Cases reported "Heroin Dependence"

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1/6. Fatal falciparum malaria among narcotic injectors.

    Eleven narcotic injectors from a prison in Saigon were hospitalized with falciparum malaria. coma and intense parasitemia were common and eight patients died soon after admission. Two of three autopsied cases also had purulent pulmonary infections. No non-addicted prisoners were hospitalized for malaria. Nine more unsuspected falciparum infections were found among 29 other addicts in the prison. The clustering of malaria infections among narcotic injectors who had not been in malarious areas indicates that the malaria was transmitted by the common use of needles and syringes. Cerebral malaria in an addict may be misdiagnosed as drug intoxication. malaria surveillance is recommended for the increasing addict population in the cities of Southeast asia.
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ranking = 1
keywords = intoxication
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2/6. Intravenous paraquat poisoning-induced multiple organ failure and fatality--a report of two cases.

    paraquat poisoning is the most common cause of fatal herbicide intoxication, mostly through oral ingestion. This work reports two cases of death following intravenous paraquat injection. The clinical courses of the two cases were fulminated and fatal. Toxic symptoms and severe organ function impairment developed soon after paraquat injection. Timely treatment with activated charcoal hemoperfusion with pulse steroid and cyclophosphamide was attempted in both cases; however, both cases died within five days owing to multiple organ failure. In cases of intravenous paraquat intoxication, toxic signs develop more quicker than with oral ingestion. The prognosis of intravenous paraquat intoxication is extremely poor.
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ranking = 3
keywords = intoxication
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3/6. Problematic behavior of drug-dependent patients in the general hospital. A clinical and administrative approach to management.

    Drug-dependent patients in general hospitals behave in ways that are difficult for medical and surgical staff to manage. Common problems include drug-seeking, states of intoxication and withdrawal, poor compliance, and behavior that is disruptive or dangerous to others. The authors describe an approach to these problematic behaviors based upon early recognition, a clinical perspective, and administrative action. Institutional initiatives are needed to overcome the practical and conceptual obstacles to effective management of these patients.
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ranking = 1
keywords = intoxication
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4/6. Acute rhabdomyolysis associated with cocaine intoxication: a case report.

    Over thirty million Americans are estimated to have tried cocaine at least once and 5 million use it on a regular basis. Recent media attention to the widespread use of cocaine has revealed the growing life-threatening complications that accompany its use. The effects of cocaine on the cardiovascular, pulmonary and central nervous system have been well-described in medical literature, but the complications of acute renal failure secondary to cocaine-induced rhabdomyolysis only recently have been addressed. Presented in this article is a case involving cocaine-induced acute renal failure.
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ranking = 4
keywords = intoxication
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5/6. Fatality due to gamma-hydroxybutyric acid (GHB) and heroin intoxication.

    The first case of fatal intoxication due to ingestion of gamma-hydroxybutyric acid (GHB) and intravenous use of heroin is reported. A 42-year-old man, known to have been a heroin addict and to have taken other psychoactive substances, who had been in treatment with GHB for several months, was found dead. Anatomohistopathologic examination showed generalized visceral congestion, edema and pulmonary anthracosis, chronic bronchitis and chronic active hepatitis. Toxicological findings included fluid and tissue distributions of GHB, morphine and 6-monoacetylmorphine. GHB and morphine concentrations were respectively 11.5 and 0.77 micrograms/mL (blood), 84.3 and 0.3 micrograms/mL (vitreous humor), 258.3 and 1.35 micrograms/mL (urine), 57.0 and 14.3 micrograms/mL (bile), 40.0 and 0.43 micrograms/g (brain), 43.0 and 0.60 micrograms/g (liver), 47.0 and 0.68 micrograms/g (kidney). blood and urine levels of 6-monoacetylmorphine were 28.5 and 12.1 ng/mL respectively. The presumed mechanism of action and pharmacokinetics of GHB are briefly reviewed, with reference to its therapeutic use and to reports of non-fatal GHB intoxication.
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ranking = 6
keywords = intoxication
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6/6. Choreoathetoid movements associated with rapid adjustment to methadone.

    Choreatiform hyperkinesias are known to be occasional movement abnormalities during intoxications with cocaine but not opiates. This is a case report of euphoria and choreoathetoid movements both transiently induced by rapid adjustment to the selective mu-opioid receptor agonist methadone in an inpatient previously abusing heroine and cocaine. In addition, minor EEG abnormalities occurred. Possible underlying neurobiological phenomena are discussed.
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ranking = 1
keywords = intoxication
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