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Query: UMLS:C0034067 (emphysema)
 11,506 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case is described of a young man who produced surgical emphysema of his left forearm using a 2-ml syringe with a modified needle. It is believed that this is the second reported example of this type of artefact. Other cases may occur with the present high incidence of drug abuse and increasing general access to syringes.
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PMID:Factitious subcutaneous emphysema: a case report. 85 41

Marked obstructive ventilatory impairment and diffusion disturbance were noted in two intravenous methylphenidate (Ritalin) abusers. In one patient, chest radiogram demonstrated pulmonary emphysema accompanied by bullae and atelectasis, and spontaneous pneumothorax was also present. The primary finding in the other patient was interstitial shadows. Both patients began to note dyspnea during exertion after about 10 years of use. Since radiography also disclosed pulmonary emphysema in an ex-companion of Ritalin abuse, and since the onset was at relatively young ages, these pulmonary disorders are considered to have been a result of intravenous Ritalin abuse. Intravenous drug abuse should be considered in patients with precocious emphysema or obstructive ventilatory impairment accompanied by diffusion disturbance.
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PMID:[Two cases of chronic respiratory failure in intravenous methylphenidate (Ritalin) abusers]. 140 6

Many studies of age-related cognitive decline have failed to distinguish between usual and successful aging. Although some degree of cognitive impairment is associated with aging, when one looks at average performance, there is great variability among individuals, with many showing little or no deleterious effects of aging on intellectual abilities. Many of the risk factors for dementia and for conditions associated with cognitive impairments can be treated or controlled. Among the preventable causes of cognitive decline are the following: AIDS, Alcohol and drug abuse, Cerebrovascular disease, Exposure to organic solvents or lead, Head trauma, Overmedication, Syphilis. Other conditions that may cause cognitive decline can be controlled or treated: Atherosclerosis, Depression, Diabetes, Emphysema, High blood pressure, Obesity, Sleep disorders, Thyroid dysfunction. In addition, it may be possible to enhance the cognitive performance of even healthy elderly people through changes in diet and lifestyle. Recent data raise the possibility that improved prenatal and perinatal care and greater access to educational opportunities may result in a decreased incidence of dementia in future generations of older adults. Although they are rapidly becoming more numerous, the efficacy of cognitive training programs in preventing or slowing cognitive decline has not yet been demonstrated. Nevertheless, such programs may ameliorate cognitive impairment by reducing the psychiatric disabilities associated with anxiety and depression. The general principle underlying these strategies for limiting cognitive impairment with age is to maximize brain reserve and minimize brain damage.
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PMID:Preventing cognitive decline. 157 76

A case of retropharyngeal emphysema associated with drug abuse is presented. Although chest symptoms of pneumomediastinum have been widely reported with substance abuse, pain localized to the neck is rarely described. In the present case, localized dysphagia was the only complaint, and no free air could be demonstrated within the thorax. For uncomplicated cervical emphysema or pneumomediastinum due to substance abuse, extensive workup may be unnecessary, and conservative therapy, including administration of 100% oxygen and observation is recommended if resolution is prompt.
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PMID:A simple sore throat? Retropharyngeal emphysema secondary to free-basing cocaine. 209 67

Three patients are described who developed either pneumomediastinum or "clicking pneumothorax" after abusing illicit drugs. In recent years, patients presenting with pneumomediastinum after abusing cocaine have been frequently reported; these patients are most commonly young males with pleuritic chest pain. Seventy-three percent have detectable subcutaneous emphysema and fifty percent have a Hamman's sign. The pathophysiology, presenting features, and treatment of patients with barotrauma related to inhalational drug abuse are reviewed.
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PMID:Barotrauma related to inhalational drug abuse. 236 15

A rare pulmonary manifestation of the acquired immunodeficiency syndrome or intravenous (IV) drug abuse is upper lobe cystic disease--pneumatoceles in Pneumocystis carinii pneumonia (PCP) and bullous emphysema in IV drug abuse. Because these disorders overlap, the radiographic findings in 56 patients were compared. During a 12-month period, 16 patients less than 40 years of age were found to have bullous emphysema; the 10 who were IV drug abusers constituted group 1. In the same time period, 40 patients with PCP were encountered; the eight (20%) who had or developed pneumatoceles constituted group 2. In both groups, the conventional radiographic manifestations of upper lobe cystic disease were similar. Eight patients underwent computed tomography of the chest. In five patients with bullous disease, the distribution of the bullous lesions was peripheral, with sparing of the central portions of the lungs. In contrast, PCP pneumatoceles in three patients were dispersed throughout the lung parenchyma.
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PMID:Pulmonary cystic disease: comparison of Pneumocystis carinii pneumatoceles and bullous emphysema due to intravenous drug abuse. 278 12

Six patients who injected talc containing drugs intended for oral use were assessed over a period of ten or more years from the time of initiation of this habit. Despite discontinuation of the drug abuse, all developed severe respiratory disability and three died from their disease. An evolving spectrum of roentgenographic and functional patterns is considered to be virtually diagnostic of this disorder. Roentgenographically, an initial diffuse, pin-point micronodularity subsequently becomes associated with conglomerates, usually in the upper lobes, closely resembling the progressive massive fibrosis (PMF) of the pneumoconioses. The lower lobes, on the other hand, become relatively translucent, in some instances with bulla formation and the development of pneumothorax. Pulmonary function, initially with both restrictive and obstructive features, eventually becomes markedly obstructive with hyperinflation and air trapping. At this late stage, pathologic examination reveals emphysema in addition to the granulomatous inflammation and fibrosis surrounding the talc particles in the pulmonary interstitium.
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PMID:Long-term follow-up of drug abusers with intravenous talcosis. 291 44

The prevalence of illicit drug use is higher among men than women, but new drug use occurs at twice the rate for females as for males. Recent data from emergency rooms and medical examiners support this pattern, but females were more likely than males to report use of tranquilizers, antidepressants, and some nonbarbiturate sedatives. Recent data show that men outnumbered women in drug treatment admissions for all drugs except tranquilizers. However, the 1984 National Institute of Mental Health Epidemiologic Catchment Area Survey shows drug abuse and dependence to be the second most commonly reported disorder for women. Smoking is the most common form of drug dependence in our society, and it has a major impact on women's health. Lung cancer is now the leading cause of cancer deaths among women. Smoking poses a special risk of coronary heart disease for women using oral contraceptives. The incidence of emphysema among women has also risen sharply. Smoking during pregnancy carries special, serious risks. Research strongly suggests that the use of marijuana during pregnancy carries significant risks, including low birth weights and fetal abnormalities. Opiate addiction among women is uncommon, but it carries disproportionate health risks for these women and their offspring; infants born of addicted mothers have much higher morbidity and mortality rates than infants in general. Acquired immune deficiency syndrome is a grave risk to women using intravenous drugs and to their children. There are a number of health problems associated with psychoactive drug use among elderly women. In addition to research, the National Institute on Drug Abuse has focused a number of its activities on the special problems and needs of women. The Institute is collaborating with the health care community to place increased emphasis on prevention and treatment services for women and is working with organizations in the public and private sector to ensure that current information about drug use is effectively disseminated.
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PMID:Substance abuse and women's health. 312 Feb 20

TB is no longer the scourge it once was, but it remains an important cause of morbidity and mortality worldwide. Fueled by increasing poverty, homelessness, immigration, drug abuse, declining prevention programs, and the HIV epidemic, its incidence in the United States has increased dramatically. The complex natural history of pulmonary TB in children is reflected in its varied radiographic manifestations. Strict distinction between "adult" and "childhood" patterns of TB should be avoided (Fig 16). In general, adenopathy is the footprint of childhood primary pulmonary TB, with or without a readily apparent primary parenchymal focus or pleural effusion. Infants and young children are more likely to present with adenopathy only than their older counterparts. The pediatric tracheobronchial tree is particularly susceptible to compression by surrounding nodes, producing segmental atelectasis, or less commonly, obstructive emphysema. Self-limited lymphohematogenous dissemination is the rule, but actual miliary disease is the exception. Pediatric postprimary TB, when it occurs, is usually observed in adolescents. It is characterized by parenchymal disease with an anatomic bias for the upper lung zones. Proper image interpretation is inextricably dependent on an understanding of the pathogenesis of this fascinating and often baffling illness whose appearance widely varies depending on host age and immunity as well as the virulence of the organism itself.
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PMID:Pulmonary tuberculosis in children. 851 92

Health status assessment and disease surveillance are essential to identify and priorize health issues, to evaluate intervention programs and to plan to meet future needs for health services. Canadians currently benefit by having among the highest life expectancies at birth in the world (81 for females, 74 for males). Disability-free life expectancies for females and males, respectively, were 10.1 and 11.3 years lower for the lowest income quintile compared to the highest. Canada's infant mortality rate in 1990 (7/1000 live births) was one of the lowest in the world but within Canada, the rate in the lowest income quintile (10.5/1000 live births) was almost double that in the highest income quintile (5.8/1000 live births). Fair or poor health was reported by 36% of adult Canadians in the lowest income category in 1990 compared to only 5% in the highest income group. The leading causes of premature death for females in 1991 were breast cancer, coronary heart disease, lung cancer, car crashes, birth defects and suicide; those for males were coronary heart disease, suicide, car crashes, lung cancer, birth defects, and AIDS. Lowest income quintile males had mortality rates at least double those for the highest income quintile for alcohol-related conditions, violence, injuries and emphysema. Cardiovascular diseases, cancer, musculoskeletal diseases, injuries and respiratory diseases imposed the highest direct and indirect economic costs in Canada in 1986. For all of these conditions, improved prevention is possible. For example, the forecasted tobacco-related deaths before age 70 among current male smokers age 15 will far exceed those due to car crashes, suicide, murder, AIDS, and drug abuse combined. Population aging will aggravate trends for many chronic conditions especially those with increasing incidence rates; there will be large increases in the numbers of persons with aging-related cancers, dementias and other conditions. There is an urgent need for Canadian health jurisdictions to ensure that rational priorities, goals/objectives, strategies, and programs are in place to enhance prevention and disease control.
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PMID:Canada's health status: a public health perspective. 855 81


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