[Ketamine as a party drug]. / Ketamine als partydrug.

Ketamine is a new party drug, which is easy to obtain. For this reason, it is possible that physicians will be increasingly confronted with users that have medical problems. Relatively few cases of ketamine intoxication with a fatal outcome have been reported thus far. Ketamine is very hallucinogenic; people can experience unpleasant flashbacks even weeks after the drug has been eliminated from the body. Ketamine has a short half-life; the elimination half-life is about 2.5 h. A serious intoxication can lead to aspiration, acidosis, rhabdomyolysis, epileptic seizures, respiratory depression, and cardiac arrest. Ketamine is frequently used as a party drug in combination with other substances. As a result, the chance of untoward effects is increased. Anaesthetists use ketamine for short surgical procedures, sedation and analgesia. It is also used more and more often as an analgesic in patients who do not respond well to opioids.

Management of essential thrombocythemia during pregnancy with aspirin, interferon alpha-2a and no treatment. A comparative analysis of the literature.

It is advisable to treat essential thrombocythemia (ET) during pregnancy, because elevated platelet counts can lead to maternal and fetal complications. In order to establish which therapy is more favorable, we undertook a review of the literature. In addition to our own case, we found 27 reports which described 75 cases with 143 pregnancies. We discussed the complications of ET during pregnancy and postpartum, fetal outcome and the therapeutic strategies. Considering the clear risk of complications during pregnancy -- especially the occurrence of spontaneous abortion in the first trimester -- and the risk of intrauterine fetal death, we believe all patients should at least be treated with aspirin unless there is a contraindication. Platelet reduction with interferon-alpha (IFN-alpha) might be able to further reduce the complications of ET during pregnancy and to improve fetal outcome (data from 14 patients). After treatment with IFN-alpha, sufficient numbers of umbilical cord blood stem cells can be collected.