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Bodenham AR, Mallick A. 
“New dimensions in toxicology: hyperthermic syndrome following amphetamine derivatives”. 
Intensive Care Med. 1996 Jul;22(7):622-4.
In recent years the abuse of sympathomimetic psychostimulants such as cocaine, amphetamines and their analogues - MDMA (Ecstasy) and MDA (Eve) - has increased world-wide, especially in the United States, United Kingdom and Continental Europe. As a result, a new spectrum in toxicology has emerged. The incidence of psychostimulant-related fatalities has also increased. Toxicological screening performed at a university hospital medical centre in the United States during 1986 revealed 10% of a patient population to be positive for cocaine and its metabolites [1]. An additional 10% sample showed evidence of amphetamines and their derivatives [2]. A recent study demonstrated that 57% of violent assault victims and 22% automobile trauma victims presenting to a trauma centre in Philadelphia had urine or blood tests positive for cocaine and/or its metabolites [3]. A variety of potentially lethal effects of psychostimulants are increasingly encountered in various accident and emergency (A&E) departments. It has therefore become increasingly important for emergency physicians, anastesists and intensivists to understand these toxic effects and their management.
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