Holistic approach to opioid use disorder: Think nitric oxide!

Holistic approach to opioid use disorder: Think nitric oxide! J Opioid Manag. 2019 Nov/Dec;15(6):521-555 Authors: Sackner MA, Lopez JR, Banderas V, Adams JA Abstract This review deals with opioid addiction, chronic pain, and an innovative, noninvasive technology with simultaneous, beneficial applications for both conditions. This technology, called passive simulated jogging device (GENTLE JOGGER, JD) targets addiction and pain by increasing endothelial nitric oxide (NO) bioavailability. It can be self-administered while sitting or lying without resorting to multitasking thereby allowing watching television or operating a computer while effortless, physical activity is produced from motorized foot pedals repetitively striking a bumper at 175-190 times per minute which adds small pulses to the circulation. This action increases shear stress (friction) to vascular endothelium that stimulates endothelial nitric oxide synthase (eNOS) to increase NO that decreases oxidative stress and inflammation, and, slows accelerated vascular ageing associated with opioids. Since the 1970s, clonidine, lofexidine, and dexmedetomidine have been used offlabel to suppress opioid withdrawal symptoms precipitated by excessive release of norepinephrine. These pharmacotherapy aids to withdrawal and tapering opioid dosagadrenoceptor agonists that act through eNOS to inhibit norepinephrine. Increasing NO as with JD and/ or in conjunction with opioid agonists should help stabilization...
Source: Journal of Opioid Management - Category: Addiction Tags: J Opioid Manag Source Type: research

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We report a case of a young male with no prior genitourinary history who presents to an emergency department with sudden onset gross hematuria, clot retention, and right-sided flank pain. On evaluation, he was found to have a renal artery aneurysm bleeding into his collecting system and underwent renal artery embolization and rapid resolution of his hematuria. Renal vascular pathology should be considered in the differential diagnosis and timely diagnosis of this condition is imperative as surgical interventions have proven to be life-saving. PMID: 32065873 [PubMed - in process]
Source: Canadian Journal of Urology - Category: Urology & Nephrology Tags: Can J Urol Source Type: research
CONCLUSIONS: BTX-A treatment using either a trigone-sparing or trigone-including injection template resulted in significant, but not location-dependent, improvement in IC/BPS symptom scores at 30 and 90 day points post-procedure with no significant difference in post-treatment complication profiles. PMID: 32065870 [PubMed - in process]
Source: Canadian Journal of Urology - Category: Urology & Nephrology Tags: Can J Urol Source Type: research
ConclusionHistory of hearing amplification and current amplification predict cochlear implant qualification. Hearing aids fitted at the time of cochlear implantation evaluation may result in lower qualification rates.
Source: American Journal of Otolaryngology - Category: Endocrinology Source Type: research
CONCLUSION: Large variability exists in the definitions, methods of reporting, and analysis of PD-associated peritonitis across trials and observational studies. Standardizing definitions for reporting of peritonitis and associated outcomes will better enable assessment of the comparative effect of interventions on peritonitis. This will facilitate continuous quality improvement measures through reliable benchmarking of this patient-important outcome across centers and countries. PMID: 32063197 [PubMed - as supplied by publisher]
Source: Peritoneal Dialysis International - Category: Urology & Nephrology Tags: Perit Dial Int Source Type: research
CONCLUSIONS: Insertion-related complications leading to significant adverse events following laparoscopic placement of PD catheters are common. Many complications occur before the start of PD. Insertion-related complications are an important area of focus for future research and quality improvement efforts. PMID: 32063191 [PubMed - as supplied by publisher]
Source: Peritoneal Dialysis International - Category: Urology & Nephrology Tags: Perit Dial Int Source Type: research
Publication date: Available online 18 February 2020Source: Anaesthesia Critical Care &Pain MedicineAuthor(s): Alexandre Lannou, Cédric Carrié, Sébastien Rubin, Hugues De Courson, Matthieu Biais
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
Publication date: Available online 18 February 2020Source: Anaesthesia Critical Care &Pain MedicineAuthor(s): Mathieu Tourangeau, Issam Tanoubi, Roger Perron, Marie-Ève Bélanger, Komi Sodoké, Pierre Drolet, Arnaud Robitaille, Mihai Georgescu
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
In this study, 91 adolescents (10-24 years; 78 females) including 30 chronic pain patients with high pain-related distress, 29 chronic pain patients with low pain-related distress, and 32 healthy peers without chronic pain completed a developmentally appropriate T–S learning paradigm. We measured self-reported fear, psychophysiology (skin conductance response), and functional magnetic resonance imaging responses (N = 72 after functional magnetic resonance imaging exclusions). After controlling for age and anxiety symptoms, patients with high pain-related distress showed altered self-reported fear and frontolimbic act...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
This study provided no evidence for the hypothesis that chronic pain is associated with accelerated brain aging (Welch t test, P = 0.74, Cohen's d = 0.061). A Bayesian independent-samples t test indicated moderate evidence in favor of the null hypothesis (BF01 = 4.875, ie, group means were equal). Our results provide indirect support for recent models of pain-related changes of brain structure, brain function, and cognitive functions. These models postulate network-specific maladaptive plasticity, rather than widespread or global neural degeneration.
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
Drawing on advances in chronic pain metrics, a simplified Graded Chronic Pain Scale-Revised was developed to differentiate mild, bothersome, and high-impact chronic pain. Graded Chronic Pain Scale-Revised was validated among adult enrollees of 2 health plans (N = 2021). In this population, the prevalence of chronic pain (pain present most or every day, prior 3 months) was 40.5%: 15.4% with mild chronic pain (lower pain intensity and interference); 10.1% bothersome chronic pain (moderate to severe pain intensity with lower interference with life activities); and 15.0% high-impact chronic pain (sustained pain-related activit...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
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