tailieunhanh - báo cáo khoa học: " Chasing the dragon - characterizing cases of leukoencephalopathy associated with heroin inhalation in British Columbia"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Chasing the dragon - characterizing cases of leukoencephalopathy associated with heroin inhalation in British Columbia | Buxton et al. Harm Reduction Journal 2011 8 3 http content 8 1 3 HARM REDUCTION JOURNAL RESEARCH Open Access Chasing the dragon - characterizing cases of leukoencephalopathy associated with heroin inhalation in British Columbia 2 14 2 Jane A Buxton Renee Sebastian Lorne Clearsky Natalie Angus Lena Shah Marcus Lem Sian D Spacey5 Abstract An association between leukoencephalopathy a disease of the white matter of the brain and smoking heroin is well recognized. This paper describes 27 cases of leukoencephalopathy identified in two cities in British Columbia Canada 2001-2006 the largest number of geographically and temporally defined reported cases in North America. Twenty cases of leukoencephalopathy were identified in and around Vancouver with onset dates December 2001 to July 2003 seven further cases were identified in Victoria September 2005-August 2006. Twenty 74 of all cases were male two couples were reported and eleven cases 55 had Asian ethnicity. One case reported smoking heroin on a single occasion and developed mild symptoms all other cases were hospitalized. Thirteen 48 cases died all had smoked heroin for a minimum of 3 years. Testing of one available heroin sample identified no substance other than common cutting agents. Although a specific etiology was not identified our study supports the theory of an intermittent exposure to a toxic agent added to the heroin or a combustion by-product. It also suggests a dose response effect rather than genetic predisposition. Collaboration with public health health professionals law enforcement and persons who use illegal drugs will facilitate the early identification of cases to enable timely and complete follow-up including obtaining samples. Testing of implicated heroin samples may allow identification of the contaminant and therefore prevent further cases. It is therefore important to ensure key stakeholders are aware of our findings. Introduction Leukoencephalopathy .