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Medication withdrawal

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https://www.readbyqxmd.com/read/28214183/-misuse-and-dependence-on-prescription-opioids-prevention-identification-and-treatment
#1
B Rolland, D Bouhassira, N Authier, M Auriacombe, V Martinez, P Polomeni, G Brousse, R Schwan, P Lack, J Bachellier, S Rostaing, P Bendimerad, P Vergne-Salle, M Dematteis, S Perrot
Since the 1990s, the use of prescription opioids has largely spread, which has brought a real progress in the treatment of pain. The long-term use of prescription opioid is sometimes required, and may lead to pharmacological tolerance and withdrawal symptoms, i.e. pharmacological dependence on prescription opioids. Occasionally, this may also lead to misuse of prescription opioids (MPO). MPO preferentially occurs in vulnerable individuals, i.e., those with a young age, history of other addictive or psychiatric disorders, especially anxious and depressive disorders...
February 14, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28203129/plasmapheresis-for-refractory-pruritus-due-to-drug-induced-cholestasis
#2
Hasan Al-Azzawi, Ruchi Patel, Gagan Sood, Sumit Kapoor
Pruritus can be a distressing symptom seen in various cholestatic disorders. It is treated with medications like bile acid sequestrants. Drug-induced cholestasis usually resolves with withdrawal of the causative medication. We describe a case of refractory pruritus due to drug-induced cholestasis, not improved with withdrawal of the drug, managed effectively with multiple sessions of plasmapheresis.
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28203072/-real-life-inhaled-corticosteroid-withdrawal-in-copd-a-subgroup-analysis-of-daccord
#3
Claus Vogelmeier, Heinrich Worth, Roland Buhl, Carl-Peter Criée, Nadine S Lossi, Claudia Mailänder, Peter Kardos
Many patients with chronic obstructive pulmonary disease (COPD) receive inhaled corticosteroids (ICSs) without a clear indication, and thus, the impact of ICS withdrawal on disease control is of great interest. DACCORD is a prospective, noninterventional 2-year study in the primary and secondary care throughout Germany. A subgroup of patients were taking ICS prior to entry - 1,022 patients continued to receive ICS for 2 years; physicians withdrew ICS on entry in 236 patients. Data from these two subgroups were analyzed to evaluate the impact of ICS withdrawal...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28203003/-bleeding-control-of-periodontal-mechanical-therapy-for-patients-taking-aspirin
#4
F Ding, Y L Lyu, W Xuan, D Y Liu, X Q Duan, X Han
OBJECTIVE: To investigate the feasibility of periodontal mechanical therapy for chronic periodontitis and coronary heart disease patients with low dose of aspirin. METHODS: Sixty nine chronic periodontitis patients with coronary heart disease were randomly selected as the experimental group (medication group, group A), the control group (withdrawal group, group B) including 20 chronic periodontitis patients with coronary artery disease, stopping the drug for one week and another control group with 50 chronic periodontitis patients (group C)...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28201843/regression-of-liver-fibrosis
#5
Lara Campana, John P Iredale
Liver fibrosis is the final common pathway of chronic or iterative liver damage. Advanced chronic fibrosis is described as cirrhosis with a loss of architecture and attendant functional failure and the development of life-threatening complications. However, compelling evidence from rodent models and human studies indicates that if the injury is removed liver fibrosis is reversible. Hepatocytes, activated hepatic stellate cells, endothelial and immune cells, particularly macrophages, cooperate in the establishment and resolution of liver fibrosis...
February 2017: Seminars in Liver Disease
https://www.readbyqxmd.com/read/28199203/neurogenetics-of-acute-and-chronic-opiate-opioid-abstinence-treating-symptoms-and-the-cause
#6
Kenneth Blum, Mark S Gold, William Jacobs, William Vaughn McCall, Marcelo Febo, David Baron, Kristina Dushaj, Zsolt Demetrovics, Rajendra D Badgaiyan
This review begins with a comprehensive history of opioid dependence and treatment in the United States. The focus is an evidence-based treatment model for opioid/opiate dependent individuals. The role of reward genetic polymorphisms and the epigenetic modifications that lead to vulnerability to use and misuse of opiates/opioid to treat pain are reviewed. The neurochemical mechanisms of acute opiate withdrawal and opiate/opioid reward mechanisms are explored with a goal of identifying specific treatment targets...
March 1, 2017: Frontiers in Bioscience (Landmark Edition)
https://www.readbyqxmd.com/read/28196024/clinical-and-morphological-features-of-paraduodenal-pancreatitis-an-italian-experience-with-120-patients
#7
Nicolò de Pretis, Fabiana Capuano, Antonio Amodio, Mattia Pellicciari, Luca Casetti, Riccardo Manfredi, Giuseppe Zamboni, Paola Capelli, Riccardo Negrelli, Pietro Campagnola, Arnaldo Fuini, Armando Gabbrielli, Claudio Bassi, Luca Frulloni
OBJECTIVES: This study aimed to evaluate the clinical and radiological features and clinical outcomes of paraduodenal pancreatitis (PP). METHODS: A final diagnosis of PP was based on surgical specimens in resected patients and on imaging in nonoperated patients. Clinical, radiological, and pathological data were collected and reevaluated. RESULTS: We studied 120 patients, 97.5% of whom were drinkers and 97.5% were smokers. Symptoms at clinical onset were acute pancreatitis in 78 patients (65%) and continuous pain in 68 patients (55...
February 14, 2017: Pancreas
https://www.readbyqxmd.com/read/28193058/development-of-a-biocompatible-in-tube-solid-phase-microextraction-device-a-sensitive-approach-for-direct-analysis-of-single-drops-of-complex-matrixes
#8
Hamed Piri-Moghadam, Sofia Lendor, Janusz Pawliszyn
The aim of the current study is to develop a sensitive solid-phase microextraction (SPME) device for direct and rapid analysis of untreated complex matrixes (i.e., single drop of the samples, V ≤ 2 μL). A thin layer of a biocompatible nanostructured polypyrrole (PPy) was electrochemically deposited inside a medical grade spinal needle, minimizing the matrix effect. Microsampling was facilitated by loading the sample inside the in-tube SPME device (withdraw of sample via plunger), where extraction was performed under static conditions...
December 20, 2016: Analytical Chemistry
https://www.readbyqxmd.com/read/28192425/improving-access-to-chagas-disease-diagnosis-and-etiologic-treatment-in-remote-rural-communities-of-the-argentine-chaco-through-strengthened-primary-health-care-and-broad-social-participation
#9
Paula Sartor, Ivana Colaianni, M Victoria Cardinal, Jacqueline Bua, Héctor Freilij, Ricardo E Gürtler
BACKGROUND: Rural populations in the Gran Chaco region have large prevalence rates of Trypanosoma cruzi infection and very limited access to diagnosis and treatment. We implemented an innovative strategy to bridge these gaps in 13 rural villages of Pampa del Indio held under sustained vector surveillance and control. METHODOLOGY: The non-randomized treatment program included participatory workshops, capacity strengthening of local health personnel, serodiagnosis, qualitative and quantitative PCRs, a 60-day treatment course with benznidazole and follow-up...
February 13, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28192226/use-of-preventive-medication-in-patients-with-limited-life-expectancy-a-systematic-review
#10
REVIEW
Arjun Poudel, Patsy Yates, Debra Rowett, Lisa M Nissen
CONTEXT: Optimal prescribing in patients with limited life expectancy remains unclear. OBJECTIVES: This study systematically reviews the published literature regarding the use of preventive medication in patients with reduced life expectancy. METHODS: A systematic literature search was conducted using three databases (MEDLINE, EMBASE and CINAHL). Articles published in English from January 1995 to December 2015 were retrieved for analysis to identify peer-reviewed, observational studies assessing use of preventive medications in patients with limited life expectancy...
February 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28190817/lc-ms-ms-measurement-of-ampicillin-residue-in-chicken-tissues-at-2-days-after-in-feed-administration
#11
Kouko Hamamoto, Yasuharu Mizuno
We assessed ampicillin (ABPC) concentrations of liver, kidney and skin at a 2-day withdrawal period in ten male and ten female White Leghorn chickens fed the diet containing ABPC (ABPC medicated feed 40 mg/kg body weight/day) for a week. The ABPC residues were measured with liquid chromatography-tandem mass spectrometry and the mean recoveries and quantitation limits ranged from 93.0% to 102.7% and from 0.1 to 1.4 ng/g, respectively. The residual ABPC concentrations were ≤7.82 ng/g for the skin and ≤0.64 ng/g for the kidney, suggesting below the Japanese provisional maximum residue limits...
February 10, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/28190439/neurologic-complications-of-polytrauma
#12
R M Jha, L Shutter
Neurologic complications in polytrauma can be classified by etiology and clinical manifestations: neurovascular, delirium, and spinal or neuromuscular problems. Neurovascular complications include ischemic strokes, intracranial hemorrhage, or the development of traumatic arteriovenous fistulae. Delirium and encephalopathy have a reported incidence of 67-92% in mechanically ventilated polytrauma patients. Causes include sedation, analgesia/pain, medications, sleep deprivation, postoperative state, toxic ingestions, withdrawal syndromes, organ system dysfunction, electrolyte/metabolic abnormalities, and infections...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28188055/the-emergency-medicine-management-of-severe-alcohol-withdrawal
#13
Drew Long, Brit Long, Alex Koyfman
INTRODUCTION: Alcohol use is widespread, and withdrawal symptoms are common after decreased alcohol intake. Severe alcohol withdrawal may manifest with delirium tremens, and new therapies may assist in management of this life-threatening condition. OBJECTIVE: To provide an evidence-based review of the emergency medicine management of alcohol withdrawal and delirium tremens. DISCUSSION: The underlying pathophysiology of alcohol withdrawal syndrome (AWS) is central nervous system hyperexcitation...
February 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28187838/pharmacologic-treatment-of-opioid-addiction-during-pregnancy
#14
REVIEW
Lori Keough, Heidi Collins Fantasia
Opioid addiction during pregnancy presents a treatment challenge to clinicians and women alike. Untreated addiction can lead to poor maternal and fetal health outcomes. Medication-assisted treatment is the standard of care, and methadone is the current drug of choice for treatment. Emerging evidence also supports the use of buprenorphine during pregnancy. Both methadone and buprenorphine have risks and benefits that should be explored before initiating treatment. Clinicians who work in obstetrics and in addiction treatment can collaborate and coordinate treatment to ensure optimal maternal and fetal outcomes...
February 2017: Nursing for Women's Health
https://www.readbyqxmd.com/read/28182329/perceived-compliance-and-barriers-to-care-in-sublingual-immunotherapy
#15
Manvinder S Kumar, Melissa S Oh, Brittany Leader, Melissa Rotella, Leisa Stillman, John M DelGaudio, Sarah K Wise
BACKGROUND: For allergy immunotherapy to be effective, patient compliance is critical. However, aqueous sublingual immunotherapy (SLIT) may be considered demanding for patients, requiring strict daily dosing and refilling of medication at regular intervals. In this study we sought to determine how patients perceive their own compliance with SLIT and identify barriers that may hinder compliance. METHODS: Using a retrospective review, 46 patients currently undergoing aqueous SLIT were identified to have less-than-excellent compliance based on frequency of clinic visits for SLIT refills...
February 9, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28182130/therapeutic-effect-of-epidural-hyaluronic-acid-in-a-rat-model-of-foraminal-stenosis
#16
Francis Sahngun Nahm, Pyung Bok Lee, Ghee Young Choe, Young Jin Lim, Yong Chul Kim
PURPOSE: Since receiving a warning from the US Food and Drug Administration (FDA) about injection of corticosteroids into the epidural space having serious adverse events, we have sought alternative medications for injection at this site. Hyaluronic acid (HA) has anti-adhesive, anti-inflammatory, and lubricating properties, so could potentially be useful for spinal pain. The exact mechanism by which spinal stenosis develops is not fully understood, but is likely to involve inflammation...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28181958/serum-concentrations-of-psychotropic-drugs-in-neonates-as-a-prognostic-factor-for-admission-to-the-neonatology-ward-and-withdrawal-symptoms-proof-1
#17
Shirley C A Sparla, Hans Coppens, Inge M Evers, Claire A I Stramrood, Pieternel C M Pasker-de Jong, Monique M L van der Westerlaken, Paul H G Hogeman, Mirte M Malingré
The aim is to determine whether serum drug concentrations obtained from the neonate's umbilical cord can be used as a prognostic factor for admission to the neonatology ward and the occurrence of withdrawal symptoms. A retrospective observational monocenter cohort study was carried out among pregnant women using psychotropic drugs and their baby. Binary logistic regression was used for the multivariate analysis. Of the 186 neonates included, 22.6% (n=42) were admitted to the neonatology ward, 6.5% (n=12) because of withdrawal...
February 8, 2017: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28181639/effectiveness-of-medication-withdrawal-in-older-fallers-results-from-the-improving-medication-prescribing-to-reduce-risk-of-falls-improvefall-trial
#18
Nicole D A Boyé, Nathalie van der Velde, Oscar J de Vries, Esther M M van Lieshout, Klaas A Hartholt, Francesco U S Mattace-Raso, Paul Lips, Peter Patka, Ed F van Beeck, Tischa J M van der Cammen
No abstract text is available yet for this article.
January 10, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28168438/old-man-young-man-t-s-%C3%A2-eliot-s-gerontion-and-the-problem-of-identity
#19
Moritz E Wigand, Hauke F Wiegand, Markus Jäger, Thomas Becker
BACKGROUND: In his poem Gerontion (1920) Nobel laureate T.S. Eliot uses powerful language to give a fictional, highly condensed, first-person account of medical and psychological conditions that arise with old age: physical frailty, cognitive decline, sensory impairment, depressive symptoms with embitterment, social withdrawal and the psychological strain of having to face old age and make meaning of one's life. Surprisingly, he wrote the poem as a young man. METHODS: In this qualitative study, we used a hermeneutic approach to interpret Gerontion from a psychiatric perspective...
February 6, 2017: Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation
https://www.readbyqxmd.com/read/28167593/a-review-on-dapsone-hypersensitivity-syndrome-among-chinese-patients-with-an-emphasis-on-preventing-adverse-drug-reactions-with-genetic-testing
#20
REVIEW
Na Wang, Leela Parimi, Hong Liu, Furen Zhang
Dapsone is a bactericidal and bacteriostatic against Mycobacterium leprae, a causative agent of leprosy. Dapsone is also applied in a range of medical fields because of its anti-inflammatory and immunomodulatory effects. Dapsone hypersensitivity syndrome (DHS) is a rare yet serious adverse drug reaction (ADR) caused by dapsone involving multiple organs. We performed a systematic review of published articles describing dapsone-induced hypersensitivity syndrome, including all Chinese articles and the latest literature available in online databases published between October 2009 and October 2015...
February 6, 2017: American Journal of Tropical Medicine and Hygiene
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