The Other Opioid Crisis: Hospital Shortages Lead To Patient Pain, Medical Error

I came across this public-accesss story, and wanted to share the perspective: Pauline Bartolone, Kaiser Health News Even as opioids flood American communities and fuel widespread addiction, hospitals are facing a dangerous shortage of the powerful painkillers needed by patients in acute pain, according to doctors, pharmacists and a coalition of health groups. The shortage, though more significant in some places than others, has left many hospitals and surgical centers scrambling to find enough injectable morphine, Dilaudid and fentanyl — drugs given to patients undergoing surgery, fighting cancer or suffering traumatic injuries. The shortfall, which has intensified since last summer, was triggered by manufacturing setbacks and a government effort to reduce addiction by restricting drug production. As a result, hospital pharmacists are working long hours to find alternatives, forcing nurses to administer second-choice drugs or deliver standard drugs differently. That raises the risk of mistakes — and already has led to at least a few instances in which patients received potentially harmful doses, according to the nonprofit Institute for Safe Medication Practices, which works with health care providers to promote patient safety. In the institute’s survey of hospital pharmacists last year, one provider reported that a patient received five times the appropriate amount of morphine when a smaller-dose vial was out of stock. In another case, a patient was mistaken...
Source: Suboxone Talk Zone - Category: Addiction Authors: Tags: Acute Pain Anesthesia Public policy surgery Chronic pain opioid addiction Source Type: blogs

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Source: BMJ Comments - Category: General Medicine Source Type: forums
This study compares the effect of Helicobacter (H.) pylori and Lactobacillus (L.) acidophilus on the cytokine profile of PBMCs of 5 men with abdominal aortic aneurysm (AAA) and 5 men with normal/insignificant angiography, CT-Scan and ultrasonography results in the single-culture and in the co-culture with HUVECs. IL-2, IL-4, IL-5, IL-6, IL-9, IL-10, IL-13, IL-17A, IL-17 F, IL-21, IL-22, IFN-γ and TNF-α were measured in culture supernatants using a commercial fluorescent-labeled-bead assay.In general, CagA+ H. pylori-extract induced higher production of IFN-γ, IL-13 and IL-21 by PBMCs. Treatment of ...
Source: Comparative Immunology, Microbiology and Infectious Diseases - Category: Infectious Diseases Source Type: research
Authors: Ma Q, Shao Y, Chen W, Quan C, Zhu Y, Xu X, Zhou Z, Wang S Abstract Aim: To investigate whether cervical cancer (CC) and cervical intraepithelial neoplasia (CIN) can be screened by analyzing gene expression profiling of peripheral blood. Methods: RNA-sequencing analysis of blood was performed on 11 CC patients, 21 CIN patients and 19 healthy controls (H). Fifty-nine genes were validated by quantitative real-time PCR using blood samples from 46 H, 83 CC and 32 CIN patients. Results: There were significant differences in the expression levels of six genes between CC and H, five genes between CIN and H and fou...
Source: Future Medicine: Biomarkers in Medicine - Category: Internal Medicine Tags: Biomark Med Source Type: research
Authors: Deng Z, Wu J, Xu S, Chen F, Zhang Z, Jin A, Wang J Abstract Exosomes have appeared as fundamental vehicle-modulated crosstalk among various cells in the tumor microenvironment. The systematic understanding of exosomes in gastric cancer (GC) enhances our comprehension about the tumor growth, metastasis, chemoresistance and diagnosis of cancers. The versatile functions of exosomes provide reasonable explanations about the propensity for GC metastasis. The selectively enriched components, especially some exosomal miRNAs, are potential noninvasive biomarkers for sensitive and specific GC diagnosis. Given the c...
Source: Future Medicine: Biomarkers in Medicine - Category: Internal Medicine Tags: Biomark Med Source Type: research
This study aimed to quantitatively grasp the structure of support for balancing cancer treatment and work among occupational health nurses (OHNs) with the current implementation status. The anonymous questionnaire was designed based on the findings of our previous qualitative study and distributed to OHNs. The degrees of support implementation for workers with cancer, superiors and colleagues, and human resource managers were assessed for each item. Factor analysis of support items was conducted, and Wilcoxon signed-rank test was carried out to compare the support scores between the factors. Support for workers with cancer...
Source: Industrial Health - Category: Occupational Health Tags: Ind Health Source Type: research
Publication date: Available online 19 February 2020Source: Mechanisms of Ageing and DevelopmentAuthor(s): Cui Chen, Min Zhou, Yuchen Ge, Xiaobo WangAbstractAging is a biological phenomenon in which the structure and function of organisms declining with the increasing of age. It has become a major risk factor of human diseases, including diabetes, cancers, cardiovascular diseases and neurodegenerative diseases. Silencing information regulator 2 related enzyme 1(sirtuin1, SIRT1) is an NAD+-dependent deacetylase, which has been reported to be involved in the regulation of cellular senescence and aging. The expression of SIRT1...
Source: Mechanisms of Ageing and Development - Category: Geriatrics Source Type: research
AbstractBackgroundThe proportion of elderly patients undergoing surgery for gastric cancer is increasing. However, limited number of therapeutic outcomes in the elderly has been reported. Here we examined the surgical results based on a nationwide survey of elderly patients who underwent surgery for Stage I gastric cancer.MethodsData from 68,353 Stage I patients who underwent gastrectomy between 2001 and 2007 were retrospectively collected. The accumulated data were reviewed and analyzed by the Japanese Gastric Cancer Association registration committee. We first classified the patients as those aged  ≤ 74&...
Source: Gastric Cancer - Category: Gastroenterology Source Type: research
AbstractBackgroundLong non-coding RNAs (lncRNAs) have emerged as important roles in gastric cancer (GC). However, the role of the dysregulated lncRNAs in GC remained large unknown. We investigated the clinical significance, biological function and mechanism of CTC-497E21.4 in GC.MethodsFirstly, RTFQ-PCR was used to detect the expression of CTC-497E21.4 in GC. Furthermore, knockdown of CTC-497E21.4 was conducted to assess the effect of CTC-497E21.4 in vitro and vivo. Subcellular localization of CTC-497E21.4 was determined by nuclear plasmolysis PCR and FISH. We also predicted CTC-497E21.4 binding miRNAs and downstream targe...
Source: Gastric Cancer - Category: Gastroenterology Source Type: research
ConclusionsThese findings demonstrated that COL1A1-014 play an important regulatory role in GC development by functioning as a ceRNA in regulating the CXCL12/CXCR4 axis via sponging miR-1273h-5p.
Source: Gastric Cancer - Category: Gastroenterology Source Type: research
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