Research
Open Access
Global cocaine intoxication research trends during 1975–2015: a bibliometric analysis of Web of Science publications
- Sa’ed H. ZyoudEmail author,
- W. Stephen Waring,
- Samah W. Al-Jabi and
- Waleed M. Sweileh
Substance Abuse Treatment, Prevention, and Policy201712:6
DOI: 10.1186/s13011-017-0090-9
© The Author(s). 2017
Received: 17 September 2016
Accepted: 1 February 2017
Published: 2 February 2017
Abstract
Background
Cocaine is subject to
recreational abuse as a stimulant and psychoactive agent, which poses a
major worldwide health problem. The aim of the present study was to
perform a bibliometric analysis of publication related to cocaine
intoxication an insight of the research trends at a global level to
enable recommendations for future research strategies in this field.
recreational abuse as a stimulant and psychoactive agent, which poses a
major worldwide health problem. The aim of the present study was to
perform a bibliometric analysis of publication related to cocaine
intoxication an insight of the research trends at a global level to
enable recommendations for future research strategies in this field.
Methods
Publications about cocaine
intoxication were retrieved from the Web of Science (WoS) Core
Collection database on December 28, 2016, and analysed regarding the
following bibliometric indicators: research trends, document types,
languages, countries/territories with their h-index, collaboration patterns, journals with their impact factors (IF), and institutions.
intoxication were retrieved from the Web of Science (WoS) Core
Collection database on December 28, 2016, and analysed regarding the
following bibliometric indicators: research trends, document types,
languages, countries/territories with their h-index, collaboration patterns, journals with their impact factors (IF), and institutions.
Results
In total, 2,902 scientific
publications from 1975 to 2015 were retrieved from the WoS database. The
annual number of publications related to cocaine toxicity increased
slightly after 1990 and reached a peak of 148 in 1992, with an average
of 103 publications per year. The USA outranked other
countries/territories with 2,089 publications, of which 1,927 arose
exclusively from the USA and 162 involved international collaborations.
The h-index for all publications related to cocaine was 212, and the h-index for all publications related to cocaine intoxication was 99. Moreover, the USA had the highest h-index of 95, followed by Spain with h-index of 24, and Canada with h-index
of 24. The main research topics were consistently reproductive
toxicity, clinical management of acute cocaine exposure, laboratory
methods for detection of exposure to cocaine, cocaine metabolism, and
cocaine toxicity in animals.
publications from 1975 to 2015 were retrieved from the WoS database. The
annual number of publications related to cocaine toxicity increased
slightly after 1990 and reached a peak of 148 in 1992, with an average
of 103 publications per year. The USA outranked other
countries/territories with 2,089 publications, of which 1,927 arose
exclusively from the USA and 162 involved international collaborations.
The h-index for all publications related to cocaine was 212, and the h-index for all publications related to cocaine intoxication was 99. Moreover, the USA had the highest h-index of 95, followed by Spain with h-index of 24, and Canada with h-index
of 24. The main research topics were consistently reproductive
toxicity, clinical management of acute cocaine exposure, laboratory
methods for detection of exposure to cocaine, cocaine metabolism, and
cocaine toxicity in animals.
Conclusions
This is the first bibliometric
approach to examining research related to cocaine toxicity and shows
that research activity has become more global and extensive since 1990.
The USA remains the leading country regarding published literature, the
highest h-index, and greatest role in international collaborations.
approach to examining research related to cocaine toxicity and shows
that research activity has become more global and extensive since 1990.
The USA remains the leading country regarding published literature, the
highest h-index, and greatest role in international collaborations.
Keywords
CocaineIntoxication
Bibliometric
Web of Science
Background
Cocaine
is subject to recreational abuse as a stimulant and psychoactive agent,
and it is commonly presented in its hydrochloride form as a white,
water-soluble powder, and may be used orally, intravenously or by nasal
insufflation. Relatively pure formulations that lack a hydrochloride
moiety are presented in a crystalline form, so-called ‘freebase’ or
‘crack’ cocaine, which may be used by nasal insufflation, smoking,
ingestion or intravenous injection. Pharmaceutical cocaine preparations
are available in countries that permit its use for medicinal purposes,
namely as a local anaesthetic agent or to assist in managing epistaxis [1, 2].
is subject to recreational abuse as a stimulant and psychoactive agent,
and it is commonly presented in its hydrochloride form as a white,
water-soluble powder, and may be used orally, intravenously or by nasal
insufflation. Relatively pure formulations that lack a hydrochloride
moiety are presented in a crystalline form, so-called ‘freebase’ or
‘crack’ cocaine, which may be used by nasal insufflation, smoking,
ingestion or intravenous injection. Pharmaceutical cocaine preparations
are available in countries that permit its use for medicinal purposes,
namely as a local anaesthetic agent or to assist in managing epistaxis [1, 2].
Peak
circulating cocaine concentrations occur almost immediately after
intravenous injection and within several minutes of smoking, and may be
delayed for up to 1 h after nasal insufflation. Cocaine is rapidly
eliminated, with a half-life is around one hour and reported duration of
acute effects between 2 and 4 h [2].
People who ingest cocaine may often be considered in two categories:
body “stuffers” and body “packers”. Body stuffers may ingest moderate
quantities of cocaine, often loosely packaged and, for example, ingested
impulsively to avoid detection. Body packers typically ingest very
large quantities of cocaine contained in multiple well wrapped packages
for the purposes of drug smuggling. Body stuffers and body packers are
at risk of systemic cocaine toxicity, and there may be severe or fatal
poisoning due to gastrointestinal absorption after disruption of packed
cocaine wrapping [3, 4, 5, 6].
circulating cocaine concentrations occur almost immediately after
intravenous injection and within several minutes of smoking, and may be
delayed for up to 1 h after nasal insufflation. Cocaine is rapidly
eliminated, with a half-life is around one hour and reported duration of
acute effects between 2 and 4 h [2].
People who ingest cocaine may often be considered in two categories:
body “stuffers” and body “packers”. Body stuffers may ingest moderate
quantities of cocaine, often loosely packaged and, for example, ingested
impulsively to avoid detection. Body packers typically ingest very
large quantities of cocaine contained in multiple well wrapped packages
for the purposes of drug smuggling. Body stuffers and body packers are
at risk of systemic cocaine toxicity, and there may be severe or fatal
poisoning due to gastrointestinal absorption after disruption of packed
cocaine wrapping [3, 4, 5, 6].
Pharmacological
mechanisms of cocaine include blockade of sodium and potassium channels
within the central nervous system, excess sympathetic autonomic
outflow, and direct alpha adrenoceptor-mediated vasoconstriction of
peripheral blood vessels [7].
Cocaine increases the risk of thrombotic and non-thrombotic acute
coronary syndrome, stroke and arterial dissection and regular users have
more advanced atherosclerosis than age-matched controls; cardiotoxicity
is enhanced in users that co-ingest ethanol due to formation of
cocaethylene [8].
These adverse effects include tachycardia, hypertension, chest pain,
myocardial infarction, aortic and coronary artery dissection, QT
prolongation due to potassium channel blockade, and arrhythmia including
ventricular fibrillation [9, 10]. Other effects include sweating, fever, rhabdomyolysis, delirium, seizures, intracranial haemorrhage, and serotonin syndrome.
mechanisms of cocaine include blockade of sodium and potassium channels
within the central nervous system, excess sympathetic autonomic
outflow, and direct alpha adrenoceptor-mediated vasoconstriction of
peripheral blood vessels [7].
Cocaine increases the risk of thrombotic and non-thrombotic acute
coronary syndrome, stroke and arterial dissection and regular users have
more advanced atherosclerosis than age-matched controls; cardiotoxicity
is enhanced in users that co-ingest ethanol due to formation of
cocaethylene [8].
These adverse effects include tachycardia, hypertension, chest pain,
myocardial infarction, aortic and coronary artery dissection, QT
prolongation due to potassium channel blockade, and arrhythmia including
ventricular fibrillation [9, 10]. Other effects include sweating, fever, rhabdomyolysis, delirium, seizures, intracranial haemorrhage, and serotonin syndrome.
Powders
and other chemicals are often added to increase bulk, including
lidocaine, benzocaine, levamisole, baking flour, talc and washing
powder, and microbial contaminants may also be present [11].
The observed effects may be caused by cocaine directly, or arise as an
adverse effect of cutting agents or other contaminants. For example,
agranulocytosis has been attributed to the presence of levamisole [12], and methaemoglobinaemia has been caused by local anaesthetic agents [13].
and other chemicals are often added to increase bulk, including
lidocaine, benzocaine, levamisole, baking flour, talc and washing
powder, and microbial contaminants may also be present [11].
The observed effects may be caused by cocaine directly, or arise as an
adverse effect of cutting agents or other contaminants. For example,
agranulocytosis has been attributed to the presence of levamisole [12], and methaemoglobinaemia has been caused by local anaesthetic agents [13].
Clinical
management of cocaine intoxication is supportive, including
administration of benzodiazepines and high doses may be required to
reduce agitation, treat seizures, and to allow control of tachycardia
and high blood pressure. Fluid and electrolyte imbalance should be
corrected and serial electrocardiographs and cardiac monitoring to
assess for underlying myocardial ischaemia or dysrhythmia. Standard
treatment for suspected cardiac ischaemia or myocardial infarction
should be considered, namely antiplatelet agents, calcium channel
blockers, nitrates, anticoagulants, and coronary arteriography [14, 15].
Intralipid may be considered for severe, life-threatening cardiac
arrhythmia although too few data exist to fully understand its potential
role in management of cocaine toxicity [16].
There has been controversy regarding the use of lidocaine due to its
sodium channel blocking effects that might be expected to worsen cocaine
cardiotoxicity; however, lidocaine may displace cocaine from cardiac
sodium channels and reduce arrhythmia risk [17].
Beta-blockers are generally avoided as first line therapy because these
will allow unopposed alpha adrenoceptor-mediated vasoconstriction, and
should normally be used with caution after an alpha adrenoceptor blocker
has been introduced [18].
management of cocaine intoxication is supportive, including
administration of benzodiazepines and high doses may be required to
reduce agitation, treat seizures, and to allow control of tachycardia
and high blood pressure. Fluid and electrolyte imbalance should be
corrected and serial electrocardiographs and cardiac monitoring to
assess for underlying myocardial ischaemia or dysrhythmia. Standard
treatment for suspected cardiac ischaemia or myocardial infarction
should be considered, namely antiplatelet agents, calcium channel
blockers, nitrates, anticoagulants, and coronary arteriography [14, 15].
Intralipid may be considered for severe, life-threatening cardiac
arrhythmia although too few data exist to fully understand its potential
role in management of cocaine toxicity [16].
There has been controversy regarding the use of lidocaine due to its
sodium channel blocking effects that might be expected to worsen cocaine
cardiotoxicity; however, lidocaine may displace cocaine from cardiac
sodium channels and reduce arrhythmia risk [17].
Beta-blockers are generally avoided as first line therapy because these
will allow unopposed alpha adrenoceptor-mediated vasoconstriction, and
should normally be used with caution after an alpha adrenoceptor blocker
has been introduced [18].
At a global level, recreational cocaine use is at historically high levels [19, 20, 21].
Emerging trends demonstrate that cocaine use is having societal and
health consequences. Bibliometric analysis is an efficient tool for
examining trends in different scientific fields [22, 23, 24, 25, 26],
and defined as the use of statistics and quantitative analysis for
research output in the evaluation of research performance. Bibliometric
network analysis allows analysis of research collaborations between
countries, authors, and institutions [27, 28, 29, 30, 31].
Emerging trends demonstrate that cocaine use is having societal and
health consequences. Bibliometric analysis is an efficient tool for
examining trends in different scientific fields [22, 23, 24, 25, 26],
and defined as the use of statistics and quantitative analysis for
research output in the evaluation of research performance. Bibliometric
network analysis allows analysis of research collaborations between
countries, authors, and institutions [27, 28, 29, 30, 31].
Recently,
bibliometric techniques have been used to explore trends in research
related to various scientific disciplines; such as lab-on-a-chip
research [32], nanotechnology research [33], public health research [34], organic farming research [35], pluripotent stem cell research [36], particulate matter and atherosclerosis research [37], and Helicobacter pylori research [38].
Earlier research has shown that the same methods may be applied to
clinical toxicology themes such as intravenous lipid emulsion as an
antidote [39], methanol poisoning [40], and calcium channel blockers poisoning [41].
To our knowledge, there has been no bibliometric study of research
related to cocaine intoxication. The present study sought to apply
established bibliometric techniques to the field of cocaine toxicity, to
allow the overall research trends to be examined from a global
perspective, and to help build recommendation for future research
opportunities.
bibliometric techniques have been used to explore trends in research
related to various scientific disciplines; such as lab-on-a-chip
research [32], nanotechnology research [33], public health research [34], organic farming research [35], pluripotent stem cell research [36], particulate matter and atherosclerosis research [37], and Helicobacter pylori research [38].
Earlier research has shown that the same methods may be applied to
clinical toxicology themes such as intravenous lipid emulsion as an
antidote [39], methanol poisoning [40], and calcium channel blockers poisoning [41].
To our knowledge, there has been no bibliometric study of research
related to cocaine intoxication. The present study sought to apply
established bibliometric techniques to the field of cocaine toxicity, to
allow the overall research trends to be examined from a global
perspective, and to help build recommendation for future research
opportunities.
The
study was designed to address the following questions: 1. What is the
intellectual structure of the field of research that deals with cocaine
intoxication? 2. What are the domains or subject clusters that are
identified in this field, according to the terms used in publication
titles and abstracts? 3. What has been the evolution of this field of
research over time? 4. What are the main research topics related to
cocaine toxicity, and connections between them? 5. What are the networks
of researchers identified in the field, according to a co-authorship
analysis? 6. What are the institutional networks in this field? 7. What
are the main prolific journals, institutions, countries in this field?
and, 8. Which publications have the highest impact on this field?
study was designed to address the following questions: 1. What is the
intellectual structure of the field of research that deals with cocaine
intoxication? 2. What are the domains or subject clusters that are
identified in this field, according to the terms used in publication
titles and abstracts? 3. What has been the evolution of this field of
research over time? 4. What are the main research topics related to
cocaine toxicity, and connections between them? 5. What are the networks
of researchers identified in the field, according to a co-authorship
analysis? 6. What are the institutional networks in this field? 7. What
are the main prolific journals, institutions, countries in this field?
and, 8. Which publications have the highest impact on this field?
Methods
Data
about cocaine intoxication were retrieved from the Web of Science (WoS)
Core Collection Database on December 28, 2016. This database is
considered one of the most complete and reliable databases for
bibliometric analyses, and covers over 12,000 of the highest impact,
quality scientific international journals [42, 43, 44, 45, 46]. To identify research related to cocaine intoxication, we took the following steps in conducting this study:
about cocaine intoxication were retrieved from the Web of Science (WoS)
Core Collection Database on December 28, 2016. This database is
considered one of the most complete and reliable databases for
bibliometric analyses, and covers over 12,000 of the highest impact,
quality scientific international journals [42, 43, 44, 45, 46]. To identify research related to cocaine intoxication, we took the following steps in conducting this study:
Step 1:
Publications with “cocaine” as keywords in the title were downloaded.
To achieve better accuracy in the results, the search was restricted to
the Title field in the WoS database over all the previous year’s up to
December 31, 2015 because if expanded to other search fields such as
Abstract or Keywords, many publications obtained were not relevant to
cocaine (i.e false-positive data). We applied a title-only search
instead of a topic search (title, abstract, and keyword) accepting a
small loss of sensitivity but significantly increasing specificity [35, 47].
Year 2016 was excluded as this year still open for new issues.
Furthermore, data proposed to be incomplete due to reasons such as the
time-lag between publications and indexing in WoS database. In this step
it was promising to get all publications in the field of cocaine
intoxication that were published in the period comprised between 1975
and 2015.
Step 2:
We limited our retrieved publications in the field of cocaine
intoxication to all those indexed under the research category
‘Toxicology” in WoS database.
Step 3:
To include all the documents about cocaine intoxication that are
published in journals or conference proceedings indexed in other subject
categories, we used the following search strategy: term cocaine in the
title; using the truncated terms *toxic*OR poison* OR overdos* as a
search phrases to search topic in the WoS database over all the earlier
years up to December 31, 2015. The search equation used produces
publications that are relevant by truncating some terms, such as
“poison*”, which leads to the recovery of publications on poison,
poisoning, or poisonous. Furthermore, in this step, we excluded
documents published in the category “Toxicology”.
Step 4:
In this step, search equations from step 1, 2 and 3 were combined in
one search query and the results were analyzed and presented. Search
query used for data extraction from WoS looked like this:
(TI = (cocaine) AND TS = (*toxic* OR poison* OR overdos*)) OR
(TI = (cocaine) AND SU = (Toxicology)); (See Additional file 1).
Step 5:
The retrieved publications were analysed regarding the following
bibliometric indicators as done in previous bibliometric studies [27, 28, 29, 30, 31]: research trends, document types, languages, countries/territories with their h-index,
collaboration patterns, journals with their impact factors (IF), and
institutions. Our study relied on the connection between countries,
topics, authors, and institutions using visualizations and clustering
algorithms to locate the main groups among them by VOSviewer software [27, 48, 49, 50]. The VOSviewer v.1.6.5 was used for viewing and constructing the desired bibliometric maps [48].
VOSviewer was employed to illustrate the co-occurrence network of
high-frequency terms related to cocaine toxicity to detect how research
topics related to cocaine changed and progressed through time. The
timespan of 1975–2015 was selected, and it was split into three periods:
1975–1995; 1996–2005, and 2006–2015. The size of circles in VOSviewer
maps represents the number of publications related to certain term, and
the distance between two terms gives an implication of the number of
co-occurrences of the terms. Furthermore, terms close to each other or
having certain color are more probable dealing with the same topic.
Statistical analysis
All
the retrieved results were imported into Excel 2007 for further
analysis, and data presented as frequencies and percentages of
publications. The ten most productive countries and journals in the
field of cocaine toxicity were identified. The journal IF was obtained
from the Journal Citation Report (JCR) Science Edition 2015. The h-index
was calculated as the number of publications (n) that have achieved at
least n citations. Publications originating from England, Northern
Ireland, Scotland, and Wales were merged as being from the United
Kingdom (UK). Pearson correlation test was used to examine the
correlations between all cocaine publication productivity and that
related to specifically to cocaine toxicity. A significance level of P < 0.05 was considered to be statistically significant. SPSS ® version 16 was used to perform the statistical analysis.
the retrieved results were imported into Excel 2007 for further
analysis, and data presented as frequencies and percentages of
publications. The ten most productive countries and journals in the
field of cocaine toxicity were identified. The journal IF was obtained
from the Journal Citation Report (JCR) Science Edition 2015. The h-index
was calculated as the number of publications (n) that have achieved at
least n citations. Publications originating from England, Northern
Ireland, Scotland, and Wales were merged as being from the United
Kingdom (UK). Pearson correlation test was used to examine the
correlations between all cocaine publication productivity and that
related to specifically to cocaine toxicity. A significance level of P < 0.05 was considered to be statistically significant. SPSS ® version 16 was used to perform the statistical analysis.
Results
From
1975 to 2015, there were 21,683 publications on cocaine, including
2,902 scientific publications related to cocaine intoxication (See
Additional file 1).
Out of the 2,902 publications in the field of cocaine toxicity that
were analysed in this study, 2,823 (97.3%) were published in English,
followed by Spanish (36; 1.2%), French (29; 1.0%) and German (12; 0.4%).
Original articles (2,205) were the most frequent publication type
(76.0%), followed by meeting abstracts (323; 11.1%), proceedings papers
(145, 5.0%), reviews (142; 4.9%), and letters (108; 3.7%). Annual
publications on cocaine toxicity are summarised in Fig. 1.
The annual number of publications related to cocaine toxicity increased
slightly after 1990 and reached a peak of 148 publications in 1992, and
then the total output has fluctuated with an average of 103
publications per year. Publication of articles related to cocaine in all
fields has increased considerably after 1986 with a peak of 825 in
1996, and a subsequent average of 746 publications per year. There was a
strong correlation between publication productivity related to cocaine
in all fields and productivity related to cocaine toxicity (r = 0.929; p-value < 0.001).
1975 to 2015, there were 21,683 publications on cocaine, including
2,902 scientific publications related to cocaine intoxication (See
Additional file 1).
Out of the 2,902 publications in the field of cocaine toxicity that
were analysed in this study, 2,823 (97.3%) were published in English,
followed by Spanish (36; 1.2%), French (29; 1.0%) and German (12; 0.4%).
Original articles (2,205) were the most frequent publication type
(76.0%), followed by meeting abstracts (323; 11.1%), proceedings papers
(145, 5.0%), reviews (142; 4.9%), and letters (108; 3.7%). Annual
publications on cocaine toxicity are summarised in Fig. 1.
The annual number of publications related to cocaine toxicity increased
slightly after 1990 and reached a peak of 148 publications in 1992, and
then the total output has fluctuated with an average of 103
publications per year. Publication of articles related to cocaine in all
fields has increased considerably after 1986 with a peak of 825 in
1996, and a subsequent average of 746 publications per year. There was a
strong correlation between publication productivity related to cocaine
in all fields and productivity related to cocaine toxicity (r = 0.929; p-value < 0.001).
Table 1
shows the leading countries/territories, ranked by number of
publications. The USA outranked other countries/territories with 2,089
publications, of which 1,927 were exclusively produced in the USA and
162 were international collaborations. Spain published the second
highest number of total publications with 145 publications, followed by
Italy with 100 publications, Canada with 92 publications, and France
with 90 publications. The h-index for all publications related to cocaine was 212, and the h-index for all publications related to cocaine intoxication was 99. Moreover, the USA had the highest h-index of 95, followed by Spain with h-index of 24, and Canada with h-index
of 24. The highest average number of citations was for publications
arising from the UK (32 citations), followed by the USA (25 citations),
and Canada (25 citations).
shows the leading countries/territories, ranked by number of
publications. The USA outranked other countries/territories with 2,089
publications, of which 1,927 were exclusively produced in the USA and
162 were international collaborations. Spain published the second
highest number of total publications with 145 publications, followed by
Italy with 100 publications, Canada with 92 publications, and France
with 90 publications. The h-index for all publications related to cocaine was 212, and the h-index for all publications related to cocaine intoxication was 99. Moreover, the USA had the highest h-index of 95, followed by Spain with h-index of 24, and Canada with h-index
of 24. The highest average number of citations was for publications
arising from the UK (32 citations), followed by the USA (25 citations),
and Canada (25 citations).
Table 1
Top ten most productive countries in the field of cocaine toxicity
SCR | Country | Number of documents (%) | Average citations per document | h-index | No. of collaborative countries | No. of publications from collaboration |
---|---|---|---|---|---|---|
1st | USA | 2089 (71.99) | 25.15 | 95 | 38 | 162 |
2nd | Spain | 145 (5.00) | 13 | 24 | 14 | 30 |
3rd | Italy | 100 (3.45) | 15.12 | 23 | 10 | 28 |
4th | Canada | 92 (3.17) | 24.83 | 24 | 9 | 31 |
5th | France | 90 (3.10) | 14.31 | 21 | 13 | 30 |
6th | UK | 80 (2.76) | 32.33 | 23 | 13 | 32 |
7th | Brazil | 55 (1.90) | 8.32 | 12 | 8 | 16 |
8th | Germany | 50 (1.72) | 14.34 | 18 | 10 | 17 |
9th | Japan | 42 (1.45) | 13.19 | 14 | 1 | 9 |
10th | Switzerland | 31 (1.07) | 20.19 | 14 | 6 | 9 |
Figure 2
illustrates the collaboration network of countries publishing more than
five documents. The size of circles represents the number of
publications of the country and the thickness of lines signifies the
size of collaboration. The USA had the most collaboration with other
worldwide countries. A co-authorship map demonstrated that the top
active authors in the field of cocaine intoxication were present in 13
different clusters (Fig. 3).
illustrates the collaboration network of countries publishing more than
five documents. The size of circles represents the number of
publications of the country and the thickness of lines signifies the
size of collaboration. The USA had the most collaboration with other
worldwide countries. A co-authorship map demonstrated that the top
active authors in the field of cocaine intoxication were present in 13
different clusters (Fig. 3).
The ten most productive of journals/periodicals in the field of cocaine toxicity are listed in Table 2. Neurotoxicology and Teratology published the most cocaine articles (274; 9.4%), followed by Journal of Analytical Toxicology (215; 7.4%), Clinical Toxicology (79; 2.7%), and Journal of Pharmacology and Experimental Therapeutics
(64; 2.2%). The top ten most productive journals accounted for 33.5% of
the total publications. The highest IF was associated with Annals of Emergency Medicine (IF = 5.008). Figures 4, 5, and 6
illustrate the co-occurrence networks for high-frequency terms related
to cocaine toxicity in the titles and abstracts of the publications
between 1975–1995, 1996–2005, and 2006–2015, respectively. Figure 7
shows the co-occurrence network of high-frequency terms in the title
or/and abstract of retrieved publications related to cocaine toxicity
during 1975–2015 which reflect most frequently encountered topics in
this field. The five most used topics in cocaine toxicity are
represented by five coloured clusters: blue, yellow, green, purple and
red colors. Cluster number 1 (yellow color) included terms related to
reproductive toxicity topic such as “prenatal cocaine exposure”,
“infant”, or “mother”; Cluster number 2 (green color) included terms
related to cocaine exposure and clinical management topic such as
“patient”, “case”, or “hospital”; Cluster number 3 (purple color)
included terms related to laboratory methods for detection of exposure
to cocaine topic such as “mass spectrometry”, “metabolite”, or
“detection”; Cluster number 4 (blue color) included terms related to
cocaine metabolism topic such as “enzyme”, “inducer”, or “metabolism”;
and Cluster number 5 (red color) included terms related to cocaine
toxicity in animal models topic such as “rat”, “mice”. Additional file 2:
Figure S1–S4 shows the density maps for co-occurrence of terms used in
the title and abstract of retrieved publications across different time
periods, from low density (blue) to high density (red).
(64; 2.2%). The top ten most productive journals accounted for 33.5% of
the total publications. The highest IF was associated with Annals of Emergency Medicine (IF = 5.008). Figures 4, 5, and 6
illustrate the co-occurrence networks for high-frequency terms related
to cocaine toxicity in the titles and abstracts of the publications
between 1975–1995, 1996–2005, and 2006–2015, respectively. Figure 7
shows the co-occurrence network of high-frequency terms in the title
or/and abstract of retrieved publications related to cocaine toxicity
during 1975–2015 which reflect most frequently encountered topics in
this field. The five most used topics in cocaine toxicity are
represented by five coloured clusters: blue, yellow, green, purple and
red colors. Cluster number 1 (yellow color) included terms related to
reproductive toxicity topic such as “prenatal cocaine exposure”,
“infant”, or “mother”; Cluster number 2 (green color) included terms
related to cocaine exposure and clinical management topic such as
“patient”, “case”, or “hospital”; Cluster number 3 (purple color)
included terms related to laboratory methods for detection of exposure
to cocaine topic such as “mass spectrometry”, “metabolite”, or
“detection”; Cluster number 4 (blue color) included terms related to
cocaine metabolism topic such as “enzyme”, “inducer”, or “metabolism”;
and Cluster number 5 (red color) included terms related to cocaine
toxicity in animal models topic such as “rat”, “mice”. Additional file 2:
Figure S1–S4 shows the density maps for co-occurrence of terms used in
the title and abstract of retrieved publications across different time
periods, from low density (blue) to high density (red).
Table 2
Ten most active journals in the field of cocaine toxicity
SCR | Journal/Periodical | Number of documents (%) | IFa |
---|---|---|---|
1st | Neurotoxicology and Teratology | 274 (9.44) | 2.488 |
2nd | Journal of Analytical Toxicology | 215 (7.41) | 2.322 |
3rd | Clinical Toxicology | 79 (2.72) | 2.886 |
4th | Journal of Pharmacology and Experimental Therapeutics | 64 (2.21) | 3.760 |
5th | Drug and Alcohol Dependence | 60 (2.07) | 3.349 |
6th | Annals of Emergency Medicine | 52 (1.79) | 5.008 |
6th | Journal of Forensic Sciences | 52 (1.79) | 1.322 |
8th | Toxicology Letters | 50 (1.72) | 3.522 |
9th | Pharmacology Biochemistry and Behavior | 48 (1.65) | 2.537 |
10th | Life Sciences | 39 (1.34) | 2.685 |
10th | Psychopharmacology | 39 (1.34) | 3.540 |
The three most cited publications in cocaine toxicity are shown for each of the top ten productive countries (Table 3) [51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80]. From 1975 to 2015, the most frequently cited article was published in Proceedings of the National Academy of Sciences by Ramamoorthy et al [55] in 1993 and had been cited 657 times. Table 4
lists the top three most productive institutions from or collaborating
with the top ten most productive countries in the field of cocaine
toxicity. Leading was the National Institute on Drug Abuse (NIDA) with 115 publications, followed by University of Miami with 65 publications. Figure 8
demonstrates the collaboration network of top-155 institutes publishing
more than five documents during 1975–2015. The size of circles
represents the number of publications of the institute and the thickness
of lines signifies the size of collaboration. As shown in Fig. 8, National Institute on Drug Abuse (NIDA), University of Miami, and Tufts University have the most collaboration with other USA or worldwide institutes.
lists the top three most productive institutions from or collaborating
with the top ten most productive countries in the field of cocaine
toxicity. Leading was the National Institute on Drug Abuse (NIDA) with 115 publications, followed by University of Miami with 65 publications. Figure 8
demonstrates the collaboration network of top-155 institutes publishing
more than five documents during 1975–2015. The size of circles
represents the number of publications of the institute and the thickness
of lines signifies the size of collaboration. As shown in Fig. 8, National Institute on Drug Abuse (NIDA), University of Miami, and Tufts University have the most collaboration with other USA or worldwide institutes.
Table 3
Top three cited publications in the field of cocaine toxicity for the top 10 most productive countries
SCR | Authors | Title | Year of publication | Source title | IFa | Cited by | Average citations per year |
---|---|---|---|---|---|---|---|
USA | |||||||
1st | Ramamoorthy et al [55] | Antidepressant- and cocaine-sensitive human serotonin transporter: molecular cloning, expression, and chromosomal localization | 1993 | Proceedings of the National Academy of Sciences | 9.423 | 657 | 27.38 |
2nd | Grant et al. [52] | Activation of memory circuits during cue-elicited cocaine craving | 1996 | Proceedings of the National Academy of Sciences | 9.423 | 636 | 30.29 |
3rd | McFarland et al. [74] | Limbic and motor circuitry underlying footshock-induced reinstatement of cocaine-seeking behavior | 2004 | Journal of Neuroscience | 5.924 | 304 | 23.38 |
Spain | |||||||
1st | Farre et al. [53] | Alcohol and cocaine interactions in humans | 1993 | Journal of Pharmacology and Experimental Therapeutics | 3.760 | 133 | 5.54 |
2nd | Farre et al. [59] | Cocaine and alcohol interactions in humans: neuroendocrine effects and cocaethylene metabolism | 1997 | Journal of Pharmacology and Experimental Therapeutics | 3.760 | 69 | 3.45 |
3rd | Ortega-Carnicer et al. [51] | Aborted sudden death, transient Brugada pattern, and wide QRS dysrrhythmias after massive cocaine ingestion | 2001 | Journal of Electrocardiology | 1.290 | 63 | 3.94 |
Italy | |||||||
1st | Tagliaro et al. [58] | Capillary electrophoresis for the investigation of illicit drugs in hair: determination of cocaine and morphine | 1993 | Journal of Chromatography A | 3.926 | 71 | 2.96 |
2nd | Addis et al. [68] | Fetal effects of cocaine: an updated meta-analysis | 2001 | Reproductive Toxicology | 2.850 | 65 | 4.06 |
3rd | Cervo et al. [77] | Protein kinases A and C are involved in the mechanisms underlying consolidation of cocaine place conditioning | 1997 | Brain Research | 2.561 | 58 | 2.90 |
Canada | |||||||
1st | Bozarth and Wise [79] | Toxicity associated with long-term intravenous heroin and cocaine self-administration in the rat | 1985 | JAMA: Journal of the American Medical Association | 37.684 | 169 | 5.28 |
2nd | Nanji and Filipenko [56] | Asystole and ventricular fibrillation associated with cocaine intoxication | 1984 | Chest | 5.94 | 169 | 5.12 |
3rd | Tyndale et al. [75] | Neuronal cytochrome P450IID1 (debrisoquine/sparteine-type): potent inhibition of activity by (-)-cocaine and nucleotide sequence identity to human hepatic P450 gene CYP2D6 | 1991 | Molecular Pharmacology | 3.931 | 143 | 5.50 |
France | |||||||
1st | Lenoir et al. [73] | Intense Sweetness Surpasses Cocaine Reward | 2007 | PLOS ONE | 3.057 | 162 | 16.20 |
2nd | Maurice et al. [78] | Sigma(1) (sigma(1)) receptor antagonists represent a new strategy against cocaine addiction and toxicity | 2002 | Neuroscience & Biobehavioral Reviews | 8.580 | 103 | 6.87 |
3rd | Pellinen et al. [62] | Cocaine N-demethylation and the metabolism-related hepatotoxicity can be prevented by cytochrome P450 3A inhibitors | 1994 | European Journal of Pharmacology | 2.730 | 75 | 3.26 |
UK | |||||||
1st | Ito et al. [64] | Differential control over cocaine-seeking behavior by nucleus accumbens core and shell | 2004 | Nature Neuroscience | 16.724 | 269 | |
2nd | Whitelaw et al. [67] | Excitotoxic lesions of the basolateral amygdala impair the acquisition of cocaine-seeking behaviour under a second-order schedule of reinforcement | 1996 | Psychopharmacology | 3.540 | 244 | |
3rd | Vorel et al. [66] | Dopamine D-3 receptor antagonism inhibits cocaine-seeking and cocaine-enhanced brain reward | 2002 | Journal of Neuroscience | 5.924 | 200 | |
Brazil | |||||||
1st | Masur et al. [72] | Increased stimulatory effect by the combined administration of cocaine and alcohol in mice. | 1989 | Alcohol | 2.440 | 36 | 1.29 |
2nd | Crouch et al. [54] | Analysis of cocaine and its metabolites from biological specimens using solid-phase extraction and positive ion chemical ionization mass spectrometry | 1995 | Journal of Analytical Toxicology | 2.322 | 34 | 1.55 |
3rd | Lepsch et al. [61] | Cocaine induces cell death and activates the transcription nuclear factor kappa-b in pc12 cells | 2009 | Molecular Brain | 3.745 | 30 | 3.75 |
Germany | |||||||
1st | Wilbert-Lampen et al. [60] | Cocaine increases the endothelial release of immunoreactiveendothelin and its concentrations in human plasma and urine - Reversal by coincubation with sigma-receptor antagonists | 1998 | Circulation | 17.047 | 69 | 3.63 |
2nd | Maurer et al. [80] | Toxicokinetics of drugs of abuse: Current knowledge of the isoenzymes involved in the human metabolism of tetrahydrocannabinol, cocaine, heroin, morphine, and codeine | 2006 | Therapeutic Drug Monitoring | 2.094 | 67 | 6.09 |
3rd | BrenzVerca et al. [65] | Distribution of alpha- and gamma-synucleins in the adult rat brain and their modification by high-dose cocaine treatment | 2003 | European Journal of Neuroscience | 2.975 | 40 | 2.86 |
Japan | |||||||
1st | Nakahara et al. [69] | Hair analysis for drugs of abuse. V. The facility in incorporation of cocaine into hair over its major metabolites, benzoylecgonine and ecgonine methyl ester | 1992 | Archives of Toxicology | 6.637 | 69 | 2.76 |
2nd | Aoki et al. [63] | Cocaine-induced liver injury in mice is mediated by nitric oxide and reactive oxygen species | 1997 | European Journal of Pharmacology | 2.730 | 45 | 2.25 |
3rd | Nakahara and Kikura [70] | Hair analysis for drugs of abuse. VII. The incorporation rates of cocaine, benzoylecgonine and ecgonine methyl ester into rat hair and hydrolysis of cocaine in rat hair | 1994 | Archives of Toxicology | 6.637 | 43 | 1.87 |
Switzerland | |||||||
1st | Boelsterli and Goldlin [57] | Biomechanisms of cocaine-induced hepatocyte injury mediated by the formation of reactive metabolites | 1991 | Archives of Toxicology | 6.637 | 95 | 3.65 |
2nd | Boelsterli et al. [71] | Identification of cytochrome P-450IIB1 as a cocaine-bioactivating isoform in rat hepatic microsomes and in cultured rat hepatocytes. | 1992 | Drug Metabolism & Disposition | 3.210 | 62 | 2.48 |
3rd | Boelsterli et al. [76] | Oxygen free radical production mediated by cocaine and its ethanol-derived metabolite, cocaethylene, in rat hepatocytes. | 1993 | Hepatology | 11.711 | 54 | 2.25 |
Table 4
Top three most
productive institutions from or collaborating with the top ten most
productive countries in the field of cocaine toxicity
productive institutions from or collaborating with the top ten most
productive countries in the field of cocaine toxicity
SCR | Institute | n (%) |
---|---|---|
USA (number of documents = 2,089) | ||
1st | National Institute on Drug Abuse (NIDA) | 115 (5.51) |
2nd | University of Miami | 65 (3.11) |
3rd | Yale University | 55 (2.63) |
Italy(number of documents = 100) | ||
1st | UniversitàCattolica del Sacro Cuore | 12 (12.00) |
2nd | IstitutoSuperiore di Sanità | 9 (9.00) |
3rd | Sapienza – Università di Roma | 8 (8.00) |
France(number of documents = 90) | ||
1st | HôpitalFernand-Widal | 15 (16.67) |
2nd | Institut national de la santé et de la recherchemédicale-INSERM | 9 (10.00) |
3rd | Columbia University College of Physicians and Surgeons | 7 (7.78) |
Brazil(number of documents = 55) | ||
1st | University of São Paulo | 22 (40.00) |
2nd | Universidade Federal de Minas Gerais | 6 (10.91) |
3rd | Universidade Federal de São Paulo | 6 (10.91) |
Japan(number of documents = 42) | ||
1st | Kyoto University | 9 (21.43) |
2nd | Showa University | 6 (14.29) |
3rd | National Institute on Drug Abuse (NIDA) | 4 (9.52) |
Spain (number of documents = 145) | ||
1st | University of Santiago de Compostela | 15 (10.35) |
2nd | Autonomous University of Barcelona | 11 (7.59) |
3rd | University of Valencia | 9 (6.21) |
Canada(number of documents = 92) | ||
1st | University of Toronto | 28 (30.44) |
2nd | The Hospital for Sick Children | 24 (26.09) |
3rd | University of British Columbia | 8 (8.70) |
UK(number of documents = 80) | ||
1st | University of Cambridge | 18 (22.50) |
2nd | Guy’s and St Thomas’ NHS Foundation Trust | 6 (7.50) |
3rd | Guy’s Hospital | 4 (5.00) |
Germany(number of documents = 50) | ||
1st | Goethe University Frankfurt | 4 (8.00) |
2nd | Maastricht University | 4 (8.00) |
3rd | Universität Heidelberg | 4 (8.00) |
Switzerland(number of documents = 31) | ||
1st | University of Zurich | 12 (38.71) |
2nd | Swiss Federal Institute of Technology | 10 (32.26) |
3rd | Université de Fribourg | 2 (6.45) |
Discussion
The
number of publications in the field of cocaine intoxication has grown
during the studied 40 years, and correlates with growth in publications
in all fields related to cocaine. There was a steady growth rate until
1992, then total output has been fairly stable with some fluctuations
between 1992 and 2015. The increased number of publications may be due
to: 1. the number of frequent cocaine users has been increasing since
1980 [81],
2. greater awareness of concerns about life-threatening consequences of
cocaine toxicity, particularly related to cardiac, cerebrovascular, and
maternal morbidity and mortality [2, 82, 83], 3. increasing cocaine use at a global level [84], and, 4. new pharmacological concepts related to cocaine use, namely in its role as a local anaesthetic agent [81, 85].
number of publications in the field of cocaine intoxication has grown
during the studied 40 years, and correlates with growth in publications
in all fields related to cocaine. There was a steady growth rate until
1992, then total output has been fairly stable with some fluctuations
between 1992 and 2015. The increased number of publications may be due
to: 1. the number of frequent cocaine users has been increasing since
1980 [81],
2. greater awareness of concerns about life-threatening consequences of
cocaine toxicity, particularly related to cardiac, cerebrovascular, and
maternal morbidity and mortality [2, 82, 83], 3. increasing cocaine use at a global level [84], and, 4. new pharmacological concepts related to cocaine use, namely in its role as a local anaesthetic agent [81, 85].
The
USA is the most productive country in research related to cocaine
intoxication, which is similar to patterns identified for other clinical
toxicology research, such as intravenous lipid emulsion as an antidote [39], paracetamol poisoning [86, 87], acetylcysteine as antidote [88], methanol poisoning [40], and calcium channel blockers poisoning [41]. Possible reasons include the comparatively large research budgets, and rapid economic growth [89]. In addition, it was reported that cocaine was the most commonly abused drug in parts of the USA [1, 19].
Another noticeable finding was that all the top cited publications in
the field of cocaine intoxication originated from the USA. These results
are consistent with data obtained by previous bibliometric studies that
a few developed countries such as the USA generate the most frequently
cited toxicology studies [39, 41, 87, 90].
This might be influenced by factors such as access to publications by
scholars from the USA. There may be greater opportunities for USA
researchers to access databases and attend international conferences and
academic exchange programs, that contribute to higher citation rates [91].
A possible explanation is the generalised trend towards increasing
publication numbers across a range of scientific fields within the USA.
Furthermore, there are some indications that the USA researchers tend to
cite publications from their own country [92].
USA is the most productive country in research related to cocaine
intoxication, which is similar to patterns identified for other clinical
toxicology research, such as intravenous lipid emulsion as an antidote [39], paracetamol poisoning [86, 87], acetylcysteine as antidote [88], methanol poisoning [40], and calcium channel blockers poisoning [41]. Possible reasons include the comparatively large research budgets, and rapid economic growth [89]. In addition, it was reported that cocaine was the most commonly abused drug in parts of the USA [1, 19].
Another noticeable finding was that all the top cited publications in
the field of cocaine intoxication originated from the USA. These results
are consistent with data obtained by previous bibliometric studies that
a few developed countries such as the USA generate the most frequently
cited toxicology studies [39, 41, 87, 90].
This might be influenced by factors such as access to publications by
scholars from the USA. There may be greater opportunities for USA
researchers to access databases and attend international conferences and
academic exchange programs, that contribute to higher citation rates [91].
A possible explanation is the generalised trend towards increasing
publication numbers across a range of scientific fields within the USA.
Furthermore, there are some indications that the USA researchers tend to
cite publications from their own country [92].
The
percentages of all publications appearing in the top journals were
comparatively low, indicating a spread of publications allocated to
generalised and specialised journals, and reflecting the broad range of
research interests related to cocaine. This is similar to several other
areas of toxicology research with a high level of multidisciplinary
interest, including intravenous lipid emulsion as an antidote [39], methanol poisoning [40], and calcium channel blockers poisoning [41].
percentages of all publications appearing in the top journals were
comparatively low, indicating a spread of publications allocated to
generalised and specialised journals, and reflecting the broad range of
research interests related to cocaine. This is similar to several other
areas of toxicology research with a high level of multidisciplinary
interest, including intravenous lipid emulsion as an antidote [39], methanol poisoning [40], and calcium channel blockers poisoning [41].
The
most frequently cited and highly influential publication was related to
a novel hypothesis of cocaine pharmacological action, namely
“Antidepressant- and cocaine-sensitive human serotonin transporter:
molecular cloning, expression, and chromosomal localization”.
Understanding the citation patterns is important in evaluating an
individual publication, and may also help understand how a certain
topics or concepts are disseminated within the scientific community [93].
most frequently cited and highly influential publication was related to
a novel hypothesis of cocaine pharmacological action, namely
“Antidepressant- and cocaine-sensitive human serotonin transporter:
molecular cloning, expression, and chromosomal localization”.
Understanding the citation patterns is important in evaluating an
individual publication, and may also help understand how a certain
topics or concepts are disseminated within the scientific community [93].
Bibliometric
analysis has a limitations, including database variations, discipline
variation, and bias towards English language [26, 94]. As with all previous bibliometric studies [94, 95, 96],
our study is limited by use of search term “cocaine” to only the title
search. Specially, any publications that used “cocaine” as a key word in
the publication may have been missed in our analysis. It is widely
known that the total number of publications from major databases such as
Google Scholar, Scopus, PubMed, and WoS differs. Furthermore, there is
an indisputable inclination that English is the language of science, and
certain databases may omit publications in different languages.
analysis has a limitations, including database variations, discipline
variation, and bias towards English language [26, 94]. As with all previous bibliometric studies [94, 95, 96],
our study is limited by use of search term “cocaine” to only the title
search. Specially, any publications that used “cocaine” as a key word in
the publication may have been missed in our analysis. It is widely
known that the total number of publications from major databases such as
Google Scholar, Scopus, PubMed, and WoS differs. Furthermore, there is
an indisputable inclination that English is the language of science, and
certain databases may omit publications in different languages.
Conclusions
Research
progress related to cocaine intoxication has been assessed for the
first time based on a bibliometric approach. Research related to cocaine
intoxication has become more global and extensive after 1990, and the
USA is the leading country with the greatest number of publications and
highest h-index. The main
topics have consistently been reproductive toxicity, cocaine exposure
and clinical management, laboratory methods for detection of exposure to
cocaine, cocaine metabolism, and cocaine toxicity in animals. These
findings may provide a valuable basis for identifying important topics
for future research, and create opportunities for collaboration between
research groups with complementary scientific interest in the field of
cocaine toxicity.
progress related to cocaine intoxication has been assessed for the
first time based on a bibliometric approach. Research related to cocaine
intoxication has become more global and extensive after 1990, and the
USA is the leading country with the greatest number of publications and
highest h-index. The main
topics have consistently been reproductive toxicity, cocaine exposure
and clinical management, laboratory methods for detection of exposure to
cocaine, cocaine metabolism, and cocaine toxicity in animals. These
findings may provide a valuable basis for identifying important topics
for future research, and create opportunities for collaboration between
research groups with complementary scientific interest in the field of
cocaine toxicity.
Abbreviations
- IFs:
-
Impact factors
- JCR:
-
Journal Citation Reports
- SCR:
-
Standard Competition Ranking
- WoS:
-
Web of Science
Declarations
Acknowledgements
Special
thanks to WHO’s Health InterNetwork Access to Research Initiative
(HINARI), and An-Najah National University for giving the opportunities
to access most recent information sources such as WoS database.
thanks to WHO’s Health InterNetwork Access to Research Initiative
(HINARI), and An-Najah National University for giving the opportunities
to access most recent information sources such as WoS database.
Funding
No funding was received for writing this study.
Availability of data and materials
Not applicable.
Authors’ contributions
SZ, SA, WS and WW were
involved in the study conception and the study design. SZ, data
collection, wrote the first draft and conducted the analysis. SA, WS and
WW contributed to the writing and critically revising the article. All
authors read and approved the final manuscript and agreed on its
submission.
involved in the study conception and the study design. SZ, data
collection, wrote the first draft and conducted the analysis. SA, WS and
WW contributed to the writing and critically revising the article. All
authors read and approved the final manuscript and agreed on its
submission.
Competing interests
The authors declare that they have no competing interests.
Consent for publication
Not applicable.
Ethics approval and consent to participate
Not applicable.
Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/),
which permits unrestricted use, distribution, and reproduction in any
medium, provided you give appropriate credit to the original author(s)
and the source, provide a link to the Creative Commons license, and
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Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
which permits unrestricted use, distribution, and reproduction in any
medium, provided you give appropriate credit to the original author(s)
and the source, provide a link to the Creative Commons license, and
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Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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