Health outcomes associated with long-term regular cannabis and tobacco smoking

This study aimed to identify patterns of health concerns associated with long-term use of cannabis and tobacco individually, as well as in combination. We recruited 350 adults aged 40 or over who smoked cannabis but not tobacco (cannabis-only group, n = 59), smoked both cannabis and tobacco (cannabis/tobacco group, n = 88), smoked tobacco but not cannabis (tobacco-only group, n = 80), or used neither substance (control group, n = 123). Participants completed a survey addressing substance use, diagnosed medical conditions, health concerns relating to smoking cannabis/tobacco, and general health (measured using the Physical Health Questionnaire and the Short Form 36). Several significant differences were found among the four groups. With regard to diagnosed medical conditions, the three smoking groups reported significantly higher rates of emphysema than did the control group (ps < .001). However, all members of the cannabis-only group diagnosed with emphysema were former regular tobacco smokers. Total general health scores, general health subscales, and items addressing smoking-related health concerns also revealed several significant group differences, and these tended to show worse outcomes for the two tobacco smoking groups. Findings suggest that using tobacco on its own and mixing it with cannabis may lead to worse physical health outcomes than using cannabis alone.     

OPTIONS FOR DENTIN/ENAMEL BONDING: PART IV

Four categories of resin‐based dentin/enamel adhesives are currently available. These include the three‐step etch‐&‐rinse, “one‐bottle” etch‐&‐rinse, two‐step self‐etch primer systems, and “all‐in‐one” self‐etch adhesives. In consecutive issues of the Journal, the Critical Appraisal series is presenting salient publications on research in each of the categories. This final installment of the series focuses on the all‐in‐one self‐etch adhesives.     

OPTIONS FOR DENTIN/ENAMEL BONDING: PART I

Four categories of resin-based dentin/enamel adhesives are currently available. These include the three-step etch-and-rinse, "one-bottle" etch-and-rinse, two-step self-etch primer systems, and "all-in-one" self-etch adhesives. In consecutive issues of the Journal, the Critical Appraisal series will present salient publications on research in each of the categories, beginning with this issue's piece on the three-step etch-and-rinse systems.     

Human islet cell transplantation--future prospects.

BACKGROUND: Islet transplantation has the potential to cure diabetes mellitus. Nevertheless despite successful reversal of diabetes in many small animal models, the clinical situation has been far more challenging. The aim of this review is to discuss why insulin-independence after islet allotransplantation has been so difficult to achieve. METHODS: A literature review was undertaken using Medline from 1975 to July 2000. Results reported to the International Islet Transplant Registry (ITR) up to December 1998 were also analysed. RESULTS: Up to December 1998, 405 islet allotransplants have been reported the ITR. Of those accurately documented between 1990 and 1998 (n = 267) only 12% have achieved insulin-independence (greater than 7 days). However with refined peri-transplant protocols insulin independence at 1 year can reach 20%. CONCLUSIONS: There are many factors which can explain the failure of achieving insulin-independence after islet allotransplantation. These include the use of diabetogenic immunosuppressive agents to abrogate both islet allo-immunity and auto-immunity, the critical islet mass to achieve insulin-independence and the detrimental effects of transplanting islets in an ectopic site. However recent evidence most notably from the Edmonton group demonstrates that islet allotransplantation still has great potential to become an established treatment option for diabetic patients.