Tolerance, interdose withdrawal symptoms, and craving predict prescription opioid-use disorder severity in chronic pain patients: A three-wave prospective study.

The DSM-5-TR diagnostic criteria for Prescription Opioid-Use Disorder (POUD) have undergone significant changes when using opioids medically supervised. However, there is a lack of research supporting these changes. This prospective study aimed to analyze the influence of tolerance, withdrawal symptoms, and craving on the severity of POUD in chronic pain population on long-term opioid therapy.

Profile of chronic pain patients with opioid withdrawal syndrome according to psychological factors: a Latent Class Analysis.

Objective: Withdrawal syndrome stands out as the strongest risk factor for Prescription Opioid-Use Disorder (POUD) and is related to psychological and pain impairment in chronic pain population. This study aimed to identify profiles of chronic pain patients with opioid withdrawal based on psychological factors, and to explore the association between the classes and demographic, clinical, and substance use variables.

Method: This cross-sectional descriptive study involved 391 patients, 221 of them with interdose withdrawal (mean age=57.

Guidelines for inhaled sedation in the ICU.

Introduction And Objectives: Sedation is used in intensive care units (ICU) to improve comfort and tolerance during mechanical ventilation, invasive interventions, and nursing care. In recent years, the use of inhalation anaesthetics for this purpose has increased. Our objective was to obtain and summarise the best evidence on inhaled sedation in adult patients in the ICU, and use this to help physicians choose the most appropriate approach in terms of the impact of sedation on clinical outcomes and the risk-benefit of the chosen strategy.

Postoperative arterial hypotension: the unnoticed enemy.

Postoperative hypotension is a frequently underestimated health problem associated with high morbidity and mortality and increased use of health care resources. It also poses significant clinical, technological, and human challenges for healthcare. As it is a modifiable and avoidable risk factor, this document aims to increase its visibility, defining its clinical impact and the technological challenges involved in optimizing its management, taking clinical-technological, humanistic, and economic aspects into account.

Result of the implementation of a quality management system based on the ISO 9001:2015 standard in a surgical intensive care unit.

Introduction: The implementation of Quality Management Systems (QMS) is one of the fundamental and future-oriented elements for the improvement of modern health systems. The objective of implementing a QMS in accordance with the requirements of the ISO 9001: 2015 Standard is to effectively carry out its activities, covering both technical and management aspects, guaranteeing the satisfaction of the needs and expectations of all its stakeholders, as well as compliance with legal and regulatory requirements. It must contemplate all those aspects that have an impact on the final quality of the product or service provided by the organization.

Differential Experience of Interdose Withdrawal During Long-Term Opioid Therapy and its Association With Patient and Treatment Characteristics: A Latent Class Analysis in Chronic Pain Population.

Opioid withdrawal is characterized by a set of physical and psychological symptoms that depend on both opioid and patient specific characteristics. The present study aims to identify different latent classes of chronic pain patients according to the type of opioid withdrawal symptoms experienced, and to analyze the relationships between the classes and demographic, opioid therapy, psychological and substance use variables. This cross-sectional descriptive study included 391 chronic pain patients on long-term opioid therapy.

Clinical and psychological factors associated with interdose opioid withdrawal in chronic pain population.

Background: The DSM-5 diagnostic criteria for Prescription Opioid-Use Disorder (POUD) have undergone some significant changes. One of the most controversial changes has been the elimination of the withdrawal symptoms criterion when opioid use is under appropriate medical supervision. For this reason, the goal of this study was to analyze factors associated with opioid withdrawal in patients with chronic non-cancer pain (CNCP).

Reduction of ventilatory time using the multidisciplinary disconnection protocol. Pilot study.

Objective: compare ventilatory time between patients with the application of a disconnection protocol, managed in a coordinated way between doctor and nurse, with patients managed exclusively by the doctor.

Method: experimental pilot study before and after. Twenty-five patients requiring invasive mechanical ventilation for 24 hours or more were included, and the protocol-guided group was compared with the protocol-free group managed according to usual practice.

Withdrawal symptoms predict prescription opioid dependence in chronic pain patients.

Background: The last version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes substantial changes for prescription opioid-use disorder (POUD). After its removal as a criterion, the goal of this study was to estimate the prevalence of withdrawal symptoms in long-term users of prescription opioids and its association with the new DSM-5 POUD classification.

Methods: Data were collected from 215 long-term consumers of opioid medication who were chronic non-cancer pain patients.

Use and dependence on opioid drugs in the Spanish population with chronic pain: Prevalence and differences according to sex.

Objectives: To analyse the prevalence in the use and dependence on opioid drugs in the Spanish population with chronic pain and evaluate the differences according to sex.

Patients And Methods: The demographic variables, opioid treatment characteristics and use of other substances were assessed in 229 users of opioid drugs. A descriptive bivariate analysis of the data was performed.

[Sugammadex in a man with a transplanted kidney: a case report].

We report the use of sugammadex to reverse a rocuronium block in a man who had received a kidney transplant 4 years earlier. The patient was admitted for gastric non-Hodgkins lymphoma and bleeding that required surgery. Arterial hypertension, tachycardia, and frequent ventricular extrasystoles were detected.

[Spontaneous pneumothorax as the first sign of pulmonary carcinoma].

We report five cases of spontaneous pneumothorax as the first sign of pulmonary carcinoma. Initial tests did not detect neoplasms. Diagnosis took place during surgery for four patients and the fifth was diagnosed by preoperative computed tomography to assess pulmonary bullous emphysema.

[Diagnostic usefulness of the determination of serum neuron-specific enolase in small cell bronchial carcinoma].

The plasma level of neuron-specific enolase (NSE) was measured in 55 patients with small cell bronchial carcinoma (SCC) with cytohistological confirmation to evaluate its diagnostic usefulness. As a control group, 132 patients with non-small cell bronchial carcinoma, 81 with non-neoplastic disease and 37 healthy individuals were used. The sensitivity of the test was 84% with a specificity of 79% when values below 13 ng/mg were considered as normal.