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Neonatal abstinence syndrome

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https://www.readbyqxmd.com/read/28320034/variations-in-infant-cyp2b6-genotype-associated-with-the-need-for-pharmacological-treatment-for-neonatal-abstinence-syndrome-in-infants-of-methadone-maintained-opioid-dependent-mothers
#1
Helen Mactier, Poppy McLaughlin, Cheryl Gillis, Michael David Osselton
Background Neonatal abstinence syndrome (NAS) in infants of methadone-maintained opioid-dependent (MMOD) mothers cannot be predicted in individual cases. We investigated whether variation in infant genotype is associated with severity of NAS. Methods This is a pilot observational cohort study of 21 MMOD mothers and their newborns. Infant buccal swabs were obtained soon after delivery, together with a maternal blood sample for the determination of maternal plasma methadone concentration. Genomic variation in five opioid-related genes (ABCB1, COMT, CYP2B6, CYP2D6, and OPRM1) was ascertained from infant buccal swabs and related to need for pharmacological treatment of NAS...
March 20, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28281336/enhancing-care-for-infants-with-neonatal-abstinence-syndrome-an-evidence-based-practice-approach-in-a-rural-midwestern-region
#2
Christy L Cook, Shannon K Dahms, Sonja J Meiers
This column shares the best evidence-based strategies and innovative ideas on how to facilitate the learning and implementation of EBP principles and processes by clinicians as well as nursing and interprofessional students. Guidelines for submission are available at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1741-6787.
March 9, 2017: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/28278146/cdc-grand-rounds-public-health-strategies-to-prevent-neonatal-abstinence-syndrome
#3
Jean Y Ko, Sara Wolicki, Wanda D Barfield, Stephen W Patrick, Cheryl S Broussard, Kimberly A Yonkers, Rebecca Naimon, John Iskander
Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome that most commonly occurs in infants after in utero exposure to opioids, although other substances have also been associated with the syndrome (1). NAS usually appears within 48-72 hours of birth with a constellation of clinical signs, including central nervous system irritability (e.g., tremors), gastrointestinal dysfunction (e.g., feeding difficulties), and temperature instability (1) (Box 1). Opioid exposure during pregnancy might result from clinician-approved use of prescription opioids for pain relief; misuse or abuse of prescription opioids; illicit use (e...
March 10, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28275973/normal-neurological-development-during-infancy-despite-massive-hyperammonemia-in-early-treated-nags-deficiency
#4
Hallvard Reigstad, Berit Woldseth, Johannes Häberle
A girl born at term was admitted to the neonatal intensive care unit because of mild respiratory distress after a complicated delivery. She recovered, but was readmitted at 58 h of life with mild respiratory distress and increased muscle tone. Neonatal abstinence syndrome because of maternal use of lithium, clomipramine, and quetiapine during pregnancy was suspected, but at 115 h of life she became unresponsive, and an immediate work-up for coma was initiated. An ammonia of 2,235 μmol/l was found, and treatment with sodium benzoate, sodium phenylacetate, arginine, glucose, and N-carbamylglutamate (NCG, Carbaglu(®)) was started...
March 9, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28266919/outpatient-management-of-neonatal-abstinence-syndrome-a-quality-improvement-project
#5
Kim T Chau, Jacqueline Nguyen, Branko Miladinovic, Carol M Lilly, Terri L Ashmeade, Maya Balakrishnan
BACKGROUND: An increasing number of infants are diagnosed with neonatal abstinence syndrome (NAS). The study's primary objectives were to describe an academic medical center's level IV neonatal ICU's (NICU's) comprehensive outpatient NAS management effort, measure guideline compliance, and assess its safety. Secondary objectives were to describe the duration and cumulative methadone exposure, and to improve parent and provider knowledge of NAS. METHODS: The study included 22 infants having a gestational age of 35-41 weeks, diagnosed with NAS, and discharged for outpatient methadone management...
November 2016: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28261981/commentary-on-gibson-et-al-2017-gestational-age-and-the-severity-of-neonatal-abstinence-syndrome
#6
Helen Mactier
No abstract text is available yet for this article.
April 2017: Addiction
https://www.readbyqxmd.com/read/28260350/morphine-treatment-for-neonatal-abstinence-syndrome-huge-dosing-variability-underscores-the-need-for-a-better-clinical-study-design
#7
Paola Mian, Dick Tibboel, Enno D Wildschut, John N van den Anker, Karel Allegaert
INTRODUCTION: At present, morphine is the most commonly used first-line therapy to treat Neonatal Abstinence Syndrome (NAS). Unfortunately, there is still lack of evidence and consensus to guide pharmacologic therapy for NAS. In this review, we provide an overview on dosing regimens of morphine currently reported to treat NAS, with the aim to stimulate discussion on the need for a standardized dosing through better study design. METHODS: A search strategy was performed in Pubmed to identify studies that provide a dosing regimen used, or advised by a review or guideline for morphine to treat NAS...
March 3, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28244941/prenatal-breastfeeding-education-impact-on-infants-with-neonatal-abstinence-syndrome
#8
Kimberley Crook, Debra Brandon
BACKGROUND: Neonatal abstinence syndrome (NAS) is a growing problem in the United States, affecting 32,000 infants annually. Although breastfeeding would benefit infants with NAS, rates among these mothers are low. PURPOSE: The purpose of this quality improvement project was to increase breastfeeding rates and decrease hospital length of stay (LOS) for infants with NAS through prenatal breastfeeding initiatives. METHOD: A pre-/postquality improvement design was used to assess the relationship between breastfeeding initiatives on breastfeeding rates and LOS in infants with NAS...
February 27, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28219965/a-public-health-response-to-opioid-use-in-pregnancy
#9
Stephen W Patrick, Davida M Schiff
The use of opioids during pregnancy has grown rapidly in the past decade. As opioid use during pregnancy increased, so did complications from their use, including neonatal abstinence syndrome. Several state governments responded to this increase by prosecuting and incarcerating pregnant women with substance use disorders; however, this approach has no proven benefits for maternal or infant health and may lead to avoidance of prenatal care and a decreased willingness to engage in substance use disorder treatment programs...
February 20, 2017: Pediatrics
https://www.readbyqxmd.com/read/28203387/an-overview-of-available-drugs-for-management-of-opioid-abuse-during-pregnancy
#10
REVIEW
Jillian Laslo, Jon-Michael Brunner, Daniel Burns, Emily Butler, Autumn Cunningham, Ryan Killpack, Courtney Pyeritz, Kimberly Rinard, Jennifer Childers, Joseph Horzempa
The prevalence of opioid abuse in the United States has been steadily increasing over the last several years among many major demographics, including pregnant women. Rise in prenatal opioid abuse has resulted in subsequent escalation of neonatal abstinence syndrome incidence, prompting the US Congress to pass the Protecting Our Infants Act of 2015. This act specifically calls for a critical review of current treatment options for prenatal opioid abuse which may ultimately lead to the development of better therapies and a decreased incidence of neonatal abstinence syndrome...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28181969/a-population-health-driver-diagram-to-address-neonatal-abstinence-syndrome
#11
Paul Campbell Erwin, Laurie L Meschke, Samantha F Ehrlich, John W Moran
This article describes the process for developing a population health driver diagram to address a priority health issue in East Tennessee: neonatal abstinence syndrome (NAS). Population health driver diagrams are used in quality improvement processes for determining and aligning actions that a community can take to achieve a specified outcome. The Tennessee Department of Health contracted with the University of Tennessee's Department of Public Health to conduct a community participatory process to contribute to a statewide health improvement plan...
February 8, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28178739/methamphetamine-consumption-during-pregnancy-effects-on-child-health
#12
Jürgen Dinger, Patricia Hinner, Jörg Reichert, Mario Rüdiger
Methamphetamine abuse during pregnancy represents an emerging health care problem. The consequences are not only of relevance to the pregnant women, but also their unborn child. It is associated with an increased risk of preeclampsia and hypertension, fetal demise, preterm delivery, and intrauterine growth restriction. The deleterious effects of prenatal methamphetamine exposure on the developing fetal brain may lead to long-term neuro-developmental and behavioral problems.Given the current evidence, abuse of methamphetamine during pregnancy must be of utmost concern to health care professionals and to policy-makers...
February 8, 2017: Pharmacopsychiatry
https://www.readbyqxmd.com/read/28168591/neonatal-abstinence-syndrome-trend-and-expenditure-in-louisiana-medicaid-2003-2013
#13
Ekwutosi M Okoroh, Rebekah E Gee, Baogong Jiang, Melissa B McNeil, Beverly A Hardy-Decuir, Amy L Zapata
Objectives Determine trends in incidence and expenditure for perinatal drug exposure and neonatal abstinence syndrome (NAS) among Louisiana's Medicaid population. We also describe the maternal characteristics of NAS affected infants. Methods Retrospective cohort analysis using linked Medicaid and vital records data from 2003 to 2013. Conducted incidence and cost trends for drug exposed infants with and without NAS. Also performed comparison statistics among drug exposed infants with and without NAS and those not drug exposed...
February 6, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28137921/neonatal-abstinence-syndrome-time-for-a-reappraisal
#14
Matthew R Grossman, Rachel R Osborn, Adam K Berkwitt
No abstract text is available yet for this article.
January 30, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28137920/impact-of-parental-presence-at-infants-bedside-on-neonatal-abstinence-syndrome
#15
Mary Beth Howard, Davida M Schiff, Nicole Penwill, Wendy Si, Anjali Rai, Tahlia Wolfgang, James M Moses, Elisha M Wachman
BACKGROUND: Despite increased incidence of neonatal abstinence syndrome (NAS) over the past decade, minimal data exist on benefits of parental presence at the bedside on NAS outcomes. OBJECTIVE: To examine the association between rates of parental presence and NAS outcomes. METHODS: This was a retrospective, single-center cohort study of infants treated pharmacologically for NAS using a rooming-in model of care. Parental presence was documented every 4 hours with nursing cares...
February 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28137347/compassion-fatigue-burnout-and-neonatal-abstinence-syndrome
#16
Erin Sweigart
NICU nurses have seen a dramatic increase in cases of neonatal abstinence syndrome (NAS). The care needs of infants with NAS are highly demanding and can lead to feelings of frustration and emotional exhaustion among NICU nurses. Although studies have examined the experiences of nurses caring for NAS patients, none have specifically addressed the risk for compassion fatigue and burnout. Nurses need practical strategies to reduce their risk for compassion fatigue and burnout when caring for these patients. Improved education and implementation of self-care measures can help nurses more effectively manage stress and positively impact care of these infants and their families...
January 1, 2017: Neonatal Network: NN
https://www.readbyqxmd.com/read/28109052/the-use-of-methadone-to-facilitate-opioid-weaning-in-pediatric-critical-care-patients-a-systematic-review-of-the-literature-and-meta-analysis
#17
REVIEW
Leslie A Dervan, Beryl Yaghmai, Robert Scott Watson, Fredric M Wolf
BACKGROUND: Continuous opioid infusion therapy is commonly utilized in the pediatric intensive care setting to treat pain and facilitate tolerance of invasive therapies. Transitioning to methadone is one common strategy for weaning from continuous opioid infusions, but in practice this transition can be challenging, and many children still experience iatrogenic withdrawal. AIM: We reviewed the literature to evaluate the best available evidence to guide methadone therapy in this setting, and to summarize associated adverse events...
January 20, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28093465/neonatal-abstinence-syndrome-and-high-school-performance
#18
Ju Lee Oei, Edward Melhuish, Hannah Uebel, Nadin Azzam, Courtney Breen, Lucinda Burns, Lisa Hilder, Barbara Bajuk, Mohamed E Abdel-Latif, Meredith Ward, John M Feller, Janet Falconer, Sara Clews, John Eastwood, Annie Li, Ian M Wright
BACKGROUND AND OBJECTIVES: Little is known of the long-term, including school, outcomes of children diagnosed with Neonatal abstinence syndrome (NAS) (International Statistical Classification of Disease and Related Problems [10th Edition], Australian Modification, P96.1). METHODS: Linked analysis of health and curriculum-based test data for all children born in the state of New South Wales (NSW), Australia, between 2000 and 2006. Children with NAS (n = 2234) were compared with a control group matched for gestation, socioeconomic status, and gender (n = 4330, control) and with other NSW children (n = 598 265, population) for results on the National Assessment Program: Literacy and Numeracy, in grades 3, 5, and 7...
February 2017: Pediatrics
https://www.readbyqxmd.com/read/28086944/prenatal-treatment-for-opioid-dependency-observations-from-a-large-inner-city-clinic
#19
Kelley Saia, Sarah M Bagley, Elisha M Wachman, Payal P Patel, Marisa D Nadas, Susan B Brogly
BACKGROUND: The objective of this study was to review changes in the prevalence of opioid use disorder in pregnancy, and to describe the prenatal care and neonatal outcomes following the implementation of buprenorphine treatment at a large US obstetrical clinic during the on-going opioid epidemic. METHODS: We conducted a retrospective cohort study of 310 women (332 pregnancies) with opioid use disorders and their neonates delivered between June 2006 and December 2010 at an obstetrical clinic in the US...
January 13, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/28079573/medically-assisted-withdrawal-detoxification-considering-the-mother-infant-dyad
#20
Hendrée E Jones, Mishka Terplan, Marjorie Meyer
Recommendations for opioid agonist pharmacotherapy and against medically assisted withdrawal were based upon early reports that associated withdrawal with maternal relapse and fetal demise. Data from recent case series have called these recommendations into question. Although these data do not support an association between medically assisted withdrawal and fetal demise, relapse remains a significant clinical concern with reported rates ranging from 17% to 96% (average 48%). Given the high loss to follow-up in these studies, the actual relapse rate is likely even greater...
March 2017: Journal of Addiction Medicine
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