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https://www.readbyqxmd.com/read/29052224/opiate-prescribing-in-hospitalized-older-adults-patterns-and-outcomes
#1
Sutapa Maiti, Liron Sinvani, Michele Pisano, Andrzej Kozikowski, Vidhi Patel, Meredith Akerman, Karishma Patel, Christopher Smilios, Christian Nouryan, Guang Qiu, Renee Pekmezaris, Gisele Wolf-Klein
BACKGROUND/OBJECTIVES: Whereas opiate prescribing patterns have been well described in outpatient and emergency department settings, they have been less defined in hospitalized older adults. The objective was to describe patterns of opiate prescribing and associated outcomes in hospitalized older adults. DESIGN: Retrospective cohort study. SETTING: Tertiary care facility. PARTICIPANTS: Hospitalized medical patients aged 65 and older (N = 9,245; mean age 80...
October 20, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29052065/robotic-ventral-hernia-repair-is-not-superior-to-laparoscopic-a-national-database-review
#2
Priscila Armijo, Akshay Pratap, Yi Wang, Valerie Shostrom, Dmitry Oleynikov
BACKGROUND: Minimally invasive surgery (MIS) use for ventral hernia repair has increased over the last decade. Whether outcomes are improved by robotic assistance remains a subject of debate. The aim of this study is to evaluate outcomes (including cost, complications, length of stay (LOS), and pain medication utilization) in patients who underwent an open (OVHR), laparoscopic (LVHR), or robotic (RVHR) ventral hernia repair (VHR). METHODS: The Vizient database was queried using ICD-9 procedure and diagnosis codes for patients who underwent VHR from January 2013 to September 2015...
October 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29051703/buprenorphine-naloxone-maintenance-therapy-an-observational-retrospective-report-on-the-effect-of-dose-on-18%C3%A2-months-retention-in-an-office-based-treatment-program
#3
Theodore V Parran, A G Mace, Yael J Dahan, Christopher A Adelman, Mykola Kolganov
CONTEXT AND OBJECTIVE: Buprenorphine has been available with few reports of the dose range necessary to adequately maintain patients. We report on the effect of 8 mg/d versus 16 mg/d of buprenorphine on long-term patient retention in office-based opioid maintenance (OBOMT). DESIGN SETTING AND PARTICIPANTS: Case series, at an urban hospital-based primary care clinic providing OBOMT to 157 opiate-dependent, low socioeconomic status, uninsured, nonhomeless patients...
2017: Substance Abuse: Research and Treatment
https://www.readbyqxmd.com/read/29046744/clinical-and-epidemiological-characteristics-of-patients-with-acute-drug-intoxication-admitted-to-icu
#4
Jose Orsini, Nanda Din, Ershad Elahi, Anthony Gomez, Salil Rajayer, Ryan Malik, Elie Jean
Background: Drug overdose continues to be the most common cause of acute poisoning worldwide. There has been a substantial increase in drug overdose incidence and prevalence over the past decade, probably as a result of the emergence of new synthetic designer drugs. The purpose of this study is to describe the clinical and epidemiological characteristics of patients with acute drug intoxication admitted to the Intensive Care Unit (ICU). Methods: A single center, prospective, observational study was conducted among all adult patients with clinical signs suggestive of acute drug intoxication admitted from the Emergency Department (ED) to ICU during a 6-month period (September to March)...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29046319/effect-of-intravenous-fentanyl-on-ticagrelor-absorption-and-platelet-inhibition-among-patients-undergoing-percutaneous-coronary-intervention-the-pacify-randomized-clinical-trial
#5
John W McEvoy, Khalil Ibrahim, Thomas S Kickler, William A Clarke, Rani K Hasan, Matthew J Czarny, Ali R Keramati, Rakesh R Goli, Travis P Gratton, Jeffrey A Brinker, Matthews Chacko, Chao-Wei Hwang, Peter V Johnston, Julie M Miller, Jeffrey C Trost, William R Herzog, Roger S Blumenthal, David R Thiemann, Jon R Resar, Steven P Schulman
Fentanyl is a potent opiate commonly administered during cardiac catheterization procedures in North America. The question of whether fentanyl could have adverse consequences in patients undergoing percutaneous coronary intervention (PCI) is raised by recent research demonstrating that intravenous morphine significantly delays the absorption of oral P2Y12 platelet inhibitors. The presumed mechanism is slowed gastric emptying. The single-center Platelet Aggregation with tiCagrelor Inhibition and FentanYl (PACIFY) trial randomized adults undergoing clinically-indicated elective coronary angiography to receive the procedure with or without intravenous fentanyl (NCT02683707)...
October 18, 2017: Circulation
https://www.readbyqxmd.com/read/29045307/prevalence-of-antipsychotic-treated-patients-in-a-cohort-of-adult-addicted-patients
#6
Hélène Peyrière, Caroline Diot, Erika Nogue, Marie Verschave, Morgan Laure, Marie-Christine Picot, Pierre Petit, Hélène Donnadieu-Rigole, Yves Leglise
PURPOSE: The objective of this cross-sectional study was to describe and estimate the prevalence of antipsychotics (AP) in a cohort of addicted patients, and to compare the profiles of addictive patients receiving AP or not. METHODS: We included all adult patients seen at the addiction care center of Montpellier University Hospital, between January 1, 2015, and March 31, 2015. Demographic, clinical, and therapeutic data were collected from the patients' medical records...
October 17, 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29044958/a-simple-validated-multi-method-for-detecting-drugs-in-oral-fluid-by-ultra-performance-liquid-chromatography-tandem-mass-spectrometry-uplc-ms-ms
#7
Yufang Zheng, Erik Sparve, Mats Bergström
BACKGROUND: Oral fluid sampling offers several advantages compared to other methods of detecting drugs in biological matrices due to its easy sampling procedure and simple supervision. Hence, the use of oral fluid for drug testing is increasing in workplaces and in roadside testing. As a result, more laboratories are required to perform analyses of drugs in oral fluid. METHODS: A multi-method using Ultra Performance Liquid Chromatography-Tandem Mass Spectrometry (UPLC-MS/MS) for tracing drugs in oral fluid was developed...
October 16, 2017: Drug Testing and Analysis
https://www.readbyqxmd.com/read/29044798/the-impact-of-substance-use-disorders-on-clinical-outcomes-in-older-adult-psychiatric-inpatients
#8
Scott D Lane, Sabrina C da Costa, Antonio L Teixeira, Charles F Reynolds, Breno S Diniz
OBJECTIVE: To examine associations among substance use disorder (SUD) and measures of length of stay (LOS) and non-psychiatric medical comorbidity (MEDCO) in older-adult inpatients with serious mental illness (SMI), hypothesizing SUD would be related to worse clinical outcomes. METHODS: A cross-sectional study analyzed medical records from 2010 to 2016 of 7258 inpatients with SMI ≥ age 50, obtained from a 274-bed psychiatric hospital. Descriptive analyses examined prevalence rates for SUD status (+/-), individual drug classes, and total number of SUDs (polysubstance use disorders)...
October 18, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/29040539/explaining-recent-mortality-trends-among-younger-and-middle-aged-white-americans
#9
Ryan K Masters, Andrea M Tilstra, Daniel H Simon
Background: Recent research has suggested that increases in mortality among middle-aged US Whites are being driven by suicides and poisonings from alcohol and drug use. Increases in these 'despair' deaths have been argued to reflect a cohort-based epidemic of pain and distress among middle-aged US Whites. Methods: We examine trends in all-cause and cause-specific mortality rates among younger and middle-aged US White men and women between 1980 and 2014, using official US mortality data...
July 19, 2017: International Journal of Epidemiology
https://www.readbyqxmd.com/read/29039292/an-innovative-short-stay-health-care-model-for-treatment-of-uncomplicated-vaso-occlusive-crisis-in-adult-sickle-cell-disease-patients-in-canada-to-reduce-emergency-department-utilization
#10
Andrew Binding, Richard Ward, Chai Phua, Veronique Naessens, Tara O'Brien, Sacha Bhatia, Hayley Baranek, Husayn Marani, Geetha Mukerji
OBJECTIVES: Patients with sickle cell disease (SCD) with vaso-occlusive crises (VOC) often visit the emergency department (ED) for management of painful episodes. The primary objective of this pilot study was to evaluate the acceptability of a short-stay model for treatment of VOC in SCD outside of the ED in Toronto, Canada. Secondary objectives were to assess patient satisfaction of this model, barriers to its use and comparison of clinical outcomes to a historical control. METHODS: Adult SCD patients with symptoms of an uncomplicated VOC between October 2014 to July 2016 were managed according to best practice recommendations in a short-stay unit as an alternative to the local emergency room...
October 17, 2017: CJEM
https://www.readbyqxmd.com/read/29035706/serious-suicide-attempts-in-outpatients-with-multiple-substance-use-disorders
#11
R Icick, E Karsinti, J-P Lépine, V Bloch, G Brousse, F Bellivier, F Vorspan
BACKGROUND: Suicide is a major public health concern and suicide attempts (SA) are frequent and burdensome in people suffering from substance use disorders (SUDs). In particular, serious SAs are a preoccupying form of attempt, which remain largely overlooked in these populations, especially regarding basic risk factors such as gender, addictive comorbidity and substance use patterns. Thus, we undertook a gender-specific approach to identify the risk factors for serious SAs in outpatients with multiple SUDs...
September 23, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29033604/chronic-pain-and-adult-hippocampal-neurogenesis-translational-implications-from-preclinical-studies
#12
Mariagrazia Grilli
Adult hippocampal neurogenesis (ahNG) occurs in the human brain. Adult generated neurons have been proposed to functionally contribute to relevant hippocampal functions such as learning and memory, mood regulation, and stress response. Learning, environmental enrichment, and physical exercise exert positive effects on ahNG. In parallel, these proneurogenic stimuli have been shown to ameliorate cognitive performance and/or depressive-like behavior in animal models. Conversely, aging, social isolation, and chronic stress exert negative effects on ahNG...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29029156/detailed-transmission-network-analysis-of-a-large-opiate-driven-outbreak-of-hiv-infection-in-the-united-states
#13
Ellsworth M Campbell, Hongwei Jia, Anupama Shankar, Debra Hanson, Wei Luo, Silvina Masciotra, S Michele Owen, Alexandra M Oster, Romeo R Galang, Michael W Spiller, Sara J Blosser, Erika Chapman, Jeremy C Roseberry, Jessica Gentry, Pamela Pontones, Joan Duwve, Paula Peyrani, Ron M Kagan, Jeannette M Whitcomb, Philip J Peters, Walid Heneine, John T Brooks, William M Switzer
In January 2015, an outbreak of undiagnosed human immunodeficiency virus (HIV) infections among persons who inject drugs (PWID) was recognized in rural Indiana. By September 2016, 205 persons in this community of approximately 4400 had received a diagnosis of HIV infection. We report results of new approaches to analyzing epidemiologic and laboratory data to understand transmission during this outbreak. HIV genetic distances were calculated using the polymerase region. Networks were generated using data about reported high-risk contacts, viral genetic similarity, and their most parsimonious combinations...
October 5, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29026137/opiate-use-inhibits-tlr9-signaling-pathway-in-vivo-possible-role-in-pathogenesis-of-hiv-1-infection
#14
Yanyan Liao, Junjun Jiang, Bingyu Liang, Fumei Wei, Jiegang Huang, Peijiang Pan, Jinming Su, Bo Zhou, Ning Zang, Li Ye, Hao Liang
The molecular mechanism of opiate use promoting HIV-1 infection is not fully understood. TLR9 is expressed in many immune cells, including monocytes, macrophages, which can recognize viruses and viral products and consequently induce the production of antiviral factors and initiate immune responses. Previous studies have shown that chronic viral infections can overcome and impair TLR9 pathway. We aimed to explore whether opiate use enhances HIV infection through inhibition of TLR9 pathway via a population-based study...
October 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29024875/social-networking-online-to-recover-from-opioid-use-disorder-a-study-of-community-interactions
#15
Alexandra R D'Agostino, Allison R Optican, Shaina J Sowles, Melissa J Krauss, Kiriam Escobar Lee, Patricia A Cavazos-Rehg
BACKGROUND: Social media has increasingly become a venue for health discourse and support, particularly for vulnerable individuals. This study examines user-generated content of an online Reddit community targeting individuals recovering from opiate addiction. METHODS: 100 Reddit posts and their comments were collected from the online community on August 19, 2016. Posts were qualitatively coded for opioid use disorder (OUD) criteria as outlined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), as well as other common themes...
October 5, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29018212/enhanced-therapeutic-treatment-of-colorectal-cancer-using-surface-modified-nanoporous-acupuncture-needles
#16
Bo Ram Lee, Hye-Rim Kim, Eun-Sook Choi, Jung-Hoon Cho, Nam-Jun Kim, Jung-Hee Kim, Kyeong-Min Lee, Abdul Razzaq, Hansaem Choi, Yunju Hwang, Craig A Grimes, Bong-Hyo Lee, Eunjoo Kim, Su-Il In
Acupuncture originated within the auspices of Oriental medicine, and today is used as an alternative method for treating various diseases and symptoms. The physiological mechanisms of acupuncture appear to involve the release of endogenous opiates and neurotransmitters, with the signals mediating through electrical stimulation of the central nervous system (CNS). Earlier we reported a nanoporous stainless steel acupuncture needle with enhanced therapeutic properties, evaluated by electrophysiological and behavioral responses in Sprague-Dawley (SD) rats...
October 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29016884/cocaine-contamination-of-banknotes-a-review
#17
Gianmarco Troiano, Isabella Mercurio, Marco Golfera, Nicola Nante, Paola Melai, Massimo Lancia, Mauro Bacci
Background: The analysis of drug traces on banknotes with different validated techniques can provide important information about the types of substances that are used in a geographical region. The aim of our review was to investigate banknotes' contamination by cocaine, by its metabolite, but also by other drugs. Methods: A systematic literature search (English written literature) was conducted in MEDLINE, and Scopus, collecting studies from 1974 till 2017. The Key search terms included: 'banknote AND drug'; 'banknote AND cocaine'...
July 16, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/28993160/inhibition-of-morphine-tolerance-by-mrgc-receptor-via-modulation-of-interleukin-1%C3%AE-and-matrix-metalloproteinase-9-in-dorsal-root-ganglia-in-rats
#18
Yue Zhang, Kai Wang, Minyan Lin, Qi Li, Yanguo Hong
Opiate tolerance is a critical issue in pain management. Previous studies show that activation of Mas-related gene (Mrg) C receptor can modulate the development of morphine tolerance. This study was designed to investigate the underlying mechanism(s). Intrathecal (i.t.) administration of morphine (20µg) increased the expression of interleukin-1β (IL-1β) and matrix metalloproteinase-9 (MMP-9) in small- and medium-sized neurons in dorsal root ganglia (DRG). Co-administration of bovine adrenal medulla 8-22 (BAM8-22), a selective MrgC receptor agonist, via i...
October 6, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28987169/neurotoxicology-and-drug-related-disorders
#19
Serge Weis, Andreas Büttner
Neuropsychiatric disorders caused by toxic substances pose a great diagnostic challenge due to the large variety of changes caused in the central and peripheral nervous system. The pathogenetic mechanisms at work are multifaceted and partly not solved. In human drug abusers (cannabis, opiates, cocaine, amphetamines, methamphetamine and "designer drugs"), a broad spectrum of central nervous system alterations are observed including infarction, intracerebral and subarachnoidal hemorrhage, hypoxic-ischemic leukoencephalopathy, infections, neuronal loss, specific astroglial and microglial reaction patterns, and vascular changes, including the endothelial cell as well as the basal lamina...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28986608/opiate-dependence-induces-cell-type-specific-plasticity-of-intrinsic-membrane-properties-in-the-rat-juxtacapsular-bed-nucleus-of-stria-terminalis-jcbnst
#20
Walter Francesconi, Attila Szücs, Fulvia Berton, George F Koob, Leandro F Vendruscolo, Pietro Paolo Sanna
RATIONALE: Drugs of abuse can alter circuit dynamics by modifying synaptic efficacy and/or the intrinsic membrane properties of neurons. The juxtacapsular subdivision of the bed nucleus of stria terminalis (jcBNST) has unique connectivity that positions it to integrate cortical and amygdala inputs and provide feed-forward inhibition to the central nucleus of the amygdala (CeA), among other regions. In this study, we investigated changes in the synaptic and intrinsic properties of neurons in the rat jcBNST during protracted withdrawal from morphine dependence using a combination of conventional electrophysiological methods and the dynamic clamp technique...
October 6, 2017: Psychopharmacology
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