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Medication withdrawal

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https://www.readbyqxmd.com/read/28319423/silexan-does-not-cause-withdrawal-symptoms-even-when-abruptly-discontinued
#1
M Gastpar, W E Müller, H P Volz, H J Möller, S Schläfke, A Dienel, S Kasper
OBJECTIVE: Subsequent to a randomised, double-blind, double dummy clinical trial assessing the efficacy of silexan compared to placebo and paroxetine in patients suffering from generalised anxiety disorder (GAD), a 1week follow-up phase was added in order to assess possible withdrawal symptoms of silexan after abrupt discontinuation. METHODS: Participants received silexan 80 mg/d, silexan 160 mg/d, paroxetine 20 mg/d, or placebo at a ratio of 1:1:1:1. Study medication was discontinued after the 10 week active treatment phase of the original trial...
March 20, 2017: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/28318388/impact-of-nutritional-intervention-on-length-of-hospital-stay-and-mortality-among-hospitalized-patients-with-malnutrition-a-clinical-randomized-controlled-trial
#2
Edgar A Cano-Torres, Luis E Simental-Mendía, Luis A Morales-Garza, José M Ramos-Delgado, Mirthala M Reyes-Gonzalez, Victor M Sánchez-Nava, Abel de J Barragán-Berlanga, Ignacio Rangel-Rodríguez, Fernando Guerrero-Romero
OBJECTIVE: The objective of this study was to evaluate the impact of a nutritional intervention on hospital stay and mortality among hospitalized patients with malnutrition. METHODS: Hospitalized patients with a diagnosis of malnutrition were enrolled and randomly allocated to either an intervention or control group. Participants in the intervention group received an individualized nutrition plan according to energy and protein (1.0-1.5 g/kg) intake requirements as well as dietary advice based on face-to-face interviews with patients and their caregivers or family members...
March 20, 2017: Journal of the American College of Nutrition
https://www.readbyqxmd.com/read/28303200/atypical-neuroleptic-malignant-syndrome-associated-with-use-of-clozapine
#3
Quevedo-Florez Leonardo, Granada-Romero Juliana, Camargo-Arenas Juan Fernando
The Neuroleptic Malignant Syndrome (NMS) is a medical emergency of infrequent presentation in the emergency department, which is associated with the use of psychiatric drugs, such as typical and atypical antipsychotics. Our case addresses a 55-year-old patient diagnosed with undifferentiated schizophrenia for 10 years, who had been receiving clozapine and clonazepam as part of their treatment. This patient presents the symptoms of Neuroleptic Malignant Syndrome without fever, which improves with treatment especially with the withdrawal of clozapine...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28301894/transitions-in-care-for-infants-with-trisomy-13-or-18
#4
Jacquelyn Patterson, Genevieve Taylor, Melissa Smith, Sarah Dotters-Katz, Arlene M Davis, Wayne Price
Background and Objectives The scope of interventions offered to infants with trisomy 13 (T13) or trisomy 18 (T18) is increasing. We describe the spectrum of care provided, highlighting transitions in care for individual patients. Patients and Methods This is a single-center, retrospective cohort of infants with T13 or T18 born between 2004 and 2015. Initial care was classified as comfort care or intervention using prenatal counseling notes. Transitions in care were identified in the medical record. Results In this study, 25 infants were divided into two groups based on their care: neonates who experienced no transition in care and neonates who experienced at least one transition...
March 16, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28301676/deprescribing-versus-continuation-of-chronic-proton-pump-inhibitor-use-in-adults
#5
REVIEW
Taline A Boghossian, Farah Joy Rashid, Wade Thompson, Vivian Welch, Paul Moayyedi, Carlos Rojas-Fernandez, Kevin Pottie, Barbara Farrell
BACKGROUND: Proton pump inhibitors (PPIs) are a class of medications that reduce acid secretion and are used for treating many conditions such as gastroesophageal reflux disease (GERD), dyspepsia, reflux esophagitis, peptic ulcer disease, and hypersecretory conditions (e.g. Zollinger-Ellison syndrome), and as part of the eradication therapy for Helicobacter pylori bacteria. However, approximately 25% to 70% of people are prescribed a PPI inappropriately. Chronic PPI use without reassessment contributes to polypharmacy and puts people at risk of experiencing drug interactions and adverse events (e...
March 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28301217/neuromodulation-with-percutaneous-electrical-nerve-field-stimulation-is-associated-with-reduction-in-signs-and-symptoms-of-opioid-withdrawal-a-multisite-retrospective-assessment
#6
Adrian Miranda, Arturo Taca
BACKGROUND: Finding an effective, non-pharmacological approach to treat opioid withdrawal could remove some of the barriers associated with pharmacotherapy. The BRIDGE® is a noninvasive, percutaneous electrical nerve field stimulator developed to target pain. OBJECTIVES: This pilot study aimed to determine (1) the effects of the BRIDGE on withdrawal scores during the induction phase of opioid withdrawal therapy, (2) the percentage of subjects who successfully transitioned to medication assisted therapy (MAT)...
March 16, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28294533/evaluation-of-donor-workups-and-exclusions-in-a-single-center-experience-of-living-donor-liver-transplantation
#7
Adianto Nugroho, Ok-Kyung Kim, Kwang-Woong Lee, Sanghee Song, Hyeyoung Kim, Suk Kyun Hong, Kyung Chul Yoon, Hyo-Sin Kim, YoungRok Choi, Hae Won Lee, Nam-Joon Yi, Kyung-Suk Suh
The process of evaluating potential donors in liver transplantation is important to ensure donor safety and provide optimal recipient outcome. However, there has been no report about donor exclusion rates and reasons for such exclusion in Korea. In this study, we aimed to elucidate the outcomes of potential live liver donor evaluation in a major LDLT center. From July 2011 to June 2015, prospectively collected data of 726 potential donors for 588 matched recipients were subsequently evaluated. Among 726 potential donors, 374 potential donors (51...
March 14, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28292795/primary-care-management-of-opioid-use-disorders-abstinence-methadone-or-buprenorphine-naloxone
#8
REVIEW
Anita Srivastava, Meldon Kahan, Maya Nader
OBJECTIVE: To advise physicians on which treatment options to recommend for specific patient populations: abstinence-based treatment, buprenorphine-naloxone maintenance, or methadone maintenance. SOURCES OF INFORMATION: PubMed was searched and literature was reviewed on the effectiveness, safety, and side effect profiles of abstinence-based treatment, buprenorphine-naloxone treatment, and methadone treatment. Both observational and interventional studies were included...
March 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28290979/orbital-cellulitis-in-a-psoriatic-patient-treated-with-adalimumab
#9
Vienna G Katana, Robert J Carpenter, John P Trafeli, Julia M Kwan
INTRODUCTION: Psoriatic patients on tumor necrosis factor alpha inhibitors (TNFi) may be at increased risk for upper respiratory tract infections, including chronic rhino-sinusitis (CRS). Rarely, CRS can progress to orbital cellulitis (OC), an emergent ophthalmic complication wherein respiratory flora from paranasal sinus disease intrude the retro-orbital space. MATERIALS AND METHODS: Single case report. RESULTS: We report the first case, to our knowledge, of an invasive sinusitis that rapidly evolved into OC in a patient receiving adalimumab treatment for plaque psoriasis and psoriatic arthritis...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28288165/neutropenia-induced-by-high-dose-intravenous-benzylpenicillin-in-treating-neurosyphilis-does-it-really-matter
#10
Rui-Rui Peng, Juan Wu, Wei Zhao, Tengfei Qi, Mei Shi, Zhifang Guan, Haikong Lu, Fuquan Long, Zixiao Gao, Sufang Zhang, Pingyu Zhou
BACKGROUND: Prompt therapy with high-dose intravenous benzylpenicillin for a prolonged period is critical for neurosyphilis patients to avoid irreversible sequelae. However, life-threatening neutropenia has been reported as a complication of prolonged therapy with high doses of benzylpenicillin when treating other diseases. This study aimed to investigate the incidence, presentation, management and prognosis of benzylpenicillin-induced neutropenia in treating neurosyphilis based on a large sample of syphilis patients in Shanghai...
March 13, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28286384/an-assessment-of-the-incidence-of-prolonged-postoperative-bleeding-after-dental-extraction-among-patients-on-uninterrupted-low-dose-aspirin-therapy-and-to-evaluate-the-need-to-stop-such-medication-prior-to-dental-extractions
#11
Brigit V Eapen, M F Baig, S Avinash
PURPOSE: To propose that low dose aspirin therapy need not be withdrawn for routine dental extraction procedure. AIM: This study was designed to evaluate the post operative bleeding in patients on low dose aspirin therapy by dividing them into two groups: one with withdrawing and the other without withdrawing the regime before dental extraction. MATERIALS AND METHODS: This study included 80 patients on low dose aspirin therapy. They were divided into two groups of 40 patients each; Group I (control group) included patients on who were asked to stop the medication 5 days prior to dental extraction; Group II (test group) included patients who were asked not to stop the medication prior to dental extraction...
March 2017: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/28285326/endogenous-opioid-system-a-promising-target-for-future-smoking-cessation-medications
#12
REVIEW
Haval Norman, Manoranjan S D'Souza
BACKGROUND: Nicotine addiction continues to be a health challenge across the world. Despite several approved medications, smokers continue to relapse. Several human and animal studies have evaluated the role of the endogenous opioid system as a potential target for smoking cessation medications. METHODS: In this review, studies that have elucidated the role of the mu (MORs), delta (DORs), and kappa (KORs) opioid receptors in nicotine reward, nicotine withdrawal, and reinstatement of nicotine seeking will be discussed...
March 11, 2017: Psychopharmacology
https://www.readbyqxmd.com/read/28284916/infusion-of-mesenchymal-stromal-cells-after-deceased-liver-transplantation-a-phase-i-ii-open-label-clinical-study
#13
Olivier Detry, Morgan Vandermeulen, Marie-Hélène Delbouille, Joan Somja, Noella Bletard, Alexandra Briquet, Chantal Lechanteur, Olivier Giet, Etienne Baudoux, Muriel Hannon, Frederic Baron, Yves Beguin
BACKGROUND & AIM: Mesenchymal stromal cell (MSC) infusion could be a mean to establish tolerance in solid organ recipients. The aim of this prospective, controlled, phase-1 study was to evaluate the feasibility, safety and tolerability of a single infusion of MSCs in liver transplant recipients. METHODS: Ten liver transplant recipients under standard immunosuppression received 1.5-3x10(6)/kg third-party unrelated MSCs on post-operative day 3±2, and were prospectively compared to a control group of 10 liver transplant recipients...
March 8, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28282523/adolescent-community-reinforcement-approach-implementation-and-treatment-outcomes-for-youth-with-opioid-problem-use
#14
Mark D Godley, Lora L Passetti, Geetha A Subramaniam, Rodney R Funk, Jane Ellen Smith, Robert J Meyers
BACKGROUND: This paper compares adolescents with primary opioid problem use (OPU) to those with primary marijuana or alcohol problem use (MAPU) who received up to six months of Adolescent Community Reinforcement Approach (A-CRA), an empirically supported treatment. METHODS: Intake clinical characteristics, treatment implementation measures, and clinical outcomes of two substance problem groups (OPU and MAPU) were compared using data from 1712 adolescents receiving A-CRA treatment...
February 22, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28279695/categorization-of-survival-and-death-after-cardiac-arrest
#15
E A Matthews, J Magid-Bernstein, A Presciutti, A Rodriguez, D Roh, S Park, J Claassen, S Agarwal
BACKGROUND: Most cardiac arrest (CA) patients remain comatose post-resuscitation, prompting goals-of-care (GOC) conversations. The impact of these conversations on patient outcomes has not been well described. METHODS: Patients (n=385) treated for CA in Columbia University ICUs between 2008-2015 were retrospectively categorized into various modes of survival and death based on documented GOC discussions. Patients were deemed "medically unstable" if there was evidence of hemodynamic instability at the time of discussion...
March 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/28278146/cdc-grand-rounds-public-health-strategies-to-prevent-neonatal-abstinence-syndrome
#16
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/28277481/prolactin-secreting-pituitary-microadenoma-results-of-transsphenoidal-surgery-after-medical-therapy-with-dopamine-agonist
#17
Mario Francesco Fraioli, Giuseppe Umana, Andrea Pagano, Bernardo Fraioli, Pierpaolo Lunardi
Medical therapy with dopamine agonist is very effective in controlling prolactin serum levels and it usually represents the first therapeutic choice for prolactin secreting pituitary adenomas. However, many patients present increase of prolactinemia after withdrawal of medical therapy which consequently should be taken for long time; other present intolerance to medical therapy; women with pregnancy need to withdraw dopamine agonists with consequent potential related problems: in these patients transsphenoidal surgery can be requested...
March 8, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28277442/divergence-palsy-due-to-divalproex-and-oxcarbazepine
#18
Marc Albert Bouffard, Louis R Caplan, Nurhan Torun
OBJECTIVE: This case series is the first to describe divergence palsy as an adverse effect of antiepileptic drug use. Diplopia is a common adverse effect of antiepileptic drugs, but no explanatory motility deficit has ever been reported. METHODS: We present 2 patients, 1 on oxcarbazepine and 1 on divalproex, each with a normal examination result between spells and divergency palsy when symptomatic. RESULTS: Discontinuation of the antiepileptic medication led to resolution of the episodes in both cases...
March 9, 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28274352/drug-induced-acne
#19
Jana Kazandjieva, Nikolay Tsankov
A variety of drugs may provoke acne, with drug-induced acne (DIA) often having some specific clinical and histopathologic features. DIA is characterized by a medical history of drug intake, sudden onset, and an unusual age of onset, with a monomorphous eruption of inflammatory papules or papulopustules. The location of the acne lesions is beyond the seborrheic zone. Corticosteroids, anabolic steroids, testosterone, halogens, isoniazid, lithium, and some new anticancer agents are drugs with undoubted causal relationship to acne...
March 2017: Clinics in Dermatology
https://www.readbyqxmd.com/read/28268215/randomised-comparison-of-a-novel-buprenorphine-oral-lyophilisate-versus-existing-buprenorphine-sublingual-tablets-in-opioid-dependent-patients-a-first-in-patient-phase-ii-randomised-open-label-safety-study
#20
John Strang, Kylie Reed, Karolina Bogdanowicz, James Bell, Rob van der Waal, Jenny Keen, Pete Beavan, Shelagh Baillie, Alastair Knight
AIMS: To test the safety of new buprenorphine oral lyophilisate wafer ("bup-lyo") versus standard sub-lingual buprenorphine ("bup-SL"). DESIGN: Randomised (2:1) open-label study; opioid-dependent subjects; subsequent partial cross-over. SETTINGS: Specialised clinical trials facility and addictions treatment facility. PARTICIPANTS: Opioid-dependent subjects (n = 36) commencing buprenorphine maintenance (personalised dose-titration) including patients co-using alcohol, cocaine and benzodiazepines (below thresholds)...
March 8, 2017: European Addiction Research
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