[Medical grade cannabis (MGC): regulation mechanisms, the present situation around the world and in Israel]

Over the past several years, there is an increased demand and use of medical grade cannabis (MGC) in Israel and around the world. Regulation of cannabis growth, use and distribution has been a subject for many discussions in the Israeli medical system, parliament and the media. The increased demand for this kind of treatment, which is considered to be safe and effective in various indications, caused increased interest in the MGC approval mechanisms. Some countries have created regulation and control mechanisms for MGC. The United Nation convention of 1961 defines the medical legal use of narcotic substances. The convention demands full governmental control of the stock of narcotic substances, including cannabis and a governmental mechanism which will license, supervise, control, document and report the yield and consumption. In the Netherlands there is full accordance with the United Nations requirements and there is a special office for MGC which approves growth, production and marketing. MGC is prescribed in the Netherlands and supplied by a pharmacist as a regular drug. In Canada, after a long legal struggle, patients pressured the government to begin a federal program of MGC. In the U.S.A there are differences in cannabis authorization policy between some of the states and the federal government, which opposes MGC use and therefore, places numerous obstacles. Currently in Israel, the Director General of the Ministry of Health, appoints a representative to certify MGC and approve marijuana growers. MGC is directly supplied by the marijuana growers. This is a problematic model which lacks separation between the growers and the patients. Another problem is that the United Nations requirements are not fulfilled. In this review we present the advantages and drawbacks of the current model and propositions for future models for control and regulation of MGC.

Serum and cerebrospinal levels of calcium and magnesium in acute versus remitted schizophrenic patients

Serum and cerebrospinal fluid levels of calcium and magnesium were measured in acute schizophrenics versus schizophrenic patients in remission. The acute schizophrenics demonstrated statistically significant lower levels of cerebrospinal fluid magnesium. The mechanism that underlies this difference is not clear.

Congenital teratoma of the orbit

A congenital teratoma of the orbit is described. Histologically, the tissues forming the tumor appeared derived from the three germinal layers and showed an advanced degree of differentiation. An exenteration was performed because of suspicion of malignant tumor in the orbit and because of the severe keratitis with impending perforation which ensued the lagophthalmos.

Photoreceptor differentiation in retinoblastomas and its significance in prognosis

Fleurette is an expression of photoreceptor differentiation and its presence is said to indicate a good prognosis. Twenty-four eyes from 22 cases of retinoblastoma sent to the Mitrani Foundation laboratory between the years 1964 and 1976 were reviewed histologically and clinically. The presence of differentiation in the tumour was not always associated with a good prognosis. The most important prognostic factor seemed to be the length of time the tumour is allowed to remain in the eye. The longer it remains the more undifferentiated the tumour cells become and the greater the probability that it will spread into the choroid and the optic nerve and out of the eye through the sclera and metastasise throughout the body. The presence of gliosis seems to improve the prognosis.