Routes of administration, reasons for use, and approved indications of medical cannabis in oncology : a scoping review

Introduction: Some patients diagnosed with cancer use medical cannabis to self-manage undesirable symptoms, including nausea and pain. To improve patient safety and oncological care quality, the routes of administration for use of medical cannabis, patients’ reasons, and prescribed indications must be better understood. Methods: Based on the Joanna Briggs Institute guidelines, a scoping review was conducted to map the current evi‑ dence regarding the use of medical cannabis in oncological settings based on the experiences of patients diagnosed with cancer and their healthcare providers. A search strategy was developed with a scientifc librarian which included fve databases (CINAHL, Web of Science, Medline, Embase, and PsycINFO) and two grey literature sources (Google Scholar and ProQuest). The inclusion criteria were: 1) population: adults aged 18 and over diagnosed with cancer; 2) phenomena of interest: reasons for cannabis use and/or the prescribed indications for medical cannabis; 3) context: oncological setting. French- or English-language primary empirical studies, knowledge syntheses, and grey literature published between 2000 and 2021 were included. Data were extracted by two independent reviewers and subjected to a thematic analysis. A narrative description approach was used to synthesize and present the fndings. Results: We identifed 5,283 publications, of which 163 met the eligibility criteria. Two main reasons for medical cannabis use emerged from the thematic analysis: limiting the impacts of cancer and its side efects; and staying connected to others. Our results also indicated that medical cannabis is mostly used for three approved indications: to manage refractory nausea and vomiting, to complement pain management, and to improve appetite and food intake. We highlighted 11 routes of administration for medical cannabis, with oils and oral solutions the most fre‑ quently reported. Conclusion: Future studies should consider the multiple routes of administration for medical cannabis, such as inha‑ lation and edibles. Our review highlights that learning opportunities would support the development of healthcare providers’ knowledge and skills in assessing the needs and preferences of patients diagnosed with cancer who use medical cannabis

L’accompagnement infirmier personnalisé à l’expérience de jeunes hommes atteints d’un cancer

Au Canada, plus de 7 500 adolescents et jeunes adultes sont diagnostiqués d’un cancer chaque année. Les types de cancers les plus diagnostiqués chez les jeunes hommes sont la glande thyroïde, les testicules, le lymphome de Hodgkin, le mélanome et le lymphome non-Hodgkinien. Selon les études disponibles, cette clientèle semble moins encline à demander de l’aide des infirmières. De plus, plusieurs jeunes adultes, dont les hommes, peuvent être réticents à l’idée de communiquer leurs préoccupations aux infirmières. Ainsi, certains jeunes hommes pourraient ressentir que l’accompagnement infirmier n’est pas personnalisé à leur parcours de vie et à leurs préoccupations. Cette étude avait pour but de décrire et comprendre un accompagnement infirmier personnalisé à l’expérience de jeunes hommes atteints d’un cancer. Une étude qualitative descriptive interprétative inspirée par l’approche méthodologique de Thorne (2016) a été réalisée. Huit jeunes hommes atteints d’un cancer, âgés de 20 à 33 ans, ont participé à une entrevue individuelle. Une analyse qualitative itérative des données a été réalisée. Les résultats ont été divisés en deux thèmes. Le premier thème porte sur l’importance de l’établissement d’une relation de confiance entre l’infirmière et le jeune homme atteint d’un cancer et se décline en ces sous-thèmes : 1) accorder une présence humaine aux jeunes hommes atteints d’un cancer; 2) établir un partenariat de soins entre l’infirmière et le jeune homme atteint d’un cancer; 3) être accessible pour le jeune homme et 4) s'intéresser au ressenti du jeune homme atteint d'un cancer. Le deuxième thème discute des besoins qui demeurent à être comblés par l’accompagnement infirmier et comporte les sous-thèmes suivants : 1) besoin de recevoir des soins adaptés à leur réalité; 2) besoin de s’identifier à d’autres jeunes hommes atteints d’un cancer; 3) besoin d’informations ciblées et 4) besoin de se sentir dans l’action; 5) besoin de soutien psychologique adapté aux jeunes hommes. Les résultats proposent que les jeunes hommes atteints d’un cancer veuillent recevoir une présence humaine des infirmières et que celles-ci s’intéressent davantage à leur ressenti. Cette clientèle semble également avoir plusieurs besoins non comblés, dont le besoin de soutien psychologique. Finalement, cette étude a permis de décrire qu’un accompagnement infirmier personnalisé aux jeunes hommes atteints d’un cancer devrait inclure une présence humaine, l’aide à l’expression des sentiments, l’implication du jeune lors des soins et un soutien psychologique. Différentes recommandations sont émises pour optimiser l’accompagnement infirmier chez les jeunes hommes atteints d’un cancer, telles que l’élaboration de formations sur l’exploration des sentiments.In Canada, more than 7,500 teenagers and young adults are diagnosed with cancer each year. The most diagnosed types of cancers in young men are thyroid gland, testicular, Hodgkin's lymphoma, melanoma and non-Hodgkin's lymphoma. According to available studies, these patients seemed less inclined to seek help from nurses. Also, many young adults, including men, may be reluctant to share their concerns with nurses. Thus, some young men may feel that nursing accompanying is not personalized to their lifestyles and their concerns. The aim of this study was to describe and understand the nursing accompanying personalized to the experience of young men with cancer. An interpretative descriptive qualitative study inspired by Thorne’s (2016) methodological approach of was carried out. Eight young men with cancer, between the ages of 20 and 33, participated in an individual interview. An iterative qualitative analysis of the data was carried out. The results were divided into two themes. The first theme focuses on the importance of establishing a relationship of trust between the nurse and the young man with cancer and is divided into these sub-themes: 1) giving a human presence to young men with cancer; 2) establishing a care partnership between the nurse and the young man with cancer; 3) be accessible for the young man and 4) be interested in the feelings of the young man with cancer. The second theme discusses the needs that remain to be met by nursing support and includes the following sub-themes: 1) need to receive care adapted to their reality; 2) need to identify with other young men with cancer; 3) need for targeted information and 4) need to feel in the action; 5) need for adapted psychological support. The results suggest that young men with cancer want to feel a human presence from nurses, whom would be more interested in their feelings. These patients also seemed to have several unmet needs, including the need for psychological support. Finally, this study made it possible to describe that personalized nursing accompanying for young men with cancer should include a human presence, some help in the expression of feelings, the involvement of the young person during care, along with psychological support. Various recommendations are issued to optimize nursing accompanying for young men with cancer, such as the development of training to explore patients’ feelings

Association of Interleukin 27 gene polymorphism and risk of Hepatitis B viral infection in Egyptian population

Background: According to the World Health Organization, Hepatitis B virus (HBV) is considered a major global public health problem. The genetic background may be a crucial etiologic factor in HBV infection and its complications. Interleukin-27 (IL-27) is a newly discovered cytokine encoded by 2 genes (EBI3 and p28). Mutations in the IL-27 gene may lead to altered cytokine production and/or activity and thus modulate individual’s susceptibility to HVB infection. Aim of the study: This work was designed to study the association of IL-27p28 (−964A/G, 2905T/G and 4730T/C) gene promoter single nucleotide polymorphism (SNP) with the risk of Hepatitis B virus (HBV) in Egyptians. To the best of our knowledge, this study is the first one that examines IL-27p28 promoter polymorphism in Egyptian patients. Subjects and methods: One hundred and sixteen patients with HBV infection and 101 healthy controls were genotyped by using polymerase chain reaction/restriction fragment length polymorphism (PCR/RFLP) in Egyptian population. Results: There were no significant differences in the genotype and allele frequencies of IL-27p28 gene polymorphisms between patients and controls. Furthermore, no association was found between the distributions of the haplotypes and HBV risk. Conclusion: Our data suggested that polymorphisms in the IL-27 gene may not contribute to HBV susceptibility. Further studies with large sample size should be conducted to validate these results in Egyptian population

mir-146a genetic polymorphisms in systemic lupus erythematosus patients: Correlation with disease manifestations

This study aimed to investigate the genetic polymorphisms of miR-146a SNPs (rs2910164, rs57095329, and rs2431697) in systemic lupus erythematosus (SLE) patients and their association with clinical manifestations. The implication of SNPs on miR-146a expression level was also evaluated. SLE patients (113) and healthy controls (104) were registered in this study. The miR-146a SNPs were genotyped by polymerase chain reaction/restriction fragment length polymorphism (PCR-RFLP). Quantitative real-time PCR was used to measure the miR-146a expression in peripheral blood mononuclear cells (PBMCs). Our results showed that the genotype frequency of miR-146a SNPs didn't deviate significantly from the Hardy–Weinberg equilibrium (HWE). The AG genotype and G allele of miR-146a (rs57095329 A/G) might be considered a risk factor for the disease (OR = 2.27; CI: 0.78–6.57 and OR: 2.35; CI: 0.79–6.92 for AG genotype and G allele, respectively). Although, no statistical significance in the distribution of miR-146a SNPs (rs2910164, rs57095329, and rs2431697) was found, indicating the lack of association between the three SNPs and SLE susceptibility. Significantly, the higher frequency of the AA genotype of miR-146a (rs57095329) was associated with pancytopenia (P < 0.05), while the CT genotype of miR-146a (rs2431697) was associated (P < 0.05) with the antiphospholipid syndrome (APS). SLE patients had significantly higher levels of miR-146a compared to controls (P < 0.05). Elevation of miR-146a was independent of any SNP genotypes. In conclusion, this pilot study shows no association between miR-146a SNPs in our population group and susceptibility to lupus. Studies concerning other miRNAs in larger sample sizes are essential for a better understanding of their role in susceptibility to SLE disease