scholarly journals Medical Cannabis in Children and Adolescents in Switzerland: a Retrospective Study

2021 ◽  
Author(s):  
Kathrin Zürcher ◽  
Carole Dupont ◽  
Peter Weber ◽  
Sebastian Grunt ◽  
Ilca Wilhelm ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Children And Adolescents ◽  
Chronic Conditions ◽  
Gastric Tube ◽  
Treatment Interruption ◽  
Medical Cannabis ◽  
Reported Data ◽  
Study Participants ◽  
Epidemiological Characteristics ◽  
To Receive

Abstract Background: Evidence on use and efficacy of medical cannabis for children is limited. We examined clinical and epidemiological characteristics of medical cannabis treatment and caregiver-reported effects in children and adolescents in Switzerland.Methods: We collected clinical data from children and adolescents (<18 years) who received Δ9-tetrahydrocannabinol (THC), cannabidiol (CBD), or a combination of the two between 2008 and 2019 in Switzerland. Results: Out of 205 contacted families, 90 agreed to participate. The median age at the first prescription was 11.5 years (interquartile range (IQR) 6-16), and 32 patients were female (36%). Fifty-one (57%) patients received CBD and 39 (43%) THC. Patients were more likely to receive THC therapy if one of the following symptoms or signs were present: spasticity, pain, lack of weight gain, vomiting, or nausea, whereas seizures were the dominant indication for CBD therapy. Improvements were reported in 59 (66%) study participants. The largest treatment effects were reported for pain, spasticity, and frequency of seizures in participants treated with THC, and for those treated with pure CBD, the frequency of seizures. However, 43% of caregivers reported treatment interruption, mainly because of lack of improvement (56%), side effects (46%), the need for a gastric tube (44%), and cost considerations (23%).Conclusions: The effects of medical cannabis in children and adolescents with chronic conditions are unknown, but the caregiver-reported data reported here may justify trials of medical cannabis with standardized concentrations of THC or CBD to assess its efficacy in the young.

scholarly journals Use and caregiver-reported efficacy of medical cannabis in children and adolescents in Switzerland

2021 ◽  
Author(s):  
Kathrin Zürcher ◽  
Carole Dupont ◽  
Peter Weber ◽  
Sebastian Grunt ◽  
Ilca Wilhelm ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Chronic Conditions ◽  
Real Life ◽  
Medical Cannabis ◽  
Prescription Practices ◽  
Seizure Disorders ◽  
Treatment Interruptions ◽  
Real Life Setting ◽  
Reported Data ◽  
Epidemiological Characteristics

AbstractEvidence on the use and efficacy of medical cannabis for children is limited. We examined clinical and epidemiological characteristics of medical cannabis treatment and caregiver-reported effects in children and adolescents in Switzerland. We collected clinical data from children and adolescents (< 18 years) who received Δ9-tetrahydrocannabinol (THC), cannabidiol (CBD), or a combination of the two between 2008 and 2019 in Switzerland. Out of 205 contacted families, 90 agreed to participate. The median age at the first prescription was 11.5 years (interquartile range (IQR) 6–16), and 32 patients were female (36%). Fifty-one (57%) patients received CBD only and 39 (43%) THC. Patients were more likely to receive THC therapy if one of the following symptoms or signs were present: spasticity, pain, lack of weight gain, vomiting, or nausea, whereas seizures were the dominant indication for CBD therapy. Improvements were reported in 59 (66%) study participants. The largest treatment effects were reported for pain, spasticity, and frequency of seizures in participants treated with THC, and for those treated with pure CBD, the frequency of seizures. However, 43% of caregivers reported treatment interruptions, mainly because of lack of improvement (56%), side effects (46%), the need for a gastric tube (44%), and cost considerations (23%).Conclusions: The effects of medical cannabis in children and adolescents with chronic conditions are unknown except for rare seizure disorders, but the caregiver-reported data analysed here may justify trials of medical cannabis with standardized concentrations of THC or CBD to assess its efficacy in the young. What is Known:• The use of medical cannabis (THC and CBD) to treat a variety of diseases among children and adolescents is increasing.• In contrast to adults, there is no evidence to support the use of medical cannabis to treat chronic pain and spasticity in children, but substantial evidence to support the use of CBD in children with rare seizure disorders. What is New:• This study provides important insights into prescription practices, dosages, and treatment outcomes in children and adolescents using medical cannabis data from a real-life setting.• The effects of medical cannabis in children and adolescents with chronic conditions shown in our study support trials of medical cannabis for chronic conditions.

Challenges in Antenatal Corticosteroid Prescribing: A Retrospective Study

2020 ◽  
Vol 16 (4) ◽  
pp. 327-333
Author(s):  
Shannon Armstrong-Kempter ◽  
Lucinda Beech ◽  
Sarah J. Melov ◽  
Adrienne Kirby ◽  
Roshini Nayyar
Keyword(s):  
Retrospective Study ◽  
Obstetric Care ◽  
Patient Characteristics ◽  
Tertiary Hospital ◽  
Optimal Timing ◽  
Prescribing Practices ◽  
Antenatal Corticosteroids ◽  
Term Infants ◽  
Preterm Premature Rupture ◽  
To Receive

Background: The discovery of the benefits of antenatal corticosteroids (ACS) for preterm infants was one of the most significant developments in obstetric care. However, due to the difficulty in predicting preterm delivery, optimal use of ACS, is challenging. Objective: To describe prescribing practices for antenatal corticosteroids (ACS) at a tertiary hospital over five years to determine whether ACS were received at optimal timing; to determine patient characteristics of women receiving ACS at optimal timing; to determine patient characteristics of those who did not receive ACS as indicated and to examine the trend in ACS prescribing over the study period. Methods: We performed a retrospective study of all deliveries from January 2011 to December 2015. The rates of ACS prescription for each group of women (preterm, late preterm, and term) were recorded and analysed. Results: A total of 65% of women who delivered before 34 weeks’ gestation received ACS. Of these women, 63% delivered within 7 days of receiving ACS. Women most likely to receive ACS with optimal timing were primiparous (relative risk [RR], 1.25 [CI, 1.08-1.45]), or women diagnosed with pre-eclampsia (RR, 1.34 [CI 1.10-1.63]), preterm premature rupture of membranes (RR, 1.33 [CI, 1.15-1.54]) or threatened preterm labour (RR, 1.42 [CI, 1.22-1.65]). Conclusion: A significant number of women and babies are exposed to ACS without commensurate benefit, and a significant number who deliver preterm do not receive ACS. The percentage of preterm and term infants receiving ACS should be determined to optimise service delivery.

scholarly journals Oxygen saturation improved with nitrate-based nutritional formula in patients with COVID-19

2021 ◽  
Vol 49 (4) ◽  
pp. 030006052110123
Author(s):  
Sergej M. Ostojic ◽  
Aleksandra Milovancev ◽  
Patrik Drid ◽  
Alexandros Nikolaidis
Keyword(s):  
Oxygen Saturation ◽  
Patient Reported Outcomes ◽  
Case Series ◽  
Potassium Nitrate ◽  
Open Label ◽  
Patient Reported ◽  
Baseline Values ◽  
Study Participants ◽  
To Receive ◽  
Test Result

In this open-label case series trial, we evaluated the effects of a nitrate-based nutritional formula on oxygen saturation (SpO2) and patient-reported outcomes in individuals with coronavirus disease 2019 (COVID-19). Five adult patients (three men and two women, age 39.6 ± 6.9 years) with a positive COVID-19 test result, breathing difficulties, and SpO2 ≤95%, who were free from other pulmonary and cardiovascular conditions, were recruited for this study. Participants were assigned to receive a multi-component nutritional formula (containing 1200 mg of potassium nitrate, 200 mg of magnesium, 50 mg of zinc, and 1000 mg of citric acid) every 4 hours during the 48-hour monitoring period. In all participants, SpO2 improved immediately after administration of the nutritional formula, from 1 to 7 percentage points (mean increase 3.6 ± 2.7 points; 95% confidence interval 0.3 to 7.0). SpO2 remained above baseline values throughout the monitoring interval, with values persisting over threshold values (>92%) for all patients and at each time point during the 48 hours. No patients reported any side effects of the intervention. These promising and rather unexpected results call for immediate, well-sampled, mechanistic randomized controlled trials to validate our findings.

scholarly journals Analysis of the etiologies of female infertility in Yunnan minority areas

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fen Zhang ◽  
Qing Feng ◽  
Linna Yang ◽  
Xuelian Liu ◽  
Lingyun Su ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Comparative Analysis ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Yunnan Province ◽  
Female Infertility ◽  
Individualized Treatment ◽  
Local Hospital ◽  
Intrauterine Adhesions ◽  
Epidemiological Characteristics

Abstract Background The present study aims to provide a comparative analysis of the etiologies of female infertility between Dehong, on the Yunnan Frontier, and Kunming. Methods A retrospective study, which included 941 infertile females in Kunming who were treated in the First People’s Hospital of Yunnan Province and infertile females who were treated in the local hospital in Dehong from January 2016 to November 2018, was conducted. A comparative analysis of the etiologies of infertility in the two regions was then carried out. Results In patients with primary infertility, ovulation disorder (15.03%) was the main cause of infertility in Kunming, and pelvic inflammatory disease (25.59%) was the main cause in Dehong. With regard to secondary infertility, although pelvic inflammatory disease was the main cause of infertility in both regions, the incidence of intrauterine adhesions in Kunming was significantly higher than in Dehong. Conclusions The etiology of infertility showed different epidemiological characteristics depending on the region, hence individualized treatment should be given accordingly

scholarly journals Subtle changes of the crystalline lens after cycloplegia: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cheng Dai ◽  
Meng Liu ◽  
Xiaodong Lv ◽  
Binzhong Li
Keyword(s):  
Retrospective Study ◽  
Children And Adolescents ◽  
Population Change ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Crystalline Lens ◽  
Equivalent Diameter ◽  
Crystalline Morphology ◽  
Significant Difference ◽  
Before And After

Abstract Background The purpose of this study was to evaluate the shape of the crystalline lens in terms of biometry and diopters before and after cycloplegia using the CASIA2 swept-source (SS) optical coherence tomography (OCT) system on the anterior segment. Methods This was a retrospective study. Children and adolescents (26 males and 29 females, aged 4–21 years) with simple ametropia were selected for optometry and CASIA2 imaging at 2 separate visits before and after cycloplegia. Diopter values were derived from the spherical power (S) obtained by optometry. Biometric parameters of the crystalline lens, including the anterior chamber depth (ACD), anterior and posterior curvature of the lens (ACL and PCL), lens thickness (LTH), lens decentration (LD), lens tilt (LT), and equivalent diameter of the lens (LED), were measured by the CASIA2 system. The differences in these parameters after compared with before cycloplegia were determined, and their relationships were analyzed. Results Fifty-five participants (106 eyes) were initially enrolled. There was a significant difference (P < 0.05) in the S (t=-7.026, P < 0.001), ACD (t=-8.796, P < 0.001), ACL (t=-13.263, P < 0.001) and LTH (t = 7.363, P < 0.001) after compared with before cycloplegia. The change in the PCL (t = 1.557, P = 0.122), LD (t = 0.876, P = 0.383), LT (t = 0.440, P = 0.661) and LED (t=-0.351, P = 0.726) was not statistically significant (P > 0.05). There was a significant (P < 0.05) correlation of the change in the S with that in the ACL (r = 0.466, P < 0.001), LTH (r=-0.592, P < 0.001), and LED (r = 0.223, P = 0.021) but not the PCL (r = 0.19, P = 0.051), LD (r=-0.048, P = 0.0628) or LT (r=-0.022, P = 0.822). Furthermore, the change in the ACD was closely related to the change in crystalline morphology. However, in children and adolescents, we found that the change in crystalline morphology was unrelated to age. Conclusions Changes in lens morphology after compared with before cycloplegia are mainly related to the ACL and LTH, but there is no difference in the PCL, LD, LT, or LED. In the adolescent population, change in the S is related to change in the ACL, LED and LTH. However, age is unrelated to the shape and tendency of the crystalline lens. Further research is required to determine whether the same conclusion applies to different age groups and different refractive states (myopia, hyperopia, emmetropia) .

scholarly journals Treatment of children and adolescents with hemangioma using propranolol: preliminary results from a retrospective study

2014 ◽  
Vol 132 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Juliana Costa Albuquerque ◽  
Rosane Aline Magalhaes ◽  
Jamille Araujo Felix ◽  
Maria Vilani Rodrigues Bastos ◽  
Juvenia Bezerra Fontenele ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Children And Adolescents ◽  
Previous Treatment ◽  
Capillary Hemangioma ◽  
Response To Treatment ◽  
Vascular Tumors ◽  
Lesion Volume ◽  
Chi Square ◽  
One Year ◽  
Almost All

CONTEXT AND OBJECTIVE: Hemangiomas are the commonest vascular tumors during childhood. In 2008, the effect of propranolol for treating capillary hemangiomas was demonstrated. Other similar results followed, showing that it rapidly reduces lesion volume. The objective here was to evaluate children and adolescents with hemangiomas that were treated with propranolol. DESIGN AND SETTING: Retrospective study, conducted in a children's hospital. METHODS : Patients aged 0-19 years with or without previous treatment, who were treated between January 2009 and December 2010, were included. The response was assessed by comparing the lesion appearance between the start of treatment and the last consultation. We considered partial or complete responses as the response to treatment. RESULTS : Sixty-nine patients with a median follow-up of 11 months (mean age: 31 months) were included. Of these, 58 patients were recently diagnosed and 11 had had previous treatment. A response (partial or complete) was seen in 60 patients (87%). Among the capillary hemangioma cases, responses were seen in 50 out of 53 (94%), while in other lesion types, it was 10 out of 16 (63%) (P = 0.3; chi-square). Responses in patients less than one year of age were seen in 37 out of 38 (97%), whereas in those over one year of age, in 23 out of 31 (74%) (P = 0.4; chi-square). Side effects were uncommon and mild. CONCLUSIONS: Propranolol seemed to be effective for treatment of hemangiomas in children and adolescents, and not just in the proliferative stage, with responses in almost all the patients.

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