1.
Carbon monoxide poisoning in narghile (water pipe) tobacco smokers.
La Fauci, G, Weiser, G, Steiner, IP, Shavit, I
CJEM. 2012;(1):57-9
Abstract
Narghile (water pipe, hookah, shisha, goza, hubble bubble, argeela) is a traditional method of tobacco use. In recent years, its use has increased worldwide, especially among young people. Narghile smoking, compared to cigarette smoking, can result in more smoke exposure and greater levels of carbon monoxide (CO). We present an acutely confused adolescent patient who had CO poisoning after narghile tobacco smoking. She presented with syncope and a carboxyhemoglobin level of 24% and was treated with hyperbaric oxygen. Five additional cases of CO poisoning after narghile smoking were identified during a literature search, with carboxyhemoglobin levels of 20 to 30%. Each patient was treated with oxygen supplementation and did well clinically. In light of the increasing popularity of narghile smoking, young patients presenting with unexplained confusion or nonspecific neurologic symptoms should be asked specifically about this exposure, followed by carboxyhemoglobin measurement.
2.
[Vision abnormalities associated to smoking. A systematic review related to a clinical case].
Sansores, RH, Ramírez-Venegas, A, Pérez-Bautista, O, Bustos, M
Revista de investigacion clinica; organo del Hospital de Enfermedades de la Nutricion. 2012;(1):89-101
3.
Assessment of patients at intermediate cardiac risk.
Bairey Merz, N
The American journal of cardiology. 2005;(8A):2J-10J
Abstract
The optimal approach to patients who are at intermediate risk for coronary artery disease is not clear. Various risk assessment scoring systems and imaging modalities can add diagnostic and prognostic value to cardiovascular evaluation. A better understanding of these available assessment tools can help physicians to optimize management and outcomes in patients who are initially categorized as at intermediate risk. Detailed case studies are presented that illustrate the use of these assessment tools in patients at intermediate risk.