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Journal: Trends in Medical Use of Opioids in the U.S., 2006-2016. (Pubmed Central) - Apr 7, 2019 With the exception of buprenorphine, used to treat an opioid use disorder, prescription opioid use has been decreasing over the past 5 years in the U.S. Further efforts are needed to continue to optimize the balance between appropriate opioid access for acute pain while minimizing diversion and treating opioid addiction.
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Journal: Analgesia Nociception Index Monitoring During Supratentorial Craniotomy. (Pubmed Central) - Apr 5, 2019 In neurosurgical patients undergoing elective supratentorial craniotomy, ANI measures response to noxious stimuli with at least as much reliability as hemodynamic variables and changes in ANI parallel the changes in HR and MAP. ANI is superior to RE for measurement of response to noxious stimuli.
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Journal: Opioid Analgesic Prescribing: Facts vs Assumptions. (Pubmed Central) - Apr 3, 2019 ...Opioid analgesic prescribing and associated overdose deaths both peaked around 2011 and are in long-term decline; the sharp overdose increase recorded in 2014 was driven by illicit fentanyl and heroin. Nonmethadone prescription opioid analgesic deaths, in the absence of co-ingested benzodiazepines, alcohol, or other central nervous system/respiratory depressants, are infrequent...No abstract available
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Journal: Propofol and fentanyl sedation for laser treatment of retinopathy of prematurity to avoid intubation. (Pubmed Central) - Apr 3, 2019 Nonmethadone prescription opioid analgesic deaths, in the absence of co-ingested benzodiazepines, alcohol, or other central nervous system/respiratory depressants, are infrequent...No abstract available The good level of anesthesia and analgesia achieved sustains the efficacy of sedation with propofol during laser photocoagulation to avoid intubation and mechanical ventilation during and after the procedure.
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Retrospective data, Journal: Identification of opioids in surface and wastewaters by LC/QTOF-MS using retrospective data analysis. (Pubmed Central) - Mar 30, 2019 The concentrations of individual opioids in surface water and wastewater effluent varied from 8.8 (EDDP) to 1640 (tramadol) ngL and from 12 (dihydrocodeine) to 1288 (tramadol) ngL, respectively. The opioids with higher overall frequency detections were tramadol, dextromethorphan and its metabolite, dextrorphan.
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Pricing, Retrospective data, Journal, HEOR: Efficacy and cost savings with the use of a minimal sedation / anxiolysis protocol for intra-articular corticosteroid injections in children with juvenile idiopathic arthritis: a retrospective review of prospectively collected data. (Pubmed Central) - Mar 29, 2019 Conclusion Clopidogrel dose-adjusted plasma concentration in STEMI patients, as well as multivessel coronary artery disease, showed significance in predicting an unfavorable composite clinical outcome after 40-month follow-up. A minimal sedation/anxiolysis protocol (including nitrous oxide, intranasal fentanyl, a topical numbing agent, acetaminophen, ibuprofen, ondansetron and child life intervention), provides safe and effective analgesia for intra-articular corticosteroid injection in a subset of patients with juvenile idiopathic arthritis and offers a lower cost alternative to general anesthesia.
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Journal: Opioids delay healing of spinal fusion: a rabbit posterolateral lumbar fusion model. (Pubmed Central) - Mar 27, 2019 Systemic opioids led to an inferior quality fusion mass with delay in maturation and remodeling at six-weeks in this rabbit spinal fusion model. These preliminary results lay foundation for further research to investigate underlying cellular mechanisms, temporal fusion process, and dose-duration relationship of opioids responsible for our findings.
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Clinical, Retrospective data, Journal: Sugammadex affects emergence agitation in children undergoing strabismus surgery. (Pubmed Central) - Mar 27, 2019 In the propensity-matched analysis, patients in the sugammadex group showed rapid recovery, but there was no difference in the EA incidence or severity. Conclusion Sugammadex did not affect EA incidence or severity compared with conventional cholinesterase inhibitors, although it showed a favorable recovery profile in children undergoing strabismus surgery.
- |||||||||| 3-day fentanyl transdermal patcht / Generic mfg., megestrol / Generic mfg., Avastin (bevacizumab) / Roche
Clinical, Review, Journal: Paraneoplastic Encephalopathy in a Patient With Metastatic Lung Cancer: A Case Study. (Pubmed Central) - Dec 28, 2018 According to her husband, RS was diagnosed with stage IIIA large cell lung cancer 8 months earlier and was treated with concurrent chemotherapy (carboplatin, pemetrexed, and bevacizumab) and radiation therapy that was completed 4 months prior to admission...Home medications included transdermal fentanyl 12 μg/hr patch changed every 72 hours; oxycodone-acetaminophen tablets 5-325 mg, two every 4 hours as needed for pain; prednisone 10 mg, one tablet daily; and megestrol 40 mg/mL suspension, 20 mL once daily for appetite stimulation...These types of encephalopathies have been seen in patients with cancer and have thus been termed paraneoplastic. The presence of anti-VGKC antibodies on RS's paraneoplastic panel directed the inpatient medical oncology team toward a paraneoplastic neurologic disorder (PND) as the most likely diagnosis.
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Journal: Impact of Fellowship Training Level on Colonoscopy Quality and Efficiency Metrics. (Pubmed Central) - Dec 22, 2018 Efficiency of detecting and resecting polyps improved throughout training without reaching attending level. Fellow involvement led to greater use of moderate sedation, which may relate to a longer procedure duration and an evolving experience in endoscopic technique.
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Journal: Evaluation of Intraosseous Fluid as an Alternative Biological Specimen in Postmortem Toxicology. (Pubmed Central) - Oct 4, 2018 This novel study supports the use of IOF as an alternative postmortem specimen for toxicological investigations as a potentially less-compromised tissue in decomposed or traumatized bodies. Preliminary data is provided for the screening of common drugs of abuse in IOF that may show to be subject to alternative rates of postmortem redistribution than to that of other biological specimens in future studies that quantitate IOF drug concentrations.
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