Reuters 29/03/2011 Although the use Medical marijuana is legal in several U.S. states, people with multiple sclerosis (MS) should think twice before you start using the drug regularly.
The authors of a small study found that patients with the autoimmune disease that damages the nervous system did not fare well performance on various psychological tests if they used marijuana.
"In MS there is a group of patients with cognitive impairment," said lead author Dr. Anthony Feinstein. "If you add marijuana to the mix, increase the problems," he said.
Still, the study does not prove that marijuana triggers the mental deterioration. And if so, some patients may choose to live with that consequence.
According to the National MS Society, about 400,000 Americans have MS and 1 in 6 smoking marijuana, said Feinstein. But there are no studies how the drug affects their minds.
"There is simply no data on the issue," said Feinstein, a psychiatrist at the University of Toronto.
With his team compared the mental abilities of two groups of 25 people with MS. A group smoked marijuana regularly (most had done daily for many years) and the other group had never consumed.
Almost two thirds of the marijuana smokers had some degree of cognitive impairment according to various psychological tests, including evaluation of the speed of information processing and memory verbal. All tests were performed at least 12 hours after last use of marijuana.
In contrast, only one third of the other group had a similar level of mental impairment. This effect was independent of other factors that could affect mental functioning, such as alcohol, depression or anxiety.
"No surprise, really," said Shaheen Lakhan, Cleveland Clinic, Ohio, who also heads the NGO Global Neuroscience Initiative Foundation, in Panorama City, California.
"adverse cognitive effects marijuana use is an old observation. But I must say that most patients with MS that I know says that pain and spasticity are very annoying, so that his relief would be a priority, "he added.
Lakhan said there are several drugs approved for treat MS symptoms such as muscle relaxants, although all have side effects.
Feinstein said that people with MS should take care if they smoke marijuana, especially since their therapeutic benefits are weak.
Still, he said that "I do not intend to be dogmatic. Is a decision that varies according to each patient. "
According to data presented at the Annual Meeting of the American Society of Interventional Radiology, Endovascular treatment is effective in alleviating the symptoms of multiple sclerosis. The data are preliminary, but the goal is to continue with the work.
diariomedico - Tuesday, March 29, 2011
Know that angioplasty is safe may encourage the development of studies that evaluate its efficacy in patients with multiple sclerosis. Kenneth Mandate of the Department of Interventional Radiology Medical Center Albany, New York, presented at the XXXVI Annual Meeting of the Society of Interventional Radiology, which is being held in Chicago, a work that shows that it is a future option in this group patients.
Mandate The group has carried out a study in 231 patients with MS (average age between 25 and 70 years, 147 women and 84 men) who underwent endovascular treatment of internal jugular and azygos vein with or without implantation of a stent . "The aim of this study was not specifically evaluate endovascular treatment but whether it was safe or whether the risks were minimal in this group of patients."
complications were arrhythmias were detected in three patients and restenosis of the treated veins in four patients. All but two patients were discharged within three hours to complete the procedure.
Good results Mandate is satisfied with the results, since it is a more data to evaluate the procedure in patients with neurological diseases. The idea is that if you get correct the stenosis and improve blood flow can reduce the severity of symptoms associated with multiple sclerosis.
At this meeting, the Society of Interventional Radiology has opted for endovascular treatment in patients with multiple sclerosis, as it has proven its efficiency cogeneration and security.
however, emphasized that angioplasty and stents not be considered as routine treatment in these patients, "although according to early results and is a promising technique, so you have to initiate studies with more patients to see if they reproduce the results obtained in this small group of patients, "added Mandate.
Future work will need to make a good selection of patients and a detailed technical analysis and prognosis after the procedure, in order to know if you get an improvement in symptoms and quality of life of subjects with multiple sclerosis, and the duration of the response.
Damage to the axons, a major component of brain nerve cells could spontaneously regress in amyotrophic multiple, according to a study of the Ludwig Maximilians University of Munich in Germany, published in the online edition of the journal Nature Medicine.
In multiple sclerosis, an inflammatory disease of the central nervous system, damage to axons mediated by the immune system leads to permanent neurological defects. It is unknown how the damage is initiated in axons. A classical view of multiple sclerosis is that the loss of myelin-coverings that insulate the axons to accelerate the transmission of nerve signals, is a prerequisite for axon damage.
The scientists, led by Martin Kerschensteiner, used imaging techniques in living mice to identify a new form of damage to axons in an experimental model of multiple sclerosis. This process, called 'focal axonal degeneration' consists of sequential stages: localized damage in the mitochondria within axons, inflammation of the nerve fiber and the further fragmentation of the axons.
Notably, most swollen axons in their experiments remained unchanged for several days and some were recovering spontaneously.
The researchers also found changes consistent with focal axonal degeneration in lesions of multiple sclerosis patients, highlighting the possible relevance of this form of axonal damage to human disease.
A new therapy for multiple sclerosis yet under investigation has shown that it can achieve a significant reduction in recurrent disease type, as it manages to decrease brain injury and thus, the risk of relapse.
This follows from a Phase II with the new drug known as ocrelizumab, whose effectiveness has been proven in more than 200 patients over 24 weeks.
Ocrelizumab has shown that it can achieve a significant reduction in recurrent disease type, as it manages to decrease brain injury and thus, the risk of relapse
The total reduction of brain lesions detected by MRI (MRI) was significantly higher, reaching 96 percent by using 2,000 milligrams and 89 percent with 600 mg compared to placebo.
The disease activity was also determined from the annual relapse rate (TAR), ie, the relapse rate or exacerbations per patient-year. At week 24, HAART was significantly lower compared with the placebo group, reaching the reduction of 73 percent to 2,000 milligrams and 80 percent to 600 milligrams.
addition, both doses were well tolerated ocrelizumab, in general, not any opportunistic infection was reported, while serious adverse events (SAEs) were similar in all treatment groups.
reactions associated with infusion during the first infusion, mild to moderate predominantly ocrelizumab were more common (34.5 and 43.6 per cent) than with placebo (9.3 percent). Now, with a second infusion of ocrelizumab decreased the reported cases, which were comparable to those described initially with placebo.
as underlined by Dr. Ludwig Kappos, Department of Neurology, University Hospital Basel (Switzerland), this efficiency is the most remarkable seen in a study of relapsing-remitting phase II, so that may have the potential to benefit patients with this disease.
Two new test developed by Dr. Luisa María Villar, head of the Section of Immunochemistry of Hospital Ramón y Cajal Madrid allow early detection of multiple sclerosis (MS) and predict which patients develop more severe forms of this disease, may well choose the best treatment.
Villar has given Thursday at the Ramón y Cajal the theoretical-practical 'Biomarkers in cerebrospinal fluid', which along Cermak neurologist Carlos Alvarez, coordinator of the EM Unit of the hospital, explained these new techniques to 65 national experts from several hospitals.
One such test is the test of oligoclonal bands of immunoglobulins G (IgG) in cerebrospinal fluid, which can identify patients with early MS symptoms that may develop the disease. This test was a previous version, even commercially, that Villar has perfected to make it more responsive and thus more reliable results.
"There were oligoclonal IgG bands in the early diagnosis of MS, but were of low sensitivity, making this test requiring highly specialized laboratories and cause actual results to differ depending on who practiced" , explained the expert to Europa Press.
"Now this test is more sensitive and allows a more reliable early diagnosis, which means that can slow the progression of disability in these patients, who tend to be young with many years of illness ahead, "he says.
" It's important to stop as soon as neurodegeneration, because there is no treatment to reverse this damage and should be treated with new therapies in the early stages, when even the patient suffers no deficit, "he added.
The second test, created entirely by Dr. Villar, is the test of oligoclonal bands inmonuglobulina M (IgM). Lets find out, in patients with early symptoms of MS, which have a higher risk of developing this disease in its severest form. So eligible specialists in these cases, early treatments or stronger.
explains the expert, M is a protein inmonuglobulina difficult to manipulate in the laboratory. To facilitate their study, it occurred "break it down into more manageable subunits without altering its characteristics," a work that began at the Institute of Neurology in London and ended in the Ramón y Cajal, which successfully tested this method on their patients. "This allowed us to identify these patients and to treat them better," he concludes.
Day is coming in Multiple Sclerosis 2011, and it is important that we all support the work of the Multiple Sclerosis International Federation (MSIF), which for decades has implemented programs to improve the quality of life of people with MS.
iconic film Day Our World MS
Worldwide in all languages, is outreach and awareness, and instituted in 2009 that the last Wednesday in May would mark the World Day of Multiple Sclerosis in an effort to unite the entire planet in the same objective.
In 2011, the theme of World is "Employers and MS."
WORLD PETITION
On the World Day of MS www.worldmsday.org can find important information in several languages, but especially invited to sign the global petition for changes to employment policies for people with MS, and invite your family, friends and associates to sign on the link http://worldmsday.org/? page_id = 607.
The request can be translated automatically on the same page, but I add here a more accurate translation:
EM Day 2011 World Campaign for Access to appropriate work
The work is a fundamental aspect of our lives. It not only provides a salary, but also a sense of self, the opportunity to lead an independent life and be a fully integrated member of society.
Millions of people around the world have no access to decent work. People with disabilities and / or diseases chronic are often marginalized by society and often their rights of access to employment are not recognized by employers and are safeguarded by the laws of their countries.
In December 2006 the General Assembly of the United Nations adopted the Convention on the Rights of Persons with Disabilities. Recognized the rights of disabled people, including the right to work on "equal footing with others," providing a platform for improving the lives of millions of people with disabilities and their families.
Join us to ask governments around the world, with employers and others, remove barriers that prevent people with chronic diseases like MS fluctuating access to decent jobs.
to our leaders and responsible decision making, We, the undersigned, urge you to recognize, protect and promote the rights of people with MS and other disabilities to access to decent jobs.
ONLINE SURVEY
In 2010 there was talk of "Work and EM "became an online survey that responded 12 000 people from various countries, and that survey concluded that small changes in the locations and working conditions can make a big profit in people with MS, so that we active and productive, for example, have flexible schedules, do the work sitting and having a space for a short break.
This year 2011, the survey is aimed at employers, business owners or business and personal positions, who can talk about policies and facilities offered by their companies to have employees with multiple sclerosis and other diseases staff chronic. (This survey is open until late March and can respond http://www.surveymonkey.com/s/MTCMRW6).
Please respond to this survey and to circulate as soon as possible between people who can help "draw" a global overview.
SUPPORT RESOURCES
Under "Tools and resources" page www.worldmsday.org (tools and resources) are various printed materials and documents that can be downloaded English for campaigns around the World Day.
Please come closer to their patients' associations or support groups, and use these materials MSIF designed for our benefit.
Model letter for employers: is important that we get letters like this and making appointments working with companies and governments to make agreements of collaboration or at least provide informative talks to prevent discrimination People with MS and we know more about our condition.
Recommendations for legislators: Aimed at policy makers work, governments, employers, medical professionals and associations of MS.
What is MS: indispensable document for distribution to as many people as possible (with or without relation to MS) but especially recommended for deliver to those who know little about the disease and have potential to influence changes to improve our quality of life.
applicable Policy: model workplace policies to promote and maintain good labor supply for people with MS or other chronic diseases.
fragment of text: "The company acknowledges that if an employee suffers from a chronic medical condition fluctuates, this is not necessarily an impediment to making a valuable contribution to the success of the company. also recognizes that to maintain employment may be of great importance for people with chronic medical conditions fluctuate. Therefore, when an employee suffers from a chronic medical condition fluctuating or develop the disorder as an employee, the company will try to ensure that the employee remains in use where and when ... " ;
recommend to get this document to business associations, chambers of commerce, trade unions, colleges of specialists in Industrial Relations and Human Resources, specialists in occupational medicine and human rights commissions to defend the right to employment.
Work and Sclerosis Multiple: This 7-page booklet is a guide for Employers and Employees.
I invite you to their websites, in their social networks and in every email you send includes the logo and a link to the page www.worldmsday.org
