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https://www.readbyqxmd.com/read/29762767/concerns-and-help-seeking-among-patients-using-opioids-for-management-of-chronic-noncancer-pain
#1
Briony Larance, Gabrielle Campbell, Teleri Moore, Suzanne Nielsen, Raimondo Bruno, Nicholas Lintzeris, Milton Cohen, Wayne Hall, Richard Mattick, Courtney O'Donnell, Louisa Degenhardt
Background: The safety and efficacy of long-term opioid treatment for chronic noncancer pain (CNCP) remains controversial. This study examined whether patients who report problematic opioid use sought help and/or perceived barriers to help-seeking. Methods: Data were collected from 1,086 people prescribed opioids for CNCP via a large prospective cohort called the Pain and Opioids IN Treatment (POINT) study. Patients' characteristics and help-seeking were examined according to scores on the Prescribed Opioids Difficulties Scale (PODS)...
May 11, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29762153/increased-mortality-and-reoperation-rates-after-treatment-for-septic-arthritis-of-the-knee-in-people-who-inject-drugs-nationwide-inpatient-sample-2000-2013
#2
David Hyung Won Oh, Alysse Gail Wurcel, David Joseph Tybor, Deirdre Burke, Mariano E Menendez, Matthew Joseph Salzler
BACKGROUND: The United States has a growing opioid epidemic impacting all aspects of health care including orthopaedic surgery. Septic arthritis of the knee is a condition commonly encountered by orthopaedic surgeons related to opioid and injection drug use (IDU). Changes in the frequency of hospitalizations for IDU-related septic arthritis and differences in septic arthritis patient outcomes according to IDU status in the setting of the burgeoning opioid epidemic are unknown. QUESTIONS/PURPOSES: (1) What proportion of patients with septic arthritis of the knee use injection drugs? (2) Are there any differences in complications, reoperations, length of stay, and leaving against medical advice among patients with septic arthritis of the knee with and without IDU? (3) What are the age and racial trends in IDU-related septic arthritis of the knee from 2000 to 2013? METHODS: The Healthcare Cost and Utilization Project, Nationwide Inpatient Sample database of years 2000 to 2013 was utilized for patients between ages 15 and 64 years with a principal discharge diagnosis of native septic arthritis of the lower leg, the vast majority of which represents the knee...
May 14, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29754729/-femoral-pseudoaneurysms-in-drug-addicts-about-4-cases
#3
M Ben Hammamia, M Fourati, J Ziadi, F Ghedira, M Ben Mrad, R Denguir
PURPOSE: To describe the therapeutic management of false aneurysms of the femoral artery in drug addicts. PATIENTS AND METHODS: We report the cases of four drug addicts with pseudoaneurysms of the femoral artery. RESULTS: All patients were male with a mean age of 36 years. Emergency surgical treatment involved removal of the pseudoaneurysm followed by a venous graft (n=3) or patch (n=1). The post-operative period was uneventful for three patients...
May 2018: Journal de Médecine Vasculaire
https://www.readbyqxmd.com/read/29752906/tramadol-understanding-the-risk-of-serotonin-syndrome-and-seizures
#4
REVIEW
Sameer Hassamal, Karen Miotto, William Dale, Itai Danovitch
Tramadol is commonly prescribed for pain control because it presents a lower risk for addiction and respiratory depression compared to other opioids. However, tramadol's serotonin and norepinephrine reuptake inhibitory effects result in a unique adverse effect profile. Two such adverse events are serotonin syndrome and seizures. The prevalence of tramadol-induced serotonin syndrome and seizures is modest in the general population but if left untreated, the morbidity and mortality can be high, and therefore prompt recognition and management is essential...
May 9, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29750036/oxycodone-hydrochloride-immediate-release-analgesic-for-managing-severe-pain-abuse-deterrent-formulations
#5
EDITORIAL
A H Kibbe, T S Franko, V M Shah
This paper is an expert opinion in response to the development of abuse-deterrent immediate-release tablets containing oxycodone HCl. There is a potential impact, both positive and negative, of this type of dosage form on patients, those suffering from the disease of addiction, health care providers, and the cost of health care.
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29748064/-helping-smoking-cessation-in-copd-asthma-lung-cancer-operated-smokers
#6
J Perriot, M Underner, G Peiffer, B Dautzenberg
Smoking is the cause of addictive behavior. Tobacco addiction is a chronic disease that makes difficult to stop smoking and leads to further use. Smoking is a risk factor for COPD, asthma and lung cancer; it may be the cause of severe perioperative complications. This finding justifies that smokers benefit from advice of stopping smoking and smoking cessation assistance. Helping patients to stop smoking increases the chances of quitting, improves the prognosis of tobacco-related diseases, the effectiveness of their treatments and the quality of life of the patients...
May 7, 2018: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/29741751/smartphone-addiction-and-school-life-adjustment-among-high-school-students-the-mediating-effect-of-self-control
#7
YoungJin Heo, Kyunghee Lee
Previous studies have reported associations among smartphone addiction, school adjustment, and self-control. However, the causal relationship between smartphone addiction and school adjustment has not been clearly demonstrated. The current study examined the association between smartphone addiction and school adjustment and investigated the mediating effect of self-control in this association. A total of 790 students from five high schools in Daegu City, South Korea, were asked to provide demographic information and complete a self-diagnostic smartphone addiction scale and validated Korean version of a self-control scale...
May 8, 2018: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/29740807/the-mental-health-parity-and-addiction-equity-act-evaluation-study-impact-on-nonquantitative-treatment-limits-for-specialty-behavioral-health-care
#8
Amber Gayle Thalmayer, Jessica M Harwood, Sarah Friedman, Francisca Azocar, L Amy Watson, Haiyong Xu, Susan L Ettner
OBJECTIVE: To assess frequency, type, and extent of behavioral health (BH) nonquantitative treatment limits (NQTLs) before and after implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). DATA SOURCES: Secondary administrative data for Optum carve-out and carve-in plans. STUDY DESIGN: Cross-tabulations and "two-part" regression models were estimated to assess associations of parity period with NQTLs...
May 8, 2018: Health Services Research
https://www.readbyqxmd.com/read/29740186/exploring-parent-expectations-of-neonatal-therapeutic-hypothermia
#9
Alexa K Craig, Roslyn Gerwin, Janelle Bainter, Scott Evans, Christine James
OBJECTIVE: We aimed to assess the parent experience of therapeutic hypothermia (TH), specifically focusing on unmet expectations. STUDY DESIGN: Open-ended questions were used in a focus group setting. We employed an inductive approach to develop thematic content from the transcribed recordings. RESULTS: 30 parents of infants treated with TH participated. Within the principal theme of managing expectations, four sub-themes emerged. These included parental concerns about morphine use; specifically the association of morphine with end-of-life care and addiction...
May 8, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29735382/evidence-based-nonpharmacologic-strategies-for-comprehensive-pain-care-the-consortium-pain-task-force-white-paper
#10
Heather Tick, Arya Nielsen, Kenneth R Pelletier, Robert Bonakdar, Samantha Simmons, Ronald Glick, Emily Ratner, Russell L Lemmon, Peter Wayne, Veronica Zador
Consortium Pain Taskforce White Paper Summary Evidence-based Nonpharmacologic Strategies for Comprehensive Pain Care Supplementary information can be found in the online version at https://doi.org/10.1016/j.explore.2018.02.001. Medical pain management is in crisis; from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addiction, diversion and overdose deaths. The rising costs of pain care and managing adverse effects of that care have prompted action from state and federal agencies including the DOD, VHA, NIH, FDA and CDC...
March 1, 2018: Explore: the Journal of Science and Healing
https://www.readbyqxmd.com/read/29729776/safe-opioid-use-management-of-opioid-related-adverse-effects-and-aberrant-behaviors
#11
REVIEW
Joseph Arthur, David Hui
Opioids are highly effective for cancer pain but are associated with multiple adverse effects and risk of addiction. This article provides a synopsis on the management of various opioid-related adverse effects and strategies to minimize aberrant opioid use in patients who have cancer. Many adverse effects can be effectively managed. Some patients on chronic opioid therapy may demonstrate aberrant behaviors suggestive of opioid misuse or diversion. Through intensive education, longitudinal monitoring, early identification, and timely management, clinicians can optimize the risk to benefit ratio to support safe opioid use...
June 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/29729554/the-burden-of-personality-disorders-on-the-dsm-5-addiction-to-tobacco-during-pregnancy
#12
Ester di Giacomo, Fabrizia Colmegna, Francesca Pescatore, Flora Aspesi, Maria Fotiadou, Massimo Clerici
BACKGROUND: Tobacco smoking is a major health concern. Many women smoke during their reproductive years, some of them during their pregnancy. Adverse outcomes for the newborns physical health are well recognized, while the influence on their mental health is still under investigation. We aim at demonstrating the contribution of maternal personality disorders in maintaining addiction to tobacco during pregnancy, to underline their role and the need of their detection as a preventive effort...
April 25, 2018: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/29723917/opiate-free-pain-therapy-using-carbamazepine-loaded-microparticles-provides-up-to-two-weeks-of-pain-relief-in-a-neuropathic-pain-model
#13
Haining Dai, Dana M Tilley, Greici Mercedes, Chris Doherty, Amitabh Gulati, Neel Mehta, Amer Khalil, Katrin Holzhaus, Francis M Reynolds
INTRODUCTION: Opioids remain a mainstay in the treatment of acute and chronic pain, despite numerous and potentially dangerous side effects. There is a great unmet medical need for alternative treatments for patients suffering from pain that do not result in addiction or adverse side effects. Anticonvulsants have been shown to be effective in managing pain, though high systemic levels and subsequent side effects limit its widespread usage. Our goal was to determine if the incorporation of an anticonvulsant, carbamazepine, into a biodegradable microparticle for local sustained perineural release would be an efficacious analgesic following a peripheral injury...
May 3, 2018: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29719345/status-investigation-of-outpatients-receiving-methadone-maintenance-treatment-mmt-in-shanghai-from-2005-to-2016
#14
Jiayi Bao, Lei Zhang, Zhen Ning, Jie Fu, Min Zhao, Jiang DU
Background: Methadone maintenance treatment (MMT) is an effective measure to control drug abuse, prevent AIDS, and improve family and social functions among those with heroin addiction. Relevant surveys in recent years show that the number of outpatients receiving MMT has a downward trend. Aims: To understand variation in maintenance treatment rates and causes of withdrawal for outpatients receiving MMT in Shanghai since initiation of this program. Method: This study was a retrospective investigation, with data from the AIDS Comprehensive Prevention and Control Data Information Management System of the China AIDS Prevention and Control Center...
December 25, 2017: Shanghai Archives of Psychiatry
https://www.readbyqxmd.com/read/29716637/is-intravenously-administered-subdissociative-dose-ketamine-non-inferior-to-morphine-for-prehospital-analgesia-the-ketamorph-study-study-protocol-for-a-randomized-controlled-trial
#15
Clément Le Cornec, Said Lariby, Vivien Brenckmann, Jean Benoit Hardouin, Claude Ecoffey, Marion Le Pottier, Philippe Fradin, Hélène Broch, Amine Kabbaj, Yannick Auffret, Florence Deciron, Céline Longo, François Javaudin, Quentin Le Bastard, Joël Jenvrin, Emmanuel Montassier
BACKGROUND: Acute pain is a common condition among prehospital patients and prompt management is pivotal. Opioids are the most frequently analgesics used in the prehospital setting. However, opioids are highly addictive, and some patients may develop opioid dependence, even when they are exposed to brief opioid treatments. Therefore, alternative non-opioid analgesia should be developed to manage pain in the prehospital setting. Used at subdissociative doses, ketamine, a noncompetitive N-methyl-D-aspartate and glutamate receptor antagonist, provides analgesic effects accompanied by preservation of protective airway reflexes...
May 2, 2018: Trials
https://www.readbyqxmd.com/read/29708863/addressing-the-growing-opioid-and-heroin-abuse-epidemic-a-call-for-medical-school-curricula
#16
Madison C Ratycz, Thomas J Papadimos, Allison A Vanderbilt
Substance abuse is a growing public health concern in the USA (US), especially now that the US faces a national drug overdose epidemic. Over the past decade, the number of drug overdose deaths has rapidly grown, largely driven by increases in prescription opioid-related overdoses. In recent years, increased heroin and illicitly manufactured fentanyl overdoses have substantially contributed to the rise of overdose deaths. Given the role of physicians in interacting with patients who are at risk for or currently abusing opioids and heroin, it is essential that physicians are aware of this issue and know how to respond...
December 2018: Medical Education Online
https://www.readbyqxmd.com/read/29704954/a-systematic-review-of-opioid-use-after-extremity-trauma-in-orthopedic-surgery
#17
REVIEW
Rikki M Koehler, Ugochi C Okoroafor, Lisa K Cannada
BACKGROUND: The United States is in a prescription opioid crisis. Orthopedic surgeons prescribe more opioid narcotics than any other surgical specialty. The purpose of this study was to evaluate the state of opioid use after extremity trauma in orthopedic surgery. METHODS: A computerized literature search of PubMed/MEDLINE was conducted to evaluate the status of opioids after extremity fractures. Six articles were identified and included in the review. RESULTS: Patients who consume more opioids communicate greater pain intensity and less satisfaction with pain control...
April 12, 2018: Injury
https://www.readbyqxmd.com/read/29704194/qualitative-assessment-of-clerkship-students-perspectives-of-the-topics-of-pain-and-addiction-in-their-preclinical-curriculum
#18
Inbar Raber, Alexander Ball, Jennifer Papac, Anuj Aggarwal, Rachel Sussman, Preetha Basaviah, Jordan Newmark, Anna Lembke
OBJECTIVE: A majority of physicians feel poorly trained in the treatment of chronic pain and addiction. As such, it is critical that medical students receive appropriate education in both pain management and addiction. The purpose of this study was to assess the pre-clinical curriculum in pain medicine and addiction from the perspective of students after they had completed their pre-clinical training and to assess what they perceived as the strengths and weaknesses of their training. METHODS: The authors conducted focused interviews among clinical medical students who had completed at least 6 months of clerkships...
April 27, 2018: Academic Psychiatry
https://www.readbyqxmd.com/read/29703765/role-of-epidermal-growth-factor-receptor-egfr-inhibitors-and-radiation-in-the-management-of-brain-metastases-from-egfr-mutant-lung-cancers
#19
REVIEW
Melin J Khandekar, Zofia Piotrowska, Henning Willers, Lecia V Sequist
The growth of genotype-directed targeted therapies, such as inhibitors of the epidermal growth factor receptor (EGFR), has revolutionized treatment for some patients with oncogene-addicted lung cancer. However, as systemic control for these patients has improved, brain metastases remain an important source of morbidity and mortality. Traditional treatment for brain metastases has been radiotherapy, either whole-brain radiation or stereotactic radiosurgery. The growing availability of drugs that can cross the blood-brain barrier and have activity in the central nervous system (CNS) has led to many studies investigating whether targeted therapy can be used in combination with or in lieu of radiation...
April 27, 2018: Oncologist
https://www.readbyqxmd.com/read/29702515/integrated-care-for-the-use-of-direct-acting-antivirals-in-patients-with-chronic-hepatitis-c-and-substance-use-disorder
#20
Jean-Baptiste Trabut, Camille Barrault, Hélène Charlot, Damien Carmona, Anne Bourdel, Mustapha Benslimane, Murielle François, Willy Kini-Matondo, Richard Causse, Françoise Roudot-Thoraval, Christophe Hézode
OBJECTIVES: Since little is currently known about predictors of response to direct-acting antiviral agents (DAAs) in people who inject drugs, we undertook an analysis of patients attending a hepatitis clinic with addiction services (outpatient clinics and inpatient services) to examine the outcomes associated with the treatment of difficult-to-manage patients with substance use. Our experience was based on integrated care. METHOD: A retrospective analysis was undertaken of 50 patients with hepatitis C virus (HCV) and a history of addiction who received treatment with DAAs, according to European guidelines...
April 26, 2018: Journal of Addiction Medicine
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