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https://www.readbyqxmd.com/read/28526156/essential-elements-of-multimodal-analgesia-in-enhanced-recovery-after-surgery-eras-guidelines
#1
REVIEW
Anair Beverly, Alan D Kaye, Olle Ljungqvist, Richard D Urman
Perioperative multimodal analgesia uses combinations of analgesic medications that act on different sites and pathways in an additive or synergistic manner to achieve pain relief with minimal or no opiate consumption. Although all medications have side effects, opiates have particularly concerning, multisystemic, long-term, and short-term side effects, which increase morbidity and prolong admissions. Enhanced recovery is a systematic process addressing each aspect affecting recovery. This article outlines the evidence base forming the current multimodal analgesia recommendations made by the Enhanced Recovery After Surgery Society (ERAS)...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28522270/lumbar-microdiscectomy-as-a-day-case-procedure-scope-for-improvement
#2
Neeraj Ahuja, Himanshu Sharma
BACKGROUND AND PURPOSE: There are no significant differences in outcomes between patients receiving inpatient and day-case lumbar microdiscectomy, but the latter is still underused in the NHS. Here we aimed to identify factors contributing to successful same-day discharge in day-case patients. METHODS: This was a retrospective observational study of patients undergoing elective lumbar microdiscectomy between August 2012 and December 2014. Age, gender, day of surgery, distance to hospital, ASA grade, regular opiate use, smoking status, order on the operating list, and side and level of surgery were examined by logistic regression to assess their influence on same-day discharge...
May 15, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28521781/telling-our-stories-heroin-assisted-treatment-and-snap-activism-in-the-downtown-eastside-of-vancouver
#3
Susan Boyd, Dave Murray, Donald MacPherson
BACKGROUND: This article highlights the experiences of a peer-run group, SALOME/NAOMI Association of Patients (SNAP), that meets weekly in the Downtown Eastside of Vancouver, British Columbia, Canada. SNAP is a unique independent peer- run drug user group that formed in 2011 following Canada's first heroin-assisted treatment trial (HAT), North America Opiate Medication Initiative (NAOMI). SNAP's members are now made up of former research participants who participated in two heroin-assisted trials in Vancouver...
May 18, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/28520273/efficacy-of-a-targeted-drug-delivery-on-demand-bolus-option-for-chronic-pain
#4
Robert B Bolash, Tariq Niazi, Meera Kumari, Gerges Azer, Nagy Mekhail
BACKGROUND AND OBJECTIVES: Intrathecal targeted drug delivery systems historically required a physician's office visits for dose adjustment to manage fluctuating pain. A wireless device now enables patients to supplement their basal intrathecal infusion with a programmed on-demand bolus dose. We sought to quantify the change in oral breakthrough opioid need associated with the use of an intrathecal bolus in comparison to those treated with the basal infusion alone. METHODS: Demographic, dosage, bolus usage and longevity data were extracted from the historical medical record of 69 patients (18/51 bolus/non-bolus) followed continuously at our center...
May 18, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28519244/neonatal-abstinence-syndrome-update-on-diagnostic-and-therapeutic-strategies
#5
Genny Raffaeli, Giacomo Cavallaro, K Karel Allegaert, Enno Diederik Wildschut, Monica Fumagalli, Massimo Agosti, Dick Tibboel, Fabio Mosca
Substance use among pregnant women is a major public health issue. Both prescription opioid use and illicit opioid abuse have increased dramatically in recent years. Prolonged in utero drug exposure may result in neonatal abstinence syndrome (NAS), an acute multisystemic clinical entity that occurs in the first days of life. This syndrome is caused by abrupt discontinuation of fetal exposure to licit or illicit drugs chronically consumed by the mother during pregnancy and transmitted to the fetus through the placenta...
May 18, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28516444/toxicological-analysis-of-opiates-from-alternative-matrices-collected-from-an-exhumed-body
#6
Marta Cippitelli, Dora Mirtella, Giovanni Ottaviani, Giovanna Tassoni, Rino Froldi, Mariano Cingolani
In this case study, the body of a 45-year-old man was exhumed after 1 year at the request of the public prosecutor to assess whether the death was caused by drug consumption. Toxicological analyses were performed on several matrices, including liver, kidney, and the alternative matrices hair and teeth. The systematic toxicological analysis (STA), which consisted of basic and acid liquid/liquid extraction and gas chromatography-mass spectrometry (GC-MS) analysis, showed the presence of opiates in each of the matrices analyzed...
May 18, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28511485/spiritual-well-being-and-associated-factors-with-relapse-in-opioid-addicts
#7
Mohammad-Reza Noormohammadi, Masoud Nikfarjam, Fatemeh Deris, Neda Parvin
INTRODUCTION: Opioid dependence relapse is a complex and multidimensional problem, and lack of spiritual well-being is a major concern in opioid addicts. AIM: This study was conducted to determine spiritual well-being and factors associated with relapse among opioid addicts. MATERIALS AND METHODS: This cross-sectional study was conducted from April 2015 to September 2015. According to purposive sampling, 312 eligible addicted patients were enrolled in the study...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28511099/the-social-exigencies-of-the-gateway-progression-to-the-use-of-illicit-drugs-from-adolescence-into-adulthood
#8
Roy Otten, Chung Jung Mun, Thomas J Dishion
BACKGROUND: There is limited empirical integration between peer clustering theory and the Gateway framework. The goal of the present study was to test the hypothesis that friendship associations partly predict gateway escalations in the use of drugs from adolescence to adulthood. METHOD: This longitudinal study analyzed 3 waves of data from a community sample of 711 male and female participants without a history of illicit drug use reporting drug use at age 17, 22, and 27...
May 11, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28511097/the-relationship-between-social-desirability-bias-and-self-reports-of-health-substance-use-and-social-network-factors-among-urban-substance-users-in-baltimore-maryland
#9
Carl A Latkin, Catie Edwards, Melissa A Davey-Rothwell, Karin E Tobin
BACKGROUND: Social desirability response bias may lead to inaccurate self-reports and erroneous study conclusions. The present study examined the relationship between social desirability response bias and self-reports of mental health, substance use, and social network factors among a community sample of inner-city substance users. METHODS: The study was conducted in a sample of 591 opiate and cocaine users in Baltimore, Maryland from 2009 to 2013. Modified items from the Marlowe-Crowne Social Desirability Scale were included in the survey, which was conducted face-to-face and using Audio Computer Self Administering Interview (ACASI) methods...
May 9, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28510368/escalator-related-injuries-in-30-dogs-2007-2014
#10
Emma-Leigh Pearson, Megan Whelan, Kiko Bracker
OBJECTIVE: To describe a population of dogs affected by escalator-related injuries, and to characterize the types of injuries sustained and describe treatment administered. DESIGN: Retrospective study from March 2007 to November 2014. SETTING: Large urban referral and emergency facility. ANIMALS: Thirty client-owned dogs presenting with injuries acquired while riding an escalator. INTERVENTIONS: None...
May 16, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28509838/long-term-effect-of-a-stigma-reduction-educational-intervention-for-physician-assistants
#11
Kathleen Crapanzano, Richard J Vath
PURPOSE: Stigma towards people with substance use disorders is a common phenomenon with far reaching effects. This study evaluated the long-term effect of using an educational intervention on the attitudes of physician assistant students. METHODS: Physician assistant students received a one-week educational intervention focused on substance abuse. Changes in student attitudes were measured one year later using the Attitude to Mental Health Questionnaire (AMIQ). RESULTS: Significant and sustained improvement was noted in attitudes in the AMIQ score for the opiate use disorder vignette; no significant change was noted in the alcohol use disorder vignette...
June 2017: Journal of Physician Assistant Education
https://www.readbyqxmd.com/read/28505689/-pain-management-in-palliative-care
#12
Martin B Steins, Corinna Eschbach, Matthias Villalobos, Michael Thomas
A consistent pain management together with treatment of dyspnoea belongs to the main issues in symptom control in particular in palliative thoracic oncology. Together with the medicamentous therapy the psychologic and social circumstances of the affected patients have to be considered as factors influencing the experience of pain. The therapeutic fundament according to the WHO guideline for cancer pain is the opiate based medicamentous adjustment combined with non-opioids. In principle, this should be performed preferably orally, as simply as possible, according to a fix drug schedule and individually adjusted to the needed dosage...
May 2017: Pneumologie
https://www.readbyqxmd.com/read/28503117/opioids-resistance-in-chronic-pain-management
#13
REVIEW
Luigi A Morrone, Damiana Scuteri, Laura Rombolà, Hirokazu Mizoguchi, Giacinto Bagetta
Chronic pain management represents a serious healthcare problem worldwide. Chronic pain affects approximately 20% of the adult European population and is more frequent in women and older people. Unfortunately, its management in the community remains generally unsatisfactory and rarely under the control of currently available analgesics. Opioids have been used as analgesics for a long history and are among the most used drugs; however, while there is no debate over their short term use for pain management, limited evidence supports their efficacy of long-term treatment for chronic non-cancer pain...
April 2017: Current Neuropharmacology
https://www.readbyqxmd.com/read/28501425/the-effects-of-kratom-on-restraint-stress-induced-analgesia-and-its-mechanisms-of-action
#14
José Luis Vázquez López, Lorenz Schild, Thomas Günther, Stefan Schulz, Hartmud Neurath, Axel Becker
ETHNOPHARMACOLOGICAL RELEVANCE: Mitragyna speciosa and its extracts are called kratom (dried leaves, extract). They contain several alkaloids with an affinity for different opioid receptors. They are used in traditional medicine for the treatment of different diseases, as a substitute by opiate addicts, and to mitigate opioid withdrawal symptoms. Apart from their medical properties, they are used to enhance physical endurance and as a means of overcoming stress. PURPOSE: The aim of this study was to determine the mechanisms underlying the effects of kratom on restraint-stress-induced analgesia which occurs during or following exposure to a stressful or fearful stimulus...
May 10, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28496952/hiv-programs-in-iran-persia-iraq-and-saudi-arabia-a-brief-review-of-current-evidence-in-west-and-southwest-asia
#15
Omid Massah, Afsaneh Moradi, Ali Farhoudian, Mahmood Amini-Lari, Hassan Joulaei, Reza Daneshmand
BACKGROUND: In Western and Southwest Asia, literature is not documented on human immunodeficiency virus (HIV) programs in Iran, Iraq and Saudi Arabia. The present study is the first brief review that describes HIV programs in these three neighboring countries. METHODS: Data regarding the evidence of HIV programs were gathered through a systematic literature searching. English publications were retrieved through searching online scientific databases. Grey literature was also searched online...
July 2016: Addiction & Health
https://www.readbyqxmd.com/read/28496173/memories-of-opiate-withdrawal-emotional-states-correlate-with-specific-gamma-oscillations-in-the-nucleus-accumbens
#16
Cyril Dejean, Mathieu Sitko, Paul Girardeau, Amine Bennabi, Stéphanie Caillé, Martine Cador, Thomas Boraud, Catherine Le Moine
No abstract text is available yet for this article.
June 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28494389/breastfeeding-support-and-opiate-dependence-a-think-aloud-study
#17
Sonya MacVicar, Tracy Humphrey, Katrina E Forbes-McKay
OBJECTIVE: international guidelines recommend the promotion and protection of breastfeeding for the substance exposed mother and baby. Yet few studies have explored the facilitators, moderators and barriers to successful breastfeeding for women enrolled on opiate maintenance treatment, or suggested targeted support strategies. The aim of this study was to explore the views of women with opiate dependence on proposed elements for inclusion in a breastfeeding support intervention. DESIGN: a qualitative study using think aloud technique...
April 27, 2017: Midwifery
https://www.readbyqxmd.com/read/28494249/evaluation-of-problematic-psychoactive-substances-use-in-people-placed-in-police-custody
#18
Marie Gérardin, Gabriel Guigand, Laura Wainstein, Pascale Jolliet, Caroline Victorri-Vigneau, Renaud Clément
INTRODUCTION AND AIMS: In France, the law states that any person held in custody could be examined by a doctor. The main objective of the medical examination is to give medical evidence of health compatibility with custody. This review identifies health risks such as addictive behaviour. We wanted to know which psychoactive substances are used in this particular population, and how problematic these uses are. DESIGN AND METHODS: A prospective, monocentric, open-ended study conducted via a structured questionnaire was carried out on detainees who reported having taken drugs or illegal substances...
May 2, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28492416/cannabinoid-1-receptor-blockade-in-the-dorsal-hippocampus-prevents-the-reinstatement-but-not-acquisition-of-morphine-induced-conditioned-place-preference-in-rats
#19
Xin Zhao, Li Yao, Fang Wang, Han Zhang, Li Wu
The cannabinoid 1 receptors (CB1Rs) signaling is strongly linked to conditioned rewarding effects of opiates. Learned associations between environmental contexts and discrete cues and drug use play an important role in the maintenance and/or relapse of morphine addiction. Although previous studies suggest that context-dependent morphine treatment alters endocannabinoid signaling and synaptic plasticity in the hippocampus, the role of endocannabinoid in morphine conditioned place preference (CPP) and reinstatement remains unknown...
May 10, 2017: Neuroreport
https://www.readbyqxmd.com/read/28491463/-pro-dopamine-regulation-kb220z%C3%A2-as-a-long-term-therapeutic-modality-to-overcome-reduced-resting-state-dopamine-tone-in-opiate-opioid-epidemic-in-america
#20
K Blum, F Marcelo, K Dushaj, L Fried, R D Badgaiyan
Since it is known that relapse, morality, and hospitalizations have been tied to the presence of the Dopamine D2 Receptor A1 allele, as one example, and carriers of this gene variant have a proclivity to favor amino-acid therapy, it seems intuitive that the incorporation of modalities to provide a balance and or restoration of hypodopaminergia should be considered as a front-line tactic to overcome the current American opiate/opioid epidemic, saving millions from death and unwanted locked-in-addiction. If we continue down the prim road path of fighting addiction to narcotics with narcotics, we are doomed to fail...
September 2016: Journal of Systems and Integrative Neuroscience
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