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At least 613 records · Page 34Linked to original sources
PubMed2006

Case report: hexachloroethane smoke inhalation: a rare cause of severe hepatic injuries.

CONTEXT: We report on two patients, a 23-year-old man and a 24-year-old man, who had chemical pneumonitis and respiratory distress after inhaling hexachloroethane/zinc oxide (HC/ZnO) smoke during military training. CASE PRESENTATION: The patients had been healthy previously and denied any history of alcohol or drug abuse. Hematologic tests revealed leukocytosis with neutrophils predominant. The respiratory conditions of both patients improved after steroid therapy and oxygen support, but deterioration of liver function was found. The laboratory results showed that alanine aminotransferase (ALT) and gamma-glutamyl transpeptidase levels were elevated about 1.5-fold the normal limits and that aspartate aminotransferase (AST) levels were marginally elevated. The elevation of liver aminotransferase started from day 1 and day 2 and peaked from day 18 to day 22. ALT/AST levels then returned to normal in 6 weeks. Common viral hepatitis was ruled out after serologic tests. Abdominal sonography and physical examination failed to show any specific findings. DISCUSSION: The hepatotoxic effect was attributed to inhalation of high-concentration HC/ZnO smoke in an enclosed area, where several hepatotoxicants, including ZnCl2, HC, and chlorinated vapors, could have been generated and mixed in the smoke. RELEVANCE TO CLINICAL PRACTICE: These case reports elaborate the hepatic effects that may occur in addition to pulmonary effects of HC/ZnO smoke.

Adult↗
PubMed1984

Tolerance and reverse tolerance to toluene inhalation: effects on open-field behavior.

Rats were exposed by inhalation to extremely high concentrations of toluene vapors twice daily for six weeks, as an animal model of organic solvent abuse. At preset intervals during repeated exposure, the rats were exposed to test concentrations of toluene and effects on behavior in an open field were measured. Concentration-effect curves were determined during Weeks 4 to 6 of repeated exposure. Tolerance to toluene was measured as a decreased response to the test exposure and a shift of the concentration-effect curve to the right. Reverse tolerance was measured as an increased response to the test exposure and a shift shift of the concentration-effect curve to the left. Results demonstrated that the effects of repeated exposure to toluene showed behavioral selectivity: tolerance developed to ataxia, hindlimb myoclonus, and inhibition of rearing, whereas reverse tolerance developed to headshakes and increased locomotor activity.

Animals↗
PubMed1996

Clinical characteristics and diagnostic delay of head and neck cancer: results from a prospective study in Belgium.

A prospective study of head and neck cancer patients was started to gather information about topographic and clinical characteristics of head and neck cancer, alcohol and nicotine abuse and the delay in diagnosis. More than half of the patients consulted our institution with an advanced stage of disease. As was expected, we found a positive association between the size of the tumour and the clinical stage of the neck. Concerning nicotine and alcohol abuse, our results support the hypothesis that tobacco smoking is more strongly associated with lesions in sites heavily exposed to inhaled smoke, whereas alcohol consumption has a stronger effect on structures belonging to the 'food channel' and reservoir systems. We found no association between delay and tumour stage at diagnosis, but a statistically significant correlation was found between the delay and the tumour site. This leads us to conclude that the tumour stage is determined mostly by the biology of the tumour.

Adult↗
PubMedDate not supplied

Analysis of diacetylmorphine, caffeine, and degradation products after volatilization of pharmaceutical heroin for inhalation.

Pharmaceutical smokable heroin was developed for a clinical trial on medical co-prescription of heroin and methadone. This product, consisting of 75% w/w diacetylmorphine base and 25% w/w caffeine anhydrate, was intended for use via "chasing the dragon", that is, inhalation after volatilization. This procedure involves heating the powder mixture, which may lead to formation of degradation products that could subsequently be inhaled. We developed a method that used a high-performance liquid chromatography system that was compatible with photodiode-array detection and mass spectrometric detection to separate diacetylmorphine- and caffeine-related compounds in a wide polarity range for analysis of the vapor. This method was used to analyze the contents of the plastic drinking straws that were used by patients to inhale the vapors from pharmaceutical heroin used via chasing the dragon, which were considered to be representative of the vapors the patients inhaled. They contained primarily unchanged diacetylmorphine, its main metabolite 6-acetylmorphine, caffeine, and some morphine. Several unidentified peaks were observed in the straw chromatograms. Chemical structures were proposed for nine degradation products: morphine derivatives with different substitution patterns of the C(3), C(6), and/or N(17) positions, which comprised 0.4-9.7% of the straw sample residue weight. Activity and toxicity of most of these compounds are unknown and require further investigation.

Caffeine↗
PubMed1978

Polyneuropathy from inhalation of N2O cartridges through a whipped-cream dispenser.

A generalized toxic polyneuropathy was identified in a 23-year-old woman after excessive intentional inhalation of compressed N2O delivery from cartridges through a whipped-cream dispenser. The chronology of the patient's N2O abuse correlated clearly with two episodes of recurrent polyneuropathy. The toxic effects were limited to the nervous system, primarily involving the peripheral nerves, although some signs suggested a possible effect on the cerebellum or its connections. The findings on sural nerve biopsy were nonspecific, characterized principally by axonal degeneration. Gas chromatographic analysis of the N2O cartridges dispensed through the whipped-cream canister revealed an exposure to N2O and 26 other compounds. Three of these, trichloroethylene, toluene, and phenol, are known neurotoxins.

Adult↗
PubMed1992

Recreational propane inhalation in an adolescent male.

Propane inhalation may be widespread, yet only a few cases have been reported. The victims were usually found dead, and only one other report describes firsthand the sought-after effects. We report on a 17 year-old male with a six month history of repeated inhalation. The patient manifested no pathophysiologic signs, but the ready availability of propane may result in an increase in its abuse. This activity carries considerable risk for trauma and/or sudden death. Our patient was able to recruit others to the practice by finding ways to avoid some of the unique, inherent deterrents.

Adolescent↗
PubMed2005

Texas poisonings at the beginning of the 21st century: 2000 through 2002.

Human exposure calls to poison centers may vary by geographic region. This investigation compared the pattern of human exposure calls to Texas poison centers with calls to those in other states from 2000 through 2002. Although the total number of human exposure calls increased for both Texas and non-Texas poison centers, the increase was twice as great for those in Texas. Patients in Texas human exposure calls tended to be younger. Texas calls were more likely to involve bites and stings, suspected suicides, and intentional abuse exposures and were less likely to involve unintentional environmental exposures. Texas exposures were less likely to occur by dermal, inhalation, and ocular routes. Texas patients were more likely to be treated with decontamination. The death rate from poisoning was slightly lower in Texas. Knowledge of the human exposure calls to particular poison centers allows the poison centers to use their resources most efficiently.

Adolescent↗
PubMed1994

Addiction medicine.

There are indications of a rise in the percentage of eighth graders who have tried marijuana and inhalants. A low level of response to alcohol challenge may be a marker for future alcoholism. Anabolic-androgenic steroid abuse is being discussed more often in the context of substance abuse.

Humans↗
PubMed1984

[Chloroform sniffing: a new variant of substance abuse].

The nearly fatal outcome of a case of chloroform sniffing is described. After a brief review of the organ toxicity of chloroform, a potential therapeutic approach is discussed. Inhalation anesthetics should be considered in the differential diagnosis of coma of unknown etiology in the adolescent.

Adolescent↗
PubMed1995

[National study of drug habits in Uruguay].

The results of a prevalence study of alcohol abuse and drugs use in the general population of the República Oriental del Uruguay are showed here. A national household sample was drawn from the most important urban areas and 2500 persons, aged between 15 and 65 years, were selected and interviewed. Illicit substances use (include use of any of the following: marihuana, cocaine, inhalants, hallucinogens) reached 4.5% for the lifetime prevalence period, 1.1% in the last twelve months and 0.7% for the last thirty day. Twenty percent of the sample classified for tobacco dependence, and alcohol abuse, in the last 30 days, was 19.5%. Significant associations, by sex and age, were found.

Adolescent↗
PubMed1991

Effects of carbamazepine on acute responses to smoked cocaine-base in human cocaine users.

A double-blind, placebo-controlled cross-over study was conducted to determine the effects of carbamazepine on the acute physiological and subjective responses to a single dose of smoked cocaine-base. Male cocaine users (N = 6) were given 400 mg carbamazepine or placebo, each for a period of 5 days. At the end of the 5-day period, a 40 mg dose of smoked cocaine was administered. The results showed a significantly higher heart rate, diastolic blood pressure elevation, and blood pressure-heart rate product under the carbamazepine compared to the placebo condition. There were no effects of carbamazepine on the subjective responses from cocaine. The increase in cardiovascular functions indicates a need to be cautious in the use of carbamazepine in the treatment of cocaine abusers.

Administration, Inhalation↗
PubMed2002

Integrated approaches to the action of general anesthetics and alcohol.

The use of inhalational anesthetics was first publicly demonstrated in 1846. Alcohol has been consumed for centuries and is now our most costly drug abuse problem. Despite widespread use, the molecular mechanism of action of these drugs has remained an enigma. The prevailing theory suggests that alcohol and anesthetics interact directly with neuronal membrane proteins to cause their effects. Our laboratories are using a variety of cutting edge approaches to gain insight into the mechanism of action of these drugs. Biophysical approaches such as high-resolution nuclear magnetic resonance (NMR) spectroscopy and genetic engineering approaches such as creation of designer mice are currently being used by our laboratories. These approaches are providing exciting insight into how these drugs exert their effects. This research could ultimately result in safer and better anesthetics, may lead to treatments for alcoholism, and may provide insight into basic biologic processes such as consciousness.

Anesthetics, General↗
PubMedDate not supplied

Management of the pediatric patient with burns.

Two million people in the United States receive medical treatment each year for burn injuries. One hundred thousand of these patients are hospitalized, and 7800 die as a direct result of their injuries. Of the patients that are hospitalized 30% to 40% are under 15 years of age. Sixty-seven percent are male. The average age of children with burns is 32 months. Flame burns account for approximately 13% of accidents, scalds account for 85%, and electrical and chemical burns account for approximately 2%. The majority of scald injuries are small. Sixteen percent of burn injuries are not accidental, and approximately half of these are a result of documentable, inflicted abuse.

Biological Dressings↗
PubMed1988

Mephentermine dependence with psychosis. A case report.

Dependence on mephentermine, a widely used sympathomimetic pressor agent, is so far unreported, although misuse of inhalers is recognised. A case of mephentermine dependence associated with chronic psychosis is reported here. Psychosis initially surfaced with chronic dexamphetamine abuse, but was sustained for 3 years by mephentermine. After a period of remission lasting for 4 years, the patient again developed psychosis on restarting abuse of mephentermine, which lasted for 5 years.

Adult↗
PubMedDate not supplied

[Cannabinoid intake by passive smoking].

The presence of cannabinoids in the urine can be produced by passive inhalation of hashish resp. marihuana smoke. The height depends on the intensity of exposure. Under extreme conditions concentrations between 40 to 50 ng/ml of cannabinoids had been found in the urine. In regard to the maximum variation-coefficient of the immunoassay methods, which is about 30%, we think it is useful to define a threshold value of 65 ng/ml of cannabinoids to distinguish between active and passive inhalation.

Adult↗
PubMed2006

Metabolic correlates of toluene abuse: decline and recovery of function in adolescent animals.

RATIONALE: Children and adolescents will readily abuse household products that contain solvents such as toluene. It is likely that reinforcing exposures to toluene alter brain glucose metabolism. OBJECTIVE: Using an animal model of drug reinforcement, we sought to identify a metabolic signature of toluene abuse in the adolescent rodent brain. Small animal PET (microPET), in combination with the glucose analog radiotracer, (18)FDG, were used to evaluate the metabolic consequences of inhaled toluene. METHODS: The exposure protocol paralleled our previously established method for assessing the conditioned reinforcing effects of toluene (5,000 ppm) using the conditioned place preference (CPP) paradigm. Animals were scanned at baseline and 2 h after the last exposure. Follow-up (18)FDG scans occurred 1 day, 3 weeks, and 2 months later. RESULTS: After six pairings, 38% of the animals preferred the toluene paired chamber and 25% were averse. The immediate metabolic effect in toluene-exposed animals was a 20% decline in whole brain (18)FDG uptake. Twenty-four hours following the last exposure, the whole brain decline was 40%, and 2 months later, the decline was 30% of pretoluene levels. A region-by-region analysis demonstrated significant additional decreases in the pons, cerebellum, striatum, midbrain, temporal cortex, and hippocampus. Two months after toluene cessation, regions of complete metabolic recovery were the thalamus and cerebellum; however, the temporal cortex did not recover. CONCLUSIONS: Brain uptake of (18)FDG appears to be a useful tool for examining the metabolic impact of toluene abuse, which include a profound decline followed by region-specific recovery after cessation.

Animals↗