The Experts below are selected from a list of 258 Experts worldwide ranked by ideXlab platform

Dagmar I. Keller - One of the best experts on this subject based on the ideXlab platform.

  • A patient full of surprises: a body packer with Cocaine Intoxication, pneumococcal pneumonia and HIV infection
    BMC Emergency Medicine, 2018
    Co-Authors: Miriam Luginbühl, Timo Junker, Dagmar I. Keller
    Abstract:

    BackgroundSmuggling of illegal drugs by hiding them inside one’s own body, also called body packing, is a worldwide phenomenon. Cocaine is the most frequently transported drug. Body packing is a potentially lethal practice. The most serious complications of body packing are gastrointestinal obstruction or perforation and drug toxicity due to packet leakage or rupture.Case presentationA 30-year-old confirmed body packer was brought to our emergency department from jail because of agitation and mydriasis. He presented with a high respiratory rate of 40/min but normal oxygen saturation on ambient air, a heart rate of 116 bpm, a blood pressure of 116/68 mmHg and a temperature of 38.0° Celsius. Blood tests were suggestive of infection, urine analysis was positive for Cocaine. Abdominal and thoracic computed tomography scans showed pulmonary infiltrates as a possible focus of infection; signs of bowel obstruction or perforation were absent. Given his clinical presentation, we suspected severe infection rather than massive Cocaine Intoxication to be the main problem. We therefore withheld immediate surgical decontamination. Instead, we started broad-spectrum antibiotic treatment with piperacillin/tazobactam plus clarithromycin for suspected severe community-acquired pneumonia or abdominal sepsis and treated the patient with intravenous midazolam for symptomatic Cocaine Intoxication. After detection of urinary pneumococcal antigen, the antibacterial regimen was changed to ceftriaxone and vancomycin for pneumococcal pneumonia. In addition, we found human immunodeficiency virus (HIV) type 1 infection as underlying disease. The patient recovered from his acute illness and was discharged after 7 days of treatment with ceftriaxone plus vancomycin. Antiretroviral therapy was started in an outpatient setting.ConclusionsWith this case report, we emphasize the need to look for alternative diagnoses to Intoxication and gastrointestinal obstruction in acutely ill body packers with atypical presentation. Special risks, such as underlying HIV infection and potential antimicrobial resistance according to the individual’s geographical origin, should be taken into account while treating these patients.

  • a patient full of surprises a body packer with Cocaine Intoxication pneumococcal pneumonia and hiv infection
    BMC Emergency Medicine, 2018
    Co-Authors: Miriam Luginbühl, Timo Junker, Dagmar I. Keller
    Abstract:

    Smuggling of illegal drugs by hiding them inside one’s own body, also called body packing, is a worldwide phenomenon. Cocaine is the most frequently transported drug. Body packing is a potentially lethal practice. The most serious complications of body packing are gastrointestinal obstruction or perforation and drug toxicity due to packet leakage or rupture. A 30-year-old confirmed body packer was brought to our emergency department from jail because of agitation and mydriasis. He presented with a high respiratory rate of 40/min but normal oxygen saturation on ambient air, a heart rate of 116 bpm, a blood pressure of 116/68 mmHg and a temperature of 38.0° Celsius. Blood tests were suggestive of infection, urine analysis was positive for Cocaine. Abdominal and thoracic computed tomography scans showed pulmonary infiltrates as a possible focus of infection; signs of bowel obstruction or perforation were absent. Given his clinical presentation, we suspected severe infection rather than massive Cocaine Intoxication to be the main problem. We therefore withheld immediate surgical decontamination. Instead, we started broad-spectrum antibiotic treatment with piperacillin/tazobactam plus clarithromycin for suspected severe community-acquired pneumonia or abdominal sepsis and treated the patient with intravenous midazolam for symptomatic Cocaine Intoxication. After detection of urinary pneumococcal antigen, the antibacterial regimen was changed to ceftriaxone and vancomycin for pneumococcal pneumonia. In addition, we found human immunodeficiency virus (HIV) type 1 infection as underlying disease. The patient recovered from his acute illness and was discharged after 7 days of treatment with ceftriaxone plus vancomycin. Antiretroviral therapy was started in an outpatient setting. With this case report, we emphasize the need to look for alternative diagnoses to Intoxication and gastrointestinal obstruction in acutely ill body packers with atypical presentation. Special risks, such as underlying HIV infection and potential antimicrobial resistance according to the individual’s geographical origin, should be taken into account while treating these patients.

Miriam Luginbühl - One of the best experts on this subject based on the ideXlab platform.

  • A patient full of surprises: a body packer with Cocaine Intoxication, pneumococcal pneumonia and HIV infection
    BMC Emergency Medicine, 2018
    Co-Authors: Miriam Luginbühl, Timo Junker, Dagmar I. Keller
    Abstract:

    BackgroundSmuggling of illegal drugs by hiding them inside one’s own body, also called body packing, is a worldwide phenomenon. Cocaine is the most frequently transported drug. Body packing is a potentially lethal practice. The most serious complications of body packing are gastrointestinal obstruction or perforation and drug toxicity due to packet leakage or rupture.Case presentationA 30-year-old confirmed body packer was brought to our emergency department from jail because of agitation and mydriasis. He presented with a high respiratory rate of 40/min but normal oxygen saturation on ambient air, a heart rate of 116 bpm, a blood pressure of 116/68 mmHg and a temperature of 38.0° Celsius. Blood tests were suggestive of infection, urine analysis was positive for Cocaine. Abdominal and thoracic computed tomography scans showed pulmonary infiltrates as a possible focus of infection; signs of bowel obstruction or perforation were absent. Given his clinical presentation, we suspected severe infection rather than massive Cocaine Intoxication to be the main problem. We therefore withheld immediate surgical decontamination. Instead, we started broad-spectrum antibiotic treatment with piperacillin/tazobactam plus clarithromycin for suspected severe community-acquired pneumonia or abdominal sepsis and treated the patient with intravenous midazolam for symptomatic Cocaine Intoxication. After detection of urinary pneumococcal antigen, the antibacterial regimen was changed to ceftriaxone and vancomycin for pneumococcal pneumonia. In addition, we found human immunodeficiency virus (HIV) type 1 infection as underlying disease. The patient recovered from his acute illness and was discharged after 7 days of treatment with ceftriaxone plus vancomycin. Antiretroviral therapy was started in an outpatient setting.ConclusionsWith this case report, we emphasize the need to look for alternative diagnoses to Intoxication and gastrointestinal obstruction in acutely ill body packers with atypical presentation. Special risks, such as underlying HIV infection and potential antimicrobial resistance according to the individual’s geographical origin, should be taken into account while treating these patients.

  • a patient full of surprises a body packer with Cocaine Intoxication pneumococcal pneumonia and hiv infection
    BMC Emergency Medicine, 2018
    Co-Authors: Miriam Luginbühl, Timo Junker, Dagmar I. Keller
    Abstract:

    Smuggling of illegal drugs by hiding them inside one’s own body, also called body packing, is a worldwide phenomenon. Cocaine is the most frequently transported drug. Body packing is a potentially lethal practice. The most serious complications of body packing are gastrointestinal obstruction or perforation and drug toxicity due to packet leakage or rupture. A 30-year-old confirmed body packer was brought to our emergency department from jail because of agitation and mydriasis. He presented with a high respiratory rate of 40/min but normal oxygen saturation on ambient air, a heart rate of 116 bpm, a blood pressure of 116/68 mmHg and a temperature of 38.0° Celsius. Blood tests were suggestive of infection, urine analysis was positive for Cocaine. Abdominal and thoracic computed tomography scans showed pulmonary infiltrates as a possible focus of infection; signs of bowel obstruction or perforation were absent. Given his clinical presentation, we suspected severe infection rather than massive Cocaine Intoxication to be the main problem. We therefore withheld immediate surgical decontamination. Instead, we started broad-spectrum antibiotic treatment with piperacillin/tazobactam plus clarithromycin for suspected severe community-acquired pneumonia or abdominal sepsis and treated the patient with intravenous midazolam for symptomatic Cocaine Intoxication. After detection of urinary pneumococcal antigen, the antibacterial regimen was changed to ceftriaxone and vancomycin for pneumococcal pneumonia. In addition, we found human immunodeficiency virus (HIV) type 1 infection as underlying disease. The patient recovered from his acute illness and was discharged after 7 days of treatment with ceftriaxone plus vancomycin. Antiretroviral therapy was started in an outpatient setting. With this case report, we emphasize the need to look for alternative diagnoses to Intoxication and gastrointestinal obstruction in acutely ill body packers with atypical presentation. Special risks, such as underlying HIV infection and potential antimicrobial resistance according to the individual’s geographical origin, should be taken into account while treating these patients.

Timo Junker - One of the best experts on this subject based on the ideXlab platform.

  • A patient full of surprises: a body packer with Cocaine Intoxication, pneumococcal pneumonia and HIV infection
    BMC Emergency Medicine, 2018
    Co-Authors: Miriam Luginbühl, Timo Junker, Dagmar I. Keller
    Abstract:

    BackgroundSmuggling of illegal drugs by hiding them inside one’s own body, also called body packing, is a worldwide phenomenon. Cocaine is the most frequently transported drug. Body packing is a potentially lethal practice. The most serious complications of body packing are gastrointestinal obstruction or perforation and drug toxicity due to packet leakage or rupture.Case presentationA 30-year-old confirmed body packer was brought to our emergency department from jail because of agitation and mydriasis. He presented with a high respiratory rate of 40/min but normal oxygen saturation on ambient air, a heart rate of 116 bpm, a blood pressure of 116/68 mmHg and a temperature of 38.0° Celsius. Blood tests were suggestive of infection, urine analysis was positive for Cocaine. Abdominal and thoracic computed tomography scans showed pulmonary infiltrates as a possible focus of infection; signs of bowel obstruction or perforation were absent. Given his clinical presentation, we suspected severe infection rather than massive Cocaine Intoxication to be the main problem. We therefore withheld immediate surgical decontamination. Instead, we started broad-spectrum antibiotic treatment with piperacillin/tazobactam plus clarithromycin for suspected severe community-acquired pneumonia or abdominal sepsis and treated the patient with intravenous midazolam for symptomatic Cocaine Intoxication. After detection of urinary pneumococcal antigen, the antibacterial regimen was changed to ceftriaxone and vancomycin for pneumococcal pneumonia. In addition, we found human immunodeficiency virus (HIV) type 1 infection as underlying disease. The patient recovered from his acute illness and was discharged after 7 days of treatment with ceftriaxone plus vancomycin. Antiretroviral therapy was started in an outpatient setting.ConclusionsWith this case report, we emphasize the need to look for alternative diagnoses to Intoxication and gastrointestinal obstruction in acutely ill body packers with atypical presentation. Special risks, such as underlying HIV infection and potential antimicrobial resistance according to the individual’s geographical origin, should be taken into account while treating these patients.

  • a patient full of surprises a body packer with Cocaine Intoxication pneumococcal pneumonia and hiv infection
    BMC Emergency Medicine, 2018
    Co-Authors: Miriam Luginbühl, Timo Junker, Dagmar I. Keller
    Abstract:

    Smuggling of illegal drugs by hiding them inside one’s own body, also called body packing, is a worldwide phenomenon. Cocaine is the most frequently transported drug. Body packing is a potentially lethal practice. The most serious complications of body packing are gastrointestinal obstruction or perforation and drug toxicity due to packet leakage or rupture. A 30-year-old confirmed body packer was brought to our emergency department from jail because of agitation and mydriasis. He presented with a high respiratory rate of 40/min but normal oxygen saturation on ambient air, a heart rate of 116 bpm, a blood pressure of 116/68 mmHg and a temperature of 38.0° Celsius. Blood tests were suggestive of infection, urine analysis was positive for Cocaine. Abdominal and thoracic computed tomography scans showed pulmonary infiltrates as a possible focus of infection; signs of bowel obstruction or perforation were absent. Given his clinical presentation, we suspected severe infection rather than massive Cocaine Intoxication to be the main problem. We therefore withheld immediate surgical decontamination. Instead, we started broad-spectrum antibiotic treatment with piperacillin/tazobactam plus clarithromycin for suspected severe community-acquired pneumonia or abdominal sepsis and treated the patient with intravenous midazolam for symptomatic Cocaine Intoxication. After detection of urinary pneumococcal antigen, the antibacterial regimen was changed to ceftriaxone and vancomycin for pneumococcal pneumonia. In addition, we found human immunodeficiency virus (HIV) type 1 infection as underlying disease. The patient recovered from his acute illness and was discharged after 7 days of treatment with ceftriaxone plus vancomycin. Antiretroviral therapy was started in an outpatient setting. With this case report, we emphasize the need to look for alternative diagnoses to Intoxication and gastrointestinal obstruction in acutely ill body packers with atypical presentation. Special risks, such as underlying HIV infection and potential antimicrobial resistance according to the individual’s geographical origin, should be taken into account while treating these patients.

Chandresh Shelat - One of the best experts on this subject based on the ideXlab platform.

  • electrophysiologic and hemodynamic effects of sodium bicarbonate in a canine model of severe Cocaine Intoxication
    Clinical Toxicology, 2003
    Co-Authors: Lance D Wilson, Chandresh Shelat
    Abstract:

    AbstractObjective. Cocaine toxicity causes myocardial depression, malignant dysrhythmias, and sudden death, partially due to Cocaine‐related myocardial sodium channel blockade. Because of Cocaine's ability to block cardiac sodium channels, sodium bicarbonate (NaHCO3) has been proposed as an antidote. The hypothesis of this study was that NaHCO3 would correct Cocaine‐induced conduction abnormalities and resultant hemodynamic compromise in an animal model simulating severe Cocaine Intoxication. Methods. Design: Prospective, controlled, experimental study in which 15 anesthetized dogs were given three successive boluses of Cocaine (7 mg/kg) and then randomized to receive NaHCO3, 2 mEq/kg (n = 8) or placebo (n = 7). Measurements: Arterial, left ventricular, and pulmonary artery pressures; cardiac output (CO); electrocardiogram (ECG); blood gases; and serum concentrations of Cocaine were measured at baseline, at fixed time intervals after each bolus of Cocaine, and then after administration of NaHCO3 or placeb...

M H Ramadan - One of the best experts on this subject based on the ideXlab platform.

  • acute rhabdomyolysis associated with Cocaine Intoxication a case report
    Hawaii medical journal, 1990
    Co-Authors: Michael H Wholey, E Ogasawara, M H Ramadan
    Abstract:

    : Over thirty million Americans are estimated to have tried Cocaine at least once and 5 million use it on a regular basis. Recent media attention to the widespread use of Cocaine has revealed the growing life-threatening complications that accompany its use. The effects of Cocaine on the cardiovascular, pulmonary and central nervous system have been well-described in medical literature, but the complications of acute renal failure secondary to Cocaine-induced rhabdomyolysis only recently have been addressed. Presented in this article is a case involving Cocaine-induced acute renal failure.