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cocaine complications

Falk Mancke, Gintarė Kaklauskaitė, Jennifer Kollmer, Markus Weiler
Nitrous oxide (N2O), a long-standing anesthetic, is known for its recreational use, and its consumption is on the rise. Several case studies have reported neurological and psychiatric complications of N2O use. To date, however, there has not been a study using standardized diagnostic procedures to assess psychiatric comorbidities in a patient consuming N2O. Here, we report about a 35-year-old male with magnetic resonance imaging confirmed subacute myelopathy induced by N2O consumption, who suffered from comorbid cannabinoid and nicotine dependence as well as abuse of amphetamines, cocaine, lysergic acid diethylamide, and ketamine...
2016: Substance Abuse and Rehabilitation
G Jeanne, D Purper-Ouakil, H Rigole, N Franc
AIM: There have been significant changes in adolescent consumption habits over the past fifteen years. New molecules have been synthesized, new devices created and a number of products have increased in popularity; and as a result clinicians sometimes lack information. We chose to focus on this population because of its vulnerability, as adolescents show low sensitivity to long-term outcomes of their actions and may be easily influenced by peers as regards experimentation of new drugs...
October 6, 2016: L'Encéphale
José Tadeu Nunes Tamanini, Vagner Tadeu Salzani, Juliana Milhomem Tamanini, Filipe Iessenco, Leonardo O Reis
Report case (s) relevant aspects: Man, 27 years old, complaining of acute testicular pain by 2 hours in the remaining left testicle. Denies fever, lower urinary tract symptoms such as dysuria, urinary frequency, concommitant or prior urethral discharge to the painful condition. He underwent right orchiectomy 13 years ago by testicular torsion. He is a chronic user of cocaine for 15 years and during the last three days the drug use was continuous and intense. Proposed premise substantiating case (s) description: Initial diagnostic hypothesis: Syndromic: Acute Scrotum Syndrome (SEA) • Main Etiologic (testicular torsion) • Secondary Etiologic (acute orchiepididymitis) Briefly delineates what might it add? Lines of research That Could be Addressed: In this challenging clinical case we presented an alternative and new etiologic diangosis for the acute scrotum which the main etiologic factor remains testicular torsion...
September 1, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Erwan Le Garff, Gilles Tournel, Coralie Becquart, Olivier Cottencin, Nicolas Dupin, Emmanuel Delaporte, Valéry Hedouin
Levamisole, which is used as an adulterated compound of cocaine, is currently being seen year after year in cocaine intoxication. For a few cases in the last decade, necrotic purpura and neutropenia after levamisole/cocaine intoxication have been described in the medical community. Herein, we present an original case of levamisole intoxication of a 40-year-old woman who smoked heroin and cocaine few during a month. She rapidly presented an extensive necrotic purpura of the nose, cheeks and extremities (lower and upper), and immunologic reactions (positive anti-MPO and anti-HNE)...
August 8, 2016: Journal of Forensic Sciences
Yunfei Tang, Feng Long, Chunmei Gu, Cheng Wang, Shitong Han, Miao He
A rapid, facile, and sensitive assay of cocaine in biological fluids is important to prevent illegal abuse of drugs. A two-step structure-switching aptasensor has been developed for cocaine detection based on evanescent wave optical biosensing platform. In the proposed biosensing platform, two tailored aptamer probes were used to construct the molecular structure switching. In the existence of cocaine, two fragments of cocaine aptamer formed a three-way junction quickly, and the fluorophore group of one fragment was effectively quenched by the quencher group of the other one...
August 24, 2016: Analytica Chimica Acta
A Saleh, J Tittley, S Anand
"Bath salts" are synthetic designer drugs that have stimulant properties and are a growing medical concern. The chemical compounds in the mixtures have an affinity for receptors in the brain resulting in a stimulant effect similar to that seen with methamphetamines and cocaine. Although illegal in Canada, these drugs are widely available online with over 20 synthetic drugs marketed as "bath salts" and used increasingly among recreational drug users. Much of the medical literature regarding these drugs comes from emergency medicine case reports, which outline the acute, severe medical and psychiatric effects of "bath salt" toxicity...
July 13, 2016: Annals of Vascular Surgery
Eric T Shimomura, Alice J Briones, Wendy S Warren, Joseph W Addison, Jessica L Knittel, Sarah A Shoemaker, Taj D King, Thomas Z Bosy
It is reasonable to expect the presence of multiple drugs to present a complicated picture of toxicity. We report a fatal case involving a young man who purchased illicit drugs and knowingly consumed them. After consuming these drugs and going to sleep in his friend's car, he was found unresponsive the next morning with no signs of physical violence. Drugs found in the peripheral blood at autopsy were oxymorphone, methylone and ethanol at concentrations of 0.106, 0.50 and 130 mg/dL, respectively. The levels of oxymorphone and methylone in peripheral blood were comparable to those observed in other reported fatalities...
September 2016: Journal of Analytical Toxicology
Lu Yang, Xufeng Chen, Samantha M Simet, Guoku Hu, Yu Cai, Fang Niu, Yeonhee Kook, Shilpa J Buch
Abuse of psychostimulants such as cocaine has been shown to be closely associated with complications of the lung such as pulmonary hypertension, edema, increased inflammation and infection. However, the mechanism by which cocaine mediates impairment of alveolar epithelial barrier integrity that underlies various pulmonary complications isn't well determined. Herein we sought to investigate the role of cocaine in disrupting the alveolar epithelial barrier function and the associated signaling cascade. Using the combinatorial ECIS and FITC-dextran permeability assays, we demonstrated cocaine-mediated disruption of the alveolar epithelial barrier as evidenced by increased epithelial monolayer permeability with a concomitant loss of tight junction protein Zo-1 in both mouse primary alveolar epithelial cells and the alveolar epithelial cell line - L2 cells...
July 8, 2016: American Journal of Respiratory Cell and Molecular Biology
Martín Rosas-Peralta, Gabriela Borrayo-Sánchez, Alejandra Madrid-Miller, Erick Ramírez-Arias, Gilberto Pérez-Rodríguez
It is inexorable that a proportion of patients with systemic arterial hypertension will develop a hypertensive crisis at some point in their lives. The hypertensive crises can be divided in hypertensive patients with emergency or hypertensive emergency, according to the presence or absence of acute end-organ damage. In this review, we discuss the cardiovascular hypertensive emergencies, including acute coronary syndrome, congestive heart failure, aortic dissection and sympathomimetic hypertensive crises (those caused by cocaine use included)...
2016: Revista Médica del Instituto Mexicano del Seguro Social
Eric J Mersereau, Cody A Boyle, Shelby Poitra, Ana Espinoza, Joclyn Seiler, Robert Longie, Lisa Delvo, Megan Szarkowski, Joshua Maliske, Sarah Chalmers, Diane C Darland, Tristan Darland
A sizeable portion of the societal drain from cocaine abuse results from the complications of in utero drug exposure. Because of challenges in using humans and mammalian model organisms as test subjects, much debate remains about the impact of in utero cocaine exposure. Zebrafish offer a number of advantages as a model in longitudinal toxicology studies and are quite sensitive physiologically and behaviorally to cocaine. In this study, we have used zebrafish to model the effects of embryonic pre-exposure to cocaine on development and on subsequent cardiovascular physiology and cocaine-induced conditioned place preference (CPP) in longitudinal adults...
2016: International Journal of Molecular Sciences
Evangelia Liakoni, Patrick C Dolder, Katharina M Rentsch, Matthias E Liechti
BACKGROUND: Although the recreational use of psychoactive substances is common there is only limited systematic collection of data on acute drug toxicity or hospital presentations, in particular regarding novel psychoactive substances (NPS) that have emerged on the illicit market in the last years. METHODS: We included all cases presenting at the emergency department (ED) of the University Hospital of Basel, Switzerland, between October 2014 and September 2015 with acute toxicity due to self-reported recreational drug use or with symptoms/signs consistent with acute toxicity...
2016: BMC Pharmacology & Toxicology
Elise D Riley, Alex H Kral, Jennifer Cohen, Samantha E Dilworth, Martha Shumway, Kara L Lynch
A growing number of case reports cite serious health complications linked to the cocaine adulterant, levamisole and women are disproportionately affected; however, the clinical effects are not well established. Between April and October of 2010, we conducted a cross-sectional study among 222 homeless and unstably housed women (116 human immunodeficiency virus [HIV]-infected and 106 HIV-uninfected). Immune markers and behavioral factors were compared in separate models by cocaine and levamisole exposure. Overall, 63% of participants were toxicology positive for cocaine/benzoylecgonine, 85% of whom also tested positive for levamisole...
September 2016: Journal of Women's Health
James D Turner, Justin L Farmer, Sean W Dobson
We describe here a 55-year-old male patient with a medical history significant for chronic back pain and substance abuse with cocaine who sustained a traumatic subarachnoid hemorrhage after a fall from a roof while acutely intoxicated on cocaine requiring decompressive hemicraniectomy and cranioplasty that was complicated by an epidural abscess requiring a repeat craniectomy. He was diagnosed with sinking skin flap syndrome consistent with altered mental status and a sunken skin flap with increased midline shift...
June 1, 2016: A & A Case Reports
Adrián Imbernón-Moya, Ricardo Chico, Antonio Aguilar-Martínez
Complications due to cocaine are a public health problem. The typical cutaneous disease is leukocytoclastic vasculitis and/or thrombotic vasculopathy affecting mainly the ears. No intense systemic involvement is usually present, but there may be several cutaneous, mucosal and systemic manifestations. Other findings associated as arthralgia, neutropaenia or agranulocytosis, low titer positive antinuclear antibodies, antiphospholipid antibody positivity and neutrophil cytoplasmic antibodies against multiple antigens help the diagnosis...
June 17, 2016: Medicina Clínica
Blanca I Indave, Silvia Minozzi, Pier Paolo Pani, Laura Amato
BACKGROUND: Cocaine dependence is a public health problem characterised by recidivism and a host of medical and psychosocial complications. Cocaine dependence remains a disorder for which no pharmacological treatment of proven efficacy exists. OBJECTIVES: To evaluate the efficacy and the acceptability of antipsychotic medications for cocaine dependence. SEARCH METHODS: This review is an update of a previous Cochrane review published in 2007...
2016: Cochrane Database of Systematic Reviews
Adriane M Dela Cruz, Thomas Carmody, Tracy L Greer, Chad D Rethorst, Diane Warden, Robrina Walker, Madhukar H Trivedi
BACKGROUND AND OBJECTIVES: Rates of medical illnesses may be higher among individuals with substance use disorders, complicating their care. This study aimed to expand the understanding of other medical conditions in treatment-seeking adults with stimulant use disorder (SUD) using data from Stimulant Reduction Intervention using Dose Exercise (STRIDE), a randomized, multisite trial investigating exercise augmentation of treatment as usual. METHODS: Utilizing STRIDE baseline data, we examined demographic and clinical characteristics based on the number of self-reported diagnosed medical conditions among participants meeting eligibility criteria (passing medical screening exam and maximal exercise test, non-opioid dependent, no concomitant beta blocker, or opioid replacement therapy)...
April 2016: American Journal on Addictions
M Patricia George, Vikas Singh, Mark T Gladwin
The goal of this review is to describe evolving epidemiology of noninfectious, nonneoplastic pulmonary complications of HIV infection, including HIV-associated pulmonary arterial hypertension (HIV-PAH) and interstitial lung disease (ILD). The development of antiretroviral therapy has rendered HIV a chronic illness in treated patients, and the landscape of HIV-associated medical conditions continues to evolve. Although there has been a shift away from AIDS-defining infectious diseases and malignancies, HIV-PAH continues to affect survival adversely when compared with HIV-infected patients without PAH...
April 2016: Seminars in Respiratory and Critical Care Medicine
Francesca Indorato, Guido Romano, Nunziata Barbera
Levamisole has been identified as a cocaine adulterant in the United States since 2002. Although there is a variation in the percentage of levamisole in cocaine samples between European countries, measurement of levamisole in human samples of cocaine users has become increasingly important. To our best knowledge, only five deaths are reported (one twice) as a result of complications secondary to levamisole-tainted cocaine and none of these cases reports the post-mortem levamisole concentration. In this article, we present the post-mortem levamisole concentrations in fluids and tissues in two young cocaine users, dead after levamisole-adulterated cocaine intake...
August 2016: Forensic Science International
Steven B Karch, Francesco Paolo Busardò, Fabio Vaiano, Francesca Portelli, Simona Zaami, Elisabetta Bertol
The first case reports of levamisole-related disease in cocaine users were published in 2010, although levamisole adulteration of cocaine was first recognized several years earlier. Currently, more than 70% of street cocaine seizures, in the US and the EU, contain levamisole, which could potentially be converted to aminorex, though the reasons for this practice still remain obscure. Here we report two fatal cases of isolated pulmonary vasculitis in abusers of levamisole-adulterated cocaine, where a complete autopsy, full toxicological analysis by gas chromatography-mass spectrometry (GC-MS) using a previously published method of Karch et al...
August 2016: Forensic Science International
Matteo Trimarchi, Vittoria Sykopetrites, Mario Bussi
A cocaine-induced midline destructive lesion (CIMDL) is a rare consequence of cocaine insufflation that involves the nose, sinuses, and occasionally the palate. Palatal perforations compromise swallowing, mastication, and speech. An obturator prosthesis can be used to overcome these complications. In selected cases, a nasal septal button is a good alternative for the sealing of a palatal perforation, especially when surgery is not indicated, such as in cases of persistent cocaine abuse. Abstinence from cocaine is the most effective long-term management option for patients with a CIMDL, and surgical correction of the defect should be postponed until the patient stops sniffing cocaine and the lesion becomes stable...
January 2016: Ear, Nose, & Throat Journal
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