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Adolescent opioid

Masaki Minami, Seishiro Nodomi, Shuichi Katayama, Kenji Waki, Tsuyoshi Imai
A 13-year-old female developed L-asparaginase (L-ASP) -associated thrombosed external hemorrhoids (TEH) during chemotherapy for Philadelphia chromosome-positive acute lymphoblastic leukemia. While undergoing induction therapy combined with imatinib, she experienced intense anal pain a day after the four-time administration of L-ASP. The anal verge contained painful bluish hemorrhoids, which reportedly were absent before the therapy commencement. Hemorrhoids occurred 5-9 days after every L-ASP treatment, which was eventually diagnosed as L-ASP-associated TEH...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Lan Guo, Min Luo, Wanxin Wang, Di Xiao, Chuhao Xi, Tian Wang, Meijun Zhao, Wei-Hong Zhang, Ciyong Lu
OBJECTIVE: The rising rate of suicidal behavior among adolescents is a growing concern, and sex differences may induce differential exposure to prescription drug misuse or suicidal behavior. We estimated, among Chinese adolescents, (1) the prevalence of nonmedical use of prescription drugs, suicidal ideation and suicide attempts; (2) whether nonmedical use of prescription drugs was independently associated with suicidal ideation and suicide attempts; and (3) whether there were sex differences in the associations...
December 10, 2018: Australian and New Zealand Journal of Psychiatry
Mustafa Karahan
Pain management is crucial for a successful result after various knee surgeries. Opioids may be included in the postoperative pain management protocol but may be abused if not controlled. Following knee arthroscopy and related surgery, adolescent and young adult patients are commonly overprescribed opioids. The driving force behind opioid prescription should be explored in addition to reviewing and emphasizing perioperative interventions that can reduce postoperative opioid consumption, including wound injections and peripheral nerve blocks...
December 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Alan R Schroeder, Melody Dehghan, Thomas B Newman, Jason P Bentley, K T Park
Importance: Through prescription writing, dental clinicians are a potential source of initial opioid exposure and subsequent abuse for adolescents and young adults. Objective: To examine the association between index dental opioid prescriptions from dental clinicians for opioid-naive adolescents and young adults in 2015 and new persistent use and subsequent diagnoses of abuse in this population. Design, Setting, and Participants: This retrospective cohort study examined outpatient opioid prescriptions for patients aged 16 to 25 years in the Optum Research Database in 2015...
December 3, 2018: JAMA Internal Medicine
Fair M Vassoler, Anika M Toorie, Elizabeth M Byrnes
RATIONALE: A growing body of evidence demonstrates that environmental exposures can impact the physiology and behavior of subsequent generations. We have previously demonstrated reduced morphine self-administration in the F1 and F2 offspring of female rats exposed to morphine during adolescence. OBJECTIVES: The current study was designed to determine whether attenuated self-administration for a substance not in the opioid class is also observed in the F1 progeny of adolescent morphine exposed females...
November 30, 2018: Psychopharmacology
Christopher Akiba, Jeremy C Kane, Stephanie Skavenski van Wyk, Ravi Paul, Chombalelo Mukunta, Laura K Murray
Introduction: Although the World Health Organization (WHO) has recommended guidelines for the treatment of opioid dependence, there are myriad challenges to successfully implementing such guidelines in resource constrained settings, such as in low and middle-income countries (LMICs). To highlight these challenges, this paper presents a clinical case study of an adolescent study participant in a randomized controlled trial comparing two counseling programs in Lusaka, Zambia. Case description: This 15 year-old male reported smoking marijuana and heroin daily, and injecting heroin monthly (while needle sharing)...
December 2018: Addictive Behaviors Reports
Mohammed Hakim, Brian J Anderson, Hina Walia, Dmitry Tumin, Marc P Michalsky, Ahsan Syed, Joseph D Tobias
BACKGROUND: Intravenous acetaminophen is commonly administered as an adjunctive to opioids during major surgical procedures, but neither the correct pharmacokinetic size descriptor nor the dose is certain in severely obese adolescents undergoing bariatric surgery. METHODS: Adolescents, 14-20 years of age, with a body mass index (BMI) ≥95th percentile for age and sex or BMI ≥40 kg·m-2 , presenting for laparoscopic or robotic assisted or vertical sleeve gastrectomy were administered intravenous acetaminophen (1000 mg) following completion of the surgical procedure...
November 28, 2018: Paediatric Anaesthesia
Sean Esteban McCabe, Philip T Veliz, Carol J Boyd, Ty S Schepis, Vita V McCabe, John E Schulenberg
BACKGROUND: This longitudinal study assesses characteristics associated with adolescents' nonmedical use of prescription opioids (NMUPO) including: frequency, co-ingestion, motives, specific opioid type; sequence of initiation of medical use of prescription opioids and NMUPO in relationship to subsequent substance use disorder (SUD) symptoms. METHODS: Twenty-one independent national cohorts of U.S. high school seniors (n = 8,373) were surveyed and followed 17 years from adolescence to age 35...
November 15, 2018: Drug and Alcohol Dependence
Consuelo Guerri, María Pascual
Evidence obtained in recent decades has demonstrated that the brain still matures in adolescence. Changes in neural connectivity occur in different regions, including cortical and subcortical structures, which undergo modifications in white and gray matter densities. These alterations concomitantly occur in some neurotransmitter systems and hormone secretion, which markedly influence the refinement of certain brain areas and neural circuits. The immaturity of the adolescent brain makes it more vulnerable to the effects of alcohol and drug abuse, whose use can trigger long-term behavioral dysfunction...
November 20, 2018: International Journal of Developmental Neuroscience
Oluwaseun Egunsola, Claire E Wylie, Kate M Chitty, Nicholas A Buckley
The barriers to opioid use in some countries necessitate the need to identify suitable alternatives or adjuncts for pain relief. The gabapentinoids (gabapentin and pregabalin) are approved for the management of persistent pain in adults, but not in children. Searches were conducted in Embase, Medline, Scopus, and Web of Science up until November 2017, for randomized controlled trials that investigated the analgesic effects of gabapentin or pregabalin in children and adolescents <18 years of age. A total of 7 publications were identified, 5 regarding gabapentin as prophylactic postsurgical pain relief for either adenotonsillectomy (n = 3) or scoliosis surgery (n = 2), and 1 for gabapentin treatment of chronic regional pain syndrome/neuropathic pain...
November 16, 2018: Anesthesia and Analgesia
Elena I Varlinskaya, Linda Patia Spear, Marvin R Diaz
The dynorphin/kappa opioid receptor (DYN/KOR) system has been identified as a primary target of stress due to behavioral effects, such as dysphoria, aversion, and anxiety-like alterations that result from activation of this system. Numerous adaptations in the DYN/KOR system have also been identified in response to stress. However, whereas most studies examining the function of the DYN/KOR system have been conducted in adult rodents, there is growing evidence suggesting that this system is ontogenetically regulated...
November 2018: Neurobiology of Stress
Zachary I Meyer, Paul Krucylak, Michelle Mo, Mark L Miller, Lindley B Wall
BACKGROUND: Opioids are a commonly utilized component of pain management following pediatric extremity fractures, yet an increasing number of adolescents and children are falling victim to their negative effects. The purpose of this study was to examine opioid use in the pediatric fracture population by determining and comparing the average hospital opioid dosage utilized in the operative pediatric elbow and femur fractures and determining and comparing the average dose prescribed following operative treatment of elbow and femur fractures...
November 13, 2018: Journal of Pediatric Orthopedics
Joshua J Gagne, Mengdong He, Brian T Bateman
No abstract text is available yet for this article.
November 12, 2018: JAMA Pediatrics
Matthew E Oetgen, Benjamin D Martin, Heather Gordish-Dressman, Jessica Cronin, Sophie R Pestieau
BACKGROUND: Recent changes in health care have begun to shift the industry from a volume-based to a value-based focus. This shift has led to standardized care pathways that decrease care variability, improve outcomes, and decrease cost. Although numerous studies have described standardized pathways for adolescent idiopathic scoliosis (AIS), few have demonstrated sustainability. We report the effectiveness and sustainability of a standardized care pathway for patients undergoing posterior spinal fusion for AIS...
November 7, 2018: Journal of Bone and Joint Surgery. American Volume
Frances A Tepolt, Jennifer Bido, Stephanie Burgess, Lyle J Micheli, Mininder S Kocher
PURPOSE: The purpose of this study was to compare the number of opioids prescribed with the amount of pain medication required after knee arthroscopy and related surgery in adolescent and young adult patients to determine the effectiveness of current pain-control practices at a single institution. The secondary purpose was to determine what demographic or surgical factors are associated with increased opioid intake. METHODS: Adolescent and young adult patients who underwent knee arthroscopy and related surgery, including ligament reconstruction or tibial tubercle osteotomy, between May and August 2016 were provided pain-control logbooks in which they were asked to maintain a record of daily pain medication intake...
November 2, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Avik Chatterjee, Marc R Larochelle, Ziming Xuan, Na Wang, Dana Bernson, Michael Silverstein, Scott E Hadland, Thomas Land, Jeffrey H Samet, Alexander Y Walley, Sarah M Bagley
BACKGROUND: Opioid-related overdoses and deaths among adolescents in the United States continue to increase, but little is known about adolescents who experience opioid-related non-fatal overdose (NFOD). Our objective was to describe (1) the characteristics of adolescents aged 11-17 who experienced NFOD and (2) their receipt of medications for opioid use disorder (MOUD) in the 12 months following NFOD, compared with adults. METHODS: We created a retrospective cohort using six Massachusetts state agency datasets linked at the individual level, with information on 98% of state residents...
October 25, 2018: Drug and Alcohol Dependence
Carla Carnovale, Faizan Mahzar, Sara Scibelli, Marta Gentili, Elena Arzenton, Ugo Moretti, Olivia Leoni, Marco Pozzi, Gabriëlla G A M Peeters, Emilio Clementi, Massimo Medaglia, Sonia Radice
Recent epidemiological studies have reported an increase in central nervous system (CNS)-active drug abuse rates in paediatric settings, raising several public health concerns. No study to date has explored this issue worldwide. We performed an extensive analysis of drugs abuse/overdose reported for children in the last decade by using the largest pharmacovigilance database, i.e. the VigiBase, collecting adverse drug reaction reports that involved at least one suspect drug belonging to the Anatomical Therapeutic Chemical code "Nervous System" through the Standardised Medical Dictionary for Drug Regulatory Affairs Queries for Drug abuse...
October 29, 2018: European Journal of Pediatrics
Anurag K Agrawal, Simon Robertson, Liat Litwin, Erica Tringale, Marsha Treadwell, Carolyn Hoppe, Anne Marsh
OBJECTIVE: Due to incomplete management of vaso-occlusive pain episodes (VOE) in patients with sickle cell disease (SCD), we sought to determine if immersive VR would be feasible for inpatients. Secondarily, we hypothesized that a single VR session would improve the VOE pain experience. PROCEDURES: Consecutive patients with SCD eight years and older admitted for VOE were offered one 15-minute VR session, utilizing a relaxing underwater world specifically created for pediatric patients and to minimize potential simulator side effects...
October 26, 2018: Pediatric Blood & Cancer
Anne Marte Sjursen Kvello, Jannike Morch Andersen, Elisabeth Leere Oiestad, Synne Steinsland, Audun Aase, Jorg Morland, Inger Lise Bogen
Escalating opioid use among fertile women has increased the number of children being exposed to opioids during fetal life. Furthermore, accumulating evidence links prenatal opioid exposure, including opioid maintenance treatment, to long-term negative effects on cognition and behavior, and presses the need to explore novel treatment strategies for pregnant opioid users. The present study examined the potential of a monoclonal antibody (mAb) targeting heroin's first metabolite, 6-acetylmorphine (6-AM), in providing fetal protection against harmful effects of prenatal heroin exposure in mice...
October 25, 2018: Journal of Pharmacology and Experimental Therapeutics
Doralina L Anghelescu, Christina-Lin Brown, Andrew J Murphy, Andrew M Davidoff, Paxton V Dickson, Evan S Glazer, Zachary E Stiles, Michael W Bishop, Luke Douthitt, Jeremiah L Deneve
BACKGROUND: Desmoplastic small round cell tumor (DSRCT) is a rare, aggressive sarcoma. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) may improve survival. METHODS: A retrospective review of anesthetic management and postoperative pain control strategies after CRS/HIPEC for DSRCT from 2013 to 2017 was performed. RESULTS: The review analyzed 10 CRS/HIPEC procedures performed for nine DSRCT patients with a median age of 19 years (range 10-24 years)...
October 23, 2018: Annals of Surgical Oncology
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