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https://www.readbyqxmd.com/read/27828699/levamisole-adulterated-cocaine-toxicity-would-you-recognize-it
#1
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 It was withdrawn from the US market in 2000 but is available in veterinary medicine.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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/27500987/extensive-necrotic-purpura-in-levamisole-adulterated-cocaine-abuse-a-case-report
#7
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
#8
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
https://www.readbyqxmd.com/read/27423726/limb-threatening-ischemia-in-a-young-man-with-cathinone-bath-salt-intoxication-a-case-report
#9
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
https://www.readbyqxmd.com/read/27405363/case-report-of-methylone-oxymorphone-and-ethanol-in-a-fatality-case-with-tissue-distribution
#10
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
https://www.readbyqxmd.com/read/27391108/reactive-oxygen-species-hypoxia-inducible-factor-1%C3%AE-platelet-derived-growth-factor-bb-autocrine-loop-contributes-to-cocaine-mediated-alveolar-epithelial-barrier-damage
#11
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 has not been well determined. Herein, we investigate the role of cocaine in disrupting the alveolar epithelial barrier function and the associated signaling cascade. Using the combinatorial electric cell-substrate impedance sensing 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 the tight junction protein zonula occludens-1 (Zo-1) in both mouse primary alveolar epithelial cells and the alveolar epithelial cell line, L2 cells...
November 2016: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/27284845/-cardiovascular-complications-of-hypertensive-crisis
#12
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
https://www.readbyqxmd.com/read/27258254/longitudinal-effects-of-embryonic-exposure-to-cocaine-on-morphology-cardiovascular-physiology-and-behavior-in-zebrafish
#13
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
https://www.readbyqxmd.com/read/27228985/presentations-due-to-acute-toxicity-of-psychoactive-substances-in-an-urban-emergency-department-in-switzerland-a-case-series
#14
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
https://www.readbyqxmd.com/read/27203838/levamisole-contaminated-cocaine-use-in-hiv-infected-and-uninfected-unstably-housed-women
#15
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
https://www.readbyqxmd.com/read/27075425/epidural-blood-patch-using-manometry-for-sinking-skin-flap-syndrome
#16
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
https://www.readbyqxmd.com/read/27033438/-cutaneous-and-mucosal-manifestations-associated-with-cocaine-use
#17
REVIEW
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
https://www.readbyqxmd.com/read/26992929/antipsychotic-medications-for-cocaine-dependence
#18
REVIEW
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...
March 19, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26991889/baseline-medical-comorbidities-in-adults-randomized-in-the-stride-trial-for-psychostimulant-use-disorders
#19
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
https://www.readbyqxmd.com/read/26974305/noninfectious-and-nonneoplastic-conditions-associated-with-human-immunodeficiency-virus-infection
#20
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
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