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Opiate testing

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https://www.readbyqxmd.com/read/28217658/pain-management-in-total-knee-arthroplasty-efficacy-of-a-multimodal-opiate-free-protocol
#1
Gian Luigi Canata, Valentina Casale, Alfredo Chiey
PURPOSE: this study was conducted to identify the most effective method of postoperative pain management, comparing the intravenous opiate infusion protocol with the use of a single periarticular local anesthetic infiltration (LAI) in patients undergoing total knee arthroplasty (TKA) surgery. METHODS: 50 patients submitted to TKA surgery between 2013 and 2015 were divided into two groups. Buprenorphine was administered intravenously to the patients in Group A, while the Group B patients received a single periarticular LAI (ropivacaine and ketorolac) during surgery...
October 2016: Joints
https://www.readbyqxmd.com/read/28167158/most-individuals-with-advanced-cirrhosis-have-sleep-disturbances-which-are-associated-with-poor-quality-of-life
#2
Marwan Ghabril, Mollie Jackson, Raghavender Gotur, Regina Weber, Eric Orman, Raj Vuppalanchi, Naga Chalasani
BACKGROUND & AIMS: Sleep disturbances are common in patients with cirrhosis, but their determinants and effects on health-related quality of life are not well understood. We investigated the prevalence of disturbed sleep in these patients, factors associated with sleep disruption, and effects on quality of life. METHODS: We performed a prospective, cross-sectional study of 193 stable ambulatory patients with cirrhosis (154 with decompensated cirrhosis). Participants completed the Pittsburgh sleep questionnaire index (to assess sleep quality), the chronic liver disease questionnaire (CLDQ), muscle cramp questionnaires, and underwent neurocognitive testing...
February 3, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28163926/rapid-analgesia-for-prehospital-hip-disruption-rapid-protocol-for-feasibility-study-of-randomised-controlled-trial
#3
Jenna K Bulger, Alan Brown, Bridie A Evans, Greg Fegan, Simon Ford, Katy Guy, Sian Jones, Leigh Keen, Ashrafunnesa Khanom, Ian Pallister, Nigel Rees, Ian T Russell, Anne C Seagrove, Helen A Snooks
BACKGROUND: Adequate pain relief at the point of injury and during transport to hospital is a major challenge in all acute traumas, especially for those with hip fractures, whose injuries are difficult to immobilise and whose long-term outcomes may be adversely affected by administration of opiate analgesics. Fascia iliaca compartment block (FICB) is a procedure routinely undertaken by doctors and nurses in the emergency department for patients with hip fracture but not yet evaluated for use by paramedics at the scene of emergency calls...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28144772/a-combined-opiate-agonist-and-antagonist-treatment-reduces-prolactin-secreting-pituitary-tumor-growth
#4
George Maglakelidze, Olivia Wynne, Dipak K Sarkar
Prolactin secreting pituitary adenomas (prolactinomas) is the most common pituitary tumors in humans. Animal studies have identified aggressive prolactinoma development in fetal alcohol exposed rats. We have recently identified a combination treatment of a μ opioid receptor antagonist naltrexone and a δ opioid receptor agonist D-Ala2-,N-Me-Phe4,Gly-ol Enkephalin (DPDPE) increases innate immune function. In this study, we tested whether naltrexone and DPDPE combination therapy is useful to control pituitary tumor growth...
January 31, 2017: Journal of Cell Communication and Signaling
https://www.readbyqxmd.com/read/28121168/annals-express-do-all-screening-immunoassay-positive-buprenorphine-samples-need-to-be-confirmed
#5
Mohamed Saleem, Helen Martin, Anne Tolya, Penny Coates
Background Interference from opiates in the Microgenics CEDIA(®) Buprenorphine assay is known to produce false positive buprenorphine screening immunoassay results necessitating confirmatory buprenorphine testing by chromatography/mass spectrometry methods. Method We reviewed data on falsely positive buprenorphine immunoassay screen (cut-off ≥ 5µg/L) but negative for buprenorphine by GCMS (cut-off ≥ 5µg/L) and had a positive opiate immunoassay result (cut-off ≥ 300µg/L). Results were collected over 3 months and the data were evaluated to determine whether there is an opiate immunoassay screen concentration below which a false positive buprenorphine result will not occur...
January 1, 2017: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/28119266/drugs-in-hair-part-i-metabolisms-of-major-drug-classes
#6
REVIEW
R M White
Currently, hair can be reliably tested for the presence of drugs. However, one major drawback to the use of parent drugs is the question of potential external or environmental contamination. The analysis of metabolites to confirm the use of the parent drugs was proposed in this short review. The development of hair as a test matrix and the incorporation of xenobiotics, in general, into the hair matrix were discussed. What constitutes an appropriate metabolite for drug testing to mirror the use of a parent drug was proposed and discussed...
January 2017: Forensic Science Review
https://www.readbyqxmd.com/read/28099189/productive-infection-of-human-neural-progenitor-cells-by-r5-tropic-hiv-1-opiate-co-exposure-heightens-infectivity-and-functional-vulnerability
#7
Joyce M Balinang, Ruturaj R Masvekar, Kurt F Hauser, Pamela E Knapp
OBJECTIVE: Human immunodeficiency virus type-1 (HIV-1) causes a spectrum of CNS complications; many are worsened by opiate co-exposure. Human neural progenitor cells (hNPCs) give rise to all CNS neurons and macroglia. We tested the hypothesis that hNPC maturation and fate are altered by HIV and opiates, contributing to HIV-1-related neuropathology. Since reports that hNPCs are infectable remain controversial, we rigorously examined hNPC infection and ability to propagate infection, and determined whether HIV effects on hNPC function required infection...
January 17, 2017: AIDS
https://www.readbyqxmd.com/read/28063774/does-addition-of-multimodal-periarticular-analgesia-to-adductor-canal-block-improve-lengths-of-stay-pain-discharge-status-and-opioid-use-after-total-knee-arthroplasty
#8
Chukwuweike U Gwam, Jaydev B Mistry, Anton Khlopas, Morad Chughtai, Melbin Thomas, Michael A Mont, Ronald E Delanois
BACKGROUND: Postoperative pain after total knee arthroplasty (TKA) can be burdensome. Multiple methods of pain control have been used, including adductor canal block (ACB) and multimodal periarticular analgesia (MPA). These two techniques have been studied have proven to be efficacious separately. The purpose of this study was to compare: (1) lengths of stay (LOS), (2) pain level, (3) discharge status, and (4) opioid use in TKA patients who received ACB alone vs patients who received ACB and MPA...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28063353/rationally-designed-benzopyran-fused-isoxazolidines-and-derived-%C3%AE-2-3-3-amino-alcohols-as-potent-analgesics-synthesis-biological-evaluation-and-molecular-docking-analysis
#9
Gagandeep Singh, Gurjit Singh, Rajbir Bhatti, Vivek Gupta, Ajay Mahajan, Palwinder Singh, Mohan Paul Singh Ishar
Based on structure activity analysis of morphine related opiates, we have synthesized some novel benzopyran fused isoxazolidines (2a-e) and derived conformationally constrained β(2,3,3)-amino alcohols (3a-e), which were evaluated in vivo for their anti-nociceptive activity through acetic acid induced writhing test (peripheral) and formalin induced algesia (central). Results showed that, compound 2a possesses significant opioid agonist activity. Further, molecular docking analysis reveals that compound 2a binds to δ-opioid receptor (DOR) with comparatively better D-score than to μ (MOR) and κ (KOR) receptors...
February 15, 2017: European Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28050185/comparing-acceptance-and-commitment-group-therapy-and-12-steps-narcotics-anonymous-in-addict-s-rehabilitation-process-a-randomized-controlled-trial
#10
Manoochehr Azkhosh, Ali Farhoudianm, Hemn Saadati, Fateme Shoaee, Leila Lashani
Objective: Substance abuse is a socio-psychological disorder. The aim of this study was to compare the effectiveness of acceptance and commitment therapy with 12-steps Narcotics Anonymous on psychological well-being of opiate dependent individuals in addiction treatment centers in Shiraz, Iran. Method: This was a randomized controlled trial. Data were collected at entry into the study and at post-test and follow-up visits. The participants were selected from opiate addicted individuals who referred to addiction treatment centers in Shiraz...
October 2016: Iranian Journal of Psychiatry
https://www.readbyqxmd.com/read/27974903/morphine-antidependence-of-erythroxylum-cuneatum-miq-kurz-in-neurotransmission-processes-in-vitro
#11
Noor Azuin Suliman, Mohamad Aris Mohd Moklas, Che Norma Mat Taib, Mohd Ilham Adenan, Mohamad Taufik Hidayat Baharuldin, Rusliza Basir, Zulkhairi Amom
Opiate abuse has been studied to cause adaptive changes observed in the presynaptic release and the mediated-synaptic plasticity proteins. The involvement of neuronal SNARE proteins reveals the role of the neurotransmitter release in expressing the opioid actions. The present study was designed to determine the effect of the alkaloid extract of Erythroxylum cuneatum (E. cuneatum) against chronic morphine and the influences of E. cuneatum on neurotransmission processes observed in vitro. The human neuroblastoma cell line, SK-N-SH, was treated with the morphine, methadone, or E...
2016: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/27936337/alcohol-use-in-an-older-adult-referred-to-a-consultation-liaison-psychiatry-service-a-case-report
#12
Adam Searby, Natalie van Swet, Phil Maude, Ian McGrath
Alcohol use disorder in older adults is associated with a number of substantial medical complications, including cognitive decline. Due to limited success and application of screening approaches in this cohort, older adults are more likely to present to general hospital settings with undiagnosed problematic alcohol use. Consultation-liaison psychiatry services operating in general hospital settings are likely to be referred older adults with alcohol use disorders for assessment and management. A 77-year-old female presented to a metropolitan hospital with symptoms including frequent falls, slurred speech, difficulty judging distance, hypersomnia, poor reasoning, and odd behaviours...
January 2017: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/27936293/effects-of-incentives-for-naltrexone-adherence-on-opiate-abstinence-in-heroin-dependent-adults
#13
Brantley P Jarvis, August F Holtyn, Anthony DeFulio, Kelly E Dunn, Jeffrey J Everly, Jeannie-Marie S Leoutsakos, Annie Umbricht, Michael Fingerhood, George E Bigelow, Kenneth Silverman
AIM: To test whether an incentive-based intervention that increased adherence to naltrexone also increased opiate abstinence. DESIGN: Post-hoc combined analysis of three earlier randomized controlled trials that individually showed that incentives for adherence to oral and to extended-release injection naltrexone dosing schedules increased naltrexone adherence but not opiate abstinence. SETTING: Outpatient therapeutic workplace in Baltimore, MD, USA...
December 9, 2016: Addiction
https://www.readbyqxmd.com/read/27922747/frailty-and-subsequent-disability-and-mortality-among-patients-with-critical-illness
#14
Nathan E Brummel, Susan P Bell, Timothy D Girard, Pratik P Pandharipande, James C Jackson, Alessandro Morandi, Jennifer L Thompson, Rameela Chandrasekhar, Gordon R Bernard, Robert S Dittus, Thomas M Gill, E Wesley Ely
INTRODUCTION The prevalence of frailty (diminished physiologic reserve) and its effect on outcomes for those ≥18 years old with critical illness is unclear. We hypothesized greater frailty would be associated with subsequent mortality, disability, and cognitive impairment, regardless of age. METHODS At enrollment, we measured frailty using the Clinical Frailty Scale (CFS, range 1 [very fit] to 7 [severely frail]). At 3 and 12 months post-discharge, we assessed vital status, instrumental and basic activities of daily living (IADLs and BADLs), and cognition...
December 6, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27916216/endocarditis-as-a-marker-for-new-epidemics-of-injection-drug-use
#15
Susana Williams Keeshin, Judith Feinberg
BACKGROUND: We examined discharges for infective endocarditis (IE) at an academic teaching hospital for over 10 years to evaluate if an increase in hospitalizations for IE and increase in hepatitis C virus (HCV) in patients with IE could predict a new epidemic of injection drug use (IDU). MATERIALS AND METHODS: Retrospective medical record review of discharged patients with the diagnosis of IE as defined by the modified Duke criteria. Student's t test, chi-squared test and Fisher's exact test were used to calculate P values...
December 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27890824/evaluating-a-switch-from-meconium-to-umbilical-cord-tissue-for-newborn-drug-testing-a-retrospective-study-at-an-academic-medical-center
#16
Kendra L Palmer, Kelly E Wood, Matthew D Krasowski
BACKGROUND: The objective of this study was to compare detection rates of newborn drug exposure at an academic medical center transitioning from meconium to umbilical cord tissue toxicology testing. METHODS: We performed an Institutional Review Board-approved retrospective chart review on all newborns (n=2072) for whom newborn drug testing was ordered at our academic medical center between June 2012 and August 2015 (in August 2013, umbilical cord tissue became the preferred specimen)...
November 24, 2016: Clinical Biochemistry
https://www.readbyqxmd.com/read/27872771/tranexamic-acid-an-exceedingly-rare-cause-of-anaphylaxis-during-anaesthesia
#17
R A Bansal, A Nicholas, A S Bansal
Tranexamic acid (TXA) allergy is extremely rare. An 80-year-old woman without prior exposure to TXA underwent elective knee replacement. Shortly after induction of anaesthesia and intravenous TXA, she developed hypotension, tachycardia, and facial erythema accompanied by a raised serum tryptase. Later, skin prick and intradermal testing confirmed positive responses to TXA in high dilution and with negative results to the other drugs used. While neuromuscular blocking agents, opiates, and antibiotics remain the most frequent cause of anaphylaxis during anaesthesia, allergy to TXA should always be borne in mind and requires skin testing for confirmation as there are presently no blood tests available...
2016: Case Reports in Immunology
https://www.readbyqxmd.com/read/27853327/the-effects-of-maternal-opium-abuse-on-fetal-heart-rate-using-non-stress-test
#18
Fatemeh Keikha, Fahimeh Ghotbizadeh Vahdani, Sahar Latifi
BACKGROUND: Opium is one of the most commonly abused opiates in developing countries including Iran. Considering the importance of maternal health on the newborn, we aimed to assess the effect of opium abuse on fetal heart rate (FHR) characteristics in a sample of pregnant women in Zahedan, Southeast Iran. METHODS: This cross-sectional study was done on 100 pregnant women referring to Ali-Ibn-Abi Talib Hospital in Zahedan, during 2011-2013. The participants were divided into two groups comprising of opium abusers and healthy individuals...
November 2016: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/27833477/transversus-abdominis-plane-block-in-renal-allotransplant-recipients-a-retrospective-chart-review
#19
S R Gopwani, M A Rosenblatt
CONTEXT: The efficacy of the transversus abdominis plane (TAP) block appears to vary considerably, depending on the surgical procedure and block technique. AIMS: This study aims to add to the existing literature and provide a more clear understanding of the TAP blocks role as a postoperative analgesic technique, specifically in renal allotransplant recipients. SETTINGS AND DESIGN: A retrospective chart review was conducted by querying the intraoperative electronic medical record system of a 1200-bed tertiary academic hospital over a 5 months period, and reviewing anesthetic techniques, as well as postoperative morphine equivalent consumption...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27809831/tailoring-a-brief-intervention-for-illicit-drug-use-and-alcohol-use-in-irish-methadone-maintained-opiate-dependent-patients-a-qualitative-process
#20
Catherine Darker, Brion Sweeney, Eamon Keenan, Lucy Whiston, Rolande Anderson, Joe Barry
BACKGROUND: The World Health Organization (WHO) recommend the tailoring of a brief intervention (BI) programme of research to ensure that it is both culturally and contextually appropriate for the country and the environment in which it is being tested. The majority of BI research has been conducted with non-opioid dependent participants. The current study developed a tailored BI for illicit drug use and alcohol use to a methadone maintained opioid dependent polydrug using cohort of patients...
November 3, 2016: BMC Psychiatry
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