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https://www.readbyqxmd.com/read/29232604/identifying-gaps-in-the-implementation-of-naloxone-programs-for-laypersons-in-the-united-states
#1
Barrot H Lambdin, Jon Zibbell, Eliza Wheeler, Alex H Kral
BACKGROUND: The opioid epidemic in the United States (US) continues to generate significant increases in morbidity and mortality with no sign of decline. Overdose education and naloxone distribution (OEND) programs are highly effective at preventing opioid overdose mortality. We assessed the geographical distribution of overdose mortality and OEND programs in the US. METHODS: We conducted a cross-sectional, ecological study of all 3142 counties in the United States...
December 9, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29232283/levocarnitine-for-the-treatment-of-valproic-acid-induced-hyperammonemic-encephalopathy-in-children-the-experience-of-large-tertiary-care-pediatric-hospital-and-a-poison-center
#2
Miguel Glatstein, Pedro Bonifacio Rino, Silvina de Pinho, Dennis Scolnik, Dikla Pivko-Levi, Christopher Hoyte
BACKGROUND: Although rare, symptomatic hyperammonemia is sometimes associated with valproic acid (VPA), especially in children. L-carnitine (levocarnitine), sometimes classified as an essential amino acid, is vital to mitochondrial utilization of fatty acids and can be helpful in treating this condition. The data supporting this, however, are limited. STUDY QUESTION: The aim of the study was to illustrate the role of L-carnitine in the treatment of patients with VPA-induced hyperammonemic encephalopathy (VPE) at 2 different institutions...
November 22, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/29231843/the-lipid-lowering-and-cardioprotective-effects-of-vernonia-calvoana-ethanol-extract-in-acetaminophen-treated-rats
#3
Godwin Eneji Egbung, Item Justin Atangwho, Ochuole Diana Odey, Victor Ndubuisi Ndiodimma
Background: Paracetamol overdose/abuse as a result of self-medication is a common occurrence amongst people living in low/middle income countries. The present study was designed to investigate the hypolipidemic and cardioprotective potentials of Vernonia calvoana (VC) ethanol extract in acetaminophen (paracetamol)-treated rats. Methods: Thirty-five Wistar rats weighing 100-150 g were randomly assigned into five groups of seven rats each. Groups 2-5 received high doses of paracetamol to induce liver damage, while group 1 was used as normal control...
December 12, 2017: Medicines (Basel, Switzerland)
https://www.readbyqxmd.com/read/29231146/comparison-of-two-naloxone-regimens-in-addicted-methadone-overdosed-patients-a-clinical-trial-study
#4
Navid Khosravi, Nasim Zamani, Hossein Hassanian-Moghaddam, Ali Ostadi, Mitra Rahimi, Ali Kabir
BACKGROUND: Methadone toxicity is one of the major causes of death in opioid dependent individuals. OBJECTIVE: We aimed to compare two different protocols for naloxone in terms of reversal of overdose and frequency of complications in opioid-dependent methadone-intoxicated patients. METHODS: One-hundred opioid-dependent patients with signs/symptoms of methadone overdose were included. The patients were consecutively assigned into Tintinalli (group 1) or Goldfrank regimen protocol (group 2) of naloxone administration...
December 11, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/29231010/-advance-of-forensic-research-in-insulin-poisoning
#5
REVIEW
F Tong, Y Liang, Q Shi, L Zhang, W H L, Y W Zhou
Insulin as a common clinical hypoglycemic agent can effectively control serves to lower the concentration of blood glucose. However, insulin overdose can lead to death. In the whole fatal cases of insulin overdose, medical accident is the most common, followed by suicide. Though insulin homicide is extremely rare, it deserves great attention. Though there are some researches about insulin poisoning on forensic toxicology and pathology, it is still a difficult task in forensic practice. In this paper, the mechanism of death, pathological changes, detection methods and diagnose criteria of insulin overdose will be discussed in the view of forensic toxicology and pathology...
February 2017: Fa Yi Xue za Zhi
https://www.readbyqxmd.com/read/29228122/tennessee-s-in-state-vulnerability-assessment-for-a-rapid-dissemination-of-hiv-or-hcv-infection-event-utilizing-data-about-the-opioid-epidemic
#6
Michael Rickles, Peter F Rebeiro, Lindsey Sizemore, Paul Juarez, Mitchell Mutter, Carolyn Wester, Melissa McPheeters
Background: Knowing which factors contribute to county-level vulnerability to an HIV/Hepatitis C (HCV) outbreak, and which counties are most vulnerable, guide public health and clinical interventions. We therefore examined the impact of locally available indicators related to the opioid epidemic on prior national models of HCV/HIV outbreak vulnerability. Methods: Tennessee's 95 counties were the study sample. Predictors from 2012 and 2013 were used, mirroring prior methodology from the US Centers for Disease Control and Prevention (CDC)...
December 7, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29227844/back-to-the-core-a-network-approach-to-bolster-harm-reduction-among-persons-who-inject-drugs
#7
Martin Bouchard, Sadaf Hashimi, Kristen Tsai, Hugh Lampkin, Ehsan Jozaghi
BACKGROUND: Injecting drugs safely almost always includes the presence of one's social network, especially for the prevention of overdose. Yet, the systematic analysis of users' social networks has yet to be established as a focal method in harm reduction research, and interventions. METHODS: This study draws from 200 interviews with persons who inject drugs recruited from North America's first sanctioned supervised injection facility and a drug user's advocacy group...
December 8, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29227321/an-innovative-model-for-naloxone-use-within-an-otp-setting-a-prospective-cohort-study
#8
Joanna G Katzman, Mikiko Y Takeda, Snehal R Bhatt, Monica Moya Balasch, Nina Greenberg, Howard Yonas
OBJECTIVES: Unintentional opioid overdose deaths are a public health crisis, and naloxone is the most effective harm reduction tool to curb many of these deaths. There is growing evidence that take-home naloxone can prevent opioid overdose in targeted populations. The goal of this study is to measure the opioid overdose reversal rate with take-home naloxone among participants with a diagnosis of opioid use disorder (OUD) in an opioid treatment program (OTP) setting. METHODS: Patients enrolled in an outpatient OTP program were eligible for this prospective cohort study between April 4, 2016 and July 4, 2016...
December 7, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/29224198/interpreting-insulin-immunoassays-during-investigation-of-apparent-spontaneous-hypoglycaemia-and-insulin-overdose
#9
Julie Chemmanam, Michelle Isaacs, Graham R Jones, Jerry R Greenfield, Morton G Burt
We report two cases of hypoglycaemia; one with apparently spontaneous hypoglycaemia and one with presumed insulin overdose. In both cases insulin concentration was normal when measured with the Roche immunoassay, but elevated when remeasured with the Advia Centaur immunoassay and a diagnosis of hypoglycaemia secondary to insulin analogue administration was made. These cases highlight that physicians need to understand the binding characteristics of the insulin immunoassay they use.
December 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29222960/drug-induced-acute-liver-failure-in-children-and-adults-results-of-a-single-center-study-of-128-patients
#10
Harshad Devarbhavi, Mallikarjun Patil, Vishnu Vardhan Reddy, Rajvir Singh, Tarun Joseph, Deepak Ganga
BACKGROUND AND AIMS: Drugs producing acute liver failure (ALF) are uncommon and vary geographically. Here we review the implicated drugs, clinical features, laboratory characteristics and outcome of patients with drug-induced ALF (DIALF). We analyzed the predictors of mortality and their relationship with MELD, Kings College criteria (KCC) and ALFSG prognostic index. METHODS: We identified DIALF patients from our drug-induced liver injury (DILI) registry (1997-2017)...
December 9, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29220642/substance-use-patterns-associated-with-recent-exposure-to-fentanyl-among-people-who-inject-drugs-in-vancouver-canada-a-cross-sectional-urine-toxicology-screening-study
#11
Kanna Hayashi, M-J Milloy, Mark Lysyshyn, Kora DeBeck, Ekaterina Nosova, Evan Wood, Thomas Kerr
INTRODUCTION: Vancouver, Canada is experiencing an opioid overdose crisis where fentanyl, a potent, synthetic opioid contaminating the illicit drug supply, has been detected in the majority of fatal overdose cases. Despite its growing presence throughout North America, few studies have characterized exposure to fentanyl among people who use illicit drugs (PWUD). We sought to identify the prevalence and correlates of fentanyl exposure among PWUD in Vancouver. METHODS: Data were derived from cohort studies of PWUD in Vancouver...
December 5, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29220615/medication-assisted-treatment-mat-for-opioid-addiction-introduction-to-the-special-issue
#12
Karen McElrath, Herman Joseph
Several countries are experiencing public health crises as a result of opioid addiction. Fatal overdoses have reached record highs in many regions and Hepatitis C virus is the norm among people who inject drugs in several countries. Thus, providing for the global availability of medication-assisted treatment (MAT) for opioid addiction is more important than ever. In this article, we introduce readers to the collection of papers that appear in this special issue on MAT for opioid addiction. We describe the articles and commentaries thematically to include topics that address 1) the contemporary history of methadone maintenance, 2) the provision of and access and barriers to MAT, 3) compliance and outcomes of MAT, 4) health issues among MAT patients, 5) race, ethnicity, and social class backgrounds of MAT patients, 6) criminalization and stigma, and 7) challenges associated with the expansion of MAT...
December 8, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/29219630/fewer-adverse-effects-with-a-modified-two-bag-acetylcysteine-protocol-in-paracetamol-overdose
#13
Richard McNulty, Jia Min Elizabeth Lim, Pramod Chandru, Naren Gunja
OBJECTIVE: Acetylcysteine (NAC), an effective antidote for paracetamol poisoning, is commonly associated with adverse reactions. This has been postulated to be related to the rapid initial infusion rate (150 mg/kg over 1 h) of the traditional three-bag protocol. We hypothesized that a slower rate would result in fewer adverse reactions. Our institution in Western Sydney moved to a modified two-bag protocol in February 2015 - first bag: 200 mg/kg over 4 h (50 mg/kg/h) and second bag: (100 mg/kg over 16 h)...
December 8, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29217823/lysophosphatidic-acid-protects-against-acetaminophen-induced-acute-liver-injury
#14
Geon Ho Bae, Sung Kyun Lee, Hyung Sik Kim, Mingyu Lee, Ha Young Lee, Yoe-Sik Bae
We investigated the effect of lysophosphatidic acid (LPA) in experimental acetaminophen (APAP)-induced acute liver injury. LPA administration significantly reduced APAP-challenged acute liver injury, showing attenuated liver damage, liver cell death and aspartate aminotransferase and alanine aminotransferase levels. APAP overdose-induced mortality was also significantly decreased by LPA administration. Regarding the mechanism involved in LPA-induced protection against acute liver injury, LPA administration significantly increased the glutathione level, which was markedly decreased in APAP challenge-induced acute liver injury...
December 8, 2017: Experimental & Molecular Medicine
https://www.readbyqxmd.com/read/29217526/first-in-human-phase-i-study-of-single-agent-vanucizumab-a-first-in-class-bi-specific-anti-ang-2-anti-vegf-antibody-in-adult-patients-with-advanced-solid-tumors
#15
Manuel Hidalgo, Maria Martinez-Garcia, Christophe Le Tourneau, Christophe Massard, Elena Garralda, Valentina Boni, Alvaro Taus, Joan Albanell, Marie-Paule Sablin, Marie Alt, Rastilav Bahleda, Andreea Varga, Christophe Boetsch, Izolda Franjkovic, Florian Heil, Angelika Lahr, Katharina Lechner, Anthony Morel, Tapan K Nayak, Simona Rossomanno, Kevin Smart, Kay-Gunnar Stubenrauch, Oliver Krieter
PURPOSE: Vanucizumab is an investigational anti-angiogenic, first-in-class, bi-specific monoclonal antibody targeting VEGF-A and angiopoietin-2 (Ang-2). This first-in-human study evaluated the safety, pharmacokinetics, pharmacodynamics, and antitumor activity of vanucizumab in adults with advanced solid tumors refractory to standard therapies. EXPERIMENTAL DESIGN: Patients received escalating bi-weekly (q2w; 3-30 mg/kg) or weekly (qw; 10-30 mg/kg) intravenous doses guided by a Bayesian logistic regression model with overdose control...
December 7, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/29216892/opiate-agonist-treatment-to-improve-health-of-individuals-with-opioid-use-disorder-in-lebanon
#16
Ali Ghaddar, Zeinab Abbas, Ramzi Haddad
BACKGROUND: Opioid agonist therapy has been widely used to reduce harms among individuals with opioid use disorder but its effectiveness has not been evaluated in the Middle East North African (MENA) region. This study aims to evaluate the effectiveness of a program using opioid agonist therapy in combination with psychosocial support on improving psychological and social well-being, reducing arrest, and reducing risky behavior in individuals with opioid use disorder in Lebanon. METHODS: A one-group pre-test post-test design study was performed at SKOUN Lebanese Addiction Centre between January 2013 and December 2014...
December 8, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/29215840/rethinking-naloxone-overdose-drug-is-only-one-part-of-the-cycle-of-narcotic-abuse
#17
Neal J Richmond
No abstract text is available yet for this article.
February 2017: JEMS: a Journal of Emergency Medical Services
https://www.readbyqxmd.com/read/29214053/severe-carvedilol-toxicity-without-overdose-caution-in-cirrhosis
#18
Satish Maharaj, Karan Seegobin, Julio Perez-Downes, Belinda Bajric, Simone Chang, Pramod Reddy
Background: Carvedilol is used in the management of hypertension, ischemic heart disease, heart failure and most recently, portal hypertension. It has been associated with improved outcomes regarding variceal bleeding, hepatic decompensation and death when compared to propranolol and endoscopic band ligation. The main cause of portal hypertension is cirrhosis and therefore carvedilol is increasingly used in these patients. Due to its extensive hepatic metabolism, carvedilol is contraindicated in severe hepatic impairment...
2017: Clinical Hypertension
https://www.readbyqxmd.com/read/29211971/sold-as-heroin-perceptions-and-use-of-an-evolving-drug-in-baltimore-md
#19
Sarah G Mars, Jeff Ondocsin, Daniel Ciccarone
Since 2001, heroin-related overdose deaths in the United States have risen six-fold, a rise unaccounted for by the expanding user population. Has heroin become a more dangerous drug? Reports of fentanyl and its analogs, often concealed in or sold as heroin, have also increased sharply. This article investigates heroin injectors' perceptions and experiences of changes in the heroin supply in the East Coast city of Baltimore, Maryland, currently facing an epidemic in heroin- and fentanyl-related overdose deaths...
December 6, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/29208503/maternal-complications-induced-by-digoxin-treatment-of-fetal-tachycardia-a-retrospective-series-of-18-cases
#20
S Moatassim, S Touleimat, T Hazelzet, M-D Brasseur, A Diguet, I Durand, E Verspyck
OBJECTIVE: To evaluate maternal tolerance to digoxin, used alone or associated to other antiarrhythmic drugs in the management of fetal tachycardia. PATIENTS AND METHODS: This retrospective study was conducted at Rouen University Hospital between January 2009 and July 2016. All women who have received a treatment by either digoxin alone or associated with another antiarrhythmic drug for fetal tachycardia were included in the study. Maternal cardiac and extracardiac adverse effects were reported and comparisons between electrocardiograms before and during treatment with digoxin alone were performed...
December 2, 2017: Journal of Gynecology Obstetrics and Human Reproduction
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