[en] Illicit drug abuse is a continuing menace of epidemic proportions associated with serious medical and social problems. Drug abuse can have a wide variety of presentations some of which can be life-threatening. The clinical diagnosis can be challenging as the history is usually limited or absent. Radiologists need to be familiar with varied imaging presentations and the related complications of illicit drug abuse to ensure correct diagnosis and appropriate timely treatment. This review will illustrate the imaging spectrum of illicit drug abuse involving several organ systems and also discuss the pathophysiological consequences of drug abuse.

[en] Synthetic cannabinoids are one of the many substances of abuse widely spreading in modern society. Medical practitioners and law enforcement alike highly seek portable, efficient, and reliable tools for on-site detection and diagnostics. Here, we propose a colorimetric lateral flow assay (LFA) combined with dye-loaded polymersome to detect the synthetic cannabinoid JWH-073 efficiently. Rhodamine B–loaded polymersome was conjugated to antibodies and fully characterized. Two LFA were proposed (sandwich and competitive), showing a high level of sensitivity with a limit of detection (LOD) reaching 0.53 and 0.31 ng/mL, respectively. The competitive assay was further analyzed by fluorescence, where the LOD reached 0.16 ng/mL. The application of the LFA over spiked synthetic saliva or real human saliva demonstrated an overall response of 94% for the sandwich assay and 97% for the competitive LFA. The selectivity of the system was assessed in the presence of various interferents. The analytical performance of the LFA system showed a coefficient of variation below 6%. The current LFA system appears as a plausible system for non-invasive detection of substance abuse and shows promise for synthetic cannabinoid on-site sensing. Graphical abstract:

[en] To characterize the source contributions of chemicals of emerging concern (CECs) from different aquatic environments of Taiwan, we collected water samples from different aquatic systems, which were screened for 30 pharmaceuticals and illicit drugs. The total estimated mass loadings of CECs were 23.1 g/d in southern aquatic systems and 133 g/d in central aquatic systems. We developed an analytical framework combining pollutant fingerprinting, hierarchical cluster analysis (HCA), and principal component analysis with multiple linear regression (PCA-MLR) to infer the pharmaco-signature and source contributions of CECs. Based on this approach, we estimate source contributions of 62.2% for domestic inputs, 16.9% for antibiotics application, and 20.9% for drug abuse/medication in southern aquatic system, compared with 47.3% domestic, 35.1% antibiotic, and 17.6% drug abuse/medication inputs to central aquatic systems. The proposed pharmaco-signature method provides initial insights into the profile and source apportionment of CECs in complex aquatic systems, which are of importance for environmental management. - Highlights: • Pharmaco-signature provides first insights into the profile and source apportionment of CECs. • Performing HCA and PCA-MLR can discern the potential source of CECs in different aquatic systems. • Chemometric results resolved 3 factors: domestic inputs, antibiotic application and drug abuse. - The proposed pharmaco-signature method provides initial insights into the profile and source apportionment of CECs in complex aquatic systems.

[en] Short communication

[en] Dopamine (DA) is considered crucial for the rewarding effects of drugs of abuse, but its role in addiction is much less clear. This review focuses on studies that used PET to characterize the brain DA system in addicted subjects. These studies have corroborated in humans the relevance of drug-induced fast DA increases in striatum [including nucleus accumbens (NAc)] in their rewarding effects but have unexpectedly shown that in addicted subjects, drug-induced DA increases (as well as their subjective reinforcing effects) are markedly blunted compared with controls. In contrast, addicted subjects show significant DA increases in striatum in response to drug-conditioned cues that are associated with self-reports of drug craving and appear to be of a greater magnitude than the DA responses to the drug. We postulate that the discrepancy between the expectation for the drug effects (conditioned responses) and the blunted pharmacological effects maintains drug taking in an attempt to achieve the expected reward. Also, whether tested during early or protracted withdrawal, addicted subjects show lower levels of D2 receptors in striatum (including NAc), which are associated with decreases in baseline activity in frontal brain regions implicated in salience attribution (orbitofrontal cortex) and inhibitory control (anterior cingulate gyrus), whose disruption results in compulsivity and impulsivity. These results point to an imbalance between dopaminergic circuits that underlie reward and conditioning and those that underlie executive function (emotional control and decision making), which we postulate contributes to the compulsive drug use and loss of control in addiction.

[en] Medication mistakes in case of chemotherapy or adjuvant treatment used in any stage of drug application process: prescription, transcription, preparation, dispense or administration, are a frequent cause of side effects of antineoplastic drugs. (Author)

[en] Computed tomography (CT) of the brain was performed in a random sample of a total of 195 men and 211 male alcoholic patients admitted for the first time during a period of two years from the same geographically limited area of Greater Stockholm as the sample. Laboratory tests were performed, including liver and pancreatic tests. Toxicological screening was performed and the consumption of hepatotoxic drugs was also investigated. The groups were then subdivided with respect to alcohol consumption and use of hepatotoxic drugs: group IA, men from the random sample with low or moderate alcohol consumption and no use of hepatotoxic drugs; IB, men from the random sample with low or moderate alcohol consumption with use of hepatotoxic drugs; IIA, alcoholic inpatients with use of alcohol and no drugs; and IIB, alcoholic inpatients with use of alcohol and drugs. Group IIB was found to have a higher incidence of cortical and subcortical changes than group IA. Group IB had a higher incidence of subcortical changes than group IA, and they differed only in drug use. Groups IIN and IIA only differed in drug use, and IIB had a higher incidence of brian damage except for anterior horn index and wide cerebellar sulci indicating vermian atrophy. Significantly higher serum levels of bilirubin, GGT, ASAT, ALAT, CK LD, and amylase were found in IIB. The results indicate that drug use influences the incidence of cortical and subcortical aberrations, except anterior horn index. It is concluded that the groups with alcohol abuse who used hepatotoxic drugs showed a picture of cortical changes (wide transport sulci and clear-cut of high-grade cortical changes) and also of subcortical aberrations, expressed as an increased widening on the third ventricle

[en] Mycotic false aneurysm caused by local arterial injury from attempted intravenous injections in drug addicts remains a challenging clinical problem. The continued increase in drug abuse has resulted in an increased incidence of this problem, particularly in high-volume urban centres. In the drug-abusing population, mycotic arterial pseudoaneurysms most often occur because of missed venous injection and are typically seen in the groin, axilla, and antecubital fossa. Mycotic aneurysms may lead to life-threatening haemorrhage, limb loss, sepsis, and even death. Any soft-tissue swelling in the vicinity of a major artery in an intravenous drug abuser should be suspected of being a false aneurysm until proven otherwise and should prompt immediate referral to a vascular surgeon for investigation and management. We report a case of rupturing mycotic pseudoaneurysm of the left common femoral artery treated by surgical resection followed by vessel reconstruction with autologous material. Unfortunately, at the time of discharge a sudden leakage from the vein graft anastomosis occurred, with subsequent massive bleeding, and required emergent endovascular covered stenting. To the best of our knowledge, this is the first reported case of femoral artery bleeding in a drug abuser treated by stent graft placement.

[en] Despite improved clinical care, heightened public awareness and wide spread use of health innovations, alcoholism remains a leading cause of death in many parts of the world. Chronic alcoholics suffer from stress and multitude of symptoms. The progressive addiction to alcohol will gradually nullify all other interests in the patient's life so that a deterioration of the physical, psychological, social, cultural and religious values takes place. The role of yoga in healing asthma, arthritis and other disorders has been known. Methods: Breathing technique (Anuloma Viloma Pranayama) was taught to chronic alcoholics. Using galvanic skin resistance, stress levels were measured before and after anuloma viloma yoga in controls and chronic alcoholics. Results: Reduced stress levels were noted using the galvanic skin resistance in both controls and chronic alcoholics after yogic breathing. Conclusion: There is a promising effect of simple yoga techniques in organising effective rehabilitation and treatment programmes to reduce stress in chronic alcoholics. This study would help to chart out a better management programme for enhancing relapse and alleviate the symptoms. (author)

[en] The treatment and control of comorbidities and complications that occur in patients with CKD required an increase in the number of drugs used, thus causing them vulnerable to the incidence of DRPs. This article aimed to review the frequency, risk factors, and types of DRPs and to become useful literature for preventing the occurrence of DRPs in CKD patients were classified by PCNE. A literature search was carried out systematically using 4 databases including PubMed, Google Scholar, 1library, and e-journal. The keywords used were ((^drug-related problems AND ^chronic kidney disease⁾).A total of 344 articles regarding DRPs have been identified by the final analysis of 9 articles. It was found the incidence of DRPs with the most common problem category was adverse drug reactions followed by drug interactions, while the most common cause category was drug/dose selection followed by drug use process. The role of pharmacists is very important to identifying, overcoming, and preventing drug-related problems. Therefore, it is necessary to optimize drug therapy by health professionals particularly pharmacists to improve the quality of life of patients with CKD. (author)