Sample records for buprenorphine substitution treatment

  1. Methadone vs. buprenorphine\\/naloxone during early opioid substitution treatment: a naturalistic comparison of cognitive performance relative to healthy controls

    Microsoft Academic Search

    Pekka Rapeli; Carola Fabritius; Hannu Alho; Mikko Salaspuro; Kristian Wahlbeck; Hely Kalska

    2007-01-01

    BACKGROUND: Both methadone- and buprenorphine-treated opioid-dependent patients frequently show cognitive deficits in attention, working memory, and verbal memory. However, no study has compared these patient groups with each other during early opioid substitution treatment (OST). Therefore, we investigated attention, working memory, and verbal memory of opioid-dependent patients within six weeks after the introduction of OST in a naturalistic setting and

  2. Opioid substitution treatment with sublingual buprenorphine in Manipur and Nagaland in Northeast India: what has been established needs to be continued and expanded

    PubMed Central

    Kumar, M Suresh; Natale, Richard D; Langkham, B; Sharma, Charan; Kabi, Rachel; Mortimore, Gordon

    2009-01-01

    Manipur and Nagaland in northeast India report an antenatal HIV prevalence of > 1% and the current HIV prevalence among injecting drug users is 24% and 4.5% respectively. Through support from DFID's Challenge Fund, Emmanuel Hospital Association (EHA) established thirteen drop-in-centres across the two states to deliver opioid substitution treatment with sublingual buprenorphine for 1200 injecting drug users. Within a short span of time the treatment has been found to be attractive to the clients and currently 1248 injecting opioid users are receiving opioid substitution treatment. The project is acceptable to the drug users, the families, the communities, religious as well as the militant groups. The treatment centres operate all days of the week, have trained staff members, utilize standardized protocols and ensure a strict supervised delivery system to prevent illicit diversion of buprenorphine. The drug users receiving the substitution treatment are referred to HIV voluntary counselling and testing. As this treatment has the potential to change HIV related risk behaviours, what has been established in the two states needs to be continued and expanded with the support from the Government of India. PMID:19243636

  3. Buprenorphine: clinical pharmacokinetics in the treatment of opioid dependence.

    PubMed

    Elkader, Alexander; Sproule, Beth

    2005-01-01

    Buprenorphine is a semi-synthetic opioid derived from thebaine, a naturally occurring alkaloid of the opium poppy, Papaver somniferum. The pharmacology of buprenorphine is unique in that it is a partial agonist at the opioid mu receptor. Buprenorphine undergoes extensive first-pass metabolism and therefore has very low oral bioavailability; however, its bioavailability sublingually is extensive enough to make this a feasible route of administration for the treatment of opioid dependence. The mean time to maximum plasma concentration following sublingual administration is variable, ranging from 40 minutes to 3.5 hours. Buprenorphine has a large volume of distribution and is highly protein bound (96%). It is extensively metabolised by N-dealkylation to norbuprenorphine primarily through cytochrome P450 (CYP) 3A4. The terminal elimination half-life of buprenorphine is long and there is considerable variation in reported values (mean values ranging from 3 to 44 hours). Most of a dose of buprenorphine is eliminated in the faeces, with approximately 10-30% excreted in urine. Naloxone has been added to a sublingual formulation of buprenorphine to reduce the abuse liability of the product. The presence of naloxone does not appear to influence the pharmacokinetics of buprenorphine. Buprenorphine crosses the placenta during pregnancy and also crosses into breast milk. Buprenorphine dosage does not need to be significantly adjusted in patients with renal impairment; however, since CYP3A activity may be decreased in patients with severe chronic liver disease, it is possible that the metabolism of buprenorphine will be altered in these patients. Although there is limited evidence in the literature to date, drugs that are known to inhibit or induce CYP3A4 have the potential to diminish or enhance buprenorphine N-dealkylation. It appears that the interaction between buprenorphine and benzodiazepines is more likely to be a pharmacodynamic (additive or synergistic) than a pharmacokinetic interaction. The relationship between buprenorphine plasma concentration and response in the treatment of opioid dependence has not been well studied. The pharmacokinetic and pharmacodynamic properties of buprenorphine allow it to be a feasible option for substitution therapy in the treatment of opioid dependence. PMID:15966752

  4. Buprenorphine

    PubMed Central

    Valadez-Meltzer, Adela

    2005-01-01

    Opioid dependence is a significant and growing problem in the United States. For nearly a century, federal regulations have made it illegal for psychiatrists and other physicians to pharmacologically manage this condition in an office-based setting using opioids. The passage of the Drug Addiction Treatment Act of 2000 has made it possible for all physicians to prescribe buprenorphine to patients in such a setting. Buprenorphine, a partial mu-opoid receptor agonist, has unique pharmacologic properties that distinguish it from methadone and other medications used in the treatment of opioid dependence. It has been shown to be as effective as methadone and is generally safe and well-tolerated. It is available in two sublingual formulations: Subutex, which contains only buprenorphine, and Suboxone, which also contains naloxone. Physicians who wish to prescribe either must obtain a special waiver from the federal government and are currently limited to prescribing it for 30 patients at a time. PMID:21124750

  5. Effect of buprenorphine dose on treatment outcome.

    PubMed

    Fareed, Ayman; Vayalapalli, Sreedevi; Casarella, Jennifer; Drexler, Karen

    2012-01-01

    The goal of this meta-analysis is to provide evidence based information about proper dosing for buprenorphine maintenance treatment to improve treatment outcome. To be selected for the review and inclusion in the meta-analysis, articles had to be randomized, controlled, or double-blind clinical trials, with buprenorphine as the study drug; the length of buprenorphine maintenance treatment had to be 3 weeks or longer; doses of buprenorphine had to be clearly stated; outcome measures had to include retention rates in buprenorphine treatment; outcome measures had to include illicit opioid use based on analytical determination of drugs of abuse in urine samples as outcome variables; and outcome measures had to include illicit cocaine use based on analytical determination of drugs of abuse in urine samples as outcome variables. Twenty-nine articles were excluded because they did not meet the inclusion criteria. The authors present the results of 21 articles that met inclusion criteria. The higher buprenorphine dose (16-32 mg per day) predicted better retention in treatment compared with the lower dose (less than 16 mg per day) (P = .009, R(2) adjusted = 0.40), and the positive urine drug screens for opiates predicted dropping out of treatment (P = .019, R(2) Adjusted = 0.40). Retention in treatment predicted less illicit opioid use (P = .033, R(2) Adjusted = 0.36), and the positive urine drug screens for cocaine predicted more illicit opioid use (P = .021, R(2) Adjusted = 0.36). Strong evidence exists based on 21 randomized clinical trials that the higher buprenorphine dose may improve retention in buprenorphine maintenance treatment. PMID:22356665

  6. Medication-assisted treatment for opioid addiction: methadone and buprenorphine.

    PubMed

    Saxon, Andrew J; Hser, Yih-Ing; Woody, George; Ling, Walter

    2013-12-01

    Among agents for treatment of opioid addiction, methadone is a full mu-opioid receptor agonist, whereas buprenorphine is a partial agonist. Both are long-acting. Buprenorphine has a superior safety profile. Methadone is formulated for oral administration and buprenorphine for sublingual administration. A subdermal buprenorphine implant with a 6-month duration of action is being considered for approval by the U.S. Food and Drug Administration. Both medications reduce mortality rates and improve other outcomes. Data from a recent randomized controlled comparison of both medications (N = 1269) show better treatment retention with methadone but reduced illicit opioid use early in treatment with buprenorphine. Human immunodeficiency virus (HIV) risk behaviors were measured using the Risk Behavior Survey at baseline, 12 weeks, and 24 weeks for study completers. In the 30 days prior to treatment entry, 14.4% of the completers randomized to treatment with buprenorphine (n = 340) and 14.1% of the completers randomized to methadone treatment (n = 391) shared needles. The percent sharing needles decreased to 2.4% for buprenorphine and 4.8 for methadone in the 30 days prior to Week 24 (p < 0.0001). In the 30 days prior to treatment entry, 6.8% of the completers randomized to buprenorphine and 8.2% of the completers randomized to methadone had multiple sexual partners, with only 5.2% and 5.1%, respectively, reporting multiple partners at Week 24 (p < 0.04). PMID:24436573

  7. Emerging adult age status predicts poor buprenorphine treatment retention.

    PubMed

    Schuman-Olivier, Zev; Weiss, Roger D; Hoeppner, Bettina B; Borodovsky, Jacob; Albanese, Mark J

    2014-09-01

    Emerging adults (18-25 years old) are often poorly retained in substance use disorder treatment. Office-based buprenorphine often enhances treatment retention among people with opioid dependence. In this study, we examined the records of a collaborative care buprenorphine treatment program to compare the treatment retention rates of emerging adults versus older adults. Subjects were 294 adults, 71 (24%) aged 18-25, followed in treatment with buprenorphine, nurse care management, and an intensive outpatient program followed by weekly psychosocial treatment. Compared to older adults, emerging adults remained in treatment at a significantly lower rate at 3 months (56% versus 78%) and 12 months (17% versus 45%), and were significantly more likely to test positive for illicit opioids, relapse, or drop out of treatment. Further research into factors associated with buprenorphine treatment retention among emerging adults is needed to improve treatment and long-term outcomes in this group. PMID:24953168

  8. Hypogonadism in men receiving methadone and buprenorphine maintenance treatment.

    PubMed

    Hallinan, R; Byrne, A; Agho, K; McMahon, C G; Tynan, P; Attia, J

    2009-04-01

    The aim of this study was to determine the prevalence and investigate the aetiology of hypogonadism in men on methadone or buprenorphine maintenance treatment (MMT, BMT). 103 men (mean age 37.6 +/- 7.9) on MMT (n = 84) or BMT (n = 19) were evaluated using hormone assays, body mass index (BMI), serological, biochemical, demographic and substance use measures. Overall 54% of men (methadone 65%; buprenorphine 28%) had total testosterone (TT) <12.0 nm; 34% (methadone 39%; buprenorphine 11%) had TT <8.0 nm. Both methadone- and buprenorphine-treated men had lower free testosterone, luteinising hormone and estradiol than age-matched reference groups. Methadone-treated men had lower TT than buprenorphine-treated men and reference groups. Prolactin did not differ between methadone, buprenorphine groups, and reference groups. Primary testicular failure was an uncommon cause of hypogonadism. Yearly percentage fall in TT by age across the patient group was 2.3%, more than twice that expected normally. There were no associations between TT and opioid dose, cannabis, alcohol and tobacco consumption, or chronic hepatitis C viraemia. On multiple regression higher TT was associated with higher alanine aminotransferase and lower TT with higher BMI. Men on MMT have high prevalence of hypogonadotrophic hypogonadism. The extent of hormonal changes associated with buprenorphine needs to be explored further in larger studies. Men receiving long term opioid replacement treatment, especially methadone treatment, should be screened for hypogonadism. Wide interindividual differences in methadone metabolism and tolerance may in a cross-sectional study obscure a methadone dose relationship to testosterone in individuals. Future studies of hypogonadism in opioid-treated men should examine the potential benefits of dose reduction, choice of opioid medication, weight loss, and androgen replacement. PMID:17971165

  9. Effects of adding behavioral treatment to opioid detoxification with buprenorphine

    Microsoft Academic Search

    Warren K. Bickel; Leslie Amass; Stephen T. Higgins; Gary J. Badger; Rebecca A. Esch

    1997-01-01

    This trial assessed whether behavioral treatment improves outcome during a 26-week outpatient opioid detoxification. Thirty-nine opioid-dependent adults were assigned randomly to a buprenorphine dose-taper combined with either behavioral or standard treatment. Behavioral treatment included (a) a voucher incentive program for providing opioid-free urine samples and engaging in verifiable therapeutic activities and (b) the community reinforcement approach, a multicomponent behavioral treatment.

  10. Use of buprenorphine in the treatment of opiate addiction. I. Physiologic and behavioral effects during a rapid dose induction

    Microsoft Academic Search

    Rolley E Johnson; Edward J Cone; Jack E Henningfield; Paul J Fudala

    1989-01-01

    A new, rapid dose-induction procedure was used in the evaluation of buprenorphine hydrochloride (buprenorphine) as a treatment for opiate dependence. Nineteen heroin-dependent men were given buprenorphine sublingually in ascending daily doses of 2, 4, and 8 mg and then maintained on 8 mg daily. The observations of the transition from heroin to buprenorphine for the first 4 days are described.

  11. HIV Provider Endorsement of Primary Care Buprenorphine Treatment: A Vignette Study

    PubMed Central

    Kunins, Hillary V.; Sohler, Nancy L.; Roose, Robert J.; Cunningham, Chinazo O.

    2009-01-01

    Background and Objectives Opioid dependence is common among HIV-infected persons in the United States. Factors associated with HIV care providers recommending buprenorphine for opioid dependence are poorly defined. Using vignettes, we sought to identify HIV provider characteristics associated with endorsing buprenorphine treatment in primary care. Methods We used a cross-sectional survey of HIV providers, including 497 physicians, nurse practitioners, and physician assistants attending HIV educational conferences in 2006. Anonymous questionnaires distributed to conference attendees contained one of two vignettes depicting opioid-dependent patients. Respondents recommended type of substance abuse treatment for the vignette patient. Using logistic regression, we tested patient and provider factors associated with HIV provider endorsement of buprenorphine in primary care. Results Sixteen percent of providers endorsed buprenorphine treatment in primary care for vignette patients. Family physicians and general internists (AOR=2.8, CI=1.1–7.1), African American providers (AOR=3.0, CI=1.3–6.8), and those with previous buprenorphine prescribing experience (AOR=4.6, CI=1.2–17.9) were more likely to endorse buprenorphine treatment in primary care. Conclusions HIV providers infrequently endorsed buprenorphine treatment in primary care for vignette patients. Generalist and African American providers and those with previous buprenorphine prescribing experience are more likely to endorse buprenorphine treatment in primary care. Targeting generalist and minority providers may be one strategy to promote effective integration of HIV care and opioid addiction treatment. PMID:19882396

  12. Buprenorphine treatment of opioid dependence: clinical trial of daily versus alternate-day dosing

    Microsoft Academic Search

    Rolley E. Johnson; Thomas Eissenberg; Maxine L. Stitzer; Eric C. Strain; Ira A. Liebson; George E. Bigelow

    1995-01-01

    Buprenorphine, a mu-opioid partial agonist, has demonstrated efficacy for the treatment of opioid dependence comparable to that of methadone. The clinical utility of buprenorphine would be enhanced if it could be dosed on a less than daily basis. The current study is a parallel-group outpatient clinical trial of daily versus alternate-day dosing with 8 mg sublingual (s.l.) buprenorphine. Participants were

  13. Buprenorphine versus methadone in the treatment of opioid-dependent cocaine users

    Microsoft Academic Search

    Eric C. Strain; Maxine L. Stitzer; Ira A. Liebson; George E. Bigelow

    1994-01-01

    This study compared the efficacy of buprenorphine to methadone for decreasing cocaine use in patients with combined opioid and cocaine use. Participants (n=51) were enrolled in a 26-week treatment program and randomly assigned to either buprenorphine or methadone. Dosing was double-blind and double-dummy. Patients were stabilized on either 8 mg sublingual buprenorphine or 50 mg oral methadone, with dose increases

  14. The Physician Clinical Support System-Buprenorphine (PCSS-B): a Novel Project to Expand/Improve Buprenorphine Treatment

    PubMed Central

    Casadonte, Paul; Gartenmann, Tracy; Martin, Judith; McCance-Katz, Elinore F.; Netherland, Julie; Renner, John A.; Weiss, Linda; Saxon, Andrew J.; Fiellin, David A.

    2010-01-01

    ABSTRACT Opioid dependence is largely an undertreated medical condition in the United States. The introduction of buprenorphine has created the potential to expand access to and use of opioid agonist treatment in generalist settings. Physicians, however, often have limited training and experience providing this type of care. Some physicians believe having a mentoring relationship with an experienced provider during their initial introduction to the use of buprenorphine would ease implementation. Our goal was to describe the development, implementation, resources, and evaluation of the Physician Clinical Support System-Buprenorphine (PCSS-B), a federally funded program to improve access to and quality of treatment with buprenorphine. We provide a description of the PCSS-B, a national network of 88 trained physician mentors with expertise in buprenorphine treatment and skills in clinical education. We provide information regarding the use the PCSS-B core services including telephone, email and in-person support, a website, clinical guidances, a warmline and outreach to primary care and specialty organizations. Between July 2005 and July 2009, 67 mentors and 4 clinical experts reported providing mentoring services to 632 participants in 48 states, Washington DC and Puerto Rico. A total of 1,455 contacts were provided through email (45%), telephone (34%) and in-person visits (20%). Seventy-six percent of contacts addressed a clinical issue. Eighteen percent of contacts addressed a logistical issue. The number of contacts per participant ranged from 1–125. Between August 2005 and April 2009 there were 72,822 visits to the PCSS-B website with 179,678 pages viewed. Seven guidances were downloaded more than 1000 times. The warmline averaged more than 100 calls per month. The PCSS-B model provides support for a mentorship program to assist non-specialty physicians in the provision of buprenorphine and may serve as a model for dissemination of other types of care. PMID:20458550

  15. The Physician Clinical Support System-Buprenorphine (PCSS-B): a novel project to expand/improve buprenorphine treatment.

    PubMed

    Egan, James E; Casadonte, Paul; Gartenmann, Tracy; Martin, Judith; McCance-Katz, Elinore F; Netherland, Julie; Renner, John A; Weiss, Linda; Saxon, Andrew J; Fiellin, David A

    2010-09-01

    Opioid dependence is largely an undertreated medical condition in the United States. The introduction of buprenorphine has created the potential to expand access to and use of opioid agonist treatment in generalist settings. Physicians, however, often have limited training and experience providing this type of care. Some physicians believe having a mentoring relationship with an experienced provider during their initial introduction to the use of buprenorphine would ease implementation. Our goal was to describe the development, implementation, resources, and evaluation of the Physician Clinical Support System-Buprenorphine (PCSS-B), a federally funded program to improve access to and quality of treatment with buprenorphine. We provide a description of the PCSS-B, a national network of 88 trained physician mentors with expertise in buprenorphine treatment and skills in clinical education. We provide information regarding the use the PCSS-B core services including telephone, email and in-person support, a website, clinical guidances, a warmline and outreach to primary care and specialty organizations. Between July 2005 and July 2009, 67 mentors and 4 clinical experts reported providing mentoring services to 632 participants in 48 states, Washington DC and Puerto Rico. A total of 1,455 contacts were provided through email (45%), telephone (34%) and in-person visits (20%). Seventy-six percent of contacts addressed a clinical issue. Eighteen percent of contacts addressed a logistical issue. The number of contacts per participant ranged from 1-125. Between August 2005 and April 2009 there were 72,822 visits to the PCSS-B website with 179,678 pages viewed. Seven guidances were downloaded more than 1000 times. The warmline averaged more than 100 calls per month. The PCSS-B model provides support for a mentorship program to assist non-specialty physicians in the provision of buprenorphine and may serve as a model for dissemination of other types of care. PMID:20458550

  16. Bringing Buprenorphine-Naloxone Detoxification to Community Treatment Providers: The NIDA Clinical Trials Network Field Experience

    PubMed Central

    Amass, Leslie; Ling, Walter; Freese, Thomas E.; Reiber, Chris; Annon, Jeffrey J.; Cohen, Allan J.; M.F.T.; McCarty, Dennis; Reid, Malcolm S.; Brown, Lawrence S.; Clark, Cynthia; Ziedonis, Douglas M.; Krejci, Jonathan; Stine, Susan; Winhusen, Theresa; Brigham, Greg; Babcock, Dean; L.C.S.W.; Muir, Joan A.; Buchan, Betty J.; Horton, Terry

    2005-01-01

    In October 2002, the U.S. Food and Drug Administration approved buprenorphine-naloxone (Suboxone®) sublingual tablets as an opioid dependence treatment available for use outside traditionally licensed opioid treatment programs. The NIDA Center for Clinical Trials Network (CTN) sponsored two clinical trials assessing buprenorphine-naloxone for short-term opioid detoxification. These trials provided an unprecedented field test of its use in twelve diverse community-based treatment programs. Opioid-dependent men and women were randomized to a thirteen-day buprenorphine-naloxone taper regimen for short-term opioid detoxification. The 234 buprenorphine-naloxone patients averaged 37 years old and used mostly intravenous heroin. Direct and rapid induction onto buprenorphine-naloxone was safe and well tolerated. Most patients (83%) received 8 mg buprenorphine-2 mg naloxone on the first day and 90% successfully completed induction and reached a target dose of 16mg buprenorphine-4 mg naloxone in three days. Medication compliance and treatment engagement was high. An average of 81% of available doses was ingested, and 68% of patients completed the detoxification. Most (80.3%) patients received some ancillary medications with an average of 2.3 withdrawal symptoms treated. The safety profile of buprenorphine-naloxone was excellent. Of eighteen serious adverse events reported, only one was possibly related to buprenorphine-naloxone. All providers successfully integrated buprenorphine-naloxone into their existing treatment milieus. Overall, data from the CTN field experience suggest that buprenorphine-naloxone is practical and safe for use in diverse community treatment settings, including those with minimal experience providing opioid-based pharmacotherapy and/or medical detoxification for opioid dependence. PMID:15204675

  17. Evaluation of buprenorphine maintenance treatment in a French cohort of HIV-infected injecting drug users

    Microsoft Academic Search

    Maria-Patrizia Carrieri; D. Rey; A. Loundou; G. Lepeu; A. Sobel; Y. Obadia

    2003-01-01

    Background: Buprenorphine was approved in France for treating opiate dependence in July 1995 and can be prescribed by general practitioners (GPs). Most studies assessing buprenorphine maintenance treatment (BMT) outcomes have taken place in GP settings. An evaluation of BMT outcomes in patients already followed for their HIV-infection could supply additional information about the changes in addictive practices in a non-GP

  18. Buprenorphine: a controlled clinical trial in the treatment of opioid dependence

    Microsoft Academic Search

    Pier Paolo Pani; Icro Maremmani; Roberto Pirastu; Alessandro Tagliamonte; Gian Luigi Gessa

    2000-01-01

    Clinical trials carried out to compare methadone and buprenorphine in the treatment of opioid dependence have generally employed an alcoholic solution of buprenorphine, which has a bioavailability superior to that of the tablets. Since the product available for large scale use is in tablet form, one intended to verify the efficacy of this formulation. In a multicentre randomised controlled double

  19. A pilot study of buprenorphine-naloxone combination tablet (Suboxone 1) in treatment of opioid dependence

    Microsoft Academic Search

    JAMES BELL; GAYE BYRON; AMY GIBSON; AMANDA MORRIS

    In Australia, maintenance treatment for opioid dependence involves supervised daily administration of a dose of methadone or buprenorphine. A sublingual tablet combining buprenorphine and naloxone in a 4 : 1 ratio (Suboxone TM ) has been developed, designed to deter diversion and intravenous misuse, and may be suitable for unsupervised administration. The aim of this study was to investigate the

  20. Deaths involving buprenorphine: a compendium of French cases

    Microsoft Academic Search

    P. Kintz

    2001-01-01

    Buprenorphine at high dosage became available in France in 1996, as a substitution treatment for heroin addicts. Since this date, numerous deaths were attributed to this drug. This paper reports two original series of 39 and 78 fatalities involving buprenorphine observed at the Institute of Legal Medicine of Strasbourg and at 13 other French forensic centers, respectively. The files were

  1. A new series of 13 buprenorphine-related deaths

    Microsoft Academic Search

    Pascal Kintz

    2002-01-01

    Objectives: Buprenorphine at high dosage became available in France in 1996, as a substitution treatment for heroin addicts. Since this date, numerous deaths were attributed to this drug. This paper reports a new series of 13 fatalities involving buprenorphine observed at the Institute of Legal Medicine of Strasbourg, between August 2000 to October 2001.Design and methods: During the mentioned period,

  2. Clinical efficacy of buprenorphine: comparisons to methadone and placebo

    Microsoft Academic Search

    Walter Ling; Donald R Wesson

    2003-01-01

    Buprenorphine has been studied extensively since 1978 when it was initially proposed as an alternative to methadone for treatment of opioid dependence. Early work by Jasinski, Mello, Mendelson and their colleagues demonstrated buprenorphine's low physical abuse potential and its ability to substitute for heroin and reduce heroin self-administration in opiate-dependent humans. The subsequent early clinical studies suggested that, in clinical

  3. Drug Treatment Outcomes among HIV-Infected Opioid Dependent Patients Receiving Buprenorphine/naloxone

    PubMed Central

    Fiellin, David A.; Weiss, Linda; Botsko, Michael; Egan, James E; Altice, Frederick L.; Bazerman, Lauri B.; Chaudhry, Amina; Cunningham, Chinazo O.; Gourevitch, Marc N.; Lum, Paula J.; Sullivan, Lynn E.; Schottenfeld, Richard S.; O'Connor, Patrick G.

    2013-01-01

    Background Buprenorphine/naloxone allows the integration of opioid dependence and HIV treatment. Methods We conducted a prospective study in HIV-infected opioid dependent patients to investigate the impact of buprenorphine/naloxone treatment on drug use. Self-report and chart review assessments were conducted every 3 months (Quarters 1 through 4) for one year. Outcomes were buprenorphine/naloxone treatment retention, drug use, and addiction treatment processes. Results Among 303 patients enrolled between July 2005 and December 2007, retention in buprenorphine/naloxone treatment was 74%, 67%, 59% and 49% during Quarters 1,2 3, and 4, respectively. Past 30 day illicit opioid use decreased from 84% of patients at baseline to 42% in retained patients over the year. Patients were 52% less likely to use illicit opioids for each quarter in treatment (OR = .66; 95% CI 0.61–0.72). Buprenorphine/naloxone doses and office visits approximated guidelines published by the United States Department of Health and Human Services. Urine toxicology monitoring was less frequent than recommended. Conclusions Buprenorphine/naloxone provided in HIV treatment settings can decrease opioid use. Strategies are needed to improve retention and address ongoing drug use in this treatment population. PMID:21317592

  4. Bringing buprenorphine-naloxone detoxification to community treatment providers: the NIDA Clinical Trials Network field experience

    Microsoft Academic Search

    Leslie Amass; Walter Ling; Thomas E. Freese; Chris Reiber; Jeffrey J. Annon; Allan J. Cohen; Dennis McCarty; Malcolm S. Reid; Lawrence S. Brown; Cynthia Clark; Douglas M. Ziedonis; Jonathan Krejci; Susan Stine; Theresa Winhusen; Greg Brigham; Dean Babcock; Joan A. Muir; Betty J. Buchan; Terry Horton

    2004-01-01

    In October 2002, the U.S. Food and Drug Administration approved buprenorphine-naloxone (Suboxone) sublingual tablets as an opioid dependence treatment available for use outside traditionally licensed opioid treatment programs. The NIDA Center for Clinical Trials Network (CTN) sponsored two clinical trials assessing buprenorphine-naloxone for short-term opioid detoxification. These trials provided an unprecedented field test of its use in twelve diverse community-based

  5. Consensus statement on office-based treatment of opioid dependence using buprenorphine

    Microsoft Academic Search

    David A. Fiellin; Herbert Kleber; Jeanne G. Trumble-Hejduk; A. Thomas McLellan; Thomas R. Kosten

    2004-01-01

    Buprenorphine and buprenorphine\\/naloxone (BUP) are newly approved for office-based treatment of opioid dependence. Federal and non-federal regulatory and monitoring agencies, national and international researchers, national professional organizations, researchers involved in monitoring, opioid treatment programs and the pharmaceutical industry met to synthesize and disseminate practical information to guide training, practice, monitoring, regulation and evaluation efforts with these medications. We performed a

  6. Impact of Research Network Participation on the Adoption of Buprenorphine for Substance Abuse Treatment

    PubMed Central

    Rieckmann, Traci R.; Abraham, Amanda J.; Kovas, Anne E.; McFarland, Bentson H.; Roman, Paul M.

    2014-01-01

    There is a growing body of research supporting the use of buprenorphine and other medication assisted treatments (MATs) for the rapidly accelerating opioid epidemic in the United States. Despite numerous advantages of buprenorphine (accessible in primary care, no daily dosing required, minimal stigma), implementation has been slow. As the field progresses, there is a need to understand the impact of participation in practitioner-scientist research networks on acceptance and uptake of buprenorphine. This paper examines the impact of research network participation on counselor attitudes toward buprenorphine addressing both counselor-level characteristics and program-level variables using hierarchical linear modeling (HLM) to account for nesting of counselors within treatment programs. Using data from the National Treatment Center Study, this project compares privately funded treatment programs (n=345) versus programs affiliated with the National Institute on Drug Abuse Clinical Trials Network (CTN) (n=198). Models included 922 counselors in 172 CTN programs and 1,203 counselors in 251 private programs. Results of two-level HLM logistic (Bernoulli) models revealed that counselors with higher levels of education, larger caseloads, more buprenorphine-specific training, and less preference for 12-step treatment models were more likely to perceive buprenorphine as acceptable and effective. Furthermore, buprenorphine was 50% more likely to be perceived as effective among counselors working in CTN-affiliated programs as compared to private programs. This study suggests that research network affiliation positively impacts counselors’ acceptance and perceptions of buprenorphine. Thus, research network participation can be utilized as a means to promote positive attitudes toward the implementation of innovations including medication assisted treatment. PMID:24594902

  7. Impact of research network participation on the adoption of buprenorphine for substance abuse treatment.

    PubMed

    Rieckmann, Traci R; Abraham, Amanda J; Kovas, Anne E; McFarland, Bentson H; Roman, Paul M

    2014-05-01

    There is a growing body of research supporting the use of buprenorphine and other medication assisted treatments (MATs) for the rapidly accelerating opioid epidemic in the United States. Despite numerous advantages of buprenorphine (accessible in primary care, no daily dosing required, minimal stigma), implementation has been slow. As the field progresses, there is a need to understand the impact of participation in practitioner-scientist research networks on acceptance and uptake of buprenorphine. This paper examines the impact of research network participation on counselor attitudes toward buprenorphine addressing both counselor-level characteristics and program-level variables using hierarchical linear modeling (HLM) to account for nesting of counselors within treatment programs. Using data from the National Treatment Center Study, this project compares privately funded treatment programs (N=345) versus programs affiliated with the National Institute on Drug Abuse Clinical Trials Network (CTN) (N=198). Models included 922 counselors in 172 CTN programs and 1203 counselors in 251 private programs. Results of two-level HLM logistic (Bernoulli) models revealed that counselors with higher levels of education, larger caseloads, more buprenorphine-specific training, and less preference for 12-step treatment models were more likely to perceive buprenorphine as acceptable and effective. Furthermore, buprenorphine was 50% more likely to be perceived as effective among counselors working in CTN-affiliated programs as compared to private programs. This study suggests that research network affiliation positively impacts counselors' acceptance and perceptions of buprenorphine. Thus, research network participation can be utilized as a means to promote positive attitudes toward the implementation of innovations including medication assisted treatment. PMID:24594902

  8. Adoption of evidence-based clinical innovations: the case of buprenorphine use by opioid treatment programs.

    PubMed

    Andrews, Christina M; D'Aunno, Thomas A; Pollack, Harold A; Friedmann, Peter D

    2014-02-01

    This article examines changes from 2005 to 2011 in the use of an evidence-based clinical innovation, buprenorphine use, among a nationally representative sample of opioid treatment programs and identifies characteristics associated with its adoption. We apply a model of the adoption of clinical innovations that focuses on the work needs and characteristics of staff; organizations' technical and social support for the innovation; local market dynamics and competition; and state policies governing the innovation. Results indicate that buprenorphine use increased 24% for detoxification and 47% for maintenance therapy between 2005 and 2011. Buprenorphine use was positively related to reliance on private insurance and availability of state subsidies to cover its cost and inversely related to the percentage of clients who injected opiates, county size, and local availability of methadone. The results indicate that financial incentives and market factors play important roles in opioid treatment programs' decisions to adopt evidence-based clinical innovations such as buprenorphine use. PMID:24051897

  9. Adoption of Evidence-Based Clinical Innovations: The Case of Buprenorphine Use by Opioid Treatment Programs

    PubMed Central

    Andrews, Christina M.; D’Aunno, Thomas A.; Pollack, Harold A.; Friedmann, Peter D.

    2015-01-01

    This article examines changes from 2005 to 2011 in the use of an evidence-based clinical innovation, buprenorphine use, among a nationally representative sample of opioid treatment programs and identifies characteristics associated with its adoption. We apply a model of the adoption of clinical innovations that focuses on the work needs and characteristics of staff; organizations’ technical and social support for the innovation; local market dynamics and competition; and state policies governing the innovation. Results indicate that buprenorphine use increased 24% for detoxification and 47% for maintenance therapy between 2005 and 2011. Buprenorphine use was positively related to reliance on private insurance and availability of state subsidies to cover its cost and inversely related to the percentage of clients who injected opiates, county size, and local availability of methadone. The results indicate that financial incentives and market factors play important roles in opioid treatment programs’ decisions to adopt evidence-based clinical innovations such as buprenorphine use. PMID:24051897

  10. Preference for buprenorphine\\/naloxone and buprenorphine among patients receiving buprenorphine maintenance therapy in France: A prospective, multicenter study

    Microsoft Academic Search

    Jean-Pierre Daulouède; Yves Caer; Pascal Galland; Pierre Villeger; Emmanuel Brunelle; Jérôme Bachellier; Jean-Michel Piquet; Jean Harbonnier; Yves Leglise; Pascal Courty

    2010-01-01

    Maintenance treatment with buprenorphine tablets (Subutex) has been associated with reductions in heroin use; however, concerns for intravenous misuse exist. A buprenorphine\\/naloxone formulation (Suboxone) was designed to reduce this misuse risk while retaining buprenorphine's efficacy and safety. This prospective, open-label, multicenter trial compared preferences for buprenorphine and buprenorphine\\/naloxone in 53 opioid-dependent patients stabilized on buprenorphine. Buprenorphine was first administered at

  11. Adjunctive Counseling During Brief and Extended Buprenorphine-Naloxone Treatment for Prescription Opioid Dependence

    PubMed Central

    Weiss, Roger D.; Potter, Jennifer Sharpe; Fiellin, David A.; Byrne, Marilyn; Connery, Hilary S.; Dickinson, William; Gardin, John; Griffin, Margaret L.; Gourevitch, Marc N.; Haller, Deborah L.; Hasson, Albert L.; Huang, Zhen; Jacobs, Petra; Kosinski, Andrzej S.; Lindblad, Robert; McCance-Katz, Elinore F.; Provost, Scott E.; Selzer, Jeffrey; Somoza, Eugene C.; Sonne, Susan C.; Ling, Walter

    2012-01-01

    Context No randomized trials have examined treatments for prescription opioid dependence, despite its increasing prevalence. Objective To evaluate the efficacy of brief and extended buprenorphine-naloxone treatment, with different counseling intensities, for patients dependent upon prescription opioids. Setting, Participants 653 treatment-seeking outpatients dependent on prescription opioids, at 10 U.S. sites from June 2006-July 2009. Design Multi-site, randomized clinical trial, using a two-phase adaptive treatment research design. Brief treatment (Phase 1) included 2-week buprenorphine-naloxone stabilization, 2-week taper, and 8-week post-medication follow-up. Patients with successful opioid use outcomes exited the study; unsuccessful patients entered Phase 2: extended (12-week) buprenorphine-naloxone treatment, 4-week taper, and 8-week post-medication follow-up. Main outcome measures Pre-defined “successful outcome” in each phase: composite measures indicating minimal or no opioid use, based on urine-confirmed self-reports. Interventions In both phases, patients were randomized to Standard Medical Management (SMM) or SMM+Opioid Drug Counseling (ODC); all received buprenorphine-naloxone. Results During Phase 1, only 6.6% (43/653) of patients had successful outcomes, with no difference between the SMM and SMM+ODC. In contrast, 49.2% (177/360) attained successful outcomes in Phase 2 during extended buprenorphine-naloxone treatment (week 12), with no difference between counseling conditions. Success rates 8 weeks after completing the buprenorphine-naloxone taper (Phase 2, week 24) dropped sharply to 8.6% (31/360), again with no counseling difference. In secondary analyses, successful Phase 2 outcomes were far more common while taking buprenorphine-naloxone than 8 weeks post-taper (49.2% (177/360) vs. 8.6% (31/360), p<0.001). Chronic pain did not affect opioid use outcomes; a history of ever using heroin was associated with lower Phase 2 success rates while taking buprenorphine-naloxone. Conclusions Prescription opioid-dependent patients are most likely to reduce opioid use during buprenorphine-naloxone treatment; if tapered off buprenorphine-naloxone, even after 12 weeks of treatment, the likelihood of unsuccessful outcome is extremely high, even among patients receiving counseling in addition to medical management. Trial Registration ClinicalTrials.gov number NCT00316277 PMID:22065255

  12. Facts about Buprenorphine for Treatment of Opioid Addiction

    MedlinePLUS

    ... or change to every other day. The main advantages of buprenorphine are: • You are unlikely to overdose ... Drink more water and juice. Eat food with fiber. Exercise more. Sweating—Shower often. Dress in layers. ...

  13. Changes in Quality of Life following Buprenorphine Treatment: Relationship with Treatment Retention and Illicit Opioid Use.

    PubMed

    Mitchell, Shannon Gwin; Gryczynski, Jan; Schwartz, Robert P; Myers, C Patrick; O'Grady, Kevin E; Olsen, Yngvild K; Jaffe, Jerome H

    2015-01-01

    Studies of substance abuse treatment outcomes that give priority to cessation of all drug use may obscure other tangible benefits of treatment that are important to patients. The aim of this study was to examine the association between changes in quality of life (QoL) and: (1) retention in treatment; and (2) opioid use as measured by self-report and urine testing. Participants were 300 African American men and women starting outpatient buprenorphine treatment. Participants completed assessments at baseline, three and six months consisting of the World Health Organization's Quality of Life brief scale, Addiction Severity Index, and urine testing for opioids. There were statistically significant increases over time across all four QoL domains: physical, psychological, environmental, and social. Self-reported frequency of opioid use was negatively associated with psychological QoL, but opioid urine test results were not significantly associated with any QoL domains. Continued treatment enrollment was significantly associated with higher psychological QoL and environmental QoL. Patients entering buprenorphine treatment experience improvements in QoL, which are amplified for patients who remain in treatment. Point-prevalence opiate urine test results obtained at each assessment were not associated with any of the QoL domains and may not accurately reflect improvements perceived by patients receiving buprenorphine treatment. PMID:25950595

  14. Changes in Quality of Life following Buprenorphine Treatment: Relationship with Treatment Retention and Illicit Opioid Use

    PubMed Central

    Mitchell, Shannon Gwin; Gryczynski, Jan; Schwartz, Robert P.; Myers, C. Patrick; O’Grady, Kevin E.; Olsen, Yngvild K.; Jaffe, Jerome H.

    2015-01-01

    Studies of substance abuse treatment outcomes that give priority to cessation of all drug use may obscure other tangible benefits of treatment that are important to patients. The aim of this study was to examine the association between changes in quality of life (QoL) and: (a) retention in treatment and (b) opioid use as measured by self-report and urine testing. Participants were 300 African American men and women starting outpatient buprenorphine treatment. Participants completed assessments at baseline, 3- and 6-months consisting of the World Health Organization’s Quality of Life brief scale, Addiction Severity Index, and urine testing for opioids. There were statistically significant increases over time across all four QoL domains: physical, psychological, environmental, and social. Self-reported frequency of opioid use was negatively associated with psychological QoL, but opioid urine test results were not significantly associated with any QoL domains. Continued treatment enrollment was significantly associated with higher psychological QoL and environmental QoL. Patients entering buprenorphine treatment experience improvements in QoL, which are amplified for patients who remain in treatment. Point-prevalence opiate urine test results obtained at each assessment were not associated with any of the QoL domains and may not accurately reflect improvements perceived by patients receiving buprenorphine treatment. PMID:25950595

  15. Practice Guidance for Buprenorphine for the Treatment of Opioid Use Disorders: Results of an Expert Panel Process

    PubMed Central

    Farmer, Carrie M.; Lindsay, Dawn; Williams, Jessica; Ayers, Amanda; Schuster, James; Cilia, Alyssa; Flaherty, Michael T.; Mandell, Todd; Gordon, Adam J.; Stein, Bradley D.

    2015-01-01

    Background Although numbers of physicians credentialed to prescribe buprenorphine has increased over time, many credentialed physicians may be reluctant to treat individuals with opioid use disorders due to discomfort with prescribing buprenorphine. Though prescribing physicians are required to complete a training course, many have questions about buprenorphine and treatment guidelines have not been updated to reflect clinical experience in recent years. We report on an expert panel process to update and expand buprenorphine guidelines. Methods We identified candidate guidelines through expert opinion and a review of the literature and used a modified RAND/UCLA Appropriateness Method to assess the validity of the candidate guidelines. An expert panel completed two rounds of rating, with a meeting to discuss the guidelines between the first and second rating. Results Through the rating process, expert panel members rated 90 candidate guideline statements across eight domains, including candidacy for buprenorphine treatment, dosing of buprenorphine, psychosocial counseling, and treatment of co-occurring depression and anxiety. A total of 65 guideline statements (72%) were rated as valid. Expert panel members had agreement in some areas, such as the treatment of co-occurring mental health problems, but disagreement in others, including the appropriate dosing of buprenorphine given patient complexities. Conclusions Through an expert panel process, we developed an updated and expanded set of buprenorphine treatment guidelines; this additional guidance may increase credentialed physicians’ comfort with prescribing buprenorphine to patients with opioid use disorders. Future efforts should focus on appropriate dosing guidance and ensuring that guidelines can be adapted to a variety of practice settings. PMID:25844527

  16. Failure to identify or effectively manage prescription opioid dependence acted as a gateway to heroin use-buprenorphine/naloxone treatment and recovery in a surgical patient.

    PubMed

    Conroy, Stephen; Hill, Duncan

    2014-01-01

    The prescribing of opioid pain medication has increased markedly in recent years, with strong opioid dispensing increasing 18-fold in Tayside, Scotland since 1995. Despite this, little data is available to quantify the problem of opioid pain medication dependence (OPD) and until recently there was little guidance on best-practice treatment. We report the case of a young mother prescribed dihydrocodeine for postoperative pain relief who became opioid dependent. When her prescription was stopped without support, she briefly used heroin to overcome her withdrawal. After re-exposure to dihydrocodeine following surgery 9 years later and treatment with methadone for dependency, she was transferred to buprenorphine/naloxone. In our clinical experience and in agreement with Department of Health and Royal College of General Practitioner guidance, buprenorphine/naloxone is the preferred opioid substitution treatment for OPD. Our patient remains within her treatment programme and has returned to work on buprenorphine 16 mg/naloxone 4 mg in conjunction with social and psychological support. PMID:25519865

  17. Buprenorphine: Considerations for Pain Management

    Microsoft Academic Search

    Rolley E. Johnson; Paul J. Fudala; Richard Payne

    2005-01-01

    New effective analgesics are needed for the treatment of pain. Buprenorphine, a partial mu-opioid agonist which has been in clinical use for over 25 years, has been found to be amenable to new formulation technology based on its physiochemical and pharmacological profile. Buprenorphine is marketed as parenteral, sublingual, and transdermal formulations. Unlike full mu-opioid agonists, at higher doses, buprenorphine's physiological

  18. Suboxone® (Buprenorphine\\/Naloxone) as an Agonist Opioid Treatment in Spain: A Budgetary Impact Analysis

    Microsoft Academic Search

    José Martínez-Raga; Francisco González Saiz; César Pascual; Miguel A. Casado; Francisco J. Sabater Torres

    2010-01-01

    Objective: To evaluate the economic impact of buprenorphine\\/naloxone (B\\/N) as an agonist opioid treatment for opiate dependence. Methods: A budgetary impact analysis model was designed to calculate the annual costs (drugs and associated costs) to the Spanish National Healthcare System of methadone versus B\\/N. Data for the model were obtained from official databases and expert panel opinion. Results: It was

  19. A placebo controlled clinical trial of buprenorphine as a treatment for opioid dependence

    Microsoft Academic Search

    Rolley E. Johnson; Thomas Eissenberg; Maxine L. Stitzer; Eric C. Strain; Ira A. Liebson; George E. Bigelow

    1995-01-01

    Large-scale placebo controlled clinical trials assessing the efficacy of medications for the treatment of drug dependence have generally been limited to alcohol, cocaine and nicotine dependent populations. The purpose of the present study was to assess the early (1–2 week) clinical effectiveness of buprenorphine versus placebo in an opioid dependent population. The study used a parallel-group design with a behavioral

  20. Brief Buprenorphine Detoxification for the Treatment of Prescription Opioid Dependence: A Pilot Study

    PubMed Central

    Sigmon, Stacey C.; Dunn, Kelly E.; Badger, Gary J.; Heil, Sarah H.; Higgins, Stephen T.

    2009-01-01

    We examined the feasibility of brief outpatient detoxification as a treatment for prescription opioid (PO) abusers. Fifteen PO-dependent adults were enrolled to receive buprenorphine stabilization, a 2-week buprenorphine taper, and subsequent naltrexone for those who completed the taper. Subjects also received behavioral therapy, urinalysis monitoring, and double-blind drug administration. Subjects provided 83.8%, 91.7% and 31.2% opioid-negative samples during stabilization, taper and naltrexone phases, respectively. Inspection of individual subject data revealed systematic differences in whether subjects successfully completed the taper without resumption of illicit opioid use. Post-hoc analyses were used to examine the characteristics of subjects who successfully completed the taper (Responders, n=5) versus those who failed to do so (Nonresponders, n=9). These pilot data suggest a subset of PO abusers may respond to brief buprenorphine detoxification, though future efforts should aim to improve outcomes, investigate individual differences in treatment response and identify characteristics that may predict those for whom longer-term agonist treatment is warranted. PMID:19081679

  1. The relative risk of fatal poisoning by methadone or buprenorphine within the wider population of England and Wales

    PubMed Central

    Marteau, Dave

    2015-01-01

    Objective To examine the population-wide overdose risk emerging from the prescription of methadone and buprenorphine for opioid substitution treatment in England and Wales. Design Retrospective administrative data study. Setting National databases for England and Wales. Participants/cases Drug-related mortality data were drawn from the Office for National Statistics, and prescription data for methadone and buprenorphine were obtained from the National Health Service for the years 2007–2012. During this 6-year period, a total of 2366 methadone-related deaths and 52 buprenorphine-related deaths were registered, corresponding to 17?333?163 methadone and 2?602?374 buprenorphine prescriptions issued. The analysis encompassed poisoning deaths among members of the wider population of England and Wales who consumed, but were not prescribed these medications, in addition to patients prescribed methadone or buprenorphine. Main outcome measures Mortality risk: substance-specific overdose rate per 1000 prescriptions issued; relative risk ratio of methadone in relation to buprenorphine. Results During the years 2007–2012, the pooled overdose death rate was 0.137/1000 prescriptions of methadone, compared to 0.022/1000 prescriptions of buprenorphine (including buprenorphine-naloxone). The analysis generated a relative risk ratio of 6.23 (95% CI 4.79 to 8.10) of methadone in relation to buprenorphine. UK Borders Agency data were taken into consideration and revealed that only negligible amounts of methadone and buprenorphine were seized on entering UK territory between 2007 and 2012, suggesting domestic diversion. Conclusions Our analysis of the relative safety of buprenorphine and methadone for opioid substitution treatment reveals that buprenorphine is six times safer than methadone with regard to overdose risk among the general population. Clinicians should be aware of the increased risk of prescribing methadone, and tighter regulations are needed to prevent its diversion. PMID:26024998

  2. Effects of buprenorphine versus buprenorphine\\/naloxone tablets in non-dependent opioid abusers

    Microsoft Academic Search

    Eric C. Strain; Kenneth Stoller; Sharon L. Walsh; George E. Bigelow

    2000-01-01

    Rationale: Buprenorphine is an opioid agonist-antagonist under development in the United States as a sublingual medication for treatment\\u000a of opioid dependence. Buprenorphine may be abused; therefore, tablets combining buprenorphine with naloxone have been developed\\u000a with the intent of reducing the abuse risk in people physically dependent upon opioids. The characteristics and abuse potential\\u000a of buprenorphine and buprenorphine\\/naloxone tablets in non-dependent

  3. Buprenorphine kinetics

    Microsoft Academic Search

    Roy E S Bullingham; Henry J McQuay; Andrew Moore; Martin R D Bennett

    1980-01-01

    Buprenorphine kinetics was determined in surgical patients using radioimmunoassay. Buprenorphine was measured in the plasma of 24 patients who had received 0.3 mg buprenorphine intraoperatively. After 3 hr 10 of these patients then received a further 0.3 mg buprenorphine intravenously for postoperative pain relief, and 11 patients were given 0.3 mg intramuscularly: again, plasma levels were measured for 3 hr.

  4. Buprenorphine treatment of pregnant opioid-dependent women: maternal and neonatal outcomes

    Microsoft Academic Search

    Rolley E Johnson; Hendrée E Jones; Donald R Jasinski; Dace S Svikis; Nancy A Haug; Lauren M Jansson; Wendy B Kissin; Gad Alpan; Michael E Lantz; Edward J Cone; Diana G Wilkins; Archie S Golden; George R Huggins; Barry M Lester

    2001-01-01

    This open-label prospective study examined maternal and neonatal safety and efficacy outcome measures during and following prenatal buprenorphine exposure. Three opioid-dependent pregnant women received 8 or 12 mg sublingual buprenorphine tablets daily for 15–16 weeks prior to delivery. Results showed that buprenorphine in combination with comprehensive prenatal care was safe and effective in these women. Prenatal exposure to buprenorphine resulted

  5. Growth In Buprenorphine Waivers For Physicians Increased Potential Access To Opioid Agonist Treatment, 2002-11.

    PubMed

    Dick, Andrew W; Pacula, Rosalie L; Gordon, Adam J; Sorbero, Mark; Burns, Rachel M; Leslie, Douglas; Stein, Bradley D

    2015-06-01

    Opioid use disorders are a significant public health problem, affecting two million people in the United States. Treatment with buprenorphine, methadone, or both is predominantly offered in methadone clinics, yet many people do not receive the treatment they need. In 2002 the Food and Drug Administration approved buprenorphine for prescription by physicians who completed a course and received a waiver from the Drug Enforcement Administration, exempting them from requirements in the Controlled Substances Act. To determine the waiver program's impact on the availability of opioid agonist treatment, we analyzed data for the period 2002-11 to identify counties with opioid treatment shortages. We found that the percentage of counties with a shortage of waivered physicians fell sharply, from 98.9 percent in 2002 to 46.8 percent in 2011. As a result, the percentage of the US population residing in what we classified as opioid treatment shortage counties declined from 48.6 percent in 2002 to 10.4 percent in 2011. These findings suggest that the increase in waivered physicians has dramatically increased potential access to opioid agonist treatment. Policy makers should focus their efforts on further increasing the number and geographical distribution of physicians, particularly in more rural counties, where prescription opioid misuse is rapidly growing. PMID:26056209

  6. Transdermal buprenorphine in the treatment of chronic pain: Resultsof a phase III, multicenter, randomized, double-blind, placebo-controlled study

    Microsoft Academic Search

    Jürgen Sorge; Reinhard Sittl

    2004-01-01

    Background:Buprenorphine, a potent opioid analgesic, has been available in parenteral and oral or sublingual(SL) formulations for >25 years. In 2001, the buprenorphine transdermal delivery system (TES) was introduced at 3 release rates (35, 52.5, and 70 ?g\\/h) for the treatment of chronic cancer and noncancer pain.

  7. Two-year Experience with Buprenorphine-naloxone (Suboxone) for Maintenance Treatment of Opioid Dependence Within a Private Practice Setting.

    PubMed

    Finch, James W; Kamien, Jonathan B; Amass, Leslie

    2007-06-01

    Office-based buprenorphine-naloxone (Suboxone) treatment in the United States has significantly improved access to safe and effective opioid-dependence therapy. Little data from physicians' experiences prescribing Suboxone in private offices have been available. This retrospective chart review describes a family practitioner's first 2 years of clinical experience prescribing Suboxone for opioid dependence to 71 patients in a private office. After directly observed rapid office dose induction, Suboxone prescriptions were given monthly after evidence of continued stability. Urine was screened regularly and patients were referred for counseling and other ancillary services. Patients averaged 32 years old, 4.3 years of opioid dependence, and were primarily white (93%) and employed (70%). Fifty-two percent used heroin primarily (most by injection), and 70% had no agonist substitution therapy history. Almost half (47%) paid for their own treatment. Compliance during dose induction was excellent. Suboxone maintenance doses averaged 10 (range, 2-24) mg per day. More than 80% of urine samples were opioid-negative after Suboxone treatment began, although urinalysis did not always include a test for oxycodone. Seventy-five percent had successful outcomes by remaining in Suboxone treatment (43%), tapering successfully (21%), transferring to methadone maintenance (7%), or inpatient treatment (4%). Fifty-eight percent reported receiving counseling. Almost all (85%) paid their fees on time. There were no safety, medication abuse, or diversion issues detected. Overall, office-based Suboxone therapy was easily implemented and the physician considered the experience excellent. Suboxone maintenance was associated with good treatment retention and significantly reduced opioid use, and it is helping to reach patients, including injection drug users, without histories of agonist substitution therapy. PMID:21768942

  8. Substitution treatment for opioid addicts in Germany

    PubMed Central

    Michels, Ingo Ilja; Stöver, Heino; Gerlach, Ralf

    2007-01-01

    Background After a long and controversial debate methadone maintenance treatment (MMT) was first introduced in Germany in 1987. The number of patients in MMT – first low because of strict admission criteria – increased considerably since the 1990s up to some 65,000 at the end of 2006. In Germany each general practitioner (GP), who has completed an additional training in addiction medicine, is allowed to prescribe substitution drugs to opioid dependent patients. Currently 2,700 GPs prescribe substitution drugs. Psychosocial care should be made available to all MMT patients. Results The results of research studies and practical experiences clearly indicate that patients benefit substantially from MMT with improvements in physical and psychological health. MMT proves successful in attaining high retention rates (65 % to 85 % in the first years, up to 50 % after more than seven years) and plays a major role in accessing and maintaining ongoing medical treatment for HIV and hepatitis. MMT is also seen as a vital factor in the process of social re-integration and it contributes to the reduction of drug related harms such as mortality and morbidity and to the prevention of infectious diseases. Some 10 % of MMT patients become drug-free in the long run. Methadone is the most commonly prescribed substitution medication in Germany, although buprenorphine is attaining rising importance. Access to MMT in rural areas is very patchy and still constitutes a problem. There are only few employment opportunities for patients participating in MMT, although regular employment is considered unanimously as a positive factor of treatment success. Substitution treatment in German prisons is heterogeneous in access and treatment modalities. Access is very patchy and the number of inmates in treatment is limited. Nevertheless, substitution treatment plays a substantial part in the health care system provided to drug users in Germany. Conclusion In Germany, a history of substitution treatment spanning 20 years has meanwhile accumulated a wealth of experience, e.g. in the development of research on health care services, guidelines and the implementation of quality assurance measures. Implementing substitution treatment with concomitant effects and treatment elements such as drug history-taking, dosage setting, co-use of other psychoactive substances (alcohol, benzodiazepines, cocaine), management of 'difficult patient populations', and integration into the social environment has been arranged successfully. Also psychosocial counseling programmes adjuvant to substitution treatment have been established and, in the framework of a pilot project on heroin-based treatment, standardised manuals were developed. Research on allocating opioid users to the 'right' form of therapy at the 'right' point in time is still a challenge, though the pilot project 'heroin-based treatment' brought experience with patients who do not benefit from methadone treatment. There is also expertise in the treatment of specific co-morbidity such as HIV/AIDS, hepatitis and psychiatric disorders. The promotion and involvement of self-help groups plays an important part in the process of successful substitution treatment. PMID:17270059

  9. Variation in use of Buprenorphine and Methadone Treatment by Racial, Ethnic and Income Characteristics of Residential Social Areas in New York City

    PubMed Central

    Hansen, Helena B.; Siegel, Carole E.; Case, Brady G.; Bertollo, David N.; DiRocco, Danae; Galanter, Marc

    2013-01-01

    National data indicate that patients treated with buprenorphine for opiate use disorders are more likely to be White, highly educated, and to have greater incomes than those receiving methadone, but patterns of buprenorphine dissemination across demographic areas have not been documented in major metropolitan areas where poverty, minority populations and injection heroin use are concentrated. Rates of buprenorphine and methadone treatment are compared among areas of New York City defined by their income and ethnic/racial composition. Residential social areas (hereinafter called social areas) were defined as aggregations of ZIP codes with similar race/ethnicity and income characteristics, and were formed based on clustering techniques. Treatment rates were obtained for each New York City ZIP code: buprenorphine treatment rates were based on the annual number of buprenorphine prescriptions written, and the methadone treatment rate on the number of methadone clinic visits for persons in each ZIP code. Treatment rates were correlated univariately with ethnicity and income characteristics of ZIP codes. Social area treatment rates were compared using individual ANOVA models for each rate. Buprenorphine and methadone treatment rates were significantly correlated with the ethnicity and income characteristics of ZIP codes, and treatment rates differed significantly across the social areas. Buprenorphine treatment rates were highest in the social area with the highest income and lowest percentage of Black and Hispanic residents. Conversely, the methadone treatment rate was highest in the social area with the highest percentage of low income and Hispanic residents. The uneven dissemination of 0pioid maintenance treatment in New York City may be reflective of the limited public health impact of buprenorphine in ethnic minority and low income areas. Specific policy and educational interventions to providers are needed to promote the use of buprenorphine for opiate use disorders in diverse populations. PMID:23702611

  10. Double-blind randomized trial of buprenorphine and methadone in opiate dependence

    Microsoft Academic Search

    Sylvie Petitjean; Rudolf Stohler; Jean-Jacques Déglon; Santino Livoti; Doris Waldvogel; Claude Uehlinger; Dieter Ladewig

    2001-01-01

    This study compared the safety and efficacy of sublingual buprenorphine tablets with oral methadone in a population of opioid-dependent individuals in a double-blind, randomized, 6-week trial using a flexible dosing procedure. Fifty-eight patients seeking treatment for opioid dependence were recruited in three outpatient facilities and randomly assigned to substitution with buprenorphine or methadone. The retention rate was significantly better in

  11. Unusual false-positive case of urinary screening for buprenorphine.

    PubMed

    Lippi, Giuseppe; Romero, Araelsis; Cervellin, Gianfranco; Mercadanti, Mariella

    2011-01-01

    Buprenorphine is a centrally acting analgesic drug that is administered for the management of opioid dependence and as an analgesic drug for the treatment of chronic pain. The growing use of this substance has determined an increased need for laboratory testing for either detection and confirmation of the illicit use or monitoring compliance as a substitution therapy for opioid dependence. We describe here the case of urinary sample adulteration with exogenous buprenorphine (6,952?ng/ml), which has led to afalse-positive immunoassay test result (14.9?ng/ml) on a subsequent sample due to a phenomenon of instrumental carry-over. This unusual case confirms the importance to take into account adulteration when screening urines for buprenorphine in patients undergoing substitution therapy for opioid dependence, routinely perform a confirmation assay on positive samples, and rule out instrumental carry-over. PMID:21786326

  12. Predictors of Abstinence: National Institute of Drug Abuse Multisite Buprenorphine/Naloxone Treatment Trial in Opioid-Dependent Youth

    ERIC Educational Resources Information Center

    Subramaniam, Geetha A.; Warden, Diane; Minhajuddin, Abu; Fishman, Marc J.; Stitzer, Maxine L.; Adinoff, Bryon; Trivedi, Madhukar; Weiss, Roger; Potter, Jennifer; Poole, Sabrina A.; Woody, George E.

    2011-01-01

    Objective: To examine predictors of opioid abstinence in buprenorphine/naloxone (Bup/Nal)-assisted psychosocial treatment for opioid-dependent youth. Method: Secondary analyses were performed of data from 152 youth (15-21 years old) randomly assigned to 12 weeks of extended Bup/Nal therapy or up to 2 weeks of Bup/Nal detoxification with weekly…

  13. Buprenorphine: how to use it right

    Microsoft Academic Search

    Rolley E. Johnson; Eric C. Strain; Leslie Amass

    2003-01-01

    The unique pharmacology of buprenorphine at the mu-opioid receptor (i.e. high affinity, low intrinsic activity and slow dissociation) results in buprenorphine having: (1) a good safety profile, (2) low physical dependence, and (3) flexibility in dose scheduling. Early studies assessed the effectiveness of buprenorphine for the treatment of opioid dependence using a sublingual solution formulation. More recently, a combination tablet

  14. Consensus statement on office-based treatment of opioid dependence using buprenorphine.

    PubMed

    Fiellin, David A; Kleber, Herbert; Trumble-Hejduk, Jeanne G; McLellan, A Thomas; Kosten, Thomas R

    2004-09-01

    Buprenorphine and buprenorphine/naloxone (BUP) are newly approved for office-based treatment of opioid dependence. Federal and non-federal regulatory and monitoring agencies, national and international researchers, national professional organizations, researchers involved in monitoring, opioid treatment programs and the pharmaceutical industry met to synthesize and disseminate practical information to guide training, practice, monitoring, regulation and evaluation efforts with these medications. We performed a review of the literature, training curricula and practice guidelines and commissioned manuscripts describing recently completed, or still in progress, studies or field experiences with BUP treatment. A consensus process generated fifteen statements: (1) The federal government should collect baseline data on opioid-related deaths and morbidity to assess the effect of BUP on public health, (2) the patient limit for group practices should apply to individual physicians rather than group practices, (3 and 4) telephone and Internet-based physician and pharmacist support is needed, (5) clinicians who provide psychosocial services to opioid dependent patients should be informed of the role of BUP, (6) opioid-dependent patients should be instructed to present for induction in mild withdrawal, (7) the existing Center for Substance Abuse Treatment guidelines provide a reasonable induction protocol, (8) physicians should be prepared to use ancillary medications with BUP induction, (9) a physician or nurse must be available to the patient during the induction period, (10) concurrent counseling and support services are necessary, (11) detoxification without appropriate followup addiction treatment leads to rapid relapse and is not as effective as maintenance, (12) pregnant opioid-dependent women should be treated using good clinical practice including specialist addiction care and prenatal care, (13) BUP induction and withdrawal treatment may benefit from different designations for payment, (14) take-home medication options should be tailored to patients' needs, (15) there is a need for clinical and policy research in unique patient populations. PMID:15450648

  15. Relative bioavailability of different buprenorphine formulations under chronic dosing conditions

    Microsoft Academic Search

    Eric C. Strain; David E. Moody; Kenneth B. Stoller; Sharon L. Walsh; George E. Bigelow

    2004-01-01

    Background: Buprenorphine is an approved medication for the treatment of opioid dependence. Three sublingual formulations have been used at various times during its development—a solution containing alcohol, tablets containing buprenorphine alone, and tablets containing buprenorphine plus naloxone. This study compared the relative buprenorphine bioavailability of these different formulations. Methods: Outpatient volunteers (N=10) were maintained for 14 days of daily administration

  16. Combined Abuse of Clonidine and Amitriptyline in a Patient on Buprenorphine Maintenance Treatment

    PubMed Central

    Dittmer, Trent; Sigman, Erika J.; Clemons, Holly; Johnson, J. Aaron

    2014-01-01

    Buprenorphine/naloxone maintenance therapy is often prescribed in primary care to treat opioid dependence. Previous reports have described concomitant abuse of opioids and clonidine. In this case, a primary care patient on buprenorphine/naloxone maintenance therapy demonstrating altered mental status, hallucinations, falls, and rebound hypertension was found to be concomitantly abusing clonidine and amitryptyline, which share metabolic pathways with buprenorphine. Clinicians should be aware of patients' combining amitryptyline, clonidine, and gabapentin with buprenorphine to achieve a mood altering state, avoid co-prescribing them if possible, and maintain communication with pharmacies and other providers when they are prescribed. PMID:25314340

  17. Genetic variation in OPRD1 and the response to treatment for opioid dependence with buprenorphine in European-American females.

    PubMed

    Clarke, T-K; Crist, R C; Ang, A; Ambrose-Lanci, L M; Lohoff, F W; Saxon, A J; Ling, W; Hillhouse, M P; Bruce, R D; Woody, G; Berrettini, W H

    2014-06-01

    Two commonly prescribed treatments for opioid addiction are methadone and buprenorphine. Although these drugs show some efficacy in treating opioid dependence, treatment response varies among individuals. It is likely that genetic factors have a role in determining treatment outcome. This study analyses the pharmacogenetic association of six polymorphisms in OPRD1, the gene encoding the delta-opioid receptor, on treatment outcome in 582 opioid addicted European Americans randomized to either methadone or buprenorphine/naloxone (Suboxone) over the course of a 24-week open-label clinical trial. Treatment outcome was assessed as the number of missed or opioid-positive urine drug screens over the 24 weeks. In the total sample, no single-nucleotide polymorphisms (SNPs) in OPRD1 were significantly associated with treatment outcome in either treatment arm. However, sex-specific analyses revealed two intronic SNPs (rs581111 and rs529520) that predicted treatment outcome in females treated with buprenorphine. Females with the AA or AG genotypes at rs581111 had significantly worse outcomes than those with the GG genotype when treated with buprenorphine (P=0.03, relative risk (RR)=1.67, 95% confidence interval (CI) 1.06-2.1). For rs529520, females with the AA genotype had a significantly worse outcome than those with the CC genotype when (P=0.006, RR=2.15, 95% CI 1.3-2.29). No significant associations were detected in males. These findings suggest that rs581111 and rs52920 may be useful when considering treatment options for female opioid addicts, however, confirmation in an independent sample is warranted. PMID:24126707

  18. Genetic variation in OPRD1 and the response to treatment for opioid dependence with buprenorphine in European American females

    PubMed Central

    Clarke, Toni-Kim; Crist, Richard C.; Ang, Alfonso; Ambrose-Lanci, Lisa M.; Lohoff, Falk W.; Saxon, Andrew J.; Ling, Walter; Hillhouse, Maureen P.; Bruce, R. Douglas; Woody, George; Berrettini, Wade H.

    2013-01-01

    Two commonly prescribed treatments for opioid addiction are methadone and buprenorphine. While these drugs show some efficacy in treating opioid dependence, treatment response varies among individuals. It is likely that genetic factors play a role in determining treatment outcome. This study analyses the pharmacogenetic association of 6 polymorphisms in OPRD1, the gene encoding the delta-opioid receptor, on treatment outcome in 582 opioid addicted European Americans randomized to either methadone or buprenorphine/naloxone ((Suboxone®) over the course of a 24 week open-label clinical trial. Treatment outcome was assessed as the number of missed or opioid positive urine drug screens over the 24 weeks. In the total sample, no SNPs in OPRD1 were significantly associated with treatment outcome in either treatment arm. However, sex-specific analyses revealed 2 intronic SNPs (rs581111 and rs529520) that predicted treatment outcome in females treated with buprenorphine. Females with the AA or AG genotypes at rs581111 had significantly worse outcomes than those with the GG genotype when treated with buprenorphine (p=0.03, RR=1.67, 95% C.I.[1.06-2.1]). For rs529520, females with the AA genotype had a significantly worse outcome than those with the CC genotype when (p=0.006, RR=2.15, 95%C.I.[1.3-2.29]). No significant associations were detected in males. These findings suggest that rs581111 and rs52920 may be useful when considering treatment options for female opioid addicts, however confirmation in an independent sample is warranted. PMID:24126707

  19. Health-related quality of life changes associated with buprenorphine treatment for opioid dependence

    PubMed Central

    Campbell, Heather M.; Garnand, David A.; Jones, Mark A.; Sather, Mike R.; Naik, Rupali; Ling, Walter

    2014-01-01

    Background Few studies have described improvement in health-related quality of life (HRQOL) associated with opioid dependence treatment with buprenorphine (ODT-B). Objective To evaluate HRQOL changes in domain scores, physical and mental component summaries, and health utilities (HUs) associated with ODT-B using the Short Form 36 (SF-36). Methods We assessed HRQOL changes in a substudy of a pharmacokinetic study that compared buprenorphine oral tablet and liquid dosage formulations over 16 weeks. Individuals, aged 18–65 years, were screened for opioid dependence. They were excluded if they would not agree to birth control or had a serious medical condition. Subjects received psychosocial counseling and weekly group therapy. The SF-36 was administered upon enrollment and at 4-week intervals. We used the SF-6D to estimate HUs. We performed intention to treat (ITT) analyses based on the last observation available for each subject. Paired t tests of each domain and HU, limited to remaining patients at each 4-week interval, were also conducted. Results Of 96 subjects enrolled, cumulative dropouts over time resulted in 80, 69, 59, and 44 subjects remaining at 4, 8, 12, and 16 weeks. There were no significant differences in opioid-positive urines, dropout rates, or dosage changes between formulations. In the ITT analyses, HRQOL improvements over time were bodily pain (62.1 vs. 69.1, P = 0.017), vitality (49.8 vs. 56.5, P = 0.001), mental health (59.9 vs. 66.0, P = 0.001), social function (66.4 vs. 74.7, P = 0.001), role emotional (59.4 vs. 71.9, P = 0.003), role physical (60.9 vs. 70.6, P = 0.005), and mental component summary (41.9 vs. 45.4, P<0.001). HU scores also improved (0.674 vs. 0.715, P = 0.001). Results from paired t tests, with only concurrently enrolled patients, showed similar improvements from baseline to 4, 8, 12, or 16 weeks. Conclusion Buprenorphine, accompanied with psychosocial counseling, was associated with improved HRQOL and HUs. PMID:21987030

  20. Office-Based Treatment of Opiate Addiction with a Sublingual-Tablet Formulation of Buprenorphine and Naloxone

    Microsoft Academic Search

    Paul J. Fudala; T. Peter Bridge; Susan Herbert; William O. Williford; C. Nora Chiang; Karen Jones; Joseph Collins; Dennis Raisch; Paul Casadonte; R. Jeffrey Goldsmith; Walter Ling; Usha Malkerneker; Laura McNicholas; John Renner; Susan Stine; Donald Tusel

    2003-01-01

    background Office-based treatment of opiate addiction with a sublingual-tablet formulation of bu- prenorphine and naloxone has been proposed, but its efficacy and safety have not been well studied. methods We conducted a multicenter, randomized, placebo-controlled trial involving 326 opiate- addicted persons who were assigned to office-based treatment with sublingual tablets consisting of buprenorphine (16 mg) in combination with naloxone (4

  1. Opioid Addiction and Abuse in Primary Care Practice: A Comparison of Methadone and Buprenorphine as Treatment Options

    PubMed Central

    Bonhomme, Jean; Shim, Ruth S.; Gooden, Richard; Tyus, Dawn; Rust, George

    2014-01-01

    Opioid abuse and addiction have increased in frequency in the United States over the past 20 years. In 2009, an estimated 5.3 million persons used opioid medications nonmedically within the past month, 200 000 used heroin, and approximately 9.6% of African Americans used an illicit drug. Racial and ethnic minorities experience disparities in availability and access to mental health care, including substance use disorders. Primary care practitioners are often called upon to differentiate between appropriate, medically indicated opioid use in pain management vs inappropriate abuse or addiction. Racial and ethnic minority populations tend to favor primary care treatment settings over specialty mental health settings. Recent therapeutic advances allow patients requiring specialized treatment for opioid abuse and addiction to be managed in primary care settings. The Drug Addiction Treatment Act of 2000 enables qualified physicians with readily available short-term training to treat opioid-dependent patients with buprenorphine in an office-based setting, potentially making primary care physicians active partners in the diagnosis and treatment of opioid use disorders. Methadone and buprenorphine are effective opioid replacement agents for maintenance and/or detoxification of opioid-addicted individuals. However, restrictive federal regulations and stigmatization of opioid addiction and treatment have limited the availability of methadone. The opioid partial agonist-antagonist buprenorphine/naloxone combination has proven an effective alternative. This article reviews the literature on differences between buprenorphine and methadone regarding availability, efficacy, safety, side-effects, and dosing, identifying resources for enhancing the effectiveness of medication-assisted recovery through coordination with behavioral/psychological counseling, embedded in the context of recovery-oriented systems of care. PMID:23092049

  2. Buprenorphine, methadone, and morphine treatment during pregnancy: behavioral effects on the offspring in rats.

    PubMed

    Chen, Hwei-Hsien; Chiang, Yao-Chang; Yuan, Zung Fan; Kuo, Chung-Chih; Lai, Mei-Dan; Hung, Tsai-Wei; Ho, Ing-Kang; Chen, Shao-Tsu

    2015-01-01

    Methadone and buprenorphine are widely used for treating people with opioid dependence, including pregnant women. Prenatal exposure to opioids has devastating effects on the development of human fetuses and may induce long-term physical and neurobehavioral changes during postnatal maturation. This study aimed at comparing the behavioral outcomes of young rats prenatally exposed to buprenorphine, methadone, and morphine. Pregnant Sprague-Dawley rats were administered saline, morphine, methadone, and buprenorphine during embryonic days 3-20. The cognitive function, social interaction, anxiety-like behaviors, and locomotor activity of offsprings were examined by novel object recognition test, social interaction test, light-dark transition test, elevated plus-maze, and open-field test between 6 weeks and 10 weeks of age. Prenatal exposure to methadone and buprenorphine did not affect locomotor activity, but significantly impaired novel object recognition and social interaction in both male and female offsprings in the same manner as morphine. Although prenatal exposure to methadone or buprenorphine increased anxiety-like behaviors in the light-dark transition in both male and female offsprings, the effects were less pronounced as compared to that of morphine. Methadone affected elevated plus-maze in both sex, but buprenorphine only affected the female offsprings. These findings suggest that buprenorphine and methadone maintenance therapy for pregnant women, like morphine, produced detrimental effects on cognitive function and social behaviors, whereas the offsprings of such women might have a lower risk of developing anxiety disorders. PMID:25834439

  3. Buprenorphine versus methadone in the treatment of pregnant opioid-dependent patients: effects on the neonatal abstinence syndrome

    Microsoft Academic Search

    Hendree E. Jones; Rolley E. Johnson; Donald R. Jasinski; Kevin E. O’Grady; Christian A. Chisholm; Robin E. Choo; Michael Crocetti; Robert Dudas; Cheryl Harrow; Marilyn A. Huestis; Lauren M. Jansson; Michael Lantz; Barry M. Lester; Lorraine Milio

    2005-01-01

    This study was designed to compare the neonatal abstinence syndrome (NAS) in neonates of methadone and buprenorphine maintained pregnant opioid-dependent women and to provide preliminary safety and efficacy data for a larger multi-center trial. This randomized, double-blind, double-dummy, flexible dosing, parallel-group controlled trial was conducted in a comprehensive drug-treatment facility that included residential and ambulatory care. Participants were opioid-dependent pregnant

  4. Long-Term Treatment with Buprenorphine\\/Naloxone in Primary Care: Results at 2-5 Years

    Microsoft Academic Search

    David A. Fiellin; Brent A. Moore; Lynn E. Sullivan; William C. Becker; Michael V. Pantalon; Marek C. Chawarski; Declan T. Barry; Patrick G. O'Connor; Richard S. Schottenfeld

    To examine long-term outcomes with primary care office- based buprenorphine\\/naloxone treatment, we followed 53 opioid-dependent patients who had already demonstrated six months of documented clinical stability for 2-5 years. Primary outcomes were retention, illicit drug use, dose, satisfaction, serum transaminases, and adverse events. Thirty-eight percent of enrolled subjects were retained for two years. Ninety-one percent of urine samples had no

  5. Effects of buprenorphine and methadone in methadone-maintained subjects

    Microsoft Academic Search

    S. L. Walsh; H. L. June; K. J. Schuh; K. L. Preston; G. E. Bigelow; M. L. Stitzer

    1995-01-01

    Buprenorphine, a partial mu opioid agonist, is an experimental medication under development for the treatment of opioid dependence as an alternative to methadone maintenance. The present study examined the relationship between level of opioid physical dependence and response to buprenorphine administration as part of a program to develop procedures for transferring patients from methadone to buprenorphine treatment. This laboratory study

  6. Cost Effectiveness of Injectable Extended Release Naltrexone Compared to Methadone Maintenance and Buprenorphine Maintenance Treatment for Opioid Dependence

    PubMed Central

    Jackson, Heide; Mandell, Kara; Johnson, Kimberly; Chatterjee, Debanjana; Vanness, David J.

    2015-01-01

    Background The aim of this study was to estimate the cost-effectiveness of injectable extended release naltrexone (XR-NTX) compared to methadone maintenance and buprenorphine maintenance treatment (MMT and BMT respectively) for adult males enrolled in treatment for opioid dependence in the United States from the perspective of state-level addiction treatment payers. Methods We used a Markov model with daily time cycles to estimate the incremental cost per opioid-free day in a simulated cohort of adult males ages 18–65 over a six-month period from the state health program perspective. Results XR-NTX is predicted to be more effective and more costly than methadone or buprenorphine in our target population, with an incremental cost per opioid-free day gained relative to the next-most effective treatment (MMT) of $72. The cost-effectiveness of XR-NTX relative to MMT was driven by its effectiveness in deterring opioid use while receiving treatment. Conclusions XR-NTX is a cost-effective medication for treating opioid dependence if state addiction treatment payers are willing to pay at least $72 per opioid-free day. PMID:25775099

  7. “The chief of the services is very enthusiastic about it”: A qualitative study of the adoption of buprenorphine for opioid addiction treatment

    PubMed Central

    Green, Carla A.; McCarty, Dennis; Mertens, Jennifer; Lynch, Frances L.; Hilde, Anadam; Firemark, Alison; Weisner, Constance M.; Pating, David; Anderson, Bradley M.

    2013-01-01

    Qualified physicians may prescribe buprenorphine to treat opioid dependence, but medication use remains controversial. We examined adoption of buprenorphine in two not-for-profit integrated health plans, over time, completing 101 semi-structured interviews with clinicians and clinician-administrators from primary and specialty care. Transcripts were reviewed, coded, and analyzed. A strong leader championing the new treatment was critical for adoption in both health plans. Once clinicians began using buprenorphine, patients’ and other clinicians’ experiences affected decisions more than did the champion. With experience, protocols developed to manage unsuccessful patients and changed to support maintenance rather than detoxification. Diffusion outside addiction and mental health settings was nonexistent; primary care clinicians cited scope-of-practice issues and referred patients to specialty care. With greater diffusion came questions about long-term use and safety. Recognizing how implementation processes develop may suggest where, when, and how to best expend resources to increase adoption of such treatments. PMID:24268947

  8. Pharmacokinetic comparison of the buprenorphine sublingual liquid and tablet

    Microsoft Academic Search

    Kory J Schuh; Chris-Ellyn Johanson

    1999-01-01

    Buprenorphine is a ? opioid partial agonist being developed as a treatment for opioid dependence. Buprenorphine, usually administered as a sublingual liquid, is now being developed as a sublingual tablet for clinical use. The present study compared participants’ plasma concentrations after daily maintenance on three buprenorphine liquid doses (2, 4 and 8 mg) and one tablet dose (8 mg). Fourteen

  9. Timing of buprenorphine adoption by privately funded substance abuse treatment programs: The role of institutional and resource-based inter-organizational linkages

    PubMed Central

    Savage, Sarah A.; Abraham, Amanda J.; Knudsen, Hannah K.; Rothrauff, Tanja C.; Roman, Paul M.

    2011-01-01

    Identifying facilitators of more rapid buprenorphine adoption may increase access to this effective treatment for opioid dependence. Using a diffusion of innovations theoretical framework, we examine the extent to which programs’ inter-organizational institutional and resource-based linkages predict the likelihood of being an earlier, later, or non-adopter of buprenorphine. Data were derived from face-to-face interviews with administrators of 345 privately funded substance abuse treatment programs in 2007–2008. Results of multinomial logistic regression models show that inter-organizational and resource linkages were associated with timing of adoption. Programs reporting membership in provider associations were more likely to be earlier adopters of buprenorphine. Programs that relied more on resources linkages, such as the detailing activities by pharmaceutical companies and the NIDA website, were more likely to be earlier adopters of buprenorphine. These findings suggest that institutional and resource-based inter-organizational linkages may expose programs to effective treatments, thereby facilitating more rapid and sustained adoption of innovative treatment techniques. PMID:21831565

  10. Dosing considerations with transdermal formulations of fentanyl and buprenorphine for the treatment of cancer pain

    PubMed Central

    Skaer, Tracy L

    2014-01-01

    Opioids continue to be first-line pharmacotherapy for patients suffering from cancer pain. Unfortunately, subtherapeutic dosage prescribing of pain medications remains common, and many cancer patients continue to suffer and experience diminished quality of life. A large variety of therapeutic options are available for cancer pain patients. Analgesic pharmacotherapy is based on the patient’s self-report of pain intensity and should be tailored to meet the requirements of each individual. Most, if not all, cancer pain patients will ultimately require modifications in their opioid pharmacotherapy. When changes in a patient’s medication regimen are needed, adequate pain control is best maintained through appropriate dosage conversion, scheduling immediate release medication for withdrawal prevention, and providing as needed dosing for breakthrough pain. Transdermal opioids are noninvasive, cause less constipation and sedation when compared to oral opioids, and may improve patient compliance. A relative potency of 100:1 is recommended when converting the patient from oral morphine to transdermal fentanyl. Based on the limited data available, there is significant interpatient variability with transdermal buprenorphine and equipotency recommendations from oral morphine of 75:1–110:1 have been suggested. Cancer patients may require larger transdermal buprenorphine doses to control their pain and may respond better to a more aggressive 75–100:1 potency ratio. This review outlines the prescribing of transdermal fentanyl and transdermal buprenorphine including how to safely and effectively convert to and use them for those with cancer pain. PMID:25170278

  11. Long-term treatment with buprenorphine/naloxone in primary care: results at 2-5 years.

    PubMed

    Fiellin, David A; Moore, Brent A; Sullivan, Lynn E; Becker, William C; Pantalon, Michael V; Chawarski, Marek C; Barry, Declan T; O'Connor, Patrick G; Schottenfeld, Richard S

    2008-01-01

    To examine long-term outcomes with primary care office-based buprenorphine/naloxone treatment, we followed 53 opioid-dependent patients who had already demonstrated six months of documented clinical stability for 2-5 years. Primary outcomes were retention, illicit drug use, dose, satisfaction, serum transaminases, and adverse events. Thirty-eight percent of enrolled subjects were retained for two years. Ninety-one percent of urine samples had no evidence of opioid use, and patient satisfaction was high. Serum transaminases remained stable from baseline. No serious adverse events related to treatment occurred. We conclude that select opioid-dependent patients exhibit moderate levels of retention in primary care office-based treatment. PMID:18393054

  12. Outcome of heroin-dependent adolescents presenting for opiate substitution treatment.

    PubMed

    Smyth, Bobby P; Fagan, John; Kernan, Kathy

    2012-01-01

    Because the outcome of methadone and buprenorphine substitution treatment in adolescents is unclear, we completed a retrospective cohort study of 100 consecutive heroin-dependent adolescents who sought these treatments over an 8-year recruitment period. The participants' average age was 16.6 years, and 54 were female. Half of the patient group remained in treatment for over 1 year. Among those still in treatment at 12 months, 39% demonstrated abstinence from heroin. The final route of departure from the treatment program was via planned detox for 22%, dropout for 32%, and imprisonment for 8%. The remaining 39% were transferred elsewhere for ongoing opiate substitution treatment after a median period of 23 months of treatment. Males were more likely to exit via imprisonment (p < .05), but other outcomes were not predicted by gender. There were no deaths during treatment among these 100 patients who had a cumulative period of 129 person years at risk. Our findings suggest that this treatment delivers reductions in heroin use and that one fifth of patients will exit treatment following detox completion within a 1- to 2-year time frame. PMID:21940134

  13. Buprenorphine and naloxone interactions in opiate-dependent volunteers

    Microsoft Academic Search

    John Mendelson; Reese T. Jones; Isabella Fernandez; Susette Welm; Ann K. Melby; Matthew J. Baggott

    1996-01-01

    Objective: Sublingual buprenorphine appears useful in the treatment of opiate dependence. A combination sublingual dose of buprenorphine and naloxone could have less potential for parenteral use by opiate-dependent individuals. To estimate the abuse potential of a combination formulation, we assessed the parenteral effects of a buprenorphine and naloxone combination in untreated heroin addicts.Methods: Eight healthy, opiate-dependent daily users of heroin

  14. Training HIV Physicians to Prescribe Buprenorphine for Opioid Dependence

    ERIC Educational Resources Information Center

    Sullivan, Lynn E.; Tetrault, Jeanette; Bangalore, Deepa; Fiellin, David A.

    2006-01-01

    Few HIV physicians are trained to provide buprenorphine treatment. We conducted a cross-sectional survey to assess the impact of an eight-hour course on the treatment of opioid dependence on HIV physicians' preparedness to prescribe buprenorphine. One hundred thirteen of 257 trained physicians (44%) provided HIV care. Post-course, the majority of…

  15. Buprenorphine in cancer pain

    Microsoft Academic Search

    Mellar P. Davis

    2005-01-01

    Buprenorphine is a broad spectrum, highly lipophilic, and long-acting partial mu opioid receptor agonist that is noncross tolerant to other opioids. Buprenorphine can be given by several routes. Metabolism is through CYP3A4 and CYP2C8 and by conjugases. Constipation and sexual dysfunction appear to be less with buprenorphine than with other opioids. The recent development of a polymer matrix patch delivery

  16. Buprenorphine for office-based practice: consensus conference overview.

    PubMed

    Kosten, Thomas R; Fiellin, David A

    2004-01-01

    This overview of the March 2003 conference on the U.S. national buprenorphine implementation program is developed to inform the practitioner about the positive experience that has been accumulated worldwide on the use of buprenorphine for office-based practice. The first paper delineates the challenges for American psychiatry in moving buprenorphine forward into general practice. Most psychiatrists are unprepared to work with opiate-dependent patients or to use buprenorphine. The international successes with office-based buprenorphine from France and Australia are presented in the next papers, followed by presentations on several U.S. studies using buprenorphine in the community for detoxification and office-based maintenance. These experiences have thus far confirmed buprenorphine's utility and promise for opiate addiction treatment in the U.S. Finally, two national monitoring programs have been implemented to assess the public health impact of this new treatment opportunity. This opportunity has a three-year window, however, and a critical need will be to attract a sufficient number of physicians into prescribing buprenorphine/naloxone in order to allow our patients increased access to this treatment. PMID:15204671

  17. Abuse potential of intranasal buprenorphine versus buprenorphine/naloxone in buprenorphine-maintained heroin users.

    PubMed

    Jones, Jermaine D; Sullivan, Maria A; Vosburg, Suzanne K; Manubay, Jeanne M; Mogali, Shanthi; Metz, Verena; Comer, Sandra D

    2015-07-01

    In spite of the clinical utility of buprenorphine, parenteral abuse of this medication has been reported in several laboratory investigations and in the real world. Studies have demonstrated lower abuse liability of the buprenorphine/naloxone combination relative to buprenorphine alone. However, clinical research has not yet examined the utility of the combined formulation to deter intranasal use in a buprenorphine-maintained population. Heroin-using volunteers (n?=?12) lived in the hospital for 8-9 weeks and were maintained on each of three sublingual buprenorphine doses (2, 8, 24?mg). Under each maintenance dose, participants completed laboratory sessions during which the reinforcing and subjective effects of intranasal doses of buprenorphine (8, 16?mg), buprenorphine/naloxone (8/2, 8/8, 8/16, 16/4?mg) and controls (placebo, heroin 100?mg, naloxone 4?mg) were assessed. Intranasal buprenorphine alone typically produced increases in positive subjective effects and the 8?mg dose was self-administered above the level of placebo. The addition of naloxone dose dependently reduced positive subjective effects and increased aversive effects. No buprenorphine/naloxone combination dose was self-administered significantly more than placebo. These data suggest that within a buprenorphine-dependent population, intranasal buprenorphine/naloxone has reduced abuse potential in comparison to buprenorphine alone. These data strongly argue in favor of buprenorphine/naloxone rather than buprenorphine alone as the more reasonable option for managing the risk of buprenorphine misuse. PMID:25060839

  18. Preliminary buprenorphine sublingual tablet pharmacokinetic data in plasma, oral fluid and sweat during treatment of opioid-dependent pregnant women

    PubMed Central

    Concheiro, Marta; Jones, Hendreé E.; Johnson, Rolley E.; Choo, Robin; Huestis, Marilyn A.

    2011-01-01

    Background Buprenorphine is currently under investigation as a pharmacotherapy to treat pregnant women for opioid dependence. This research evaluates buprenorphine (BUP), norbuprenophine (NBUP), buprenorphine-glucuronide (BUP-Gluc) and norbuprenorphine-glucuronide (NBUP-Gluc) pharmacokinetics after high dose (14–20 mg) BUP sublingual tablet administration in three opioid-dependent pregnant women. Methods Oral fluid and sweat specimens were collected in addition to plasma specimens for 24 h during gestation weeks 28 or 29 and 34, and 2 months after delivery. Tmax was not affected by pregnancy; however, BUP and NBUP Cmax and AUC0–24h tended to be lower during pregnancy compared to postpartum levels. Results Statistically significant but weak positive correlations were found for BUP plasma and OF concentrations, and BUP/NBUP ratios in plasma and OF. Conclusion Statistically significant negative correlations were observed for times of specimen collection and BUP and NBUP OF/plasma ratios. BUP-Gluc and NBUP-Gluc were detected in only 5% of OF specimens. In sweat, BUP and NBUP were detected in only 4 of 25 (12 or 24 h) specimens in low concentrations (<2.4 ng/patch). These preliminary data describe BUP and metabolite pharmacokinetics in pregnant women and suggest that, like methadone, upward dose adjustments may be needed with advancing gestation. PMID:21860340

  19. Buprenorphine decreases the CCL2-mediated chemotactic response of monocytes.

    PubMed

    Carvallo, Loreto; Lopez, Lillie; Che, Fa-Yun; Lim, Jihyeon; Eugenin, Eliseo A; Williams, Dionna W; Nieves, Edward; Calderon, Tina M; Madrid-Aliste, Carlos; Fiser, Andras; Weiss, Louis; Angeletti, Ruth Hogue; Berman, Joan W

    2015-04-01

    Despite successful combined antiretroviral therapy, ? 60% of HIV-infected people exhibit HIV-associated neurocognitive disorders (HAND). CCL2 is elevated in the CNS of infected people with HAND and mediates monocyte influx into the CNS, which is critical in neuroAIDS. Many HIV-infected opiate abusers have increased neuroinflammation that may augment HAND. Buprenorphine is used to treat opiate addiction. However, there are few studies that examine its impact on HIV neuropathogenesis. We show that buprenorphine reduces the chemotactic phenotype of monocytes. Buprenorphine decreases the formation of membrane projections in response to CCL2. It also decreases CCL2-induced chemotaxis and mediates a delay in reinsertion of the CCL2 receptor, CCR2, into the cell membrane after CCL2-mediated receptor internalization, suggesting a mechanism of action of buprenorphine. Signaling pathways in CCL2-induced migration include increased phosphorylation of p38 MAPK and of the junctional protein JAM-A. We show that buprenorphine decreases these phosphorylations in CCL2-treated monocytes. Using DAMGO, CTAP, and Nor-BNI, we demonstrate that the effect of buprenorphine on CCL2 signaling is opioid receptor mediated. To identify additional potential mechanisms by which buprenorphine inhibits CCL2-induced monocyte migration, we performed proteomic analyses to characterize additional proteins in monocytes whose phosphorylation after CCL2 treatment was inhibited by buprenorphine. Leukosialin and S100A9 were identified and had not been shown previously to be involved in monocyte migration. We propose that buprenorphine limits CCL2-mediated monocyte transmigration into the CNS, thereby reducing neuroinflammation characteristic of HAND. Our findings underscore the use of buprenorphine as a therapeutic for neuroinflammation as well as for addiction. PMID:25716997

  20. Use of buprenorphine in the treatment of opioid addiction. II. Physiologic and behavioral effects of daily and alternate-day administration and abrupt withdrawal

    Microsoft Academic Search

    Paul J Fudala; Jerome H Jaffe; Elizabeth M Dax; Rolley E Johnson; Rolley E Johnson PharmD

    1990-01-01

    Nineteen heroin-dependent male volunteers were administered buprenorphine sublingually, in ascending daily doses of 2, 4, and 8 mg. They were maintained on 8 mg daily through study day 18. On study days 19 through 36, subjects in group 1 continued to receive burprenorphine daily; subjects in group 2 received buprenorphine or placebo on alternate days. On days 37 through 52,

  1. PREVALENCE AND CORRELATES OF STREET-OBTAINED BUPRENORPHINE USE AMONG CURRENT AND FORMER INJECTORS IN BALTIMORE, MARYLAND

    PubMed Central

    Genberg, Becky L.; Gillespie, Mirinda; Schuster, Charles R.; Johanson, Chris-Ellyn; Astemborski, Jacquie; Kirk, Gregory D.; Vlahov, David; Mehta, Shruti H.

    2013-01-01

    Objectives There are few systematic assessments of street-obtained buprenorphine use from community-based samples in the United States. The objective of this study was to characterize the prevalence, correlates, and reasons for street-obtained buprenorphine use among current and former injection drug users (IDUs) in Baltimore, Maryland. Methods In 2008, participants of the ALIVE (AIDS Linked to the IntraVenous Experience) study, a community-based cohort of IDUs, were administered a survey on buprenorphine. Street-obtained buprenorphine represented self-reported use of buprenorphine obtained from the street or a friend in the prior three months. Results 602 respondents were predominantly male (65%), African-American (91%), and 30% were HIV-positive. Overall, nine percent reported recent street-obtained buprenorphine use, and only 2% reported using to get high. Among active opiate users, 23% reported recent use of street-obtained buprenorphine. Use of buprenorphine prescribed by a physician, injection and non-injection drug use, use of street-obtained methadone and prescription opiates, homelessness, and opioid withdrawal symptoms were positively associated, while methadone treatment, health insurance, outpatient care, and HIV-infection were negatively associated with recent street-obtained buprenorphine use in univariate analysis. After adjustment, active injection and heroin use were positively associated with street-obtained buprenorphine use. Ninety-one percent reported using street-obtained buprenorphine to manage withdrawal symptoms. Conclusions While 9% reported recent street-obtained buprenorphine use, only a small minority reported using buprenorphine to get high, with the majority reporting use to manage withdrawal symptoms. There is limited evidence of diversion of buprenorphine in this sample and efforts to expand buprenorphine treatment should continue with further monitoring. PMID:24018232

  2. The clinical pharmacology of buprenorphine: extrapolating from the laboratory to the clinic

    Microsoft Academic Search

    Sharon L Walsh; Thomas Eissenberg

    2003-01-01

    This paper will review clinical pharmacology studies on buprenorphine, a mixed opioid agonist–antagonist currently approved as a treatment for opioid dependence. The focus is on studies characterizing buprenorphine's pharmacodynamic actions, including its safety, abuse liability, withdrawal suppression and withdrawal precipitation capacity, physical dependence potential, cross-tolerance and duration of action as well as a review of the pharmacological profile of buprenorphine\\/naloxone

  3. Buprenorphine and naloxone co-administration in opiate-dependent patients stabilized on sublingual buprenorphine

    Microsoft Academic Search

    Debra S Harris; Reese T Jones; Susette Welm; Robert A Upton; Emil Lin; John Mendelson

    2000-01-01

    Buprenorphine and naloxone sublingual (s.l.) dose formulations may decrease parenteral buprenorphine abuse. We evaluated pharmacologic interactions between 8 mg s.l. buprenorphine combined with 0, 4, or 8 mg of naloxone in nine opiate-dependent volunteers stabilized on 8 mg s.l. buprenorphine for 7 days. Combined naloxone and buprenorphine did not diminish buprenorphine's effects on opiate withdrawal nor alter buprenorphine bioavailability. Opiate

  4. Models for Integrating Buprenorphine Therapy into the Primary HIV Care Setting

    Microsoft Academic Search

    Sanjay Basu; R. Douglas Bruce; Frederick L. Altice

    2006-01-01

    Opiate dependence among human immunodeficiency virus (HIV)-infected patients has been associated with negative clinical outcomes, yet few affected patients receive appropriate and coordinated treatment for both conditions. The introduction of buprenorphine maintenance therapy into HIV care settings provides an opportunity for providers to integrate treatment for opiate dependence into their practices. Buprenorphine maintenance therapy has been associated with reductions in

  5. A buprenorphine education and training program for primary care residents: Implementation and evaluation

    PubMed Central

    Kunins, Hillary V.; Sohler, Nancy L.; Giovanniello, Angela; Thompson, Devin; Cunningham, Chinazo O.

    2013-01-01

    Background Although substance use disorders are highly prevalent, resident preparation to care for patients with these disorders is frequently insufficient. With increasing rates of opioid abuse and dependence, and the availability of medication-assisted treatment, one strategy to improve resident skills is to incorporate buprenorphine treatment into training settings. Methods Residency faculty delivered our BupEd education and training program to 71 primary care residents. BupEd included: 1) a didactic session on buprenorphine, 2) an interactive motivational interviewing session, 3) monthly case conferences, and 4) supervised clinical experience providing buprenorphine treatment. To evaluate BupEd, we assessed: 1) residents' provision of buprenorphine treatment during residency, 2) residents' provision of buprenorphine treatment after residency, and 4) treatment retention among patients treated by resident versus attending physicians. Results Of 71 residents, most served as a covering or primary provider to at least one buprenorphine-treated patient (84.5 and 66.2% respectively). Of 40 graduates, 27.5% obtained a buprenorphine waiver and 17.5% prescribed buprenorphine. Treatment retention was similar between patients cared for by resident PCPs versus attending PCPs ((90-day retention: 63.6% (n=35) vs. 67.9% (n=152), p=0.55)). Conclusion BupEd is feasible, provides residents with supervised clinical experience in treating opioid dependent patients, and can serve as a model to prepare primary care physicians to care for patients with opioid dependence. PMID:23844954

  6. Assessment of immunotoxicity of buprenorphine

    Microsoft Academic Search

    H. Van Loveren; N. Gianotten; C. F. M. Hendriksen; H. J. Schuurman; J. W. Van Der Laan

    1994-01-01

    Summary In order to use buprenorphine as an analgesic in immunological experiments, we have studied the potential immunotoxicity of buprenorphine. Three-week-old male Wistar Riv: TOX rats were subcutaneously treated with buprenorphine by injection of 0.1, 0.4, or 1.6 mg\\/kg body weight per day over a period of 4 weeks. Concentrations used were within the range for analgesia in rats. A

  7. Effect of Telaprevir on the Pharmacokinetics of Buprenorphine in Volunteers on Stable Buprenorphine/Naloxone Maintenance Therapy

    PubMed Central

    Luo, Xia; Trevejo, Jose; van Heeswijk, Rolf P. G.; Smith, Frances

    2012-01-01

    This was an open-label, single-sequence trial in hepatitis C virus-negative volunteers on stable, individualized, buprenorphine maintenance therapy. Telaprevir at 750 mg every 8 h was coadministered with buprenorphine/naloxone (4:1 ratio as sublingual tablets) for 7 days with food. Pharmacokinetic profiles of buprenorphine, norbuprenorphine, and naloxone were measured over the 24-hour dosing interval on day ?1 (buprenorphine/naloxone alone, reference) and day 7 of telaprevir coadministration (test). Geometric least-squares mean ratios and associated 90% confidence intervals of treatment ratios (test/reference) were calculated using log-transformed pharmacokinetic parameters. Opioid withdrawal symptoms were evaluated throughout the study (via questionnaires and pupillometry). Pharmacokinetic data were available for 14 and 13 volunteers on day ?1 and day 7, respectively. The area under the concentration-time curve (AUC) for buprenorphine was unchanged and the maximum concentration of drug in serum (Cmax) for buprenorphine, Cmax and AUC for norbuprenorphine, and Cmax naxolone were modestly decreased during coadministration with telaprevir. Geometric least-squares mean ratios (90% confidence intervals) for buprenorphine were 0.80 (0.69, 0.93) for the Cmax and 0.96 (0.84, 1.10) for the AUC from 0 to 24 h (AUC0–24); for norbuprenorphine, values were 0.85 (0.66, 1.09) for Cmax and 0.91 (0.71, 1.16) for AUC0–24; for naloxone, the Cmax was 0.84 (0.62, 1.13). Coadministration of telaprevir did not increase withdrawal symptom frequency, and there were no serious adverse events reported during or after completion of telaprevir coadministration. Results suggest dose adjustment may not be necessary when telaprevir and buprenorphine/naloxone are coadministered. PMID:22564847

  8. Unobserved versus observed office buprenorphine\\/naloxone induction: A pilot randomized clinical trial

    Microsoft Academic Search

    Erik W. Gunderson; Xin-Qun Wang; David A. Fiellin; Benjamin Bryan; Frances R. Levin

    2010-01-01

    Physician adoption of buprenorphine treatment of opioid dependence may be limited in part by concerns regarding the induction process. Although national guidelines recommend observed induction, some physicians utilize unobserved induction outside the office. The aim of this pilot randomized clinical trial was to assess preliminary safety and effectiveness of unobserved versus observed office buprenorphine\\/naloxone induction among patients entering a 12-week

  9. Buprenorphine-Naloxone Maintenance Following Release from Jail

    PubMed Central

    Lee, Joshua D.; Grossman, Ellie; Truncali, Andrea; Rotrosen, John; Rosenblum, Andrew; Magura, Steven; Gourevitch, Marc N.

    2012-01-01

    Primary care is understudied as a re-entry drug and alcohol treatment setting. This study compared treatment retention and opioid misuse among opioid dependent adults seeking buprenorphine/naloxone maintenance in an urban primary care clinic following release from jail vs. community referrals. Post-release patients were either; a) induced to buprenorphine in-jail as part of a clinical trial, or, b) seeking buprenorphine induction post-release. From 2007–2008, N=142 patients were new to primary care buprenorphine: n=32 post-release; n=110 induced after community referral and without recent incarceration. Jail-released patients were more likely African American or Hispanic and uninsured. Treatment retention rates for post-release (37%) vs. community (30%) referrals were similar at 48 weeks. Rates of opioid positive urines and self-reported opioid misuse were also similar between groups. Post-release patients in primary care buprenorphine treatment had equal treatment retention and rates of opioid abstinence vs. community-referred patients. PMID:22263712

  10. New developments in the management of opioid dependence: focus on sublingual buprenorphine-naloxone.

    PubMed

    Soyka, Michael

    2015-01-01

    Opioid maintenance therapy is a well-established first-line treatment approach in opioid dependence. Buprenorphine, a partial opioid agonist, has been found by numerous studies to be an effective and safe medication in the treatment of opioid dependence. At present, buprenorphine is available as a monodrug or in a fixed 4:1 ratio combination with naloxone. A diminished risk of diversion and abuse for the buprenorphine-naloxone combination is likely but not firmly established. Conventional formulations are given sublingually to avoid the hepatic first-pass effect. A novel film tablet is available only in the US and Australia. Other novel, sustained-release formulations (implant, depot) are currently being developed and tested. Recent studies, including a Cochrane meta-analysis, suggest that the retention with buprenorphine is lower than for methadone, but that buprenorphine may be associated with less drug use. Higher doses of buprenorphine are associated with better retention rates. Buprenorphine has a ceiling effect at the opioid receptor with regard to respiratory depression, and may cause fewer fatal intoxications than methadone. Possible antidepressant effects of buprenorphine and its use in comorbid psychiatric patients has not been studied in much detail. Clinical implications are discussed. PMID:25610012

  11. Buprenorphine and naloxone combinations: the effects of three dose ratios in morphine-stabilized, opiate-dependent volunteers

    Microsoft Academic Search

    J. Mendelson; Reese T. Jones; Susette Welm; Matthew Baggott; Isabella Fernandez; Ann K. Melby; Rajneesh P. Nath

    1999-01-01

    Sublingual buprenorphine is a promising new treatment for opiate dependence, but its opioid agonist effects pose a risk for\\u000a parenteral abuse. A formulation combining buprenorphine with the opiate antagonist naloxone could discourage such abuse. The\\u000a effects of three intravenous (IV) buprenorphine and naloxone combinations on agonist effects and withdrawal signs and symptoms\\u000a were examined in 12 opiate-dependent subjects. Following stabilization

  12. Buprenorphine prescription by general practitioners in a French region

    Microsoft Academic Search

    X. Thirion; V. Lapierre; J. Micallef; E. Ronflé; A. Masut; V. Pradel; C. Coudert; J. C. Mabriez; J. L. Sanmarco

    2002-01-01

    Since 1996 French general practitioners (GPs) may prescribe sublingual buprenorphine tablets as maintenance treatment for opiate dependence. The computerised data management of the main French health reimbursement system now allows surveillance of the use of this drug, and how it is prescribed. The purpose of this study is to determine the profile of maintained patients, prescribed doses, associated psychotropic treatments

  13. One-year mortality rates of patients receiving methadone and buprenorphine maintenance therapy: a nationally representative cohort study in 2694 patients.

    PubMed

    Soyka, Michael; Apelt, Sabine M; Lieb, Martin; Wittchen, Hans-Ulrich

    2006-12-01

    Mortality rates in drug-dependent patients in substitution treatment remain a matter of debate. Although several retrospective toxicological or forensic postmortem studies on this issue have been conducted, few prospective studies have addressed this problem. In a nationally representative sample of 2694 opioid dependent patients in substitution treatment either with methadone or buprenorphine at baseline were monitored over a 12-month period (response rate, 91%). A total number of 1629 (60.4%) were still in treatment after 12 months. The overall mortality rate was 1.04%. In total, 28 patients of the initial sample deceased within the 1-year follow-up period. Eleven (0.4%) of these deaths are due to a fatal intoxication. Three patients (0.1%) died of human immunodeficiency virus/acquired immunodeficiency syndrome, and 3 (0.1%) committed suicide. Thirteen of these patients (4 with overdose/polyintoxication) were not in substitution treatment at the time of death. Other reasons included accidents and deaths due to other medical conditions. Only in one case the reason could not be ascertained. The mortality rate was similar in methadone as compared with buprenorphine patients. Taking into account the high comorbidity of opioid dependent patients and the severity of dependence, the mortality rate of approximately 1% confirms that maintenance treatment could be regarded as a fairly safe treatment. PMID:17110826

  14. Sublingual versus subcutaneous buprenorphine in opiate abusers

    Microsoft Academic Search

    Donald R Jasinski; Paul J Fudala; Rolley E Johnson; R E Johnson NIDA

    1989-01-01

    To compare the pharmacologic profiles of sublingually and subcutaneously administered buprenorphine, 10 healthy male subjects with histories of opiate abuse were given sublingually administered buprenorphine (1, 2, and 4 mg), subcutaneously administered buprenorphine (1 and 2 mg), and placebo in a double-blind, double-dummy, placebo-controlled study. All active buprenorphine dosages produced a significant degree of miosis but no significant changes in

  15. Efficacy of daily and alternate-day dosing regimens with the combination buprenorphine–naloxone tablet

    Microsoft Academic Search

    Leslie Amass; Jonathan B Kamien; Susan K Mikulich

    2000-01-01

    This study evaluated the efficacy of a combination tablet formulation of buprenorphine containing 8 mg of buprenorphine and 2 mg of naloxone for every other day treatment and whether increasing the daily maintenance dose was essential for maintaining an efficacious alternate-day treatment. Twenty-six opioid-dependent outpatients completing a 16-day baseline entered a double-blind, placebo-controlled, triple crossover trial. Twenty-one days of daily

  16. Assessing Cognitive and Psychomotor Performance Under Long-Term Treatment with Transdermal Buprenorphine in Chronic Noncancer Pain Patients

    Microsoft Academic Search

    Oguzhan Dagtekin; Hans J. Gerbershagen; Werner Wagner; Frank Petzke; Lukas Radbruch; Rainer Sabatowski

    2007-01-01

    BACKGROUND: The therapeutic use of opioids has been associated with altered cognition and impaired psychomotor function. Several studies have demonstrated the impact of opioid therapy on psychomotor performance and cognition, but there are no data about the effect of long-term treatment with transdermal buprenor- phine on driving ability. METHODS: Thirty patients suffering from chronic noncancer pain, who had been treated

  17. The cost-effectiveness of buprenorphine maintenance therapy for opiate addiction in the United States

    Microsoft Academic Search

    Paul G. Barnett; Gregory S. Zaric; Margaret L. Brandeau

    2001-01-01

    Aims. To determine the cost-effectiveness of buprenorphine maintenance therapy for opiate addiction in the United States, particularly its effect on the HIV epidemic. Design. We developed a dynamic model to capture the effects of adding buprenorphine maintenance to the current opiate dependence treatment system. We evaluated incremental costs, including all health-care costs, and incremental effectiveness, measured as quality-adjusted life years

  18. Disulfiram versus placebo for cocaine dependence in buprenorphine-maintained subjects: a preliminary trial

    Microsoft Academic Search

    Tony P George; Marek C Chawarski; Juliana Pakes; Kathleen M Carroll; Thomas R Kosten; Richard S Schottenfeld

    2000-01-01

    Background: We examined the effects of disulfiram versus placebo on cocaine dependence in buprenorphine-maintained subjects.Methods: Opioid and cocaine dependent subjects (n = 20) were induced onto buprenorphine maintenance, then randomized to disulfiram (250 mg q.d.; n = 11) or placebo (n = 9) treatment for 12 weeks.Results: Groups were comparable at baseline on demographic measures and on baseline measures of

  19. Combined administration of buprenorphine and naltrexone produces antidepressant-like effects in mice.

    PubMed

    Almatroudi, Abdulrahman; Husbands, Stephen M; Bailey, Christopher P; Bailey, Sarah J

    2015-07-01

    Opiates have been used historically for the treatment of depression. Renewed interest in the use of opiates as antidepressants has focused on the development of kappa opioid receptor (?-receptor) antagonists. Buprenorphine acts as a partial µ-opioid receptor agonist and a ?-receptor antagonist. By combining buprenorphine with the opioid antagonist naltrexone, the activation of µ-opioid receptors will be reduced and the ?-antagonist properties enhanced. We have established that a combination dose of buprenorphine (1 mg/kg) with naltrexone (1 mg/kg) functions as a short-acting ?-antagonist in the mouse tail withdrawal test. Furthermore, this dose combination is neither rewarding nor aversive in the conditioned place preference paradigm, and is without significant locomotor effects. We have shown for the first time that systemic co-administration of buprenorphine (1 mg/kg) with naltrexone (1 mg/kg) in CD-1 mice produced an antidepressant-like response in behaviours in both the forced swim test and novelty induced hypophagia task. Behaviours in the elevated plus maze and light dark box were not significantly altered by treatment with buprenorphine alone, or in combination with naltrexone. We propose that the combination of buprenorphine with naltrexone represents a novel, and potentially a readily translatable approach, to the treatment of depression. PMID:26045511

  20. Drug Interactions of Clinical Importance among the Opioids, Methadone and Buprenorphine, and other Frequently Prescribed Medications: A Review

    PubMed Central

    McCance-Katz, Elinore F.; Sullivan, Lynn; Nallani, Srikanth

    2012-01-01

    Drug interactions are a leading cause of morbidity and mortality. Methadone and buprenorphine are frequently prescribed for the treatment of opioid addiction. Patients needing treatment with these medications often have co-occurring medical and mental illnesses that require medication treatment. The abuse of illicit substances is also common in opioid-addicted individuals. These clinical realities place patients being treated with methadone and buprenorphine at risk for potentially toxic drug interactions. A substantial literature has accumulated on drug interactions between either methadone or buprenorphine with other medications when ingested concomitantly by humans. This review summarizes current literature in this area. PMID:20132117

  1. Counseling plus Buprenorphine–Naloxone Maintenance Therapy for Opioid Dependence

    Microsoft Academic Search

    David A. Fiellin; Michael V. Pantalon; Marek C. Chawarski; Brent A. Moore; Lynn E. Sullivan; Patrick G. O'Connor; Richard S. Schottenfeld

    2006-01-01

    Background The optimal level of counseling and frequency of attendance for medication distri- bution has not been established for the primary care, office-based buprenorphine- naloxone treatment of opioid dependence. Methods We conducted a 24-week randomized, controlled clinical trial with 166 patients assigned to one of three treatments: standard medical management and either once-weekly or thrice-weekly medication dispensing or enhanced medical

  2. Memory function in opioid-dependent patients treated with methadone or buprenorphine along with benzodiazepine: longitudinal change in comparison to healthy individuals

    PubMed Central

    Rapeli, Pekka; Fabritius, Carola; Kalska, Hely; Alho, Hannu

    2009-01-01

    Background Opioid-substitution treatment (OST) for opioid dependence (OD) has proven effective in retaining patients in treatment and reducing illegal opiate abuse and crime. Consequently, the World Health Organization (WHO) has listed the opioid agonists methadone and buprenorphine as essential drugs for OD that should be available worldwide. In many areas of the world, OD is often associated with concomitant benzodiazepine (BZD) dependence and abuse, which complicates treatment. However, possible changes in the cognitive functioning of these patients are not well-known. The present study is the first to examine longitudinal stability of memory function in OST patients with BZD use, thus providing a new tool for health policy authorities in evaluating the usefulness of OST. Methods Within the first two months (T1) and between 6–9 months (T2) after OST admission, we followed the working memory, immediate verbal memory, and memory consolidation of 13 methadone- and 15 buprenorphine- or buprenorphine/naloxone-treated patients with BZD dependence or abuse disorder. The results were compared to those of fifteen normal comparison participants. All participants also completed a self-reported memory complaint questionnaire on both occasions. Results Both patient groups performed statistically significantly worse than normal comparison participants in working memory at time points T1 and T2. In immediate verbal memory, as measured by list learning at T1, patients scored lower than normal comparison participants. Both patient groups reported significantly more subjective memory problems than normal comparison participants. Patients with more memory complaints recalled fewer items at T2 from the verbal list they had learned at T1 than those patients with fewer memory complaints. The significance of the main analyses remained nearly the same when the statistical tests were performed without buprenorphine-only patients leaving 12 patients to buprenorphine/naloxone group. Conclusion Working memory may be persistently affected in OST patients with BZD use. A high number of memory complaints among OST patients with BZD use may indicate memory consolidation impairment. These findings show that recovery of memory function in OD patients treated along with BZDs takes time, and their memory complaints may have practical relevance. PMID:19374740

  3. Oligodendrocyte responses to buprenorphine uncover novel and opposing roles of ?-opioid- and nociceptin/orphanin FQ receptors in cell development: implications for drug addiction treatment during pregnancy.

    PubMed

    Eschenroeder, Andrew C; Vestal-Laborde, Allison A; Sanchez, Emilse S; Robinson, Susan E; Sato-Bigbee, Carmen

    2012-01-01

    Although the classical function of myelin is the facilitation of saltatory conduction, this membrane and the oligodendrocytes, the cells that make myelin in the central nervous system (CNS), are now recognized as important regulators of plasticity and remodeling in the developing brain. As such, oligodendrocyte maturation and myelination are among the most vulnerable processes along CNS development. We have shown previously that rat brain myelination is significantly altered by buprenorphine, an opioid analogue currently used in clinical trials for managing pregnant opioid addicts. Perinatal exposure to low levels of this drug induced accelerated and increased expression of myelin basic proteins (MBPs), cellular and myelin components that are markers of mature oligodendrocytes. In contrast, supra-therapeutic drug doses delayed MBP brain expression and resulted in a decreased number of myelinated axons. We have now found that this biphasic-dose response to buprenorphine can be attributed to the participation of both the ?-opioid receptor (MOR) and the nociceptin/orphanin FQ receptor (NOP receptor) in the oligodendrocytes. This is particularly intriguing because the NOP receptor/nociceptin system has been primarily linked to behavior and pain regulation, but a role in CNS development or myelination has not been described before. Our findings suggest that balance between signaling mediated by (a) MOR activation and (b) a novel, yet unidentified pathway that includes the NOP receptor, plays a crucial role in the timing of oligodendrocyte maturation and myelin synthesis. Moreover, exposure to opioids could disrupt the normal interplay between these two systems altering the developmental pattern of brain myelination. PMID:22002899

  4. Buprenorphine and methadone for opioid addiction during pregnancy.

    PubMed

    Mozurkewich, Ellen L; Rayburn, William F

    2014-06-01

    Buprenorphine and methadone are opioid-receptor agonists used as opioid substitution therapy during pregnancy to limit exposure of the fetus to cycles of opioid withdrawal and reduce the risk of infectious comorbidities of illicit opioid use. As part of a comprehensive care plan, such therapy may result in improved access to prenatal care, reduced illicit drug use, reduced exposure to infections associated with intravenous drug use, and improved maternal nutrition and infant birth weight. This article describes differences in patient selection between the two drugs, their relative safety during pregnancy, and changes in daily doses as a guide for prescribing clinicians. PMID:24845488

  5. BUPRENORPHINE-NALXONE THERAPY IN PAIN MANAGEMENT

    PubMed Central

    Chen, Kelly Yan; Chen, Lucy; Mao, Jianren

    2014-01-01

    Buprenorphine-naloxone (bup/nal in 4:1 ratio; Suboxone®, Reckitt Benckiser Pharmaceuticals Incorporation, Richmond, VA) is approved by the Food and Drug Administration for outpatient office-based addiction treatment. In the past few years, bup/nal has been increasingly prescribed off-label for chronic pain management. The current data suggests that bup/nal may provide pain relief in chronic pain patients with opioid dependence or addiction. However, the unique pharmacological profile of bup/nal confers it to be a weak analgesic that is unlikely to provide adequate pain relief for patients without opioid dependence or addiction. Possible mechanisms of pain relief by bup/nal therapy in opioid-dependent chronic pain patients may include reversal of opioid-induced hyperalgesia as well as improvement in opioid tolerance and addiction. Additional studies are needed to assess the implication of bup/nal therapy in clinical anesthesia and perioperative pain management. PMID:24509068

  6. Pharmacokinetic interactions between buprenorphine\\/naloxone and tipranavir\\/ritonavir in HIV-negative subjects chronically receiving buprenorphine\\/naloxone

    Microsoft Academic Search

    R. Douglas Bruce; Frederick L. Altice; David E. Moody; Shen-Nan Lin; Wenfang B. Fang; John P. Sabo; Jan M. Wruck; Peter J. Piliero; Carolyn Conner; Laurie Andrews; Gerald H. Friedland

    2009-01-01

    HIV-infected patients with opioid dependence often require opioid replacement therapy. Pharmacokinetic interactions between HIV therapy and opioid dependence treatment medications can occur.HIV-seronegative subjects stabilized on at least 3 weeks of buprenorphine\\/naloxone (BUP\\/NLX) therapy sequentially underwent baseline and steady-state pharmacokinetic evaluation of open-label, twice daily tipranavir 500mg co-administered with ritonavir 200mg (TPV\\/r).Twelve subjects were enrolled and 10 completed the study. Prior

  7. The Baltimore Buprenorphine Initiative: understanding the role of buprenorphine in addressing heroin addiction in an urban-based community.

    PubMed

    Murphy, Lyn Stankiewicz; Oros, Marla T; Dorsey, Susan G

    2014-01-01

    Adequate drug treatment for substance users continues to be a challenge for most U.S. cities. To address heroin addiction in Baltimore, the Baltimore Buprenorphine Initiative was implemented as a joint project to promote individualized, patient-centered buprenorphine therapy in conjunction with behavioral treatment to accelerate recovery from opioid addiction. The purpose of this analysis was to explore differences in recovery trajectories predicting length of stay and use this information to predict characteristics that influence an individual's ability to remain in the Baltimore Buprenorphine Initiative program. The sample consisted of 1,039 subjects enrolled in the program between January 2008 and June 2009. The regression modeling determined that age, income, employment, and higher level of treatment were significant predictors of length of stay in the recovery program. The findings of this study have practical implications for the design and implementation of heroin addiction programs. The research indicates that focusing on these specific predictive variables early in the program design phase could increase recovery success rates as measured by length of stay. PMID:24613946

  8. Abuse and diversion of buprenorphine sublingual tablets and film.

    PubMed

    Lavonas, Eric J; Severtson, S Geoffrey; Martinez, Erin M; Bucher-Bartelson, Becki; Le Lait, Marie-Claire; Green, Jody L; Murrelle, Lenn E; Cicero, Theodore J; Kurtz, Steven P; Rosenblum, Andrew; Surratt, Hilary L; Dart, Richard C

    2014-07-01

    Buprenorphine abuse is common worldwide. Rates of abuse and diversion of three sublingual buprenorphine formulations (single ingredient tablets; naloxone combination tablets and film) were compared. Data were obtained from the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS) System Poison Center, Drug Diversion, Opioid Treatment (OTP), Survey of Key Informants' Patients (SKIP), and College Survey Programs through December 2012. To control for drug availability, event ratios (rates) were calculated quarterly, based on the number of patients filling prescriptions for each formulation ("unique recipients of a dispensed drug," URDD) and averaged and compared using negative binomial regression. Abuse rates in the OTP, SKIP, and College Survey Programs were greatest for single ingredient tablets, and abuse rates in the Poison Center Program and illicit diversion rates were greatest for the combination tablets. Combination film rates were significantly less than rates for either tablet formulation in all programs. No geographic pattern could be discerned. PMID:24680219

  9. Management of opioid addiction with buprenorphine: French history and current management

    PubMed Central

    Poloméni, Pierre; Schwan, Raymund

    2014-01-01

    The way in which opioid addiction is managed in France is unique, as it is based on the prescription of buprenorphine by general practitioners and is dispensed by retail pharmacies. This policy has had a direct, positive impact on the number of deaths caused by heroin overdose, which was reduced by four-fifths between 1994 and 2002. In addition, certain associated comorbidities, such as infection with the human immunodeficiency virus, have also been reduced; the incidence of acquired immune deficiency syndrome in intravenous drug users fell from 25% in the mid-1990s to 6% in 2010. Since the implementation of this French model of opioid management, major scientific progress has been made, leading to a better understanding of the pathophysiologic mechanisms of addiction and of the management modalities required for its treatment. However, despite notable advances in scientific knowledge and in the implementation of devices, opioid addiction remains a major public health care issue in France, with 275,000–360,000 “problem drug users” being reported in 2011. The situation is still particularly worrying due to psychoactive substance use and misuse of opioid substitution treatments. Since 2003, there has been a persistent increase in the number of deaths and comorbidities related to opioid addiction, principally hepatitis C virus infection, which affects up to 40% of intravenous drug users. In France, the direct involvement of general practitioners in the management of opioid addiction is indisputable. Nevertheless, management could be optimized through better understanding of the pathophysiologic mechanisms of the disease, better knowledge of the pharmacology of opioid substitution treatments, and clear definition of short-, medium- and long-term treatment objectives. Data related to the management of opioid addiction by general practitioners in France have been published in 2005. Since then, the context has changed, other drugs were launched on the market such as generics of buprenorphine, methadone capsule, and Suboxone. Thus, an update seems necessary. This paper provides a description of opioid addiction management objectives and treatment modalities for general practitioners, based on currently available knowledge. PMID:24623988

  10. Opioid receptor imaging and displacement studies with [6- O-[ 11C]methyl]buprenorphine in baboon brain

    Microsoft Academic Search

    Igor Galynker; David J. Schlyer; Stephen L. Dewey; Joanna S. Fowler; Jean Logan; S. John Galley; Robert R. MacGregor; Richard A. Ferrieri; M. J. Holland; Jonathan Brodie; Eric Simon; Alfred P. Wolf

    1996-01-01

    Buprenorphine (BPN) is a mixed opiate agonist-antagonist used as an analgesic and in the treatment of opiate addiction. We have used [6-O-[11C]methyl]buprenorphine ([11C]BPN) to measure the regional distribution in baboon brain, the test-retest stability of repeated studies in the same animal, the displacement of the labeled drug by naloxone in vivo, and the tissue distribution in mice. The regional distribution

  11. Randomized, Placebo-Controlled Pilot Trial of Gabapentin During an Outpatient, Buprenorphine-Assisted Detoxification Procedure1

    PubMed Central

    Sanders, Nichole C.; Mancino, Michael J.; Gentry, W. Brooks; Guise, J. Benjamin; Bickel, Warren K.; Thostenson, Jeff; Oliveto, Alison H.

    2014-01-01

    This pilot study examined the efficacy of the N-type calcium channel blocker gabapentin to improve outcomes during a brief detoxification protocol with buprenorphine. Treatment-seeking opioid-dependent individuals were enrolled in a 5-wk, double blind, placebo-controlled trial examining the effects of gabapentin during a 10-day outpatient detoxification from buprenorphine. Participants were inducted onto buprenorphine sublingual tablets during week 1, were randomized and inducted onto gabapentin or placebo during week 2, underwent a 10-day buprenorphine taper during weeks 3–4 and then were tapered off gabapentin/placebo during week 5. Assessments included thrice-weekly opioid withdrawal scales, vitals, and urine drug screens. Twenty-four individuals (13 male, 17 Caucasian, 3 African American, 4 Latino, mean age 29.7 yrs) participated in the detoxification portion of the study (gabapentin, N=11; placebo, N=13). Baseline characteristics did not differ significantly between groups. Self-reported and observer-rated opioid withdrawal ratings were relatively low and did not differ between groups during the buprenorphine taper. Urine results showed a drug x time interaction, such that the probability of opioid-positive urines significantly decreased over time in the gabapentin versus placebo groups during weeks 3–4 (OR=0.73, p=0.004). These results suggest that gabapentin reduces opioid use during a 10-day buprenorphine detoxification procedure. PMID:23855333

  12. The Reinforcing and Subjective Effects of Intravenous and Intranasal Buprenorphine in Heroin Users

    PubMed Central

    Jones, Jermaine D.; Madera, Gabriela; Comer, Sandra D.

    2014-01-01

    Abuse of buprenorphine (BUP) by the intravenous (IV) route has been documented in several studies, and reports of intranasal (IN) abuse are increasing. However, no studies have directly compared the effects of BUP when it is administered intranasally and intravenously. The present secondary analysis used data from two separate studies to compare the reinforcing and subjective effects of IV and IN buprenorphine. One study evaluated IV buprenorphine (N=13) and the other evaluated IN buprenorphine (N=12). Participants were maintained on 2 mg sublingual (SL) BUP and tested with each intranasal or intravenous buprenorphine test dose (0 mg, 2 mg, 4 mg, 8 mg, and 16 mg). During morning laboratory sessions, participants received money (US $20) and sample doses of IN or IV BUP, and then completed subjective effects questionnaires. Later that day, they completed a self-administration task to receive 10% portions of the drug and/or money they previously sampled. In general, positive subjective ratings for both IV and IN BUP were significantly greater than placebo, with IV BUP having a greater effect than IN BUP. All active BUP doses (IV and IN) maintained significantly higher progressive ratio breakpoint values than placebo, but breakpoint values for IV BUP were greater than for IN BUP. Buprenorphine is an effective maintenance treatment for opioid dependence, valued for its ability to reduce the positive subjective effects of other opioids. Nevertheless, the present data demonstrate that in participants maintained on a low dose of SL BUP, the medication itself has abuse liability when used intravenously or intranasally. PMID:24793093

  13. The reinforcing and subjective effects of intravenous and intranasal buprenorphine in heroin users.

    PubMed

    Jones, Jermaine D; Madera, Gabriela; Comer, Sandra D

    2014-07-01

    Abuse of buprenorphine (BUP) by the intravenous (IV) route has been documented in several studies, and reports of intranasal (IN) abuse are increasing. However, no studies have directly compared the effects of BUP when it is administered intranasally and intravenously. The present secondary analysis used data from two separate studies to compare the reinforcing and subjective effects of IV and IN buprenorphine. One study evaluated IV buprenorphine (N=13) and the other evaluated IN buprenorphine (N=12). Participants were maintained on 2 mg sublingual (SL) BUP and tested with each intranasal or intravenous buprenorphine test dose (0 mg, 2 mg, 4 mg, 8 mg, and 16 mg). During morning laboratory sessions, participants received money (US $20) and sample doses of IN or IV BUP, and then completed subjective effects questionnaires. Later that day, they completed a self-administration task to receive 10% portions of the drug and/or money they previously sampled. In general, positive subjective ratings for both IV and IN BUP were significantly greater than placebo, with IV BUP having a greater effect than IN BUP. All active BUP doses (IV and IN) maintained significantly higher progressive ratio breakpoint values than placebo, but breakpoint values for IV BUP were greater than for IN BUP. Buprenorphine is an effective maintenance treatment for opioid dependence, valued for its ability to reduce the positive subjective effects of other opioids. Nevertheless, the present data demonstrate that in participants maintained on a low dose of SL BUP, the medication itself has abuse liability when used intravenously or intranasally. PMID:24793093

  14. Pronociceptive and Antinociceptive Effects of Buprenorphine in the Spinal Cord Dorsal Horn Cover a Dose Range of Four Orders of Magnitude.

    PubMed

    Gerhold, Katharina J; Drdla-Schutting, Ruth; Honsek, Silke D; Forsthuber, Liesbeth; Sandkühler, Jürgen

    2015-07-01

    Due to its distinct pharmacological profile and lower incidence of adverse events compared with other opioids, buprenorphine is considered a safe option for pain and substitution therapy. However, despite its wide clinical use, little is known about the synaptic effects of buprenorphine in nociceptive pathways. Here, we demonstrate dose-dependent, bimodal effects of buprenorphine on transmission at C-fiber synapses in rat spinal cord dorsal horn in vivo. At an analgesically active dose of 1500 ?g·kg(-1), buprenorphine reduced the strength of spinal C-fiber synapses. This depression required activation of spinal opioid receptors, putatively ?1-opioid receptors, as indicated by its sensitivity to spinal naloxone and to the selective ?1-opioid receptor antagonist naloxonazine. In contrast, a 15,000-fold lower dose of buprenorphine (0.1 ?g·kg(-1)), which caused thermal and mechanical hyperalgesia in behaving animals, induced an enhancement of transmission at spinal C-fiber synapses. The ultra-low-dose buprenorphine-induced synaptic facilitation was mediated by supraspinal naloxonazine-insensitive, but CTOP-sensitive ?-opioid receptors, descending serotonergic pathways, and activation of spinal glial cells. Selective inhibition of spinal 5-hydroxytryptamine-2 receptors (5-HT2Rs), putatively located on spinal astrocytes, abolished both the induction of synaptic facilitation and the hyperalgesia elicited by ultra-low-dose buprenorphine. Our study revealed that buprenorphine mediates its modulatory effects on transmission at spinal C-fiber synapses by dose dependently acting on distinct ?-opioid receptor subtypes located at different levels of the neuraxis. PMID:26134641

  15. Benzodiazepines increase the reward effects of buprenorphine in a conditioned place preference test in the mouse.

    PubMed

    Ma, Lin-Lin; Freret, Thomas; Lange, Mathilde; Bourgine, Joanna; Coquerel, Antoine; Lelong-Boulouard, Véronique

    2014-12-01

    Buprenorphine (BPN) is widely used as a substitution treatment for opioid addiction. Some cases of abuse and misuse, especially associated with various benzodiazepines (BZDs), have been described, and a previous study has shown that BZDs increase the sedative effect of BPN and decrease its anxiogenic properties. To investigate the reward effect that may lead to the abusive combination of BPN and BZD, we studied the influence of different doses of three BZDs extensively used with BPN by drug addicts on conditioned place preference behavior in mice. BPN (0.3, 1, 3 mg/kg) was injected subcutaneously into male mice alone or in combination with a BZD administered intraperitoneally: dipotassium clorazepate (CRZ; 1, 4, 16 mg/kg), diazepam (DAZ; 0.5, 1, 5 mg/kg), or bromazepam (BMZ; 0.5, 1, 3 mg/kg). Amphetamine (8 mg/kg) was used as a reference drug. Reward effects of BPN alone or in combination were measured in a conditioned place preference paradigm using an unbiased procedure. Our results showed that groups treated with BPN associated with different doses of diazepam and clorazepate, but not bromazepam, spent significantly more time in the drug-paired compartment compared to the group treated with BPN alone. Our study shows that joint consumption of diazepam and clorazepate, but not bromazepam, can increase the reward properties of BPN alone in mice. These results could help to explain the use of this type of drug combination in the drug addict population. PMID:24617653

  16. Effects of voluntarily-ingested buprenorphine on plasma corticosterone levels, body weight, water intake, and behaviour in permanently catheterised rats.

    PubMed

    Goldkuhl, Renée; Hau, Jann; Abelson, Klas S P

    2010-01-01

    This study investigated the peri- and postoperative effect of pre-emptive analgesia through voluntary ingestion of buprenorphine in Nutella, in male Sprague-Dawley rats. An arterial catheter was inserted and the rats were connected to an automated blood sampling device (AccuSampler). Blood samples were drawn up to 18 h after surgery and the plasma concentrations of corticosterone were quantified. Postoperative changes in water intake and body weight were recorded, and the behaviour of the rats was analysed during two 30-min periods. Pre-emptive oral buprenorphine treatment reduced the plasma corticosterone levels in the postoperative period, compared to controls treated with local anaesthetics. Buprenorphine-treated rats consumed more water and maintained body weight better. Behavioural observations indicated that buprenorphine changed the behaviour in non-operated rats but there was no difference in the operated rats. The present study strengthens the hypothesis that pre-emptive oral buprenorphine in Nutella is suitable for treatment of postoperative pain in rats. PMID:20363983

  17. Different Saliva Substitutes for Treatment of Xerostomia Following Radiotherapy

    Microsoft Academic Search

    Felix Momm; Natalja Jurievna Volegova-Neher; Jürgen Schulte-Mönting; Roland Guttenberger

    2005-01-01

    Background and Purpose: Xerostomia is an important chronic side effect of radiotherapy in the head and neck area. The authors investigated the efficacy of different artificial saliva compounds in patients with postirradiation xerostomia. Patients and Methods: In 120 patients with xerostomia after radiotherapy for head and neck cancer, four different saliva substitute compounds (gel, carmellose spray, oil, mucin spray) were

  18. Prenatal buprenorphine exposure decreases neurogenesis in rats.

    PubMed

    Wu, Chih-Cheng; Hung, Chih-Jen; Shen, Ching-Hui; Chen, Wen-Ying; Chang, Cheng-Yi; Pan, Hung-Chuan; Liao, Su-Lan; Chen, Chun-Jung

    2014-02-10

    Perinatal opioid exposure has a negative effect on neurogenesis and produces neurological consequences. However, its mechanisms of action are incompletely understood. Buprenorphine, a mixed opioid agonist/antagonist, is an alternative medication for managing pregnant opioid addicts. This study provides evidence of decreased neurogenesis and depression-like consequences following prenatal exposure to buprenorphine and sheds light on mechanisms of action in a rat model involving administration of intraperitoneal injection to pregnant rats starting from gestation day 7 and lasting for 14 days and a cultured neurosphere model. Results of forced swimming test and tail suspension test showed that pups at postnatal day 21 had worse parameters of depression-like neurobehaviors, independent of gender. Neurobehavioral changes were accompanied by reduction of neuronal composition, biochemical parameters of neural stem/progenitor cells, brain-derived neurotrophic factor (BDNF) expression, tropomyosin-related kinase receptor type B phosphorylation, protein kinase A (PKA) activity, and cAMP response element-binding protein phosphorylation. Results of parallel cell studies further demonstrated a negative impact of buprenorphine on cultured neurospheres, including proliferation, differentiation, BDNF expression and signaling, and PKA activity. Taken together, our results suggest that prenatal exposure to buprenorphine might result in depression-like phenotypes associated with impaired BDNF action and decreased neurogenesis in the developing brain of weanlings. PMID:24321744

  19. The pharmacodynamic and pharmacokinetic profile of intranasal crushed buprenorphine and buprenorphine/naloxone tablets in opioid abusers

    PubMed Central

    Middleton, L.S.; Nuzzo, P.A.; Lofwall, M.R.; Moody, D.E.; Walsh, S.L.

    2011-01-01

    Aims Sublingual buprenorphine and buprenorphine/naloxone are efficacious opioid dependence pharmacotherapies, but there are reports of their diversion and misuse by the intranasal route. The study objectives were to characterize and compare their intranasal pharmacodynamic and pharmacokinetic profiles. Design A randomized, double-blind, placebo-controlled, crossover study. Setting An in-patient research unit at the University of Kentucky. Participants Healthy adults (n=10) abusing, but not physically dependent on, intranasal opioids. Measurements Six sessions (72 hours apart) tested five intranasal doses [0/0, crushed buprenorphine (2, 8 mg), crushed buprenorphine/naloxone (2/0.5, 8/2 mg)] and one intravenous dose (0.8 mg buprenorphine/0.2 mg naloxone for bioavailability assessment). Plasma samples, physiological, subject- and observer-rated measures were collected before and for up to 72 hours after drug administration. Findings Both formulations produced time- and dose-dependent increases on subjective and physiological mu-opioid agonist effects (e.g. ‘liking’, miosis). Subjects reported higher subjective ratings and street values for 8 mg compared to 8/2 mg, but these differences were not statistically significant. No significant formulation differences in peak plasma buprenorphine concentration or time-course were observed. Buprenorphine bioavailability was 38–44% and Tmax was 35–40 minutes after all intranasal doses. Naloxone bioavailability was 24% and 30% following 2/0.5 and 8/2 mg, respectively. Conclusions It is difficult to determine if observed differences in abuse potential between intranasal buprenorphine and buprenorphine/naloxone are clinically relevant at the doses tested. Greater bioavailability and faster onset of pharmacodynamic effects compared to sublingual administration suggests a motivation for intranasal misuse in non-dependent opioid abusers. However, significant naloxone absorption from intranasal buprenorphine/naloxone administration may deter the likelihood of intranasal misuse of buprenorphine/naloxone, but not buprenorphine, in opioid-dependent individuals. PMID:21395892

  20. [Outcome of a substitution therapy program in an outpatient treatment setting of a psychiatric hospital].

    PubMed

    Unglaub, Willi; Loncarek, Ema; Wismath, Martin; Johann, Monika; Wodarz, Norbert; Klein, Helmfried

    2004-11-01

    We look at 42 opiate addicts being in substitution therapy at a certain date (24.9.2003) in an outpatient treatment setting of a psychiatric hospital. Treatment outcome is described with amount of take home, reduced delinquency, increased social reintegration as well as pharmacological treatment. 25 men and 17 women, age from 20 to 49 (29) have been in our treatment between 1 to 52 months (29). 20 of them (48 %) got an additional psychiatric medication, mostly antidepressants (42 %) but also neuroleptics (9,5 %). 21 patients had a drug free urine test (including cannabis) during the last month and could take their opiate medication at home. Necessity of support by social security declines from 25 % before to 16 % in substitution treatment. Also the need of unemployment benefit could be reduced from 36 % before to 26 % in treatment. Full time jobs increase from 31 % to 48 %, part time jobs from 3 % to 7 % in treatment. PMID:15570492

  1. Do methadone and buprenorphine have the same impact on psychopathological symptoms of heroin addicts?

    Microsoft Academic Search

    Giovanni Icro Angelo Maremmani; Luca Rovai; Pier Paolo Pani; Matteo Pacini; Francesco Lamanna; Fabio Rugani; Elisa Schiavi; Liliana Dell’Osso; Icro Maremmani

    2011-01-01

    Background  The idea that the impact of opioid agonist treatment is influenced by the psychopathological profile of heroin addicts has\\u000a not yet been investigated, and is based on the concept of a specific therapeutic action displayed by opioid agents on psychopathological\\u000a symptoms. In the present report we compared the effects of buprenorphine and methadone on the psychopathological symptoms\\u000a of 213 patients

  2. Comparison of methadone and high dosage buprenorphine users in French care centres

    Microsoft Academic Search

    Karine Barrau; Xavier Thirion; Joëlle Micallef; Christine Chuniaud-Louche; Béatrice Bellemin; Jean Louis San Marco

    2001-01-01

    Aims. In France, maintenance programmes for opiate users were adopted later than in other countri~s. Two maintenance treatments are available: methadone is only delivered in specialized centres while high dosage (HD) buprenorphine can be prescribed by al1 general practitioners and in specialized centres. The aim of this study was to compare the socio-demographic projiles, the practices and drug consumption patterns

  3. Clinical pharmacology of buprenorphine: Ceiling effects at high doses

    Microsoft Academic Search

    Sharon L Walsh; Kenzie L Preston; Maxine L Stitzer; Edward J Cone; George E Bigelow

    1994-01-01

    Objective: The purpose of this study was to characterize the acute effects of buprenorphine, an opioid partial (?-agonist, across a wide range of doses in comparison to methadone.Method: Healthy adult male volunteers, who had experience with but were not physically dependent on opioids, participated while residing on a closed research unit. Four subjects received buprenorphine (0, 1, 2, 4, 8,

  4. Effects of Buprenorphine and Meloxicam Analgesia on Induced Cerebral Ischemia in C57BL/6 Male Mice

    PubMed Central

    Jacobsen, Kirsten R; Fauerby, Natasha; Raida, Zindy; Kalliokoski, Otto; Hau, Jann; Johansen, Flemming F; Abelson, Klas SP

    2013-01-01

    Laboratory mice constitute an extensively used model to study the pathologic and functional outcomes of cerebral ischemic stroke. The middle cerebral artery occlusion (MCAO) model requires surgical intervention, which potentially can result in postsurgical pain and stress. In the present study, we investigated whether buprenorphine and meloxicam, at clinically relevant doses provided pain relief without altering infarct volume in male C57BL/6 mice. Common known side-effects of buprenorphine, including decreased food consumption, were noted after surgery in buprenorphine-treated mice, but these effects were brief and seen only during the treatment period. Fecal corticosterone metabolites did not differ significantly between the groups. In the present study, buprenorphine treatment did not alter infarction volume when compared with that of mice that did not receive analgesia. In contrast, meloxicam treatment significantly reduced infarct volume and may be a confounder if used as an analgesic during MCAO surgery. Furthermore, investigation of behavioral profiles by using an automated behavioral scoring system showed that rearing and sniffing behaviors decreased as infarct volume increased. This suggests that studies of exploratory behavior may aid in developing new markers of short-term stroke-related behavioral deficiencies in laboratory mice. PMID:23582417

  5. Cocaine Use Reduction with Buprenorphine (CURB): Rationale, design, and methodology?

    PubMed Central

    Mooney, Larissa J.; Nielsen, Suzanne; Saxon, Andrew; Hillhouse, Maureen; Thomas, Christie; Hasson, Albert; Stablein, Don; McCormack, Jennifer; Lindblad, Robert; Ling, Walter

    2013-01-01

    Background Effective medications to treat cocaine dependence have not been identified. Recent pharmacotherapy trials demonstrate the potential efficacy of buprenorphine (BUP) (alone or with naltrexone) for reducing cocaine use. The National Institute on Drug Abuse Clinical Trials Network (CTN) launched the Cocaine Use Reduction with Buprenorphine (CURB) investigation to examine the safety and efficacy of sublingual BUP (as Suboxone®) in the presence of extended-release injectable naltrexone (XR-NTX, as Vivitrol®) for the treatment of cocaine dependence. This paper describes the design and rationale for this study. Methods This multi-site, double-blind, placebo-controlled study will randomize 300 participants across 11 sites. Participants must meet the DSM-IV criteria for cocaine dependence and past or current opioid dependence or abuse. Participants are inducted onto XR-NTX after self-reporting at least 7 days of abstinence from opioids and tolerating a naloxone challenge followed by oral naltrexone and are then randomly assigned to one of three medication conditions (4 mg BUP, 16 mg BUP, or placebo) for 8 weeks. Participants receive a second injection of XR-NTX 4 weeks after the initial injection, and follow-up visits are scheduled at 1 and 3 months post-treatment. Participants receive weekly cognitive behavioral therapy (CBT). Recruitment commenced in September, 2011. Enrollment, active medication, and follow-up phases are ongoing, and recruitment is exceeding targeted enrollment rates. Conclusions This research using 2 medications will demonstrate whether BUP, administered in the presence of XR-NTX, reduces cocaine use in adults with cocaine dependence and opioid use disorders and will demonstrate if XR-NTX prevents development of physiologic dependence on BUP. PMID:23159524

  6. A Randomized, Double-blind Evaluation of Buprenorphine Taper Duration in Primary Prescription Opioid Abusers

    PubMed Central

    Sigmon, Stacey C.; Dunn, Kelly E.; Saulsgiver, Kathryn; Patrick, Mollie E.; Badger, Gary J.; Heil, Sarah H.; Brooklyn, John R.; Higgins, Stephen T.

    2014-01-01

    IMPORTANCE Although abuse of prescription opioids (POs) is a significant public health problem, few experimental studies have investigated the treatment needs of this growing population. OBJECTIVE To evaluate, following brief stabilization with a combination of buprenorphine hydrochloride and naloxone hydrochloride dihydrate, the relative efficacy of 1-, 2-, and 4-week buprenorphine tapering regimens and subsequent naltrexone hydrochloride therapy in PO-dependent outpatients. DESIGN, SETTING, AND PARTICIPANTS A double-blind, 12-week randomized clinical trial was conducted in an outpatient research clinic. Following a brief period of buprenorphine stabilization, 70 PO-dependent adults were randomized to receive 1-, 2-, or 4-week tapers followed by naltrexone therapy. INTERVENTION During phase 1 (weeks 1–5 after randomization), participants visited the clinic daily; during phase 2 (weeks 6–12), visits were reduced to thrice weekly. Participants received behavioral therapy and urine toxicology testing throughout the trial. MAIN OUTCOMES AND MEASURES The percentage of participants negative for illicit opioid use, retention, naltrexone ingestion, and favorable treatment response (ie, retained in treatment, opioid abstinent, and receiving naltrexone at the end of the study). RESULTS Opioid abstinence at the end of phase 1 was greater in the 4-week compared with the 2- and 1-week taper conditions (P = .02), with 63% (n = 14), 29% (n = 7), and 29% (n = 7) of participants abstinent in the 4-, 2-, and 1-week conditions, respectively. Abstinence at the end of phase 2 was also greater in the 4-week compared with the 2- and 1-week conditions (P = .03), with 50% (n = 11), 16% (n = 4), and 20% (n = 5) of participants abstinent in the 4-, 2-, and 1-week conditions, respectively. There were more treatment responders in the 4-week condition (P = .03), with 50% (n = 11), 17% (n = 4), and 21% (n = 5) of participants in the 4-, 2-, and 1-week groups considered responders at the end of treatment, respectively. Retention and naltrexone ingestion also were superior in the 4-week vs briefer tapers (both P = .04). Experimental condition (ie, taper duration) was the strongest predictor of treatment response, followed by buprenorphine stabilization dose. CONCLUSIONS AND RELEVANCE This study represents a rigorous experimental evaluation of outpatient buprenorphine stabilization, brief taper, and naltrexone maintenance for treatment of PO dependence. Results suggest that a meaningful subset of PO-dependent outpatients may respond positively to a 4-week taper plus naltrexone maintenance intervention. PMID:24153411

  7. Drug use and opioid substitution treatment for prisoners

    Microsoft Academic Search

    Heino Stöver; Ingo Ilja Michels

    2010-01-01

    Drug use is prevalent throughout prison populations, and, despite advances in drug treatment programmes for inmates, access to and the quality of these programmes remain substantially poorer than those available for non-incarcerated drug users. Because prisoners may be at greater risk for some of the harms associated with drug use, they deserve therapeutic modalities and attitudes that are at least

  8. Shifts in opioid substitution treatment policy in Denmark from 2000-2011.

    PubMed

    Frank, Vibeke Asmussen; Bjerge, Bagga; Houborg, Esben

    2013-08-01

    This article discusses how opioid substitution treatment policy has developed from 2000 to 2011 in Denmark. Empirically, it takes its point of departure in a stakeholder analysis including 17 qualitative interviews with stakeholders who have played important roles in this field. Analytically, it is inspired by Kingdon's concepts of agenda and policy window. Three major shifts are identified: a shift from psychosocial to medical thinking and practice, from an abstinence driven ideology to health care, and from perceptions of passive clients to user involvement. These shifts are discussed in relation to the legal context of substitute prescribing medicine. PMID:23952511

  9. Atipamezole Reverses Ketamine–Dexmedetomidine Anesthesia without Altering the Antinociceptive Effects of Butorphanol and Buprenorphine in Female C57BL/6J Mice

    PubMed Central

    Izer, Jenelle M; Whitcomb, Tiffany L; Wilson, Ronald P

    2014-01-01

    Butorphanol and buprenorphine are common analgesics used in laboratory mice. Inadvertent attenuation of the antinociceptive effects of these analgesics via the administration of an anesthetic reversal agent could result in postprocedural pain and distress, with subsequent negative effects on animal welfare, study outcomes, and regulatory compliance. This study was undertaken to determine whether atipamezole reverses ketamine–dexmedetomidine anesthesia and alters the antinociceptive effects of butorphanol and buprenorphine in female C57BL/6J mice. Atipamezole reliably reversed the anesthetic effects of ketamine–dexmedetomidine, and mice were ambulatory 17.4 ± 30.6 min after administration of the ?2-adrenoreceptor antagonist. Atipamezole alone had no significant effect on tail-flick latency and did not alter the antinociceptive properties of butorphanol or low-dose (0.05 mg/kg) or high-dose (0.1 mg/kg) buprenorphine in female C57BL/6J mice. After reversal of ketamine–dexmedetomidine anesthesia, tail-flick latency at 30, 60, and 150 min after analgesic treatment differed significantly between mice treated with atipamezole alone and those given atipamezole followed by butorphanol or high-dose buprenorphine. These results suggest that the analgesic effects of butorphanol and buprenorphine are not affected by atipamezole. Buprenorphine (0.1 mg/kg) administered 30 min prior to or at the time of anesthesia resulted in a greater magnitude of antinociception after antagonism of anesthesia than when given at the time of reversal. Given these results, we recommend the use of ketamine–dexmedetomidine anesthesia with buprenorphine administered either preemptively or at the time of anesthetic induction to provide a defined period of surgical anesthesia that is effectively reversed by atipamezole. PMID:25650975

  10. Medicines and the drug control treaties: is buprenorphine for opioid addiction at risk of being lost?

    PubMed

    Costa E Silva, J A

    2004-06-01

    Over the past century, a worldwide system for the control of drugs with abuse potential has developed through the adoption of a series of international treaties. The important multilateral conventions currently in force are the United Nations Single Convention on Narcotic Drugs, 1961 (Single Convention), the United Nations Convention on Psychotropic Substances, 1971 (Psychotropic Convention) and the United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 1988. From the beginning, the aim of these drug control treaties has been to control the abuse and trafficking of substances with abuse potential while assuring that the availability of these drugs for medical and scientific purposes is not unduly restricted. There is activity in the World Health Organization and the International Narcotics Control Board to determine whether the international control of buprenorphine, a partial mu-opioid agonist used as an analgesic and for the treatment of opioid addiction, should be changed from the Psychotropic Convention to the Single Convention. This change would result in the classification and regulation of buprenorphine as a narcotic drug rather than a psychotropic substance. Such a move is unwarranted medically and scientifically and would provoke increased controls on buprenorphine that would fundamentally disrupt the medical practice of pain management and opioid replacement therapy around the world. The negative impact of inappropriate regulatory controls when licensed medicines come under such scrutiny are described. PMID:15181649

  11. Acute Pain Management for Patients Receiving Maintenance Methadone or Buprenorphine Therapy

    PubMed Central

    Alford, Daniel P.; Compton, Peggy; Samet, Jeffrey H.

    2007-01-01

    More patients with opioid addiction are receiving opioid agonist therapy (OAT) with methadone and buprenorphine. As a result, physicians will more frequently encounter patients receiving OAT who develop acutely painful conditions, requiring effective treatment strategies. Undertreatment of acute pain is suboptimal medical treatment, and patients receiving long-term OAT are at particular risk. This paper acknowledges the complex interplay among addictive disease, OAT, and acute pain management and describes 4 common misconceptions resulting in suboptimal treatment of acute pain. Clinical recommendations for providing analgesia for patients with acute pain who are receiving OAT are presented. Although challenging, acute pain in patients receiving this type of therapy can effectively be managed. PMID:16418412

  12. Buprenorphine for Cancer Pain: Is It Ready for Prime Time?

    PubMed

    Prommer, Eric

    2014-08-27

    Buprenorphine (BUP) is a semisynthetic derivative of the opium alkaloid thebaine found in the poppy Papaver somniferum. Its chemical structure contains the morphine structure but differs by having a cyclopropylmethyl group. Buprenorphine is a potent µ opioid agonist. Buprenorphine undergoes extensive first-pass metabolism in the liver and gut. The development of a transdermal BUP formulation in 2001 led to its evaluation in cancer pain. This article provides the practitioner with an update on the current role of BUP in cancer care. It highlights data suggesting effectiveness in various types of cancer pain. The article reviews pharmacology, routes of administration, adverse effects, drug interactions, and cost considerations. PMID:25163678

  13. Future advances in addiction treatment

    Microsoft Academic Search

    Herbert D. Kleber

    2005-01-01

    In the next decade, we should witness a number of treatment advances for opioids, stimulants, and cannabis derivatives. For opioids, this will include long acting, i.e., one month to one year, injectable or implants of the antagonist naltrexone, injectable or implants of the partial agonist buprenorphine, and innovative detoxification methods using buprenorphine. In addition, there should be much wider office

  14. The pharmacological treatment of opioid addiction—a clinical perspective

    Microsoft Academic Search

    Philipp Lobmaier; Michael Gossop; Helge Waal; Jorgen Bramness

    2010-01-01

    This article reviews the main pharmacotherapies that are currently being used to treat opioid addiction. Treatments include\\u000a detoxification using tapered methadone, buprenorphine, adrenergic agonists such as clonidine and lofexidine, and forms of\\u000a rapid detoxification. In opioid maintenance treatment (OMT), methadone is most widely used. OMT with buprenorphine, buprenorphine-naloxone\\u000a combination, or other opioid agonists is also discussed. The use of the

  15. Buprenorphine and naloxone alone and in combination in opioid-dependent humans

    Microsoft Academic Search

    Kenzie L. Preston; George E. Bigelow; Ira A. Liebson

    1988-01-01

    Subjective, physiological and behavioral effects of subcutaneously administered hydromorphone (6 mg), naloxone (0.2 mg), buprenorphine (0.2 and 0.3 mg), and two buprenorphine-naloxone combinations (buprenorphine 0.2 mg plus naloxone 0.2 mg and buprenorphine 0.3 mg plus naloxone 0.2 mg) were assessed under double-blind conditions in six opioid-dependent volunteers. Physiologic measures and subject- and observer-rated behavioral responses were measured before dosing and

  16. ROAD TRAFFIC CRASHES AND PRESCRIBED METHADONE AND BUPRENORPHINE: A FRENCH REGISTRY-BASED CASE-

    E-print Network

    Boyer, Edmond

    ROAD TRAFFIC CRASHES AND PRESCRIBED METHADONE AND BUPRENORPHINE: A FRENCH REGISTRY-BASED CASE traffic crash among patients under buprenorphine or methadone has not been subject to epidemiological for a road traffic crash and the use of buprenorphine and methadone. Methods: Data from three French national

  17. CESAR FAX Buprenorphine Series March 31, 2003 to February 4, 2013

    E-print Network

    Hill, Wendell T.

    CESAR FAX Buprenorphine Series March 31, 2003 to February 4, 2013 (updated February 4, 2013) CESAR Research #12;CESAR is pleased to provide this compilation of CESAR FAX issues focusing on buprenorphine. While research indicates that buprenorphine is an effective drug for treating opioid dependence, we feel

  18. Barriers to Opioid Substitution Treatment Access, Entry and Retention: A Survey of Opioid Users, Patients in Treatment, and Treating and Non-Treating Physicians

    Microsoft Academic Search

    Heino Stöver

    2011-01-01

    Background\\/Aims: Although the number of patients in opioid substitution treatment (OST) in Germany has increased in recent years, many dependent opioid users remain out of treatment. Project IMPROVE assessed attitudes and beliefs regarding barriers to OST. Methods: Data were collected from opioid-dependent individuals (using self-complete questionnaires) currently in treatment (n = 200) or not in treatment (n = 200), and

  19. Epidural analgesia with morphine or buprenorphine in ponies with lipopolysaccharide (LPS)-induced carpal synovitis

    PubMed Central

    Freitas, Gabrielle C.; Carregaro, Adriano B.; Gehrcke, Martielo I.; De La Côrte, Flávio D.; Lara, Valéria M.; Pozzobon, Ricardo; Brass, Karin E.

    2011-01-01

    This study evaluated the analgesia effects of the epidural administration of 0.1 mg/kg bodyweight (BW) of morphine or 5 ?g/kg BW of buprenorphine in ponies with radiocarpal joint synovitis. Six ponies were submitted to 3 epidural treatments: the control group (C) received 0.15 mL/kg BW of a 0.9% sodium chloride (NaCl) solution; group M was administered 0.1 mg/kg BW of morphine; and group B was administered 5 ?g/kg BW of buprenorphine, both diluted in 0.9% NaCl to a total volume of 0.15 mL/kg BW administered epidurally at 10 s/mL. The synovitis model was induced by injecting 0.5 ng of lipopolysaccharide (LPS) in the left or right radiocarpal joint. An epidural catheter was later introduced in the lumbosacral space and advanced up to the thoracolumbar level. The treatment started 6 h after synovitis induction. Lameness, maximum angle of carpal flexion, heart rate, systolic arterial pressure, respiratory rate, temperature, and intestinal motility were evaluated before LPS injection (baseline), 6 h after LPS injection (time 0), and 0.5, 1, 2, 4, 6, 8, 10, 12, 16, 20, and 24 h after treatments. Although the model of synovitis produced clear clinical signs of inflammation, the lameness scores in group C were different from the baseline for only up to 12 h. Both morphine and buprenorphine showed a reduction in the degree of lameness starting at 0.5 and 6 h, respectively. Reduced intestinal motility was observed at 0.5 h in group M and at 0.5 to 1 h in group B. Epidural morphine was a more effective analgesic that lasted for more than 12 h and without side effects. It was concluded that morphine would be a valuable analgesic option to alleviate joint pain in the thoracic limbs in ponies. PMID:21731186

  20. Involvement of cytochrome P450 3A4 in N-dealkylation of buprenorphine in human liver microsomes

    Microsoft Academic Search

    Christelle Iribarne; Daniel Picart; Yvonne Dréano; Jean-Pierre Bail; François Berthou

    1997-01-01

    Buprenorphine is a long acting analgesic of the opiate family. Recently, it has been proposed for the opioid dependency treatment at a large scale. The drug is extensively metabolized by the hepatic cytochrome P450 in man, yielding a N-dealkylated metabolite, norbuprenorphine. The specific forms of P450 involved in this oxidative N-demethylation were examined in a panel of 18 human liver

  1. Association of Race and Ethnicity With Withdrawal Symptoms, Attrition, Opioid Use, and Side-Effects During Buprenorphine Therapy

    Microsoft Academic Search

    E. Sherwood Brown; Carlos Tirado; Abu Minhajuddin; Maureen Hillhouse; Bryon Adinoff; Walter Ling; Geetha Doraimani; Christie Thomas

    2010-01-01

    Some studies report differences in opioid withdrawal between racial\\/ethnic groups. However, it is not known if these differences are reflected in differential treatment response. Data from National Institute on Drug Abuse (NIDA) Clinical Trials Network-003 were used to examine racial\\/ethnic differences before and during stabilization with buprenorphine. At induction, non-Hispanic Caucasians had higher objective and subjective withdrawal scores and greater

  2. Effect of ?-opioids morphine and buprenorphine on the development of adjuvant arthritis in rats

    Microsoft Academic Search

    J. S. Walker; A. K. Chandler; J. L. Wilson; W. Binder; R. O. Day

    1996-01-01

    Objective and Design: On the basis that endogenous opioids play a role in the physiological response to inflammation, this\\u000a study tests the antiarthritic effects of a ?-opioid agonist, morphine and the partial ?-agonist, buprenorphine.\\u000a \\u000a Material: Male Lewis rats were used.\\u000a \\u000a \\u000a Treatment: Rats were innoculated subcutaneously with 0.05 ml of Freund's complete adjuvant (5 mg\\/ml) into the right hind paw\\u000a to

  3. Predictors of Dropout from Inpatient Opioid Detoxification with Buprenorphine: A Chart Review

    PubMed Central

    Hallén, Emma

    2014-01-01

    Inpatient withdrawal treatment (detoxification) is common in opioid dependence, although dropout against medical advice often limits its outcome. This study aimed to assess baseline predictors of dropout from inpatient opioid detoxification with buprenorphine, including age, gender, current substance use, and type of postdetoxification planning. A retrospective hospital chart review was carried out for inpatient standard opioid detoxifications using buprenorphine taper, in a detoxification ward in Malmö, Sweden (N = 122). Thirty-four percent of patients (n = 42) dropped out against medical advice. In multivariate logistic regression, dropout was significantly associated with younger age (OR 0.93 [0.89–0.97]) and negatively predicted by inpatient postdetoxification plan (OR 0.41 [0.18–0.94]), thus favouring an inpatient plan as opposed to outpatient treatment while residing at home. Dropout was unrelated to baseline urine toxicology. In opioid detoxification, patients may benefit from a higher degree of postdetoxification planning, including transition to residential treatment, in order to increase the likelihood of a successful detoxification and treatment entry. Young opioid-dependent patients may need particular attention in the planning of detoxification. PMID:25530903

  4. Reversibility of opioid receptor occupancy of buprenorphine in vivo.

    PubMed

    Englberger, Werner; Kögel, Babette; Friderichs, Elmar; Strassburger, Wolfgang; Germann, Tieno

    2006-03-18

    The slow association and incomplete dissociation of buprenorphine from opioid receptors observed in vitro have been suggested to reduce the accessibility of opioid receptors in vivo. If so, it might be expected that buprenorphine continues to occupy opioid receptors long after the antinociceptive activity has dissipated. To examine this hypothesis, buprenorphine (46.4 microg/kg i.v.) was administered to rats 1, 2, 4 or 8 h before isolation of their forebrain membranes and the maximal binding capacity (Bmax) for [3H]-[D-Ala2, N-methyl-Phe4-Gly5-ol]-enkephalin ([3H]DAMGO) was determined to measure the number of mu-opioid receptor binding sites remaining. Extent and duration of the reduction of Bmax by buprenorphine (ED50 11.2 microg/kg 1 h post-application) correlated with the antinociceptive activity in the rat tail flick (ED50 16.4 microg/kg i.v. 1 h post-application). At 8 h after administration there was still residual antinociception but no further attenuation of Bmax was detectable. Thus receptor occupancy by buprenorphine does not cause impairment of mu-opioid receptor accessibility beyond the duration of its antinociceptive activity. Therefore, no impairment of antinociception in the case of an opioid switch is to be expected. PMID:16490191

  5. Buprenorphine Response as a Function of Neurogenetic Polymorphic Antecedents: Can Dopamine Genes Affect Clinical Outcomes in Reward Deficiency Syndrome (RDS)?

    PubMed Central

    Blum, Kenneth; Oscar-Berman, Marlene; Jacobs, William; McLaughlin, Thomas; Gold, Mark S.

    2014-01-01

    There is a plethora of research indicating the successful treatment of opioid dependence with either buprenorphine alone or in combination with naloxone (Suboxone®). However, we encourage caution in long-term maintenance with these drugs, albeit, lack of any other FDA approved opioid maintenance compound to date. Our concern has been supported by severe withdrawal (even with tapering of the dosage of for example Suboxone® which is 40 times more potent than morphine) from low dose of buprenorphine (alone or with naloxone). In addition our findings of a long-term flat affect in chronic Suboxone® patients amongst other unwanted side effects including diversion and suicide attempts provides impetus to reconsider long-term utilization. However, it seems prudent to embrace genetic testing to reveal reward circuitry gene polymorphisms especially those related to dopaminergic pathways as well as opioid receptor(s) as a way of improving treatment outcomes. Understanding the interaction of reward circuitry involvement in buprenorphine effects and respective genotypes provide a novel framework to augment a patient's clinical experience and benefits during opioid replacement therapy. PMID:25664200

  6. Clonazepam as Agonist Substitution Treatment for Benzodiazepine Dependence: A Case Report

    PubMed Central

    Maremmani, Angelo Giovanni Icro; Rovai, Luca; Rugani, Fabio; Bacciardi, Silvia; Pacini, Matteo; Dell'Osso, Liliana; Maremmani, Icro

    2013-01-01

    Nowadays, the misuse of benzodiazepines (BZDs) is a cause for a serious concern among pharmacologically inexperienced patients, whether treated or untreated, that could lead to significant complications, including tolerance, dependence, and addiction. We present a case report in which an Italian patient affected by anxiety disorder and treated with BZDs presented a severe case of dependence on BZDs. We treated him according to an agonist substitution approach, switching from the abused BZD to a slow-onset, long-acting, high potency agonist (clonazepam), and looking at the methadone treatment model as paradigm. We decided to use clonazepam for its pharmacokinetic properties. The advantage of choosing a slow-onset, long-lasting BZD for the treatment of our patient was that it led us to a remarkable improvement in the clinical situation, including the cessation of craving, absence of withdrawal symptoms, reduced anxiety, improvements in social functioning, and a better cognition level. PMID:23424702

  7. Adherence to HIV treatment among IDUs and the role of opioid substitution treatment (OST)

    Microsoft Academic Search

    Bruno Spire; Gregory M. Lucas; M. Patrizia Carrieri

    2007-01-01

    In the era of highly effective anti-retroviral therapy (ART), data show a significant difference in treatment outcomes between injecting drug users (IDUs) and non-IDUs. Factors that may contribute to suboptimal treatment outcomes in IDUs include delayed access to ART, competing comorbid diseases, psychosocial barriers and poor long-term adherence to ART.This review describes and compares several studies on adherence to ART

  8. Buprenorphine Outpatient Outcomes Project: can Suboxone be a viable outpatient option for heroin addiction?

    PubMed Central

    Sittambalam, Charmian D.; Vij, Radhika; Ferguson, Robert P.

    2014-01-01

    Background Opioid dependence treatment traditionally involves methadone clinics, for which dispensing schedules can be cumbersome. Buprenorphine, a partial agonist of the mu receptor and antagonist of the kappa receptor, is a potential outpatient alternative to methadone. Funded by a grant from the State of Maryland's Community Health Resources Commission (CHRC), the Buprenorphine Outpatient Outcomes Project (BOOP) evaluates the outcome of Suboxone (buprenorphine/naloxone) treatment on abstinence from heroin use, rates of emergency room visits and hospitalizations, legal issues, and quality of life. Methods Active heroin users were recruited between June 2007 and June 2010 and induction therapy with Suboxone was instituted during hospitalization. Once discharged, patients were followed as outpatients for maintenance treatment and counseling. Data were collected from electronic medical records, Maryland state legal records, and SF-36® Health Surveys regarding several parameters and patients were categorized according to duration of treatment with Suboxone into one of three groups: <1 month, 1–3 months, and >3 months. Results A total of 220 participants were included in the study. The age range of participants was 18–67 years with most being African American males. Eighty-three (38%) remained in the study for at least 1 month, with 37 of the 83 (45%) remaining in treatment for >3 months. Ten of the 37 (27%) never relapsed after their longest period of abstinence from heroin. During the first year after initiating treatment with Suboxone, hospitalization and emergency room visit rates for all 220 participants decreased by 45 and 23%, respectively, as compared to the year prior to starting treatment. The number of legal charges for drug possession decreased from 70 to 62. Anecdotally, the quality of life seemed to improve in those who were treated with Suboxone for longer periods of time and received regular counseling. Conclusion Overall, Suboxone is an effective treatment method for heroin addiction and is a viable outpatient therapy option. Individualized treatment plans and counseling must be implemented for maximum benefits to be seen. Retention of patients for a long duration of therapy was difficult, but for those who did remain, benefits were seen in overall health, abstinence from heroin use, cognition, and quality of life. PMID:24765257

  9. In vitro release of clomipramine HCl and buprenorphine HCl from poly adipic anhydride (PAA) and poly trimethylene carbonate (PTMC) blends.

    PubMed

    Dinarvand, Rassoul; Alimorad, Mohammed Massoud; Amanlou, Massoud; Akbari, Hamid

    2005-10-01

    Controlled drug-delivery technology is concerned with the systematic release of a pharmaceutical agent to maintain a therapeutic level of the drug in the body for modulated and/or prolonged periods of time. This may be achieved by incorporating the therapeutic agent into a degradable polymer vehicle, which releases the agent continuously as the matrix erodes. In this study, poly trimethylene carbonate (PTMC), an aliphatic polycarbonate, and poly adipic anhydride (PAA), an aliphatic polyanhydride, were synthesized via melt condensation and ring-opening polymerization of trimethylene carbonate and adipic acid, respectively. The release of clomipramine HCl and buprenorphine HCl from discs prepared with the use of PTMC-PAA blends in phosphate buffer (pH 7.4) are also described. Clomipramine HCl and buprenorphine HCl were both used as hydrophilic drug models. Theoretical treatment of the data with the Peppas model revealed that release of clomipramine HCl (5%) in devices containing 70% PTMC or more followed a Fickian diffusion model. However, the releases of buprenorphine HCl (5%) in the same devices were anomalous. For devices containing 50% and more PAA, surface erosion may play a significant role in the release of both molecules. PMID:16044413

  10. Development and GC-MS validation of a highly sensitive recombinant G6PDH-based homogeneous immunoassay for the detection of buprenorphine and norbuprenorphine in urine.

    PubMed

    Wang, Guohong; Vincent, Michael; Rodrigues, Warren; Agrawal, Alpana; Moore, Christine; Barhate, Rekha; Abolencia, E; Coulter, Cynthia; Soares, James; Zheng, Yi-Feng; Taylor, Celeste; Morjana, Nihmat

    2007-09-01

    Buprenorphine is now increasingly prescribed as an alternative to methadone for the treatment of heroin addiction. Because of its potency (dosage usages from 0.2 mg to 8 mg), the drug concentrations in body fluids are normally very low. Here, we report the first recombinant glucose-6-phosphate dehydrogenase (G6PDH)-based homogeneous immunoassay (EMIT-type assay) for free buprenorphine and free norbuprenorphine in urine. The antibody used in this assay cross-reacts nearly identically with buprenorphine and norbuprenorphine and, at the same time, has less than 1% cross-reactivity with a wide range of commonly prescribed opiates, particularly those structurally related compounds such as morphine, codeine, and dihydrocodeine. More importantly, this assay has a low detection limit of 1 ng/mL for buprenorphine or norbuprenorphine. Further evaluation of this technique using gas chromatography-mass spectrometry (GC-MS) of authentic urine samples demonstrated that the accuracy of the assay is greater than 95%. Because this assay is designed to measure the free drugs in urine, it resulted in simplification for GC-MS or liquid chromatography-MS confirmation methods that did not require urine hydrolysis before solid-phase or liquid-liquid extraction. PMID:17725885

  11. Buprenorphine versus methadone maintenance: a cost-effectiveness analysis

    Microsoft Academic Search

    Christopher M. Doran; Marian Shanahan; Richard P. Mattick; Robert Ali; Jason White; James Bell

    2003-01-01

    This article presents the cost-effectiveness results of a randomised controlled trial conducted in two Australian cities. The trial was designed to assess the safety, efficacy and cost-effectiveness of buprenorphine versus methadone in the management of opioid dependence. The trial utilised a flexible dosing regime that was tailored to the clinical need of the patients, with high maximum doses, using the

  12. Development of an enhanced formulation for delivering sustained release of buprenorphine hydrochloride

    PubMed Central

    Koocheki, S.; Madaeni, S.S.; Niroomandi, P.

    2011-01-01

    To control the minimum effective dose, and reduce the number and quantity of administered potent drugs are unique features of advanced drug delivery in situ forming gel formulation. The efficacy, consistency, and increasing the application of existing injection therapies can be enhanced through optimization of controlled released systems by using FDA approved biodegradable PLGA (poly-d,l-lactide-co-glycolide) polymer. The purpose of this study was to develop different in situ forming implant (ISFI) formulations of buprenorphine hydrochloride for post treatment of drug addicts, acute and chronic pains. The drug releases from different ISFIs membranes with and without Tween 80 were compared over a period of time. Kinetic equation followed the Korsmeyer–Peppas model, as the plots showed high linearity. The influence of this additive on polymer properties was investigated using differential scanning calorimetry (DSC), and the membranes structure was studied by X-ray diffractometry (XRD) and scanning electron microscope (SEM). Data revealed that Tween 80 modified the drug release pattern using diffusion mechanism and decreased the glass transition temperature (Tg) significantly. The degree of crystallinity was decreased after phase inversion which helps the dissolution of drug from membrane. The porosity of modified membranes was in accordance with release profiles. These findings suggest four different in situ forming implant formulations which can release various dose of the buprenorphine hydrochloride in a prolonged time. Also this surfactant can be an attractive additive for modifying the release rate of drugs from PLGA-based membrane drug delivery systems. PMID:23960766

  13. Buprenorphine from detox and beyond: preliminary evaluation of a pilot program to increase heroin dependent individuals' engagement in a full continuum of care.

    PubMed

    Donovan, Dennis M; Knox, Patricia C; Skytta, Jenny A F; Blayney, Jessica A; DiCenzo, Jessica

    2013-04-01

    Absence of successful transition to post-detoxification treatment leads to high rates of relapse among detoxified heroin users. The present study evaluated a pilot buprenorphine treatment program (BTP). Heroin dependent individuals were inducted onto buprenorphine/naloxone in detox, maintained while transitioning through an intensive inpatient program (IIP), and gradually tapered off medication over 5 months of outpatient (OP) treatment. Compared to programmatic indicators of treatment engagement in the year prior to BTP implementation, referrals from detox to IIP, entry into and completion of IIP and subsequent OP, and days in OP treatment increased substantially. BTP completers, compared to non-completers, viewed abstinence as more difficult and as requiring more assistance to achieve, were less likely to be current cocaine and alcohol users or to have relapsed during the course of treatment. Although preliminary and in need of replication, initial adjunctive use of buprenorphine in an abstinence-based continuum of care may improve post-detoxification treatment entry, engagement, and completion. PMID:23007109

  14. A multi-center randomized trial of buprenorphine-naloxone versus clonidine for opioid detoxification: findings from the National Institute on Drug Abuse Clinical Trials Network

    Microsoft Academic Search

    Walter Ling; Leslie Amass; Steve Shoptaw; Jeffrey J. Annon; Maureen Hillhouse; Dean Babcock; Greg Brigham; Judy Harrer; Malcolm S. Reid; Joan A. Muir; Betty J. Buchan; Debbie Orr; George Woody; Jonathan Krejci; Douglas M. Ziedonis

    2005-01-01

    AIMS: The clinical effectiveness of buprenorphine-naloxone (bup-nx) and clonidine for opioid detoxification in in-patient and out-patient community treatment programs was investigated in the first studies of the National Institute of Drug Abuse Clinical Trials Network.\\u000aDESIGN: Diagnostic and Statistical Manual version IV (DSM IV)-diagnosed opioid-dependent individuals seeking short-term treatment were randomly assigned, in a 2 : 1 ratio favoring bup-nx,

  15. Psychiatric and medical comorbidities, associated pain, and health care utilization of patients prescribed buprenorphine.

    PubMed

    Mark, Tami L; Dilonardo, Joan; Vandivort, Rita; Miller, Kay

    2013-01-01

    This study describes the comorbidities and health care utilization of individuals treated with buprenorphine using the 2007-2009 MarketScan Research Databases. Buprenorphine recipients had a high prevalence of comorbidities associated with chronic pain, including back problems (42%), connective tissue disease (24-27%), and nontraumatic joint disorders (20-23%). Approximately 69% of recipients filled prescriptions for opioid agonist medications in the 6 months before buprenorphine initiation. Buprenorphine recipients were frequently diagnosed with anxiety (23-42%) and mood disorders (39-51%) and filled prescriptions for antidepressants (47-56%) and benzodiazepines (47-56%) at high rates. Surprisingly, only 53-54% of patients filling a prescription for buprenorphine had a coded opioid abuse/dependence diagnosis. Research is needed to better understand buprenorphine's effectiveness in the context of prescription drug abuse and the best way to coordinate services to address the patient's comorbid addiction, pain, and psychiatric illnesses. PMID:23265445

  16. Predictors of outcome for short-term medically supervised opioid withdrawal during a randomized, multicenter trial of buprenorphine-naloxone and clonidine in the NIDA clinical trials network drug and alcohol dependence.

    PubMed

    Ziedonis, Douglas M; Amass, Leslie; Steinberg, Marc; Woody, George; Krejci, Jonathan; Annon, Jeffrey J; Cohen, Allan J; Waite-O'Brien, Nancy; Stine, Susan M; McCarty, Dennis; Reid, Malcolm S; Brown, Lawrence S; Maslansky, Robert; Winhusen, Theresa; Babcock, Dean; Brigham, Greg; Muir, Joan; Orr, Deborah; Buchan, Betty J; Horton, Terry; Ling, Walter

    2009-01-01

    Few studies in community settings have evaluated predictors, mediators, and moderators of treatment success for medically supervised opioid withdrawal treatment. This report presents new findings about these factors from a study of 344 opioid-dependent men and women prospectively randomized to either buprenorphine-naloxone or clonidine in an open-label 13-day medically supervised withdrawal study. Subjects were either inpatient or outpatient in community treatment settings; however not randomized by treatment setting. Medication type (buprenorphine-naloxone versus clonidine) was the single best predictor of treatment retention and treatment success, regardless of treatment setting. Compared to the outpatient setting, the inpatient setting was associated with higher abstinence rates but similar retention rates when adjusting for medication type. Early opioid withdrawal severity mediated the relationship between medication type and treatment outcome with buprenorphine-naloxone being superior to clonidine at relieving early withdrawal symptoms. Inpatient subjects on clonidine with lower withdrawal scores at baseline did better than those with higher withdrawal scores; inpatient subjects receiving buprenorphine-naloxone did better with higher withdrawal scores at baseline than those with lower withdrawal scores. No relationship was found between treatment outcome and age, gender, race, education, employment, marital status, legal problems, baseline depression, or length/severity of drug use. Tobacco use was associated with worse opioid treatment outcomes. Severe baseline anxiety symptoms doubled treatment success. Medication type (buprenorphine-naloxone) was the most important predictor of positive outcome; however the paper also considers other clinical and policy implications of other results, including that inpatient setting predicted better outcomes and moderated medication outcomes. PMID:18805656

  17. Safety and efficacy of buprenorphine for analgesia in laboratory mice and rats.

    PubMed

    Guarnieri, Michael; Brayton, Cory; DeTolla, Louis; Forbes-McBean, Nadine; Sarabia-Estrada, Rachel; Zadnik, Patricia

    2012-11-01

    Buprenorphine is a long-acting opiate with a high therapeutic index. The authors review the pharmacology, toxicity, analgesic effects and delivery of buprenorphine for use in laboratory mice and rats. Buprenorphine-based analgesic therapy has a substantial record of safety, and there is growing evidence of its effectiveness for treating post-operative pain. Nonetheless, more research is needed to determine optimal delivery systems and analgesic regimens for pain therapy in laboratory animals. PMID:23079917

  18. Photocatalytic Properties of Layered Metal Oxides Substituted with Silver by a Molten AgNO3 Treatment.

    PubMed

    Horie, Hirotaka; Iwase, Akihide; Kudo, Akihiko

    2015-07-15

    K4Nb6O17 (BG: 3.67 eV) and Na2W4O13 (BG: 3.12 eV) layered oxide photocatalysts with wide band gaps were treated with a molten AgNO3 to substitute K(+) and Na(+) with Ag(+), resulting in red-shifts of absorption edges in diffuse reflectance spectra. A part of Na(+) ions in the interlayer of Na2W4O13 was substituted with Ag(+) ions by the molten AgNO3 treatment with keeping the layered structure. Both Ag(I)-substituted K4Nb6O17 and Na2W4O13 showed photocatalytic activities for O2 evolution from aqueous solutions containing a sacrificial reagent utilizing the absorption bands newly formed by the Ag(I)-substitution. Notably, the Ag(I)-substituted Na2W4O13 produced O2 under visible light irradiation. When ball-milled Na2W4O13 was treated with a molten AgNO3, the Ag(I)-substitution rate increased. The Ag(I)-substituted Na2W4O13 with ball-milling showed higher photocatalytic activity for O2 evolution than that without ball-milling. Z-schematic water splitting proceeded under visible light irradiation by combining the Ag(I)-substituted Na2W4O13 of an O2-evolving photocatalyst with Ru-loaded SrTiO3 doped with Rh of a H2-evolving photocatalyst. PMID:26099451

  19. Pharmacokinetics of buprenorphine hydrochloride following intramuscular and intravenous administration to American kestrels (Falco sparverius)

    USGS Publications Warehouse

    Gustavsen, Kate A.; Guzman, David Sanchez-Migallon; Knych, Heather K.; Petritz, Olivia A.; Olsen, Glenn H.; Paul-Murphy, Joanne R.

    2014-01-01

    Conclusions and Clinical Relevance—Buprenorphine was rapidly absorbed, and bioavailability was good after IM administration to American kestrels. Plasma buprenorphine concentrations were > 1 ng/mL for 9 hours after both IM and IV administration. These results, in combination with those of a pharmacodynamic study, suggested that the analgesic effects of buprenorphine could last at least 6 to 9 hours in this species. Further investigations of the duration of analgesic effects, multiple-dose protocols, and potential adverse effects of buprenorphine are warranted in American kestrels and other raptors.

  20. Synthesis of N-substituted ?-hexonolactams as pharmacological chaperones for the treatment of N370S mutant Gaucher disease.

    PubMed

    Wang, Guan-Nan; Twigg, Gabriele; Butters, Terry D; Zhang, Siwei; Zhang, Liangren; Zhang, Li-He; Ye, Xin-Shan

    2012-04-21

    A series of N-substituted ?-hexonolactams have been designed and prepared by a concise route with a tandem ring-expansion reaction as the key step. Some of the N-substituted ?-hexonolactams show better enhancements to N370S mutant ?-glucocerebrosidase activity than NB-DNJ and NN-DNJ. Both the experimental results and computational studies highlight the importance of the carbonyl group for stabilizing protein folds in the mutant enzyme. The structure-activity relationships are also discussed. These novel N-alkylated iminosugars are promising pharmacological chaperones for the treatment of N370S mutant Gaucher disease. PMID:22286559

  1. Effect of Rifampin and Nelfinavir on the Metabolism of Methadone and Buprenorphine in Primary Cultures of Human Hepatocytes

    E-print Network

    Omiecinski, Curtis

    Effect of Rifampin and Nelfinavir on the Metabolism of Methadone and Buprenorphine in Primary and buprenorphine. Hepatocytes (five donors) were preincubated with dimethyl sulfoxide (DMSO) (vehicle), rifampin, or nelfinavir before incubation with methadone or buprenorphine. Culture me- dia (0­60 min) was analyzed

  2. Buprenorphine: dose-related effects on cocaine and opioid use in cocaine-abusing opioid-dependent humans

    Microsoft Academic Search

    Richard S. Schottenfeld; Juliana Pakes; Douglas M. Ziedonis; Thomas R. Kosten

    1993-01-01

    Fifteen subjects dependent on both opioids and cocaine completed an ascending and tapering schedule of buprenorphine dosing, with maintenance for 21 days at each dose of buprenorphine (4, 8, 12, 16 mg sublingual daily) during both ascending and tapering phases. Higher doses of buprenorphine led to greater reductions in opioid use: 64.7% of subjects were opioid abstinent for 3 weeks

  3. Buprenorphine and norbuprenorphine findings in hair during constant maintenance dosage

    Microsoft Academic Search

    Gisela Skopp; Anja Kniest; Joerg Haisser; Karl Mann; Derik Hermann

    2011-01-01

    It is still a matter of debate whether a positive correlation between the dose and the amount of drug in the hair exists.\\u000a Drugs such as buprenorphine (BUP) used under controlled conditions present an opportunity to prove a possible relationship.\\u000a Due to discrepant findings of BUP\\/norbuprenorphine (NBUP) ratios in hair, in vitro degradation of both analytes in diluted\\u000a acid was

  4. False-positive buprenorphine by CEDIA in patients prescribed amisulpride or sulpiride.

    PubMed

    Birch, M A; Couchman, L; Pietromartire, S; Karna, T; Paton, C; McAllister, R; Marsh, A; Flanagan, R J

    2013-05-01

    Buprenorphine is a potent partial opioid agonist that is analyzed in urine to (i) monitor adherence to maintenance or detoxification therapy and (ii) detect illicit use. Buprenorphine analysis is commonly conducted on urine by immunoassay, but is subject to cross-reactivity from other drugs/drug metabolites, including morphine, codeine and dihydrocodeine. This study reports false-positive buprenorphine analysis [Thermo Fisher Scientific cloned enzyme donor immunoassay (CEDIA)] in patients who denied unauthorized buprenorphine use prior to sampling, but who had been prescribed amisulpride. In two cases, confirmatory analysis by liquid chromatography-tandem mass spectrometry was negative (<0.5 µg/L) for buprenorphine and metabolites and positive for amisulpride. Although the cross-reactivity of amisulpride and sulpiride in the CEDIA buprenorphine assay is low (estimated at 0.003 and 0.002%, respectively), it remains a significant consideration given the likely high concentrations of these compounds in urine relative to the low cutoff of the buprenorphine assay. Neither amisulpride nor sulpiride was listed as potential sources of interference on the CEDIA data sheet when this work was performed. These findings highlight the importance of confirming immunoassay-positive buprenorphine results using a more selective analytical technique. PMID:23471956

  5. Pain management after lumbar spinal fusion surgery using continuous subcutaneous infusion of buprenorphine

    Microsoft Academic Search

    Tomoyuki Kawamata; Yasumitsu Sato; Yukitoshi Niiyama; Keiichi Omote; Akiyoshi Namiki

    2005-01-01

    Purpose. The continuous subcutaneous infusion (CSI) technique is a simple, inexpensive method for managing postoperative pain. We examined the analgesic effects of CSI of buprenorphine in patients undergoing lumbar spinal fusion surgery. Methods. The patients were randomly assigned to one of three groups for postoperative pain management: control group (n = 17), high-dose buprenorphine group (BH group, n = 17),

  6. Brain opioid receptor adaptation and expression after prenatal exposure to buprenorphine

    Microsoft Academic Search

    Mariana M. Belcheva; Laura M. Bohn; Matthew T. Ho; Frank E. Johnson; Joseph Yanai; Susan Barron; Carmine J. Coscia

    1998-01-01

    Previous in vivo studies revealed that buprenorphine can down-regulate ? and up-regulate ?2 and ?1 opioid receptors in adult and neonatal rat brain. To assess gestational effects of buprenorphine on offspring, pregnant rats were also administered this drug and opioid receptor binding parameters (Kd and Bmax values) were measured by homologous binding assays of postnatal day 1 (P1) brain membranes.

  7. Buprenorphine added to the local anesthetic for axillary brachial plexus block prolongs postoperative analgesia

    Microsoft Academic Search

    Kenneth D. Candido; Alon P. Winnie; Ahmed H. Ghaleb; Maher W. Fattouh; Carlo D. Franco

    2002-01-01

    Background and Objectives: Buprenorphine added to local anesthetic solutions for supraclavicular block was found to triple postoperative analgesia duration in a previous study when compared with local anesthetic block alone. That study, however, did not control for potentially confounding factors, such as the possibility that buprenorphine was affecting analgesia through intramuscular absorption or via a spinal mechanism. To specifically delineate

  8. Use of buprenorphine in pregnancy: patient management and effects on the neonate

    Microsoft Academic Search

    Rolley E. Johnson; Hendrée E. Jones; Gabriele Fischer

    2003-01-01

    It is estimated that 55–94% of infants born to opioid-dependent mothers in US will show signs of opioid withdrawal. Buprenorphine has been reported to produce little or no autonomic signs or symptoms of opioid withdrawal following abrupt termination in adults. To date, there have been 21 published reports representing approximately 15 evaluable cohorts of infants exposed to buprenorphine in utero.

  9. Evaluation of a Combined Online and in Person Training in the Use of Buprenorphine

    ERIC Educational Resources Information Center

    Gunderson, Erik W.; Levin, Frances R.; Kleber, Herbert D.; Fiellin, David A.; Sullivan, Lynn E.

    2006-01-01

    To evaluate buprenorphine training methodology, we surveyed physicians who had completed a combined online and in person buprenorphine curriculum. Of 53/70 (76%) survey respondents, 57% were psychiatrists and 40% generalists. On a scale of 1 (very poor) to 7 (superlative), the overall training rated a mean of 5.8. The online course (5.0) rated…

  10. Abuse liability of buprenorphine–naloxone tablets in untreated IV drug users

    Microsoft Academic Search

    Hannu Alho; David Sinclair; Erkki Vuori; Antti Holopainen

    2007-01-01

    Buprenorphine (Subutex®) is widely abused in Finland. A combination of buprenorphine plus naloxone (Suboxone®) has been available since late 2004, permitting a comparison of the abuse of the two products among untreated intravenous (IV) users. A survey was distributed to attendees at a Helsinki needle exchange program over 2-weeks in April, 2005, At least 30% were returned anonymously. Survey variables

  11. Comparison of buprenorphine and pethidine given intravenously on demand to relieve postoperative pain

    Microsoft Academic Search

    K Chakravarty; W Tucker; M Rosen; M D Vickers

    1979-01-01

    In a double-blind study of on-demand intravenous analgesia buprenorphine was found to be about 600 times as potent as pethidine. The incidence of side effects was similar with both drugs. The quality of analgesia, subjectively assessed, was good with both drugs using this method of administration. Provided that its low potential for abuse is substantiated, buprenorphine appears to be a

  12. Ability to Work and Employability of Patients in Opioid Substitution Treatment Programs in Slovenia

    PubMed Central

    Bilban, Marjan; Kasteli?, Andrej; Zaletel-Kragelj, Lijana

    2008-01-01

    Aim To assess the ability to work and employability of individuals taking part in opioid substitution treatment programs (OSTP). Methods The study was composed of two surveys. In the first survey, 237 of 480 patients enrolled in OSTP responded to the questionnaire about their employment status, opinion about employment, and perception of assignments before and during OSTP. In the second survey, 66 of 100 employers responded to the questionnaire on the occurrence, perception, and management of addiction problems in their companies. Results Unemployment rate in individuals enrolled in OSTP was 43.5% and decreased during OSTP by 10.5% (P?=?0.027). Irregular use of OSTP medications was the most important factor for unemployment (odds ratio, 2.44; P?=?0.016). OSTP was highly effective in achieving a positive change in patients’ perception of different kinds of assignments previously perceived as beyond their abilities. Thus, perception of mentally demanding assignments (P?

  13. Duration of Action of Sustained-Release Buprenorphine in 2 Strains of Mice

    PubMed Central

    Carbone, Elizabeth T; Lindstrom, Krista E; Diep, Sandy; Carbone, Larry

    2012-01-01

    Buprenorphine HCl is a common analgesic for laboratory mice undergoing surgical procedures. The documented duration of action of buprenorphine HCl is as short as 3 to 5 h in mice, potentially necessitating readministration for continued analgesia. A long-acting buprenorphine formulation would reduce handling-associated stress and provide uninterrupted analgesia. This study used the hot-plate assay to assess the antinociceptive effects of a single injection of sustained-release buprenorphine (bup-SR), buprenorphine-HCl (bup-HCl), and saline over 72 h in young adult male BALB/cJ and SWR/J mice. SWR/J mice had shorter baseline latencies than did BALB/cJ mice, possibly reflecting greater sensitivity to thermal nociception. Relative increase from baseline latency (% maximal possible effect) was significant for buprenorphine-SR at 2, 6, and 12 h compared with saline. According to results from a hot-plate assay, the analgesic efficacy of buprenorphine-SR appears to last at least 12 h in male BALB/cJ and SWR/J mice. PMID:23294889

  14. Safety studies of post-surgical buprenorphine therapy for mice.

    PubMed

    Traul, Karl A; Romero, Jennell B; Brayton, Cory; DeTolla, Louis; Forbes-McBean, Nadine; Halquist, Matthew S; Karnes, H Thomas; Sarabia-Estrada, Rachel; Tomlinson, Michael J; Tyler, Betty M; Ye, Xiaobu; Zadnik, Patricia; Guarnieri, Michael

    2015-04-01

    The use of appropriate analgesia in laboratory mice may be suboptimal because of concerns about adverse events (AE). Target Animal Safety trials were conducted to determine the safety of an extended-release suspension of buprenorphine. Drug or control suspensions were injected subcutaneously in surgically-treated BALB/c mice anesthetized with ketamine-xylazine to mimic post-operative conditions in which the compound might commonly be administered. Single and repeat five-fold (5×) excesses of the 3.25 mg/kg intended dose were used to provoke potential AE. Trials included prospective measurements of weight changes, blood chemistry, hematology, and histopathology. Clinical and histopathology findings were similar in drug-treated and control mice in a four-day trial using a single 16.25 mg/kg, 5× overdose of the drug. In a 12-day trial, which used a total buprenorphine dose of 48.75 mg/kg, clinical and histopathology values were also similar in control and drug-treated female mice. In the male arm of the repeat-overdose trial, two of eight mice died on the morning of day 12, three days following the third 16.25 mg/kg overdose administration. Histopathology did not reveal a cause of death. In a 14-month trial using a single 3.25 mg/kg dose of the drug, no significant findings identified potential AE. These findings indicate a high tolerance to an extended-release buprenorphine suspension administered post-operatively in mice with appropriate husbandry. PMID:25305141

  15. Effect of low-level laser treatment of tissue-engineered skin substitutes: contraction of collagen lattices

    NASA Astrophysics Data System (ADS)

    Ho, Gideon; Barbenel, Joseph; Grant, M. Helen

    2009-05-01

    Fibroblast-populated collagen lattices (FPCL) are widely used in tissue-engineered artificial skin substitutes, but their main drawback is that interaction of fibroblasts and matrix causes contraction of the lattice, reducing it to about 20% of its original area. The effect of low-level laser treatment (LLLT) on the behavior of 3T3 fibroblasts seeded in collagen lattices containing 20% chondroitin-6-sulphate was investigated to determine whether LLLT could control the contraction of FPCL. A He-Ne laser was used at 632.8 nm to deliver a 5-mW continuous wave with fluences from 1 to 4 J/cm2. Laser treatment at 3 J/cm2 increased contraction of collagen lattices in the absence of cells but decreased contraction of cell seeded lattices over a 7-day period. The effect was energy dependent and was not observed at 1, 2, or 4 J/cm2. There was no alteration in fibroblast viability, morphology, or mitochondrial membrane potential after any laser treatments, but the distribution of actin fibers within the cells and collagen fibers in the matrices was disturbed at 3 J/cm2. These effects contribute to the decrease in contraction observed. LLLT may offer a means to control contraction of FPCL used as artificial skin substitutes.

  16. Treatment failure after substitution of generic pancrelipase capsules. Correlation with in vitro lipase activity.

    PubMed

    Hendeles, L; Dorf, A; Stecenko, A; Weinberger, M

    1990-05-01

    Pancreatic enzyme products are formulated, manufactured, and sold without submitting efficacy or bioavailability data to the Food and Drug Administration because of a quirk in the law. We documented therapeutic failures in three patients with cystic fibrosis after pharmacists substituted generic pancrelipase capsules for the Pancrease brand. Gastrointestinal symptoms and fat malabsorption rapidly resolved after therapy was reinstituted with brand name products. In vitro analysis indicated that after 1 hour of exposure to simulated gastric fluid, lipase activity was less than 200 U per capsule from all three generic capsules dispensed to the patients compared with 6820 U per capsule from Pancrease. These data indicate that the enteric coating of the generic product was defective and that the substituted product was not bioequivalent to the prescribed brand. We conclude that the Food and Drug Administration should institute regulations over this group of products. PMID:2329633

  17. The Severity, Frequency, and Variety of Crime in Heroin-Dependent Prisoners Enrolled in a Buprenorphine Clinical Trial

    PubMed Central

    Gordon, Michael S.; Kinlock, Timothy W.; Schwartz, Robert P.; Couvillion, Kathryn A.; O’Grady, Kevin E.

    2014-01-01

    Data were obtained on four dimensions of criminal activity (frequency, variety, severity, and income) from male and female prisoners (N = 200) with preincarceration heroin dependence who participated in a randomized clinical trial of buprenorphine treatment. The article examines the above-mentioned dimensions of crime and their relationships with demographic characteristics, substance use, legitimate employment, drug treatment episodes, and psychological problems. Results largely show several important similarities to results on previous prison inmate cohorts with histories of heroin addiction, although the present sample may have more of a tendency toward violent crime than earlier cohorts of heroin-dependent offenders. This study’s findings may have implications for the design of appropriate treatment interventions for prisoners with preincarceration heroin dependence that address not only substance use but also criminal activity. PMID:25392564

  18. Effects of buprenorphine on balance of oxidant/antioxidant system in the different ages of male rat liver.

    PubMed

    Samarghandian, Saeed; Azimi-Nezhad, Mohsen; Afshari, Reza; Farkhondeh, Tahereh; Karimnezhad, Fatemeh

    2015-06-01

    Our knowledge about a link between buprenorphine and hepatotoxicity is controversial. This study evaluated the effects of buprenorphine on the liver of young, adult, and aged rats. For this reason, young, adult, and aged rats received intraperitoneally 0.25, 0.5, and 1 mg/kg buprenorphine for 30 days. The present results revealed that the normal aging was associated with a significant decrease in the activities of antioxidant enzymes, and an increase in the liver lipid peroxidation, serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH) activities in the aged rats. This study also demonstrated that buprenorphine led to a significant increase in the serum activities of ALT, AST, and LDH as well as liver lipid peroxidation content with a decrease in the antioxidant enzymes in the liver of buprenorphine-treated aged rat versus the aged matched control animals. In conclusion, the present results demonstrate that buprenorphine deteriorated oxidative damage in the aged livers. PMID:25683329

  19. Buprenorphine During Pregnancy Reduces Neonate Distress

    MedlinePLUS

    ... Good For Mothers, Better for Infants Of 175 women who started a study medication, 131 continued until they gave birth. Those ... Articles of Interest NIDA Notes Distinct Challenges Affect Women’s HIV Treatment Outcomes After Jail Study Points to Individualized Therapy for Opioid Addiction Patients ...

  20. Buprenorphine dosing every 1, 2, or 3 days in opioid-dependent patients

    Microsoft Academic Search

    Warren K. Bickel; Leslie Amass; John P. Crean; Gary J. Badger

    1999-01-01

    Rationale: Administration of double the maintenance dose of buprenorphine has been shown to permit every-other-day dosing. Whether\\u000a longer periods between dosing can be achieved is unknown. Objectives: To examine whether triple the maintenance dose can be administered every 72 h without opioid withdrawal or intoxication. Methods: Sixteen opioid-dependent outpatients each received three conditions (1) the maintenance dose of buprenorphine every

  1. On drug treatment and social control: Russian narcology's great leap backwards

    PubMed Central

    Elovich, Richard; Drucker, Ernest

    2008-01-01

    The medical discipline of narcology in Russia is a subspecialty of psychiatry from the Soviet era and it is given warrant to define the scope of health activities with regard to alcohol and other drug use, drug users, and related problems. Narcological practice is in turn constrained by the State. The emergence of widespread injection opiate use and associated HIV morbidities and mortalities during the first decade following the collapse of the Soviet Union has brought the contradictions in Russian narcological discourse into high relief. Narcology officials in the Russian Federation have consistently opposed substitution treatment for opiate dependence – the replacement of a short-acting illegal substance with a longer acting prescribed drug with similar pharmacological action but lower degree of risk. Thus, despite the addition of methadone and buprenorphine to WHO's list of essential medicines in 2005 and multiple position papers by international experts calling for substitution treatment as a critical element in the response to HIV (IOM, 2006; UNODC, UNAIDS, and WHO, 2005), methadone or buprenorphine remain prohibited by law in Russia. The authors detail Russian opposition to the prescription of methadone and buprenorphine, describing four phenomena: (1) the dominance of law enforcement and drug control policy over public health and medical ethics ; (2) the conflation of Soviet era alcoholism treatment with treatment for opiate dependence; (3) the near universal representation of detoxification from drugs as treatment for dependence; and (4) a framework for judging treatment efficacy that is restricted to "cure" versus "failure to cure," and does not admit its poor outcomes or recognize alternative frameworks for gauging treatment of opiate dependence. In keeping with this position, Russian narcology officials have taken an implacable ideological stance toward illicit drug use, the people who use drugs, and their treatment. By adopting policies and practices totally unsupported by scientific evidence and inquiry, officials in Russia have rendered narcology ( and medical practice) insensitive to the alarming rates and continued spread of HIV, with its dire morbidity and mortality rates in the Russian Federation, turning their backs on all the other health problems posed by opiate use and dependence itself. PMID:18577225

  2. Comparative pharmacokinetics of intravenous fentanyl and buprenorphine in healthy greyhound dogs.

    PubMed

    KuKanich, B; Allen, P

    2014-12-01

    The purpose of this study was to compare the pharmacokinetics of two highly protein-bound, lipophilic opioid drugs. Fentanyl (10 ?g/kg) and buprenorphine (20 ?g/kg) were administered intravenously (IV) to six healthy greyhound dogs (three males and three females). The doses were based on clinically administered doses for dogs. Plasma drug concentrations were determined using liquid chromatography with mass spectrometry, and noncompartmental pharmacokinetics were estimated with computer software. The volume of distribution (area) was larger for fentanyl (7.42 L/kg) compared to buprenorphine (3.54 L/kg). The plasma clearance of fentanyl (38.6 mL·min/kg) was faster than buprenorphine (10.3 mL·min/kg). The terminal half-life of fentanyl (2.22 h) was shorter than buprenorphine (3.96 h). Despite similar physicochemical properties including octanol-water partition coefficient and pKa, the pharmacokinetics of fentanyl and buprenorphine were not similar. Both fentanyl (84%) and buprenorphine (95-98%) are considered highly protein bound, but the differences in protein binding may contribute to the lack of similarity of pharmacokinetics in healthy dogs. PMID:24684621

  3. Antinociceptive actions of morphine and buprenorphine given intrathecally in the conscious rat.

    PubMed Central

    Bryant, R. M.; Olley, J. E.; Tyers, M. B.

    1983-01-01

    1 The antinociceptive effects of morphine and buprenorphine given intrathecally and subcutaneously have been compared in the conscious rat. 2 In the paw pressure test, when given subcutaneously buprenorphine 0.001-0.1 mg/kg s.c., was approximately 100 times more potent than morphine 0.1-3 mg/kg s.c., but in the hot plate test, buprenorphine 0.03-3.0 mg/kg s.c., produced a bell-shaped dose-response curve of low maximum effect and was about equipotent with morphine 0.03-3 mg/kg s.c. 3 When given intrathecally buprenorphine 10 micrograms and morphine, 10-60 micrograms, were approximately equipotent in both paw pressure and hot plate tests. Furthermore, morphine produced these effects at 1/25th of the minimum effective parenteral dose while the dose of buprenorphine exceeded the parenteral dose. 4 It is concluded that the predominant site of the analgesic action of buprenorphine is supraspinal. The significance of these findings in relation to the role of spinal opiate receptors is discussed. PMID:6687818

  4. Solvent substitution

    SciTech Connect

    Not Available

    1990-01-01

    The DOE Environmental Restoration and Waste Management Office of Technology Development and the Air Force Engineering and Services Center convened the First Annual International Workshop on Solvent Substitution on December 4--7, 1990. The primary objectives of this joint effort were to share information and ideas among attendees in order to enhance the development and implementation of required new technologies for the elimination of pollutants associated with industrial use of hazardous and toxic solvents; and to aid in accelerating collaborative efforts and technology transfer between government and industry for solvent substitution. There were workshop sessions focusing on Alternative Technologies, Alternative Solvents, Recovery/Recycling, Low VOC Materials and Treatment for Environmentally Safe Disposal. The 35 invited papers presented covered a wide range of solvent substitution activities including: hardware and weapons production and maintenance, paint stripping, coating applications, printed circuit boards, metal cleaning, metal finishing, manufacturing, compliance monitoring and process control monitoring. This publication includes the majority of these presentations. In addition, in order to further facilitate information exchange and technology transfer, the US Air Force and DOE solicited additional papers under a general Call for Papers.'' These papers, which underwent review and final selection by a peer review committee, are also included in this combined Proceedings/Compendium. For those involved in handling, using or managing hazardous and toxic solvents, this document should prove to be a valuable resource, providing the most up-to-date information on current technologies and practices in solvent substitution. Individual papers are abstracted separated.

  5. Production and validation of model iron-tannate dyed textiles for use as historic textile substitutes in stabilisation treatment studies

    PubMed Central

    2012-01-01

    Background For millennia, iron-tannate dyes have been used to colour ceremonial and domestic objects shades of black, grey, or brown. Surviving iron-tannate dyed objects are part of our cultural heritage but their existence is threatened by the dye itself which can accelerate oxidation and acid hydrolysis of the substrate. This causes many iron-tannate dyed textiles to discolour and decrease in tensile strength and flexibility at a faster rate than equivalent undyed textiles. The current lack of suitable stabilisation treatments means that many historic iron-tannate dyed objects are rapidly crumbling to dust with the knowledge and value they hold being lost forever. This paper describes the production, characterisation, and validation of model iron-tannate dyed textiles as substitutes for historic iron-tannate dyed textiles in the development of stabilisation treatments. Spectrophotometry, surface pH, tensile testing, SEM-EDX, and XRF have been used to characterise the model textiles. Results On application to textiles, the model dyes imparted mid to dark blue-grey colouration, an immediate tensile strength loss of the textiles and an increase in surface acidity. The dyes introduced significant quantities of iron into the textiles which was distributed in the exterior and interior of the cotton, abaca, and silk fibres but only in the exterior of the wool fibres. As seen with historic iron-tannate dyed objects, the dyed cotton, abaca, and silk textiles lost tensile strength faster and more significantly than undyed equivalents during accelerated thermal ageing and all of the dyed model textiles, most notably the cotton, discoloured more than the undyed equivalents on ageing. Conclusions The abaca, cotton, and silk model textiles are judged to be suitable for use as substitutes for cultural heritage materials in the testing of stabilisation treatments. PMID:22616934

  6. The politics of place(ment): problematising the provision of hepatitis C treatment within opiate substitution clinics.

    PubMed

    Rance, Jake; Newland, Jamee; Hopwood, Max; Treloar, Carla

    2012-01-01

    The hepatitis C virus (HCV) epidemic is a significant public health challenge in Australia. Current initiatives to expand access to HCV treatment focus on opiate substitution therapy (OST) settings where the prevalence of hepatitis C among clients is high. In Australia, the provision of OST for many clients is via large clinics, with an estimated median of 150 clients per service. Conceptually informed by the work of Michel Foucault, our analysis of the proposed integrated treatment model focuses on the critical but overlooked question of organisational culture and power operating within OST. We argue that the specific context of OST not merely reflects but actively participates in the political economy of social exclusion via which the socio-spatial segregation and stigmatisation of the service user as 'drug user' is enacted. This paper analyses data collected from two samples during 2008/9: OST clients living in New South Wales, Australia and a range of OST health professionals working in Australian settings. In total, 27 interviews were conducted with current OST clients; 19 by phone and 8 face-to-face. One focus group and 16 telephone interviews were conducted with OST health professionals. Our analysis of key themes emerging from the interview data suggests that the successful introduction of HCV treatment within the OST clinic is not a given. We are concerned that particular areas of tension, if not explicit contradiction, have been overlooked in current research and debates informing the proposed combination treatment model. We question the appropriateness of co-locating a notoriously arduous, exacting treatment (HCV) within the highly surveillant and regulatory environment of OST. While applauding the intention to improve access to HCV care and treatment for people who inject drugs we caution against a treatment model that risks further entrenching (socio-spatial) stigmatisation amongst those already experiencing significant marginalisation. PMID:22133583

  7. Substituting the postproduction treatment for bulk-heterojunction solar cells using chemical additives

    Microsoft Academic Search

    Almantas Pivrikas; Philipp Stadler; Helmut Neugebauer; Niyazi Serdar Sariciftci

    2008-01-01

    Postproduction treatment of poly (3-alkylthiophene) based bulk-heterojunction solar cells is an important and required procedure in order to fabricate organic solar cells with highest power conversion efficiencies. Postproduction treatment, by means of annealing solar cells at elevated temperatures during which an external voltage is simultaneously applied, is not very suitable for large scale production schemes due to the need for

  8. 40 CFR 268.3 - Dilution prohibited as a substitute for treatment.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...Dilution of wastes that are hazardous...characteristic in treatment systems which...which treat wastes subsequently discharged to a water of the United...of the Clean Water Act (CWA), or which treat wastes in a CWA-equivalent treatment system,...

  9. 40 CFR 268.3 - Dilution prohibited as a substitute for treatment.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...Dilution of wastes that are hazardous...characteristic in treatment systems which...which treat wastes subsequently discharged to a water of the United...of the Clean Water Act (CWA), or which treat wastes in a CWA-equivalent treatment system,...

  10. 40 CFR 268.3 - Dilution prohibited as a substitute for treatment.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...Dilution of wastes that are hazardous...characteristic in treatment systems which...which treat wastes subsequently discharged to a water of the United...of the Clean Water Act (CWA), or which treat wastes in a CWA-equivalent treatment system,...

  11. 40 CFR 268.3 - Dilution prohibited as a substitute for treatment.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...Dilution of wastes that are hazardous...characteristic in treatment systems which...which treat wastes subsequently discharged to a water of the United...of the Clean Water Act (CWA), or which treat wastes in a CWA-equivalent treatment system,...

  12. Evaluation of medetomidine, ketamine and buprenorphine for neutering feral cats.

    PubMed

    Harrison, Kelly A; Robertson, Sheilah A; Levy, Julie K; Isaza, Natalie M

    2011-12-01

    A combination of medetomidine (M, 100 ?g/kg), ketamine (K, 10 mg/kg) and buprenorphine (B, 10 ?g/kg), administered by intramuscular injection, was evaluated for spaying and castration (neutering) of feral cats (n = 101). Eleven animals (11%) required supplemental anesthesia (isoflurane by mask) to maintain an adequate plane of surgical anesthesia. Atipamezole (A, 125 ?g/kg) was administered subcutaneously at the completion of surgery. All cats recovered from surgery and were released the following day. A hemoglobin saturation (SpO(2)) value of < 95% was recorded at least once during anesthesia in all cats. This MKB combination can be used in a feral cat sterilization clinic, but isoflurane supplementation may be necessary. Further research is indicated to determine the clinical significance of the low SpO(2) values associated with this anesthetic regimen. PMID:21885310

  13. Illicit Use of Buprenorphine in a Community Sample of Young Adult Non-Medical Users of Pharmaceutical Opioids

    PubMed Central

    Daniulaityte, Raminta; Falck, Russel; Carlson, Robert G.

    2011-01-01

    BACKGROUND There is growing evidence about illicit use of buprenorphine in the U.S. The study aims to: 1) identify prevalence and predictors of illicit buprenorphine use in a community sample of 396 young adult (18-23 years old) non-medical users of pharmaceutical opioids; 2) describe knowledge, attitudes and behaviors linked to illicit buprenorphine use as reported by a qualitative sub-sample (n=51). METHODS Participants were recruited using respondent-driven sampling. Qualitative interview participants were selected from the larger sample. The sample (n=396) was 54% male and 50% white; 7.8% reported lifetime illicit use of buprenorphine. RESULTS Logistic regression analysis results indicate that white ethnicity, intranasal inhalation of pharmaceutical opioids, symptoms of opioid dependence, and a greater number of pharmaceutical opioids used in lifetime were statistically significant predictors of illicit buprenorphine use. Qualitative interviews revealed that buprenorphine was more commonly used by more experienced users who were introduced to it by their “junkie friends.” Those who used buprenorphine to self-medicate withdrawal referred to it as a “miracle pill.” When used to get high, reported experiences ranged from “the best high ever” to “puking for days.” Participants reported using buprenorphine/naloxone orally or by intranasal inhalation. Injection of buprenorphine without naloxone was also reported. CONCLUSION Our findings suggest that illicit buprenorphine use is gaining ground primarily among whites and those who are more advanced in their drug use careers. Continued monitoring is needed to better understand evolving patterns and trends of illicit buprenorphine use. PMID:22036303

  14. Comparative Trial to Study the Effectiveness of Clonidine Hydrochloride and Buprenorphine-Naloxone in Opioid Withdrawal – A Hospital Based Study

    PubMed Central

    Farhat, Samina; Rather, Yasir Hassan; Abbas, Zaffar

    2015-01-01

    Objectives: Prevalence of opioid addiction has alarmingly increased over the recent years. In South Asian region alone there are more than 10 million opioid abusers amounting to 2% of world population. Detoxification remains to be the first step for the successful treatment of opioid addiction. The present study was carried out to compare the relative efficacy and safety of buprenorphine –naloxone and clonidine hydrochloride in the detoxification of opioid-dependents. Materials and Methods: Present trial was conducted at De- addiction centre of Institute of Mental and Neurosciences (IMNS), GMC Srinagar. Fifty four (54) treatment seeking subjects, 15-50 years of age, fulfilling DSM-1V TR (American Psychiatric association`s Mental Disorders-1V text revision) criteria for opioid dependence were included and randomized into two groups. The groups received either clonidine hydrochloride (Group A) or buprenorphine- naloxone (Bup-Nax) (Group B) for the duration of 10 days. The efficacy of the two drugs in controlling the opioid withdrawal was evaluated by Clinical Opioid Withdrawal Scale (COWS) and their effect on the desire for the abused substance was measured by Visual Analogue Scale (VAS). The safety of the two drugs was measured by taking the side effect profile of the two compared drugs into consideration. Results: There was significant difference of COWS-score between the two groups which was evident from day 3 (14.85 ± 3.43 vs. 11.67 ± 2.40, p<0.005) and continued till day 6 (2.56 ± 1.40 vs. 0.30 ± 0.61, p<0.005), for Group A and group B respectively. The effect of two drugs in controlling the craving for the abused substance also showed significant difference from day 2 (66.30 ± 10.80 vs. 47.40 ± 12.90, p<0.005) till day 5 (7.78 ± 6.41 vs. 1.85 ± 6.22, p<0.005), for Group A and Group B respectively. Conclusion: Administration of buprenorphine-naloxone was more efficient in reducing the signs and symptoms of opioid withdrawal and in controlling the craving for the abused substance during the first few days of detoxification. PMID:25738001

  15. Buprenorphine/Naloxone and Methadone Effects on Laboratory Indices of Liver Health: a Randomized Trial

    PubMed Central

    Saxon, Andrew J.; Ling, Walter; Hillhouse, Maureen; Thomas, Christie; Hasson, Albert; Ang, Alfonso; Doraimani, Geetha; Tasissa, Gudaye; Lokhnygina, Yuliya; Leimberger, Jeff; Bruce, R. Douglas; McCarthy, John; Wiest, Katharina; McLaughlin, Paul; Bilangi, Richard; Cohen, Allan; Woody, George; Jacobs, Petra

    2012-01-01

    BACKGROUND Buprenorphine/naloxone (BUP) and methadone (MET) are efficacious treatments for opioid dependence, although concerns about a link between BUP and drug-induced hepatitis have been raised. This study compares the effects of BUP and MET on liver health in opioid-dependent participants. METHODS This was a randomized controlled trial of 1269 opioid-dependent participants seeking treatment at 8 federally licensed opioid treatment programs and followed for up to 32 weeks between May 2006 and August 2010; 731 participants met “evaluable” criteria defined as completing 24 weeks of medication and providing at least 4 blood samples for transaminase testing. Participants were randomly assigned to receive BUP or MET for 24 weeks. Shift table analysis determined how many evaluable participants moved between categories of low and elevated transaminase levels. Predictors of moving from low to high transaminase levels were identified. RESULTS Changes in transaminase levels did not differ by medication condition. Baseline infection with hepatitis C or B was the only significant predictor of moving from low to elevated transaminase levels; 9 BUP and 15 MET participants showed extreme liver test elevations and were more likely than those without extreme elevations to have seroconverted to both hepatitis B and C during the study, or to use illicit drugs during the first 8 weeks of treatment. MET participants were retained longer in treatment than BUP participants. CONCLUSIONS This study demonstrated no evidence of liver damage during the initial 6 months of treatment in either condition. Physicians can prescribe either medication without major concern for liver injury. PMID:22921476

  16. Opioid partial agonist buprenorphine dampens responses to psychosocial stress in humans.

    PubMed

    Bershad, Anya K; Jaffe, Jerome H; Childs, Emma; de Wit, Harriet

    2015-02-01

    Pre-clinical and clinical evidence indicates that opioid drugs have stress-dampening effects. In animal models, opioid analgesics attenuate responses to isolation distress, and in humans, opioids reduce stress related to anticipation of physical pain. The stress-reducing effects of opioid drugs may contribute to their abuse potential. Despite this evidence in laboratory animals, the effects of opioids on responses to psychosocial stress have not been determined in humans. Here we examined the effects of buprenorphine, a ?-opioid partial agonist used to treat opioid dependence and pain, on subjective and physiological responses to a stressful public speaking task in healthy adults. We hypothesized that buprenorphine would reduce subjective and physiological stress responses. Healthy adult volunteers (N=48) were randomly assigned to receive placebo, 0.2mg sublingual buprenorphine, or 0.4mg sublingual buprenorphine in a two-session study with a stressful speaking task (Trier Social Stress Test; TSST) and a non-stressful control task. During the sessions, the participants reported on their mood states, provided subjective appraisals of the task, and measures of salivary cortisol, heart rate, and blood pressure at regular intervals. Stress produced its expected effects, increasing heart rate, blood pressure, salivary cortisol, and subjective ratings of anxiety and negative mood. In line with our hypothesis, both doses of buprenorphine significantly dampened salivary cortisol responses to stress. On self-report ratings, buprenorphine reduced how threatening participants found the tasks. These results suggest that enhanced opioid signaling dampens responses to social stress in humans, as it does in laboratory animals. This stress-dampening effect of buprenorphine may contribute to the non-medical use of opioid drugs. PMID:25544740

  17. Pharmacokinetics of Sustained-Release and Transdermal Buprenorphine in Göttingen Minipigs (Sus scrofa domestica)

    PubMed Central

    Thiede, Allison J; Garcia, Kelly D; Stolarik, DeAnne F; Ma, Junli; Jenkins, Gary J; Nunamaker, Elizabeth A

    2014-01-01

    The opioid buprenorphine has been shown to provide adequate postoperative analgesia in both companion and laboratory animals. However, its use is still hindered by the need for multiple parenteral injections to achieve continuous analgesia. The purpose of the current study was to conduct a pharmacokinetic analysis of 2 new long-acting formulations of buprenorphine—an injectable sustained-release buprenorphine (SRB) and a transdermal buprenorphine (TDB) patch—in healthy Göttingen minipigs by using liquid chromatography–electrospray ionization–tandem mass spectrometry. Administration of 0.18 mg/kg SC SRB and 30 ?g/h TDB achieved AUC0-Tlast of 221.6 ± 26.8 and 25.2 ± 3.9 ng × h/mL, respectively, compared with 9.7 ± 1.4 ng*h/mL for 0.02 mg/kg IV buprenorphine. By using a hypothesized therapeutic plasma buprenorphine concentration threshold of 0.1 ng/mL, therapeutic concentrations were achieved at the first study time point (5 to 30 min) and lasted an average of 8.0 ± 1.3 h for intravenous buprenorphine and 264.0 ± 32.2 h for SRB. TDB achieved therapeutic concentrations in 12 to 24 h after patch application, which lasted until the patch was removed at 72 h. The results of this study suggest that SRB and TDB are long-acting alternatives for pain management, and their use could decrease animal handling and stress, thereby simplifying pain management and improving welfare in laboratory swine. PMID:25650977

  18. Acute and chronic administration of clorazepate modifies the cell surface regulation of mu opioid receptors induced by buprenorphine in specific regions of the rat brain.

    PubMed

    Debruyne, Danièle; Quentin, Thomas; Poisnel, Géraldine; Lelong-Boulouard, Véronique; Barré, Louisa; Coquerel, Antoine

    2005-08-01

    The aim of the present study was to investigate the acute and chronic effects of clorazepate (CRZ) alone or in combination with buprenorphine (BPN) on binding of the selective mu opiate tritiated ligand [3H]-DAMGO in the rat brain. Using 0.1 to 5 nM [3H]-DAMGO concentrations and a beta-imager, Bmax (maximal receptor density) and K(D) (the dissociation constant) were directly determined at different regions of interest (ROI) in the brains of rats treated with BPN and/or CRZ administered either once or over 21 consecutive days. Differences in Bmax and K(D) were related to both treatment and location. Acute BPN induced a down-regulation (62% mean decrease in Bmax observed on the whole brain) of mu opiate receptors. CRZ induced a mean 39% decrease in Bmax associated with substantially decreased affinity, particularly after acute administration (136% mean K(D) increase). Addition of CRZ to BPN [mean Bmax decreases of 34% (acute) and 29% (chronic)] induced significantly less down-regulation than did BPN alone, while altering affinity. These changes were maximal in the amygdaloid nucleus. Significant and persistent decreases in Bmax and affinity were also detected in the hippocampus, hypothalamus and thalamus. In the thalamus, an opposite regulation of Bmax was observed that was maximal with the combination. As the regions where changes were greatest have been specifically implicated in memory and socio-emotional functions and/or vegetative and endocrine adaptations, there is reason to suspect that the addition of CRZ to BPN may have clinical consequences. On the one hand, it may have some impact on drug abuse and misuse behaviors towards treatments including heroin substitute and BZD, and on the other, amplify the BPN effect-particularly hedonic or toxic-mainly after sporadic BPN-BZD abuses. These pharmacodynamic findings may explain, at least in part, the well-established preference of patients for the BPN-benzodiazepine combination and the toxicity with which it is associated. PMID:16023087

  19. BUPRENORPHINE DOES NOT AFFECT ACUTE MURINE TOXOPLASMOSIS AND IS RECOMMENDED AS AN ANALGESIC IN TOXOPLASMA GONDII STUDIES IN MICE

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Groups of mice were infected with tachyzoites of the RH strain of Toxoplasma gondii treated with the opioid analgesic buprenorphine, sodium sulfadiazine, a combination of buprenorphine and sodium sulfadiazine, or nothing in the drinking water on days –1 to 12 post-infection. Mice in T. gondii infect...

  20. Impacts of Substituting Aluminum-Based Coagulants in Drinking Water Treatment

    Microsoft Academic Search

    Patrick Niquette; Frédéric Monette; Abdelkrim Azzouz; Robert Hausler

    2004-01-01

    Aluminum-based coagulants in drinking water treatment are widely used across Canada. According to the literature, the presence of aluminum in drinking water poses possible risks to humans. Preliminary studies investigating the use of alterna- tive coagulating agents such as iron-based coagulants, lanthanide salts and organic coagulants have already revealed that their implementation is possible, but require further studies concerning their

  1. Discovery of vinylcycloalkyl-substituted benzimidazole TRPM8 antagonists effective in the treatment of cold allodynia.

    PubMed

    Calvo, Raul R; Meegalla, Sanath K; Parks, Daniel J; Parsons, William H; Ballentine, Shelley K; Lubin, Mary Lou; Schneider, Craig; Colburn, Raymond W; Flores, Christopher M; Player, Mark R

    2012-03-01

    Thermosensitive transient receptor potential melastatin 8 (TRPM8) antagonists are considered to be potential therapeutic agents for the treatment of cold hypersensitivity. The discovery of a new class of TRPM8 antagonists that shows in vivo efficacy in the rat chronic constriction injury (CCI)-induced model of neuropathic pain is described. PMID:22330635

  2. Opioid receptor imaging and displacement studies with [6-O-[11C] methyl]buprenorphine in baboon brain.

    PubMed

    Galynker, I; Schlyer, D J; Dewey, S L; Fowler, J S; Logan, J; Gatley, S J; MacGregor, R R; Ferrieri, R A; Holland, M J; Brodie, J; Simon, E; Wolf, A P

    1996-04-01

    Buprenorphine (BPN) is a mixed opiate agonist-antagonist used as an analgesic and in the treatment of opiate addiction. We have used [6-O-[11C]methyl]buprenorphine ([11C]BPN) to measure the regional distribution in baboon brain, the test-retest stability of repeated studies in the same animal, the displacement of the labeled drug by naloxone in vivo, and the tissue distribution in mice. The regional distribution of radioactivity in baboon brain determined with PET was striatum > thalamus > cingulate gyrus > frontal cortex > parietal cortex > occipital cortex > cerebellum. This distribution corresponded to opiate receptor density and to previously published data (37). The tracer uptake in adult female baboons showed no significant variation in serial scans in the same baboon with no intervention in the same scanning session. HPLC analysis of baboon plasma showed the presence of labeled metabolites with 92% +/- 2.2% and 43% +/- 14.4% of the intact tracer remaining at 5 and 30 min, respectively. Naloxone, an opiate receptor antagonist, administered 30-40 min after tracer injection at a dose of 1.0 mg/kg i.v., reduced [11C]BPN binding in thalamus, striatum, cingulate gyrus, and frontal cortex to values 0.25 to 0.60 of that with no intervention. There were minimal (< 15%) effects on cerebellum. Naloxone treatment significantly reduced the slope of the Patlak plot in receptor-containing regions. These results demonstrate that [11C]BPN can be displaced by naloxone in vivo, and they affirm the feasibility of using this tracer and displacement methodology for short-term kinetics studies with PET. Mouse tissue distribution data were used to estimate the radiation dosimetry to humans. The critical organ was the small intestine, with a radiation dose estimate to humans of 117 nrad/mCi. PMID:8782244

  3. Pharmacokinetics of a single subcutaneous dose of sustained release buprenorphine in northern elephant seals (Mirounga angustirostris).

    PubMed

    Molter, Christine M; Barbosa, Lorraine; Johnson, Shawn; Knych, Heather K; Chinnadurai, Sathya K; Wack, Raymund F

    2015-03-01

    Information regarding analgesics in pinnipeds is limited. This study aimed to establish the pharmacokinetic parameters of a single subcutaneous dose of sustained release buprenorphine (Buprenorphine SR) in juvenile northern elephant seals (Mirounga angustirostris) with regard to its potential to provide long-lasting analgesia that requires infrequent dosing. Seals (n=26) were administered a single dose of sustained release buprenorphine at 0.12 mg/kg s.c. Blood samples were collected from the extradural intervertebral vein at 0 hr and at three or four of the following time points: 0.5, 1, 2, 6, 12, 24, 36, 48, 60, 96, 120, and 144 hr. Seals were examined daily for systemic and local adverse reactions. Plasma was analyzed by liquid chromatography tandem-mass spectrometry for buprenorphine and norbuprenorphine concentrations. A noncompartmental analysis for pharmacokinetic parameters was calculated using standard methods and equations. An average maximum concentration of 1.21 ng/ml (0.3-2.9 ng/ml) was detected 12 hr postadministration. Concentrations were quantifiable up to 144 hr postadministration but were below those expected to provide analgesia in some other species. No systemic adverse effects were noted in healthy seals receiving sustained release buprenorphine. Cellulitis or abscesses at the injection site were observed in 6/26 (23%) seals between 24 and 168 hr postadministration. Adverse local effects suggest that this drug should be used with caution in northern elephant seals. PMID:25831576

  4. Antinociceptive efficacy of buprenorphine and hydromorphone in red-eared slider turtles (Trachemys scripta elegans).

    PubMed

    Mans, Christoph; Lahner, Lesanna L; Baker, Bridget B; Johnson, Stephen M; Sladky, Kurt K

    2012-09-01

    Despite the frequent clinical use of buprenorphine in reptiles, its antinociceptive efficacy is not known. In a randomized, complete cross-over study, the antinociceptive efficacy of buprenorphine (0.2 mg/kg s.c.) was compared with hydromorphone (0.5 mg/kg s.c.), and saline (0.9% s.c. equivalent volume) in 11 healthy red-eared slider turtles (Trachemys scripta elegans). Additionally, buprenorphine at 0.1 and 1 mg/kg was compared with saline in six turtles. Hindlimb withdrawal latencies were measured after exposure to a focal, thermal noxious stimulus before and between 3 hr and up to 96 hr after drug administration. Buprenorphine did not significantly increase hindlimb withdrawal latencies at any time point compared with saline. In contrast, hydromorphone administration at 0.5 mg/kg significantly increased hindlimb withdrawal latencies for up to 24 hr. These results show that hydromorphone, but not buprenorphine, provides thermal antinociception in red-eared slider turtles. PMID:23082538

  5. Clinical Efficacy of Sustained-Release Buprenorphine with Meloxicam for Postoperative Analgesia in Beagle Dogs Undergoing Ovariohysterectomy

    PubMed Central

    Nunamaker, Elizabeth A; Stolarik, DeAnne F; Ma, Junli; Wilsey, Amanda S; Jenkins, Gary J; Medina, Chris L

    2014-01-01

    The goal of the current study was to compare the efficacy, adverse effects, and plasma buprenorphine concentrations of sustained-release buprenorphine (SRB) and buprenorphine after subcutaneous administration in dogs undergoing ovariohysterectomy. In a prospective, randomized, blinded design, 20 healthy adult female Beagle dogs underwent routine ovariohysterectomy and received multimodal analgesia consisting of meloxicam and one of two buprenorphine formulations. Dogs were randomly assigned to receive either SRB (0.2 mg/kg SC, once) or buprenorphine (0.02 mg/kg SC every 12 h for 3 d). Blinded observers assessed all dogs by using sedation scores, pain scores, temperature, HR, RR, and general wellbeing. Dogs were provided rescue analgesia with 0.02 mg/kg buprenorphine SC if the postoperative pain score exceeded a predetermined threshold. Blood samples were collected, and mass spectrometry was used to determine plasma buprenorphine concentrations. Data were analyzed with a linear mixed model and Tukey–Kramer multiple comparison. Age, body weight, anesthetic duration, surgical duration, sevoflurane concentration, and cardiorespiratory variables did not differ significantly between groups. Dogs in both formulation groups had comparable postoperative sedation and pain scores. One dog from each formulation group had breakthrough pain requiring rescue analgesia. Plasma buprenorphine concentrations remained above a hypothesized therapeutic concentration of 0.6 ng/mL for 136.0 ± 11.3 and 10.67 ± 0.84 h for SRB and buprenorphine, respectively. Based on the results of this study, multimodal analgesic regimens consisting of meloxicam and either buprenorphine or SRB are equally efficacious in managing pain associated with an ovariohysterectomy and show comparable side effects. PMID:25255072

  6. Extended release naltrexone injection is performed in the majority of opioid dependent patients receiving outpatient induction: a very low dose naltrexone and buprenorphine open label trial

    PubMed Central

    Mannelli, Paolo; Wu, Li-Tzy; Peindl, Kathleen S.; Swartz, Marvin S.; Woody, George E.

    2014-01-01

    BACKGROUND The approval of extended release injectable naltrexone (XR-NTX; Vivitrol®) has introduced a new option for treating opioid addiction, but studies are needed to identify its place within the spectrum of available therapies. The absence of physiological opioid dependence is a necessary and challenging first step for starting XR-NTX. Outpatient detoxification gives poor results and inpatient detoxification is either unavailable or too brief for the physiological effects of opioids to resolve. Here we present findings from an open label study that tested whether the transition from opioid addiction to XR-NTX can be safely and effectively performed in an outpatient setting using very low dose naltrexone and buprenorphine. METHODS Twenty treatment seeking opioid addicted individuals were given increasing doses of naltrexone starting at 0.25 mg with decreasing doses of buprenorphine starting at 4 mg during a 7-day outpatient XR-NTX induction procedure. Withdrawal discomfort, craving, drug use, and adverse events were assessed daily until the XR-NTX injection, then weekly over the next month. RESULTS Fourteen of the 20 participants received XR-NTX and 13 completed weekly assessments. Withdrawal, craving, and opioid or other drug use were significantly lower during induction and after XR-NTX administration compared with baseline, and no serious adverse events were recorded. CONCLUSIONS Outpatient transition to XR-NTX combining upward titration of very low dose naltrexone with downward titration of low dose buprenorphine was safe, well tolerated, and completed by most participants. Further studies with larger numbers of subjects are needed to see if this approach is useful for naltrexone induction. PMID:24602363

  7. HIV Risk Reduction With Buprenorphine-Naloxone or Methadone: Findings From A Randomized Trial

    PubMed Central

    Woody, George; Bruce, Douglas; Korthuis, P. Todd; Chhatre, Sumedha; Hillhouse, Maureen; Jacobs, Petra; Sorensen, James; Saxon, Andrew J.; Metzger, David; Ling, Walter

    2014-01-01

    Objectives Compare HIV injecting and sex risk in patients being treated with methadone (MET) or buprenorphine-naloxone (BUP). Methods Secondary analysis from a study of liver enzyme changes in patients randomized to MET or BUP who completed 24-weeks of treatment and had 4 or more blood draws. The initial 1:1 randomization was changed to 2:1 (BUP: MET) after 18 months due to higher dropout in BUP. The Risk Behavior Survey (RBS) measured past 30-day HIV risk at baseline and weeks 12 and 24. Results Among 529 patients randomized to MET, 391 (74%) were completers; among 740 randomized to BUP, 340 (46%) were completers; 700 completed the RBS. There were significant reductions in injecting risk (p< 0.0008) with no differences between groups in mean number of times reported injecting heroin, speedball, other opiates, and number of injections; or percent who shared needles, did not clean shared needles with bleach, shared cookers, or engaged in front/back loading of syringes. The percent having multiple sex partners decreased equally in both groups (p<0.03). For males on BUP the sex risk composite increased; for males on MET, the sex risk decreased resulting in significant group differences over time (p<0.03). For females, there was a significant reduction in sex risk (p<0.02) with no group differences. Conclusions Among MET and BUP patients that remained in treatment, HIV injecting risk was equally and markedly reduced, however MET retained more patients. Sex risk was equally and significantly reduced among females in both treatment conditions, but increased for males on BUP, and decreased for males on MET. PMID:24751432

  8. Illicit use of methadone and buprenorphine among adolescents and young adults in Sweden

    PubMed Central

    2013-01-01

    Background Illicit use of methadone and buprenorphine has been described as a growing problem in Sweden in recent years, and has been associated with an increased drug-related mortality. Critics claim that the substances have become popular among adolescents and that they function as a gateway to heroin use. The aim of this study is to investigate, firstly, the extent to which illicit use of methadone and buprenorphine occurs among adolescents and young adults in Sweden, and secondly, at what stage in a user’s drug career these substances tend to appear. Methods The study is based on surveys and structured interviews on drug use among various populations of young people, in addition to qualitative interviews with 86 informants who, in their professional capacity, encounter adolescents or young adults who are using illicit drugs. Results Illicit use of methadone and buprenorphine is rare among young people in Sweden. According to high school surveys, less than 0.1% have tried these substances. Among young drug users in general, few have tried the substances, and there is nothing to indicate that they act as gateway drugs. Among adolescents and young adults with severe drug problems, however, the illicit use of methadone and buprenorphine is more common (54% in a compulsory care sample). These substances normally enter the drug career late, and few use them as their main drug of choice. Other prescription drugs, like benzodiazepines and tramadol, are used by adolescents to a far greater extent. Diversion and illicit use of methadone and buprenorphine is not seen as a serious problem by the professionals interviewed. A general view is that the substances are mainly used by people with a heroin or polydrug addiction, often for “self-medication” purposes. However, several informants express concern that methadone and buprenorphine may cause fatalities among young drug users without an opioid tolerance. Conclusions Illicit use of methadone and buprenorphine among young drug users is not a widespread problem in Sweden. Harm-reduction measures should target drug users with more severe problems, among whom illicit use of methadone and buprenorphine is more common and pose a medical risk. Illicit use of other prescription drugs, which are less controlled and more widely used by young people, is an important issue for further research. PMID:24139199

  9. Synthesis and biological evaluation of 4-substituted fluoronucleoside analogs for the treatment of hepatitis B virus infection.

    PubMed

    Yang, Qinghua; Kang, Jinfeng; Zheng, Liyun; Wang, Xue-Jun; Wan, Na; Wu, Jie; Qiao, Yan; Niu, Pengfei; Wang, Sheng-Qi; Peng, Youmei; Wang, Qingduan; Yu, Wenquan; Chang, Junbiao

    2015-05-14

    A series of 4-substituted fluoronucleosides have been synthesized in order to address the toxicity issue of the parent compound 7, and after in vitro evaluation, the cyclopropylamino analog 1f was selected for in vivo study. In mice, this compound exhibited a significantly improved toxicity profile. Administered orally, compound 1f was well-tolerated at a dose up to 3 g/kg and showed insignificant toxicity on white blood cells and a low mutagenic effect at dosages up to 80 mg/kg (single) or 20 mg/kg/day (5 days). In duck HBV (DHBV)-infected duck models, both the serum and liver DHBV DNA levels (74.2 and 82.1%, respectively) were markedly reduced by the treatment of 1f at a dose of 1 mg/kg/day for 10 days. In addition, both the viral DNA levels had a lower degree of recovery after withdrawal of the test compound for 3 days. PMID:25905540

  10. Buprenorphine versus dihydrocodeine for opiate detoxification in primary care: a randomised controlled trial

    Microsoft Academic Search

    Nat MJ Wright; Laura Sheard; Charlotte NE Tompkins; Clive E Adams; Victoria L Allgar; Nicola S Oldham

    2007-01-01

    BACKGROUND: Many drug users present to primary care requesting detoxification from illicit opiates. There are a number of detoxification agents but no recommended drug of choice. The purpose of this study is to compare buprenorphine with dihydrocodeine for detoxification from illicit opiates in primary care. METHODS: Open label randomised controlled trial in NHS Primary Care (General Practices), Leeds, UK. Sixty

  11. Buprenorfina en el manejo de dolor por cáncer The Use of Buprenorphine to Control Cancer Pain

    Microsoft Academic Search

    María Catalina; Soto Niño

    Opiods are the current pharmalogical remedies of choice for the control of moderate to severe pain. Subsequently, it is important to rely on a number of prescriptions and applications for these drugs, particularly in the case of oncological patients. Low molecular weight, high potency and liposolubility of buprenorphine combine with its favorable tolerance and low abuse probability. Clinical evidence reveals

  12. 78 FR 34108 - Determination That SUBOXONE (Buprenorphine Hydrochloride and Naloxone Hydrochloride) Sublingual...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-06

    ...and Naloxone Hydrochloride) Sublingual Tablets, 2 Milligrams/0.5 Milligrams and...HCl) and naloxone HCl) sublingual tablets, 2 milligrams (mg)/0.5 mg and 8...buprenorphine HCl and naloxone HCl sublingual tablets, 2 mg/0.5 mg and 8 mg/2 mg,...

  13. Opioid effects and opioid withdrawal during a 24 h dosing interval in patients maintained on buprenorphine

    Microsoft Academic Search

    Olga V Lopatko; Jason M White; Alice Huber; Walter Ling

    2003-01-01

    In maintenance patients methadone has been shown to produce considerable changes in opioid effects and withdrawal over the dosing interval. As a partial agonist buprenorphine may be expected to produce smaller changes, but the nature and magnitude of these changes have only been described for single doses. In the present study opioid effects and withdrawal were described in patients maintained

  14. Buprenorphine added to the local anesthetic for brachial plexus block to provide postoperative analgesia in outpatients

    Microsoft Academic Search

    Kenneth D. Candido; Carlo D. Franco; Mohammad A. Khan; Alon P. Winnie; Durre S. Raja

    2001-01-01

    Background and Objectives: Over the past 10 years, several studies have suggested that the addition of certain opiates to the local anesthetic used for brachial block may provide effective, long-lasting postoperative analgesia. One of these studies indicated that the agonist-antagonist, buprenorphine, added to bupivacaine provided a longer period of postoperative analgesia than the traditional opiates, but in this study, it

  15. Effect of modern analgesic drugs (tramadol, pentazocine, and buprenorphine) on the bile duct sphincter in man

    Microsoft Academic Search

    M Staritz; T Poralla; M Manns; K H Meyer Zum Büschenfelde

    1986-01-01

    Modern narcotic analgesic drugs, such as tramadol, pentazocine, and buprenorphine share similarities of molecular structure with morphine which is widely believed to cause spasm of the bile duct sphincter and so impede bile flow. This study assessed the effects of intravenously administered analgesics on bile duct sphincter motor activity measured by ERCP manometry. Ten minutes after pentazocine injection the duration

  16. Pharmaceutical and pharmacokinetic characterization of a novel sublingual buprenorphine/naloxone tablet formulation in healthy volunteers

    PubMed Central

    Fischer, Andreas; Hjelmström, Peter

    2015-01-01

    Abstract Context Bitter taste, as well as dissolve time, presents a significant challenge for the acceptability of formulations for oral transmucosal drug delivery. Objective To characterize a novel sublingual tablet formulation of buprenorphine/naloxone with regards to pharmacokinetics, dissolve time and formulation acceptability. Methods Dry mixing techniques were employed to produce a small and fast dissolving buprenorphine/naloxone sublingual tablet formulation, OX219 (Zubsolv®), using sucralose and menthol as sweetener and flavor to mask the bitter taste of the active ingredients. Two cross-over studies were performed in healthy volunteers to evaluate pharmacokinetics, dissolve time and acceptability of OX219 5.7/1.4?mg tablets compared to the commercially available buprenorphine/naloxone formulations Suboxone® tablets and films (8/2?mg). Results Buprenorphine exposure was equivalent in OX219 and Suboxone tablets. Sublingual dissolve times were significantly shorter for OX219 than for Suboxone tablets and were similar to Suboxone films. The OX219 formulation received significantly higher subjective ratings for taste and overall acceptability than both Suboxone formulations. OX219 was preferred over Suboxone tablet and film formulations by 77.4% and 88.9% of subjects, respectively. Conclusions A sublingual tablet formulation with an improved acceptability has been successfully developed. PMID:24099551

  17. Skin substitutes: An Indian perspective

    PubMed Central

    Singh, A. K.; Shenoy, Y. R.

    2012-01-01

    There have been numerous alternatives developed to replace skin. These can either be permanent substitutes or temporary substitutes, which need to be replaced later by autologous grafts. These have been tried in recent times as an attempt to reduce the need or in the case of permanent substitutes ,altogether replace autologous skin grafts. However till date no ideal skin substitute has been developed. Various factors have to be considered while choosing one of these substitutes. In a developing country like India awareness and availability of these skin substitutes is not adequate considering the volume of cases that require this modality of treatment. Also there are skin substitutes developed in our country that need to be highlighted. This article is an attempt to review the vast array of skin substitutes that have been developed and consider their utility and feasibility for developing countries. PMID:23162239

  18. Skin Substitutes

    PubMed Central

    Howe, Nicole; Cohen, George

    2014-01-01

    In a relatively short timespan, a wealth of new skin substitutes made of synthetic and biologically derived materials have arisen for the purpose of wound healing of various etiologies. This review article focuses on providing an overview of skin substitutes including their indications, contraindications, benefits, and limitations. The result of this overview was an appreciation of the vast array of options available for clinicians, many of which did not exist a short time ago. Yet, despite the rapid expansion this field has undergone, no ideal skin substitute is currently available. More research in the field of skin substitutes and wound healing is required not only for the development of new products made of increasingly complex biomolecular material, but also to compare the existing skin substitutes. PMID:25371771

  19. Early development of opioid?exposed infants born to mothers in buprenorphine?replacement therapy

    Microsoft Academic Search

    Sara Salo; Johanna Politi; Sarimari Tupola; Zeynep Biringen; Mirjam Kalland; Erja Halmesmäki; Hanna Kahila

    2010-01-01

    The purpose of the study was to examine cognitive development (using the Bayley MDI) and mother–child interaction (using the Emotion Availability Scales, 3rd edition) among infants of opioid?abusing mothers. Participants were 87 dyads (15 opioid?exposed, 15 maternal depression and 57 unexposed mother–infant dyads). The study group included 15 infants (mean age=7.0 months, sd=2.8 months) of mothers who participated in buprenorphine?replacement

  20. Experiences from a Community Based Substance Use Treatment Centre in an Urban Resettlement Colony in India

    PubMed Central

    Balhara, Yatan Pal Singh; Ranjan, Rajeev; Dhawan, Anju; Yadav, Deepak

    2014-01-01

    Background. There are limited community based treatment services for drug dependence in India. Rural areas and urban resettlement colonies are in particular deficient in such services. Aims. The current study aimed at preliminary assessment of substance use disorder management services at a community based substance use treatment clinic in an urban resettlement colony. Methods. The study was carried out at community based substance use treatment centre in a resettlement colony in India. The records of the centre were chart reviewed. Results. A total of 754 patients were registered at the clinic during the study period. Heroin was the primary drug of abuse for 63% of the patients. The mean duration of follow-up for the patients with opioid and alcohol dependence was 13.47 (SD ± 10.37; range 0–39) months. A total of 220 patients of opioid dependence were prescribed substation or abstinence directed therapy. Buprenorphine (87), slow release oral morphine (SROM) (16), and dextropropoxyphene (98) were used for opioid substitution. Conclusion. It is possible to deliver substance use disorder treatment services in community setting. There is a need to develop area specific community based treatment services for substance abuse in socially disadvantaged populations such as urban resettlement colonies. PMID:25431739

  1. Use of mineralized collagen bone graft substitutes and dorsal locking plate in treatment of elder metaphyseal comminuted distal radius fracture

    NASA Astrophysics Data System (ADS)

    Liu, Ke-Bin; Huang, Kui; Teng, Yu; Qu, Yan-Zheng; Cui, Wei; Huang, Zhen-Fei; Sun, Ting-Fang; Guo, Xiao-Dong

    2014-03-01

    Bone graft may be needed to fill bone defect in elderly patients with a metaphyseal comminuted distal radius fracture. In this retrospective, nonrandomized, single-surgeon study, we evaluated the clinical and radiologic outcomes of using both dorsal locking plates with or without augmentation with mineralized collagen (MC) bone graft for elderly patients with dorsally metaphyseal comminuted radius fractures. Patients in group 1 ( n = 12) were treated with dorsal locking plates with MC bone graft application into the metaphyseal bone defect, and those in group 2 ( n = 12) only with dorsal locking plates. Clinical and radiologic parameters were determined at three and 12 months after surgery. At final follow-up, no significant difference was noted between the 2 groups in terms of palmar tilt and radial inclination ( p = 0.80); however, ulnar variance increased significantly in the group 2 treated with dorsal locking plates without augmentation ( p < 0.05). Functionally, there was no significant difference between the groups. Our preliminary study suggests that combination of MC as bone-graft substitutes and dorsal locking plates may be a usefully alternative for elderly patients with metaphyseal comminuted distal radius fracture.

  2. Comparison of Intrathecal Dexmedetomidine with Buprenorphine as Adjuvant to Bupivacaine in Spinal Asnaesthesia

    PubMed Central

    Gupta, Mahima; Shailaja, S.; Hegde, K. Sudhir

    2014-01-01

    Background: The supplementation of local anaesthetics with adjuvants to improve the efficacy of subarachnoid block has been recognised since long. The most preferred drug has been opioids, but newer drugs like dexmedetomidine has also been introduced and investigated as an effective adjuvant. Aim: This study was conducted to evaluate and compare the characteristics of subarachnoid blockade, hemodynamic stability and adverse effects of intrathecal buprenorphine and intrathecal dexmedetomidine as an adjuvant to 0.5% hyperbaric bupivacaine for lower abdominal surgeries. Materials and Methods: The present study included 60 patients aged between 18-60 years classified as American Society of Anesthesiologists (ASA) Physical Status (PS) I/II scheduled for elective lower abdominal surgeries. The patients were randomly allotted to two groups to receive intrathecal 3ml of 0.5% bupivacine with 60µg of buprenorphine (Group B; n=30) or 3ml of 0.5% bupivacaine with 5µg of dexmedetomidine (Group D; n=30). The onset time to peak sensory level, motor block, sedation, Haemodynamic variables, duration of motor block, analgesia and any adverse effects were noted. Results: There was no significant difference between groups regarding demographic characteristics and type of surgery. The motor, sensory blockade and time of rescue analgesia were significantly prolonged in Group D compared to Group B. The sedation level was higher in Group D compared to Group B. There was no significant difference in haemodynamic variables although Group B had lower Heart Rate (HR) than Group D. Conclusion: Intrathecal dexmedetomidine when compared to intrathecal buprenorphine causes prolonged anaesthesia and analgesia with reduced need for sedation and rescue analgesics. PMID:24701498

  3. Blood as a Substitute for Tumor Tissue in Detecting EGFR Mutations for Guiding EGFR TKIs Treatment of Nonsmall Cell Lung Cancer: A Systematic Review and Meta-Analysis.

    PubMed

    Mao, Chen; Yuan, Jin-Qiu; Yang, Zu-Yao; Fu, Xiao-Hong; Wu, Xin-Yin; Tang, Jin-Ling

    2015-05-01

    Tumor tissues are often absent or insufficient for testing epidermal growth factor receptor (EGFR) mutations to guide EGFR tyrosine kinase inhibitors (TKIs) treatment of patients with nonsmall cell lung cancer (NSCLC).We conducted this systematic review and meta-analysis to assess whether blood can be used as a substitute for tumor tissue in detecting EGFR mutations.MEDLINE, EMBASE, and the Cochrane Library were searched for studies that provided data to estimate the accuracy of blood testing against tissue testing in NSCLC patients and/or those directly compared the efficacy of EGFR TKIs in EGFR mutant and wild-type patients according to sources of specimens.Sensitivity, specificity, and concordance rate were used as measures of the accuracy. Risk ratio (RR) for objective response and hazard ratio (HR) for progression-free survival (PFS) and overall survival (OS) were used as measures for treatment efficacy. We combined the effects by using the fixed-effects model unless there was evidence of heterogeneity, in which case a random-effects mode was used.This systematic review included 25 studies with 2605 patients. The pooled overall sensitivity, specificity, and concordance rate were 0.61, 0.90, and 0.79, respectively. Serum showed lower sensitivity (0.56 vs 0.65) but higher specificity (0.95 vs 0.85) and higher concordance (0.86 vs 0.74) than plasma. EGFR mutations (exon 19 or 21) in blood were significantly associated with objective response (RR: 4.08; 95% confidence interval [CI] 2.48-6.70), PFS (HR: 0.72; 95% CI 0.64-0.80), and OS (HR: 0.71; 95% CI 0.50-0.99). Importantly, the association of the mutations with the 3 clinical outcomes for serum was similar to that for tumor tissue and higher than that for plasma.Blood, in particular serum, is a good substitute when tumor tissue is absent or insufficient for testing EGFR mutations to guide EGFR TKIs treatment in patients with NSCLC. EGFR mutation positivity in blood could be used to recommend EGFR TKIs treatment, but the absence of blood positivity should not necessarily be construed with confirmed negativity. PMID:26020382

  4. Relative efficacy of cash versus vouchers in engaging opioid substitution treatment clients in survey-based research.

    PubMed

    Topp, Libby; Islam, M Mofizul; Day, Carolyn Ann

    2013-04-01

    Concerns that cash payments to people who inject drugs (PWID) to reimburse research participation will facilitate illicit drug purchases have led some ethical authorities to mandate department store/supermarket vouchers as research reimbursement. To examine the relative efficacy of the two forms of reimbursement in engaging PWID in research, clients of two public opioid substitution therapy clinics were invited to participate in a 20-30 min, anonymous and confidential interview about alcohol consumption on two separate occasions, 4 months apart. Under the crossover design, at Time 1, clients of Clinic 1 were offered $A20 cash as reimbursement, while clients of Clinic 2 were offered an $A20 voucher; at Time 2, the form of reimbursement was reversed. Using clinic records to determine the denominator (number of clients dosed), we found that compared with clients offered a voucher, a significantly higher proportion of clients who were offered cash participated in the survey (58% (139/241) vs 74% (186/252); ?(2)=14.27; p=0.0002). At first participation, respondents most commonly reported planning to purchase food/drinks/groceries (68%), cigarettes (21%) and transport/fuel (11%) with their payments, with those reimbursed in cash more likely to report planning to fund transport/fuel (19% vs 1%; p<.01) and less likely to report planning to purchase food/drinks/groceries (62% vs 76%; p=0.02). Just three out of 155 cash participants reported planning to purchase illicit drugs with their payment. Results demonstrate that modest cash payments enhanced recruitment of this group, an important consideration given the challenges of delineating the parameters of a population defined by illegal activity, seemingly without promoting excessive additional drug use. PMID:23236087

  5. Analgesic efficacy and tolerability of transdermal buprenorphine in patients with inadequately controlled chronic pain related to cancer and other disorders: A multicenter, randomized, double-blind, placebo-controlled trial

    Microsoft Academic Search

    Reinhard Sittl; Norbert Griessinger; Rudolf Likar

    2003-01-01

    Background: Buprenorphine is a potent opioid analgesic that is available in sublingual and parenteral formulations. A new formulation, buprenorphine transdermal delivery system (TDS), has been developed.Objective: The aim of this study was to compare the analgesic efficacy and tolerability of the 3 available dosages of buprenorphine TDS (35.0, 52.5, and 70.0 ?g\\/h) with placebo.Methods: This was a randomized, double-blind, placebo-controlled,

  6. Emotional Availability, Parental Self-Efficacy Beliefs, and Child Development in Caregiver-Child Relationships with Buprenorphine-Exposed 3-year-olds

    Microsoft Academic Search

    Saara Salo; Kaisa Kivistö; Riikka Korja; Zeynep Biringen; Sarimari Tupola; Hanna Kahila; Satu Kivitie-Kallio

    2009-01-01

    Objective. The purpose was to compare emotional availability, maternal self-efficacy beliefs, and child developmental status in caregiver–child relationships with prenatally buprenorphine-exposed and nonexposed 3-year-old children. Design. We compared prenatally buprenorphine-exposed children living either with the biological mother (n = 7) or in foster care (n = 14) to nonexposed participants (n = 13). Emotional availability was coded from videotaped parent-child

  7. Antimycobacterial and anti-inflammatory activities of substituted chalcones focusing on an anti-tuberculosis dual treatment approach.

    PubMed

    Ventura, Thatiana Lopes Biá; Calixto, Sanderson Dias; de Azevedo Abrahim-Vieira, Bárbara; de Souza, Alessandra Mendonça Teles; Mello, Marcos Vinícius Palmeira; Rodrigues, Carlos Rangel; Soter de Mariz E Miranda, Leandro; Alves de Souza, Rodrigo Octavio Mendonça; Leal, Ivana Correa Ramos; Lasunskaia, Elena B; Muzitano, Michelle Frazão

    2015-01-01

    Tuberculosis (TB) remains a serious public health problem aggravated by the emergence of M. tuberculosis (Mtb) strains resistant to multiple drugs (MDR). Delay in TB treatment, common in the MDR-TB cases, can lead to deleterious life-threatening inflammation in susceptible hyper-reactive individuals, encouraging the discovery of new anti-Mtb drugs and the use of adjunctive therapy based on anti-inflammatory interventions. In this study, a series of forty synthetic chalcones was evaluated in vitro for their anti-inflammatory and antimycobacterial properties and in silico for pharmacokinetic parameters. Seven compounds strongly inhibited NO and PGE2 production by LPS-stimulated macrophages through the specific inhibition of iNOS and COX-2 expression, respectively, with compounds 4 and 5 standing out in this respect. Four of the seven most active compounds were able to inhibit production of TNF-? and IL-1?. Chalcones that were not toxic to cultured macrophages were tested for antimycobacterial activity. Eight compounds were able to inhibit growth of the M. bovis BCG and Mtb H37Rv strains in bacterial cultures and in infected macrophages. Four of them, including compounds 4 and 5, were active against a hypervirulent clinical Mtb isolate as well. In silico analysis of ADMET properties showed that the evaluated chalcones displayed satisfactory pharmacokinetic parameters. In conclusion, the obtained data demonstrate that at least two of the studied chalcones, compounds 4 and 5, are promising antimycobacterial and anti-inflammatory agents, especially focusing on an anti-tuberculosis dual treatment approach. PMID:25951004

  8. Poly-substance use and antisocial personality traits at admission predict cumulative retention in a buprenorphine programme with mandatory work and high compliance profile

    PubMed Central

    2011-01-01

    Background Continuous abstinence and retention in treatment for alcohol and drug use disorders are central challenges for the treatment providers. The literature has failed to show consistent, strong predictors of retention. Predictors and treatment structure may differ across treatment modalities. In this study the structure was reinforced by the addition of supervised urine samples three times a week and mandatory daily work/structured education activities as a prerequisite of inclusion in the program. Methods Of 128 patients consecutively admitted to buprenorphine maintenance treatment five patients dropped out within the first week. Of the remaining 123 demographic data and psychiatric assessment were used to predict involuntary discharge from treatment and corresponding cumulative abstinence probability. All subjects were administered the Structured Clinical Interview for DSM-IV-TR, and the Symptom Checklist 90 (SCL-90), the Alcohol Use Disorder Identification Test (AUDIT), the Swedish universities Scales of Personality (SSP) and the Sense of Coherence Scale (SOC), all self-report measures. Some measures were repeated every third month in addition to interviews. Results Of 123 patients admitted, 86 (70%) remained in treatment after six months and 61 (50%) remained in treatment after 12 months. Of those discharged involuntarily, 34/62 individuals were readmitted after a suspension period of three months. Younger age at intake, poly-substance abuse at intake (number of drugs in urine), and number of conduct disorder criteria on the SCID Screen were independently associated with an increased risk of involuntary discharge. There were no significant differences between dropouts and completers on SCL-90, SSP, SOC or AUDIT. Conclusion Of the patients admitted to the programme 50% stayed for the first 12 months with continuous abstinence and daily work. Poly-substance use before intake into treatment, high levels of conduct disorder on SCID screen and younger age at intake had a negative impact on retention and abstinence. PMID:21569440

  9. Opioid substitution therapy in manipur and nagaland, north-east india: operational research in action

    PubMed Central

    2010-01-01

    Background There is good evidence for the effectiveness of opioid substitution therapy (OST) for injecting drug users (IDUs) in middle and high-income countries but little evidence regarding the provision of OST by non-government organisations (NGOs) in resource-poor settings. This paper reports on outcomes of an NGO-based OST program providing sub-lingual buprenorphine to opiate dependent IDUs in two north-east Indian states (Manipur and Nagaland), a region where conflict, under-development and injecting of heroin and Spasmoproxyvon (SP) are ongoing problems. The objectives of the study were: 1) to calculate OST treatment retention, 2) to assess the impact on HIV risk behaviours and quality of life, and 3) to identify client characteristics associated with cessation of treatment due to relapse. Methods This study involves analysis of data that were routinely and prospectively collected from all clients enrolled in an OST program in Manipur and Nagaland between May 2006 and December 2007 (n = 2569, 1853 in Manipur and 716 in Nagaland) using standardised questionnaires, and is best classified as operational research. The data were recorded at intake into the program, after three months, and at cessation. Outcome measures included HIV risk behaviours and quality of life indicators. Predictors of relapse were modelled using binary logistic regression. Results Of all clients enrolled in OST during the month of May 2006 (n = 713), 72.8% remained on treatment after three months, and 63.3% after six months. Statistically significant (p = 0.05) improvements were observed in relation to needle sharing, unsafe sex, incidents of detention, and a range of quality of life measures. Greater spending on drugs at intake (OR 1.20), frequently missing doses (OR 8.82), and having heroin rather than SP as the most problematic drug (OR 1.95) were factors that increased the likelihood of relapse, and longer duration in treatment (OR 0.76) and regular family involvement in treatment (OR 0.20) reduced the likelihood of relapse. Conclusion The findings from this operational research indicate that the provision of OST by NGOs in the severely constrained context of Manipur and Nagaland achieved outcomes that are internationally comparable, and highlights strategies for strengthening similar programs in this and other resource-poor settings. PMID:21122129

  10. Treatment of chronic experimental Trypanosoma cruzi infections in mice with MK-436, a 2-substituted 5-nitroimidazole.

    PubMed Central

    Andrade, S. G.; Silva, R. C.; Santiago, C. M.

    1989-01-01

    The antiprotozoal drug 3-(1-methyl-5-nitroimidazol-2-yl)-3a, 4,5,6,7,7a-hexahydro-1,2-benzisoxazole (MK-436) is highly efficacious for treating mice chronically infected with different strains of Trypanosoma cruzi. The compound was administered by gavage in two daily doses of 250 mg per kg body weight to 130 mice that had been infected for 90 to 400 days with either type II or III strains of T. cruzi. The following parasitological cure tests were carried out: xenodiagnosis, haemoculture, and inoculation of blood into newborn mice. Indirect immunofluorescence tests and histopathological studies were also performed. The results indicate that the drug is highly efficacious against chronic infection caused by both type II (cure rate, 90%) and type III strains (cure rate, 95.7%). Histopathological examinations showed complete clearance of the cardiac and muscular lesions in 36% of the mice infected with type II strains and a decrease in the intensity and extension of the lesions in mice infected with type III strains. Indirect immunofluorescence tests were persistently positive for all the mice 3-6 months after the treatment. Images Fig. 1 Fig. 2 PMID:2515007

  11. 40 CFR 721.8780 - Substituted pyridine azo substituted phenyl.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Substituted pyridine azo substituted phenyl. 721.8780 Section 721.8780 ...Substituted pyridine azo substituted phenyl. (a) Chemical substance and significant...as substituted pyridine azo substituted phenyl (PMNs P-96-767 and...

  12. 40 CFR 721.8780 - Substituted pyridine azo substituted phenyl.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Substituted pyridine azo substituted phenyl. 721.8780 Section 721.8780 ...Substituted pyridine azo substituted phenyl. (a) Chemical substance and significant...as substituted pyridine azo substituted phenyl (PMNs P-96-767 and...

  13. 40 CFR 721.8780 - Substituted pyridine azo substituted phenyl.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Substituted pyridine azo substituted phenyl. 721.8780 Section 721.8780 ...Substituted pyridine azo substituted phenyl. (a) Chemical substance and significant...as substituted pyridine azo substituted phenyl (PMNs P-96-767 and...

  14. 40 CFR 721.8780 - Substituted pyridine azo substituted phenyl.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Substituted pyridine azo substituted phenyl. 721.8780 Section 721.8780 ...Substituted pyridine azo substituted phenyl. (a) Chemical substance and significant...as substituted pyridine azo substituted phenyl (PMNs P-96-767 and...

  15. 40 CFR 721.8780 - Substituted pyridine azo substituted phenyl.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Substituted pyridine azo substituted phenyl. 721.8780 Section 721.8780 ...Substituted pyridine azo substituted phenyl. (a) Chemical substance and significant...as substituted pyridine azo substituted phenyl (PMNs P-96-767 and...

  16. Morphine intake and the effects of naltrexone and buprenorphine on the acquisition of methamphetamine intake.

    PubMed

    Eastwood, E C; Phillips, T J

    2014-02-01

    Some common genetic factors appear to influence risk for drug dependence across multiple drugs of abuse. In previous research, mice that were selectively bred for higher amounts of methamphetamine consumption, using a two-bottle choice methamphetamine drinking procedure, were found to be less sensitive to the locomotor stimulant effects of morphine and of the more selective ?-opioid receptor agonist fentanyl, compared to mice that were bred for low methamphetamine consumption. This suggested that ?-opioid receptor-mediated pathways may influence genetic risk for methamphetamine consumption. We hypothesized that these differences in opioid sensitivity would impact opioid intake in the methamphetamine drinking lines and that drugs with ?-opioid receptor activity would impact methamphetamine intake. Consumption of morphine was examined in 2, two-bottle choice studies, one that compared morphine to quinine consumption and another that used a saccharin fading procedure. Next, naltrexone (0, 0.5, 1, 2, 5, 10 and 20?mg/kg), a ?-opioid receptor antagonist, and buprenorphine (0, 1, 2 or 4?mg/kg), a ?-opioid receptor partial agonist, were each examined for their effects on the acquisition of methamphetamine consumption. Low methamphetamine drinking mice consumed more morphine compared to high methamphetamine drinking mice. Naltrexone did not alter methamphetamine consumption in either selected line; however, buprenorphine reduced methamphetamine intake in the high methamphetamine drinking line. These data show that greater sensitivity to opioids is associated with greater opioid intake and warrant further investigation of drugs with ?-opioid receptor-specific agonist activity in genetically determined differences in methamphetamine consumption. PMID:24152140

  17. The in vivo glucuronidation of buprenorphine and norbuprenorphine determined by liquid chromatography-electrospray ionization-tandem mass spectrometry.

    PubMed

    Huang, Wei; Moody, David E; McCance-Katz, Elinore F

    2006-04-01

    The opioid partial agonist medication, buprenorphine (BUP), and its primary metabolite, norbuprenorphine (NBUP), are extensively glucuronidated. Sensitive analytical methods that include determination of buprenorphine-3-glucuronide (BUPG) and norbuprenorphine-3-glucuronide (NBUPG) are needed to more fully understand the metabolism and pharmacokinetics of buprenorphine. A method has now been developed that uses solid-phase extraction followed by liquid chromatography-electrospray ionization-tandem mass spectrometry. BUP-d4, NBUP-d3, and morphine-3-glucuronide-d3 were used as internal standards. The lower limit of quantitation was 0.1 and 0.5 ng/mL for each of the analytes in 1-mL of human plasma and urine, respectively, except for NBUP in urine in which it was 2.5 ng/mL. The analytes were stable under the following conditions: plasma and urine at room temperature, up to 20 hours; plasma and urine at -20 degrees C for 119 and 85 days, respectively; plasma freeze-thaw, up to 3 cycles; processed sample, up to 96 hours at -20 degrees C and up to 48 hours on the autosampler; stock solutions at room temperature and at -20 degrees C, up to 6 hours and 128 days, respectively. In plasma collected from 5 subjects on maintenance daily sublingual doses of 16 mg BUP and 4 mg naloxone, respective 0- to 24-hour areas under the curve were 32, 88, 26, and 316 ng/mL x h for BUP, NBUP, BUPG, and NBUPG. In urine samples respective percent of daily dose excreted in the 24-hour urine were 0.014%, 1.89%, 1.01%, and 7.76%. This method allowed us to determine that NBUPG is a major metabolite present in plasma and urine of BUP. Because urinary elimination is limited ( approximately 11% of daily dose), the role of NBUPG in total clearance of buprenorphine is not yet known. PMID:16628138

  18. Skin Substitutes and Wound Healing

    Microsoft Academic Search

    F. A. Auger; D. Lacroix; L. Germain

    2009-01-01

    Medical science has vastly improved on the means and methods available for the treatment of wounds in the clinic. The production and use of various types of skin substitutes has led to dramatic improvements in the odds of survival for severely burned patients, but they have also shown promise for many other applications, including cases involving chronic wounds that are

  19. From morphine clinics to buprenorphine: regulating opioid agonist treatment of addiction in the United States

    Microsoft Academic Search

    Jerome H. Jaffe; Charles O'Keeffe

    2003-01-01

    The practice of prescribing opioid drugs for opioid dependent patients in the U.S. has been subjected to special government scrutiny for almost 100 years. From 1920 until 1964, doctors who used opioids to treat addicts risked federal and\\/or state criminal prosecution. Although that period ended when oral methadone maintenance was established as legitimate medical practice, public concern about methadone diversion

  20. Impact of human immunodeficiency virus type 1 gp41 amino acid substitutions selected during enfuvirtide treatment on gp41 binding and antiviral potency of enfuvirtide in vitro.

    PubMed

    Mink, M; Mosier, S M; Janumpalli, S; Davison, D; Jin, L; Melby, T; Sista, P; Erickson, J; Lambert, D; Stanfield-Oakley, S A; Salgo, M; Cammack, N; Matthews, T; Greenberg, M L

    2005-10-01

    Enfuvirtide (ENF), a novel human immunodeficiency virus type 1 (HIV-1) fusion inhibitor, has potent antiviral activity against HIV-1 both in vitro and in vivo. Resistance to ENF observed after in vitro passaging was associated with changes in a three-amino-acid (aa) motif, GIV, at positions 36 to 38 of gp41. Patients with ongoing viral replication while receiving ENF during clinical trials acquired substitutions within gp41 aa 36 to 45 in the first heptad repeat (HR-1) of gp41 in both population-based plasma virus sequences and proviral DNA sequences from isolates showing reduced susceptibilities to ENF. To investigate their impact on ENF susceptibility, substitutions were introduced into a modified pNL4-3 strain by site-directed mutagenesis, and the susceptibilities of mutant viruses and patient-derived isolates to ENF were tested. In general, susceptibility decreases for single substitutions were lower than those for double substitutions, and the levels of ENF resistance seen for clinical isolates were higher than those observed for the site-directed mutant viruses. The mechanism of ENF resistance was explored for a subset of the substitutions by expressing them in the context of a maltose binding protein chimera containing a portion of the gp41 ectodomain and measuring their binding affinity to fluorescein-labeled ENF. Changes in binding affinity for the mutant gp41 fusion proteins correlated with the ENF susceptibilities of viruses containing the same substitutions. The combined results support the key role of gp41 aa 36 to 45 in the development of resistance to ENF and illustrate that additional envelope regions contribute to the ENF susceptibility of fusion inhibitor-naïve viruses and resistance to ENF. PMID:16160172

  1. Buprenorphine added to bupivacaine prolongs femoral nerve block duration and improves analgesia in patients undergoing primary total knee arthroplasty-a randomised prospective double-blind study.

    PubMed

    Kosel, Juliusz; Bobik, Piotr; Siemi?tkowski, Andrzej

    2015-02-01

    The aim of the study was to determine whether the addition the long-acting opioid buprenorphine as an adjuvant to the local anaesthetic agent would improve quality and prolong duration of femoral nerve blockade in post-operative analgesia following primary total knee arthroplasty. The study involved 48 patients. The femoral nerve was anaesthetised with a 0.25% solution of bupivacaine with adrenaline or with the addition of 0.3mg of buprenorphine. The duration of the sensory block and analgesic effect was assessed according to NRS scale at 12, 24, 36, 48, 60 and 72 hours post-surgery. Patients who received buprenorphine as an adjuvant to the local anaesthetic had significantly longer sensory blockade and lower NRS-rated pain intensity with the difference reaching statistical significance at 12 hours post-surgery. PMID:25512031

  2. Novel pharmacotherapeutic strategies for treatment of opioid-induced neonatal abstinence syndrome

    PubMed Central

    McLemore, Gabrielle L.; Lewis, Tamorah; Jones, Catherine H.; Gauda, Estelle B.

    2014-01-01

    Summary The non-medical use of prescription drugs, in general, and opioids, in particular, is a national epidemic, resulting in enormous addiction rates, healthcare expenditures, and overdose deaths. Prescription opioids are overly prescribed, illegally trafficked, and frequently abused, all of which have created a new opioid addiction pathway, adding to the number of opioid-dependent newborns requiring treatment for neonatal abstinence syndrome (NAS), and contributing to challenges in effective care in maternal and fetal/neonatal (M-F/N) medicine. The standard of care for illicit or prescription opioid dependence during pregnancy is opioid agonist (methadone or buprenorphine) substitution therapy, which are also frequently abused. The next generation of pharmacotherapies for the treatment of illicit or prescription opioid addiction in the M-F/N interactional dyad must take into consideration the interplay between genetic, epigenetic, and environmental factors. Addiction to illicit drugs during pregnancy presents unique challenges to effectively treat the mother, and the developing fetus and infant after delivery. New pharmacotherapies should be safe to the developing fetus, effective in treating the physical and psychological consequences of addiction in the mother, and reduce the incidence and severity of NAS in the infant after birth. More pharmacotherapeutic options should be available to the physician such that a more individualized rather than a one-drug/strategy-fits-all approach can be used. A myriad of new and exciting pharmacotherapeutic strategies for the treatment of opioid dependence and addiction are on the horizon. This review focuses on such three strategies: (i) pharmacotherapeutic targeting of the serotoninergic system; (ii) mixed opioid immunotherapeutics (vaccines); (iii) pharmacogenomics as a therapeutic strategy to insure personalized care. We review and discuss how these strategies may offer additional treatment modalities for the treatment of M-F/N during pregnancy and the treatment of the infant after birth. PMID:23059064

  3. Substitute Addiction: A Concern for Researchers and Practitioners

    ERIC Educational Resources Information Center

    Sussman, Steve; Black, David S.

    2008-01-01

    An understanding of the role of substitute addictions remains unclear. This article examines the range and possible reward functions of substitute addictions. We suggest that prevention education and treatment need to take into account substitute addictions as an influential aspect of recovery. Research is needed to better understand the…

  4. Borate substituted ettringites

    SciTech Connect

    Csetenyi, L.J.; Glasser, F.P. [Univ. of Aberdeen, Old Aberdeen, Scotland (United Kingdom)

    1993-12-31

    The setting of cement is adversely affected by soluble borates. To reduce interference, the extent to which borate can be insolubilized has been investigated. One specific mechanism of insolubilization is by inclusion into ettringite. Ettringite, Ca{sub 6}Al{sub 2}(SO{sub 4}){sub 3}(OH){sub 12}{center_dot}26H{sub 2}O, is a normal and stable constituent of Portland cement. It has an open but non-zeolitic framework. Borate can substitute partially or fully for sulfate. Formation conditions, solubility and stability of borate ettringites, Ca{sub 6}Al{sub 2}(BO{sub 4}){sub 2-4}(OH,O){sub 12}{center_dot}26H{sub 2}O, are characterized using XRD, IR, DTA, and SEM. The potential durability of borate ettringites in a repository environment have been assessed by exposing it to Na-sulfate and Na-carbonate attack at different concentrations. Ion exchange occurs; back substitution of borate by sulfate is incomplete; high carbonate concentrations can, however, decompose borate ettringite. On heat treatment up to 85{degrees}C the crystalline morphology and the OH arrangement of the structure are altered, but the X-ray powder pattern, and hence its structural framework are largely unaffected. It is concluded that ettringite has potential to reduce the solubility of borate.

  5. Clorazepate affects cell surface regulation of delta and kappa opioid receptors, thereby altering buprenorphine-induced adaptation in the rat brain.

    PubMed

    Quentin, Thomas; Debruyne, Daniele; Lelong-Boulouard, Veronique; Poisnel, Geraldine; Barre, Louisa; Coquerel, Antoine

    2005-11-23

    Concomitant abuse of buprenorphine (BPN) and benzodiazepines (BZD) may relate to a pharmacodynamic interaction between the two. The objective of the present work was to investigate the acute and chronic effects of clorazepate (CRZ) alone or in combination with BPN on selective kappa opiate tritiated ligand [3H]-U69 593 and delta opiate radioligand [3H]-deltorphine II binding in the rat brain. Bmax (maximal receptor density) and Kd (the dissociation constant) were directly determined at different brain regions of interest (ROI) selected for high densities of kappa and/or delta receptors in rats treated with BPN and/or CRZ. The agents were administered either once or for 21 consecutive days. Differences in Bmax and Kd (for both specific ligands) were related to drug treatment and receptor location. Globally, single BPN administration induced no changes in kappa or delta opiate receptor binding, whereas repeated BPN administration up-regulated kappa receptor density and decreased delta affinity. At the kappa receptor level, repeated administration of CRZ acted only on Kd, whereas the delta receptor was up-regulated. Repeated addition of CRZ to BPN had no effect on kappa receptor Bmax versus chronic controls. By significantly decreasing Bmax, CRZ nullified the effect of chronic BPN on the kappa receptor. The modifications were strongest in the nucleus accumbens, where both types of receptor occur. Treatments had region-selective effects in some brain areas, such as the amygdala, periaqueductal gray matter, hypothalamus and caudate putamen. Increased mu and delta receptor densities would be expected to provide reinforcement by enhancing reward, and impairment of kappa receptor availability would be expected to decrease aversion. The effects described are likely to influence addictive behavior among people abusing BZD and BPN. PMID:16269137

  6. 40 CFR 721.1620 - Benzenesulfonamide, alkylphenyl substituted phenyl substituted carbonyl- (generic).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...Benzenesulfonamide, alkylphenyl substituted phenyl substituted carbonyl- (generic...Benzenesulfonamide, alkylphenyl substituted phenyl substituted carbonyl- (generic...benzenesulfonamide alkylphenyl substituted phenyl substituted carbonyl- (PMN...

  7. 40 CFR 721.1620 - Benzenesulfonamide, alkylphenyl substituted phenyl substituted carbonyl- (generic).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...Benzenesulfonamide, alkylphenyl substituted phenyl substituted carbonyl- (generic...Benzenesulfonamide, alkylphenyl substituted phenyl substituted carbonyl- (generic...benzenesulfonamide alkylphenyl substituted phenyl substituted carbonyl- (PMN...

  8. 40 CFR 721.1620 - Benzenesulfonamide, alkylphenyl substituted phenyl substituted carbonyl- (generic).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...Benzenesulfonamide, alkylphenyl substituted phenyl substituted carbonyl- (generic...Benzenesulfonamide, alkylphenyl substituted phenyl substituted carbonyl- (generic...benzenesulfonamide alkylphenyl substituted phenyl substituted carbonyl- (PMN...

  9. 40 CFR 721.1620 - Benzenesulfonamide, alkylphenyl substituted phenyl substituted carbonyl- (generic).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...Benzenesulfonamide, alkylphenyl substituted phenyl substituted carbonyl- (generic...Benzenesulfonamide, alkylphenyl substituted phenyl substituted carbonyl- (generic...benzenesulfonamide alkylphenyl substituted phenyl substituted carbonyl- (PMN...

  10. 40 CFR 721.1620 - Benzenesulfonamide, alkylphenyl substituted phenyl substituted carbonyl- (generic).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...Benzenesulfonamide, alkylphenyl substituted phenyl substituted carbonyl- (generic...Benzenesulfonamide, alkylphenyl substituted phenyl substituted carbonyl- (generic...benzenesulfonamide alkylphenyl substituted phenyl substituted carbonyl- (PMN...

  11. 40 CFR 721.10214 - Poly(oxyalkylenediyl),.alpha.-substituted carbomonocycle-.omega.-substituted carbomonocycle...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...alpha.-substituted carbomonocycle-.omega.-substituted carbomonocycle (generic...alpha.-substituted carbomonocycle-.omega.-substituted carbomonocycle (generic...alpha.-substituted carbomonocycle-.omega.-substituted carbomonocycle...

  12. 40 CFR 721.10214 - Poly(oxyalkylenediyl),.alpha.-substituted carbomonocycle-.omega.-substituted carbomonocycle...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...alpha.-substituted carbomonocycle-.omega.-substituted carbomonocycle (generic...alpha.-substituted carbomonocycle-.omega.-substituted carbomonocycle (generic...alpha.-substituted carbomonocycle-.omega.-substituted carbomonocycle...

  13. 40 CFR 721.10214 - Poly(oxyalkylenediyl),.alpha.-substituted carbomonocycle-.omega.-substituted carbomonocycle...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...alpha.-substituted carbomonocycle-.omega.-substituted carbomonocycle (generic...alpha.-substituted carbomonocycle-.omega.-substituted carbomonocycle (generic...alpha.-substituted carbomonocycle-.omega.-substituted carbomonocycle...

  14. 40 CFR 721.10214 - Poly(oxyalkylenediyl),.alpha.-substituted carbomonocycle-.omega.-substituted carbomonocycle...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...alpha.-substituted carbomonocycle-.omega.-substituted carbomonocycle (generic...alpha.-substituted carbomonocycle-.omega.-substituted carbomonocycle (generic...alpha.-substituted carbomonocycle-.omega.-substituted carbomonocycle...

  15. Implantable bone substitute materials.

    PubMed

    Hanft, J R; Sprinkle, R W; Surprenant, M S; Werd, M B

    1995-07-01

    This article focuses on materials used as bone substitutes. The materials may be used as substitutes for autografts or, in some cases, along with autografts. Each material has unique properties that may be beneficial for specific applications. Some future developments in bone substitute materials are also discussed. PMID:7553534

  16. The Leeds Evaluation of Efficacy of Detoxification Study (LEEDS) prisons project pilot study: protocol for a randomised controlled trial comparing dihydrocodeine and buprenorphine for opiate detoxification

    Microsoft Academic Search

    Laura Sheard; Clive E Adams; Nat MJ Wright; Hany El-Sayeh; Richard Dalton; Charlotte NE Tompkins

    2007-01-01

    BACKGROUND: In the United Kingdom (UK), there is an extensive market for the class 'A' drug heroin. Many heroin users spend time in prison. People addicted to heroin often require prescribed medication when attempting to cease their drug use. The most commonly used detoxification agents in UK prisons are buprenorphine, dihydrocodeine and methadone. However, national guidelines do not state a

  17. The effects of buprenorphine, nalbuphine and butorphanol alone or following halothane anaesthesia on food and water consumption and locomotor movement in rats

    Microsoft Academic Search

    Jane H. Liles; P. A. Flecknell

    1992-01-01

    Summary Locomotor activity and food and water con- sumption are potentially indices of post-operative pain in laboratory rodents, but it is important to establish whether these variables are directly affected by opioid analgesics or by halothane anaesthesia in normal rats. The effects of three opioids, buprenorphine, nalbuphine and butor- phanol administered alone or following halothane anaesthesia, were studied in groups

  18. Antinociceptive Effects of Sustained-Release Buprenorphine in a Model of Incisional Pain in Rats (Rattus norvegicus)

    PubMed Central

    Chum, Helen H; Jampachairsri, Katechan; McKeon, Gabriel P; Yeomans, David C; Pacharinsak, Cholawat; Felt, Stephen A

    2014-01-01

    Effective management of postoperative pain is an essential component of the care and welfare of laboratory animals. A sustained-release formulation of buprenorphine (Bup-SR) has recently been introduced to the veterinary market and has been reported to provide analgesia for as long as 72 h. Using evoked mechanical and thermal hypersensitivity tests, we here evaluated the antinociceptive effects of Bup-SR in a model of incisional pain in rats. Paw withdrawal responses were obtained before and 1 through 4 d after surgery. Rats are assigned to receive Bup-SR (0.3, 1.2, or 4.5 mg/kg SC once) or buprenorphine HCl (Bup HCl, 0.05 mg/kg SC twice daily for 3 d). Responses to mechanical and thermal stimuli in the 1.2 and 4.5 Bup-SR groups did not differ from those of rats in the Bup HCl group. Thermal latency on day 3 in rats that received 0.3 mg/kg Bup-SR was significantly different from baseline, indicating that this dose effectively decreased thermal hypersensitivity for at least 48 h. Marked sedation occurred in rats in the 4.5 Bup-SR group. Our findings indicate that Bup-SR at 0.3 or 1.2 mg/kg SC is effective in minimizing hypersensitivity with minimal sedation for at least 48 h (thermal hypersensitivity) and 72 h, respectively, in the incisional pain model in rats. PMID:24602547

  19. Fabrication of an ultrasensitive impedimetric buprenorphine hydrochloride biosensor from computational and experimental angles.

    PubMed

    Gholivand, Mohammad-Bagher; Jalalvand, Ali R; Goicoechea, Hector C; Skov, Thomas

    2014-06-01

    For the first time, an ultrasensitive impedimetric buprenorphine hydrochloride (BN) biosensor based on immobilization of bovine serum albumin (BSA) onto multi-walled carbon nanotubes (MWCNTs)/glassy carbon electrode (BSA/MWCNTs/GCE) has been developed using initial characterization by computational methods and complementing them by experimental observations. Computational results showed that the BSA hydrophobically binds to MWCNTs which is energetically favorable and leads to spontaneous formation of the stable BSA/MWCNTs nanobiocomposite (bioconjugate). Computational results also showed that the interaction of BN with BSA is mainly driven by hydrophobic interactions. The interactions of BSA with MWCNTs and BN with BSA were also monitored by fluorescence and UV-vis spectroscopic techniques, and their results were consistent with the computational results. Morphology and electrochemical properties of the fabricated composite electrodes were examined by scanning electron microscopy (SEM), cyclic voltammetry (CV), and electrochemical impedance spectroscopy (EIS). Besides complementing the computational studies, experimental results showed that the addition of MWCNTs to the surface of the GCE greatly facilitated the electron transfer reactions, and also showed that the presence of BSA inhibits the interfacial electron transfer in some extent due to the non-conductive properties of BSA. On the other hand, the presence of BN may form an electroactive complex with BSA which accelerates the interfacial electron transfer and leads to obvious Faradaic impedance changes. The Faradaic impedance responses were linearly related to BN concentration between 5.0 nM and 72.0 nM and a limit of detection (LOD, 3S(b)/b) of 1.5 nM was achieved. Finally, the proposed biosensor was successfully applied to determination of BN in urine samples of both healthy and addict volunteers. The results were satisfactory and comparable to those obtained by applying the reference method based on high performance liquid chromatography-ultraviolet detection (HPLC-UV). It is expected that the distinctive features of BSA/MWCNTs nanobiocomposite would make it potentially advantageous for a broad range of biosensing, and clinical applications. PMID:24767442

  20. Substitution of hexavalent chromate conversion treatment with a plasma electrolytic oxidation process to improve the corrosion properties of ion vapour deposited AlMg coatings

    Microsoft Academic Search

    N. M. Alanazi; A. Leyland; A. L. Yerokhin; A. Matthews

    2010-01-01

    In this paper plasma electrolytic oxidation (PEO) is examined as a potentially beneficial post-deposition treatment for Al-5wt.%Mg coatings deposited onto Ti alloy substrates using Ion Vapour Deposition (IVD), with a view to replacing toxic hexavalent chromate conversion treatments and at the same time enhancing the barrier protection properties of such IVD coatings. The aqueous corrosion behaviour of PEO layers formed

  1. No Substitute for Quality.

    ERIC Educational Resources Information Center

    Russo, Alexander

    2001-01-01

    School leaders are trying pay incentives, consortia, and temp firms to assuage their need for qualified substitute teachers. Five coping strategies include making the job more attractive, increasing the candidate pool, hiring some permanent subs, using automated calling systems, and examining systemic issues. Substitutes are unionizing in some…

  2. Correlation between the Critical-current Anisotropy and Microstructure of ex-situ Processed MgB2 Tapes Using Carbon-substitution Treatment

    NASA Astrophysics Data System (ADS)

    Kuroda, T.; Fujii, H.; Ye, S.; Kitaguchi, H.

    Correlation between the critical current anisotropy and the textured microstructure of the ex-situ processed MgB2 tapes with the Fe sheath was studied to obtain basic data related to the commercial application of the ex-situ processed MgB2. Ex situ processed MgB2 tapes were fabricated using newly developed technique to substitute carbon for boron in the MgB2 compound through the ex situ route. These MgB2-xCx tapes showed comparable critical current anisotropy to that of pure MgB2 tapes, but in higher magnetic fields because of their higher irreversible critical field than the pure MgB2 tapes. The x-ray pole figure data show that the tape core texturing of the MgB2-xCx tapes was moderate, but it was a slightly higher degree than that of the pure MgB2 tapes. This result was consistent with results of the critical current anisotropy.

  3. The Use of Dermal Substitutes in Burn Surgery: Acute Phase

    PubMed Central

    Shahrokhi, Shahriar; Anna, Arno; Jeschke, Marc G.

    2013-01-01

    Dermal substitutes are increasingly becoming an essential part of the burn care strategy. During the acute phase of burn treatment, dermal substitutes improve functional and cosmetic results long-term and thus increase quality of life. In the chronic wound setting, dermal substitutes are used to reconstruct and improve burn scars and other defects. Despite some successes in the use of dermal substitutes there are more needs and requirements to further improve outcomes and hence further research is required not only to strengthen scientific evidence regarding their effects but also to develop new technology and products. Dermal substitutes also emerge as pivotal research strategies to develop adequate scaffolds for stem cells, tissue engineering and regenerative medicine applications to obtain long-lasting and scarless artificial skin. This review discusses status-quo of dermal substitutes and novel strategies in the use of dermal substitutes with a focus on burn care. PMID:24393152

  4. Client and counselor attitudes toward the use of medications for treatment of opioid dependence.

    PubMed

    Rieckmann, Traci; Daley, Marilyn; Fuller, Bret E; Thomas, Cindy P; McCarty, Dennis

    2007-03-01

    Attitudes, perceived social norms, and intentions were assessed for 376 counselors and 1,083 clients from outpatient, methadone, and residential drug treatment programs regarding four medications used to treat opiate dependence: methadone, buprenorphine, clonidine, and ibogaine. Attitudes, social norms, and intentions to use varied by treatment modality. Methadone clients and counselors had more positive attitudes toward the use of methadone, whereas their counterparts in residential and outpatient settings had neutral or negative assessments. Across modalities, attitudes, perceived social norms, and intentions toward the use of buprenorphine were relatively neutral. Assessments of clonidine and ibogaine were negative for clients and counselors in all settings. Social normative influences were dominant across settings and medications in determining counselor and client intentions to use medications, suggesting that perceptions about beliefs of peers may play a critical role in use of medications to treat opiate dependence. PMID:17306729

  5. Methadone inhibits CYP2D6 and UGT2B7/2B4 in vivo: a study using codeine in methadone- and buprenorphine-maintained subjects

    PubMed Central

    Gelston, Eloise A; Coller, Janet K; Lopatko, Olga V; James, Heather M; Schmidt, Helmut; White, Jason M; Somogyi, Andrew A

    2012-01-01

    AIMS To compare the O-demethylation (CYP2D6-mediated), N-demethylation (CYP3A4-mediated) and 6-glucuronidation (UGT2B4/7-mediated) metabolism of codeine between methadone- and buprenorphine-maintained CYP2D6 extensive metabolizer subjects. METHODS Ten methadone- and eight buprenorphine-maintained subjects received a single 60 mg dose of codeine phosphate. Blood was collected at 3 h and urine over 6 h and assayed for codeine, norcodeine, morphine, morphine-3- and -6-glucuronides and codeine-6-glucuronide. RESULTS The urinary metabolic ratio for O-demethylation was significantly higher (P = 0.0044) in the subjects taking methadone (mean ± SD, 2.8 ± 3.1) compared with those taking buprenorphine (0.60 ± 0.43), likewise for 6-glucuronide formation (0.31 ± 0.24 vs. 0.053 ± 0.027; P < 0.0002), but there was no significant difference (P = 0.36) in N-demethylation. Similar changes in plasma metabolic ratios were also found. In plasma, compared with those maintained on buprenorphine, the methadone-maintained subjects had increased codeine and norcodeine concentrations (P < 0.004), similar morphine (P = 0.72) and lower morphine-3- and -6- and codeine-6-glucuronide concentrations (P < 0.008). CONCLUSION Methadone is associated with inhibition of CYP2D6 and UGTs 2B4 and 2B7 reactions in vivo, even though it is not a substrate for these enzymes. Plasma morphine was not altered, owing to the opposing effects of inhibition of both formation and elimination; however, morphine-6-glucuronide (analgesically active) concentrations were substantially reduced. Drug interactions with methadone are likely to include drugs metabolized by various UGTs and CYP2D6. PMID:22092298

  6. 40 CFR 721.981 - Substituted naphtholoazo-substituted naphthalenyl-substituted azonaphthol chromium complex.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...naphthalenyl-substituted azonaphthol chromium complex. 721.981 Section 721...naphthalenyl-substituted azonaphthol chromium complex. (a) Chemical substance...naphthalenyl-substituted azonaphthol chromium complex (PMN P-93-1631) is...

  7. Development and validation of a HPLC method for the determination of buprenorphine hydrochloride, naloxone hydrochloride and noroxymorphone in a tablet formulation.

    PubMed

    Mostafavi, Ali; Abedi, Ghazaleh; Jamshidi, Ahmad; Afzali, Daryoush; Talebi, Mohammad

    2009-02-15

    A simple isocratic reversed-phase high-performance liquid chromatographic method (RP-HPLC) was developed for the simultaneous determination of buprenorphine hydrochloride, naloxone hydrochloride dihydrate and its major impurity, noroxymorphone, in pharmaceutical tablets. The chromatographic separation was achieved with 10 mmol L(-1) potassium phosphate buffer adjusted to pH 6.0 with orthophosphoric acid and acetonitrile (17:83, v/v) as mobile phase, a C-18 column, Perfectsil Target ODS3 (150 mm x 4.6mm i.d., 5 microm) kept at 35 degrees C and UV detection at 210 nm. The compounds were eluted isocratically at a flow rate of 1.0 mL min(-1). The average retention times for naloxone, noroxymorphone and buprenorphine were 2.4, 3.8 and 8.1 min, respectively. The method was validated according to the ICH guidelines. The validation characteristics included accuracy, precision, linearity, range, specificity, limit of quantitation and robustness. The calibration curves were linear (r>0.996) over the concentration range 0.22-220 microg mL(-1) for buprenorphine hydrochloride and 0.1-100 microg mL(-1) for naloxone hydrochloride dihydrate and noroxymorphone. The recoveries for all three compounds were above 96%. No spectral or chromatographic interferences from the tablet excipients were found. This method is rapid and simple, does not require any sample preparation and is suitable for routine quality control analyses. PMID:19084658

  8. The effects of nucleotide substitution on amino acid substitution

    SciTech Connect

    Tumanyan, V.G.; Yakovleva, S.V.; Krovatsky, Yu.V.; Esipova, N.G. [Russian Academy of Sciences, Moscow (Russian Federation). Engelhardt Inst. of Molecular Biology

    1993-12-31

    The aim of the work consists of modeling Dayhoff matrix from the experimentally estimated matrix of nucleotide substitutions. The close resemblance observed between the Dayhoff matrix and the modeling matrix suggests that frequencies of transitions and transversions in genome determine the frequencies of amino acids substitutions. The substitutions apparently are not a consequence of selection of interchangeable amino acids substitutions.

  9. An Attempted Substitute Study of Total Skin Electron Therapy Technique by Using Helical Photon Tomotherapy with Helical Irradiation of the Total Skin Treatment: A Phantom Result

    PubMed Central

    Lin, Chi-Ta; Tien, Hui-Ju; Yeh, Hsin-Pei

    2013-01-01

    An anthropomorphic phantom was used to investigate a treatment technique and analyze the dose distributions for helical irradiation of the total skin (HITS) by helical tomotherapy (HT). Hypothetical bolus of thicknesses of 0, 10, and 15?mm was added around the phantom body to account for the dose homogeneity and setup uncertainty. A central core structure was assigned as a “complete block” to force the dose tangential delivery. HITS technique with prescribed dose (Dp) of 36?Gy in 36 fractions was generated. The radiochromic EBT2 films were used for the dose measurements. The target region with 95.0% of the Dp received by more than 95% of the PTV was obtained. The calculated mean doses for the organs at risk (OARs) were 4.69, 3.10, 3.20, and 2.94?Gy for the lung, heart, liver, and kidneys, respectively. The measurement doses on a phantom surface for a plan with 10?mm hypothetical bolus and bolus thicknesses of 0, 1, 2, and 3?mm are 89.5%, 111.4%, 116.9%, and 117.7% of Dp, respectively. HITS can provide an accurate and uniform treatment dose in the skin with limited doses to OARs and is safe to replace a total skin electron beam regimen. PMID:23984313

  10. Presence of illicit drugs and metabolites in influents and effluents of 25 sewage water treatment plants and map of drug consumption in France.

    PubMed

    Nefau, Thomas; Karolak, Sara; Castillo, Luis; Boireau, Véronique; Levi, Yves

    2013-09-01

    Consumption of illicit drugs is a new concern for water management that must be considered not only because of the social and public health aspects but also in an environmental context in relation with the contamination of surface waters. Indeed, sewage treatment plant (STP) effluents contain drug residues that have not been eliminated since STP treatments are not completely efficient in their removal. We developed and validated an HPLC-MS/MS analytical method to assess the concentrations of 17 illicit drugs and metabolites in raw urban wastewaters: cocaine and its metabolites, amphetamine and amphetamine-likes (methamphetamine, MDMA, MDEA, MDA), opiates and opiate substitutes (methadone and buprenorphine), and THC-COOH cannabis metabolite. This method has been applied to the analysis of influent and effluent samples from 25 STPs located in France all over the country. The results allowed evaluating the drug consumption in the areas connected to the STPs and the efficiency of the treatment technology implied. We selected STPs according to their volume capacity, their treatment technologies (biofilters, activated sludges, MBR) and their geographical location. In influents, the concentrations varied between 6 ng/L for EDDP (main metabolite of methadone) and 3050 ng/L for benzoylecgonine (cocaine metabolite). Consumption maps were drawn for cocaine, MDMA, opiates, cannabis and amphetamine-like compounds. Geographical significant differences were observed and highlighted the fact that drug consumption inside a country is not homogeneous. In parallel, comparisons between STP technology processes showed differences of efficiency. More, some compounds appear very resistant to STP processes leading to the contamination of receiving water. PMID:23770552

  11. Baseline characteristics and treatment outcomes in prescription opioid dependent patients with and without co-occurring psychiatric disorder

    PubMed Central

    Griffin, Margaret L.; Dodd, Dorian R.; Potter, Jennifer S.; Rice, Lindsay S.; Dickinson, William; Sparenborg, Steven; Weiss, Roger D.

    2013-01-01

    Background Given the growing prevalence of prescription opioid dependence and the considerable rates of additional psychopathology in drug dependence, we examined the association between the presence of a co-occurring Axis I psychiatric disorder and sociodemographic and clinical characteristics in this secondary analysis of patients entering a treatment study for dependence on prescription opioids. Treatment outcomes were also compared. Methods Patients dependent on prescription opioids participated in a multi-site, two-phase, randomized, controlled trial to assess different lengths of buprenorphine-naloxone pharmacotherapy and different intensities of counseling (Clinicaltrials.gov identifier: NCT00316277). Among the 653 participants entering the first phase of the trial, 360 entered the second phase, receiving 12 weeks of buprenorphine-naloxone treatment; they are reported here. Half of those participants (180/360) had a current co-occurring psychiatric disorder in addition to substance dependence. Results Sociodemographic characteristics were similar overall between those with and without a co-occurring psychiatric disorder, but women were 1.6 times more likely than men to have a co-occurring disorder. On several clinical indicators at baseline, participants with a co-occurring disorder had greater impairment. However, they had better opioid use outcomes at the conclusion of 12 weeks of buprenorphine-naloxone stabilization than did participants without a co-occurring disorder. Conclusions Prescription opioid dependent patients with a co-occurring psychiatric disorder had a better response to buprenorphine-naloxone treatment despite demonstrating greater impairment at baseline. Additional research is needed to determine the mechanism of this finding and to adapt treatments to address this population. PMID:24219166

  12. Pharmacological characterization and therapeutic potential for the treatment of opioid abuse with ATPM-ET, an N-ethyl substituted aminothiazolomorphinan with ? agonist and ? agonist/antagonist activity.

    PubMed

    Sun, Jian-Feng; Wang, Yu-Hua; Chai, Jing-Rui; Li, Fu-Ying; Hang, Ai; Lu, Gang; Tao, Yi-Min; Cheng, Yun; Chi, Zhi-Qiang; Neumeyer, John L; Zhang, Ao; Liu, Jing-Gen; Wang, Yu-Jun

    2014-10-01

    We previously reported that the ? agonists with mixed ? activity could attenuate heroin self-administration with less potential to develop tolerance. The present study further investigated the effects of (-)-3-N-Ethylamino-thiazolo[5,4-b]-N-cyclopropylmethylmorphinan hydrochloride (ATPM-ET), a ? agonist and ? agonist/antagonist, on the acquisition and reinstatement of morphine-induced conditioned place preference (CPP), heroin self-administration and heroin-primed reinstatement of drug-seeking behavior. We found that ATPM-ET produced a longer duration of potent antinociceptive effects with less side effect of sedation. More importantly, ATPM-ET attenuated the acquisition of morphine-induced CPP, without affecting the reinstatement of morphine CPP. Furthermore, ATPM-ET significantly inhibited heroin self-administration and the reinstatement of heroin primed drug-seeking behavior. Taken together, ATPM-ET, a novel ? agonist and ? agonist/antagonist may have utility for the treatment of drug dependence. PMID:24998879

  13. 40 CFR 721.9545 - Substituted phenyl azo substituted sulfocarbopolycle, sodium salt.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 2013-07-01 false Substituted phenyl azo substituted sulfocarbopolycle, sodium...Substances § 721.9545 Substituted phenyl azo substituted sulfocarbopolycle, sodium...identified generically as a substituted phenyl azo substituted...

  14. 40 CFR 721.9545 - Substituted phenyl azo substituted sulfocarbopolycle, sodium salt.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 2014-07-01 false Substituted phenyl azo substituted sulfocarbopolycle, sodium...Substances § 721.9545 Substituted phenyl azo substituted sulfocarbopolycle, sodium...identified generically as a substituted phenyl azo substituted...

  15. 40 CFR 721.1555 - Substituted phenyl azo substituted benzenediazonium salt.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 2011-07-01 false Substituted phenyl azo substituted benzenediazonium salt...Substances § 721.1555 Substituted phenyl azo substituted benzenediazonium salt...identified generically as a substituted phenyl azo substituted benzenediazonium...

  16. 40 CFR 721.9545 - Substituted phenyl azo substituted sulfocarbopolycle, sodium salt.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 2011-07-01 false Substituted phenyl azo substituted sulfocarbopolycle, sodium...Substances § 721.9545 Substituted phenyl azo substituted sulfocarbopolycle, sodium...identified generically as a substituted phenyl azo substituted...

  17. 40 CFR 721.2122 - Substituted phenyl azo substituted sulfo carbopolycycle.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 2010-07-01 false Substituted phenyl azo substituted sulfo carbopolycycle...Substances § 721.2122 Substituted phenyl azo substituted sulfo carbopolycycle...identified generically as a substituted phenyl azo substituted sulfo...

  18. 40 CFR 721.1555 - Substituted phenyl azo substituted benzenediazonium salt.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 2012-07-01 false Substituted phenyl azo substituted benzenediazonium salt...Substances § 721.1555 Substituted phenyl azo substituted benzenediazonium salt...identified generically as a substituted phenyl azo substituted benzenediazonium...

  19. 40 CFR 721.9545 - Substituted phenyl azo substituted sulfocarbopolycle, sodium salt.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 2010-07-01 false Substituted phenyl azo substituted sulfocarbopolycle, sodium...Substances § 721.9545 Substituted phenyl azo substituted sulfocarbopolycle, sodium...identified generically as a substituted phenyl azo substituted...

  20. Geographic variability in HIV and injection drug use in Ukraine: Implications for integration and expansion of drug treatment and HIV care

    PubMed Central

    Zaller, Nickolas; Mazhnaya, Alonya; Larney, Sarah; Islam, Zahed; Shost, Alyona; Prokhorova, Tatiana; Rybak, Natasha; Flanigan, Timothy

    2015-01-01

    Background Ukraine has the highest HIV burden of any European country with much of the current HIV epidemic concentrated among people who inject drugs (PWIDs) and their sexual partners. Opiate substitution therapy (OST) is limited in Ukraine and expansion of OST is urgently needed to help stem the tide of the HIV epidemic. Methods We accessed publicly available data in Ukraine in order to explore geographic variability with respect to prevalence of HIV, PWIDs and OST programmes. Results The regions of Ukraine with the largest number of opioid dependent persons (the south and eastern portions of the country) correspond to the regions with the highest HIV prevalence and HIV incidence. The number of opioid PWIDs per 100,000 population as well as the number of all OST treatment slots per 100,000 varied significantly across the three HIV prevalence categories. Overall, the proportion of individuals receiving either methadone maintenance therapy (MMT) or buprenorphine maintenance therapy (BMT) was quite low: average across categories: 7.3% and 0.4%, respectively. Additionally, less than half of OST patients receiving MMT or BMT were HIV positive patients. Conclusion There is significant geographic variability in both numbers of HIV positive individuals and numbers of PWIDs across Ukraine, however, there may be a more concentrated epidemic among PWIDs in many regions of the country. Scale up of addiction treatment for PWID, especially OST, can have a significant impact on preventing injection related morbidity, such as HIV and HCV infection. Ukraine can learn from the mistakes other nations have made in denying critical treatment opportunities to PWID. PMID:25304049

  1. SUBSTITUTION REACTIONS FOR THE DETOXIFICATION OF HAZARDOUS CHEMICALS

    EPA Science Inventory

    Chemical Treatment is one of several treatment techniques used for the remediation of toxic and hazardous chemicals. Chemical treatment in this report is defined as substitution of halogens by hydrogens for the conversion of halogenated organic toxicant into its native hydrocarb...

  2. Currency Substitution in Russia

    Microsoft Academic Search

    Fridman Alla; Verbetsky Aleksey

    2001-01-01

    Due to high inflation and the lack of financial instruments, the Russian economy is currently highly dollarized. The share of dollars in the total amount of cash circulating in the Russian economy constitutes about 80%. What is the degree of this currency substitution phenomenon? What are the implications of dollarization for the possibility of inflationary financing of the budget deficit

  3. The Age of Substitutability

    ERIC Educational Resources Information Center

    Goeller, H. E.; Weinberg, Alvin M.

    1976-01-01

    Dwindling mineral resources might cause a shift from nonrenewable resources to renewable resources and inexhaustible elements such as iron and aluminum. Alternative energy sources such as breeder, fusion, solar, and geothermal power must be developed for production and recycling of materials. Substitution and, hence, living standards ultimately…

  4. An Intronic Variant in OPRD1 Predicts Treatment Outcome for Opioid Dependence in African-Americans

    PubMed Central

    Crist, Richard C; Clarke, Toni-Kim; Ang, Alfonso; Ambrose-Lanci, Lisa M; Lohoff, Falk W; Saxon, Andrew J; Ling, Walter; Hillhouse, Maureen P; Bruce, R Douglas; Woody, George; Berrettini, Wade H

    2013-01-01

    Although buprenorphine and methadone are both effective treatments for opioid dependence, their efficacy can vary significantly among patients. Genetic differences may explain some of the variability in treatment outcome. Understanding the interactions between genetic background and pharmacotherapy may result in more informed treatment decisions. This study is a pharmacogenetic analysis of the effects of genetic variants in OPRD1, the gene encoding the ?-opioid receptor, on the prevalence of opioid-positive urine tests in African-Americans (n=77) or European-Americans (n=566) undergoing treatment for opioid dependence. Patients were randomly assigned to treatment with either methadone or buprenorphine/naloxone (Suboxone) over a 24-week open-label clinical trial, in which illicit opioid use was measured by weekly urinalysis. In African-Americans, the intronic SNP rs678849 predicted treatment outcome for both medications. Methadone patients with the CC genotype were less likely to have opioid-positive urine tests than those in the combined CT and TT genotypes group (relative risk (RR)=0.52, 95% confidence interval (CI)=0.44–0.60, p=0.001). In the buprenorphine treatment group, however, individuals with the CC genotype were more likely to have positive opioid drug screens than individuals in the combined CT and TT genotypes group (RR=2.17, 95% CI=1.95–2.68, p=0.008). These findings indicate that the genotype at rs678849 predicts African-American patient response to two common treatments for opioid dependence, suggesting that matching patients to treatment type based on the genotype at this locus may improve overall treatment efficacy. This observation requires confirmation in an independent population. PMID:23612435

  5. Determination of buprenorphine by differential pulse voltammetry on carbon paste electrode using SDS as an enhancement factor.

    PubMed

    Behpour, Mohsen; Valipour, Akram; Keshavarz, Mahin

    2014-09-01

    In the present study, a facile electrochemical approach is proposed for the determination of buprenorphine (BPR) in the presence of sodium dodecyl sulfate (SDS). SDS was applied for amplification of oxidation signal. Carbon paste electrode (CPE) used as working electrode and cyclic voltammetry (CV), differential pulse voltammetry (DPV) and electrochemical impedance spectroscopy (EIS) were carried out in phosphate buffer solution (pH3.0). Under optimal experimental conditions, the oxidation current increased with the addition of BPR in the sample and two dynamic ranges obtained from 4.00 nM to 0.126 ?M and from 0.126 to 0.317 ?M by DPV and exhibited a low detection limit (LOD) of 1.33 nM (S/N=3). This offered method has been used for the determination of BPR in the real samples and has validated with the recovery test for BPR spiked urine samples. The result demonstrated that this method is a simple, sensitive, rapid, low-cost, and stable method for BPR detection. PMID:25063147

  6. Treatment

    Cancer.gov

    The development of more effective and less toxic treatments is fundamental to improving outcomes for patients with cancer. NCI is leading efforts on several fronts to develop and evaluate new cancer treatments.

  7. U.S. Food and Drug Administration approval summary: Erlotinib for the first-line treatment of metastatic non-small cell lung cancer with epidermal growth factor receptor exon 19 deletions or exon 21 (L858R) substitution mutations.

    PubMed

    Khozin, Sean; Blumenthal, Gideon M; Jiang, Xiaoping; He, Kun; Boyd, Karen; Murgo, Anthony; Justice, Robert; Keegan, Patricia; Pazdur, Richard

    2014-07-01

    On May 14, 2013, the U.S. Food and Drug Administration approved erlotinib (Tarceva, Astellas Pharma Inc., Northbrook, IL, http://www.us.astellas.com/) for the first-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) whose tumors have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 (L858R) substitution mutations. This indication for erlotinib was approved concurrently with the cobas EGFR Mutation Test (Roche Molecular Systems, Inc., Basel, Switzerland, http://www.molecular.roche.com), a companion diagnostic test for patient selection. The approval was based on clinically important improvements in progression-free survival (PFS) and objective response rate (ORR) and an acceptable toxicity profile demonstrated in a multicenter, open label trial enrolling 174 patients with metastatic NSCLC whose tumors had EGFR mutations as determined by a laboratory-developed test. Patients were randomized (1:1) to receive erlotinib (150 mg/day) or platinum-based doublet chemotherapy. The primary endpoint was investigator-assessed PFS. Secondary endpoints included overall survival (OS) and ORR. Superior PFS (hazard ratio [HR] 0.34; 95% confidence interval [CI]: 0.23, 0.49; p < .001) and ORR (65% vs. 16%) were observed in the erlotinib arm. Median PFS was 10.4 months and 5.2 months in the erlotinib and chemotherapy arms, respectively. There was no difference in OS (HR 0.93; 95% CI: 0.64, 1.35) with median OS of 22.9 months and 19.5 months in the erlotinib and chemotherapy arms, respectively. The most frequent (?30%) adverse reactions in the erlotinib-treated patients were rash, diarrhea, asthenia, cough, dyspnea, and decreased appetite. The most frequent (?5%) grade 3 and 4 adverse reactions were rash and diarrhea. PMID:24868098

  8. U.S. Food and Drug Administration Approval Summary: Erlotinib for the First-Line Treatment of Metastatic Non-Small Cell Lung Cancer With Epidermal Growth Factor Receptor Exon 19 Deletions or Exon 21 (L858R) Substitution Mutations

    PubMed Central

    Blumenthal, Gideon M.; Jiang, Xiaoping; He, Kun; Boyd, Karen; Murgo, Anthony; Justice, Robert; Keegan, Patricia; Pazdur, Richard

    2014-01-01

    On May 14, 2013, the U.S. Food and Drug Administration approved erlotinib (Tarceva, Astellas Pharma Inc., Northbrook, IL, http://www.us.astellas.com/) for the first-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) whose tumors have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 (L858R) substitution mutations. This indication for erlotinib was approved concurrently with the cobas EGFR Mutation Test (Roche Molecular Systems, Inc., Basel, Switzerland, http://www.molecular.roche.com), a companion diagnostic test for patient selection. The approval was based on clinically important improvements in progression-free survival (PFS) and objective response rate (ORR) and an acceptable toxicity profile demonstrated in a multicenter, open label trial enrolling 174 patients with metastatic NSCLC whose tumors had EGFR mutations as determined by a laboratory-developed test. Patients were randomized (1:1) to receive erlotinib (150 mg/day) or platinum-based doublet chemotherapy. The primary endpoint was investigator-assessed PFS. Secondary endpoints included overall survival (OS) and ORR. Superior PFS (hazard ratio [HR] 0.34; 95% confidence interval [CI]: 0.23, 0.49; p < .001) and ORR (65% vs. 16%) were observed in the erlotinib arm. Median PFS was 10.4 months and 5.2 months in the erlotinib and chemotherapy arms, respectively. There was no difference in OS (HR 0.93; 95% CI: 0.64, 1.35) with median OS of 22.9 months and 19.5 months in the erlotinib and chemotherapy arms, respectively. The most frequent (?30%) adverse reactions in the erlotinib-treated patients were rash, diarrhea, asthenia, cough, dyspnea, and decreased appetite. The most frequent (?5%) grade 3 and 4 adverse reactions were rash and diarrhea. PMID:24868098

  9. Deviant smooth pursuit in preschool children exposed prenatally to methadone or buprenorphine and tobacco affects integrative visuomotor capabilities

    PubMed Central

    Melinder, Annika; Konijnenberg, Carolien; Sarfi, Monica

    2013-01-01

    Background and aims Although an increasing number of children are born to mothers in opioid maintenance therapy (OMT), little is known about the long-term effects of these opioids. Previous studies suggest an association between prenatal OMT exposure and difficulties in eye movement control. Also, the effects of tobacco smoking on eye movements have been reported. The present study examined the influence of eye movements, i.e. smooth pursuit, on visuomotor capabilities in children of smoking mothers in OMT. Design The study comprised a 2 (OMT versus contrast group) × 2 (slow versus fast smooth pursuit) between-subject factorial design. Setting The cognitive developmental research unit at the University of Oslo, Norway. Participants Participants were 26 4-year-old children of tobacco-smoking women in OMT and 23 non-exposed 4-year-old children, with non-smoking mothers, matched by gender and age. Measurement Eye movements and smooth pursuit were recorded using a Tobii 1750 eyetracker. Visuomotor functions were examined by Bender test. Findings The OMT group tracked slowly moving objects with smooth pursuit in a similar manner to their non-exposed peers. When fast smooth pursuit was measured, the OMT group of children tracked the object more slowly than the contrast group, P = 0.02, ?p2 = 0.11. A regression analysis showed that fast smooth pursuit predicted children’s performance on a visuomotor task, R2 = 0.37. Conclusion Impaired eye-tracking skills in 4-year-old children exposed to methadone or buprenorphine and tobacco prenatally could inhibit the development of some cognitive functions in later life. PMID:23734878

  10. Simultaneous analysis of buprenorphine, methadone, cocaine, opiates and nicotine metabolites in sweat by liquid chromatography tandem mass spectrometry

    PubMed Central

    Concheiro, Marta; Shakleya, Diaa M.

    2013-01-01

    A liquid chromatography tandem mass spectrometry method for buprenorphine (BUP), norbuprenorphine (NBUP), methadone, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP), cocaine, benzoylecgonine, ecgonine methyl ester (EME), morphine, codeine, 6-acetylmorphine, heroin, 6-acetylcodeine, cotinine, and trans-3?-hydroxycotinine quantification in sweat was developed and comprehensively validated. Sweat patches were mixed with 6 mL acetate buffer at pH 4.5, and supernatant extracted with Strata-XC-cartridges. Reverse-phase separation was achieved with a gradient mobile phase of 0.1% formic acid and acetonitrile in 15 min. Quantification was achieved by multiple reaction monitoring of two transitions per compound. The assay was a linear 1–1,000 ng/patch, except EME 5–1,000 ng/patch. Intra-, inter-day and total imprecision were <10.1%CV, analytical recovery 87.2–107.7%, extraction efficiency 35.3– 160.9%, and process efficiency 25.5–91.7%. Ion suppression was detected for EME (?63.3%) and EDDP (?60.4%), and enhancement for NBUP (42.6%). Deuterated internal standards compensated for these effects. No carryover was detected, and all analytes were stable for 24 h at 22 °C, 72 h at 4 °C, and after three freeze/thaw cycles. The method was applied to weekly sweat patches from an opioid-dependent BUP-maintained pregnant woman; 75.0% of sweat patches were positive for BUP, 93.8% for cocaine, 37.5% for opiates, 6.3% for methadone and all for tobacco biomarkers. This method permits a fast and simultaneous quantification of 14 drugs and metabolites in sweat patches, with good selectivity and sensitivity. PMID:21125263

  11. Polyimides comprising substituted benzidines

    NASA Technical Reports Server (NTRS)

    Harris, Frank W. (Inventor)

    1991-01-01

    A new class of polyimides and copolyimides made from substituted benzidines and aromatic dianhydrides and other aromatic diamines. The polyimides obtained with said diamines are distinguished by excellent thermal, excellent solubility, excellent electrical properties such as very low dielectric constants, excellent clarity and mechanical properties making the polyimides ideally suited as coating materials for microelectronic apparatii, as membranes for selective molecular or gas separation, as fibers in molecular composites, as high tensile strength, high compression strength fibers, as film castable coatings, or as fabric components.

  12. Biotransformation and Biodegradation of N-Substituted Aromatics in Methanogenic Granular Sludge

    Microsoft Academic Search

    E. Razo Flores

    1997-01-01

    N-substituted aromatic compounds are environmental contaminants associated with the production and use of dyes, explosives, pesticides and pharmaceuticals among others. Nitro- and azo-substituted aromatic compounds with strong electron withdrawing groups are poorly biodegradable in aerobic treatment systems. Therefore anaerobic treatment technologies were considered in this research. The toxicity of these compounds to methanogenic bacteria was studied. Batch toxicity assays indicated

  13. Effects of buprenorphine and naloxone in morphine-stabilized opioid addicts 1 Some of the results from this study were presented at the 97th Annual Meeting of the American Society for Clinical Pharmacology and Therapeutics, Lake Buena Vista, FL, 22 March 1996. 1

    Microsoft Academic Search

    Paul J. Fudala; Elmer Yu; Wayne Macfadden; Chris Boardman; C. Nora Chiang

    1998-01-01

    The present study, conducted as part of the development of a buprenorphine\\/naloxone combination product, was designed to evaluate the individual and combined effects of intravenously administered buprenorphine and naloxone. This in-patient trial used a randomized, double-blind, crossover design. Ten opioid-dependent male subjects were stabilized and maintained on morphine, 15 mg given intramuscularly four times daily. Then, at 48- to 72-h

  14. 76 FR 60359 - Phytosanitary Treatments; Location of and Process for Updating Treatment Schedules; Technical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-29

    ...Service to approve treatments that are not found in the Treatment Manual, and...substitute for other treatments. In this amendment...S. Gadh, Senior Risk Manager--Treatments, Regulations...phytosanitary treatment regulations...

  15. Trifluoromethyl-substituted tetrathiafulvalenes

    PubMed Central

    Jeannin, Olivier; Barrière, Frédéric

    2015-01-01

    Summary A series of tetrathiafulvalenes functionalized with one or two trifluoromethyl electron-withdrawing groups (EWG) is obtained by phosphite coupling involving CF3-substituted 1,3-dithiole-2-one derivatives. The relative effects of the EWG such as CF3, CO2Me and CN on the TTF core were investigated from a combination of structural, electrochemical, spectrochemical and theoretical investigations. Electrochemical data confirm the good correlations between the first oxidation potential of the TTF derivatives and the ?meta Hammet parameter, thus in the order CO2Me < CF3 < CN, indicating that, in any case, the mesomeric effect of the substituents is limited. Besides, crystal structure determinations show that the deformation of the unsymmetrically substituted dithiole rings, when bearing one, or two different EWG, and attributed to the mesomeric effect of ester or nitrile groups, is not notably modified or counter-balanced by the introduction of a neighboring trifluoromethyl group. DFT calculations confirm these observations and also show that the low energy HOMO–LUMO absorption band found in nitrile or ester-substituted TTFs is not found in TTF-CF3, where, as in TTF itself, the low energy absorption band is essentially attributable to a HOMO?LUMO + 1 transition. Despite relatively high oxidation potentials, these donor molecules with CF3 EWG can be involved in charge transfer complexes or cation radical salts, as reported here for the CF3-subsituted EDT-TTF donor molecule. A neutral charge transfer complex with TCNQ, (EDT-TTF-CF3)2(TCNQ) was isolated and characterized through alternated stacks of EDT-TTF-CF3 dimers and TCNQ in the solid state. A radical cation salt of EDT-TTF-CF3 is also obtained upon electrocrystallisation in the presence of the FeCl4 ? anion. In this salt, formulated as (EDT-TTF-CF3)(FeCl4), the (EDT-TTF-CF3)+• radical cations are associated two-by-two into centrosymmetric dyads with a strong pairing of the radical species in a singlet state. PMID:26124867

  16. Substitution Delone Sets

    E-print Network

    Jeffrey C. Lagarias; Yang Wang

    2002-08-31

    This paper addresses the problem of describing aperiodic discrete structures that have a self-similar or self-affine structure. Substitution Delone set families are families of Delone sets (X_1, ..., X_n) in R^d that satisfy an inflation functional equation under the action of an expanding integer matrix in R^d. This paper studies such functional equation in which each X_i is a discrete multiset (a set whose elements are counted with a finite multiplicity). It gives necessary conditions on the coefficients of the functional equation for discrete solutions to exist. It treats the case where the equation has Delone set solutions. Finally, it gives a large set of examples showing limits to the results obtained.

  17. Substituted androstanes as aromatase inhibitors

    NASA Astrophysics Data System (ADS)

    Levina, Inna S.

    1998-11-01

    The synthesis and structure-activity relationships of inhibitors of steroid aromatase which catalyses the last stage of a multistep biotransformation of cholesterol into estrogens, viz., aromatisation of C19-steroids into C18-phenolic steroids, are discussed. Compounds of the androstane series which are structurally related to the natural substrate, viz., androst-4-ene-3,17-dione, are the subjects of consideration. The review encompasses problems of synthesis of various substituted androstanes and their aromatase-inhibiting activities and structural requirements for selective specific aromatase inhibitors based on in vitro and in vivo structure-activity studies of compounds synthesised, their biological properties and the results of clinical trials. Special attention is paid to practical applications of aromatase inhibitors in the treatment of hormone-dependent mammary and ovarian tumours as well as benign prostatic tumours. In writing this report, the author has used all the information currently available in the chemical, biochemical, endocrinological and medicinal literature as well as in patents. The bibliography includes 173 references.

  18. The dynamics of technological substitutions

    Microsoft Academic Search

    Brice Dattee; David FitzPatrick; Henry Birdseye Weil

    Technological substitution is the process by which disruptive technologies replace the dominant ones in an industry. The formu lation of classical models of diffusion and substitution impose simplification co nstraints to reach analytical solvability. We use the system dynamics methodology to build upon existing models by integrating dynamic aspects derived from a broad th eoretical framework and to explore the

  19. The Elementary Substitute Teacher Questionnaire.

    ERIC Educational Resources Information Center

    Mastrian, Lou; And Others

    The purpose of this paper is to present a 50-item instrument (Appendix B) designed to assess needs for elementary school substitutes. Its use may provide valuable information for inservice training of substitute teachers, the often neglected cadre of professional educators. A priori and a posteriori validation procedures are described. A factor…

  20. MICROWAVE PHOTOCHEMISTRY OF SUBSTITUTED PHENOLS

    E-print Network

    Cirkva, Vladimir

    MICROWAVE PHOTOCHEMISTRY OF SUBSTITUTED PHENOLS V. Církva, J. Kurfürstová, M. Hájek Institute application for organic photochemistry has been shown only recently [5-11]. We disclosed the studies of microwave photochemistry of substituted phenols in an original photoche- mical reactor consisting of EDL

  1. 40 CFR 721.3063 - Substituted phenyl azo substituted phenyl esters (generic name).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 2010-07-01 false Substituted phenyl azo substituted phenyl esters (generic name). 721.3063 Section...Chemical Substances § 721.3063 Substituted phenyl azo substituted phenyl esters (generic...

  2. 40 CFR 721.3063 - Substituted phenyl azo substituted phenyl esters (generic name).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...2013-07-01 2013-07-01 false Substituted phenyl azo substituted phenyl esters (generic name). 721.3063 Section...Chemical Substances § 721.3063 Substituted phenyl azo substituted phenyl esters (generic...

  3. 40 CFR 721.3063 - Substituted phenyl azo substituted phenyl esters (generic name).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...2012-07-01 2012-07-01 false Substituted phenyl azo substituted phenyl esters (generic name). 721.3063 Section...Chemical Substances § 721.3063 Substituted phenyl azo substituted phenyl esters (generic...

  4. 40 CFR 721.3063 - Substituted phenyl azo substituted phenyl esters (generic name).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...2011-07-01 2011-07-01 false Substituted phenyl azo substituted phenyl esters (generic name). 721.3063 Section...Chemical Substances § 721.3063 Substituted phenyl azo substituted phenyl esters (generic...

  5. 40 CFR 721.3063 - Substituted phenyl azo substituted phenyl esters (generic name).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...2014-07-01 2014-07-01 false Substituted phenyl azo substituted phenyl esters (generic name). 721.3063 Section...Chemical Substances § 721.3063 Substituted phenyl azo substituted phenyl esters (generic...

  6. 40 CFR 721.5930 - Phenylenebis[imino (chlorotriazinyl)imino(substituted naphthyl)azo(substituted phenyl)azo, sodium...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...substituted naphthyl)azo(substituted phenyl)azo, sodium salt (generic name...substituted naphthyl)azo(substituted phenyl)azo, sodium salt (generic name...substituted naphthyl)azo (substituted phenyl) azo, sodium salt (PMN...

  7. 40 CFR 721.5930 - Phenylenebis[imino (chlorotriazinyl)imino(substituted naphthyl)azo(substituted phenyl)azo, sodium...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...substituted naphthyl)azo(substituted phenyl)azo, sodium salt (generic name...substituted naphthyl)azo(substituted phenyl)azo, sodium salt (generic name...substituted naphthyl)azo (substituted phenyl) azo, sodium salt (PMN...

  8. How Do Substitute Teachers Substitute? An Empirical Study of Substitute-Teacher Labor Supply

    ERIC Educational Resources Information Center

    Gershenson, Seth

    2012-01-01

    This paper examines the daily labor supply of a potentially important, but often overlooked, source of instruction in U.S. public schools: substitute teachers. I estimate a sequential binary-choice model of substitute teachers' job-offer acceptance decisions using data on job offers made by a randomized automated calling system. Importantly, this…

  9. 1-((3 S,4 S)-4Amino1-(4-substituted-1,3,5-triazin-2-yl) pyrrolidin-3-yl)-5,5-difluoropiperidin-2-one inhibitors of DPP-4 for the treatment of type 2 diabetes

    Microsoft Academic Search

    Kim M. Andrews; David A. Beebe; John W. Benbow; David A. Boyer; Shawn D. Doran; Yu Hui; Shenping Liu; R. Kirk McPherson; Constantin Neagu; Janice C. Parker; David W. Piotrowski; Steven R. Schneider; Judith L. Treadway; Maria A. VanVolkenberg; William J. Zembrowski

    2011-01-01

    A 3-amino-4-substituted pyrrolidine series of dipeptidyl peptidase IV (DPP-4) inhibitors was rapidly developed into a candidate series by identification of a polar valerolactam replacement for the lipophilic 2,4,5-trifluorophenyl pharmacophore. The addition of a gem-difluoro substituent to the lactam improved overall DPP-4 inhibition and an efficient asymmetric route to 3,4-diaminopyrrolidines was developed. Advanced profiling of a subset of analogs identified 5o

  10. 40 CFR 721.323 - Substituted acrylamide.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...2012-07-01 false Substituted acrylamide. 721.323 Section 721.323 ...Substances § 721.323 Substituted acrylamide. (a) Chemical substance and significant...generically identified as substituted acrylamide (PMN P-90-1687) is subject...

  11. 40 CFR 721.323 - Substituted acrylamide.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...2014-07-01 false Substituted acrylamide. 721.323 Section 721.323 ...Substances § 721.323 Substituted acrylamide. (a) Chemical substance and significant...generically identified as substituted acrylamide (PMN P-90-1687) is subject...

  12. 40 CFR 721.323 - Substituted acrylamide.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...2013-07-01 false Substituted acrylamide. 721.323 Section 721.323 ...Substances § 721.323 Substituted acrylamide. (a) Chemical substance and significant...generically identified as substituted acrylamide (PMN P-90-1687) is subject...

  13. Perioperative substitution of anti-epileptic drugs.

    PubMed

    Wichards, Wilma S W; Schobben, Alfred F A M; Leijten, Frans S S

    2013-11-01

    A common problem in brain and abdominal surgery is the perioperative substitution of antiepileptic drugs (AEDs) when patients are temporarily unable to take these drugs orally. We searched the literature for clinical trials with patients or healthy volunteers in whom non-oral formulations of AEDs as substitution were tested. Different search engines, handbooks, expert opinion and our own experience, were used. Pharmaceutical companies were approached for recommendations. This led to three categories of replacement: 1. commercial alternative (n = 10) for clonazepam, diazepam, lacosamide, levetiracetam, lorazepam, midazolam, nitrazepam, phenobarbital, phenytoin, and valproic acid; 2. alternatives that must be prepared (n = 6) for carbamazepine, clobazam, lamotrigine, oxcarbazepine, primidone, topiramate; 3. no alternative (n = 7) for ethosuccimide, felbamate, retigabine, stiripentol, tiagabine, vigabatrin, zonisamide. Thus, for a substantial number of AEDs, unofficial perioperative treatment strategies need to be followed for lack of alternatives to oral administration. There is little clinical research addressing the equivalence of oral and parenteral formulas. Perioperative substitution of AEDs is an underestimated problem, and may increase the risk of postoperative seizures. PMID:23996127

  14. Maternal stress and behavioral adaptation in methadone- or buprenorphine-exposed toddlers.

    PubMed

    Sarfi, Monica; Sundet, Jon Martin; Waal, Helge

    2013-12-01

    The current study examined the relationship between early interaction, parenting stress, maternal psychological distress symptoms, and behavior problems and health-related quality of life among children born to mothers in opioid maintenance treatment (OMT) in Norway during the period 2005-2007 (N = 36). This group was compared with a normative sample of mothers without substance abuse problems and their children (N = 36). There were significant group differences (p < .01) in perceived child problems in toddlerhood. In a regression model, mothers' self-reported psychological distress symptoms in terms of depression and anxiety symptoms significantly predicted child behavior problems (p < .01) and health-related quality of life (p < .01) rather than parenting stress. No significant, unique effect of exposure was found after controlling for other factors that could influence developmental outcomes. These findings add to the growing evidence on the importance of maternal psychological well-being for child development, and underscore the need to address opioid-maintained women's personal maladjustment and the constellation of stress experienced by mothers in recovery. PMID:23999378

  15. Vitreous substitutes: challenges and directions

    PubMed Central

    Gao, Qian-Ying; Fu, Yue; Hui, Yan-Nian

    2015-01-01

    The natural vitreous body has a fine structure and complex functions. The imitation of the natural vitreous body by vitreous substitutes is a challenging work for both researchers and ophthalmologists. Gases, silicone oil, heavy silicone oil and hydrogels, particularly the former two vitreous substitutes are clinically widely used with certain complications. Those, however, are not real artificial vitreous due to lack of structure and function like the natural vitreous body. This article reviews the situations, challenges, and future directions in the development of vitreous substitutes, particularly the experimental and clinical use of a new artificial foldable capsular vitreous body. PMID:26085987

  16. Synthesis and electronic structure of proton-type partially substituted birnessite by period-four transition metal

    SciTech Connect

    Takei, Takahiro, E-mail: takei@yamanashi.ac.jp [Center for Crystal Science and Technology, University of Yamanashi, 7-32 Miyamae, Kofu, Yamanashi 400-8511 (Japan)] [Center for Crystal Science and Technology, University of Yamanashi, 7-32 Miyamae, Kofu, Yamanashi 400-8511 (Japan); Dong, Qiang; Yonesaki, Yoshinori; Kumada, Nobuhiro; Kinomura, Nobukazu [Center for Crystal Science and Technology, University of Yamanashi, 7-32 Miyamae, Kofu, Yamanashi 400-8511 (Japan)] [Center for Crystal Science and Technology, University of Yamanashi, 7-32 Miyamae, Kofu, Yamanashi 400-8511 (Japan)

    2011-11-15

    Highlights: {yields} Partial metal substitutions of birnessite result in three types of crystal structure. {yields} Rhombohedral, monoclinic and hexagonal phase emerged in the substituted birnessite. {yields} The electrical conductivity decreased by substitution of transition metal for Mn. {yields} Partially substitution by Fe, Co and Ni poses splitting of crystal field for MnO{sub 6}. -- Abstract: Partially substituted proton-type birnessite were prepared by solid state reaction and their structures were refined. The formed birnessite with no substitution is identified to rhombohedral phase. In the case of substitution treatment by V and Cr for Mn, birnessite phase was not formed. On substituting Fe, hexagonal phase increased with increase of the amount of the Fe. For Co and Ni-substitution, monoclinic phase emerged at substitution ratio of around 0.37 and 0.02, respectively. For the substitution of Cu, only the monoclinic birnessite formed irrespective of the ratio. The electric conductivity of the partially substituted birnessites was examined at room temperature. The general trend is lower conductivity with increasing ratio of contained substituents. On several mol% of the substitution by Ni and Cu, the conductivity slightly increased. From DOS calculation of these compounds, the partially substitution for Mn by Fe, Co and Ni in the birnessite poses splitting of crystal field to emerge new bands at around -1 and +1 eV by Mn(IV) 3d orbital.

  17. Medication-assisted treatment of opioid use disorder: review of the evidence and future directions.

    PubMed

    Connery, Hilary Smith

    2015-01-01

    Medication-assisted treatment of opioid use disorder with physiological dependence at least doubles rates of opioid-abstinence outcomes in randomized, controlled trials comparing psychosocial treatment of opioid use disorder with medication versus with placebo or no medication. This article reviews the current evidence for medication-assisted treatment of opioid use disorder and also presents clinical practice imperatives for preventing opioid overdose and the transmission of infectious disease. The evidence strongly supports the use of agonist therapies to reduce opioid use and to retain patients in treatment, with methadone maintenance remaining the gold standard of care. Combined buprenorphine/naloxone, however, also demonstrates significant efficacy and favorable safety and tolerability in multiple populations, including youth and prescription opioid-dependent individuals, as does buprenorphine monotherapy in pregnant women. The evidence for antagonist therapies is weak. Oral naltrexone demonstrates poor adherence and increased mortality rates, although the early evidence looks more favorable for extended-release naltrexone, which has the advantages that it is not subject to misuse or diversion and that it does not present a risk of overdose on its own. Two perspectives-individualized treatment and population management-are presented for selecting among the three available Food and Drug Administration-approved maintenance therapies for opioid use disorder. The currently unmet challenges in treating opioid use disorder are discussed, as are the directions for future research. PMID:25747920

  18. DESIGNING ENVIRONMENTALLY BENIGN SOLVENT SUBSTITUTES

    EPA Science Inventory

    Since the signing of 1987 Montreal Protocol, reducing and eliminating the use of harmful solvents has become an internationally imminent environmental protection mission. Solvent substitution is an effective way to achieve this goal. The Program for Assisting the Replacement of...

  19. One-Pot Synthesis of r-Iodo-Substituted r, -Unsaturated Aldehydes from Propargylic

    E-print Network

    Wang, Jianbo

    1a (Ar ) Ph) as the substrate to test the one-pot reaction. Treatment of compound 1a with aqueous HIOne-Pot Synthesis of r-Iodo-Substituted r, -Unsaturated Aldehydes from Propargylic Alcohols Shufeng An efficient one-pot method for the preparation of R-iodo- substituted R, -unsaturated aldehydes (R

  20. Production of zinc substituted hydroxyapatite using various precipitation routes.

    PubMed

    Shepherd, David; Best, Serena M

    2013-04-01

    Substituted hydroxyapatites have been investigated for use as bone grafts and have been investigated for many years. Zinc is of interest due to its potential to reduce bone resorption and antibacterial properties. However, it has proven problematic to substitute biologically significant levels of zinc into the crystal structure through wet chemical routes, whilst retaining the high temperature phase stability required for processing. The aim of this study is to investigate two different precipitation routes used to synthesize zinc substituted hydroxyapatite and to explore the effects of ammonia used in the reactions on the levels of zinc substituted into the crystal lattice. It was found that considerable amounts of ammonia are required to maintain a pH sufficiently high for the production of stoichiometric hydroxyapatite using a reaction between calcium nitrate, zinc nitrate and ammonium phosphate. X-ray fluorescence analysis showed that a significant proportion of the zinc added did not substitute into the hydroxyapatite lattice. Fourier transform infrared spectroscopy revealed the existence of a zinc-ammonia complex that, it is proposed, inhibits zinc substitution for calcium. It was found that by reacting orthophosphoric acid with calcium nitrate and zinc nitrate, the volume of ammonia required in the reaction was reduced and higher levels of zinc substitution were achieved, with up to 0.58 wt% incorporated into the hydroxyapatite lattice. The resulting products were found to be stoichiometric hydroxyapatite and did not appear to contain any extraneous calcium phosphate phases after heat treatment up to 1100 °C. X-ray diffraction and Rietveld analysis revealed that the effect of substituting zinc into the HA lattice was to decrease the a-lattice parameter whilst increasing the c-lattice. Transmission electron microscopy also showed that the incorporation of zinc reduced both the length and width of the precipitated crystals. PMID:23343575

  1. Partitioning the Variation in Mammalian Substitution Rates

    Microsoft Academic Search

    Nick G. C. Smith; Adam Eyre-Walker

    2003-01-01

    We have used analysis of variance to partition the variation in synonymous and amino acid substitution rates between three effects (gene, lineage, and a gene-by-lineage interaction) in mammalian nuclear and mitochondrial genes. We find that gene effects are stronger for amino acid substitution rates than for synonymous substitution rates and that lineage effects are stronger for synonymous substitution rates than

  2. Synthesis of substituted thienothiazoles

    Microsoft Academic Search

    P. I. Abramenko; T. K. Ponomareva; G. I. Priklonskikh

    1979-01-01

    The action of sulfur monochloride on 2-amino-3-carboxy-5-phenylthiophene or 2-amino5-phenylthiophene hydrochloride gave 5-phenylthieno[2,3-d]-2-thioniathiazole chloride, which is converted to the corresponding hydrate on treatment with water. Heating of the thionium salt or its hydrate with carbon disulfide in an aqueous alcohol solution of aklaki gave 2-mercapto-5-phenylthieno[2,3-d]thiazole, which under the influence of dialkyl sulfates or on oxidation with potassium permanganate in alkaline media

  3. A pharmaceutical industry perspective on the economics of treatments for alcohol and opioid use disorders.

    PubMed

    Gastfriend, David R

    2014-10-01

    Individuals with alcohol and/or drug use disorders often fail to receive care, or evidence-based care, yet the literature shows health economic benefits. Comparative effectiveness research is emerging that examines approved approaches in terms of real, total healthcare cost/utilization. Comprehensive retrospective insurance claims analyses are few but tend to be nationally distributed and large. The emerging pattern is that, while treatment in general is cost effective, specific therapeutics can yield different health economic outcomes. Cost/utilization data consistently show greater savings with pharmacotherapies (despite their costs) versus psychosocial treatment alone. All FDA-approved addiction pharmacotherapies (oral naltrexone, extended-release naltrexone, acamprosate, disulfiram, buprenorphine, buprenorphine/naloxone, and methadone) are intended for use in conjunction with psychosocial management, not as stand-alone therapeutics; hence, pharmacotherapy costs must offer benefits in addition to abstinence alone or psychological therapy. Patient persistence is problematic, and (despite its cost) extended-release pharmacotherapy may be associated with lower or no greater total healthcare cost, mostly due to reduced hospitalization. The reviewed studies use rigorous case-mix adjustment to balance treatment cohorts but lack the randomization that clinical trials use to protect against confounding. Unlike trials, however, these studies can offer generalizability to diverse populations, providers, and payment models--and are of particular salience to payers. PMID:25236185

  4. 40 CFR 721.1555 - Substituted phenyl azo substituted benzenediazonium salt.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...phenyl azo substituted benzenediazonium salt. 721.1555 Section 721.1555 ...phenyl azo substituted benzenediazonium salt. (a) Chemical substance and significant...phenyl azo substituted benzenediazonium salt (PMN P-92-652) is subject to...

  5. 40 CFR 721.1555 - Substituted phenyl azo substituted benzenediazonium salt.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...phenyl azo substituted benzenediazonium salt. 721.1555 Section 721.1555 ...phenyl azo substituted benzenediazonium salt. (a) Chemical substance and significant...phenyl azo substituted benzenediazonium salt (PMN P-92-652) is subject to...

  6. 40 CFR 721.1555 - Substituted phenyl azo substituted benzenediazonium salt.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...phenyl azo substituted benzenediazonium salt. 721.1555 Section 721.1555 ...phenyl azo substituted benzenediazonium salt. (a) Chemical substance and significant...phenyl azo substituted benzenediazonium salt (PMN P-92-652) is subject to...

  7. 40 CFR 721.9545 - Substituted phenyl azo substituted sulfocarbopolycle, sodium salt.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...azo substituted sulfocarbopolycle, sodium salt. 721.9545 Section 721.9545 ...azo substituted sulfocarbopolycle, sodium salt. (a) Chemical substance and significant...azo substituted sulfocarbopolycle, sodium salt (PMN P-96-1263) is subject to...

  8. 40 CFR 721.2577 - Copper complex of (substituted sulfonaphthyl azo substituted phenyl) disulfonaphthyl azo, amine...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...2011-07-01 2011-07-01 false Copper complex of (substituted sulfonaphthyl...Specific Chemical Substances § 721.2577 Copper complex of (substituted sulfonaphthyl...chemical substances identified generically as copper complex of (substituted...

  9. 40 CFR 721.2577 - Copper complex of (substituted sulfonaphthyl azo substituted phenyl) disulfonaphthyl azo, amine...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...2013-07-01 2013-07-01 false Copper complex of (substituted sulfonaphthyl...Specific Chemical Substances § 721.2577 Copper complex of (substituted sulfonaphthyl...chemical substances identified generically as copper complex of (substituted...

  10. 40 CFR 721.10126 - Alkyl amino substituted triazine amino substituted benezenesulfonic acid reaction product with...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...phenyl azo substituted benzenesulfonic acid copper compound (generic). 721.10126...phenyl azo substituted benzenesulfonic acid copper compound (generic). (a) Chemical...phenyl azo substituted benzenesulfonic acid copper compound (PMN P-06-689) is...

  11. 40 CFR 721.10126 - Alkyl amino substituted triazine amino substituted benezenesulfonic acid reaction product with...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...phenyl azo substituted benzenesulfonic acid copper compound (generic). 721.10126...phenyl azo substituted benzenesulfonic acid copper compound (generic). (a) Chemical...phenyl azo substituted benzenesulfonic acid copper compound (PMN P-06-689) is...

  12. 40 CFR 721.2577 - Copper complex of (substituted sulfonaphthyl azo substituted phenyl) disulfonaphthyl azo, amine...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...2014-07-01 2014-07-01 false Copper complex of (substituted sulfonaphthyl...Specific Chemical Substances § 721.2577 Copper complex of (substituted sulfonaphthyl...chemical substances identified generically as copper complex of (substituted...

  13. 40 CFR 721.2577 - Copper complex of (substituted sulfonaphthyl azo substituted phenyl) disulfonaphthyl azo, amine...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...2012-07-01 2012-07-01 false Copper complex of (substituted sulfonaphthyl...Specific Chemical Substances § 721.2577 Copper complex of (substituted sulfonaphthyl...chemical substances identified generically as copper complex of (substituted...

  14. 40 CFR 721.10126 - Alkyl amino substituted triazine amino substituted benezenesulfonic acid reaction product with...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...phenyl azo substituted benzenesulfonic acid copper compound (generic). 721.10126...phenyl azo substituted benzenesulfonic acid copper compound (generic). (a) Chemical...phenyl azo substituted benzenesulfonic acid copper compound (PMN P-06-689) is...

  15. 40 CFR 721.2577 - Copper complex of (substituted sulfonaphthyl azo substituted phenyl) disulfonaphthyl azo, amine...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 2010-07-01 false Copper complex of (substituted sulfonaphthyl...Specific Chemical Substances § 721.2577 Copper complex of (substituted sulfonaphthyl...chemical substances identified generically as copper complex of (substituted...

  16. 40 CFR 721.5340 - Substituted benzothiazole-azo-substituted benzoquinoline nickel complex (generic).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...benzothiazole-azo-substituted benzoquinoline nickel complex (generic). 721.5340 Section...benzothiazole-azo-substituted benzoquinoline nickel complex (generic). (a) Chemical...benzothiazole-azo-substituted benzoquinoline nickel complex (PMN P-99-897) is...

  17. 40 CFR 721.5340 - Substituted benzothiazole-azo-substituted benzoquinoline nickel complex (generic).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...benzothiazole-azo-substituted benzoquinoline nickel complex (generic). 721.5340 Section...benzothiazole-azo-substituted benzoquinoline nickel complex (generic). (a) Chemical...benzothiazole-azo-substituted benzoquinoline nickel complex (PMN P-99-897) is...

  18. 40 CFR 721.5340 - Substituted benzothiazole-azo-substituted benzoquinoline nickel complex (generic).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...benzothiazole-azo-substituted benzoquinoline nickel complex (generic). 721.5340 Section...benzothiazole-azo-substituted benzoquinoline nickel complex (generic). (a) Chemical...benzothiazole-azo-substituted benzoquinoline nickel complex (PMN P-99-897) is...

  19. 40 CFR 721.5340 - Substituted benzothiazole-azo-substituted benzoquinoline nickel complex (generic).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...benzothiazole-azo-substituted benzoquinoline nickel complex (generic). 721.5340 Section...benzothiazole-azo-substituted benzoquinoline nickel complex (generic). (a) Chemical...benzothiazole-azo-substituted benzoquinoline nickel complex (PMN P-99-897) is...

  20. 40 CFR 721.5340 - Substituted benzothiazole-azo-substituted benzoquinoline nickel complex (generic).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...benzothiazole-azo-substituted benzoquinoline nickel complex (generic). 721.5340 Section...benzothiazole-azo-substituted benzoquinoline nickel complex (generic). (a) Chemical...benzothiazole-azo-substituted benzoquinoline nickel complex (PMN P-99-897) is...

  1. 40 CFR 721.10126 - Alkyl amino substituted triazine amino substituted benezenesulfonic acid reaction product with...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...triazine amino substituted benezenesulfonic acid reaction product with naphthalenesulfonato...phenyl azo substituted benzenesulfonic acid copper compound (generic). 721.10126...triazine amino substituted benezenesulfonic acid reaction product with...

  2. 40 CFR 721.10126 - Alkyl amino substituted triazine amino substituted benezenesulfonic acid reaction product with...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...triazine amino substituted benezenesulfonic acid reaction product with naphthalenesulfonato...phenyl azo substituted benzenesulfonic acid copper compound (generic). 721.10126...triazine amino substituted benezenesulfonic acid reaction product with...

  3. Substituted decision making: elder guardianship.

    PubMed

    Leatherman, Martha E; Goethe, Katherine E

    2009-11-01

    The goal of this column is to help experienced clinicians navigate the judicial system when they are confronted with requests for capacity evaluations that involve guardianship (conservatorship). The interface between the growing elderly medical population and increasing requests for substituted decision making is becoming more complex. This column will help practicing psychiatrists understand the medical, legal, and societal factors involved in adult guardianship. Such understanding is necessary in order to effectively perform guardianship evaluations and adequately inform courts, patients, and families about the psychiatric diagnoses central to substituted decision making. PMID:19934723

  4. Automated multiple development thin-layer chromatography for separation of opiate alkaloids and derivatives

    Microsoft Academic Search

    Jacques Pothier; Nicole Galand

    2005-01-01

    There are three types of opiate alkaloids. First, the poppy alkaloids: morphine, codeine, thebaine, noscapine and papaverine; then, the semi-synthetic and synthetic derivatives used in therapy as antitussives and analgesics, such as pholcodine, ethylmorphine and dextromethorphan; at last narcotic compounds, diacetylmorphine (heroin) and opiates employed as substitutes in treatment of addiction: buprenorphine and methadone. For classical thin-layer chromatography (TLC) of

  5. Dual functional selenium-substituted hydroxyapatite

    PubMed Central

    Wang, Yanhua; Ma, Jun; Zhou, Lei; Chen, Jin; Liu, Yonghui; Qiu, Zhiye; Zhang, Shengmin

    2012-01-01

    Hydroxyapatite (HA) doped with trace elements has attracted much attention recently owing to its excellent biological functions. Herein, we use a facile co-precipitation method to incorporate selenium into HA by adding sodium selenite during synthesis. The obtained selenium-substituted HA products are needle-like nanoparticles which have  size and crystallinity that are similar to those of the pure HA nanoparticles (HANs) when the selenium content is low. HANs are found to have the ability to induce the apoptosis of osteosarcoma cells, and the anti-tumour effects are enhanced after incorporation of selenium. Meanwhile, the nanoparticles can also support the growth of bone marrow stem cells. Furthermore, the flow cytometric results indicate that the apoptosis induction of osteosarcoma cells is caused by the increased reactive oxygen species and decreased mitochondrial membrane potential. These results show that the selenium-substituted HANs are potentially promising bone graft materials in osteosarcoma treatment due to their dual functions of supporting normal cell growth and inducing tumour cell apoptosis. PMID:23741613

  6. 40 CFR 721.1925 - Substituted carboheterocyclic butane tetracarboxylate (generic).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... false Substituted carboheterocyclic butane tetracarboxylate (generic). 721...1925 Substituted carboheterocyclic butane tetracarboxylate (generic). (a...generically as substituted carboheterocyclic butane tetracarboxylate (PMNs...

  7. 40 CFR 721.1925 - Substituted carboheterocyclic butane tetracarboxylate (generic).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... false Substituted carboheterocyclic butane tetracarboxylate (generic). 721...1925 Substituted carboheterocyclic butane tetracarboxylate (generic). (a...generically as substituted carboheterocyclic butane tetracarboxylate (PMNs...

  8. 40 CFR 721.1925 - Substituted carboheterocyclic butane tetracarboxylate (generic).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... false Substituted carboheterocyclic butane tetracarboxylate (generic). 721...1925 Substituted carboheterocyclic butane tetracarboxylate (generic). (a...generically as substituted carboheterocyclic butane tetracarboxylate (PMNs...

  9. Mobile opioid agonist treatment and public funding expands treatment for disenfranchised opioid-dependent individuals.

    PubMed

    Hall, Gerod; Neighbors, Charles J; Iheoma, Jude; Dauber, Sarah; Adams, Merribeth; Culleton, Robert; Muench, Fred; Borys, Suzanne; McDonald, Rebecca; Morgenstern, Jon

    2014-04-01

    The New Jersey Medication Assisted Treatment Initiative (NJ-MATI) sought to reduce barriers to treatment by providing free, opioid agonist treatment (OAT, methadone or buprenorphine) via mobile medication units (MMUs). To evaluate barriers to OAT, logistic regression was used to compare opioid dependent patients enrolled in NJ-MATI to those entering treatment at fixed-site methadone clinics or non-medication assisted treatment (non-MAT). Client demographic and clinical data were taken from an administrative database for licensed treatment providers. The MMUs enrolled a greater proportion of African-American, homeless, and uninsured individuals than the fixed-site methadone clinics. Compared to non-MAT and traditional methadone clients, NJ-MATI patients were more likely to be injection drug users and daily users but less likely to have a recent history of treatment. These observations suggest that the patient-centered policies associated with NJ-MATI increased treatment participation by high severity, socially disenfranchised patients who were not likely to receive OAT. PMID:24468235

  10. Coupled substitutions in the tourmaline group

    Microsoft Academic Search

    Franklin F. Foit; Philip E. Rosenberg

    1977-01-01

    Statistical analysis of 136 natural tourmaline compositions from the literature reveals the presence and extent of coupled substitutions involving several cations and structural sites. In schorls and dravites these are a dehydroxylation type substitution (1) (OH)-+R2+ = R3++O2- and an alkali-defect type substitution (2) R++R2+ = R3++?, Al3+ being the predominant R3+ action. Substitution (1) which represents solid solution towards

  11. Establishing a Child Care Substitute Caregiver System.

    ERIC Educational Resources Information Center

    Love, Lynne

    Substitute caregivers are needed by day care centers in every state. Indeed, some areas are experiencing severe shortages of applicants for child care positions and short-term substitute work. This article describes problems encountered in current substitute caregiver systems and suggests ways of dealing with such problems. Specifically discussed…

  12. Efficient Cryptanalysis of Homophonic Substitution Amrapali Dhavare

    E-print Network

    Stamp, Mark

    technique to the "Zodiac 340" cipher, which is an unsolved message created by the infamous Zodiac killer. Keywords: homophonic substitution cipher, simple substitution cipher, hill climb, heuristic search, Zodiac. Our motivation for considering homophonic substitution ciphers is the unsolved "Zodiac 340," which

  13. Ethynyl and substituted ethynyl-terminated polysulfones

    NASA Technical Reports Server (NTRS)

    Hergenrother, P. M. (inventor)

    1984-01-01

    Ethynyl and substituted ethynyl-terminated polysulfones and a process for preparing the same are disclosed. These polysulfones are thermally cured to induce cross-linking and chain extension, producing a polymer system with improved solvent resistance and use temperature. Also disclosed are substituted 4-ethynylbenzoyl chlorides as precursors to the substituted ethynyl-terminated polysulfones and a process for preparing the same.

  14. Field studies on sugar substitutes.

    PubMed

    Scheinin, A

    1985-09-01

    Four field studies assessing the caries preventive value of partial substitution of sucrose by xylitol or a mixture of xylitol and sorbitol were recently conducted. The trials (in Thailand, Hungary and two in French Polynesia) had certain common features, i.e. protocols approved by the WHO; low intake of polyol(s); non-randomized young study populations, differing baseline caries prevalences between groups; and planned duration of 32-36 months. Analysis of the findings was facilitated through the use of rates to measure caries increments expressed as DMF teeth and surface counts in relation to the numbers of teeth at risk. Irrespective of baseline differences, all studies revealed, in comparison to known methods, that partial substitution of sucrose was associated with a preventive effect. PMID:3902660

  15. Currency Substitution and Financial Innovation

    Microsoft Academic Search

    Pablo E Guidotti

    1993-01-01

    This paper explores the domestic effects as well as the international transmission of financial innovation. The analysis is carried out in a cash-in-advance model with two currencies and tw o goods in which income velocity is variable because of inventory-type considerations in the determination of the demand for money. The discussion emphasizes the role of currency substitution, which occur s

  16. Resonant photodissociation in substituted benzenes

    NASA Astrophysics Data System (ADS)

    Scarborough, Tim; McAcy, Collin; Foote, David; Uiterwaal, Cornelis

    2011-05-01

    Cyclic aromatic molecules are abundant in organic chemistry, with a wide variety of applications, including pharmacology, pollution studies and genetic research. Among the simplest of these molecules is benzene (C6H6) , with many relevant molecules being benzene-like with a single atomic substitution. In such a substitution, the substituent determines a characteristic perturbation of the electronic structure of the molecule. We discuss the substitution of halogens into the ring (C6H5X), and its effects on the dynamics of ionization and dissociation of the molecule without the focal volume effect. In particular, using 800-nm, 50-fs laser pulses, we present results in the dissociation of fluorobenzene, chlorobenzene, bromobenzene and iodobenzene into the phenyl ring (C6H5) and the atomic halogen, and the subsequent ionization of these fragments. The impact of the ``heavy atom effect'' on a 1 (? , ?*) -->3 (n , ?*) singlet-triplet intersystem crossing will be emphasized. Currently under investigation is whether such a dissociation can be treated as an effective source of the neutral substituent. This material is based upon work supported by the National Science Foundation under Grant No. PHY-0355235.

  17. Effectiveness, safety and cost of drug substitution in hypertension

    PubMed Central

    Johnston, Atholl; Stafylas, Panagiotis; Stergiou, George S

    2010-01-01

    Cost-containment measures in healthcare provision include the implementation of therapeutic and generic drug substitution strategies in patients whose condition is already well controlled with pharmacotherapy. Treatment for hypertension is frequently targeted for such measures. However, drug acquisition costs are only part of the cost-effectiveness equation, and a variety of other factors need to be taken into account when assessing the impact of switching antihypertensives. From the clinical perspective, considerations include maintenance of an appropriate medication dose during the switching process; drug equivalence in terms of clinical effectiveness; and safety issues, including the diverse adverse-event profiles of available alternative drugs, differences in the ‘inactive’ components of drug formulations and the quality of generic formulations. Patients' adherence to and persistence with therapy may be negatively influenced by switching, which will also impact on treatment effectiveness. From the economic perspective, the costs that are likely to be incurred by switching antihypertensives include those for additional clinic visits and laboratory tests, and for hospitalization if required to address problems arising from adverse events or poorly controlled hypertension. Indirect costs and the impact on patients' quality of life also require assessment. Substitution strategies for antihypertensives have not been tested in large outcome trials and there is little available clinical or economic evidence on which to base decisions to switch drugs. Although the cost of treatment should always be considered, careful assessment of the human and economic costs and benefits of antihypertensive drug substitution is required before this practice is recommended. PMID:20716230

  18. Exfoliation and thermal transformations of Nb-substituted layered titanates

    SciTech Connect

    Song Haiyan; Sjastad, Anja O.; Fjellvag, Helmer; Okamoto, Hiroshi [Department of Chemistry and Centre for Materials Science and Nanotechnology, University of Oslo, P.O. Box 1033, Blindern, N-0315 Oslo (Norway); Vistad, Ornulv B.; Arstad, Bjornar [SINTEF Materials and Chemistry, P.O. Box 124, Blindern, N-0314 Oslo (Norway); Norby, Poul, E-mail: pnor@risoe.dtu.dk [Department of Chemistry and Centre for Materials Science and Nanotechnology, University of Oslo, P.O. Box 1033, Blindern, N-0315 Oslo (Norway); Materials Research Division, Riso National Laboratory for Sustainable Energy, Technical University of Denmark, P.O. Box 49, DK-4000 Roskilde (Denmark)

    2011-12-15

    Single-layer Nb-substituted titanate nanosheets of ca. 1 nm thickness were obtained by exfoliating tetrabutylammonium (TBA)-intercalated Nb-substituted titanates in water. AFM images and turbidity measurements reveal that the exfoliated nanosheets crack and corrugate when sonicated. Upon heating, the thermal transformation into anatase and further to rutile is retarded. This suppression of the phase transition upon higher valent substitution may promote technological applications of anatase thin films, hereunder development of films with TCO properties. Depending on the oxygen partial pressure during the transformation, the Nb-substitution into TiO{sub 2} provokes different defect situations and also electronic properties. At reducing conditions, Nb is incorporated as Nb{sup V} and an equivalent amount of Ti{sup IV} is transformed to Ti{sup III} as evidenced by XPS. Magnetic susceptibility data show accordingly paramagnetic behavior. For samples heated in air Ti{sup IV} and Nb{sup V} cations prevail, the latter is compensated by cation vacancies. {sup 93}Nb MAS NMR data prove that Nb is finely dispersed into the transformed (Ti,Nb)O{sub 2} oxide matrices without sign of Nb{sub 2}O{sub 5} (nano)precipitates. The Nb-O-Ti bonds and defects at cation sites are considered key factors for increasing the transformation temperatures for conversion of the nanosheets to anatase and finally into rutile. It is further tempting to link the delay in crystallization to morphology limitations originating from the nanosheets. The present work shows that layered Nb-titanates are appropriate precursors for formation of highly oriented Nb-substituted anatase thin films via delamination, reconstruction and subsequent heat treatment. - Graphical abstract: Layered Nb-titanates are appropriate precursors for formation of highly oriented Nb-substituted anatase thin films via delamination, reconstruction and subsequent heat treatment. Highlights: Black-Right-Pointing-Pointer Single layer Nb-substituted nanosheets were obtained by exfoliation of layered titanates. Black-Right-Pointing-Pointer Nb(V) successfully introduced into anatase and rutile solid solutions. Black-Right-Pointing-Pointer Anatase obtained from reconstructed nanosheets exhibit enhanced thermal stability. Black-Right-Pointing-Pointer Oxygen partial pressure influences the valence of Nb in heat-treated samples. Black-Right-Pointing-Pointer Deposition of oriented thin Ti(Nb)O{sub 2} layers by spray coating was demonstrated.

  19. Buprenorphine/naloxone as a promising therapeutic option for opioid abusing patients with chronic pain: Reduction of pain, opioid withdrawal symptoms, and abuse liability of oral oxycodone

    PubMed Central

    Roux, Perrine; Sullivan, Maria A.; Cohen, Julien; Fugon, Lionel; Jones, Jermaine D.; Vosburg, Suzanne K.; Cooper, Ziva D.; Manubay, Jeanne M.; Mogali, Shanthi; Comer, Sandra D.

    2013-01-01

    Aim Few studies have examined abuse of prescription opioids (PO) among individuals with chronic pain under buprenorphine/naloxone (Bup/Nx) maintenance. The current 7-week inpatient study assessed oral oxycodone self-administration by patients with chronic pain who had a history of opioid abuse. Methods Participants (N=25) were transitioned from their pre-admission prescribed opioid to Bup/Nx. All of the participants were tested under each of the sublingual Bup/Nx maintenance doses (2/0.5, 8/2 or 16/4 mg) in random order. During each maintenance period, participants could self-administer oxycodone orally (0, 10, 20, 40 or 60 mg, PO) or receive money during laboratory sessions. Drug choice (percent) was the primary dependent variable. Subjective ratings of clinical pain and withdrawal symptoms also were measured. Mann-Whitney tests compared % drug choice for each active oxycodone dose to placebo. Logistic regression analyses identified correlates of oxycodone preference, defined as 60% or greater choice of oxycodone compared to money. Results Pain was significantly reduced while participants were maintained on Bup/Nx compared to pre-admission ratings. No differences in percent drug choice were observed between the active oxycodone doses and placebo under each Bup/Nx maintenance dose. However, factors associated with oxycodone preference were: lower Bup/Nx maintenance dose, more withdrawal symptoms and more pain. Conclusions These data suggest that Bup/Nx was effective in reducing pain and supplemental oxycodone use. Importantly, adequate management of pain and withdrawal symptoms by Bup/Nx may reduce oxycodone preference in this population. PMID:23707283

  20. Activation of Peroxisome Proliferator-Activated Receptor   by Substituted Urea-Derived Soluble Epoxide Hydrolase Inhibitors

    Microsoft Academic Search

    Xiang Fang; Shanming Hu; Takaho Watanabe; Neal L. Weintraub; Gary D. Snyder; Jianrong Yao; Yi Liu; John Y.-J. Shyy; Bruce D. Hammock; Arthur A. Spector

    2005-01-01

    Soluble epoxide hydrolase (sEH) plays a major role in regulating vascular epoxyeicosatrienoic acid metabolism and function, and substituted urea derivatives that inhibit sEH activity reduce blood pressure in hypertensive rats. We found that substituted urea derivatives containing a dodecanoic acid group, besides effectively inhibiting sEH, increased peroxisome proliferator- activated receptor (PPAR) activity. In PPAR transfected COS-7 cells, treatment with 10

  1. A general synthesis of substituted formylpyrroles from ketones and 4-formyloxazole.

    PubMed

    Reeves, Jonathan T; Song, Jinhua J; Tan, Zhulin; Lee, Heewon; Yee, Nathan K; Senanayake, Chris H

    2007-05-10

    A novel two-step synthesis of substituted 2-formylpyrroles is described. Aldol adducts of ketones and 4-formyloxazole undergo a dehydration/oxazole hydrolysis/cyclization cascade on sequential treatment with MsCl/Et3N and aqueous NaOH to yield 5-substituted and 4,5-disubstituted 2-formylpyrroles. The methodology was extended to an N-benzyl thiazolium salt. PMID:17355146

  2. Substance abuse/dependence treatment: a European perspective.

    PubMed

    Metz, Verena E; Brandt, Laura; Unger, Annemarie; Fischer, Gabriele

    2014-01-01

    During the past decade, substantial progress has been made in the field of addiction medicine in Europe, particularly regarding the development of new treatment interventions, resulting in a wide range of therapeutic options for patients with substance use disorders. However, not all interventions are evidence based. Patients with cannabis and cocaine/amphetamine use disorders and special patient populations especially lack evidence-based treatment recommendations. Many patients undergo treatment that has not been scientifically evaluated for quality and efficacy. Moreover, there are large disparities regarding availability and treatment access across Europe, with the new member states of the European Union (EU) reporting long waiting lists and low treatment coverage. Even in Austria, which ranks among the countries with relatively high treatment coverage and good diversification of treatment in opioid maintenance therapy due to the availability of methadone, buprenorphine, and slow-release oral morphine (SROM), a considerable population of untreated or inadequately treated patients exists. Treatment for substance use disorders in Europe still has scope for improvement in terms of treatment availability and access, which is ideally provided by further development and implementation of evidence-based interventions. PMID:24766667

  3. The reuse of municipal solid waste incinerator fly ash slag as a cement substitute

    Microsoft Academic Search

    K. L Lin; K. S Wang; B. Y Tzeng; C. Y Lin

    2003-01-01

    The results of the treatment of fly ash from a municipal solid waste incinerator (MSWI) by melting are described, and the safety and the effectiveness of using the slag produced by this melting treatment are studied. The properties of the MSWI fly ash slag were analyzed, to evaluate the feasibility of its reuse as a substitute for part of the

  4. Use of plasma volume substitutes and plasma in developing countries*

    PubMed Central

    Lundsgaard-Hansen, P.; Collins, J. A.; David-West, A. S.; Lopez, C. G.; Hantchef, Z. S.; Lothe, F.; von Steffens, E.

    1983-01-01

    Plasma and plasma substitutes are used in the treatment of various conditions such as haemorrhage and shock. This article examines the role of crystalloids, artificial colloids, human plasma, human albumin, and plasma protein fraction, in the treatment of such patients, with particular reference to peripheral health facilities in developing countries. It is concluded that 0.9% saline, together with 5-6% dextrose, is of particular importance in this situation since it is easy to produce locally, is stable at high temperatures, and has a low cost/benefit ratio. The second priority is to ensure the availability of a limited quantity of one or more colloid plasma substitutes. In the field of plasma, fresh frozen or fresh liquid plasma is most useful for the treatment of various haemostatic derangements and follow-up treatment of severe burns, since it contains the widest spectrum of therapeutically useful components and can be produced locally with an acceptable degree of difficulty. The treatment of severe diarrhoea with special alkaline electrolyte solutions and oral rehydration solutions is also outlined. PMID:6188548

  5. A Novel Approach for the Synthesis of N-substituted Pyrroles Starting Directly From Nitro Compounds in Water

    Microsoft Academic Search

    Biswanath Das; Digambar Balaji Shinde; Boddu Shashi Kanth; Jayprakash Narayan Kumar

    2011-01-01

    A distinct novel approach for a facile high-yielding synthesis of N-substituted pyrroles has been discovered by the treatment of nitroarenes with 2, 5-dimethoxytetrahydrofuran using indium in dilute aqueous HCl at room temperature.

  6. Novel Approach for the Synthesis of N-Substituted Pyrroles Starting Directly from Nitro Compounds in Water

    Microsoft Academic Search

    Biswanath Das; Digambar Balaji Shinde; Boddu Shashi Kanth; Jayprakash Narayan Kumar

    2012-01-01

    A novel approach for a facile high-yielding synthesis of N-substituted pyrroles has been discovered by the treatment of nitroarenes with 2,5-dimethoxytetrahydrofuran using indium in dilute aqueous HCl at room temperature.

  7. 3D Printing of Octacalcium Phosphate Bone Substitutes

    PubMed Central

    Komlev, Vladimir S.; Popov, Vladimir K.; Mironov, Anton V.; Fedotov, Alexander Yu.; Teterina, Anastasia Yu.; Smirnov, Igor V.; Bozo, Ilya Y.; Rybko, Vera A.; Deev, Roman V.

    2015-01-01

    Biocompatible calcium phosphate ceramic grafts are able of supporting new bone formation in appropriate environment. The major limitation of these materials usage for medical implants is the absence of accessible methods for their patient-specific fabrication. 3D printing methodology is an excellent approach to overcome the limitation supporting effective and fast fabrication of individual complex bone substitutes. Here, we proposed a relatively simple route for 3D printing of octacalcium phosphates (OCP) in complexly shaped structures by the combination of inkjet printing with post-treatment methodology. The printed OCP blocks were further implanted in the developed cranial bone defect followed by histological evaluation. The obtained result confirmed the potential of the developed OCP bone substitutes, which allowed 2.5-time reducing of defect’s diameter at 6.5?months in a region where native bone repair is extremely inefficient.

  8. SIMILARITY NETWORK FOR SEMANTIC WEB SERVICES SUBSTITUTION

    E-print Network

    Paris-Sud XI, Université de

    SIMILARITY NETWORK FOR SEMANTIC WEB SERVICES SUBSTITUTION Chantal Cherifi LE2I Laboratory, Burgundy is performed on a benchmark of semantically annotated Web services. Results show that this approach allows a more detailed analysis of substitutable Web services. Keywords - Semantic Web services, Functional

  9. A virtual substitution of Brouwer choice sequence

    E-print Network

    Klaus Lange

    2009-08-24

    Step by step a substitution of the well known Brouwer choice sequence will be constructed. It begins with an establishing of quasi alternating prime number series followed by a construction of a virtual sequence in sense of the virtual set definition. The last step gives reasons for why this virtual sequence substitutes the choice sequence created by L. E. J. Brouwer.

  10. Substitute Teachers: Making Lost Days Count

    ERIC Educational Resources Information Center

    True, Charlene; Butler, Kyle; Sefton, Rachel

    2011-01-01

    As K-12 teachers and administrators grow increasingly concerned with issues of accountability, research-based methods, and intervention strategies, little discussion exists on the impact of substitute teachers in the classroom. In the rush to analyze test scores, are the days covered by substitute teachers even considered? Though districts are…

  11. PALINDROME COMPLEXITY BOUNDS FOR PRIMITIVE SUBSTITUTION SEQUENCES

    E-print Network

    PALINDROME COMPLEXITY BOUNDS FOR PRIMITIVE SUBSTITUTION SEQUENCES DAVID DAMANIK 1;2 AND DOUGLAS on the frequencies of palindromes in such words. As an application of these bounds, we prove that the strongly palindromic sequences in a primitive substitution dynamical sys­ tem form a set of measure zero. 1

  12. Palindrome complexity bounds for primitive substitution sequences

    Microsoft Academic Search

    David Damanik; Douglas Zare

    2000-01-01

    . We consider one-sided infinite words generated via iteration byprimitive substitutions on finite alphabets and provide bounds on the palindromecomplexity function as well as uniform bounds on the frequencies ofpalindromes in such words. As an application of these bounds, we prove thatthe strongly palindromic sequences in a primitive substitution dynamical systemform a set of measure zero.1. IntroductionIn this paper we

  13. [Prophylaxis of dental caries using sugar substitutes].

    PubMed

    Eberle, G

    1984-12-01

    Among the three measures, which are capable of producing a preventive effect against caries only when applied combined, i.e. adequate fluoride supply, proper mouth hygiene and healthy nutrition, the latter is dealt with in greater detail. The use of sugar substitutes is discussed under the aspects of caries prevention, substitute composition and production technology as well as from a medical point of view. Among the presently available sugar substitutes with nutritive value are mentioned Xylite, Lycasine, Mannite, Sorbite, Palatinite, the non-calorific substitutes such as the natural Aspartame as well as the synthetic sweetening agents Saccharine and Cyclamate. The possibilities and limitations of using these sugar substitutes in the prevention of caries in adults and children are presented. PMID:6532015

  14. Medication-assisted treatment research with criminal justice populations: challenges of implementation.

    PubMed

    Gordon, Michael S; Kinlock, Timothy W; Miller, Patrice M

    2011-01-01

    Creating, implementing and evaluating substance abuse interventions, especially medication-assisted treatments, for prisoners, parolees, and probationers with histories of heroin addiction is an especially challenging endeavor because of the difficulty in coordinating and achieving cooperation among diverse criminal justice, substance abuse treatment, research, and social service agencies, each with its own priorities and agenda. In addition, there are special rules that must be followed when conducting research with criminal justice-involved populations, particularly prisoners. The following case studies will explore the authors' experience of over 10?years conducting pharmacotherapy research using methadone, buprenorphine, and naltrexone with criminal justice populations. The major obstacles and how they were overcome are presented. Finally, recommendations are provided with regard to implementing and conducting research with criminal justice populations. PMID:22086665

  15. Medication Assisted Treatment Research with Criminal Justice Populations: Challenges of Implementation

    PubMed Central

    Gordon, Michael S.; Kinlock, Timothy W.; Miller, Patrice M.

    2011-01-01

    Creating, implementing and evaluating substance abuse interventions, especially medication-assisted treatments, for prisoners, parolees, and probationers with histories of heroin addiction is an especially challenging endeavor because of the difficulty in coordinating and achieving cooperation among diverse criminal justice, substance abuse treatment, research, and social service agencies, each with its own priorities and agenda. In addition, there are special rules that must be followed when conducting research with criminal justice-involved populations, particularly prisoners. The following case studies will explore the authors’ experience of over 10 years conducting pharmacotherapy research using methadone, buprenorphine, and naltrexone with criminal justice populations. The major obstacles and how they were overcome are presented. Finally, recommendations are provided with regard to implementing and conducting research with criminal justice populations. PMID:22086665

  16. Microbiological aspects of some caloric sugar substitutes.

    PubMed

    Birkhed, D; Kalfas, S; Svensäter, G; Edwardsson, S

    1985-03-01

    Several caloric sugar substitutes are available today, e.g. maltitol, Lycasin, sorbitol, xylitol, palatinit, sorbose, coupling sugar, palatinose, fructose and invert sugar. When evaluating the cariogenicity of these sugar substitutes from a bacteriological point of view, different analytical procedures should be considered. In vitro studies on the capacity of pure oral bacterial strains and dental plaque material to decompose the substitute to acid. Studies on the catabolism of the substitute. Possible adaptation of the oral microflora to metabolize the substitute in vivo as well as in vitro. Studies on any inhibitory effect of the substitute on the microbial activities in dental plaque and on the oral microflora. The capacity of oral bacteria, e.g. Streptococcus mutans, to induce caries in animal experiments should also be considered. Results from such microbiological studies make it possible to classify the caloric sugar substitutes into different groups. The first, most suitable, group seems to consist of xylitol and sorbose. These substitutes are fermented by few oral bacteria and no negative adaptation of the oral flora has been observed. A reducing effect upon dental plaque formation and on acid production from glucose has been reported. A second group consists of maltitol, palatinite, palatinose, sorbitol and Lycasin. These substitutes are fermented by certain groups of organisms within the oral genera Actinomyces, Lactobacillus and Streptococcus. Adaptation of oral bacteria to palatinose and to sorbitol, resulting in a more pronounced acid production, has been observed. No inhibitory effects have been reported. The results from experimental studies suggest that these sugar substitutes have no or little cariogenic action in rodents inoculated with S. mutans.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3858233

  17. High-throughput simultaneous analysis of buprenorphine, methadone, cocaine, opiates, nicotine, and metabolites in oral fluid by liquid chromatography tandem mass spectrometry

    PubMed Central

    Concheiro, Marta; Gray, Teresa R.; Shakleya, Diaa M.

    2011-01-01

    A method for simultaneous determination of buprenorphine (BUP), norbuprenorphine (NBUP), methadone, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP), cocaine, benzoylecgonine (BE), ecgonine methyl ester (EME), anhydroecgonine methyl ester (AEME), morphine, codeine, 6-acetylmorphine (6AM), heroin, 6-acetylcodeine (6AC), nicotine, cotinine, and trans-3?-hydroxycotinine (OH-cotinine) by liquid chromatography tandem mass spectrometry in oral fluid (OF) was developed and extensively validated. Acetonitrile (800 ?L) and OF (250 ?L) were added to a 96-well Isolute-PPT+protein precipitation plate. Reverse-phase separation was achieved in 16 min and quantification was performed by multiple reaction monitoring. The assay was linear from 0.5 or 1 to 500 ?g/L. Intraday, interday, and total imprecision were less than 13% (n=20), analytical recovery was 92–114% (n= 20), extraction efficiencies were more than 77% (n=5), and process efficiencies were more than 45% (n=5). Although ion suppression was detected for EME, cocaine, morphine, 6AC, and heroin (less than 56%) and enhancement was detected for BE and nicotine (less than 316%), deuterated internal standards compensated for these effects. The method was sensitive (limit of detection 0.2–0.8 ?g/L) and specific (no interferences) except that 3-hydroxy-4-methoxyamphetamine interfered with AEME. No carryover was detected, and all analytes were stable for 24 h at 22 °C, for 72 h at 4 °C, and after three freeze–thaw cycles, except cocaine, 6AC, and heroin (22–97% loss). The method was applied to 41 OF specimens collected throughout pregnancy with a Salivette® OF collection device from an opioid-dependent BUP-maintained pregnant woman. BUP ranged from 0 to 7,400 ?g/L, NBUP from 0 to 71 ?g/L, methadone from 0 to 3 ?g/L, nicotine from 32 to 5,020 ?g/L, cotinine from 125 to 508 ?g/L, OH-cotinine from 11 to 51 ?g/L, cocaine from 0 to 419 ?g/L, BE from 0 to 351 ?g/L, EME from 0 to 286 ?g/L, AEME from 0 to 7 ?g/L, morphine from 0 to 22 ?g/L, codeine from 0 to 1 ?g/L, 6AM from 0 to 4 ?g/L, and heroin from 0 to 2 ?g/L. All specimens tested negative for EDDP and 6AC. This method permits a fast and simultaneous quantification of 16 drugs and metabolites in OF, with good selectivity and sensitivity. PMID:20652688

  18. Pharmacological maintenance treatments of opiate addiction.

    PubMed

    Bell, James

    2014-02-01

    For people seeking treatment, the course of heroin addiction tends to be chronic and relapsing, and longer duration of treatment is associated with better outcomes. Heroin addiction is strongly associated with deviant behaviour and crime, and the objectives in treating heroin addiction have been a blend of humane support, rehabilitation, public health intervention and crime control. Reduction in street heroin use is the foundation on which all these outcomes are based. The pharmacological basis of maintenance treatment of dependent individuals is to minimize withdrawal symptoms and attenuate the reinforcing effects of street heroin, leading to reduction or cessation of street heroin use. Opioid maintenance treatment can be moderately effective in suppressing heroin use, although deviations from evidence-based approaches, particularly the use of suboptimal doses, have meant that treatment as delivered in practice may have resulted in poorer outcomes than predicted by research. Methadone treatment has been 'programmatic', with a one-size-fits-all approach that in part reflects the perceived need to impose discipline on deviant individuals. However, differences in pharmacokinetics and in side-effects mean that many patients do not respond optimally to methadone. Injectable diamorphine (heroin) provides a more reinforcing medication for some 'nonresponders' and can be a valuable option in the rehabilitation of demoralized, socially excluded individuals. Buprenorphine, a partial agonist, is a less reinforcing medication with different side-effects and less risk of overdose. Not only is it a different medication, but also it can be used in a different paradigm of treatment, office-based opioid treatment, with less structure and offering greater patient autonomy. PMID:23210630

  19. 40 CFR 721.3565 - Ethylenediamine, substituted, sodium salt.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Ethylenediamine, substituted, sodium salt. 721.3565 Section 721.3565 ...Ethylenediamine, substituted, sodium salt. (a) Chemical substance and significant...as ethylenediamine, substituted, sodium salt (PMN P-97-328) is subject to...

  20. 40 CFR 721.8900 - Substituted halogenated pyridinol, alkali salt.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...Substituted halogenated pyridinol, alkali salt. 721.8900 Section 721.8900 ...Substituted halogenated pyridinol, alkali salt. (a) Chemical substances and significant...substituted halogenated pyridinols, alkali salts (PMNs P-88-1271 and...

  1. 40 CFR 721.5278 - Substituted naphthalenesulfonic acid, alkali salt.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...Substituted naphthalenesulfonic acid, alkali salt. 721.5278 Section 721.5278 ...Substituted naphthalenesulfonic acid, alkali salt. (a) Chemical substance and significant...substituted naphthalenesulfonic acid, alkali salt (PMN P-95-85) is subject to...

  2. 40 CFR 721.5278 - Substituted naphthalenesulfonic acid, alkali salt.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...Substituted naphthalenesulfonic acid, alkali salt. 721.5278 Section 721.5278 ...Substituted naphthalenesulfonic acid, alkali salt. (a) Chemical substance and significant...substituted naphthalenesulfonic acid, alkali salt (PMN P-95-85) is subject to...

  3. 40 CFR 721.8900 - Substituted halogenated pyridinol, alkali salt.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...Substituted halogenated pyridinol, alkali salt. 721.8900 Section 721.8900 ...Substituted halogenated pyridinol, alkali salt. (a) Chemical substances and significant...substituted halogenated pyridinols, alkali salts (PMNs P-88-1271 and...

  4. 40 CFR 721.3440 - Haloalkyl substituted cyclic ethers.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... false Haloalkyl substituted cyclic ethers. 721.3440 Section 721.3440 ...3440 Haloalkyl substituted cyclic ethers. (a) Chemical substance and significant...substances haloalkyl substituted cyclic ethers (PMN P-85-368 and...

  5. 40 CFR 721.3440 - Haloalkyl substituted cyclic ethers.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... false Haloalkyl substituted cyclic ethers. 721.3440 Section 721.3440 ...3440 Haloalkyl substituted cyclic ethers. (a) Chemical substance and significant...substances haloalkyl substituted cyclic ethers (PMN P-85-368 and...

  6. 40 CFR 721.3440 - Haloalkyl substituted cyclic ethers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... false Haloalkyl substituted cyclic ethers. 721.3440 Section 721.3440 ...3440 Haloalkyl substituted cyclic ethers. (a) Chemical substance and significant...substances haloalkyl substituted cyclic ethers (PMN P-85-368 and...

  7. 40 CFR 721.3440 - Haloalkyl substituted cyclic ethers.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... false Haloalkyl substituted cyclic ethers. 721.3440 Section 721.3440 ...3440 Haloalkyl substituted cyclic ethers. (a) Chemical substance and significant...substances haloalkyl substituted cyclic ethers (PMN P-85-368 and...

  8. 40 CFR 721.10708 - Zirconium substituted heteropolycyclic (generic).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...2014-07-01 2014-07-01 false Zirconium substituted heteropolycyclic (generic...Chemical Substances § 721.10708 Zirconium substituted heteropolycyclic (generic...chemical substance identified generically as zirconium substituted heteropolycyclic...

  9. 40 CFR 721.640 - Amine substituted metal salts.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 2010-07-01 false Amine substituted metal salts. 721.640...Specific Chemical Substances § 721.640 Amine substituted metal salts. (a) Chemical...chemical substances identified generically as amine substituted metal salts (PMNs...

  10. 40 CFR 721.3764 - Fluorene substituted aromatic amine.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... false Fluorene substituted aromatic amine. 721.3764 Section 721.3764 ...3764 Fluorene substituted aromatic amine. (a) Chemical substance and significant...generically as a fluorene substituted aromatic amine (PMN P-91-43) is subject to...

  11. 40 CFR 721.10254 - Substituted acrylamide (generic).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...2013-07-01 false Substituted acrylamide (generic). 721.10254 Section...Substances § 721.10254 Substituted acrylamide (generic). (a) Chemical substance...identified generically as substituted acrylamide (PMN P-09-390) is subject...

  12. 40 CFR 721.320 - Acrylamide-substituted epoxy.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...2012-07-01 2012-07-01 false Acrylamide-substituted epoxy. 721.320 ...Chemical Substances § 721.320 Acrylamide-substituted epoxy. (a) Chemical...chemical substance identified generically as acrylamide-substituted epoxy (PMN...

  13. 40 CFR 721.10254 - Substituted acrylamide (generic).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...2012-07-01 false Substituted acrylamide (generic). 721.10254 Section...Substances § 721.10254 Substituted acrylamide (generic). (a) Chemical substance...identified generically as substituted acrylamide (PMN P-09-390) is subject...

  14. 40 CFR 721.10254 - Substituted acrylamide (generic).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...2014-07-01 false Substituted acrylamide (generic). 721.10254 Section...Substances § 721.10254 Substituted acrylamide (generic). (a) Chemical substance...identified generically as substituted acrylamide (PMN P-09-390) is subject...

  15. 40 CFR 721.320 - Acrylamide-substituted epoxy.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...2014-07-01 2014-07-01 false Acrylamide-substituted epoxy. 721.320 ...Chemical Substances § 721.320 Acrylamide-substituted epoxy. (a) Chemical...chemical substance identified generically as acrylamide-substituted epoxy (PMN...

  16. 40 CFR 721.320 - Acrylamide-substituted epoxy.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...2013-07-01 2013-07-01 false Acrylamide-substituted epoxy. 721.320 ...Chemical Substances § 721.320 Acrylamide-substituted epoxy. (a) Chemical...chemical substance identified generically as acrylamide-substituted epoxy (PMN...

  17. 40 CFR 721.320 - Acrylamide-substituted epoxy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 2010-07-01 false Acrylamide-substituted epoxy. 721.320 ...Chemical Substances § 721.320 Acrylamide-substituted epoxy. (a) Chemical...chemical substance identified generically as acrylamide-substituted epoxy (PMN...

  18. 40 CFR 721.320 - Acrylamide-substituted epoxy.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...2011-07-01 2011-07-01 false Acrylamide-substituted epoxy. 721.320 ...Chemical Substances § 721.320 Acrylamide-substituted epoxy. (a) Chemical...chemical substance identified generically as acrylamide-substituted epoxy (PMN...

  19. When You're Absent: Preparing for the Substitute.

    ERIC Educational Resources Information Center

    Fox, Brian A.

    1988-01-01

    Suggests ways classroom teachers can prepare for absences and help make substitute teaching productive. Recommends forming a list of preferred substitutes at the beginning of the school year; clarifying with students expected behavior; and preparing a permanent substitute packet. (LS)

  20. 40 CFR 721.3440 - Haloalkyl substituted cyclic ethers.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... false Haloalkyl substituted cyclic ethers. 721.3440 Section 721.3440 ...3440 Haloalkyl substituted cyclic ethers. (a) Chemical substance and significant...substances haloalkyl substituted cyclic ethers (PMN P-85-368 and...

  1. The relationship between primary prescription opioid and buprenorphine-naloxone induction outcomes in a prescription opioid dependent sample

    PubMed Central

    Nielsen, Suzanne; Hillhouse, Maureen; Weiss, Roger D.; Mooney, Larissa; Potter, Jennifer Sharpe; Lee, Joshua; Gourevitch, Marc N.; Ling, Walter

    2014-01-01

    Background and objectives This analysis aims to: (1) compare induction experiences among participants who self-reported using one of the 4 most commonly reported POs, and (2) examine factors associated with difficult bup-nx induction. Our hypothesis, based on previous research and current guidelines, is that those on longer-acting opioids will have experienced more difficult inductions. Methods The Prescription Opioid Addiction Treatment Study (POATS) was a multi-site, randomized clinical trial, using a two-phase adaptive treatment research design. This analysis examines bup-nx induction of participants who self-reported primary PO use of methadone, ER-oxycodone, IR-oxycodone and hydrocodone (n = 569). Analyses examined characteristics associated with difficult induction, defined as increased withdrawal symptoms measured by the Clinical Opiate Withdrawal Scale (COWS) after the first bup-nx dose with higher scores denoting greater withdrawal symptoms/severity. Results Contrary to our hypothesis, difficult induction experiences did not differ by primary PO type. Those who experienced a post-induction increase in COWS score had lower pre-dose COWS scores compared to those who did not experience a post-induction increase in COWS score (10.09 vs. 12.77, t(624) = ?13.56, p < .001). Demographics characteristics, depression, and pain history did not predict a difficult induction. Conclusions and scientific significance Difficult bup-nx inductions were not associated with participants’ primary PO. Severity of withdrawal, measured with the COWS, was an important variable, reminding clinicians that bup-nx should not be commenced prior to evidence of moderate opioid withdrawal. These findings add to the evidence that with careful procedures, bup-nx can used with few difficulties in PO-dependent patients. PMID:24112096

  2. Heterogeneity of keratan sulfate substituted on human chondrocytic large proteoglycans.

    PubMed

    Block, J A; Inerot, S E; Kimura, J H

    1992-04-15

    Newly synthesized 35S-labeled chondrocytic keratan sulfate chains were generated by chondrocytes of human chondrosarcoma cell line 105KC and were analyzed for heterogeneity of regional substitution, hydrodynamic size, and charge density. After isolation of the high density large chondrocytic proteoglycans and sequential digestions with chondroitinase ABC, L-1-tosylamido-2-phenylethyl chloromethyl ketone-treated trypsin, and alpha-chymotrypsin, followed by Superose 6 chromatography, two populations of keratan sulfate-containing proteoglycan fragments were identified and pooled separately. Keratan sulfate chains from each of the regions were compared after release by Pronase digestion, and differences in substitution patterns were observed; keratan sulfate chains of greater polydispersity, as well as a population of larger hydrodynamic size, were present in only one of the two regions. Alkaline/borohydride treatment confirmed both the existence of a population of uniquely large keratan sulfate chains and its restriction to a single region of proteoglycan fragments. In addition to heterogeneity of hydrodynamic size, the keratan sulfate chains exhibited regional heterogeneity of charge density and hence, of sulfation patterns. Analysis by Mono Q chromatography identified distinct groups of keratan sulfate that segregated by charge density and whose proportionate composition differed between the proteoglycan regions. Furthermore, the most highly charged species were unique to a single region and encompassed the chains of larger hydrodynamic size. This suggests that there may be regional heterogeneity of keratan sulfate chains substituted along a single class of proteoglycans and identifies a novel population of large, highly sulfated chondrocytic keratan sulfate chains. PMID:1559968

  3. Substitutive administration of thyroxine in patients after strumectomy.

    PubMed

    Orlicz-Szczesna, Grazyna; Dabrowski, Piotr

    2004-01-01

    The aim of the study is to present practical suggestions as to substitutive administration of thyroxine in patients who underwent strumectomy. Hypothyerosis due to strumectomy is an indication for starting treatment with thyroxine. Until thyroid cancer is excluded on the basis of histopathological examinations the patient should not take thyroxine, as there may be a possibility for the need of scinthigraphy of the whole body. Proper management of the patient with hypothyreosis includes informing the patient about the necessity of regular taking the hormone and undergoing regular check-ups. PMID:16146126

  4. CDC Vital Signs: Today's Heroin Epidemic

    MedlinePLUS

    ... Food and Drug Administration approved MAT options (methadone, buprenorphine, and naltrexone) in patients addicted to prescription opioid ... for Opioid Addiction: Facts for Families and Friends Buprenorphine Treatment Locator Mental Health Treatment Locator The White ...

  5. ER Practices Key to Helping Those Addicted to Painkillers

    MedlinePLUS

    ... and treatment with buprenorphine that was continued in primary care. Patients given buprenorphine had the best outcomes and ... initiated medication and referral for ongoing treatment in primary care were twice as likely as the others to ...

  6. 40 CFR 721.267 - N-[2-[(substituted dinitrophenyl)azo]diallylamino-4- substituted phenyl] acetamide (generic name).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...azo]diallylamino-4- substituted phenyl] acetamide (generic name). 721...azo]diallylamino-4- substituted phenyl] acetamide (generic name). (a...azo]diallylamino-4-substituted phenyl] acetamide (PMN P-95-513)...

  7. 40 CFR 721.267 - N-[2-[(substituted dinitrophenyl)azo]diallylamino-4- substituted phenyl] acetamide (generic name).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...azo]diallylamino-4- substituted phenyl] acetamide (generic name). 721...azo]diallylamino-4- substituted phenyl] acetamide (generic name). (a...azo]diallylamino-4-substituted phenyl] acetamide (PMN P-95-513)...

  8. 40 CFR 721.267 - N-[2-[(substituted dinitrophenyl)azo]diallylamino-4- substituted phenyl] acetamide (generic name).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...azo]diallylamino-4- substituted phenyl] acetamide (generic name). 721...azo]diallylamino-4- substituted phenyl] acetamide (generic name). (a...azo]diallylamino-4-substituted phenyl] acetamide (PMN P-95-513)...

  9. 40 CFR 721.267 - N-[2-[(substituted dinitrophenyl)azo]diallylamino-4- substituted phenyl] acetamide (generic name).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...azo]diallylamino-4- substituted phenyl] acetamide (generic name). 721...azo]diallylamino-4- substituted phenyl] acetamide (generic name). (a...azo]diallylamino-4-substituted phenyl] acetamide (PMN P-95-513)...

  10. 40 CFR 721.267 - N-[2-[(substituted dinitrophenyl)azo]diallylamino-4- substituted phenyl] acetamide (generic name).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...azo]diallylamino-4- substituted phenyl] acetamide (generic name). 721...azo]diallylamino-4- substituted phenyl] acetamide (generic name). (a...azo]diallylamino-4-substituted phenyl] acetamide (PMN P-95-513)...

  11. Opioid dependence and substitution therapy: thymoquinone as potential novel supplement therapy for better outcome for methadone maintenance therapy substitution therapy

    PubMed Central

    Adnan, Liyana Hazwani Mohd; Bakar, Nor Hidayah Abu; Mohamad, Nasir

    2014-01-01

    Methadone is widely being used for opioid substitution therapy. However, the administration of methadone to opioid dependent individual is frequently accompanied by withdrawal syndrome and chemical dependency develops. Other than that, it is also difficult to retain patients in the treatment programme making their retention rates are decreasing over time. This article is written to higlights the potential use of prophetic medicines, Nigella sativa, as a supplement for opioid dependent receiving methadone. It focuses on the potential role of N. sativa and its major active compound, Thymoquinone (TQ) as a calcium channel blocking agent to reduce withdrawal syndrome and opioid dependency. PMID:25859295

  12. Enantioselective synthesis of alkyne-substituted quaternary carbon stereogenic centers through NHC-Cu-catalyzed allylic substitution reactions with (i-Bu)2(alkynyl)aluminum reagents.

    PubMed

    Dabrowski, Jennifer A; Gao, Fang; Hoveyda, Amir H

    2011-04-01

    A catalytic enantioselective method for the formation of alkyne-substituted all-carbon quaternary stereogenic centers is reported. Additions of alkynylaluminums to alkyl-, aryl-, carboxylic ester-, or silyl-substituted allylic phosphates are promoted by 1.0-5.0 mol % loadings of NHC-Cu complexes derived from air-stable and commercially available CuCl(2)·2H(2)O. The requisite Al-based reagents are prepared through treatment of the corresponding aryl-, heteroaryl-, alkyl-, or alkenyl-substituted terminal alkynes with diisobutylaluminum hydride in the presence of 5.0 mol % Et(3)N at ambient temperature. The desired 1,4-enynes are obtained in up to 98% yield and >99:1 enantiomeric ratio. Selected Au-catalyzed cyclizations involving the alkyne unit of the enantiomerically enriched products are presented as a demonstration of the method's utility in chemical synthesis. PMID:21384918

  13. Enzymatic hydrolysis of low substituted carboxymethyl cellulose

    E-print Network

    Chanona Dominquez, Guadalupe

    1984-01-01

    ENZYMATIC HYDROLYSIS OF LOW SUBSTITUTED CARBOXYMETHYL CELLULOSE A Thesis by GUADALUPE CHANONA DOMINGUEZ Submitted to the Graduate College of Texas A&M University in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE... December 1984 Major Subject: Agricultural Engineering ENZYMATIC HYDROLYSIS OF LOW SUBSTITUTED CARBOXYMETHYL CELLULOSE A Thesis by GUADALUPE CHANONA DOMINGUEZ Approved as to style and content by: Cady R. Engler airman) Ed. J. Soltes (Member...

  14. Nutrient-substituted hydroxyapatites: synthesis and characterization

    NASA Technical Reports Server (NTRS)

    Golden, D. C.; Ming, D. W.

    1999-01-01

    Incorporation of Mg, S, and plant-essential micronutrients into the structure of synthetic hydroxyapatite (HA) may be advantageous for closed-loop systems, such as will be required on Lunar and Martian outposts, because these apatites can be used as slow-release fertilizers. Our objective was to synthesize HA with Ca, P, Mg, S, Fe, Cu, Mn, Zn, Mo, B, and Cl incorporated into the structure, i.e., nutrient-substituted apatites. Hydroxyapatite, carbonate hydroxyapatite (CHA), nutrient-substituted hydroxyapatite (NHA), and nutrient-substituted carbonate hydroxyapatite (NCHA) were synthesized by precipitating from solution. Chemical and mineralogical analysis of precipitated samples indicated a considerable fraction of the added cations were incorporated into HA, without mineral impurities. Particle size of the HA was in the 1 to 40 nm range, and decreased with increased substitution of nutrient elements. The particle shape of HA was elongated in the c-direction in unsubstituted HA and NHA but more spherical in CHA and NCHA. The substitution of cations and anions in the HA structure was confirmed by the decrease of the d[002] spacing of HA with substitution of ions with an ionic radius less than that of Ca or P. The DTPA-extractable Cu ranged from 8 to 8429 mg kg-1, Zn ranged from 57 to 1279 mg kg-1, Fe from 211 to 2573 mg kg-1, and Mn from 190 to 1719 mg kg-1, depending on the substitution level of each element in HA. Nutrient-substituted HA has the potential to be used as a slow-release fertilizer to supply micronutrients, S, and Mg in addition to Ca and P.

  15. An exergetic analysis of R22 substitution

    Microsoft Academic Search

    C Aprea; A Greco

    2002-01-01

    This paper deals with the substitution of R22 in an experimental vapour compression plant with the most widely used drop-in substitute, i.e. the zeotropic mixture R407C. A comparative exergetic analysis, carried on with experimental tests, has been presented. The experimental tests are performed in a vapour compression plant working with water and air as secondary fluids in the condenser and

  16. Comparison of Dermal Substitutes in Wound Healing Utilizing a Nude Mouse Model

    PubMed Central

    Truong, Anh-Tuan N.; Kowal-Vern, Areta; Latenser, Barbara A.; Wiley, Dorion E.; Walter, Robert J.

    2005-01-01

    Background: Dermal skin substitutes have become a standard of care in burn treatment. Objective: To compare and assess wound contracture reduction and histologic incorporation into the wound, dermal substitutes were implanted into full-thickness skin wounds in nude mice. Materials and Methods: Thirty-seven mice received a full-thickness 2 × 2 cm dorsal skin wound, and were either implanted with an acellular dermal matrix, Alloderm, Dermagraft-TC, Dermalogen, or Integra or assigned to the control group (with no dermal substitute). At 28 days postsurgery, the wounds were assessed for contraction, epithelialization, and other histological characteristics. Results: Each dermal substitute decreased wound contracture, but Alloderm and the acellular dermal matrix did so significantly compared to the control (P < .01 and P < .03, respectively). Within-group and control comparisons showed no significant differences with respect to the presence of dystrophic calcification, squamous hyperplasia, infiltration of neutrophils, fibroblasts, and macrophages, epidermal keratinocyte stratification, or collagen fiber configuration. Conclusions: Integra elicited the greatest foreign body response. Although the Dermalogen group had the thickest elastin fiber fragments, Dermagraft may have initiated the earliest elastin fiber formation in the wounds. While all dermal substitutes were incorporated into the wound bed and wound contracture was decreased, acellular dermal matrix and Alloderm, both human skin–derived products, produced less contraction and the thickest new “dermis” in the healed wounds compared to the control or synthetic dermal substitutes. PMID:16921409

  17. Rapid hydrothermal flow synthesis and characterisation of carbonate- and silicate-substituted calcium phosphates

    PubMed Central

    Knowles, Jonathan C; Rehman, Ihtesham; Darr, Jawwad A

    2013-01-01

    A range of crystalline and nano-sized carbonate- and silicate-substituted hydroxyapatite has been successfully produced by using continuous hydrothermal flow synthesis technology. Ion-substituted calcium phosphates are better candidates for bone replacement applications (due to improved bioactivity) as compared to phase-pure hydroxyapatite. Urea was used as a carbonate source for synthesising phase pure carbonated hydroxyapatite (CO3-HA) with ?5?wt% substituted carbonate content (sample 7.5CO3-HA) and it was found that a further increase in urea concentration in solution resulted in biphasic mixtures of carbonate-substituted hydroxyapatite and calcium carbonate. Transmission electron microscopy images revealed that the particle size of hydroxyapatite decreased with increasing urea concentration. Energy-dispersive X-ray spectroscopy result revealed a calcium deficient apatite with Ca:P molar ratio of 1.45 (±0.04) in sample 7.5CO3-HA. For silicate-substituted hydroxyapatite (SiO4-HA) silicon acetate was used as a silicate ion source. It was observed that a substitution threshold of ?1.1?wt% exists for synthesis of SiO4-HA in the continuous hydrothermal flow synthesis system, which could be due to the decreasing yields with progressive increase in silicon acetate concentration. All the as-precipitated powders (without any additional heat treatments) were analysed using techniques including Transmission electron microscopy, X-ray powder diffraction, Differential scanning calorimetry, Thermogravimetric analysis, Raman spectroscopy and Fourier transform infrared spectroscopy. PMID:22983020

  18. Biotransformation and biodegradation of N-substituted aromatics in methanogenic granular sludge

    Microsoft Academic Search

    El??as Razo-Flores; Brian Donlon; Gatze Lettinga; Jim A Field

    1997-01-01

    N-Substituted aromatic compounds are environmental contaminants associated with the production and use of dyes, explosives, pesticides and pharmaceuticals. In this article, we examine the potential of anaerobic granular sludge from anaerobic treatment systems towards the detoxification, transformation, and mineralization of nitroaromatic and azo compounds. Nitroaromatics and azo dyes with strong electron withdrawing are highly inhibitory to acetoclastic methanogenic bacteria. However,

  19. Fate of psychoactive compounds in wastewater treatment plant and the possibility of their degradation using aquatic plants.

    PubMed

    Macku?ak, Tomáš; Mosný, Michal; Škubák, Jaroslav; Grabic, Roman; Birošová, Lucia

    2015-03-01

    In this study we analyzed and characterized 29 psychoactive remedies, illicit drugs and their metabolites in single stages of wastewater treatment plants in the capital city of Slovakia. Psychoactive compounds were present within all stages, and tramadol was detected at a very high concentration (706 ng/L). Significant decreases of codeine, THC-COOH, cocaine and buprenorphine concentration were observed in the biological stage. Consequently, we were interested in the possibility of alternative tertiary post-treatment of effluent water with the following aquatic plants: Cabomba caroliniana, Limnophila sessiliflora, Egeria najas and Iris pseudacorus. The most effective plant for tertiary cleansing was I. pseudacorus which demonstrated the best pharmaceutical removal capacity. After 48 h codeine and citalopram was removed with 87% efficiency. After 96 h were all analyzed compounds were eliminated with efficiencies above 58%. PMID:25818110

  20. Dolutegravir resistance mutation R263K cannot coexist in combination with many classical integrase inhibitor resistance substitutions.

    PubMed

    Anstett, Kaitlin; Mesplede, Thibault; Oliveira, Maureen; Cutillas, Vincent; Wainberg, Mark A

    2015-04-01

    The new integrase strand transfer inhibitor (INSTI) dolutegravir (DTG) displays limited cross-resistance with older drugs of this class and selects for the R263K substitution in treatment-experienced patients. We performed tissue culture selections with DTG, using viruses resistant to older INSTIs and infectivity and resistance assays, and showed that the presence of the E92Q or N155H substitution was compatible with the emergence of R263K, whereas the G140S Q148R, E92Q N155H, G140S, Y143R, and Q148R substitutions were not. PMID:25653436

  1. The effect of particle size on the osteointegration of injectable silicate-substituted calcium phosphate bone substitute materials

    PubMed Central

    Coathup, Melanie J; Cai, Qian; Campion, Charlie; Buckland, Thomas; Blunn, Gordon W

    2013-01-01

    Calcium phosphate (CaP) particles as a carrier in an injectable bone filler allows less invasive treatment of bony defects. The effect of changing granule size within a poloxamer filler on the osteointegration of silicate-substituted calcium phosphate (SiCaP) bone substitute materials was investigated in an ovine critical-sized femoral condyle defect model. Treatment group (TG) 1 consisted of SiCaP granules sized 1000–2000 ?m in diameter (100 vol %). TG2 investigated a granule size of 250–500 ?m (75 vol %), TG3 a granule size of 90–125 ?m (75 vol %) and TG4 a granule size of 90–125 ?m (50 vol %). Following a 4 and 8 week in vivo period, bone area, bone-implant contact, and remaining implant area were quantified within each defect. At 4 weeks, significantly increased bone formation was measured in TG2 (13.32% ± 1.38%) when compared with all other groups (p = 0.021 in all cases). Bone in contact with the bone substitute surface was also significantly higher in TG2. At 8 weeks most new bone was associated within defects containing the smallest granule size investigated (at the lower volume) (TG4) (42.78 ± 3.36%) however this group was also associated with higher amounts of fragmented SiCaP. These smaller particles were phagocytosed by macrophages and did not appear to have a negative influence on healing. In conclusion, SiCaP granules of 250–500 ?m in size may be a more suitable scaffold when used as an injectable bone filler and may be a convenient method for treating bony defects. © 2013 The Authors. Journal of Biomedical Materials Research Part B: Applied Biomaterials Published by Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 101B: 902–910, 2013 PMID:23362131

  2. Water/Wastewater Treatment Plant Operator Qualifications.

    ERIC Educational Resources Information Center

    Water and Sewage Works, 1979

    1979-01-01

    This article summarizes in tabular form the U.S. and Canadian programs for classification of water and wastewater treatment plant personnel. Included are main characteristics of the programs, educational and experience requirements, and indications of requirement substitutions. (CS)

  3. Emergence of a Novel Lamivudine-Resistant Hepatitis B Virus Variant with a Substitution Outside the YMDD Motif

    Microsoft Academic Search

    Hiromi Yatsuji; Chiemi Noguchi; Nobuhiko Hiraga; Nami Mori; Masataka Tsuge; Michio Imamura; Shoichi Takahashi; Eiji Iwao; Yoshifumi Fujimoto; Hidenori Ochi; Hiromi Abe; Toshiro Maekawa; Chise Tateno; Katsutoshi Yoshizato; Fumitaka Suzuki; Hiromitsu Kumada; Kazuaki Chayama

    2006-01-01

    Lamivudine is a major drug approved for treatment of chronic hepatitis B virus (HBV) infection. Emergence of drug-resistant mutants with amino acid substitutions in the YMDD motif is a well-documented problem during long-term lamivudine therapy. Here we report a novel lamivudine-resistant strain of HBV with an intact YMDD motif, which included an amino acid substitution, rtA181T, in the reverse transcriptase

  4. Preparation of 1-Substituted Tetrahydro-?-carbolines by Lithiation-Substitution.

    PubMed

    Cochrane, Edward J; Hassall, Lorraine A; Coldham, Iain

    2015-06-01

    A method to prepare 1-substituted N-Boc-tetrahydro-?-carbolines was developed by lithiation followed by electrophilic substitution. The deprotonation to give the organolithium was optimized by in situ IR spectroscopy and showed that the Boc group rotates slowly at low temperature. The chemistry was applied to the synthesis of 9-methyleleagnine (N-methyltetrahydroharman) and 11-methylharmicine. PMID:25974712

  5. One-pot synthesis of highly substituted N-fused heteroaromatic bicycles from azole aldehydes.

    PubMed

    Outlaw, Victor K; d'Andrea, Felipe B; Townsend, Craig A

    2015-04-17

    An efficient route to substituted N-fused aromatic heterocycles, including indolizines, imidazo[1,2-a]pyridines, and imidazo[1,5-a]pyridines from azole aldehydes, is reported. Wittig olefination of the aldehydes with fumaronitrile and triethylphosphine affords predominantly E-alkenes that undergo rapid cyclization upon treatment with a mild base. Substituent control of the 1-, 2-, and 3-positions of the resulting heteroaromatic bicycles is shown. Alternatively, the isolable E-alkene undergoes selective alkylation with electrophiles, followed by in situ annulation to indolizines additionally substituted at the 6-position. PMID:25815402

  6. [Subclinical hypothyroidism--what level of TSH is an indication for substitution?].

    PubMed

    Mann, K; Janssen, O E

    2006-03-01

    Overt hypothyroidism is always an indication for substitution with levothyroxine. In patients with subclinical hypothyroidism and clearly elevated TPO antibodies, a wish to bear a child, infertility, and pregnancy, as also hypothyroidism-associated symptoms, including depression, a trial substitution with levothyroxine is justified. Before long-term treatment is initiated, an improvement in the clinical symptoms must be confirmed. Even though levothyroxine reduces the LDL cholesterol, or other risk factors are improved, it has not so far been unequivocally shown that levothyroxine reduces morbidity and mortality. These questions should be investigated in prospective clinical studies. PMID:16566389

  7. Improvement of the magnetic properties of nanocomposite permanent magnetic alloys with Dy and Ga substitutions

    Microsoft Academic Search

    Mingang Zhang; Gang Sun; Dongcheng Guo; Zhihao Jin

    2002-01-01

    The Dy and Ga substituted NdFeB nanocomposite permanent magnetic alloys with high magnetic properties have been prepared by appropriate wheel speed of melt-spinning and post-annealing treatment. Under optimal conditions, compared with the best magnetic properties of ternary NdFeB alloy of Jr=1.18T, Hci=379.5kA\\/m and (BH)max=119.5kJ\\/m3, the best magnetic properties of the alloy with Dy and Ga substitutions are Jr=1.16T, Hci=580.5kA\\/m, and

  8. Curriculum Vitae Rajendra Badgaiyan, MD

    E-print Network

    Badgaiyan, Rajendra D.

    Substance Related Training and Authorization DEA number: FB1211781 DEA number to prescribe buprenorphine: XB1211781 Training on Buprenorphine and Office-Based Treatment of Opioid Dependence, American Society

  9. Vitreous Substitutes: The Present and the Future

    PubMed Central

    Caprani, Simona Maria; Airaghi, Giulia; Bartalena, Luigi; Testa, Francesco; Mariotti, Cesare; Porta, Giovanni; Simonelli, Francesca

    2014-01-01

    Vitreoretinal surgery has advanced in numerous directions during recent years. The removal of the vitreous body is one of the main characteristics of this surgical procedure. Several molecules have been tested in the past to fill the vitreous cavity and to mimic its functions. We here review the currently available vitreous substitutes, focusing on their molecular properties and functions, together with their adverse effects. Afterwards we describe the characteristics of the ideal vitreous substitute. The challenges facing every ophthalmology researcher are to reach a long-term intraocular permanence of vitreous substitute with total inertness of the molecule injected and the control of inflammatory reactions. We report new polymers with gelification characteristics and smart hydrogels representing the future of vitreoretinal surgery. Finally, we describe the current studies on vitreous regeneration and cell cultures to create new intraocular gels with optimal biocompatibility and rheological properties. PMID:24877085

  10. Vitreous substitutes: the present and the future.

    PubMed

    Donati, Simone; Caprani, Simona Maria; Airaghi, Giulia; Vinciguerra, Riccardo; Bartalena, Luigi; Testa, Francesco; Mariotti, Cesare; Porta, Giovanni; Simonelli, Francesca; Azzolini, Claudio

    2014-01-01

    Vitreoretinal surgery has advanced in numerous directions during recent years. The removal of the vitreous body is one of the main characteristics of this surgical procedure. Several molecules have been tested in the past to fill the vitreous cavity and to mimic its functions. We here review the currently available vitreous substitutes, focusing on their molecular properties and functions, together with their adverse effects. Afterwards we describe the characteristics of the ideal vitreous substitute. The challenges facing every ophthalmology researcher are to reach a long-term intraocular permanence of vitreous substitute with total inertness of the molecule injected and the control of inflammatory reactions. We report new polymers with gelification characteristics and smart hydrogels representing the future of vitreoretinal surgery. Finally, we describe the current studies on vitreous regeneration and cell cultures to create new intraocular gels with optimal biocompatibility and rheological properties. PMID:24877085

  11. Nd–Co substituted strontium hexaferrite powders with enhanced coercivity

    SciTech Connect

    Herme, C.A. [Facultad de Ingeniería, Universidad de Buenos Aires, LAFMACEL-INTECIN, Paseo Colón 850, 1063 Buenos Aires (Argentina)] [Facultad de Ingeniería, Universidad de Buenos Aires, LAFMACEL-INTECIN, Paseo Colón 850, 1063 Buenos Aires (Argentina); Bercoff, P.G., E-mail: bercoff@famaf.unc.edu.ar [Facultad de Matemática, Astronomía y Física, Universidad Nacional de Córdoba, IFEG, CONICET, Ciudad Universitaria, 5000 Córdoba (Argentina); Jacobo, S.E. [Facultad de Ingeniería, Universidad de Buenos Aires, LAFMACEL-INTECIN, Paseo Colón 850, 1063 Buenos Aires (Argentina)] [Facultad de Ingeniería, Universidad de Buenos Aires, LAFMACEL-INTECIN, Paseo Colón 850, 1063 Buenos Aires (Argentina)

    2012-11-15

    Graphical abstract: Display Omitted Highlights: ? Sr{sub 1?x}Nd{sub x}Fe{sub 11?x}Co{sub x}O{sub 19} was prepared by sol–gel auto-combustion method with 0 ? x ? 0.4. ? Coercivity increases 11% with 0.2 Nd–Co substitution, reaching a value of 68.9 A/m. ? The appearance of two magnetic orderings is noticed in susceptibility measurements. ? This is supported by Curie temperature and susceptibility data. -- Abstract: In this work we report the synthesis of Nd–Co substituted strontium hexaferrites of composition Sr{sub 1?x}Nd{sub x}Fe{sub 11?x}Co{sub x}O{sub 19} by the sol–gel auto-combustion method with further heat treatment. The analysis of the X-ray diffraction spectra shows the M-type hexagonal structure in samples treated at 1100 °C for 2 h. Coercivity increases 11% with 0.2 Nd–Co substitution, reaching a value of 68.9 A/m (5480 Oe) while saturation magnetization is reduced 6% to 91 A m{sup 2}/kg (91 emu/g). The behavior of magnetic susceptibility with an applied field shows two different maxima which are assigned to different magnetic orderings. This assumption is supported by the appearance of two experimental values of Curie temperatures (T{sub C}) for all the prepared samples. Magnetic susceptibility ? and T{sub C} measurements suggest an uneven distribution of the iron vacancies.

  12. Preparation and characterization of cobalt-substituted anthrax lethal factor

    SciTech Connect

    Saebel, Crystal E.; Carbone, Ryan; Dabous, John R.; Lo, Suet Y. [Department of Chemistry and Biochemistry, Laurentian University, 935 Ramsey Lake Rd., Sudbury, Ontario, Canada P3E 2C6 (Canada)] [Department of Chemistry and Biochemistry, Laurentian University, 935 Ramsey Lake Rd., Sudbury, Ontario, Canada P3E 2C6 (Canada); Siemann, Stefan, E-mail: ssiemann@laurentian.ca [Department of Chemistry and Biochemistry, Laurentian University, 935 Ramsey Lake Rd., Sudbury, Ontario, Canada P3E 2C6 (Canada)] [Department of Chemistry and Biochemistry, Laurentian University, 935 Ramsey Lake Rd., Sudbury, Ontario, Canada P3E 2C6 (Canada)

    2011-12-09

    Highlights: Black-Right-Pointing-Pointer Cobalt-substituted anthrax lethal factor (CoLF) is highly active. Black-Right-Pointing-Pointer CoLF can be prepared by bio-assimilation and direct exchange. Black-Right-Pointing-Pointer Lethal factor binds cobalt tightly. Black-Right-Pointing-Pointer The electronic spectrum of CoLF reveals penta-coordination. Black-Right-Pointing-Pointer Interaction of CoLF with thioglycolic acid follows a 2-step mechanism. -- Abstract: Anthrax lethal factor (LF) is a zinc-dependent endopeptidase involved in the cleavage of mitogen-activated protein kinase kinases near their N-termini. The current report concerns the preparation of cobalt-substituted LF (CoLF) and its characterization by electronic spectroscopy. Two strategies to produce CoLF were explored, including (i) a bio-assimilation approach involving the cultivation of LF-expressing Bacillus megaterium cells in the presence of CoCl{sub 2}, and (ii) direct exchange by treatment of zinc-LF with CoCl{sub 2}. Independent of the method employed, the protein was found to contain one Co{sup 2+} per LF molecule, and was shown to be twice as active as its native zinc counterpart. The electronic spectrum of CoLF suggests the Co{sup 2+} ion to be five-coordinate, an observation similar to that reported for other Co{sup 2+}-substituted gluzincins, but distinct from that documented for the crystal structure of native LF. Furthermore, spectroscopic studies following the exposure of CoLF to thioglycolic acid (TGA) revealed a sequential mechanism of metal removal from LF, which likely involves the formation of an enzyme: Co{sup 2+}:TGA ternary complex prior to demetallation of the active site. CoLF reported herein constitutes the first spectroscopic probe of LF's active site, which may be utilized in future studies to gain further insight into the enzyme's mechanism and inhibitor interactions.

  13. Amino acid substitution matrices from protein blocks.

    PubMed Central

    Henikoff, S; Henikoff, J G

    1992-01-01

    Methods for alignment of protein sequences typically measure similarity by using a substitution matrix with scores for all possible exchanges of one amino acid with another. The most widely used matrices are based on the Dayhoff model of evolutionary rates. Using a different approach, we have derived substitution matrices from about 2000 blocks of aligned sequence segments characterizing more than 500 groups of related proteins. This led to marked improvements in alignments and in searches using queries from each of the groups. PMID:1438297

  14. EPR of Cobalt-Substituted Zinc Enzymes

    Microsoft Academic Search

    Brian Bennett

    \\u000a Co(II) is sometimes utilized as a spectroscopically active substitute for Zn(II) in enzymes. Metal binding sites in enzymes\\u000a that contain catalytically active Zn(II) generally yield high-spin S = 3\\/2 Co(II) ions when substituted with cobalt, and these provide EPR spectra rich in information. Extracting this information\\u000a involves an appreciation of the extent to which the properties of Co(II) mirror those

  15. 2-substituted quinoline alkaloids as potential antileishmanial drugs.

    PubMed Central

    Fournet, A; Barrios, A A; Muñoz, V; Hocquemiller, R; Cavé, A; Bruneton, J

    1993-01-01

    Ten 2-substituted quinoline alkaloids isolated from a plant used for treatment of New World cutaneous leishmaniasis have antileishmanial in vitro activities against the extracellular forms of Leishmania spp. BALB/c mice infected with Leishmania amazonensis PH8 or H-142 or Leishmania venezuelensis were treated 1 day after the parasitic infection with a quinoline alkaloid (100 mg/kg of body weight per day) or with reference drug N-methylglucamine antimonate (Glucantime) (56 mg of pentavalent antimony [Sbv] per kg per day) for 14 days. Lesion development was the criterium used to assess disease severity. Two three-carbon chain quinolines [2-n-propylquinoline and 2-(1',2'-trans-epoxypropyl)quinoline (chimanine D)] were more potent than N-methylglucamine antimonate against L. amazonensis PH8, and five quinoline alkaloids [2-(3,4-methylenedioxyphenylethyl)quinoline, cusparine, 2-(3,4-dimethoxyphenylethyl)quinoline, 2-(E)-prop-1'-enylquinoline (chimanine B), and skimmianine] were as effective as the reference drug. Single treatment near the site of infection, 14 days after infection with L. amazonensis, with 2-n-propylquinoline or chimanine B reduced the severity of lesions but less notably than N-methylglucamine antimonate. 2-n-Propylquinoline exhibited significant activity against the virulent strain L. venezuelensis. The active products did not show any apparent toxicities during the experiment. This study is, to our knowledge, the first to show the activity of 2-substituted quinoline alkaloids for experimental treatment of New World cutaneous leishmaniasis. Further investigations of these compounds might yet prove helpful for the development of new antileishmanial drugs. PMID:8494383

  16. U n i v e r s i t y o f M a r y l a n d , C o l l e g e P a r k A Weekly FAX from the Center for Substance Abuse Research

    E-print Network

    Milchberg, Howard

    CESAR as the source. Buprenorphine/Naloxone Treatment for Opioid Dependence in HIV-Infected Persons Improves Quality of HIV Care Received A recent multisite study found that buprenorphine can effectively demonstration project also found that providing buprenorphine treatment for opioid dependence improves

  17. Dermal substitute-assisted healing: enhancing stem cell therapy with novel biomaterial design.

    PubMed

    Hodgkinson, T; Bayat, A

    2011-07-01

    The use of dermal substitutes is increasingly widespread but the outcomes of substitute-assisted healing remain functionally deficient. Presently, the most successful scaffolds are acellular polymer matrices, prepared through lyophilization and phase separation techniques, designed to mimic the dermal extracellular matrix. The application of scaffolds containing viable cells has proven to be problematic due to short shelf-life, high cost and death of transplanted cells as a result of immune rejection and apoptosis. Recent advances in biomaterial science have made new techniques available capable of increasing scaffold complexity, allowing the creation of 3D microenvironments that actively control cell behaviour. Importantly, it may be possible through these sophisticated novel techniques, including bio-printing and electrospinning, to accurately direct stem cell behaviour. This complex proposal involves the incorporation of cell-matrix, cell-cell, mechanical cues and soluble factors delivered in a spatially and temporally pertinent manner. This requires accurate modelling of three-dimensional stem cell interactions within niche environments to identify key signalling molecules and mechanisms. The application of stem cells within substitutes containing such environments may result in greatly improved transplanted cell viability. Ultimately this may increase cellular organization and complexity of skin substitutes. This review discusses progress made in improving the efficacy of cellular dermal substitutes for the treatment of cutaneous defects and the potential of evolving new technology to improve current results. PMID:21365208

  18. [Skin substitutes--the present and the future].

    PubMed

    Gosk, Jerzy

    2012-01-01

    Full-thickness skin deficits are indications to autologic skin graft. In extensive skin injuries an employment of skin substitutes is sometimes necessary. In this study we presented the classification of skin substitutes (permanent, temporary, biological, synthetic). The different kinds of skin substitutes approved to commercial production were described (epidermal substitutes, dermal substitutes, composite dermo-epidermal substitutes). The possibilities of clinical applications of skin equivalents and results obtained by many authors after employment of artificial skin were also presented. Still existing limitations in possibilities of recovery of all skin functions were emphasized and the directions of future development of the studies were presented. PMID:23016441

  19. Coal as a Substitute for Carbon Black

    NASA Technical Reports Server (NTRS)

    Kushida, R. O.

    1982-01-01

    New proposal shows sprayed coal powder formed by extrusion of coal heated to plastic state may be inexpensive substitute for carbon black. Carbon black is used extensively in rubber industry as reinforcing agent in such articles as tires and hoses. It is made from natural gas and petroleum, both of which are in short supply.

  20. Balances for xed points of primitive substitutions

    E-print Network

    Provence Aix-Marseille I, Université de

    Balances for #12;xed points of primitive substitutions Boris Adamczewski Institut de Math#19. Abstract An in#12;nite word de#12;ned over a #12;nite alphabet A is balanced if for any pair (!; ! 0 generalize this notion and introduce a measure of balance for an in#12;nite sequence. In the case of #12;xed

  1. Substitute or Complement?: Spousal Influence on Volunteering

    ERIC Educational Resources Information Center

    Rotolo, Thomas; Wilson, John

    2006-01-01

    Social scientists have documented the influence of family statuses on volunteering, ignoring intrafamily effects. Using newly issued data from the Current Population Survey on the volunteer behavior of 19,626 American couples, we test two competing theories concerning spousal influences on volunteering. Substitution theory predicts that spouses…

  2. Confidentiality Issues with Substitutes and Paraeducators.

    ERIC Educational Resources Information Center

    Fleury, Marlaine L.

    2000-01-01

    This article offers guidelines to first-year special education teachers concerning confidentiality issues, especially in relation to substitute teachers and paraprofessionals. Guidelines address what to do if the teacher is absent and what to do if teaching assistants are absent. Also provided are several Web resources on confidentiality. (DB)

  3. Implicit Semantic Perception in Object Substitution Masking

    ERIC Educational Resources Information Center

    Goodhew, Stephanie C.; Visser, Troy A. W.; Lipp, Ottmar V.; Dux, Paul E.

    2011-01-01

    Decades of research on visual perception has uncovered many phenomena, such as binocular rivalry, backward masking, and the attentional blink, that reflect "failures of consciousness". Although stimuli do not reach awareness in these paradigms, there is evidence that they nevertheless undergo semantic processing. Object substitution masking (OSM),…

  4. Means for maintaining the substitutability of LNG

    Microsoft Academic Search

    R. C. Proctor; R. W. Parrish

    1967-01-01

    Substitutability as applied to liquid natural gas (LNG) is a method of reducing vaporization of the more volatile components and thus maintaining the heating value at a desirable level. A continuous process is described for cooling LNG below the boiling point of its most volatile component. A large-scale storage tank is provided with adequate space in the top for a

  5. Trends in Autism Prevalence: Diagnostic Substitution Revisited

    ERIC Educational Resources Information Center

    Coo, Helen; Ouellette-Kuntz, Helene; Lloyd, Jennifer E. V.; Kasmara, Liza; Holden, Jeanette J. A.; Lewis, M. E. Suzanne

    2008-01-01

    There has been little evidence to support the hypothesis that diagnostic substitution may contribute to increases in the administrative prevalence of autism. We examined trends in assignment of special education codes to British Columbia (BC) school children who had an autism code in at least 1 year between 1996 and 2004, inclusive. The proportion…

  6. A Partial Taxonomy of Substitutability and Interchangeability

    E-print Network

    Karakashian, Shant; Choueiry, Berthe Y; Prestwhich, Steven; Freuder, Eugene C

    2010-01-01

    Substitutability, interchangeability and related concepts in Constraint Programming were introduced approximately twenty years ago and have given rise to considerable subsequent research. We survey this work, classify, and relate the different concepts, and indicate directions for future work, in particular with respect to making connections with research into symmetry breaking. This paper is a condensed version of a larger work in progress.

  7. A simple sterile polypropylene fingernail substitute

    Microsoft Academic Search

    P. Tos; S. Artiaco; S. Coppolino; L. G. Conforti; B. Battiston

    2009-01-01

    Traumatic nail injuries are often observed in clinical practice. Usually the fingernail can be preserved, cleaned and disinfected in order to use it in the reconstructive procedure. However, in some cases the nail can be avulsed and lost or too damaged to be used. In cases when the nail is not available it should be replaced by a substitute in

  8. Evaluation of Inventory Policies with Unidirectional Substitutions

    E-print Network

    Lee, Chi-Guhn

    failures of power transformers pose a big hurdle. Although a variety of power transformer types can. Substitution between different transformer types is useful especially in power distribution networks since be found in the distribution network, it is often the case that the capacity of transformer is the only

  9. Mechanochemically enhanced synthesis of isomorphously substituted kaolinites

    Microsoft Academic Search

    David T. Restrepo; Carolin Griebel; Kyle Giesler; Eric J. Buker; Danielle K. Silletti; Sarah A. Brokus; Graham F Peaslee; Richard G. Blair

    2011-01-01

    A mechanochemical method for the rapid, bulk synthesis of kaolinite has been developed. Metal hydroxides and silicic acid are mechanically ground and hydrothermally treated for as little as a day at 250°C to produce X-ray pure crystalline materials. This approach has been expanded to allow the synthesis of kaolinites with a portion of the aluminum sites isomorphously substituted with other

  10. Information complements, substitutes, and strategic product design

    Microsoft Academic Search

    Geoffrey G. Parker; Marshall W. van Alstyne

    2000-01-01

    Competitive maneuvering in the information economy has raised a pressing question: how can firms raise profits by giving away products for free? This paper provides a possible answer and articulates a strategy space for information product design. Free strategic complements can raise a firm's own profits while free strategic substitutes can lower profits for competitors. We introduce a formal model

  11. The Approval Plan: Selection Aid, Selection Substitute

    ERIC Educational Resources Information Center

    Fenner, Audrey

    2004-01-01

    Approval plans are used by many libraries as an adjunct to title-by-title selection, and sometimes as a substitute for it. The author examines this approach to purchasing library materials, considering positive and negative effects approval plans may have on collection balance as well as on acquisitions budgets and workflow. The article also…

  12. N3-substituted thymidine bioconjugates for cancer therapy and imaging

    PubMed Central

    Khalil, Ahmed; Ishita, Keisuke; Ali, Tehane; Tjarks, Werner

    2013-01-01

    The compound class of 3-carboranyl thymidine analogues (3CTAs) are boron delivery agents for boron neutron capture therapy (BNCT), a binary treatment modality for cancer. Presumably, these compounds accumulate selectively in tumor cells via intracellular trapping, which is mediated by hTK1. Favorable in vivo biodistribution profiles of 3CTAs led to promising results in preclinical BNCT of rats with intracerebral brain tumors. This review presents an overview on the design, synthesis, and biological evaluation of first- and second-generation 3CTAs. Boronated nucleosides developed prior to 3CTAs for BNCT and non-boronated N3-substituted thymidine conjugates for other areas of cancer therapy and imaging are also described. In addition, basic features of carborane clusters, which are used as boron moieties in the design and synthesis of 3CTAs, and the biological and structural features of TK1-like enzymes, which are the molecular targets of 3CTAs, are discussed. PMID:23617430

  13. 40 CFR 721.9480 - Resorcinol, formaldehyde substituted carbomonocycle resin (generic).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 false Resorcinol, formaldehyde substituted carbomonocycle resin...Substances § 721.9480 Resorcinol, formaldehyde substituted carbomonocycle resin...identified generically as resorcinol, formaldehyde substituted carbomonocycle...

  14. 40 CFR 721.10517 - Alkyl methacrylates, polymer with substituted carbomonocycle, hydroxymethyl acrylamide and...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...substituted carbomonocycle, hydroxymethyl acrylamide and fluorinatedalkyl acrylate (generic...substituted carbomonocycle, hydroxymethyl acrylamide and fluorinatedalkyl acrylate (generic...substituted carbomonocycle, hydroxymethyl acrylamide and fluorinatedalkyl acrylate...

  15. Synthesis of Al-substituted 11 A tobermorite from newsprint recycling residue: a feasibility study

    SciTech Connect

    Coleman, Nichola J.; Brassington, David S

    2003-02-20

    Newsprint recycling is responsible for significant volumes of secondary waste material for which further reprocessing and market development would be beneficial. In response to this problem, a layer lattice, ion exchange material, Al-substituted 11 A tobermorite, has been synthesised from newsprint recycling residue comprising gehlenite (Ca{sub 2}Al{sub 2}SiO{sub 7}), akermanite (Ca{sub 2}MgSi{sub 2}O{sub 7}), {beta}-dicalcium silicate (Ca{sub 2}SiO{sub 4}) and anorthite (CaAl{sub 2}Si{sub 2}O{sub 8}) under hydrothermal conditions at 100 deg. C in the presence of NaOH. The hydrogarnet phase, katoite (Ca{sub 3}Al{sub 2}SiO{sub 12}H{sub 8}), was also formed. Similar treatment regimes in the presence of LiOH and KOH did not yield significant quantities of Al-substituted 11 A tobermorite. A batch sorption study confirmed that the Al-substituted 11 A tobermorite-bearing product was effective in the exclusion of Cd{sup 2+}, Pb{sup 2+} and Zn{sup 2+} from acidified aqueous media. The potential to enhance the yield of Al-substituted 11 A tobermorite relative to that of katoite and thus optimise the ion exchange efficiency of the product is discussed with respect to its application to heavy metal-contaminated wastewater treatment.

  16. 41 CFR 101-26.304 - Substitution policy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    41 Public Contracts and Property...true Substitution policy. 101-26.304...Section 101-26.304 Public Contracts and Property...REGULATIONS SUPPLY AND PROCUREMENT 26-PROCUREMENT...304 Substitution policy. In...

  17. 40 CFR 721.4133 - Dimethyl-3-substituted heteromonocyclic amine.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 false Dimethyl-3-substituted heteromonocyclic amine. 721.4133 Section 721.4133 Protection of Environment... § 721.4133 Dimethyl-3-substituted heteromonocyclic amine. (a) Chemical substance and significant new uses...

  18. SUBSTITUTION OF CADMIUM CYANIDE ELECTROPLATING WITH ZINC CHLORIDE ELECTROPLATING

    EPA Science Inventory

    The study evaluated the zinc chloride electroplating process as a substitute for cadmium cyanide electroplating in the manufacture of industrial connectors and fittings at Aeroquip Corporation. The process substitution eliminates certain wastes, specifically cadmium and cyanide, ...

  19. Practical Linguistic Steganography using Contextual Synonym Substitution and a

    E-print Network

    Practical Linguistic Steganography using Contextual Synonym Substitution and a Novel Vertex Coding steganography is concerned with hiding information in natural language text. One of the major transformations used in linguistic steganography is synonym substitution. However, few existing studies have studied

  20. How Magnesium Substitution Changes the Magnetostrictive Properties of Cobalt Ferrite

    NASA Astrophysics Data System (ADS)

    Jiles, David C.; Nlebedim, Cajetan; Hadimani, Ravi; Prozorov, Ruslan

    2013-03-01

    Materials based on cobalt ferrite are promising for magnetostrictive applications. Significant research effort has been invested towards understanding the effects of substituting different cations into the spinel crystal lattice of cobalt ferrite on its magnetostrictive properties. Al and Mg are the two cations that occupy the tetrahedral and octahedral sites of the spinel (MgAl2O4) from which cobalt ferrite derives its crystal structure. In our previous study, compared with other cation substituted cobalt ferrite studies, Al substitution resulted in the best compromise in magnetostriction and strain sensitivity. In this study, we present the effects of substituting Mg for Fe in cobalt ferrite. It was found that Mg substitution resulted in a near-linear decrease in magnetization of the samples. Remarkably, both magnetostriction and strain sensitivity showed a similar dependence on Mg substitution. This trend is unlike previous observations in which both properties show opposite dependence on cation substitution at lower concentrations of the substituted cations.

  1. Management of neck contractures by single-stage dermal substitutes and skin grafting in extensive burn patients

    PubMed Central

    Seo, Dong-Kook; Kym, Dohern

    2014-01-01

    Purpose Severe neck contracture is a problem that must be resolved by priority. We consider the best contracture treatment to be the full-thickness skin graft. However, clinicians often encounter patients, especially extensive burn patients, who have insufficient donor sites for the full-thickness skin graft. We treated extensive burn patients with neck scar contractures with a split-thickness skin graft (STSG) combined with dermal substitutes. The purpose of this study was to evaluate clinical outcomes of neck contracture treatment in extensive burn patients performing STSG with dermal substitutes as adjuvant treatment. Methods We analyzed the retrospective clinical and photographic records of 28 patients with severe neck contracture who were admitted to Hallym University Hangang Sacred Heart Hospital, Seoul, Korea, from January 2012 to December 2012. We performed STSG in combination with dermal substitutes to minimize the degree of contracture. Results The overall take rate of skin to dermal substitutes was 95.9%, and no grafts failed to affect recontracture except in one patient with a partial loss of artificial dermis who underwent a follow-up skin graft without any problems. Excellent/good outcomes were shown in 27 out of 28 patients. Conclusion In extensive burn patients, skin grafting in combination with dermal substitutes can be an alternative to STSG alone for contracture release. PMID:25368851

  2. Two types of amino acid substitutions in protein evolution

    Microsoft Academic Search

    Takashi Miyata; Sanzo Miyazawa; Teruo Yasunaga

    1979-01-01

    Summary The frequency of amino acid substitutions, relative to the frequency expected by chance, decreases linearly with the increase in physico-chemical differences between amino acid pairs involved in a substitution. This correlation does not apply to abnormal human hemoglobins. Since abnormal hemoglobins mostly reflect the process of mutation rather than selection, the correlation manifest during protein evolution between substitution frequency

  3. 40 CFR 721.562 - Substituted alkylamine salt.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...2013-07-01 false Substituted alkylamine salt. 721.562 Section 721.562 Protection... § 721.562 Substituted alkylamine salt. (a) Chemical substance and significant...generically as a substituted alkylamine salt (PMN P-85-941) is subject to...

  4. 40 CFR 721.562 - Substituted alkylamine salt.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...2012-07-01 false Substituted alkylamine salt. 721.562 Section 721.562 Protection... § 721.562 Substituted alkylamine salt. (a) Chemical substance and significant...generically as a substituted alkylamine salt (PMN P-85-941) is subject to...

  5. 40 CFR 721.562 - Substituted alkylamine salt.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 false Substituted alkylamine salt. 721.562 Section 721.562 Protection... § 721.562 Substituted alkylamine salt. (a) Chemical substance and significant...generically as a substituted alkylamine salt (PMN P-85-941) is subject to...

  6. 40 CFR 721.562 - Substituted alkylamine salt.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...2014-07-01 false Substituted alkylamine salt. 721.562 Section 721.562 Protection... § 721.562 Substituted alkylamine salt. (a) Chemical substance and significant...generically as a substituted alkylamine salt (PMN P-85-941) is subject to...

  7. Peer-Reviewed Articles Substitutability in Recreational Fishing

    Microsoft Academic Search

    ROBERT B. DITTON; STEPHEN G. SUTTON

    2004-01-01

    The authors wanted to know the extent to which anglers were willing to make substitution decisions when constrained, and identify explanatory variables for substitution decisions. Anglers were asked if there were other outdoor recreation activities that would provide them with the same satisfaction and enjoyment they received from fishing. About 51% said yes. The most fre- quently identified substitutes were

  8. Evolution of base-substitution gradients in primate mitochondrial genomes

    Microsoft Academic Search

    Sameer Z. Raina; Jeremiah J. Faith; Todd R. Disotell; Hervé Seligmann; Caro-Beth Stewart; David D. Pollock

    2005-01-01

    Inferences of phylogenies and dates of divergence rely on accurate modeling of evolutionary processes; they may be confounded by variation in substitution rates among sites and changes in evolutionary processes over time. In vertebrate mitochondrial genomes, substitution rates are affected by a gradient along the genome of the time spent being single-stranded during replication, and different types of substitutions respond

  9. The Single-Day Substitute: Achieving Dignity Despite Tradition.

    ERIC Educational Resources Information Center

    Recker, Terrance

    1985-01-01

    States that the problems of substitute teachers are caused by a breakdown of communication. Suggests that regular teachers leave the substitute a more complete and concise agenda as well as convince their pupils that substitutes are a vital part of the entire educational process. (EL)

  10. 76 FR 8666 - Substitution in Case of Death of Claimant

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-15

    ...RIN 2900-AN91 Substitution in Case of Death of Claimant AGENCY: Department of Veterans...may, not later than one year after the death of the claimant, request to be substituted...2900-AN91--Substitution in Case of Death of Claimant.'' Copies of comments...

  11. 76 FR 39062 - Substitution in Case of Death of Claimant

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-05

    ...RIN 2900-AN91 Substitution in Case of Death of Claimant AGENCY: Department of Veterans...proposed rule, ``Substitution in Case of Death of Claimant'' (76 FR 8666), published...2900-AN91--Substitution in Case of Death of Claimant.'' Copies of comments...

  12. Bone grafts, bone substitutes and orthobiologics

    PubMed Central

    Roberts, Timothy T.; Rosenbaum, Andrew J.

    2012-01-01

    The biology of fracture healing is better understood than ever before, with advancements such as the locking screw leading to more predictable and less eventful osseous healing. However, at times one’s intrinsic biological response, and even concurrent surgical stabilization, is inadequate. In hopes of facilitating osseous union, bone grafts, bone substitutes and orthobiologics are being relied on more than ever before. The osteoinductive, osteoconductive and osteogenic properties of these substrates have been elucidated in the basic science literature and validated in clinical orthopaedic practice. Furthermore, an industry built around these items is more successful and in demand than ever before. This review provides a comprehensive overview of the basic science, clinical utility and economics of bone grafts, bone substitutes and orthobiologics. PMID:23247591

  13. Substitutional alloy of Ce and Al

    PubMed Central

    Zeng, Qiao-Shi; Ding, Yang; Mao, Wendy L.; Luo, Wei; Blomqvist, Andreas; Ahuja, Rajeev; Yang, Wenge; Shu, Jinfu; Sinogeikin, Stas V.; Meng, Yue; Brewe, Dale L.; Jiang, Jian-Zhong; Mao, Ho-kwang

    2009-01-01

    The formation of substitutional alloys has been restricted to elements with similar atomic radii and electronegativity. Using high-pressure at 298 K, we synthesized a face-centered cubic disordered alloy of highly dissimilar elements (large Ce and small Al atoms) by compressing the Ce3Al intermetallic compound >15 GPa or the Ce3Al metallic glass >25 GPa. Synchrotron X-ray diffraction, Ce L3-edge absorption spectroscopy, and ab initio calculations revealed that the pressure-induced Kondo volume collapse and 4f electron delocalization of Ce reduced the differences between Ce and Al and brought them within the Hume-Rothery (HR) limit for substitutional alloying. The alloy remained after complete release of pressure, which was also accompanied by the transformation of Ce back to its ambient 4f electron localized state and reversal of the Kondo volume collapse, resulting in a non-HR alloy at ambient conditions. PMID:19188608

  14. Adrenopause und Dehydroepiandrosteron: Pharmakotherapie versus Substitution

    Microsoft Academic Search

    Alexander Römmler

    2003-01-01

    ZusammenfassungHintergrund: Die Adrenopause ist als alterstypische partielle Nebennierenrindeninsuffizienz durch erniedrigte Blutspiegel von Dehydroepiandrosteron (DHEA) und DHEA-Sulfat (DS) bei unverändertem Cortisol charakterisiert. Für DHEA sind eigenständige Wirkungen sowie solche als Vorläufer von Sexualhormonen im ZNS und in der Peripherie etabliert. Günstige epidemiologische Daten höherer DS-Spiegel bei Männern sowie positive klinische Berichte über eine DHEA-Substitution bei beiden Geschlechtern lassen seinen Einsatz zur

  15. LPC parameters substitution for speech information hiding

    Microsoft Academic Search

    Zhi-jun WU; Wei GAO; Wei YANG

    2009-01-01

    Information hiding techniques adopted in secret communication should meet the requirements of high hiding capacity, real-time and high robustness. For the purpose of real-time speech secure communication, an information hiding algorithm based on the analysis-by-synthesis (ABS) speech coding scheme is presented in this article. This algorithm substitutes secret speech data bits for linear predictive coefficients (LPCs) in linear predictive coding

  16. Copper Substituted Iron Telluride: A Phase Diagram

    NASA Astrophysics Data System (ADS)

    Valdivia, Patrick; SSRL Beamline 2-1 Collaboration; NIST Bt-1 Collaboration; Birgeneau Group Team

    2014-03-01

    Investigations of superconductivity in the FeCh family (Ch =S,Se,Te) have produced rich physics and notable materials challenges despite the ostensible simplicity of thE system. We have studied the effects of copper substitution in iron-telluride. We map out basic physical parameters of this phase diagram and invesitgate structure-property relationships through a variety of transport and diffraction measurements.

  17. Single ?³-amino acid substitutions to MOG peptides suppress the development of experimental autoimmune encephalomyelitis.

    PubMed

    McDonald, Courtney A; Payne, Natalie L; Sun, Guizhi; Clayton, Daniel J; Del Borgo, Mark P; Aguilar, Marie-Isabel; Perlmutter, Patrick; Bernard, Claude C A

    2014-12-15

    CD4(+) T-cells play a key role in the pathogenesis of multiple sclerosis (MS). Altered peptide ligands capable of modulating T-cell autoreactivity are considered a promising strategy for development of antigen-specific therapies for MS. Since peptides are inherently unstable, the current study explored single ?-amino acid substitution as a means of stabilizing an epitope of myelin oligodendrocyte glycoprotein. ?-Amino acid substitution at position 44, the major T-cell receptor contact residue, increased the half-life of active metabolites. Vaccination with one altered peptide, MOG44?F, conferred protection from EAE, decreased T-cell autoreactivity and pro-inflammatory cytokine production. Additional studies using MOG44?F in an oral treatment regimen, administered after EAE induction, also attenuated disease severity. Thus, altered peptides such as those reported here may lead to the development of novel and more specific treatments for MS. PMID:25454728

  18. 40 CFR 721.5930 - Phenylenebis[imino (chlorotriazinyl)imino(substituted naphthyl)azo(substituted phenyl)azo, sodium...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...azo(substituted phenyl)azo, sodium salt (generic name). 721.5930 Section...azo(substituted phenyl)azo, sodium salt (generic name). (a) Chemical substance...azo (substituted phenyl) azo, sodium salt (PMN P-95-274) is subject to...

  19. 40 CFR 721.5930 - Phenylenebis[imino (chlorotriazinyl)imino(substituted naphthyl)azo(substituted phenyl)azo, sodium...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...azo(substituted phenyl)azo, sodium salt (generic name). 721.5930 Section...azo(substituted phenyl)azo, sodium salt (generic name). (a) Chemical substance...azo (substituted phenyl) azo, sodium salt (PMN P-95-274) is subject to...

  20. 40 CFR 721.5930 - Phenylenebis[imino (chlorotriazinyl)imino(substituted naphthyl)azo(substituted phenyl)azo, sodium...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...azo(substituted phenyl)azo, sodium salt (generic name). 721.5930 Section...azo(substituted phenyl)azo, sodium salt (generic name). (a) Chemical substance...azo (substituted phenyl) azo, sodium salt (PMN P-95-274) is subject to...

  1. n engl j med 353;17 www.nejm.org october 27, 2005 correspondence

    E-print Network

    Steinbach, Joe Henry

    Francisco, CA 94143 Potential for Abuse of Buprenorphine in Office-Based Treatment of Opioid DependenceAdministration(DEA)expressedconcern that the use of buprenorphine in opioid-dependent populations would inevitably lead to its diversion and abuse.1,2 Thus, buprenorphine was moved from Schedule V of the Controlled Substances Act to

  2. S216 CID 2006:43 (Suppl 4) Bruce et al. S U P P L E M E N T A R T I C L E

    E-print Network

    Steinbach, Joe Henry

    Interactions between Buprenorphine and Antiretroviral Medications R. Douglas Bruce,1 Elinore McCance-Katz,2 at Buffalo, State University of New York, Buffalo Buprenorphine is used for the treatment of opioid to grow, so too does the existence and clinical impact of drug interactions between buprenorphine

  3. Composite bone substitutes prepared by two methods

    NASA Astrophysics Data System (ADS)

    Lee, Hoe Y.

    A variety of ceramics and polymers exists that can be used as bone substitute materials with desirable properties such as biocompatibility and osteoconductivity. A key feature missing in these bone substitutes, or scaffolds, is the ability to bear loads. This work explored two methods for solving this problem. The first used cancellous bone taken from bovine femoral bone to create a natural scaffold through a heat treating process that eliminated the organic components and sintered the bone minerals, known as hydroxyapatite, together. The strength and Young's modulus of the natural scaffold were greatly improved after polymer infiltration with polymethylmethacrylate. Unfortunately, compression testing revealed that there was not a good interfacial bond between the mineral and polymer phases. The second method employed a freeze-casting technique to create synthetic hydroxyapatite scaffolds that have an aligned lamellar microstructure. By varying the amount of hydroxyapatite in the initial slurry mixture and the cooling rate, synthetic scaffolds with a range of porosities and strengths was produced. The highest solid loading and fastest cooling rate produced a scaffold with a strength and modulus approaching that of cortical bone. Further study is required to produce a two phase composite that is chemically bonded together for optimal performance. The synthetic scaffolds, with their tunable mechanical properties and ease of fabrication, make them a promising material for a load-bearing bone substitute.

  4. Variance estimation for nucleotide substitution models.

    PubMed

    Chen, Weishan; Wang, Hsiuying

    2015-09-01

    The current variance estimators for most evolutionary models were derived when a nucleotide substitution number estimator was approximated with a simple first order Taylor expansion. In this study, we derive three variance estimators for the F81, F84, HKY85 and TN93 nucleotide substitution models, respectively. They are obtained using the second order Taylor expansion of the substitution number estimator, the first order Taylor expansion of a squared deviation and the second order Taylor expansion of a squared deviation, respectively. These variance estimators are compared with the existing variance estimator in terms of a simulation study. It shows that the variance estimator, which is derived using the second order Taylor expansion of a squared deviation, is more accurate than the other three estimators. In addition, we also compare these estimators with an estimator derived by the bootstrap method. The simulation shows that the performance of this bootstrap estimator is similar to the estimator derived by the second order Taylor expansion of a squared deviation. Since the latter one has an explicit form, it is more efficient than the bootstrap estimator. PMID:25981189

  5. Using mid-level cadres as substitutes for internationally mobile health professionals in Africa. A desk review

    PubMed Central

    Dovlo, Delanyo

    2004-01-01

    Background Substitute health workers are cadres who take on some of the functions and roles normally reserved for internationally recognized health professionals such as doctors, pharmacists and nurses but who usually receive shorter pre-service training and possess lower qualifications. Methods A desk review is conducted on the education, regulation, scopes of practice, specialization, nomenclature, retention and cost-effectiveness of substitute health workers in terms of their utilization in countries such as Tanzania, Malawi, Mozambique, Zambia, Ghana etc., using curricula, evaluations and key-informant questionnaires. Results The cost-effectiveness of using substitutes and their relative retention within countries and in rural communities underlies their advantages to African health systems. Some studies comparing clinical officers and doctors show minimal differences in outcomes to patients. Specialized substitutes provide services in disciplines such as surgery, ophthalmology, orthopedics, radiology, dermatology, anesthesiology and dentistry, demonstrating a general bias of use for clinical services. Conclusions The findings raise interest in expanding the use of substitute cadres, as the demands of expanding access to services such as antiretroviral treatment requires substantial human resources capacity. Understanding the roles and conditions under which such cadres best function, and managing the skepticism and professional turf protection that restricts their potential, will assist in effective utilization of substitutes. PMID:15207010

  6. Using mid-level cadres as substitutes for internationally mobile health professionals in Africa. A desk review.

    PubMed

    Dovlo, Delanyo

    2004-06-18

    BACKGROUND: Substitute health workers are cadres who take on some of the functions and roles normally reserved for internationally recognized health professionals such as doctors, pharmacists and nurses but who usually receive shorter pre-service training and possess lower qualifications. METHODS: A desk review is conducted on the education, regulation, scopes of practice, specialization, nomenclature, retention and cost-effectiveness of substitute health workers in terms of their utilization in countries such as Tanzania, Malawi, Mozambique, Zambia, Ghana etc., using curricula, evaluations and key-informant questionnaires. RESULTS: The cost-effectiveness of using substitutes and their relative retention within countries and in rural communities underlies their advantages to African health systems. Some studies comparing clinical officers and doctors show minimal differences in outcomes to patients. Specialized substitutes provide services in disciplines such as surgery, ophthalmology, orthopedics, radiology, dermatology, anesthesiology and dentistry, demonstrating a general bias of use for clinical services. CONCLUSIONS: The findings raise interest in expanding the use of substitute cadres, as the demands of expanding access to services such as antiretroviral treatment requires substantial human resources capacity. Understanding the roles and conditions under which such cadres best function, and managing the skepticism and professional turf protection that restricts their potential, will assist in effective utilization of substitutes. PMID:15207010

  7. A Bilayer Engineered Skin Substitute for Wound Repair in an Irradiation-Impeded Healing Model on Rat

    PubMed Central

    Mohd Hilmi, A.B.; Hassan, Asma; Halim, Ahmad Sukari

    2015-01-01

    Objective: An engineered skin substitute is produced to accelerate wound healing by increasing the mechanical strength of the skin wound via high production of collagen bundles. During the remodeling stage of wound healing, collagen deposition is the most important event. The collagen deposition process may be altered by nutritional deficiency, diabetes mellitus, microbial infection, or radiation exposure, leading to impaired healing. This study describes the fabrication of an engineered bilayer skin substitute and evaluates its effectiveness for the production of collagen bundles in an impaired healing model. Approach: Rats were exposed to 10 Gy of radiation. Two months postirradiation, the wounds were excised and treated with one of three skin replacement products: bilayer engineered skin substitutes, chitosan skin templates, or duoderm©. The collagen deposition was analyzed by hematoxylin and eosin staining. Results: On day 21 postwound, the irradiated wounds displayed increased collagen bundle deposition after treatment using bilayer engineered skin substitutes (3.4±0.25) and chitosan skin templates (3.2±0.58) compared with duoderm (2.0±0.63). Innovation: We provide the first report on the fabrication of bilayer engineered skin substitutes using high density human dermal fibroblasts cocultured with HFSCs on chitosan skin templates. Conclusion: The high density of fibroblasts significantly increases the penetration of cells into chitosan skin templates, contributing to the fabrication of bilayer engineered skin substitute. PMID:26005597

  8. A review of opioid dependence treatment: pharmacological and psychosocial interventions to treat opioid addiction.

    PubMed

    Veilleux, Jennifer C; Colvin, Peter J; Anderson, Jennifer; York, Catherine; Heinz, Adrienne J

    2010-03-01

    Opioid dependence is a problem of national concern, especially with dramatically increased rates of abuse and dependence of prescription opioids. The current article provides an up-to-date review of the literature on opioid dependence treatment, with a focus on conclusions drawn by experts in the field (e.g., Cochrane reviews and meta-analyses) and methodologically rigorous studies (e.g., randomized controlled trials). We describe the major classes of drug treatments available, including opioid agonist (e.g., methadone, buprenorphine, LAAM), antagonist (e.g., naltrexone) and non-opioid pharmacotherapies (e.g., alpha2 adrenergic agonists). These treatments are discussed in the context of detoxification and long term treatment options such as abstinence-based and maintenance strategies. We review the state of the literature as to prevention of opioid overdose and discuss the widespread problem of comorbidity among opioid-dependent populations. We also focus prominently on evidence for inclusion of psychosocial approaches in treatment regimens, either as stand-alone or in conjunction with psychopharmacological options. PMID:19926374

  9. Abstract Navigation for blind persons represents a challenge for researchers in vision substitution. In this field, one of the

    E-print Network

    Paris-Sud XI, Université de

    sensor (e.g. a digital camera). A treatment unit converts the visual information (i.e. the image captured.g. the tactilo-kinesthetic modality, with the perception of an electro-tactile or vibro-tactile image ) and then understood by the Central Nervous System. By the end of the 60's the first tactile visual substitution system

  10. FTIRI Parameters describing Acid Phosphate Substitution in Biologic Hydroxyapatite

    PubMed Central

    Spevak, Lyudmila; Flach, Carol R.; Hunter, Tracey; Mendelsohn, Richard; Boskey, Adele

    2013-01-01

    Acid phosphate substitution into mineralized tissue is an important determinant of their mechanical properties and their response to treatment. This study identifies and validates Fourier Transform Infrared Spectroscopic Imaging (FTIRI) spectral parameters that provide information on the acid phosphate (HPO4) substitution into hydroxyapatite in developing mineralized tissues. Curve fitting and Fourier self-deconvolution were used to identify subband positions in model compounds (with and without HPO4). The intensity of subbands at 1127 cm?1 and 1110 cm?1 correlated with the acid phosphate content in these models. Peak height ratios of these subbands to the ?3 vibration at 1096 cm?1 found in stoichiometric apatite, were evaluated in the model compounds and mixtures thereof. FTIRI spectra of bones and teeth at different developmental ages were analyzed using these spectral parameters. Factor analysis (a chemometric technique) was also conducted on the tissue samples and resulted in factor loadings with spectral features corresponding to the HPO4 vibrations described above. Images of both factor correlation coefficients and the peak height ratios 1127cm?1/1096cm?1 and 1112cm?1/1096cm?1 demonstrated higher acid phosphate content in younger vs. more mature regions in the same specimen. Maps of the distribution of acid phosphate content will be useful for characterizing the extent of new bone formation, areas of potential decreased strength, and the effects of therapies such as those used in metabolic bone diseases (osteoporosis, chronic kidney disease) on mineral composition. Because of the wider range of values obtained with the 1127 cm?1/1096 cm?1 parameter compared to the 1110 cm?1/1096 cm?1 parameter, and the smaller scatter in the slope, it is suggested that this ratio should be the parameter of choice. PMID:23380987

  11. Modeling of Substitutional Site Preference in Ordered Intermetallic Alloys

    NASA Technical Reports Server (NTRS)

    Bozzolo, Guillermo; Noebe, Ronald D.; Honecy, Frank

    1998-01-01

    We investigate the site substitution scheme of specific alloying elements in ordered compounds and the dependence of site occupancy on compound stoichiometry, alloy concentration. This basic knowledge, and the interactions with other alloying additions are necessary in order to predict and understand the effect of various alloying schemes on the physical properties of a material, its response to various temperature treatments, and the resulting mechanical properties. Many theoretical methods can provide useful but limited insight in this area, since most techniques suffer from constraints in the type of elements and the crystallographic structures that can be modeled. With this in mind, the Bozzolo-Ferrante-Smith (BFS) method for alloys was designed to overcome these limitations, with the intent of providing an useful tool for the theoretical prediction of fundamental properties and structure of complex systems. After a brief description of the BFS method, its use for the determination of site substitution schemes for individual as well as collective alloying additions to intermetallic systems is described, including results for the concentration dependence of the lattice parameter. Focusing on B2 NiAl, FeAl and CoAl alloys, the energetics of Si, Ti, V, Cr, Fe, Co, Ni, Cu, Zr, Nb, Mo, Ru, Hf, Ta and W alloying additions are surveyed. The effect of single additions as well as the result of two simultaneous additions, discussing the interaction between additions and their influence on site preference schemes is considered. Finally, the BFS analysis is extended to ternary L1(sub 2) (Heusler phase) alloys. A comparison between experimental and theoretical results for the limited number of cases for which experimental data is available is also included.

  12. Synthesis and Antiulcer Activity Studies of 2-(1?-Iminothioimido Substituted)-1?-Substituted Phenylbenzoic acids

    PubMed Central

    Subudhi, B. B.; Bhatta, D.; Panda, P. K.; Mishra, P.; Pradhan, D.

    2008-01-01

    Certain 2-(1'-iminothioimido substituted)-1'-substituted phenybenzoic acids (P1-9) were synthesized by reaction of phthalic anhydride with benzotriazole, 2-mercapto benzothiazole and 2-p-amino phenyl benzimidazole, respectively (A1-3) followed by imine formation with Schiff bases of thiourea with salicylaldehyde, furfuraldehyde and 1-phenyl-3-methyl-5-pyrazolone. Antiulcer activity was evaluated using reduction in total acidity, free acidity and ulcer index as parameters. Compounds P3, P6, P7 and P9(100 mg/kg) showed significant (P< 0.001) antiulcer action compared to control and omeprazole (40 mg/kg). PMID:20046753

  13. Cationic gold clusters ligated with differently substituted phosphines: effect of substitution on ligand reactivity and binding.

    PubMed

    Johnson, Grant E; Olivares, Astrid; Hill, David; Laskin, Julia

    2015-05-27

    We present a systematic study of the effect of the number of methyl (Me) and cyclohexyl (Cy) functional groups in monodentate phosphine ligands on the solution-phase synthesis of ligated sub-nanometer gold clusters and their gas-phase fragmentation pathways. Small mixed ligand cationic gold clusters were synthesized using reactions between pre-formed triphenylphosphine ligated (PPh3) gold clusters and monodentate Me- and Cy-substituted phosphine ligands in solution and characterized using electrospray ionization mass spectrometry (ESI-MS) and collision-induced dissociation (CID) experiments. Under the same experimental conditions, larger gold-PPh3 clusters undergo efficient exchange of unsubstituted PPh3 ligands for singly Me- and Cy-substituted PPh2Me and PPh2Cy ligands. The efficiency of reaction decreases with an increasing number of Me or Cy groups in the substituted phosphine ligands. CID experiments performed for a series of mixed-ligand gold clusters indicate that loss of a neutral Me-substituted ligand is preferred over loss of a neutral PPh3 ligand while the opposite trend is observed for Cy-substituted ligands. The branching ratio of the competing ligand loss channels is strongly correlated with the electron donating ability of the phosphorous lone pair as determined by the relative proton affinity of the ligand. The results indicate that the relative ligand binding energies increase in the order PMe3 < PPhMe2 < PPh2Me < PPh3 < PPh2Cy < PPhCy2 < PCy3. Furthermore, the difference in relative ligand binding energies increases with the number of substituted PPh3-mMem or PPh3-mCym ligands (L) on each cluster. This study provides the first experimental determination of the relative binding energies of ligated gold clusters containing differently substituted monophosphine ligands, which are important to controlling their synthesis and reactivity in solution. The results also indicate that ligand substitution is an important parameter that must be considered in theoretical modeling of these complex systems. PMID:25971528

  14. Acceptability of blood and blood substitutes.

    PubMed

    Ferguson, E; Prowse, C; Townsend, E; Spence, A; Hilten, J A van; Lowe, K

    2008-03-01

    Alternatives to donor blood have been developed in part to meet increasing demand. However, new biotechnologies are often associated with increased perceptions of risk and low acceptance. This paper reviews developments of alternatives and presents data, from a field-based experiment in the UK and Holland, on the risks and acceptance of donor blood and alternatives (chemical, genetically modified and bovine). UK groups perceived all substitutes as riskier than the Dutch. There is a negative association between perceived risk and acceptability. Solutions to increasing acceptance are discussed in terms of implicit attitudes, product naming and emotional responses. PMID:18205767

  15. Cyclizations of phenylethyl-substituted pyridinecarboxaldehydes.

    PubMed

    Naredla, Rajasekhar Reddy; Klumpp, Douglas A

    2013-03-01

    Several phenylethyl-substituted pyridinecarboxaldehydes were prepared from 2-bromo-3-pyridinecarboxaldehyde and these substances are found to undergo cyclization reactions in acidic media. In the absence of added nucleophile, acid promoted cyclization and oxidation (MnO2) provides an efficient route to 10,11-dihydro-5H-benzo[4,5]cyclohepta[1,2-b]pyridin-5-ones. Arene nucleophiles may also be added to the acidic mixture to provide good yields of triarylmethane products. Mechanisms are proposed involving dicationic superelectrophilic intermediates. PMID:24143036

  16. Substituted Ureas. Methods of Synthesis and Applications

    NASA Astrophysics Data System (ADS)

    Vishnyakova, T. P.; Golubeva, I. A.; Glebova, E. V.

    1985-03-01

    Systematic data on the method of synthesis of ureas by the interaction of compounds containing the amino-group with organic isocyanates, of amines and alkyl halides with alkali metal cyanates, and of primary and secondary amines with phosgene, carbon dioxide, urea, or nitrourea and by the carbonylation of amines are presented. The reactions involving the alkylation of urea and its interaction with various compounds containing functional groups are considered. The advantages and disadvantages of various methods are noted. The principal and practical applications of substituted ureas, including their applications as additives to organic materials, are discussed. The bibliography includes 314 references.

  17. Differences in Frontal Cortical Activation by a Working Memory Task after Substitution of Risperidone for Typical Antipsychotic Drugs in Patients with Schizophrenia

    Microsoft Academic Search

    Garry D. Honey; Edward T. Bullmore; William Soni; Malini Varatheesan; Steve C. R. Williams; Tonmoy Sharma

    1999-01-01

    Antipsychotic drug treatment of schizophrenia may be complicated by side effects of widespread dopaminergic antagonism, including exacerbation of negative and cognitive symptoms due to frontal cortical hypodopaminergia. Atypical antipsychotics have been shown to enhance frontal dopaminergic activity in animal models. We predicted that substitution of risperidone for typical antipsychotic drugs in the treatment of schizophrenia would be associated with enhanced

  18. 40 CFR 721.8775 - Substituted pyridines.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...treatment in a lined, self-contained solar evaporation pond where UV light will degrade...treatment in a lined, self-contained solar evaporation pond where UV light will degrade...treatment in a lined, self-contained solar evaporation pond where UV light will...

  19. 40 CFR 721.8775 - Substituted pyridines.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...treatment in a lined, self-contained solar evaporation pond where UV light will degrade...treatment in a lined, self-contained solar evaporation pond where UV light will degrade...treatment in a lined, self-contained solar evaporation pond where UV light will...

  20. 40 CFR 721.2095 - Chromate(3-), bis 2-[[substituted-3-[(5-sulfo-1-naphthalenyl)azo] phenyl]azo]substituted...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...5-sulfo-1-naphthalenyl)azo] phenyl]azo]substituted monocycle, trisodium...5-sulfo-1-naphthalenyl)azo] phenyl]azo]substituted monocycle, trisodium...5-sulfo-1-naphthalenyl) azo]phenyl]azo]substituted monocycle,...