Ever since I started working with the homeless youth of Delhi, I have noticed their drug and substance dependence issues and how, despite knowing the ill-effects, they have not been able to get out from under the chemical spell. Thus, when I came across a short report in the CDC’s Morbidity and Mortality Weekly Reports that Florida…... Read more »
Johnson H, Paulozzi L, Porucznik C, Mack K, Herter B, & Hal Johnson Consulting and Division of Disease Control and Health Promotion, Florida Department of Health. (2014) Decline in drug overdose deaths after state policy changes - Florida, 2010-2012. MMWR. Morbidity and mortality weekly report, 63(26), 569-74. PMID: 24990490
In the last post, I examined some recent research in the epidemiology of traumatic brain injury (TBI).Two studies showed the top two causes of TBI to be motor vehicle crashes and falls.In this post, I will review some recent data on the geographic variability of TBI in the United States.The Centers for Disease Control provides an online tool called WISQARS that allows users to search for a variety of statistics related to unintentional injury by state in the U.S.They have recently added a iPad a........ Read more »
Centers for Disease Control and Prevention (CDC). (2013) CDC grand rounds: reducing severe traumatic brain injury in the United States. MMWR. Morbidity and mortality weekly report, 62(27), 549-52. PMID: 23842444
The Middle Eastern Respiratory Syndrome coronavirus (MERS CoV) is a novel single stranded RNA virus that has been doing the rounds in the Middle East, bits of Europe and North America. Given our experiences the last time we had a new respiratory virus (remember the pandemic?), things have moved rather fast this time once the…... Read more »
Azhar, E., El-Kafrawy, S., Farraj, S., Hassan, A., Al-Saeed, M., Hashem, A., & Madani, T. (2014) Evidence for Camel-to-Human Transmission of MERS Coronavirus. New England Journal of Medicine, 370(26), 2499-2505. DOI: 10.1056/NEJMoa1401505
Traumatic brain injury (TBI) contributes significantly to mortality and long-term disability.In the U.S. there are an estimated 52,000 deaths yearly due to TBI with over 1,000,000 emergency room (ER) visits.Understanding the epidemiology of TBI can provides clues to designing prevention programs.Four relevant recent research studies provide insight about the epidemiology of TBI.TBI in hospitalized patients in Scotland Tara Shivaji and colleagues in Scotland examined the prevalence and patte........ Read more »
Shivaji T, Lee A, Dougall N, McMillan T, & Stark C. (2014) The epidemiology of hospital treated traumatic brain injury in Scotland. BMC neurology, 2. PMID: 24386897
Kerr ZY, Harmon KJ, Marshall SW, Proescholdbell SK, & Waller AE. (2014) The epidemiology of traumatic brain injuries treated in emergency departments in North Carolina, 2010-2011. North Carolina medical journal, 75(1), 8-14. PMID: 24487751
I have been very critical of plans to have first responders treat people they suspect of having a heroin (or other) opioid overdose with naloxone.
Would first responders be safer with fentanyl?
It is not really the same question, but it does highlight the differences and why I think fentanyl is safer. The patient will be seen by someone more likely to recognize when the treatment is inappropriate. This study looked at IN (IntraNasal) fentanyl given by basic EMTs prior to transport to the E........ Read more »
Krauss, W., Shah, S., Shah, S., & Thomas, S. (2011) Fentanyl in the Out-of-Hospital Setting: Variables Associated with Hypotension and Hypoxemia. The Journal of Emergency Medicine, 40(2), 182-187. DOI: 10.1016/j.jemermed.2009.02.009
Karlsen AP, Pedersen DM, Trautner S, Dahl JB, & Hansen MS. (2014) Safety of intranasal fentanyl in the out-of-hospital setting: a prospective observational study. Annals of emergency medicine, 63(6), 699-703. PMID: 24268523
A drugs worker told me a few years back that he would never refer a patient to a recovery service on the basis that he would not be following the evidence base. I did ask him at the time ‘but what if that’s not what the client wants?’ It seemed the evidence base came first. [...]
The post Evidence based medicine – holding things back? appeared first on Recovery Review.
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Electronic or e-cigarettes are a tobacco cigarette alternative that is growing in popularity.Proponents of e-cigarettes note the product contains no carbon monoxide, tar or other tobacco residue. The inhaled vapor in e-cigarettes is primarily nicotine.Additionally, some proponents of e-cigarettes declare the product is associated with reduction or cessation of tobacco-based cigarette use.Unfortunately, this is an area where public health trends come before scientific research data is collected. ........ Read more »
Bullen, C., Howe, C., Laugesen, M., McRobbie, H., Parag, V., Williman, J., & Walker, N. (2013) Electronic cigarettes for smoking cessation: a randomised controlled trial. The Lancet, 382(9905), 1629-1637. DOI: 10.1016/S0140-6736(13)61842-5
Caponnetto P, Auditore R, Russo C, Cappello GC, & Polosa R. (2013) Impact of an electronic cigarette on smoking reduction and cessation in schizophrenic smokers: a prospective 12-month pilot study. International journal of environmental research and public health, 10(2), 446-61. PMID: 23358230
Varenicline is a drug designed to assist smokers in cessation. It is marketed in the U.S. as Chantix.Varenicline is one of the first drugs to target the nicotine receptor. It is classified as a partial agonist, meaning it stimulates the nicotine receptor but to a weaker effect than nicotine itself.The mechanism of action of varenicline differs from that of another smoking cessation drug bupropion marked under trade name Zyban in the U.S.One concern with varenicline is the risk for psychiatric ad........ Read more »
Ebbert JO, Hatsukami DK, Croghan IT, Schroeder DR, Allen SS, Hays JT, & Hurt RD. (2014) Combination varenicline and bupropion SR for tobacco-dependence treatment in cigarette smokers: a randomized trial. JAMA : the journal of the American Medical Association, 311(2), 155-63. PMID: 24399554
Rose JE, & Behm FM. (2014) Combination Treatment With Varenicline and Bupropion in an Adaptive Smoking Cessation Paradigm. The American journal of psychiatry. PMID: 24934962
Anthenelli RM, Morris C, Ramey TS, Dubrava SJ, Tsilkos K, Russ C, & Yunis C. (2013) Effects of varenicline on smoking cessation in adults with stably treated current or past major depression: a randomized trial. Annals of internal medicine, 159(6), 390-400. PMID: 24042367
Boudrez H, Hoengenaert JP, Nackaerts K, Messig M, & Metcalfe M. (2013) Predictors of quit success in Belgian participants of a varenicline observational smoking cessation study. Acta clinica Belgica, 68(1), 37-42. PMID: 23627193
While the whole nation has been gripped by a media-induced frenzy about the fatal effects of the so-called “litchi virus” (do not get me started on this! This issue deserves a whole post of its own!), another virus-related news has quietly slipped beneath the radars of the cumulative hysteria. This article in the Times of India […]... Read more »
Maramattom BV, Philips G, Sudheesh N, & Arunkumar G. (2014) Acute flaccid paralysis due to West nile virus infection in adults: A paradigm shift entity. Annals of Indian Academy of Neurology, 17(1), 85-8. PMID: 24753667
Conduct disorder is a serious behavioral disorder of childhood characterized by aggression, destruction of property, lying, theft and violation of rules.A significant number of children with conduct disorder go on to adult antisocial personality disorder.Conduct disorder is known to have genetic as well as environmental risk factors.Darya Gaysina from the United Kingdom and colleagues recently published a review of maternal smoking during pregnancy and offspring conduct problems.This review exam........ Read more »
Gaysina D, Fergusson DM, Leve LD, Horwood J, Reiss D, Shaw DS, Elam KK, Natsuaki MN, Neiderhiser JM, & Harold GT. (2013) Maternal smoking during pregnancy and offspring conduct problems: evidence from 3 independent genetically sensitive research designs. JAMA psychiatry, 70(9), 956-63. PMID: 23884431
Cadoret RJ, Yates WR, Troughton E, Woodworth G, & Stewart MA. (1995) Genetic-environmental interaction in the genesis of aggressivity and conduct disorders. Archives of general psychiatry, 52(11), 916-24. PMID: 7487340
Smoking cessation in those with nicotine dependence is one of the most difficult challenges for patients and their clinicians.Research targeting the neurobiology of smoking cessation provides hope for designing more effective treatments for nicotine dependence.Takeshi Isomura along with colleagues in the U.S. and Japan recently summarized recent findings in the brain pleasure response in nicotine dependence.The brain ventral striatum region is known to be key in nearly all sensations of pleasure........ Read more »
Isomura T, Suzuki J, & Murai T. (2014) Paradise Lost: The relationships between neurological and psychological changes in nicotine-dependent patients. Addiction research , 22(2), 158-165. PMID: 24719610
Peters J, Bromberg U, Schneider S, Brassen S, Menz M, Banaschewski T, Conrod PJ, Flor H, Gallinat J, Garavan H.... (2011) Lower ventral striatal activation during reward anticipation in adolescent smokers. The American journal of psychiatry, 168(5), 540-9. PMID: 21362742
Finally, a possible vaccine for cancer. [Infographic]... Read more »
Yukai He,, Yuan Hong,, Yibing Peng,, Lisa Butterfield,, Sheng Guo,, David Bartlett,, David Munn1,, Jose Guevara-Patino,, Junfeng Pang,, & Nahid Mivechi,. (2014) Engineering AFP and GPC3 to create highly immunogenic gene vaccines to prevent carcinogen-induced murine autochthonous hepatocellular carcinoma. The Journal of Immunology, 192(1). info:/
Smoking cigarettes during pregnancy is linked to a variety of adverse effects including increased perinatal mortality, gestational bleeding and placenta abruptio and placenta previa.Newborns of smoking mothers weigh less than newborns of nonsmoking mothers.The specific distribution of target organ growth impairment with maternal smoking is less well studied.Devasuda Anblagan and colleagues in the United Kingdom and Canada recently published a study of fetal organ growth in smoking mothers.Using ........ Read more »
Anblagan D, Jones NW, Costigan C, Parker AJ, Allcock K, Aleong R, Coyne LH, Deshpande R, Raine-Fenning N, Bugg G.... (2013) Maternal smoking during pregnancy and fetal organ growth: a magnetic resonance imaging study. PloS one, 8(7). PMID: 23843995
Tobacco smoking and nicotine dependence produce harmful effects on the brain.Some of these effects are related to direct effects on vascular health. Vascular changes seen with smoking are known to contribute to increased risk for stroke and dementia.Advances in brain imaging techniques allow for more direct study on smoking's effect on specific brain structures.Diffusion tensor imaging (DTI) is a relatively recent imaging tool allowing for study of brain white matter function.Brain white matter ........ Read more »
Umene-Nakano W, Yoshimura R, Kakeda S, Watanabe K, Hayashi K, Nishimura J, Takahashi H, Moriya J, Ide S, Ueda I.... (2014) Abnormal white matter integrity in the corpus callosum among smokers: tract-based spatial statistics. PloS one, 9(2). PMID: 24516568
Learning mathematics is a complex process that forms a key element in modern education.Significant mathematics learning difficulties emerge in 5 to 10 per cent of all elementary and secondary education students.Struggling to acquire skills in mathematics is more than a single deficit and appears to involve multiple cognitive skills.Giannis Karagiannakis and colleagures recently summarized what is known about mathematics learning disorders and proposed four subtypes. I will summarize these subtyp........ Read more »
Karagiannakis G, Baccaglini-Frank A, & Papadatos Y. (2014) Mathematical learning difficulties subtypes classification. Frontiers in human neuroscience, 57. PMID: 24574997
Executive functions (EF) of the brain are processes used to make complex decisions and plans.Deficits in EF can produce significant impairment in the ability to successfully many daily life challenges.EF are felt to be primarily a reflection of workings of the frontal lobe although additional brain regions contribute this cognitive skill.Simonetta Panerai and colleagues from Italy recently examined the key components of EF in a group of children with autism sprectrum disorder (ASD). They adminis........ Read more »
Panerai S, Tasca D, Ferri R, Genitori D'Arrigo V, & Elia M. (2014) Executive Functions and Adaptive Behaviour in Autism Spectrum Disorders with and without Intellectual Disability. Psychiatry journal, 941809. PMID: 24829905
Gene scissors allow scientists to cut out any gene: a dream for gene therapy! [Infographic]... Read more »
Gaj, T., Gersbach, C., & Barbas, C. (2013) ZFN, TALEN, and CRISPR/Cas-based methods for genome engineering. Trends in Biotechnology, 31(7), 397-405. DOI: 10.1016/j.tibtech.2013.04.004
Resting connectivity is a measure of brain circuitry obtained by functional magnetic resonance imaging (fMRI).This technique is relatively new but there is emerging evidence of the potential value in research and clinical assessment.Research in brain connectivity includes looking for distinct patterns in brain disorders compared to health controls.One such type of study in autism has been published by a group of Japanese researchers.Takashi Itahashi and colleagues recruited 46 adult subjects wit........ Read more »
Itahashi T, Yamada T, Watanabe H, Nakamura M, Jimbo D, Shioda S, Toriizuka K, Kato N, & Hashimoto R. (2014) Altered network topologies and hub organization in adults with autism: a resting-state FMRI study. PloS one, 9(4). PMID: 24714805
There is evidence that treatment seekers favour abstinence when they come for help, but what does abstinence offer in terms of quality of life (QOL), compared to continued heavy drinking or moderate drinking? My own experience is that many dependent drinkers will first seek to try out controlled drinking. However some have already realised that [...]
The post Moderate drinking or abstinence for alcoholics? appeared first on Recovery Review.
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Daeppen, J., Faouzi, M., Sanchez, N., Rahhali, N., Bineau, S., & Bertholet, N. (2014) Quality of Life Depends on the Drinking Pattern in Alcohol-Dependent Patients. Alcohol and Alcoholism. DOI: 10.1093/alcalc/agu027
If we are going to give epinephrine to patients with rhythms that are not shockable (PEA [Pulseless Electrical Activity] or Asystole), it appears that patients receiving epinephrine earlier have better outcomes than patients who receive epinephrine later in the hospital in the less acute care settings.
Does this mean that patients who receive epinephrine have better outcomes than patients who do not receive epinephrine?
We remain willfully ignorant of the answer to that question.
... Read more »
Bigham BL, Koprowicz K, Aufderheide TP, Davis DP, Donn S, Powell J, Suffoletto B, Nafziger S, Stouffer J, Idris A.... (2010) Delayed prehospital implementation of the 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiac care. Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors, 14(3), 355-60. PMID: 20388032
Donnino, M., Salciccioli, J., Howell, M., Cocchi, M., Giberson, B., Berg, K., Gautam, S., Callaway, C., & , . (2014) Time to administration of epinephrine and outcome after in-hospital cardiac arrest with non-shockable rhythms: retrospective analysis of large in-hospital data registry. BMJ, 348(may20 2). DOI: 10.1136/bmj.g3028
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