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1.
PLoS One ; 15(5): e0229389, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32469882

RESUMO

Links between crystalline methamphetamine (CM) use and criminal offending are often drawn in the media; however, there has been little scientific research into this relationship. The aim of this study was to ascertain the prevalence and correlates of lifetime CM use among a sample of young people in detention in Australia and to examine whether an association exists between lifetime CM use and recidivism in this population.The sample included 202 young people (164 males) in youth detention in the state of Victoria, Australia. Participants were administered questionnaires related to lifetime substance use and socio-environmental experiences. Lifetime mental health data and offending data were obtained for each participant from public mental health and policing databases. More than one third (38%) of the sample reported lifetime CM use. In multivariate logistic regression analyses, older age, male gender, polysubstance use, and high levels of community disorganisation were associated with CM use. The presence of a psychiatric diagnosis over the lifetime was not significantly associated with CM use. CM use was also not significantly associated with violent recidivism. Efforts to address CM use and related harm in detained youth should include community-based strategies to reduce CM use among this vulnerable population following their release from detention. However, the findings suggest that CM use on its own is unlikely to be an important consideration for professionals concerned with determining which young people should be selected for treatment designed to reduce the risk of violent recidivism.


Assuntos
Comportamento Criminoso/efeitos dos fármacos , Delinquência Juvenil/psicologia , Metanfetamina/toxicidade , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Adulto , Analgésicos Opioides/efeitos adversos , Austrália/epidemiologia , Cannabis/efeitos adversos , Comportamento Criminoso/fisiologia , Feminino , Medicina Legal , Humanos , Delinquência Juvenil/legislação & jurisprudência , Masculino , Saúde Mental , Abuso Físico/psicologia , Polícia/estatística & dados numéricos , Saúde Pública , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Inquéritos e Questionários , Adulto Jovem
2.
N Z Med J ; 133(1515): 54-69, 2020 05 22.
Artigo em Inglês | MEDLINE | ID: mdl-32438377

RESUMO

AIMS: To explore patterns of medicinal cannabis use prior to implementation of the new Medicinal Cannabis Scheme (MCS) in New Zealand. METHODS: An anonymous online convenience survey of 3,634 last-year medicinal users of cannabis promoted via Facebook™ from May to August 2019. RESULTS: Fifty percent of the sample were female, 18% were Maori and the median age was 38 years. The medical conditions for which cannabis was most often used were pain (81%), sleep (66%) and mental health conditions (64%). Respondents perceived cannabis to be an effective therapy and reported reducing use of other pharmaceutical medicines. Fifty-two percent reported side effects from cannabis use, including increased appetite (29%), drowsiness (12%), eye irritation (11%), dependency (10%), memory impairment (10%) and lack of energy (9%). Smoking was the dominant route of administration. Nearly half (47%) had discussed their use of cannabis with a medical professional in the previous year, while 14% had requested a prescription and 5% accessed a prescribed cannabis-based product (mostly oral CBD). CONCLUSION: Respondents self-medicated with cannabis to treat a wide range of health complaints. Only half discussed medicinal cannabis use with their medical professional, and a minority requested a prescription and used a prescribed cannabis-based product.


Assuntos
Cannabis , Maconha Medicinal/uso terapêutico , Fitoterapia/estatística & dados numéricos , Extratos Vegetais/uso terapêutico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Cannabis/efeitos adversos , Feminino , Política de Saúde , Humanos , Masculino , Fumar Maconha/efeitos adversos , Fumar Maconha/legislação & jurisprudência , Maconha Medicinal/efeitos adversos , Maconha Medicinal/economia , Maconha Medicinal/provisão & distribução , Transtornos Mentais/tratamento farmacológico , Pessoa de Meia-Idade , Nova Zelândia , Dor/tratamento farmacológico , Extratos Vegetais/efeitos adversos , Extratos Vegetais/economia , Extratos Vegetais/provisão & distribução , Transtornos do Sono-Vigília/tratamento farmacológico , Inquéritos e Questionários , Adulto Jovem
3.
N Z Med J ; 133(1515): 79-88, 2020 05 22.
Artigo em Inglês | MEDLINE | ID: mdl-32438379

RESUMO

AIMS: Personal cannabis use is common across New Zealand, and an upcoming referendum will enable the public to vote on whether this should be legalised. The present research aimed to examine the attitudes of midlife New Zealand adults on cannabis use and legalisation, and to identify potential predictors of those attitudes. METHODS: At age 40, 899 participants drawn from the Christchurch Health and Development Study were interviewed about the perceived harmfulness of cannabis use, opinions on legalisation for recreational use and supply, and the use of cannabis for medicinal purposes. In addition, a range of potential predictors of legislative attitudes were examined. RESULTS: We identified a wide range of attitudes across the cohort, however the majority tended to hold a neutral view. More than 80% of the cohort expressed support for medicinal cannabis, while 47.8% supported decriminalisation, and 26.8% expressed support for legalisation for recreational use. The strongest predictors of support for legalisation were prior use of cannabis and other drugs, while additional positive predictors included a history of depression, Maori ancestry, parental drug use, novelty seeking and higher educational attainment. Predictors of more negative attitudes were also identified, and included female gender and having dependent children. CONCLUSIONS: These findings provide insight into cannabis-related views within the New Zealand context, and may help to predict voting behaviour during the 2020 Cannabis Referendum.


Assuntos
Atitude , Cannabis , Fumar Maconha/legislação & jurisprudência , Maconha Medicinal/uso terapêutico , Adolescente , Adulto , Atitude/etnologia , Cannabis/efeitos adversos , Estudos de Coortes , Escolaridade , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Humanos , Drogas Ilícitas , Masculino , Fumar Maconha/efeitos adversos , Maconha Medicinal/efeitos adversos , Nova Zelândia , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Pais , Fatores Sexuais , Adulto Jovem
4.
Curr Opin Anaesthesiol ; 33(3): 318-326, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32371642

RESUMO

PURPOSE OF REVIEW: Both cannabis and e-cigarette use are increasing, particularly among adolescents. The use of cannabis products may impact patients' physiology under anesthesia. Understanding the effects of cannabis and vaping are critical to the provision of safe and effective anesthetic care. RECENT FINDINGS: E-cigarettes have recently been implicated in a severe presentation of acute lung injury, often in association with vaporization of the cannabinoid, THC. E-cigarette use appears to be associated with other less-acute pulmonary adverse effects that are yet to be fully understood. Cannabis affects many organ systems with alterations in cardiovascular, respiratory and neurological function. Specifically, there is emerging evidence that cannabis use may reduce the efficacy of sedative agents and postoperative pain management efforts. SUMMARY: There is a very wide variety of cannabis products currently available, with respect to both route of administration as well as cannabinoid content. Patients using cannabis products prior to anesthesia may present with altered physiology that place them at increased risk for cardiovascular and respiratory complications. They may also be tolerant to the effects of propofol and opioid for pain management, thus consideration should be given to use of a multimodal regimen.


Assuntos
Anestesia , Canabinoides , Cannabis/efeitos adversos , Sistemas Eletrônicos de Liberação de Nicotina , Vaping/efeitos adversos , Adolescente , Humanos , Lesão Pulmonar
5.
PLoS One ; 15(3): e0230419, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32226050

RESUMO

BACKGROUND: The notion that smoking cannabis may damage the respiratory tract has been introduced in recent years but there is still a paucity of studies on this subject. The aim of this study was to investigate the relationship between cannabis smoking, pneumothorax and bullous lung disease in a population of operated patients. METHODS AND FINDINGS: We performed a retrospective study on patients operated on for spontaneous pneumothorax. Patients were divided into three groups according to their smoking habit: cannabis smokers, only-tobacco smokers and nonsmokers. Cannabis lifetime exposure was expressed in dose-years (1d/y = 1 gram of cannabis/week for one year). Clinical, radiological and perioperative variables were collected. The variables were analyzed to find associations with smoking habit. The impact of the amount of cannabis consumption was also investigated by ROC curves analysis. Of 112 patients, 39 smoked cannabis, 23 smoked only tobacco and 50 were nonsmokers. Median cannabis consumption was 28 dose/years, median tobacco consumption was 6 pack/years. Cannabis smokers presented with more severe chronic respiratory symptoms and bullous lung disease and with a higher incidence of tension pneumothorax than both tobacco smokers and nonsmokers. Cannabis smokers also developed a larger pneumothorax, experienced prolonged postoperative stay and demonstrated a higher incidence of pneumothorax recurrence after the operation than nonsmokers did. The risk of occurrence of chronic respiratory symptoms and bullous lung disease in cannabis smokers was dose-related. CONCLUSIONS: Cannabis smoking seems to increase the risk of suffering from respiratory complaints and can have detrimental effects on lung parenchyma, in a dose-dependent manner. Cannabis smoking also negatively affected the outcome of patients operated for spontaneous pneumothorax. A history of cannabis abuse should always be taken in patients with pneumothorax. There may be need for a specific treatment for pneumothorax in cannabis smokers.


Assuntos
Vesícula/fisiopatologia , Fumar Maconha/efeitos adversos , Pneumotórax/fisiopatologia , Fumar Tabaco/efeitos adversos , Adulto , Vesícula/diagnóstico por imagem , Vesícula/etiologia , Vesícula/cirurgia , Cannabis/efeitos adversos , Feminino , Alucinógenos/efeitos adversos , Humanos , Pulmão/diagnóstico por imagem , Pulmão/fisiopatologia , Masculino , Abuso de Maconha/epidemiologia , Abuso de Maconha/fisiopatologia , Pessoa de Meia-Idade , Pneumotórax/diagnóstico por imagem , Pneumotórax/etiologia , Pneumotórax/cirurgia , Enfisema Pulmonar/diagnóstico por imagem , Enfisema Pulmonar/fisiopatologia , Enfisema Pulmonar/cirurgia , Sistema Respiratório/diagnóstico por imagem , Sistema Respiratório/fisiopatologia , Índice de Gravidade de Doença , Fumantes , Tomografia Computadorizada por Raios X , Adulto Jovem
6.
An. Fac. Cienc. Méd. (Asunción) ; 53(1): 41-48, 20200401.
Artigo em Espanhol | LILACS | ID: biblio-1095636

RESUMO

Introducción: el trastorno por déficit de atención e hiperactividad es un trastorno del neurodesarrollo con una prevalencia del 5% en niños y adolescentes y del 2,5% en adultos y está asociado a una alta comorbilidad con el trastorno por consumo de cannabis, otros trastornos por consumo de sustancias y otros trastornos psiquiátricos. Objetivo: determinar la evidencia científica actual sobre el uso cannabis y el desarrollo de trastorno por déficit de atención e hiperactividad. Metodología: esta fue una revisión sistemática de la literatura. Se realizó una búsqueda en línea de publicaciones relevantes en PubMed, CICCO y Web of Science. La búsqueda se limitó a artículos escritos en inglés o español, entre los años 2008 a 2019. La sintaxis de búsqueda incluyó: "cannabis AND ADHD", "Attention-deficit/hyperactivity AND cannabis". Resultados: se encontraron 229 publicaciones relacionadas. La mayoría de los textos excluidos correspondieron a estudios que no informaron una relación causal entre cannabis y trastorno por déficit de atención e hiperactividad, que era el objetivo de la presente revisión sistemática. Se excluyeron aquellos textos completos que presentaban al cannabis como tratamiento del trastorno o porque informaban que las personas con dicho diagnóstico eran más propensas al consumo de sustancias. Discusión: el consumo de cannabis reduce los niveles de síntesis de dopamina estriatal y se asocia con déficits de la función ejecutiva y reducción sinérgica de la dopamina, provocando una exacerbación del déficit cognitivo relacionado con el trastorno por déficit de atención o con el propio uso de cannabis. Asimismo, el consumo de cannabis conduce al uso de otras drogas, lo que a su vez produce un aumento de los síntomas de trastorno por déficit de atención. La relación causal de uso de cannabis y desarrollo posterior de trastorno por déficit de atención e hiperactividad debe estudiarse más a fondo, ya que las investigaciones sobre este aspecto concreto son pocas y no concluyentes.


Attention deficit hyperactivity disorder is a neurodevelopmental disorder with a prevalence of 5% in children and adolescents and 2.5% in adults and is associated with high comorbidity with cannabis use disorder, other substance use and other psychiatric disorders.Objective: To determine the current scientific evidence on cannabis use and the development of attention deficit hyperactivity disorder. Methodology: This was a systematic review of the literature. An online search of relevant publications was conducted in PubMed, CICCO and Web of Science databases. The search was limited to articles written in English or Spanish, between 2008 and 2019. The search syntax included: "cannabis AND ADHD", "Attention-deficit/hyperactivity AND cannabis". Results: 229 related publications were found. Most of the excluded texts corresponded to studies that did not report a causal relationship between cannabis and attention deficit hyperactivity disorder, which was the objective of this systematic review. Those full texts that presented cannabis as a treatment for the disorder or because they reported that people with this diagnosis were more prone to substance use were excluded. Discussion: Cannabis use reduces levels of striatal dopamine synthesis and is associated with deficits of executive function and synergistic reduction of dopamine, causing an exacerbation of the cognitive deficit related to attention deficit disorder or the use of cannabis itself. Also, cannabis use leads to the use of other drugs, which in turn produces an increase in symptoms of attention deficit disorder. The causal relationship of cannabis use and subsequent development of attention deficit hyperactivity disorder should be studied further, since research on this particular aspect is few and inconclusive.


Assuntos
Cannabis/efeitos adversos
7.
Phytother Res ; 34(7): 1670-1677, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32083789

RESUMO

The number of patients using cannabis for therapeutic purposes is growing worldwide. While research regarding the treatment of certain diseases/disorders with cannabis and cannabinoids is also expanding, only a few longitudinal studies have assessed the mid-term impacts of medical cannabis use on psychological variables and quality of life (QoL). The aim of the study was to assess the psychological safety and QoL of patients with chronic diseases who self-medicate with cannabis over time. We recruited patients with various chronic diseases who use cannabis and collected data regarding patterns of cannabis use as well as mental health, personality and QoL. Participants were followed-up at baseline, 4, 8 and 12 months. Hair analysis was conducted to confirm the presence of cannabinoids. Personality assessment showed a consistent decrease in self-transcendence and self-directedness scores. Neither cognitive nor psychopathological deterioration was found. There were also no variations in QoL. Mid-term use of medical cannabis seems to show adequate tolerability regarding cognitive and psychopathological abilities, and it may help patients with chronic diseases to maintain an acceptable QoL.


Assuntos
Cannabis/efeitos adversos , Saúde Mental/normas , Personalidade/fisiologia , Qualidade de Vida/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Adulto , Idoso , Doença Crônica , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Adulto Jovem
8.
JAMA Netw Open ; 3(1): e1919792, 2020 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-31977062

RESUMO

Importance: While a diverse array of cannabis products that may appeal to youth is currently available, it is unknown whether the risk of persistent cannabis use and progression to higher frequency of use after experimentation differs among cannabis products. Objective: To estimate the comparative relative risk of experimental use of 5 cannabis products on use status and frequency of use among adolescents during 12 months of follow-up. Design, Setting, and Participants: In this cohort study, data were collected from 3065 adolescents at 10 high schools in southern California, with baseline data collected in spring 2016, when students were in 11th grade, and 6-month and 12-month follow-up surveys collected in fall 2016 and spring 2017, when students were in 12th grade. Analyses, conducted from April to June 2019, were restricted to 2685 participants who were light or nonusers of any cannabis product (ie, ≤2 days in the past 30 days) at baseline. Exposures: Number of days of use of each cannabis product (ie, combustible, blunts, vaporized, edible, or concentrated) in the past 30 days at baseline (ie, 1-2 vs 0 days). Main Outcomes and Measures: Past 6-month use (ie, yes vs no) and number of days of use in the past 30 days at 6-month and 12-month follow-ups for each product. Results: Of 2685 individuals in the analytic sample, 1477 (55.0%) were young women, the mean (SD) age was 17.1 (0.4) years, and a plurality (1231 [46.6%]) were Hispanic individuals. Among them, 158 (5.9%) reported combustible cannabis use on 1 to 2 days of the past 30 days at baseline, 90 (3.4%) reported blunt use, 78 (2.9%) reported edible cannabis use, 17 (0.6%) reported vaping cannabis, and 15 (0.6%) reported using cannabis concentrates. In regression models adjusting for demographic characteristics and poly-cannabis product use, statistically stronger associations of baseline use with subsequent past 6-month use at the 6-month and 12-month follow-ups were observed for combustible cannabis use (odds ratio, 6.01; 95% CI, 3.66-9.85) and cannabis concentrate use (odds ratio, 5.87; 95% CI, 1.18-23.80) compared with use of blunts (OR, 2.77; 95% CI, 1.45-5.29) or edible cannabis (OR, 3.32; 95% CI, 1.86-5.95) (P for comparison < .05); vaporized cannabis use (OR, 5.34; 95% CI, 1.51-11.20) was not significantly different from the other products. In similarly adjusted models, we found the association of cannabis use at baseline with mean days of use at the 6-month and 12-month follow-ups was significantly stronger for cannabis concentrate than for other cannabis products; participants who had used cannabis concentrate on 1 to 2 of the past 30 days at baseline (vs 0 days) used cannabis concentrate a mean of 9.42 (95% CI, 2.02-35.50) more days in the past 30 days at the 6-month and 12-month follow-ups (P for comparison < .05). Conclusions and Relevance: Cannabis control efforts should consider targeting specific cannabis products, including combustible cannabis and cannabis concentrate, for maximum public health consequences.


Assuntos
Comportamento do Adolescente/psicologia , Cannabis/efeitos adversos , Usuários de Drogas/psicologia , Fumar Maconha/psicologia , Estudantes/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Usuários de Drogas/estatística & dados numéricos , Feminino , Humanos , Masculino , Razão de Chances , Fatores de Risco , Autorrelato/estatística & dados numéricos , Inquéritos e Questionários , Estados Unidos
10.
N Z Med J ; 133(1508): 12-28, 2020 01 17.
Artigo em Inglês | MEDLINE | ID: mdl-31945040

RESUMO

AIM: To investigate GP knowledge of the use of cannabis as a medicine and its regulation in New Zealand. METHOD: A convenience sample of GPs completed a questionnaire during continuing medical education sessions. Key domains investigated were: patient interactions around use of cannabis as a medicine; prescription facilitation and impediments; knowledge of evidence for and against the use of cannabis as a medicine; knowledge of the New Zealand regulatory processes and knowledge of pharmaceutical grade products. Questionnaires were administered between June and October 2018. RESULTS: There were 42/76 (55%) GPs who stated at least one patient had asked for a cannabis prescription for medical use in the last 12 months and 43/76 (57%) were aware of pharmaceutical grade preparations, the majority Sativex. There were 59/75 (79%) who expressed concerns about future prescribing; however, 63/75 (84%) indicated they would be 'somewhat' or 'very' likely to prescribe a PHARMAC-funded product with good evidence in specific conditions. CONCLUSION: Some GPs have concerns about prescribing medicinal cannabis. Due to regulatory restrictions, including no currently funded products, and uncertain scientific evidence of efficacy and safety, education programmes will be required to inform the medico-legal, evidential and practical elements of prescribing cannabis as a medicine.


Assuntos
Clínicos Gerais/ética , Clínicos Gerais/estatística & dados numéricos , Maconha Medicinal/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Cannabis/efeitos adversos , Educação Médica Continuada/normas , Feminino , Humanos , Conhecimento , Masculino , Pessoa de Meia-Idade , Motivação/fisiologia , Nova Zelândia/epidemiologia , Segurança do Paciente , Inquéritos e Questionários , Resultado do Tratamento
11.
Clin EEG Neurosci ; 51(1): 45-50, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31741395

RESUMO

In psychiatry, routine EEGs are often abnormal and not very specific, raising questions about the clinical relevance and consequences of potential anomalies. One such question is whether the administration of anticonvulsants would be useful if epileptic discharges are detected in patients without any clinical correlates. With regard to this question, we present a case study in which abnormal EEG patterns were observed in a patient with chronic migraine and cannabis addiction. The patient was a 34-year-old woman with a 14-year history of cannabis abuse who, during withdrawal, showed epileptic spikes, without any corresponding clinical symptoms, and migraine attacks of increasing intensity and frequency. This case study is in line with the new DSM-5 diagnostic tool that for the first time includes the diagnosis of cannabis withdrawal.


Assuntos
Cannabis/efeitos adversos , Eletroencefalografia , Epilepsia/complicações , Transtornos de Enxaqueca/complicações , Síndrome de Abstinência a Substâncias , Adulto , Anticonvulsivantes/uso terapêutico , Encéfalo/fisiopatologia , Eletroencefalografia/métodos , Epilepsia/diagnóstico , Epilepsia/fisiopatologia , Feminino , Humanos , Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/fisiopatologia
12.
Am J Case Rep ; 20: 1874-1878, 2019 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-31838485

RESUMO

BACKGROUND Marijuana is the considered the most widely available and used drug across the world. Up to this time, there have been no reports of human death directly caused by acute marijuana toxicity in adults, fetuses, or newborn neonates. CASE REPORT We report a death of an 11-day-old white female neonate due to acute marijuana toxicity. She died of extensive necrosis and hemorrhage of the liver and adrenals due to maternal use of marijuana. CONCLUSIONS This case is unique in that other possible causes of death can be eliminated. With growing use of marijuana by pregnant women and increases in newborn drug screening of umbilical cord homogenate, more cases of neonatal death due to acute marijuana toxicity could be discovered.


Assuntos
Doenças das Glândulas Suprarrenais/induzido quimicamente , Cannabis/efeitos adversos , Doença Hepática Induzida por Substâncias e Drogas , Morte Perinatal/etiologia , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Evolução Fatal , Feminino , Humanos , Recém-Nascido , Gravidez
13.
Arch. argent. pediatr ; 117(6): 360-367, dic. 2019. tab, graf
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-1046199

RESUMO

El consumo de cocaína y/o cannabis durante el embarazo constituye un problema en ascenso, de importancia para la salud pública mundial. Los niños expuestos pueden presentar un amplio rango de complicaciones en el período perinatal, pero los conocimientos sobre la evolución posterior son escasos.Objetivo: Describir y comparar las trayectorias sanitarias de niños expuestos y no expuestos prenatalmente a cocaína y/o cannabis durante 4 años. Métodos: Estudio de cohorte retrospectivo con grupo de comparación doble. Los niños expuestos fueron detectados en el Servicio de Neonatología de un hospital público mediante una prueba de orina, entre 2009 y 2013. Resultados: Se evaluaron 29 niños expuestos y 58 no expuestos. Las principales drogas detectadas en el grupo expuesto fueron cocaína y cannabis. La mayoría de las madres fueron policonsumidoras. En los niños del grupo expuesto, se encontraron diferencias significativas en menor frecuencia de controles de salud (p < 0,0001) y mayor frecuencia de consultas en Emergencias (p = 0,0295) e Internaciones (p = 0,007), principalmente, por cuadros respiratorios. Presentaron, además, mayor frecuencia de enfermedad pulmonar obstructiva crónica, cambios de hogar y judicialización. En ese grupo, hubo 1 niño y 2 progenitores muertos por causa violenta. No hubo ninguna muerte en el grupo no expuesto.Conclusiones: Los niños expuestos a cocaína y/o cannabis prenatalmente tuvieron menor número de controles de salud y mayor frecuencia de consultas en Emergencias e Internaciones. Presentaron, además, mayor frecuencia de enfermedad pulmonar obstructiva crónica, cambios de hogar, judicialización y muertes violentas en el grupo familiar directo.


Cocaine and/or cannabis use during pregnancy is a growing problem of relevance for global public health. Exposed children may have a wide range of perinatal complications, but there is little knowledge on their course.Objective: To describe and compare the health trajectories of children prenatally exposed and unexposed to cocaine and/or cannabis over 4 years.Methods: Retrospective, cohort study with a double control group. Exposed children were detected through a urine test by the Department of Neonatology of a public hospital between 2009 and 2013. Results: A total of 29 exposed children and 58 unexposed children were assessed. The most common drugs detected in the exposed group were cocaine and cannabis. Most mothers were poly-drug users. The exposed group showed significant differences in relation to a lower frequency of health checkups (p < 0.0001) and a higher number of visits to the emergency department (p = 0.0295) and hospitalizations (p = 0.007), mainly due to respiratory conditions. In addition, they had a greater rate of chronic obstructive pulmonary disease, changes of home, and legal interventions. In this group, 1 child and 2 parents had a violent death. No deaths were reported in the unexposed group. Conclusions: Children prenatally exposed to cocaine and/or cannabis had a lower number of health checkups and a higher number of visits to the emergency department and hospitalizations. Besides, they showed a greater rate of chronic obstructive pulmonary disease, changes of home, legal interventions, and violent deaths in the direct family group.


Assuntos
Humanos , Masculino , Feminino , Gravidez , Recém-Nascido , Lactente , Pré-Escolar , Efeitos Tardios da Exposição Pré-Natal , Cannabis/efeitos adversos , Indicadores de Morbimortalidade , Seguimentos , Cocaína/efeitos adversos , Estudos Retrospectivos , Mães
14.
Ann Agric Environ Med ; 26(4): 661-664, 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31885242

RESUMO

Introduction. Before cigarettes became popular, lung cancer was an extremely rare disease, but currently it is the most common cause worldwide of cancer death in both genders. Therefore, it constitutes a huge epidemiological, diagnostic and socio-economic challenge around the world. In Poland, lung cancer is the second most common carcinoma in both men and women, and it is also the most prevailing cause of carcinous death. Undoubtedly, although smoking classical cigarettes is the strongest risk factor of developing the cancer, unfortunately it is not the only one. Objective. The aim of this study was to present smoking-related factors, e.g. cigars, pipes, e-cigarettes or marijuana smoking, etiologically related to lung cancer incidence.


Assuntos
Neoplasias Pulmonares/epidemiologia , Fumar/efeitos adversos , Produtos do Tabaco/efeitos adversos , Cannabis/efeitos adversos , Sistemas Eletrônicos de Liberação de Nicotina , Feminino , Humanos , Neoplasias Pulmonares/etiologia , Masculino , Polônia/epidemiologia , Fatores de Risco
15.
Presse Med ; 48(11 Pt 1): 1229-1236, 2019 Nov.
Artigo em Francês | MEDLINE | ID: mdl-31732360

RESUMO

Cannabis use is widespread among people at ultra-high risk (UHR) for psychosis. The causal link as well as the temporal link between cannabis use and further occurrence of psychosis in UHR people remain inconclusive. Current science data supported an increased risk of transition to psychosis in cannabis users who are genetically predisposed to psychosis. This risk would be even greater in the presence of a family history of psychosis, in case of a strong use and an early onset use. Several models have been cited to explain the link between cannabis use and the subsequent onset of psychosis or prepsychotic states: cannabis-induced modifications of some brain structures, a dysregulation of the hypothalamic-pituitary axis and an alteration of normal neurological development via the endocannabinoid system. Cannabis represents a modifiable risk for psychosis. Current interventions aim to reduce or stop the cannabis use in order to reduce the risk of transition to psychosis.


Assuntos
Cannabis/efeitos adversos , Abuso de Maconha/complicações , Psicoses Induzidas por Substâncias/etiologia , Fatores Etários , Encéfalo/efeitos dos fármacos , Endocanabinoides/fisiologia , Predisposição Genética para Doença , Humanos , Sistema Hipotálamo-Hipofisário/efeitos dos fármacos , Anamnese , Psicoses Induzidas por Substâncias/prevenção & controle , Risco
16.
Pediatr Emerg Care ; 35(11): 799-804, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31688799

RESUMO

The change in legal status of cannabis (the botanical species Cannabis sativa, commonly known as marijuana) in the United States has had significant impact on pediatric drug exposures. In states with decriminalization of recreational and medicinal use of cannabis, emergency department visits and poison control center calls for unintentional pediatric cannabis intoxication are on the rise in the last few decades. Exploratory or unintentional ingestions of cannabis-containing products (as opposed to those derived from synthetic cannabinoids, which may mimic the structure and/or function of cannabis, but are not the focus of this article) can lead to significant pediatric toxicity, including encephalopathy, coma, and respiratory depression. With the increasing magnitude of the public health implications of widespread cannabis use, clinicians who care for pediatric patients routinely must be adept in the recognition, evaluation, management, and counseling of unintentional cannabis exposure.


Assuntos
Canabinoides , Cannabis/envenenamento , Uso da Maconha/efeitos adversos , Canabinoides/farmacocinética , Canabinoides/farmacologia , Cannabis/efeitos adversos , Criança , Feminino , Humanos , Masculino , Uso da Maconha/legislação & jurisprudência , Receptores de Canabinoides/metabolismo , Estados Unidos
19.
Isr J Health Policy Res ; 8(1): 75, 2019 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-31619286

RESUMO

The leading formal drug policy in Israel is the traditional approach of abstinence, probation, and punitive measures based on three main pillars: Enforcement, Treatment and Rehabilitation, and Prevention. However, under the treatment pillar, Israel has adopted a number of harm reduction services, focused mostly on people who use heroin and people who inject drugs. These include Methadone Maintenance Treatment, Buprenorphine Maintenance Treatment, and Needle and Syringe Exchange Programs. More specialized services are designated mostly for people who use drugs, who frequent the largest open drug scene in Tel-Aviv. These include a health clinic, an emergency apartment for female addict sex-workers, and a 'First Step' center. Even so, the harm reduction approach has remained controversial, stigmatized, and is considered a sub-category for total-abstinence treatment in Israel. This paper follows the evolution of harm reduction interventions in Israel among people who use drugs and sheds light on the lack of a comprehensive, well-planned, formal national harm reduction drug policy. Additionally, this article expresses concern over the uncertain future of Israel's comprehensive and balanced drug treatment policies caused by the structural changes in abolishing the Israel Anti-Drug Authority, the statutory authority and central body in Israel that promoted and coordinated all national policies related to treatment and harm reduction. CONCLUSIONS: Although it is a major challenge to translate worldwide evidence and research findings into action and social change, recommendations are offered to implement a comprehensive harm reduction drug policy led by a multidisciplinary group of policy-makers across all areas of drug policy. These focus on expanding and developing more services for Opioid Maintenance Therapy patients and people who inject drugs as well as a national effort to reduce high levels of stigma and discrimination against them, encompassing other common substances and focusing on populations such as adolescents and young adults that engage in other types of substance use such as cannabis, amphetamine-type stimulants, and hallucinogens.


Assuntos
Redução do Dano , Política de Saúde , Tratamento de Substituição de Opiáceos , Abuso de Substâncias por Via Intravenosa/epidemiologia , Abuso de Substâncias por Via Intravenosa/reabilitação , Fatores Etários , Buprenorfina/administração & dosagem , Cannabis/efeitos adversos , Humanos , Israel/epidemiologia , Metadona/administração & dosagem , Programas de Troca de Agulhas
20.
PLoS One ; 14(10): e0222929, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31634346

RESUMO

BACKGROUND: Many potentially modifiable risk factors for MS are investigated. It is not known, however, if these factors also apply to MS-related cognitive impairment (CI), a frequent consequence of MS. OBJECTIVE: The aim of our study was to assess risk factors for CI in MS patients, focusing on environmental exposures, lifestyle and comorbidities. METHODS: We included MS patients referring to MS Centers in Florence and Barletta between 2014 and 2017. Neuropsychological performance was assessed through the Rao's battery and Stroop test, cognitive reserve (premorbid intelligence quotient-IQ) was evaluated using the National Adult Reading Test (NART). Potential risk factors were investigated through a semi-structured questionnaire. RESULTS: 150 patients were included. CI was detected in 45 (30%) subjects and was associated with older age (p<0.005), older age at MS onset (p = 0.016), higher EDSS score (p<0.005), progressive disease course (p = 0.048) and lower premorbid IQ score (p<0.005). As for risk factors, CI was related with lower physical activity in childhood-adolescence (p<0.005). In women, hormonal therapy resulted to be protective against CI (p = 0.041). However, in the multivariable analysis, the only significant predictors of CI were older age (p<0.05; OR 1.06, 95% CI 1.02-1.10) and lower premorbid IQ (p<0.05; OR 0.93, 95% CI: 0.88-0.98). Removing IQ from the model, CI was associated with higher EDSS (p = 0.030; OR 1.25, 95% CI 1.02-1.53) and, marginally, previous physical activity (p = 0.066; OR 0.49, 95% CI: 0.23-1.05). CONCLUSIONS: Our findings suggest that physical activity in childhood-adolescence could be a contributor to cognitive reserve building, thus representing a potential protective factors for MS-related CI susceptible to preventive strategies.


Assuntos
Cannabis/efeitos adversos , Disfunção Cognitiva/tratamento farmacológico , Exercício Físico/fisiologia , Esclerose Múltipla/tratamento farmacológico , Adulto , Disfunção Cognitiva/complicações , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/fisiopatologia , Reserva Cognitiva/fisiologia , Progressão da Doença , Feminino , Humanos , Testes de Inteligência , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/epidemiologia , Esclerose Múltipla/fisiopatologia , Testes Neuropsicológicos , Fatores de Risco , Fumar/efeitos adversos , Escalas de Wechsler
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