Depressive symptoms and alcohol and marijuana use among adolescents / Sintomas depressivos e uso de álcool e maconha em adolescentes / Síntomas depresivos y uso de alcohol y marihuana en adolescentes

Risk behaviors are common in adolescence and demonstrates an association with depressive symptoms. Considering the psychological health implications of this phase in adult life, the aim of this study was to verify associations between depressive symptoms and consumption of alcohol and marijuana, self-injurious behavior, health self-perception, life satisfaction, anxiety symptoms and suicidal ideation in adolescents. A total of 298 adolescents, aged 12 to 14 years (61.1% girls), participated in the study. The measures were the translated Health Behavior in School-aged Children questionnaire (HBSC - BR) and the Children's Depression Inventory (CDI). The chi-square test, student's t test and binomial logistic regression (p<0.05) were used. Depressive symptoms were associated with anxiety symptoms and self-injury. Higher risk for alcohol use and consumption, self-injury, negative health self-perception, anxiety and depression related to females. The findings of this population suggest worrying health outcomes, especially for girl. (AU)

Comportamentos de risco são comuns na adolescência e demonstram associação com sintomas depressivos. Considerando as implicações da saúde psicológica dessa fase na vida adulta, o objetivo deste trabalho foi verificar associações entre sintomas depressivos e consumo de álcool e maconha, comportamento autolesivo, autopercepção de saúde, satisfação com a vida, sintomas ansiosos e ideação suicida em adolescentes. Participaram 298 adolescentes, de 12 a 14 anos (61,1% meninas). Os instrumentos utilizados foram o questionário traduzido Health Behavior in School-aged Children (HBSC - BR) e o Inventário de Depressão Infantil (CDI). Utilizou-se os teste Qui-Quadrado, t de student e regressão logística binomial (p<0,05). Sintomas depressivos associaram-se com sintomas ansiosos e autolesão. Maior risco para uso e consumo de álcool, autolesão, autopercepção de saúde negativa, ansiedade e depressão em relação ao sexo feminino. Os achados desta população sugerem resultados preocupantes de saúde, sobretudo para o sexo feminino. (AU)

Las conductas de riesgo son comunes en la adolescencia y demuestran una asociación con síntomas depresivos. Considerando las implicaciones psicológicas para la salud de esta fase en la vida adulta, el objetivo de este estudio fue verificar asociaciones entre síntomas depresivos y consumo de alcohol y marihuana, autolesión, autopercepción de salud, satisfacción con la vida, ansiedad e ideación suicida en adolescentes. Participaron 298 adolescentes de 12 a 14 años (61,1% niñas). Los instrumentos utilizados fueron el cuestionario traducido Health Behavior in School-aged Children (HBSC - BR) y el Inventario de Depresión Infantil (CDI). Se utilizaron las pruebas de chi-cuadrado, t de Student y regresión logística binomial (p<0,05). Los síntomas depresivos se asociaron con síntomas de ansiedad y autolesiones. Mayor riesgo de uso y consumo de alcohol, autolesiones, autopercepción negativa de la salud, ansiedad y depresión en relación con el sexo femenino. Los hallazgos de esta población sugieren resultados de salud preocupantes, especialmente para las mujeres. (AU)

Consumo de drogas: enfrentamiento a un problema latente / Drug use: confronting a latent problem i: en

Algunas situaciones ponen en riesgo a Cuba en cuanto al uso de drogas, entre ellas el aumento del turismo, las relaciones con países que poseen altas tasas de consumo, la ubicación geográfica en corredores de narcotraficantes y la alta prevalencia de drogas porteras. Al respecto, el Sistema Nacional de Salud debe estar preparado para la prevención del problema y la atención a los afectados, de manera que resulta necesario mantener una información actualizada sobre los factores de riesgo y los principales productos utilizados por los consumidores. En la presente revisión bibliográfica sobre el tema se busca llamar la atención de los trabajadores de la salud en tal sentido, se ofrecen datos sobre la magnitud del problema y se abordan elementos de sus antecedentes, así como de la clasificación de las drogas, los factores de riesgo asociados a su consumo y las bases jurídicas para su control en Cuba.

Some situations put Cuba at risk for drug use, such as an increase in tourism, relations with countries that have high rates of substance abuse, the geographic location in drug trafficking corridors, and the high prevalence of "opening doors" drugs. In this regard, the National Health System must be prepared to prevent the problem and care for those affected, so it is necessary to maintain updated information on risk factors and main products used by consumers. In the present literature review on the subject, it is sought to draw the attention of health workers to this point, data on the magnitude of the problem and elements of its background are offered, as well as drug classification, the risk factors associated with its use and the legal bases for its control in Cuba.

Immunochromatography screening devices for cannabinoids in oral fluid sample

Abstract Cannabis sativa L. is one of the most consumed drugs in the world and recent studies have associated its use with an increase in the number of traffic accidents in different countries. In many countries, like Brazil, simple and reliable methodologies are still needed for the detection of drugs on site, mainly cannabinoids, considering its prevalence of use and oral fluid (OF) has been proved as an appropriate biological matrix for this purpose. Considering that, this work aims to review previous studies on immunochromatographic devices for on-site detection of cannabinoids in OF, discussing their sensitivity, specificity, cut-offs values and confirmatory methods. This data shows the importance of choosing a screening device and it reinforces the need for its implementation in Brazil. The research was conducted on 5 databases and all original articles, published in the last 10 years, were selected. A total of 32 articles were found, providing data for 17 screening devices of distinct brands. Only 2 screening devices showed satisfactory sensitivity and specificity in the evaluated studies (≥80% and ≥90% respectively). However, it should be considered that the screening devices still have some limitations, such as a higher cut-off than those recommended by international guidelines (cut-off > 2 ng/mL), therefore demonstrating the need for more studies in the area and the importance of confirmatory analysis usually fulfilled by LC-MS/MS, GC-MS/MS or GC-MS. Thus, the screening analyzes should not be evaluated by itself, but in association with confirmatory results and observational traits (behavioral changes), for a better understanding of the traffic scenario

Inconsistencia científica de los estudios que difunden los efectos paliativos de la marihuana o relativizan sus consecuencias nocivas / Scientific inconsistency of the studies that disseminate the palliative effects of marijuana or downplay its harmful consequences

Los países o territorios que legalizaron la marihuana o consideran hacerlo tienen que prevenir el aumento de las sobredosis por drogas; los resultados que ofrecen las experiencias de Estados Unidos -promocionadas con dudoso respaldo científico- se confirmaron equivocados. Las tendencias de mortalidad por opioides en los Estados Unidos, líder mundial tanto en mortalidad por opioides como en trastorno por consumo de cannabis, no acompaña la hipótesis que propone la disponibilidad de marihuana para reducir la mortalidad por opioides. Durante la última década, las tendencias de mortalidad por opioides del país en las jurisdicciones que legalizan y no legalizan la marihuana, sugieren lo contrario. Las personas de raza negra no hispanas y los hispanos en particular, necesitan ayuda para revertir las tendencias que pudieron facilitarse por la legalización de la marihuana.

Understanding cannabis use in Singapore: profile of users and drug progression

INTRODUCTION@#Cannabis has consistently been the third most commonly abused drug among drug arrestees in Singapore over the past few years. Accordingly, this study aimed to understand the profile of cannabis users in Singapore and explore the effects of cannabis use on drug progression.@*METHODS@#A total of 450 participants who had used cannabis at least once in their lifetime were recruited from the National Addictions Management Service, prisons, the Community Rehabilitation Centre and halfway houses from August 2017 to May 2018. A face-to-face questionnaire was administered and descriptive analyses were conducted.@*RESULTS@#The mean participant age was 40.9 ± 14.51 years, and 93.1% of them were male. The participants generally initiated cannabis use during adolescence, at a mean onset age of 16.5 ± 4.46 years. Most (89.6%) were introduced to cannabis by peers. Approximately half of them (46.9%) had used cannabis before other illicit drugs and 42.1% of them had used heroin as the succeeding drug.@*CONCLUSION@#In Singapore, cannabis use is often initiated during adolescence, largely under peer influence. Cannabis users may progress to other illicit drugs, particularly heroin, later in life.

The inhibitory effect of Cannabis Sativa L. and Morus nigra L. against lipid peroxidation in goat liver and brain homogenates / O efeito inibitório de Cannabis Sativa L. e Morus nigra L. contra a peroxidação lipídica em homogenatos de fígado e cérebro de cabra

The present study was aimed to evaluate the antioxidant potential and inhibitory effect of Cannabis sativa and Morus nigra against lipid peroxidation in goat brain and liver homogenates. The formation of free radicals, highly reactive oxygen species (ROS) and reactive nitrogen species (RNS) is a normal metabolic process for cellular signaling and countering the antigens. However, they may cause serious damage if they produced at amplified tolls. In addition, metabolic disorders also serve as sources of these reactive species. Although the issue can be addressed through supplements and other phytochemicals. In this study, two plant species were evaluated for their biological potential by employing a spectrum of antioxidant assays. The antioxidant activity was performed by lipid peroxidation assay. The water extract prepared from leaves of Cannabis sativa and Morus nigra showed significant (P<0.05) inhibition as compared to control i.e., 522.6±0.06 and 659.97±0.03 µg/mL against iron-induced lipid peroxidation in goat brain homogenate while the inhibitions were 273.54±0.04 and 309.18±0.05 µg/mL against nitroprusside induced lipid peroxidation of the brain. The iron and nitroprusside induced lipid peroxidation was also significantly inhibited by leaf extracts of Cannabis sativa and Morus nigra in liver homogenates such as 230.63±0.52 and 326.91±0.01 µg/mL (iron-induced) while 300.47±0.07 and 300.47±0.07 µg/mL (nitroprusside induced), respectively. The extracts of Cannabis sativa extract showed promising activity (96.04±0.060%) against DPPH radicals while Morus nigra showed a moderate activity (34.11±0.120%). The results suggest that different accessions of Cannabis sativa and Morus nigra are a potential source of antioxidants and have a therapeutic effect against disease induced by oxidative stress and hence can be used for novel drug discovery and development.

O presente estudo teve como objetivo avaliar o potencial antioxidante e o efeito inibitório de Cannabis sativa e Morus nigra contra a peroxidação lipídica em homogenatos de cérebro e fígado de cabras. A formação de radicais livres, espécies altamente reativas de oxigênio (ROS) e espécies reativas de nitrogênio (RNS), é um processo metabólico normal para sinalização celular e combate aos antígenos. No entanto, eles podem causar sérios danos se forem produzidos em portagens ampliadas. Além disso, distúrbios metabólicos também servem como fontes dessas espécies reativas, embora o problema possa ser resolvido por meio de suplementos e outros fitoquímicos. Neste estudo, duas espécies de plantas foram avaliadas quanto ao seu potencial biológico, empregando um espectro de ensaios antioxidantes. A atividade antioxidante foi realizada por ensaio de peroxidação lipídica. O extrato de água preparado a partir de folhas de Cannabis sativa e Morus nigra mostrou inibição significativa (P < 0,05) em comparação com o controle, ou seja, 522,6 ± 0,06 e 659,97 ± 0,03 µg / mL contra peroxidação lipídica induzida por ferro em homogenato de cérebro de cabra, enquanto as inibições foram 273,54 ± 0,04 e 309,18 ± 0,05 µg / mL contra a peroxidação lipídica do cérebro induzida por nitroprussiato. A peroxidação lipídica induzida por ferro e nitroprussiato também foi significativamente inibida por extratos de folhas de Cannabis sativa e Morus nigra em homogenatos de fígado, como 230,63 ± 0,52 e 326,91 ± 0,01 µg / mL (induzida por ferro), enquanto 300,47 ± 0,07 e 300,47 ± 0,07 µg / mL (induzida por nitroprussiato), respectivamente. Os extratos do extrato de Cannabis sativa apresentaram atividade promissora (96,04 ± 0,060%) contra os radicais DPPH enquanto Morus nigra apresentou atividade moderada (34,11 ± 0,120%). Os resultados sugerem que diferentes acessos de Cannabis sativa e Morus nigra são uma fonte potencial de antioxidantes e têm efeito terapêutico [...].

The inhibitory effect of Cannabis Sativa L. and Morus nigra L. against lipid peroxidation in goat liver and brain homogenates / O efeito inibitório de Cannabis Sativa L. e Morus nigra L. contra a peroxidação lipídica em homogenatos de fígado e cérebro de cabra

Abstract The present study was aimed to evaluate the antioxidant potential and inhibitory effect ofCannabis sativa and Morus nigra against lipid peroxidation in goat brain and liver homogenates. The formation of free radicals, highly reactive oxygen species (ROS) and reactive nitrogen species (RNS) is a normal metabolic process for cellular signaling and countering the antigens. However, they may cause serious damage if they produced at amplified tolls. In addition, metabolic disorders also serve as sources of these reactive species. Although the issue can be addressed through supplements and other phytochemicals. In this study, two plant species were evaluated for their biological potential by employing a spectrum of antioxidant assays. The antioxidant activity was performed by lipid peroxidation assay. The water extract prepared from leaves of Cannabis sativa and Morus nigra showed significant (P<0.05) inhibition as compared to control i.e., 522.6±0.06 and 659.97±0.03 µg/mL against iron-induced lipid peroxidation in goat brain homogenate while the inhibitions were 273.54±0.04 and 309.18±0.05 µg/mL against nitroprusside induced lipid peroxidation of the brain. The iron and nitroprusside induced lipid peroxidation was also significantly inhibited by leaf extracts of Cannabis sativa and Morus nigra in liver homogenates such as 230.63±0.52 and 326.91±0.01 µg/mL (iron-induced) while 300.47±0.07 and 300.47±0.07 µg/mL (nitroprusside induced), respectively. The extracts of Cannabis sativa extract showed promising activity (96.04±0.060%) against DPPH radicals while Morus nigra showed a moderate activity (34.11±0.120%). The results suggest that different accessions ofCannabis sativa and Morus nigra are a potential source of antioxidants and have a therapeutic effect against disease induced by oxidative stress and hence can be used for novel drug discovery and development.

Resumo O presente estudo teve como objetivo avaliar o potencial antioxidante e o efeito inibitório de Cannabis sativa e Morus nigra contra a peroxidação lipídica em homogenatos de cérebro e fígado de cabras. A formação de radicais livres, espécies altamente reativas de oxigênio (ROS) e espécies reativas de nitrogênio (RNS), é um processo metabólico normal para sinalização celular e combate aos antígenos. No entanto, eles podem causar sérios danos se forem produzidos em portagens ampliadas. Além disso, distúrbios metabólicos também servem como fontes dessas espécies reativas, embora o problema possa ser resolvido por meio de suplementos e outros fitoquímicos. Neste estudo, duas espécies de plantas foram avaliadas quanto ao seu potencial biológico, empregando um espectro de ensaios antioxidantes. A atividade antioxidante foi realizada por ensaio de peroxidação lipídica. O extrato de água preparado a partir de folhas de Cannabis sativa e Morus nigra mostrou inibição significativa (P < 0,05) em comparação com o controle, ou seja, 522,6 ± 0,06 e 659,97 ± 0,03 µg / mL contra peroxidação lipídica induzida por ferro em homogenato de cérebro de cabra, enquanto as inibições foram 273,54 ± 0,04 e 309,18 ± 0,05 µg / mL contra a peroxidação lipídica do cérebro induzida por nitroprussiato. A peroxidação lipídica induzida por ferro e nitroprussiato também foi significativamente inibida por extratos de folhas de Cannabis sativa e Morus nigra em homogenatos de fígado, como 230,63 ± 0,52 e 326,91 ± 0,01 µg / mL (induzida por ferro), enquanto 300,47 ± 0,07 e 300,47 ± 0,07 µg / mL (induzida por nitroprussiato), respectivamente. Os extratos do extrato de Cannabis sativa apresentaram atividade promissora (96,04 ± 0,060%) contra os radicais DPPH enquanto Morus nigra apresentou atividade moderada (34,11 ± 0,120%). Os resultados sugerem que diferentes acessos de Cannabis sativa e Morus nigra são uma fonte potencial de antioxidantes e têm efeito terapêutico contra doenças induzidas por estresse oxidativo e, portanto, podem ser usados ​​para a descoberta e desenvolvimento de novos medicamentos.

Perfil de fitocannabinoides en muestras derivadas al Laboratorio de control de calidad de la ENyS / Phytocannabinoid profile in samples sent to the ENyS quality control laboratory

[RESUMEN]. Las plantas de cannabis se clasifican en quimiotipos, según las concentraciones relativas de tetrahidrocannabinol (THC) y cannabidiol (CBD). El quimiotipo I tiene alto contenido de THC (sativa dominante); el quimiotipo II tiene un contenido aproximado 1:1 de THC:CBD (híbrida) y el quimiotipo III con CBD como constituyente predominante (indica dominante). El objetivo fue clasificar las muestras recibidas en el Laboratorio de con trol de calidad de la ENyS según su quimiotipo. El análisis de cannabinoides se realizó mediante cromatografía líquida de ultra alta resolución acoplada a espectrometría de masas y se calculó la razón THC/CBD. Se analizaron 121 muestras de tejido vegetal, que tuvieron un fuerte predominio de quimiotipo I (75%) y 139 muestras de aceite, con 41% de quimiotipo I, 40% de quimiotipo II y 19% de quimiotipo III.

[ABSTRACT]. Cannabis plants are classified into chemotypes, based on the relative concentrations of tetrahydrocannabinol (THC) and cannabidiol (CBD). Chemotype I has high THC content (sativa dominant); chemotype II has an approximate 1:1 content of THC:CBD (hybrid) and chemotype III has CBD as the predominant constituent (indica dominant). Our aim was to classify the samples received at the ENyS Quality Control Laboratory according to their chemotype. Cannabinoid analysis was performed using ultra-high-performance liquid chromatography coupled to mass spectrometry and the THC/CBD ratio was calculated. 121 plant tissue samples were analyzed, which had a strong predominance of chemotype I (75%) as well as 139 oil samples, wich rendered 41% chemotype I, 40% chemotype II and 19% chemotype III.

A new dihydrostilbene from aerial part of Cannabis sativa / 中国中药杂志

The present study investigated the chemical constituents in the aerial part of Cannabis sativa. The chemical constituents were isolated and purified by silica gel column chromatography and HPLC and identified according to their spectral data and physicochemical properties. Thirteen compounds were isolated from the acetic ether extract of C. sativa and identified as 3',5',4″,2-tetrahydroxy-4'-methoxy-3-methyl-3″-butenyl p-disubstituted benzene ethane(1), 16R-hydroxyoctadeca-9Z,12Z,14E-trienoic acid methyl ester(2),(1'R,2'R)-2'-(2-hydroxypropan-2-yl)-5'-methyl-4-pentyl-1',2',3',4'-tetrahydro-(1,1'-biphenyl)-2,6-diol(3), β-sitosteryl-3-O-β-D-glucopyranosyl-6'-O-palmitate(4), 9S,12S,13S-trihydroxy-10-octadecenoate methyl ester(5), benzyloxy-1-O-β-D-glucopyranoside(6), phenylethyl-O-β-D-glucopyranoside(7), 3Z-enol glucoside(8), α-cannabispiranol-4'-O-β-D-glucopyranose(9), 9S,12S,13S-trihydroxyoctadeca-10E,15Z-dienoic acid(10), uracil(11), o-hydroxybenzoic acid(12), and 2'-O-methyladenosine(13). Compound 1 is a new compound, compound 3 is a new natural product, and compounds 2, 4-8, 10, and 13 were isolated from Cannabis plant for the first time.

Neuroprotective potential of cannabidiol: Molecular mechanisms and clinical implications / 中西医结合学报

Cannabidiol (CBD), a nonpsychotropic phytocannabinoid that was once largely disregarded, is currently the subject of significant medicinal study. CBD is found in Cannabis sativa, and has a myriad of neuropharmacological impacts on the central nervous system, including the capacity to reduce neuroinflammation, protein misfolding and oxidative stress. On the other hand, it is well established that CBD generates its biological effects without exerting a large amount of intrinsic activity upon cannabinoid receptors. Because of this, CBD does not produce undesirable psychotropic effects that are typical of marijuana derivatives. Nonetheless, CBD displays the exceptional potential to become a supplementary medicine in various neurological diseases. Currently, many clinical trials are being conducted to investigate this possibility. This review focuses on the therapeutic effects of CBD in managing neurological disorders like Alzheimer's disease, Parkinson's disease and epilepsy. Overall, this review aims to build a stronger understanding of CBD and provide guidance for future fundamental scientific and clinical investigations, opening a new therapeutic window for neuroprotection. Please cite this article as: Tambe SM, Mali S, Amin PD, Oliveira M. Neuroprotective potential of Cannabidiol: Molecular mechanisms and clinical implications. J Integr Med. 2023; 21(3): 236-244.

Caracterización y seguimiento de una población de uruguayos usuarios de derivados de cannabis medicinal artesanal / Characterization and follow up of a population of Uruguayan cannabis derivatives users in artisanal medicine / Caracterização e monitoramento de uma população de usuários uruguaios de derivados artesanais de cannabis medicinal

Introducción: el conocimiento del cannabis medicinal data de hace más de 10.000 años y tiene sus orígenes en el continente asiático y en la medicina oriental. En el último tiempo ha surgido especial interés en su uso terapéutico, y Uruguay desde 2013 cuenta con una ley que regula la tenencia y uso de la planta de cannabis. Objetivo: caracterizar el uso de los derivados de cannabis medicinal (DCM) en una población de usuarios uruguayos. Metodología: se realizó un estudio observacional, prospectivo, en una población de usuarios de DCM, a través de encuestas telefónicas. Los datos obtenidos se analizaron utilizando Excel®, mediante estadística descriptiva. Resultados: se incluyeron 32 usuarios entre 29 y 78 años, la mayoría de sexo femenino. La forma farmacéutica más utilizada fue el aceite y la principal indicación fue para el tratamiento del dolor. Se observó una disminución en la intensidad del dolor postratamiento. El principal efecto adverso observado fue la sequedad de boca. Conclusiones: es el primer estudio nacional en caracterizar el uso de DCM artesanal. Se incluyeron 32 usuarios de DCM artesanal. La principal indicación de DCM fue para el tratamiento del dolor, siendo la artrosis su principal causa. Todos los usos fueron para indicaciones no aprobadas si se compara con sus equivalentes industrializados. Predominó el uso en mujeres adultas. Se destacó una gran expectativa frente al inicio del uso. Los eventos adversos observados estuvieron dentro de los esperados y de entidad leve.

Summary: Introduction: knowledge on medical cannabis is over 10,000 years old and stems from Asian and Eastern medicine. In recent years, special interest on its therapeutic use has arisen, and in 2013 Uruguay passed a law to regulate possession and use of cannabis plants. Objective: to characterize the use of medicinal cannabis derivatives in a population of Uruguayan users. Method: observational, prospective study in a population of medicinal cannabis derivatives users through telephone surveys. Data obtained were analysed with Excel®, by using descriptive statistics. Results: thirty two users were included in the study, between 29 and 78 years old, most of which were female. The most widely used pharmaceutical form was oil and the main indication was to treat pain. A decline in pain intensity after treatment was observed. The main adverse effect observed was dry mouth. Conclusions: this is the first national study to characterize the use of artisanal medicinal cannabis derivatives. Thirty two users of artisanal medicinal cannabis derivatives were included in the study. The main indication for artisanal medicinal cannabis derivatives was the treatment of pain, arthrosis being the main cause. All users followed non-approved indications if compared to industrialized equivalents. The use was more extended among women. Great expectation upon initiation of use was noticed. Adverse events observed were mild and the expected.

Introdução: o conhecimento da cannabis medicinal remonta a mais de 10.000 anos e tem suas origens no continente asiático e na medicina oriental. Nos últimos tempos, surgiu um interesse especial em seu uso terapêutico e, desde 2013, o Uruguai possui uma lei que regula a posse e o uso da planta de cannabis. Objetivo: caracterizar o uso de derivados de cannabis medicinal (DCM) em uma população de usuários uruguaios. Metodologia: Foi realizado um estudo observacional, prospectivo, em uma população de usuários de DCM, por meio de inquéritos telefônicos. Os dados obtidos foram analisados ​​no programa Excel®, por meio de estatística descritiva. Resultados: foram incluídos 32 usuários entre 29 e 78 anos, a maioria do sexo feminino. A forma farmacêutica mais utilizada foi o óleo e a principal indicação foi para o tratamento da dor. Observou-se diminuição da intensidade da dor pós-tratamento. O principal efeito adverso observado foi boca seca. Conclusões: este é o primeiro estudo nacional a caracterizar o uso de DCM artesanal. Foram incluídos 32 usuários artesanais de DCM. A principal indicação da CMD foi para o tratamento da dor, sendo a osteoartrite sua principal causa. Todos os usos foram para indicações não aprovadas quando comparados aos seus equivalentes industrializados. Predominou o uso em mulheres adultas. Houve uma grande expectativa desde o início do uso. Os eventos adversos observados estavam dentro do esperado e de entidade leve.

Cannabis medicinal: puntos críticos para su uso clínico / Medical cannabis: Critical points for clinical application

El cannabis se ha utilizado desde la antigüedad con fines recreativos y medicinales. Es una fuente muy rica de compuestos químicos, la mayoría denominados fitocannabinoides, que tienen una variedad de efectos fisiológicos, principalmente por su unión a receptores cannabinoides endógenos como el CB1 y CB2, entre otros. El cannabis tiene propiedades terapéuticas potenciales y sus preparaciones se han utilizado como remedios tradicionales para tratar el dolor y la emesis. Los cannabinoides sintéticos se utilizan clínicamente como analgésicos, antiespasmódico, antieméticos y estimulantes del apetito. La toxicidad significativa del cannabis es poco común en los adultos, sin embargo, puede tener múltiples efectos adversos agudos y crónicos. La calidad de la evidencia en este campo se ha visto limitada por la corta duración de los estudios, los reducidos tamaños de las muestras, la falta de grupos de control y la existencia de sesgos en la mayoría de los estudios revisados. En este contexto, son necesarios más estudios de mejor calidad metodológica para apoyar el uso seguro de esta terapia en otras enfermedades. La decisión de incorporar los cannabinoides como terapia en alguna de las condiciones descritas depende de la evidencia, el uso de terapias previas y el tipo de paciente.

Since ancient times cannabis has been used for recreational and medicinal purposes. It is a significant source of chemical compounds, most of them called phytocannabinoids. These compounds have several physiological effects and produce their effects primarily by binding to endogenous cannabinoid receptors such as CB1 and CB2, among others. Cannabis has potential therapeutic properties and its preparations have been used as traditional remedies to treat pain and emesis. Synthetic cannabinoids are used clinically as analgesics, antispastics, antiemetics, and appetite stimulants. Significant cannabis toxicity is rare in adults; however, it can produce countless acute and chronic side effects. The quality of the evidence in this field is limited by the short duration of the trials, poor sample sizes, lack of a control group, and the existence of bias in most of the reviewed studies. Therefore, a larger number of studies with better methodological quality is required to support the safe use of this therapy. The decision to include cannabinoids as a treatment for any of the conditions described will depend on the evidence, the use of previous therapies, and the type of patient.

Intoxicación accidental por marihuana en pediatría. Serie de 3 casos / Accidental poisoning by marijuana in pediatrics. Series of 3 cases

Resumen La marihuana o cannabis es la sustancia psicoactiva ilícita de mayor consumo. Una consecuencia no deseada de la regulación de su cultivo y la difusión popular de su uso medicinal y recreativo, es su asociación con el aumento de la disponibilidad de cultivos en la población general y de productos, como alimentos y fármacos elaborados con infusiones de esta planta, con concentraciones desconocidas de delta-9-tetrahidrocannabinol (A9THC), su principal componente psicoactivo. Se presenta una serie de 3 pacientes expuestos a esta sustancia de forma no intencional, por vía digestiva, asistidos de forma presencial por los servicios de Toxicología y Emergencias del Hospital Interzonal de Agudos Especializado en Pediatría "Sor María Ludovica" de La Plata. A diferencia de la absorción por vía inhalatoria, por vía digestiva se producen concentraciones mucho más variables y ciclos temporales mayores de A9THC y sus metabolitos, que ejercen sus efectos sobre los receptores CB1, dispuestos en el sistema nervioso central, incluido tronco encefálico, región con mayor presencia de éstos en niños, lo que justifica las manifestaciones neurológicas frecuentes y de mayor gravedad en este grupo etario, en relación a los adultos. La sospecha clínica, la anamnesis y la detección temprana de cannabinoides en orina son los pilares fundamentales para establecer el diagnóstico temprano. El tratamiento consiste en medidas de sostén y sintomáticas, que se implementan según la gravedad del cuadro. Debe considerarse la posibilidad de exposición a esta sustancia frente a cuadros de letargo o somnolencia de aparición brusca, con ataxia, modificaciones del humor, alteraciones sensoperceptivas, convulsiones o coma, con o sin insuficiencia respiratoria, con taquicardia o bradicardia. Es de fundamental importancia la educación y concientización de los adultos a cargo de niños sobre estos riesgos.

Abstract Marijuana or cannabis is the illicit psychoactive substance most widely used. An unwanted consequence of the regula-tion of its cultivation and the popular diffusion of its medicinal and recreational use, is the association with an increase in the avail-ability of crops in the general population, products, foods and medicines made with cannabis infusions, with unknown concentra-tions of delta-9-tetrahydrocannabinol (A9THC), the most important psychoactive component. We present a series with 3 patients with unintentional exposure to this substance through the digestive tract, assisted by the Toxicology and Emergency services of the Interzonal Hospital for Acute Specialized in Pediatrics "Sor María Ludovica". Unlike absorption through the inhalation route, more variable concentrations and greater temporal cycles of A9THC and its metabolites are produced through the digestive route, which exert their effects on CB1 receptors, arranged in the central nervous system, including brainstem, the region with greatest presence of this receptors in children, that justifies the frequent and more serious neurological manifestations in children, compared to adults. Clinical suspicion, anamnesis and early detection of cannabinoids in urine are the fundamental pillars to establish an early diagnosis. Treatment consists in supportive and symptomatic measures, that are implemented according to the severity of the condition. The possibility of exposure to this substance must be estimated in the face of sudden onset of lethargy or drowsi-ness, with ataxia, mood modifications, sensory-perceptual disturbances, seizures or coma, with or without respiratory failure, with tachycardia or bradycardia. The education and awareness of caretakers adults, about these risks is of fundamental importance.

Etiopathogenesis of drug dependence: an explanatory synthesis from an epigenetic perspective / Etiopatogenia de las drogodependencias: una síntesis explicativa desde una perspectiva epigenética / Etiopatogenia das toxicodependências: uma síntese explicativa a partir de uma perspectiva epigenética

The use of substances with addictive potential is a relevant health problem. Scientific evidence suggests that the underlying mechanisms that regulate behavioral processes in addictions involve a complex interplay between genetic and environmental factors. Therefore, this narrative review aims to provide a framework to synthesize the evidence on gene-environment-agent interactions from the perspective of the natural history of the disease and the stages of the addictive process for alcohol, nicotine, cannabis, psychostimulants, and opioids. In this review, we conducted an exhaustive literature search without time limits in PubMed, Ebsco, Lilacs, and SciELO, reviewing the title and abstract we selected original articles in humans or animals that addressed the etiology of addictions according to the methodological approach of gene-environment (G-E) interaction, including articles in Spanish, English, and Portuguese. Genetic studies have revealed the critical role of epigenetic modifiers (histone acetylation) in maintaining brain homeostasis in pathological conditions and focusing on G-E interactions will also allow characterizing subgroups (based on environmental factors) at high risk for addictive behaviors that can be targeted for specific interventions, Thus, treatment strategies should encompass a combination of psychosocial interventions with gene therapy involving pharmacological manipulations of histones that may contribute to design better therapies and perhaps lead to more successful management of drug dependencies.

El consumo de sustancias con potencial adictivo es un problema relevante de salud. La evidencia científica sugiere que los mecanismos subyacentes que regulan los procesos comportamentales en las adicciones involucran un complejo interjuego entre factores genéticos y ambientales. Por lo tanto, esta revisión narrativa tiene como objetivo aportar un marco de referencia que permita sintetizar la evidencia sobre interacciones genes- ambiente-agente desde la perspectiva de la historia natural de la enfermedad y los estadios del proceso adictivo para: alcohol, nicotina, cannabis, psicoestimulantes y opioides. En esta revisión realizamos una búsqueda exhaustiva de la literatura sin límites de tiempo en PubMed, Ebsco, Lilacs y SciELO, revisando el título y el resumen se seleccionaron artículos originales en humanos o animales que abordaran la etiología de las adiciones según el enfoque metodológico de interacción entre genes y ambiente (G-A), incluyendo artículos en español, inglés y portugués. Los estudios genéticos han revelado el papel crítico de los modificadores epigenéticos (acetilación de las histonas) en mantener la homeóstasis cerebral en condiciones patológicas y enfocarse en las interacciones G-A también permitirá caracterizar subgrupos (basados en los factoresambientales) de alto riesgo para conductas adictivas que pueden ser objeto de intervenciones específicas, por lo que, las estrategias de tratamiento deben englobar una combinación de intervenciones psicosociales con terapia génica que involucren las manipulaciones farmacológicas de las histonas que pueden contribuir a diseñar mejores terapias y tal vez conducir a un manejo más exitoso de las drogodependencias.

O consumo de substâncias com potencial viciante é um relevante problema de saúde. Evidências científicas sugerem que os mecanismos subjacentes que regulam os processos comportamentais em vícios envolvem uma interação complexa entre fatores genéticos e ambientais. Portanto, esta revisão narrativa visa fornecer um quadro de referência que permita sintetizar as evidências sobre interações gene-ambiente-agente sob a perspectiva da história natural da doença e as etapas do processo de dependência para: álcool, nicotina, cannabis, psicoestimulantes e opióides. Nesta revisão, realizamos uma busca exaustiva da literatura sem limites de tempo no PubMed, Ebsco , Lilacs e SciELO, revisando o título e o resumo, foram selecionados artigos originais em humanos ou animais que abordassem a etiologia dos acréscimos de acordo com a abordagem metodológica de interação entre genes e ambiente (GA), incluindo artigos em espanhol, inglês e português. Estudos genéticos revelaram o papel crítico dos modificadores epigenéticos (acetilação de histonas) na manutenção da homeostase cerebral em condições patológicas, e o direcionamento das interações GA também permitirá caracterizar subgrupos (com base em fatores ambientais) de alto risco para comportamentos aditivos que podem ser alvo de ataques específicos. intervenções, portanto, as estratégias de tratamento devem abranger uma combinação de intervenções psicossociais com terapia gênica envolvendo manipulações farmacológicas de histonas que podem contribuir para projetar melhores terapias e talvez levar a um manejo mais bem-sucedido das dependências de drogas.

Significados e representações do uso recreativo de maconha para mulheres / Meanings and representations of recreational use of marijuana by women

Diante das especificidades de gênero, este trabalho busca identificar o significado do uso recreativo de maconha para as mulheres em momentos de lazer. O estudo é uma pesquisa social desenvolvida por meio de entrevistas semiestruturadas. Foram entrevistadas 8 mulheres, acessadas pelo método 'Bola de Neve'. Resultados: Foram definidas as seguintes categorias de sentidos atribuídos ao uso da maconha pelas mulheres: sociabilidade, relacionamentos afetivos e sexo com uso da maconha; relaxamento e descanso; 'calmante' e medicamento; autoconhecimento, afirmação de identidade e criatividade. De acordo com os achados da pesquisa foi identificado que a maconha se insere no universo feminino como parte constituinte da cultura e da identidade das mulheres usuárias.

In view of gender specificities, this paper discusses the meaning of recreational use of marijuana by women at leisure. The study was a social survey was conducted through semi-structured interviews. Eight women were interviewed, they were accessed using the Snowball sampling method. Results: the data were systematized into categories of meanings attributed to the use of marijuana by women: sociability, affective relationships and sex with marijuana use; relaxation and rest; 'Soothing' and medicine; self-knowledge, identity affirmation and creativity. According to research findings, it was identified that marijuana is inserted in the female universe as a constituent part of the culture and identity of women.

O emprego da Cannabis medicinal no enfrentamento à doenças / The use of medicinal Cannabis in fighting diseases

A Cannabis possui como subespécie a Cannabis sativa. As plantas do gênero Cannabis possuem propriedades terapêuticas que são oriundas de compostos denominados canabinoides. O objetivo do presente artigo foi evidenciar como procede o uso terapêutico da Cannabis para enfrentamento das doenças. Realizou-se revisão narrativa da literatura com busca nas bases de dados: PubMED, Google Acadêmico com levantamento de artigos que tratavam acerca do uso da Cannabis medicinal para o tratamento de algumas doenças. Canabinoides correlacionam-se a receptores do nosso corpo, influindo nos mecanismos que regulam o organismo. Cannabis possibilita abordar e intervir em determinadas patologias presentes nos pacientes advindo de possuir ações benéficas anticonvulsivantes, anti-inflamatórias, analgésicas, ansiolíticas, antipsicóticas e antitumorais. Em nosso corpo existem os canabinoides ou endocanabinoides, que são similares aos canabinoides naturais ou fitocanabinoides estruturados na Cannabis. O canabidiol e o tetra-hidrocarbinol constituem canabinoides provenientes da Cannabis que podem tecer relação com os canabinoides configurados por nosso próprio corpo. O sistema de endocanabinoides possibilitou averiguar-se acerca do emprego do canabidiol para tratamento de patologias, como: Doença de Parkinson, Autismo e Epilepsia. Concluiu-se que o emprego terapêutico da Cannabis medicinal pode representar recurso que será válido para resolução do problema de saúde, podendo propiciar melhores condições e qualidade de vida aos pacientes portadores de determinadas patologias em que essa droga pode ser utilizada para tratamento.

Cannabis has Cannabis sativa as a subspecies. Cannabis plants have therapeutic properties that come from compounds called cannabinoids. The aim of this article was to show how the therapeutic use of Cannabis to cope with diseases proceeds. A narrative review of the literature was carried out with a search in the following databases: PubMED, Google Scholar with a survey of articles that dealt with the use of medicinal Cannabis for the treatment of some diseases. Cannabinoids correlate to our body's receptors, influencing the mechanisms that regulate the body. Cannabis makes it possible to address and intervene in certain pathologies present in patients arising from having beneficial anticonvulsant, anti-inflammatory, analgesic, anxiolytic, antipsychotic and antitumor actions. In our body there are cannabinoids or endocannabinoids, which are similar to natural cannabinoids or phytocannabinoids structured in Cannabis. Cannabidiol and Tetrahydrocannabinol are cannabinoids derived from Cannabis that can be related to cannabinoids configured by our own body. The endocannabinoid system made it possible to investigate the use of cannabidiol for the treatment of pathologies, such as: Parkinson's Disease, Autism and Epilepsy. It was concluded that the therapeutic use of medicinal Cannabis can represent a resource that will be valid for solving the health problem, providing better conditions and quality of life for patients with certain pathologies in which this drug can be used for treatment.

Cannabidiol para la epilepsia resistente a fármacos en Argentina: evaluación de tecnología sanitaria / Cannabidiol for drug-resistant epilepsy in Argentina: health technology assessment

INTRODUCCIÓN: El cannabidiol (CBD), un derivado de la planta de cannabis, está autorizado como especialidad medicinal para su comercialización en Argentina y otros países con el fin de tratar la epilepsia resistente a fármacos. Se encuentran en estudio otras potenciales indicaciones. MÉTODOS: Se realizó una evaluación de tecnología sanitaria para la Comisión Nacional de Evaluación de Tecnologías de Salud (CONETEC) sobre CBD para epilepsia resistente a fármacos en Argentina. RESULTADOS: Se describen aspectos legales, regulatorios y económicos, las evidencias disponibles sobre eficacia y seguridad en epilepsia y el impacto presupuestario. DISCUSIÓN: La evaluación pone de manifiesto una serie de desafíos para el sistema de salud argentino, relacionados con el mercado del CBD para la epilepsia en el país, su tamaño, los distintos actores y su comportamiento. Se indaga acerca de la estructura de costos, los márgenes de ganancia, y se mencionan algunas estrategias que fueron puestas en práctica por la industria farmacéutica en Argentina y otros países. Se discute el impacto de la competencia en los precios y se describen potenciales herramientas del Estado para la regulación como el uso de precios de referencia internacionales, la evaluación de tecnologías sanitarias y las compras mancomunadas, así como la articulación con productores nacionales y actores internacionales.

INTRODUCTION: Cannabidiol (CBD), a derivative of the cannabis plant, is authorized as a medicinal product for sale in Argentina and other countries for the treatment of drug-resistant epilepsy. Other potential indications are under study. METHODS: A health technology assessment was conducted for CONETEC (National Commission for Health Technology Assessment), analyzing CBD for drug-resistant epilepsy in Argentina. RESULTS: Legal, regulatory and economic aspects are described as well as the available evidence on efficacy and safety in epilepsy, and the budget impact. DISCUSSION: The assessment highlights a series of challenges for the Argentine health system, related to the CBD market for epilepsy, its size, the different actors, and their behavior. Inquiries are made about cost structure and profit margins, mentioning some strategies that were put into practice by the pharmaceutical industry in Argentina and other countries. The impact of competition on prices is discussed, and potential State tools for price regulation like the use of international reference prices, health technology assessment and joint purchases, as well as articulation with national producers and international actors are described.

Cannabis and cannabinoids as an alternative remedy in metabolic syndrome

Abstract Metabolic syndrome (MetS), an epidemic defined as a group of interconnected physiological, biochemistry, clinical, and metabolic factors, directly increases the risk of cardiovascular disease, atherosclerosis, type 2 diabetes, and death. MetS therapy includes diet, physical exercise, and a poly-pharmacological intervention. Cannabis is mainly recognized for its recreational uses and has several medical applications for neurological diseases, due to its hypnotic, anxiolytic, antinociceptive, anti-inflammatory, and anticonvulsant activities. Although several clinical observations in Cannabis smokers suggest metabolic effects, its utility in metabolic disorders is unclear. This review aims to determine under what conditions Cannabis might be useful in the treatment of MetS. Cannabis contains 120 phytocannabinoids, of which Δ9-THC mediates its psychoactive effects. Cannabinoids exert biological effects through interactions with the endocannabinoid system, which modulates several physiologic and metabolic pathways through cannabinoid receptors (CB1/CB2). Signaling through both receptors inhibits neurotransmitter release. In general, endocannabinoid system stimulation in Cannabis smokers and Δ9-THC signaling through CB1 have been implicated in MetS development, obesity, and type 2 diabetes. In contrast, CB1 antagonists and non-psychotropic phytocannabinoids like cannabidiol reduce these effects through interactions with both cannabinoid and non-cannabinoid receptors. These pharmacological approaches represent a source of new therapeutic agents for MetS. However, more studies are necessary to support the therapeutic potential of Cannabis and cannabinoids in metabolic abnormalities