Parkinson's
drug listed on PBS
19:34 AEST Mon Jun 2 2008
By Melissa Jenkins
The
listing of a Parkinson's drug on the Pharmaceutical Benefits Scheme
(PBS), which previously cost up to $15,000 a year, has opened
a new chapter of treatment for sufferers of the disease.
Pramipexole imitates the natural chemical dopamine, which controls
movement and co-ordination and is reduced in Parkinson's sufferers.
The drug retails as Sifrol and has been listed on the PBS for
moderate to advanced Parkinson's sufferers for use with another
drug, called levodopa.
Its listing means rather than costing up to $15,000 a year, the
drug will be available for $30-a-month for non-pensioners and
$5 for pensioners.
Neurologist Victor Fung, who sits on the Parkinson's Australia
scientific advisory board, said pramipexole was the only drug
of its kind listed on the PBS that did not have potential heart-valve
complications.
"The concern surrounding heart-valvular disease in patients
has created a significant unmet medical need for a well-tolerated
and effective treatment," he said.
"The availability of Sifrol is long overdue.
"It will open an exciting new chapter in the treatment of
Parkinson's disease in Australia."
Dr Fung warned that 15 per cent of patients taking pramipexole,
or other dopamine agonists, can suffer side-effects including
compulsive gambling, hyper-sexuality and binge eating.
But, he said, the benefits of the drug outweighed the risks. "On
balance, it helps a significant number of people and Australia
is really 10 years behind the rest of the world in terms of this
drug being available for routine treatment," Dr Fung said.
Parkinson's sufferer John Silk, 72, of St Ives in Sydney, said
he was planning to switch his medication to pramipexole in a fortnight.
"It will rid me of the fear of stretching the heart too far,"
he told AAP.
There are an estimated 80,000 Parkinson's sufferers in Australia,
with 25 new cases diagnosed daily.
Dr Fung said it was a widely-held view amongst neurologists that
the drug should be available on the PBS to early stage Parkinson's
suffers.
Global pharmaceutical company Boehringer Ingelheim sells pramipexole.
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Cannabis
shrinks brain volume: study
07:07 AEST Wed Jun 4 2008
By Tamara McLean
Heavy
marijuana use over many years appears to shrink parts of the brain
that control emotion and memory, an Australian study shows.
Brain scans on 15 men who smoked at least five joints a day for
more than a decade show for the first time that they have structural
brain abnormalities not seen in non-smokers.
The researchers from the University of Melbourne say their findings
should settle the historic controversy over the long-term effects
of cannabis use with solid proof of the damage it causes.
"These findings challenge the widespread perception of cannabis
as having limited or no consequences on the brain," said
study leader Dr Murat Yucel, a clinical neuropsychologist at the
Melbourne Neuropsychiatry Centre.
"Although modest use may not lead to significant neurotoxic
effects, these results suggest that heavy daily use might indeed
be toxic to human brain tissue."
The study, published in the US journal Archives of General Psychiatry,
showed two important areas of the brain were smaller in long term
smokers.
The hippocampus, thought to regulate emotion and memory, was 12
per cent smaller in volume and the amygdala, involved with fear
and aggression, was reduced by seven per cent.
The smokers also were more likely to show mild signs of psychiatric
disorders, but not enough to be formally diagnosed with one, Dr
Yucel said.
The men also performed "significantly worse" in a memory
test that involved trying to recall a list of 15 words.
He admitted the findings did not necessarily prove marijuana was
responsible for the difference in brain volume but the findings
strongly suggest this was the cause.
If this was the case, this indicated everyone was vulnerable to
potential changes in the brain, some memory problems and psychiatric
symptoms if they used heavily enough and for long enough, the
researchers said.
The study involved men who were around the age of 40 and who had
not taken other illicit drugs more than 10 times.
Another recent research review from the University of NSW showed
that cannabis smokers had a 40 per cent increased risk of developing
schizophrenia, and smoking daily drives the risk up two-fold.
Other studies have linked the habit to gum disease and lung cancer.
Statistics show a third of Australians have smoked at least once
in their life, with about 300,000 using daily.
A
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Blood
thinner recalled - Clexane
Batches of a common blood-thinning medicine have been recalled
in Australia after testing positive to a dangerous contaminant.
The medicines watchdog, the Therapeutic Goods Administration (TGA),
has recalled five batches of Clexane, commonly used in patients
undergoing heart and joint surgery, and in patients with kidney
failure and other conditions.
Clexane contains heparin, intravenous forms of which have been
linked to severe allergic reactions, including dozens of deaths,
in the US.
TGA head Dr Rohan Hammett said all intravenous forms of the drug
in Australia had been tested and cleared.
"At this stage, the Clexane product, or five batches of it,
have tested positive for that contaminant and we are recalling
those batches of Clexane," Dr Hammett said on ABC radio.
"It is important to note that to date there have been no
reports of adverse events or untoward reactions to Clexane in
Australia.
"This is purely precautionary at this stage."
Dr Hammett said there were different theories about how the contamination
may have occurred.
"The TGA is actively investigating where the contamination
may have occurred along the manufacturing supply chain,"
he said.
Australian Medical Association president Rosanna Capolingua praised
the recall.
"This is a very serious situation, there have been a number
of recorded deaths due to anaphylaxis, which is a severe allergic
reaction, to heparin products, to Clexane for instance, in the
United States," she said.
Dr Capolingua said hospitals should think very carefully about
rationing unaffected batches of Clexane.
The US Food and Drug Administration (FDA) has identified a Chinese
plant as the source of the contaminated heparin, according to
the New York Times newspaper.
The FDA had identified the contaminant as oversulphated chondroitin
sulphate, a "cheap fake additive", the newspaper said.
The FDA launched an investigation after a spike in reported deaths
of patients given heparin between November and February.
The US FDA yesterday sent a warning letter to Changzhou SPL, the
Chinese plant identified as the source of contaminated heparin,
the Times said.
The
FDA had identified 12 Chinese companies that supplied contaminated
heparin to Australia, Canada, China, Denmark, France, Germany,
Italy, Japan, the Netherlands, New Zealand and the United States,
the report said.
A Chinese official disputed the assertion the blood thinner has
caused death, but admitted heparin produced in China contained
a contaminant.
"We
don't have a strong evidence to show that it is heparin or its
contaminant that caused the problem,'' Ning Chen, second secretary
of the Chinese embassy, told the Times.
He
said the illnesses associated with heparin had occurred only in
the US and said Chinese inspectors should be allowed to inspect
the US plant where the final stage of the drug's production took
place.
23.04.08
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New
stem cell hub opens in Brisbane
Thursday Apr 3 00:02 AEDT
Australia's second hub for cutting-edge stem cell research will
open in Brisbane on Thursday.
The Australian Stem Cell Centres (ASCC) Brisbane laboratories
at the University of Queensland will include the first human embryonic
stem cell production facility in Queensland, federal Science Minister
Kim Carr said.
Scientists in Brisbane will investigate possible treatments of
blood-related disease and kidney diseases using cell lines expanded
from existing human embryonic stem cell lines, known as MEL1 and
MEL2, created in Melbourne, he said.
ASCC chair Vicki Sara said the Brisbane hub linked scientists
from four internationally renowned Brisbane-based research institutes.
"This state has everything to offer in terms of outstanding
facilities, first class institutes, outstanding scientific talent
and a lifestyle that no state can match," Prof Sara said.
The ASCC employs scientists within their own dedicated laboratories
on the University of Queensland campus with the ASCC's chief scientist,
Prof Melissa Little, also based at the Queensland laboratories.
It also funds six external research groups in Brisbane focusing
on blood and the development of a safe, transfusible blood product
from various stem cell types, Prof Sara said.
ASCC chief executive officer Stephen Livesey said the Brisbane
hub was another step towards developing a product to save and
improve the lives of patients with blood-related diseases.
Other projects in Queensland include the application of adult
stem cells to kidney disease and heart disease.
There is also research underway into normal tissue repair, comparisons
between different stem cell types, investigations into the safety
and effectiveness of embryonic stem cells, and the development
of processes to boost cell numbers.
The headquarters of the ASCC and the first major cluster of research
facilities was established in 2003 in Melbourne.
©AAP 2008
A
SPECIAL THANK YOU TO AAP FOR THIS ARTICLE
Tests
urged for women on natural HRT
Sunday Apr 6 12:18 AEST
Women who take menopause medication containing the herbal extract
black cohosh are being recommended to have liver function tests
after a South Australian woman suffered organ failure while taking
the remedy.
Thousands of Australian women, and millions worldwide, take over-the-counter
remedies with black cohosh for the relief of menopausal symptoms
like hot flushes, night sweats and irritability.
The extract, first used for gynaecological conditions by North
American Indians, is a key ingredient in more than 200 drugs and
is marketed as a natural and safe alternative to controversial
hormone replacement therapy (HRT).
But while studies show the extract is well tolerated, there are
emerging reports of a rare but severe side effect on the liver.
Seven women have suffered liver failure in the past decade, five
requiring liver transplantation, and in a new case, reported in
the Medical Journal of Australia on Sunday, an otherwise healthy
51-year-old Adelaide women also had to undergo a transplant.
Her treating physician, Dr Elizabeth Chow from Flinders Medical
Centre in Adelaide, said the patient had taken the drug within
the recommended dose over three years.
Dr Chow said the latest case was further proof tighter regulations
were required to monitor the use and safety of these preparations.
She called for more randomised-controlled trials to test products
and said new guidelines were needed recommending women who take
black cohosh to have their liver tested.
"We recommend that liver function be checked before and during
use of black cohosh," she said.
The public also needed to be better briefed about the risks of
using complementary medicines, and in particular black cohosh,
a member of the buttercup family.
"There is a widespread belief in the community that 'natural'
plant substances are safe, effective and free of side effects,"
she said.
The Therapeutic Goods Administration updated labels on black cohosh
products in 2006 and again in November 2007 in response to adverse
drug events reported worldwide.
©AAP 2008
A
SPECIAL THANK YOU TO AAP FOR THIS ARTICLE
Dodgy
doctors jeopardise Medicare: govt
Thursday Apr 3 19:03 AEDT
Federal Health Minister Nicola Roxon says "dodgy" doctors
rorting Medicare are undermining the entire system.
Ms Roxon said that while rorting of the system was not widespread,
she vowed to come down hard on those doctors who did the wrong
thing.
A total of 27 doctors were referred to the Professional Services
Review (PSR) - the agency that investigates doctors suspected
of inappropriate use of the Medicare system - last financial year,
with indications that figure will grow to at least 60 cases this
year.
Of the 27, 16 resulted in doctors either agreeing or being ordered
to make repayments to Medicare totalling more than $1.7 million,
an increase from the previous year when doctors paid back $1.3
million.
One doctor alone had to repay $400,000.
The doctors faced punishments including reprimands, counselling
and disqualification from using Medicare schemes for various periods
of time.
"It's really important we send a strong message to those
doctors who are doing the wrong thing," Ms Roxon said.
"And I think it's important for other doctors to be doing
that too, because it jeopardises the benefits of Medicare for
everybody if it's being rorted or if it's more extensively rorted.
"We want to come down hard on these practices, but I'm calling
today on the doctors to also assist us in this fight.
"If we don't stop the dodgy practices, then it is compromising
for all doctors and for Medicare."
Australian Medical Association (AMA) president Rosanna Capolingua
said there was only a very small number of doctors rorting the
system, adding that the increase in the number of doctors being
investigated was because the efficiency of the PSR system had
been improved.
Dr Capolingua said the majority of doctors did the right thing.
"It's a very small number that have been picked up ... the
majority of doctors ... are actually very actively thinking about
what (patients) need and picking the appropriate investigations
for your clinical conditions or concerns at the time," she
said.
"Indeed, the AMA believes very firmly that doctors need to
practice appropriately," she said.
Dr Capolingua said the AMA supported the PSR.
"We supported its establishment and worked to establish the
PSR and have been involved in the recent review of the PSR which
has actually enabled the increased reporting that has just become
evident in the current report," she said.
"The PSR has been established to monitor any doctors, and
there's a very small number of those, a very small percentage
of the total scheme of things, that are outside what we believe
to be appropriate practice.
"And we support the PSR in taking the appropriate action
to investigate and look at the issues around those particular
doctors of concern."
Dr Tony Webber, who heads the review body, said examples of misuse
of the Medicare scheme included ordering unnecessary patient tests
to receive a rebate.
"It would be inappropriate to order a prostate blood test
on 25-year-olds, and that has happened," Dr Webber said.
"I've seen on a number of occasions tests that you would
normally associate with older age groups being ordered for teenagers.
"Which, in our view, is most inappropriate and most inappropriate
use of commonwealth money."
Dr Webber said the rorting was not widespread, but computerisation
had made it easier for doctors to over-order pathology tests.
©AAP 2008
©AAP
2008
A SPECIAL THANK YOU TO AAP FOR THIS ARTICLE
Call
to change cough medicine marketing
9:24a.m. 28 March 2008
Australia should follow the lead of UK authorities and overhaul
the marketing of children's cough medicines, a Sydney hospital
professor says.
Six cough medicines sold for children under two years old have
been removed from sale in the UK and another 90 have been temporarily
taken from shelves to upgrade overdose warnings on their packaging.
Asked on the Seven Network if Australia should take similar action,
Professor Dominic Fitzgerald from Westmead Children's Hospital
said, "absolutely".
"There is no clear benefit from using these medications and
there's no justification in my mind for continuing to market them,"
he said.
Professor Fitzgerald's main concern about the medications was
their unproven effectiveness and fears of overdose.
"Studies both in the US and in the UK (and) several other
countries around the world have clearly demonstrated there's no
benefit for these medications so the first thing to think about
is, why give something if there's no real benefit?" he said.
"We're focusing here on the under-two-year-olds ... the real
issue is there's a potential mix of up to a dozen different medications.
Some are antihistamines which have sedative affects and others
are cough suppressants.
"The difficulty you have is cough is such a common symptom,
it's non-specific and usually related to ... a simple common cold.
"A cold will last several days and get better by itself so
there is no need necessarily to give any medication. Sometimes
less is better than more.
"But the potential problem here is when parents understandably
give some medication ... and the medication doesn't seem to do
anything to help the child ... `maybe I should give more' and
so ... inadvertently parents can give excessive doses of these
medications."
Professor Fitzgerald said studies had shown that old-fashioned
remedies such as honey on a teaspoon or a warm lemon drink were
more effective than the proprietary medications in calming coughing
children.
