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Objective: Although the consumption of abusive substances is almost as old as humanity itself, in the last 25 years new drugs of abuse have appeared. This has modified the type of overdose patient treated. We present the results of a study carried out in our hospital with the aim of profiling this type of patient. Methods: Records of patients attended in the Emergency Department of our hospital for a period of three months (March-May 2000) were reviewed and patients presenting because of drug overdose, including alcohol, were identified. The variables studied were age, sex, drug type, target organ, treatment given and evolution. The results were analyzed with the SPSS statistical program. Results: During the period studied, 36.712 patients attended the Emergency Department of which 151 (0.4%) were for overdose of drugs of abuse. Two-thirds (98 cases) were alcohol-only intoxications, and the remaining third (53 cases) overdoses of other drugs: cocaine (49%), amphetamines or ecstasy (21%), cannabis (19%) and heroin (17%); cases of LSD, liquid ecstasy, ketamine and trichloroethylene were also detected. The patients who presented after taking drugs of abuse were younger than those presenting after alcohol overdose (27 years vs 37 years). These patients (drug of abuse group) also needed greater therapeutic intervention (use of antidotes, pharmacological sedation or physical restraints), a longer stay in the Emergency observation unit and, on occasion (4 cases), admission to Reanimation or Intensive Care Units. The presence of patients who had ingested liquid ecstasy (gamma-hydroxybutyrate) or 'Special-K' (ketamine) was also notable, confirming the constant changes in abusive substances in our society. Mortality was 0% for both groups. Conclusion: Overdoses of drugs of abuse continue to be a daily problem in the Emergency Department. Patients seen as a result of drugs such as cocaine, amphetamines or heroin are younger and more often male than those seen as a result of alcohol abuse. Morbidity associated to alcohol abuse is less than with other drugs of abuse, requiring the use of less resources and with a shorter stay in the Emergency Department. In both groups the prognosis is good., Nogue S, Castro M, Medina M, Serrano L, De la Red G, Mestre G, Picon M, Corcuera R, Nicolas JM, Munne P. Intensive Care and Clinical Toxicology Unit, Hospital Clinic, [...]

Background: Recently, we demonstrated that chronic smoking is associated with a 23% of decrease in cytochrome c oxidase (COX) activity with respect to non-smoking individuals matched by gender, age and physical activity[1]. Since this enzyme is the latest step (complex IV) of mitochondrial respiratory chain (MRC), we hypothesised that this inhibition could contribute to the pathogenesis of diverse diseases associated with tobacco consumption. However, it is not known if this inhibition is reversed when smokers became abstinent. Objective: To assess if the cessation in smoking is associated with a recovery of COX activity. Patients and Methods: We studied MRC from peripheral lymphocytes of 8 healthy, smoking individuals (age 43 [+ or -] 7; 50% men) before ([t.sub.0]) and seven days after ([t.sub.1]) cessation of tobacco consumption. At both times, carboxyhemoglobin was determined in blood samples by CO-oximetry, and carbon monoxide concentration in exhaled breath of participants by an electrochemical transducer. Lymphocytes were isolated by Ficoll's gradient, protein content was determined by Bradford's methodology, and MRC function was studied using two techniques First, individual enzyme activities of complex II, III and IV of MRC were assessed spectrophotometrically. Second, oxygen consumption was polarographically measured in permeabilized lymphocytes using pyruvate, succinate and glycerol-3-phosphate as complex I, II and III substrates, respectively. This later methodology ascertains if eventual dysfunction of any MRC complex has some effect on the whole mitochondrial respiratory capacity. The paired t test was used to compare measurements at [t.sub.0] and [t.sub.1]. Results: All patients remained abstinent, as judged by a decrease in both, carboxyhemoglobin levels from 4.74% [+ or -] 1.6 to 0.66% [+ or -] 0.38 (p [is less than] 0.001), and carbon monoxide exhalation from 24 [+ or -] 6 ppm to 4 [+ or -] 2 ppm (p [is less than] 0.001). Stopping the tobacco consumption was associated with a recovery in COX activity from 36.63 [+ or -] 14.33 nmol/min/mg of protein to 48.89 [+ or -] 13.21 nmol/min/mg of protein (p [is less than] 0.005). No other changes in enzyme activities of the rest of MRC complexes assayed were found. Similarly, oxygen consumption was found to be similar at [t.sub.0] and [t.sub.1]. Conclusion: COX inhibition associated with chronic smoking disappears after cessation of smoking. References: [1] Carcinogenesis 1999;20:1331-1336. (Supported by FIPSE 3102/00, FIS 00/0927, DGCYT PM99-0038, SGR 1999/00279 and Premi Fi de Residencia 1998 of HCP)., Alonso JR, Miro O, Picon M, Casademont J, Cardellach F. Muscle Research Unit, Department of Internal Medicine, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Catalonia, [...]