Yasmin
By I. Mortis. Washburn University.
Ovarian Cysts Other female issues in the pelvis buy 3.03 mg yasmin with amex birth control pills 4 hours late, such as large or ruptured ovarian cysts buy yasmin 3.03mg fast delivery birth control holder, could also cause pain due to pressure or bleeding. An ovarian cyst is an accumulation of fluid within an ovary that is surrounded by a wall. Many arise from egg follicles, but other can be benign or, less often, cancerous tumors. Most cysts cause pain by rupturing; a rupture may either cause a painful irritation of the abdominal lining or an episode of internal bleeding. Sometimes, ovarian cysts go away spontaneously, but a ruptured cyst that is actively bleeding will require surgery. A right-sided ruptured cyst could appear similar to appendicitis as the pain is in the same location. The diagnosis of appendicitis or other causes of abdominal pain without modern diagnostic equipment will be challenging. Despite this, we have to remember that medical personnel, in the past, had only the physical signs and symptoms to help them reach a diagnosis. Hopefully, we will never be placed in a situation where modern medical care is not available. Many of the conditions described above will represent a possibly fatal result without the ability to perform surgery or give intravenous medications. You might find it interesting to know that urine, although a waste product is normally sterile. An infection of the bladder is known as “cystitis”, this type of infection usually affects the urethra (the tube that drains the bladder) as well. Although men are not immune from a bladder infection, the male urethra is much longer. In men, painful urination (also called “dysuria”) is very common, though most women might only note a yellowish vaginal discharge. Although painful urination is not uncommon in cystitis, the most common symptom is frequency. Some people notice that the stream of urine is somewhat hesitant (“hesitancy”) or may feel an urgent need to go without warning (“urgency”). If not treated, a bladder infection may possibly ascend to the kidneys, causing an infection known as “pyelonephritis”. Once an infections is in the kidney, your patient may experience: One-sided back or flank pain Persistent fever and chills Abdominal pain Bloody, cloudy, or foul urine Dysuria Sweating Mental changes (in the elderly) Once the infection is in the kidneys, antibiotics will be necessary. If the infection is not treated, the condition may progress to “sepsis”, where the infection reaches the bloodstream via the kidneys. These patients will show signs of shock, such as rapid breathing, decreased blood pressure, fever and chills, and confusion or loss of consciousness. Preventative medicine plays a large role in decreasing the likelihood of this problem. Adherence to basic hygienic methods in those at high risk, especially women, is warranted. Standard recommendations include wiping from front to back after urinating or defecating, as well as urinating right after an episode of sexual intercourse. Advise your patients to wear cotton undergarments; this will allow better air circulation in areas that might otherwise encourage bacterial or fungal growth. Consider natural diuretics (substances that increase urine output) to flush out your system. Lots of water will help flush out the infection by decreasing the concentration of bacteria in the bladder or kidney. Antibiotics are another mainstay of therapy (brand names and veterinary equivalents in parenthesis): Sulfamethoxazole- trimethoprim (Bactrim, Septra, Bird-Sulfa) Amoxicillin (Amoxil, Fish- Mox) Nitrofurantoin (Macrobid) Ampicillin (Fish-Cillin) Ciprofloxacin (Cipro, Fish- Flox) An over-the-counter medication that eliminates the painful urination seen in urinary infections is Phenazopyridine (also known as Pyridium, Uristat, Azo, etc. Don’t be alarmed if your urine turns reddish-orange; it is an effect of the drug and is temporary. Vitamin C supplements are thought to reduce the concentration of bacteria in the urine, and should also be considered. A few natural remedies for urinary tract infections are listed below: Garlic or garlic oil (preferably in capsules). Alka Seltzer in 2 ounces warm water (poured directly over the urethra) Use any one of these remedies three times per day.
Where facilities are available discount yasmin 3.03 mg without prescription birth control for 50 year olds, investigation and management is usually done with guidance or referral to a specialist yasmin 3.03 mg mastercard birth control pills pcos. Management should be carried out or guided by a nephrologist according to the biopsy result. Postural blood pressure for monitoring fluid loss and to prevent excessive diuresis. Common complications of acute renal failure include: » fluid overload and pulmonary oedema, » hyperkalaemia, » bleeding, » acidosis, and » encephalopathy. Both haemodialysis and peritoneal dialysis are acceptable modalities of therapy in the acute setting. For long-term or chronic, non-urgent need for potassium removal: • Sodium polystyrene sulfonate, oral, 15 g with 15 mL lactulose, 6 hourly. Hyperphosphataemia To decrease absorption of phosphate in acute renal failure: • Aluminium hydroxide 300 mg/5 mL, oral, 10 mL 8 hourly. Do not administer aluminium hydroxide and sodium polystyrene sulfonate simultaneously as this may potentiate aluminium toxicity. Alkalinising agents are not advised as many antibiotics require a lower urinary pH. For pregnant women: • Amoxicillin/clavulanic acid, oral, 875/125 mg 12 hourly for 7 days. If there is a poor response, perform an ultrasound on all hospitalised patients urgently as in-patients or electively as out-patients. Duration of antibiotic therapy: » fluoroquinolones 7 days » other antibiotics 14 days. Longer courses of therapy, 2–3 weeks, should be given for complicated pyelonephritis. Switch to oral therapy as soon as the patient is able to take oral fluids: • Ciprofloxacin, oral, 500 mg 12 hourly for 7 days. Switch to oral therapy as soon as the patient is able to take oral fluids: • Ciprofloxacin, oral, 500 mg 12 hourly for 7 days. Two types occur: » Relapse or recurrence of bacteriuria with the same organism within 3 weeks of completing treatment. Send urine for microscopy, culture and sensitivity as treatment is determined by the results. Patients with impaired bladder emptying require careful urological examination to establish whether surgical treatment is required. In this setting, treatment with a short, intensive course of antibiotic is appropriate. Clinical features include: » pyrexia, » acute pain in the pelvis and perineum, » urinary retention or difficulty, and » acutely tender prostate on rectal examination. Note: The presence of blood on urine test strips does not indicate infection and should be investigated as above. The cause is unknown and believed to be due to changes in hormone levels associated with ageing. For patients presenting with urinary retention, insert a urethral catheter as a temporary measure while the patient is transferred for referral. Organic causes include neurogenic, vasculogenic or endocrinological causes as well as many systemic diseases and certain drugs. Investigations 08h00 serum cortisol level (or at time of presentation in acute crisis): > 550 nmol/L: virtually excludes the diagnosis < 100 nmol/L: highly suggestive of hypoadrenalism 8. To maintain adequate intravascular volume guided by blood pressure: • Sodium chloride 0. For patients who remain symptomatically hypotensive: • Fludrocortisone, oral, 50–100 mcg daily. With minor stress maintenance therapy should be doubled for the duration of illness and gradually tapered to usual dose. Low dose betamethasone (equivalent to dexamethasone) suppression test: • Betamethasone, oral, 1 mg. In patients with type 2 diabetes mellitus, appropriate weight loss if weight exceeds ideal weight. Measure HbA1c: » annually in patients who meet treatment goals, and » 3–6 monthly in patients whose therapy has changed until stable. In patients with severe target organ damage, therapy should be tailored on an individual patient basis and should focus on avoiding hypoglycaemia.
Physics-based scoring of protein-ligand complexes: enrichment of known inhibitors in large-scale virtual screening buy discount yasmin 3.03 mg birth control with no hormones. Scoring functions and their evaluation methods for protein-ligand docking: recent advances and future directions purchase 3.03 mg yasmin fast delivery birth control 3 months. An iterative knowledge-based scoring function to predict protein-ligand interactions: I. Probing the stereoselectivity of P-glycoprotein-synthesis, biological activity and ligand docking studies of a set of enantiopure benzopyrano[3,4-b][1,4]oxazines. Molecular recognition of receptor sites using a genetic algorithm with a description of desolvation. Docking and scoring in virtual screening for drug discovery: methods and applications. Exhaustive sampling of docking poses reveals binding hypotheses for propafenone type inhibitors of P-glycoprotein. Diaryloxime and diarylvinyl ether derivatives of nipecotic acid and guvacine as anticonvulsant agents. X-ray structures of LeuT in substrate-free outward- open and apo inward-open states. How different amino acid sequences determine similar protein structures: the structure and evolutionary dynamics of the globins. Simultaneous binding of two different drugs in the binding pocket of the human multidrug resistance P-glycoprotein. Human P-glycoprotein is active when the two halves are clamped together in the closed conformation. The transmembrane domains of the human multidrug resistance P-glycoprotein are sufficient to mediate drug binding and trafficking to the cell surface. Location of the rhodamine-binding site in the human multidrug resistance P-glycoprotein. Ivermectin sensitivity in collies is associated with a deletion mutation of the mdr1 gene. A general protocol for the crystallization of membrane proteins for X-ray structural investigation. Automated docking using a Lamarckian genetic algorithm and an empirical binding free energy function. Interaction of transported drugs with the lipid bilayer and P-glycoprotein through a solvation exchange mechanism. Major human gamma-aminobutyrate transporter: in silico prediction of substrate efficacy. Substrate-Na+ complex formation: coupling mechanism for gamma-aminobutyrate symporters. Progress in the development and application of computational methods for probabilistic protein design. P-glycoprotein substrate binding domains are located at the transmembrane domain/transmembrane domain interfaces: a combined photoaffinity labeling- protein homology modeling approach. Fumitremorgin C reverses multidrug resistance in cells transfected with the breast cancer resistance protein. The high-affinity binding site for tricyclic antidepressants resides in the outer vestibule of the serotonin transporter. Targeted molecular dynamics: A new approach for searching pathways of conformational transitions. A structural model for the open conformation of the mdr1 P-glycoprotein based on the MsbA crystal structure. Stimulation of P-glycoprotein-mediated drug transport by prazosin and progesterone. The mechanism of a neurotransmitter:sodium symporter--inward release of Na+ and substrate is triggered by substrate in a second binding site. Sodium-dependent neurotransmitter transporters: oligomerization as a determinant of transporter function and trafficking. The N terminus of monoamine transporters is a lever required for the action of amphetamines.
Early mortality (n=8); G2 animals received 20% grafts with adenosine infusion yasmin 3.03 mg birth control for women with depression, (n=9) buy cheap yasmin 3.03mg birth control for women 8 months. Postoperative complications were not significantly different between the three groups. The severity of complications (Clavien score) was similar in the three groups (A: 1. Department of Surgery, The from such observations with surgical outcomes was investigated. The impact of donor age on the outcomes of both donor hepatectomy mmHg (range, 8 to 37 mmHg) to 14 mmHg (range, 10 to 26 mmHg) after and living donor liver transplantation had not been clarified. Portal inflow had a positive correlation with portal pressure before Methods: We performed retrospective analysis of recipients of right lobe native liver hepatectomy (R2= 0. Patients were mL/min/100 g) before donor right hepatectomy to 318 mL/min/100 g (range, divided into 2 groups, donor age ≤45 years (group A) and >45 years (group 102 to 754 mL/min/100 g) after graft implantation. Blood loss, operation time, and post-operative complications of donor linear correlation with the recipient portal pressure before hepatectomy of right hepatectomy were compared. Operation time in both correlation with the portal pressure after graft implantation reflected relief of groups were comparable (454 minutes vs. Despite the high portal inflow hepatectomy in group B had more blood loss (312ml vs. Complications of Clavien Grade between two groups of donors were comparable (17% vs. Delvart1, Conclusion: Provided stringent selection protocol and standardized surgical M. Three periods have been considered according months) occurred in 6 of the 2634 donors (0. Fourteen patients (14/15) were transplanted at our institution, one preservation time (p=0. Mean recipient age was 56 years, 13/15 were males been decreasing along the three periods. Survival was greatly affected with 10 patients 91%-55%-33% ; 91%-74%-72% ; and 91%-78%. The negative impact of worse donors and recipients with high rates of morbidity and mortality. Ponziani , Raffaella Viganò , Luca Belli , Giovambattista Pinzello4, Michele Colledan2, Eleonora De Martin7, proven antifunginal, antitumoral, and immunosuppressive proprieties. Amir Yosephy, Thomas mean ribavirine dose was 549 mg/daily and 13% of the patients were treated J. Department of General, Visceral and Transplantation Surgery, Charité Campus Virchow, Augustenburger Platz 1, Berlin, Germany Background: The inevitable persistence of the hepatitis-c-virus leads to the re-infection of the transplant within a few days. The development of the transplant fibrosis is accelerated and varies among individuals. These findings were correlated with low and Abstract# O-76 fast fibrosis progression. Archer, gender incompatibility of the graft recipient and donor, recipients´ age and Richard T. An F-test was performed to determine significant differences between the patient conditions. A network of believe that when present, these histological features identify a subgroup positive and negative co-stimulatory pathways regulates T cell activation. Previous estimates have relied on single biopsies and/or lymphocytes, defective in their ability to mount efficient pro-inflammatory assumed constant linear progression between stages and with time. Time-dependent changes in histological stage were analyzed to create a stage-specific transition matrix for fibrosis progression over 1 year. The transition matrix (table) shows the expected outcome in 1 year for a patient currently in stages 0-4. Fibrosis is non-linear, stage-dependent, and accelerates with François Bayle, Philippe Lang, Pierre Merville, Eric Thervet, increasing donor age. Service de Chirurgie Hépato- Bilaire et Digestive, Hopital Pontchaillou - Université Rennes 1, Rennes, France Background.
Several studies have demonstrated that environmental factors play a major role in this process of initiating autoimmunity 26–30 and may be responsible for the increased prevalence of autoimmune diseases in highly industrialised countries 31 discount yasmin 3.03mg on line birth control gif. Environmental factors operating in a genetically susceptible individual may directly initiate buy 3.03mg yasmin otc birth control pills dizziness, facilitate, or exacerbate pathological immune process, induce mutations in genes coding for immunoregulatory factors, or modify immune tolerance or regulatory and immune effector pathways 31. One of the environmental factors that may be of importance in the development or progression of autoimmunity is exposure to certain drugs 32. The frst cases in literature on drug-induced autoimmunity were patients developing various lupus-like symptoms after receiving sulphadiazine 37 and hydralazine 38,39. In the last decade, there has been an increase in reports of drug-induced autoimmunity 41–43. Numerous drugs have been reported to be associated with autoimmunity or resemble autoimmune disorders (table 1), and these numbers continue to increase as new therapeutics are introduced into practice 40,44. There is an increasing number of immunomodulatory drugs on the market, however, only a small group of patients who were treated with these drugs over a prolonged period of time, develop a systemic drug-induced syndrome 45. According to this general consensus, there should be a temporal relationship between continuous drug exposure (> one month) and clinical fndings. The clinical fndings should not be present in the patient prior to the use and should be resolved upon cessation of the offending drug 32,44–46. Several hypotheses for the mechanism underlying drug-induced autoimmunity have been postulated but none of them have been clearly demonstrated. Currently, available data strongly suggest that there is no single mechanism responsible for drug-induced autoimmunity. The frst mechanism is based on the presumed capacity of either the drug or its metabolites to produce stable complexes with self-macromolecules or stimulate lymphocytes directly. Essentially, this concept is a drug hypersensitivity mechanism in which the drug or its reactive metabolites bind to the protein (hapten), making it ‘foreign’ and stimulating an immune response against the hapten or possibly self-antigens (molecular mimicry) 43,45,52,53. As suggested in several studies, drugs or their reactive metabolites are capable of inducing specifc T cell responses, apparently by the altered self-proteins, however, there is no convincing evidence that this results in autoimmune diseases 40,50. Secondly, it has been postulated that certain reactive drug metabolites directly cause cell death via a non-immune mediated process of direct cytotoxicity 45,52. Vasoo postulated that these reactive metabolites alter degradation and clearance of apoptotic cells, which could lead to the loss of self-tolerance 45. Recently, it has been demonstrated that these drugs, quinidine and procainamide, could indeed inhibit the uptake of apoptotic and necrotic cells by macrophages 61, which may increase the autoantibody production against cellular antigens 62. In addition, certain drugs including hydralazine, isoniazid, quinidine, or chlorpromazine, but not procainamide induce apoptosis of activated peripheral blood mononuclear cells 63. Finally, drug-induced autoimmunity may be due to interference with central immune tolerance. The thymus provides tolerance by deleting auto-reactive T cells during thymus maturation. As a result, autoreactive T cells are migrated from the thymus to the periphery where they provide Th cell function to B cells with the potential to produce autoantibodies 76,77. As described earlier, the confrmation of drug-induced autoimmunity may be achieved by re-exposure to the drug. However, deliberate rechallenge is usually not advocated, as patients are likely to have a severe response when they are re-exposed to the drug. As straightforward as this approach seems, making a diagnosis of drug-induced autoimmunity often proves to be challenging in clinical practice 32. Many patients, especially elderly patients, may have multiple diagnoses and treatments, or have a medical history that is not well documented, which could make it diffcult to establish an association between the drug in question and the patient’s symptoms. Another diffculty that may be encountered in setting a diagnosis of drug-induced autoimmunity is the nature of autoimmune disease. Although each autoimmune disease is unique, many 1 share features with other diseases, making it diffcult to establish whether the presence of autoantibodies is part of the underlying disease or attributable to the drug. In daily practice, it is rather diffcult to detect these side effects because they are relatively uncommon, its symptoms are generally mild to moderate, appear after prolonged exposure to the drug, and may occasionally persist, despite drug discontinuation 44. According to a French survey using the French pharmacovigilance system, approximately 0. Not only for pharmacovigilance working parties but also for physicians it is a major challenge to set a diagnosis of drug-induced autoimmunity. Nevertheless, it must be emphasised that drug-induced autoimmunity can be chronic, with long-term morbidity, and therefore may potentially impose a heavy burden on public health. Drug-induced autoimmune disorders often exhibit heterogeneity in clinical features and drugs are capable of eliciting an immune response to certain auto-antigens.
Hydatid disease Management Repeated ultrasound guided aspirations may be re- Definition quired generic yasmin 3.03 mg with amex birth control and weight loss. Extensive effective 3.03mg yasmin birth control for women with depression, difficult to approach abscesses are A tapeworm infection of the liver common in sheep rear- drained by open surgery, with soft pliable drains. Chapter 5: Disorders of the liver 213 Aetiology/pathophysiology r Hepatic adenomas are oestrogen dependent tumours In man hydatid disease is caused by one of two tape- generally only seen in women. They are strongly asso- worms Echinococcus granulosus and Echinococcus mul- ciated with the oral contraceptive pill. Clinical features The disease may be symptomless but chronic right up- Primary hepatocellular carcinoma perquadrant pain with enlargement of the liver is the common presentation. The cyst may rupture into the Definition biliary tree or peritoneal cavity and may cause an acute Also called hepatoma, this is a tumour of the liver anaphylactic reaction. Investigations Incidence/prevalence Eosinophilia is common and serological tests are avail- Relatively uncommon in the Western world (2–3%), but able. Small, calcified cysts may be seen on plain abdom- by far the most common primary tumour of the liver inal X-ray. Percutaneous ultrasound guided fine nee- Sex dle aspiration with injection of scolicidal agents and re- M > F (3–4:1) aspiration may be used. Large symptomatic cysts may be surgically excised intact taking great care to avoid con- Geography tamination of the peritoneal cavity. High incidence (40% of all cancers) in countries where predisposing factors such as hepatitis B are common, e. Tumours of the liver Aetiology Benign tumours of the liver Tumours arise in a chronically damaged liver especially Benign tumours of the liver must be differentiated from in cirrhosis independent of the cause. Hepatitis B virus malignant tumours such as metastases or primary hepa- carrier states and chronic active hepatitis predisposes to tocellular tumour and cysts or abscesses. There are four primary hepatocellular carcinoma, especially when hep- main types: atitisBinfectionoccursinearlylife. Hepatotoxinssuchas r Cavernous haemangiomas are the most common be- mycotoxinspresentinfood,increasetheincidenceofpri- nign tumours of the liver. Aflatoxin, produced by Aspergillus flavus, rarely become large and produce pain, enlarged liver is frequently found in stored nuts and grains in tropical or haemorrhage. Sometimes rare syn- mour,whichusuallypresentslateinpatientswhoalready dromes occur such as hypercalcaemia, hypoglycaemia haveaseriousunderlyingpathology,cirrhosis. Theprog- and porphyria cutanea tarda (bullae on the skin follow- nosis is very poor. Median survival is <6 months from ing sun exposure or minor trauma due to a defect in a diagnosis. Aetiology Clinical features The most common sites of the primary tumour are Insidious onset with anorexia, weight loss and poorly bronchus, breast, bowel (stomach, colon) and pancreas. On ex- The liver is also an important site of growth for lym- amination, the liver is usually enlarged and there may be phomas and leukaemias. Pathophysiology Macroscopy/microscopy Haematogenous spread via the portal vein or the hep- The right lobe is more frequently affected than the left. Large or There is usually one large, haemorrhagic, soft mass or multifocal tumours cause loss of liver parenchyma and multifocal nodules. Histologically cells that there is a primary tumour present, or it may occur in rangefromwelldifferentiatedtoanaplastic,withatypical a patient with known past or present malignant disease. Clinical features Complications Insidious onset of fatigue, anorexia and weight loss oc- Metastases most commonly occur via the bloodstream curs. Direct spread may also occur to abdominal be felt over the liver, which may be irregular, firm and lymph nodes and to other abdominal organs. Investigations r Persistently high levels of serum α feto-protein is very Investigations suspicious of carcinoma. Management Management r Curative treatment by partial liver resection is feasible Treatment depends on the natural history of the primary in patients with tumour in only one lobe and with tumour. Chapter 5: Disorders of the gallbladder 215 r Rarely curative excision of a liver metastasis is per- hypercholesterolaemia has not been associated with formed, particularly for slow-growing tumours.
La consommation accrue observée ces cours des quelques années qui ont précédé 2007 order yasmin 3.03 mg mastercard birth control pills hair loss. La majeure partie de cette Kilogrammes substance est consommée en Allemagne yasmin 3.03mg with visa birth control pills start date, qui a absorbé 6 000 en 2007 94 % du total mondial, tandis que la Belgique en absorbait 5 %. Six autres pays, à savoir le Botswana, la Bulgarie, la Grèce, l’Italie, le Luxembourg et la Suisse, 5 000 ont déclaré avoir consommé des quantités de tilidine inférieures à 50 kg en 2007. Les stocks mondiaux de tilidine ont atteint 32,9 tonnes en 2007, l’essentiel 2 000 étant détenu par l’Allemagne (26 tonnes, soit 80 % des stocks mondiaux), suivie par l’Irlande et l’Italie 1 000 (7,5 tonnes chacune). La fabrication de trimépéridine a fortement aLes statistiques communiquées par les gouvernements servent à calculer, fluctué pendant la période 1998-2007. La fabrication mondiale déclarée de pentazocine augmente fortement et régulièrement. En 2007, elle a était de plus de 4,5 tonnes en moyenne pendant la atteint le niveau record de plus de 4,8 tonnes, soit plus de période 1998-2007, l’Inde et l’Italie étant les principaux quatre fois la quantité fabriquée en 2000 (voir fig. La presque totalité de la pentazocine Le Royaume-Uni et l’Inde représentaient 86 % de la fabriquée en Inde est destinée à la consommation quantité fabriquée au niveau mondial; ils étaient suivis interne. L’Italie exporte le gros de la pentazocine qu’elle par l’Australie et la Belgique. L’Australie, l’Allemagne fabrique, ce qui en fait le premier exportateur dans le et le Royaume-Uni ont été les principaux exportateurs monde. Les États-Unis, ainsi que le principal consommateur de la substance l’Allemagne et la France, dans l’ordre des quantités avec l’Inde et le Pakistan. Une quarantaine d’autres importées, en ont été les principaux importateurs, avec pays signalent régulièrement des importations de plus de 76 % des importations mondiales. Cannabis: production, consommation ment augmenté, passant de 1,4 tonne en 2000 à 5,3 ton- a et stocks au niveau mondial, 1988-2007 nes en 2002, pour se stabiliser ensuite à environ 6 tonnes. En 2007, elle s’est fortement accrue, pour s’établir à Tonnes 10,1 tonnes, dont 5,7 tonnes produites au Royaume- 25 Uni, 3,7 tonnes au Canada, 672 kg aux États-Unis et 99 kg aux Pays-Bas (voir fig. Avant 2000, les États-Unis étaient le seul pays à déclarer l’utilisation de cannabis uniquement à des fins scientifiques. Depuis lors, le cannabis et les extraits de 15 cannabis ont été également utilisés à des fins scientifiques dans d’autres pays. Le cannabis est consommé à des fins médicales au Canada depuis 2001, et aux Pays-Bas 10 depuis 2003. La consommation mondiale de cannabis et d’extraits de cannabis24 à des fins scientifiques et 5 médicales est passée de 858 kg en 2000 à 4,3 tonnes en 2004. Après être tombée à environ 3 tonnes en 2005 et 2006, elle a de nouveau augmenté en 2007 pour atteindre 0 le niveau record de 4,4 tonnes. Le Canada était le premier 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 consommateur en 2007 (près de 3,8 tonnes), suivi par Année l’Allemagne (318 kg), les Pays-bas (217 kg), l’Afrique Stocks Production Consommation du Sud (102 kg), la République tchèque (26 kg) et les a Stocks au 31 décembre de l’année considérée. En outre, Sri Lanka utilise à des fins licites (en médecine ayurvédique) du cannabis saisi; en 2006, ce sont 140 kg qui ont été ainsi utilisés. Les stocks mondiaux de cannabis, qui s’étaient maintenus entre à 22,6 tonnes en 2007. Les pays ayant déclaré détenir 2 et 2,8 tonnes jusqu’en 1999, ont considérablement d’importants stocks de cannabis en 2007 étaient le augmenté, passant à environ 12,6 tonnes en 2004 et 25 Royaume-Uni (19,2 tonnes ), les États-Unis (1,6 tonne), la Suisse (880 kg) et le Canada (864 kg). Le Pérou est depuis 2000 le seul exportateur de feuille de coca sur le marché mondial. Les États-Unis Kilogrammes sont le premier importateur, avec près de 98 % des 1 400 importations mondiales. Les importations de ce pays sont tombées de 175,3 tonnes en 2001 à 22,7 tonnes 1 200 en 2006 puis ont à nouveau augmenté pour s’établir à 45,1 tonnes en 2007. L’utilisation de la feuille de coca 1 000 aux États-Unis, pour l’extraction d’aromatisants et la fabrication accessoire de cocaïne, a fluctué entre 1988 800 et 2007, accusant une tendance générale à la baisse. De petites 200 quantités de feuille de coca sont utilisées en Italie, aux Pays-Bas et en Suisse pour l’extraction d’aromatisants 0 et en France dans des médicaments homéopathiques. En 2007, Stocks Fabrication Consommation ce pays en détenait 771 tonnes, soit 79 % des stocks aStocks au 31 décembre de l’année considérée. La consommation mondiale de cocaïne n’a baisse continue, tombant d’une moyenne annuelle de cessé de diminuer au cours de la période 1988-2007, 850 kg au cours de la période 1987-1990 à un peu tombant d’une moyenne annuelle d’environ 600 kg plus de 300 kg en 2006. En 2007, toutefois, elle a entre 1987 et 1990 à 216 kg en 2007, niveau le plus de nouveau augmenté pour atteindre 524 kg, dont bas jamais enregistré. En 2007, les États-Unis sont restés 318 kg (61 %) étaient obtenus au Pérou et le reste aux le premier consommateur de cocaïne (81 kg, soit 38 % États-Unis (voir fig.
