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Marijuana: An overview
327 results, nonspecific or generic prevention efforts were tried in both areas. These efforts, too, did not prevent drug use or drug problems. More recently, using cigarette smoking prevention initiatives in schools as a model, hopeful results have been achieved. These efforts combine education about immediate negative effects of drug use with training in skills to resist peer pressure to use drugs. These efforts also build youth peer rejection of drug use. Promising a wider community effort to prevent chemical dependency are several macro prevention programs. These include efforts to decrease tolerance for drug use and to identify drug users in four specific areas: families, schools, highways, and the workplace. Chemical dependency can be prevented by a variety of interventions, including one-to-one encounters, school-based skills training, and society-wide initiatives to reject drug use. The teenage years are a time of unique vulnerability to initiation of drug and alcohol use. The clear goal of prevention is to help young people to survive these years without using drugs, including the gateway drugs: alcohol, tobacco, marijuana, and cocaine. The pediatrician can play a vital role in successful prevention activities with patients, with their families, in communities, and in the nation as a whole. Marijuana:
An overview
Schwartz RH PEDIATR. CLIN. NORTH AM.; 34/2 (305-3171/1987/ Marijuana is a potent, intoxicating drug that can alter mood and mind. Sinsemilla marijuana, used preferentially by frequent marijuana smokers, is 600 per cent more potent than the marijuana used in the previous decade. In 1985, marijuana was smoked on a daily basis by 120,000 American high school seniors and an unknown number of high school dropouts. DeltaSTHC, the primary psychoactive chemical in marijuana, exerts pronounced adverse effects on the estimation of time, on short-term memory stores, and on complex performance tasks. Experimentation with marijuana even once during adolescence carries with it at least an 8 per cent risk of one’s becoming a daily marijuana smoker with attendant psychosocial consequences. For those adolescents with serious underlying genetic and developmental risk factors, the risk of progression from experimental use to the cannabis dependence syndrome appears to be much higher: furthermore, it is highly unlikely that adolescents will try cocaine or hallucinogens without prior experimentation with marijuana. Parents of adolescents and physicians must be aware that any sustained deterioration in school performance, ethical values, interpersonal relationships, or a combination of these is often associated with frequent use of cannabis. There is also a real risk of serious accidental injury, running away, and suicide attempts in adolescents who develop the cannabis dependency syndrome. Urine toxicology screening tests, in selected cases, can help the physician to diagnose and manage deceptive adolescent drug users who deny or minimize the association of their drug use with their psychosocial problems. Enzymatic
frostbite
eschar
debridement
by bromelain
Ahle NW; Hamlet MP ANN. EMERG. MED.; 1619 (1063- 10651/1987/ Bromelain is a plant proteinase derived from the stem of the pineapple plant that has been used successfully to debride the eschar from third-degree burn injuries. Its applicability to frostbite eschar removal was extrapolated and investigated. Third-degree frostbite lesions were produced on swine using supercooled air as the freezing media, and the resulting eschars were treated with a bromelain preparation. In the initial trial, no debridement other than that of the superficial layers of the eschar was noted. The experiment then was repeated with the introduction of third-degree burn injuries as a control to validate the efficacy of the enzyme preparation. Although the burn injuries debrided to a graftable bed after two applications of the enzyme, the frostbite injuries remained unaffected. It was concluded that the patent vasculature, resulting tissue edema, and lack of coagulation of proteins found in the freeze injury are sufficient to inactivate the bromelain enzyme before tissue digestion and dissection can be effected.
An overview
Schwartz RH PEDIATR. CLIN. NORTH AM.; 34/2 (305-3171/1987/ Marijuana is a potent, intoxicating drug that can alter mood and mind. Sinsemilla marijuana, used preferentially by frequent marijuana smokers, is 600 per cent more potent than the marijuana used in the previous decade. In 1985, marijuana was smoked on a daily basis by 120,000 American high school seniors and an unknown number of high school dropouts. DeltaSTHC, the primary psychoactive chemical in marijuana, exerts pronounced adverse effects on the estimation of time, on short-term memory stores, and on complex performance tasks. Experimentation with marijuana even once during adolescence carries with it at least an 8 per cent risk of one’s becoming a daily marijuana smoker with attendant psychosocial consequences. For those adolescents with serious underlying genetic and developmental risk factors, the risk of progression from experimental use to the cannabis dependence syndrome appears to be much higher: furthermore, it is highly unlikely that adolescents will try cocaine or hallucinogens without prior experimentation with marijuana. Parents of adolescents and physicians must be aware that any sustained deterioration in school performance, ethical values, interpersonal relationships, or a combination of these is often associated with frequent use of cannabis. There is also a real risk of serious accidental injury, running away, and suicide attempts in adolescents who develop the cannabis dependency syndrome. Urine toxicology screening tests, in selected cases, can help the physician to diagnose and manage deceptive adolescent drug users who deny or minimize the association of their drug use with their psychosocial problems. Enzymatic
frostbite
eschar
debridement
by bromelain
Ahle NW; Hamlet MP ANN. EMERG. MED.; 1619 (1063- 10651/1987/ Bromelain is a plant proteinase derived from the stem of the pineapple plant that has been used successfully to debride the eschar from third-degree burn injuries. Its applicability to frostbite eschar removal was extrapolated and investigated. Third-degree frostbite lesions were produced on swine using supercooled air as the freezing media, and the resulting eschars were treated with a bromelain preparation. In the initial trial, no debridement other than that of the superficial layers of the eschar was noted. The experiment then was repeated with the introduction of third-degree burn injuries as a control to validate the efficacy of the enzyme preparation. Although the burn injuries debrided to a graftable bed after two applications of the enzyme, the frostbite injuries remained unaffected. It was concluded that the patent vasculature, resulting tissue edema, and lack of coagulation of proteins found in the freeze injury are sufficient to inactivate the bromelain enzyme before tissue digestion and dissection can be effected.