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Physician addiction

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https://www.readbyqxmd.com/read/27891385/when-pulmonary-function-test-is-available-should-we-wait-for-the-copd-symptoms-to-develop
#1
REVIEW
Varshil Mehta, Nimit Desai, Smit Patel
Adolescent smokers are more likely to be addicted to nicotine and develop a chronic habit. Chronic smoking has a direct impact on quality of life and life expectancy. Repeated environmental exposure and smoke inhalation can be deleterious to health. In order to evaluate the core functioning of the lungs, Pulmonary Function Tests (PFTs) are conducted. This panel of tests should be advised for all patients complaining of shortness of breath. Since clinical features resulting from chronic smoking tend to appear late in the course of the disease, PFTs are immensely useful for early identification of abnormalities in asymptomatic adult smokers...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27876616/protocol-for-three-parallel-multi-site-stepped-care-effectiveness-studies-for-unhealthy-alcohol-use-in-hiv-positive-patients
#2
E Jennifer Edelman, Stephen A Maisto, Nathan B Hansen, Christopher J Cutter, James Dziura, Lynn E Fiellin, Patrick G O'Connor, Roger Bedimo, Cynthia Gibert, Vincent C Marconi, David Rimland, Maria C Rodriguez-Barradas, Michael S Simberkoff, Amy C Justice, Kendall J Bryant, David A Fiellin
Unhealthy alcohol use is common among HIV-positive patients, yet effective evidence-based treatments are rarely provided in clinical settings providing HIV care. Further, given patient variability in response to initial treatments, stepped care approaches may be beneficial. We describe the rationale, aims and study design for the current StartingTreatment forEthanol inPrimary care Trials (STEP Trials); three parallel randomized controlled effectiveness trials being conducted in five Infectious Disease Clinics...
November 20, 2016: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/27871198/-it-is-easier-for-me-to-shoot-up-stigma-abandonment-and-why-hiv-positive-drug-users-in-russia-fail-to-link-to-hiv-care
#3
Tetiana Kiriazova, Karsten Lunze, Anita Raj, Natalia Bushara, Elena Blokhina, Evgeny Krupitsky, Carly Bridden, Dmitry Lioznov, Jeffrey H Samet, Allen L Gifford
Many HIV-positive people who inject drugs (PWID) globally are not receiving HIV care. This represents a major challenge among key populations to end the global HIV epidemic. This qualitative study explored the process and associated barriers of linking HIV-positive PWID who are in addiction treatment to HIV care in St. Petersburg, Russia. We conducted three focus groups and seven semi-structured interviews with participants in the LINC ("Linking Infectious and Narcology Care") project at addiction and HIV hospitals in St...
November 22, 2016: AIDS Care
https://www.readbyqxmd.com/read/27842786/toxicology-in-addiction-medicine
#4
REVIEW
Daniel A Schwarz, M P George, Martin H Bluth
Toxicology testing in addiction medicine varies across the spectrum, yet remains a powerful tool in monitoring addictive patients. There are many reference laboratories offering toxicology testing, and physicians should have some understanding of laboratory, methodology, testing portfolio, and customer support structure to aid them in selecting the best toxicology laboratory for their patients. Consultation with a clinical pathologist/toxicologist in conjunction with the consideration of monitoring large numbers of illicit and psychoactive drugs in the addictive patient may provide important clinical information for their treatment...
December 2016: Clinics in Laboratory Medicine
https://www.readbyqxmd.com/read/27837404/the-biology-of-addiction
#5
Brent MacNicol
In this narrative review, the neurobiological mechanisms underlying substance abuse and addiction are discussed with a particular emphasis on the mechanisms that promote ongoing use and relapse. Addiction is estimated to affect 10-15% or more of the adult population, including physicians. Genetic predisposition, psychological and environmental risk factors, the timing of exposure to the substance, the type of substance used, and the frequency of use influence the individual's susceptibility to addiction. Abused substances act on the brain's reward system, a neural circuit that produces pleasurable feelings in response to stimuli that promote survival, thereby modifying future behavior to seek out similar stimuli...
November 11, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27832755/experience-of-the-use-of-ketamine-to-manage-opioid-withdrawal-in-an-addicted-woman-a-case-report
#6
Laurence Lalanne, Chloe Nicot, Jean-Philippe Lang, Gilles Bertschy, Eric Salvat
BACKGROUND: Opioids are good painkillers, but many patients treated with opioids as painkillers developed a secondary addiction. These patients need to stop misusing opioids, but the mild-to-severe clinical symptoms associated with opioid withdrawal risk increasing their existing pain. In such cases, ketamine, which is used by anaesthetists and pain physicians to reduce opioid medication, may be an effective agent for managing opioid withdrawal. CASE PRESENTATION: We describe the case of a woman who developed a severe secondary addiction to opioids in the context of lombo-sciatic pain...
November 10, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27813656/filler-migration-to-the-forehead-due-to-multiple-filler-injections-in-a-patient-addicted-to-cosmetic-fillers
#7
Chia-Hua Lin, Chien-Ping Chiang, Bai-Yao Wu, Hong-Wei Gao
Filler migration is a potential complication following the injection of multiple fillers. With the increasing popularity of multiple filler injections, migrated granulomas should be an essential differential diagnosis for newly growing facial lumps. It is important for all physicians to be aware that complication induced by dermal fillers can occur in locations other than the planned injected sites. We described a case of filler migration to the forehead due to not only two fillers injections, as the patient was addicted to cosmetic fillers...
November 4, 2016: Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology
https://www.readbyqxmd.com/read/27803891/a-qualitative-study-of-the-relationship-between-methamphetamine-abuse-and-sexual-dysfunction-in-male-substance-abusers
#8
Behrouz Dolatshahi, Ali Farhoudian, Mozhgan Falahatdoost, Mahmoud Tavakoli, Ebrahim Rezaie Dogahe
BACKGROUND: Increased prevalent use of methamphetamine is a global public challenge. Information on drug use can be helpful in preventing high-risk behavior related to drug abuse. OBJECTIVES: This study aims to investigate the sexual function changes related to methamphetamine use in the male clients of public and private addiction treatment centers. PATIENTS AND METHODS: In this qualitative study, 45 men (35 methamphetamine users, 5 family members of the users, and 5 psychiatrists or physicians who were famous for treating or researching addiction) are involved...
September 2016: International Journal of High Risk Behaviors & Addiction
https://www.readbyqxmd.com/read/27797649/state-of-training-clinical-services-and-research-on-dual-disorders-across-france-india-israel-and-spain
#9
Yatan Pal Singh Balhara, Shaul Lev-Ran, José Martínez-Raga, Amine Benyamina, Shalini Singh, Lisa Blecha, Nestor Szerman
OBJECTIVE: This article overviews training, clinical services, and research on dual disorders across four countries: France, India, Israel, and Spain. METHODS: The current dual disorders systems in each of the four countries were reviewed, with a focus on strengths and limitations of each. RESULTS: In France, psychiatric care occurs within the public health care system and involves little training of medical graduates for managing dual disorders...
July 2016: Journal of Dual Diagnosis
https://www.readbyqxmd.com/read/27785104/smoking-alcohol-and-substance-use-and-rates-of-quitting-during-pregnancy-is-it-hard-to-quit
#10
Ahmet Bulent Yazici, Hilal Uslu Yuvaci, Esra Yazici, Ebru Halimoglu Caliskan, Arif Serhan Cevrioglu, Atila Erol
BACKGROUND: Alcohol and substance use is a major health challenge in Turkey, as it is worldwide. Recently, there has been a rapid increase in the number of females using substances and although usage tends to reduce during pregnancy, it is of critical importance to determine its exact level as substance use negatively impacts on the health of both the mother and infant. AIM: The aim of the present study was to investigate the frequency of smoking, alcohol, and substance use, and quitting rates during pregnancy...
2016: International Journal of Women's Health
https://www.readbyqxmd.com/read/27776681/typologies-of-individuals-attending-an-addiction-rehabilitation-center-based-on-diagnosis-of-mental-disorders
#11
Christophe Huỳnh, Joël Tremblay, Marie-Josée Fleury
OBJECTIVES: This study aimed to: (1) identify clusters based on the diagnostic status of mental disorders among individuals with problematic substance use treated in an addiction rehabilitation center (ARC), and (2) characterize these clusters according to socio-demographic variables, neighborhood characteristics, and health service utilization. METHODS: Data were compiled for 4526 individuals with problematic substance use who received services from an ARC in 2004...
December 2016: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/27757048/medical-cannabis-the-canadian-perspective
#12
Gordon D Ko, Sara L Bober, Sean Mindra, Jason M Moreau
Cannabis has been widely used as a medicinal agent in Eastern medicine with earliest evidence in ancient Chinese practice dating back to 2700 BC. Over time, the use of medical cannabis has been increasingly adopted by Western medicine and is thus a rapidly emerging field that all pain physicians need to be aware of. Several randomized controlled trials have shown a significant and dose-dependent relationship between neuropathic pain relief and tetrahydrocannabinol - the principal psychoactive component of cannabis...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27755988/eight-years-of-psychiatric-examination-of-detainees-by-forensic-physicians-in-the-netherlands
#13
Karen E van den Hondel, Anne Linde Saaltink, Peter Paul M Bender
BACKGROUND: Forensic physicians are responsible for first-line medical care of detainees (individuals held in custody) in the police station. The Dutch police law contains a 'duty of care', which gives the police responsibility for the apparent mentally ill and/or confused people they encounter during their work. The police can ask a forensic physician to do a primary psychiatric assessment of any apparent mentally ill detainee. The forensic physician determines if the apparent mentally ill behavior of the detainee is due to a somatic illness, or has a psychiatric cause for which the detainee needs admission to a psychiatric hospital...
October 11, 2016: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/27754542/egen-prim%C3%A3-rv%C3%A3-rd-f%C3%A3-r-patienter-med-substitutionsbehandling-v%C3%A3-rdcentral-och-laro-mottagningar-i-malm%C3%A3-driver-pilotprojekt
#14
Disa Dahlman, Åsa Palm, Christina Sunesdotter, Katja Troberg, Camilla Wallin
Low-threshold primary care for patients in opiate maintenance therapy. A pilot project in Malmö, Sweden, integrates primary care and OMT  This report illustrates how integration of primary care and opiate maintenance therapy (OMT) may improve OMT patients health and minimize obstacles for care seeking. OMT patients have poor health. Around 80 % have hepatitis C, a majority smoke tobacco, and socio-economic status is generally low. However, somatic health is often under-prioritized in this group. To improve OMT patients physical health', two OMT clinics and one primary care center in Malmö, Sweden, started a pilot project in 2014...
October 14, 2016: Läkartidningen
https://www.readbyqxmd.com/read/27739258/physicians-knowledge-of-and-attitudes-toward-use-of-opioids-in-long-term-care-facilities
#15
Charlotte Griffioen, Eva G Willems, Sanne M Kouwenhoven, Monique A A Caljouw, Wilco P Achterberg
BACKGROUND: Insufficient pain management in vulnerable older persons living in long-term care facilities is common, and opiophobia might contribute to this. As opiophobia and its related factors have not been investigated in long-term care, this study evaluates the degree of knowledge of opioids among elderly-care physicians (ECPs) and ECP trainees, as well as their attitudes and other factors possibly influencing the clinical use of opioids in these facilities. METHODS: A questionnaire was designed and distributed among ECPs and ECP trainees by email, regional symposia, and all three university training faculties for elderly-care medicine in the Netherlands...
October 14, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27717535/trends-in-major-opioid-analgesic-consumption-in-taiwan-2002-2014
#16
Kai-Hsiang Kang, Li-Fen Kuo, I-Chen Cheng, Chih-Shiuh Chang, Wen-Ing Tsay
BACKGROUND/PURPOSE: According to WHO guideline, the consumption of opioids is an important sign of national progress in cancer pain relief. However, precise data on the consumption of opioid analgesics consumption in Taiwan has not been published. We investigate opioid analgesic consumption in Taiwan between 2002 and 2014 compare the results with those in other countries to see what we could learn about other methods of pain management. To find out the different patterns between Taiwan and other country, improves the quality of pain management...
October 4, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/27697895/associations-with-resident-physicians-early-adoption-of-electronic-cigarettes-for-smoking-cessation
#17
Eric Egnot, Kim Jordan, John O Elliott
BACKGROUND: Use of the electronic cigarette for nicotine delivery has increased dramatically in recent years. Information continues to emerge on its role as a smoking cessation aid, but little is known about resident physician use of the device in clinical practice. METHODS: In 2015, an electronic survey was administered to resident physicians in one healthcare system in Columbus, Ohio. The survey included questions about personal smoking exposure, knowledge, beliefs, attitudes about electronic cigarettes and early adoption of electronic cigarettes with patients...
October 3, 2016: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/27687632/implementing-an-mhealth-system-for-substance-use-disorders-in-primary-care-a-mixed-methods-study-of-clinicians-initial-expectations-and-first-year-experiences
#18
Marie-Louise Mares, David H Gustafson, Joseph E Glass, Andrew Quanbeck, Helene McDowell, Fiona McTavish, Amy K Atwood, Lisa A Marsch, Chantelle Thomas, Dhavan Shah, Randall Brown, Andrew Isham, Mary Jane Nealon, Victoria Ward
BACKGROUND: Millions of Americans need but don't receive treatment for substance use, and evidence suggests that addiction-focused interventions on smart phones could support their recovery. There is little research on implementation of addiction-related interventions in primary care, particularly in Federally Qualified Health Centers (FQHCs) that provide primary care to underserved populations. We used mixed methods to examine three FQHCs' implementation of Seva, a smart-phone app that offers patients online support/discussion, health-tracking, and tools for coping with cravings, and offers clinicians information about patients' health tracking and relapses...
September 29, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27664496/all-the-darkness-we-don-t-see
#19
Julia M Geynisman-Tan, Jolyn S Taylor, Terri Edersheim, Debra Taubel
Trafficking of women and children for sexual exploitation is the fastest growing criminal enterprise in the world. This is a public health crisis and, as physicians who have direct contact with victims, we have a unique opportunity to intervene. The authors developed a specialty clinic for survivors of sex trafficking in 2013 at an academic medical center in New York City. Twenty of the 24 women seen in the Survivor Clinic saw a physician while being trafficked. Sex trafficking violates basic human rights, including the rights to bodily integrity, dignity, health and freedom from violence and torture...
September 21, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27635092/opioid-prescribing-habits-of-physicians-in-kwara-state-nigeria
#20
Zakari A Suleiman, Kolawole W Wahab, Israel K Kolawole
OBJECTIVE: Although opioid analgesics are effective in the treatment of moderate to severe acute, cancer and chronic non-malignant pains, they are under-prescribed in Nigeria. The objective of this study was to assess the prescription pattern of opioids among physicians in a north central State, Nigeria.. DESIGN: This was a descriptive cross sectional study. SETTING: The study was conducted at the International Association for the Study of Pain (IASP)-sponsored workshops on pain and palliative care at the University of Ilorin Teaching Hospital, Ilorin, Nigeria...
June 2016: Ghana Medical Journal
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