cannabis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4307971/
https://www.nature.com/articles/nrn3530
Our work on cannabis has been delayed because it turned out that cannabis placebo is considered a Schedule 1 drug in the UK. This meant that placebo had to be added to our licence and that import and export licences were then required for obtaining it from overseas suppliers. As these licences only last for 8 weeks, they commonly time-expire before the university or the supplier have dealt with the contractual documents. We are currently on our third licence for placebo cannabis and still awaiting supply
2014 – cochrane review -No reliable conclusions can be drawn at present regarding the efficacy of cannabinoids as a treatment for epilepsy. The dose of 200 to 300 mg daily of cannabidiol was safely administered to small numbers of patients generally for short periods of time, and so the safety of long term cannabidiol treatment cannot be reliably assessed.
http://onlinelibrary.wiley.com/store/10.1002/14651858.CD009270.pub3/asset/CD009270.pdf?v=1&t=jdukvcao&s=6bd3311891f6e563c7ea4e57e1f76ccb5ce980f9
US systematic review 2014
https://www.ncbi.nlm.nih.gov/pubmed/24778283/
For patients with epilepsy, data are insufficient to support or refute the efficacy of cannabinoids for reducing seizure frequency (no Class I–III studies).
Specifically, outcomes of cannabis therapy were significantly better when families moved their residence to Colorado in order to access the medication compared with families already residing in Colorado (Fig. 3).
Lancet trial 2016
https://www.ncbi.nlm.nih.gov/pubmed/24854329?dopt=Abstract
Adverse events were reported in 128 (79%) of the 162 patients within the safety group. Adverse events reported in more than 10% of patients were somnolence (n=41 [25%]), decreased appetite (n=31 [19%]), diarrhoea (n=31 [19%]), fatigue (n=21 [13%]), and convulsion (n=18 [11%]). Five (3%) patients discontinued treatment because of an adverse event. Serious adverse events were reported in 48 (30%) patients, including one death—a sudden unexpected death in epilepsy regarded as unrelated to study drug. 20 (12%) patients had severe adverse events possibly related to cannabidiol use, the most common of which was status epilepticus (n=9 [6%]).
future trials to be reported (ClinicalTrials.gov, numbers NCT02091375 and NCT02224703), Lennox–Gastaut syndrome (NCT02224560 and NCT02224690), and tuberous sclerosis complex (NCT02544763).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5767492/
flu vaccinations
https://ecdc.europa.eu/en/seasonal-influenza/prevention-and-control/vaccines/types-of-seasonal-influenza-vaccine
https://app.box.com/s/iddfb4ppwkmtjusir2tc/file/247634612957
2016/7 season -> reduced effectiveness of flu vaccine in older people
older people also do worst with flu -> in terms of mortality
eg they calculated that 75 years upwards x7 more likely to die from flu compared with people aged 64-74
so in terms of where you want it to be most effective – clearly in your highest risk groups
new vaccine licensed for older people – 2017/8 availability
adjuvanted trivalent inactivated influenza vaccine – better in elderly compared with trivalent inactivated vaccine
The Committee noted that aTIV, under quite conservative estimates of effectiveness, would be highly cost -effective in both the 65- 74 and 75 and over age groups.The Committee agreed that if a change in approach were to be considered,
switching vaccination of the 75 years and upwards age group to adjuvanted
vaccine would be the first priority, given the un-
adjuvanted inactivated vaccine
showed no significant effectiveness in this group
The Committee asked the Department of Health, Public Health England and NHS
England to give consideration to the evidence that had been provided on the
provision of adjuvanted influenza vaccine to those aged 65 years
and over. The Committee recognised, however, that there were also practical issues for DH to consider for such a policy, because of the current arrangements for procurement for influ enza vaccines for those aged 65 years upwards, which were procured by individual GPs and Clinical Commissioning Groups and open to market choice.
https://www.sciencedirect.com/science/article/pii/S0264410X13010451?via%3Dihub – but no data on mortality
not in long term care residents
one flu season only
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