Entries by Michelle Smith

Confronting The Harms Caused By Racism In Perinatal Drug Testing

Today, you are the doctor in the well-baby nursery. As you walk from one hospital room to the next, talking with new parents, most of your patients are healthy. Your job is to ensure that rare but serious health problems don’t go undetected before these babies go home with their parents. As you walk by the nurses’ station, a nurse pulls you aside.

“The baby in room 7 is jittery,” she tells you. “And he just seems fussy. The resident had me check his blood sugar and calcium levels. Both were normal.”

You stand silent for an extra beat, waiting to see what else the nurse might say.

“Has anyone asked the mom how she thinks her baby is doing?” You say this because a parent’s perspective always matters.

“I don’t know,” the nurse offers.

“Thank you for letting me know your concerns. Let me go look at him.”

You knock, open the door, sit down beside this mother, and offer congratulations on the birth of her child. You ask if you can examine him.

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Therapeutic Potential of Minor Cannabinoids in Dermatological Diseases—A Synthetic Review

Dermatological diseases pose a significant burden on the quality of life of individuals and can be challenging to treat effectively. In this aspect, cannabinoids are gaining increasing importance due to their therapeutic potential in various disease entities including skin diseases. In this synthetic review, we comprehensively analyzed the existing literature in the field of potential dermatological applications of a lesser-known subgroup of cannabinoids, the so-called minor cannabinoids, such as cannabidivarin (CBDV), cannabidiforol (CBDP), cannabichromene (CBC), tetrahydrocannabivarin (THCV), cannabigerolic acid (CBGA), cannabigerol (CBG), cannabielsoin (CBE), cannabimovone (CBM) or cannabinol (CBN), while drawing attention to their unique pharmacological properties. We systematically searched the available databases for relevant studies and analyzed the data to provide an overview of current thematic knowledge.

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Dispensary personnel’s views and experiences regarding oncologic cannabis and the counsel they offer adults with cancer

A minority of oncologists feel qualified to advise adults with can- cer on issues pertaining to medicinal cannabis. Adults with cancer frequently ac- cess medicinal cannabis information from non-medical sources such as cannabis dispensaries. We explored dispensary personnel’s views and experiences regard- ing oncologic cannabis and the counsel they extend individuals with cancer. Methods: Snowball sampling in this qualitative study facilitated recruitment across 13 states (N = 26). Semi-structured phone interviews ceased with thematic saturation. A multi-stage thematic analysis combined inductive and deductive codes.

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Cannabis Extracts on Glioblastoma Cell Lines: Chemical Composition and Pharmacologic Insights

Glioblastoma multiforme (GBM), also called grade IV astrocytoma, is an aggressive, malignant brain tumor with a low treatment success rate, particularly in patients with immune checkpoint-active tumors. These types of tumors are associated with a 5-year survival rate of <3%. Targeted treatments specifically designed for GBM are urgently needed. The aim of this study was to evaluate the effects of chemovar-specific cannabis extractions (CSCEs) in patients with GBM using liquid chromatography-mass spectrometry (LC-MS).

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The potential for medicinal cannabis to help manage challenging behaviour in people with intellectual disability: A perspective review

Around 2% of the population have intellectual disabilities. Over one-third people with intellectual disabilities (PwID) present with ‘challenging behaviour’, which nosologically and diagnostically is an abstract concept. Challenging behaviour is influenced by a range of bio-psycho-social factors in a population, which is unable to suitably comprehend and/or communicate concerns. This predisposes to poor health and social outcomes. There is no evidence-based treatments for managing challenging behaviour. Cannabidiol (CBD) and tetrahydrocannabinol (THC) are being trialled for a range of disorders, which are over-represented in PwID and provoke challenging behaviours, such as severe epilepsy, spasticity, post-traumatic stress disorder, social phobia, pain, etc.

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FAAH inhibition ameliorates breast cancer in a murine model

Breast cancer is the leading cancer among females worldwide. Disease outcome depends on the hormonal status of the cancer and whether or not it is metastatic, but there is a need for more efficacious therapeutic strategies where first line treatment fails. In this study, Fatty Acid Amide Hydrolase (FAAH) inhibition and endocannabinoids were examined as therapeutic alternatives. FAAH is an integral membrane enzyme that hydrolyzes endocannabinoids, rendering them inactive, and FAAH inhibition is predicted to increase cancer cell death. To test this, breast cancer cells were probed for FAAH expression using Western blot analysis, treated with FAAH inhibitors, exogenous endocannabinoids, and combinations of the two treatments, and assessed for viability.

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Supporting gut health with medicinal cannabis in people with advanced cancer: potential benefits and challenges

The side effects of cancer therapy continue to cause significant health and cost burden to the patient, their friends and family, and governments. A major barrier in the way in which these side effects are managed is the highly siloed mentality that results in a fragmented approach to symptom control. Increasingly, it is appreciated that many symptoms are manifestations of common underlying pathobiology, with changes in the gastrointestinal environment a key driver for many symptom sequelae. Breakdown of the mucosal barrier (mucositis) is a common and early side effect of many anti-cancer agents, known to contribute (in part) to a range of highly burdensome symptoms such as diarrhoea, nausea, vomiting, infection, malnutrition, fatigue, depression, and insomnia. Here, we outline a rationale for how, based on its already documented effects on the gastrointestinal microenvironment, medicinal cannabis could be used to control mucositis and prevent the constellation of symptoms with which it is associated. We will provide a brief update on the current state of evidence on medicinal cannabis in cancer care and outline the potential benefits (and challenges) of using medicinal cannabis during active cancer therapy.

An overview of phytochemical constituents and pharmacological implications of Cannabis sativa L.

Cannabis sativa L. is an annual, dioecious, herbaceous, monotypic genus of blooming plants, synthetically rich in the natural constituents of complex compounds including terpenophenolic chemicals such as phytocannabinoids. Thus, cannabis is gaining a distinct fascination in the pharmaceutical research under its medicinal properties despite being prohibited in many countries. This study aims to provide overview of cannabis’s phytochemical and pharmacological qualities as well as its cannabinoids synthesis.

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Medical Cannabis Alleviates Chronic Neuropathic Pain Effectively and Sustainably without Severe Adverse Effect: A Retrospective Study on 99 Cases

Medical cannabis may provide a treatment option for chronic neuropathic pain. However, empirical disease-specific data are scarce. This is a retrospective observational study including 99 patients with chronic neuropathic pain. These patients received medical cannabis by means of inhaling dried flowers with tetrahydrocannabinol content of <12–22% at a maximal daily dose of 0.15–1 g. Up to six follow-ups were carried out at intervals of 4–6 weeks. Pain severity, sleep disturbance, general improvement, side effects, and therapy tolerance at the follow-up consultations were assessed in interviews and compared with the baseline data using non-parametric Wilcoxon signed-rank test.

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Long-term efficacy and adverse effects of cannabidiol in adjuvant treatment of drug-resistant epilepsy: a systematic review and meta-analysis

Epilepsy is one of the most common chronic brain diseases. Almost one-thirdof patients have drug-resistant epilepsy (DRE). Cannabidiol is being considered as a potential novel drug for treating DRE. To investigate long-term efficacy and safety of cannabidiol in treatment of DRE and the differences in cannabidiol treatment among patients with different characteristics.

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Medical Cannabis Alleviates Chronic Neuropathic Pain Effectively and Sustainably without Severe Adverse Effect: A Retrospective Study on 99 Cases

Medical cannabis may provide a treatment option for chronic neuropathic pain. However, empirical disease-specific data are scarce. This is a retrospective observational study including 99 patients with chronic neuropathic pain. These patients received medical cannabis by means of inhaling dried flowers with tetrahydrocannabinol content of <12–22% at a maximal daily dose of 0.15–1 g. Up to six follow-ups were carried out at intervals of 4–6 weeks. Pain severity, sleep disturbance, general improvement, side effects, and therapy tolerance at the follow-up consultations were assessed in interviews and compared with the baseline data using non-parametric Wilcoxon signed-rank test.

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A Functional Magnetic Resonance Imaging Open-Label Clinical Trial

Cannabis use is associated with brain functional changes in regions implicated in prominent neuroscientific theories of addiction. Emerging evidence suggests that cannabidiol (CBD) is neuroprotective and may reverse structural brain changes associated with prolonged heavy cannabis use. In this study, we examine how an ∼10-week exposure of CBD in cannabis users affected resting-state functional connectivity in brain regions functionally altered by cannabis use.