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  1 / 9111 MEDLINE  
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[PMID]:29188669
[Au] Autor:Huang WQ; Li LH; Li Z; Hong SJ
[Ad] Endereço:School of Forensic Medicine, Kunming Medical University, Kunming 650500, China.
[Ti] Título:[Forensic Analysis of 20 Dead Cases Related to Heroin Abuse].
[So] Source:Fa Yi Xue Za Zhi;32(4):266-268, 2016 Aug.
[Is] ISSN:1004-5619
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVES: To perform retrospective analysis on 20 dead cases related to heroin abuse, and to provide references for the forensic assessment of correlative cases. METHODS: Among 20 dead cases related to heroin abuse, general situation, using method of drug, cause of death and result of forensic examination were analyzed by statistical analysis for summarizing the cause of death and pathologic changes. RESULTS: The dead were mostly young adults, with more male than female. The results of histopathological examinations showed non-specific pathological changes. There were four leading causes of death, including acute poisoning of heroin abuse or leakage (13 cases, 65%), concurrent diseases caused by heroin abuse (3 cases, 15%), inspiratory asphyxia caused by taking heroin (2 cases, 10%), and heroin withdrawal syndrome (2 cases, 10%). CONCLUSIONS: The forensic identification on dead related to heroin abuse must base on the comprehensive autopsy, and combine with the qualitative and quantitative analysis of heroin and its metabolites in death and the case information, as well as the scene investigation.
[Mh] Termos MeSH primário: Overdose de Drogas/diagnóstico
Heroína/envenenamento
[Mh] Termos MeSH secundário: Adulto
Autopsia
Causas de Morte
Feminino
Patologia Legal
Toxicologia Forense
Seres Humanos
Masculino
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
70D95007SX (Heroin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.3969/j.issn.1004-5619.2016.04.008


  2 / 9111 MEDLINE  
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[PMID]:29343479
[Au] Autor:Brat GA; Agniel D; Beam A; Yorkgitis B; Bicket M; Homer M; Fox KP; Knecht DB; McMahill-Walraven CN; Palmer N; Kohane I
[Ad] Endereço:Department of Biomedical Informatics, Harvard Medical School, Countway Library, Boston, MA 02215, USA gbrat@bidmc.harvard.edu.
[Ti] Título:Postsurgical prescriptions for opioid naive patients and association with overdose and misuse: retrospective cohort study.
[So] Source:BMJ;360:j5790, 2018 01 17.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To quantify the effects of varying opioid prescribing patterns after surgery on dependence, overdose, or abuse in an opioid naive population. DESIGN: Retrospective cohort study. SETTING: Surgical claims from a linked medical and pharmacy administrative database of 37 651 619 commercially insured patients between 2008 and 2016. PARTICIPANTS: 1 015 116 opioid naive patients undergoing surgery. MAIN OUTCOME MEASURES: Use of oral opioids after discharge as defined by refills and total dosage and duration of use. The primary outcome was a composite of misuse identified by a diagnostic code for opioid dependence, abuse, or overdose. RESULTS: 568 612 (56.0%) patients received postoperative opioids, and a code for abuse was identified for 5906 patients (0.6%, 183 per 100 000 person years). Total duration of opioid use was the strongest predictor of misuse, with each refill and additional week of opioid use associated with an adjusted increase in the rate of misuse of 44.0% (95% confidence interval 40.8% to 47.2%, P<0.001), and 19.9% increase in hazard (18.5% to 21.4%, P<0.001), respectively. CONCLUSIONS: Each refill and week of opioid prescription is associated with a large increase in opioid misuse among opioid naive patients. The data from this study suggest that duration of the prescription rather than dosage is more strongly associated with ultimate misuse in the early postsurgical period. The analysis quantifies the association of prescribing choices on opioid misuse and identifies levers for possible impact.
[Mh] Termos MeSH primário: Analgésicos Opioides/uso terapêutico
Overdose de Drogas/epidemiologia
Transtornos Relacionados ao Uso de Opioides/epidemiologia
Dor Pós-Operatória/tratamento farmacológico
Uso Excessivo de Medicamentos Prescritos/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Bases de Dados Factuais
Esquema de Medicação
Feminino
Seres Humanos
Masculino
Meia-Idade
Padrões de Prática Médica/estatística & dados numéricos
Estudos Retrospectivos
Fatores de Risco
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180119
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5790


  3 / 9111 MEDLINE  
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[PMID]:29236368
[Au] Autor:Benhaberou-Brun D
[Ti] Título:Surdose d'opioïdes. La naloxone, un antidote qui peut sauver des vies..
[So] Source:Perspect Infirm;14(2):35-37, 2017 Mar-Apr.
[Is] ISSN:1708-1890
[Cp] País de publicação:Canada
[La] Idioma:fre
[Mh] Termos MeSH primário: Analgésicos Opioides/envenenamento
Overdose de Drogas/tratamento farmacológico
Naloxona/uso terapêutico
Antagonistas de Entorpecentes/uso terapêutico
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Narcotic Antagonists); 36B82AMQ7N (Naloxone)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE


  4 / 9111 MEDLINE  
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[PMID]:29231010
[Au] Autor:Tong F; Liang Y; Shi Q; Zhang L; L WH; Zhou YW
[Ad] Endereço:Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
[Ti] Título:[Advance of Forensic Research in Insulin Poisoning].
[So] Source:Fa Yi Xue Za Zhi;33(1):48-51, 2017 Feb.
[Is] ISSN:1004-5619
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:Insulin as a common clinical hypoglycemic agent can effectively control serves to lower the concentration of blood glucose. However, insulin overdose can lead to death. In the whole fatal cases of insulin overdose, medical accident is the most common, followed by suicide. Though insulin homicide is extremely rare, it deserves great attention. Though there are some researches about insulin poisoning on forensic toxicology and pathology, it is still a difficult task in forensic practice. In this paper, the mechanism of death, pathological changes, detection methods and diagnose criteria of insulin overdose will be discussed in the view of forensic toxicology and pathology. We hope that this paper could enhance relative knowledges of insulin poisoning for medical examiners.
[Mh] Termos MeSH primário: Overdose de Drogas
Toxicologia Forense
Hipoglicemiantes/envenenamento
Insulinas/envenenamento
Envenenamento/patologia
[Mh] Termos MeSH secundário: Acidentes
Morte
Homicídio
Seres Humanos
Hipoglicemiantes/uso terapêutico
Insulinas/uso terapêutico
Suicídio
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Hypoglycemic Agents); 0 (Insulins)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171213
[St] Status:MEDLINE
[do] DOI:10.3969/j.issn.1004-5619.2017.01.012


  5 / 9111 MEDLINE  
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[PMID]:29289268
[Au] Autor:Kamal F; Snook L; Saikumar JH
[Ad] Endereço:University of Tennessee Health Science Center (FK, JS), Memphis, Memphis, Tennessee. Electronic address: fkamal1@uthsc.edu.
[Ti] Título:Rhabdomyolysis-Associated Acute Kidney Injury With Normal Creatine Phosphokinase.
[So] Source:Am J Med Sci;355(1):84-87, 2018 Jan.
[Is] ISSN:1538-2990
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Rhabdomyolysis is a syndrome characterized by the breakdown of skeletal muscle and leakage of intracellular myocyte contents, such as creatine phosphokinase (CPK) and myoglobin, into the interstitial space and plasma resulting in acute kidney injury (AKI). Elevated CPK of at least 5 times the upper limit of normal is an important diagnostic marker of Rhabdomyolysis. We present a case of rhabdomyolysis with severe AKI with a normal CPK at presentation. A 32-year-old man presented with acute respiratory failure and AKI after an overdose of recreational drugs. Urinalysis at presentation showed trace amounts of blood, identified as rare red blood cells under microscopy. CPK was 156 U/L at presentation. Workup for glomerulonephritis and vasculitis was negative. He was initiated on renal replacement therapy, and a kidney biopsy showed severe acute tubular injury with positive myoglobin casts. Supportive management and renal replacement therapy was provided, and renal function spontaneously improved after a few weeks. This is an uncommon clinical presentation of severe rhabdomyolysis complicated by AKI. This suggests that CPK alone may not be a sensitive marker for rhabdomyolysis-induced AKI in some cases.
[Mh] Termos MeSH primário: Lesão Renal Aguda
Creatina Quinase/sangue
Overdose de Drogas
Terapia de Substituição Renal
Rabdomiólise
Drogas Ilícitas/efeitos adversos
[Mh] Termos MeSH secundário: Lesão Renal Aguda/sangue
Lesão Renal Aguda/induzido quimicamente
Lesão Renal Aguda/terapia
Adulto
Biomarcadores/sangue
Overdose de Drogas/sangue
Overdose de Drogas/complicações
Overdose de Drogas/terapia
Seres Humanos
Masculino
Rabdomiólise/sangue
Rabdomiólise/induzido quimicamente
Rabdomiólise/terapia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Street Drugs); EC 2.7.3.2 (Creatine Kinase)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180101
[St] Status:MEDLINE


  6 / 9111 MEDLINE  
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[PMID]:27776382
[Au] Autor:Parmar MK; Strang J; Choo L; Meade AM; Bird SM
[Ad] Endereço:MRC Clinical Trials Unit at University College London, London, UK.
[Ti] Título:Randomized controlled pilot trial of naloxone-on-release to prevent post-prison opioid overdose deaths.
[So] Source:Addiction;112(3):502-515, 2017 Mar.
[Is] ISSN:1360-0443
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND AIMS: Naloxone is an opioid antagonist used for emergency resuscitation following opioid overdose. Prisoners with a history of heroin injection have a high risk of drug-related death soon after release from prison. The NALoxone InVEstigation (N-ALIVE) pilot trial (ISRCTN34044390) tested feasibility measures for randomized provision of naloxone-on-release (NOR) to eligible prisoners in England. DESIGN: Parallel-group randomized controlled pilot trial. SETTING: English prisons. PARTICIPANTS: A total of 1685 adult heroin injectors, incarcerated for at least 7 days pre-randomization, release due within 3 months and more than 6 months since previous N-ALIVE release. INTERVENTION: Using 1 : 1 minimization, prisoners were randomized to receive on release a pack containing either a single 'rescue' injection of naloxone or a control pack with no syringe. MEASUREMENTS: Key feasibility outcomes were tested against prior expectations: on participation (14 English prisons; 2800 prisoners), consent (75% for randomization), returned prisoner self-questionnaires (RPSQs: 207), NOR-carriage (75% in first 4 weeks) and overdose presence (80%). FINDINGS: Prisons (16) and prisoners (1685) were willing to participate [consent rate, 95% confidence interval (CI) = 70-74%]; 218 RPSQs were received; NOR-carriage (95% CI = 63-79%) and overdose presence (95% CI = 75-84%) were as expected. We randomized 842 to NOR and 843 to control during 30 months but stopped early, because only one-third of NOR administrations were to the ex-prisoner. Nine deaths within 12 weeks of release were registered for 1557 randomized participants released before 9 December 2014. CONCLUSIONS: Large randomized trials are feasible with prison populations. Provision of take-home emergency naloxone prior to prison release may be a life-saving interim measure to prevent heroin overdose deaths among ex-prisoners and the wider population.
[Mh] Termos MeSH primário: Overdose de Drogas/prevenção & controle
Dependência de Heroína/mortalidade
Naloxona/uso terapêutico
Antagonistas de Entorpecentes/uso terapêutico
Prisioneiros/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Overdose de Drogas/mortalidade
Inglaterra/epidemiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Projetos Piloto
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Narcotic Antagonists); 36B82AMQ7N (Naloxone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1111/add.13668


  7 / 9111 MEDLINE  
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[PMID]:29269691
[Au] Autor:Nakagawa Y; Ishizaki M; Kozono A; Hanada K; Higashi T; Ueyama H
[Ad] Endereço:Department of Pharmacy, National Hospital Organization Kumamoto Medical Center.
[Ti] Título:[A case of myasthenia-like symptoms induced by cibenzoline overdosage].
[So] Source:Rinsho Shinkeigaku;58(1):41-44, 2018 Jan 26.
[Is] ISSN:1882-0654
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:The present patient was an 87-year-old man who had been taking cibenzoline for tachyarrhythmia. Five years after initiation of administration, he was referred to our hospital for ptosis that worsened from midday, as well as weakness of the facial and limb muscles. He tested negative for anti-acetylcholine receptor antibody but positive in the edrophonium test, suggesting that he had myasthenia gravis. He was admitted to our hospital 3 years later due to worsening symptoms of ptosis and muscle weakness. He had hypoglycemia, cardiac conduction defect, and renal dysfunction. In addition, blood concentration of cibenzoline was markedly high (1,850 ng/ml). We terminated the administration of cibenzoline, after which the patient's neurologic symptoms improved. Our findings suggest that cibenzoline toxicity must be considered in differentiating myasthenia gravis when a patient also presents with renal dysfunction.
[Mh] Termos MeSH primário: Overdose de Drogas/complicações
Imidazóis/envenenamento
Miastenia Gravis/induzido quimicamente
[Mh] Termos MeSH secundário: Lesão Renal Aguda/etiologia
Idoso de 80 Anos ou mais
Diagnóstico Diferencial
Monitoramento de Medicamentos
Seres Humanos
Imidazóis/sangue
Masculino
Miastenia Gravis/diagnóstico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Imidazoles); Z7489237QT (cifenline)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171223
[St] Status:MEDLINE
[do] DOI:10.5692/clinicalneurol.cn-001070


  8 / 9111 MEDLINE  
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[PMID]:29342206
[Au] Autor:Papackova Z; Heczkova M; Dankova H; Sticova E; Lodererova A; Bartonova L; Poruba M; Cahova M
[Ad] Endereço:Department of Metabolism and Diabetes, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
[Ti] Título:Silymarin prevents acetaminophen-induced hepatotoxicity in mice.
[So] Source:PLoS One;13(1):e0191353, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Acetaminophen or paracetamol (APAP) overdose is a common cause of liver injury. Silymarin (SLM) is a hepatoprotective agent widely used for treating liver injury of different origin. In order to evaluate the possible beneficial effects of SLM, Balb/c mice were pretreated with SLM (100 mg/kg b.wt. per os) once daily for three days. Two hours after the last SLM dose, the mice were administered APAP (300 mg/kg b.wt. i.p.) and killed 6 (T6), 12 (T12) and 24 (T24) hours later. SLM-treated mice exhibited a significant reduction in APAP-induced liver injury, assessed according to AST and ALT release and histological examination. SLM treatment significantly reduced superoxide production, as indicated by lower GSSG content, lower HO-1 induction, alleviated nitrosative stress, decreased p-JNK activation and direct measurement of mitochondrial superoxide production in vitro. SLM did not affect the APAP-induced decrease in CYP2E1 activity and expression during the first 12 hrs. Neutrophil infiltration and enhanced expression of inflammatory markers were first detected at T12 in both groups. Inflammation progressed in the APAP group at T24 but became attenuated in SLM-treated animals. Histological examination suggests that necrosis the dominant cell death pathway in APAP intoxication, which is partially preventable by SLM pretreatment. We demonstrate that SLM significantly protects against APAP-induced liver damage through the scavenger activity of SLM and the reduction of superoxide and peroxynitrite content. Neutrophil-induced damage is probably secondary to necrosis development.
[Mh] Termos MeSH primário: Acetaminofen/efeitos adversos
Doença Hepática Induzida por Substâncias e Drogas/prevenção & controle
Silimarina/farmacologia
[Mh] Termos MeSH secundário: Acetaminofen/farmacologia
Animais
Overdose de Drogas/patologia
Fígado/metabolismo
Masculino
Camundongos
Camundongos Endogâmicos BALB C
Necrose/patologia
Substâncias Protetoras/farmacologia
Silimarina/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Protective Agents); 0 (Silymarin); 362O9ITL9D (Acetaminophen)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180118
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191353


  9 / 9111 MEDLINE  
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[PMID]:29205976
[Au] Autor:Chen L; Lu YX
[Ad] Endereço:Wuhai Public Security Bureau, Wuhai 016000, China.
[Ti] Título:[Research Progress of the Death Caused by Insulin Intoxication].
[So] Source:Fa Yi Xue Za Zhi;32(6):452-454, 2016 Dec.
[Is] ISSN:1004-5619
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:In recent years, with the sustained increase of the incidence of diabetes in humans and the wider use of exogenous insulin, the cases of inappropriate use and overdose of insulin is growing, even the cases of suicide and homicide using insulin. Through searching the literature at home and abroad about the mechanism, clinical and case report of poisoning and death caused by insulin intoxication, this paper reviews the mechanism, clinical manifestations, pathological changes, and forensic examination.
[Mh] Termos MeSH primário: Overdose de Drogas/diagnóstico
Insulina/envenenamento
[Mh] Termos MeSH secundário: Morte
Homicídio
Seres Humanos
Suicídio
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Insulin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.3969/j.issn.1004-5619.2016.06.015


  10 / 9111 MEDLINE  
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[PMID]:29393310
[Au] Autor:Jiang Y; McDonald JV; Wilson ME; Koziol J; Goldschmidt A; King E; Viner-Brown S; Powell SM; Alexander-Scott N
[Ad] Endereço:Senior Public Health Epidemiologist in the Center for Health Data and Analysis at the Rhode Island Department of Health, and Assistant Professor of the Practice of Epidemiology, School of Public Health, Brown University.
[Ti] Título:Rhode Island Unintentional Drug Overdose Death Trends and Ranking - Office of the State Medical Examiners Database.
[So] Source:R I Med J (2013);101(1):33-36, 2018 Feb 02.
[Is] ISSN:2327-2228
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:[Full article available at http://rimed.org/rimedicaljournal-2018-02.asp].
[Mh] Termos MeSH primário: Overdose de Drogas/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Médicos Legistas
Bases de Dados Factuais
Feminino
Seres Humanos
Modelos Lineares
Masculino
Meia-Idade
Rhode Island/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE



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