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https://www.readbyqxmd.com/read/29668039/medical-marijuana-use-in-older-adults
#1
Joshua Briscoe, David Casarett
Symptom management in older adults, including pain and distressing non-pain symptoms, can be challenging. Medications can cause side effects that worsen quality of life or create other symptoms, and polypharmacy itself can be detrimental in older adults. Cannabinoids may offer a way of managing selected symptoms with fewer side effects. Medical marijuana is an important area of study for older adults because of the side effects of other medications. It is also important for Baby Boomers, who are likely to have more experience with marijuana than older adults of previous generations...
April 18, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29664895/medical-marijuana-users-are-more-likely-to-use-prescription-drugs-medically-and-nonmedically
#2
Theodore L Caputi, Keith Humphreys
OBJECTIVES: Previous studies have found a negative population-level correlation between medical marijuana availability in US states, and trends in medical and nonmedical prescription drug use. These studies have been interpreted as evidence that use of medical marijuana reduces medical and nonmedical prescription drug use. This study evaluates whether medical marijuana use is a risk or protective factor for medical and nonmedical prescription drug use. METHODS: Simulations based upon logistic regression analyses of data from the 2015 National Survey on Drug Use and Health were used to compute associations between medical marijuana use, and medical and nonmedical prescription drug use...
April 17, 2018: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/29662957/new-york-physicians-perspectives-and-knowledge-of-the-state-medical-marijuana-program
#3
Alexandra Sideris, Fahad Khan, Alina Boltunova, Germaine Cuff, Christopher Gharibo, Lisa V Doan
Introduction: In 2014, New York (NY) became the 23rd state to legalize medical marijuana (MMJ). The purpose of this survey was to collect data about practicing NY physicians' comfort level, opinions, and experience in recommending or supporting patient use of MMJ. Materials and Methods: An anonymous web-based survey was distributed to medical societies and to academic departments in medical schools within NY. Results: A total of 164 responses were analyzed. Physician participants were primarily located in New York City and surrounding areas...
2018: Cannabis and Cannabinoid Research
https://www.readbyqxmd.com/read/29652682/kratom-an-emerging-drug-of-abuse-a-case-report-of-overdose-and-management-of-withdrawal
#4
Jack Diep, David Tian Chin, Somdatta Gupta, Faraz Syed, Ming Xiong, Jianguo Cheng
Kratom is an herb indigenous to Southeast Asia with psychoactive opioid compounds, often used as a treatment for chronic pain or opiate withdrawal symptoms. It is legally and readily available via Internet sales and has been identified as an emerging drug of abuse in the United States. Kratom use has been associated with psychosis, seizures, and even death. At lower doses, kratom acts as a stimulant, while at higher doses, it produces analgesia and euphoria. Here, we describe the successful management of kratom overdose and withdrawal in a young man with negative toxicology screens...
April 15, 2018: A&A practice
https://www.readbyqxmd.com/read/29624475/access-to-strong-opioid-analgesics-in-the-context-of-legal-and-regulatory-barriers-in-eleven-central-and-eastern-european-countries
#5
Marjolein J M Vranken, Aukje K Mantel-Teeuwisse, Marie-Hélène D B Schutjens, Willem K Scholten, Saskia Jünger, Dr Rer Medic, Hubert G M Leufkens
BACKGROUND: In 2011-2013, >95% of the global opioid analgesics consumption occurred in three regions, accounting for 15% of the world population. Despite abundant literature on barriers to access, little is known on the correlation between actual access to opioid analgesics and barriers to access, including legal and regulatory barriers. OBJECTIVE: This study aimed to evaluate the correlation between access to strong opioid analgesics and barriers to access in national legislation and regulations in 11 central and eastern European countries that participated in the Access to Opioid Medication in Europe (ATOME) project...
April 6, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29621089/intense-instantaneous-and-shooting-pain-during-local-anesthesia-for-implant-surgery
#6
Antonio Scarano, Bruna Sinjari, Felice Lorusso, Carmen Mortellaro, Cristian D'Ovidio, Francesco Carinci
Administration of local anesthetics is daily routine for most dental practitioners. Normally, the effect is achieved, and no adverse effects are seen. In this article, the authors describe the complications of immediate, intense and shooting pain, numbness, and marked pallor of the cheek, which occurred during infiltration of a local anesthetic in buccal vestibule infiltration. The patients moved suddenly because of pain and marked pallor of the cheek near the root of the nose and lower eyelid pallor was observed...
April 4, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29607335/using-newly-deceased-patients-in-teaching-clinical-skills-its-ethical-and-educational-challenges
#7
Mahboobeh Saber, Seyed Ali Enjoo, Ali Mahboudi, Seyed Ziaadin Tabei
Introduction: The newly deceased patients have long been used in medical schools to teach clinical skills without any challenges as it helps to train skilled doctors. Nowadays, the use of moulages and simulators are common in teaching clinical skills since these tools provide the opportunity for frequent practice without any pain and injury. There are specific procedures which still require the use of cadavers. However, the increased significance of patient rights has generally challenged the practicality of using the deceased bodies for this purpose...
April 2018: Journal of Advances in Medical Education & Professionalism
https://www.readbyqxmd.com/read/29605272/title-impact-of-ambiguous-and-restrictive-regulations-on-opioid-prescribing-practice-in-georgia
#8
Pati Dzotsenidze, Tamar Lekashvili, Nino Chikhladze, Maka Jorbenadze, Ioseb Abesadze, Dimitri Kordzaia
CONTEXT: Chronic pain management with opioids in incurable patients remains a challenge of modern medicine regardless of the evidence-based effectiveness of opioids and recommendations of authorities such as the World Health Organization (WHO) and International Narcotics Control Board (INCB). Many countries, including Georgia, maintain overly restrictive regulations that contribute to inadequate pain management. OBJECTIVE: To identify barriers to pain management in Georgia caused by legislation, administrative issues and physicians' lack of knowledge and understanding of legislative aspects governing opioid use, and their impact on opioid-prescribing practice...
March 29, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29604201/discrepancies-in-the-evaluation-of-incapacity-for-work-in-a-patient-with-epidermolysis-bullosa-acquisita-between-public-pension-fund-and-occupational-medicine-expert-raise-the-issue-of-competencies
#9
Hrvoje Lalić
Abstrat A 50-year-old female patient suffering from a severe form of epidermolysis bullosa acquisita (EBA) took legal action against the Croatian Pension Insurance Institute (CPII) in an attempt to overturn their assessment that she was no longer capable of working as a seamstress but still capable of doing administrative jobs. Her claim was that she was not capable of doing any job at all. She was first diagnosed EBA in 2000, and the disease progressed slowly with intermittent remissions. In 2012, skin erosions appeared on her feet, followed by the loss of all toenails and lesions and infiltrations on the tongue and oral mucosa...
March 1, 2018: Arhiv za Higijenu Rada i Toksikologiju
https://www.readbyqxmd.com/read/29594968/profiles-of-patients-who-use-marijuana-for-inflammatory-bowel-disease
#10
Ann Marie Kerlin, Millie Long, Michael Kappelman, Christopher Martin, Robert S Sandler
BACKGROUND: Marijuana is legal in a number of states for indications that include inflammatory bowel diseases (IBD), and patients are interested in its potential benefits. AIMS: We aimed to describe the legal use of marijuana in individuals with IBD in the USA who participate within the CCFA Partners internet-based cohort. METHODS: A total of 2357 participants who lived in states where prescription or recreational marijuana was legal, were offered the opportunity to complete a survey on marijuana use and IBD symptoms including perceived benefits of therapy...
March 29, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29551331/trends-in-medical-use-of-opioids-in-the-u-s-2006-2016
#11
Brian J Piper, Dipam T Shah, Olapeju M Simoyan, Kenneth L McCall, Stephanie D Nichols
INTRODUCTION: The U.S. is experiencing an opioid epidemic which is at least partially iatrogenic and fueled by both prescription and illicit misuse. This study provides a nationwide examination of opioid distribution patterns during the last decade. METHODS: Data were obtained from the U.S. Drug Enforcement Administration's Automation of Reports and Consolidated Orders System for 2006-2016. Analyses include quantities of ten opioids legally dispensed nationwide by weight and converted to Morphine Milligram Equivalents...
March 9, 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29513625/leveraging-user-perspectives-for-insight-into-cannabis-concentrates
#12
Patricia A Cavazos-Rehg, Melissa J Krauss, Shaina J Sowles, Glennon M Floyd, Elizabeth S Cahn, Veronica L Chaitan, Marisel Ponton
BACKGROUND: The US has seen an increase in the popularity of highly concentrated forms of cannabis (hereafter concentrates) and too little is known about the potential risks associated with their use. OBJECTIVES: The present study aims to better understand the patterns and outcomes of concentrates use through the perspectives of young adult users. METHODS: Participants (N = 234, 27.9% female) aged 18-35 years were recruited using SurveyMonkey Audience® and had ingested concentrates at least once in the past 6 months...
March 7, 2018: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/29464700/septic-cavernous-sinus-thrombosis-following-a-minor-head-injury-a-rare-cause-of-medico-legal-death
#13
Supawon Srettabunjong
Septic cavernous sinus thrombosis (SCST) is an uncommon consequence of head and face infection, but a rare complication after craniofacial fracture. In this case, SCST developed in a 13-year-old girl following a minor fall during volleyball, with impact and resulting abrasive contusion of the left forehead. She developed watery rhinorrhea, progressive headache, fever, nausea, vomiting, and left proptosis with blurred vision, and was admitted to hospital 3 days after injury. Drowsiness, high-grade fever, severe headache, left ocular pain with marked periorbital swelling, and paralysis of extraocular eye movements developed...
February 21, 2018: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/29451883/management-of-post-abortion-complications-in-botswana-the-need-for-a-standardized-approach
#14
Tadele Melese, Dereje Habte, Billy M Tsima, Keitshokile Dintle Mogobe, Mercy N Nassali
BACKGROUND: Post abortion complications are the third leading cause of maternal death after hemorrhage and hypertension in Botswana where abortion is not legalized. This study aimed at assessing the management of post abortion complications in Botswana. METHODS: A retrospective study was conducted at four hospitals in Botswana in 2014. Socio-demographic, patient management and outcomes data were extracted from patients' medical records. Descriptive statistics and chi-square test were used to analyze and present the data...
2018: PloS One
https://www.readbyqxmd.com/read/29445297/managing-severe-pain-and-abuse-potential-the-potential-impact-of-a-new-abuse-deterrent-formulation-oxycodone-naltrexone-extended-release-product
#15
REVIEW
Joseph V Pergolizzi, Robert Taylor, Jo Ann LeQuang, Robert B Raffa
Proper management of severe pain represents one of the most challenging clinical dilemmas. Two equally important goals must be attained: the humanitarian/medical goal to relieve suffering and the societal/legal goal to not contribute to the drug abuse problem. This is an age-old problem, and the prevailing emphasis placed on one or the other goal has resulted in pendulum swings that have resulted in either undertreatment of pain or the current epidemic of misuse and abuse. In an effort to provide efficacious strong pain relievers (opioids) that are more difficult to abuse by the most dangerous routes of administration, pharmaceutical companies are developing products in which the opioid is manufactured in a formulation that is designed to be tamper resistant...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29441736/the-legal-doctrine-on-the-liability-of-physicians-in-medical-malpractice-lawsuits-involving-complex-regional-pain-syndrome
#16
SuHwan Shin, Seung Gyeong Jang, KyeongTae Min, Won Lee, So Yoon Kim
BACKGROUND: Complex regional pain syndrome (CRPS) involves severe pain and it is difficult to identify the exact cause or pathogenesis. Therefore, there are controversies regarding legal issues related to the establishment of damage in medical malpractice lawsuits involving CRPS. This study aimed to analyze malpractice lawsuits involving CRPS, which occurred after the disputed medical treatment, to provide information on the courts' opinion and characteristics of the cases. METHODS: This study analyzed 23 lawsuit judgments involving CRPS that were sentenced from 2005 to 2015...
February 26, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29429037/long-term-follow-up-of-whiplash-injuries-reported-to-insurance-companies-a-cohort-study-on-patient-reported-outcomes-and-impact-of-financial-compensation
#17
Eric Rydman, Sari Ponzer, Rosa Brisson, Carin Ottosson, Hans Pettersson-Järnbert
PURPOSE: The long-term outcome of Whiplash-associated disorder (WADs) has been reported to be poor in populations from medical settings. However, no trials have investigated the long-term prognosis of patients from medico-legal environment. For this group, the "compensation hypothesis" suggests financial compensation being associated with worsened outcome. The aims of this study were to describe long-term (2-4 years) non-recovery rates in participants with WAD recruited from insurance companies and to investigate the association between self-reported non-recovery and financial compensation...
February 10, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29399427/myocardial-ischemia-with-cannabinoid-use-in-an-adolescent
#18
Jeet J Mehta, Arjun K Mahendran, Ravi K Bajaj, Arpan R Doshi
A 16-year-old male presented to the emergency department with chest pain after smoking a synthetic cannabinoid from a vape pen. He had rising troponin I levels, and his exercise stress echocardiogram showed distal apical and septal hypokinesis that resolved at six-month follow-up. This case report raises concern about cardiac ischemia related to synthetic cannabinoid abuse in the pediatric population in the current era of cannabis legalization.
November 30, 2017: Curēus
https://www.readbyqxmd.com/read/29377381/medical-cannabis-a-forward-vision-for-the-clinician
#19
REVIEW
M A Fitzcharles, E Eisenberg
Medical cannabis has entered mainstream medicine and is here to stay. Propelled by public advocacy, the media and mostly anecdote rather than sound scientific study, patients worldwide are exploring marijuana use for a vast array of medical conditions including management of chronic pain. Contrary to the usual path of drug approval, medical cannabis has bypassed traditional evidence-based study and has been legalized as a therapeutic product by legislative bodies in various countries. While there is a wealth of basic science and preclinical studies demonstrating effects of cannabinoids in neurobiological systems, especially those pertaining to pain and inflammation, clinical study remains limited...
January 29, 2018: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29338150/the-role-of-cannabinoids-in-pain-control-the-good-the-bad-and-the-ugly
#20
Joseph V Pergolizzi, Jo Ann Lequang, Robert Taylor, Robert B Raffa, Daniel Colucci
Cannabinoids appear to possess many potential medical uses, which may extend to pain control. A narrative review of the literature has found a variety of studies testing botanical and synthetic cannabinoids in different pain syndromes (acute pain, cancer pain, chronic noncancer pain, fibromyalgia pain, migraine, neuropathic pain, visceral pain, and others). Results from these studies are mixed; cannabinoids appear to be most effective in controlling neuropathic pain, allodynia, medication-rebound headache, and chronic noncancer pain, but do not seem to offer any advantage over nonopioid analgesics for acute pain...
January 16, 2018: Minerva Anestesiologica
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