Narcotic Poisoning of Children (1) Through Accidental Ingestion of Methadone and (2) in utero

PEDIATRICS ◽  
1974 ◽  
Vol 54 (3) ◽  
pp. 329-332
Author(s):  
Saul Blatman
Keyword(s):  
Gastrointestinal Tract ◽  
Clinical Medicine ◽  
Well Being ◽  
Pharmacological Action ◽  
In Utero ◽  
Abuse Liability ◽  
Practice Of Medicine ◽  
Life Threatening ◽  
Repeated Use ◽  
The Brain

Narcotics have been known to man since prehistoric times, and they continue to be among the most used analgesics in the practice of medicine. They comprise a group of drugs whose analgesic effect is coupled with euphoria and somnolence. In addition, their spasmogenic effect on smooth muscle has made them useful agents in the alleviation of certain gastrointestinal tract symptoms. For most narcotics, therapeutic dosage does not produce serious untoward effects. Unfortunately, they have a depressant effect on respiration by directly influencing the respiratory center of the brain. This may be life threatening when recommended dosages are exceeded. Narcotics have been abused since the recognition that they can induce euphoria and a feeling of well being. Tolerance and physical and psychological dependence result from their repeated use. The occurrence of withdrawal symptomatology in humans using these drugs repeatedly helps to produce a pattern of drug dependence; an individual has but to repeat a dose of drug in order to prevent withdrawal symptoms. Abuse liability is thus great. All narcotics share this addiction potential. Those most frequently prescribed in clinical medicine are morphine, trieperidine, codeine and methadone. Heroin (diacetylmorphine), the most commonly abused narcotic, available only illicitly, is not prescribed in clinical practice. After injection, it is hydrolyzed to morphine which produces its pharmacological action. While morphine and heroin are absorbed only following parenteral administration, some narcotics are absorbed readily from the gastrointestinal tract as well as after injection (methadone, codeine, meperidine). Regardless of the mode of administration, narcotics taken by a pregnant addict readily pass the placental barrier and are capable of producing effects on the infant in utero and after birth.

Fact file 1: Critical care and emergency medicine

2017 ◽  
Author(s):  
Daisy Fancourt
Keyword(s):  
Emergency Medicine ◽  
Critical Care ◽  
Sports Medicine ◽  
Orthopaedic Surgery ◽  
Extreme Environment ◽  
Disaster Medicine ◽  
Medical Attention ◽  
Life Threatening ◽  
Medical Disciplines ◽  
The Brain

Emergency medicine involves the care of patients who require immediate medical attention. The specialty encompasses a broad range of medical disciplines, including anaesthesia, cardiology (a field related to the heart), neurology (a field related to the brain), plastic surgery, orthopaedic surgery (surgery relating to the bones or muscles), and cardiothoracic surgery (surgery relating to the heart, chest, or lungs). There are also a number of subspecialties including extreme environment medicine, disaster medicine and sports medicine. Related to emergency medicine is the specialty of critical care medicine, which is concerned with the care of patients with life-threatening conditions often treated in intensive care settings....

scholarly journals Herbal Remedies and Their Possible Effect on the GABAergic System and Sleep

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 530
Author(s):  
Oliviero Bruni ◽  
Luigi Ferini-Strambi ◽  
Elena Giacomoni ◽  
Paolo Pellegrino
Keyword(s):  
Gaba Receptors ◽  
Herbal Medicines ◽  
Well Being ◽  
Herbal Remedies ◽  
Gamma Aminobutyric Acid ◽  
Systematic Analysis ◽  
Inhibitory Neurotransmitter ◽  
Alternative Medicines ◽  
Molecular Components ◽  
The Brain

Sleep is an essential component of physical and emotional well-being, and lack, or disruption, of sleep due to insomnia is a highly prevalent problem. The interest in complementary and alternative medicines for treating or preventing insomnia has increased recently. Centuries-old herbal treatments, popular for their safety and effectiveness, include valerian, passionflower, lemon balm, lavender, and Californian poppy. These herbal medicines have been shown to reduce sleep latency and increase subjective and objective measures of sleep quality. Research into their molecular components revealed that their sedative and sleep-promoting properties rely on interactions with various neurotransmitter systems in the brain. Gamma-aminobutyric acid (GABA) is an inhibitory neurotransmitter that plays a major role in controlling different vigilance states. GABA receptors are the targets of many pharmacological treatments for insomnia, such as benzodiazepines. Here, we perform a systematic analysis of studies assessing the mechanisms of action of various herbal medicines on different subtypes of GABA receptors in the context of sleep control. Currently available evidence suggests that herbal extracts may exert some of their hypnotic and anxiolytic activity through interacting with GABA receptors and modulating GABAergic signaling in the brain, but their mechanism of action in the treatment of insomnia is not completely understood.

scholarly journals Unilateral mydriasis in a child with a ventriculoperitoneal shunt for obstructive hydrocephalus: a diagnostic dilemma

2020 ◽  
Vol 13 (12) ◽  
pp. e237257
Author(s):  
Monidipa Banerjee ◽  
Eiman Haj Ahmed ◽  
Kathryn Foster ◽  
Arundoss Gangadharan
Keyword(s):  
Ipratropium Bromide ◽  
Obstructive Hydrocephalus ◽  
Sudden Onset ◽  
Unique Case ◽  
Diagnostic Dilemma ◽  
Vp Shunt ◽  
Life Threatening ◽  
Unilateral Mydriasis ◽  
The Brain ◽  
Rule Out

There are several causes for sudden onset unilateral mydriasis, however impending transtentorial uncal herniation needs to be ruled out. This unique case highlights an uncommon adverse response to a common mode of treatment that leads to a diagnostic dilemma. A 3-year-old boy with a ventriculoperitoneal (VP) shunt for an obstructive hydrocephalus presented with an acute respiratory distress. He developed unilateral mydriasis with absent light reflex during treatment with nebulisers. An urgent CT scan of the brain did not show any new intracranial abnormality. A case of pharmacological anisocoria was diagnosed that resolved completely within 24 hours of discontinuation of ipratropium bromide. Although ipratropium-induced anisocoria has been reported in children, but to our knowledge none in a child with VP shunt for hydrocephalus. This emphasises the urgency in evaluating unilateral mydriasis to rule out life-threatening conditions. Clinicians should remember that ipratropium administered through ill-fitting face masks could cause this completely reversible adverse effect.

scholarly journals Multidisciplinary Approach to Suspected Sudden Death Caused by Arteriovenous Malformation Rupture: A Case Report

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 644
Author(s):  
Federico Giuseppe Patanè ◽  
Massimiliano Esposito ◽  
Andrea Giovanni Musumeci ◽  
Monica Palermo ◽  
Marco Torrisi ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Cause Of Death ◽  
Venous Malformation ◽  
Healthy Woman ◽  
Unexpected Death ◽  
Medical Problems ◽  
Variable Diameter ◽  
Life Threatening ◽  
Brain Avms ◽  
The Brain

Arteriovenous malformations (AVMs) are rare congenital conditions with a prevalence of less than 1% and are mostly asymptomatic. However, these malformations can suddenly cause intense pain or bleeding, leading to life-threatening medical problems. This report presents a case of an unexpected death in a 37-year-old previously healthy woman due to an intra-cerebellum arteriovenous malformation rupture identified during autopsy. While infective processes where preliminarily excluded, a Post Mortem Computed Tomography (PMCT) identified a tetra ventricular hemorrhage and intra-cerebellum hemorrhage. Toxicological examination was negative for most substances of abuse. During autopsy an intense hemorrhagic infiltrate in the subarachnoid space was observed. After formalin fixation of the brain the cerebellum showed hemorrhagic infarction on fourth ventricle sides, as well as several small reddish infarctions across the entire cerebellum parenchyma. Histological examination of the brain and cerebellum showed a suffusion of erythrocytes in the sub-arachnoid region. Evidence of an arterio-venous malformation, with several intertwine vessels of variable diameter, surrounded by hemorrhagic evidence. The autopsy played a crucial role in identifying the location and the possibly affected vessel, as well as defining the cause of death. It is necessary to have a greater number of autopsies to make an epidemiological contribution. Furthermore, it is crucial to create a multicenter data network with other authors from other departments to improve information about epidemiological, clinical, diagnostic and therapeutic data. Most brain AVMs as cause of death are often undiscovered.

scholarly journals Social Volunteering in Aging Adults Increases Regions of the Amygdala and Correlates With Enhanced Generativity

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 795-795
Author(s):  
Michelle Carlson
Keyword(s):  
Social Engagement ◽  
Controlled Trial ◽  
Well Being ◽  
Health Study ◽  
Brain Health ◽  
Volunteer Program ◽  
Intention To Treat ◽  
Intervention Impact ◽  
Aging Adults ◽  
The Brain

Abstract The Brain Health Study (BHS) of the Baltimore Experience Corps Trial (BECT) examined whether a randomized, controlled trial of an intergenerational social volunteer program, entitled Experience Corps, increased subregions of the amygdala related to socioemotional memory and risk for Alzheimer’s disease in aging adults. We further assessed functional correlates of these intervention-related changes and changes in aging adults’ developmental need to be generative, or, to give back to the well-being of others. The BHS simultaneously randomized 112 men and women (59 intervention; 53 control) within BECT to evaluate intervention impact on biomarkers of brain health at baseline and annual follow-ups during the two-year trial. Intention-to-treat analyses revealed program-specific increases in the shape of the centromedial and basomedial regions of the left amygdala (p’s≤0.05 adjusted), which were correlated with increases in generativity (p’s =0.06). Meaningful social engagement buffered amygdalar declines important to preservation of emotionally salient memory and risk for dementia. Part of a symposium sponsored by Brain Interest Group.

scholarly journals Bedside examination of the vestibular and ocular motor system in patients with acute vertigo or dizziness

2019 ◽  
Vol 3 (2) ◽  
pp. 2514183X1988615
Author(s):  
Alexander A Tarnutzer ◽  
Marianne Dieterich
Keyword(s):  
Diagnostic Testing ◽  
Initial Assessment ◽  
Head Impulse Test ◽  
Motor Deficits ◽  
Ocular Motor ◽  
Bedside Examination ◽  
Life Threatening ◽  
Ocular Motor System ◽  
Bedside Tests ◽  
The Brain

In the initial assessment of the patient with acute vertigo or dizziness, both structured history-taking and a targeted bedside neuro-otological examination are essential for distinguishing potentially life-threatening central vestibular causes from those of benign, self-limited peripheral labyrinthine origin and thus for deciding on further diagnostic testing. In this article, the key elements of the vestibular and ocular motor examination, which should be obtained at the bedside in these acutely dizzy patients, will be discussed. Specifically, this will include the following five domains: ocular stability for (I) nystagmus and for (II) eye position (skew deviation), (III) the head-impulse test (HIT), (IV) postural stability, and (V) ocular motor deficits of saccades, smooth pursuit eye movements, and optokinetic nystagmus. We will also discuss the diagnostic accuracy of specific combinations of these bedside tests (i.e. HIT, testing for nystagmus and vertical divergence, referred to as the H.I.N.T.S. three-step examination), emphasizing that the targeted neuro-otological bedside examination is more sensitive for identifying central causes in acute prolonged vertigo and dizziness than early MRI of the brain.

Finite Difference Time Domain Simulations of Hybrid Neurotransducers Based Optical Microlasers

2020 ◽  
Author(s):  
Maurizio Manzo ◽  
Omar Cavazos
Keyword(s):  
Finite Difference ◽  
Chronic Traumatic Encephalopathy ◽  
Numerical Technique ◽  
Well Being ◽  
Infrared Light ◽  
Neuron Activity ◽  
Living Matter ◽  
Brain Functions ◽  
Laser Modes ◽  
The Brain

Abstract Different pathologies such as Alzheimer’s, Parkinson’s, Wilson’s diseases, and chronic traumatic encephalopathy due to blasts and impacts affect the brain functions altering the neuronal electrical activity. An important aspect of the brain study is the use of non-invasive, non-surgical methodologies that are suitable to the well-being of the patients. Only a portion of the electromagnetic field can be detected by applying sensors outside the scalp; in addition, surgery is often involved if sensors are applied in the subcutaneous region of the skull. Optical techniques applied to biomedical research and diagnostics have been spread during the last decades. For example, near infrared light (NIR) of spectral range goes from 800 nm to 1300 nm, it is harmless radiation for the living tissue, and can penetrate the living matter in depth as, it turns out that most of the living matter is transparent to the NIR light. Optical microlasers have been recently proposed as neurotransducers for minimally invasive neuron activity detection for the next generation of brain-computer interface (BCI) systems. They are lightweight, require low power consumption and exhibit low latency. This novel sensor that can be made of biocompatible material is coupled with a voltage sensitive dye; the fluorescence of the dye, which is excited by an external light source, is used to generate optical (laser) modes. Any variation in the neurons’ membrane electric potential via evanescent field’s perturbation turn affect the shifting of these laser modes. In order to reduce the energy required to power these devices and to improve their optical emission, metal nanoparticles can be coupled in order to use their plasmonic effect. In this paper, finite-difference timedomain (FDTD) numerical technique is used to analyze the performances on a dye-doped microlaser. Purcell effect and resonant wavelengths are observed.

Putative neural consequences of captivity for elephants and cetaceans

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Bob Jacobs ◽  
Heather Rally ◽  
Catherine Doyle ◽  
Lester O’Brien ◽  
Mackenzie Tennison ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Behavioral Health ◽  
Negative Impact ◽  
Well Being ◽  
Present Review ◽  
Large Mammals ◽  
Impoverished Environment ◽  
Neural Underpinnings ◽  
The Impact ◽  
The Brain

Abstract The present review assesses the potential neural impact of impoverished, captive environments on large-brained mammals, with a focus on elephants and cetaceans. These species share several characteristics, including being large, wide-ranging, long-lived, cognitively sophisticated, highly social, and large-brained mammals. Although the impact of the captive environment on physical and behavioral health has been well-documented, relatively little attention has been paid to the brain itself. Here, we explore the potential neural consequences of living in captive environments, with a focus on three levels: (1) The effects of environmental impoverishment/enrichment on the brain, emphasizing the negative neural consequences of the captive/impoverished environment; (2) the neural consequences of stress on the brain, with an emphasis on corticolimbic structures; and (3) the neural underpinnings of stereotypies, often observed in captive animals, underscoring dysregulation of the basal ganglia and associated circuitry. To this end, we provide a substantive hypothesis about the negative impact of captivity on the brains of large mammals (e.g., cetaceans and elephants) and how these neural consequences are related to documented evidence for compromised physical and psychological well-being.

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