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https://www.readbyqxmd.com/read/29456602/review-of-management-in-cardiotoxic-overdose-and-efficacy-of-delayed-intralipid-use
#1
Edward Walter, James McKinlay, Jade Corbett, Justin Kirk-Bayley
We present the case of a 51-year-old woman admitted to our intensive care unit following an intentional overdose of a calcium channel antagonist and a beta blocker. The resultant hypotension was reversed with glucagon, noradrenaline, calcium and high-dose insulin. Despite these interventions, she remained vasoplegic and received a delayed, standard dose of intralipid. Subsequently, the vasoplegia resolved rapidly, and the vasopressor was stopped. Here, we review the management of overdose of calcium channel and beta-adrenergic receptor blockers, concentrating on the pharmacology of lipid emulsion therapy...
February 2018: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/29454747/plasminogen-activator-inhibitor-1-reduces-tpa-dependent-fibrinolysis-and-intrahepatic-hemorrhage-in-experimental-acetaminophen-overdose
#2
Asmita Pant, Anna K Kopeć, Kevin S Baker, Holly Cline-Fedewa, Daniel A Lawrence, James P Luyendyk
Acetaminophen (APAP)-induced liver injury in mice is associated with activation of the coagulation cascade and deposition of fibrin in liver. Plasminogen activator inhibitor-1 (PAI-1) is an important physiological inhibitor of tissue-type plasminogen activator (tPA) and plays a critical role in fibrinolysis. PAI-1 expression is increased in both experimental APAP-induced liver injury and patients with acute liver failure. Prior studies have shown that PAI-1 prevents intrahepatic hemorrhage and mortality after APAP challenge, but the downstream mechanisms are not clear...
February 15, 2018: American Journal of Pathology
https://www.readbyqxmd.com/read/29454483/postoperative-opioid-prescribing-getting-it-rightt
#3
REVIEW
Brian K Yorkgitis, Gabriel A Brat
BACKGROUND: Prescription opioid medications account for a large number of fatal and non-fatal overdoses. Many opioid prescription medications after surgery go unused, with the potential for diversion and misuse. As surgeons become increasingly aware of their role in opioid misuse, better tools are needed to guide behavior. DATA SOURCES: There has recently been a plethora of research into opioid prescribing after surgery. A review of this literature was performed using a search for manuscripts written in the English language...
February 6, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29452065/past-year-nonmedical-use-of-prescription-drugs-among-women-on-probation-and-parole-a-cross-sectional-study
#4
Martin T Hall, Diana Ball, Jeanelle Sears, George E Higgins, T K Logan, Seana Golder
BACKGROUND: Prescription drug-related overdose deaths have increased dramatically in recent years. Women in the justice system experience high rates of drug use, victimization, trauma symptoms, and other health problems, and would appear to be at high risk for nonmedical use of prescription drugs (NMUPD). This study will be among the first to describe prevalence and correlates of NMUPD among this population. METHODS: This cross-sectional study collected data from 406 victimized women on probation and parole between 2010 and 2012...
February 16, 2018: Substance Abuse
https://www.readbyqxmd.com/read/29451373/regional-structural-and-functional-specialisations-in-the-urethra-of-the-female-rat-evidence-for-complex-physiological-control-systems
#5
Monica Eggermont, Stefan De Wachter, Jane Eastham, James Gillespie
The present study characterises the complex structural and functional elements of the female rat urethra that may be involved in controlling urethral closure and continence. Urethras were dissected from female Sprague-Dawley rats (n=12) euthanized by pentobarbital overdose. Tissues were fixed (4% paraformaldehyde), frozen and sectioned (8μm) for light microscopy and immunohistochemistry. Antibodies were used to detect immunoreactivity to calcitonin gene related peptide, nitric oxide synthase, vesicular acetylcholine transporter and tyrosine hydroxylase...
February 16, 2018: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
https://www.readbyqxmd.com/read/29451045/modified-release-paracetamol-overdose-a-prospective-observational-study-atom-3
#6
Angela L Chiew, Geoffrey K Isbister, Colin B Page, Katharine A Kirby, Betty S H Chan, Nicholas A Buckley
BACKGROUND: Modified-release (MR) paracetamol is available in many countries as 665 mg tablets of which 69% is MR and 31% is immediate release. There are concerns that MR paracetamol overdose has higher rates of liver injury despite standard treatment algorithms. The objective of this study was to describe the clinical characteristics and outcomes of acute MR paracetamol overdose. METHODS: Prospective observational study, recruiting patients from January 2013 to June 2017, from five clinical toxicology units and calls to two Poisons Information Centres in Australia...
February 16, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/29450443/postincarceration-fatal-overdoses-after-implementing-medications-for-addiction-treatment-in-a-statewide-correctional-system
#7
Traci C Green, Jennifer Clarke, Lauren Brinkley-Rubinstein, Brandon D L Marshall, Nicole Alexander-Scott, Rebecca Boss, Josiah D Rich
No abstract text is available yet for this article.
February 14, 2018: JAMA Psychiatry
https://www.readbyqxmd.com/read/29450244/characteristics-of-adherence-to-methadone-maintenance-treatment-over-a-15-year-period-among-homeless-adults-experiencing-mental-illness
#8
Milad Parpouchi, Akm Moniruzzaman, Stefanie N Rezansoff, Angela Russolillo, Julian M Somers
Background: Methadone maintenance treatment (MMT) has important protective effects related to reduced illicit opioid use, infectious disease transmission, and overdose mortality. Adherence to MMT has not been examined among homeless people. We measured MMT adherence and reported relevant characteristics among homeless adults experiencing mental illness in Vancouver, British Columbia, Canada. Material and methods: Homeless adults living with mental illness who had received MMT prior to the baseline interview of the Vancouver At Home study ( n = 78) were included in analyses...
December 2017: Addictive Behaviors Reports
https://www.readbyqxmd.com/read/29446115/iatrogenic-risk-factors-associated-with-hospital-readmission-of-elderly-patients-a-matched-case-control-study-using-a-clinical-data-warehouse
#9
C Schwab, V Korb-Savoldelli, J B Escudie, C Fernandez, P Durieux, O Saint-Jean, B Sabatier
WHAT IS KNOWN: Hospital readmission within 30 days of patient discharge has become a standard to judge the quality of hospitalizations. It is estimated that 14% of the elderly, people over 75 years old or those over 65 with comorbidities, are at risk of readmission, of which 23% are avoidable. It may be possible to identify elderly patients at risk of readmission and implement steps to reduce avoidable readmissions. OBJECTIVE: The aim of this study was to identify iatrogenic risk factors for readmission...
February 14, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29445281/suicidal-drug-overdose-following-stroke-in-elderly-patients-a-retrospective-population-based-cohort-study
#10
Chun-Hung Chang, Shaw-Ji Chen, Chieh-Yu Liu, Hsin-Chi Tsai
Purpose: The purpose of this study was to investigate the incidence and risk of suicidal drug overdose (SDO) after stroke in older patients. Methods: We enrolled patients aged 60-99 years who were diagnosed with new-onset stroke between 2002 and 2013 and age-, sex-, and index-year-matched controls who did not have stroke. Patients with a history of SDO before enrollment were excluded. Both groups were observed until December 31, 2013. The primary end point was the occurrence of newly diagnosed SDO...
2018: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/29442611/relative-toxicity-of-benzodiazepines-and-hypnotics-commonly-used-for-self-poisoning-an-epidemiological-study-of-fatal-toxicity-and-case-fatality
#11
Galit Geulayov, Anne Ferrey, Deborah Casey, Claudia Wells, Alice Fuller, Clare Bankhead, David Gunnell, Caroline Clements, Navneet Kapur, Jennifer Ness, Keith Waters, Keith Hawton
The relative toxicity of anxiolytic and hypnotic drugs commonly used for self-poisoning was assessed using data on suicides, prescriptions and non-fatal self-poisonings in England, 2005-2012. Data on suicide by self-poisoning were obtained from the Office for National Statistics, information on intentional non-fatal self-poisoning was derived from the Multicentre Study of Self-harm in England and data on prescriptions in general practice from the Clinical Practice Research Datalink. We used two indices of relative toxicity: fatal toxicity (the number of fatal self-poisonings relative to the number of individuals prescribed each drug) and case fatality (the number of fatal relative to non-fatal self-poisonings)...
February 1, 2018: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/29441826/protective-effect-of-an-l-type-calcium-channel-blocker-amlodipine-on-paracetamol-induced-hepatotoxicity-in-rats
#12
H Kaya, B Polat, A Albayrak, T Mercantepe, B Buyuk
Paracetamol (P), one of the most popular and commonly used analgesic and antipyretic agents, causes hepatotoxicity in overdoses. Amlodipine (AML), an L-type calcium channel blocker, has been shown to have anti-inflammatory activity by reversing the effect of calcium in the inflammation pathogenesis. In this study, the hepatoprotective activity of AML on P-induced hepatotoxicity was evaluated. Thirty male albino Wistar rats were divided into five groups: (1) control, (2) 2 g/kg of P, (3) 2 g/kg of P + 5 mg/kg of AML, (4) 2 g/kg of P + 10 mg/kg of AML, and (5) 10 mg/kg of AML...
January 1, 2018: Human & Experimental Toxicology
https://www.readbyqxmd.com/read/29439266/effect-of-the-opioid-crisis-on-the-donor-pool-for-kidney-transplantation-an-analysis-of-national-kidney-deceased-donor-trends-from-2010-2016
#13
Donald F Chute, Meghan E Sise
BACKGROUND: The opioid crisis has led to a dramatic increase in the number of drug overdose deaths in the United States. Little is known about the effect of the opioid crisis on the kidney transplant donor pool, particularly on hepatitis C virus (HCV)-infected donors. METHODS: This is a retrospective analysis of the data from the Organ Procurement and Transplantation Network from 2010 to 2016. We determined the changes in characteristics of kidney transplant donors and evaluated which changes may be directly related to the opioid crisis...
February 13, 2018: American Journal of Nephrology
https://www.readbyqxmd.com/read/29437536/opioid-stewardship-in-otolaryngology-state-of-the-art-review
#14
John D Cramer, Brad Wisler, And Christopher J Gouveia
Objective The United States is facing an epidemic of opioid addiction. Deaths from opioid overdose have quadrupled in the past 15 years and now surpass annual deaths during the height of the human immunodeficiency virus epidemic. There is a link between opioid prescriptions after surgery, opioid misuse, opioid diversion, and use of other drugs of abuse. As surgeons, otolaryngologists contribute to this crisis. Our objective is to outline the risk of abuse from opioids in the management of acute postoperative pain in otolaryngology-head and neck surgery (OHNS) and strategies to avoid misuse...
February 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29436397/impacts-of-an-opioid-overdose-prevention-intervention-delivered-subsequent-to-acute-care
#15
Caleb J Banta-Green, Phillip O Coffin, Joseph O Merrill, Jeanne M Sears, Chris Dunn, Anthony S Floyd, Lauren K Whiteside, Norbert D Yanez, Dennis M Donovan
BACKGROUND: Opioid overdose is a major and increasing cause of injury and death. There is an urgent need for interventions to reduce overdose events among high-risk persons. METHODS: Adults at elevated risk for opioid overdose involving heroin or pharmaceutical opioids who had been cared for in an emergency department (ED) were randomised to overdose education combined with a brief behavioural intervention and take-home naloxone or usual care. Outcomes included: (1) time to first opioid overdose-related event resulting in medical attention or death using competing risks survival analysis; and (2) ED visit and hospitalisation rates, using negative binomial regression and adjusting for time at risk...
February 7, 2018: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
https://www.readbyqxmd.com/read/29433040/pharmaceutical-opioid-overdose-deaths-and-the-presence-of-witnesses
#16
Rowan P Ogeil, Jeremy Dwyer, Lyndal Bugeja, Cherie Heilbronn, Dan I Lubman, Belinda Lloyd
BACKGROUND: In the past two decades, rates of pharmaceutical opioid use and harms resulting from their use (including death) have risen. The present study identified a series of fatal opioid overdoses where there was evidence that witnesses had noted symptoms consistent with overdose, and examined associated contextual factors. METHODS: A retrospective review was undertaken utilising the Coroners Court of Victoria's Overdose Deaths Register for pharmaceutical opioid overdose deaths between 2011 and 2013...
February 9, 2018: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29432760/toxic-effects-of-fluoride-on-organisms
#17
REVIEW
Huan Zuo, Liang Chen, Ming Kong, Lipeng Qiu, Peng Lü, Peng Wu, Yanhua Yang, Keping Chen
Accumulation of excess fluoride in the environment poses serious health risks to plants, animals, and humans. This endangers human health, affects organism growth and development, and negatively impacts the food chain, thereby affecting ecological balance. In recent years, numerous studies focused on the molecular mechanisms associated with fluoride toxicity. These studies have demonstrated that fluoride can induce oxidative stress, regulate intracellular redox homeostasis, and lead to mitochondrial damage, endoplasmic reticulum stress and alter gene expression...
February 9, 2018: Life Sciences
https://www.readbyqxmd.com/read/29432758/paper-spray-mass-spectrometry-for-the-direct-semi-quantitative-measurement-of-fentanyl-and-norfentanyl-in-complex-matrices
#18
Gregory W Vandergrift, Arden J Hessels, Jan Palaty, Erik T Krogh, Chris G Gill
BACKGROUND: Fentanyl is a potent, synthetic opioid at the centre of an international health crisis that has seen thousands of fatal overdoses. Most analytical methods focus on the detection of fentanyl in blood and/or urine (i.e., post-drug use). Harm reduction (including pre-screening before drug use) may be an effective strategy against fentanyl overdoses. METHOD: Paper spray-mass spectrometry (PS-MS) is an inexpensive, direct sampling strategy where a small volume of sample (<10 μL) is spotted onto a piece of paper that is then wetted and connected to high voltage...
February 9, 2018: Clinical Biochemistry
https://www.readbyqxmd.com/read/29432503/therapeutic-drug-monitoring-of-atypical-antipsychotics
#19
REVIEW
Anna Emilia Urban, Wiesław Jerzy Cubała
The paper presents an overview and analysis of the results of research on therapeutic ranges of concentrations and receptor occupancy, mainly D2 receptors, in the treatment with some atypical antipsychotic drugs. Amisulpride, aripiprazole, clozapine, quetiapine, olanzapine, risperidone, paliperidone, sertindole, and ziprasidone were taken into account. The benefits of therapeutic drug monitoring to optimize the effectiveness of treatment and avoid side effects or toxicity were shown. The safety of patients, with the possibility to use the lowest effective dose, is an undoubted profit of TDM...
December 30, 2017: Psychiatria Polska
https://www.readbyqxmd.com/read/29432084/the-relationship-between-drug-use-settings-roles-in-the-drug-economy-and-witnessing-a-drug-overdose-in-baltimore-maryland
#20
Carl A Latkin, Catie Edwards, Melissa A Davey-Rothwell, Cui Yang, Karin E Tobin
BACKGROUND: There has been a dramatic increase in drug overdose deaths in the US. In the current study, we examined factors associated with witnessing a drug overdose. METHODS: A sample of 450 substance users in Baltimore, Maryland, US were recruited for a behavioral intervention and were administered a survey. Multinomial logistic regression models were used to compare participants who never witnessed a drug overdose to those who witnessed one in the prior six months and those who witnessed an overdose over six months ago...
February 12, 2018: Substance Abuse
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