The prevalence of marijuana use has increased by about 16% since 2006, translating to approximately 200 million people worldwide. Being so widely used, long-term effects of marijuana use on cardiovascular health are largely unknown. Previous studies have had conflicting results, either showing marijuana use having a negative impact or no significant impact on cardiovascular health. This study aims to add evidence regarding the impact marijuana use has on the prevalence of cardiovascular disease. Methods This retrospective study was conducted using the Behavioral Risk Factor Surveillance System (BRFSS) database. Patients who completed the questionnaire and answered all questions in relation to marijuana use and the diagnosis of cardiovascular disease in 2017 were a part of this study. Subjects were excluded if they were children (<18 years old) or had missing data for marijuana use or cardiovascular disease. Age, gender, race/ethnicity, body mass index (BMI), income, exercise, tobacco use, alcohol use, and depression were all considered as potential confounders. Bivariate analysis was conducted to find an initial association between marijuana use and cardiovascular disease, which was followed by a multivariate regression analysis to adjust for confounders. Odds ratios and 95% confidence intervals were calculated. Results A total of 56,742 subjects were included in the analysis. The unadjusted bivariate analysis showed a reduced prevalence of cardiovascular disease in individuals using marijuana (OR 0.65, 95%CI [0.50-0.84]). After adjustment with all additional variables, an adjusted model showed a similar odds ratio, but statistical significance of the association was lost (OR 0.74, 95%CI [0.54-1.01]). Discussion A systematic review by Ravi et al in 2018, which looked at marijuana use, cardiovascular risk factors, and clinical outcomes concluded that there was insufficient data to make conclusions regarding the effect of marijuana use and negative long-term cardiovascular effects. Our study lends support to the notion that marijuana use does not have an association with cardiovascular disease. A limitation in our study was that there was missing data from the BRFSS questionnaire due to participants not fully answering all questions concerning cardiovascular disease and marijuana use. This decreased our sample size from 67,974 to 56,742 subjects. The missing participants led to a decrease in the power of our odds ratio, which may have impacted statistical significance of our results. Conclusion Although previous literature has shown that marijuana use has a negative impact on cardiovascular health, our study suggests that users and non-users of marijuana did not have an association with the prevalence of cardiovascular disease. Varying levels of support within the literature highlights the need for further research of this association.
The reduction in opioid use has become a public health priority. We aimed to assess if performing buccal nerve blocks (BNB) at the time of buccal mucosa graft (BMG) harvest impacts post-operative narcotic usage in the inpatient setting. We retrospectively reviewed clinical characteristics and morphine milligram equivalents (MMEs) received for all patients that underwent a BMG urethroplasty at our institution. The primary outcome measure was post-operative MMEs for patients before and after implementing the BNB. We identified 74 patients that underwent BMG urethroplasty, 37 of which were before the implementation of the BNB and 37 of which were after. No other changes were made to the peri-operative pathway between these time points. The mean total MMEs per day, needed post-operatively, was lower in the BNB group (8.8 vs. 5.0, p = 0.12). A histogram distribution of the two groups, categorized by number of MMEs received, showed no significant differences between the two groups. In this retrospective analysis, we report our experience using BNBs at the time of buccal mucosa graft harvest. While there were no significant differences between the number of MMEs received before and after implementation, further research is needed to assess the blocks’ impact on pain scores.
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