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https://www.readbyqxmd.com/read/29048960/machine-learning-to-detect-prescription-opioid-abuse-promotion-and-access-via-twitter
#1
Tim K Mackey, Janani Kalyanam, Takeo Katsuki, Gert Lanckriet
OBJECTIVES: To deploy a methodology accurately identifying tweets marketing the illegal online sale of controlled substances. METHODS: We first collected tweets from the Twitter public application program interface stream filtered for prescription opioid keywords. We then used unsupervised machine learning (specifically, topic modeling) to identify topics associated with illegal online marketing and sales. Finally, we conducted Web forensic analyses to characterize different types of online vendors...
October 19, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/29047196/to-what-extent-do-data-from-pharmaceutical-claims-under-estimate-opioid-analgesic-utilisation-in-australia
#2
Natasa Gisev, Sallie-Anne Pearson, Emily A Karanges, Briony Larance, Nicholas A Buckley, Sarah Larney, Timothy Dobbins, Bianca Blanch, Louisa Degenhardt
PURPOSE: Although pharmaceutical claims are an essential data source for pharmacoepidemiological studies, these data potentially under-estimate opioid utilisation. Therefore, this study aimed to quantify the extent to which pharmaceutical claims from Australia's national medicines subsidy programs (Pharmaceutical Benefits Scheme [PBS] and Repatriation Schedule of Pharmaceutical Benefits [RPBS]) under-estimate prescription-only and total national opioid utilisation across time and for different opioids...
October 19, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29047128/onset-of-labour-epidural-analgesia-with-low-dose-bupivacaine-and-different-doses-of-fentanyl
#3
R Vedagiri Sai, S I Singh, F Qasem, D Nguyen, S Dhir, K Marmai, R Adam, P M Jones
This study investigated the effects of different doses of epidural fentanyl on the time to onset of epidural analgesia in women in early labour. We hypothesised that onset of epidural labour analgesia (the primary outcome defined as time in minutes from completion of epidural bolus to the first uterine contraction with a numeric pain rating scale [NPRS] score ≤ 3) would be faster with 100 μg of fentanyl epidural bolus compared with 20 μg or 50 μg. Epidural labour analgesia was initiated with 20 μg of fentanyl (F20 group), 50 μg (F50 group) or 100 μg (F100 group) along with 10 ml bupivacaine 0...
November 2017: Anaesthesia
https://www.readbyqxmd.com/read/29046775/effect-of-preoperative-incentive-spirometry-on-fentanyl-induced-cough-a-prospective-randomized-controlled-study
#4
Vipin Kumar Goyal, Suresh Kumar Bhargava, Birbal Baj
BACKGROUND: Fentanyl-induced cough (FIC) has a reported incidence of 13-65% on induction of anesthesia. Incentive spirometry (IS) creates forceful inspiration, while stretching pulmonary receptors. We postulated that spirometry just before the fentanyl (F) bolus would decrease the incidence and severity of FIC. METHODS: This study enrolled 200 patients aged 18-60 years and with American Society of Anesthesiologists status I or II. The patients were allocated to two groups of 100 patients each depending on whether they received preoperative incentive spirometry before fentanyl administration...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29046319/effect-of-intravenous-fentanyl-on-ticagrelor-absorption-and-platelet-inhibition-among-patients-undergoing-percutaneous-coronary-intervention-the-pacify-randomized-clinical-trial
#5
John W McEvoy, Khalil Ibrahim, Thomas S Kickler, William A Clarke, Rani K Hasan, Matthew J Czarny, Ali R Keramati, Rakesh R Goli, Travis P Gratton, Jeffrey A Brinker, Matthews Chacko, Chao-Wei Hwang, Peter V Johnston, Julie M Miller, Jeffrey C Trost, William R Herzog, Roger S Blumenthal, David R Thiemann, Jon R Resar, Steven P Schulman
Fentanyl is a potent opiate commonly administered during cardiac catheterization procedures in North America. The question of whether fentanyl could have adverse consequences in patients undergoing percutaneous coronary intervention (PCI) is raised by recent research demonstrating that intravenous morphine significantly delays the absorption of oral P2Y12 platelet inhibitors. The presumed mechanism is slowed gastric emptying. The single-center Platelet Aggregation with tiCagrelor Inhibition and FentanYl (PACIFY) trial randomized adults undergoing clinically-indicated elective coronary angiography to receive the procedure with or without intravenous fentanyl (NCT02683707)...
October 18, 2017: Circulation
https://www.readbyqxmd.com/read/29045280/sedation-practice-in-extracorporeal-membrane-oxygenation-treated-patients-with-acute-respiratory-distress-syndrome-a-retrospective-study
#6
Julian deBacker, Erik Tamberg, Laveena Munshi, Lisa Burry, Eddy Fan, Sangeeta Mehta
Our objective was to characterize sedation management in adult patients with severe respiratory distress syndrome (ARDS) treated with venovenous extracorporeal membrane oxygenation (VV-ECMO). We conducted a retrospective chart review of these patients treated at Toronto General Hospital between January 2012 and October 2015. Medications administered (sedative, analgesic, paralytic, and antipsychotic), sedation depth (Sedation Agitation Scale [SAS] score) delirium assessments, and mobilization were recorded daily...
October 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29045066/fatality-involving-ocfentanil-documented-by-identification-of-metabolites
#7
Nathalie Allibe, Camille Richeval, Mélodie Phanithavong, Amandine Faure, Delphine Allorge, François Paysant, Françoise Stanke-Labesque, Hélène Eysseric-Guerin, Jean-Michel Gaulier
New psychoactive substances (NPS) use has rapidly increased over the last decade, and in the last 4 years producers increasingly appear to be targeting non-controlled synthetic opioids, involving fentanyl derivatives such as ocfentanil (OcF). Identification of metabolites is of major importance in the context of NPS use as it could improve detection window in biological matrices in clinical and forensic intoxication cases. Hence, this work aims to report a fatality involving OcF documented by the identification of metabolites...
October 16, 2017: Drug Testing and Analysis
https://www.readbyqxmd.com/read/29042317/fentanyl-fentanyl-analogs-and-novel-synthetic-opioids-a-comprehensive-review
#8
REVIEW
Patil Armenian, Kathy T Vo, Jill Barr-Walker, Kara L Lynch
Deaths from opioid use are increasing in the US, with a growing proportion due to synthetic opioids. Until 2013, sporadic outbreaks of fentanyl and fentanyl analogs contaminating the heroin supply caused some deaths in heroin users. Since then, fentanyl has caused deaths in every state and fentanyl and its analogs have completely infiltrated the North American heroin supply. In 2014, the first illicit pills containing fentanyl, fentanyl analogs, and other novel synthetic opioids such as U-47700 were detected...
October 14, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/29038737/significant-bradycardia-in-critically-ill-patients-receiving-dexmedetomidine-and-fentanyl
#9
Channing Hui, Maria Cardinale, Balaji Yegneswaran
PURPOSE: To report a case series of three patients who developed significant bradycardia while receiving the combination of dexmedetomidine and fentanyl for sedation and analgesia. MATERIALS AND METHODS: This is a case series of patients obtained from a mixed medical, surgical, and cardiac ICU in a community teaching hospital. Three intubated patients receiving fentanyl and dexmedetomidine infusion developed sudden bradycardia requiring intervention. In all three cases, adjustments to therapy were required...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29037799/thermography-as-an-early-predictive-measurement-for-evaluating-epidural-and-femoral-sciatic-block-success-in-dogs
#10
Nina Küls, Karen J Blissitt, Darren J Shaw, Gudrun Schöffmann, Richard E Clutton
OBJECTIVE: To evaluate skin temperature increase as an early predictive measure for evaluating epidural and femoral-sciatic block success in dogs. STUDY DESIGN: Prospective clinical trial. ANIMALS: A total of 29 dogs undergoing orthopaedic surgery on one hindlimb. METHODS: Dogs were anaesthetized and placed into lateral recumbency with the affected limb uppermost and the coat was clipped. Baseline infrared thermographic images (T0) of the affected limb, of the paw pad of the affected leg and of the ipsilateral paw pad were taken...
March 25, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29036502/three-cases-of-fatal-acrylfentanyl-toxicity-in-the-united-states-and-a-review-of-literature
#11
Daniel C Butler, Kevin Shanks, George S Behonick, Dustin Smith, Susan E Presnell, Lee Marie Tormos
Fentanyl analogs pose a unique challenge for forensic pathologists and toxicologists. The extreme potency of these analogs results in minute blood, urine and vitreous concentrations that are technically difficult to identify. This in addition to their absence from standard drug screening may potentiate a setting of apparent drug overdose without an immediately identifiable source. The following case series illustrates three such encounters with acrylfentanyl, an analog whose presence has not yet been reported in the scientific literature in the United States...
September 28, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29034983/pleth-variability-index-can-predict-spinal-anaesthesia-induced-hypotension-in-patients-undergoing-caesarean-delivery
#12
S Kuwata, K Suehiro, T Juri, S Tsujimoto, A Mukai, K Tanaka, T Yamada, T Mori, K Nishikawa
BACKGROUND: Spinal anaesthesia carries a risk of hypotension. We hypothesized that pleth variability index and perfusion index would assess maternal volume status, and thus, allow identification of patients at higher risk of developing hypotension after spinal anaesthesia for caesarean delivery. METHODS: Fifty patients undergoing elective caesarean delivery were enrolled. All patients received spinal anaesthesia with 0.5% hyperbaric bupivacaine (10 mg) and fentanyl (10 mcg)...
October 16, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29033729/use-of-rocuronium-and-sugammadex-under-neuromuscular-transmission-monitoring-in-a-patient-with-multiple-sclerosis
#13
Chryssoula Staikou, Martina Rekatsina
Multiple sclerosis (MS) is a potentially disabling disease characterized by demyelinating lesions in the central nervous system. One of the anesthetic challenges encountered in surgical patients with MS is the management of neuromuscular blockade (NMB) and its reversal. We report a case of a 31-year-old female patient suffering from MS, who underwent gynecological surgery under general anesthesia with sevoflurane, fentanyl, and rocuronium which was successfully reversed with sugammadex. Neuromuscular transmission (NMT) monitoring was used to guide the intraoperative doses of rocuronium and also the reversal of NMB by the use of sugammadex to ensure a safe tracheal extubation...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033722/effect-of-intravenous-phenylephrine-infusion-on-dose-requirement-of-intrathecal-plain-levobupivacaine-for-cesarean-section-a-placebo-controlled-preliminary-study
#14
Asha Tyagi, Aanchal Kakkar, Namrata Niwal, Medha Mohta, Ashok Kumar Sethi
BACKGROUND: Phenylephrine infusion has been shown to decrease rostral spread of plain and hyperbaric local anesthetic (LA) when compared to ephedrine infusion. However, it does not result in higher dose requirement of hyperbaric LA for cesarean section. There is no trial evaluating the effect of phenylephrine infusion on ED50 of a plain intrathecal LA. METHODS: Pregnant patients with term uncomplicated singleton pregnancy undergoing elective cesarean section were given combined spinal-epidural anesthesia...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033716/transdermal-fentanyl-as-an-adjuvant-to-paravertebral-block-for-pain-control-after-breast-cancer-surgery-a-randomized-double-blind-controlled-trial
#15
Ahmed H Bakeer, Nasr M Abdallah
OBJECTIVE: The aim of this study is to investigate the effect of transdermal fentanyl (TDF) as an adjuvant to paravertebral block (PVB) for pain control after breast cancer surgery. PATIENTS AND METHODS: This randomized, double-blind trial included fifty females with breast cancer scheduled for surgery. They were randomly allocated into one of two equal groups. The TDF group used transdermal fentanyl patches (TFPs) 25 μg/h applied 10 h preoperative then PVB with 20 mL of bupivacaine 0...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29032916/combination-of-magnesium-sulphate-and-ropivacaine-epidural-analgesia-for-hip-arthroplasty-in-dogs
#16
Elena Lardone, Bruno Peirone, Chiara Adami
OBJECTIVE: The aim of this study was to determine whether lumbosacral epidural administration of magnesium sulphate added to ropivacaine prolongs and improves perioperative analgesia, without adverse effects on motor block duration or hind limb neurological function, in dogs undergoing hip arthroplasty. STUDY DESIGN: Investigator-blind, controlled, randomized, prospective clinical trial. ANIMALS: A group of 20 client-owned dogs undergoing hip arthroplasty were allocated randomly to either group C (control, 1 mg kg(-1)epidural ropivacaine) or group M (magnesium, epidural injection of 1 mg kg(-1) ropivacaine and 2 mg kg(-1)magnesium sulphate)...
June 16, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29030938/opioid-use-disorder-and-misuse-a-review-of-the-epidemiology-and-medical-implications-for-pediatric-anesthesiologists
#17
REVIEW
Emily Knipper, Caleb J Banta-Green, Nathalia Jimenez
This educational review presents an overview of opioid use disorder, misuse and overdose among adolescents, and the clinical implications for anesthesiologists. It provides definitions, discusses the epidemiology worldwide, (focusing on North America), and emphasizes the clinical implications of patients with chronic opioid exposure, including perioperative pain management, as well as opioid overdose and prolonged use of opioids after acute exposure. In the USA, opioid use disorder and negative outcomes related to opioids rose dramatically from 1999-2010; concomitantly heroin use and fatal overdoses have increased as heroin use is associated with the disordered use of licit opioids...
November 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29029797/comparison-of-intravenous-dexketoprofen-trometamol-fentanyl-and-paracetamol-in-the-treatment-of-patients-admitted-to-the-emergency-department-for-renal-colic-a-randomized-controlled-trial
#18
Behcet Al, Mehmet Mustafa Sunar, Suat Zengin, Mustafa Sabak, Mustafa Bogan, Basri Can, Seval Kul, M Murat Oktay, Sevki Hakan Eren
OBJECTIVE: In this study, we aimed to compare the analgesic efficacy of intravenous dexketoprofen trometamol, fentanyl, and paracetamol in patients presenting to the emergency department with renal colic. MATERIALS AND METHOD: Data obtained from the emergency departments of Gaziantep University's Hospital for Research and Practice along with two other state hospitals in Gaziantep, Turkey between January 2016 and January 2017 was used for this study. A total of three hundred patients (n=300), who presented to the ER with complaints most common to renal colic whose diagnoses were subsequently confirmed with Computerized Tomography were included in the study...
September 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29027653/comparison-of-dexmedetomidine-and-fentanyl-to-prevent-haemodynamic-response-to-skull-pin-application-in-neurosurgery-double-blind-randomized-controlled-trial
#19
Cattleya Thongrong, Pannawat Sirikannarat, Pornthep Kasemsiri, Pichayen Duangthongphon
BACKGROUND: Skull pin application during craniotomy is a highly noxious stimulus. Therefore, the attenuated effect between dexmedetomidine and fentanyl was investigated. METHOD: A randomized, double-blind controlled trial included sixty patients, randomly allocated into groups A and B. After patients entered the operative room, blood pressure and heart rate were measured (T1). At 5 minutes after propofol induction (T2), group A received dexmedetomidine 1 µg kg⁻¹ whereas group B received normal saline...
October 13, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29027301/challenges-of-post-authorization-safety-studies-lessons-learned-and-results-of-a-french-study-of-fentanyl-buccal-tablet
#20
REVIEW
Natalie Gavrielov-Yusim, Ilda Bidollari, Sigal Kaplan, Netta Bartov
PURPOSE: Recruiting and retaining participants in real-world studies that collect primary data are challenging. This article illustrates these challenges using a post-authorization safety study (PASS) to assess adverse events (AEs) experienced with fentanyl buccal tablet (FBT) over 3 months of treatment. METHODS: This was an observational, prospective, multicenter study in France conducted over 1 year. The study employed primary data collection in FBT-treated patients and their treating physicians via a site qualification questionnaire and patient log completed by physicians and a questionnaire and pain diary completed by patients...
October 13, 2017: Pharmacoepidemiology and Drug Safety
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