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149-470: Pemoline , formerly sold under the brand name Cylert among others, is a stimulant medication which has been used in the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy . It has been discontinued in most countries due to rare but serious problems with liver toxicity . The medication was taken by mouth . Side effects of pemoline include insomnia , decreased appetite , abdominal pain , irritability , and headaches . Rarely,

298-430: A norepinephrine-dopamine reuptake inhibitor (NDRI), by blocking the norepinephrine transporter (NET) and the dopamine transporter (DAT). Methylphenidate has a higher affinity for the dopamine transporter than for the norepinephrine transporter, and so its effects are mainly due to elevated dopamine levels caused by the inhibited reuptake of dopamine, however increased norepinephrine levels also contribute to various of

447-403: A substituted amphetamine and consequently, a substituted phenethylamine . Major stimulant classes include phenethylamines and their daughter class substituted amphetamines . Substituted amphetamines are a class of compounds based upon the amphetamine structure; it includes all derivative compounds which are formed by replacing, or substituting , one or more hydrogen atoms in

596-755: A 1995 publication on liver toxicity with pemoline. However, findings suggested that clinicians poorly followed the FDA's directives on use of pemoline. In any case, sales of pemoline in the United States increased until 1997 and declined between 1996 and 1999. Pemoline was withdrawn due to liver toxicity in the United Kingdom in September 1997, in Canada in September 1999, and in the United States in 2005. Abbott Laboratories voluntarily withdrew pemoline from

745-638: A benzyloxy connected to the 3 carbon of a tropane . Various modifications include substitutions on the benzene ring , as well as additions or substitutions in place of the normal carboxylate on the tropane 2 carbon. Various compound with similar structure activity relationships to cocaine that aren't technically analogs have been developed as well. Most stimulants exert their activating effects by enhancing catecholamine neurotransmission. Catecholamine neurotransmitters are employed in regulatory pathways implicated in attention, arousal, motivation, task salience and reward anticipation. Classical stimulants either block

894-408: A biopsy of nervous tissue is taken from the brain or spinal cord to aid in diagnosis. Biopsy is usually requested after a mass is detected by medical imaging . With autopsies, the principal work of the neuropathologist is to help in the post-mortem diagnosis of various conditions that affect the central nervous system. Biopsies can also consist of the skin. Epidermal nerve fiber density testing (ENFD)

1043-446: A combination known as general pathology. Cytopathology (sometimes referred to as "cytology") is a branch of pathology that studies and diagnoses diseases on the cellular level. It is usually used to aid in the diagnosis of cancer, but also helps in the diagnosis of certain infectious diseases and other inflammatory conditions as well as thyroid lesions, diseases involving sterile body cavities (peritoneal, pleural, and cerebrospinal), and

1192-438: A conclusive diagnosis, and a skin biopsy is taken to be examined under the microscope using usual histological tests. In some cases, additional specialized testing needs to be performed on biopsies, including immunofluorescence , immunohistochemistry , electron microscopy , flow cytometry , and molecular-pathologic analysis. One of the greatest challenges of dermatopathology is its scope. More than 1500 different disorders of

1341-429: A drug allows its user to run faster, lift heavier, or last longer, it is said to have ergogenic effects. Drugs such as ephedrine, pseudoephedrine, amphetamine and methylphenidate have well documented ergogenic effects, while cocaine has the opposite effect. Neurocognitive enhancing effects of stimulants, specifically modafinil , amphetamine and methylphenidate have been reported in healthy adolescents by some studies, and

1490-571: A drug can elicit activating effects. Caffeine is an adenosine receptor antagonist , and only indirectly increases catecholamine transmission in the brain. Pitolisant is an histamine 3 (H 3 )-receptor inverse agonist . As histamine 3 (H 3 ) receptors mainly act as autoreceptors , pitolisant decreases negative feedback to histaminergic neurons, enhancing histaminergic transmission. The precise mechanism of action of some stimulants, such as modafinil, for treating symptoms of narcolepsy and other sleep disorders, remains unknown. Amphetamine

1639-447: A far greater risk of serious side effects, such as dependence, which only rarely arises with therapeutic amphetamine use. Caffeine is a stimulant compound belonging to the xanthine class of chemicals naturally found in coffee , tea , and (to a lesser degree) cocoa or chocolate . It is included in many soft drinks , as well as a larger amount in energy drinks . Caffeine is the world's most widely used psychoactive drug and by far

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1788-525: A fixative that stabilizes the tissues to prevent decay. The most common fixative is formalin , although frozen section fixing is also common. To see the tissue under a microscope, the sections are stained with one or more pigments. The aim of staining is to reveal cellular components; counterstains are used to provide contrast. Histochemistry refers to the science of using chemical reactions between laboratory chemicals and components within tissue. The histological slides are then interpreted diagnostically and

1937-549: A formal area of specialty was not fully developed until the late 19th and early 20th centuries, with the advent of detailed study of microbiology . In the 19th century, physicians had begun to understand that disease-causing pathogens, or "germs" (a catch-all for disease-causing, or pathogenic, microbes, such as bacteria , viruses , fungi , amoebae , molds , protists , and prions ) existed and were capable of reproduction and multiplication, replacing earlier beliefs in humors or even spiritual agents, that had dominated for much of

2086-1065: A four-year period found that there were few negative effects of stimulant treatment, but stressed the need for longer-term studies. A review of a year long period of prescription stimulant use in those with ADHD found that cardiovascular side effects were limited to transient increases in blood pressure only. However, a 2024 systematic review of the evidence found that stimulants overall improve ADHD symptoms and broadband behavioral measures in children and adolescents, though they carry risks of side effects like appetite suppression and other adverse events. Initiation of stimulant treatment in those with ADHD in early childhood appears to carry benefits into adulthood with regard to social and cognitive functioning, and appears to be relatively safe. Abuse of prescription stimulants (not following physician instruction) or of illicit stimulants carries many negative health risks. Abuse of cocaine, depending upon route of administration, increases risk of cardiorespiratory disease, stroke , and sepsis . Some effects are dependent upon

2235-471: A general examination or an autopsy ). Anatomical pathology is itself divided into subfields, the main divisions being surgical pathology , cytopathology , and forensic pathology . Anatomical pathology is one of two main divisions of the medical practice of pathology, the other being clinical pathology, the diagnosis of disease through the laboratory analysis of bodily fluids and tissues. Sometimes, pathologists practice both anatomical and clinical pathology,

2384-399: A large driver of drowsiness and sleep, and their action increases with extended wakefulness. Caffeine has been found to increase striatal dopamine in animal models, as well as inhibit the inhibitory effect of adenosine receptors on dopamine receptors, however the implications for humans are unknown. Unlike most stimulants, caffeine has no addictive potential. Caffeine does not appear to be

2533-422: A marker for liver toxicity, though serious cases are rare. Over 200,000 children with ADHD were prescribed pemoline in the United States and Canada alone during the approximate 25 years that it was available, plus a smaller number of adults prescribed it for other indications (and not including prescriptions in the rest of the world). As such, the number of liver failure cases was statistically not that large. However

2682-437: A number of visual and microscopic tests and an especially large variety of tests of the biophysical properties of tissue samples involving automated analysers and cultures . Sometimes the general term "laboratory medicine specialist" is used to refer to those working in clinical pathology, including medical doctors, Ph.D.s and doctors of pharmacology. Immunopathology , the study of an organism's immune response to infection,

2831-480: A pathologist generally requires specialty -training after medical school , but individual nations vary some in the medical licensing required of pathologists. In the United States, pathologists are physicians ( D.O. or M.D. ) who have completed a four-year undergraduate program, four years of medical school training, and three to four years of postgraduate training in the form of a pathology residency . Training may be within two primary specialties, as recognized by

2980-607: A prescription due to a possible increased risk of stroke in younger women. In a few countries in Europe, however, it is still available either by prescription or sometimes over-the-counter. In Canada, it was withdrawn from the market on 31 May 2001. In India, human use of PPA and its formulations were banned on 10 February 2011. Pathology As a field of general inquiry and research, pathology addresses components of disease: cause, mechanisms of development ( pathogenesis ), structural alterations of cells (morphologic changes), and

3129-471: A reinforcing stimulus, and some degree of aversion may actually occur, per a study on drug abuse liability published in an NIDA research monograph that described a group preferring placebo over caffeine. In large telephone surveys only 11% reported dependence symptoms. However, when people were tested in labs, only half of those who claim dependence actually experienced it, casting doubt on caffeine's ability to produce dependence and putting societal pressures in

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3278-416: A significant portion of all general pathology practice is concerned with cancer , the practice of oncology makes extensive use of both anatomical and clinical pathology in diagnosis and treatment. In particular, biopsy, resection , and blood tests are all examples of pathology work that is essential for the diagnoses of many kinds of cancer and for the staging of cancerous masses . In a similar fashion,

3427-425: A suspicious lesion , whereas excisional biopsies remove the entire lesion, and are similar to therapeutic surgical resections. Excisional biopsies of skin lesions and gastrointestinal polyps are very common. The pathologist's interpretation of a biopsy is critical to establishing the diagnosis of a benign or malignant tumor, and can differentiate between different types and grades of cancer, as well as determining

3576-459: A vast array of species, but with a significantly smaller number of practitioners, so understanding of disease in non-human animals, especially as regards veterinary practice , varies considerably by species. Nevertheless, significant amounts of pathology research are conducted on animals, for two primary reasons: 1) The origins of diseases are typically zoonotic in nature, and many infectious pathogens have animal vectors and, as such, understanding

3725-459: A wide range of other body sites. Cytopathology is generally used on samples of free cells or tissue fragments (in contrast to histopathology, which studies whole tissues) and cytopathologic tests are sometimes called smear tests because the samples may be smeared across a glass microscope slide for subsequent staining and microscopic examination. However, cytology samples may be prepared in other ways, including cytocentrifugation . Dermatopathology

3874-418: A wide variety of diseases, including those caused by fungi , oomycetes , bacteria , viruses , viroids , virus-like organisms, phytoplasmas , protozoa , nematodes and parasitic plants . Damage caused by insects , mites , vertebrate , and other small herbivores is not considered a part of the domain of plant pathology. The field is connected to plant disease epidemiology and especially concerned with

4023-545: Is metabolized in the liver . Its metabolites include pemoline conjugate, pemoline dione, mandelic acid, and unidentified polar metabolites. Pemoline is excreted mainly by the kidneys with around 50% excreted in unchanged form and only minor amounts present as metabolites. The elimination half-life of pemoline is 7 to 12   hours. The half-life is 7   hours in children but may increase to 11 to 12   hours with age. The relatively long half-life of pemoline allows for once-daily administration. No differences in

4172-419: Is a psychoactive drug of the phenethylamine and amphetamine chemical classes that is used as a stimulant, decongestant , and anorectic agent. It is commonly used in prescription and over-the-counter cough and cold preparations . In veterinary medicine , it is used to control urinary incontinence in dogs under trade names Propalin and Proin. In the United States, PPA is no longer sold without

4321-479: Is a synthetic stimulant drug of the amphetamine and cathinone classes. Slang names include drone and MCAT. It is reported to be manufactured in China and is chemically similar to the cathinone compounds found in the khat plant of eastern Africa . It comes in the form of tablets or a powder, which users can swallow, snort, or inject, producing similar effects to MDMA , amphetamines , and cocaine . Mephedrone

4470-430: Is a commonly cited reason among illicit drug users for use, particularly among college students in the context of studying. Still, results of these studies is inconclusive: assessing the potential overall neurocognitive benefits of stimulants among healthy youth is challenging due to the diversity within the population, the variability in cognitive task characteristics, and the absence of replication of studies. Research on

4619-884: Is a euphoriant, empathogen , and stimulant of the amphetamine class. Briefly used by some psychotherapists as an adjunct to therapy, the drug became popular recreationally and the DEA listed MDMA as a Schedule I controlled substance , prohibiting most medical studies and applications. MDMA is known for its entactogenic properties. The stimulant effects of MDMA include hypertension , anorexia (appetite loss), euphoria , social disinhibition, insomnia (enhanced wakefulness/inability to sleep), improved energy , increased arousal, and increased perspiration , among others. Relative to catecholaminergic transmission, MDMA enhances serotonergic transmission significantly more, when compared to classical stimulants like amphetamine. MDMA does not appear to be significantly addictive or dependence forming. Due to

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4768-496: Is a more recently developed neuropathology test in which a punch skin biopsy is taken to identify small fiber neuropathies by analyzing the nerve fibers of the skin. This test is becoming available in select labs as well as many universities; it replaces the traditional nerve biopsy test as less invasive . Pulmonary pathology is a subspecialty of anatomic (and especially surgical) pathology that deals with diagnosis and characterization of neoplastic and non-neoplastic diseases of

4917-470: Is a niche indication and as clinicians are wary of the liver toxicity that it has been associated with. Under the Convention on Psychotropic Substances , it is a schedule IV controlled substance . Pemoline is Schedule IV Non-Narcotic (Stimulant) controlled substance with a DEA ACSCN of 1530 and is not subject to annual manufacturing quotas. Pemoline has been studied in and reported to be effective in

5066-446: Is a potent central nervous system (CNS) stimulant of the phenethylamine class that is approved for the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy . Amphetamine is also used off-label as a performance and cognitive enhancer , and recreationally as an aphrodisiac and euphoriant . Although it is a prescription medication in many countries, unauthorized possession and distribution of amphetamine

5215-445: Is a small piece of tissue removed primarily for surgical pathology analysis, most often in order to render a definitive diagnosis. Types of biopsies include core biopsies, which are obtained through the use of large-bore needles, sometimes under the guidance of radiological techniques such as ultrasound , CT scan , or magnetic resonance imaging . Incisional biopsies are obtained through diagnostic surgical procedures that remove part of

5364-467: Is a stimulant drug that is often used in the treatment of ADHD and narcolepsy and occasionally to treat obesity in combination with diet restraints and exercise. Its effects at therapeutic doses include increased focus, increased alertness, decreased appetite, decreased need for sleep and decreased impulsivity. Methylphenidate is not usually used recreationally, but when it is used, its effects are very similar to those of amphetamines. Methylphenidate acts as

5513-474: Is a stronger CNS stimulant than levomethamphetamine ; however, both are addictive and produce the same toxicity symptoms at high doses. Although rarely prescribed due to the potential risks, methamphetamine hydrochloride is approved by the United States Food and Drug Administration (USFDA) under the trade name Desoxyn . Recreationally, methamphetamine is used to increase sexual desire , lift

5662-428: Is a subspecialty of anatomic pathology that focuses on the skin and the rest of the integumentary system as an organ. It is unique, in that there are two paths a physician can take to obtain the specialization. All general pathologists and general dermatologists train in the pathology of the skin, so the term dermatopathologist denotes either of these who has reached a certain level of accreditation and experience; in

5811-421: Is addictive and dependence forming. Tobacco, the most common source of nicotine, has an overall harm to user and self score 3 percent below cocaine, and 13 percent above amphetamines, ranking 6th most harmful of the 20 drugs assessed, as determined by a multi-criteria decision analysis. Phenylpropanolamine (PPA; Accutrim; β-hydroxyamphetamine), also known as the stereoisomers norephedrine and norpseudoephedrine,

5960-404: Is also heavily, and increasingly, informed upon by neuroscience and other of the biological cognitive sciences . Mental or social disorders or behaviours seen as generally unhealthy or excessive in a given individual, to the point where they cause harm or severe disruption to the person's lifestyle, are often called "pathological" (e.g., pathological gambling or pathological liar ). Although

6109-534: Is also possible to take a Royal College of Pathologists diploma in forensic pathology, dermatopathology, or cytopathology, recognising additional specialist training and expertise and to get specialist accreditation in forensic pathology, pediatric pathology , and neuropathology. All postgraduate medical training and education in the UK is overseen by the General Medical Council. In France, pathology

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6258-411: Is considered a subfield of anatomical pathology. A physician who specializes in neuropathology, usually by completing a fellowship after a residency in anatomical or general pathology, is called a neuropathologist. In day-to-day clinical practice, a neuropathologist generates diagnoses for patients. If a disease of the nervous system is suspected, and the diagnosis cannot be made by less invasive methods,

6407-562: Is described as a selective dopamine reuptake inhibitor that only weakly stimulates dopamine release. While drugs like dextroamphetamine and methylphenidate are classified as schedule II and have considerable misuse potential, pemoline is listed as schedule IV (non-narcotic). In studies conducted on primates, pemoline fails to demonstrate a potential for self-administration. It is thought to have little potential for abuse and dependence. Nonetheless, misuse may theoretically occur owing to its similarity to other psychostimulants. Studies of

6556-439: Is divided into a number of subdisciplines within the distinct but deeply interconnected aims of biological research and medical practice . Biomedical research into disease incorporates the work of a vast variety of life science specialists, whereas, in most parts of the world, to be licensed to practice pathology as a medical specialty, one has to complete medical school and secure a license to practice medicine. Structurally,

6705-530: Is high (higher than amphetamine), and so its sale and possession are strictly controlled in most jurisdictions. Other tropane derivative drugs related to cocaine are also known such as troparil and lometopane but have not been widely sold or used recreationally. Nicotine is the active chemical constituent in tobacco , which is available in many forms, including cigarettes , cigars , chewing tobacco , and smoking cessation aids such as nicotine patches , nicotine gum , and electronic cigarettes . Nicotine

6854-428: Is known to have a high potential for abuse and addiction . Recreational use of methamphetamine may result in psychosis or lead to post-withdrawal syndrome , a withdrawal syndrome that can persist for months beyond the typical withdrawal period. Unlike amphetamine and cocaine , methamphetamine is neurotoxic to humans, damaging both dopamine and serotonin neurons in the central nervous system (CNS). Unlike

7003-595: Is named) having developed methods of diagnosis and prognosis for a number of diseases. The medical practices of the Romans and those of the Byzantines continued from these Greek roots, but, as with many areas of scientific inquiry, growth in understanding of medicine stagnated somewhat after the Classical Era , but continued to slowly develop throughout numerous cultures. Notably, many advances were made in

7152-433: Is no evidence that coffee stunts a child's growth. Caffeine may increase the effectiveness of some medications including ones used to treat headaches . Caffeine may lessen the severity of acute mountain sickness if taken a few hours prior to attaining a high altitude. Ephedrine is a sympathomimetic amine similar in molecular structure to the well-known drugs phenylpropanolamine and methamphetamine , as well as to

7301-456: Is often applied in a context that is as much scientific as directly medical and encompasses the development of molecular and genetic approaches to the diagnosis and classification of human diseases, the design and validation of predictive biomarkers for treatment response and disease progression, and the susceptibility of individuals of different genetic constitution to particular disorders. The crossover between molecular pathology and epidemiology

7450-422: Is often tightly controlled due to the significant health risks associated with uncontrolled or heavy use. As a consequence, amphetamine is illegally manufactured in clandestine labs to be trafficked and sold to users. Based upon drug and drug precursor seizures worldwide, illicit amphetamine production and trafficking is much less prevalent than that of methamphetamine . The first pharmaceutical amphetamine

7599-647: Is poor/mixed. Notably, two recent large phase III studies of lisdexamfetamine (a prodrug to amphetamine) as an adjunct to an SSRI or SNRI in the treatment of major depressive disorder showed no further benefit relative to placebo in effectiveness. Numerous studies have demonstrated the effectiveness of drugs such as Adderall (a mixture of salts of amphetamine and dextroamphetamine ) in controlling symptoms associated with ADHD . Due to their availability and fast-acting effects, substituted amphetamines are prime candidates for abuse. Hundreds of cocaine analogs have been created, all of them usually maintaining

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7748-560: Is possible, but the evidence is inconclusive. Moderate coffee consumption may decrease the risk of cardiovascular disease , and it may somewhat reduce the risk of type 2 diabetes . Drinking 1-3 cups of coffee per day does not affect the risk of hypertension compared to drinking little or no coffee. However those who drink 2–4 cups per day may be at a slightly increased risk. Caffeine increases intraocular pressure in those with glaucoma but does not appear to affect normal individuals. It may protect people from liver cirrhosis . There

7897-715: Is represented by a related field " molecular pathological epidemiology ". Molecular pathology is commonly used in diagnosis of cancer and infectious diseases. Molecular Pathology is primarily used to detect cancers such as melanoma, brainstem glioma, brain tumors as well as many other types of cancer and infectious diseases. Techniques are numerous but include quantitative polymerase chain reaction (qPCR), multiplex PCR , DNA microarray , in situ hybridization , DNA sequencing , antibody-based immunofluorescence tissue assays, molecular profiling of pathogens, and analysis of bacterial genes for antimicrobial resistance . Techniques used are based on analyzing samples of DNA and RNA. Pathology

8046-445: Is said to have fewer side effects than them. Rarely, pemoline is implicated in causing hepatotoxicity. Because of this, the FDA recommended that regular liver tests be performed in those treated with it. Since being introduced, it has been linked with at least 21 cases of liver failure , of which 13 resulted in liver replacement or death. Approximately 1–2% of patients taking the drug show elevated levels of liver transaminase enzymes,

8195-411: Is separated into two distinct specialties, anatomical pathology, and clinical pathology. Residencies for both lasts four years. Residency in anatomical pathology is open to physicians only, while clinical pathology is open to both physicians and pharmacists . At the end of the second year of clinical pathology residency, residents can choose between general clinical pathology and a specialization in one of

8344-427: Is sometimes considered to fall within the domain of clinical pathology. Hematopathology is the study of diseases of blood cells (including constituents such as white blood cells , red blood cells , and platelets ) and the tissues, and organs comprising the hematopoietic system. The term hematopoietic system refers to tissues and organs that produce and/or primarily host hematopoietic cells and includes bone marrow ,

8493-530: Is the best and most definitive evidence of disease (or lack thereof) in cases where tissue is surgically removed from a patient. These determinations are usually accomplished by a combination of gross (i.e., macroscopic) and histologic (i.e., microscopic) examination of the tissue, and may involve evaluations of molecular properties of the tissue by immunohistochemistry or other laboratory tests. There are two major types of specimens submitted for surgical pathology analysis: biopsies and surgical resections. A biopsy

8642-423: Is the generating of visual representations of the interior of a body for clinical analysis and medical intervention. Medical imaging reveals details of internal physiology that help medical professionals plan appropriate treatments for tissue infection and trauma. Medical imaging is also central in supplying the biometric data necessary to establish baseline features of anatomy and physiology so as to increase

8791-475: Is the release of vesicular stores of monoamine neurotransmitters through VMAT2 , thereby increasing the concentration of these neurotransmitters in the cytosol , or intracellular fluid, of the presynaptic neuron . Amphetamines-type stimulants are often used for their therapeutic effects. Physicians sometimes prescribe amphetamine to treat major depression , where subjects do not respond well to traditional SSRI medications, but evidence supporting this use

8940-410: Is they stimulate the sympathetic branch of the autonomic nervous system. This leads to effects such as mydriasis , increased heart rate, blood pressure, respiratory rate and body temperature. When these changes become pathological, they are called arrhythmia , hypertension , and hyperthermia , and may lead to rhabdomyolysis , stroke , cardiac arrest , or seizures . However, given the complexity of

9089-505: Is to classify mental illness, elucidate its underlying causes, and guide clinical psychiatric treatment accordingly. Although diagnosis and classification of mental norms and disorders is largely the purview of psychiatry—the results of which are guidelines such as the Diagnostic and Statistical Manual of Mental Disorders , which attempt to classify mental disease mostly on behavioural evidence, though not without controversy —the field

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9238-452: Is used to relieve nasal or sinus congestion caused by the common cold, sinusitis, hay fever and other respiratory allergies; it is also used to relieve ear congestion caused by ear inflammation or infection. Stimulants were one of the first classes of drugs to be used in the treatment of depression , beginning after the introduction of the amphetamines in the 1930s. However, they were largely abandoned for treatment of depression following

9387-414: Is used widely throughout the world for its stimulating and relaxing effects. Nicotine exerts its effects through the agonism of nicotinic acetylcholine receptors , resulting in multiple downstream effects such as increase in activity of dopaminergic neurons in the midbrain reward system , and acetaldehyde one of the tobacco constituent decreased the expression of monoamine oxidase in the brain. Nicotine

9536-615: Is widely used for gene therapy and disease diagnosis. Oral and Maxillofacial Pathology is one of nine dental specialties recognized by the American Dental Association , and is sometimes considered a specialty of both dentistry and pathology. Oral Pathologists must complete three years of post doctoral training in an accredited program and subsequently obtain diplomate status from the American Board of Oral and Maxillofacial Pathology. The specialty focuses on

9685-495: The Ancient Greek roots pathos ( πάθος ), meaning "experience" or "suffering", and -logia ( -λογία ), meaning "study of". The term is of early 16th-century origin, and became increasingly popularized after the 1530s. The study of pathology, including the detailed examination of the body, including dissection and inquiry into specific maladies, dates back to antiquity. Rudimentary understanding of many conditions

9834-409: The kidneys . In a medical setting, renal pathologists work closely with nephrologists and transplant surgeons , who typically obtain diagnostic specimens via percutaneous renal biopsy. The renal pathologist must synthesize findings from traditional microscope histology, electron microscopy , and immunofluorescence to obtain a definitive diagnosis. Medical renal diseases may affect the glomerulus ,

9983-416: The lungs and thoracic pleura . Diagnostic specimens are often obtained via bronchoscopic transbronchial biopsy, CT -guided percutaneous biopsy, or video-assisted thoracic surgery . These tests can be necessary to diagnose between infection, inflammation , or fibrotic conditions. Renal pathology is a subspecialty of anatomic pathology that deals with the diagnosis and characterization of disease of

10132-488: The lymph nodes , thymus , spleen , and other lymphoid tissues. In the United States, hematopathology is a board certified subspecialty (licensed under the American Board of Pathology) practiced by those physicians who have completed a general pathology residency (anatomic, clinical, or combined) and an additional year of fellowship training in hematology. The hematopathologist reviews biopsies of lymph nodes, bone marrows and other tissues involved by an infiltrate of cells of

10281-402: The pharmacokinetics of pemoline in humans are very limited. The time to peak levels of pemoline is 2 to 4   hours. Peak levels have been reported to be in the range of 2 to 4.5   μg/mL. Steady-state levels of pemoline are reached in 2 to 3   days. Pemoline is variously reported to have no significant plasma protein binding or to have 50% plasma protein binding. Pemoline

10430-1062: The reward system , learning , memory , and emotion . By increasing their availability, stimulants can produce a range of effects, from mild stimulation to euphoria , depending on the specific drug, dose, route of administration, and individual factors. Stimulants have a long history of use, both for medical and non-medical purposes. They have been used to treat various conditions, such as narcolepsy , attention deficit hyperactivity disorder (ADHD), obesity , depression , and fatigue . They have also been used as recreational drugs , performance-enhancing substances , and cognitive enhancers , by various groups of people, such as students, athletes, artists, workers, and soldiers. However, stimulants also have potential risks and side effects, such as addiction , tolerance , withdrawal , psychosis , anxiety , insomnia , cardiovascular problems , and neurotoxicity . The misuse and abuse of stimulants can lead to serious health and social consequences, such as overdose , dependence , crime , and violence . Therefore,

10579-475: The tubules and interstitium , the vessels, or a combination of these compartments. Surgical pathology is one of the primary areas of practice for most anatomical pathologists. Surgical pathology involves the gross and microscopic examination of surgical specimens, as well as biopsies submitted by surgeons and non-surgeons such as general internists , medical subspecialists , dermatologists , and interventional radiologists . Often an excised tissue sample

10728-488: The 17th century, the study of rudimentary microscopy was underway and examination of tissues had led British Royal Society member Robert Hooke to coin the word " cell ", setting the stage for later germ theory . Modern pathology began to develop as a distinct field of inquiry during the 19th Century through natural philosophers and physicians that studied disease and the informal study of what they termed "pathological anatomy" or "morbid anatomy". However, pathology as

10877-534: The American Board of Pathology: [anatomical pathology and clinical pathology, each of which requires separate board certification. The American Osteopathic Board of Pathology also recognizes four primary specialties: anatomic pathology, dermatopathology, forensic pathology, and laboratory medicine . Pathologists may pursue specialised fellowship training within one or more subspecialties of either anatomical or clinical pathology. Some of these subspecialties permit additional board certification, while others do not. In

11026-487: The US, either a general pathologist or a dermatologist can undergo a 1 to 2 year fellowship in the field of dermatopathology. The completion of this fellowship allows one to take a subspecialty board examination, and becomes a board certified dermatopathologist. Dermatologists are able to recognize most skin diseases based on their appearances, anatomic distributions, and behavior. Sometimes, however, those criteria do not lead to

11175-696: The United Kingdom, pathologists are physicians licensed by the UK General Medical Council . The training to become a pathologist is under the oversight of the Royal College of Pathologists . After four to six years of undergraduate medical study, trainees proceed to a two-year foundation program. Full-time training in histopathology currently lasts between five and five and a half years and includes specialist training in surgical pathology, cytopathology, and autopsy pathology. It

11324-404: The United States due to its relation to other stimulants and a potential for misuse . It seems to have less misuse potential than other stimulants. Pemoline has been used in the treatment of ADHD and narcolepsy. It has also been used in the treatment of excessive daytime sleepiness . The medication was typically used at doses of 18.75 to 112.5   mg once per day in the treatment of ADHD, with

11473-579: The United States market in May 2005 and the FDA withdrew approval of generic pemoline in November 2005. Pemoline remains available in Japan for treatment of narcolepsy as of 2017. Pemoline is the generic name of the drug and its INN Tooltip International Nonproprietary Name , USAN Tooltip United States Adopted Name , and BAN Tooltip British Approved Name . Pemoline was formerly marketed under

11622-664: The United States. Also, the production, distribution, sale, and possession of methamphetamine is restricted or illegal in many other countries due to its placement in schedule II of the United Nations Convention on Psychotropic Substances treaty. In contrast, levomethamphetamine is an over-the-counter drug in the United States. In low doses, methamphetamine can cause an elevated mood and increase alertness, concentration, and energy in fatigued individuals. At higher doses, it can induce psychosis , rhabdomyolysis , and cerebral hemorrhage . Methamphetamine

11771-476: The ability to focus, a principle of the Yerkes-Dodson Law . The Yerkes-Dodson Law is a psychological theory that describes how stress affects performance. The theory says that there is an optimal level of stress that helps people perform better, but too much or too little stress can impair performance. The theory can be illustrated by an upside-down U-shaped curve, where the peak of the curve represents

11920-442: The above which are identical in weight to the salt mentioned. Pemoline free base and pemoline cobalt, strontium, silver, barium, lithium, sodium, potassium, zinc, manganese, and caesium are research chemicals which can be produced in situ for experiments. Others such as lanthanide pemoline salts such as pemoline cerium can be prepared; pemoline beryllium would presumably be toxic. Pemoline was first synthesized in 1913 but its activity

12069-429: The accuracy with which early or fine-detail abnormalities are detected. These diagnostic techniques are often performed in combination with general pathology procedures and are themselves often essential to developing new understanding of the pathogenesis of a given disease and tracking the progress of disease in specific medical cases. Examples of important subdivisions in medical imaging include radiology (which uses

12218-659: The actions of the sympathetic nervous system . The sympathetic nervous system is a part of the nervous system that prepares the body for action, such as increasing the heart rate, blood pressure, and breathing rate. Stimulants can activate the same receptors as the natural chemicals released by the sympathetic nervous system (namely epinephrine and norepinephrine ) and cause similar effects. Stimulants in therapeutic doses, such as those given to patients with attention deficit hyperactivity disorder (ADHD), increases ability to focus, vigor, sociability, libido and may elevate mood. However, in higher doses, stimulants may actually decrease

12367-473: The activity of norepinephrine (noradrenaline) on adrenergic receptors . It is most usually marketed as the hydrochloride or sulfate salt. The herb má huáng ( Ephedra sinica ), used in traditional Chinese medicine (TCM), contains ephedrine and pseudoephedrine as its principal active constituents. The same may be true of other herbal products containing extracts from other Ephedra species. 3,4-Methylenedioxymethamphetamine (MDMA, ecstasy, or molly)

12516-429: The activity of specific molecular pathways in the tumor. Surgical resection specimens are obtained by the therapeutic surgical removal of an entire diseased area or organ (and occasionally multiple organs). These procedures are often intended as definitive surgical treatment of a disease in which the diagnosis is already known or strongly suspected, but pathological analysis of these specimens remains important in confirming

12665-597: The amphetamine core structure with substituents . Examples of substituted amphetamines are amphetamine (itself), methamphetamine , ephedrine , cathinone , phentermine , mephentermine , bupropion , methoxyphenamine , selegiline , amfepramone , pyrovalerone , MDMA (ecstasy), and DOM (STP). Many drugs in this class work primarily by activating trace amine-associated receptor 1 (TAAR1); in turn, this causes reuptake inhibition and effluxion, or release, of dopamine , norepinephrine , and serotonin . An additional mechanism of some substituted amphetamines

12814-423: The basis of the involved sample types (comparing, for example, cytopathology , hematopathology , and histopathology ), organs (as in renal pathology ), and physiological systems ( oral pathology ), as well as on the basis of the focus of the examination (as with forensic pathology ). Pathology is a significant field in modern medical diagnosis and medical research . The Latin term pathology derives from

12963-417: The brand names Cylert, Betanamin, Ceractiv, Hyperilex, Kethamed, Ronyl, Stimul, Tamilan, Tradon, Tropocer, and Volital. Pemoline has been marketed in the United States, Canada, the United Kingdom, Belgium, Luxembourg, Spain, Germany, Switzerland, Japan and Argentina. It remains available in Japan for the treatment of narcolepsy as of 2017. However, the medication is said to be rarely used in Japan as narcolepsy

13112-710: The cognitive enhancement effects of modafinil in healthy non-sleep-deprived individuals has yielded mixed results, with some studies suggesting modest improvements in attention and executive functions while others show no significant benefits or even a decline in cognitive functions. In some cases, psychiatric phenomena may emerge such as stimulant psychosis , paranoia , and suicidal ideation . Acute toxicity has been reportedly associated with homicide, paranoia, aggressive behavior, motor dysfunction, and punding . The violent and aggressive behavior associated with acute stimulant toxicity may partially be driven by paranoia. Most drugs classified as stimulants are sympathomimetics, that

13261-399: The consequences of changes (clinical manifestations). In common medical practice, general pathology is mostly concerned with analyzing known clinical abnormalities that are markers or precursors for both infectious and non-infectious disease, and is conducted by experts in one of two major specialties, anatomical pathology and clinical pathology . Further divisions in specialty exist on

13410-683: The death of a young man from acute caffeine toxicity. In Canada, Health Canada has proposed to limit the amount of caffeine in energy drinks to 180 mg per serving, and to require warning labels and other safety measures on these products. Caffeine is also included in some medications, usually for the purpose of enhancing the effect of the primary ingredient, or reducing one of its side-effects (especially drowsiness). Tablets containing standardized doses of caffeine are also widely available. Caffeine's mechanism of action differs from many stimulants, as it produces stimulant effects by inhibiting adenosine receptors. Adenosine receptors are thought to be

13559-525: The diagnosis, clinical management and investigation of diseases that affect the oral cavity and surrounding maxillofacial structures including but not limited to odontogenic , infectious, epithelial , salivary gland , bone and soft tissue pathologies. It also significantly intersects with the field of dental pathology . Although concerned with a broad variety of diseases of the oral cavity, they have roles distinct from otorhinolaryngologists ("ear, nose, and throat" specialists), and speech pathologists ,

13708-442: The disciplines, but they can not practice anatomical pathology, nor can anatomical pathology residents practice clinical pathology. Though separate fields in terms of medical practice, a number of areas of inquiry in medicine and medical science either overlap greatly with general pathology, work in tandem with it, or contribute significantly to the understanding of the pathology of a given disease or its course in an individual. As

13857-580: The editor . Clinicians were little-aware of liver toxicity with pemoline until the 1990s. Warnings for liver toxicity for pemoline were added to the United States Food and Drug Administration (FDA) label for the medication in December 1996 and a black box warning was added in June 1999 along with requirements for written consent and frequent monitoring of liver enzymes . These warnings followed

14006-523: The effective dose for most people being in the range of 56.25 to 75   mg. The onset of action of pemoline is gradual and therapeutic benefits may not occur until the third or fourth weeks of use. This may be due to a cautious low initial starting dose of 37.5   mg and gradual titration in dose upwards over several weeks. Pemoline was available in the form of 18.75, 37.5, and 75   mg oral immediate-release tablets (Cylert) as well as 37.5   mg oral immediate-release chewable tablets . It

14155-416: The effects caused by the drug. Methylphenidate is sold under a number of brand names including Ritalin. Other versions include the long lasting tablet Concerta and the long lasting transdermal patch Daytrana. Cocaine is an SNDRI . Cocaine is made from the leaves of the coca shrub, which grows in the mountain regions of South American countries such as Bolivia , Colombia , and Peru , regions in which it

14304-443: The effects of stimulants has been studied and characterized both in animals and humans. Stimulant withdrawal is remarkably similar in its symptoms to those of major depressive disorder . Classifying stimulants is difficult, because of the large number of classes the drugs occupy, and the fact that they may belong to multiple classes; for example, ecstasy can be classified as a substituted methylenedioxyphenethylamine ,

14453-420: The examination of a biopsy or surgical specimen by a pathologist, after the specimen has been processed and histological sections have been placed onto glass slides. This contrasts with the methods of cytopathology, which uses free cells or tissue fragments. Histopathological examination of tissues starts with surgery , biopsy , or autopsy. The tissue is removed from the body of an organism and then placed in

14602-708: The general definition of a stimulant, but other drugs such as cannabinoid receptor antagonists also belong to this group. Eugeroics are used in management of sleep disorders characterized by excessive daytime sleepiness , such as narcolepsy , and include stimulants such as modafinil and pitolisant . Stimulants are used in impulse control disorders such as ADHD and off-label in mood disorders such as major depressive disorder to increase energy , focus and elevate mood. Stimulants such as epinephrine , theophylline and salbutamol orally have been used to treat asthma, but inhaled adrenergic drugs are now preferred due to less systemic side effects. Pseudoephedrine

14751-504: The hematopoietic system. In addition, the hematopathologist may be in charge of flow cytometric and/or molecular hematopathology studies. Molecular pathology is focused upon the study and diagnosis of disease through the examination of molecules within organs, tissues or bodily fluids . Molecular pathology is multidisciplinary by nature and shares some aspects of practice with both anatomic pathology and clinical pathology, molecular biology , biochemistry , proteomics and genetics . It

14900-425: The human host. To determine causes of diseases, medical experts used the most common and widely accepted assumptions or symptoms of their times, a general principle of approach that persists in modern medicine. Modern medicine was particularly advanced by further developments of the microscope to analyze tissues, to which Rudolf Virchow gave a significant contribution, leading to a slew of research developments. By

15049-431: The identity of a corpse. The requirements for becoming a licensed practitioner of forensic pathology varies from country to country (and even within a given nation ) but typically a minimal requirement is a medical doctorate with a specialty in general or anatomical pathology with subsequent study in forensic medicine. The methods forensic scientists use to determine death include examination of tissue specimens to identify

15198-490: The imaging technologies of X-ray radiography ) magnetic resonance imaging , medical ultrasonography (or ultrasound), endoscopy , elastography , tactile imaging , thermography , medical photography , nuclear medicine and functional imaging techniques such as positron emission tomography . Though they do not strictly relay images, readings from diagnostics tests involving electroencephalography , magnetoencephalography , and electrocardiography often give hints as to

15347-399: The important neurotransmitter epinephrine (adrenaline). Ephedrine is commonly used as a stimulant, appetite suppressant , concentration aid, and decongestant , and to treat hypotension associated with anesthesia. In chemical terms, it is an alkaloid with a phenethylamine skeleton found in various plants in the genus Ephedra (family Ephedraceae ). It works mainly by increasing

15496-412: The introduction of conventional antidepressants in the 1950s. Subsequent to this, there has been a resurgence in interest in stimulants for depression in recent years. Stimulants produce a fast-acting and pronounced but transient and short-lived mood lift . In relation to this, they are minimally effective in the treatment of depression when administered continuously. In addition, tolerance to

15645-435: The largest body of research in veterinary pathology. Animal testing remains a controversial practice, even in cases where it is used to research treatment for human disease. As in human medical pathology, the practice of veterinary pathology is customarily divided into the two main fields of anatomical and clinical pathology. Although the pathogens and their mechanics differ greatly from those of animals, plants are subject to

15794-431: The late 1920s to early 1930s pathology was deemed a medical specialty. Combined with developments in the understanding of general physiology , by the beginning of the 20th century, the study of pathology had begun to split into a number of distinct fields, resulting in the development of a large number of modern specialties within pathology and related disciplines of diagnostic medicine . The modern practice of pathology

15943-435: The latter of which helps diagnose many neurological or neuromuscular conditions relevant to speech phonology or swallowing . Owing to the availability of the oral cavity to non-invasive examination, many conditions in the study of oral disease can be diagnosed, or at least suspected, from gross examination, but biopsies, cell smears, and other tissue analysis remain important diagnostic tools in oral pathology. Becoming

16092-491: The long-term use of amphetamine in prescription doses, which may improve certain brain regions in individuals with ADHD, there is evidence that methamphetamine causes brain damage from long-term use in humans; this damage includes adverse changes in brain structure and function, such as reductions in gray matter volume in several brain regions and adverse changes in markers of metabolic integrity. However, recreational amphetamine doses may also be neurotoxic. Methylphenidate

16241-448: The mechanisms of action for these pathogens in non-human hosts is essential to the understanding and application of epidemiology and 2) those animals that share physiological and genetic traits with humans can be used as surrogates for the study of the disease and potential treatments as well as the effects of various synthetic products. For this reason, as well as their roles as livestock and companion animals , mammals generally have

16390-470: The mechanisms that underlie these potentially fatal outcomes of acute stimulant toxicity, it is impossible to determine what dose may be lethal. Assessment of the effects of stimulants is relevant given the large population currently taking stimulants. A systematic review of cardiovascular effects of prescription stimulants found no association in children, but found a correlation between prescription stimulant use and ischemic heart attacks . A review over

16539-416: The medication appears to act as a dopamine reuptake inhibitor and releasing agent . By increasing dopamine levels in the brain, it functions as an indirect agonist of dopamine receptors . In contrast to most other stimulants, pemoline appears to produce no significant central or peripheral noradrenergic effects. As a result, it has minimal or no cardiovascular or sympathomimetic effects. Pemoline

16688-451: The medication can cause serious liver damage , and this can result in liver transplantation or death. Pemoline is a stimulant and acts as a selective dopamine reuptake inhibitor and releasing agent . Hence, it functions as an indirect agonist of dopamine receptors . Pemoline has little effect on norepinephrine and hence has minimal or no cardiovascular or sympathomimetic effects, in contrast to many other stimulants. Pemoline

16837-551: The medieval era of Islam (see Medicine in medieval Islam ), during which numerous texts of complex pathologies were developed, also based on the Greek tradition. Even so, growth in complex understanding of disease mostly languished until knowledge and experimentation again began to proliferate in the Renaissance , Enlightenment , and Baroque eras, following the resurgence of the empirical method at new centers of scholarship. By

16986-447: The mood , and increase energy , allowing some users to engage in sexual activity continuously for several days straight. Methamphetamine may be sold illicitly, either as pure dextromethamphetamine or in an equal parts mixture of the right- and left-handed molecules (i.e., 50% levomethamphetamine and 50% dextromethamphetamine). Both dextromethamphetamine and racemic methamphetamine are schedule II controlled substances in

17135-448: The mood-lifting effects of amphetamine has led to dose escalation and dependence . Although the efficacy for depression with continuous administration is modest, it may still reach statistical significance over placebo and provide benefits similar in magnitude to those of conventional antidepressants. The reasons for the short-term mood-improving effects of stimulants are unclear, but may relate to rapid tolerance . Tolerance to

17284-461: The most common stimulant. In North America , 90% of adults consume caffeine daily. A few jurisdictions restrict the sale and use of caffeine. In the United States, the FDA has banned the sale of pure and highly concentrated caffeine products for personal consumption, due to the risk of overdose and death. The Australian Government has announced a ban on the sale of pure and highly concentrated caffeine food products for personal consumption, following

17433-480: The most common stimulants are caffeine , nicotine , amphetamines , cocaine , methylphenidate , and modafinil . Stimulants work by affecting the levels of certain neurotransmitters , such as dopamine , norepinephrine , serotonin , histamine and acetylcholine , in the synapses between neurons . Stimulants sometimes also work by binding to the receptors for neurotransmitters. These neurotransmitters regulate various functions, such as arousal , attention ,

17582-475: The opposite effect and reduce the ability to focus. This is because the higher doses cause too much stress, which exceeds the optimal level and harms performance. In higher doses, stimulants may also produce euphoria, vigor, and a decreased need for sleep. Many, but not all, stimulants have ergogenic effects. The term "ergogenic" means "enhancing physical performance". Ergogenic effects are those effects that improve physical performance or endurance. For example, if

17731-416: The optimal level of stress and performance. The theory was developed by psychologists Robert Yerkes and John Dillingham Dodson in 1908, based on experiments with mice. Drugs that stimulate the central nervous system, such as those used to treat ADHD, can improve the ability to focus and other aspects of mood and behavior when taken in appropriate doses. However, when taken in higher doses, these drugs can have

17880-716: The patients that developed liver failure had not showed elevated liver transaminase levels when tested previously. On the other hand, there are no cases of liver failure associated with pemoline in Japan, although it is used at lower doses and is only prescribed for the niche indication of narcolepsy in this country. Overdose of pemoline may present with choreoathetosis symptoms. Other stimulants and monoamine oxidase inhibitors are contraindicated with pemoline. The pharmacodynamics of pemoline are poorly understood and its precise mechanism of action hasn't been definitively determined. However, pemoline has similar activity and effects to those of other psychostimulants , and in animals

18029-587: The pharmacokinetics of pemoline were found with conventional tablets, chewable tablets swallowed, or chewable tablets chewed. Pemoline is a member of the 4- oxazolidinone class and is structurally related to other members of the class including aminorex , 4-methylaminorex , clominorex , cyclazodone , fenozolone , fluminorex , and thozalinone . The salts of pemoline in use are pemoline magnesium (free base conversion ratio .751), pemoline iron (.578), pemoline copper (.644), pemoline nickel (.578), pemoline rubidium, pemoline calcium, pemoline chromium, and chelates of

18178-518: The presence or absence of natural disease and other microscopic findings, interpretations of toxicology on body tissues and fluids to determine the chemical cause of overdoses, poisonings or other cases involving toxic agents, and examinations of physical trauma . Forensic pathology is a major component in the trans-disciplinary field of forensic science . Histopathology refers to the microscopic examination of various forms of human tissue . Specifically, in clinical medicine, histopathology refers to

18327-477: The previous 1,500 years in European medicine. With the new understanding of causative agents, physicians began to compare the characteristics of one germ's symptoms as they developed within an affected individual to another germ's characteristics and symptoms. This approach led to the foundational understanding that diseases are able to replicate themselves, and that they can have many profound and varied effects on

18476-485: The previous diagnosis. Clinical pathology is a medical specialty that is concerned with the diagnosis of disease based on the laboratory analysis of bodily fluids such as blood and urine , as well as tissues, using the tools of chemistry , clinical microbiology , hematology and molecular pathology. Clinical pathologists work in close collaboration with medical technologists , hospital administrations, and referring physicians. Clinical pathologists learn to administer

18625-406: The reactions proved idiosyncratic and unpredictable, with patients sometimes taking the drug with no issue for months or even years, before suddenly developing severe liver toxicity. There was no clear exposure–toxicity relationship, and no characteristic liver pathology findings. Some patients showed as little as one week between first appearance of jaundice and complete liver failure, and some of

18774-416: The relative safety of MDMA, some researchers such as David Nutt have criticized the scheduling level, writing a satirical article finding MDMA to be 28 times less dangerous than horseriding, a condition he termed "equasy" or "Equine Addiction Syndrome". Methylenedioxypyrovalerone (MDPV) is a psychoactive drug with stimulant properties that acts as a norepinephrine-dopamine reuptake inhibitor (NDRI). It

18923-508: The resulting pathology report describes the histological findings and the opinion of the pathologist. In the case of cancer, this represents the tissue diagnosis required for most treatment protocols. Neuropathology is the study of disease of nervous system tissue, usually in the form of either surgical biopsies or sometimes whole brains in the case of autopsy. Neuropathology is a subspecialty of anatomic pathology, neurology , and neurosurgery . In many English-speaking countries, neuropathology

19072-622: The reuptake or stimulate the efflux of these catecholamines, resulting in increased activity of their circuits. Some stimulants, specifically those with empathogenic and hallucinogenic effects, also affect serotonergic transmission. Some stimulants, such as some amphetamine derivatives and, notably, yohimbine , can decrease negative feedback by antagonizing regulatory autoreceptors . Adrenergic agonists , such as, in part, ephedrine , act by directly binding to and activating adrenergic receptors , producing sympathomimetic effects. There are also more indirect mechanisms of action by which

19221-663: The route of administration, with intravenous use associated with the transmission of many disease such as Hepatitis C , HIV/AIDS and potential medical emergencies such as infection , thrombosis or pseudoaneurysm , while inhalation may be associated with increased lower respiratory tract infection , lung cancer , and pathological restricting of lung tissue. Cocaine may also increase risk for autoimmune disease and damage nasal cartilage. Abuse of methamphetamine produces similar effects as well as marked degeneration of dopaminergic neurons, resulting in an increased risk for Parkinson's disease . Stimulants are widely used throughout

19370-409: The same subjective sensations on abusers. Methamphetamine (contracted from N - meth yl - a lpha- m ethyl ph en et hyl amine ) is a potent psychostimulant of the phenethylamine and amphetamine classes that is used to treat attention deficit hyperactivity disorder (ADHD) and obesity . Methamphetamine exists as two enantiomers , dextrorotary and levorotary . Dextromethamphetamine

19519-607: The skin exist, including cutaneous eruptions (" rashes ") and neoplasms . Therefore, dermatopathologists must maintain a broad base of knowledge in clinical dermatology, and be familiar with several other specialty areas in Medicine. Forensic pathology focuses on determining the cause of death by post-mortem examination of a corpse or partial remains. An autopsy is typically performed by a coroner or medical examiner, often during criminal investigations; in this role, coroners and medical examiners are also frequently asked to confirm

19668-471: The spotlight. Coffee consumption is associated with a lower overall risk of cancer . This is primarily due to a decrease in the risks of hepatocellular and endometrial cancer , but it may also have a modest effect on colorectal cancer. There does not appear to be a significant protective effect against other types of cancers, and heavy coffee consumption may increase the risk of bladder cancer . A protective effect of caffeine against Alzheimer's disease

19817-517: The state and function of certain tissues in the brain and heart respectively. Pathology informatics is a subfield of health informatics . It is the use of information technology in pathology. It encompasses pathology laboratory operations, data analysis, and the interpretation of pathology-related information. Key aspects of pathology informatics include: Psychopathology is the study of mental illness , particularly of severe disorders. Informed heavily by both psychology and neurology , its purpose

19966-474: The study of disease is divided into many different fields that study or diagnose markers for disease using methods and technologies particular to specific scales, organs , and tissue types. Anatomical pathology ( Commonwealth ) or anatomic pathology ( United States ) is a medical specialty that is concerned with the diagnosis of disease based on the gross , microscopic , chemical, immunologic and molecular examination of organs, tissues, and whole bodies (as in

20115-452: The tissue and blood analysis techniques of general pathology are of central significance to the investigation of serious infectious disease and as such inform significantly upon the fields of epidemiology , etiology , immunology , and parasitology . General pathology methods are of great importance to biomedical research into disease, wherein they are sometimes referred to as "experimental" or "investigative" pathology . Medical imaging

20264-435: The treatment of fatigue due to multiple sclerosis and HIV -related disease. Stimulant Stimulants (also known as central nervous system stimulants , or psychostimulants , or colloquially as uppers ) are a class of drugs that increase the activity of the brain . They are used for various purposes, such as enhancing alertness , attention , motivation , cognition , mood , and physical performance . Some of

20413-446: The use of stimulants is regulated by laws and policies in most countries, and requires medical supervision and prescription in some cases. A stimulant is an overarching term that covers many drugs including those that increase the activity of the central nervous system and the body, drugs that are pleasurable and invigorating, or drugs that have sympathomimetic effects. Sympathomimetic effects are those effects that mimic or copy

20562-474: The vast majority of lab work and research in pathology concerns the development of disease in humans, pathology is of significance throughout the biological sciences. Two main catch-all fields exist to represent most complex organisms capable of serving as host to a pathogen or other form of disease: veterinary pathology (concerned with all non-human species of kingdom of Animalia ) and phytopathology , which studies disease in plants. Veterinary pathology covers

20711-417: The world as prescription medicines as well as without a prescription (either legally or illicitly ) as performance-enhancing or recreational drugs. Among narcotics, stimulants produce a noticeable crash or comedown at the end of their effects. In the US, the most frequently prescribed stimulants as of 2013 were lisdexamfetamine (Vyvanse), methylphenidate (Ritalin), and amphetamine (Adderall). It

20860-1262: Was Benzedrine , a brand of inhalers used to treat a variety of conditions. Because the dextrorotary isomer has greater stimulant properties, Benzedrine was gradually discontinued in favor of formulations containing all or mostly dextroamphetamine. Presently, it is typically prescribed as mixed amphetamine salts , dextroamphetamine , and lisdexamfetamine . Amphetamine is a norepinephrine-dopamine releasing agent (NDRA). It enters neurons through dopamine and norepinephrine transporters and facilitates neurotransmitter efflux by activating TAAR1 and inhibiting VMAT2 . At therapeutic doses, this causes emotional and cognitive effects such as euphoria, change in libido, increased arousal, and improved cognitive control . Likewise, it induces physical effects such as decreased reaction time, fatigue resistance, and increased muscle strength. In contrast, supratherapeutic doses of amphetamine are likely to impair cognitive function and induce rapid muscle breakdown . Very high doses can result in psychosis (e.g., delusions and paranoia), which very rarely occurs at therapeutic doses even during long-term use. As recreational doses are generally much larger than prescribed therapeutic doses, recreational use carries

21009-478: Was cultivated and used for centuries mainly by the Aymara people . In Europe, North America, and some parts of Asia, the most common form of cocaine is a white crystalline powder. Cocaine is a stimulant but is not normally prescribed therapeutically for its stimulant properties, although it sees clinical use as a local anesthetic, in particular in ophthalmology . Most cocaine use is recreational and its abuse potential

21158-602: Was estimated in 2015 that the percentage of the world population that had used cocaine during a year was 0.4%. For the category "amphetamines and prescription stimulants" (with "amphetamines" including amphetamine and methamphetamine ) the value was 0.7%, and for MDMA 0.4%. Stimulants have been used in medicine for many conditions including obesity , sleep disorders , mood disorders , impulse control disorders , asthma , nasal congestion and, in case of cocaine, as local anesthetics . Drugs used to treat obesity are called anorectics and generally include drugs that follow

21307-485: Was first developed in the 1960s by a team at Boehringer Ingelheim. MDPV remained an obscure stimulant until around 2004, when it was reported to be sold as a designer drug . Products labeled as bath salts containing MDPV were previously sold as recreational drugs in gas stations and convenience stores in the United States, similar to the marketing for Spice and K2 as incense. Incidents of psychological and physical harm have been attributed to MDPV use. Mephedrone

21456-558: Was first synthesized in 1929, but did not become widely known until it was rediscovered in 2003. By 2007, mephedrone was reported to be available for sale on the Internet; by 2008 law enforcement agencies had become aware of the compound; and, by 2010, it had been reported in most of Europe, becoming particularly prevalent in the United Kingdom. Mephedrone was first made illegal in Israel in 2008, followed by Sweden later that year. In 2010, it

21605-676: Was made illegal in many European countries, and, in December 2010, the EU ruled it illegal. In Australia, New Zealand, and the US, it is considered an analog of other illegal drugs and can be controlled by laws similar to the Federal Analog Act . In September 2011, the USA temporarily classified mephedrone as illegal, in effect from October 2011. Mephedrone is neurotoxic and has abuse potential, predominantly exerted on 5-hydroxytryptamine (5-HT) terminals, mimicking that of MDMA with which it shares

21754-432: Was not discovered until the 1930s. Pemoline was approved for the treatment of ADHD in the United States in 1975. Cases of serious liver toxicity and associated death related to pemoline in children and adolescents were reported to the United States Food and Drug Administration 's MedWatch between 1977 and 1996. Serious liver toxicity with pemoline was first described in the medical literature in 1984 and 1989 letters to

21903-512: Was present in most early societies and is attested to in the records of the earliest historical societies , including those of the Middle East , India , and China . By the Hellenic period of ancient Greece , a concerted causal study of disease was underway (see Medicine in ancient Greece ), with many notable early physicians (such as Hippocrates , for whom the modern Hippocratic Oath

22052-404: Was provided mainly in the form of the free base but also as the magnesium salt . Side effects of pemoline include insomnia , decreased appetite , abdominal pain , irritability , and headaches . It has minimal cardiovascular or sympathomimetic side effects. Pemoline is described as a lower-efficacy/milder stimulant than classical stimulants like amphetamines and methylphenidate and

22201-405: Was synthesized in 1913 but was not discovered to be a stimulant until the 1930s and was not used in the treatment of ADHD until 1975. It was withdrawn due to liver toxicity in many countries between 1997 and 2005, including the United States. However, it remains available in Japan for the treatment of narcolepsy at lower doses than used for ADHD. Pemoline is a schedule IV controlled substance in

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