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Abstinence syndrome

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https://www.readbyqxmd.com/read/28519244/neonatal-abstinence-syndrome-update-on-diagnostic-and-therapeutic-strategies
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/28490916/the-cannabis-withdrawal-syndrome-current-insights
#8
REVIEW
Udo Bonnet, Ulrich W Preuss
The cannabis withdrawal syndrome (CWS) is a criterion of cannabis use disorders (CUDs) (Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition) and cannabis dependence (International Classification of Diseases [ICD]-10). Several lines of evidence from animal and human studies indicate that cessation from long-term and regular cannabis use precipitates a specific withdrawal syndrome with mainly mood and behavioral symptoms of light to moderate intensity, which can usually be treated in an outpatient setting...
2017: Substance Abuse and Rehabilitation
https://www.readbyqxmd.com/read/28488805/breastfeeding-considerations-for-mothers-of-infants-with-neonatal-abstinence-syndrome
#9
Amy P Holmes, Holly N Schmidlin, Eliana N Kurzum
Breastfeeding offers many benefits to both mother and baby. Breastfeeding is generally recommended for mothers of infants with neonatal abstinence syndrome (NAS) unless some associated risk outweighs the benefits. Evidence indicates that infants with NAS who receive human milk require less pharmacologic treatment and have shorter hospital lengths of stay. Perhaps the greatest barrier to breastfeeding for women with opioid dependence is the inaccurate and inconsistent information they receive from different sources, including health care professionals...
May 10, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28486709/anhedonia-its-dynamic-relations-with-craving-negative-affect-and-treatment-during-a-quit-smoking-attempt
#10
Jessica W Cook, Stephanie T Lanza, Wanghuan Chu, Timothy B Baker, Megan E Piper
Introduction: Research shows that abstinence from tobacco leads to a withdrawal-related decrement in responsivity to nondrug rewards (ie, anhedonia). However, it remains unclear how anhedonia relates to other key withdrawal symptoms and withdrawal-related constructs over time. We analyzed ecological momentary assessment data to examine whether a decrement in response to rewards during a 10-day period following quitting shows a pattern of associations with other variables (ie, treatment, tobacco dependence, negative affect, and craving) that is consistent with anhedonia being a tobacco withdrawal symptom...
June 1, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/28468518/buprenorphine-for-the-treatment-of-the-neonatal-abstinence-syndrome
#11
Walter K Kraft, Susan C Adeniyi-Jones, Inna Chervoneva, Jay S Greenspan, Diane Abatemarco, Karol Kaltenbach, Michelle E Ehrlich
Background Current pharmacologic treatment of the neonatal abstinence syndrome with morphine is associated with a lengthy duration of therapy and hospitalization. Buprenorphine may be more effective than morphine for this indication. Methods In this single-site, double-blind, double-dummy clinical trial, we randomly assigned 63 term infants (≥37 weeks of gestation) who had been exposed to opioids in utero and who had signs of the neonatal abstinence syndrome to receive either sublingual buprenorphine or oral morphine...
May 4, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28465360/male-sex-associated-with-increased-risk-of-neonatal-abstinence-syndrome
#12
M Katherine Charles, William O Cooper, Lauren M Jansson, Judith Dudley, James C Slaughter, Stephen W Patrick
BACKGROUND: Neonatal abstinence syndrome (NAS) is a postnatal opioid withdrawal syndrome. Factors associated with development of the syndrome are poorly understood; however, infant sex may influence the risk of NAS. Our objective was to determine if infant sex was associated with the development or severity of the syndrome in a large population-based cohort. METHODS: This retrospective cohort study used vital statistics and prescription, outpatient, and inpatient administrative data for mothers and infants enrolled in the Tennessee Medicaid program between 2009 and 2011...
May 2, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28459984/treatment-of-opioid-use-disorder-during-pregnancy-may-increase-cases-of-neonatal-abstinence-syndrome-reply
#13
Joshua D Brown, Jeffery C Talbert
No abstract text is available yet for this article.
May 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28459976/treatment-of-opioid-use-disorder-during-pregnancy-and-cases-of-neonatal-abstinence-syndrome
#14
Davida M Schiff, Stephen W Patrick
No abstract text is available yet for this article.
May 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28445899/evidence-based-guidelines-for-the-pharmacologic-management-of-methamphetamine-dependence-relapse-prevention-chronic-methamphetamine-related-and-comorbid-psychiatric-disorders-in-post-acute-settings
#15
Roland Härtel-Petri, Anne Krampe-Scheidler, Wolf-Dietrich Braunwarth, Ursula Havemann-Reinecke, Peter Jeschke, Winfried Looser, Stephan Mühlig, Ingo Schäfer, Norbert Scherbaum, Lydia Bothe, Corinna Schaefer, Willem Hamdorf
The increasing abuse of the street drug crystal meth (methamphetamine) in many countries worldwide has resulted in a growing demand to treat patients who have acquired a methamphetamine-related disorder. The results of a systematic literature search which led to the consensus-based recommendations by the Working Group of the German Agency for Quality in Medicine (Ärztliches Zentrum für Qualität in der Medizin - ÄZQ) are presented. Pharmacological treatments were reviewed in 58 out of the 103 publications included...
May 2017: Pharmacopsychiatry
https://www.readbyqxmd.com/read/28430046/an-outpatient-methadone-weaning-program-by-a-neonatal-intensive-care-unit-for-neonatal-abstinence-syndrome
#16
Andrew Lai, Patrick Philpot, Jenny Boucher, Andrew Meyer
Through retrospective chart review, this study described characteristics and length of stay for a cohort of newborns discharged on methadone following an inpatient weaning for neonatal abstinence syndrome (NAS). Data were assessed for all term infants born between January 1, 2010, and December 31, 2014, admitted to the hospital with a co-diagnosis of NAS at discharge, for gestational age, length of stay, days on treatment protocol before discharge, time to once-daily interval methadone dosing, and hospital charges, as well as for categorical characteristics...
April 21, 2017: Population Health Management
https://www.readbyqxmd.com/read/28426726/vibrotactile-stimulation-a-non-pharmacological-intervention-for-opioid-exposed-newborns
#17
Ian Zuzarte, Premananda Indic, Bruce Barton, David Paydarfar, Francis Bednarek, Elisabeth Bloch-Salisbury
OBJECTIVE: To examine the therapeutic potential of stochastic vibrotactile stimulation (SVS) as a complementary non-pharmacological intervention for withdrawal in opioid-exposed newborns. STUDY DESIGN: A prospective, within-subjects single-center study was conducted in 26 opioid-exposed newborns (>37 weeks; 16 male) hospitalized since birth and treated pharmacologically for Neonatal Abstinence Syndrome. A specially-constructed mattress delivered low-level SVS (30-60Hz, 10-12μm RMS), alternated in 30-min intervals between continuous vibration (ON) and no vibration (OFF) over a 6-8 hr session...
2017: PloS One
https://www.readbyqxmd.com/read/28426544/neonatal-abstinence-syndrome-where-are-we-and-where-do-we-go-from-here
#18
Laura Brandt, Loretta P Finnegan
PURPOSE OF REVIEW: Over the last 15 years the prevalence of neonatal abstinence syndrome (NAS) increased almost five-fold. A considerable diversity seems to prevail in the management of NAS. This review provides an overview of factors affecting the expression and course of NAS, and recent developments in NAS assessment and treatment. RECENT FINDINGS: Apart from different pharmacological and nonpharmacological treatment modalities, maturity of the infant and genetic variations likely are (co)responsible for interpatient variability in NAS severity, despite similar maternal exposure...
April 19, 2017: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/28426507/peripartum-anesthetic-management-of-the-opioid-tolerant-or-buprenorphine-suboxone-dependent-patient
#19
Aileen Pan, Mark Zakowski
Opioid abuse and dependence continues to rise in both the general population and pregnancy, with opioid overdose deaths having quadrupled in the last 15 years. Illicit drug use in last 30 days of pregnancy was over 4% with almost 0.6% documented maternal opiate use at time of birth. The management of the opioid-tolerant, buprenorphine-dependent or methadone-dependent patient in the peripartum period is reviewed. Options for treatment of opioid dependence, acute pain management, and perioperative multimodal analgesia are discussed...
June 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28422588/alterations-in-redox-homeostasis-during-recovery-from-unexplained-underperformance-syndrome-in-an-elite-international-rower
#20
Nathan A Lewis, Ann Redgrave, Mark Homer, Richard Burden, Wendy Martinson, Brian Moore, Charles R Pedlar
PURPOSE: This case study of an international rower examines a diagnosis of Unexplained Under Performance Syndrome (UUPS or Overtraining Syndrome) describing a full recovery and return to elite competition the same year. METHODS: On diagnosis and 4 and 14 months post-diagnosis, detailed assessments including physiological, nutritional, and biomarkers were made. RESULTS: Clinical examination and laboratory results for haematology, biochemistry, thyroid function, immunology, vitamins and minerals were unremarkable and did not explain the presentation and diagnosis...
April 19, 2017: International Journal of Sports Physiology and Performance
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