Background: The Gateway Drug Theory suggests that licit drugs, such as tobacco and alcohol, serve as a "gateway" toward the use of other, illicit drugs. However, there remains some discrepancy regarding which drug-alcohol, tobacco, or even marijuana-serves as the initial "gateway" drug subsequently leading to the use of illicit drugs such as cocaine and heroin. The purpose of this investigation was to determine which drug (alcohol, tobacco, or marijuana) was the actual "gateway" drug leading to additional substance use among a nationally representative sample of high school seniors.
Methods: This investigation conducted a secondary analysis of the 2008 Monitoring the Future 12th-grade data. Initiation into alcohol, tobacco, and other drug use was analyzed using a Guttman scale. Coefficients of reliability and scalability were calculated to evaluate scale fit. Subsequent cross tabulations and chi-square test for independence were conducted to better understand the relationship between the identified gateway drug and other substances' use.
Results: Results from the Guttman scale indicated that alcohol represented the "gateway" drug, leading to the use of tobacco, marijuana, and other illicit substances. Moreover, students who used alcohol exhibited a significantly greater likelihood of using both licit and illicit drugs.
Conclusion: The findings from this investigation support that alcohol should receive primary attention in school-based substance abuse prevention programming, as the use of other substances could be impacted by delaying or preventing alcohol use. Therefore, it seems prudent for school and public health officials to focus prevention efforts, policies, and monies, on addressing adolescent alcohol use.
daily drug addiction is increasing at a higher rate.. and simply we all need to stop this if we want ourselves to live longer and healthier and also if we want any other relative of our who is addicted towards this..we need to stop this...and we need to create awareness against taking drugs...drugs in medicines are ok because they are used in it in a proper amount but drugs directly...HELL! IT CAN SNATCH YOUR LIFE JUST AWAY FROM YOUR BODY !
daily drug addiction is increasing at a higher rate.. and simply we all need to stop this if we want ourselves to live longer and healthier and also if we want any other relative of our who is addicted towards this..we need to stop this...and we need to create awareness against taking drugs...drugs in medicines are ok because they are used in it in a proper amount but drugs directly...HELL! IT CAN SNATCH YOUR LIFE JUST AWAY FROM YOUR BODY !
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
3. A DRUG IS ANY SUBSTANCE OTHER
THAN FOOD WHICH CHANGES THE
WAY THE BODY OR MIND FUNCTIONS.
4. Types of drugs
Hallucinogens – These drugs
alter the user’s state of
consciousness. (Distort auditory
and visual sensations) Examples are
LSD, ecstasy, magic mushrooms,
marijuana.
5. Types of drugs
Stimulants (uppers) – Speed up the brain
and central nervous system.
Examples are caffeine (coffee, tea)
nicotine (cigarettes),
amphetamines, speed, cocaine and
diet pills.
6. Types of drugs
Depressants (downers) – Slow down the
brain and central nervous system.
Examples are alcohol, beer, wine,
vodka, gin etc heroin, tranquilizers,
sleeping pills.
9. Risks Of Underage Drinking
• Motor Vehicle Accidents
• Sexual Assault or other violence
• Long-Term Brain Damage
• Alcoholism
• Suspension/Expulsion
10. ALCOHOL
• Alcohol goes directly from your
digestive system into your blood and
within minutes spreads to entire body,
including brain
• It spreads evenly throughout body-
except brain which gets the highest
concentration because it gets more
blood than any other part of body
• More blood equals more alcohol
• Intoxication (drunkenness) starts in the
brain
11. The path of alcohol in the body
1. Mouth: alcohol enters the body.
2. Stomach: some alcohol gets into the bloodstream
in the stomach, but most goes on to the small
intestine.
3. Small Intestine: alcohol enters the bloodstream
through the walls of the small intestine.
4. Heart: pumps alcohol throughout the body.
5. Brain: alcohol reaches the brain.
6. Liver: alcohol is oxidized by the liver at a rate of
about 0.5 oz per hour.
• Alcohol is converted into water, carbon dioxide
and energy.
12. How alcohol can effect you
• Factors that influence how alcohol will
affect a person include:
– age
– gender
– physical condition (Body Size)
– amount of food eaten
– other drugs or medicines taken
13. Life-Threatening Effects
• Motor Vehicle Crashes
• Overdose (Alcohol Poisoning)
- Binge Drinking- excessive amounts at
one setting.
• Interactions with other Drugs
14. Alcohol
Physical Effects
• Co-ordination is
impaired, clumsiness,
slower reflexes
• High blood pressure,
damage to the heart
• Liver damage
• Kidneys increase urine
Production
• Too much Alcohol may
cause vomiting
Mental and
Emotional
• Behave in ways that
you normally wouldn’t
• Increase in aggressive
and violent behaviour
• Problems with school
and learning
15. ALCOHOL and the LIVER
• The liver removes poisons – include alcohol
from the body
• People who drink regularly can have
serious liver damage and may even get
liver cancer
• If the liver is damaged badly enough, it
can stop working, causing the person to
die.
17. ALCOHOL
• Alcohol is the oldest and most widely used
drug in the world.
• About two-thirds of Grade 6 students say
they have experimented with alcohol.
• By Grade 10, over 90% have tried it.
• Leading cause of death for teens and
young adults is motor vehicle accidents-
many of which involve alcohol use.
18. Nicotine Vocabulary
• Nicotine- very addictive chemical in
tobacco products
• Smokeless Tobacco- Tobacco that is
chewed, placed lower lip, or sniffed
through nose
• Chewing Tobacco- “dip or “Chew”
• Snuff- Finely ground, powdered tobacco
19. NICOTINE
• Most addictive drug
• Causes more long term health problems
than any other drug
• Adults are smoking less, younger people
under 18 smoke more
• When someone stops smoking they have:
strong cravings
irritability (everything gets on
nerves)
thoughts of it-can’t stop thinking
about it
20. Nicotine
• Cardiovascular- Increase heart rate and
blood pressure
• Nervous- Increase activity/ activates brain
pathway
• Digestive- Increases Saliva and bowel
• Respiratory- Decreases muscles in lung’s
and cause breathing to become more
shallow.
21. NICOTINE
What it does to your body,
brain and behavior
• depression
• lung cancer
• lung diseases
• heart disease
• skin becomes thinner and wrinkled
27. Drug Awareness Basic Terms
• Drug- (First Slide)
• Drug Abuse- intentionally using
improperly or unsafely
• Drug Misuse- The improper use of
medicines (prescription or over-the-
counter)
• Prescription- Drug that can be only
purchased with written consent of a doctor.
28. Drug Awareness Basic Terms
• Over-The-Counter- Medicine sold legally
at any retail store.
• Chemical/Psychological/Physical
Dependence
• Tolerance- When a drug is used repeatedly,
body builds a tolerance
• Withdrawal- A person who becomes
dependent will develop physical side
effects.
29. MARIJUANA
• Marijuana is the most common illegal drug
around
• Comes from a plant called “cannabis”
• Some people call it pot, weed, grass, hash,
smoke or ganja
• Cannabis has the chemical
“tetrahydrocannabinol” or THC
• When you smoke a joint the THC goes into
the lungs, then into the heart which pumps
into the bloodstream which takes it
directly to brain
30. MARIJUANA
• Only takes few minutes for THC to get to
brain when you smoke marijuana
• Eating takes longer to get to brain-passes
through digestive system first
• In brain, activates “receptors” gives you
the feeling of being high
• Marijuana changes physical and chemical
balance in your brain
31. MARIJUANA
• Short Term Effects:
Increase in heart rate,
lead to anxiety and
paranoia
Distorted concept of
time and space
Decrease in
concentration skills,
short-term memory
capacity
Feeling tired after the
“high” wears off
Increase in appetite,
weight gain
• Long Term Effects:
• Breathing problems
• Lung cancer
• Damage cells and
tissues in the body
that fight disease
• Lack of motivation
• Difficulty processing
new information
32. MARIJUANA
• Marijuana and cigarette smoke have some
of the same cancer-causing substances.
• Benzopyrene (cancer-producing agent)
higher in marijuana
• 400 chemicals in marijuana smoke affect
lungs, throat and esophagus
33. • Certain drugs have become popular among teens and
young adults at dance clubs and raves.
34. • Ecstasy is a slang term for an illegal drug
MDMA
• MDMA is synthetic-doesn’t come from a
plant but made in secret labs
• Other chemicals or substances are added
to it such as caffeine, amphetamines,
dextromethorphan (in some cough syrups),
or cocaine.
35. • Mind-altering drug
• Hallucinogen-acts on the mind to cause people to see or feel
things that aren’t really there
• Hallucinogens mix up pictures in the mind and throw people
into scary or sad experiences in the past
• Ecstasy is called “love pill” increases perception of color, sound
and sensations
36. • “Hit” of ecstasy lasts 3-6 hrs
• Once swallowed takes 15 min to enter
bloodstream and reach brain
• 45 min later user reaches peak level high
• It’s downhill from there unless user takes
more
37. Effects
• Feeling of sadness
• Anxiety, Depression
• Memory Difficulties
• Paranoia
• Nervousness
• Insomnia
• Drug cravings
• Increased touch of sense
• Suppresses need to eat or sleep
• Moist skin or dry mouth
38. ROHYPNOL
• Rohypnol can affect your brain and body
• Damages neurons in your brain, impairing
your senses, memory, judgment, and
coordination
• Artificial drug-created in a chem lab during
medical research
39. ROHYPNOL
• Makes user very relaxed, confused, “spaced-out”
• Takes away all inhibitions, making people do things they
normally wouldn’t
40. ROHYPNOL
• Can make user pass out or slip into coma if taken in large dose or
mixed with other drugs
• Affects your self-control - is used in “date rape” and other assaults can
make you unconscious and immobilizes you
• Causes a kind of amnesia-user doesn’t remember what they said or
did while on the drug
• Comes in a form of a pill, or sometimes powder mixed with a drink, or
put into someone’s drink
41. HEROIN
• Processed from morphine – obtained from
opium poppy
• “downer” affects brain’s pleasure systems
– interferes with brains ability to feel
pain
42. HEROIN
• white to dark brown powder or tar-like
substance
• is cut with other drugs or substances
(sugar, starch, powdered milk)
• abusers don’t know actual strength of
drug or true contents = high chance of
overdose or death
• sharing needles and equipment cause other
diseases and problems for users
43. HEROIN
• leads to flushing of skin, dry mouth,
collapsed veins, liver disease
• additives don’t dissolve leading to
clogs in blood vessels that lead to
lungs, liver, kidney or brain
• tolerance develops with regular use –
user needs more heroin to achieve
same intensity
44.
45.
46.
47.
48.
49.
50. Cocaine + CRACK
• Cocaine is a stimulant drug-more
alert and energetic
• Cocaine is a white powder comes
from the leaves of coca plant
• Can be one of the hardest drugs to
quit
51. Cocaine + CRACK
• Cocaine makes people feel energetic,
talkative, alert and euphoric
• More aware of senses (increases sound,
touch, sight and sexuality)
• Reduces hunger and need to sleep
• Increase in self-control and confidence
• High doses cause panic attacks, psychotic
episodes (paranoia), violent behavior
52. Cocaine + CRACK
• Blood vessels thicken and constrict,
reduce flow of oxygen to heart
• Heart muscles work harder can lead to
heart attack or stroke
• Raises blood pressure, can explode
weakened blood vessels in brain
• Small amount can lead to overdose
• Overdose can cause seizure or heart
failure
• Snorting cocaine can cause sinus infection
and loss of smell
53. Cocaine + CRACK
• Damage tissues in nose, cause hole in nose
• Damage lungs-severe chest pains,
breathing problems, high temperatures
• Cocaine increases the same chemicals in
the brain that make people feel good when
they eat, drink or have sex
54. CRYSTAL METH
• Man-made drug
• Easy to produce (15 chemicals used)
• Main ingredient pseudo ephedrine ( cold
remedy), is cooked with chemicals found
at hardware store-red phosphorous,
iodine, ammonia, paint thinner, ether,
Drano, lithium from batteries
• Investment of $150 can yield up to
$10,000 worth of the drug
• Each kg of meth produced 5-7kg of
chemical waste dumped down the drain or
dumped in backyard
55. CRYSTAL METH
• By-product is toxic gas which causes fires
or explosions
• Drug was used during Second World War
to keep pilots awake on long missions
• Methamphetamine releases high levels of
dopamine in the brain a neurotransmitter
that is associated with pleasurable or
rewarding experiences
• After it is taken user feels increased
wakefulness and physical activity and
decreased appetite
56. CRYSTAL METH
• Higher doses cause irritability, insomnia,
confusion, hallucinations, anxiety, paranoia
and increased aggression
• Even higher doses can cause hypothermia,
convulsions and lead to death
• When body is stimulated by meth it
causes irreversible damage
• Increased heart rate and blood pressure
damage blood vessels in the brain, causing
strokes, irregular heart beat causing a
collapse or death
57. Sex risks
Substance abuse is correlated with
risky sex…
In one study a woman coming off of
meth reported 100 different sexual
encounters with 60 different
partners in the past month.
Risky sex is correlated with many
diseases
68. • “It was the hardest boyfriend I
ever had to break up with.”
"I dug deep as to why I got there.
It's the drug that's addicting. But
it's why you start doing it in the
first place that's more
interesting”
• "A lot of it was being a child
actor, I learned to suppress
feelings."
• “ Performing, instead of taking
drugs, now helps me express my
emotions.”
69. Substance abuse and society
What are the effects of substance abuse on
society?
• Spread of diseases such as HIV/AIDS and
Hepatitis C through sharing needles, or
having unprotected sex
70. Substance abuse and society
Effects on unborn children or other
complications from drug use
71. EFFECTS OF DRUG USE
ON CHILD
• Miscarriages
• Premature birth
• Low birth weight
• Birth defects
• Developmental problems
• A baby’s health problems, if caused by a
drug will continue to grow as the child
grows.
72. Substance abuse and society
CRIME
• drug possession
• drug use
• drug trafficking
• drug manufacturing
• theft
• break and enter
• robbery
• motor vehicle theft
