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Biomedical subjects

F Grotenhermen

Publications and source records attributed to F Grotenhermen.

10 recordsLinked to original sources
PubMed2006

The treatment of spasticity with Delta9-tetrahydrocannabinol in persons with spinal cord injury.

STUDY DESIGN: Open label study to determine drug dose for a randomized double-blind placebo-controlled parallel study. OBJECTIVES: To assess the efficacy and side effects of oral Delta(9)-tetrahydrocannabinol (THC) and rectal THC-hemisuccinate (THC-HS) in SCI patients. SETTING: REHAB Basel, Switzerland. METHOD: Twenty-five patients with SCI were included in this three-phase study with individual dose adjustment, each consisting of 6 weeks. Twenty-two participants received oral THC open label starting with a single dose of 10 mg (Phase 1, completed by 15 patients). Eight subjects received rectal THC-HS (Phase 2, completed by seven patients). In Phase 3, six patients were treated with oral THC and seven with placebo. Major outcome parameters were the spasticity sum score (SSS) using the Modified Ashworth Scale (MAS) and self-ratings of spasticity. RESULTS: Mean daily doses were 31 mg with THC and 43 mg with THC-HS. Mean SSS for THC decreased significantly from 16.72 (+/-7.60) at baseline to 8.92 (+/-7.14) on day 43. Similar improvement was seen with THC-HS. We observed a significant improvement of SSS with active drug (P=0.001) in the seven subjects who received oral THC in Phase 1 and placebo in Phase 3. Major reasons for drop out were increase of pain and psychological side effects. CONCLUSION: THC is an effective and safe drug in the treatment of spasticity. At least 15-20 mg per day were needed to achieve a therapeutic effect.

Administration, Oral↗
PubMed2003

Spleen involvement in Hodgkin's lymphoma: assessment and risk profile.

Diagnostic laparotomy is no longer routinely performed in Hodgkin's lymphoma and noninvasive diagnosis of spleen involvement remains uncertain. In order to assess the probability of splenic involvement based on clinical parameters, we retrospectively analyzed data on patients of the German Hodgkin's Lymphoma Study Group (GHSG) who underwent staging laparotomy and for whom splenic weight and size were available. Our study included 376 patients with Hodgkin's lymphoma who underwent staging laparotomy and splenectomy according to the treatment policy of the GHSG between February 1981 and January 1993. Univariate and multivariate analyses of pretherapeutic clinical characteristics and splenic weight were performed in order to predict the probability of splenic involvement. Computed tomographic (CT) images of 25 patients were available and used to correlate radiological splenic size and pathological splenic weight. In 171 of 376 patients spleen involvement was found. Average weight of the spleens was 258 g (+/-257) ranging from 55 to 3290 g. All spleens with a weight above 2000 g showed disease involvement, while those under 150 g were never involved. In the multivariate analysis, splenic weight ( p<0.001), erythrocyte sedimentation rate ( p<0.001), and clinical stage ( p<0.01) were found to be independently prognostic for spleen involvement. Splenic weight was highly correlated with a spleen index defined as the product of length, width, and thickness measured by CT (correlation coefficient: 0.93). By applying the identified risk factors in clinically staged patients spleen involvement can be determined. Spleen weight can be estimated with the help of a spleen index. Above an index of 1000 the probability of spleen involvement is higher than 90%. This might be of outstanding importance for patients being scheduled for involved field radiation.

Adolescent↗
PubMed1999

[The effects of cannabis and THC].

Cannabis and THC exert manifold actions on a number of organ systems. A lethal dose of THC in humans is unknown. Above the psychotropic threshold, ingestion of cannabis causes an enhanced well-being and relaxation with an intensification of ordinary sensory experiences. The most important unwanted acute psychical effects are anxiety and panic attacks. Acute somatic effects are increased heart rate, changes of blood pressure, conjunctival injection and dry mouth. Properties that might be used therapeutically comprise analgesia, muscle relaxation, sedation, increase of mood, stimulation of appetite, antiemesis, lowering of intraoccular pressure and bronchodilation. Chronic use may lead to dependency and to a mild withdrawal syndrome. The extent of possible long-term damage on psyche and cognition, immune system, fertility and pregnancy remains controversial. Marijuana can induce a schizophrenic psychosis in vulnerable persons presumably without increasing the incidence of the disease. Disturbance of immunological and hormonal functions and long-term impairment of memory, attention, and complex cognitive processes are low and do not preclude a legitimate therapeutic use.

Analgesia↗
PubMed1999

[Results of a standardized survey on the medical use of cannabis products in the German-speaking area].

The plant Cannabis sativa has a long history of medical use in the treatment of pain and spasms, the promotion of sleep, and the suppression of nausea and vomiting. However, in the early 70s cannabis was classified in the Narcotic Acts in countries all over the world as having no therapeutic benefit; therefore, it cannot be prescribed by physicians or dispensed by pharmacists. In the light of this contradictory situation an increasing number of patients practices a self-prescription with cannabis products for relieving a variety of symptoms. An anonymous standardized survey of the medical use of cannabis and cannabis products of patients in Germany, Austria and Switzerland was conducted by the Association for Cannabis as Medicine (Cologne, Germany). During about one year 170 subjects participated in this survey; questionnaires of 128 patients could be included into the evaluation. 68% of these participants were males, 32% females, with a total mean age of 37.5 (+/- 9.6) years. The most frequently mentioned indications for medicinal cannabis use were depression (12.0%), multiple sclerosis (10.8%), HIV-infection (9.0%), migraine (6.6%), asthma (6.0%), back pain (5.4%), hepatitis C (4. 8%), sleeping disorders (4.8%), epilepsy (3.6%), spasticity (3.6%), headache (3.6%), alcoholism (3.0%), glaucoma (3.0%), nausea (3.0%), disk prolapse (2.4%), and spinal cord injury (2.4%). The majority of patients used natural cannabis products such as marihuana, hashish and an alcoholic tincture; in just 5 cases dronabinol (Marinol) was taken by prescription. About half of the 128 participants of the survey (52.4%) had used cannabis as a recreational drug before the onset of their illness. To date 14.3% took cannabis orally, 49.2% by inhalation and in 36.5% of cases both application modes were used. 72.2% of the patients stated the symptoms of their illness to have 'much improved' after cannabis ingestion, 23.4% stated to have 'slightly improved', 4.8% experienced 'no change' and 1.6% described that their symptoms got 'worse'. Being asked for the satisfaction with their therapeutic use of cannabis 60.8% stated to be 'very satisfied', 24.0% 'satisfied', 11.2% 'partly satisfied' and 4.0% were 'not satisfied'. 70.8% experienced no side effects, 26.4% described 'moderate' and 3.3% 'strong' side effects. 84.1% of patients have not felt any need for dose escalation during the last 3 months, 11.0% had to increase their cannabis dose 'moderately' and 4.8% 'strongly' in order to maintain the therapeutic effects. Thus, this survey demonstrates a successful use of cannabis products for the treatment of a multitude of various illnesses and symptoms. This use was usually accompanied only by slight and in general acceptable side effects. Because the patient group responding to this survey is presumably highly selected, no conclusions can be drawn about the quantity of wanted and unwanted effects of the medicinal use of the hemp plant for particular indications.

Adolescent↗
PubMed1999

[Some practice-relevant aspects of the pharmacokinetics of THC].

The pharmacokinetics of THC varies in dependence of its route of administration. Pulmonary assimilation of Cannabis (smoking, inhalation) leads to a maximum THC concentration within minutes, psychotropic effects start within seconds to a few minutes, reach a maximum after 15-30 min, and slope down within 1-2 h. In case of oral ingestion the effect sets in delayed after 30-90 min, reaches its maximum after 2-3 h and lasts about 4-8 h. Duration of action depends on measured parameters. Intestinal absorption of THC is increased by application in a lipophilic base. Cannabinoids are present in the plant mainly as pharmacologically inactive carboxylic acids (more than 95%), that are transformed into the active phenols by heating (smoking, baking). Heating of 5 min to 200 degrees C seems to be optimal.

Dronabinol↗
PubMedDate not supplied

Evaluating the impact of hemp food consumption on workplace drug tests.

Foods containing seeds or oil of the hemp plant (Cannabis sativa L.) are increasingly found in retail stores in the U.S. The presence of delta9-tetrahydrocannabinol (THC) in these foods has raised concern over their impact on the results of workplace drug tests for marijuana. Previous studies have shown that eating hemp foods can cause screening and confirmed positive results in urine specimens. This study evaluated the impact of extended daily ingestion of THC via hemp oil on urine levels of its metabolite 11-nor-9-carboxy-delta9-tetrahydrocannabinol (THC-COOH) for four distinct daily THC doses. Doses were representative of THC levels now commonly found in hemp seed products and a range of conceivable daily consumption rates. Fifteen THC-naïve adults ingested, over four successive 10-day periods, single daily THC doses ranging from 0.09 to 0.6 mg. Subjects self-administered THC in 15-mL aliquots (20 mL for the 0.6-mg dose) of four different blends of hemp and canola oils. Urine specimens were collected prior to the first ingestion of oil, on days 9 and 10 of each of the four study periods, and 1 and 3 days after the last ingestion. All specimens were screened for cannabinoids by radioimmunoassay (Immunalysis Direct RIA Kit), confirmed for THC-COOH by gas chromatography-mass spectrometry (GC-MS), and analyzed for creatinine to identify dilute specimens. None of the subjects who ingested daily doses of 0.45 mg of THC screened positive at the 50-ng/mL cutoff. At a daily THC dose of 0.6 mg, one specimen screened positive. The highest THC-COOH level found by GC-MS in any of the specimens was 5.2 ng/mL, well below the 15-ng/mL confirmation cutoff used in federal drug testing programs. A THC intake of 0.6 mg/day is equivalent to the consumption of approximately 125 mL of hemp oil containing 5 microg/g of THC or 300 g of hulled seeds at 2 microg/g. These THC concentrations are now typical in Canadian hemp seed products. Based on our findings, these concentrations appear to be sufficiently low to prevent confirmed positives from the extended and extensive consumption of hemp foods.

Adult↗