Contemporary Targeted Therapies in Rheumatology

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Publisher: Informa Healthcare
Number Of Pages: 636
Publication Date: 2007-10-24
ISBN-10 / ASIN: 1841844845
ISBN-13 / EAN: 9781841844848
Binding: Hardcover

Product Description:
Targeted Therapies in Rheumatology established itself as an excellent reference for all those needing to know about the clinical implications of new drugs and developments for patients suffering from rheumatoid arthritis. This volume takes up the further developments that have occurred in several of the drug therapies covered in the first volume, as well as looking at the latest areas of promising research. Targeted therapies of rheumatic diseases have become a reality and have completely changed patient care as well as patient expectations.
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Atlas of Mesotherapy in Skin Rejuvenation

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Publisher: Informa HealthCare
Number Of Pages: 128
Publication Date: 2007-10-24
ISBN-10 / ASIN: 0415419948
ISBN-13 / EAN: 9780415419949
Binding: Hardcover

Product Description:
The injection of a combination of vitamins and medications into the middle layer of the skin has been practised in continental Europe for some fifty years now, but because the literature has hitherto not been published in English the topic is still surrounded by a great deal of ignorance and prejudice. This atlas from a renowned authorship will document in detail what is involved in the practical techniques of mesotherapy and will be of extreme interest to all practitioners of cosmetic dermatology.
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Contemporary Targeted Therapies in Rheumatology

Posted by Anonymous



Publisher: Informa Healthcare
Number Of Pages: 636
Publication Date: 2007-10-24
ISBN-10 / ASIN: 1841844845
ISBN-13 / EAN: 9781841844848
Binding: Hardcover

Product Description:
Targeted Therapies in Rheumatology established itself as an excellent reference for all those needing to know about the clinical implications of new drugs and developments for patients suffering from rheumatoid arthritis. This volume takes up the further developments that have occurred in several of the drug therapies covered in the first volume, as well as looking at the latest areas of promising research. Targeted therapies of rheumatic diseases have become a reality and have completely changed patient care as well as patient expectations.
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CARA PASANG EKG-how to install EKG

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ekg instalation pictures
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Cardiology Explained

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Ashley and Niebauer
Cardiology Explained
2003 - Remedica, 243 pp
ISBN 9781901346220 



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Atlas of Kidney Diseases/Table of Contents

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Robert W. Schrier
Department of Medicine, University of Colorado School of Medicine Denver
1999
1000 pp 



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EBOOK TUBERCULOSIS 2007 PDF

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Textbook on Tuberculosis
The winners of the Amedeo Tuberculosis Award are Juan Carlos Palomino, Sylvia Cardoso Leão, Viviana Ritacco, and 37 other clinicians and researchers from 12 countries. Tuberculosis 2007 was published on May 29th, 2007.

DOWNLOAD HERE 

FROM : http://amedeochallenge.org



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EBOOK INFLUENZA REPORT 2006 PDF

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Influenza Report, a medical textbook on influenza and its treatment (PDF, 225 pp, 




source: http://www.influenzareport.com/
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Clinical Neurology, Seventh Edition (LANGE Clinical Medicine)

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image


Clinical Neurology, Seventh Edition (LANGE Clinical Medicine)


Product Description
A comprehensive overview of basic and clinical neurology using a symptom-oriented approach
A Doody's Core Title ESSENTIAL PURCHASE!
"The book is presented as a teaching tool for students and practitioners. The focus of the book and its easy readability will appeal to a full spectrum of healthcare providers....This edition of the classic book has been updated and revised to make it even more clinically relevant. A quick overview of each topic is provided to be translated into advanced patient therapy. Besides its quality, focus, and easy readability, the book is light and convenient to hold, read, and access at a moment's notice. 3 Stars."--Doody's Review Service
No other book makes the link between basic neuroscience and current approaches in diagnosis and treatment easier to understand than ClinicalNeurology. Distinguished by its practice-oriented approach to neurology based on the patients' presenting symptoms, this classic has been updated and revised to make it even more clinically-relevant and enjoyable to read.
Features:
Essential concepts are presented within the framework of problems encountered in a clinical setting for greater relevance to real-world practice
Chapter outlines provide a quick overview of each topic
Treatment protocols reflect the most recent advances in the field
Advances in molecular biology and genetics are incorporated throughout to enhance understanding of neurologic disease
A step-by-step description of the neurologic examination
More than 200 tables and figures
About the Author
Roger P. Simon, MD
Robert Stone Dow Chair of Neurology
Director of Neurobiology Research
Legacy Health Systems
Portland, OR
David A. Greenberg, MD, PhD
Professor and Vice-President for Special Research Programs
Buck Institute for Age Research
Novato, CA
Michael J. Aminoff, MD, DSc, FRCP
Professor and Executive Vice-Chair
Department of Neurology
School of Medicine
University of Califo

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Mayo Clinic Cardiology: Concise Textbook, Third Edition

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Mayo Clinic Cardiology: Concise Textbook, Third Edition



For busy clinicians, residents, and fellows continually challenged with a rapidly expanding body of cardiology information, this expertly conceived Third Edition of a best-selling textbook provides a contemporary succinct distillation of the current status of cardiovascular knowledge and disease. From specific diseases to particular signs, symptoms, and patient concerns, including pregnancy and heart disease and cardiac emergency, this easily readable textbook guides the reader through all the essential information required to skillfully approach professional board examinations and practice state-of-the-art clinical patient care.
Download links:
http://freakshare.net/files/3u465e10/Moyo-CVS.part1.rar.html
http://freakshare.net/files/htaac84g/Moyo-CVS.part2.rar.html
http://freakshare.net/files/exlwwdrh/Moyo-CVS.part3.rar.html
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Haematology at a Glance

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 Haematology at a Glance


Following the familiar, easy-to-use at a Glance format, and in full-colour, Haematology at a Glance is an accessible introduction and revision text for medical students. Fully revised and updated to reflect changes to the content and assessment methods used by medical schools, this at a Glance provides a user-friendly overview of haematology to encapsulate all that the student needs to know.
This new edition of Haematology at a Glance:
  • Contains full-colour artwork throughout, making the subject easy to understand
  • Presents schematic diagrams on the left page and concise explanations on the right
  • Has been rearranged to provide more structured and logical coverage of the topics
  • Includes more explanation of the basics of haematology science and the latest clinical treatments
  • Features expanded chapters on Lymphoma and Myeloproliferative disorders - incorporating new advances in knowledge and practice
  • Contains self-assessment case studies and MCQs
This book is an invaluable resource for all undergraduates in medicine, immunology, and pharmacy, as well as for junior doctors, nurses and clinical nurse specialists and pharmacists who all need an introduction to haematology.

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MRI at a Glance

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MRI at a Glance


MRI at a Glance provides concise, easily accessible information on MRI physics and is an invaluable revision aid. All topics are included from magnetism to safety, K space to pulse sequences, image contrast to artefacts. The second edition has been fully revised and updated with brand new information on data acquisition and pulse sequences. The book is now in full colour throughout and follows the familiar, easy-to-useat a Glance format with each topic presented as a double-page spread with key facts accompanied by clear diagrams encapsulating essential knowledge.

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Jawetz, Melnick, & Adelberg's Medical Microbiology

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Jawetz, Melnick, & Adelberg's Medical Microbiology

The science of microbiology, Cell structure, Classification of bacteria, The growth and survival and death of microorganisms, Cultivation of microorganisms, Microbial metabolism, Microbial genetics, Immunology, Pathogenesis of bacterial infection, Antimicrobial chemotherapy, Normal microbial flora of the human body Spore-forming gram-positive bacilli: bacillus & clostridium species, Non-spore-forming gram-positive bacilli, corynebacterium, propionibacterium, listeria, erysipelothrix, actinomycetes, The staphylococci, The streptococci, Enteric gram-negative rods (enterobacteriaceae), Pseudomonads, acinetobacters, uncommon gram-negative bacteria, Vibrios, campylobacters, helicobacter, Haemophilus, bordetella, brucella, francisella, Yersinia & pasteurella, The neisseriae, Infections caused by anaerobic bacteria, Legionellae, bartonella, unusual bacterial pathogens, Mycobacteria, Spirochetes & other spiral microorganisms, Mycoplasmas & cell wall-defective bacteria, Rickettsia & ehrlichia, Chlamydiae, General properties of viruses, Pathogenesis & control of viral diseases, Parvoviruses, Adenoviruses, Herpesviruses, Poxviruses, Hepatitis viruses, Picornaviruses (enterovirus & rhinovirus groups), Reoviruses, rotaviruses, & caliciviruses, Arthropod-borne & rodent-borne viral diseases, Orthomyxoviruses (influenza viruses), Paramyxoviruses & rubella virus, Coronaviruses, Rabies, slow virus infections, prion diseases, Human cancer viruses, AIDS & lentiviruses, Medical mycology, Medical parasitology, Principles of diagnostic medical microbiology


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MICROBIOLOGY IMMUNOLOGY NOTES: (Basic Medical Science Notes)

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 MICROBIOLOGY IMMUNOLOGY NOTES: (Basic Medical Science Notes)



Paperback: 203.0 pages
Publisher: S. H. Kaplan Educational Center, (January 1, 1993)
Language: English
ASIN: B000CDUH12


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Microbiology & Immunology: Board Review Series

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 Microbiology & Immunology: Board Review Series
Product Description
Univ. of Minnesota, Duluth. Designed for students preparing for USMLE Step 1 and course exams. Previous edition:
Paperback: 302 pages
Publisher: Lippincott Williams & Wilkins; Fourth Edition edition (December 15, 2001)
Language: English
ISBN-10: 0781727707
ISBN-13: 978-0781727709
Product Dimensions: 9.9 x 7 x 0.5 inches


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Medical Microbiology

Posted by Anonymous






Mims et al continue their proud tradition of delivering important and often complex material in a simple and informative style. Replete with new and colourful diagrams, impressively detailed images and totally new chapters this book is well formed for integration into the modernmedical course. The new'Key Facts' boxes at the end of each chapter, concisely sum-up the preceeding information, and the MCQ-style questions test your knowledge. Undoubtedly it is a superb resource and a phenomenally written textbook. I can strongly recommendMedical Microbiology 3E as a vital resource to medical learning, and a generally interesting text about basic microbiology and immunological concepts. Mims appears to have an assured position onMedical Student bookshelves the world over.

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Harrison's Principles of Internal Medicine, 17th Edition

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Harrison's Principles of Internal Medicine, 17th Edition

by Anthony S. Fauci (Author), Eugene Braunwald (Author), Dennis L. Kasper (Author), Stephen L. Hauser (Author), Dan L. Longo (Author), J. Larry Jameson (Author), Joseph Loscalzo (Author)

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Thyroid Cytopathology: An Atlas and Text

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Thyroid Cytopathology: A Text and Atlas (9780781768832): Sudha R Kini: Books

ISBN: 0781768837
ISBN-13: 9780781768832

Written by a leading expert in thyroid biopsy interpretation, this text/atlas is the most comprehensive reference on thyroid pathology. It contains over 1,700 full-color photomicrographs depicting the full range of findings seen on fine needle aspiration biopsies. The illustrations show the wide spectrum of cytologic features for each disease entity, including unusual as well as typical patterns. Particular attention is given to diagnostic pitfalls, overlapping patterns, and differential diagnosis. The book also includes chapters on basic concepts of cytopathology, fine-needle aspiration biopsy techniques, cytopreparation, ancillary diagnostic techniques, liquid-based cytologic preparations, and the application of needle biopsy findings to management decisions. The fully searchable online text and a full-color image bank are available on a companion Website. (www.kinisolution.com)
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Ophthalmology Clinical Signs and Differential Diagnosis

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product details
Publisher: Mosby; 1 edition (January 15, 1999)
Language: English
ISBN-10: 0723431213
ISBN-13: 978-0723431213LOR= "Blue"]
Book Description:

World-renowned author Jack J. Kanski and co-author Ken K. Nischal provide a new, complete, visual catalog of clinical ophthalmologic signs uniquely organized by anatomical site. This reference is an essential, first of its kind tool in ophthalmology specifically geared toward differential diagnosis. Pertinent information is succinctly provided for each disorder including diagnostic signs, ocular and systemic associations, causes, and other indicators relating to patient history and confirmation of diagnosis. More than 1,500 high-quality, color photographs and nearly 50 angiograms throughout allow you to compare directly with patient symptoms as they appear in clinical practice. This reference is a desk-side companion every ophthalmologist and optometrist will use repeatedly to match and verify diagnosis, and a valuable review tool for trainees.
PDF, 45.7 MB
download and enjoy
with my best wishes
dr_hero

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Ophthalmology: Expert Consult -Yanoff-3rd Ed

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  • Publisher: Mosby
  • Number Of Pages: 1552
  • ISBN-10 / ASIN: 0323043321
  • ISBN-13 / EAN: 9780323043328
Product Description:
Based on valuable customer feedback, Doctors Yanoff and Duker have streamlined their best-selling reference, Ophthalmology, to zero in on just the clinical answers you need in day-to-day practice. They’ve removed most of the basic science and anatomy information from the printed book and put it on the companion web site where it is easily accessible along with the entire contents of the book. This new edition presents unparalleled guidance on nearly every ophthalmic condition and procedure including the latest advances in the field, such as optical coherence tomography (OCT), the ocular surface, new pharmacologic therapies, updated oculoplastic surgical techniques, the latest in refractive surgery, and so much more. And, as an Expert Consult title, this meticulously updated 3rd edition comes with access to the complete contents online, fully searchable, plus additional basic science information.
  • Provides access to the complete contents online, fully searchable, plus additional basic science information, and a downloadable image library for use in electronic presentations.
  • Discusses every aspect of clinical ophthalmology for complete coverage in a single volume.
  • Uses 2250 full-color illustrations that depict a wide range of ophthalmic techniques and disorders.
  • Presents a more streamlined format to the printed text to help you focus on the clinically actionable information you need everyday.
  • Discusses hot topics such OCT, the ocular surface, glaucoma testing, refractive surgery, advances in molecular biology and genetics, neuro-ophthalmology, and retinal studies to keep you absolutely current.
  • Provides enhanced coverage of cataracts, including advances in phacoemulsification and surgical complications.
  • Helps you make optimal use of the newest drug therapies, including Anti-VEGF treatment for wet ARMD and bevacizumab treatment for complications of diabetes.
  • Offers authoritative guidance on the newest treatment options for cornea disorders, including evolving ocular surface reconstruction techniques and new cornea procedures such as DSEK.
  • Incorporates new chapters on increasingly popular aesthetic oculoplastic surgical techniques to help you meet today’s demands.
or
or
CHM in RAR 4×100 + 1×1.4 MB
No pass

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Lecture Notes: Clinical Medicine ebook

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"This book is excellent, no nonsense, to the point, what you need to know is this. If only all books were as easy to learn from."
Sphincter, Liverpool Medical School Gazette
"The Lecture Notes series gets better and better and this is no exception [...] It is a joy to use and I would use it in preference to other 'baby' final year revision texts on the market [...] There is a small and illuminating chapter on the eye, and how to successfully focus an opthalmoscope. Surely, that in itself is worth the cover price."
GKT Gazette, December 2004
"The logical, well laid-out approach taken by this book really does facilitate learning. Thoroughly recommended."
University of Wales College of Medicine Student Gazette
"It is a useful refresher of information that is, or perhaps should be, deep down there somewhere.The book is positively crammed with information."
2nd Opinion
"It will be a good base for revision for any organized dudes out there, but it will also be a good oh-my-god-the-exams-is-in-half-an-hour last minute revision textbook. So yeah, I totally recommend it, but only for 3rd/4th years."
2nd Year Medical Student, Liverpool Medical School
Sphincter, December 2003
"...this book tackles the vast subject that is clinical medicine in a matter of fact, easy to learn way. It does exactly what it says on the tin: a no-nonsense overview of clinical medicine, perfect in the run up to finals."
Oxford Medical School Gazette, vol. 54 (1)
"This book more than lives up to the other popular books in the same 'lecture notes' series with its clear, concise, no-nonsense format [...] ideal for revision."
North Wing, Sheffield Medics Magazine, Winter 2004

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Oxford Handbook of Acute Medicine

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 Oxford Handbook of Acute Medicine
Review

`Review from previous edition Reviews from the printed edition: Overall, I think the authors have done a tremendous job, and it certainly will make life on the wards a bit easier for clinicians. The book reads very well, and manages to include an admirable amount of detail, whilst remaining comprehensible. Well done!' Shreelatta Datta, Pre-registration House Officer
`It's pretty impressive. There has been quite a lot of re-writing and touching up. The style remains excellent, very clear and to the point, and comparing it to the current edition, I think the second edition is much more so. In all, I think the manuscript is excellent, and faultless. The authors have worked hard on an already good text to update it, and make it very saleable, and appealing to readers. Well done. I look forward to seeing it in print.' James Dawson, House Officer
`This pocket-sized book contains an absolute wealth of information on acute medical problems and is very comprehensive in the breadth of its coverage.' Hospital Doctor, February 2005
`The Oxford Handbook series have done it again, another great book to add to this ever growing collection . . . I would have thought juniormedical staff would benefit most from this book but GPs and their registrars would also appreciate some of the wisdom. Even more seniormedical staff would also want to own a copy and best of all is the price. This book truly represents superb value for money and even if this book gets a bit dog eared after a few months use, or worse gets lost or pinched (surely not), it will not break the bank to get another one . . . Certainly this book ranks up there with a BNF, a stethoscope, and a bleep that juniormedical staff need to go about their daily duties. As for other practitioners both hospital and non hospital based, this is also a very useful book to keep them up to date with what goes on in acute medicine.' Dr Harry Brown on the Univadis website

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Manual of Laboratory and Diagnostic Tests, Eighth Edition

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 Manual of Laboratory and Diagnostic Tests, Eighth Edition, for PDA: Powered by Skyscape, Inc. (9780781790222): Frances Talaska Fischbach, Marshall B Dunning: Books



The new Eighth Edition of this best-selling clinical reference is now available in PDA format, for quick, easy point-of-care access. This handheld reference covers the full range of current laboratory and diagnostic tests and studies and describes each test in detail, with step-by-step instructions on correct procedure and tips for accurate interpretation. Platform: Palm OS, Windows CE, and Pocket PC handheld devices Also Available for iPhone/IPod touch

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High-Yield Microbiology and Infectious Diseases

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this new edition extracts the most important information on microbiology and infectious diseases and presents it in a concise, succinct fashion to prepare students for the USMLE. The book also serves as an excellent course review, with illustrations, review questions, and high-yield case study sections. This edition features 70 new images. High-Yield(TM) means exactly that...readers reap maximum benefits from very focused study.

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ACR BI-RADS American College Of Radiology

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Mammographiebefundung nach BI-RADS. Illustrierte Anleitung zur einheitlichen Befunderstellung von Mammographie, Mammasonographie, MR Mammographie (9783131369727): unknown: Books



The richly illustrated BI-RADS® Atlas provides guidance on BI-RADS through the use of illustrated cases, sample reports, statistical definitions, and explanations for performing the mammography audit. This comprehensive guide provides standardized breast imaging terminology; a report organization; assessment structure; and a classification system for mammography, ultrasound, and MR of the breast. The BI-RADS Atlas includes the fourth edition of the mammography lexicon and audit system.
The BI-RADS® Atlas is designed to serve as a comprehensive guide providing standarized breast imaging terminology, a report organization, assessment structure and a classification system for mammography, ultrasound and MRI of the breast. The report organization assists radiologists in providing a succinct review of mammographic, ultrasound and MRI findings. Results are then communicated to the referring physician in a clear fashion with a final assessment that indicates a specific course of action. Results are compiled in a standardized manner that permits the maintenance and collection analysis of demographic, mammographic and outcome data. Through a medical audit and outcome monitoring, the system provides important peer review and quality assurance data to improve the quality of patient care. The BI-RADS® Atlas also includes the 2003 revisions to the assessment categories, to lexicon terminology, and statistical definitions for the performance of amammography audit.
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Atlas of Clinical Diagnosis

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 Atlas of Clinical Diagnosis (9780702026683): M. Azfal Mir: Books

the author feels there is still a place for bedside medicine and this book is proof...
The book is fully indexed so it is easy to find what you are looking for, by either looking here or in the contents. You could easily while away an hour idly leafing through the book, picking up numerous snippets by which to impress your colleagues." Dr JM Sager, Medix-UK, July 2003
over 1200 full colour, high quality photos of pathologies...a good book, well laid out and written." Medical Student, GKT Gazette, February 2004 --This text refers to an out of print or unavailable edition of this title.

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Interpretation of Diagnostic Tests

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"What tests do I order, and what do the results mean?" Interpretation of Diagnostic Tests, Eighth Edition provides the answers--quickly and clearly--for a vast range of adult and pediatric conditions. Arranged by organ system, the book summarizes the available tests for most diseases, explains what the results mean, and discusses differential diagnoses. This thoroughly updated edition includes additional tests based on molecular biology, new data on the use of genetic tests, and many new diagnostic laboratory tests in chemistry. Imaging tests are included where they play a key role in diagnosis. The section on chemical and microbiological terrorism has been expanded. Readers can search for information in the way that best suits their needs--by index, table of contents, test results, or specific disease. Also included are extensive tables of normal and panic values, tables comparing test results in similar diseases, and an appendix of conversion factors between conventional and SI units.

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Lippincott Professional Guides: Anatomy & Physiology

Posted by Anonymous


Pocket quick reference for students and nurses. Features a body-system arrangement; overview of terms, cell and tissue types, chemical make-up of the body; illustrations, and tips on remembering complex points. Previous edition: c1998. Wire-spiral binding. DNLM: Anatomy--Handbooks.

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3D Clinic Professional (ISO)

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3DClinic Professional is a sophisticated educational tool designed specifically for use by doctors in communicating with patients in the clinical setting. Containing more than 100 distinct pieces of interactive media accessed via a simple and easy to navigate menu structure, 3D Clinic Professional replaces traditional analogue media (such as medical illustration books and skeleton models) used by doctor to converse with patient. With the unique advantage of draw-on-screen, type-on-screen, print, email and save-to-disk functionality, is not only designed to improve patient compliance, but also lower malpractice risk.
The unique selling point of 3DClinic Professional is our ability to facilitate a better patient outcome via a healthcare professional's communication of 3D interactive imagery. It is the intent of 3DClinic to take a competitive position throughout the world in any market segment where a healthcare professional, teacher, parent or other individual wishes to achieve an improved educational outcome in the area of anatomy, medicine and health via communication of 3D interactive imagery. The core value of our first product developed for use in general practice is a better patient outcome.
Our product is not designed to be additive to GP's current workflow practices, rather, simply replace the use by doctor of analogue media he/she would traditionally use to educate patients about their condition.
The software features:
• Simple menu structure for ease of navigation
• Health topics that provide a 3D interactive journey from a healthy to unhealthy state.
• A 3D library of anatomical images of the human body
• Draw and Type features that enable you to 'personalize' imagery for your patient
• Ability to Print, Email (for referrals) & Save these images for future reference
• Links to patient education materials provided by recognized professional associations


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The ECG In Practice

Posted by Anonymous

image

This clinically-orientated book shows how the electrocardiogram is used to aid the diagnosis of patients with cardiovascular disease. Each chapter begins with a brief consideration of the history and examination of the patient to assist the doctor plan how to use the ECG in the most intelligent and profitable way. The text explains the variations in the patterns of ECGs which are seen in both healthy people as well as those with cardiac problems, and illustrates the abnormalities with a comprehensive range of examples.
A new page size and text design gives a much clearer presentation of the ECGs, allowing full traces to be presented on one page
A new chapter on electrophysiology and electrical devices responds to the increasing occurrence of pacemakers and implanted defibrillators in patients
The "What to do" sections at the end of chapters have been fully updated

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Medical Journal Review : ALLERGY

Posted by Anonymous

  • Exploring the association between severe respiratory syncytial virus (RSV) infection and asthma (A).
    Does RSV cause A, or do those infants who later develop A have a genotype that both predisposes them to A and makes them more susceptible to severe RSV infection? That question is explored in this population-based study of hospitalization data from all Danish twins born alive between 1994 and 2000 (8280 twin pairs). The diagnosis of RSV infection was based on hospital diagnosis and/or RSV identification by ELISA. Presence of A was assessed by hospital discharge diagnosis and parental questionnaire. Among the children with RSV infections, 50% were hospitalized before the age of 6 mo and 75% before 12 mo. 95% had been hospitalized before 24 mo. Twins hospitalized for RSV were more likely to have A. The data were subjected to statistical analysis and direction of causation (DOC) modeling. Monozygotic twins showed a higher correlation for A than dizygotic twins, suggesting a genetic component in disease susceptibility; but for RSV there was no such correlation, meaning that environmental factors play a larger role. When data were fitted to a DOC model, it was found that the best fit occurred for RSV infection resulting from the underlying susceptibility to A rather than vice-versa.
    Editor’s comment: These data support the concept that RSV is associated with but does not cause A implying unknown genetic factors are involved.
    Thomsen SF et al., Am J Resp Crit Care Med 2009; 179:1091-1097. Also see editorial by Kuehni and Silverman, pp. 1079-80 (Abstract not available online)
  • Urine concentrations of cysteinyl leukotrienes (CysLTs) in children with obstructive sleep-disordered breathing (SDB).
    Adenotonsillar tissue from children (C) with SDB shows high levels of CysLTs and their receptors that may contribute to this disorder. C with SDB were compared to C with no evidence of SDB but with a history of recurrent tonsillitis. Subjects with asthma, respiratory tract infection or chronic inflammatory disorders were excluded along with those using antihistamines or intranasal corticosteroids. An obstructive apnea-hypopnea index (OAHI) was determined by overnight polysomnography and tonsillar size graded. Morning urine samples were assayed for CysLTs. A total of 92 C were enrolled and results were evaluated according to OAHI. C with OAHI ≥5 episodes/hr had significantly higher urine CysLT levels than those with mild or no SDB. Higher BMIs and larger tonsils were also predictors of SDB. These data support the hypothesis that SDB is associated with inflammation as well as anatomical factors, but whether the SDB is more severe because of the increased CysLTs or severe SDB causes an increase in CysLTs cannot be determined.
    Editor’s comment: This study suggests that there is a link between SDB and inflammation.
    Kaditis AG et al., Chest 2009; 135:1496-1501.
  • Venom immunotherapy (VIT) reduces large local reactions (LLRs) to insect stings.
    LLRs to Hymenoptera occur in 10% of adults and have significant effects on QOL, often requiring oral corticosteroids. This 4 yr controlled pilot study was performed to determine the effectiveness of VIT in reducing the severity of LLRs. Enrollees had a history of LLRs and skin sensitivity to venom. Those with previous sting anaphylaxis were excluded. A baseline sting challenge was performed at entry and only those with skin induration of at least 16 cm were included. 19 subjects (there were 10 untreated controls) achieved a maintenance dose in 7 weeks. Sting challenges were administered and patients recorded the size of induration at 1, 12, 24, and 48 hr after the sting. No additional medications (e.g., antihistamines) were allowed until 48 hr after the sting. The size and duration of LLRs decreased significantly with increasing time of VIT. Patient satisfaction was >90%.
    Editor’s comment: Several studies now indicate that VIT is effective to treat LLRs induced by Hymenoptera stings.
    Golden DBK et al., J Allergy Clin Immunol 2009; 123:1371-1375.
  • Overweight and changes in weight status during childhood in relation to asthma (A) symptoms at 8 years.
    A symptoms in relation to body mass index (BMI) were assessed at 3, 6 and 8 yrs in a group of 3756 children in a birth cohort. Yearly questionnaires were returned by parents reporting the child’s weight and height and whether they had A symptoms- wheeze and/or dyspnea and/or a prescription for inhaled corticosteroids in the previous year. At age 8, a subgroup of children gave a blood sample analyzed for a panel of specific IgE. Bronchial hyperresponsiveness (BHR) also was determined. A high BMI at an earlier age was not associated with dyspnea in children who were at normal weight at 8 yr. Eight year-old children who had A symptoms and BHR were significantly more likely to have had a high BMI at 6-7 yr but not at earlier ages. IgE levels did not correlate with BMI.
    Editor’s comment: High BMIs in children at certain ages may be associated with the onset of asthma and BHR.
    Scholtens S, et al., J Allergy Clin Immunol 2009; 123:1312-1318. Also see editorial by Schwartzstein and Gold, pp. 1319-20.
  • Work group report: oral food challenge (OFC) testing.
    This document is a comprehensive, practical guide to administering an OFC. The criteria for deciding when to conduct an OFC and the risk/benefit analysis are discussed with guidelines for skin-prick and serum IgE testing. The different types of OFC—open, single-blind, placebo-controlled and double-blind are described. An open OFC may be done for simple screening while the more rigorous DBPC is primarily for research. An OFC procedure form and flow sheet are included.
    Editor’s comment: This is a practical and highly useful document about OFC.
    Nowak-Wegrzyn et al., J Allergy Clin Immunol 2009; 123 (suppl):S365-383.
  • Reparative capacity of airway epithelium impacts deposition and remodeling of extracellular matrix (ECM).
    Defective repair of damaged epithelium is linked to fibrosis and remodeling in chronic lung disease. This mouse-model study focuses on the interactions between epithelial repair systems and the regulation of ECM deposition and fibrosis. Epithelial lesions were produced by intraperitoneal injection of naphthalene and mice were examined from 0 (control) to 6 days afterwards. In repair-competent mice exposed to naphthalene, a specific phenotypic signature was seen representing airway repair, cell proliferation and ECM regulation. The ECM protein, tenascin C (Tnc), was transiently up-regulated in naphthalene-challenged wild type mice but returned to normal following epithelial repair. In mice deficient in epithelial repair cells, however, lung damage led to a significant and sustained increase in Tnc and uncontrolled matrix deposition. Lack of repair of damaged epithelium led to an accumulation of Tnc protein in the sub-epithelial mesenchyme of airways and alveoli.
    Editor’s comment: This study sheds additional light on the possible role of epithelial repair cells and Tnc in airway remodeling.
    Snyder JC et al., Am J Resp Cell Mol Biol 2009; 40:633-642.
  • T-bet expression is regulated by EGR1-mediated signaling in activated T cells.
    T-bet is a transcription factor that polarizes T cell development along the Th1 pathway and suppresses Th2-type cytokine production and stimulates expression of IFN-gamma and the IL-12 receptor. Regulation of T-bet production by early growth response gene 1 (EGR1) was studied in this report using human B and T cell lines and T cells isolated from mice. EGR1 binds to the gene promoter for T-bet in T cells and activates its expression, while depletion of EGR1 in T cells prevents induction of T-bet. Naïve CD4+ T cells, isolated from mice and activated by antigen-presenting cells under Th0, Th1 or Th2 conditions, shows concomitant expression of EGR1 and T-bet in Th0 and Th1 cells but not Th2.
    Editor’s comment: EGR1 appears to be a key upstream regulator of T-bet expression.
    Shin H-J et al., Clin Immunol 2009; 131:385-394.
  • Increases in urinary 9α,11β-prostaglandin F2 indicate mast cell activation in wine-induced asthma.
    Wine-sensitive individuals can experience asthmatic symptoms after wine consumption. 8 participants with self-reported wine sensitivity were tested with high- and low-sulfite wines given double-blind. As primary outcome, urinary 9α,11β-prostaglandin F2 (a metabolite of prostaglandin D2, PGD2) was measured before and after consumption. With high-sulfite wines versus low-sulfite wines, the 9α,11β-prostaglandin F2 level increased 1.6- and 1.5-fold, respectively, demonstrating that sulfites probably are not linked to the asthmatic symptoms of wine consumption. PGD2 is elevated as a result of mast cell activation and urinary 9α,11β-prostaglandin F2 is currently the most sensitive indicator of degranulation. It is more likely that IgE-indpendent activation of mast cells occurs based on clinical characteristics of these subjects.
    Editor’s comment: The reasons why wine may exacerbate asthma remain a mystery.
    Misso NLA et al., Int Arch Allergy Immunol 2009; 149:127-132.
  • Desensitization in interferon-β1α (IFN-b) allergy: a case report.
    IFN-b is the standard Rx for relapsing-remitting multiple sclerosis (MS), but an immune response to the drug can occur preventing treatment. A 41-year-old female with MS diagnosed 15 months earlier presented with urticaria and angioedema after s.c. IFN-b. Urticaria and pruritus, not associated with the injection site, appeared after the first month of Rx and grew progressively worse until periorbital and perioral angioedema developed and the IFN-b was stopped. The urticaria cleared immediately with no relapse. Skin-prick and intradermal tests with IFN-b were positive for 1:1 and =1:1000 dilutions, respectively. A desensitization schedule with incremental alternating s.c. IFN-b injections every 30 min over a period of 4 days was performed. Desensitization was successful and the patient resumed IFN-b Rx 3X/wk with no adverse effects.
    Editor’s comment: This is a quick and simple desensitization procedure for immediate hypersensitivity to IFN-b.
    Kalpaklioglu AF et al., Int Arch Allergy Immunol 2009; 149:178-180.
  • Inhibition of non-neuronal α7-nicotinic acid receptor for lung cancer treatment.
    Non-small cell lung cancer (NSCLC) tumorigenesis appears to involve nicotinic acetylcholine receptors (nAChRs). The effect of blocking the α7-nAChR with alpha-cobratoxin (α-CbT) was investigated on various human lung tumor cells and in nonobese diabetic/severe combined immunodeficient (NOD/SCID) mice engrafted with NSCLC cells. The proliferation of tumor cells in vitro was inhibited by α-CbT compared to normal bronchial epithelial cells and the degree of inhibition was proportional to the density of α7-nAChRs on the tumor cells. For the in vivo evaluation of α7-nAChR inhibition, NSCLC cells were injected into the lungs of NOD/SCID mice, allowed to grow for 7 days, after which they were treated with vehicle control, cisplatin (lung cancer chemotherapeutic agent) or α-CbT (i.v. injection 3 times/wk for 3 wks). The endpoint was length of survival from time of injection of the cells. Cisplatin improved survival 16% relative to controls, while treatment with α-CbT resulted in survival, 80% higher than cisplatin and 93% than controls. Assays on tumor cells from α-CbT-treated mice showed >80% apoptosis.
    Editor’s comment: This treatment offers promise as a way to slow the progression of NSCLC.
    Paleari L, et al., Am J Resp Crit Care Med 2009; 179:1141-1150. Also see editorial by ER Spindel, pp. 1081-82 (Abstract not available online)
  • Bronchial airway epithelial cell damage following exposure to cigarette smoke (CS) includes disassembly of tight junction (TJ) components mediated by the extracellular signal-regulated kinase 1/2 (ERK1/2) pathway.
    CS is a mixture of many chemicals that have a variety of effects on airway epithelial cells, including changes in signaling pathways, such as those involving epidermal growth factor receptor (EGFR) and ERK1/2. CS condensate (CSC) was prepared by collecting CS particulates on a filter and dissolving the filtrate in cell culture medium. Cultured normal human bronchial epithelial cell lines were incubated with various concentrations of CSC and the effects on TJs, cytotoxicity, DNA integrity and ERK1/2 signaling were measured. CSC caused disassembly of tight junctions in a time- and dose-dependent manner. Decreased cell proliferation was seen only at the highest dose of CSC (20%) but apoptosis was seen at 10% and 20% CSC. Preincubation of cells with EGFR inhibitor blocked CSC activation of the ERK1/2 pathway and prevented both DNA fragmentation and disassembly of TJs.
    Editor’s comment: This in vitro evidence of ERK1/2 involvement in TJ damage warrants further study in animal models.
    Petecchia L et al., Chest 2009; 135:1502-1512.
  • Acid-suppressive medication use and the risk for hospital-acquired pneumonia.
    Use of proton pump inhibitors (PPIs) or histamine-2 (H2) receptor blockers for controlling acid reflux has increased and are being given routinely to many hospital inpatients. All patients ≥18 yr of age admitted to a large metropolitan hospital with a stay of 3 or more days were eligible for inclusion in this prospective cohort study. Admission to ICU was excluded. The primary outcome scored was a discharge diagnosis of pneumonia and the final cohort included 63,878 subjects. Use of acid-suppressing drugs (82% PPIs, 23% H2 blockers, and some both) was ordered for 52% of the patients and use of PPIs (but not H2 blockers) was associated with a 30% increase in the odds of having pneumonia while in the hospital.
    Editor’s comment: Proton pump inhibitors may increase the risk for both inpatient and outpatient pneumonia.
    Herzig SJ et al., JAMA, 2009; 301(20):2120-2128.
More aboutMedical Journal Review : ALLERGY

Cannabis (drug)

Posted by Anonymous

Cannabis (drug)

By Various

"Marijuana" redirects here. For other uses, see Marijuana (disambiguation).
For the plant genus, see Cannabis. For other uses of cannabis, see Industrial and Personal Uses of Cannabis.
Cannabis, also known as marijuana, marihuana, and ganja (from Sanskrit: गांजा gañjā, meaning "hemp"), among many other namesa[›], refers to any number of preparations of the Cannabis plant intended for use as a psychoactive drug. The most common form of cannabis used as a drug is the dried herbal form.

The typical herbal form of cannabis consists of the flowers and subtending leaves and stalks of mature pistillate or female plants. The resinous form of the drug is known as hashish (or merely as 'hash').

The major psychoactive chemical compound in cannabis is Δ9-tetrahydrocannabinol (commonly abbreviated as THC). At least 66 other cannabinoids are also present in cannabis, including cannabidiol (CBD), cannabinol (CBN) and tetrahydrocannabivarin (THCV) among many others, which are believed in influence the effects of THC alone.

Cannabis use has been found to have occurred as long ago as the third millennium B.C. In modern times, the drug has been used for recreational, religious or spiritual, and medicinal purposes. The United Nations (UN) estimated that in 2004 about 4% of the world's adult population (162 million people) use cannabis annually, and about 0.6% (22.5 million) use it on a daily basis. The possession, use, or sale of cannabis preparations containing psychoactive cannabinoids became illegal in most parts of the world in the early twentieth century. Since then, some countries have intensified the enforcement of cannabis prohibition, while others have reduced it.

Contents

1 History
2 Forms
2.1 Cannabis (herbal form)
2.2 Hashish
2.3 Hash oil
2.4 Kief
2.5 Resin
3 Potency
4 Routes of administration
5 Effects
5.1 Classification
5.2 Medical use
5.3 Long-term effects
5.4 Adulterants
6 Gateway drug theory
7 Legal status
8 Price
9 Truth serum
10 Breeding and cultivation
11 See also
12 Notes
13 References
14 Further reading
15 External links
History


The use of cannabis, at least as fiber, has been shown to go back at least 10,000 years in Taiwan. Má (Pinyin pronunciation), the Chinese expression for hemp, is a pictograph of two plants under a shelter.
Cannabis is indigenous to Central and South Asia. Evidence of the inhalation of cannabis smoke can be found as far back as the 3rd millennium B.C., as indicated by charred cannabis seeds found in a ritual brazier at an ancient burial site in present day Romania. Cannabis is also known to have been used by the ancient Hindus of India and Nepal thousands of years ago. The herb was called ganjika in Sanskrit (गांजा/গাঁজা ganja in modern Indic languages). The ancient drug soma, mentioned in the Vedas as a sacred intoxicating hallucinogen, was sometimes associated with cannabis.

Cannabis was also known to the ancient Assyrians, who discovered its psychoactive properties through the Aryans. Using it in some religious ceremonies, they called it qunubu (meaning "way to produce smoke"), a probable origin of the modern word "cannabis". Cannabis was also introduced by the Aryans to the Scythians and Thracians/Dacians, whose shamans (the kapnobatai—"those who walk on smoke/clouds") burned cannabis flowers to induce a state of trance. Members of the cult of Dionysus, believed to have originated in Thrace (Bulgaria, Greece and Turkey), are also thought to have inhaled cannabis smoke. In 2003, a leather basket filled with cannabis leaf fragments and seeds was found next to a 2,500- to 2,800-year-old mummified shaman in the northwestern Xinjiang Uygur Autonomous Region of China.


Cannabis sativa from Vienna Dioscurides, 512 A.D.
Cannabis has an ancient history of ritual use and is found in pharmacological cults around the world. Hemp seeds discovered by archaeologists at Pazyryk suggest early ceremonial practices like eating by the Scythians occurred during the 5th to 2nd century B.C., confirming previous historical reports by Herodotus. One writer has claimed that cannabis was used as a religious sacrament by ancient Jews and early Christians due to the similarity between the Hebrew word "qannabbos" ("cannabis") and the Hebrew phrase "qené bósem" ("aromatic cane"). It was used by Muslims in various Sufi orders as early as the Mamluk period, for example by the Qalandars.

A study published in the South African Journal of Science showed that "pipes dug up from the garden of Shakespeare's home in Stratford upon Avon contain traces of cannabis." The chemical analysis was carried out after researchers hypothesized that the "noted weed" mentioned in Sonnet 76 and the "journey in my head" from Sonnet 27 could be references to cannabis and the use thereof.

Cannabis was criminalized in the United States in 1937 due to Marihuana Tax Act of 1937. Several theories try to explain why it is illegal in most Western societies. Jack Herer, a cannabis legalization activist and writer, argues that the economic interests of the paper and chemical industry were a driving force to make it illegal. Another explanation is that beneficial effects of hemp would lower the profit of pharmaceutical companies which therefore have a vital interest to keep cannabis illegal. Those economic theories were criticized for not taking social aspect into account. The illegalization was rather a result of racism directed to associate American immigrants of Mexican and African descent with cannabis abuse.

Forms

Cannabis (herbal form)


Dried Cannabis flowers in its herbal form; commonly known as marijuana.
The terms cannabis or marijuana generally refer to the dried flowers and subtending leaves and stems of the female cannabis plant. This is the most widely consumed form, containing 3% to 22% THC. In contrast, cannabis strains used to produce industrial hemp contain less than 1% THC and are thus not valued for recreational use.

Hashish


Hashish.
Main article: Hashish
Hashish (also spelled hasheesh) or hash is a concentrated resin produced from the flowers of the female cannabis plant. Hash is more potent than marijuana and can be smoked or chewed. It varies in color from black to golden brown depending upon purity.

Hash oil

Main article: Hash oil
Hash oil, or honey oil, is an essential oil extracted from the cannabis plant through the use of various solvents. It has a high proportion of cannabinoids (ranging from 40-90%). This oil is also used in the process of making a variety of cannabis foods.

Kief

Main article: Kief
Kief is a powder made from trichomes removed from the leaves and flowers of cannabis plants. Kief can also be compressed to produce one form of hashish, or consumed in powder form.

Resin


Resin collected from a pipe.
Main article: Cannabis (hashish) rosin
Because of THC's adhesive properties, resin builds up inside the paraphernalia when cannabis is smoked. It has tar-like properties but still contains THC as well as other cannabinoids. This resin still has all the psychoactive properties of cannabis but is more difficult to smoke due to the discomfort caused to the throat and lungs. Cannabis users typically only smoke resin when cannabis is unavailable. Glass may be water-steamed at a low temperature prior to scraping in order to make the resin easier to remove.

Potency

According to the United Nations Office on Drugs and Crime (UNODC), "the amount of THC present in a cannabis sample is generally used as a measure of cannabis potency." The three main forms of cannabis products are the herb (marijuana), resin (hashish), and oil (hash oil). The UNODC states that marijuana often contains 5% THC content, resin "can contain up to 20% THC content", and that "Cannabis oil may contain more than 60% THC content."

A scientific study published in 2000 in the Journal of Forensic Sciences (JFS) found that the potency (THC content) of confiscated cannabis in the United States (US) rose from "approximately 3.3% in 1983 and 1984", to "4.47% in 1997". It also concluded that "other major cannabinoids (i.e., CBD, CBN, and CBC)" (other chemicals in cannabis) "showed no significant change in their concentration over the years".. More recent research undertaken at the University of Mississippi's Potency Monitoring Project has found that average THC levels in cannabis samples between 1975 and 2007 have increased from 4% in 1983 to 9.6% in 2007.

Australia's National Cannabis Prevention and Information Centre (NCPIC) states that the buds (flowers) of the female cannabis plant contain the highest concentration of THC, followed by the leaves. The stalks and seeds have "much lower THC levels". The UN states that the leaves can contain ten times less THC than the buds, and the stalks one hundred times less THC.

Routes of administration


A Volcano vaporizer. The balloon (top), after filling with vapors, may be removed and inhaled from.

Cannabis joints are potentially the most harmful method of consumption. Burning temperature can reach 700°C (1292°F).

A narrow, screened single-toke utensil, such as the midwakh (shown here) or kiseru, provides small, low-temperature servings, protecting against health damage.
Main article: Cannabis consumption
Cannabis is consumed in many different ways, most of which involve inhaling smoke.

The most commonly used include screened bowls, bubblers (small pipes with water chambers), bongs, one-hitters, chillums, paper-wrapped joints and tobacco-leaf-wrapped blunts. Local methods differ by the preparation of the cannabis plant before use, the parts of the cannabis plant which are used, and the treatment of the smoke before inhalation.

A vaporizer heats herbal cannabis to 365–410 °F (185–210 °C), which causes the active ingredients to evaporate into a gas without burning the plant material (the boiling point of THC is 392°F (200°C) at 0.02mmHg pressure, and somewhat higher at standard atmospheric pressure). A lower proportion of toxic chemicals are released than by smoking, although this may vary depending on the design of the vaporizer and the temperature at which it is set. This method of consuming cannabis produces markedly different effects than smoking due to the flash points of different cannabinoids; for example, CBN has a flash point of 212.7°C and would normally be present in smoke but might not be present in vapor.

As an alternative to smoking, cannabis may be consumed orally. However, the cannabis or its extract must be sufficiently heated or dehydrated to cause decarboxylation of its most abundant cannabinoid, tetrahydrocannabinolic acid (THCA), into psychoactive THC.

Cannabinoids can be leached from cannabis plant matter using high-proof spirits (often grain alcohol) to create a tincture, often referred to as Green Dragon.

Cannabis can also be consumed as a tea. THC is lipophilic and only slightly water soluble (with a solubility of 2.8 mg per liter), so tea is made by first adding a saturated fat to hot water (i.e. cream or any milk except skim) with a small amount of cannabis, green or black tea leaves and honey or sugar, steeped for approximately 5 minutes.

Effects


Main short-term physical effects of cannabis.
Main article: Effects of cannabis
Cannabis has psychoactive and physiological effects when consumed. The minimum amount of THC required to have a perceptible psychoactive effect is about 10 micrograms per kilogram of body weight. Aside from a subjective change in perception, the most common short-term physical and neurological effects include increased heart rate, lowered blood pressure, impairment of short-term episodic memory, working memory, psychomotor coordination, and concentration. Long-term effects are less clear.

Classification

Main article: Effects of cannabis#Psychoactive effects
While many drugs clearly fall into the category of either stimulant, depressant, or hallucinogen, cannabis exhibits a mix of all properties, perhaps leaning the most towards hallucinogen or psychedelic properties, though with other effects quite pronounced as well. Though THC is typically considered the primary active component of the cannabis plant, various scientific studies have suggested that certain other cannabinoids like CBD may also play a significant role in its psychoactive effects.



Medical use

Main article: Medical cannabis
Although the extent of the medicinal value of cannabis has been debated, it does have several well-documented beneficial effects. Among these are: the amelioration of nausea and vomiting, stimulation of hunger in chemotherapy and AIDS patients, lowered intraocular eye pressure (shown to be effective for treating glaucoma), as well as general analgesic effects (pain reliever).b[›]

Less confirmed individual studies also have been conducted indicating cannabis to be beneficial to a gamut of conditions running from multiple sclerosis to depression. Synthesized cannabinoids are also sold as prescription drugs, including Marinol (dronabinol in the United States and Germany) and Cesamet (nabilone in Canada, Mexico, The United States and The United Kingdom).b[›]

Currently, the U.S. Food and Drug Administration (FDA) has not approved smoked marijuana for any condition or disease in the United States. Regardless, thirteen states have legalized cannabis for medical use. Canada, Spain, The Netherlands and Austria have also legalized cannabis for medicinal use.

Long-term effects

Main article: Effects of cannabis#Long-term effects
The smoking of cannabis is the most harmful method of consumption, as the inhalation of smoke from organic materials can cause various health problems.

By comparison, studies on the vaporization of cannabis found that subjects were "only 40% as likely to report respiratory symptoms as users who do not vaporize, even when age, sex, cigarette use, and amount of cannabis consumed are controlled." Another study found vaporizers to be "a safe and effective cannabinoid delivery system."


Cannabis is ranked one of the least harmful drugs by a study published in the UK medical journal, The Lancet.
While a study in New Zealand of 79 lung-cancer patients suggested daily cannabis smokers have a 5.7 times higher risk of lung cancer than non-users, another study of 2252 people in Los Angeles failed to find a correlation between the smoking of cannabis and lung, head or neck cancers. These effects have been attributed to the well documented anti-tumoral properties of cannabinoids, specifically tetrahydrocannabinol (THC) and cannabidiol. Some studies have also found that moderate cannabis use may protect against head and neck cancers, as well as lung cancer. Some studies have shown that cannabidiol may also be useful in treating breast cancer.

Cannabis use has been assessed by several studies to be correlated with the development of anxiety, psychosis, and depression. Indeed, a 2007 meta-analysis estimated that cannabis use is statistically associated, in a dose-dependent manner, to an increased risk in the development of psychotic disorders, including schizophrenia. However, it is important to note that no causal mechanism has been proven, and the meaning of the correlation and its direction is a subject of debate that has not been resolved in the scientific community. Some studies assess that the causality is more likely to involve a path from cannabis use to psychotic symptoms rather than a path from psychotic symptoms to cannabis use, while others assess the opposite direction of the causality, or hold cannabis to only form parts of a "causal constellation", while not inflicting mental health problems that would not have occurred in the absence of the cannabis use.

Though cannabis use has at times been associated with stroke, there is no firmly established link, and potential mechanisms are unknown. Similarly, there is no established relationship between cannabis use and heart disease, including exacerbation of cases of existing heart disease. Though some fMRI studies have shown changes in neurological function in long term heavy cannabis users, no long term behavioral effects after abstinence have been linked to these changes.

Adulterants

Adulterants in cannabis are less common than in other drugs of abuse. Chalk (in the Netherlands) and glass particles (in the UK) have been used at times to make cannabis appear to be higher quality. Increasing the weight of hashish products in Germany with lead caused lead intoxication in at least 29 users. In the Netherlands two chemical analogs of Sildenafil (Viagra) were found in adulterated marijuana.

Gateway drug theory

Further information: Gateway drug theory
Some claim that trying cannabis increases the probability that users will eventually use "harder" drugs. This hypothesis has been one of the central pillars of anti-cannabis drug policy in the United States, though the validity and implications of these hypotheses are highly debated. Studies have shown that tobacco smoking is a better predictor of concurrent illicit hard drug use than smoking cannabis.

No widely accepted study has ever demonstrated a cause-and-effect relationship between the use of cannabis and the later use of harder drugs like heroin and cocaine. However, the prevalence of tobacco cigarette advertising and the practice of mixing tobacco and cannabis together in a single large joint, common in Europe, are believed to be a factor in promoting nicotine dependency among young persons investigating cannabis.

A 2005 comprehensive review of the literature on the cannabis gateway hypothesis found that pre-existing traits may predispose users to addiction in general, the availability of multiple drugs in a given setting confounds predictive patterns in their usage, and drug sub-cultures are more influential than cannabis itself. The study called for further research on "social context, individual characteristics, and drug effects" to discover the actual relationships between cannabis and the use of other drugs.

A new user of cannabis who feels there is a difference between anti-drug information and their own experiences will apply this distrust to public information about other, more powerful drugs. Some studies state that while there is no proof for this gateway hypothesis, young cannabis users should still be considered as a risk group for intervention programs. Other findings indicate that hard drug users are likely to be "poly-drug" users, and that interventions must address the use of multiple drugs instead of a single hard drug.

Another gateway hypothesis is that while cannabis is not as harmful or addictive as other drugs, a gateway effect may be detected as a result of the "common factors" involved with using any illegal drug. Because of its illegal status, cannabis users are more likely to be in situations which allow them to become acquainted with people who use and sell other illegal drugs. By this argument, some studies have shown that alcohol and tobacco may be regarded as gateway drugs. However, a more parsimonious explanation could be that cannabis is simply more readily available (and at an earlier age) than illegal hard drugs, and alcohol/tobacco are in turn easier to obtain earlier than cannabis (though the reverse may be true in some areas), thus leading to the "gateway sequence" in those people who are most likely to experiment with any drug offered.

Legal status


Cannabis propaganda sheet from 1935.
Main article: Legality of cannabis
See also: Drug prohibition, Drug liberalization, and AB 390
Since the beginning of the 20th century, most countries have enacted laws against the cultivation, possession, or transfer of cannabis for recreational use. These laws have impacted adversely on the cannabis plant's cultivation for non-recreational purposes, but there are many regions where, under certain circumstances, handling of cannabis is legal or licensed. Many jurisdictions have lessened the penalties for possession of small quantities of cannabis, so that it is punished by confiscation and sometimes a fine, rather than imprisonment, focusing more on those who traffic the drug on the black market.

In some areas where cannabis use has been historically tolerated, some new restrictions have been put in place, such as the closing of cannabis coffee shops near the borders of the Netherlands, closing of coffee shops near secondary schools in the Netherlands and crackdowns on "Pusher Street" in Christiania, Copenhagen in 2004.

Some jurisdictions use free voluntary treatment programs and/or mandatory treatment programs for frequent known users. Simple possession can carry long prison terms in some countries, particularly in East Asia, where the sale of cannabis may lead to a sentence of life in prison or even execution.

Price

The price or street value of cannabis varies strongly by region and area. In addition, some dealers may sell potent buds at a higher price.

In the United States, cannabis is overall the #4 value crop, and is #1 or #2 in many states including California, New York and Florida, averaging $3,000/lb. It is believed to generate an estimated $36 billion market. Most of the money is spent not on growing and producing but on smuggling the supply to buyers. The United Nations Office on Drugs and Crime claims in its 2008 World Drug Report that typical U.S. retail prices are 10-15 dollars per gram (approximately $290 to $430 per ounce). Street prices in North America are known to range at about $150 to $250 per ounce.

The European Monitoring Centre for Drugs and Drug Addiction reports that typical retail prices in Europe for cannabis varies from 2€ to 14€ per gram, with a majority of European countries reporting prices in the range 4–10€. In the United Kingdom, a cannabis plant has an approximate street value of £300.

Truth serum

Cannabis was used as a truth serum by the Office of Strategic Services (OSS), a US government intelligence agency formed during World War II. In the early 1940s, it was the most effective truth drug developed at the OSS labs at St. Elizabeths Hospital; it caused a subject "to be loquacious and free in his impartation of information."

In May 1943, Major George Hunter White, head of OSS counter-intelligence operations in the US, arranged a meeting with Augusto Del Gracio, an enforcer for gangster Lucky Luciano. Del Gracio was given cigarettes spiked with THC concentrate from cannabis, and subsequently talked openly about Luciano's heroin operation. On a second occasion the dosage was increased such that Del Gracio passed out for two hours.

Breeding and cultivation


Maturing female Cannabis plant
Main article: Cannabis cultivation
It is often claimed by growers and breeders of herbal cannabis that advances in breeding and cultivation techniques have increased the potency of cannabis since the late 1960s and early '70s, when THC was first discovered and understood. However, potent seedless marijuana such as "Thai sticks" were already available at that time. Sinsemilla (Spanish for "without seed") is the dried, seedless inflorescences of female cannabis plants. Because THC production drops off once pollination occurs, the male plants (which produce little THC themselves) are eliminated before they shed pollen to prevent pollination. Advanced cultivation techniques such as hydroponics, cloning, high-intensity artificial lighting, and the sea of green method are frequently employed as a response (in part) to prohibition enforcement efforts that make outdoor cultivation more risky. These intensive horticultural techniques have made it possible to grow strains with fewer seeds and higher potency. It is often cited that the average levels of THC in cannabis sold in United States rose dramatically between the 1970s and 2000, but such statements are likely skewed because of undue weight given to much more expensive and potent, but less prevalent samples.


"Skunk" cannabis is a potent strain of cannabis, grown through selective breeding and usually hydroponics, which is a cross-breed of Cannabis sativa and C. indica. Skunk cannabis potency ranges usually from 6% to 15% and rarely as high as 20%. The average THC level in coffee shops in the Netherlands is about 18–19%.

In revisions to cannabis rescheduling in the UK, the government has rescheduled cannabis back from C to B. One of the purported reasons is the appearance of high potency cannabis.

A Dutch double-blind, randomized, placebo-controlled, cross-over study examining male volunteers aged 18–45 years with a self-reported history of regular cannabis use concluded that smoking of cannabis with high THC levels (marijuana with 9–23% THC), as currently sold in coffee shops in the Netherlands, may lead to higher THC blood-serum concentrations. This is reflected by an increase of the occurrence of impaired psychomotor skills, particularly among younger or inexperienced cannabis smokers, who do not adapt their smoking style to the higher THC content. High THC concentrations in cannabis was associated with a dose-related increase of physical effects (such as increase of heart rate, and decrease of blood pressure) and psychomotor effects (such as reacting more slowly, being less concentrated, making more mistakes during performance testing, having less motor control, and experiencing drowsiness). It was also observed during the study that the effects from a single joint at times lasted for more than eight hours. Reaction times remained impaired five hours after smoking, when the THC serum concentrations were significantly reduced, but still present. The researchers suggested that THC may accumulate in blood-serum when cannabis is smoked several times per day.

Another study showed that consumption of 15 mg of Δ9-THC resulted in no impairment to learning whatsoever occurring over a three-trial selective reminding task after two hours. In several tasks, Δ9-THC increased both speed and error rates, reflecting “riskier” speed–accuracy trade-offs.

See also

Cannabis plant
Bhang
Cannabinoids
Cannabidiol (CBD)
Cannabinol (CBN)
Tetrahydrocannabinol (THC)
Tetrahydrocannabivarin (THCV)
Cannabis strains
Hash or hashish
Hash oil or honey oil
Hemp oil
Kief
Sinsemilla
Cannabis health
Medical Cannabis
Cannabis legality
1937 Marihuana Tax Act
Cannabis political parties
Global Marijuana March
International Opium Convention
Legal and medical status of cannabis
Legality of cannabis by country
Marijuana Control, Regulation, and Education Act
Marijuana Policy Project
National Organization for the Reform of Marijuana Laws
List of drugs illegal in the United Kingdom
Cannabis use demographics
Adult lifetime cannabis use by country
Annual cannabis use by country
Notes

^ a: Weed, pot, buddha or bud, Mary Jane, grass, herb, dope, schwag, and reefer, are among the many other nicknames for marijuana or cannabis as a drug.
^ b: Sources for this section (as well as far more information) can be found in the Medical cannabis article.

References

^ a b http://www.ars-grin.gov/cgi-bin/npgs/html/taxon.pl?8862
^ See, Etymology of marijuana.
^ Company, Houghton Mifflin; American Heritage Dictionaries (2007-11-14). Spanish Word Histories and Mysteries. Houghton Mifflin Harcourt. p. 142. ISBN 0618910549, 9780618910540. http://books.google.com/books?id=VTYBbGybtNEC&pg=PA142.
^ Matthew J. Atha (Independent Drug Monitoring Unit). "Types of Cannabis Available in the United Kingdom (UK)". http://www.idmu.co.uk/can.htm.
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Further reading

Martin Booth (2005). Cannabis: A History. Macmillan Publishers & Random House, Inc. pp. 448. ISBN (10): 0-312-42494-9, (13): 978-0-312-42494-7. http://books.google.com/books?id=O7AoY6ljSygC&printsec=frontcover.
External links

Wiktionary Appendix of Cannabis Slang
Marijuana Policy Project
National Organization for the Reform of Marijuana Laws
Comprehensive Cannabis FAQs and Marijuana Information
The Union: The Business Behind Getting High
Scannabis.com - Cannabis News and Reports
National Cannabis Prevention and Information Centre
Tobacco and Marijuana Market Impact Index - National Trends
Opioids
Codeine · Heroin · Hydrocodone · Morphine (Opium) · Oxycodone
Stimulants
Amphetamine · Arecoline (Areca) · Betel · Caffeine (Coffee, Tea) · Cathinone (Khat) · Cocaine (Coca) · Ephedrine (Ephedra) · Methamphetamine · Methylphenidate · Nicotine (Tobacco) · Theobromine (Cocoa)

Culture and Related Topics
Cannabis
420 · Stoner Film · Spiritual Use of Cannabis · Medical Cannabis · Cannabis Cultivation · Cannabis smoking
Psychedelic
Art · Drug · Experience · Literature · Music
Other
Counterculture of the 1960s · Club Drug · Dance Party · Drug Tourism · Drug Paraphernalia · Hippie · Party and Play · Poly Drug Use · Rave · Sex and Drugs Spiritual use of drugs
Problems With Drug Use
Abuse · Addiction (Prevention · Rehabilitation · Responsible Use) · Illegal Trade · Overdose
Legality of Drug Use
International
1961 Narcotic Drugs · 1971 Psychotropic Substances · 1988 Drug Trafficking
State Level
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Drug Possession · Drug Test · Hard and Soft Drugs · Narc · War on Drugs
Lists of Countries By...
Alcohol Consumed · Cannabis Legality (Annual Use · Lifetime Use) · Cocaine Use · Opiate Use · Tobacco Smoked
Endocannabinoid
activity enhancers
AM-404 • CAY-10401 • CAY-10402 • JZL184 • N-arachidonoyl-serotonin • O-1624 • PF-622 • PF-750 • PF-3845 • URB-597 • URB-602 • Genistein • Arvanil • Olvanil • Kaempferol • Biochanin A • URB-754

Cannabinoid receptor
antagonists and
inverse agonists
AM-251 • AM-281 • AM-630 • BML-190 • CAY-10508 • CB-25 • CB-52 • Drinabant • Ibipinabant • JTE-907 • LY-320,135 • MK-9470 • NESS-0327 • O-1184 • O-1248 • O-2050 • O-2654 • Org 27569 • Otenabant • Rimonabant • SR-144,528 • Surinabant • Taranabant • Curcumin • Resveratrol • VCHSR
More aboutCannabis (drug)