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https://www.readbyqxmd.com/read/27889114/the-hidden-web-and-the-fentanyl-problem-detection-of-ocfentanil-as-an-adulterant-in-heroin
#1
Pol Quintana, Mireia Ventura, Marc Grifell, Alvaro Palma, Liliana Galindo, Iván Fornís, Cristina Gil, Xoán Carbón, Fernando Caudevilla, Magí Farré, Marta Torrens
BACKGROUND: The popularization of anonymous markets such as Silk Road is challenging current drug policy and may provide a new context for old issues, such as adulteration of heroin with fentanyl derivatives. The aims of this paper are to report the presence of ocfentanil, a novel, potent, non-controlled fentanyl analog, in samples sold as heroin in the hidden web, and to summarize the effects reported by users. METHODS: In 2015, four samples allegedly bought as heroin in cryptomarkets of the hidden web were sent to Energy Control for analysis...
November 23, 2016: International Journal on Drug Policy
https://www.readbyqxmd.com/read/27867510/effect-of-adding-intrathecal-morphine-to-a-multimodal-analgesic-regimen-for-postoperative-pain-management-after-laparoscopic-bariatric-surgery-a-prospective-double-blind-randomized-controlled-trial
#2
Fatma Adel El Sherif, Ahmed Hassan Othman, Ahmad Mohammad Abd El-Rahman, Osama Taha
BACKGROUND: Pain control after bariatric surgery is a major challenge. Our objective was to study the efficacy and safety of intrathecal (IT) morphine 0.3 mg added to bupivacaine 0.5% for postoperative pain after laparoscopic bariatric surgery. METHODS: After local ethics committee approval, 100 morbidly obese patients scheduled for laparoscopic bariatric surgery were enrolled in this study. Patients were randomly assigned into two groups: Group I received IT 0...
November 2016: British Journal of Pain
https://www.readbyqxmd.com/read/27792212/postoperative-analgesia-for-elective-total-knee-arthroplasty-under-subarachnoid-anesthesia-with-opioids-comparison-between-epidural-femoral-block-and-adductor-canal-block-techniques-with-and-without-perineural-adjuvants-a-prospective-randomized-clinical-trial
#3
José R Ortiz-Gómez, Marta Perepérez-Candel, José M Vázquez-Torres, José M Rodriguez-Del Río, Berta Torrón-Abad, Inocencia Fornet-Ruiz, Francisco J Palacio-Abizanda
BACKGROUND: Optimal control of acute postoperative pain and prevention of chronic persistent pain in total knee arthroplasty (TKA) remain a challenge. The main hypothesis was that nerve blocks improve postoperative analgesia especially if perineural adjuvants are added. METHODS: Immediate postoperative pain (24 h) was evaluated every hour in 639 patients using a verbal rating 11-point scale for patient self-reporting of pain (VRS-11). All patients received subarachnoid anesthesia and were randomly allocated in 8 groups: control group, epidural (EA) and single shots femoral (FNB) or adductor canal blocks (ACB), both with and without adjuvants: dexamethasone (+Dexa) or dexmedetomidine (+Dexm)...
October 28, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27785937/paracetamol-and-morphine-for-infant-and-neonatal-pain-still-a-long-way-to-go
#4
Manuel A Baarslag, Karel Allegaert, John N Van Den Anker, Catherijne A J Knibbe, Monique Van Dijk, Sinno H P Simons, Dick Tibboel
Pharmacologic pain management in newborns and infants is often based on limited scientific data. To close the knowledge gap, drug-related research in this population is increasingly supported by the authorities, but remains very challenging. This review summarizes the challenges of analgesic studies in newborns and infants on morphine and paracetamol (acetaminophen). Areas covered: Aspects such as the definition and multimodal character of pain are reflected to newborn infants. Specific problems addressed include defining pharmacodynamic endpoints, performing clinical trials in this population and assessing developmental changes in both pharmacokinetics and pharmacodynamics...
November 9, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27750355/-medical-treatment-of-newly-arrived-refugees-in-erlangen-a-study-of-drug-prescription-rates-focused-on-psychotropic-drugs
#5
Fabian Kahl, Andreas Frewer
Background: In 2015 the number of refugees who sought asylum in Germany has increased dramatically. Therefore, the medical care for these refugees faces huge challenges. The treatment of mental illness of refugees is a particular difficult topic. Objective of this study is the acquisition of the outpatient prescriptions of drugs for newly arrived refugees in Erlangen, focused on psychotropic drugs. Methods: Evaluation of all outpatient prescribed drugs (n=1 137), which were prescribed between 10/01/2014 and 09/30/2015 for asylum seekers living in the refugee center in Erlangen, a branch of the "Central Admission Institution" ("ZAE") Zirndorf...
October 17, 2016: Psychotherapie, Psychosomatik, Medizinische Psychologie
https://www.readbyqxmd.com/read/27738964/the-challenges-of-treating-sciatica-pain-in-older-adults
#6
Manuela L Ferreira, Andrew McLachlan
Sciatica is a debilitating condition affecting approximately 25 % of the population. Typically, the patient will complain of lower limb pain that is more severe than pain in the lower back, usually accompanied by numbness and motor weakness. Most international guidelines recommend pharmacological management for the pain relief of sciatica, including paracetamol, non-steroidal anti-inflammatory drugs, opioid analgesics, anticonvulsants, and corticosteroids, among others. However, the evidence for most of these pharmacological options is scarce, and the majority of clinical trials exclude older patients...
October 13, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27727412/medicines-use-in-hospitalised-children-current-status-and-outcome-after-an-intervention
#7
S N Thiyahiny, M G Sathiadas, K Sanchayan, C Vamadevan, R Balasubramaniam, S Sri Ranganathan
INTRODUCTION: Challenges in rational use of medicines (RUM) in children are different from that of adults. In Sri Lanka, data on RUM in children are limited. OBJECTIVE: To assess the current status and to investigate effectiveness of an intervention in improving RUM in children. METHODS: Non-randomised controlled before and after study design was employed. Study settings were one paediatric unit in two Teaching Hospitals one for intervention (IU) and the other as a control (CU) unit...
2016: Ceylon Medical Journal
https://www.readbyqxmd.com/read/27712027/clinical-practice-guidelines-for-the-noninvasive-management-of-low-back-pain-a-systematic-review-by-the-ontario-protocol-for-traffic-injury-management-optima-collaboration
#8
J J Wong, P Côté, D A Sutton, K Randhawa, H Yu, S Varatharajan, R Goldgrub, M Nordin, D P Gross, H M Shearer, L J Carroll, P J Stern, A Ameis, D Southerst, S Mior, M Stupar, T Varatharajan, A Taylor-Vaisey
: We conducted a systematic review of guidelines on the management of low back pain (LBP) to assess their methodological quality and guide care. We synthesized guidelines on the management of LBP published from 2005 to 2014 following best evidence synthesis principles. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane, DARE, National Health Services Economic Evaluation Database, Health Technology Assessment Database, Index to Chiropractic Literature and grey literature. Independent reviewers critically appraised eligible guidelines using AGREE II criteria...
October 6, 2016: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/27682287/postoperative-pain-relief-and-functional-outcome-following-total-knee-arthroplasty-a-prospective-comparative-audit-of-three-analgesic-regimes
#9
A Rajeev, N Tumia, K Karn, S Kashyap, D Mayne
Pain control plays a key role in joint-replacement -surgery. As a surgeon the challenge is to reduce pain to an acceptable level in the post-operative period. The aim of the study was to assess the efficacy of bolus -local anaesthesia, infusion in to the surgical site and nerve blocks with femoral nerve catheter and its functional outcome. A prospective audit of 114 patients undergoing total knee arthroplasty were carried out.The patients were divided in to three groups : Group 1 (n = 27) received a bolus injection of 20 ml 0...
August 2016: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/27677236/-amoxicillin-and-paracetamol-dosing-in-children-playing-safe
#10
B Peters, E G P M de Bont, J W L Cals
Amoxicillin and paracetamol are the two most widely prescribed and recommended medicines in children. Due to lack of scientific evidence of the most effective dosage, dosing instructions of both medicines are often unclear. In this article we challenge general practitioners, paediatricians, child-health clinic physicians, ENT specialists, pharmacists and guideline committees to critically evaluate the current dosing instructions of these two medicines. The Netherlands paediatric formulary, the Kinderformularium, should become the primary formulary for children in the Netherlands, but it has to be more in line with daily practice, and basic dosing instructions should be less ambiguous: (a) dosing instructions based on body weight instead of age; b) in case of pain, paracetamol should be given 60 mg/kg/day in four divided doses; (c) in case of common uncomplicated infections, amoxicillin should be given orally 60 mg/kg/day in two divided doses; (d) the following should be mentioned on the antibiotic prescription: the daily dose, the number of divided doses, the duration of therapy, the indication for the prescription, and the child's weight...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27661700/anharmonic-and-quantum-fluctuations-in-molecular-crystals-a-first-principles-study-of-the-stability-of-paracetamol
#11
Mariana Rossi, Piero Gasparotto, Michele Ceriotti
Molecular crystals often exist in multiple competing polymorphs, showing significantly different physicochemical properties. Computational crystal structure prediction is key to interpret and guide the search for the most stable or useful form, a real challenge due to the combinatorial search space, and the complex interplay of subtle effects that work together to determine the relative stability of different structures. Here we take a comprehensive approach based on different flavors of thermodynamic integration in order to estimate all contributions to the free energies of these systems with density-functional theory, including the oft-neglected anharmonic contributions and nuclear quantum effects...
September 9, 2016: Physical Review Letters
https://www.readbyqxmd.com/read/27588429/fenton-like-catalysis-and-oxidation-adsorption-performances-of-acetaminophen-and-arsenic-pollutants-in-water-on-a-multimetal-cu-zn-fe-ldh
#12
Hongtao Lu, Zhiliang Zhu, Hua Zhang, Jianyao Zhu, Yanling Qiu, Linyan Zhu, Stephan Küppers
Acetaminophen can increase the risk of arsenic-mediated hepatic oxidative damage; therefore, the decontamination of water polluted with coexisting acetaminophen and arsenic gives rise to new challenges for the purification of drinking water. In this work, a three-metal layered double hydroxide, namely, Cu-Zn-Fe-LDH, was synthesized and applied as a heterogeneous Fenton-like oxidation catalyst and adsorbent to simultaneously remove acetaminophen (Paracetamol, PR) and arsenic. The results showed that the degradation of acetaminophen was accelerated with decreasing pH or increasing H2O2 concentrations...
September 28, 2016: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/27566865/when-voluntary-paracetamol-overdose-requires-a-drug-challenge
#13
Ania Carsin, Joana Vitte, Pascal Demoly, Jean-Christophe Dubus
No abstract text is available yet for this article.
October 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27499419/the-role-of-paracetamol-for-closing-patent-ductus-arteriosus-a-challenging-alternative-for-ductal-closure
#14
Inés Tofé Valera, María Pilar Jaraba Caballero, María Dolores Ruiz González, María Victoria Rodríguez Benítez, María José Parraga Quiles
No abstract text is available yet for this article.
August 4, 2016: Revista Española de Cardiología
https://www.readbyqxmd.com/read/27497000/a-novel-reagentless-glutamate-microband-biosensor-for-real-time-cell-toxicity-monitoring
#15
G Hughes, R M Pemberton, P R Fielden, J P Hart
A reagentless glutamate biosensor was applied to the determination of glutamate released from liver hepatocellular carcinoma cells (HepG2) in response to toxic challenge from various concentrations of paracetamol. A screen printed carbon electrode (SPCE) containing the electrocatalyst Meldola's Blue (MB-SPCE) served as the electron mediator for the oxidation of NADH. A mixture of the enzyme glutamate dehydrogenase (GLDH), cofactor nicotinamide adenine dinucleotide (NAD(+)) and the biopolymer chitosan (CHIT) were drop-coated onto the surface of the transducer (MB-SPCE) in a simple one step fabrication process...
August 24, 2016: Analytica Chimica Acta
https://www.readbyqxmd.com/read/27489545/asthma-and-rhinitis-induced-by-selective-immediate-reactions-to-paracetamol-and-non-steroidal-anti-inflammatory-drugs-in-aspirin-tolerant-subjects
#16
Diana Pérez-Alzate, Natalia Blanca-López, Inmaculada Doña, José A Agúndez, Elena García-Martín, José A Cornejo-García, James R Perkins, Miguel Blanca, Gabriela Canto
In subjects with non-steroidal anti-inflammatory drugs (NSAIDs)- exacerbated respiratory disease (NERD) symptoms are triggered by acetyl salicylic acid (ASA) and other strong COX-1 inhibitors, and in some cases by weak COX-1 or by selective COX-2 inhibitors. The mechanism involved is related to prostaglandin pathway inhibition and leukotriene release. Subjects who react to a single NSAID and tolerate others are considered selective responders, and often present urticaria and/or angioedema and anaphylaxis (SNIUAA)...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27478585/further-effort-is-needed-to-improve-management-of-chronic-pain-in-primary-care-results-from-the-arkys-project
#17
Gaetano Piccinocchi, Roberto Piccinocchi
Treatment of chronic pain is challenging. The Arkys project was initiated in Italy to assist general practitioners (GPs) in the management of chronic pain. The main objective of this study was to determine the usefulness of Arkys for selecting new therapeutic strategies. An online interactive questionnaire for assessing pain and guiding therapeutic decisions was made available to GPs participating to Arkys. The GPs were invited to complete the questionnaire for each patient who presented moderate-severe chronic pain, and to decide on a new analgesic treatment based on the information provided by the questionnaire...
April 26, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27477800/low-grade-disease-activity-in-early-life-precedes-childhood-asthma-and-allergy
#18
Bo Lund Krogsgaard Chawes
Asthma and allergies are today the most common chronic diseases in children and the leading causes of school absences, chronic medication usage, emergency department visits and hospitalizations, which affect all members of the family and represent a significant societal and scientific challenge. These highly prevalent disorders are thought to originate from immune distortion in early childhood, but the etiology and heterogeneity of the disease mechanisms are not understood, which hampers preventive initiatives and makes treatment inadequate...
August 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27368089/analytical-method-development-for-powder-characterization-visualization-of-the-critical-drug-loading-affecting-the-processability-of-a-formulation-for-direct-compression
#19
Cosima Hirschberg, Changquan Calvin Sun, Jukka Rantanen
Characterization of particulate systems (powders) is one of the remaining scientific challenges. Evaluation of powder behaviour is often empirical and the decision-making processes are experience-based. There is a need for development of analytical instrumentation enabling more fundamental understanding of powder behaviour. Flowability and tabletability, two key factors in commercial scale manufacturing of tablets with direct compression (DC) approach, were analysed for formulations containing increasing amounts of several model active pharmaceutical ingredients (APIs)...
September 5, 2016: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/27311495/transdermal-buprenorphine-relieves-neuropathic-pain-a-randomized-double-blind-parallel-group-placebo-controlled-trial-in-diabetic-peripheral-neuropathic-pain
#20
Richard W Simpson, John H Wlodarczyk
OBJECTIVE: To evaluate the efficacy and safety of transdermal buprenorphine in patients with diabetic peripheral neuropathic pain (DPNP). RESEARCH DESIGN AND METHODS: This multicenter, randomized, double-blind, placebo-controlled, parallel-group trial enrolled patients with type 1 or type 2 diabetes and stable glycemic control who had been experiencing moderate to severe DPNP for at least 6 months on maximal tolerated conventional therapy. Patients were randomly assigned to receive buprenorphine (5 μg/h) or placebo patches...
September 2016: Diabetes Care
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