Intravenous Drug Addicts Research Articles

Profiles of primary brain abscesses and their impact on survival: An international ID-IRI study

ObjectivesThis study of 331 primary brain abscess (PBA) patients aimed to understand infecting agents, predisposing factors, and outcomes, with a focus on factors affecting mortality. MethodsData were collected from 39 centers across 16 countries between January 2010 and December 2022, and clinical, radiological, and microbiological findings, along with their impact on mortality, were analyzed. ResultsThe patients had a mean ± SD age of 46.8 ± 16.3 years, with a male predominance of 71.6%. Common symptoms included headache (77.9%), fever (54.4%), and focal neurological deficits (53.5%). Gram-positive cocci were the predominant pathogens, with Viridans group streptococci identified as the most frequently isolated organisms. All patients received antimicrobial therapy and 71.6% underwent interventional therapies. The 42-day and 180-day survival rates were 91.9% and 86.1%, respectively. Significant predictors of 42-day mortality included intravenous drug addiction (HR: 6.02, 95% CI: 1.38-26.26), malignancy (HR: 3.61, 95% CI: 1.23-10.58), confusion (HR: 2.65, 95% CI: 1.19-5.88), and unidentified bacteria (HR: 4.68, 95% CI: 1.76-12.43). Significant predictors of 180-day mortality included malignancy (HR: 2.70, 95% CI: 1.07-6.81), confusion (HR: 2.14, 95% CI: 1.11-4.15), temporal lobe involvement (HR: 2.10, 95% CI: 1.08-4.08), and unidentified bacteria (HR: 3.02, 95% CI: 1.49-6.15). ConclusionThe risk of death in PBA extends beyond the infection phase, with different factors influencing the 42-day and 180-day mortality rates. Intravenous drug addiction was associated with early mortality, while temporal lobe involvement was associated with late mortality.

Successful healing of infective endocarditis in an intravenous drug addict

Successful healing of infective endocarditis in an intravenous drug addict

Embolectomy at the Time of Ligation of Femoral Vessels in Psuedoaneurysm in Intravenous Drug Addicts can save Limb

Aim: To determine the impact of embolectomy at the time of ligation of femoral artery in management of pseudoaneurysmin intravenous drug addicts Study design: Descriptive cross-sectional study Methods: This study was carried out at Vascular surgery department, CMH Lahore and included 28 patientsof intravenous drug addiction of both genders presenting in emergency of CMH Lahore with viable limb from 1st August 2021 to31st January 2023. Unsalvageable limbs at the time of presentation were excluded from the study. SPSS Version 20.0 was used for data analysis of age, sex, co-morbidities (infection), mode of presentation and outcome variables. Results: This study comprised of28 patientsadmitted through Emergency Department of CMH, Lahore. The mean age was found to be 32.16 years ±7.63 years. All patients 28(100%) were males with majority belonging to third decade of life 20(71.4%).Chronic viral infection was present in all cases. Almost half of them had hepatitis B virus infection (48%) while cases positive with hepatitis C virus and HIV infections were 37% and 15% respectively.Majority of the patients came to the hospital with bleeding from ruptured pseudoaneurysm (60.7%) and infected pulsatile swelling (32.1%), while pulsatile swelling without bleedingand wrong diagnosis were least common.Alllimbs were salvaged in first and second follow-up visits, 20 patients were lost on follow up on 12th week. Conclusion/Practical implication: Embolectomy is a very useful adjunct in the management of pseudoaneurysm of intravenous drug addicts. It should be routinely practiced in treatment of these patients to save limbs. Keywords: Embolectomy, ligation, femoral vessels, intravenous drug addicts

Infectious endocarditis in HIV-infected intensive care unit patients

Infective endocarditis (IE) is one of the most common cardiac complications in HIV patients who are intravenous drug addicts. The presence of IE and secondary diseases in immunocompromised individuals usually requires specific diagnostic and therapeutic approach.Aim: Optimizing the diagnosis of IE in patients with advanced HIV/AIDS.Materials and methods We reviewed 429 case records of HIV/AIDS ICU patients using the modified duke criteria for diagnosis of infective endocarditis. Statistical significance (p <0.05) of data was assessed using the χ2 test.Results. 25 patients were diagnosed with IE. The male gender dominated – 68%. Mean age was 38. 60% had stage 4B HIV infection. 68% were ART naive. The medium viral load was 294560 copies / ml, while the medium CD4 count was 218 cells / μl. Fever of >38°C was a key symptom found in all patients. Blood cultures were positive in 60% cases. 80% had a high C reactive protein (CRP), and 44% had CRP levels above 100 mg/l. Procalcitonin (PCT) levels were increased in 52%. Echocardiogram revealed IE in 92%. Pneumonia was diagnosed in 92%. Fatal outcome occurred in 76%. Anemia was a predictor of severe outcome (p<0.002), while patients with leukocytosis had good prognosis (p<0.05).Conclusion. Infective endocarditis is a common complication among HIV IDUs. The most common diagnostic criteria are fever >38°C, pneumonia, anemia, leukocytosis, thrombocytopenia and echocardiographic findings. The levels of the hemoglobin and WBCs could evaluate prognosis of the disease outcome.

Outcomes of Covered Stents With Vacuum Sealing Drainage For Treatment of Infected Femoral Pseudoaneurysms in Intravenous Drug Addicts

For treatment of infected femoral artery pseudoaneurysms (IFAPs) with the covered stent, debridement technique is important but frequently ignored. Our study aims to review our experience and outcomes of patients undergoing covered stents placement and debridement with vacuum sealing drainage (VSD). This study retrospectively analyzed 41 intravenous drug addicts with IFAP who received covered stent implantation and debridement with VSD from January 2015 to December 2020. The diagnosis was based on the previous history of local injection and the presence of pulsatile mass at the injection site. All cases were confirmed by CT angiography (CTA), ultrasound, or digital subtraction angiography (DSA). Technical success, time of wound care, and clinical outcomes were evaluated. Technical success was achieved in all patients. The interval from diagnosis to treatment was 26 ± 11 hours. The time of continuous drainage with VSD was 18.79 ± 6.56 days. 38 patients (92.68%) with fresh granulation tissue were sutured and discharged from the hospital. Stents in 31(91.18%) of 34 cases were patent during follow-ups. Three patients had stent occlusion caused by thrombosis, and two of them were complicated with stent infection. The two infectious stents were removed and the femoral arteries were ligated. One of them received open-surgical reconstruction with the great saphenous because of claudication. Two patients were admitted to the hospital for rebleeding caused by drug abuse relapse. Covered stents placement is convenient and rapid to control massive hemorrhage in IFAPs of intravenous drug abuse. Early debridement of infected tissue with continued VSD may shorten the time of wound care and make the incidence of stent infection relatively low. Meanwhile, the patency in a short time follow-up is acceptable. These results indicate that covered stents implantation with VSD may be a safe, effective, and feasible measure for the treatment of IFAPs.

DIAGNOSTICS AND TREATMENT OF PURULENT ARTHRITIS OF THE STERNOCLAVICULAR JOINT

Summary. Inflammatory lesion of the sternoclavicular joint (SCJ) is a rare disease that requires surgical treatment. Traditional radiography reveals osteolysis and osteosclerosis, however, at the onset of the disease, such changes are absent. Difficulties in diagnosing this disease require further study of the problem and the development of new therapeutic and diagnostic approaches.
 Aim of the work: to study the role of sonography in the diagnosis of purulent arthritis of SCJ and the choice of treatment tactics.
 Materials and methods. Prospective single-center study of 28 cases of acute nonspecific arthritis of SCJ. The patients were divided into 2 groups: the first included patients who received drug therapy, the second included patients subject to surgical treatment.
 Results and discussion. Ultrasound scanning of SCJ identified 3 sonographic variants of the lesion: exudative, destructive with synovial hyperperfusion, and destructive with synovial hypoperfusion.
 The duration of hospital stay in both groups did not differ statistically: 12 (12; 13.5) vs 14 (12; 14) days, p = 0.194.
 Analysis of long-term results in patients of the first group established the progression of the disease with the development of osteomyelitis or recurrence of arthritis in 3 cases (30 %). Among the patients of the second group, no complications or recurrence were detected during the indicated observation period.
 Conclusion. Sonography is diagnostically significant in the diagnosis of SCJ arthritis. It allows you to determine the group of patients subject to mandatory surgical correction. Intravenous drug addiction associated with bacteremia is a predictor of poor drug treatment outcomes and an indication for active surgical tactics.

Polymicrobial Pseudomonas Plus Candida Parapsilosis Endocarditis in an Injection Drug User: Considerations for Diagnosis and Management

Fungal endocarditis (FE) is a potentially lethal condition and its diagnosis can be challenging due to the low yield from blood cultures. FE should be suspected in patients with associated risk factors despite the identification of positive bacterial blood cultures. The common risk factors for FE discussed in the literature are total parenteral nutrition, immune suppression, prior antimicrobial therapy, intravenous drug addiction, and cardiac surgery. In this report, we discuss a patient who had positive blood cultures for Pseudomonas but was found to have Candida parapsilosis on valve culture. Physicians need to maintain a high index of suspicion for co-infective endocarditis in this patient population.

Outcomes of Femoral Artery Pseudoaneurysm in Intravenous Drug Abusers Managed at a Tertiary Care Center.

ObjectivesThe aim of this study was to assess the effects of ligation and excision of femoral artery pseudoaneurysm without revascularization in intravenous drug abusers presenting in the tertiary care center.MethodsThis was a retrospective study conducted at Shaheed Mohtarma Benazir Bhutto Institute, Karachi, Pakistan, and included 119 patients admitted for vascular injuries of the groin between June 2016 and June 2020. Data collected from the hospital's medical records included all intravenous drug addicts presented with mass near or at groin area only, while other pseudoaneurysm locations secondary to vascular trauma, arteriovenous fistula, and hemodialysis were excluded. SPSS Version 20.0 (IBM Corp., Armonk, NY, USA) was used for data analysis.ResultsThis study included 119 patients, all of whom presented and admitted to the Accident and Emergency Department, with a mean age of about 32 years ± 11.34 years and a mean duration of addiction of 2.47 years ± 1.37 years. Males constituted 83.2% of the patients, while females constituted 16.8%. The left femoral artery was affected more commonly than the right femoral artery, with an average of 75.6% and 24.4%, respectively. The most common presentation was bleeding from ruptured pseudoaneurysm (76.5%) and oozing with pulsatile mass (17.6%), while infected pulsatile swelling and misdiagnosis were uncommon. After surgical intervention, limb salvage was 95.8%, whereas mortality and amputation rate were 2.5 % and 1.7%, respectively.ConclusionThe optimal management of femoral artery pseudoaneurysm in intravenous drug addicts is ligation and excision of the pseudoaneurysm without revascularization.

Инфекционный эндокардит и его осложнения

The article presents a clinical observation of infective endocarditis of the tricuspid and aortic valves in a patient suffering from intravenous drug addiction. A feature of this observation is the developed multiple complications — ischemic stroke, pneumonia, spleen infarction. The diagnosis of infective endocarditis became possible after the appearance of the clinical picture of ischemic stroke. Clinical observation demonstrates the need to take into account all possible etiological factors in the event of a picture of ischemic stroke in the process of diagnosis.

Management of Brachial Artery Pseudoaneurysms in Intravenous Drug Abusers

ObjectiveTo determine the outcomes of the ligation and excision of brachial artery pseudoaneurysm in IV drug abusers without revascularization. MethodologyThis retrospective observational study was conducted at the vascular surgery department Shaheed Muhtarma Benazir Bhutto trauma center Karachi from January 2019 to June 2020. All the patients with a history of intravenous drug abuse presented with pulsatile mass at or near cubital fossa, diagnosed as pseudoaneurysm, age ranging from 18-70 years, and of either gender were included in the study. Patients with pseudo-aneurysm secondary to trauma, hemodialysis, arteriovenous fistula, location other than cubital fossa, and whom primary revascularization was performed were excluded. The recorded data entered and analyzed using SPSS 20.0 (IBM Corp., Armonk, NY).ResultsA total of 20 intravenous drug addicts were included in the study. The mean age was of 31.10 ± 7.80 years, and the mean duration of addiction was 2.24 ± 1.16 years. The right arm is affected in almost two-thirds of patients. The most common presentation in the emergency department was ruptured pseudo-aneurysm with bleeding (65%), followed by oozing with pulsatile mass (30%), and infected pulsatile mass (5%). The outcome was Limb salvage (100%), and none of the patients had developed threatened ischemia of the arm or required amputation.ConclusionThe ligation and excision of the pseudo-aneurysm, without revascularization, is a safe and effective treatment option for the management of pseudoaneurysm of the brachial artery secondary to intravenous drug addiction.

Le syndrome des grosses mains : un diagnostic méconnu

Puffy hand syndrome is a rare complication of intravenous drug addiction. Diagnosis is based on the patient's history and clinical examination. A woman and two men, aged 42, 39 and 36years old, are described. All had a history of intravenous drug use of heroin and oral buprenorphine misuse. Puffy hand syndrome appeared during drug addiction (n=2) or after its withdrawal (n=1). It was associated with acrocyanosis (n=1) or injection scars (n=1). Upper limb ultrasonography showed sequelae of venous (n=3) or arterial (n=1) thrombosis. An upper limb lymphoscintigraphy in one patient showed decreased radionuclide uptake of axillary lymph node and subdermal reflux tracer in the forearm. Treatment was based on low-stretch bandages to reduce the volume and then elastic compression sleeve for long-term stabilization. Puffy hand syndrome seen in intravenous drug addicts is poorly understood. It is a chronic complication despite the cessation of drug use. This syndrome has to become more widely known because its management is mandatory, although symptomatic.

Treatment strategies and outcomes for injection-associated inguinal perivascular abscesses in intravenous drug addicts

HintergrundLangzeitdrogenabhängige präsentieren sich nach dem Verbrauch der oberflächlichen Venen regelmäßig mit tiefen inguinalen vaskulär assoziierten Abszessen infolge fortgesetzter Drogeninjektionen. Die Behandlung dieser Komplikationen stellt anhaltend eine große medizinische Herausforderung dar. Bisher werden keine einheitlichen Therapieregime in der Literatur beschrieben.FragestellungWelche Behandlungsstrategien und Ergebnisse gibt es bei injektionsassoziierten inguinalen perivaskulären Abszessen bei Drogenabhängigen?Material und MethodenDie Daten aller im Zeitraum zwischen 01.01.2004 und 31.05.2019 am Universitätsklinikum Augsburg behandelten Drogenkonsumenten wurden retrospektiv aufgearbeitet und mit der vorliegenden Literatur verglichen.ErgebnisseEs konnten 37 Fälle (männlich = 25, weiblich = 12) nach Anwendung der Einschlusskriterien in die Datenerhebung eingeschlossen werden. Das mediane Alter im untersuchten Patientenkollektiv lag bei 34,3 Jahren. Die 30-Tage-Mortalität lag bei 2,7 % (1/37). Die Amputationsrate betrug 2,8 %. Im untersuchten Kollektiv lag bei 13 Patienten eine arterielle Beteiligung vor. In 5 Fällen wurde primär arteriell ligiert. Bei weiteren 5 Fällen wurde primär eine Rekonstruktion mittels autologen Interponats durchgeführt. In weiteren 3 Fällen erfolgte die Anlage eines Obturatorbypasses (1/3) sowie die Durchführung einer Patchplastik (2/3). Die Offenheitsrate nach arterieller Rekonstruktion lag bei 87,5 % bei einem mittleren Follow-up von 421 Tagen. Die Gesamtkomplikationsrate lag bei 51,4 %.DiskussionBei vaskulärer Beteiligung ist ein situationsgerechtes Vorgehen sinnvoll. Neben der Beseitigung komplizierter, septisch-venöser Thrombosen erscheint die Korrektur arterieller Blutungen mittels autologer Rekonstruktionsmaßnahmen aussichtsreich.

Critical View on the Usage of Ribavirin in Already Existing Psychostimulant-Use Disorder.

Substance-use disorder represents a frequently hidden non-communicable chronic disease. Patients with intravenous drug addiction are at high risk of direct exposure to a variety of viral infections and are considered to be the largest subpopulation infected with the hepatitis C virus. Ribavirin is a synthetic nucleoside analog that has been used as an integral component of hepatitis C therapy. However, ribavirin medication is quite often associated with pronounced psychiatric adverse effects. It is not well understood to what extent ribavirin per se contributes to changes in drug-related neurobehavioral disturbances, especially in the case of psychostimulant drugs, such as amphetamine. It is now well-known that repeated amphetamine usage produces psychosis in humans and behavioral sensitization in animals. On the other hand, ribavirin has an affinity for adenosine A1 receptors that antagonistically modulate the activity of dopamine D1 receptors, which play a critical role in the development of behavioral sensitization. This review will focus on the current knowledge of neurochemical/neurobiological changes that exist in the psychostimulant drug-addicted brain itself and the antipsychotic-like efficiency of adenosine agonists. Particular attention will be paid to the potential side effects of ribavirin therapy, and the opportunities and challenges related to its application in already existing psychostimulant-use disorder.

Thymus Involution and Intravenous Drug Abuse.

Thymus glands from 283 autopsy cases were sampled and evaluated with histochemical and immunohistochemical methods. A subpopulation of 41 intravenous drug addicts were compared with age-matched control cases.It was found that an accelerated involution of the thymus occurred in the 20- to 25-year interval and thereafter with a steady pace of 5% per year. Also the size of Hassall bodies declined successively.In drug addicts, an increased dystrophic calcification of the Hassall bodies and a significant difference in thymus size (atrophy) compared with controls were seen. Moreover, a difference was seen in the relative numbers of CD4 and CD8 lymphocytes where CD4+ cells were reduced in drug addicts.It is hypothesized that signs of hepatitis C virus infection that was found in the majority of drug addicts and the reduced number of functionally intact Hassall corpuscles could explain the reduction of CD4+ lymphocytes and thymic hypotrophy in this population.

Pattern of chest diseases among addicts in Poison Control Center of Ain Shams University Hospitals

BackgroundDrug addiction results in serious pulmonary complications. Thoracic complications of drug addiction vary depending on the type and the route of administration of the drug that has been abused.AimTo study the pattern of chest diseases among addicts in Poison Control Center of Ain Shams University Hospitals.Patients and methodsA total of 200 addict patients were selected from Poison Control Center of Ain Shams University Hospitals in the duration between June 2016 and June 2018. All patients with pulmonary complications referred to Abbasia Chest Hospital were included.ResultsA total of 200 addict patients were enrolled in this study. Of them, 100 addicts with drug overdose with no pulmonary complications were excluded, and the other 100 patients were included, comprising 99 males and only one female, with mean age of 39.91±10.75 years. Overall, 63% of drug addicts were cannabis addicts, 27.0% were opiate addicts, 8.0% were polysubstance abusers, and 2.0% were alcohol addicts. Pulmonary tuberculosis was the most common pulmonary complication of all drug addicts. There was a statistically significant correlation between the type of drug addiction and the pulmonary complications. Pulmonary tuberculosis was the most common among cannabis addicts as well as polysubstance abusers. Parenchymal lung diseases (pneumonia and lung abscess) were the most common among opiate and intravenous drug addicts. There was no significant difference between different types of drugs and outcomes of the patients. Mortality represented 3.0% of all drug addicts.ConclusionMany pulmonary complications are associated with drug addiction. Achievement of early diagnosis and treatment can be obtained by proper counseling and therapeutic programs.

Caractéristiques des plaies chroniques chez les toxicomanes : étude rétrospective de 58 patients

Drug addiction causes chronic wounds (CW) responsible for severe complications. Very few studies are available on this topic. The aim of our study was to describe the demographic, clinical and etiological characteristics as well as the course of CW in drug addicts. This was a retrospective and prospective multicenter study including all drug addicts with CW. We included 58 patients (17 prospectively), 84.5% of whom were male, of median age 43 years, presenting multiple CW as a result of intravenous (78.2%), inhaled (41.1%) and/or snorted (20%) drug abuse. Addiction to opioids (68.4%), cocaine (47.4%) and/or cannabis (40.4%) was ended and/or treated through substitution in 79.3% of patients. CW were fibrinous and necrotic (42.9 to 53.6%), recurrent (54.2%), and in some cases had been present for more than 1 year (61.5%). Intravenous drug addiction was associated with large, fibrinous, ulcers in a setting of venous and lymphatic insufficiency (74%). Only 23% of these wounds involved the upper limbs. Necrotic ulcers associated with clinical arteriopathy were described mainly with inhaled addiction. Abscesses (50%) and erysipelas (29.3%) were the most common cutaneous complications. After 3 months, 50% of CW were improved and 29.2% of patients were lost to follow-up. Drug abuse-related CW occurred preferentially in young men with history of intravenous abuse. For the most part, CW were seen on the legs and were associated with venous and lymphatic insufficiency, and the resulting major risk for cutaneous infection increased morbidity and mortality in this population in whom medical follow-up is inherently complicated.

THE ECONOMIC IMPACT OF TREATING CHRONIC HEPATITIS C

Hepatitis C is a viral infection of the liver. This infection is a global problem because over 180 million people worldwide have chronic hepatitis type C (about 3% of the world's population). The highest prevalence occurs among intravenous drug addicts (about 52%), the virus can be transmitted from mother to child during childbirth (4-8%), and further the virus is transmitted through medical interventions, piercing, tattooing. In the Republic of Macedonia in the period from 2011 to 2017, 511 newly infected with Hepatitis C from a total of 31 municipalities were registered. Among the healthy population in Macedonia, 0.4% were positive for HCV, while among the risk groups, 23% -52% were positive for HCV. In Macedonia, the groups at highest risk of HCV are: people who inject drugs (with a prevalence of 51.53%), people who are being treated with hemodialysis (with a prevalence of 37.91%), people who have become infected with HCV by transfusion (with a prevalence of 1,48%), people who have become HCV infected in other risky ways (with a prevalence of 9,08%). Hepatitis C virus is a serious health, but also an economic problem. Treatment of hepatitis C is expensive and therefore hardly accessible to people motivated to heal from hepatitis C. Тhe treatment of patients with chronic hepatitis C was performed with a combination of pegylated interferon alfa and ribavirin (dual therapy) for 24 or 48 weeks. Early detection of HCV infection is very important, because chronic hepatitis C is already a treatable disease, until the stage of decompensated cirrhosis and / or HCC. Disease control is successfully achieved by 30-60% with standard interferon, 40-70% depending on the genotype with pegylated interferon (in combination with ribavirin), and 40-90% with new direct-acting antivirals (DAAs). In addition, the benefit of treatment is that it reduces the risk of further spread of the virus. Treatment with the most recent direct-acting drugs (DAAs) started in 2011, lasts much shorter, 12 to 24 weeks, has the least risky effects and the highest percentage of negativity (up to 90%) but is not yet widely used (expensive in many countries not yet registered ). For example, sophosuvir is only regressed in some richer countries, and treatment with it costs about $ 84,000 ($ 1,000 per pill). In 2011, treatment with Copegus and Pegasus for 48 weeks of treatment, for patients under 75 kg, required a total of 1,215,974 MKD (44,831 MKD cost per one Copegus package and 15,993 MKD for a Pegasus injection). For patients over 75 kg the total cost is 1,305,636 MKD. For genotype 2 and 3 the total costs for all patients regardless of body weight were 563,156 MKD. Total costs in 2017 for Copegus and Pegasus for 48 weeks of treatment for patients with Hepatitis C genotype 1 and 4 in Macedonia cost 655,964 MKD, which means a 46% decrease compared to 2011.

The Main Factors Affecting the Tendency for “Injection Drug Use”

Background: Injection drug use (IDU) is one of the most dangerous and addictive methods of drug abuse. The current statistics showed that the rate of IDU is increasing, and is higher compared to other methods of drugs abuse. In addition, it is one of the main routes of transmitting infectious diseases, such as human immunodeficiency virus (HIV) and hepatitis in Iran. Objectives: In light of this, the present study aimed at examining the main factors, affecting the tendency for IDU. Patients and Methods: This study was a descriptive study of 823 individuals, having an active file at centers and referred to Kermanshah-based maintenance methadone therapy (MMT) centers, in 2015. Sample collection was performed through multi-stage sampling of all MMT centers. Information gathering was performed with the help of a Psychologist of the ward, in charge of interviewing the referees. The data were analyzed, using multi-variable logistic regression. Results: All the clients were males with an average age of 38.48 ± 11.21 years. Average age of drug abuse initiation was 23.03 ± 7.9 years. After controlling for confounding variables, the individuals, who were a drug addicts for more than 10 years had 3.01 (1.6 to 5.6) times greater tendencies for intravenous drug addiction, compared to those, who were a drug addict for less than five years. In addition, individuals aged more than 35 years had 0.06 (0.01 - 0.22) times less tendencies to IDU drugs, compared to those, who were younger than 19 years old. Although the type of drug that the patient used for the first time, was not affecting the tendency, the risk of intravenous drug addiction in those, who used oral drugs was 1.74 (1.1 to 2.56) times more than those, who developed a drug addiction through nasal drugs. Conclusions: By taking into consideration that drug abuse initiation and the duration of drug use were the main causes of the tendency for IDU, prevention by decreasing the age of the development of drug addiction and decreasing the duration of drug use, could be an effective measure to decrease the rate of IDU in the society.

Surgical Management of the Infected Femoral Pseudoaneurysms In Intravenous Drug Addicts

Background: Vascular system complications are an ongoing hazard of intravenous drug abuse. Patients and Method: This is a prospective study. The study was conducted on twenty patients who were presented at AL Hussein University Hospital in Cairo with infected femoral artery pseudoaneurysm over a period of eight months from Nov 2017 to July 2018. The inpatient medical charts were reviewed. Data were obtained on their demographic, clinical, management and outcome parameters. Result: Among the twenty intravenous drug users presenting with infected femoral artery pseudoaneurysms, (16) of the patients (80%) were seropositive for HCV. All were operated, with (5%) mortality. Primary ligation and debridement was the technique used almost exclusively (75%). One patient was managed by primary reconstruction by direct in-situ repair. Four patients were managed by primary revascularization through exta-anatomical bypass. Mean follow up period was three months. Conclusion: Ligation and debridement appears to be a simple, safe and effective procedure in infected pseudoaneurysms in IV drug users.

Surgical Management of the Infected Femoral Pseudoaneurysms In Intravenous Drug Addicts

Background: Vascular system complications are an ongoing hazard of intravenous drug abuse. Patients and Method: This is a prospective study. The study was conducted on twenty patients who were presented at AL Hussein University Hospital in Cairo with infected femoral artery pseudoaneurysm over a period of eight months from Nov 2017 to July 2018. The inpatient medical charts were reviewed. Data were obtained on their demographic, clinical, management and outcome parameters. Result: Among the twenty intravenous drug users presenting with infected femoral artery pseudoaneurysms, (16) of the patients (80%) were seropositive for HCV. All were operated, with (5%) mortality. Primary ligation and debridement was the technique used almost exclusively (75%). One patient was managed by primary reconstruction by direct in-situ repair. Four patients were managed by primary revascularization through exta-anatomical bypass. Mean follow up period was three months. Conclusion: Ligation and debridement appears to be a simple, safe and effective procedure in infected pseudoaneurysms in IV drug users.