Development of transdermal delivery systems for innovative clinical applications of cannabinoids

The use of cannabis for medicinal purposes is deeply rooted in history, dating back to ancient times. While there has been a strong push for legalizing medicinal cannabis and research, conclusive evidence regarding the short- and long-term health effects (harms and benefits) of cannabis use remains elusive because of a high variability when cannabinoids are administered orally or by inhalation. Transdermal delivery of cannabinoids could allow a constant, defined release of these active ingredients. The main goal of this project was to develop innovative pharmaceutical forms in order to ensure a constant release of cannabinoids to the patient. By using a synthesized model molecule, desoxy-CBD, innovative vesicular systems were developed, characterized, and compared with vesicles loaded with cannabis extracts

Development of transdermal delivery systems for innovative clinical applications of cannabinoids

L\u2019uso della cannabis a scopo terapeutico ha radici molto profonde nella storia. Nonostante ci sia stato un forte impulso verso la legalizzazione dell\u2019uso terapeutico della cannabis e la ricerca a riguardo, rimangono tuttora sfuggenti le evidenze scientifiche riguardanti gli effetti a breve o lungo termine, sia in termini di tossicit\ue0 che di efficienza terapeutica, a causa di una grande variabilit\ue0 nella dose somministrata per via orale o inalatoria. La somministrazione transdermica dei cannabinoidi potrebbe assicurare un rilascio costante, definito e prolungato nel tempo. L'obiettivo principale di questo progetto \ue8 stato lo sviluppo di forme farmaceutiche innovative al fine di garantire un rilascio costante di cannabinoidi per il paziente. Tramite l'uso di una molecola modello appositamente sintetizzata, desossi-CBD, sono stati sviluppati sistemi vescicolari innovativi, successivamente caratterizzati e confrontati con vescicole contenenti estratti di cannabis stessa

Application of the National Early Warning Score (NEWS) as a stratification tool on admission in an Italian acute medical ward: A perspective study

Aim We aimed to assess the performance of the National Early Warning Score (NEWS) as tool for patient risk stratification at admission in an acute Internal Medicine ward and to ensure patient placement in ward areas with the required and most appropriate intensity of care. As secondary objective, we considered NEWS performance in two subgroups of patients: sudden cardiac events (acute coronary syndromes and arrhythmic events), and chronic respiratory insufficiency. Methods We conducted a perspective cohort single centre study on 2,677 unselected patients consecutively admitted from July 2013 to March 2015 in the Internal Medicine ward of the hospital of Trento, Italy. The NEWS was mandatory collected on ward admission. We defined three risk categories for clinical deterioration: low score (NEWS 0-4), medium score (NEWS 5-6), and high score (NEWS≥7). Following adverse outcomes were considered: total and early (<72 hours) in-hospital mortality, urgent transfers to a higher intensity of care. A logistic regression model quantified the association between outcomes and NEWS. Results For patients with NEWS >4 vs patients with NEWS <4, the risk of early death increased from 12 to 36 times, total mortality from 3.5 to 9, and urgent transfers from 3.5 to 7. In patients with sudden cardiac events, lower scores were significantly associated with higher risk of transfer to a higher intensity of care. In patients affected by chronic hypoxaemia, adverse outcomes occurred less in medium and high score categories of NEWS. Conclusions National Early Warning Score assessed on ward admission may enable risk stratification of clinical deterioration and can be a good predictor of in-hospital serious adverse outcomes, although sudden cardiac events and chronic hypoxaemia could constitute some limits