International Report

Internal Medicine World ReportMarch 2005

International Report

Use of Marijuana Authorized in Selective Spanish Health Facilities

MADRID—Sixty pharmacies and 4 hospitals have been authorized to prescribe marijuana for medical treatment when other therapies have proven unsuccessful.

Physicians in Catalonia have been given the go-ahead to prescribe marijuana in capsules or as an infusion in an effort to help patients with 4 specific conditions: anorexia in patients with AIDS, nausea resulting from chemotherapy in patients with cancer, constant pain (including migraine) that has not responded to other treatments, and muscular problems in patients with multiple sclerosis. Approximately 150,000 patients are expected to benefit.

The new measure follows a proposal by Barcelona’s College of Pharmacists and is based a similar experiment in the Netherlands in 2004, which involved about 8000 patients.

UK General Physicians Blamed for Poor Cancer Survival Record

LONDON—The United Kingdom is at the bottom of a list of western European countries in terms of cancer survival, a new report shows.

The report, issued by the British Department of Health, noted that Wales, Scotland, and England have worse 5-year survival rates than Denmark, The Netherlands, Finland, France, Sweden, and Germany. The report maintained that general physicians are not “good enough” at detecting cancer symptoms and also noted that long delays for diagnostic scans and treatments, such as radiotherapy, are “putting lives at risk.”

In addition, a shortage of specialty cancer surgeons was identified as a major problem. For example, the report stated that although all prostate surgery should be performed by physicians who perform at least ³50 such operations each year, only 12 of 133 hospitals carried out >50 operations during a recent 12-month period.

Statistics released in 2003 based on 19 European countries showed that only former Eastern bloc states, such as Estonia, Slovenia, and Poland, fared worse than the United Kingdom in cancer survival, where roughly 25% of all deaths each year are due to cancer.

Listening to Jazz Can Help Insomniacs

TAIPEI—New data from a Taiwanese group suggest that listening to 45 minutes of jazz just before bedtime may benefit insomniacs, according to a study published in the Journal of Advanced Nursing (2005;49:234-244)

Hui-Ling Lai, PhD, of the Tzu Chi University, Taipei, and colleagues assigned 60 persons (aged 60-83 years) with documented sleep problems to 2 groups—one group listened to jazz for 45 minutes just before bedtime, and the other group was not given any form of sleep aid.

During the 3-week treatment period, the group that listened to jazz experienced physical changes that helped establish restful sleep, including reduced heart and breathing rates. Notably, their quality and length of time asleep improved by 35%.

New HIV Investigational Vaccine Trial to Begin

LAUSANNE, Switzerland, LONDON, United Kingdom—A phase 1 clinical trial of novel investigational vaccines consisting of DNA-HIV-C and NYVAC-HIV-C for the prevention of HIV infection was initiated in Lausanne and London in February 2005, according to the European Vaccine Effort against HIV/AIDS, which is sponsoring the trial. These vaccines are based on HIV subtype C, which is widespread in China, India, and sub-Saharan Africa, and constitutes >50% of new HIV infections worldwide. The trial will assess the safety and immunogenicity of the vaccines—in particular their ability to generate HIV-specific cell-mediated immune response to HIV.

PARIS—Japanese women who move to Paris are at risk of “Paris syndrome,” according to Hiroaki Ota, MD, a Paris-based Japanese psychiatrist who coined the term to describe the depression often encountered by many Japanese shortly after they move to Paris.

Dr Oka explained that the condition results from the clash between the Japanese idea of Paris and the reality of Paris life. Symptoms typically present after 3 months of living in Paris and frequently require hospitalization.

Dr Oka, who formerly practiced psychiatry at St. Anne’s, the city’s primary mental hospital, said patients typically report that they feel “intellectually ridiculed” by the French. He noted that this is especially difficult for the Japanese who are extremely sensitive, particularly Japanese women.

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