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https://www.readbyqxmd.com/read/29790369/an-innovative-perioperative-pain-program-for-chronic-opioid-users-an-academic-medical-center-s-response-to-the-opioid-crisis
#1
Marie N Hanna, Traci J Speed, Ronen Shechter, Michael C Grant, Rosanne Sheinberg, Elizabeth Goldberg, Claudia M Campbell, Nicholas Theodore, Colleen G Koch, Kayode Williams
Increased utilization of prescription opioids for pain management has led to a nationwide public health crisis with alarming rates of addiction and opioid-related deaths. In the surgical setting, opioid prescriptions have been implicated as a contributing factor to the opioid epidemic. The authors developed an innovative model to address aspects of pain management and opioid utilization during preoperative evaluation, acute surgical hospitalization, and postoperative follow-up for chronic opioid users. This program involves multidisciplinary teams that include acute and chronic pain specialists, psychiatrists, integrative medicine specialists, and physical medicine and rehabilitation services...
May 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29607171/enhanced-recovery-after-thoracic-surgery-reduces-discharge-on-highly-dependent-narcotics
#2
Min P Kim, Edward Y Chan, Leonora M Meisenbach, Razvan Dumitru, Jessica K Brown, Faisal N Masud
Background: There is large prescription drug epidemic in United States. We want to determine if ERATS (enhanced recovery after thoracic surgery) program can reduce discharge on highly dependent narcotics. Methods: We performed a retrospective analysis of prospectively collected data on patients who underwent lung resection and foregut procedures on thoracic surgery service over an 8-month time period. Patients underwent preoperative conditioning instructions, multimodal non-narcotic pharmaceutical usage, total intravenous anesthesia (TIVA) and minimizing highly addictive narcotics during the post-operative period...
February 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29564862/-anesthetic-care-of-patient-with-heroin-addiction-a-case-report
#3
Wen-Yi Lee, Shu-Yu Kuo
The use of illegal drugs in Taiwan is on the rise. Drug addicts often have complex physical, psychological, and social problems. In addition, they often avoid disclosing their illicit drug use by deceit, concealment, or under-reporting. Building and maintaining relationships of trust with drug-addict patients has become a critical issue in achieving better care quality. In this case report, we report on an anesthesia care process for a heroin addict who was admitted for open reduction and internal fixation surgery for the femur and patella fractures after a car accident...
April 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29547920/nicotine-addiction-management-following-surgery-a-quality-improvement-approach-in-the-post-anesthesia-care-unit
#4
Barry A Finegan, Daniel Roblin, Fadi Hammal
Quality problem: For smokers, hospital admission is accompanied by forced involuntary nicotine abstinence due to smoke-free site/grounds policies. An audit of patients admitted to our surgical wards revealed that identification of smoking status was inadequate and that nicotine addiction management (NAM) was infrequently offered. The project aimed to enhance both these metrics by initiating NAM in the post anesthesia care unit (PACU). Initial assessment: Out of 744 patients admitted to our PACU in August 2015, 54% had their smoking status documented...
March 14, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29546602/the-many-faces-of-apomorphine-lessons-from-the-past-and-challenges-for-the-future
#5
REVIEW
Manon Auffret, Sophie Drapier, Marc Vérin
Apomorphine is now recognized as the oldest antiparkinsonian drug on the market. Though still underused, it is increasingly prescribed in Europe for patients with advanced Parkinson's disease (PD) with motor fluctuations. However, its history is far from being limited to movement disorders. This paper traces the history of apomorphine, from its earliest empirical use, to its synthesis, pharmacological development, and numerous indications in human and veterinary medicine, in light of its most recent uses and newest challenges...
March 15, 2018: Drugs in R&D
https://www.readbyqxmd.com/read/29514775/scope-breadth-and-differences-in-online-physician-ratings-related-to-geography-specialty-and-year-observational-retrospective-study
#6
Jessica Janine Liu, John Justin Matelski, Chaim M Bell
BACKGROUND: Physician ratings websites have emerged as a novel forum for consumers to comment on their health care experiences. Little is known about such ratings in Canada. OBJECTIVE: We investigated the scope and trends for specialty, geographic region, and time for online physician ratings in Canada using a national data source from the country's leading physician-rating website. METHODS: This observational retrospective study used online ratings data from Canadian physicians (January 2005-September 2013; N=640,603)...
March 7, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29474213/the-opioid-epidemic-and-the-current-prevalence-of-substance-use-disorder-in-anesthesiologists
#7
Ethan O Bryson
PURPOSE OF REVIEW: There has been a substantial increase in prescription and illicit opioid abuse in the general population observed over the last two decades. Initially fueled by an influx of prescription opioid medications, the opioid epidemic now includes increasingly potent heroin and illicit fentanyl. Younger anesthesiologists, those currently in training or recent graduates, have come of age in a society where opioid abuse is much more prevalent. RECENT FINDINGS: The current prevalence of substance use disorder (SUD) in the physician population is slightly higher than in the general population and appears to be increasing...
June 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29470436/neurobiology-of-propofol-addiction-and-supportive-evidence-what-is-the-new-development
#8
REVIEW
Ming Xiong, Nimisha Shiwalkar, Kavya Reddy, Peter Shin, Alex Bekker
Propofol is a short-acting intravenous anesthetic agent suitable for induction and maintenance of general anesthesia as well as for procedural and intensive care unit sedation. As such it has become an unparalleled anesthetic agent of choice in many institutional and office practices. However, in addition to its idealistic properties as an anesthetic agent, there is accumulating evidence suggesting its potential for abuse. Clinical and experimental evidence has revealed that not only does propofol have the potential to be abused, but also that addiction to propofol shows a high mortality rate...
February 22, 2018: Brain Sciences
https://www.readbyqxmd.com/read/29159751/septal-and-turbinate-surgery-is-overnight-essential
#9
Ana Sousa Menezes, Joana R Guimarães, Miguel Breda, Vicente Vieira, Luís Dias
INTRODUCTION: The performance of septoplasty and turbinate surgery in an outpatient basis is an increasingly established practice, although is still a controversial topic. METHODS: Retrospective analysis of 227 patients who underwent septoplasty ± inferior and/or middle turbinoplasty. Demographic, clinical, surgical, and anesthetic data were collected. Our primary outcomes were rates of perioperative complications, prolongation of hospital stay (PHS), unexpected hospital revisits (UHR), or readmissions within 30 days of surgery...
January 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28772011/brain-molecular-changes-and-behavioral-alterations-induced-by-propofol-anesthesia-exposure-in-peripubertal-rats
#10
Željko Pavković, Kosara Smiljanić, Selma Kanazir, Desanka Milanović, Vesna Pešić, Sabera Ruždijić
BACKGROUND: Propofol is commonly used in modern anesthesiology. Some findings suggest that it is highly addictive. AIM: In this study it was examined whether propofol anesthesia exposure was able to induce behavioral alterations and brain molecular changes already described in addictive drug usage in peripubertal rats, during the onset of mid/periadolescence as a developmental period with increasing vulnerability to drug addiction. METHODS: The expression of D1 dopamine receptor, a dopamine, and cAMP-regulated phosphoprotein with a Mr 32 000; Ca2+ /calmodulin-dependent protein kinase IIα; and Finkel-Biskis-Jinkins murine osteosarcoma viral oncogene homolog-B was examined in peripubertal rats 4, 24, and 48 hour after propofol anesthesia exposure by Western blot and immunohistochemistry...
September 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28413287/de-addiction-a-new-risk-for-anesthesia
#11
Gurkaran Kaur, Seema Jindal, Gurpreet Kaur
No abstract text is available yet for this article.
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28333299/bilateral-breast-reduction-without-opioid-analgesics-a-comparative-study
#12
Fereydoun Don Parsa, Justin Cheng, Brad Stephan, Nikki Castel, Leslie Kim, Daniel Murariu, Alan A Parsa
Background: Breast reduction has traditionally been performed under general anesthesia with adjunct opioid use. However, opioids are associated with a wide variety of adverse effects, including nausea, vomiting, constipation, postoperative sedation, dizziness, and addiction. Objectives: This study compares bilateral breast reduction using a multimodal opioid-free pain management regimen vs traditional general anesthesia with adjunct opioids. Methods: A total of 83 female patients were enrolled in this study...
September 1, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28257514/analysis-of-print-news-media-framing-of-ketamine-treatment-in-the-united-states-and-canada-from-2000-to-2015
#13
Melvyn W B Zhang, Ying X Hong, Syeda F Husain, Keith M Harris, Roger C M Ho
OBJECTIVES: There are multifaceted views on the use of ketamine, a potentially addictive substance, to treat mental health problems. The past 15 years have seen growing media coverage of ketamine for medical and other purposes. This study examined the print news media coverage of medical and other uses of ketamine in North America to determine orientations and trends over time. METHODS: Print newspaper coverage of ketamine from 2000 to 2015 was reviewed, resulting in 43 print news articles from 28 North American newspapers...
2017: PloS One
https://www.readbyqxmd.com/read/28251524/pain-management-of-patients-with-substance-abuse-in-the-ambulatory-setting
#14
REVIEW
Nalini Vadivelu, Alice M Kai, Vijay Kodumudi, Richard Zhu, Roberta Hines
PURPOSE OF REVIEW: Abuse of illicit substances and prescription opioids is a growing problem that presents challenges for pain management in the inpatient and outpatient setting. With future patient care models shifting toward shorter hospital stays and more same-day surgeries, it is crucial that clinicians learn to manage this patient population and strike a balance between the overtreatment of pain that can subsequently worsen tolerance and addiction, and the undertreatment of pain that can lead to pseudoaddiction...
February 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/27928715/the-impaired-anesthesiologist-what-you-should-know-about-substance-abuse
#15
Stefan T Samuelson, Ethan O Bryson
PURPOSE: Despite our considerable experience with the problem of addiction in our specialty, most anesthesia care providers don't know how to identify or help an impaired colleague. The purpose of this article to provide sufficient information on substance use disorder (SUD) to aid in its identification amongst colleagues and to assist in its management. PRINCIPAL FINDINGS: Depending on the region, 10-15% of the general population is prone to developing a SUD and will abuse drugs or alcohol at some point in their life...
February 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27790356/moderate-hypothermia-and-its-effects-in-reducing-the-applied-dose-of-anesthetics-for-patients-with-opium-dependence-in-cardiac-surgery-a-randomized-controlled-trial
#16
Reza Jalaian Taghadomi, Ebrahim Golmakani, Kambiz Alizadeh, Behrooz Mottahedi, Ali Rahdari, Shima Sheybani
BACKGROUND: An increasing number of patients addicted to opium are experiencing awareness during coronary artery bypass surgery (CABG) as a result of tolerance to anesthetics. OBJECTIVES: This research was primarily intended to determine the potential diminishing effects of moderate hypothermia on anesthetic dosage and recall of anesthesia during the procedure. METHODS: In this double-blind randomized controlled trial, a total of 80 CABG candidates with known addiction to opium were divided into two groups: one normothermic (N) and the other moderately hypothermic (H), both undergoing induction as well as close monitoring from September 2014 to January 2016...
September 2016: Electronic Physician
https://www.readbyqxmd.com/read/27579281/the-cortisol-level-and-its-relationship-with-depression-stress-and-anxiety-indices-in-chronic-methamphetamine-dependent-patients-and-normal-individuals-undergoing-inguinal-hernia-surgery
#17
Bijan Pirnia, Fatemeh Givi, Rasool Roshan, Kambiz Pirnia, Ali Akbar Soleimani
BACKGROUND: Stimulants addition and abuse can cause some functional and morphological changes in the normal function of glands and hormones. Methamphetamine as an addictive stimulant drug affects the Hypothalamic- pituitary-adrenal (HPA) axis and consequently makes some changes in the psychological state of the drug users. The present study aims to examine the relationship between plasma levels of cortisol with depression, stress and anxiety symptoms in chronic methamphetamine-dependent patients and normal individuals who have undergone the inguinal hernia surgery...
2016: Medical Journal of the Islamic Republic of Iran
https://www.readbyqxmd.com/read/27564553/mechanisms-for-research-support
#18
REVIEW
Philipp Houck, Manon Hache, Jennifer Busse
During the second day of the Pediatric Anesthesia NeuroDevelopment Assessment (PANDA) symposium 2016, 3 invited speakers focused on future directions for the PANDA group. This session, entitled "The Way Forward," included 3 talks on how other groups have organized through public-private partnerships (ACTTION), obtained NIH funding, and how to better communicate a research message. Dr Robert H. Dworkin spoke on the mission of the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities and Networks (ACTTION), which is a public-private partnership with the United States Food and Drug Administration that pushes forward research related to pain and analgesics...
October 2016: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/27460517/parental-smoking-and-children-undergoing-anesthesia-is-there-a-role-for-pediatric-hospitals-in-smoking-cessation
#19
MULTICENTER STUDY
Krista Niedermeier, Cynthia S Selleck
PURPOSE: Pediatric hospitals within the Children's Hospital Association were surveyed to determine their tobacco cessation efforts for parents/patients. DESIGN AND METHODS: Electronic surveys were sent to 75 anesthesia providers and/or preoperative surgery specialists at 41 facilities. RESULTS: A total of 52 completed surveys were returned. The majority (97%) of facilities were smoke-free, and 68% included preoperative questions about parental smoking and secondhand smoke (SHS) exposure...
October 2016: Journal for Specialists in Pediatric Nursing: JSPN
https://www.readbyqxmd.com/read/27378852/social-isolation-blunted-the-response-of-mesocortical-dopaminergic-neurons-to-chronic-ethanol-voluntary-intake
#20
Valeria Lallai, Letizia Manca, Laura Dazzi
Previous studies have shown that stress can increase the response of mesolimbic dopaminergic neurons to acute administration of drugs of abuse included ethanol. In this study, we investigated the possible involvement of the mesocortical dopaminergic pathway in the development of ethanol abuse under stress conditions. To this aim we trained both socially isolated (SI) and group housed (GH) rats to self administer ethanol which was made available only 2 ha day (from 11:00 to 13:00 h). Rats have been trained for 3 weeks starting at postnatal day 35...
2016: Frontiers in Cellular Neuroscience
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