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https://www.readbyqxmd.com/read/29142795/comorbid-post-traumatic-stress-disorder-and-opioid-dependence
#1
Rikinkumar S Patel, Ahmed Elmaadawi, Suhayl Nasr, John Haskin
Post-traumatic stress disorder (PTSD) is predominant amongst individuals addicted to opioids and obscures the course of illness and the treatment outcome. We report the case of a patient with major depressive disorder and opioid dependence, who experienced post-traumatic stress disorder symptoms during a recent visit to the inpatient unit. The similarity of symptoms between post-traumatic stress disorder and opioid dependence is so high that, sometimes, it is a challenge to differentiate between these conditions...
September 3, 2017: Curēus
https://www.readbyqxmd.com/read/29142219/electroacupuncture-attenuates-induction-of-inflammatory-pain-by-regulating-opioid-and-adenosine-pathways-in-mice
#2
Hsien-Yin Liao, Ching-Liang Hsieh, Chun-Ping Huang, Yi-Wen Lin
Although inflammatory pain is a common clinical condition, its mechanisms are still unclear. Electroacupuncture (EA), a well-known method of pain management, may reduce inflammatory pain by regulating neurons, astrocytes, and inflammatory signaling pathways. Injections of complete Freund's adjuvant (CFA), which can initiate cell-mediated inflammatory pain, resulted in significant hyperalgesia, which was subsequently prevented by EA. In CFA-injected mice, a dramatic increase was observed in the expression of the following proteins in the dorsal root ganglion and spinal cord dorsal horn: the astrocytic marker GFAP, S100B, RAGE, pPKCε, COX-2, pERK, and pNFκB...
November 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29141380/-the-analysis-of-anesthetic-management-for-renal-cell-carcinoma-with-associated-inferior-vena-cava-tumor-thrombus
#3
H Zeng, X Y Rong, Y Wang, X Y Guo
Objective: To explore the key points of anesthetic management for renal cell carcinoma combined with inferior vena cava (IVC) tumor thrombus. Methods: Twenty-seven cases of renal cell carcinoma with inferior vena cava (IVC) tumor thrombus underwent radical nephrectomy and inferior caval venous thrombectomy were reviewed retrospectively during January 2014 to January 2017 in our hospital.Analyzed data includs demographics, classification of tumor, perioperative anesthetic management and monitoring approaches, IVC clamping time , vital signs during cardiopulmonary bypass(CPB), estimated blood loss (EBL), usage of blood products, hospitalization time and ICU time , as well as postoperative outcomes...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29138590/the-prevalence-of-probable-neuropathic-pain-in-the-us-results-from-a-multimodal-general-population-health-survey
#4
Marco D DiBonaventura, Alesia Sadosky, Kristen Concialdi, Markay Hopps, Ian Kudel, Bruce Parsons, Joseph C Cappelleri, Patrick Hlavacek, Andrea H Alexander, Brett R Stacey, John D Markman, John T Farrar
Background: The prevalence of neuropathic pain (NeP) has been estimated within specific health conditions; however, there are no published data on its broad prevalence in the US. The current exploratory study addresses this gap using the validated PainDetect questionnaire as a screener for probable NeP in a general-population health survey conducted with a multimodal recruitment strategy to maximize demographic representativeness. Materials and methods: Adult respondents were recruited from a combination of Internet panels, telephone lists, address lists, mall-based interviews, and store-receipt invitations using a random stratified-sampling framework, with strata defined by age, sex, and race/ethnicity...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29137427/association-of-opioid-receptor-mu-1-oprm1-a118g-polymorphism-rs1799971-with-nicotine-dependence
#5
Xiangyi Kong, Hao Deng, Theodore Alston, Yanguo Kong, Jingping Wang
Background and Object: Whether opioid-receptor mu 1 (OPRM1) A118G polymorphism (rs1799971) is associated with nicotine dependence is controversial. We analyzed the combined results from published studies of this possibility. Methods: Literature reviews were performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Web of Science, Chinese National Science Infrastructure (CNKI), PubMed, Embase and Google Scholar database searches using MeSH terms were conducted to find all relevant researches up to October 2016...
October 13, 2017: Oncotarget
https://www.readbyqxmd.com/read/29135692/ultrasound-with-neurostimulation-compared-with-ultrasound-guidance-alone-for-lumbar-plexus-block-a-randomised-single-blinded-equivalence-trial
#6
Vanlapa Arnuntasupakul, Theerawat Chalachewa, Prangmalee Leurcharusmee, Worakamol Tiyaprasertkul, Roderick J Finlayson, De Q Tran
BACKGROUND: Ultrasound-guided lumbar plexus blocks usually require confirmatory neurostimulation. A simpler alternative is to inject local anaesthetic inside the posteromedial quadrant of the psoas muscle under ultrasound guidance. OBJECTIVE: We hypothesised that both techniques would result in similar total anaesthesia time, defined as the sum of performance and onset time. DESIGN: A randomised, observer-blinded, equivalence trial (equivalence margin = 7...
November 11, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29135138/-laparoscopic-radical-cystectomy-innovations-and-classics
#7
D V Perlin, I V Aleksandrov, V P Zipunnikov, M Popova
INTRODUCTION: Radical cystectomy remains the gold-standard treatment for muscle-invasive bladder cancer. To combine the advantages of minimally invasive interventions and the well-established open surgery, we attempted to reproduce as accurately as possible the technique of open radical cystectomy using a laparoscopic procedure. MATERIALS AND METHODS: The study comprised 35 patients (27 men and 8 women) with invasive bladder cancer who underwent laparoscopic radical cystectomy (LRC) between April 2013 and March 2016...
October 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/29133887/a-complementary-scale-of-biased-agonism-for-agonists-with-differing-maximal-responses
#8
Javier Burgueño, Marta Pujol, Xavier Monroy, David Roche, Maria Jose Varela, Manuel Merlos, Jesús Giraldo
Compelling data in the literature from the recent years leave no doubt about the pluridimensional nature of G protein-coupled receptor function and the fact that some ligands can couple with different efficacies to the multiple pathways that a receptor can signal through, a phenomenon most commonly known as functional selectivity or biased agonism. Nowadays, transduction coefficients (log(τ/KA)), based on the Black and Leff operational model of agonism, are widely used to calculate bias. Nevertheless, combining both affinity and efficacy in a single parameter can result in compounds showing a defined calculated bias of one pathway over other though displaying varying experimental bias preferences...
November 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29130474/interventions-for-the-reduction-of-prescribed-opioid-use-in-chronic-non-cancer-pain
#9
REVIEW
Christopher Eccleston, Emma Fisher, Kyla H Thomas, Leslie Hearn, Sheena Derry, Cathy Stannard, Roger Knaggs, R Andrew Moore
BACKGROUND: This is the first update of the original Cochrane Review published in 2013. The conclusions of this review have not changed from the 2013 publication. People with chronic non-cancer pain who are prescribed and are taking opioids can have a history of long-term, high-dose opioid use without effective pain relief. In those without good pain relief, reduction of prescribed opioid dose may be the desired and shared goal of both patient and clinician. Simple, unsupervised reduction of opioid use is clinically challenging, and very difficult to achieve and maintain...
November 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29128652/differences-in-combinations-and-concentrations-of-drugs-of-abuse-in-fatal-intoxication-and-driving-under-the-influence-cases
#10
Hilde Erøy Edvardsen, Torill Tverborgvik, Joachim Frost, Sidsel Rogde, Inge Morild, Helge Waal, Thomas Clausen, Lars Slørdal, Vigdis Vindenes
BACKGROUND: In toxicology, international classification systems focus on single intoxicants as the cause of death. It is, however, well known that very few drug related deaths are caused by a single substance and that information concerning the drug concentrations as well as the combinations of drugs are essential in order to ascertain the cause of death. The aim of the study was to assess whether those prone to fatal intoxications differ significantly from chronic drug users - in terms of demographics and drug exposure patterns...
November 6, 2017: Forensic Science International
https://www.readbyqxmd.com/read/29128486/lower-dose-of-sufentanil-does-not-enhance-fast-track-significantly-a-randomized-study
#11
Rajesh Bhavsar, Pia Katarina Ryhammer, Jacob Greisen, Carl-Johan Jakobsen
OBJECTIVE: Adjustment in the doses of opioids has been a focus of interest for achieving better fast-track conditions in cardiac anesthesia, but relatively sparse information exists on the potential effect of psychologic and behavioral factors, such as stress, anxiety, and type of personality, on anesthesia requirements and patient turnover in the cardiac recovery unit (CRU); to the authors' knowledge, this particular focus has not been systematically investigated. In this randomized study, the authors tested the hypothesis that low-dose sufentanil, compared with a standard dose, can improve fast-track parameters and the overall quality of recovery...
August 9, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29127135/traditional-chinese-medicine-facilitated-treatments-may-relieve-anxiety-symptoms-during-drug-switching-from-methadone-to-buprenorphine-naloxone-for-treating-opioid-dependence
#12
Kai-Chiang Yu, Han-Ting Wei, Yuh-Hsiang Yeh, Chung-Hua Hsu
This study investigated a 51-year-old married man with a history of heroin dependence who underwent methadone maintenance treatment for 7 years. He received traditional Chinese medicine (TCM)-facilitated treatments and switched from methadone to buprenorphine/naloxone. Strong anxiety symptoms were observed during the initial stage; therefore, we prescribed a combination of Chaihu-Shugan-San, Zhi Bai Di Huang and Chin-Gin-Kuan-Ming decoction as the major herbal synergic regimen to relieve the symptoms of opioid withdrawal, anxiety and insomnia...
November 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29127114/compared-with-what-estimating-the-effects-of-injury-prevention-policies-using-the-synthetic-control-method
#13
Carl Bonander
INTRODUCTION: This paper discusses the application of the synthetic control method to injury-related interventions using aggregate data from public information systems. The method selects and determines the optimal control unit in the data by minimising the difference between the pre-intervention outcomes in one treated unit (eg, a state) and a weighted combination of potential control units. METHOD: I demonstrate the synthetic control method by an application to Florida's post-2010 policy and law enforcement initiatives aimed at bringing down opioid overdose deaths...
November 10, 2017: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
https://www.readbyqxmd.com/read/29122372/sufentanil-sublingual-tablet-30mcg-for-moderate-to-severe-acute-pain-in-the-emergency-department
#14
James R Miner, Zubaid Rafique, Harold S Minkowitz, Karen P DiDonato, Pamela P Palmer
BACKGROUND: Pharmacological properties of the sufentanil sublingual tablet 30mcg (SST 30mcg) could offer potential analgesic advantages in settings requiring noninvasive, acute pain management. The feasibility of using SST 30mcg for moderate-to-severe pain management in the emergency department (ED) was evaluated. METHODS: This open-label, multicenter feasibility study included patients aged ≥18years who presented to the ED with moderate-to-severe pain (≥4 on the numeric rating scale of pain intensity (NRS); opioid-tolerant patients were excluded...
October 31, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29121327/short-acting-opioids-are-associated-with-comparable-analgesia-to-long-acting-opioids-in-patients-with-chronic-osteoarthritis-with-a-reduced-opioid-equivalence-dosing
#15
Ameer Ghodke, Stephanie Barquero, Paul R Chelminski, Timothy J Ives
Setting: There are no studies that exist within the primary care setting that address optimal opioid therapy in osteoarthritis patients. In light of the recently released US Centers for Disease Control and Prevention guidelines on opioid use in chronic noncancer pain, there is a pressing need to better characterize the effectiveness of long- and short-acting opioids. Objective: To examine the effectiveness of short-acting opioids (SAO) vs long-acting opioids (LAO) and combination therapies (SAO and LAO) for treating chronic osteoarthritis pain in a retrospective trial...
November 7, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29121158/opioid-use-by-patients-after-rhinoplasty
#16
Sagar Patel, Angela Sturm, Michael Bobian, Peter F Svider, Giancarlo Zuliani, Russell Kridel
Importance: Given the increase in opioid addiction and overdose in the United States, reasoned opioid use after outpatient surgery may affect prescription medication abuse. Objectives: To examine patient use of opioids after rhinoplasty and establish an optimal postrhinoplasty pain management regimen. Design, Setting, and Participants: In this case series, opioid use was evaluated in 62 patients who underwent rhinoplasty performed by 3 fellowship-trained facial plastic surgeons, 2 in private practice in Texas and 1 in an academic setting in Michigan, from February 2016 to September 2016...
November 9, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/29120851/the-generalizability-of-the-structure-of-substance-abuse-and-antisocial-behavioral-syndromes-a-systematic-review
#17
REVIEW
S E Soe-Agnie, M C S Paap, J E L VanDerNagel, H J M Nijman, C A J de Jong
BACKGROUND: Although several authors have suggested that a single externalizing spectrum encompassing both antisocial behavioral syndromes and substance use disorder is to be preferred, this assumption has not been evaluated systematically throughout studies. PURPOSE: The objective was to establish the generalizability of transdiagnostic models of externalizing disorders across different types of disorders and populations, in regard to the strength of the evidence...
November 4, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/29120311/alberta-s-provincial-take-home-naloxone-program-a-multi-sectoral-and-multi-jurisdictional-response-to-overdose
#18
Lisa K Freeman, Stacey Bourque, Nick Etches, Karin Goodison, Claire O'Gorman, Kay Rittenbach, Christopher A Sikora, Mark Yarema
SETTING: Alberta is a prairie province located in western Canada, with a population of approximately 4.3 million. In 2016, 363 Albertans died from apparent drug overdoses related to fentanyl, an opioid 50-100 times more toxic than morphine. This surpassed the number of deaths from motor vehicle collisions and homicides combined. INTERVENTION: Naloxone is a safe, effective, opioid antagonist that may quickly reverse an opioid overdose. In July 2015, a committee of community-based harm reduction programs in Alberta implemented a geographically restricted take-home naloxone (THN) program...
November 9, 2017: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
https://www.readbyqxmd.com/read/29118914/the-neuroprotective-effects-of-remifentanil-on-isoflurane-induced-apoptosis-in-the-neonatal-rat-brain
#19
Bo Pan, Shaoqiang Huang, Shen Sun, Tingting Wang
Remifentanil is one of the most frequently prescribed opioids used in combination with inhalation anesthetics in clinical practice, but the effects of such combinations on the developing rat brain are unknown. In our study, we investigated first the potential neurotoxic effects of remifentanil on the developing brain and then the effects of remifentanil on isoflurane-induced apoptosis in the neonatal rat brain following exposure to a nociceptive stimulus. In the first experiment, postnatal day (P) 7 rats were randomly exposed to 30% oxygen, 1...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/29114833/effect-of-a-single-dose-of-oral-opioid-and-nonopioid-analgesics-on-acute-extremity-pain-in-the-emergency-department-a-randomized-clinical-trial
#20
Andrew K Chang, Polly E Bijur, David Esses, Douglas P Barnaby, Jesse Baer
Importance: The choice of analgesic to treat acute pain in the emergency department (ED) lacks a clear evidence base. The combination of ibuprofen and acetaminophen (paracetamol) may represent a viable nonopioid alternative. Objectives: To compare the efficacy of 4 oral analgesics. Design, Settings, and Participants: Randomized clinical trial conducted at 2 urban EDs in the Bronx, New York, that included 416 patients aged 21 to 64 years with moderate to severe acute extremity pain enrolled from July 2015 to August 2016...
November 7, 2017: JAMA: the Journal of the American Medical Association
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