BackgroundCannabis (marijuana) had been used for medicinal purposes for millennia. Cannabinoid agonists are now attracting growing interest and there is also evidence that botanical cannabis is being used as self-medication for stress and anxiety as well as adjunctive therapy by the seriously ill and by patients with terminal illnesses. California became the first state to authorize medicinal use of cannabis in 1996, and it was recently estimated that between 250,000 and 350,000 Californians may now possess the physician's recommendation required to use it medically. More limited medical use has also been approved in 12 additional states and new initiatives are being considered in others. Despite that evidence of increasing public acceptance of "medical" use, a definitional problem remains and all use for any purpose is still prohibited by federal law.ResultsCalifornia's 1996 initiative allowed cannabis to be recommended, not only for serious illnesses, but also "for any other illness for which marijuana provides relief," thus maximally broadening the range of allowable indications. In effect, the range of conditions now being treated with federally illegal cannabis, the modes in which it is being used, and the demographics of the population using it became potentially discoverable through the required screening of applicants. This report examines the demographic profiles and other selected characteristics of 4117 California marijuana users (62% from the Greater Bay Area) who applied for medical recommendations between late 2001 and mid 2007.ConclusionThis study yielded a somewhat unexpected profile of a hitherto hidden population of users of America's most popular illegal drug. It also raises questions about some of the basic assumptions held by both proponents and opponents of current policy.

No abstract

No abstract

Replacement of major veins, particularly the superior vena cava and inferior vena cava, is a relatively infrequent surgical problem, but there is a definite need for suitable graft material for surgery on the venous defects caused by thrombosis, injury and radical cancer surgery. Only limited information is available on which to base the selection of a graft suitable for use in the major vein.1-8 Homografts have been unsuccessful, while prostheses give only good short-term results. 9-14 The ideal replacement for the vena cava would be a large autogenous vein graft,l~-18 but these grafts are difficult to obtain. When a large caliber autograft was constructed by suturing together several venous segments, the autograft functioned poorly. The pericardium, atrium and trachea were also used without success. 19-21 Some favorable results were obtained with the simultaneous creation of a distal arteriovenous fistula.22Previously no attempt has been made to replace a segment of the vein with small bowel; yet, autografts of small bowel are readily available and the length of the graft needed presents no problem. The following experiments were undertaken in an effort to determine the fate of small bowel grafts inserted into the superior and inferior vena cava in circumstances involving essentially normal venous pressure. MATERIALS AND METHODSSixty-nine mongrel dogs of both sexes, ranging in weight from 15 to 20 kg were used. All were fed a normal laboratory diet and kept nothing by mouth 8 hr prior to the surgery. All operations were carried out under intravenous pentobarbital anesthesia with sterile conditions. Patency of grafts was determined by serial weekly cavograms and by autopsy in all dogs dying or sacrificed.In the first group, consisting of 10 dogs, segments of inferior or superior vena cava up to 10 cm in length were replaced by free grafts of uninverted jejunum used as a simple tube. In the second group, consisting of 9 dogs, the segment of bowel was inverted and the mucosal villi scraped with a scissors. The tube of bowel was then returned to its original position with the villi inside, and the graft was sewn in place. Group 3 consisted of 50 dogs and was distinguished from groups 1 and 2 by the inversion of the bowel prior to its use as a free graft. The bowel was in-

No abstract