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https://www.readbyqxmd.com/read/28645060/young-people-who-use-drugs-engaged-in-harm-reduction-programs-in-new-york-city-overdose-and-other-risks
#1
Michele Calvo, Jessica MacFarlane, Heather Zaccaro, Matthew Curtis, María Cabán, Jamie Favaro, Marian R Passannante, Taeko Frost
BACKGROUND: Little is known about the engagement of young people who use drugs (PWUD) in harm reduction programs (HRPs), and few studies have included non-opioid users and non-injectors. While HRPs have effectively engaged PWUD, young people are under-represented in their services. METHODS: The Injection Drug Users Health Alliance Citywide Study (IDUCS) is the largest community-based study of PWUD in HRPs in the US. From 2014-2015, 2421 HRP participants across New York City (NYC) completed a cross-sectional survey...
June 15, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28645059/association-of-elevated-ambient-temperature-with-death-from-cocaine-overdose
#2
Nathalie Auger, Marianne Bilodeau-Bertrand, Maud Emmanuelle Labesse, Tom Kosatsky
BACKGROUND: Ecologic data suggest that elevated outdoor temperature is correlated with mortality rates from cocaine overdose. Using non-aggregated death records, we studied the association of hot temperatures with risk of death from cocaine overdose. METHODS: We carried out a case-crossover study of all deaths from cocaine or other drug overdose between the months of May and September, from 2000 through 2013 in Quebec, Canada. We used conditional logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) for the association between maximum outdoor temperature and death from cocaine or other drug overdose...
June 10, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28644687/massive-paracetamol-overdose-an-observational-study-of-the-effect-of-activated-charcoal-and-increased-acetylcysteine-dose-atom-2
#3
Angela L Chiew, Geoffrey K Isbister, Katharine A Kirby, Colin B Page, Betty S H Chan, Nicholas A Buckley
CONTEXT: Paracetamol is commonly taken in overdose, with increasing concerns that those taking "massive" overdoses have higher rates of hepatotoxicity and may require higher doses of acetylcysteine. The objective was to describe the clinical characteristics and outcomes of "massive" (≥ 40 g) paracetamol overdoses. METHODS: Patients were identified through the Australian Paracetamol Project, a prospective observational study through Poisons Information Centres in NSW and Queensland, over 3 and 1...
June 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28644412/a-systematic-review-of-fatalities-related-to-acute-ingestion-of-salt-a-need-for-warning-labels
#4
REVIEW
Norm R C Campbell, Emma J Train
There are sporadic cases of fatalities from acutely eating salt. Yet, on social media, there are "challenges to" and examples of children and some adults acutely eating salt, and recently a charity advocated eating small amounts of salt to empathize with Syrian refugees. We performed a systematic review of fatalities from ingesting salt to assess if relatively moderate doses of salt could be fatal. In 27 reports, there were 35 fatalities documented (19 in adults and 16 in children). The lethal dose was estimated to be less than 10 g of sodium (<5 teaspoons of salt) in two children, and less than 25 g sodium in four adults (<4 tablespoons of salt)...
June 23, 2017: Nutrients
https://www.readbyqxmd.com/read/28644243/role-of-breathing-conditions-during-exercise-testing-on-training-prescription-in-chronic-obstructive-pulmonary-disease
#5
Daniel Neunhäuserer, Eva Steidle-Kloc, Marco Bergamin, Gertraud Weiss, Andrea Ermolao, Bernd Lamprecht, Michael Studnicka, Josef Niebauer
This study investigated whether different breathing conditions during exercise testing will influence measures of exercise capacity commonly used for training prescription in chronic obstructive pulmonary disease. Twenty-seven patients with chronic obstructive pulmonary disease (forced expiratory volume in 1 sec = 45.6 [9.4]%) performed three maximal exercise tests within 8 days, but at least 48 hrs apart. Subjects were thereby breathing either room air through a tightly fitting face mask like during any cardiopulmonary exercise test (MASK), room air without mask (No-MASK), or 10 l/min of oxygen via nasal cannula (No-MASK + O2)...
June 21, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28644216/what-do-pas-need-to-know-about-prescription-drug-monitoring-programs
#6
Geoffrey A Mospan, Austin Lucas
As controlled-substance abuse continues to increase in the United States, clinicians find themselves on the front lines of this epidemic. State-operated prescription drug monitoring programs are a valuable resource that prescribers can use to see patients' controlled substance history. Despite some limitations, these programs have been shown to be an effective method in reducing overdose deaths and the supply of controlled substances in the community.
July 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28644049/the-standard-treatment-protocol-for-paracetamol-poisoning-may-be-inadequate-following-overdose-with-modified-release-formulation-a-pharmacokinetic-and-clinical-analysis-of-53-cases
#7
Heléne Salmonson, Gunilla Sjöberg, Jacob Brogren
OBJECTIVE: The use of the standard procedure for managing overdoses with immediate release (IR) paracetamol is questionable when applied to overdoses with modified release (MR) formulations. This study describes the pharmacokinetics of paracetamol and the clinical outcomes following overdoses with a MR formulation. METHODS: Medical records including laboratory analyses concerning overdoses of MR paracetamol from 2009 to 2015 were collected retrospectively. Inclusion criteria were ingestion of a toxic dose, known time of intake and documented measurements of serum paracetamol and liver function tests...
June 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28641995/acetylator-status-impacts-amifampridine-phosphate-firdapse%C3%A2-pharmacokinetics-and-exposure-to-a-greater-extent-than-renal-function
#8
Peter E Haroldsen, Zlatko Sisic, Joe Datt, Donald G Musson, Gary Ingenito
PURPOSE: The purpose of this study is to evaluate safety, tolerability, and pharmacokinetic (PK) properties of amifampridine phosphate (Firdapse™) and its major inactive 3-N-acetyl metabolite in renally impaired and healthy individuals with slow acetylator (SA) and rapid acetylator (RA) phenotypes. METHODS: This was a Phase I, multicenter, open-label study of the PK properties and safety profile of amifampridine phosphate in individuals with normal, mild, moderate, or severely impaired renal function...
June 19, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28639963/takotsubo-like-cardiomyopathy-after-loperamide-overdose
#9
Kinner M Patel, Siddharth Shah, Dinesh Subedi
No abstract text is available yet for this article.
April 27, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28633650/effects-of-tolvaptan-in-patients-with-acute-heart-failure-a-systematic-review-and-meta-analysis
#10
Chunbin Wang, Bo Xiong, Lin Cai
BACKGROUND: Acute heart failure, which requires urgent evaluation and treatment, is a leading cause for admission to the emergency department. The aim of this meta-analysis was to evaluate the effects of tolvaptan on acute heart failure and compare them with the effects of conventional therapy or placebo. METHODS: The electronic databases PubMed, EMBASE, and the Cochrane Controlled Trial registry were searched from their starting dates to October 24, 2016. Two authors independently read the trials and extracted related information from the included studies...
June 20, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28633003/assessment-of-selected-overdose-poisoning-indicators-in-health-care-administrative-data-in-4-states-2012
#11
Beth Hume, Barbara Gabella, Jeanne Hathaway, Scott Proescholdbell, Cristy Sneddon, Elizabeth Brutsch, Riley Hedin, Christopher J Drucker
OBJECTIVES: In 2012, a consensus document was developed on drug overdose poisoning definitions. We took the opportunity to apply these new definitions to health care administrative data in 4 states. Our objective was to calculate and compare drug (particularly opioid) poisoning rates in these 4 states for 4 selected Injury Surveillance Workgroup 7 (ISW7) drug poisoning indicators, using 2 ISW7 surveillance definitions, Option A and Option B. We also identified factors related to the health care administrative data used by each state that might contribute to poisoning rate variations...
January 1, 2017: Public Health Reports
https://www.readbyqxmd.com/read/28631318/bupropion-overdose-resulted-in-a-pharmacobezoar-in-a-fatal-bupropion-wellbutrin-%C3%A2-sustained-release-overdose-postmortem-distribution-of-bupropion-and-its-major-metabolites
#12
Gregory Schmit, Evy De Boosere, Jessica Vanhaebost, Arnaud Capron
Bupropion (BUP) overdose commonly causes generalized seizures and central nervous system depression. The case of a 28-year-old woman who died from a massive lethal overdose with sustained-release bupropion (Wellbutrin(®) 300 mg) is herein presented. The autopsy revealed the presence of a pharmacobezoar consisting of at least 40 tablets in the stomach. Determination of bupropion and its active metabolites (hydroxybupropion, threobupropion, erythrobupropion) was achieved by a liquid chromatographic mass spectrometry (LC-MS/MS) method...
June 20, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28627395/the-opioid-epidemic-is-an-historic-opportunity-to-improve-both-prevention-and-treatment
#13
Robert L DuPont
The current narrative describing the national opioid epidemic as the result of overprescribing opioid pain medicines fails to capture the full dimensions of problem and leads to inadequate and even confounding solutions. Overlooked is the fact that polysubstance use is nearly ubiquitous among overdose deaths, demonstrating that the opioid overdose death problem is bigger than opioids. The foundation of the nation's opioid overdose crisis - and the totality of the nation's drug epidemic - is widespread recreational pharmacology, the use of drugs for fun or "self-medication...
June 13, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28624886/pharmacokinetic-modelling-of-modified-acetylcysteine-infusion-regimens-used-in-the-treatment-of-paracetamol-poisoning
#14
Anselm Wong, Cornelia Landersdorfer, Andis Graudins
PURPOSE: Paracetamol overdose is common and is treated with acetylcysteine to prevent the development of hepatotoxicity. N-acetyl-p-benzoquinone imine (NAPQI) is the toxic metabolite of paracetamol overdose. We aimed to assess the expected acetylcysteine concentration time profiles following delivery of modified acetylcysteine regimens proposed for those at high and low risk of hepatotoxicity. In addition, we will determine acetylcysteine concentrations post-cessation of abbreviated infusions...
June 17, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28623805/heroin-and-pharmaceutical-opioid-overdose-events-emergency-medical-response-characteristics
#15
Caleb J Banta-Green, Phillip O Coffin, Jennie A Schoeppe, Joseph O Merrill, Lauren K Whiteside, Abigail K Ebersol
BACKGROUND: Emergency Medical Services (EMS) data may provide insight into opioid overdose incidence, clinical characteristics, and medical response. This analysis describes patient characteristics, clinical features, and EMS response to opioid overdoses, comparing heroin and pharmaceutical opioid (PO) overdoses, using a structured opioid overdose case criteria definition. METHODS: A case series study was conducted. EMS medical staff screened cases for possible overdoses and study staff categorized the likelihood of opioid overdose...
June 10, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28622073/neighborhood-poverty-and-9-1-1-ambulance-contacts
#16
Josh Seim, Joshua English, Karl Sporer
BACKGROUND: Neighborhood poverty is positively associated with frequency of 9-1-1 ambulance utilization, but it is unclear whether this association remains significant when accounting for variations in the severities and types of ambulance contacts. METHODS: We merged EMS ambulance contact records in a single California county (n = 88,027) with data from the American Community Survey at the census tract level (n = 300). Using tract as a proxy for neighborhood and negative binomial regression as an analytical tool, we predicted 16 outcomes: any ambulance contacts, ambulance contacts stratified by three intervention severities, and ambulance contacts varied by 12 primary impression categories...
June 16, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28622071/survival-in-out-of-hospital-rapid-sequence-intubation-of-non-traumatic-brain-pathologies
#17
Pieter Francsois Fouche, Paul Andrew Jennings, Karen Smith, Malcolm Boyle, Gabriel Blecher, Jonathan Knott, Mani Raji, Pamela Rosengarten, Michael Roberto Augello, Stephen Bernard
INTRODUCTION: Rapid sequence intubation (RSI) is not only used in traumatic brain injuries in the out-of-hospital setting, but also for non-traumatic brain pathologies (NTBP) such as brain tumors, meningitis, encephalitis, hypoxic/anoxic brain injury, stroke, arteriovenous malformations, tumors, aneurysms, brain hemorrhage, as well as brain injury due to diabetes, seizures and toxicity, metabolic conditions, and alcohol and drug overdose. Previous research suggests that RSI is common in non-traumatic coma, but with an unknown prevalence of NTBP in those that receive RSI...
June 16, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28622067/opioid-involved-overdose-among-male-afghanistan-iraq-era-u-s-military-veterans-a-multidimensional-perspective
#18
Alex S Bennett, Luther Elliott, Andrew Golub, Brett Wolfson-Stofko, Honoria Guarino
BACKGROUND: Mirroring nationwide trends in a broad range of U.S. populations, an alarming number of Afghanistan/Iraq-era U.S. Military veterans have experienced opioid-related overdoses. A growing body of research has examined the proximal behaviors that can precipitate an overdose; considerably less is known about more distal physiological, psychosocial and structural influences on these risk behaviors. OBJECTIVES: This study adopts a multidimensional approach to better understand opioid-related overdose among U...
June 16, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28621658/zoning-out-methadone-and-rising-opioid-related-deaths-in-ontario-reforms-and-municipal-government-actions
#19
Carol Strike, Miroslav Miskovic
In this commentary, we argue that the use of amendments to bylaws by Ontario cities and municipalities to restrict where and how methadone maintenance treatment (MMT) clinics and pharmacies operate may run counter to efforts to prevent record high rates of opioid-related overdoses. As the province of Ontario seeks to reform the opioid treatment system, it is crucial to understand the structural (e.g., stigma) and treatment system organization factors that drive the actions of municipalities such as those described above...
June 16, 2017: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
https://www.readbyqxmd.com/read/28621023/pediatric-liver-transplantation-for-fulminant-hepatic-failure-secondary-to-intentional-iron-overdose
#20
Joanne Lai, Jaime Chu, Ronen Arnon
Acute iron poisoning may lead to life-threatening hepatotoxicity. We present the cases of two pediatric patients with hepatotoxicity following intentional iron ingestion that progressed rapidly to fulminant hepatic failure despite treatment with deferoxamine. Liver transplantation was lifesaving in both patients. These cases emphasize the need for a high index of suspicion for iron ingestion, close monitoring for liver toxicity, and timely consideration for liver transplantation.
June 15, 2017: Pediatric Transplantation
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