Cannabinoids for Symptom Management in Patients with Kidney Failure

2022 ◽  
pp. CJN.11560821
Author(s):  
Hayley Worth ◽  
Daniel O'Hara ◽  
Neeru Agarwal ◽  
David Collister ◽  
Frank Brennan ◽  
...  
Keyword(s):  
Kidney Failure ◽  
Cannabinoid Receptors ◽  
Treatment Options ◽  
Symptom Relief ◽  
Symptom Burden ◽  
Poor Quality ◽  
The Body ◽  
Wide Range ◽  
New Treatment

People with kidney failure can experience a range of symptoms that lead to suffering and poor quality of life. Available therapies are limited, and evidence for new treatment options is sparse, often resulting in incomplete relief of symptoms. There is growing interest in the potential for cannabinoids, including cannabidiol and tetrahydrocannabinol, to treat symptoms across a wide range of chronic diseases. As legal prohibitions are withdrawn or minimized in many jurisdictions, patients are increasingly able to access these agents. Cannabinoid receptors, CB1 and CB2, are widely expressed in the body, including within the nervous and immune systems, and exogenous cannabinoids can have anxiolytic, anti-emetic, analgesic and anti-inflammatory effects. Considering their known physiological actions and successful studies in other patient populations, cannabinoids may be viewed as potential therapies for a variety of common symptoms affecting those with kidney failure, including pruritus, nausea, insomnia, chronic neuropathic pain, anorexia, and restless legs syndrome. In this review, we summarize the pharmacology and pharmacokinetics of cannabinoids, along with what is known about the use of cannabinoids for symptom relief in those with kidney disease, and the evidence available concerning their role in management of common symptoms. Presently, while these agents show varying efficacy with a reasonable safety profile in other patient populations, evidence-based prescribing of cannabinoids for people with symptomatic kidney failure is not possible. Given the symptom burden experienced by individuals with kidney failure, there is an urgent need to understand the tolerability and safety of these agents in this population, which must ultimately be followed by robust, randomized controlled trials to determine if they are effective for symptom relief.

The Different of Quality of Life Between Patient with Kidney Failure Undergoing Hemodialysis and Continous Ambulatory Peritoneal Dialysis (CAPD)

2019 ◽  
Vol 8 (1) ◽  
pp. 28-33
Author(s):  
Sutrisno Sutrisno ◽  
Alfian Fawzi ◽  
Mayta Sari Dwianggimawati
Keyword(s):  
Quality Of Life ◽  
Peritoneal Dialysis ◽  
Research Design ◽  
Kidney Failure ◽  
Treatment Options ◽  
Chronic Kidney Failure ◽  
The Body ◽  
Main Function ◽  
Cross Sectional

Dialysis is a therapy that aims to remove waste and excess fluid from the body. This method replaces the main function of the kidney. Two types of dialysis are known, namely Peritoneal Dialysis and Hemodialysis. Patients with chronic kidney failure are faced with these two treatment options. Both types of dialysis therapy have a risk of complications during the treatment period that can affect the quality of life of patients. The purpose of this study was to determine the differences in dialysis methods of patients with chronic kidney failure with CAPD (continuous ambulatory peritoneal dialysis) and hemodialysis in terms of quality of life as a basis for palliative care. The research design uses a cross-sectional comparative analytical research design. The independent variable is the action of hemodialysis and CAPD. The dependent variable is quality of life. 

Immunotherapy and potential predictive biomarkers in the treatment of neuroendocrine neoplasia

2020 ◽  
Author(s):  
Guanghui Xu ◽  
Yuhao Wang ◽  
Hushan Zhang ◽  
Xueke She ◽  
Jianjun Yang
Keyword(s):  
Current Knowledge ◽  
Checkpoint Inhibitors ◽  
Treatment Options ◽  
Predictive Biomarkers ◽  
The Body ◽  
Low Grade ◽  
Ablative Therapies ◽  
Cancer Types ◽  
New Treatment ◽  
Well Differentiated

Neuroendocrine neoplasias (NENs) are a heterogeneous group of rare tumors scattered throughout the body. Surgery, locoregional or ablative therapies as well as maintenance treatments are applied in well-differentiated, low-grade NENs, whereas cytotoxic chemotherapy is usually applied in high-grade neuroendocrine carcinomas. However, treatment options for patients with advanced or metastatic NENs are limited. Immunotherapy has provided new treatment approaches for many cancer types, including neuroendocrine tumors, but predictive biomarkers of immune checkpoint inhibitors (ICIs) in the treatment of NENs have not been fully reported. By reviewing the literature and international congress abstracts, we summarize the current knowledge of ICIs, potential predicative biomarkers in the treatment of NENs, implications and efficacy of ICIs as well as biomarkers for NENs of gastroenteropancreatic system, lung NENs and Merkel cell carcinoma in clinical practice.

scholarly journals Polymer-Drug Conjugates as Nanotheranostic Agents

2021 ◽  
Vol 2 (1) ◽  
pp. 63-81
Author(s):  
Sajana Manandhar ◽  
Erica Sjöholm ◽  
Johan Bobacka ◽  
Jessica M. Rosenholm ◽  
Kuldeep K. Bansal
Keyword(s):  
Drug Delivery ◽  
Drug Release ◽  
Treatment Options ◽  
The Body ◽  
Drug Conjugates ◽  
Imaging Characteristics ◽  
Wide Range ◽  
Systemic Side Effects ◽  
Theranostic Agents ◽  
The Stability

Since the last decade, the polymer-drug conjugate (PDC) approach has emerged as one of the most promising drug-delivery technologies owing to several benefits like circumventing premature drug release, offering controlled and targeted drug delivery, improving the stability, safety, and kinetics of conjugated drugs, and so forth. In recent years, PDC technology has advanced with the objective to further enhance the treatment outcomes by integrating nanotechnology and multifunctional characteristics into these systems. One such development is the ability of PDCs to act as theranostic agents, permitting simultaneous diagnosis and treatment options. Theranostic nanocarriers offer the opportunity to track the distribution of PDCs within the body and help to localize the diseased site. This characteristic is of particular interest, especially among those therapeutic approaches where external stimuli are supposed to be applied for abrupt drug release at the target site for localized delivery to avoid systemic side effects (e.g., Visudyne®). Thus, with the help of this review article, we are presenting the most recent updates in the domain of PDCs as nanotheranostic agents. Different methodologies utilized to design PDCs along with imaging characteristics and their applicability in a wide range of diseases, have been summarized in this article.

scholarly journals Epigenetic Regulation of Cannabinoid-Mediated Attenuation of Inflammation and Its Impact on the Use of Cannabinoids to Treat Autoimmune Diseases

2021 ◽  
Vol 22 (14) ◽  
pp. 7302
Author(s):  
Bryan Latrell Holloman ◽  
Mitzi Nagarkatti ◽  
Prakash Nagarkatti
Keyword(s):  
Autoimmune Diseases ◽  
Chronic Inflammation ◽  
Cannabinoid Receptors ◽  
T Regulatory Cells ◽  
Neurological Diseases ◽  
Suppressor Cells ◽  
The Body ◽  
New Class ◽  
Wide Range ◽  
Clinical Disorders

Chronic inflammation is considered to be a silent killer because it is the underlying cause of a wide range of clinical disorders, from cardiovascular to neurological diseases, and from cancer to obesity. In addition, there are over 80 different types of debilitating autoimmune diseases for which there are no cure. Currently, the drugs that are available to suppress chronic inflammation are either ineffective or overtly suppress the inflammation, thereby causing increased susceptibility to infections and cancer. Thus, the development of a new class of drugs that can suppress chronic inflammation is imperative. Cannabinoids are a group of compounds produced in the body (endocannabinoids) or found in cannabis (phytocannabinoids) that act through cannabinoid receptors and various other receptors expressed widely in the brain and immune system. In the last decade, cannabinoids have been well established experimentally to mediate anti-inflammatory properties. Research has shown that they suppress inflammation through multiple pathways, including apoptosis and inducing immunosuppressive T regulatory cells (Tregs) and myeloid-derived suppressor cells (MDSCs). Interestingly, cannabinoids also mediate epigenetic alterations in genes that regulate inflammation. In the current review, we highlight how the epigenetic modulations caused by cannabinoids lead to the suppression of inflammation and help identify novel pathways that can be used to target autoimmune diseases.

Study of the main problems of delivery of orthopedic care in dentistry

2020 ◽  
pp. 47-53
Author(s):  
Valentina Sevagina ◽  
Sofiya Botsarova ◽  
Tatiyana Goncharova ◽  
Anastasiya Mikhlyaeva
Keyword(s):  
Dental Care ◽  
Dental Health ◽  
Poor Quality ◽  
The Body ◽  
Special Role ◽  
The Status ◽  
Quality Of Delivery ◽  
Orthopedic Care ◽  
Denture Treatment

The purpose of the article is to conduct a study of the main problems of delivery of orthopedic care in dentistry. It is known that dental health determines the overall health of the body. The comfort of life of the population depends on their condition, since damaged teeth negatively affect the state of the digestive system and respiratory organs. As for the aesthetics of the appearance, here teeth have a special role, since they are able to provide both proper speech and the necessary level of human sociability. Thus, improving the quality of delivery of medical care is an important task for the industry today. The problem of the availability of orthopedic dentists exists only in those areas of the region where there is no orthopedic care encounters at all, or orthopedic care encounters are carried out by part-time doctors. Accordingly, it can be said that municipal dental clinics are generally provided with the necessary personnel. In this regard, one can talk about the need to improve the quality of treatment of dental diseases in polyclinics, primarily in terms of orthopedic care for the population. However, today there are frequent cases of return visits for orthopedic care due to its poor-quality during initial treatment. And the doctor’s task during second denture treatment is to avoid mistakes made earlier and to provide competent and highquality orthopedic services. The author concludes that the results of a study of the work of orthopedic units of the region showed a steady growth of most indicators year by year, but a number of economic problems were found during the analysis of the profitability reserves of orthopedic dental care. So, it is necessary to create a unified system for calculating the financial plan for the correct assessment of the status of orthopedic dental care for the population, to analyze the quality indicators for subsidized denture treatment, to introduce the concept of “prosthesis working lifespan”, which will establish the reasons and justify the terms of the second denture treatment.

Usage of 3D Anthropometric Data in CAD/CAM Individual Measurement List

2015 ◽  
Vol 1117 ◽  
pp. 283-286
Author(s):  
Inga Dāboliņa ◽  
Ausma Viļumsone ◽  
Jānis Dāboliņš ◽  
Dana Beļakova
Keyword(s):  
The Body ◽  
Human Anatomy ◽  
Anthropometric Data ◽  
Individual Measurement ◽  
Data Usage ◽  
Scanning Device ◽  
Wide Range ◽  
Cad Cam ◽  
Speed Up

Computer aided designing software not only the possibility to speed up the process of putting a new model into production and improve the quality of the products, but also reduces material costs and labour intensity, ensuring an elastic change of the assortment. The designing of clothes includes a row of processes and one of the most time and labour consuming is constructing. A construction displays the layout (pattern) of the surface of the body (garment). As it depends on correct anthropometric data, it is very important to get ones right. The use of 3D surface scanning technologies to produce digitized representations of the human anatomy has the potential to help change the way a wide range of products are designed and produced. Every scanning device is equipped with optic (light) appliances to ensure non-contact measuring. Measurements acquired by 3D scanning device should be checked out for compliance with CAD systems for automatized pattern making procedure. The paper introduces the experiment with scanned data usage in CAD pattern making. The project aims to implement scanned data values in the CAD/CAM individual measurement list for acquiring individualized pattern blocks.

scholarly journals Does Conservative Kidney Management Offer a Quantity or Quality of Life Benefit Compared to Dialysis? A Systematic Review

2021 ◽  
Author(s):  
Buur Louise Engelbrecht ◽  
Madsen Jens Kristian ◽  
Eidemak Inge ◽  
Krarup Elizabeth ◽  
Lauridsen Thomas Guldager ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Treatment Options ◽  
Symptom Burden ◽  
Place Of Death ◽  
Cochrane Library ◽  
Elderly Individuals ◽  
Secondary Outcomes ◽  
The Cochrane Library

Abstract Background Patients with stage 5 chronic kidney disease (CKD5) collaborate with their clinicians when choosing their future treatment modality. Most elderly patients with CKD5 may only have two treatment options: dialysis or conservative kidney management (CKM). The objective of this systematic review was to investigate whether CKM offers a quantity or quality of life benefit compared to dialysis for some patients with CKD5.MethodsThe databases MEDLINE, EMBASE, the Cochrane Library, and CINAHL were systematically searched for studies comparing patients with CKD5 treated with CKM or dialysis. The primary outcomes were mortality and quality of life (QoL). Hospitalization, symptom burden, and place of death were secondary outcomes. For studies reporting hazard ratios, pooled values were calculated, and forest plots conducted.ResultsTwenty-four primary studies, all observational, were identified. All studies except one reported an increased mortality in patients treated with CKM (pooled hazard ratio 0.53, 95% confidence interval 0.41-0.69). For patients aged ≥ 80 years and for elderly individuals with comorbidities, results were ambiguous. In most studies, CKM seemed advantageous for QoL and secondary outcomes. Findings were limited by the heterogeneity of studies and biased outcomes favouring dialysis.ConclusionsIn general, patients with CKD5 live for a shorter time on CKM than on dialysis. In patients aged ≥ 80 years old, and in elderly individuals with comorbidities, the survival benefits of dialysis seem to be lost. Regarding QoL, symptom burden, hospitalization, and place of death, CKM may have advantages. Higher quality studies are needed to guide patients and clinicians in the decision-making process.

Treatment options for hypoplastic left heart syndrome: a mother's perspective

1995 ◽  
Vol 15 (3) ◽  
pp. 70-72 ◽  
Author(s):  
LT Swanson
Keyword(s):  
Treatment Options ◽  
Palliative Surgery ◽  
First Year ◽  
Success Rates ◽  
Choice Of Treatment ◽  
New Treatment ◽  
Attending Physician ◽  
Left Heart Syndrome ◽  
Made In

The congenital heart defect of HLHS is nearly uniformly fatal without intervention. As surgeons gain experience with the techniques the success rates are improving; more infants with HLHS are being offered hope for survival and quality of life. The critical nature of this diagnosis, the relatively new treatment options, and uncertainty of the surgical outcome impose tremendous stress on the parents. Choice of treatment is difficult and should be made in collaboration with the attending physician. Although the first year of my son's life was difficult, the past 5 years have been wonderful. He continues to thrive and enjoy most of the activities other 6-year-olds enjoy. In retrospect, palliative surgery was a good option for him. As both his mother and a cardiac nurse, I recognize that he may once again require surgical intervention, but I am encouraged that medical and surgical advances are being made for children with HLHS.

scholarly journals Determination of prioritization for maintenance of the upper structure of truss bridge

2019 ◽  
Vol 276 ◽  
pp. 01036 ◽  
Author(s):  
Heni Fitriani ◽  
M. Ade Surya Pratama ◽  
Yakni Idris ◽  
Gunawan Tanzil
Keyword(s):  
Poor Quality ◽  
Truss Bridges ◽  
Vehicle Load ◽  
Bridge Maintenance ◽  
Wide Range ◽  
Maintenance Systems ◽  
Truss Bridge ◽  
Hierarchy Process

Bridge maintenance is one of the major issues of infrastructure problems. Deterioration of a bridge’s structure will continuously increase without proper maintenance. This condition will adversely affect the service life of a bridge. Moreover, the damage will also have a direct impact on structural and functional failure of the bridge. This paper aims at identifying the damages of truss bridges and determining the most significant criteria and sub-criteria used in prioritizing bridge maintenance. Analytical Hierarchy Process (AHP) was used to assess the most important criteria that give significant weight to bridge maintenance analysis. The objects of research were nine truss bridges with a wide range of types and levels of damage. It was found that there were approximately 900 m' of components damaged at the railing of Baruga Bridge and 227 m' truss damages due to poor quality of the galvanized paint. Furthermore, based on the analysis, the most significant criteria were the level of damage (27.6%), the technical aspects (25.7%), the finance (21%), the vehicle load (13.6%) and the resources (12%). The results of this research showed important findings in determining the priority scales for bridge repair and maintenance systems.

New Novel Treatment Approaches for Heart Failure With Reduced Ejection Fraction

2016 ◽  
Vol 30 (5) ◽  
pp. 541-548
Author(s):  
Shreya Patel ◽  
Keith Veltri
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Hospital Readmission ◽  
Treatment Options ◽  
Poor Quality ◽  
Pharmacological Agents ◽  
Reduced Ejection Fraction ◽  
New Novel ◽  
Novel Treatment

Despite availability of standardized drug therapies with proven beneficial outcomes, heart failure is associated with poor quality of life, increased hospital readmission, and high mortality rate. In the recent years, comprehensive understanding of the pathophysiological mechanisms of heart failure has led to the development and approval of 2 new pharmacological agents, sacubitril–valsartan and ivabradine. These agents are currently approved for use in heart failure with reduced ejection fraction (HFrEF) and present as novel approaches to further improve prognosis and outcomes in patients with HF. They offer alternative treatment options for patients who are intolerant or continue to be symptomatic despite utilization of standard HF drug therapies at optimally tolerated dosages. A review of these 2 novel agents in HFrEF, including information on pivotal trials that led to its approval and its place in therapy for HFrEF, is presented.

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