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https://www.readbyqxmd.com/read/29129552/clinical-characteristics-of-suicidal-behavior-in-an-intensive-care-unit-at-a-university-hospital-in-japan-a-7-year-observational-study
#1
Takashi Takeuchi, Yasuyuki Okumura, Akihito Uezato, Toru Nishikawa
BACKGROUND: Suicidal behavior accounts for at least 40,000 admissions per year to emergency departments in Japan; however, little is known about emergency admissions owing to suicidal behavior in metropolitan areas. Therefore, we examined the clinical characteristics of suicidal behavior using psychosocial assessments performed by experienced psychiatrists in an intensive care unit. METHODS: Participants were 971 patients admitted to a university hospital's intensive care unit for suicidal behavior between July 2006 and June 2013...
November 7, 2017: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/29128652/differences-in-combinations-and-concentrations-of-drugs-of-abuse-in-fatal-intoxication-and-driving-under-the-influence-cases
#2
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/29123931/rapid-ascending-sensorimotor-paralysis-hearing-loss-and-fatal-arrhythmia-in-a-multimorbid-patient-due-to-an-accidental-overdose-of-fluoxetine
#3
Matthew Herrmann, Prissilla Xu, Antonio Liu
Background: Common side effects of selective serotonin reuptake inhibitors (SSRIs) include tachycardia, drowsiness, tremor, nausea, and vomiting. Although SSRIs have less toxic side effects compared to more traditional antidepressants, serious and life threatening cases of SSRI overdose have been reported. We describe a 24-year-old multimorbid female who presented to the emergency department with rapid onset ascending sensorimotor paralysis, complicated by respiratory and cardiac arrest, found to have fatal levels of fluoxetine by toxicological analysis, not taken in a suicidal act...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29123869/drug-induced-anaphylaxis-in-the-emergency-room
#4
REVIEW
Tomonori Takazawa, Kiyohiro Oshima, Shigeru Saito
Anaphylaxis is a life-threatening, systemic allergic reaction that presents unique challenges for emergency care practitioners. Anaphylaxis occurs more frequently than previously believed. Therefore, proper knowledge regarding the epidemiology, mechanisms, symptoms, diagnosis, and treatment of anaphylaxis is essential. In particular, the initial treatment strategy, followed by correct diagnosis, in the emergency room is critical for preventing fatal anaphylaxis, although making a diagnosis is not easy because of the broad and often atypical presentation of anaphylaxis...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29095168/deaths-associated-with-brotizolam-poisoning-from-a-single-drug-overdose-four-reported-cases
#5
Kentaro Sakai, Kazuyuki Saito, Aya Takada, Wakako Hikiji, Yosuke Kikuchi, Tatsushige Fukunaga
Brotizolam is a short-acting hypnotic in the benzodiazepine family, and fatal poisonings by an overdose of brotizolam are rare. This report describes 4 cases of deaths associated with brotizolam poisoning from a single drug overdose. The ages ranged from 51 to 90 years, and the postmortem interval between death and tissue sampling was 1.5 to 2.5 days. These deaths were classified as 1 homicide and 3 suicides. The concentration of the brotizolam ranged from 0.05 to 0.21 mg/L in the blood samples. Ethanol, which could cause mild alcohol intoxication, was detected in the blood samples from 2 cases...
November 1, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29059534/use-of-prescription-opioids-and-motor-vehicle-crashes-a-meta-analysis
#6
Stanford Chihuri, Guohua Li
OBJECTIVES: Opioid analgesics are a major driver of the ongoing opioid epidemic in the United Sates, accounting for about two thirds of drug overdose fatalities. There are conflicting reports regarding the effects of prescription opioids on driving safety. A meta-analysis was performed to assess the epidemiologic evidence for the association between use of prescription opioids and the risk of motor vehicle crashes. METHODS: Studies examining the association between driver prescription opioid use and motor vehicle crash involvement or crash culpability and published in English were identified through a comprehensive search of 15 bibliographic databases...
October 20, 2017: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/29040841/-caught-with-a-body-yet-protected-by-law-calling-911-for-opioid-overdose-in-the-context-of-the-good-samaritan-law
#7
Amanda D Latimore, Rachel S Bergstein
BACKGROUND: To address soaring opioid overdose fatality rates, 41U.S. states have passed Good Samaritan Laws (GSLs) extending legal immunity to overdose bystanders who call for emergency assistance. This study, conducted during the period that followed implementation of a GSL, aimed to characterize current factors determining the decision to call for emergency medical help (911) at the scene of an overdose with specific attention to exploring the role of the GSL as one such factor in decision-making...
October 14, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29040568/u-47700-a-not-so-new-opioid
#8
Timothy P Rohrig, Samuel A Miller, Tyson R Baird
U-47700 was developed by the Upjohn Co. in the 1970s as part of their search for a selective μ-opioid agonist with similar potency as morphine. U-47700 has re-emerged recently in the illicit drug market and is easily and cheaply obtained via the internet as well as on the street, many times falsely sold as another drug. Several fatalities from U-47700 have been reported in scientific literature, often in combination with other intoxicants. This case report describes the first death in south-central Kansas resulting solely from U-47700 intoxication: a 26-year-old white male found dead in his bedroom with apparent drug paraphernalia...
October 11, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29036502/three-cases-of-fatal-acrylfentanyl-toxicity-in-the-united-states-and-a-review-of-literature
#9
Daniel C Butler, Kevin Shanks, George S Behonick, Dustin Smith, Susan E Presnell, Lee Marie Tormos
Fentanyl analogs pose a unique challenge for forensic pathologists and toxicologists. The extreme potency of these analogs results in minute blood, urine and vitreous concentrations that are technically difficult to identify. This in addition to their absence from standard drug screening may potentiate a setting of apparent drug overdose without an immediately identifiable source. The following case series illustrates three such encounters with acrylfentanyl, an analog whose presence has not yet been reported in the scientific literature in the United States...
September 28, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28988943/how-addictive-are-gabapentin-and-pregabalin-a-systematic-review
#10
REVIEW
U Bonnet, N Scherbaum
In the last ten years, gabapentin and pregabalin have been becoming dispensed broadly and sold on black markets, thereby, exposing millions to potential side-effects. Meanwhile, several pharmacovigilance-databases have warned for potential abuse liabilities and overdose fatalities in association with both gabapentinoids. To evaluate their addiction risk in more detail, we conducted a systematic review on PubMed/Scopus and included 106 studies. We did not find convincing evidence of a vigorous addictive power of gabapentinoids which is primarily suggested from their limited rewarding properties, marginal notes on relapses, and the very few cases with gabapentinoid-related behavioral dependence symptoms (ICD-10) in patients without a prior abuse history (N=4)...
October 5, 2017: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28977581/stability-of-synthetic-cathinones-in-blood
#11
Lindsay Glicksberg, Sarah Kerrigan
The synthetic cathinones are powerful psychostimulants that have been associated with impairment, intoxication and fatal overdose. Forensic laboratories must be able to identify these new drugs as part of antemortem and postmortem toxicology investigations. Preliminary reports have indicated that some of the synthetic cathinones are unstable in biological matrices. It is important to understand drug stability in biological evidence so that analytical findings can be interpreted appropriately. The objective of this study was to systematically evaluate the concentration, temperature and analyte-dependent stability of synthetic cathinones in preserved blood using liquid-chromatography/quadrupole-time of flight-mass spectrometry (LC/Q-TOF-MS)...
August 31, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28972445/knowledge-of-the-911-good-samaritan-law-and-911-calling-behavior-of-overdose-witnesses
#12
Andrea Jakubowski, Hillary V Kunins, Zina Huxley-Reicher, Anne Siegler
BACKGROUND: Overdose deaths tripled between 1999 and 2014. Most fatal overdoses are witnessed, offering an opportunity for bystanders to call 911. However, fear of arrest may prevent them from calling authorities. Many states have passed 911 Good Samaritan laws that protects the 911 caller and overdose victim from prosecution for drug possession. Little is known, however, about whether the law affects 911-calling behavior of overdose witnesses. This study investigated the relationship between knowledge of a 911 Good Samaritan Law (GSL) and 911-calling behavior of study participants trained in opioid overdose rescue...
October 3, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28940805/methods-for-delivering-the-uk-s-multi-centre-prison-based-naloxone-on-release-pilot-randomised-trial-n-alive-europe-s-largest-prison-based-randomised-controlled-trial
#13
Angela Mary Meade, Sheila Macdonald Bird, John Strang, Tracey Pepple, Laura Lea Nichols, Monica Mascarenhas, Louise Choo, Mahesh Kumar Bhikhubhai Parmar
INTRODUCTION AND AIMS: Naloxone is an opioid antagonist used for emergency resuscitation following opioid overdose. Prisoners with a history of heroin use by injection have a high risk of drug-related death in the first weeks after prison-release. The N-ALIVE trial was planned as a large prison-based randomised controlled trial (RCT) to test the effectiveness of naloxone-on-release in the prevention of fatal opiate overdoses soon after release. The N-ALIVE pilot trial was conducted to test the main trial's assumptions on recruitment of prisons and prisoners, and the logistics for ensuring that participants received their N-ALIVE pack on release...
September 21, 2017: Drug and Alcohol Review
https://www.readbyqxmd.com/read/28882143/characteristics-of-persons-who-inject-drugs-and-who-witness-opioid-overdoses-in-vietnam-a-cross-sectional-analysis-to-inform-future-overdose-prevention-programs
#14
N A Blackburn, K E Lancaster, T V Ha, C A Latkin, W C Miller, C Frangakis, V A Chu, T Sripaipan, V M Quan, N L Minh, P T Vu, V F Go
BACKGROUND: Persons who use opioids have a high risk of overdose and associated mortality. In Vietnam, little is known about the characteristics of this population and the persons who are witness to those overdoses. One approach to combatting fatal overdose has been the use of peer interventions in which a friend or injecting partner administers overdose reversal medication, but availability in Vietnam of these medications is limited to pilot programs with aims to expand in the future (Le Minh and V...
September 7, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/28861516/cannabis-as-a-substitute-for-opioid-based-pain-medication-patient-self-report
#15
Amanda Reiman, Mark Welty, Perry Solomon
Introduction: Prescription drug overdoses are the leading cause of accidental death in the United States. Alternatives to opioids for the treatment of pain are necessary to address this issue. Cannabis can be an effective treatment for pain, greatly reduces the chance of dependence, and eliminates the risk of fatal overdose compared to opioid-based medications. Medical cannabis patients report that cannabis is just as effective, if not more, than opioid-based medications for pain. Materials and Methods: The current study examined the use of cannabis as a substitute for opioid-based pain medication by collecting survey data from 2897 medical cannabis patients...
2017: Cannabis and Cannabinoid Research
https://www.readbyqxmd.com/read/28860946/increases-in-united-states-life-expectancy-through-reductions-in-injury-related-death
#16
REVIEW
Scott R Kegler, Grant T Baldwin, Rose A Rudd, Michael F Ballesteros
BACKGROUND: During the previous century the average lifespan in the United States (US) increased by over 30 years, with much of this increase attributed to public health initiatives. This report examines further gains that might be achieved through reduced occurrence of injury-related death. METHODS: US life tables and injury death rate data were used to estimate potential increases in life expectancy assuming various reductions in the rate of fatal injuries. Corresponding numbers of deaths potentially averted annually were also estimated; unit (per death) medical and lifetime work loss costs were employed to estimate total costs potentially averted annually...
2017: Population Health Metrics
https://www.readbyqxmd.com/read/28859050/overdose-deaths-related-to-fentanyl-and-its-analogs-ohio-january-february-2017
#17
Raminta Daniulaityte, Matthew P Juhascik, Kraig E Strayer, Ioana E Sizemore, Kent E Harshbarger, Heather M Antonides, Robert R Carlson
Ohio is experiencing unprecedented loss of life caused by unintentional drug overdoses (1), with illicitly manufactured fentanyl (IMF) emerging as a significant threat to public health (2,3). IMF is structurally similar to pharmaceutical fentanyl, but is produced in clandestine laboratories and includes fentanyl analogs that display wide variability in potency (2); variations in chemical composition of these drugs make detection more difficult. During 2010-2015, unintentional drug overdose deaths in Ohio increased 98%, from 1,544 to 3,050...
September 1, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28854976/increases-in-united-states-life-expectancy-through-reductions-in-injury-related-death
#18
REVIEW
Scott R Kegler, Grant T Baldwin, Rose A Rudd, Michael F Ballesteros
BACKGROUND: During the previous century the average lifespan in the United States (US) increased by over 30 years, with much of this increase attributed to public health initiatives. This report examines further gains that might be achieved through reduced occurrence of injury-related death. METHODS: US life tables and injury death rate data were used to estimate potential increases in life expectancy assuming various reductions in the rate of fatal injuries. Corresponding numbers of deaths potentially averted annually were also estimated; unit (per death) medical and lifetime work loss costs were employed to estimate total costs potentially averted annually...
August 30, 2017: Population Health Metrics
https://www.readbyqxmd.com/read/28816830/fatal-cerebral-edema-seizures-and-hyponatremia-after-trazodone-overdose
#19
Jose David Avila
Trazodone is a serotonin antagonist and reuptake inhibitor that is widely used for the treatment of depression and insomnia. Fatal overdose is rare and usually occurs when combined with other drugs or alcohol. Only a few lethal cases of pure trazodone overdose have been reported, all attributed to cardiotoxicity. We reported a 37-year-old woman who presented after ingesting 6.45 g of trazodone in a suicidal attempt. She was hyponatremic because of the syndrome of inappropriate antidiuretic hormone secretion and, shortly after, had a seizure and developed fatal cerebral edema...
September 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28799198/does-paying-service-providers-by-results-improve-recovery-outcomes-for-drug-misusers-in-treatment-in-england
#20
Andrew Jones, Matthias Pierce, Matt Sutton, Thomas Mason, Tim Millar
AIM: To compare drug recovery outcomes in commissioning areas included in a 'payment by results' scheme with all other areas. DESIGN: Observational and data linkage study of the National Drug Treatment Monitoring System, Office for National Statistics mortality database and Police National Computer criminal records, for 2 years before and after introduction of the scheme. Pre-post controlled comparison compared outcomes in participating versus non-participating areas following adjustment for drug use, functioning and drug treatment status...
August 10, 2017: Addiction
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