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Roset-Altadill A, Wat D, Radike M. Cardiovascular and pulmonary complications of recreational drugs: A pictorial review. Eur J Radiol 2024; 178:111648. [PMID: 39089058 DOI: 10.1016/j.ejrad.2024.111648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 07/12/2024] [Accepted: 07/22/2024] [Indexed: 08/03/2024]
Abstract
Recreational drug abuse constitutes a serious health problem worldwide. Consumption of cocaine, amphetamine-type stimulants, opioids and cannabis can lead to multiple acute and chronic cardiopulmonary complications, resulting in high morbidity and mortality. These complications may be first detected at imaging, since clinical presentation is usually non-specific. Cardiovascular complications include myocardial infarction, endocarditis, aortic dissection, infectious pseudoaneurysm, retained needle fragments, cardiomyopathy and pulmonary arterial hypertension. Pulmonary complications encompass pulmonary oedema, crack lung, pneumonia, septic emboli, barotrauma, airway disease, emphysema and excipient lung disease. Knowledge of the cardiopulmonary imaging manifestations of illicit drug use in conjunction with clinical history and a high grade of suspicion enable an accurate diagnosis and appropriate management plan. In this article we aim to provide a pictorial review of the most frequent cardiopulmonary manifestations of recreational drugs, emphasizing the underlying pathophysiologic mechanisms and the various imaging appearances.
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Affiliation(s)
- Adria Roset-Altadill
- Institut de Diagnòstic per la Imatge, Hospital Universitari de Girona Doctor Josep Trueta, Avinguda de França S/N, 17007, Girona, Spain.
| | - Dennis Wat
- Respiratory Medicine Department, Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool L14 3PE, United Kingdom.
| | - Monika Radike
- Radiology Department, Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool L14 3PE, United Kingdom; Cardiovascular Research Center-ICCC, IIB-Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
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Tamargo JA, Martin HR, Diaz-Martinez J, Delgado-Enciso I, Johnson A, Bastida Rodriguez JA, Trepka MJ, Brown DR, Garba NA, Roldan EO, Hernandez Suarez Y, Marty AM, Bursac Z, Campa A, Baum MK. Drug use and COVID-19 testing, vaccination, and infection among underserved, minority communities in Miami, Florida. PLoS One 2024; 19:e0297327. [PMID: 38687734 PMCID: PMC11060546 DOI: 10.1371/journal.pone.0297327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 12/24/2023] [Indexed: 05/02/2024] Open
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic has disproportionately impacted people who use drugs (PWUD). This study explored relationships between drug use, COVID-19 testing, vaccination, and infection. This cross-sectional study was conducted in Miami, Florida between March 2021 and October 2022 as part of the National Institutes of Health (NIH) Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) initiative and the Miami Adult Studies on HIV (MASH) cohort. Users of cannabis, cocaine/crack, heroin/fentanyl, methamphetamines, hallucinogens, and/or prescription drug misuse in the previous 12 months were considered PWUD. Sociodemographic data, COVID-19 testing history, and vaccination-related beliefs were self-reported. Vaccinations were confirmed with medical records and positivity was determined with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing. Statistical analyses included chi-square tests and logistic regression. Of 1,780 participants, median age was 57 years, 50.7% were male, 50.2% Non-Hispanic Black, and 66.0% reported an annual income less than $15,000. Nearly 28.0% used drugs. PWUD were less likely than non-users to self-report ever testing positive for SARS-CoV-2 (14.7% vs. 21.0%, p = 0.006). However, 2.6% of participants tested positive for SARS-CoV-2, with no significant differences between PWUD and non-users (3.7% vs. 2.2%, p = 0.076). PWUD were more likely than non-users to experience difficulties accessing testing (10.2% vs. 7.1%, p = 0.033), vaccine hesitancy (58.9% vs. 43.4%, p = 0.002) and had lower odds of receiving any dose of a COVID-19 vaccine compared to non-users (aOR, 0.63; 95% CI, 0.49-0.81; p<0.001). PWUD presented with greater difficulties accessing COVID-19 testing, greater vaccine hesitancy, and lower odds of vaccination. Testing and immunization plans that are tailored to the needs of PWUD and consider access, trust-building campaigns, and education may be needed.
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Affiliation(s)
- Javier A. Tamargo
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, United States of America
| | - Haley R. Martin
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, United States of America
| | - Janet Diaz-Martinez
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, United States of America
| | - Ivan Delgado-Enciso
- Faculty of Medicine, University of Colima, Las Víboras, Colima, Mexico
- Cancerology State Institute, Colima State Health Services, La Esperanza, Colima, Mexico
| | - Angelique Johnson
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, United States of America
| | - Jose A. Bastida Rodriguez
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, United States of America
| | - Mary Jo Trepka
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, United States of America
| | - David R. Brown
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States of America
| | - Nana A. Garba
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States of America
| | - Eneida O. Roldan
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States of America
| | - Yolangel Hernandez Suarez
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States of America
| | - Aileen M. Marty
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States of America
| | - Zoran Bursac
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, United States of America
| | - Adriana Campa
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, United States of America
| | - Marianna K. Baum
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, United States of America
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Moon SJE, Schlenk EA, Lee H. Heart Rate Variability in Adults With Substance Use Disorder: A Comprehensive Narrative Review. J Am Psychiatr Nurses Assoc 2024; 30:240-251. [PMID: 36856156 DOI: 10.1177/10783903221145142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
BACKGROUND Heart rate variability (HRV) is an indicator of autonomic abnormalities. However, little is known about the role of HRV related to substance use behavior and the association between the changes in HRV and signs of relapse in substance use. AIM The purpose of this study was to review the existing literature on autonomic response to substance use (i.e., opioids, cocaine, and methamphetamine) measured by HRV and its outcomes related to the risk factors of relapse. METHODS A systematic search of the literature was conducted using PubMed, PsychINFO, and Ovid Medline databases. The study includes full-text articles published in English from 2010 to 2020, using measures of HRV in human subjects who use substances. RESULTS A total of 14 studies were reviewed. Studies included outpatients with a prescription or nonprescription opioid misuse behavior with a primary diagnosis being chronic pain or substance use disorder (SUD). Significantly decreased resting HRV was found in substance users compared to healthy controls. Lower resting HRV has been significantly associated with stress, craving, and greater symptom severities in individuals with SUD and other substance dependence. HRV indices can be potential measures of homeostatic imbalance and self-regulation flexibility. CONCLUSION HRV may be a useful tool for monitoring early indication of relapse so that relapse prevention measures can be implemented in a timely manner. Future studies in substance use may benefit from examining HRV in relations to substance use and relapse signs and symptoms in a larger population to guide future relapse prevention strategies.
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Affiliation(s)
| | - Elizabeth A Schlenk
- Elizabeth A. Schlenk, PhD, RN, CNL, FAAN, University of Pittsburgh, Pittsburgh, PA, USA
| | - Heeyoung Lee
- Heeyoung Lee, PhD, PMHNP-BC, University of Pittsburgh, Pittsburgh, PA, USA
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Zhang M, Chen C, Li G, Koric A, Lee YA, Morgenstern H, Schwartz SM, Sturgis EM, Boffetta P, Hashibe M, Zhang Z. Cocaine use and head and neck cancer risk: A pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. Cancer Med 2024; 13:e7019. [PMID: 38400665 PMCID: PMC10891447 DOI: 10.1002/cam4.7019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Cocaine is an illegal recreational drug used worldwide, yet little is known about whether cocaine inhalation (smoking/snorting) increases the risk of head and neck cancer (HNC). METHODS The analyses were conducted by pooling data from three case-control studies with 1639 cases and 2506 controls from the International Head and Neck Cancer Epidemiology Consortium. Epidemiologic data, including cocaine use histories, were obtained in face-to-face interviews. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using hierarchical logistic regression models. RESULTS Controlling for cumulative tobacco and alcohol use, we observed a weak positive association between cocaine use and HNC (ORever vs. never = 1.35, 95% CI: 0.96, 1.90). In stratified analysis, while we did not detect associations among never tobacco or alcohol users due to the limited sample size, the association with cocaine use was observed among tobacco users and alcohol drinkers. ORs for ever and high cumulative use (>18 times) versus never use were 1.40 (95% CI: 0.98, 2.00) and 1.66 (95% CI: 1.03, 2.69) among tobacco users, and 1.34 (95% CI: 0.93, 1.92) and 1.59 (95% CI: 1.00, 2.51) among alcohol drinkers, respectively. CONCLUSION In this pooled analysis, we observed a weak positive association between cocaine inhalation and HNC risk. Our findings provide preliminary evidence of the potential carcinogenic effect of cocaine on HNC. Because of study limitations, including limited number of cocaine users, confounding, and heterogeneity across studies, future investigations will require larger studies with more detailed information on cocaine use history.
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Affiliation(s)
- Mingyan Zhang
- Department of EpidemiologyUCLA Fielding School of Public HealthLos AngelesCaliforniaUSA
| | - Chu Chen
- Program in Epidemiology, Division of Public Health SciencesFred Hutchinson Cancer CenterSeattleWashingtonUSA
| | - Guojun Li
- Department of Head and Neck Surgery, Division of SurgeryUniversity of Texas M. D. Anderson Cancer CenterHoustonTexasUSA
| | - Alzina Koric
- Division of Public Health, Department of Family and Preventive MedicineUniversity of Utah School of Medicine, and Huntsman Cancer InstituteSalt Lake CityUtahUSA
| | - Yuan‐Chin Amy Lee
- Division of Public Health, Department of Family and Preventive MedicineUniversity of Utah School of Medicine, and Huntsman Cancer InstituteSalt Lake CityUtahUSA
| | - Hal Morgenstern
- Departments of Epidemiology and Environmental Health Sciences, School of Public Health and Department of Urology, Medical SchoolUniversity of MichiganAnn ArborMichiganUSA
| | - Stephen M. Schwartz
- Program in Epidemiology, Division of Public Health SciencesFred Hutchinson Cancer CenterSeattleWashingtonUSA
| | - Erich M. Sturgis
- Department of Otolaryngology‐Head and Neck SurgeryBaylor College of MedicineHoustonTexasUSA
| | - Paolo Boffetta
- Stony Brook Cancer Center, Department of Family, Population and Preventive MedicineStony Brook UniversityStony BrookNew YorkUSA
- Department of Medical and Surgical SciencesUniversity of BolognaBolognaItaly
| | - Mia Hashibe
- Division of Public Health, Department of Family and Preventive MedicineUniversity of Utah School of Medicine, and Huntsman Cancer InstituteSalt Lake CityUtahUSA
| | - Zuo‐Feng Zhang
- Department of EpidemiologyUCLA Fielding School of Public HealthLos AngelesCaliforniaUSA
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Harris M, Scott J, Hope V, Busza J, Sweeney S, Preston A, Southwell M, Eastwood N, Vuckovic C, McGaff C, Yoon I, Wilkins L, Ram S, Lord C, Bonnet P, Furlong P, Simpson N, Slater H, Platt L. Safe inhalation pipe provision (SIPP): protocol for a mixed-method evaluation of an intervention to improve health outcomes and service engagement among people who use crack cocaine in England. Harm Reduct J 2024; 21:19. [PMID: 38263202 PMCID: PMC10804795 DOI: 10.1186/s12954-024-00938-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/15/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Over 180,000 people use crack cocaine in England, yet provision of smoking equipment to support safer crack use is prohibited under UK law. Pipes used for crack cocaine smoking are often homemade and/or in short supply, leading to pipe sharing and injuries from use of unsafe materials. This increases risk of viral infection and respiratory harm among a marginalised underserved population. International evaluations suggest crack pipe supply leads to sustained reductions in pipe sharing and use of homemade equipment; increased health risk awareness; improved service access; reduction in injecting and crack-related health problems. In this paper, we introduce the protocol for the NIHR-funded SIPP (Safe inhalation pipe provision) project and discuss implications for impact. METHODS The SIPP study will develop, implement and evaluate a crack smoking equipment and training intervention to be distributed through peer networks and specialist drug services in England. Study components comprise: (1) peer-network capacity building and co-production; (2) a pre- and post-intervention survey at intervention and non-equivalent control sites; (3) a mixed-method process evaluation; and (4) an economic evaluation. Participant eligibility criteria are use of crack within the past 28 days, with a survey sample of ~ 740 for each impact evaluation survey point and ~ 40 for qualitative process evaluation interviews. Our primary outcome measure is pipe sharing within the past 28 days, with secondary outcomes pertaining to use of homemade pipes, service engagement, injecting practice and acute health harms. ANTICIPATED IMPACT SIPP aims to reduce crack use risk practices and associated health harms; including through increasing crack harm reduction awareness among service providers and peers. Implementation has only been possible with local police approvals. Our goal is to generate an evidence base to inform review of the legislation prohibiting crack pipe supply in the UK. This holds potential to transform harm reduction service provision and engagement nationally. CONCLUSION People who smoke crack cocaine in England currently have little reason to engage with harm reduction and drug services. Little is known about this growing population. This study will provide insight into population characteristics, unmet need and the case for legislative reform. TRIAL REGISTRATION ISRCTN12541454 https://doi.org/10.1186/ISRCTN12541454.
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Affiliation(s)
- Magdalena Harris
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| | - Jenny Scott
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, BS8 2PS, UK
| | - Vivian Hope
- Public Health Institute/School of Public and Allied Health, Liverpool John Moores University, 3rd Floor Exchange Station, Tithebarn Street, Liverpool, L2 2QP, UK
| | - Joanna Busza
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Sedona Sweeney
- Department of Global Health and Development, LSHTM, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Andrew Preston
- Exchange Supplies, 1 Great Western Industrial Centre, Dorchester, Dorset, DT1 1, UK
| | | | | | - Cedomir Vuckovic
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Caitlynne McGaff
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Ian Yoon
- Department of Global Health and Development, LSHTM, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Louise Wilkins
- The Health Shop, 12 Broad Street, Nottingham, NG1 3AL, UK
| | - Shoba Ram
- The Maples, Verona House, 53 Filwood Rd, Bristol, BS16 3RX, UK
| | - Catherine Lord
- Bristol Drugs Project, 11 Brunswick Square, St Paul's, Bristol, BS2 8PE, UK
| | - Philippe Bonnet
- The Hepatitis C Trust, 72 Weston Street, London, SE1 3QG, UK
| | - Peter Furlong
- Change Grow Live, 34 Albion Place, Leeds, LS1 6JH, UK
| | | | - Holly Slater
- POW Nottingham, 16 Independent Street, Nottingham, NG7 3LN, UK
| | - Lucy Platt
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
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Shehataa MS, Abdelfattah AH, Selim AN. A Case Report of Acute Respiratory Distress Syndrome From Cannabis and Amphetamine Use. Cureus 2023; 15:e50003. [PMID: 38186429 PMCID: PMC10766567 DOI: 10.7759/cureus.50003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2023] [Indexed: 01/09/2024] Open
Abstract
Illicit drug usage (IDU) is a big challenge in clinical practice, with increasing incidence in the last decades. Daily, clinicians encounter a wide variety of complications related to IDU. Common infections related to illicit drugs are infective endocarditis, abscesses, osteomyelitis, pneumonia, HIV, hepatitis C, and B. Other rare complications could happen like leukoencephalopathy, IDU-related lung injury, and acute respiratory distress syndrome (ARDS) which is a severe and potentially life-threatening condition characterized by the sudden onset of respiratory failure, often necessitating mechanical ventilation. While the most common etiologies of ARDS are related to infections and sepsis, there is emerging evidence that substance abuse can also be associated with the development of ARDS with unclear mechanisms. IDU-related lung injury is a rare entity with few cases reported in the literature. Its management usually involves supportive care, including mechanical ventilation, oxygen therapy, and close monitoring of fluid balance. We present a case of a 25-year-old male presented with ARDS and multiorgan failure related to methamphetamine and cannabis abuse.
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Affiliation(s)
- Mohamed S Shehataa
- Critical Care Medicine, Cairo University, Cairo, EGY
- Critical Care Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Ahmed H Abdelfattah
- Internal Medicine, University of Kentucky College of Medicine, Lexington, USA
| | - Ahmed N Selim
- Critical Care Medicine, Beni Suef University Hospital, Beni Suef, EGY
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Kaiber DB, Chrusciel JH, Martins M, Mattos B, Gomes M, Wearick-Silva LE, Donadio MVF, Friedrich F, Jones MH, Viola TW. Changes in lung function in adolescents with substance use disorders: an exploratory study. J Bras Pneumol 2023; 49:e20230274. [PMID: 37991075 PMCID: PMC10760415 DOI: 10.36416/1806-3756/e20230274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/16/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVE To compare lung function between adolescents with and without substance use disorder (SUD). METHODS This was an observational, cross-sectional exploratory study. The sample consisted of 16 adolescents with SUD and 24 age-matched healthy controls. The adolescents in the clinical group were recruited from a psychiatric inpatient unit for detoxification and rehabilitation; their primary diagnosis was SUD related to marijuana, cocaine, or polysubstance use. Questionnaires and pulmonary function tests were applied for clinical evaluation. RESULTS We found that FVC, FEV1, and their percentages of the predicted values were significantly lower in the adolescents with SUD than in those without. Those differences remained significant after adjustment for BMI and the effects of high levels of physical activity. The largest effect size (Cohen's d = 1.82) was found for FVC as a percentage of the predicted value (FVC%), which was, on average, 17.95% lower in the SUD group. In addition, the years of regular use of smoked substances (tobacco, marijuana, and crack cocaine) correlated negatively with the FVC%. CONCLUSIONS This exploratory study is innovative in that it demonstrates the early consequences of smoked substance use for the lung health of adolescents with SUD.
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Affiliation(s)
- Daniela Benvenutti Kaiber
- . Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - João Henrique Chrusciel
- . Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Maiara Martins
- . Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Bernardo Mattos
- . Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Miguel Gomes
- . Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Luis Eduardo Wearick-Silva
- . Grupo de Pesquisa em Exercício Físico, Comportamento e Cognição - GPECC - Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Márcio Vinícius Fagundes Donadio
- . Laboratório de Atividade Física em Pediatria, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
- . Departamento de Fisioterapia, Faculdad de Medicina y Ciencias de la Salud, Universitat International de Catalunya - UIC - Barcelona, España
| | - Frederico Friedrich
- . Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
- . Laboratório de Fisiologia Respiratória, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Marcus Herbert Jones
- . Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
- . Laboratório de Fisiologia Respiratória, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Thiago Wendt Viola
- . Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
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Underner M, Perriot J, Peiffer G, Brousse G, Jaafari N. [Bronchial diseases and heroin use. A systematic review]. Rev Mal Respir 2023; 40:783-809. [PMID: 37925326 DOI: 10.1016/j.rmr.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 09/11/2023] [Indexed: 11/06/2023]
Abstract
INTRODUCTION Heroin use can cause respiratory complications including asthma, chronic obstructive pulmonary disease (COPD) and bronchiectasis (BD). OBJECTIVES A general review of the literature presenting the data on the relationships between heroin consumption and bronchial complications, while underlining the difficulties of diagnosis and management. DOCUMENTARY SOURCES Medline, 1980-2022, keywords "asthma" or "bronchospasm" or "COPD" or "bronchiectasis" and "heroin" or "opiate" or "opiates", with limits pertaining to "Title/Abstract". Concerning asthma, 26 studies were included, as were 16 for COPD and 5 for BD. RESULTS Asthma and COPD are more prevalent among heroin addicts, who are less compliant than other patients with their treatment. The authors found a positive association between frequency of asthma exacerbations, admission to intensive care and heroin inhalation. Late diagnosis of COPD worsens the course of the disease; emphysema and BD are poor prognostic factors. CONCLUSION Bronchial diseases in heroin users can be identified by means of respiratory function exploration and chest CT scans. These tests should be performed frequently in view of optimizing their care, which includes their weaning themselves from addictive substances.
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Affiliation(s)
- M Underner
- Unité de recherche clinique Pierre-Deniker, centre hospitalier Laborit, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France.
| | - J Perriot
- Dispensaire Émile-Roux, CLAT, centre de tabacologie, 63100 Clermont-Ferrand, France
| | - G Peiffer
- Service de pneumologie, CHR Metz-Thionville, 57038 Metz, France
| | - G Brousse
- Service d'addictologie, CHU de Clermont-Ferrand, université Clermont Auvergne, 63100 Clermont-Ferrand, France
| | - N Jaafari
- Unité de recherche clinique Pierre-Deniker, centre hospitalier Laborit, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France
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Rehman S, Arif S, Ushakumari LG, Amreen J, Nagelli A, Moonnumackel SJ, Nair A. Assessment of Bacterial Infections and Antibiotic Regimens in Intravenous Drug Users. Cureus 2023; 15:e45716. [PMID: 37868523 PMCID: PMC10590200 DOI: 10.7759/cureus.45716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2023] [Indexed: 10/24/2023] Open
Abstract
Bacterial infections in people who inject drugs (PWID) are a significant cause of hospitalizations and increased morbidity in this group. In this review, we evaluated bacterial trends in the most common infections and appropriate empiric antibiotic coverage. Articles from PubMed and Google Scholar were curated in a Google document with shared access. Discussion and development of the paper were achieved over Zoom meetings. The common infections in PWID were skin and soft tissue infections (SSTIs), infective endocarditis, septic arthritis, osteomyelitis, and bloodstream infections (BSIs). The presence of comorbidities increased susceptibility to bacterial infections. Staphylococcus aureus was the predominant species in all the infections and included methicillin-resistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA). The current standard of antibiotic use for Staphylococcus species was found to be sufficient. The gram-negative bacillus Serratia marcescens was prevalent in PWID as a causative agent of septic arthritis, osteomyelitis, and infective endocarditis. Its treatment required a combination of β-lactam and either a fluoroquinolone or an aminoglycoside for a prolonged duration. Streptococci were commonly implicated in SSTIs and BSIs. The appropriate response was seen with β-lactam antibiotics. In PWID, Enterococcus and Pseudomonas were implicated in infective endocarditis of native and prosthetic valves. The former being difficult to treat, a new strategy of using dual β-lactam antibiotics was found to be supported by clinical data. Anti-pseudomonal antibiotics can be avoided in other infections seen in this group, as their prevalence was low. PWID, especially those with comorbidities, have an increased risk of acquiring infections with difficult-to-treat microbes. Therefore, empiric antibiotic treatment should be relevant to the infection, for which bacterial trends and antibiotic susceptibility must be reassessed periodically.
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Affiliation(s)
- Sana Rehman
- Medicine, Fatima Memorial Hospital (FMH) College of Medicine and Dentistry, Lahore, PAK
| | - Sehrish Arif
- Medicine, Fatima Memorial Hospital (FMH) College of Medicine and Dentistry, Lahore, PAK
| | - Lekshmi G Ushakumari
- Medicine, Jagadguru Jayadeva Murugarajendra (JJM) Medical College, Davanagere, IND
| | - Jasiya Amreen
- Medicine, Dr. Vizarath Rasool Khan (VRK) Women's Medical College, Hyderabad, IND
| | | | | | - Arun Nair
- Pediatrics, Saint Peter's University Hospital, Somerset, USA
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Barreveld AM, Mendelson A, Deiling B, Armstrong CA, Viscusi ER, Kohan LR. Caring for Our Patients With Opioid Use Disorder in the Perioperative Period: A Guide for the Anesthesiologist. Anesth Analg 2023; 137:488-507. [PMID: 37590794 DOI: 10.1213/ane.0000000000006280] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
Opioid use disorder (OUD) is a rising public health crisis, impacting millions of individuals and families worldwide. Anesthesiologists can play a key role in improving morbidity and mortality around the time of surgery by informing perioperative teams and guiding evidence-based care and access to life-saving treatment for patients with active OUD or in recovery. This article serves as an educational resource for the anesthesiologist caring for patients with OUD and is the second in a series of articles published in Anesthesia & Analgesia on the anesthetic and analgesic management of patients with substance use disorders. The article is divided into 4 sections: (1) background to OUD, treatment principles, and the anesthesiologist; (2) perioperative considerations for patients prescribed medications for OUD (MOUD); (3) perioperative considerations for patients with active, untreated OUD; and (4) nonopioid and nonpharmacologic principles of multimodal perioperative pain management for patients with untreated, active OUD, or in recovery. The article concludes with a stepwise approach for the anesthesiologist to support OUD treatment and recovery. The anesthesiologist is an important leader of the perioperative team to promote these suggested best practices and help save lives.
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Affiliation(s)
- Antje M Barreveld
- From the Department of Anesthesiology, Tufts University School of Medicine, Newton-Wellesley Hospital, Newton, Massachusetts
| | - Andrew Mendelson
- Department of Anesthesiology, University of Virginia School of Medicine, University of Virginia Hospital, Charlottesville, Virginia
| | - Brittany Deiling
- Department of Anesthesiology, University of Virginia School of Medicine, University of Virginia Hospital, Charlottesville, Virginia
| | - Catharina A Armstrong
- Department of Medicine, Tufts University School of Medicine, Newton-Wellesley Hospital, Newton, Massachusetts
| | - Eugene R Viscusi
- Department of Anesthesiology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Lynn R Kohan
- Department of Anesthesiology, University of Virginia School of Medicine, University of Virginia Hospital, Charlottesville, Virginia
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11
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Bisconti M, De Palma A, Pacifici R, Rotolo MC, Pichini S, Brascia D, Trabucco X, Pellegrini M, Carrozzi L, Pistelli F, Marulli G. Spontaneous Pneumothorax Secondary to Bullous Lung Emphysema Positive for Cannabinoids upon Toxicological Examination. J Clin Med 2023; 12:4956. [PMID: 37568358 PMCID: PMC10419578 DOI: 10.3390/jcm12154956] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/27/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Cannabis can be related to respiratory diseases, but the relationship between smoking marijuana and the development of a pneumothorax has scarcely been investigated. We aimed to analyze, in patients with a history of cannabis smoking abuse submitted to lung apicectomy for a primary spontaneous pneumothorax (PSP), the correlation between the presence of cannabinoids in the resected lung and the detection of bullous emphysema within the same tissue. Patients undergoing lung apicectomy for a PSP were prospectively enrolled, and the correlation between the presence of cannabinoids in the resected lung tissue and histological finding of bullous emphysema was investigated with Fisher's exact test. There were 21 male patients, with a median age of 27 years. The cannabinoids found by the toxicological examination in surgical specimens were mainly delta-9-tetrahydrocannabinol (THC), cannabinol (CBN), and cannabidiol (CBD). In 14/21 patients, cannabinoids were detected in the resected lung tissue, and bullous emphysema was present in 13/14 of these (93%), while bullous emphysema was found in only 1/7 (14%) of the remaining patients who were negative for cannabinoids in the lung tissue, and the difference was found to be statistically significant (p < 0.0009). Our study demonstrated the presence of bullous emphysema in most cannabinoid-positive patients and its absence in most of those who were cannabinoid-negative, supporting the correlation between cannabinoids in the lung tissue and bullous emphysema with the development of a "secondary" spontaneous pneumothorax.
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Affiliation(s)
- Mario Bisconti
- Unit of Thoracic Surgery, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy; (M.B.); (D.B.); (G.M.)
- Unit of Pneumology, Hospital “Vito Fazzi”, 73100 Lecce, Italy
| | - Angela De Palma
- Unit of Thoracic Surgery, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy; (M.B.); (D.B.); (G.M.)
| | - Roberta Pacifici
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy; (R.P.); (M.C.R.); (S.P.); (M.P.)
| | - Maria Concetta Rotolo
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy; (R.P.); (M.C.R.); (S.P.); (M.P.)
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy; (R.P.); (M.C.R.); (S.P.); (M.P.)
| | - Debora Brascia
- Unit of Thoracic Surgery, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy; (M.B.); (D.B.); (G.M.)
| | - Xenia Trabucco
- Unit of Pathology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Manuela Pellegrini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy; (R.P.); (M.C.R.); (S.P.); (M.P.)
| | - Laura Carrozzi
- Unit of Pneumology, University of Pisa, 56126 Pisa, Italy; (L.C.); (F.P.)
| | - Francesco Pistelli
- Unit of Pneumology, University of Pisa, 56126 Pisa, Italy; (L.C.); (F.P.)
| | - Giuseppe Marulli
- Unit of Thoracic Surgery, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy; (M.B.); (D.B.); (G.M.)
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12
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Zhang M, Hashibe M, Rao JY, Jung SY, Tashkin DP, Morgenstern H, Zhang ZF. Opium, phencyclidine, and crack cocaine smoking associations with lung and upper aerodigestive tract cancers: exploratory findings from a case-control study in Los Angeles County. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:440-449. [PMID: 37433108 PMCID: PMC10540566 DOI: 10.1080/00952990.2023.2220875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/18/2023] [Accepted: 05/28/2023] [Indexed: 07/13/2023]
Abstract
Background: Illicit drug use has become a global epidemic, yet it is unclear if drug smoking increases the risk of tobacco-related cancers.Objectives: We aimed to evaluate hypothesized associations between smoking three drugs - opium, phencyclidine (PCP) and crack cocaine and lung and upper aerodigestive tract (UADT) cancers.Methods: A population-based case-control study with 611 lung cancer cases (50% male), 601 UADT cancers cases (76% male), and 1,040 controls (60% male) was conducted in Los Angeles County (1999-2004). Epidemiologic data including drug smoking histories were collected in face-to-face interviews. Associations were estimated with logistic regressions.Results: Adjusting for potential confounders, ever vs. never crack smoking was positively associated with UADT cancers (aOR = 1.56, 95% CI: 1.05, 2.33), and a dose-response relationship was observed for lifetime smoking frequency (p for trend = .024). Heavy (> median) vs. never crack smoking was associated with UADT cancers (aOR = 1.81, 95% CI: 1.07, 3.08) and lung cancer (aOR = 1.58, 95% CI: 0.88, 2.83). A positive association was also observed between heavy PCP smoking and UADT cancers (aOR = 2.29, 95% CI: 0.91, 5.79). Little or no associations were found between opium smoking and lung cancer or UADT cancers.Conclusion: The positive associations between illicit drug use and lung and/or UADT cancers suggest that smoking these drugs may increase the risk of tobacco-related cancers. Despite the low frequency of drug smoking and possible residual confounding, our findings may provide additional insights on the development of lung and UADT cancers.
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Affiliation(s)
- Mingyan Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Mia Hashibe
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Jian-Yu Rao
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Department of Pathology and Laboratory Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Su Yon Jung
- Translational Sciences Section, UCLA Jonsson Comprehensive Cancer Center and UCLA School of Nursing, Los Angeles, CA, USA
| | - Donald P Tashkin
- Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Hal Morgenstern
- Departments of Epidemiology and Environmental Health Sciences, School of Public Health and Department of Urology, Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
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13
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Underner M, Perriot J, Peiffer G, Urban T, Jaafari N. [Diffuse alveolar hemorrhage in cannabis smokers. A systematic literature review]. Rev Mal Respir 2023:S0761-8425(23)00140-7. [PMID: 37087352 DOI: 10.1016/j.rmr.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 03/20/2023] [Indexed: 04/24/2023]
Abstract
Cannabis is the most widely used illicit psychoactive substance in France. It can be responsible for numerous pulmonary complications, including diffuse alveolar hemorrhage (DAH). The objective of this systematic review of the literature was to present data concerning the relationship between cannabis smoking and DAH, which has rarely been reported in the literature. The review was based on a Medline search covering the 1980-2022 period and utilizing data drawn from 10 articles. DAH diagnosis is based on an association of hemoptysis, anemia and diffuse alveolar opacities on chest radiography with siderophages in the Bronchoalveolar Lavage Fluid (BAL). The 11 patients identified in this review were daily or regular cannabis smokers; in 4 cases they presented recent or recurrent hemoptysis with anemia; imaging revealed diffuse alveolar opacities in 10 of them, while BAL endoscopy highlighted a diffuse hemorrhage in the bronchial tree, and siderophages were observed in 6 cases. While evolution was favorable when cannabis consumption was discontinued, resumption occasioned DAH recurrence, and one patient died. Advice to quit should systematically be accompanied by addictological follow-up.
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Affiliation(s)
- M Underner
- Unité de recherche clinique Pierre-Deniker, centre hospitalier Laborit, université de Poitiers, 370, avenue Jacques-Coeur, CS 10587, 86021 Poitiers cedex, France.
| | - J Perriot
- Dispensaire Émile-Roux, CLAT-63, centre de tabacologie, 63100 Clermont-Ferrand, France
| | - G Peiffer
- CHR Metz-Thionville, 57038 Metz, France
| | - T Urban
- Service de pneumologie, CHU d'Angers, 49000 Angers, France
| | - N Jaafari
- Unité de recherche clinique Pierre-Deniker, centre hospitalier Laborit, université de Poitiers, 370, avenue Jacques-Coeur, CS 10587, 86021 Poitiers cedex, France
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14
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Parisi CE, Yousey‐Hindes K, Holstein R, O'Halloran A, Kirley PD, Alden NB, Anderson EJ, Kim S, McMahon M, Khanlian SA, Spina N, Gaitan MA, Shiltz E, Thomas A, Schaffner W, Talbot K, Crossland MT, Cook RL, Garg S, Meek J, Hadler J. Drug use and severe outcomes among adults hospitalized with influenza, 2016-2019. Influenza Other Respir Viruses 2023; 17:e13052. [PMID: 36300969 PMCID: PMC9835414 DOI: 10.1111/irv.13052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Influenza is a persistent public health problem associated with severe morbidity and mortality. Drug use is related to myriad health complications, but the relationship between drug use and severe influenza outcomes is not well understood. The study objective was to evaluate the relationship between drug use and severe influenza-associated outcomes. METHODS Data were collected by the Influenza Hospitalization Surveillance Network (FluSurv-NET) from the 2016-2017 through 2018-2019 influenza seasons. Among persons hospitalized with influenza, descriptive statistics and logistic regression models were used to analyze differences in demographic characteristics, risk and behavioral factors, and severe outcomes (intensive care unit [ICU] admission, mechanical ventilation, or death) between people who use drugs (PWUD), defined as having documented drug use within the past year, and non-PWUD. RESULTS Among 48,430 eligible hospitalized influenza cases, 2019 were PWUD and 46,411 were non-PWUD. PWUD were younger than non-PWUD and more likely to be male, non-Hispanic Black or Hispanic/Latino, smoke tobacco, abuse alcohol, and have chronic conditions including asthma, chronic liver disease, chronic lung disease, or immunosuppressive conditions. PWUD had greater odds of ICU admission and mechanical ventilation, but not death compared with non-PWUD; however, these findings were not statistically significant after adjustment. Opioid use specifically was associated with increased risk of ICU admission and mechanical ventilation. CONCLUSION These results support targeted initiatives to prevent influenza in this population, including influenza vaccination, which remains one of the most important tools to prevent influenza infection and associated severe outcomes.
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Affiliation(s)
- Christina E. Parisi
- Department of EpidemiologyUniversity of FloridaGainesvilleFloridaUSA
- Emerging Infections ProgramYale University School of Public HealthNew HavenConnecticutUSA
| | - Kimberly Yousey‐Hindes
- Emerging Infections ProgramYale University School of Public HealthNew HavenConnecticutUSA
| | - Rachel Holstein
- Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Alissa O'Halloran
- Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | | | - Nisha B. Alden
- Colorado Department of Public Health and EnvironmentDenverColoradoUSA
| | - Evan J. Anderson
- Emory University School of MedicineAtlantaGeorgiaUSA
- Georgia Emerging Infections ProgramAtlantaGeorgiaUSA
- Atlanta VA Medical CenterDecaturGeorgiaUSA
| | - Sue Kim
- Michigan Department of Health and Human ServicesLansingMichiganUSA
| | | | | | - Nancy Spina
- New York State Department of HealthAlbanyNew YorkUSA
| | - Maria A. Gaitan
- Center for Community Health and PreventionUniversity of Rochester School of Medicine and DentistryRochesterNew YorkUSA
| | - Eli Shiltz
- Ohio Department of HealthColumbusOhioUSA
| | - Ann Thomas
- Oregon Health AuthorityPortlandOregonUSA
| | | | - Keipp Talbot
- Vanderbilt University School of MedicineNashvilleTennesseeUSA
| | | | - Robert L. Cook
- Department of EpidemiologyUniversity of FloridaGainesvilleFloridaUSA
| | - Shikha Garg
- Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - James Meek
- Emerging Infections ProgramYale University School of Public HealthNew HavenConnecticutUSA
| | - James Hadler
- Emerging Infections ProgramYale University School of Public HealthNew HavenConnecticutUSA
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15
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Forsyth S, Alati R, Kinner SA. Asthma-related mortality after release from prison: a retrospective data linkage study. J Asthma 2023; 60:167-173. [PMID: 35175870 DOI: 10.1080/02770903.2022.2039936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND People who experience incarceration are at increased risk of asthma and have a higher prevalence of risk factors associated with asthma-related mortality. However, there has been little research on the relationship between asthma and mortality in people released from prison. OBJECTIVES This study examined the association between asthma and all-cause and cause-specific mortality, and estimated the increased risk of asthma-related mortality among adults released from prison compared to the age- and sex-matched general population. DESIGN We used data from a nested case-control sample (N = 1658) within a retrospective cohort study of all adults released from prisons in Queensland, Australia, from 1994 to 2007 (N = 42015). Deaths were identified using linkage to national mortality records. Nested study cases were sampled from deaths, with a matched control from the cohort. We examined medical and case management records to identify risk factors potentially associated with mortality. Asthma-related mortality in the cohort was compared to that of the matched general population of Queensland. RESULTS People released from prison were more likely than their age and sex matched general population counterparts to have an asthma-related death (HR = 3.32 95%CI:2.14-5.16). Those who had been identified as having asthma in prison had increased odds of mortality from all-cause (OR = 1.86 95%CI:1.40-2.47), drug-related (OR = 2.5 95%CI:1.40-4.46), cardiovascular-related (OR = 3.2 95%CI:1.57-6.51), and respiratory-related (OR = 3.30 95%CI:1.63-6.70). CONCLUSION Among people exposed to incarceration, those with asthma are at elevated risk of death after release from custody. Improved management of respiratory disease in this population may contribute to reducing their high rate of preventable mortality.
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Affiliation(s)
- Simon Forsyth
- Faculty of Medicine and Biomedical Sciences, School of Public Health, University of Queensland, Herston, Australia
| | - Rosa Alati
- School of Public Health, Curtin University, Perth, Australia.,Institute for Social Science Research, University of Queensland, Indooroopilly, Australia
| | - Stuart A Kinner
- Justice Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Australia.,Mater Research Institute-UQ, University of Queensland, South Brisbane, Australia.,Griffith Criminology Institute, Griffith University, Mount Gravatt, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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16
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Moore K, Lautenbach E, Blumberg EA, Han J, Lee DH, Clauss H, Hasz R, Bilker WB, Molnar E, Alimenti D, West S, Tolomeo P, Anesi JA. Impact of deceased organ donor injection drug use on donor culture positivity and recipient outcomes. Transpl Infect Dis 2022; 24:e13942. [PMID: 35986571 PMCID: PMC9780151 DOI: 10.1111/tid.13942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/01/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Due to the ongoing opioid epidemic in the United States, deceased organ donors increasingly have a history of injection drug use (IDU), raising concerns about infectious risks to solid organ transplant (SOT) recipients. We sought to determine how recent IDU among deceased organ donors impacted donor culture results and recipient outcomes. METHODS A retrospective cohort study was performed at three transplant centers. Exposed donors were those with "recent IDU" (in the prior 12 months). Primary outcomes included (1) positive donor cultures for bacteria or Candida species, (2) recipient bacterial or Candida infection within 3 months posttransplant, and (3) recipient graft failure or death within 12 months posttransplant. Mixed effects multivariable regression models were used to evaluate the relationship between recent donor IDU and each outcome. RESULTS A total of 658 SOT recipients who received organs from 394 donors were included. Sixty-six (17%) donors had a history of recent IDU. Recent IDU in donors was associated with a significantly increased odds of donor culture positivity (aOR 3.65, 95% CI 1.06-12.60, p = .04) but was not associated with SOT recipient infection (aHR 0.98, 95% CI 0.71-1.36, p = .92) or graft failure or death (aHR 0.67, 95% CI 0.29-1.51, p = .33). CONCLUSION Donors with recent IDU are more likely to have positive cultures, but their recipients' outcomes are unaffected, suggesting organs from donors with recent IDU may be safely utilized.
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Affiliation(s)
- Krista Moore
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ebbing Lautenbach
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Emily A. Blumberg
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jennifer Han
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Dong Heun Lee
- Division of Infectious Diseases, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Heather Clauss
- Section of Infectious Diseases, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
| | - Richard Hasz
- Gift of Life Donor Program, Philadelphia, Pennsylvania, USA
| | - Warren B. Bilker
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Esther Molnar
- Section of Infectious Diseases, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
| | - Darcy Alimenti
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sharon West
- Gift of Life Donor Program, Philadelphia, Pennsylvania, USA
| | - Pam Tolomeo
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Judith A. Anesi
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Bathgate CJ, Hjelm M, Filigno SS, Smith BA, Georgiopoulos AM. Management of Mental Health in Cystic Fibrosis. Clin Chest Med 2022; 43:791-810. [PMID: 36344081 DOI: 10.1016/j.ccm.2022.06.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This article is intended for use among all cystic fibrosis care team members. It covers common mental health concerns and their unique presentations in persons with cystic fibrosis (pwCF) in areas such as depression, anxiety, trauma, behavioral disorders emerging in childhood, sleep, problematic eating patterns, and the impact of substance use. Furthermore, the authors address ways to manage these mental health symptoms through risk assessment, psychological interventions, and/or psychotropic medications. Quick reference tables are provided for evidence-based psychological interventions and medications often used for mental health conditions in pwCF.
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Affiliation(s)
| | - Michelle Hjelm
- University of Cincinnati College of Medicine; Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | - Stephanie S Filigno
- University of Cincinnati College of Medicine; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
| | - Beth A Smith
- Jacobs School of Medicine and Biomedical Sciences, Children's Psychiatry Clinic, 1028 Main Street, Buffalo, NY 14202, USA
| | - Anna M Georgiopoulos
- Part-Time, Harvard Medical School; Department of Psychiatry, Massachusetts General Hospital, Yawkey 6900, 55 Fruit Street, Boston, MA 02114, USA
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18
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Cheng KA, Nichols H, McAdams HP, Henry TS, Washington L. Imaging of Smoking and Vaping Related Diffuse Lung Injury. Radiol Clin North Am 2022; 60:941-950. [DOI: 10.1016/j.rcl.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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19
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Taraxasterol Inhibits Hyperactivation of Macrophages to Alleviate the Sepsis-induced Inflammatory Response of ARDS Rats. Cell Biochem Biophys 2022; 80:763-770. [PMID: 36070121 DOI: 10.1007/s12013-022-01092-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 08/24/2022] [Indexed: 11/03/2022]
Abstract
To explore the effect and mechanism of taraxasterol on sepsis-induced acute respiratory distress syndrome (ARDS). Twenty-four male SD rats were randomly divided into four groups: the control group, model (lipopolysaccharide, LPS) group, lipopolysaccharide+taraxasterol (LPS + TXL) group, and lipopolysaccharide+ulinastatin (LPS + UTI) group. The model of sepsis-induced ARDS was established by intraperitoneal injection of LPS. The lung water content of the rats in each group was determined by the dry/wet ratio. Pathology of rat lung tissue was observed through H&E staining. Wright staining was applied to count the number of neutrophils, macrophages, and total cells. ELISA was utilized to measure the levels of the inflammatory factors TNF-α, IL-1β, and IL-6 in bronchoalveolar lavage fluid (BALF). Biochemical detection was adopted to check the levels of myeloperoxidase (MPO), superoxide dismutase (SOD) and catalase (CAT) in lung tissue. Western blotting was performed to check the protein expression of IL-12, iNOS, Arg-1, and Mrc1 in lung tissue. Compared with the LPS group, both taraxasterol and ulinastatin significantly decreased lung tissue water content, improved lung tissue injury, reduced the number of neutrophils, macrophages and total cells, and decreased the level of inflammatory factors. In addition, taraxasterol and ulinastatin also reduced the content of MPO and the expression of IL-12 and iNOS and increased the activity of SOD and CAT as well as the protein expression of Arg-1 and Mrc1. Taraxasterol can suppress macrophage M1 polarization to alleviate the inflammatory response and oxidative stress, thereby treating sepsis-induced ARDS.
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Lai H, Mubashir T, Shiwalkar N, Ahmad H, Balogh J, Williams G, Bauer C, Maroufy V. Association of pre-admission opioid abuse and/or dependence on major complications in traumatic brain injury (TBI) patients. J Clin Anesth 2022; 79:110719. [PMID: 35276593 DOI: 10.1016/j.jclinane.2022.110719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 02/23/2022] [Accepted: 02/28/2022] [Indexed: 11/17/2022]
Abstract
SETTING In the last few decades, an opioid related health crisis has been a challenging problem in many countries around the world, especially the United States. Better understanding of the association of pre-admission opioid abuse and/or dependence (POAD) on specific major complications in traumatic brain injury (TBI) patients can aid the medical team in improving patient care management and outcomes. STUDY OBJECTIVE Our goal is to assess and quantify the risk of POAD on in-hospital mortality and major complications in TBI patients. DESIGN We conducted a retrospective study and used the National Inpatient Sample (NIS) database from 2004 to 2015 to investigate the impact of POAD on in-hospital mortality and major complications in TBI patients. We utilized propensity score matching and conditional logistic regression models, adjusted with injury severity score (ISS) and comorbidities, to obtain the adjusted odds ratios (OR). MAIN RESULTS POAD TBI patients had lower risks of in-hospital mortality (OR 0.58; p < 0.001) and acute myocardial infarction (OR 0.53; p = 0.045), while a higher risk of respiratory (OR 1.59; p < 0.001) and neurologic complications (OR 2.54; p < 0.001), compared to non-POAD TBI patients. Additionally, POAD patients were significantly more likely to have sepsis (OR 2.16, p < 0.001), malnutrition (OR 1.56, p < 0.001), delirium (OR 2.81, p < 0.001), respiratory failure (OR 1.79, p < 0.001), and acute renal failure (OR 1.83, p < 0.001). POAD TBI patients had shorter length of hospital stay compared to non-POAD TBI patients (mean 8.0 vs 9.2 days, p < 0.001). CONCLUSIONS POAD TBI patients have a lower in-hospital mortality, shorter duration of hospitalization and a lower risk of acute myocardial infarction, while they are more likely to have respiratory failure, delirium, sepsis, malnutrition, and acute renal failure compared to TBI patients without POAD. Prospective study is warranted to further confirm these findings.
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Affiliation(s)
- Hongyin Lai
- Department of Biostatistics and Data Science, UTHealth School of Public Health, 1200 Pressler St, Houston, TX 77030, USA
| | - Talha Mubashir
- Department of Anesthesiology, UTHealth McGovern Medical School, 6410 Fannin St, Houston, TX 77030, USA
| | - Nimisha Shiwalkar
- Department of Anesthesiology and Critical Care, Zen Multispecialty Hospital and Research Center, Mumbai, India
| | - Hunza Ahmad
- Department of Anesthesiology, UTHealth McGovern Medical School, 6410 Fannin St, Houston, TX 77030, USA
| | - Julius Balogh
- Department of Anesthesiology, University of Arkansas for Medical Sciences, 4301 West Markham, #515, Little Rock, AR 72205, USA
| | - George Williams
- Department of Anesthesiology, UTHealth McGovern Medical School, 6410 Fannin St, Houston, TX 77030, USA
| | - Cici Bauer
- Department of Biostatistics and Data Science, UTHealth School of Public Health, 1200 Pressler St, Houston, TX 77030, USA
| | - Vahed Maroufy
- Department of Biostatistics and Data Science, UTHealth School of Public Health, 1200 Pressler St, Houston, TX 77030, USA.
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21
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Shain LM, Ahmed T, Bodine ML, Bauman JG. Drug use-related right-sided infective endocarditis complicated by empyema and bronchopleural fistula. BMJ Case Rep 2022; 15:e246663. [PMID: 35027382 PMCID: PMC8762097 DOI: 10.1136/bcr-2021-246663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2021] [Indexed: 11/04/2022] Open
Abstract
Right-sided infective endocarditis is frequently accompanied by septic pulmonary emboli, which may result in a spectrum of respiratory complications. We present the case of a 25-year-old woman diagnosed with infective endocarditis secondary to intravenous drug use. During a long and arduous hospital course, the patient developed empyema with bronchopleural fistula, representing severe but uncommon sequelae that may arise from this disease process. She was treated with several weeks of antibiotics as well as surgical thorascopic decortication and parietal pleurectomy.
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Affiliation(s)
- Lindsey M Shain
- University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Taha Ahmed
- Divison of Hospital/Internal Medicine, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Michele L Bodine
- Advanced Practice Provider Residency Program, Division of Hospital Medicine, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Jennifer G Bauman
- Advanced Practice Provider Residency Program, Division of Hospital Medicine, University of Kentucky College of Medicine, Lexington, Kentucky, USA
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22
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Gad El-Hak HN, Mohamed OE, Nabil ZI. Evaluating the protective role of Deglycyrrhizinated licorice root supplement on bleomycin induced pulmonary oxidative damage. Toxicol Mech Methods 2021; 32:180-193. [PMID: 34488542 DOI: 10.1080/15376516.2021.1977881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The goal of this study was to investigate the protective effect of licorice supplements in a rat model of Bleomycin-induced lung oxidative damage over a duration of one month. The rats were randomly divided into six groups (n = 10 per group). Control group; Bleomycin group (B): rats were IP injected with bleomycin 5 mg/kg twice weekly. Licorice group (L): rats received orally 300 mg/kg licorice extract. Bleomycin and a low dose of Licorice group (BLLG): rats received orally 75 mg/kg licorice daily and injected as the B group. Bleomycin and a middle dose of Licorice group (BMLG): rats received orally 150 mg/kg licorice daily and injected as the Bleomycin group. Bleomycin and a high dose of Licorice group (BHLG): rats received orally 300 mg/kg licorice daily and injected as the Bleomycin group. Treatment with Bleomycin induced inflammation and oxidative damage to the lungs expressed in the disturbance of the measured parameters in the blood serum, the lung tissue, and the broncholavage fluid. In addition to the decreased expression of superoxide dismutase (SOD), glutathione peroxidase (GSH-PX), and catalase (CAT) in the lung tissues. Bleomycin caused deformative changes in the histopathological and cellular examination of the lungs especially in the alveolar cells and the interstitial space. On the other hand, treated the bleomycin group with different doses of licorice supplement activates the antioxidant defense mechanism and attenuates the oxidative damage and damage induced to the lung. In conclusion, Deglycyrrhizinated licorice root supplement provided strong antioxidant and protective effects on Bleomycin-induced lung damage.
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Affiliation(s)
- Heba N Gad El-Hak
- Zoology Department, Faculty of Science, Suez Canal University, Ismailia, Egypt
| | - Osman E Mohamed
- Zoology Department, Faculty of Science, Suez Canal University, Ismailia, Egypt
| | - Zohour I Nabil
- Zoology Department, Faculty of Science, Suez Canal University, Ismailia, Egypt
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Abstract
Sympathomimetic drugs comprise a broad category of substances including both illicit and prescribed drugs that have deleterious effects when ingested or abused. The clinical syndromes that result from overstimulation of the sympathetic nervous system by reuptake inhibition of biogenic amines, such as norepinephrine and dopamine, carry significant morbidity. Recognition and awareness of the appropriate supportive measures are required to mitigate life-threatening complications of multiple organ systems. The sympathomimetic toxidrome is recognized by a constellation of symptoms including agitation, hyperthermia, tachycardia, and hypertension, and the primary treatment involves supportive care, including the liberal use of benzodiazepines.
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Affiliation(s)
- Hallie Brown
- Department of Emergency Medicine, Indiana University School of Medicine, 720 Eskenazi Avenue, Fifth Third Bank Building - Third Floor, Indianapolis, IN 46202, USA
| | - Katherine A Pollard
- Department of Emergency Medicine, Indiana University School of Medicine, 720 Eskenazi Avenue, Fifth Third Bank Building - Third Floor, Indianapolis, IN 46202, USA; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
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24
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Munagala R, Chiruvella V, Pucar D, Keshavamurthy J. Cocaine-induced pulmonary complications: A diagnosis of waiting and watching. Lung India 2021; 38:362-364. [PMID: 34259176 PMCID: PMC8272414 DOI: 10.4103/lungindia.lungindia_164_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Pulmonary complications of cocaine among users are common. Manifestations include lung congestion, intra-alveolar edema, and diffuse alveolar hemorrhage (DAH). Direct cellular toxicity, eosinophilia, barotrauma, and vasoactive effects of cocaine are believed to induce DAH. We present a rare case of cocaine-associated focal alveolar hemorrhage mimicking malignancy on imaging. Initially contemplated biopsy was avoided based on rapid growth of concerning lung lesion, with subsequent near resolution on follow-up. This case illustrates the importance of epidemiologic and temporal multimodality correlation when evaluating indeterminate lung lesions.
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Affiliation(s)
- Rohit Munagala
- Department of Radiology, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Varsha Chiruvella
- Department of Radiology, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Darko Pucar
- Department of Radiology, Yale School of Medicine, New Haven, CT, USA
| | - Jayanth Keshavamurthy
- Department of Radiology, Medical College of Georgia at Augusta University, Augusta, GA, USA
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25
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Das S, Mahintamani T, Ghosh A. Pleural Effusion in a Patient with Injection Heroin Use: An Unusual Presentation with an Unusual Pathogen. Indian J Psychol Med 2021; 43:369-371. [PMID: 34385738 PMCID: PMC8327866 DOI: 10.1177/0253717620934200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 05/25/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- Sauvik Das
- Dept. of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Tathagata Mahintamani
- Dept. of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Abhishek Ghosh
- Dept. of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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26
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Toquet S, Cousson J, Choiselle N, Gozalo C, Giusti D, Bani-Sadr F, N'Guyen Y. Alveolar hemorrhage due to marijuana smoking using water pipe made with plastic bottle: case report and narrative review of the literature. Inhal Toxicol 2021; 33:168-176. [PMID: 34180335 DOI: 10.1080/08958378.2021.1939465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION We described a case of alveolar hemorrhage (AH) after marijuana smoking using a water pipe made with plastic bottle (bong) before making a narrative review of the literature. CASE REPORT A 19-year-old male was admitted for hemoptysis and dyspnea evolving since the previous day. He smoked marijuana ten times a day using bongs. Computed tomography scan of the chest (chest CT-scan) evidenced ground glass opacities involving upper lobes with crazy-paving pattern. Bronchoalveolar lavage (BAL) yielded fluid becoming progressively bloody suggestive of AH. Screening of drug metabolites ruled out the presence of cocaine degradation products. Treatment with prednisone was prescribed and oxygen requirements decreased rapidly. The patient accepted to stop bongs, but kept on smoking marijuana using joints. He was asymptomatic 2 months later; all ground glass opacities had vanished. REVIEW OF THE LITERATURE Four cases described exactly the same circumstances as ours. All were young male patients containing ground glass opacities with diffuse or bilateral pattern in their chest CT-scan. The explanation suggested by the authors of these cases was the potential concomitant inhalation of acid anhydrides derived from use of heated plastic bottle. No acid anhydrides were experimentally evidenced after thermodesorption of heated polyethylene terephthalate (PET) (in which a majority of plastic bottles are made) we performed, but other compounds were. E-cigarette, or vaping, product use-associated lung injuries cases share some chest CT-scan patterns with those of AH following bong use and we tried to draw a parallel between these two latter before discussing a physiopathological hypothesis.
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Affiliation(s)
- Ségolène Toquet
- Service de Médecine Interne, Maladies Infectieuses et Immunologie Clinique, Hôpital Robert Debré, CHU Reims, Reims, France
| | - Joël Cousson
- Unité de Réanimation Polyvalente, Hôpital Robert Debré, CHU Reims, Reims, France
| | - Nathalie Choiselle
- Ecole Nationale Supérieure d'Ingénieurs de Reims ESIREIMS, Université de Reims Champagne Ardennes, Reims, France
| | - Claire Gozalo
- Laboratoire de Pharmacologie, Hôpital Maison Blanche, CHU Reims, Reims, France
| | - Delphine Giusti
- Laboratoire d'Immunologie, Hôpital Robert Debré, CHU Reims, Reims, France
| | - Firouze Bani-Sadr
- Service de Médecine Interne, Maladies Infectieuses et Immunologie Clinique, Hôpital Robert Debré, CHU Reims, Reims, France
| | - Yohan N'Guyen
- Service de Médecine Interne, Maladies Infectieuses et Immunologie Clinique, Hôpital Robert Debré, CHU Reims, Reims, France
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27
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Severe Respiratory and Hemodynamic Failures following Successful Spontaneous Pneumothorax Drainage. Case Rep Emerg Med 2021; 2021:6677656. [PMID: 34055425 PMCID: PMC8133856 DOI: 10.1155/2021/6677656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/03/2021] [Accepted: 05/03/2021] [Indexed: 11/17/2022] Open
Abstract
Spontaneous pneumothorax is a frequent situation in respiratory medicine, and its treatment is based on conservative treatment or pleural drainage. Reexpansion pulmonary edema (REPE) is often a mild complication following pneumothorax drainage. We report here a severe case of unilateral REPE following spontaneous pneumothorax drainage associated with major pulmonary plasmatic leakage. The clinical presentation was severe and sudden with respiratory and circulatory failures. Initial resuscitation was mostly based on prone and head-down positioning in association to fluid expansion and mechanical ventilation. On the basis of this clinical case report, we strongly suggest to think about severe pulmonary reexpansion edema when respiratory and hemodynamic failures occur few hours after pneumothorax-related efficient pleural tube drainage.
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28
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Baillargeon J, Polychronopoulou E, Kuo YF, Raji MA. The Impact of Substance Use Disorder on COVID-19 Outcomes. Psychiatr Serv 2021; 72:578-581. [PMID: 33138712 PMCID: PMC8089118 DOI: 10.1176/appi.ps.202000534] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The goal of this study was to examine the impact of substance use disorder on the risk of hospitalization, complications, and mortality among adult patients diagnosed as having COVID-19. METHODS The authors conducted a propensity score (PS)-matched double-cohort study (N=5,562 in each cohort) with data from the TriNetX Research Network database to identify 54,529 adult patients (≥18 years) diagnosed as having COVID-19 between February 20 and June 30, 2020. RESULTS Primary analysis (PS matched on demographic characteristics and presence of diabetes and obesity) showed that substance use disorder was associated with an increased risk of hospitalization (odds ratio [OR]=1.84, 95% confidence interval [CI]=1.69-2.01), ventilator use (OR=1.45, 95% CI=1.22-1.72), and mortality (OR=1.30, 95% CI=1.08-1.56). CONCLUSIONS The findings suggest that COVID-19 patients with substance use disorders are at increased risk for adverse outcomes. The attenuation of ORs in the model that matched for chronic respiratory and cardiovascular diseases associated with substance abuse suggests that the observed risks may be partially mediated by these conditions.
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Affiliation(s)
- Jacques Baillargeon
- Department of Preventive Medicine and Population Health (all authors), and Department of Internal Medicine (Kuo, Raji), University of Texas Medical Branch, Galveston
| | - Efstathaia Polychronopoulou
- Department of Preventive Medicine and Population Health (all authors), and Department of Internal Medicine (Kuo, Raji), University of Texas Medical Branch, Galveston
| | - Yong-Fang Kuo
- Department of Preventive Medicine and Population Health (all authors), and Department of Internal Medicine (Kuo, Raji), University of Texas Medical Branch, Galveston
| | - Mukaila A Raji
- Department of Preventive Medicine and Population Health (all authors), and Department of Internal Medicine (Kuo, Raji), University of Texas Medical Branch, Galveston
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29
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Ategbole M, Su BB, Wang N, Loudermilk E, Xie X, Acevedo P, Ozuna K, Xu C, Liu Y, Wang K. Gender differences in the associations of early onset poly tobacco and drug use prior to age 18 with the prevalence of adult bronchitis in the United States. J Addict Dis 2021; 39:189-198. [PMID: 33215555 PMCID: PMC8366588 DOI: 10.1080/10550887.2020.1847992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE We investigated the associations of early onset polysubstance use prior to age 18 with the prevalence of bronchitis among U.S. adults and tested whether the associations differ by gender. METHODS A total of 77,950 adults, of them 2,653 with bronchitis in the past year, were from the combined 2013 and 2014 National Survey on Drug Use and Health data. The variable cluster analysis was used to classify nine variables about substance use prior to age 18 (cigarettes, cigars, smokeless tobacco, marijuana, cocaine, heroin, methamphetamines, ecstasy, and phencyclidine). Weighted multivariate logistic regression analysis (MLR) was used to examine the associations with bronchitis. RESULTS Nine variables were divided into two clusters: early onset poly tobacco use (three tobacco use variables) and early onset poly drug use (six drug use variables). The overall prevalence of bronchitis was 3.8% (5.1% for females and 2.3% for males). MLR analysis showed that being female, elderly (ages 65 and above), obese, and early onset poly tobacco use were associated with increased odds of bronchitis (p < 0.05). Gender-stratified analyses showed that early-onset poly tobacco use was significantly associated with bronchitis only in males, whereas early onset poly drug use was associated with bronchitis only in females. Moreover, obesity and tobacco use in the past year revealed associations with bronchitis regardless of gender. CONCLUSIONS Obesity, early onset poly tobacco use prior to age 18, and tobacco use in the past year were positively associated with bronchitis; furthermore, the associations of early onset polysubstance use with bronchitis differed by gender, which indicated that gender differences should be considered in developing effective prevention strategies.
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Affiliation(s)
- Muyiwa Ategbole
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Brenda Bin Su
- Department of Health and Biomedical Science, College of Health Affairs, University of Texas Rio Grande Valley, TX, USA
| | - Nianyang Wang
- Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, MD, USA
| | - Elaine Loudermilk
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Xin Xie
- Department of Economics and Finance, College of Business and Technology, East Tennessee State University, Johnson City, TN, USA
| | - Priscila Acevedo
- Department of Health and Biomedical Science, College of Health Affairs, University of Texas Rio Grande Valley, TX, USA
| | - Kaysie Ozuna
- Department of Health and Biomedical Science, College of Health Affairs, University of Texas Rio Grande Valley, TX, USA
| | - Chun Xu
- Department of Health and Biomedical Science, College of Health Affairs, University of Texas Rio Grande Valley, TX, USA
| | - Ying Liu
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Kesheng Wang
- Department of Family and Community Health, School of Nursing, Health Sciences Center, West Virginia University, Morgantown, WV, USA
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30
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Blinick R, Chaya N, Zalta B, Haramati LB, Shmukler A. Cracking the Opium Den: Cardiothoracic Manifestations of Drug Abuse. J Thorac Imaging 2021; 36:W16-W31. [PMID: 32102017 DOI: 10.1097/rti.0000000000000488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Recreational drug use is increasing worldwide, with emergency room visits and total deaths from drug overdose rising in recent years. Complications from prescription and recreational drug use may result from the biochemical effects of the drugs themselves, impurities mixed with substances, or from causes related to the method of drug administration. The presentation of drug overdose may be complex due to multisubstance abuse, including cigarette smoking and alcoholism, and can impact any organ system. Patients may present without history, and radiologists may be the first clinicians to suggest the diagnosis. We aim to explore the cardiothoracic manifestations of drug abuse and their multimodality imaging manifestations.
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Affiliation(s)
| | - Nathan Chaya
- Montefiore Medical Center, Bronx
- Staten Island University Hospital, Staten Island, NY
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31
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Sanvisens A, Hernández-Rubio A, Zuluaga P, Fuster D, Papaseit E, Galan S, Farré M, Muga R. Long-Term Outcomes of Patients With Cocaine Use Disorder: A 18-years Addiction Cohort Study. Front Pharmacol 2021; 12:625610. [PMID: 33679404 PMCID: PMC7930813 DOI: 10.3389/fphar.2021.625610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/14/2021] [Indexed: 11/16/2022] Open
Abstract
Objective: Cocaine Use Disorder (CUD) has been associated with multiple complications and premature death. The purpose of the present study was to analyze the relationship between baseline medical comorbidity and long-term medical outcomes (i.e., hospitalization, death) in a cohort of patients primarily admitted for detoxification. In addition, we aimed to analyze cause-specific mortality. Methods: longitudinal study in CUD patients admitted for detoxification between 2001 and 2018. Substance use characteristics, laboratory parameters and medical comorbidity by VACS Index were assessed at admission. Follow-up and health-related outcomes were ascertained through visits and e-health records. Kaplan-Meier and Cox regression models were used to analyze survival and predictors of hospitalization and death. Results: 175 patients (77.7% men) were included. Age at admission was 35 years [IQR: 30–41 years], 59.4% of the patients being intranasal users, 33.5% injectors, and 7.1% smokers. Almost 23% of patients had concomitant alcohol use disorder, 39% were cannabis users and 9% opiate users. The median VACS Index score on admission was 10 points [IQR: 0–22]. After 12 years [IQR: 8.6–15 years] of follow-up there were 1,292 (80.7%) ED admissions and 308 (19.3%) hospitalizations. The incidence rate of ED admission and hospitalization was 18.6 × 100 p-y (95% CI: 15.8–21.8 × 100 p-y). Mortality rate was 1.4 × 100 p-y (95% CI: 0.9–2.0 × 100 p-y) and, baseline comorbidity predicted hospitalization and mortality: those with VACS Index >40 were 3.5 times (HR:3.52, 95% CI: 1.19–10.4) more likely to dye with respect to patients with VACS < 20. Conclusion: addiction care warrants optimal stratification of medical comorbidity to improve health outcomes and survival of CUD patients seeking treatment of the disorder.
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Affiliation(s)
- Arantza Sanvisens
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol-IGTP, Universitat Autónoma de Barcelona, Department of Medicine, Badalona, Spain
| | - Anna Hernández-Rubio
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol-IGTP, Universitat Autónoma de Barcelona, Department of Medicine, Badalona, Spain
| | - Paola Zuluaga
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol-IGTP, Universitat Autónoma de Barcelona, Department of Medicine, Badalona, Spain
| | - Daniel Fuster
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol-IGTP, Universitat Autónoma de Barcelona, Department of Medicine, Badalona, Spain
| | - Esther Papaseit
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol-IGTP, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Sara Galan
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol-IGTP, Universitat Autónoma de Barcelona, Department of Medicine, Badalona, Spain
| | - Magí Farré
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol-IGTP, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Robert Muga
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol-IGTP, Universitat Autónoma de Barcelona, Department of Medicine, Badalona, Spain
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Bulathsinghala CP, De Silva PR, Dadhwal R, Taweesedt PT, Surani S. Foreign Body Aspiration Getting Weird: Crack Pipe Aspiration. Cureus 2021; 13:e13267. [PMID: 33728203 PMCID: PMC7948311 DOI: 10.7759/cureus.13267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Inhalation of cocaine derivatives is associated with a number of pulmonary and systemic complications. We report a case of less recognized complication, the aspiration of a metallic object used as a screen for crack cocaine abuse. A 42-year-old female presented with a two-day history of gradually worsening cough and a history of “food aspiration.” Her lung examination revealed wheezing and fine crackles with diminished air entry at the left base. A chest X-ray revealed an 8 mm radiopaque foreign body overlying the region of the left lower lobe bronchus, with a confirmatory computed tomography scan of the chest. An urgent bronchoscopy revealed a metallic foreign body impacted into the left lower lobe bronchus proper, soon after the takeoff of the superior segment, which was removed with forceps. The patient signed out against medical advice soon after. Though relatively uncommon, this case highlights a possible complication associated with crack cocaine abuse that may require emergent intervention.
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Affiliation(s)
| | - Palla Rivi De Silva
- Pulmonary Critical Care, University of Incarnate Word School of Osteopathic Medicine, San Antonio, USA
| | - Rahul Dadhwal
- Pulmonary Medicine, Pulmonary Associates, Corpus Christi, USA
| | | | - Salim Surani
- Internal Medicine, University of Incarnate Word School of Osteopathic Medicine, San Antonio, USA
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33
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Dollard SC, Annambhotla P, Wong P, Meneses K, Amin MM, La Hoz RM, Lease ED, Budev M, Arrossi AV, Basavaraju SV, Thomas CP. Donor-derived human herpesvirus 8 and development of Kaposi sarcoma among 6 recipients of organs from donors with high-risk sexual and substance use behavior. Am J Transplant 2021; 21:681-688. [PMID: 32633035 PMCID: PMC7891580 DOI: 10.1111/ajt.16181] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 01/25/2023]
Abstract
Kaposi sarcoma (KS) can develop following organ transplantation through reactivation of recipient human herpesvirus 8 (HHV-8) infection or through donor-derived HHV-8 transmission. We describe 6 cases of donor-derived HHV-8 infection and KS investigated from July 2018 to January 2020. Organs from 6 donors, retrospectively identified as HHV-8-positive, with a history of drug use disorder, were transplanted into 22 recipients. Four of 6 donors had risk factors for HHV-8 infection reported in donor history questionnaires. Fourteen of 22 organ recipients (64%) had evidence of posttransplant HHV-8 infection. Lung recipients were particularly susceptible to KS. Four of the 6 recipients who developed KS died from KS or associated complications. The US opioid crisis has resulted in an increasing number and proportion of organ donors with substance use disorder, and particularly injection drug use history, which may increase the risk of HHV-8 transmission to recipients. Better awareness of the risk of posttransplant KS for recipients of organs from donors with HHV-8 infection risk could be useful for recipient management. Testing donors and recipients for HHV-8 is currently challenging with no validated commercial serology kits available. Limited HHV-8 antibody testing is available through some US reference laboratories and the Centers for Disease Control and Prevention.
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Affiliation(s)
| | | | - Phili Wong
- Centers for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Katherine Meneses
- Liver Transplant DepartmentUniversity of California Los AngelesLos AngelesCaliforniaUSA
| | - Minal M. Amin
- Centers for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Ricardo M. La Hoz
- Department of Internal MedicineUniversity of Texas Southwestern Medical CenterDallasTexasUSA
| | - Erika D. Lease
- Division of Pulmonary Critical Care and Sleep MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Maria Budev
- Department of Pulmonary MedicineCleveland Clinic FoundationClevelandOhioUSA
| | | | | | - Christie P. Thomas
- Department of Internal MedicineUniversity of Iowa Carver College of MedicineIowa CityIowaUSA,Veterans Affairs Medical CenterIowa CityIowaUSA
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Underner M, Peiffer G, Perriot J, Jaafari N. Republication de : Complications pulmonaires chez les consommateurs de cocaïne. JOURNAL EUROPÉEN DES URGENCES ET DE RÉANIMATION 2020. [DOI: 10.1016/j.jeurea.2020.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Barile M. Pulmonary Edema: A Pictorial Review of Imaging Manifestations and Current Understanding of Mechanisms of Disease. Eur J Radiol Open 2020; 7:100274. [PMID: 33163585 PMCID: PMC7607415 DOI: 10.1016/j.ejro.2020.100274] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 09/22/2020] [Indexed: 12/20/2022] Open
Abstract
Pulmonary edema is a common clinical entity caused by the extravascular movement of fluid into the pulmonary interstitium and alveoli. The four physiologic categories of edema include hydrostatic pressure edema, permeability edema with and without diffuse alveolar damage (DAD), and mixed edema where there is both an increase in hydrostatic pressure and membrane permeability. As radiographic manifestations and etiologies are varied, an appreciation for both the common and uncommon manifestations and causes of pulmonary edema is essential for accurate diagnosis.
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Affiliation(s)
- Maria Barile
- Department of Radiology at University of Massachusetts Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, United States
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Nicolakis J, Gmeiner G, Reiter C, Seltenhammer MH. Aspiration in lethal drug abuse-a consequence of opioid intoxication. Int J Legal Med 2020; 134:2121-2132. [PMID: 32929594 PMCID: PMC7578170 DOI: 10.1007/s00414-020-02412-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 08/27/2020] [Indexed: 12/12/2022]
Abstract
AIMS The primary objective of this study was to investigate whether the fatalities of opioid abuse are not only related to respiratory depression but also as a result of other side effects such as emesis, delayed gastric emptying, a reduction of the cough reflex, and impaired consciousness leading to the aspiration of gastric contents, a finding regularly observed in drug-related deaths. DESIGN A retrospective exploratory study analyzing heroin/morphine/methadone-related deaths submitted to court-ordered autopsy. SETTING Center for Forensic Medicine, Medical University of Vienna, Austria (2010-2015). PARTICIPANTS Two hundred thirty-four autopsy cases were included in the study: morphine (n = 200), heroin (n = 11), and methadone (n = 23) intoxication. FINDINGS Analyses revealed that 41.88% of all deceased showed aspiration of gastric contents with equal gender distribution (p = 0.59). Aspiration was more frequent in younger deceased (χ2 = 8.7936; p = 0.012) and in deceased with higher body mass index (BMI) (χ2 = 6.2441; p = 0.044). Blood opioid concentration was lower in deceased with signs of aspiration than in non-aspirators (p = 0.013). Toxicological evaluation revealed a high degree of concomitant substance abuse (91%)-benzodiazepines (61.6%) and/or alcohol (21.8%). CONCLUSIONS There are lower opioid concentrations in deceased with signs of aspiration, a fact which strongly points to aspiration as alternative cause of death in opioid-related fatalities. Furthermore, this study highlights the common abuse of slow-release oral morphine in Vienna and discusses alternative medications in substitution programs (buprenorphine/naloxone or tamper-resistant slow-release oral morphine preparations), as they might reduce intravenous abuse and opioid-related deaths.
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Affiliation(s)
- Johannes Nicolakis
- Center for Forensic Medicine, Medical University of Vienna, Sensengasse 2, A-1090, Vienna, Austria
| | - Günter Gmeiner
- Seibersdorf Laboratories, Campus Seibersdorf, A-2444, Seibersdorf, Austria
| | - Christian Reiter
- Center for Forensic Medicine, Medical University of Vienna, Sensengasse 2, A-1090, Vienna, Austria
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Underner M, Peiffer G, Perriot J, Jaafari N. [Asthma and cannabis, cocaine or heroin use]. Rev Mal Respir 2020; 37:572-589. [PMID: 32653338 PMCID: PMC7345369 DOI: 10.1016/j.rmr.2020.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 04/09/2020] [Indexed: 02/05/2023]
Abstract
INTRODUCTION The use of cannabis, cocaine or heroin can be responsible for many respiratory complications including asthma. OBJECTIVES The aim of this systematic literature review of data was to expose the relations between cannabis, cocaine or heroin use and asthma. RESULTS Cannabis, cocaine or heroin use by inhalation may be responsible for respiratory symptoms (cough, wheezing), asthma onset, acute asthma exacerbations (which may require intubation and invasive ventilation) or deaths related to asthma. Lower adherence to asthma treatment is also observed. Cannabis induces a rapid bronchodilator effect. In contrast, its chronic use may induce a decrease in specific airway conductance. Studies on forced expiratory volume in one second (FEV1) reduction or decline are discordant. CONCLUSION Cannabis, cocaine or heroin use must be considered in cases of acute respiratory symptoms or asthma exacerbation in young persons and practitioners must help illicit substance users to stop their consumption.
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Affiliation(s)
- M Underner
- Consultation de tabacologie, unité de recherche clinique, centre hospitalier Henri-Laborit, université de Poitiers, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France.
| | - G Peiffer
- Service de pneumologie, CHR Metz-Thionville, 57038 Metz, France
| | - J Perriot
- Dispensaire Émile-Roux, CLAT 63, centre de tabacologie, 63100 Clermont-Ferrand, France
| | - N Jaafari
- Consultation de tabacologie, unité de recherche clinique, centre hospitalier Henri-Laborit, université de Poitiers, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France
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Self M, Tainter C. More Than a Frog: Sore Throat After Inhaling Methamphetamine. J Emerg Med 2020; 59:132-134. [PMID: 32456960 DOI: 10.1016/j.jemermed.2020.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/08/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Michael Self
- Department of Emergency Medicine, University of California San Diego Health System, San Diego, California
| | - Christopher Tainter
- Department of Emergency Medicine, University of California San Diego Health System, San Diego, California; Department of Anesthesiology, Division of Critical Care Medicine, University of California San Diego Health System, San Diego, California
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Pavlek LR, Dillard J, Rogers LK. The role of oxidative stress in toxicities due to drugs of abuse. CURRENT OPINION IN TOXICOLOGY 2020. [DOI: 10.1016/j.cotox.2020.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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40
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Ayu AP, van der Ven M, Suryani E, Puspadewi N, Joewana S, Rukmini E, de Jong C, Schellekens A. Improving medical students' attitude toward patients with substance use problems through addiction medicine education. Subst Abus 2020; 43:47-55. [PMID: 32105582 DOI: 10.1080/08897077.2020.1732512] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Patients with addiction often encounter negative attitudes from health care professionals, including medical doctors. Addiction medicine training might improve medical students' attitudes toward patients with addiction problems and change the way they think about addiction. We evaluated the effect of comprehensive addiction medicine training on students' attitudes and illness perceptions and explored which perceptions are most relevant for attitude development. Methods: In a quasi-experimental non-randomized study, fourth-year students (n = 296) participated in either addiction medicine training (intervention) or one of three other blocks (control). We used the Medical Condition Regards Scale to measure attitudes and the Illness Perception Questionnaire Addiction version for perceptions. We analyzed the effect of the intervention using repeated measures MANOVA. The contribution of illness perception to attitude was explored in the intervention group using linear regression analysis. Results: Addiction medicine training improved students' attitudes toward patients with addiction, compared to the control group. After the training, students expressed a less demoralized perception, a stronger perception of a coherent understanding of addiction, addiction as a cyclical condition, and attributed addiction more to psychological factors, compared to the control group. In the intervention group, attitude and emotional representation before training and illness coherence after the training were associated with attitude after the training. Conclusions: Addiction medicine training is effective in improving medical students' attitudes toward patients with addiction and changing their illness perceptions of addiction. The development of an understanding of addiction might be particularly relevant for attitude improvement. These findings underscore the relevance of addiction medicine training as part of medical curricula and argue for including aspects related to attitude development in the curriculum.
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Affiliation(s)
- Astri Parawita Ayu
- School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.,Nijmegen Institute for Scientist-Practitioners in Addiction, Nijmegen, the Netherlands
| | - Margot van der Ven
- Nijmegen Institute for Scientist-Practitioners in Addiction, Nijmegen, the Netherlands
| | - Eva Suryani
- School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Natalia Puspadewi
- School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Satya Joewana
- School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Elisabeth Rukmini
- School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Cor de Jong
- Nijmegen Institute for Scientist-Practitioners in Addiction, Nijmegen, the Netherlands
| | - Arnt Schellekens
- Nijmegen Institute for Scientist-Practitioners in Addiction, Nijmegen, the Netherlands.,Department of Psychiatry, Radboud University Medical Centre, Nijmegen, the Netherlands
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41
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Taylor A, Birkett JW. Pesticides in cannabis: A review of analytical and toxicological considerations. Drug Test Anal 2020; 12:180-190. [DOI: 10.1002/dta.2747] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/09/2019] [Accepted: 12/10/2019] [Indexed: 01/31/2023]
Affiliation(s)
- Amelia Taylor
- School of Pharmacy and Biomolecular Sciences, Faculty of ScienceLiverpool John Moores University Liverpool UK
| | - Jason W. Birkett
- School of Pharmacy and Biomolecular Sciences, Faculty of ScienceLiverpool John Moores University Liverpool UK
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Nitta M, Tamakawa T, Kamimura N, Honda T, Endoh H. A case of diffuse alveolar hemorrhage following synthetic cathinone inhalation. World J Emerg Med 2020; 11:182-184. [PMID: 32351652 DOI: 10.5847/wjem.j.1920-8642.2020.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Masakazu Nitta
- Advanced Emergency and Critical Care Center, Niigata University Medical and Dental Hospital, Chuo-ku, Niigata, Japan
| | - Taro Tamakawa
- Advanced Emergency and Critical Care Center, Niigata University Medical and Dental Hospital, Chuo-ku, Niigata, Japan
| | - Natsuo Kamimura
- Advanced Emergency and Critical Care Center, Niigata University Medical and Dental Hospital, Chuo-ku, Niigata, Japan
| | - Tadayuki Honda
- Advanced Emergency and Critical Care Center, Niigata University Medical and Dental Hospital, Chuo-ku, Niigata, Japan
| | - Hiroshi Endoh
- Advanced Emergency and Critical Care Center, Niigata University Medical and Dental Hospital, Chuo-ku, Niigata, Japan
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43
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Shen YC, Liao KM, Lin YS, Huang YJ, Lin CL, Tsai CW, Chang WS, Shen TC, Bau DT, Hsia TC. Depression is associated with subsequent risk of pleural empyema. Ther Adv Respir Dis 2020. [PMCID: PMC7549156 DOI: 10.1177/1753466620951048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Respiratory system infections are prevalent in patients with depression.
However, it remains unclear if patients with depression are at an increased
risk of developing pleural empyema. Methods: We conducted a retrospective cohort study using data from the National Health
Insurance Research Database of Taiwan. The depression group included 42,283
newly diagnosed patients between 2000 and 2012. The comparison group
included the same number of individuals without depression, frequency
matched for age, sex, comorbidities, and the year of diagnosis. The
occurrence of pleural empyema was monitored until the end of 2013. Results: The overall incidence of pleural empyema was 1.32-fold higher in the
depression group than in the comparison group (3.94 versus
2.97 per 10,000 person-years), with an adjusted hazard ratio of 1.33 (95%
confidence interval, 1.27−1.40). Stratified analyses by age, sex, and
comorbidity revealed that the crude and adjusted hazard ratios of pleural
empyema associated with depression were significant in all subgroups. The
30-day mortality for pleural empyema was higher, but not significantly, in
the depression group compared to the comparison group (10.7%
versus 6.4%, adjusted odds ratio = 2.23, 95% confidence
interval, 0.77−6.49). Conclusion: An association between depression and the development of pleural empyema may
exist; however, more evidence is required to support this association. The reviews of this paper are available via the supplemental
material section.
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Affiliation(s)
- Yi-Chen Shen
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Kuang-Ming Liao
- Department of Internal Medicine, Chi Mei Medical Center (Chiali), Tainan, Taiwan
| | - Yen-Sung Lin
- Division of Pulmonary and Critical Care Medicine, Tainan Municipal An Nan Hospital, Tainan, Taiwan
- Department of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Yu-Jhen Huang
- Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Wen Tsai
- Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Wen-Shin Chang
- Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Te-Chun Shen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, No. 2 Yude Road, Taichung 404, Taiwan
- School of Medicine, College of Medicine, China Medical University, No.91, Hsueh-Shih Road, Taichung 404, Taiwan
| | - Da-Tian Bau
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan
- Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Wufeng, Taichung, Taiwan
| | - Te-Chun Hsia
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
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Underner M, Peiffer G, Perriot J, Jaafari N. [Pulmonary complications in cocaine users]. Rev Mal Respir 2019; 37:45-59. [PMID: 31883817 DOI: 10.1016/j.rmr.2019.11.641] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 07/03/2019] [Indexed: 02/05/2023]
Abstract
Cocaine can be responsible for many psychiatric and/or somatic disorders. The aim of this systematic literature review of data was to expose relations between cocaine use and pulmonary complications. Cocaine can be responsible for acute respiratory symptoms (cough, black sputum, hemoptysis, dyspnea, wheezing, chest pain) and for various pulmonary disorders including barotrauma (pneumothorax, pneumomediastinum, subcutaneous emphysema, pneumopericardium), airway damage, asthma, bronchiolitis obliterans with organizing pneumonia, acute pulmonary edema, alveolar hemorrhage, alveolar pneumonia with carbonaceous material, bullous emphysema, acute eosinophilic pneumonia, pulmonary granulomatosis caused by talc or cellulose, interstitial pneumonitis and pulmonary fibrosis, vasculitis, pulmonary hypertension, pulmonary embolism and pulmonary infarction, mycotic pulmonary arterial aneurysms, septic emboli, aspiration pneumonia, community-acquired pneumonia, HIV-related opportunistic infections, latent tuberculosis infection, pulmonary tuberculosis, lung cancer and crack lung. Some of these complications are serious and may have a fatal outcome. Pulmonary function tests, thoracic tomodensitometry, bronchial fibroscopy with bronchoalveolar lavage and lung scintigraphy may be an aid to the diagnosis of these pulmonary compications. Cocaine use must be sought in case of respiratory symptoms in young persons.
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Affiliation(s)
- M Underner
- Unité de recherche clinique Pierre-Deniker, centre hospitalier Henri-Laborit, université de Poitiers, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France.
| | - G Peiffer
- Pneumologie, CHR Metz-Thionville, CHR Mercy, 57085 Metz cedex 3, France
| | - J Perriot
- Dispensaire Émile-Roux, centre de tabacologie, 63100 Clermont-Ferrand, France
| | - N Jaafari
- Unité de recherche clinique Pierre-Deniker, centre hospitalier Henri-Laborit, université de Poitiers, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France
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Underner M, Perriot J, Peiffer G, Urban T, Jaafari N. [Acute eosinophilic pneumonia and illicit psychoactive substance use]. Rev Mal Respir 2019; 37:34-44. [PMID: 31862136 DOI: 10.1016/j.rmr.2019.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 07/11/2019] [Indexed: 02/08/2023]
Abstract
Illicit psychoactive substance (IPAS) use can lead to a number of respiratory complications, including acute eosinophilic pneumonia (AEP). Systematic literature review of data on AEP in IPAS users (cannabis, cocaine, heroin and amphetamine). Of two cases of cannabis and tobacco users reported to have developed AEP, one, a teenage15 year old boy presented with acute respiratory distress syndrome (ARSD) which necessitated extracorporeal membrane oxygenation (ECMO). Five cases of AEP in cocaine smokers (crack) are reported, one of which was fatal. The patient presented with acute pulmonary edema and ARDS which progressed to ventricular fibrillation and asystole. A 24-year-old woman presented with AEP after repeated inhalation of heroin. Finally, a case of an amphetamine abuser who developed AEP and ARDS after amphetamine inhalation is reported. The time between the first IPAS use and admission in cases reported ranged from 7 days to 4 years, while time between the last IPAS use and admission was short (less than 15 days). IPAS use must be sought in case of AEP, especially in young adults, and practitioners must advise and help users to stop their consumption.
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Affiliation(s)
- M Underner
- Unité de recherche clinique, université de Poitiers, centre hospitalier Henri Laborit, 86021 Poitiers, France.
| | - J Perriot
- Dispensaire Emile Roux, Centre de tabacologie, 63100 Clermont-Ferrand, France
| | - G Peiffer
- Service de pneumologie, CHR Metz-Thionville, 57038 Metz, France
| | - T Urban
- Service de pneumologie, CHU d'Angers, 4, rue Larrey, 49933 Angers, France
| | - N Jaafari
- Unité de recherche clinique, université de Poitiers, centre hospitalier Henri Laborit, 86021 Poitiers, France
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Fabbri KR, Anderson‐Haag TL, Spenningsby AM, Israni A, Nygaard RM, Stahler PA. Marijuana use should not preclude consideration for kidney transplantation. Clin Transplant 2019; 33:e13706. [DOI: 10.1111/ctr.13706] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 08/28/2019] [Accepted: 08/30/2019] [Indexed: 12/13/2022]
Affiliation(s)
| | | | | | - Ajay Israni
- Department of Nephrology Hennepin Healthcare Minneapolis MN USA
| | | | - Paul A. Stahler
- Department of Surgery Hennepin Healthcare Minneapolis MN USA
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Bisconti M, Marulli G, Pacifici R, Sollitto F, Nex G, Trabucco X, Ardò N, Rotolo M, De Iaco G, Panza T, Brascia D, Schiavone M, Signore F, Pistelli F, De Palma A. Cannabinoids Identification in Lung Tissues of Young Cannabis Smokers Operated for Primary Spontaneous Pneumothorax and Correlation with Pathologic Findings. Respiration 2019; 98:503-511. [DOI: 10.1159/000503456] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 09/17/2019] [Indexed: 11/19/2022] Open
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Tsai H, Lee J, Hedlin H, Zamanian RT, de Jesus Perez VA. Methamphetamine use association with pulmonary diseases: a retrospective investigation of hospital discharges in California from 2005 to 2011. ERJ Open Res 2019; 5:00017-2019. [PMID: 31637253 PMCID: PMC6791966 DOI: 10.1183/23120541.00017-2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 07/01/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Methamphetamine can have acute and long-term adverse health consequences. Our objective was to determine whether methamphetamine use is associated with more hospitalisation codes for asthma exacerbation, chronic obstructive pulmonary disease (COPD) exacerbation, pneumonia and acute respiratory failure (ARF). METHODS The Health Care Utilization Project (HCUP) database includes retrospective inpatient discharge abstracts from 2005 through 2011 from the California state inpatient databases (SIDs). ICD-9 codes were used to identify hospitalisations for asthma exacerbation, COPD exacerbation, acute pneumonia, ARF and methamphetamine use from discharges with complete demographic data and ages 18 to 75 years. Adjusted rate ratios comparing methamphetamine users with nonusers were estimated separately for each pulmonary disease diagnosis by sex using negative binomial regression models. RESULTS We included 21 125 249 inpatient discharges from 2005 through 2011 in California in our analysis; 182 766 (0.87%) had methamphetamine use. The rate ratio comparing pneumonia in discharges with methamphetamine use versus those without were 1.40 (95% CI 1.18, 1.67) for women and 1.18 (95% CI 1.04, 1.35) for men; comparing ARF 1.77 (95% CI 1.59, 1.98) for women and 1.24 (95% CI 1.12, 1.37) for men; and comparing COPD exacerbation 1.40 (95% CI 1.18, 1.67) for women and 0.90 (95% CI 0.79, 1.02) for men. CONCLUSIONS A positive association was found when comparing inpatient hospital discharge diagnoses for methamphetamine use and those for pneumonia and ARF in both sexes. This association was not seen when comparing discharge diagnoses for methamphetamine and those for asthma exacerbation in both sexes or COPD exacerbation in men. While future investigation for is warranted, this finding may help to further characterise the pulmonary toxicity of methamphetamine.
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Affiliation(s)
- Halley Tsai
- Division of Pulmonary and Critical Care Medicine, Stanford University, Stanford, CA, USA
| | - Justin Lee
- Quantitative Sciences Unit, Stanford University, Stanford, CA, USA
| | - Haley Hedlin
- Quantitative Sciences Unit, Stanford University, Stanford, CA, USA
| | - Roham T. Zamanian
- Division of Pulmonary and Critical Care Medicine, Stanford University, Stanford, CA, USA
- Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford University, Stanford, CA, USA
- Both authors contributed equally
| | - Vinicio A. de Jesus Perez
- Division of Pulmonary and Critical Care Medicine, Stanford University, Stanford, CA, USA
- Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford University, Stanford, CA, USA
- Both authors contributed equally
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49
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Alqahtani A, Ammari Z, Ramahi A, Said Ahmed TS, Klada E. Cannabis Smoking-induced Diffuse Alveolar Hemorrhage. Cureus 2019; 11:e5089. [PMID: 31511809 PMCID: PMC6726419 DOI: 10.7759/cureus.5089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Cannabis smoking is common among adolescents and young adults. Diffuse alveolar hemorrhage (DAH) is a rare and life-threatening complication of cannabis abuse. DAH is characterized by bleeding into alveoli secondary to the disruption of the alveolar-capillary basement membrane as a result of an injury at the level of alveolar microcirculation. The differential diagnosis of DAH includes systemic vasculitis, bland pulmonary hemorrhage, and alveolar damage. The impact of cannabis on the respiratory function includes mucus hypersecretion, inflammatory edema, and increased alveolar permeability. Moreover, in vitro coagulation studies on rats showed that two major cannabinoids, cannabinol and THC, have antithrombotic activity. We present two cases of cannabis use resulting in acute lung injury and diffuse alveolar hemorrhage.
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Affiliation(s)
- Ali Alqahtani
- Internal Medicine, University of Toledo Medical Center, Toledo, USA
| | - Zaid Ammari
- Internal Medicine, University of Toledo Medical Center, Toledo, USA
| | - Ahmad Ramahi
- Internal Medicine, University of Toledo Medical Center, Toledo, USA
| | - Tamer S Said Ahmed
- Pulmonary / Critical Care Medicine, University of Toledo Medical Center, Toledo, USA
| | - Emile Klada
- Pulmonary / Critical Care Medicine, Promedica Toledo Hospital, Toledo, USA
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Ciriaco P, Rossetti F, Carretta A, Sant'Angelo M, Arrigoni G, Negri G. Spontaneous pneumothorax in cocaine users. QJM 2019; 112:519-522. [PMID: 30895319 DOI: 10.1093/qjmed/hcz070] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 03/14/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Pneumothorax is one of the respiratory toxic effects of cocaine inhalation. The literature counts several cases, some associated to other respiratory conditions such as pneumomediastinum, haemoptysis and others not requiring surgical treatment. AIM We present a series of nonHIV cocaine-inhaler subjects who underwent video-assisted thoracoscopic surgery (VATS) for isolated spontaneous pneumothorax. DESIGN Nine subjects, with a mean age of 24 ± 4 years, admitting cocaine inhalation, developed spontaneous pneumothorax and underwent 10 surgical treatments by means of VATS, at our Institution. RESULTS Previous pneumothorax occurred in six cases episodes ranged from 0 to 5 (mean 1.6 ± 1.6). Chest computed tomography (CT) scan showed abnormalities in seven cases. All subjects underwent lung apicectomy, apical pleurectomy and mechanical pleurodesis. Seven subjects had also bullectomy. In all cases the visceral pleura was partially covered by fibrinous exudate. Histology of the lung showed small foreign body granulomatous inflammation in fibrotic and/or emphysematous pulmonary parenchyma. Relapse of pneumothorax occurred in one subject at 60 days and it was surgically treated. Mean follow-up was 150 ± 38 months (range 120-239). All subjects are now well, with no evidence of pneumothorax. CONCLUSIONS Spontaneous pneumothorax in cocaine-inhaler subjects is a reality of which physicians need to be aware. Chest CT scan might not reveal abnormalities. Macroscopically the lung might presents bullae and/or peculiar visceral pleura. Foreign body granulomas observed in the specimens suggest that the particulate component of inhaled substances can injure the lung. Surgical treatment of the bullous disease and mechanical pleurodesis can provide a long-term follow-up without relapse of pneumothorax.
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Affiliation(s)
| | | | | | - M Sant'Angelo
- Department of Pathology, Scientific Institute and University Vita-Salute San Raffaele, Ospedale San Raffaele, Milan, Italy
| | - G Arrigoni
- Department of Pathology, Scientific Institute and University Vita-Salute San Raffaele, Ospedale San Raffaele, Milan, Italy
| | - G Negri
- Department of Thoracic Surgery
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