The science behind medical cannabis

2021 ◽  
Author(s):  
Gloabl Rheumatology By PANLAR
Keyword(s):  
Palliative Care ◽  
Scientific Evidence ◽  
Important Change ◽  
Evidence Based ◽  
Medical Cannabis ◽  
Use Patterns ◽  
Founding Member ◽  
Current State ◽  
Patterns Of Use ◽  
Therapeutic Possibility

The use of cannabis as medicine has undergone an important change in recent years, being currently evaluated as a therapeutic possibility for various pathologies, among them, of course, rheumatic diseases. Today in Un café por la reumatología we will discuss the current state of medical cannabis, the scientific evidence concerning its use, patterns of use and clinical experience in the region. Joining Carlo Vinicio Caballero, editor-in-chief of Global Rheumatology, and Diego Jaimes, will be Dario Scublinsky, a rheumatologist internist with a doctorate in medicine, former editor of the Revista Argentina de Reumatología and currently coordinator of rheumatology at Swiss Medical; as well as Paola Cubillos, Colombian physician from Universidad del Rosario, founding member of Procannacol, focused on the evidence-based use of medical cannabis; and Dr. Jaime Jaramillo Mejía, anesthesiologist, specialist in pain and palliative care.

Drug Utilization Studies – An Overview

2010 ◽  
Vol 3 (1) ◽  
pp. 803-810 ◽  
Author(s):  
Shalini S ◽  
Ravichandran V ◽  
Saraswathi R ◽  
BK Mohanty ◽  
Dhanaraj S K
Keyword(s):  
Drug Utilization ◽  
Evidence Based ◽  
Future Trends ◽  
Medical Prescription ◽  
Drug Usage ◽  
Current State ◽  
Patterns Of Use ◽  
Drug Utilization Studies ◽  
Drug Expenditures

 Aspire of the Drug Utilization Studies (DUS) is to appraise factors related to the prescribing, dispensing, administering and taking of medication, and it’s associated. Since the middle of twentieth century, interest in DUS has been escalating, first for market-only purposes, then for appraising the quality of medical prescription and comparing patterns of use of specific drugs. The scope of DUS is to evaluate the current state and future trends of drug usage, to estimate roughly disease pervasiveness, drug expenditures, aptness of prescriptions and adherence to evidence-based recommendations. The increasing magnitude of DUS as a valuable investigation resource in pharmacoepidemiology has been bridging it with other health allied areas, such as public health, rational use of drug, evidence based drug use, pharmacovigilance, pharmacoeconomics, eco-pharmacovigilance and pharmacogenetics.

Patterns of knowledge and use of medical cannabis among Brazilian oncologists and palliative care physicians.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24099-e24099
Author(s):  
Júlia Maria Mathias Pedreira de Freitas ◽  
Daniela Oliveira de Almeida ◽  
Luciana Castro G. Landeiro ◽  
Tércia Vilasboas Reis ◽  
Thomas Azevedo de Carmo ◽  
...  
Keyword(s):  
Palliative Care ◽  
Online Survey ◽  
Scientific Evidence ◽  
Complementary Therapy ◽  
Medical Cannabis ◽  
Patients With Cancer ◽  
Brazilian Legislation ◽  
Oncological Diseases ◽  
Care Outcomes ◽  
Lack Of Knowledge

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.

Self-Management of Arthritis

2017 ◽  
pp. 171-196
Author(s):  
Jessica M. Brooks ◽  
Kanako Iwanaga ◽  
Fong Chan
Keyword(s):  
Scientific Evidence ◽  
The United States ◽  
Self Management ◽  
Future Research ◽  
Counseling Services ◽  
Evidence Based ◽  
Physical Conditions ◽  
Current State ◽  
The Individual ◽  
The Impact

Arthritis is ranked among the top causes of disability in the United States and worldwide. Despite recent improvements in medications and medical treatment, there is no known cure for arthritis. Providing evidence-based psychoeducation and counseling services to people with arthritis lessens the impact of pain-related symptoms and disability on the individual and society. The purpose of this chapter is to provide an overview of the most common arthritic conditions, co-occurring physical conditions, and psychosocial factors associated with arthritis. Barriers to self-management and existing self-management programs are also discussed along with the current state of scientific evidence. The chapter concludes with some questions for future research.

scholarly journals Clasificación Oxford para la validación de un  protocolo de antibioticoterapia subcutánea  paliativa

2017 ◽  
Vol 14 (1) ◽  
pp. 95
Author(s):  
Miguel  Antonio  Sánchez-Cárdenas ◽  
Laura  Camila  Pulido-Garzón ◽  
Leydy  Viviana Santamaría-Orozco ◽  
Lina  Katerine  Rodríguez-Laverde ◽  
Mónica  Andrea  Preciado-Vargas ◽  
...  
Keyword(s):  
Palliative Care ◽  
Evidence Based Medicine ◽  
Review Process ◽  
Scientific Evidence ◽  
Evidence Based ◽  
Promising Alternative ◽  
Revisión Sistemática ◽  
Nursing Skills ◽  
Based Medicine ◽  
Systematic Review Process

Introducción: los casos de pacientes con procesos infecciosos al final de la vida muestran la necesidad de contar con alternativas que garanticen el cuidado y el manejo terapéutico instaurado. Las vías clásicas intravenosa, intramuscular y oral se ven limitadas, mientras que la vía subcutánea demuestra ser una alternativa prometedora; sin embargo, la escasa evidencia científica reflejada en el bajo número de investigaciones, devela la necesidad de explorar y generar productos científicos que respalden esta práctica. Metodología: estudio documental, con base en un proceso de revisión sistemática, en el cual se realiza la búsqueda de 10 acciones descritas en un protocolo. Fueron seleccionados 34 artículos en idioma inglés y español, excluyendo 17.Los artículosfueron clasificados a partir de la escala del Centre for Evidence-Based Medicine, Oxford, consultando las bases: Nursing Skills, Clinicalkey, Pubmed, Springerlink, Science Direct, ProQuest y Cochrane. Se utilizaron como descriptores: antibacterianos, cuidados paliativos, protocolos, catéter, subcutáneo, signos, tiempo, antibiótico, enfermería, registros, consentimiento informado, valoración. Resultados: el 60% de las acciones propuestas en el protocolo no tuvo artículos que respaldaran su práctica, solamente el 40% fue clasificado. Conclusión: el protocolo no se recomienda, puesto que más del 50% de las actividades no cuentan con evidencia científica que las respalde.PALABRAS CLAVE: antibacterianos, cuidados paliativos,  protocolos, tejido subcutáneo.Oxford classification for the validation of a protocol of palliative subcutaneous  antibiotic therapy                                                              ABSTRACTIntroduction: the cases of patients with infectious processes at the end of life show the necessity  to count with alternatives that guarantee the care and the established therapeutic management.  The classic intravenous, intramuscular and oral routes are limited, while the subcutaneous route  demonstrates to be a promising alternative; however, the scarce scientific evidence reflected in  the low number of research, unveils the necessity to explore and generate scientific products to  endorse this practice. Methodology: a documental study, based on a systematic review process,  in which the search of 10 actions described in a protocol is performed. 34 articles in English and  Spanish were selected, excluding 17. The articles were classified based on the scale from Centre for  Evidence-Based Medicine, Oxford, consulting the databases: Nursing Skills, Clinicalkey, Pubmed,  Springerlink, ScienceDirect, ProQuest and Cochrane. The used descriptors: antibacterials, palliative  care, protocols, subcutaneous catheter, signs, time, antibiotic, nursing, records, informed consent,  and valuation. Results: 60% of the actions proposed in the protocol did not have articles to endorse  their practice, only 40% was classified. Conclusion: the protocol is not recommended, since more  than 50% of the activities do not have scientific evidence to endorse them.KEYWORDS: anti-bacterial agents, palliative care, protocols, subcutaneous tissue.Classificação Oxford para a validação de um  protocolo de aplicação paliativa de antibióticos                                           por via subcutânea                                                                      RESUMOIntrodução: os casos de pacientes com processos infecciosos ao final da vida mostram a necessidade  de contar com alternativas que garantam o cuidado e o manejo terapêutico estabelecido. As vias  clássicas intravenosa, intramuscular e oral estão limitadas, enquanto que a via subcutânea demostra  ser uma alternativa prometedora; porém, a escassa evidencia científica refletida no baixo número de  pesquisas, revela a necessidade de explorar e gerar produtos científicos que respaldem esta prática.  Metodologia: estudo documental, baseado num processo de revisão sistemática, no qual se realizou  a busca de 10 ações descritas num protocolo. Foram selecionados 34 artigos em idioma inglês e  espanhol, excluindo 17. Os artigos foram classificados a partir da escala do Centre for Evidence-Based  Medicine, Oxford, consultando as bases: Nursing Skills, Clinicalkey, Pubmed, Springerlink, Science  Direct, ProQuest e Cochrane. Utilizaram-se como descritores: antibacterianos, cuidados paliativos,  protocolos, cateter, subcutâneo, signos, tempo, antibiótico, enfermagem, registros, consentimento  informado, valoração. Resultados: o 60% das ações propostas no protocolo não teve artigos que  respaldaram sua prática, somente o 40% foi classificado. Conclusão: o protocolo não se recomenda,  já que mais do 50% das atividades não têm evidencia científica para apoiá-lo.PALAVRAS-CHAVE: antibacterianos, cuidados paliativos, protocolos, tela subcutânea.

scholarly journals Continuous Electronic Fetal Monitoring during Labor: A Critique and a Reply to Contemporary Proponents

2018 ◽  
Vol 04 (01) ◽  
pp. e23-e28 ◽  
Author(s):  
Thomas Sartwelle ◽  
James Johnston
Keyword(s):  
Scientific Evidence ◽  
Fetal Monitoring ◽  
Standard Of Care ◽  
Developed Countries ◽  
Evidence Based ◽  
Current State ◽  
Electronic Fetal Monitoring ◽  
The Developed Countries ◽  
State Of Affairs ◽  
Continuous Electronic Fetal Monitoring

AbstractA half century after continuous electronic fetal monitoring (EFM) became the omnipresent standard of care for the vast majority of labors in the developed countries, and the cornerstone for cerebral palsy litigation, EFM advocates still do not have any scientific evidence justifying EFM use in most labors or courtrooms. Yet, these EFM proponents continue rationalizing the procedure with a rhetorical fog of meaningless words, misleading statistics, archaic concepts, and a complete disregard for medical ethics. This article illustrates the current state of affairs by providing an evidence-based review penetrating the rhetorical fog of a prototypical EFM advocate.

Comparative Analysis: The State of Colorado Study, Part II

2004 ◽  
Vol 9 (2) ◽  
pp. 1-16
Author(s):  
Christopher R. Brigham ◽  
Kathryn Mueller ◽  
Douglas Van Zet ◽  
Debra J. Northrup ◽  
Edward B. Whitney ◽  
...  
Keyword(s):  
Daily Living ◽  
Scientific Evidence ◽  
Pain Syndrome ◽  
Evidence Based ◽  
Clinical Assessments ◽  
Physician Judgment ◽  
History Of ◽  
Key Terms ◽  
Causation Analysis ◽  
Work Interference

Abstract [Continued from the January/February 2004 issue of The Guides Newsletter.] To understand discrepancies in reviewers’ ratings of impairments based on different editions of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), users can usefully study the history of the revisions as successive editions attempted to provide a comprehensive, valid, reliable, unbiased, and evidence-based system. Some shortcomings of earlier editions have been addressed in the AMA Guides, Fifth Edition, but problems remain with each edition, largely because of the limited scientific evidence available. In the context of the history of the different editions of the AMA Guides and their development, the authors discuss and contextualize a number of key terms and principles including the following: definitions of impairment and normal; activities of daily living; maximum medical improvement; impairment percentages; conversion of regional impairments; combining impairments; pain and other subjective complaints; physician judgment; and causation analysis; finally, the authors note that impairment is not synonymous with disability or work interference. The AMA Guides, Fifth Edition, contrasts impairment evaluations and independent medical evaluations (this was not done in previous editions) and discusses impairment evaluations, rules for evaluations, and report standards. Upper extremity and lower extremity impairment evaluations are discussed in terms of clinical assessments and rating processes, analyzing important changes between editions and problematic areas (eg, complex regional pain syndrome).

日本における抑うつ症状に対する心理学的介入を目的とした スマートフォン用アプリケーション・プログラムのレビュー

2020 ◽  
Author(s):  
Hikari Takashina ◽  
Kengo Yokomitsu
Keyword(s):  
Depressive Symptoms ◽  
Daily Life ◽  
Behavioral Therapy ◽  
Mobile Apps ◽  
Evaluation Model ◽  
Ease Of Use ◽  
Background Information ◽  
Evidence Based ◽  
Privacy And Security ◽  
Current State

There are thousands of mobile apps delivering information and offering support and intervention in situations of daily life. The aim of this study was to identify the current state of apps for depressive symptoms or prevention of depression within the official Android and iOS app stores in Japan. The 47 apps for depression available for download from the app stores were evaluated by the App Evaluation Model regarding background information, risk/ privacy and security, evidence, ease of use, and interoperability. Also, we evaluated their primary purpose, technology components, and cognitive-behavioral therapy components. The results suggest that in general few apps have been developed that are evidence-based, secure, and provide the services that users expect. In the future, it will be necessary to develop a framework for developing and disseminating more effective apps. This study is the first review of apps for depression available in Japan and seeks to help create a framework for such apps.

Cancer screening. Current state of the problem

2020 ◽  
pp. 4-12
Author(s):  
Marina Kochiyeva
Keyword(s):  
Breast Cancer ◽  
Cervical Cancer ◽  
Colon Cancer ◽  
Cancer Screening ◽  
Target Population ◽  
Evidence Based ◽  
Screening Programs ◽  
Current State ◽  
Methodological Approaches ◽  
Based Medicine

Data on modern methodological approaches that are used in screening for cancer are summarized. General principles of organizing screening studies are examined from the perspective of evidence-based medicine, target population, research methods, and effectiveness of the implemented screening programs for breast cancer, cervical cancer, and colon cancer are determined.

An Evidence-Based Review of Antitussive Herbs Containing Essential Oils in Traditional Persian Medicine

2020 ◽  
Vol 17 ◽  
Author(s):  
Ayda Hosseinkhani ◽  
Bijan Ziaeian ◽  
Kamran Hessami ◽  
Mohammad Mehdi Zarshenas ◽  
Ali Kashkooe ◽  
...  
Keyword(s):  
Medicinal Plants ◽  
Essential Oils ◽  
Scientific Evidence ◽  
Herbal Remedies ◽  
Future Research ◽  
Evidence Based ◽  
Online Databases ◽  
Persian Medicine ◽  
Troublesome Symptom ◽  
Traditional Persian Medicine

Background: Cough is one of the most common medical symptoms for which medical advice is sought. Although cough is a protective reflex responsible for clearing the airways from secretions and foreign bodies, it can be a troublesome symptom that causes discomfort to patients. Due to the increasing interest in herbal remedies in the both developed and developing countries, in the current study, we aimed to overview medicinal herbs containing essential oils used as antitussive agents according to the Traditional Persian Medicine [TPM] textbooks. We summarized the relevant scientific evidence on their possible pharmacological actions. Methods: To collect the evidence for treatment of cough or “seaal” [cough in ancient books] from TPM sources, five main medicinal Persian manuscripts were studied. The antitussive herbs were listed and their scientific names were identified and authenticated in accordance with botanical reference books. ScienceDirect and PubMed online databases were searched for related mechanisms of action of the reported medicinal plants. Results: The number of 49 herbs containing essential oils were recommended in TPM for the treatment of cough; 21 of them had at least one known mechanism of action for cough suppression in the scientific literature. According to this review, most of the cited medicinal plants were assessed for either nitric oxide inhibitory or antitussive/expectorant activities. Conclusion: In addition to advantageous effects of antitussive herbs noted by TPM, the present review highlighted some recent evidence-based data on these promising candidates that could be used as an outline for future research on their medicinal use.

scholarly journals Herbal Preparations of Medical Cannabis: A Vademecum for Prescribing Doctors

Medicina ◽  
2020 ◽  
Vol 56 (5) ◽  
pp. 237 ◽  
Author(s):  
Pietro Brunetti ◽  
Simona Pichini ◽  
Roberta Pacifici ◽  
Francesco Paolo Busardò ◽  
Alessandro del Rio
Keyword(s):  
Therapeutic Potential ◽  
Scientific Evidence ◽  
Abuse Liability ◽  
Medical Cannabis ◽  
Preparation Methods ◽  
Herbal Preparations ◽  
Routes Of Administration ◽  
International Agencies ◽  
Medical Indications ◽  
Different Sources

Cannabis has been used for centuries for therapeutic purposes. In the last century, the plant was demonized due to its high abuse liability and supposedly insufficient health benefits. However, recent decriminalization policies and new scientific evidence have increased the interest in cannabis therapeutic potential of cannabis and paved the way for the release of marketing authorizations for cannabis-based products. Although several synthetic and standardized products are currently available on the market, patients’ preferences lean towards herbal preparations, because they are easy to handle and self-administer. A literature search was conducted on multidisciplinary research databases and international agencies or institutional websites. Despite the growing popularity of medical cannabis, little data is available on the chemical composition and preparation methods of medical cannabis extracts. The authors hereby report the most common cannabis preparations, presenting their medical indications, routes of administration and recommended dosages. A practical and helpful guide for prescribing doctors is provided, including suggested posology, titration strategies and cannabinoid amounts in herbal preparations obtained from different sources of medical cannabis.

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