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https://www.readbyqxmd.com/read/28888172/simultaneous-extraction-of-propofol-and-propofol-glucuronide-from-hair-followed-by-validated-lc-ms-ms-analyses
#1
Alexandra Maas, Christoph Maier, Stefanie Iwersen-Bergmann, Burkhard Madea, Cornelius Hess
Besides its clinical application, the anaesthetic agent propofol is being increasingly misused, mostly by healthcare professionals, and its abuse potential gained worldwide attention after the tragic death of Michael Jackson in 2009. Due to the short duration of its narcotic effects, propofol abuse is especially easy to hide compared with the use of other recreational drugs. However, propofol possesses a very narrow therapeutic window between the desired effect and potentially fatal toxicity, making abuse of the drug extremely dangerous even in experienced physicians...
September 1, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28862884/opioid-prescribing-patterns-by-obstetrics-and-gynecology-residents-in-the-united-states
#2
Adam D Baruch, Daniel McBurney Morgan, Vanessa K Dalton, Carolyn Swenson
BACKGROUND: Despite the opioid epidemic in the U.S., little data exist to guide postoperative opioid prescribing in Obstetrics & Gynecology (Ob/Gyn). OBJECTIVE: To describe Ob/Gyn resident opioid prescription patterns in the U.S. and assess influential factors. METHODS: An anonymous survey was emailed to Ob/Gyn residents in the U.S. between January-February 2015. Respondents reported the typical number of discharge narcotic tablets prescribed following six common procedures...
September 1, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28827940/assessment-of-private-homes-as-spaces-for-the-dying-elderly
#3
Tulika Bhattacharyya, Suhita Chopra Chatterjee, Dipannita Chand, Debolina Chatterjee, Jaydeep Sengupta
AIM: This study makes an assessment of end-of-life care of the elderly in private homes in Kolkata, West Bengal, India. PARTICIPANTS AND METHODS: Primary data were collected from private homes which supported elder care through observation and semi-structured interviews with primary family caregivers of the elderly. RESULTS: The study finds that the major factors preventing private homes from providing adequate care to the elderly were architecturally inadequate housing conditions, paucity of financial support, and scarcity of skilled caregivers...
July 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28735847/transcutaneous-electrical-nerve-stimulation-for-postoperative-pain-relief-after-arthroscopic-rotator-cuff-repair-a-prospective-double-blinded-randomized-trial
#4
Siddharth A Mahure, Andrew S Rokito, Young W Kwon
BACKGROUND: Arthroscopic rotator cuff repair (ARCR) can be associated with significant postoperative pain. Concern for opioid abuse has led surgeons to identify alternative, efficacious methods of postoperative analgesia. To determine whether transcutaneous electrical nerve stimulation (TENS) can have a similarly beneficial effect after shoulder procedures, we conducted a prospective double-blinded randomized trial in patients undergoing outpatient ARCR. METHODS: All patients undergoing ARCR of a full-thickness rotator cuff tear by the senior authors were identified...
July 20, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28721538/-methamphetamine-epidemiology-clinical-importance-and-sequelae-of-abuse
#5
N Arnaud, R Thomasius
Methamphetamine (also known as meth and crystal meth) is a highly psychoactive synthetic amphetamine type stimulant, which falls under the German Federal Narcotics Law. The substance is similar to other stimulants but has distinct features with respect to psychoactive effects, clinical symptoms, user characteristics and short and long-term consequences including substance-induced problems and comorbidities. The consumption and misuse of crystal meth is still limited to certain regions in Germany; however, the substance causes significant clinical and public health concerns in the affected regions and beyond due to the associated high potential for misuse and dependence, neurotoxic and neurodegenerative effects as well as many other severe health risks...
July 18, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28713291/an-expanding-world-of-novel-psychoactive-substances-opioids
#6
REVIEW
Jolanta B Zawilska
The abuse of novel psychoactive substances (NPS) has been increasing dramatically worldwide since late 2000s. By the end of 2015, more than 560 NPS had been reported to the European Monitoring Centre for Drugs and Drug Addiction. Although the most popular compounds are synthetic cannabinoids and psychostimulatory derivatives of cathinone (so-called β-keto-amphetamines), novel synthetic opioids have recently emerged on the recreational drug market. They include fentanyl (a potent narcotic analgesic) and its analogs (e...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28705485/trainees-as-agents-of-change-in-the-opioid-epidemic-optimizing-the-opioid-prescription-practices-of-surgical-residents
#7
Alexander S Chiu, James M Healy, Michael P DeWane, Walter E Longo, Peter S Yoo
OBJECTIVE: Opioid abuse has become an epidemic in the United States, causing nearly 50,000 deaths a year. Postoperative pain is an unavoidable consequence of most surgery, and surgeons must balance the need for sufficient analgesia with the risks of overprescribing. Prescribing narcotics is often the responsibility of surgical residents, yet little is known about their opioid-prescribing habits, influences, and training experience. DESIGN: Anonymous online survey that assessed the amounts of postoperative opioid prescribed by residents, including type of analgesia, dosage, and number of pills, for a series of common general surgery procedures...
July 10, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28668768/low-brain-tissue-oxygenation-contributes-to-the-development-of-delirium-in-critically-ill-patients-a-prospective-observational-study
#8
Michael D Wood, David M Maslove, John G Muscedere, Andrew G Day, J Gordon Boyd
PURPOSE: To test the hypothesis that poor brain tissue oxygenation (BtO2) during the first 24h of critical illness correlates with the proportion of time spent delirious. We also sought to define the physiological determinants of BtO2. MATERIALS AND METHODS: Adult patients admitted to the ICU within the previous 24h were considered eligible for enrollment if they required mechanical ventilation, and/or vasopressor support. BtO2 was measured using near-infrared spectroscopy, for 24h after enrollment...
June 15, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28636707/incidence-and-predictors-of-opioid-prescription-at-discharge-after-traumatic-injury
#9
Muhammad Ali Chaudhary, Andrew J Schoenfeld, Alyssa F Harlow, Anju Ranjit, Rebecca Scully, Ritam Chowdhury, Meesha Sharma, Stephanie Nitzschke, Tracey Koehlmoos, Adil H Haider
Importance: In the current health care environment with increased scrutiny and growing concern regarding opioid use and abuse, there has been a push toward greater regulation over prescriptions of opioids. Trauma patients represent a population that may be affected by this regulation, as the incidence of pain at hospital discharge is greater than 95%, and opioids are considered the first line of treatment for pain management. However, the use of opioid prescriptions in trauma patients at hospital discharge has not been explored...
June 21, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28635020/fentanyl-novel-derivative-related-deaths
#10
Arianna Giorgetti, Carmela Centola, Raffaele Giorgetti
OBJECTIVE: Fentanyl (FEN) is a potent, synthetic narcotic used as an anaesthetic and a pain reliever, but also illegally manufactured. For diversion purpose, it is being steadily modified to produce new analogous compounds and derivatives (FENS), categorised as novel psychoactive substances. While potential FEN abuse is already known, even in the absence of a clear lethal dosage, there is still a shortage of data on its derivatives. METHODS: A literature review of FENS-related deaths was performed, to better understand potential damage and future perspectives of FEN congeners...
May 2017: Human Psychopharmacology
https://www.readbyqxmd.com/read/28592146/drug-use-the-drug-environment-and-child-physical-abuse-and-neglect
#11
Bridget Freisthler, Jennifer Price Wolf, Wendy Wiegmann, Nancy J Kepple
Although drug use is considered a risk factor for child maltreatment, very little work has examined how the drug environment may affect physical abuse and neglect by parents. Utilizing information from a telephone survey with 2,597 respondents from 43 cities with valid police data on narcotics incidents, we analyzed the relationship between drug use, drug availability, and child maltreatment using multilevel models. City-level rates of drug abuse and dependence were related to more frequent physical abuse. Parents who use drugs in areas with greater availability of drugs reported more physical abuse and physical neglect...
January 1, 2017: Child Maltreatment
https://www.readbyqxmd.com/read/28533997/metoclopramide-for-acute-migraine-treatment-in-the-emergency-department-an-effective-alternative-to-opioids
#12
REVIEW
Mejdi Najjar, Tyler Hall, Blanca Estupinan
In light of recent warnings by the United States (US) Surgeon General and Centers for Disease Control (CDC) guidelines for recommending more prudent use of opioid narcotics, the search for a non-opioid alternative for aborting acute migraines is particularly relevant. The CDC also estimates the prevalence of opioid dependence may be as high as 26% among patients prescribed opioids for chronic pain, not due to cancer, in the primary care setting. Given such staggering data, it is imperative that we, as caretakers, not foster opioid dependence but rather continue to investigate non-opioid therapies for the management of acute migraines in the emergent care settings...
April 20, 2017: Curēus
https://www.readbyqxmd.com/read/28496355/cannabis-as-a-substitute-for-prescription-drugs-a-cross-sectional-study
#13
James M Corroon, Laurie K Mischley, Michelle Sexton
BACKGROUND: The use of medical cannabis is increasing, most commonly for pain, anxiety and depression. Emerging data suggest that use and abuse of prescription drugs may be decreasing in states where medical cannabis is legal. The aim of this study was to survey cannabis users to determine whether they had intentionally substituted cannabis for prescription drugs. METHODS: A total of 2,774 individuals were a self-selected convenience sample who reported having used cannabis at least once in the previous 90 days...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28455085/randomized-controlled-trial-of-intravenous-acetaminophen-for-postcesarean-delivery-pain-control
#14
RANDOMIZED CONTROLLED TRIAL
Brie Altenau, Catrina C Crisp, C Ganga Devaiah, Donna S Lambers
BACKGROUND: Cesarean delivery is a common surgery in the United States, with 1.3 million performed during 2009.(1) Obstetricians must balance the growing concern with opioid abuse, dependence, and side effects with optimal postoperative pain control. Intravenous acetaminophen may represent an additional method to decrease the reliance on opioid medications and improve postoperative pain following cesarean delivery. OBJECTIVE: The objective of the study was to determine whether the administration of intravenous acetaminophen following routine scheduled cesarean delivery would decrease the need for narcotic medications to control postoperative pain...
September 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28317510/predictors-and-outcomes-of-twelve-step-sponsorship-of-stimulant-users-secondary-analyses-of-a-multisite-randomized-clinical-trial
#15
RANDOMIZED CONTROLLED TRIAL
Dennis C Wendt, Kevin A Hallgren, Dennis C Daley, Dennis M Donovan
OBJECTIVE: This secondary data analysis explored predictors and outcomes of having a 12-step sponsor among individuals receiving treatment for stimulant use disorders, inclusive of four types of 12-step groups (Narcotics Anonymous, Alcoholics Anonymous, Cocaine Anonymous, and Crystal Meth Anonymous). METHOD: For a multisite randomized clinical trial, participants (N = 471; 59% women) were recruited among adult patients in 10 U.S. community treatment programs. Participants were randomized into treatment as usual (TAU) or a 12-step facilitation (TSF) intervention: Stimulant Abuser Groups to Engage in 12-Step (STAGE-12)...
March 2017: Journal of Studies on Alcohol and Drugs
https://www.readbyqxmd.com/read/28314070/long-lasting-effects-of-chronic-heavy-cannabis-abuse
#16
Joannis N Nestoros, Elena Vakonaki, Manolis N Tzatzarakis, Athanasios Alegakis, Markos D Skondras, Aristidis M Tsatsakis
BACKGROUND AND OBJECTIVES: The purpose of this study was to evaluate the extent of short-term memory impairment and schizophrenia-like symptoms in heavy and systematic cannabis users and the association between the severity of abuse and the longevity of its persistent symptoms after refraining from such use. METHODS: A complete psychiatric examination and a psychometric evaluation were performed in 48 solely cannabis users. Additionally, head hair samples were analyzed and the detected cannabinoids levels were correlated with the psychometric findings...
June 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28296623/medicalizing-the-opioid-epidemic-in-the-u-s-in-the-era-of-health-care-reform
#17
David E Smith
The medicalization of the current opioid epidemic in the era of health care reform and parity, and its possible dismantling, poses many challenges. Between 2002 and 2013, drug overdose rates quadrupled. Parallel to an increase in prescription opioid overdose, heroin overdose deaths are increasing as patients shift to cheaper and more accessible heroin from the prescription opioids which physicians are prescribing less often due to increasing regulatory restrictions, as well as enhanced education and awareness...
April 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28292504/pharmacists-perceptions-regarding-the-impact-of-hydrocodone-rescheduling-on-prescription-volume-workflow-management-and-patient-outcomes
#18
Tyler J Varisco, Motolani E Ogunsanya, Jamie C Barner, Marc L Fleming
OBJECTIVES: To determine (1) pharmacists' perceptions of how rescheduling of hydrocodone combination products (HCPs) from Drug Enforcement Agency (DEA) Schedule III to DEA Schedule II has influenced prescription volume and revenue, pharmacy workflow management, and patient outcomes; and (2) whether perceptions differed between pharmacists who support versus those who oppose HCP rescheduling. DESIGN: A cross-sectional mail survey. SETTING: Texas community pharmacies from October to December 2015...
March 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28290530/identifying-life-threatening-admissions-for-drug-dependence-or-abuse-iliadda-derivation-and-validation-of-a-model
#19
Tri-Long Nguyen, Thierry Boudemaghe, Géraldine Leguelinel-Blache, Céline Eiden, Jean-Marie Kinowski, Yannick Le Manach, Hélène Peyrière, Paul Landais
Given that drug abuse and dependence are common reasons for hospitalization, we aimed to derive and validate a model allowing early identification of life-threatening hospital admissions for drug dependence or abuse. Using the French National Hospital Discharge Data Base, we extracted 66,101 acute inpatient stays for substance abuse, dependence, mental disorders or poisoning associated with medicines or illicit drugs intake, recorded between January 1(st), 2009 and December 31(st), 2014. We split our study cohort at the center level to create a derivation cohort and a validation cohort...
March 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28240756/assessment-and-therapeutic-choice-in-septic-arthritis-of-the-hip-in-an-intravenous-drug-abuser-case-report-at-14-years-follow-up-and-review-of-literature
#20
REVIEW
P Persiani, F M Ranaldi, O Mazza, A Calistri, M Bove, M Crostelli, C Villani
INTRODUCTION: Osteoarticular infections are found frequently in drug addicted individuals, representing one of the main reasons for their hospitalization. Through inoculation, the pathogenic agents can enter the individual's system directly through the skin or parenterally, transmitted, that is, through syringes and other objects used during such practice. In these particular conditions, or when the medical history is vague, a warranted suspicion and the execution of targeted research can help in the diagnosis of high-risk patients such as addicts...
January 2017: La Clinica Terapeutica
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