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Int J Circumpolar Health 2019 Dec;78(1):1599275

f Alaska Neonatology Associates.

The current opioid crisis in Alaska and the USA will negatively affect the health and wellbeing of future generations. The increasing number of infants born with neonatal opioid withdrawal syndrome (NOWS) has had a profound impact on families, health care providers and the child welfare system. This manuscript summarises the main themes of a Symposium held in Anchorage, Alaska with health care providers, researchers, elders and public health officials that focused on identifying emerging challenges, trends and potential solutions to address the increasing number of infants and children affected by maternal opioid use. Read More

Bull Exp Biol Med 2019 Apr 24. Epub 2019 Apr 24.

V. V. Zakusov Research Institute of Pharmacology, Moscow, Russia.

Activities of noncompetitive NMDA receptor antagonists (aminoadamantane derivatives) were assessed in random-bred rats with modeled morphine withdrawal syndrome. A single intraperitoneal injection of hemantane (10 or 20 mg/kg) significantly and dose-dependently moderated some behavioral symptoms (teeth-chattering, ptosis, and vocalization) and reduced total score of morphine withdrawal syndrome. In morphine-abstinent rats, hemantane partially prevented the decrease in the thresholds of tactile sensitivity, but had no effect on locomotor activity and body weight loss. Read More

J Pediatr Pharmacol Ther 2019 Mar-Apr;24(2):148-155

Objectives: To compare the modified Finnegan Scoring System (modified Finnegan) with an Adjusted Scoring System Criteria (adjusted Finnegan) for infants after cardiothoracic surgery with iatrogenic opioid abstinence syndrome (IOAS).

Methods: This was a retrospective, observational pilot study. This study was conducted in a tertiary care academic hospital. Read More

Adv Ther 2019 Apr 23. Epub 2019 Apr 23.

NEMA Research, Inc., Naples, FL, USA.

The 2016 CDC guidelines for opioid prescribing by primary care physicians have exposed some shortfalls in our thinking about opioid use and stranded many chronic pain patients with inadequate analgesia. Opioid prescribing rates started to decline in 2012, but still remain high. The response from providers to the 2016 guidelines have led to unintended consequences. Read More

J Psychopharmacol 2019 Apr 23:269881119840521. Epub 2019 Apr 23.

Laboratorio de Neurofarmacología Conductual, Microcirugía y Terapéutica Experimental, Instituto Nacional de Psiquiatría, cuidad de México, Mexico.

Background: Anxiety and depression, key symptoms of the cocaine withdrawal syndrome in human addicts, are considered the main factors that precipitate relapse in chronic cocaine addiction. Preclinical studies have found that rodents exposed to different withdrawal periods show an increase in anxiety and depressive-like behavior. Mirtazapine - a tetracyclic medication - is used primarily to treat depression and, sometimes, anxiety. Read More

Clin Perinatol 2019 Jun 30;46(2):349-366. Epub 2019 Mar 30.

Clinical Research Unit, Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, 1170 Main Building, 132 South 10th Street, Philadelphia, PA 19107-5244, USA.

When opioid misuse rises in the United States, pregnant women and their neonates are affected. This article summarizes the use of Food and Drug Administration-approved products, including methadone, buprenorphine, and the combination formulation of buprenorphine and naloxone to treat adult opioid use disorder during the perinatal period. All labels include pregnancy, neonatal, and lactation information and note the accepted use of these medications during the perinatal period if the benefits outweigh the risks. Read More

Arthritis Rheumatol 2019 Apr 22. Epub 2019 Apr 22.

Sorbonne Université, Département de Médecine Interne et Immunologie Clinique, F-75013, Paris, France.

Objective: Oral ulcers (OU), the hallmark lesion of Behçet's disease (BD), can be disabling and resistant to conventional treatment. There remains a need for safe and effective treatment. We report here the long term safety and efficacy of ustekinumab therapy for BD related OU resistant to colchicine. Read More

Therapie 2019 Mar 31. Epub 2019 Mar 31.

Dermatology Department, Habib Thameur Hospital, 1089 Tunis, Tunisia.

Background: Bullous fixed drug eruption (BFDE) is a rare and particular adverse drug reaction characterized by localized or generalized blisters and erosions, which can be confused with Stevens-Johnson syndrome, toxic epidermal necrolysis, major erythema multiforme and autoimmune bullous dermatosis.

Objective: The aim of our study was to assess the epidemiological, clinical and therapeutic features and outcome of BFDE.

Methods: A retrospective and descriptive study collecting all observations of BFDE was conducted in the dermatology department of Habib Thameur Hospital in Tunisia, over an 18-year period (2000-2017). Read More

Int J Obstet Anesth 2019 Feb 10. Epub 2019 Feb 10.

Virginia Apgar Professor of Anesthesiology, Department of Anesthesiology, Columbia University Medical Center, Columbia University College of Physicians & Surgeons, New York, United States. Electronic address:

The opioid crisis has reached an unprecedented magnitude in the United States and worldwide, and data on opioid use and misuse in the obstetric population are extremely concerning. Despite an abundant number of studies evaluating strategies to prevent neonatal opioid withdrawal syndrome mothers who are chronic opioid users, in babies born to mothers using chronic opioids, numerous questions remain unanswered, including (1) how to optimally manage postpartum pain in opioid-dependent patients (2) how to reconcile buprenorphine and methadone use with intrapartum and postpartum analgesia, so as to avoid opioid withdrawal during and after delivery (3) how to safely and effectively provide a stepwise multimodal approach that incorporates systemic opioid-sparing approaches, such as neuraxial opioids, clonidine, ketamine, gabapentin, and regional anesthetic blocks, to ensure adequate pain relief while avoiding opioid withdrawal (4) how to optimally manage postpartum recovery and (5) how to avoid excessive opioid prescription and possibly left-over opioids that may promote persistent use, misuse and diversion. With the recognition that an increasing number of pregnant women are taking chronic opioids, the goals of this review article are to summarize the existing literature on post-cesarean pain management in the obstetric patient with an opioid-use disorder; and to provide clinicians with a stepwise approach for management before, as well as during and after, cesarean delivery of women who have been chronically using opioids during their pregnancy. Read More

Paediatr Child Health 2019 May 14;24(2):81-84. Epub 2018 Aug 14.

University of Saskatchewan - College of Nursing, Saskatoon, Saskatchewan, Saskatchewan.

Opioid use in Canada continues to rise. Infants exposed to opioids in utero are at high risk for neonatal abstinence syndrome. Signs and symptoms of withdrawal may not develop before the infant is discharged home. Read More

Beijing Da Xue Xue Bao Yi Xue Ban 2019 Apr;51(2):356-358

Department of Neonatology, Children's Hospital of Soochow University, Suzhou 215025, Jiangsu, China.

Drug induced hypersensitivity syndrome (DIHS) is often manifested as severe systemic drug trans-reactions characterized by acute and extensive skin lesions (mostly measles-like rash), fever, enlargement of lymph nodes, multiple organ involvement (hepatitis, nephritis, and pneumonia), eosinophilia and mononucleosis,within 2-6 weeks of the application of sensitizing drugs. In the early stage of the lesion, macular papules or erythema multiforme were common, and in severe cases, exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis were also common. Most of them developed after taking allergic drugs for 2-6 weeks (average: 3 weeks). Read More

Indian J Psychiatry 2019 Mar-Apr;61(2):125-130

Department of Psychiatry, Shadan Medical College, Hyderabad, India.

Context: Severity of alcohol dependence is related to the high-risk behavior of alcohol dependents.

Aim: To assess the high-risk behavior in patients with alcohol dependence and study the association between them.

Settings And Design: This is a descriptive study of high-risk behavior in patients with alcohol dependence, conducted over a period of 15-month duration that is from January 2011 to April 2012 on 200 alcohol-dependent patients (178 men and 22 women) in the Department of Psychiatry, Mamata Medical College and General Hospital, Khammam (TS), India. Read More

Am J Drug Alcohol Abuse 2019 Apr 16:1-7. Epub 2019 Apr 16.

a Department of Pharmacy Services , Hartford Hospital , Hartford , CT , USA.

Background: Benzodiazepines have remained the standard of care for alcohol withdrawal syndrome; however, they have numerous unfavorable physiologic effects. Gabapentin has limited data to support a benefit in reducing benzodiazepine usage in alcohol withdrawal syndrome.

Objectives: Evaluate the association of an institutional guideline and order set for alcohol withdrawal that incorporates high dose gabapentin tapers in acutely withdrawing patients. Read More

Occup Ther Health Care 2019 Apr 16:1-30. Epub 2019 Apr 16.

b Department of Pediatrics/Neonatology , Queen's University , Kingston , ON , Canada.

With opioid use in North America rising, there is a growing incidence of neonatal abstinence syndrome (NAS). Infants with NAS experience withdrawal signs that interfere with their occupational performance in activities of daily living. This scoping review aims to identify the non-pharmacologic interventions currently used in the treatment of infants with NAS that fall within the scope of the occupational therapy profession. Read More

Neural Plast 2019 11;2019:2098083. Epub 2019 Mar 11.

Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China.

Although referred pain or hypersensitivity has been repeatedly reported in irritable bowel syndrome (IBS) patients and experimental colitis rodents, little is known about the neural mechanisms. Spinal long-term potentiation (LTP) of nociceptive synaptic transmission plays a critical role in the development of somatic hyperalgesia in chronic pain conditions. Herein, we sought to determine whether spinal LTP contributes to the referral hyperalgesia in colitis rats and particularly whether electroacupuncture (EA) is effective to alleviate somatic hyperalgesia via suppressing spinal LTP. Read More

Sci Rep 2019 Apr 9;9(1):5823. Epub 2019 Apr 9.

Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.

Brown and beige adipocytes are enriched in mitochondria with uncoupling protein-1 (UCP1) to generate heat instead of ATP contributing to healthy energy balance. There are few human cellular models to reveal regulatory networks in adipocyte browning and key targets for enhancing thermogenesis in obesity. The Simpson-Golabi-Behmel syndrome (SGBS) preadipocyte line has been a useful tool to study human adipocyte biology. Read More

Addict Biol 2019 Apr 9. Epub 2019 Apr 9.

Bowles Center for Alcohol Studies, UNC Chapel Hill School of Medicine, Chapel Hill, NC, USA.

The United States is experiencing an opioid crisis imposing enormous fiscal and societal costs and driving the staggering overdose death rate. While prescription opioid analgesics are essential for treating acute pain, cessation of use in individuals with a physical dependence induces an aversive withdrawal syndrome that promotes continued drug use to alleviate/avoid these symptoms. Additionally, repeated bouts of withdrawal often lead to an increased propensity for relapse. Read More

Curr Treat Options Neurol 2019 Apr 8;21(5):23. Epub 2019 Apr 8.

EA 7280 Laboratory of Neuropychopharmacology of the Subcortical Dopaminergic Systems, UFR Medecine, Université Clermont Auvergne, Clermont-Ferrand, France.

Purpose Of Review: This paper reviews clinical and pathophysiological features of both impulse control disorders (ICDs) and REM sleep behavior disorder (RBD) in Parkinson's disease (PD), as well as current evidences of their association. Then, we suggest recommendations to manage PD patients with RBD in order to prevent this potentially devastating psychiatric complication.

Recent Findings: ICDs are psychiatric complications occurring in patients with Parkinson's disease (PD) treated with dopaminergic replacement therapies (DRT). Read More

Resuscitation 2019 Apr 2. Epub 2019 Apr 2.

Department of Neurology, Yale University School of Medicine, New Haven, CT, United States; Department of Neurology, Boston University School of Medicine, Boston, MA, United States.

Purpose: To assess the performance of neuroprognostic guidelines proposed by the American Academy of Neurology (AAN), European Resuscitation Council/European Society of Intensive Care Medicine (ERC/ESICM), and American Heart Association (AHA) in predicting outcomes of patients who remain unconscious after cardiac arrest.

Methods: We retrospectively identified a cohort of unconscious post-cardiac arrest patients at a single tertiary care centre from 2011 to 2017 and reviewed hospital records for clinical, radiographic, electrophysiologic, and biochemical findings. Outcomes at discharge and 6 months post-arrest were abstracted and dichotomized as good (Cerebral Performance Category (CPC) scores of 1-2) versus poor (CPC 3-5). Read More

Prog Neuropsychopharmacol Biol Psychiatry 2019 Apr 1;93:161-170. Epub 2019 Apr 1.

Laboratory of Psychopharmacology and Behavior, Basic Sciences Institute of Health, Graduate Program in Biological Sciences: Neuroscience, Federal University of Rio Grande do Sul, Porto Alegre, RS 90050-170, Brazil; Graduate Program in Biological Sciences: Pharmacology and Therapeutics, Basic Sciences Institute of Health, Federal University of Rio Grande do Sul, Porto Alegre, RS 90050-170, Brazil; Zebrafish Neuroscience Research Consortium (ZNRC), Los Angeles, United States. Electronic address:

Alcohol abuse is a highly prevalent condition that substantially contributes to global morbidity and mortality. Most available pharmacological treatments offer little efficacy as relapse rates are high, due in part to the symptoms experienced during abstinence. The roles of oxidative stress and glutamatergic transmission in alcohol withdrawal have been demonstrated in several studies, suggesting that restoration of oxidative status and glutamatergic function may represent a new pharmacological target to prevent the behavioral and biochemical alterations observed during withdrawal. Read More

Neurourol Urodyn 2019 Apr 4. Epub 2019 Apr 4.

Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin.

Aims: The neuropathophysiology of a debilitating chronic urologic pain condition, bladder pain syndrome (BPS), remains unknown. Our recent data suggests withdrawal of cardiovagal modulation in subjects with BPS, in contrast to sympathetic nervous system dysfunction in another chronic pelvic pain syndrome, myofascial pelvic pain (MPP). We evaluated whether comorbid disorders differentially associated with BPS vs MPP shed additional light on these autonomic differences. Read More

J Clin Oncol 2019 Apr 2:JCO1801859. Epub 2019 Apr 2.

1 Memorial Sloan Kettering Cancer Center, New York, NY.

Purpose: Recurrent or metastatic adenoid cystic carcinoma (R/M ACC) is a malignant neoplasm of predominantly salivary gland origin for which effective therapies are lacking. We conducted a phase II trial evaluating the multitargeted tyrosine kinase inhibitor lenvatinib in patients with R/M ACC.

Patients And Methods: This study was conducted with a two-stage minimax design. Read More

Birth 2019 Apr 2. Epub 2019 Apr 2.

Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.

Background: Neonatal abstinence syndrome is a multisystem disorder resulting from exposure to maternal addictive substance use in pregnancy. Withdrawal is characterized by neonatal tremors, feeding difficulties, and sleep disruption. The aim of this systematic review is to explore the nonpharmacological management of infants at risk of neonatal abstinence syndrome after prenatal exposure. Read More

J Gen Intern Med 2019 Apr 1. Epub 2019 Apr 1.

Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.

Background: Benzodiazepines are the standard medication class for treating alcohol withdrawal. Guidelines recommend dosing based on objectively measured symptoms (symptom-triggered therapy) rather than fixed dose regimens. However, the superiority of symptom-triggered therapy has been questioned, and concerns have been raised about its inappropriate use and safety. Read More

N Z Vet J 2019 Apr 1:1-5. Epub 2019 Apr 1.

b Faculty of Veterinary and Agricultural Sciences , University of Melbourne , Werribee , Victoria , Australia.

Case History: Dairy cows recumbent following calving on farms in South Gippsland, Australia were examined during two 3-month seasonal calving periods in 2011 and 2012 as part of a larger study of 218 recumbent cows. A cohort of 104 cows diagnosed with calving paralysis following dystocia was derived from the larger group, which were examined with 3 days of becoming recumbent. A thorough medical and musculoskeletal clinical examination was performed on each cow including flexor-withdrawal and patellar reflex tests, and postural assessment in the lifted position, unless the facilities were not available. Read More

Semin Fetal Neonatal Med 2019 04 29;24(2):121-132. Epub 2019 Jan 29.

School of Nursing and Midwifery, Western Sydney University, Translational Health Research Institute (THRI), Locked Bag 1797, Western Sydney University, Penrith, NSW, 2751, Australia. Electronic address:

Opioid use disorders and the prescription of long-acting medications for their treatment have increased dramatically over the last decade among pregnant women. Newborns who experience prolonged in utero opioid exposure may develop neonatal abstinence syndrome (NAS). Until recently, much of the focus on improving care for NAS has been on pharmacologically-based care models. Read More

Presse Med 2019 Mar 26. Epub 2019 Mar 26.

CHU de Toulouse, hôpital Larrey, service de pneumologie, pôle des voies respiratoires, 31059 Toulouse, France.

Cough is divided into two categories: acute cough lasting less than 3 weeks, and chronic cough lasting more than 8 weeks. Acute cough is usually triggered by a viral infection of the upper airways. Evidence of treatment effectiveness is low and management of acute cough is complex in clinical practice. Read More

Acta Paediatr 2019 Mar 29. Epub 2019 Mar 29.

School of Women's and Children's Heath, University of New South Wales, Sydney, NSW, Australia.

Aim: To validate the diagnostic discharge coding of neonatal abstinence syndrome (NAS) (International Classification of Diseases [ICD]-10-AM, P96.1).

Methods: Retrospective record review of infants diagnosed with NAS (P96. Read More

J Med Chem 2019 Apr 12;62(8):4142-4157. Epub 2019 Apr 12.

Department of Medicinal Chemistry, College of Pharmacy , University of Michigan , 428 Church Street , Ann Arbor , Michigan 48109 , United States.

We have previously reported a series of μ-opioid receptor (MOR) agonist/δ-opioid receptor (DOR) antagonist ligands to serve as potential nonaddictive opioid analgesics. These ligands have been shown to be active in vivo, do not manifest withdrawal syndromes or reward behavior in conditioned-place preference assays in mice, and do not produce dependence. Although these attributes are promising, these analogues exhibit poor metabolic stability in mouse liver microsomes, likely due to the central tetrahydroquinoline scaffold in this series. Read More

Semin Fetal Neonatal Med 2019 Apr 30;24(2):95-104. Epub 2019 Jan 30.

Geisel School of Medicine at Dartmouth, Children's Hospital at Dartmouth-Hitchcock, Dartmouth-Hitchcock Medical Center, DHMC Pediatrics, One Medical Center Drive, Lebanon, NH, 03756, USA. Electronic address:

With rare exception, breastfeeding is the optimal way to feed infants, and has special benefits for women and infants with perinatal opioid exposure. Infants breastfed and/or fed their mother's own breastmilk experience less severe opioid withdrawal symptoms, have shorter hospital stays, and are less likely to be treated with medication for withdrawal. The specific impact of mothers' milk feeding on opioid withdrawal may be related to the act of breastfeeding and associated skin-to-skin contact, qualities of breastmilk, healthier microbiome, small amounts of opioid drug in breastmilk, or a combination of these. Read More

Medicine (Baltimore) 2019 Mar;98(13):e15052

Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, Azienda Ospedaliera Universitaria Senese.

Rationale: Aromatase inhibitors (AIs) are a class of drugs widely used in the treatment of estrogen sensitive breast and ovarian cancer which convert testosterone to estradiol and androstenedione to estrogen. The AIs of third generation, including anastrazole, letrozole and exemestane, have actually become the standard of care of estrogen-receptor-positive breast cancer in menopausal women and are recommended as adjuvant treatment after surgery in place of/or following tamoxifen. Their main side-effects include reduction in bone mineral density, occurrence of menopausal manifestations and development of musculoskeletal symptoms which are, usually, transient, but sometimes evolve into a typical form of arthritis, such as rheumatoid arthritis (RA). Read More

Geriatr Psychol Neuropsychiatr Vieil 2019 Mar;17(S1):13-19

Pôle hospitalo-universitaire de gérontologie clinique, CHU Nantes, France.

Epilepsia is a frequent disease in the elderly. Most of the time seizures are the consequence of another or other comorbidities and they are generally partial. Causal pathologies are either cerebral or general. Read More

Br J Haematol 2019 Mar 27. Epub 2019 Mar 27.

Department of Haematology, UCLH, Cardiometabolic programme- NIHR UCLH/UCL BRC, London, UK.

The complement inhibitor, eculizumab, has revolutionised the management of atypical haemolytic uraemic syndrome (aHUS), although the optimum treatment duration is debated. Twenty-two cases of acute aHUS managed with eculizumab were retrospectively reviewed, including outcomes after eculizumab withdrawal. Although 41% had an associated complement genetic abnormality, mutation status did not affect severity of clinical presentation. Read More

J Addict Med 2019 Mar 19. Epub 2019 Mar 19.

British Columbia Centre on Substance Use, Vancouver, BC, Canada (SH, KA, MM, MES); Department of Family Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada (SH, KA, MM); Vancouver Detox, Vancouver Coastal Health, Vancouver, BC, Canada (SH, KA, MM); Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada (MES).

Background: Gamma-hydroxybutyrate (GHB)-a GABA-B agonist-can lead to a use disorder, and a withdrawal syndrome similar to that of alcohol. At present, evidence is lacking for how to best manage GHB withdrawal, and often clinicians rely on alcohol withdrawal management approaches, using medications like benzodiazepines (BZD). However, BZD doses needed to control GHB withdrawal symptoms are typically much higher than those required for alcohol, posing significant safety risks. Read More

Mol Biol Rep 2019 Mar 22. Epub 2019 Mar 22.

The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453002, Henan, People's Republic of China.

Patients with alcohol use disorder may develop acute ethanol withdrawal syndrome (EWS). Previous studies showed that an epigenetic modification of the N-methyl-D-aspartate (NMDA) receptor, especially NMDA receptor 2B subunit (NR2B), was involved in the pathological process of EWS. However, the relationship between the epigenetic regulation of the NR2B gene in the rat hippocampus region and EWS were inconsistent. Read More

Physiol Behav 2019 Mar 19;206:22-27. Epub 2019 Mar 19.

"Sapienza" University of Rome Polo Pontino, Department of Medico-Surgical Sciences and Biotechonologies, Latina, Italy.

To explore the role of strong negative emotions in spinal nociception, we evaluated the effect of fear-relevant videos of small animals on the nociceptive withdrawal reflex (NWR) and reflex-related pain perception in healthy subjects with a specific phobia of small animals. Twenty healthy subjects with a specific phobia of small animals diagnosed according to DSM-V criteria were included in this study. The NWR was evoked in the lower limb by stimulating the sural nerve and recording EMG activity in the biceps femoris. Read More

Prostate 2019 May 22;79(7):732-745. Epub 2019 Mar 22.

Department of Biological Sciences, University of Maryland, Baltimore, Maryland.

Background: Elevated expression of the proinflammatory cytokine interleukin 1β (IL-1β) has been observed in expressed prostatic secretions of patients with chronic prostatitis/chronic pelvic pain syndrome, and genetic polymorphisms associated with the IL1B gene are linked to increased risk for aggressive prostate cancer.

Methods: To study the role of IL-1β expression in prostate inflammation, we examined IL1B expression in human prostatic proliferative inflammatory atrophy (PIA) lesions and developed a tetracycline-regulated human IL1B transgene in the mouse prostate.

Results: Here, we demonstrate that IL1B expression is a common finding in human PIA lesions, which harbored focal IL1B expression in epithelial and stromal compartments. Read More

Toxicol Lett 2019 Jun 18;308:7-16. Epub 2019 Mar 18.

Programa de Pós-Graduação em Farmacologia, Universidade Federal de Santa Maria (UFSM), RS, Brazil; Departamento de Fisiologia e Farmacologia, UFSM, RS, Brazil. Electronic address:

Opioids are addictive drugs, whose misuse evoke withdrawal and relapse. Mediterranean-based diet (MBD) is rich in n-3 polyunsaturated fatty acids (PUFA), while Western based diets (WBDs) contain saturated fatty acids including interesterified fat (IF) and palm oil (PO), influencing neural functions. We compared MBD and WBDs on morphine-induced addiction parameters. Read More

Eur Addict Res 2019 Mar 21;25(3):103-110. Epub 2019 Mar 21.

Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.

Aims: Patients with alcohol use disorder (AUD) frequently suffer from cognitive deficits ranging from mild symptoms to most severe forms. Wernicke encephalopathy (WE), caused by thiamine deficiency, is a potentially fatal syndrome characterized by the clinical triad of ophthalmoplegia, ataxia, and confusion. WE frequently presents in patients with AUD and, if left untreated, can progress to Wernicke-Korsakoff syndrome, which constitutes severe anterograde amnesia, confabulation, and behavioral abnormalities. Read More

Nat Commun 2019 03 18;10(1):1238. Epub 2019 Mar 18.

Department of Neuroscience, The Scripps Research Institute, La Jolla, CA, 92037, USA.

The activation of a neuronal ensemble in the central nucleus of the amygdala (CeA) during alcohol withdrawal has been hypothesized to induce high levels of alcohol drinking in dependent rats. In the present study we describe that the CeA neuronal ensemble that is activated by withdrawal from chronic alcohol exposure contains ~80% corticotropin-releasing factor (CRF) neurons and that the optogenetic inactivation of these CeA CRF+ neurons prevents recruitment of the neuronal ensemble, decreases the escalation of alcohol drinking, and decreases the intensity of somatic signs of withdrawal. Optogenetic dissection of the downstream neuronal pathways demonstrates that the reversal of addiction-like behaviors is observed after the inhibition of CeA CRF projections to the bed nucleus of the stria terminalis (BNST) and that inhibition of the CRF pathway is mediated by inhibition of the CRF-CRF system and inhibition of BNST cell firing. Read More

Lancet Gastroenterol Hepatol 2019 May 16;4(5):364-375. Epub 2019 Mar 16.

Division of Population Medicine, Cardiff University School of Medicine, Cardiff, UK. Electronic address:

Background: Most post-colonoscopy interval colorectal cancers are proximal; serrated polyps are often precursors to these cancers and are considered difficult to detect. We assessed the safety, feasibility, and economic effect of chromocolonoscopy on detection of proximal serrated neoplasia.

Methods: We did an open-label, multicentre, randomised, controlled non-inferiority trial including patients from Bowel Screening Wales centres. Read More

Am J Emerg Med 2019 Mar 9. Epub 2019 Mar 9.

Minnesota Poison Control System, MN, United States of America; Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN, United States of America.

Background: Phenibut is a synthetically produced central nervous system (CNS) depressant that is structurally similar to the inhibitory neurotransmitter γ-aminobutyric acid (GABA). Phenibut has been identified as a drug of abuse with numerous clinical effects in overdose and a withdrawal syndrome with chronic use. The purpose of this study is to report the incidence of exposure calls regarding phenibut to a poison center, describe the reasons for its use and clinical effects. Read More

Psychosomatics 2019 Feb 14. Epub 2019 Feb 14.

Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD Massachusetts General Hospital, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA.

Background: Benzodiazepine-based protocols offer a standard of care for management of alcohol withdrawal, though they may not be safe or appropriate for all patients. Phenobarbital, a long-acting barbiturate, presents an alternative to conventional benzodiazepine treatment, though existing research offers only modest guidance to the safety and effectiveness of phenobarbital in managing alcohol withdrawal syndrome (AWS) in general hospital settings.

Methods: To compare clinical effectiveness of phenobarbital versus benzodiazepines in managing symptoms of alcohol withdrawal, we conducted a retrospective chart review of 562 patients admitted over a 2-year period to a general hospital and treated for AWS. Read More

Anticancer Drugs 2019 Apr;30(4):431-434

Department of Medicine, Zucker School of Medicine, Northwell Health Cancer Institute, Lake Success, New York, USA.

Capecitabine, an oral prodrug of 5-fluorouracil (5-FU) is extensively used to treat many solid tumors, particularly breast and colorectal cancers. Neurotoxicity of capecitabine has been rarely reported as peripheral neuropathy, cerebellar syndrome, and multifocal leukoencephalopathy. Although very little is known about the pathogenetic mechanisms responsible for this toxicity, dihydropyrimidine dehydrogenase (DPD) deficiency has been found in few of these patients. Read More

Ann Neurol 2019 May 22;85(5):740-751. Epub 2019 Mar 22.

Genetic Medicine Department and Pediatric Institute of Rare Diseases, Sant Joan de Déu Hospital Research Institute, Barcelona, Spain.

Objective: Phosphomannomutase deficiency (PMM2 congenital disorder of glycosylation [PMM2-CDG]) causes cerebellar syndrome and strokelike episodes (SLEs). SLEs are also described in patients with gain-of-function mutations in the CaV2.1 channel, for which acetazolamide therapy is suggested. Read More

Clin Transl Oncol 2019 Mar 13. Epub 2019 Mar 13.

Division of Medical Oncology, Department of Internal Medicine, Trakya University School of Medicine, Edirne, 22030, Turkey.

Background: Sarcopenia is related to poor prognosis and drug toxicities in solid tumors. The aim of our study is to investigate the predisposition of patients with metastatic colorectal carcinoma who started regorafenib treatment to sarcopenia and prolonged survival.

Methods: Patients with metastatic colorectal carcinoma who receives regorafenib were search retrospectively. Read More

Anasthesiol Intensivmed Notfallmed Schmerzther 2019 Mar 13;54(3):194-205. Epub 2019 Mar 13.

Nowadays, management of hemotherapy is regulated in Germany by the transfusion act and several guidelines while the transfusing physician is responsible for correct implementation at the bedside. Indications for blood products have to be carefully adapted to the patient's current clinical situation and pre-existing diseases have to be considered as well. Today, for most perioperative elective surgeries, evidence-based transfusion thresholds for packed red blood cell concentrates (RBC) have been defined and should be considered. Read More

PeerJ 2019 6;7:e6575. Epub 2019 Mar 6.

Department of Biomedical Engineering, University at Buffalo, The State University of New York (SUNY), Buffalo, NY, United States of America.

Background: The vegetative state (VS)/unresponsive wakefulness syndrome (UWS) denotes brain-injured, awake patients who are seemingly without awareness. Still, up to 15% of these patients show signs of covert consciousness when examined by functional magnetic resonance imaging (fMRI) or EEG, which is known as cognitive motor dissociation (CMD). Experts often prefer the term to avoid the negative connotations associated with and to highlight the possibility for CMD. Read More

CNS Spectr 2019 Feb;24(1):205-206

3Medical Director Inpatient Mental Health Services,Psychiatry, Department of Veteran Affairs Washington,DC.

A 46 year old Caucasian male veteran with a mental health history of Bipolar Disorder was admitted to the inpatient psychiatric unit following an episode of mania. He was re-started on his outpatient medication regimen for mood stabilization with Quetiapine, Lamotrigine, and Clonazepam. He improved initially, however, on hospital Day 3, the veteran was noted to have acute worsening of manic and psychotic symptoms including, decreased need for sleep, excess energy and responding to internal stimuli. Read More