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Ziani H, Nasri S, Kamaoui I, Skiker I. Cocaine-Induced Lung Damage and Uncommon Involvement of the Basal Ganglia. Cureus 2024; 16:e53330. [PMID: 38435923 PMCID: PMC10907052 DOI: 10.7759/cureus.53330] [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: 01/30/2024] [Indexed: 03/05/2024] Open
Abstract
Cocaine use is responsible for multiorgan damage, including the brain and lungs. Bilateral and symmetrical involvement of the basal ganglia may be due to toxic, metabolic, vascular, inflammatory, infectious, or tumoral causes. Cocaine-related encephalopathy mainly affects the white matter, while basal ganglia involvement is an uncommon finding. Cocaine-induced lung damage varies clinically and even radiologically, with signs that lack specificity. The diagnosis of cocaine-induced lung or brain injury is based on suggestive radiological signs in the context of cocaine consumption and after the elimination of other etiologies likely to present the same patterns. The context of cocaine use is often not spontaneously declared, making diagnosis more complicated. We report the case of a 28-year-old male patient, with a history of freebase cocaine use, admitted to the emergency room in severe coma with respiratory distress. Brain MRI showed bilateral and symmetrical abnormalities of the basal ganglia. A chest CT scan revealed interstitial lung damage dominated by the ground-glass pattern. The urine toxicology test was positive for cocaine. Cocaine-related lesions can be reversible, and therapeutic management is essentially based on supportive care.
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Affiliation(s)
- Hamid Ziani
- Radiology, Mohammed VI University Hospital, Faculty of Medicine, University Mohammed First, Oujda, MAR
| | - Siham Nasri
- Radiology, Mohammed VI University Hospital, Faculty of Medicine, University Mohammed First, Oujda, MAR
| | - Imane Kamaoui
- Radiology, Mohammed VI University Hospital, Faculty of Medicine, University Mohammed First, Oujda, MAR
| | - Imane Skiker
- Radiology, Mohammed VI University Hospital, Faculty of Medicine, University Mohammed First, Oujda, MAR
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Casadesús JM, Nieto-Moragas J, Serrando MT, Boadas-Vaello P, Carrera A, Aguirre F, Tubbs RS, Reina F. Pulmonary barotrauma in SCUBA diving-related fatalities: a histological and histomorphometric analysis. Forensic Sci Med Pathol 2023; 19:541-550. [PMID: 36705884 PMCID: PMC10752830 DOI: 10.1007/s12024-022-00567-1] [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] [Accepted: 12/14/2022] [Indexed: 01/28/2023]
Abstract
Arterial gas embolism following pulmonary barotrauma occurs in 13-24% of cases of diving deaths. The study aimed to evaluate the usefulness of a histomorphometric digital analysis in the detection of air space over-distension due to pulmonary barotrauma. The study was performed on lung parenchyma specimens of 12 divers: six had died due to arterial gas embolism following pulmonary barotrauma (mean age at death of 54 years, range of 41-61 years), and six had drowned in saltwater without a diagnosis of pulmonary barotrauma (mean age at death of 54 years, range of 41-66 years) (positive controls). For negative controls, six cases of non-SCUBA divers (mean age of death of 42 years, range of 23-55 years) who died of intracerebral haemorrhage were evaluated. No significant differences were observed in the characteristics of the air spaces between control groups (positive and negative). However, differences were observed in the area occupied by air spaces and the percentage of air space area when we compared the case group to the controls (p < 0.01); and there was a slight difference in the maximum and minimum diameters of air space (p < 0.05). The mean area occupied by air spaces and the mean percentage of air space were the most useful for discriminating pulmonary barotrauma from other causes of death (100% sensitivity and 91.7% specificity). Based on our study, inclusion of an increased pattern of air spaces as a possible diagnostic criterion for pulmonary barotrauma would be useful in discerning the cause of diving death.
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Affiliation(s)
- Josep M Casadesús
- Institute of Legal Medicine and Forensic Sciences of Catalonia (Division of Girona, Spain), Av. Ramón Folch, 4-6, Girona, 17001, Spain.
- Research Group On Clinical Anatomy, Embryology and Neuroscience (NEOMA), Department of Medical Sciences, University of Girona, Girona, Spain.
- Experimental Neurophysiology and Clinical Anatomy (NE&AC; 2017 SGR 01279), Department of Medical Sciences, University of Girona, Girona, Spain.
- Department of Medical Sciences, Faculty of Medicine, University of Girona (Spain), Av. Emili Grahit 77, Girona, 17003, Spain.
| | - Javier Nieto-Moragas
- Research Group On Clinical Anatomy, Embryology and Neuroscience (NEOMA), Department of Medical Sciences, University of Girona, Girona, Spain
- Department of Medical Sciences, Faculty of Medicine, University of Girona (Spain), Av. Emili Grahit 77, Girona, 17003, Spain
- ICS-IAS Girona Clinical Laboratory, Av. Dr. Castany S/N, Salt, 17190, Spain
| | - Maria T Serrando
- Research Group On Clinical Anatomy, Embryology and Neuroscience (NEOMA), Department of Medical Sciences, University of Girona, Girona, Spain
- Department of Medical Sciences, Faculty of Medicine, University of Girona (Spain), Av. Emili Grahit 77, Girona, 17003, Spain
- ICS-IAS Girona Clinical Laboratory, Av. Dr. Castany S/N, Salt, 17190, Spain
| | - Pere Boadas-Vaello
- Research Group On Clinical Anatomy, Embryology and Neuroscience (NEOMA), Department of Medical Sciences, University of Girona, Girona, Spain
- Experimental Neurophysiology and Clinical Anatomy (NE&AC; 2017 SGR 01279), Department of Medical Sciences, University of Girona, Girona, Spain
- Department of Medical Sciences, Faculty of Medicine, University of Girona (Spain), Av. Emili Grahit 77, Girona, 17003, Spain
| | - Ana Carrera
- Research Group On Clinical Anatomy, Embryology and Neuroscience (NEOMA), Department of Medical Sciences, University of Girona, Girona, Spain
- Experimental Neurophysiology and Clinical Anatomy (NE&AC; 2017 SGR 01279), Department of Medical Sciences, University of Girona, Girona, Spain
- Department of Medical Sciences, Faculty of Medicine, University of Girona (Spain), Av. Emili Grahit 77, Girona, 17003, Spain
| | - Fernando Aguirre
- Research Group On Clinical Anatomy, Embryology and Neuroscience (NEOMA), Department of Medical Sciences, University of Girona, Girona, Spain
- Special Group for Underwater Activities (GEAS), Spanish Civil Guard, C/Torroella S/N, Estartit, 17258, Spain
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
| | - Francisco Reina
- Research Group On Clinical Anatomy, Embryology and Neuroscience (NEOMA), Department of Medical Sciences, University of Girona, Girona, Spain
- Experimental Neurophysiology and Clinical Anatomy (NE&AC; 2017 SGR 01279), Department of Medical Sciences, University of Girona, Girona, Spain
- Department of Medical Sciences, Faculty of Medicine, University of Girona (Spain), Av. Emili Grahit 77, Girona, 17003, Spain
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Underner M, Peiffer G, Urban T. [And if we wagered that 10 years from now, there will be no new "lungs and addictives substances" series in the Revue des Maladies Respiratoires?]. Rev Mal Respir 2023; 40:455-456. [PMID: 37308260 DOI: 10.1016/j.rmr.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 06/14/2023]
Affiliation(s)
- M Underner
- Unité de recherche clinique Pierre-Deniker, centre hospitalier Laborit, université de Poitiers, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France.
| | - G Peiffer
- CHR Metz-Thionville, 57038 Metz, France
| | - T Urban
- Service de pneumologie, CHU d'Angers, 49000 Angers, France
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Hawkins L, Khalid MA, Barton A. Pneumomediastinum and subcutaneous emphysema post cocaine and amphetamine insufflation. JRSM Open 2022; 13:20542704221079120. [PMID: 35186300 PMCID: PMC8855391 DOI: 10.1177/20542704221079120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A 20-year-old gentleman presented with blood-streaked vomitus after insufflation of an unknown amount of powder cocaine and amphetamine. This was taken with an unspecified amount of alcohol. Other notable symptoms were dysphagia, chest pain, palpitations and the patient reported a ‘crunchy’ sensation in his chest. A chest x-ray revealed pneumomediastinum and a computerised tomography (CT) trauma confirmed these findings with associated subcutaneous emphysema without an identifiable cause. Follow up investigations included a barium swallow and gastroscopy which showed no obvious perforation but mild gastritis and duodenitis. He was managed conservatively with proton pump inhibitor cover and his symptoms resolved.
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Affiliation(s)
- Leah Hawkins
- Furness General Hospital, University Hospitals of Morecambe NHS Trust, Barrow-in-Furness, UK
| | - Mohammed Ayaz Khalid
- Furness General Hospital, University Hospitals of Morecambe NHS Trust, Barrow-in-Furness, UK
| | - Alan Barton
- Furness General Hospital, University Hospitals of Morecambe NHS Trust, Barrow-in-Furness, UK
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de Vargas D, Pereira CF, Volpato RJ, Lima AVC, da Silva Ferreira R, de Oliveira SR, Aguilar TF. Strategies Adopted by Addiction Facilities during the Coronavirus Pandemic to Support Treatment for Individuals in Recovery or Struggling with a Substance Use Disorder: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212094. [PMID: 34831850 PMCID: PMC8624445 DOI: 10.3390/ijerph182212094] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 11/16/2022]
Abstract
This review aimed to identify and synthesize strategies and actions adopted by addiction facilities to support and maintain treatment during the coronavirus disease 2019 (COVID-19) pandemic. A scoping review was conducted using the following information sources: Virtual Health Library, SCOPUS, Web of Science, PubMed, CINAHL, and Latin American and Caribbean Health Science Literature. From a total of 971 articles, 28 studies were included. The strategies to maintain the care offer were telehealth/telemedicine, counselling/screening, 24-h telephone, webinars, conducting group therapy and support among users, adaptation for electronic health records, increased methadone/naloxone dispensing, restriction in the number of medication dispensing/day, and electronic prescription and home delivery medications. These strategies can be used to support health professionals in addressing the impact of the pandemic on the treatment of those in recovery or struggling with a substance use disorder when in-person treatment is not possible.
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Affiliation(s)
- Divane de Vargas
- School of Nursing, São Paulo University, São Paulo 05403-000, Brazil; (C.F.P.); (R.J.V.); (A.V.C.L.); (S.R.d.O.); (T.F.A.)
- Nucleon of Addiction Nursing Research, School of Nursing (NEPEEA), University of São Paulo, São Paulo 05403-000, Brazil;
- Correspondence:
| | - Caroline Figueira Pereira
- School of Nursing, São Paulo University, São Paulo 05403-000, Brazil; (C.F.P.); (R.J.V.); (A.V.C.L.); (S.R.d.O.); (T.F.A.)
- Nucleon of Addiction Nursing Research, School of Nursing (NEPEEA), University of São Paulo, São Paulo 05403-000, Brazil;
| | - Rosa Jacinto Volpato
- School of Nursing, São Paulo University, São Paulo 05403-000, Brazil; (C.F.P.); (R.J.V.); (A.V.C.L.); (S.R.d.O.); (T.F.A.)
- Nucleon of Addiction Nursing Research, School of Nursing (NEPEEA), University of São Paulo, São Paulo 05403-000, Brazil;
| | - Ana Vitória Corrêa Lima
- School of Nursing, São Paulo University, São Paulo 05403-000, Brazil; (C.F.P.); (R.J.V.); (A.V.C.L.); (S.R.d.O.); (T.F.A.)
- Nucleon of Addiction Nursing Research, School of Nursing (NEPEEA), University of São Paulo, São Paulo 05403-000, Brazil;
| | - Rogério da Silva Ferreira
- Nucleon of Addiction Nursing Research, School of Nursing (NEPEEA), University of São Paulo, São Paulo 05403-000, Brazil;
| | - Sheila Ramos de Oliveira
- School of Nursing, São Paulo University, São Paulo 05403-000, Brazil; (C.F.P.); (R.J.V.); (A.V.C.L.); (S.R.d.O.); (T.F.A.)
- Nucleon of Addiction Nursing Research, School of Nursing (NEPEEA), University of São Paulo, São Paulo 05403-000, Brazil;
| | - Thiago Faustino Aguilar
- School of Nursing, São Paulo University, São Paulo 05403-000, Brazil; (C.F.P.); (R.J.V.); (A.V.C.L.); (S.R.d.O.); (T.F.A.)
- Nucleon of Addiction Nursing Research, School of Nursing (NEPEEA), University of São Paulo, São Paulo 05403-000, Brazil;
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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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