuals with a previous diagnosis or treatment for open-angle glaucoma and 91 percent higher in those treated with one particular beta-blocker agent. Cardiovasular deaths were also 28 percent higher in those with ocular hypertension at the beginning of the study.

The researchers write in “Open-angle Glaucoma and Mortality” that “one explanation for the excess mortality found in persons with previously diagnosed open-angle glaucoma could be their longer duration of disease compared with those with newly diagnosed disease.” They also point out that another explanation could be related to the open-angle glaucoma treatment that patients received, as beta blockers and other medications used to treat open-angle glaucoma may harm the cardiovascular system and increase death risk.

The authors conclude that their research findings underscore the importance of careful monitoring and controlling of adequate intraocular pressure levels in the study population, and other high-risk populations. Close monitoring of treatment to lower the intraocular pressure and correction of its complications, they suggest, may prevent early deaths.

Wu’s coauthors include: Stony Brook University researchers Barbara Nemesure, Ph.D.; Anselm Hennis, Ph.D., FRCP; Leslie Hyman, Ph.D.; M. Cristina Leske, M.D., M.P.H.; and Andrew P. Schachat, M.D., of the Cleveland Clinic Foundation in Cleveland, Ohio.
SBU
tag: Medical Research, glaucoma,

Research On Alzheimer's and Parkinson's Gains Highly Promising Results.

LEIDEN, The Netherlands, -- Top Institute Pharma presents a new and highly promising research project. The TI Pharma project is a large-scale study into the brain material of Alzheimer's and Parkinson's patients, who gave permission to the Netherlands Brain Bank for their tissue to be used for scientific research. The analysis is a continuation of highly-promising results from previous studies and focuses on the genes that could be involved in the development of Alzheimer's disease and Parkinson's disease. The study - that must form the basis for potential drugs - is one of the largest to be carried out on an international level.

The project is being realized in cooperation with Solvay Pharmaceuticals B.V., DNage B.V., the Netherlands Institute for Neuroscience, the Netherlands Brain Bank, VU University Amsterdam, VU Medical Center, the Leiden University Medical Center, Utrecht University, University Medical Center Utrecht and the Erasmus MC in Rotterdam.

It is a follow-up to previous studies carried out by two public-private partnerships: that between Solvay Pharmaceuticals, the Netherlands Brain Bank and the Netherlands Institute for Neuroscience on the one hand, and DNage and the Erasmus Medical Center on the other. The highly promising results from both studies were the reason why TI Pharma opted for a large-scale project.

Principle investigator Joost Verhaagen of the Netherlands Institute for Neuroscience: "This study is unique in several aspects. Never before has such a large-scale study been carried out into Alzheimer's disease and Parkinson's disease. Moreover, we have been able to do research on people who did not yet know they had Alzheimer's disease or in whom the disease was only just starting. We can therefore follow the very first changes due to the disease as well as its progression. And that is also unique."

Additionally, this study is using rapidly-aging mouse models from DNage, in which Alzheimer and Parkinson like symptoms spontaneously occur. Following this neurodegeneration is also an interesting part of the study. Verhaagen: "We expect that this study will also yield new insights into the development of Alzheimer's disease and Parkinson's disease and that it could therefore form the basis for potential drugs."

Daan Crommelin and Victor Nickolson, scientific director and general director of TI Pharma respectively, are pleased that the top institute has this project under its wings. "TI Pharma has successfully consolidated the available strengths: companies, knowledge institutes and universities are now working together. Thanks to this partnership research results will be obtained far more quickly. And important steps can be made towards new drugs."

Alzheimer's disease is the most prevalent variant of dementia. Two-thirds of all patients who are demented suffer from Alzheimer's disease. The disease is characterized by a progressive deterioration of the psychological functioning. Alzheimer's disease usually starts at somewhere between 70 and 80 years of age, but can also start at a much younger age. It is estimated that some 24 million people worldwide suffer from Alzheimer's disease. There are 250,000 Alzheimer's patients in the Netherlands. Over the next few decades this number will double as a result of the aging population.

Parkinson's disease mostly begins at an older age of between 50 and 60 years. However, about 10% of the patients are younger than 40 years. Parkinson's disease is mainly characterized by a progressive disruption of the locomotor system that gravely affects the daily lives of patients and can be debilitating. The disease arises as a result of nervous cells in the midbrain dying. The cause of the disease is (still) not known and therefore prevention and cure are not possible.

tag: Alzheimer's, Parkinson's, Medical Research, Solvay Pharmaceuticals, DNage, Netherlands Institute for Neuroscience, Netherlands Brain Bank, VU University Amsterdam, VU Medical Center, TI Pharma project, the Leiden University Medical Center, Utrecht University,