1/100. methamphetamine-related stroke: four cases.Amphetamine use in certain parts of the united states has risen dramatically. methamphetamine, the most-common illicitly abused type of amphetamine, can be inhaled, injected intravenously, or smoked. It is a potent sympathomimetic that may lead to vascular events including myocardial infarction and stroke. Because of the demographics of drug use, these potentially devastating events usually occur in relatively young patients. The pathophysiology of stroke related to amphetamine use is multifactorial. Elevation in blood pressure, vasculitis, or other vascular toxicity are postulated as major mechanisms. Four cases of stroke associated with the use of methamphetamine, all occurring in patients ranging in age from 29-45 years, are described. methamphetamine use appears to be a risk factor for the development of stroke. The rise in methamphetamine use will undoubtedly result in increased Emergency Department admissions with clinical presentations very similar to those of cocaine intoxication.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
2/100. Phenomenology of gasoline intoxication and withdrawal symptoms among adolescents in india: a case series.Inhalant withdrawal symptoms have previously been described but not well documented. This case-series describes the sociodemographic and clinical characteristics of nine children and adolescents with gasoline abuse. gasoline inhalation was the drug of choice in our patients. The mean age was 13.6 years and all the subjects belonged to low socioeconomic status. Most of the subjects used daily and all subjects reported alcohol abuse in the father. All subjects reported a syndrome of intoxication as described in previous reports. All subjects also reported a withdrawal syndrome including irritability, psychomotor retardation, anhedonia, dry mouth, sleep disturbances, craving, and increased lacrimation.- - - - - - - - - - ranking = 5keywords = intoxication (Clic here for more details about this article) |
3/100. Sexual assault under benzodiazepine submission in a paris suburb.Sexual assaults under benzodiazepine submission have been described, since use of benzodiazepine enables non consensual sexual activity but rarely fully reported. An accurate evaluation of the phenomenon has seemed interesting. Files of 23 adult males and females examined at the Emergency Forensic Unit of an University teaching Hospital near paris were reviewed. All the victims had complained from sexual assault under drug submission, in the years 1996 and 1997. A complete examination for sexual assault was realised linked to clinical examination of drug intoxication. Every victim of rape under drug submission was sampled for urine screening (mean delay of 17.5 h after sexual assault) and blood alcohol level quantification. urine was screened for benzodiazepines, cocaine, opiates and cannabinoids with qualitative immunochromatographic test. Traumatic lesions of sexual penetration were retrieved in 10 victims and sperm in 5. Clinical signs of benzodiazepine intoxication were retrieved in 12 out of 23 victims. urine benzodiazepine screening was positive, over the cut-off values (300 ng/mL)when sampled less than 20 h after the facts. In 6 out of 23 victims, drugs of abuse and alcohol were associated to benzodiazepines. A reinforced attention can be brought to the rape under drug submission including the need of a proper examination and samplings shortly after the alleged facts to ascertain the diagnosis and to help the victim facing the Justice inquiry.- - - - - - - - - - ranking = 2keywords = intoxication (Clic here for more details about this article) |
4/100. 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.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
5/100. hypercalcemia and human nature.patients on hemodialysis may develop severe and symptomatic hypercalcemia if skeletal buffering is ineffective. We report a case of persistent hypercalcemia with apparent extrarenal vitamin d synthesis. Associated aluminium intoxication was suggested on desferrioxamine challenge and adynamic uremic osteodystrophy confirmed on bone biopsy. plasma calcitriol did not suppress with corticosteroids but did with ketoconazole. No other evidence for underlying granulomatous disease was found. We discuss our approach to less usual causes of hypercalcemia, and emphasise the pitfalls associated with factitious disorders.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
6/100. Severe intoxication from xylazine inhalation.We present the first documented case of overdose from xylazine inhalation. The patient developed findings consistent with alpha 2 adrenergic agonist toxicity, eg coma, miosis, apnea, bradycardia, hypothermia, and dry mouth 2 hours after exposure. Standard dose naloxone did not reverse these effects. The patient fully recovered after appropriate supportive measures. A review of prior reports of xylazine exposure is provided.- - - - - - - - - - ranking = 4keywords = intoxication (Clic here for more details about this article) |
7/100. Three cases of angel's trumpet tea-induced psychosis in adolescent substance abusers.An increase of intoxications in persons using alkaloid-containing ornamental plants (mainly angel's trumpet) for their hallucinogenic effects and easy and cheap availability is registered. It is mainly adolescents who are experimenting with these plants. In addition to severe vegetative anticholinergic symptoms, the clinical picture is often dominated by a toxic psychosis with hallucinations, disturbances of orientation, and psychomotoric agitation, aggression, or anxiety. Three cases of severe psychotic pictures with only mild or completely missing vegetative symptoms after ingestion of angel's trumpet tea are reported. Caused by the increasing spreading of angel's trumpet shrubberies in europe and north america, intoxications with large numbers of fatalities have to be expected in the future. The taxonomical, pharmacological, and clinical aspects of angel's trumpet-induced disorders are discussed. knowledge of the clinical picture is important for correct diagnosis and treatment. Prevention by mass media should mainly focus on the medical fatalities of abuse and not emphasize the hallucinogenic effects, presumably increasing unwanted interest for these plants among youths.- - - - - - - - - - ranking = 2keywords = intoxication (Clic here for more details about this article) |
8/100. Pseudo-subarachnoid hemorrhage of the head diagnosed by computerized axial tomography: a postmortem study of ten medical examiner cases.In this report, we describe ten cases of pseudo-subarachnoid hemorrhage on computer axial tomography (CT) scan of the head. A pseudo-subarachnoid hemorrhage is a false positive finding by CT of the head in which the scan is interpreted as being positive for a subarachnoid hemorrhage not substantiated by subsequent neuropathologic findings. This study is a retrospective review of postmortem cases brought into the Office of the Chief Medical Examiner for the State of maryland over a three-year period (from 1997 to 2000). We compared the clinician's impression of the CT scan with the postmortem neuropathology. The clinical diagnosis of subarachnoid hemorrhage was based on misinterpretation of non-contrast CT scans of the head. In six of the ten cases, the reading was performed by a radiologist and in four cases by nonradiologist physicians (emergency room physician, neurologist, or neurosurgeon). All the patients survived between a few hours to a few days after being admitted to the hospital. For most of the cases (80%), the neuropathology showed hypoxic/ischemic encephalopathy. The most common cause of death (four out of ten cases) was narcotic intoxication. This report is submitted so that clinicians and pathologist become more familiar with this entity.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
9/100. designer drugs in the general hospital.This article has reviewed the potential complications of acute intoxication and withdrawal from some of the more commonly used club, or designer, drugs. Although limited, acute use of these drugs is claimed by users to be benign, in the context of crowded raves and circuit parties, where multiple drugs may be used, hyperthermia, dehydration, and life-threatening reactions may occur. In addition, mounting evidence of the long-term effects of continued use of these drugs is cause for great concern. Finally, awareness of a severe withdrawal syndrome from GHB and its precursors is particularly important to psychiatrists of the medically ill, who may be called on to help in the management of these patients.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
10/100. Ten years of "body packers" in new york city: 50 deaths.We reviewed all 50 body packer deaths in new york city from 1990 to 2001. The majority (37/50) of deaths were caused by acute intoxications due to open or leaking drug packets in the gastrointestinal tract. The number of packets recovered ranged from 1 to 111 (average 46). The weight of the combined packets ranged from 9.4 to 1,200 g (average of 377). The age ranged from 19 to 57 years (mean 37.1). The decedents were: 82% male, 66% Hispanic, 24% Black, and 10% White. The manners of death were 47 accidents, 1 homicide, 1 natural, and 1 undetermined. The causes of death included 42 acute intoxications, 5 intestinal obstructions/bowel perforations, 1 gunshot wound, 1 intracerebral hemorrhage due to hypertensive disease, and 1 undetermined. Of the 50 decedents, 42 were transporting opiates, 4 cocaine, and 4 both opiates and cocaine. There were 9 deaths from 1990-1995 and 41 from 1996-2001. Of the 41 deaths between 1996 and 2001, only 6 involved cocaine. In new york city there has been an increase in body packer deaths from the early 1990s to the late 1990s. Along with this increase is a marked predominance of opiate body packer deaths with few cocaine deaths.- - - - - - - - - - ranking = 2keywords = intoxication (Clic here for more details about this article) |
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