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Organize and mobilize for implementation effectiveness to improve overdose education and naloxone distribution from syringe services programs: a randomized controlled trial.
Implement Sci
February 2024
RTI International, 2150 Shattuck Avenue, 8Th Floor, Berkeley, CA, 94704, USA.
Background: The United States (US) continues to face decades-long increases in opioid overdose fatalities. As an opioid overdose reversal medication, naloxone can dramatically reduce opioid overdose mortality rates when distributed to people likely to experience or witness an opioid overdose and packaged with education on its use, known as overdose education and naloxone distribution (OEND). Syringe services programs (SSPs) are ideal venues for OEND with staff who are culturally competent in providing services for people who are at risk of experiencing or observing an opioid overdose.
View Article and Find Full Text PDFEffect of dalargin on apoptosis of l929 fibroblasts during cold stress.
Cryo Letters
February 2024
Institute for Problems of Cryobiology and Cryomedicine of National Academy of Sciences of Ukraine, 23, Pereyaslavska Str., Kharkiv 61016, Ukraine.
Background: The search for compounds that can prevent cold stress-attributed apoptosis is of immediate interest. In this regard, the use of neuropeptides, in particular synthetic leu-enkephalin, as protectors is promising, due to their ability to prevent the development of apoptosis under some stresses.
Objective: To study apoptotic phenomena after cold stress and to evaluate the protective effect of dalargin on these processes.
In this focused update, the American Heart Association provides updated guidance for resuscitation of patients with cardiac arrest, respiratory arrest, and refractory shock due to poisoning. Based on structured evidence reviews, guidelines are provided for the treatment of critical poisoning from benzodiazepines, β-adrenergic receptor antagonists (also known as β-blockers), L-type calcium channel antagonists (commonly called calcium channel blockers), cocaine, cyanide, digoxin and related cardiac glycosides, local anesthetics, methemoglobinemia, opioids, organophosphates and carbamates, sodium channel antagonists (also called sodium channel blockers), and sympathomimetics. Recommendations are also provided for the use of venoarterial extracorporeal membrane oxygenation.
View Article and Find Full Text PDFAdrenal Crisis Masked as Septic Shock in a Patient With Opioid Use Disorder on Buprenorphine.
Cureus
July 2023
Adolescent Medicine, Nationwide Children's Hospital, Columbus, USA.
Opioid-induced adrenal insufficiency is a known side effect of chronic opioid use, but opioid-induced adrenal insufficiency related to chronic buprenorphine-naloxone therapy is less well-known. We present a case of a patient with opioid use disorder on chronic buprenorphine-naloxone therapy admitted with presumed septic shock and found to be in an adrenal crisis. The patient presented to our hospital with a shock-like presentation, requiring vasopressors, intubation, empiric glucocorticoids, and antibiotics.
View Article and Find Full Text PDFA Peculiar Case of Fentanyl-Induced Cardiomyopathy.
Cureus
August 2022
Pulmonary and Critical Care Medicine, Mather Hospital at Northwell Health, Port Jefferson, USA.
An alarming rise in prescription and non-prescription misuse of opioids has been observed recently, leading to potentially devastating consequences. Opioid misuse contributes to cardiac risk burden and can cause diseases such as acute coronary syndrome, congestive heart failure, arrhythmias, QTc prolongation, and endocarditis. Here, we describe the case of a 35-year-old male with recreational fentanyl use who was found to have a cardiogenic shock on point-of-care ultrasound (POCUS), likely due to fentanyl-induced cardiomyopathy.
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