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https://www.readbyqxmd.com/read/28100012/characterization-and-management-of-patients-with-heroin-versus-non-heroin-opioid-overdoses-experience-at-an-academic-medical-center
#1
Kate M Morizio, Regan A Baum, Adam Dugan, Julia E Marin, Abby M Bailey
STUDY OBJECTIVES: To characterize the differences between patients who had heroin and non-heroin opioid overdoses and to determine whether there were any significant differences in their management with regard to the naloxone use. DESIGN: Retrospective cohort study. SETTING: Large, academic medical center. PATIENTS: A total of 923 patients admitted to the medical center who were identified for overdose by heroin or other opiate-related narcotics between January 2010 and September 2015; 480 patients experienced a non-heroin opioid overdose event, and 443 patients experienced a heroin overdose event...
January 18, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28092305/prevalence-and-impact-of-inflammatory-bowel-disease-irritable-bowel-syndrome-on-patient-reported-outcomes-in-ccfa-partners
#2
Maisa I Abdalla, Robert S Sandler, Michael D Kappelman, Christopher F Martin, Wenli Chen, Kristen Anton, Millie D Long
BACKGROUND: Inflammatory bowel disease (IBD) patients with persistent symptoms despite no or minimal inflammation are frequently described as having an overlap of IBD and irritable bowel syndrome (IBD-IBS). Limited data are available on how IBS impacts the individual patient with IBD. In this study, we aimed to evaluate the prevalence of IBD-IBS and investigate its impact on patient-reported outcomes. METHOD: We performed a cross-sectional analysis within the CCFA Partners Study...
January 12, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28087135/surgical-site-infection-related-to-use-of-elastomeric-pumps-in-pectus-excavatum-repair-lessons-learned-from-root-cause-analysis
#3
Nadja Apelt, Joshua Schaffzin, Christina Bates, Rebeccah L Brown, Marc Mecoli, Senthilkumar Sadhasivam, Victor Garcia
BACKGROUND: Pectus excavatum repair (PEX) is among the most painful thoracic procedures performed. Continuous peripheral nerve blockade (CPNB) is known to be efficacious in optimizing pain control while limiting narcotic use in adult thoracic procedures. It was introduced in May 2015 as a bridge to oral pain control in children undergoing PEX. Consequently, the surgical site infection (SSI) rate increased from 2.7% to 27.7%. METHODS: SSI surveillance followed national guidelines...
January 6, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28080998/determination-of-oxycodone-and-its-major-metabolites-noroxycodone-and-oxymorphone-by-ultra-high-performance-liquid-chromatography-tandem-mass-spectrometry-in-plasma-and-urine-application-to-real-cases
#4
Flaminia Pantano, Stefano Brauneis, Alexandre Forneris, Roberta Pacifici, Enrico Marinelli, Chrystalla Kyriakou, Simona Pichini, Francesco Paolo Busardò
BACKGROUND: Oxycodone is a narcotic drug widely used to alleviate moderate and severe acute and chronic pain. Variability in analgesic efficacy could be explained by inter-subject variations in plasma concentrations of parent drug and its active metabolite, oxymorphone. To evaluate patient compliance and to set up therapeutic drug monitoring (TDM), an ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) assay was developed and validated for the parent drug and its major metabolites noroxycodone and oxymorphone...
January 12, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28079776/enhanced-recovery-program-and-length-of-stay-after-laparotomy-on-a-gynecologic-oncology-service-a-randomized-controlled-trial
#5
Elizabeth L Dickson, Erica Stockwell, Melissa A Geller, Rachel Isaksson Vogel, Sally A Mullany, Rahel Ghebre, Boris J N Witherhoff, Levi S Downs, Linda F Carson, Deanna Teoh, Michelle Glasgow, Matt Gerber, Colleen Rivard, Britt K Erickson, Jacob Hutchins, Peter A Argenta
OBJECTIVE: To estimate whether a rapid recovery program would reduce length of stay among patients undergoing laparotomy on a gynecologic oncology service. METHODS: We conducted a prospective, randomized, controlled trial comparing an enhanced recovery after surgery protocol with routine postoperative care among women undergoing laparotomy on the gynecologic oncology service. Protocol elements included: preoperative counseling, regional anesthesia, intraoperative fluid restriction, and early postoperative ambulation and feeding...
January 9, 2017: Obstetrics and Gynecology
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/28076828/perinatal-risk-factors-for-low-and-moderate-five-minute-apgar-scores-at-term
#7
Shimona Lai, Christopher Flatley, Sailesh Kumar
OBJECTIVE: To evaluate the specific maternal and perinatal variables associated with a low (≤3) or moderate (4-6) Apgar score, compared to a high (≥7) score. STUDY DESIGN: This was a retrospective, cohort study of 58429 term singleton babies born at the Mater Mother's Hospital in Brisbane, Australia in 2007-2013. Maternal demographics, socio-economic status using the Australian Socioeconomic Index for Areas (SEIFA) score, obstetric factors, and birth outcomes were compared for neonates grouped into three categories based on their five-minute Apgar: low (≤3), moderate (4-6) and high (≥7)...
January 6, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28074756/risk-factors-and-effects-of-care-management-on-hospital-readmissions-among-high-users-at-an-academic-medical-center
#8
Quang H Pham, Sara X Li, Brent C Williams
Few studies have examined predictors of hospital readmission among high-using patients enrolled in a behaviorally oriented intensive care management program. The purpose of this case control study was to describe risk factors and the effectiveness of a complex care management program for hospital readmission among vulnerable patients at a large academic medical center. One hundred sixty-three patients enrolled in the University of Michigan Complex Care Management Program (UM CCMP) were hospitalized between January 2014 and March 2015...
September 1, 2016: Care Management Journals: Journal of Case Management ; the Journal of Long Term Home Health Care
https://www.readbyqxmd.com/read/28070147/liposomal-bupivacaine-in-total-hip-arthroplasty-do-the-results-justify-the-cost
#9
Jason A Beachler, Daniel M Kopolovich, Creighton C Tubb, Siraj A Sayeed
INTRODUCTION: Liposomal bupivacaine has a paucity of data regarding narcotic requirements and hospital length of stay in comparison to other peri-articular injections, specifically in the total hip arthroplasty (THA) population. METHODS: 69 patients who underwent THA by a single surgeon were divided into two cohorts over a 3 year period in this retrospective study comparing narcotic requirements, hospital length of stay and cost. The study group (n = 29) received liposomal bupivacaine whereas a matched control group (n = 40) received a pharmacy-mixed cocktail in peri-articular structures...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28067743/comparative-perioperative-pain-and-recovery-in-women-undergoing-vaginal-reconstruction-versus-robotic-sacrocolpopexy
#10
Lauren B Westermann, Catrina C Crisp, Donna Mazloomdoost, Steven D Kleeman, Rachel N Pauls
BACKGROUND: In this study of patients undergoing vaginal hysterectomy with either robotic or vaginal prolapse repair, there was no difference in quality of life in the weeks following surgery; however, less narcotics were used, less pain was documented by nurses and Surgical Pain Scale (SPS), and better performance on voiding trials was noted in those undergoing robotic sacrocolpopexy. OBJECTIVES: Minimally invasive surgery for pelvic organ prolapse is the preferred surgical route for optimal recovery...
January 6, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28061487/thermal-induced-osteonecrosis-of-adjacent-vertebra-after-intradiscal-electrothermal-therapy
#11
Soonjoon Kim, Sun-Ho Lee, Eun-Sang Kim, Whan Eoh
A 42-year-old man was admitted to our hospital with complaints of low back pain and intermittent right thigh pain. Twelve weeks before admission, the patient received intradiscal electrothermal therapy (IDET) at a local hospital. The patient still reported low back pain after the procedure that was managed with narcotic analgesics. Follow-up magnetic resonance imaging (MRI) was performed, and his referring physician thought the likely diagnosis was spondylodiscitis at the L4-5 spinal segment with a small epidural abscess...
January 1, 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28059489/evaluation-of-the-phototoxicity-of-unsubstituted-and-alkylated-pahs-to-mysid-shrimp-americamysis-bahia-validation-of-predictive-models
#12
Bryson E Finch, Solmaz Marzooghi, Dominic M Di Toro, William A Stubblefield
Crude oils are composed of an assortment of hydrocarbons, some of which are polycyclic aromatic hydrocarbons (PAHs). Polycyclic aromatic hydrocarbons are of particular interest due to their narcotic and potential phototoxic effects. Several studies have examined the phototoxicity of individual PAHs and fresh and weathered crude oils and several models have been developed to predict PAH toxicity. Fingerprint analyses of oils have shown that PAHs in crude oils are predominately alkylated. However, current models for estimating PAH phototoxicity assume toxic equivalence between unsubstituted (i...
January 6, 2017: Environmental Toxicology and Chemistry
https://www.readbyqxmd.com/read/28050185/comparing-acceptance-and-commitment-group-therapy-and-12-steps-narcotics-anonymous-in-addict-s-rehabilitation-process-a-randomized-controlled-trial
#13
Manoochehr Azkhosh, Ali Farhoudianm, Hemn Saadati, Fateme Shoaee, Leila Lashani
Objective: Substance abuse is a socio-psychological disorder. The aim of this study was to compare the effectiveness of acceptance and commitment therapy with 12-steps Narcotics Anonymous on psychological well-being of opiate dependent individuals in addiction treatment centers in Shiraz, Iran. Method: This was a randomized controlled trial. Data were collected at entry into the study and at post-test and follow-up visits. The participants were selected from opiate addicted individuals who referred to addiction treatment centers in Shiraz...
October 2016: Iranian Journal of Psychiatry
https://www.readbyqxmd.com/read/28042065/civil-society-driven-drug-policy-reform-for-health-and-human-welfare-india
#14
Nandini Vallath, Tripti Tandon, Tania Pastrana, Diederik Lohman, S Asra Husain, James Cleary, Ganpati Ramanath, M R Rajagopal
The lack of adequate access to opioids in India as analgesics and for agonist therapies, forces millions to live with severe unalleviated pain, or languish with suffering associated with drug dependence. Although India is a major opium exporter, the excessively prohibitive 1985 narcotics law formulated to control harmful use of drugs, impeded the availability and access to opioids for medical and scientific purposes. Amendment of this law in 2014 established a new national regulatory framework for improved access to essential opioid analgesics...
December 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28040448/randomized-clinical-trial-of-postoperative-belladonna-and-opium-rectal-suppositories-in-vaginal-surgery
#15
K Butler, J Yi, M Wasson, J Klauschie, D Ryan, J Hentz, J Cornella, P Magtibay, R Kho
BACKGROUND: Following vaginal surgery oral and parenteral narcotics are commonly used for pain relief and their use may exacerbate the incidence of sedation, nausea, and vomiting; ultimately delaying convalescence. Previous studies have demonstrated that rectal analgesia following surgery results in lower pain scores and less intravenous morphine consumption. Belladonna and opium (B&O) rectal suppositories may be used to relieve pain and minimize side effects; however their efficacy has not been confirmed...
December 28, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28035547/diabetics-on-narcotics-are-less-likely-to-achieve-excellent-bowel-preparation-than-are-patients-with-either-condition
#16
Mohammad F Madhoun, Hussein Bitar, Owais Bhatti, Hassaan Zia, Pratyusha Parava, Muhammad H Bashir
BACKGROUND: Diabetes and chronic narcotic use negatively affect the quality of bowel preparation before colonoscopy. AIM: To investigate whether narcotic use and diabetes have an additive negative impact on bowel preparation. PATIENTS AND METHODS: We performed a retrospective study of 2841 patients (mean age 61 ± 10.2; 94% male) who received outpatient colonoscopies at our Veterans Affairs Medical Center between June 2012 and December 2014...
December 29, 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28018759/could-the-use-of-an-enhanced-recovery-protocol-in-laparoscopic-donor-nephrectomy-be-an-incentive-for-live-kidney-donation
#17
Aparna Rege, Harold Leraas, Deepak Vikraman, Kadiyala Ravindra, Todd Brennan, Tim Miller, Julie Thacker, Debra Sudan
INTRODUCTION AND BACKGROUND: Gastrointestinal (GI) recovery after major abdominal surgery can be delayed from an ongoing need for narcotic analgesia thereby prolonging hospitalization. Enhanced recovery after surgery (ERAS) is a multimodal perioperative care pathway designed to facilitate early recovery after major surgery by maintaining preoperative body composition and physiological organ function and modifying the stress response induced by surgical exposure. Enhanced recovery programs (ERPs) in colorectal surgery have decreased the duration of postoperative ileus and the hospital stay while showing equivalent morbidity, mortality, and readmission rates in comparison to the traditional standard of care...
November 22, 2016: Curēus
https://www.readbyqxmd.com/read/28013218/genetic-targets-of-acute-toluene-inhalation-in-drosophila-melanogaster
#18
Philip J Bushnell, William Ward, Tatiana V Morozova, Wendy M Oshiro, Mimi T Lin, Richard S Judson, Susan D Hester, John M McKee, Mark Higuchi
Interpretation and use of data from high-throughput assays for chemical toxicity require links between effects at molecular targets and adverse outcomes in whole animals. The well-characterized genome of Drosophila melanogaster provides a potential model system by which phenotypic responses to chemicals can be mapped to genes associated with those responses, which may in turn suggest adverse outcome pathways associated with those genes. To determine the utility of this approach, we used the Drosophila Genetics Reference Panel (DGRP), a collection of ~200 homozygous lines of fruit flies whose genomes have been sequenced...
December 24, 2016: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/28013078/toxicity-of-oil-sands-acid-extractable-organic-fractions-to-freshwater-fish-pimephales-promelas-fathead-minnow-and-oryzias-latipes-japanese-medaka
#19
Anthony E Bauer, Richard A Frank, John V Headley, Kerry M Peru, Andrea J Farwell, D George Dixon
The Alberta oil sands are one of the largest global petroleum deposits and, due to non-release practices for oil sands process-affected waters, produced tailings are stored in large ponds. The acid extractable organic (AEO) compounds in oil sands process-affected water are of greatest concern due to their persistence and toxicity to a variety of aquatic biota. The present study evaluated the toxicity of the five AEO fractions to two fish species: Oryzias latipes (Japanese medaka) and Pimephales promelas (fathead minnow)...
December 14, 2016: Chemosphere
https://www.readbyqxmd.com/read/28005125/the-role-of-liposomal-bupivacaine-in-value-based-care
#20
Richard Iorio
Multimodal pain control strategies are crucial in reducing opioid use and delivering effective pain management to facilitate improved surgical outcomes. The utility of liposomal bupivacaine in enabling effective pain control in multimodal strategies has been demonstrated in several studies, but others have found the value of liposomal bupivacaine in such approaches to be insignificant. At New York University Langone Medical Center, liposomal bupivacaine injection and femoral nerve block were compared in their delivery of efficacious and cost-effective multimodal analgesia among patients undergoing total joint arthroplasty (TJA)...
November 2016: American Journal of Orthopedics
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