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Abstinence syndrome

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https://www.readbyqxmd.com/read/27907936/early-treatment-for-neonatal-abstinence-syndrome-a-palliative-approach
#1
Jennifer Hudson, Rachel Mayo, Lori Dickes, Liwei Chen, Windsor Westbrook Sherrill, Julie Summey, Bradley Dalton, Kindal Dankovich
Objective To describe medical, safety, and health care utilization outcomes associated with an early treatment model for neonatal opioid withdrawal. Study Design This is a retrospective review of 117 opioid-exposed infants born in a large regional hospital and treated in the level I nursery with methadone initiated within 48 hours of birth. Results For this cohort, mean length of stay was 8.3 days. Hospital safety events were infrequent; there were no medication errors or deaths. Within 30 days of discharge, 14% of infants visited the emergency department; 7% were readmitted...
December 1, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27889436/wide-variation-found-in-care-of-opioid-exposed-newborns
#2
Debra L Bogen, Bonny L Whalen, Laura R Kair, Mark Vining, Beth A King
OBJECTIVE: Standardized practices for the management of neonatal abstinence syndrome (NAS) are associated with shorter lengths of stay, but optimal protocols are not established. We sought to identify practice variations for newborns with in utero chronic opioid exposure among hospitals in the Better Outcomes Through Research for Newborns (BORN) network. METHODS: Nursery site leaders completed a survey about hospitals' policies and practices regarding care for infants with chronic opioid exposure (≥3 weeks)...
November 23, 2016: Academic Pediatrics
https://www.readbyqxmd.com/read/27886650/the-relationship-between-gestational-age-and-the-severity-of-neonatal-abstinence-syndrome
#3
Kelly S Gibson, Ms Sydney Stark, Deepak Kumar, Jennifer L Bailit
BACKGROUND AND AIMS: The relationship between gestational age at delivery and the severity of neonatal abstinence syndrome (NAS) is poorly understood. Our objective was to compare the length of pharmacotherapy and hospital stay among opioid exposed infants born during the late preterm, early term, full term, and late term periods. DESIGN: Retrospective cohort study of infants affected by NAS SETTING: MetroHealth Medical Center in Cleveland, Ohio, USA: an urban tertiary care hospital serving as the referral center for opioid dependency in pregnancy with a level III neonatal intensive care unit PARTICIPANTS: All deliveries complicated by maternal opioid exposure from January 2000 to October 2014; 403 were eligible to be included (n = 102 Late Preterm, 34-36weeks (LP), n = 158 Early Term, 37-38weeks (ET), n = 122 Full Term, 39-40weeks (FT), n = 21 Late Term, ≥41 weeks (LT))...
November 25, 2016: Addiction
https://www.readbyqxmd.com/read/27885245/personal-lifestyle-as-a-resource-for-work-engagement
#4
Daisuke Nishi, Yuriko Suzuki, Junko Nishida, Kazuo Mishima, Yoshio Yamanouchi
OBJECTIVES: Personal lifestyle, including diet, exercise, and sleep, might have an impact on work engagement, though previous studies have not focused on these relationships. The aim of this study was to examine whether dietary intake of fish, regular exercise, sufficient sleep, abstinence from alcohol, and abstinence from tobacco were positively associated with work engagement. METHODS: We recruited adults aged 40-74 years who attended the health checkups with a particular focus on the metabolic syndrome in central Tokyo...
November 22, 2016: Journal of Occupational Health
https://www.readbyqxmd.com/read/27876117/neonatal-abstinence-syndrome-and-the-gastrointestinal-tract
#5
Denise Maguire, Maureen Gröer
Development of a healthy gut microbiome is essential in newborns to establish immunity and protection from pathogens. Recent studies suggest that infants who develop dysbiosis may be at risk for lifelong adverse health consequences. Exposure to opioid drugs during pregnancy is a factor of potential importance for microbiome health that has not yet been investigated. Since these infants are born after an entire gestation exposed to mu opioid receptor agonists and have severe gastrointestinal and neurological symptoms, we hypothesize that these infants are at risk for dysbiosis...
December 2016: Medical Hypotheses
https://www.readbyqxmd.com/read/27849239/importance-of-the-use-of-protocols-for-the-management-of-analgesia-and-sedation-in-pediatric-intensive-care-unit
#6
Emiliana Motta, Michele Luglio, Artur Figueiredo Delgado, Werther Brunow de Carvalho
Introduction: Analgesia and sedation are essential elements in patient care in the intensive care unit (ICU), in order to promote the control of pain, anxiety and agitation, prevent the loss of devices, accidental extubation, and improve the synchrony of the patient with mechanical ventilation. However, excess of these medications leads to rise in morbidity and mortality. The ideal management will depend on the adoption of clinical and pharmacological measures, guided by scales and protocols...
September 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27824233/cigarette-smoking-and-adhd-an-examination-of-prognostically-relevant-smoking-behaviors-among-adolescents-and-young-adults
#7
Jessica D Rhodes, William E Pelham, Elizabeth M Gnagy, Saul Shiffman, Karen J Derefinko, Brooke S G Molina
Attention-deficit/hyperactivity disorder (ADHD) is associated with health risks in adolescence which includes the potential for smoking cigarettes, early smoking initiation, and rapid progression to daily smoking. Much less is known, however, about prognostically relevant smoking behaviors among individuals with childhood ADHD. Further research in this area is important for identifying individuals at pronounced risk for nicotine addiction, and for developing effective interventions for this population. This study examined initiation of cigarette smoking, progression to regular smoking, quantity of use, indicators of tobacco dependence, and quit rates among adolescents and young adults with (n = 364) and without (n = 240) childhood ADHD...
August 2016: Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors
https://www.readbyqxmd.com/read/27821184/a-core-outcome-set-for-neonatal-abstinence-syndrome-study-protocol-for-a-systematic-review-parent-interviews-and-a-delphi-survey
#8
Lauren E Kelly, Lauren M Jansson, Wendy Moulsdale, Jodi Pereira, Sarah Simpson, Astrid Guttman, Karel Allegaert, Lisa Askie, Henry Roukema, Thierry Lacaze, Jonathan M Davis, Loretta Finnegan, Paula Williamson, Martin Offringa
BACKGROUND: The prevalence of neonatal abstinence syndrome (NAS) is increasing globally resulting in an increased incidence of adverse neonatal outcomes and health system costs. Evidence regarding the effectiveness of NAS prevention and management strategies is very weak and further research initiatives are critically needed to support meta-analysis and clinical practice guidelines. In NAS research, the choice of outcomes and the use of valid, responsive and feasible measurement instruments are crucial...
November 8, 2016: Trials
https://www.readbyqxmd.com/read/27819720/male-idiopathic-infertility-and-the-tp53-polymorphism-in-codon-72
#9
M P de Morais, R F Curado, K S F E Silva, K K V O Moura, J T Arruda
Many environmental agents affect the development of male germ cells at different stages. Apoptosis is common during normal spermatogenesis; it plays an important role in controlling the number of germ cells and the disposal of defective stem cells to produce functional sperm. The presence of p53 in primary spermatocytes suggests that it plays a role in the prophase of meiosis. p53 is expressed in the testis in both spermatocytes and spermatogonia. This suggests that the p53 gene (TP53) is important for apoptosis regulation during spermatogenesis, and may be associated with male infertility...
November 3, 2016: Genetics and Molecular Research: GMR
https://www.readbyqxmd.com/read/27799240/observational-study-of-the-safety-of-buprenorphine-naloxone-in-pregnancy-in-a-rural-and-remote-population
#10
Naana Afua Jumah, Craig Edwards, Jazmyn Balfour-Boehm, Kassandra Loewen, Joseph Dooley, Lianne Gerber Finn, Len Kelly
OBJECTIVES: To describe the effect of in utero exposure to the buprenorphine+naloxone combination product in a rural and remote population. SETTING: A district hospital that services rural and remote, fly-in communities in Northwestern Ontario, Canada. PARTICIPANTS: A retrospective cohort study was conducted of 855 mother infant dyads between 1 July 2013 and 30 June 2015. Cases included all women who had exposure to buprenorphine+naloxone during pregnancy (n=62)...
October 31, 2016: BMJ Open
https://www.readbyqxmd.com/read/27776623/evidence-based-treatment-options-in-cannabis-dependency
#11
Lisa Walther, Andreas Gantner, Andreas Heinz, Tomislav Majić
BACKGROUND: Now that the consumption of natural and synthetic cannabinoids is becoming more widespread, the specific treatment of cannabis-related disturbances is an increasingly important matter. There are many therapeutic options, and it is not always clear which ones are evidence-based and appropriate for use in a given clinical situation. METHODS: This review is based on reports of pertinent randomized and controlled trials (RCTs) that were retrieved by a selective search in the PubMed and Cochrane databases...
September 30, 2016: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/27757817/novel-treatments-for-cyclic-vomiting-syndrome-beyond-ondansetron-and-amitriptyline
#12
Sanjay Bhandari, Thangam Venkatesan
Cyclic vomiting syndrome (CVS) is a chronic functional gastrointestinal disorder that is characterized by episodic nausea and vomiting. Initially thought to only affect children, CVS in adults was often misdiagnosed with significant delays in therapy. Over the last decade, there has been a considerable increase in recognition of CVS in adults but there continues to be a lack of knowledge about management of this disorder. This paper seeks to provide best practices in the treatment of CVS and also highlight some novel therapies that have the potential in better treating this disorder in the future...
October 18, 2016: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/27729254/opioid-dependence-and-pregnancy-minimizing-stress-on-the-fetal-brain
#13
John J Mccarthy, Martin H Leamon, Loretta P Finnegan, Catherine Fassbender
Increase in the number of opioid dependent pregnant women delivering babies at risk for neonatal abstinence syndrome (NAS) prompted a General Accountability Office (GAO) report documenting deficits in research and provider knowledge about care of the maternal/fetal unit and the neonate. There are three general sources of dependence: untreated opioid use disorder (OUD), pain management, and medication assisted treatment with methadone or buprenorphine. A survey of methadone patients' experiences when telling a physician of their pregnancy and opioid dependence demonstrated physician confusion about proper care, frequent negative interactions with the mother, and failures to provide appropriate referral...
October 8, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27723910/neonatal-abstinence-syndrome-twelve-years-of-experience-at-a-regional-referral-center
#14
S Mücke, M Nagel, J P Siedentopf, C Bührer, D Hüseman
Background: Infants exposed to opiates antenatally display withdrawal symptoms after birth referred to as neonatal abstinence syndrome (NAS). Patients: A total of 366 newborns (166 females, 10 twins) from 361 mothers were diagnosed with NAS from 2000 to 2011 at a single large metropolitan referral center. Methods: Retrospective chart review of all newborn infants exposed to opiates in utero. Results: 20% were premature (gestational age<37 weeks), 32% were small-for-gestational-age (<10(th) percentile)...
October 10, 2016: Klinische Pädiatrie
https://www.readbyqxmd.com/read/27695339/a-comparison-of-morphine-delivery-in-neonatal-opioid-withdrawal
#15
Brian Chisamore, Safaa Labana, Sandra Blitz, Alice Ordean
Current estimates of the prevalence of opioid withdrawal in newborns from the 2012 Better Outcomes Registry and Network Ontario reveal that more than 4 births per 1000 display recognizable symptoms of neonatal abstinence syndrome (NAS). With a growing consensus surrounding aspects of newborn opioid withdrawal care, clinicians might agree that all infants exposed to maternal opioids require supportive observation and care to ensure appropriate adaptation and growth in the newborn period and, likewise, that there exists a smaller percentage of newborns who require additional pharmacotherapy...
2016: Substance Abuse: Research and Treatment
https://www.readbyqxmd.com/read/27679504/a-swedish-population-based-study-of-adverse-birth-outcomes-among-pregnant-women-treated-with-buprenorphine-or-methadone-preliminary-findings
#16
Keele E Wurst, Barbara K Zedler, Andrew R Joyce, Maciek Sasinowski, E Lenn Murrelle
BACKGROUND: Untreated opioid dependence in pregnant women is associated with adverse birth outcomes. Buprenorphine and methadone are options for opioid agonist medication-assisted treatment during pregnancy. OBJECTIVE: The aim of this study was to describe adverse birth outcomes observed with buprenorphine or methadone treatment compared to the general population in Sweden. METHODS: Pregnant women and their corresponding births during 2005-2011 were identified in the Swedish Medical Birth Register...
2016: Substance Abuse: Research and Treatment
https://www.readbyqxmd.com/read/27669331/rates-of-neonatal-abstinence-syndrome-amid-efforts-to-combat-the-opioid-abuse-epidemic
#17
Joshua D Brown, Pratik A Doshi, Nathan J Pauly, Jeffery C Talbert
No abstract text is available yet for this article.
September 26, 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/27650761/uptake-and-efficacy-of-a-systematic-intensive-smoking-cessation-intervention-using-motivational-interviewing-for-smokers-hospitalised-for-an-acute-coronary-syndrome-a-multicentre-before-after-study-with-parallel-group-comparisons
#18
Reto Auer, Baris Gencer, Rodrigo Tango, David Nanchen, Christian M Matter, Thomas Felix Lüscher, Stephan Windecker, François Mach, Jacques Cornuz, Jean-Paul Humair, Nicolas Rodondi
OBJECTIVES: To compare the efficacy of a proactive approach with a reactive approach to offer intensive smoking cessation intervention using motivational interviewing (MI). DESIGN: Before-after comparison in 2 academic hospitals with parallel comparisons in 2 control hospitals. SETTING: Academic hospitals in Switzerland. PARTICIPANTS: Smokers hospitalised for an acute coronary syndrome (ACS). INTERVENTION: In the intervention hospitals during the intervention phase, a resident physician trained in MI systematically offered counselling to all smokers admitted for ACS, followed by 4 telephone counselling sessions over 2 months by a nurse trained in MI...
September 20, 2016: BMJ Open
https://www.readbyqxmd.com/read/27647475/a-qualitative-study-of-family-experience-with-hospitalization-for-neonatal-abstinence-syndrome
#19
Emily C Atwood, Grace Sollender, Erica Hsu, Christine Arsnow, Victoria Flanagan, Joanna Celenza, Bonny Whalen, Alison V Holmes
BACKGROUND AND OBJECTIVES: Although the incidence of neonatal abstinence syndrome (NAS) in the United States quintupled between 2000 and 2012, little is known about the family perspective of the hospital stay. We interviewed families to understand their experiences during the newborn hospitalization for NAS and to improve family-centered care. METHODS: A multidisciplinary team from 3 hospital units composed open-ended interview questions based on a literature review, clinical experience, and an internal iterative process...
October 2016: Hospital Pediatrics
https://www.readbyqxmd.com/read/27636698/adding-to-our-practice-toolkit-using-the-acts-script-to-address-stigmatizing-peer-behaviors-in-the-context-of-maternal-substance-use
#20
Lenora Marcellus, Elizabeth Poag
Infants with neonatal abstinence syndrome (NAS) are a growing population in the NICU setting, and nurses report that caring for families can be challenging. Women who are pregnant and newly parenting who use drugs and alcohol typically face significant negative attitudes, judgment, and stigma within their communities and from providers when they access health care. When nurses witness biased behavior or communication from their peers, they may feel distressed and unprepared to address the situation. Using script guides or structured communication frameworks (e...
2016: Neonatal Network: NN
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