Cannabinoids-Perspectives for Individual Treatment in Selected Patients: Analysis of the Case Series.

Cannabinoids can be successfully used in the treatment of many symptoms and diseases; however, most often they are not the drugs of first choice. They can be added to the primary therapy, which can improve its effectiveness, or be introduced as the basic treatment when the conventional methods have failed. Small clinical trials and case reports prove the benefits of applying medicinal cannabis in various indications; however, clinical trials in larger groups of patients are scarce and often controversial. Due to limited scientific evidence, it is essential to conduct further experimental trials. Understanding the role of endocannabinoids, as well as the composition of cannabis containing both phytocannabinoids and terpenes plays an important role in their clinical use. The clinical effects of cannabinoids depend, among other things, on the activity of the endocannabinoid system, the proportion of phytocannabinoids, such as Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD), and the dosage used. The article discusses the role of phytocannabinoids and the potential of using them in different clinical cases in patients suffering from chronic pain, opioid dependence, depression and migraine, who did not respond to the conventional therapeutic methods. In each of the presented cases, the implementation of cannabinoids altered the course of the disease and resulted in symptom relief. Every decision to introduce cannabinoids to the treatment should be made individually with careful attention paid to details. Additionally, it is worth taking care of good clinical communication and education so that the implemented therapy is safe, effective and properly perceived by the patient.

Nutritional Treatment of Patients with Colorectal Cancer.

Colorectal cancer is one of the most common cancers in Europe and the world. Cancer treatments have side effects and cause significant deterioration of the patient's nutritional status. Patient malnutrition may worsen the health condition and prevent the deliberate effects of the therapy. The aim of this review was to describe the available data about clinical nutrition in colorectal cancer patients. A large proportion of colorectal cancer patients suffer from malnutrition, which negatively affects the survival prognosis, quality of life, and oncological therapy. Therefore, monitoring nutritional status during the treatment is essential and can be used to arrange proper nutritional therapy to enhance patient responses, prevent side effects, and shorten recovery time. The principles of nutrition during anticancer therapy should mainly consider light and low-fat foods, the exclusion of lactose and gluten-containing foods in certain cases, or the introduction of special dietary products such as oral nutrition supplements and it should be tailored to patients' individual needs.

Anti-Inflammatory and Antiviral Effects of Cannabinoids in Inhibiting and Preventing SARS-CoV-2 Infection.

The COVID-19 pandemic caused by the SARS-CoV-2 virus made it necessary to search for new options for both causal treatment and mitigation of its symptoms. Scientists and researchers around the world are constantly looking for the best therapeutic options. These difficult circumstances have also spurred the re-examination of the potential of natural substances contained in Cannabis sativa L. Cannabinoids, apart from CB1 and CB2 receptors, may act multifacetedly through a number of other receptors, such as the GPR55, TRPV1, PPARs, 5-HT1A, adenosine and glycine receptors. The complex anti-inflammatory and antiviral effects of cannabinoids have been confirmed by interactions with various signaling pathways. Considering the fact that the SARS-CoV-2 virus causes excessive immune response and triggers an inflammatory cascade, and that cannabinoids have the ability to regulate these processes, it can be assumed that they have potential to be used in the treatment of COVID-19. During the pandemic, there were many publications on the subject of COVID-19, which indicate the potential impact of cannabinoids not only on the course of the disease, but also their role in prevention. It is worth noting that the anti-inflammatory and antiviral potential are shown not only by well-known cannabinoids, such as cannabidiol (CBD), but also secondary cannabinoids, such as cannabigerolic acid (CBGA) and terpenes, emphasizing the role of all of the plant's compounds and the entourage effect. This article presents a narrative review of the current knowledge in this area available in the PubMed, Scopus and Web of Science medical databases.

Relationship between breakthrough cancer pain, background cancer pain and analgesic treatment - case series and review of the literature.

The assessment and treatment of breakthrough cancer pain (BTcP) remain a major challenge in medicine due to its high impact on several aspects of health-related quality of life. BTcP should be carefully monitored in all cancer care settings by a multidisciplinary team to provide an appropriate and personalized clinical approach. The aim of this paper is to provide healthcare professionals involved in cancer pain management with a review of the relevant literature on the relationship between background cancer pain and BTcP which, by definition, occurs despite adequately controlled background cancer pain. The clinical cases presented contribute to a better understanding of this issue and underline its impact in daily clinical practice. This article is part of the Management of breakthrough cancer pain Special Issue: https://www.drugsincontext.com/special_issues/management-of-breakthrough-cancer-pain.

The Therapeutic Potential of Cannabis in Counteracting Oxidative Stress and Inflammation.

Significant growth of interest in cannabis (Cannabis sativa L.), especially its natural anti-inflammatory and antioxidative properties, has been observed recently. This narrative review aimed to present the state of the art of research concerning the anti-inflammatory activity of all classes of cannabinoids published in the last five years. Multimodal properties of cannabinoids include their involvement in immunological processes, anti-inflammatory, and antioxidative effects. Cannabinoids and non-cannabinoid compounds of cannabis proved their anti-inflammatory effects in numerous animal models. The research in humans is missing, and the results are unconvincing. Although preclinical evidence suggests cannabinoids are of value in treating chronic inflammatory diseases, the clinical evidence is scarce, and further well-designed clinical trials are essential to determine the prospects for using cannabinoids in inflammatory conditions.

Dietary intake of antioxidants and fats in the context of coronary heart disease prevention among elderly people.

INTRODUCTION: Some literature data indicate that the proper intake of exogenic antioxidants from food and the proper intake of fats can offer significant protection against coronary heart disease. OBJECTIVES: The estimation of total antioxidant capacity of food intake on the basis of Dietary Antioxidant Index (DAI), together with an assessment of the contribution of particular food products in DAI, and the evaluation of consumption of all dietary fats and frequency of consumption of products that are a source of fats among elderly people in Krakow, Poland. MATERIAL AND METHODS: 143 persons (73 women and 70 men) aged 65-80 were studied. None of them was under specialist medical control, including cardiological control. DAI was investigated on the basis of the Food Frequency Questionnaire (FFQ) which included 145 food items. DAI was measured using the method by Benzi and expressed as FRAP (the ability to reduce Fe3+ to Fe2+, measured in mMol/l). The daily intake of fats was estimated using the 24-h nutritional recall. The frequency of fats consumption was estimated with the usage of FFQ. For statistical analysis, χ2 test was used. RESULTS: The mean value of DAI of all studied persons was 34.27 + 11.72 mMol/l. The largest percentage of those studied had FRAP values in the range 25-35 mMol/l. The highest contribution in the total DAI value was found in fruit (36.2%), grains and cereal-based products (23.6%), and beverages (24.0%). The consumption of vegetables was on the fourth position (7.1%). The contribution of the remaining food products was low. The consumption of total fats (about 70g/24h) and saturated fatty acids (14% of energetic value) exceeded the recommendations. The participation of mono-and polyunsaturated fatty acids in the diets was not in accordance with recommendations. The most frequently consumed fats were animal fats (sausages, butter) and cakes, but the consumption of vegetable oils, fish, nuts and seeds of oil plants was too low. CONCLUSIONS: The majority of elderly people made mistakes in their nutrition. The enrichment in natural antioxidants of the diets of elderly people and the normalization of their fats consumption should become an important element of primary and secondary prophylaxis of cardiovascular diseases.

Overweight and obesity vs. simple carbohydrates consumption by elderly people suffering from diseases of the cardiovascular system.

INTRODUCTION: Overweight and obesity belong to the alarming and constantly increasing problems of the 21st century among all age groups. One of the major factors enhancing these problems are simple carbohydrates commonly found in popular sweet drinks. OBJECTIVE: The aim of the study was to estimate the nutritional patterns of elderly people with diagnosed cardiovascular system diseases, and analysis of the relationship between consumption of simple carbohydrates and prevalence of overweight and obesity. MATERIAL AND METHODS: From 233 individuals hospitalized in the Clinic of Cardiology and Hypertension in Krakow, Poland, a group of 128 elderly people was selected (66 women and 62 men). Actual food consumption for each individual was assessed using a 24-hour nutrition recall. BMI values was calculated for assessment of nutritional status. Statistical analysis was performed on two groups: one with BMI <25kg/m2 and other with BMI≥25kg/m2. RESULTS: Overweight was stated among 33.8% of women and 50% of men, obesity among 27.7% of women and 17.7% of men. Results indicated that consumption of products rich in sucrose was associated with overweight and obesity. People with overweight and obesity statistically more often ate sweet products comparing to those with proper weight: 46.2 g vs 33.8g. The growing world-wide epidemic of overweight and obesity is one of the main priorities of preventive medicine remains changing eating patterns As observed in this study, one additional spoon of sugar consumed daily increases the risk of being overweight or obese by about 14%. CONCLUSIONS: Overweight and obesity was found among 60% of the examined elderly people. Correlation was found between rise in risk of obesity or overweight by about 14% with each additional spoon of sugar (5g) eaten every day.

Dioxins: validation of food frequency questionnaire and intake in a group of adolescents.

INTRODUCTION: A lot of has been heard about dioxins and dioxins-like compounds. These molecules are typically connected in public awareness with affairs. The main source of dioxins for humans is food (90% of typical exposition); thus, assessment of dioxins intake and monitoring of levels of dioxins in food remain an important issue. OBJECTIVE: The aim of the presented work was checking the reproducibility of the authors' semi-quantitative food frequency questionnaire, focusing on products that may contain dioxins and related compounds among adolescents. The uptake of these compounds was also assessed using obtained data. For survey purposes, an album of food products from the questionnaire was constructed. MATERIAL AND METHODS: A modified semi-quantitative food frequency questionnaire was constructed and distributed twice in a 2-week time span among 55, 15-year-old, students of secondary schools. RESULTS: The correlation coefficient for both declared frequencies and assessed amounts in the case of the majority of food items was above 0.70. The average assessed intake of dioxins and related compounds was 1.57pgWHO-TEQ/kg body weight per day, and 1.85 pgWHO-TEQ/kg body weight per day, during test and retest, respectively. CONCLUSIONS: The modified semi-quantitative food frequency questionnaire is a reproducible tool that can be used for adolescents. Average intake in the analyzed group was lower than the Tolerable Daily Intake, but in contrast to other countries remains one of the highest intakes in a comparable age group. The main sources of dioxins exposition were fish (38%), and meat products.

A Survey of Genetic Variation and Genome Evolution within the Invasive Fallopia Complex.

The knotweed taxa Fallopia japonica, F. sachalinensis and their interspecific hybrid F. × bohemica are some of the most aggressive invaders in Europe and North America and they are serious threats to native biodiversity. At the same time, they constitute a unique model system for the creation of hybrids and studies of the initiation of evolutionary processes. In the presented study, we focused on (i) examining genetic diversity in selected populations of three Fallopia taxa in the invaded (Poland) and native ranges (Japan), (ii) establishing genome size and ploidy levels and (iii) identifying ribosomal DNA (rDNA)-bearing chromosomes in all of the taxa from the invaded range. We found that the genetic diversity within particular taxa was generally low regardless of their geographical origin. A higher level of clonality was observed for the Polish populations compared to the Japanese populations. Our study suggests that the co-occurrence of F. sachalinensis together with the other two taxa in the same stand may be the source of the higher genetic variation within the F. × bohemica hybrid. Some shift towards the contribution of F. japonica alleles was also observed for selected F. × bohemica individuals, which indicates the possibility of producing more advanced generations of F. × bohemica hybrids. All of the F. sachalinensis individuals were hexaploid (2n = 6x = 66; 2C = 6.01 pg), while those of F. japonica were mostly octoploid (2n = 8x = 88; 2C = 8.87 pg) and all of the F. × bohemica plants except one were hexaploid (2n = 6x = 66; 2C = 6.46 pg). Within the chromosome complement of F. japonica, F. sachalinensis and F. × bohemica, the physical mapping of the rDNA loci provided markers for 16, 13 and 10 chromosomes, respectively. In F. × bohemica, a loss of some of rDNA loci was observed, which indicates the occurrence of genome changes in the hybrid.

Breakfast and Other Meal Consumption in Adolescents from Southern Poland.

The aim of the study was to evaluate the frequency of breakfast and other meal consumption by adolescents and to assess the relationship between the first and the last meal consumption and sex, body mass index (BMI), and middle school and high school students' education level. The study was conducted in 2013-2014 among 3009 students (1658 girls and 1351 boys) from middle s and high schools in Krakow and Silesia (Poland). The data was obtained from questionnaires that were analyzed with a logistic regression model for measurable and dichotomous variables. Breakfast consumers were seen to eat other meals (second breakfast, lunch, dessert, supper) significantly more often than breakfast skippers. The main meal consumption habits depend on sex and change as adolescents age. Being a girl and a high school student predisposed participants to skip breakfast and supper more often. The BMI of breakfast consumers does not differ significantly from the BMI of breakfast skippers, so BMI might thus not be a sufficient marker of breakfast consumption regularity and dietary habits in an adolescent group. The importance of regularly eaten meals, especially breakfast, together with adequate daily dietary energy intake are beneficial for physical and psychological development and cannot be overestimated in nutritional education and it is necessary to promote healthy eating behavior for well-being in later adult life.

The Structure of Fats and Fatty Acid Consumption in Elderly People with Cardiovascular System Diseases.

BACKGROUND: Patients with cardiovascular system diseases having their origin in arteriosclerosis require special dietetic treatment. Among many nutritional components, fats in the diet (both their quantity and quality) play a very important role in primary and secondary prevention of these diseases. OBJECTIVES: The aim of the study was the estimation of total fats participation (saturated fatty acids, mono- and polyunsaturated fatty acids and cholesterol) in the Daily Nutritional Ration (DNR) of elderly people with cardiovascular system diseases. MATERIAL AND METHODS: The study included 128 persons (66 women and 62 men, mean age 73.2 ± 6.9) hospitalized in the 1st Clinic of Cardiology and Hypertension, UJCM in Kraków. Daily intakes of energy were estimated using the 24-h nutritional recall and Food Frequency Questionnaire. RESULTS: A higher consumption of fats and fatty acids was observed in men's diet than in women's diet. The percentage of energy from saturated fatty acids (10.6% M and W) was higher than dietary recommendations. The consumption of monounsaturated fatty acids was in accordance with nutritional recommendations. The participation in the diet of polyunsaturated fatty acids was insufficient versus the newest nutritional recommendations and was determined as 4.6% of energy in DNR in men and 4.1% of energy of DNR in women. CONCLUSIONS: The excessive amount of saturated fatty acids together with the insufficient amount of polyunsaturated fatty acids in the diet are the result of the excessive consumption of products which are a source of animal fat and insufficient consumption of plant fat, fish and seafood.

[Diet with high antioxidant capacity as important factor in primary and secondary prevention of asthma]. / Dieta o wysokim potencjale antyoksydacyjnym jako wazny czynnik w pierwotnej i wtórnej prewencji astmy oskrzelowej.

UNLABELLED: In primary and secondary prevention of diseases resulted from antioxidant failure and changes towards oxidation processes (autoimmunological/allergic diseases, especially asthma) intake of exogenic antioxidants from food is crucial. The aim of the study was to estimate diet antioxidant capacity (measured as DWA values) among healthy inhabitants of Krakow and assess which food products had the main contribution in DAI, in order to give the indications for people suffering from bronchial asthma. MATERIAL AND METHODS: The study group consisted of 478 persons: 350 of healthy inhabitants of Krakow and two specific subpopulations: 48 men with high level of physical activity and 80 students from Jagiellonian University and Technical Academy. Dietary antioxidant index (DWA) was investigated on the basis of food frequency questionnaire (FFQ). In the FFQ 145 food items were classified into groups such as fruit and dried fruits, vegetables and vegetable oils, sweets, grains and cereal-based products, mixed dishes, fresh herbs, spices and beverages. The total antioxidant capacity of food intake was measured using the method developed by Benzi. This method exploits the ability of the sample to reduce ferricions to ferrousions (FRAP). RESULTS: The total antioxidant capacity (measured as DWA) of diet of 225 examined women was higher than calculated from 253 men and statistically significant (82.7 Mmol/l vs 49.1 Mmol/l). Moreover FRAP values of particular groups of food products were higher in case of women than men. The highest contribution in total DWA value had fruits and subsequently: cereals, juices and beverages. Unfortunately, examined people consumed to low amount of vegetables, fresh herbs and spices, which have well-documented antioxidant property. CONCLUSIONS: DWA values of healthy individuals presented in this study may be treated as a low reference value of antioxidant capacity for diets of asthmatic people. Enrichment in natural antioxidants diets of asthmatic individuals (mainly men), should become an important element of primary and secondary prophylaxis in bronchial asthma.

Digestive complaints in patients with hematologic malignancies undergoing bone marrow transplantation.

The aim of this study was to assess the severity and frequency of complaints affecting the digestive system in 57 patients with hematological malignancies, who underwent allogeneic (Group I, n = 22) and autologous (Group II, n = 35) hematopoietic stem cell transplantation. Chemotherapy-related toxicities affecting the digestive system (mucositis, nausea/vomiting, diarrhea) were assessed according to the WHO scale for organ toxicity. Selection of the feeding route (oral or parenteral) depended on the tolerance to oral nutrition. Parenteral nutrition (PN) was introduced when oral intake represented ≤ 50% of the total energy requirement over 2 days. PN was started in the third 24-h period. 63.6% of patients undergoing allogeneic transplantation and 54.3% of patients undergoing autologous transplantation needed PN. Ailments affecting the digestive system began in both groups during the administration of conditioning chemotherapy and gradually decreased in the posttransplantation period. Mucositis grade 3/4 requiring PN was observed in 85% patients in Group I and 52.7% patients in Group II. In Group I, grade 3 diarrhea was observed only in patients requiring PN. Severe grade 3/4 organ toxicity from chemotherapy was the main indication for PN in patients undergoing hematopoietic stem cell transplantation.