New York state journal of medicine
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In a retrospective and prospective study using DSM-III-R criteria for substance dependence in 232 inpatients and 51 outpatients, the clinical suspicion that cocaine addicts use other drugs including marijuana was confirmed. As many as 53% of cocaine addicts diagnosed by DSM-III-R criteria for cocaine dependence qualified for a diagnosis of cannabis dependence. ⋯ The diagnosis of other drug use and dependence in cocaine dependence has importance with regard to prognosis and treatment. This study found a high prevalence of marijuana (cannabis) dependence in patients with cocaine dependence.
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Comparative Study
Small bowel injuries following blunt abdominal trauma. Early recognition and management.
We reviewed the cases of 15 patients with intestinal perforation following blunt abdominal trauma, which occurred between 1971 and 1988. Twelve patients were treated at The Mary Imogene Bassett Hospital (Cooperstown, NY); three other patients were treated at surrounding area hospitals. These injuries included 11 motor vehicle accidents, three low-velocity impact injuries, and one blast injury. ⋯ Computer tomographic scanning should employ oral and intravenous contrast to increase accuracy; perforation of a hollow viscus may not be immediately recognized. Four of the five patients operated on within 12 hours had an uncomplicated course. Complications occurred in all six patients operated on beyond 24 hours and included intraabdominal abscesses in five, and death for one patient.(ABSTRACT TRUNCATED AT 250 WORDS)