Prospective analysis of safety and efficacy of medical cannabis in large unselected population of patients with cancer

e24099 Background: Medical cannabis (MC) emerged as an important complementary therapy in the context of oncological diseases. In 2019, the Brazilian Health Regulatory Agency (Anvisa) approved use of MC, which can be produced in the country and sold in pharmacies under medical prescription. Previous investigations have extensively correlated MC effectiveness, over management and support of symptoms caused by the disease and/ or its treatment. However, studies evaluating knowledge and patterns of MC use in oncology patients MC are lacking. In the present study, we assessed the perception of oncologists and palliative care physicians on MC as a complementary therapy for cancer patients, and their personal experiences in clinical practice in Brazil. Methods: In October 2020 an online survey was sent via e-mail by the Brazilian Society of Clinical Oncology and the National Academy of Palliative Care for physicians with expertise in oncology and/or palliative care. Outcomes measured included knowledge and opinions about MC, prescription experience and impressions about the Brazilian legislation. Data analysis was performed with descriptive statistics, comparison tests and the Poisson regression model with robust variance, using the IBM Statistical Package for the Social Sciences software, version 25. Results: A total of 124 physician participated in the study and, of those, 58.1% were oncologists, and 82.3% believed that MC has application as a complementary therapy in cancer. In contrast, only 52.4% of the participants felt comfortable recommending its use and only 15.3% have ever prescribed MC for their patients with cancer. Further, among those who have never prescribed, 71% have already referred patients to other professionals to prescribe, and 61% indicated lack of knowledge as the main factor for not prescribing. In addition, more than half of participants claimed not knowing Brazilian legislation regarding MC use. Nausea and vomiting were mentioned by 73.4% of physicians as the major indication for MC. Conclusions: Oncologists and palliative care physicians agree with the applicability of MC use for the management of symptoms related with or caused by cancer. However, our findings infer that factors such as lack of knowledge, legislation barriers and lack of robust scientific evidence, lead to its limited use among Brazilian oncologists and palliative care physicians.

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Blood albumin as a prognostic factor among unselected medically treated inpatients

Biomarkers in Medicine ◽

10.2217/bmm-2018-0465 ◽

2019 ◽

Vol 13 (13) ◽

pp. 1059-1069

Author(s):

Krzysztof Tojek ◽

Gabriel Kowalczyk ◽

Beata Czerniak ◽

Wioletta Banaś ◽

Beata Szukay ◽

...

Keyword(s):

Odds Ratio ◽

Lower Risk ◽

Prognostic Value ◽

Medical Documentation ◽

Hospital Death ◽

Prospective Analysis ◽

Ideal Bodyweight ◽

Unselected Population ◽

Diagnostic Power ◽

Blood Albumin

Aim: The aim of this study is to determine the prognostic value of blood albumin (BA) in an unselected population of inpatients. Materials & methods: We performed prospective analysis of the medical documentation of 7279 patients hospitalized between July 2014 and September 2017. Results: Individuals with BA ≥3.35 mg/dl had significantly lower risk of in-hospital death (odds ratio [OR]: 0.22; 95% CI: 0.19–0.27; p < 0.001) and 14-day readmission (OR: 0.64; 95% CI: 0.55–0.77; p < 0.0001). BA concentration was the strongest favorable factor predicting inpatient survival in a Cox hazard regression model (OR: 0.43; 95% CI: 0.36–0.50; p < 0.001), did not correlate with body mass index and actual-to-ideal bodyweight ratio and was strongly affected by numerous non-nutrient factors. Conclusion: BA concentration showed similar or better predictive and diagnostic power in relation to all-cause in-hospital mortality and 14-day readmission among inpatients than selected multifactorial scores.

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