These substances should be avoided by carriers of pathogenic variants since this pattern increases the risk of adverse cardiac events

Moreover, in their study of heavy cannabis users, Taylor et al. found that 77% had traces of THC in their hair, 73% had CBN, and 19% had CBD . Similarly, Franz et al. found that THC-OH concentrations in participants’ hair varied between 0.05 and 37.6 pg/mg . The research indicates that exposure to high levels of undeclared tetrahydrocannabinol can adversely affect consumer health, particularly in the form of cannabinoid sensitisation or the development of a cannabinoid allergy, with symptoms ranging from mild to potentially fatal reactions. This sensitisation is particularly of concern because of cross-reactivity with similar substances, such as latex, tobacco, or alcoholic beverages derived from plants or other foods . There is also evidence of cannabis arteritis among young cannabisconsuming adults, which is a severe peripheral vascular disease that can cause a loss of limb use .

Moreover, preclinical research has indicated that although cannabinoids can have antineoplastic effects, they might contribute to the early stages of malignant trans-formation . Based on the abovementioned evidence, there is a clear need to conduct thorough research into the effects of cannabinoid use and to ensure that these effects are used solely for the treatment of dermatological conditions. Of particular concern is this study’s fifinding that cosmetic products meant to be left on tend to have a higher total tetrahydrocannabinol content than those that are rinsed off. This may be the result of most of the products tested here being marketed as treatments for atopic dermatitis and eczema. These dermatological conditions imply inflflammatory dermatoses that can cause the skin barrier to weaken, meaning an increased risk of skin infection for consumers of cosmetic or personal care products adulterated with undeclared tetrahydrocannabinol. In addition, more vulnerable groups, such as the elderly, children below three years of age, and immunocompromised individuals, are particularly susceptible to the effects of adulterated cannabinoid-based products .

Finally, products marketed as suitable for application near the eyes are a particular issue due to the fragility of periocular skin . This study has revealed that although cannabinoid-based cosmetics offer potential treatment methods for a variety of inflflammatory conditions, there are still several areas of concern. For example, only limited research has demonstrated their effificacy and safety, with most data emerging from preliminary animal studies. In addition, the frequent adulteration of these products with undeclared tetrahydrocannabinol is an important issue. Therefore, it is strongly recommended that current regulations be revised and updated to ensure better compliance for cannabinoid-based cosmetic products. Sudden death can be defined as the unexpected natural death of a healthy individual occurring within the first hour after the onset of symptoms or, if death is unwitnessed, within 24 h of the victim being seen in a healthy state. Albeit SD can have many causes, it is normally of cardiac origin, and in those younger than 35 years, it is mainly due to cardiomyopathies and channelopathies . Brugada syndrome is the second most common channelopathy after Long QT syndrome. Sudden death is often the first clinical manifestation of BrS, and this syndrome is not associated with macroscopic/microscopic anomalies, albeit recurrent flogosis and fibrosis in some cardiac districts have been reported .

BrS is characterized by autosomal dominant pattern of inheritance, incomplete penetrance and variable expressivity . SCN5A, which encodes the pore-forming ion-conducting α-subunit of the cardiac sodium channel , is the most frequently mutated gene in BrS cases . In particular, the level of expression of Nav1.5 sodium channels is a critical determinantof the arrhythmogenic process, and its decrease may be a sign of BrS in heterozygous patients . In particular, SCN5A variants can cause late Na+ current and thus the clinical manifestations of both BrS and Long QT syndrome.The only diagnostic ECG pattern of BrS can occur either spontaneously or in response to many licit and illicit drugs.Despite there being not strong evidence of an association between cannabis use and type 1 Brugada ECG pattern, a potential favoring role of this substance has been described . In this paper, we report a case of sudden death in a young consumer of cannabis in which the autopsy revealed a long and thick myocardial bridging , adipositas cordis, fibrosis of the sino-atrial node, and postmortem genetic testing found a variant previously associated to BrS.

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There is growing interest in the roles of CBs in the modulation of various aspects of cancer growth

Enzymes involved in the synthesis and degradation of ECs play an important role in cell signal transduction . Both AEA and 2-AG are removed from their sites of action by uptake and metabolized intracellularly . The enzymes involved in the degradation of ECs are fatty acid-amide hydrolase and monoacylglycerol lipase . In some tissues, ECs can also undergo oxidative catabolism through the lipoxygenase, cyclooxygenase 2 , and cytochrome P450 isoenzymes . The action of these enzymes leads to the generation of various compounds such as prostaglandin-ethanolamides and glyceryl esters, hydroxy-anandamides and hydroxycosatetraenoylglycerols . Some of these endocannabinoid metabolites are biologically active .Cancer cells rapidly and uncontrollably proliferate and have the ability to invade other tissues, causing metastasis . It has been reported that ECS dysregulation occurs during carcinogenesis and may be responsible for cancer aggressiveness . ECs can modulate several aspects of tumorigenesis . A major discovery was the recognition of the ability of CBs to kill a plethora of cancer cells .

CBs promote apoptosis and autophagy, induce cell cycle arrest, and have inhibitory effects on the migration, invasion, and self-renewal of tumor cells . These processes can be both dependent and independent of CB receptors, showing that the antitumor activity of CBs has much more complex molecular mechanisms than originally thought . In addition, CBs exhibit several palliative effects in cancer patients . Apoptosis, autophagy and inhibition of proliferation. A major characteristic of cancer cells is uncontrolled proliferation. CB receptor activation increases de novo production of ceramide, a sphingolipid with proapoptotic functions . The upregulation of the ceramide-induced stress-regulated protein p8 causes apoptosis through the overexpression of genes encoding the activating transcription factor 4, and Tribbles homolog 3 . TRB3 is also responsible for inhibition of the Akt/mTORC1 complex axis, which causes autophagy-mediated apoptosis and the inhibition of cell proliferation .Although it is best known as the source of a recreational drug, the Cannabis sativa plant has a large variety of other uses, e.g., as an ingredient in food and cosmetics, a textile material, and a medicinal product . The cannabis plant contains various chemical compounds known as cannabinoids, which is a term that initially only encompassed those substances produced by the plant, namely, phytocannabinoids.

One of these compounds is tetrahydrocannabinol , which causes psychoactive effects known from the recreational use of cannabis. Moreover, endocannabinoids refer to cannabinoids that are naturally produced within the body as part of the endocannabinoid system, while synthetic cannabinoids are manufactured substances that have similar properties to phytocannabinoids . The phytocannabinoid cannabidiol has been the focus of attention due to its neurological and anti-inflflammatory effects . Products containing CBD are often sold over the counter, e.g., as dietary supplements, to circumvent the laws regulating medicinal products. Substances derived from cannabis, such as hemp oil and other cannabis extracts, are becoming increasingly common ingredients in cosmetics . Recent studies have demonstrated the potential use of cannabinoids to treat dermatological conditions, such as pruritus, skin cancer, and inflflammatory skin diseases . For instance, hemp oil is offered on the market as a cosmetic hair treatment, with product manufacturers claiming that the direct application of the oil can moisturise and protect hair, promote hair growth, and repair damaged hair. Despite the lack of scientifific evidence supporting these claims, numerous online outlets sell these products, which range in composition from pure hemp oil to shampoos and similar hair treatments containing lower concentrations of hemp oil .

EU cosmetics regulations state that all hemp-derived natural raw materials contained in cosmetics must be derived from Cannabis sativa plant parts, including seeds, leaves, or leaves without tops, whereby the total THC content must not exceed 0.2%; notably, the flflowering or fruiting parts of Cannabis sativa generally feature higher THC concentrations. The use of nonfifibrous cannabis material with an excess of 0.2% THC is forbidden, and this limit of THC refers only to hemp plants—not to hemp-derived cosmetic ingredients . In contrast, UAE cosmetic regulations state that the manufacturer of any cosmetic product containing hemp oil or cosmetic oil containing CBD must demonstrate that their fifinished cosmetic products are free from tetrahydrocannabinols by tetrahydrocannabinol content testing in municipal laboratories or accredited laboratories.

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All participants provided informed consent electronically before beginning the survey

Investigating the mechanisms involved in both alcohol and cannabis-mediated inflflammatory priming within the lung is important to better understand the pulmonary immune system and may reveal pathways susceptible to pharmacological intervention. In conclusion, although the experimental data are emerging, the increase in alcohol and cannabis sales during the time of pandemic should focus the attention of health and scientific professionals to this potential problem, for both health of both direct and indirect victims of COVID-19. Since the declaration of COVID-19 as a global pandemic by the World Health Organization on 11 March 2020, disparities in COVID-19-associated morbidity and mortality have emerged among older adults and individuals living with chronic health conditions . Within the United States, medicinal cannabis use is legal in certain states for individuals with certain health conditions, such as cancer .

Cancer survivors, including those who use medicinal cannabis, have been recommended to take additional precautions to reduce COVID-19 exposure due to increased risk for COVID-19 hospitalization and mortality among individuals with pre-existing chronic health conditions . Beyond the physical risks of COVID-19, individuals with chronic health conditions are reporting increased anxiety and depressive symptoms, as well as adverse economic outcomes including loss of employment and health insurance . Prior studies, including those conducted by the study team, have documented increased reports of physical and mental health symptoms during the pandemic period among cancer survivors compared to adults without a history of cancer . Legal qualifying medical conditions for cannabis use vary by state within the United States; cancer and HIV/AIDs are conditions consistently included across all legal states . Despite variation in the legality of cannabis, “conclusive or substantial evidence” in the effectiveness of cannabis to treat chronic pain, chemotherapy-induced nausea and vomiting, and patient-reported multiple sclerosis spasticity symptoms were identified in 2017 by the National Academies of Sciences, Engineering, and Medicine in a report on the Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research .

Cannabis contains phytocannabinoids that have been shown to engage with the endocannabinoid system, an endogenous system responsible for homeostasis. Receptors for the endocannabinoid system, CB1 and CB2, are located throughout the body and bind with phytocannabinoids depending on their affinity. CB2 receptors have been identified as opportunities for cannabis, CBD in particular, to impact the health of cancer patients due to its opportunity to effect pain and immune function, for example . Though clinical evidence on the indications of cannabis use for cancer has traditionally been limited due to federal legalization status, observational studies of cannabis consumers identify pain management, nausea, appetite, anxiety, depression, and sleep as most prevalent reasons for use . Further, medical cannabis use has been identified as a coping strategy to help manage physical and mental health symptoms among cancer survivors . However, the impacts of the COVID-19 pandemic on cannabis use behaviors and other coping strategies among cancer survivors remains underexplored. Cannabis as a coping strategy differs from other strategies largely due to its unique relationship with the human endocannabinoid system.

Cannabis has the opportunity to impact physical and mental health through cannabinoids that engage with the body based on the type of cannabis used and the method of delivery. The objective of the study is to identify changes to cannabis use, methods of cannabis delivery, and coping strategies among cancer survivors, and to describe differences in cannabis behaviors and coping strategies by cancer status among an age-matched sample of cannabis users from the COVID-19 cannabis health study.Cross-sectional data are from the COVID-19 cannabis health study, a multisite study designed to examine COVID-19 impacts on cannabis use patterns and related behaviors among adult medicinal and recreational cannabis users . The study includes domains regarding COVID-19 testing, diagnosis, and probable COVID-19 symptoms; measures of mental health symptoms reported since the COVID-19 pandemic; cannabis and other substance use behaviors before and during the pandemic period; and self-report of physician diagnosis of chronic health conditions. Study eligibility criteria included adults 18 yearsof age or older; participants included cannabis users and non-cannabis users.

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As seen in the previous section the recovery of terpenes consists of extracting EO

Differences in yield appear depending on the state of the material and the particle size. Considering the need to find sustainable processes, it also seems important to explore eco-friendly solvent extraction. UAE is an extraction technique using ultrasound waves, mechanical vibrations that pass through the extraction medium. The waves create acoustic cavitation through the generation of cycles of expansion and compression, inducing the formation of bubbles which expand and collapse. These effects provoke the destruction of cell walls, thereby releasing the cell contents . Table 2 summarizes the different operating conditions used and the results obtained in the different studies using UAE process for the extraction of PC from cannabis. Most UAE is done using an ultrasonic bath with methanol or its aqueous mixture as a solvent. These two solvents are often used for the extraction of antioxidants from plants . The influence of the nature of the solvent on the extraction of PC using ultrasounds has been carried out on defatted seed and meal . The solvents used are water, MeOH, EtOH and acetone at various concentrations. Pure solvents and water led to a lower extraction of PC in comparison with a mixture of aqueous solvents, emphasizing the importance of the polarity of the solvent for the extraction. The optimum yield is obtained for an aqueous mixture of 75% or 80% acetone.

Microwave-assisted extraction , pressurized liquid extraction , extrusion and rapid solid–liquid dynamic extraction have also been used to recover PC from cannabis. Microwaves are electromagnetic radiations that can penetrate plant biomass and interact with polar molecules. The water contained in the biomass absorbs the microwave energy and induces rapid heating of the cells, causing their disruption and the release of the desired components . MAE is an excellent green extraction technology and is particularly appropriate for the recovery of polar molecules such as phenolic compounds from plant materials . The operating conditions tested were water as solvent with liquid/solid ratios between 4 and 6 mL/g, a microwave input power equal to 440, 700 or 1100 W, and times of extraction ranging from 1 to 5 min. The optimum conditions obtained by applying the response surface methodology are a L/S ratio of 6 mL/g, an input power of 700 W, and an extraction time of 5 min. Extraction by ultrasounds of the biomass pretreated by microwaves yielded respective TPC and TFC contents of 13.31 mg GAE/g FW and 0.19 mg LUE/g FW. The resulting extract showed 27.52% of DPPH inhibition and a reducing power of 15.64 µmol Fe/g FW. Similarly to ultrasounds, the authors underlined the influenceof the microwave power, in particular the appearance of degradations due to an excessive temperature in the material generated by microwave power and its interaction with time. Pressurized liquid extraction is a technique used to perform extractions from solid and semi-solid samples under pressure. Accelerated solvent extraction is an equivalent technique, the equipment named identically can operate at room temperature as well as temperatures above the boiling point of solvents, using pressure to keep the solvent in its liquid state . Like MAE, only a few studies have used PLE for the recovery of PC from cannabis. Kitryt˙e et al. used this technology to develop and optimize a multi-step biorefining process for the isolation of cannabinoid and antioxidant fractions from hemp aerial parts.

Their biorefining approach included three consecutive processes, a supercritical CO2 extraction for the isolation of cannabinoids, a PLE for the extraction of PC, and a fifinal step with enzyme assisted extraction to break the cell wall and release its interesting compounds. During the PLE extraction, acetone was applied during optimized conditions of extraction , followed by an EtOH aqueous mixture in the same conditions. The acetone and ethanolic fractions resulted in TPC contents of 5.02 mg GAE/g DW and 23.52 mg GAE/g DW of initial plant material, respectively. In accordance with the cited results, most identifified flflavonoids were in the ethanolic fraction. Temperature was an important parameter: an increase to 100 C enables better extraction of PC while extraction at 130 C leads to a color change and potential degradation of PC. In addition, the ethanolic fraction showed the highest antioxidant capacity. A strong correlation was found between PC and the antioxidant activity of the extract, in particular using ABTS assay. ASE is usually considered to be an interesting technique to replace CSE because a better extraction efficiency is achieved using less solvent in a shorter time as in the work of Bassil . The focused was on the extraction of coumaric and ferulic acids from hemp hurds and dust. ASE yielded 1.5 times more total phenolic content in 30 min than CSE in 24 h. However, ASE was equivalent to CSE in the case of dust.The terpenes are among the main compounds of the essential oil of cannabis . Cannabis’ EO is a liquid with a yellow color more or less pronounced, composed of monoand sesquiterpenes but also of other molecules such as terpene alcohols and cannabinoids.Diverse biological activities have been associated with C. sativa EO including insecticidal, nematicide, antimicrobial, fungicidal, anti-leishmanial, antioxidant, anti-acetylcholinesterase or neuroactive activities . The terpenes present in cannabis EO are responsible for the smell of the plant . Based on the studied articles, the yield of cannabis EO can reach up to 0.55% of dry matter , the most abundant monoterpene found is often β-myrcene. This compound described in Figure 4 have demonstrated antiinflammatory, analgesic, and anxiolytic activities and is used as a flavoring agent, solvent oradditive of lubricating oils.

Caryophyllene, also used as flavoring agent, is the most abundant sesquiterpene in many cultivars. Other sesquiterpenes present in significant quantities such as humulene and caryophyllene oxide can be identified in the EO of cannabis, the latter is the degradation product of caryophyllene.These compounds have shown an important anti-inflammatory activity as well as anticancer, analgesic and antipyretic properties, mainly for caryophyllene and caryophyllene oxide . Since terpenes constitute the major components of cannabis EO, studies of EO are often linked to terpenes. Cannabis EO yield and the terpene contents vary significantly according to the varieties, and between monoecious and dioecious varieties . Moreover, sesquiterpenes are the highest in the earlier harvest time while monoterpenes appear to increase in comparison to sesquiterpenes in the late harvest time, especially when the crop is subject to a water stress .

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