1/25. stroke associated with marijuana abuse.We present the case of a 15-year-old with a cerebellar infarct that involved multiple arterial territories. It was temporally related to, and probably caused by, heavy marijuana use. While the mechanism of marijuana-associated stroke is unclear, the drug is known to cause hypotension and to impair peripheral vasomotor reflexes. We suspect that the child had diminished cerebral autoregulatory capacity and developed the stroke during a period of hypotension.- - - - - - - - - - ranking = 1keywords = abuse (Clic here for more details about this article) |
2/25. cocaine-contaminated allogeneic bone marrow transplantation.Should a person with history of drug addiction be categorically denied as a bone marrow donor? The answer to the question is controversial. We report a case of allogeneic bone marrow transplantation for refractory acute myeloid leukemia preceded by essential thrombocythemia. The donor used cocaine and marijuana the night before the bone marrow harvest.- - - - - - - - - - ranking = 0.3253054308229keywords = addiction (Clic here for more details about this article) |
3/25. Persisting visual hallucinations and illusions in previously drug-addicted patients.BACKGROUND: Tetrahydrocannabinol (cannabis) and lysergic acid diethylamide (LSD) are psychomimetic agents that induce impairment of sensory perception. illusions and hallucinations are mostly visual. Most frequently the visual phenomena occur in conjunction with drug abuse. PATIENTS AND methods: Three previously drug-addicted patients were examined for either persisting or spontaneously recurrent visual phenomena. Two patients complained of persisting visual illusions (vibrations, dyskinetopsia and impaired depth perception) during more than 12 months after an excessive use of cannabis. The third patient was a multiple drug abuser (LSD for 6 years) and complained of visual hallucinations and palinopsia following heavy ethanol intake, 20 years after stopping the use of any drug. RESULTS: Results from neuro-ophthalmic and neurological examinations were normal for the first two patients. The third patient presented abnormal visual fields with preserved visual acuity; electroencephalography was abnormal, suggesting an underlying toxic encephalopathy. CONCLUSIONS: Persistent visual illusions or hallucinations can occur during several months after an intake of cannabis. Flash-back phenomena are frequent amongst LSD abusers. They rarely occur at long times after the last intake (20 years in the present case); when they do so, precipitating factors are often present (ethanol, medication, anesthesia). Such phenomena reflect the cortical dysfunctions that can be induced by illegal substances.- - - - - - - - - - ranking = 0.75keywords = abuse (Clic here for more details about this article) |
4/25. cannabis arteritis.The main causes of arteriopathy in young patients include drugs, metabolic diseases, pseudoxanthoma elasticum and Buerger's disease. arteritis due to cannabis indica was first reported in 1960, and the role of this drug as a risk factor for arteritis was confirmed in several subsequent publications. A 38-year-old smoker with no previous contributory medical history except for long-standing cannabis abuse developed a dry necrotic lesion of the left big toe. Imaging examinations revealed proximal arteriopathy of the lower limbs that predominated on the left side. He had no atherogenic or thrombogenic risk factors, and no signs of pseudoxanthoma elasticum were found. Remarkably, the development of arteritis paralleled cannabis abuse. The course was slowly favourable after weaning from the drug, vasodilator treatment and hyperbaric oxygen therapy. Despite some subtle clinical differences (more proximal than distal involvement), cannabis arteritis may be considered as a particular form of Buerger's disease, where cannabis, along with tobacco, seems to cause arterial lesions. Along with the noxious effects of cannabis on vessels, a role for contaminating arsenic is also possible. cannabis arteritis is not widely known, but may prove not to be so rare if one considers consumption of cannabis besides that of tobacco.- - - - - - - - - - ranking = 0.5keywords = abuse (Clic here for more details about this article) |
5/25. hypothermia-related deaths--united states, 2003-2004.hypothermia, a reduction in the body's core temperature to <95.0 degrees F (<35.0 degrees C), is a preventable medical emergency usually caused by prolonged exposure to cold temperatures without adequate protective clothing. Warning signs and symptoms of hypothermia include lethargy, weakness and loss of coordination, confusion, uncontrollable shivering, and reduced respiratory or heart rate. Common risk factors are advanced age, substance abuse, altered mental status, and increased contact with substances that promote heat loss, such as water. This report describes three hypothermia-related deaths that occurred in the united states during 2003-2004, summarizes hypothermia-related mortality during 1979-2002, describes risk factors for and symptoms of hypothermia, and reviews measures to prevent hypothermia-related injury and death. public health strategies tailored to persons at increased risk for exposure to excessive cold might help reduce hypothermia-related morbidity and mortality.- - - - - - - - - - ranking = 0.25keywords = abuse (Clic here for more details about this article) |
6/25. hair analysis by GC/MS/MS to verify abuse of drugs.Because of its peculiar characteristics, hair analysis provides a way of obtaining information that cannot be acquired by other commonly used forensic medical analyses, such as blood or urine analysis. In the keratin matrix many xenobiotics are incorporated permanently, in contrast to the situation with blood or urine where they are generally only detectable for a few hours or days. Therefore hair analysis should be the method of choice in the clinical and forensic toxicology field when the assessment of repeated or chronic exposure to a drug is required, e.g. in the case of criminal responsibility, revocation/restoration of a driving licence or in workplace testing. Some factors that can affect the concentrations of drugs in hair, such as passive contamination, age, ethnicity and cosmetic treatment, must be considered. Analytical methodology is also very important: GC/MS/MS has proved to be a highly sensitive and specific technique for the detection of very low concentrations of such drugs in hair. In this study five cases of the application of hair analyses using this technique for the determination of abused drugs (opiates, cocaine, amphetamine, anabolic steroids) are described.- - - - - - - - - - ranking = 1.25keywords = abuse (Clic here for more details about this article) |
7/25. cannabis use and mood disorders: patterns of clinical presentations among adolescents in a developing country.Notwithstanding the increase use of cannabis among adolescents in both developing and developed countries, few studies have looked at cannabis use and mood disorders. In a series of case studies, this research project seeks to investigate patterns of clinical presentations seen among cannabis users in psychiatric outpatients in Trinidad. Five clinical patterns of presentations are identified among cannabis users and abusers based on variables of dosing, age of initial use, duration of use, tolerance and reverse tolerance and poly-drug abuse. All patients in these case studies were standardized for method of use and potency of cannabis used. Patients were screened by urine tests to determine co-morbid use of other substances. Other variables such as environmental factors and genetic vulnerability were reviewed as far as possible from historical accounts of family members. The five patterns described are low, controlled use with mild euphoria and heightened awareness, moderate use with mixed depressive symptoms and suicidal behaviour, heavy, short term use with manic symptoms, long term incremental use with psychotic symptoms due to the trumping of depressive symptoms and cannabis mixed with other substances resulting in florid psychosis. mood disorders appear to be a common finding among adolescents using cannabis. Sensitization to symptomatic presentation and early detection of cannabis use in young adolescents are necessary. Further research is needed on the effect of cannabinoids on emotions, behaviour and thinking and its relationship to mental disorders. This study is useful as a guideline for the implementation of public health strategies and legislation concerning the use of cannabis in youths.- - - - - - - - - - ranking = 0.5keywords = abuse (Clic here for more details about this article) |
8/25. Unrecognized substance misuse: clinical hazards and legal vulnerabilities.This paper explores clinical psychologists' relative lack of attention to alcohol and other drug problems, and examines clinical consequences as well as legal vulnerabilities. The ease with which manifestations of substance abuse readily imitate every other entity seen in clinical practice allows both use and abuse to influence treatment in ways which remain often unrecognized. borderline personality disorder is a common example. Failure to assess and appropriately treat or refer places the psychologist in an increasingly untenable position, especially as sophistication about alcohol and drug problems increases among other professionals and the lay public. The paper outlines sources of legal vulnerabilities, such as negligence and deviation from the standard of care, as they could be arise in substance abuse cases.- - - - - - - - - - ranking = 0.75keywords = abuse (Clic here for more details about this article) |
9/25. Visual illusions associated with previous drug abuse.We describe the visual illusions experienced by five patients with a history of previous use of hallucinogens, marijuana, or both. Symptoms included shimmering of images, illusory movement of images, visual perseveration of stationary objects, streaking of moving objects, and moving objects appearing as a consecutive series of stationary images. In all cases, the symptoms had persisted or recurred after periods of drug abstinence ranging from several months to several years. Despite thorough and repeated examinations and investigations, there was no evidence of neurologic ophthalmologic disease in these patients. When patients present with these and other visual illusions, a thorough drug history may afford the answer, provided that other recognized causes of these visual symptoms, such as migraine, epilepsy, and intracranial lesions have been excluded.- - - - - - - - - - ranking = 1keywords = abuse (Clic here for more details about this article) |
10/25. Justified paternalism in adolescent health care. Cases of anorexia nervosa and substance abuse.This essay on the limits of adolescent autonomy espouses justified paternalism in adolescent medicine as a 1980s alternative to the "antipaternalistic" rights position of the 1970s. Thus, it proposes that the harm principle be a basis for justified limitations of liberty. In turn, justified paternalism should be both testable and severely limited because by definition it always involves treating someone in a way that violates a moral rule (e.g., coercive deprivation of freedom, invasion of privacy). Therefore, paternalism can only be justified when the evil prevented from occurring to the person is greater than the wrong caused by the violation of the moral rule and, more importantly, if it can be universally justified under relevantly similar circumstances always to treat persons in this way.- - - - - - - - - - ranking = 1keywords = abuse (Clic here for more details about this article) |
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