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https://www.readbyqxmd.com/read/28092324/long-term-use-of-opioids-for-nonmalignant-pain-among-community-dwelling-persons-with-and-without-alzheimer-disease-in-finland-a-nationwide-register-based-study
#1
Aleksi Hamina, Heidi Taipale, Antti Tanskanen, Anna-Maija Tolppanen, Niina Karttunen, Liisa Pylkkänen, Jari Tiihonen, Sirpa Hartikainen
Persons with Alzheimer disease (AD) commonly present with chronic nonmalignant pain, but long-term use of opioids among this population has not been studied previously. Our aim was to investigate the prevalence of long-term (≥180 days) use of opioids for nonmalignant pain and associated factors among community-dwelling persons with AD and to compare the prevalence with a matched cohort without AD. The Medication use and Alzheimer's disease (MEDALZ) cohort was used for this study, comprising all community-dwelling persons diagnosed with AD in Finland during 2005 to 2011 and their matched comparison persons without AD...
February 2017: Pain
https://www.readbyqxmd.com/read/28091881/identifying-metabolites-of-meclonazepam-by-high-resolution-mass-spectrometry-using-human-liver-microsomes-hepatocytes-a-mouse-model-and-authentic-urine-samples
#2
Svante Vikingsson, Ariane Wohlfarth, Mikael Andersson, Henrik Gréen, Markus Roman, Martin Josefsson, Fredrik C Kugelberg, Robert Kronstrand
Meclonazepam is a benzodiazepine patented in 1977 to treat parasitic worms, which recently appeared as a designer benzodiazepine and drug of abuse. The aim of this study was to identify metabolites suitable as biomarkers of drug intake in urine using high-resolution mass spectrometry, authentic urine samples, and different model systems including human liver microsomes, cryopreserved hepatocytes, and a mice model. The main metabolites of meclonazepam found in human urine were amino-meclonazepam and acetamido-meclonazepam; also, minor peaks for meclonazepam were observed in three of four urine samples...
January 13, 2017: AAPS Journal
https://www.readbyqxmd.com/read/28090727/italian-patients-with-more-recent-onset-of-major-depressive-disorder-have-a-shorter-duration-of-untreated-illness
#3
Bernardo Dell'Osso, Laura Cremaschi, Benedetta Grancini, Francesca De Cagna, Beatrice Benatti, Giulia Camuri, Chiara Arici, Cristina Dobrea, Lucio Oldani, Maria Carlotta Palazzo, Matteo Vismara, A Carlo Altamura
BACKGROUND: Previous investigation on the duration of untreated illness (DUI) in patients with Major Depressive Disorder (MDD) revealed a different latency to first antidepressant treatment, with adverse consequences in terms of outcome for individuals with a longer DUI. Recent reports, moreover, documented a reduced DUI, as observed with the passage of time, in patients with different psychiatric disorders. Hence, the present study was aimed to assess DUI and related variables in a sample of Italian patients with MDD as well as to investigate potential differences in subjects with onset before and after 2000...
January 15, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28090524/the-samukeppra-study-in-prehospital-status-epilepticus-lessons-for-future-study
#4
COMMENT
Andrew C Schomer, Jaideep Kapur
In the Lancet Neurology article "Prehospital treatment with levetiracetam plus clonazepam or placebo plus clonazepam in status epilepticus (SAMUKeppra): a randomised, double-blind, phase 3 trial" the authors conducted a prehospital, randomized controlled study to determine which treatment is more effective for status epilepticus (SE): benzodiazepine alone, or in combination with levetiracetam (LEV). Although the study had negative results, several aspects of the trial design likely masked any added effect that LEV may have had in controlling SE, including: higher doses of benzodiazepines, lower thresholds for determining cessation of SE, and a smaller sample size...
December 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28080146/perceptions-vs-evidence-therapeutic-substitutes-for-antipsychotics-in-patients-with-dementia-in-long-term-care
#5
Brianne L Olivieri-Mui, John W Devlin, Aileen Ochoa, Danielle Schenck, Becky Briesacher
OBJECTIVE: To compare differences between clinician perceptions of therapeutic substitutes for antipsychotics prescribed to patients with dementia in long term care (LTC) and published evidence. METHODS: A mixed-methods approach that included a drug information search, online survey of 55 LTC clinicians and a comprehensive literature review was used. For 41 pharmacologic antipsychotic substitute candidates identified, LTC clinicians rated the likelihood they would substitute each for patients with dementia and identified non-pharmacologic antipsychotic substitutes...
January 12, 2017: Aging & Mental Health
https://www.readbyqxmd.com/read/28079605/delirium-in-critically-ill-children-an-international-point-prevalence-study
#6
Chani Traube, Gabrielle Silver, Ron W Reeder, Hannah Doyle, Emily Hegel, Heather A Wolfe, Christopher Schneller, Melissa G Chung, Leslie A Dervan, Jane L DiGennaro, Sandra D W Buttram, Sapna R Kudchadkar, Kate Madden, Mary E Hartman, Mary L deAlmeida, Karen Walson, Erwin Ista, Manuel A Baarslag, Rosanne Salonia, John Beca, Debbie Long, Yu Kawai, Ira M Cheifetz, Javier Gelvez, Edward J Truemper, Rebecca L Smith, Megan E Peters, A M Iqbal O'Meara, Sarah Murphy, Abdulmohsen Bokhary, Bruce M Greenwald, Michael J Bell
OBJECTIVES: To determine prevalence of delirium in critically ill children and explore associated risk factors. DESIGN: Multi-institutional point prevalence study. SETTING: Twenty-five pediatric critical care units in the United States, the Netherlands, New Zealand, Australia, and Saudi Arabia. PATIENTS: All children admitted to the pediatric critical care units on designated study days (n = 994). INTERVENTION: Children were screened for delirium using the Cornell Assessment of Pediatric Delirium by the bedside nurse...
January 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28079530/can-intoxication-status-be-used-as-a-prediction-tool-for-manner-of-death-a-comparison-of-the-intoxication-status-in-violent-suicides-and-homicides
#7
D Kimberley Molina, Veronica M Hargrove
Determining the manner of death in medicolegal death investigations can be difficult. The investigator relies on many facets of death investigation, including the circumstances of death and autopsy examination. A study was designed to analyze whether the intoxication status of the decedent could be used as another tool in death investigations. The intoxication status of violent (nonoverdose or poisoning) suicides and homicides was retrospectively reviewed and compared. A total of 625 deaths were identified, including 366 suicides and 259 homicides...
January 10, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28078633/benzodiazepine-use-and-risk-of-developing-alzheimer-s-disease-a-case-control-study-based-on-swiss-claims-data
#8
Fabienne A Biétry, Alena M Pfeil, Oliver Reich, Matthias Schwenkglenks, Christoph R Meier
BACKGROUND: A possible association between benzodiazepine use and Alzheimer's disease (AD) has been hypothesized in previous studies. OBJECTIVES: Using claims data from the Helsana Group, a large Swiss health insurance provider, we examined the association between previous benzodiazepine use and the risk of AD. METHODS: We conducted a matched case-control study and identified 1438 incident AD cases between 2013 and 2014 based on recorded first-time use of drugs used to treat AD [i...
January 11, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28078203/catatonia-our-current-understanding-of-its-diagnosis-treatment-and-pathophysiology
#9
REVIEW
Sean A Rasmussen, Michael F Mazurek, Patricia I Rosebush
Catatonia is a psychomotor syndrome that has been reported to occur in more than 10% of patients with acute psychiatric illnesses. Two subtypes of the syndrome have been identified. Catatonia of the retarded type is characterized by immobility, mutism, staring, rigidity, and a host of other clinical signs. Excited catatonia is a less common presentation in which patients develop prolonged periods of psychomotor agitation. Once thought to be a subtype of schizophrenia, catatonia is now recognized to occur with a broad spectrum of medical and psychiatric illnesses, particularly affective disorders...
December 22, 2016: World Journal of Psychiatry
https://www.readbyqxmd.com/read/28075519/an-update-of-management-of-insomnia-in-patients-with-chronic-orofacial-pain
#10
REVIEW
Galit Almoznino, Yaron Haviv, Yair Sharav, Rafael Benoliel
In this review we discuss the management of chronic orofacial pain (COFP) patients with insomnia. Diagnostic work-up and follow-up routines of COFP patients should include assessment of sleep problems. Management is based on a multidisciplinary approach, addressing the factors that modulate the pain experience as well as insomnia and including both non-pharmacological and pharmacological modalities. Parallel to treatment, patients should receive therapy for co-morbid medical and psychiatric disorders, and possible substance abuse that may be that may trigger or worsen the COFP and/or their insomnia...
January 11, 2017: Oral Diseases
https://www.readbyqxmd.com/read/28073923/what-to-do-when-patients-with-epilepsy-cannot-take-their-usual-oral-medications
#11
Anna M Bank, Jong Woo Lee, Patricia Krause, Aaron L Berkowitz
When people with epilepsy are hospitalised for medical or surgical conditions, they may be unable to take their home antiepileptic drugs (AEDs). Such 'nil by mouth' people with epilepsy require alternative AED regimens to prevent breakthrough seizures. Here, we describe several strategies for maintaining seizure control in patients with epilepsy who have medical or surgical contraindications to their home oral regimens. These strategies include using non-pill oral formulations, using an intravenous formulation of the patient's home AED(s), using a benzodiazepine bridge and/or using alternative intravenous AED(s) when there are no intravenous formulations...
January 10, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28073114/a-study-of-acute-poisoning-cases-admitted-to-the-university-hospital-emergency-department-in-tabriz-iran
#12
Mehdi Oraie, Mir-Jamal Hosseini, Mina Islambulchilar, Seyed-Hasan Hosseini, Mehdi Ahadi-Barzoki, Habib Sadr, Hashem Yaghoubi
Chemical substances have an important threat due to extensive use in medicine, agriculture, industry and environment. In this retrospective study, etiological and demographic characteristics of acute poisoning cases admitted to a hospital in Iran were investigated. We compared these data with those reported from other parts of the country and the international experiences to evaluate any difference if exists. 7 052 poisoned cases admitted to the hospital from April 2006 to March 2013, by data collected from the medical record in poison center section...
January 10, 2017: Drug Research
https://www.readbyqxmd.com/read/28072593/use-of-benzodiazepines-and-related-drugs-is-associated-with-a-risk-of-stroke-among-persons-with-alzheimer-s-disease
#13
Heidi Taipale, Marjaana Koponen, Antti Tanskanen, Piia Lavikainen, Anna-Maija Tolppanen, Reijo Sund, Jari Tiihonen, Sirpa Hartikainen
The aim of our study was to investigate the risk of any, ischemic, and hemorrhagic stroke associated with incident benzodiazepine and related drug (BZDR) use among community-dwelling individuals with Alzheimer's disease (AD). Data from the MEDALZ cohort including all community-dwelling persons newly diagnosed with AD between 2005 and 2011 in Finland were utilized. Incident BZDR users were identified with a 1-year washout period for previous use. Persons with a previous stroke were excluded, resulting in a final study sample of 45 050 individuals...
January 7, 2017: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28072037/benzodiazepine-maintenance-in-opiate-substitution-treatment-good-or-bad-a-retrospective-primary-care-case-note-review
#14
Adam Bakker, Emmanuel Streel
BACKGROUND: Co-prescribing benzodiazepines to patients in opiate substitution treatment is controversial and often alleged to increase mortality. In an inner-London general practice, patients with problematic benzodiazepine co-dependence were allowed benzodiazepine maintenance treatment (BMT) since 1994, providing an opportunity for analysis. METHOD: 1) Case-note review of all 278 opiate substitution treatment patients, accruing 1289 patient treatment years; 46% had concurrent BMT...
January 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28068983/a-comparison-of-two-psychiatric-service-approaches-findings-from-the-consultation-vs-liaison-psychiatry-study
#15
Caroline Lücke, Jürgen M Gschossmann, Alena Schmidt, Juliane Gschossmann, Alexandra Philomena Lam, Charlotte Elizabeth Schneider, Alexandra Philipsen, Helge H Müller
BACKGROUND: Psychiatric comorbidities are common in somatically ill patients. There is a lack of data that can provide clear insights into substantial comparative advantages of different Consultation/Liaison Psychiatry (CLP) services. METHODS: The Consultation versus Liaison Psychiatry-Study collected and analyzed data of 890 primarily somatically ill hospital inpatients presenting with psychiatric symptoms in a prospective observational study design. One group was treated via a liaison-model (LM) with regular consultation hours, the other via an on-demand-model (ODM) with individually requested consultations...
January 10, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28068610/spectroscopic-and-molecular-docking-approaches-for-investigating-conformation-and-binding-characteristics-of-clonazepam-with-bovine-serum-albumin-bsa
#16
Yan-Yue Lou, Kai-Li Zhou, Dong-Qi Pan, Jia-Le Shen, Jie-Hua Shi
Clonazepam, a type of benzodiazepine, is a classical drug used to prevent and treat seizures, panic disorder, movement disorder, among others. For further clarifying the distribution of clonazepam in vivo and the pharmacodynamic and pharmacokinetic mechanisms, the binding interaction between clonazepam and bovine serum albumin (BSA) was investigated using ultraviolet spectroscopy (UV), steady-state fluorescence spectroscopy, synchronous fluorescence spectroscopy, three-dimensional (3D) fluorescence spectroscopy, Fourier transform infrared spectroscopy (FT-IR) and molecular docking methods...
December 24, 2016: Journal of Photochemistry and Photobiology. B, Biology
https://www.readbyqxmd.com/read/28067201/false-negative-on-a-proven-involuntary-intoxication-in-two-children-with-lorazepam
#17
Catherine Feliu, Hélène Guillemin, Claire Gozalo, Aurélie Fouley, Hélène Marty, Hervé Millart, Zoubir Djerada
Children aged between 1 to 4 years are the most at risk of unintentional poisonings. Benzodiazepines are the most medicine often cause of the poisoning. Among the twenty-two most prescribed benzodiazepines in France, lorazepam ranks fifth behind zolpidem, alprazolam, bromazepam and zopiclone. However the automated assay currently available does not allow to detect and/or to quantify lorazepam. The alternative to the immunoassay is the liquid chromatography coupled with mass spectrometry (HPLC/MS). This technique, highly sensitive and specific, requires a pre-treatment phase and a good technical proficiency, justifying specialized staff...
January 9, 2017: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/28067180/dispensing-patterns-of-anxiolytics-and-sedative-hypnotics-a-feasibility-study-comparing-datasets-from-a-developed-and-developing-country-australia-and-south-africa
#18
Therése Kairuz, Ilse Truter, Laurence Rossato, Alex Pudmenzky
BACKGROUND: Dispensing patterns reflect drug usage trends. Benzodiazepines are known as drugs with potential for misuse, and frequent dispensing may be a surrogate marker of misuse. OBJECTIVE: The primary aim of this study was to obtain a comparative snapshot of anxiolytic and sedative-hypnotic dispensing in a developing country and a developed country, to determine whether further research about benzodiazepines is warranted. METHOD: A cross-national, cross-sectional retrospective drug utilisation study was conducted on benzodiazepines and z-drugs...
January 9, 2017: Current Drug Safety
https://www.readbyqxmd.com/read/28067060/update-on-pharmacotherapy-of-myoclonic-seizures
#19
Pasquale Striano, Vincenzo Belcastro
Myoclonic seizures are brief, involuntary muscular jerks arising from the central nervous system that can occur in different epilepsy syndromes, including idiopathic generalized epilepsies or the most severe group of epileptic encephalopathies. Valproate is commonly the first choice alone or in combination with some benzodiazepines or levetiracetam. However, more treatment options exist today as there is emerging evidence to support the efficacy of some newer antiepileptic drugs. In addition, of major importance remains avoidance of medications (e...
January 8, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28066107/anxiolytic-activity-of-aqueous-extract-of-camellia-sinensis-in-rats
#20
Rajeshwari Shastry, Sheetal Dinkar Ullal, Shreyas Karkala, Seema Rai, Akash Gadgade
OBJECTIVES: The present study was undertaken to evaluate anxiolytic effect of Camellia sinensis (CS) and possible mechanism on acute and chronic administration in rats. MATERIALS AND METHODS: Eight groups of rats with six in each group were used. Group I served as control. Group II received diazepam (1 mg/kg). Groups III, IV, and V received CS in doses of 3.3, 16.5, and 33 mg/kg, respectively. Three pharmacologically validated experimental models - elevated plus maze (EPM), light and dark box (LDB), and open field tests (OFT) - were employed...
November 2016: Indian Journal of Pharmacology
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