1
|
Singer ED, Faiz SA, Qdaisat A, Abdeldaem K, Dagher J, Chaftari P, Yeung SCJ. Hemoptysis in Cancer Patients. Cancers (Basel) 2023; 15:4765. [PMID: 37835458 PMCID: PMC10571539 DOI: 10.3390/cancers15194765] [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: 08/27/2023] [Revised: 09/22/2023] [Accepted: 09/24/2023] [Indexed: 10/15/2023] Open
Abstract
Hemoptysis in cancer patients can occur for various reasons, including infections, tumors, blood vessel abnormalities and inflammatory conditions. The degree of hemoptysis is commonly classified according to the quantity of blood expelled. However, volume-based definitions may not accurately reflect the clinical impact of bleeding. This review explores a more comprehensive approach to evaluating hemoptysis by considering its risk factors, epidemiology and clinical consequences. In particular, this review provides insight into the risk factors, identifies mortality rates associated with hemoptysis in cancer patients and highlights the need for developing a mortality prediction score specific for cancer patients. The use of hemoptysis-related variables may help stratify patients into risk categories; optimize the control of bleeding with critical care; implement the use of tracheobronchial or vascular interventions; and aid in treatment planning. Effective management of hemoptysis in cancer patients must address the underlying cause while also providing supportive care to improve patients' quality of life.
Collapse
Affiliation(s)
- Emad D. Singer
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (E.D.S.); (A.Q.); (K.A.)
- Department of Abdominal Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Saadia A. Faiz
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Aiham Qdaisat
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (E.D.S.); (A.Q.); (K.A.)
| | - Karim Abdeldaem
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (E.D.S.); (A.Q.); (K.A.)
| | - Jim Dagher
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut 1100, Lebanon
| | - Patrick Chaftari
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (E.D.S.); (A.Q.); (K.A.)
| | - Sai-Ching J. Yeung
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (E.D.S.); (A.Q.); (K.A.)
| |
Collapse
|
2
|
Peruch M, Giacomello E, Radaelli D, Concato M, Addobbati R, Fluca AL, Aleksova A, D’Errico S. Subcellular Effectors of Cocaine Cardiotoxicity: All Roads Lead to Mitochondria-A Systematic Review of the Literature. Int J Mol Sci 2023; 24:14517. [PMID: 37833964 PMCID: PMC10573028 DOI: 10.3390/ijms241914517] [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: 08/23/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
Cocaine abuse is a serious public health problem as this drug exerts a plethora of functional and histopathological changes that potentially lead to death. Cocaine causes complex multiorgan toxicity, including in the heart where the blockade of the sodium channels causes increased catecholamine levels and alteration in calcium homeostasis, thus inducing an increased oxygen demand. Moreover, there is evidence to suggest that mitochondria alterations play a crucial role in the development of cocaine cardiotoxicity. We performed a systematic review according to the Preferred Reporting Items for Systemic Reviews and Meta-Analysis (PRISMA) scheme to evaluate the mitochondrial mechanisms determining cocaine cardiotoxicity. Among the initial 106 articles from the Pubmed database and the 17 articles identified through citation searching, 14 final relevant studies were extensively reviewed. Thirteen articles included animal models and reported the alteration of specific mitochondria-dependent mechanisms such as reduced energy production, imbalance of membrane potential, increased oxidative stress, and promotion of apoptosis. However, only one study evaluated human cocaine overdose samples and observed the role of cocaine in oxidative stress and the induction of apoptosis though mitochondria. Understanding the complex processes mediated by mitochondria through forensic analysis and experimental models is crucial for identifying potential therapeutic targets to mitigate or reverse cocaine cardiotoxicity in humans.
Collapse
Affiliation(s)
- Michela Peruch
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy; (M.P.); (E.G.); (D.R.); (M.C.); (A.L.F.); (A.A.)
| | - Emiliana Giacomello
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy; (M.P.); (E.G.); (D.R.); (M.C.); (A.L.F.); (A.A.)
| | - Davide Radaelli
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy; (M.P.); (E.G.); (D.R.); (M.C.); (A.L.F.); (A.A.)
| | - Monica Concato
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy; (M.P.); (E.G.); (D.R.); (M.C.); (A.L.F.); (A.A.)
| | - Riccardo Addobbati
- Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, 34137 Trieste, Italy;
| | - Alessandra Lucia Fluca
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy; (M.P.); (E.G.); (D.R.); (M.C.); (A.L.F.); (A.A.)
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, 34149 Trieste, Italy
| | - Aneta Aleksova
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy; (M.P.); (E.G.); (D.R.); (M.C.); (A.L.F.); (A.A.)
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, 34149 Trieste, Italy
| | - Stefano D’Errico
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy; (M.P.); (E.G.); (D.R.); (M.C.); (A.L.F.); (A.A.)
| |
Collapse
|
3
|
Mainali A, Chowdhury T, Adhikari S, Uprety N, Noel P, Gousy N. A Rare Case of Cocaine-Induced Muscle Hematoma Followed by Rhabdomyolysis in Association With Acute Kidney Injury and Severe Transaminitis. Cureus 2022; 14:e25035. [PMID: 35719808 PMCID: PMC9198731 DOI: 10.7759/cureus.25035] [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] [Accepted: 05/16/2022] [Indexed: 11/07/2022] Open
Abstract
Cocaine use can result in a few infrequent complications, among which is localized hematoma. As far as we know, there are very few cases reporting cocaine-induced non-traumatic muscle hematoma complicated by severe transaminitis and rhabdomyolysis. Here we present a patient who developed a significant lower extremity muscle hematoma secondary to inhalational cocaine use. We are reporting this case to bring to light this rare and unusual complication of cocaine use. With recreational use of this drug being so prominent in the patient population, early recognition of this complication can help expedite treatment and reduce the severity of end-organ damage.
Collapse
|
4
|
Jiménez-Zarazúa O, Vélez-Ramírez LN, Ramírez-Casillas CA, Mondragón JD. Pulmonary thromboembolism and alveolar hemorrhage as initial manifestations of systemic lupus erythematosus. Lupus 2022; 31:116-124. [PMID: 35042383 PMCID: PMC8793315 DOI: 10.1177/09612033211066481] [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: 11/21/2022]
Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disease that affects multiple organs. SLE can affect the lung, the pulmonary vasculature, and the pleura. A 38-year-old female with limb pain and ecchymosis who later developed pulmonary thromboembolism and alveolar hemorrhage is presented here. Clinical, imaging, laboratory, and histopathological evidence is presented. The patient met the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) criteria for SLE. Furthermore, the patient had a Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score of 35; thus, indicating severe disease. This case is an example of concomitant venous and arterial lung complications in an SLE patient.
Collapse
Affiliation(s)
- O Jiménez-Zarazúa
- Hospital General Regional IMSS No. 21, 42581Department of Internal Medicine, León, Guanajuato, Mexico.,Department of Medicine and Nutrition, 10173Universidad de Guanajuato, Guanajuato, Mexico
| | - L N Vélez-Ramírez
- Department of Medicine and Nutrition, 10173Universidad de Guanajuato, Guanajuato, Mexico.,Hospital General de León, Department of Radiology, León, Guanajuato, Mexico
| | - C A Ramírez-Casillas
- Hospital General Regional IMSS No. 21, 42581Department of Internal Medicine, León, Guanajuato, Mexico.,Department of Medicine and Nutrition, 10173Universidad de Guanajuato, Guanajuato, Mexico
| | - J D Mondragón
- Department of Medicine and Nutrition, 10173Universidad de Guanajuato, Guanajuato, Mexico.,Hospital General de León, Department of Radiology, León, Guanajuato, Mexico.,University of Groningen, University Medical Center Groningen, Department of Neurology, The Netherlands.,University of Groningen, University Medical Center Groningen, Alzheimer Center Groningen, The Netherlands
| |
Collapse
|
5
|
Banga N, Mohanka M. Prevalence, Clinical Characteristics, and Outcomes Among Lung Transplant Recipients of Donors With Cocaine Use. Transplant Proc 2021; 53:3069-3074. [PMID: 34728078 DOI: 10.1016/j.transproceed.2021.08.055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/30/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION There is limited data regarding lung transplant (LT) outcomes among recipients of donors with a history of cocaine use. We sought to assess the burden of cocaine abuse among LT donors, describe their characteristics, and evaluate the association with post-transplant outcomes. METHODS From the United Network for Organ Sharing database, we included adult patients (age ≥18 years) who underwent LT between 1996 and 2014 (N = 20,106; mean age 53.7 ± 13 years; male: 57%). Study groups were divided based on the donor history of recent cocaine abuse (last 6 months). Donor and recipient characteristics were compared between the 2 groups. With 1-year survival as the primary endpoint, multivariate logistic regression analysis was conducted to assess for an independent association with the donor history of cocaine use. RESULTS The overall frequency of donors with any history of cocaine use was 10.9% (n = 2189), although less than half were current users (n = 1001, 4.98%). Unadjusted 1-year survival was worse among recipients of donors with current cocaine use, although it did not achieve statistical significance (84.4% vs 82.2%; odds ratio 1.17, 95% confidence interval 0.99-1.38; P = .07). After adjusting for potential confounders, the current use of cocaine was not associated with 1-year survival (adjusted OR 1.06, 95% CI 0.95-1.18; P = .29). CONCLUSIONS A significant proportion of lung donors have a history of cocaine abuse. Although unadjusted early outcomes appear to worsen among recipients of active cocaine users, an independent association was not seen with 1-year survival. The current analysis supports the continued use of donors with a history of cocaine abuse, assuming they meet other criteria for organ quality.
Collapse
Affiliation(s)
- Natasha Banga
- Lung Transplant Program, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Manish Mohanka
- Lung Transplant Program, University of Texas Southwestern Medical Center, Dallas, Texas.
| |
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
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]
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
Managing and securing the bleeding upper airway: a narrative review. Can J Anaesth 2019; 67:128-140. [DOI: 10.1007/s12630-019-01479-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 06/12/2019] [Accepted: 06/14/2019] [Indexed: 12/11/2022] Open
|
10
|
Cocaine in Hospital Admissions for Diseases of the Circulatory System and as the Underlying Cause of Death: Analysis and Discussion. Cardiovasc Toxicol 2019; 20:20-27. [DOI: 10.1007/s12012-019-09537-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|