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https://www.readbyqxmd.com/read/29340924/impact-of-preoperative-opioid-use-after-emergency-general-surgery
#1
Young Kim, Alexander R Cortez, Koffi Wima, Vikrom K Dhar, Krishna P Athota, Jason J Schrager, Timothy A Pritts, Michael J Edwards, Shimul A Shah
BACKGROUND: Preoperative exposure to narcotics has recently been associated with poor outcomes after elective major surgery, but little is known as to how preoperative opioid use impacts outcomes after common, emergency general surgical procedures (EGS). METHODS: A high-volume, single-center analysis was performed on patients who underwent EGS from 2012 to 2013. EGS was defined as the seven emergent operations that account for 80% of the national burden. Preoperative opioid use was defined as having an active opioid prescription within 7 days prior to surgery...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29336857/identifying-risk-factors-for-the-development-of-stiffness-after-revision-total-knee-arthroplasty
#2
S B Dowdle, Nicholas A Bedard, Jessell M Owens, Yubo Gao, John J Callaghan
BACKGROUND: Although there are several studies concerning manipulation under anesthesia (MUA) after primary total knee arthroplasty, there is a paucity of literature evaluating MUA after revision total knee arthroplasty (rTKA). The purpose of this study was to determine the incidence, timing, and risk factors associated with MUA after rTKA. METHODS: The Humana database was reviewed from 2007 to 2015 for all patients who underwent rTKA. Patients who underwent rTKA followed by ipsilateral MUA were identified...
December 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29335074/trends-in-narcotics-and-sedative-use-during-mechanical-ventilation-of-preterm-infants-in-canadian-neonatal-intensive-care-units
#3
(no author information available yet)
OBJECTIVE: Mechanical ventilation (MV) in preterm infants (PTI) causes discomfort. Whether it causes pain is controversial. Meta analysis reviews of published work on PTI during MV have shown no clinically significant impact of opioids on pain scales, and hence not recommended for routine use in neonatal intensive care units (NICUs). Similarly regular use of sedative midazolam is also not recommended. Therefore we hypothesized a downward trend in narcotics and sedatives used in MV of PTI in NICUs...
January 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29332024/the-effects-of-apotel-and-remifentanil-on-postoperative-pain
#4
Alireza Kamali, Katayoun Vakilian, Leyli Mortazavi, Maryam Shokrpour
Context • One of the most common complications of a Caesarean section (C-section) is postoperative inflammation as well as operative and postoperative pain associated with the surgery. The control and mitigation of pain after surgery is the main goal of anesthesiologists. Objectives • This study aimed to compare the effects of intravenous apotel and remifentanil on postoperative pain control in women undergoing an elective C-section. Design • The research team designed a single-blinded, randomized clinical trial...
January 15, 2018: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/29321104/neurectomy-for-anterior-cutaneous-nerve-entrapment-syndrome-in-children
#5
Lindsey B Armstrong, Pradeep Dinakar, David P Mooney
INTRODUCTION: Anterior cutaneous nerve entrapment syndrome (ACNES) is an underrecognized etiology of chronic abdominal pain that causes great morbidity to those affected. We sought to determine the outcome of neurectomy for ACNES in children. METHODS: Demographic and clinical data on children who underwent neurectomy for ACNES by a single surgeon from 10/2011 to 01/2017 were reviewed. RESULTS: Twenty-six patients underwent neurectomy for ACNES...
December 8, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29318006/naloxone-dosage-for-opioid-reversal-current-evidence-and-clinical-implications
#6
REVIEW
Rachael Rzasa Lynn, J L Galinkin
Opioid-related mortality is a growing problem in the United States, and in 2015 there were over 33,000 opioid-related deaths. To combat this mortality trend, naloxone is increasingly being utilized in a pre-hospital setting by emergency personnel and prescribed to laypersons for out-of-hospital administration. With increased utilization of naloxone there has been a subsequent reduction in mortality following an opioid overdose. Reversal of opioid toxicity may precipitate an opioid-withdrawal syndrome. At the same time, there is a risk of inadequate response or re-narcotization after the administration of a single dose of naloxone in patients who have taken large doses or long-acting opioid formulations, as the duration of effect of naloxone is shorter than that of many opioid agonists...
January 2018: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/29317354/laccase-catalyzed-elimination-of-morphine-from-aqueous-systems
#7
Daniela Huber, Klaus Bleymaier, Alessandro Pellis, Robert Vielnascher, Andreas Daxbacher, Katrin J Greimel, Georg M Guebitz
Pharmaceuticals contaminate the environment for several reasons, including metabolic excretion after intake, industrial waste and improper disposal. The narcotic drug morphine is commonly utilized for chronic pain management, and the distribution of morphine in aqueous systems and in waste waters is of high concern. Here. the removal of morphine by a laccase from Myceliophthora thermophila both in its free form as well as immobilized on Accurel MP1000 beads was investigated. Complete morphine elimination was achieved within 30 min for the free and the immobilized enzyme (70% bound protein) for concentrations between 1 and 1,000 mg L-1 according to LC-TOF mass spectrometry analysis...
January 6, 2018: New Biotechnology
https://www.readbyqxmd.com/read/29312839/safety-and-efficacy-of-the-use-of-intrathecal-morphine-for-spinal-three-column-osteotomy
#8
Jason R Audlin, Swamy Kurra, William Lavelle, Richard A Tallarico, Mike H Sun, Nathaniel R Ordway, Elizabeth A Demers Lavelle
Introduction The use of intrathecal morphine has the potential to help alleviate the pain that patients experience undergoing spinal surgeries. Complications can cause immobilization, which can lead to vascular thrombosis and ileus. Studies have shown epidural analgesia significantly lowered postoperative pain scores in scoliosis surgeries. Intrathecal anesthesia has been shown to have good pain control over the initial 24-hour postoperative period. Purpose Determine if intrathecal morphine would reduce postoperative pain with minimal side effects...
November 3, 2017: Curēus
https://www.readbyqxmd.com/read/29307670/validity-and-comprehensibility-of-outcome-measures-in-children-with-shoulder-and-elbow-disorders-creation-of-a-new-pediatric-and-adolescent-shoulder-and-elbow-survey-pedi-ases
#9
Benton Heyworth, Lara Cohen, Johan von Heideken, Mininder S Kocher, Maura Daly Iversen
BACKGROUND: Valid patient-reported outcomes (PROs) for the shoulder and elbow do not exist for children. We assessed children's comprehension of the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire and the American Shoulder and Elbow Surgeons (ASES) standardized shoulder assessment form, identified response errors, and modified items to create a new pediatric shoulder and elbow PRO. METHODS: We recruited 50 children (aged 10-18 years) with shoulder or elbow disorders from a children's hospital-based orthopedic clinic for this qualitative study...
January 5, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29290135/preoperative-depression-lumbar-fusion-and-opioid-use-an-assessment-of-postoperative-prescription-quality-and-economic-outcomes
#10
Chloe O'Connell, Tej Deepak Azad, Vaishali Mittal, Daniel Vail, Eli Johnson, Atman Desai, Eric Sun, John K Ratliff, Anand Veeravagu
OBJECTIVE Preoperative depression has been linked to a variety of adverse outcomes following lumbar fusion, including increased pain, disability, and 30-day readmission rates. The goal of the present study was to determine whether preoperative depression is associated with increased narcotic use following lumbar fusion. Moreover, the authors examined the association between preoperative depression and a variety of secondary quality indicator and economic outcomes, including complications, 30-day readmissions, revision surgeries, likelihood of discharge home, and 1- and 2-year costs...
January 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29289751/patient-selection-for-total-pancreatectomy-with-islet-autotransplantation-in-the-surgical-management-of-chronic-pancreatitis
#11
Katherine A Morgan, William P Lancaster, Stefanie M Owczarski, Hongjun Wang, Jeffrey Borckardt, David B Adams
BACKGROUND: Best practice to select patients with chronic pancreatitis for surgical management with total pancreatectomy with islet autotransplantation (TPIAT) is in evolution as new discoveries are made in the pathogenesis of chronic pancreatitis. METHODS: A prospectively maintained database of patients undergoing TPIAT is reviewed. Islet function is inferred from daily insulin requirement. Pain relief is evaluated by healthcare utilization and narcotic use. Quality of life (QOL) is measured with SF-12...
December 28, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29289394/laparoscopic-guided-abdominal-wall-nerve-blocks-in-the-pediatric-population-a-novel-technique-with-comparison-to-ultrasound-guided-blocks-and-local-wound-infiltration-alone
#12
Alessandra Landmann, Mihaela Visoiu, Marcus M Malek
BACKGROUND: Abdominal wall nerve blocks have been gaining popularity for the treatment of perioperative pain in children. Our aim was to compare a technique of surgeon-performed, laparoscopic abdominal wall nerve blocks to anesthesia-placed, ultrasound-guided abdominal wall nerve blocks and the current standard of local wound infiltration. METHODS: After institutional review board approval was obtained, a retrospective chart review was performed of pediatric patients treated at a single institution during a 2-year period...
December 27, 2017: Surgery
https://www.readbyqxmd.com/read/29284416/preoperative-medication-use-and-postoperative-delirium-a-systematic-review
#13
Gizat M Kassie, Tuan A Nguyen, Lisa M Kalisch Ellett, Nicole L Pratt, Elizabeth E Roughead
BACKGROUND: Medications are frequently reported as both predisposing factors and inducers of delirium. This review evaluated the available evidence and determined the magnitude of risk of postoperative delirium associated with preoperative medication use. METHODS: A systematic search in Medline and EMBASE was conducted using MeSH terms and keywords for postoperative delirium and medication. Studies which included patients 18 years and older who underwent major surgery were included...
December 29, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29279713/tramadol-induced-adrenal-insufficiency-histological-immunohistochemical-ultrastructural-and-biochemical-genetic-experimental-study
#14
Shereen Abdelhakim Abdelaleem, Osama A Hassan, Rasha F Ahmed, Nagwa M Zenhom, Rehab A Rifaai, Nashwa F El-Tahawy
Tramadol is a synthetic, centrally acting analgesic. It is the most consumed narcotic drug that is prescribed in the world. Tramadol abuse has dramatically increased in Egypt. Long term use of tramadol can induce endocrinopathy. So, the aim of this study was to analyze the adrenal insufficiency induced by long term use of tramadol in experimental animals and also to assess its withdrawal effects through histopathological and biochemical genetic study. Forty male albino rats were used in this study. The rats were divided into 4 groups (control group, tramadol-treated group, and withdrawal groups)...
2017: Journal of Toxicology
https://www.readbyqxmd.com/read/29277619/epithelioid-granulomas-associate-with-increased-severity-and-progression-of-crohn-s-disease-based-on-6-year-follow-up
#15
Christopher M Johnson, Douglas J Hartman, Claudia Ramos-Rivers, Bhavana Bhagya Rao, Abhik Bhattacharya, Miguel Regueiro, Marc Schwartz, Jason Swoger, Jana Al Hashash, Arthur Barrie, Timothy P Pfanner, Michael Dunn, Ioannis E Koutroubakis, David G Binion
BACKGROUND & AIMS: Epithelioid granulomas are characteristics of a subset of patients with Crohn's disease (CD), but their significance, with regard to disease progression and severity, is unclear. We investigated the relationship between granulomas and CD severity over a 6-year time period in a large cohort of patients. METHODS: We performed a retrospective study of patients with CD seen at the Inflammatory Bowel Disease Center at the University of Pittsburgh; data were collected from 2009 through 2014 and patients were assigned to groups with and without histologic evidence of granuloma...
December 22, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29275804/from-circe-s-root-to-spongia-soporifera-the-role-of-the-mandrake-as-true-anesthetic-of-ancient-times
#16
Marta Mion
Several ancient authors cited mandrake as a powerful and well-known narcotic drug: from Homer to Dioscorides, from Plato to Aristotle, passing from Hippocrates, Demosthenes, Theophrastus, Celsus, and Apuleius. Their detailed studies included the concrete appearance of the plant, the related recipes including mandrake as essential ingredient, the right dosages, how to administer the obtained medication, and the possible collateral effects. Even in the Middle Ages, the success of this root continued: Isidore of Seville, Theodoric of Cervia, Gilbertus Anglicus, and William from Varignana extensively reported their researches on sponges soaked with mandrake juice, which were used before surgical interventions as soporific tools...
October 2017: Journal of Anesthesia History
https://www.readbyqxmd.com/read/29273560/transnational-social-movement-theory-and-the-waning-war-on-drugs-case-studies-from-ungass-2016
#17
Ben Mostyn, Helen Gibbon
BACKGROUND: The United Nations Convention against Illicit Traffic in Narcotic Drugs 1988 ("1988 Convention") expresses a strong normative preference for criminalising drug possession. Historically, the United Nations offices responsible for overseeing the treaties have held that decriminalisation of drug possession is contrary to the treaties. Leading up to and during UNGASS 2016, however, rather than emphasise criminalisation, the high-ranking officials from the drug control offices emphasised the treaties' allowance of alternatives to punishment for drug possession offences...
December 19, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29261036/communication-with-orthopedic-trauma-patients-via-an-automated-mobile-phone-messaging-robot
#18
Chris A Anthony, Alexander Volkmar, Apurva S Shah, Mike Willey, Matt Karam, J Lawrence Marsh
BACKGROUND: Communication with orthopedic trauma patients is traditionally problematic with low response rates (RRs). The purpose of this investigation was to (1) evaluate the feasibility of communicating with orthopedic trauma patients postoperatively, utilizing an automated mobile phone messaging platform; and (2) assess the first 2 weeks of postoperative patient-reported pain and opioid use after lower extremity orthopedic trauma procedures. MATERIALS AND METHODS: This was a prospective investigation at a Level 1 trauma center in the United States...
December 20, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29251300/rapid-detection-of-fentanyl-fentanyl-analogues-and-opioids-for-on-site-or-laboratory-based-drug-seizure-screening-using-thermal-desorption-dart-ms-and-ion-mobility-spectrometry
#19
Edward Sisco, Jennifer Verkouteren, Jessica Staymates, Jeffrey Lawrence
Fentanyl and fentanyl analogues represent a current and emerging threat in the United States as pure illicit narcotics and in mixtures with heroin. Because of their extreme potency, methods to safely and rapidly detect these compounds are of high interest. This work investigates the use of thermal desorption direct analysis in real time mass spectrometry (TD-DART-MS) and ion mobility spectrometry (IMS) as tools for the rapid and sensitive (nanogram to picograms) detection of fentanyl, 16 fentanyl analogues, and five additional opioids...
June 2017: Forensic Chem
https://www.readbyqxmd.com/read/29249547/current-pain-prescribing-habits-for-common-shoulder-operations-a-survey-of-the-american-shoulder-and-elbow-surgeons-membership
#20
K Linnea Welton, Matthew J Kraeutler, Eric C McCarty, Armando F Vidal, Jonathan T Bravman
BACKGROUND: Orthopedic surgeons are among the highest prescribers of narcotic pills, and no guidelines currently exist for appropriate management of postoperative pain within this field. The purpose of this study was to gain understanding of the current pain management strategies used perioperatively and postoperatively among orthopedic shoulder surgeons. METHODS: Members of the American Shoulder and Elbow Surgeons were e-mailed an online survey regarding methods for managing pain in the perioperative and postoperative setting for total shoulder arthroplasty, labral and capsular stabilization procedures, and rotator cuff repair...
December 14, 2017: Journal of Shoulder and Elbow Surgery
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