scholarly journals The impact of medical cannabis consumption on the oral flora and saliva

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247044
Author(s):  
George Habib ◽  
Doron Steinberg ◽  
Adel Jabbour

Objective To evaluate the effect of medical cannabis consumption on oral flora and saliva. Design A clinical prospective study, at the rheumatology clinic of the Nazareth Hospital in Nazareth, recruiting consecutively patients approved for medical cannabis, evaluating their saliva flow, pH and microbial load of Streptococcus mutans and Lactobacillus, prior to and under medical cannabis treatment. Methods Patients recently licensed for medical cannabis treatment, were recruited just prior to starting medical cannabis consumption (week 0), 1 and 4 weeks later, patients provided 5-minute time saliva samples, which were measured for their volume and pH, and cultured on a special microbial kit, evaluating the growth of Streptococcus mutans and Lactobacillus. Results Out of 16 patients enrolled, 14 were female and had fibromyalgia. The mean age of the patients was 52.8±12.9 years. The mean saliva flow at week 0, week 1 and week 4 were 5.38±3.36 ml/5-minutes, 6 (p = 0.769) and 5.45 (p = 0.391), respectively, and for saliva pH were 6.28, 5.94 (p = 0.51) and 5.5 (p = 0.07) respectively also. The mean Streptococcus mutans growth score at weeks 0, 1 and 4 was1.8±0.75, 1.6±0.83 (p = 0.234), and 2.4±0.84 (p = 0.058), respectively. The mean Lactobacilli growth score at weeks 0, 1 and 4 was 2.59±0.88, 3.1±0.69 (p = 0.033) and 3.3±0.67 (p = 0.025), respectively. Conclusions The results of this study show that medical cannabis consumption has no significant effect on saliva volume or pH, but it may be associated with changes in salivary levels of oral microbes such as Streptococcus mutans and Lactobacilli.

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
George Habib ◽  
Irit Avisar

Objective. To report on the habits of cannabis consumption among fibromyalgia patients in Israel. Patients and Methods. An Internet-based questionnaire was posted to three large fibromyalgia Facebook groups in our country. The questionnaire was anonymous and included demographic, clinical, and cannabis-related questions, including acquisition of a license for medical cannabis (MC) method and amount of cannabis consumption; need to buy cannabis beyond the medical allowance; effect of cannabis on pain, sleep, depression, and anxiety; adverse effects of cannabis; feelings of dependence on cannabis or other meds; the involvement of family members; tendency to drive after using cannabis; and employment and social disability status. Results. Of 2,705 people, 383 (14%) responded to the questionnaire, with a mean age of 42.2±14.2 years. Of the responders, 84% reported consuming cannabis, and 44% were licensed for MC. The mean amount per month of cannabis consumed was 31.4±16.3g, and 80% of cannabis consumers (CC) smoked pure cannabis or cannabis mixed with tobacco. Pain relief was reported by 94% of CC, while 93% reported improved sleep quality, 87% reported improvement in depression, and 62% reported improvement in anxiety. Of MC-licensed CC, 55% bought cannabis beyond the medical allowance on the black market. Adverse effects were reported by 12% of CC. Only 8% reported dependence on cannabis. Most CC (64%) worked either full- or part-time jobs, and 74% reported driving “as usual” under cannabis use. Conclusions. Cannabis consumption among fibromyalgia patients in our country is very common and is mostly not licensed. Nearly all CC reported favorable effects on pain and sleep, and few reported adverse effects or feeling of dependence on cannabis.


Children ◽  
2021 ◽  
Vol 8 (9) ◽  
pp. 800
Author(s):  
Pilar Alfageme-García ◽  
Julián Fernando Calderón-García ◽  
Alfonso Martínez-Nova ◽  
Sonia Hidalgo-Ruiz ◽  
Belinda Basilio-Fernández ◽  
...  

Background: Schoolchildren often spend a lot of time carrying a backpack with school equipment, which can be very heavy. The impact a backpack may have on the pronated feet of schoolchildren is unknown. Aims: The objective of this study was to evaluate the association of the backpack use on static foot posture in schoolchildren with a pronated foot posture over 36 months of follow-up. Methods: This observational longitudinal prospective study was based on a cohort of consecutive healthy schoolchildren with pronated feet from fifteen different schools in Plasencia (Spain). The following parameters were collected and measured in all children included in the study: sex, age, height, weight, body mass index, metatarsal formula, foot shape, type of shoes, and type of schoolbag (non-backpack and backpack). Static foot posture was determined by the mean of the foot posture index (FPI). The FPI was assessed again after 36 months. Results: A total of 112 participants used a backpack when going to school. Over the 36-month follow-up period, 76 schoolchildren who had a static pronated foot posture evolve a neutral foot posture. Univariate analysis showed that the schoolchildren using backpacks were at a greater risk of not developing neutral foot (odds ratio [OR]: 2.09; 95% CI: 1.08–4.09). The multivariate analysis provided similar results, where the schoolchildren using a backpack (adjusted OR [aOR]: 1.94; 95% CI: 1.02–3.82) had a significantly greater risk of not developing a neutral foot posture. Conclusions: A weak relationship was found between backpack use and schoolchildren aged from five to eleven years with static pronated feet not developing a neutral foot posture over a follow-up period of 36 months.


2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0006
Author(s):  
Ersin Kuyucu ◽  
Barış Gülenç ◽  
Mehmet Erdil ◽  
Yavuz Kocabey

Background: This study aimed to assess the arthroscopic treatment, one of the surgical treatment options, for early grade focal osteochondral lesions of the first MTP joint, and to determine the impact of the arthroscopic microdrill hole surgery on foot function and daily life in a patient group with failed conservative treatment. Materials-Methods: This prospective study reviewed 27 patients having hallux rigidus with osteochondral injury of the first MTP joint who were operated with first MTP joint arthroscopy. Six patients had Coughlin-Shurnas grade 4 hallux rigidus and were excluded from the study; 5 patients were excluded due to having an arthroscopic kissing lesion, and 3 patients were excluded for not having attended regular follow-up after third month. After excluding the above patients, the study was completed with 14 patients Results: The mean hallux vagus angle was 13.29⁰ (±1.93 SD) and the mean intermetatarsal angle was 9.14⁰ (±0.86 SD). Apart from joint arthroscopy, no soft tissue procedure and/or any procedure requiring osteotomy was intended in any patient. The median operative duration was 27.8 (19-56) minutes.The patients had mean preoperative VPS and AOFAS-Hallux scores of 8.14±0.86 SD and 48.64±4.27, respectively; the corresponding postoperative values of both scores were 1.86±0.66 SD and 87.00±3.70. Both VPS and AOFAS-Hallux scores changed significantly (p<0.01) Discussion: In this prospective study we explored the impact of arthroscopic microdrill hole surgery on foot functions and daily life activities in patients with focal osteochondral lesions of the first MTP joint. Our results indicated significant improvements in VAS and AOFAS scores with this treatment. The micro drill technique we applied in this study is based on the principle of opening 4-6-mm long tunnels to enable stem cells to migrate to the defected area and achieve cure by differentiation in full-thickness chondral injuries with exposed subchondral bone.In conclusion, arthroscopic microhole drill technique can be applied with impressive functional scores and without any complication in persons who failed conservative therapy for hallux rigidus with focal chordal injury, a common foot problem. There is a need for comparative studies with long follow-up period in this field.


2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Philippe Lucas ◽  
Susan Boyd ◽  
M.-J. Milloy ◽  
Zach Walsh

Abstract Background Despite repeated calls by medical associations to gather evidence on the harms and benefits of cannabis, there are ongoing methodological challenges to conducting observational and clinical studies on cannabis, including a high rate of patients that are lost to follow-up (LTFU). This study explores factors potentially associated with retention in a large prospective study of Canadian medical cannabis patients, with the goal of reducing the probability that patients will be lost to follow-up in future cannabis research. Methods The Tilray Observational Patient Study (TOPS) was a multi-site, prospective study assessing the impact of medical cannabis over 6 months in a broad population of authorized Canadian cannabis patients. The study took place from 2016 to 19, and we conducted a series of exploratory analyses including a Kaplan–Meier survival analysis and logistic regressions to assess the potential association between study retention and variables including patient characteristics, cannabis and prescription drug use, quality of life, and the legalization of non-medical cannabis. Results Overall, 1011 participants were included in this analysis, contributing 287 patient-years of data. Retention was 728 (72%) at 3 months, and 419 (41.4%) at 6 months. Our analyses found significantly lower adjusted odds of retention following legalization (AOR 0.28, 95% CI 0.18–0.41), and in patients that used prescription opioids at baseline (AOR 0.62, 95% CI 0.46–0.85), while increased odds of retention were found in patients with a higher baseline psychological score (AOR 1.43, 95% CI 1.08–1.90) or that used anti-seizure medications at baseline (AOR 1.91, 95% CI 1.30–2.81). Discussion TOPS provided a unique opportunity to examine patient characteristics and other variables that may be associated with retention in prospective medical cannabis studies. Our findings highlight some of the challenges of conducting medical cannabis research at a time when patients have a multitude of cannabis access options, including legal adult dispensaries and a robust illicit market. High LTFU rates can impact the validity of studies, and potentially lead to misestimations of the harms and benefits of medical cannabis use. Despite being a multi-site prospective study, this was a convenience sample, thereby limiting the generalizability of these findings. Additionally, data regarding the use of cannabis was self-reported by patients, so is subject to potential recall bias. Conclusion We found evidence that external policy changes that affect access to cannabis such as the legalization of non-medical adult use and patient characteristics associated with patient physical/psychological capacity can impact retention in prospective medical cannabis studies. Evidence-based strategies to reduce study burden on participants, such as minimizing in-person visits by providing digitized internet-based surveys and phone or telemedicine follow-up options as well as ensuring adequate participant compensation could improve retention. Additionally, policy-related changes aimed at improving access to medical cannabis, including increased cost-coverage and community-based distribution, could encourage patients to remain in the federal medical cannabis program and thereby reduce LTFU in associated studies.


2021 ◽  
Vol 42 (2) ◽  
pp. 117-122
Author(s):  
Thaweesub Chaikaew ◽  
◽  
Jaraspong Vuthiwong ◽  
Phitsanu Mahawong ◽  
◽  
...  

Objective: The negative consequences of enuresis in children can be far reaching and an understanding of the impact of these is essential for effective treatment by the clinician. Enuresis can be categorized into monosymptomatic nocturnal enuresis (MNE) and non-monosymptomatic nocturnal enuresis (NMNE). There have been several studies in treatment of MNE with lyophilizate desmopressin melt but very limited research into the efficacy of desmopressin melt in treating NMME. The objectives of this study were to measure the efficacy and side effects of desmopressin melt in treating children with NMNE. Materials and Methods: Children aged 6 to 18 years with NMNE who visited the outpatient department of pediatric urology were included in this prospective study. Any underlying diseases and lower urinary tract symptoms were corrected then their enuresis was treated with 120-240 mcg of desmopressin melt for 6-8 weeks. Outcomes were defined as complete response, partial response, and no-response as defined by the International Children’s Continence Society guidelines. Results: A total of 25 children with NMNE were included in the study. The results showed 44% complete response, 20% partial response, and 36% no-response. The mean volume of nocturnal enuresis decreased from 159.96 to 115.30 ml in the pre and post treatment periods, respectively (p = 0.012). The mean frequency of enuresis decreased from 4.36 to 2.84 days per week in pre and post treatment periods, respectively (p < 0.001). The mean whole night urine volume decreased from 373.39 to 292.37 ml in pre and post treatment periods (p = 0.061). There were no major side effects in the study. Conclusion: Desmopressin melt is effective and safe in treating NMNE in children. However, to add weight to the findings of this study further research with a larger number of patients should be considered in the near future.


2016 ◽  
Vol 50 (4) ◽  
pp. 635-641 ◽  
Author(s):  
Armando dos Santos Trettene ◽  
Cassiana Mendes Bertoncelo Fontes ◽  
Ana Paula Ribeiro Razera ◽  
Marcia Ribeiro Gomide

Abstract OBJECTIVES To assess the impact of promoting self-care in nursing workload and associate it to the variables: age, gender, socioeconomic status, education, marital status and number of children of caregivers. METHODS Prospective study with 31 children and their caregivers. Participants were assessed at two moments, 1st and 2nd hospitalization, the nursing workload was measured by the Nursing Activities Score (NAS). RESULTS The mean NAS in the 1st hospitalization was 60.9% and in the 2nd hospitalization was 41.6%, that is, 14.6 and 9.9 hours of nursing, respectively. The nursing workload on the first day of hospitalization was higher compared to the last day, both for the 1st (p<0.001) and for the 2nd hospitalization (p<0.001), and higher in the first (p<0.001) and in the last day (p=0.025) in the 1st hospitalization. Comparing the 1st hospitalization to the 2nd hospitalization, the first was higher (p<0.001), and NAS items related to the training of self-care was influenced (p<0.001). CONCLUSION The nursing workload associated to self-care promotion corresponded to 14.6 hours and was higher than determined by the existing legislation.


Author(s):  
Hannan Ebrahimi ◽  
Hadi Digaleh ◽  
Ahmad Pour-Rashidi ◽  
Vahid Kazemi ◽  
Azar Hadadi ◽  
...  

Abstract Introduction Coronavirus disease 2019 (COVID-19) is a devastating pandemic that may also affect the nervous system. One of its neurological manifestations is intracerebral hemorrhage (ICH). Data about pure spontaneous intraparenchymal hemorrhage related to COVID-19 is scarce. In this study, we present some patients with COVID-19 disease who also had spontaneous intraparenchymal hemorrhage along with a review of the literature. Methods This single-center prospective study was done among 2,862 patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) between March 1 and November 1, 2020. Out of 2,862 patients with SARS-CoV-2, 14 patients with neurological manifestations were assessed with a noncontrast brain computed tomography scan. Seven patients with spontaneous intraparenchymal hemorrhage were enrolled. Results All seven patients were male, with a mean age of 60.8 years old. Six patients (85.7%) only had minimal symptoms of COVID-19 without significant respiratory distress. The level of consciousness in two patients (28.5%) was less than eight, according to the Glasgow Coma Scale (GCS). Hypertension (71.4%) was the most common risk factor in their past medical history. The mean volume of hematoma was 41cc. Four patients died during hospitalization, and the others were discharged with a mean hospital stay of 42.6 days. All patients with GCS less than 11 died. Conclusion It concluded that ICH patients with COVID-19 are related to higher blood volume, cortical and subcortical location of hemorrhage, higher fatality rate, and younger age that is different to spontaneous ICH in general population. We recommend more specific neuroimaging in patients with COVID 19 such as brain magnetic resonance imaging concomitant with vascular studies in future. The impact of COVID-19 on mortality rate is not clear because of limited epidemiologic studies, but identifying the causal relationship between COVID-19 and ICH requires further clinical and laboratory studies.


2020 ◽  
Vol 14 (1) ◽  
pp. 482-488
Author(s):  
Sawsan Abdullah Alshahrani ◽  
Nawaf Abdulrahman Almufareh ◽  
Bandary Almarshady ◽  
Rasil Khaled Alotaibi ◽  
Wedad Saeed Al-Qahtani

Background: The current study has been conducted to estimate the impact of Catha Edulis Forsk (simply known as khat) on pH and saliva flow rate in teeth unaffected by caries among patients from Arab, Yemen, consuming the plant. The goal was to evaluate the relation of these indicators with gene manifestation of CHRM1 and CHRM3, which contributes to the regulation of saliva secretions. Methods: Overall, 60 respondents aged between 27 and 54 years were selected for the research. They were distributed among two groups, group I and group II, including 30 respondents equally. Group I incorporated respondents consuming no khat, having teeth caries, adequate saliva flow, and generally, healthy oral cavity. In turn, group II incorporated respondents consuming khat having caries-free teeth, inadequate saliva flow and relatively unhealthy oral cavity. Saliva samples were taken from all respondents. They were analyzed for indicators of flow rate as well as pH of saliva. Salivary gland biopsy specimens have also been taken. The whole RNA was allocated, cDNA synthesized and reinforced to estimate the gene manifestation of CHRM1 and CHRM3. Results: A considerable rise in the mean salivary flow rate along with a drastic decline in the mean salivary pH within caries-free teeth among the respondents consuming khat was observed during the study. The mRNA expressions CHRM1 and CHRM3 were significantly increased among participants consuming khat. Results were contrasted to the control group of patients not consuming khat. Conclusion: The characteristics of salivary flow rate, pH, and caries-free teeth have been related to the gene manifestations of CHRM1 and CHRM3 in respondents consuming khat.


1997 ◽  
Vol 161 ◽  
pp. 197-201 ◽  
Author(s):  
Duncan Steel

AbstractWhilst lithopanspermia depends upon massive impacts occurring at a speed above some limit, the intact delivery of organic chemicals or other volatiles to a planet requires the impact speed to be below some other limit such that a significant fraction of that material escapes destruction. Thus the two opposite ends of the impact speed distributions are the regions of interest in the bioastronomical context, whereas much modelling work on impacts delivers, or makes use of, only the mean speed. Here the probability distributions of impact speeds upon Mars are calculated for (i) the orbital distribution of known asteroids; and (ii) the expected distribution of near-parabolic cometary orbits. It is found that cometary impacts are far more likely to eject rocks from Mars (over 99 percent of the cometary impacts are at speeds above 20 km/sec, but at most 5 percent of the asteroidal impacts); paradoxically, the objects impacting at speeds low enough to make organic/volatile survival possible (the asteroids) are those which are depleted in such species.


Author(s):  
Julie L. Wambaugh ◽  
Lydia Kallhoff ◽  
Christina Nessler

Purpose This study was designed to examine the association of dosage and effects of Sound Production Treatment (SPT) for acquired apraxia of speech. Method Treatment logs and probe data from 20 speakers with apraxia of speech and aphasia were submitted to a retrospective analysis. The number of treatment sessions and teaching episodes was examined relative to (a) change in articulation accuracy above baseline performance, (b) mastery of production, and (c) maintenance. The impact of practice schedule (SPT-Blocked vs. SPT-Random) was also examined. Results The average number of treatment sessions conducted prior to change was 5.4 for SPT-Blocked and 3.9 for SPT-Random. The mean number of teaching episodes preceding change was 334 for SPT-Blocked and 179 for SPT-Random. Mastery occurred within an average of 13.7 sessions (1,252 teaching episodes) and 12.4 sessions (1,082 teaching episodes) for SPT-Blocked and SPT-Random, respectively. Comparisons of dosage metric values across practice schedules did not reveal substantial differences. Significant negative correlations were found between follow-up probe performance and the dosage metrics. Conclusions Only a few treatment sessions were needed to achieve initial positive changes in articulation, with mastery occurring within 12–14 sessions for the majority of participants. Earlier occurrence of change or mastery was associated with better follow-up performance. Supplemental Material https://doi.org/10.23641/asha.12592190


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