Friday, April 25, 2008

What is Condom?

What Is It?

Condoms are considered a barrier method of contraception. There are male condoms and female condoms. A male condom is a thin latex (a type of rubber) sheath that is worn on the penis. A female condom is a polyurethane sheath with a flexible ring at either end. One end is closed and is inserted into the vagina, the other end is open and the ring sits outside the opening of the vagina. The male condom is far more widely used and is sometimes called a "rubber" or "prophylactic."

How Does It Work?

The condom works by keeping semen (the fluid that contains sperm) from entering the vagina. The male condom is placed on a guy's penis when it becomes erect. It is unrolled all the way to the base of the penis while holding the tip of the condom to leave some extra rubber. This creates a space for semen after ejaculation and makes it less likely that the condom will break.

After the guy ejaculates, he should hold the condom at the base of the penis as he pulls out of the vagina. He must do this while the penis is still erect to prevent the condom from slipping off when he gets soft. If this happens, sperm could enter the vagina.

The female condom is inserted into the vagina using the closed-end ring. The other ring creates the open end of the condom. The sheath then lines the walls of the vagina creating a barrier between the sperm and the cervix. The male and female condoms should not be used at the same time because they can get stuck together and cause one or the other to slip during intercourse, making them ineffective. The female condom can be inserted up to 8 hours prior to intercourse. It should be removed immediately after sex.

A used condom should be thrown in the garbage, not down the toilet. Once a condom is used, it cannot be reused. A new condom should be used each time you have sex and it must be used from start to finish every time you have sex to prevent pregnancy and sexually transmitted diseases (STDs). Never use oil-based lubricants such as mineral oil, petroleum jelly, or baby oil with condoms because these substances can break down the rubber.

And if a condom ever seems dry, sticky, or stiff when it comes out of the package, or if it is past its expiration date, throw it away and use a new one. It's a good idea to have several condoms on hand in case there is a problem with one. It's best to store unused condoms in a cool, dry place.

How Well Does It Work?

Over the course of 1 year, 15 out of 100 typical couples who rely on male condoms alone to prevent pregnancy will have an accidental pregnancy. The use of the female condom is a little less reliable and 21 out of 100 couples will have an unintended pregnancy.

Of course, these are average figures and the chance of getting pregnant depends on whether you use this method correctly and every time you have sex. In fact studies show that, although it's possible for condoms to break or slip during intercourse, the most common reason that condoms "fail" is that the couple fails to use one at all.

Experts used to think that using spermicide with a condom would decrease the pregnancy rate as well as help fight against STDs. However, more recent information indicates that this is not necessarily true and spermicide does not help make condoms more effective.

In general, how well each type of birth control method works depends on a lot of things. One factor is whether the method chosen is convenient — and whether the person remembers to use it correctly all the time.

Abstinence (not having sex) is the only method that always prevents pregnancy and STDs.

Protection Against STDs

Most male condoms are made of latex. Those made of lambskin may offer less protection against some STDs, including HIV, so use of latex condoms is recommended. For people who may have an allergic skin reaction to latex, both male and female condoms made of polyurethane are available.

When properly used, latex and polyurethane condoms are effective against most STDs. Condoms do not protect against infections spread from sores on the skin not covered by a condom (such as the base of the penis or scrotum). For those having sex, condoms must always be used to protect against STDs even when using another method of birth control.

Possible Side Effects

Most men and women have no problems using condoms. Side effects that can occasionally occur include:

  • allergy to latex condoms
  • irritation of the penis or the vagina from spermicides or lubricants that some condoms are treated with

Who Uses It?

Couples who are responsible enough to stop and put a condom on each time before sex and people who want protection against STDs use condoms. Because condoms are the only method of birth control currently available for men, they allow the guy to take responsibility for birth control and STD protection. Condoms are also a good choice for people who do not have a lot of money to spend on birth control.

How Do You Get It?

Condoms are available without a prescription and are sold in drugstores, supermarkets, and even vending machines (in some stores, they're in the "Family Planning" aisle). Condoms come in different sizes, textures, and colors.

How Much Does It Cost?

Condoms are the least expensive and most available method of birth control — other than abstinence, of course. Male condoms cost about $0.50 to $1 each and are less expensive when they are bought in boxes that contain several condoms.

In addition, many health centers and family planning clinics (such as Planned Parenthood) and some schools distribute them free of charge. Female condoms are a little more expensive and cost about $2 to $3 per condom.

Forms of democracy

Main article: Democracy (varieties)

[edit] Representative

Representative democracy involves the selection of government officials by the people being represented. The most common mechanisms involve election of the candidate with a majority or a plurality of the votes. Representatives may be elected or become diplomatic representatives by a particular district (or constituency), or represent the entire electorate proportionally proportional systems, with some using a combination of the two. Some representative democracies also incorporate elements of direct democracy, such as referendums. A characteristic of representative democracy is that while the representatives are elected by the people to act in their interest, they retain the freedom to exercise their own judgment as how best to do so.

[edit] Parliamentary democracy

Parliamentary democracy where government is appointed by parliamentary representatives as opposed to a 'presidential rule' by decree dictatorship. Under a parliamentary democracy government is exercised by delegation to an executive ministry and subject to ongoing review, checks and balances by the legislative parliament elected by the people. [7] [8] [9] [10] [11] [12] [13] [14]

[edit] Liberal democracy

A Liberal democracy is a representative democracy in which the ability of the elected representatives to exercise decision-making power is subject to the rule of law, and usually moderated by a constitution that emphasizes the protection of the rights and freedoms of individuals, and which places constraints on the leaders and on the extent to which the will of the majority can be exercised against the rights of minorities (see civil liberties).

[edit] Direct Democracy

Direct democracy is a political system where the citizens participate in the decision-making personally, contrary to relying on intermediaries or representatives. The supporters of direct democracy argue that democracy is more than merely a procedural issue (i.e., voting).[15] Most direct democracies to date have been weak forms, relatively small communities, usually city-states. However, some see the extensive use of referendums, as in California, as akin to direct democracy in a very large polity with more than 20 million in California, 1898-1998 (2000) (ISBN 0-8047-3821-1). In Switzerland, five million voters decide on national referendums and initiatives two to four times a year; direct democratic instruments are also well established at the cantonal and communal level. Vermont towns have been known for their yearly town meetings, held every March to decide on local issues.

[edit] Socialist Democracy

Socialist thought has several different views on democracy. Social democracy, democratic socialism, and the dictatorship of the proletariat (usually exercised through Soviet democracy) are some examples. Many democratic socialists and social democrats believe in a form of participatory democracy and workplace democracy combined with a representative democracy.

Within Marxist orthodoxy there is a hostility to what is commonly called "liberal democracy", which they simply refer to as parliamentary democracy because of its often centralized nature. Because of their desire to eliminate the political elitism they see in capitalism, Marxists, Leninists and Trotskyists believe in direct democracy implemented though a system of communes (which are sometimes called soviets). This system ultimately manifests itself as council democracy and begins with workplace democracy. (See Democracy in Marxism)

[edit] Anarchist Democracy

The only form of democracy considered acceptable to many anarchists is direct democracy. Some anarchists oppose direct democracy while others favour it. Pierre-Joseph Proudhon argued that the only acceptable form of direct democracy is one in which it is recognized that majority decisions are not binding on the minority, even when unanimous.[16] However, anarcho-communist Murray Bookchin criticized individualist anarchists for opposing democracy,[17] and says "majority rule" is consistent with anarchism.[18] Some anarcho-communists oppose the majoritarian nature of direct democracy, feeling that it can impede individual liberty and opt in favour of a non-majoritarian form of consensus democracy, similar to Proudhon's position on direct democracy.[19]

[edit] Iroquois Democracy

Iroquois society had a form of participatory democracy and representative democracy.[20] Iroquois government and law was discussed by Benjamin Franklin[21] and Thomas Jefferson.[22] Because of this many scholars regard it to have influenced the formation of American representative democracy.[22] However scholars who reject multiculturalism disagree that the influence existed or was of any great importance.[23]

[edit] Sortition

Sometimes called "democracy without elections", sortition is the process of choosing decision makers via a random process. The intention is that those chosen will be representative of the opinions and interests of the people at large, and be more fair and impartial than an elected official. The technique was in widespread use in Athenian Democracy and is still used in modern jury selection. It is not universally agreed that sortition should be considered "democracy" due to the lack of actual elections[citation needed].

[edit] Consensus democracy

Consensus democracy requires varying degrees of consensus rather than just a mere democratic majority. It typically attempts to protect minority rights from domination by majority rule.


[edit] Interactive Democracy

Interactive Democracy seeks to utilise information technology to involve voters in law making. It provides a system for proposing new laws, prioritising proposals, clarifying them through parliament and validating them through referendum.

Democracy (disambiguation)

Voting is an important part of the democratic process.
Voting is an important part of the democratic process.

In political theory, democracy describes a small number of related forms of government and also a political philosophy. A common feature of democracy as currently understood and practiced is competitive elections. Competitive elections are usually seen to require freedom of speech, freedom of the press, and some degree of rule of law. Civilian control of the military is often seen as necessary to prevent military dictatorship and interference with political affairs. In some countries, democracy is based on the philosophical principle of equal rights.

"Majority rule" is a major principle of democracy, though many democratic systems do not adhere to this strictly—representative democracy is more common than direct democracy, and minority rights are often protected from what is sometimes called "the tyranny of the majority". Popular sovereignty is common but not a universal motivating philosophy for establishing a democracy.

No universally accepted definition of 'democracy' exists, especially with regard to the elements in a society which are required for it.[1] Many people use the term "democracy" as shorthand for liberal democracy, which may include additional elements such as political pluralism, equality before the law, the right to petition elected officials for redress of grievances, due process, civil liberties, human rights, and elements of civil society outside the government. In the United States, separation of powers is often cited as a supporting attribute, but in other countries, such as the United Kingdom, the dominant philosophy is parliamentary sovereignty (though in practice judicial independence is generally maintained). In other cases, "democracy" is used to mean direct democracy.

Though the term "democracy" is typically used in the context of a political state, the principles are also applicable to private organizations and other groups. Democracy has its origins in Ancient Greece, Ancient Rome, Europe, and North and South America [2] but modern conceptions are significantly different. Democracy has been called the "last form of government" and has spread considerably across the globe.[3] Suffrage has been expanded in many jurisdictions over time from relatively narrow groups (such as wealthy men of a particular ethnic group), but still remains a controversial issue with regard disputed territories, areas with significant immigration, and countries that exclude certain demographic groups.

The Ear

The ear is the sense organ that detects sounds. The vertebrate ear shows a common biology from fish to humans, with variations in structure according to order and species. It not only acts as a receiver for sound, but plays a major role in the sense of balance and body position. The ear is part of the auditory system.

The word "ear" may be used correctly to describe the entire organ or just the visible portion. In most animals, the visible ear is a flap of tissue that is also called the pinna. The pinna may be all that shows of the ear, but it serves only the first of many steps in hearing and plays no role in the sense of balance. In people, the pinna is often called the auricle. Vertebrates have a pair of ears, placed symmetrically on opposite sides of the head. This arrangement aids in the ability to localize sound sources.

Heart Attack Symptoms and Warning Signs

If you think you're having a heart attack, call 9-1-1 or your emergency medical system immediately.

Some heart attacks are sudden and intense — the "movie heart attack," where no one doubts what's happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren't sure what's wrong and wait too long before getting help. Here are signs that can mean a heart attack is happening:

  • Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
  • Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
  • Shortness of breath. May occur with or without chest discomfort.
  • Other signs: These may include breaking out in a cold sweat, nausea or lightheadedness

As with men, women's most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.

If you or someone you're with has chest discomfort, especially with one or more of the other signs, don't wait longer than a few minutes (no more than 5) before calling for help. Call 9-1-1... Get to a hospital right away.

Calling 9-1-1 is almost always the fastest way to get lifesaving treatment. Emergency medical services staff can begin treatment when they arrive — up to an hour sooner than if someone gets to the hospital by car. The staff are also trained to revive someone whose heart has stopped. You'll also get treated faster in the hospital if you come by ambulance.

If you can't access the emergency medical services (EMS), have someone drive you to the hospital right away. If you're the one having symptoms, don't drive yourself, unless you have absolutely no other option.

How do I know if a heart attack has occurred?

A doctor who's studied the results of several tests must diagnose a heart attack. The doctor will

  • review the patient's complete medical history.
  • give a physical examination.
  • use an electrocardiogram (e-lek"tro-KAR'de-o-gram) (ECG or EKG) to discover any abnormalities caused by damage to the heart. An ECG is a medical device that makes a graphical record of the heart's electrical activity.
  • sometimes use a blood test to detect abnormal levels of certain enzymes in the bloodstream.

Blood tests confirm (or refute) suspicions raised in the early stages of evaluation that may occur in an emergency room, intensive care unit or urgent care setting. These tests are sometimes called heart damage markers or cardiac enzymes.

Related AHA publications:

The Effect of LSD on the Human Brain

Anna Bacon
Heather Cagle
Paul Mikowski
Michael Rosol

Abstract

    This paper will explore the link between the microscopic world of neurons and neurotransmitters and the macroscopic physiological effects of LSD on the human subject. Both the actions of synapses and the outward behavioral and physical effects of LSD are well known, but the fundamental connection between these two phenomena is still a mystery to science.

Introduction

    In order to have any hope of understanding the complex biological action that LSD has on the human brain and our sense of perception, one must first appreciate the mechanics that lie beneath both neurotransmitters and neurons themselves. In the body, the brain and spinal cord make up what is known as the central nervous system, or the CNS. Each neuron in the human body connects to other neurons and communicates with them by means of electrical signals. These electrical signals must first pass between the small gap between neurons before it can be transmitted. The gaps between neurons are known as synapses. Messages constantly pass through the synapses between our neurons, and these messages allow us to sense, to think, and to act upon these feelings and thoughts. There are two main types of synapses: chemical and electrical. In chemical synapses, which are by far the more common, electrical signal pass from neuron to neuron through the use of mediating chemicals known as neurotransmitters. In electrical synapses, the neurons are in electrical contact with one another, and no intermediate chemicals are needed.

    To truly understand the critical action of the neurons, we must investigate the chemical synapse at a microscopic level. The cell that is attempting to transmit the message, or impulse, is known as the pre-synaptic cell, and the cell receiving the impulse is known as the post-synaptic cell. When the pre-synaptic cell attempts to transmit an impulse, it first releases the neurotransmitter chemical through its outer membrane and into the synapse. The strength of the impulse determines to a certain extent the amount of neurotransmitter released. If this neurotransmitter is present in sufficient quantities, then it is absorbed by the post-synaptic cell, and this cell becomes more able to receive the impulse.

    At this point, one may wonder exactly how this neurotransmitter makes the post-synaptic cell more receptive. This question is closely related to the method in which neurons accept and receive impulses. Each neuron involved in the transmission of impulses can be approximated as a container of negatively charged ions (like Cl-) sealed off from the environment, which is a sea of positively charged ions (like K+ and Na+). The cell "fires," or transmits an impulse to its related post-synaptic neurons when certain channels open up on the outer membrane of the neuron. This firing of the neuron is known as setting up of an action potential. When the channels on the neuron open, these channels allow a certain amount of positively charged ions into the cell. This movement of charge sets up a current which becomes the impulse. Certain factors influence when and how often these channels open. If the cell in question is a sensory one, like in the tips of our fingers, tactile, pressure, or temperature stimulation will cause the cells to "fire." If the cell is an interneuron, which transmits impulses from the CNS to the PNS, then action potentials will most likely arise from an impulse sent from a pre-synaptic cell. What neurotransmitters do is they change the permeability of the post-synaptic neuron's membrane, so that these channels on the membrane become either easier to open, or more difficult to open, and in turn, it is then simpler or more difficult for Na+ and K+ ions to enter, which then changes how easily it is for the cell to generate an action potential.

    The two kinds of neurotransmitters that exist are excitory and inhibitory. Excitory neurotransmitters make it easier for the cell to allow positive ions in, and therefore decrease the threshold, or the smallest stimulation that will cause the cell to generate an impulse. Inhibitory neurotransmitter, on the other hand, make the neuron's membrane more permeable to negative ions, and increase the threshold.

    The cell ceases to fire once there is no charge difference across the membrane, once the original pre-synaptic cell absorbs the neurotransmitter, once enzymes degrade the neurotransmitter, or once the amount of neurotransmitter diffuses down to almost nothing. Once the cell has fired, there is a certain period of time that exists before that cell can again generate an action potential. This time period is known as the refractory period. During this time, the charge inside the cell is nearly equal to the charge outside the cell, and it requires a great deal of stimulus to make this cell fire again. It is for this reason that many stimuli seem to fade if we are subjected to them several times within a reasonably short period. Certain neurotransmitters, like norepinephrine, instead of changing the threshold potentials, instead decrease the refractory period, resulting in neurons firing several action potentials for each stimulation.

    Finally, yet another method of action of neurotransmitters is much more subtle. In this case, the neurotransmitters alter the neurotransmitter receptor sites on the post-synaptic neuron. Molecules that make it easier for the post-synaptic cell to be influenced by neurotransmitters are known as agonists, and those that make it more difficult are known as antagonists. For example, an antagonist that makes a cell less responsive to an inhibitory neurotransmitter would cause an excitory response.

    In order to translate this information to the macroscopic world, it is important to understand that many of the mind-altering drugs in use today, are psychologically active because they mimic or affect the production of the neurotransmitters that our body naturally produces. Our neurons are constantly receiving stimuli from the outside world. The vast majority of these stimuli are too weak to actually set up an action potential, and of those that set up a local action potential, fewer still are strong enough to be noticed by our conscious mind. If hallucinogens in a person's system lower the threshold at which our nerves fire, then these very weak stimuli, which the person without the drug would not even notice, will form a false image. Therefore, the over-active mind will create vivid hallucinations out of amplified stimuli from the ordinary world.

Principles

    Serotonin and LSD

    Though the precise biochemical action of hallucinogens is unknown, it is believed that it probably stems from a complex reaction with serotonin (5-HT) from the cortex to the spinal cord. In fact, LSD seems to closely resemble serotonin in structure. Thus, the study of serotonin reveals a great deal about LSD.

    Though located in many cells throughout the body, it is the serotonin of the nervous system that concern the actions of LSD. It exists mainly in the Locus Coeruleus and Raphe Nuclei, or the midline of the upper brain stem. It is here that the chemical is believed to play a large role in moderating behaviors and moods. Anti-social personality disorders, violence, and impulsive behavior have been connected with its lowering. Severe depression and suicidal states are also connected to a low serotoin activity, while high serotonin corresponds to alertness.

    These facts can be traced back to serotonin's importance in 'language'; that is in hearing, seeing words or objects, and motor (including voice) control. It plays this role by breaking sensory relay and exciting motor relay from the brain. The release of serotonin in doing this is self-regulating. As it is released by the synapses, it prevents further release.

    Given this information, and knowing the effect of LSD and other hallucinogenic drugs, a connection should not seem surprising. In fact, LSD, along with psilocin, and DMT, contain indole rings very similar in makeup to those of serotonin. It is this similarity that allows LSD to mimic the serotin at the receptors and inhibit the firing of the serotonergic neurons.

    The actions of serotonin(5-HT) and the effects of LSD on the human subject are inextricably linked. The neurological pathways that allow serotonin to regulate so many of the body's activities are the same ones that allow the LSD molecule to so profoundly affect the body. The true frontiers of chemistry lie here, in the serotonergic neurons and the bodies' response to the disruption of the normal pathways. As of now, there is still great confusion over how LSD affects the neurons, especially at the synaptic level.

    It is important to first understand the workings of the neurotransmitters and the receptors involved with the 5-HT response in order to have a meaningful discussion of the different theories involving LSD action. Both the pre-synaptic and post-synaptic neurons contain receptors that allow neurotransmitters to modulate their activity. This modulation can take the form of a change in membrane permeability or a change in that neuron's production of a neurotransmitter.

    On the serotonin neurons themselves, there seem to be two main types of receptors to which LSD and 5-HT both can attach. The two types are known the 5HT1 receptors, usually part of pre-synaptic neurons and the 5HT2 receptors, which are usually on the post-synaptic neuron. When a molecule becomes chemically attached to 5HT1 receptors of the serotonin producing neurons, the neuron slows or stops its production of serotonin, creating a negative feedback loop, where excess serotonin will halt further production. When a molecule binds to the 5HT2 receptors, the post-synaptic neuron is inhibited, and it is more difficult for it to generate an action potential. Apparently, serotonin will attach itself to either of these two receptors with equal frequency, but it has been proposed that LSD prefers the 5HT1 type to the 5HT2 type.

    Among researchers, much importance is placed on the effects of LSD in the Raphe Nuclei, because it is a small area of the brain which contains most of the brain's serotonergic cells. Part of the function of the RN is postulated to be the protection of the brain from over-stimulation and sensory overload. It is also connected to many other areas of the brain, which if LSD action is truly based in the RN, would explain how such small doses can create such wide-ranging sensory and hallucinatory effects. As stated before, researchers are still working to discover exactly how LSD interacts with serotonin. While no one is sure as to the nature of this interaction, there are several theories that are still being tested today.

The description of the area of cutting edge work

    The first postulated mechanism for the action of LSD involved its theorized affinity for pre-synaptic 5HT1 receptors. It was believed that the presence of LSD would flood the 5HT1 receptors, which would, in turn, force the serotonergic pre-synaptic neuron to cease serotonin production. This would lead to an increase in post-synaptic activity. All effects of LSD were believed to have their roots in this theorized suppression of serotonin.

    The largest debate that still exists today involves the action of LSD on the 5HT2 receptors. The biggest question is whether LSD inhibits the 5HT2 receptors' uptake of serotonin, or whether it facilitates that uptake. In other words, they are trying to determine whether it is agonistic or antagonistic. For a great while, there was convincing evidence for both sides of the antagoinist/agonist argument and the researchers in the field lined up on both sides with seemingly contradictory evidence.

    The newest theory attempts to resolve this debate without going against the accumulated evidence. In this case, it is theorized that LSD is only a partial agonist. According to this explanation of LSD action, the LSD molecule is more attracted to the post-synaptic 5HT2 receptors than the 5HT molecule. Once attached to the 5HT2 receptor, LSD can cause the same effect as normal serotonin (the damping of post-synaptic neural activity), but it does so much less effectively than serotonin. Thus, in experiment where the synapses being tested were devoid of the natural serotonin, LSD appeared to be agonistic and functioned as serotonin. However, when the experiments judged the activity of LSD against the normal activity of serotonin, the LSD, with the higher receptor affinity, blocked the serotonin, and the system behaved as if serotonin was reduced, because the less effective LSD was acting instead of the more effective LSD. This theory of LSD acting as an antagonist or as an agonist seems to be the most promising, but much more conclusive research needs to be conducted.

    Neurobiologists study brain function at the level of neurons while psychologists look for the laws describing behavior and cognitive mechanisms. Many in these fields believe that it is possible that one day we will be able to understand complicated behaviors in terms of neuronal mechanisms. While research on the level of neurons and psychological mechanisms is fairly well developed, the area in between these is rather unclear. However, some progress has been made. Cognitive scientists have been able to associate mechanisms with areas of the brain and have also been able to describe the effects on these systems by various neurotransmitters. The lack of knowledge in the middle ground between neurobiology and psychology makes a description of the mechanisms of hallucinogens necessarily coarse. A brief exploration of the possible mechanisms of LSD will ensue, along with a deeper look at the more developed studies of the mechanisms on a neuronal level.

    Researchers have attempted to identify the mechanism of LSD through three different approaches: comparing the effects of LSD with the behavioral interactions already identified with neuotransmitters, chemically determining which neurotransmitter and receptors LSD interacts with, and identifying regions of the brain that could be responsible for a wide variety of effects.

    Initial research found that LSD structurally resembled serotonin (5-HT). 5-HT is implicated in the regulation of many systems known to be effected by LSD. This evidence indicates that many of the effects of LSD are through serotonin mediated pathways. Subsequent research revealed that LSD not only has affinities for 5-HT receptors but also for receptors of histamine, ACh, dopamine, and the catecholines: epinephrine and norepinephrine.

    Two areas of the brainstem that are thought to be involved in LSD’s pathway are the Locus Coeruleus (LC) and the Raphe Nuclei. The LC is a small cluster of norepinephrin containing neurons in the pons beneath the 4th ventricle. It is responsible for the majority of norepinephrine neuronal input in most brain regions. While norepinephrine activity throughout the brain is mainly mediated by the LC, the majority of serotonergic neurons are located in the Raphe Nuclei (RN). The RN is located in the middle of the brainstem from the midbrain to the medulla. Along with the LC, the RN is part of the ascending reticular activating system. 5-HT inhibits ascending traffic in the reticular system; perhaps protecting the brain from sensory overload. It is also believed that post-synaptic 5-HT receptors in the visual areas are inhibited. It is apparent that an interruption of 5-HT activity would result in the excitation of various sensory modalities.

    Current thought is that the mechanism of LSD is related to the regulation of 5-HT activity in the RN. However, the RN is also influenced by GABAergic, catecholamergic, and histamergic neurons. LSD has been shown to also have affinities for many of these receptors. Thus it is possible that some of its effects may be mediated through other pathways. Current research has focused on the effects of LSD on 5-HT activity.

Current related work

The current focus of much of today’s research on LSD is whether it is an agonist or an antagonist. Molecules that excite receptors are labeled agonists, while molecules that inhibit the action and interfere with the binding of the receptor are known as antagonists. Pierce and Peroutka have argued that LSD has a number of antagonistic properties. They observed that spiperone, a 5-HT antagonist doesn’t block the behavior of LSD. Another piece of evidense is that radio ligand binding studies have shown that the affinity of a 5-HT2 receptor agonist is pH dependent while the affinity of 5-HT2 receptor antagonist is pH independent. The action and effects of LSD is pH independent. (Peroutka & Pierce 1990)

This study also looked at 5-HT2 receptors that are connected to a phosphatidylinositol (PI) second messenger system. PI turnover rate has been found to be stimulated by 5-HT and the reverse is true for 5-HT2 antagonists. LSD doesn’t stimulate PI turnover. This was a further example of antagonistic behavior by LSD.

Also observed in this study was the excitement of central nervous system neurons by 5-HT receptors. This was caused by a decrease in K+ conductance which can be attributed to the activation of 5-HT2 receptors. LSD was shown to inhibit CNS neurons, again displaying antagonistic tendencies.

While these scientists seem to have created a credible argument on the antagonistic properties of LSD, subsequent studies have leaned in the opposite direction. Glennon has developed a number of counterpoints to Pierce and Peroutka’s evidense. He studied the effects of LSD on the PI turnover rate at differing doses. This yielded vastly different results due to the fact that LSD has biphasic responses. That is it illicits the opposite effects at low doses as those at high doses. (Glennon 1990) This study indicated that LSD acts as a partial agonist. The LSD produced approximately twenty five percent of the PI turnover as was observed to be produced by 5-HT. From this, it can be concluded that LSD has a higher affinity for 5-HT receptors than 5-HT, but a lower efficacy. If LSD acts as a partial agonist with low efficacy, it could compete with 5-HT for 5-HT2 receptors. However, since 5-HT is a more potent agonist than LSD, the agonistic tendencies of LSD are masked and it appears to behave antagonistically.

Glennon also observed the effects of LSD on platelet aggregation. This action is affected by 5-HT2 mechanisms. Hallucinogens, such as LSD, were shown to be antagonized by 5-HT2 antagonists, such as keratin, in the presence of platelet aggregation. This also supports the argument that LSD is agonistic.

The Heffter Organization is currently working to sponsor a new study in Zurich, Switzerland and La Jolla California. They will study the interaction of LSD and keratin. The project will combine state-of-the-art psychological, brain imaging, and psychophysiological methods to explore the mechanisms of action and sites of keratin in humans. Human subjects will be used for the first time. The volunteers will be treated with psychedelic agents, such as LSD, and another drug whose corresponding receptors are known. Drug effects will be monitored using psychological scales of altered states of consciousness, flourodeoxyglucose Position Emission Tomography (PET) imaging of the metabolic activities of various parts of the brain, and psychophysiological measures of information processing and attention filtering. The PET studies will enable the determination of which areas of the human brain are activated or inactivated. This in turn will tell whether the drug in an agonist or antagonist. Glennon also observed that the relationship between LSD and 5-HT2a and 5-HT2c receptors is like that between 5-HT1 and 5-HT2 receptors. 5-HT1 receptors antagonize the 5-HT2 receptors. His study showed that LSD had an affinity for 5-HT2a and 5-HT2c sites and is antagonized by 5-HT1. This is evidense that LSD is agonistic.

The Fishberg Research Center in Neurobiology at Mount Sinai School of Medicine did a study this year mapping the binding sites of the 5-HT2a receptor. They tested the interaction between LSD and the receptor binding sites. They used site directed mutagenesis of serine Ser3.36(159)-->Ala and Ser3.36(159)-->Cys The results showed that the affinity of LSD to the 5-HT2a site was unaffected by the mutation.

The Heffter Organization is sponsoring another upcoming study of the effects of LSD. David L. Nichols, Ph.D. will try to develop receptor binding profiles for lysergamides that have been tested in humans. This will attempt to derive correlations between pharmacological effects and affinity for particular receptors. Statistical tests will be used to determine which receptors are most likely to attract LSD. As related in the above paragraph, current research indicates that it will have an affinity for 5-HT2a, but an interaction at one or more of the other receptors may be contributing to the exceptional potency of LSD

Heat and Sun Illnesses Beat the Heat!

There are between 175 and 1250 heat deaths each year in the United States. Most of these deaths result from a general lack of knowledge about how and when heat injuries occur and how they should be treated.

The heat is on
Our bodies produce and maintain heat, even in excessively hot conditions. Our natural method for cooling off is sweat, which is best evaporated by low humidity and wind. But stagnant, humid air makes sweating (cooling) less effective. As our cooling sytem begins to fail, our body (much like a car) begins to overheat, which can lead to heat stroke or heat exhaustion.

What is heat stroke?
Heat stroke is the most serious of heat illnesses and is caused by a body temperature of 105° F or more, where your bodily cooling process fails; mental impairment and death can result. Most cases occur without warning, and a few cases progress from lesser heat injuries, such as heat exhaustion. The classic signs (fever, sluggishness, confusion, and hot and dry skin) may not be present. Heat stroke can damage vital organs, such as the liver, kidneys, and brain.

There are two categories of heat stroke: classic heat stroke and exertional heat stroke. Classic heat stroke mostly affects the elderly, chronically ill, those who do not exercise, and people taking certain medications (such as psychiatric drugs, decongestants, some blood pressure pills, diuretics, and antihistamines). This type of heat stroke is seen during heat waves in unaccustomed areas.

Exertional heat stroke occurs mostly in younger individuals who are strenuously exercising or working in hot conditions. This type of heat stroke results from increased heat production and may cause organ damage.

How do I treat heat stroke?
Treatment of heat stroke involves rapid cooling of body temperature to less than 102.2° F. Evaporative cooling is best: a large fan blows while lukewarm water is sprayed or sponged over the victim. Immersion in an ice-water bath is an alternate. If the victim is far from a health care facility, he or she should be removed from the hot environment and placed in shade or a cool shelter. Unnecessary clothing is removed, and the victim is sprayed with lukewarm water and fanned. If available, ice packs may be placed in the groin and armpits, where large blood vessels act as cooling radiators.

Preventing heat injuries
Most heat injuries can be prevented by knowing the risk factors. They include dehydration, heavy clothing, prolonged exertion (athletics, military exercises, outdoor work), poor conditioning, lack of adaptation, obesity, sleep deprivation, alcohol, poor living conditions, aging, chronic (long-lasting) disease, saunas, and some medications. A major risk factor is a prior heat stroke, which makes you more susceptible to having another one.

Dehydration is avoided by drinking cool water before and during heat exposure (11/2 to 2 cups before, then 1 cup every 20 minutes during heat exposure). Sports drinks that are too sweet, which can interfere with fluid absorption, may be diluted to half strength by adding water. Work and rest cycles can prevent overexertion. During summer sport training programs, the hydration of athletes should be monitored with practice weigh-ins and weigh-outs; athletes who have lost excess water weight (2-3% of body weight) are at higher risk for a heat injury. Despite popular belief, salt tablets should be avoided. Clothing should be loose, breathable, and light in color, and activities should be planned for cooler morning or evening hours whenever possible.

Acclimatization through gradual, daily exposure to heat reduces most forms of heat illness. This natural adaptation takes 10 to 14 days and allows your body to cool off more efficiently. The effects are not permanent, however, and modest continued exposure is needed to maintain them.

Minor heat illnesses, such as heat cramps (cramps in large working muscles), heat edema (swollen feet or ankles), and heat syncope (fainting), do not cause lasting effects and are usually avoided by limiting exposure and becoming acclimatized.

Heat exhaustion
Heat exhaustion, although not as dangerous as heat stroke, is a serious injury. It can progress to heat stroke if not treated immediately. Heat exhaustion itself does not cause damage to vital organs, nor does it cause mental impairment. The body temperature of someone suffering from heat exhaustion is less than 102°F. Symptoms include sweating, headache, dizziness, nausea and vomiting, muscle weakness, cramps, and blurry vision. Dehydration and chronic salt depletion can cause this illness.

How do I treat heat exhaustion?
First, the victim is removed from the hot environment. Then, the victim is cooled off, as with heat stroke. Finally, fluids must be replenished.

Sun illnesses
Our sun emits radiation, and fortunately most harmful radiation is absorbed by the atmosphere. Of the remaining radiation, ultraviolet radiation (UVR) causes the most problems. UVR levels are highest during summer months, especially between 9:00 a.m. and 3:00 p.m. UVR passes through clouds, even causing sunburn on a cloudy day. Environmental factors such as snow, sand, and water reflect UVR and can increase exposure.

There are two main types of UVR: UV A and UV B. UV A causes tanning and had been regarded as safe; however, recent studies suggest that prolonged exposure can lead to cataracts. UV B is more harmful and is responsible for most skin injuries.

How does UVR affect me?
Sunburn is the most common reaction to UVR exposure, resulting in reddened, painful, and blistered skin. The skin cells suffer short-term damage, but repeated exposures can also lead to skin thickening, discoloration, wrinkles, and cancer. Sunburn can occur after just 20 minutes of exposure in peak conditions. Individuals with different skin types have different responses to UVR. Light-skinned persons tend to burn easily, while dark-skinned persons do not.

Snow blindness (photokeratitis) is sunburn of the eye. This painful condition is caused by the heightened exposure from the reflective surface of snow, sand, or water. It usually occurs at higher altitudes, but can affect people who live near a body of water. Snow blindness is temporary, but sun exposure over the years can lead to a cataract (hardening of the eye's lens). Intense light conditions (such as staring at an eclipse) can irreversibly damage the retina (back part) of the eye and cause vision loss.

How can I limit UVR exposure?
Protective clothing (such as long-sleeve shirts and hats) and avoiding peak sunlight hours of 9:00 a.m. to 3:00 p.m. are recommended. Sunscreens help by absorbing UVR before it penetrates into the skin to cause damage. Sun Protection Factor (SPF) is a scale that rates effectiveness; the higher the number, the more protection. Various products resist sweat and water to different degrees. Sunscreen of at least SPF 15 should be worn on exposed areas and reapplied according to the instructions. Sun damage begins in childhood and is cumulative; therefore, children should always be protected. Although sunscreen does offer some protection, you should not spend endless time in the sun.

The best way to protect your eyes is to wear polarized sunglasses. Polarized sunglasses filter out UVR and should be worn for most outdoor activities (including driving). These glasses may reduce the long-term risk of cataracts. "Glacier" glasses with side shields are recommended for high-intensity snow or sea conditions. Non-polarized glasses are dangerous; they trick the eye into an illusion of less light, but do not block harmful radiation.

Heat and sun illnesses are serious. By taking a few preventive measures, however, you can continue to enjoy the outdoors and cut down on the risk of injury.