Upregulation of opioid receptor binding following spontaneous epileptic seizures.

Posted on May 13, 2007 by Maurice Preter MD
 
Brain. 2007 Apr;130(Pt 4):1009-16. Epub 2007 Feb 14. Related Articles, Links
Click here to read 
Upregulation of opioid receptor binding following spontaneous epileptic seizures.

Hammers A, Asselin MC, Hinz R, Kitchen I, Brooks DJ, Duncan JS, Koepp MJ.

MRC Clinical Sciences Centre and Division of Neuroscience, Faculty of Medicine, Imperial College, Hammersmith Hospital, London, UK.

Animal and limited human data suggest an important anticonvulsant role for opioid peptides and their receptors. We aimed to provide direct human in vivo evidence for changes in opioid receptor availability following spontaneous seizures. We scanned nine patients within hours of spontaneous temporal lobe seizures and compared their postictal binding of the non-subtype selective opioid receptor PET radioligand [11C]diprenorphine (DPN), quantified as a volume-of-distribution (VD), with interictal binding and with binding changes in 14 healthy controls, controlling for a range of behavioural variables associated with opioid action. A regionally specific increase of opioid receptor availability was evident in the temporal pole and fusiform gyrus ipsilateral to the seizure focus following seizures (Z 5.01, P < 0.001, 16 432 mm3). Within this region, there was a negative correlation between VD and log10 time since last seizure (r = -0.53, P < 0.03), compatible with an early increase and gradual return to baseline. [11C]DPN VD did not undergo systematic changes between time points in controls. This study provides direct human in vivo evidence for changes in opioid receptor availability over a time course of hours following spontaneous seizures, emphasizing an important role of the opioid system in seizure control.

Publication Types:

PMID: 17301080 [PubMed – in process]

Posted in News | Tagged |

Phosphodiesterase inhibitors for erectile dysfunction in patients with diabetes mellitus.

Posted on May 13, 2007 by Maurice Preter MD
 
Cochrane Database Syst Rev. 2007 Jan 24;(1):CD002187. Related Articles, Links
Click here to read 
Phosphodiesterase inhibitors for erectile dysfunction in patients with diabetes mellitus.

Vardi M, Nini A.

Carmel Medical Center, Internal Medicine, 7 Michal St, Haifa, Haifa, Israel, 34362. mvardi@013.net.il

BACKGROUND: Erectile dysfunction is a common multi-factorial complication of diabetes mellitus. Numerous strategies have been tried to overcome this diabetic complication. In recent years, phosphodiesterase type 5 (PDE-5) inhibitors have been introduced in the management of erectile dysfunction. OBJECTIVES: The objective of this review was to assess the effect of PDE-5 inhibitors on the management of erectile dysfunction in diabetic men. SEARCH STRATEGY: Studies were obtained from computerised searches of MEDLINE, EMBASE and The Cochrane Library. SELECTION CRITERIA: Randomised controlled trials, in which treatment with PDE-5 inhibitors was compared to control, in diabetic patients with erectile dysfunction. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and assessed trial quality. MAIN RESULTS: Eight randomised controlled trials were identified. A total 976 men were allocated to receive a PDE-5 inhibitor and 741 were randomised to the control groups. Overall, 80% of the participants suffered from type 2 diabetes mellitus. The weighted mean difference (WMD) for the International Index of Erectile Function (IIEF) questions 3 and 4 (frequency of penetration during and maintaining erection to completion of intercourse) was 0.9 (95% CI 0.8 to 1.1) and 1.1 (95% CI 1.0 to 1.2) at the end of the study period, in favour of the intervention group. The WMD for the IIEF erectile dysfunction domain at the end of the study period was 6.6 (95% CI 5.2 to 7.9) in favour of the PDE-5 inhibitors arm. The relative risk (RR) for answering “yes” to a global efficacy question ( “did the treatment improve your erections?”) was 3.8 (CI 95% 3.1 to 4.5) in the PDE-5 inhibitors compared with the control arm. The WMD between the percentage of successful attempts in the PDE-5 inhibitors and in the control arm was 26.7 (95% CI 23.1 to 30.3). Mortality was not reported in any of the included trials. Adverse cardiovascular effects were reported in one study. Headache was the most frequent adverse event reported, flushing was the second most common event, with upper respiratory tract complaints and flu like syndromes, dyspepsia, myalgia, abnormal vision and back pain also reported in a descending order of frequency. The overall risk ratio for developing any adverse reaction was 4.8 (CI 95% 3.74 to 6.16) in the PDE-5 inhibitors arm as compared to the control. AUTHORS’ CONCLUSIONS: Sufficient evidence exists that PDE-5 inhibitors form a care that improves erectile dysfunction in diabetic men.

Publication Types:

PMID: 17253475 [PubMed – indexed for MEDLINE]

Posted in Psychiatry/Neurology |

Childhood adversities experienced by working-age migraine patients.

Posted on May 13, 2007 by Maurice Preter MD
 
J Psychosom Res. 2007 Feb;62(2):139-43. Related Articles, Links
Click here to read 
Childhood adversities experienced by working-age migraine patients.

Sumanen M, Rantala A, Sillanmaki LH, Mattila KJ.

University of Tampere, Medical School, Tampere, Finland. markku.sumanen@kolumbus.fi <markku.sumanen@kolumbus.fi>

OBJECTIVE: The objective of this work was to study associations between childhood adversities and migraine. METHODS: This is a case-control study of individuals drawn from the Finnish Population Register comprising four age groups: 20-24, 30-34, 40-44, and 50-54 years. Altogether, 21,101 individuals responded to postal questionnaire (response rate=40%). The subjects were asked whether a doctor had told them that they have or have had migraine. They were then requested (through six questions) to think about their childhood adversities. One randomly selected age-matched and sex-matched control for comparison was selected for every patient (n=4046). RESULTS: Among migraine patients, 76.8% were women. Each of the six childhood adversities was more common among migraine patients than among controls. In conditional logistic regression analysis for matched-pairs data, long-lasting financial difficulties in the family, a family member having been seriously or chronically ill, serious conflicts in the family, and parents having divorced remained statistically significant after adjusting for education, state of health, and depression. Odds ratios varied between 1.22 and 1.29. CONCLUSION: Our findings suggest that social factors during childhood are associated with migraine.

PMID: 17270571 [PubMed – in process]

Posted in Aging |

Headaches amongst pool players.

Posted on May 13, 2007 by Maurice Preter MD
 
Headache. 2007 Feb;47(2):270-4. Related Articles, Links
Click here to read 
Headaches amongst pool players.

Seet RC, Chan YH, Lim EC.

Division of Neurology, National University Hospital, Singapore.

BACKGROUND: Pool-players’ headache is a newly described entity. We studied the prevalence and risk factors for the development of headaches amongst pool players. METHODS: We obtained demographic information, history of pre-existing headaches, frequency and duration of pool-playing, history of pre-existing headaches and their subtypes, competitive pool-playing and worsening or development of headaches amongst pool-players at 2 pool centers. Univariate and multivariate analyses were performed and statistical significance was set at P < .05. RESULTS: Two hundred and three players, of mean age 22.6 (SD 7.7 years), participated in this study. Of the 21 respondents who reported headaches when playing pool, 11 (52.4%) had pre-existing headaches and 10 (47.6%) had no pre-existing headaches. Age and history of pre-existing headaches were significantly associated with worsening of headaches. CONCLUSION: Pool-players are susceptible to the development of headaches. Avoidance and reduction in the frequency of pool-playing may reduce the frequency of headaches amongst pool players.

PMID: 17300367 [PubMed – indexed for MEDLINE]

Posted in News | Tagged |

"[A]cupuncture in addition to usual care was an effective and safe treatment."

Posted on May 13, 2007 by Maurice Preter MD
 
Acupunct Med. 2006 Dec;24 Suppl:S33-39. Related Articles, Links
Click here to read 
Efficacy, effectiveness, safety and costs of acupuncture for chronic pain – results of a large research initiative.

Witt CM, Brinkhaus B, Reinhold T, Willich SN.

BACKGROUND: The aim of the ‘Acupuncture Model Project of the Techniker Krankenkasse’ was to determine efficacy, effectiveness, safety and cost effectiveness of acupuncture treatment in standard medical care. METHODS: We evaluated a total of 304 674 patients (34.5% men, aged 53.1+/-13.8 and 65.5% women, aged 49.5+/-14.2) who were in the care of over 10 000 physicians and received on average 10+/-3 acupuncture treatments for chronic pain (osteoarthritis of the hip or knee, low back pain, neck pain, headache) during a period of three months. RESULTS AND CONCLUSIONS: Our findings demonstrate that for the diagnoses examined, acupuncture in addition to usual care was an effective and safe treatment. Whether the effects of acupuncture can be attributed primarily to specific or nonspecific mechanisms appeared to depend on the diagnosis, and should be investigated in further studies. Using acupuncture as an adjunctive treatment was more expensive than usual care alone, but was cost-effective according to internationally accepted threshold values.

PMID: 17308507 [PubMed – in process]

Posted in News | Tagged |