103,203 results match your criteria withdrawal therapeutic

Drug and sexual HIV-risk behaviors among adolescents and young adults with opioid use disorder.

J Subst Abuse Treat 2021 May 19;130:108477. Epub 2021 May 19.

Friends Research Institute, Inc., 1040 Park Avenue, Suite 103, Baltimore, MD 21201, United States of America.

Opioid use disorder (OUD) among adolescents and young adults (youth) is associated with drug use and sexual HIV-related risk behaviors and opioid overdose. This mixed methods analysis assesses risk behaviors among a sample of 15-21-year-olds (N = 288) who were being treated for OUD in a residential drug treatment program in Baltimore, Maryland. Participants were enrolled in a parent study in which they received either extended-release naltrexone (XR-NTX) or Treatment as Usual (TAU), consisting of outpatient counseling with or without buprenorphine, prior to discharge. Read More

View Article and Full-Text PDF

Cognitive insight, medication adherence and methamphetamine cessation in people enrolled in a pharmacotherapy trial for methamphetamine use.

J Subst Abuse Treat 2021 May 15;130:108473. Epub 2021 May 15.

National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.

Background: The current study examined correlates of cognitive insight in people enrolled in a methamphetamine pharmacotherapy trial; whether cognitive insight at the start of the trial predicted medication adherence and reductions in methamphetamine use during the trial; and, whether insight would remain stable over the trial or improve with reductions in methamphetamine use.

Methods: A subset of people enrolled in a 12-week randomised placebo-controlled pharmacotherapy trial for methamphetamine dependence completed the Beck Cognitive Insight Scale, comprising subscales for Self-Reflection and Self-Certainty, at baseline (n = 152) and at week 12 (n = 79). Medication adherence was expressed as the percentage of non-missed doses measured using eCAP™ technology. Read More

View Article and Full-Text PDF

Bridge clinic buprenorphine program decreases emergency department visits.

J Subst Abuse Treat 2021 Apr 17;130:108410. Epub 2021 Apr 17.

Department of Emergency Medicine, Upstate Medical University, Syracuse, NY, USA.

Introduction: Opioid withdrawal due to opioid use disorder (OUD) is an increasing health emergency and complaint in emergency departments (EDs) across the United States. As a response to the increased need for OUD treatment, a low threshold buprenorphine program, or Bridge Clinic, was established within our hospital system. Patients are primarily connected to the Bridge Clinic through the ED, and are able to complete their consultation appointment reliably within 1-3 days of referral. Read More

View Article and Full-Text PDF

Extended-release naltrexone for youth with opioid use disorder.

J Subst Abuse Treat 2021 Apr 15;130:108407. Epub 2021 Apr 15.

Friends Research Institute, 1040 Park Avenue, Suite, 103 Baltimore, MD, USA. Electronic address:

Background: Few published research studies have examined the effectiveness of extended-release naltrexone (XR-NTX) for the treatment of opioid use disorder (OUD) among adolescents and young adults.

Methods: This two-group randomized controlled trial recruited 288 youth, ages 15-21, with moderate/severe OUD from a residential addiction treatment program in Baltimore, Maryland. The study randomized the youth within the first week of treatment entry to receive either XR-NTX or treatment-as-usual (TAU; either buprenorphine maintenance treatment or treatment without OUD medication following medically managed withdrawal) prior to discharge, with continued treatment in the community for 6 months. Read More

View Article and Full-Text PDF

Buprenorphine use and disparities in access among emergency department patients with opioid use disorder: A cross-sectional study.

J Subst Abuse Treat 2021 Apr 20;130:108405. Epub 2021 Apr 20.

Cooper Medical School of Rowan University, 401 Broadway, Camden, NJ 08103, United States of America; Cooper University Hospital, Department of Emergency Medicine, Keleman 152, 1 Cooper Plaza, Camden, NJ 08103, United States of America. Electronic address:

Background: Buprenorphine, a partial mu-opioid agonist and kappa-opioid antagonist, is an approved treatment for opioid use disorder (OUD). Studies demonstrate that buprenorphine decreases cravings for other opioids, effectively ameliorates withdrawal symptoms, and decreases opioid overdose and mortality. However, buprenorphine remains under-utilized. Read More

View Article and Full-Text PDF

Interactive effects of (±)-trans-U50488 and its stereoisomers with cannabinoids.

Pharmacol Biochem Behav 2021 Jun 9:173218. Epub 2021 Jun 9.

Department of Pharmacology and Experimental Therapeutics, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA; Alcohol and Drug Abuse Center of Excellence, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.

The adverse effects of mu opioid agonists have spurred a renewed interest in using kappa opioid receptor (KOR) agonists as analgesics. KOR agonists also have potential for development as diuretics for the treatment of edema and hypertension. Here, we evaluated the discriminative stimulus, antinociceptive, and diuretic effects of the kappa agonist (±)-trans-U-50488 and its stereoisomers (-)-(1S,2S)-U-50488 or (+)-(1R,2R)-U-50488) alone and in combination with the cannabinoid agonist (-)-CP 55,940. Read More

View Article and Full-Text PDF

Pralsetinib for patients with advanced or metastatic RET-altered thyroid cancer (ARROW): a multi-cohort, open-label, registrational, phase 1/2 study.

Lancet Diabetes Endocrinol 2021 Jun 9. Epub 2021 Jun 9.

Earle A Chiles Research Institute, Providence Portland Medical Center, Portland, OR, USA.

Background: Oncogenic alterations in RET represent important therapeutic targets in thyroid cancer. We aimed to assess the safety and antitumour activity of pralsetinib, a highly potent, selective RET inhibitor, in patients with RET-altered thyroid cancers.

Methods: ARROW, a phase 1/2, open-label study done in 13 countries across 71 sites in community and hospital settings, enrolled patients 18 years or older with RET-altered locally advanced or metastatic solid tumours, including RET-mutant medullary thyroid and RET fusion-positive thyroid cancers, and an Eastern Co-operative Oncology Group performance status of 0-2 (later limited to 0-1 in a protocol amendment). Read More

View Article and Full-Text PDF

Pralsetinib for RET fusion-positive non-small-cell lung cancer (ARROW): a multi-cohort, open-label, phase 1/2 study.

Lancet Oncol 2021 Jun 9. Epub 2021 Jun 9.

Department of Investigational Cancer Therapeutics, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Background: Oncogenic alterations in RET have been identified in multiple tumour types, including 1-2% of non-small-cell lung cancers (NSCLCs). We aimed to assess the safety, tolerability, and antitumour activity of pralsetinib, a highly potent, oral, selective RET inhibitor, in patients with RET fusion-positive NSCLC.

Methods: ARROW is a multi-cohort, open-label, phase 1/2 study done at 71 sites (community and academic cancer centres) in 13 countries (Belgium, China, France, Germany, Hong Kong, Italy, Netherlands, Singapore, South Korea, Spain, Taiwan, the UK, and the USA). Read More

View Article and Full-Text PDF

Negative affect-associated drug refusal self-efficacy, illicit opioid use, and medication use following short-term inpatient opioid withdrawal management.

J Subst Abuse Treat 2021 Jul 27;126:108309. Epub 2021 Jan 27.

Behavioral Medicine and Addictions Research Unit, Butler Hospital, Providence, RI, USA; Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA.

Introduction: Persons with opioid use disorder (OUD) are prone to frequent relapse following brief inpatient medically managed withdrawal. This longitudinal, naturalistic study examines associations among illicit opioid use, use of medication for opioid use disorder (MOUD), and one's confidence in the ability to resist drug use in the face of negative emotions (i.e. Read More

View Article and Full-Text PDF

Real-world outcomes with extended-release buprenorphine (XR-BUP) in a low threshold bridge clinic: A retrospective case series.

J Subst Abuse Treat 2021 Jul 2;126:108316. Epub 2021 Feb 2.

Department of Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA, United States of America. Electronic address:

Background: In clinical trial settings, extended-release buprenorphine (XR-BUP) is noninferior to sublingual buprenorphine and may offer some advantages. However, real-world experiences of XR-BUP are limited and outcomes are unknown for low-threshold clinics with high-risk populations. Practical guidance is lacking on overcoming treatment challenges, such as inability for some to stabilize on sublingual (SL) BUP for seven days prior to XR-BUP and ongoing craving/withdrawal symptoms during treatment. Read More

View Article and Full-Text PDF

Gastrostomy for infants with severe epidermolysis bullosa simplex in neonatal intensive care.

Orphanet J Rare Dis 2021 Jun 11;16(1):271. Epub 2021 Jun 11.

Department of Dermatology, CRMRPM-Sud, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, 06200, Nice, France.

Introduction: Severe epidermolysis bullosa simplex (EBS sev) is a rare genodermatosis characterized by congenital generalized blistering and mucosal involvement. Increased needs and decreased intake quickly lead to nutritional imbalance. Enteral nutrition support is proposed, but classical nasogastric tubes are not well tolerated in these patients and gastrostomy is preferred. Read More

View Article and Full-Text PDF

Efficacy and safety of ciprofol for the sedation/anesthesia in patients undergoing colonoscopy: Phase IIa and IIb multi-center clinical trials.

Eur J Pharm Sci 2021 Jun 8:105904. Epub 2021 Jun 8.

Department of Anesthesiology, West China Hospital, Sichuan University & The Research Units of West China (2018RU012), Chinese Academy of Medical Sciences Chengdu, China. Electronic address:

Objective: Ciprofol is a new intravenous anesthetic agent similar to propofol that has the pharmacodynamic characteristics of a rapid rate of onset and recovery in pre-clinical experiments. The aims of the present clinical trials were to compare the efficacy and safety of ciprofol emulsion for sedation or general anesthesia during colonoscopy and to define optimal doses for a subsequent phase III clinical trial.

Methods: A phase IIa multi-center, open-label, non-randomized, positive control, dose-escalating study was performed to determine a recommended phase IIb dose (RP2D) of ciprofol to induce sedation or anesthesia in patients undergoing colonoscopy. Read More

View Article and Full-Text PDF

The Effects of At-Birth Adoption on Atypical Behavior and Anxiety: A Nonhuman Primate Model.

J Am Acad Child Adolesc Psychiatry 2021 Jun 8. Epub 2021 Jun 8.

Objective: Adopted children tend to show an increased risk for a variety of psychopathological outcomes, even when adoption occurs at birth, which some suggest is a result of non-random assignment of adoptees and parents. This study utilizes a nonhuman primate model, in which adoptions were randomly assigned, to investigate the behavioral and physiological outcomes associated with at-birth adoption.

Method: Immediately following birth, rhesus monkey infants were randomly assigned to be reared by either their biological mother (n=113) or by an unrelated, lactating, adoptive mother (n=34). Read More

View Article and Full-Text PDF

Subregion-specific effects on striatal neurotransmission and dopamine-signaling by acute and repeated amphetamine exposure.

Neuropharmacology 2021 Jun 8;194:108638. Epub 2021 Jun 8.

Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Pharmacology, Institute of Neuroscience and Physiology, Sahlgrenska Academy University of Gothenburg, Sweden. Electronic address:

Repeated administration of psychostimulants, such as amphetamine, is associated with a progressive increased sensitivity to some of the drug's effects, but tolerance towards others. We hypothesized that these adaptations in part could be linked to differential effects by amphetamine on dopaminergic signaling in striatal subregions. To test this theory, acute and long-lasting changes in dopaminergic neurotransmission were assessed in the nucleus accumbens (nAc) and the dorsomedial striatum (DMS) following amphetamine exposure in Wistar rats. Read More

View Article and Full-Text PDF

Integrated Review of the Assessment of Newborns With Neonatal Abstinence Syndrome.

J Obstet Gynecol Neonatal Nurs 2021 Jun 8. Epub 2021 Jun 8.

Objective: To critically review and summarize current knowledge regarding the assessment of newborns with neonatal abstinence syndrome (NAS).

Data Sources: We searched the following databases for articles on the assessment of newborns with NAS that were published in English between January 2014 and June 2020: PubMed, CINAHL, and PsycINFO. Keywords and Medical Subject Heading terms used to identify relevant research articles included neonatal abstinence syndrome; Finnegan Scale; eat, sleep, console; epigenetics; genetics; pharmacokinetics; and measurement. Read More

View Article and Full-Text PDF

A role for the Cockayne Syndrome B (CSB)-Elongin ubiquitin ligase complex in signal-dependent RNA polymerase II transcription.

J Biol Chem 2021 Jun 8:100862. Epub 2021 Jun 8.

Stowers Institute for Medical Research, Kansas City, MO 64110; Department of Biochemistry & Molecular Biology, University of Kansas Medical Center. Electronic address:

The Elongin complex was originally identified as an RNA polymerase II (RNAPII) elongation factor and subsequently as the substrate recognition component of a Cullin-RING E3 ubiquitin ligase. More recent evidence indicates the Elongin ubiquitin ligase assembles with the Cockayne syndrome B helicase (CSB) in response to DNA damage and can target stalled polymerases for ubiquitylation and removal from the genome. In this report, we present evidence that the CSB-Elongin ubiquitin ligase pathway has roles beyond the DNA damage response in the activation of RNAPII-mediated transcription. Read More

View Article and Full-Text PDF

Identifying research priorities to improve the health of incarcerated populations: results of citizens' juries in Australian prisons.

Lancet Public Health 2021 Jun 8. Epub 2021 Jun 8.

School of Population Health, University of New South Wales (UNSW Sydney), Sydney, NSW, Australia.

Health disparities in incarcerated populations should guide investment in the health care and research of these communities. Although users of health-care services are important in providing input into decisions about research, the voices of people in prison are absent regarding research into their health. In this Health Policy paper, we present priorities for research into the health of people in prison according to people in prison themselves. Read More

View Article and Full-Text PDF

The Negative Impact of Maternal Perinatal Opioid Use on Neonatal Outcomes.

Prim Care Companion CNS Disord 2021 Jun 10;23(3). Epub 2021 Jun 10.

Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota.

To compare outcomes among newborns of opioid-using and nonopioid drug-using mothers with those of control mothers who did not report substance use.

Using the Rochester Epidemiology Project, newborns diagnosed with drug withdrawal syndrome (per or codes) from January 2010 through June 2017 were identified. For mothers, data collected included age, race, drug use, number of prenatal visits, and results of the urinary drug abuse survey, meconium test, and self-report survey. Read More

View Article and Full-Text PDF

VEGF-VEGFR2 inhibitor-associated hyaline occlusive glomerular microangiopathy: a Japanese single-center experience.

Clin Exp Nephrol 2021 Jun 11. Epub 2021 Jun 11.

Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, Akita, Japan.

Background: Inhibitors of vascular endothelial growth factor (VEGF)-VEGF receptor 2 (VEGFR2) signaling, such as bevacizumab (Bmab), are used for the treatment of various advanced cancers. However, these inhibitors induce renal thrombotic microangiopathy (TMA). Recently, two European cohort studies showed a distinctive histopathological pseudothrombotic pattern different from TMA in Bmab-treated patients. Read More

View Article and Full-Text PDF

GABAA receptor encephalitis associated with human parvovirus B19 virus infection: Case report.

Medicine (Baltimore) 2021 Jun;100(23):e26324

Faculdades Pequeno Principe.

Rationale: Human parvovirus B19 (B19) infection can produce a spectrum of clinical syndromes, including neurological manifestations, most notably encephalitis. Although symptoms suggestive of autoimmune disease in patients with B19 infection have been previously described, a clear association of autoimmune encephalitis with B19 infection has yet to be established.

Patient Concerns: We describe the case of a 6-year-old boy who was hospitalized due to status epilepticus, which evolved to super-refractory status epilepticus that was only mildly responsive to anticonvulsant drugs. Read More

View Article and Full-Text PDF

Efficacy of thromboelastography in the management of anticoagulation for veno-venous extracorporeal membrane oxygenation in a coronavirus disease 2019 patient: A case report.

Medicine (Baltimore) 2021 Jun;100(23):e26313

Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.

Rationale: In coronavirus disease 2019 (COVID-19) patients with acute respiratory distress syndrome refractory to optimal conventional management, we should consider the indication for veno-venous extracorporeal membrane oxygenation (V-V ECMO). Growing evidence indicates that COVID-19 frequently causes coagulopathy, presenting as hypercoagulation and incidental thrombosis. For these reasons, a multifactorial approach with several anticoagulant markers should be considered in the management of anticoagulation using heparin in COVID-19 patients on V-V ECMO. Read More

View Article and Full-Text PDF

Sexual excitation and sex-linked substance use predict overall cannabis use in mostly heterosexual and bisexual women.

Tierney K Lorenz

Am J Drug Alcohol Abuse 2021 Jun 11:1-11. Epub 2021 Jun 11.

Department of Psychology and Center for Brain, Biology & Behavior, University of Nebraska-Lincoln, Lincoln, Nebraska, USA.

Bisexual and mostly heterosexual women report higher substance use than exclusively heterosexual or lesbian women. In sexual minority men, sex-linked substance use (SLSU) can increase risk for substance use problems; equivalent research in women is lacking. To test if sexual excitation and inhibition mediate the association between sexual minority status and women's SLSU. Read More

View Article and Full-Text PDF

Pro-inflammatory signals induce 20α-HSD expression in myometrial cells: A key mechanism for local progesterone withdrawal.

J Cell Mol Med 2021 Jun 10. Epub 2021 Jun 10.

Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada.

Metabolism of progesterone (P4) by the enzyme 20α hydroxysteroid dehydrogenase (20α-HSD) in myometrial cells is postulated to be a mechanism for P4 withdrawal, which occurs concomitant to uterine inflammation (physiologic or infection-induced) and associated activation of transcription factors: NF-кB and AP-1, common to term and preterm labour. We found that 20α-HSD protein is significantly increased in human myometrium during term labour, and in mouse uterus during term and preterm labour. Treatment of human myometrial cells with the pro-inflammatory mediators, lipopolysaccharide (LPS, mimicking infection) and 12-O-tetradecanoylphorbol-13-acetate (TPA, mimicking inflammation), induced 20α-HSD gene expression and increased 20α-HSD protein abundance. Read More

View Article and Full-Text PDF

Why Depressed Mood is Adaptive: A Numerical Proof of Principle for an Evolutionary Systems Theory of Depression.

Comput Psychiatr 2021 2;5(1):60-80. Epub 2021 Jun 2.

Centre for Youth Mental Health, The University of Melbourne, AU; Department of Psychiatry, The University of Melbourne, AU; Orygen, AU.

We provide a proof of principle for an evolutionary systems theory (EST) of depression. This theory suggests that normative depressive symptoms counter socioenvironmental volatility by increasing interpersonal support via social signalling and that this response depends upon the encoding of uncertainty about social contingencies, which can be targeted by neuromodulatory antidepressants. We simulated agents that committed to a series of decisions in a social two-arm bandit task before and after social adversity, which precipitated depressive symptoms. Read More

View Article and Full-Text PDF

Understanding Adolescents' Perceptions of Diarrhea: A Formative Research Study of a Visual Scale to Measure Self-Reported Diarrhea in Low-Resource Settings.

Front Public Health 2021 25;9:561367. Epub 2021 May 25.

Department of Public Health, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway.

Although water, sanitation, and hygiene interventions are effective in reducing diarrhea, there are methodological issues regarding the research tools used to evaluate their health impact. Moreover, there is limited research on individuals' subjective interpretations of diarrheal illness which may introduce further limitations in relying on self-reported data. Therefore, we conducted a study that aims to understand adolescents' perceptions of diarrheal illness in rural Tamil Nadu, India. Read More

View Article and Full-Text PDF

Pushing or Pulling Your "Poison": Clinical Correlates of Alcohol Approach and Avoidance Bias Among Inpatients Undergoing Alcohol Withdrawal Treatment.

Front Psychol 2021 25;12:663087. Epub 2021 May 25.

School of Psychology, Deakin University, Geelong, VIC, Australia.

Alcohol approach bias, the tendency to automatically move toward alcohol cues, has been observed in people who drink heavily. However, surprisingly, some alcohol-dependent patients demonstrate an alcohol avoidance bias. This inconsistency could be explained by the clinical or demographic profile of the population studied, yet this has not been examined in approach bias modification (ABM) trials to date. Read More

View Article and Full-Text PDF

Improving NKCC1 Function Increases the Excitability of DRG Neurons Exacerbating Pain Induced After TRPV1 Activation of Primary Sensory Neurons.

Front Cell Neurosci 2021 25;15:665596. Epub 2021 May 25.

The Key Laboratory of Xinjiang Endemic and Ethnic Diseases, Department of Physiology, Shihezi University Medical College, Shihezi, China.

Our aim was to investigate the effects of the protein expression and the function of sodium, potassium, and chloride co-transporter (NKCC1) in the dorsal root ganglion (DRG) after activation of transient receptor potential vanilloid 1 receptor (TRPV1) in capsaicin-induced acute inflammatory pain and the possible mechanism of action. Male Sprague-Dawley rats were randomly divided into control, capsaicin, and inhibitor groups. The expression and distribution of TRPV1 and NKCC1 in rat DRG were observed by immunofluorescence. Read More

View Article and Full-Text PDF

Therapeutic Approaches to Opioid Use Disorder: What is the Current Standard of Care?

Int J Gen Med 2021 3;14:2305-2311. Epub 2021 Jun 3.

Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.

Opioid use disorder is a frequent cause of suffering to communities worldwide. Therapeutic approaches to opioid use disorder include screening, appropriate assessment and diagnosis, consideration of level of care, acute management of overdose or withdrawal, treatment with medications, psychotherapeutic approaches, and community support. People who struggle with addiction to opioids often suffer deeply from direct and indirect consequences of use. Read More

View Article and Full-Text PDF

Gene Therapy for Overactive Bladder: A Review of BK-Channel α-Subunit Gene Transfer.

Ther Clin Risk Manag 2021 4;17:589-599. Epub 2021 Jun 4.

Department of Urology, Albert Einstein College of Medicine, Ardsley, NY, USA.

A need exists for local (ie, bladder-specific) interventions to treat overactive bladder (OAB) with low risk of unwanted postprocedural outcomes. Gene therapy targeted to leverage endogenous physiology in bladder cells may assist in restoring normal cell and organ function. Herein, we review the potential promise of gene therapy for treating OAB, focusing on gene transfer of URO-902, a non-viral naked plasmid DNA expressing the big potassium (BK) channel. Read More

View Article and Full-Text PDF

Microscopic colitis.

Nat Rev Dis Primers 2021 Jun 10;7(1):39. Epub 2021 Jun 10.

Gastroenterology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.

Microscopic colitis (MC) is an inflammatory disease of the large intestine associated with urgent watery diarrhoea. MC may occur in people of all ages, although the disease primarily affects older women. Once believed to be rare, MC is now known to be a common cause of chronic watery diarrhoea in high-income countries, affecting 1 in 115 women and 1 in 286 men during their lifetime in Swedish population-based estimates. Read More

View Article and Full-Text PDF