Perception of Patients with Cancer Enquiring About Adjuvant Therapy with Cannabis Medicine for Palliation of Symptoms:An Interview Study among Danish Health Care Professionals

BACKGROUND: A medicinal cannabis pilot program was launched in Denmark in 2018 to support patients as countermeasure against self-medication by use of cannabis products from the illicit market. The aim was to facilitate patient access to adjuvate therapy using medicinal cannabis under the guidance of physicians. OBJECTIVE: The aim of this interview study was to elucidate how health care professionals (HCPs) perceive cancer patients enquiring about cannabis medicine (CM), including medicinal cannabis and cannabis-based medicine, for adjuvant palliative therapy. DESIGN: The program used semistructured qualitative research interviews with thematic analysis. SETTING/PARTICIPANTS: Fifty HCPs took part in the study with 10 informants in each of the following 5 groups: oncologists, palliative care specialists, general practitioners, registered nurses in oncology, and in palliative care. RESULTS: The informants reported that optional CM as adjuvant therapy was only discussed when initiated by the patient or relatives. Reluctance by HCPs to enter into a dialogue about CM with their patients was mainly explained by the lack of clinical evidence for the use of CM in palliative care of patients with cancer. None of the oncologists had ever prescribed CM, while three palliative care specialists and two general practitioners had issued prescriptions on rare occasions. CONCLUSION: HCPs involved in cancer treatment and palliative care are in general reluctant to discuss optional adjuvant CM therapy with their patients. The Danish health care authorities need to address this barrier to ensure that patients eligible for CM therapy are given this option as intended by the launch of the national pilot program

Gut microbiota profiles of autism spectrum disorder and attention deficit/hyperactivity disorder:A systematic literature review

Accumulating evidence has implicated an involvement of the gut-brain axis in autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD), however with highly diverse results. This systematic review aims to describe and evaluate studies investigating the gut microbiota composition in individuals with ASD or ADHD and to evaluate if variations in gut microbiota are associated with these disorders. Twenty-four articles were identified in a systematic literature search of PubMed and Embase up to July 22, 2019. They consisted of 20 studies investigating ASD and four studies investigating ADHD. For ASD, several studies agreed on an overall difference in β-diversity, although no consistent bacterial variation between all studies was reported. For ADHD, the results were more diverse, with no clear differences observed. Several common characteristics in gut microbiota function were identified for ASD compared to controls. In contrast, highly heterogeneous results were reported for ADHD, and thus the association between gut microbiota composition and ADHD remains unclear. For both disorders, methodological differences hampered the comparison of studies

Use of Fermented Red Clover Isoflavones in the Treatment of Overactive Bladder in Postmenopausal Women: A Randomized, Double-Blinded, Placebo-Controlled Trial

Postmenopausal women are at risk of developing an overactive bladder (OAB). Conventional vaginal estrogen has shown promise for symptom relief. Isoflavones have proven effective as an alternative to estrogen treatment against menopause-related symptoms. However, its effect on OAB symptoms has not been studied. This study investigates if fermented red clover isoflavones reduce OAB symptoms in postmenopausal women. In this randomized, double-blinded, placebo-controlled trial, women were administered red clover extract (RCE) or a placebo twice daily for three months. Women filled out the International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB) and Urinary Incontinence Short Form (ICIQ-UI-SF), together with a fluid intake and voiding diary. A total of 33 women (16 in the RCE group and 17 in the placebo group) were included in the analysis. Baseline demographics and OAB characteristics were comparable across groups. Intake of RCE did not lead to significant relief in most urinary bladder symptom measures, although a significant reduction in the bother of urinary urgency (p = 0.033) and a tendency towards a decreased ICIQ-OAB score were observed (p = 0.056). In contrast, the placebo exhibited a significant decrease in the ICIQ-OAB score (p = 0.021) and in some diary outcomes. We found that an intake of isoflavones did not relieve OAB symptoms in postmenopausal women.</p

Decrease in Seminal HIV-1 RNA Load After Praziquantel Treatment of Urogenital Schistosomiasis Coinfection in HIV-Positive Men-An Observational Study

Abstract Background Urogenital schistosomiasis due to Schistosoma hematobium infection is hypothesized to cause increased HIV-1 RNA shedding in semen in HIV co-infected men as result of chronic egg-induced inflammation in the prostate and the seminal vesicles. The effect of treatment with the antihelminthic agent praziquantel on seminal HIV-1 RNA load was assessed in this study. Methods HIV-1 RNA load was determined in blood plasma and semen at baseline and at 10-week follow-up. Praziquantel was administered at baseline and two weeks later. Results Eighteen HIV-positive men with S. haematobium co-infection were enrolled into the study. Status of antiretroviral therapy (ART): 6 ART-naïve and 12 ART-experienced. All participants became egg-negative in urine at follow-up. Among the ART-naïve men, the mean HIV-1 RNA load decreased by 0.32 log10 copies per mL (4.41 vs 4.09) in blood plasma from baseline to follow-up, and in semen by 1.06 log10 copies per mL (4.06 vs 3.00). Conclusions This study demonstrated a decline in seminal HIV-1 RNA load following praziquantel treatment of urogenital schistosomiasis infection in HIV-positive men. The finding needs further exploration in a larger randomized study targeting praziquantel as a supplementary preventive measure of sexual transmission of HIV-1 in S. haematobium endemic areas in sub-Saharan Africa. </jats:sec

Children and adolescents with attention deficit hyperactivity disorder and autism spectrum disorder share distinct microbiota compositions

ABSTRACTAn association has been suggested between altered gut microbiota, and attention deficit hyperactivity disorder (ADHD), and autism spectrum disorder (ASD), respectively. Thus, we analyzed the gut microbiota composition in children and adolescents with or without these disorders and evaluated the systemic effects of these bacteria. We recruited study participants diagnosed with ADHD, ASD, and comorbid ADHD/ASD, while the control groups consisted both of siblings and non-related children. The gut microbiota was analyzed by 16S rRNA gene sequencing of the V4 region, while the concentration of lipopolysaccharide-binding protein (LBP), cytokines, and other signaling molecules were measured in plasma. Importantly the gut microbiota compositions of cases with ADHD and ASD were highly similar for both alpha- and beta-diversity while differing from that of non-related controls. Furthermore, a subset of ADHD and ASD cases had an increased LBP concentration compared to non-affected children, which was positively correlated with interleukin (IL)-8, 12, and 13. These observations indicate disruption of the intestinal barrier and immune dysregulation among the subset of children with ADHD or ASD