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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
#1
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/29220110/non-responsiveness-and-susceptibility-of-opioids-side-effects-related-to-cancer-patients-clinical-characteristics-a-post-hoc-analysis
#2
Oscar Corli, Anna Roberto, Michael I Bennett, Francesca Galli, Nicole Corsi, Eliana Rulli, Raffaella Antonione
BACKGROUND: Response to opioids is not always positive in cancer patients. A considerable proportion of patients do not respond (non-responders, NRs) or experience severe toxicity. The aim of this analysis was to assess the role of demographic characteristics, pain features, comorbidities and ongoing therapy on the lack of efficacy and on the occurrence of severe adverse drug reactions (ADRs). METHODS: This is a post-hoc analysis of a randomized controlled trial that involved 520 patients and was aimed to evaluate the efficacy and safety of four strong opioids...
December 8, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29218318/patient-comfort-scores-do-not-affect-endoscopist-behavior-during-colonoscopy-while-trainee-involvement-has-negative-effects-on-patient-comfort
#3
Brian P H Chan, Amanda Hussey, Natalie Rubinger, Lawrence C Hookey
Introduction : Patient comfort is an important part of endoscopy and reflects procedure quality and endoscopist technique. Using the validated, Nurse Assisted Patient Comfort Score (NAPCOMS), this study aimed to determine whether the introduction of NAPCOMS would affect sedation use by endoscopists. Patients and methods : The study was conducted over 3 phases. Phase One and Two consisted of 8 weeks of endoscopist blinded and aware data collection, respectively...
December 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29216524/multiple-fatalities-in-the-north-of-england-associated-with-synthetic-fentanyl-analogue-exposure-detection-and-quantitation-a-case-series-from-early-2017
#4
Laura Hikin, Paul R Smith, Eleanor Ringland, Simon Hudson, Stephen R Morley
BACKGROUND: Synthetic fentanyl analogues are highly potent opioid drugs which have no pharmaceutical use in humans. We detected the synthetic fentanyl analogues; carfentanil, butyryl fentanyl, fluorobutyrylfentanyl, furanylfentanyl, and alfentanil as well as fentanyl itself in 25 cases in early 2017. There have been no previous reports of synthetic fentanyl deaths in the United Kingdom (UK). METHODS: Cases in which the history clearly stated drug use but where a post mortem blood morphine concentration was lower than would be expected to explain the sudden death, were referred for further analysis by high resolution accurate mass (HRAM) mass spectrometry...
November 29, 2017: Forensic Science International
https://www.readbyqxmd.com/read/29213283/lateral-supratrochanteric-approach-to-sciatic-and-femoral-nerve-blocks-in-children-a-feasibility-study
#5
Andrew A Albokrinov, Ulbolhan A Fesenko, Taras B Huz, Valentyna M Perova-Sharonova
Background: Sciatic and femoral nerve blocks (SNB and FNB) result in effective lower limb analgesia. Classical SNB and FNB require patient repositioning which can cause pain and discomfort. Alternative approaches to sciatic and femoral nerve blocks in supine patients can be useful. Materials and Methods: Neurostimulator-guided SNB and FNB from the lateral supratrochanteric approach were performed. Local anesthetic spread in SNB and FNB after radiographic opacification was analyzed...
2017: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/29211971/sold-as-heroin-perceptions-and-use-of-an-evolving-drug-in-baltimore-md
#6
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/29210063/opioid-induced-inhibition-of-the-human-serotonin-and-norepinephrine-transporters-in-vitro-link-to-clinical-reports-of-serotonin-syndrome
#7
Anna Rickli, Evangelia Liakoni, Marius C Hoener, Matthias E Liechti
BACKGROUND AND PURPOSE: Opioids may inhibit the serotonin and norepinephrine transporters (SERT and NET, respectively). NET inhibition may contribute to analgesia, and SERT inhibition or interactions with serotonin receptors may cause serotonergic toxicity. However, the effects of different opioids on the human SERT, NET, and serotonin receptors have not been sufficiently studied. EXPERIMENTAL APPROACH: We determined the potencies of different opioids to inhibit the SERT and NET in vitro using human transporter-transfected cells...
December 6, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/29207811/comparative-evaluation-of-ropivacaine-and-fentanyl-versus-ropivacaine-and-fentanyl-with-clonidine-for-postoperative-epidural-analgesia-in-total-knee-replacement-surgery
#8
Shivali Panwar, Preeti S Govind, Parag Jyoti Duarah, Hari Kishan Mahajan, Smita Anil Korde
Introduction: Clonidine an alpha 2 adrenoceptor agonist possesses analgesic properties and has been used as an adjuvant in epidural analgesia. The addition of clonidine to other analgesics may result in enhanced analgesia through additive mechanisms or synergistic mechanisms. The enhanced analgesia may lead to a decrease in the dosage of analgesic drugs along with reduction of side effects. Aim: The purpose of this study was to evaluate the effect of adding clonidine to epidural ropivacaine and fentanyl mixture in terms of quality of analgesia and side effects in patients of total knee replacement surgery...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29207810/comparative-study-of-the-effect-of-dexmedetomidine-vs-fentanyl-on-haemodynamic-response-in-patients-undergoing-elective-laparoscopic-surgery
#9
Jayshree P Vaswani, Debasis Debata, Varsha Vyas, Surekha Pattil
Introduction: Dexmedetomidine and fentanyl, both have sedative and analgesic effects. They are often used as adjunct during anaesthesia to attenuate pressor response during tracheal intubation. Limited study has been done comparing the effect of both drugs on haemodynamic response in patients undergoing laparoscopic surgery. Aim: The study was designed to compare the effect of dexmedetomidine Vs fentanyl on haemodynamic response to tracheal intubation, following pneumoperitoneum and intraoperative period in patients undergoing laparoscopic surgery...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29205811/prehospital-analgesic-choice-in-injured-patients-does-not-impact-on-rates-of-vomiting-experience-from-a-new-south-wales-primary-retrieval-service
#10
Michael Zhang, Timothy Cowan, John-Paul Smiles, Mary Morgan, Jessica Armstrong, Chinky Goswami, Claire Sewell
OBJECTIVE: This study aimed to explore the analgesic regimes adopted in our contemporary retrieval practice and the incidence of vomiting in ED after prehospital analgesic use. METHOD: A retrospective review was conducted on trauma patients retrieved by the Hunter Primary Retrieval Service in the Hunter New England Local Health District, New South Wales, Australia, during 2015. RESULTS: Of the 379 patients attended by the service in 2015, 196 of them (mean age 38...
December 4, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29202454/fentanyl-related-designer-drugs-w-18-and-w-15-lack-appreciable-opioid-activity-in-vitro-and-in-vivo
#11
Xi-Ping Huang, Tao Che, Thomas J Mangano, Valerie Le Rouzic, Ying-Xian Pan, Michael D Cameron, Michael H Baumann, Gavril W Pasternak, Bryan L Roth
W-18 (4-chloro-N-[1-[2-(4-nitrophenyl)ethyl]-2-piperidinylidene]-benzenesulfonamide) and W-15 (4-chloro-N-[1-(2-phenylethyl)-2-piperidinylidene]-benzenesulfonamide) represent two emerging drugs of abuse chemically related to the potent opioid agonist fentanyl (N-(1-(2-phenylethyl)-4-piperidinyl)-N-phenylpropanamide). Here, we describe the comprehensive pharmacological profiles of W-18 and W-15, as examination of their structural features predicted that they might lack opioid activity. We found W-18 and W-15 to be without detectible activity at μ, δ, κ, and nociception opioid receptors in a variety of assays...
November 16, 2017: JCI Insight
https://www.readbyqxmd.com/read/29201964/intravenous-lidocaine-compared-to-fentanyl-in-renal-colic-pain-management-a-randomized-clinical-trial
#12
Hassan Motamed, Mohammadreza Maleki Verki
Introduction: Using alpha blockers such as intravenous (IV) lidocaine has been deemed effective in controlling acute pain. Therefore, the current study was designed with the aim of evaluating the efficiency of IV lidocaine in comparison to IV fentanyl in pain management of patients with renal colic in emergency department (ED). Methods: In this double blind clinical trial, 18-65 year old patients that presented to ED with colicky flank pain and met the inclusion criteria of the study were allocated to either lidocaine or fentanyl group using block randomization and compared regarding pain severity 5, 10, 15, and 30 minutes after drug administration...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/29201847/the-efficacy-of-fentanyl-transdermal-patch-as-the-first-line-medicine-for-the-conservative-treatment-of-osteoporotic-compression-fracture
#13
June Ho Choi, Hui Dong Kang, Jin Hoon Park, Bon Sub Gu, Sang Ku Jung, Se Hyun Oh
Objective: There are no strong guidelines on how long or how we should undertake conservative treatment during the acute period of an osteoporotic vertebral compression fracture (VCF). Methods: We treated 202 patients with conservative treatment on VCF from March 2012 to August 2015. On inclusion criteria, 75 patients (22 males and 53 females) were included in the final analysis. After admission, a transdermal fentanyl patch with low dose (12.5 µg) application was attempted in all patients...
October 2017: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29200828/fentanyl-induced-respiratory-depression-is-attenuated-in-pregnant-patients
#14
Xiaofei Cao, Shijiang Liu, Jie Sun, Min Yu, Yin Fang, Zhengnian Ding
Background: Respiratory depression is a complication of intravenous fentanyl administration. The effect of pregnancy on respiratory depression following opioid administration is unclear. This study investigated the effect of pregnancy on fentanyl-induced respiratory depression. Patients and methods: Female patients were divided into three groups (n=20 per group): control group (non-pregnant and scheduled for laparoscopic surgery), early pregnancy group (pregnant for 45-60 days and scheduled for abortion), and postpartum group (5-7 days postpartum scheduled for complete curettage of uterine cavity)...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29200369/anesthetic-management-of-a-patient-with-a-history-of-rhabdomyolysis-for-dental-treatment
#15
Hitomi Terasaki, Shinichi Ito
When general anesthesia is administered for patients considered at high risk for rhabdomyolysis, appropriate precautions are warranted. The use of suitable anesthetics, with attention to intravenous fluid management, electrolyte balance, respiration, and metabolism, should be addressed. We performed general anesthesia for dental treatment and biopsy for fibrous hyperplasia of the buccal mucosa in a patient with a history of rhabdomyolysis. We utilized thiamylal sodium, midazolam, rocuronium bromide, nitrous oxide, fentanyl, and remifentanil without using volatile anesthetics and propofol for this case...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/29200141/effects-of-the-introduction-of-intranasal-fentanyl-on-reduction-of-pain-severity-score-in-children-an-interrupted-time-series-analysis
#16
Bill Lord, Paul A Jennings, Karen Smith
OBJECTIVES: Children are at risk of inadequate analgesia due to paramedics' inexperience in assessing children and challenges in administering analgesics when the patient is distressed and uncooperative. This study reports on the outcome of a change to practice guidelines that added intranasal fentanyl and intramuscular morphine within a large statewide ambulance service. METHODS: This retrospective study included patients younger than 15 years treated by paramedics between January 2008 and December 2011...
December 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29200140/evaluating-the-implementation-barriers-of-an-intranasal-fentanyl-pain-pathway-for-pediatric-long-bone-fractures
#17
Tamara Arnautovic, Kathryn Sommese, Paul C Mullan, Steven Barron Frazier, Turaj Vazifedan, Dana Erikson Ramirez
OBJECTIVES: This study aimed to assess physician comfort, knowledge, and implementation barriers regarding the use of intranasal fentanyl (INF) for pain management in patients with long-bone fractures in a pediatric emergency department (ED) with an INF pain pathway. METHODS: A retrospective chart review was conducted of patients, 3 to 21 years old, in our ED with an International Classification of Diseases-9th Revision code for a long-bone fracture from September 1, 2013, to August 31, 2015...
December 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29199397/opioid-tolerance-and-urine-drug-testing-among-initiates-of-extended-release-or-long-acting-opioids-in-food-and-drug-administration-s-sentinel-system
#18
Marc R Larochelle, Noelle M Cocoros, Jennifer Popovic, Elizabeth C Dee, Cynthia Kornegay, Jing Ju, Judith A Racoosin
OBJECTIVE: A risk evaluation and mitigation strategy for extended-release and long-acting (ER/LA) opioid analgesics was approved by the Food and Drug Administration in 2012. Our objective was to assess frequency of opioid tolerance and urine drug testing for individuals initiating ER/LA opioid analgesics. DESIGN: Retrospective cohort study. SETTING: Sentinel, a distributed database with electronic healthcare data on >190 million predominantly commercially insured members...
September 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/29197801/in-contrast-to-morphine-buprenorphine-enhances-macrophage-induced-humoral-immunity-and-as-oxycodone-slightly-suppresses-the-effector-phase-of-cell-mediated-immune-response-in-mice
#19
Iwona Filipczak-Bryniarska, Katarzyna Nazimek, Bernadeta Nowak, Michael Kozlowski, Magdalena Wąsik, Krzysztof Bryniarski
BACKGROUND: Opioid receptors are commonly expressed on various immune cells, macrophages especially. Thus, these cells are prone to stimulation with opioids, which seems to be responsible for opioid-induced immunomodulatory effects. While morphine, fentanyl and methadone influence on mouse immune response was recently studied, little is known about the potential immunomodulatory impact of buprenorphine and oxycodone. AIM: The current research aimed to investigate the influence of buprenorphine and oxycodone on immune responses in mice under homeostatic conditions...
November 30, 2017: International Immunopharmacology
https://www.readbyqxmd.com/read/29197080/determination-of-the-optimal-programmed-intermittent-epidural-bolus-volume-of-bupivacaine-0-0625-with-fentanyl-2-%C3%AE-g-ml-1-at-a-fixed-interval-of-forty-minutes-a-biased-coin-up-and-down-sequential-allocation-trial
#20
P Zakus, C Arzola, R Bittencourt, K Downey, X Y Ye, J C Carvalho
The optimum time interval for 10 ml boluses of bupivacaine 0.0625% + fentanyl 2 μg.ml-1 as part of a programmed intermittent epidural bolus regimen has been found to be 40 min. This regimen was shown to be effective without the use of supplementary patient-controlled epidural analgesia boluses in 90% of women during the first stage of labour, although with a rate of sensory block to ice above T6 in 34% of women. We aimed to determine the optimum programmed intermittent epidural bolus volume at a 40 min interval to provide effective analgesia in 90% of women (EV90 ) during the first stage of labour, without the use of patient-controlled epidural analgesia...
December 2, 2017: Anaesthesia
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