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Diagnosis and Treatment of Presumed Naltrexone-XR-precipitated Opioid Withdrawal in a Patient Chronically Treated With Buprenorphine-XR: A Case Report.
J Addict Med
November 2024
From the Division of Addiction Medicine, Cooper University Healthcare, 1 Cooper Plaza, Camden, NJ (JM, KF, EE, XG, RE-D, MS); and Department of Emergency Medicine, Division of, Addiction Medicine, Temple University Hospital, Philadelphia, PA (JM).
Naltrexone, buprenorphine, and methadone are Food and Drug Administration-approved medications for the treatment of opioid use disorder in the United States. Naltrexone, an opioid antagonist, can precipitate opioid withdrawal if administered too quickly after the use of full or partial opioid agonists for those with either dependence or use disorder. We describe a case of severe precipitated opioid withdrawal syndrome after reported buprenorphine extended-release (XR) administration, despite the patient having been stable on buprenorphine-XR for several years, with no missed doses or recent opioid use.
View Article and Find Full Text PDFElasticity and rheology of auxetic granular metamaterials.
Proc Natl Acad Sci U S A
April 2024
Faculteit der Natuurwetenschappen, Wiskunde en Informatica, Institute of Physics, Universiteit van Amsterdam, Amsterdam 1098 XH, The Netherlands.
The flowing, jamming, and avalanche behavior of granular materials is satisfyingly universal and vexingly hard to tune: A granular flow is typically intermittent and will irremediably jam if too confined. Here, we show that granular metamaterials made from particles with a negative Poisson's ratio yield more easily and flow more smoothly than ordinary granular materials. We first create a collection of auxetic grains based on a re-entrant mechanism and show that each grain exhibits a negative Poisson's ratio regardless of the direction of compression.
View Article and Find Full Text PDFArtificial Urinary Sphincter With Bilateral Atrophic Kidneys and Accessory Renal Arteries in a Male Cadaveric Subject: A Case Report and Clinicopathological Reconciliation of Urinary Abnormalities and Embryogenetic Correlation of Vascular Aberrations.
Cureus
April 2023
Internal Medicine, Richmond Gabriel University College of Medicine, Belair, VCT.
A unique combination of triple abnormality in a willed male body donor dissection, with putative clinicopathological correlations during the subject's lifetime, is described in this case report. The subject had a three-piece artificial urinary sphincter surgically implanted around the proximal corpus spongiosum, left scrotal pouch and in the lower left abdominal wall, ostensibly for urinary incontinence during his lifetime, though the etiology of the latter was not immediately obvious. He also had a total of three accessory renal arteries involving both sides, complicated by bilateral diffuse renal atrophy from presumable glomerulosclerosis or nephrosclerosis-induced nephrotic syndrome.
View Article and Find Full Text PDFUnderstanding how the primary endpoint impacts the interpretation of trial results: The Japanese Adult Moyamoya bypass trial.
Neurochirurgie
March 2023
Department of radiology, service of neuroradiology, centre hospitalier de l'université de Montréal (CHUM), Montreal, Quebec, Canada. Electronic address:
Background: The meaning of a clinical trial depends to a large extent on the choice of the primary outcome measure, which can be explanatory or pragmatic.
Methods: We review the Japanese Adult Moyamoya (JAM) trial, that compared surgical extracranial to intracranial (EC-IC) bypass and medical management of hemorrhagic moyamoya disease. We also review some principles which guide the selection of the primary trial endpoint.
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