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https://www.readbyqxmd.com/read/28408236/unintentional-pediatric-cocaine-exposures-result-in-worse-outcomes-than-other-unintentional-pediatric-poisonings
#1
Patil Armenian, Michelle Fleurat, George Mittendorf, Kent R Olson
BACKGROUND: Unintentional pediatric cocaine exposures are rare but concerning due to potentially serious complications such as seizures, dysrhythmias, and death. OBJECTIVES: The objectives were to assess the demographic and clinical characteristics of pediatric cocaine exposures reported to the California Poison Control System. METHODS: This is a retrospective study of all confirmed pediatric (< 6 years of age) cocaine exposures reported to the California Poison Control System from January 1, 1997-September 30, 2010...
April 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28336675/evolving-risk-factors-and-antibiotic-sensitivity-patterns-for-microbial-keratitis-at-a-large-county-hospital
#2
Haoxing Jin, Walter T Parker, Nathan W Law, Cameron L Clarke, Jordan D Gisseman, Stephen C Pflugfelder, Li Wang, Zaina N Al-Mohtaseb
Purpose: To identify the risk factors, causative organisms, antimicrobial susceptibility and outcomes of microbial keratitis in a large county hospital in Houston, Texas. Design: Case series. METHODS: Setting: A large county hospital in Houston, Texas. Study Population: Patients with known diagnosis of microbial keratitis from January 2011 to May 2015. Observation Procedure: Retrospective chart review. Main Outcomes: Epidemiology, risk factors, outcomes and antibiotic susceptibility of microbial keratitis...
March 23, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28314885/adverse-effects-of-levamisole-in-cocaine-users-a-review-and-risk-assessment
#3
REVIEW
Tibor Markus Brunt, Jorrit van den Berg, Ed Pennings, Bastiaan Venhuis
The immunomodulatory adjuvant and antihelminth levamisole is increasingly used as an adulterant in cocaine worldwide. An accumulating body of clinical and toxicological literature has appeared since 2010 describing neutropenia, agranulocytosis, leukoencephalopathy and vasculitis in cases associated with levamisole-adulterated cocaine. Mostly, neutropenia and agranulocytosis were reported, characterized by a decimation of neutrophils. A large proportion of cases also involved vasculopathy, characterized by pronounced black and purple skin purpura with cutaneous necrosis...
March 17, 2017: Archives of Toxicology
https://www.readbyqxmd.com/read/28306693/cocaine-and-coronary-artery-diseases-a-systematic-review-of-the-literature
#4
Giovanni P Talarico, Maria L Crosta, Maria B Giannico, Francesco Summaria, Leonardo Calò, Roberto Patrizi
Cocaine is associated with important cardiac complications such as sudden death, acute myocarditis, dilated cardiomyopathy, life-threatening arrhythmias, and myocardial ischemia as well as infarction. It is well known that cocaine may induce vasospasm through adrenergic stimulation of the coronary arteries. Moreover, cocaine may promote intracoronary thrombosis, triggered by alterations in the plasma constituents, and platelet aggregation, leading to subsequent myocardial infarction. The long-term use of cocaine may stimulate atherosclerosis, probably through endothelial cell dysfunction...
May 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28284332/confirmed-case-of-levamisole-associated-multifocal-inflammatory-leukoencephalopathy-in-a-cocaine-user
#5
Jeffrey R Vitt, Ethan G Brown, Daniel S Chow, S Andrew Josephson
Levamisole is a common adulterant in cocaine and has previously been associated with a variety of serious complications including multifocal inflammatory leukoencephalopathy (MIL). There have been several reports of MIL in patients taking cocaine and, though suspected, the presence of levamisole was not confirmed. We present a case of a 63-year-old woman presenting with stupor and spastic quadraparesis found to have urine positive for cocaine and levamisole. An MRI brain revealed innumerable FLAIR hyperintensities with restricted diffusion and incomplete ring-enhancement...
April 15, 2017: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/28264690/presentations-to-an-urban-emergency-department-in-bern-switzerland-associated-with-acute-recreational-drug-toxicity
#6
Evangelia Liakoni, Sabine Müller, Adrian Stoller, Meret Ricklin, Matthias E Liechti, Aristomenis K Exadaktylos
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. Currently, data from Switzerland are only available from the University Hospital of Basel. The present study aimed to describe the presentations due to recreational drug use at an emergency department in Bern, Switzerland during a 4 year period. METHODS: Retrospective analysis of cases presenting from May 2012 to April 2016 at the emergency department of the University Hospital of Bern, Switzerland, with symptoms/signs consistent with acute toxicity of recreational drug use...
March 7, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28230244/topical-anaesthetics-for-pain-control-during-repair-of-dermal-laceration
#7
REVIEW
Baraa O Tayeb, Anthony Eidelman, Cristy L Eidelman, Ewan D McNicol, Daniel B Carr
BACKGROUND: Topical local anaesthetics provide effective analgesia for patients undergoing numerous superficial procedures, including repair of dermal lacerations. The need for cocaine in topical anaesthetic formulations has been questioned because of concern about adverse effects, thus novel preparations of cocaine-free anaesthetics have been developed. This review was originally published in 2011 and has been updated in 2017. OBJECTIVES: To assess whether benefits of non-invasive topical anaesthetic application occur at the expense of decreased analgesic efficacy...
February 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28166084/unexpected-complication-of-cocaine-associated-anti-neutrophil-cytoplasmic-antibody-vasculitis-related-to-persistent-in-hospital-cocaine-use
#8
Travis D Olives, Rebecca L Kornas, Russell Fujisawa, Jon B Cole
INTRODUCTION: Levamisole-adulterated cocaine has been implicated in anti-neutrophil cytoplasmic antibody (ANCA) vasculitis. We present a case of spontaneous intraperitoneal hemorrhage, an unexpectedly severe complication of cocaine-related ANCA vasculitis, developing late during hospitalization. CASE REPORT: An adult male with a history of hepatitis C, distant cocaine use, and limited health care presented to a local emergency department (ED) with volume overload, renal failure, hyperkalemia and non-anion gap metabolic acidosis...
March 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28157591/higher-prevalence-of-detectable-troponin-i-among-cocaine-users-without-known-cardiovascular-disease
#9
Elise D Riley, Priscilla Y Hsue, Eric Vittinghoff, Alan H B Wu, Phillip O Coffin, Peter K Moore, Kara L Lynch
BACKGROUND: While cocaine use is an established risk factor for acute cardiovascular complications, associations between cocaine use and markers of cardiac injury outside of acute hospital presentation remain poorly characterized. We leveraged advances in cardiac troponin (cTnI) testing to assess low but clinically meaningful levels of cardiac injury among cocaine users and non-users. METHODS: We conducted a case control study comparing cTnI levels by the presence of cocaine among patients presenting for non-cardiac care in an urban safety net hospital...
January 19, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28125506/oral-modafinil-facilitates-intracranial-self-stimulation-in-rats-comparison-with-methylphenidate
#10
Matthew F Lazenka, S Stevens Negus
Modafinil is a low-potency inhibitor of dopamine transporters (DAT) approved clinically to promote wakefulness. In most procedures used for abuse-liability assessment, modafinil produces effects similar to those of abused DAT inhibitors such as cocaine and methylphenidate, although modafinil often shows lower effectiveness. However, modafinil has failed to maintain drug self-administration or produce conditioned place preferences in rats. The low potency and poor solubility of modafinil complicate its delivery by parenteral routes of administration commonly used in rats, and this may contribute toward negative results...
January 25, 2017: Behavioural Pharmacology
https://www.readbyqxmd.com/read/28008563/agitation-after-subarachnoid-hemorrhage-a-frequent-omen-of-hospital-complications-associated-with-worse-outcomes
#11
Michael E Reznik, J Michael Schmidt, Ali Mahta, Sachin Agarwal, David J Roh, Soojin Park, Hans Peter Frey, Jan Claassen
BACKGROUND: Agitated delirium is frequent following acute brain injury, but data are limited in patients with subarachnoid hemorrhage (SAH). We examined incidence, risk factors, and consequences of agitation in these patients in a single-center retrospective study. METHODS: We identified all patients treated with antipsychotics or dexmedetomidine from a prospective observational cohort of patients with spontaneous SAH. Agitation was confirmed by chart review. Outcomes were assessed at 12 months using the modified Rankin Scale (mRS), Telephone Interview for Cognitive Status (TICS), and Lawton IADL (Instrumental Activities of Daily Living) scores...
December 22, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27994816/horner-syndrome-following-thyroid-surgery-the-clinical-and-pharmacological-presentations
#12
Giuseppe Giannaccare, Corrado Gizzi, Michela Fresina
PURPOSE: To report the clinical and pharmacological findings of a patient with iatrogenic Horner syndrome (HS) which occurred after thyroid surgery. CASE REPORT: A 29-year-old man was referred to our emergency ward due to anisocoria and unilateral eyelid ptosis reported by the patient immediately after a recent thyroidectomy for a papillary carcinoma. Ophthalmologic examination revealed 3 mm ptosis of the right eyelid. In dim illumination, the right and left pupil size was measured 3 and 6 mm, respectively...
October 2016: Journal of Ophthalmic & Vision Research
https://www.readbyqxmd.com/read/27828699/levamisole-adulterated-cocaine-toxicity-would-you-recognize-it
#13
Suneela Cherlopalle, Manasa Enja, Melanie Lippmann, Steven Lippmann
Adulteration of cocaine with levamisole is common and can induce serious medical complications. Levamisole is an antihelminthic agent originally approved as an immunomodulator in the treatment of autoimmune disorders and as a chemotherapy adjunct. It was withdrawn from the US market in 2000 but is available in veterinary medicine. Cocaine-using patients may present with nonspecific constitutional symptoms, cutaneous eruptions, leukopenia, vasculitis, and organ damage. Skin manifestations may include severe necrosis, especially of the ear lobes...
July 14, 2016: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/27805341/cocaine-abuse-an-unusual-association
#14
S C Chaudhary, K K Sawlani, H S Malhotra, Apurva, S Nanda, P K Rao
Cocaine addiction is a common problem in the adolescent and the young adults, pharmacologic interventions to reverse the effects of which do not exist. Neurological complications of cocaine abuse, such as seizures, headache, ischemic or hemorrhagic stroke, or subarachnoid hemorrhage, can be disastrous as a result of uncontrolled vasoconstriction and vasculitic damage. The lone occurrence of subdural hematoma in the absence of any other intracranial hemorrhagic complication is rarely seen in patients of cocaine abuse...
November 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27777711/cocaine-use-and-splenic-rupture-a-rare-yet-serious-association
#15
Nishrutha Karthik, Karthik Gnanapandithan
Cocaine abuse is frequent in patients visiting the emergency department. The knowledge of the cardiovascular complications of cocaine is excellent among physicians. However the awareness regarding its abdominal complications, the most important of which include gastroduodenal perforation, bowel ischemia and splenic rupture is less adequate. We report a 58-year-old with cocaine use who presents with upper abdominal pain and a rapidly worsening clinical status. He was found to have atraumatic splenic rupture causing a hemoperitoneum that was managed by intervention radiology guided splenic artery embolization...
August 8, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27729826/psychiatric-comorbidities-in-a-young-man-with-subacute-myelopathy-induced-by-abusive-nitrous-oxide-consumption-a-case-report
#16
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
https://www.readbyqxmd.com/read/27720453/-new-patterns-of-substance-use-and-abuse-among-french-adolescents-a-knowledge-synthesis
#17
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
https://www.readbyqxmd.com/read/27583357/cocaine-abuse-that-presents-with-acute-scrotal-pain-and-mimics-testicular-torsion
#18
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 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/27500987/extensive-necrotic-purpura-in-levamisole-adulterated-cocaine-abuse-a-case-report
#19
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)...
November 2016: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27497011/reusable-split-aptamer-based-biosensor-for-rapid-detection-of-cocaine-in-serum-by-using-an-all-fiber-evanescent-wave-optical-biosensing-platform
#20
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
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