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Opioid error

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https://www.readbyqxmd.com/read/28324705/more-pain-more-gain-blocking-the-opioid-system-boosts-adaptive-cognitive-control
#1
Henk van Steenbergen, Daniel H Weissman, Dan J Stein, Susan Malcolm-Smith, Jack van Honk
The ability to adaptively increase cognitive control in response to cognitive challenges is crucial for goal-directed behavior. Recent findings suggest that aversive arousal triggers adaptive increases of control, but the neurochemical mechanisms underlying these effects remain unclear. Given the known contributions of the opioid system to hedonic states, we investigated whether blocking this system increases adaptive control modulations. To do so, we conducted a double-blind, placebo-controlled psychopharmacological study (n=52 females) involving a Stroop-like task...
March 7, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/28321300/identifying-highlighting-and-reducing-polypharmacy-in-a-uk-hospice-inpatient-unit-using-improvement-science-methods
#2
Alison Phippen, Jennie Pickard, Douglas Steinke, Matt Cope, Dai Roberts
Polypharmacy, the concurrent use of multiple medications by one individual is a growing global issue driven by an ageing population and increasing prevalence of multi-morbidity[1]. Polypharmacy can be problematic: interactions between medications, reduced adherence to medication, burden of medication to patients, administration time, increased risk of errors and increased cost. Quality improvement methods were applied to identify and highlight polypharmacy patients with the aim of reducing their average number of regular tablets/capsules per day by 25%...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28319551/a-contemporary-medicolegal-analysis-of-implanted-devices-for-chronic-pain-management
#3
Christopher R Abrecht, Penny Greenberg, Ellen Song, Richard D Urman, James P Rathmell
BACKGROUND: Analysis of closed malpractice claims allows the study of rare but serious complications and likely results in improved patient safety by raising awareness of such complications. Clinical studies and closed claims analyses have previously reported on the common complications associated with intrathecal drug delivery systems (IDDS) and spinal cord stimulators (SCS). This study provides a contemporary analysis of claims from within the past 10 years. METHODS: We performed a closed claims analysis for a period January 1, 2009 to December 31, 2013 for cases with pain medicine as the primary service...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28292491/joint-utility-estimators-in-substance-use-disorders
#4
Eve Wittenberg, Jeremy W Bray, Achamyeleh Gebremariam, Brandon Aden, Bohdan Nosyk, Bruce R Schackman
BACKGROUND: Although co-occurring conditions are common with substance use disorders (SUDs), estimation methods for joint health state utilities have not yet been tested in this context. OBJECTIVES: To compare joint health state utility estimators in SUD to inform economic evaluation. METHODS: We conducted two Internet-based surveys of US adults to collect community perspective standard gamble utilities for SUD and common co-occurring conditions...
March 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28291085/respiratory-effects-of-the-nociceptin-orphanin-fq-peptide-and-opioid-receptor-agonist-cebranopadol-in-healthy-human-volunteers
#5
Albert Dahan, Merel Boom, Elise Sarton, Justin Hay, Geert Jan Groeneveld, Meike Neukirchen, John Bothmer, Leon Aarts, Erik Olofsen
BACKGROUND: Cebranopadol is a novel strong analgesic that coactivates the nociceptin/orphanin FQ receptor and classical opioid receptors. There are indications that activation of the nociceptin/orphanin FQ receptor is related to ceiling in respiratory depression. In this phase 1 clinical trial, we performed a pharmacokinetic-pharmacodynamic study to quantify cebranopadol's respiratory effects. METHODS: Twelve healthy male volunteers received 600 μg oral cebranopadol as a single dose...
April 2017: Anesthesiology
https://www.readbyqxmd.com/read/28273693/outcome-adaptive-lasso-variable-selection-for-causal-inference
#6
Susan M Shortreed, Ashkan Ertefaie
Methodological advancements, including propensity score methods, have resulted in improved unbiased estimation of treatment effects from observational data. Traditionally, a "throw in the kitchen sink" approach has been used to select covariates for inclusion into the propensity score, but recent work shows including unnecessary covariates can impact both the bias and statistical efficiency of propensity score estimators. In particular, the inclusion of covariates that impact exposure but not the outcome, can inflate standard errors without improving bias, while the inclusion of covariates associated with the outcome but unrelated to exposure can improve precision...
March 8, 2017: Biometrics
https://www.readbyqxmd.com/read/28215574/the-impact-of-pharmacy-services-on-opioid-prescribing-in-dental%C3%A2-practice
#7
Autumn Stewart, Kelsey J Zborovancik, Kara L Stiely
OBJECTIVES: To compare rates of dental opioid prescribing between periods of full and partial integration of pharmacy services and periods of no integration. METHODS: This observational study used a retrospective chart review of opioid prescriptions written by dental providers practicing in a free dental clinic for the medically underserved over a period of 74 months. Pharmacy services were fully integrated into the practice model for 48 of the 74 months under study...
February 15, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28178050/filled-prescriptions-for-opioids-after-vaginal-delivery
#8
Marian Jarlenski, Lisa M Bodnar, Joo Yeon Kim, Julie Donohue, Elizabeth E Krans, Debra L Bogen
OBJECTIVE: To estimate the prevalence of filled opioid prescriptions after vaginal delivery. METHODS: We conducted a retrospective cohort study of 164,720 Medicaid-enrolled women in Pennsylvania who delivered a liveborn neonate vaginally from 2008 to 2013, excluding women who used opioids during pregnancy or who had an opioid use disorder. We assessed overall filled prescriptions as well as filled prescriptions in the presence or absence of the following pain-inducing conditions: bilateral tubal ligation, perineal laceration, or episiotomy...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28103892/prehospital-intravenous-fentanyl-to-patients-with-hip-fracture-an-observational-cohort-study-of-risk-factors-for-analgesic-non-treatment
#9
Kristian D Friesgaard, Erika F Christensen, Hans Kirkegaard, Mette D Bendtsen, Flemming B Jensen, Lone Nikolajsen
BACKGROUND: Patients with proximal femoral neck fracture have a high short-term mortality, a high risk of postoperative complications, and impaired quality of life. One of the challenges related to the prehospital treatment of these patients is to administer systemic opioids fast and properly. Effective analgesic prehospital treatment ought be initiated rapidly in order to alleviate the stress that follows acute pain, to facilitate transportation, and to improve quality of care. The objectives of this study were to explore the prevalence of prehospital administration of intravenous fentanyl to patients with proximal femoral neck fracture in the ambulances and to assess risk factors for analgesic non-treatment...
January 19, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28069072/pansaid-paracetamol-and-nsaid-in-combination-study-protocol-for-a-randomised-trial
#10
Kasper Højgaard Thybo, Daniel Hägi-Pedersen, Jørn Wetterslev, Jørgen Berg Dahl, Henrik Morville Schrøder, Hans Henrik Bülow, Jan Gottfrid Bjørck, Ole Mathiesen
BACKGROUND: Effective postoperative pain management is essential for the rehabilitation of the surgical patient. No 'gold standard' exists after total hip arthroplasty (THA) and combinations of different nonopioid medications are used with virtually no evidence for additional analgesic efficacy compared to monotherapy. The objective of this trial is to investigate the analgesic effects and safety of paracetamol and ibuprofen alone and in combination in different dosages after THA. METHODS: PANSAID is a placebo-controlled, parallel four-group, multicentre trial with centralised computer-generated allocation sequence and allocation concealment and with varying block size and stratification by site...
January 10, 2017: Trials
https://www.readbyqxmd.com/read/28049076/olfactory-identification-in-patients-with-schizophrenia%C3%A2-%C3%A2-the-influence-of-%C3%AE-endorphin-and-calcitonin-gene-related-peptide-concentrations
#11
M Urban-Kowalczyk, J Śmigielski, D Strzelecki
BACKGROUND: The relationship between the olfactory system and emotional processing is an area of growing interest in schizophrenia research. Both the orbitofrontal cortex and amygdala are involved in the processing of olfactory information, and olfactory deficits may be also influenced by endogenous opioids and calcitonin gene-related peptide (CGRP), which is probably involved in dopaminergic transmission. However, the relationship between endorphins and dopaminergic transmission has not been fully explored...
March 2017: European Psychiatry: the Journal of the Association of European Psychiatrists
https://www.readbyqxmd.com/read/27907936/early-treatment-for-neonatal-abstinence-syndrome-a-palliative-approach
#12
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
#13
Herminio M Guajardo, Kevin Snyder, Andrew Ho, Rita J Valentino
Stress-related neuropsychiatric pathologies are more prevalent in females compared with 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...
December 14, 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
#14
REVIEW
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...
December 2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/27763703/performance-measures-of-diagnostic-codes-for-detecting-opioid-overdose-in-the-emergency-department
#15
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
#16
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
#17
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
#18
REVIEW
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
#19
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...
December 4, 2016: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/27610712/non-steroid-anti-inflammatory-drugs-for-biliary-colic
#20
REVIEW
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
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