heroin and Brain-Injuries

Several mechanisms leading to noncardiac pulmonary edema have been reviewed. Common features are damage to and increased permeability of vascular endothelium, interstitial and alveolar edema fluid high in protein content, increased pulmonary vascular resistance and pressure, nondependent distribution of the edema and normal left atrial or wedge pressure. The available evidence suggests that in some instances the sites of leakage are the pulmonary arterial walls and, perhaps in some, overperfused, damaged capillary beds. Therapeutic obestives differ from those in cardiac pulmonary edema in that efforts are directed toward a reduction in pulmonary blood flow and pulmonary arterial pressure during the period that endothelial healing is taking place.

Topics: Altitude Sickness; Animals; Bacterial Infections; Brain Injuries; Capillaries; Capillary Permeability; Ethchlorvynol; Heroin; Humans; Hypersensitivity; Hypoxia; Lung; Paraquat; Pulmonary Alveoli; Pulmonary Artery; Pulmonary Edema; Respiratory Distress Syndrome; Ultrafiltration

Topics: Acute Disease; Brain Diseases; Brain Injuries; Chronic Disease; Gas Poisoning; Heart Diseases; Heroin; Humans; Hypersensitivity; Iatrogenic Disease; Infusions, Parenteral; Kidney Failure, Chronic; Mountaineering; Pulmonary Edema; Radiography; Renal Dialysis; Sympathomimetics

To evaluate regulation of the endoplasmic reticulum stress (ERS) response by acupuncture and to investigate its neuroprotective effect on brain injury caused by heroin addiction.. A total of 48 male Sprague-Dawley rats were randomly divided into a healthy control group (Control), an untreated heroin exposed group (Heroin) and a heroin exposed group receiving electroacupuncture (EA) treatment at GV14 and GV20 (Heroin+acupuncture) with n=16 rats per group. A rat model of heroin addiction was established by intramuscular injection of incremental doses of heroin for 8 consecutive days. A rat model of heroin relapse was established according to the exposure (addiction) → detoxification method. Apoptotic changes in nerve cells in the hippocampus and ventral tegmental area (VTA) were evaluated in each group of rats using terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL) assay. PERK, eIF2a, CHOP, IRE1 and JNK gene expression and protein expression were measured using quantitative real-time PCR (RT-qPCR) assay and immunohistochemical assay, respectively.. The total number of positive nerve cells in the hippocampus and VTA was significantly lower in the Heroin+acupuncture group than in the Heroin group (p<0.01). Compared with the Heroin group, mRNA and protein expression of PERK, eIF2a, CHOP, IRE1 and JNK in the hippocampus and VTA were significantly downregulated in the Heroin+acupuncture group (p<0.05).. The acupuncture-regulated ERS response appears to mediate the neuroprotective effect of acupuncture in heroin-addicted rats with brain injury. Inhibition of CHOP and JNK upregulation and reduction of nerve cell apoptosis may be the main mechanisms underlying the effects of acupuncture on heroin addiction-induced brain injury.

Topics: Acupuncture Therapy; Animals; Apoptosis; Brain; Brain Injuries; Disease Models, Animal; Electroacupuncture; Endoplasmic Reticulum Stress; Heroin; Heroin Dependence; JNK Mitogen-Activated Protein Kinases; Male; Neuroprotective Agents; Rats, Sprague-Dawley; Transcription Factor CHOP

The survival to discharge rate after unwitnessed, non-cardiac out-of-hospital cardiac arrest (OHCA) is dismal. We report the successful use of therapeutic hypothermia in a 26-year old woman with OHCA due to intentional poisoning with heroin, amphetamine and insulin.The cardiac arrest was not witnessed, no bystander CPR was initiated, the time interval from the call to ambulance arrival was 9 minutes and the initial cardiac rhythm was asystole. Eight minutes of advanced cardiac life support resulted in ROSC.Upon hospital admission, the patient's pupils were dilated. Her arterial lactate was 17 mmol/l, base excess -20, pH 6.9 and serum glucose 0.2 mmol/l. During the first 24 hours in the ICU, the patient developed maximally dilated pupils not reacting to light and became increasingly haemodynamically unstable, requiring both inotropic support and massive fluid resuscitation. After 1 week in the ICU, however, she made an uneventful recovery with a Cerebral Performance Category of 1 at hospital discharge and at a follow up examination at 6 months.. According to most prognostic factors, the patient had a statistical chance for survival of less than 1%, not taking into account her severe state of hypoglyaemia. We suggest that this case exemplifies the need for more studies on the use of TH in non-coronary causes of OHCA.

Topics: Adult; Amphetamine; Brain Injuries; Female; Heart Arrest; Heroin; Humans; Hypoglycemia; Hypothermia, Induced; Insulin; Prognosis

Grafting of neural progenitors has been shown to reverse a wide variety of neurobehavioral defects. While their role of replacing injured cells and restoring damaged circuitries has been shown, it is widely accepted that this cannot be the only mechanism, as therapy can occur even when an insufficient number of transplanted cells are found. We hypothesized that one major mechanism by which transplanted neural progenitors exert their therapeutic effect is by enhancing endogenous cells production. Consequently, in an allographic model of transplantation, prenatally heroin-exposed genetically heterogeneous (HS) mice were made defective in their hippocampal neurobehavioral function by exposing their mothers to heroin (10 mg kg(-1) heroin on gestation days 9-18). Hippocampal damage was confirmed by deficient performance in the Morris maze (P<0.009), and decreased production of endogenous cells in the dentate gyrus by 39% was observed. On postnatal day 35, they received an HS-derived neural progenitors transplant followed by repeated bromodeoxyuridine injections. The transplant returned endogenous cells production to normal levels (P<0.006) and reversed the behavioral defects (P<0.03), despite the fact that only 0.0334% of the transplanted neural progenitors survived and that they differentiated mainly to astrocytes. An immunological study demonstrated the presence of macrophages and T cells as a possible explanation for the paucity of the transplanted cells. This study suggests one mechanism for the therapeutic action of neural progenitors, the enhancement of the production of endogenous cells, pointing to future clinical applications in this direction by use of neural progenitors or by analogous cell-inducing techniques.

Topics: Animals; Animals, Newborn; Behavior, Animal; Brain Injuries; Bromodeoxyuridine; Cell Count; Cell Differentiation; Cell Proliferation; Disease Models, Animal; Female; Glial Fibrillary Acidic Protein; Heroin; Hippocampus; Male; Maze Learning; Mice; Neurons; Pregnancy; Prenatal Exposure Delayed Effects; Stem Cell Transplantation; Stem Cells; Time Factors

Topics: Altitude; Brain Injuries; Central Nervous System Diseases; Heart Failure; Heroin; Humans; Hypoxia; Pulmonary Edema; Shock; Substance-Related Disorders