Cocaine‐Induced Intracerebral Hemorrhage in a Patient with Cerebral Amyloid Angiopathy*

Abstract: Intracerebral hemorrhage (ICH) is a well‐recognized complication of recreational cocaine use. The precise mechanism of the cocaine‐induced hemorrhagic event is unclear, although multiple factors have been implicated. We report a case of a 62‐year‐old woman who suffered left parieto‐occipital ICH with herniation and death, following a cocaine binge. Microscopic examination also revealed extensive cerebral amyloid angiopathy (CAA) in the vicinity of the hemorrhage. We additionally studied brain tissue in eight subjects between ages of 60 and 80 who were positive for cocaine metabolites at autopsy; of these, none had vascular amyloid‐β deposits by immunohistochemistry. Whereas we found no evidence that chronic cocaine use is a risk factor for CAA, given the age‐associated nature of CAA and the aging population using cocaine, CAA‐induced hemorrhage in the setting of cocaine use may be more common than recognized. This is the first reported case of CAA‐associated ICH precipitated by cocaine.     

The Right to Be Racist in College: Racist Speech,White Institutional Space,and the First Amendment

Throughout the post–civil rights era, colleges and universities across the United States have periodically experienced explicitly racist incidents on their campuses. From the hurling of racial slurs at students of color, to the hanging of nooses on campus, to students donning Ku Klux Klan outfits or throwing “ghetto” parties that caricaturize communities of color, these incidents challenge the notion that modern racism has changed to a more subtle form, referred to as color‐blind racism. We place these incidents within a broader context of race and institutions, suggesting a connection between overt racist expressions and the more covert elements of neoliberal color‐blind racism. Through a critical discourse analysis of news stories about these incidents, the website of the Foundation for Individual Rights in Education, and the controlling legal cases involving racist expression on campuses, we suggest that explicitly racist incidents operate in tandem with neoliberal educational policies and color‐blind racism to mark and reinscribe colleges and universities as white institutional spaces.     

Increased Lung Weights in Drug‐related Fatalities

This study is of autopsy data for potential validation as to whether increased weights of the lungs support toxic effects of drugs as the cause of death. This retrospective study compared data from 133 deaths resulting from the toxic effects of drugs with previously reported normal lung weights (Toxicol Mech Methods, 22, 2012, 159; Am J Forensic Med Pathol 33, 2012, 368). The lung weights and their standard errors were used in a two‐sample independent t‐test comparing the average drug‐related death weight to the average control weights. To account for multiple comparisons, a Bonferroni‐adjusted alpha level of 0.0125 was used. We are 98.75% confident that the mean right lung weight for female drug‐related deaths is between 227 and 377 g greater than the mean right lung weight for female non‐drug‐related deaths. We are 98.75% confident that the mean right lung weight for male drug‐related deaths is between 245 and 378 g greater than the mean right lung weight for male non‐drug‐related deaths.     

Nova Scotia renews its HIV/AIDS strategy

On 1 December 2003, after a five-year process of consultation and planning, Nova Scotia embarked on a new HIV/AIDS strategy. It replaces the first strategy, launched a decade earlier. The renewed strategy is meant to promote collaborative action on the determinants of vulnerability to HIV infection and on the capacity of people living with HIV/AIDS to achieve optimal health and quality of life.     

Black soldier fly (Diptera: Stratiomyidae) colonization of pig carrion in south Georgia

The black soldier fly, Hermetia illucens (L.), is thought to colonize corpses 20-30 days postmortem. However, recent observations indicate this might not be true for all cases. Therefore, we conducted a study examining colonization by the black soldier fly and other Diptera on pig carrion in a plowed field in southern Georgia from 20 September through 21 February. Our data indicate black soldier flies could colonize a corpse within the first week after death. Knowing this information could prevent a serious mistake in estimating the time at which a corpse is colonized by this species. This study also represents the first record of Chrysomya rufifacies in Georgia.     

Psychological Distress Following Suicidality Among Gay,Lesbian, and Bisexual Youths: Role of Social Relationships

Longitudinal relations between past suicidality and subsequent changes in psychological distress at follow-up were examined among gay, lesbian, and bisexual (GLB) youths, as were psychosocial factors (e.g., self-esteem, social support, negative social relationships) that might mediate or moderate this relation. Past suicide attempters were found to have higher levels of depressive symptoms, anxious symptoms, and conduct problems at a later time than youths who neither attempted nor ideated. Psychosocial factors failed to mediate this relation. The interaction among past suicidality, social support, and negative relationships was associated with subsequent changes in all 3 psychological distress indicators 6 months later. Specifically, high levels of support (either from family or friends) or negative relationships were found to predict increased psychological distress among those with a history of suicide attempts, but not among youths without a history of suicidality. The findings suggest that GLB youths who attempt suicide continue to have elevated levels of psychological distress long after their attempt and they highlight the importance of social relationships in the youths psychological distress at follow-up.Earlier versions of this paper were presented at the biannual meeting of the European Association for Research on Adolescence, Oxford, UK, September 2002; and, at the annual meeting of the American Public Health Association, San Francisco, CA, November 2003.Associate Professor of Psychology, The City University of New York—The City College and Graduate Center. Received PhD in psychology from New York University. Research interests include the relation of identity to health, the intersection of multiple identities, and the relation of violence to health.Doctoral candidate in Social/Personality Psychology and Health Psychology, The City University of New York—Graduate Center. Research interests include the role of social relationships in the preservation of health and well-being.Research Scientist, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute; and Assistant Professor, Department of Psychiatry, Columbia University. Received doctorate in social welfare (DSW) from The City University of New York—Graduate Center. Research and clinical interests include the design and implementation of interventions for gay, lesbian, and bisexual adolescents.