Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034067 (emphysema)
 11,506 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Addiction is a chronic relapsing disorder characterized by repetitive and compulsive drug-seeking behavior and drug abuse despite negative health or social consequences. Cocaine addiction is a significant worldwide public health problem, which has somatic, psychological, psychiatric, socio-economic and judicial complications. Some of the most frequent complications are cardiovascular effects (acute coronary syndrome, cardiac arrhythmias, increased blood pressure); respiratory effects (fibrosis, interstitial pneumonitis, pulmonary hypertension, alveolar haemorrhage, asthma exacerbation; emphysema), neurological effects (strokes, aneurysms, seizures, headaches); risk for contracting HIV/AIDS, hepatitis B and C, sexual transmitted disease and otolaryngologic effects. Other complications are not discussed here. The vast majority of studies indicate that there are cognitive deficits induced by cocaine addiction. Attention, visual and working memories, executive functioning are affected in cocaine users. Psychiatric complications found in clinical practice are major depressive disorders, cocaine-induced paranoia, cocaine-induced compulsive foraging and panic attacks.
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PMID:[Complications of cocaine addiction]. 1964 39

Not commonly seen, the risk of sudden death after significant emotional stress has been reported since antiquity and incorporated into folk wisdom, reflected by phrases such as "scared to death" and "broken heart." A typical "victim" suffers from significant and often life-threatening natural diseases, making determination of the manner of death complicated, and at times controversial. The present study is designed to assess inter-rater variability and nonuniformity and controversy seen in manner of death certification in certain cases of death with significant stress involved in the circumstances of death. Members of the National Association of Medical Examiner (NAME) were surveyed to assess differences in manner of death certification for eight sudden unexpected death scenarios in middle-aged men and women with underlying cardiac disease after significant stressful events including: being chased down a lonely road followed by a verbal confrontation, a roll-over motor vehicle collision (MVC) without injuries, a fall from a wheelchair in a MVC, an alleged armed robbery, an involuntary commitment, an arrest by police, sexual intercourse, and a severe panic attack with breathing problems. In all cases, the autopsy examination revealed hypertensive and arteriosclerotic cardiovascular disease. In all cases, natural diseases were identified as significant contributing condtions, including emphysema in six cases and diabetes mellitus in three. Eighty-six responses were collected. The results show wide inter-rater variability, ranging from very good to poor (Kappa ranges from 0.16 to 0.94). One hundred fifty-five comments were collected. Most of the comments addressed more than one topic and were followed by discussions, open questions, and responders' experiences with previous cases and legal proceedings. Our data show that cases of sudden death after significant stress have almost complete agreement in four cases and very high inter-rater variability in the other four. We propose that a detailed analysis of each case and an algorithmic approach could improve the predictability of the outcomes of death investigations for the legal system and for families.
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PMID:Manner of Death Certification After Significant Emotional Stress: An Inter-Rater Variability Study and Review of the Literature. 3124 64

Vomiting-induced pneumomediastinum can be a result of barotrauma causing alveolar rupture or Boerhaave's syndrome. Although a rare cause of secondary pneumomediastinum, Boerhaave's syndrome allows extravasation of air and fluid due to oesophageal perforation. We report a case of a 20-year-old female who presented with prolonged vomiting during a panic attack. Extensive surgical emphysema and pneumomediastinum were visualised radiologically. A source of oesophageal rupture was not visualised on cross-sectional computed tomography imaging following contrast ingestion. A complication of mediastinitis provided the evidence that this was a case of Boerhaave's syndrome whereby microscopic perforation of the oesophagus led to secondary pneumomediastinum, rather than vomiting-induced spontaneous pneumomediastinum caused by barotrauma. Recurrent Boerhaave's syndrome in this case is owed to the patient having previously experienced identical symptoms which spontaneously resolved.
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PMID:Vomiting-induced pneumomediastinum as a result of recurrent Boerhaave's syndrome. 3250 66