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Curitiba where can I buy cocaine

Matthew J. Abdo, Maeve B. Mello, Francisco I. Thus, the authors empirically assessed a promising new method for estimating the sizes of most at-risk populations: the network scale-up method. Using 4 different data sources, 2 of which were from other researchers, the authors produced 5 estimates of the number of heavy drug users in Curitiba, Brazil. The authors found that the network scale-up and generalized network scale-up estimators produced estimates 5—10 times higher than estimates made using standard methods the multiplier method and the direct estimation method using data from and Given that equally plausible methods produced such a wide range of results, the authors recommend that additional studies be undertaken to compare estimates based on the scale-up method with those made using other methods. The resulting lack of accurate, timely, and comprehensive information makes evidence-based approaches to targeting prevention programs and monitoring effectiveness difficult. Consider one of the most basic questions one might ask: How large are the most at-risk populations around the world, and how are the sizes of these populations changing over time? Despite enormous amounts of work carried out using a variety of methods, much uncertainty remains 1. For example, in many countries where injecting drug use has been reported, no reliable estimate of the number of drug injectors exists 2. Even the estimates that do exist are difficult to interpret because of methodological differences between countries and over time within countries 3. Similar uncertainties exist about the numbers of female sex workers and men who have sex with men 4—7. One promising approach for estimating the sizes of groups most at risk of HIV infection is the network scale-up method, a technique that is new to epidemiology but has established roots in anthropology and social network analysis 8— Therefore, we empirically assessed the utility of the network scale-up method and the newer generalized network scale-up method in this context. Therefore, we conducted our study in a most-at-risk population whose size had been estimated previously: heavy drug users in Curitiba, Brazil. In addition to this previous estimate, we also estimated the number of heavy drug users in Curitiba using 2 standard methods: the multiplier method and the direct estimation method These 3 estimates provided a background that we could use to assess the scale-up and generalized scale-up estimates. Thus, while most studies of hard-to-count populations produce only a single estimate, our study produced 5 different estimates based on 4 distinct data sources, 2 of which were from other researchers. The target population in our study was heavy drug users, defined as people who had used illegal drugs other than marijuana more than 25 times in the past 6 months. Our study used 4 data sources to produce 5 estimates, as summarized in Figure 1. One source of data, which were collected by our research team, was a face-to-face survey administered to a household-based random sample of adult i. The second source of data, also collected by our research team, was a respondent-driven sample 13—17 of heavy drug users in Curitiba selected in 18 , Design of a study for estimating the number of heavy drug users in Curitiba, Brazil. Four distinct data sources, 2 of which were from other researchers, were used to produce 5 estimates. The network scale-up method estimates population sizes using information about the personal networks of survey respondents under the assumption that personal networks are, on average, representative of the general population. This estimate can be improved by averaging data over many respondents 9. The data needed for the network scale-up method come from interviews with a random sample of the general population. In this context, the 2 methods most appropriate for estimating the total number of people known by each respondent are the known population method and the summation method Because it was not clear a priori which method would produce more accurate estimates in this context, we used both methods in our study. Tests described in the Supplementary Data showed that in this study, the data from the known population method were preferable, and therefore those data will be presented throughout. The network scale-up method makes some strong implicit assumptions, and for that reason, we also collected the data needed for the generalized scale-up estimator. These data come from a sample of the target population—in this case, heavy drug users—and are then combined with the data from the general population to produce 2 correction factors: one for the lack of information flow and one for the differential network size between the target population and the general population. These correction factors and the procedures needed to estimate them are described in detail in the Supplementary Data. The results from all 5 estimates are presented in Figure 2 and described in detail below. Five estimates of the prevalence of heavy drug use in Curitiba, Brazil, and — Scale-up and generalized scale-up estimates were substantially higher than those obtained from standard methods direct estimation and the multiplier method. Estimates of the number of heavy drug users in Curitiba ranged from 4, to , We had 2 different sources of data for direct estimates. First, in , the Brazilian Ministry of Health conducted the PCAP survey, which included approximately 1, people in Curitiba, and asked directly about the use of powder cocaine and injected cocaine. From these data, we estimated a prevalence of heavy drug use within the Curitiba population of 0. In our survey of the general population, we produced a direct estimate of the prevalence of heavy drug use in the general population of 0. To produce our multiplier estimate, we learned from administrative records that heavy drug users were enrolled in the CAPS drug treatment program in August We also estimated from our sample of heavy drug users data collected in that 3. Thus, we see that these 2 commonly used methods produced similar estimates. While this is somewhat reassuring, there are reasons to suspect that direct estimation and the multiplier method both produce underestimates. Direct estimates of the prevalence of drug use can be plagued by nonsampling error 21 and are suspected to be underestimates for 2 reasons First, several studies that compared self-reported drug-use data with drug-testing data found that respondents underreport their drug use, in some cases substantially 23— Second, heavy drug users appear to be more difficult to reach in standard household surveys, which creates differential nonresponse 26 , However, the multiplier-based estimates are only as good as the data used to create them. Multiplier methods will tend to produce underestimates if the members of the target population that appear in administrative data are overrepresented in the sample of the target population—akin to problems with capture-recapture when capture probabilities are correlated For example, we suspect that participants in the CAPS treatment programs were overrepresented in our sample of heavy drug users, because middle- and upper-class heavy drug users were less likely to participate in CAPS because it is a free government program and less likely to participate in our respondent-driven sampling study because the financial incentives for participation were less attractive for middle- and upper-class drug users. If this pattern did occur, these middle- and upper-class heavy drug users would be essentially invisible to the multiplier method. Given these sources of concern about the commonly used methods, we now turn to another indirect method, the network scale-up method. Respondents in our general population survey reported knowing a total of 3, heavy drug users in Curitiba. Further, we estimated that our respondents knew a total of 92, people in Curitiba. Therefore, the scale-up estimator produced an estimated proportion of heavy drug users of 3. The generalized network scale-up estimator relaxes 2 assumptions of the network scale-up estimator. It relaxes both the assumption that people are aware of everything about the people they are connected to and the assumption that the target population has the same average personal network size as the population as a whole. As we describe in more detail in the Supplementary Data , we estimated the 2 necessary correction factors using data from our sample of heavy drug users and produced a generalized scale-up estimate of the proportion of heavy drug users of 6. The estimates derived from the network scale-up method and the generalized network scale-up method were substantially higher than those from standard methods Figure 2. However, our scale-up-based estimates of drug use are roughly comparable to those of previous national-level studies in Brazil and international benchmarks see Supplementary Data. Further, because the scale-up method allows researchers to estimate the sizes of multiple target populations, our study also estimated the number of female sex workers and men who have sex with men in Curitiba. We find that these estimates too are roughly comparable with those of other studies from Brazil and international meta-analysis see Supplementary Data. We caution, however, that all of these comparisons have a large degree of uncertainty because of differences between the studies and ambiguities in the definitions of the target populations. Although these consistency checks are somewhat encouraging, they cannot assess the accuracy of the estimates. Therefore, as a final check, we note that we also asked respondents how many people they knew in 20 populations of known size—for example, women who have given birth in the last 12 months, students enrolled in public universities, and employees of the city of Curitiba see the Supplementary Data for a list of the 20 populations. Therefore, to assess the network scale-up method, we estimated the size of each of these populations using our sample and the scale-up estimator equation 1. Figure 3 reveals that for most of the 20 populations, the size estimates, while not perfect, were quite reasonable. However, Figure 3 also reveals a tendency to overestimate the sizes of smaller populations and underestimate the sizes of larger populations, a finding that is consistent with previous studies 29 , The fact that this exact estimator in this exact sample can produce reasonable estimates for quantities we can check gives us some additional confidence about the estimates for quantities we cannot check. Validation of network scale-up estimates for 20 populations of known size in Curitiba, Brazil, A list of the 20 populations is presented in the Supplementary Data. The estimates were generally similar to the true values, but there was a tendency to overestimate the sizes of small groups and underestimate the sizes of large groups, a pattern that has been observed in other scale-up studies as well 29 , While this is somewhat discouraging, it is also exciting that we can actually detect this problem we suspect that the confidence intervals for many comparable methods are also too small, but this problem is largely invisible. Therefore, we suggest that in future research, investigators also address nonsampling sources of uncertainty, such as those introduced by response bias or recall errors. Because the scale-up-based estimates were so much higher than those obtained with existing methods, we considered many possible sources of error that might have inflated our estimates of course, as explained above, there are reasons to suspect that the standard estimates are too low. One possible source of overestimation could be the order of the questions in our survey: Heavy drug users were the first group asked about, and this might have led to inflated responses. However, no effects of question order were found in a previous telephone-based network scale-up survey in Italy Unfortunately, we were unable to randomize the order of our questions for logistical reasons, so we cannot address this possibility directly with our data. We recommend that future researchers randomize the order of the questions if possible. An alternative explanation for these apparently high estimates is that some interviewers may not have followed the study protocol. This shorter question could have produced much higher responses that would have led to a higher estimated population size. Although we had no reason to believe that this occurred, we assessed the robustness of our estimates to data from a single interviewer by systematically dropping the data collected by each of our 9 interviewers. This analysis showed that no particular interviewer had a large effect on the estimate see Supplementary Data. For example, if a respondent knew someone who drank alcohol every day, the respondent might have included this person in his or her count even though that person did not match our study criteria. A further possible source of error in the scale-up estimates is problems with the sampling frame. If residents of Curitiba differ in their propensity to know heavy drug users 30 and if the sampling frame was less likely to include persons with higher propensities to know heavy drug users possibly the homeless , then our scale-up estimates could be too low. Conversely, if the sampling frame systematically excluded persons who have a lower propensity to know heavy drug users possibly those living in gated communities , then our scale-up estimates could be too high. The relative magnitude of these problems is difficult to assess empirically, and the sensitivity of the network scale-up method to sampling frame problems is an important question for future research. Prior to data collection, we expected that the scale-up-based estimates might be higher than those made with other methods, but we did not expect them to be so much higher. As was described above, we suspect that direct estimates and multiplier estimates will be too low in our setting and possibly in many other settings. However, the generalized scale-up method, which we believe is more statistically appropriate than the scale-up method, produced estimates that were much higher than expected. Since these equally plausible methods produced such different results, we recommend that in additional studies investigators compare scale-up-based estimates with those made using other methods; conducting additional scale-up studies without having results from other methods for comparison will not address this challenge. Fortunately, our research design Figure 1 can be easily replicated in other settings. In this case, by adding a few additional questions to each data collection effort, investigators can replicate our study at virtually no cost. Further, our research design could be enriched with additional sources of data and additional estimation methods. For example, distributing a unique object to members of the target population before sampling from the target population could produce a capture-recapture estimate 33 , although some features of the target population sampling—in this case, respondent-driven sampling—may complicate this approach 17 , 33— Other sources of administrative data, such as HIV registry data, could be used to produce additional multiplier method estimates 37 , but the accuracy of these estimates will depend on the availability of administrative data and possible statistical dependencies between data sources. An additional variation in design would be to use alternative sampling methods to reach the target population e. Alternatively, it may be the case that existing methods have been systematically underestimating the sizes of these populations. At this point, we do not have enough evidence to definitively address this important possibility. However, Brazil is an emergent country with a growing population and competing health priorities Human and material resources in Brazil and in other countries should be mobilized in the most equitable way possible, on the basis of sound empirical evidence. The present study shows that scale-up-based estimators are a promising alternative to commonly used approaches, but more research is needed. The authors thank Dr. Mahy, Dr. Lyerla, Dr. Bernard, Dr. McCarty, Dr. Zheng, Dr. McCormick, K. Levy, and D. Feehan for helpful comments. They also thank Dr. Pascom, M. Vettorazzi, Dr. Moyses, D. Blitzkow, C. Venetikides, and M. Thomaz for assistance. The opinions expressed here represent the views of the authors and not the funding agencies. Google Scholar. Google Preview. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Sign in through your institution. Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents Abstract. Journal Article. Salganik , Matthew J. Oxford Academic. Dimitri Fazito. Neilane Bertoni. Alexandre H. Maeve B. Francisco I. Cite Cite Matthew J. Select Format Select format. Permissions Icon Permissions. Figure 1. Open in new tab Download slide. From these survey data, one can estimate the size of the target population as. For comparison with the scale-up and generalized scale-up estimates, we estimated the number of heavy drug users using 2 common methods: direct estimation and the multiplier method Direct estimation involves asking a sample of the general population whether they are heavy drug users. The multiplier method estimates the size of the target population based on 2 pieces of information: 1 the number of people in the target population with some specific characteristic e. This information is combined as follows:. Figure 2. Figure 3. Google Scholar Crossref. Search ADS. Global epidemiology of injecting drug use and HIV among people who inject drugs: a systematic review. Improving the data to strengthen the global response to HIV among people who inject drugs. Elevated risk for HIV infection among men who have sex with men in low- and middle-income countries — a systematic review. Estimating the number of men who have sex with men in low and middle income countries. Epidemiology of male same-sex behaviour and associated sexual health indicators in low- and middle-income countries: — estimates. Estimates of the number of female sex workers in different regions of the world. Estimating the size of an average personal network and of an event subpopulation: some empirical results. Estimation of seroprevalence, rape, and homelessness in the United States using a social network approach. Counting hard-to-count populations: the network scale-up method for public health. HIV prevalence among female sex workers, drug users and men who have sex with men in Brazil: a systematic review and meta-analysis. Respondent-driven sampling II: deriving valid population estimates from chain-referral samples of hidden populations. Respondent-driven sampling: a new approach to the study of hidden populations. Sampling and estimation in hidden populations using respondent-driven sampling. Knowledge, practices and behaviours related to HIV transmission among the Brazilian population in the 15—54 years age group, Validity of drug use reporting in a high-risk community sample: a comparison of cocaine and heroin survey reports with hair tests. The validity of drug use responses in a household survey in Puerto Rico: comparison of survey responses of cocaine and heroin use with hair tests. How many people do you know in prison? How many men who have sex with men and female sex workers live in El Salvador? Using respondent-driven sampling and capture-recapture to estimate population sizes. Capture-recapture methods and respondent-driven sampling: their potential and limitations. Estimation of the number of injection drug users in St. Petersburg, Russia. Health conditions and health-policy innovations in Brazil: the way forward. Issue Section:. Download all slides. Supplementary data. Supplementary Data - zip file. Views 2, More metrics information. Total Views 2, Email alerts Article activity alert. Advance article alerts. New issue alert. Receive exclusive offers and updates from Oxford Academic. Citing articles via Web of Science Associations between pre-diagnostic plasma metabolites and biliary tract cancer risk in the prospective UK Biobank cohort. Effect of disability, homelessness, and neighborhood marginalization on risk-adjustment for hospital performance measurement. 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Curitiba where can I buy cocaine

Official websites use. Share sensitive information only on official, secure websites. Correspondence to: Edson Marchiori. Fax: 55 21 E-mail: edmarchiori gmail. This is an open-access article distributed under the terms of the Creative Commons Attribution License. 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. In 8 patients In Among the remaining 14 patients 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. 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. Cocaine is an alkaloid found in the leaves of a bush of the Erythroxylaceae family: the coca bush Erythroxylum coca. Cocaine is the most widely consumed illicit drug among patients treated in emergency rooms, as well as being the leading cause of drug abuse-related deaths. Although there have been some studies reporting cocaine-induced pulmonary changes on chest X-ray CXR , there have been few studies describing CT findings. The objective of the present study was to evaluate, by means of an analysis of HRCT scans of the chest in 22 patients with pulmonary changes that were temporally related to cocaine use, the most common HRCT findings, their morphological characteristics, and the distribution of the lesions in the lung parenchyma. In addition, we studied some epidemiological aspects of those patients. Because the study was retrospective, patient informed consent was not required. This was a descriptive, retrospective observational study of HRCT scans of the chest in 22 patients with pulmonary changes induced by cocaine use, all of which were randomly gathered via personal contacts with radiologists and pulmonologists from seven different institutions, located in six Brazilian states. Eighteen patients were male, and 4 were female. Ages ranged from 19 to 52 years. Patients were assessed for route of cocaine administration, type of cocaine used, and the presence of AIDS. The diagnosis was based on the association between HRCT findings and their temporal relationship with cocaine use, after excluding other possible causes. Among the cases studied, we found patients with different types of pulmonary involvement, presenting with different clinical syndromes caused by cocaine use. In order to group patients and their imaging findings efficiently, we defined a subgroup of 8 patients presenting with features of the 'crack lung' syndrome, which is characterized by respiratory failure associated with pulmonary opacities that are temporally related to crack use, with no other apparent causal factors, and which resolves rapidly after discontinuation of such use. As multiple institutions were involved, the HRCT scans of the chest were obtained with different scanners, using the high-resolution technique, with images being acquired from lung apex to lung base. The scans were evaluated by two radiologists independently, discordant results being resolved by consensus. All scans were analyzed for the following: ground-glass opacities, consolidations, interlobular septal thickening, the crazy-paving pattern, nodules, small parenchymal nodules, centrilobular nodules, the tree-in-bud pattern, cavitation, the halo sign, paraseptal emphysema, apical bullae, bullous emphysema, masses, and architectural distortion. The HRCT findings were also analyzed for laterality bilateral, left, or right , as well as for distribution in the axial plane central, peripheral, or random and in the craniocaudal plane upper, middle, lower, or diffuse. Lesions predominating in the inner third of the lung were defined as central, those predominating in the outer third of the lung were defined as peripheral; and those showing no preferential distribution were defined as random. The craniocaudal distribution of the lesions was characterized as follows: upper, for those located preferably above the level of the aortic arch; middle, for those located from the level of the aortic arch to the level of the carina; lower, for those located below the level of the carina; and diffuse, for those with no apparent predominance. We assessed 22 patients with cocaine-induced pulmonary disease, of whom 18 All patients were adults, and ages ranged from 19 to 52 years mean age of 32 years. The route of cocaine administration was inhalation smokers or 'snorters' , in 19 cases Crack use alone was reported in 9 cases, and other cocaine use, including cocaine hydrochloride and freebase cocaine, was reported in 11 cases. Two patients reported both crack and other cocaine use. The prevalence of AIDS was The clinical and tomographic findings were consistent with the 'crack lung' syndrome in 8 cases. Those changes were clinically divided into acute 'crack lung', barotrauma, pulmonary infarction, septic embolism, and cardiogenic pulmonary edema or chronic talcosis, organizing pneumonia, chronic eosinophilic pneumonia, and bullous emphysema. The crazy-paving pattern was identified in 1 case In another case Paraseptal emphysema in the lung apices was identified in 1 case Although the association of HRCT patterns was common, ground-glass opacities predominated in all cases analyzed. Regarding laterality, the involvement was bilateral in all 8 cases. The axial plane distribution was predominantly peripheral in 5 cases and predominantly central in the remaining 3. In none of the cases was the distribution random. In the craniocaudal plane, lesions were found to predominate in the upper third of the lung in 2 cases and in the lower third of the lung in 2 cases. In addition, diffuse involvement was seen in 4 cases. No case was found to have lesions predominating in the middle third of the lung. Barotrauma was found in 3 patients. Two of those patients reported using cocaine by inhalation, and the other one reported using cocaine by inhalation and injection. Pneumomediastinum Figure 2 , pneumothorax, and spontaneous hemopneumothorax occurred in 1 patient, respectively. Three patients developed talcosis. One of those patients reported using cocaine by inhalation, and the other 2 reported using cocaine by injection. All patients presented with perihilar conglomerate masses associated with architectural distortion and emphysema Figure 3. In 1 of the injection cocaine users, increased density was noted within the masses, whereas, in the other one, there were also small parenchymal nodules in the adjacent parenchyma. Organizing pneumonia was identified in 2 patients. Both of them reported using cocaine by inhalation and had HRCT findings of central and peripheral consolidations associated with architectural distortion. The diagnosis was confirmed by lung biopsy. Bullous emphysema was found in 2 patients who smoked cocaine, 1 of whom reported both cocaine and marijuana use. In that patient, HRCT showed large emphysema bullae in the lung apices, associated with architectural distortion. One patient developed pulmonary infarction and reported using cocaine by inhalation. The HRCT scan of that patient showed triangular subpleural consolidation with a pleural base. The diagnosis of pulmonary infarction was based on the clinical condition of the patient in combination with the radionuclide imaging pattern. The patient with HRCT findings consistent with septic embolism reported using cocaine by injection. In that case, the HRCT findings consisted of predominantly peripheral pulmonary nodules, most of which were cavitated Figure 4. Cardiogenic edema was identified in 1 patient, who reported using cocaine by inhalation. The HRCT scan of that patient showed ground-glass opacities interspersed with smooth interlobular septal thickening, resulting in a crazy-paving pattern, associated with bilateral pleural effusion and an enlarged cardiac silhouette. The patient with eosinophilic pneumonia reported using crack by inhalation. He presented with peripheral and pulmonary eosinophilia. His HRCT scan showed peripheral areas of ground-glass attenuation. Cocaine is the second most widely used illicit drug second only to marijuana in Brazil and in the world, as well as being associated with numerous health problems, such as those related to the respiratory system. For this reason, few case series have been published on the topic, being primarily limited to the study of the profile of cocaine users and their symptoms, especially those associated with psychological and behavioral changes. Because of the pulmonary impairment observed in cocaine users, chest radiology plays a critical role in the assessment of such patients. Large prospective studies aimed at the radiological investigation of pulmonary changes are scarce and limited to CXR series. Regarding the profile of cocaine users in Brazil and in South America, the incidence of use is higher in males in the to year age group. Currently, the most widely used form of cocaine is crack, mainly because of its intense euphoric effects, which are obtained within a few minutes, and its lower cost. In Brazil, at least two other varieties of freebase cocaine, designated 'merla' and 'oxi', are administered by inhalation smoked. There is a relationship between cocaine use and the presence of HIV infection and AIDS 5 ; this is due to increased exposure to risky sexual behavior and to transmission via injection drug use. The diagnosis of cocaine-induced pulmonary impairment is based primarily on a history of exposure to cocaine, consistent radiological findings, and the exclusion of other apparent causes for those findings. Certain physical examination findings, such as burned fingertips, resulting from handling the glass pipes typically used to smoke the drug, or the presence of black sputum, characteristic of crack use and attributed to the inhalation of carbon residues from butane or from the alcohol-soaked cotton used for the purpose of cooking the cocaine, can suggest the diagnosis. The frequency of cocaine-induced pulmonary complications is unknown; however, a wide spectrum of changes have been described in literature reviews. In our study, the HRCT scans of 22 patients were evaluated, and the most common finding was 'crack lung', in 8 cases, followed by barotrauma and talcosis, in 3 cases each. Other findings included organizing pneumonia and bullous emphysema, in 2 cases each. In addition, pulmonary infarction, septic embolism, cardiogenic edema, and eosinophilic pneumonia were identified in one case each. It should be considered, however, that no radiological finding alone is diagnostic of pulmonary changes induced by cocaine use. Most imaging findings are nonspecific and should be correlated with a history of cocaine use. The term 'crack lung' refers to an acute pulmonary syndrome that occurs after inhalation of freebase cocaine and is associated with fever, hypoxemia, hemoptysis, respiratory failure, and the presence of diffuse alveolar infiltrates rich in eosinophils. HRCT findings in patients with 'crack lung' include ground-glass opacities, consolidations, airspace nodules, smooth interlobular septal thickening, and, in some cases, the crazy-paving pattern. In our study, a bilateral distribution was found in all cases, being predominantly peripheral in the axial plane and diffuse in the craniocaudal plane. Barotrauma is another complication that is often related to crack smoking and to the inhalation of powdered cocaine. In our study, we found 3 cases of barotrauma, 1 case of pneumomediastinum, and 2 cases of pneumothorax, 1 of which was associated with hemothorax. Talc, silica, cellulose, and other adulterants are added to street cocaine. In 1 case, increased density was noted within the masses, and, in another one, there were also small nodules in the adjacent parenchyma. Organizing pneumonia has been reported in young crack smokers. Septic pulmonary embolism and community-acquired pneumonia are among the most commonly observed infectious pulmonary complications in i. Our study had some limitations. First, the study was retrospective. Second, HRCT techniques varied widely, given the multicenter origin of the cases studied. Another important limitation of the present study, as well as of any other study related to drug users, is that, in certain cases, there are difficulties in establishing a causal relationship between cocaine use and HRCT patterns with certainty. Many of those individuals used or use other illicit drugs by inhalation or i. Therefore, when crushed and injected into a peripheral vein, oral use tablets can also cause pulmonary talcosis. In other cases, the added use of marijuana can cause pulmonary bullous lesions. Despite these limitations, the present study includes the largest series of patients with cocaine-induced pulmonary changes identified on HRCT scans that has ever been published. In conclusion, the most frequently found type of pulmonary change was 'crack lung'. Other highly prevalent thoracic complications related to cocaine use were barotrauma and talcosis, followed by bullous emphysema and organizing pneumonia, as well as by cases of pulmonary infarction, septic embolism, cardiogenic pulmonary edema, and eosinophilic pneumonia. Pulmonary changes induced by cocaine use are nonspecific and should be temporally correlated with such use, after exclusion of other causes. As TCAR foram avaliadas por dois radiologistas, de forma independente, e os casos discordantes foram resolvidos por consenso. Dezoito pacientes eram do sexo masculino e 4 eram do sexo feminino, com idades variando de 19 a 52 anos. Os exames foram avaliados por dois observadores, de forma independente, e os resultados discordantes foram resolvidos por consenso. Barotrauma foi encontrado em 3 pacientes. As a library, NLM provides access to scientific literature. J Bras Pneumol. View full-text in Portuguese. Find articles by Renata Rocha de Almeida. Find articles by Arthur Soares Souza Jr. Find articles by Luciana Soares de Souza. Find articles by Jorge Luiz Pereira e Silva. Find articles by Dante Luiz Escuissato. Find articles by Klaus Loureiro Irion. Find articles by Luiz Felipe Nobre. Find articles by Bruno Hochhegger. Find articles by Edson Marchiori. Open in a new tab. Financial support: None. Issue date Jul-Aug. PMC Copyright notice. Apoio financeiro: Nenhum. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel.

Curitiba where can I buy cocaine