scholarly journals Guidelines for the Use of Cannabinoid Compounds in Chronic Pain

2005 ◽  
Vol 10 (suppl a) ◽  
pp. 44A-46A ◽  
Author(s):  
AJ Clark ◽  
ME Lynch ◽  
M Ware ◽  
P Beaulieu ◽  
IJ McGilveray ◽  
...  

OBJECTIVE: To provide clinicians with guidelines for the use of cannabinoid compounds in the treatment of chronic pain.METHODS: Publications indexed from 1990 to 2005 in the National Library of Medicine Index Medicus were searched through PubMed. A consensus concerning these guidelines was achieved by the authors through review and discussion.RESULTS: There are few clinical trials, case reports or case series concerning the use of cannabinoid compounds in the treatment of chronic pain. There are no randomized clinical trials examining the use of herbal cannabis in the treatment of chronic pain.CONCLUSIONS: A practical approach to the treatment of chronic pain with cannabinoid compounds is presented. Specific suggestions about the off-label dosing of nabilone (Cesamet, Valeant Canada limitée/Limited) and dronabinol (Marinol, Solvay Pharma Inc, Canada) in the treatment of chronic pain are provided.

Author(s):  
Roberta Lopes de Castro Martinelli ◽  
Reinaldo Jordão Gusmão ◽  
María Paz Moya Daza ◽  
Irene Queiroz Marchesan ◽  
Giédre Berretin-Felix

This work aims to describe the profile of scientific production referring to ankyloglossia. For this an investigation was carried out by searching for scientific articles indexed in the electronic databases LILACS and PUBMED. For the bibliometric review, the data referring to the year of publication, type of study and level of evidence were examined and tabulated. The data were discussed on the quantitative and representative values optics. The first results allowed to analyzic 651 published studies were analyzed. Most of the research on tongue tie found correspond to descriptive studies and case series (49.31%), followed by case reports, in vitro research, in animals and literature review (24.27%), cohort and cases and controls (11.98%), specialist opinion (11.68%), randomized clinical trials (1.54%) and systematic reviews (1.22%). Few studies addressed complications during or after lingual frenulum release surgery. In conclusion Scientific production on ankyloglossia has shown an increasing increase in the last 28 years, with studies with evidence levels 1, 2 and 3 being published, whose main focus was the performance of surgery to release the lingual frenulum.


2017 ◽  
Vol 01 (04) ◽  
pp. E307-E311 ◽  
Author(s):  
Florin Gandor ◽  
Georg Ebersbach

AbstractDue to the changing legal status of medical cannabis and derivatives in numerous countries, this therapeutic option has moved into the field of public debate. Neurologists treating patients with idiopathic Parkinson’s disease are increasingly confronted with questions regarding cannabis as a treatment alternative, especially for levodopa-resistant Parkinson’s symptoms. A number of single case reports and case series suggested improvement of Parkinsonian symptoms after cannabinoid intake, but the small number of available randomized clinical trials failed to reproduce the extent of these findings. Only one trial found a reduction of levodopa-induced dyskinesia with cannabinoid treatment, the remaining three trials showed no effect on Parkinsonian symptoms. This article gives an overview on the effects of cannabis, and reviews experimental and clinical trials studying the effects of cannabinoids in idiopathic Parkinson’s disease.


Materials ◽  
2021 ◽  
Vol 14 (12) ◽  
pp. 3234
Author(s):  
Georgina González-Valls ◽  
Elisabet Roca-Millan ◽  
Juan Manuel Céspedes-Sánchez ◽  
Beatriz González-Navarro ◽  
Aina Torrejon-Moya ◽  
...  

To determine the marginal bone loss and the survival, success and failure rates of narrow dental implants, a systematic literature search was carried out in the MEDLINE (Pubmed), Cochrane, Scopus, and Scielo databases for articles published between 2010 and 2021. The exclusion criteria were: systematic reviews, case reports, expert opinions; animal studies; samples of less than 10 subjects; follow-up periods of less than 36 months; smokers of minimum 10 cigarettes/day; and articles about mini-implants for orthodontic anchorage. Meta-analyses were performed to assess marginal bone loss and implant survival, success, and failure rates. Fifteen studies were included: 7 clinical trials, 3 randomized clinical trials, 3 cohort studies, and 2 case series. The total number of subjects was 773, in whom 1245 implants were placed. The survival rate for the narrow diameter implants was 97%, the success rate 96.8%, and the failure rate 3%. Marginal bone loss was 0.821 mm. All these data were evaluated at 36 months. Based on the literature, it can be considered that there is sufficient evidence to consider small diameter implants a predictable treatment option. These show favorable survival and success rates and marginal bone loss. All of them are comparable to those of standard diameter dental implants.


2021 ◽  
Vol 87 ◽  
pp. 14-21
Author(s):  
Roger N. Haber ◽  
Nicole G. Dib

Darier disease (DD) is a rare type of inherited keratinizing disorder with no definitive therapeutic approach. The objective of this study is to provide a detailed literature review of all the available treatment modalities of Darier disease, including those that are both surgical and non surgical, to compare their efficacies and to propose a novel therapeutic approach. A complete search of the literature for all articles describing the different treatments of Darier disease, with no restrictions on patients’ ages, gender or nationalities, was performed with the use of PubMed. A total of 68 articles were included in the study: 3 prospective studies, 44 case reports/case series and 21 letters/correspondences/clinical images. The treatments described were topical, oral or physical. Retinoids (isotretinoin, tazarotene and adapalene) and fluorouracil were the two most effective topical treatments. Oral retinoids were the most effective oral therapy and were prescribed in the cases of generalized Darier disease. For localized and resistant skin lesions, physical therapies including surgical excision, dermabrasion and CO2 laser ablation were the first line choices. Limitations of this article include the inability to verify the accuracy of the published data, the relatively small sample size, the absence of randomized controlled clinical trials and possible unidentified confounding factors in various studies. In every therapeutic approach to Darier disease, consideration of patient comorbidities, disease distribution, severity and treatment accessibility is essential. Large and randomized clinical trials are necessary for the comparison of the efficacy and the safety of all the treatments of Darier disease and settling a consensus for management.


2021 ◽  
Vol 10 (4) ◽  
pp. 1-7
Author(s):  
Sadeq A. Al-Maweri ◽  
◽  
Rawan Alanazi ◽  
Mohammed Nasser Alhajj ◽  
Ammar Daer ◽  
...  

Background: Oral lichen planus (OLP) is a chronic inflam-matory disorder with a potential of malignant transformation. Despite the extensive research on the topic, the management of OLP is still quite challenging, with no definitive cure. Objective: The present systematic review assessed the efficacy of topical hyaluronic acid in the management of OLP. Material and Methods: A comprehensive search of PubMed, Scopus, Web of Science and Google Scholar was carried out by two independent investigators. All randomized clinical trials that compared the efficacy of hyaluronic acid with other interventions and/or placebo in the management of OLP and fulfilled the following criteria were included: 1) OLP diagnosis was confirmed clinically and histopathologically, 2) the study included systemically healthy patients aged 15 years and older, 3) a minimum sample size of 10, and 4) reporting the main outcomes including pain, erythema, and ulcer size. Case reports, case series, reviews, animal studies, uncontrolled trials were excluded. Results: Four clinical trials involving 234 patients were included. Two studies compared hyaluronic acid with a topical corticosteroid, and two studies compared it with placebo. Only one of the four included studies was at low risk of bias. Overall, topical hyaluronic acid showed good efficacy in alleviating the signs and symptoms of OLP. Two studies found hyaluronic acid significantly more effective in reducing pain and improving clinical signs of OLP compared to placebo. Compared to topical corticosteroids, one study reported comparable results; and one study found hyaluronic acid to be superior to triamcinolone in reducing pain but inferior to triamcinolone in improving the healing time. Conclusion: The limited available evidence suggests that hyaluronic acid may have some benefits in the management of OLP. Further well-designed studies with adequate follow-up periods are highly recommended.


Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1172
Author(s):  
Gregorio Paolo Milani ◽  
Marina Macchi ◽  
Anat Guz-Mark

Vitamin C is an essential nutrient that serves as antioxidant and plays a major role as co-factor and modulator of various pathways of the immune system. Its therapeutic effect during infections has been a matter of debate, with conflicting results in studies of respiratory infections and in critically ill patients. This comprehensive review aimed to summarize the current evidence regarding the use of vitamin C in the prevention or treatment of patients with SARS-CoV2 infection, based on available publications between January 2020 and February 2021. Overall, 21 publications were included in this review, consisting of case-reports and case-series, observational studies, and some clinical trials. In many of the publications, data were incomplete, and in most clinical trials the results are still pending. No studies regarding prevention of COVID-19 with vitamin C supplementation were found. Although some clinical observations reported improved medical condition of patients with COVID-19 treated with vitamin C, available data from controlled studies are scarce and inconclusive. Based on the theoretical background presented in this article, and some preliminary encouraging studies, the role of vitamin C in the treatment of patients with SARS-CoV-2 infection should be further investigated.


2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Monirah A. Albabtain ◽  
Yahya Alhebaishi ◽  
Ola Al-Yafi ◽  
Hatim Kheirallah ◽  
Adel Othman ◽  
...  

Abstract Background Rivaroxaban has been recently introduced for the management of non-valvular intra-cardiac thrombosis with variable results. We aimed to compare the results of the off-label use of rivaroxaban versus warfarin in the management of patients with left ventricle (LV) thrombus. This research is a retrospective study conducted on 63 patients who had LV thrombus from January to December 2016. We compared patients treated with warfarin (n=35) to patients who had rivaroxaban (n=28), and study outcomes were time to thrombus resolution, bleeding, stroke, and mortality. Results The median duration of treatment was 9.5 (25th-75th percentiles: 6-32.5) months for rivaroxaban and 14 (3-41) months for warfarin. Thrombus resolution occurred in 24 patients in the warfarin group (68.6%) and 20 patients in the rivaroxaban group (71.4%). The median time to resolution in the warfarin group was 9 (4-20) months and 3 (2-11.5) months in the rivaroxaban group. Thrombus resolution was significantly faster in patients on rivaroxaban (p= 0.019). Predictors of thrombus resolution were thrombus surface area (HR: 1.21; CI 95% (1.0-1.46); p= .048) and the use of rivaroxaban (HR: 1.92; CI 95% (1.01-3.65); p= 0.048). There was no difference in stroke, bleeding, and mortality between both groups. Conclusion Rivaroxaban was as effective and safe as warfarin in managing patients with left ventricle thrombus. Larger randomized clinical trials are recommended to confirm our findings.


1996 ◽  
Vol 30 (11) ◽  
pp. 1316-1322 ◽  
Author(s):  
Marcia L Buck

OBJECTIVE: TO provide a comprehensive review of warfarin use in infants and children, including recommendations for appropriate dosage and monitoring parameters. DATA SOURCES: A MEDLINE search (1966-1995) was used to identify pertinent English-language articles in the medical literature. The key search term was warfarin. Additional material was obtained from references cited in articles retrieved through MEDLINE. STUDY SELECTION: All articles involving children younger than 18 years were evaluated. In addition, articles on the pharmacokinetics and pharmacodynamics in adults, adverse effects, and drug interactions were included. DATA EXTRACTION: Material selected for review included clinical trials, case reports, and surveys of practice. DATA SYNTHESIS: Warfarin has been used as prophylactic therapy in children with prosthetic cardiac valves as well as for prevention of thromboembolic complications associated with autoimmune disorders and protein C or protein S deficiency. Warfarin also has been used to prevent embolization in children with deep-vein thrombosis or clots in central venous catheters. According to the literature, an initial dosage of 0.1 mg/kg/d should provide anticoagulation without significant adverse effects. As in adults, dosing should be adjusted to achieve a target international normalized ratio (INR). Although the target range in children is not well established, INR values of 1.5–3 are recommended for most patients. Higher values have been used in children with prosthetic cardiac valves and hereditary clotting disorders. CONCLUSIONS: Due to its infrequent use, there is limited information on the effects of warfarin in children. Basic guidelines for initiating and monitoring warfarin were developed by using data gathered from clinical trials, retrospective reviews, case series, and surveys of practice.


Antibiotics ◽  
2019 ◽  
Vol 8 (1) ◽  
pp. 30 ◽  
Author(s):  
Nicole Lounsbury ◽  
Mary Reeber ◽  
Georges Mina ◽  
Christiane Chbib

Objective: The objective of this review is to describe the outcomes of patients treated with ceftaroline in the non-Food and Drug Administration (FDA) approved indication of methicillin-resistant Staphylococcus aureus (MRSA) infections in both pediatric and adult populations. Data sources: A systematic overview was conducted by searching PubMed, Medline, and The Cochrane Library up to January 2019. Study selection and data extraction: All English-language clinical trials and case reports related to the efficacy of ceftaroline in new, not-yet-approved FDA indications in MRSA infections in pediatric or adult populations. Data synthesis: In the case of MRSA bacteremia (MRSAB) infections, three different randomized studies in pediatric patients showed effectiveness of ceftaroline. When used in the case of adult populations with MRSA bacteremia, a small trial of 16 patients showed 50% clinical success in patients with acute bacterial skin and skin structure infections versus 63% clinical success in patients with community-acquired bacterial pneumonia. Another case series of six refractory case reports showed 50% clinical success of ceftaroline in patients with MRSA. Conclusions: Although there are few case reports and limited data to date, ceftaroline fosamil should continue to be studied as an alternative therapy in MRSA infections in both pediatric and adult populations. Clinical success rates of ceftaroline were, in most cases, considered high when treating patients with MRSA infection. More clinical trials need to be studied. In the specific case of MRSA bacteremia, the treatment options remain few and ceftaroline should be extensively studied for the salvage treatment of MRSAB.


2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Daniel Sánchez-Cano ◽  
José Luis Callejas-Rubio ◽  
Ricardo Ruiz-Villaverde ◽  
Raquel Ríos-Fernández ◽  
Norberto Ortego-Centeno

Tumoral necrosis factorαplays a central role in both the inflammatory response and that of the immune system. Thus, its blockade with the so-called anti-TNF agents (infliximab, etanercept, adalimumab, certolizumab pegol, and golimumab) has turned into the most important tool in the management of a variety of disorders, such as rheumatoid arthritis, spondyloarthropatties, inflammatory bowel disease, and psoriasis. Nonetheless, theoretically, some other autoimmune disorders may benefit from these agents. Our aim is to review these off-label uses of anti-TNF blockers in three common conditions: Behçet’s disease, sarcoidosis, and noninfectious uveitis. Due to the insufficient number of adequate clinical trials and consequently to their lower prevalence compared to other immune disorders, this review is mainly based on case reports and case series.


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