Smoke and thriving: An ecological study

Studies suggest a possible inverse correlation between smoking attitude and happiness levels. The present paper investigates the relation between males and females smoking prevalence and happiness levels in 155 countries worldwide. Analyses, after adjusting for socio-economic factors, reveal a different relationship between happiness and prevalence of tobacco smoking in the two genders. Countries with highest prevalence of males smoking show the lowest wellbeing levels (Beta coefficient: -0.350; P Value <0.001) while countries with highest prevalence of females smoking show the highest levels of wellbeing (Beta coefficient: 0.144; P Value: 0.030). The countries with the highest prevalence of people thriving are those with the highest prevalence of women smoking and the lowest prevalence of males smoking

Profilo farmacologico dei politossicodipendenti

Per valutare le possibili conseguenze della politossicodipendenza sulla storia naturale dei tossicodipendenti da eroina, sonostati esaminati due gruppi di pazienti: tossicodipendenti da eroina (td-E) e tossicodipendenti da eroina con problemi di abuso di alcol (td-EPAA). E' stato inoltre verificato se l'associazione triplice: eroina, alcol e benzodiazepine fosse connessa con particolari modalità di assunzione della droga. I risultati ottenuti mettono in evidenza che i td-EPAA, rispetto ai td-E, risultano avere un profilo farmacologico caratterizzato da una più lunga storia di abuso di eroina, da assunzione di dosi maggiori di metadone ed infine da una maggiore pervasività del comportamento di assunzione di droghe. Uguale nei due gruppi risulta l'abitudine a scambiare siringhe, mentre i comportamenti ad elevato rischio di malattie infettive, quali rapporti sessuali con partners td, con sconosciuti o con soggetti HIV positivi risultano più frequenti nei td- EPAA, tali comportamenti potrebbero essere dovuti all'effetto disinibente dell'alcol Malgrado tali comportamenti la positività per HIV non varia, in maniera significativa, tra i due gruppi (49 % nei td-E e 52% nei td-EPAA). Quest'ultimo dato indica come in tutti i td da noi esaminati, i fattori responsabili dell'incremento di infezione da HIV siano da riportare oltre che all'uso stesso degli oppiacei, farmaci immunodepressivi, al comportamento, sempre diffuso tra tutti i td, di scambiare siringhe

Efficacy of first-line sodium thiosulphate administration in a case of potassium cyanide poisoning

Cyanide poisoning may occur following accidental fire-smoke inhalation or deliberate ingestion of salts. Hydroxocobalamin represents a first-line life-saving antidote. Although hydroxocobalamin represents a first-line lifesaving antidote, it is still not promptly available in the emergency department. Sodium thiosulfate can be administered in association with hydroxocobalamin whereas the delayed onset of clinical response makes sodium thiosulfate less suitable for emergency use. We describe a case of cyanide intoxication of a 43-year-old man who ingested an unknown amount of potassium cyanide, purchased via the Internet, in an attempted suicide. At admission to the emergency department, the patient presented GCS 3 with severe lactic acidosis. Orotracheal intubation, gastric lavage and oral activated charcoal were applied. Sodium thiosulfate was available in the emergency department and 10 grams were infused over a 30 minute period. Hydroxocobalamin was prescribed by the poison control centre and 5 grams were infused 2 hours after admission. Following sodium thiosulfate administration the patient was arousable and lactate concentration improved. No adverse effects were noted. Metabolic acidosis completely resolved 12 hours later. Cyanide concentration performed on blood samples collected at admission confirmed high cyanide blood levels (15 mg/L). This report highlights as the first-line administration of sodium thiosulfate, in rapid infusion, resulted effective and safe for cyanide poisoning. Our report suggests that sodium thiosulfate should be considered when hydroxocobalamin is not promptly available in an emergency settin

Cardiovascular and hepatic toxicity of cocaine: potential beneficial effects of modulators of oxidative stress

Oxidative stress (OS) is thought to play an important role in the pharmacological and toxic effects of various drugs of abuse. Herein we review the literature on the mechanisms responsible for the cardiovascular and hepatic toxicity of cocaine with special focus on OS-related mechanisms. We also review the preclinical and clinical literature concerning the putative therapeutic effects of OS modulators (such as N-acetylcysteine, superoxide dismutase mimetics, nitroxides and nitrones, NADPH oxidase inhibitors, xanthine oxidase inhibitors, and mitochondriotropic antioxidants) for the treatment of cocaine toxicity. We conclude that available OS modulators do not appear to have clinical efficacy

An Attempted Suicide with Copper Sulphate injected intravenously:Pathopsysiology and Therapy about a case report

Acute copper sulphate poisoning is an unusual event, rarely following parenteral exposure, complicated by toxicological effects as haemolytic anaemia, methaemoglobinaemia , hepato-renal damage and acute rhabdomyolysis. Currently, the therapeutic management ignores unique classes of evidence and is mainly based on supportive and chelation therapies. Case details. This case report describes acute copper sulphate poisoning in a 37-year-old man who attempted suicide by self-injecting an unknown amount of copper sulphate. Within three days the patient developed severe intravascular haemolysis and rhabdomyolysis. Initial therapy relied on intensive supportive care with fluids administration, electrolyte correction and packed red blood cells transfusion. The D-penicillamine (30 mg/Kg/day per os) was prescribed as chelation therapy by the poison control centre. The N-acetilcysteine and ascorbic acid were administered to prevent further oxidative stress. Later on, two sessions of therapeutic plasma exchange were performed in order to support the drug therapy. Haemolysis and rhabdomyolysis reversed throughout the hospital stay. Discussion. In this case the antidotic and antioxidant therapy resulted effective to reverse haemolysis and rhabdomyolysis and to prevent hepatic and renal damage. Moreover, this case underlies that therapeutic plasma exchange should be considered as an additive measure to undertake since the earlier stages of the emergency intervention. Acute copper sulphate poisoning is an event complicated by toxicological effects: haemolytic anaemia, methaemoglobinaemia, hepato-renal damage, acute rhabdomyolysis. The therapeutic management ignores unique classes of evidence and is based on supportive and chelation therapies. In this case: i) the antidotic and antioxidant therapy resulted effective to reverse haemolysis and rhabdomyolysis and to prevent hepatic and renal damage, ii) therapeutic plasma exchange should be considered as an additive measure to undertake

A case of infant botulism in a 4-month-old baby

This case-report highlights: i) the difficulty of IB diagnosis as it is a rare syndrome with subclinical onset, ii) the need for an accurate training for physicians involved in IB management, iii) the efficacy and safety of TEqA in IB treatment, iv) homemade honey is not the only cause of IB

Monitoring chemotherapy-induced alopecia with trichoscopy

Background: Chemotherapy-induced alopecia (CIA) ranks among the psychologically most devastating effects of cancer treatment for oncological patients, with an overall incidence of 65%. Nowadays trichoscopy is largely employed in the diagnosis of alopecia, but no description of CIA trichoscopic pattern is present in literature. Aims: We want to create an organic description of CIA trichoscopic aspects. Methods: Oncological patients candidate to chemotherapy drugs, afferent to our trichological outpatient were studied. Anamnesis, clinical exam, clinical global photography, pull test, trichogram, and trichoscopy were conducted at the different moments of therapeutic treatment. Results: A definite trichoscopic pattern in the different phases of treatment was observed. After the first 3 weeks of chemotherapy rare and scattered black dots, broken hairs, flame hairs and pohl pinkus appeared. At the end of chemotherapy besides the features described above, numerous thin hair in regrowth were detected, together to rare terminal hair, scattered black dots and circle hair. Three months after chemotherapy a progressive increase of follicular units and elongation of the existing hair were visible. Conclusions: We propose an description of CIA trichoscopic pattern and its evolution during the different phases of chemotherapy

Smoking E-CigaRette and HEat-noT-burn Products: the SECRHET study, a large observational survey among young people in Italy

Aim: Electronic cigarettes (eCig) and heated tobacco products (HTP), that heat a solution (e-liquid) to create vapour and tobacco at a temperature below the point of combustion, respectively, are emerging forms of smoking device widely diffused. The aim of this study was to investigate knowledge, attitudes and behaviour toward HTP among young people in Italy. Methods: The Smoking E-CigaRette and HEat-noT-burn products (SECRHET) study was an online survey carried out in April 2019 using the platform Skuola.net, a platform where 2.5 million students are registered. Questions were related to knowledge about new generation smoking products, such as “Do you know what happens to tobacco when you use a heat-not-burn product?”, “Do you think electronic cigarettes create addiction?”, “Are products that use heated tobacco harmful to health?”, “Are electronic cigarettes harmful to health?”, “Have you ever heard of products that use heated tobacco?”, “Is nicotine present in products that use heated tobacco?”&nbsp; Results: A total of 13882 people completed the questionnaire, of which 8056 (58%) were females. Regarding smoking habits, 3393 (24.4%) declared to be current cigarette smokers, while 802 (5.8%) and 3173 (22.9%) were current and former e-cigarette smokers, respectively. Moreover, 715 (5.2%) and 1148 (8.3%) declared to be current and former heat-not-burn cigarette smokers. The variables associated to both eCig and HTP use were current smoking, age over 18 years, male gender, and residence in Central and Southern Regions. Concerning knowledge issues, almost half of respondents believe that electronic cigarettes are addictive and are harmful to health. Moreover, most of respondents do not know what happens to tobacco when using a heated tobacco device and if heated tobacco products are harmful to health. Conclusion: The prevalence of eCig and HTP use is higher among young people in Italy compared to adults and older people, and requires adequate public health interventions. &nbsp; &nbsp; Conflicts of interest: None declared. &nbsp; Funding: This research received no external funding. &nbsp; Acknowledgments: The authors are grateful to the personnel of skuola.net

Smoking E-CigaRette and HEat-noT-burn Products: the SECRHET study, a large observational survey among young people in Italy

Aim:&nbsp;Electronic cigarettes (eCig) and heated tobacco products (HTP), that heat a solution (e-liquid) to create vapour and tobacco at a temperature below the point of combustion, respectively, are emerging forms of smoking device widely diffused. The aim of this study was to investigate knowledge, attitudes and behaviour toward HTP among young people in Italy. Methods:&nbsp;The Smoking E-CigaRette and HEat-noT-burn products (SECRHET) study was an online survey carried out in April 2019 using the platform Skuola.net, a platform where 2.5 million students are registered. Questions were related to knowledge about new generation smoking products, such as “Do you know what happens to tobacco when you use a heat-not-burn product?”, “Do you think electronic cigarettes create addiction?”, “Are products that use heated tobacco harmful to health?”, “Are electronic cigarettes harmful to health?”, “Have you ever heard of products that use heated tobacco?”, “Is nicotine present in products that use heated tobacco?”&nbsp; Results:&nbsp;A total of 13882 people completed the questionnaire, of which 8056 (58%) were females. Regarding smoking habits, 3393 (24.4%) declared to be current cigarette smokers, while 802 (5.8%) and 3173 (22.9%) were current and former e-cigarette smokers, respectively. Moreover, 715 (5.2%) and 1148 (8.3%) declared to be current and former heat-not-burn cigarette smokers. The variables associated to both eCig and HTP use were current smoking, age over 18 years, male gender, and residence in Central and Southern Regions. Concerning knowledge issues, almost half of respondents believe that electronic cigarettes are addictive and are harmful to health. Moreover, most of respondents do not know what happens to tobacco when using a heated tobacco device and if heated tobacco products are harmful to health. Conclusion:&nbsp;The prevalence of eCig and HTP use is higher among young people in Italy compared to adults and older people, and requires adequate public health interventions. &nbsp

Cardiovascular and Hepatic Toxicity of Cocaine: Potential Beneficial Effects of Modulators of Oxidative Stress

Oxidative stress (OS) is thought to play an important role in the pharmacological and toxic effects of various drugs of abuse. Herein we review the literature on the mechanisms responsible for the cardiovascular and hepatic toxicity of cocaine with special focus on OS-related mechanisms. We also review the preclinical and clinical literature concerning the putative therapeutic effects of OS modulators (such as N-acetylcysteine, superoxide dismutase mimetics, nitroxides and nitrones, NADPH oxidase inhibitors, xanthine oxidase inhibitors, and mitochondriotropic antioxidants) for the treatment of cocaine toxicity. We conclude that available OS modulators do not appear to have clinical efficacy