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  • March 4, 2012
  • 09:44 PM

Night Owls Get a Coffee Break

by Dirk Hanson in Addiction Inbox

“Morning people” have more caffeine-related sleep problems.

Let me start by saying that I love this caffeine study for personal reasons. As a lifelong night owl, I have been chastised by wife, family, and friends over the years for my regular habit of drinking coffee after 10 pm. (And falling easily asleep two or three hours later, if I choose to.) Other coffee drinkers have told me how rare and weird this is. If we have a cup, they tell me, or even an afternoon sip, we toss and turn all n........ Read more »

  • March 1, 2012
  • 01:03 PM

Placebo Power

by APS Daily Observations in Daily Observations

APS Fellow and Charter Member Irving Kirsch, associate director of the Placebo Studies Program at Harvard Medical School, says the difference between the effect of a placebo and the effect ... Read more »

  • February 20, 2012
  • 05:44 PM

Implanted Wireless Microchip offers Osteoporosis Drug Delivery that improves patient Quality of Life

by Pieter Droppert in Biotech Strategy Blog

Contrary to popular opinion, innovation is not dead in the biomedical industry, as evidenced by news of a novel drug-delivery system published as a Rapid Publication in Science Translational Medicine (STM) on February 16, 2012. The paper from Robert Farra of … Continue reading →... Read more »

Farra, R., Sheppard, N., McCabe, L., Neer, R., Anderson, J., Santini, J., Cima, M., & Langer, R. (2012) First-in-Human Testing of a Wirelessly Controlled Drug Delivery Microchip. Science Translational Medicine. DOI: 10.1126/scitranslmed.3003276  

  • February 20, 2012
  • 09:50 AM

Intramuscular Midazolam for Seizures – Part III

by Rogue Medic in Rogue Medic

This presents an interesting conundrum. Doses of benzodiazepines (midazolam, lorazepam, diazepam, . . .) are often limited, due to a fear of causing respiratory complications. When treating seizures, higher doses of benzodiazepines may protect patients from respiratory complications.... Read more »

Silbergleit, R., Durkalski, V., Lowenstein, D., Conwit, R., Pancioli, A., Palesch, Y., & Barsan, W. (2012) Intramuscular versus Intravenous Therapy for Prehospital Status Epilepticus. New England Journal of Medicine, 366(7), 591-600. DOI: 10.1056/NEJMoa1107494  

Alldredge BK, Gelb AM, Isaacs SM, Corry MD, Allen F, Ulrich S, Gottwald MD, O'Neil N, Neuhaus JM, Segal MR.... (2001) A comparison of lorazepam, diazepam, and placebo for the treatment of out-of-hospital status epilepticus. The New England journal of medicine, 345(9), 631-7. PMID: 11547716  

  • February 19, 2012
  • 07:30 AM

Intramuscular Midazolam for Seizures – Part II

by Rogue Medic in Rogue Medic

While there have been studies comparing IM (IntraMuscular) midazolam (Versed) with IV (IntraVenous) anti-epileptic medications, this is a large study that compares IM midazolam with the best IV anti-epileptic medication in a double-blind, randomized, noninferiority trial.

For the study, there were two different doses for the auto-injector (the same as an EpiPen). The doses were not small.

Midazolam for seizures is an off-label use both when given IM and when given IV.[2]

The lorazepa........ Read more »

Silbergleit, R., Durkalski, V., Lowenstein, D., Conwit, R., Pancioli, A., Palesch, Y., & Barsan, W. (2012) Intramuscular versus Intravenous Therapy for Prehospital Status Epilepticus. New England Journal of Medicine, 366(7), 591-600. DOI: 10.1056/NEJMoa1107494  

  • February 14, 2012
  • 12:18 AM

PROMETA™ Postmortem

by Dirk Hanson in Addiction Inbox

How the latest miracle cure for addiction failed to deliver.

PROMETA™: Last seen going down fast, smoke pouring from all engines.

As reported here at Addiction Inbox, a double-blind placebo-controlled evaluation of PROMETA™ by W. Ling and associates, published online last month in the journal Addiction, found that the much-publicized treatment protocol for meth addiction “appears to be no more effective than placebo in reducing methamphetamine use, retaining patients in treatment or red........ Read more »

  • February 9, 2012
  • 06:36 AM

Why parkin has scientists backing the future of Parkinson's research

by Andrew Watt in A Hippo on Campus

Back in the '80s the name Michael J. Fox was more or less interchangeable with that of Marty McFly, the effortlessly cool protagonist from the Back to the Future trilogy who introduced an entire generation of kids to hoverboards, self-lacing shoes and flux capacitors. Not to mention 'Johnny B Goode'. These days however Fox's name is more likely to have us thinking of his fight with Parkinson's disease, which he was diagnosed with back in 1991, or the advocacy work he does for his ........ Read more »

Obeso JA, Rodríguez-Oroz MC, Benitez-Temino B, Blesa FJ, Guridi J, Marin C, & Rodriguez M. (2008) Functional organization of the basal ganglia: therapeutic implications for Parkinson's disease. Movement disorders : official journal of the Movement Disorder Society. PMID: 18781672  

  • February 7, 2012
  • 05:00 AM

Thoughts on World Cancer Day: Part I–Unraveling Yuvraj Singh’s Cancer

by Pranab Chatterjee in Scepticemia

Sorry for missing the train on this one. February 4th is the World Cancer Day and is one of the public health days that could do with some more propaganda in the public eye. I was so caught up with work and studies it just passed me by and I could not even get the [...]... Read more »

  • February 2, 2012
  • 07:30 AM

This is the Way to Bad Medicine - II

by Rogue Medic in Rogue Medic

Their categorization of only 3 (out of 32) serious adverse events as "Probably related to treatment" and none as "Definitely related to treatment" suggests that they are not being objective. How do they explain this in the discussion? They don’t. Maybe they aren’t referring to the serious adverse events, but are referring to deaths. I don’t know and since they do not explain, I can only speculate.... Read more »

  • January 31, 2012
  • 07:15 PM

How antipsychotics cause side effects such as obesity and diabetes

by Sanford- Burnham in Beaker

Sanford-Burnham study suggests that many antipsychotics affect metabolism because they activate the TGFbeta pathway—a finding that could lead to safer therapeutics for bipolar disorder and schizophrenia patients.... Read more »

  • January 31, 2012
  • 12:20 PM

Reward and Punish: Say Hello to Dopamine’s Leetle Friend

by Dirk Hanson in Addiction Inbox

  Dopamine recruits a helper to track drug rewards.
Ah, dopamine. Whenever it seems like researchers have finally gotten a bead on how that tricky molecule modulates pleasure and reward, and the role in plays in the process of drug and alcohol addiction, along come new findings that rearrange its role, deepening and complicating our understanding of brain function.
We know that the ultimate site of dopamine activity caused by drugs is the ventral tegmental area, or VTA, and an associated ........ Read more »

  • January 29, 2012
  • 04:28 AM

2011 Orwellian Prize for Journalistic Misrepresentation

by Dorothy Bishop in bishopblog

The Orwellian Prize was set up to identify bad science journalism. The winner for 2011 contains a spectacular number of errors in reporting on a paper about cannabinoid receptors in rats.... Read more »

  • January 16, 2012
  • 11:06 AM

The Neuropsychology of Opioid Abuse

by William Yates, M.D. in Brain Posts

This is the last post in a series on prescription opioid abuse and dependence.   Prescription opioid overdose fatalities is a growing public health problem in the United States.  This problem varies by state of residence.  There are effective pharmacological strategies for the treatment of opioid dependence, but relapse rates are high.With this growing problem, an important clinical question is "What are the cognitive effects of chronic opioid use/abuse/dependence?".  One of ........ Read more »

Fernández-Serrano MJ, Pérez-García M, & Verdejo-García A. (2011) What are the specific vs. generalized effects of drugs of abuse on neuropsychological performance?. Neuroscience and biobehavioral reviews, 35(3), 377-406. PMID: 20451551  

  • January 15, 2012
  • 09:09 PM

Avoiding Lasting Pain With Administration of High Dosage Spurts of Morphine

by DJ Busby in Astronasty

This discovery, in a nutshell, can be found in the last sentence of the abstract:
"Opioids thus not only temporarily dampen pain but may also erase a spinal memory trace of pain."... Read more »

  • January 13, 2012
  • 10:56 AM

Suboxone Treatment for Prescription Opioid Abuse

by William Yates, M.D. in Brain Posts

Chemical Structures for Buprenorphine and NaloxoneIn three previous posts I have reviewed several aspects of prescription opioid abuse including posts on epidemiology, toxicology and clinical pathways to abuse.Given the growing numbers of individuals with prescription opioid abuse, safe and effective treatment options become increasingly important.Opioid withdrawal can be quite painful and often leads to resumption of opioid use.  Treatment of opioid withdrawal can include non-opioid drugs ........ Read more »

  • January 5, 2012
  • 02:29 PM

Pathways to Prescription Opioid Overdose

by William Yates, M.D. in Brain Posts

The majority of initial prescriptions for opioid analgesics in acute pain management occur without development of a pattern of misuse or abuse.However, in some individuals, opioid prescriptions produce a pathway for misuse, abuse and risk of opioid overdose death.  In two previous posts, I have outlined the epidemiology of opioid overdose death and the toxicology of these compounds.Risk factors for the development of prescription opioid drugs have not been extensively studied.  However........ Read more »

Paulozzi, L., Kilbourne, E., Shah, N., Nolte, K., Desai, H., Landen, M., Harvey, W., & Loring, L. (2011) A History of Being Prescribed Controlled Substances and Risk of Drug Overdose Death. Pain Medicine. DOI: 10.1111/j.1526-4637.2011.01260.x  

  • January 4, 2012
  • 03:20 PM

Nifekalant versus lidocaine for in-hospital shock-resistant ventricular fibrillation or tachycardia

by Rogue Medic in Rogue Medic

Why compare nikefelant with lidocaine? Why not compare nikefelant with amiodarone? Why not compare nikefelant with an antiarrhythmic that is more effective than amiodarone – procainamide, sotalol, or ajmaline?

Lidocaine is probably used because the IRB (Institutional Review Board) would consider it unethical to have a placebo group. Lidocaine is the placebo, but with less safety than the placebo.... Read more »

  • December 29, 2011
  • 11:02 AM

Beta blockers and genetic variation

by EE Giorgi in CHIMERAS

It's happening again.I'm sitting in a meeting, and suddenly I feel my hands prickling. My heart thumps faster. I can't concentrate on what people around me are saying. My head is buzzing, and cold sweat trickles down my neck. I feel the tingling of panic biting at the tip of my fingers. My muscles tense, adrenaline spikes. Every cell of my body screams, "Danger!"Now, part of me wants to take out my notebook and jot everything down for my next high-adrenaline, action-packed story.The other (more ........ Read more »

  • December 20, 2011
  • 01:45 PM

Antidepressant Effects in Healthy Brains

by William Yates, M.D. in Brain Posts

In a previous post I summarized some of what is known about the effect of antidepressants in healthy brains.  This issue is important because antidepressant drugs have indications outside of mood and anxiety disorders including peripheral neuropathy and migraine prophylaxis.  Additionally, understanding the effects of antidepressants in healthy brains may also provide insight into the brain mechanisms related to depression.A recent fMRI imaging study provides some additional insight in........ Read more »

  • December 15, 2011
  • 07:30 AM

Intraosseous Versus Intravenous Vascular Access During Out-of- Hospital Cardiac Arrest – A Randomized Controlled Trial

by Rogue Medic in Rogue Medic

For treatment of medical cardiac arrest patients, which is better – IO (IntraOsseous) or IV (IntraVenous) access for medication administration?

Since no medications have ever been demonstrated to improve survival from cardiac arrest (only chest compressions and defibrillation have), the most important consideration will be what method results in the least interruption of compressions and the least interference with defibrillation.... Read more »

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