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Abstinence syndrome

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https://www.readbyqxmd.com/read/28929914/the-conundrum-of-opioid-tapering-in-long-term-opioid-therapy-for-chronic-pain-a-commentary
#1
Ajay Manhapra, Albert A Arias, Jane C Ballantyne
BACKGROUND: In response to the opioid epidemic and new guidelines, many patients on high-dose long term opioid therapy (LTOT) for chronic pain are getting tapered off opioids. As a result, a unique clinical challenge is emerging: while many on LTOT have poor pain control, functional decline, psychiatric instability, aberrancies and misuse, these issues may often worsen with opioid tapering. Currently, a clear explanation and practical guidance on how to manage this perplexing clinical scenario is lacking...
September 20, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28927533/from-sperm-to-offspring-assessing-the-heritable-genetic-consequences-of-paternal-smoking-and-potential-public-health-impacts
#2
REVIEW
Marc A Beal, Carole L Yauk, Francesco Marchetti
Individuals who smoke generally do so with the knowledge of potential consequences to their own health. What is rarely considered are the effects of smoking on their future children. The objective of this work was to review the scientific literature on the effects of paternal smoking on sperm and assess the consequences to offspring. A literature search identified over 200 studies with relevant data in humans and animal models. The available data were reviewed to assess the weight of evidence that tobacco smoke is a human germ cell mutagen and estimate effect sizes...
July 2017: Mutation Research
https://www.readbyqxmd.com/read/28918267/compulsivity-in-opioid-dependence
#3
Serenella Tolomeo, Keith Matthews, J Douglas Steele, Alex Baldacchino
OBJECTIVE: This study aimed to investigate the relationship between compulsivity versus impulsivity and structural MRI abnormalities in opioid dependence. METHOD: We recruited 146 participants: i) patients with a history of opioid dependence due to chronic heroin use (n=24), ii) heroin users stabilised on methadone maintenance treatment (n=48), iii) abstinent participants with a history of opioid dependence due to heroin use (n=24) and iv) healthy controls (n=50)...
September 13, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28917206/maternal-and-infant-outcomes-following-third-trimester-exposure-to-marijuana-in-opioid-dependent-pregnant-women-maintained-on-buprenorphine
#4
Alane B O'Connor, Brandon K Kelly, Liam M O'Brien
BACKGROUND: To determine whether maternal and infant outcomes are associated with exposure to marijuana during the third trimester in a population of opioid dependent pregnant women maintained on buprenorphine. METHODS: This retrospective cohort study of 191 maternal-infant dyads exposed to buprenorphine during pregnancy examines a variety of variables including gestational age, birthweight, method of delivery, Apgar scores at one and five minutes, duration of infant hospital stay, peak neonatal abstinence syndrome (NAS) score, duration of NAS and incidence of pharmacologic treatment of NAS in infants exposed to marijuana during the third trimester as compared to infants not exposed to marijuana during the third trimester...
September 7, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28891099/opioid-and-benzodiazepine-weaning-in-pediatric-patients-review-of-current-literature
#5
Norman E Fenn, Kimberly S Plake
Pediatric opioid and benzodiazepine withdrawal are avoidable complications of pain and sedation management that is well described in the literature. To prevent withdrawal from occurring, practitioners regularly employ a steady decrease of pain and sedation medications, also known as a weaning or tapering schedule. The weaning schedule is highly variable based on clinician preference and is usually dependent on the clinician. The purpose of this review is to evaluate the current literature on the process of opioid and benzodiazepine weaning in pediatric patients and to assess the various standardized protocols used to decrease withdrawal occurrences...
September 11, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28886591/predictors-of-early-dropout-in-treatment-for-gambling-disorder-the-role-of-personality-disorders-and-clinical-syndromes
#6
G Maniaci, C La Cascia, F Picone, A Lipari, C Cannizzaro, D La Barbera
Several treatment options for gambling disorder (GD) have been tested in recent years; however dropout levels still remain high. This study aims to evaluate whether the presence of psychiatric comorbidities predicts treatment outcome according to Millon's evolutionary theory, following a six-month therapy for GD. The role of severity, duration of the disorder, typology of gambling (mainly online or offline) and pharmacological treatment were also analysed. The recruitment included 194 pathological gamblers (PGs) to be compared with 78 healthy controls (HCs)...
August 5, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28879171/the-genomics-of-neonatal-abstinence-syndrome
#7
REVIEW
F Sessions Cole, Daniel J Wegner, Jonathan M Davis
Significant variability has been observed in the development and severity of neonatal abstinence syndrome (NAS) among neonates exposed to prenatal opioids. Since maternal opioid dose does not appear to correlate directly with neonatal outcome, maternal, placental, and fetal genomic variants may play important roles in NAS. Previous studies in small cohorts have demonstrated associations of variants in maternal and infant genes that encode the μ-opioid receptor (OPRM1), catechol-O-methyltransferase (COMT), and prepronociceptin (PNOC) with a shorter length of hospital stay and less need for treatment in neonates exposed to opioids in utero...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28877016/buprenorphine-for-the-neonatal-abstinence-syndrome
#8
LETTER
Walter K Kraft, Susan C Adeniyi-Jones, Michelle E Ehrlich
New England Journal of Medicine, Volume 377, Issue 10, Page 996-998, September 2017.
September 7, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28877015/buprenorphine-for-the-neonatal-abstinence-syndrome
#9
LETTER
Stephen Christiansen
No abstract text is available yet for this article.
September 7, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28869859/maternal-buprenorphine-treatment-and-infant-outcome
#10
Lauren M Jansson, Martha L Velez, Krystle McConnell, Nancy Spencer, Michelle Tuten, Hendree Jones, Rebeca Rios, Van L King, Neeraj Gandotra, Lorraine Millio, Janet A DiPietro
BACKGROUND AND OBJECTIVES: Maternal buprenorphine maintenance predisposes the infant to exhibit neonatal abstinence syndrome (NAS), but there is insufficient published information regarding the nature of NAS and factors that contribute to its severity in buprenorphine-exposed infants. METHODS: The present study evaluated forty-one infants of buprenorphine-maintained women in comprehensive substance use disorder treatment who participated in an open-label study examining the effects of maternal buprenorphine maintenance on infant outcomes...
August 31, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28839105/alcohol-abuse-is-associated-with-enhanced-pulmonary-and-systemic-xanthine-oxidoreductase-activity
#11
Mehdi A Fini, Jeanette Gaydos, Alicia McNally, Vijaya Karoor, Ellen L Burnham
The acute respiratory distress syndrome (ARDS) is a common and devastating disorder. Alcohol use disorders (AUDs) increase ARDS risk, and worsen outcomes, through mechanisms that may include enhancing pulmonary oxidative stress. Alcohol consumption increases activity of the enzyme xanthine oxidoreductase (XOR) that contributes to production of both reactive oxygen species (ROS) and uric acid, a damage-associated molecular pattern. These by-products have the potential to modulate pro-inflammatory pathways such as those involving cyclooxygenase (COX)-2, and to activate the nucleotide-binding domain, leucine-rich-containing family, pyrin-domain containing-3 (NLRP3) inflammasome...
August 24, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/28829626/transitioning-from-methadone-to-buprenorphine-maintenance-in-management-of-opioid-use-disorder-during-pregnancy
#12
Shakevia Johnson, Peter R Martin
BACKGROUND: Opioid use disorder during pregnancy is a growing health concern. Methadone maintenance is the treatment of choice but emerging data indicate buprenorphine is a viable alternative. Due to costs and limited accessibility of methadone, pregnant women may require transition from methadone to buprenorphine for maintenance treatment. OBJECTIVES: To assess safety and effectiveness of transitioning from methadone to buprenorphine when necessary during pregnancy...
August 22, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28814260/neonatal-abstinence-syndrome-management-a-review-of-recent-evidence
#13
Matthew Grossman, Carl Seashore, Alison Volpe Holmes
BACKGROUND: The evaluation and management of infants with neonatal abstinence syndrome (NAS), the constellation of opioid withdrawal specific to newborns, has received renewed attention over the past decade during a new epidemic of opioid use, misuse, abuse, and dependence. Infants with NAS often endure long and costly hospital stays. OBJECTIVE: We aim to review recent literature on the management and outcomes of infants with, and at risk for, opioid withdrawal...
August 16, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28811779/effect-of-exercise-and-morphine-on-psychological-and-physical-dependencies-bdnf-and-trkb-gene-expression-in-rat-s-hippocampus
#14
Mojtaba Naghshvarian, Mohammad-Reza Zarrindast, Shahram Ejtemaei Mehr, Mohammad Mehdi Ommati, Seyedeh Fatemeh Sajjadi
OBJECTIVES: To compare the effect of exercise and morphine on abstinence syndrome and hippocampal gene expression in rat model. METHODS: Thirty adult male rats were exposed to voluntary wheel exercise (low, medium, high) for 28 days. The subjects entered Conditioned Place Preference (CPP) apparatus and experienced morphine (low, medium, high) CPP and followed by naloxone test. Correlation between exercise level, morphine injection, concurrent morphine administration and exercise with morphine CPP, BDNF and TrkB genes was determined...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28804749/morphine-versus-methadone-treatment-for-neonatal-withdrawal-and-impact-on-early-infant-development
#15
Sharon Burke, Anna Malia Beckwith
Objective. Compare developmental outcomes in infants treated with morphine versus methadone. Method. Retrospective chart review of newborns identified through use of ICD-9 code for neonatal abstinence syndrome (NAS). Thirty-six infants were evaluated-17 treated with methadone and 19 treated with morphine. Assessment was completed following treatment using the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III). Scores in Cognitive, Language, and Motor domains were compared. Results. Comparison of scores between morphine- and methadone-treated groups revealed differences in mean Cognitive Composite (91...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28802566/alcohol-use-and-cardiovascular-disease-risk-in-patients-with-nonalcoholic-fatty-liver-disease
#16
Lisa B VanWagner, Hongyan Ning, Norrina B Allen, Veeral Ajmera, Cora E Lewis, John Jeffrey Carr, Donald M Lloyd-Jones, Norah A Terrault, Juned Siddique
BACKGROUND & AIMS: Cardiovascular disease (CVD) is the leading cause of death among patients with non-alcoholic fatty liver disease (NAFLD). Moderate drinking (vs abstinence) is associated with lower risk of CVD in the general population. We assessed whether alcohol use is associated with CVD risk in patients with NAFLD. METHODS: We analyzed data from participants in the Coronary Artery Risk Development in Young Adults longitudinal cohort study of 5115 black and white young adults, 18-30 years old, recruited from 4 cities in the United States from 1985 through 1986...
August 9, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28791703/the-medial-habenula-and-interpeduncular-nucleus-circuitry-is-critical-in-addiction-anxiety-and-mood-regulation
#17
REVIEW
Ian McLaughlin, John A Dani, Mariella De Biasi
Abstinence from chronic use of addictive drugs triggers an aversive withdrawal syndrome that compels relapse and deters abstinence. Many features of this syndrome are common across multiple drugs, involving both affective and physical symptoms. Some of the network signaling underlying withdrawal symptoms overlaps with activity that is associated with aversive mood states, including anxiety and depression. Given these shared features, it is not surprising that a particular circuit, the dorsal diencephalic conduction system, and the medial habenula (MHb) and interpeduncular nucleus (IPN), in particular, have been identified as critical to the emergence of aversive states that arise both as a result and, independently, of drug addiction...
August 2017: Journal of Neurochemistry
https://www.readbyqxmd.com/read/28769793/in-metastatic-non-small-cell-lung-cancer-platinum-based-treated-patients-herbal-treatment-improves-the-quality-of-life-a-prospective-randomized-controlled-clinical-trial
#18
Huiru Guo, Jia X Liu, Hegen Li, Jan P A Baak
Background: According to clinical experience, Traditional Chinese Medicine (TCM) herbs added to platinum-based therapy (PBT) improve the Quality of Life (QOL) in metastatic non-small cell lung cancer (NSCLC) patients, but this must be prospectively validated. Patients and Methods: Based on clinical impressions regarding the effect of adding TCM herbs to platinum-based chemotherapy, we anticipated that 2 × 21 patients would be sufficient to obtain significant results with an α < 0.05 and power (1 - β) of 90%...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28762223/-factors-associated-with-successful-smoking-cessation-in-male-patients-with-coronary-artery-disease-at-3-months-after-hospital-discharge
#19
Huey-Ling Wang, Peng-Chih Wang, Yen-Wen Wu, Kou-Gi Shyu
BACKGROUND: The promising effects of smoking cessation for coronary artery disease (CAD) patients include decreased risks of subsequent clinical events and mortality. However, most CAD patients continue to smoke after being hospitalized for a cardiac event. PURPOSE: To explore the factors that are associated with successful smoking cessation in CAD male patients at 3 months after hospital discharge. METHODS: A correlational design was applied...
August 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28754255/tailoring-a-nicu-based-tobacco-treatment-program-for-mothers-who-are-dependent-on-opioids
#20
Amanda Fallin-Bennett, Kristin Ashford
OBJECTIVE: To collect formative information to design a tailored tobacco treatment intervention for women with newborns treated or evaluated for neonatal abstinence syndrome and to explore current tobacco use behaviors and facilitators and barriers to smoking cessation. DESIGN: Qualitative descriptive study. SETTING: An academic medical center in the southern United States. PARTICIPANTS: Mothers of newborns who were treated or evaluated for neonatal abstinence syndrome at birth within the preceding 3 months...
July 26, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
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