phenylephrine-hydrochloride and Substance-Related-Disorders

Studies indicate that cocaine abuse in Denmark is rising. The drug can damage the midface's nasal tissues, cartilage, and bone. Diagnosing the cocaine-induced midline destructive lesions condition is difficult as patients may not admit to drug use. Thus, this review finds that physicians should ask about cocaine abuse in younger patients who present with midline destructions of unknown origin. Mild symptoms are reversible with total abstinence, which is why it is important to involve addiction services early. Besides drug abstinence, comprehensive treatment involves assistance from GPs, physiatrists, rhinologists, and plastic surgeons.

Topics: Cocaine; Cocaine-Related Disorders; Diagnosis, Differential; Humans; Nose; Substance-Related Disorders

Concern for illicit and restricted drug use in otolaryngology is similar to other surgical specialties with a few notable exceptions. Many illicit drugs are consumed transnasally. Repeated nasal exposure to stimulants or narcotics can cause local tissue destruction that can present as chronic rhinosinusitis or nasoseptal perforation. Further, the Food and Drug Administration has taken a stance against codeine for pediatric patients undergoing adenotonsillectomy. They have identified an increased risk of death postoperatively with these medications. Because codeine has been the most commonly prescribed narcotic, this has shifted the standard practice.

Topics: Analgesics, Opioid; Codeine; Drug Overdose; Humans; Illicit Drugs; Narcotics; Nasal Septal Perforation; Nose; Osteonecrosis; Otolaryngology; Substance-Related Disorders

Idiopathic midline destructive disease (IMDD) is a diagnosis of exclusion in patients who manifest midline nasal necrosis with no specific etiology such as infection, tumor, or Wegener's granulomatosis. Recently, a group of cocaine abusers has been identified that manifests a syndrome that mimics IMDD, but is less fulminant in its course. To better define the natural history of this syndrome, we reviewed the medical records, radiographs, and pathologic material from five such patients treated at the University of California, Los Angeles. Other causes of midline nasal destruction were excluded in each patient on the basis of histopathology, cultures, and laboratory tests. Biopsy material, available in four patients, demonstrated inflammation and necrosis without vasculitis. Treatment was conservative in four of the five patients, using antibiotics, local care, debridement, and cessation of cocaine use. During the follow-up period, progressive disease developed in one of the five patients, requiring radiation and steroid therapy. We conclude that the treatment of midline nasal destruction in cocaine abusers should initially be conservative, once other etiologies have been systematically excluded.

Topics: Adult; Cocaine; Female; Humans; Male; Nose; Nose Deformities, Acquired; Substance-Related Disorders; Tomography, X-Ray Computed

Topics: Adult; Carrier State; Cocaine; Humans; Male; Nose; Sepsis; Staphylococcal Infections; Substance-Related Disorders

Infection with strains of methicillin-resistant Staphylococcus aureus occurred in 40 patients at time of admission to a large urban hospital from March to December 1980. Community-acquired methicillin-resistant S. aureus infections occurred in 24 drug abusers and 16 nonabusers. Patients with infections had a longer mean hospitalization and previously had received antimicrobial therapy more frequently than control subjects. Drug abusers with infections had been treated with cephalosporins more often than control subjects (P less than 0.05). Phage typing of 32 isolates showed that 21 were linked by a common phage type (29/52/80/95). Transmission of methicillin-resistant S. aureus from community-acquired cases occurred in the hospital. By January 1981, methicillin-resistant S. aureus accounted for 30.6% of nosocomial S. aureus infections at Henry Ford Hospital. Methicillin-resistant S. aureus infection may arise in the community as well as in the hospital and has the potential to disseminate in both settings.

Topics: Adult; Cross Infection; Disease Outbreaks; Humans; Male; Methicillin; Nose; Staphylococcal Infections; Staphylococcus aureus; Substance-Related Disorders

Topics: Animals; Death, Sudden; Gasoline; Humans; Nose; Petroleum; Reflex; Substance-Related Disorders

Topics: Accidents, Traffic; Adult; Ethanol; Female; Fractures, Bone; Humans; Male; Mandibular Fractures; Maxillary Fractures; Nose; Prospective Studies; Substance-Related Disorders; Violence; Zygomatic Fractures

Topics: Humans; Mental Disorders; Nose; Substance-Related Disorders

Topics: Heroin; Humans; Morphine; Morphine Derivatives; Nose; Substance-Related Disorders

Topics: Humans; Mental Disorders; Nose; Nose Diseases; Substance-Related Disorders; Vasoconstrictor Agents

Topics: Humans; Nose; Sodium Chloride; Sodium Chloride, Dietary; Substance-Related Disorders

Topics: Humans; Mental Disorders; Nose; Substance-Related Disorders