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alcohol withdrawal syndrome

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https://www.readbyqxmd.com/read/28322465/opioid-substitution-therapy-or-hidden-opioids-are-a-minefield-for-nalmefene-an-atypical-case-series-of-11-patients-in-lorraine
#1
Melissa Yéléhé-Okouma, Hervé Martini, Jérémie Lemarié, Pierre Labroca, Nadine Petitpain, Valérie Gibaja, François Paille, Pierre Gillet
Opioid antagonists such as naltrexone and nalmefene are used in drug therapy for alcoholism. Nalmefene, approved in Europe in February 2013 for the reduction of alcohol consumption is used in patients with alcohol dependence. We report 11 cases of opioid withdrawal syndrome after a single dose of nalmefene in patients usually treated with methadone, buprenorphine, but also with fentanyl or loperamide. Nalmefene is both a partial agonist and an antagonist of opioid receptors. Regarding to its opioid antagonist activity, nalmefene is contraindicated in patients with an opioid treatment...
March 21, 2017: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/28289647/central-pontine-myelinolysis-induced-by-alcohol-withdrawal-a-case-report
#2
Jae Ho Kim, Sae Hyun Kim, Ho Joong Jeong, Young Joo Sim, Dong Kyu Kim, Ghi Chan Kim
Central pontine myelinolysis (CPM) is a demyelinating disorder characterized by the loss of myelin in the center of the basis pons, and is mainly caused by the rapid correction of hyponatremia. We report the case of a young woman who presented with gait disturbance and alcohol withdrawal, and who was eventually diagnosed with CPM. Generally, the cause and pathogenesis of CPM in chronic alcoholics remain unclear. In this cases, the CPM may be unrelated to hyponatremia or its correction. However, it is possible that the osmotic pressure changes due to refeeding syndrome after alcohol withdrawal was the likely cause in this case...
February 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28266937/occurrence-predictors-and-prognosis-of-alcohol-withdrawal-syndrome-and-delirium-tremens-following-traumatic-injury
#3
Kristin Salottolo, Emmett McGuire, Charles W Mains, Erika C van Doorn, David Bar-Or
OBJECTIVES: We sought to determine occurrence, predictors, and prognosis of alcohol withdrawal syndrome and delirium tremens in patients with traumatic injury. DESIGN: Retrospective multicenter cohort study. SETTING: Three U.S. trauma centers. PATIENTS: Twenty-eight thousand one hundred one trauma patients admitted from 2010-2014. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Measures included occurrence of alcohol withdrawal syndrome and delirium tremens, injury characteristics, risk factors for alcohol withdrawal syndrome, clinical outcomes, pharmacologic treatment for alcohol withdrawal syndrome, and Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar) scores...
March 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28190432/acute-neurotoxicology-of-drugs-of-abuse
#4
S J Traub, M D Levine
Many substances can affect the central nervous system, and may cause patients to become critically ill. Acute central neurotoxicologic syndromes associated with drugs of abuse are usually caused by an overdose of sedative-hypnotic agents (including alcohol) or opioids, withdrawal from sedative-hypnotic agents, or an overdose of anticholinergic or sympathomimetic agents. Clinical findings are often syndromic, making physical examination the most important diagnostic tool in the approach to the patient with an unknown ingestion...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28188055/the-emergency-medicine-management-of-severe-alcohol-withdrawal
#5
Drew Long, Brit Long, Alex Koyfman
INTRODUCTION: Alcohol use is widespread, and withdrawal symptoms are common after decreased alcohol intake. Severe alcohol withdrawal may manifest with delirium tremens, and new therapies may assist in management of this life-threatening condition. OBJECTIVE: To provide an evidence-based review of the emergency medicine management of alcohol withdrawal and delirium tremens. DISCUSSION: The underlying pathophysiology of alcohol withdrawal syndrome (AWS) is central nervous system hyperexcitation...
February 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28179883/new-microrna-biomarkers-for-drug-induced-steatosis-and-their-potential-to-predict-the-contribution-of-drugs-to-non-alcoholic-fatty-liver-disease
#6
Mireia López-Riera, Isabel Conde, Laia Tolosa, Ángela Zaragoza, José V Castell, María J Gómez-Lechón, Ramiro Jover
Background and Aims: Drug-induced steatosis is a major reason for drug failure in clinical trials and post-marketing withdrawal; and therefore, predictive biomarkers are essential. These could be particularly relevant in non-alcoholic fatty liver disease (NAFLD), where most patients show features of the metabolic syndrome and are prescribed with combined chronic therapies, which can contribute to fatty liver. However, specific biomarkers to assess the contribution of drugs to NAFLD are lacking. We aimed to find microRNAs (miRNAs) responsive to steatotic drugs and to investigate if they could become circulating biomarkers for drug-induced steatosis...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28166603/electroacupuncture-attenuates-hyperalgesia-in-rats-withdrawn-from-chronic-alcohol-drinking-via-habenular-mu-opioid-receptors
#7
Jing Li, Caihong Fu, Hongwei Liu, Rao Fu, Wanhong Zuo, Seungwoo Kang, Pei Chen, Danielle Gregor, Rose Paulose, Alex Bekker, Jiang-Hong Ye
BACKGROUND: Hyperalgesia or increased sensitivity to pain is often found in alcoholics during alcohol withdrawal and may contribute to relapse drinking. Alternative therapies such as acupuncture and electroacupuncture (EA), through mechanisms involving opioid receptors, may reduce pain and substance dependence and withdrawal syndromes. The lateral habenula (LHb), an epithalamic structure rich in mu opioid receptors (MORs), is a critical target for both drugs of abuse and pain. We previously observed hyperalgesia in rats withdrawn from chronic ethanol (EtOH) drinking and found that EA at the acupoint Zusanli (ST36) reduced EtOH intake...
March 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/28096011/a-systematic-nurse-led-approach-to-withdrawal-risk-screening-prevention-and-treatment-among-inpatients-with-an-alcohol-use-disorder-in-an-ear-nose-throat-and-jaw-surgery-department-a-formative-evaluation
#8
Deborah Linda Leuenberger, Katharina Fierz, Andreas Hinck, Daniel Bodmer, Wolfgang Hasemann
INTRODUCTION: Among patients with head and neck cancer comorbid alcohol use disorder is frequent which contributes to higher risk of developing perioperative alcohol withdrawal syndrome/delirium or delirium due to medical conditions. Although guidelines emphasize prevention and treatment of alcohol withdrawal in hospitalized patients, a validated systematic approach for management of these patients is still lacking. Our aim was to formatively evaluate our newly developed systematic approach in view of nurses' adherence to screening patients for regular alcohol consumption and managing their withdrawal symptoms using the Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised...
February 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28065808/bacterial-meningitis-in-alcoholic-patients-a-population-based-prospective-study
#9
Kiril E B van Veen, Matthijs C Brouwer, Arie van der Ende, Diederik van de Beek
OBJECTIVES: To study clinical features and outcome of community-acquired bacterial meningitis in alcoholic patients. METHODS: Patients with a history of alcoholism were selected from our nationwide, prospective cohort on community-acquired bacterial meningitis performed from March 2006 to October 2014. Data on patient history, symptoms and signs on admission, treatment, and outcome were prospectively collected. RESULTS: Of 1359 included episodes, 88 episodes (6%) occurred in 88 alcoholic patients...
January 5, 2017: Journal of Infection
https://www.readbyqxmd.com/read/28045949/influence-of-volatile-anesthesia-on-the-release-of-glutamate-and-other-amino-acids-in-the-nucleus-accumbens-in-a-rat-model-of-alcohol-withdrawal-a-pilot-study
#10
Thomas Seidemann, Claudia Spies, Rudolf Morgenstern, Klaus-Dieter Wernecke, Nicolai Netzhammer
BACKGROUND: Alcohol withdrawal syndrome is a potentially life-threatening condition, which can occur when patients with alcohol use disorders undergo general anesthesia. Excitatory amino acids, such as glutamate, act as neurotransmitters and are known to play a key role in alcohol withdrawal syndrome. To understand this process better, we investigated the influence of isoflurane, sevoflurane, and desflurane anesthesia on the profile of excitatory and inhibitory amino acids in the nucleus accumbens (NAcc) of alcohol-withdrawn rats (AWR)...
2017: PloS One
https://www.readbyqxmd.com/read/28017182/prevalence-of-restless-legs-syndrome-during-detoxification-from-alcohol-and-opioids
#11
Susan E Mackie, R Kathryn McHugh, Katherine McDermott, Margaret L Griffin, John W Winkelman, Roger D Weiss
BACKGROUND AND AIMS: Restless legs syndrome (RLS) is a movement disorder associated with adverse health outcomes and decreased quality of life. Small case series suggest that symptoms of RLS occur during opioid withdrawal. However, the prevalence is unknown. METHODS: We conducted an observational study to determine the prevalence of RLS among inpatients patients receiving buprenorphine detoxification from opioids. To assess the specificity of RLS to opioid detoxification, we also evaluated patients receiving detoxification from alcohol as a comparison group...
February 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/27989609/limbic-circuitry-activation-in-ethanol-withdrawal-is-regulated-by-a-chromosome-1-locus
#12
Kari J Buck, Gang Chen, Laura B Kozell
Physiological dependence and associated withdrawal episodes are thought to constitute a motivational force sustaining alcohol use/abuse and contributing to relapse in alcoholics. Although no animal model exactly duplicates alcoholism, models for specific factors, including the withdrawal syndrome, are useful for identifying potential genetic and neural determinants of liability in humans. We previously identified highly significant quantitative trait loci (QTLs) with large effects on predisposition to withdrawal after chronic and acute alcohol exposure in mice and mapped these loci to the same region of chromosome 1 (Alcdp1 and Alcw1, respectively)...
February 2017: Alcohol
https://www.readbyqxmd.com/read/27988884/proactive-regional-pharmacovigilance-system-versus-national-spontaneous-reporting-for-collecting-safety-data-on-concerning-off-label-prescribing-practices-an-example-with-baclofen-and-alcohol-dependence-in-france
#13
Marine Auffret, Julien Labreuche, Alain Duhamel, Sylvie Deheul, Olivier Cottencin, Régis Bordet, Sophie Gautier, Benjamin Rolland
INTRODUCTION: Off-label prescribing (OLP) may raise serious safety concerns that traditional spontaneous reporting of adverse drug reactions (ADRs) may not identify in a timely manner. In France, the 'Multidisciplinary Consultation Service for Off-Label Prescribing in Addiction Medicine' (CAMTEA) is a proactive regional system established to identify ADRs associated with the OLP of baclofen for alcohol dependence. OBJECTIVE: The aim was to demonstrate, using the French pharmacovigilance database (FPVD), that CAMTEA allowed for the reporting of a substantial amount of ADRs, comparable in nature to those provided via spontaneous reporting...
March 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/27850538/900-alternative-approach-to-alcohol-withdrawal-syndrome
#14
Jennifer Severing, Adam Manko, William Healy, Derek Brown, Manu Kaushal, Christopher Kempe, Jessica Kynyk
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850515/877-correlation-between-mminds-and-ciwa-ar-scoring-tools-in-patients-with-alcohol-withdrawal-syndrome
#15
Audrey Littlefield, Claire Chan, Dawn Cooper, Jason Heavner, Jeanette Kurtz, Margaret Pisani, Mojdeh Heavner
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850144/504-phenobarbital-versus-benzodiazepines-in-the-treatment-of-alcohol-withdrawal-syndrome
#16
Douglas Hsu, John Marshall, George Abdallah, Randy Hollins, Peter Clardy, Michael Donnino, Kenneth Mukamal
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27816567/efficacy-and-safety-of-adjunctive-bitopertin-versus-placebo-in-patients-with-suboptimally-controlled-symptoms-of-schizophrenia-treated-with-antipsychotics-results-from-three-phase-3-randomised-double-blind-parallel-group-placebo-controlled-multicentre-studies
#17
Dragana Bugarski-Kirola, Nakao Iwata, Snjezana Sameljak, Carol Reid, Thomas Blaettler, Laurie Millar, Tiago Reis Marques, George Garibaldi, Shitij Kapur
BACKGROUND: Many patients with schizophrenia require high doses of medication for their ongoing psychotic symptoms. Glutamate theories and findings from studies showing efficacy of sarcosine, an endogenous, non-selective glycine-reuptake inhibitor mediated by GlyT1, offer an alternative approach. We undertook the SearchLyte trial programme to examine the efficacy of bitopertin, a selective GlyT1-mediated glycine-reuptake inhibitor, as an adjunctive treatment to ongoing antipsychotic treatment...
December 2016: Lancet Psychiatry
https://www.readbyqxmd.com/read/27734823/-ibogaine-structure-influence-on-human-body-clinical-relevance
#18
REVIEW
Zygmunt Zdrojewicz, Bartłomiej Kuszczak, Natalia Olszak
Ibogaine is a natural chemical compound, which belongs to the indole alkaloid family. It can be naturally found within the root bark of african plant Tabernanthe iboga. Ibogaine plays a significant role among tribal cultures. Ibogaine, in small amount, causes reduction of hunger, thirst and exhaustion. In bigger amount, however, it can cause intensive visions. Other effects include reduction or complete disappearance of absitnence symptoms visible in people addicted to the nicotine, alcohol, methamphetamine, cocaine or opioids, what has been scientifically proven after the tests on animals and small groups of people...
July 29, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/27733668/a-symptom-triggered-benzodiazepine-protocol-utilizing-sas-and-ciwa-ar-scoring-for-the-treatment-of-alcohol-withdrawal-syndrome-in-the-critically-ill
#19
Soumitra Sen, Philip Grgurich, Amanda Tulolo, Andrew Smith-Freedman, Yuxiu Lei, Anthony Gray, James Dargin
BACKGROUND: There are limited data on the efficacy of symptom-triggered therapy for alcohol withdrawal syndrome (AWS) in the intensive care unit (ICU). OBJECTIVE: To evaluate the safety and efficacy of a symptom-triggered benzodiazepine protocol utilizing Riker Sedation Agitation Scale (SAS) scoring for the treatment of AWS in the ICU. METHODS: We performed a before-and-after study in a medical ICU. A protocol incorporating SAS scoring and symptom-triggered benzodiazepine dosing was implemented in place of a protocol that utilized the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scale and fixed benzodiazepine dosing...
February 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/27699780/diet-and-headache-part-1
#20
Vincent T Martin, Brinder Vij
BACKGROUND: The role of diet in the management of the headache patient is a controversial topic in the headache field. OBJECTIVES: To review the evidence supporting the hypothesis that specific foods or ingredients within foods and beverages trigger attacks of headache and/or migraine and to discuss the use of elimination diets in the prevention of headache disorders METHODS: This represents part 1 of a narrative review of the role of diet in the prevention of migraine and other headache disorders...
October 2016: Headache
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