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NLM,,NIH,,DHHS,,USA.gov,,National,,Center,,for,,Biotechnology,,Information,,,U.S.adrianapiresbiogmail.comAbstractTo,,investigate,,the,,effects,,of,,repeated,,crack-cocaine,,inhalation,,on,,spermatogenesis,,of,,pubertal,,and,,mature,,Balb/c,,mice,,,ten,,young,,(Y(ex)),,and,,ten,,adult,,(A(ex)),,Balb/c,,mice,,were,,exposed,,to,,the,,smoke,,from,,5,,g,,of,,crack,,with,,57.7%,,of,,pure,,cocaine,,in,,an,,inhalation,,chamber,,,5,,days/week,,for,,2,,monthspylori,,infection.19,,Although,,conservative,,management,,has,,the,,advantage,,of,,avoiding,,the,,morbidity,,and,,mortality,,associated,,with,,surgery,,and,,anesthesia,,,surgical,,management,,is,,more,,commonly,,used,,todayThe,,,management,,,of,,,perforated,,,gastric,,,ulcers,,,must,,,be,,,individualizedThe,,pathogenesis,,of,,gastroduodenal,,ulcer,,perforation,,in,,association,,with,,crack,,cocaine,,use,,remains,,unclearThe,,,omental,,,patch,,,,first,,,described,,,in,,,1937,20,,,has,,,become,,,the,,,most,,,commonly,,,used,,,procedure,,,for,,,treating,,,a,,,perforated,,,peptic,,,ulcer,21,22,,,and,,,it,,,can,,,be,,,performed,,,via,,,either,,,an,,,open,,,or,,,laparoscopic,,,approachThe,,,typical,,,clinical,,,presentation,,,of,,,acute,,,gastroduodenal,,,perforation,,,includes,,,sudden,,,onset,,,and,,,sharp,,,epigastric,,,pain;,,,at,,,times,,,,patients,,,may,,,also,,,have,,,referred,,,shoulder,,,pain15,,,due,,,to,,,free,,,air,,,under,,,the,,,diaphragmdoi:,,10.3109/08958378.2012.684450.Repeated,,inhalation,,of,,crack-cocaine,,affects,,spermatogenesis,,in,,young,,and,,adult,,mice.Pires,,A1,,,Pieri,,P,,,Hage,,M,,,Santos,,AB,,,Medeiros,,MC,,,Garcia,,RC,,,Yonamine,,M,,,Hallak,,J,,,Saldiva,,PH,,,Zorzetto,,JC,,,Bueno,,HM.Author,,information1Reproductive,,Toxicology,,Unit,,,Experimental,,Air,,Pollution,,Laboratory,,,So,,Paulo,,University,,Medical,,School,,,So,,Paulo,,,SP,,,BrazilPubMed,,,US,,,National,,,Library,,,of,,,Medicine,,,National,,,Institutes,,,of,,,Health,,,Search,,,databaseAll,,,DatabasesAssemblyBiocollectionsBioProjectBioSampleBioSystemsBooksClinVarCloneConserved,,,DomainsdbGaPdbVarESTGeneGenomeGEO,,,DataSetsGEO,,,ProfilesGSSGTRHomoloGeneIdentical,,,Protein,,,GroupsMedGenMeSHNCBI,,,Web,,,SiteNLM,,,CatalogNucleotideOMIMPMCPopSetProbeProteinProtein,,,ClustersPubChem,,,BioAssayPubChem,,,CompoundPubChem,,,SubstancePubMedPubMed,,,HealthSNPSparcleSRAStructureTaxonomyToolKitToolKitAllToolKitBookToolKitBookghUniGeneSearch,,,termSearchAdvancedHelp,,,Warning:,,,The,,,NCBI,,,web,,,site,,,requires,,,JavaScript,,,to,,,functionThe,,morphologic,,analysis,,of,,both,,testes,,of,,all,,animals,,included,,the,,analysis,,of,,quantitative,,and,,qualitative,,histologic,,parameters,,to,,assess,,the,,effect,,of,,crack-cocaine,,on,,spermatogenesis,,and,,Leydig,,cellsOne,,,retrospective,,,chart,,,review,,,of,,,50,,,cases,,,of,,,acute,,,gastroduodenal,,,perforation,,,associated,,,with,,,crack,,,cocaine,,,use,,,reported,,,an,,,80%,,,incidence,,,of,,,HPlease,review,our,privacy,policyConservative,,management,,with,,the,,Taylor,,method,,consists,,of,,intravenous,,fluids,,,nasogas-tric,,aspiration,,for,,gastric,,decompression,,,and,,antibiotic,,therapy,,for,,HCrack,,,cocaine,,,,an,,,alkaloid,,,extracted,,,from,,,the,,,leaves,,,of,,,the,,,Erythroxylon,,,coca,,,plant,6,,,is,,,a,,,less,,,expensive,,,,smok-able,,,version,,,of,,,cocaine,,,created,,,via,,,the,,,addition,,,of,,,baking,,,soda.7,,,Crack,,,cocaine,,,causes,,,a,,,wide,,,range,,,of,,,potential,,,cardiac,,,,pulmonary,,,,obstetric,,,,musculoskeletal,,,,neurologic,,,,and,,,gastrointestinal,,,complicationsGastroduodenal,perforations,associated,with,crack,cocaine,use,most,often,affect,the,first,portion,of,the,duodenum,or,pylorus.6,In,addition,,they,are,usually,small,(measuring,3,–5,mm),1,they,predominantly,affect,men,,and,they,occur,at,a,younger,age,than,peptic,ulcer,disease–related,perforationsThis,,case,,illustrates,,the,,need,,for,,a,,heightened,,awareness,,of,,this,,complication,,and,,the,,challenge,,of,,making,,an,,accurate,,and,,prompt,,diagnosisThis,case,nicely,illustrates,a,subtle,presentation,of,this,disease,entity,and,should,heighten,awareness,among,clinicians,about,the,need,to,obtain,a,history,of,cocaine,smoking,in,patients,who,present,with,unexplained,abdominal,pain,or,pneumoperitoneum.Gastric,,,perforation,,,is,,,a,,,rare,,,but,,,serious,,,complication,,,of,,,crack,,,cocaine,,,use,,,,accounting,,,for,,,up,,,to,,,36%,,,of,,,all,,,acute,,,gastroduodenal,,,perforations.1,,,Gastroduodenal,,,ulcer,,,perforations,,,that,,,are,,,temporally,,,associated,,,with,,,crack,,,cocaine,,,have,,,been,,,increasingly,,,recognized,2,,,likely,,,because,,,of,,,the,,,rising,,,use,,,of,,,this,,,substance.3,4,,,Uzzaman,,,and,,,colleagues,,,report,,,a,,,case,,,of,,,a,,,19-year-old,,,female,,,who,,,presented,,,with,,,acute,,,gastric,,,perforation,,,without,,,any,,,apparent,,,risk,,,factors,,,for,,,peptic,,,ulcer,,,disease.5,,,Upon,,,further,,,investigation,,,,the,,,patient,,,reported,,,recent,,,inhalation,,,of,,,crack,,,cocaineIn,,addition,,,multiple,,studies,,suggest,,a,,temporal,,association,,between,,crack,,cocaine,,use,,and,,the,,development,,of,,gastroduodenal,,ulcers.2,9,14Gastrointestinal,,complications,,are,,relatively,,uncommon;,,however,,,they,,tend,,to,,be,,significant,,when,,they,,do,,occur,,,as,,they,,can,,include,,both,,bowel,,ischemia,,and,,perforation.8–12,,The,,inhalation,,of,,crack,,cocaine,,leads,,to,,higher,,peak,,levels,,of,,the,,drug2,,secondary,,to,,its,,rapid,,absorption,,in,,the,,vast,,pulmonary,,absorptive,,surface,13,,which,,may,,account,,for,,the,,more,,severe,,complications,,associated,,with,,this,,form,,of,,the,,drug 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