1/44. 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 = hyperthermia (Clic here for more details about this article) |
2/44. The influence of nonsteroidal anti-inflammatory drugs abuse and chronic stress on the development of necrotizing fasciitis--case report.In this report we present the case of a 19-year-old woman who was admitted to hospital due to an intense pain of the left gluteofemoral region and the symptoms of toxic shock. For 5 days before admission to hospital the patient had a strong pain and fever, up to 40 degrees C, treated with high doses of nonsteroidal anti-inflammatory drugs administered by oral and intramuscular routes. During the next 20 hours a large oedema of the left femoral region developed, the skin became purplish, and bullae filled with the hemorrhagic fluid appeared. On the group of typical skin changes, results of computed tomography and findings during surgical treatment necrotizing fasciitis was recognized. The patient was transferred by plane to the National Center of Hyperbaric Medicine Institute of Sea and tropical medicine where she was successfully treated with hyperbaric oxygen therapy. In this paper we discuss the problem of the association between the use of nonsteroidal anti-inflammatory drugs, chronic stress and the development of necrotizing fasciitis.- - - - - - - - - - ranking = 0.001102476720665keywords = fever (Clic here for more details about this article) |
3/44. An overdose of ecstasy. A role for dantrolene.An overdose of the semisynthetic, hallucinogenic amphetamine 3,4-methylenedioxymethamphetamine resulted in convulsions, hyperthermia, hyperkalaemia and rhabdomyolysis. The patient's management, which included the use of dantrolene, is discussed.- - - - - - - - - - ranking = 1keywords = hyperthermia (Clic here for more details about this article) |
4/44. Paramethoxyamphetamine (PMA) poisoning; a 'party drug' with lethal effects.Among young people in norway the recreational use of amphetamine derivatives seems to be increasing. Methylenedioxymethamphetamine (MDMA), known as ecstasy, is the dominant substance, having both stimulant and psychedelic properties. Depending on the illegal source of these so-called 'party drugs' the content and purity can vary. This case report describes the first lethal case of paramethoxyamphetamine (PMA) and paramethoxymethamphetamine (PMMA) intoxication reported in norway. A 16-year-old male was admitted to a local hospital in a coma with seizures and hyperthermia after he had been found undressed and barefooted in a local forest (temperature 2 degrees C). He was intubated and given supportive care. blood chemistry revealed hypoglycaemia, hypocalcaemia and hyperkalaemia. Shortly after transfer to the central hospital he developed bradycardia with continuous seizures and asystole. Adverse effects of MDMA are well described and include serotonergic and sympathomimetic symptoms with hyperthermia, coagulopathy, rhabdomyolysis and acute kidney and liver failure. case reports of PMA deaths collectively suggest PMA to be more toxic than MDMA. A delayed effect after intake of PMA compared with MDMA can lead to increased intake. Hypoglycaemia and hyperkalaemia may be specific to PMA poisoning. Increased thermo genesis will result in a search for cooling, which explains the attempt to undress and a desire to submerge in water. In a cool climate this behaviour itself can be lethal. Measures to treat seizures, hypoglycaemia, electrolyte anomalies and hyperthermia are the therapeutic goals. No specific treatment is available.- - - - - - - - - - ranking = 3keywords = hyperthermia (Clic here for more details about this article) |
5/44. Cocaine induced eosinophilic lung disease.A patient developed fever, bronchoconstriction, hypoxaemia, pulmonary infiltrates, and serum and bronchoalveolar lavage fluid eosinophilia on two occasions after inhaling crack cocaine. Transbronchial biopsy specimens showed normal lung parenchyma but a dense eosinophilic infiltrate within the bronchial wall. Both episodes resolved promptly after treatment with corticosteroids. Eosinophilic lung disease may be a steroid responsive complication of crack cocaine abuse.- - - - - - - - - - ranking = 0.001102476720665keywords = fever (Clic here for more details about this article) |
6/44. Pulmonary complications from alveolar accumulation of carbonaceous material in a cocaine smoker.A 27-year-old woman presented with cough, fever, and pulmonary infiltrates after heavy cocaine smoking. Large amounts of carbonaceous material and pigment-laden macrophages were recovered by bronchoalveolar lavage. Alveolar deposition of particulate matter from heavy cocaine smoking has not been previously reported and may have been the cause of this patient's symptoms and abnormal findings on chest radiograph.- - - - - - - - - - ranking = 0.001102476720665keywords = fever (Clic here for more details about this article) |
7/44. Methylenedioxymethamphetamine (ecstasy)-related hyperthermia.MDMA (or 3, 4 methylenedioxymethamphetamine) was first manufactured in the 1920s and found to have structural similarities to both mescaline and amphetamines. Used briefly by some therapists in the 1970s and early 1980s as an adjunct to psychotherapy, it is now primarily abused by teenagers and young adults as an illicit recreational drug known as "ecstasy." As its popularity has increased, so have the number of fatalities and adverse events related to its use. We report six patients suffering fatal or life-threatening hyperthermia after MDMA use. These cases illustrate that hyperthermia associated with MDMA use cannot be solely attributed to rave parties (high ambient temperatures, excessive dancing, dehydration, and overcrowded conditions), drug contaminants, or co-ingestants. A better understanding of the etiology of hyperthermia after MDMA use is needed so that appropriate harm-reduction measures can be developed and instituted.- - - - - - - - - - ranking = 7keywords = hyperthermia (Clic here for more details about this article) |
8/44. Repeat episodes of severe muscle rigidity in a child receiving sevoflurane.We report on a patient who developed two episodes of severe muscle rigidity, increased endtidal CO2 and increased creatine phosphate kinase associated with sevoflurane anesthesia. Dysrhythmias and hyperthermia were not observed and dantrolene was not administered. genetic testing for the 17 known mutations associated with malignant hyperthermia (MH) was negative. Although we cannot rule out MH or other neuromuscular diseases we suggest that this rare event may be a direct effect of sevoflurane.- - - - - - - - - - ranking = 2keywords = hyperthermia (Clic here for more details about this article) |
9/44. Thrombotic thrombocytopenic purpura first seen as massive vaginal necrosis.Thrombotic thrombocytopenic purpura is a hematologic disorder that affects the microcirculation. A 38-year-old woman was first seen with fever, thrombocytopenia, and vaginal bleeding. Pelvic examination revealed massive vaginal necrosis. hematology consultation resulted in agreement with the diagnosis of thrombotic thrombocytopenic purpura. This is the first reported case of thrombotic thrombocytopenic purpura first seen as vaginal necrosis of which we are aware.- - - - - - - - - - ranking = 0.001102476720665keywords = fever (Clic here for more details about this article) |
10/44. Crack lung: an acute pulmonary syndrome with a spectrum of clinical and histopathologic findings.In this report, we review the hospital course of four patients who presented with an acute pulmonary syndrome after inhaling freebase cocaine and compare them with previously described case reports. Two patients had prolonged inflammatory pulmonary injury associated with fever, hypoxemia, hemoptysis, respiratory failure, and diffuse alveolar infiltrates. Lung tissue specimens from both patients revealed diffuse alveolar damage, alveolar hemorrhage, and interstitial and intraalveolar inflammatory cell infiltration notable for the prominence of eosinophils. Immunofluorescent staining performed on one of the biopsy specimens showed a striking deposition of IgE in both lymphocytes and alveolar macrophages. Both patients were treated with systemic corticosteroids and rapidly improved. In contrast, two patients presented acutely with diffuse pulmonary alveolar infiltrates associated with dyspnea and hypoxemia, but without fever, and within 36 h of discontinuing cocaine their pulmonary infiltrates and symptoms had spontaneously resolved. Our report further supports the finding that an acute pulmonary syndrome can occur after inhalation of freebase cocaine. Furthermore, the lung injury may respond to systemic corticosteroid therapy when it is associated with a prominent inflammatory cell infiltration.- - - - - - - - - - ranking = 0.00220495344133keywords = fever (Clic here for more details about this article) |
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