Morphine administered post-trial can induce potent conditioned morphine effects

2019 ◽  
Vol 179 ◽  
pp. 134-141 ◽  
Author(s):  
Lucas Rangel de Oliveira ◽  
Breno Garone dos Santos ◽  
João Marcos de Mello Bastos ◽  
Richard Ian Samuels ◽  
Robert J. Carey ◽  
...  
Keyword(s):  
Post Trial

Retrospective analysis on the effect of spinal cord stimulation on opioid consumption

2020 ◽  
Author(s):  
Awinita Barpujari ◽  
Michael A Erdek
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Retrospective Analysis ◽  
Spinal Cord Stimulation ◽  
Alternative Therapy ◽  
Opioid Consumption ◽  
Opioid Use ◽  
Number Of Patients ◽  
Chronic Pain Conditions ◽  
Post Trial

Aim: Spinal cord stimulation (SCS) is used to clinically manage and/or treat several chronic pain etiologies. A limited amount is known about the influence on patients' use of opioid pain medication. This retrospective analysis evaluated SCS effect on opioid consumption in patients presenting with chronic pain conditions. Materials & methods: Sixty-seven patients underwent a temporary trial device, permanent implant or both. Patients were divided for assessment based on the nature of their procedure(s). Primary outcome was change in morphine equivalent dose (MED), ascertained from preoperative and postoperative medication reports. Results: Postoperative MED was significantly lower in patients who received some form of neuromodulation therapy. Pretrial patients reported an average MED of 41.01 ± 10.23 mg per day while post-trial patients reported an average of 13.30 ± 5.34 mg per day (p < 0.001). Pre-implant patients reported an average MED of 39.14 ± 13.52 mg per day while post-implant patients reported an average MED of 20.23 ± 9.01 mg per day (p < 0.001). There were no significant differences between pre-trial and pre-implant MED, nor between post-trial and post-implant MED. Of the 42 study subjects who reported some amount of pre-intervention opioid use, 78.57% indicated a lower MED (n = 33; p < 0.001), 16.67% indicated no change (n = 7) and 4.76% (n = 2) indicated a higher MED, following intervention. Moreover, SCS therapy resulted in a 26.83% reduction (p < 0.001) in the number of patients with MED >50 mg per day. Conclusion: Spinal cord stimulation may reduce opioid use when implemented appropriately. Neuromodulation may represent alternative therapy for alleviating chronic pain which may avoid a number of deleterious side effects commonly associated with opioid consumption.

The pharmacology of post-trial memory processing in septum

1998 ◽  
Vol 350 (1) ◽  
pp. 31-38 ◽  
Author(s):  
James F Flood ◽  
Susan A Farr ◽  
Kayoko Uezu ◽  
John E Morley
Keyword(s):  
Memory Processing ◽  
Post Trial

scholarly journals Recovery facilitation with Montmorency cherries following high-intensity, metabolically challenging exercise

2015 ◽  
Vol 40 (4) ◽  
pp. 414-423 ◽  
Author(s):  
Phillip G. Bell ◽  
Ian H. Walshe ◽  
Gareth W. Davison ◽  
Emma J. Stevenson ◽  
Glyn Howatson
Keyword(s):  
High Intensity ◽  
Functional Performance ◽  
High Sensitivity ◽  
Lipid Hydroperoxides ◽  
Necrosis Factor Alpha ◽  
Maximum Voluntary Isometric Contraction ◽  
Exercise Induced ◽  
Post Trial ◽  
S Peak ◽  
The Impact

The impact of Montmorency tart cherry (Prunus cerasus L.) concentrate (MC) on physiological indices and functional performance was examined following a bout of high-intensity stochastic cycling. Trained cyclists (n = 16) were equally divided into 2 groups (MC or isoenergetic placebo (PLA)) and consumed 30 mL of supplement, twice per day for 8 consecutive days. On the fifth day of supplementation, participants completed a 109-min cycling trial designed to replicate road race demands. Functional performance (maximum voluntary isometric contraction (MVIC), cycling efficiency, 6-s peak cycling power) and delayed onset muscle soreness were assessed at baseline, 24, 48, and 72 h post-trial. Blood samples collected at baseline, immediately pre- and post-trial, and at 1, 3, 5, 24, 48, and 72 h post-trial were analysed for indices of inflammation (interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor alpha, high-sensitivity C-reactive protein (hsCRP)), oxidative stress (lipid hydroperoxides), and muscle damage (creatine kinase). MVIC (P < 0.05) did not decline in the MC group (vs. PLA) across the 72-h post-trial period and economy (P < 0.05) was improved in the MC group at 24 h. IL-6 (P < 0.001) and hsCRP (P < 0.05) responses to the trial were attenuated with MC (vs. PLA). No other blood markers were significantly different between MC and PLA groups. The results of the study suggest that Montmorency cherry concentrate can be an efficacious functional food for accelerating recovery and reducing exercise-induced inflammation following strenuous cycling exercise.

scholarly journals Continuous intraperitoneal insulin infusion in type 1 diabetes: a 6-year post-trial follow-up

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Peter R van Dijk ◽  
Susan JJ Logtenberg ◽  
Klaas H Groenier ◽  
Rijk OB Gans ◽  
Nanne Kleefstra ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Infusion ◽  
Intraperitoneal Insulin ◽  
Post Trial

scholarly journals Effectiveness and cost-effectiveness of implementing HIV testing in primary care in East London: protocol for an interrupted time series analysis

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018163 ◽  
Author(s):  
Werner Leber ◽  
Lee Beresford ◽  
Claire Nightingale ◽  
Estela Capelas Barbosa ◽  
Stephen Morris ◽  
...  
Keyword(s):  
Primary Care ◽  
Time Series ◽  
General Practice ◽  
Cost Effectiveness ◽  
Hiv Testing ◽  
Cost Effective ◽  
Interrupted Time Series ◽  
Rapid Hiv Testing ◽  
Post Trial ◽  
Implementation Programme

IntroductionHIV remains underdiagnosed. Guidelines recommend routine HIV testing in primary care, but evidence on implementing testing is lacking. In a previous study, the Rapid HIV Assessment 2 (RHIVA2) cluster randomised controlled trial, we showed that providing training and rapid point-of-care HIV testing at general practice registration (RHIVA2 intervention) in Hackney led to cost-effective, increased and earlier diagnosis of HIV. However, interventions effective in a trial context may be less so when implemented in routine practice. We describe the protocol for an MRC phase IV implementation programme, evaluating the impact of rolling out the RHIVA2 intervention in a post-trial setting. We will use a longitudinal study to examine if the post-trial implementation in Hackney practices is effective and cost-effective, and a cross-sectional study to compare Hackney with two adjacent boroughs providing usual primary care (Newham) and an enhanced service promoting HIV testing in primary care (Tower Hamlets).Methods and analysisService evaluation using interrupted time series and cost-effectiveness analyses. We will include all general practices in three contiguous high HIV prevalence East London boroughs. All adults aged 16 and above registered with the practices will be included. The interventions to be examined are: a post-trial RHIVA2 implementation programme (including practice-based education and training, external quality assurance, incentive payments for rapid HIV testing and incorporation of rapid HIV testing in the sexual health Local Enhanced Service) in Hackney; the general practice sexual health Network Improved Service in Tower Hamlets and usual care in Newham. Coprimary outcomes are rates of HIV testing and new HIV diagnoses.Ethics and disseminationThe chair of the Camden and Islington NHS Research Ethics Committee, London, has endorsed this programme as an evaluation of routine care. Study results will be published in peer-reviewed journals and reported to commissioners.

Retention disruption following post-trial picrotoxin injection into the substantia nigra

1976 ◽  
Vol 113 (3) ◽  
pp. 620-625 ◽  
Author(s):  
Haing-Ja Kim ◽  
Aryeh Routtenberg
Keyword(s):  
Substantia Nigra ◽  
Post Trial

A Thankfully Wide Sea between England and Apprendi-Land

2020 ◽  
Author(s):  
Thomas Curr
Keyword(s):  
Reasonable Doubt ◽  
State Courts ◽  
Guilty Plea ◽  
Previous Evidence ◽  
The Us ◽  
Before And After ◽  
American Law ◽  
Fact Finding ◽  
Post Trial ◽  
Trial Phase

ABSTRACT This article uses the US Supreme Court’s line of cases beginning with Apprendi v. New Jersey to illuminate territory in which English law, in comparison to American law, is comparatively underdeveloped—currently affording a Newton-style hearing only where a guilty plea obliterates any previous evidence. This need not be so. Both before and after Apprendi, US federal and state courts have implemented post-trial fact-finding procedures for sentencing purposes, and we could do the same. The Davies case, where the requirement of proof beyond a reasonable doubt was imported from the trial phase, into consideration of the statutory starting points for murder sentencing, will, for reasons to be given, be doubted.

Abstract 3622: End of Trial Period for Randomized Controlled Cardiology Trials: Is patient safety monitored and protected?

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Mohammad I Zia ◽  
Ronald Heslegrave ◽  
Gary E Newton
Keyword(s):  
Study Drug ◽  
Ethical Review ◽  
Trial Participation ◽  
List Type ◽  
Negative Consequences ◽  
Trial Period ◽  
Study Drug Administration ◽  
Consent Forms ◽  
Post Trial

Background: The post trial period is the period after the end of study drug administration. The Declaration of Helsinki (DOH) states that “at the conclusion of the study, every patient entered into the study should be assured of access to the best proven prophylactic, diagnostic and therapeutic methods identified by the study.” It further adds that “post trial access arrangements or other care must be described in the study protocol so the ethical review committee may consider such arrangements during its review.” Therefore our objectives were: to determine whether research trial protocols systematically consider post trial period issues including planned follow-up and patient surveillance in the post trial period; and to assess if consent forms addressed end of trial issues. Methods: We searched the research ethics board (REB) databases at 2 academic institutions in Toronto from 1995 to 2006 to identify approved randomized clinical trials of chronic medical therapies for cardiac conditions. Results: Fourty-two studies were identified including 18 heart failure and 15 coronary artery disease trials. Thirty-eight of these trials were industry funded. Almost all trials (n=37) ended study drug abruptly at the last clinic visit, while only 4 studies offered a clinical visit post trial termination, and an additional 3 reported a telephone contact after trial completion. Only 5 trials submitted consent forms to the REB with a discussion of the post trial period. After REB review, no additional consent forms addressed the post trial period. When comparing the time period before and after the updated version of the DOH in 2000, there was a trend towards a decline in addressing post trial care (p=0.08). Conclusion: The majority of cardiac trials end study drug abruptly with unknown and potentially negative consequences, and most patients have no systematic post trial follow up from trial investigators. Study patients are also not made aware of the post trial period, as the majority of study consent forms do not discuss post trial care. Therefore, an important aspect of clinical trial design, the post trial period, could be improved by systematic follow-up described in the protocol, and full discussion of this aspect of trial participation in the consent form.

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