<1001. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 550862
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - MEDLINE
AU  - Ravizza L
FA  - Ravizza, L
TI  - [Drug-dependent patients. Emergency and non-emergency treatment in hospital and ambulatory environments]. [Italian]
OT  - Tossicodipendenti. La cura d'urgenza e non in ambiente ospedaliero ed ambulatoriale.
SO  - Minerva Psichiatrica. 20(4):217-25, 1979 Oct-Dec
AS  - Minerva Psichiatr. 20(4):217-25, 1979 Oct-Dec
NJ  - Minerva psichiatrica
VO  - 20
IP  - 4
PG  - 217-25
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - mg4, 7707981
IO  - Minerva Psichiatr
SB  - Index Medicus
CP  - Italy
MH  - Ambulatory Care
MH  - Cyclazocine/tu [Therapeutic Use]
MH  - Emergency Services, Psychiatric
MH  - Hospitalization
MH  - Humans
MH  - Methadone/tu [Therapeutic Use]
MH  - Nalorphine/tu [Therapeutic Use]
MH  - Naloxone/tu [Therapeutic Use]
MH  - *Psychotherapy
MH  - Substance Withdrawal Syndrome/th [Therapy]
MH  - Substance-Related Disorders/rh [Rehabilitation]
MH  - *Substance-Related Disorders/th [Therapy]
RN  - 36B82AMQ7N (Naloxone)
RN  - J5W1B1159C (Cyclazocine)
RN  - U59WB2WRY2 (Nalorphine)
RN  - UC6VBE7V1Z (Methadone)
IS  - 0374-9320
IL  - 0374-9320
PT  - English Abstract
PT  - Journal Article
PP  - ppublish
LG  - Italian
DP  - 1979 Oct-Dec
EZ  - 1979/10/01
DA  - 1979/10/01 00:01
DT  - 1979/10/01 00:00
YR  - 1979
ED  - 19801024
RD  - 20131121
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med1&AN=550862

<1002. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 161305
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - MEDLINE
AU  - Nicholson DP
FA  - Nicholson, D P
TI  - Care of the overdose patient.
SO  - Journal of the Arkansas Medical Society. 76(7):249-53, 1979 Dec
AS  - J Ark Med Soc. 76(7):249-53, 1979 Dec
NJ  - The Journal of the Arkansas Medical Society
VO  - 76
IP  - 7
PG  - 249-53
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - hev, 7503069
IO  - J Ark Med Soc
SB  - Index Medicus
CP  - United States
MH  - Adrenal Cortex Hormones/tu [Therapeutic Use]
MH  - Adult
MH  - Anti-Bacterial Agents/tu [Therapeutic Use]
MH  - Gastric Lavage
MH  - Humans
MH  - Male
MH  - Mannitol/tu [Therapeutic Use]
MH  - Naloxone/tu [Therapeutic Use]
MH  - Poisoning/dt [Drug Therapy]
MH  - *Poisoning/th [Therapy]
MH  - Respiration, Artificial
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Anti-Bacterial Agents)
RN  - 36B82AMQ7N (Naloxone)
RN  - 3OWL53L36A (Mannitol)
IS  - 0004-1858
IL  - 0004-1858
PT  - Case Reports
PT  - Journal Article
PP  - ppublish
LG  - English
DP  - 1979 Dec
EZ  - 1979/12/01
DA  - 1979/12/01 00:01
DT  - 1979/12/01 00:00
YR  - 1979
ED  - 19800523
RD  - 20131121
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med1&AN=161305

<1003. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 759083
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - MEDLINE
AU  - Rothstein RJ
FA  - Rothstein, R J
TI  - Emergency management of poisoning and overdose.
SO  - Comprehensive Therapy. 5(1):7-14, 1979 Jan
AS  - Compr Ther. 5(1):7-14, 1979 Jan
NJ  - Comprehensive therapy
VO  - 5
IP  - 1
PG  - 7-14
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - dmz, 7605837
IO  - Compr Ther
SB  - Index Medicus
CP  - United States
MH  - Adult
MH  - *Antidotes/tu [Therapeutic Use]
MH  - Atropine/tu [Therapeutic Use]
MH  - Child
MH  - *Emergencies
MH  - Emetics/tu [Therapeutic Use]
MH  - Ethanol/tu [Therapeutic Use]
MH  - Glucose/tu [Therapeutic Use]
MH  - Humans
MH  - Naloxone/tu [Therapeutic Use]
MH  - Nitrates/tu [Therapeutic Use]
MH  - Nitrites/tu [Therapeutic Use]
MH  - Oxygen/tu [Therapeutic Use]
MH  - Physostigmine/tu [Therapeutic Use]
MH  - Poisoning/co [Complications]
MH  - *Poisoning/th [Therapy]
AB  - The management of the poisoned patient can be difficult and challenging. The task often demands the physician's entire resources in putting together pieces of history and significant physical findings to make a diagnosis. He must then carefully support and stabilize the patient under constant monitoring, while making efforts to prevent further absorption of the toxin, enhance excretion, and treat complications as they arise.
RN  - 0 (Antidotes)
RN  - 0 (Emetics)
RN  - 0 (Nitrates)
RN  - 0 (Nitrites)
RN  - 36B82AMQ7N (Naloxone)
RN  - 3K9958V90M (Ethanol)
RN  - 7C0697DR9I (Atropine)
RN  - 9U1VM840SP (Physostigmine)
RN  - IY9XDZ35W2 (Glucose)
RN  - S88TT14065 (Oxygen)
IS  - 0098-8243
IL  - 0098-8243
PT  - Journal Article
PP  - ppublish
LG  - English
DP  - 1979 Jan
EZ  - 1979/01/01
DA  - 1979/01/01 00:01
DT  - 1979/01/01 00:00
YR  - 1979
ED  - 19790324
RD  - 20131121
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med1&AN=759083

<1004. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 657774
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - MEDLINE
AU  - Fauman BJ
AU  - Fauman MA
FA  - Fauman, B J
FA  - Fauman, M A
TI  - Recognition and management of drug abuse emergencies.
SO  - Comprehensive Therapy. 4(5):38-43, 1978 May
AS  - Compr Ther. 4(5):38-43, 1978 May
NJ  - Comprehensive therapy
VO  - 4
IP  - 5
PG  - 38-43
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - dmz, 7605837
IO  - Compr Ther
SB  - Index Medicus
CP  - United States
MH  - Central Nervous System/de [Drug Effects]
MH  - Coma/ci [Chemically Induced]
MH  - Coma/th [Therapy]
MH  - Depression, Chemical
MH  - *Emergency Medical Services
MH  - Gastric Lavage
MH  - Humans
MH  - Naloxone/tu [Therapeutic Use]
MH  - Psychotropic Drugs/po [Poisoning]
MH  - Substance-Related Disorders/di [Diagnosis]
MH  - *Substance-Related Disorders/th [Therapy]
MH  - Suicide, Attempted
AB  - As with any medical emergency, the initial approach to the management of the drug abuse emergency is to attend to the potential threat to life. Establish and maintain an adequate airway, with respiratory support if necessary: secure a reliable intravenous route: administer appropriate drugs and antidotes; and perform the necessary diagnostic procedures to identify the cause of the problem. Always make an assessment of the psychological threat of self-destruction before discharging a patient who has taken an overdose. Be suspicious of drug overdose ina comatose or oddly-behaving patient. Consider the possibility of multiple drug abuse. Finally, always consider the possibility that causes other than drugs may be producing these symptoms.
RN  - 0 (Psychotropic Drugs)
RN  - 36B82AMQ7N (Naloxone)
IS  - 0098-8243
IL  - 0098-8243
PT  - Journal Article
PP  - ppublish
LG  - English
DP  - 1978 May
EZ  - 1978/05/01
DA  - 1978/05/01 00:01
DT  - 1978/05/01 00:00
YR  - 1978
ED  - 19780814
RD  - 20131121
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med1&AN=657774

<1005. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 619926
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - MEDLINE
AU  - Villalobos Cuevas E
AU  - Soto Oviedo F
AU  - Arnaiz Toledo C
AU  - Bonavides Mateos C
AU  - Flores Perez M
AU  - Figueroa Tarango A
FA  - Villalobos Cuevas, E
FA  - Soto Oviedo, F
FA  - Arnaiz Toledo, C
FA  - Bonavides Mateos, C
FA  - Flores Perez, M
FA  - Figueroa Tarango, A
TI  - [Diphenoxylate poisoning]. [Spanish]
OT  - Intoxicacion por difenoxilato.
SO  - Boletin Medico del Hospital Infantil de Mexico. 35(1):189-96, 1978 Jan-Feb
AS  - Bol Med Hosp Infant Mex. 35(1):189-96, 1978 Jan-Feb
NJ  - Boletin medico del Hospital Infantil de Mexico
VO  - 35
IP  - 1
PG  - 189-96
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - ag0, 0414106
IO  - Bol Med Hosp Infant Mex
SB  - Index Medicus
CP  - Mexico
MH  - *Accidents, Home
MH  - Child, Preschool
MH  - *Diphenoxylate/po [Poisoning]
MH  - Drug Evaluation
MH  - Female
MH  - Gastric Lavage
MH  - Humans
MH  - Infant
MH  - *Isonipecotic Acids/po [Poisoning]
MH  - Male
MH  - Naloxone/ad [Administration & Dosage]
MH  - Naloxone/tu [Therapeutic Use]
MH  - Poisoning/dt [Drug Therapy]
MH  - Tablets
AB  - During the year 1976, 18 patients intoxicated with lomotil were admitted to the Emergency Service of the Centro Medico La Raza, I.M.S.S. with ages fluctuating between 4 months and 3 years; the average age was 22 mos. 88.8% of intoxications were accidental. Initial manifestations of atropinism and diphenoxylate showed the same proportion and 22% showed mixed symptoms. There were no deaths. All patients were given stomach washings and it was seen that the earlier the washing was given, the lesser the symptoms showed. The specific treatment given was with naloxone chloride (Narcanti) at a dose of 10 micrograms, per kilo and per dose intravenously and was repeated as often as necessary. Response was spectacular with improvement within 15 seconds. No patient showed side-effects to the application of the antagonist. Lomotil intoxication rated up to 15% of the total sum of intoxications admitted.
RN  - 0 (Isonipecotic Acids)
RN  - 0 (Tablets)
RN  - 36B82AMQ7N (Naloxone)
RN  - 73312P173G (Diphenoxylate)
IS  - 0539-6115
IL  - 0539-6115
PT  - Comparative Study
PT  - English Abstract
PT  - Journal Article
PP  - ppublish
LG  - Spanish
DP  - 1978 Jan-Feb
EZ  - 1978/01/01
DA  - 1978/01/01 00:01
DT  - 1978/01/01 00:00
YR  - 1978
ED  - 19780329
RD  - 20131121
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med1&AN=619926

<1006. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 558608
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - MEDLINE
AU  - Lazzara A
FA  - Lazzara, A
TI  - Resuscitation of the newborn.
SO  - Postgraduate Medicine. 61(5):203-8, 210, 1977 May
AS  - Postgrad Med. 61(5):203-8, 210, 1977 May
NJ  - Postgraduate medicine
VO  - 61
IP  - 5
PG  - 203-8, 210
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - 0401147, pfk
IO  - Postgrad Med
SB  - Core Clinical Journals (AIM)
SB  - Index Medicus
CP  - England
MH  - Apnea/th [Therapy]
MH  - Asphyxia Neonatorum/co [Complications]
MH  - Asphyxia Neonatorum/th [Therapy]
MH  - Congenital Abnormalities/co [Complications]
MH  - Delivery, Obstetric/ae [Adverse Effects]
MH  - Female
MH  - Fetus/de [Drug Effects]
MH  - Humans
MH  - Infant, Newborn
MH  - Infant, Newborn, Diseases/et [Etiology]
MH  - *Infant, Newborn, Diseases/th [Therapy]
MH  - Intubation, Intratracheal
MH  - Maternal-Fetal Exchange
MH  - Meconium
MH  - Pregnancy
MH  - Resuscitation/mt [Methods]
MH  - *Resuscitation
MH  - Suction/mt [Methods]
MH  - Wounds and Injuries/co [Complications]
MH  - Wounds and Injuries/et [Etiology]
AB  - Effective resuscitation of the newborn requires knowledge of the cause of depression. Four major causes are trauma, asphyxia, medication, and malformation. More than one of these may contribute to depression in a single infant. The first principles of resuscitation are to avoid cooling the infant and to establish an airway. Infants with an Apgar score of 3 to 4 at one minute usually need bag-and-mask ventilation, while those with scores of 0 to 2 require immediate ventilation, preferably by means of endotracheal intubation. Severely depressed infants may also require chemical resuscitation and closed cardiac massage. Fetal depression caused by narcotic analgesics given to the mother can be reversed with the use of naloxone hydrochloride (Narcan). Infants asphyxiated on the basis of malformations may benefit from expeditious diagnostic and therapeutic procedures performed in the delivery room.
IS  - 0032-5481
IL  - 0032-5481
PT  - Journal Article
PP  - ppublish
LG  - English
DP  - 1977 May
EZ  - 1977/05/01
DA  - 1977/05/01 00:01
DT  - 1977/05/01 00:00
YR  - 1977
ED  - 19770622
RD  - 20071115
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med1&AN=558608

<1007. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 843415
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - MEDLINE
AU  - Jimenez Renteria E
AU  - Garza Villarreal G
AU  - Porcayo Vergara FA
AU  - Serafin FJ
FA  - Jimenez Renteria, E
FA  - Garza Villarreal, G
FA  - Porcayo Vergara, F A
FA  - Serafin, F J
TI  - [Analysis of 50 cases of Lomotil poisoning in children]. [Spanish]
OT  - Analisis de cincuenta casos de intoxicacion por Lomotil en ninos
SO  - Boletin Medico del Hospital Infantil de Mexico. 34(2):519-26, 1977 Mar-Apr
AS  - Bol Med Hosp Infant Mex. 34(2):519-26, 1977 Mar-Apr
NJ  - Boletin medico del Hospital Infantil de Mexico
VO  - 34
IP  - 2
PG  - 519-26
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - ag0, 0414106
IO  - Bol Med Hosp Infant Mex
SB  - Index Medicus
CP  - Mexico
MH  - Administration, Oral
MH  - *Atropine/po [Poisoning]
MH  - Atropine/tu [Therapeutic Use]
MH  - Child, Preschool
MH  - Diarrhea, Infantile/dt [Drug Therapy]
MH  - Drug Combinations
MH  - Drug Evaluation
MH  - Gastric Lavage
MH  - Humans
MH  - Infant
MH  - *Isonipecotic Acids/po [Poisoning]
MH  - Isonipecotic Acids/tu [Therapeutic Use]
MH  - Mexico
MH  - Poisoning/dt [Drug Therapy]
AB  - The authors reviewed the clinical histories of 50 children admitted to the Emergency Department of Hospital de Pediatria, C.M.N., I.M.S.S. from 1971 through 1975, with the diagnosis of lomotil intoxication. No differences were found as to sex. Frequency was greater at ages from 2 to 3 years from accidental mechanism, which increased between 1973 to 1975. Lethality was similar to that reported by other authors. In the clinical picture, the depressive action of diphenoxylate and the anticholinergic action of atropine were outstanding, without being possible to establish the limits between the two, with somnolence and flushness as main symptoms. The treatment given followed the purpose to eliminate the toxic: emesis, gastric washing and in cases of respiratory depression, naloxone was given. Therefore, it is concluded that since the value of lomotil in the treatment of diarrhea has not been proved and that the risk of its administration is greater than the benefit, this product should be proscribed, specially for pediatric use.
RN  - 0 (Drug Combinations)
RN  - 0 (Isonipecotic Acids)
RN  - 7C0697DR9I (Atropine)
IS  - 0539-6115
IL  - 0539-6115
PT  - English Abstract
PT  - Journal Article
PP  - ppublish
LG  - Spanish
DP  - 1977 Mar-Apr
EZ  - 1977/03/01
DA  - 1977/03/01 00:01
DT  - 1977/03/01 00:00
YR  - 1977
ED  - 19770525
RD  - 20131121
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med1&AN=843415

<1008. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 790367
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - MEDLINE
AU  - Clarke RS
FA  - Clarke, R S
TI  - Anaesthesia. [Review] [18 refs]
SO  - Practitioner. 217(1300 SPEC NO):611-5, 1976 Oct
AS  - Practitioner. 217(1300 SPEC NO):611-5, 1976 Oct
NJ  - The Practitioner
VO  - 217
IP  - 1300 SPEC NO
PG  - 611-5
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - phq, 0404245
IO  - Practitioner
SB  - Index Medicus
CP  - England
MH  - Alfaxalone Alfadolone Mixture/ae [Adverse Effects]
MH  - Anesthesia, Intravenous/ae [Adverse Effects]
MH  - *Anesthesia, Intravenous
MH  - Drug Hypersensitivity
MH  - Etomidate/ae [Adverse Effects]
MH  - Humans
MH  - Mobile Health Units
MH  - Naloxone/tu [Therapeutic Use]
MH  - Respiratory Insufficiency/dt [Drug Therapy]
MH  - Resuscitation
RN  - 36B82AMQ7N (Naloxone)
RN  - 8067-82-1 (Alfaxalone Alfadolone Mixture)
RN  - Z22628B598 (Etomidate)
IS  - 0032-6518
IL  - 0032-6518
PT  - Journal Article
PT  - Review
PP  - ppublish
LG  - English
DP  - 1976 Oct
EZ  - 1976/10/01
DA  - 1976/10/01 00:01
DT  - 1976/10/01 00:00
YR  - 1976
ED  - 19770103
RD  - 20131121
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med1&AN=790367

<1009. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 933393
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - MEDLINE
AU  - Persky VW
AU  - Goldfrank LR
FA  - Persky, V W
FA  - Goldfrank, L R
TI  - Methadone overdoses in a New York City hospital.
SO  - JACEP. 5(2):111-3, 1976 Feb
AS  - JACEP. 5(2):111-3, 1976 Feb
NJ  - JACEP
VO  - 5
IP  - 2
PG  - 111-3
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - krm, 0317011
IO  - JACEP
SB  - Index Medicus
CP  - United States
MH  - Adult
MH  - Emergency Service, Hospital
MH  - Female
MH  - Hospital Records
MH  - Humans
MH  - Liver/pp [Physiopathology]
MH  - Male
MH  - Methadone/ai [Antagonists & Inhibitors]
MH  - *Methadone/po [Poisoning]
MH  - Muscles/pp [Physiopathology]
MH  - Naloxone/pd [Pharmacology]
MH  - Pulmonary Edema/ci [Chemically Induced]
AB  - Charts of the 81 methadone overdose patients admitted to Morrisania City Hospital from the Emergency Department during the eight month period between June, 1973 and January, 1974 were reviewed. There were 87 overdose cases in the 81 patients. All were treated successfully with naloxone hydrochloride administered intravenously. Four patients had pulmonary edema. In more than half, liver and muscle function studies showed abnormalities. Ninety percent (79) of the overdoses were associated with a combination of methadone and other non-opiate drugs, including alcohol.
RN  - 36B82AMQ7N (Naloxone)
RN  - UC6VBE7V1Z (Methadone)
IS  - 0361-1124
IL  - 0361-1124
PT  - Journal Article
PP  - ppublish
LG  - English
DP  - 1976 Feb
EZ  - 1976/02/01
DA  - 1976/02/01 00:01
DT  - 1976/02/01 00:00
YR  - 1976
ED  - 19760901
RD  - 20131121
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med1&AN=933393

<1010. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 1124710
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - MEDLINE
AU  - Neaderthal RL
AU  - Calabro JJ
FA  - Neaderthal, R L
FA  - Calabro, J J
TI  - Treating heroin overdose.
SO  - American Family Physician. 11(2):141-5, 1975 Feb
AS  - Am Fam Physician. 11(2):141-5, 1975 Feb
NJ  - American family physician
VO  - 11
IP  - 2
PG  - 141-5
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - 3bt, 1272646
IO  - Am Fam Physician
SB  - Core Clinical Journals (AIM)
SB  - Index Medicus
CP  - United States
MH  - Arrhythmias, Cardiac/ci [Chemically Induced]
MH  - Chemical and Drug Induced Liver Injury/et [Etiology]
MH  - Dose-Response Relationship, Drug
MH  - Emergency Service, Hospital
MH  - Endocarditis/ci [Chemically Induced]
MH  - Female
MH  - Genital Diseases, Female/co [Complications]
MH  - *Heroin/po [Poisoning]
MH  - Heroin Dependence/co [Complications]
MH  - Heroin Dependence/th [Therapy]
MH  - Humans
MH  - Infant, Newborn
MH  - Infant, Newborn, Diseases
MH  - Infection/et [Etiology]
MH  - Male
MH  - Methadone/tu [Therapeutic Use]
MH  - Naloxone/tu [Therapeutic Use]
MH  - Pulmonary Edema/ci [Chemically Induced]
MH  - Respiratory Insufficiency/ci [Chemically Induced]
AB  - Immediate attention must be given to the respiratory system of the heroin abuser; then he should be given naloxone HCl. Search for evidence of use of additional drugs, which may compound problems. Pulmonary edema, aspiration pneumonia and pulmonary embolization are the most common complications. Infections, particularly endocarditis, and cardiac arrhythmia also occur with heroin overdose. Hepatitis is common. Treatment must include not only attention to the presenting symptoms but also referral to a rehabilitation center when possible.
RN  - 36B82AMQ7N (Naloxone)
RN  - 70D95007SX (Heroin)
RN  - UC6VBE7V1Z (Methadone)
IS  - 0002-838X
IL  - 0002-838X
PT  - Journal Article
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PP  - ppublish
LG  - English
DP  - 1975 Feb
EZ  - 1975/02/01
DA  - 1975/02/01 00:01
DT  - 1975/02/01 00:00
YR  - 1975
ED  - 19750703
RD  - 20161123
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med1&AN=1124710

<1011. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 4759720
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - MEDLINE
AU  - Holcenberg JS
FA  - Holcenberg, J S
TI  - Treatment of overdose and withdrawal of abused drugs.
SO  - Postgraduate Medicine. 54(6):123-7, 1973 Dec
AS  - Postgrad Med. 54(6):123-7, 1973 Dec
NJ  - Postgraduate medicine
VO  - 54
IP  - 6
PG  - 123-7
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - 0401147, pfk
IO  - Postgrad Med
SB  - Core Clinical Journals (AIM)
SB  - Index Medicus
CP  - England
MH  - Amphetamine
MH  - Cathartics/tu [Therapeutic Use]
MH  - Charcoal/tu [Therapeutic Use]
MH  - Diuretics/tu [Therapeutic Use]
MH  - Gastric Lavage
MH  - Hallucinogens
MH  - Humans
MH  - Hypnotics and Sedatives
MH  - Methadone/tu [Therapeutic Use]
MH  - Naloxone/ad [Administration & Dosage]
MH  - Naloxone/tu [Therapeutic Use]
MH  - Opium/tu [Therapeutic Use]
MH  - Parasympatholytics
MH  - Pulmonary Edema/ci [Chemically Induced]
MH  - Renal Dialysis
MH  - Respiration, Artificial
MH  - Substance Withdrawal Syndrome/di [Diagnosis]
MH  - *Substance Withdrawal Syndrome/dt [Drug Therapy]
MH  - Substance-Related Disorders/di [Diagnosis]
MH  - *Substance-Related Disorders/th [Therapy]
MH  - Tranquilizing Agents
MH  - Vomiting/ci [Chemically Induced]
RN  - 0 (Cathartics)
RN  - 0 (Diuretics)
RN  - 0 (Hallucinogens)
RN  - 0 (Hypnotics and Sedatives)
RN  - 0 (Parasympatholytics)
RN  - 0 (Tranquilizing Agents)
RN  - 16291-96-6 (Charcoal)
RN  - 36B82AMQ7N (Naloxone)
RN  - 8008-60-4 (Opium)
RN  - CK833KGX7E (Amphetamine)
RN  - UC6VBE7V1Z (Methadone)
IS  - 0032-5481
IL  - 0032-5481
PT  - Journal Article
PP  - ppublish
LG  - English
DP  - 1973 Dec
EZ  - 1973/12/01
DA  - 1973/12/01 00:01
DT  - 1973/12/01 00:00
YR  - 1973
ED  - 19740201
RD  - 20131121
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med1&AN=4759720

<1012. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 4703402
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - MEDLINE
AU  - Arena JM
FA  - Arena, J M
TI  - Two current poisonings: tricyclic drugs and methadone.
SO  - Pediatrics. 51(5):919-22, 1973 May
AS  - Pediatrics. 51(5):919-22, 1973 May
NJ  - Pediatrics
VO  - 51
IP  - 5
PG  - 919-22
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - oxv, 0376422
IO  - Pediatrics
SB  - Core Clinical Journals (AIM)
SB  - Index Medicus
CP  - United States
MH  - Anti-Arrhythmia Agents/tu [Therapeutic Use]
MH  - *Antidepressive Agents/po [Poisoning]
MH  - Barbiturates/tu [Therapeutic Use]
MH  - Catecholamines/tu [Therapeutic Use]
MH  - Diuresis
MH  - Gastric Lavage
MH  - Humans
MH  - Methadone/me [Metabolism]
MH  - *Methadone/po [Poisoning]
MH  - Muscle Relaxants, Central/tu [Therapeutic Use]
MH  - Nalorphine/tu [Therapeutic Use]
MH  - Naloxone/tu [Therapeutic Use]
MH  - Poisoning/di [Diagnosis]
MH  - Poisoning/th [Therapy]
MH  - Respiration, Artificial
MH  - Vasoconstrictor Agents/tu [Therapeutic Use]
MH  - Ventricular Fibrillation/pc [Prevention & Control]
RN  - 0 (Anti-Arrhythmia Agents)
RN  - 0 (Antidepressive Agents)
RN  - 0 (Barbiturates)
RN  - 0 (Catecholamines)
RN  - 0 (Muscle Relaxants, Central)
RN  - 0 (Vasoconstrictor Agents)
RN  - 36B82AMQ7N (Naloxone)
RN  - U59WB2WRY2 (Nalorphine)
RN  - UC6VBE7V1Z (Methadone)
IS  - 0031-4005
IL  - 0031-4005
PT  - Journal Article
PP  - ppublish
LG  - English
DP  - 1973 May
EZ  - 1973/05/01
DA  - 1973/05/01 00:01
DT  - 1973/05/01 00:00
YR  - 1973
ED  - 19730709
RD  - 20131121
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med1&AN=4703402

<1013. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 4405102
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - MEDLINE
AU  - Synder R
AU  - Mofenson HC
AU  - Greensher J
FA  - Synder, R
FA  - Mofenson, H C
FA  - Greensher, J
TI  - Toxicity from Lomotil. Accidental ingestion by a 22-month-old child.
SO  - Clinical Pediatrics. 12(1):47-9, 1973 Jan
AS  - Clin Pediatr (Phila). 12(1):47-9, 1973 Jan
NJ  - Clinical pediatrics
VO  - 12
IP  - 1
PG  - 47-9
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - dhe, 0372606, 8407647
IO  - Clin Pediatr (Phila)
SB  - Core Clinical Journals (AIM)
SB  - Index Medicus
CP  - United States
MH  - *Atropine/po [Poisoning]
MH  - Drug Combinations
MH  - *Gastrointestinal Agents/po [Poisoning]
MH  - Humans
MH  - Infant
MH  - Ipecac/tu [Therapeutic Use]
MH  - *Isonipecotic Acids/po [Poisoning]
MH  - Male
MH  - Naloxone/tu [Therapeutic Use]
MH  - Poisoning/th [Therapy]
MH  - Respiration, Artificial
MH  - Seizures/ci [Chemically Induced]
MH  - Tachycardia/ci [Chemically Induced]
MH  - Vomiting/ci [Chemically Induced]
RN  - 0 (Drug Combinations)
RN  - 0 (Gastrointestinal Agents)
RN  - 0 (Isonipecotic Acids)
RN  - 36B82AMQ7N (Naloxone)
RN  - 7C0697DR9I (Atropine)
RN  - 8012-96-2 (Ipecac)
IS  - 0009-9228
IL  - 0009-9228
PT  - Journal Article
ID  - 10.1177/000992287301200112 [doi]
PP  - ppublish
LG  - English
DP  - 1973 Jan
EZ  - 1973/01/01
DA  - 1973/01/01 00:01
DT  - 1973/01/01 00:00
YR  - 1973
ED  - 19730305
RD  - 20170214
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med1&AN=4405102

<1014. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 5166910
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - MEDLINE
AU  - Lowenstein E
FA  - Lowenstein, E
TI  - Antagonism of morphine anesthesia by naloxone. Guest discussion.
SO  - Anesthesia & Analgesia. 50(6):958-9, 1971 Nov-Dec
AS  - Anesth Analg. 50(6):958-9, 1971 Nov-Dec
NJ  - Anesthesia and analgesia
VO  - 50
IP  - 6
PG  - 958-9
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - 4r8, 1310650
IO  - Anesth. Analg.
SB  - Index Medicus
CP  - United States
MH  - *Anesthesia, Intravenous
MH  - Humans
MH  - Injections, Intravenous
MH  - *Morphinans
MH  - Morphine/ad [Administration & Dosage]
MH  - *Morphine/ai [Antagonists & Inhibitors]
MH  - Narcotic Antagonists/ad [Administration & Dosage]
MH  - *Narcotic Antagonists
MH  - Respiration, Artificial
RN  - 0 (Morphinans)
RN  - 0 (Narcotic Antagonists)
RN  - 76I7G6D29C (Morphine)
IS  - 0003-2999
IL  - 0003-2999
PT  - Journal Article
PP  - ppublish
LG  - English
DP  - 1971 Nov-Dec
EZ  - 1971/11/01
DA  - 1971/11/01 00:01
DT  - 1971/11/01 00:00
YR  - 1971
ED  - 19720223
RD  - 20131121
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med1&AN=5166910

<1015. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28915153
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Gold LS
AU  - Hansen RN
AU  - Avins AL
AU  - Bauer Z
AU  - Comstock BA
AU  - Deyo RA
AU  - Heagerty PJ
AU  - Rundell SD
AU  - Suri P
AU  - Turner JA
AU  - Jarvik JG
FA  - Gold, Laura S
FA  - Hansen, Ryan N
FA  - Avins, Andrew L
FA  - Bauer, Zoya
FA  - Comstock, Bryan A
FA  - Deyo, Richard A
FA  - Heagerty, Patrick J
FA  - Rundell, Sean D
FA  - Suri, Pradeep
FA  - Turner, Judith A
FA  - Jarvik, Jeffrey G
IN  - Gold, Laura S. Department of Radiology, Comparative Effectiveness, Cost, and Outcomes Research Center.
IN  - Hansen, Ryan N. Pharmaceutical Outcomes Research and Policy Program Department of Pharmacy.
IN  - Hansen, Ryan N. Department of Health Services.
IN  - Avins, Andrew L. Division of Research, Northern California Kaiser-Permanente, San Francisco, CA.
IN  - Bauer, Zoya. Department of Radiology, Comparative Effectiveness, Cost, and Outcomes Research Center.
IN  - Comstock, Bryan A. Department of Biostatistics, School of Public Health.
IN  - Deyo, Richard A. Departments of Family Medicine, Internal Medicine, Public Health and Preventive Medicine, and Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR.
IN  - Heagerty, Patrick J. Department of Biostatistics, School of Public Health.
IN  - Rundell, Sean D. Department of Radiology, Comparative Effectiveness, Cost, and Outcomes Research Center.
IN  - Rundell, Sean D. Department of Rehabilitation Medicine.
IN  - Suri, Pradeep. Department of Rehabilitation Medicine.
IN  - Suri, Pradeep. Veteran's Administration Puget Sound Health Care System, Seattle, WA.
IN  - Turner, Judith A. Department of Rehabilitation Medicine.
IN  - Turner, Judith A. Department of Psychiatry and Behavioral Sciences.
IN  - Jarvik, Jeffrey G. Department of Radiology, Comparative Effectiveness, Cost, and Outcomes Research Center.
IN  - Jarvik, Jeffrey G. Department of Health Services.
IN  - Jarvik, Jeffrey G. Department of Neurological Surgery, University of Washington.
TI  - Associations of Early Opioid Use With Patient-reported Outcomes and Health Care Utilization Among Older Adults With Low Back Pain.
SO  - Clinical Journal of Pain. 34(4):297-305, 2018 Apr
AS  - Clin J Pain. 34(4):297-305, 2018 Apr
NJ  - The Clinical journal of pain
VO  - 34
IP  - 4
PG  - 297-305
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - beg, 8507389
IO  - Clin J Pain
CP  - United States
AB  - OBJECTIVES: The objective of this study was to compare outcomes and health care utilization of older patients who did versus did not fill opioid prescriptions within 90 days of initiating care for low back pain.
AB  - MATERIALS AND METHODS: For patients >=65 years with new back pain visits, we used propensity scores to match those who filled no opioid prescriptions to those who filled >=2 opioid prescriptions within 90 days (and the first opioid prescription within 30d) of the index visit. Over 24 months, we examined patient-reported outcomes, health care utilization, and subsequent opioid prescription fills.
AB  - RESULTS: Among 1954 patients eligible for matching, 238 (12%) filled >=2 opioid prescriptions within 90 days; 200 of these were matched to controls. Patients with versus without early opioid prescriptions had similar patient-reported outcomes but were more likely to have filled >=1 opioid prescription 18 to 24 months after the index visit (odds ratio [95% confidence interval]=2.4 [1.5-3.9]) and to have had >=1 visit to the emergency department in the subsequent 24 months (OR, 1.6; 95% confidence interval, 1.0-2.5).
AB  - DISCUSSION: Among older patients with new back pain visits, filling >=2 opioid prescriptions within 90 days of the visit was associated with similar back pain-related outcomes but increased likelihood of filling opioid prescriptions 18 to 24 months later compared with matched patients who did not fill early opioid prescriptions.
ES  - 1536-5409
IL  - 0749-8047
DO  - https://dx.doi.org/10.1097/AJP.0000000000000557
PT  - Journal Article
ID  - 10.1097/AJP.0000000000000557 [doi]
ID  - PMC5837891 [pmc]
ID  - NIHMS904070 [mid]
PP  - ppublish
GI  - No: R01 HS019222
Organization: (HS) *AHRQ HHS*
Country: United States

GI  - No: R01 HS022972
Organization: (HS) *AHRQ HHS*
Country: United States
LG  - English
DP  - 2018 Apr
PQ  - 2019/04/01
EZ  - 2017/09/16 06:00
DA  - 2017/09/16 06:00
DT  - 2017/09/16 06:00
YR  - 2018
RD  - 20180412
UP  - 20180412
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28915153

<1016. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28835443
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Alexandridis AA
AU  - McCort A
AU  - Ringwalt CL
AU  - Sachdeva N
AU  - Sanford C
AU  - Marshall SW
AU  - Mack K
AU  - Dasgupta N
AI  - Alexandridis, Apostolos A; ORCID: http://orcid.org/0000-0001-9140-2889
FA  - Alexandridis, Apostolos A
FA  - McCort, Agnieszka
FA  - Ringwalt, Christopher L
FA  - Sachdeva, Nidhi
FA  - Sanford, Catherine
FA  - Marshall, Stephen W
FA  - Mack, Karin
FA  - Dasgupta, Nabarun
IN  - Alexandridis, Apostolos A. Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
IN  - McCort, Agnieszka. Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
IN  - Ringwalt, Christopher L. Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
IN  - Sachdeva, Nidhi. Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
IN  - Sachdeva, Nidhi. Chronic Disease and Injury Section, Division of Public Health, North Carolina Department of Health and Human Services, Injury and Violence Prevention Branch, Raleigh, North Carolina, USA.
IN  - Sanford, Catherine. Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
IN  - Marshall, Stephen W. Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
IN  - Mack, Karin. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
IN  - Dasgupta, Nabarun. Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
TI  - A statewide evaluation of seven strategies to reduce opioid overdose in North Carolina.
SO  - Injury Prevention. 24(1):48-54, 2018 Feb
AS  - Inj Prev. 24(1):48-54, 2018 Feb
NJ  - Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention
VO  - 24
IP  - 1
PG  - 48-54
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - crz, 9510056
IO  - Inj. Prev.
CP  - England
KW  - Epidemiology;  Outcome Evaluation;  Poisoning;  Surveillance;  Time Series
AB  - BACKGROUND: In response to increasing opioid overdoses, US prevention efforts have focused on prescriber education and supply, demand and harm reduction strategies. Limited evidence informs which interventions are effective. We evaluated Project Lazarus, a centralised statewide intervention designed to prevent opioid overdose.
AB  - METHODS: Observational intervention study of seven strategies. 74 of 100 North Carolina counties implemented the intervention. Dichotomous variables were constructed for each strategy by county-month. Exposure data were: process logs, surveys, addiction treatment interviews, prescription drug monitoring data. Outcomes were: unintentional and undetermined opioid overdose deaths, overdose-related emergency department (ED) visits. Interrupted time-series Poisson regression was used to estimate rates during preintervention (2009-2012) and intervention periods (2013-2014). Adjusted IRR controlled for prescriptions, county health status and time trends. Time-lagged regression models considered delayed impact (0-6 months).
AB  - RESULTS: In adjusted immediate-impact models, provider education was associated with lower overdose mortality (IRR 0.91; 95%CI 0.81 to 1.02) but little change in overdose-related ED visits. Policies to limit ED opioid dispensing were associated with lower mortality (IRR 0.97; 95%CI 0.87 to 1.07), but higher ED visits (IRR 1.06; 95%CI 1.01 to 1.12). Expansions of medication-assisted treatment (MAT) were associated with increased mortality (IRR 1.22; 95%CI 1.08 to 1.37) but lower ED visits in time-lagged models.
AB  - CONCLUSIONS: Provider education related to pain management and addiction treatment, and ED policies limiting opioid dispensing showed modest immediate reductions in mortality. MAT expansions showed beneficial effects in reducing ED-related overdose visits in time-lagged models, despite an unexpected adverse association with mortality.

Copyright © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
CI  - Competing interests: KM is an employee of the United States Centers for Disease Control and Prevention, which funded the evaluation of the study.
ES  - 1475-5785
IL  - 1353-8047
DO  - https://dx.doi.org/10.1136/injuryprev-2017-042396
PT  - Journal Article
ID  - injuryprev-2017-042396 [pii]
ID  - 10.1136/injuryprev-2017-042396 [doi]
ID  - PMC5795575 [pmc]
ID  - NIHMS933912 [mid]
PP  - ppublish
PH  - 2017/03/10 [received]
PH  - 2017/06/13 [revised]
PH  - 2017/07/22 [accepted]
GI  - No: CC999999
Organization: *Intramural CDC HHS*
Country: United States
LG  - English
EP  - 20170823
DP  - 2018 Feb
PQ  - 2018/08/01
EZ  - 2017/08/25 06:00
DA  - 2017/08/25 06:00
DT  - 2017/08/25 06:00
YR  - 2018
RD  - 20180412
UP  - 20180412
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28835443

<1017. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28791786
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Kim HS
AU  - McCarthy DM
AU  - Hoppe JA
AU  - Mark Courtney D
AU  - Lambert BL
FA  - Kim, Howard S
FA  - McCarthy, Danielle M
FA  - Hoppe, Jason A
FA  - Mark Courtney, D
FA  - Lambert, Bruce L
IN  - Kim, Howard S. Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
IN  - McCarthy, Danielle M. Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
IN  - Hoppe, Jason A. Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO.
IN  - Hoppe, Jason A. Rocky Mountain Poison & Drug Center, Denver, CO.
IN  - Mark Courtney, D. Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
IN  - Lambert, Bruce L. Department of Communication Studies, Northwestern University Feinberg School of Medicine, Chicago, IL.
IN  - Lambert, Bruce L. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL.
TI  - Emergency Department Provider Perspectives on Benzodiazepine-Opioid Coprescribing: A Qualitative Study.
SO  - Academic Emergency Medicine. 25(1):15-24, 2018 Jan
AS  - Acad Emerg Med. 25(1):15-24, 2018 Jan
NJ  - Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
VO  - 25
IP  - 1
PG  - 15-24
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - ce1, 9418450
IO  - Acad Emerg Med
CP  - United States
AB  - OBJECTIVE: Benzodiazepines and opioids are prescribed simultaneously (i.e., "coprescribed") in many clinical settings, despite guidelines advising against this practice and mounting evidence that concomitant use of both medications increases overdose risk. This study sought to characterize the contexts in which benzodiazepine-opioid coprescribing occurs and providers' reasons for coprescribing.
AB  - METHODS: We conducted focus groups with emergency department (ED) providers (resident and attending physicians, advanced practice providers, and pharmacists) from three hospitals using semistructured interviews to elicit perspectives on benzodiazepine-opioid coprescribing. Discussions were audio-recorded and transcribed. We performed qualitative content analysis of the resulting transcripts using a consensual qualitative research approach, aiming to identify priority categories that describe the phenomenon of benzodiazepine-opioid coprescribing.
AB  - RESULTS: Participants acknowledged coprescribing rarely and reluctantly and often provided specific discharge instructions when coprescribing. The decision to coprescribe is multifactorial, often isolated to specific clinical and situational contexts (e.g., low back pain, failed solitary opioid therapy) and strongly influenced by a provider's beliefs about the efficacy of combination therapy. The decision to coprescribe is further influenced by a self-imposed pressure to escalate care or avoid hospital admission. When considering potential interventions to reduce the incidence of coprescribing, participants opposed computerized alerts but were supportive of a pharmacist-assisted intervention. Many providers found the process of participating in peer discussions on prescribing habits to be beneficial.
AB  - CONCLUSIONS: In this qualitative study of ED providers, we found that benzodiazepine-opioid coprescribing occurs in specific clinical and situational contexts, such as the treatment of low back pain or failed solitary opioid therapy. The decision to coprescribe is strongly influenced by a provider's beliefs and by self-imposed pressure to escalate care or avoid admission.

Copyright © 2017 by the Society for Academic Emergency Medicine.
ES  - 1553-2712
IL  - 1069-6563
DO  - https://dx.doi.org/10.1111/acem.13273
PT  - Journal Article
ID  - 10.1111/acem.13273 [doi]
ID  - PMC5764790 [pmc]
ID  - NIHMS898208 [mid]
PP  - ppublish
PH  - 2017/04/25 [received]
PH  - 2017/07/21 [revised]
PH  - 2017/08/04 [accepted]
GI  - No: T32 HS000078
Organization: (HS) *AHRQ HHS*
Country: United States
LG  - English
EP  - 20170919
DP  - 2018 Jan
PQ  - 2019/01/01
EZ  - 2017/08/10 06:00
DA  - 2017/08/10 06:00
DT  - 2017/08/10 06:00
YR  - 2018
RD  - 20180412
UP  - 20180412
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28791786

<1018. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29506986
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - PubMed-not-MEDLINE
AU  - Borgundvaag B
AU  - McLeod S
AU  - Khuu W
AU  - Varner C
AU  - Tadrous M
AU  - Gomes T
FA  - Borgundvaag, Bjug
FA  - McLeod, Shelley
FA  - Khuu, Wayne
FA  - Varner, Catherine
FA  - Tadrous, Mina
FA  - Gomes, Tara
IN  - Borgundvaag, Bjug. Affiliations: Division of Emergency Medicine (Borgundvaag, McLeod, Varner), Department of Family and Community Medicine, University of Toronto; Schwartz/Reisman Emergency Medicine Institute (Borgundvaag, McLeod, Varner), Mount Sinai Hospital; Li Ka Shing Knowledge Institute (Tadrous), St. Michael's Hospital; Institute for Clinical Evaluative Sciences (Khuu, Gomes); Leslie Dan Faculty of Pharmacy (Tadrous, Gomes), University of Toronto, Toronto, Ont.
IN  - McLeod, Shelley. Affiliations: Division of Emergency Medicine (Borgundvaag, McLeod, Varner), Department of Family and Community Medicine, University of Toronto; Schwartz/Reisman Emergency Medicine Institute (Borgundvaag, McLeod, Varner), Mount Sinai Hospital; Li Ka Shing Knowledge Institute (Tadrous), St. Michael's Hospital; Institute for Clinical Evaluative Sciences (Khuu, Gomes); Leslie Dan Faculty of Pharmacy (Tadrous, Gomes), University of Toronto, Toronto, Ont.
IN  - Khuu, Wayne. Affiliations: Division of Emergency Medicine (Borgundvaag, McLeod, Varner), Department of Family and Community Medicine, University of Toronto; Schwartz/Reisman Emergency Medicine Institute (Borgundvaag, McLeod, Varner), Mount Sinai Hospital; Li Ka Shing Knowledge Institute (Tadrous), St. Michael's Hospital; Institute for Clinical Evaluative Sciences (Khuu, Gomes); Leslie Dan Faculty of Pharmacy (Tadrous, Gomes), University of Toronto, Toronto, Ont.
IN  - Varner, Catherine. Affiliations: Division of Emergency Medicine (Borgundvaag, McLeod, Varner), Department of Family and Community Medicine, University of Toronto; Schwartz/Reisman Emergency Medicine Institute (Borgundvaag, McLeod, Varner), Mount Sinai Hospital; Li Ka Shing Knowledge Institute (Tadrous), St. Michael's Hospital; Institute for Clinical Evaluative Sciences (Khuu, Gomes); Leslie Dan Faculty of Pharmacy (Tadrous, Gomes), University of Toronto, Toronto, Ont.
IN  - Tadrous, Mina. Affiliations: Division of Emergency Medicine (Borgundvaag, McLeod, Varner), Department of Family and Community Medicine, University of Toronto; Schwartz/Reisman Emergency Medicine Institute (Borgundvaag, McLeod, Varner), Mount Sinai Hospital; Li Ka Shing Knowledge Institute (Tadrous), St. Michael's Hospital; Institute for Clinical Evaluative Sciences (Khuu, Gomes); Leslie Dan Faculty of Pharmacy (Tadrous, Gomes), University of Toronto, Toronto, Ont.
IN  - Gomes, Tara. Affiliations: Division of Emergency Medicine (Borgundvaag, McLeod, Varner), Department of Family and Community Medicine, University of Toronto; Schwartz/Reisman Emergency Medicine Institute (Borgundvaag, McLeod, Varner), Mount Sinai Hospital; Li Ka Shing Knowledge Institute (Tadrous), St. Michael's Hospital; Institute for Clinical Evaluative Sciences (Khuu, Gomes); Leslie Dan Faculty of Pharmacy (Tadrous, Gomes), University of Toronto, Toronto, Ont.
TI  - Opioid prescribing and adverse events in opioid-naive patients treated by emergency physicians versus family physicians: a population-based cohort study.
SO  - CMAJ open. 6(1):E110-E117, 2018 Mar 01
AS  - CMAJ Open. 6(1):E110-E117, 2018 Mar 01
NJ  - CMAJ open
VO  - 6
IP  - 1
PG  - E110-E117
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - 101620603
IO  - CMAJ Open
CP  - Canada
AB  - BACKGROUND: Emergency physicians provide primary care to patients and often prescribe opioids for acutely painful self-limiting conditions. The objective of this study was to describe patterns of opioid prescribing by emergency physicians and family physicians and to explore the relation between setting of initiation of opioid treatment and adverse events over the subsequent 2 years.
AB  - METHODS: This was a population-based cohort study using administrative data from Ontario. Opioid-naive patients aged 15-64 years who received an opioid prescription for noncancer pain from an emergency or family physician between Apr. 1, 2008, and Mar. 31, 2012 were eligible for inclusion.
AB  - RESULTS: A total of 34713 and 45952 patients were initiated on an opioid by an emergency physicians and family physicians, respectively. Both emergency and family physicians most commonly prescribed codeine-containing products (58.9% and 79.6% of prescriptions, respectively); however, emergency physicians were twice as likely as family physicians to prescribe higher-potency opioids (morphine, oxycodone, hydromorphone, fentanyl, meperidine) (both combination and single-agent preparations) (40.6% v. 19.9%,  = 20.7, 95% confidence interval [CI] 20.0-21.3). Compared to patients in the family physician group, those in the emergency physician group received significantly higher daily dosages, a higher proportion were initiated on a daily dosage of 100 mg of morphine equivalents (MEQs) or more, and had a hospital admission for opioid toxicity within 2 years (0.5% v. 0.3%,  = 0.2%, 95% CI 0.1%-0.3%). A higher proportion of patients in the family physician group than in the emergency physician group had dosage escalation beyond 199 mg MEQs within 2 years (0.7% v. 0.1%,  = 0.6%, 95% CI 0.5%-0.7%).
AB  - INTERPRETATION: Codeine was the most common opioid prescribed by emergency and family physicians. Compared to patients prescribed opioids by family physicians, those prescribed opioids by emergency physicians received higher initial daily dosages and had an increased likelihood of opioid toxicity.

Copyright 2018, Joule Inc. or its licensors.
CI  - Competing interests: Tara Gomes has received unrestricted grant funding from the Ontario Ministry of Health and Long-Term Care (MOHLTC). Mina Tadrous has received support from the MOHLTC Health System Research Fund. No other competing interests were declared.
IS  - 2291-0026
IL  - 2291-0026
DO  - https://dx.doi.org/10.9778/cmajo.20170151
PT  - Journal Article
ID  - 6/1/E110 [pii]
ID  - 10.9778/cmajo.20170151 [doi]
ID  - PMC5878958 [pmc]
PP  - ppublish
LG  - English
DP  - 2018 Mar 01
EZ  - 2018/03/07 06:00
DA  - 2018/03/07 06:01
DT  - 2018/03/07 06:00
YR  - 2018
RD  - 20180408
UP  - 20180409
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29506986

<1019. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29340937
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Delgado MK
AU  - Shofer FS
AU  - Patel MS
AU  - Halpern S
AU  - Edwards C
AU  - Meisel ZF
AU  - Perrone J
FA  - Delgado, M Kit
FA  - Shofer, Frances S
FA  - Patel, Mitesh S
FA  - Halpern, Scott
FA  - Edwards, Christopher
FA  - Meisel, Zachary F
FA  - Perrone, Jeanmarie
IN  - Delgado, M Kit. Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. kit.delgado@uphs.upenn.edu.
IN  - Delgado, M Kit. Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. kit.delgado@uphs.upenn.edu.
IN  - Delgado, M Kit. Center for Health Incentives and Behavioral Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. kit.delgado@uphs.upenn.edu.
IN  - Delgado, M Kit. Penn Injury Science Center, University of Pennsylvania, Philadelphia, PA, USA. kit.delgado@uphs.upenn.edu.
IN  - Shofer, Frances S. Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
IN  - Patel, Mitesh S. Center for Health Incentives and Behavioral Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
IN  - Patel, Mitesh S. Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
IN  - Halpern, Scott. Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
IN  - Halpern, Scott. Center for Health Incentives and Behavioral Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
IN  - Halpern, Scott. Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
IN  - Halpern, Scott. Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
IN  - Edwards, Christopher. Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
IN  - Meisel, Zachary F. Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
IN  - Meisel, Zachary F. Penn Injury Science Center, University of Pennsylvania, Philadelphia, PA, USA.
IN  - Perrone, Jeanmarie. Center for Emergency Care Policy and Research, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
TI  - Association between Electronic Medical Record Implementation of Default Opioid Prescription Quantities and Prescribing Behavior in Two Emergency Departments.
SO  - Journal of General Internal Medicine. 33(4):409-411, 2018 Apr
AS  - J Gen Intern Med. 33(4):409-411, 2018 Apr
NJ  - Journal of general internal medicine
VO  - 33
IP  - 4
PG  - 409-411
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - 8605834
IO  - J Gen Intern Med
CP  - United States
KW  - EMR;  defaults;  opioid prescribing
ES  - 1525-1497
IL  - 0884-8734
DO  - https://dx.doi.org/10.1007/s11606-017-4286-5
PT  - Journal Article
ID  - 10.1007/s11606-017-4286-5 [doi]
ID  - 10.1007/s11606-017-4286-5 [pii]
ID  - PMC5880773 [pmc]
PP  - ppublish
GI  - No: P30 DA040500
Organization: (DA) *NIDA NIH HHS*
Country: United States
LG  - English
DP  - 2018 Apr
PQ  - 2019/04/01
EZ  - 2018/01/18 06:00
DA  - 2018/01/18 06:00
DT  - 2018/01/18 06:00
YR  - 2018
RD  - 20180405
UP  - 20180405
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29340937

<1020. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29599018
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Janakiram C
AU  - Chalmers NI
AU  - Fontelo P
AU  - Huser V
AU  - Lopez Mitnik G
AU  - Iafolla TJ
AU  - Brow AR
AU  - Dye BA
FA  - Janakiram, Chandrashekar
FA  - Chalmers, Natalia I
FA  - Fontelo, Paul
FA  - Huser, Vojtech
FA  - Lopez Mitnik, Gabriela
FA  - Iafolla, Timothy J
FA  - Brow, Avery R
FA  - Dye, Bruce A
TI  - Sex and race or ethnicity disparities in opioid prescriptions for dental diagnoses among patients receiving Medicaid.
SO  - Journal of the American Dental Association. 149(4):246-255, 2018 Apr
AS  - J Am Dent Assoc. 149(4):246-255, 2018 Apr
NJ  - Journal of the American Dental Association (1939)
VO  - 149
IP  - 4
PG  - 246-255
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - h5j, 7503060
IO  - J Am Dent Assoc
CP  - England
KW  - Medicaid;  Opioid;  drug prescriptions;  oral diagnosis
AB  - BACKGROUND: The objective of this study was to identify specific factors (sex, race or ethnicity, and health care provider type) associated with patient receipt of an opioid prescription after a dental diagnosis.
AB  - METHODS: The authors used Medicaid claims dated from January 1, 2013, through September 30, 2015, for 13 US states in this study. The authors identified oral health-related conditions by using International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes 520.0 through 529.9.
AB  - RESULTS: During the 2013-2015 study period, among the more than 890,000 Medicaid patients with a dental diagnosis, 23% received an opioid within 14 days of diagnosis. Female patients were 50% more likely to receive an opioid for pain management of a dental condition than were men (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.52 to 1.55). Non-Hispanic whites and African Americans were approximately twice as likely to receive opioids than were Hispanics (OR, 2.11; 95% CI, 2.05 to 2.17 and OR, 1.88; 95% CI, 1.83 to 1.93, respectively). Patients receiving oral health care in an emergency department were nearly 5 times more likely to receive an opioid prescription than were patients treated in a dental office (OR, 4.66; 95% CI, 4.59 to 4.74). Patients with a dental condition diagnosed were nearly 3 times as likely to receive an opioid from a nurse practitioner as from a dentist (OR, 2.64; 95% CI, 2.57 to 2.70). Opioid use was substantially higher among African American female patients (OR, 3.29; 95% CI, 3.18 to 3.40) and non-Hispanic white female patients (OR, 3.24; 95% CI, 3.14 to 3.35) than among Hispanic female patients.
AB  - CONCLUSIONS: Opioid prescribing patterns differ depending on patient race or ethnicity, sex, and health care provider source in patients with a dental diagnosis in the United States.
AB  - PRACTICAL IMPLICATIONS: Dentists are providing substantially less opioid prescriptions compared to their medical colleagues for pain treatment following a dental diagnosis in the Medicaid population. When considering pain management for dental and related conditions, dentists should continue with conservative prescribing practices as recommended.

Copyright © 2018 American Dental Association. Published by Elsevier Inc. All rights reserved.
ES  - 1943-4723
IL  - 0002-8177
DI  - S0002-8177(18)30115-6
DO  - https://dx.doi.org/10.1016/j.adaj.2018.02.010
PT  - Journal Article
ID  - S0002-8177(18)30115-6 [pii]
ID  - 10.1016/j.adaj.2018.02.010 [doi]
PP  - ppublish
PH  - 2018/02/03 [received]
PH  - 2018/02/09 [revised]
PH  - 2018/02/12 [accepted]
LG  - English
DP  - 2018 Apr
DT  - 2018/03/31 06:00
YR  - 2018
RD  - 20180330
UP  - 20180330
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29599018

<1021. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29596725
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Bisaga A
AU  - Mannelli P
AU  - Sullivan MA
AU  - Vosburg SK
AU  - Compton P
AU  - Woody GE
AU  - Kosten TR
AI  - Bisaga, Adam; ORCID: http://orcid.org/0000-0003-1415-5436
AI  - Mannelli, Paolo; ORCID: http://orcid.org/0000-0002-7834-6138
FA  - Bisaga, Adam
FA  - Mannelli, Paolo
FA  - Sullivan, Maria A
FA  - Vosburg, Suzanne K
FA  - Compton, Peggy
FA  - Woody, George E
FA  - Kosten, Thomas R
IN  - Bisaga, Adam. Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York.
IN  - Mannelli, Paolo. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
IN  - Sullivan, Maria A. Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York.
IN  - Sullivan, Maria A. Alkermes Inc., Waltham, Massachusetts.
IN  - Vosburg, Suzanne K. Scientific Consultant, Edgewater, New Jersey.
IN  - Compton, Peggy. Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
IN  - Woody, George E. Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
IN  - Kosten, Thomas R. Baylor College of Medicine, Houston, Texas.
TI  - Antagonists in the medical management of opioid use disorders: Historical and existing treatment strategies. [Review]
SO  - American Journal on Addictions. 27(3):177-187, 2018 Apr
AS  - Am J Addict. 27(3):177-187, 2018 Apr
NJ  - The American journal on addictions
VO  - 27
IP  - 3
PG  - 177-187
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - 9208821
IO  - Am J Addict
CP  - England
AB  - BACKGROUND AND OBJECTIVES: Opioid use disorder (OUD) is a chronic condition with potentially severe health and social consequences. Many who develop moderate to severe OUD will repeatedly seek treatment or interact with medical care via emergency department visits or hospitalizations. Thus, there is an urgent need to develop feasible and effective approaches to help persons with OUD achieve and maintain abstinence from opioids. Treatment that includes one of the three FDA-approved medications is an evidence-based strategy to manage OUD. The purpose of this review is to address practices for managing persons with moderate to severe OUD with a focus on opioid withdrawal and naltrexone-based relapse-prevention treatment.
AB  - METHODS: Literature available on PubMed was used to review the evolution of treatment strategies from the 1960s onward to manage opioid withdrawal and initiate treatment with naltrexone.
AB  - RESULTS: Emerging practices for extended-release naltrexone induction include the use of agonist tapers and adjuvant medications. Clinical challenges frequently encountered when initiating this therapy include managing withdrawal and ongoing opioid use during treatment. Clinical factors may inform decisions regarding patient selection and length of naltrexone treatment, such as recent opioid use and patient preferences.
AB  - CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Treatment strategies to manage opioid withdrawal have evolved, but many patients with OUD do not receive medication for the prevention of relapse. Clinical strategies for induction onto extended-release naltrexone are now available and can be safely and effectively implemented in specialty and select primary care settings. (© 2018 The Authors. The American Journal on Addictions Published by Wiley Periodicals, Inc. on behalf of The American Academy of Addiction Psychiatry (AAAP);27:177-187).

Copyright © 2018 The Authors. The American Journal on Addictions Published by Wiley Periodicals, Inc. on behalf of The American Academy of Addiction Psychiatry (AAAP).
ES  - 1521-0391
IL  - 1055-0496
DO  - https://dx.doi.org/10.1111/ajad.12711
PT  - Journal Article
PT  - Review
ID  - 10.1111/ajad.12711 [doi]
PP  - ppublish
PH  - 2017/09/08 [received]
PH  - 2018/03/02 [revised]
PH  - 2018/03/03 [accepted]
LG  - English
DP  - 2018 Apr
EZ  - 2018/03/30 06:00
DA  - 2018/03/30 06:00
DT  - 2018/03/30 06:00
YR  - 2018
RD  - 20180329
UP  - 20180330
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29596725

<1022. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29595421
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Grywacheski V
AU  - O'Connor S
AU  - Louie K
FA  - Grywacheski, Vera
FA  - O'Connor, Shannon
FA  - Louie, Krista
IN  - Grywacheski, Vera. Senior analyst with the PDA team at CIHI, Ottawa, Ontario. Vera can be reached by e-mail at vgrywacheski@cihi.ca.
IN  - O'Connor, Shannon. Senior analyst with the PDA team at CIHI, Ottawa, Ontario. Shannon can be reached by e-mail at soconnor@cihi.ca.
IN  - Louie, Krista. Program lead with the PDA team at CIHI, Ottawa, Ontario. Krista can be reached by e-mail at klouie@cihi.ca.
TI  - Opioid-Related Harms in Canada.
SO  - Healthcare Quarterly. 20(4):10-12, 2018 Jan
AS  - Healthc Q. 20(4):10-12, 2018 Jan
NJ  - Healthcare quarterly (Toronto, Ont.)
VO  - 20
IP  - 4
PG  - 10-12
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - 101208192
IO  - Healthc Q
CP  - Canada
AB  - The rise in harms associated with opioids is an issue of increasing public health importance in Canada. The Government of Canada recently reported 2,816 apparent opioid-related deaths across the country in 2016. Recent 2017 data show that deaths involving fentanyl-related opioids have doubled from January to March as compared to the same time period in 2016 (Government of Canada 2017). Additional measures that provide a better understanding of opioid-related harms, such as hospitalizations and emergency department (ED) visits, are a high priority. The objective of this study is to present pan-Canadian data on hospitalizations and ED visits because of opioid poisoning.

Copyright © 2018 Longwoods Publishing.
IS  - 1710-2774
IL  - 1710-2774
DI  - hcq.2018.25430
DO  - https://dx.doi.org/10.12927/hcq.2018.25430
PT  - Journal Article
ID  - hcq.2018.25430 [pii]
ID  - 10.12927/hcq.2018.25430 [doi]
PP  - ppublish
LG  - English
DP  - 2018 Jan
DT  - 2018/03/30 06:00
YR  - 2018
RD  - 20180329
UP  - 20180329
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29595421

<1023. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29530105
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Klassen AB
AU  - Core SB
AU  - Lohse CM
AU  - Sztajnkrycer MD
AI  - Klassen, Aaron B; ORCID: http://orcid.org/0000-0002-0772-4584
FA  - Klassen, Aaron B
FA  - Core, S Brent
FA  - Lohse, Christine M
FA  - Sztajnkrycer, Matthew D
IN  - Klassen, Aaron B. 1Department of Emergency Medicine,Mayo Clinic,Rochester,MinnesotaUSA.
IN  - Core, S Brent. 1Department of Emergency Medicine,Mayo Clinic,Rochester,MinnesotaUSA.
IN  - Lohse, Christine M. 2Division of Biomedical Statistics and Informatics,Mayo Clinic,Rochester,MinnesotaUSA.
IN  - Sztajnkrycer, Matthew D. 1Department of Emergency Medicine,Mayo Clinic,Rochester,MinnesotaUSA.
TI  - A Descriptive Analysis of Care Provided by Law Enforcement Prior to EMS Arrival in the United States.
SO  - Prehospital & Disaster Medicine. 33(2):165-170, 2018 Apr
AS  - Prehospital Disaster Med. 33(2):165-170, 2018 Apr
NJ  - Prehospital and disaster medicine
VO  - 33
IP  - 2
PG  - 165-170
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - bdf, 8918173
IO  - Prehosp Disaster Med
CP  - United States
KW  - AED automated external defibrillator;  ALS Advanced Life Support;  BLS Basic Life Support;  EMS Emergency Medical Services;  ICU intensive care unit;  NEMSIS National EMS Information System;  Emergency Medical Services;  bleeding control;  cardiac arrest;  law enforcement;  mass-casualty incident
AB  - Study Objectives Law enforcement is increasingly viewed as a key component in the out-of-hospital chain of survival, with expanded roles in cardiac arrest, narcotic overdose, and traumatic bleeding. Little is known about the nature of care provided by law enforcement prior to the arrival of Emergency Medical Services (EMS) assets. The purpose of the current study was to perform a descriptive analysis of events reported to a national EMS database.
AB  - METHODS: This study was a descriptive analysis of the 2014 National Emergency Medical Services Information System (NEMSIS) public release research data set, containing EMS emergency response data from 41 states. Code E09_02 1200 specifically identifies care provided by law enforcement prior to EMS arrival.
AB  - RESULTS: A total of 25,835,729 unique events were reported. Of events in which pre-arrival care was documented, 2.0% received prior aid by law enforcement. Patients receiving law enforcement care prior to EMS arrival were more likely to be younger (52.8 [SD=23.3] years versus 58.7 [SD=23.3] years), male (54.8% versus 46.7%), and white (80.3% versus 77.5%). Basic Life Support (BLS) EMS response was twice as likely in patients receiving prior aid by law enforcement. Multiple-casualty incidents were five times more likely with prior aid by law enforcement. Compared with prior aid by other services, law enforcement pre-arrival care was more likely with motor vehicle accidents, firearm assaults, knife assaults, blunt assaults, and drug overdoses, and less likely at falls and childbirths. Cardiac arrest was significantly more common in patients receiving prior aid by law enforcement (16.5% versus 2.6%). Tourniquet application and naloxone administration were more common in the law enforcement prior aid group.
AB  - CONCLUSION: Where noted, law enforcement pre-arrival care occurs in 2.0% of EMS patient encounters. The majority of cases involve cardiac arrest, motor vehicle accidents, and assaults. Better understanding of the nature of law enforcement care is required in order to identify potential barriers to care and to develop appropriate training and policy recommendations. Klassen AB , Core SB , Lohse CM , Sztajnkrycer MD . A descriptive analysis of care provided by law enforcement prior to EMS arrival in the United States. Prehosp Disaster Med. 2018;33(2):165-170.
ES  - 1945-1938
IL  - 1049-023X
DO  - https://dx.doi.org/10.1017/S1049023X18000213
PT  - Journal Article
ID  - S1049023X18000213 [pii]
ID  - 10.1017/S1049023X18000213 [doi]
PP  - ppublish
LG  - English
EP  - 20180313
DP  - 2018 Apr
EZ  - 2018/03/14 06:00
DA  - 2018/03/14 06:00
DT  - 2018/03/14 06:00
YR  - 2018
RD  - 20180328
UP  - 20180328
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29530105

<1024. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29241835
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Suffoletto B
AU  - Lynch M
AU  - Pacella CB
AU  - Yealy DM
AU  - Callaway CW
FA  - Suffoletto, Brian
FA  - Lynch, Michael
FA  - Pacella, Charissa B
FA  - Yealy, Donald M
FA  - Callaway, Clifton W
IN  - Suffoletto, Brian. Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Electronic address: suffbp@upmc.edu.
IN  - Lynch, Michael. Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
IN  - Pacella, Charissa B. Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
IN  - Yealy, Donald M. Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
IN  - Callaway, Clifton W. Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
TI  - The Effect of a Statewide Mandatory Prescription Drug Monitoring Program on Opioid Prescribing by Emergency Medicine Providers Across 15 Hospitals in a Single Health System.
SO  - Journal of Pain. 19(4):430-438, 2018 Apr
AS  - J PAIN. 19(4):430-438, 2018 Apr
NJ  - The journal of pain : official journal of the American Pain Society
VO  - 19
IP  - 4
PG  - 430-438
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 100898657
IO  - J Pain
CP  - United States
KW  - Opioids;  emergency;  prescription
AB  - Prescription drug monitoring programs (PDMPs) enable registered prescribers to obtain real-time information on patients' prescription history of controlled medications. We sought to describe the effect of a state-mandated PDMP on opioid prescribing by emergency medicine providers. We retrospectively analyzed electronic medical records of 122,732 adult patients discharged with an opioid prescription from 15 emergency departments in a single health system in Pennsylvania from July 2015 to March, 2017. We used an interrupted time series design to evaluate the percentage of patients discharged each month with an opioid prescription before and after state law-mandated PDMP use on August 25, 2016. From August (pre-PDMP) to September, 2016 (post-PDMP), the opioid prescribing rate decreased from 12.4% (95% confidence interval [CI], 10.8%-14.1%) to 10.2% (95% CI, 8.8%-11.8%). For each month between September 2016 to March 2017, there was a mean decline of .46% (95% CI, -.38% to -.53%) in the percentage of patients discharged with an opioid prescription. There was heterogeneity in opioid prescribing across hospitals as well as according to patient diagnosis.
AB  - PERSPECTIVE: This study examined the effect of a state-mandated PDMP on opioid prescribing among emergency medicine providers from 15 different hospitals in a single health system. Findings support current PDMP mandates in reducing opioid prescriptions, which could curb the prescription opioid epidemic and may ultimately reduce abuse, misuse, and overdose death.

Copyright © 2017 The American Pain Society. Published by Elsevier Inc. All rights reserved.
ES  - 1528-8447
IL  - 1526-5900
DI  - S1526-5900(17)30787-3
DO  - https://dx.doi.org/10.1016/j.jpain.2017.11.010
PT  - Journal Article
ID  - S1526-5900(17)30787-3 [pii]
ID  - 10.1016/j.jpain.2017.11.010 [doi]
ID  - PMC5869080 [pmc]
ID  - NIHMS926644 [mid]
PP  - ppublish
PH  - 2017/08/07 [received]
PH  - 2017/11/14 [revised]
PH  - 2017/11/28 [accepted]
GI  - No: K23 AA023284
Organization: (AA) *NIAAA NIH HHS*
Country: United States
LG  - English
EP  - 20171211
DP  - 2018 Apr
PQ  - 2019/04/01
EZ  - 2017/12/16 06:00
DA  - 2017/12/16 06:00
DT  - 2017/12/16 06:00
YR  - 2018
RD  - 20180328
UP  - 20180328
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29241835

<1025. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29560071
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Santistevan JR
AU  - Sharp BR
AU  - Hamedani AG
AU  - Fruhan S
AU  - Lee AW
AU  - Patterson BW
FA  - Santistevan, Jamie R
FA  - Sharp, Brian R
FA  - Hamedani, Azita G
FA  - Fruhan, Scott
FA  - Lee, Andrew W
FA  - Patterson, Brian W
IN  - Santistevan, Jamie R. University of Wisconsin School of Medicine and Public Health, BerbeeWalsh Department of Emergency Medicine, Madison, Wisconsin.
IN  - Sharp, Brian R. University of Wisconsin School of Medicine and Public Health, BerbeeWalsh Department of Emergency Medicine, Madison, Wisconsin.
IN  - Hamedani, Azita G. University of Wisconsin School of Medicine and Public Health, BerbeeWalsh Department of Emergency Medicine, Madison, Wisconsin.
IN  - Fruhan, Scott. University of California San Francisco, Zuckerberg San Francisco General.
IN  - Fruhan, Scott. Kaiser Permanente Oakland Medical Center, Emergency Department, Oakland, California.
IN  - Lee, Andrew W. University of Wisconsin School of Medicine and Public Health, BerbeeWalsh Department of Emergency Medicine, Madison, Wisconsin.
IN  - Patterson, Brian W. University of Wisconsin School of Medicine and Public Health, BerbeeWalsh Department of Emergency Medicine, Madison, Wisconsin.
IN  - Patterson, Brian W. Health Innovation Program, University of Wisconsin-Madison, Madison, Wisconsin.
TI  - By Default: The Effect of Prepopulated Prescription Quantities on Opioid Prescribing in the Emergency Department.
SO  - The Western Journal of Emergency Medicine. 19(2):392-397, 2018 Mar
AS  - West J Emerg Med. 19(2):392-397, 2018 Mar
NJ  - The western journal of emergency medicine
VO  - 19
IP  - 2
PG  - 392-397
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 101476450
IO  - West J Emerg Med
CP  - United States
AB  - Introduction: Opioid prescribing patterns have come under increasing scrutiny with the recent rise in opioid prescriptions, opioid misuse and abuse, and opioid-related adverse events. To date, there have been limited studies on the effect of default tablet quantities as part of emergency department (ED) electronic order entry. Our goal was to evaluate opioid prescribing patterns before and after the removal of a default quantity of 20 tablets from ED electronic order entry.
AB  - Methods: We performed a retrospective observational study at a single academic, urban ED with 58,000 annual visits. We identified all adult patients (18 years or older) seen in the ED and discharged home with prescriptions for tablet forms of hydrocodone and oxycodone (including mixed formulations with acetaminophen). We compared the quantity of tablets prescribed per opioid prescription 12 months before and 10 months after the electronic order-entry prescription default quantity of 20 tablets was removed and replaced with no default quantity. No specific messaging was given to providers, to avoid influencing prescribing patterns. We used two-sample Wilcoxon rank-sum test, two-sample test of proportions, and Pearson's chi-squared tests where appropriate for statistical analysis.
AB  - Results: A total of 4,104 adult patients received discharge prescriptions for opioids in the pre-intervention period (151.6 prescriptions per 1,000 discharged adult patients), and 2,464 post-intervention (106.69 prescriptions per 1,000 discharged adult patients). The median quantity of opioid tablets prescribed decreased from 20 (interquartile ration [IQR] 10-20) to 15 (IQR 10-20) (p<0.0001) after removal of the default quantity. While the most frequent quantity of tablets received in both groups was 20 tablets, the proportion of patients who received prescriptions on discharge that contained 20 tablets decreased from 0.5 (95% confidence interval [CI] [0.48-0.52]) to 0.23 (95% CI [0.21-0.24]) (p<0.001) after default quantity removal.
AB  - Conclusion: Although the median number of tablets differed significantly before and after the intervention, the clinical significance of this is unclear. An observed wider distribution of the quantity of tablets prescribed after removal of the default quantity of 20 may reflect more appropriate prescribing patterns (i.e., less severe indications receiving fewer tabs and more severe indications receiving more). A default value of 20 tablets for opioid prescriptions may be an example of the electronic medical record's ability to reduce practice variability in medication orders actually counteracting optimal patient care.
CI  - Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. No author has professional or financial relationships with any companies that are relevant to this study. There are no conflicts of interest or sources of funding to declare.
ES  - 1936-9018
IL  - 1936-900X
DO  - https://dx.doi.org/10.5811/westjem.2017.10.33798
PT  - Journal Article
ID  - 10.5811/westjem.2017.10.33798 [doi]
ID  - wjem-19-392 [pii]
ID  - PMC5851516 [pmc]
PP  - ppublish
PH  - 2017/01/30 [received]
PH  - 2017/10/11 [revised]
PH  - 2017/10/09 [accepted]
LG  - English
EP  - 20180212
DP  - 2018 Mar
EZ  - 2018/03/22 06:00
DA  - 2018/03/22 06:00
DT  - 2018/03/22 06:00
YR  - 2018
RD  - 20180323
UP  - 20180323
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29560071

<1026. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29559868
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - PubMed-not-MEDLINE
AU  - Guarisco J
AU  - Salup A
FA  - Guarisco, Joseph
FA  - Salup, Adam
IN  - Guarisco, Joseph. Department of Emergency Medicine, Ochsner Clinic Foundation, New Orleans, LA.
IN  - Guarisco, Joseph. The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
IN  - Salup, Adam. Project Management Office, Ochsner Clinic Foundation, New Orleans, LA.
TI  - Reducing Opioid Prescribing Rates in Emergency Medicine.
SO  - Ochsner Journal. 18(1):42-45, 2018
AS  - OCHSNER J. 18(1):42-45, 2018
NJ  - The Ochsner journal
VO  - 18
IP  - 1
PG  - 42-45
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - 101125795
IO  - Ochsner J
CP  - United States
KW  - Analgesics-opioids;  chronic pain;  drug prescriptions;  emergency medicine;  quality improvement;  systems analysis
AB  - Background: Pain management is one of the most common reasons patients visit the emergency department. Understanding the contributions of emergency medicine-and specifically Ochsner Health System's emergency providers-to the opioid crisis is important. Benchmark prescribing data indicated that Ochsner Health System emergency medicine providers' opioid prescription rates were significantly higher than the national average in emergency medicine.
AB  - Methods: Data relevant to visit and opioid prescription counts were extracted from the organization's electronic health record system. Opioid prescription rates were calculated for each provider. A data transparency project was initiated in which provider opioid prescription rates were unblinded and distributed among the provider group.
AB  - Results: Opioid prescription rates declined in aggregate for the emergency services from 22% to 14% during the 1-year project timeline. Some physicians demonstrated a 70% reduction in prescription rates. Importantly, patient satisfaction scores were not negatively impacted by declining opioid prescription rates.
AB  - Conclusion: Provider performance transparency using unblinded and transparent data analytics can efficiently and significantly alter provider practice.
IS  - 1524-5012
IL  - 1524-5012
PT  - Journal Article
ID  - PMC5855421 [pmc]
PP  - ppublish
LG  - English
DP  - 2018
EZ  - 2018/03/22 06:00
DA  - 2018/03/22 06:01
DT  - 2018/03/22 06:00
YR  - 2018
RD  - 20180323
UP  - 20180323
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29559868

<1027. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29558304
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Hershman M
AU  - Carmody R
AU  - Udayasankar UK
FA  - Hershman, Michelle
FA  - Carmody, Raymond
FA  - Udayasankar, Unni K
IN  - Hershman, Michelle. From the Department of Medical Imaging, University of Arizona College of Medicine, 1501 N Campbell Ave, Tucson, AZ 85724.
IN  - Carmody, Raymond. From the Department of Medical Imaging, University of Arizona College of Medicine, 1501 N Campbell Ave, Tucson, AZ 85724.
IN  - Udayasankar, Unni K. From the Department of Medical Imaging, University of Arizona College of Medicine, 1501 N Campbell Ave, Tucson, AZ 85724.
TI  - Case 252: Acute Hyperammonemic Encephalopathy Resulting from Late-Onset Ornithine Transcarbamylase Deficiency.
SO  - Radiology. 287(1):353-359, 2018 Apr
AS  - Radiology. 287(1):353-359, 2018 Apr
NJ  - Radiology
VO  - 287
IP  - 1
PG  - 353-359
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - qsh, 0401260
IO  - Radiology
CP  - United States
AB  - History A 19-year-old woman with no pertinent medical history was brought to the emergency department after being found unconscious on her bathroom floor by her roommate. In the preceding weeks, she had reported intractable nausea and vomiting, for which she had been taking ondansetron. No other medications had been prescribed. The day prior to presentation, she had contacted her mother and described increasing confusion. Glasgow coma scale score on arrival in the emergency department was 4. Intravenous naloxone was administered, without immediate response. Initial blood glucose level was 232 mg/dL (12.8 mmol/L) (normal range, 79-140 mg/dL [4.4- 7.7 mmol/L]), and other routine laboratory test results were normal. Urine toxicology results were negative. Cerebrospinal fluid evaluation revealed levels were within normal limits. Neurologic examination revealed dilated pupils, which showed a sluggish response to light, and left lower extremity rigidity with intermittent tremors. Initial unenhanced cranial computed tomographic (CT) findings were negative. Magnetic resonance (MR) imaging of the brain was performed. The patient's condition deteriorated, with increasing cerebral edema over the next week, and she was declared brain dead. Her liver was transplanted into an adult recipient, who subsequently developed cerebral edema and elevated plasma ammonia levels, resulting in death in the immediate postoperative period.
ES  - 1527-1315
IL  - 0033-8419
DO  - https://dx.doi.org/10.1148/radiol.2018161834
PT  - Journal Article
ID  - 10.1148/radiol.2018161834 [doi]
PP  - ppublish
LG  - English
DP  - 2018 Apr
EZ  - 2018/03/21 06:00
DA  - 2018/03/21 06:00
DT  - 2018/03/21 06:00
YR  - 2018
RD  - 20180320
UP  - 20180321
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29558304

<1028. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29509652
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Kaplan L
FA  - Kaplan, Louise
IN  - Kaplan, Louise. Louise Kaplan is an associate professor at Washington State University College of Nursing in Vancouver, Wash., and a family nurse practitioner at Tumwater Family Practice Clinic in Tumwater, Wash.
TI  - Opioids: A public health emergency.
SO  - Nurse Practitioner. 43(4):12-13, 2018 Apr 19
AS  - Nurse Pract. 43(4):12-13, 2018 Apr 19
NJ  - The Nurse practitioner
VO  - 43
IP  - 4
PG  - 12-13
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - oa1, 7603663
IO  - Nurse Pract
CP  - United States
ES  - 1538-8662
IL  - 0361-1817
DO  - https://dx.doi.org/10.1097/01.NPR.0000531073.34429.81
PT  - Journal Article
ID  - 10.1097/01.NPR.0000531073.34429.81 [doi]
PP  - ppublish
LG  - English
DP  - 2018 Apr 19
EZ  - 2018/03/07 06:00
DA  - 2018/03/07 06:00
DT  - 2018/03/07 06:00
YR  - 2018
RD  - 20180320
UP  - 20180320
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29509652

<1029. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29305103
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - McLaughlin DC
AU  - Cheah JW
AU  - Aleshi P
AU  - Zhang AL
AU  - Ma CB
AU  - Feeley BT
FA  - McLaughlin, Dell C
FA  - Cheah, Jonathan W
FA  - Aleshi, Pedram
FA  - Zhang, Alan L
FA  - Ma, C Benjamin
FA  - Feeley, Brian T
IN  - McLaughlin, Dell C. Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA, USA.
IN  - Cheah, Jonathan W. Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA, USA.
IN  - Aleshi, Pedram. Department of Anesthesiology, University of California, San Francisco, San Francisco, CA, USA.
IN  - Zhang, Alan L. Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA, USA.
IN  - Ma, C Benjamin. Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA, USA.
IN  - Feeley, Brian T. Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA, USA. Electronic address: Brian.Feeley@ucsf.edu.
TI  - Multimodal analgesia decreases opioid consumption after shoulder arthroplasty: a prospective cohort study.
SO  - Journal of Shoulder & Elbow Surgery. 27(4):686-691, 2018 Apr
AS  - J Shoulder Elbow Surg. 27(4):686-691, 2018 Apr
NJ  - Journal of shoulder and elbow surgery
VO  - 27
IP  - 4
PG  - 686-691
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 9206499, B94
IO  - J Shoulder Elbow Surg
CP  - United States
KW  - Shoulder arthroplasty;  multimodal analgesia;  opioid use;  pain control;  perioperative analgesia;  postoperative length of inpatient stay
AB  - BACKGROUND: Studies on perioperative pain control in shoulder arthroplasty focus on regional anesthesia, with little research on other approaches. Perioperative multimodal analgesia regimens decrease opioid intake and opioid-related side effects in lower-extremity arthroplasty. In this study we compare pain scores, opioid consumption, length of stay, and readmission rates in postoperative shoulder arthroplasty patients treated with a standard or multimodal analgesia regimen.
AB  - METHODS: A prospective cohort analysis was performed at a single institution. Patients undergoing elective shoulder arthroplasty were treated with either a standard opioid-based regimen or a multimodal analgesia regimen perioperatively. Outcome measures included inpatient pain scores, opioid use, length of stay, and 30- and 90-day emergency department visits and readmission rates.
AB  - RESULTS: Seventy-five patients were included in each cohort. Patients treated with the multimodal analgesia regimen had lower postoperative day 0 pain scores (mean, 1.5 vs 2.2; P=.027). Opioid use in the multimodal cohort was lower on all days: 47% lower on postoperative day 0, 37% on day 1, and 44% on day 2 (all P<.01). The length of inpatient stay was significantly shorter for multimodal patients than for patients treated with the standard regimen (1.44 days vs 1.91 days, P <.01). There was no difference in the rate of 30- or 90-day emergency department visits or readmission.
AB  - CONCLUSION: Patients undergoing shoulder arthroplasty have decreased postoperative pain and opioid consumption and shorter hospital stays when given a multimodal analgesia regimen. There is no increase in short-term complications or unplanned readmissions, indicating that this is a safe and effective means to control postoperative pain.

Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.
ES  - 1532-6500
IL  - 1058-2746
DI  - S1058-2746(17)30761-9
DO  - https://dx.doi.org/10.1016/j.jse.2017.11.015
PT  - Journal Article
ID  - S1058-2746(17)30761-9 [pii]
ID  - 10.1016/j.jse.2017.11.015 [doi]
PP  - ppublish
PH  - 2017/08/27 [received]
PH  - 2017/11/03 [accepted]
LG  - English
EP  - 20180103
DP  - 2018 Apr
EZ  - 2018/01/07 06:00
DA  - 2018/01/07 06:00
DT  - 2018/01/07 06:00
YR  - 2018
RD  - 20180320
UP  - 20180320
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29305103

<1030. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28829522
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Grasso MA
AU  - Dezman ZDW
AU  - Grasso CT
AU  - Jerrard DA
FA  - Grasso, Michael A
FA  - Dezman, Zachary D W
FA  - Grasso, Clare T
FA  - Jerrard, David A
IN  - Grasso, Michael A. Assistant Professor, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
IN  - Dezman, Zachary D W. Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
IN  - Grasso, Clare T. Candidate in Computer Science, Department of Computer Science and Electrical Engineering, University of Maryland Baltimore County, Baltimore, Maryland.
IN  - Jerrard, David A. Associate Professor, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
TI  - Opioid pain medication prescriptions obtained through emergency medical visits in the Veterans Health Administration.
SO  - Journal of Opioid Management. 13(2):77-84, 2017 Mar/Apr
AS  - J Opioid Manag. 13(2):77-84, 2017 Mar/Apr
NJ  - Journal of opioid management
VO  - 13
IP  - 2
PG  - 77-84
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - 101234523
IO  - J Opioid Manag
CP  - United States
AB  - OBJECTIVE: This study sought to characterize national patterns for opioid pain medication (OPM) prescriptions received during emergency medical encounters in the Veterans Health Administration (VA).
AB  - DESIGN: The authors conducted a retrospective study of all emergency department (ED) visits by adults in the VA between January 2009 and June 2015. We examined demographics, comorbidities, utilization measures, diagnoses, and prescriptions.
AB  - MAIN OUTCOME MEASURES: The percentage of ED visits that culminated in the receipt of a prescription for an OPM.
AB  - RESULTS: There were 6,721,134 emergency medical visits by 1,708,545 individuals during the study period. An OPM was prescribed during 913,872 visits (13.6 percent), and 407,408 individuals (27.5 percent) received at least one OPM prescription. Prescriptions for OPMs peaked in 2011 at 14.5 percent, declining to 12.3 percent in 2015. The percentage of prescriptions limited to 12 pills increased from 25.0 to 32.4 percent. The heaviest users (top 1.5 percent, n = 7,247) received an average 602.5 total doses, and had at least 10 ED visits during the study period. The most frequently prescribed OPMs were acetaminophen/hydrocodone, followed by tramadol and acetaminophen/oxycodone. Receiving a prescription was associated with younger patients, musculoskeletal diagnoses, higher pain scores, a history of chronic pain, a history of mental illness, a history of substance abuse, prior heavy prescription OPM use, and lower participation in outpatient services.
AB  - CONCLUSIONS: The writing of OPM prescriptions after an ED visit is on the decline in the VA. Compliance with prescribing guidelines is increasing, but is not yet at goal.
IS  - 1551-7489
IL  - 1551-7489
DI  - jom.2017.0371
DO  - https://dx.doi.org/10.5055/jom.2017.0371
PT  - Journal Article
ID  - jom.2017.0371 [pii]
ID  - 10.5055/jom.2017.0371 [doi]
PP  - ppublish
LG  - English
DP  - 2017 Mar/Apr
EZ  - 2017/08/23 06:00
DA  - 2017/08/23 06:00
DT  - 2017/08/23 06:00
YR  - 2017
RD  - 20180319
UP  - 20180320
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28829522

<1031. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29433352
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Kelty E
AU  - Cumming C
AU  - Troeung L
AU  - Hulse G
AI  - Kelty, Erin; ORCID: https://orcid.org/0000-0002-0841-2216
FA  - Kelty, Erin
FA  - Cumming, Craig
FA  - Troeung, Lakhhina
FA  - Hulse, Gary
IN  - Kelty, Erin. 1 Division of Psychiatry, University of Western Australia, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
IN  - Kelty, Erin. 2 School of Population and Global Health, University of Western Australia, Crawley, WA, Australia.
IN  - Cumming, Craig. 2 School of Population and Global Health, University of Western Australia, Crawley, WA, Australia.
IN  - Cumming, Craig. 3 National Drug Research Institute, Curtin University, Bentley, WA, Australia.
IN  - Troeung, Lakhhina. 2 School of Population and Global Health, University of Western Australia, Crawley, WA, Australia.
IN  - Hulse, Gary. 1 Division of Psychiatry, University of Western Australia, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
IN  - Hulse, Gary. 4 School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.
TI  - Buprenorphine alone or with naloxone: Which is safer?.
SO  - Journal of Psychopharmacology. 32(3):344-352, 2018 Mar
AS  - J Psychopharmacol. 32(3):344-352, 2018 Mar
NJ  - Journal of psychopharmacology (Oxford, England)
VO  - 32
IP  - 3
PG  - 344-352
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - cph, 8907828
IO  - J. Psychopharmacol. (Oxford)
CP  - United States
KW  - Buprenorphine;  mortality;  naloxone;  safety
AB  - To address concerns regarding the intravenous diversion of buprenorphine, a combined buprenorphine-naloxone (BUP-NLX) preparation was developed. The aim of this study is to compare health outcomes in opioid dependent patients treated with BUP and BUP-NLX. All patients treated with BUP and/or BUP-NLX in Western Australia between 2001 and 2010 were included in the study ( N = 3455). Patients were identified via State prescribing records and matched against the State mortality, hospital, and emergency department records. Rates of health events were examined and compared using Cox Proportional Hazard Models and Generalized Estimating Equations. While on treatment there was no significant difference between mortality rates in the two groups, mortality rates following the cessation of treatment were significantly higher in patients treated with BUP-NLX (adjusted hazard ratio: 1.59). Rates of hospitalization were significantly elevated in BUP-NLX patients (adjusted odds ratio: 1.17) compared with BUP treated patients; however, rates of hospitalization with a skin/subcutaneous diagnosis were significantly lower in BUP-NLX treated patients (adjusted odds ratio: 0.65). Off-treatment rates of both all-cause hospital admissions (adjusted odds ratio: 1.53) and hospital admissions with an opioid poisoning diagnosis (adjusted odds ratio: 1.59) were significantly elevated in BUP-NLX treated patients compared with BUP treated patients. The addition of naloxone does not appear to improve the safety profile of buprenorphine.
ES  - 1461-7285
IL  - 0269-8811
DO  - https://dx.doi.org/10.1177/0269881118756015
PT  - Journal Article
ID  - 10.1177/0269881118756015 [doi]
PP  - ppublish
LG  - English
EP  - 20180213
DP  - 2018 Mar
EZ  - 2018/02/13 06:00
DA  - 2018/02/13 06:00
DT  - 2018/02/14 06:00
YR  - 2018
RD  - 20180319
UP  - 20180319
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29433352

<1032. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 27575827
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Barry DT
AU  - Sofuoglu M
AU  - Kerns RD
AU  - Wiechers IR
AU  - Rosenheck RA
FA  - Barry, Declan T
FA  - Sofuoglu, Mehmet
FA  - Kerns, Robert D
FA  - Wiechers, Ilse R
FA  - Rosenheck, Robert A
IN  - Barry, Declan T. Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; APT Foundation Pain Treatment Services, New Haven, Connecticut.
IN  - Sofuoglu, Mehmet. Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Veterans Health Administration Mental Illness Research, Education and Clinical Center, West Haven, Connecticut.
IN  - Kerns, Robert D. Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Pain Research, Informatics, Multimorbidities and Education Center of Innovation VA Connecticut Healthcare System, West Haven, Connecticut.
IN  - Wiechers, Ilse R. VA Connecticut Healthcare System, West Haven, Connecticut; Robert Wood Johnson Foundation Clinical Scholars Program, Yale University School of Medicine, New Haven, Connecticut.
IN  - Rosenheck, Robert A. Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Veterans Health Administration Mental Illness Research, Education and Clinical Center, West Haven, Connecticut.
TI  - Prevalence and correlates of coprescribing anxiolytic medications with extensive prescription opioid use in Veterans Health Administration patients with metastatic cancer.
SO  - Journal of Opioid Management. 12(4):259-68, 2016 Jul-Aug
AS  - J Opioid Manag. 12(4):259-68, 2016 Jul-Aug
NJ  - Journal of opioid management
VO  - 12
IP  - 4
PG  - 259-68
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - 101234523
IO  - J Opioid Manag
SB  - Index Medicus
CP  - United States
AB  - OBJECTIVE: To examine the prevalence and correlates of concomitant anxiolytic prescription fills in Veterans Health Administration (VHA) patients with metastatic cancer who have extensive prescription opioid use.
AB  - DESIGN, SETTING, AND PARTICIPANTS: National VHA data for fiscal year 2012 were used to identify veterans diagnosed with metastatic cancer (ICD-9 codes 196-199) who also had extensive prescription opioid use (at least 10 opioid prescriptions during the year, comprising the highest 29 percent of opioid users). Bivariate and multivariate analyses were used to examine correlates of receiving anxiolytic medication among veterans with metastatic cancer and extensive prescription opioid use.
AB  - RESULTS: Of the 5,950 veterans with metastatic cancer and extensive prescription opioid use, 51 percent also received anxiolytic medication, of whom 64 percent had a medical indication and 85 percent had a psychiatric or medical indication for psychotropics. Of those with extensive prescription opioid use who filled an anxiolytic, 64 percent also received antidepressants and 38 percent received three or more classes of psychotropic medication (ie, polypharmacy). In multivariate analyses, factors associated with receipt of an anxiolytic included any anxiety disorder, insomnia, the prescription of antidepressants or antipsychotics, bipolar disorder, younger age, more emergency department visits, and greater number of opioid prescriptions.
AB  - CONCLUSIONS: VHA patients with metastatic cancer and extensive prescription opioid use who are prescribed anxiolytics are likely to have a Food and Drug Administration-approved indication for psychotropics, and anxiolytics in particular, but represent a clinically vulnerable group which merits careful monitoring.
IS  - 1551-7489
IL  - 1551-7489
DI  - jom.2016.0341
DO  - https://dx.doi.org/10.5055/jom.2016.0341
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, Non-P.H.S.
ID  - jom.2016.0341 [pii]
ID  - 10.5055/jom.2016.0341 [doi]
PP  - ppublish
GI  - No: R01 DA029577
Organization: (DA) *NIDA NIH HHS*
Country: United States

GI  - No: CIN 13-407
Organization: *VA Health Administratoin*
Country: International
LG  - English
DP  - 2016 Jul-Aug
EZ  - 2016/08/31 06:00
DA  - 2016/08/31 06:00
DT  - 2016/08/31 06:00
YR  - 2016
RD  - 20180319
UP  - 20180319
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=27575827

<1033. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29402676
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Pauly NJ
AU  - Slavova S
AU  - Delcher C
AU  - Freeman PR
AU  - Talbert J
FA  - Pauly, N J
FA  - Slavova, S
FA  - Delcher, C
FA  - Freeman, P R
FA  - Talbert, J
IN  - Pauly, N J. Institute for Pharmaceutical Outcomes and Policy, University of Kentucky College of Pharmacy, 789 South Limestone, Lexington, KY 40536, United States. Electronic address: Nathan.Pauly@uky.edu.
IN  - Slavova, S. Department of Biostatistics, University of Kentucky College of Public Health, 333 Waller Avenue, Suite 242, Lexington, KY 40504, United States.
IN  - Delcher, C. Department of Health Outcomes and Policy, University of Florida, 2004 Mowry Road, Suite 2237, P.O. Box 100177, Gainesville, FL 32610, United States.
IN  - Freeman, P R. Institute for Pharmaceutical Outcomes and Policy, University of Kentucky College of Pharmacy, 789 South Limestone, Lexington, KY 40536, United States.
IN  - Talbert, J. Institute for Pharmaceutical Outcomes and Policy, University of Kentucky College of Pharmacy, 789 South Limestone, Lexington, KY 40536, United States.
TI  - Features of prescription drug monitoring programs associated with reduced rates of prescription opioid-related poisonings.
SO  - Drug & Alcohol Dependence. 184:26-32, 2018 Mar 01
AS  - Drug Alcohol Depend. 184:26-32, 2018 Mar 01
NJ  - Drug and alcohol dependence
VO  - 184
PG  - 26-32
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - ebs, 7513587
IO  - Drug Alcohol Depend
CP  - Ireland
KW  - Evaluation;  Opioid;  Poisoning;  Policy;  Prescription drug monitoring program
AB  - BACKGROUND: The United States is in the midst of an opioid epidemic. In addition to other system-level interventions, all states have responded during the crisis by implementing prescription drug monitoring programs (PDMPs). This study examines associations between specific administrative features of PDMPs and changes in the risk of prescription opioid-related poisoning (RxORP) over time.
AB  - METHODS: This longitudinal, observational study utilized a 'natural experiment' design to assess associations between PDMP features and risk of RxORP in a nationally-representative population of privately-insured adults from 2004 to 2014. Administrative health claims data were used to identify inpatient hospital admissions and emergency department visits related to RxORP. Generalized estimating equation Poisson regression models were used to examine associations between specific PDMP features and changes in relative risk (RR) of RxORP over time.
AB  - RESULTS: In adjusted analyses, states without PDMPs experienced an average annual increase in the rate of RxORP of 9.51% over the study period, while states with operational PDMPs experienced an average annual increase of 3.17%. The increase in RR of RxORP over time in states with operational PDMPs was significantly less than increases in states without PDMPs. States with specific features, including those that monitored more schedules or required more frequent data reporting, experienced stronger protective effects on the RR of RxORP over time.
AB  - CONCLUSION: This study examined associations between specific PDMP features and RxORP rates in a nationally-representative population of privately-insured adults. Results of this study may be used as empirical evidence to guide PDMP best practices.

Copyright © 2018 Elsevier B.V. All rights reserved.
ES  - 1879-0046
IL  - 0376-8716
DI  - S0376-8716(18)30010-3
DO  - https://dx.doi.org/10.1016/j.drugalcdep.2017.12.002
PT  - Journal Article
ID  - S0376-8716(18)30010-3 [pii]
ID  - 10.1016/j.drugalcdep.2017.12.002 [doi]
ID  - PMC5854200 [pmc]
ID  - NIHMS937054 [mid]
PP  - ppublish
PH  - 2017/08/22 [received]
PH  - 2017/12/01 [revised]
PH  - 2017/12/02 [accepted]
GI  - No: UL1 TR001998
Organization: (TR) *NCATS NIH HHS*
Country: United States
LG  - English
EP  - 20180111
DP  - 2018 Mar 01
PQ  - 2019/03/01
EZ  - 2018/02/07 06:00
DA  - 2018/02/07 06:00
DT  - 2018/02/07 06:00
YR  - 2018
RD  - 20180317
UP  - 20180319
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29402676

<1034. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29174580
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Pathan SA
AU  - Mitra B
AU  - Cameron PA
FA  - Pathan, Sameer A
FA  - Mitra, Biswadev
FA  - Cameron, Peter A
IN  - Pathan, Sameer A. Emergency Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar; Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia; National Trauma Research Institute, The Alfred Hospital, Melbourne, Australia. Electronic address: sameer.pathan@monash.edu.
IN  - Mitra, Biswadev. Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia; National Trauma Research Institute, The Alfred Hospital, Melbourne, Australia; Emergency & Trauma Centre, The Alfred Hospital, Melbourne, Australia.
IN  - Cameron, Peter A. Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia; National Trauma Research Institute, The Alfred Hospital, Melbourne, Australia; Emergency & Trauma Centre, The Alfred Hospital, Melbourne, Australia.
TI  - A Systematic Review and Meta-analysis Comparing the Efficacy of Nonsteroidal Anti-inflammatory Drugs, Opioids, and Paracetamol in the Treatment of Acute Renal Colic. [Review]
SO  - European Urology. 73(4):583-595, 2018 Apr
AS  - Eur Urol. 73(4):583-595, 2018 Apr
NJ  - European urology
VO  - 73
IP  - 4
PG  - 583-595
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - enm, 7512719
IO  - Eur. Urol.
CP  - Switzerland
KW  - Analgesia;  Emergency department;  Nonsteroidal anti-inflammatory drugs;  Opioids;  Paracetamol;  Renal colic;  Urolithiasis;  Urology
AB  - CONTEXT: Renal colic is a common, acute presentation of urolithiasis that requires immediate pain relief. European Association of Urology guidelines recommend nonsteroidal anti-inflammatory drugs (NSAIDs) as the preferred analgesia. However, the fear of NSAID adverse effects and the uncertainty about superior analgesic effect have maintained the practice of advocating intravenous opioids as the initial analgesia.
AB  - OBJECTIVE: The objective of this systematic review and meta-analysis was to compare the safety and efficacy of NSAIDs with opioids and paracetamol (acetaminophen) for the management of acute renal colic.
AB  - EVIDENCE ACQUISITION: Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, World Health Organization International Clinical Trials Registry Platform, Google Scholar, and the reference list of retrieved articles were searched up to December 2016 without language restrictions. Two reviewers independently assessed eligible studies using the Cochrane Collaboration tool for assessing and reporting the risk of bias and abstracted data using predefined data fields.
AB  - EVIDENCE SYNTHESIS: From 468 potentially relevant studies, 36 randomized controlled trials (RCTs) including 4887 patients, published between 1982 and 2016, were included in this systematic review. The treatment effect observed indicated marginal benefit of NSAIDs over opioids in initial pain reduction at 30min (11 RCTs, n=1985, mean difference [MD] -5.58, 95% confidence interval [CI] -10.22 to -0.95; heterogeneity I<sup>2</sup>=81%). In the subgroup analyses by the route of administration, NSAIDs required fewer rescue treatments (seven RCTs, n=541, number needed to treat [NNT] 11, 95% CI 6-75) and had lower vomiting rates compared with opioids (five RCTs, n=531, NNT 5, 95% CI 4-8). Comparisons of NSAIDs with paracetamol showed no difference for both drugs at 30min (four RCTs, n=1325, MD -5.67, 95% CI -17.52 to 6.18, p=0.35; I<sup>2</sup>=89%). Patients treated with NSAIDs required fewer rescue treatments (two trials, n=1145, risk ratio 0.56, 95% CI 0.42-0.74, p<0.001; I<sup>2</sup>=0%).
AB  - CONCLUSIONS: NSAIDs were equivalent to opioids or paracetamol in the relief of acute renal colic pain at 30min. There was less vomiting and fewer requirements for rescue analgesia with NSAIDs compared with opioids. Patients treated with NSAIDs required less rescue analgesia compared with paracetamol. Despite observed heterogeneity among the included studies and the overall quality of evidence, the findings of a lower need for rescue analgesia and fewer adverse events, in conjunction with the practical advantages of ease of delivery, suggest that NSAIDs should be the preferred analgesic option for patients presenting to the emergency department with renal colic.
AB  - PATIENT SUMMARY: In kidney stone-related acute pain episodes in patients with adequate renal function, treatment with nonsteroidal anti-inflammatory drugs offers effective and most sustained pain relief, with fewer side effects, when compared with opioids or paracetamol.

Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.
ES  - 1873-7560
IL  - 0302-2838
DI  - S0302-2838(17)30977-6
DO  - https://dx.doi.org/10.1016/j.eururo.2017.11.001
PT  - Journal Article
PT  - Review
ID  - S0302-2838(17)30977-6 [pii]
ID  - 10.1016/j.eururo.2017.11.001 [doi]
PP  - ppublish
PH  - 2017/08/02 [received]
PH  - 2017/11/03 [accepted]
LG  - English
EP  - 20171122
DP  - 2018 Apr
EZ  - 2017/11/28 06:00
DA  - 2017/11/28 06:00
DT  - 2017/11/28 06:00
YR  - 2018
RD  - 20180317
UP  - 20180319
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29174580

<1035. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29320915
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Shah A
AU  - Duncan M
AU  - Atreja N
AU  - Tai KS
AU  - Gore M
FA  - Shah, Ankit
FA  - Duncan, Margaret
FA  - Atreja, Nipun
FA  - Tai, Kei Sing
FA  - Gore, Mugdha
IN  - Shah, Ankit. a Alkermes, Inc. , Waltham , MA , USA.
IN  - Duncan, Margaret. a Alkermes, Inc. , Waltham , MA , USA.
IN  - Atreja, Nipun. a Alkermes, Inc. , Waltham , MA , USA.
IN  - Tai, Kei Sing. b Symlink, LLC , Portage , MI , USA.
IN  - Gore, Mugdha. a Alkermes, Inc. , Waltham , MA , USA.
TI  - Healthcare utilization and costs associated with treatment for opioid dependence.
SO  - Journal of Medical Economics. 21(4):406-415, 2018 Apr
AS  - J Med Econ. 21(4):406-415, 2018 Apr
NJ  - Journal of medical economics
VO  - 21
IP  - 4
PG  - 406-415
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 9892255
IO  - J Med Econ
CP  - England
KW  - Naltrexone;  buprenorphine;  healthcare costs;  healthcare resource utilization;  methadone;  opioid dependence
AB  - OBJECTIVE: Opioid use disorder (OUD) can be managed with medication assisted therapy (MAT) (methadone [MET], buprenorphine [BUP], or extended-release naltrexone [XR-NTX]) or counseling alone (non-pharmacological therapy [NPT]). The objective of this study was to evaluate healthcare resource utilization and costs associated with XR-NTX compared with alternative treatments for opioid dependence.
AB  - METHODS: Adults with a diagnosis of opioid dependence who initiated treatment with XR-NTX, BUP, MET, or NPT between January 1, 2011 and December 31, 2014 were identified in the Truven Health MarketScan Commercial administrative claims database. Healthcare resource utilization, costs (inpatient [IP], emergency department [ED], outpatient [OP], and pharmacy) and adherence were evaluated for each cohort during 12-month baseline and follow-up periods.
AB  - RESULTS: A total of 29,235 patients were included in the analysis; 1,041, 20,566, 745, and 6,883 received XR-NTX, BUP, MET, and NPT, respectively. Patients in the XR-NTX cohort were significantly younger and had more comorbidities compared with the other cohorts. Patients in the XR-NTX group had the largest percentage decrease in IP and ED utilization and costs from baseline to follow-up. OP and pharmacy costs increased significantly from baseline to follow-up for all cohorts. Overall, there was no significant change in total healthcare costs for the XR-NTX group, whereas the costs increased significantly for other groups (BUP=+43%, MET=+47.7%, NPT=+38.8%).
AB  - CONCLUSIONS: Healthcare resource utilization and costs increased from baseline to follow-up in BUP, MET, and NPT patients, whereas patients receiving XR-NTX experienced no such increase. This analysis suggests there may be economic value in the use of XR-NTX for OUD.
ES  - 1941-837X
IL  - 1369-6998
DO  - https://dx.doi.org/10.1080/13696998.2018.1427101
PT  - Journal Article
ID  - 10.1080/13696998.2018.1427101 [doi]
PP  - ppublish
LG  - English
EP  - 20180201
DP  - 2018 Apr
EZ  - 2018/01/13 06:00
DA  - 2018/01/13 06:00
DT  - 2018/01/12 06:00
YR  - 2018
RD  - 20180316
UP  - 20180316
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29320915

<1036. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29100261
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Devlin LA
AU  - Davis JM
FA  - Devlin, Lori A
FA  - Davis, Jonathan M
IN  - Devlin, Lori A. Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky.
IN  - Davis, Jonathan M. Department of Pediatrics, The Floating Hospital at Tufts Medical Center and the Tufts Clinical and Translational Science Institute, Tufts University, Boston, Massachusetts.
TI  - A Practical Approach to Neonatal Opiate Withdrawal Syndrome.
SO  - American Journal of Perinatology. 35(4):324-330, 2018 Mar
AS  - Am J Perinatol. 35(4):324-330, 2018 Mar
NJ  - American journal of perinatology
VO  - 35
IP  - 4
PG  - 324-330
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - aa3, 8405212
IO  - Am J Perinatol
CP  - United States
AB  - Perinatal opioid misuse and neonatal opioid withdrawal syndrome (NOWS) are a significant public health problem that has grown exponentially over the past decade. In the United States, a woman seeks emergency room care for prescription opioid misuse every 3 minutes and approximately every 25 minutes, a child is born with signs of drug withdrawal. The economic impact of perinatal opioid misuse is significant with annual hospital charges for NOWS in 2012 as $1.5 billion dollars. Perinatal opioid misuse is a complex, multifaceted problem that demands a multidisciplinary cross specialty approach. This article will review the current state of NOWS and provide medical practitioners with a practical guide to enhance evidence based practice.

Copyright Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
CI  - Disclosure The authors report no conflicts of interest in this work.
ES  - 1098-8785
IL  - 0735-1631
DO  - https://dx.doi.org/10.1055/s-0037-1608630
PT  - Journal Article
ID  - 10.1055/s-0037-1608630 [doi]
PP  - ppublish
LG  - English
EP  - 20171103
DP  - 2018 Mar
EZ  - 2017/11/04 06:00
DA  - 2017/11/04 06:00
DT  - 2017/11/04 06:00
YR  - 2018
RD  - 20180307
UP  - 20180308
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29100261

<1037. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28956680
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Lynch MJ
AU  - Suyama J
AU  - Guyette FX
FA  - Lynch, Michael J
FA  - Suyama, Joe
FA  - Guyette, Francis X
TI  - Scene Safety and Force Protection in the Era of Ultra-Potent Opioids.
SO  - Prehospital Emergency Care. 22(2):157-162, 2018 Mar-Apr
AS  - Prehosp Emerg Care. 22(2):157-162, 2018 Mar-Apr
NJ  - Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
VO  - 22
IP  - 2
PG  - 157-162
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - c5i, 9703530
IO  - Prehosp Emerg Care
CP  - England
KW  - PPE;  carfentanil;  overdose;  scene safety
AB  - Ultra-potent opioids (fentanyl, carfentanil) are now widely available and fueling an epidemic of overdose. First responders are increasingly exposed to these potent narcotics necessitating guidance for scene safety and force protection from medical directors. Reports in lay media have sensationalized accounts of exposure and harm that may lead providers to fear providing care to patients suspected of opioid overdose. The likelihood of prehospital providers suffering ill effects from opioid exposure during routine emergency medical services (EMS) operations is extremely low. We propose recommendation to assist medical directors in providing guidance and education to their providers minimizing the risk of provider exposure while allowing the delivery of prompt and appropriate care to patients with suspected overdose.
ES  - 1545-0066
IL  - 1090-3127
DO  - https://dx.doi.org/10.1080/10903127.2017.1367446
PT  - Journal Article
ID  - 10.1080/10903127.2017.1367446 [doi]
PP  - ppublish
LG  - English
EP  - 20170928
DP  - 2018 Mar-Apr
EZ  - 2017/09/29 06:00
DA  - 2017/09/29 06:00
DT  - 2017/09/29 06:00
YR  - 2018
RD  - 20180306
UP  - 20180306
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28956680

<1038. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28873050
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Chakravarthy B
AU  - Somasundaram S
AU  - Mogi J
AU  - Burns R
AU  - Hoonpongsimanont W
AU  - Wiechmann W
AU  - Lotfipour S
AI  - Hoonpongsimanont, Wirachin; ORCID: http://orcid.org/0000-0003-0507-7149
FA  - Chakravarthy, Bharath
FA  - Somasundaram, Shashank
FA  - Mogi, Jennifer
FA  - Burns, Roshan
FA  - Hoonpongsimanont, Wirachin
FA  - Wiechmann, Warren
FA  - Lotfipour, Shahram
IN  - Chakravarthy, Bharath. a Department of Emergency Medicine , University of California, Irvine , Irvine , California , USA.
IN  - Somasundaram, Shashank. a Department of Emergency Medicine , University of California, Irvine , Irvine , California , USA.
IN  - Somasundaram, Shashank. b School of Biological Sciences , University of California Irvine , Irvine , California , USA.
IN  - Mogi, Jennifer. a Department of Emergency Medicine , University of California, Irvine , Irvine , California , USA.
IN  - Burns, Roshan. a Department of Emergency Medicine , University of California, Irvine , Irvine , California , USA.
IN  - Hoonpongsimanont, Wirachin. a Department of Emergency Medicine , University of California, Irvine , Irvine , California , USA.
IN  - Wiechmann, Warren. a Department of Emergency Medicine , University of California, Irvine , Irvine , California , USA.
IN  - Lotfipour, Shahram. a Department of Emergency Medicine , University of California, Irvine , Irvine , California , USA.
TI  - Randomized pilot trial measuring knowledge acquisition of opioid education in emergency department patients using a novel media platform.
SO  - Substance Abuse. 39(1):27-31, 2018 Jan 02
AS  - Subst Abus. 39(1):27-31, 2018 Jan 02
NJ  - Substance abuse
VO  - 39
IP  - 1
PG  - 27-31
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 8808537, 101514834
IO  - Subst Abus
CP  - United States
KW  - Analgesics;  drug overdose;  emergency services;  multimedia;  narcotics;  opioid;  opioid-related disorders;  patient discharge;  prescriptions;  standard of care;  surveys and questionnaires
AB  - BACKGROUND: The number of active opioid analgesic prescriptions has risen steadily, causing increases in nonmedical opioid use, addiction, and overdose. Insufficient focus on patient discharge instructions has contributed to lack of patient awareness regarding dangers of opioids. This study examines whether an educational Khan Academy-style animation discharge instruction on the dangers and safe usage of opioid analgesics elicits higher knowledge acquisition than current standard of care. Additionally, it measures the feasibility of implementing this video discharge instruction in the emergency department (ED).
AB  - METHODS: Fifty-two English-speaking patients aged 18 years or older receiving an opioid prescription were enrolled in this study. Patients were randomized into 2 groups. The standard of care group received verbal instruction and an informational sheet, whereas the video animation group received a 6-minute video on proper usage of opioids in addition to standard of care. Video content was sourced from samhsa.gov and administered within the ED prior to discharge. Both groups received a 26-question test regarding the dangers and safe usage of opioids immediately after education. An unpaired t test compared knowledge acquisition between the 2 groups.
AB  - RESULTS: Fifty-four patients were approached, 52 patients enrolled; 27 in the standard group and 25 in the animation group. The standard of care group averaged 65% knowledge acquisition (16.8/26 correct), whereas the animation group averaged 82% acquisition (21.2/26 correct). The video animation significantly increased patient knowledge acquisition about opioid medications' risks and proper usage and disposal (P = .001).
AB  - CONCLUSION: It can be concluded that medical knowledge acquisition is improved in the video animation group compared with the current standard of care (P = .001). It can also be concluded that it is feasible to implement a novel media platform to educate patients receiving opioid analgesics in the ED (96.1%).
ES  - 1547-0164
IL  - 0889-7077
DO  - https://dx.doi.org/10.1080/08897077.2017.1375061
PT  - Journal Article
ID  - 10.1080/08897077.2017.1375061 [doi]
PP  - ppublish
LG  - English
EP  - 20170929
DP  - 2018 Jan 02
EZ  - 2017/09/06 06:00
DA  - 2017/09/06 06:00
DT  - 2017/09/06 06:00
YR  - 2018
RD  - 20180306
UP  - 20180306
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28873050

<1039. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28723312
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Bahorik AL
AU  - Satre DD
AU  - Kline-Simon AH
AU  - Weisner CM
AU  - Young-Wolff KC
AU  - Campbell CI
FA  - Bahorik, Amber L
FA  - Satre, Derek D
FA  - Kline-Simon, Andrea H
FA  - Weisner, Constance M
FA  - Young-Wolff, Kelly C
FA  - Campbell, Cynthia I
IN  - Bahorik, Amber L. a Department of Psychiatry , University of California , San Francisco , California , USA.
IN  - Satre, Derek D. a Department of Psychiatry , University of California , San Francisco , California , USA.
IN  - Satre, Derek D. b Division of Research, Kaiser Permanente Northern California , Oakland , California , USA.
IN  - Kline-Simon, Andrea H. b Division of Research, Kaiser Permanente Northern California , Oakland , California , USA.
IN  - Weisner, Constance M. a Department of Psychiatry , University of California , San Francisco , California , USA.
IN  - Weisner, Constance M. b Division of Research, Kaiser Permanente Northern California , Oakland , California , USA.
IN  - Young-Wolff, Kelly C. a Department of Psychiatry , University of California , San Francisco , California , USA.
IN  - Young-Wolff, Kelly C. b Division of Research, Kaiser Permanente Northern California , Oakland , California , USA.
IN  - Campbell, Cynthia I. a Department of Psychiatry , University of California , San Francisco , California , USA.
IN  - Campbell, Cynthia I. b Division of Research, Kaiser Permanente Northern California , Oakland , California , USA.
TI  - Alcohol, marijuana, and opioid use disorders: 5-Year patterns and characteristics of emergency department encounters.
SO  - Substance Abuse. 39(1):59-68, 2018 Jan 02
AS  - Subst Abus. 39(1):59-68, 2018 Jan 02
NJ  - Substance abuse
VO  - 39
IP  - 1
PG  - 59-68
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 8808537, 101514834
IO  - Subst Abus
CP  - United States
KW  - Access/demand/utilization of services;  administrative data uses;  managed care organizations;  mental health;  substance abuse
AB  - BACKGROUND: Changes in substance use patterns stemming from opioid misuse, ongoing drinking problems, and marijuana legalization may result in new populations of patients with substance use disorders (SUDs) using emergency department (ED) resources. This study examined ED admission trends in a large sample of patients with alcohol, marijuana, and opioid use disorders in an integrated health system.
AB  - METHODS: In a retrospective design, electronic health record (EHR) data identified patients with >=1 of 3 common SUDs in 2010 (n = 17,574; alcohol, marijuana, or opioid use disorder) and patients without SUD (n = 17,574). Logistic regressions determined odds of ED use between patients with SUD versus controls (2010-2014); mixed-effect models examined 5-year differences in utilization; moderator models identified subsamples for which patients with SUD may have a greater impact on ED resources.
AB  - RESULTS: Odds of ED use were higher at each time point (2010-2014) for patients with alcohol (odds ratio [OR] range: 5.31-2.13, Ps < .001), marijuana (OR range: 5.45-1.97, Ps < .001), and opioid (OR range: 7.63-4.19, Ps < .001) use disorders compared with controls; odds decreased over time (Ps < .001). Patients with opioid use disorder were at risk of high ED utilization; patients were 7.63 times more likely to have an ED visit in 2010 compared with controls and remained 5.00 (average) times more likely to use ED services. ED use increased at greater rates for patients with alcohol and opioid use disorders with medical comorbidities relative to controls (Ps < .045).
AB  - CONCLUSIONS: ED use is frequent in patients with SUDs who have access to private insurance coverage and integrated medical services. ED settings provide important opportunities in health systems to identify patients with SUDs, particularly patients with opioid use disorder, to initiate treatment and facilitate ongoing care, which may be effective for reducing excess medical emergencies and ED encounters.
ES  - 1547-0164
IL  - 0889-7077
DO  - https://dx.doi.org/10.1080/08897077.2017.1356789
PT  - Journal Article
ID  - 10.1080/08897077.2017.1356789 [doi]
PP  - ppublish
GI  - No: T32 DA007250
Organization: (DA) *NIDA NIH HHS*
Country: United States
LG  - English
EP  - 20170906
DP  - 2018 Jan 02
EZ  - 2017/07/21 06:00
DA  - 2017/07/21 06:00
DT  - 2017/07/21 06:00
YR  - 2018
RD  - 20180306
UP  - 20180306
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28723312

<1040. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29289871
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Wallace B
AU  - Barber K
AU  - Pauly BB
FA  - Wallace, Bruce
FA  - Barber, Katrina
FA  - Pauly, Bernadette Bernie
IN  - Wallace, Bruce. School of Social Work, Canadian Institute for Substance Use Research, University of Victoria, Box 1700 STN CSC, Victoria, BC, Canada. Electronic address: barclay@uvic.ca.
IN  - Barber, Katrina. Social Dimensions of Health, Canadian Institute for Substance Use Research, University of Victoria, Box 1700 STN CSC, Victoria, BC, Canada. Electronic address: kbarber@uvic.ca.
IN  - Pauly, Bernadette Bernie. School of Nursing, Canadian Institute for Substance Use Research, University of Victoria, Box 1700 STN CSC, Victoria, BC, Canada. Electronic address: bpauly@uvic.ca.
TI  - Sheltering risks: Implementation of harm reduction in homeless shelters during an overdose emergency.
SO  - International Journal of Drug Policy. 53:83-89, 2018 Mar
AS  - Int J Drug Policy. 53:83-89, 2018 Mar
NJ  - The International journal on drug policy
VO  - 53
PG  - 83-89
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 9014759
IO  - Int. J. Drug Policy
CP  - Netherlands
KW  - Harm reduction;  Homelessness;  Overdose;  Shelters;  Substance use
AB  - BACKGROUND: The current opioid overdose crisis in North America is heightening awareness of the need for and the challenges of implementing harm reduction, notably within complex and diverse settings such as homeless shelters. In this paper, we explore the implementation of harm reduction in homeless shelters during an emerging overdose emergency.
AB  - METHODS: The objective of this qualitative study was to identify and understand micro-environment level factors within emergency shelters responding to homelessness and substance use, and the macro-level influences that produce and sustain structural vulnerabilities. We conducted eight focus groups with a total of 49 participants during an emerging overdose emergency. These included shelter residents (n=23), shelter staff (n=13), and harm reduction workers (n=13).
AB  - RESULTS: The findings illustrate the challenges of implementing an overdose response when substance use is prohibited onsite, without an expectation of abstinence, and where harm reduction services are limited to the distribution of supplies. In this context, harm reduction is partially implemented and incomplete. Shelters can be a site of risks and trauma for residents and staff due to experiencing, witnessing, and responding to overdoses.
AB  - CONCLUSION: The current overdose crisis heightens the challenges of implementing harm reduction, particularly within complex and diverse settings such as homeless shelters. When harm reduction is limited to the distribution of supplies such as clean equipment and naloxone, important principles of engagement and the development of trust necessary to the provision of services are overlooked with negative implications for service users.

Copyright © 2017 Elsevier B.V. All rights reserved.
ES  - 1873-4758
IL  - 0955-3959
DI  - S0955-3959(17)30367-5
DO  - https://dx.doi.org/10.1016/j.drugpo.2017.12.011
PT  - Journal Article
ID  - S0955-3959(17)30367-5 [pii]
ID  - 10.1016/j.drugpo.2017.12.011 [doi]
PP  - ppublish
PH  - 2017/06/27 [received]
PH  - 2017/12/01 [revised]
PH  - 2017/12/11 [accepted]
LG  - English
EP  - 20180104
DP  - 2018 Mar
EZ  - 2018/01/01 06:00
DA  - 2018/01/01 06:00
DT  - 2018/01/01 06:00
YR  - 2018
RD  - 20180305
UP  - 20180305
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29289871

<1041. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28734745
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Koester S
AU  - Mueller SR
AU  - Raville L
AU  - Langegger S
AU  - Binswanger IA
FA  - Koester, Stephen
FA  - Mueller, Shane R
FA  - Raville, Lisa
FA  - Langegger, Sig
FA  - Binswanger, Ingrid A
IN  - Koester, Stephen. Department of Anthropology, University of Colorado Denver, Denver, CO, USA; Department of Health & Behavioral Sciences, University of Colorado Denver, Denver, CO, USA. Electronic address: steve.koester@ucdenver.edu.
IN  - Mueller, Shane R. Department of Health & Behavioral Sciences, University of Colorado Denver, Denver, CO, USA; Division of General Internal Medicine, University of Colorado School of Medicine, 12631 E. 17th Ave. B-180 Aurora, CO 80045, USA(1); Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA(2). Electronic address: shane.mueller@ucdenver.edu.
IN  - Raville, Lisa. Harm Reduction Action Center, 231 E Colfax Ave, Denver, CO 80203, USA. Electronic address: lisa.harm.reduction@gmail.com.
IN  - Langegger, Sig. Faculty of International Liberal Arts, Akita International University, Japan. Electronic address: sig.langegger@aiu.ac.jp.
IN  - Binswanger, Ingrid A. Division of General Internal Medicine, University of Colorado School of Medicine, 12631 E. 17th Ave. B-180 Aurora, CO 80045, USA(1); Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA(2). Electronic address: Ingrid.binswanger@ucdenver.edu.
TI  - Why are some people who have received overdose education and naloxone reticent to call Emergency Medical Services in the event of overdose?.
SO  - International Journal of Drug Policy. 48:115-124, 2017 Oct
AS  - Int J Drug Policy. 48:115-124, 2017 Oct
NJ  - The International journal on drug policy
VO  - 48
PG  - 115-124
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 9014759
IO  - Int. J. Drug Policy
CP  - Netherlands
KW  - Calling emergency medical services (911);  Good Samaritan law;  Homelessness;  Opioid overdose;  Policing
AB  - BACKGROUND: Overdose Education and Naloxone Distribution (OEND) training for persons who inject drugs (PWID) underlines the importance of summoning emergency medical services (EMS). To encourage PWID to do so, Colorado enacted a Good Samaritan law providing limited immunity from prosecution for possession of a controlled substance and/or drug paraphernalia to the overdose victim and the witnesses who in good faith provide emergency assistance. This paper examines the law's influence by describing OEND trained PWIDs' experience reversing overdoses and their decision about calling for EMS support.
AB  - METHODS: Findings from two complementary studies, a qualitative study based on semi-structured interviews with OEND trained PWID who had reversed one or more overdoses, and an on-going fieldwork-based project examining PWIDs' self-identified health concerns were triangulated to describe and explain participants' decision to call for EMS.
AB  - RESULTS: In most overdose reversals described, no EMS call was made. Participants reported several reasons for not doing so. Most frequent was the fear that despite the Good Samaritan law, a police response would result in arrest of the victim and/or witness for outstanding warrants, or sentence violations. Fears were based on individual and collective experience, and reinforced by the city of Denver's aggressive approach to managing homelessness through increased enforcement of misdemeanors and the imposition of more recent ordinances, including a camping ban, to control space. The city's homeless crisis was reflected as well in the concern expressed by housed PWID that an EMS intervention would jeopardize their public housing.
AB  - CONCLUSION: Results suggest that the immunity provided by the Good Samaritan law does not address PWIDs' fear that their current legal status as well as the victim's will result in arrest and incarceration. As currently conceived, the Good Samaritan law does not provide immunity for PWIDs' already enmeshed in the criminal justice system, or PWID fearful of losing their housing.

Copyright © 2017 Elsevier B.V. All rights reserved.
ES  - 1873-4758
IL  - 0955-3959
DI  - S0955-3959(17)30179-2
DO  - https://dx.doi.org/10.1016/j.drugpo.2017.06.008
PT  - Journal Article
ID  - S0955-3959(17)30179-2 [pii]
ID  - 10.1016/j.drugpo.2017.06.008 [doi]
ID  - PMC5825210 [pmc]
ID  - NIHMS942595 [mid]
PP  - ppublish
PH  - 2016/06/24 [received]
PH  - 2017/06/15 [revised]
PH  - 2017/06/15 [accepted]
GI  - No: UL1 TR001082
Organization: (TR) *NCATS NIH HHS*
Country: United States
LG  - English
EP  - 20170719
DP  - 2017 Oct
PQ  - 2018/10/01
EZ  - 2017/07/25 06:00
DA  - 2017/07/25 06:00
DT  - 2017/07/24 06:00
YR  - 2017
RD  - 20180227
UP  - 20180227
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28734745

<1042. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29248333
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Sun BC
AU  - Charlesworth CJ
AU  - Lupulescu-Mann N
AU  - Young JI
AU  - Kim H
AU  - Hartung DM
AU  - Deyo RA
AU  - McConnell KJ
FA  - Sun, Benjamin C
FA  - Charlesworth, Christina J
FA  - Lupulescu-Mann, Nicoleta
FA  - Young, Jenny I
FA  - Kim, Hyunjee
FA  - Hartung, Daniel M
FA  - Deyo, Richard A
FA  - McConnell, K John
IN  - Sun, Benjamin C. Center for Policy Research-Emergency Medicine, Oregon Health & Science University, Portland, OR. Electronic address: sunb@ohsu.edu.
IN  - Charlesworth, Christina J. Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, OR.
IN  - Lupulescu-Mann, Nicoleta. Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, OR.
IN  - Young, Jenny I. Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, OR.
IN  - Kim, Hyunjee. Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, OR.
IN  - Hartung, Daniel M. College of Pharmacy, Oregon Health & Science University, Portland, OR; College of Pharmacy, Oregon State University, Portland, OR.
IN  - Deyo, Richard A. Department of Family Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, OR; Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR.
IN  - McConnell, K John. Center for Policy Research-Emergency Medicine, Oregon Health & Science University, Portland, OR; Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, OR.
TI  - Effect of Automated Prescription Drug Monitoring Program Queries on Emergency Department Opioid Prescribing.
SO  - Annals of Emergency Medicine. 71(3):337-347.e6, 2018 Mar
AS  - Ann Emerg Med. 71(3):337-347.e6, 2018 Mar
NJ  - Annals of emergency medicine
VO  - 71
IP  - 3
PG  - 337-347.e6
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 8002646
IO  - Ann Emerg Med
CP  - United States
AB  - STUDY OBJECTIVE: We assess whether an automated prescription drug monitoring program intervention in emergency department (ED) settings is associated with reductions in opioid prescribing and quantities.
AB  - METHODS: We performed a retrospective cohort study of ED visits by Medicaid beneficiaries. We assessed the staggered implementation (pre-post) of automated prescription drug monitoring program queries at 86 EDs in Washington State from January 1, 2013, to September 30, 2015. The outcomes included any opioid prescribed within 1 day of the index ED visit and total dispensed morphine milligram equivalents. The exposure was the automated prescription drug monitoring program query intervention. We assessed program effects stratified by previous high-risk opioid use. We performed multiple sensitivity analyses, including restriction to pain-related visits, restriction to visits with a confirmed prescription drug monitoring program query, and assessment of 6 specific opioid high-risk indicators.
AB  - RESULTS: The study included 1,187,237 qualifying ED visits (898,162 preintervention; 289,075 postintervention). Compared with the preintervention period, automated prescription drug monitoring program queries were not significantly associated with reductions in the proportion of visits with opioid prescribing (5.8 per 1,000 encounters; 95% confidence interval [CI] -0.11 to 11.8) or the amount of prescribed morphine milligram equivalents (difference 2.66; 95% CI -0.15 to 5.48). There was no evidence of selective reduction in patients with previous high-risk opioid use (1.2 per 1,000 encounters, 95% CI -9.5 to 12.0; morphine milligram equivalents 1.22, 95% CI -3.39 to 5.82). The lack of a selective reduction in high-risk patients was robust to all sensitivity analyses.
AB  - CONCLUSION: An automated prescription drug monitoring program query intervention was not associated with reductions in ED opioid prescribing or quantities, even in patients with previous high-risk opioid use.

Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
ES  - 1097-6760
IL  - 0196-0644
DI  - S0196-0644(17)31807-3
DO  - https://dx.doi.org/10.1016/j.annemergmed.2017.10.023
PT  - Journal Article
ID  - S0196-0644(17)31807-3 [pii]
ID  - 10.1016/j.annemergmed.2017.10.023 [doi]
ID  - PMC5820164 [pmc]
ID  - NIHMS927601 [mid]
PP  - ppublish
PH  - 2017/09/12 [received]
PH  - 2017/10/12 [revised]
PH  - 2017/10/19 [accepted]
GI  - No: R01 DA036522
Organization: (DA) *NIDA NIH HHS*
Country: United States
LG  - English
EP  - 20171213
DP  - 2018 Mar
PQ  - 2019/03/01
EZ  - 2017/12/19 06:00
DA  - 2017/12/19 06:00
DT  - 2017/12/18 06:00
YR  - 2018
RD  - 20180222
UP  - 20180222
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29248333

<1043. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29458802
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Barrett TW
AU  - Bellew SD
FA  - Barrett, Tyler W
FA  - Bellew, Shawna D
IN  - Barrett, Tyler W. Vanderbilt University Medical Center, Nashville, TN.
IN  - Bellew, Shawna D. Vanderbilt University Medical Center, Nashville, TN.
TI  - What Role Has Emergency Medicine Played in the Opioid Epidemic: Partner in Crime or Canary in the Coal Mine?: March 2018 Annals of Emergency Medicine Journal Club.
SO  - Annals of Emergency Medicine. 71(3):426-428, 2018 Mar
AS  - Ann Emerg Med. 71(3):426-428, 2018 Mar
NJ  - Annals of emergency medicine
VO  - 71
IP  - 3
PG  - 426-428
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - 8002646
IO  - Ann Emerg Med
CP  - United States
ES  - 1097-6760
IL  - 0196-0644
DI  - S0196-0644(18)30046-5
DO  - https://dx.doi.org/10.1016/j.annemergmed.2018.01.033
PT  - Journal Article
ID  - S0196-0644(18)30046-5 [pii]
ID  - 10.1016/j.annemergmed.2018.01.033 [doi]
PP  - ppublish
LG  - English
DP  - 2018 Mar
DT  - 2018/02/21 06:00
YR  - 2018
RD  - 20180220
UP  - 20180220
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29458802

<1044. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28967517
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Jeffery MM
AU  - Hooten WM
AU  - Hess EP
AU  - Meara ER
AU  - Ross JS
AU  - Henk HJ
AU  - Borgundvaag B
AU  - Shah ND
AU  - Bellolio MF
FA  - Jeffery, Molly Moore
FA  - Hooten, W Michael
FA  - Hess, Erik P
FA  - Meara, Ellen R
FA  - Ross, Joseph S
FA  - Henk, Henry J
FA  - Borgundvaag, Bjug
FA  - Shah, Nilay D
FA  - Bellolio, M Fernanda
IN  - Jeffery, Molly Moore. Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Division of Health Care Policy Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN. Electronic address: jeffery.molly@mayo.edu.
IN  - Hooten, W Michael. Department of Anesthesiology, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN.
IN  - Hess, Erik P. Department of Emergency Medicine, Mayo Clinic, Rochester, MN.
IN  - Meara, Ellen R. Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH.
IN  - Ross, Joseph S. Department of Internal Medicine, Yale University School of Medicine, New Haven, CT.
IN  - Henk, Henry J. OptumLabs, Optum, Eden Prairie, MN.
IN  - Borgundvaag, Bjug. Schwartz/Reisman Emergency Medicine Institute, Division of Emergency Services, Mount Sinai Hospital, Toronto, Ontario, Canada.
IN  - Shah, Nilay D. Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Division of Health Care Policy Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
IN  - Bellolio, M Fernanda. Department of Emergency Medicine, Mayo Clinic, Rochester, MN.
TI  - Opioid Prescribing for Opioid-Naive Patients in Emergency Departments and Other Settings: Characteristics of Prescriptions and Association With Long-Term Use.
SO  - Annals of Emergency Medicine. 71(3):326-336.e19, 2018 Mar
AS  - Ann Emerg Med. 71(3):326-336.e19, 2018 Mar
NJ  - Annals of emergency medicine
VO  - 71
IP  - 3
PG  - 326-336.e19
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 8002646
IO  - Ann Emerg Med
CP  - United States
AB  - STUDY OBJECTIVE: We explore the emergency department (ED) contribution to prescription opioid use for opioid-naive patients by comparing the guideline concordance of ED prescriptions with those attributed to other settings and the risk of patients' continuing long-term opioid use.
AB  - METHODS: We used analysis of administrative claims data (OptumLabs Data Warehouse 2009 to 2015) of opioid-naive privately insured and Medicare Advantage (aged and disabled) beneficiaries to compare characteristics of opioid prescriptions attributed to the ED with those attributed to other settings. Concordance with Centers for Disease Control and Prevention (CDC) guidelines and rate of progression to long-term opioid use are reported.
AB  - RESULTS: We identified 5.2 million opioid prescription fills that met inclusion criteria. Opioid prescriptions from the ED were more likely to adhere to CDC guidelines for dose, days' supply, and formulation than those attributed to non-ED settings. Disabled Medicare beneficiaries were the most likely to progress to long-term use, with 13.4% of their fills resulting in long-term use compared with 6.2% of aged Medicare and 1.8% of commercial beneficiaries' fills. Compared with patients in non-ED settings, commercial beneficiaries receiving opioid prescriptions in the ED were 46% less likely, aged Medicare patients 56% less likely, and disabled Medicare patients 58% less likely to progress to long-term opioid use.
AB  - CONCLUSION: Compared with non-ED settings, opioid prescriptions provided to opioid-naive patients in the ED were more likely to align with CDC recommendations. They were shorter, written for lower daily doses, and less likely to be for long-acting formulations. Prescriptions from the ED are associated with a lower risk of progression to long-term use.

Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
ES  - 1097-6760
IL  - 0196-0644
DI  - S0196-0644(17)31526-3
DO  - https://dx.doi.org/10.1016/j.annemergmed.2017.08.042
PT  - Journal Article
ID  - S0196-0644(17)31526-3 [pii]
ID  - 10.1016/j.annemergmed.2017.08.042 [doi]
PP  - ppublish
PH  - 2017/07/05 [received]
PH  - 2017/08/11 [revised]
PH  - 2017/08/11 [accepted]
LG  - English
EP  - 20170926
DP  - 2018 Mar
EZ  - 2017/10/03 06:00
DA  - 2017/10/03 06:00
DT  - 2017/10/03 06:00
YR  - 2018
RD  - 20180220
UP  - 20180220
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28967517

<1045. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28760380
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Beaudoin FL
AU  - Janicki A
AU  - Zhai W
AU  - Choo EK
FA  - Beaudoin, Francesca L
FA  - Janicki, Adam
FA  - Zhai, Wanting
FA  - Choo, Esther K
IN  - Beaudoin, Francesca L. The Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, United States. Electronic address: Francesca_Beaudoin@brown.edu.
IN  - Janicki, Adam. The Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, United States; The Department of Emergency Medicine, University of Pittsburg, Pittsburg, PA, United States.
IN  - Zhai, Wanting. The Department of Biostatistics, Brown University, Providence, RI, United States.
IN  - Choo, Esther K. The Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, United States; The Department of Emergency Medicine, Oregon Health and Science University, Portland, OR, United States.
TI  - Trends in opioid prescribing before and after implementation of an emergency department opioid prescribing policy.
SO  - American Journal of Emergency Medicine. 36(2):329-331, 2018 Feb
AS  - Am J Emerg Med. 36(2):329-331, 2018 Feb
NJ  - The American journal of emergency medicine
VO  - 36
IP  - 2
PG  - 329-331
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - aa2, 8309942
IO  - Am J Emerg Med
CP  - United States
KW  - Emergency department;  Pain;  Policy;  Prescription opioids
ES  - 1532-8171
IL  - 0735-6757
DI  - S0735-6757(17)30616-2
DO  - https://dx.doi.org/10.1016/j.ajem.2017.07.068
PT  - Letter
ID  - S0735-6757(17)30616-2 [pii]
ID  - 10.1016/j.ajem.2017.07.068 [doi]
ID  - PMC5776062 [pmc]
ID  - NIHMS905145 [mid]
PP  - ppublish
PH  - 2017/06/12 [received]
PH  - 2017/07/19 [revised]
PH  - 2017/07/20 [accepted]
GI  - No: K23 DA031881
Organization: (DA) *NIDA NIH HHS*
Country: United States
LG  - English
EP  - 20170721
DP  - 2018 Feb
EZ  - 2017/08/02 06:00
DA  - 2017/08/02 06:00
DT  - 2017/08/02 06:00
YR  - 2018
RD  - 20180220
UP  - 20180220
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28760380

<1046. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28956286
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Peckham AM
AU  - Fairman KA
AU  - Sclar DA
AI  - Peckham, Alyssa M; ORCID: http://orcid.org/0000-0002-9638-7005
FA  - Peckham, Alyssa M
FA  - Fairman, Kathleen A
FA  - Sclar, David A
IN  - Peckham, Alyssa M. Department of Pharmacy Practice, Midwestern University College of Pharmacy-Glendale, 19555 N. 59th Avenue, Glendale, AZ, 85308, USA. apeckh@midwestern.edu.
IN  - Fairman, Kathleen A. Department of Pharmacy Practice, Midwestern University College of Pharmacy-Glendale, 19555 N. 59th Avenue, Glendale, AZ, 85308, USA.
IN  - Sclar, David A. Department of Pharmacy Practice, Midwestern University College of Pharmacy-Glendale, 19555 N. 59th Avenue, Glendale, AZ, 85308, USA.
TI  - All-Cause and Drug-Related Medical Events Associated with Overuse of Gabapentin and/or Opioid Medications: A Retrospective Cohort Analysis of a Commercially Insured US Population.
SO  - Drug Safety. 41(2):213-228, 2018 Feb
AS  - Drug Saf. 41(2):213-228, 2018 Feb
NJ  - Drug safety
VO  - 41
IP  - 2
PG  - 213-228
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - ahq, 9002928
IO  - Drug Saf
CP  - New Zealand
AB  - INTRODUCTION: Overuse of gabapentin and/or opioids occurs in a small percentage of patients at > 3-fold labeled dosages. Gabapentin may potentiate opioid effects.
AB  - OBJECTIVE: The aim was to assess patient harm, defined as use of inpatient hospital (IPH) or emergency department (ED) services, associated with overuse of gabapentin with or without concomitant overuse of opioids.
AB  - DATA SOURCE: Data were sourced from the Truven Health MarketScan<sup></sup> Commercial Claims and Encounters database, for the years 2013-2015.
AB  - ELIGIBILITY CRITERIA: The eligibility criteria were two or more claims (billed encounters) and >=120 days of treatment with gabapentin and/or opioids.
AB  - METHODS: Cohort identification was based on daily-dosage thresholds of 50 morphine-milligram equivalents and 3600 mg of gabapentin in a 12-month follow-up: (1) no overuse; (2) mild overuse (two or more claims or two or fewer calendar quarters over threshold); and (3) sustained overuse (three or more over-threshold calendar quarters). IPH and ED use were measured for 6 months after the first overuse date (cohorts 2 and 3) or a randomly assigned date (cohort 1). Logistic regression analyses controlled for pre-treatment IPH/ED utilization, indication, addiction diagnosis, concomitant sedative/hypnotic use, and demographics.
AB  - RESULTS: All-cause and drug-related IPH/ED utilization increased monotonically with degree of overuse, particularly of more than one medication. Sustained overuse of gabapentin multiplied odds of all-cause IPH by 1.366 [95% confidence interval (CI) 1.055-1.769], drug-related IPH by 1.440 (95% CI 1.010-2.053), and IPH/ED for altered mental status (e.g., euphoria, anxiety) by 1.864 (95% CI 1.324-2.624). Sustained overuse of both medications quadrupled odds of all-cause IPH, drug-related IPH, and IPH/ED for altered mental status or respiratory depression.
AB  - CONCLUSION: Despite modest effects of gabapentin overuse alone, overuse of gabapentin with opioids may increase risk of harm and health-service utilization, supporting calls to make gabapentin a controlled substance in the USA.
ES  - 1179-1942
IL  - 0114-5916
DO  - https://dx.doi.org/10.1007/s40264-017-0595-1
PT  - Journal Article
ID  - 10.1007/s40264-017-0595-1 [doi]
ID  - 10.1007/s40264-017-0595-1 [pii]
PP  - ppublish
LG  - English
DP  - 2018 Feb
EZ  - 2017/09/29 06:00
DA  - 2017/09/29 06:00
DT  - 2017/09/29 06:00
YR  - 2018
RD  - 20180219
UP  - 20180220
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28956286

<1047. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29146420
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Greenberg K
AU  - Kohl B
FA  - Greenberg, Karen
FA  - Kohl, Benjamin
IN  - Greenberg, Karen. Drexel Neurosciences Institute, Drexel University College of Medicine, 219 North Broad St 7th Floor, Philadelphia, PA 19107, USA. Electronic address: karen_greenberg@teamhealth.com.
IN  - Kohl, Benjamin. Aria Jefferson Health System, Torresdale campus, 10800 Knights Road, Philadephia, PA 19114, USA. Electronic address: benjaminkohl@ariahealth.org.
TI  - ECMO used successfully in a near fatal case of opioid-induced acute respiratory distress syndrome.
SO  - American Journal of Emergency Medicine. 36(2):343.e5-343.e6, 2018 Feb
AS  - Am J Emerg Med. 36(2):343.e5-343.e6, 2018 Feb
NJ  - The American journal of emergency medicine
VO  - 36
IP  - 2
PG  - 343.e5-343.e6
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - aa2, 8309942
IO  - Am J Emerg Med
CP  - United States
KW  - ARDS;  Acute respiratory distress syndrome;  ECMO;  Extracorporeal membrane oxygenation;  Heroin;  Opioid overdose
AB  - Acute Respiratory Distress Syndrome (ARDS) was first recognized during the 1960s. It is a distinct type of hypoxemic respiratory failure characterized by acute abnormality of both lungs. Extracorporeal membrane oxygenation (ECMO) is being increasingly used for patients with severe ARDS refractory to otherwise conventional management. A 29year old male arrived with Emergency Medical Services (EMS) status post presumed heroin overdose. He was administered Naloxone 2mg intravenously prior to arrival in the emergency department. The patient arrived in severe respiratory distress with a pulse oximetry level of 50% and was immediately intubated. The patient's pulse oximetry level remained in the seventies despite intubation and aggressive ventilator management. The Intensive Care Unit team in conjunction with cardiothoracic surgery initiated venovenous ECMO therapy in the emergency department itself. The patient was transferred to a tertiary center for venoarterial ECMO that was continued for 6 more days. After an extensive hospitalization, the patient was ultimately transferred to an acute medical rehabilitation center. With the current opioid crisis, emergency physicians and providers need to be aware that opioids can induce severe ARDS refractory to mechanical ventilation. ECMO as a treatment option can be used safely and successfully as described in this unique patient case report.

Copyright © 2017 Elsevier Inc. All rights reserved.
ES  - 1532-8171
IL  - 0735-6757
DI  - S0735-6757(17)30928-2
DO  - https://dx.doi.org/10.1016/j.ajem.2017.11.020
PT  - Journal Article
ID  - S0735-6757(17)30928-2 [pii]
ID  - 10.1016/j.ajem.2017.11.020 [doi]
PP  - ppublish
PH  - 2017/11/04 [received]
PH  - 2017/11/08 [accepted]
LG  - English
EP  - 20171108
DP  - 2018 Feb
EZ  - 2017/11/18 06:00
DA  - 2017/11/18 06:00
DT  - 2017/11/18 06:00
YR  - 2018
RD  - 20180215
UP  - 20180216
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29146420

<1048. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29327358
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Sayuk GS
AU  - Kanuri N
AU  - Gyawali CP
AU  - Gott BM
AU  - Nix BD
AU  - Rosenheck RA
AI  - Sayuk, G S; ORCID: http://orcid.org/0000-0003-1586-199X
AI  - Gyawali, C P; ORCID: http://orcid.org/0000-0002-3388-0660
FA  - Sayuk, G S
FA  - Kanuri, N
FA  - Gyawali, C P
FA  - Gott, B M
FA  - Nix, B D
FA  - Rosenheck, R A
IN  - Sayuk, G S. Division of Gastroenterology, Washington University School of Medicine, St. Louis, MO, USA.
IN  - Sayuk, G S. Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
IN  - Sayuk, G S. Gastroenterology Section, John Cochran Veterans Affairs Medical Center, St. Louis, MO, USA.
IN  - Kanuri, N. Division of Gastroenterology, Washington University School of Medicine, St. Louis, MO, USA.
IN  - Gyawali, C P. Division of Gastroenterology, Washington University School of Medicine, St. Louis, MO, USA.
IN  - Gott, B M. Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
IN  - Nix, B D. Division of Gastroenterology, Washington University School of Medicine, St. Louis, MO, USA.
IN  - Rosenheck, R A. Department of Veterans Affairs, New England Mental Illness Research, Education, and Clinical Center, West Haven, CT, USA.
IN  - Rosenheck, R A. Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
TI  - Opioid medication use in patients with gastrointestinal diagnoses vs unexplained gastrointestinal symptoms in the US Veterans Health Administration.
SO  - Alimentary Pharmacology & Therapeutics. 47(6):784-791, 2018 Mar
AS  - Aliment Pharmacol Ther. 47(6):784-791, 2018 Mar
NJ  - Alimentary pharmacology & therapeutics
VO  - 47
IP  - 6
PG  - 784-791
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - a5d, 8707234
IO  - Aliment. Pharmacol. Ther.
CP  - England
AB  - BACKGROUND: While opioid prescriptions have increased alarmingly in the United States (US), their use for unexplained chronic gastrointestinal (GI) pain (eg, irritable bowel syndrome) carries an especially high risk for adverse effects and questionable benefit.
AB  - AIM: To compare opioid use among US veterans with structural GI diagnoses (SGID) and those with unexplained GI symptoms or functional GI diagnoses (FGID), a group for whom opioids have no accepted role.
AB  - METHODS: Veterans Health Administration (VHA) administrative data from fiscal year 2012 were used to identify veterans with diagnostic codes recorded for SGID and FGID. This cohort study examined VHA pharmacy data to compare groups receiving >= 1 opioid prescription during the year and number of prescriptions filled. Bivariate and multiple logistic regression analyses adjusted for potential confounding factors (demographics, medical diagnoses, social factors) and identified potential mediators (service use, psychiatric comorbidity) of opioid use in these groups.
AB  - RESULTS: A greater proportion of veterans with FGID received an opioid prescription during fiscal year 2012 (36.0% of 272 431) compared to only 28.9% of 1 223 744 in the SGID group (Relative Risk [RR] = 1.25). In multivariate logistic regression, personality disorders and drug abuse (OR 1.23 for each group), recent homelessness (OR 1.22), psychotropic medication fills (OR 1.55) and emergency department encounters (OR 1.21) were independently associated with opioid prescription use.
AB  - CONCLUSIONS: Despite the potential for adverse consequences, opioids more often are prescribed for veterans with chronic, unexplained GI symptoms compared to those with structural diagnoses. Psychiatric comorbidities and frequent healthcare encounters mediate some of the opioid use risk.

Copyright © 2018 John Wiley & Sons Ltd.
ES  - 1365-2036
IL  - 0269-2813
DO  - https://dx.doi.org/10.1111/apt.14503
PT  - Journal Article
ID  - 10.1111/apt.14503 [doi]
PP  - ppublish
PH  - 2017/07/13 [received]
PH  - 2017/08/05 [revised]
PH  - 2017/12/15 [accepted]
LG  - English
EP  - 20180112
DP  - 2018 Mar
EZ  - 2018/01/13 06:00
DA  - 2018/01/13 06:00
DT  - 2018/01/13 06:00
YR  - 2018
RD  - 20180215
UP  - 20180215
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29327358

<1049. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29415846
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Robertson AG
AU  - Easter MM
AU  - Lin HJ
AU  - Frisman LK
AU  - Swanson JW
AU  - Swartz MS
FA  - Robertson, Allison G
FA  - Easter, Michele M
FA  - Lin, Hsiu-Ju
FA  - Frisman, Linda K
FA  - Swanson, Jeffrey W
FA  - Swartz, Marvin S
IN  - Robertson, Allison G. Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, United States. Electronic address: allison.gilbert@duke.edu.
IN  - Easter, Michele M. Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, United States.
IN  - Lin, Hsiu-Ju. Connecticut Department of Mental Health and Addiction Services, University of Connecticut School of Social Work, United States.
IN  - Frisman, Linda K. Connecticut Department of Mental Health and Addiction Services, University of Connecticut School of Social Work, United States.
IN  - Swanson, Jeffrey W. Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, United States.
IN  - Swartz, Marvin S. Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, United States.
TI  - Associations between pharmacotherapy for opioid dependence and clinical and criminal justice outcomes among adults with co-occurring serious mental illness.
SO  - Journal of Substance Abuse Treatment. 86:17-25, 2018 Mar
AS  - J Subst Abuse Treat. 86:17-25, 2018 Mar
NJ  - Journal of substance abuse treatment
VO  - 86
PG  - 17-25
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - kai, 8500909
IO  - J Subst Abuse Treat
CP  - United States
KW  - Arrest;  Co-occurring mental health and substance use disorders;  Crisis-driven treatment utilization;  Incarceration;  Pharmacotherapy for opioid dependence
AB  - Adults suffering from a serious mental illness (SMI) and a substance use disorder are at especially high risk for poor clinical outcomes and also arrest and incarceration. Pharmacotherapies for treating opioid dependence could be a particularly important mode of treatment for opioid-dependent adults with SMI to lower their risk for overdose, high-cost hospitalizations, repeated emergency department visits, and incarceration, given relapse rates are very high following detoxification in the absence of one of the three FDA-approved pharmacotherapies. This study estimates the effects of methadone, buprenorphine, and oral naltrexone on clinical and justice-related outcomes in a sample of justice-involved adults with SMI, opioid dependence, and criminal justice involvement. Administrative data were merged from several public agencies in Connecticut for 8736 adults 18years of age or older with schizophrenia spectrum disorder, bipolar disorder, or major depression; co-occurring moderate to severe opioid dependence; and who also had at least one night in jail during 2002-2009. Longitudinal multivariable regression models estimated the effect of opioid-dependence pharmacotherapy as compared to outpatient substance abuse treatment without opioid-dependence pharmacotherapy on inpatient substance abuse or mental health treatment, emergency department visits, criminal convictions, and incarcerations, analyzing instances of each outcome 12months before and after an index treatment episode. Several baseline differences between the study groups (opioid-dependence pharmacotherapy group versus outpatient treatment without opioid-dependence pharmacotherapy) were adjusted for in the regression models. All three opioid-dependence pharmacotherapies were associated with reductions in inpatient substance abuse treatment, and among the oral naltrexone subgroup, also reductions in inpatient mental health treatment, as well as improved adherence to SMI medications. Overall, the opioid-dependence pharmacotherapy group had higher rates of arrest and incarceration in the follow-up period than the comparison group; but those using oral naltrexone had lower rates of arrest (including felonies). The analysis of observational administrative data provides useful population-level estimates but also has important limitations that preclude conclusive causal inferences. Large reductions in crisis-driven service utilization associated with opioid-dependence pharmacotherapy in this study suggest that evidence-based medications for treating opioid dependence can be used successfully in adults with SMI and should be considered more systematically during assessments of treatment needs for this population.

Copyright © 2017 Elsevier Inc. All rights reserved.
ES  - 1873-6483
IL  - 0740-5472
DI  - S0740-5472(17)30424-5
DO  - https://dx.doi.org/10.1016/j.jsat.2017.12.003
PT  - Journal Article
ID  - S0740-5472(17)30424-5 [pii]
ID  - 10.1016/j.jsat.2017.12.003 [doi]
ID  - PMC5808599 [pmc]
ID  - NIHMS930967 [mid]
PP  - ppublish
PH  - 2017/09/24 [received]
PH  - 2017/12/06 [revised]
PH  - 2017/12/08 [accepted]
GI  - No: K01 MH100544
Organization: (MH) *NIMH NIH HHS*
Country: United States
LG  - English
EP  - 20171212
DP  - 2018 Mar
PQ  - 2019/03/01
EZ  - 2018/02/09 06:00
DA  - 2018/02/09 06:00
DT  - 2018/02/09 06:00
YR  - 2018
RD  - 20180214
UP  - 20180214
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29415846

<1050. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29371005
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Surmaitis RM
AU  - Amaducci A
AU  - Henry K
AU  - Jong M
AU  - Kiernan EA
AU  - Kincaid H
AU  - Houck LJ
AU  - Sabbatini SJ
AU  - Greenberg MR
AU  - Katz KD
FA  - Surmaitis, Ryan M
FA  - Amaducci, Alexandra
FA  - Henry, Kathryn
FA  - Jong, Michael
FA  - Kiernan, Emily A
FA  - Kincaid, Hope
FA  - Houck, Lindsay J
FA  - Sabbatini, Sandra J
FA  - Greenberg, Marna Rayl
FA  - Katz, Kenneth D
IN  - Surmaitis, Ryan M. Department of Emergency Medicine, Lehigh Valley Hospital and Health Network/USF MCOM, Allentown, PA.
IN  - Amaducci, Alexandra. Department of Emergency Medicine, Lehigh Valley Hospital and Health Network/USF MCOM, Allentown, PA.
IN  - Henry, Kathryn. Department of Emergency Medicine, Lehigh Valley Hospital and Health Network/USF MCOM, Allentown, PA.
IN  - Jong, Michael. Department of Emergency Medicine, Lehigh Valley Hospital and Health Network/USF MCOM, Allentown, PA.
IN  - Kiernan, Emily A. Department of Emergency Medicine, Lehigh Valley Hospital and Health Network/USF MCOM, Allentown, PA.
IN  - Kincaid, Hope. Department of Emergency Medicine, Lehigh Valley Hospital and Health Network/USF MCOM, Allentown, PA.
IN  - Houck, Lindsay J. Department of Emergency Medicine, Lehigh Valley Hospital and Health Network/USF MCOM, Allentown, PA.
IN  - Sabbatini, Sandra J. Department of Emergency Medicine, Lehigh Valley Hospital and Health Network/USF MCOM, Allentown, PA.
IN  - Greenberg, Marna Rayl. Department of Emergency Medicine, Lehigh Valley Hospital and Health Network/USF MCOM, Allentown, PA. Electronic address: mrgdo@ptd.net.
IN  - Katz, Kenneth D. Department of Emergency Medicine, Lehigh Valley Hospital and Health Network/USF MCOM, Allentown, PA.
TI  - Perception and Practice Among Emergency Medicine Health Care Providers Regarding Discharging Patients After Opioid Administration.
SO  - Clinical Therapeutics. 40(2):214-223.e5, 2018 Feb
AS  - Clin Ther. 40(2):214-223.e5, 2018 Feb
NJ  - Clinical therapeutics
VO  - 40
IP  - 2
PG  - 214-223.e5
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - cpe, 7706726
IO  - Clin Ther
CP  - United States
KW  - analgesics;  opiate;  opioid;  safe discharge
AB  - PURPOSE: This study aimed to determine the current attitudes, perceptions, and practices of emergency medicine providers and nurses (RNs) regarding the discharge of adult patients from the emergency department (ED) after administration of opioid analgesics.
AB  - METHODS: A cross-sectional survey was administered at 3 hospital sites with a combined annual ED census of >180,000 visits per year. All 59 attending emergency physicians (EPs), 233 RNs, and 23 advanced practice clinicians (APCs) who worked at these sites were eligible to participate.
AB  - FINDINGS: Thirty-five EPs (59.3%), 88 RNs (37.8%), and 14 APCs (60.9%) completed the survey for an overall response rate of 51.75%. Most respondents were female (95 [69.9%]). The factor ranked most important to consider when discharging a patient from the ED after administration of opioids was the patient's functional status and vital signs (median, 2.00; interquartile range, 2.00-3.50). More RNs (84 [96.6%]) than EPs (29 [82.9%]) reported that developing an ED policy or guideline for safe discharge after administration of opioids is important to clinical practice (P = 0.02). Only 8 physicians (23.5%) reported that they did not prescribe intramuscular morphine, and 15 (42.9%) reported that they did not prescribe intramuscular hydromorphone. EPs (7 [20.0%]) and RNs (3 [3.4%]) differed in regard to whether they were aware if any patients to whom they administered an opioid had experienced an adverse drug-related event (P = 0.01). Most EPs (24 [68.6%]) and RNs (54 [61.4%]) believed that the decision for patient discharge should be left to both the emergency medicine provider and the RN.
AB  - IMPLICATIONS: Most study participants believed that developing a policy or guideline for safe discharge after administration opioids in the ED is important to clinical practice. Only a few physicians reported that they did not prescribe intramuscular hydromorphone or morphine. Most participants believed the discharge decision after administration of opioids in the ED should be primarily determined by both the emergency medicine provider and the RN.

Copyright © 2018 Elsevier HS Journals, Inc. All rights reserved.
ES  - 1879-114X
IL  - 0149-2918
DI  - S0149-2918(18)30001-8
DO  - https://dx.doi.org/10.1016/j.clinthera.2018.01.001
PT  - Journal Article
ID  - S0149-2918(18)30001-8 [pii]
ID  - 10.1016/j.clinthera.2018.01.001 [doi]
PP  - ppublish
PH  - 2017/10/31 [received]
PH  - 2017/12/23 [revised]
PH  - 2018/01/02 [accepted]
LG  - English
EP  - 20180120
DP  - 2018 Feb
EZ  - 2018/01/27 06:00
DA  - 2018/01/27 06:00
DT  - 2018/01/27 06:00
YR  - 2018
RD  - 20180213
UP  - 20180213
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29371005

<1051. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29232630
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - PubMed-not-MEDLINE
AU  - Poitras R
AU  - Warren D
AU  - Oyogoa S
FA  - Poitras, Renee
FA  - Warren, Daun'Lee
FA  - Oyogoa, Sylvanus
IN  - Poitras, Renee. Avalon University School of Medicine, Youngstown, OH, United States. Electronic address: reneelexiepoitras@gmail.com.
IN  - Warren, Daun'Lee. Avalon University School of Medicine, Youngstown, OH, United States.
IN  - Oyogoa, Sylvanus. Department of General Surgery, Raleigh General Hospital, Beckley, WV, United States.
TI  - Opioid drugs and stercoral perforation of the colon: Case report and review of literature.
SO  - International Journal of Surgery Case Reports. 42:94-97, 2018
AS  - Int J Surg Case Rep. 42:94-97, 2018
NJ  - International journal of surgery case reports
VO  - 42
PG  - 94-97
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Print
JC  - 101529872
IO  - Int J Surg Case Rep
CP  - Netherlands
KW  - Buprenorphine;  Constipation;  Opioids;  Stercoral perforation;  Suboxone
AB  - INTRODUCTION: Stercoral perforation of the colon is a rare pathology, which is believed to be caused by an increased intraluminal pressure created by a fecaloma. Opioid induced constipation is a rare and often unsuspected cause of colonic perforation.
AB  - PRESENTATION OF CASE: We report the case of a 58-year-old woman, who presented to the emergency department (ED) with severe hypotension, abdominal pain and gastrointestinal bleeding. She was found to have a diffusely tender and distended abdomen. Her history was positive for long-term suboxone use and chronic constipation. Abdominopelvic computed tomography (CT) scan revealed a bowel perforation, ascites and fecal impaction. Emergency laparotomy revealed extensive stool in the peritoneal cavity as well as hemoperitoneum. There was a fecal bolus with perforation located in the sigmoid colon. On postoperative day (POD) six, a second abdominopelvic CT scan was performed and results revealed the necessity of a second exploratory laparotomy. She had multiple loculated abscesses within the small bowel and other areas, which were opened and washed out.
AB  - DISCUSSION: Due to the inflating use of drugs in the opioid class, the recognition of this pathology has become increasingly important. The action of the drug on the mu-opioid receptors, any patients taking opioid medications are at risk for constipation progressing to stercoral perforation and should be monitored closely.
AB  - CONCLUSION: Patients presenting with chronic constipation, fecal impaction on imaging and clinical signs of peritonitis or sepsis, should consider stercoral perforation in their differential diagnosis since early detection is key to reduce mortality rates in these cases.

Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
IS  - 2210-2612
IL  - 2210-2612
DI  - S2210-2612(17)30640-5
DO  - https://dx.doi.org/10.1016/j.ijscr.2017.11.060
PT  - Journal Article
ID  - S2210-2612(17)30640-5 [pii]
ID  - 10.1016/j.ijscr.2017.11.060 [doi]
ID  - PMC5730425 [pmc]
PP  - ppublish
PH  - 2017/06/26 [received]
PH  - 2017/11/28 [revised]
PH  - 2017/11/28 [accepted]
LG  - English
EP  - 20171207
DP  - 2018
EZ  - 2017/12/13 06:00
DA  - 2017/12/13 06:00
DT  - 2017/12/13 06:00
YR  - 2018
RD  - 20180209
UP  - 20180209
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29232630

<1052. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28810127
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Cochran G
AU  - Gordon AJ
AU  - Gellad WF
AU  - Chang CH
AU  - Lo-Ciganic WH
AU  - Lobo C
AU  - Cole E
AU  - Frazier W
AU  - Zheng P
AU  - Kelley D
AU  - Donohue JM
FA  - Cochran, Gerald
FA  - Gordon, Adam J
FA  - Gellad, Walid F
FA  - Chang, Chung-Chou H
FA  - Lo-Ciganic, Wei-Hsuan
FA  - Lobo, Carroline
FA  - Cole, Evan
FA  - Frazier, Winfred
FA  - Zheng, Ping
FA  - Kelley, David
FA  - Donohue, Julie M
IN  - Cochran, Gerald. University of Pittsburgh, 4200 Forbes Ave, 2117 CL, Pittsburgh, PA 15260. E-mail: gcochran@pitt.edu.
TI  - Medicaid prior authorization and opioid medication abuse and overdose.
SO  - American Journal of Managed Care. 23(5):e164-e171, 2017 May 01
AS  - Am J Manag Care. 23(5):e164-e171, 2017 May 01
NJ  - The American journal of managed care
VO  - 23
IP  - 5
PG  - e164-e171
PI  - Journal available in: Electronic
PI  - Citation processed from: Internet
JC  - cw0, 9613960
IO  - Am J Manag Care
CP  - United States
AB  - OBJECTIVES: The US opioid medication epidemic has resulted in serious health consequences for patients. Formulary management tools adopted by payers, specifically prior authorization (PA) policies, may lower the rates of opioid medication abuse and overdose. We compared rates of opioid abuse and overdose among enrollees in plans that varied in their use of PA from "High PA" (ie, required PA for 17 to 74 opioids), with "Low PA" (ie, required PA for 1 opioid), and "No PA" policies for opioid medications.
AB  - STUDY DESIGN: Retrospective cohort study of patients initiating opioid treatment in Pennsylvania Medicaid from 2010 to 2012.
AB  - METHODS: Generalized linear models with generalized estimating equations were employed to assess the relationships between the presence of PA policies and opioid medication abuse and overdose, as measured in Medicaid claims data, adjusting for demographics, comorbid health conditions, benzodiazepine/muscle relaxant use, and emergency department use.
AB  - RESULTS: The study cohort included 297,634 enrollees with a total of 382,828 opioid treatment episodes. Compared with plans with No PA, enrollees in High PA (adjusted rate ratio [ARR], 0.89; 95% confidence interval [CI], 0.85-0.93; P <.001) and Low PA plans (ARR, 0.93; 95% CI, 0.87-1.00; P = .04) had lower rates of abuse. Enrollees in the Low PA plan had a lower rate of overdose than those within plans with No PA (ARR, 0.75; 95% CI, 0.59-0.95; P = .02). High PA plan enrollees were also less likely than No PA enrollees to experience an overdose, but this association was not statistically significant (ARR, 0.88; 95% CI, 0.76-1.02; P = .08).
AB  - CONCLUSIONS: Enrollees within Medicaid plans that utilize PA policies appear to have lower rates of abuse and overdose following initiation of opioid medication treatment.
ES  - 1936-2692
IL  - 1088-0224
PT  - Journal Article
ID  - 87082 [pii]
PP  - epublish
GI  - No: U01 CE002496
Organization: (CE) *NCIPC CDC HHS*
Country: United States
LG  - English
EP  - 20170501
DP  - 2017 May 01
EZ  - 2017/08/16 06:00
DA  - 2017/08/16 06:00
DT  - 2017/08/16 06:00
YR  - 2017
RD  - 20180208
UP  - 20180208
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28810127

<1053. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29375277
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - PubMed-not-MEDLINE
AU  - Chintha KK
AU  - Indic P
AU  - Chapman B
AU  - Boyer EW
AU  - Carreiro S
FA  - Chintha, Keerthi Kumar
FA  - Indic, Premananda
FA  - Chapman, Brittany
FA  - Boyer, Edward W
FA  - Carreiro, Stephanie
IN  - Chintha, Keerthi Kumar. Department of Electrical Engineering, University of Texas at Tyler, Tyler, TX.
IN  - Indic, Premananda. Department of Electrical Engineering, University of Texas at Tyler, Tyler, TX.
IN  - Chapman, Brittany. Department of Emergency Medicine, Division of Medical Toxicology, University of Massachusetts, Medical School, Worcester, MA.
IN  - Boyer, Edward W. Department of Emergency Medicine, Division of Medical Toxicology, Brigham and Women's Hospital, Boston, MA.
IN  - Carreiro, Stephanie. Department of Emergency Medicine, Division of Medical Toxicology, University of Massachusetts, Medical School, Worcester, MA.
TI  - Wearable Biosensors to Evaluate Recurrent Opioid Toxicity After Naloxone Administration: A Hilbert Transform Approach.
SO  - Proceedings of the Annual Hawaii International Conference on System Sciences. 2018:3247-3252, 2018 Jan
AS  - Proc. Annu. Hawaii Int. Conf. Syst. Sci.. 2018:3247-3252, 2018 Jan
NJ  - Proceedings of the ... Annual Hawaii International Conference on System Sciences. Annual Hawaii International Conference on System Sciences
VO  - 2018
PG  - 3247-3252
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Print
JC  - 101660575
IO  - Proc Annu Hawaii Int Conf Syst Sci
CP  - United States
AB  - Opioid abuse is a rapidly escalating problem in the United States. Effective opioid reversal is achieved with the antidote naloxone, but often does not last as long as the offending opioid, necessitating in-hospital observation. Continuous physiologic monitoring using wearable biosensors represents a potential option to extend monitoring capability outside the clinical setting across the spectrum of opioid abuse including post- naloxone administration. The present study aims to identify the physiologic change that marks the cessation of naloxone's effect. Eleven participants were recruited in the Emergency Department after naloxone administration for an opioid overdose and continuously monitored using a wearable biosensor measuring heart rate, temperature, electrodermal activity and accelerometry. Hilbert transform was used to evaluate a 90- minute post naloxone time point. Physiologic changes were consistent with the onset of opioid drug effect across parameters, but only changes in heart rate and skin temperature research statistical significance.
IS  - 1530-1605
IL  - 1530-1605
PT  - Journal Article
ID  - PMC5782803 [pmc]
ID  - NIHMS934169 [mid]
PP  - ppublish
GI  - No: KL2 TR001455
Organization: (TR) *NCATS NIH HHS*
Country: United States
LG  - English
EP  - 20180103
DP  - 2018 Jan
PQ  - 2018/07/01
EZ  - 2018/01/30 06:00
DA  - 2018/01/30 06:01
DT  - 2018/01/30 06:00
YR  - 2018
RD  - 20180206
UP  - 20180206
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29375277

<1054. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29335260
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Tyndall M
FA  - Tyndall, Mark
IN  - Tyndall, Mark. BC Centre for Disease Control, Vancouver, BC; School of Population and Public Health, University of British Columbia, Vancouver, BC mark.tyndall@bccdc.ca.
TI  - An emergency response to the opioid overdose crisis in Canada: a regulated opioid distribution program.
SO  - CMAJ Canadian Medical Association Journal. 190(2):E35-E36, 2018 Jan 15
AS  - CMAJ. 190(2):E35-E36, 2018 Jan 15
NJ  - CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
VO  - 190
IP  - 2
PG  - E35-E36
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - 9711805
IO  - CMAJ
CP  - Canada
CI  - Competing interests: None declared.
ES  - 1488-2329
IL  - 0820-3946
DO  - https://dx.doi.org/10.1503/cmaj.171060
PT  - Journal Article
ID  - 190/2/E35 [pii]
ID  - 10.1503/cmaj.171060 [doi]
ID  - PMC5770249 [pmc]
PP  - ppublish
LG  - English
DP  - 2018 Jan 15
PQ  - 2019/01/15
EZ  - 2018/01/18 06:00
DA  - 2018/01/18 06:00
DT  - 2018/01/17 06:00
YR  - 2018
RD  - 20180202
UP  - 20180202
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29335260

<1055. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 27649040
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Beauchamp GA
AU  - Kerrey BT
AU  - Mittiga MR
AU  - Rinderknecht AS
AU  - Yin S
FA  - Beauchamp, Gillian A
FA  - Kerrey, Benjamin T
FA  - Mittiga, Matthew R
FA  - Rinderknecht, Andrea S
FA  - Yin, Shan
IN  - Beauchamp, Gillian A. From the *Department of Emergency Medicine, University of Cincinnati; and +Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
TI  - Toxicological Emergencies in the Resuscitation Area of a Pediatric Emergency Department: A 12-Month Review.
SO  - Pediatric Emergency Care. 33(10):670-674, 2017 Oct
AS  - Pediatr Emerg Care. 33(10):670-674, 2017 Oct
NJ  - Pediatric emergency care
VO  - 33
IP  - 10
PG  - 670-674
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - pau, 8507560
IO  - Pediatr Emerg Care
CP  - United States
AB  - OBJECTIVE: Few studies of children with toxicological emergencies describe those undergoing acute resuscitation, and most describe exposures to single agents. We describe a 12-month sample of patients evaluated in the resuscitation area of a pediatric emergency department (ED) for a toxicological emergency.
AB  - METHODS: We conducted a retrospective chart review of patients in a high-volume, academic pediatric ED. We identified patients evaluated in the ED resuscitation area for toxicological exposure and conducted structured chart reviews to collect relevant data. For all variables of interest, we calculated standard descriptive statistics.
AB  - RESULTS: Of 2999 patients evaluated in the resuscitation area through 12 months (March 2009 to April 2010), we identified 80 (2.7%) whose primary ED diagnosis was toxicological. The mean age was 11.4 years. Eighty-six percent of patients were triaged to the resuscitation area for significantly altered mental status. The most frequent single exposures were ethanol (25%), clonidine (10%), and acetaminophen (5%). At least 1 laboratory test was performed for almost all patients (97%). Interventions performed in the resuscitation area included intravenous access placement (97%), activated charcoal (20%), naloxone (19%), and endotracheal intubation (12%). Eighty-two percent of patients were admitted to the hospital; 37% to the intensive care unit. No patients studied in this sample died and most received only supportive care.
AB  - CONCLUSIONS: In a high-volume pediatric ED, toxicological emergencies requiring acute resuscitation were rare. Ethanol and clonidine were the most frequent single exposures. Most patients received diagnostic testing and were admitted. Further studies are needed to describe regional differences in pediatric toxicological emergencies.
ES  - 1535-1815
IL  - 0749-5161
DO  - https://dx.doi.org/10.1097/PEC.0000000000000858
PT  - Journal Article
ID  - 10.1097/PEC.0000000000000858 [doi]
PP  - ppublish
LG  - English
DP  - 2017 Oct
EZ  - 2016/09/21 06:00
DA  - 2016/09/21 06:00
DT  - 2016/09/21 06:00
YR  - 2017
RD  - 20180201
UP  - 20180201
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=27649040

<1056. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28850356
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Sondergaard J
AU  - Christensen HN
AU  - Ibsen R
AU  - Jarbol DE
AU  - Kjellberg J
FA  - Sondergaard, Jens
FA  - Christensen, Helene Nordahl
FA  - Ibsen, Rikke
FA  - Jarbol, Dorte Ejg
FA  - Kjellberg, Jakob
IN  - Sondergaard, Jens. Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
IN  - Christensen, Helene Nordahl. AstraZeneca Nordic-Baltic, Sodertalje, Sweden. Electronic address: Helene.nordahlchristensen@astrazeneca.com.
IN  - Ibsen, Rikke. i2minds, Arhus, Denmark.
IN  - Jarbol, Dorte Ejg. Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
IN  - Kjellberg, Jakob. KORA, Danish Institute for Local and Regional Government Research, Copenhagen, Denmark.
TI  - Healthcare resource use and costs of opioid-induced constipation among non-cancer and cancer patients on opioid therapy: A nationwide register-based cohort study in Denmark.
SO  - Scandinavian Journal of Pain. 15:83-90, 2017 Apr
AS  - Scand J Pain. 15:83-90, 2017 Apr
NJ  - Scandinavian journal of pain
VO  - 15
PG  - 83-90
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 101520867
IO  - Scand J Pain
CP  - Germany
KW  - Cancer;  Denmark;  Healthcare costs;  Non-cancer;  Opioid-induced constipation
AB  - BACKGROUND AND AIM: Opioid analgesics are often effective for pain management, but may cause constipation. The aim of this study was to determine healthcare resource use and costs in non-cancer and cancer patients with opioid-induced constipation (OIC).
AB  - METHODS: This was a nationwide register-based cohort study including patients >=18 years of age initiating >=4 weeks opioid therapy (1998-2012) in Denmark. A measure of OIC was constructed based on data from Danish national health registries, and defined as >=1 diagnosis of constipation, diverticulitis, mega colon, ileus/subileus, abdominal pain/acute abdomen or haemorrhoids and/or >=2 subsequent prescription issues of laxatives. Total healthcare resource utilization and costs (including pharmacy dispense, inpatient-, outpatient-, emergency room- and primary care) were estimated according to OIC status, opioid treatment dosage and length, gender, age, marital status, and comorbidities using Generalised Linear Model.
AB  - RESULTS: We identified 97169 eligible opioid users (77568 non-cancer and 19601 patients with a cancer diagnosis). Among non-cancer patients, 15% were classified with OIC, 10% had previous constipation, and 75% were without OIC. Patients characteristics of non-cancer OIC patients showed a higher frequency of strong opioid treatment (69% versus 41%), long-term opioid treatment (1189 days versus 584 days), advanced age (73 years versus 61 years), and cardiovascular disease (31% versus 19%) compared to those without OIC (P<0.001 for all comparisons). Non-cancer patients with OIC had 34% higher total healthcare costs compared to those without OIC (P<0.001) after adjusting for age, gender, opioid usage, marital status and comorbidities. Among cancer patients, 35% were classified with OIC, 14% had previous constipation, and 51% were without OIC. A higher proportion of cancer patients with OIC were continuous opioid users (85% versus 83%) and strong opioid users (97% versus 85%), compared to those without OIC (P<0.001 for both comparisons). Further, the mean number of days on opioids were higher for cancer patients with versus without OIC (329 days versus 238 days, P<0.001). Total healthcare costs were 25% higher for cancer patients with versus without OIC (P<0.001) after adjusting for age, gender, opioid usage, marital status and comorbidities.
AB  - CONCLUSIONS: The results of this nationwide study based on real life data suggested that both non-cancer patients and cancer patients suffering from opioid-induced constipation (OIC) may have higher healthcare resource utilization and higher associated costs compared to those without OIC.
AB  - IMPLICATIONS: Reducing the number of OIC patients has potential cost savings for the health care system. Special attention should be on patients at potential high risk of OIC, such as strong and long-term opioid treatment, advanced age, and concomitant cardiovascular disease.

Copyright © 2017 Scandinavian Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
ES  - 1877-8879
IL  - 1877-8860
DI  - S1877-8860(17)30014-9
DO  - https://dx.doi.org/10.1016/j.sjpain.2017.01.006
PT  - Journal Article
ID  - S1877-8860(17)30014-9 [pii]
ID  - 10.1016/j.sjpain.2017.01.006 [doi]
PP  - ppublish
PH  - 2016/11/09 [received]
PH  - 2017/01/24 [revised]
PH  - 2017/01/25 [accepted]
LG  - English
EP  - 20170220
DP  - 2017 Apr
EZ  - 2017/08/30 06:00
DA  - 2017/08/30 06:00
DT  - 2017/08/30 06:00
YR  - 2017
RD  - 20180126
UP  - 20180129
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28850356

<1057. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29103410
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Fan AY
AU  - Miller DW
AU  - Bolash B
AU  - Bauer M
AU  - McDonald J
AU  - Faggert S
AU  - He H
AU  - Li YM
AU  - Matecki A
AU  - Camardella L
AU  - Koppelman MH
AU  - Stone JAM
AU  - Meade L
AU  - Pang J
FA  - Fan, Arthur Yin
FA  - Miller, David W
FA  - Bolash, Bonnie
FA  - Bauer, Matthew
FA  - McDonald, John
FA  - Faggert, Sarah
FA  - He, Hongjian
FA  - Li, Yong Ming
FA  - Matecki, Amy
FA  - Camardella, Lindy
FA  - Koppelman, Mel Hopper
FA  - Stone, Jennifer A M
FA  - Meade, Lindsay
FA  - Pang, John
IN  - Fan, Arthur Yin. The American TCM Association, Vienna, VA 22182, USA.
IN  - Miller, David W. The American Society of Acupuncturists, Chicago, IL 60618, USA.
IN  - Miller, David W. The Joint Acupuncture Opioid Task Force, La Verne, CA 91750, USA.
IN  - Miller, David W. Pacific College of Oriental Medicine, Chicago, IL 60601, USA.
IN  - Bolash, Bonnie. The Joint Acupuncture Opioid Task Force, La Verne, CA 91750, USA.
IN  - Bauer, Matthew. The Joint Acupuncture Opioid Task Force, La Verne, CA 91750, USA.
IN  - Bauer, Matthew. The Acupuncture Now Foundation, La Verne, CA 91750, USA.
IN  - McDonald, John. The Joint Acupuncture Opioid Task Force, La Verne, CA 91750, USA.
IN  - McDonald, John. The Acupuncture Evidence Project, Providence, RI 02860, USA.
IN  - Faggert, Sarah. The American Society of Acupuncturists, Chicago, IL 60618, USA.
IN  - Faggert, Sarah. The Acupuncture Society of Virginia, Vienna, VA 22182, USA.
IN  - He, Hongjian. The American Society of Acupuncturists, Chicago, IL 60618, USA.
IN  - He, Hongjian. The National Federation of Chinese TCM Organizations, New York, NY 11501, USA.
IN  - He, Hongjian. The American Alliance for Professional Acupuncture Safety, Greenwich, CT 06878, USA.
IN  - Li, Yong Ming. The American Traditional Chinese Medicine Society, New York, NY 11501, USA.
IN  - Matecki, Amy. The American Alliance for Professional Acupuncture Safety, Greenwich, CT 06878, USA.
IN  - Matecki, Amy. Highland Hospital, Alameda Health System, Oakland, CA 94602, USA.
IN  - Camardella, Lindy. The American Society of Acupuncturists, Chicago, IL 60618, USA.
IN  - Camardella, Lindy. The Joint Acupuncture Opioid Task Force, La Verne, CA 91750, USA.
IN  - Koppelman, Mel Hopper. The Joint Acupuncture Opioid Task Force, La Verne, CA 91750, USA.
IN  - Koppelman, Mel Hopper. The Acupuncture Evidence Project, Providence, RI 02860, USA.
IN  - Stone, Jennifer A M. The American Society of Acupuncturists, Chicago, IL 60618, USA.
IN  - Stone, Jennifer A M. Indiana University School of Medicine, Indianapolis, IN 46202, USA.
IN  - Meade, Lindsay. The American Society of Acupuncturists, Chicago, IL 60618, USA.
IN  - Meade, Lindsay. The Joint Acupuncture Opioid Task Force, La Verne, CA 91750, USA.
IN  - Pang, John. University of California, San Diego School of Medicine, San Diego, CA 92093, USA.
TI  - Acupuncture's Role in Solving the Opioid Epidemic: Evidence, Cost-Effectiveness, and Care Availability for Acupuncture as a Primary, Non-Pharmacologic Method for Pain Relief and Management-White Paper 2017.
SO  - The Journal of Integrative Medicine. 15(6):411-425, 2017 Nov
AS  - J. integr. med.. 15(6):411-425, 2017 Nov
NJ  - Journal of integrative medicine
VO  - 15
IP  - 6
PG  - 411-425
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - 101603118
IO  - J Integr Med
CP  - Netherlands
AB  - The United States (U.S.) is facing a national opioid epidemic, and medical systems are in need of non-pharmacologic strategies that can be employed to decrease the public's opioid dependence. Acupuncture has emerged as a powerful, evidence-based, safe, cost-effective, and available treatment modality suitable to meeting this need. Acupuncture has been shown to be effective for the management of numerous types of pain conditions, and mechanisms of action for acupuncture have been described and are understandable from biomedical, physiologic perspectives. Further, acupuncture's cost-effectiveness can dramatically decrease health care expenditures, both from the standpoint of treating acute pain and through avoiding addiction to opioids that requires costly care, destroys quality of life, and can lead to fatal overdose. Numerous federal regulatory agencies have advised or mandated that healthcare systems and providers offer non-pharmacologic treatment options for pain. Acupuncture stands out as the most evidence-based, immediately available choice to fulfil these calls. Acupuncture can safely, easily, and cost-effectively be incorporated into hospital settings as diverse as the emergency department, labor and delivery suites, and neonatal intensive care units to treat a variety of commonly seen pain conditions. Acupuncture is already being successfully and meaningfully utilized by the Veterans Administration and various branches of the U.S. Military, in some studies demonstrably decreasing the volume of opioids prescribed when included in care.
IS  - 2095-4964
DI  - S2095-4964(17)60378-9
DO  - https://dx.doi.org/10.1016/S2095-4964(17)60378-9
PT  - Journal Article
ID  - S2095-4964(17)60378-9 [pii]
ID  - 10.1016/S2095-4964(17)60378-9 [doi]
PP  - ppublish
LG  - English
DP  - 2017 Nov
EZ  - 2017/11/07 06:00
DA  - 2017/11/07 06:00
DT  - 2017/11/07 06:00
YR  - 2017
RD  - 20180124
UP  - 20180125
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29103410

<1058. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28802541
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Molokie RE
AU  - Montminy C
AU  - Dionisio C
AU  - Farooqui MA
AU  - Gowhari M
AU  - Yao Y
AU  - Suarez ML
AU  - Ezenwa MO
AU  - Schlaeger JM
AU  - Wang ZJ
AU  - Wilkie DJ
FA  - Molokie, Robert E
FA  - Montminy, Chariz
FA  - Dionisio, Corissa
FA  - Farooqui, Muhammad Ahmen
FA  - Gowhari, Michel
FA  - Yao, Yingwei
FA  - Suarez, Marie L
FA  - Ezenwa, Miriam O
FA  - Schlaeger, Judith M
FA  - Wang, Zaijie J
FA  - Wilkie, Diana J
IN  - Molokie, Robert E. University of Illinois at Chicago, College of Medicine, Department of Hematology/Oncology, 820 S. Wood Street Suite 172 CSN (M/C 712), Chicago, IL 60612, United States; Jesse Brown Veterans Administration Medical Center, 820 S. Damen Avenue, MP 111, Chicago, IL 60612, United States; University of Illinois at Chicago, College of Pharmacy, Department of Biopharmaceutical Sciences, 833 S. Wood Street, Chicago, IL 60612, United States. Electronic address: remolokie@uic.edu.
IN  - Montminy, Chariz. University of Illinois Hospital and Health Sciences System, Department of Nursing, 1740 W. Taylor, Chicago, IL 60614, United States. Electronic address: ccalip2@uic.edu.
IN  - Dionisio, Corissa. Riley Hospital for Children at Indiana University Health Department of Psychiatry, 705 Riley Hospital Drive, Indianapolis, IN 46202, United States. Electronic address: coridion@iu.edu.
IN  - Farooqui, Muhammad Ahmen. Saint George's University, University Centre, Grenada.
IN  - Gowhari, Michel. University of Illinois at Chicago, College of Medicine, Department of Hematology/Oncology, 820 S. Wood Street Suite 172 CSN (M/C 712), Chicago, IL 60612, United States. Electronic address: mgowhal@uic.edu.
IN  - Yao, Yingwei. University of Illinois at Chicago, College of Nursing, Department of Biobehavioral Health Science, 845 S. Damen Avenue, (M/C 802), Chicago, IL 60612, United States; University of Florida, College of Nursing, Department of Biobehavioral Nursing Science, 1225 Center Drive, Room 2203, Gainesville, FL 32610, United States. Electronic address: yyao@uic.edu.
IN  - Suarez, Marie L. University of Illinois at Chicago, College of Nursing, Department of Biobehavioral Health Science, 845 S. Damen Avenue, (M/C 802), Chicago, IL 60612, United States. Electronic address: mlsuarez@uic.edu.
IN  - Ezenwa, Miriam O. University of Illinois at Chicago, College of Nursing, Department of Biobehavioral Health Science, 845 S. Damen Avenue, (M/C 802), Chicago, IL 60612, United States; University of Florida, College of Nursing, Department of Biobehavioral Nursing Science, 1225 Center Drive, Room 2203, Gainesville, FL 32610, United States. Electronic address: moezenwa@uic.edu.
IN  - Schlaeger, Judith M. University of Illinois at Chicago, College of Nursing, Department of Women, Children and Family Health Science, 845 S. Damen Avenue, (M/C 802), Chicago, IL 60612, United States. Electronic address: jschlaeg@uic.edu.
IN  - Wang, Zaijie J. University of Illinois at Chicago, College of Pharmacy, Department of Biopharmaceutical Sciences, 833 S. Wood Street, Chicago, IL 60612, United States. Electronic address: zjwang@uic.edu.
IN  - Wilkie, Diana J. University of Illinois at Chicago, College of Nursing, Department of Biobehavioral Health Science, 845 S. Damen Avenue, (M/C 802), Chicago, IL 60612, United States; University of Florida, College of Nursing, Department of Biobehavioral Nursing Science, 1225 Center Drive, Room 2203, Gainesville, FL 32610, United States. Electronic address: diwilkie@uic.edu.
TI  - Opioid doses and acute care utilization outcomes for adults with sickle cell disease: ED versus acute care unit.
SO  - American Journal of Emergency Medicine. 36(1):88-92, 2018 Jan
AS  - Am J Emerg Med. 36(1):88-92, 2018 Jan
NJ  - The American journal of emergency medicine
VO  - 36
IP  - 1
PG  - 88-92
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - aa2, 8309942
IO  - Am J Emerg Med
CP  - United States
KW  - Acute care unit;  Emergency department;  Hospital admission;  Opioid;  Pain;  Sickle cell disease
AB  - BACKGROUND: Acute care units (ACUs) with focused sickle cell disease (SCD) care have been shown to effectively address pain and limit hospitalizations compared to emergency departments (ED), the reason for differences in admission rates is understudied. Our aim was compare effects of usual care for adult SCD pain in ACU and ED on opioid doses and discharge pain ratings, hospital admission rates and lengths of stay.
AB  - METHODS: In a retrospective, comparative cohort, single academic tertiary center study, 148 adults with sickle cell pain received care in the ED, ACU or both. From the medical records we documented opioid doses, unit discharge pain ratings, hospital admission rates, and lengths of stay.
AB  - FINDINGS: Pain on admission to the ED averaged 8.7+/-1.5 and to the ACU averaged 8.0+/-1.6. The average pain on discharge from the ED was 6.4+/-3.0 and for the ACU was 4.5+/-2.5. 70% of the 144 ED visits resulted in hospital admissions as compared to 37% of the 73 ACU visits. Admissions from the ED or ACU had similar inpatient lengths of stay. Significant differences between ED and ACU in first opioid dose and hourly opioid dose were noted.
AB  - CONCLUSIONS: Applying guidelines for higher dosing of opioids for acute painful episodes in adults with SCD in ACU was associated with improved pain outcomes and decreased hospitalizations, compared to ED. Adoption of this approach for SCD pain in ED may result in improved outcomes, including a decrease in hospital admissions.

Copyright Published by Elsevier Inc.
ES  - 1532-8171
IL  - 0735-6757
DI  - S0735-6757(17)30566-1
DO  - https://dx.doi.org/10.1016/j.ajem.2017.07.037
PT  - Journal Article
ID  - S0735-6757(17)30566-1 [pii]
ID  - 10.1016/j.ajem.2017.07.037 [doi]
PP  - ppublish
PH  - 2017/04/20 [received]
PH  - 2017/07/11 [revised]
PH  - 2017/07/12 [accepted]
LG  - English
EP  - 20170713
DP  - 2018 Jan
EZ  - 2017/08/15 06:00
DA  - 2017/08/15 06:00
DT  - 2017/08/14 06:00
YR  - 2018
RD  - 20171215
UP  - 20171215
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28802541

<1059. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28709712
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Patel NA
AU  - Afshar S
FA  - Patel, Nisarg A
FA  - Afshar, Salim
IN  - Patel, Nisarg A. Harvard School of Dental Medicine, 188 Longwood Ave, Boston, MA 02115, USA. Electronic address: nisarg_patel@hms.harvard.edu.
IN  - Afshar, Salim. Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, USA. Electronic address: salim.afshar@childrens.harvard.edu.
TI  - Addressing the high rate of opioid prescriptions for dental pain in the emergency department.
SO  - American Journal of Emergency Medicine. 36(1):138-139, 2018 Jan
AS  - Am J Emerg Med. 36(1):138-139, 2018 Jan
NJ  - The American journal of emergency medicine
VO  - 36
IP  - 1
PG  - 138-139
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - aa2, 8309942
IO  - Am J Emerg Med
CP  - United States
KW  - Health policy;  Opioids;  Pain management;  Public health
ES  - 1532-8171
IL  - 0735-6757
DI  - S0735-6757(17)30512-0
DO  - https://dx.doi.org/10.1016/j.ajem.2017.07.003
PT  - Letter
ID  - S0735-6757(17)30512-0 [pii]
ID  - 10.1016/j.ajem.2017.07.003 [doi]
PP  - ppublish
PH  - 2017/05/03 [received]
PH  - 2017/06/30 [revised]
PH  - 2017/07/02 [accepted]
LG  - English
EP  - 20170703
DP  - 2018 Jan
EZ  - 2017/07/16 06:00
DA  - 2017/07/16 06:00
DT  - 2017/07/16 06:00
YR  - 2018
RD  - 20171215
UP  - 20171215
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28709712

<1060. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29128677
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Hollingsworth A
AU  - Ruhm CJ
AU  - Simon K
FA  - Hollingsworth, Alex
FA  - Ruhm, Christopher J
FA  - Simon, Kosali
IN  - Hollingsworth, Alex. School of Public and Environmental Affairs, Indiana University, United States.
IN  - Ruhm, Christopher J. Public Policy and Economics, Frank Batten School of Leadership and Public Policy, University of Virginia, United States; NBER, United States.
IN  - Simon, Kosali. School of Public and Environmental Affairs, Indiana University, United States; NBER, United States. Electronic address: simonkos@indiana.edu.
TI  - Macroeconomic conditions and opioid abuse.
SO  - Journal of Health Economics. 56:222-233, 2017 Dec
AS  - J Health Econ. 56:222-233, 2017 Dec
NJ  - Journal of health economics
VO  - 56
PG  - 222-233
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 8410622, jhe
IO  - J Health Econ
CP  - Netherlands
KW  - Macroeconomic conditions;  Opioids;  Unemployment
AB  - We examine how deaths and emergency department (ED) visits related to use of opioid analgesics (opioids) and other drugs vary with macroeconomic conditions. As the county unemployment rate increases by one percentage point, the opioid death rate per 100,000 rises by 0.19 (3.6%) and the opioid overdose ED visit rate per 100,000 increases by 0.95 (7.0%). Macroeconomic shocks also increase the overall drug death rate, but this increase is driven by rising opioid deaths. Our findings hold when performing a state-level analysis, rather than county-level; are primarily driven by adverse events among whites; and are stable across time periods.

Copyright © 2017 Elsevier B.V. All rights reserved.
ES  - 1879-1646
IL  - 0167-6296
DI  - S0167-6296(17)30338-7
DO  - https://dx.doi.org/10.1016/j.jhealeco.2017.07.009
PT  - Journal Article
ID  - S0167-6296(17)30338-7 [pii]
ID  - 10.1016/j.jhealeco.2017.07.009 [doi]
PP  - ppublish
PH  - 2017/04/10 [received]
PH  - 2017/07/31 [accepted]
LG  - English
EP  - 20170823
DP  - 2017 Dec
EZ  - 2017/11/13 06:00
DA  - 2017/11/13 06:00
DT  - 2017/11/13 06:00
YR  - 2017
RD  - 20171217
UP  - 20171218
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29128677

<1061. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29132953
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Guy GP Jr
AU  - Pasalic E
AU  - Zhang K
FA  - Guy, Gery P Jr
FA  - Pasalic, Emilia
FA  - Zhang, Kun
IN  - Guy, Gery P Jr. Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: irm2@cdc.gov.
IN  - Pasalic, Emilia. Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
IN  - Zhang, Kun. Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
TI  - Emergency Department Visits Involving Opioid Overdoses, U.S., 2010-2014.
SO  - American Journal of Preventive Medicine. 54(1):e37-e39, 2018 Jan
AS  - Am J Prev Med. 54(1):e37-e39, 2018 Jan
NJ  - American journal of preventive medicine
VO  - 54
IP  - 1
PG  - e37-e39
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 8704773, apl
IO  - Am J Prev Med
CP  - Netherlands
ES  - 1873-2607
IL  - 0749-3797
DI  - S0749-3797(17)30494-4
DO  - https://dx.doi.org/10.1016/j.amepre.2017.09.003
PT  - Journal Article
ID  - S0749-3797(17)30494-4 [pii]
ID  - 10.1016/j.amepre.2017.09.003 [doi]
PP  - ppublish
PH  - 2017/05/05 [received]
PH  - 2017/08/09 [revised]
PH  - 2017/09/06 [accepted]
LG  - English
EP  - 20171111
DP  - 2018 Jan
EZ  - 2017/11/15 06:00
DA  - 2017/11/15 06:00
DT  - 2017/11/15 06:00
YR  - 2018
RD  - 20171219
UP  - 20171219
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29132953

<1062. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28967324
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Barry CL
FA  - Barry, Colleen L
IN  - Barry, Colleen L. Dr. Barry is the Fred and Julie Soper Professor and Chair of the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore.
TI  - Fentanyl and the Evolving Opioid Epidemic: What Strategies Should Policy Makers Consider?.
SO  - Psychiatric Services. 69(1):100-103, 2018 Jan 01
AS  - Psychiatr Serv. 69(1):100-103, 2018 Jan 01
NJ  - Psychiatric services (Washington, D.C.)
VO  - 69
IP  - 1
PG  - 100-103
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 9502838, b8t
IO  - Psychiatr Serv
CP  - United States
AB  - Major policy efforts are being aimed at combating the epidemic of opioid addiction and overdose deaths. In response to the epidemic, the medical community and policy makers have attempted to intervene; to date, these varied approaches have done little to reverse the increase in mortality related to opioid overdose. One factor that has complicated efforts to control overdose deaths has been the emergence of a public health crisis related to illicit fentanyl. The rise in fentanyl-related overdose deaths means that new approaches are needed to combat the opioid epidemic, including adoption of harm reduction strategies. Specific strategies that should be considered as part of efforts to combat the opioid crisis include safe drug consumption sites, anonymous drug-checking services, updated naloxone distribution policies, harm reduction-oriented policing, expansion of evidence-based pharmacological treatments in criminal justice and emergency department settings, and stigma-reduction messaging emphasizing the risks of fentanyl.
ES  - 1557-9700
IL  - 1075-2730
DO  - https://dx.doi.org/10.1176/appi.ps.201700235
PT  - Journal Article
ID  - 10.1176/appi.ps.201700235 [doi]
PP  - ppublish
LG  - English
EP  - 20171002
DP  - 2018 Jan 01
EZ  - 2017/10/03 06:00
DA  - 2017/10/03 06:00
DT  - 2017/10/03 06:00
YR  - 2018
RD  - 20180102
UP  - 20180102
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28967324

<1063. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29102093
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Faryar KA
AU  - Freeman CL
AU  - Persaud AK
AU  - Furmanek SP
AU  - Guinn BE
AU  - Mattingly WA
AU  - Wiemken TL
AU  - Buckner KA
AU  - Huecker MR
FA  - Faryar, Kiran A
FA  - Freeman, Clifford L
FA  - Persaud, Annuradha K
FA  - Furmanek, Stephen P
FA  - Guinn, Brian E
FA  - Mattingly, William A
FA  - Wiemken, Timothy L
FA  - Buckner, Kimberley A
FA  - Huecker, Martin R
IN  - Faryar, Kiran A. Department of Emergency Medicine, University of Louisville School of Medicine, Louisville, Kentucky.
IN  - Freeman, Clifford L. Department of Emergency Medicine, University of Louisville School of Medicine, Louisville, Kentucky.
IN  - Persaud, Annuradha K. Division of Infectious Diseases Clinical Research Support Program, University of Louisville School of Medicine, Louisville, Kentucky.
IN  - Furmanek, Stephen P. Division of Infectious Diseases Clinical Research Support Program, University of Louisville School of Medicine, Louisville, Kentucky.
IN  - Guinn, Brian E. Division of Infectious Diseases Clinical Research Support Program, University of Louisville School of Medicine, Louisville, Kentucky.
IN  - Mattingly, William A. Division of Infectious Diseases Clinical Research Support Program, University of Louisville School of Medicine, Louisville, Kentucky.
IN  - Wiemken, Timothy L. Division of Infectious Diseases Clinical Research Support Program, University of Louisville School of Medicine, Louisville, Kentucky.
IN  - Buckner, Kimberley A. Division of Infectious Diseases Clinical Research Support Program, University of Louisville School of Medicine, Louisville, Kentucky.
IN  - Huecker, Martin R. Department of Emergency Medicine, University of Louisville School of Medicine, Louisville, Kentucky.
TI  - The Effects of Kentucky's Comprehensive Opioid Legislation on Patients Presenting with Prescription Opioid or Heroin Abuse to One Urban Emergency Department.
SO  - Journal of Emergency Medicine. 53(6):805-814, 2017 Dec
AS  - J Emerg Med. 53(6):805-814, 2017 Dec
NJ  - The Journal of emergency medicine
VO  - 53
IP  - 6
PG  - 805-814
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - ibo, 8412174
IO  - J Emerg Med
CP  - United States
KW  - Kentucky;  heroin;  opioid legislation;  opioids;  substance abuse
AB  - BACKGROUND: Prescription opioid abuse has increased to epidemic proportions in the United States. Kentucky, along with other states, passed comprehensive legislation to monitor and curb opioid prescribing.
AB  - OBJECTIVES: This paper characterizes patients who presented to the emergency department (ED) after abusing prescription opioids and heroin prior to and after the passage of House Bill 1 (HB1) in April 2012.
AB  - METHODS: Based on a retrospective review of ED visits from 2009-2014 in one urban adult facility, patients were included if the chief complaint or diagnosis was directly related to prescription opioid or heroin abuse. The primary outcome is the number and type of substance abused by each ED patient.
AB  - RESULTS: From 2009-2014, 2945 patients presented to the ED after prescription opioid or heroin abuse. The number of prescription opioid patients decreased from 215 (of 276 patients) in 2009 to 203 (of 697 patients) in 2014; 77.9% of patients abused opioids in 2009, vs. 29% in 2014 (a 63% decrease). The number of heroin patients increased from 61 in 2009 to 494 in 2014; 22% of patients in 2009 abused heroin, vs. 71% in 2014 (a 221% increase). Both piecewise regression and autoregressive integrated moving average trend models showed an increased trend in patient heroin abuse beginning in 2011-2012.
AB  - CONCLUSIONS: Our facility experienced a decrease in the number of patients who abused prescription opioids and an increase in the number of patients who abused heroin over the study period. The transition seemed to occur just prior to, or concurrent with, enforcement of statewide opioid legislation.

Copyright © 2017 Elsevier Inc. All rights reserved.
IS  - 0736-4679
IL  - 0736-4679
DI  - S0736-4679(17)30772-2
DO  - https://dx.doi.org/10.1016/j.jemermed.2017.08.066
PT  - Journal Article
ID  - S0736-4679(17)30772-2 [pii]
ID  - 10.1016/j.jemermed.2017.08.066 [doi]
PP  - ppublish
PH  - 2017/04/07 [received]
PH  - 2017/06/28 [revised]
PH  - 2017/08/11 [accepted]
LG  - English
EP  - 20171106
DP  - 2017 Dec
EZ  - 2017/11/06 06:00
DA  - 2017/11/06 06:00
DT  - 2017/11/06 06:00
YR  - 2017
RD  - 20171202
UP  - 20171204
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29102093

<1064. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28644688
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Elliott A
AU  - Dube PA
AU  - Cossette-Cote A
AU  - Patakfalvi L
AU  - Villeneuve E
AU  - Morris M
AU  - Gosselin S
AI  - Dube, Pierre-Andre; ORCID: http://orcid.org/0000-0003-0114-7648
AI  - Villeneuve, Eric; ORCID: http://orcid.org/0000-0003-0510-8144
AI  - Morris, Martin; ORCID: http://orcid.org/0000-0002-5659-2995
AI  - Gosselin, Sophie; ORCID: http://orcid.org/0000-0002-0694-5588
FA  - Elliott, Audree
FA  - Dube, Pierre-Andre
FA  - Cossette-Cote, Amelie
FA  - Patakfalvi, Laura
FA  - Villeneuve, Eric
FA  - Morris, Martin
FA  - Gosselin, Sophie
IN  - Elliott, Audree. a Department of Environmental Health and Toxicology , Institut National de Sante Publique du Quebec , Quebec , QC , Canada.
IN  - Dube, Pierre-Andre. a Department of Environmental Health and Toxicology , Institut National de Sante Publique du Quebec , Quebec , QC , Canada.
IN  - Dube, Pierre-Andre. b Faculty of Pharmacy , Universite Laval , QC , Canada.
IN  - Cossette-Cote, Amelie. c Department of Pharmacy, Centre Integre de Sante et de Services Sociaux du Bas-Saint-Laurent , Hopital de Rimouski , Rimouski , QC , Canada.
IN  - Patakfalvi, Laura. d Department of Family Medicine & Hospital Medicine , McGill University , Montreal , Canada.
IN  - Villeneuve, Eric. e Department of Pharmacy , McGill University Health Centre , Montreal , Quebec , Canada.
IN  - Morris, Martin. f Schulich Library of Physical Sciences, Life Sciences and Engineering , McGill University , Montreal , Canada.
IN  - Gosselin, Sophie. g Department of Medicine and Emergency Medicine , McGill University Health Centre , Montreal , Quebec , Canada.
IN  - Gosselin, Sophie. h Centre antipoison du Quebec, Province of Alberta Drug Information Service , Quebec , Canada.
TI  - Intraosseous administration of antidotes - a systematic review.
SO  - Clinical Toxicology: The Official Journal of the American Academy of Clinical Toxicology & European Association of Poisons Centres & Clinical Toxicologists. 55(10):1025-1054, 2017 Dec
AS  - Clin Toxicol (Phila). 55(10):1025-1054, 2017 Dec
NJ  - Clinical toxicology (Philadelphia, Pa.)
VO  - 55
IP  - 10
PG  - 1025-1054
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 101241654
IO  - Clin Toxicol (Phila)
CP  - England
KW  - Intoxication;  administration route;  poisoning;  shock;  treatment
AB  - CONTEXT: Intraosseous (IO) access is an established route of administration in resuscitation situations. Patients with serious poisoning presenting to the emergency department may require urgent antidote therapy. However, intravenous (IV) access is not always readily available.
AB  - OBJECTIVE: This study reviews the current evidence for IO administration of antidotes that could be used in poisoning. The primary outcome was mortality as a surrogate of efficacy. Secondary outcomes included hemodynamic variables, electrocardiographic variables, neurological status, pharmacokinetics outcomes, and adverse effects as defined by each article.
AB  - METHODS: A medical librarian created a systematic search strategy for Medline, subsequently translated to Embase, BIOSIS, PubMed, Web of Science, Cochrane, Database of Abstracts of Reviews of Effects (DARE), and the CENTRAL clinical trial register, all of which we searched from inception to 30 June 2016. Interventions included IO administration of selected antidotes. Articles included volunteer studies, poisoning, or other resuscitation contexts such as cardiac arrest, burns, dehydration, seizure, hemorrhagic shock, or undifferentiated shock. We considered all human studies and animal experiments to the exception of in vitro studies. Two reviewers independently selected studies, and a third adjudicated in case of disagreement. Three reviewers extracted all relevant data. Three reviewers evaluated the risk of bias and quality of the articles using specific scales according to each type of study design.
AB  - RESULTS: A total of 47 publications (46 articles and one abstract) met our inclusion criteria and described IO administration of 13 different antidotes. These included one case series and 21 case reports describing 26 patients, and 25 animal experiments. Of those, seven human case reports and four animal experiments specifically reported the use of antidotes in poisoning. Human case reports suggested favorable outcomes with IO use of atropine, diazepam, hydroxocobalamin, insulin, lipid emulsion, methylene blue, phentolamine, prothrombin complex concentrate, and sodium bicarbonate. Clinical outcomes varied according to the antidote used. The only reported adverse event was ventricular tachycardia following IO naloxone. Regarding the animal experiments, IO administration of lipid emulsion and of hydroxocobalamin showed improved survival in bupivacaine-poisoned rats and in cyanide-intoxicated swine, respectively. Animal data also suggested an equivalent bio-availability between IO and IV administration for atropine, calcium chloride, dextrose 50%, diazepam, methylene blue, pralidoxime, and sodium bicarbonate. Adverse effect reporting of fat emboli after IO administration of sodium bicarbonate, for example, was conflicting due to the significant heterogeneity in the timing of lung examination across studies.
AB  - CONCLUSION: The evidence supporting the use of IO route for the administration of antidotes in a context of poisoning is scarce. The majority of the evidence consists of case reports and animal experiments. Common antidotes such as acetylcysteine, fomepizole, and digoxin-specific antibody fragments have not been studied or reported with the use of the IO route. Despite the low-quality evidence available, IO access is a potential option for antidotal treatments in toxicological resuscitation when IV access is unavailable.
ES  - 1556-9519
IL  - 1556-3650
DO  - https://dx.doi.org/10.1080/15563650.2017.1337122
PT  - Journal Article
ID  - 10.1080/15563650.2017.1337122 [doi]
PP  - ppublish
LG  - English
EP  - 20170623
DP  - 2017 Dec
EZ  - 2017/06/24 06:00
DA  - 2017/06/24 06:00
DT  - 2017/06/24 06:00
YR  - 2017
RD  - 20171201
UP  - 20171201
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28644688

<1065. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28958216
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Upadhye S
FA  - Upadhye, Suneel
IN  - Upadhye, Suneel. *Division of Emergency Medicine,McMaster University,Hamilton,ON.
TI  - Creating opioid dependence in the emergency department.
SO  - CJEM Canadian Journal of Emergency Medical Care. 20(1):100-103, 2018 Jan
AS  - CJEM, Can. j. emerg. med. care. 20(1):100-103, 2018 Jan
NJ  - CJEM
VO  - 20
IP  - 1
PG  - 100-103
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 100893237
IO  - CJEM
CP  - England
KW  - ED initiation;  opioid dependence
AB  - Clinical question What is the risk of creating opioid dependence from an ED opioid prescription? Article chosen Barnett ML, Olenski AR, Jena AB. Opioid-prescribing patterns of emergency physicians and risk of long-term use. N Engl J Med 2017;376:663-73, doi:10.1056/NEJMsa1610524.
AB  - OBJECTIVE: This study examined the risk of creating long-term opioid dependence from a prescription written in an opioid-naive patient in the ED.
IS  - 1481-8035
IL  - 1481-8035
DO  - https://dx.doi.org/10.1017/cem.2017.370
PT  - Journal Article
ID  - S1481803517003700 [pii]
ID  - 10.1017/cem.2017.370 [doi]
PP  - ppublish
LG  - English
EP  - 20170929
DP  - 2018 Jan
EZ  - 2017/09/30 06:00
DA  - 2017/09/30 06:00
DT  - 2017/09/30 06:00
YR  - 2018
RD  - 20180115
UP  - 20180115
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28958216

<1066. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28646524
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Fox LM
AU  - Hoffman RS
AU  - Vlahov D
AU  - Manini AF
AI  - Fox, Lindsay M; ORCID: http://orcid.org/0000-0001-5027-2694
AI  - Hoffman, Robert S; ORCID: http://orcid.org/0000-0002-0091-9573
AI  - Manini, Alex F; ORCID: http://orcid.org/0000-0001-8276-9320
FA  - Fox, Lindsay M
FA  - Hoffman, Robert S
FA  - Vlahov, David
FA  - Manini, Alex F
IN  - Fox, Lindsay M. Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, NY, USA.
IN  - Hoffman, Robert S. Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, NY, USA.
IN  - Vlahov, David. Yale School of Nursing, New Haven CT, USA.
IN  - Manini, Alex F. Division of Medical Toxicology, Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, New York, NY, USA.
TI  - Risk factors for severe respiratory depression from prescription opioid overdose.
SO  - Addiction. 113(1):59-66, 2018 Jan
AS  - Addiction. 113(1):59-66, 2018 Jan
NJ  - Addiction (Abingdon, England)
VO  - 113
IP  - 1
PG  - 59-66
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - bm3, 9304118
IO  - Addiction
CP  - England
KW  - Drug abuse;  drug overdose;  emergency medicine;  hypoventilation;  naloxone;  opioid-related disorders
AB  - BACKGROUND AND AIMS: Prescription opioid overdose is a leading cause of injury-related morbidity and mortality in the United States. We aimed to identify characteristics associated with clinical severity in emergency department patients with prescription opioid overdose.
AB  - DESIGN: This was a secondary data analysis of adult prescription opioid overdoses from a large prospective cohort of acute overdoses. We examined elements of a typical emergency department evaluation using a multivariable model to determine which characteristics were associated with clinical severity, specifically severe respiratory depression (SRD).
AB  - SETTING: This study was conducted at two urban academic emergency departments in New York City, USA.
AB  - PARTICIPANTS: Adult patients who presented with acute prescription opioid overdose between 2009 and 2013 were included in the current study. We analyzed 307 patients (mean age = 44.7, 42% female, 2.0% mortality).
AB  - MEASUREMENTS: Patient demographics, reported substances ingested, suspected intent for ingesting the substance, vital signs, laboratory data, treatments including antidotes and intubation and outcome of death were recorded by trained research assistants. Intent was categorized into four mutually exclusive categories: suicide, misuse, therapeutic error and undetermined. The primary outcome was SRD, defined as administration of either (a) naloxone or (b) endotracheal intubation (ETI).
AB  - FINDINGS: A total of 109 patients suffered SRD with 90 patients receiving naloxone alone, nine ETI alone and 10 both naloxone and ETI. The most common opioids were oxycodone (n = 124) and methadone (n = 116). Mean age was higher in patients with SRD (51.1 versus 41.1, P < 0.001). Opioid misuse was associated with SRD in the multivariable analysis [odds ratio (OR) = 2.07, 95% confidence interval (CI) = 1.21-3.55]. The unadjusted relative risk of SRD was high for fentanyl (83.3% SRD) and lowest for codeine (3.6% SRD).
AB  - CONCLUSION: In emergency department patients in the United States with prescription opioid overdose, worse clinical severity was associated with opioid misuse, increased with age and was widely variable, depending on the specific opioid medication involved.

Copyright © 2017 Society for the Study of Addiction.
ES  - 1360-0443
IL  - 0965-2140
DO  - https://dx.doi.org/10.1111/add.13925
PT  - Journal Article
ID  - 10.1111/add.13925 [doi]
ID  - PMC5725269 [pmc]
ID  - NIHMS887578 [mid]
PP  - ppublish
PH  - 2016/06/07 [received]
PH  - 2016/10/24 [revised]
PH  - 2017/06/19 [accepted]
GI  - No: K23 DA026476
Organization: (DA) *NIDA NIH HHS*
Country: United States

GI  - No: R01 DA037317
Organization: (DA) *NIDA NIH HHS*
Country: United States
LG  - English
EP  - 20170906
DP  - 2018 Jan
PQ  - 2019/01/01
EZ  - 2017/06/25 06:00
DA  - 2017/06/25 06:00
DT  - 2017/06/25 06:00
YR  - 2018
RD  - 20171213
UP  - 20171214
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28646524

<1067. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28971325
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Griswold MK
AU  - Chai PR
AU  - Krotulski AJ
AU  - Friscia M
AU  - Chapman BP
AU  - Varma N
AU  - Boyer EW
AU  - Logan BK
AU  - Babu KM
FA  - Griswold, Matthew K
FA  - Chai, Peter R
FA  - Krotulski, Alex J
FA  - Friscia, Melissa
FA  - Chapman, Brittany P
FA  - Varma, Neha
FA  - Boyer, Edward W
FA  - Logan, Barry K
FA  - Babu, Kavita M
IN  - Griswold, Matthew K. Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
IN  - Chai, Peter R. Division of Medical Toxicology, Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
IN  - Krotulski, Alex J. Center for Forensic Science Research and Education, Fredric Rieders Family Foundation, Willow Grove, PA, USA.
IN  - Friscia, Melissa. Center for Forensic Science Research and Education, Fredric Rieders Family Foundation, Willow Grove, PA, USA.
IN  - Chapman, Brittany P. Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
IN  - Varma, Neha. Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA.
IN  - Boyer, Edward W. Division of Medical Toxicology, Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
IN  - Logan, Barry K. Center for Forensic Science Research and Education, Fredric Rieders Family Foundation, Willow Grove, PA, USA.
IN  - Babu, Kavita M. Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA. kavitambabu@gmail.com.
TI  - A Novel Oral Fluid Assay (LC-QTOF-MS) for the Detection of Fentanyl and Clandestine Opioids in Oral Fluid After Reported Heroin Overdose.
SO  - Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology. 13(4):287-292, 2017 Dec
AS  - J Med Toxicol. 13(4):287-292, 2017 Dec
NJ  - Journal of medical toxicology : official journal of the American College of Medical Toxicology
VO  - 13
IP  - 4
PG  - 287-292
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 101284598
IO  - J Med Toxicol
CP  - United States
KW  - Drug test;  Fentanyl;  Heroin;  Oral fluid;  QTOF
AB  - INTRODUCTION: The adulteration of heroin with non-pharmaceutical fentanyl and other high-potency opioids is one of the factors contributing to striking increases in overdose deaths. To fully understand the magnitude of this problem, accurate detection methods for fentanyl and other novel opioid adulterant exposures are urgently required. The objective of this work was to compare the detection of fentanyl in oral fluid and urine specimens using liquid chromatography quadrupole time-of-flight mass spectrometry (LC-QTOF-MS) in a population of heroin users presenting to the Emergency Department after overdose.
AB  - METHODS: This was a prospective observational study of adult Emergency Department patients who presented after a reported heroin overdose requiring naloxone administration. Participants provided paired oral fluid and urine specimens, which were prepared, extracted, and analyzed using a dual LC-QTOF-MS workflow for the identification of traditional and emerging drugs of abuse. Analytical instrumentation included SCIEX TripleTOF 5600+ and Waters Xevo G2-S QTOF systems.
AB  - RESULTS: Thirty participants (N = 30) were enrolled during the study period. Twenty-nine participants had fentanyl detected in their urine, while 27 had fentanyl identified in their oral fluid (overall agreement 93.3%, positive percent agreement 93.1%). Cohen's Kappa (k) was calculated and demonstrated moderately, significant agreement (k = 0.47; p value 0.002) in fentanyl detection between oral fluid and urine using this LC-QTOF-MS methodology. Additional novel opioids and metabolites, including norfentanyl, acetylfentanyl, and U-47700, were detected during this study.
AB  - CONCLUSION: In this study of individuals presenting to the ED after reported heroin overdose, a strikingly high proportion had a detectable fentanyl exposure. Using LC-QTOF-MS, the agreement between paired oral fluid and urine testing for fentanyl detection indicates a role for oral fluid testing in surveillance for nonpharmaceutical fentanyl. Additionally, the use of LC-QTOF-MS allowed for the detection of other clandestine opioids (acetylfentanyl and U-47700) in oral fluid.
ES  - 1937-6995
IL  - 1556-9039
DO  - https://dx.doi.org/10.1007/s13181-017-0632-6
PT  - Journal Article
ID  - 10.1007/s13181-017-0632-6 [doi]
ID  - 10.1007/s13181-017-0632-6 [pii]
ID  - PMC5711761 [pmc]
PP  - ppublish
PH  - 2017/05/23 [received]
PH  - 2017/09/14 [accepted]
PH  - 2017/09/08 [revised]
GI  - No: 5K24DA037109
Organization: *National Institute on Drug Abuse*
Country: United States
LG  - English
EP  - 20171002
DP  - 2017 Dec
PQ  - 2018/12/01
EZ  - 2017/10/04 06:00
DA  - 2017/10/04 06:00
DT  - 2017/10/04 06:00
YR  - 2017
RD  - 20171213
UP  - 20171214
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28971325

<1068. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28576389
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Soares WE 3rd
AU  - Wilson D
AU  - Rathlev N
AU  - Lee JD
AU  - Gordon M
AU  - Nunes EV
AU  - O'Brien CP
AU  - Friedmann PD
FA  - Soares, William E 3rd
FA  - Wilson, Donna
FA  - Rathlev, Niels
FA  - Lee, Joshua D
FA  - Gordon, Michael
FA  - Nunes, Edward V
FA  - O'Brien, Charles P
FA  - Friedmann, Peter D
IN  - Soares, William E 3rd. Department of Emergency Medicine, Baystate Medical Center, 759 Chestnut St. Springfield, MA 01199, United States. Electronic address: William.soaresMD@baystatehealth.org.
IN  - Wilson, Donna. Baystate Medical Center, 759 Chestnut St. Springfield, MA 01199, United States. Electronic address: donna.wilson@baystatehealth.org.
IN  - Rathlev, Niels. Baystate Medical Center, 759 Chestnut St. Springfield, MA 01199, United States. Electronic address: Niels.rathlev@baystatehealth.org.
IN  - Lee, Joshua D. Department of Population Health, New York University, 227 E. 30th St., New York, NY 10016, United States. Electronic address: joshua.lee@nyumc.org.
IN  - Gordon, Michael. Friends Research Institute, 1040 Park Avenue, Baltimore, MD 21201, United States. Electronic address: mgordon@friendsresearch.org.
IN  - Nunes, Edward V. Columbia University Medical Center, 617 West End Avenue, New York, NY 10024, United States. Electronic address: Nunesed@nyspi.columbia.edu.
IN  - O'Brien, Charles P. Department of Psychiatry, University of Pennsylvania, Department of Behavior Health, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, United States. Electronic address: obrien@mail.med.upenn.edu.
IN  - Friedmann, Peter D. Baystate Medical Center, 759 Chestnut St. Springfield, MA 01199, United States. Electronic address: Peter.friedmannmd@baystatehealth.org.
TI  - Healthcare utilization in adults with opioid dependence receiving extended release naltrexone compared to treatment as usual.
SO  - Journal of Substance Abuse Treatment. 85:66-69, 2018 Feb
AS  - J Subst Abuse Treat. 85:66-69, 2018 Feb
NJ  - Journal of substance abuse treatment
VO  - 85
PG  - 66-69
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - kai, 8500909
IO  - J Subst Abuse Treat
CP  - United States
KW  - Criminal justice population;  Healthcare utilization;  Long acting naltrexone;  Opioid use disorders
AB  - BACKGROUND: Opioid use disorders have reached epidemic proportions, with overdose now the leading cause of accidental death in the United States. Extended release naltrexone (XR-NTX) has emerged as a medication treatment that reduces opioid use and craving. However, the effect of XR-NTX therapy on acute healthcare utilization, including emergency department visits and inpatient hospitalizations, remains uncertain. The objective of the current study is to evaluate hospital-based healthcare resource utilization in adults involved in the criminal justice system with a history of opioid use disorder randomized to XR-NTX therapy compared with treatment as usual (TAU) during a 6-month treatment phase and 12months post-treatment follow up.
AB  - METHODS: This retrospective exploratory analysis uses data collected in a published randomized trial. Comparisons of the number of emergency department visits and hospital admissions (for drug detox, psychiatric care and other medical reasons) were performed using chi square tests for any admission and negative binomial models for number of admissions.
AB  - RESULTS: Of the 308 participants randomized, 96% had utilization data (76% complete 6months, 67% complete follow up). No significant differences were seen in overall healthcare utilization (IRR=0.88, 95%CI 0.63-1.23, p=0.45), or substance use-related drug detox hospitalizations (IRR=0.83, 95%CI 0.32-2.16, p=0.71). Despite having more participants report chronic medical problems at baseline (43% vs. 32%, p=0.05), those receiving XR-NTX generally experienced equivalent or lower rates of healthcare utilization compared to TAU. The XR-NTX group had significantly lower medical/surgical related hospital admissions (IRR=0.55, 95%CI 0.30-1.00, p=0.05) during the course of the entire study.
AB  - CONCLUSIONS: XR-NTX did not significantly increase rates of healthcare utilization compared to TAU. Provider concerns regarding healthcare utilization should not preclude the consideration of XR-NTX as therapy for opioid use disorders.

Copyright © 2018 Elsevier Inc. All rights reserved.
ES  - 1873-6483
IL  - 0740-5472
DI  - S0740-5472(16)30374-9
DO  - https://dx.doi.org/10.1016/j.jsat.2017.05.009
PT  - Journal Article
ID  - S0740-5472(16)30374-9 [pii]
ID  - 10.1016/j.jsat.2017.05.009 [doi]
PP  - ppublish
PH  - 2016/10/01 [received]
PH  - 2017/05/10 [revised]
PH  - 2017/05/11 [accepted]
LG  - English
EP  - 20170512
DP  - 2018 Feb
EZ  - 2017/06/04 06:00
DA  - 2017/06/04 06:00
DT  - 2017/06/04 06:00
YR  - 2018
RD  - 20180102
UP  - 20180102
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28576389

<1069. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29181541
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Oliva EM
AU  - Bounthavong M
FA  - Oliva, Elizabeth M
FA  - Bounthavong, Mark
IN  - Oliva, Elizabeth M. From VA Program Evaluation and Resource Center, Office of Mental Health and Suicide Prevention, VA Center for Innovation to Implementation, Menlo Park, California; and VHA Pharmacy Benefits Management Services, Academic Detailing Service, Seattle, Washington.
IN  - Bounthavong, Mark. From VA Program Evaluation and Resource Center, Office of Mental Health and Suicide Prevention, VA Center for Innovation to Implementation, Menlo Park, California; and VHA Pharmacy Benefits Management Services, Academic Detailing Service, Seattle, Washington.
TI  - Emergency Medical Services Naloxone Administration: Many Unknowns and Opportunities.
SO  - Annals of Internal Medicine. 167(12):890-891, 2017 Dec 19
AS  - Ann Intern Med. 167(12):890-891, 2017 Dec 19
NJ  - Annals of internal medicine
VO  - 167
IP  - 12
PG  - 890-891
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 0372351
IO  - Ann. Intern. Med.
CP  - United States
ES  - 1539-3704
IL  - 0003-4819
DO  - https://dx.doi.org/10.7326/M17-2963
PT  - Journal Article
ID  - 2664377 [pii]
ID  - 10.7326/M17-2963 [doi]
PP  - ppublish
LG  - English
EP  - 20171128
DP  - 2017 Dec 19
EZ  - 2017/11/29 06:00
DA  - 2017/11/29 06:00
DT  - 2017/11/29 06:00
YR  - 2017
RD  - 20171219
UP  - 20171219
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29181541

<1070. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28918769
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Lacroix L
AU  - Thurgur L
AU  - Orkin AM
AU  - Perry JJ
AU  - Stiell IG
FA  - Lacroix, Lauren
FA  - Thurgur, Lisa
FA  - Orkin, Aaron M
FA  - Perry, Jeffrey J
FA  - Stiell, Ian G
IN  - Lacroix, Lauren. *Department of Emergency Medicine,University of Ottawa,Ottawa,ON.
IN  - Thurgur, Lisa. *Department of Emergency Medicine,University of Ottawa,Ottawa,ON.
IN  - Orkin, Aaron M. ++Schwartz/Reisman Emergency Medicine Institute,Mount Sinai, Toronto,ON.
IN  - Perry, Jeffrey J. *Department of Emergency Medicine,University of Ottawa,Ottawa,ON.
IN  - Stiell, Ian G. *Department of Emergency Medicine,University of Ottawa,Ottawa,ON.
TI  - Emergency physicians' attitudes and perceived barriers to the implementation of take-home naloxone programs in Canadian emergency departments.
SO  - CJEM Canadian Journal of Emergency Medical Care. 20(1):46-52, 2018 Jan
AS  - CJEM, Can. j. emerg. med. care. 20(1):46-52, 2018 Jan
NJ  - CJEM
VO  - 20
IP  - 1
PG  - 46-52
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 100893237
IO  - CJEM
CP  - England
KW  - emergency department;  naloxone;  opioids
AB  - OBJECTIVES: Rates of opioid-related deaths have reached the level of national public health crisis in Canada. Community-based opioid overdose education and naloxone distribution (OEND) programs distribute naloxone to people at risk, and the emergency department (ED) may be an underutilized setting to deliver naloxone to these people. The goal of this study was to identify Canadian emergency physicians' attitudes and perceived barriers to the implementation of take-home naloxone programs.
AB  - METHODS: This was an anonymous Web-based survey of members of the Canadian Association of Emergency Physicians. Survey questions were developed by the research team and piloted for face validity and clarity. Two reminder emails were sent to non-responders at 2-week intervals. Respondent demographics were collected, and Likert scales were used to assess attitudes and barriers to the prescription of naloxone from the ED.
AB  - RESULTS: A total of 459 physicians responded. The majority of respondents were male (64%), worked in urban tertiary centres (58.3%), and lived in Ontario (50.6%). Overall, attitudes to OEND were strongly positive; 86% identified a willingness to prescribe naloxone from the ED. Perceived barriers included support for patient education (57%), access to follow-up (44%), and inadequate time (37%). In addition to people at risk of overdose, 77% of respondents identified that friends and family members may also benefit.
AB  - CONCLUSIONS: Canadian emergency physicians are willing to distribute take-home naloxone, but thoughtful systems are required to facilitate opioid OEND implementation. These data will inform the development of these programs, with emphasis on multidisciplinary training and education.
IS  - 1481-8035
IL  - 1481-8035
DO  - https://dx.doi.org/10.1017/cem.2017.390
PT  - Journal Article
ID  - S1481803517003906 [pii]
ID  - 10.1017/cem.2017.390 [doi]
PP  - ppublish
LG  - English
EP  - 20170918
DP  - 2018 Jan
EZ  - 2017/09/19 06:00
DA  - 2017/09/19 06:00
DT  - 2017/09/19 06:00
YR  - 2018
RD  - 20180115
UP  - 20180115
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28918769

<1071. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29214309
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Abbasi J
FA  - Abbasi, Jennifer
TI  - Emergency Department Opioid Misuse Diagnoses Increasing in Adolescents and Young Adults.
SO  - JAMA. 318(24):2416-2417, 2017 Dec 26
AS  - JAMA. 318(24):2416-2417, 2017 Dec 26
NJ  - JAMA
VO  - 318
IP  - 24
PG  - 2416-2417
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - 7501160
IO  - JAMA
CP  - United States
ES  - 1538-3598
IL  - 0098-7484
DO  - https://dx.doi.org/10.1001/jama.2017.16586
PT  - Journal Article
ID  - 2665901 [pii]
ID  - 10.1001/jama.2017.16586 [doi]
PP  - ppublish
LG  - English
DP  - 2017 Dec 26
EZ  - 2017/12/08 06:00
DA  - 2017/12/08 06:00
DT  - 2017/12/08 06:00
YR  - 2017
RD  - 20171228
UP  - 20171228
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29214309

<1072. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28681615
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Griswold MK
AU  - Chai PR
AU  - Krotulski AJ
AU  - Friscia M
AU  - Chapman B
AU  - Boyer EW
AU  - Logan BK
AU  - Babu KM
AI  - Babu, Kavita M; ORCID: http://orcid.org/0000-0002-2908-0468
FA  - Griswold, Matthew K
FA  - Chai, Peter R
FA  - Krotulski, Alex J
FA  - Friscia, Melissa
FA  - Chapman, Brittany
FA  - Boyer, Edward W
FA  - Logan, Barry K
FA  - Babu, Kavita M
IN  - Griswold, Matthew K. a Division of Medical Toxicology, Department of Emergency Medicine , University of Massachusetts Medical School , Worcester , MA , USA.
IN  - Chai, Peter R. b Division of Medical Toxicology, Department of Emergency Medicine , Brigham and Women's Hospital, Harvard Medical School , Boston , MA , USA.
IN  - Krotulski, Alex J. c The Center for Forensic Science Research and Education (CFSRE) , Willow Grove , PA , USA.
IN  - Friscia, Melissa. c The Center for Forensic Science Research and Education (CFSRE) , Willow Grove , PA , USA.
IN  - Chapman, Brittany. a Division of Medical Toxicology, Department of Emergency Medicine , University of Massachusetts Medical School , Worcester , MA , USA.
IN  - Boyer, Edward W. b Division of Medical Toxicology, Department of Emergency Medicine , Brigham and Women's Hospital, Harvard Medical School , Boston , MA , USA.
IN  - Logan, Barry K. c The Center for Forensic Science Research and Education (CFSRE) , Willow Grove , PA , USA.
IN  - Logan, Barry K. d NMS Labs , Willow Grove , PA , USA.
IN  - Babu, Kavita M. a Division of Medical Toxicology, Department of Emergency Medicine , University of Massachusetts Medical School , Worcester , MA , USA.
TI  - Self-identification of nonpharmaceutical fentanyl exposure following heroin overdose.
SO  - Clinical Toxicology: The Official Journal of the American Academy of Clinical Toxicology & European Association of Poisons Centres & Clinical Toxicologists. 56(1):37-42, 2018 Jan
AS  - Clin Toxicol (Phila). 56(1):37-42, 2018 Jan
NJ  - Clinical toxicology (Philadelphia, Pa.)
VO  - 56
IP  - 1
PG  - 37-42
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 101241654
IO  - Clin Toxicol (Phila)
CP  - England
KW  - Heroin;  U-47700;  acetylfentanyl;  drug testing;  fentanyl;  opioid epidemic;  overdose;  time-of-flight
AB  - OBJECTIVE: To compare user self-identification of nonpharmaceutical fentanyl exposure with confirmatory urine drug testing in emergency department (ED) patients presenting after heroin overdose.
AB  - METHODS: This was a cross-sectional study of adult ED patients who presented after a heroin overdose requiring naloxone administration. Participants provided verbal consent after which they were asked a series of questions regarding their knowledge, attitudes and beliefs toward heroin and nonpharmaceutical fentanyl. Participants also provided urine samples, which were analyzed using liquid chromatography coupled to quadrupole time-of-flight mass spectrometry to identify the presence of fentanyl, heroin metabolites, other clandestine opioids, common pharmaceuticals and drugs of abuse.
AB  - RESULTS: Thirty participants were enrolled in the study period. Ten participants (33%) had never required naloxone for an overdose in the past, 20 participants (67%) reported recent abstinence, and 12 participants (40%) reported concomitant cocaine use. Naloxone was detected in all urine drug screens. Heroin or its metabolites were detected in almost all samples (93.3%), as were fentanyl (96.7%) and its metabolite, norfentanyl (93.3%). Acetylfentanyl was identified in nine samples (30%) while U-47700 was present in two samples (6.7%). Sixteen participants self-identified fentanyl in their heroin (sensitivity 55%); participants were inconsistent in their qualitative ability to identify fentanyl in heroin.
AB  - CONCLUSIONS: Heroin users presenting to the ED after heroin overdose requiring naloxone are unable to accurately identify the presence of nonpharmaceutical fentanyl in heroin. Additionally, cutting edge drug testing methodologies identified fentanyl exposures in 96.7% of our patients, as well as unexpected clandestine opioids (like acetylfentanyl and U-47700).
ES  - 1556-9519
IL  - 1556-3650
DO  - https://dx.doi.org/10.1080/15563650.2017.1339889
PT  - Journal Article
ID  - 10.1080/15563650.2017.1339889 [doi]
PP  - ppublish
LG  - English
EP  - 20170706
DP  - 2018 Jan
EZ  - 2017/07/07 06:00
DA  - 2017/07/07 06:00
DT  - 2017/07/07 06:00
YR  - 2018
RD  - 20171213
UP  - 20171213
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28681615

<1073. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28631577
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Grewal K
AU  - Austin PC
AU  - Kapral MK
AU  - Lu H
AU  - Atzema CL
FA  - Grewal, Keerat
FA  - Austin, Peter C
FA  - Kapral, Moira K
FA  - Lu, Hong
FA  - Atzema, Clare L
IN  - Grewal, Keerat. *Department of Medicine,Division of Emergency Medicine,University of Toronto,Toronto,ON.
IN  - Austin, Peter C. +Sunnybrook Health Sciences Centre,University of TorontoFaculty of Medicine,Toronto,ON.
IN  - Kapral, Moira K. ++University Health Network,University of Toronto,Toronto,ON.
IN  - Lu, Hong. |Institute for Clinical Evaluative Sciences,Toronto,ON.
IN  - Atzema, Clare L. *Department of Medicine,Division of Emergency Medicine,University of Toronto,Toronto,ON.
TI  - The impact of opioid medications on subsequent fractures in discharged emergency department patients with peripheral vertigo.
SO  - CJEM Canadian Journal of Emergency Medical Care. 20(1):28-35, 2018 Jan
AS  - CJEM, Can. j. emerg. med. care. 20(1):28-35, 2018 Jan
NJ  - CJEM
VO  - 20
IP  - 1
PG  - 28-35
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 100893237
IO  - CJEM
CP  - England
KW  - bone;  emergency department;  opioids;  peripheral vertigo
AB  - BACKGROUND: Vertigo is common in the emergency department (ED). Most aetiologies are peripheral and do not require hospitalization, but many patients still fear falling. Some patients may be taking opioid analgesic medications (for other reasons); the risk of falls leading to fractures among patients with vertigo could be potentiated by the simultaneous use of opioids.
AB  - OBJECTIVES: To examine the risk of fractures in discharged ED patients with peripheral vertigo who were being prescribed opioids during the same time period.
AB  - METHODS: Linked administrative databases from Ontario were used to compare discharged ED patients aged >=65 with peripheral vertigo to patients with urinary tract infection (UTI) from 2006 to 2011. We used Cox regression analysis with an interaction term to estimate the modifying effect of an opioid prescription on the hazard of fracture within 90 days.
AB  - RESULTS: There were 13,012 patients with a peripheral vertigo syndrome and 76,885 with a UTI. Thirteen percent of the vertigo cohort and 25% of the UTI cohort had access to a filled opioid prescription. Compared to vertigo patients who did not fill an opioid prescription, the adjusted hazard of fracture among vertigo patients who did fill a prescription was 3.59 (95% CI 1.97-6.13). Among UTI patients who filled an opioid prescription the hazard ratio was 1.68 (95% CI 1.43-1.97) compared to UTI patients who did not.
AB  - CONCLUSIONS: Patients discharged from the ED with peripheral vertigo who were also being prescribed opioids had a higher hazard of subsequent fracture compared to those who were not, and the effect was much greater than among UTI patients. These results suggest that in the acutely vertiginous older patient, opioid analgesic medications should be modified, where possible.
IS  - 1481-8035
IL  - 1481-8035
DO  - https://dx.doi.org/10.1017/cem.2017.37
PT  - Journal Article
ID  - S1481803517000379 [pii]
ID  - 10.1017/cem.2017.37 [doi]
PP  - ppublish
LG  - English
EP  - 20170620
DP  - 2018 Jan
EZ  - 2017/06/21 06:00
DA  - 2017/06/21 06:00
DT  - 2017/06/21 06:00
YR  - 2018
RD  - 20180115
UP  - 20180115
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28631577

<1074. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29068170
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - AlTamimi A
AU  - Malhis NK
AU  - Khojah NM
AU  - Manea SA
AU  - AlTamimi A
AU  - AlShammary SA
FA  - AlTamimi, Abdullah
FA  - Malhis, Nidal K
FA  - Khojah, Najla M
FA  - Manea, Saleh A
FA  - AlTamimi, Abdulrahman
FA  - AlShammary, Sami Ayed
IN  - AlTamimi, Abdullah. Pediatric Emergency, King Fahad Medical City, Riyadh, Saudi Arabia.
IN  - Malhis, Nidal K. Pediatric Emergency, King Fahad Medical City, Riyadh, Saudi Arabia.
IN  - Khojah, Najla M. Pediatric Emergency, King Fahad Medical City, Riyadh, Saudi Arabia.
IN  - Manea, Saleh A. Pharmacy Department, King Fahad Medical City, Riyadh, Saudi Arabia.
IN  - AlTamimi, Abdulrahman. Pharmacy Department, King Fahad Medical City, Riyadh, Saudi Arabia.
IN  - AlShammary, Sami Ayed. Palliative Care, King Fahad Medical City, Riyadh Saudi Arabia.
TI  - Antidote Availability in Saudi Arabia Hospitals in the Riyadh Province.
SO  - Basic & Clinical Pharmacology & Toxicology. 122(2):288-292, 2018 Feb
AS  - Basic Clin Pharmacol Toxicol. 122(2):288-292, 2018 Feb
NJ  - Basic & clinical pharmacology & toxicology
VO  - 122
IP  - 2
PG  - 288-292
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 101208422
IO  - Basic Clin. Pharmacol. Toxicol.
CP  - England
AB  - Inadequate antidote stocking is a global problem in hospitals. Insufficient supplies and delays in the administration of antidotes could lead to death and additional potentially negative clinical consequences. Our objective was to determine the availability of antidotes in hospitals listed on the Saudi Ministry of Health website in the Riyadh Province and to evaluate the leading poison in Saudi Arabia. A cross-sectional study was conducted using questionnaires. The questionnaires were distributed to pharmacist directors and emergency room-treating physicians in 17 public hospitals throughout the Riyadh Province. None (0/17) of the pharmacies contained the 24 recommended essential antidotes by the expert consensus guidelines for stocking of antidotes in hospitals. Polyvalent scorpion antivenom, atropine sulphate, calcium gluconate, flumazenil and naloxone hydrochloride were stocked in 94.12% (16/17) of hospitals. 66.67% of patients presented with osmolality, and 55.56% of referral patients with opiates, barbiturates, acetaminophen and salicylate. Our findings have important implications for healthcare institutions and pharmaceutical practices. National practice guidelines are needed to assist pharmacists in selecting appropriate antidotes based on the local pattern of poisoning incidents. Therefore, further study in the Kingdom of Saudi Arabia needs to be completed to fully evaluate the availability of antidotes throughout the country.

Copyright © 2017 The Authors. Basic & Clinical Pharmacology & Toxicology published by John Wiley & Sons Ltd on behalf of Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).
ES  - 1742-7843
IL  - 1742-7835
DO  - https://dx.doi.org/10.1111/bcpt.12897
PT  - Journal Article
ID  - 10.1111/bcpt.12897 [doi]
PP  - ppublish
PH  - 2017/06/21 [received]
PH  - 2017/08/23 [accepted]
LG  - English
EP  - 20171025
DP  - 2018 Feb
EZ  - 2017/10/27 06:00
DA  - 2017/10/27 06:00
DT  - 2017/10/26 06:00
YR  - 2018
RD  - 20180115
UP  - 20180115
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29068170

<1075. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 27071690
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Silvestre J
AU  - Reddy A
AU  - de la Cruz M
AU  - Wu J
AU  - Liu D
AU  - Bruera E
AU  - Todd KH
FA  - Silvestre, Julio
FA  - Reddy, Akhila
FA  - de la Cruz, Maxine
FA  - Wu, Jimin
FA  - Liu, Diane
FA  - Bruera, Eduardo
FA  - Todd, Knox H
IN  - Silvestre, Julio. Department of Emergency Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.
IN  - Reddy, Akhila. Department of Palliative Care and Rehabilitation Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.
IN  - de la Cruz, Maxine. Department of Palliative Care and Rehabilitation Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.
IN  - Wu, Jimin. Department of Biostatistics,The University of Texas MD Anderson Cancer Center,Houston,Texas.
IN  - Liu, Diane. Department of Biostatistics,The University of Texas MD Anderson Cancer Center,Houston,Texas.
IN  - Bruera, Eduardo. Department of Palliative Care and Rehabilitation Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.
IN  - Todd, Knox H. Department of Emergency Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.
TI  - Frequency of unsafe storage, use, and disposal practices of opioids among cancer patients presenting to the emergency department.
SO  - Palliative & Supportive Care. 15(6):638-643, 2017 Dec
AS  - Palliat Support Care. 15(6):638-643, 2017 Dec
NJ  - Palliative & supportive care
VO  - 15
IP  - 6
PG  - 638-643
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 101232529
IO  - Palliat Support Care
CP  - England
KW  - Accidental opioid poisoning;  Cancer patients;  Emergency center;  Opioid Disposal;  Opioid diversion;  Opioid storage;  Prescription opioid abuse
AB  - OBJECTIVE: Approximately 75% of prescription opioid abusers obtain the drug from an acquaintance, which may be a consequence of improper opioid storage, use, disposal, and lack of patient education. We aimed to determine the opioid storage, use, and disposal patterns in patients presenting to the emergency department (ED) of a comprehensive cancer center.
AB  - METHOD: We surveyed 113 patients receiving opioids for at least 2 months upon presenting to the ED and collected information regarding opioid use, storage, and disposal. Unsafe storage was defined as storing opioids in plain sight, and unsafe use was defined as sharing or losing opioids.
AB  - RESULTS: The median age was 53 years, 55% were female, 64% were white, and 86% had advanced cancer. Of those surveyed, 36% stored opioids in plain sight, 53% kept them hidden but unlocked, and only 15% locked their opioids. However, 73% agreed that they would use a lockbox if given one. Patients who reported that others had asked them for their pain medications (p = 0.004) and those who would use a lockbox if given one (p = 0.019) were more likely to keep them locked. Some 13 patients (12%) used opioids unsafely by either sharing (5%) or losing (8%) them. Patients who reported being prescribed more pain pills than required (p = 0.032) were more likely to practice unsafe use. Most (78%) were unaware of proper opioid disposal methods, 6% believed they were prescribed more medication than required, and 67% had unused opioids at home. Only 13% previously received education about safe disposal of opioids. Overall, 77% (87) of patients reported unsafe storage, unsafe use, or possessed unused opioids at home.
AB  - SIGNIFICANCE OF RESULTS: Many cancer patients presenting to the ED improperly and unsafely store, use, or dispose of opioids, thus highlighting a need to investigate the impact of patient education on such practices.
ES  - 1478-9523
IL  - 1478-9515
DO  - https://dx.doi.org/10.1017/S1478951516000158
PT  - Journal Article
ID  - S1478951516000158 [pii]
ID  - 10.1017/S1478951516000158 [doi]
PP  - ppublish
LG  - English
EP  - 20160413
DP  - 2017 Dec
EZ  - 2016/04/14 06:00
DA  - 2016/04/14 06:00
DT  - 2016/04/14 06:00
YR  - 2017
RD  - 20171205
UP  - 20171205
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=27071690

<1076. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29077648
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Grover AS
AU  - Mitchell PD
AU  - Manzi SF
AU  - Fox VL
FA  - Grover, Amit S
FA  - Mitchell, Paul D
FA  - Manzi, Shannon F
FA  - Fox, Victor L
IN  - Grover, Amit S. Division of Gastroenterology, Hepatology and Nutrition.
IN  - Mitchell, Paul D. Institutional Centers for Clinical and Translational Research.
IN  - Manzi, Shannon F. Department of Pharmacy, Division of Genetics & Genomics, Clinical Pharmacogenomics Service, Boston Children's Hospital, Harvard Medical School, Boston, MA.
IN  - Fox, Victor L. Division of Gastroenterology, Hepatology and Nutrition.
TI  - Initial Pain Management in Pediatric Acute Pancreatitis: Opioid Versus Non-opioid.
SO  - Journal of Pediatric Gastroenterology & Nutrition. 66(2):295-298, 2018 Feb
AS  - J Pediatr Gastroenterol Nutr. 66(2):295-298, 2018 Feb
NJ  - Journal of pediatric gastroenterology and nutrition
VO  - 66
IP  - 2
PG  - 295-298
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - jl6, 8211545
IO  - J. Pediatr. Gastroenterol. Nutr.
CP  - United States
AB  - Nearly all patients with acute pancreatitis (AP) experience some degree of abdominal pain that is severe enough to prompt medical evaluation and necessitate analgesia. Effective analgesia is a priority in caring for such patients. Despite its importance, strategies for pain management in AP have been poorly studied, particularly in the field of pediatrics. Presently, no published data examine the management of pain because of AP in children at the time of initial presentation. Management approaches are often extrapolated from adult practice and based on anecdotal experience in the absence of objective data. The aim of our study was to examine the initial provision of analgesia to children who presented to a pediatric emergency department with AP.
ES  - 1536-4801
IL  - 0277-2116
DO  - https://dx.doi.org/10.1097/MPG.0000000000001809
PT  - Journal Article
ID  - 10.1097/MPG.0000000000001809 [doi]
PP  - ppublish
LG  - English
DP  - 2018 Feb
EZ  - 2017/10/28 06:00
DA  - 2017/10/28 06:00
DT  - 2017/10/28 06:00
YR  - 2018
RD  - 20180123
UP  - 20180124
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29077648

<1077. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29052224
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Maiti S
AU  - Sinvani L
AU  - Pisano M
AU  - Kozikowski A
AU  - Patel V
AU  - Akerman M
AU  - Patel K
AU  - Smilios C
AU  - Nouryan C
AU  - Qiu G
AU  - Pekmezaris R
AU  - Wolf-Klein G
FA  - Maiti, Sutapa
FA  - Sinvani, Liron
FA  - Pisano, Michele
FA  - Kozikowski, Andrzej
FA  - Patel, Vidhi
FA  - Akerman, Meredith
FA  - Patel, Karishma
FA  - Smilios, Christopher
FA  - Nouryan, Christian
FA  - Qiu, Guang
FA  - Pekmezaris, Renee
FA  - Wolf-Klein, Gisele
IN  - Maiti, Sutapa. Division of Hospital Medicine, Northwell Health, Manhasset, New York.
IN  - Sinvani, Liron. Division of Hospital Medicine, Northwell Health, Manhasset, New York.
IN  - Pisano, Michele. Department of Medicine, Northwell Health, Manhasset, New York.
IN  - Kozikowski, Andrzej. Department of Medicine, Northwell Health, Manhasset, New York.
IN  - Patel, Vidhi. Department of Medicine, Northwell Health, Manhasset, New York.
IN  - Akerman, Meredith. Feinstein Institute for Medical Research, Manhasset, New York.
IN  - Patel, Karishma. Division of Hospital Medicine, Northwell Health, Manhasset, New York.
IN  - Smilios, Christopher. Department of Medicine, Northwell Health, Manhasset, New York.
IN  - Nouryan, Christian. Department of Medicine, Northwell Health, Manhasset, New York.
IN  - Qiu, Guang. Department of Medicine, Northwell Health, Manhasset, New York.
IN  - Pekmezaris, Renee. Department of Medicine, Northwell Health, Manhasset, New York.
IN  - Wolf-Klein, Gisele. Division of Hospital Medicine, Northwell Health, Manhasset, New York.
IN  - Wolf-Klein, Gisele. Division of Geriatric and Palliative Medicine, Northwell Health, Manhasset, New York.
TI  - Opiate Prescribing in Hospitalized Older Adults: Patterns and Outcomes.
SO  - Journal of the American Geriatrics Society. 66(1):70-75, 2018 Jan
AS  - J Am Geriatr Soc. 66(1):70-75, 2018 Jan
NJ  - Journal of the American Geriatrics Society
VO  - 66
IP  - 1
PG  - 70-75
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 7503062, h6v
IO  - J Am Geriatr Soc
CP  - United States
KW  - clinical outcomes;  long-acting opiates;  older adults;  opiates;  short-acting opiates
AB  - BACKGROUND/OBJECTIVES: Whereas opiate prescribing patterns have been well described in outpatient and emergency department settings, they have been less defined in hospitalized older adults. The objective was to describe patterns of opiate prescribing and associated outcomes in hospitalized older adults.
AB  - DESIGN: Retrospective cohort study.
AB  - SETTING: Tertiary care facility.
AB  - PARTICIPANTS: Hospitalized medical patients aged 65 and older (N = 9,245; mean age 80.3, 55.2% female, 72.3% white, 90.8% non-Hispanic).
AB  - MEASUREMENTS: Opiate exposure and duration of action, concurrent use of potentially inappropriate medications (PIMs), adverse events, discharge disposition, length of stay (LOS), and 30-day readmissions.
AB  - RESULTS: There was no difference in sex, race, ethnicity, or Charlson Comorbidity Index between opiate exposure groups. Participants who had never received opiates had a significantly shorter mean LOS than prior and new opiate users (5.2, 6.8, 7.7 days; P < .001) and were more likely to be discharged home (88.6%, 82.8%, 82.5%; P < .001) and significantly less likely to be readmitted within 30-days (19.6%, 25.0%, 22.3%; P < .001). Participant who had never been exposed to opiates had a significantly shorter mean LOS than those receiving short- and long-acting opiates (5.2, 7.3, 8.6 days; P < .001) and were more likely to be discharged home (88.6%, 82.6%, 82.4%; P < .001) and significantly less likely to be readmitted within 30-days (19.6%, 27.7%, 28.9%; P < .001).
AB  - CONCLUSION: Opiate use is widespread during hospitalization and is associated with significant negative clinical outcomes and quality metrics. There is an urgent need to develop innovative pain management alternatives to opiate use.

© 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.
ES  - 1532-5415
IL  - 0002-8614
DO  - https://dx.doi.org/10.1111/jgs.15127
PT  - Journal Article
ID  - 10.1111/jgs.15127 [doi]
PP  - ppublish
LG  - English
EP  - 20171020
DP  - 2018 Jan
EZ  - 2017/10/21 06:00
DA  - 2017/10/21 06:00
DT  - 2017/10/21 06:00
YR  - 2018
RD  - 20180122
UP  - 20180122
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29052224

<1078. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29320313
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Bates DDB
AU  - Gallagher K
AU  - Yu H
AU  - Uyeda J
AU  - Murakami AM
AU  - Setty BN
AU  - Anderson SW
AU  - Clement MO
AI  - Bates, David D B; ORCID: http://orcid.org/0000-0002-3105-156X
FA  - Bates, David D B
FA  - Gallagher, Katherine
FA  - Yu, HeiShun
FA  - Uyeda, Jennifer
FA  - Murakami, Akira M
FA  - Setty, Bindu N
FA  - Anderson, Stephan W
FA  - Clement, Mariza O
IN  - Bates, David D B. From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114 (D.D.B.B., H.Y.); Department of Radiology, Boston University Medical Center, Boston, Mass (D.D.B.B., K.G., H.Y., A.M.M., B.N.S., S.W.A., M.O.C.); and Department of Radiology, Brigham and Women's Hospital, Boston, Mass (J.U.).
IN  - Gallagher, Katherine. From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114 (D.D.B.B., H.Y.); Department of Radiology, Boston University Medical Center, Boston, Mass (D.D.B.B., K.G., H.Y., A.M.M., B.N.S., S.W.A., M.O.C.); and Department of Radiology, Brigham and Women's Hospital, Boston, Mass (J.U.).
IN  - Yu, HeiShun. From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114 (D.D.B.B., H.Y.); Department of Radiology, Boston University Medical Center, Boston, Mass (D.D.B.B., K.G., H.Y., A.M.M., B.N.S., S.W.A., M.O.C.); and Department of Radiology, Brigham and Women's Hospital, Boston, Mass (J.U.).
IN  - Uyeda, Jennifer. From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114 (D.D.B.B., H.Y.); Department of Radiology, Boston University Medical Center, Boston, Mass (D.D.B.B., K.G., H.Y., A.M.M., B.N.S., S.W.A., M.O.C.); and Department of Radiology, Brigham and Women's Hospital, Boston, Mass (J.U.).
IN  - Murakami, Akira M. From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114 (D.D.B.B., H.Y.); Department of Radiology, Boston University Medical Center, Boston, Mass (D.D.B.B., K.G., H.Y., A.M.M., B.N.S., S.W.A., M.O.C.); and Department of Radiology, Brigham and Women's Hospital, Boston, Mass (J.U.).
IN  - Setty, Bindu N. From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114 (D.D.B.B., H.Y.); Department of Radiology, Boston University Medical Center, Boston, Mass (D.D.B.B., K.G., H.Y., A.M.M., B.N.S., S.W.A., M.O.C.); and Department of Radiology, Brigham and Women's Hospital, Boston, Mass (J.U.).
IN  - Anderson, Stephan W. From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114 (D.D.B.B., H.Y.); Department of Radiology, Boston University Medical Center, Boston, Mass (D.D.B.B., K.G., H.Y., A.M.M., B.N.S., S.W.A., M.O.C.); and Department of Radiology, Brigham and Women's Hospital, Boston, Mass (J.U.).
IN  - Clement, Mariza O. From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114 (D.D.B.B., H.Y.); Department of Radiology, Boston University Medical Center, Boston, Mass (D.D.B.B., K.G., H.Y., A.M.M., B.N.S., S.W.A., M.O.C.); and Department of Radiology, Brigham and Women's Hospital, Boston, Mass (J.U.).
TI  - Acute Radiologic Manifestations of America's Opioid Epidemic.
SO  - Radiographics. 38(1):109-123, 2018 Jan-Feb
AS  - Radiographics. 38(1):109-123, 2018 Jan-Feb
NJ  - Radiographics : a review publication of the Radiological Society of North America, Inc
VO  - 38
IP  - 1
PG  - 109-123
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - rdg, 8302501
IO  - Radiographics
CP  - United States
AB  - The United States is in the midst of an opioid use epidemic, which has severe medical, social, and economic consequences. Addictions to and abuse of prescription and illicit opioids are increasing, and emergency department radiologists are increasingly being faced with the task of examining patients who present with opioid-related complications. These complications may be the result of direct drug toxicity or nonsterile injection of the drugs. Neurologic, musculoskeletal, cardiopulmonary, genitourinary, and gastrointestinal complications may be evident at diagnostic imaging in emergent settings. Heroin-induced leukoencephalopathy, cerebral septic emboli, mycotic arterial aneurysms, soft-tissue infections, and infective endocarditis are some of the conditions that patients may be found to have after they present to the emergency department. In this article, the above topics, including clinical features, pathophysiology, imaging findings, and treatment options, are reviewed. Recognizing the limitations of diagnostic imaging modalities that are available to radiologists is equally important, as some conditions can be successfully diagnosed after the initial triage-for example, transesophageal echocardiography can be performed to diagnose infective endocarditis. The emergency department radiologist may be responsible for identifying acute conditions, which can be life threatening. Some of the more common emergent opioid-related conditions and complications are reviewed, with specific emphasis on cases in which emergency department radiologists encounter conditions for which additional expertise is required. Becoming familiar with the conditions directly related to the current opioid epidemic will enable the diagnosis of these entities in a timely and accurate manner. <sup>©</sup>RSNA, 2018.
ES  - 1527-1323
IL  - 0271-5333
DO  - https://dx.doi.org/10.1148/rg.2018170114
PT  - Journal Article
ID  - 10.1148/rg.2018170114 [doi]
PP  - ppublish
LG  - English
DP  - 2018 Jan-Feb
EZ  - 2018/01/11 06:00
DA  - 2018/01/11 06:00
DT  - 2018/01/11 06:00
YR  - 2018
RD  - 20180110
UP  - 20180111
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29320313

<1079. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29279911
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - PubMed-not-MEDLINE
AU  - Kuehn B
FA  - Kuehn, Bridget
TI  - Opioid Emergency Declared.
SO  - JAMA. 318(24):2418, 2017 Dec 26
AS  - JAMA. 318(24):2418, 2017 Dec 26
NJ  - JAMA
VO  - 318
IP  - 24
PG  - 2418
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - 7501160
IO  - JAMA
CP  - United States
ES  - 1538-3598
IL  - 0098-7484
DO  - https://dx.doi.org/10.1001/jama.2017.19014
PT  - Journal Article
ID  - 2667046 [pii]
ID  - 10.1001/jama.2017.19014 [doi]
PP  - ppublish
LG  - English
DP  - 2017 Dec 26
EZ  - 2017/12/28 06:00
DA  - 2017/12/28 06:01
DT  - 2017/12/28 06:00
YR  - 2017
RD  - 20171228
UP  - 20171229
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29279911

<1080. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28816263
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - PubMed-not-MEDLINE
AU  - Anonymous
TI  - Opioid emergency, climate language and a frozen fruit cake.
SO  - Nature. 548(7667):264-265, 2017 08 16
AS  - Nature. 548(7667):264-265, 2017 08 16
NJ  - Nature
VO  - 548
IP  - 7667
PG  - 264-265
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - 0410462
IO  - Nature
CP  - England
ES  - 1476-4687
IL  - 0028-0836
DO  - https://dx.doi.org/10.1038/548264a
PT  - Journal Article
ID  - 548264a [pii]
ID  - 10.1038/548264a [doi]
PP  - ppublish
LG  - English
DP  - 2017 08 16
EZ  - 2017/08/18 06:00
DA  - 2017/08/18 06:01
DT  - 2017/08/18 06:00
YR  - 2017
RD  - 20171211
UP  - 20171212
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28816263

<1081. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29180553
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Thackeray A
AU  - Hess R
AU  - Dorius J
AU  - Brodke D
AU  - Fritz J
FA  - Thackeray, Anne
FA  - Hess, Rachel
FA  - Dorius, Josette
FA  - Brodke, Darrel
FA  - Fritz, Julie
IN  - Thackeray, Anne. From the Department of Physical Therapy and Athletic Training (AT, JF), Health System Innovation and Research (AT, RH), General Internal Medicine (RH), University of Utah Health Plans (JD), and the Department of Orthopaedics (DB, JF), University of Utah, Salt Lake City, UT. a.thackeray@utah.edu.
IN  - Hess, Rachel. From the Department of Physical Therapy and Athletic Training (AT, JF), Health System Innovation and Research (AT, RH), General Internal Medicine (RH), University of Utah Health Plans (JD), and the Department of Orthopaedics (DB, JF), University of Utah, Salt Lake City, UT.
IN  - Dorius, Josette. From the Department of Physical Therapy and Athletic Training (AT, JF), Health System Innovation and Research (AT, RH), General Internal Medicine (RH), University of Utah Health Plans (JD), and the Department of Orthopaedics (DB, JF), University of Utah, Salt Lake City, UT.
IN  - Brodke, Darrel. From the Department of Physical Therapy and Athletic Training (AT, JF), Health System Innovation and Research (AT, RH), General Internal Medicine (RH), University of Utah Health Plans (JD), and the Department of Orthopaedics (DB, JF), University of Utah, Salt Lake City, UT.
IN  - Fritz, Julie. From the Department of Physical Therapy and Athletic Training (AT, JF), Health System Innovation and Research (AT, RH), General Internal Medicine (RH), University of Utah Health Plans (JD), and the Department of Orthopaedics (DB, JF), University of Utah, Salt Lake City, UT.
TI  - Relationship of Opioid Prescriptions to Physical Therapy Referral and Participation for Medicaid Patients with New-Onset Low Back Pain.
SO  - Journal of the American Board of Family Medicine: JABFM. 30(6):784-794, 2017 Nov-Dec
AS  - J Am Board Fam Med. 30(6):784-794, 2017 Nov-Dec
NJ  - Journal of the American Board of Family Medicine : JABFM
VO  - 30
IP  - 6
PG  - 784-794
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - 101256526
IO  - J Am Board Fam Med
CP  - United States
KW  - Back Pain;  Health Services;  Opioid Analgesics;  Physical Therapy Modalities
AB  - INTRODUCTION: Physical therapy (PT) early in the management of low back pain (LBP) is associated with reductions in subsequent health care utilization and LBP-related costs. The objectives of this study were to 1) Examine differences among newly consulting patients with LBP who received a PT referral and those who did not, 2) examine differences between patients who participated in PT to those who did not, and 3) compare the impact of a PT referral and PT participation on LBP-related health care utilization and costs over 1 year.
AB  - METHODS: This was a retrospective cohort study using electronic medical records and claims data. Participants were 454 Medicaid enrollees with new LBP consultations (mean age, 40.4 years; SD = 12.0; 70% women). Outcomes included advanced imaging, injections, emergency department visits, opioid prescriptions, surgery and LBP-related costs. Variables associated with a PT consult, PT participation, and subsequent outcomes were evaluated with multivariate models.
AB  - RESULTS: A total of 251 (55%) participants received a PT consult within 7 days of the index LBP visit and 81 (19%) participated in PT. The odds of a PT consult were increased if patients were prescribed non-steroidal anti-inflammatories (aOR = 1.81; 95% confidence interval [CI], 1.0 to 3.27; P = .05) or muscle relaxers (adjusted odds ratio [aOR] = 2.24; 95% CI, 1.03 to 4.87; P = .04). Whereas tobacco users and individual with multiple comorbidities were less likely to receive a PT consult (aOR = 0.52; 95% CI, 0.20 to 0.91) and 0.42 (95% CI, 0.23 to 0.78), respectively). Odds of participating in PT were higher for patients receiving an radiograph at baseline (odds ratio [OR] = 2.63; 95% CI, 1.25 to 5.53) or having multiple comorbidities (OR = 2.96; 95% CI, 1.20 to 7.20). The odds of receiving an opioid prescription over the year following the index visit reduced with a PT consult (aOR = 0.65; 95% CI, 0.43 to 1.00) and with PT participation (aOR = 0.47; 95% CI, 0.24 to 0.92). No differences in LBP related costs over 1 year were noted between any of the groups.
AB  - CONCLUSIONS: Among Medicaid recipients with new-onset LBP, the index provider's prescription and imaging decisions and patient demographics were associated with PT referrals and participation. A referral to PT and subsequent PT participation was associated with reduced opioid prescriptions during follow-up. There was no difference in overall LBP-related health care costs.

© Copyright 2017 by the American Board of Family Medicine.
CI  - Conflict of interest: none declared.
ES  - 1558-7118
IL  - 1557-2625
DO  - https://dx.doi.org/10.3122/jabfm.2017.06.170064
PT  - Journal Article
ID  - 30/6/784 [pii]
ID  - 10.3122/jabfm.2017.06.170064 [doi]
PP  - ppublish
PH  - 2017/02/18 [received]
PH  - 2017/05/24 [revised]
PH  - 2017/05/26 [accepted]
LG  - English
DP  - 2017 Nov-Dec
EZ  - 2017/11/29 06:00
DA  - 2017/11/29 06:00
DT  - 2017/11/29 06:00
YR  - 2017
RD  - 20171128
UP  - 20171129
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29180553

<1082. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28950033
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Priano J
AU  - Faley B
AI  - Priano, James; ORCID: https://orcid.org/0000-0003-2096-140X
FA  - Priano, James
FA  - Faley, Brian
IN  - Priano, James. Emergency Medicine, Florida Hospital, Orlando, Florida.
IN  - Faley, Brian. Medical Affairs, Pharmacy Alliance, Pacira Pharmaceuticals Inc., San Diego, California.
TI  - Alternative Viewpoint: Predictors of Response in Emergency Department Patients Receiving Intravenous Opioids for Severe Pain.
SO  - Pharmacotherapy:The Journal of Human Pharmacology & Drug Therapy. 37(11):e118-e119, 2017 11
AS  - Pharmacotherapy. 37(11):e118-e119, 2017 11
NJ  - Pharmacotherapy
VO  - 37
IP  - 11
PG  - e118-e119
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - par, 8111305
IO  - Pharmacotherapy
CP  - United States
KW  - *Analgesia;  *emergency department;  *opioids
ES  - 1875-9114
IL  - 0277-0008
DO  - https://dx.doi.org/10.1002/phar.2030
PT  - Journal Article
ID  - 10.1002/phar.2030 [doi]
PP  - ppublish
LG  - English
EP  - 20171026
DP  - 2017 11
EZ  - 2017/09/28 06:00
DA  - 2017/09/28 06:00
DT  - 2017/09/27 06:00
YR  - 2017
RD  - 20171128
UP  - 20171129
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28950033

<1083. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29115231
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - The Lancet
FA  - The Lancet
TI  - The opioid crisis in the USA: a public health emergency.
SO  - Lancet. 390(10107):2016, 2017 Nov 04
AS  - Lancet. 390(10107):2016, 2017 Nov 04
NJ  - Lancet (London, England)
VO  - 390
IP  - 10107
PG  - 2016
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - 2985213r, l0s, 0053266
IO  - Lancet
CP  - England
ES  - 1474-547X
IL  - 0140-6736
DI  - S0140-6736(17)32808-8
DO  - https://dx.doi.org/10.1016/S0140-6736(17)32808-8
PT  - Editorial
ID  - S0140-6736(17)32808-8 [pii]
ID  - 10.1016/S0140-6736(17)32808-8 [doi]
PP  - ppublish
LG  - English
DP  - 2017 Nov 04
EZ  - 2017/11/09 06:00
DA  - 2017/11/09 06:00
DT  - 2017/11/09 06:00
YR  - 2017
RD  - 20171108
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29115231

<1084. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29105956
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Lyapustina T
AU  - Castillo R
AU  - Omaki E
AU  - Shields W
AU  - McDonald E
AU  - Rothman R
AU  - Gielen A
FA  - Lyapustina, Tatyana
FA  - Castillo, Renan
FA  - Omaki, Elise
FA  - Shields, Wendy
FA  - McDonald, Eileen
FA  - Rothman, Richard
FA  - Gielen, Andrea
IN  - Lyapustina, Tatyana. University of Connecticut Health Center, Farmington, Connecticut, U.S.A.
IN  - Lyapustina, Tatyana. Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A.
IN  - Castillo, Renan. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, U.S.A.
IN  - Omaki, Elise. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, U.S.A.
IN  - Shields, Wendy. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, U.S.A.
IN  - McDonald, Eileen. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, U.S.A.
IN  - Rothman, Richard. Division of Emergency Medicine, Johns Hopkins Medicine, Baltimore, Maryland, U.S.A.
IN  - Gielen, Andrea. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, U.S.A.
TI  - Response to Letter to the Editor The Contribution of the Emergency Department to Opioid Pain Reliever Misuse and Diversion: A Critical Review.
SO  - Pain Practice. 17(8):1123, 2017 Nov
AS  - Pain pract.. 17(8):1123, 2017 Nov
NJ  - Pain practice : the official journal of World Institute of Pain
VO  - 17
IP  - 8
PG  - 1123
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 101130835
IO  - Pain Pract
CP  - United States
ES  - 1533-2500
IL  - 1530-7085
DO  - https://dx.doi.org/10.1111/papr.12598
PT  - Letter
ID  - 10.1111/papr.12598 [doi]
PP  - ppublish
LG  - English
EP  - 20171106
DP  - 2017 Nov
EZ  - 2017/11/07 06:00
DA  - 2017/11/07 06:00
DT  - 2017/11/07 06:00
YR  - 2017
RD  - 20171108
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29105956

<1085. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29100569
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Waszak DL
AU  - Fennimore LA
FA  - Waszak, Daria L
FA  - Fennimore, Laura A
IN  - Waszak, Daria L. Lodi, NJ; Pittsburgh, PA. Electronic address: dariawas@yahoo.com.
IN  - Fennimore, Laura A. Lodi, NJ; Pittsburgh, PA.
TI  - Achieving the Institute of Medicine's 6 Aims for Quality in the Midst of the Opioid Crisis: Considerations for the Emergency Department.
SO  - Journal of Emergency Nursing. 43(6):512-518, 2017 11
AS  - J Emerg Nurs. 43(6):512-518, 2017 11
NJ  - Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association
VO  - 43
IP  - 6
PG  - 512-518
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - 7605913
IO  - J Emerg Nurs
CP  - United States
ES  - 1527-2966
IL  - 0099-1767
DI  - S0099-1767(17)30034-X
DO  - https://dx.doi.org/10.1016/j.jen.2017.05.008
PT  - Journal Article
ID  - S0099-1767(17)30034-X [pii]
ID  - 10.1016/j.jen.2017.05.008 [doi]
PP  - ppublish
PH  - 2017/01/26 [received]
PH  - 2017/04/21 [revised]
PH  - 2017/05/23 [accepted]
LG  - English
DP  - 2017 11
EZ  - 2017/11/05 06:00
DA  - 2017/11/05 06:00
DT  - 2017/11/05 06:00
YR  - 2017
RD  - 20171114
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=29100569

<1086. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28987314
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Culver MA
AU  - Richards EC
AU  - Jarrell DH
AU  - Edwards CJ
FA  - Culver, Mark A
FA  - Richards, Emily C
FA  - Jarrell, Daniel H
FA  - Edwards, Christopher J
IN  - Culver, Mark A. Department of Pharmacy, Banner University Medical Center Phoenix, Phoenix, Arizona.
IN  - Richards, Emily C. Department of Pharmacy, Banner University Medical Center Phoenix, Phoenix, Arizona.
IN  - Jarrell, Daniel H. Department of Pharmacy, Banner University Medical Center Tucson, Tucson, Arizona.
IN  - Edwards, Christopher J. Department of Pharmacy, Banner University Medical Center Tucson, Tucson, Arizona.
TI  - Use of Prophylactic Ondansetron with Intravenous Opioids in Emergency Department Patients: A Prospective Observational Pilot Study.
SO  - Journal of Emergency Medicine. 53(5):629-634, 2017 Nov
AS  - J Emerg Med. 53(5):629-634, 2017 Nov
NJ  - The Journal of emergency medicine
VO  - 53
IP  - 5
PG  - 629-634
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - ibo, 8412174
IO  - J Emerg Med
CP  - United States
KW  - emesis;  nausea;  ondansetron;  opioids;  pain
AB  - BACKGROUND: The current literature suggests that the prophylactic use of antiemetics is ineffective at preventing nausea or vomiting caused by opioids in the emergency department (ED). While there is no data evaluating ondansetron's efficacy for preventing opioid-induced nausea and vomiting, this practice remains common despite a lack of supporting evidence.
AB  - OBJECTIVES: This study aimed to identify if prophylactic ondansetron administered with intravenous (IV) opioids prevents opioid-induced nausea or vomiting.
AB  - METHODS: This prospective observational study was conducted in the ED at two academic medical institutions. Patients were eligible for enrollment if they were prescribed an IV opioid with or without IV ondansetron and absence of baseline nausea. Patients' level of nausea was evaluated at baseline, 5 min, and 30 min after an IV opioid was administered and then observed for 2 hours.
AB  - RESULTS: One hundred thirty-three patients were enrolled, with 90% of patients presenting with a chief complaint of pain. Sixty-four (48.1%) patients received an IV opioid alone and 69 (51.9%) patients received both IV ondansetron and an IV opioid. Twenty-three (17.3%) patients developed nausea caused by opioid administration. One (0.75%) patient had an emetic event and 3 (2.3%) patients required rescue antiemetics during their observation period. Rate of nausea was similar between treatment groups 5 min after the opioid was administered (p = 0.153). There was no statistical difference in emesis, rescue medication requirements, or nausea severity between treatment groups.
AB  - CONCLUSION: Our trial found that ondansetron did not appear to be effective at preventing opioid-induced nausea or vomiting. These findings and previous literature suggest prophylactic ondansetron should not be given to ED patients who are receiving IV opioids.

Copyright © 2017 Elsevier Inc. All rights reserved.
IS  - 0736-4679
IL  - 0736-4679
DI  - S0736-4679(17)30616-9
DO  - https://dx.doi.org/10.1016/j.jemermed.2017.06.040
PT  - Journal Article
ID  - S0736-4679(17)30616-9 [pii]
ID  - 10.1016/j.jemermed.2017.06.040 [doi]
PP  - ppublish
PH  - 2017/01/18 [received]
PH  - 2017/05/21 [revised]
PH  - 2017/06/29 [accepted]
LG  - English
EP  - 20171005
DP  - 2017 Nov
EZ  - 2017/10/11 06:00
DA  - 2017/10/11 06:00
DT  - 2017/10/09 06:00
YR  - 2017
RD  - 20171112
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28987314

<1087. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28971919
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Tedesco D
AU  - Asch SM
AU  - Curtin C
AU  - Hah J
AU  - McDonald KM
AU  - Fantini MP
AU  - Hernandez-Boussard T
FA  - Tedesco, Dario
FA  - Asch, Steven M
FA  - Curtin, Catherine
FA  - Hah, Jennifer
FA  - McDonald, Kathryn M
FA  - Fantini, Maria P
FA  - Hernandez-Boussard, Tina
IN  - Tedesco, Dario. Dario Tedesco is a postdoctoral scholar in the Department of Medicine, Stanford University, in California.
IN  - Asch, Steven M. Steven M. Asch is director of the Center for Innovation to Implementation at the Veterans Affairs Palo Alto Health Care System and vice chief of the Division of Primary Care and Population Health at Stanford University.
IN  - Curtin, Catherine. Catherine Curtin is an associate professor of surgery at Palo Alto Veterans Affairs Hospital and at Stanford University School of Medicine.
IN  - Hah, Jennifer. Jennifer Hah is an instructor of anesthesiology at Stanford University School of Medicine.
IN  - McDonald, Kathryn M. Kathryn M. McDonald is executive director of the Center for Health Policy and the Center for Primary Care Outcomes Research at Stanford University.
IN  - Fantini, Maria P. Maria P. Fantini is a professor of hygiene and public health in the Department of Biomedical and Neuromotor Sciences at the University of Bologna, in Italy.
IN  - Hernandez-Boussard, Tina. Tina Hernandez-Boussard (boussard@stanford.edu) is an associate professor of medicine, biomedical data sciences, and surgery at Stanford University School of Medicine.
TI  - Opioid Abuse And Poisoning: Trends In Inpatient And Emergency Department Discharges.
SO  - Health Affairs. 36(10):1748-1753, 2017 Oct 01
AS  - Health Aff (Millwood). 36(10):1748-1753, 2017 Oct 01
NJ  - Health affairs (Project Hope)
VO  - 36
IP  - 10
PG  - 1748-1753
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - 8303128, gag
IO  - Health Aff (Millwood)
CP  - United States
KW  - Opioid epidemic;  Pharmaceuticals
AB  - Addressing the opioid epidemic is a national priority. We analyzed national trends in inpatient and emergency department (ED) discharges for opioid abuse, dependence, and poisoning using Healthcare Cost and Utilization Project data. Inpatient and ED discharge rates increased overall across the study period, but a decline was observed for prescription opioid-related discharges beginning in 2010, while a sharp increase in heroin-related discharges began in 2008.

Copyright Project HOPE-The People-to-People Health Foundation, Inc.
ES  - 1544-5208
IL  - 0278-2715
DO  - https://dx.doi.org/10.1377/hlthaff.2017.0260
PT  - Journal Article
ID  - 36/10/1748 [pii]
ID  - 10.1377/hlthaff.2017.0260 [doi]
PP  - ppublish
GI  - No: K23 DA035302
Organization: (DA) *NIDA NIH HHS*
Country: United States

GI  - No: R01 HS024096
Organization: (HS) *AHRQ HHS*
Country: United States
LG  - English
DP  - 2017 Oct 01
EZ  - 2017/10/04 06:00
DA  - 2017/10/04 06:00
DT  - 2017/10/04 06:00
YR  - 2017
RD  - 20171024
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28971919

<1088. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28932163
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - PubMed-not-MEDLINE
AU  - Alsaad SSM
AU  - Abu-Grain SHS
AU  - El-Kheir DYM
FA  - Alsaad, Sanaa S M
FA  - Abu-Grain, Salma H S
FA  - El-Kheir, Dalia Y M
IN  - Alsaad, Sanaa S M. Qatif Primary Health Care Centers, Ministry of Health, Dammam, Saudi Arabia.
IN  - Abu-Grain, Salma H S. Qatif Primary Health Care Centers, Ministry of Health, Dammam, Saudi Arabia.
IN  - El-Kheir, Dalia Y M. Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
TI  - Preparedness of Dammam primary health care centers to deal with emergency cases.
SO  - Journal of Family and Community Medicine. 24(3):181-188, 2017 Sep-Dec
AS  - J Family Community Med. 24(3):181-188, 2017 Sep-Dec
NJ  - Journal of family & community medicine
VO  - 24
IP  - 3
PG  - 181-188
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - 101553144, 100911100
IO  - J Family Community Med
CP  - India
KW  - Check list;  emergency services;  human and nonhuman resources;  primary health care center
AB  - OBJECTIVES: The objective of the study was to assess the availability of human and nonhuman resources for emergency medical services (EMSs) at the primary health care (PHC) level.
AB  - MATERIALS AND METHODS: A cross-sectional study with mixed research methods (quantitative and qualitative) was carried out in governmental PHC centers in Dammam, Eastern Province of Saudi Arabia, between September 2014 and January 2015. Using systematic random sampling technique, 13 out of 26 PHC centers were included in the study. The study consisted of two main parts: The first involved the completion of an observational checklist to assess the availability and adequacy of human and nonhuman resources (workforce, emergency infrastructure, equipment, drugs and supporting facilities). The second part involved face-to-face interviews with key informants of nurses from the emergency room (ER) in the sampled centers.
AB  - RESULTS: Analysis of the checklist showed that the total number of physicians "actually" present ranged from 2 to 8 per center and nurses actually present were 4-11 whereas the officially assigned number was 3-12 physicians and 8-17 nurses per center. Only 2 out of 13 (15.4%) centers had a place reserved for EMS in each male and female section. Only 4 (30.8%) PHC centers had a male ER located on the ground floor, near the entrance, and with a separate ramp. None of the centers had the emergency drugs such as metergotamine, calcium chloride, and naloxone. Regarding ER equipment, none of the studied centers had cervical collars, mouth gags, or a tracheostomy sets. Only one (7.6%) center had a functioning fully equipped ambulance. Five (38.46%) centers were equipped with electrocardiogram and X-ray machines. In the interviews, the informants confirmed the deficiencies identified in the checklist.
AB  - CONCLUSION: Resources for EMS at Dammam PHC centers were deficient in infrastructure and supporting facilities.
CI  - There are no conflicts of interest.
IS  - 1319-1683
IL  - 1319-1683
DO  - https://dx.doi.org/10.4103/jfcm.JFCM_5_17
PT  - Journal Article
ID  - 10.4103/jfcm.JFCM_5_17 [doi]
ID  - JFCM-24-181 [pii]
ID  - PMC5596631 [pmc]
PP  - ppublish
LG  - English
DP  - 2017 Sep-Dec
EZ  - 2017/09/22 06:00
DA  - 2017/09/22 06:01
DT  - 2017/09/22 06:00
YR  - 2017
RD  - 20170924
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28932163

<1089. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28880201
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - PubMed-not-MEDLINE
AU  - Morse S
AU  - Bride BE
FA  - Morse, Siobhan
FA  - Bride, Brian E
IN  - Morse, Siobhan. Foundations Recovery Network, Brentwood, TN 37027, USA. siobhan.morse@frnmail.com.
IN  - Bride, Brian E. School of Social Work, Georgia State University, Atlanta, GA 30302, USA. bbride@gsu.edu.
TI  - Decrease in Healthcare Utilization and Costs for Opioid Users Following Residential Integrated Treatment for Co-Occurring Disorders.
SO  - Healthcare. 5(3), 2017 Sep 07
AS  - Healthcare (Basel). 5(3), 2017 Sep 07
NJ  - Healthcare (Basel, Switzerland)
VO  - 5
IP  - 3
PI  - Journal available in: Electronic
PI  - Citation processed from: Print
JC  - 101666525
IO  - Healthcare (Basel)
CP  - Switzerland
KW  - co-occurring disorders;  healthcare costs;  opioid use;  residential treatment
AB  - BACKGROUND: Opioid use results in higher healthcare utilization and costs, particularly among those with co-occurring mental health disorders. Presumably, effective treatment would result in a reduction in healthcare utilization and costs. To date, research has not examined this question. As such, the purpose of this study was to estimate and compare pre- and post-treatment healthcare utilization and costs for individuals receiving residential integrated treatment for co-occurring mental health and opioid use disorders.
AB  - METHODS: A single-group, repeated measures design was used to examine changes in pre- and post-treatment healthcare utilization and costs among a sample of individuals with co-occurring mental health and opioid use disorders who received residential, integrated treatment.
AB  - RESULTS: Significant reductions in emergency rooms visits, inpatient admissions, and resulting costs were observed in the six months following treatment.
AB  - CONCLUSIONS: Residential, integrated treatment of co-occurring mental health and opioid use disorders can significantly decrease both utilization and cost of healthcare among opioid users with co-occurring mental health disorders.
CI  - The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.
IS  - 2227-9032
IL  - 2227-9032
DI  - E54
DO  - https://dx.doi.org/10.3390/healthcare5030054
PT  - Journal Article
ID  - healthcare5030054 [pii]
ID  - 10.3390/healthcare5030054 [doi]
ID  - PMC5618182 [pmc]
PP  - epublish
PH  - 2017/06/10 [received]
PH  - 2017/08/28 [revised]
PH  - 2017/08/30 [accepted]
LG  - English
EP  - 20170907
DP  - 2017 Sep 07
EZ  - 2017/09/08 06:00
DA  - 2017/09/08 06:01
DT  - 2017/09/08 06:00
YR  - 2017
RD  - 20171001
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28880201

<1090. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28860892
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - PubMed-not-MEDLINE
AU  - Maeng DD
AU  - Han JJ
AU  - Fitzpatrick MH
AU  - Boscarino JA
FA  - Maeng, Daniel D
FA  - Han, John J
FA  - Fitzpatrick, Michael H
FA  - Boscarino, Joseph A
IN  - Maeng, Daniel D. Department of Epidemiology and Health Services Research.
IN  - Han, John J. Department of Pain Medicine.
IN  - Fitzpatrick, Michael H. Department of Emergency Medicine, Geisinger Health System, Danville, PA, USA.
IN  - Boscarino, Joseph A. Department of Epidemiology and Health Services Research.
TI  - Patterns of health care utilization and cost before and after opioid overdose: findings from 10-year longitudinal health plan claims data.
SO  - Substance Abuse & Rehabilitation. 8:57-67, 2017
AS  - Subst. abuse rehabil.. 8:57-67, 2017
NJ  - Substance abuse and rehabilitation
VO  - 8
PG  - 57-67
PI  - Journal available in: Electronic-eCollection
PI  - Citation processed from: Print
JC  - 101558476
IO  - Subst Abuse Rehabil
CP  - New Zealand
KW  - claims data;  cost of care;  electronic health records;  opioid;  overdose;  utilization
AB  - OBJECTIVE: To describe the longitudinal pattern of health care utilization and cost of care before and after opioid overdose (OD) over a 10-year period using health plan claims data.
AB  - METHODS: Patients who had experienced opioid ODs between April 2005 and March 2015 were identified from Geisinger Health System's electronic health records. Among these patients, a subgroup of patients who were Geisinger Health Plan (GHP) members at any point between January 2006 and December 2015 were also identified. From the corresponding GHP claims data, their all-cause health care utilization (inpatient admissions, emergency department [ED] visits, and physician office visits) and total medical costs, excluding prescription medication cost, were obtained. Per-member-per-month estimates for each month before and after the index date of opioid OD were calculated, adjusting for age, gender, plan type, year, and comorbidity via multivariate regression models.
AB  - RESULTS: A total of 942 opioid OD patients with an average GHP enrollment period of 41.4 months were identified. ED visit rates rose rapidly starting around 19-24 months prior to the opioid OD date. Acute inpatient admission rates and total medical cost also rose rapidly starting around 12 months prior. After the OD date, the utilization rates and cost declined but tended to remain above those of the pre-OD period.
AB  - CONCLUSION: Opioid OD is preceded by sharp increases in utilization of acute care and cost well before the actual OD. These findings therefore suggest that early signals of OD may be detected from patterns of acute care utilization, particularly the ED visits.
CI  - Disclosure Dr Maeng conducted this study as a part of his employment with Geisinger Health System. All authors are current employees of Geisinger Health System. The authors report no other conflicts of interest in this work.
IS  - 1179-8467
IL  - 1179-8467
DO  - https://dx.doi.org/10.2147/SAR.S135884
PT  - Journal Article
ID  - 10.2147/SAR.S135884 [doi]
ID  - sar-8-057 [pii]
ID  - PMC5565388 [pmc]
PP  - epublish
LG  - English
EP  - 20170816
DP  - 2017
EZ  - 2017/09/02 06:00
DA  - 2017/09/02 06:01
DT  - 2017/09/02 06:00
YR  - 2017
RD  - 20170903
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28860892

<1091. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28858888
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Suffoletto B
AU  - Yanta J
AU  - Kurtz R
AU  - Cochran G
AU  - Douaihy A
AU  - Chung T
FA  - Suffoletto, Brian
FA  - Yanta, Joseph
FA  - Kurtz, Ryan
FA  - Cochran, Gerald
FA  - Douaihy, Antoine
FA  - Chung, Tammy
IN  - Suffoletto, Brian. Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA (BS, JY, RK); School of Social Work, University of Pittsburgh, Pittsburgh, PA (GC); and Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA (AD, TC).
TI  - Acceptability of an Opioid Relapse Prevention Text-message Intervention for Emergency Department Patients.
SO  - Journal of Addiction Medicine. 11(6):475-482, 2017 Nov/Dec
AS  - J Addict Med. 11(6):475-482, 2017 Nov/Dec
NJ  - Journal of addiction medicine
VO  - 11
IP  - 6
PG  - 475-482
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - 101306759
IO  - J Addict Med
CP  - United States
AB  - OBJECTIVE: To explore whether a text message-based relapse prevention intervention (Preventing and Interrupting Early Relapse [PIER]1) is acceptable to treatment-seeking adults with opioid use disorder (OUD) after Emergency Department (ED) discharge using mixed-methods design.
AB  - METHODS: Adults seeking care in an urban ED for OUD (n = 20; mean age 22; 55% female; 75% white race) completed a baseline survey, and were invited to enroll in PIER1, which was delivered in 7-day blocks, with the option to re-enroll at the end of each block, up to 4 blocks. PIER1 included a morning "push" message focused on positive thinking, adaptive coping feedback tailored to twice-daily assessments of craving severity and contextual correlates of craving, and end-of-day feedback on daily opioid use and goal commitment. Participants were asked to complete a follow-up phone interview after the first 7 days of PIER1. Transcripts were thematically coded.
AB  - RESULTS: Seventeen out of 20 participants enrolled in PIER1. In the first 7 days, response rates to text-message assessments averaged 30%. Ten out of 17 participants re-enrolled after 7 days. Main themes from follow-up interviews (n = 9) included ease of use, social connection, and self-empowerment. Participants desired more personalized support and the ability to communicate through text messaging with another person about their struggles. Event-level data suggest that higher craving severity increased risk of opioid lapses.
AB  - CONCLUSIONS: In this mixed-methods intervention development study, we found conflicting evidence supporting an automated text-message intervention providing relapse prevention support for treatment-seeking individuals with OUD discharged from the ED. Qualitative feedback suggests that PIER1 could be useful and acceptability enhanced through personalized human support.
ES  - 1935-3227
IL  - 1932-0620
DO  - https://dx.doi.org/10.1097/ADM.0000000000000351
PT  - Journal Article
ID  - 10.1097/ADM.0000000000000351 [doi]
ID  - PMC5659903 [pmc]
ID  - NIHMS898544 [mid]
PP  - ppublish
GI  - No: K23 AA023284
Organization: (AA) *NIAAA NIH HHS*
Country: United States
LG  - English
DP  - 2017 Nov/Dec
PQ  - 2018/11/01
EZ  - 2017/09/01 06:00
DA  - 2017/09/01 06:00
DT  - 2017/09/01 06:00
YR  - 2017
RD  - 20171031
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28858888

<1092. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28858889
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Grasso MA
AU  - Grasso CT
AU  - Jerrard DA
FA  - Grasso, Michael A
FA  - Grasso, Clare T
FA  - Jerrard, David A
IN  - Grasso, Michael A. University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, MD (MAG); University of Maryland Baltimore County, Department of Computer Science and Electrical Engineering, Baltimore, MD (CTG); University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, MD (DAJ).
TI  - Prescriptions Written for Opioid Pain Medication in the Veterans Health Administration Between 2000 and 2016.
SO  - Journal of Addiction Medicine. 11(6):483-488, 2017 Nov/Dec
AS  - J Addict Med. 11(6):483-488, 2017 Nov/Dec
NJ  - Journal of addiction medicine
VO  - 11
IP  - 6
PG  - 483-488
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - 101306759
IO  - J Addict Med
CP  - United States
AB  - OBJECTIVES: The purpose of this study was to identify national opioid pain medication (OPM) prescribing trends within the Veterans Health Administration (VA), and assess the impact of educational campaigns introduced in 2010 and 2013.
AB  - METHODS: We created a national cohort that documents more than 21 million patient records and 97 million outpatient OPM prescriptions covering a 17-year period. We examined OPM prescriptions in emergency departments, outpatient clinics, and inpatient settings.
AB  - RESULTS: The cohort accounted for 2.5 billion outpatient clinic visits, 18.9 million emergency department visits, and 12.4 million hospital admissions. The number of OPM prescriptions peaked in 2011, when they were provided during 5% of all outpatient visits and 15% of all emergency department visits. The morphine milligram equivalents (MMEs) peaked in 2014 at almost 17 billion in outpatient clinics and at 137 million in emergency departments. In 2016, OPM prescriptions were down 37% in outpatient clinics and 23% in emergency departments, and MMEs were down 30% in both settings. Prescriptions for hydrocodone and tramadol increased markedly between 2011 and 2015. OPM doses in inpatient settings continued to rise until 2015.
AB  - CONCLUSIONS: We used a large national cohort to study trends in OPM prescriptions within the VA. Educational efforts to reduce the number of OPM prescriptions coincided with these reductions, but were initially associated with an increase in OPM dosage, an increase in the use of tramadol and hydrocodone, and an increase in the use of OPMs in inpatient settings.
ES  - 1935-3227
IL  - 1932-0620
DO  - https://dx.doi.org/10.1097/ADM.0000000000000352
PT  - Journal Article
ID  - 10.1097/ADM.0000000000000352 [doi]
PP  - ppublish
LG  - English
DP  - 2017 Nov/Dec
EZ  - 2017/09/01 06:00
DA  - 2017/09/01 06:00
DT  - 2017/09/01 06:00
YR  - 2017
RD  - 20171027
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28858889

<1093. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28815789
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Busch SH
AU  - Fiellin DA
AU  - Chawarski MC
AU  - Owens PH
AU  - Pantalon MV
AU  - Hawk K
AU  - Bernstein SL
AU  - O'Connor PG
AU  - D'Onofrio G
FA  - Busch, Susan H
FA  - Fiellin, David A
FA  - Chawarski, Marek C
FA  - Owens, Patricia H
FA  - Pantalon, Michael V
FA  - Hawk, Kathryn
FA  - Bernstein, Steven L
FA  - O'Connor, Patrick G
FA  - D'Onofrio, Gail
IN  - Busch, Susan H. Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA.
IN  - Fiellin, David A. Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA.
IN  - Fiellin, David A. Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
IN  - Chawarski, Marek C. Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
IN  - Owens, Patricia H. Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA.
IN  - Pantalon, Michael V. Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA.
IN  - Hawk, Kathryn. Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA.
IN  - Bernstein, Steven L. Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA.
IN  - Bernstein, Steven L. Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.
IN  - O'Connor, Patrick G. Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
IN  - D'Onofrio, Gail. Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA.
TI  - Cost-effectiveness of emergency department-initiated treatment for opioid dependence.
SO  - Addiction. 112(11):2002-2010, 2017 Nov
AS  - Addiction. 112(11):2002-2010, 2017 Nov
NJ  - Addiction (Abingdon, England)
VO  - 112
IP  - 11
PG  - 2002-2010
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - bm3, 9304118
IO  - Addiction
CP  - England
KW  - Buprenorphine;  cost analysis;  emergency department;  health services research;  opiates;  screening
AB  - BACKGROUND AND AIMS: In a recent randomized trial, patients with opioid dependence receiving brief intervention, emergency department (ED)-initiated buprenorphine and ongoing follow-up in primary care with buprenorphine (buprenorphine) were twice as likely to be engaged in addiction treatment compared with referral to community-based treatment (referral) or brief intervention and referral (brief intervention). Our aim was to evaluate the relative cost-effectiveness of these three methods of intervening on opioid dependence in the ED.
AB  - DESIGN: Measured health-care use was converted to dollar values. We considered a health-care system perspective and constructed cost-effectiveness acceptability curves that indicate the probability each treatment is cost-effective under different thresholds of willingness-to-pay for outcomes studied.
AB  - SETTING: An urban ED in the United States.
AB  - PARTICIPANTS: Opioid-dependent patients aged 18 years or older.
AB  - MEASUREMENTS: Self-reported 30-day assessment data were used to construct cost-effectiveness acceptability curves for patient engagement in formal addiction treatment at 30 days and the number of days illicit opioid-free in the past week.
AB  - FINDINGS: Considering only health-care system costs, cost-effectiveness acceptability curves indicate that at all positive willingness-to-pay values, ED-initiated buprenorphine treatment was more cost-effective than brief intervention or referral. For example, at a willingness-to-pay threshold of $1000 for 30-day treatment engagement, we are 79% certain ED-initiated buprenorphine is most cost-effective compared with other studied treatments. Similar results were found for days illicit opioid-free in the past week. Results were robust to secondary analyses that included patients with missing cost data, included crime and patient time costs in the numerator, and to changes in unit price estimates.
AB  - CONCLUSION: In the United States, emergency department-initiated buprenorphine intervention for patients with opioid dependence provides high value compared with referral to community-based treatment or combined brief intervention and referral.

Copyright © 2017 Society for the Study of Addiction.
ES  - 1360-0443
IL  - 0965-2140
DO  - https://dx.doi.org/10.1111/add.13900
PT  - Journal Article
ID  - 10.1111/add.13900 [doi]
ID  - PMC5657503 [pmc]
ID  - NIHMS883890 [mid]
PP  - ppublish
PH  - 2016/10/11 [received]
PH  - 2017/01/19 [revised]
PH  - 2017/06/02 [accepted]
GI  - No: K12 DA033312
Organization: (DA) *NIDA NIH HHS*
Country: United States

GI  - No: R01 DA025991
Organization: (DA) *NIDA NIH HHS*
Country: United States

GI  - No: R01 DA026414
Organization: (DA) *NIDA NIH HHS*
Country: United States
LG  - English
EP  - 20170816
DP  - 2017 Nov
PQ  - 2018/11/01
EZ  - 2017/08/18 06:00
DA  - 2017/08/18 06:00
DT  - 2017/08/18 06:00
YR  - 2017
RD  - 20171028
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28815789

<1094. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28769587
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - PubMed-not-MEDLINE
AU  - Landsman-Blumberg PB
AU  - Katz N
AU  - Gajria K
AU  - D'Souza AO
AU  - Chaudhari SL
AU  - Yeung PP
AU  - White R
FA  - Landsman-Blumberg, Pamela B
FA  - Katz, Nathaniel
FA  - Gajria, Kavita
FA  - D'Souza, Anna O
FA  - Chaudhari, Sham L
FA  - Yeung, Paul P
FA  - White, Richard
IN  - Landsman-Blumberg, Pamela B. Real-World Evidence, Xcenda LLC, Palm Harbor, FL.
IN  - Katz, Nathaniel. Analgesic Solutions, Natick, MA.
IN  - Katz, Nathaniel. Tufts University School of Medicine, Boston, MA.
IN  - Gajria, Kavita. Global Health Economics Outcomes Research, Teva Pharmaceuticals, Inc., Frazer, PA.
IN  - D'Souza, Anna O. Real-World Evidence, Xcenda LLC, Palm Harbor, FL.
IN  - Chaudhari, Sham L. Real-World Evidence, Xcenda LLC, Palm Harbor, FL.
IN  - Yeung, Paul P. Migraine and Headache Clinical Development, Teva Pharmaceuticals, Inc., Frazer, PA.
IN  - White, Richard. Neuroscience, Angarrack Value Solutions, West Chester, PA, USA.
TI  - Health care resource use and cost differences by opioid therapy type among chronic noncancer pain patients.
SO  - Journal of pain research. 10:1713-1722, 2017
AS  - J Pain Res. 10:1713-1722, 2017
NJ  - Journal of pain research
VO  - 10
PG  - 1713-1722
PI  - Journal available in: Electronic-eCollection
PI  - Citation processed from: Print
JC  - 101540514
IO  - J Pain Res
CP  - New Zealand
KW  - chronic pain;  database study;  health care claims;  long-acting opioids;  short-acting opioids
AB  - The study assessed 12-month chronic pain (CP)-related health care utilization and costs among chronic noncancer pain (CNCP) patients who initiated various long-term opioid treatments. Treatments included monotherapy with long-acting opioids (mono-LAOs), mono-therapy with short-acting opioids (mono-SAOs), both LAOs and SAOs (combination), and opioid therapy initiated with SAO or LAO and switched to the other class (switch). Using MarketScan<sup></sup> claims databases (2006-2012), we identified CNCP patients with >=90 days opioid supply after pain diagnosis and continuous enrollment 12 months before pain diagnosis (baseline period) and 12 months after opioid start (post-index period). Outcomes included CP-related health care utilization and costs. Among CNCP patients (n=21,203), the cohort distribution was 74% mono-SAOs, 22% combination, 2% mono-LAOs, and 2% switch. During follow-up, the average daily morphine equivalent dose was highest in mono-LAO patients (96.4 mg) compared with combination patients (89.8 mg), switch patients (64.3 mg), and mono-SAO patients (36.2 mg). After adjusting for baseline differences, the mono-LAO cohort had lower total CP-related costs ($4,933) compared with the mono-SAO ($8,604), switch ($10,470), and combination ($15,190) cohorts (all: P<0.05). Mono-LAO patients had greater CP-related prescription costs but lower medical costs than the other cohorts during the follow-up period, including lower CP-related hospitalizations (1% vs 11%-20%), emergency department visits (4% vs 11%-18%), and diagnostic radiology use (21% vs 54%-61%) (all: P<0.001). Use of pain-related medications and other treatment modalities was also significantly lower in the mono-LAO cohort relative to the other cohorts. CNCP patients using long-term monotherapy with LAOs had the lowest CP-related total health care costs in the 12 months after opioid initiation compared with mono-SAO, switch, or combination patients despite higher opioid daily doses and higher prescription costs. Future research accounting for severity and duration of pain would aid in determining the optimal long-term opioid regimen for CNCP patients.
CI  - Disclosure KG and PPY are employees of Teva Pharmaceuticals, Inc. RW was an employee of Teva Pharmaceuticals, Inc., at the time this research was conducted. PBL-B and AOD are employees of Xcenda, which has received research funding from Teva Pharmaceuticals, Inc., for the conduct of this study and for the preparation of this manuscript. SLC was an employee of Xcenda at the time this research was conducted; he is now an employee of Galaxy Informatica, Maharashtra, India. NK has received research funding and consulting fees from Teva Pharmaceuticals, Inc. The authors report no other conflicts of interest in this work.
IS  - 1178-7090
IL  - 1178-7090
DO  - https://dx.doi.org/10.2147/JPR.S130913
PT  - Journal Article
ID  - 10.2147/JPR.S130913 [doi]
ID  - jpr-10-1713 [pii]
ID  - PMC5533567 [pmc]
PP  - epublish
LG  - English
EP  - 20170721
DP  - 2017
EZ  - 2017/08/05 06:00
DA  - 2017/08/05 06:01
DT  - 2017/08/04 06:00
YR  - 2017
RD  - 20170807
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28769587

<1095. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28729010
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Patel PM
AU  - Goodman LF
AU  - Knepel SA
AU  - Miller CC
AU  - Azimi A
AU  - Phillips G
AU  - Gustin JL
AU  - Hartman A
FA  - Patel, Pina M
FA  - Goodman, Lauren F
FA  - Knepel, Sheri A
FA  - Miller, Charles C
FA  - Azimi, Asma
FA  - Phillips, Gary
FA  - Gustin, Jillian L
FA  - Hartman, Amber
IN  - Patel, Pina M. Division of Palliative Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States.
IN  - Goodman, Lauren F. Division of Palliative Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States; Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States. Electronic address: lauren.goodman@osumc.edu.
IN  - Knepel, Sheri A. Division of Palliative Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States.
IN  - Miller, Charles C. Division of Palliative Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States.
IN  - Azimi, Asma. Division of Palliative Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States.
IN  - Phillips, Gary. The Ohio State University Center for Biostatistics, Columbus, Ohio, United States.
IN  - Gustin, Jillian L. Division of Palliative Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States.
IN  - Hartman, Amber. Division of Palliative Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States; Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States.
TI  - Evaluation of Emergency Department Management of Opioid-Tolerant Cancer Patients With Acute Pain.
SO  - Journal of Pain & Symptom Management. 54(4):501-507, 2017 Oct
AS  - J Pain Symptom Manage. 54(4):501-507, 2017 Oct
NJ  - Journal of pain and symptom management
VO  - 54
IP  - 4
PG  - 501-507
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 8605836, ijj
IO  - J Pain Symptom Manage
CP  - United States
KW  - Cancer pain;  emergency;  opioid tolerance;  pain crisis;  palliative
AB  - CONTEXT: There are no previously published studies examining opioid doses administered to opioid-tolerant cancer patients during emergency department (ED) encounters.
AB  - OBJECTIVES: To determine if opioid-tolerant cancer patients presenting with acute pain exacerbations receive adequate initial doses of as needed (PRN) opioids during ED encounters based on home oral morphine equivalent (OME) use.
AB  - METHODS: We performed a retrospective cohort study of opioid-tolerant cancer patients who received opioids in our ED over a two-year period. The percentage of patients who received an adequate initial dose of PRN opioid (defined as >=10% of total 24-hour ambulatory OME) was evaluated. Logistic regression was used to establish the relationship between 24-hour ambulatory OME and initial ED OME to assess whether higher home usage was associated with higher likelihood of being undertreated.
AB  - RESULTS: Out of 216 patients, 61.1% of patients received an adequate initial PRN dose of opioids in the ED. Of patients taking <200 OMEs per day at home, 77.4% received an adequate initial dose; however, only 3.2% of patients taking >400 OMEs per day at home received an adequate dose. Patients with ambulatory 24-hour OME greater than 400 had 99% lower odds of receiving an adequate initial dose of PRN opioid in the ED compared to patients with ambulatory 24-hour OME less than 100 (OR <0.01, CI 0.00-0.02, P < 0.001).
AB  - CONCLUSIONS: Patients with daily home use less than 200 OMEs generally received adequate initial PRN opioid doses during their ED visit. However, patients with higher home opioid usage were at increased likelihood of being undertreated.

Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
ES  - 1873-6513
IL  - 0885-3924
DI  - S0885-3924(17)30276-2
DO  - https://dx.doi.org/10.1016/j.jpainsymman.2017.07.013
PT  - Journal Article
ID  - S0885-3924(17)30276-2 [pii]
ID  - 10.1016/j.jpainsymman.2017.07.013 [doi]
PP  - ppublish
PH  - 2016/11/02 [received]
PH  - 2017/03/29 [revised]
PH  - 2017/07/06 [accepted]
LG  - English
EP  - 20170717
DP  - 2017 Oct
EZ  - 2017/07/22 06:00
DA  - 2017/07/22 06:00
DT  - 2017/07/22 06:00
YR  - 2017
RD  - 20171007
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28729010

<1096. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28664359
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Vozoris NT
AU  - Wang X
AU  - Austin PC
AU  - Lee DS
AU  - Stephenson AL
AU  - O'Donnell DE
AU  - Gill SS
AU  - Rochon PA
FA  - Vozoris, Nicholas T
FA  - Wang, Xuesong
FA  - Austin, Peter C
FA  - Lee, Douglas S
FA  - Stephenson, Anne L
FA  - O'Donnell, Denis E
FA  - Gill, Sudeep S
FA  - Rochon, Paula A
IN  - Vozoris, Nicholas T. Division of Respirology, Department of Medicine, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. nick.vozoris@utoronto.ca.
IN  - Vozoris, Nicholas T. Keenan Research Centre in the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada. nick.vozoris@utoronto.ca.
IN  - Vozoris, Nicholas T. Department of Medicine, University of Toronto, Toronto, ON, Canada. nick.vozoris@utoronto.ca.
IN  - Wang, Xuesong. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
IN  - Austin, Peter C. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
IN  - Austin, Peter C. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
IN  - Lee, Douglas S. Department of Medicine, University of Toronto, Toronto, ON, Canada.
IN  - Lee, Douglas S. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
IN  - Lee, Douglas S. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
IN  - Stephenson, Anne L. Division of Respirology, Department of Medicine, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.
IN  - Stephenson, Anne L. Keenan Research Centre in the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
IN  - Stephenson, Anne L. Department of Medicine, University of Toronto, Toronto, ON, Canada.
IN  - Stephenson, Anne L. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
IN  - O'Donnell, Denis E. Department of Medicine, Queen's University, Kingston, ON, Canada.
IN  - Gill, Sudeep S. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
IN  - Gill, Sudeep S. Department of Medicine, Queen's University, Kingston, ON, Canada.
IN  - Rochon, Paula A. Department of Medicine, University of Toronto, Toronto, ON, Canada.
IN  - Rochon, Paula A. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
IN  - Rochon, Paula A. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
IN  - Rochon, Paula A. Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
TI  - Adverse cardiac events associated with incident opioid drug use among older adults with COPD.
SO  - European Journal of Clinical Pharmacology. 73(10):1287-1295, 2017 Oct
AS  - Eur J Clin Pharmacol. 73(10):1287-1295, 2017 Oct
NJ  - European journal of clinical pharmacology
VO  - 73
IP  - 10
PG  - 1287-1295
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - en4, 1256165
IO  - Eur. J. Clin. Pharmacol.
CP  - Germany
KW  - COPD;  Cardiac;  Drug safety;  Opioids;  Pharmacoepidemiology
AB  - PURPOSE: We evaluated whether incident opioid drug use was associated with adverse cardiac events among older adults with chronic obstructive pulmonary disease (COPD).
AB  - METHODS: This was an exploratory, retrospective cohort study using health administrative data from Ontario, Canada, from 2008 to 2013. Using a validated algorithm, we identified adults aged 66 years and older with non-palliative COPD. Hazard ratios (HR) were estimated for adverse cardiac events within 30 days of incident opioid receipt compared to controls using inverse probability of treatment weighting using the propensity score.
AB  - RESULTS: There were 134,408 community-dwelling individuals and 14,685 long-term care residents with COPD identified, 67.0 and 60.6% of whom received an incident opioid. Incident use of any opioid was associated with significantly decreased rates of emergency room (ER) visits and hospitalizations for congestive heart failure (CHF) among community-dwelling older adults (HR 0.84; 95% CI 0.73-0.97), but significantly increased rates of ischemic heart disease (IHD)-related mortality among long-term care residents (HR 2.15; 95% CI 1.50-3.09). In the community-dwelling group, users of more potent opioid-only agents without aspirin or acetaminophen combined had significantly increased rates of ER visits and hospitalizations for IHD (HR 1.38; 95% CI 1.08-1.77) and IHD-related mortality (HR 1.83; 95% CI 1.32-2.53).
AB  - CONCLUSIONS: New opioid use was associated with elevated rates of IHD-related morbidity and mortality among older adults with COPD. Adverse cardiac events may need to be considered when administering new opioids to older adults with COPD, but further studies are required to establish if the observed associations are causal or related to residual confounding.
ES  - 1432-1041
IL  - 0031-6970
DO  - https://dx.doi.org/10.1007/s00228-017-2278-3
PT  - Journal Article
ID  - 10.1007/s00228-017-2278-3 [doi]
ID  - 10.1007/s00228-017-2278-3 [pii]
PP  - ppublish
PH  - 2017/04/20 [received]
PH  - 2017/06/02 [accepted]
LG  - English
EP  - 20170629
DP  - 2017 Oct
EZ  - 2017/07/01 06:00
DA  - 2017/07/01 06:00
DT  - 2017/07/01 06:00
YR  - 2017
RD  - 20171117
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28664359

<1097. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28626504
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - PubMed-not-MEDLINE
AU  - Olufade T
AU  - Kong AM
AU  - Princic N
AU  - Juneau P
AU  - Kulkarni R
AU  - Zhang K
AU  - Datto C
FA  - Olufade, Tope
FA  - Kong, Amanda M
FA  - Princic, Nicole
FA  - Juneau, Paul
FA  - Kulkarni, Rucha
FA  - Zhang, Kui
FA  - Datto, Catherine
IN  - Olufade, Tope. Director, Health Economics & Outcomes Research, AstraZeneca, Wilmington, DE.
IN  - Kong, Amanda M. Research Leader, Truven Health Analytics, an IBM Company, Bethesda, MD.
IN  - Princic, Nicole. Manager Research Analyst, Truven Health Analytics, an IBM Company, Bethesda, MD.
IN  - Juneau, Paul. Senior Statistician, Truven Health Analytics, an IBM Company, Bethesda, MD.
IN  - Kulkarni, Rucha. Research Analyst at the time of this study, Truven Health Analytics, an IBM Company, Bethesda, MD.
IN  - Zhang, Kui. Senior Programmer/Analyst, Truven Health Analytics, an IBM Company, Bethesda, MD.
IN  - Datto, Catherine. US Medical Lead, AstraZeneca.
TI  - Comparing Healthcare Utilization and Costs Among Medicaid-Insured Patients with Chronic Noncancer Pain with and without Opioid-Induced Constipation: A Retrospective Analysis.
SO  - American Health & Drug Benefits. 10(2):79-86, 2017 Apr
AS  - Am. health drug benefits. 10(2):79-86, 2017 Apr
NJ  - American health & drug benefits
VO  - 10
IP  - 2
PG  - 79-86
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - 101479877
IO  - Am Health Drug Benefits
CP  - United States
KW  - Medicaid;  chronic pain;  constipation;  costs;  healthcare utilization;  noncancer pain;  opioid-induced constipation;  opioids;  propensity score matching;  side effects
AB  - BACKGROUND: Constipation is a common adverse effect of opioid use and has been associated with increased healthcare utilization and costs among patients receiving opioids for pain management.
AB  - OBJECTIVE: To compare the healthcare utilization and costs of Medicaid patients with chronic noncancer pain with and without constipation who were receiving opioids.
AB  - METHODS: This retrospective, claims-based study was conducted using data from the Truven Health MarketScan Medicaid Multi-State database. Patients with no evidence of cancer who initiated opioid therapy between January 1, 2009, and June 30, 2013, were eligible for the study. Patients had to have continuous enrollment in the database in the 6 months before and 12 months after opioid initiation, with no evidence of substance abuse or functional or inflammatory bowel disease. Medical and pharmacy claims during the 12 months after opioid initiation were evaluated for a diagnosis of constipation or for prescription or over-the-counter medications indicative of constipation. All-cause healthcare utilization and costs were measured over the same period and were compared between propensity score-matched cohorts of patients with evidence of constipation and patients without constipation.
AB  - RESULTS: Of the 25,744 patients meeting the study inclusion criteria, 2716 (10.5%) had evidence of constipation. After 1:1 propensity score matching, the 2 cohorts had similar demographic and clinical characteristics (ie, mean age, 47 years; 26%-27% male). During the 12-month follow-up period, healthcare utilization was more frequent among patients with constipation, including inpatient admissions and emergency department visits, than in the matched patients without constipation. The total all-cause mean healthcare costs were substantially higher among the patients with constipation ($28,234; 95% confidence interval [CI], $24,307-$32,160) than in the patients without constipation ($13,709; 95% CI, $12,618-$14,801), with a median cost difference of $4166 per patient (P <.001).
AB  - CONCLUSION: Among Medicaid enrollees who receive opioids for chronic noncancer pain, constipation is associated with increased all-cause healthcare utilization and costs.
IS  - 1942-2962
IL  - 1942-2962
PT  - Journal Article
ID  - PMC5470245 [pmc]
PP  - ppublish
LG  - English
DP  - 2017 Apr
EZ  - 2017/06/20 06:00
DA  - 2017/06/20 06:01
DT  - 2017/06/20 06:00
YR  - 2017
RD  - 20170714
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28626504

<1098. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28604141
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Carter JA
AU  - Dammerman R
AU  - Frost M
AI  - Carter, John A; ORCID: http://orcid.org/0000-0001-8539-5352
FA  - Carter, John A
FA  - Dammerman, Ryan
FA  - Frost, Michael
IN  - Carter, John A. a EPI-Q Inc. , Oak Brook , IL , USA.
IN  - Dammerman, Ryan. b Formerly of Braeburn Pharmaceuticals , Princeton , NJ , USA.
IN  - Frost, Michael. c Eagleville Hospital , Eagleville , PA , USA.
TI  - Cost-effectiveness of subdermal implantable buprenorphine versus sublingual buprenorphine to treat opioid use disorder.
SO  - Journal of Medical Economics. 20(8):893-901, 2017 Aug
AS  - J Med Econ. 20(8):893-901, 2017 Aug
NJ  - Journal of medical economics
VO  - 20
IP  - 8
PG  - 893-901
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 9892255
IO  - J Med Econ
CP  - England
KW  - buprenorphine;  buprenorphine implant;  cost-effectiveness;  maintenance treatment;  opioid dependence
AB  - AIMS: Subdermal implantable buprenorphine (BSI) was recently approved to treat opioid use disorder (OUD) in clinically-stable adults. In the pivotal clinical trial, BSI was associated with a higher proportion of completely-abstinent patients (85.7% vs 71.9%; p=.03) vs sublingual buprenorphine (SL-BPN). Elsewhere, relapse to illicit drug use is associated with diminished treatment outcomes and increased costs. This study evaluated the cost-effectiveness of BSI vs SL-BPN from a US societal perspective.
AB  - METHODS: A Markov model simulated BSI and SL-BPN cohorts (clinically-stable adults) transiting through four mutually-exclusive health states for 12 months. Cohorts accumulated direct medical costs from drug acquisition/administration; treatment-diversion/abuse; newly-acquired hepatitis-C; emergency room, hospital, and rehabilitation services; and pediatric poisonings. Non-medical costs of criminality, lost wages/work-productivity, and out-of-pocket expenses were also included. Transition probabilities to a relapsed state were derived from the aforementioned trial. Other transition probabilities, costs, and health-state utilities were derived from observational studies and adjusted for trial characteristics. Outcomes included incremental cost per quality-adjusted-life-year (QALY) gained and incremental net-monetary-benefit (INMB). Uncertainty was assessed by univariate and probabilistic sensitivity analysis (PSA).
AB  - RESULTS: BSI was associated with lower total costs (-$4,386), more QALYs (+0.031), and favorable INMB at all willingness-to-pay (WTP) thresholds considered. Higher drug acquisition costs for BSI (+$6,492) were outpaced, primarily by reductions in emergency room/hospital utilization (-$8,040) and criminality (-$1,212). BSI was cost-effective in 89% of PSA model replicates, and had a significantly higher NMB at $50,000/QALY ($20,783 vs $15,007; p<.05).
AB  - CONCLUSIONS: BSI was preferred over SL-BPN from a health-economic perspective for treatment of OUD in clinically-stable adults. These findings should be interpreted carefully, due to some relationships having been modeled from inputs derived from multiple sources, and would benefit from comparison with outcomes from studies that employ administrative claims data or a naturalistic comparative design.
ES  - 1941-837X
IL  - 1369-6998
DO  - https://dx.doi.org/10.1080/13696998.2017.1341416
PT  - Journal Article
ID  - 10.1080/13696998.2017.1341416 [doi]
PP  - ppublish
LG  - English
EP  - 20170622
DP  - 2017 Aug
EZ  - 2017/06/13 06:00
DA  - 2017/06/13 06:00
DT  - 2017/06/13 06:00
YR  - 2017
RD  - 20170718
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28604141

<1099. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28586701
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - O'Halloran C
AU  - Cullen K
AU  - Njoroge J
AU  - Jessop L
AU  - Smith J
AU  - Hope V
AU  - Ncube F
FA  - O'Halloran, Charlotte
FA  - Cullen, Katelyn
FA  - Njoroge, Jaquelyn
FA  - Jessop, Lucy
FA  - Smith, Josie
FA  - Hope, Vivian
FA  - Ncube, Fortune
IN  - O'Halloran, Charlotte. HIV & STI Department, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK. Electronic address: charlotte.ohalloran@phe.gov.uk.
IN  - Cullen, Katelyn. HIV & STI Department, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK.
IN  - Njoroge, Jaquelyn. HIV & STI Department, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK.
IN  - Jessop, Lucy. Public Health Agency, Health Protection Service, 12-22 Linenhall Street, Belfast BT2 8BS, Northern Ireland, UK.
IN  - Smith, Josie. Public Health Wales, Temple of Peace & Health, Cathays Park, Cardiff CF10 3NW, UK.
IN  - Hope, Vivian. HIV & STI Department, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK.
IN  - Ncube, Fortune. HIV & STI Department, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK.
TI  - The extent of and factors associated with self-reported overdose and self-reported receipt of naloxone among people who inject drugs (PWID) in England, Wales and Northern Ireland.
SO  - International Journal of Drug Policy. 46:34-40, 2017 Aug
AS  - Int J Drug Policy. 46:34-40, 2017 Aug
NJ  - The International journal on drug policy
VO  - 46
PG  - 34-40
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 9014759
IO  - Int. J. Drug Policy
CP  - Netherlands
KW  - Harm reduction;  Heroin;  Naloxone;  Overdose;  People who inject drugs;  United Kingdom
AB  - BACKGROUND: Overdose is a major cause of death among PWID, and for opioid overdoses naloxone administration can reduce harm. However, globally there is limited national level data on the extent of non-fatal overdose and naloxone uptake. The first national level data on the extent of self-reported overdose and self-reported receipt of naloxone among UK PWID, providing a baseline to monitor the impact of the recent policy change regarding naloxone availability, is presented.
AB  - METHODS: Data on self-reported overdose and receipt of naloxone during the preceding year for 2013-2014 from a national survey of PWID was analysed. Participants who reported injecting during the preceding year were included.
AB  - RESULTS: Participants (3850) were predominantly male (75%); mean age was 36 years. The most commonly injected drugs were: heroin (91%), crack (45%) and amphetamine (29%). 15% (591) reported overdosing during the preceding year. There were no differences in the proportion reporting overdose by age or gender, but overdose was more common among those who: injected multiple drugs; recently ceased addiction treatment; injected with used needles/syringes; ever had transactional sex; had used a sexual health clinic or emergency department and lived in Wales or Northern Ireland. Among those reporting an overdose during the preceding year, a third reported two to four overdoses and 7.5% five or more overdoses; half reported receiving naloxone. Those reporting naloxone receipt in the preceding year were more likely to: live in Wales or Northern Ireland; ever received used needles/syringes; ever been imprisoned; and less likely to have injected two drug types.
AB  - CONCLUSION: These data provide a baseline for monitoring the impact of the 2015 UK policy change to improve take-home naloxone access. Interventions tackling overdose should promote naloxone awareness and access, and target those who; are poly-drug injectors, have ceased treatment, share needles/syringes and whose drug use links to sexual activity.

Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.
ES  - 1873-4758
IL  - 0955-3959
DI  - S0955-3959(17)30121-4
DO  - https://dx.doi.org/10.1016/j.drugpo.2017.05.017
PT  - Journal Article
ID  - S0955-3959(17)30121-4 [pii]
ID  - 10.1016/j.drugpo.2017.05.017 [doi]
PP  - ppublish
PH  - 2016/11/29 [received]
PH  - 2017/03/11 [revised]
PH  - 2017/05/03 [accepted]
LG  - English
EP  - 20170603
DP  - 2017 Aug
EZ  - 2017/06/07 06:00
DA  - 2017/06/07 06:00
DT  - 2017/06/07 06:00
YR  - 2017
RD  - 20170805
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28586701

<1100. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28562813
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Kreling MCGD
AU  - Mattos-Pimenta CA
FA  - Kreling, Maria Clara Giorio Dutra
FA  - Mattos-Pimenta, Cibele Andrucioli de
IN  - Kreling, Maria Clara Giorio Dutra. Universidade de Sao Paulo, School of Nursing, Postgraduate Program in Nursing in Adult Health. Sao Paulo, Brazil.
IN  - Mattos-Pimenta, Cibele Andrucioli de. Universidade de Sao Paulo, School of Nursing, Postgraduate Program in Nursing in Adult Health. Sao Paulo, Brazil.
TI  - Opioid analgesic administration in patients with suspected drug use.
SO  - Revista Brasileira de Enfermagem. 70(3):626-632, 2017 May-Jun
AS  - Rev Bras Enferm. 70(3):626-632, 2017 May-Jun
NJ  - Revista brasileira de enfermagem
VO  - 70
IP  - 3
PG  - 626-632
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - 7910105, rh5
IO  - Rev Bras Enferm
CP  - Brazil
AB  - Objective:: To identify the prevalence of patients suspected of drug use according to the nursing professionals' judgement, and compare the behavior of these professionals in opioid administration when there is or there is no suspicion that patient is a drug user.
AB  - Method:: A cross-sectional study with 507 patients and 199 nursing professionals responsible for administering drugs to these patients. The Chi-Square test, Fisher's Exact and a significance level of 5% were used for the analyzes.
AB  - Results:: The prevalence of suspected patients was 6.7%. The prevalence ratio of administration of opioid analgesics 'if necessary' is twice higher among patients suspected of drug use compared to patients not suspected of drug use (p = 0.037).
AB  - Conclusion:: The prevalence of patients suspected of drug use was similar to that of studies performed in emergency departments. Patients suspected of drug use receive more opioids than patients not suspected of drug use.
AB  - Objetivo:: Identificar a prevalencia de pacientes com suspeita de uso de drogas conforme opiniao de profissionais de enfermagem e comparar a conduta desses profissionais na administracao de opioides quando ha ou nao suspeita de que o paciente seja usuario de drogas.
AB  - Metodo:: Estudo transversal com 507 pacientes e 199 profissionais de enfermagem responsaveis pela administracao de medicamentos a esses pacientes. Para as analises foram utilizados os testes de Qui-Quadrado, Exato de Fisher e um nivel de significancia de 5%.
AB  - Resultados:: A prevalencia de pacientes suspeitos foi 6,7%. A razao de prevalencia de administracao de analgesicos opioides "se necessario" e duas vezes maior entre os pacientes suspeitos em relacao aos nao suspeitos (p=0,037).
AB  - Conclusao:: A prevalencia de suspeitos foi semelhante a de estudos realizados em departamentos de emergencia. Os suspeitos de serem usuarios de drogas recebem mais opioides do que os nao suspeitos.
IS  - 0034-7167
IL  - 0034-7167
DI  - S0034-71672017000300626
DO  - https://dx.doi.org/10.1590/0034-7167-2016-0501
PT  - Journal Article
ID  - S0034-71672017000300626 [pii]
ID  - 10.1590/0034-7167-2016-0501 [doi]
PP  - ppublish
PH  - 2016/10/13 [received]
PH  - 2017/01/18 [accepted]
LG  - English
LG  - Portuguese
DP  - 2017 May-Jun
EZ  - 2017/06/01 06:00
DA  - 2017/06/01 06:00
DT  - 2017/06/01 06:00
YR  - 2017
RD  - 20170531
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28562813

<1101. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28557292
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Mazer-Amirshahi M
AU  - Motov S
AU  - Nelson L
FA  - Mazer-Amirshahi, Maryann
FA  - Motov, Sergey
FA  - Nelson, Lewis
IN  - Mazer-Amirshahi, Maryann. Department of Emergency Medicine, MedStar Washington Hospital Center, Washington, District of Columbia, U.S.A.
IN  - Mazer-Amirshahi, Maryann. Georgetown University School of Medicine, Washington, District of Columbia, USA.
IN  - Motov, Sergey. Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, New York, USA.
IN  - Nelson, Lewis. Department of Emergency Medicine, Rutgers New Jersey School of Medicine, Newark, New Jersey, USA.
TI  - In Response: The Contribution of the Emergency Department to Opioid Pain Reliever Misuse and Diversion: A Critical Review.
SO  - Pain Practice. 17(8):1122, 2017 Nov
AS  - Pain pract.. 17(8):1122, 2017 Nov
NJ  - Pain practice : the official journal of World Institute of Pain
VO  - 17
IP  - 8
PG  - 1122
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 101130835
IO  - Pain Pract
CP  - United States
ES  - 1533-2500
IL  - 1530-7085
DO  - https://dx.doi.org/10.1111/papr.12590
PT  - Letter
ID  - 10.1111/papr.12590 [doi]
PP  - ppublish
LG  - English
EP  - 20170530
DP  - 2017 Nov
EZ  - 2017/05/31 06:00
DA  - 2017/05/31 06:00
DT  - 2017/05/31 06:00
YR  - 2017
RD  - 20171108
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28557292

<1102. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28533997
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - PubMed-not-MEDLINE
AU  - Najjar M
AU  - Hall T
AU  - Estupinan B
FA  - Najjar, Mejdi
FA  - Hall, Tyler
FA  - Estupinan, Blanca
IN  - Najjar, Mejdi. College of Medicine, University of Central Florida College of Medicine.
IN  - Hall, Tyler. College of Medicine, University of Central Florida College of Medicine.
IN  - Estupinan, Blanca. College of Medicine, University of Central Florida College of Medicine.
TI  - Metoclopramide for Acute Migraine Treatment in the Emergency Department: An Effective Alternative to Opioids. [Review]
SO  - Cureus. 9(4):e1181, 2017 Apr 20
AS  - Cureus. 9(4):e1181, 2017 Apr 20
NJ  - Cureus
VO  - 9
IP  - 4
PG  - e1181
PI  - Journal available in: Electronic
PI  - Citation processed from: Print
JC  - 101596737
IO  - Cureus
CP  - United States
KW  - acute migraine;  emergency medicine;  headache;  metoclopramide;  opioids
AB  - In light of recent warnings by the United States (US) Surgeon General and Centers for Disease Control (CDC) guidelines for recommending more prudent use of opioid narcotics, the search for a non-opioid alternative for aborting acute migraines is particularly relevant. The CDC also estimates the prevalence of opioid dependence may be as high as 26% among patients prescribed opioids for chronic pain, not due to cancer, in the primary care setting. Given such staggering data, it is imperative that we, as caretakers, not foster opioid dependence but rather continue to investigate non-opioid therapies for the management of acute migraines in the emergent care settings. Our literature review demonstrates that metoclopramide should be used more frequently as first-line therapy for an acute migraine over opioids. The use of opioids specifically has been discouraged as migraine treatment by the American Headache Society citing "insufficient evidence" as the main reason. Metoclopramide, specifically using the 10 mg dose, has been cited as "highly likely to be effective" by the same guidelines. Another major issue with opioids is the growing potential for abuse, thus minimizing the use of these drugs for only special circumstances would be beneficial overall.
CI  - The authors have declared that no competing interests exist.
IS  - 2168-8184
IL  - 2168-8184
DO  - https://dx.doi.org/10.7759/cureus.1181
PT  - Journal Article
PT  - Review
ID  - 10.7759/cureus.1181 [doi]
ID  - PMC5438233 [pmc]
PP  - epublish
LG  - English
EP  - 20170420
DP  - 2017 Apr 20
EZ  - 2017/05/24 06:00
DA  - 2017/05/24 06:01
DT  - 2017/05/24 06:00
YR  - 2017
RD  - 20170816
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28533997

<1103. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28506855
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Shah AS
AU  - Blackwell RH
AU  - Kuo PC
AU  - Gupta GN
FA  - Shah, Arpeet S
FA  - Blackwell, Robert H
FA  - Kuo, Paul C
FA  - Gupta, Gopal N
IN  - Shah, Arpeet S. Department of Urology, Loyola University Medical Center, Maywood, Illinois. Electronic address: arshah@lumc.edu.
IN  - Blackwell, Robert H. Department of Urology, Loyola University Medical Center, Maywood, Illinois; One:MAP Division of Clinical Informatics and Analytics, Loyola University Medical Center, Maywood, Illinois.
IN  - Kuo, Paul C. Department of Surgery, Loyola University Medical Center, Maywood, Illinois; One:MAP Division of Clinical Informatics and Analytics, Loyola University Medical Center, Maywood, Illinois.
IN  - Gupta, Gopal N. Department of Urology, Loyola University Medical Center, Maywood, Illinois; Department of Surgery, Loyola University Medical Center, Maywood, Illinois; One:MAP Division of Clinical Informatics and Analytics, Loyola University Medical Center, Maywood, Illinois.
TI  - Rates and Risk Factors for Opioid Dependence and Overdose after Urological Surgery.
SO  - Journal of Urology. 198(5):1130-1136, 2017 Nov
AS  - J Urol. 198(5):1130-1136, 2017 Nov
NJ  - The Journal of urology
VO  - 198
IP  - 5
PG  - 1130-1136
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - kc7, 0376374
IO  - J. Urol.
CP  - United States
KW  - analgesics;  drug overdose;  opioid;  postoperative complications;  substance-related disorders;  urological surgical procedures
AB  - PURPOSE: Effective pain management is a critical component of the perioperative process with opioids representing a mainstay of therapy. The opioid epidemic is a growing concern in the United States. The goal of this study was to quantify the risk of opioid dependence or overdose among patients undergoing urological surgery and to identify risk factors of opioid dependence or overdose.
AB  - MATERIALS AND METHODS: We retrospectively reviewed data on urological surgery from 2007 to 2011. Data sources included the HCUP (Healthcare Cost and Utilization Project) inpatient, ambulatory surgery and emergency department data sets. Outcomes of postoperative opioid dependence and overdose were identified by previously validated ICD-9 codes. Multivariable logistic regression adjusted for surgical procedure was performed to identify predictors of opioid dependence or overdose following urological surgery.
AB  - RESULTS: Overall 675,527 patients underwent urological surgery, of whom 0.09% were diagnosed with opioid dependence or overdose. Patients in whom opioid dependence or overdose developed were younger (median age 51 vs 62 years), carried nonprivate insurance (69.6% vs 66%), underwent an inpatient procedure (81.0% vs 42.4%) and had a longer length of stay (median 3 vs 0 days) and a history of depression (14.4% vs 3.4%) or chronic obstructive pulmonary disease (20.3% vs 8.9%, all p <0.001). On adjusted multivariable analysis these factors remained independent risk factors for opioid dependence or overdose.
AB  - CONCLUSIONS: Postoperative opioid dependence or overdose affects 1 of 1,111 urological surgery patients. Risk factors for opioid dependence or overdose included younger age, inpatient surgery and increasing hospitalization duration, baseline depression, tobacco use and chronic obstructive pulmonary disease as well as insurance provider, including Medicaid, Medicare (age less than 65 years) and noninsured status.

Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
ES  - 1527-3792
IL  - 0022-5347
DI  - S0022-5347(17)67187-8
DO  - https://dx.doi.org/10.1016/j.juro.2017.05.037
PT  - Journal Article
ID  - S0022-5347(17)67187-8 [pii]
ID  - 10.1016/j.juro.2017.05.037 [doi]
PP  - ppublish
PH  - 2017/05/04 [accepted]
LG  - English
EP  - 20170512
DP  - 2017 Nov
EZ  - 2017/05/17 06:00
DA  - 2017/05/17 06:00
DT  - 2017/05/17 06:00
YR  - 2017
RD  - 20171024
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28506855

<1104. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28500651
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Radcliff JA
AU  - Rafeq RM
AU  - Bowen JF
AU  - Pontiggia L
AU  - Sen S
AI  - Radcliff, Jacob A; ORCID: http://orcid.org/0000-0002-4455-2224
FA  - Radcliff, Jacob A
FA  - Rafeq, Rachel M
FA  - Bowen, Jane F
FA  - Pontiggia, Laura
FA  - Sen, Sanchita
IN  - Radcliff, Jacob A. Department of Pharmacy Practice and Pharmacy Administration, Philadelphia College of Pharmacy, University of the Sciences, Philadelphia, Pennsylvania.
IN  - Rafeq, Rachel M. Cooper University Hospital, Camden, New Jersey.
IN  - Bowen, Jane F. Department of Pharmacy Practice and Pharmacy Administration, Philadelphia College of Pharmacy, University of the Sciences, Philadelphia, Pennsylvania.
IN  - Pontiggia, Laura. Department of Mathematics, Physics, and Statistics, University of the Sciences, Philadelphia, Pennsylvania.
IN  - Sen, Sanchita. Department of Pharmacy Practice and Pharmacy Administration, Philadelphia College of Pharmacy, University of the Sciences, Philadelphia, Pennsylvania.
TI  - Predictors of Response in Emergency Department Patients Receiving Intravenous Opioids for Severe Pain.
SO  - Pharmacotherapy:The Journal of Human Pharmacology & Drug Therapy. 37(7):799-805, 2017 Jul
AS  - Pharmacotherapy. 37(7):799-805, 2017 Jul
NJ  - Pharmacotherapy
VO  - 37
IP  - 7
PG  - 799-805
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - par, 8111305
IO  - Pharmacotherapy
CP  - United States
KW  - emergency department;  hydromorphone;  morphine;  pain;  predictor;  response
AB  - The primary objective of this study was to identify significant environmental and patient characteristics of emergency department (ED) patients who responded to intravenous (IV) hydromorphone and IV morphine for severe pain. Secondary objectives were to investigate the individual effect of the significant environmental and patient characteristics of responders, and to assess the nature and strength of the correlation of initial dose and change in pain score from arrival to pre-administration. A retrospective chart review was performed in patients who received IV hydromorphone or morphine in the ED for severe pain. Key evaluated patient characteristics included patient demographics, recent opioid use, history of drug or alcohol abuse, and pain location, among others. Key evaluated environmental characteristics included initial opioid administered, time to first dose, initial pain score, and initial dose of opioid administered, among others. Environmental and patient characteristics associated with response to pain management were first identified using bivariate analyses and then entered into a multiple stepwise logistic regression mode. Patients were excluded if they were younger than 18 years, did not have a follow-up pain score within 2 hours of drug administration, or if they were discharged from the ED within 1 hour of administration. Patients meeting the inclusion criteria were grouped into two cohorts based on response and lack of response to treatment. A total of 200 patients were included. A decrease in pain score from arrival until pre-administration pain score and an inactive tobacco history had a positive association with response (odds ratio [OR] 1.488, 95% confidence interval [CI] 1.088-2.036, p=0.013, and OR 1.835, 95% CI 0.801-4.200, overall p=0.022, respectively). A higher initial dose and an active tobacco history had a negative association with response (OR 0.715, 95% CI 0.580-0.881, p=0.002, and OR 0.582, 95% CI 0.296-1.144, overall p=0.022, respectively). Two characteristics were associated with response to IV opioid pain management in the ED, inactive tobacco history and an increase in pain score from arrival until pre-administration, and two characteristics were associated with nonresponse to IV opioid pain management in the ED, active tobacco history and a higher initial dose. Previous literature supports both characteristics identified as risk factors but does not support either characteristic identified as protective factors, prompting the need for further research.

Copyright © 2017 Pharmacotherapy Publications, Inc.
ES  - 1875-9114
IL  - 0277-0008
DO  - https://dx.doi.org/10.1002/phar.1949
PT  - Journal Article
ID  - 10.1002/phar.1949 [doi]
PP  - ppublish
LG  - English
DP  - 2017 Jul
EZ  - 2017/05/14 06:00
DA  - 2017/05/14 06:00
DT  - 2017/05/14 06:00
YR  - 2017
RD  - 20170720
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28500651

<1105. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28481656
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Faul M
AU  - Lurie P
AU  - Kinsman JM
AU  - Dailey MW
AU  - Crabaugh C
AU  - Sasser SM
FA  - Faul, Mark
FA  - Lurie, Peter
FA  - Kinsman, Jeremiah M
FA  - Dailey, Michael W
FA  - Crabaugh, Charmaine
FA  - Sasser, Scott M
TI  - Multiple Naloxone Administrations Among Emergency Medical Service Providers is Increasing.
SO  - Prehospital Emergency Care. 21(4):411-419, 2017 Jul-Aug
AS  - Prehosp Emerg Care. 21(4):411-419, 2017 Jul-Aug
NJ  - Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
VO  - 21
IP  - 4
PG  - 411-419
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - c5i, 9703530
IO  - Prehosp Emerg Care
CP  - England
KW  - EMS;  Naloxone;  heroin;  opioid;  overdose
AB  - BACKGROUND: Opioid overdoses are at epidemic levels in the United States. Emergency Medical Service (EMS) providers may administer naloxone to restore patient breathing and prevent respiratory arrest. There was a need for contemporary data to examine the number of naloxone administrations in an EMS encounter.
AB  - METHODS: Using data from the National Emergency Medical Services Information System, we examined data from 2012-5 to determine trends in patients receiving multiple naloxone administrations (MNAs). Logistic regression including demographic, clinical, and operational information was used to examine factors associated with MNA.
AB  - RESULTS: Among all events where naloxone was administered only 16.7% of the 911 calls specifically identified the medical emergency as a drug ingestion or poisoning event. The percentage of patients receiving MNA increased from 14.5% in 2012 to 18.2% in 2015, which represents a 26% increase in MNA in 4 years. Patients aged 20-29 had the highest percentage of MNA (21.1%). Patients in the Northeast and the Midwest had the highest relative MNA (Chi Squared = 539.5, p < 0.01 and Chi Squared = 351.2, p < 0.01, respectively). The logistic regression model showed that the adjusted odds ratios (aOR) for MNA were greatest among people who live in the Northeast (aOR = 1.18, 95% CI = 1.13-1.22) and for men (aOR = 1.13, 95% CI = 1.10-1.16), but lower for suburban and rural areas (aOR = 0.76, 95% CI = 0.72-0.80 and aOR = 0.85, 95% CI = 0.80-0.89) and lowest for wilderness areas (aOR = 0.76, 95% CI = 0.68-0.84). Higher adjusted odds of MNA occurred when an advanced life support (ALS 2) level of service was provided compared to basic life support (BLS) ambulances (aOR = 2.15, 95% CI = 1.45-3.16) and when the dispatch complaint indicated there was a drug poisoning event (aOR = 1.12, 95% CI = 1.09-1.16). Reported layperson naloxone administration prior to EMS arrival was rare (1%).
AB  - CONCLUSION: This study shows that frequency of MNA is growing over time and is regionally dependent. MNA may be a barometer of the potency of the opioid involved in the overdose. The increase in MNA provides support for a dosage review. Better identification of opioid related events in the dispatch system could lead to a better match of services with patient needs.
ES  - 1545-0066
IL  - 1090-3127
DO  - https://dx.doi.org/10.1080/10903127.2017.1315203
PT  - Journal Article
ID  - 10.1080/10903127.2017.1315203 [doi]
PP  - ppublish
LG  - English
EP  - 20170508
DP  - 2017 Jul-Aug
EZ  - 2017/05/10 06:00
DA  - 2017/05/10 06:00
DT  - 2017/05/09 06:00
YR  - 2017
RD  - 20170711
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28481656

<1106. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28410960
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Murphy SM
AU  - Howell D
AU  - McPherson S
AU  - Grohs R
AU  - Roll J
AU  - Neven D
FA  - Murphy, Sean M
FA  - Howell, Donelle
FA  - McPherson, Sterling
FA  - Grohs, Rebecca
FA  - Roll, John
FA  - Neven, Darin
IN  - Murphy, Sean M. Department of Health Policy and Administration, Washington State University, Spokane, Washington; Program of Excellence in Addictions Research, Washington State University, Spokane, Washington.
IN  - Howell, Donelle. Program of Excellence in Addictions Research, Washington State University, Spokane, Washington.
IN  - McPherson, Sterling. Program of Excellence in Addictions Research, Washington State University, Spokane, Washington.
IN  - Grohs, Rebecca. Program of Excellence in Addictions Research, Washington State University, Spokane, Washington.
IN  - Roll, John. Program of Excellence in Addictions Research, Washington State University, Spokane, Washington.
IN  - Neven, Darin. Program of Excellence in Addictions Research, Washington State University, Spokane, Washington.
TI  - A Randomized Controlled Trial of a Citywide Emergency Department Care-Coordination Program to Reduce Prescription Opioid-Related Visits: An Economic Evaluation.
SO  - Journal of Emergency Medicine. 53(2):186-194, 2017 Aug
AS  - J Emerg Med. 53(2):186-194, 2017 Aug
NJ  - The Journal of emergency medicine
VO  - 53
IP  - 2
PG  - 186-194
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - ibo, 8412174
IO  - J Emerg Med
CP  - United States
KW  - ED care coordination;  economic evaluation;  frequent ED use;  nonmedical prescription opioid use
AB  - BACKGROUND: Care provided in the emergency department (ED) can cost up to five times as much as care received for comparable diagnoses in alternative settings. Small groups of patients, many of whom suffer from an opioid use disorder, often account for a large proportion of total ED visits. We recently conducted, and demonstrated the effectiveness of, the first randomized controlled trial of a citywide ED care-coordination program intending to reduce prescription-opioid-related ED visits. All EDs in the metropolitan study area were connected to a Web-based information exchange system.
AB  - OBJECTIVE: The objective of this article was to perform an economic evaluation of the 12-month trial from a third-party-payer perspective.
AB  - METHODS: We modeled the person-period monthly for the 12-month observation period, and estimated total treatment costs and return on investment (ROI) with regard to cost offsets, over time, for all visits where the patient was admitted to and discharged from the ED.
AB  - RESULTS: By the end of month 4, the mean cumulative cost differential was significantly lower for intervention relative to treatment-as-usual participants (-$1370; p = 0.03); this figure climbed to -$3200 (p = 0.02) by the end of month 12. The ROI trended upward throughout the observation period, but failed to reach statistical significance by the end of month 12 (ROI = 3.39, p = 0.07).
AB  - CONCLUSION: The intervention produced significant cost offsets by the end of month 4, which continued to accumulate throughout the trial; however, ROI was not significant. Because the per-patient administrative costs of the program are incurred at the time of enrollment, our results highlight the importance of future studies that are able to follow participants for a period beyond 12 months to more accurately estimate the program's ROI.

Copyright © 2017 Elsevier Inc. All rights reserved.
IS  - 0736-4679
IL  - 0736-4679
DI  - S0736-4679(17)30151-8
DO  - https://dx.doi.org/10.1016/j.jemermed.2017.02.014
PT  - Journal Article
ID  - S0736-4679(17)30151-8 [pii]
ID  - 10.1016/j.jemermed.2017.02.014 [doi]
ID  - PMC5572814 [pmc]
ID  - NIHMS893806 [mid]
PP  - ppublish
PH  - 2016/08/15 [received]
PH  - 2017/02/07 [revised]
PH  - 2017/02/25 [accepted]
GI  - No: P30 DA040500
Organization: (DA) *NIDA NIH HHS*
Country: United States
LG  - English
EP  - 20170412
DP  - 2017 Aug
PQ  - 2018/08/01
EZ  - 2017/04/16 06:00
DA  - 2017/04/16 06:00
DT  - 2017/04/16 06:00
YR  - 2017
RD  - 20170829
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28410960

<1107. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28318458
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Moore K
AU  - Lew J
AU  - Buttemer S
AU  - Kielstra L
FA  - Moore, Kieran
FA  - Lew, Julia
FA  - Buttemer, Samantha
FA  - Kielstra, Lauren
IN  - Moore, Kieran. *Department of Medicine,Public Health and Preventive Medicine,Queen's University,Kingston,ON.
IN  - Lew, Julia. +School of Medicine,Public Health and Preventive Medicine,Queen's University,Kingston,ON.
IN  - Buttemer, Samantha. ++Department of Family Medicine,Public Health and Preventive Medicine,Queen's University,Kingston,ON.
IN  - Kielstra, Lauren. *Department of Medicine,Public Health and Preventive Medicine,Queen's University,Kingston,ON.
TI  - First, do no harm: Advocating for opioid prescribing guidelines in Canadian emergency departments.
SO  - CJEM Canadian Journal of Emergency Medical Care. 19(4):324-326, 2017 Jul
AS  - CJEM, Can. j. emerg. med. care. 19(4):324-326, 2017 Jul
NJ  - CJEM
VO  - 19
IP  - 4
PG  - 324-326
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 100893237
IO  - CJEM
CP  - England
KW  - opioids;  prescribing guidelines;  public health
IS  - 1481-8035
IL  - 1481-8035
DO  - https://dx.doi.org/10.1017/cem.2017.8
PT  - Journal Article
ID  - S1481803517000082 [pii]
ID  - 10.1017/cem.2017.8 [doi]
PP  - ppublish
LG  - English
EP  - 20170320
DP  - 2017 Jul
EZ  - 2017/03/21 06:00
DA  - 2017/03/21 06:00
DT  - 2017/03/21 06:00
YR  - 2017
RD  - 20170815
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28318458

<1108. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28286847
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - PubMed-not-MEDLINE
AU  - Mehrara M
AU  - Tavakoli N
AU  - Fathi M
AU  - Mahshidfar B
AU  - Zare MA
AU  - Asadi A
AU  - Hosseinzadeh S
AU  - Safdarian M
FA  - Mehrara, Mostafa
FA  - Tavakoli, Nader
FA  - Fathi, Marzieh
FA  - Mahshidfar, Babak
FA  - Zare, Mohammad Amin
FA  - Asadi, Azita
FA  - Hosseinzadeh, Saeedeh
FA  - Safdarian, Mehdi
IN  - Mehrara, Mostafa. Department of Emergency Medicine, Hazrat-e-Rasoul Akram Medical Centre, Iran University of Medical Sciences, Tehran, Iran.
IN  - Tavakoli, Nader. Department of Emergency Medicine, Hazrat-e-Rasoul Akram Medical Centre, Iran University of Medical Sciences, Tehran, Iran.
IN  - Fathi, Marzieh. Department of Emergency Medicine, Hazrat-e-Rasoul Akram Medical Centre, Iran University of Medical Sciences, Tehran, Iran.
IN  - Mahshidfar, Babak. Department of Emergency Medicine, Hazrat-e-Rasoul Akram Medical Centre, Iran University of Medical Sciences, Tehran, Iran.
IN  - Zare, Mohammad Amin. Department of Emergency Medicine, Hazrat-e-Rasoul Akram Medical Centre, Iran University of Medical Sciences, Tehran, Iran.
IN  - Asadi, Azita. Department of Emergency Medicine, Hazrat-e-Rasoul Akram Medical Centre, Iran University of Medical Sciences, Tehran, Iran.
IN  - Hosseinzadeh, Saeedeh. Department of Emergency Medicine, Hazrat-e-Rasoul Akram Medical Centre, Iran University of Medical Sciences, Tehran, Iran.
IN  - Safdarian, Mehdi. Department of Emergency Medicine, Hazrat-e-Rasoul Akram Medical Centre, Iran University of Medical Sciences, Tehran, Iran.
TI  - Protocol Adherence in Prehospital Medical Care Provided for Patients with Chest Pain and Loss of Consciousness; a Brief Report.
SO  - Emergency (Tehran, Iran). 5(1):e40, 2017
AS  - Emerg (Tehran). 5(1):e40, 2017
NJ  - Emergency (Tehran, Iran)
VO  - 5
IP  - 1
PG  - e40
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Print
JC  - 101648866
IO  - Emerg (Tehran)
CP  - Iran
KW  - Emergency medical services;  chest pain;  medical audit;  protocol adherence;  unconsciousness
AB  - INTRODUCTION: Although many protocols are available in the field of the prehospital medical care (PMC), there is still a notable gap between protocol based directions and applied clinical practice. This study measures the rate of protocol adherence in PMC provided for patients with chest pain and loss of consciousness (LOC).
AB  - METHOD: In this cross-sectional study, 10 educated research assistants audited the situation of provided PMC for non-traumatic chest pain and LOC patients, presenting to the emergency department of a tertiary level teaching hospital, compare to national recommendations in these regards.
AB  - RESULTS: 101 cases with the mean age of 56.7 +/- 12.3 years (30-78) were audited (55.4% male). 61 (60.3%) patients had chest pain and 40 (39.7%) cases had LOC. Protocol adherence rates for cardiac monitoring (62.3%), O2 therapy (32.8%), nitroglycerin administration (60.7%), and aspirin administration (52.5%) in prehospital care of patients with chest pain were fair to poor. Protocol adherence rates for correct patient positioning (25%), O2 therapy (75%), cardiac monitoring (25%), pupils examination (25%), bedside glucometery (50%), and assessing for naloxone administration (55%) in prehospital care of patients with LOC were fair to poor.
AB  - CONCLUSION: There were more than 20% protocol violation regarding prehospital care of chest pain patients regarding cardiac monitoring, O2 therapy, and nitroglycerin and aspirin administration. There were same situation regarding O2 therapy, positioning, cardiac monitoring, pupils examination, bedside glucometery, and assessing for naloxone administration of LOC patients in prehospital setting.
CI  - There is no conflict of interest between authors.
IS  - 2345-4563
IL  - 2345-4563
PT  - Journal Article
ID  - PMC5325911 [pmc]
PP  - ppublish
LG  - English
EP  - 20170111
DP  - 2017
EZ  - 2017/03/14 06:00
DA  - 2017/03/14 06:01
DT  - 2017/03/14 06:00
YR  - 2017
RD  - 20170816
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28286847

<1109. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28259526
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Bailey AM
AU  - Baum RA
AU  - Horn K
AU  - Lewis T
AU  - Morizio K
AU  - Schultz A
AU  - Weant K
AU  - Justice SN
FA  - Bailey, Abby M
FA  - Baum, Regan A
FA  - Horn, Karolyn
FA  - Lewis, Tameka
FA  - Morizio, Kate
FA  - Schultz, Amy
FA  - Weant, Kyle
FA  - Justice, Stephanie N
IN  - Bailey, Abby M. Department of Pharmacy, University of Kentucky HealthCare, Lexington, Kentucky.
IN  - Baum, Regan A. Department of Pharmacy, University of Kentucky HealthCare, Lexington, Kentucky.
IN  - Horn, Karolyn. Department of Pharmacy, University of Kentucky HealthCare, Lexington, Kentucky.
IN  - Lewis, Tameka. Department of Pharmacy, Charleston Area Medical Center, Charleston, West Virginia.
IN  - Morizio, Kate. Department of Pharmacy, University of Kentucky HealthCare, Lexington, Kentucky.
IN  - Schultz, Amy. Department of Pharmacy, Charleston Area Medical Center, Charleston, West Virginia.
IN  - Weant, Kyle. Department of Pharmacy, Medical University of South Carolina, Charleston, South Carolina.
IN  - Justice, Stephanie N. Department of Pharmacy, St. Claire Regional Medical Center, Morehead, Kentucky.
TI  - Review of Intranasally Administered Medications for Use in the Emergency Department.
SO  - Journal of Emergency Medicine. 53(1):38-48, 2017 Jul
AS  - J Emerg Med. 53(1):38-48, 2017 Jul
NJ  - The Journal of emergency medicine
VO  - 53
IP  - 1
PG  - 38-48
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - ibo, 8412174
IO  - J Emerg Med
CP  - United States
KW  - emergency department;  intranasal;  medication;  nasal;  prehospital
AB  - BACKGROUND: Intranasal (IN) medication delivery is a viable alternative to other routes of administration, including intravenous (IV) and intramuscular (IM) administration. The IN route bypasses the risk of needle-stick injuries and alleviates the emotional trauma that may arise from the insertion of an IV catheter.
AB  - OBJECTIVE: This review aims to evaluate published literature on medications administered via the IN route that are applicable to practice in emergency medicine.
AB  - DISCUSSION: The nasal mucosa is highly vascularized, and the olfactory tissues provide a direct conduit to the central nervous system, bypass first-pass metabolism, and lead to an onset of action similar to IV drug administration. This route of administration has also been shown to decrease delays in drug administration, which can have a profound impact in a variety of emergent scenarios, such as seizures, acutely agitated or combative patients, and trauma management. IN administration of midazolam, lorazepam, flumazenil, dexmedetomidine, ketamine, fentanyl, hydromorphone, butorphanol, naloxone, insulin, and haloperidol has been shown to be a safe, effective alternative to IM or IV administration. As the use of IN medications becomes a more common route of administration in the emergency department setting, and in prehospital and outpatient settings, it is increasingly important for providers to become more familiar with the nuances of this novel route of medication delivery.
AB  - CONCLUSIONS: IN administration of the reviewed medications has been shown to be a safe and effective alternative to IM or IV administration. Use of IN is becoming more commonplace in the emergency department setting and in prehospital settings.

Copyright © 2017 Elsevier Inc. All rights reserved.
IS  - 0736-4679
IL  - 0736-4679
DI  - S0736-4679(17)30024-0
DO  - https://dx.doi.org/10.1016/j.jemermed.2017.01.020
PT  - Journal Article
ID  - S0736-4679(17)30024-0 [pii]
ID  - 10.1016/j.jemermed.2017.01.020 [doi]
PP  - ppublish
PH  - 2016/08/03 [received]
PH  - 2016/12/13 [revised]
PH  - 2017/01/22 [accepted]
LG  - English
EP  - 20170301
DP  - 2017 Jul
EZ  - 2017/03/06 06:00
DA  - 2017/03/06 06:00
DT  - 2017/03/06 06:00
YR  - 2017
RD  - 20170812
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28259526

<1110. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28243878
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Murimi IB
FA  - Murimi, Irene Berita
IN  - Murimi, Irene Berita. Center for Drug Safety and Effectiveness, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. imurimi1@jhmi.edu.
TI  - Capsule Commentary on D'Onofrio et al., Emergency Department-Initiated Buprenorphine for Opioid Dependence with Continuation in Primary Care: Outcomes During and After Intervention.
SO  - Journal of General Internal Medicine. 32(6):683, 2017 Jun
AS  - J Gen Intern Med. 32(6):683, 2017 Jun
NJ  - Journal of general internal medicine
VO  - 32
IP  - 6
PG  - 683
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - 8605834
IO  - J Gen Intern Med
CP  - United States
ES  - 1525-1497
IL  - 0884-8734
DO  - https://dx.doi.org/10.1007/s11606-017-4015-0
PT  - Journal Article
ID  - 10.1007/s11606-017-4015-0 [doi]
ID  - 10.1007/s11606-017-4015-0 [pii]
ID  - PMC5442021 [pmc]
PP  - ppublish
LG  - English
DP  - 2017 Jun
PQ  - 2018/06/01
EZ  - 2017/03/01 06:00
DA  - 2017/03/01 06:00
DT  - 2017/03/01 06:00
YR  - 2017
RD  - 20170609
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28243878

<1111. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28226416
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Lyapustina T
AU  - Castillo R
AU  - Omaki E
AU  - Shields W
AU  - McDonald E
AU  - Rothman R
AU  - Gielen A
FA  - Lyapustina, Tatyana
FA  - Castillo, Renan
FA  - Omaki, Elise
FA  - Shields, Wendy
FA  - McDonald, Eileen
FA  - Rothman, Richard
FA  - Gielen, Andrea
IN  - Lyapustina, Tatyana. University of Connecticut Health Center, Farmington, Connecticut, U.S.A.
IN  - Lyapustina, Tatyana. Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A.
IN  - Castillo, Renan. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, U.S.A.
IN  - Omaki, Elise. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, U.S.A.
IN  - Shields, Wendy. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, U.S.A.
IN  - McDonald, Eileen. Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, U.S.A.
IN  - Rothman, Richard. Division of Emergency Medicine, Johns Hopkins Medicine, Baltimore, Maryland, U.S.A.
IN  - Gielen, Andrea. Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, U.S.A.
TI  - The Contribution of the Emergency Department To Opioid Pain Reliever Misuse And Diversion: A Critical Review. [Review]
SO  - Pain Practice. 17(8):1097-1104, 2017 Nov
AS  - Pain pract.. 17(8):1097-1104, 2017 Nov
NJ  - Pain practice : the official journal of World Institute of Pain
VO  - 17
IP  - 8
PG  - 1097-1104
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 101130835
IO  - Pain Pract
CP  - United States
KW  - opioid analgesics;  opioid-related disorders;  self medication
AB  - Prescription opioid pain reliever (OPR) misuse and diversion is an important and growing public health problem in the United States that is responsible for significant morbidity and mortality. Emergency physicians are among the top prescribers of OPRs, yet the relative contribution of emergency department (ED) OPR prescriptions to the overall opioid abuse epidemic remains unclear. This study critically reviews seven peer-reviewed studies that specifically identified the ED as a source of OPRs. Of the OPRs prescribed in the ED, approximately 10% are associated with indicators of inappropriate prescribing, and approximately 42% may ultimately be misused; of the OPRs that are diverted, approximately 10% originate from an ED prescription. Among patients who suffer an OPR-related death, approximately 1.8% of the OPR pills given to the decedents will have come from the ED. In addition to the need for more research, the existing literature suggests an urgent need for interventions in the ED to reduce OPR misuse and diversion.

Copyright © 2017 World Institute of Pain.
ES  - 1533-2500
IL  - 1530-7085
DO  - https://dx.doi.org/10.1111/papr.12568
PT  - Journal Article
PT  - Review
ID  - 10.1111/papr.12568 [doi]
PP  - ppublish
PH  - 2016/07/24 [received]
PH  - 2016/12/11 [revised]
PH  - 2017/01/18 [accepted]
LG  - English
EP  - 20170320
DP  - 2017 Nov
EZ  - 2017/02/23 06:00
DA  - 2017/02/23 06:00
DT  - 2017/02/23 06:00
YR  - 2017
RD  - 20171108
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28226416

<1112. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28100012
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Morizio KM
AU  - Baum RA
AU  - Dugan A
AU  - Martin JE
AU  - Bailey AM
FA  - Morizio, Kate M
FA  - Baum, Regan A
FA  - Dugan, Adam
FA  - Martin, Julia E
FA  - Bailey, Abby M
IN  - Morizio, Kate M. Department of Pharmacy, Banner University Medical Center at the University of Arizona, Tucson, Arizona.
IN  - Baum, Regan A. Department of Pharmacy, University of Kentucky HealthCare, Lexington, Kentucky.
IN  - Dugan, Adam. Department of Emergency Medicine, University of Kentucky HealthCare, Lexington, Kentucky.
IN  - Martin, Julia E. Department of Emergency Medicine, University of Kentucky HealthCare, Lexington, Kentucky.
IN  - Bailey, Abby M. Department of Pharmacy, University of Kentucky HealthCare, Lexington, Kentucky.
TI  - Characterization and Management of Patients with Heroin versus Nonheroin Opioid Overdoses: Experience at an Academic Medical Center.
SO  - Pharmacotherapy:The Journal of Human Pharmacology & Drug Therapy. 37(7):781-790, 2017 Jul
AS  - Pharmacotherapy. 37(7):781-790, 2017 Jul
NJ  - Pharmacotherapy
VO  - 37
IP  - 7
PG  - 781-790
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - par, 8111305
IO  - Pharmacotherapy
CP  - United States
KW  - academic medical center;  heroin;  naloxone;  opioid overdose;  overdose demographics;  prescription opioid
AB  - STUDY OBJECTIVES: To characterize the differences between patients who had heroin and nonheroin opioid overdoses and to determine whether there were any significant differences in their management with regard to the naloxone use.
AB  - DESIGN: Retrospective cohort study.
AB  - SETTING: Large academic medical center.
AB  - PATIENTS: A total of 923 patients admitted to the medical center who were identified for overdose by heroin or other opiate-related narcotics between January 2010 and September 2015; 480 patients experienced a nonheroin opioid overdose event, and 443 patients experienced a heroin overdose event.
AB  - MEASUREMENTS AND MAIN RESULTS: Patients presenting with heroin overdose tended to be younger and male, with higher rates of hepatitis C virus (HCV) infection compared with those presenting with nonheroin opioid overdose (p<0.05). Patients in the heroin group were also more likely to have a previous overdose event, history of injection drug use, and history of prescription opioid abuse compared with the nonheroin group (p<0.05). Those presenting with heroin overdose were more likely to receive naloxone in the prehospital setting (p<0.05) but were less likely to receive naloxone once admitted (p<0.05). Patients with nonheroin opioid overdoses required more continuous infusions of naloxone (p<0.05) and admission to the intensive care unit (p<0.05). Of all 923 patients, 178 (19.3%) had a repeat admission for any reason, and 70 (7.6%) were readmitted over the course of the study period for another overdose event with the same drug. The proportion of patients presenting with a heroin overdose steadily increased from 2010-2015; the number of patients presenting to the emergency department with nonheroin opioid overdoses steadily decreased. As rates of heroin overdose increased each year, the incidence of HCV infection increased dramatically.
AB  - CONCLUSION: This study indicates that the incidence of heroin overdoses has significantly increased over the last several years, and the rates of HCV infection 4-fold since the start of the study period. Patients admitted for nonheroin opioid overdose were more likely to be admitted to the hospital and intensive care unit compared with those admitted for heroin overdose. The rise in overdose events only further illustrates a gap in our understanding of the cycle of addiction, drug abuse, and overdose events.

Copyright © 2017 Pharmacotherapy Publications, Inc.
ES  - 1875-9114
IL  - 0277-0008
DO  - https://dx.doi.org/10.1002/phar.1902
PT  - Journal Article
ID  - 10.1002/phar.1902 [doi]
PP  - ppublish
LG  - English
EP  - 20170227
DP  - 2017 Jul
EZ  - 2017/01/19 06:00
DA  - 2017/01/19 06:00
DT  - 2017/01/19 06:00
YR  - 2017
RD  - 20170720
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28100012

<1113. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28078707
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - M Orkin A
AU  - Buchman DZ
AI  - Buchman, Daniel Z; ORCID: http://orcid.org/0000-0001-8944-6647
FA  - M Orkin, Aaron
FA  - Buchman, Daniel Z
IN  - M Orkin, Aaron. Schwartz/Reisman Emergency Medicine Institute, Sinai Health System, Toronto, Ontario, Canada.
IN  - M Orkin, Aaron. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
IN  - Buchman, Daniel Z. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
IN  - Buchman, Daniel Z. University Health Network, Toronto, Ontario, Canada.
IN  - Buchman, Daniel Z. Joint Centre for Bioethics, University of Toronto, Toronto, Ontario, Canada.
TI  - Commentary on McAuley et al. (2017): Naloxone programs must reduce marginalization and improve access to comprehensive emergency care.
SO  - Addiction. 112(2):309-310, 2017 Feb
AS  - Addiction. 112(2):309-310, 2017 Feb
NJ  - Addiction (Abingdon, England)
VO  - 112
IP  - 2
PG  - 309-310
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - bm3, 9304118
IO  - Addiction
CP  - England
KW  - Emergency care;  first aid;  naloxone;  opioid misuse;  pre-hospital care;  stigma
ES  - 1360-0443
IL  - 0965-2140
DO  - https://dx.doi.org/10.1111/add.13662
PT  - Journal Article
ID  - 10.1111/add.13662 [doi]
PP  - ppublish
PH  - 2016/10/13 [received]
PH  - 2016/10/19 [accepted]
LG  - English
DP  - 2017 Feb
EZ  - 2017/01/13 06:00
DA  - 2017/01/13 06:00
DT  - 2017/01/13 06:00
YR  - 2017
RD  - 20170112
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28078707

<1114. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28009931
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Process
AU  - Pardo B
FA  - Pardo, Bryce
IN  - Pardo, Bryce. School of Public Policy, University of Maryland, College Park, MD, USA.
TI  - Do more robust prescription drug monitoring programs reduce prescription opioid overdose?.
SO  - Addiction. 112(10):1773-1783, 2017 Oct
AS  - Addiction. 112(10):1773-1783, 2017 Oct
NJ  - Addiction (Abingdon, England)
VO  - 112
IP  - 10
PG  - 1773-1783
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - bm3, 9304118
IO  - Addiction
CP  - England
KW  - Law/regulation;  medical marijuana;  opioids;  overdose;  prescription drug monitoring programs;  prescription drugs
AB  - BACKGROUND AND AIMS: In the United States, overdose deaths attributed to opioid pain relievers (OPR) have quadrupled since 1999, prompting many states to adopt Prescription Drug Monitoring Programs (PMP). This study aimed to: (1) estimate the relationship of PMP strength with OPR overdose deaths across states and over time; (2) measure what threshold in PMP strength is associated with the greatest reduction in OPR overdose; and (3) assess the relationship of medical marijuana dispensaries with OPR overdose deaths.
AB  - DESIGN: Panel data from the Centers for Disease Control and Prevention's (CDC's) Wide-ranging Online Data for Epidemiologic Research database (WONDER) were analyzed using fixed effects to regress state-year death rates on an index variable compiled from the Prescription Drug Abuse Policy System (PDAPS) while controlling for PMP administration, demographic factors and laws that might affect OPR overdose.
AB  - SETTING AND PARTICIPANTS: Age-adjusted opioid overdose death rates for all 50 states and the District of Columbia between 1999 and 2014 for a total of 816 observations.
AB  - MEASUREMENTS: PMP strength was calculated using legal data compiled by the Prescription Drug Abuse Policy System (PDAPS). In addition to demographic controls, other covariates included laws that regulate pain clinics, access to naloxone, use of emergency services (Good Samaritan Laws) and medical marijuana.
AB  - FINDINGS: PMP strength was associated negatively with OPR overdose deaths. Every 1-point increase in PMP strength was associated with a 1% [95% confidence interval (CI) = 0.2-2%] reduction in overdose deaths. When collapsed into quartiles, PMPs in the third quartile were associated with an approximately 18% (95% CI = 1.6-29%) reduction in OPR overdose death rates compared with states without a PMP. States with medical marijuana dispensaries reported a 16% (95% CI = 1-30%) reduction in OPR overdoses.
AB  - CONCLUSIONS: US states that have more robust prescription drug monitoring programs have fewer prescription opioid overdose deaths than states with weaker PMPs. States with medical marijuana dispensaries also report fewer opioid overdose deaths than states without these.

Copyright © 2016 Society for the Study of Addiction.
ES  - 1360-0443
IL  - 0965-2140
DO  - https://dx.doi.org/10.1111/add.13741
PT  - Journal Article
ID  - 10.1111/add.13741 [doi]
PP  - ppublish
PH  - 2016/08/19 [received]
PH  - 2016/11/07 [revised]
PH  - 2016/12/22 [accepted]
LG  - English
EP  - 20170208
DP  - 2017 Oct
EZ  - 2016/12/24 06:00
DA  - 2016/12/24 06:00
DT  - 2016/12/24 06:00
YR  - 2017
RD  - 20170911
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28009931

<1115. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28817847
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - PubMed-not-MEDLINE
AU  - Aaker BC
AU  - Michels C
AU  - VanKeulen SG
FA  - Aaker, Benjamin C
FA  - Michels, Collin
FA  - VanKeulen, Scott G
IN  - Aaker, Benjamin C. Avera Health Sacred Heart Hospital.
IN  - Aaker, Benjamin C. University of South Dakota Sanford School of Medicine.
IN  - Michels, Collin. University of South Dakota Sanford School of Medicine.
IN  - VanKeulen, Scott G. Avera Health Queen of Peace.
IN  - VanKeulen, Scott G. University of South Dakota Sanford School of Medicine.
TI  - No Pain, No Thebaine: Opioids in the Emergency Department.
SO  - South Dakota Medicine: The Journal of the South Dakota State Medical Association. No:28-33, 2016 Spec
AS  - S D Med. No:28-33, 2016 Spec
NJ  - South Dakota medicine : the journal of the South Dakota State Medical Association
VO  - No
PG  - 28-33
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - 101265265
IO  - S D Med
CP  - United States
AB  - BACKGROUND: Opioid misuse has reached epidemic levels. Forty-six people die every day in the U.S. from prescription opioids. Opioid-taking patients cost emergency departments (EDs) and society more than non-opioid-taking patients. Many patients prescribed opioids will go on to become addicted, yet we find it much easier to prescribe these medications than explain to the patient why they are not indicated. The ED takes care of many of these people, whether by prescribing opioids, or treating opioid misuse. We examine the ED's role in this epidemic.
AB  - METHODS: Data were obtained through literature search and the authors' personal experiences treating patients in the ED. The search was limited to specific harm to patients, hospitals, and society caused by opioid misuse, physiology of pain, and possible methods to manage the problem.
AB  - CONCLUSIONS: The ED clearly deserves some of the blame for the opioid epidemic. A consistent reinforcement of appropriate expectations for management of chronic pain across the medical spectrum will do much to manage the problem. We offer some ways to improve the problem, including pain contracts, pain guidelines, alternative therapies, pain management referrals, high-risk patient profiles, legislation, and drug take-back programs.
IS  - 0038-3317
IL  - 0038-3317
PT  - Journal Article
PP  - ppublish
LG  - English
DP  - 2016 Spec
EZ  - 2016/01/01 00:00
DA  - 2016/01/01 00:01
DT  - 2017/08/18 06:00
YR  - 2016
RD  - 20170817
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28817847

<1116. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 27980436
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - PubMed-not-MEDLINE
AU  - Finkelman MD
AU  - Kulich RJ
AU  - Butler SF
AU  - Jackson WC
AU  - Friedman FD
AU  - Smits N
AU  - Weiner SG
FA  - Finkelman, Matthew D
FA  - Kulich, Ronald J
FA  - Butler, Stephen F
FA  - Jackson, William C
FA  - Friedman, Franklin D
FA  - Smits, Niels
FA  - Weiner, Scott G
IN  - Finkelman, Matthew D. Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, MA, USA.
IN  - Kulich, Ronald J. Craniofacial Pain and Headache Center, Tufts University School of Dental Medicine, Boston, MA, USA; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital.
IN  - Butler, Stephen F. Inflexxion Inc, Newton, MA, USA.
IN  - Jackson, William C. Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital.
IN  - Friedman, Franklin D. Department of Emergency Medicine, Tufts Medical Center, Boston, MA, USA.
IN  - Smits, Niels. Department of Methods and Statistics, Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands.
IN  - Weiner, Scott G. Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA.
TI  - An investigation of completion times on the Screener and Opioid Assessment for Patients with Pain - revised (SOAPP-R).
SO  - Journal of pain research. 9:1163-1171, 2016
AS  - J Pain Res. 9:1163-1171, 2016
NJ  - Journal of pain research
VO  - 9
PG  - 1163-1171
PI  - Journal available in: Electronic-eCollection
PI  - Citation processed from: Print
JC  - 101540514
IO  - J Pain Res
CP  - New Zealand
KW  - aberrant drug-related behavior;  chronic pain;  response latency;  response times;  risk stratification;  substance abuse
AB  - BACKGROUND: Respondents' scores to the Screener and Opioid Assessment for Patients with Pain - revised (SOAPP-R) have been shown to be predictive of aberrant drug-related behavior (ADB). However, research is lacking on whether an individual's completion time (the amount of time that he/she takes to finish the screener) has utility in predicting ADB, despite the fact that response speed has been useful in predicting behavior in other fields. The purpose of this study was to evaluate the degree to which SOAPP-R completion time is predictive of ADB.
AB  - MATERIALS AND METHODS: This retrospective study analyzed completion-time data from 82 adult emergency department patients who completed the SOAPP-R on a tablet computer. The utility of SOAPP-R completion times in predicting ADB was assessed via logistic regression and the area under the curve (AUC) statistic. An external measure of ADB using Prescription Drug Monitoring Program data defined ADB to have occurred in individuals with at least four opioid prescriptions and at least four prescribers in 12 months.
AB  - RESULTS: Although there was a slight trend for individuals with greater completion times to have greater odds of ADB (odds ratio 1.004 in simple logistic regression), the association between SOAPP-R completion time and ADB was not statistically significant in either simple logistic regression (P=0.307) or multiple logistic regression adjusting for SOAPP-R score (P=0.419). AUC values for the prediction of ADB using completion time alone, SOAPP-R score alone, and both completion time and SOAPP-R score were 0.63, 0.64, and 0.65, respectively.
AB  - CONCLUSION: There was no significant evidence that SOAPP-R completion times were predictive of ADB among emergency department patients. However, the AUC value for completion times was only slightly less than that for SOAPP-R total scores.
CI  - DisclosureSFB is an employee of Inflexxion Inc. Inflexxion holds the copyright for the Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R). The other authors report no conflicts of interest in this work.
IS  - 1178-7090
IL  - 1178-7090
PT  - Journal Article
ID  - 10.2147/JPR.S123454 [doi]
ID  - jpr-9-1163 [pii]
ID  - PMC5147397 [pmc]
PP  - epublish
LG  - English
EP  - 20161205
DP  - 2016
EZ  - 2016/12/17 06:00
DA  - 2016/12/17 06:01
DT  - 2016/12/17 06:00
YR  - 2016
RD  - 20170816
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=27980436

<1117. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 27895451
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - PubMed-not-MEDLINE
AU  - Bazoukis G
AU  - Spiliopoulou A
AU  - Mourouzis K
AU  - Grigoropoulou P
AU  - Yalouris A
FA  - Bazoukis, G
FA  - Spiliopoulou, A
FA  - Mourouzis, K
FA  - Grigoropoulou, P
FA  - Yalouris, A
IN  - Bazoukis, G. Department of Internal Medicine, General Hospital of Athens <<Elpis>>, Athens, Greece.
IN  - Spiliopoulou, A. Department of Internal Medicine, General Hospital of Athens <<Elpis>>, Athens, Greece.
IN  - Mourouzis, K. Department of Internal Medicine, General Hospital of Athens <<Elpis>>, Athens, Greece.
IN  - Grigoropoulou, P. Department of Internal Medicine, General Hospital of Athens <<Elpis>>, Athens, Greece.
IN  - Yalouris, A. Department of Internal Medicine, General Hospital of Athens <<Elpis>>, Athens, Greece.
TI  - Non-cardiogenic pulmonary edema, rhabdomyolysis and myocardial injury following heroin inhalation: a case report.
SO  - Hippokratia. 20(1):84-87, 2016 Jan-Mar
AS  - Hippokratia. 20(1):84-87, 2016 Jan-Mar
NJ  - Hippokratia
VO  - 20
IP  - 1
PG  - 84-87
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - 101296613
IO  - Hippokratia
CP  - Greece
KW  - Heroin inhalation;  heroin;  illegal drugs;  non-cardiogenic pulmonary edema;  rhabdomyolysis
AB  - BACKGROUND: Heroin use by non-injecting routes of administration (snorting, swallowing, "chasing the dragon") is considered to be safer but is not risk-free for fatal overdose or serious side effects. We report the case of an adolescent who was transferred unconscious to the emergency department after heroin inhalation. Description of the case: A 17-year-old male was transferred to the emergency department unconscious (Glasgow coma scale: 6/15) after heroin inhalation. He was treated with non-rebreather mask and intravenous infusion of naloxone with gradual improvement of consciousness and arterial blood gasses. The chest computed tomography showed signs of acute respiratory distress syndrome. Laboratory exams on the second day of hospitalization showed elevated creatine kinase (CK) and troponin-I levels while his electrocardiography (ECG) showed J-point elevation in V1, V2, and V3 precordial leads. On the second day of hospitalization the pulmonary infiltrates were not present in his chest X-ray while on the eighth day, troponin-I and CK levels were normalized without dynamic ECG changes and the patient was discharged uneventfully.
AB  - CONCLUSION: Heroin inhalation may cause severe complications, such as non-cardiogenic pulmonary edema, rhabdomyolysis or myocardial injury. Hippokratia 2016, 20(1): 84-87.
IS  - 1108-4189
IL  - 1108-4189
PT  - Journal Article
ID  - PMC5074406 [pmc]
PP  - ppublish
LG  - English
DP  - 2016 Jan-Mar
EZ  - 2016/11/30 06:00
DA  - 2016/11/30 06:01
DT  - 2016/11/30 06:00
YR  - 2016
RD  - 20170816
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=27895451

<1118. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 27704485
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - PubMed-not-MEDLINE
AU  - Marrett E
AU  - Kwong WJ
AU  - Frech F
AU  - Qian C
AI  - Marrett, Elizabeth; ORCID: http://orcid.org/0000-0002-8881-6455
FA  - Marrett, Elizabeth
FA  - Kwong, Winghan Jacqueline
FA  - Frech, Feride
FA  - Qian, Chunlin
IN  - Marrett, Elizabeth. Daiichi Sankyo, Inc., Parsippany, NJ, USA. emarrett@dsi.com.
IN  - Kwong, Winghan Jacqueline. Daiichi Sankyo, Inc., Parsippany, NJ, USA.
IN  - Qian, Chunlin. Daiichi Sankyo, Inc., Parsippany, NJ, USA.
TI  - Health Care Utilization and Costs Associated with Nausea and Vomiting in Patients Receiving Oral Immediate-Release Opioids for Outpatient Acute Pain Management.
SO  - Pain and Therapy. 5(2):215-226, 2016 Dec
AS  - Pain Ther. 5(2):215-226, 2016 Dec
NJ  - Pain and therapy
VO  - 5
IP  - 2
PG  - 215-226
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Print
JC  - 101634491
IO  - Pain Ther
CP  - New Zealand
KW  - Acute pain;  Analgesia;  Analgesics;  Antiemetics;  Health care costs;  Health care utilization;  Opioid;  Opioid-induced nausea and vomiting;  Outpatient;  Rehospitalization
AB  - INTRODUCTION: Nausea and vomiting (NV) are common side effects of opioid use and limiting factors in pain management. This study sought to quantify the frequency of antiemetic prescribing and the impact of NV on health care resource utilization and costs in outpatients prescribed opioids for acute pain. The perspective was that of a commercial health plan.
AB  - METHODS: Medical and pharmacy claims from IMS PharMetrics Plus were used to identify patients initiating opioid therapy with a prescription for an oxycodone-, hydrocodone- or codeine-containing immediate-release product for acute use (<=15-day supply) between October 1, 2013 and September 30, 2014. Patients with a medical claim for NV (International Classification of Diseases, Ninth Revision, Clinical Modification codes 787.0x), with or without an antiemetic prescription fill, were compared with patients with no NV claim or antiemetic prescription fill to assess differences in all-cause health care utilization and costs over 1 month. Propensity score matching (PSM) was used to adjust for between-group differences in baseline patient characteristics.
AB  - RESULTS: The co-prescribing of opioids with antiemetic agents was 10.2%. After PSM (n = 45,790 per group), patients with NV claims had significantly more hospitalizations (11.5% vs 4.2%), emergency department visits (65.0% vs 12.1%), and physician office visits (85.2% vs 64.5%) compared with patients with no NV claims (all P < 0.0001). Mean total health care costs were higher among patients with a NV claim versus those without evidence of the side effect ($6290 vs $2309; P < 0.0001). Among patients with a recent hospitalization, patients with NV claims had higher rates of 30-day rehospitalization than those with no NV claims (24.4% vs 3.0%; P < 0.0001).
AB  - CONCLUSIONS: Among outpatients prescribed opioids for management of acute pain, co-prescribing with antiemetics was low, and the economic burden associated with NV was high. Efforts to prevent NV in patients receiving opioid therapy may improve patient outcomes and provide cost savings to the health care system.
AB  - FUNDING: Daiichi Sankyo, Inc.
IS  - 2193-8237
PT  - Journal Article
ID  - 10.1007/s40122-016-0057-y [doi]
ID  - 10.1007/s40122-016-0057-y [pii]
ID  - PMC5130907 [pmc]
PP  - ppublish
PH  - 2016/08/22 [received]
LG  - English
EP  - 20161004
DP  - 2016 Dec
EZ  - 2016/10/06 06:00
DA  - 2016/10/06 06:01
DT  - 2016/10/06 06:00
YR  - 2016
RD  - 20170816
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=27704485

<1119. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 25590547
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - In-Data-Review
AU  - Brabant M
AU  - Brissette S
AU  - Lauzon P
AU  - Marsan S
AU  - Ouellet-Plamondon C
AU  - Pelletier MC
FA  - Brabant, Michel
FA  - Brissette, Suzanne
FA  - Lauzon, Pierre
FA  - Marsan, Stephanie
FA  - Ouellet-Plamondon, Clairelaine
FA  - Pelletier, Marie-Chantal
IN  - Brabant, Michel. Service de medecine des toxicomanies CHUM; Departement de medecine familiale et medecine d'urgence (DMFMU), Universite de Montreal.
IN  - Brissette, Suzanne. Service de medecine des toxicomanies et Centre de recherche CHUM; Departement de medecine familiale et medecine d'urgence (DMFMU), Universite de Montreal.
IN  - Lauzon, Pierre. Service de medecine des toxicomanies CHUM; Departement de medecine familiale et medecine d'urgence (DMFMU), Universite de Montreal.
IN  - Marsan, Stephanie. Service de medecine des toxicomanies CHUM; Departement de medecine familiale et medecine d'urgence (DMFMU), Universite de Montreal.
IN  - Ouellet-Plamondon, Clairelaine. Unite de psychiatrie des toxicomanies CHUM; Departement de psychiatrie, Universite de Montreal.
IN  - Pelletier, Marie-Chantal. Service de medecine des toxicomanies CHUM; Departement de medecine familiale et medecine d'urgence (DMFMU), Universite de Montreal.
TI  - [Opioid use disorder in patients with chronic non-cancer pain]. [French]
OT  - Les troubles lies a l'utilisation des opioides prescrits medicalement.
SO  - Sante Mentale au Quebec. 39(2):117-32, 2014
AS  - Sante Ment Que. 39(2):117-32, 2014
NJ  - Sante mentale au Quebec
VO  - 39
IP  - 2
PG  - 117-32
PI  - Journal available in: Print
PI  - Citation processed from: Print
JC  - a33, 9424773
IO  - Sante Ment Que
SB  - Index Medicus
CP  - Canada
AB  - Epidemiology Canada now has the second highest number of opioid prescriptions per capita in the world. The rate of prescriptions has increased over the last decade, most notably in adults over 55 years of age. A recognition of the importance of treating pain has influenced this increase, but higher rates of opioid prescribing have produced undesirable outcomes including the misuse of medication as well as an increased number of deaths and emergency department visits attributable to opioids. Diverse psychiatric disorders, such as major depression, now also occur in 40% of those with an opioid use disorder (OUD). Neuroscience We now understand that addictive behaviors are caused by both environmental and genetic factors. Although OUD has historically been perceived as a weakness of character, it is now clear that it is a chronic disease, which results from a complex interaction between a substance, such as opioid, environmental factors, and an individual's genotype. Unfortunately, this evidence has yet to be successfully translated into clinical practice and most physicians are unable to diagnose and manage OUD patients appropriately.Clinical guidelines Many clinical guidelines for the management of chronic, non-cancer pain are available. All guidelines identify the need to assess the patient appropriately and screen for factors associated with misuse before prescribing opioids. Guidelines generally acknowledge that patients should not be denied appropriate pain management, but that some patients will require close supervision and frequent follow-up to prevent the misuse of prescription opioids.
IS  - 0383-6320
IL  - 0383-6320
PT  - English Abstract
PT  - Journal Article
ID  - 1027835ar [pii]
PP  - ppublish
LG  - French
DP  - 2014
EZ  - 2015/01/16 06:00
DA  - 2015/01/16 06:01
DT  - 2015/01/16 06:00
YR  - 2014
RD  - 20170817
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=25590547

<1120. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29493849
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Ghobadi A
AU  - Van Winkle PJ
AU  - Menchine M
AU  - Chen Q
AU  - Huang BZ
AU  - Sharp AL
FA  - Ghobadi, Ali
FA  - Van Winkle, Patrick J
FA  - Menchine, Michael
FA  - Chen, Qiaoling
FA  - Huang, Brian Z
FA  - Sharp, Adam L
IN  - Ghobadi, Ali. Department of Emergency Medicine, Orange County Anaheim Medical Center, Kaiser Permanente Southern California, Anaheim, CA.
IN  - Van Winkle, Patrick J. Department of Pediatrics, Orange County Anaheim Medical Center, Kaiser Permanente Southern California, Anaheim, CA.
IN  - Menchine, Michael. Department of Emergency Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.
IN  - Chen, Qiaoling. Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
IN  - Huang, Brian Z. Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
IN  - Sharp, Adam L. Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
IN  - Sharp, Adam L. Department of Emergency Medicine, Los Angeles Medical Center, Kaiser Permanente Southern California, Los Angeles, CA.
TI  - Reduction of Parenteral Opioid Use in Community Emergency Departments Following Implementation of Treatment Guidelines.
SO  - Academic Emergency Medicine.  2018 Mar 01
AS  - Acad Emerg Med.  2018 Mar 01
NJ  - Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - ce1, 9418450
IO  - Acad Emerg Med
CP  - United States
AB  - OBJECTIVE: Opioid prescribing guidelines are commonly seen as part of the solution to America's opioid epidemic. However, the effectiveness of specific treatment guidelines on altering opioid prescribing in the emergency department (ED) is unclear. We examined provider ordering patterns before and after implementation of opioid use guidelines for ED patients overall and the specific subsets of ED patients with either chronic opioid use or fracture.
AB  - METHODS: We conducted a pre-post interrupted time series analysis of adult (>=18 years old) ED encounters in 14 integrated community EDs before (2013) and after (2014) the implementation of opioid prescribing guidelines. We compared opioid use pre- and postintervention using segmented logistic regression for primary and secondary analyses. The primary outcome was parenteral opioid use in the ED, with additional subgroup analysis of chronic pain and fracture cohorts. We also examined ED oral opioid use and discharge prescribing.
AB  - RESULTS: There were 508,337 pre- and 531,620 postintervention encounters. The intervention was associated with an initial reduction in the odds of parenteral opioids ordered (odds ratio [OR] = 0.89, 95% CI = 0.87-0.91) and a decrease in the monthly trend compared to the preintervention period (OR = 0.99, 95% CI = 0.99-0.99). The immediate reduction in parenteral opioid use was significantly larger in the cohort of patients with chronic pain (OR = 0.81, 95% CI = 0.72-0.91), whereas the fracture cohort showed no change (OR = 1.10, 95% CI = 0.97-1.25).
AB  - CONCLUSION: The use of an opioid ordering guideline was associated with significant reduction in parenteral opioid use in the ED and as intended subgroup comparisons suggest that acute fractures were not affected and chronic pain visits were associated with larger decreases in opioid use.

Copyright © 2018 by the Society for Academic Emergency Medicine.
ES  - 1553-2712
IL  - 1069-6563
DO  - https://dx.doi.org/10.1111/acem.13395
PT  - Journal Article
ID  - 10.1111/acem.13395 [doi]
PP  - aheadofprint
PH  - 2017/10/31 [received]
PH  - 2018/01/28 [revised]
PH  - 2018/02/01 [accepted]
LG  - English
EP  - 20180301
DP  - 2018 Mar 01
EZ  - 2018/03/02 06:00
DA  - 2018/03/02 06:00
DT  - 2018/03/02 06:00
YR  - 2018
RD  - 20180410
UP  - 20180411
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29493849

<1121. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29627349
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Zuckerman M
AU  - Vo T
FA  - Zuckerman, Matthew
FA  - Vo, Tim
IN  - Zuckerman, Matthew. Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado.
IN  - Vo, Tim. Denver Health and Hospital Authority, Department of Emergency Medicine, Denver, Colorado.
TI  - Recurrent Ethylene Glycol Poisoning with Elevated Lactate Levels to Obtain Opioid Medications.
SO  - Journal of Emergency Medicine.  2018 Apr 04
AS  - J Emerg Med.  2018 Apr 04
NJ  - The Journal of emergency medicine
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - ibo, 8412174
IO  - J Emerg Med
CP  - United States
KW  - ethylene glycol poisoning;  factitious disorder;  lactatemia;  malingering
AB  - BACKGROUND: Malingering is when a patient feigns illness for secondary gain. While most patients with malingering manufacture or exaggerate symptoms, some patients may induce illness. Previous reports of malingering patients inducing illness include sepsis, kidney pain, migraine, and chest pain. However, acute poisoning as a manifestation of malingering appears to be rare.
AB  - CASE REPORT: We describe the case of a 39-year-old man who presented to the emergency department complaining of diffuse body pain. The patient reported multiple admission at outside hospitals for "lactate" and said, "it feels like it is happening again because of how my body feels." Laboratory findings were concerning for serum lactate of >20.0 mmol/L and ethylene glycol (EG) level of 19 mg/dL. A chart review found that the man had been admitted for elevated serum lactate 8 times to area hospitals in several years, often in the setting of EG poisoning. During these episodes he required intravenous fluids and frequent intravenous pain medications. When confronted about concern regarding the recurrent fallacious lactate levels in the setting of factitious EG ingestion, the patient often became combative and left against medical advice. The primary metabolite of EG, glycolic acid, can interfere with lactate assays, causing a false elevation. Our patient apparently recognized this and took advantage of it to be admitted and receive intravenous opioids. This is the only case known to us of malingering via EG ingestion. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should be aware that metabolites of EG may interfere with serum lactate assay. In addition, they should be aware of possible malingering-related poisoning and plausible association with requests for intravenous opioid pain medications. This represents a risk to the patient and others if undiagnosed.

Copyright © 2018 Elsevier Inc. All rights reserved.
IS  - 0736-4679
IL  - 0736-4679
DI  - S0736-4679(18)30100-8
DO  - https://dx.doi.org/10.1016/j.jemermed.2018.01.044
PT  - Journal Article
ID  - S0736-4679(18)30100-8 [pii]
ID  - 10.1016/j.jemermed.2018.01.044 [doi]
PP  - aheadofprint
PH  - 2017/10/18 [received]
PH  - 2017/12/22 [revised]
PH  - 2018/01/25 [accepted]
LG  - English
EP  - 20180404
DP  - 2018 Apr 04
EZ  - 2018/04/09 06:00
DA  - 2018/04/09 06:00
DT  - 2018/04/09 06:00
YR  - 2018
RD  - 20180408
UP  - 20180409
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29627349

<1122. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29626076
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Gardner RA
AU  - Brewer KL
AU  - Langston DB
FA  - Gardner, Robert Andrew
FA  - Brewer, Kori L
FA  - Langston, Dennis B
IN  - Gardner, Robert Andrew. Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA.
IN  - Brewer, Kori L. Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA.
IN  - Brewer, Kori L. Emergency Department, Vidant Medical Center, East Carolina University, Greenville, North Carolina, USA.
IN  - Langston, Dennis B. Emergency Department, Vidant Medical Center, East Carolina University, Greenville, North Carolina, USA.
TI  - Predicting opioid use disorder in patients with chronic pain who present to the emergency department.
SO  - Injury Prevention.  2018 Apr 06
AS  - Inj Prev.  2018 Apr 06
NJ  - Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - crz, 9510056
IO  - Inj. Prev.
CP  - England
KW  - chronic pain;  emergency department;  opioid use disorder
AB  - BACKGROUND: Emergency department (ED) patients with chronic pain challenge providers to make quick and accurate assessments without an in-depth pain management consultation. Emergency physicians need reliable means to determine which patients may receive opioid therapy without exacerbating opioid use disorder (OUD).
AB  - METHODS: Eighty-nine ED patients with a chief complaint of chronic pain were enrolled. Researchers administered questionnaires and reviewed medical and state prescription monitoring database information. Participants were classified as either OUD or non-OUD. Statistical analysis included a bivariate analysis comparing differences between groups and multivariate logistic regression evaluating ORs.
AB  - RESULTS: The 45 participants categorised as OUD had a higher proportion of documented or reported psychiatric diagnoses (p=0.049), preference of opioid treatment (p=0.005), current oxycodone prescription (p=0.043), borrowed pain medicine (p=0.004) and non-authorised dose increase (p<0.001). The state prescription monitoring database revealed the OUD group to have an increased number of opioid prescriptions (p=0.005) and pills (p=0.010). Participants who borrowed pain medicine and engaged in non-authorised dose increase were 5.2 (p=0.025, 95%CI 1.24 to 21.9) and 6.1 times (p=0.001, 95%CI 1.55 to 24.1) more likely to have OUD, respectively.
AB  - LIMITATIONS: Major limitations of our study include a small sample size, self-reported measures and convenience sample which may introduce selection bias.
AB  - CONCLUSION: Patients with chronic pain with OUD have distinguishable characteristics. Emergency physicians should consider such evidence-based variables prior to opioid therapy to ameliorate the opioid crisis and limit implicit bias.

Copyright © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
CI  - Competing interests: None declared.
ES  - 1475-5785
IL  - 1353-8047
DI  - injuryprev-2018-042723
DO  - https://dx.doi.org/10.1136/injuryprev-2018-042723
PT  - Journal Article
ID  - injuryprev-2018-042723 [pii]
ID  - 10.1136/injuryprev-2018-042723 [doi]
PP  - aheadofprint
PH  - 2018/01/05 [received]
PH  - 2018/03/20 [revised]
PH  - 2018/03/25 [accepted]
LG  - English
EP  - 20180406
DP  - 2018 Apr 06
DT  - 2018/04/08 06:00
YR  - 2018
RD  - 20180407
UP  - 20180409
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29626076

<1123. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29498155
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Michael SS
AU  - Babu KM
AU  - Androski C Jr
AU  - Reznek MA
FA  - Michael, Sean S
FA  - Babu, Kavita M
FA  - Androski, Christopher Jr
FA  - Reznek, Martin A
IN  - Michael, Sean S. Department of Emergency Medicine, Worcester, MA.
IN  - Michael, Sean S. Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO.
IN  - Babu, Kavita M. Department of Emergency Medicine, Worcester, MA.
IN  - Androski, Christopher Jr. University of Massachusetts Medical School, Worcester, MA.
IN  - Reznek, Martin A. Department of Emergency Medicine, Worcester, MA.
TI  - Effect of a Data-driven Intervention on Opioid Prescribing Intensity Among Emergency Department Providers: A Randomized Controlled Trial.
SO  - Academic Emergency Medicine.  2018 Mar 02
AS  - Acad Emerg Med.  2018 Mar 02
NJ  - Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - ce1, 9418450
IO  - Acad Emerg Med
CP  - United States
AB  - OBJECTIVE: Little is known about accuracy of provider self-perception of opioid prescribing. We hypothesized that an intervention asking emergency department (ED) providers to self-identify their opioid prescribing practices compared to group norms-and subsequently providing them with their actual prescribing data-would alter future prescribing compared to controls.
AB  - METHODS: This was a prospective, multicenter randomized trial in which all attending physicians, residents, and advanced practice providers at four EDs were randomly assigned either to no intervention or to a brief data-driven intervention during which providers were: 1) asked to self-identify and explicitly report to research staff their perceived opioid prescribing in comparison to their peers and 2) then given their actual data with peer group norms for comparison. Our primary outcome was the change in each provider's proportion of patients discharged with an opioid prescription at 6 and 12 months. Secondary outcomes were opioid prescriptions per hundred total prescriptions and normalized morphine milligram equivalents prescribed. Our primary comparison stratified intervention providers by those who underestimated their prescribing and those who did not underestimate their prescribing, both compared to controls.
AB  - RESULTS: Among 109 total participants, 51 were randomized to the intervention, 65% of whom underestimated their opioid prescribing. Intervention participants who underestimated their baseline prescribing had larger-magnitude decreases than controls (Hodges-Lehmann difference = -2.1 prescriptions per hundred patients at 6 months [95% confidence interval {CI} = -3.9 to -0.5] and -2.2 per hundred at 12 months [95% CI = -4.8 to -0.01]). Intervention participants who did not underestimate their prescribing had similar changes to controls.
AB  - CONCLUSIONS: Self-perception of prescribing was frequently inaccurate. Providing clinicians with their actual opioid prescribing data after querying their self-perception reduced future prescribing among providers who underestimated their baseline prescribing. Our findings suggest that guideline and policy interventions should directly address the potential barrier of inaccurate provider self-awareness.

Copyright © 2018 by the Society for Academic Emergency Medicine.
ES  - 1553-2712
IL  - 1069-6563
DO  - https://dx.doi.org/10.1111/acem.13400
PT  - Journal Article
ID  - 10.1111/acem.13400 [doi]
PP  - aheadofprint
PH  - 2017/10/09 [received]
PH  - 2017/12/29 [accepted]
LG  - English
EP  - 20180302
DP  - 2018 Mar 02
EZ  - 2018/03/03 06:00
DA  - 2018/03/03 06:00
DT  - 2018/03/03 06:00
YR  - 2018
RD  - 20180402
UP  - 20180402
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29498155

<1124. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29602664
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Pedigo JR
AU  - Seifert CF
FA  - Pedigo, Justin Ray
FA  - Seifert, Charles F
IN  - Pedigo, Justin Ray. Department of Pharmacy Practice, Texas Tech University Health Sciences Center School of Pharmacy, University Medical Center, Lubbock, TX, United States.
IN  - Seifert, Charles F. Department of Pharmacy Practice, Texas Tech University Health Sciences Center School of Pharmacy, University Medical Center, Lubbock, TX, United States. Electronic address: charles.seifert@ttuhsc.edu.
TI  - Rate of patients at elevated risk of opioid overdose visiting the emergency department.
SO  - American Journal of Emergency Medicine.  2018 Mar 22
AS  - Am J Emerg Med.  2018 Mar 22
NJ  - The American journal of emergency medicine
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - aa2, 8309942
IO  - Am J Emerg Med
CP  - United States
KW  - Emergency department;  Naloxone;  Opioid;  Overdose risk
AB  - OBJECTIVE: To determine the rate of patients visiting the emergency department who are at risk of opioid overdose.
AB  - METHODS: The electronic records of a 412 bed tertiary care county teaching hospital were searched for emergency department (ED) visits from January 1, 2013 to October 31, 2016 to find patients on at least 100mg morphine equivalents (MME) of oral opioid therapy, or an opioid in combination with a benzodiazepine. Records were also searched for patients with a positive urinalysis for opioids when no opioid was present on their home medication list. Medication reconciliations were searched for patients at risk of opioid overdose who were subsequently discharged on naloxone.
AB  - RESULTS: An analysis of 2521 patients visiting the ED was performed, and the overall rate of risk of opioid overdose increased from 25.84% to 47.41% (p<0.0001) in patients meeting inclusion criteria from 2013 to 2016. For patients on opioids, the rate of patients on 100 MME daily or greater increased from 9.72% to 28.24% (p<0.0001) from 2013 to 2016. The rate of patients on opioid therapy in combination with benzodiazepine therapy did not change significantly from 2013 to 2016. When comparing patients at risk of opioid overdose to total emergency department visits, we found the rate of at risk patients increased significantly from 0.12% to 0.56% (p<0.0001) from 2013 to 2016.
AB  - CONCLUSIONS: The rate of patients visiting the emergency department at risk of opioid overdose increased significantly from 2013 to 2016. Naloxone was not routinely prescribed to this patient cohort.

Copyright © 2018 Elsevier Inc. All rights reserved.
ES  - 1532-8171
IL  - 0735-6757
DI  - S0735-6757(18)30247-X
DO  - https://dx.doi.org/10.1016/j.ajem.2018.03.055
PT  - Journal Article
ID  - S0735-6757(18)30247-X [pii]
ID  - 10.1016/j.ajem.2018.03.055 [doi]
PP  - aheadofprint
PH  - 2018/02/23 [received]
PH  - 2018/03/19 [revised]
PH  - 2018/03/20 [accepted]
LG  - English
EP  - 20180322
DP  - 2018 Mar 22
DT  - 2018/04/01 06:00
YR  - 2018
RD  - 20180331
UP  - 20180402
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29602664

<1125. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29588147
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Barbour K
AU  - McQuade M
AU  - Somasundaram S
AU  - Chakravarthy B
FA  - Barbour, Kyle
FA  - McQuade, Miriam
FA  - Somasundaram, Shashank
FA  - Chakravarthy, Bharath
IN  - Barbour, Kyle. University of California, Irvine, Department of Emergency Medicine, 101 the City Drive, Route 128-01, Orange, CA 92868, United States; Orange County Needle Exchange Program (OCNEP), c/o the LGBT Center OC, 1605 N Spurgeon St, Santa Ana, CA 92701, United States. Electronic address: kyle.barbour@uci.edu.
IN  - McQuade, Miriam. University of California, Irvine, Department of Emergency Medicine, 101 the City Drive, Route 128-01, Orange, CA 92868, United States; Orange County Needle Exchange Program (OCNEP), c/o the LGBT Center OC, 1605 N Spurgeon St, Santa Ana, CA 92701, United States. Electronic address: mcquadem@uci.edu.
IN  - Somasundaram, Shashank. University of California, Irvine, Department of Emergency Medicine, 101 the City Drive, Route 128-01, Orange, CA 92868, United States. Electronic address: ssomasun@uci.edu.
IN  - Chakravarthy, Bharath. University of California, Irvine, Department of Emergency Medicine, 101 the City Drive, Route 128-01, Orange, CA 92868, United States. Electronic address: bchakrav@uci.edu.
TI  - Emergency physician resistance to a take-home naloxone program led by community harm reductionists.
SO  - American Journal of Emergency Medicine.  2018 Mar 17
AS  - Am J Emerg Med.  2018 Mar 17
NJ  - The American journal of emergency medicine
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - aa2, 8309942
IO  - Am J Emerg Med
CP  - United States
KW  - Community outreach;  Harm reduction;  Injection drug use;  Overdose prevention and naloxone distribution;  Social stigma;  Take-home naloxone
ES  - 1532-8171
IL  - 0735-6757
DI  - S0735-6757(18)30228-6
DO  - https://dx.doi.org/10.1016/j.ajem.2018.03.036
PT  - Letter
ID  - S0735-6757(18)30228-6 [pii]
ID  - 10.1016/j.ajem.2018.03.036 [doi]
PP  - aheadofprint
PH  - 2018/03/14 [received]
PH  - 2018/03/15 [revised]
PH  - 2018/03/16 [accepted]
LG  - English
EP  - 20180317
DP  - 2018 Mar 17
DT  - 2018/03/29 06:00
YR  - 2018
RD  - 20180328
UP  - 20180328
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29588147

<1126. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29484686
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Peckham AM
AU  - Evoy KE
AU  - Covvey JR
AU  - Ochs L
AU  - Fairman KA
AU  - Sclar DA
AI  - Peckham, Alyssa M; ORCID: http://orcid.org/0000-0002-9638-7005
AI  - Evoy, Kirk E; ORCID: http://orcid.org/0000-0003-0913-7145
AI  - Covvey, Jordan R; ORCID: http://orcid.org/0000-0003-2913-2042
AI  - Fairman, Kathleen A; ORCID: http://orcid.org/0000-0001-8704-7271
AI  - Sclar, David A; ORCID: http://orcid.org/0000-0002-0983-4293
FA  - Peckham, Alyssa M
FA  - Evoy, Kirk E
FA  - Covvey, Jordan R
FA  - Ochs, Leslie
FA  - Fairman, Kathleen A
FA  - Sclar, David A
IN  - Peckham, Alyssa M. Department of Pharmacy Practice, College of Pharmacy-Glendale, Midwestern University, Glendale, Arizona.
IN  - Evoy, Kirk E. College of Pharmacy, The University of Texas at Austin, San Antonio, Texas.
IN  - Evoy, Kirk E. School of Medicine, UT Health Science Center San Antonio, San Antonio, Texas.
IN  - Evoy, Kirk E. Southeast Clinic, University Health System, San Antonio, Texas.
IN  - Evoy, Kirk E. UT Health Science Center San Antonio, Pharmacotherapy Education and Research Center, San Antonio, Texas.
IN  - Covvey, Jordan R. Division of Pharmaceutical, Administrative and Social Sciences, Duquesne University School of Pharmacy, Pittsburgh, Pennsylvania.
IN  - Ochs, Leslie. Department of Pharmacy Practice, University of New England College of Pharmacy, Portland, Maine.
IN  - Fairman, Kathleen A. Department of Pharmacy Practice, College of Pharmacy-Glendale, Midwestern University, Glendale, Arizona.
IN  - Sclar, David A. Department of Pharmacy Practice, College of Pharmacy-Glendale, Midwestern University, Glendale, Arizona.
TI  - Predictors of Gabapentin Overuse With or Without Concomitant Opioids in a Commercially Insured U.S. Population.
SO  - Pharmacotherapy:The Journal of Human Pharmacology & Drug Therapy.  2018 Feb 27
AS  - Pharmacotherapy.  2018 Feb 27
NJ  - Pharmacotherapy
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - par, 8111305
IO  - Pharmacotherapy
CP  - United States
KW  - addiction;  gabapentin;  opioid;  prescription drug abuse;  substance abuse
AB  - OBJECTIVE: Research suggests the medical consequences of gabapentin overuse depend on whether gabapentin is abused alone or with opioids to potentiate an opioid "high." The objective of this study was to assess predictors of gabapentin overuse with or without concomitant opioids.
AB  - METHODS: Data were obtained from the Truven Health MarketScan<sup></sup> Commercial Claims and Encounters database for 2013 through 2015. Eligibility criteria were gabapentin utilization, with or without opioids, for 120 days or longer throughout a 12-month observation period. Cohort identification was based on patterns of overuse exceeding thresholds of 3600 mg of gabapentin and/or 50 morphine-mg equivalents of opioids; sustained overuse was defined as three or more quarters exceeding threshold. Diagnostic predictors were measured in the 6 months pretreatment in inpatient (IP) or emergency department (ED) settings. Indications were measured in IP, ED, or ambulatory settings. Logistic regression analyses adjusted for age, sex, indication, use of benzodiazepine or z-hypnotics (i.e., zaleplon, zolpidem, eszopiclone) during gabapentin treatment, pretreatment ED/IP use, and pretreatment diagnoses of anxiety or depression.
AB  - RESULTS: Criteria for sustained overuse were met by 2.0% of 44,148 patients treated with gabapentin without opioids and by 11.7% of 15,335 patients treated with concomitant gabapentin-opioid. The top three predictors of sustained overuse for gabapentin-only patients were insomnia (7.0%), euphoria (4.5%), and bipolar disorder (4.5%), and were detoxification (35.6%), altered mental status (26.3%), and addiction (21.6%) for gabapentin-opioid patients. In adjusted analyses, concomitant opioid use multiplied the odds of sustained misuse by 6.32 (95% confidence interval [CI] = 5.80-6.89) and the interaction of addiction with opioid use by 1.88 (95% CI = 1.32-2.66). Among gabapentin-only patients, sustained misuse was predicted by a history of anxiety (odds ratio = 1.56, 95% CI = 1.02-2.38) but not by a history of addiction.
AB  - CONCLUSIONS: The likelihood of gabapentin overuse alone is low but significantly increases with concomitant opioid use, especially when coupled with a history of addiction. History of addiction does not appear to increase risk of gabapentin misuse among those with gabapentin alone.

Copyright © 2018 Pharmacotherapy Publications, Inc.
ES  - 1875-9114
IL  - 0277-0008
DO  - https://dx.doi.org/10.1002/phar.2096
PT  - Journal Article
ID  - 10.1002/phar.2096 [doi]
PP  - aheadofprint
LG  - English
EP  - 20180227
DP  - 2018 Feb 27
EZ  - 2018/02/28 06:00
DA  - 2018/02/28 06:00
DT  - 2018/02/28 06:00
YR  - 2018
RD  - 20180328
UP  - 20180328
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29484686

<1127. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29572041
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Zhang X
AU  - Marchand C
AU  - Sullivan B
AU  - Klass EM
AU  - Wagner KD
FA  - Zhang, Xiangjun
FA  - Marchand, Christopher
FA  - Sullivan, Bobbie
FA  - Klass, Evan M
FA  - Wagner, Karla D
IN  - Zhang, Xiangjun. School of Community Health Sciences, University of Nevada, Reno, 1664 N. Virginia St. MC 0274, Reno, NV 89557, USA.
IN  - Marchand, Christopher. Office of Statewide Initiatives, University of Nevada, Reno School of Medicine, 411 West Second Street, Reno, NV 89503-5308, USA.
IN  - Sullivan, Bobbie. Nevada State Health Division, Emergency Medical Systems, 4126 Technology Way, Suite 201, Carson City, NV 89706, USA.
IN  - Klass, Evan M. Office of Statewide Initiatives, University of Nevada, Reno School of Medicine, 411 West Second Street, Reno, NV 89503-5308, USA.
IN  - Wagner, Karla D. School of Community Health Sciences, University of Nevada, Reno, 1664 N. Virginia St. MC 0274, Reno, NV 89557, USA. Electronic address: karlawagner@unr.edu.
TI  - Naloxone access for Emergency Medical Technicians: An evaluation of a training program in rural communities.
SO  - Addictive Behaviors.  2018 Mar 05
AS  - Addict Behav.  2018 Mar 05
NJ  - Addictive behaviors
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 2gw, 7603486
IO  - Addict Behav
CP  - England
KW  - First responders;  Naloxone;  Opioid overdose;  Rural communities
AB  - INTRODUCTION: Opioid-related overdose death rates in rural communities in the United States are much higher than their urban counterparts. However, basic life support (BLS) personnel, who are more common in rural areas, have much lower rates of naloxone administration than other levels of emergency medical services (EMS). Training and equipping basic level Emergency Medical Technician (EMTs) to administer naloxone for an opioid overdose could yield positive outcomes.
AB  - METHODS: Following a legislative change that allowed EMTs to administer naloxone in one rural state, we evaluated an EMT training program by examining EMTs' opioid overdose knowledge and attitudes before and after the training.
AB  - RESULTS: One-hundred-seventeen rural EMTs participated the training. They demonstrated statistically significant improvements on almost all of the knowledge questions after the training (p's=0.0469 to <0.0001). The opioid overdose competency and concern scales showed statistically significant improvement (p<0.0001) and reduction (p<0.0001), respectively. Furthermore, statistically significant changes in knowledge and opinions of state law regarding naloxone administration were observed. Significantly more EMTs supported the idea of expanding naloxone to people at risk for overdose (p=0.0026) after the training.
AB  - CONCLUSIONS: At a time when states are passing legislation to expand first responders' access to naloxone, this study provides evidence about authorizing EMTs to administer naloxone.

Copyright © 2018 Elsevier Ltd. All rights reserved.
ES  - 1873-6327
IL  - 0306-4603
DI  - S0306-4603(18)30109-6
DO  - https://dx.doi.org/10.1016/j.addbeh.2018.03.004
PT  - Journal Article
ID  - S0306-4603(18)30109-6 [pii]
ID  - 10.1016/j.addbeh.2018.03.004 [doi]
PP  - aheadofprint
PH  - 2017/09/01 [received]
PH  - 2018/03/04 [accepted]
LG  - English
EP  - 20180305
DP  - 2018 Mar 05
DT  - 2018/03/25 06:00
YR  - 2018
RD  - 20180324
UP  - 20180326
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29572041

<1128. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29561298
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Jain N
AU  - Phillips FM
AU  - Weaver T
AU  - Khan SN
FA  - Jain, Nikhil
FA  - Phillips, Frank M
FA  - Weaver, Tristan
FA  - Khan, Safdar N
IN  - Jain, Nikhil. The Ohio State University Wexner Medical Center, Columbus, OH.
IN  - Phillips, Frank M. Midwest Orthopedics at Rush, Rush University Medical Center, Chicago, IL.
IN  - Weaver, Tristan. The Ohio State University Wexner Medical Center, Columbus, OH.
IN  - Khan, Safdar N. The Ohio State University Wexner Medical Center, Columbus, OH.
TI  - Pre-operative Chronic Opioid Therapy: A Risk Factor for Complications, Readmission, Continued Opioid Use and Increased Costs After One- and Two-Level Posterior Lumbar Fusion.
SO  - Spine.  2018 Mar 20
AS  - Spine.  2018 Mar 20
NJ  - Spine
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 7610646, uxk, 7610649
IO  - Spine
CP  - United States
AB  - STUDY DESIGN: Retrospective, economic analysis.
AB  - OBJECTIVE: To study patient profile associated with preoperative chronic opioid therapy (COT), and study COT as a risk factor for 90-day complications, emergency department (ED) visits, and readmission after primary one- to two-level posterior lumbar fusion (PLF) for degenerative spine disease. We also evaluated associated costs, risk factors, and adverse events related to long-term postoperative opioid use.
AB  - SUMMARY OF BACKGROUND DATA: Chronic opioid use is associated with poor outcomes and dependence after spine surgery. Risk factors, complications, readmissions, adverse events, and costs associated with COT in patients undergoing lumbar fusion are not entirely known. As providers look to reduce healthcare costs and improve outcomes, identification of modifiable risk factors is important.
AB  - METHODS: Commercial insurance data from 2007 to Q3-2015 was used to study preoperative opioid use in patients undergoing primary one- to two-level PLF. Ninety-day complications, ED visits, readmissions, 1-year adverse events, and associated costs have been described. Multiple-variable regression analyses were done to study preoperative COT patient profile and opioid use as a risk factor for complications and adverse events.
AB  - RESULTS: A total of 24,610 patients with a mean age of 65.6 +/- 11.5 years were included. Five thousand five hundred (22.3%) patients had documented opioid use for more than 6 months before surgery, and 87.4% of these had continued long-term use postoperatively. On adjusted analysis, preoperative COT was found to be a risk factor for 90-day wound complications, pain diagnoses, ED visits, readmission, and continued use postoperatively. Postspinal fusion long-term opioid users had an increased utilization of epidural/facet joint injections, risk for revision fusion, and increased incidence of new onset constipation within 1 year postsurgery. The cost associated with increase resource use in these patients has been reported.
AB  - CONCLUSION: Preoperative COT is a modifiable risk factor for complications, readmission, adverse events, and increased costs after one- or two-level PLF.
AB  - LEVEL OF EVIDENCE: 3.
ES  - 1528-1159
IL  - 0362-2436
DO  - https://dx.doi.org/10.1097/BRS.0000000000002609
PT  - Journal Article
ID  - 10.1097/BRS.0000000000002609 [doi]
PP  - aheadofprint
LG  - English
EP  - 20180320
DP  - 2018 Mar 20
DT  - 2018/03/22 06:00
YR  - 2018
RD  - 20180321
UP  - 20180321
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29561298

<1129. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29555468
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - King AB
AU  - Spann MD
AU  - Jablonski P
AU  - Wanderer JP
AU  - Sandberg WS
AU  - McEvoy MD
FA  - King, Adam B
FA  - Spann, Matthew D
FA  - Jablonski, Patrick
FA  - Wanderer, Jonathan P
FA  - Sandberg, Warren S
FA  - McEvoy, Matthew D
IN  - King, Adam B. Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee.
IN  - Spann, Matthew D. Department of Surgical Science, Vanderbilt University Medical Center, Nashville, Tennessee.
IN  - Jablonski, Patrick. Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address: patrick.m.jablonski@vanderbilt.edu.
IN  - Wanderer, Jonathan P. Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee.
IN  - Sandberg, Warren S. Vanderbilt University School of Medicine, Nashville, Tennessee.
IN  - McEvoy, Matthew D. Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee.
TI  - An enhanced recovery program for bariatric surgical patients significantly reduces perioperative opioid consumption and postoperative nausea.
SO  - Surgery for Obesity & Related Diseases.  2018 Feb 13
AS  - Surg. obes. relat. dis..  2018 Feb 13
NJ  - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 101233161
IO  - Surg Obes Relat Dis
CP  - United States
KW  - Bariatric surgery;  Enhanced recovery after surgery;  Length of stay;  Opioid consumption
AB  - BACKGROUND: Patients frequently remain in the hospital after bariatric surgery due to pain, nausea, and inability to tolerate oral intake. Enhanced recovery after surgery (ERAS) concepts address these perioperative complications and therefore improve length of stay for bariatric surgery patients.
AB  - OBJECTIVES: To determine if ERAS concepts increase the proportion of patients discharged on postoperative day 1. Secondary objectives included mean length of stay, perioperative opioid use, emergency department visits, and readmissions.
AB  - SETTING: A large metropolitan university tertiary hospital.
AB  - METHODS: A quantitative before and after study was conducted for patients undergoing bariatric surgical patients. Data were collected surrounding length of stay, perioperative opioid consumption, antiemetic therapy requirements postoperatively, multimodal analgesia compliance, emergency department visits, and hospital readmission rates. Wilcoxon rank-sum and chi<sup>2</sup> test were used to compare continuous and categorical variables, respectively. A secondary analysis was performed using Aligned Rank Transformation and Cochran-Mantel-Haenszel chi<sup>2</sup> tests to account for an increase in sleeve gastrectomies in the intervention group.
AB  - RESULTS: The 2 groups had clinically similar baseline characteristics. Comparison group (N = 366) and ERAS group (N = 715) patients underwent a primary bariatric surgery procedure. There was an increase in the number of patients undergoing a laparoscopic sleeve gastrectomy in the intervention group. After accounting for this increase, the percentage of patients discharged on postoperative day 1 was unchanged (79.8% non-ERAS versus 83.1% ERAS, P = .52). ERAS length of stay was statistically significantly lower for gastric bypass (P<.001) and robotic gastric bypass (P = .01). Perioperative opioid consumption was reduced (41.0 versus 16.2 morphine equivalents, P<0.001), and fewer ERAS patients required postoperative antiemetics (68.8% versus 46.2%, P<.001). Emergency department visits at 7 days were reduced (6.0% versus 3.2%, P = .04), but hospital readmission rates were unchanged.
AB  - CONCLUSIONS: Implementing ERAS did not reduce the percentage of patients discharged on postoperative day 1 in a bariatric surgery program with historically low length of stay, but it led to significant reductions in perioperative opioid use, decreases in postoperative nausea, and early emergency room visits.

Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
ES  - 1878-7533
IL  - 1550-7289
DI  - S1550-7289(18)30089-3
DO  - https://dx.doi.org/10.1016/j.soard.2018.02.010
PT  - Journal Article
ID  - S1550-7289(18)30089-3 [pii]
ID  - 10.1016/j.soard.2018.02.010 [doi]
PP  - aheadofprint
PH  - 2017/10/18 [received]
PH  - 2018/01/05 [revised]
PH  - 2018/02/04 [accepted]
LG  - English
EP  - 20180213
DP  - 2018 Feb 13
DT  - 2018/03/21 06:00
YR  - 2018
RD  - 20180320
UP  - 20180320
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29555468

<1130. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29530654
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Scheuermeyer FX
AU  - DeWitt C
AU  - Christenson J
AU  - Grunau B
AU  - Kestler A
AU  - Grafstein E
AU  - Buxton J
AU  - Barbic D
AU  - Milanovic S
AU  - Torkjari R
AU  - Sahota I
AU  - Innes G
FA  - Scheuermeyer, Frank X
FA  - DeWitt, Christopher
FA  - Christenson, Jim
FA  - Grunau, Brian
FA  - Kestler, Andrew
FA  - Grafstein, Eric
FA  - Buxton, Jane
FA  - Barbic, David
FA  - Milanovic, Stefan
FA  - Torkjari, Reza
FA  - Sahota, Indy
FA  - Innes, Grant
IN  - Scheuermeyer, Frank X. Department of Emergency Medicine, St Paul's Hospital and the University of British Columbia, Vancouver, Canada. Electronic address: frank.scheuermeyer@gmail.com.
IN  - DeWitt, Christopher. Department of Emergency Medicine, St Paul's Hospital and the University of British Columbia, Vancouver, Canada.
IN  - Christenson, Jim. Department of Emergency Medicine, St Paul's Hospital and the University of British Columbia, Vancouver, Canada.
IN  - Grunau, Brian. Department of Emergency Medicine, St Paul's Hospital and the University of British Columbia, Vancouver, Canada.
IN  - Kestler, Andrew. Department of Emergency Medicine, St Paul's Hospital and the University of British Columbia, Vancouver, Canada.
IN  - Grafstein, Eric. Department of Emergency Medicine, St Paul's Hospital and the University of British Columbia, Vancouver, Canada.
IN  - Buxton, Jane. British Columbia Center for Disease Control, Vancouver, Canada.
IN  - Barbic, David. Department of Emergency Medicine, St Paul's Hospital and the University of British Columbia, Vancouver, Canada.
IN  - Milanovic, Stefan. Department of Emergency Medicine, St Paul's Hospital and the University of British Columbia, Vancouver, Canada.
IN  - Torkjari, Reza. Department of Emergency Medicine, St Paul's Hospital and the University of British Columbia, Vancouver, Canada.
IN  - Sahota, Indy. Department of Emergency Medicine, St Paul's Hospital and the University of British Columbia, Vancouver, Canada.
IN  - Innes, Grant. Department of Emergency Medicine, Rockyview Hospital and the University of Calgary, Calgary, Canada.
TI  - Safety of a Brief Emergency Department Observation Protocol for Patients With Presumed Fentanyl Overdose.
SO  - Annals of Emergency Medicine.  2018 Mar 09
AS  - Ann Emerg Med.  2018 Mar 09
NJ  - Annals of emergency medicine
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 8002646
IO  - Ann Emerg Med
CP  - United States
AB  - STUDY OBJECTIVE: Fentanyl overdoses are increasing and few data guide emergency department (ED) management. We evaluate the safety of an ED protocol for patients with presumed fentanyl overdose.
AB  - METHODS: At an urban ED, we used administrative data and explicit chart review to identify and describe consecutive patients with uncomplicated presumed fentanyl overdose (no concurrent acute medical issues) from September to December 2016. We linked regional ED and provincial vital statistics databases to ascertain admissions, revisits, and mortality. Primary outcome was a composite of admission and death within 24 hours. Other outcomes included treatment with additional ED naloxone, development of a new medical issue while in the ED, and length of stay. A prespecified subgroup analysis assessed low-risk patients with normal triage vital signs.
AB  - RESULTS: There were 1,009 uncomplicated presumed fentanyl overdose, mainly by injection. Median age was 34 years, 85% were men, and 82% received out-of-hospital naloxone. One patient was hospitalized and one discharged patient died within 24 hours (combined outcome 0.2%; 95% confidence interval [CI] 0.04% to 0.8%). Sixteen patients received additional ED naloxone (1.6%; 95% CI 1.0% to 2.6%), none developed a new medical issue (0%; 95% CI 0% to 0.5%), and median length of stay was 173 minutes (interquartile range 101 to 267). For 752 low-risk patients, no patients were admitted or developed a new issue, and one died postdischarge; 3 (0.4%; 95% CI 0.01% to 1.3%) received ED naloxone.
AB  - CONCLUSION: In our cohort of ED patients with uncomplicated presumed fentanyl overdose-typically after injection-deterioration, admission, mortality, and postdischarge complications appear low; the majority can be discharged after brief observation. Patients with normal triage vital signs are unlikely to require ED naloxone.

Copyright © 2018 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
ES  - 1097-6760
IL  - 0196-0644
DI  - S0196-0644(18)30082-9
DO  - https://dx.doi.org/10.1016/j.annemergmed.2018.01.054
PT  - Journal Article
ID  - S0196-0644(18)30082-9 [pii]
ID  - 10.1016/j.annemergmed.2018.01.054 [doi]
PP  - aheadofprint
PH  - 2017/10/25 [received]
PH  - 2018/01/18 [revised]
PH  - 2018/01/25 [accepted]
LG  - English
EP  - 20180309
DP  - 2018 Mar 09
DT  - 2018/03/14 06:00
YR  - 2018
RD  - 20180313
UP  - 20180313
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29530654

<1131. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29523371
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Houry DE
AU  - Haegerich TM
AU  - Vivolo-Kantor A
FA  - Houry, Debra E
FA  - Haegerich, Tamara M
FA  - Vivolo-Kantor, Alana
IN  - Houry, Debra E. Centers for Disease Control and Prevention, Atlanta, GA. Electronic address: dhoury@cdc.gov.
IN  - Haegerich, Tamara M. Centers for Disease Control and Prevention, Atlanta, GA.
IN  - Vivolo-Kantor, Alana. Centers for Disease Control and Prevention, Atlanta, GA.
TI  - Opportunities for Prevention and Intervention of Opioid Overdose in the Emergency Department.
SO  - Annals of Emergency Medicine.  2018 Mar 02
AS  - Ann Emerg Med.  2018 Mar 02
NJ  - Annals of emergency medicine
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 8002646
IO  - Ann Emerg Med
CP  - United States
ES  - 1097-6760
IL  - 0196-0644
DI  - S0196-0644(18)30079-9
DO  - https://dx.doi.org/10.1016/j.annemergmed.2018.01.052
PT  - Editorial
ID  - S0196-0644(18)30079-9 [pii]
ID  - 10.1016/j.annemergmed.2018.01.052 [doi]
PP  - aheadofprint
PH  - 2018/01/22 [received]
LG  - English
EP  - 20180302
DP  - 2018 Mar 02
DT  - 2018/03/11 06:00
YR  - 2018
RD  - 20180310
UP  - 20180312
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29523371

<1132. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29516486
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Friedman BW
AU  - Latev A
AU  - Campbell C
AU  - White D
AI  - Friedman, Benjamin W; ORCID: http://orcid.org/0000-0002-2753-5860
FA  - Friedman, Benjamin W
FA  - Latev, Alexander
FA  - Campbell, Caron
FA  - White, Deborah
IN  - Friedman, Benjamin W. Department of Emergency Medicine, Albert Einstein College of Medicine, Montefiore Health System, Bronx, NY, USA.
IN  - Latev, Alexander. Department of Emergency Medicine, Albert Einstein College of Medicine, Montefiore Health System, Bronx, NY, USA.
IN  - Campbell, Caron. Department of Emergency Medicine, Albert Einstein College of Medicine, Montefiore Health System, Bronx, NY, USA.
IN  - White, Deborah. Department of Emergency Medicine, Albert Einstein College of Medicine, Montefiore Health System, Bronx, NY, USA.
TI  - Opioid-Induced "Likeability" and "Feeling Good" Are Not Associated With Return Visits to an ED Among Migraine Patients Administered IV Hydromorphone.
SO  - Headache.  2018 Mar 08
AS  - Headache.  2018 Mar 08
NJ  - Headache
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 2985091r, g1n
IO  - Headache
CP  - United States
KW  - euphoria;  migraine;  opioid;  return visits
AB  - BACKGROUND: Parenteral opioids are used in more than 50% of emergency department (ED) visits for migraine. Use of opioids for migraine has been associated with subsequent ED visits, perhaps because of opioid-induced euphoria. In this study, we quantify the extent to which nontherapeutic effects of opioids influence migraine outcomes. We hypothesized that "feeling good" and medication likeability would in fact be associated with receipt of opioids (rather than relief of migraine pain) and that receipt of opioids (rather than relief of migraine pain) would be associated with return visits to the ED.
AB  - METHODS: During an ED-based clinical trial, migraine patients were randomized to receive hydromorphone 1 mg or prochlorperazine 10 mg+diphenhydramine 25 mg IV. Thirty minutes after medication administration, we asked, (1) How much did you like the medication you received? and (2) How good did the medication make you feel? Participants were asked to provide answers on a 0-10 scale. We also determined 0-10 pain scores at baseline and 1 hour and number of return visits for headache during the subsequent month.
AB  - RESULTS: Sixty-three patients received prochlorperazine and 64 hydromorphone. Prochlorperazine pain scores improved by 6.8 (SD: 2.6), hydromorphone by 4.7 (SD: 3.3) (95%CI for difference of 2.1: 1.0, 3.2). On the 0-10 likeability scale, prochlorperazine patients reported a mean of 7.2 (SD: 2.8), hydromorphone 6.9 (SD: 2.9) (95% CI for difference of 0.3: -0.7, 1.3). On the 0-10 feeling good scale, prochlorperazine patients reported a mean of 7.5 (SD: 2.3), hydromorphone 6.8 (SD: 2.8) (95%CI: for difference of 0.7: -0.2, 1.6). In the hydromorphone group, 8/57 (14%, 95%CI: 7, 26%) returned to the ED vs 5/63 (8%, 95%CI: 3,18%) in the prochlorperazine group. In regression modeling, feeling good was independently associated with pain relief (P<.01) but not with medication received (P=.67) or return visits (P=.12). Similarly, medication likeability was independently associated with pain relief (P<.01) but not medication received (P=.12) or return visits (P=.16).
AB  - CONCLUSION: We did not detect an association between hydromorphone and medication likeability, feeling good, or return visits to the ED. Headache relief was associated with medication likeability and feeling good.

Copyright © 2018 American Headache Society.
ES  - 1526-4610
IL  - 0017-8748
DO  - https://dx.doi.org/10.1111/head.13292
PT  - Journal Article
ID  - 10.1111/head.13292 [doi]
PP  - aheadofprint
PH  - 2018/01/12 [received]
PH  - 2018/02/03 [revised]
PH  - 2018/02/05 [accepted]
LG  - English
EP  - 20180308
DP  - 2018 Mar 08
DT  - 2018/03/09 06:00
YR  - 2018
RD  - 20180308
UP  - 20180308
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29516486

<1133. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28591852
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Kelty E
AU  - Hulse G
FA  - Kelty, Erin
FA  - Hulse, Gary
IN  - Kelty, Erin. School of Psychiatry and Clinical Neuroscience, University of Western Australia, Sir Charles Gairdner Hospital, Nedlands, Western Australian 6009, Australia.
IN  - Kelty, Erin. School of Population and Global Health, University of Western Australia, Western Australian 6009, Australia.
IN  - Hulse, Gary. School of Psychiatry and Clinical Neuroscience, University of Western Australia, Sir Charles Gairdner Hospital, Nedlands, Western Australian 6009, Australia.
TI  - Morbidity and mortality in opioid dependent patients after entering an opioid pharmacotherapy compared with a cohort of non-dependent controls.
SO  - Journal of Public Health. :1-6, 2017 Jun 07
AS  - J Public Health (Oxf). :1-6, 2017 Jun 07
NJ  - Journal of public health (Oxford, England)
PG  - 1-6
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 101188638
IO  - J Public Health (Oxf)
CP  - England
KW  - hospitalization;  mortality;  opioid dependence;  opioid pharmacotherapy
AB  - Aims: To compare morbidity and mortality in opioid dependence patients following the commencement of treatment with the general population.
AB  - Methods: Morbidity and mortality in all patients treated with methadone, buprenorphine or implant naltrexone for opioid dependence for the first time between 2001 and 2010 in Western Australia was compared to a cohort of age and gender matched controls using state health records.
AB  - Results: Compared to community controls rates of all-cause mortality, hospital admissions and Emergency Department attendances are significantly elevated in opioid dependent persons following the commencement of their first treatment. Not surprisingly, rates of opioid and non-opioid drug poisoning, and intentional self-harm/suicide mortality and hospital admissions were significantly elevated in opioid dependent patients compared with non-dependent controls. However, significant increases in mortality and hospital admissions for conditions which are not generally associated with opioid use were also identified including cardiovascular, respiratory and traffic accidents. Life-time prevalence of both HBV and HCV were significantly elevated in opioid dependent patients compared with non-dependent patients.
AB  - Conclusions: Even after the commencement of treatment, opioid dependent patients are at a high risk of morbidity and mortality compared with non-dependent age and gender matched controls.

Copyright © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
ES  - 1741-3850
IL  - 1741-3842
DO  - https://dx.doi.org/10.1093/pubmed/fdx063
PT  - Journal Article
ID  - 3862394 [pii]
ID  - 10.1093/pubmed/fdx063 [doi]
PP  - aheadofprint
PH  - 2016/12/21 [received]
LG  - English
EP  - 20170607
DP  - 2017 Jun 07
EZ  - 2017/06/08 06:00
DA  - 2017/06/08 06:00
DT  - 2017/06/08 06:00
YR  - 2017
RD  - 20180308
UP  - 20180308
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=28591852

<1134. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29502329
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Varney SM
AU  - Perez CA
AU  - Arana AA
AU  - Carey KR
AU  - Ganem VJ
AU  - Zarzabal LA
AU  - Ramos RG
AU  - Bebarta VS
AI  - Varney, Shawn M; ORCID: http://orcid.org/0000-0001-5049-174X
AI  - Bebarta, Vikhyat S; ORCID: http://orcid.org/0000-0001-8816-1199
FA  - Varney, Shawn M
FA  - Perez, Crystal A
FA  - Arana, Allyson A
FA  - Carey, Katherine R
FA  - Ganem, Victoria J
FA  - Zarzabal, Lee A
FA  - Ramos, Rosemarie G
FA  - Bebarta, Vikhyat S
IN  - Varney, Shawn M. University of Texas Health San Antonio, 7703 Floyd Curl Dr, San Antonio, TX, 78229-3900, USA. varney@uthscsa.edu.
IN  - Perez, Crystal A. USAF En Route Care Research Center, U.S. Army Institute of Surgical Research, 3698 Chambers Pass STE B, JBSA Fort Sam Houston, San Antonio, TX, 78234, USA.
IN  - Arana, Allyson A. USAF En Route Care Research Center, U.S. Army Institute of Surgical Research, 3698 Chambers Pass STE B, JBSA Fort Sam Houston, San Antonio, TX, 78234, USA.
IN  - Carey, Katherine R. The Geneva Foundation, San Antonio Military Medical Center, 3551 Roger Brooke Dr, Fort Sam Houston, TX, 78234, USA.
IN  - Ganem, Victoria J. The Geneva Foundation, San Antonio Military Medical Center, 3551 Roger Brooke Dr, Fort Sam Houston, TX, 78234, USA.
IN  - Zarzabal, Lee A. STS Systems Integration, 1077 Central Pkwy S, San Antonio, TX, 78232, USA.
IN  - Ramos, Rosemarie G. University of Texas Health San Antonio, 7703 Floyd Curl Dr, San Antonio, TX, 78229-3900, USA.
IN  - Bebarta, Vikhyat S. University of Colorado-Denver-Anschutz Medical Campus, 13001 E 17th Place, Aurora, CO, 80045, USA.
TI  - Detecting aberrant opioid behavior in the emergency department: a prospective study using the screener and Opioid Assessment for Patients with Pain-Revised (SOAPP<sup></sup>-R), Current Opioid Misuse Measure (COMM)TM, and provider gestalt.
SO  - Internal & Emergency Medicine.  2018 Mar 03
AS  - Intern. emerg. medicine.  2018 Mar 03
NJ  - Internal and emergency medicine
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 101263418
IO  - Intern Emerg Med
CP  - Italy
KW  - Aberrant opioid behavior;  Current Opioid Misuse Measure (COMM);  Emergency department;  Gestalt;  Military;  Prescription opioid misuse;  Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R)
AB  - Emergency department (ED) providers have limited time to evaluate patients at risk for opioid misuse. A validated tool to assess the risk for aberrant opioid behavior may mitigate adverse sequelae associated with prescription opioid misuse. We sought to determine if SOAPP-R, COMM, and provider gestalt were able to identify patients at risk for prescription opioid misuse as determined by pharmacy records at 12 months. We conducted a prospective observational study of adult patients in a high volume US ED. Patients completed the SOAPP-R and COMM, and treating EM providers evaluated patients' opioid misuse risk. We performed variable-centered, person-centered, and hierarchical cluster analyses to determine whether provider gestalt, SOAPP-R, or COMM, or a combination, predicted higher misuse risk. The primary outcome was the number of opioid prescriptions at 12 months according to pharmacy records. For 169 patients (mean age 43 years, 51% female, 73% white), correlation analysis showed a strong relationship between SOAPP-R and COMM with predicting the number of opioid prescriptions dispensed at 12 months. Provider scores estimating opioid misuse were not related to SOAPP-R and only weakly associated with COMM. In our adjusted regression models, provider gestalt and SOAPP-R uniquely predicted opioid prescriptions at 6 and 12 months. Using designated cutoff scores, only SOAPP-R detected a difference in the number of opioid prescriptions. Cluster analysis revealed that provider gestalt, SOAPP-R, and COMM scores jointly predicted opioid prescriptions. Provider gestalt and self-report instruments uniquely predicted the number of opioid prescriptions in ED patients. A combination of gestalt and self-assessment scores can be used to identify at-risk patients who otherwise miss the cutoff scores for SOAPP-R and COMM.
ES  - 1970-9366
IL  - 1828-0447
DO  - https://dx.doi.org/10.1007/s11739-018-1804-3
PT  - Journal Article
ID  - 10.1007/s11739-018-1804-3 [doi]
ID  - 10.1007/s11739-018-1804-3 [pii]
PP  - aheadofprint
PH  - 2017/08/08 [received]
PH  - 2018/02/25 [accepted]
GI  - No: unknown
Organization: *US Air Force Office of the Surgeon General*
LG  - English
EP  - 20180303
DP  - 2018 Mar 03
EZ  - 2018/03/05 06:00
DA  - 2018/03/05 06:00
DT  - 2018/03/05 06:00
YR  - 2018
RD  - 20180304
UP  - 20180305
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29502329

<1135. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29492780
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Penm J
AU  - MacKinnon NJ
AU  - Lyons MS
AU  - Tolle E
AU  - Sneed GT
FA  - Penm, Jonathan
FA  - MacKinnon, Neil J
FA  - Lyons, Michael S
FA  - Tolle, Erica
FA  - Sneed, Gregory T
IN  - Penm, Jonathan. Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia.
IN  - MacKinnon, Neil J. College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA.
IN  - Lyons, Michael S. College of Medicine, University of Cincinnati, Cincinnati, OH, USA.
IN  - Tolle, Erica. Institute for Wellness and Education, Woodstock, GA, USA.
IN  - Tolle, Erica. Physician's Pharmacy, Austell, GA, USA.
IN  - Sneed, Gregory T. College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA. Gregory.Sneed@uc.edu.
TI  - Combatting Opioid Overdoses in Ohio: Emergency Department Physicians' Prescribing Patterns and Perceptions of Naloxone.
SO  - Journal of General Internal Medicine.  2018 Feb 28
AS  - J Gen Intern Med.  2018 Feb 28
NJ  - Journal of general internal medicine
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 8605834
IO  - J Gen Intern Med
CP  - United States
KW  - drug abuse;  emergency medicine;  practice variation;  substance abuse;  survey research
ES  - 1525-1497
IL  - 0884-8734
DO  - https://dx.doi.org/10.1007/s11606-018-4353-6
PT  - Journal Article
ID  - 10.1007/s11606-018-4353-6 [doi]
ID  - 10.1007/s11606-018-4353-6 [pii]
PP  - aheadofprint
LG  - English
EP  - 20180228
DP  - 2018 Feb 28
DT  - 2018/03/02 06:00
YR  - 2018
RD  - 20180301
UP  - 20180301
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29492780

<1136. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29485328
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Kinsman JM
AU  - Robinson K
FA  - Kinsman, Jeremiah M
FA  - Robinson, Kathy
TI  - National Systematic Legal Review of State Policies on Emergency Medical Services Licensure Levels' Authority to Administer Opioid Antagonists.
SO  - Prehospital Emergency Care. :1-5, 2018 Feb 27
AS  - Prehosp Emerg Care. :1-5, 2018 Feb 27
NJ  - Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
PG  - 1-5
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - c5i, 9703530
IO  - Prehosp Emerg Care
CP  - England
KW  - drug overdose;  emergency medical services;  naloxone;  narcotic antagonists;  policy
AB  - OBJECTIVE: Previous research conducted in November 2013 found there were a limited number of states and territories in the United States (US) that authorize emergency medical technicians (EMTs) and emergency medical responders (EMRs) to administer opioid antagonists. Given the continued increase in the number of opioid-related overdoses and deaths, many states have changed their policies to authorize EMTs and EMRs to administer opioid antagonists. The goal of this study is to provide an updated description of policy on EMS licensure levels' authority to administer opioid antagonists for all 50 US states, the District of Columbia (DC), and the Commonwealth of Puerto Rico (PR).
AB  - METHODS: State law and scopes of practice were systematically reviewed using a multi-tiered approach to determine each state's legally-defined EMS licensure levels and their authority to administer an opioid antagonist. State law, state EMS websites, and state EMS scope of practice documents were identified and searched using Google Advanced Search with Boolean Search Strings. Initial results of the review were sent to each state office of EMS for review and comment.
AB  - RESULTS: As of September 1, 2017, 49 states and DC authorize EMTs to administer an opioid antagonist. Among the 40 US jurisdictions (39 states and DC) that define the EMR or a comparable first responder licensure level in state law, 37 states and DC authorize their EMRs to administer an opioid antagonist. Paramedics are authorized to administer opioid antagonists in all 50 states, DC, and PR. All 49 of the US jurisdictions (48 states and DC) that define the advanced emergency medical technician (AEMT) or a comparable intermediate EMS licensure level in state law authorize their AEMTs to administer an opioid antagonist.
AB  - CONCLUSIONS: 49 out of 52 US jurisdictions (50 states, DC, and PR) authorize all existing levels of EMS licensure levels to administer an opioid antagonist. Expanding access to this medication can save lives, especially in communities that have limited advanced life support coverage.
ES  - 1545-0066
IL  - 1090-3127
DO  - https://dx.doi.org/10.1080/10903127.2018.1439129
PT  - Journal Article
ID  - 10.1080/10903127.2018.1439129 [doi]
PP  - aheadofprint
LG  - English
EP  - 20180227
DP  - 2018 Feb 27
DT  - 2018/02/28 06:00
YR  - 2018
RD  - 20180227
UP  - 20180227
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29485328

<1137. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29459055
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Lynch MJ
AU  - Yealy DM
FA  - Lynch, Michael J
FA  - Yealy, Donald M
IN  - Lynch, Michael J. University of Pittsburgh and UPMC, Pittsburgh, PA.
IN  - Yealy, Donald M. University of Pittsburgh and UPMC, Pittsburgh, PA. Electronic address: yealydm@upmc.edu.
TI  - Looking Ahead: The Role of Emergency Physicians in the Opioid Epidemic.
SO  - Annals of Emergency Medicine.  2018 Feb 16
AS  - Ann Emerg Med.  2018 Feb 16
NJ  - Annals of emergency medicine
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 8002646
IO  - Ann Emerg Med
CP  - United States
ES  - 1097-6760
IL  - 0196-0644
DI  - S0196-0644(18)30078-7
DO  - https://dx.doi.org/10.1016/j.annemergmed.2018.01.051
PT  - Editorial
ID  - S0196-0644(18)30078-7 [pii]
ID  - 10.1016/j.annemergmed.2018.01.051 [doi]
PP  - aheadofprint
PH  - 2018/01/17 [received]
LG  - English
EP  - 20180216
DP  - 2018 Feb 16
DT  - 2018/02/21 06:00
YR  - 2018
RD  - 20180220
UP  - 20180220
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29459055

<1138. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29436397
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Banta-Green CJ
AU  - Coffin PO
AU  - Merrill JO
AU  - Sears JM
AU  - Dunn C
AU  - Floyd AS
AU  - Whiteside LK
AU  - Yanez ND
AU  - Donovan DM
FA  - Banta-Green, Caleb J
FA  - Coffin, Phillip O
FA  - Merrill, Joseph O
FA  - Sears, Jeanne M
FA  - Dunn, Chris
FA  - Floyd, Anthony S
FA  - Whiteside, Lauren K
FA  - Yanez, Norbert D
FA  - Donovan, Dennis M
IN  - Banta-Green, Caleb J. Alcohol & Drug Abuse Institute and Department of Health Services, School of Public Health University of Washington, Seattle, Washington, USA.
IN  - Coffin, Phillip O. Substance Use Research, San Francisco Department of Public Health, San Francisco, California, USA.
IN  - Coffin, Phillip O. Department of Medicine, University of California San Francisco, San Francisco, California, USA.
IN  - Merrill, Joseph O. Department of Medicine, University of Washington, Seattle, Washington, USA.
IN  - Sears, Jeanne M. Department of Health Services, School of Public Health and Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA.
IN  - Sears, Jeanne M. Institute for Work and Health, Toronto, Ontario, Canada.
IN  - Dunn, Chris. Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, Washington, USA.
IN  - Floyd, Anthony S. Alcohol & Drug Abuse Institute and Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA.
IN  - Whiteside, Lauren K. Department of Emergency Medicine, University of Washington, Seattle, Washington, USA.
IN  - Yanez, Norbert D. Oregon Health & Science University/Portland State University School of Public Health, Oregon Health & Science University, Portland, Oregon, USA.
IN  - Donovan, Dennis M. Alcohol & Drug Abuse Institute and Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, Washington, USA.
TI  - Impacts of an opioid overdose prevention intervention delivered subsequent to acute care.
SO  - Injury Prevention.  2018 Feb 07
AS  - Inj Prev.  2018 Feb 07
NJ  - Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - crz, 9510056
IO  - Inj. Prev.
CP  - England
KW  - behavior change;  drugs;  health education
AB  - BACKGROUND: Opioid overdose is a major and increasing cause of injury and death. There is an urgent need for interventions to reduce overdose events among high-risk persons.
AB  - METHODS: Adults at elevated risk for opioid overdose involving heroin or pharmaceutical opioids who had been cared for in an emergency department (ED) were randomised to overdose education combined with a brief behavioural intervention and take-home naloxone or usual care. Outcomes included: (1) time to first opioid overdose-related event resulting in medical attention or death using competing risks survival analysis; and (2) ED visit and hospitalisation rates, using negative binomial regression and adjusting for time at risk.
AB  - RESULTS: During the follow-up period, 24% of the 241 participants had at least one overdose event, 85% had one or more ED visits and 55% had at least one hospitalisation, with no significant differences between intervention and comparison groups. The instantaneous risk of an overdose event was not significantly lower for the intervention group (sub-HR: 0.83; 95%CI 0.49 to 1.40).
AB  - DISCUSSION: These null findings may be due in part to the severity of the population in terms of housing insecurity (70% impermanently housed), drug use, unemployment and acute healthcare issues. Given the high overdose and healthcare utilisation rates, more intensive interventions, such as direct referral and provision of housing and opioid agonist treatment medications, may be necessary to have a substantial impact on opioid overdoses for this high-acuity population in acute care settings.
AB  - TRIAL REGISTRATION NUMBER: NCT0178830; Results.

Copyright © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
CI  - Competing interests: POC has previously directed National Institutes of Health-funded trials that have received donated study medications from Alkermes (2014-2015) and Gilead (2015-2017).
ES  - 1475-5785
IL  - 1353-8047
DI  - injuryprev-2017-042676
DO  - https://dx.doi.org/10.1136/injuryprev-2017-042676
PT  - Journal Article
ID  - injuryprev-2017-042676 [pii]
ID  - 10.1136/injuryprev-2017-042676 [doi]
PP  - aheadofprint
PH  - 2017/11/25 [received]
PH  - 2018/01/16 [revised]
PH  - 2018/01/18 [accepted]
LG  - English
EP  - 20180207
DP  - 2018 Feb 07
DT  - 2018/02/14 06:00
YR  - 2018
RD  - 20180213
UP  - 20180213
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29436397

<1139. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29266577
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Martin A
AU  - Mitchell A
AU  - Wakeman S
AU  - White B
AU  - Raja A
FA  - Martin, Alister
FA  - Mitchell, Andreas
FA  - Wakeman, Sarah
FA  - White, Ben
FA  - Raja, Ali
IN  - Martin, Alister. Massachusetts General Hospital Emergency Department.
IN  - Mitchell, Andreas. Harvard Medical School and Harvard Kennedy School, Boston, MA.
IN  - Wakeman, Sarah. Massachusetts General Hospital Substance Use Disorders Initiative.
IN  - White, Ben. Massachusetts General Hospital Emergency Department.
IN  - Raja, Ali. Massachusetts General Hospital Emergency Department.
TI  - Emergency Department Treatment of Opioid Addiction: An Opportunity to Lead.
SO  - Academic Emergency Medicine.  2017 Dec 21
AS  - Acad Emerg Med.  2017 Dec 21
NJ  - Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - ce1, 9418450
IO  - Acad Emerg Med
CP  - United States
ES  - 1553-2712
IL  - 1069-6563
DO  - https://dx.doi.org/10.1111/acem.13367
PT  - Journal Article
ID  - 10.1111/acem.13367 [doi]
PP  - aheadofprint
LG  - English
EP  - 20171221
DP  - 2017 Dec 21
EZ  - 2017/12/22 06:00
DA  - 2017/12/22 06:00
DT  - 2017/12/22 06:00
YR  - 2017
RD  - 20180213
UP  - 20180213
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29266577

<1140. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29400924
BK  - https://www.ncbi.nlm.nih.gov/books/NBK481369
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
AU  - Weiss AJ
AU  - Bailey MK
AU  - O'Malley L
AU  - Barrett ML
AU  - Elixhauser A
AU  - Steiner CA
FA  - Weiss, Audrey J
FA  - Bailey, Molly K
FA  - O'Malley, Lauren
FA  - Barrett, Marguerite L
FA  - Elixhauser, Anne
FA  - Steiner, Claudia A
TI  - Patient Residence Characteristics of Opioid-Related Inpatient Stays and Emergency Department Visits Nationally and by State, 2014: Statistical Brief #226. [Review]
BT  - Healthcare Cost and Utilization Project (HCUP) Statistical Briefs
SO  - Agency for Healthcare Research and Quality (US).  2006 02
AS  - Agency for Healthcare Research and Quality (US).  2006 02
PL  - Rockville (MD)
SN  - Introduction
https://www.ncbi.nlm.nih.gov/books/n/hcupsb/sb226
SN  - 
Findings
https://www.ncbi.nlm.nih.gov/books/n/hcupsb/sb226
SN  - 
Data Source
https://www.ncbi.nlm.nih.gov/books/n/hcupsb/sb226
SN  - 
Definitions
https://www.ncbi.nlm.nih.gov/books/n/hcupsb/sb226
SN  - 
For More Information
https://www.ncbi.nlm.nih.gov/books/n/hcupsb/sb226
PT  - Review
MT  - Internet
PP  - ppublish
LG  - English
DP  - 2006 02
EZ  - 2018/02/06 06:01
DA  - 2018/02/06 06:01
DT  - 2018/02/06 06:01
BD  - 200602
CB  - 201707
YR  - 2006
UP  - 20180207
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29400924

<1141. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29400925
BK  - https://www.ncbi.nlm.nih.gov/books/NBK481370
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
AU  - Weiss AJ
AU  - Bailey MK
AU  - O'Malley L
AU  - Barrett ML
AU  - Elixhauser A
AU  - Steiner CA
FA  - Weiss, Audrey J
FA  - Bailey, Molly K
FA  - O'Malley, Lauren
FA  - Barrett, Marguerite L
FA  - Elixhauser, Anne
FA  - Steiner, Claudia A
TI  - Patient Characteristics of Opioid-Related Inpatient Stays and Emergency Department Visits Nationally and by State, 2014: Statistical Brief #224. [Review]
BT  - Healthcare Cost and Utilization Project (HCUP) Statistical Briefs
SO  - Agency for Healthcare Research and Quality (US).  2006 02
AS  - Agency for Healthcare Research and Quality (US).  2006 02
PL  - Rockville (MD)
SN  - Introduction
https://www.ncbi.nlm.nih.gov/books/n/hcupsb/sb224
SN  - 
Findings
https://www.ncbi.nlm.nih.gov/books/n/hcupsb/sb224
SN  - 
Data Source
https://www.ncbi.nlm.nih.gov/books/n/hcupsb/sb224
SN  - 
Definitions
https://www.ncbi.nlm.nih.gov/books/n/hcupsb/sb224
SN  - 
For More Information
https://www.ncbi.nlm.nih.gov/books/n/hcupsb/sb224
PT  - Review
MT  - Internet
PP  - ppublish
LG  - English
DP  - 2006 02
EZ  - 2018/02/06 06:01
DA  - 2018/02/06 06:01
DT  - 2018/02/06 06:01
BD  - 200602
CB  - 201706
YR  - 2006
UP  - 20180207
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29400925

<1142. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29400083
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Ringwalt C
AU  - Sanford C
AU  - Dasgupta N
AU  - Alexandridis A
AU  - McCort A
AU  - Proescholdbell S
AU  - Sachdeva N
AU  - Mack K
FA  - Ringwalt, Christopher
FA  - Sanford, Catherine
FA  - Dasgupta, Nabarun
FA  - Alexandridis, Apostolos
FA  - McCort, Agnieszka
FA  - Proescholdbell, Scott
FA  - Sachdeva, Nidhi
FA  - Mack, Karin
IN  - Ringwalt, Christopher. 1 University of North Carolina, Chapel Hill, Chapel Hill, NC, USA.
IN  - Sanford, Catherine. 1 University of North Carolina, Chapel Hill, Chapel Hill, NC, USA.
IN  - Dasgupta, Nabarun. 1 University of North Carolina, Chapel Hill, Chapel Hill, NC, USA.
IN  - Alexandridis, Apostolos. 1 University of North Carolina, Chapel Hill, Chapel Hill, NC, USA.
IN  - McCort, Agnieszka. 1 University of North Carolina, Chapel Hill, Chapel Hill, NC, USA.
IN  - Proescholdbell, Scott. 2 NC Department of Health and Human Services, Raleigh, NC, USA.
IN  - Sachdeva, Nidhi. 2 NC Department of Health and Human Services, Raleigh, NC, USA.
IN  - Mack, Karin. 3 Centers for Disease Control and Prevention, Atlanta, GA, USA.
TI  - Community Readiness to Prevent Opioid Overdose.
SO  - Health Promotion Practice. :1524839918756887, 2018 Feb 01
AS  - HEALTH PROMOT PRACT. :1524839918756887, 2018 Feb 01
NJ  - Health promotion practice
PG  - 1524839918756887
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 100890609
IO  - Health Promot Pract
CP  - United States
KW  - community readiness;  health directors;  opioids;  overdose;  prevention
AB  - Effective community-based actions are urgently needed to combat the ongoing epidemic of opioid overdose. Community readiness (CR) has been linked to communities' support for collective action, which in turn has been associated with the success of community-wide prevention strategies and resulting behavior change. Our study, conducted in North Carolina, assessed the relationship between CR and two indices of opioid overdose. County-level data included a survey of health directors that assessed CR to address drug overdose prevention programs, surveillance measures of opioid overdose collected from death records and emergency departments, and two indicators of general health-related status. We found that counties' rates of CR were positively associated with their opioid-related mortality (but not morbidity) and that this relationship persisted when we controlled for health status. North Carolina counties with the highest opioid misuse problems appear to be the most prepared to respond to them.
IS  - 1524-8399
IL  - 1524-8399
DO  - https://dx.doi.org/10.1177/1524839918756887
PT  - Journal Article
ID  - 10.1177/1524839918756887 [doi]
PP  - aheadofprint
LG  - English
EP  - 20180201
DP  - 2018 Feb 01
DT  - 2018/02/06 06:00
YR  - 2018
RD  - 20180205
UP  - 20180205
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29400083

<1143. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29396593
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Zylla D
AU  - Steele G
AU  - Shapiro A
AU  - Richter S
AU  - Gupta P
AI  - Zylla, Dylan; ORCID: http://orcid.org/0000-0003-1726-3715
FA  - Zylla, Dylan
FA  - Steele, Grant
FA  - Shapiro, Alice
FA  - Richter, Sara
FA  - Gupta, Pankaj
IN  - Zylla, Dylan. Frauenshuh Cancer Center, Park Nicollet Oncology Research and HealthPartners Institute, 3800 Park Nicollet Blvd, Minneapolis, MN, 55416, USA. dylan.zylla@parknicollet.com.
IN  - Zylla, Dylan. HealthPartners Institute, Minneapolis, MN, USA. dylan.zylla@parknicollet.com.
IN  - Steele, Grant. Frauenshuh Cancer Center, Park Nicollet Oncology Research and HealthPartners Institute, 3800 Park Nicollet Blvd, Minneapolis, MN, 55416, USA.
IN  - Steele, Grant. HealthPartners Institute, Minneapolis, MN, USA.
IN  - Shapiro, Alice. Frauenshuh Cancer Center, Park Nicollet Oncology Research and HealthPartners Institute, 3800 Park Nicollet Blvd, Minneapolis, MN, 55416, USA.
IN  - Shapiro, Alice. HealthPartners Institute, Minneapolis, MN, USA.
IN  - Richter, Sara. Frauenshuh Cancer Center, Park Nicollet Oncology Research and HealthPartners Institute, 3800 Park Nicollet Blvd, Minneapolis, MN, 55416, USA.
IN  - Richter, Sara. Professional Data Analysts, Inc., Minneapolis, MN, USA.
IN  - Gupta, Pankaj. Hematology/Oncology Section, Department of Medicine, Minneapolis VA Health Care System, Minneapolis, USA.
TI  - Impact of opioid use on health care utilization and survival in patients with newly diagnosed stage IV malignancies.
SO  - Supportive Care in Cancer.  2018 Feb 02
AS  - Support Care Cancer.  2018 Feb 02
NJ  - Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 9302957, b1l
IO  - Support Care Cancer
CP  - Germany
KW  - Analgesics;  Health care utilization;  Neoplasms;  Opioid;  Survival
AB  - PURPOSE: Patients with advanced cancers frequently experience pain. Opioids are commonly prescribed to treat cancer-related pain, but their use might be associated with undesirable consequences including adverse effects and tumor progression, resulting in increased heath care utilization and shorter survival. We examined these possibilities in a large cohort of patients diagnosed with ten common advanced malignancies.
AB  - METHODS: We identified 1386 newly diagnosed patients with stage IV non-hematologic malignancies from 2005 to 2013 and ascertained opioid utilization within 90 days of starting anti-cancer treatment using electronic medical record and tumor registry data. Opioid utilization was stratified into low opioid (LO; <5 mg oral morphine equivalents (OME)/day) and high opioid (HO; >=5 mg OME/day). Health care utilization included tallies of emergency room, urgent care, and inpatient visits. The association of opioid use, tumor type prognosis, age, and gender with overall survival was analyzed in univariate and multivariate models.
AB  - RESULTS: HO use patients (n=624) had greater health care utilization compared to LO use patients (n=762; p<0.05). HO use patients also had shorter survival (median survival, 5.5 vs 12.4 months; p<0.0001). On multivariate analysis, HO use remained associated with shorter overall survival (HR 1.4; 95% CI, 1.3-1.6; p<0.0001) after adjusting for age, gender, and prognostic group.
AB  - CONCLUSIONS: In advanced cancer patients, HO use is associated with greater health care utilization and shorter survival. Prospective studies using opioid-sparing approaches are indicated, to confirm these retrospective findings and to evaluate if these undesirable effects associated with opioid use can be mitigated.
ES  - 1433-7339
IL  - 0941-4355
DO  - https://dx.doi.org/10.1007/s00520-018-4062-z
PT  - Journal Article
ID  - 10.1007/s00520-018-4062-z [doi]
ID  - 10.1007/s00520-018-4062-z [pii]
PP  - aheadofprint
PH  - 2017/07/20 [received]
PH  - 2018/01/22 [accepted]
LG  - English
EP  - 20180202
DP  - 2018 Feb 02
DT  - 2018/02/04 06:00
YR  - 2018
RD  - 20180203
UP  - 20180205
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29396593

<1144. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29373155
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Axeen S
AU  - Seabury SA
AU  - Menchine M
FA  - Axeen, Sarah
FA  - Seabury, Seth A
FA  - Menchine, Michael
IN  - Axeen, Sarah. Department of Emergency Medicine; Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA. Electronic address: axeen@usc.edu.
IN  - Seabury, Seth A. Department of Ophthalmology, Keck School of Medicine; Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA.
IN  - Menchine, Michael. Department of Emergency Medicine.
TI  - Emergency Department Contribution to the Prescription Opioid Epidemic.
SO  - Annals of Emergency Medicine.  2018 Jan 10
AS  - Ann Emerg Med.  2018 Jan 10
NJ  - Annals of emergency medicine
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 8002646
IO  - Ann Emerg Med
CP  - United States
AB  - STUDY OBJECTIVE: We characterize the relative contribution of emergency departments (EDs) to national opioid prescribing, estimate trends in opioid prescribing by site of care (ED, office-based, and inpatient), and examine whether higher-risk opioid users receive a disproportionate quantity of their opioids from ED settings.
AB  - METHODS: This was a retrospective analysis of the nationally representative Medical Expenditure Panel Survey from 1996 to 2012. Individuals younger than 18 years and with malignancy diagnoses were excluded. All prescriptions were standardized through conversion to milligrams of morphine equivalents. Reported estimates are adjusted with multivariable regression analysis.
AB  - RESULTS: From 1996 to 2012, 47,081 patient-years (survey-weighted population of 483,654,902 patient-years) surveyed by the Medical Expenditure Panel Survey received at least 1 opioid prescription. During the same period, we observed a 471% increase in the total quantity of opioids (measured by total milligrams of morphine equivalents) prescribed in the United States. The proportion of opioids from office-based prescriptions was high and increased throughout the study period (71% of the total in 1996 to 83% in 2012). The amount of opioids originating from the ED was modest and declined throughout the study period (7.4% in 1996 versus 4.4% in 2012). For people in the top 5% of opioid consumption, ED prescriptions accounted for only 2.4% of their total milligrams of morphine equivalents compared with 87.8% from office visits.
AB  - CONCLUSION: Between 1996 and 2012, opioid prescribing for noncancer patients in the United States significantly increased. The majority of this growth was attributable to office visits and refills of previously prescribed opioids. The relative contribution of EDs to the prescription opioid problem was modest and declining. Thus, further efforts to reduce the quantity of opioids prescribed may have limited effect in the ED and should focus on office-based settings. EDs could instead focus on developing and disseminating tools to help providers identify high-risk individuals and refer them to treatment.

Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
ES  - 1097-6760
IL  - 0196-0644
DI  - S0196-0644(17)31969-8
DO  - https://dx.doi.org/10.1016/j.annemergmed.2017.12.007
PT  - Journal Article
ID  - S0196-0644(17)31969-8 [pii]
ID  - 10.1016/j.annemergmed.2017.12.007 [doi]
PP  - aheadofprint
PH  - 2017/02/01 [received]
PH  - 2017/11/21 [revised]
PH  - 2017/12/01 [accepted]
LG  - English
EP  - 20180110
DP  - 2018 Jan 10
EZ  - 2018/01/27 06:00
DA  - 2018/01/27 06:00
DT  - 2018/01/27 06:00
YR  - 2018
RD  - 20180126
UP  - 20180129
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29373155

<1145. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29165853
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Hawk K
AU  - D'Onofrio G
AU  - Fiellin DA
AU  - Chawarski MC
AU  - O'Connor PG
AU  - Owens PH
AU  - Pantalon MV
AU  - Bernstein SL
FA  - Hawk, Kathryn
FA  - D'Onofrio, Gail
FA  - Fiellin, David A
FA  - Chawarski, Marek C
FA  - O'Connor, Patrick G
FA  - Owens, Patricia H
FA  - Pantalon, Michael V
FA  - Bernstein, Steven L
IN  - Hawk, Kathryn. Department of Emergency Medicine, Yale School of Medicine, New Haven, CT.
IN  - D'Onofrio, Gail. Department of Emergency Medicine, Yale School of Medicine, New Haven, CT.
IN  - Fiellin, David A. Department of Emergency Medicine, Yale School of Medicine, New Haven, CT.
IN  - Fiellin, David A. Department of Internal Medicine, Yale School of Medicine, New Haven, CT.
IN  - Fiellin, David A. Yale School of Public Health, New Haven, CT.
IN  - Chawarski, Marek C. Department of Psychiatry, Yale School of Medicine, New Haven, CT.
IN  - O'Connor, Patrick G. Department of Internal Medicine, Yale School of Medicine, New Haven, CT.
IN  - Owens, Patricia H. Department of Emergency Medicine, Yale School of Medicine, New Haven, CT.
IN  - Pantalon, Michael V. Department of Emergency Medicine, Yale School of Medicine, New Haven, CT.
IN  - Bernstein, Steven L. Department of Emergency Medicine, Yale School of Medicine, New Haven, CT.
IN  - Bernstein, Steven L. Yale School of Public Health, New Haven, CT.
TI  - Past-year Prescription Drug Monitoring Program Opioid Prescriptions and Self-reported Opioid Use in an Emergency Department Population With Opioid Use Disorder.
SO  - Academic Emergency Medicine.  2017 Nov 22
AS  - Acad Emerg Med.  2017 Nov 22
NJ  - Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - ce1, 9418450
IO  - Acad Emerg Med
CP  - United States
AB  - BACKGROUND: Despite increasing reliance on prescription drug monitoring programs (PDMPs) as a response to the opioid epidemic, the relationship between aberrant drug-related behaviors captured by the PDMP and opioid use disorder is incompletely understood. How PDMP data should guide emergency department (ED) assessment has not been studied.
AB  - OBJECTIVES: The objective was to evaluate a relationship between PDMP opioid prescription records and self-reported nonmedical opioid use of prescription opioids in a cohort of opioid-dependent ED patients enrolled in a treatment trial.
AB  - METHODS: PDMP opioid prescription records during 1 year prior to study enrollment on 329 adults meeting Diagnostic and Statistical Manual IV criteria for opioid dependence entering a randomized clinical trial in a large, urban ED were cross-tabulated with data on 30-day nonmedical prescription opioid use self-report. The association among these two types of data was assessed by the Goodman and Kruskal's gamma; a logistic regression was used to explore characteristics of participants who had PDMP record of opioid prescriptions.
AB  - RESULTS: During 1 year prior to study enrollment, 118 of 329 (36%) patients had at least one opioid prescription (range = 1-51) in our states' PDMP. Patients who reported >=15 of 30 days of nonmedical prescription opioid use were more likely to have at least four PDMP opioid prescriptions (20/38; 53%) than patients reporting 1 to 14 days (14/38, 37%) or zero days of nonmedical prescription opioid use (4/38, 11%; p = 0.002). Female sex and having health insurance were significantly more represented in the PDMP (p < 0.05 for both).
AB  - CONCLUSION: PDMPs may be helpful in identifying patients with certain aberrant drug-related behavior, but are unable to detect many patients with opioid use disorder. The majority of ED patients with opioid use disorder were not captured by the PDMP, highlighting the importance of using additional methods such as screening and clinical history to identify opioid use disorders in ED patients and the limitations of PDMPs to detect opioid use disorders.

Copyright © 2017 by the Society for Academic Emergency Medicine.
ES  - 1553-2712
IL  - 1069-6563
DO  - https://dx.doi.org/10.1111/acem.13352
PT  - Journal Article
ID  - 10.1111/acem.13352 [doi]
PP  - aheadofprint
PH  - 2017/06/02 [received]
PH  - 2017/10/11 [revised]
PH  - 2017/11/16 [accepted]
GI  - No: K12 DA033312
Organization: (DA) *NIDA NIH HHS*
Country: United States

GI  - No: R01 DA025991
Organization: (DA) *NIDA NIH HHS*
Country: United States
LG  - English
EP  - 20171122
DP  - 2017 Nov 22
EZ  - 2017/11/23 06:00
DA  - 2017/11/23 06:00
DT  - 2017/11/23 06:00
YR  - 2017
RD  - 20180124
UP  - 20180124
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29165853

<1146. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28385954
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Omaki E
AU  - Castillo R
AU  - Eden K
AU  - Davis S
AU  - McDonald E
AU  - Murtaza U
AU  - Gielen A
AU  - My Healthy Choices Decision Aid Study Team
FA  - Omaki, Elise
FA  - Castillo, Renan
FA  - Eden, Karen
FA  - Davis, Steve
FA  - McDonald, Eileen
FA  - Murtaza, Umbreen
FA  - Gielen, Andrea
FA  - My Healthy Choices Decision Aid Study Team
IN  - Omaki, Elise. Johns Hopkins Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
IN  - Castillo, Renan. Johns Hopkins Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
IN  - Eden, Karen. Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, Oregon, USA.
IN  - Davis, Steve. WVU injury Control and Research Center, West Virginia University, Morgantown, West Virginia, USA.
IN  - McDonald, Eileen. Johns Hopkins Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
IN  - Murtaza, Umbreen. Department of Pharmacy, Johns Hopkins Hospital and Health System, Baltimore, Maryland, USA.
IN  - Gielen, Andrea. Johns Hopkins Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
IR  - Shields W
IR  - Rizzutti N
IR  - Frattaroli S
IR  - Case J
IR  - Rothman R
IR  - Coben J
TI  - Using m-health tools to reduce the misuse of opioid pain relievers.
SO  - Injury Prevention.  2017 Apr 06
AS  - Inj Prev.  2017 Apr 06
NJ  - Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - crz, 9510056
IO  - Inj. Prev.
CP  - England
AB  - BACKGROUND: Emergency department (ED) patients are among the many groups at risk for prescription drug overdose. There is limited research on how best to communicate with ED patients about options for pain management and the risks of opioids. The aim of this study is to pilot test a web-based, patient-centred educational programme that encourages the patient to have an informed discussion about pain medication options with their ED provider.
AB  - METHODS: This multisite, randomised trial will evaluate an m-health programme designed to aid the patient in making an informed decision about their pain treatment. Patients reporting to the ED with an injury-related or pain- related chief complaint who agree to participate are randomised to receive the intervention programme, My Healthy Choices, or an attention-matched control. My Healthy Choices pairs tailored education with a patient decision aid to describe what opioid and non-opioid pain medications are, assess the patient's risk factors for opioid-related adverse effects, and produce a tailored report that patients are encouraged to share with their doctor. Data are collected through surveys at three time points during the ED encounter (baseline, immediately after the intervention and just before discharge), and at a 6-week follow-up survey. The primary outcomes are whether the patient prefers an opioid pain reliever (OPR) and whether the patient takes an OPR.
AB  - DISCUSSION: We hope this programme will facilitate patient-provider communication, as well as reduce the number of prescriptions written for OPRs and thus the number of patients exposed to prescription opioids and the associated risks of addiction and overdose.
AB  - TRIAL REGISTRATION NUMBER: NCT03012087; Pre-results.

Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
ES  - 1475-5785
IL  - 1353-8047
DI  - injuryprev-2017-042319
DO  - https://dx.doi.org/10.1136/injuryprev-2017-042319
PT  - Journal Article
ID  - injuryprev-2017-042319 [pii]
ID  - 10.1136/injuryprev-2017-042319 [doi]
PP  - aheadofprint
PH  - 2017/01/05 [received]
PH  - 2017/01/25 [revised]
PH  - 2017/02/07 [accepted]
SI  - ClinicalTrials.gov
SA  - ClinicalTrials.gov/NCT03012087
SL  - https://clinicaltrials.gov/search/term=NCT03012087
LG  - English
EP  - 20170406
DP  - 2017 Apr 06
EZ  - 2017/04/08 06:00
DA  - 2017/04/08 06:00
DT  - 2017/04/08 06:00
YR  - 2017
RD  - 20180120
UP  - 20180122
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=28385954

<1147. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29340924
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Kim Y
AU  - Cortez AR
AU  - Wima K
AU  - Dhar VK
AU  - Athota KP
AU  - Schrager JJ
AU  - Pritts TA
AU  - Edwards MJ
AU  - Shah SA
FA  - Kim, Young
FA  - Cortez, Alexander R
FA  - Wima, Koffi
FA  - Dhar, Vikrom K
FA  - Athota, Krishna P
FA  - Schrager, Jason J
FA  - Pritts, Timothy A
FA  - Edwards, Michael J
FA  - Shah, Shimul A
IN  - Kim, Young. Cincinnati Research in Outcomes and Safety in Surgery (CROSS), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA.
IN  - Cortez, Alexander R. Cincinnati Research in Outcomes and Safety in Surgery (CROSS), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA.
IN  - Wima, Koffi. Cincinnati Research in Outcomes and Safety in Surgery (CROSS), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA.
IN  - Dhar, Vikrom K. Cincinnati Research in Outcomes and Safety in Surgery (CROSS), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA.
IN  - Athota, Krishna P. Cincinnati Research in Outcomes and Safety in Surgery (CROSS), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA.
IN  - Schrager, Jason J. Cincinnati Research in Outcomes and Safety in Surgery (CROSS), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA.
IN  - Pritts, Timothy A. Cincinnati Research in Outcomes and Safety in Surgery (CROSS), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA.
IN  - Edwards, Michael J. Cincinnati Research in Outcomes and Safety in Surgery (CROSS), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA.
IN  - Shah, Shimul A. Cincinnati Research in Outcomes and Safety in Surgery (CROSS), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA. Shimul.shah@uc.edu.
IN  - Shah, Shimul A. Division of Transplantation, University of Cincinnati School of Medicine, 231 Albert Sabin Way, ML 0558, MSB 2006C, Cincinnati, OH, 45267-0558, USA. Shimul.shah@uc.edu.
TI  - Impact of Preoperative Opioid Use After Emergency General Surgery.
SO  - Journal of Gastrointestinal Surgery.  2018 Jan 16
AS  - J Gastrointest Surg.  2018 Jan 16
NJ  - Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 9706084, c7y
IO  - J. Gastrointest. Surg.
CP  - United States
KW  - Emergency general surgery;  Narcotics;  Opioids;  Outcomes
AB  - BACKGROUND: Preoperative exposure to narcotics has recently been associated with poor outcomes after elective major surgery, but little is known as to how preoperative opioid use impacts outcomes after common, emergency general surgical procedures (EGS).
AB  - METHODS: A high-volume, single-center analysis was performed on patients who underwent EGS from 2012 to 2013. EGS was defined as the seven emergent operations that account for 80% of the national burden. Preoperative opioid use was defined as having an active opioid prescription within 7 days prior to surgery. Chronic opioid use was defined as having an opioid prescription concurrent with 90 days after discharge.
AB  - RESULTS: A total of 377 patients underwent EGS during the study period. Preoperative opioid use was present in 84 patients (22.3%). Preoperative opioid users had longer hospital LOS (10.5 vs 6 days), higher costs of care ($25,331 vs $11,454), and higher 30-day readmission rates (22.6 vs 8.2%) compared with opioid-naive patients (p<0.001 each). After covariate adjustment, preoperative opioid use was predictive of LOS (RR 1.19 [1.01-1.41]) and 30-day hospital readmission (OR 2.69 [1.25-5.75]) (p<0.05 each). Total direct cost was not different after modeling. Preoperative opioid users required more narcotic refills compared with opioid-naive patients (5 vs 0 refills, p<0.001). After discharge, 15.4% of opioid-naive patients met criteria for chronic opioid use, vs 77.4% in preoperative opioid users (p<0.001).
AB  - CONCLUSIONS: Preoperative opioid use is associated with greater resource utilization after emergency general surgery, as well as vastly different postoperative opioid prescription patterns. These findings may help to inform the impact of preoperative opioid use on patient care, and its implications on hospital and societal cost.
ES  - 1873-4626
IL  - 1091-255X
DO  - https://dx.doi.org/10.1007/s11605-017-3665-x
PT  - Journal Article
ID  - 10.1007/s11605-017-3665-x [doi]
ID  - 10.1007/s11605-017-3665-x [pii]
PP  - aheadofprint
PH  - 2017/10/11 [received]
PH  - 2017/12/22 [accepted]
LG  - English
EP  - 20180116
DP  - 2018 Jan 16
DT  - 2018/01/18 06:00
YR  - 2018
RD  - 20180117
UP  - 20180117
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29340924

<1148. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29307211
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Effiong A
AU  - Kumari P
FA  - Effiong, Andem
FA  - Kumari, Prerna
IN  - Effiong, Andem. Kennedy Institute of Ethics, Georgetown University, Washington, DC, USA. andem.effiong@me.com.
IN  - Kumari, Prerna. Manipal University College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India.
TI  - Integrating palliative care and emergency medicine for optimal management of sickle cell pain in the wake of the United States opioid epidemic.
SO  - Annals of Palliative Medicine.  2017 Dec 18
AS  - Ann. palliat. med..  2017 Dec 18
NJ  - Annals of palliative medicine
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 101585484
IO  - Ann Palliat Med
CP  - China
ES  - 2224-5839
IL  - 2224-5820
DI  - apm.2017.12.01
DO  - https://dx.doi.org/10.21037/apm.2017.12.01
PT  - Journal Article
ID  - apm.2017.12.01 [pii]
ID  - 10.21037/apm.2017.12.01 [doi]
PP  - aheadofprint
LG  - English
EP  - 20171218
DP  - 2017 Dec 18
DT  - 2018/01/09 06:00
YR  - 2017
RD  - 20180108
UP  - 20180108
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29307211

<1149. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29298006
BK  - https://www.ncbi.nlm.nih.gov/books/NBK475631
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
AU  - Crane EH
FA  - Crane, Elizabeth H.
TI  - Emergency Department Visits Involving the Accidental Ingestion of Opioid Pain Relievers by Children Aged 1 to 5. [Review]
BT  - The CBHSQ Report
SO  - Substance Abuse and Mental Health Services Administration (US). :1-6, 2013
AS  - Substance Abuse and Mental Health Services Administration (US). :1-6, 2013
PG  - 1-6
PL  - Rockville (MD)
AB  - Background: The ingestion of opioid pain relievers is dangerous for children. This report analyzes emergency department (ED) visits for children aged 1 to 5 that involved opioid pain relievers that occurred in 2011, and also examines combined data from 2004 to 2011 to identify characteristics of the ED visits. Method: Estimates on ED visits involving opioid pain relievers where the patient was a child aged 1 to 5 were examined for trends, and combined 2004 to 2011 DAWN data were analyzed to identify which specific opioid pain relievers were involved in the ED visits, to assess whether the visits involved a single drug or multiple drugs, and to learn the outcome of the ED visits. Results: In 2011, an estimated 4,321 ED visits involved accidental ingestion of opioid pain relievers by children aged 1 to 5, an increase of 200.7 percent from 2004. The combined 2004 to 2011 data showed that 85 percent of the ED visits involved opioids only, nearly 6,000 visits involved hydrocodone, and over 5,000 visits involved buprenorphine. Most patients (71percent) were treated and released; 16 percent were admitted to the hospital. Conclusion: The number of ED visits involving accidental ingestion of opioid pain relievers more than doubled between 2004 and 2011. Nearly one-third of these ED visits were serious enough to have ended with hospitalization or transfer to another health facility. These findings show a critical need for increased education and awareness among parents, family members, and caregivers about the danger of accidental ingestion of opioid pain relievers and other medications.
SN  - In Brief
https://www.ncbi.nlm.nih.gov/books/n/cbqhsq_sr/SR-264_RB-3398
SN  - 
Introduction
https://www.ncbi.nlm.nih.gov/books/n/cbqhsq_sr/SR-264_RB-3398
SN  - 
ED Visits: Trends 2004 to 2011
https://www.ncbi.nlm.nih.gov/books/n/cbqhsq_sr/SR-264_RB-3398
SN  - 
ED Visits: Combined 2004 to 2011
https://www.ncbi.nlm.nih.gov/books/n/cbqhsq_sr/SR-264_RB-3398
SN  - 
Discussion
https://www.ncbi.nlm.nih.gov/books/n/cbqhsq_sr/SR-264_RB-3398
SN  - 
Suggested Citation
https://www.ncbi.nlm.nih.gov/books/n/cbqhsq_sr/SR-264_RB-3398
SN  - 
Endnotes
https://www.ncbi.nlm.nih.gov/books/n/cbqhsq_sr/SR-264_RB-3398
PT  - Review
PP  - ppublish
LG  - English
DP  - 2013
EZ  - 2018/01/04 06:01
DA  - 2018/01/04 06:01
DT  - 2018/01/04 06:01
BD  - 2013
CB  - 20171130
YR  - 2013
UP  - 20180105
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29298006

<1150. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29174833
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Sun BC
AU  - Lupulescu-Mann N
AU  - Charlesworth CJ
AU  - Kim H
AU  - Hartung DM
AU  - Deyo RA
AU  - McConnell KJ
FA  - Sun, Benjamin C
FA  - Lupulescu-Mann, Nicoleta
FA  - Charlesworth, Christina J
FA  - Kim, Hyunjee
FA  - Hartung, Daniel M
FA  - Deyo, Richard A
FA  - McConnell, K John
IN  - Sun, Benjamin C. Center for Policy Research-Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, OR. Electronic address: sunb@ohsu.edu.
IN  - Lupulescu-Mann, Nicoleta. Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, OR.
IN  - Charlesworth, Christina J. Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, OR.
IN  - Kim, Hyunjee. Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, OR.
IN  - Hartung, Daniel M. College of Pharmacy, Oregon State University, Oregon Health & Science University, Portland, OR.
IN  - Deyo, Richard A. Department of Family Medicine, Department of Medicine and Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR.
IN  - McConnell, K John. Center for Policy Research-Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, OR; Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, OR.
TI  - Does Prescription Opioid Shopping Increase Overdose Rates in Medicaid Beneficiaries?.
SO  - Annals of Emergency Medicine.  2017 Nov 23
AS  - Ann Emerg Med.  2017 Nov 23
NJ  - Annals of emergency medicine
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 8002646
IO  - Ann Emerg Med
CP  - United States
AB  - STUDY OBJECTIVE: The link between prescription opioid shopping and overdose events is poorly understood. We test the hypothesis that a history of prescription opioid shopping is associated with increased risk of overdose events.
AB  - METHODS: This is a secondary analysis of a linked claims and controlled substance dispense database. We studied adult Medicaid beneficiaries in 2014 with prescription opioid use in the 6 months before an ambulatory care or emergency department visit with a pain-related diagnosis. The primary outcome was a nonfatal overdose event within 6 months of the cohort entry date. The exposure of interest (opioid shopping) was defined as having opioid prescriptions by different prescribers with greater than or equal to 1-day overlap and filled at 3 or more pharmacies in the 6 months before cohort entry. We used a propensity score to match shoppers with nonshoppers in a 1:1 ratio. We calculated the absolute difference in outcome rates between shoppers and nonshoppers.
AB  - RESULTS: We studied 66,328 patients, including 2,571 opioid shoppers (3.9%). There were 290 patients (0.4%) in the overall cohort who experienced a nonfatal overdose. In unadjusted analyses, shoppers had higher event rates than nonshoppers (rate difference of 4.4 events per 1,000; 95% confidence interval 0.8 to 7.9). After propensity score matching, there were no outcome differences between shoppers and nonshoppers (rate difference of 0.4 events per 1,000; 95% confidence interval -4.7 to 5.5). These findings were robust to various definitions of opioid shoppers and look-back periods.
AB  - CONCLUSION: Prescription opioid shopping is not independently associated with increased risk of overdose events.

Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
ES  - 1097-6760
IL  - 0196-0644
DI  - S0196-0644(17)31790-0
DO  - https://dx.doi.org/10.1016/j.annemergmed.2017.10.007
PT  - Journal Article
ID  - S0196-0644(17)31790-0 [pii]
ID  - 10.1016/j.annemergmed.2017.10.007 [doi]
PP  - aheadofprint
PH  - 2017/07/27 [received]
PH  - 2017/09/21 [revised]
PH  - 2017/10/06 [accepted]
GI  - No: R01 DA036522
Organization: (DA) *NIDA NIH HHS*
Country: United States
LG  - English
EP  - 20171123
DP  - 2017 Nov 23
EZ  - 2017/11/28 06:00
DA  - 2017/11/28 06:00
DT  - 2017/11/28 06:00
YR  - 2017
RD  - 20171219
UP  - 20171220
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29174833

<1151. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29237542
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Kaucher KA
AU  - Acquisto NM
AU  - Broderick KB
FA  - Kaucher, Kevin A
FA  - Acquisto, Nicole M
FA  - Broderick, Kerry B
IN  - Kaucher, Kevin A. Department of Pharmacy, Denver Health Medical Center, 777 Bannock St. MC 0056, Denver, CO 80204, United States. Electronic address: kevin.kaucher@dhha.org.
IN  - Acquisto, Nicole M. Department of Pharmacy, University of Rochester Medical Center, 601 Elmwood Ave., Box 655, Rochester, NY 14642, United States; Department of Emergency Medicine, University of Rochester Medical Center, 601 Elmwood Ave., Box 655, Rochester, NY 14642, United States.
IN  - Broderick, Kerry B. Department of Emergency Medicine, University of Colorado, 12401 E. 17th Avenue, Aurora, CO 80045, United States; Denver Health Medical Center, 777 Bannock Street, MC #0108, Denver, CO 80204, United States.
TI  - Emergency department naloxone rescue kit dispensing and patient follow-up.
SO  - American Journal of Emergency Medicine.  2017 Dec 07
AS  - Am J Emerg Med.  2017 Dec 07
NJ  - The American journal of emergency medicine
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - aa2, 8309942
IO  - Am J Emerg Med
CP  - United States
KW  - Emergency department;  Naloxone;  Narcan;  Opioid;  Rescue kit
ES  - 1532-8171
IL  - 0735-6757
DI  - S0735-6757(17)31008-2
DO  - https://dx.doi.org/10.1016/j.ajem.2017.12.020
PT  - Letter
ID  - S0735-6757(17)31008-2 [pii]
ID  - 10.1016/j.ajem.2017.12.020 [doi]
PP  - aheadofprint
PH  - 2017/12/05 [received]
PH  - 2017/12/07 [accepted]
LG  - English
EP  - 20171207
DP  - 2017 Dec 07
EZ  - 2017/12/15 06:00
DA  - 2017/12/15 06:00
DT  - 2017/12/15 06:00
YR  - 2017
RD  - 20171214
UP  - 20171215
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29237542

<1152. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29229229
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Gottlieb M
AU  - Ryan KW
AU  - Binkley C
FA  - Gottlieb, Michael
FA  - Ryan, Kelly W
FA  - Binkley, Christine
IN  - Gottlieb, Michael. Department of Emergency Medicine, Rush University Medical Center, Chicago, IL.
IN  - Ryan, Kelly W. Department of Emergency Medicine, Rush University Medical Center, Chicago, IL.
IN  - Binkley, Christine. Department of Emergency Medicine, Rush University Medical Center, Chicago, IL.
TI  - Is Low-Dose Ketamine an Effective Alternative to Opioids for the Treatment of Acute Pain in the Emergency Department?.
SO  - Annals of Emergency Medicine.  2017 Dec 08
AS  - Ann Emerg Med.  2017 Dec 08
NJ  - Annals of emergency medicine
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 8002646
IO  - Ann Emerg Med
CP  - United States
ES  - 1097-6760
IL  - 0196-0644
DI  - S0196-0644(17)31844-9
DO  - https://dx.doi.org/10.1016/j.annemergmed.2017.10.028
PT  - Editorial
ID  - S0196-0644(17)31844-9 [pii]
ID  - 10.1016/j.annemergmed.2017.10.028 [doi]
PP  - aheadofprint
PH  - 2017/10/02 [received]
LG  - English
EP  - 20171208
DP  - 2017 Dec 08
EZ  - 2017/12/13 06:00
DA  - 2017/12/13 06:00
DT  - 2017/12/13 06:00
YR  - 2017
RD  - 20171212
UP  - 20171213
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29229229

<1153. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29262202
BK  - https://www.ncbi.nlm.nih.gov/books/NBK470415
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
AU  - Schiller EY
AU  - Mechanic OJ
FA  - Schiller, Elizabeth Y.
FA  - Mechanic, Oren J.
IN  - Schiller, Elizabeth Y.. University of Connecticut
IN  - Mechanic, Oren J.. Harvard Medical School/BIDMC
TI  - Opioid, Overdose. [Review]
BT  - StatPearls
SO  - StatPearls Publishing.  2017 06
AS  - StatPearls Publishing.  2017 06
PL  - Treasure Island (FL)
AB  - Opioid overdose occurs when a person has excessive unopposed stimulation of the opiate pathway. This can lead to decreased respiratory effort and possibly death. The frequency of opioid overdose is rapidly increasing. Drug overdose is the leading cause of accidental death in the United States, with opioids being the most common drug. The Centers for Disease Control and Prevention (CDC) currently estimates more than 1000 emergency department visits daily related to the misuse of opioids and about 91 opioid overdose deaths every day. Prescriptions for opioid-containing medications quadrupled between 1999 and 2010. This was paralleled by a four-fold increase in overdose deaths due to opioids. The majority of the opioid deaths are attributable to the use of heroin and synthetic opioids other than methadone. Though annual rates of transition are low, this is commonly caused by individuals transitioning from the nonmedical use of prescription opioids to heroin. Heroin, at about $2 a bag, is up to 10-fold cheaper and more readily available than prescription opioid medications for street purchase, which cost on average about a dollar per milligram. Additionally, there is an increasing trend of heroin being mixed with fentanyl and other synthetic opioid compounds, which creates variable concentrations of opioid potency and a higher risk of overdose.

Copyright © 2017, StatPearls Publishing LLC.
SN  - Introduction
https://www.ncbi.nlm.nih.gov/books/n/statpearls/article-26226
SN  - 
Etiology
https://www.ncbi.nlm.nih.gov/books/n/statpearls/article-26226
SN  - 
Epidemiology
https://www.ncbi.nlm.nih.gov/books/n/statpearls/article-26226
SN  - 
Pathophysiology
https://www.ncbi.nlm.nih.gov/books/n/statpearls/article-26226
SN  - 
Toxicokinetics
https://www.ncbi.nlm.nih.gov/books/n/statpearls/article-26226
SN  - 
History and Physical
https://www.ncbi.nlm.nih.gov/books/n/statpearls/article-26226
SN  - 
Evaluation
https://www.ncbi.nlm.nih.gov/books/n/statpearls/article-26226
SN  - 
Treatment / Management
https://www.ncbi.nlm.nih.gov/books/n/statpearls/article-26226
SN  - 
Pearls and Other Issues
https://www.ncbi.nlm.nih.gov/books/n/statpearls/article-26226
SN  - 
Questions
https://www.ncbi.nlm.nih.gov/books/n/statpearls/article-26226
SN  - 
References
https://www.ncbi.nlm.nih.gov/books/n/statpearls/article-26226
PT  - Review
MT  - Internet
PP  - ppublish
LG  - English
DP  - 2017 06
EZ  - 2017/12/22 06:01
DA  - 2017/12/22 06:01
DT  - 2017/12/22 06:01
BD  - 201706
CB  - 20171128
YR  - 2017
UP  - 20171226
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29262202

<1154. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29168404
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Pace C
AU  - Shah S
AU  - Zhang AX
AU  - Zosel AE
AI  - Pace, Caroline; ORCID: http://orcid.org/0000-0002-3765-0328
FA  - Pace, Caroline
FA  - Shah, Sneha
FA  - Zhang, Amy X
FA  - Zosel, Amy E
IN  - Pace, Caroline. a Department of Emergency Medicine , Medical College of Wisconsin , Milwaukee , WI , USA.
IN  - Shah, Sneha. b Medical College of Wisconsin , Milwaukee , WI , USA.
IN  - Zhang, Amy X. b Medical College of Wisconsin , Milwaukee , WI , USA.
IN  - Zosel, Amy E. c Wisconsin Poison Center, Department of Emergency Medicine, Section of Medical Toxicology , Medical College of Wisconsin , Milwaukee , WI , USA.
TI  - Impact of a chronic pain management pathway on opioid administration and prescribing in an Emergency Department.
SO  - Clinical Toxicology: The Official Journal of the American Academy of Clinical Toxicology & European Association of Poisons Centres & Clinical Toxicologists. :1-7, 2017 Nov 23
AS  - Clin Toxicol (Phila). :1-7, 2017 Nov 23
NJ  - Clinical toxicology (Philadelphia, Pa.)
PG  - 1-7
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 101241654
IO  - Clin Toxicol (Phila)
CP  - England
KW  - Opioid;  acute pain;  chronic abdominal pain;  chronic back pain;  chronic pain;  chronic pain management pathway;  emergency medicine;  long bone fracture;  opioid abuse;  opioid misuse;  prescription narcotics
AB  - CONTEXT: Prescription opioid abuse and misuse is a significant public health crisis. In 2012, an opioid prescribing pathway for patients with chronic pain presenting to the Emergency Department (ED) was implemented. The objective of this study is to determine the impact of the pathway for administration of opioids in the ED as well as the prescribing of opioids for home use after discharge.
AB  - METHODS: Retrospective pre- and post-intervention time series study of consecutive patients presenting to the ED with acute and chronic pain complaints before and after implementation of the pathway. For the purposes of this study, we included patients with chronic abdominal or back pain - defined as pain present for greater than three months - and acute pain as acute long bone fracture.
AB  - RESULTS: Before pathway implementation, there was no statistically significant difference in the mean morphine equivalent (MEQ) dose administered for chronic or acute pain patients. After pathway implementation, there was a decrease in IV/IM morphine administered to patients with chronic pain (p=.0200) but not to patients with acute pain (p=.0820). Overall, MEQs administered did not change in either group. In the acute pain group, no significant differences were found in the number of patients who received opioid prescriptions upon discharge (p=.7749). However, in the chronic pain group, the number of patients who received opioid prescriptions upon discharge decreased with statistical significance (p=.0017).
AB  - CONCLUSIONS: After the implementation of a chronic pain management pathway in an ED, there is a decrease noted in opioids administered to patients with chronic pain both in the ED and prescriptions on discharge. In patients presenting with acute pain, there was no change in administration or prescription of opioids.
ES  - 1556-9519
IL  - 1556-3650
DO  - https://dx.doi.org/10.1080/15563650.2017.1401081
PT  - Journal Article
ID  - 10.1080/15563650.2017.1401081 [doi]
PP  - aheadofprint
LG  - English
EP  - 20171123
DP  - 2017 Nov 23
EZ  - 2017/11/24 06:00
DA  - 2017/11/24 06:00
DT  - 2017/11/24 06:00
YR  - 2017
RD  - 20171123
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29168404

<1155. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29137902
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Marco CA
AU  - Mann D
AU  - Rasp J
AU  - Ballester M
AU  - Perkins O
AU  - Holbrook MB
AU  - Rako K
FA  - Marco, Catherine A
FA  - Mann, Dennis
FA  - Rasp, Jordan
FA  - Ballester, Michael
FA  - Perkins, Oswald
FA  - Holbrook, Michael B
FA  - Rako, Kyle
IN  - Marco, Catherine A. Department of Emergency Medicine, Wright State University Boonshoft School of Medicine, Dayton, OH, United States. Electronic address: Catherine.Marco@wright.edu.
IN  - Mann, Dennis. Department of Emergency Medicine, Wright State University Boonshoft School of Medicine, Dayton, OH, United States.
IN  - Rasp, Jordan. Ohio State University, Columbus, OH, United States.
IN  - Ballester, Michael. Department of Emergency Medicine, Wright State University Boonshoft School of Medicine, Dayton, OH, United States.
IN  - Perkins, Oswald. Wright State University Boonshoft School of Medicine, Dayton, OH, United States.
IN  - Holbrook, Michael B. Wright State University Boonshoft School of Medicine, Dayton, OH, United States.
IN  - Rako, Kyle. Wright State University Boonshoft School of Medicine, Dayton, OH, United States.
TI  - Effects of opioid medications on cognitive skills among Emergency Department patients.
SO  - American Journal of Emergency Medicine.  2017 Nov 08
AS  - Am J Emerg Med.  2017 Nov 08
NJ  - The American journal of emergency medicine
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - aa2, 8309942
IO  - Am J Emerg Med
CP  - United States
AB  - INTRODUCTION: Treatment for pain and related conditions has been identified as the most common reason for Emergency Department (ED) visits. Concerns exist regarding the effects of opioid pain medications on cognition and patient ability to consent for procedures, hospital admission, or to refuse recommended medical interventions. This study was undertaken to identify cognitive skills before and after opioid pain medication in the ED setting.
AB  - METHODS: This was a prospective study comparing performance on the Mini-Mental Status Examination (MMSE) and Montreal Cognitive Assessment (MoCA) before and after administration of opioid pain medications. Eligible participants included ED patients with pain, who received opioid treatment. Participants were randomized to receive either the MMSE before pain medication and the MoCA after medication, or the reverse. MoCA scores were converted to MMSE equivalent scores for comparison.
AB  - RESULTS: Among 65 participants, the median age was 36 and median triage pain score was 8. 35% of patients were considered cognitively impaired based on their MMSE score prior to any opioid medication (MMSE<27). There was a median decrease in pain scores of 1 point following pain medication, p-value<0.001. There was a median decrease in MMSE scores of 1 point following pain medication, p-value=0.003. The range of change in scores (post minus pre) on the MMSE-equivalent was -7 to 3. 35 patients (56%) had a decrease in scores, 6 (10%) had no change, and 21 (34%) had an increase. After medication, 31 (48%) were abnormal (MMSE score<27). No differences in MMSE scores were identified by gender, ethnicity, mode of arrival, insurance, age, triage pain scores, opioid agent given, or ED diagnosis.
AB  - CONCLUSIONS: There is an association between opioid pain medication and decrease in cognitive performance on the MMSE. Because of the wide range of cognitive performance following opioid pain medication, assessment of individual patients' cognitive function is indicated.

Copyright © 2017. Published by Elsevier Inc.
ES  - 1532-8171
IL  - 0735-6757
DI  - S0735-6757(17)30925-7
DO  - https://dx.doi.org/10.1016/j.ajem.2017.11.017
PT  - Journal Article
ID  - S0735-6757(17)30925-7 [pii]
ID  - 10.1016/j.ajem.2017.11.017 [doi]
PP  - aheadofprint
PH  - 2017/11/06 [received]
PH  - 2017/11/08 [accepted]
LG  - English
EP  - 20171108
DP  - 2017 Nov 08
EZ  - 2017/11/16 06:00
DA  - 2017/11/16 06:00
DT  - 2017/11/16 06:00
YR  - 2017
RD  - 20171115
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29137902

<1156. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29107318
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Waszak DL
AU  - Mitchell AM
AU  - Ren D
AU  - Fennimore LA
FA  - Waszak, Daria L
FA  - Mitchell, Ann M
FA  - Ren, Dianxu
FA  - Fennimore, Laura A
IN  - Waszak, Daria L. Pittsburgh, PA; Lodi, NJ.
IN  - Mitchell, Ann M. Pittsburgh, PA; Lodi, NJ.
IN  - Ren, Dianxu. Pittsburgh, PA; Lodi, NJ.
IN  - Fennimore, Laura A. Pittsburgh, PA; Lodi, NJ. Electronic address: laf36@pitt.edu.
TI  - A Quality Improvement Project to Improve Education Provided by Nurses to ED Patients Prescribed Opioid Analgesics at Discharge.
SO  - Journal of Emergency Nursing.  2017 Oct 27
AS  - J Emerg Nurs.  2017 Oct 27
NJ  - Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 7605913
IO  - J Emerg Nurs
CP  - United States
KW  - counseling;  discharge;  opiate;  opioid;  patient education;  teach-back
AB  - BACKGROUND: The opioid crisis continues to take an unprecedented number of lives and is the top cause of injury death in the United States. The emergency department is a setting where patients with pain seek care and may be prescribed an opioid, yet many patients do not receive evidence-based education about taking their opioid safely. Like many communities across the country, Allegheny County, Pennsylvania, has experienced an increased rate of opioid overdoses; from 2015-2016, the number of opioid-related overdose deaths in the county increased by 44%.
AB  - METHODS: This quality improvement project is the implementation of a nurse-delivered, evidence-based education initiative for patients prescribed an opioid in an emergency department. Nurses were briefly trained on opioid safety and patient education, then over 12 weeks, delivered the dual-modal (verbal and written) education with a patient teach-back to verify comprehension.
AB  - RESULTS: Nurses who completed the project training on opioid safety and patient education had a statistically significant improvement in their knowledge. Patient satisfaction surveys showed 100% of patients reported clear understanding of how to take their pain medication, and out of the patients receiving the opioid pain education for the first time, 88.2% learned something new about how to safely take, store, or dispose of their pain medication.
AB  - IMPLICATIONS FOR PRACTICE: Improving the delivery of opioid prescription education at emergency department discharge will enhance patient knowledge and promote safety, which may help mitigate the opioid crisis by reducing the rate of opioid use disorder and accidental overdoses.

Copyright © 2017 Elsevier Inc. All rights reserved.
ES  - 1527-2966
IL  - 0099-1767
DI  - S0099-1767(17)30377-X
DO  - https://dx.doi.org/10.1016/j.jen.2017.09.010
PT  - Journal Article
ID  - S0099-1767(17)30377-X [pii]
ID  - 10.1016/j.jen.2017.09.010 [doi]
PP  - aheadofprint
PH  - 2017/07/18 [received]
PH  - 2017/09/16 [revised]
PH  - 2017/09/20 [accepted]
LG  - English
EP  - 20171027
DP  - 2017 Oct 27
EZ  - 2017/11/07 06:00
DA  - 2017/11/07 06:00
DT  - 2017/11/07 06:00
YR  - 2017
RD  - 20171113
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29107318

<1157. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29103795
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Love JS
AU  - Perrone J
AU  - Nelson LS
FA  - Love, Jennifer S
FA  - Perrone, Jeanmarie
FA  - Nelson, Lewis S
IN  - Love, Jennifer S. Department of Emergency Medicine, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA.
IN  - Perrone, Jeanmarie. Department of Emergency Medicine, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA.
IN  - Nelson, Lewis S. Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, NJ.
TI  - Should Buprenorphine Be Administered to Patients With Opioid Withdrawal in the Emergency Department?.
SO  - Annals of Emergency Medicine.  2017 Nov 03
AS  - Ann Emerg Med.  2017 Nov 03
NJ  - Annals of emergency medicine
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 8002646
IO  - Ann Emerg Med
CP  - United States
ES  - 1097-6760
IL  - 0196-0644
DI  - S0196-0644(17)31754-7
DO  - https://dx.doi.org/10.1016/j.annemergmed.2017.10.002
PT  - Editorial
ID  - S0196-0644(17)31754-7 [pii]
ID  - 10.1016/j.annemergmed.2017.10.002 [doi]
PP  - aheadofprint
PH  - 2017/07/06 [received]
LG  - English
EP  - 20171103
DP  - 2017 Nov 03
EZ  - 2017/11/07 06:00
DA  - 2017/11/07 06:00
DT  - 2017/11/07 06:00
YR  - 2017
RD  - 20171106
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29103795

<1158. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 29084121
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Nagel FW
AU  - Kattan JA
AU  - Mantha S
AU  - Nelson LS
AU  - Kunins HV
AU  - Paone D
FA  - Nagel, Frederick W
FA  - Kattan, Jessica A
FA  - Mantha, Shivani
FA  - Nelson, Lewis S
FA  - Kunins, Hillary V
FA  - Paone, Denise
IN  - Nagel, Frederick W. New York City Department of Health and Mental Hygiene, New York, New York (Drs Nagel, Kattan, Kunins, Paone and Ms Mantha) and Department of Emergency Medicine, New York University School of Medicine, New York City Poison Control Center, New York, New York (Dr Nelson). Dr Nagel is now with the North Central Bronx Hospital Emergency Department, Albert Einstein College of Medicine, Bronx, New York. Dr Nelson is now with the Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, New Jersey.
TI  - Promoting Health Department Opioid-Prescribing Guidelines for New York City Emergency Departments: A Qualitative Evaluation.
SO  - Journal of Public Health Management & Practice.  2017 Oct 27
AS  - J Public Health Manag Pract.  2017 Oct 27
NJ  - Journal of public health management and practice : JPHMP
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - c0l, 9505213
IO  - J Public Health Manag Pract
CP  - United States
AB  - To address the epidemic of opioid misuse and overdose, the New York City Department of Health and Mental Hygiene partnered with an expert panel of emergency medicine physicians to develop voluntary guidelines for judicious prescribing of opioids upon discharge from an emergency department. A qualitative evaluation of the guidelines was conducted using semistructured interviews with emergency department directors and providers. The guidelines were widely supported by respondents and cited as helpful in easing difficult negotiations with patients requesting opioids. Involvement of the expert panel in development of guidelines was particularly valuable in ensuring their credibility. Health departments should consider partnering with emergency physicians to promote the public health goal of judicious opioid prescribing.
ES  - 1550-5022
IL  - 1078-4659
DO  - https://dx.doi.org/10.1097/PHH.0000000000000670
PT  - Journal Article
ID  - 10.1097/PHH.0000000000000670 [doi]
PP  - aheadofprint
LG  - English
EP  - 20171027
DP  - 2017 Oct 27
EZ  - 2017/10/31 06:00
DA  - 2017/10/31 06:00
DT  - 2017/10/31 06:00
YR  - 2017
RD  - 20171030
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=29084121

<1159. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28977468
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Dudley LS
AU  - Konomos D
AU  - Robbins V
AU  - Qiu L
AU  - Bauter R
AU  - Merlin MA
FA  - Dudley, Larissa S
FA  - Konomos, Dorothy
FA  - Robbins, Vince
FA  - Qiu, Linda
FA  - Bauter, Robert
FA  - Merlin, Mark A
IN  - Dudley, Larissa S. Emergency Medical Services and Disaster Medicine, Newark Beth Israel Medical Center, Newark, NJ, USA.
IN  - Konomos, Dorothy. Emergency Medicine, Newark Beth Israel Medical Center, Newark, NJ, USA.
IN  - Robbins, Vince. MONOC EMS. New Jersey's Hospital Service Corporation, Wall Township, Neptune, NJ, USA.
IN  - Qiu, Linda. Emergency Medicine, Newark Beth Israel Medical Center, Newark, NJ, USA.
IN  - Bauter, Robert. MONOC EMS. New Jersey's Hospital Service Corporation, Wall Township, Neptune, NJ, USA.
IN  - Merlin, Mark A. MONOC EMS. New Jersey's Hospital Service Corporation, Wall Township, Neptune, NJ, USA.
IN  - Merlin, Mark A. Emergency Department, Newark Beth Israel Medical Center, Newark, NJ, USA.
TI  - Opioid crisis at the Jersey Shore-special report.
SO  - Journal of Public Health. :1-6, 2017 Aug 31
AS  - J Public Health (Oxf). :1-6, 2017 Aug 31
NJ  - Journal of public health (Oxford, England)
PG  - 1-6
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 101188638
IO  - J Public Health (Oxf)
CP  - England
KW  - emergency care;  health services;  public health
AB  - The USA is experiencing an epidemic of drug overdoses and deaths with a 200% increase in overdose deaths involving opioids including heroin. Legislation since 2013 has created paths to reduce opioid overdose deaths and since, basic life support (BLS) and police agencies have been administering naloxone to patients with suspected opioid overdoses as part of standard treatment protocols. Charts were reviewed from 1 January 2016 to 15 April 2016 on the de-identified electronic medical records of patients in a two-county system comprising the 'Jersey Shore' who received naloxone to determine the number of naloxone administrations and heroin overdoses. Additionally, narratives were examined for evidence of heroin use. Of the 312 patients, 213 received a first dose of naloxone by a family member or bystander, police, or by BLS; 99 received a first dose by a paramedic (ALS). About 233 were initially unresponsive or had altered mental status that improved after naloxone administration. About210 (67.3%) charts illustrated obvious opioid use. Of the note, 282 patients arrived to an emergency department alive. About 30 patients were pronounced dead. From 1 February 2016 to 31 March 2016, the number of opioid overdoses increased and the subsequent use of naloxone has increased by 176%.

Copyright © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
ES  - 1741-3850
IL  - 1741-3842
DO  - https://dx.doi.org/10.1093/pubmed/fdx106
PT  - Journal Article
ID  - 4098860 [pii]
ID  - 10.1093/pubmed/fdx106 [doi]
PP  - aheadofprint
PH  - 2017/02/22 [received]
LG  - English
EP  - 20170831
DP  - 2017 Aug 31
EZ  - 2017/10/05 06:00
DA  - 2017/10/05 06:00
DT  - 2017/10/05 06:00
YR  - 2017
RD  - 20171004
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=28977468

<1160. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28967451
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Merriman MS
AU  - Acquisto NM
AU  - Nelson S
AU  - Jones CMC
AU  - Li T
AU  - McCann M
AU  - Adler DH
FA  - Merriman, Matthew S
FA  - Acquisto, Nicole M
FA  - Nelson, Steven
FA  - Jones, Courtney M C
FA  - Li, Timmy
FA  - McCann, Molly
FA  - Adler, David H
IN  - Merriman, Matthew S. Department of Emergency Medicine, University of Rochester Medical Center, 601 Elmwood Ave., Box 655, Rochester, NY 14642, United States.
IN  - Acquisto, Nicole M. Department of Emergency Medicine, University of Rochester Medical Center, 601 Elmwood Ave., Box 655, Rochester, NY 14642, United States; Department of Pharmacy, 601 Elmwood Ave. Box 638, Rochester, NY 14642. Electronic address: Nicole_acquisto@urmc.rochester.edu.
IN  - Nelson, Steven. Department of Emergency Medicine, University of Rochester Medical Center, 601 Elmwood Ave., Box 655, Rochester, NY 14642, United States.
IN  - Jones, Courtney M C. Emergency Medicine Research, Emergency Medicine and Public Health Services, University of Rochester, 601 Elmwood Ave., Box 655, Rochester, NY 14642, United States.
IN  - Li, Timmy. Emergency Medicine Research, Emergency Medicine and Public Health Services, University of Rochester, 601 Elmwood Ave., Box 655, Rochester, NY 14642, United States.
IN  - McCann, Molly. Emergency Medicine Research, Emergency Medicine and Public Health Services, University of Rochester, 601 Elmwood Ave., Box 655, Rochester, NY 14642, United States.
IN  - Adler, David H. Emergency Medicine Research, Emergency Medicine and Public Health Services, University of Rochester, 601 Elmwood Ave., Box 655, Rochester, NY 14642, United States.
TI  - Emergency department opioid pain medication prescribing: Influence of patient satisfaction and other factors.
SO  - American Journal of Emergency Medicine.  2017 Sep 24
AS  - Am J Emerg Med.  2017 Sep 24
NJ  - The American journal of emergency medicine
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - aa2, 8309942
IO  - Am J Emerg Med
CP  - United States
KW  - Emergency department;  Opioids;  Pain management;  Patient satisfaction;  Provider perceptions
ES  - 1532-8171
IL  - 0735-6757
DI  - S0735-6757(17)30765-9
DO  - https://dx.doi.org/10.1016/j.ajem.2017.09.039
PT  - Letter
ID  - S0735-6757(17)30765-9 [pii]
ID  - 10.1016/j.ajem.2017.09.039 [doi]
PP  - aheadofprint
PH  - 2017/08/08 [received]
PH  - 2017/09/19 [revised]
PH  - 2017/09/22 [accepted]
LG  - English
EP  - 20170924
DP  - 2017 Sep 24
EZ  - 2017/10/03 06:00
DA  - 2017/10/03 06:00
DT  - 2017/10/03 06:00
YR  - 2017
RD  - 20171002
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=28967451

<1161. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28952972
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Parthvi R
AU  - Agrawal A
AU  - Khanijo S
AU  - Tsegaye A
AU  - Talwar A
FA  - Parthvi, Rukma
FA  - Agrawal, Abhinav
FA  - Khanijo, Sameer
FA  - Tsegaye, Adey
FA  - Talwar, Arunabh
IN  - Parthvi, Rukma. 1Department of Internal Medicine, Forest Hills Hospital, New York, NY; and 2Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Hofstra Northwell School of Medicine, North Shore University Hospital & Long Island Jewish Medical Center, New Hyde Park, NY.
TI  - Acute Opiate Overdose: An Update on Management Strategies in Emergency Department and Critical Care Unit.
SO  - American Journal of Therapeutics.  2017 Sep 13
AS  - Am J Ther.  2017 Sep 13
NJ  - American journal of therapeutics
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - db7, 9441347
IO  - Am J Ther
CP  - United States
AB  - BACKGROUND: Opioids are natural, semisynthetic, or synthetic substances that act on opioid receptors in the central nervous system. Clinically, they are prescribed for pain management. Opioid overdose (OOD) occurs when the central nervous system and respiratory drive are suppressed because of excessive consumption of the drug. Symptoms of OOD include drowsiness, slow breathing, pinpoint pupils, cyanosis, loss of consciousness, and death. Due to their addictive potential and easy accessibility opioid addiction is a growing problem worldwide. Emergency medical services and the emergency department often perform initial management of OOD. Thereafter, some patients require intensive care management because of respiratory failure, metabolic encephalopathy, acute kidney injury, and other organ failure.
AB  - AREAS OF UNCERTAINTY: We sought to review the literature and present the most up-to-date treatment strategies of patients with acute OOD requiring critical care management.
AB  - DATA SOURCES: A PubMed search was conducted to review all articles between 1950 and 2017 and the relevant articles were cited.
AB  - RESULTS & CONCLUSIONS: Worldwide, approximately 69,000 people die of OOD each year, and approximately 15 million people have opioid addiction. In the United States, death from OOD has increased almost 5-fold from 2001 to 2013. OOD leading to intensive care unit admission has increased by 50% from 2009 to 2015. At the same time, the mortality associated with these admissions has doubled. The management strategies include airway management, use of reversal agents, assessing and treating coingestions and associated complications, treatment of opioid withdrawal with alpha-agonists, and psychosocial support to help with opiate addiction and withdrawal. This warrants awareness among clinicians regarding the adverse effects associated with opioid use, management strategies, and calls for a multidisciplinary approach to treating these patients.
ES  - 1536-3686
IL  - 1075-2765
DO  - https://dx.doi.org/10.1097/MJT.0000000000000681
PT  - Journal Article
ID  - 10.1097/MJT.0000000000000681 [doi]
PP  - aheadofprint
LG  - English
EP  - 20170913
DP  - 2017 Sep 13
EZ  - 2017/09/28 06:00
DA  - 2017/09/28 06:00
DT  - 2017/09/28 06:00
YR  - 2017
RD  - 20170927
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=28952972

<1162. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28927481
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Murphy NG
AU  - Bona DR
AU  - Hurley TA
FA  - Murphy, Nancy G
FA  - Bona, D Ruth
FA  - Hurley, Theresa A
IN  - Murphy, Nancy G. *Izaak Walton Killam Regional Poison Centre,Halifax,NS.
IN  - Bona, D Ruth. *Izaak Walton Killam Regional Poison Centre,Halifax,NS.
IN  - Hurley, Theresa A. ++Pharmacy Department,Nova Scotia Health Authority,Halifax,NS.
TI  - A system-wide solution to antidote stocking in emergency departments: the Nova Scotia antidote program.
SO  - CJEM Canadian Journal of Emergency Medical Care. :1-10, 2017 Sep 20
AS  - CJEM, Can. j. emerg. med. care. :1-10, 2017 Sep 20
NJ  - CJEM
PG  - 1-10
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 100893237
IO  - CJEM
CP  - England
KW  - antidote;  emergency preparedness;  poison centre
AB  - OBJECTIVE: Inadequate stocking of essential antidotes in hospitals is an internationally documented problem. A concrete and sustainable system-wide solution for easy access to antidotes in emergency departments (EDs) was developed and implemented in Nova Scotia, Canada.
AB  - METHODS: Antidote stocking guidelines and a systemwide antidote management strategy were established. A standardized collection of antidotes housed in highly visible containers in provincial EDs was implemented for timely access. Antidote-specific online administration guidelines were developed. Using the poison centre for surveillance, the antidote program maintained a database of antidote utilization patterns; 11 years of data were available for analysis.
AB  - RESULTS: 2/2 (100%) tertiary care, 9/9 (100%) regional EDs, and 21/25 (84%) community EDs in Nova Scotia stock antidote kits, for an overall compliance rate of 32/36 (89%). A total of 678 antidotes (excluding N-acetylcysteine) were used for 520 patients. The distribution of antidote use by hospital type was 99/678 (14.6%) at community hospitals, 379/678 (55.9%) at regional hospitals, and 200/678 (29.5%) at tertiary care hospitals. The five most commonly used antidotes were: naloxone 143/678 (21.1%), fomepizole 111/678 (16.4%), glucagon 94/678 (13.9%), calcium 70/678 (10.3%), and sodium bicarbonate 67/678 (9.9%). Of the 520 patients in whom antidotes were used, death occurred in 3% (15/520), major outcomes in 35% (183/520), and moderate outcomes in 39% (205/520).
AB  - CONCLUSION: The Nova Scotia Antidote Program demonstrates that a solution to inadequate antidote stocking is achievable and requires a system-wide approach with ongoing maintenance and surveillance. The frequency and distribution of antidote usage documented in this program supports the need for enhancement of emergency preparedness. The poison centre and hospital pharmacies are crucial to surveillance and maintenance of this program.
IS  - 1481-8035
IL  - 1481-8035
DO  - https://dx.doi.org/10.1017/cem.2017.400
PT  - Journal Article
ID  - S1481803517004006 [pii]
ID  - 10.1017/cem.2017.400 [doi]
PP  - aheadofprint
LG  - English
EP  - 20170920
DP  - 2017 Sep 20
EZ  - 2017/09/21 06:00
DA  - 2017/09/21 06:00
DT  - 2017/09/21 06:00
YR  - 2017
RD  - 20170920
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=28927481

<1163. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28719481
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - DePhillips M
AU  - Watts J
AU  - Lowry J
AU  - Dowd MD
FA  - DePhillips, Michelle
FA  - Watts, Jennifer
FA  - Lowry, Jennifer
FA  - Dowd, M Denise
IN  - DePhillips, Michelle. From the Departments of *Emergency Medicine and +Pharmacology, Toxicology, and Therapeutic Innovations, Children's Mercy Hospital, Kansas City, MO.
TI  - Opioid Prescribing Practices in Pediatric Acute Care Settings.
SO  - Pediatric Emergency Care.  2017 Jul 17
AS  - Pediatr Emerg Care.  2017 Jul 17
NJ  - Pediatric emergency care
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - pau, 8507560
IO  - Pediatr Emerg Care
CP  - United States
AB  - OBJECTIVES: Deaths due to prescription opioid overdoses are at record-high levels. Limiting the amount of opioid prescribed has been suggested as a prevention strategy. The purpose of this study was to describe the opioid prescribing practices in the emergency departments and urgent care sites of a Midwestern tertiary care children's hospital system.
AB  - METHODS: This retrospective medical record review examined the visits from the 2 pediatric emergency departments and 2 pediatric urgent care sites in the system from June 1, 2012, to May 31, 2013, during which an outpatient opioid prescription was written. The primary outcome was number of days of opioid prescribed. Other data collected included patient demographics, diagnosis, and prescriber information; factors associated with prescriptions written for more than 5 days were identified.
AB  - RESULTS: A total of 4075 opioid prescriptions were included in the 1-year study period, and 3991 of these had complete data for analysis. The median amount prescribed was 3.3 days with an interquartile range of 2.5 days. Odds of receiving a prescription of more than 5 days' duration were higher for children younger than 1 year (odds ratio [OR], 12.3; 95% confidence interval [CI], 7.3-21.0), 1 to 4 years of age (OR, 7.7; 95% CI, 5.5-10.8), and 5 to 9 years of age (OR, 2.4; 95% CI, 1.7-3.4); for children with noninjury diagnoses (OR, 1.4; 95% CI, 1.2-1.7); or if prescribed by a resident physician (OR, 1.4; 95% CI, 1.1-1.8) or from the urgent care (OR, 1.4; 95% CI, 1.1-1.7).
AB  - CONCLUSIONS: Opioid prescriptions of more than 5 days were more frequently prescribed for younger patients, noninjury diagnoses, or if prescribed by a resident physician or from the urgent care. We need to focus on medical student, resident, and provider education as well as further opioid research in order to decrease unnecessary prescribing.
ES  - 1535-1815
IL  - 0749-5161
DO  - https://dx.doi.org/10.1097/PEC.0000000000001239
PT  - Journal Article
ID  - 10.1097/PEC.0000000000001239 [doi]
PP  - aheadofprint
LG  - English
EP  - 20170717
DP  - 2017 Jul 17
EZ  - 2017/07/19 06:00
DA  - 2017/07/19 06:00
DT  - 2017/07/19 06:00
YR  - 2017
RD  - 20170718
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=28719481

<1164. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 27657853
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Klar SA
AU  - Brodkin E
AU  - Gibson E
AU  - Padhi S
AU  - Predy C
AU  - Green C
AU  - Lee V
FA  - Klar, Salman A
FA  - Brodkin, Elizabeth
FA  - Gibson, Erin
FA  - Padhi, Shovita
FA  - Predy, Christine
FA  - Green, Corey
FA  - Lee, Victoria
TI  - Notes from the Field: Furanyl-Fentanyl Overdose Events Caused by Smoking Contaminated Crack Cocaine - British Columbia, Canada, July 15-18, 2016.
SO  - MMWR - Morbidity & Mortality Weekly Report. 65(37):1015-1016, 2016 Sep 23
AS  - MMWR Morb Mortal Wkly Rep. 65(37):1015-1016, 2016 Sep 23
NJ  - MMWR. Morbidity and mortality weekly report
VO  - 65
IP  - 37
PG  - 1015-1016
PI  - Journal available in: Electronic
PI  - Citation processed from: Internet
JC  - ne8, 7802429
IO  - MMWR Morb. Mortal. Wkly. Rep.
CP  - United States
AB  - On July 15 2016, Surrey Memorial Hospital's emergency department notified the medical health officer on call of a sharp increase in opioid overdose events in Surrey, Fraser Health Authority, in British Columbia, Canada. During July 15-18, the number of persons with suspected opioid overdose evaluated in Surrey Memorial Hospital's emergency department increased approximately 170%, from an average of four suspected cases per day during the period January-June 2016 to 43 (nearly 11 per day) during the 4-day period (Figure). Most patients (22 [51%]) became unconscious after smoking what they believed to be crack cocaine. The majority of overdose events occurred within a small geographic area in Surrey that has a high population of homeless persons and persons who use illicit drugs, including opioids and crack cocaine. Most cases occurred in males (36 cases [84%]); the average age of the patients was 42 years (range = 18-63 years). Forty (93%) patients were brought to the emergency department by ambulance. A total of 37 (86%) patients received injectable naloxone before arriving in the emergency department, including 12 who received it only from community members, 16 who received it only from paramedics, five who received it from both community members and paramedics, one who received it from the fire department and paramedics, and one who received it from the fire department, community, and paramedics; for two patients, the source of naloxone was not known. Reports from first responders, the community, and emergency department staff members indicated that patients required high doses of injectable naloxone, in some cases up to 3.0 mg (usual dose = 0.4 mg). Thirty-five (81%) patients were treated and discharged within a few hours, two patients left without being seen by a health care provider, and six patients were admitted to the hospital; among these, three were transferred to the intensive care unit, one of whom died.
ES  - 1545-861X
IL  - 0149-2195
DO  - https://dx.doi.org/10.15585/mmwr.mm6537a6
PT  - Journal Article
ID  - 10.15585/mmwr.mm6537a6 [doi]
PP  - epublish
LG  - English
EP  - 20160923
DP  - 2016 Sep 23
EZ  - 2016/09/23 06:00
DA  - 2016/09/23 06:00
DT  - 2016/09/23 06:00
YR  - 2016
RD  - 20160922
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=27657853

<1165. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 27084413
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Mazer-Amirshahi M
AU  - Mullins PM
AU  - Sun C
AU  - Pines JM
AU  - Nelson LS
AU  - Perrone J
FA  - Mazer-Amirshahi, Maryann
FA  - Mullins, Peter M
FA  - Sun, Christie
FA  - Pines, Jesse M
FA  - Nelson, Lewis S
FA  - Perrone, Jeanmarie
IN  - Mazer-Amirshahi, Maryann. *Department of Emergency Medicine, MedStar Washington Hospital Center, Washington, DC Georgetown University School of Medicine, Washington, DC.
IN  - Mullins, Peter M. Center for Clinical Practice Innovation, The George Washington University, Washington, DC.
IN  - Sun, Christie. *Department of Emergency Medicine, MedStar Washington Hospital Center, Washington, DC Georgetown University School of Medicine, Washington, DC.
IN  - Pines, Jesse M. Center for Clinical Practice Innovation, The George Washington University, Washington, DC Department of Emergency Medicine, The George Washington University, Washington, DC.
IN  - Nelson, Lewis S. Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, New York *Department of Emergency Medicine, MedStar Washington Hospital Center, Washington, DC.
IN  - Perrone, Jeanmarie. Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
TI  - Trends in Opioid Analgesic Use in Encounters Involving Physician Trainees in U.S. Emergency Departments.
SO  - Pain Medicine.  2016 Apr 14
AS  - PAIN MED.  2016 Apr 14
NJ  - Pain medicine (Malden, Mass.)
PI  - Journal available in: Print-Electronic
PI  - Citation processed from: Internet
JC  - 100894201
IO  - Pain Med
CP  - England
KW  - Emergency Department;  Opioids;  Trainee
AB  - BACKGROUND: Opioid analgesic use has increased dramatically in emergency departments (EDs), but the relative contribution of physician trainees has not been explored. We assessed trends in opioid utilization focusing on ED encounters where a physician trainee was involved.
AB  - METHODS: We studied ED visits from the National Hospital Ambulatory Medical Care Survey, 2001-2011. Adult ED visits in which an opioid was administered in the ED or prescribed at discharge were stratified by whether or not there was trainee involvement. Trends in use over time for five common opioids (codeine, hydrocodone, hydromorphone, morphine, oxycodone) were tested using survey-weighted logistic regression.
AB  - RESULTS: From 2001-02 to 2009-11, the proportion of ED visits where an opioid analgesic was used increased 31.5% from 21.9% (95% CI: 20.3-23.6) of visits to 28.8% (95% CI: 27.5-30.1). Trainee involvement in ED visits was stable, with 9.3% (95% CI: 7.7-11.3) seen by a trainee in 2001-02 vs. 10.2% (95% CI: 8.1-12.7) in 2010-11. Opioid use in visits with trainee involvement did not change significantly over time relative to visits without a trainee (increase of 36.8% compared to 31.2% without trainees,P=0.652). Trends in opioid utilization for trainee visits paralleled non-trainee visits. Hydromorphone had the greatest relative increase in use for all providers. Adjusted for patient- and hospital-level factors, the probability of receiving opioids when a trainee was involved increased to a greater extent than among non-trainee visits (30.9% vs. 24.0%).
AB  - CONCLUSION: Opioid utilization patterns for visits involving trainees reflect similar trends in attending practice, and highlights the more liberal opioid prescribing climate over time.

Copyright © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
ES  - 1526-4637
IL  - 1526-2375
DI  - pnw048
PT  - Journal Article
ID  - pnw048 [pii]
ID  - 10.1093/pm/pnw048 [doi]
PP  - aheadofprint
LG  - English
EP  - 20160414
DP  - 2016 Apr 14
EZ  - 2016/04/17 06:00
DA  - 2016/04/17 06:00
DT  - 2016/04/17 06:00
YR  - 2016
RD  - 20160417
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=27084413

<1166. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 27631051
BK  - https://www.ncbi.nlm.nih.gov/books/NBK384672
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
AU  - Day C
FA  - Day, Charles
TI  - Benzodiazepines in Combination with Opioid Pain Relievers or Alcohol: Greater Risk of More Serious ED Visit Outcomes. [Review]
BT  - The CBHSQ Report
SO  - Substance Abuse and Mental Health Services Administration (US). :1-9, 2013
AS  - Substance Abuse and Mental Health Services Administration (US). :1-9, 2013
PG  - 1-9
PL  - Rockville (MD)
AB  - Background: Benzodiazepines are used to relieve symptoms of anxiety, panic attacks, and seizures and are safe and effective when taken as prescribed and directed. However, benzodiazepines depress central nervous system (CNS) activity and, when combined with other drugs that depress CNS activity such as alcohol or opioid pain relievers, may present serious or even life-threatening problems. Concerns exist about the increasing number of patients prescribed both benzodiazepines and opioids and about serious complications arising from the use of benzodiazepines with alcohol. Methods: Drug Abuse Warning Network (DAWN) data on drug-related emergency department (ED) visits from 2005 to 2011 were combined to ensure adequate sample size. Logistic regression was used to examine the association between ED visit outcome and benzodiazepine combinations with opioids and alcohol, patient age, gender, and the year in which the visit occurred. Results: During the 7 years from 2005 to 2011, almost a million (an estimated 943,032) ED visits involved benzodiazepines alone or in combination with opioid pain relievers or alcohol and no other substances. The predicted risk of a more serious outcome (hospitalization or, rarely, death in the ED rather than treatment and release), was greater than 20% for all age categories for benzodiazepines alone. Combinations of benzodiazepines with opioid pain relievers or alcohol were associated with a 24 to 55% increase in the predicted risk of a more serious outcome compared with benzodiazepines alone. Increasing age was associated with increasing predicted risk of a more serious outcome for visits involving benzodiazepines alone or in combination with opioid pain relievers or alcohol and no other substances. Conclusion: ED visits involving benzodiazepines alone pose a significant risk of hospitalization. Combining benzodiazepines with opioid pain relievers or alcohol significantly increases the risk of serious ED visit outcome for all age groups. Further, older patients experience increased risk of a serious outcome, even for visits involving benzodiazepines alone. Together, these facts suggest that individuals are at risk and that the baseline risks are high enough to suggest a public health concern.
SN  - Introduction
https://www.ncbi.nlm.nih.gov/books/n/cbqhsq_sr/SR-192_RB-2420
SN  - 
Methodology
https://www.ncbi.nlm.nih.gov/books/n/cbqhsq_sr/SR-192_RB-2420
SN  - 
Overview
https://www.ncbi.nlm.nih.gov/books/n/cbqhsq_sr/SR-192_RB-2420
SN  - 
Risk of More Serious Outcomes
https://www.ncbi.nlm.nih.gov/books/n/cbqhsq_sr/SR-192_RB-2420
SN  - 
Comparing the Association of Drug Combinations and Patient Age with ED Visit Outcome
https://www.ncbi.nlm.nih.gov/books/n/cbqhsq_sr/SR-192_RB-2420
SN  - 
Discussion
https://www.ncbi.nlm.nih.gov/books/n/cbqhsq_sr/SR-192_RB-2420
SN  - 
Suggested Citation
https://www.ncbi.nlm.nih.gov/books/n/cbqhsq_sr/SR-192_RB-2420
PT  - Review
PP  - ppublish
LG  - English
DP  - 2013
EZ  - 2016/09/16 06
DA  - 2016/09/16 06
DT  - 2016/09/16 06
BD  - 2013
CB  - 20141218
YR  - 2013
UP  - 20171211
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=27631051

<1167. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 28682575
BK  - https://www.ncbi.nlm.nih.gov/books/NBK441648
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
AU  - Weiss AJ
AU  - Elixhauser A
AU  - Barrett ML
AU  - Steiner CA
AU  - Bailey MK
AU  - O'Malley L
FA  - Weiss, Audrey J.
FA  - Elixhauser, Anne
FA  - Barrett, Marguerite L.
FA  - Steiner, Claudia A.
FA  - Bailey, Molly K.
FA  - O'Malley, Lauren
TI  - Opioid-Related Inpatient Stays and Emergency Department Visits by State, 2009-2014: Statistical Brief #219. [Review]
BT  - Healthcare Cost and Utilization Project (HCUP) Statistical Briefs
SO  - Agency for Healthcare Research and Quality (US).  2006 02
AS  - Agency for Healthcare Research and Quality (US).  2006 02
PL  - Rockville (MD)
AB  - This HCUP Statistical Brief presents data from HCUP Fast Stats on the national rate of opioid-related hospital inpatient stays and emergency department (ED) visits from 2005 to 2014. Rates for more than 40 individual States and the District of Columbia are provided for 2014 along with changes in rates for the 6-year period from 2009 to 2014. Identification of opioid-related stays and visits is based on all-listed diagnoses and includes events associated with prescription opioids or illicit opioids such as heroin. Differences greater than 10 percent between estimates are noted in the text.
SN  - Introduction
https://www.ncbi.nlm.nih.gov/books/n/hcupsb/sb219
SN  - 
Findings
https://www.ncbi.nlm.nih.gov/books/n/hcupsb/sb219
SN  - 
Data Source
https://www.ncbi.nlm.nih.gov/books/n/hcupsb/sb219
SN  - 
Definitions
https://www.ncbi.nlm.nih.gov/books/n/hcupsb/sb219
SN  - 
For More Information
https://www.ncbi.nlm.nih.gov/books/n/hcupsb/sb219
PT  - Review
MT  - Internet
PP  - ppublish
LG  - English
DP  - 2006 02
EZ  - 2017/07/07 06:01
DA  - 2017/07/07 06:01
DT  - 2017/07/07 06:01
BD  - 200602
CB  - 201612
YR  - 2006
RD  - 20170101
UP  - 20171211
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=28682575

<1168. >
VN  - Ovid Technologies
DB  - Ovid MEDLINE(R)
UI  - 11099924
VI  - 1
RO  - From MEDLINE, a database of the U.S. National Library of Medicine.
ST  - Publisher
AU  - Strang J
AU  - Best D
AU  - Man L
AU  - Noble A
AU  - Gossop M
FA  - Strang
FA  - Best
FA  - Man
FA  - Noble
FA  - Gossop
IN  - Strang, . National Addiction Centre, Institute of Psychiatry The Maudsley, Denmark Hill, SE5 8AF, London, UK
TI  - Peer-initiated overdose resuscitation: fellow drug users could be mobilised to implement resuscitation.
SO  - International Journal of Drug Policy. 11(6):437-445, 2000 Dec 01
AS  - Int J Drug Policy. 11(6):437-445, 2000 Dec 01
NJ  - The International journal on drug policy
VO  - 11
IP  - 6
PG  - 437-445
PI  - Journal available in: Print
PI  - Citation processed from: Internet
JC  - 9014759
IO  - Int. J. Drug Policy
CP  - Netherlands
AB  - Research interviews about overdose experiences were conducted with 115 patients attending a methadone maintenance clinic in south London, UK. While almost half (49.6%) reported having experienced overdose personally (on an average of four occasions each), almost all (97.4%) reported that they had witnessed overdoses (on an average of six occasions each). This represents a total of 706 overdoses witnessed, of which 106 had resulted in fatalities. The vast majority of patients (86/97) reported that they had taken actions when they had witnessed overdoses with those acting taking an average of nearly threee different actions on the last occasion on which they had seen someone overdosing. Most respondents reported that they would be willing to act, even if they did not know the overdose victim personally and that they had not been deterred from acting by the previous response from the emergency services. Fear of punishment was not a strong deterrent from acting certainly not for this sample, with many participants also expressing an interest in expanding their repertoire of overdose interventions, for example through training in resuscitation techniques and by keeping naloxone at home for use in overdose emergency.
ES  - 1873-4758
IL  - 0955-3959
PT  - Journal Article
ID  - S0955395900000700 [pii]
PP  - ppublish
LG  - English
DP  - 2000 Dec 01
EZ  - 2000/12/02
DA  - 2000/12/02
DT  - 2000/12/02 00:00
YR  - 2000
RD  - 20001201
UP  - 20171128
XL  - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=11099924