Entries by Michelle Smith

Inhaled Marijuana and the Lung

Although vaping has recently increased as a mode of inhaling marijuana and has been associated with numerous and sometimes fatal cases of acute severe lung injury, smoking remains the most common method of inhaling marijuana and has been studied more extensively. Smoking marijuana has been shown to produce modest but significant short-term bronchodilation both in healthy subjects and in those with asthma. Long-term effects of habitual marijuana smoking include the following: (1) symptoms of chronic bronchitis (increased cough, sputum production, and wheezing); (2) modest effects on lung function in cross-sectional studies (no significant decrease in FEV1 but mild reductions in FEV1/forced vital capacity ratio, an increase in forced vital capacity and other lung volumes, reductions in specific airway conductance, and variable effects of maximal midexpiratory flow rates and diffusing capacity); and (3) variable effects on age-related decline in FEV1 in longitudinal studies. Most cohort and case-control studies have failed to show that marijuana smoking is a significant risk factor for lung cancer despite the presence of procarcinogenic components in marijuana smoke, although further study is warranted. The question whether marijuana smoking is associated with asthma is unclear and requires further investigation.

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A Case Series of the Role of Cannabis Based Medicine in the Palliative Care Setting

Complex refractory pain is highly prevalent in the palliative care setting. Opioid therapies play a pivotal role in pain management, but have an extensive side effect profile and frequently fail to provide sufficient relief, despite dose optimisation or concurrent use of standard adjuvant analgesics.(1) Therefore, identification of novel analgesics to alleviate pain would be very beneficial.(2)Currently, there is equipoise within the available clinical evidence of the efficacy and safety of cannabis-based medications in the management of pain.(3) This is a case series of three patients with complex pain, with inadequate pain relief with standard multimodal analgesia. Each of these patients were commenced on Sativex, an oromucosal spray composed of two cannabis extracts, delta-9- tetrahydrocannabinol and cannabidiol, and the dose was titrated until therapeutic benefit was
achieved. All three cases demonstrated a positive analgesic effect without any adverse symptoms.

A bibliometric analysis of the cannabis and cannabinoid research literature

Cannabis refers to a plant in the family Cannabaceae, which has been used medically, recreationally, and industrially. The last two decades, in particular, have seen a large increase in the volume of literature on this topic. The present bibliometric analysis aims to capture the characteristics of scholarly journal publications on the topic of cannabis and cannabinoid research.

Brain Anatomical Alterations in Young Cannabis Users: Is it All Hype? A Meta-Analysis of Structural Neuroimaging Studies

The last two decades have seen a dramatic shift in cannabis legislation around the world. Cannabis products are now widely available and commercial production and use of phytocannabinoid products is rapidly growing. However, this growth is outpacing the research needed to elucidate the therapeutic efficacy of the myriad of chemical compounds found primarily in the flower of the female cannabis plant. This lack of research and corresponding regulation has resulted in processing methods, products, and terminology that are variable and confusing for consumers.

The impact of extraction protocol on the chemical profile of cannabis extracts from a single cultivar

The last two decades have seen a dramatic shift in cannabis legislation around the world. Cannabis products are now widely available and commercial production and use of phytocannabinoid products is rapidly growing. However, this growth is outpacing the research needed to elucidate the therapeutic efficacy of the myriad of chemical compounds found primarily in the flower of the female cannabis plant. This lack of research and corresponding regulation has resulted in processing methods, products, and terminology that are variable and confusing for consumers.

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The Effectiveness and Safety of Medical Cannabis for Treating Cancer Related Symptoms in Oncology Patients

The use of medical cannabis (MC) to treat cancer-related symptoms is rising. However, there is a lack of long-term trials to assess the benefits and safety of MC treatment in this population. In this work, we followed up prospectively and longitudinally on the effectiveness and safety of MC treatment. Oncology patients reported on multiple symptoms before and after MC treatment initiation at one-, three-, and 6-month follow-ups. Oncologists reported on the patients’ disease characteristics. Intention-to-treat models were used to assess changes in outcomes from baseline. MC treatment was initiated by 324 patients and 212, 158 and 126 reported at follow-ups. Most outcome measures improved significantly during MC treatment for most patients (p < 0.005). Specifically, at 6 months, total cancer symptoms burden declined from baseline by a median of 18%, from 122 (82–157) at baseline to 89 (45–138) at endpoint (−18.98; 95%CI= −26.95 to −11.00; p < 0.001). Reported adverse effects were common but mostly non-serious and remained stable during MC treatment. The results of this study suggest that MC treatment is generally safe for oncology patients and can potentially reduce the burden of associated symptoms with no serious MC-related adverse effects.

Online information on medical cannabis is not always aligned with scientific evidence and may raise unrealistic expectations

There is a growing literature on the potential medical uses of Cannabis sativa and cannabinoid com- pounds. Although these have only been approved by regulatory agencies for a few indications, there is a hype about their possible benefits in a variety of conditions and a large market in the wellness industry. As in many cases patients search for information on cannabis products online, we have analyzed the information on medical cannabis avail- able on the Internet. Therefore, this study aims at assessing the quality of the information available online on medical cannabis.

Association of Mental Health Burden With Prenatal Cannabis Exposure From Childhood to Early Adolescence

Dramatic increases in cannabis use during pregnancy are alarming because of evidence that prenatal exposure may be associated with a host of adverse outcomes.1 We previously found that prenatal cannabis exposure (PCE) following maternal knowledge of pregnancy is associated with increased psychopathology during middle childhood using baseline data from the Adolescent Brain Cognitive Development (ABCD) study.2 Here, leveraging longitudinal ABCD study data (data release 4.0), we examined whether associations with psychopathology persist into early adolescence.

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The chemical composition of ethanolic extracts from six genotypes of medical cannabis (Cannabis sativa L.) and their selective cytotoxic activity

Cannabis (Cannabis sativa L.) for medical purposes has been legalized again in many countries in recent years. Currently, only two major cannabinoids (Δ9-THC and CBD) are considered in the legislation and medication, which is not sufficient in case of dried plant material or resulting extract. Other substances (mainly terpenes/terpenoids), or their specific combinations, could influence the resulting therapeutic effect for specific oncology diagnosis and specific patients. Six different genotypes (Conspiracy Kush, Jilly Bean, Jack Cleaner 2, Jack Skellington, Nordle and Nurse Jackie) were cultivated indoor at the Czech University of Life Sciences Prague. Ethanol extracts taken from the inflorescences were assayed for their content of main cannabinoids and terpenes/terpenoids. The extracts were used for in vitro cytotoxicity studies on hepatocarcinoma human cell lines Hep-G2 and colorectal carcinoma human cell lines Caco-2 and Ht-29.

Online information on medical cannabis is not always aligned with scientific evidence and may raise unrealistic expectations

There is a growing literature on the potential medical uses of Cannabis sativa and cannabinoid com- pounds. Although these have only been approved by regulatory agencies for a few indications, there is a hype about their possible benefits in a variety of conditions and a large market in the wellness industry. As in many cases patients search for information on cannabis products online, we have analyzed the information on medical cannabis avail- able on the Internet. Therefore, this study aims at assessing the quality of the information available online on medical cannabis.

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A Randomized Controlled Trial of Topical Cannabidiol for the Treatment of Thumb Basal Joint Arthritis

Since the passage of the Agricultural Improvement Act of 2018, hand surgeons have increasingly encountered patients seeking counseling on over-the-counter, topical cannabidiol (CBD) for the treatment of pain. To this end, we designed a human clinical trial to investigate the therapeutic potential of CBD for the treatment of pain associated with thumb basal joint arthritis.