This document discusses the history of cannabis use and research. It notes that cannabis has a long history of medicinal use but was removed from the US Pharmacopoeia in 1942 and classified as a Schedule I drug in 1970 despite evidence that it has medical applications and relatively low risks. Barriers to research have impeded scientific understanding of the endocannabinoid system and cannabis's potential medical benefits.
In this webinar, clinicians from two Ryan White clinics with successful buprenorphine programs describe what buprenorphine is, how it works, what opioids do to the brain, how buprenorphine differs from methadone, important drug-drug interactions, the concept of precipitated withdrawal and how to recognize it, how to determine patient eligibility, and clinical aspects of working with opiod-addicted people living with HIV.
Presenters Pamela Vergara-Rodriguez, MD, (CORE Center in Chicago), and Jacqueline Tulsky, MD (University of California at San Francisco and San Francisco General Hospital), also describe the challenges and successes of the SPNS buprenorphine projects at their institutions.
Visit the Integrating HIV Innovative Practices webpage to learn more about integrating buprenorphine into HIV primary care settings and to access additional training materials.
In this webinar, clinicians from two Ryan White clinics with successful buprenorphine programs describe what buprenorphine is, how it works, what opioids do to the brain, how buprenorphine differs from methadone, important drug-drug interactions, the concept of precipitated withdrawal and how to recognize it, how to determine patient eligibility, and clinical aspects of working with opiod-addicted people living with HIV.
Presenters Pamela Vergara-Rodriguez, MD, (CORE Center in Chicago), and Jacqueline Tulsky, MD (University of California at San Francisco and San Francisco General Hospital), also describe the challenges and successes of the SPNS buprenorphine projects at their institutions.
Visit the Integrating HIV Innovative Practices webpage to learn more about integrating buprenorphine into HIV primary care settings and to access additional training materials.
Joshua Riley presented for the Kolmac School in Silver Spring, MD on Friday, April 24, 2015. "Working with LGBT Substance Abuse Users and the Persistence of Methamphetamine Use Among Gay and Bi-Sexual Men" was adored by all. Enjoy his slides!
Treatment Strategies for Women and Families with Substance AbuseErikaAGoyer
NATIONAL PERINATAL ASSOCIATION 2014 CONFERENCE
Treatment Strategies for Women and Families with
Substance Abuse: The participant will be able to:
Interpret the term “opioid use disorder,” explain the
benefits of Methadone Assisted Treatment (MAT) and
identify the characteristics of Neonatal Abstinence
Syndrome.
At Bella Nirvana Center Drug and Alcohol Treatment Center, we understand how hard it is to functions in a daily basis when you are suffering from PTSD, Anxiety, and depression. We have a well-experienced counselor that will help you on how to cope with stress and learn some tools. Our physician who is well experienced in handling clients who have PTSD will assist you with a medication regimen.
Now that medical cannabis is available in Maryland as well as DC, patients are looking for guidance from clinicians – who have received little or no information about this substance in their formal training. Furthermore, much of the information being offered about the dangers and benefits of cannabis tends to be distorted positively or negatively according to the philosophical orientation of the source.
Joshua Riley presented for the Kolmac School in Silver Spring, MD on Friday, April 24, 2015. "Working with LGBT Substance Abuse Users and the Persistence of Methamphetamine Use Among Gay and Bi-Sexual Men" was adored by all. Enjoy his slides!
Treatment Strategies for Women and Families with Substance AbuseErikaAGoyer
NATIONAL PERINATAL ASSOCIATION 2014 CONFERENCE
Treatment Strategies for Women and Families with
Substance Abuse: The participant will be able to:
Interpret the term “opioid use disorder,” explain the
benefits of Methadone Assisted Treatment (MAT) and
identify the characteristics of Neonatal Abstinence
Syndrome.
At Bella Nirvana Center Drug and Alcohol Treatment Center, we understand how hard it is to functions in a daily basis when you are suffering from PTSD, Anxiety, and depression. We have a well-experienced counselor that will help you on how to cope with stress and learn some tools. Our physician who is well experienced in handling clients who have PTSD will assist you with a medication regimen.
Now that medical cannabis is available in Maryland as well as DC, patients are looking for guidance from clinicians – who have received little or no information about this substance in their formal training. Furthermore, much of the information being offered about the dangers and benefits of cannabis tends to be distorted positively or negatively according to the philosophical orientation of the source.
How the drugs has been brought into the market, what are the several steps involved in the discovery of drugs.
clinical trials are also involved.
COVID-19 new clinical trials have been incarporated
Pharmacology is study of the substances which interact with living system by activating or inhibiting normal body processes. It includes physical and chemical properties, biochemical and physiological effects, mechanism of action, therapeutic uses and adverse effects of drugs.
Medical Marijuana and Clinical Oncology in 2022"The Good the Bad and the Potentially Ugly"
Marijuana/cannabinoids are particularly appealing for oncology patients offering the possibility of a single medication to encompass a variety of problems, such as pain, nausea, anorexia, sleep disorders , and anxiety.
Dr. Malcolm Brigden - University of Calgary - Canada.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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.
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
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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
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1. Cannabis: The Fog of Ignorance
ChiefClinicalOfficer ClinicalProfessorofPsychiatry
GeorgetownUniversitySchoolof
Medicine
UniversityofMarylandSchoolof
Medicine
GeorgeKolodner, M.D.
2. Long History of Medicinal Use
• 2700 BC. First documented use (China)
• Used for millennia in India, China, Egypt,
Middle East
• Western medicine: mainstream use in 19th
and early 20th Centuries
– 1850 to 1942. Listed in U.S. Pharmacopoeia
• Fluidextracts(notrawplantforinhalation)
• Manufacturedbymajorpharmaceuticalcompanies
3. Dr. William Osler’s Opinions
• Regarding medication in general
– “One ofthe first duties ofthe physician is to
educatethe masses not to take medication.”
– “Youcannot have a drug for everymalady.”
• Regarding cannabis
– “Probably the most satisfactoryremedyfor the
treatmentof migraine headaches.”
– TextbookofMedicine,1892-1915
4. Repetitious Process
1. Concern about widespread illegaluse and
uncertainty about facts
2. Appointment of high levelgovernment
commission or scientific committee
• Conclusion:“Cannabisisnotwithoutdangers,but
penaltiesforusearedisproportionatetothethreat”
• Recommenddecriminalization
3. Opposition from law enforcement,politicians,
some physicians
4. Sweeping,confident, disrespectful assertions by
extremeson both sides
5. Stalematewith minimal or no legalchanges
6. De-Medicalization of Cannabis
(Harry Anslinger)
1937
Marijuana Tax Act
• Allowed medical use but imposed
heavy administrative burdens
• Adopted despite AMA opposition
• Declared unconstitutional in 1969
1942
Removed from U.S.
Pharmacopeia
1961
Included in UN Single
Narcotics Convention
1970
Classified as Schedule 1
Substance in Controlled Drug
Substances Act
7. DEA as an Information Source
• “ReeferMadness.” 1936 movie referred to
cannabis as “the burning weed with its roots
in hell … that leads to debauchery, murder,
suicide and the ultimate end -- hopeless
insanity.”
• Assertionsthatcannabis a “gateway drug” and
causes cognitive damage and psychosis in
adults wererecentlyremovedfrom DEA website
8. DEA Schedule I Criteria
1. High potential for abuse
2. No currently accepted use for treatment in
the United States
3. Lack of accepted safety for use under
medical supervision
9. Context of Classification
as Schedule I
"Since there is still a considerable void in our
knowledge of the plant and effects of the
active drug contained in it, our
recommendation is that marijuana be
retained within Schedule I at least until the
completion of certain studies now
underway to resolve the issue.“
Dr.RogerO.Egeberg
AssistantSecretaryofHealth
August14,1970
10. Raphael Mechoulam
• 86 y.o. Israeli chemist, still professionally
active
• Identified THC as the primary psychoactive
ingredient in cannabis
• Discovered the endocannabinoid system
• “The Scientist”: YouTube documentary
about his discoveries
– https://www.youtube.com/watch?v=csbJnBKq
wIw
11. Modern Timeline
• 1940. Cannabidiol (CBD) isolated from plant
• 1964. THC isolated from plant
• 1981. CBD anticonvulsant effect demonstrated
• 1985. Synthetic THC approved by FDA
• 1988. CB1 receptoridentified
• 1992. Endogenous anandamide (AEA)
• 1993. CB2 receptoridentified
• 1995. Endogenous 2-arachidonoyl glycerol
12. Endocannabinoid System:
Helps Regulate Multiple Systems
• Pain
• Immunity
• Inflammation
• Movement
• Bone density
• Tumor surveillance
• Appetite
• Stress
• Mood
13. Endocannabinoid Receptors
• CB1
– MostcommonreceptorinCNS
• Responsibleforpsychoactiveeffects
• Absentinbrainstemnorespiratorydepression
– Alsoinperipheralnervesandnon-neuronaltissues
• CB2
– Locatedinmacrophages
– Involvedinimmunesystemandanti-inflammatory
activity
• Exactfunctionsunknownduetoabsenceofgoodprobes
• Both inhibit synaptictransmission
• Other receptorsnot as well characterized
17. Obstacles to Knowledge
• Access
– Singlesourceforresearchgrade
• UniversityofMississippifarm,contractedbyNIDA
• LowTHCconcentrationofresearchgrade
• Fall,2016:DEAwillingtoallowothersources
– 5levelsofapproval(morethananyotherdrug)
DEA–notFDA–hasfinalauthority
• Organizationalissues
– Nogovernmentagencyfocusedonbeneficialuses
• Discouragesdevelopmentof new
pharmaceuticalproducts
• Endocannabinoidsystem is not being taughtin
medicalschools
18. Summary
• Cannabis has medicinalvalue
– Benefitsandriskstendtobeexaggerated
• Influenceof law enforcementagencieshas
outweighedhealth agencies
• Politicalconsiderationshaveinterferedwith
scientificevaluationand left physicians in a
disadvantagedposition
– Bewareofselectiveuseofdatatosupport
particularpositions
• Barriers toresearch and pharmaceutical
developmentshould be lowered