scholarly journals Characteristics and Outcomes of Cocaine-Related Spontaneous Intracerebral Hemorrhages

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Abubakr A. Bajwa ◽  
Scott Silliman ◽  
James D. Cury ◽  
Vandana Seeram ◽  
Adil Shujaat ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Tertiary Care ◽  
Drug Screen ◽  
Care Hospital ◽  
Urine Drug Screen ◽  
Cocaine Use ◽  
Number Of Patients ◽  
Positive Urine ◽  
Urine Drug ◽  
Intracerebral Hemorrhages

To date there is only one single-center study that has exclusively reported characteristics, location, and outcomes of spontaneous intracerebral hemorrhages (ICH) among cocaine users. We aimed to describe the radiological location and characteristics along with clinical outcomes of spontaneous ICH in a similar population. We conducted a retrospective chart review of consecutive patients admitted to a tertiary care hospital, with a spontaneous ICH, who had a urine drug screen performed within 48 hours of admission. Exposure to cocaine was defined by a positive urine drug screen within 48 hours of hospital admission. Demographics, radiographic features of ICH, and short-term clinical outcomes of patients with a positive urine drug screen were analyzed and compared with the cocaine negative group. Among the 102 patients analyzed, 20 (19.6%) had documented exposure to cocaine. There was a predominance of males in both groups with significantly more Blacks in the cocaine positive group (). A statistically significant number of patients with cocaine use had ICH in a subcortical location () when compared to cocaine negative patients. There was no difference in GCS, ICH volume, intraventricular extension, ICU days, hospital days, hospital cost, mortality, and ICH score. ICH in cocaine use is more frequently seen in the subcortical location.

Cocaine Use in Women From a Defined Population: Prevalence at Delivery and Effects on Growth in Infants

PEDIATRICS ◽  
1993 ◽  
Vol 91 (2) ◽  
pp. 350-354 ◽  
Author(s):  
W. T. Weathers ◽  
K. J. Sauvain ◽  
M. M. Crane ◽  
D. W. Blackhurst
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sudden Infant Death ◽  
Drug Screen ◽  
Sudden Infant ◽  
Urine Drug Screen ◽  
Urban Hospitals ◽  
Positive Urine ◽  
Urine Drug

Adverse health effects associated with intrauterine cocaine exposure (prematurity and its associated morbidity, intrauterine growth retardation, possible risk of sudden infant death syndrome) are based on studies from large urban hospitals, but few data exist from other sources. The current study, set in a community hospital, was designed to (1) estimate the prevalence of maternal cocaine use at delivery, (2) describe neonatal outcomes, and (3) evaluate physiological growth in exposed children. The study was conducted over 30 months (total births were 14 074) at The Children's Hospital of Greenville Memorial Hospital, the major source of neonatal care for Greenville County, South Carolina (1990 population: 320 000). A child was considered exposed to cocaine if there was documented evidence of use in the mother's medical record or if one member of the pair had a positive urine drug screen. Growth data were abstracted from clinical records. Overall prevalence of exposure was 1.0%. Of the 137 subjects (89, positive urine drug screen; 48 self-reported exposure), 21 (15%, 95% confidence interval, 9% to 21%) were premature (gestational age <37 weeks) and 2 died of sudden infant death syndrome. Mean age- and sex-adjusted percentiles for weight, length, and head circumference increased from 23%, 29%, and 18%, respectively, at birth to 43%, 49%, and 54% in children followed for 12 months; however, 50% of the cohort were lost to follow-up, and these children were smaller at birth than those under active follow-up. Rates of prematurity and infant death were similar to those reported in urban hospitals. These data support the concept that cocaine-exposed children can achieve expected growth levels by 1 year of age.

Concordance between urine drug screen and self-reported cocaine use

2017 ◽  
Vol 171 ◽  
pp. e188
Author(s):  
Gaurav Sharma ◽  
Neal Oden ◽  
Paul VanVeldhuisen
Keyword(s):  
Drug Screen ◽  
Urine Drug Screen ◽  
Cocaine Use ◽  
Urine Drug

scholarly journals Clinical Appraisal of Fosfomycin in the Era of Antimicrobial Resistance

2015 ◽  
Vol 59 (12) ◽  
pp. 7355-7361 ◽  
Author(s):  
Sangeeta Sastry ◽  
Lloyd G. Clarke ◽  
Hind Alrowais ◽  
Ashley M. Querry ◽  
Kathleen A. Shutt ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Clinical Outcomes ◽  
Tertiary Care ◽  
Asymptomatic Bacteriuria ◽  
Clinical Success Rate ◽  
Care Hospital ◽  
Content Type ◽  
E Coli ◽  
Number Of Patients ◽  
Tract Infections

ABSTRACTFosfomycin is recommended as one of the first-line agents for treatment of urinary tract infections (UTIs) in the latest guidelines endorsed by the Infectious Diseases Society of America (IDSA) and the European Society for Clinical Microbiology and Infectious Diseases (ESCMID). We evaluated the use of fosfomycin among inpatients at a tertiary care hospital between 2009 and 2013. UTI cases were defined using physician diagnosis and the National Healthcare Safety Network (NHSN) surveillance definitions. The number of patients treated with fosfomycin increased from none in 2009 to 391 in 2013. Among 537 patients who received fosfomycin for any indication during this period, UTI was the most common indication (74%), followed by asymptomatic bacteriuria (10%). All except 19 patients received a single dose of fosfomycin.Escherichia coliwas the most common organism involved (52%). For 119 patients with UTIs, after exclusion of those with negative urine culture results, negative urinalysis results, receipt of additional agents, or indeterminate clinical outcomes, the clinical success rate at 48 h was 74.8%. Of 89 patients who met the criteria for NHSN-defined UTIs, 89.9% had successful outcomes. Recurrent infections occurred in 4.3% of cases, and mild adverse events were observed in 2.0%. All 100 randomly selected extended-spectrum β-lactamase (ESBL)-producingE. coliclinical isolates from this period were susceptible to fosfomycin. In conclusion, the use of fosfomycin has increased substantially since implementation of the updated guidelines at this hospital. Fosfomycin was used mainly for the treatment of physician-diagnosed UTIs, and the clinical outcomes were generally favorable. Fosfomycin maintained activity againstE. colidespite the increased use of the agent.

51 We Test Everyone… Really? Bias in Drug Screening in an Academic Burn Center

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S37-S38
Author(s):  
Keturah Sloan ◽  
David G Greenhalgh ◽  
Soman Sen ◽  
Tina L Palmieri ◽  
Kathleen S Romanowski
Keyword(s):  
Logistic Regression ◽  
Drug Screening ◽  
Illicit Drugs ◽  
Burn Injury ◽  
Drug Screen ◽  
Urine Drug Screen ◽  
Burn Center ◽  
Number Of Patients ◽  
Urine Drug ◽  
The Mean

Abstract Introduction Previous studies have found that burn-injured patients who use illicit substances, such as methamphetamines, have worse outcomes and longer hospital lengths of stay when compared to those who do not use illicit drugs. It is our units’ stated practice to perform a urine drug screen on all patients admitted with a burn injury. We hypothesize that, while we intend to test all patients, we fall short of this goal. The purpose of this study is to examine our urine drug screening practices. Methods Following IRB approval, a retrospective chart review was conducted using electronic medical records of all adult patients admitted to the burn center from 2016–2018. Data collected included information on the burn injury, drug screening, and demographics. Due to the fact that many patients receive opioids and benzodiazepines for pain and anxiety related to their burn injury, these were not considered positive if present on drug screen without gas chromatography to confirm use. Data analysis was conducted using chi-square, t-test, and logistic regression models. Results A total of 1134 patients (mean age 45.9 ± 17.3 years, 855 males (75.4%), mean burn size (TBSA) 12.1±15.5%) were analyzed. Of the 1134 patients admitted, 65% had a urine drug screen performed. Of those who were not screened, 12.1% had a test ordered but not performed while 87.8% had no test ordered. Globally, amphetamines/methamphetamines were the most commonly detected substances in 262 patients (23.1%) followed by cocaine with 14 patients (0.2%) Those with larger burns were more likely to be tested with the mean burn size of those tested being 15.0% while the mean size of those not tested was 6.6%, p< 0.0001. When looking at the effect of age on drug screening, those at the extremes of age (< 20 years (37.5%), 61–70 years (38.9%), 71–80 years (51.5%) and >80 years (76.9%)) were more likely to not be tested (p< 0.0001). All other age groups had a rate of not testing between 30.3% and 33.3%. Additionally, overall men were more likely to be tested than women (68.3% vs. 54.8%, p< 0.0001). On multivariate logistic regression, age (OR 0.99 (0.98–0.99), p< 0.0001), burn size (OR 1.07 (1.05–1.08), p< 0.0001), and female gender (OR 0.61 (0.45–0.81), p=0.0008) were independently associated with a patient receiving a urine drug screen. Conclusions Although our intention is to perform a urine drug screen on all patients admitted with burn injury, we fall short of this goal. A significant number of patients do not get tested and these tend to be older patients, those with smaller burns, and women. Given that drugs of abuse can alter patient outcomes we need to be more rigorous in our efforts to obtain tests on all patients.

scholarly journals Mexiletine and False Positive Urine Drug Screen for Amphetamine: A Case Review

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Sumit Sohal ◽  
Mina Sous ◽  
Gauri Pethe ◽  
Shanmugha V. Padmanabhan ◽  
Rajesh Akbari ◽  
...  
Keyword(s):  
Health Care Providers ◽  
False Positive ◽  
Ventricular Arrhythmias ◽  
Screen Test ◽  
Drug Screen ◽  
Urine Drug Screen ◽  
Case Review ◽  
Care Providers ◽  
Positive Urine ◽  
Urine Drug

Advanced heart failure patients commonly suffer from ventricular arrhythmias which can be managed by antiarrhythmic drugs like mexiletine. These ventricular arrhythmias can be complicated by illicit drug use which alter outcomes and can potentially impact the patient-physician relationship through countertransference. However, mexiletine can lead to false positive urine drug screen testing for amphetamine, and these false-positive urine drug screen test results can affect the decision-making process. Health care providers should be aware of this fact and should either use confirmatory testing or look for confounding compounds in patients who deny using illicit substances and have a positive urine drug screen. Our patient is 64 years old who arrived at the emergency department after experiencing a shock by his intracardiac defibrillator. The patient tested positive for amphetamine on his urine drug screen and was later ruled out by confirmatory quantitative testing.

scholarly journals Can tapentadol cause a false-positive urine drug screen result for amphetamine?

2012 ◽  
Vol 50 (10) ◽  
pp. 1174-1175 ◽  
Author(s):  
Schirin Tang ◽  
Michael E. Mullins ◽  
Benjamin M. Braun ◽  
Karl G. Hock ◽  
Mitchell G. Scott ◽  
...  
Keyword(s):  
False Positive ◽  
Drug Screen ◽  
Urine Drug Screen ◽  
Screen Result ◽  
Positive Urine ◽  
Urine Drug
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