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Results 401 - 450 of 552
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Morris D C - - 1991
Unlike neurologic toxicity, myocardial infarction appears to be an idiosyncratic response to the drug, unrelated to dose, duration of use, or route of administration. There is no marker to identify the person who may have life-threatening cardiac effects after taking cocaine, but those who experienced myocardial ischemia once are at ...
Brickner M E - - 1991
BACKGROUND: This study was performed to determine whether chronic cocaine abuse is associated with left ventricular hypertrophy in humans. METHODS AND RESULTS: A consecutive series of 40 chronic cocaine abusers 23-44 years old who were enrolled in an inpatient drug rehabilitation program were considered for the study. Subjects with elevated ...
Oster Z H - - 1991
Severe and often fatal cardiac complications have been reported in cocaine users with narrowed coronary arteries caused by atherosclerosis as well as in young adults with normal coronaries. We have found that in normal dogs cocaine induces severe temporary hypoperfusion of the left ventricle as indicated by a significantly lower ...
Fuster V V Division of Cardiology, Mount Sinai Medical Center, New York, New - - 1991
The hypothesis originated by Carl Rokitansky a century ago that thrombosis contributes substantially to atherosclerosis has been rekindled by accumulating experimental and clinical evidence. On the basis of our experience with the experimental porcine model, several important biologic determinants of thrombosis have been identified. The degree of vascular injury seems ...
Boulton J - - 1991
These are case reports of two children with structurally normal hearts and with normal coronary arteries, who survived myocardial infarction in the early neonatal period. They are only the third and fourth reported survivors of neonatal myocardial infarction and the first in which hypercholesterolemia is postulated to have played an ...
Zimmerman J L - - 1991
STUDY OBJECTIVES: To describe the clinical and ECG features of cocaine abusers evaluated in the emergency department and admitted to the medical coronary care unit with chest pain consistent with myocardial ischemia. DESIGN: A four-month retrospective review of all cocaine abusers who presented to the ED with chest pain and ...
Kolodgie F D - - 1991
Coronary vasospasm has been implicated as a cause of myocardial ischemia and sudden cardiac death in cocaine abusers. However, the mechanism or mechanisms remain unknown. Autopsy records (n = 5,871) from the medical examiner's files at Baltimore, Maryland and northern Virginia were examined and 495 persons (8.4%) were identified with ...
Vargas R - - 1991
Case reports suggest that cocaine use is associated with acute myocardial infarction which may be due to coronary spasm. The present study reports the effect of cocaine on the isolated coronary artery. Ring segments were prepared from the porcine left anterior descending coronary artery and suspended in tissue baths under ...
Stambler B S - - 1991
This study was designed to test the hypothesis that cocaine intoxication induces distinctive alterations in sinus rhythm heart rate dynamics. Time-series and spectral analysis techniques were used to examine the effects of lethal doses of cocaine on heart rate variability in conscious, restrained ferrets. In all animals (n = 5), ...
Shepard T H - - 1991
A fetus weighing 947 g was autopsied after prenatal echocardiographic diagnosis of a single ventricular heart. At autopsy a single ventricle was present with a pear-shaped scar in the area presumed to represent the right ventricle. A small stoma from the single ventricle connected to the scar and the pulmonary ...
Coniglio K - - 1991
The use of cocaine as a recreational drug is rapidly escalating in this country. Because of this, an increase in cocaine-related morbidity and mortality is occurring. Cocaine toxicity has been recognized for several years and was thought to be related to high doses or repeated use. Now several researchers have ...
Nademanee K - - 1991
The finding that most young cocaine addict patients had a negative exercise treadmill test suggests that they did not have preexisting obstructive coronary artery disease. Noninvasive testing did show, however, that these patients frequently had a high incidence of ST elevation episodes during the first 2 weeks of withdrawal. The ...
Laposata E A - - 1991
Cocaine use has increased in recent years, in part as a result of the increased availability of "crack," the inexpensive freebase form. Although it is used medicinally and initially was considered a relatively safe street drug, cocaine clearly has addictive potential as well as adverse health consequences even in low ...
Isner J M - - 1991
Clinical and experimental data published to date suggest several possible mechanisms by which cocaine may result in acute myocardial infarction. In individuals with preexisting, high-grade coronary arterial narrowing, acute myocardial infarction may result from an increase in myocardial oxygen demand associated with cocaine-induced increase in rate-pressure product. In other individuals ...
Barroso-Moguel R - - 1991
Historical data concerning the use of cocaine, its epidemiology, chemistry and pharmacology, as well as its medical complications and treatment, in both acute intoxication and chronic addiction is reported. Its repercussion and damage upon the nervous system with neurologic and psychiatric alterations is also reported. The frequency of cerebral hemorrhages ...
Virmani R - - 1991
With regard to cardiac findings in cocaine abuse, at autopsy the vast majority of patients dying with cocaine toxicity have either no pathologic change in the heart or only minimal changes that could not account for the patient's death. The second most frequent finding is underlying, mild-to-moderate coronary atherosclerosis, with ...
Isner J M - - 1991
Cocaine abuse is now firmly associated with several cardiac complications. Acute myocardial infarction is the best documented of these complications and appears to result from cocaine-induced coronary arterial spasm. Myocarditis and/or cardiomyopathy have also been reported in a smaller number of patients. Finally, life-threatening cardiac arrhythmias may also result from ...
Kuhn F E - - 1990
This study investigated the effect of intravenous cocaine (0.5 to 2 mg/kg body weight) on the coronary circulation and systemic hemodynamics in closed chest sedated dogs. The role of alpha- and beta-adrenoceptor stimulation in mediating these effects was also investigated. Cocaine produced dose-dependent increases in mean arterial pressure and rate-pressure ...
Baader W - - 1990
A 60-year-old trauma victim developed severe ischemia of all four extremities following administration of heparin-dihydroergotamine as prophylaxis against deep venous thrombosis. Despite cessation of heparin-dihydroergotamine and infusion of intraarterial papaverine into the right femoral artery, both lower extremities progressed to frank gangrene and amputation (above-knee on the left and below-knee ...
Harris R D - - 1990
High-resolution ultrasound (US) and pathologic analysis were used to define the relationship between placental hypoechoic-anechoic areas, frequently seen in the third trimester, and the clinically significant entity of placental infarction. Placentas were obtained from three groups of patients: those prospectively demonstrating one or more placental hypoechoic-anechoic areas greater than or ...
Roh L S - - 1990
Three cases of acute myocardial infarction due to cocaine-related coronary artery disease are presented. Pathogenesis and autopsy findings are discussed.
Bertolet B D - - 1990
To determine the frequency and severity of clinically unrecognized left ventricular (LV) dysfunction related to cocaine use, 84 asymptomatic cocaine abusers underwent cardiac evaluation which included chest x-ray, electrocardiography (ECG), and radionuclide angiography after a two-week abstinence from cocaine use. LV dysfunction was discovered in 6/84 (7%). Regional wall motion ...
Deykin D - - 1990
The history of antithrombotic therapy is traced over the past 5 decades, with a focus on the treatment of 2 major disorders: venous thromboembolism and acute myocardial infarction. Five subjects pertinent to clinical management decisions are discussed: (1) theories of thrombosis and coagulation, (2) tests of coagulation, (3) the availability ...
Dressler F A - - 1990
From January 1979 to February 1989, 22 cocaine addicts were studied at necropsy. The 22 patients were divided into 2 groups: death associated with increased cocaine levels at necropsy (13 patients, aged 23 to 45 years [mean 32], and mean total blood cocaine level, 0.36 mg/dl) and noncocaine-related death (9 ...
Born G V - - 1990
Acute myocardial infarction is most commonly initiated by fissuring of an atheromatous plaque. Through such fissures the blood is exposed to thrombogenic constituents of the intima, causing thrombotic obstruction of the coronary artery. Why plaque fissuring occurs is not known. Our investigation is to establish which types of plaque undergo ...
Ratajczyk-Pakalska E - - 1990
The studies have been conducted on normal hearts using microhistoangiographical method. Angioarchitectonics of venous vascularization of the left and right ventricular walls have been described. The so-called "perforating veins", venous vessels of type I (intramuscular venous plexuses), venous vessels of type II and the Thebesian veins have been distinguished.
Combs A B - - 1990
Toxic injury is one of the many ways by which the functional integrity of the heart may become compromised. Any of the subcellular elements may be the target of toxic injury, including all of the various membranes and organelles. Understanding the mechanisms underlying cardiotoxicity may lead to treatment of the ...
Seaman M E - - 1990
We present the case of a 29-year-old patient who developed a cerebral infarction, without hemorrhage, after using cocaine. A computed tomography scan of the brain at the time of initial presentation was entirely normal; a repeat CT scan on the fifth hospital day showed a basal ganglion infarction. No evidence ...
Lange R A - - 1989
Intranasal cocaine is used frequently as a local anesthetic during many rhinolaryngologic procedures. Although its "recreational" use in high doses has been associated with chest pain and myocardial infarction, this association has not been established when cocaine is used in low doses as a topical anesthetic, and its effect on ...
Nademanee K - - 1989
STUDY OBJECTIVE: To determine the prevalence of myocardial ischemia in patients with cocaine addiction. DESIGN: Myocardial ischemia in chronic cocaine users was detected by serial 24-hour electrocardiographic ambulatory (Holter) monitoring and exercise treadmill testing in chronic cocaine users. The Holter tapes were coded, scanned in a blinded manner, and mixed ...
Pallasch T J - - 1989
Cocaine may induce totally unexpected cardiotoxicity in young individuals at some time distant from the cocaine ingestion. Commonly, such individuals are asymptomatic for coronary artery disease; some have no demonstrable coronary artery disease even after the cardiac event. Those who use cocaine must be considered at risk of cardiotoxicity at ...
Hale S L - - 1989
Smoking "crack" is currently popular; this results in rapidly peaking, high blood levels of cocaine. Our purpose was to investigate the effects of rapid cocaine administration. Hemodynamics, myocardial blood flow, and left ventricular cavity end-systolic and end-diastolic areas were measured in pentobarbital-anesthetized dogs before and 15 minutes after (1) a ...
Hupp J R - - 1989
Coronary artery disease is a common malady in industrialized societies. The end stage of this progressive disorder frequently results in myocardial infarction (MI), now known to be due to acute thrombosis of a narrowed coronary artery. In the past, supportive care was all that could be offered to patients suffering ...
Kossowsky W A - - 1989
Since our initial report in 1984 of six patients with AMI temporally related to cocaine use, we have observed 19 additional patients in whom ischemic chest pain syndromes occurred shortly after intranasal or IV use of cocaine or after smoking the drug. Seventeen patients (89 percent) developed non-Q wave infarction ...
Peng S K - - 1989
The morbidity and mortality associated with cocaine abuse has markedly increased in recent years. Although several articles indicate a possible connection of cocaine with coronary spasm and acute myocardial infarction, this study in seven patients with a history of cocaine abuse, who underwent endomyocardial biopsy, suggests that cocaine may cause ...
Archie J P JP - - 1989
The accuracy of Doppler examination for lower extremity deep venous thrombosis in a community hospital vascular laboratory was determined by comparing the Doppler results with venograms of 97 limbs in 90 patients. There were 47 limbs with a normal Doppler study, 46 abnormal (consistent with deep venous thrombosis) and 4 ...
Vitullo J C - - 1989
Cocaine abuse has been associated with pathologic cardiovascular events including acute myocardial infarction (AMI) and sudden death. Although coronary vasospasm has been proposed as a possible mechanism, the ability of cocaine to induce coronary spasm has not been conclusively demonstrated. In these studies, isolated rat hearts were perfused with cocaine ...
VanDette J M - - 1989
The chemistry, pharmacology, and pharmacokinetics of cocaine are described, and the medical complications of illicit cocaine use are reviewed. Cocaine is readily absorbed from mucous membranes, the gastrointestinal tract, and the vascular beds of the lungs. Thus there are a number of routes for illicit cocaine administration, with the most ...
Stenberg R G - - 1989
Myocardial infarction is now a well-recognized complication of cocaine abuse. This report describes a 38-year-old man who sustained simultaneous acute thrombosis of two major epicardial coronary arteries shortly after intravenous cocaine use. The finding of layers of mural thrombus of varying age, from acute to two to three days, in ...
Rubin R B - - 1989
PURPOSE: Cocaine abuse has recently emerged as a major problem among young adults, and is increasingly associated with a variety of medical complications. In view of recent reports demonstrating that illicit cocaine use may cause rhabdomyolysis, we reviewed the collective experience of a university-affiliated medical center to identify patients with ...
Grèen K - - 1989
The effect of a single dose of 500 mg acetaminophen (paracetamol) on the in vivo synthesis of prostacyclin was studied in healthy volunteers by measurements of the urinary excretion of 2,3-dinor-6-keto-PGF1 alpha. Acetaminophen caused a marked reduction of prostacyclin synthesis for 6-8 hours without any obvious effect on the thromboxane ...
Smith E F EF - - 1989
Thromboxane (TX) A2 and the prostaglandin endoperoxides, PGG2 and PGH2, have a number of biological activities including contraction of vascular and bronchial smooth muscle, platelet secretion and aggregation, and lysis of cellular membranes. Activation of TXA2 receptors may have deleterious consequences in various pathophysiologies, including coronary thrombosis, myocardial infarction, hypertension ...
Cannistra A J - - 1988
A patient with endogenously acquired Clostridium septicum panophthalmitis is presented. The patient exhibited a striking sequence of signs and symptoms associated with this devastating ocular infection. Intensive antibiotic therapy was ineffective and enucleation of the globe was required. The microscopic pathology of the enucleated globe showed extensive infarction and necrosis ...
Inoue H - - 1988
The mechanism of cocaine-related sudden death is unknown. To test whether cocaine potentiated changes in sinus cycle length, conduction in the atrioventricular node (AH interval) and ventricular effective refractory period induced by infused norepinephrine and ansae subclaviae stimulation, the dose-response curves of sinus cycle length, AH interval and ventricular effective ...
Reeve T - - 1988
Gastric dilatation caused by psychogenic polyphagia or bulimia may, under extreme circumstances, progress to total gastric necrosis. We have described a patient in whom acute abdominal symptoms and signs developed while he was receiving psychiatric treatment. Laparotomy showed massive gastric dilatation with near-total infarction. Total gastrectomy with cervical esophagostomy, feeding ...
Gradman A H - - 1988
Over the past 15 years, there has been a dramatic increase in the abuse of purified cocaine preparations throughout the industrialized world. The potential lethality of the drug is now recognized, and a growing series of case reports indicate that cardiotoxicity may be an important factor in the morbidity and ...
Clavien P A - - 1988
Ninety-eight patients with documented mesenteric infarction during a 19-year period were reviewed. In 13 patients infarction was due to a mesenteric venous thrombosis (MVT). Patients with MVT distinguished themselves from those having another aetiology by: (1) longer history of pain before admission (median 8 days, P less than 0.0001); (2) ...
Chamsi-Pasha H - - 1988
To determine the incidence and natural history of left ventricular thrombosis in acute transmural myocardial infarction we performed serial two-dimensional echocardiography in 51 patients. Seventeen patients had inferior infarcts. None of these developed left ventricular thrombosis. The remaining 34 patients had anterior infarcts. Ten of these developed left ventricular thrombus ...
Li G C - - 1988
The specific factors predisposing to thrombosis in patients with LAs have not been resolved. With extensive cross-reactivity, and several proposed sites of action, LAs and their effects may be heterogeneous. While the risk of thrombosis with phenothiazine-induced LAs is probably low, the incidence of thrombosis in association with procainamide-induced LAs ...
Maung R - - 1988
A 19-year-old woman developed gradually worsening abdominal pain, signs of peritonitis, and hematemesis. Laparotomy revealed peritonitis due to segmental small-bowel infarction, and the underlying pathologic condition was mesenteric vein thrombosis. A primary thrombotic disorder was suggested and antithrombin III deficiency was found. Before anticoagulant therapy could be initiated, she developed ...
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