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      Cocaine-induced pulmonary changes: HRCT findings *

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          Abstract

          Objective:

          To evaluate HRCT scans of the chest in 22 patients with cocaine-induced pulmonary disease.

          Methods:

          We included patients between 19 and 52 years of age. The HRCT scans were evaluated by two radiologists independently, discordant results being resolved by consensus. The inclusion criterion was an HRCT scan showing abnormalities that were temporally related to cocaine use, with no other apparent causal factors.

          Results:

          In 8 patients (36.4%), the clinical and tomographic findings were consistent with "crack lung", those cases being studied separately. The major HRCT findings in that subgroup of patients included ground-glass opacities, in 100% of the cases; consolidations, in 50%; and the halo sign, in 25%. In 12.5% of the cases, smooth septal thickening, paraseptal emphysema, centrilobular nodules, and the tree-in-bud pattern were identified. Among the remaining 14 patients (63.6%), barotrauma was identified in 3 cases, presenting as pneumomediastinum, pneumothorax, and hemopneumothorax, respectively. Talcosis, characterized as perihilar conglomerate masses, architectural distortion, and emphysema, was diagnosed in 3 patients. Other patterns were found less frequently: organizing pneumonia and bullous emphysema, in 2 patients each; and pulmonary infarction, septic embolism, eosinophilic pneumonia, and cardiogenic pulmonary edema, in 1 patient each.

          Conclusions:

          Pulmonary changes induced by cocaine use are varied and nonspecific. The diagnostic suspicion of cocaine-induced pulmonary disease depends, in most of the cases, on a careful drawing of correlations between clinical and radiological findings.

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          Most cited references 48

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          World Drug Report

           UNODC (2012)
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            Profile of cocaine and crack users in Brazil

            This article aims to systematize the profile of cocaine and crack users in Brazil. The study adopted a literature review of the MEDLINE, LILACS, Cochrane Library databases and CAPES thesis/dissertation database. Data were grouped in thematic categories: national household surveys, surveys of specific population groups, profile of patients that seek treatment, and mortality and morbidity. Within each category the principal findings from the Brazilian literature were described and then discussed. The article concludes that the information on cocaine and crack consumption in Brazil is still incipient, but that the scientific community can already draw on a relevant theoretical corpus that can be used to update current public policies on this issue.
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              Clinical characteristics of septic pulmonary embolism in adults: a systematic review.

              To describe the clinical characteristics of septic pulmonary embolism in adults in order to improve its diagnosis and treatment.
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                Author and article information

                Journal
                J Bras Pneumol
                J Bras Pneumol
                jbpneu
                Jornal Brasileiro de Pneumologia
                Sociedade Brasileira de Pneumologia e Tisiologia
                1806-3713
                1806-3756
                Jul-Aug 2015
                Jul-Aug 2015
                : 41
                : 4
                : 323-330
                Affiliations
                [1 ]Programa de Pós-Graduação em Radiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil.
                [2 ]Faculdade de Medicina de Petrópolis, Petrópolis, Brasil.
                [3 ]Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, Brasil.
                [4 ]Ultra-X, São José do Rio Preto, São José do Rio Preto, Brasil.
                [5 ]Departamento de Medicina e Apoio Diagnóstico, Universidade Federal da Bahia, Salvador, Brasil.
                [6 ]Departamento de Clínica Médica, Universidade Federal do Paraná, Curitiba, Brasil.
                [7 ]Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, United Kingdom.
                [8 ]Radiologia Anchieta, Hospital Anchieta, Taguatinga, Brasil.
                [9 ]Universidade Federal de Santa Catarina, Florianópolis, Brasil.
                [10 ]Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brasil.
                [11 ]Universidade Federal Fluminense, Niterói, Brasil.
                [1 ]Programa de Pós-Graduação em Radiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil.
                [2 ]Faculdade de Medicina de Petrópolis, Petrópolis (RJ) Brasil.
                [3 ]Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto (SP) Brasil.
                [4 ]Ultra-X, São José do Rio Preto, São José do Rio Preto (SP) Brasil.
                [5 ]Departamento de Medicina e Apoio Diagnóstico, Universidade Federal da Bahia, Salvador (BA) Brasil.
                [6 ]Departamento de Clínica Médica, Universidade Federal do Paraná, Curitiba (PR) Brasil.
                [7 ]Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, United Kingdom.
                [8 ]Radiologia Anchieta, Hospital Anchieta, Taguatinga (DF) Brasil.
                [9 ]Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil.
                [10 ]Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre (RS) Brasil.
                [11 ]Universidade Federal Fluminense, Niterói (RJ) Brasil.
                Author notes
                Correspondence to: Edson Marchiori. Rua Thomaz Cameron, 438, Valparaiso, CEP 25685-120, Petrópolis, RJ, Brasil. Tel.: 55 24 2249-2777. Fax: 55 21 2629-9017. E-mail: edmarchiori@ 123456gmail.com
                Endereço para correspondência: Edson Marchiori. Rua Thomaz Cameron, 438, Valparaiso, CEP 25685-120, Petrópolis, RJ, Brasil. Tel.: 55 24 2249-2777. Fax: 55 21 2629-9017. E-mail: edmarchiori@ 123456gmail.com
                Article
                10.1590/S1806-37132015000000025
                4635952
                26398752

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                Page count
                Figures: 8, Tables: 4, Equations: 0, References: 36, Pages: 8
                Categories
                Original Article

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