可卡因和主动脉夹层:需要合作来克服少报的偏见。

IF 1.4 4区 医学 Q2 MEDICINE, LEGAL
Forensic Science, Medicine and Pathology Pub Date : 2025-09-01 Epub Date: 2025-01-23 DOI:10.1007/s12024-025-00951-7
Pascale Basilicata, Antonio Lombardi, Mariagrazia Marisei, Emanuele Capasso, Angela Simonelli, Maria Pieri
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引用次数: 0

摘要

主动脉夹层是吸食可卡因的一个严重且可能致命的后果。然而,这一现象的潜在机制和特征仍有待深入研究。一名46岁白人男性被发现在家中失去反应和意识,并有滥用可卡因的历史。尸检结果显示主动脉弓和正常口径的胸主动脉,并有证据表明主动脉上升心包内部分的中膜夹层动脉瘤。法医毒理学分析证明,在所有液体(外周血、胆汁和尿液)、肝脏和大脑匀浆中,可卡因及其主要代谢物苯甲酰冈碱呈阳性反应。数据还证明了对酒精的阳性反应,证实了过去的饮酒史。本病例证实了可卡因成瘾与主动脉夹层风险之间的联系,强调需要增加对这种药物相关风险的了解。报告强调,需要对出现与可卡因使用有关的心脏症状的患者进行及时检查和有效治疗,并需要对使用/滥用其他心脏毒性物质的证据进行准确的回顾。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Cocaine and aortic dissection: the need for collaboration to overcome the underreporting bias.

Cocaine and aortic dissection: the need for collaboration to overcome the underreporting bias.

The dissection of the aorta is a serious and potentially fatal consequence of cocaine use. Nonetheless, the underlying mechanisms and characteristics of this phenomenon remain to be deeply studied. The autopsy case of a 46-year-old white male found irresponsive and unconscious in his house and had a history of abusing cocaine is presented. Autopsy findings showed aortic arch and thoracic aorta of regular calibre, with evidence of a mid-adventitial dissecting aneurysm of the ascending intrapericardial portion of the aorta. Forensic toxicological analyses evidenced a positivity to cocaine and its main metabolite, benzoylecgonine, in all fluids (peripheral blood, bile and urine), liver and brain homogenates. Data also evidenced a positivity to alcohol, confirming a past history of intake. The presented case confirms the connection between cocaine addiction and the risk of aortic dissection, emphasizing the need for increased knowledge about the risks connected to this drug. It is emphasized the need of prompt examination and effective treatment of patients exhibiting cardiac symptoms linked to cocaine use, as well as the need of an accurate anamnesis to evidence use/abuse of other cardiotoxic substances.

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来源期刊
Forensic Science, Medicine and Pathology
Forensic Science, Medicine and Pathology MEDICINE, LEGAL-PATHOLOGY
CiteScore
3.90
自引率
5.60%
发文量
114
审稿时长
6-12 weeks
期刊介绍: Forensic Science, Medicine and Pathology encompasses all aspects of modern day forensics, equally applying to children or adults, either living or the deceased. This includes forensic science, medicine, nursing, and pathology, as well as toxicology, human identification, mass disasters/mass war graves, profiling, imaging, policing, wound assessment, sexual assault, anthropology, archeology, forensic search, entomology, botany, biology, veterinary pathology, and DNA. Forensic Science, Medicine, and Pathology presents a balance of forensic research and reviews from around the world to reflect modern advances through peer-reviewed papers, short communications, meeting proceedings and case reports.
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