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https://www.readbyqxmd.com/read/28429200/achalasia-it-is-not-all-black-and-white
#1
REVIEW
Santosh Sanagapalli, Rami Sweis
PURPOSE OF REVIEW: This review aims to shed light on subtleties of achalasia diagnosis, including potential pitfalls that may lead to errors. Optimal methods for assessment of disease severity and the relationship between achalasia and other motility disorders will also be reviewed with an emphasis on recent findings from the literature. RECENT FINDINGS: Adjunctive testing with viscous substances or larger water volumes should be used routinely as it improves the accuracy of achalasia diagnosis...
June 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28428748/resting-state-neuroimaging-and-neuropsychological-findings-in-opioid-use-disorder-during-abstinence-a-review
#2
REVIEW
Hada Fong-Ha Ieong, Zhen Yuan
Dependence to opiates, including illicit heroin and prescription pain killers, and treatment of the opioid use disorder (OUD) have been longstanding problems over the world. Despite intense efforts to scientific investigation and public health care, treatment outcomes have not significantly improved for the past 50 years. One reason behind the continuing use of heroin worldwide despite such efforts is its highly addictive nature. Brain imaging studies over the past two decades have made significant contribution to the understanding of the addictive properties as to be due in part to biological processes, specifically those in the brain structure and function...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28426507/peripartum-anesthetic-management-of-the-opioid-tolerant-or-buprenorphine-suboxone-dependent-patient
#3
Aileen Pan, Mark Zakowski
Opioid abuse and dependence continues to rise in both the general population and pregnancy, with opioid overdose deaths having quadrupled in the last 15 years. Illicit drug use in last 30 days of pregnancy was over 4% with almost 0.6% documented maternal opiate use at time of birth. The management of the opioid-tolerant, buprenorphine-dependent or methadone-dependent patient in the peripartum period is reviewed. Options for treatment of opioid dependence, acute pain management, and perioperative multimodal analgesia are discussed...
June 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28426471/advances-in-the-management-of-malignant-pleural-effusion
#4
Labib G Debiane, David E Ost
PURPOSE OF REVIEW: The current review describes the latest evidence in the management of malignant pleural effusions (MPE). RECENT FINDINGS: Daily drainage of indwelling pleural catheters achieved auto-pleurodesis at a higher rate compared with every-other-day drainage [0.47 vs. 0.24; difference in proportion of 0.23; 95% confidence interval (CI) 0.08-0.38; P = 0.003]. In patients with MPE undergoing talc pleurodesis, a large multicenter randomized clinical trial found that pain control with opiates vs...
April 19, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28425132/early-post-operative-management-after-lung-transplantation-results-of-an-international-survey
#5
Christopher S King, Vincent Valentine, Ashok Cattamanchi, Domingo Franco-Palacios, Oksana A Shlobin, A Whitney Brown, Ramesh Singh, Linda Bogar, Steven D Nathan
INTRODUCTION: Little data exists regarding optimal therapeutic strategies post-operatively after lung transplant (LTx). Current practice patterns rely on expert opinion and institutional experience resulting in non-uniform post-operative care. To better define current practice patterns, an international survey of LTx clinicians was conducted. METHODS: A 30-question survey was sent to transplant clinicians via email to the ISHLT open forum mailing list and directly to the chief transplant surgeon and pulmonologist of all LTx centers in the United States...
April 20, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28422795/trial-design-and-endpoint-evaluation-in-clinical-studies-addressing-chronic-back-pain
#6
Peter Staats
STUDY DESIGN: A review of the literature evaluating clinical trials of chronic back pain. OBJECTIVE: To assist physicians in assessing the quality of clinical trial data to make the most informed treatment decisions. SUMMARY OF BACKGROUND DATA: Chronic pain is a tremendous public health issue, affecting close to 100 million adults in the United States, and costs the American people billions of dollars. One traditional treatment approach, the long-term use of opiate medications, has recently come under intense scrutiny for problems with complications, diversion, abuse, addiction and lack of efficacy...
April 18, 2017: Spine
https://www.readbyqxmd.com/read/28422138/abnormal-resting-state-functional-connectivity-in-the-orbitofrontal-cortex-of-heroin-users-and-its-relationship-with-anxiety-a-pilot-fnirs-study
#7
Hada Fong-Ha Ieong, Zhen Yuan
Drug addiction is widely linked to the orbitofrontal cortex (OFC), which is essential for regulating reward-related behaviors, emotional responses, and anxiety. Over the past two decades, neuroimaging has provided significant contributions revealing functional and structural alternations in the brains of drug addicts. However, the underlying neural mechanism in the OFC and its correlates with drug addiction and anxiety still require further elucidation. We first presented a pilot investigation to examine local networks in OFC regions through resting-state functional connectivity (rsFC) using functional near-infrared spectroscopy (fNIRS) from eight abstinent addicts in a heroin-dependent group (HD) and seven subjects in a control group (CG)...
April 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28414682/a-left-main-coronary-artery-thrombus-presenting-as-a-non-st-elevation-mi
#8
U Ezema, D Daberkow, T Delord, L Guidry, N R Sells
INTRODUCTION: Left main coronary artery (LMCA); thrombus with an acute myocardial infarction identified with coronary angiography is a clinically rare condition with an extremely high mortality rate. We present a case of LMCA thrombus that presented as a non-ST elevation myocardial infarction (NSTEMI);. CASE: A 45-year-old woman with a history of tobacco use and hyperlipidemia presented with a complaint of 10/10 "hard pain" across her chest radiating to her left shoulder and breast which woke her from sleep...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28414664/gonococcal-endocarditis-the-gift-that-stops-giving-an-uncommon-presentation-of-a-common-disease
#9
G Olayemi, M Oferczak, A Elagizi, I El-Abbassi, M Eschete, J Crowe
INTRODUCTION: Gonorrhea is the 2nd most common sexually transmitted disease in the US with 800,000 cases of gonorrhea each year. Disseminated gonorrhea infection occurs in 0.5 percent - 3 percent of these patients and is more frequent in woman younger than 40 years of age. CASE: A 36 year old woman with a history of polysubstance abuse presented with 10 day history of feeling generally unwell. At presentation, vitals were remarkable for tachycardia and hypotension...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28412916/cannabis-epidemiological-neurobiological-and-psychopathological-issues-an-update
#10
Maria Antonietta De Luca, Gaetano Di Chiara, Cristina Cadoni, Daniele Lecca, Laura Orsolini, Duccio Papanti, John Corkery, Fabrizio Schifano
Cannabis is the illicit drug with both the largest current levels of consumption and the highest lifetime prevalence in the world. Across different countries, the prevalence of cannabis use varies according to the individual income, with the highest use reported in North America, Australia and Europe. Despite its 'soft drug' reputation, cannabis misuse may be associated with several acute and chronic adverse effects. The present article aims at reviewing several papers on epidemiological, neurobiological and psychopathological aspects of the use of cannabis...
April 13, 2017: CNS & Neurological Disorders Drug Targets
https://www.readbyqxmd.com/read/28411530/the-influence-of-intrapartum-opioid-use-on-breastfeeding-experience-at-6-weeks-post-partum-a-secondary-analysis
#11
Julie-Anne Fleet, Meril Jones, Ingrid Belan
OBJECTIVE: To examine breastfeeding experiences up to 6 weeks postpartum for mothers administered intranasal fentanyl, subcutaneous fentanyl or intramuscular pethidine for intrapartum analgesia. DESIGN: A secondary analysis was undertaken using the per-protocol dataset to examine the third phase of a larger randomised controlled trial. This phase of the study examined breastfeeding intention and experience from the first hour of birth to 6 weeks postpartum. Medical records were audited and women were contacted at 6 weeks postpartum to complete a telephone questionnaire...
April 3, 2017: Midwifery
https://www.readbyqxmd.com/read/28398354/global-genetic-variation-of-select-opiate-metabolism-genes-in-self-reported-healthy-individuals
#12
F R Wendt, G Pathak, A Sajantila, R Chakraborty, B Budowle
CYP2D6 is a key pharmacogene encoding an enzyme impacting poor, intermediate, extensive and ultrarapid phase I metabolism of many marketed drugs. The pharmacogenetics of opiate drug metabolism is particularly interesting due to the relatively high incidence of addiction and overdose. Recently, trans-acting opiate metabolism and analgesic response enzymes (UGT2B7, ABCB1, OPRM1 and COMT) have been incorporated into pharmacogenetic studies to generate more comprehensive metabolic profiles of patients. With use of massively parallel sequencing, it is possible to identify additional polymorphisms that fine tune, or redefine, previous pharmacogenetic findings, which typically rely on targeted approaches...
April 11, 2017: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/28397130/antidiarrheal-drug-therapy
#13
REVIEW
Lawrence R Schiller
INTRODUCTION: Acute diarrhea often runs a self-limited course and little by way of treatment is needed except for oral rehydration therapy. Chronic diarrhea poses a longer-term problem. If not treatable with specific therapy aimed at the underlying pathophysiology, chronic diarrhea often needs long-term symptomatic therapy. PURPOSE OF REVIEW: This paper aims to examine the options for symptomatic, nonspecific treatment of diarrhea. RECENT FINDINGS: The most frequently used therapies are opiate antidiarrheal drugs...
May 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28396932/comparison-of-analgaesia-with-lumbar-epidurals-and-lumbar-plexus-nerve-blocks-in-patients-receiving-multimodal-analgaesics-following-primary-total-hip-arthroplasty-a-retrospective-analysis
#14
N Robert Harvey, Bethany J Wolf, Eric D Bolin, Sylvia H Wilson
PURPOSE: Significant post-operative pain occurs after hip arthroplasty. In a prior study, lumbar plexus nerve blocks provided comparable analgaesia to lumbar epidurals; however, multimodal analgaesics were not used consistently. METHODS: This study assessed a randomly selected cohort of 48 patients undergoing primary hip arthroplasty who received a regional anaesthesia technique for post-operative pain. Twenty-four patients with lumbar epidurals and 24 with single-injection lumbar plexus nerve blocks were reviewed using electronic medical records...
April 11, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28394671/the-u-k-nice-2014-guidelines-for-osteoarthritis-of-the-knee-lessons-learned-in-a-narrative-review-addressing-inadvertent-limitations-and-bias
#15
Stephen Birch, Myeong Soo Lee, Nicola Robinson, Terje Alraek
Several systematic reviews suggest that acupuncture is effective for knee osteoarthritis (OA), and furthermore a safe and cost-effective treatment for this condition. A recent clinical practice guideline (CPG) from the National Institute for Health and Care Excellence (NICE), in the United Kingdom, recommended against the use of acupuncture on the grounds that the effect size (ES) in comparison with sham acupuncture is too small. Safety data were not considered in the review, in addition the levels of evidence for acupuncture against other recommended therapies were not compared...
April 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/28394056/putting-a-face-to-opiate-addiction-for-students-at-a-needle-exchange-programme
#16
Rolando Tringale, Jo Marie Reilly
No abstract text is available yet for this article.
May 2017: Medical Education
https://www.readbyqxmd.com/read/28393548/hiv-and-hcv-infection-among-opiate-dependent-patients-and-methadone-doses-the-proteus-study
#17
Carlos Roncero, Daniel Fuster, Raul Felipe Palma-Álvarez, Laia Rodriguez-Cintas, Nieves Martinez-Luna, F Javier Álvarez
Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) are prevalent infections in opiate-dependent patients. Opiate replacement treatment (ORT) with methadone or buprenorphine is associated with several important outcomes among patients with opiate dependence. However, little is known about outcomes in patients with HIV and/or HCV infections that are in ORT. Also, it is not well established whether the presence of HCV or HIV infection could be associated with higher methadone doses. This paper reanalyzes the database of PROTEUS study, using two principal variables: methadone dose and presence of HIV and/or HCV infection...
April 9, 2017: AIDS Care
https://www.readbyqxmd.com/read/28388932/the-efficacy-of-sodium-benzoate-as-an-adjunctive-treatment-in-early-psychosis-cadence-bz-study-protocol-for-a-randomized-controlled-trial
#18
Alex Ryan, Andrea Baker, Frances Dark, Sharon Foley, Anne Gordon, Sean Hatherill, Stephen Stathis, Sukanta Saha, George Bruxner, Martin Beckman, Drew Richardson, Michael Berk, Olivia Dean, John McGrath, Cadence Working Group, James Scott
BACKGROUND: Psychotic disorders affect up to 3% of the population and are often chronic and disabling. Innovation in the pharmacological treatment of psychosis has remained stagnant in recent decades. In order to improve outcomes for those with psychotic disorders, we present a protocol for the trial of a common food preservative, sodium benzoate, as an adjunctive treatment in early psychosis. METHODS: Persons experiencing early psychosis (n = 160) will be recruited through hospitals and community mental health services in Queensland, Australia...
April 7, 2017: Trials
https://www.readbyqxmd.com/read/28380057/specific-behavioral-and-cellular-adaptations-induced-by-chronic-morphine-are-reduced-by-dietary-omega-3-polyunsaturated-fatty-acids
#19
Joshua Hakimian, Ani Minasyan, Lily Zhe-Ying, Mariana Loureiro, Austin Beltrand, Camille Johnston, Alexander Vorperian, Nicole Romaneschi, Waleed Atallah, Fernando Gomez-Pinilla, Wendy Walwyn
Opiates, one of the oldest known drugs, are the benchmark for treating pain. Regular opioid exposure also induces euphoria making these compounds addictive and often misused, as shown by the current epidemic of opioid abuse and overdose mortalities. In addition to the effect of opioids on their cognate receptors and signaling cascades, these compounds also induce multiple adaptations at cellular and behavioral levels. As omega-3 polyunsaturated fatty acids (n-3 PUFAs) play a ubiquitous role in behavioral and cellular processes, we proposed that supplemental n-3 PUFAs, enriched in docosahexanoic acid (DHA), could offset these adaptations following chronic opioid exposure...
2017: PloS One
https://www.readbyqxmd.com/read/28379816/improving-family-medicine-with-thoughtful-research
#20
EDITORIAL
Anne Victoria Neale, Marjorie A Bowman, Dean A Seehusen
This issue is about improving primary health care outcomes, from behavioral health to opioid issues to diagnosing hypertension to providing hope for childhood obesity. It includes hints for integrating behavioral health and care managers into family medicine practices. Opiate prescribing practices vary considerably between Japan and the United States, with helpful insights for our opiate abuse epidemic. Suicidality is high among patients taking opiates. Diagnosing hypertension the recommended way is not easily accomplished...
March 2017: Journal of the American Board of Family Medicine: JABFM
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