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Aseem F, Lin V, Gilbert AL, Rivadeneira AC, Jennette JC, Bouldin TW, Khoshbakht F, Lee YZ, Chamberlin K, Gelinne A, Mehrabyan AC, Javed B, Dujmovic Basuroski I, Diaz MM. ANCA-associated vasculitis presenting with isolated neurological manifestations in a patient with cocaine abuse: a case report and literature review. Clin Rheumatol 2024; 43:1401-1407. [PMID: 38416306 DOI: 10.1007/s10067-024-06919-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/14/2024] [Accepted: 02/21/2024] [Indexed: 02/29/2024]
Abstract
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of rare conditions predominantly affecting small vessels of skin, musculoskeletal, pulmonary, renal, and rarely central and peripheral nervous systems. Isolated neurological manifestations of AAV are uncommon and challenging to diagnose. Cocaine has been reported as a potential trigger for the development of AAV. There are only a few case reports of isolated neurological involvement in cocaine-induced AAV with poorly characterized histopathological features. We present a unique case of AAV with isolated neurological manifestations presenting with multiple cranial neuropathies, leptomeningeal enhancement on imaging and histopathologic evidence of small-vessel vasculitis in the leptomeninges and brain and extensive dural fibrosis in a patient with cocaine abuse. The patient's progressive neurological deficits were controlled after starting immunosuppression with rituximab and prednisone. We also reviewed the literature to provide the diagnostic overview of AAV and evaluate intervention options. To our knowledge, this is the first case of AAV with isolated neurological manifestations and histopathologic evidence of small-vessel vasculitis in a patient with cocaine abuse. Patients with multiple cranial neuropathies and meningeal involvement should be screened for AAV, especially if they have a history of cocaine abuse.
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Affiliation(s)
- Fazila Aseem
- Department of Neurology, University of North Carolina School of Medicine, 170 Manning Drive, CB 7025, Chapel Hill, NC, 27599, USA
| | - Victor Lin
- Department of Neurology, University of Washington School of Medicine, Seattle, WA, 98195, USA
| | - Abigail L Gilbert
- Department of Medicine, Division of Rheumatology, Allergy, and Immunology, University of North Carolina School of Medicine, Chapel Hill, NC, 27599, USA
| | - Alfredo C Rivadeneira
- Department of Medicine, Division of Rheumatology, Allergy, and Immunology, University of North Carolina School of Medicine, Chapel Hill, NC, 27599, USA
| | - J Charles Jennette
- Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, 27599, USA
| | - Thomas W Bouldin
- Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, 27599, USA
| | - Freshta Khoshbakht
- Department of Neurology, University of North Carolina School of Medicine, 170 Manning Drive, CB 7025, Chapel Hill, NC, 27599, USA
| | - Yueh Z Lee
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC, 27599, USA
| | - Kelly Chamberlin
- Department of Neurosurgery, University of North Carolina School of Medicine, Chapel Hill, NC, 27599, USA
| | - Aaron Gelinne
- Department of Neurosurgery, University of North Carolina School of Medicine, Chapel Hill, NC, 27599, USA
| | - Anahit C Mehrabyan
- Department of Neurology, University of North Carolina School of Medicine, 170 Manning Drive, CB 7025, Chapel Hill, NC, 27599, USA
| | - Bushra Javed
- Department of Neurology, University of North Carolina School of Medicine, 170 Manning Drive, CB 7025, Chapel Hill, NC, 27599, USA
| | - Irena Dujmovic Basuroski
- Department of Neurology, University of North Carolina School of Medicine, 170 Manning Drive, CB 7025, Chapel Hill, NC, 27599, USA
| | - Monica M Diaz
- Department of Neurology, University of North Carolina School of Medicine, 170 Manning Drive, CB 7025, Chapel Hill, NC, 27599, USA.
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Alayyash A, Alam MK, Rashid ME, Mathew A, Di Blasio M, Ronsivalle V, Cicciù M, Minervini G. Prenatal incidence of cleft lip/palate and cocaine abuse in parents: a systematic review and meta-analysis. BMC Oral Health 2024; 24:185. [PMID: 38317147 PMCID: PMC10840297 DOI: 10.1186/s12903-024-03884-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/10/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND The study aimed to investigate the association between maternal cocaine abuse during pregnancy and the prevalence of cleft lip/palate (CL/P) in offspring, synthesizing existing evidence through a systematic review and meta-analysis. CL/P is a congenital craniofacial anomaly with complex etiology, and prior research has suggested potential links between maternal cocaine use and CL/P. However, these associations remain inconclusive. METHODS A comprehensive literature search was conducted to identify relevant studies published up to the study's cutoff date in September 2021. Several databases were systematically searched using predefined search terms. Inclusion criteria were set to encompass studies reporting on the prevalence of CL/P in infants born to mothers with a history of cocaine use during pregnancy, with a comparison group of non-cocaine-using mothers. Data were extracted, and a meta-analysis was performed using a random-effects model to calculate pooled odds ratios (OR) and relative risks (RR) with their respective 95% confidence intervals (CI). RESULTS The review included data from 4 studies that met the inclusion criteria. The combined OR from two studies was 0.05 (95% CI: 0.00, 4.41), which does not suggest a statistically significant association between prenatal cocaine exposure and the incidence of CL/P due to the confidence interval crossing the null value. Additionally, the combined RR was 0.17 (95% CI: 0.04, 0.66), indicating a statistically significant decrease in the risk of CL/P associated with prenatal cocaine exposure. These results, with an OR that is not statistically significant and an RR suggesting decreased risk, should be interpreted with caution due to considerable heterogeneity and variability among the included studies' findings. Further research is needed to clarify these associations. CONCLUSION The findings from this systematic review and meta-analysis suggest that maternal cocaine use during pregnancy is not a statistically significant independent risk factor for the development of CL/P in offspring. These results underscore the multifactorial nature of CL/P etiology and emphasize the importance of considering other genetic, environmental, and nutritional factors in understanding the condition's origins. While the study provides important insights, limitations such as data heterogeneity and potential confounders should be acknowledged. Future research should adopt rigorous study designs and explore a broader range of potential risk factors to comprehensively elucidate CL/P development.
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Affiliation(s)
- Afnan Alayyash
- Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Mohammad Khursheed Alam
- Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia.
- Department of Dental Research Cell, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Chennai, 600077, India.
- Department of Public Health, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, 1207, Bangladesh.
| | - Mohammed Enamur Rashid
- Department of Oral Basic and Clinical Sciences, College of Dentistry, Taibah University, Al Madinah, Al Munawara, Kingdom of Saudi Arabia
| | - Asok Mathew
- Clinical Science Department, Center of Medical and Bioallied Health Sciences Research, Ajman University, Ajman, UAE
| | - Marco Di Blasio
- University Center of Dentistry, Department of Medicine and Surgery, University of Parma, 43126, Parma, Italy.
| | - Vincenzo Ronsivalle
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123, Catania, Italy
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123, Catania, Italy
| | - Giuseppe Minervini
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania, Luigi Vanvitelli, 80138, Naples, Italy
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Girotto R, Monarchi G, De Feudis F, Paglianiti M, Balercia P. Prelamination of the Forearm Flap for Soft Palate Reconstruction: A Case Report. Indian J Otolaryngol Head Neck Surg 2023; 75:2829-2835. [PMID: 37974795 PMCID: PMC10645686 DOI: 10.1007/s12070-023-03870-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/05/2023] [Indexed: 11/19/2023] Open
Abstract
Microsurgical reconstruction is nowadays the treatment of choice of several head and neck deformities that otherwise could be repaired with limited or unsatisfactory results. The forearm free flap has its own goals expecially the possibility to reconstruct small and extremely specialized anatomical structures such as the soft palate. The abuse of drugs like cocaine, generally taken by sniffing, can produce vascular impairment in nasal and oral tissues producing, as long as the abuse is kept, necrosis of facial anatomical structures and increase of the empty space in the depth of the face or nose. The consequences are generally represented by palatal fistulas or defect, leak of food or drink from the nose, and rhinolalia. Prelamination of the flap before microvascular transfer ensures not only preparation ofadequate tissue volume to resurface the defect but also optimization of the venous outflow. This two times approach, consisting first in preparation and then elevation/transfer of the flap, gives the chances to ensure viability of the flap itself and organize the surgical strategy several times to reduce forthcoming complications. The authors believe that this technical modification could be used for many other chronic defects in the head and neck region but could also be extended, with experience, to bigger defects. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-03870-7.
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Affiliation(s)
- Riccardo Girotto
- Division of Maxillofacial Surgery, Department of Neurological Sciences, University Hospitals of Ancona, Ancona, Italy
| | - Gabriele Monarchi
- Department of medicine, Section of maxillo-facial surgery, University of Siena, Viale Bracci, Siena, 53100 Italy
| | - Francesco De Feudis
- Division of Maxillofacial Surgery, Department of Neurological Sciences, University Hospitals of Ancona, Ancona, Italy
| | - Mariagrazia Paglianiti
- Department of medicine, Section of maxillo-facial surgery, University of Siena, Viale Bracci, Siena, 53100 Italy
| | - Paolo Balercia
- Division of Maxillofacial Surgery, Department of Neurological Sciences, University Hospitals of Ancona, Ancona, Italy
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Mo A, Cha JW, Yang M. Successful medical management of a 16-month chronic type A aortic dissection. Radiol Case Rep 2020; 15:660-663. [PMID: 32280396 PMCID: PMC7136586 DOI: 10.1016/j.radcr.2020.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 03/03/2020] [Accepted: 03/04/2020] [Indexed: 10/26/2022] Open
Abstract
Stanford type A dissections usually require surgery because they are associated with high morbidity and mortality. However, there are situations where medical management becomes the definitive treatment. We report the successful medical management of a 16-month chronic type A aortic dissection in a 56-year-old male patient with a past surgical history of ascending aortic aneurysm repair. The dissection is unique because it is distal to the graft and does not extend into the main aortic branches. A review of a patient's surgical history and nonenhanced imaging studies is essential when a type A dissection is discovered. Ascending aortic grafts may preclude the most serious complications of type A dissections.
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Affiliation(s)
- Alan Mo
- Larkin Community Hospital, 7031 SW 62nd Avenue, South Miami, FL 33143, USA
| | - Jin-Whan Cha
- Larkin Community Hospital, 7031 SW 62nd Avenue, South Miami, FL 33143, USA
| | - Millet Yang
- Larkin Community Hospital, 7031 SW 62nd Avenue, South Miami, FL 33143, USA
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Dallelucci CC, Bragiato EC, Areco KCN, Fidalgo TM, da Silveira DX. Sexual risky behavior, cocaine and alcohol use among substance users in an outpatient facility: a cross section study. Subst Abuse Treat Prev Policy 2019; 14:46. [PMID: 31694694 PMCID: PMC6836442 DOI: 10.1186/s13011-019-0238-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 10/23/2019] [Indexed: 11/10/2022]
Abstract
Background Substance dependence is considered an international health issue and studies that access the characteristic of this population are required to develop public health programs for harm reduction. To this aim, we purpose to to identify, in a population undergo addiction treatment, if the use of substances leads to sexual risky behavior and also check if another variables influences in this behavior. Method Observational study of clinical sample collected of adult patients seeking treatment to dependence of alcohol and cocaine. The data collected were: socio-demographic, substance use, sexual behavior and childhood abuse. Risky sexual behaviors were considered: inconsistent use of condoms and presence of multiple sexual partners in the past six months. An exploratory analysis of the association between the variable “risky sexual behavior” and the other variables was performed using Pearson’s chi-square, followed by a multivariate logistic regression analysis. Results After analyzing the variables with the presence or absence of risky sexual behavior, were included in the logistic regression the data that presented association with sexual risk behavior, and age appears as an independent factor for risky sexual behaviors. Other factors, such as schooling and unemployment, influence as much as the use of substances in risky sexual behaviors. Conclusion Attributing just to the substance use this risky sexual behavior seems too simplistic. Other structural factors such as schooling, work, age and sexual abuse in childhood can influence decision making for safe sex.
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Affiliation(s)
- Claudia Chaves Dallelucci
- Psychiatry Department, Universidade Federal de São Paulo, Major Maragliano Street, 241, São Paulo, SP, 04017-030, Brazil.
| | - Emi Carneiro Bragiato
- Psychiatry Department, Universidade Federal de São Paulo, Major Maragliano Street, 241, São Paulo, SP, 04017-030, Brazil
| | | | - Thiago Marques Fidalgo
- Psychiatry Department, Universidade Federal de São Paulo, Major Maragliano Street, 241, São Paulo, SP, 04017-030, Brazil
| | - Dartiu Xavier da Silveira
- Psychiatry Department, Universidade Federal de São Paulo, Major Maragliano Street, 241, São Paulo, SP, 04017-030, Brazil
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Li S, Garg G, Goyal B, Abdelbaki A, Hegde R, Kumar A, Rosovsky M. Rhombencephalitis in cocaine-induced nasal septal perforation and skull base erosion. Proc (Bayl Univ Med Cent) 2019; 32:82-84. [PMID: 30956592 DOI: 10.1080/08998280.2018.1536586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 10/03/2018] [Accepted: 10/08/2018] [Indexed: 12/30/2022] Open
Abstract
Rhombencephalitis is a rare and potentially fatal condition involving the brainstem, with infectious, autoimmune, and paraneoplastic etiologies. We present a patient presenting with left-extremity weakness and dysphonia who had brainstem imaging findings suggestive of rhombencephalitis. We suspect that the case was due to inoculation of the brainstem from nasopharyngeal adenoviral infection. Due to heavy cocaine use, extensive basiocciput erosion led to direct contact between the brainstem and the nasopharyngeal mucosa. The patient's milder clinical course might have been due to some degree of pre-existing immunity against adenovirus. Additionally, clinicians need to be aware of the proximity of the brainstem to the nasopharynx when there is basiocciput erosion, due to the potential risk of injury during instrumentation.
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Affiliation(s)
- Shuo Li
- Department of Interventional Radiology, University of Miami/Jackson Memorial HospitalMiamiFlorida
| | - Gunjan Garg
- Department of Radiology, Yale New Haven Health Bridgeport HospitalBridgeportConnecticut
| | - Bobby Goyal
- Department of Physiology and Neuroscience, St. George's University School of MedicineGreat RiverNew York
| | - Ahmed Abdelbaki
- Department of Radiology, Yale New Haven Health Bridgeport HospitalBridgeportConnecticut
| | - Rahul Hegde
- Department of Radiology, Yale New Haven Health Bridgeport HospitalBridgeportConnecticut
| | - Anil Kumar
- Department of Neurology, Great Plains HealthNorth PlatteNebraska
| | - Mark Rosovsky
- Department of Radiology, Yale New Haven Health Bridgeport HospitalBridgeportConnecticut
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Wang W, Worhunsky PD, Zhang S, Le TM, Potenza MN, Li CSR. Response inhibition and fronto-striatal-thalamic circuit dysfunction in cocaine addiction. Drug Alcohol Depend 2018; 192:137-145. [PMID: 30248560 PMCID: PMC6200592 DOI: 10.1016/j.drugalcdep.2018.07.037] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/20/2018] [Accepted: 07/27/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Many studies have investigated how cognitive control may be compromised in cocaine addiction. Here, we extend this literature by employing spatial Independent Component Analysis (ICA) to describe circuit dysfunction in relation to impairment in response inhibition in cocaine addiction. METHODS Fifty-five cocaine-dependent (CD) and 55 age- and sex-matched non-drug-using healthy control individuals (HC) participated in the study. Task-relatedness of 40 independent components (ICs) was assessed using multiple regression analyses of component time courses with the modeled time courses of hemodynamic activity convolved with go success (GS), stop success (SS) and stop error (SE). This procedure produced beta-weights that represented the degree to which each IC was temporally associated with, or 'engaged', by each task event. RESULTS Behaviorally, CD participants showed prolonged stop signal reaction times (SSRTs) as compared to HC participants (p < 0.01). ICA identified two networks that showed differences in engagement related to SS between CD and HC (p < 0.05, FDR-corrected). The activity of the fronto-striatal-thalamic network was negatively correlated with SSRTs in HC but not in CD, suggesting a specific role of this network in mediating deficits of response inhibition in CD individuals. In contrast, the engagement of the fronto-parietal-temporal network did not relate to SSRTs, was similarly less engaged for both SS and SE trials, and may reflect attentional dysfunction in cocaine addiction. CONCLUSIONS This study highlights the utility of ICA in identifying neural circuitry engagement related to SST performance and suggests that specific networks may represent important targets in remedying executive-control impairment in cocaine addiction.
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Affiliation(s)
- Wuyi Wang
- Department of Psychiatry, Yale University School of Medicine, 300 George St, #901, New Haven, CT 06511, USA; Connecticut Mental Health Center, 34 Park St, New Haven, CT 06519, USA.
| | - Patrick D. Worhunsky
- Department of Psychiatry, Yale University School of Medicine, 300 George St, #901, New Haven, CT 06511, USA
| | - Sheng Zhang
- Department of Psychiatry, Yale University School of Medicine, 300 George St, #901, New Haven, CT 06511, USA,Connecticut Mental Health Center, 34 Park St, New Haven, CT 06519, USA
| | - Thang M. Le
- Department of Psychiatry, Yale University School of Medicine, 300 George St, #901, New Haven, CT 06511, USA,Connecticut Mental Health Center, 34 Park St, New Haven, CT 06519, USA
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, 300 George St, #901, New Haven, CT 06511, USA,Connecticut Mental Health Center, 34 Park St, New Haven, CT 06519, USA,Department of Neuroscience, Yale University School of Medicine, 200 S Frontage Rd, New Haven, CT 06510, USA,Child Study Center, Yale University School of Medicine, 230 South Frontage Rd., New Haven, CT 06519, USA,Interdepartmental Neuroscience Program, Yale University School of Medicine, SHM L-200, P.O. Box 208074, New Haven CT 06520-8074, USA,Connecticut Council on Problem Gambling, 100 Great Meadow Rd, Wethersfield, CT 06109, USA
| | - Chiang-Shan R. Li
- Department of Psychiatry, Yale University School of Medicine, 300 George St, #901, New Haven, CT 06511, USA,Connecticut Mental Health Center, 34 Park St, New Haven, CT 06519, USA,Department of Neuroscience, Yale University School of Medicine, 200 S Frontage Rd, New Haven, CT 06510, USA,Interdepartmental Neuroscience Program, Yale University School of Medicine, SHM L-200, P.O. Box 208074, New Haven CT 06520-8074, USA
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8
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Blanco-Presas L, Moreno-Alcázar A, Alonso-Lana S, Salvador R, Pomarol-Clotet E, McKenna P. Cognitive impairment associated with cocaine use: The role of co-existent alcohol abuse/dependence. Drug Alcohol Depend 2018; 189:70-75. [PMID: 29886366 DOI: 10.1016/j.drugalcdep.2018.03.054] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 03/05/2018] [Accepted: 03/06/2018] [Indexed: 01/13/2023]
Abstract
BACKGROUND Cocaine abuse has been reported as leading to impaired cognitive function. However, cocaine abusers commonly also abuse alcohol, which can itself produce cognitive impairment. This study, therefore, aimed to examine the potential confounding effect of alcohol abuse on neuropsychological test performance in cocaine and alcohol abusing individuals, comparing them with individuals who abused alcohol alone and non-abusing controls. METHODS Nineteen cocaine abusers who also met DSM-IV criteria for alcohol abuse/dependence (14 m, 5f; mean age 38.65 ± 3.83) and 20 matched individuals who met criteria for alcohol abuse/dependence alone (12 m, 8f; mean age 38.19 ± 4.82) were administered a battery of neuropsychological tests covering executive function, memory, language and visual/visuospatial function after two to four weeks of abstinence. Nineteen matched healthy controls (8 m, 11f; mean age 37.01 ± 5.98) were also tested. RESULTS Both the cocaine + alcohol group and the alcohol group performed significantly more poorly than the healthy controls on the executive (ESs 2.13 and 2.57) and memory tests (ESs 0.58 and 1.06). The findings were similar for language (ESs 0.92 and 1.69), where the cocaine + alcohol abusers additionally performed significantly better than the alcohol abusers. Both patient groups were impaired on two of the five tests of visual/visuospatial function, with better performance by the cocaine + alcohol group on one of them. CONCLUSIONS Chronic cocaine abuse does not appear from this study to be associated with cognitive impairment over and above that which can be attributed to co-existent alcohol abuse.
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Affiliation(s)
| | - Ana Moreno-Alcázar
- FIDMAG, Germanes Hospitalàries Research Foundation, Avda. Jordà, 8, Barcelona, 08035, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Av. Monforte de Lemos, 3-5 Pabellón, 11. Planta 0, 28029, Spain
| | - Silvia Alonso-Lana
- FIDMAG, Germanes Hospitalàries Research Foundation, Avda. Jordà, 8, Barcelona, 08035, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Av. Monforte de Lemos, 3-5 Pabellón, 11. Planta 0, 28029, Spain
| | - Raymond Salvador
- FIDMAG, Germanes Hospitalàries Research Foundation, Avda. Jordà, 8, Barcelona, 08035, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Av. Monforte de Lemos, 3-5 Pabellón, 11. Planta 0, 28029, Spain
| | - Edith Pomarol-Clotet
- FIDMAG, Germanes Hospitalàries Research Foundation, Avda. Jordà, 8, Barcelona, 08035, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Av. Monforte de Lemos, 3-5 Pabellón, 11. Planta 0, 28029, Spain
| | - Peter McKenna
- FIDMAG, Germanes Hospitalàries Research Foundation, Avda. Jordà, 8, Barcelona, 08035, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Av. Monforte de Lemos, 3-5 Pabellón, 11. Planta 0, 28029, Spain.
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Gill D, Sheikh N, Ruiz VG, Liu K. Case report: Cocaine-induced takotsubo cardiomyopathy. Hellenic J Cardiol 2017; 59:129-132. [PMID: 28600168 DOI: 10.1016/j.hjc.2017.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 05/15/2017] [Accepted: 05/24/2017] [Indexed: 10/19/2022] Open
Affiliation(s)
- Dalvir Gill
- Department of Internal Medicine, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY, 13210, USA.
| | - Natasha Sheikh
- Ross University School of Medicine, 485 US Highway 1 South, Iselin, New Jersey, 08830, USA.
| | - Vanessa Goyes Ruiz
- Department of Internal Medicine, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY, 13210, USA.
| | - Kan Liu
- Department of Cardiology, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY, 13210, USA.
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Radunski UK, Fuger U, Bohnen S, Lund GK, Stehning C, Zeller T, Tahir E, Avanesov M, Adam G, Blankenberg S, Reimer J, Muellerleile K. Asymptomatic Cocaine Abuse - Myocardial Tissue Characterization Using Cardiac Biomarkers and Cardiovascular Magnetic Resonance Imaging. Circ J 2017; 81:701-708. [PMID: 28179611 DOI: 10.1253/circj.cj-16-0941] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Use of cocaine is widespread and associated with several cardiovascular diseases. Recent CMR studies indicate frequent myocardial scar/fibrosis in asymptomatic cocaine abusers (CA).Methods and Results:This study used a combination of advanced CMR tissue characterization techniques, including late gadolinium enhancement (LGE) for focal, and extracellular volume (ECV) imaging for diffuse myocardial injury/fibrosis, with circulating biomarkers for a comprehensive characterization of myocardial injury. We included 20 cardiac asymptomatic CA and a control group of 20 healthy volunteers. The comprehensive assessment included physical examination, resting ECG, exercise ECG, cardiac biomarkers, transthoracic echocardiogram and CMR. We did not find significant differences between CA and controls either in functional CMR parameters such as LVEDVi, LVESVi, LVEF, LV mass index, or in global myocardial ECV. Neither CA nor controls had evidence of myocardial edema on T2-weighted CMR, but 8 CA (40%), and none of the controls had focal myocardial scar (P<0.01). Interestingly, CA with focal myocardial scar on LGE had significantly higher high-sensitivity troponin I (hs-TNI) compared with CA without focal scar (median, 1.7 ng/L; IQR, 1.3-2.5 ng/L vs. 0.6 ng/L; 0.4-1.3 ng/L; P<0.01). CONCLUSIONS Focal myocardial injury in terms of subtle LGE in 40% of asymptomatic CA was associated with higher hs-TNI. Comprehensive assessment including advanced ECV imaging indicates a focal rather than diffuse pattern of myocardial involvement in asymptomatic CA.
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Affiliation(s)
- Ulf K Radunski
- Department of General and Interventional Cardiology, University Heart Center Hamburg
| | - Ulrike Fuger
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf
| | - Sebastian Bohnen
- Department of General and Interventional Cardiology, University Heart Center Hamburg
| | - Gunnar K Lund
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf
| | | | - Tanja Zeller
- Department of General and Interventional Cardiology, University Heart Center Hamburg
| | - Enver Tahir
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf
| | - Maxim Avanesov
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf
| | - Gerhard Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf
| | - Stefan Blankenberg
- Department of General and Interventional Cardiology, University Heart Center Hamburg
| | - Jens Reimer
- Center for Psychosocial Medicine, Health North.,Center for Interdisciplinary Addiction Medicine, University of Hamburg
| | - Kai Muellerleile
- Department of General and Interventional Cardiology, University Heart Center Hamburg
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Singh M, Keer D, Klimas J, Wood E, Werb D. Topiramate for cocaine dependence: a systematic review and meta-analysis of randomized controlled trials. Addiction 2016; 111:1337-46. [PMID: 26826006 DOI: 10.1111/add.13328] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 07/28/2015] [Accepted: 01/26/2016] [Indexed: 12/21/2022]
Abstract
AIMS To assess the efficacy of topiramate in treating cocaine use disorder (i.e. retention, efficacy, safety and craving reduction) through a systematic review and meta-analysis. METHODS We searched six scientific databases from inception to 23 December 2014 with no date limits. Data were reviewed, extracted and analysed systematically. Studies were included if they were peer-reviewed randomized control trials with participants meeting diagnostic criteria for cocaine dependence or cocaine use disorder, with the treatment arm involving topiramate with or without psychosocial intervention, and the control arm involving no intervention or psychosocial intervention with or without placebo. A random-effects meta-analytical model was computed. RESULTS Five studies met inclusion criteria (n = 518). Topiramate was compared with placebo (four studies) and no medication (one study). In a meta-analysis, we observed no significant differences between topiramate and placebo in improving treatment retention risk ratio (RR) = 0.85; 95% confidence interval (CI) = 0.60-1.22, P = 0.38. However, compared with a placebo, use of topiramate was associated with increased continuous abstinence in two of five studies (RR = 2.43; 95% CI = 1.31-4.53, P = 0.005). No differences were observed in frequency of adverse effects reported between topiramate and placebo (RR = 1.06; 95% CI = 0.91-1.23, P = 0.48). Topiramate was associated significantly (P < 0.05) with a reduction in craving in only one of five studies. CONCLUSIONS Evidence does not currently support the use of topiramate to improve treatment retention for cocaine use disorder, although it may extend cocaine abstinence with a similar risk of adverse events compared with placebo.
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Affiliation(s)
- Mohit Singh
- St Paul's Hospital, University of British Columbia, Vancouver, Canada.,Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Dipinder Keer
- St Paul's Hospital, University of British Columbia, Vancouver, Canada.,Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - Jan Klimas
- St Paul's Hospital, University of British Columbia, Vancouver, Canada.,Urban Health Research Initiative, BC Centre for Excellence in HIV/AIDS, Vancouver, Canada.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Evan Wood
- Urban Health Research Initiative, BC Centre for Excellence in HIV/AIDS, Vancouver, Canada.,Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Dan Werb
- Urban Health Research Initiative, BC Centre for Excellence in HIV/AIDS, Vancouver, Canada.,Division of Global Public Health, University of California San Diego, La Jolla, CA, USA
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Dendramis G, Paleologo C, Piraino D, Assennato P. Relationship between coronary artery ectasia, cocaine abuse and acute coronary syndromes. World J Cardiol 2016; 8:351-355. [PMID: 27231522 PMCID: PMC4877364 DOI: 10.4330/wjc.v8.i5.351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Revised: 02/03/2016] [Accepted: 03/09/2016] [Indexed: 02/06/2023] Open
Abstract
Coronary artery ectasia (CAE) often represents a coronary angiography finding casually detected or following the occurrence of an acute coronary syndrome. The pathogenetic role of cocaine abuse in the genesis of CAE is still little known and very few data are available in literature. We describe a case of a 31-year-old male cocaine user admitted to our department for typical acute chest pain. Coronary angiography showed diffuse coronary ectasia with slow flows and without hemodynamically significant stenosis. An increasing of matrix metalloproteinases values and a reduction of their tissue inhibitors was showed both during hospitalization and at one month after discharge. This case report emphasizes the close relationship between cocaine abuse, CAE and acute coronary syndromes in patients without hemodynamically significant coronary stenosis. As reported by Satran et al, cocaine abuse should be considered an important risk factor for CAE and these patients appear to be at increased risk of angina and acute myocardial infarct. Further studies that can strengthen this hypothesis would be useful to deepen and better analyze this interesting association.
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13
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Boulagnon C, Kovacs OB, Patey M. [A cause of palatal necrosis not to ignore]. Ann Pathol 2015; 35:168-72. [PMID: 25778762 DOI: 10.1016/j.annpat.2015.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 10/22/2014] [Accepted: 01/18/2015] [Indexed: 11/30/2022]
Abstract
We report a case of pseudotumoral nasal septum and hard palate perforation in a 42-years-old man. The diagnosis retained after differential diagnosis exclusion was necrotic midfacial lesion due to chronic inhalation of cocaine. This condition can mimic vasculitis, primary tumors and granulomatous infections. Differential diagnosis and pathophysiology of this condition will be discussed in this anatomo-clinical case.
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Affiliation(s)
- Camille Boulagnon
- Laboratoire d'anatomie et cytologie pathologiques, CHU de Reims, 45, rue Cognac-Jay, 51100 Reims, France.
| | - Ovidiu-Bujor Kovacs
- Consultation d'oto-rhino-laryngologie, centre hospitalier de Vitry-le-François, 2, rue Charles-Simon, 51308 Vitry-le-François, France
| | - Martine Patey
- Laboratoire d'anatomie et cytologie pathologiques, CHU de Reims, 45, rue Cognac-Jay, 51100 Reims, France
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Fioravanti G, Castellini G, Lo Sauro C, Ianni S, Montanelli L, Rotella F, Faravelli C, Ricca V. Course and moderators of emotional eating in anorectic and bulimic patients: a follow-up study. Eat Behav 2014; 15:192-6. [PMID: 24854803 DOI: 10.1016/j.eatbeh.2014.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 12/10/2013] [Accepted: 01/22/2014] [Indexed: 11/26/2022]
Abstract
Emotion dysregulation has been found to be associated with specific eating attitudes and behavior in Eating Disorder (ED) patients. The present study evaluated whether emotional eating profile of ED patients changes over time and the possible effects of a psychotherapeutic intervention on the emotional eating dimension. One hundred and two ED patients (28 with Anorexia Nervosa restricting type [AN-R], 35 with Anorexia Nervosa binge/purging subtype [AN-B/P] and 39 with Bulimia Nervosa [BN]) were evaluated at baseline, at the end of a Cognitive Behavioral Therapy, at 3 and 6 year follow-up. The Structured Clinical Interview for DSM IV Axis I Disorders, the Emotional Eating Scale (EES) and several self-reported questionnaires for eating specific and general psychopathology were applied. A control group of 86 healthy subjects was also studied, in order to compare psychopathological variables at baseline. A significant EES total score reduction was observed among AN-B/P and BN patients, whereas no significant change was found in the AN-R group. Mixed Models analyses showed that a significant effect on EES total score variation was found for cocaine or amphetamine abuse (b = .25; p < .01). Patients who assumed these substances reported no significant EES reduction across time, unlike other patients. The present results suggest that ED patients with a history of cocaine or amphetamine abuse represent a sub-population of patients with lasting dysfunctional mood modulatory mechanisms.
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Affiliation(s)
- Giulia Fioravanti
- Department of Health Sciences, Section of Psychology and Psychiatry, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
| | - Giovanni Castellini
- Psychiatric Unit, Careggi Teaching Hospital, Largo Brambilla 3, 50134 Florence, Italy
| | - Carolina Lo Sauro
- Department of Health Sciences, Section of Psychology and Psychiatry, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
| | - Sirio Ianni
- Psychiatric Unit, Careggi Teaching Hospital, Largo Brambilla 3, 50134 Florence, Italy
| | - Luca Montanelli
- Psychiatric Unit, Careggi Teaching Hospital, Largo Brambilla 3, 50134 Florence, Italy
| | - Francesco Rotella
- Psychiatric Unit, Careggi Teaching Hospital, Largo Brambilla 3, 50134 Florence, Italy
| | - Carlo Faravelli
- Department of Health Sciences, Section of Psychology and Psychiatry, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
| | - Valdo Ricca
- Psychiatric Unit, Careggi Teaching Hospital, Largo Brambilla 3, 50134 Florence, Italy.
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15
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Szabo ST, Fowler JC, Froeliger B, Lee TH. Time-dependent changes in nicotine behavioral responsivity during early withdrawal from chronic cocaine administration and attenuation of cocaine sensitization by mecamylamine. Behav Brain Res 2014; 262:42-6. [PMID: 24412684 DOI: 10.1016/j.bbr.2013.12.051] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 12/24/2013] [Accepted: 12/26/2013] [Indexed: 10/25/2022]
Abstract
Cocaine abuse is associated with a high prevalence of nicotine dependence. In animals, nicotinic antagonists have been reported to block the development of cocaine behavioral sensitization and to attenuate cocaine place preference or self-administration. In the present study, we have determined: (1) changes in the locomotor responses to nicotine challenge during the first week of withdrawal from daily cocaine pretreatment; and (2) effects of the non-selective nicotinic acetylcholine receptor (nAChR) antagonist mecamylamine given during the first 5 days of cocaine withdrawal on the maintenance of cocaine behavioral sensitization. Male Sprague-Dawley rats were pretreated with daily saline (SI) or cocaine (CI) injections for 14 days. In Experiment 1, separate animals in the SI and CI groups received a single nicotine challenge on day 1, 3, or 7 of withdrawal from their respective pretreatments. The CI group displayed enhanced locomotor responses to nicotine as compared to SI controls on days 3 and 7 of withdrawal, but not day 1. In Experiment 2, SI and CI animals were treated once a day with either saline or mecamylamine during the first 5 days of withdrawal, and were subsequently challenged with single cocaine injections on both withdrawal days 7 and 14. Mecamylamine treatment significantly attenuated expression of cocaine behavioral sensitization on both withdrawal days 7 and 14. Time-dependent changes in nicotinic responses occur during the first week of cocaine withdrawal, and intact nAChR neurotransmission during this period may be necessary for maintenance of cocaine behavioral sensitization.
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Affiliation(s)
- Steven T Szabo
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States
| | - J C Fowler
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States
| | - Brett Froeliger
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States; Duke-UNC Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, United States
| | - Tong H Lee
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States.
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