heroin and Carbon-Monoxide-Poisoning

Leukoencephalopathy is a syndrome of neurologic deficits, including alteration of mental status, caused by pathologic changes in the cerebral white matter. The term, toxic leukoencephalopathy, encompasses a wide variety of exposures and clinical presentations. The diagnosis in these Frontiers in Clinical Neurotoxicology syndromes is made by careful attention to the history, clinical features, and radiologic findings. This article details three of the best-defined toxic leukoencephalopathies: delayed posthypoxic leukoencephalopathy, including delayed neurologic sequelae after carbon monoxide poisoning; heroin inhalation leukoencephalopathy; and posterior reversible encephalopathy syndrome.

Topics: Administration, Inhalation; Carbon Monoxide Poisoning; Heroin; Humans; Hypoxia; Leukoencephalopathies; Neuroimaging; Posterior Leukoencephalopathy Syndrome; Prognosis; Radiography

Leukoencephalopathy is a syndrome of neurologic deficits, including alteration of mental status, caused by pathologic changes in the cerebral white matter. The term, toxic leukoencephalopathy, encompasses a wide variety of exposures and clinical presentations. The diagnosis in these syndromes is made by careful attention to the history, clinical features, and radiologic findings. This article details three of the best-defined toxic leukoencephalopathies: delayed posthypoxic leukoencephalopathy, including delayed neurologic sequelae after carbon monoxide poisoning; heroin inhalation leukoencephalopathy; and posterior reversible encephalopathy syndrome.

Topics: Carbon Monoxide; Carbon Monoxide Poisoning; Heroin; Humans; Leukoencephalopathies

A spongiform leucoencephalopathy sometimes develops as a result of inhaling illicit heroin as well as due to carbon monoxide-intoxication. Clinically psychiatric symptoms precede a neurological deterioration. Some patients die. After a brief description of several epidemiological and historical-cultural aspects regarding the smoking of opiates, the typical neuroradiological signs such as hypodensity of the white matter in CCT and signal alterations in MRT, and neuropathological sequelae such as intramyelinic vacuolisation are listed. Pathophysiologically an edema of the white matter in the beginning is suspected. Second, a dysfunction of the mitochondria is addressed relying on the particular metabolism of the oligodendrocytes. Since smoking of heroin is an increasingly preferred way of application in all continents and therapeutic options are still lacking, the need of further explanation of the underlying processes is stressed.

Topics: Administration, Inhalation; Brain; Brain Diseases; Carbon Monoxide Poisoning; Heroin; Heroin Dependence; Humans; Magnetic Resonance Imaging; Tomography, X-Ray Computed

During acute intoxications rhabdomyolysis appear with a great clinical polymorphism. The muscular involvement is not always evident because of its shortness and latence. Practically the problem is one of localised muscle damage, hyperkaliema or acute renal insufficiency. The serum isoenzymes of CPK levels, the presence of myoglobinuria are necessary for the diagnosis. The most serious rhabdomyolysis depend on the added injury of respiratory muscles and myocardium. Many toxic substances can involve rhabdomyolysis but the most frequent ones are sedatives, carbonic oxyde, ethanol. Only the complications are treated.

Topics: Alcoholic Intoxication; Anesthesia, General; Animals; Carbon Monoxide Poisoning; Foodborne Diseases; Glycyrrhiza; Heroin; Humans; Hypnotics and Sedatives; Muscles; Myoglobinuria; Plants, Medicinal; Poisoning; Quail; Succinylcholine

Topics: 1-Propanol; Alcoholic Intoxication; Amphetamine; Carbon Monoxide Poisoning; Chloral Hydrate; Chlordiazepoxide; Dextropropoxyphene; Diazepam; Ethchlorvynol; Glutethimide; Heroin; Humans; Meprobamate; Methadone; Methanol; Morphine; Orphenadrine; Paraldehyde; Pentazocine; Phenothiazines; Phenytoin; Poisoning; Quinine; Salicylates; Toxicology; Tranquilizing Agents

Studies on the mortalities of drug abusers in China are scarce. This study explores the deaths of methamphetamine, opioid, and ketamine abusers in Shanghai (2004-2017) and Wuhan (2005-2017). Chi-square/Fisher's exact tests were used to compare the differences in terms of region, gender, age, cause of death, and the method used in the last drug abuse. Poisson regression models were used to estimate the rate ratios ("RRs") and annual percentage changes ("APCs"). 314 heroin, 43 methamphetamine, and 4 ketamine abusers were included. Furthermore, simultaneously, 6 abusers used heroin and methamphetamine, and 7 abusers used methamphetamine and ketamine. Heroin-related deaths have declined in Shanghai (APC, -16.1; 95 % CI, -18.4 to -11.3) and Wuhan (APC, -16.0; 95 % CI, -18.9 to -10.6), whereas methamphetamine-related deaths have increased in Wuhan (APC, 12.8; 95 % CI, 0.0 to 29.2). On the whole, in the two cities, males were more frequently observed than females in heroin-related deaths (4.4, 230/52). However, the gender ratios for methamphetamine- (1.8, 34/19) and ketamine-related deaths (1.2, 6/5) were close to one. In view of the mortality rates of the drug abusers in most Chinese cities were still unclear, it is thus important to improve mortality surveillance of the drug abusers at the national level.

Topics: Adolescent; Adult; Age Distribution; Analgesics, Opioid; Carbon Monoxide Poisoning; China; Female; Heroin; Humans; Illicit Drugs; Ketamine; Male; Methamphetamine; Middle Aged; Sex Distribution; Substance-Related Disorders; Suicide; Young Adult

To provide references for forensic expertise by investigating the kinds of toxicant, routes of exposure and manners of poisoning deaths, etc.. Six hundred and seven autopsy cases of poisoning deaths from 1957 to 2008 in Department of Forensic Medicine, Tongji Medical College (Tongji Forensic Science Identification Center of Hubei), were comparatively reviewed.. In 218 cases from 1999 to 2008, more than 50% of decedents were male in the ages of 30-49. The toxicants are usually taken orally and the most common manner of death was accidental. The common substances involved in poisoning death were rodenticide, poisoning gas and insecticide. Compared to the data of 1983-1998 and 1957-1982, the common toxic agents had changed significantly. The number of cases involving insecticide and cyanide poisoning decreased in recent years, and the number of cases of rodenticide, poisoning gas, alcohols poisoning displayed an increase tendency, especially for drugs abuse.. Poisoning deaths of pesticides remain a major public health problem for a long time and the awareness of prevention need to be raised, especially for the prevention of deaths from multiple poisons.

Topics: Accidents; Adolescent; Adult; Age Distribution; Aged; Alcoholic Intoxication; Anesthetics; Autopsy; Carbon Monoxide Poisoning; Cause of Death; Child; Child, Preschool; China; Female; Forensic Medicine; Heroin; Humans; Hypnotics and Sedatives; Infant; Male; Middle Aged; Pesticides; Poisoning; Retrospective Studies; Rodenticides; Sex Distribution; Suicide; Young Adult

Topics: Aged; Autopsy; Barbiturates; Blister; Carbon Monoxide Poisoning; Female; Heroin; Humans; Male; Middle Aged; Skin Manifestations