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Opiates and children

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https://www.readbyqxmd.com/read/28971091/the-effects-of-perinatal-oxycodone-exposure-on-behavioral-outcome-in-a-rodent-model
#1
Thitinart Sithisarn, Sandra J Legan, Philip M Westgate, Melinda Wilson, Kristen Wellmann, Henrietta S Bada, Susan Barron
Opiate addiction is now a major public health problem. Perinatal insults and exposure to opiates such as morphine in utero are well known to affect development of the hypothalamic-pituitary-adrenal axis of the offspring adversely and are associated with a higher risk of developing neurobehavioral problems. Oxycodone is now one of the most frequently abused pain killers during pregnancy; however, limited data are available regarding whether and how perinatal oxycodone exposure (POE) alters neurobehavioral outcomes of the offspring...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28814263/acute-pain-management-in-hospitalized-children
#2
Ria Dancel, Edmund Allen Liles, Darren Fiore
BACKGROUND: Acute pain in hospitalized pediatric patients is prevalent. Recent shifts in the paradigm of pediatric acute pain management focus less on reliance on opioids, due to their adverse side effects and risk of dependence, and more on multimodal pain management. OBJECTIVE: We sought to review the most recent studies on acute pain management in hospitalized pediatric patients. METHODS: We searched the Cochrane Database and PubMed for articles published in the past five years regarding the treatment of acute pain in pediatric patients focusing on large randomized or quasi-randomized control trials, cohort trials, and meta-analyses...
August 16, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28793780/iatrogenic-opioid-withdrawal-in-critically-ill-patients-a-review-of-assessment-tools-and-management
#3
Ada W Chiu, Sofia Contreras, Sangeeta Mehta, Jennifer Korman, Marc M Perreault, David R Williamson, Lisa D Burry
OBJECTIVE: To (1) provide an overview of the epidemiology, clinical presentation, and risk factors of iatrogenic opioid withdrawal in critically ill patients and (2) conduct a literature review of assessment and management of iatrogenic opioid withdrawal in critically ill patients. DATA SOURCES: We searched MEDLINE (1946-June 2017), EMBASE (1974-June 2017), and CINAHL (1982-June 2017) with the terms opioid withdrawal, opioid, opiate, critical care, critically ill, assessment tool, scale, taper, weaning, and management...
August 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28686142/care-and-supportive-measures-in-school-aged-children-with-prenatal-substance-exposure
#4
Lisbeth B Sandtorv, Siren Haugland, Irene Elgen
AIMS: Prenatal exposure to substances, including alcohol, opiates, and a number of illicit drugs, may have a negative impact on fetal development. Studies have shown that substance exposure can influence a child's neurodevelopment and the need for care and supportive measures. In this study, we aimed to investigate the care status and the level of supportive measures in school-aged children prenatally exposed to alcohol and other substances. METHODS: This study included children aged between 6 and 14 years who were referred to Haukeland University Hospital in Norway with developmental impairment and a history of prenatal substance exposure...
July 1, 2017: Scandinavian Journal of Public Health
https://www.readbyqxmd.com/read/28669612/detecting-pharmaceuticals-in-the-red-blood-cell-inventory-of-a-hospital-blood-bank
#5
Eric A Gehrie, Amaris Keiser, Carrie J Haglock-Adler, Frederick Strathmann, Garrett S Booth
We tested 220 red blood cell units for the presence of pharmaceuticals; 15 units (6.8%) were confirmed to contain low concentrations of opiates, benzodiazepines, stimulants, or barbiturates. Further study is needed to determine whether these drugs, which are not prohibited in donated blood by current Food and Drug Administration standards, could mediate adverse reactions in children.
October 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28639958/pediatric-jellyfish-envenomation-in-the-mediterranean-sea
#6
Miguel Glatstein, Dikla Adir, Bella Galil, Dennis Scolnik, Ayelet Rimon, Dikla Pivko-Levy, Christopher Hoyte
BACKGROUND: Several species of jellyfish native to the western Indian Ocean have entered the Mediterranean Sea through the Suez Canal. Since the late 1980s, each summer Rhopilema nomadica forms swarms as long as 100 km in the southeastern Levant and since the millennium aggregations of additional nonnative jellyfish have been sighted. The aim of this study was to evaluate children seen in the emergency department after jellyfish envenomations and to establish patterns of toxicity associated with this organism...
June 20, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28379816/improving-family-medicine-with-thoughtful-research
#7
EDITORIAL
Anne Victoria Neale, Marjorie A Bowman, Dean A Seehusen
This issue is about improving primary health care outcomes, from behavioral health to opioid issues to diagnosing hypertension to providing hope for childhood obesity. It includes hints for integrating behavioral health and care managers into family medicine practices. Opiate prescribing practices vary considerably between Japan and the United States, with helpful insights for our opiate abuse epidemic. Suicidality is high among patients taking opiates. Diagnosing hypertension the recommended way is not easily accomplished...
March 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/27862905/intranasal-fentanyl-for-initial-treatment-of-vaso-occlusive-crisis-in-sickle-cell-disease
#8
RANDOMIZED CONTROLLED TRIAL
Daniel M Fein, Jeffrey R Avner, Kathryn Scharbach, Deepa Manwani, Hnin Khine
BACKGROUND: Analgesia administration for children with vaso-occlusive crises is often delayed in the emergency department. Intranasal fentanyl (INF) has been shown to be safe and effective in providing rapid analgesia for other painful conditions. Our objective was to determine if children with a vaso-occlusive crisis (VOC) who received initial treatment with INF compared to placebo achieved a greater decrease in pain score after 20 min. PROCEDURE: This was a randomized, double-blind, placebo-controlled trial...
June 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27729502/a-retrospective-study-of-sedation-and-analgesic-requirements-of-pediatric-patients-on-extracorporeal-membrane-oxygenation-ecmo-from-a-single-center-experience
#9
Pilar Anton-Martin, Vinai Modem, Donna Taylor, Donald Potter, Cindy Darnell-Bowens
INTRODUCTION: The purpose of this study is to describe the sedative and analgesic requirements identifying factors associated with medication escalation in neonates and children supported on ECMO. METHOD: Observational retrospective cohort study in a tertiary pediatric intensive care unit from June 2009 to June 2013. RESULTS: One hundred and sixty patients were included in the study. Fentanyl and midazolam were the first line agents used while on ECMO...
April 2017: Perfusion
https://www.readbyqxmd.com/read/27678506/gastric-electrical-stimulation-for-gastroparesis-and-chronic-unexplained-nausea-and-vomiting
#10
REVIEW
John M Wo, Thomas V Nowak, Shamaila Waseem, Matthew P Ward
Gastroparesis is a heterogeneous clinical syndrome. Some patients have debilitating vomiting, weight loss, and dehydration, while others have effortless regurgitation of undigested foods or postprandial distress suggestive of functional dyspepsia. Gastric electrical stimulation (GES) has been proposed as an effective treatment option for patients with gastroparesis refractory to medical therapy. Evidence suggests that the clinically available device, a low-energy high-frequency GES, activates the vagal afferent pathways to influence the central control mechanisms for nausea and vomiting...
December 2016: Current Treatment Options in Gastroenterology
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
#11
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
https://www.readbyqxmd.com/read/27540207/evaluation-of-the-current-practice-of-delivering-intravenous-opioids-infusions-in-a-uk-paediatric-hospital
#12
Asia N Rashed, Stephen Tomlin
INTRODUCTION: Opiate intravenous infusions are the therapy of choice in severe pain. However, administering infusions to children requires complex dosage calculations, rate adjustments and often multiple manipulations of injectable medicines to obtain the final "ready to use" solution for both continuous infusion and additional boluses; potentially putting children at high risk.1 2 AIM: To investigate the practice and accuracy of healthcare professionals (HCPs) in hospital theatres and wards in preparing morphine infusions for nurse/patient controlled analgesia (N/PCA) use in a UK children's hospital...
September 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27540189/an-audit-of-the-management-of-acute-pain-in-children
#13
Junndeep Sidhu, Neil Tickner
AIM: To evaluate clinical management of acute pain with respect to pain assessment, scoring and timing of analgesia and whether appropriate supportive medicines were prescribed alongside strong opiates. A previous pain audit found dosing of analgesia was appropriate but did not assess clinical management against pain scores. Our paediatric guideline does not currently stipulate guidance on appropriate time frames to administer analgesia and re-assess pain. Standards were developed with a multidisciplinary team to audit against...
September 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27514091/-prophylaxis-of-postoperative-hyperalgesia-based-on-morphological-substantiation-of-the-analgesia-method
#14
D V Dmytriyev, V S Konoplytskyi
The investigation was conducted in 20 children, operated on for abdominal oncological diseases in a 2010-2015 yrs period, using various methods of analgesia. While application of a constant infusion of high doses of phentanyl--1-4 MKr/(kg x h) in perioperative period the occurrence of the opiate-induced hyperalgesia is possible with the accompanied morphological changes in intestinal wall; in anesthesia of a transverse abdominal muscle (a TAP-blockade) and combined spinal epidural analgesia such changes were not observed...
March 2016: Klinichna Khirurhiia
https://www.readbyqxmd.com/read/27450349/port-site-local-anesthetic-infiltration-vs-single-dose-intrathecal-opioid-injection-to-control-perioperative-pain-in-children-undergoing-minimal-invasive-surgery-a-comparative-analysis
#15
Arun K Srinivasan, Dhiren Shrivastava, Rebecca E Kurzweil, Dana A Weiss, Christopher J Long, Aseem R Shukla
OBJECTIVE: To compare the efficacy of the intrathecal opiate vs wound site local anesthetic infiltration for perioperative pain control during and after surgery in patients undergoing minimally invasive pediatric urologic procedures. METHODS: Using an Institutional Review Board-approved registry database, we identified patients who underwent minimally invasive urologic procedures at our institution between 2009 and 2013. We collected all relevant preoperative variables and postoperative outcomes...
November 2016: Urology
https://www.readbyqxmd.com/read/27434597/treatments-for-the-prevention-of-sudden-unexpected-death-in-epilepsy-sudep
#16
REVIEW
Melissa J Maguire, Cerian F Jackson, Anthony G Marson, Sarah J Nolan
BACKGROUND: Sudden Unexpected Death in Epilepsy (SUDEP) is defined as sudden, unexpected, witnessed or unwitnessed, non-traumatic or non-drowning death of people with epilepsy, with or without evidence of a seizure, excluding documented status epilepticus and in whom postmortem examination does not reveal a structural or toxicological cause for death. SUDEP has a reported incidence of 1 to 2 per 1000 patient years and represents the most common epilepsy-related cause of death. The presence and frequency of generalised tonic-clonic seizures (GTCS), male sex, early age of seizure onset, duration of epilepsy, and polytherapy are all predictors of risk of SUDEP...
July 19, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27411064/multicenter-evaluation-of-prehospital-opioid-pain-management-in-injured-children
#17
Lorin R Browne, Manish I Shah, Jonathan R Studnek, Daniel G Ostermayer, Stacy Reynolds, Clare E Guse, David C Brousseau, E Brooke Lerner
BACKGROUND: The National Association of Emergency Medical Services Physicians' (NAEMSP) Position Statement on Prehospital Pain Management and the joint National Highway Traffic Safety Administration (NHTSA) and Emergency Medical Services for Children (EMSC) Evidence-based Guideline for Prehospital Analgesia in Trauma aim to improve the recognition, assessment, and treatment of prehospital pain. The impact of implementation of these guidelines on pain management in children by emergency medical services (EMS) agencies has not been assessed...
November 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27355825/a-pediatric-sedation-protocol-for-mechanically-ventilated-patients-requires-sustenance-beyond-implementation
#18
Beryl F Yaghmai, Jane L Di Gennaro, Gretchen A Irby, Kristina H Deeter, Jerry J Zimmerman
OBJECTIVES: To reevaluate the effect of a nursing-driven sedation protocol for mechanically ventilated patients on analgesic and sedative medication dosing durations. We hypothesized that lack of continued quality improvement efforts results in increased sedation exposure, as well as mechanical ventilation days, and ICU length of stay. DESIGN: Quasi-experimental, uncontrolled before-after study. SETTING: Forty-five-bed tertiary care, medical-surgical-cardiac PICU in a metropolitan university-affiliated children's hospital...
August 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27336798/behavior-and-attention-problems-in-eight-year-old-children-with-prenatal-opiate-and-poly-substance-exposure-a-longitudinal-study
#19
Egil Nygaard, Kari Slinning, Vibeke Moe, Kristine B Walhovd
Multiple studies have found that children born to mothers with opioid or poly-substance use during pregnancy have more behavior and attention problems and lower cognitive functioning than non-exposed children. The present study aimed to investigate whether behavior and attention problems are more prominent than general cognitive deficits in this risk group and whether the problems wane or increase over time. This prospective longitudinal cross-informant study compared 72 children who were prenatally exposed to heroin and multiple drugs with a group of 58 children without known prenatal risk factors...
2016: PloS One
https://www.readbyqxmd.com/read/27203162/-investigation-of-the-medical-and-social-situation-of-patients-managed-by-opiate-replacement-regimens-for-over-10-years-by-their-gp
#20
Nassir Messaadi, Jonathan Favre, Benjamin Rolland, Olivier Cottencin, Matthieu Calafiore, Bertrand Stalnikiewicz, Christophe Berkhout
OBJECTIVE: Management with opiate replacement regimens (ORRs) of patients presenting to primary care settings with opiate addiction has become a long-term follow-up. The aim of this survey study was to describe patients who had been prescribed ORRs for at least 10 years by their general practitioner (GP). METHOD: In 2011, two questionnaires were sent to a sample of 38 GPs prescribing ORRs in Northern France. Doctors' questionnaires collected their typology and opinions on their patients receiving opiate substitution treatments for over 10 years...
October 2016: Thérapie
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