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 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This paper presents the results of a retrospective study of 1,382 patients admitted to the Narcotics Treatment Centre for Hill Tribes in Thailand, which was operated by the WHO/UN/Thai Programme for Drug Abuse Control. The study revealed widespread opium addiction among the hill tribes. Of these, the Karen were the largest group. Mean age on admission for treatment was 35 years. The male:female ratio was 7:1. Sixty-six per cent were heads of households. About one-third came from households with more than one addict. The mean duration of daily opium use before admission was 7.9 years. Over 90% of them were addicted to opium; there were eight heroin users. The mean amount of opium used daily was 3.9 g for males and 3.2 g for females. About three-quarters of them used salicylate analgesics with opium. Illness, in particular abdominal pain, was the most frequent cause of their addiction.
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PMID:Hill tribe opium addicts: a retrospective study of 1,382 patients. 16 Aug 9

Bulimia is an eating disorder characterized by binge eating followed by purging, i.e. self-induced vomiting, abuse of cathartic or diuretic drugs, increased activity or periods of restrictive dieting. Studies show that persons with bulimia are prone to a number of medical complications as a result of binge-eating, vomiting and drug abuse. Vomiting is the most harmful in terms of medical risk, and also the most common source of complications. Both vomiting and purging lead to loss of body fluids and electrolytes, often resulting in hypokalemia. Vomiting also leads to sore throats and dental problems such as destruction of enamel. Gastric dilatation is the only complication directly associated with binge-eating. Harmless symptoms, such as abdominal pain, diarrhoea, constipation and neuromuscular symptoms are common. This article discusses the pathophysiology behind the complications and their treatment.
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PMID:[Somatic and biochemical complications in bulimia]. 218 71

The superior mesenteric artery is a frequent site of mycotic aneurysm formation. With the increasing popularity of parenteral drug abuse the incidence of superior mesenteric aneurysms is likely to increase. It should be suspected in any patient who has a history of bacterial endocarditis, sepsis, and abdominal pain. Abdominal CT scanning and visceral angiography are most useful in establishing the diagnosis, and surgical therapy should ensue with minimal delay. The various intraoperative methods of eradicating this lesion are described, with a review of the literature and report of successful management of one such case.
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PMID:Mycotic aneurysm of the superior mesenteric artery. 359 85

We discuss the case of a 24-year-old black woman at 33--34 weeks gestation, who after intravenous injection of Talwin presented with the following symptom complex: pyrexia, nausea, vomiting, shaking, chills, headache, myalgias, polyarthralgias, severe abdominal pain and "contractions." This symptomatology presents a complex diagnostic problem. Systematic laboratory evaluation eliminated more common etiologies, i.e., sub-acute bacterial endocarditis, HAA + hepatitis, placental abruption, chorioamnionitis, and urinary tract infection. The Talwin had been filtered through cotton ball. History plus exclusion of other etiologies led to the diagnosis of "cotton fever." The available literature is reviewed, and the importance of recognizing this entity when servicing a pregnant population with a high rate of drug abuse is discussed.
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PMID:Cotton fever and pregnancy. A confusing clinical problem. 721 12

Five cases of acalculous cholecystitis associated with Cryptosporidium intestinal infection in HIV infected patients are reported. Clinical, Biological and Microbiological features as well as imaging studies are described. All the patients were males. Risk factors for HIV infection included previous I.V. drug abuse (3), homosexuality (1) and unknown (1). On admission a similar history of weight loss, fever, abdominal pain, diarrhea, anorexia and asthenia, together with biological data of cholestasis, was present in all patients. Ultrasound studies showed a distended gallbladder without calculi and a thickened wall, the bile duct being dilated in four of five cases. Cryptosporidium were found in stool specimens of all patients as well as histologically in one of two patients who underwent surgery while CMV was shown in the other one. Endoscopic retrograde cholangiography was performed in four cases showing a congestive, edematous and protruded papila in three patients, being normal in the fourth with a choledocal stenosis.
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PMID:[Acalculous cholecystitis and intestinal cryptosporidiosis: frequent association in HIV patients]. 757 11

A 33 year old patient was admitted to the hospital because of deteriorated general condition, upper abdominal pain and progressive dyspnea. He had a positive HIV-serology associated with i.v. drug abuse. The CDC classification on admission was B1. There was no history of opportunistic infections, the patient had refused all prophylactic treatment. The physical examination showed an elevated central venous pressure, decreased breath-sound and percussible dullness, the liver was enlarged and a tumor was palpable on chest. The x-ray of the thorax confirmed a pleural effusion. Cytology of the effusion revealed blasts of malignant non-Hodgkin's lymphoma of B-cell type. A CT-scan of the thorax and abdomen showed a tumor mass in the right ventricle and superior vena cava, a pleural effusion and multiple lesions in the liver. The patient refused a palliative chemotherapy with vincristine and prednisone and died few days after admission.
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PMID:[Upper influx distension in a patient with HIV; unusual localization of an HIV-associated lymphoma]. 784 32

The entity of delayed splenic rupture represents an initially missed injury, a delayed presentation of the latter, or an actually delayed development of an initially latent, minor, splenic injury. Having encountered a number of patients presenting with splenic rupture days after what was considered a minor abdominal trauma we review our experience with this entity. This is a retrospective study. During the past 6 years 26 patients were treated at our level II trauma center for blunt splenic injuries. The 8 patients who presented 48 h or more after injury are the focus of this communication. All patients had an underlying medical condition: five were drug addicts (one was HIV positive) and the other three were affected by cirrhosis, sickle cell disease, and HIV. The mechanisms of injury were as follows: blunt assault in 5 patients, a fall in 2 patients, and unknown in 1 patient. The patients presented to our hospital after a mean lag time of 5 days after injury (range, 2-10 days). One patient presented in shock and underwent laparotomy after a positive diagnostic peritoneal lavage. Four presented with a clinical acute abdomen, and three presented with abdominal pain and anemia. Abdominal computed tomography (CT) was performed in the seven hemodynamically stable patients demonstrating hemoperitoneum in all: five had a grade III injury and two had a grade II injury. All patients survived after an emergency splenectomy. Delayed presentation of splenic injury after minor abdominal trauma is not uncommon in our indigenous population. It may be associated with drug abuse and HIV.
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PMID:Delayed presentation of splenic injury: still a common syndrome. 1222 14

We present here a case of sepsis due to infectious endocarditis in a methamphetamine abuser. A 32 year-old male presented high fever and abdominal pain last two weeks. He was admitted to the hospital on the diagnosis of infectious endocarditis. In the evening on the day of admission, he suddenly collapsed. Despite of cardiopulmonary resuscitation, his death was confirmed. From the autopsy findings, toxicological analysis and results of the microbiological examination, we concluded that the cause of death was septic shock due to infectious endocarditis, presumably based on the methamphetamine abuse. The result obtained from microbiological examination gave us useful information. We shall have to be on the lookout, not only for acute poisoning, but also for cases of drug abuse related deaths.
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PMID:An autopsy case of infectious endocarditis in a methamphetamine abuser usefulness of microbiological examination. 1596 86

Chronic pancreatitis is a progressive inflammatory condition characterized by repeated attacks of abdominal pain, and the destruction and fibrosis of the pancreatic parenchyma which causes to reduced exocrine and endocrine functions. Alcohol is the most common cause of chronic pancreatitis. Although abstinence is usually considered a prerequisite for successful treatment of alcoholic chronic pancreatitis, we often encounter patients who have repeated attacks from the compensated stage through the transitional stage. In alcoholic chronic pancreatitis, continued alcohol consumption causes changes in the digestive hormones and vagal nerve function that induce the pancreatic acinar cells to oversecrete protein, increasing the protein concentration and viscosity of the pancreatic juice. This induces protein sedimentation from the pancreatic juice and formation of protein plugs within the pancreatic duct, triggering repeated attacks of acute pancreatitis. The treatment of alcoholic chronic pancreatitis includes alleviation of symptoms, particularly abdominal pain, elimination of trigger factors, prevention of recurrence and disease progression, adjuvant therapies for pancreatic exocrine and endocrine failure. Recently, the main constituent proteins in these protein plugs have been identified, enabling trials of several therapies, such as the administration of secretin formulations and endoscopic removal. Bromhexine hydrochloride, a bronchial mucolytic, has an affinity for the pancreatic acinar cells, inducing them to secrete pancreatic juice of low viscosity. In this review, we summarize the most recent thoughts about alcoholic chronic pancreatitis, and the new treatments, and in particular, we present our findings concerning the efficacy of bromhexine hydrochloride in the treatment of this disease.
Curr Drug Abuse Rev 2008 Jun
PMID:Recent developments in the treatment of alcoholic chronic pancreatitis. 1963 Jul 18

Depression is one of the most prevalent mental disorders, according to Hungarian and international data. In Western- Europe, lifetime prevalence of major depression is 13%, while one-year prevalence is 4%. The prevalence of severe depressive symptoms is similar in Hungary: approximately 5 to 8% of all patients seen by primary care physicians suffer from some kind of depressive disorders. Depression is more prevalent in women and in the elderly. According to the World Health Organization, depression is the third most common disabling disorder. Patients with depression experience impaired quality of life, anxiety, sleep disturbances, alcohol and drug abuse, and different somatic disorders. Furthermore, depression is the most important risk factor for suicide. Primary care physicians have a crucial role in the screening and diagnosing of depressive disorders. Depressive disorders can exist not only in patients complaining about depressed mood, but also in patients with "medically unexplained symptoms" (headache, fatigue, abdominal pain, gastrointestinal symptoms, weight change). Primary care physicians should have appropriate knowledge about the different therapeutic options (including various psychotherapies, antidepressant medications and other treatment options) to be able to treat their patients properly. We review the literature about the significance and epidemiology of depression and summarize the diagnostic and therapeutic options of depressive disorders in primary care practice.
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PMID:[Diagnosis and therapy of depression in family practice]. 1970 83


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