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New Technology to Predict Cancer Recurrence in Melanoma Patients

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The beginning of melanoma takes place when a small pigmented spot appears on the skin. By removing the lesion, a primary melanoma can be treated but it has a tendency of reoccurrence and can spread throughout the body. A new study showed that the likelihood of cancer can be predicted after the removal of the lesion.

Despite all medical advancements, the analysis of lesion his performed in the same old way. Generally, molecular diagnostic labs have many advances for the detection of other forms of cancer but for the skin lesion cancer the way of diagnosis is very simple. The diagnosis is based on the thickness of the melanoma and microscopic features.

A patient with thinner melanomas is considered to be normal and the T stage from 1 to 4 is assigned. The complete details of this study are published in Nature Cancer.

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The researchers from the Brigham and Women’s Hospital in collaboration with international colleagues showed a new technique about the reoccurrence and spread of melanomas. It leverages the sequences of DNA for predicting the possible factors involved in the reoccurrence and spread of melanomas.

Thomas Kupper who is the chairperson of the department of dermatology at the Brigham that there were no treatments available for metastatic melanoma 10 years ago. But now it is possible to treat the patients who have metastatic melanoma and these treatments can be given at the primary stage of the disease. It is important to have a clear idea about the patient’s progress report after giving the new immunotherapy treatments, so we can modify the treatment.

There are immune checkpoint inhibitors that can reinitiate the immune response through T cell against the cancer cells. These inhibitors have changed the results and options for the patients in which cancer has spread throughout the body. Immune checkpoint inhibitors can start dramatic responses such as long-term remission in the period of curing a patient.

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Kupper and colleagues wanted to know about some measurable features of T cells. These features are used to check the predictions of the reoccurrence of melanoma in the removed primary melanoma and disease-free patients. Scientists study T2, T2, and T4 primary melanoma as the T1 are rarely metastasized melanoma.

They also face difficulty in finding the sample that was enough for results because skin lesion surgeries are usually performed at private clinics and ambulatory clinics. So, the concentration of the specimen is not available in the hospitals. For resolving this issue and for sharing the resources researchers collaborated with colleagues of the Melanoma Institute of Australia and the Zealand university Hospital in Denmark. The sample size for the analysis contains more than 300 patients from different areas.

The samples of primary melanoma patients with progress have been compared with those patients whose primary melanoma did not show any progress. For analyzing the T cell range of tumors, Adaptive Biotechnologies performed high throughput DNA sequencing. It was found that out of all identified variables the T cell fraction (TCFr) was an independent and strong predictor for the patients’ progress condition.

Patients with the same lesion thickness were more at the risk of developing metastatic disease. If the TCFr value is lower than 20 % in the patients, then they are more at the risk of disease progression. On the other hand, if the TCFr value is more than 20% then the risk of disease progression is low in patients.

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 The test used in this study is not available at the commercial level for clinical use. It is only used for research purposes. The authors said that the study is retrospective because it took the sample and data of patients that are already available. While the prospective study is that in which data for outcomes is not known and further tests are needed for validation.

Kupper and colleagues imagine that if a test could bring to the clinics then it will improve the patient care and strengthen the results. The test is elegant, simple and quantitative. These types of tests will help us in the future to modify the treatments according to the situation. If the patients have high TCFr then we will benefit him with checkpoint inhibitor therapy. If the value is low in patients, then more interventions are needed.

 

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Cannabis

Cannabis And The Mental Health – The Risks Involved

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The cannabis plant consists of over 500 identified chemical constituents, out of which over 100 are cannabinoids. Cannabinoids interact with the endocannabinoid system – a naturally occurring communication network that exists in our brains and bodies. Varying amounts and combinations of the dosages of cannabis, can, in turn, affect several physiological and psychological processes in different ways such as – gastrointestinal function, appetite, pain, memory, movement, immunity, inflammation, and mental health are all included.

The complexity of cannabis, however, is what makes it a potential medication for numerous illnesses. The concern is the gap that exists between the hype about cannabis, and the research with evidence supporting the hype. The concern holds a lot of relevance to mental health, where the effectiveness of cannabis as a treatment for a variety of psychiatric conditions, such as depression, anxiety, post-traumatic stress, psychosis, and addiction, is touted.

However, the reality of cannabis is that it cannot be held on the extremes of being either strictly helpful or strictly harmful. Instead, discussion regarding the potential benefits and harms of cannabis are encouraged, but with careful and nuanced consideration of science, with an addition of a humble attitude.

The science regarding the role of the endocannabinoid system in mood regulation is very clear with respect to depression. The use of cannabis or particular cannabinoids, in the treatment of depressive disorders, has had no support from any randomized controlled trials yet. On the contrary, the existing scientific data is mixed and tilts towards the idea of the worsening and development of depressive symptoms, by the ingestion of cannabis plant material. Although these findings are not satisfying, they aren’t straightforward either.

Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are the two best-known examples of cannabinoids found in the cannabis plant. Generally, the production of anxiety and psychotic features has been shown by THC, especially at higher doses. Meanwhile, production of anxiolytic and antipsychotic effects have been shown by CBD

However, a person’s increased or decreased anxiety or psychotic symptoms after ingesting cannabis can be affected by several other variables. This could include

  • Potency levels – Any presence of other cannabis-related chemicals
  • The amount of cannabis used
  • The frequency of use by the patient
  • Any past experience with cannabis
  • The patient’s likelihood to develop and/or experience psychiatric symptoms

There is added confusion regarding the relationship between cannabis and addiction. According to scientific literature, a substantial minority of users could hold the possibility of cannabis addiction – euphoric effects of THC are expected to be held somewhat responsible for the addictive potential. This includes the possibility of cannabis addiction in one in ten people, which still holds the representation of a large number of people.

A replacement to opioids by cannabis is encouraged if the goal of the treatment would be the reduction of harm. However, cannabis treatment for other substance addictions is not the most ideal option. Addiction involves more complications than cannabis itself. That may be the reason that cannabis-based medicines cannot be the solution to the treatment of addiction, even while it may play a helpful role in it. Solutions of addiction may continue to be multipronged as the causes of it are multifaceted.

In conclusion, the person’s motive for cannabis use matters. Temporary relief and avoidance from uncomfortable thoughts and emotions may be provided by the use of cannabis but psychiatric and psychological treatments focus on the skills and coping mechanisms to confront the difficult thoughts and emotions. Research shows, use of cannabis with this motive could ultimately lead to difficulties with mental health symptoms, and addiction. Positive and negative reinforcement could be caused by mind-altering substances such as high THC cannabis products.

 

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Glaucoma and Cannabis : What Opthalmologists Have To Say

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Myths can stay around for a long time. One of them was about Cannabis being a potential treatment for glaucoma patients. Glaucoma is a complex eye condition that involves the damage of the optic nerve over time, initially reducing peripheral vision and ultimately leading to blindness. The higher than normal eye pressure (intraocular pressure or IOP) is one of the major causes of optic nerve damage.

With the legalization of medical and recreational cannabis use in more U.S. states and Canada, researchers have been studying the use of cannabis as possible treatments for various health conditions. Although research from the 1970s and 1980s has shown a detectable drop in intraocular pressure for three to four hours, after the consumption of cannabis – by smoking, or by the ingestion of TH in the form of pills or injection, treatment for glaucoma would require control of eye pressure for a complete 24 hours.

Studies show that ingestion of about 18 to 20 mg of THC, six to eight times daily, is required for the reduction and maintenance of intraocular pressure by 3 to 5 mm Hg. This could also include significant negative effects on mood, mental clarity, and lung health (if smoked). Driving, operation of machinery, or engagement in various common activities would be prohibited. Additionally, the amount of cannabis needed to be consumed every three to four hours makes it cost-prohibitive for a significant number of patients.

Comparatively, alcohol has moderate intraocular pressure-lowering effects for an hour after consumption. However, the consumption of alcohol would never be recommended by doctors as a treatment for glaucoma.

Is THC Effective or Reliable as a Treatment for Glaucoma?

THC eye drops, pills and cigarettes have been studied, and the results aren’t positive. Burning and irritated eyes were caused by eye drops, with no decrease in eye pressure. Similarly, no decrease in eye pressure was recorded, after the use of sublingual THC compounds either. Meanwhile, use of THC-containing pills and/or cigarettes was stopped by patients after 9 months, due to the side effects.

With further research about glaucoma, scientists have concluded that the high intraocular pressure in the fluid at the front of the eye, is not the sole cause of the optic nerve damage. Further evidence shows that another cause could be the reduced blood flow in the optic nerve. While cannabis may lower eye pressure, it also lowers the patient’s blood pressure. Thus, the potential of cannabis to lower blood pressure effectively cancels out its ability to lower intraocular pressure.

What About CBD?

Currently available cannabis and cannabis-derived compounds – like CBD is not a sufficient treatment for any eye condition, including glaucoma. Cannabis is not a practical treatment to maintain lowered eye pressure for 24 hours, in order to treat glaucoma.

CBD has gained a lot of attention and scrutiny in the last few years. Although CBD is a derivative of cannabis as well, it doesn’t cause any mood-altering effects. However, current research does not support the use of CBD as an effective treatment for glaucoma. On the contrary, a recent study has shown that an increase in IOP may be caused by the CBD, making glaucoma worse.

The Future of Cannabis For Glaucoma Treatment

Currently, ophthalmologists say that the only way to control glaucoma and control vision is to lower the patient’s intraocular pressure. Depending on the type of glaucoma and severity, ophthalmologists can use medications such as prescription eye drops or surgery, as a form of treatment for glaucoma.

Furthermore, cannabis or any other cannabis products are NOT RECOMMENDED for the treatment of glaucoma, by the American Academy of Opthalmology, along with the agreement of the American Glaucoma Society and the Canadian Opthalmological Society.

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Cannabis Contact High: Should You Be Concerned?

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A contact high – or second-hand high, is the term given to the idea of a person getting stoned, or getting THC in their system, due to the secondhand exposure to cannabis smoke. While this may not be a concern for cannabis smokers, questions arise in the mind of nonsmokers, regarding the possible harmful effects of secondhand cannabis smoke.

According to the 1999 researchers from The British Journal of Anesthesia, it was reported that the amount of THC absorbed depends on the smoking style. However, approximately 50% of the THC and other cannabinoids that are present in a typical cannabis cigarette, will also be present in the mainstream smoke.

Moreover, virtually all of the cannabinoids in present in the mainstream could enter the bloodstream, inexperienced smokers – due to deep inhalation and prolonged presence of smoke in the lungs before exhalation. Older studies from the 1980s on secondhand highs, cannot be relied on completely because of how cannabis has changed since then. The potency of cannabis has increased over the years, which is why the results hold less relevance today.

On the contrary, a comparatively recent study suggests an even lesser percentage. “Pharmacokinetics of cannabinoids”, conducted in 2005, suggested that the variability of THC in plant material (0.3% to 30%) will eventually lead to the variability in tissue THC levels from smoking. It further added that it is a highly individual process. Hence, it leads to the bioavailability average of THC to be 30 percent.

Irrespective of the possible effect that length and duration of the inhalation may have on absorption, THC could still be present in exhaled cannabis smoke. But even with any amount of presence of cannabinoids in secondhand cannabis smoke, the question is if it is enough to stone a person or affect a drug test.

A study titled “Non-Smoker Exposure to Secondhand Cannabis Smoke II” was conducted in 2015, where researchers experimented with ventilation. Minor but detectable, levels of performance impairment on some cognitive assessments were found, along with minor increases to hart rate. Under very extreme conditions, non-smokers did get high. Meanwhile, in ventilated spaces, no detectable levels of cannabinoids were found in the blood 30 minutes prior to the exposure.

In certain studies, trace amounts of THC and it’s derivatives THC-OH and THC-COOH were found in the blood, saliva, and urine tests of some of the participants, immediately after exposure to second-hand smoke. However, these amounts of THC disappeared within one to three hours after exposure and were not exceeding the limits ( 50 nanograms per milliliter) that are set by the government. Although the derivatives could be present in the body for up to 14 hours due to their slower metabolism, they were still not enough to cause any psychoactive effects.

However, secondhand cannabis smoke can still be potentially harmful, even if it doesn’t make someone feel high. Combustion smoke is still harmful nevertheless and generates harmful byproducts and toxins that can damage the lungs, circulatory system, and tissues.

While vaping can eliminate the toxins from combustion, it has it’s own hazards – such as the uncertain and questionable ingredients in cannabis oils, and the metal toxins that could leak from the vape pen battery.

As long as you’re in a ventilated space, you are safe from any cannabinoids showing up on a drug test. Nonetheless, smokers are expected to still be considerate about their smoke. No one should have to be exposed to second-hand smoke against their will, and it is advisable for smokers to smoke in ventilated spaces where non-smokers have the option to leave if need be.

Lastly, while secondhand smoke may not have much effect on adults, it can be dangerous for pets and children.

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