Long-term medical cannabis use and risk factors for diversion: Report on physician's guidance and patients’ behaviour

2019 ◽  
Vol 18 (1) ◽  
pp. 18-23
Author(s):  
Sharon R. Sznitman ◽  
Victoria Goldberg ◽  
Hedva Sheinman-Yuffe ◽  
Yuval Zolotov ◽  
Ezequiel Flechter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cannabis Use ◽  
Medical Cannabis ◽  
Safety Practices ◽  
Face To Face ◽  
Safe Storage ◽  
Regular Manner ◽  
Key Aspects ◽  
The Relationship

AbstractObjectivesVarious jurisdictions have legalized cannabis for medical purposes. As with all psychoactive medications, medical cannabis carries a risk of diversion and accidental ingestion. These risks may be particularly high among long-term medical cannabis patients as safety practices may become less salient to patients once the treatment becomes part of everyday life. The current study examines whether patients who have used medical cannabis for longer periods differ from those who have used for shorter periods in terms of sociodemographic background and other key aspects of medical cannabis use. Furthermore, the study examines the relationship between length of medical cannabis treatment and risk factors related to storage and diversion. Finally, the study examines the extent to which oncologists provide information to their patients about safe storage and disposal.MethodsOne hundred twenty-one medical cannabis oncology patients were interviewed face-to-face and 55 oncologists participated in a survey about safe storage and disposal practices related to medical cannabis.ResultsLength of medical cannabis treatment was related to administration by smoking and using higher monthly dosages. In terms of risk for unsafe storage and diversion, length of medical cannabis was positively associated with using cannabis outside the home and having been asked to give away medical cannabis. Physicians did not report providing information to patients regarding safe storage and disposal practices in a regular manner.Significance of resultsResults suggest that there is an ongoing risk of unsafe storage and diversion over the course of medical cannabis treatment. Oncologists may need to give more consistent and continued training in safe storage and disposal practices, especially among long-term medical cannabis patients.

scholarly journals Association between physical exercise and stroke recurrence among first-ever ischemic stroke survivors

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lisha Hou ◽  
Mier Li ◽  
Ju Wang ◽  
Yawen Li ◽  
Qianwen Zheng ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Exercise Duration ◽  
Stroke Recurrence ◽  
Stroke Survivors ◽  
Face To Face ◽  
Baseline Information ◽  
Exercise Type ◽  
The Relationship

AbstractThe relationship between exercise and stroke recurrence is controversial. This study was designed to test whether an association exists between exercise and ischemic stroke recurrence in first-ever ischemic stroke survivors. Data were collected from January 2010 to June 2016. Baseline information was obtained during face-to-face interviews, and follow-up phone interviews were conducted every 3 months. Exercise type, frequency, intensity, and duration were recorded. Discrete-time survival analysis was used to determine the relationship between exercise and stroke recurrence. 760 first-ever ischemic stroke survivors who were able to exercise were enrolled. After adjusting for covariates, patients who exercised 3.5–7 h per week and more than 7 h per week had a lower relapse risk than patients who did not exercise (3.5–7: OR 0.415; > 7: OR 0.356). Moreover, if the fluctuation of exercise duration was over 4 h, the patients had a higher risk of stroke recurrence than those with variability of less than 2 h (OR 2.153, P = 0.013). Stroke survivors who engage in long-term regular mild exercise (more than 5 sessions per week and lasting on average 40 min per session) have a lower recurrence rate. Irregular exercise increases the risk of stroke recurrence.

scholarly journals Investigating Relationships Between Alcohol and Cannabis Use in an Online Survey of Cannabis Users: A Focus on Cannabinoid Content and Cannabis for Medical Purposes

2020 ◽  
Vol 11 ◽  
Author(s):  
Hollis C. Karoly ◽  
Raeghan L. Mueller ◽  
Chrysta C. Andrade ◽  
Kent E. Hutchison
Keyword(s):  
Alcohol Consumption ◽  
Survey Data ◽  
Online Survey ◽  
Medical Condition ◽  
Cannabis Use ◽  
Medical Cannabis ◽  
Drinking Frequency ◽  
The Relationship ◽  
Drinking Occasion

Cannabis is commonly used among people who drink alcohol, but findings are mixed regarding the direction of this relationship. The type of cannabis used [high-cannabidiol (CBD) vs. high-delta-9tetrahydrocannabinol (THC)] and motives for use (i.e., whether cannabis is used to treat a medical condition) may influence the relationship between cannabis and drinking. Specifically, CBD has shown preclinical promise in reducing alcohol consumption, and medical cannabis users report using cannabis to reduce drinking. This study leverages survey data from cannabis users who drink alcohol (N = 533). Respondents were categorized as using cannabis to treat (CTT) a medical condition or as individuals whose cannabis use is not intended to treat (NCTT) a medical condition and grouped based on the THC/CBD ratio of the flower or edible cannabis they typically use (e.g., “High-THC/CBD,” “Medium-THC/CBD” and “Low-THC/CBD”). The CTT group (n = 412) reported drinking significantly less frequently than the NCTT group (n = 121). Cannabinoid content of flower cannabis was associated with alcohol consumed on cannabis-use days, such that individuals in the High-THC/CBD group drink more on cannabis-use days compared to the Medium-THC/CBD group. Cannabinoid content of edible cannabis was associated with drinks per drinking occasion, such that the High-THC/CBD group consumed the most drinks and the Low-THC/CBD group consumed the fewest. For both edible and flower groupings, higher-THC/CBD cannabis was associated with more frequent co-use than lower-THC/CBD cannabis. Results suggest that whether someone uses cannabis to treat a medical condition may impact their drinking frequency, and the cannabinoid content in flower and edible cannabis impacts alcohol consumption.

scholarly journals The effects of cannabis use on salience attribution: a systematic review

2016 ◽  
Vol 30 (1) ◽  
pp. 43-57 ◽  
Author(s):  
Surapi Bhairavi Wijayendran ◽  
Aisling O’Neill ◽  
Sagnik Bhattacharyya
Keyword(s):  
Brain Regions ◽  
Cannabis Use ◽  
Cognitive Tasks ◽  
Indirect Measures ◽  
Neural Processes ◽  
Aberrant Salience ◽  
And Performance ◽  
The Relationship ◽  
Chronic Use

ObjectiveThe relationship between cannabis use and the onset of psychosis is well established. Aberrant salience processing is widely thought to underpin many of these symptoms. Literature explicitly investigating the relationship between aberrant salience processing and cannabis use is scarce; with those few studies finding that acute tetrahydrocannabinol (THC) administration (the main psychoactive component of cannabis) can result in abnormal salience processing in healthy cohorts, mirroring that observed in psychosis. Nevertheless, the extent of and mechanisms through which cannabis has a modulatory effect on aberrant salience, following both acute and chronic use, remain unclear.MethodsHere, we systematically review recent findings on the effects of cannabis use – either through acute THC administration or in chronic users – on brain regions associated with salience processing (through functional MRI data); and performance in cognitive tasks that could be used as either direct or indirect measures of salience processing. We identified 13 studies either directly or indirectly exploring salience processing. Three types of salience were identified and discussed – incentive/motivational, emotional/affective, and attentional salience.ResultsThe results demonstrated an impairment of immediate salience processing, following acute THC administration. Amongst the long-term cannabis users, normal salience performance appeared to be underpinned by abnormal neural processes.ConclusionsOverall, the lack of research specifically exploring the effects of cannabis use on salience processing, weaken any conclusions drawn. Additional research explicitly focussed on salience processing and cannabis use is required to advance our understanding of the neurocognitive mechanisms underlying the association between cannabis use and development of psychosis.

Coagulopathy on the first postoperative day predicting the long-term survival of traumatic brain injury patients

2020 ◽  
Author(s):  
Wenxing Cui ◽  
Shunnan Ge ◽  
Yingwu Shi ◽  
Xun Wu ◽  
Jianing Luo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Cox Regression ◽  
Term Survival ◽  
Long Term Survival ◽  
Cox Regression Analysis ◽  
Independent Risk Factors ◽  
The Relationship ◽  
Underlying Risk

Abstract Objective: The purpose of this study was to identify the relationship between coagulopathy during the perioperative period (before the operation and on the first day after the operation) and the long-term survival of TBI patients undergoing surgery, as well as to explore the predisposing risk factors that may cause perioperative coagulopathy.Methods: This retrospective study included 447 TBI patients who underwent surgery from January 1, 2015 to April 25, 2019. Clinical parameters, including patient demographic characteristics, biochemical tests, perioperative coagulation function tests (before the operation and on the first day after the operation) and intraoperative factors were collected. Log-rank univariate analysis and Cox regression models were conducted to assess the relationship between perioperative coagulopathy and the long-term survival of TBI patients. Furthermore, univariate and multivariate analyses were performed to identify the underlying risk factors for perioperative coagulopathy.Results: Multivariate Cox regression analysis identified age, AIS(head) = 5, GCS ≤ 8, systolic pressure at admission < 90 mmHg and postoperative coagulopathy (all P < 0.05) as independent risk factors for survival following TBI; we were the first to identify postoperative coagulopathy as an independent risk factor. According to multivariate logistic regression analysis, for the first time, abnormal ALT and RBC at admission, preoperative coagulopathy, infusion of colloidal solution > 1100 mL and intraoperative bleeding > 950 mL (all P < 0.005) were identified as independent risk factors for postoperative coagulation following surgery after TBI.Conclusions: Those who suffered from postoperative coagulopathy due to TBI had a higher hazard for poor prognosis than those who did not. Closer attention should be paid to postoperative coagulopathy and more emphasis should be placed on managing the underlying risk factors.

Relationship between magnetic resonance imaging findings and prognosis of intracranial tuberculosis

2021 ◽  
pp. 028418512110620
Author(s):  
Xuan Wu ◽  
Xiuhong Yang ◽  
Bo Wang ◽  
Nan Yin ◽  
Xiaohui Mao ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Risk Factors ◽  
Resonance Imaging ◽  
Short Term ◽  
Enhanced Mri ◽  
Cranial Mri ◽  
Independent Risk Factors ◽  
Long Term Prognosis ◽  
The Relationship

Background Intracranial tuberculosis (TB) is an intracranial infection caused by Mycobacterium tuberculosis. Magnetic resonance imaging (MRI), in particular enhanced MRI scan, has the ability to detect characteristic lesions of tuberculous meningitis or cerebral parenchymal TB. Purpose To analyze the relationship between MRI findings and prognosis of patients with intracranial TB. Material and Methods In this retrospective study, a total of 60 patients were confirmed with intracranial TB in the hospital from May 2019 to December 2020. All enrolled patients underwent TB-related laboratory examinations, cranial MRI, and contrast-enhanced MRI. Laboratory tests were analyzed and the relationship between clinical prognosis and cranial MRI features was evaluated. Results Of the 60 patients, 28 (46.67%) had disseminated TB complications, 20 (36.67%) had secondary TB complications, and the remaining 10 (16.66%) had lymphatic TB or spinal TB complications. Of the patients, 25 had good short-term prognosis and 35 had poor short-term prognosis; 44 patients had good long-term prognosis and 16 had poor long-term prognosis. The incidence of cerebral parenchymal tuberculomas on enhanced MRI was significantly higher in the group with good prognosis compared to that in the group with poor prognosis ( P < 0.05). Logistic analysis suggested that hydrocephalus (odds ratio [OR] = 0.057, 95% confidence interval [CI] = 0.003–0.444; P = 0.018) and cistern involvement (OR = 0.100, 95% CI = 0.011–0.581; P = 0.017) were independent risk factors for poor short-term prognosis. Conclusion MRI can display the pathological changes of intracranial TB in detail; hydrocephalus and cistern involvement were independent risk factors for poor short-term prognosis.

scholarly journals Pesticide Concentrations in Vacuum Dust from Farm Homes: Variation between Planting and Nonplanting Seasons

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Vijay Golla ◽  
Brian Curwin ◽  
Wayne Sanderson ◽  
Marcia Nishioka
Keyword(s):  
Risk Factors ◽  
Pesticide Contamination ◽  
Farm Families ◽  
Pesticide Exposures ◽  
Potential Sources ◽  
Exposure Levels ◽  
One Year ◽  
The Relationship ◽  
Planting Season

The hazards of chronic low-level pesticide exposures inside homes have received little attention. Research to date does not provide answers regarding the long-term potential bioavailability of pesticides in homes and its risk factors. The purpose of this study was to investigate pesticide levels in Iowa homes during one year and assess the relationship between exposure levels and potential sources of pesticide contamination. The study involved sampling surveys of the target pesticide atrazine among 32 farm families in a three-county area of Iowa during the planting season (April–June) and nonplanting season (November-December). Dust samples were collected, and information gathered through questionnaires to evaluate pesticide migration inside homes. This study found that dust in every farm home surveyed was contaminated with atrazine during both seasons and these concentrations significantly decreased by the nonplanting season. Pesticide amounts, acreage, and spraying time determined the presence and persistence of this herbicide inside farm homes.

OS 04-08 THE RELATIONSHIP BETWEEN CHILDHOOD RISK FACTORS AND LONG-TERM ARTERIAL STIFFNESS — A 26-YEAR FOLLOW-UP STUDY

2016 ◽  
Vol 34 (Supplement 1) ◽  
pp. e57
Author(s):  
Jianjun Mu ◽  
Chao Chu ◽  
Dan Wang ◽  
Tongshuai Guo ◽  
Yang Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Arterial Stiffness ◽  
Follow Up Study ◽  
Childhood Risk Factors ◽  
The Relationship

Does Relation Between Women’s Justification of Wife Beating and Intimate Partner Violence Differ in Context of Husband’s Controlling Attitudes in Nigeria?

2019 ◽  
Vol 41 (1) ◽  
pp. 85-108 ◽  
Author(s):  
Adegbenga M. Sunmola ◽  
Olusegun A. Mayungbo ◽  
Gregory A. Ashefor ◽  
Luqman A. Morakinyo
Keyword(s):  
Risk Factors ◽  
Partner Violence ◽  
Intimate Partner ◽  
Married Women ◽  
Wife Beating ◽  
Regression Analyses ◽  
Face To Face ◽  
Nationally Representative ◽  
Relationship Of ◽  
The Relationship

Controlling and domineering attitudes of husbands are risk factors for women’s experience of physical, sexual, and emotional violence in Nigeria. Other studies imply that husband’s attitudes may also influence the risk of women’s justification of wife beating. Consistently, it was hypothesized that husband’s controlling and domineering attitudes would influence the relationship between women’s justification of wife beating and the three types of violence experience. Participants were 19,360 nationally representative sample of married women in Nigeria. Data were collected through face-to-face interviews. Regression analyses were conducted to analyze the contributions of justification of wife beating and husband attitudes to the three types of women’s violence experience. Findings showed that women who justified wife beating experienced more physical, sexual, and emotional violence. The relationship of justification of wife beating still persisted with sexual and emotional violence in the context of husband’s controlling and domineering attitudes. Implications of study findings were discussed.

scholarly journals Cannabis Use and Prospective Long-Term Association with Anxiety: A Systematic Review and Meta-Analysis of Longitudinal Studies: Usage du cannabis et association prospective à long terme avec l’anxiété: une revue systématique et une méta-analyse d’études longitudinales

2020 ◽  
pp. 070674372095225
Author(s):  
Siqi Xue ◽  
M. Ishrat Husain ◽  
Haoyu Zhao ◽  
Arun V. Ravindran
Keyword(s):  
Anxiety Disorder ◽  
Longitudinal Studies ◽  
Depressive Disorders ◽  
Meta Analysis ◽  
Cannabis Use ◽  
Hand Search ◽  
Published Evidence ◽  
Increased Risk ◽  
The Relationship

Objectives: Cannabis use is proposed as a risk factor for psychosis and is associated with depressive disorders. However, the relationship between recreational cannabis use and its longitudinal implications on anxiety conditions is less studied. The aim of this investigation is to systematically evaluate published literature and perform a meta-analysis of the data. Methods: A systematic search was performed of MEDLINE, Embase, and PsychINFO from inception to May 31, 2020, in addition to a hand search. Longitudinal studies that evaluated the relationship of cannabis use and development of anxiety were included. Where applicable, adjusted odds ratios ( ORs) were extracted, pooled, and evaluated using random-effects meta-analysis. Results: After screening of unique abstracts ( n = 6835), the final evaluation included 24 studies, of which 10 reported ORs that were analyzed quantitatively. Cannabis use was significantly associated with increased odds of developing any anxiety conditions ( OR = 1.25; 95% CI, 1.01 to 1.54). Cannabis use was not significantly associated with developing generalized anxiety disorder, panic disorder, or social anxiety disorder. Review of studies not reporting OR revealed mixed results but are suggestive of a link between cannabis use and increased rates/severity of anxiety. Conclusions: Published evidence suggests that cannabis use is likely associated with increased risk of anxiety in the long term but variability of study designs precludes declaration of a causal relationship. Awareness of this association is of relevance for both clinical practice and mental health policy implementation.

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