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https://www.readbyqxmd.com/read/28932964/treatment-strategies-for-the-opioid-dependent-patient
#1
REVIEW
Shweta Teckchandani, Meredith Barad
PURPOSE OF REVIEW: This review is intended to help the headache physician think through and plan for management issues concerning the use of opioids. We ask the headache physician to consider if there are instances where prescribing or continuing prescriptions of opiates is plausible, and if so, how can the physician proceed as safely as possible. Our goal is to start a conversation regarding the inevitable encounter with a patient on opiates or requesting opiates. RECENT FINDINGS: The use of opiates in our society has reached a crisis in staggering death and addiction rates...
September 20, 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28924527/hepatitis-c-screening-the-downstream-dissemination-of-evolving-guidelines-in-a-resident-continuity-clinic
#2
Kamraan Madhani, Ali Aamar, David Chia
Background In 2012, the Centers for Disease Control and Prevention (CDC) published guidelines supporting one-time screening for hepatitis C (HCV) in all persons born between 1945 and 1965. It is estimated that 75% of adults infected with HCV fall within this cohort. Furthermore, it is projected that this preventative health intervention would lead to the diagnosis of 800,000 unknown cases and the prevention of 120,000 deaths. Objectives The primary objectives are to measure adherence to HCV screening in a continuity practice staffed by internal medicine residents and attending physicians and to measure the effect of educational interventions to enhance HCV screening...
July 7, 2017: Curēus
https://www.readbyqxmd.com/read/28917018/temporal-trends-in-utilization-and-outcomes-of-endoscopic-retrograde-cholangiopancreatography-in-acute-cholangitis-due-to-choledocholithiasis-from-1998-to-2012
#3
Malav P Parikh, Niyati M Gupta, Prashanthi N Thota, Rocio Lopez, Madhusudhan R Sanaka
BACKGROUND AND AIMS: Expeditious endoscopic retrograde cholangiopancreatography (ERCP) in acute cholangitis with biliary decompression is associated with better outcomes. In this study, we evaluated the temporal trends of ERCP utilization and healthcare outcomes among patients hospitalized with acute cholangitis due to choledocholithiasis (CDC) from 1998 to 2012. METHODS: We identified patients with a combined diagnosis of cholangitis and choledocholithiasis from the national inpatient sample database...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28890191/considerations-for-use-of-ebola-vaccine-during-an-emergency-response
#4
REVIEW
Jenny A Walldorf, Emily A Cloessner, Terri B Hyde, Adam MacNeil
Vaccination against Ebola virus disease is a tool that may limit disease transmission and deaths in future outbreaks, integrated within traditional Ebola outbreak prevention and control measures. Although a licensed Ebolavirus vaccine (EV) is not yet available, the 2014-2016 West African Ebola outbreak has accelerated EV clinical trials and given public health authorities in Guinea, Liberia, and Sierra Leone experience with implementation of emergency ring vaccination. As evidence supporting the use of EV during an outbreak response has become available, public health authorities in at-risk countries are considering how to integrate EV into future emergency Ebola responses and for prevention in high-risk groups, such as healthcare workers and frontline workers (HCW/FLWs), even before an EV is licensed...
September 7, 2017: Vaccine
https://www.readbyqxmd.com/read/28885516/treating-acute-pain-in-the-opiate-dependent-patient
#5
Coleen Dever
Opioid drugs, including prescription as well as heroin, have come to the national spotlight due to the unprecedented rate of overdose and addiction. The Centers for Disease Control and Prevention (CDC) has termed this problem as an "epidemic" that has reached record numbers of deaths in 2014. Approximately half of these deaths are the result from prescribed opioids. Also on the rise are the numbers of individuals who are diagnosed with chronic pain and are treated with opioids, methadone and buprenorphine. Individuals currently taking opioids for chronic pain confound the treatment of acute pain after traumatic injury...
September 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28876286/investigation-of-early-syphilis-trends-among-men-who-have-sex-with-men-to-identify-gaps-in-screening-and-case-finding-in-baltimore-city-maryland
#6
Christina M Schumacher, Errol Fields, Aruna Chandran, Omeid Heidari, Yvonne Kingon, Patrick Chaulk, Jacky M Jennings
BACKGROUND: Syphilis incidence is increasing across the United States among men who have sex with men (MSM). Early latent (EL) versus primary and secondary (P&S) syphilis may be an indicator of delayed diagnosis and increased opportunity for transmission. To inform syphilis control strategies and identify potential gaps in case finding, we described recent syphilis trends among MSM and compared characteristics of syphilis cases by diagnosis stage. METHODS: We used public health surveillance data on P&S and EL syphilis diagnoses reported to the Baltimore City Health Department between 2009 and 2015...
August 28, 2017: Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/28845205/medicolegal-death-scene-investigations-after-natural-disaster-and-weather-related-events-a-review-of-the-literature
#7
Luciana A Rocha, Catharine Q Fromknecht, Sarah Davis Redman, Joanne E Brady, Sarah E Hodge, Rebecca S Noe
BACKGROUND: The number of disaster-related deaths recorded by vital statistics departments often differs from that reported by other agencies, including the National Oceanic and Atmospheric Administration-National Weather Service storm database and the American Red Cross. The Centers for Disease Control and Prevention (CDC) has launched an effort to improve disaster-related death scene investigation reporting practices to make data more comparable across jurisdictions, improve accuracy of reporting disaster-related deaths, and enhance identification of risk and protective factors...
June 1, 2017: Acad Forensic Pathol
https://www.readbyqxmd.com/read/28831576/prevention-of-fracture-related-infection-a-multidisciplinary-care-package
#8
REVIEW
Willem-Jan Metsemakers, Jolien Onsea, Emilie Neutjens, Ester Steffens, Annette Schuermans, Martin McNally, Stefaan Nijs
Fracture-related infection (FRI) remains a challenging complication. It may result in permanent functional loss or even amputation in otherwise healthy patients. For these reasons, it is important to focus attention on prevention. In treatment algorithms for FRI, antibiotic stewardship programmes have already proved their use by means of a multidisciplinary collaboration between microbiologists, surgeons, pharmacists, infectious disease physicians and nursing staff. A similar approach, however, has not been described for infection prevention...
August 22, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28819477/evaluation-of-the-adverse-drug-reaction-surveillance-system-kadoma-city-zimbabwe-2015
#9
MULTICENTER STUDY
Caroline Muringazuva, Daniel Chirundu, More Mungati, Gerald Shambira, Notion Gombe, Donewell Bangure, Tsitsi Juru, Mufuta Tshimanga
INTRODUCTION: Medicines have the potential to cause adverse drug reactions and because of this Zimbabwe monitor reactions to medicines through the Adverse Drug Reaction Surveillance System. The Medicines Control Authority of Zimbabwe monitors reactions to medicines through the Adverse Drugs Reactions Surveillance System. The system relies on health professionals to report adverse drug reactions to maximize patient safety. We report results of an evaluation of the Adverse Drugs Reactions Surveillance System in Kadoma District...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28805953/factors-associated-with-physical-activity-among-adolescent-and-young-adult-survivors-of-early-childhood-cancer-a-report-from-the-childhood-cancer-survivor-study-ccss
#10
Katie A Devine, Ann C Mertens, John A Whitton, Carmen L Wilson, Kirsten K Ness, Jordan Gilleland Marchak, Wendy Leisenring, Kevin C Oeffinger, Leslie L Robison, Gregory T Armstrong, Kevin R Krull
OBJECTIVE: To evaluate concurrent and longitudinal associations between psychosocial functioning and physical activity in adolescent and young adult survivors of early childhood cancer. METHODS: Adolescent survivors of early childhood cancer (diagnosed before age four) participating in the Childhood Cancer Survivor Study completed the Coping Health and Illness Profile-Adolescent Edition (CHIP-AE; n=303; mean age at survey 17.6 years). A subset of these survivors (n=248) completed a follow-up survey an average of 6...
August 14, 2017: Psycho-oncology
https://www.readbyqxmd.com/read/28749874/new-cdc-guideline-for-the-prevention-of-surgical-site-infection
#11
Betsy Todd
This updates the 1999 original, published before formal evidence-based guidelines were in routine use.
August 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28721112/current-perspectives-in-the-usa-on-the-diagnosis-and-treatment-of-pelvic-inflammatory-disease-in-adolescents
#12
REVIEW
William L Risser, Jan M Risser, Amanda L Risser
In this review, the epidemiology, diagnosis, and treatment of pelvic inflammatory disease (PID) are discussed from a USA perspective and the difficulties that USA adolescents face in recognizing and seeking care for PID and other sexually transmitted infections (STIs) are emphasized. Females aged 15-24 years have the highest incidence of cervical infection with Chlamydia trachomatis and Neisseria gonorrheae, the principal causes of PID. PID is common in this age group. However, the incidence of PID in the USA is not known, because it is not a reportable disease, and because clinicians vary in the criteria used for the diagnosis...
2017: Adolescent Health, Medicine and Therapeutics
https://www.readbyqxmd.com/read/28721089/combination-treatment-of-neuropathic-pain-danish-expert-recommendations-based-on-a-delphi-process
#13
EDITORIAL
Jakob Vormstrup Holbech, Anne Jung, Torsten Jonsson, Mette Wanning, Claus Bredahl, Flemming W Bach
BACKGROUND: Current Danish treatment algorithms for pharmacological treatment of neuropathic pain (NeP) are tricyclic antidepressants (TCA), gabapentin and pregabalin as first-line treatment for the most common NeP conditions. Many patients have insufficient pain relief on monotherapy, but combination therapy had not been included in guidelines until recently. Based on clinical empiricism and scientific evidence, a Delphi consensus process provided a consolidated guidance on pharmacological combination treatment of NeP...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28683056/vital-signs-changes-in-opioid-prescribing-in-the-united-states-2006-2015
#14
Gery P Guy, Kun Zhang, Michele K Bohm, Jan Losby, Brian Lewis, Randall Young, Louise B Murphy, Deborah Dowell
BACKGROUND: Prescription opioid-related overdose deaths increased sharply during 1999-2010 in the United States in parallel with increased opioid prescribing. CDC assessed changes in national-level and county-level opioid prescribing during 2006-2015. METHODS: CDC analyzed retail prescription data from QuintilesIMS to assess opioid prescribing in the United States from 2006 to 2015, including rates, amounts, dosages, and durations prescribed. CDC examined county-level prescribing patterns in 2010 and 2015...
July 7, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28681751/assessment-of-surgical-risk-factors-in-the-development-of-ventilator-associated-pneumonia-in-neurosurgical-intensive-care-unit-patients-alarming-observations
#15
Deepashu Sachdeva, Daljit Singh, Poonam Loomba, Amandeep Kaur, Monica Tandon, Ishu Bishnoi
BACKGROUND: Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in patients receiving mechanical ventilation (MV) and contributes to a longer intensive care unit (ICU) stay, duration of MV, and a high morbidity and mortality. OBJECTIVE: The purpose of study was to determine the incidence of VAP in neurosurgery ICU patients and to assess the probable contributing neurosurgical risk factors like the site and nature of the lesion in the brain, the duration of surgery, blood loss during surgery, and infection elsewhere in the body, in the development of VAP...
July 2017: Neurology India
https://www.readbyqxmd.com/read/28662018/walking-for-transportation-or-leisure-among-u-s-women-and-men-national-health-interview-survey-2005-2015
#16
Emily N Ussery, Susan A Carlson, Geoffrey P Whitfield, Kathleen B Watson, David Berrigan, Janet E Fulton
Physical activity confers considerable health benefits, but only half of U.S. adults report participating in levels of aerobic physical activity consistent with guidelines (1,2). Step It Up! The Surgeon General's Call to Action to Promote Walking and Walkable Communities identified walking as an important public health strategy to increase physical activity levels (3). A previous report showed that the self-reported prevalence of walking for transportation or leisure increased by 6 percentage points from 2005 to 2010 (4), but it is unknown whether this increase has been sustained...
June 30, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28632194/a-mind-body-approach-to-pediatric-pain-management
#17
REVIEW
Melanie L Brown, Enrique Rojas, Suzanne Gouda
Pain is a significant public health problem that affects all populations and has significant financial, physical and psychological impact. Opioid medications, once the mainstay of pain therapy across the spectrum, can be associated with significant morbidity and mortality. Centers for Disease and Control (CDC) guidelines recommend that non-opioid pain medications are preferred for chronic pain outside of certain indications (cancer, palliative and end of life care). Mindfulness, hypnosis, acupuncture and yoga are four examples of mind-body techniques that are often used in the adult population for pain and symptom management...
June 20, 2017: Children
https://www.readbyqxmd.com/read/28602044/the-dynamic-interaction-between-pain-and-opioid-misuse
#18
REVIEW
Adrianne R Wilson-Poe, Jose A Morón
In 2014, drug overdose surpassed automobile accidents as the number one cause of accidental death for the first time in the history of the United States. The overdose epidemic is largely driven by opioids, and genuine prescription opioid analgesics play the biggest role in this phenomenon. Despite advancements in abuse deterrent formulations, prescription drug monitoring programmes and clinical assessments for the detection of abuse potential, drug overdoses continue to escalate. The Center for Disease Control has recently issued new guidelines for opioid prescription, yet even these recommendations have their shortcomings...
June 11, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28589269/improving-std-screening-rates-on-a-university-campus
#19
Amanda Myers, Sherrie P McCaskill, Kathryn VanRavenstein
Gonorrhea and chlamydia infections have a high incidence among young adults. To increase screening rates among individuals aged 25 years of age and younger on a university campus, this quality improvement project was implemented to improve providers' knowledge of CDC guidelines through education. Education was provided to providers and staff members at a health clinic on a private residential university campus through informational sessions to increase knowledge of guideline-directed screening for gonorrhea and chlamydia...
June 6, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28542123/malaria-surveillance-united-states-2014
#20
Kimberly E Mace, Paul M Arguin
PROBLEM/CONDITION: Malaria in humans is caused by intraerythrocytic protozoa of the genus Plasmodium. These parasites are transmitted by the bite of an infective female Anopheles mosquito. The majority of malaria infections in the United States occur among persons who have traveled to regions with ongoing malaria transmission. However, malaria is occasionally acquired by persons who have not traveled out of the country through exposure to infected blood products, congenital transmission, laboratory exposure, or local mosquitoborne transmission...
May 26, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
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