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https://www.readbyqxmd.com/read/27907936/early-treatment-for-neonatal-abstinence-syndrome-a-palliative-approach
#1
Jennifer Hudson, Rachel Mayo, Lori Dickes, Liwei Chen, Windsor Westbrook Sherrill, Julie Summey, Bradley Dalton, Kindal Dankovich
Objective To describe medical, safety, and health care utilization outcomes associated with an early treatment model for neonatal opioid withdrawal. Study Design This is a retrospective review of 117 opioid-exposed infants born in a large regional hospital and treated in the level I nursery with methadone initiated within 48 hours of birth. Results For this cohort, mean length of stay was 8.3 days. Hospital safety events were infrequent; there were no medication errors or deaths. Within 30 days of discharge, 14% of infants visited the emergency department; 7% were readmitted...
December 1, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27827371/sex-differences-in-%C3%AE-opioid-receptor-regulation-of-the-rat-locus-coeruleus-and-their-cognitive-consequences
#2
Herminio M Guajardo, Kevin Snyder, Andrew Ho, Rita J Valentino
Stress-related neuropsychiatric pathologies are more prevalent in females compared to males. An important component of the stress response is activation of the locus coeruleus (LC)-norepinephrine system. Because LC activation is tempered by endogenous opioid release during stress, the magnitude of opioid regulation of the LC could determine stress vulnerability. Here we report convergent evidence for decreased μ-opioid receptor (MOR) function in the female rat LC. The selective MOR agonist, DAMGO (10 pg), completely inhibited LC discharge of male, but not female rats and DAMGO (30 pg) produced no further inhibition of female LC neurons...
November 9, 2016: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/27796147/sufentanil-sublingual-tablet-system-for-the-management-of-postoperative-pain
#3
Rovnat Babazade, Alparslan Turan
Intravenous patient-controlled opioid analgesia has been an important improvement in addressing insufficient management of acute postoperative pain for over 40 years. However, there are number of weaknesses for intravenous patient-controlled analgesia, including operator and device error, intravenous line patency issues, and risk of catheter-related infection, all of which contribute to the complications and increase in cost of care. The sublingual sufentanil tablet system is a major evolution in both drug and technological management of postoperative pain...
October 31, 2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/27763703/performance-measures-of-diagnostic-codes-for-detecting-opioid-overdose-in-the-emergency-department
#4
Christopher Rowe, Eric Vittinghoff, Glenn-Milo Santos, Emily Behar, Caitlin Turner, Phillip Coffin
OBJECTIVES: Opioid overdose mortality has tripled in the USA since 2000 and opioids are responsible for more than half of all drug overdose deaths, which reached an all-time high in 2014. Opioid overdoses resulting in death, however, represent only a small fraction of all opioid overdose events and efforts to improve surveillance of this public health problem should include tracking nonfatal overdose events. International Classification of Disease (ICD) diagnosis codes, increasingly used for the surveillance of nonfatal drug overdose events, have not been rigorously assessed for validity in capturing overdose events...
October 20, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27739172/progressive-white-matter-impairment-as-a-predictor-of-outcome-in-a-cohort-of-opioid-dependent-patient-s-post-detoxification
#5
Jo-Hanna Ivers, Jacqueline Fitzgerald, Christopher Whelan, Brion Sweeney, Eamon Keenan, Andrew Fagan, Jason McMarrow, Jim Meany, Joe Barry, Thomas Frodl
White matter impairment is associated with opioid dependence. However, the specific neuropathology related to opioid dependence is still not fully understood. The main aims of this study were to: (1) assess the association between white matter impairment and duration of dependence; (2) examine whether this impairment correlates with treatment outcome measures in opioid-dependent patients post-detoxification. Fifty-eight opioid-dependent patients participated, 20 females and 38 males, across three groups: less than 10 years use (n = 18), 10-15 years use (n = 26) and 16-25+ years use (n = 14)...
October 13, 2016: Addiction Biology
https://www.readbyqxmd.com/read/27734573/intervention-study-with-algoplus-%C3%A2-a-pain-behavioral-scale-for-older-patients-in-the-emergency-department
#6
Fares Moustafa, Nicolas Macian, Fatiha Giron, Jeannot Schmidt, Bruno Pereira, Gisèle Pickering
OBJECTIVES: Evaluation of acute pain is often difficult in older patients admitted to the Emergency Department (ED), and self-evaluation of pain is not always possible. This observational study evaluates how the systematic use of Algoplus(®) , a validated behavioral scale, could improve pain management of older persons admitted to the ED. METHOD: The intervention study (NCT 02258503) took place in 4 steps in the ED, University Hospital Clermont-Ferrand, France...
October 13, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27697139/the-analgesic-effects-of-exogenous-melatonin-in-humans
#7
Lars Peter Holst Andersen
The hormone, melatonin is produced with circadian rhythm by the pineal gland in humans. The melatonin rhythm provides an endogenous synchronizer, modulating e.g. blood pressure, body temperature, cortisol rhythm, sleep-awake-cycle, immune function and anti-oxidative defence. Interestingly, a number of experimental animal studies demonstrate significant dose-dependent anti-nociceptive effects of exogenous melatonin. Similarly, recent experimental- and clinical studies in humans indicate significant analgesic effects...
October 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27664442/freeze-dried-extracts-of-bidens-biternata-lour-merr-and-sheriff-show-significant-antidiarrheal-activity-in-in-vivo-models-of-diarrhea
#8
Dennis Gacigi Kinuthia, Anne W Muriithi, Peter Waweru Mwangi
ETHNOPHARMACOLOGICAL RELEVANCE OF THE STUDY: Diarrhea remains one of the main killers of children aged below five years. Traditional antidiarrheal remedies form a potentially viable source of novel low cost efficacious treatments in low resource settings. There is therefore a pressing need to scientifically evaluate these remedies. AIM OF THE STUDY: This study aimed to investigate the in vivo and in vitro antidiarrheal activity of freeze dried Bidens biternata, a herb used in traditional Ayurvedic medicine in the management of diarrhea...
September 21, 2016: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/27610712/non-steroid-anti-inflammatory-drugs-for-biliary-colic
#9
Mirella Fraquelli, Giovanni Casazza, Dario Conte, Agostino Colli
BACKGROUND: Cholelithiasis refers to the presence of gallstones, which are concretions that form in the biliary tract, usually in the gallbladder. Cholelithiasis is one of the most common surgical problems worldwide and is particularly prevalent in most Western countries.Biliary colic is the term used for gallbladder pain experienced by a person with gallstones and without overt infection around the gallbladder. It is the most common manifestation of cholelithiasis, observed in over one-third of people with gallstones over the course of 10 or more years...
September 9, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27575829/caveat-emptor-erroneous-safety-information-about-opioids-in-online-drug-information-compendia
#10
Sonia R Talwar, Amarita S Randhawa, Erica H Dankiewicz, Nancy T Crudele, J David Haddox
BACKGROUND: Healthcare professionals and consumers refer to online drug-information compendia (eg, Epocrates and WebMD) to learn about prescription medications, including opioid analgesics. With the significant risks associated with opioids, including abuse, misuse, and addiction, any of which can result in life-threatening overdose, it is important for those seeking information from online compendia to have access to current, accurate, and complete drug information to help support clinical treatment decisions...
July 2016: Journal of Opioid Management
https://www.readbyqxmd.com/read/27562292/application-of-human-factors-engineering-hfe-to-the-design-of-a-naloxone-auto-injector-for-the-treatment-of-opioid-emergencies
#11
Robert B Raffa, Robert Taylor, Joseph V Pergolizzi, Srinivas Nalamachu, Eric S Edwards, Evan T Edwards
The increased use of opioids for chronic treatment of pain and the resulting epidemic of opioid overdoses have created a major public health challenge. Parenteral naloxone has been used since the 1970's to treat opioid overdose. Recently, a novel naloxone auto-injector device (EVZIO, kaleo, Inc., Richmond, VA) was approved by the Food and Drug Administration. In this article, we review the Human Factors Engineering (HFE) process used in the development and testing of this novel naloxone auto-injector currently used in nonmedical settings for the emergency treatment of known or suspected opioid overdose...
August 25, 2016: Drug Delivery and Translational Research
https://www.readbyqxmd.com/read/27537538/intraperitoneal-local-anesthetic-for-laparoscopic-appendectomy-in-children-a-randomized-controlled-trial
#12
James K Hamill, Andrew Liley, Andrew G Hill
OBJECTIVE: The aim of this study was to investigate the efficacy of intraperitoneal local anesthetic (IPLA) on pain after acute laparoscopic appendectomy in children. SUMMARY OF BACKGROUND: IPLA reduces pain in adult elective surgery. It has not been well studied in acute peritoneal inflammatory conditions. We hypothesized that IPLA would improve recovery in pediatric acute laparoscopic appendectomy. METHODS: This randomized controlled trial in acute laparoscopic appendectomy recruited children aged 8 to 14 years to receive 20 mL 0...
August 17, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27520885/understanding-opioid-overdose-characteristics-involving-prescription-and-illicit-opioids-a-mixed-methods-analysis
#13
Bobbi Jo H Yarborough, Scott P Stumbo, Shannon L Janoff, Micah T Yarborough, Dennis McCarty, Howard D Chilcoat, Paul M Coplan, Carla A Green
BACKGROUND: Opioid abuse and misuse are significant public health issues. The CDC estimated 72% of pharmaceutical-related overdose deaths in the US in 2012 involved opioids. While studies of opioid overdoses have identified sociodemographic characteristics, agents used, administration routes, and medication sources associated with overdoses, we know less about the context and life circumstances of the people who experience these events. METHODS: We analyzed interviews (n=87) with survivors of opioid overdoses or family members of decedents...
October 1, 2016: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/27470230/non-opioid-anesthetic-drug-abuse-among-anesthesia-care-providers-a-narrative-review
#14
Alix Zuleta-Alarcón, John C Coffman, Suren Soghomonyan, Thomas J Papadimos, Sergio D Bergese, Kenneth R Moran
PURPOSE: The objective of this narrative review is to provide an overview of the problem of non-opioid anesthetic drug abuse among anesthesia care providers (ACPs) and to describe current approaches to screening, therapy, and rehabilitation of ACPs suffering from non-opioid anesthetic drug abuse. SOURCE: We first performed a search of all literature available on PubMed prior to April 11, 2016. The search was limited to articles published in Spanish and English, and the following key words were used: anesthesiology, anesthesia personnel, AND substance-related disorders...
July 28, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27468916/response-of-the-tail-of-the-ventral-tegmental-area-to-aversive-stimuli
#15
María-José Sánchez-Catalán, Fanny Faivre, Ipek Yalcin, Marc-Antoine Muller, Dominique Massotte, Monique Majchrzak, Michel Barrot
The GABAergic tail of the ventral tegmental area (tVTA), also named rostromedial tegmental nucleus (RMTg), exerts an inhibitory control on dopamine neurons of the VTA and substantia nigra. The tVTA has been implicated in avoidance behaviors, response to drugs of abuse, reward prediction error and motor functions. Stimulation of the lateral habenula inputs to the tVTA, or of the tVTA itself, induces avoidance behaviors, which suggests a role of the tVTA in processing aversive information. Our aim was to test the impact of aversive stimuli on the molecular recruitment of the tVTA, and the behavioral consequences of tVTA lesions...
July 29, 2016: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/27464485/determination-of-21-drugs-in-oral-fluid-using-fully-automated-supported-liquid-extraction-and-uhplc-ms-ms
#16
Anja Valen, Åse Marit Leere Øiestad, Dag Helge Strand, Ragnhild Skari, Thomas Berg
Collection of oral fluid (OF) is easy and non-invasive compared to the collection of urine and blood, and interest in OF for drug screening and diagnostic purposes is increasing. A high-throughput ultra-high-performance liquid chromatography-tandem mass spectrometry method for determination of 21 drugs in OF using fully automated 96-well plate supported liquid extraction for sample preparation is presented. The method contains a selection of classic drugs of abuse, including amphetamines, cocaine, cannabis, opioids, and benzodiazepines...
July 28, 2016: Drug Testing and Analysis
https://www.readbyqxmd.com/read/27436277/development-of-a-multi-residue-method-for-scrutinizing-psychotropic-compounds-in-natural-waters
#17
V Brieudes, S Lardy-Fontan, S Vaslin-Reimann, H Budzinski, B Lalere
The present work describes a multi-residue SPE-UPLC-MS/MS method aiming at the characterization of 68 compounds in natural waters, including parent compounds as well as their major metabolites and glucuronide conjugates. Development was conducted toward the quantitative determination of a broad range of analytes belonging to different class of psychotropic drugs such as benzodiazepines, antidepressants, stimulants, opiates and opioids, anticonvulsants, anti-dementia drugs, analgesic and anti-inflammatory drugs (as anthropic indicators) in the low ngL(-1) range of concentration...
July 7, 2016: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/27376347/assessing-fidelity-of-a-community-based-opioid-overdose-prevention-program-modification-of-the-fidelity-checklist
#18
Angela Clark, Susie Breitenstein, Donna S Martsolf, Erin L Winstanley
BACKGROUND: The evaluation and maintenance of treatment fidelity is an important methodological consideration in intervention research. Treatment fidelity is the degree to which interventions are delivered as outlined by the program developers. A lack of fidelity to the intervention model has the potential to be a large source of error, including type I and type II error. Monitoring and assuring fidelity is critical to assuring the validity of the interventions. The Fidelity Checklist is a reliable and valid tool designed to measure fidelity in a group-based parenting program...
July 2016: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/27330656/quality-improvement-initiative-to-decrease-variability-of-emergency-physician-opioid-analgesic-prescribing
#19
John H Burton, Jason A Hoppe, Jeff M Echternach, Justin M Rodgers, Michael Donato
INTRODUCTION: Addressing pain is a crucial aspect of emergency medicine. Prescription opioids are commonly prescribed for moderate to severe pain in the emergency department (ED); unfortunately, prescribing practices are variable. High variability of opioid prescribing decisions suggests a lack of consensus and an opportunity to improve care. This quality improvement (QI) initiative aimed to reduce variability in ED opioid analgesic prescribing. METHODS: We evaluated the impact of a three-part QI initiative on ED opioid prescribing by physicians at seven sites...
May 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27208973/chromothripsis-and-epigenomics-complete-causality-criteria-for-cannabis-and-addiction-connected-carcinogenicity-congenital-toxicity-and-heritable-genotoxicity
#20
REVIEW
Albert Stuart Reece, Gary Kenneth Hulse
The recent demonstration that massive scale chromosomal shattering or pulverization can occur abruptly due to errors induced by interference with the microtubule machinery of the mitotic spindle followed by haphazard chromosomal annealing, together with sophisticated insights from epigenetics, provide profound mechanistic insights into some of the most perplexing classical observations of addiction medicine, including cancerogenesis, the younger and aggressive onset of addiction-related carcinogenesis, the heritability of addictive neurocircuitry and cancers, and foetal malformations...
July 2016: Mutation Research
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