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https://www.readbyqxmd.com/read/29763579/social-ecological-examination-of-factors-that-influence-the-treatment-of-newborns-with-neonatal-abstinence-syndrome
#1
Lenora Marcellus
Health care systems are challenged with issues of overdiagnosis and overtreatment. Neonatal abstinence syndrome (NAS) may be overdiagnosed with standardized assessment protocols and may be overtreated with current NICU-based models of care. Clinical approaches to caring for neonates with NAS and their families have not significantly changed for 40 years, and there is growing interest in revisiting long-standing routine practices. I used Bronfenbrenner's social ecological systems framework to organize an exploration of factors that contribute to overdiagnosis and overtreatment in the care of neonates with NAS...
May 12, 2018: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/29757685/the-effect-of-standardizing-treatment-when-managing-neonatal-abstinence-syndrome
#2
Tara Burnette, Lindsey Chernicky, Craig V Towers
OBJECTIVE: Standardizing treatment of neonatal abstinence syndrome (NAS) is currently recommended; however, single institution prospective studies are lacking regarding the success of this approach. The study objective was to evaluate overall newborn response and length of stay (LOS) of neonates treated for NAS following the institution of a strict standardized treatment protocol. METHODS: From 1 January 2014 to 30 June 2016, a prospective cohort study was performed collecting neonatal outcomes before and after the standardization of a strict NAS morphine weaning treatment protocol...
May 14, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29754866/outpatient-pharmacotherapy-for-neonatal-abstinence-syndrome
#3
Faouzi I Maalouf, William O Cooper, James C Slaughter, Judith Dudley, Stephen W Patrick
OBJECTIVE: To determine differences in lengths of stay, length of therapy, emergency department (ED) utilization, and hospital readmissions between infants with neonatal abstinence syndrome (NAS) treated exclusively with inpatient pharmacotherapy compared with those discharged on outpatient pharmacotherapy. STUDY DESIGN: This retrospective cohort study of infants enrolled in the Tennessee Medicaid program used administrative and vital records data from 2009 to 2011...
May 7, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29752818/fluoxetine-uses-in-nociceptive-pain-management-a-promising-adjuvant-to-opioid-analgesics
#4
Mostafa M Hamdy, Mohamed M Elbadr, Ahmed Barakat
Fluoxetine, a commonly prescribed antidepressant, use in nociceptive pain management represent one of the unsettled issues of fluoxetine therapeutics. By reviewing the literature about fluoxetine's possible roles in this setting; those could be solitary antinociceptive effect, enhancement of acute morphine analgesia, blocking morphine tolerance development, and blocking dependence development and associated abstinence syndrome. In this study, we examined those four alleged roles of fluoxetine. Moreover, since effective alleviation of morphine tolerance, dependence, and abstinence syndrome represents one of the most challenging medical needs, we biochemically analyzed fluoxetine effect on these phenomena...
May 12, 2018: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/29747726/opioid-use-disorders-and-pregnancy
#5
REVIEW
Amanda J Johnson, Cresta W Jones
Opioid use disorder presents an increased risk of complications in pregnancy, particularly when untreated. To optimize outcomes, medication-assisted treatment using methadone or buprenorphine as a part of a comprehensive care model is recommended. Neonatal abstinence syndrome and poor fetal growth remain significant complications of this disorder despite maternal treatment.
June 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/29746453/access-to-syringe-services-programs-kentucky-north-carolina-and-west-virginia-2013-2017
#6
Danae Bixler, Greg Corby-Lee, Scott Proescholdbell, Tina Ramirez, Michael E Kilkenny, Matt LaRocco, Robert Childs, Michael R Brumage, Angela D Settle, Eyasu H Teshale, Alice Asher
The Appalachian region of the United States is experiencing a large increase in hepatitis C virus (HCV) infections related to injection drug use (IDU) (1). Syringe services programs (SSPs) providing sufficient access to safe injection equipment can reduce hepatitis C transmission by 56%; combined SSPs and medication-assisted treatment can reduce transmission by 74% (2). However, access to SSPs has been limited in the United States, especially in rural areas and southern and midwestern states (3). This report describes the expansion of SSPs in Kentucky, North Carolina, and West Virginia during 2013-August 1, 2017...
May 11, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29740196/quality-improvement-initiative-to-improve-inpatient-outcomes-for-neonatal-abstinence-syndrome
#7
Elisha M Wachman, Matthew Grossman, Davida M Schiff, Barbara L Philipp, Susan Minear, Elizabeth Hutton, Kelley Saia, Fnu Nikita, Ahmad Khattab, Angela Nolin, Crystal Alvarez, Karan Barry, Ginny Combs, Donna Stickney, Jennifer Driscoll, Robin Humphreys, Judith Burke, Camilla Farrell, Hira Shrestha, Bonny L Whalen
OBJECTIVES: To improve Neonatal Abstinence Syndrome (NAS) inpatient outcomes through a comprehensive quality improvement (QI) program. DESIGN: Inclusion criteria were opioid-exposed infants ≥36 weeks. QI methodology including stakeholder interviews and plan-do-study-act (PDSA) cycles were utilized. We compared pre- and post-intervention NAS outcomes after a QI initiative that included: A non-pharmacologic care bundle, function-based assessments consisting of symptom prioritization and then the "Eat, Sleep, Console" (ESC) Tool; and a switch to methadone for pharmacologic treatment...
May 8, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29739484/outpatient-pharmacologic-weaning-for-neonatal-abstinence-syndrome-a-systematic-review
#8
Jodie Murphy-Oikonen, Karen McQueen
AimThe purpose of this systematic review was to assess the literature regarding the effectiveness and safety of outpatient pharmacologic weaning for infants with neonatal abstinence syndrome (NAS). BACKGROUND: NAS is a multi-system disorder observed in infants experiencing withdrawal from opioid exposure in utero. Infants requiring pharmacologic treatment to manage withdrawal, traditionally receive treatment as a hospital inpatient resulting in lengthy hospitalization periods. However, there is evidence to suggest that some healthcare institutions are continuing outpatient pharmacologic weaning for select infants in a home environment...
May 9, 2018: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/29714153/thiamine-and-alcohol-for-brain-pathology-super-imposing-or-different-causative-factors-for-brain-damage
#9
Rita Moretti, Paola Caruso, Matteo Dal Ben, Silvia Gazzin, Claudio Tiribelli
Drinking more than the recommended limits is a worldwide emerging problem, difficult to circumscribe, and alcohol related brain damages are an under-recognized health problem. Alcohol-cognitive disruption can be considered as transient and recoverable if the alcohol consumption is limited and occasional; if not, it can progress to the so-called alcohol-related dementia (ARD), or to the Wernicke encephalopathy, or it can even induce the Korsakoff syndrome, an irreversible and long-lasting medical condition. ARD still remains poorly diagnosed and addressed, even if it had recently raised increased research interest...
April 2, 2018: Current Drug Abuse Reviews
https://www.readbyqxmd.com/read/29698814/ocular-abnormalities-in-congenital-zika-syndrome-are-the-ophthalmoscopic-findings-the-top-of-the-iceberg
#10
REVIEW
João Rafael de Oliveira Dias, Camila V Ventura, Bruno de Paula Freitas, Juliana Prazeres, Liana O Ventura, Vasco Bravo-Filho, Tomas Aleman, Albert Icksang Ko, Andréa Zin, Rubens Belfort, Mauricio Maia
Zika virus (ZIKV) is an arbovirus mainly transmitted to humans by mosquitoes from Aedes genus. Other ways of transmission include the perinatal and sexual routes, blood transfusion, and laboratory exposure. Although the first human cases were registered in 1952 in African countries, outbreaks were only reported since 2007, when entire Pacific islands were affected. In March 2015, the first cases of ZIKV acute infection were notified in Brazil and, to date, 48 countries and territories in the Americas have confirmed local mosquito-borne transmission of ZIKV...
April 23, 2018: Progress in Retinal and Eye Research
https://www.readbyqxmd.com/read/29680426/willis-ekbom-disease-restless-legs-syndrome-in-patients-with-opioid-withdrawal
#11
Ravi Gupta, Ramjan Ali, Rajat Ray
INTRODUCTION: Many patients with opioid use disorder report symptoms similar to restless legs syndrome (RLS) during withdrawal. However, whether these symptoms are true RLS, their predictors and effect of treatment with pregabalin are still unknown. METHOD: A total of 19 consecutive patients with opioid use disorder who were admitted for detoxification were included in this study after obtaining informed consent. Information regarding addiction was noted, and they were screened for RLS every morning and evening...
May 2018: Sleep Medicine
https://www.readbyqxmd.com/read/29618930/symptoms-associated-with-attention-deficit-hyperactivity-disorder-and-autism-spectrum-disorders-in-school-aged-children-prenatally-exposed-to-substances
#12
Lisbeth Beate Sandtorv, Silje Katrine Elgen Fevang, Sondre Aasen Nilsen, Tormod Bøe, Rolf Gjestad, Siren Haugland, Irene Bircow Elgen
Prenatal exposure to substances may influence a child's neurodevelopment and impact on subsequent mental health. In a hospital-based population of school-aged children prenatally exposed to opiates and a number of illicit substances (n = 57), we evaluated mental health symptoms associated with attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) using the Swanson, Nolan, and Pelham Questionnaire, revision IV (SNAP-IV) and the Autism Spectrum Screening Questionnaire (ASSQ) and compared the scores to a reference group which comprised children from the population-based Bergen Child Study (n = 171)...
2018: Substance Abuse: Research and Treatment
https://www.readbyqxmd.com/read/29616150/methadone-treatment-of-opiate-addiction-a-systematic-review-of-comparative-studies
#13
REVIEW
Shahid Ali, Barira Tahir, Shagufta Jabeen, Madeeha Malik
Opiate misuse is a chronic relapsing disease that has become an epidemic in the United States. Methadone is the mainstay of treatment for opiate addiction and has been researched widely. Recently, new avenues of treatment have been researched and developed. The objective of this review is to study methadone in comparison to other pharmacological options available or being considered for opiate addiction treatment through a methodical search and review of evidence provided by recent clinical trials conducted in this regard...
July 2017: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/29614184/neonatal-abstinence-syndrome-advances-in-diagnosis-and-treatment
#14
REVIEW
Elisha M Wachman, Davida M Schiff, Michael Silverstein
Importance: Neonatal abstinence syndrome, which occurs as a result of in utero opioid exposure, affects between 6.0 and 20 newborns per 1000 live US births. There is substantial variability in how neonatal abstinence syndrome is diagnosed and managed. Objective: To summarize key studies examining the diagnosis and management (both pharmacologic and nonpharmacologic) of neonatal abstinence syndrome published during the past 10 years. Evidence Review: PubMed, Web of Science, and CINAHL were searched for articles published between July 1, 2007, and December 31, 2017...
April 3, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29608897/uses-of-fluoxetine-in-nociceptive-pain-management-a-literature-overview
#15
REVIEW
Ahmed Barakat, Mostafa M Hamdy, Mohamed M Elbadr
Fluoxetine is one of the top ten prescribed antidepressants. Other therapeutic applications were approved for fluoxetine including, anxiety disorders, bulimia nervosa, and premature ejaculation. However, the role of fluoxetine in nociceptive pain management is still unclear. In this review, we discuss an overview of five possible roles of fluoxetine in pain management: intrinsic antinociceptive effect, enhancement of acute opioid analgesia, attenuation of tolerance development to opioid analgesia, attenuation of dependence development and abstinence syndrome, and attenuation of opioid induced hyperalgesia...
March 30, 2018: European Journal of Pharmacology
https://www.readbyqxmd.com/read/29596152/upregulation-of-p2x2-and-p2x3-receptors-in-rats-with-hyperalgesia-induced-by-heroin-withdrawal
#16
Changlong Leng, Lin Chen, Xiaokang Gong, Baomiao Ma, Weimin Gan, Yuanren Si, Huaqiao Xiao, Chaoying Li
Drug dependence and withdrawal syndrome induced by abrupt cessation of opioid administration remain a severe obstacle in the clinical treatment of chronic pain and opioid drug addiction. One of the key symptoms during opioid withdrawal is hyperalgesia. The mechanism of opioid withdrawal-induced hyperalgesia remains unclear. P2X2 and P2X3 receptors, members of P2X receptor subunits, act as the integrator of multiple forms of noxious stimuli and play an important role in nociception transduction of chronic neuropathic and inflammatory pain...
March 28, 2018: Neuroreport
https://www.readbyqxmd.com/read/29595550/changing-neonatal-nurses-perceptions-of-caring-for-infants-experiencing-neonatal-abstinence-syndrome-and-their-mothers-an-evidenced-based-practice-opportunity
#17
Kobi Brooke Tobin
BACKGROUND: Neonatal intensive care units (NICUs) are caring for an increasing number of infants born with neonatal abstinence syndrome (NAS). The literature identifies the need for education for NICU nurses on NAS including skills for interacting with the mother with substance use disorder. PURPOSE: An evidence-based practice project was developed to offer an educational presentation targeting these topics to 206 NICU participants (93% registered nurses, 1% licensed vocational nurses, and 6% nursing assistants) at a level IV NICU...
April 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29581161/smoking-abstinence-1-year-after-acute-coronary-syndrome-follow-up-from-a-randomized-controlled-trial-of-varenicline-in-patients-admitted-to-hospital
#18
Sarah B Windle, Payam Dehghani, Nathalie Roy, Wayne Old, François R Grondin, Iqbal Bata, Ayman Iskander, Claude Lauzon, Nalin Srivastava, Adam Clarke, Daniel Cassavar, Danielle Dion, Herbert Haught, Shamir R Mehta, Jean-François Baril, Charles Lambert, Mina Madan, Beth L Abramson, Mark J Eisenberg
BACKGROUND: Patients who continue to smoke after acute coronary syndrome are at increased risk of reinfarction and death. We previously found use of varenicline to increase abstinence 24 weeks after acute coronary syndrome; here we report results through 52 weeks. METHODS: The EVITA trial was a multicentre, double-blind, randomized, placebo-controlled trial of varenicline for smoking cessation in patients admitted to hospital with acute coronary syndrome. Participants were randomly assigned (1:1) to receive varenicline or placebo for 12 weeks, in conjunction with low-intensity counselling...
March 26, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/29580450/opioid-utilization-by-pregnant-women-with-sickle-cell-disease-and-the-risk-of-neonatal-abstinence-syndrome
#19
Aisha Nnoli, Neil S Seligman, Kevin Dysart, Jason K Baxter, Samir K Ballas
BACKGROUND: Pregnant women with sickle cell disease (SCD) are at increased risk of maternal and fetal complications. There are limited data on the outcome of the treatment of VOCs with opioids in relation to neonatal complications during pregnancy. METHODS: This is a retrospective cohort study of women with SCD from January 1999 to December 2008. Women with SCD were identified by ICD-9 codes and matched 2:1 to a control group of women on methadone for opioid dependence...
April 2018: Journal of the National Medical Association
https://www.readbyqxmd.com/read/29575474/epigenetic-variation-in-oprm1-gene-in-opioid-exposed-mother-infant-dyads
#20
Elisha M Wachman, Marie J Hayes, Hira Shrestha, Fnu Nikita, Angela Nolin, Leonie Hoyo, Katrina Daigle, Hendrée E Jones, David A Nielsen
Neonatal abstinence syndrome (NAS) due to in-utero opioid exposure has significant variability of severity. Preliminary studies have suggested that epigenetic variation within the μ-opioid receptor (OPRM1) gene impacts NAS. We aimed to determine if DNA methylation in OPRM1 within opioid-exposed mother-infant dyads is associated with differences in NAS severity in an independent cohort. Full-term opioid-exposed newborns and their mothers (N=68 pairs) were studied. A DNA sample was obtained and then assessed for level of DNA methylation at 20 CpG sites within the OPRM1 promoter region by next-generation sequencing...
March 25, 2018: Genes, Brain, and Behavior
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