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Abasi S, Aggas JR, Garayar-Leyva GG, Walther BK, Guiseppi-Elie A. Bioelectrical Impedance Spectroscopy for Monitoring Mammalian Cells and Tissues under Different Frequency Domains: A Review. ACS MEASUREMENT SCIENCE AU 2022; 2:495-516. [PMID: 36785772 PMCID: PMC9886004 DOI: 10.1021/acsmeasuresciau.2c00033] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 08/05/2022] [Accepted: 08/05/2022] [Indexed: 05/13/2023]
Abstract
Bioelectrical impedance analysis and bioelectrical impedance spectroscopy (BIA/BIS) of tissues reveal important information on molecular composition and physical structure that is useful in diagnostics and prognostics. The heterogeneity in structural elements of cells, tissues, organs, and the whole human body, the variability in molecular composition arising from the dynamics of biochemical reactions, and the contributions of inherently electroresponsive components, such as ions, proteins, and polarized membranes, have rendered bioimpedance challenging to interpret but also a powerful evaluation and monitoring technique in biomedicine. BIA/BIS has thus become the basis for a wide range of diagnostic and monitoring systems such as plethysmography and tomography. The use of BIA/BIS arises from (i) being a noninvasive and safe measurement modality, (ii) its ease of miniaturization, and (iii) multiple technological formats for its biomedical implementation. Considering the dependency of the absolute and relative values of impedance on frequency, and the uniqueness of the origins of the α-, β-, δ-, and γ-dispersions, this targeted review discusses biological events and underlying principles that are employed to analyze the impedance data based on the frequency range. The emergence of BIA/BIS in wearable devices and its relevance to the Internet of Medical Things (IoMT) are introduced and discussed.
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Affiliation(s)
- Sara Abasi
- Center
for Bioelectronics, Biosensors and Biochips (C3B®), Department
of Biomedical Engineering, Texas A&M
University, 400 Bizzell Street, College Station, Texas 77843, United States
- Cell
Culture Media Services, Cytiva, 100 Results Way, Marlborough, Massachusetts 01752, United States
| | - John R. Aggas
- Center
for Bioelectronics, Biosensors and Biochips (C3B®), Department
of Biomedical Engineering, Texas A&M
University, 400 Bizzell Street, College Station, Texas 77843, United States
- Test
Development, Roche Diagnostics, 9115 Hague Road, Indianapolis, Indiana 46256, United
States
| | - Guillermo G. Garayar-Leyva
- Center
for Bioelectronics, Biosensors and Biochips (C3B®), Department
of Biomedical Engineering, Texas A&M
University, 400 Bizzell Street, College Station, Texas 77843, United States
- Department
of Electrical and Computer Engineering, Texas A&M University, 400 Bizzell Street, College Station, Texas 77843, United States
| | - Brandon K. Walther
- Center
for Bioelectronics, Biosensors and Biochips (C3B®), Department
of Biomedical Engineering, Texas A&M
University, 400 Bizzell Street, College Station, Texas 77843, United States
- Department
of Cardiovascular Sciences, Houston Methodist
Institute for Academic Medicine and Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, Texas 77030, United States
| | - Anthony Guiseppi-Elie
- Center
for Bioelectronics, Biosensors and Biochips (C3B®), Department
of Biomedical Engineering, Texas A&M
University, 400 Bizzell Street, College Station, Texas 77843, United States
- Department
of Electrical and Computer Engineering, Texas A&M University, 400 Bizzell Street, College Station, Texas 77843, United States
- Department
of Cardiovascular Sciences, Houston Methodist
Institute for Academic Medicine and Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, Texas 77030, United States
- ABTECH Scientific,
Inc., Biotechnology Research Park, 800 East Leigh Street, Richmond, Virginia 23219, United
States
- . Tel.: +1(804)347.9363.
Fax: +1(804)347.9363
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Lucyk SN. Acute Cardiovascular Toxicity of Cocaine. Can J Cardiol 2022; 38:1384-1394. [PMID: 35697321 DOI: 10.1016/j.cjca.2022.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/22/2022] [Accepted: 05/02/2022] [Indexed: 11/27/2022] Open
Abstract
Cocaine is one of the most commonly abused drugs and represents a major public health concern. Cocaine users frequently present to the emergency department, with chest pain being the most common presenting complaint. The incidence of acute myocardial infarction in patients with cocaine-associated chest pain is often quoted as 6%, but it is highly variable depending on the included population. Risk assessment can be challenging in these patients; serial assessment of electrocardiograms and troponins is often required. This review focuses on the assessment and management of patients presenting with cocaine-associated chest pain and cardiotoxicity. Specific treatments are discussed, including benzodiazepines, nitroglycerin, calcium channel blockers, and phentolamine, and how treatment priorities differ from patients with noncocaine presentations. The use of beta-blockers in this population remains controversial, and the literature around its use is reviewed. The most recent literature and recommendations for the use of percutaneous coronary intervention and fibrinolytics in cocaine-associated myocardial infarction is discussed as well. Cocaine-associated dysrhythmias are suggested to be the cause of sudden cardiac death in some users. The pathophysiology and evidence-based treatments for dysrhythmias are reviewed. This review provides evidence-based recommendations for the assessment and management of patients presenting with cocaine-associated cardiovascular toxicity.
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Affiliation(s)
- Scott N Lucyk
- Poison and Drug Information Service, Alberta Health Services, Calgary, Alberta, Canada; Department of Emergency Medicine, University of Calgary, Calgary, Alberta, Canada; Section of Clinical Pharmacology and Toxicology, Alberta Health Services, Calgary, Alberta, Canada.
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Suen LW, Davy-Mendez T, LeSaint KT, Riley ED, Coffin PO. Emergency department visits and trends related to cocaine, psychostimulants, and opioids in the United States, 2008-2018. BMC Emerg Med 2022; 22:19. [PMID: 35120449 PMCID: PMC8814795 DOI: 10.1186/s12873-022-00573-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 01/18/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Drug-related emergency department (ED) visits are escalating, especially for stimulant use (i.e., cocaine and psychostimulants such as methamphetamine). We sought to characterize rates, presentation, and management of ED visits related to cocaine and psychostimulant use, compared to opioid use, in the United States (US). METHODS We used 2008-2018 National Hospital Ambulatory Medical Care Survey data to identify a nationally representative sample of ED visits related to cocaine and psychostimulant use, with opioids as the comparator. To make visits mutually exclusive for analysis, we excluded visits related to 2 or more of the three possible drug categories. We estimated annual rate trends using unadjusted Poisson regression; described demographics, presenting concerns, and management; and determined associations between drug-type and presenting concerns (categorized as psychiatric, neurologic, cardiopulmonary, and drug toxicity/withdrawal) using logistic regression, adjusting for age, sex, race/ethnicity, and homelessness. RESULTS Cocaine-related ED visits did not significantly increase, while psychostimulant-related ED visits increased from 2008 to 2018 (2.2 visits per 10,000 population to 12.9 visits per 10,000 population; p < 0.001). Cocaine-related ED visits had higher usage of cardiac testing, while psychostimulant-related ED visits had higher usage of chemical restraints than opioid-related ED visits. Cocaine- and psychostimulant-related ED visits had greater odds of presenting with cardiopulmonary concerns (cocaine adjusted odds ratio [aOR] 2.95, 95% CI 1.70-5.13; psychostimulant aOR 2.46, 95% CI 1.42-4.26), while psychostimulant-related visits had greater odds of presenting with psychiatric concerns (aOR 2.69, 95% CI 1.83-3.95) and lower odds of presenting with drug toxicity/withdrawal concerns (aOR 0.47, 95%CI 0.30-0.73) compared to opioid-related ED visits. CONCLUSION Presentations for stimulant-related ED visits differ from opioid-related ED visits: compared to opioids, ED presentations related to cocaine and psychostimulants are less often identified as related to drug toxicity/withdrawal and more often require interventions to address acute cardiopulmonary and psychiatric complications.
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Affiliation(s)
- Leslie W. Suen
- National Clinician Scholars Program, Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 290 Illinois Street, Suite 7227, Box 0936, San Francisco, CA 94158 USA
- San Francisco Veterans Affairs Medical Center, San Francisco, CA USA
| | - Thibaut Davy-Mendez
- Division of Infectious Diseases, Department of Medicine, University of North Carolina, Chapel Hill, NC USA
| | - Kathy T. LeSaint
- Department of Emergency Medicine, University of California, San Francisco, San Francisco, CA USA
| | - Elise D. Riley
- Department of Medicine, Division of HIV, Infectious Diseases and Global Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA USA
| | - Phillip O. Coffin
- Department of Medicine, Division of HIV, Infectious Diseases and Global Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA USA
- Department of Public Health, San Francisco, CA USA
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Abstract
General hospital clinicians frequently deal with injecting drug users because substance use has diverse medical and psychiatric complications. Non-specialist clinicians often initiate management when specialist consultation is not available or accepted by the patient. Here, we summarise evidence for the management of hospitalised injecting drug users. The first challenge is to engage a drug user into medical care. A non-judgmental approach towards patients and acceptance of their lifestyle choices facilitates engagement. Pragmatic clinical goals can be negotiated and achieved. We also describe common conditions of injecting drug users. Accurate diagnosis and appropriate management focus on common issues such as intoxication, withdrawal, pain management, drug seeking, psychological comorbidity, behavioural difficulties, and pregnancy. Effective management can reduce the medical and social effect of these conditions and is not difficult.
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Affiliation(s)
- Paul S Haber
- Drug Health Services, Royal Prince Alfred Hospital, Camperdown, and University of Sydney, Discipline of Addiction Medicine, Sydney, NSW, Australia.
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Burillo-Putze G, López B, Borreguero León JM, Sánchez Sánchez M, García González M, Domínguez Rodriguez A, Vallbona Afonso E, Jiménez Sosa A, Mirò O. Undisclosed cocaine use and chest pain in emergency departments of Spain. Scand J Trauma Resusc Emerg Med 2009; 17:11. [PMID: 19254377 PMCID: PMC2660281 DOI: 10.1186/1757-7241-17-11] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2008] [Accepted: 03/02/2009] [Indexed: 11/21/2022] Open
Abstract
Aims Illicit cocaine consumption in Spain is one of the highest in Europe. Our objective was to study the incidence of undisclosed cocaine consumption in patients attending in two Spanish Emergency Departments for chest pain. Methods We analysed urine samples from consenting consecutive patients attending ED for chest pain to determine the presence of cocaine, and other drugs, by semiquantative tests with fluorescence polarization immunoassay (FPIA). Results Of 140 cases, 15.7 presented positive test for drugs, and cocaine was present in 6.4%. All cocaine-positive patients were younger (p < 0.001); none was admitted to Hospital (p = 0.08). No significant differences in ED stay or need for hospitalization were found between cocaine-positive and negative patients. Conclusion This finding in chest pain patients who consented to urine analysis suggests that the true incidence of cocaine use leading to such ED visits may be higher.
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Affiliation(s)
- Guillermo Burillo-Putze
- Emergency Department, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Tenerife, Spain.
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The many faces of aortic dissections: Beware of unusual presentations. Eur J Radiol 2008; 65:359-64. [DOI: 10.1016/j.ejrad.2007.09.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2007] [Revised: 09/07/2007] [Accepted: 09/08/2007] [Indexed: 12/29/2022]
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Glauser J, Queen JR. An overview of non-cardiac cocaine toxicity. J Emerg Med 2007; 32:181-6. [PMID: 17307630 DOI: 10.1016/j.jemermed.2006.05.044] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2004] [Revised: 09/07/2005] [Accepted: 05/17/2006] [Indexed: 10/23/2022]
Abstract
Cocaine use in the United States continues to be a significant problem. Cocaine use is responsible for approximately 143,000 Emergency Department visits annually. The cardiac effects of cocaine are well known and much is written on this topic; this is beyond the scope of this article. Cocaine use is also responsible for a variety of non-cardiac, systemic complications, which it is our purpose to review. Multiple systemic effects of cocaine are seen with both acute and chronic use. These systems include: psychological and psychiatric, neurological, renal, pulmonary, gastrointestinal, obstetrical, and otolaryngological.
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Affiliation(s)
- Jonathan Glauser
- Department of Emergency Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA
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Abstract
Cocaine-associated chest pain is a clinical entity that crosses all socioeconomic groups and hence will be encountered by many physicians. The initial evaluation and treatment of cocaine-induced chest pain are similar to those of patients who have non-cocaine-induced chest pain, but there are several notable exceptions. This article reviews the pathophysiology, evaluation, management, and disposition decisions unique to patients presenting with cocaine-induced chest pain.
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Affiliation(s)
- James H Jones
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
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Abstract
The pathophysiology of cocaine leading to myocardial ischemia is multifactorial. Given the paucity of well-designed clinical studies, treatment is directed toward the potential mechanisms involved in the development of myocardial ischemia. Fortunately, morbidity and mortality in this patient population are low, and the vast majority of patients will not suffer AMI or other cardiac complications. Long-term prognosis is excellent for those who abstain from continued cocaine use.
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Affiliation(s)
- James H Jones
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
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Complicaciones cardiovasculares asociadas al consumo de cocaíne. HIPERTENSION Y RIESGO VASCULAR 2002. [DOI: 10.1016/s1889-1837(02)71314-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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