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https://www.readbyqxmd.com/read/28543087/death-due-to-complications-of-bowel-obstruction-following-raw-poppy-seed-ingestion
#1
Leah M Schuppener, Robert F Corliss
Eating poppy seeds can cause a positive urine drug screen, but it is unknown whether ingesting large quantities can result in opiate intoxication or toxicity. A 54-year-old woman with intractable vomiting was found unresponsive at home and later pronounced dead. At autopsy, a cast-like large bowel obstruction composed of poppy seeds was identified. Postmortem blood morphine level was < 10 ng/mL. Cause of death was determined to be complications of a bowel obstruction secondary to poppy seed ingestion. Deaths related to eating poppy seeds have not been described in the literature...
May 23, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28521781/telling-our-stories-heroin-assisted-treatment-and-snap-activism-in-the-downtown-eastside-of-vancouver
#2
Susan Boyd, Dave Murray, Donald MacPherson
BACKGROUND: This article highlights the experiences of a peer-run group, SALOME/NAOMI Association of Patients (SNAP), that meets weekly in the Downtown Eastside of Vancouver, British Columbia, Canada. SNAP is a unique independent peer- run drug user group that formed in 2011 following Canada's first heroin-assisted treatment trial (HAT), North America Opiate Medication Initiative (NAOMI). SNAP's members are now made up of former research participants who participated in two heroin-assisted trials in Vancouver...
May 18, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/28426507/peripartum-anesthetic-management-of-the-opioid-tolerant-or-buprenorphine-suboxone-dependent-patient
#3
Aileen Pan, Mark Zakowski
Opioid abuse and dependence continues to rise in both the general population and pregnancy, with opioid overdose deaths having quadrupled in the last 15 years. Illicit drug use in last 30 days of pregnancy was over 4% with almost 0.6% documented maternal opiate use at time of birth. The management of the opioid-tolerant, buprenorphine-dependent or methadone-dependent patient in the peripartum period is reviewed. Options for treatment of opioid dependence, acute pain management, and perioperative multimodal analgesia are discussed...
June 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28422795/trial-design-and-endpoint-evaluation-in-clinical-studies-addressing-chronic-back-pain
#4
Peter Staats
STUDY DESIGN: A review of the literature evaluating clinical trials of chronic back pain. OBJECTIVE: To assist physicians in assessing the quality of clinical trial data to make the most informed treatment decisions. SUMMARY OF BACKGROUND DATA: Chronic pain is a tremendous public health issue, affecting close to 100 million adults in the United States, and costs the American people billions of dollars. One traditional treatment approach, the long-term use of opiate medications, has recently come under intense scrutiny for problems with complications, diversion, abuse, addiction and lack of efficacy...
April 18, 2017: Spine
https://www.readbyqxmd.com/read/28398354/global-genetic-variation-of-select-opiate-metabolism-genes-in-self-reported-healthy-individuals
#5
F R Wendt, G Pathak, A Sajantila, R Chakraborty, B Budowle
CYP2D6 is a key pharmacogene encoding an enzyme impacting poor, intermediate, extensive and ultrarapid phase I metabolism of many marketed drugs. The pharmacogenetics of opiate drug metabolism is particularly interesting due to the relatively high incidence of addiction and overdose. Recently, trans-acting opiate metabolism and analgesic response enzymes (UGT2B7, ABCB1, OPRM1 and COMT) have been incorporated into pharmacogenetic studies to generate more comprehensive metabolic profiles of patients. With use of massively parallel sequencing, it is possible to identify additional polymorphisms that fine tune, or redefine, previous pharmacogenetic findings, which typically rely on targeted approaches...
April 11, 2017: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/28380057/specific-behavioral-and-cellular-adaptations-induced-by-chronic-morphine-are-reduced-by-dietary-omega-3-polyunsaturated-fatty-acids
#6
Joshua Hakimian, Ani Minasyan, Lily Zhe-Ying, Mariana Loureiro, Austin Beltrand, Camille Johnston, Alexander Vorperian, Nicole Romaneschi, Waleed Atallah, Fernando Gomez-Pinilla, Wendy Walwyn
Opiates, one of the oldest known drugs, are the benchmark for treating pain. Regular opioid exposure also induces euphoria making these compounds addictive and often misused, as shown by the current epidemic of opioid abuse and overdose mortalities. In addition to the effect of opioids on their cognate receptors and signaling cascades, these compounds also induce multiple adaptations at cellular and behavioral levels. As omega-3 polyunsaturated fatty acids (n-3 PUFAs) play a ubiquitous role in behavioral and cellular processes, we proposed that supplemental n-3 PUFAs, enriched in docosahexanoic acid (DHA), could offset these adaptations following chronic opioid exposure...
2017: PloS One
https://www.readbyqxmd.com/read/28349724/loperamide-metabolite-induced-cardiomyopathy-and-qtc-prolongation
#7
Zabeer Bhatti, Jessica Norsworthy, Tamas Szombathy
Loperamide is an over-the-counter, peripherally acting, μ-opioid receptor agonist used for the treatment of diarrhea. In recent times users have found that at higher doses, loperamide crosses the blood-brain barrier and reaches central μ-receptors in the brain, leading to central opiate effects including euphoria and respiratory depression. We report a case of a 37-year-old female who attempted suicide with over 200 loperamide tablets. During her overdose, her QTc was significantly prolonged at >600 ms...
March 28, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28323538/relationships-between-a-dissociative-subtype-of-ptsd-and-clinical-characteristics-in-patients-with-substance-use-disorders
#8
Michaela Mergler, Martin Driessen, Christel Lüdecke, Martin Ohlmeier, Claudia Chodzinski, Steffen Weirich, Detlef Schläfke, Dirk Wedekind, Ursula Havemann-Reinecke, Walter Renner, Ingo Schäfer
The increasing support for a dissociative subtype of post-traumatic stress disorder (PTSD-D) has led to its inclusion in DSM-5. We examined relationships between PTSD-D and relevant variables in patients with substance use disorders (SUD). The sample comprised N = 459 patients with SUD. The International Diagnostic Checklist and the Posttraumatic Diagnostic Scale were used to diagnose PTSD. In addition, participants completed the Childhood Trauma Questionnaire and the Dissociative Experiences Scale. The course of SUD was assessed by means of the European Addiction Severity Index...
March 21, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28301858/anti-nerve-growth-factor-therapy-increases-spontaneous-day-night-activity-in-mice-with-orthopedic-surgery-induced-pain
#9
Lisa A Majuta, Jean-Marc G Guedon, Stefanie A T Mitchell, Michael H Ossipov, Patrick W Mantyh
Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are 2 of the most common and successful surgical interventions to relieve osteoarthritis pain. Control of postoperative pain is critical for patients to fully participate in the required physical therapy which is the most influential factor in effective postoperative knee rehabilitation. Currently, opiates are a mainstay for managing postoperative orthopedic surgery pain including TKA or THA pain. Recently, issues including efficacy, dependence, overdose, and death from opiates have made clinicians and researchers more critical of use of opioids for treating nonmalignant skeletal pain...
April 2017: Pain
https://www.readbyqxmd.com/read/28246098/opiate-addiction-and-overdose-experiences-attitudes-and-appetite-for-community-naloxone-provision
#10
Tomás Barry, Jan Klimas, Helen Tobin, Mairead Egan, Gerard Bury
BACKGROUND: More than 200 opiate overdose deaths occur annually in Ireland. Overdose prevention and management, including naloxone prescription, should be a priority for healthcare services. Naloxone is an effective overdose treatment and is now being considered for wider lay use. AIM: To establish GPs' views and experiences of opiate addiction, overdose care, and naloxone provision. DESIGN AND SETTING: An anonymous postal survey to GPs affiliated with the Department of Academic General Practice, University College Dublin, Ireland...
February 28, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28127666/examining-fatal-opioid-overdoses-in-marion-county-indiana
#11
Bradley Ray, Kenna Quinet, Timothy Dickinson, Dennis P Watson, Alfarena Ballew
Drug-related overdoses are now the leading injury-related death in the USA, and many of these deaths are associated with illicit opioids and prescription opiate pain medication. This study uses multiple sources of data to examine accidental opioid overdoses across 6 years, 2010 through 2015, in Marion County, IN, an urban jurisdiction in the USA. The primary sources of data are toxicology reports from the county coroner, which reveal that during this period, the most commonly detected opioid substance was heroin...
April 2017: Journal of Urban Health: Bulletin of the New York Academy of Medicine
https://www.readbyqxmd.com/read/28100012/characterization-and-management-of-patients-with-heroin-versus-nonheroin-opioid-overdoses-experience-at-an-academic-medical-center
#12
Kate M Morizio, Regan A Baum, Adam Dugan, Julia E Martin, Abby M Bailey
STUDY OBJECTIVES: To characterize the differences between patients who had heroin and nonheroin 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 nonheroin opioid overdose event, and 443 patients experienced a heroin overdose event...
January 18, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28051839/social-context-and-perspectives-of-non-medical-prescription-opioid-use-among-young-adults-in-rhode-island-a-qualitative-study
#13
Jesse L Yedinak, Elizabeth N Kinnard, Scott E Hadland, Traci C Green, Melissa A Clark, Brandon D L Marshall
BACKGROUND AND OBJECTIVES: This pilot study examined the context of nonmedical prescription opioid (NMPO) use and related risk behaviors among young adults in Rhode Island, a New England region with markedly high prevalence of NMPO use and overdose mortality. METHODS: We conducted semi-structured interviews (n = 13) with young adults (18-29 year-olds) who reported current or recent NMPO use. We also conducted focus groups (two groups, n = 14 total) with professional service providers recruited from service organizations...
December 2016: American Journal on Addictions
https://www.readbyqxmd.com/read/28009632/anti-nerve-growth-factor-therapy-increases-spontaneous-day-night-activity-in-mice-with-orthopedic-surgery-induced-pain
#14
Lisa A Majuta, Jean-Marc G Guedon, Stefanie A T Mitchell, Michael H Ossipov, Patrick W Mantyh
Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are two of the most common and successful surgical interventions to relieve osteoarthritis pain. Control of postoperative pain is critical for patients to fully participate in the required physical therapy which is the most influential factor in effective postoperative knee rehabilitation. Currently opiates are a mainstay for managing postoperative orthopedic surgery pain including TKA/THA pain. Recently, issues including efficacy, dependence, overdose and death from opiates have made clinicians and researchers more critical of use of opioids for treating non-malignant skeletal pain...
December 15, 2016: Pain
https://www.readbyqxmd.com/read/27986693/cautious-use-and-optimal-dose-of-morphine-for-relieving-malignant-pain-in-a-complex-patient-with-multiple-comorbidities
#15
Vinod Kumar, Rakesh Garg, Nishkarsh Gupta, Sachidanand Jee Bharati
Oral morphine remains the drug of choice for the management of severe pain due to cancer as per WHO ladder of analgesia. Providing adequate pain relief in palliative care settings for pain due to cancer is challenging. Options become limited in cases of associated systemic comorbidities such as renal dysfunction, hypoproteinaemia, anaemia. Patients with renal dysfunction and other comorbidities may develop drug overdose due to abnormal pharmacokinetics. Renal dysfunction affects the pharmacokinetics of morphine by altering its absorption, metabolism and clearance...
December 16, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27984493/anti-nerve-growth-factor-therapy-increases-spontaneous-day-night-activity-in-mice-with-orthopedic-surgery-induced-pain
#16
Lisa A Majuta, Jean-Marc G Guedon, Stefanie A T Mitchell, Michael H Ossipov, Patrick W Mantyh
Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are two of the most common and successful surgical interventions to relieve osteoarthritis pain. Control of postoperative pain is critical for patients to fully participate in the required physical therapy which is the most influential factor in effective postoperative knee rehabilitation. Currently opiates are a mainstay for managing postoperative orthopedic surgery pain including TKA/THA pain. Recently, issues including efficacy, dependence, overdose and death from opiates have made clinicians and researchers more critical of use of opioids for treating non-malignant skeletal pain...
December 15, 2016: Pain
https://www.readbyqxmd.com/read/27863698/striatal-h3k27-acetylation-linked-to-glutamatergic-gene-dysregulation-in-human-heroin-abusers-holds-promise-as-therapeutic-target
#17
Gabor Egervari, Joseph Landry, James Callens, John F Fullard, Panos Roussos, Eva Keller, Yasmin L Hurd
BACKGROUND: Opiate abuse and overdose reached epidemic levels in the United States. However, despite significant advances in animal and in vitro models, little knowledge has been directly accrued regarding the neurobiology of the opiate-addicted human brain. METHODS: We used postmortem human brain specimens from a homogeneous European Caucasian population of heroin users for transcriptional and epigenetic profiling, as well as direct assessment of chromatin accessibility in the striatum, a brain region central to reward and emotion...
April 1, 2017: Biological Psychiatry
https://www.readbyqxmd.com/read/27859761/methadone-complications-amongst-opioid-dependent-patients-in-malaysia-a-case-series
#18
Philip George, Balasingam Vicknasingam, Sivakumar Thurairajasingam, Parameswaran Ramasamy, Haslina Mohd Yusof, Mohd Azhar Bin Mohd Yasin, Zia U Bahkt Sultan Shah
INTRODUCTION AND AIMS: Opioid dependence remains the main type of illicit substance used in Malaysia, which has an estimated 187 771 opiate users. There are currently 333 active methadone maintenance treatment centres nationwide. Although methadone has proven to be an effective maintenance therapy, it has clinical concerns which can have an impact on its effectiveness and safety. DESIGN, METHODS AND RESULTS: A case series of seven patients from Malaysian private and public hospital settings who had an adverse reaction with methadone is discussed...
November 8, 2016: Drug and Alcohol Review
https://www.readbyqxmd.com/read/27727036/an-unusual-case-of-alternating-ventricular-morphology-on-the-12-lead-electrocardiogram
#19
Maura Sammon, Alveena Dawood, Scott Beaudoin, Richard A Harrigan
BACKGROUND: One of the principal tasks of an emergency physician is identifying potentially life-threatening conditions in the undifferentiated patient; cardiac dysrhythmia is an example of such a condition. A systematic approach to a patient with atypical dysrhythmia enables proper identification of such-life threatening conditions. CASE REPORT: We describe a 31-year-old man presenting to the emergency department with an undifferentiated dysrhythmia after naloxone reversal of an opiate overdose...
March 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27673424/drugs-guns-and-cars-how-far-we-have-come-to-improve-safety-in-the-united-states-yet-we-still-have-far-to-go
#20
REVIEW
James Dodington, Pina Violano, Carl R Baum, Kirsten Bechtel
Significant breakthroughs in the field of injury prevention and childhood safety have occurred during the past half-century. For example, the Poison Prevention Packaging Act of 1970 and the institution of child passenger safety laws are responsible for a significant reduction in injuries among children and adolescents. This review will focus on the following three topics because of their significant contribution to pediatric injury morbidity, especially among adolescents, and their promise for further effective prevention research...
October 26, 2016: Pediatric Research
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