Publications by authors named "B Judge"
Background: Tramadol is an adulterant of illicit opioids. As it is a serotonin-norepinephrine reuptake inhibitor as well as a μ-opioid agonist, tramadol adulteration may worsen overdose signs and symptoms or affect the amount of naloxone patients receive.
Methods: This is a multicenter, prospective cohort of adult patients with suspected opioid overdoses who presented to one of eight United States emergency departments and were included in the Toxicology Investigators Consortium's Fentalog Study.
Objective: Despite treatments which reduce relapses in multiple sclerosis (MS), many patients continue to experience progressive disability accumulation. MS is associated with metabolic disruptions and cerebral metabolic stress predisposes to tissue injury and possibly impaired remyelination. Additionally, myelin homeostasis is metabolically expensive and reliant on glycolysis.
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- Opioid overdose deaths in the U.S. have dramatically increased due to the rise of illicit fentanyl, which also raises the risk of HIV infection among those affected by injection drug use.
- A study analyzed data from 1,690 patients who experienced acute opioid overdoses across 10 hospitals to identify HIV prevalence and associated risk factors.
- The findings revealed that 5.6% of patients with known HIV status were HIV positive, with stimulant use being more common among HIV-positive individuals and a significant link found between bipolar psychiatric history and increased HIV risk.
Article Synopsis
- The study investigates how thalamic tissue damage occurs in multiple sclerosis (MS) patients, following a specific gradient from the ventricular surface, using quantitative gradient-recalled echo (qGRE) MRI.
- Results showed that MS patients had a steeper gradient of tissue integrity compared to healthy controls, and this gradient was linked to longer disease duration and higher disability levels.
- These findings support the idea that the damage in MS follows a 'surface-in' pattern and may involve a process influenced by cerebrospinal fluid (CSF), affecting both sides of the thalamus symmetrically.
Heroin or fentanyl: Prevalence of confirmed fentanyl in ED patients with suspected heroin overdose.
J Am Coll Emerg Physicians Open
August 2024
Article Synopsis
- The study analyzed emergency department patients with documented heroin overdoses to determine the presence of fentanyl and its analogs.
- Findings revealed that 88% of those who claimed to have used heroin had fentanyl or a fentanyl analog in their system, while only 27% actually had heroin detected.
- The results indicate a significant discrepancy between the opioids patients thought they were using and what was actually found, suggesting that clinicians should assume fentanyl involvement in all opioid overdoses.