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Reasons for Use and Perceived Effects of Medical Cannabis: A Cross-Sectional Statewide Survey. 使用医用大麻的原因和预期效果:一项全州范围的横断面调查。
Q1 Medicine Pub Date : 2024-07-30 eCollection Date: 2024-01-01 DOI: 10.1159/000540593
Ruba Sajdeya, Sebastian Jugl, Yan Wang, Juan G Perez, Sophie Maloney, Catalina Lopez-Quintero, Amie J Goodin, Almut G Winterstein, Robert L Cook
<p><strong>Introduction: </strong>Medical cannabis (MC) is available upon certification for one of several qualifying conditions in Florida, USA. Previous studies suggested that some people seek cannabis for medical conditions/symptoms beyond those legally permitted. However, data remain limited on patient motives for seeking MC and their experiences around its impact on their health. We aimed to compare reported qualifying conditions for MC certification with the most frequently self-reported reasons for using MC while assessing the alignment between the two and understanding the perceived impacts of MC on self-reported conditions and symptoms.</p><p><strong>Methods: </strong>We conducted a cross-sectional study using survey data from the Medical Marijuana and Me (M<sup>3</sup>) Data Bank of individuals receiving MC in Florida, USA, in 2022. Participants were recruited via convenience sampling from nine MC clinics/clinic networks across Florida and were asked to fill out an online survey. The study measures included sociodemographic variables, self-reported health conditions, self-reported main reasons for using MC, self-reported qualifying conditions for MC certification, and self-reported perceived impact of MC on health conditions. We cross-tabulated reported qualifying conditions and reasons for MC use and reported the perceived impact per condition.</p><p><strong>Results: </strong>A total of 632 participants completed the survey, of whom 396 (62.66%) were female and 471 (74.53%) were non-Hispanic white. The median (IQR) age was 45 (35, 58). The most frequently reported qualifying conditions were post-traumatic stress disorder (PTSD) (<i>n</i> = 187, 29.59%), a condition not on the qualifying conditions list (<i>n</i> = 175, 27.69%), medical conditions of the same kind/comparable to those listed (<i>n</i> = 140, 22.15%), and chronic nonmalignant pain (<i>n</i> = 62, 25.63%). The top ten most frequently reported reasons for using MC were anxiety (<i>n</i> = 383, 60.60%), chronic pain (<i>n</i> = 278, 43.99%), depression (<i>n</i> = 252, 39.87%), PTSD (<i>n</i> = 220, 34.81%), headaches/migraine (<i>n</i> = 134, 21.20%), fibromyalgia (<i>n</i> = 67, 10.60%), attention-deficit hyperactivity disorder (ADHD) (<i>n</i> = 59, 9.34%), bipolar disorder (<i>n</i> = 53, 8.39%), high blood pressure (<i>n</i> = 41, 6.49%), and cancer (<i>n</i> = 18,2.85%). Of respondents, 70-90% with each qualifying condition reported it as one of the main reasons for using MC. Most respondents reported improvement of anxiety (<i>n</i> = 430/451, 95.34%), depression (<i>n</i> = 381/392, 97.20%), chronic pain (<i>n</i> = 305/310, 98.39%), insomnia/sleeping problems (<i>n</i> = 225/295, 86.44%), PTSD (<i>n</i> = 247/270, 91.48%), headaches/migraine (<i>n</i> = 172/218, 78.90%), ADHD (<i>n</i> = 82/123, 66.67%), bipolar disorder (<i>n</i> = 79/89, 88.76%), and fibromyalgia (<i>n</i> = 77/82, 93.90%). Most respondents were unsure/reported no change in blood pressure (<i>n</i
简介:在美国佛罗里达州,医用大麻(Medical cannabis,MC)经认证可用于治疗几种符合条件的病症之一。之前的研究表明,一些人寻求大麻治疗的病症/症状超出了法律允许的范围。然而,有关患者寻求使用大麻的动机以及大麻对其健康的影响的数据仍然有限。我们的目的是将所报告的获得 MC 认证的合格条件与最常自我报告的使用 MC 的原因进行比较,同时评估两者之间的一致性,并了解 MC 对自我报告的病情和症状的影响:我们利用 "医用大麻与我"(M3)数据库中的调查数据,对 2022 年在美国佛罗里达州接受医用大麻治疗的个人进行了一项横断面研究。我们从佛罗里达州的九家医用大麻诊所/诊所网络中通过便利抽样的方式招募参与者,并要求他们填写一份在线调查问卷。研究措施包括社会人口变量、自我报告的健康状况、自我报告的使用 MC 的主要原因、自我报告的 MC 认证合格条件以及自我报告的 MC 对健康状况的影响。我们对所报告的合格条件和使用 MC 的原因进行了交叉分析,并报告了每种条件的可感知影响:共有 632 名参与者完成了调查,其中 396 人(62.66%)为女性,471 人(74.53%)为非西班牙裔白人。年龄中位数(IQR)为 45(35,58)。最常报告的合格病症是创伤后应激障碍(PTSD)(187 人,占 29.59%)、不在合格病症列表中的病症(175 人,占 27.69%)、与列表中病症相同/相似的病症(140 人,占 22.15%)和慢性非恶性疼痛(62 人,占 25.63%)。最常报告的使用 MC 的十大原因是焦虑(n = 383,60.60%)、慢性疼痛(n = 278,43.99%)、抑郁(n = 252,39.87%)、创伤后应激障碍(n = 220,34.81%)、头痛/偏头痛(n = 134,21.20%)、纤维肌痛(n = 67,10.60%)、注意力缺陷多动障碍(ADHD)(n = 59,9.34%)、双相情感障碍(n = 53,8.39%)、高血压(n = 41,6.49%)和癌症(n = 18,2.85%)。在受访者中,70%-90%的受访者表示,每种符合条件的疾病都是使用 MC 的主要原因之一。大多数受访者表示焦虑(430/451,95.34%)、抑郁(381/392,97.20%)、慢性疼痛(305/310,98.39%)、失眠/睡眠问题(225/295,86.44%)、创伤后应激障碍(n = 247/270,91.48%)、头痛/偏头痛(n = 172/218,78.90%)、多动症(n = 82/123,66.67%)、躁郁症(n = 79/89,88.76%)和纤维肌痛(n = 77/82,93.90%)。大多数受访者不确定/报告血压没有变化(n = 93/162,57.41%)。小部分受访者表示他们认为自己的病情恶化了:结论:大多数受访者的病情和自述的使用 MC 的原因是一致的。然而,在美国佛罗里达州,有相当一部分受访者寻求 MC 的目的是为了获得更广泛的治疗效果,而不是官方认可的合格病症。大多数患者都能感受到积极的疗效,包括那些疗效证据有限的患者。
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引用次数: 0
Medical Cannabis Prescription Practices and Quality of Life in Thai Patients: A Nationwide Prospective Observational Cohort Study 泰国患者的医用大麻处方实践与生活质量:一项全国性前瞻性观察队列研究
Q1 Medicine Pub Date : 2024-07-17 DOI: 10.1159/000540153
Pramote Stienrut, K. Pongpirul, P. Phutrakool, C. Savigamin, Pim Sermsaksasithorn, Ornpapha Chanhom, Panthakan Jeamjumrus, Pimlada Pongchaichanon, Preecha Nootim, Mala Soisamrong, A. Chuthaputti, K. Wanaratna, Tewan Thaneerat
Introduction: The legalization of cannabis in Thailand has renewed interest in its traditional medical use. This study aimed to explore the prescribing patterns of traditional practitioners and assess the impact of cannabis oil on patients’ quality of life, with a specific focus on comparing outcomes between cancer and non-cancer patients. Methods: We conducted a prospective observational cohort study across 30 sites in 21 Thai provinces to analyze the use of “Ganja Oil,” a cannabis extract in 10% coconut oil, prescribed for symptoms like pain, anorexia, and insomnia across a diverse patient group, including cancer and migraines. Quality of life was assessed using the Edmonton Symptom Assessment Scale (ESAS) and EQ-5D-5L at baseline, 1, 2, and 3 months. The study included a predefined subgroup analysis to compare the effects on cancer versus non-cancer patients. Data management was facilitated through Research Electronic Data Capture (REDCap), with statistical analysis performed using Stata/MP. Results: Among 21,284 participants, the mean age was 54.10 ± 15.32 years, with 52.49% being male. The baseline EQ-5D-5L index was 0.85 ± 0.24. Significant differences in EQ-5D-5L indices were seen between cancer patients (0.79 ± 0.32) and non-cancer patients (0.85 ± 0.23; p < 0.001). ESAS scores also differed significantly between these groups for all symptoms, except anxiety. The most frequent prescription of Ganja Oil was oral administration at bedtime (88.26%), with the predominant dosage being three drops daily, approximately 0.204 mg of tetrahydrocannabinol in total. Posttreatment, significant improvements were noted: the EQ-5D-5L index increased by 0.11 points (95% CI: 0.11, 0.11; p < 0.001) overall, 0.13 points (95% CI: 0.12, 0.14; p < 0.001) for cancer patients, and 0.11 points (95% CI: 0.10, 0.11; p < 0.001) for non-cancer patients. ESAS pain scores improved by −2.66 points (95% CI: −2.71, −2.61; p < 0.001) overall, −2.01 points (95% CI: −2.16, −1.87; p < 0.001) for cancer patients, and −2.75 points (95% CI: −2.80, −2.70; p < 0.001) for non-cancer patients, with similar significant improvements in other symptoms. Conclusion: Our study indicates potential benefits of Ganja Oil for improving quality of life among Thai patients, as a complementary treatment. These findings must be viewed in light of the study’s design limitations. Further controlled studies are essential to ascertain its efficacy and inform dosing guidelines.
导言:大麻在泰国的合法化重新激发了人们对其传统医学用途的兴趣。本研究旨在探索传统医师的处方模式,并评估大麻精油对患者生活质量的影响,尤其侧重于比较癌症和非癌症患者的治疗效果。研究方法我们在泰国 21 个府的 30 个地点开展了一项前瞻性观察性队列研究,分析了 "Ganja 油 "的使用情况。"Ganja 油 "是一种萃取自 10% 椰子油的大麻提取物,可用于治疗不同患者群体的疼痛、厌食和失眠等症状,包括癌症和偏头痛。在基线、1 个月、2 个月和 3 个月时,使用埃德蒙顿症状评估量表 (ESAS) 和 EQ-5D-5L 对生活质量进行评估。该研究包括一项预定义的亚组分析,以比较对癌症患者和非癌症患者的影响。数据管理通过研究电子数据采集 (REDCap) 进行,统计分析使用 Stata/MP 进行。结果在 21284 名参与者中,平均年龄为(54.10 ± 15.32)岁,男性占 52.49%。基线 EQ-5D-5L 指数为 0.85 ± 0.24。癌症患者(0.79 ± 0.32)和非癌症患者(0.85 ± 0.23;P < 0.001)的 EQ-5D-5L 指数存在显著差异。除焦虑外,这两组患者在所有症状方面的 ESAS 评分也存在显著差异。最常见的天麻油处方是睡前口服(88.26%),主要剂量是每天三滴,总计约 0.204 毫克四氢大麻酚。治疗后,效果明显改善:EQ-5D-5L 指数总体提高了 0.11 分(95% CI:0.11,0.11;p < 0.001),癌症患者提高了 0.13 分(95% CI:0.12,0.14;p < 0.001),非癌症患者提高了 0.11 分(95% CI:0.10,0.11;p < 0.001)。ESAS疼痛评分总体改善了-2.66分(95% CI:-2.71,-2.61;p < 0.001),癌症患者改善了-2.01分(95% CI:-2.16,-1.87;p < 0.001),非癌症患者改善了-2.75分(95% CI:-2.80,-2.70;p < 0.001),其他症状也有类似的显著改善。结论我们的研究表明,甘麻油作为一种辅助治疗方法,对改善泰国患者的生活质量具有潜在的益处。这些发现必须考虑到研究设计的局限性。必须进一步开展对照研究,以确定其疗效并提供剂量指南。
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引用次数: 0
Cannabinoid Awareness, Reporting Use to Health Care Providers, and Perceptions Regarding Safety - Pennsylvania, March 2023-April 2023. 大麻素认知、向医疗保健提供者报告使用情况以及对安全性的看法 - 宾夕法尼亚州,2023 年 3 月至 2023 年 4 月。
Q1 Medicine Pub Date : 2024-07-17 eCollection Date: 2024-01-01 DOI: 10.1159/000539956
Paul T Kocis, Daniel J Mallinson, Timothy J Servinsky

Introduction: With the continued societal and policy interest in cannabinoids, the Penn State Harrisburg Center for Survey Research (CSR) conducted a web survey (Cannabinoid Lion Poll) for adult-aged Pennsylvanians between March 6 and April 2, 2023.

Methods: The Lion Poll omnibus survey asked questions of adult-aged Pennsylvanians to assess awareness of cannabidiol (CBD) and products containing tetrahydrocannabinol (THC), including marijuana, the likelihood of reporting cannabinoid use to health care providers (HCPs), and perceptions regarding safety.

Results: Of these 1,045 respondents, 51.2% were female; 83.0% were white, non-Hispanic; and 48.6% and 27.5% were within the 35-64-year and 18-34-year age ranges, respectively. Of the respondents, 52.1% and 53.9% told their HCPs they took CBD or products containing THC, respectively. Alcohol was perceived by the large proportion of respondents as unsafe (47.3%), followed by products containing THC (25.2%), anxiety/depression medications (21.7%), CBD (16.1%), and over-the-counter (OTC) pain medications (8.1%). Most combinations were perceived to be unsafe when asked to consider the safety of taking them with other prescription medications. Again, alcohol was perceived to be unsafe by the largest proportion (77.4%), followed by anxiety/depression medications (43.2%), products containing THC (42.6%), CBD (33.4%), and then OTC pain medications (24.8%).

Conclusions: Adult-aged Pennsylvanians perceive CBD and THC containing products as safer than alcohol. There is considerable underreporting of cannabinoid use to HCPs, and therefore significant implications for patient safety. It remains vital that HCPs have open communications with their patients about cannabinoid use.

简介:随着社会和政策对大麻素的持续关注,宾夕法尼亚州立哈里斯堡调查研究中心(CSR)在 2023 年 3 月 6 日至 4 月 2 日期间对宾夕法尼亚州的成年居民进行了一项网络调查(大麻素狮子民意调查):Lion Poll 综合调查向宾夕法尼亚州的成年居民提出问题,以评估他们对大麻二酚 (CBD) 和含有四氢大麻酚 (THC) 的产品(包括大麻)的认识、向医疗保健提供者 (HCP) 报告大麻使用情况的可能性以及对安全性的看法:在 1,045 名受访者中,51.2% 为女性;83.0% 为非西班牙裔白人;年龄在 35-64 岁和 18-34 岁之间的受访者分别占 48.6% 和 27.5%。在受访者中,分别有 52.1% 和 53.9% 的人告诉他们的保健医生他们服用 CBD 或含有四氢大麻酚的产品。大部分受访者认为酒精不安全(47.3%),其次是含有 THC 的产品(25.2%)、焦虑/抑郁药物(21.7%)、CBD(16.1%)和非处方(OTC)止痛药(8.1%)。当被要求考虑与其他处方药一起服用的安全性时,大多数组合药物被认为是不安全的。同样,认为酒精不安全的比例最高(77.4%),其次是焦虑/抑郁药物(43.2%)、含有四氢大麻酚的产品(42.6%)、CBD(33.4%),然后是非处方药止痛药(24.8%):宾夕法尼亚州的成年人认为 CBD 和含 THC 的产品比酒精更安全。向保健医生报告大麻素使用情况的人数严重不足,因此对患者安全产生了重大影响。保健医生与患者就大麻素的使用进行坦诚交流仍然至关重要。
{"title":"Cannabinoid Awareness, Reporting Use to Health Care Providers, and Perceptions Regarding Safety - Pennsylvania, March 2023-April 2023.","authors":"Paul T Kocis, Daniel J Mallinson, Timothy J Servinsky","doi":"10.1159/000539956","DOIUrl":"10.1159/000539956","url":null,"abstract":"<p><strong>Introduction: </strong>With the continued societal and policy interest in cannabinoids, the Penn State Harrisburg Center for Survey Research (CSR) conducted a web survey (Cannabinoid Lion Poll) for adult-aged Pennsylvanians between March 6 and April 2, 2023.</p><p><strong>Methods: </strong>The Lion Poll omnibus survey asked questions of adult-aged Pennsylvanians to assess awareness of cannabidiol (CBD) and products containing tetrahydrocannabinol (THC), including marijuana, the likelihood of reporting cannabinoid use to health care providers (HCPs), and perceptions regarding safety.</p><p><strong>Results: </strong>Of these 1,045 respondents, 51.2% were female; 83.0% were white, non-Hispanic; and 48.6% and 27.5% were within the 35-64-year and 18-34-year age ranges, respectively. Of the respondents, 52.1% and 53.9% told their HCPs they took CBD or products containing THC, respectively. Alcohol was perceived by the large proportion of respondents as unsafe (47.3%), followed by products containing THC (25.2%), anxiety/depression medications (21.7%), CBD (16.1%), and over-the-counter (OTC) pain medications (8.1%). Most combinations were perceived to be unsafe when asked to consider the safety of taking them with other prescription medications. Again, alcohol was perceived to be unsafe by the largest proportion (77.4%), followed by anxiety/depression medications (43.2%), products containing THC (42.6%), CBD (33.4%), and then OTC pain medications (24.8%).</p><p><strong>Conclusions: </strong>Adult-aged Pennsylvanians perceive CBD and THC containing products as safer than alcohol. There is considerable underreporting of cannabinoid use to HCPs, and therefore significant implications for patient safety. It remains vital that HCPs have open communications with their patients about cannabinoid use.</p>","PeriodicalId":18415,"journal":{"name":"Medical Cannabis and Cannabinoids","volume":"7 1","pages":"119-124"},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11324245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141982694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Optimization of Trimming Techniques for Enhancing Cannabinoid and Terpene Content in Medical Cannabis Inflorescences. 优化修剪技术,提高医用大麻花序中的大麻素和萜烯含量。
Q1 Medicine Pub Date : 2024-06-27 eCollection Date: 2024-01-01 DOI: 10.1159/000539192
Nimrod Brikenstein, Matan Birenboim, David Kenigsbuch, Jakob A Shimshoni

Introduction: Cannabis sativa L. inflorescences are widely used in the medicinal field as treatments for a variety of symptoms and illnesses due to their unique phytochemicals such as cannabinoids and terpenes. Common postharvest procedures for cannabis inflorescence include trimming, followed by drying, curing, and subsequent storage. The postharvest trimming step, particularly its timing (pre- or post-drying) and the extent of trimming, is not optimally refined in terms of its impact on the cannabinoid and terpene content. In this study, our objective was to identify the optimal trimming conditions for a commercially available medicinal cannabis hybrid chemovar, with the goal of maximizing its cannabinoid and terpene content.

Methods: To achieve this, we investigated the effects of pre- versus post-drying trimming and evaluated the impact of mild versus aggressive trimming prior to drying on the cannabinoid and terpene profiles using liquid and gas chromatography.

Results: Our results indicated that pre-drying mild trimming yielded the highest cannabinoid concentration, possibly due to optimal balance between stress signals and precursor influx from the sugar leaves to the inflorescence. On the other, post-drying trimming yielded the highest terpene content.

Conclusion: Identifying the optimal trimming conditions that maximize both cannabinoid and terpene levels in cannabis is challenging. Therefore, growers face a decision in their trimming practices: to prioritize either enhanced cannabinoid content or increased aromatic terpene concentrations, as optimizing for both simultaneously appears to be difficult.

简介:大麻(Cannabis sativa L.)花序因其独特的植物化学物质(如大麻素和萜烯)而被广泛用于医药领域,治疗各种症状和疾病。大麻花序收获后的常见程序包括修剪、干燥、腌制和随后的储存。收获后的修剪步骤,尤其是修剪时间(干燥前或干燥后)和修剪程度,对大麻素和萜烯含量的影响尚未达到最佳水平。在这项研究中,我们的目标是确定一种市售药用大麻杂交化学品种的最佳修剪条件,以最大限度地提高其大麻素和萜烯含量:为此,我们研究了干燥前与干燥后修剪的效果,并使用液相和气相色谱法评估了干燥前轻度修剪与重度修剪对大麻素和萜烯含量的影响:结果:我们的研究结果表明,干燥前温和修剪产生的大麻素浓度最高,这可能是由于压力信号和前体从糖叶流入花序之间达到了最佳平衡。另一方面,干燥后修剪产生的萜烯含量最高:确定最佳修剪条件以最大限度地提高大麻中的大麻素和萜烯含量具有挑战性。因此,种植者在修剪方法上面临一个抉择:要么优先提高大麻素含量,要么优先提高芳香萜烯含量,因为要同时优化这两个方面似乎很难。
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引用次数: 0
Efficacy and Safety of Cannabis Transdermal Patch for Alleviating Psoriasis Symptoms: Protocol for a Randomized Controlled Trial (CanPatch). 大麻透皮贴片缓解牛皮癣症状的有效性和安全性:随机对照试验协议》(CanPatch)。
Q1 Medicine Pub Date : 2024-05-30 eCollection Date: 2024-01-01 DOI: 10.1159/000539492
Pim Sermsaksasithorn, Pravit Asawanonda, Phanupong Phutrakool, Thunnicha Ondee, Pajaree Chariyavilaskul, Sunchai Payungporn, Krit Pongpirul, Nattiya Hirankarn

Introduction: Current topical treatments for psoriasis offer limited efficacy and are associated with long-term adverse effects in a subset of patients, highlighting the need for new therapeutic options. Cannabidiol (CBD), a non-psychoactive cannabinoid derived from Cannabis sativa L., has shown potential in reversing psoriasis pathology through its action on skin receptors in preclinical studies. Given the promising properties of CBD, transdermal patches containing this compound represent a novel approach to psoriasis treatment. However, comprehensive data on their efficacy and safety remain scarce.

Methods: We outline a randomized, double-blind, placebo-controlled trial to assess the efficacy and safety of CBD transdermal patches with minimal tetrahydrocannabinol (THC) in 60 patients with mild to moderate plaque-type psoriasis at a university hospital in Thailand (n = 60). This study aims to evaluate the changes in the local psoriasis severity index (LPSI), itch score via a visual analog scale, and occurrence of adverse events on day 0, 30, 60, and 90 of the study. Additionally, we will examine the alteration in the skin, gut, and oral microbiome in a subset of participants to explore potential correlations with treatment outcomes. The primary outcome will focus on the difference in LPSI scores at the end of the study period, employing an intention-to-treat analysis. Multivariate logistic regression will be used to identify baseline clinical and microbiological predictors of treatment response.

Conclusion: This study aims to investigate the efficacy and safety of CBD transdermal patches in alleviating the symptoms of psoriasis. The results of this study may highlight a novel topical treatment option that reduces suffering in patients with psoriasis. We also designed to provide a holistic evaluation by considering both clinical outcomes and the underlying biological mechanisms, including the interaction with the human microbiome. Through this trial, we aim to contribute valuable insights into personalized psoriasis management strategies.

简介:目前治疗银屑病的外用疗法疗效有限,而且对部分患者有长期不良影响,因此需要新的治疗方案。大麻二酚(CBD)是从大麻(Cannabis sativa L.)中提取的一种非精神活性大麻素,在临床前研究中通过对皮肤受体的作用显示出逆转银屑病病理的潜力。鉴于 CBD 具有良好的特性,含有这种化合物的透皮贴剂是治疗牛皮癣的一种新方法。然而,有关其疗效和安全性的全面数据仍然很少:我们概述了一项随机、双盲、安慰剂对照试验,以评估含有极少量四氢大麻酚(THC)的 CBD 透皮贴剂对泰国一所大学医院的 60 名轻度至中度斑块型银屑病患者(n = 60)的疗效和安全性。本研究旨在评估局部银屑病严重程度指数(LPSI)的变化、通过视觉模拟量表进行的瘙痒评分以及研究第 0、30、60 和 90 天的不良反应发生情况。此外,我们还将检查一部分参与者的皮肤、肠道和口腔微生物组的变化,以探索与治疗结果的潜在关联。主要结果将侧重于研究结束时 LPSI 分数的差异,采用意向治疗分析法。多变量逻辑回归将用于确定治疗反应的基线临床和微生物预测因素:本研究旨在探讨 CBD 透皮贴剂在缓解银屑病症状方面的有效性和安全性。这项研究的结果可能会凸显一种新型的局部治疗方案,减轻银屑病患者的痛苦。我们还旨在通过考虑临床结果和潜在的生物机制(包括与人体微生物组的相互作用)来提供全面的评估。通过这项试验,我们希望为个性化银屑病管理策略提供有价值的见解。
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引用次数: 0
The Relationship between Muscarinic and Cannabinoid Receptors in Neuronal Excitability and Epilepsy: A Review. 神经元兴奋性与癫痫中的毒蕈碱受体和大麻素受体之间的关系:综述。
Q1 Medicine Pub Date : 2024-05-22 eCollection Date: 2024-01-01 DOI: 10.1159/000538297
Ryan Renaldo Hall, Damian Hugh Cohall

Background: Of the seventy million people who suffer from epilepsy, 40 percent of them become resistant to more than one antiepileptic medication and have a higher chance of death. While the classical definition of epilepsy was due to the imbalance between excitatory glutamatergic and inhibitory γ-aminobutyric acid (GABA)-ergic signalling, substantial evidence implicates muscarinic receptors in the regulation of neural excitability.

Summary: Cannabinoids have shown to reduce seizure activity and neuronal excitability in several epileptic models through the activation of muscarinic receptors with drugs which modulate their activity. Cannabinoids also have been effective in reducing antiepileptic activity in pharmaco-resistant individuals; however, the mechanism of its effects in temporal lobe epilepsy is not clear.

Key messages: This review seeks to elucidate the relationship between muscarinic and cannabinoid receptors in epilepsy and neural excitability.

背景:在七千万癫痫患者中,有 40% 的人对一种以上的抗癫痫药物产生抗药性,而且死亡的几率更高。虽然癫痫的经典定义是由于兴奋性谷氨酸能信号和抑制性γ-氨基丁酸(GABA)能信号之间的不平衡,但大量证据表明毒蕈碱受体与神经兴奋性的调节有关。摘要:大麻素通过使用调节毒蕈碱受体活性的药物激活毒蕈碱受体,在多个癫痫模型中减少了癫痫发作活动和神经元兴奋性。大麻素还能有效降低药物耐药性患者的抗癫痫活动;然而,大麻素对颞叶癫痫的作用机制尚不清楚:本综述旨在阐明癫痫中毒蕈碱受体和大麻素受体与神经兴奋性之间的关系。
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引用次数: 0
Cannabinoid Hyperemesis Syndrome: What Do We Know? 大麻亢进综合征:我们知道些什么?
Q1 Medicine Pub Date : 2024-05-03 DOI: 10.1159/000539182
Dionna Shine, A. Goodin
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引用次数: 0
Relief in Gastrointestinal Symptoms with Medical Marijuana Over 1 Year. 使用医用大麻缓解胃肠道症状超过 1 年。
Q1 Medicine Pub Date : 2024-04-16 eCollection Date: 2024-01-01 DOI: 10.1159/000538694
Matthew P Wallingford, Erin L Kelly, Allison Herens, Daniel Hanna, Emily Hajjar, Brooke Worster

Introduction: Subjective improvement in gastrointestinal (GI) symptoms was assessed among patients using medical marijuana (MMJ).

Methods: Participants completed surveys at 0 days, 30 days, 6 months, and 12 months with questions about the severity of their GI symptoms on a scale from 1 (mild) to 3 (severe).

Results: In each survey, participants reported a significant decrease in GI symptom severity when using MMJ versus when not using MMJ (p < 0.05). The most common self-reported side effects from using MMJ were increased appetite (12-21.4%), fatigue (6-16.7%), anxiety (4-11.9%), cough (4-11.9%), headache (6-7.9%), and dry mouth (4-7.1%).

Conclusion: In patients with chronic GI symptoms, MMJ may provide persistent symptom severity improvement. Limited product availability and mild to moderate side effects are factors to consider before trialing MMJ.

介绍:对使用医用大麻(MMJ)的患者胃肠道(GI)症状的主观改善情况进行评估:参试者分别在服药 0 天、30 天、6 个月和 12 个月时填写了调查问卷,调查内容为胃肠道症状的严重程度,评分标准从 1 分(轻微)到 3 分(严重):在每次调查中,参与者都报告说,使用 MMJ 与不使用 MMJ 相比,胃肠道症状的严重程度明显减轻(P < 0.05)。使用五味子大麻最常见的自我报告副作用是食欲增加(12-21.4%)、疲劳(6-16.7%)、焦虑(4-11.9%)、咳嗽(4-11.9%)、头痛(6-7.9%)和口干(4-7.1%):结论:对于有慢性消化道症状的患者,MMJ 可以持续改善症状的严重程度。有限的产品供应和轻度至中度的副作用是试用 MMJ 之前需要考虑的因素。
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引用次数: 0
Characteristics for Medical Cannabis Treatment Adherence Among Autistic Children and Their Families: A Mixed-Methods Analysis 自闭症儿童及其家庭坚持医用大麻治疗的特征:混合方法分析
Q1 Medicine Pub Date : 2024-04-16 DOI: 10.1159/000538901
Ayelet David, O. Stolar, M. Berkovitch, E. Kohn, Michal Waisman-Nitzan, Inbar Hartmann, Eynat Gal
IIntroduction. Medical cannabis treatment for autistic children has recently become popular, and studies have focused on examining the treatment’s effects on children’s symptom presentation, reported side effects, and dropout rates. However, no previous study has investigated the factors influencing adherence and dropout rates in cannabis treatment. Method. This explanatory sequential mixed-methods study explored these factors by examining the characteristics of 87 autistic children and their families and deepening parents’ perspectives and experiences of the 6-month CBD-rich cannabis treatment’s benefits and barriers. Results. We found this treatment to have a high (75%) adherence rate, relatively mild side effects, and substantial reported benefits for the children and families. However, this treatment was not free of barriers; the intake regime, some side effects, and in some cases, unrealistic parental expectations made adherence difficult for some families. Conclusion. Our results highlight the importance of providing professional guidance and knowledge to parents of autistic children, enhancing their understanding of the impact of CBD-rich cannabis treatment on their children and expected related challenges and coordinating realistic treatment expectations. We hope that addressing these important aspects will influence parents’ ability to adhere to and enjoy the benefits of cannabis treatment for their autistic children.
导言。针对自闭症儿童的医用大麻治疗近来很受欢迎,相关研究主要集中在研究这种治疗对儿童症状表现、报告的副作用和辍学率的影响。然而,此前还没有研究调查过影响大麻治疗依从性和辍学率的因素。研究方法。这项解释性顺序混合方法研究通过考察 87 名自闭症儿童及其家庭的特征来探索这些因素,并加深家长对 6 个月富含 CBD 的大麻治疗的益处和障碍的看法和体验。结果。我们发现这种治疗方法的坚持率很高(75%),副作用相对较小,而且儿童和家庭都表示受益匪浅。但是,这种治疗方法也并非没有障碍;摄入制度、一些副作用以及在某些情况下家长不切实际的期望都使一些家庭难以坚持治疗。结论我们的研究结果凸显了为自闭症儿童家长提供专业指导和知识的重要性,加深了他们对富含 CBD 的大麻治疗对其子女的影响和预期相关挑战的理解,并协调了现实的治疗期望。我们希望,解决这些重要方面的问题将影响家长坚持治疗自闭症儿童并从中获益的能力。
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引用次数: 0
The use of Tetrahydrocannabinol (THC) is associated with an increase in survival time in palliative cancer patients: A retrospective multi-center cohort study. 使用四氢大麻酚(THC)与延长姑息治疗癌症患者的生存时间有关:一项回顾性多中心队列研究。
Q1 Medicine Pub Date : 2024-03-14 DOI: 10.1159/000538311
Knud Gastmeier, Anne Gastmeier, Frank Schwab, Thomas Herdegen
Introduction: Tetrahydrocannabinol (THC) is often prescribed for ambulatory palliative patients to improve sleep quality and appetite and to reduce anxiety, stress, and pain. However, it is not known if THC has also an effect on the mortality of these patients. Method: The objective is the impact of THC on mortality of ambulatory palliative patients. For this purpose, data from the palliative treatment documentation from 5 ambulatory palliative care teams in Brandenburg, Germany were used for this analysis. Survival time was calculated for 3 groups of patients: 1) Without THC; 2) with THC in a low dosage (4.7 mg per day); and 3) THC in higher doses (>4.7 mg per day). The analysis was done for two cohorts of patients. Cohort 1: all patients with a survival time of at least 7 days after inclusion in specialized ambulatory palliative care (SAPC) and cohort 2: a sub-group of patients with a survival time between 7 and 100 days. Kaplan Meier curves were created, and multivariate analysis was done to investigate the impact of THC on mortality.Results: A total of 9419 patients with a survival time of at least 7 days after inclusion in SAPC were included in the analysis (cohort 1). 7085 among them had a survival time between 7 and 100 days (cohort 2). In both cohorts, survival time was significantly prolonged by THC, but only when the daily THC dose was above the median of 4.7 mg. Survival time was 15 days longer in cohort 2 (40 vs. 25 days), when more than 4.7 mg THC were prescribed per day.Conclusion: Use of THC is associated with a a significant increase in survival time in ambulatory palliative patients which survive longer than 7 days the initiation of THC prescription and which use of THC >4.7 mg/d.
简介四氢大麻酚(THC)经常被开给非卧床的姑息治疗患者,以改善睡眠质量和食欲,减轻焦虑、压力和疼痛。然而,四氢大麻酚是否对这些患者的死亡率也有影响尚不清楚。研究方法目的是研究 THC 对非卧床姑息治疗患者死亡率的影响。为此,本分析采用了德国勃兰登堡州 5 个非住院姑息治疗小组的姑息治疗记录数据。计算了三组患者的存活时间:1)不使用 THC;2)使用低剂量 THC(4.7 毫克/天);3)使用高剂量 THC(>4.7 毫克/天)。对两组患者进行了分析。队列 1:所有在接受专科门诊姑息治疗(SAPC)后存活时间至少为 7 天的患者;队列 2:存活时间在 7 天至 100 天之间的患者子群。研究人员绘制了卡普兰-梅耶尔曲线,并进行了多变量分析,以研究THC对死亡率的影响:共有 9419 名纳入 SAPC 后存活时间至少为 7 天的患者被纳入分析(队列 1)。其中 7085 名患者的存活时间在 7 至 100 天之间(队列 2)。在这两个组群中,四氢大麻酚都能显著延长存活时间,但只有当四氢大麻酚的日剂量高于中位数 4.7 毫克时才会出现这种情况。当每天处方的 THC 超过 4.7 毫克时,第二组患者的存活时间延长了 15 天(40 天对 25 天):使用 THC 可显著延长门诊姑息治疗患者的存活时间,这些患者在开具 THC 处方后的存活时间超过 7 天,且 THC 的使用量大于 4.7 毫克/天。
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引用次数: 0
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Medical Cannabis and Cannabinoids
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