Parasite Eggs From the Celtic Period Found in Basel

Archaeologists from the University of Basel discovered eggs of intestinal parasites in samples from the former Celtic settlement “Basel-Gasfabrik”, and concluded that its population lived in poor sanitary conditions. Using special geoarchaelogical methods, they found three different types of parasites, as reported in the Journal of Archaeological Science.

As part of an international project, researchers at the Integrative Prehistory and Archaeological Science center (IPAS) at the University of Basel examined samples from the “Basel-Gasfabrik” Celtic settlement, at the present day site of Novartis. The settlement was inhabited around 100 B.C. and is one of the most significant Celtic sites in Central Europe. The team found the durable eggs of roundworms (Ascaris sp.), whipworms, (Trichuris sp.) and liver flukes (Fasciola sp.). The eggs of these intestinal parasites were discovered in the backfill of 2000 year-old storage and cellar pits from the Iron Age.

The presence of the parasite eggs was not, as is usually the case, established by wet sieving of the soil samples. Instead, a novel geoarchaeology-based method was applied using micromorphological thin sections, which enable the parasite eggs to be captured directly in their original settings. The thin sections were prepared from soil samples embedded in synthetic resin, thus permitting the researchers to determine the number and exact location of the eggs at their site of origin in the sediments of the pits. This offered new insights into diseases triggered by parasites in the Iron Age settlement.

Poor sanitary conditions

The eggs of the Iron Age parasites originate from preserved human and animal excrement (coprolites) and show that some individuals were host to several parasites at the same time. Furthermore, the parasite eggs were distributed throughout the former topsoil, which points to the waste management practiced for this special type of 'refuse'. It may, for example, have been used as fertilizer for the settlement's vegetable gardens. As liver flukes require freshwater snails to serve as intermediate hosts, it is conceivable that this type of parasite was introduced via livestock brought in from the surrounding areas to supply meat for the settlement's population.

The archaeologists also used the microscopic slides to show that the eggs of the intestinal parasites were washed out with water and dispersed in the soil. This suggests poor sanitary conditions in the former Celtic community, in which humans and animals lived side by side. At the same time, the distribution of the parasite eggs indicates possible routes of transmission within and between species.

The results of the study were published in the Journal of Archaeological Science. The research project conducted by the IPAS (University of Basel), and Archäologische Bodenforschung Basel-Stadt was also supported by the Swiss National Science Foundation and the Freiwillige Akademische Gesellschaft Basel.

Original sourceSandra L. Pichler, Christine Pümpin, David Brönnimann, Philippe Rentzel
Life in the Proto-Urban Style: The identification of parasite eggs in micromorphological thin sections from the Swiss Basel-Gasfabrik late Iron Age settlement. 
Journal of Archaeological Science (2014) | doi:10.1016/j.jas.2013.12.00

Tomado de: www.unibas.ch

FELIZ AÑO 2015

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Moderate alcohol benefits: only for 15% of population

An alcoholic beverage a day is claimed to keep coronary heart disease at bay, but only for 15% of the population, confirms a new study at Sahlgrenska Academy, University of Gothenburg in Sweden.

Alcoholic consumption (ethanol intake) at "moderate" level, up to 1 drink a day for women (corresponding to 14 g or 0.6 ounces of ethanol) and 2 drinks a day for men is associated with a decreased risk of coronary heart disease.

However, your favorite nightly tipple may only have cardio-protective benefits for people of a particular genotype of the cholesteryl ester transfer protein (CETP) polymorphism. For the other 85% of the population, this is not the case.

A previous study of men found an association between alcohol consumption and coronary heart disease, but the evidence had not been confirmed in further studies, until now.

The new study, published in Alcohol, specifically re-examines the potential association between alcohol consumption and coronary heart disease with the presence of the CETP TaqIB (rs708272) polymorphism.

There were 618 patients included in the study, including both men and women, below the age of 75. They were from three regional hospitals admitted for acute coronary syndrome and diagnosed with myocardial infarction, with a typical history, ECG, and enzyme changes or unstable angina.

Of the 618 participants, 453 were men and 165 women. First-time acute myocardial infarction or unstable angina was present in 209 men and 86 women, while the remaining 323 had an exacerbation of previously diagnosed coronary heart disease.

Study contributors and 2,921 healthy control subjects answered self-administered questionnaires on environmental and lifestyle-related exposure variables, and anthropometric measures and venous blood samples were collected.

All participants were asked about their intake of different types of alcoholic beverage (low-alcohol beer, medium-strong beer, strong beer, wine, dessert wine and spirits) and the serving size and frequency of consumption.

Participants were tested in order to identify if the CETP TaqIB genotype was present - the genotype found to play a role in the health benefits of alcohol consumption in a previous study. The researchers also tested whether the participants carried the B1 or B2 alleles of this genotype.

Moderate drinking alone does not have a strong protective effect

Results show that the distribution of CETP TaqIB genotype was similar in both female and male cases and controls. The researchers found:

• The B2 genotype was associated with a lower coronary heart disease risk, with a similar magnitude in men and women
• 19% of participants were homozygous for the CETP TaqIB B2 allele
• The group with intermediate alcohol intake had the lowest risk compared with low intake, but this was markedly more pronounced in B2 homozygotes than in B1 carriers.

The protective effect of B2 genotype in the categories of intermediate or high ethanol intake was more pronounced when the cases were restricted to the first-time coronary cases.

The results echo that of the previous study and confirm that moderate alcohol helps protect against coronary heart disease for the percentage of people who have the genotype.

Prof. Dag Thelle, Professor Emeritus at Sahlgrenska Academy, University of Gothenburg, says:

"In other words, moderate drinking has a protective effect among only 15% of the general population."

Alcohol consumption advice 'far too sweeping'

The researchers point out that a common attitude toward alcohol focuses on the breadcrumb that "moderate drinking has health benefits for everyone." However, evidence suggests that this advice may be too sweeping and needs reassessing.

"Moderate drinking alone does not have a strong protective effect," comments Prof. Lauren Lissner, who also participated in the study. "Nor does this particular genotype. But the combination of the two appears to reduce the risk of coronary heart disease significantly."

Study authors devised two hypotheses for how the CETP affects the "good" cardio-protective high-density lipoprotein (HDL) cholesterol that assists in the removal of excess lipids from the blood vessels:

1. Alcohol by some means affects the CETP in a way that benefits HDL cholesterol
2. Alcohol contains healthy, protective antioxidants.

One or both of these hypotheses may prove correct, but the mechanisms by which HDL cholesterol or antioxidants might act remain unknown.

Prof. Thelle notes:

"Our study represents a step in the right direction, but a lot more research is needed. Assuming that we are able to describe these mechanisms, it may be a simple matter one day to perform genetic testing and determine whether someone belongs to the lucky 15%."

"That would be useful to know when offering advice on healthy alcohol consumption. But the most important thing is to identify new means of using the body's resources to prevent coronary heart disease," he concludes.

Medical News Today recently reported that individuals over the age of 60 who partake in a little drinking may experience better episodic memory in later life.

Tomado de: medicalnewstoday.com Written by Hannah Nichols  Copyright: Medical News Today

CLASE PARASITOSIS INTESTINALES

CLASE PARASITOSIS INTESTINALES
MODULO GASTROENTEROLOGIA
NOVIEMBRE 2014

APRENDIZAJE BASADO EN UN CASO CLINICO

Paciente de 27 años, con síndrome nefrótico por amiloidosis renal secundaria a Enfermedad de Crohn, remitido a urgencias por malestar general, vómitos y diarrea de 10 días de evolución. 

El paciente mantenía hasta este cuadro función renal estable con Crs: 2-2 5 mg/dL, y mantenía tratamiento crónico con esteroides. 10 días antes de su ingreso el paciente comenzó con síndrome febril y diarrea sanguinolenta (6-7 deposiciones/día), y vómitos ocasionales. A su llegada urgencias el paciente estaba en muy mala situación clínica. Respiración de Kussmaul, mal perfundido y signos de deshidratación. TA: 90/60. Frecuencia: 130 lpm. Intensa palidez cutáneo-mucosa. Hábito asténico. El resto de la exploración física fue anodina 

Las exploraciones complementarias reflejaron:

• Hcto: 16, Hgb: 5.7, VCM: 87,
• Plaquetas: 599.000, Leucocitos: 43.600 (936N, 3L, 1M); 
• Crs: 9 mg/dL, Urea: 246 mg/dL, Na: 137 mEq/L, K: 9 mEq/L, Cl: 120 mEq/L, 
• Proteínas totales: 3.7 g/dL, Calcio: 7.2 mg/dL.
• pH: 7.13, pCO2: 12, HCO3: 4.1, pO2: 92 mm Hg.
  

PREGUNTAS:

1.- ¿Cuál es el trastorno ácido-base? ¿Es adecuada la compensación? ¿Cuáles son las causas más probables del cuadro? ¿Por qué el anión GAP es normal?


2.- ¿Como considera de grave el cuadro clínico?

3.- ¿Cuáles serían las primeras medidas terapéuticas a adoptar?

Tomado de S.E.N 

Questioning Medicine: Prostate Cancer Screening

Andrew Buelt, DO, and Joe Weatherly, DO, are family medicine residents in St. Petersburg, Fla. Together, they co-produce the podcast Questioning Medicine, where they deconstruct issues confronting today's clinicians. In this guest blog, Buelt gives his take on the overuse of prostate cancer screenings

Let the Prostate Be

As prostate cancer awareness month just ended, prostate cancer screening seemed a fitting subject for this week's blog.

Those who know the evidence might think this argument pits European practices against our own domestic actions. Almost like a Ryder Cup for prostate screening. However, I recently saw that almost 50% of patients admit to undergoing lubed finger insertions and blood tests, which we know to be fairly inaccurate, in the last 12 months.

In a Research Letter in JAMA Internal Medicine by Sammon et al., the fact that so many physicians are still screening for prostate cancer makes my evidence-based medicine soul cringe. In a 2012 survey, the authors found that among 114,544 respondents, 37% had undergone screening. Higher socioeconomic status nearly doubled a man's odds of being screened (odds ratio 1.91, 95% CI 2.69-3.34).

Prostate cancer screening has been placed in the no-go category by the U.S. Preventive Services Task Force and the Choosing Wisely campaign, as well as by many other major medical associations.

Even the American Urological Association, which stands to lose the most money from reduced screening, states, "Men ages 55 to 69 ... should talk with their doctors about the benefits and harms of testing ...." In my opinion, they deserve a standing ovation for speaking to the evidence and not to the money, as the American College of Obstetrics and Gynecologists has with pelvic exams.

I suppose some physicians will try to argue that rectal exams are not unpleasant or uncomfortable for the patient, as many did in the comments section of my pelvic exam post. However, if you really believe that, it's probably been a while since your last rectal exam.

The Screening Process

There are two parts to prostate screening: the digital rectal exam (DRE) and the prostate-specific antigen (PSA) blood test. Guided by evidence, here's a look at harms and benefits.

First, is the index finger so sensitive and accurate that it can really detect cancer with the DRE? A little common sense would tell us "no chance," and the evidence seems to support that.

In a study published in the Annals of Surgical Oncology by Richie et al., among 644 asymptomatic men, 241 had an abnormal DRE or elevated PSA. And of the 163 who underwent further ultrasound or biopsy, 77% were found to have normal results.

A retrospective analysis of 14 studies by Hoogendam et al. suggested that the positive predictive value of the DRE was only 28% (95% CI 0.20-0.36), meaning that out of 100 men who were diagnosed by their physician's finger, 72 did not actually have cancer. Plus, according to an analysis by Collins et al., 25% of the time when cancer was found after DRE, the biopsy located it in a different part of the prostate!

So unless your patient has a fecal impaction there is probably very little reason to perform a DRE.

What about the PSA blood test? Its accuracy is also riddled with way too many false positives and false negatives. This is one of those tests that has led to serious rates of overdiagnosis.

Only about 24% of those who undergo prostate biopsy because of elevated PSA actually have prostate cancer (Studer and Collette). The study included 162,243 men, and about 76% of those with a PSA over 3 ng/mL were false positives.

In a study published in the Journal of the National Cancer Institute, which reported the results of The Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, Andriole et al. found barely any benefit with PSA screening and DRE. The cumulative mortality rates in the intervention arm were 3.7 compared to 3.4 per 10,000 person-years in the control arm.

Authors of the European Randomized Study of Screening for Prostate Cancer (ERSPC) found a 20% reduction in prostate cancer deaths with PSA. Yet, when you look at actual numbers, it paints a much different picture. The ERSPC study estimated that 1,410 men would need to undergo screening, and 48 more cases of prostate cancer would need to be treated, for one life to be saved. Meaning 48 men will possibly endure erectile dysfunction or urinary incontinence for life, for every one life saved.

When the USPSTF looked at the evidence, they found for every 1,000 men screened for 10 years, roughly 220 had a positive result. About 110 subsequently get a true diagnosis of prostate cancer, 50 get a complication from treatment, and at most one life is saved.

I'll repeat the most important part of that rant: one out of a thousand is saved! At least 50 men will have a serious complication and about 100 will have to undergo anxiety and sleepless nights for a disease they don't even have.

Just under half of those in a different study with a positive screen and negative biopsy, 40%, admitted to worrying about prostate cancer "a lot" or "some of the time." This could qualify as harmful to a man's mental health.

Better Left Unchecked

Finally, in an estimate by Draisma et al., almost 50% of those diagnosed with prostate cancer would have never developed any symptoms of disease had they been left unchecked. Too often people will argue a 10 to 12 years' increase in survival with those screened for prostate cancer.

The problem is the very small or almost nonsignificant increase in mortality. I do not care if my patient survives longer with a disease, as long as the age of mortality remains the same.

After all, the reason we treat hypertension, high cholesterol, or screen for cancer is to have people live longer; not to die at the same age.

Of course, there are physicians out there with anecdotal evidence of catching life-threatening prostate cancer in early stages during a routine DRE or PSA, and will therefore insist they are great tests, just like the pelvic exam.

What shouldn't be forgotten is all of the men who now wear a diaper, can't get an erection, or can't sleep from high anxiety.

So why even have the test available? Possibly if the patient has a positive family history. It seems to increase the patient's risk two or three times above the standard rate of incidence, according to Whittemore et al.

Thus, instead of one out of 1,000, it is 2.5 out of 1,000. At that point, it might be worth at least a conversation. It is also decent to trend the success of prostate cancer treatment. However, as a screening tool it's like swimming with a shark: rarely will it kill you, but it will likely to leave you mentally or physically scarred, feeling vulnerable, and with high anxiety.

Tomado de: Medpagetoday.com  By Andrew Buelt, DO

CLASE ENFERMEDADES MUSCULO ESQUELETICAS

CLASE
ENZIMAS EN ENFERMEDADES MUSCULO ESQUELETICO
OCTUBRE 2014

New study challenges claims that low vitamin D causes type 2 diabetes

A new study from the University of Cambridge in the UK challenges findings of earlier research that concludes having higher levels of circulating vitamin D might prevent type 2 diabetes.

These earlier observational studies raised suggestions that low vitamin D contributes to the development of type 2diabetes. But because they were not designed to investigate cause and effect, they could not prove it: they could only establish a link.

Now a large genetic study published in The Lancet Diabetes and Endocrinology journal, concludes there is no evidence that a person's low level of vitamin D leads them to develop type 2 diabetes.

Senior author Dr. Nita Forouhi, leader of the Nutritional Epidemiology program at Cambridge's Medical Research Council (MRC) Epidemiology Unit, says:

"Observational studies that show a strong and consistent higher risk of type 2 diabetes with lower levels of vitamin D may do so because they have thus far not been able to adequately control for distorting or confounding factors, such as physical activity levels, that may be related both to vitamin D levels and to the risk of type 2 diabetes."

Using data from several studies covering thousands of people of European descent, Dr. Forouhi and colleagues investigated the link between levels of vitamin D and risk of developing diabetes by examining the genes that control blood levels of vitamin D.

The authors also used circulating 25-hydroxyvitamin D levels - considered the best indicator of vitamin D status - as the measure for vitamin D. Insufficiency was defined as having blood levels of 25-hydroxyvitamin D under 50 nmol/L.

No evidence that low vitamin D causes type 2 diabetes

The researchers found no evidence of a link between the risk of developing type 2 diabetes and the different gene variants that control blood levels of vitamin D.

They also found no links between varying levels of vitamin D and several features of type 2 diabetes, such as glucose and glycated hemoglobin, and neither did they find evidence that low vitamin D causes the disease.

Dr. Forouhi says their results echo those of randomized controlled trials - the classic way to test cause and effect links - which have generally concluded taking vitamin D supplements does not stop people developing type 2 diabetes.

"Our findings suggest that interventions to reduce the risk of type 2 diabetes by increasing concentrations of vitamin D are not currently justified," she notes.

Research must continue, especially with longer-term trials say experts

However, "we are far from done with this topic," says Dr. Forouhi who calls for better clinical trials and observational studies to measure more precisely the factors that might link vitamin D to disease.

"Until then, we need to be cautious about vitamin D's potential role in the prevention of type 2 diabetes and stick to things that are proven to work - diet and exercise," she urges.

One of the reasons to persist with research on the link between vitamin D and diabetes is that there appears to be a plausible biological explanation. The active form of the vitamin interacts with proteins in the insulin-producing beta cells in the pancreas. Also, people with diabetes tend to have low blood levels of vitamin D.

Another expert commenting in a linked article says the new findings need to be interpreted carefully. He also makes the point that despite the fact results of short-term studies do not appear to offer much hope, we need to await the results of longer-term trials before drawing final conclusions. However:

"The sky is becoming rather clouded for vitamin D in the context of preventing type 2 diabetes," says Dr. Brian Buijsse, of the German Institute of Human Nutrition in Potsdam-Rehbruecke in Germany.

This news follows reports of another UK study that found contrary to some previous claims, taking vitamin D supplements does not prevent heart attack or stroke.

Tomado: Medical News Today  Written by Catharine Paddock PhD.    Association between circulating 25-hydroxyvitamin D and incident type 2 diabetes: a mendelian randomisation study, Zheng Ye, et al., Lancet Diabetes Endocrinol, DOI: 10.1016/S2213-8587(14)70184-6, abstract.

Gene Study Finds No Proof Vitamin D Guards Against Type 2 Diabetes

There's no genetic evidence that high levels of vitamin D can prevent type 2 diabetes, a new study says.

Some previous research had suggested that elevated levels of vitamin D might protect people against type 2 diabetes, raising the possibility of a link between vitamin D deficiency and the blood sugar disease.

In this study, British researchers investigated the association between diabetes risk and vitamin D by focusing on genes that control blood levels of vitamin D. They found no connection between different variants of these genes and the risk of developing type 2 diabetes.

The results were published Sept. 30 in The Lancet Diabetes & Endocrinology.

"Our findings suggest that interventions to reduce the risk of type 2 diabetes by increasing concentrations of vitamin D are not currently justified. Observational studies that show a strong and consistent higher risk of type 2 diabetes with lower levels of vitamin D may do so because they have thus far not been able to adequately control for distorting or confounding factors, such as physical activity levels," study author Dr. Nita Forouhi, of the University of Cambridge's School of Clinical Medicine, said in a journal news release.

The findings add to evidence showing that taking vitamin D supplements does not prevent diabetes. The only proven ways to prevent type 2 diabetes are diet and exercise, Forouhi said.

One expert noted that long-term trials that are still looking at any possible connection should be weighed in the final analysis.

The results "need careful interpretation, and long-term randomized trials of vitamin D supplementation, which are underway, remain important," Dr. Brian Buijsse, from the German Institute of Human Nutrition Potsdam-Rehbruecke in Germany, wrote in an accompanying commentary in the journal.

"The results of an [analysis] of 35 short-term trials, however, do not offer much hope that vitamin D supplementation can be used to prevent type 2 diabetes. The sky is becoming rather clouded for vitamin D in the context of preventing type 2 diabetes," he said.

Tomado de : Healthday.com

SOURCE: The Lancet Diabetes & Endocrinology, news release, Sept. 30, 2014

Discovery of hormone essential for iron supply

US researchers have discovered a new hormone that regulates the iron supply needed for the production of red blood cells. According to a study published in "Nature Genetics", the erythroferrone hormone is produced by red blood-cell progenitors in the bone marrow.

Stimulating the production of erythrocytes increases the release of erythroferrone. Subsequently, the hormone regulates the hormone hepcidin, which controls the absorption of iron from food and its distribution in the body. The higher the erythroferrone level, the higher the likelihood that hepcidin is blocked, which, in turn, makes more iron available for the production of red blood cells.

Both too much as well as too little iron can make a person ill. "Modulating the activity of erythroferrone could be a viable strategy for the treatment of iron disorders of both overabundance and scarcity", explained senior author Tomas Ganz from the University of California, Los Angeles.

The discovery may lead to treatments of other diseases associated with anaemia, such as chronic kidney disease, rheumatic disorders or inflammatory diseases. Under these conditions, hepcidin is increased due to inflammation, whereby the iron is practically "locked up". Erythroferrone, or drugs that have the same effect, could suppress hepcidin and thereby make more iron available for the production of red blood cells.

Tomado de Univadis.com

Ref: Nature Genetics 46, 678–684 (2014)

Cortical bone microstructure, tibia density deficits seen with type 2 diabetes, high HbA1c

Type 2 diabetes and increased HbA1c are associated with deficits in cortical bone microstructure and bone density at the distal tibia, according to research presented at the American Society for Bone and Mineral Research 2014 Annual Meeting
Although it is still uncertain whether the cortical bone deficits explain increased lower leg fracture risks seen in patients with diabetes, the findings identify target areas to investigate the mechanism responsible for skeletal fragility.

“Diabetic bone may be characterized by specific deficits to cortical bone, which are not captured by traditional DXA bone mineral density tests,” Elizabeth J. Samelson, PhD, of the Institute for Aging Research at Hebrew SeniorLife, Harvard Medical School,

amelson and colleagues conducted a community-based study involving 627 adults (367 women, 260 men; mean age, 65 years) to compare bone microarchitecture by high-resolution peripheral quantitative computed tomography (HRpQCT) in patients with type 2 diabetes (31 women, 40 men) and healthy individuals and determine relationships with HbA1c.

Participants, all from the Framingham Offspring Cohort, were evaluated for type 2 diabetes and had HbA1c measured at baseline; diabetes was defined as glucose >126 mg/dl or use of diabetes medication. They all underwent HRpQCT scanning at the tibia and radius at 6 years.

The researchers used linear regression to calculate means and correlations for the association between volumetric bone mineral density (vBMD), geometry and microstructure indices of trabecular and cortical bone and type 2 diabetes and HbA1C. Adjustments were made for age, sex and weight. 

Patients with type 2 diabetes exhibited higher numbers than healthy patients at the tibia for

total vBMD (291.06 mg/cm3 vs. 284 .53 mg/ cm3), trabecular vBMD (184.13 mg/cm3 vs. 175.09 mg/cm3) and trabecular number (2.15 1/mm vs. 2.07 1/mm); the differences were not significant.

Conversely, patients with type 2 diabetes demonstrated significantly lower numbers than healthy patients for cortical vBMD (796.74 mg/cm3 vs. 814 mg/cm3) and cortical porosity (11.17% vs. 10.03%).

Similar results were seen with increasing HbA1c, with trabecular indices better with higher levels but cortical bone indices worse; the significance was limited to trabecular number.
No other differences were seen in HRpQCT bone indices between groups or based on HbA1c level. At the radius, no significant associations were seen between bone HRpQCT indices and type 2 diabetes or HbA1C.

“Older adults with type 2 diabetes have increased risk of fracture but higher bone mass density than those without diabetes,” Samelson said. “ If deficits to cortical bone explain increased skeletal fragility in type 2 diabetes, then future therapies that target cortical bone strength can reduce fracture risk in this vulnerable and growing population.” — by Allegra Tiver

For more information: Samelson E. Abstract 1083. Presented at: American Society for Bone and Mineral Research 2014 Annual Meeting; Sept. 12-15, 2014; Houston.

Tomado de http://www.healio.com/endocrinology/bone-mineral-metabolism

Cannabis use in adolescence has negative impact on education

A study looks to add more fuel to the heated debate around the use of marijuana, as researchers have linked the frequent use of cannabis among adolescents with reduced educational attainment. The study also links frequent use of the drug with other negative health outcomes, such as suicide attempts.


The study's lead author, Dr. Edmund Silins, says that the results "provide strong evidence that the prevention or delay of cannabis use is likely to have broad health and social benefits."

The team, comprised of researchers from Australia and New Zealand, received funding from the Australian Government National Health and Medical Research Council, and the study has been published in The Lancet Psychiatry.


Many researchers are pushing for cannabis to be used in a therapeutic capacity, as a form of pain relief or to alleviate symptoms of conditions such as multiple sclerosis (MS) and post-traumatic stress disorder(PTSD).

However, study author Richard Mattick believes that moves toward the decriminalization and legalization of cannabis also contribute toward "raising the possibility that the drug might become more accessible to young people."

Outside of legal avenues, cannabis is the most widely used illicit drug worldwide. The National Institute on Drug Abuse (NIDA) report that around 7% of US high-school seniors are daily or near-daily cannabis users, with around 46% having tried the drug at some point during their lifetime.

Although the study uses data from adolescents in Australia and New Zealand, the authors state that the rates of cannabis use are similar across high-income countries. For example, they cite that the rates of cannabis use among adults in Australia and New Zealand are 10% and 15% respectively, compared with a rate of 15% in the US.

Does early cannabis use compromise education?

For the study, the researchers utilized the data of 3,765 participants from three large, long-term longitudinal studies, tracking cannabis use alongside several developmental outcomes from before the age of 17 up to the age of 30.

They recorded the frequency of cannabis use as never, less than monthly, monthly or more, weekly or more, or daily. The researchers chose to record the following developmental outcomes:

• Cannabis dependence
• Completing high school
• Depression
• Obtaining a university degree
• Suicide attempts
• Use of other illicit drugs
• Welfare dependence.

The researchers found significant associations between the frequency of adolescent cannabis use and all of the designated developmental outcomes. After adjusting for potential confounding factors such as socioeconomic status and mental illness, they found that five of the associations remained significant.

Individuals who had used cannabis daily before the age of 17 were 60% less likely to complete high school or obtain a degree than those who had never used cannabis. They were also 18 times more likely to become dependent on cannabis, eight times more likely to use other illicit drugs and seven times more likely to attempt suicide by the age of 25.

Most significantly, the researchers found that the risk of negative developmental outcomes increased relative to the frequency of the cannabis dose. Daily cannabis users experienced the strongest effects of the association.

Impact on reforming legislation


In a linked commentary, Prof. Merete Nordentoft, of the University of Copenhagen, Denmark, explains why these results may have occurred:

"Persistent cannabis use has adverse effects, such as low energy and initiative, and impairment of cognitive functions, and these factors are likely to mediate the harmful effect of cannabis on educational attainment."

The authors say that these findings are consistent with the results of previous studies investigating early cannabis use alongside these developmental outcomes. They suggest that preventing or delaying cannabis use in adolescents could have far-reaching benefits, both socially and with regard to health.

One measure that the authors suggest could be implemented is screening for cannabis use in adolescents as standard practice during visits to doctors, child psychiatrists, school nurses and other health care practitioners. This is due to an estimated lack of self-reporting among adolescent cannabis users.

"Efforts to reform cannabis legislation should be carefully assessed to ensure they reduce adolescent cannabis use and prevent potentially adverse effects on adolescent development," says Dr. Silins.

In spite of this, the authors also acknowledge that within US states where cannabis has been made increasingly available for medical use, there has been no reported increase in use among young people.

The study still urges caution. The landscape is undeniably changing with regard to how cannabis is perceived and utilized, and the authors believe that as this framework changes, the needs of the youth must always be considered in order to prevent adverse developmental outcomes.

Tomado de: Medical News Today. Written by James McIntosh