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https://www.readbyqxmd.com/read/28614178/patterns-of-opioid-use-and-risk-of-opioid-overdose-death-among-medicaid-patients
#1
Renu K Garg, Deborah Fulton-Kehoe, Gary M Franklin
BACKGROUND: The Centers for Disease Control and Prevention recognizes Medicaid as a high-risk population for fatal opioid overdose. Further research is needed to identify factors that put Medicaid patients at increased risk. OBJECTIVE: To determine whether patterns of opioid use are associated with risk of opioid-related mortality among opioid users. DESIGN: This is a retrospective cohort study. PATIENTS: In total, 150,821 noncancer pain patients aged 18-64 years with ≥1 opioid prescription, April 2006 to December 2010, Washington Medicaid...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28610897/efficacy-and-safety-of-etomidate-based-sedation-compared-with-propofol-based-sedation-during-ercp-in-low-risk-patients-a-double-blind-randomized-non-inferiority-trial
#2
Chan Hyuk Park, Se Woo Park, Bomi Hyun, Jin Lee, Sea Hyub Kae, Hyun Joo Jang, Dong Hee Koh, Min Ho Choi
BACKGROUND AND AIMS: Etomidate is a short-acting intravenous hypnotic with a safety profile that is superior to alternative drugs such as propofol. However, there is a lack of evidence on the safety of etomidate in endoscopic retrograde cholangiopancreatography (ERCP). The objective of this study was to compare efficacy and safety profiles of etomidate and propofol for endoscopic sedation. METHODS: This single-center, randomized, double-blind, non-inferiority trial included patients with American Society of Anesthesiologists (ASA) physical status I-II who had been scheduled for ERCP...
June 10, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28598927/intraoperative-analgesia-nociception-index-guided-fentanyl-administration-during-sevoflurane-anesthesia-in-lumbar-discectomy-and-laminectomy-a-randomized-clinical-trial
#3
Henry D Upton, Guy L Ludbrook, Andrew Wing, Jamie W Sleigh
BACKGROUND: The "Analgesia Nociception Index" (ANI; MetroDoloris Medical Systems, Lille, France) is a proposed noninvasive guide to analgesia derived from an electrocardiogram trace. ANI is scaled from 0 to 100; with previous studies suggesting that values ≥50 can indicate adequate analgesia. This clinical trial was designed to investigate the effect of intraoperative ANI-guided fentanyl administration on postoperative pain, under anesthetic conditions optimized for ANI functioning...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28551058/-anesthesia-recovery-comparison-between-remifentanil-propofol-and-remifentanil-desflurane-guided-by-bispectral-index-%C3%A2-monitoring
#4
Raphael Grossi Rocha, Eduardo Giarola Almeida, Lara Moreira Mendes Carneiro, Natália Farias de Almeida, Walkíria Wingester Vilas Boas, Renato Santiago Gomez
BACKGROUND AND OBJECTIVES: There is a strong demand for fast and predictable anesthesia recovery with few side effects. Choice of the hypnotic agent could impact on that. This study investigated the differences between recoveries after remifentanil-propofol and remifentanil-desflurane anesthesias guided by bispectral index (BIS(®)). METHODS: Forty patients were randomly assigned into 2 groups according to the anesthesia technique applied: remifentanil-propofol (REM-PRO) and remifentanil-desflurane (REM-DES)...
May 25, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28550260/living-alone-with-alzheimer-s-disease-data-from-svedem-the-swedish-dementia-registry
#5
Pavla Cermakova, Maja Nelson, Juraj Secnik, Sara Garcia-Ptacek, Kristina Johnell, Johan Fastbom, Lena Kilander, Bengt Winblad, Maria Eriksdotter, Dorota Religa
BACKGROUND: Many people with Alzheimer's disease (AD) live alone in their own homes. There is a lack of knowledge about whether these individuals receive the same quality of diagnostics and treatment for AD as patients who are cohabiting. OBJECTIVES: To investigate the diagnostic work-up and treatment of community-dwelling AD patients who live alone. METHODS: We performed a cross-sectional cohort study based on data from the Swedish Dementia Registry (SveDem)...
May 25, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28545329/psychotropic-drug-use-before-during-and-after-pregnancy-a-population-based-study-in-a-canadian-cohort-2001-2013
#6
Christine Leong, Colette Raymond, Dan Château, Matthew Dahl, Silvia Alessi-Severini, Jamie Falk, Shawn Bugden, Alan Katz
OBJECTIVE: To describe the extent of increase in use and the rate of continuation versus discontinuation of psychotropic agents before, during, and after pregnancy. METHODS: Rates of psychotropic use (antidepressants, anxiolytic/sedative-hypnotics, antiepileptics, antipsychotics, lithium, stimulants) among women with a hospital-recorded pregnancy outcome were assessed using databases at the Manitoba Centre for Health Policy. Rate of use was defined as ≥1 prescription over the total number of pregnancies in the 3-12 months before pregnancy, 0-3 months before pregnancy, during pregnancy, or 3 months after pregnancy...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28526163/new-hypnotic-drug-development-and-pharmacologic-considerations-for-clinical-anesthesia
#7
REVIEW
Mariah Kincaid Tanious, Sascha S Beutler, Alan D Kaye, Richard D Urman
Since the public demonstration of ether as a novel, viable anesthetic for surgery in 1846, the field of anesthesia has continually sought the ideal anesthetic-rapid onset, potent sedation-hypnosis with a high therapeutic ratio of toxic dose to minimally effective dose, predictable clearance to inactive metabolites, and minimal side effects. This article aims to review current progress of novel induction agent development and provide an update on the most promising drugs poised to enter clinical practice. In addition, the authors describe trends in novel agent development, implications for health care costs, and implications for perioperative care...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28514325/an-etomidate-analogue-with-less-adrenocortical-suppression-stable-hemodynamics-and-improved-behavioral-recovery-in-rats
#8
Bin Wang, Jun Yang, Jun Chen, Yi Kang, Ling-Hui Yang, Jin Liu, Wen-Sheng Zhang
BACKGROUND: ET-26 hydrochloride (ET-26HCl) is a novel etomidate analogue designed to alleviate the adrenocortical suppression caused by etomidate while retaining the rapid sedative-hypnotic onset and stable hemodynamic features of etomidate. This study compared the anesthetic effect, hemodynamic stability, and recovery profiles of ET-26HCl, etomidate, and the sedative-hypnotic drug propofol in rats. METHODS: The metabolic half-life of ET-26HCl was determined in vitro using high performance liquid chromatography analysis of samples of rat plasma and liver homogenates taken from 3 animals...
May 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28508438/the-effect-of-chronotherapy-on-delirium-in-critical-care%C3%A2-%C3%A2-a-systematic-review
#9
Roseanne Luther, Anne McLeod
BACKGROUND: Delirium is highly prevalent within critical care and is linked to adverse clinical outcomes, increased mortality and impaired quality of life. Development of delirium is thought to be caused by multiple risk factors, including disruption of the circadian rhythm. Chronotherapeutic interventions, such as light therapy, music and use of eye shades, have been suggested as an option to improve circadian rhythm within intensive care units. AIM: This review aims to answer the question: Can chronotherapy reduce the prevalence of delirium in adult patients in critical care? DESIGN: This study is a systematic review of quantitative studies...
May 15, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28505500/increase-in-the-prescription-rate-of-antidepressants-after-the-sewol-ferry-disaster-in-ansan-south-korea
#10
Kyu-Man Han, Kyoung-Hoon Kim, Mikyung Lee, Sang-Min Lee, Young-Hoon Ko, Jong-Woo Paik
BACKGROUND: Previous pharmaco-epidemiological studies have reported increases in the prescription of psychotropic medications after a disaster, reflecting post-disaster changes in psychiatric conditions and mental health service utilization. We investigated changes in the prescription of psychotropic medications in the Danwon district of Ansan city (Ansan Danwon) compared to a control community before and after the Sewol Ferry disaster on April 16, 2014. METHODS: Data was collected from the Korean Health Insurance Review and Assessment Service database...
May 10, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28499448/comparison-of-demographic-characteristics-and-psychiatric-comorbidity-among-methamphetamine-heroin-and-methamphetamine-heroin-co-dependent-males-in-hunan-china
#11
Huixi Dong, Mei Yang, Liang Liu, Chenxi Zhang, Mengqi Liu, Yidong Shen, Huanzhong Liu, Wei Hao
BACKGROUND: There is little research of psychiatric comorbidity differences among people with different types of drug dependence in Chinese population. We explored demographic and comorbid psychiatric differences among methamphetamine- dependent males (MDs), heroin-dependent males (HDs) and methamphetamine and heroin co-dependent males (M/HDs) in Hunan province, China. METHODS: A cross-sectional, structured and clinical interview method was used to examine differences in DSM-IV-TR Axis I Disorders among 346 MDs, 698 HDs and 247 M/HDs from three compulsory rehabilitation centers and two voluntary rehabilitation centers in Hunan...
May 12, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28489797/a-previously-published-propofol-remifentanil-response-surface-model-does-not-predict-patient-response-well-in-video-assisted-thoracic-surgery
#12
Hsin-Yi Wang, Chien-Kun Ting, Jing-Yang Liou, Kun-Hui Chen, Mei-Young Tsou, Wen-Kuei Chang
Modern anesthesia usually employs a hypnotic and an analgesic to produce synergistic sedation and analgesia. Two remifentanil-propofol interaction response surface models were used to predict sedation using Observer's Assessment of Alertness/Sedation (OAA/S) scores; one predicts an OAA/S <2 and the other <4. We hypothesized that both models would predict regained responsiveness (RR) after video-assisted thoracic surgery (VATS) to reduce total anesthesia time and make early extubation clinically relevant...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28489008/-do-opioids-sedatives-and-proton-pump-inhibitors-increase-the-risk-of-fractures
#13
Gudlaug Thorsdottir, Elisabet Benedikz, Sigridur A Thorgeirsdottir, Magnus Johannsson
INTRODUCTION: A pharmacoepidemiological study was conducted to analyse the relationship between bone fracture and the use of certain drugs. MATERIAL/METHODS: The study includes patients 40 years and older, diagnosed with bone fractures in the Emergency Department of Landspitali University Hospital in Reykjavik, Iceland, during a 10-year period (2002-2011). Also were included those who picked up from a pharmacy 90 DDD or more per year of the drugs included in the study in the capital region of Iceland during same period...
May 2017: Læknablađiđ
https://www.readbyqxmd.com/read/28476551/emergency-department-visits-involving-benzodiazepines-and-non-benzodiazepine-receptor-agonists
#14
Christopher N Kaufmann, Adam P Spira, G Caleb Alexander, Lainie Rutkow, Ramin Mojtabai
OBJECTIVE: Sedative-hypnotic medications (e.g., Benzodiazepines [BZDs] and non-benzodiazepine receptor agonists [nBZRAs]) are associated with adverse events, especially in the elderly, that may require emergency department (ED) treatment. This study assessed outcomes from ED visits attributed to BZDs and/or nBZRAs, and variations in these associations by age group. METHODS: Data came from the 2004-2011 waves of the Drug Abuse Warning Network (DAWN). Visits were categorized as involving: (1) BZDs-only, (2) nBZRAs-only, (3) combination of BZDs and nBZRAs, or (4) any other sedative-hypnotic medication...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28467209/use-of-sedative-hypnotic-drugs-among-older-adults
#15
Diana R Mager, Rose Iannino-Renz
The purpose of this study was to reduce numbers of concurrently ordered sedative-hypnotic drugs for older adults in long-term (N = 220) and home-care (N = 357) settings. All active records were reviewed and numbers of sedative-hypnotics per patient were documented. Upon record review completion, educational sessions focused on dangers posed by use of multiple sedative-hypnotics were presented to nurses. One month posteducation, researchers reviewed the same records to evaluate changes. Matched pair t-tests suggested significant decreases in sedative-hypnotic use in long term, but not in the home care setting...
April 2017: Journal of Community Health Nursing
https://www.readbyqxmd.com/read/28463021/identifying-the-demographic-and-mental-health-factors-that-influence-insomnia-treatment-recommendations-within-a-veteran-population
#16
Adam D Bramoweth, Jenna G Renqvist, Barbara H Hanusa, Jon D Walker, Anne Germain, Charles W Atwood
OBJECTIVE/BACKGROUND: Insomnia is a pervasive and costly disorder that is particularly prevalent within the U.S. Veteran population. Although Cognitive Behavioral Therapy for Insomnia (CBT-I) is the recommended first-line treatment for insomnia, high rates of sedative-hypnotic prescribing continue. There is little research investigating the rates and factors impacting insomnia treatment recommendations, both behavioral and pharmacological. PARTICIPANTS: A cohort of 5,254 Veterans referred for either CBT-I or prescribed a sedative-hypnotic medication at a single VA Medical Center composed the group of participants...
May 2, 2017: Behavioral Sleep Medicine
https://www.readbyqxmd.com/read/28459898/high-prevalence-of-inappropriate-benzodiazepine-and-sedative-hypnotic-prescriptions-among-hospitalized-older-adults
#17
Elisabeth Anna Pek, Andrew Remfry, Ciara Pendrith, Chris Fan-Lun, R Sacha Bhatia, Christine Soong
BACKGROUND: Benzodiazepines and sedative hypnotics are commonly used to treat insomnia and agitation in older adults despite significant risk. A clear understanding of the extent of the problem and its contributors is required to implement effective interventions. OBJECTIVE: To determine the proportion of hospitalized older adults who are inappropriately prescribed benzodiazepines or sedative hypnotics, and to identify patient and prescriber factors associated with increased prescriptions...
May 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28457093/deliberate-self-harm-in-older-adults-a-general-hospital-emergency-department-survey
#18
Irina Briskman, Assaf Shelef, Uri Berger, Yehuda Baruch, Gali Bar, Jack Asherov, Artur Lvovski, Alan Apter, Yoram Barak
BACKGROUND: Deliberate self-harm (DSH) increases the danger of future suicide death and the risk increases with age. Self-harm in older adults is often associated with greater suicidal intent and lethality. OBJECTIVES: To investigate clinical and psychosocial variables of older patients (age ≥ 65 years) assessed due to DSH, compared with younger adults. METHODS: Patients admitted to the Emergency Department following DSH during an 8 year period were included...
March 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28449404/changes-in-prescribing-and-healthcare-resource-utilization-after-fda-drug-safety-communications-involving-zolpidem-containing-medications
#19
Aaron S Kesselheim, Macarius Donneyong, Gerald J Dal Pan, Esther H Zhou, Jerry Avorn, Sebastian Schneeweiss, John D Seeger
PURPOSE: Products containing the sedative/hypnotic zolpidem were subject to Drug Safety Communications (DSCs) in January and May 2013 describing the risk of next-morning impairment and recommending lower starting doses particularly for women. This study aimed to assess whether zolpidem DSCs were associated with prescribing-pattern changes between January 2011 and December 2013. METHODS: We assessed overall dispensings of zolpidem-containing products between January 2011 and December 2013 by conducting a time-series analysis...
April 27, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28448697/national-trends-in-antidepressant-benzodiazepine-and-other-sedative-hypnotic-treatment-of-older-adults-in-psychiatric-and-primary-care
#20
Donovan T Maust, Frederic C Blow, Ilse R Wiechers, Helen C Kales, Steven C Marcus
OBJECTIVE: To describe how use of antidepressants, benzodiazepines, and other anxiolytic/sedative-hypnotics among older adults (age ≥ 65 years) has changed over time among visits to primary care providers and psychiatrists. METHODS: Data were from the National Ambulatory Medical Care Survey (years 2003-2005 and 2010-2012), a nationally representative cross-section of outpatient physician visits. Analysis focused on visits to primary care providers (n = 14,282) and psychiatrists (n = 1,095) at which an antidepressant, benzodiazepine, or other anxiolytic/sedative-hypnotic was prescribed, which were stratified by demographic and clinical characteristic (including ICD-9-CM diagnosis) and compared across study intervals...
April 2017: Journal of Clinical Psychiatry
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