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Posts Tagged "study"

20Feb

Flu vaccine protected 6 out of 10 in B.C. during unusual influenza season: study

by admin


A flu shot


Justin Sullivan / Getty Images

VANCOUVER — Getting vaccinated for the flu may have prevented about six out of 10 people from becoming infected in an early Canadian flu season, says a study involving a network of family doctors who monitored patients in British Columbia, Alberta, Ontario and Quebec.

Dr. Danuta Skowronski, lead author of the study and lead epidemiologist for influenza at the B.C. Centre for Disease Control, said the study involved about 2,800 patients who were seen by their physicians for a flu-like illness between Nov. 1, 2019 and Feb. 1.

The current flu season was the most unusual in about five years because of an early spike in influenza B as influenza A was circulating across Canada and the northern hemisphere.

Skowronski said the doctors are part of the Sentinel Practitioner Surveillance Network involved in helping to determine vaccine effectiveness. They took nasal swabs from patients who were at least a year old and were seen within seven days of the start of symptoms such as fever, cough and sore throat.

The study, published Thursday in Eurosurveillance, a journal on infectious disease surveillance, epidemiology, prevention and control, found about an equal number of people were sickened by influenza A and B.

“This vaccine prevented about 60 per cent of cases of influenza that would have otherwise occurred in unvaccinated cases,” Skowronski said.

She said vaccination effectiveness was estimated by comparing vaccine coverage of patients who tested negative for influenza versus those who tested positive.

The so-called test-negative method was pioneered by the B.C. Centre for Disease Control in 2004 and has come to be used globally in place of randomized control trials, which would require a group of unvaccinated patients, an unethical scenario given everyone should get the vaccine, Skowronski said.

“Other countries have now adopted that methodology,” she said. “Collectively, we submit our findings to the World Health Organization. Later this month the WHO will be meeting to decide whether it needs to update the vaccine strains for next season’s formulation,” she said of the virus that changes every year.

“This is good news in that the vaccine is performing better than it has in previous years,” Skowronski said of the findings, adding they highlight the fact that the public should get vaccinated annually to protect themselves against various strains of the influenza virus, especially if they have a heart or lung condition or are in contact with vulnerable people including the elderly.

“If you want to prevent a miserable illness, and influenza is a miserable illness, a vaccine will protect you against that. But that might be an individual decision. For me, it’s really a kind of double tragedy when high-risk individuals experience these severe outcomes and they could have been prevented through vaccination.”

Concerns about the novel coronavirus should create a greater appreciation for influenza vaccines, Skowronski said.

In place of no vaccine for COVID-19, people should rely on conventional public health measures used for other coronaviruses, such as washing their hands and sneezing and coughing into their elbow, she said.

However, she said knowing who will or won’t get the flu is complex and could include issues such as which influenza subtypes were prevalent around the time someone was born, giving them a lifelong immunity to those subtypes.

British Columbia, Quebec and New Brunswick are the only provinces that do not offer publicly funded vaccination for influenza for all residents but provide it in limited cases, including for pregnant women.

The Public Health Agency of Canada said an average of 12,200 people are hospitalized for the flu every year and 3,500 people die of it annually.

It says everyone aged six months and older should get immunized, and the best time for that is between October and December, before the virus begins spreading.

23Jan

Living near traffic corridors linked to risk of MS, Parkinson’s, Alzheimer’s disease: UBC study | CBC News

by admin

Researchers at the University of British Columbia have found that living near major roads or highways is linked to an increased risk of neurological disorders, while proximity to parks and green spaces is linked to a decreased risk.

The findings are included in a study published this week in the journal Environmental Health.

“Neurological disorders are one of the leading causes of death and disability, globally, and we know very little about the risk factors associated with neurological disorders,” said Weiran Yuchi, the study’s lead author and PhD candidate at UBC school of population and public health.

Yuchi’s study looked at the neurological health effects of green space, air and noise pollution all together, but she said they made no findings regarding noise pollution.

The researchers found an increase in the incidence of multiple sclerosis, Parkinson’s disease, Alzheimer’s disease and non-Alzheimer’s dementia among those living close to busy roads and highways. 

In the case of Parkinson’s, the risk increased by seven per cent among those living close to busy roads and highways. For non-Alzheimer’s dementia, the risk rose by 14 per cent.

But on the flip side, the study showed green spaces are associated with a three to eight per cent lower risk of neurological disorders, said Yuchi, who characterized the link as “protective effects.”

Study based on Metro Vancouver population

Yuchi said the study doesn’t demonstrate that busy roads and green spaces cause the increased and decreased risks, respectively, only that a correlation exists.

In terms of how close to a road one needs to live to fall into the affected population, Yuchi’s study used as its measure 50 metres from a major road and 150 metres from a highway. 

The researchers used a data set including nearly 700,000 adults living in Metro Vancouver for their study. They relied on hospital records, prescription information and doctor visits. They then estimated individuals’ exposure to air and noise pollution and proximity to green space using their postal codes.

In terms of access to green space, Yuchi said the study used 100 metres as a measure, and beyond the role trees play in creating clean oxygen to breathe, the positive effects could be associated with the likelihood of being more physically active and other benefits of living close to a park. 

“We’re not in a position to tell where people should live, but we do suggest that urban planning efforts to increase accessibility to green spaces and to reduce motor vehicle traffic would be beneficial for neurological health at population level,” she said.

Yuchi said the study accounted for socio-economic status — things like income and education — as determinants of health, but the researchers didn’t look at the effects of those factors directly.

She said she’s already working on a similar study with data from across the country, which includes 20 per cent of Canada’s population to get an even clearer picture of how environmental conditions relate to the risk of neurological disorders.


Do you have more to add to this story? Email rafferty.baker@cbc.ca

Follow Rafferty Baker on Twitter: @raffertybaker

23Jan

Living near major traffic routes increases risk of dementia and other conditions: UBC study

by admin

VANCOUVER —
People who live less than 50 metres from a major road or less than 150 metres from a highway are at a higher risk of developing dementia or Parkinson’s disease, according to new research from UBC.

Researchers looked at 678,000 adults living in Metro Vancouver between 1994 and 1998, and then followed up with them once again from 1999 to 2003. They used postal code information to assess each person’s closeness to the road and their exposure to air pollution, noise and green spaces. They ended up identifying 13,170 cases of dementia, 4,210 cases of Parkinson’s disease, 1,277 cases of Alzheimer’s, and 658 cases of Multiple Sclerosis (MS). Researchers classified the different categories of roads based on the traffic volume and the width of the lanes.

The study’s lead author and UBC PhD candidate Weiran Yuchi told CTV News Vancouver the research found living near a major traffic route increased the risk of dementia by 14 per cent, and increased the risk of Parkinson’s by seven per cent.

“We believe that the air pollution associated with traffic actually contributes to the onset of these neurological disorders,” she said.

Due to the relatively low number of Alzheimer’s and MS cases identified, researchers were not able to link an increased risk of those diseases to air pollution, specifically. They are now studying information from across the country to try and get a better understanding of any potential connection.

There was one thing researchers found could mitigate the effects of air pollution: living within 100 metres of a green space.

“There could be several reasons,” Yuchi said. “We believe that maybe the visual presentation … actually is one possible reason. Or, you know, people who live near green space, they’re more physically active, and they pay more attention to their health, and as a result they are at less risk of developing certain neurological disorders.”

Increasing access to parks is one of the goals the City of Vancouver set in its “Greenest City Action Plan,” but according to the Park Board, it hasn’t quite hit its stated target of having everyone within a five-minute walk of a green space by this year.

Senior environment and sustainability planner Chad Townsend said in an email to CTV News Vancouver: “99 per cent of people are within a 10-minute walk of a park or green space (80% are within a five-minute walk). However, distribution is uneven and some neighbourhoods are underserved.”

He singled out Grandview-Woodland and Fairview as areas which have less park land per 1,000 residents, comparatively.

Another goal was to plant 150,000 more trees between 2010 and 2020. Townsend said the Park Board expects to achieve that goal by the end of this year.

Yuchi said in light of Canada’s aging population, the study’s authors are hoping that city planners will take their findings to heart and find ways to increase access to green spaces while reducing traffic.

“The number of cases of neurological disorders are forecast to increase dramatically,” Yuchi said. “Neurological disorders (are) actually one of (the) leading causes of death and disability globally, and we know little about the risk factors of neurological disorders, so therefore we think that it’s necessary for people to pay more attention to neurological health.” 

23Jan

UBC study links living near highways to risk of neurological disorders

by admin


UBC researchers have linked living near a highway with a higher risk of developing a neurological disorder.


Francis Georgian / Postmedia News Files

Researchers at the University of B.C. have found a link between living near highways and an increased risk of several major neurological disorders, including dementia and Parkinson’s disease.

The study, published this week in Environmental Health, found proximity to major roads may also increase the risk for multiple sclerosis and Alzheimer’s diseases, likely because of exposure to more air pollution such as nitrogen dioxide and particulate matter.

Lead author Weiran Yuchi, and a team of researchers at the UBC school of population and public health, analyzed data for 678,000 adults between the ages of 45 and 84 in Metro Vancouver. The subjects were interviewed from 1994 to 1998, and again during a follow-up period from 1999 to 2003.

The researchers concluded that living less than 50 metres from a major road or less than 150 metres from a highway is associated with a higher risk of the neurological disorders, while living near green spaces such as parks and forests reduced risk.

“In our research we found that the green spaces have protective effects against developing the neurological disorders,” said Yuchi, adding that they measured green space using an index of satellite images.

Yuchi said this is the first time UBC researchers have confirmed a link between air pollution and traffic proximity with a higher risk of dementia, Parkinson’s, Alzheimer’s and MS at the population level. There are other epidemiological studies that have reported associations between road proximity and traffic-related air pollution with impaired cognitive function in adults and neurological disorders.


Weiran Yuchi, a researcher at the UBC school of population and public health, is the lead author of a study that links living near highways with an increased risk of developing a neurological disorder such as dementia or Parkinson’s disease.

UBC handout /

PNG

Living near a major road or highway was was associated with a 14 per cent risk for dementia, and seven per cent for Parkinson’s disease.

While the researchers did not identify a percentage for risk for MS and Alzeihmer’s, they did find road proximity was associated with incidence of both.

Yuchi noted that the research does not make recommendations on whether people should be living near highways, but they do suggest more green spaces and accessibility to parks be included in urban planning efforts.

She said their research shows that there is a three to eight per cent reduction in the risk of developing the neurological disorders for those who  live near parks or forest.

They do not make recommendations about how to minimize the risk for those who do live near major roadways, and say more research is needed.  The study did not account for people who live near roads but spend a significant amount of time in nature hiking or visiting parks.

Michael Brauer, the study’s senior author and professor in the UBC school of population and public health, said, in a UBC statement, that those who live close to a green space are likely to be more physically and socially active, and may benefit from the visual aspects of vegetation.

Brauer added that the findings underscore the importance for city planners to ensure they incorporate greenery and parks when planning and developing residential neighbourhoods.

The study was co-authored by Hind Sbihi, Hugh Davies, and Lillian Tamburic in the UBC school of population and public health.

Researchers are now looking at national data which contains information for 20 per cent of the Canadian population, and they are hoping that this will provide more insight into the association between proximity to highways, air pollution, and neurological disorders.

ticrawford@postmedia.com

7Jan

UBC study says ketone drinks may help control blood sugar

by admin


Dr. Jonathan Little, associate professor at UBC Okanagan’s School of Health and Exercise Sciences, is the lead researcher of a new study that looks at how ketone supplements affect blood sugar.


UBC handout / PNG

Ketone monoester drinks, which have become a popular supplement with the low-carbohydrate, ketogenic-diet crowd, may help people with diabetes, suggests new research from UBC Okanagan.

The study’s lead author Dr. Jonathan Little, associate professor at UBC Okanagan’s School of Health and Exercise Sciences, says while ketone supplements are not a magic bullet in managing the disease, they may be another tool to help control blood sugar.

Ketones are molecules produced by the liver from fatty acids during periods of low food intake, carbohydrate restrictive diets, starvation, and prolonged intense exercise.

Little and his team asked 15 people, who were not following a veto or other restrictive diet, to consume a ketone drink, made with medical ester supplied by the University of Oxford, after fasting overnight.

Many of the subjects were candidates for diabetes, or had higher blood sugar levels than normal.

After 30 minutes, the subjects were asked to drink a fluid containing 75 grams of sugar while blood samples were taken.

“It turns out that the ketone drink seemed to launch participants into a sort of pseudo-ketogenic state where they were better able to control their blood sugar levels with no changes to their insulin,” he said.

The product used in the testing is now sold commercially as Hvmn Ketone Ester, he said. There are also other ketone supplements on the market called BHB, which he said can be less potent and may have a high sodium content.

These are considered dietary supplement and not necessarily something that a doctor would prescribe, he said.

Ketone supplements are being used for sport endurance because they are a new fuel. Usually your body can only make ketones when you are starving or severely restrict carbohydrate intake like on a ketogenic diet, said Little.

“So the concept is that you are providing a new fuel or a fourth macronutrient along with carbs, fat and protein that you can drink that can fuel your heart, muscles or brain for exercise,” he said.

Those who follow the keto or intermittent fasting lifestyles may be using these supplements to maintain a state of ketosis.

“Because they’re so new, there’s very little research on how they can influence metabolism and we’re among the first to look at their use in non-athletes,” said Little.

He added that researchers don’t know the effect of long-term use of ketone supplements, and said further study is needed to determine safety.

“When you take them your blood sugar goes down and this may be a good thing, but we don’t know for sure yet. But it’s intriguing.” he said.

Type 2 diabetes is a disease whereby the body is unable to control the level of sugar in the blood because of defects in the functioning of a hormone called insulin.

He said there is mounting evidence that a low-carb keto diet is very effective in controlling blood sugar and even reversing Type 2 diabetes, and that there are doctors who support this diet for patients with this disease.

He cautioned that if someone with diabetes wants to follow a ketogenic diet, it should be done under the direction of a health care provider because it may conflict with some medication.

Little said the research could be a step toward treating diabetes with diet instead of medication.

“There are more anecdotes on the Internet than there are research studies on this, so it is early days and we definitely need more research to back up those anecdotes.”

The study was published in the American Journal of Clinical Nutrition with funding from the Heart and Stroke Foundation of Canada.

ticrawford@postmedia.com

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28Nov

UBC study finds dogs may help motivate kids to read

by admin


A new study from UBC Okanagan found that children who read with a dog appear more motivated and engaged with reading.


UBC handout / PNG

Many kids have bedtime routines that include a bath and story time, maybe even a healthy snack, but what about a dog?

Researchers at UBC Okanagan have found that reading with a dog, regardless of  breed or age, motivates children to read more and stay engaged.

One of the study’s authors Camille Rousseau, a doctoral student at UBC Okanagan’s School of Education, makes a case for the potential of therapy dogs to support reading motivation for young children.

Researchers examined the behaviour of 17 children (eight girls and nine boys) from Grades 1 to 3, while reading with and without a dog.

The study says participants were recruited based on their ability to read independently, and they were tested to determine their reading range. The researchers then choose stories slightly beyond the child’s reading level.

During the study’s sessions, participants would read aloud to either an observer, the dog handler and their pet or without the dog. After finishing their first page, they would be offered the option of a second reading task or finishing the session.

Reading tasks took up to 12 minutes per task for a maximum of 24 minutes.


A new study from UBC Okanagan found that children who read with a dog appear more motivated and engaged with reading.

UBC handout /

PNG

Rousseau said that the findings showed that children spent significantly more time reading and showed more persistence when a dog was in the room as opposed to when they read without them.

For example, 41.2 per cent of the children chose to read the second part of the story when there was no dog compared with 70.6 per cent who chose to continue reading with a dog present. The study notes that the children who chose to continue reading when the therapy dog was not present were more likely to be the stronger readers in the sample group.

“In addition, the children reported feeling more interested and more competent,”  said Rousseau, in a UBC news release.

For most of the children in the study, reading with a therapy dog was a new experience.

Rousseau hopes the research could help to develop a gold standard for canine-assisted strategies for young kids struggling with reading.

“There have been studies that looked at the impact of therapy dogs on enhancing students’ reading abilities, but this was the first study that carefully selected and assigned challenging reading to children,” she said.

The study concludes that this type of program might be more relevant among young readers, children with a learning disability in reading, or struggling readers because they often engage with challenging reading tasks to learn to read.

The study was published in September in Anthrozoös, a multidisciplinary journal focusing on the interactions of people and animals.

It was conducted with Christine Tardif-Williams, a professor at Brock University’s department of child and youth studies.

ticrawford@postmedia.com

16Oct

HPV immunization program in B.C. cuts rates of pre-cancer in women: study

by admin


Dr. Gina Ogilvie


Francis Georgian / PNG

Rates of cervical pre-cancer in women have been cut by more than half in British Columbia and the province’s school immunization program for the human papillomavirus is being given credit for the results.

A study published in the Journal of Infectious Diseases says those who took part in the program to prevent the sexually transmitted infection had a 57 per cent reduction in incidence of pre-cancer cells compared to unvaccinated women.

The program has been in place in public schools for 12 years and the first groups of women who were vaccinated in Grade 6 entered into the cervix screening program, allowing researchers to compare outcomes with those who hadn’t been vaccinated.

Dr. Gina Ogilvie, a senior research adviser at B.C. Women’s Hospital, says the study adds to the growing body of evidence highlighting the positive impact of the vaccine.

HPV is common in both men and women.

It can be easily spread through sexual contact and while most HPV infections clear up on their own, some pre-cancerous lesions can develop into cancer if not treated.

The Canadian Partnership Against Cancer says HPV immunization is offered to children in all provinces and territories, generally between grades 4 and 7.

B.C. Health Minister Adrian Dix says the lower rates of pre-cancer shows the importance of having children immunized early.

“The dramatic success — pre-cancer rates dropping by over half, shows us the importance of having children immunized early to protect their lives,” he said in a statement on Wednesday.

HPV has been identified as the cause of almost all cervical cancers.

The province implemented a voluntary publicly funded school-based HPV immunization program in 2008.

Education Minister Rob Fleming said the study reinforces the importance of such school-based programs.

“The decline we are seeing in HPV-related cancer rates highlights how strong partnerships between school districts and health authorities can significantly improve the well-being of B.C. students.”

1Sep

Real benefits to stenting multiple blocked arteries, not just the one that caused a heart attack, study says

by admin

Unblocking additional plaque or cholesterol-clogged coronary arteries with stents after a heart attack — instead of just the one that caused the heart attack — leads to a reduction in the risk of dying or having another heart attack, a multinational study involving B.C. experts and patients shows.

Experts predict the “landmark” study will have immediate implications for heart attack patients as interventional cardiologists will now stent additional coronary arteries with significant narrowing (more than 70 per cent) instead of just the culprit artery that caused the heart attack. There are three major coronary arteries and when heart attack patients have one blocked artery, it is not unusual to see blockages in the others, referred to as multi-vessel coronary artery disease.

The study began in 2013 at hospitals in 31 countries, predominately in Europe and North America. It was published in the New England Journal of Medicine and was presented as a late-breaking session at the World Congress of Cardiology in France.

The COMPLETE study, as it is called, involved 4,041 patients (200 in Vancouver) who were followed for about three years. All patients got stents in the culprit arteries as an emergency rescue measure. But in one arm of the study, half were then released from the hospital and prescribed the usual post-angioplasty medications while in the other study arm, patients had their other blocked arteries stented in what is called complete revascularization, either at the same time as the heart attack causing culprit stenting or within 45 days.


Participants in the COMPLETE trial

Deaths from heart disease, further heart attacks or related to the medical procedure occurred in 179 patients (8.9 per cent) in the complete revascularization group, compared to 339 (16.7 per cent) of those who had only one stent put in.

After a median followup of three years, the risk of a second heart attack or death from heart disease occurred in 7.8 per cent of the patients who had complete revascularization while it was 10.5 per cent in those who got one stent.

“In the past, the gestalt was you do an immediate angioplasty to open the culprit blocked artery and then do less with the other ones, put patients on meds and monitor them instead of fixing the additional blockages at the same time or right after,” said Dr. David Wood, the Vancouver co-principal investigator and director of the Vancouver General Hospital Cardiac Catheterization Lab.

“But in this study, the results show that doing more stenting, even within the first 45 days after the heart attack, was beneficial. There was a 26 per cent reduction in the patients’ risk of dying or having another heart attack.”


Dr. David Wood and Dr. John Cairns at Vancouver General Hospital. The pair participated in the COMPLETE trial, focusing on the effect of stenting additional arteries of heart attack victiims. Photo: Arlen Redekop/Postmedia

Arlen Redekop /

PNG

Dr. Shamir Mehta, the principal investigator of the study led by McMaster University and Hamilton Health Sciences, said the data shows that there are benefits to clearing all the arteries and no major downside to the additional procedures.

“Given its large size, international scope and focus on patient-centred outcomes, the COMPLETE trial will change how doctors treat this condition and prevent many thousands of recurrent heart attacks globally every year,” said Mehta, an interventional cardiologist and a senior scientist at the Population Health Research Institute.

Dr. John Cairns, a Vancouver cardiologist who is the former dean of UBC medical school and a study collaborator said: “(Additional) blockages should be fixed in the first 45 days after a patient’s initial heart attack.”

Leslie Carey was one of the trial participants. In 2015, the Burnaby resident had a heart attack while riding a bus to work,

Carey’s chest pains were so severe that he got off the bus and called 911. Paramedics quickly attended to him in a nearby parking lot, whisking him off to VGH.

Life was stressful at the time but his health was pretty good, or so he thought.

“I didn’t have high blood pressure or diabetes but I was taking meds on and off for cholesterol,” said the 58-year old marine administrator for the Royal Vancouver Yacht Club.

Right after a coronary artery was stented, Carey said he felt so much better. His chest pain was gone. Since he was randomly assigned to the trial arm of patients who would get further treatment, he then had another stent inserted into another partly blocked artery. And months later, yet another stent was added so he now has three stents propping open his major coronary arteries.

“I’m fully wired now,” said Carey.

About 20,000 B.C. residents have diagnostic angiograms and angioplasties — usually with stents — each year and another 2,000 have open heart surgery, which is indicated for more serious cases and for patients with diseases like diabetes, according to a Cardiac Services B.C. provincial registry.


Leslie Carey had a heart attack while on a bus to work at Royal Vancouver Yacht Club and had three stents put in. Photo: Arlen Redekop/Postmedia

Arlen Redekop /

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Mehta said patients who had angioplasties were on the right medications to reduce their risk of a heart attack. No one should jump to the conclusion that the medications weren’t effective.

“We don’t know if the same benefit of angioplasty would be there if they were not on the medication. The angioplasty can be considered as an add-on to the medications to prevent further events.”

Mehta, Cairns and Wood agreed that doing more angioplasties on patients with heart attacks is not going to overburden the Canadian health care system. A future study may look at the economics of “front-loading” angioplasties and Cairns said he thinks there could be some cost efficiencies in addition to health benefits.

“We are well equipped in Canada to perform the additional procedures, particularly since the trial shows they can be done any time within 45 days of the index (first) heart attack,” said Mehta.

The median age of trial participants was about 62 and 80 per cent were male. Study authors said that is because more men have large heart attacks.  About 50 per cent of study participants had high blood pressure and 40 per cent were smokers. Just under 40 per cent had high cholesterol.

The study cost over $14 million; $3 million came from the Canadian Institutes of Health Research and just over $11 million from Boston Scientific and AstraZeneca. The companies had no role in trial design, analysis or manuscript writing, according to the authors.

pfayerman@postmedia.com

Twitter: @MedicineMatters

9Jul

Ballsy participants sought for Vancouver testicle study

by admin


Dr. Ryan Flannigan inside VGH’s Robert Ho research building in Vancouver. Dr. Flannigan is leading a study on a new way to treat scrotum pain. Photo: Arlen Redekop/Postmedia


Arlen Redekop / PNG

Males who suffer debilitating scrotal pain can now sign up for a new study using an old but reformulated numbing medication with lidocaine.

Nearly five per cent of males can suffer so much that mere walking can be painful if they have chronic pain in their testicles and scrotum, the latter of which are the sacs of skin surrounding the testicles.

Dr. Ryan Flannigan, a Vancouver General Hospital urologist who is the director of the male infertility and sexual medicine research program at the University of B.C., said that he has seen up to 100 men with chronic scrotum pain in the last six months alone. Some patients come from as far away as the Northwest Territories. But many men don’t bother to seek medical attention because, as Flannigan points out, males are generally more reluctant than women to go to doctors and more inclined to brush off medical concerns.

Flannigan, who specializes in testicular and penile abnormalities, said testicular pain is described by patients as either constant aching or episodes of sharp pain.

The scrotal pain condition occurs in a range of ages — from teenagers to men in their ’60s — but it most commonly affects those in their 20s and 30s, Flannigan said.

While conventional treatment has involved injecting a lidocaine anesthetic into the spermatic cord to help numb pain, it is temporary relief for only up to four hours. So in the new study, soon to enrol 20 patients, lidocaine will be reformulated into a polymer paste that is designed for a slow, more sustained release, over seven to 14 days.

The needlepoke through the skin at the top of the scrotum into the spermatic cord can be uncomfortable but Flannigan said he tells patients “it’s like a visit to the dentist when the freezing goes in.”


In a study that will soon enrol participants who suffer from severe scrotum pain, Dr. Ryan Flannigan will be injecting a newly formulated solution of a numbing agent designed to provide longer relief. Photo: Arlen Redekop/Postmedia

Arlen Redekop /

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The paste, developed by a UBC spinoff company called Sustained Therapeutics (which is funding the study), will be injected into tissues, not blood vessels. Flannigan said the polymer material will “naturally break down” as it is metabolized.

Besides lidocaine-based injections, other treatments that may be tried include anti-inflammatories, steroids, and sometimes even surgery to cut nerves that are transmitting the pain. Physiotherapy can also help when the pain originates in another area of the body and is referred to the testicles.

Preclinical trials in animals at UBC affirmed the safety and proof of concept behind the intervention. Now the goal of the Phase 1 trial in humans will be to determine a safe and effective dose.

Flannigan said common causes of the condition include a blow to the testicle area, a previous infection in the area, inflammation in the spermatic cord that stores and carries sperm, and nerves pinched during hernia repair or a previous vasectomy. Pain can also be caused by enlarged veins in the scrotum, cysts, or kidney stones. The cause remains unknown in nearly half of cases.

Flannigan said men from around B.C. — or even outside the province — will be considered for the trial. To register an interest, males should contact the clinical trials unit at the Vancouver Prostate Centre or call 604-875-5675.

pfayerman@postmedia.com

Twitter: @MedicineMatters

 

 

 

 




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10Jun

New drug helps extend survival rate of men with advanced prostate cancer: B.C. Cancer Agency study

by admin


Dr. Kim Ch, who led a clinical trial which found that over half of patients who used a new type of hormone-reducing medication saw a reduction in their risk of cancer progression and a 33% improvement in overall survival, in Vancouver BC., June 10, 2019.


NICK PROCAYLO / PNG

A new drug has helped reduce the risk of death by 33 per cent in men with prostate cancer that has spread, according to the results of an international trial led by the B.C. Cancer Agency’s Dr. Kim Chi.

The double-blind study on the androgen receptor inhibitor drug called apalutamide was conducted in 23 countries at 260 cancer centres. It involved 1,052 men whose median age was 68. The study was sponsored by Janssen, the drug company who makes apalutamide.

At two years, those taking the treatment drug in addition to their standard treatment had a 52 per cent lower risk of cancer spread or death.

The findings of the TITAN (Targeted Investigational Treatment Analysis of Novel Anti-androgen) trial which began in 2015 are published in the New England Journal of Medicine (NEJM). Results were also recently presented by Chi at the annual meeting of the American Society of Clinical Oncology.

Chi, an oncologist, said overall survival rate is only about five years once prostate cancer has spread beyond the prostate so new treatments are desperately needed. The percentage of patients who took the drug whose cancer did not spread was 68.2 per cent, but in the placebo group the proportion was 47.5 per cent. There was a 33 per cent reduction in the risk of death for those who took the drug.

After about two years, 82 per cent of men in the investigational drug group were alive compared to 74 per cent on placebo. Men in both groups also took standard male hormone deprivation therapy showing that combination therapy helps to improve survival. Male hormones (androgens) like testosterone feed prostate tumours and currently, men with metastatic cancer are put on hormone deprivation treatment that has been the standard of care for many decades. Apalutamide, also called Erleada, is said to more completely block male hormones.

Chi said the drug is “not toxic” and there were no significant differences in the proportion of study participants in the intervention or placebo groups who experienced side effects, but skin rashes were just over three times more common in the drug group.

The drug has already been approved in Canada for certain patients with hormone-resistant, non-metastatic cancer but Chi said now that it is showing benefit for patients whose cancer has spread, he expects the drug will be approved by Health Canada for those patients as well, perhaps later this year. After that approval, provinces will have to decide on whether to expand funding for the drug, which costs about $3,000 a month. Chi said he expects more Canadian patients will have access to it next year.

“This is a next generation, better-designed androgen inhibitor and we really need better drugs for those with metastatic prostate cancer,” Chi said.

“There’s a critical need to improve outcomes for these patients and this study suggests this treatment can prolong survival and delay the spread of the disease.”

Chi was also a co-author on another drug trial, the results of which were published in the same issue of the NEJM medical journal. The ENZAMET trial, as it was called, is on a drug called enzalutamide (Xtandi). The results of that trial were similarly favourable.

About 2,700 men will be newly diagnosed with prostate cancer in B.C. this year. More than 600 men will die from it. 

pfayerman@postmedia.com

Twitter: @MedicineMatters




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