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Mahesh K B Parmar, John Strang, Louise Choo, Angela M Meade, Sheila M Bird
BACKGROUND AND AIMS: Naloxone is an opioid antagonist used for emergency resuscitation following opioid overdose. Prisoners with a history of heroin injection have a high risk of drug-related death soon after release from prison. The N-ALIVE pilot trial (ISRCTN34044390) tested feasibility measures for randomized provision of naloxone-on-release (NOR) to eligible prisoners in England. DESIGN: Parallel group randomized controlled pilot trial. SETTING: English prisons...
October 24, 2016: Addiction
Liting Deng, Wan-Hung Lee, Zhili Xu, Alexandros Makriyannis, Andrea G Hohmann
Neuropathic pain impacts approximately 3-4.5% of the global population and remains an unresolved health problem. The management of neuropathic pain has two distinct goals-prevention of development and control of established neuropathic pain. We examined the impact of both prophylactic and therapeutic treatments with the tricyclic antidepressant desipramine on the development and maintenance of toxic neuropathic pain induced by the chemotherapeutic agent paclitaxel. We also investigated the involvement of endogenous analgesic (i...
October 20, 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Shanta Islam, Md Shafiullah Shajib, Tajnin Ahmed
BACKGROUND: Celosia cristata Linn. (Amaranthaceae) is used in traditional medicine for the treatment of headache, sores, ulcers, eye inflammations, skin eruption, painful menstruation and carpal tunnel syndrome. This study was performed to evaluate the antinociceptive activity of methanol extract of the whole plant of C. cristata (MECC). METHODS: The evaluation of the antinociceptive effect of MECC was performed using thermal (hot plate, tail immersion test) and chemical (acetic acid, formalin, and glutamate-induced nociception test) pain models in mice at four different doses (50, 100, 200, 400 mg/kg; p...
October 22, 2016: BMC Complementary and Alternative Medicine
Daniel Kolinsky, Samuel M Keim, Brian G Cohn, Evan S Schwarz, Donald M Yealy
BACKGROUND: The current standards for domestic emergency medical services suggest that all patients suspected of opioid overdose be transported to the emergency department for evaluation and treatment. This includes patients who improve after naloxone administration in the field because of concerns for rebound toxicity. However, various emergency medical services systems release such patients at the scene after a 15- to 20-min observation period as long as they return to their baseline...
October 18, 2016: Journal of Emergency Medicine
Brett Wolfson-Stofko, Alex S Bennett, Luther Elliott, Ric Curtis
BACKGROUND: Though public bathroom drug injection has been documented from the perspective of people who inject drugs, no research has explored the experiences of the business managers who oversee their business bathrooms and respond to drug use. These managers, by default, are first-responders in the event of a drug overdose and thus of intrinsic interest during the current epidemic of opioid-related overdoses in the United States. This exploratory study assists in elucidating the experiences that New York City business managers have with people who inject drugs, their paraphernalia, and their overdoses...
October 18, 2016: International Journal on Drug Policy
Shehla Akbar, Fazal Subhan, Nasiara Karim, Muhammad Shahid, Nisar Ahmad, Gowhar Ali, Wajahat Mahmood, Khwaja Fawad
BACKGROUND: Diabetic neuropathy is the most prevalent, persistent and debilitating complication of diabetes mellitus often coupled with vulvodynia that may present as an isolated symptom or as a part of constellation of other neuropathic abnormalities. OBJECTIVE: Flavonoids have selective affinity for GABA receptors and 6-methoxyflavanone (6-MeOF) is a positive allosteric modulator of GABA responses at human recombinant GABAA receptors. GABAergic and opioidergic system inhibition have been shown to facilitate neuropathic pain...
October 17, 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Daniel S Budnitz, Maribeth C Lovegrove, Mathew R P Sapiano, Justin Mathew, Scott R Kegler, Andrew I Geller, Christian Hampp
Expanding access to office-based medication-assisted treatment with buprenorphine/naloxone for opioid dependence is a key part of the national strategy to address the opioid abuse epidemic (1). However, as buprenorphine/naloxone prescribing increased, emergency department (ED) visits and hospitalizations for unsupervised ingestions by young children began to increase, with buprenorphine/naloxone ingestions becoming the most common cause of hospitalization for medication ingestions by young children during 2010-2011 (2)...
October 21, 2016: MMWR. Morbidity and Mortality Weekly Report
Pamela Leece, Margaret Gassanov, Shaun Hopkins, Chantel Marshall, Peggy Millson, Rita Shahin
SETTING: A harm reduction program at a public health unit in Toronto, Ontario, between August 31, 2011 and August 31, 2013. INTERVENTION: We conducted a process evaluation of the first two years of an opioid overdose prevention and response program, Prevent Overdose in Toronto (POINT), including analysis of data from program documentation forms, as well as qualitative interviews with program staff, representatives from partner agencies, and program clients. OUTCOMES: In the first two years of the program, 662 individuals (52...
October 20, 2016: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Christopher Rowe, Eric Vittinghoff, Glenn-Milo Santos, Emily Behar, Caitlin Turner, Phillip Coffin
OBJECTIVES: Opioid overdose mortality has tripled in the USA since 2000 and opioids are responsible for more than half of all drug overdose deaths, which reached an all-time high in 2014. Opioid overdoses resulting in death, however, represent only a small fraction of all opioid overdose events and efforts to improve surveillance of this public health problem should include tracking nonfatal overdose events. International Classification of Disease (ICD) diagnosis codes, increasingly used for the surveillance of nonfatal drug overdose events, have not been rigorously assessed for validity in capturing overdose events...
October 20, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
F Creamer, A Balfour, S Nimmo, I Foo, J D Norrie, L J Williams, K C Fearon, H M Paterson
BACKGROUND: Combined oral modified-release oxycodone-naloxone may reduce opioid-induced postoperative gut dysfunction. This study examined the feasibility of a randomized trial of oxycodone-naloxone within the context of enhanced recovery for laparoscopic colorectal resection. METHODS: In a single-centre open-label phase II feasibility study, patients received analgesia based on either oxycodone-naloxone or oxycodone. Primary endpoints were recruitment, retention and protocol compliance...
October 20, 2016: British Journal of Surgery
Mari-Lynn Drainoni, Elisa A Koppelman, James A Feldman, Alexander Y Walley, Patricia M Mitchell, Jacqueline Ellison, Edward Bernstein
BACKGROUND: The increase in opioid overdose deaths has become a national public health crisis. Naloxone is an important tool in opioid overdose prevention. Distribution of nasal naloxone has been found to be a feasible, and effective intervention in community settings and may have potential high applicability in the emergency department, which is often the initial point of care for persons at high risk of overdose. One safety net hospital introduced an innovative policy to offer take-home nasal naloxone via a standing order to ensure distribution to patients at risk for overdose...
October 18, 2016: BMC Research Notes
Michael S Toce, Michele M Burns, Katherine A O'Donnell
CONTEXT: Exploratory buprenorphine ingestions in young children have been associated with clinically significant toxicity. However, detailed data on the clinical presentation and management of these patients are lacking. In an attempt to obtain more comprehensive data, we sought to examine a single center cohort of patients with report of buprenorphine exposure and provide descriptive analysis of rates of respiratory depression, time to respiratory depression, interventions, disposition, and outcomes...
October 19, 2016: Clinical Toxicology
Josef Donnerer, Ingrid Liebmann
Allyl isothiocyanate (AITC, mustard oil, 50-200 µmol/l), depending on specific dosages, inhibited the cholinergic twitch response in the longitudinal muscle-myenteric plexus (LMMP) strip of the guinea-pig ileum. AITC also induced short-lasting contractile responses, and decreases of the basal tone of the LMMP strip at low concentrations and increases at high concentrations. Hexamethonium, a blocker of nicotinic ganglionic transmission, was able to prevent the AITC-evoked inhibitory effect, an effect that was also observed with the opioid antagonist naloxone...
October 19, 2016: Pharmacology
Rebecca E Giglio, Guohua Li, Charles J DiMaggio
The objective of this review was to assess the effectiveness of bystander naloxone administration and overdose education programs by synthesizing quantitative results reported in the research literature. Studies meeting predefined criteria were identified and reviewed, and their results were synthesized through meta-analysis. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for overdose recoveries for individuals who received naloxone dispensed by non-medical community members, and the standardized mean difference was calculated for test scores of non-medical volunteers who received training in overdose management versus the scores of untrained volunteers...
December 2015: Injury Epidemiology
Taddesse Yayeh, Kyunghwa Yun, Soyong Jang, Seikwan Oh
BACKGROUND: Red ginseng and ginsenosides have shown plethoric effects against various ailments. However, little is known regarding the effect of red ginseng on morphine-induced dependence and tolerance. We therefore investigated the effect of red ginseng extract (RGE) and biotransformed ginsenosides Rh2, Rg3, and compound K on morphine-induced dependence in mice and rats. METHODS: While mice were pretreated with RGE and then morphine was injected intraperitoneally, rats were infused with ginsenosides and morphine intracranially for 7 days...
October 2016: Journal of Ginseng Research
Andrew Kestler, Jane Buxton, Gray Meckling, Amanda Giesler, Michelle Lee, Kirsten Fuller, Hong Quian, Dalya Marks, Frank Scheuermeyer
STUDY OBJECTIVE: Although the World Health Organization recommends take-home naloxone to address the increasing global burden of opioid-related deaths, few emergency departments (EDs) offer a take-home naloxone program. We seek to determine the take-home naloxone acceptance rate among ED patients at high risk of opioid overdose and to examine factors associated with acceptance. METHODS: At a single urban ED, consecutive eligible patients at risk of opioid overdose were invited to complete a survey about opioid use, overdose experience, and take-home naloxone awareness, and then offered take-home naloxone...
October 10, 2016: Annals of Emergency Medicine
Janie Simmons, Sonali Rajan, Lloyd Goldsamt, Luther Elliott
BACKGROUND: This article reports on the first web-based implementation of an opioid-overdose prevention, recognition and response training for professional first responders. The training was disseminated nationally over one listserv in November 2014. The same year, following Act 139, which mandated the provision of an online training for police officers in Pennsylvania, the Pennsylvania Department of Health approved the training. It was subsequently adopted as the primary training tool for police and other first responders in Pennsylvania and has been used as a training tool by first responders nationally...
October 11, 2016: Drug and Alcohol Dependence
Romain Lefaucheur, Axel Lebas, Emmanuel Gérardin, Lou Grangeon, Ozlem Ozkul-Wermester, Carole Aubier-Girard, Olivier Martinaud, David Maltête
A 29-year-old man was admitted for acute cognitive impairment. Three weeks earlier, he had been admitted for coma due to sniffed heroin abuse responsive to naloxone infusion. At admission, the patient presented with apraxia, severe memory impairment and anosognosia. Brain MRI revealed symmetric hyperintensities of supratentorial white matter, sparing brainstem and cerebellum, on FLAIR and B1000 sequences. Four months later, repeated neuropsychological assessment revealed dramatic improvement of global cognitive functions...
October 11, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Mohammadali Nikoo, Nooshin Nikoo, Sanam Javid, Afshar Amiri, Marc Vogel, Fiona Choi, Amir Ali Sepehry, Amir Hooshang Bagheri Valoojerdi, Kerry Jang, Christian Schütz, Shahin Akhondzadeh, Michael Krausz
BACKGROUND AND AIMS: Recently, there has been a growing interest in using Opium Tincture (OT) for treating opioid dependence in certain regions. We aimed to assess the evidence on its safety and efficacy for this indication. METHODS: We searched several databases (CENTRAL, Medline, EMBASE, Web of Science, PsychINFO, ProQuest Dissertation & Theses Database, Iran Medex,, and with no language or publication date limitations. Two reviewers selected Randomized Controlled Trials (RCT), cohort /case-control/ cross-sectional studies and case-series on safety or efficacy of OT for treating opioid dependence and then extracted reported measures of mentioned outcomes from selected studies...
October 14, 2016: Addiction
Koichi Morisaki, Takuya Matsumoto, Yutaka Matsubara, Kentaro Inoue, Yukihiko Aoyagi, Daisuke Matsuda, Shinichi Tanaka, Jun Okadome, Yoshihiko Maehara
We herein report a case of a rare complication of spinal cord ischemia (SCI) following endovascular aneurysm repair (EVAR). Computed tomography showed stenosis and calcification of bilateral iliac arteries and a saccular aneurysm of the terminal aorta. Paraplegia occurred soon after balloon angioplasty of iliac arteries and EVAR. Cerebrospinal fluid drainage was not performed because the patient was on dual antiplatelet drugs. The patient was treated with intravenous methylpredonisolone and naloxone; however, this did not improve his paraplegia...
2016: Annals of Vascular Diseases
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