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Abstinence syndrome

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https://www.readbyqxmd.com/read/28637193/effect-of-intensive-personalized-5as-5rs-intervention-on-smoking-cessation-in-hospitalized-acute-coronary-syndrome-patients-not-ready-to-quit-immediately-a-randomized-controlled-trial
#1
Jing-Guang Luo, Ling Han, Li-Wei Chen, Yun Gao, Xiao-Jun Ding, Ying Li, Ye Ja, Ming Yang, Chang-Sheng Ma
Introduction: The acute coronary syndrome (ACS) patients who are not ready to quit smoking immediately have an extremely low rate of cessation. This study aims to investigate the efficacy of intensive personalized '5As+5Rs'intervention (IPANR intervention) on smoking cessation in this population. Methods: A parallel-group randomized controlled trial was carried out, which compared IPANR intervention with routine 5Rs (control) at Fu Xing Hospital, Capital Medical University, Bei Jing, China...
June 20, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/28625784/heightened-sympathetic-arousal-is-demonstrated-by-skin-conductance-responsivity-to-auditory-stimuli-in-a-small-cohort-of-neonates-with-opiate-withdrawal
#2
Christiana N Oji-Mmuo, Fumiyuki Chin Gardner, Kim K Doheny
To determine the effects of auditory stimulus on skin conductance (SC) in infants with severe neonatal abstinence syndrome (NAS) that required morphine treatment (MT) compared with NAS infants that did not require morphine treatment (non-MT). We prospectively enrolled opiate-exposed term infants without polysubstance exposure. Skin conductance responses to an auditory stimulus (ringing a bell for 3seconds) near the time of discharge were obtained. Skin conductance was measured before, during, and after the stimulus...
June 15, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28612362/the-economic-burden-of-neonatal-abstinence-syndrome-in-the-united-states
#3
Tammy E Corr, Christopher S Hollenbeak
BACKGROUND AND AIMS: While hospital charges related to neonatal abstinence syndrome (NAS) have increased recently, there are no data available regarding costs. Therefore, we sought to describe the NAS population and compare with the non-NAS population, determine the incidence of NAS in the United States and estimate the total annual costs and hospital days of NAS admissions, and estimate the incremental costs and length of stay of an NAS admission compared with a non-NAS admission. DESIGN: Retrospective, observational study...
June 13, 2017: Addiction
https://www.readbyqxmd.com/read/28602070/a-prognostic-evaluation-and-management-of-alcoholic-hepatitis
#4
Ramesh Rana, Sheng-Lan Wang, Jing Li, Lu Xia, Mei-Yi Song, Chang-Qing Yang
Alcoholic hepatitis is an acute and severe form of alcoholic liver disease associated with high morbidity and mortality of 30-50% worldwide, severity ranging from asymptomatic derangement of liver biochemistries to fulminant liver failure or death. Rapidly progressing jaundice and coagulopathy in prolonged excessive alcohol abusers with or without fever, malnutrition, and tender liver are the clinical hallmarks. The prognostic models (MELD, MDF, ABIC, GAHS, Lille's score) not only predict the short term mortality, but also guide the clinicians to choose appropriate specific therapy (corticosteroid or pentoxifylline) and as a stopping rule if there is no significant benefits of it...
June 9, 2017: Minerva Medica
https://www.readbyqxmd.com/read/28594753/opioid-use-in-pregnancy-neonatal-abstinence-syndrome-and-childhood-outcomes-executive-summary-of-a-joint-workshop-by-the-eunice-kennedy-shriver-national-institute-of-child-health-and-human-development-american-college-of-obstetricians-and-gynecologists-american
#5
Uma M Reddy, Jonathan M Davis, Zhaoxia Ren, Michael F Greene
In April 2016, the Eunice Kennedy Shriver National Institute of Child Health and Human Development invited experts to a workshop to address numerous knowledge gaps and to review the evidence for the screening and management of opioid use in pregnancy and neonatal abstinence syndrome. The rising prevalence of opioid use in pregnancy has led to a concomitant dramatic fivefold increase in neonatal abstinence syndrome over the past decade. Experts from diverse disciplines addressed research gaps in the following areas: 1) optimal screening for opioid use in pregnancy; 2) complications of pregnancy associated with opioid use; 3) appropriate treatments for pregnant women with opioid use disorders; 4) the best approaches for detecting, treating, and managing newborns with neonatal abstinence syndrome; and 5) the long-term effects of prenatal opioid exposure on children...
June 7, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28594450/evaluation-of-the-effectiveness-of-two-morphine-protocols-to-treat-neonatal-abstinence-syndrome-in-a-level-ii-nursery-in-a-community-hospital
#6
Heather N DeAtley, Amanda Burton, Michelle DeLuca Fraley, Joan Haltom
STUDY OBJECTIVE: To evaluate the impact on length of hospital stay and treatment duration of morphine after implementation of a change in the institutional protocol for managing neonatal abstinence syndrome (NAS) in an effort to improve patient outcomes. DESIGN: Single-center, retrospective chart review. SETTING: Level II nursery in a community hospital in Kentucky. PATIENTS: Fifty-nine neonates born between January 1, 2014, and December 31, 2015, who were diagnosed with NAS and received morphine for treatment were included...
June 8, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28562267/an-initiative-to-improve-the-quality-of-care-of-infants-with-neonatal-abstinence-syndrome
#7
Matthew R Grossman, Adam K Berkwitt, Rachel R Osborn, Yaqing Xu, Denise A Esserman, Eugene D Shapiro, Matthew J Bizzarro
BACKGROUND AND OBJECTIVES: The incidence of neonatal abstinence syndrome (NAS), a constellation of neurologic, gastrointestinal, and musculoskeletal disturbances associated with opioid withdrawal, has increased dramatically and is associated with long hospital stays. At our institution, the average length of stay (ALOS) for infants exposed to methadone in utero was 22.4 days before the start of our project. We aimed to reduce ALOS for infants with NAS by 50%. METHODS: In 2010, a multidisciplinary team began several plan-do-study-act cycles at Yale New Haven Children's Hospital...
May 18, 2017: Pediatrics
https://www.readbyqxmd.com/read/28561904/neonatal-abstinence-syndrome-neurobehavior-at-6-weeks-of-age-in-infants-with-or-without-pharmacological-treatment-for-withdrawal
#8
Nicole A Heller, Beth A Logan, Deborah G Morrison, Jonathan A Paul, Mark S Brown, Marie J Hayes
Use and abuse of prescription opioids and concomitant increase in Neonatal Abstinence Syndrome (NAS), a condition that may lead to protracted pharmacological treatment in more than 60% of infants, has tripled since 2000. This study assessed neurobehavioral development using the NICU Network Neurobehavioral Scale in 6-week old infants with prenatal methadone exposure who did (NAS+; n = 23) or did not (NAS-; n = 16) require pharmacological treatment for NAS severity determined by Finnegan Scale. An unexposed, demographically similar group of infants matched for age served as comparison (COMP; n = 21)...
May 31, 2017: Developmental Psychobiology
https://www.readbyqxmd.com/read/28557994/the-societal-cost-of-heroin-use-disorder-in-the-united-states
#9
Ruixuan Jiang, Inyoung Lee, Todd A Lee, A Simon Pickard
OBJECTIVE: Heroin use in the United States has reached epidemic proportions. The objective of this paper is to estimate the annual societal cost of heroin use disorder in the United States in 2015 US dollars. METHODS: An analytic model was created that included incarceration and crime; treatment for heroin use disorder; chronic infectious diseases (HIV, Hepatitis B, Hepatitis C, and Tuberculosis) and their treatments; treatment of neonatal abstinence syndrome; lost productivity; and death by heroin overdose...
2017: PloS One
https://www.readbyqxmd.com/read/28554910/supportive-text-messages-for-patients-with-alcohol-use-disorder-and-a-comorbid-depression-a-protocol-for-a-single-blind-randomised-controlled-aftercare-trial
#10
Dan Hartnett, Edel Murphy, Elizabeth Kehoe, Vincent Agyapong, Declan M McLoughlin, Conor Farren
INTRODUCTION: Alcohol use disorders (AUDs) and mood disorders commonly co-occur, and are associated with a range of negative outcomes for patients. Mobile phone technology has the potential to provide personalised support for such patients and potentially improve outcomes in this difficult-to-treat cohort. The aim of this study is to examine whether receiving supporting SMS text messages, following discharge from an inpatient dual diagnosis treatment programme, has a positive impact on mood and alcohol abstinence in patients with an AUD and a comorbid mood disorder...
May 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28543284/in-utero-oxcarbazepine-exposure-and-neonatal-abstinence-syndrome-case-report-and-brief-review-of-the-literature
#11
Chao-Yang Chen, Xing Li, Ling-Yue Ma, Peng-Hui Wu, Ying Zhou, Qi Feng, Yi-Min Cui
Oxcarbazepine is a second-generation antiepileptic drug that is used to treat partial seizures. Although it has been increasingly used in pregnant women, its fetal safety has not been fully validated. We describe a 12-hour-old neonate who developed neonatal abstinence syndrome (NAS) following intrauterine exposure to oxcarbazepine. The neonate was born by cesarean section to a mother who took oxcarbazepine 300 mg/day for treatment of seizures throughout her pregnancy. Approximately 12 hours after birth, the infant developed paroxysmal jitter, which mainly presented as increased excitability, irritability, limb shaking, and increased muscle tone...
May 20, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28543191/methadone-buprenorphine-and-naltrexone-for-the-treatment-of-opioid-use-disorder-in-pregnant-women
#12
Tran H Tran, Brooke L Griffin, Rebecca H Stone, Kathleen M Vest, Timothy J Todd
Pregnant women with opioid use disorder can be treated with methadone, buprenorphine, or naltrexone to reduce opioid use and improve retention to treatment. In this review, we compare the pregnancy outcomes of methadone, buprenorphine, and naltrexone in clinical trials and discuss the potential behavioral and developmental effects of these agents seen in offspring in animal studies. Important clinical considerations in the management of opioid use disorder in pregnant women and their infants are also discussed...
May 24, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28536981/a-retrospective-cohort-study-of-birth-outcomes-in-neonates-exposed-to-naltrexone-in-utero-a-comparison-with-methadone-buprenorphine-and-non-opioid-exposed-neonates
#13
Erin Kelty, Gary Hulse
BACKGROUND: Naltrexone may provide a suitable alternative to methadone and buprenorphine in the treatment of pregnant opioid-dependent women; however, little is known about its effects on neonatal morbidity and mortality. OBJECTIVE: The aim was to evaluate the health of neonates exposed to naltrexone in utero, and compare it with outcomes in neonates exposed to methadone or buprenorphine and a non-exposed control group. METHODS: Sequential cohorts of Western Australian (WA) opioid-dependent women treated with implant naltrexone, oral methadone or sublingual buprenorphine were identified via records from a drug and alcohol clinic (Subiaco, WA) for naltrexone and state prescribing records for methadone and buprenorphine...
May 23, 2017: Drugs
https://www.readbyqxmd.com/read/28519244/neonatal-abstinence-syndrome-update-on-diagnostic-and-therapeutic-strategies
#14
Genny Raffaeli, Giacomo Cavallaro, K Karel Allegaert, Enno Diederik Wildschut, Monica Fumagalli, Massimo Agosti, Dick Tibboel, Fabio Mosca
Substance use among pregnant women is a major public health issue. Both prescription opioid use and illicit opioid abuse have increased dramatically in recent years. Prolonged in utero drug exposure may result in neonatal abstinence syndrome (NAS), an acute multisystemic clinical entity that occurs in the first days of life. This syndrome is caused by abrupt discontinuation of fetal exposure to licit or illicit drugs chronically consumed by the mother during pregnancy and transmitted to the fetus through the placenta...
May 18, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28517024/treatment-of-severe-alcoholic-hepatitis-past-present-and-future
#15
REVIEW
Nicolas Lanthier, Peter Stärkel
Alcoholic hepatitis manifests as a clinical syndrome characterized by recent jaundice and liver function deterioration in an actively drinking patient. The principal cause of alcoholic hepatitis is alcoholic steatohepatitis defined histologically by the coexistence of steatosis, hepatocyte ballooning and satellitosis. While non-severe alcoholic hepatitis usually responds to alcohol abstinence, severe alcoholic hepatitis, identified by Maddrey scoring ≥ 32, has a bad prognosis and is traditionally treated by a 28-day course of prednisone therapy...
May 18, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28501035/motivation-to-quit-smoking-after-acute-coronary-syndrome
#16
Vânia Rocha, Marina Guerra, Marina Lemos, Júlia Maciel, Geoffrey Williams
INTRODUCTION: Self-Determination Theory explores the process through which a person acquires motivation to initiate new behaviours related to health and to maintain them over time. This study aimed to determine the overall fit of Self-Determination Theory Model for Health Behavior to the data obtained from a sample of smokers hospitalized with acute coronary syndrome, and to identify the predictors of smoking status six months after clinical discharge. MATERIAL AND METHODS: The sample included 110 participants, regular smokers, hospitalized due to acute coronary syndrome...
January 31, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28500694/trends-of-neonatal-abstinence-syndrome-epidemic-and-maternal-risk-factors-in-florida
#17
Xi Wang, Yanmin Zhu, Chintan V Dave, Adel A Alrwisan, Stacy A Voils, Almut G Winterstein
OBJECTIVE: This study aimed to examine secular trends of (i) maternal prescription opioid use in late pregnancy, (ii) neonatal abstinence syndrome (NAS) stratified by late maternal prescription opioid use, and (iii) maternal risk factors among NAS deliveries. METHODS: Women with a live birth who were enrolled 90 days before and 30 days after delivery in Florida Medicaid Analytic Extract billing records linked to birth certificates from 2000 to 2010 were identified for the study...
May 13, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28500681/comparison-of-time-to-first-dose-of-oral-morphine-in-the-treatment-of-neonatal-abstinence-syndrome
#18
Sarah T Mitchell, Tracy J Costello, Kara M Nedderman
OBJECTIVE: To compare time to first dose of oral morphine used in the treatment of neonatal abstinence syndrome (NAS) in a neonatal intensive care unit (NICU) versus a special care nursery (SCN) setting. METHODS: A retrospective chart review was completed of patient data from two community hospitals in a single health network. Infants born at either facility between January 2013 and August 2015 were eligible for inclusion in the study if treated for NAS with a course of oral morphine...
May 13, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28500629/early-prediction-tool-to-identify-the-need-for-pharmacotherapy-in-infants-at-risk-of-neonatal-abstinence-syndrome
#19
Barbara T Isemann, Elaina C Stoeckle, Afshin A Taleghani, Eric W Mueller
OBJECTIVE: To develop a tool to predict the need for pharmacologic treatment of neonatal abstinence syndrome (NAS) within 36 hours from birth in infants at risk for opioid withdrawal. STUDY DESIGN: Retrospective study of infants born at 34 weeks or later gestation with in utero exposure to opioids during two time periods from January 2013 through October 2016. Period 1 was used to develop a predictive tool for validation during Period 2. Birth weight, gestational age, four categories of opioid exposure, and individual scores for 21 withdrawal symptoms from the Modified Finnegan Score at 36 hours of life were recorded...
May 13, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28494389/breastfeeding-support-and-opiate-dependence-a-think-aloud-study
#20
Sonya MacVicar, Tracy Humphrey, Katrina E Forbes-McKay
OBJECTIVE: international guidelines recommend the promotion and protection of breastfeeding for the substance exposed mother and baby. Yet few studies have explored the facilitators, moderators and barriers to successful breastfeeding for women enrolled on opiate maintenance treatment, or suggested targeted support strategies. The aim of this study was to explore the views of women with opiate dependence on proposed elements for inclusion in a breastfeeding support intervention. DESIGN: a qualitative study using think aloud technique...
April 27, 2017: Midwifery
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