Letteratura scientifica selezionata sul tema "Overdose"

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Articoli di riviste sul tema "Overdose"

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Hacker, Karen, Latika Davis Jones, LuAnn Brink, Abby Wilson, Marc Cherna, Erin Dalton, and Eric G. Hulsey. "Linking Opioid-Overdose Data to Human Services and Criminal Justice Data: Opportunities for Intervention." Public Health Reports 133, no. 6 (October 9, 2018): 658–66. http://dx.doi.org/10.1177/0033354918803938.

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Objectives: In Allegheny County, Pennsylvania, the incidence of opioid-related overdose deaths increased from 17.4 per 100 000 population in 2008 to 23.9 per 100 000 population in 2014. Our objectives were to describe local demographic characteristics of this epidemic, identify public human services targets for intervention, determine temporal relationships between use of public human services and overdose mortality, and provide recommendations about potentially beneficial interventions. Methods: We used autopsy data from the Allegheny County Medical Examiner to link people who died of overdoses from 2008 through 2014 to their premortem incarcerations and use of mental health services and substance use disorder services. We calculated the frequency of use of public human services by decedents and the interval between the last use of these services and overdose death. Results: Of the 1399 decedents, 957 (68.4%) had a public human service encounter before overdose death. Of these 957 decedents, 531 (55.5%) had ever been incarcerated, 616 (64.4%) had ever used a mental health service, and 702 (73.4%) had ever used a substance use disorder service. Of 211 decedents incarcerated in the year before their overdose death, 54 (25.6%) overdosed within 30 days of their last release from jail. Of 510 decedents using mental health services in the year before death, 231 (45.3%) overdosed within 30 days of their last use of the services. Of 350 decedents using substance use disorder services in the year before their overdose death, 134 (38.3%) overdosed within 30 days of their last use of the services. Conclusions: Merging data on overdose mortality with data on use of public human services can be a useful strategy to identify trends in, and factors contributing to, the opioid epidemic; to target interventions; and to stimulate collaboration to address the epidemic.
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Latkin, Carl A., Lauren Dayton, Melissa Davey-Rothwell, and Abenaa Jones. "The Relationship Between Methadone and Buprenorphine Enrollment and Overdose Prevention and Treatment Behaviors Among a Community Sample of People Who Use Opioids in Baltimore, Maryland." International Journal of Environmental Research and Public Health 22, no. 2 (February 3, 2025): 213. https://doi.org/10.3390/ijerph22020213.

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Background: Methadone and buprenorphine can reduce overdose-related mortality. Behavioral approaches can also reduce fatal overdoses. The current study examined the relationship between methadone and buprenorphine and overdose history and overdose prevention and treatment behaviors. Methods: Between December 2022 and August 2024, 647 individuals who used opioids in the prior month enrolled in a community recruited study on overdose. Participants were administered a face-to-face survey. Key behaviors assessed included overdose recency, testing drugs for potency, ingesting drugs slowly, using fentanyl test strips, using drugs alone, and carrying naloxone. Chi-square and logistic regression models examined the relationships between methadone and buprenorphine and overdose-related outcomes. Results: In total, 32.9% of participants were currently taking methadone and 15.5% buprenorphine. Most (69.2%) reported ever overdosing, and among those, 33.7% had overdosed within the prior 6 months. There were no significant associations between methadone or buprenorphine status and overdose prevention and care behaviors. In the multivariable logistic regression model, methadone use was associated with a lower odds ratio (aOR = 0.49, 95% CI = 0.30–0.79of a recent overdose compared to buprenorphine. Daily or almost daily crack use was associated with greater odds of a recent overdose (aOR = 2.21, 95% CI = 1.44–3.39. Discussion: Findings suggest the importance of promoting overdose prevention and care behaviors to people in drug treatment and training them to promote overdose prevention and care behaviors among their drug-using network members and other community members.
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Marziali, Megan E., Katherine W. Kooij, Wendy Zhang, Michael Budu, Silvia S. Martins, Julio S. G. Montaner, and Robert S. Hogg. "Fatal overdoses among people with HIV experiencing nonfatal overdoses in British Columbia, Canada." AIDS 39, no. 3 (January 30, 2025): 328–30. https://doi.org/10.1097/qad.0000000000004039.

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The breadth of the overdose crisis is underestimated because of a lack of quantifying nonfatal overdoses. We estimate the proportion of nonfatal overdoses among all people with HIV (PWH) in British Columbia, Canada, and the prevalence of fatal overdoses among people who had a nonfatal overdose, stratified by sex. A small proportion of PWH who experienced a nonfatal overdose subsequently died of a fatal overdose, signaling opportunities for crucial interventions and treatment to prevent overdose death.
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Baca-García, Enrique, Carmen Diaz-Sastre, Jeronimo Saiz-Ruiz, and Jose de Leon. "How safe are psychiatric medications after a voluntary overdose?" European Psychiatry 17, no. 8 (December 2002): 466–70. http://dx.doi.org/10.1016/s0924-9338(02)00706-x.

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SummaryPurpose.This study assessed psychiatric medications and their potential lethality in a representative sample of suicide attempts.Materials and methods.During 1996–98, 563 suicide attempts were studied in a general hospital in Madrid (Spain). Medication overdose was used in 456 suicide attempts (81%). The ratio between dose taken and maximum prescription dose recommended was used to evaluate the medication toxicity.Results.Benzodiazepines were the drugs most often used in self-poisoning (65% of overdoses), followed by new antidepressants (11%), tricyclic antidepressants (TCAs) (10%), and antipsychotics (8%). An overdose with any of the three latter psychiatric medications was significantly more frequent in patients prescribed those medications. The overdoses for TCA were potentially lethal in 47% of the cases. However, all patients who overdosed on psychiatric medications recovered well and were discharged without any sequelae.Discussion.This study suggests that psychiatric medications, particularly benzodiazepines, new antidepressants and antipsychotics, are relatively safe when they are used for self-poisoning. If patients with mental illnesses are under treated, there is a clear and documented higher risk for suicide.Conclusion.It is better to prescribe psychiatric medications, particularly the new ones, rather than withhold them due to an exaggerated fear of a lethal overdose
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Griffith, Jennifer, Laura C. Chambers, Benjamin D. Hallowell, Ashley Gaipo, Craig Mailloux, Janette Baird, Francesca L. Beaudoin, and Elizabeth A. Samuels. "Examination of the Accuracy of Existing Overdose Surveillance Systems." JAMA Network Open 6, no. 6 (June 28, 2023): e2320789. http://dx.doi.org/10.1001/jamanetworkopen.2023.20789.

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ImportanceHealth departments have used a variety of methods for overdose surveillance, and the Centers for Disease Control and Prevention (CDC) is implementing a standardized case definition to improve overdose surveillance nationally. The comparative accuracy of the CDC opioid overdose case definition vs existing state opioid overdose surveillance systems is unknown.ObjectiveTo evaluate the accuracy of the CDC opioid overdose case definition and existing Rhode Island Department of Health (RIDOH) state opioid overdose surveillance system.Design, Setting, and ParticipantsThis cross-sectional study of ED opioid overdose visits was conducted at 2 EDs in Providence, Rhode Island, at the state’s largest health system from January to May 2021. Electronic health records (EHRs) were reviewed for opioid overdoses identified by the CDC case definition and opioid overdoses reported to the RIDOH state surveillance system. Included patients were those at study EDs whose visit met the CDC case definition, was reported to the state surveillance system, or both. True overdose cases were confirmed by EHR review using a standard case definition; 61 of 460 EHRs (13.3%) were double reviewed to estimate classification accuracy. Data were analyzed from January through May 2021.Main Outcome and MeasureAccurate identification of an opioid overdose was assessed by estimating the positive predictive value of the CDC case definition and state surveillance system using results from the EHR review.ResultsAmong 460 ED visits that met the CDC opioid overdose case definition, were reported to the RIDOH opioid overdose surveillance system, or both (mean [SD] age, 39.7 [13.5] years; 313 males [68.0%]; 61 Black [13.3%], 308 White [67.0%], and 91 other race [19.8%]; and 97 Hispanic or Latinx [21.1%] among each patient visit), 359 visits (78.0%) were true opioid overdoses. For these visits, the CDC case definition and RIDOH surveillance system agreed that 169 visits (36.7%) were opioid overdoses. Of 318 visits meeting the CDC opioid overdose case definition, 289 visits (90.8%; 95% CI, 87.2%-93.8%) were true opioid overdoses. Of 311 visits reported to the RIDOH surveillance system, 235 visits (75.6%; 95% CI, 70.4%-80.2%) were true opioid overdoses.Conclusions and RelevanceThis cross-sectional study found that the CDC opioid overdose case definition more often identified true opioid overdoses compared with the Rhode Island overdose surveillance system. This finding suggests that using the CDC case definition for opioid overdose surveillance may be associated with improved data efficiency and uniformity.
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Espelt, Albert, Gregorio Barrio, Dolores Álamo-Junquera, Maria José Bravo, Ana Sarasa-Renedo, Fernando Vallejo, Gemma Molist, and M. Teresa Brugal. "Lethality of Opioid Overdose in a Community Cohort of Young Heroin Users." European Addiction Research 21, no. 6 (2015): 300–306. http://dx.doi.org/10.1159/000377626.

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Background: The aim of the study was to estimate the lethality of opioid overdose among young heroin users. Methods: A prospective community cohort study was conducted in Barcelona and Madrid, Spain. Participants included 791 heroin users aged 18-30 years who were followed up between 2001 and 2006. Fatal overdoses were identified by record linkage of the cohort with the general mortality register, while non-fatal overdoses were self-reported at baseline and follow-up interviews. The person-years (py) at risk were computed for each participant. Fatal and non-fatal overdose rates were estimated by city. Transition towards injection shortly before the overdose could not be measured. Overdose lethality (rate of fatal overdose in proportion to total overdose) and its 95% CI was estimated using Bayesian models. Results: The adjusted rates of fatal and non-fatal opioid overdose were 0.7/100 py (95% CI: 0.4-1.1) and 15.8/100 py (95% CI: 14.3-17.6), respectively. The adjusted lethality was 4.2% (95% CI: 2.5-6.5). Conclusions: Four out of 100 opioid overdoses are fatal. These are preventable deaths that could be avoided before or after the overdose takes place. Resources are urgently needed to prevent fatal opioid overdose.
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Samuels, Elizabeth A., William Goedel, Lauren Conkey, Jennifer Koziol, Sarah Karim, Rachel P. Scagos, Lee Ann Jordison Keeler, et al. "41538 Characterizing Opioid Overdose Hotspots for Targeted Overdose Prevention and Treatment." Journal of Clinical and Translational Science 5, s1 (March 2021): 84–85. http://dx.doi.org/10.1017/cts.2021.619.

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ABSTRACT IMPACT: Identifying factors associated with opioid overdoses will enable better resource allocation in communities most impacted by the overdose epidemic. OBJECTIVES/GOALS: Opioid overdoses often occur in hotspots identified by geographic and temporal trends. This study uses principles of community engaged research to identify neighborhood and community-level factors associated with opioid overdose within overdose hotspots which can be targets for novel intervention design. METHODS/STUDY POPULATION: We conducted an environmental scan in three overdose hotspots’‘ two in an urban center and one in a small city’‘ identified by the Rhode Island Department of Health as having the highest opioid overdose burden in Rhode Island. We engaged hotspot community stakeholders to identify neighborhood factors to map within each hotspot. Locations of addiction treatment, public transportation, harm reduction programs, public facilities (i.e., libraries, parks), first responders, and social services agencies were converted to latitude and longitude and mapped in ArcGIS. Using Esri Service Areas, we will evaluate the service areas of stationary services. We will overlay overdose events and use logistic regression identify neighborhood factors associated with overdose by comparing hotspot and non-hotspot neighborhoods. RESULTS/ANTICIPATED RESULTS: We anticipate that there will be differing neighborhood characteristics associated with overdose events in the densely populated urban area and those in the smaller city. The urban area hotspots will have overlapping social services, addiction treatment, and transportation service areas, while the small city will have fewer community resources without overlapping service areas and reduced public transportation access. We anticipate that overdoses will occur during times of the day when services are not available. Overall, overdose hotspots will be associated with increased census block level unemployment, homelessness, vacant housing, and low food security. DISCUSSION/SIGNIFICANCE OF FINDINGS: Identifying factors associated with opioid overdoses will enable better resource allocation in communities most impacted by the overdose epidemic. Study results will be used for novel intervention design to prevent opioid overdose deaths in communities with high burden of opioid overdose.
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von Borstel, R., J. O'Neil, and M. Bamat. "Vistonuridine: An orally administered, life-saving antidote for 5-fluorouracil (5FU) overdose." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): 9616. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.9616.

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9616 Background: 5FU is widely used to treat solid tumors and is often administered via infusion pump at or near its maximum tolerated dose (MTD). Toxicities and even death can occur in patients over-exposed to 5FU. Uridine is a direct biochemical antagonist of 5FU toxicity; uridine nucleotides dilute intracellular fluorouridine nucleotides derived from 5FU, reducing their lethal incorporation into RNA. However, uridine is poorly bioavailable (7%) and is therefore not a clinically viable antidote. Vistonuridine is an orally administered prodrug of uridine that delivers approximately 8-fold more uridine than administration of uridine itself. Methods: 17 patients overdosed with 5FU have been treated with vistonuridine as an antidote. Patients received vistonuridine (10g q6h for 20 doses) beginning 8 to 96 hours after overdose. Data from 13 patients with similar 5FU overdoses provide the time course and outcomes for patients receiving available supportive care without vistonuridine. A severity score, integrating dose and infusion rate, was calculated for all the patients, and this tool could be used by healthcare workers to determine the expected severity and outcome of a 5FU overdose. Results: All 17 overdose patients treated with vistonuridine recovered fully. Most, especially those for whom vistonuridine treatment was initiated sooner, had relatively modest toxicity. In marked contrast, all 11 of the literature-reported cases of 5FU overdose for which an outcome of death would have been predicted died from the overdose despite receiving available supportive care. Conclusions: These clinical data illustrate the serious, debilitating and life threatening nature of 5FU overdose and the current lack of effective treatments. Vistonuridine appears to be a safe and effective, life-saving antidote to 5FU overdose. [Table: see text]
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Falade-Nwulia, Oluwaseun, Kathleen Ward, Karla D. Wagner, Hamidreza Karimi-Sari, Jeffrey Hsu, Mark Sulkowski, Carl Latkin, and Evaristus Nwulia. "Loneliness and fearfulness are associated with non-fatal drug overdose among people who inject drugs." PLOS ONE 19, no. 2 (February 21, 2024): e0297209. http://dx.doi.org/10.1371/journal.pone.0297209.

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Background People who inject drugs (PWID) experience high rates of drug overdose death with the risk of mortality increasing after each non-fatal event. Racial differences exist in drug overdose rates, with higher rates among Black people who use drugs. Psychological factors may predict drug overdose. Methods Cross-sectional data from a survey administered to PWID in Baltimore, MD enrolled in a social network-based intervention were analyzed. Linear regression methods with generalized estimating equations were used to analyze data from indexes and network members to assess for psychological factors significantly associated with self-reported number of lifetime drug overdoses. Factors associated with number of overdoses were assessed separately by race. Results Among 111 PWID enrolled between January 2018 and January 2019, 25.2% were female, 65.7% were Black, 98.2% reported use of substances in addition to opioids, and the mean age was 49.0 ± 8.3 years. Seventy-five individuals (67.6%) had a history of any overdose with a mean of 5.0 ± 9.7 lifetime overdoses reported. Reports of feeling fearful (β = 9.74, P = 0.001) or feeling lonely all of the time (β = 5.62, P = 0.033) were independently associated with number of drug overdoses. In analyses disaggregated by race, only the most severe degree of fearfulness or loneliness was associated with overdose among Black participants, whereas among White participants, any degree of fearfulness or loneliness was associated with overdose. Conclusions In this study of PWID loneliness and fearfulness were significantly related to the number of reported overdose events. These factors could be targeted in future interventions.
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Whipple, Julianne K., Edward J. Quebbeman, Kelly S. Lewis, Mark S. Gottlieb, and Robert K. Ausman. "Difficulties in Diagnosing Narcotic Overdoses in Hospitalized Paitents." Annals of Pharmacotherapy 28, no. 4 (April 1994): 446–50. http://dx.doi.org/10.1177/106002809402800403.

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OBJECTIVE: To describe the clinical presentation of narcotic overdose in hospitalized patients and to differentiate this circumstance from other conditions often misdiagnosed as overdose. DESIGN: Case series. SETTING: Two acute-care teaching hospitals. PATIENTS: Forty-three hospitalized patients who received naloxone for a clinically suspected narcotic overdose. INTERVENTIONS: Two investigators independently evaluated each incident to determine whether the patient had a narcotic overdose. The patients were judged to have had an overdose if caregivers documented an immediate improvementin mental status, respiratory rate, or blood pressure after naloxone administration. MEASUREMENTS: The clinical presentation of a narcotic overdose in hospitalized patients was defined. Conditions misdiagnosed as an overdose were determined. MAIN RESULTS: Symptoms improved rapidly with the administration of naloxone in 28 incidents (65 percent) and were designated overdose. In 15 other instances there was no improvement in symptoms; these patients were designated nonoverdose. Only half of the overdose patients had a respiratory rate <8 breaths/min immediately prior to naloxone administration. Only two of the overdose patients had the classic triad of symptoms (respiratory depression, coma, and pinpoint pupils). Other overdose patients had only one or two of the classic signs. The clinical presentation of narcotic overdoses in hospitalized patients did not include respiratory depression, hypotension, or coma in the majority of patients. All overdose patients showed a decrease in mental status. The majority of nonoverdose patients had pulmonary conditions that were misdiagnosed as a narcotic overdose. CONCLUSIONS: Narcotic overdoses in hospitalized patients seldom fit the classic description. The lack of respiratory depression does not mean the absence of a narcotic overdose. Patients who receive narcotics and develop a signficant decrease in mental status should be evaluated for a possible overdose. Pulmonary, neurologic, cardiovascular, and electrolyte abnormalities often are misdiagnosed as a narcotic overdose in hospitalized patients.
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Tesi sul tema "Overdose"

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Robinson, D. "Factors influencing paracetamol overdose." Thesis, Queen's University Belfast, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.403484.

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Fallon, Marissa S. "Drug overdose treatment by nanoparticles." [Gainesville, Fla.] : University of Florida, 2005. http://purl.fcla.edu/fcla/etd/UFE0013055.

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Smith, Rachel. "'Facing the risk of overdose' : a grounded theory study exploring heroin users' experiences of overdose." Thesis, University of East London, 2008. http://roar.uel.ac.uk/3778/.

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Overdose is a significant cause of death among heroin users and up to two-thirds of heroin users will experience at least one non-fatal overdose in their lifetime. Despite a recent increase in the literature on overdose psychological understandings of the processes involved are limited, particularly from the perspective of heroin users. This study explored heroin users' experiences of overdose particularly the two areas of intent and risk. Semi-structured interviews were conducted with thirteen individuals who had a history of heroin use and were attending a treatment service in south London. A social constructionist grounded theory approach was followed and the theory 'facing the risk of overdose' was developed. The findings suggested that risk of overdose was affected by complex inter-relationships between individual, social and substance related factors. Participants located overdose in a context with other risks some of which were linked to a drug-using lifestyle. Therefore, overdose was often not the only risk faced by participants and this had implications for how they considered and managed risks. Overall, 'facing the risk of overdose' was best characterised as a social process influenced by acquaintances, friends, family and professionals. Intent appeared complex and dynamic, and although many overdoses were described as accidents some were intentional or accompanied by ambivalence about survival; attributions were also made to luck or chance. The findings are discussed in relation to existing literature. Clinical implications for services include dissemination of context-specific harm reduction information and the importance of addressing mental health needs as well as substance misuse. Recommendations for clinical psychologists include an increase in psychologically informed interventions. In recognition that overdose was a social behaviour clinical implications are also discussed at the community level. Finally, recommendations for future research are highlighted.
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Coughlan, Geraldine. "Construing alternatives to taking an overdose." Thesis, University of East London, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.532392.

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Daniels, Katherine. "Difficulties Investigating and Prosecuting Heroin Overdose Cases." Honors in the Major Thesis, University of Central Florida, 2004. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/701.

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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.<br>Bachelors<br>Health and Public Affairs<br>Legal Studies
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Sharer, Rustan. "Trends In Unintentional Drug Overdose-related Deaths." Thesis, The University of Arizona, 2012. http://hdl.handle.net/10150/221390.

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A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.<br>Since undergoing a radical paradigm shift in prescribing trends in the late 80s/early 90s, the therapeutic use and non-therapeutic abuse of controlled prescription drugs (specifically opioids) has reached prolific levels in the US. Despite seemingly widespread awareness of such trends and associated dangers, mortality and morbidity associated with such medications continues to escalate in the face of rapidly increasing prescribing patterns. This investigation attempts to further characterize time trends of accidental deaths secondary to overdoses of various drugs (primarily comparing Arizona to national trends with respect to various demographic identifiers). Utilizing publicly available data sources, a statistical analysis was performed on yearly mortality rates for selected drug-overdose related causes of death between 1999 and 2007. Arizona consistently exhibited higher death rates--with Pinal County claiming the highest among all urbanizations--(but lower annual rates of increase) than the national trends. Men were also shown to have much higher death rates than women (although women’s rates are increasing much faster than men). Furthermore, Hispanics demonstrated significantly lower death rates than non-Hispanics (whose death rates were shown to be increasing three times faster than Hispanics). Rapidly increasing death rates pose a significant concern at both the state and national levels.
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Lees, Rosemary Jane. "The role of alcohol in fatal opioid overdose." Thesis, University of Bristol, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.573136.

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Fatal opioid overdose is the leading cause of death in UK opioid users, and increasingly a clinical concern for chronic pain management. Concomitant use of central nervous system depressants, in particular alcohol, is identified as a risk factor for opioid overdose. It is plausible alcohol and heroin may interact pharmacologically to enhance overdose risk, however other psychological or social factors may be important. The primary aim of this thesis was to further elucidate the role of alcohol in opioid overdose. Simulating opioid overdose is inherently difficult, so a multi-method approach comprising three complementary studies was used. Firstly, a metabolite of alcohol, ethyl glucuronide, was posed as a tool to provide a drug consumption history in post-mortem opioid overdose samples. Detecting hair ethyl glucuronide did however not prove a sensitive technique for quantitating alcohol history. Secondly a qualitative study was completed to document the behaviours and patterns associated with alcohol use in heroin users. Using focus groups, opioid dependent individuals were interviewed about their alcohol and opioid use. The results of this study indicate alcohol is used very purposefully as a 'substitute' or 'enhancer' to the effects of heroin. This is an important finding and informed the design of the third study presented here, a pharmacological alcohol challenge. In this paradigm alcohol was administered to opioid-dependent individuals to mimic a drinking binge and provide a human model in which to measure the alcohol-opioid interaction. Limited differences were observed between opioid-dependent participants and healthy controls for objective and subjective parameters, providing little support for a pharmacological role of alcohol in opioid overdose. The strong evidence for a role of alcohol in opioid overdose is not fully explained by the findings presented in this thesis. Defining the nature of opioid overdose, and elucidating the differential roles of different risk factors may allow for the development of specific targeted interventions and evidence-based advice for opioid users.
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Clark, Angela K. "A Feasibility Study of a Group-based Opioid Overdose Prevention Educational Intervention." University of Cincinnati / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1427980151.

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LaBrosse, A. D., and John B. Bossaer. "Accidental Overdose of Everolimus Secondary to Poor Patient Education." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/2354.

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Shi, Yun, and 施昀. "Escalation with overdose control for phase I drug-combination trials." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hub.hku.hk/bib/B49799733.

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The escalation with overdose control (EWOC) method is a popular modelbased dose finding design for phase I clinical trials. Dose finding for combined drugs has grown rapidly in oncology drug development. A two-dimensional EWOC design is proposed for dose finding with two agents in combination based on a four-parameter logistic regression model. During trial conduct, the posterior distribution of the maximum tolerated dose (MTD) combination is updated continuously in order to find the appropriate dose combination for each cohort of patients. The probability that the next dose combination exceeds the MTD combination can be controlled by a feasibility bound, which is based on a prespecified quantile for the MTD distribution such as to reduce the possibility of over-dosing. Dose escalation, de-escalation or staying at the same doses is determined by searching the MTD combination along rows and columns in a two-drug combination matrix. Simulation studies are conducted to examine the performance of the design under various practical scenarios, and illustrate it with a trial example.<br>published_or_final_version<br>Statistics and Actuarial Science<br>Master<br>Master of Philosophy
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Libri sul tema "Overdose"

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D'Adamo, Francesco. Overdose. Milano: A. Mondadori, 1990.

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D'Adamo, Francesco. Overdose. Milano: Mondadori, 1990.

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3

R, Olson Kent, and San Francisco Bay Area Regional Poison Control Center., eds. Poisoning & drug overdose. 3rd ed. Norwalk, CT: Appleton & Lange, 1999.

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4

R, Olson Kent, and San Francisco Bay Area Regional Poison Control Center., eds. Poisoning & drug overdose. 2nd ed. Norwalk, CT: Appleton & Lange, 1994.

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R, Olson Kent, and Becker Charles E, eds. Poisoning & drug overdose. Englewood Cliffs: Prentice Hall, 1990.

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R, Olson Kent, and California Poison Control System, eds. Poisoning & drug overdose. 4th ed. New York: Lange Medical Books/McGraw-Hill, 2004.

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R, Olson Kent, and San Francisco Bay Area Regional Poison Control Center., eds. Poisoning & drug overdose. 2nd ed. London: Prentice Hall International, 1994.

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8

San Francisco Bay Area Regional Poison Control Center. Poisoning & drug overdose. Norwalk, CT: Appleton & Lange, 1990.

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9

System, California Poison Control, and Knovel (Firm), eds. Poisoning & drug overdose. 4th ed. New York: Lange Medical Books/McGraw-Hill, 2004.

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R, Olson Kent, and California Poison Control System, eds. Poisoning & drug overdose. 5th ed. New York: Lange Medical Books/McGraw-Hill, 2007.

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Capitoli di libri sul tema "Overdose"

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Nahler, Gerhard. "overdose." In Dictionary of Pharmaceutical Medicine, 128. Vienna: Springer Vienna, 2009. http://dx.doi.org/10.1007/978-3-211-89836-9_985.

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Shamil, Eamon, Praful Ravi, and Janice Rymer. "Overdose?" In 100 Cases in Clinical Medicine, 7–8. 4th ed. Boca Raton: CRC Press, 2025. https://doi.org/10.1201/9781003350934-4.

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Champion, Howard R., Nova L. Panebianco, Jan J. De Waele, Lewis J. Kaplan, Manu L. N. G. Malbrain, Annie L. Slaughter, Walter L. Biffl, et al. "Acetaminophen Overdose." In Encyclopedia of Intensive Care Medicine, 32–34. Berlin, Heidelberg: Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-642-00418-6_795.

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Citerio, G., C. Giussani, Hugo Sax, Didier Pittet, Xiaoyan Wen, John A. Kellum, Angela M. Mills, et al. "Iron Overdose." In Encyclopedia of Intensive Care Medicine, 1302–5. Berlin, Heidelberg: Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-642-00418-6_834.

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Kashani, John, Richard D. Shih, Thomas H. Cogbill, David H. Jang, Lewis S. Nelson, Mitchell M. Levy, Margaret M. Parker, et al. "Salicylate Overdose." In Encyclopedia of Intensive Care Medicine, 2011–14. Berlin, Heidelberg: Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-642-00418-6_851.

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Adams, Sue, and Gary Tubman. "Drug overdose." In Planning Patient Care, 53–65. London: Macmillan Education UK, 1988. http://dx.doi.org/10.1007/978-1-349-10102-3_7.

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Nahler, Gerhard. "significant overdose." In Dictionary of Pharmaceutical Medicine, 169. Vienna: Springer Vienna, 2009. http://dx.doi.org/10.1007/978-3-211-89836-9_1287.

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McMullen, Isabel, and Lisa Conlan. "OPIATE OVERDOSE." In Psychiatry: Breaking the ICE, 405–7. Chichester, UK: John Wiley & Sons, Ltd, 2015. http://dx.doi.org/10.1002/9781118557211.ch66.

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Champion, Howard R., Nova L. Panebianco, Jan J. De Waele, Lewis J. Kaplan, Manu L. N. G. Malbrain, Annie L. Slaughter, Walter L. Biffl, et al. "Aspirin Overdose." In Encyclopedia of Intensive Care Medicine, 274. Berlin, Heidelberg: Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-642-00418-6_1167.

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Harr, Jeffrey N., Philip F. Stahel, Phillip D. Levy, Antoine Vieillard-Baron, Yang Xue, Muhammad N. Iqbal, Jeffrey Chan, et al. "Heroin Overdose." In Encyclopedia of Intensive Care Medicine, 1097. Berlin, Heidelberg: Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-642-00418-6_1696.

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Atti di convegni sul tema "Overdose"

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Garizio, J., S. Shah, A. Cody, M. Murthy, and H. Nazir. "An Overdose Overload - A Unique Case of Ibuprofen Overdose." In American Thoracic Society 2023 International Conference, May 19-24, 2023 - Washington, DC. American Thoracic Society, 2023. http://dx.doi.org/10.1164/ajrccm-conference.2023.207.1_meetingabstracts.a3514.

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Lingamoorthy, Anush Niranjan, Abhishek Kumar Mishra, Suman Kumar, David Gordon, Jacob Brenner, Nagarajan Kandasamy, and Amanda Watson. "Drug Overdose Vital-Signs Evaluator Using Machine Learning." In Thirty-Third International Joint Conference on Artificial Intelligence {IJCAI-24}. California: International Joint Conferences on Artificial Intelligence Organization, 2024. http://dx.doi.org/10.24963/ijcai.2024/814.

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Abstract (sommario):
Opioid overdose is an escalating global epidemic, affecting 16 million individuals. Lack of overdose detection and slower response times are the leading causes of overdose deaths. During a fatal opioid overdose, the user exhibits motionlessness, lack of breathing, and hypoxemia (oxygen saturation drops). In this paper, we discuss the development of a shoulder-based wearable overdose detection device that monitors hypoxemia, motion, and respiration. The device's design considers the underserved socio-economic population and their psychological contexts. However, conventional approaches to detecting an overdose typically focus on a single biomarker. To address this, we have developed a robust capsule networks based machine learning (ML) model, OxyCaps that integrates oxygen saturation, respiration rate, and motion to classify different levels of hypoxemia. This also helps improve patient adherence by decreasing the chances of false positive alerts. To determine a hypoxemic state, the model considers various features like skin tone, body physiology, motion, and photoplethysmography (PPG) signals. In the absence of real-world opioid overdose data, our research leverages data collected by our device from 19 patients experiencing sleep apnea, exploiting the parallels between overdose and apnea biomarkers. Our dataset provides a novel compilation of raw PPG and motion signals detected from the shoulder. Our model classifies 3 stages of hypoxemia with an average accuracy of 92%, specifically achieving a high recall of 0.98 for the critical hypoxemic state that is crucial in determining an overdose.
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Leap, J., S. Baltaji, and A. Singh. "Fatal Epsom Salt Overdose." In American Thoracic Society 2019 International Conference, May 17-22, 2019 - Dallas, TX. American Thoracic Society, 2019. http://dx.doi.org/10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a4826.

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Menon, A., M. Bachan, Z. Khan, and A. Menon. "Consequences of Benadryl Overdose." In American Thoracic Society 2021 International Conference, May 14-19, 2021 - San Diego, CA. American Thoracic Society, 2021. http://dx.doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2931.

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Patel, Swet M., James A. Espinosa, and Alan Lucerna. "Over the Counter Overdose: A Case of Tylenol Toxicity." In 28th Annual Rowan-Virtua Research Day. Rowan University Libraries, 2024. http://dx.doi.org/10.31986/issn.2689-0690_rdw.stratford_research_day.80_2024.

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Abstract (sommario):
We report a case of a 51-year-old man presenting to the Emergency Department (ED) with suicidal ideations (SI) endorsing an intentional overdose of acetaminophen. Just as important is the clinical presentation; it is equally important to obtain a detailed history of patient's presentation leading to the ED visit when evaluating a suicide attempt. Tylenol (acetaminophen) is a common over the counter (OTC) medication available to the public. Management of Tylenol overdose follows a standard outline of things to observe and intervene on. In this case, we discuss how Tylenol overdose is managed in a clinical setting through a patient who had an intentional overdose.
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Coleman, C., A. M. Massie, R. A. Harkins, G. W. Wigger, N. Barker, and L. Daniels. "Double Trouble with Olanzapine Overdose." In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a1674.

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Albuquerque, Juliana Maria de Oliveira, and Susan Carolyne Da Silva Freire. "HIPOPROTEINEMIA POR OVERDOSE DE PROPOFOL." In I Congresso On-line Nacional de Clínica Veterinária de Pequenos Animais. Revista Multidisciplinar em Saúde, 2021. http://dx.doi.org/10.51161/rems/1817.

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Introdução: o propofol é um anestésico da classe dos alquilfenóis, podendo ser usado como sedativo para anestesia geral ou medicação pré-anestésica. O medicamento em questão, usado em excesso leva a hipoproteinemia, que nada mais é do que a redução das proteínas do sangue. Esta revisão bibliográfica foi realizada com base no relato de caso da anestesia intravenosa com propofol em ovinos. A medicação pré anestésica foi composta por cetamina 4,5 mg kg, midazolam 0,1 mg kg e tramadol 2 mg kg, e a indução com propofol 3,5 mg Kg junto com cetamina 1 mg Kg, a manutenção anestésica foi feita com propofol 0,28 mg Kg e cetamina 0,06 mg kg, durante 60 minutos. O foco vai ser dado para as amostras hemogasométricas, que foram retiradas no pré cirúrgico e a cada 30 minutos. Objetivo: Expor o risco de usar propofol por tempo prolongado, mesmo com a dosagem adequada. Material e métodos: os materiais usados foram estudos de casos que relataram hipoproteinemia após utilizar propofol, com foco no relato de caso de ovinos, sempre comparando e relacionando-os. Resultados: Observou-se nos exames que a hipoproteinemia ocorreu após 60 minutos. A administração em tempos prolongados por propofol leva o animal a ter uma overdose, resultando em hipoproteinemia. Conclusão: O trabalho baseado nesta revisão só mediu em 3 tempo a gasometria, o que nos dá uma margem muito grande de erro, pois antes mesmo dos 60 minutos o animal já pode estar saturado por propofol, seria interessante fazer um analise a cada 10 minutos para ter maior precisão até onde podemos fazer a administração sem causar sérios danos ao animal.
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Dahabra, L., A. Kassem, S. B. A. Sattar, M. Muhammad, M. Assaad, N. Narula, and D. Elsayegh. "Conventional Dialysis in Amlodipine Overdose." In American Thoracic Society 2022 International Conference, May 13-18, 2022 - San Francisco, CA. American Thoracic Society, 2022. http://dx.doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1586.

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Leng, Kenny Kah-Keng, Victoria Wong Murray, Alexus Weatherspoon, Amy Palen, Kenneth W. Stagliano та Stephen M. Scheinthal. "Spot the Signs- 防范未然,及时干预- 培训". У 28th Annual Rowan-Virtua Research Day. Rowan University Libraries, 2024. https://doi.org/10.31986/issn.2689-0690_rdw.stratford_research_day.164_2024.

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Abstract (sommario):
Opiate overdose is an unfortunately common risk factor for suicide; suicide attempts accounted for an estimated 30% of fatal opioid overdoses during the pandemic, and patients with an episode of opiate overdose were at an 18 times higher risk of suicide in the following year. As a result, the Rowan School of Osteopathic Medicine Department of Psychiatry developed an Integrated Mental Health Awareness and Suicide Prevention program targeted at members of the community and frontline workers to increase awareness and provide brief interventions, which demonstrated an improvement of 89% in our English-speaking attendees. Chinese is the second-most common non-English language in New Jersey, with an estimated 120 thousand speakers, and major Chinatowns in the adjacent cities of New York City and Philadelphia. Chinese patients also frequently experience culturally bound stigmas and symptoms, so it is vital to ensure content is appropriately targeted for maximum impact. In this poster, we showcase some examples of translated and targeted content, and detail several terms that differ between dialects or regional varieties commonly spoken in New Jersey. Attention to matching dialect and the use of local terminology for culturally specific syndromes can increase effectiveness of patient education programs in underserved populations.The use of qualified human medical translators proficient in the dialect spoken by specific patients or provider-patient concordance also prevents misunderstanding and may improve rapport.
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Coghlan, M. A., B. Ulrich, and L. Hinkle. "Methamphetamine Overdose Induced Disseminated Intravascular Coagulation." In American Thoracic Society 2022 International Conference, May 13-18, 2022 - San Francisco, CA. American Thoracic Society, 2022. http://dx.doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1566.

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Rapporti di organizzazioni sul tema "Overdose"

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Omitaomu, Olufemi, Ozgur Ozmen, Haoran Niu, Hilda Klasky, and Mohammed Olama. ICAPA-HD: Hazard Detection Methods for Improving Overdose Prevention. Office of Scientific and Technical Information (OSTI), September 2021. http://dx.doi.org/10.2172/1821987.

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Hedegaard, Holly, Arialdi Miniño, Merianne Rose Spencer, and Margaret Warner. Drug Overdose Deaths in the United States, 1999–2020. National Center for Health Statistics ( U.S.), December 2021. http://dx.doi.org/10.15620/cdc:112340.

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This report uses the most recent data from the National Vital Statistics System (NVSS) to update statistics on deaths from drug overdose in the United States, showing rates by demographic group and by specific types of drugs involved (such as opioids or stimulants), with a focus on changes from 2019 to 2020.
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Hedegaard, Holly, Arialdi M. Miniño, Merianne Rose Spencer, and Margaret Warner. Drug Overdose Deaths in the United States, 1999–2020. National Center for Health Statistics ( U.S.), December 2021. http://dx.doi.org/10.15620/cdc:112644.

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Abstract (sommario):
This report uses the most recent data from the National Vital Statistics System (NVSS) to update statistics on deaths from drug overdose in the United States, showing rates by demographic group and by specific types of drugs involved (such as opioids or stimulants), with a focus on changes from 2019 to 2020.
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Merianne Rose, Spencer, Matthew Garnett, and Miniño Arialdi M. Urban–Rural Differences in Drug Overdose Death Rates, 2020. National Center for Health Statistics (U.S.), July 2022. http://dx.doi.org/10.15620/cdc:118601.

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This report uses the most recent final mortality data from the National Vital Statistics System to describe urban and rural differences in drug overdose death rates in 2020, by sex, race and Hispanic origin, and selected types of opioids and stimulants.
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Spencer, Merianne, Matthew Garnett, and Arialdi Miniño. Drug Overdose Deaths in the United States, 2002-2022. National Center for Health Statistics (U.S.), December 2023. http://dx.doi.org/10.15620/cdc:135849.

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Spencer, Merianne, Arialdi Miniño, and Margaret Warner. Drug Overdose Deaths in the United States, 2001–2021. National Center for Health Statistics (U.S.), December 2022. http://dx.doi.org/10.15620/cdc:122556.

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Abstract (sommario):
This report uses the most recent data from the National Vital Statistics System to update statistics on deaths from drug overdose in the United States. It shows rates by demographic groups and types of drugs involved, with a focus on changes from 2020 through 2021.
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Spencer, Merianne, Jodi Cisewski, Margaret Warner, and Matthew Garnett. Drug Overdose Deaths Involving Xylazine, United States, 2018–2021. National Center for Health Statistics (U.S.), June 2023. http://dx.doi.org/10.15620/cdc:129519.

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This study presents trends in drug overdose death rates involving xylazine from 2018 through 2021, overall and by sex. Rates of drug overdose deaths involving xylazine are also presented by age group and race and Hispanic origin from 2020 to 2021, and by the U.S. Department of Health and Human Services public health regions in 2021. Co-involvement for the most frequent drugs involved with xylazine is also reported.
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Garnett, Matthew F., and Arialdi M. Miniño. Drug Overdose Deaths in the United States, 2003-2023. Hyattsville, MD: National Center Health Statistics (U.S.), December 2024. http://dx.doi.org/10.15620/cdc/170565.

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Hedegaard, Holly. Urban–Rural Differences in Drug Overdose Death Rates, 1999–2019. National Center for Health Statistics, March 2021. http://dx.doi.org/10.15620/cdc:102891.

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Abstract (sommario):
This report uses the most recent mortality data from the National Vital Statistics System (NVSS) to examine urban–rural differences in drug overdose death rates, for all drugs and by selected types of opioids and stimulants.
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Miniño., Arialdi. Drug Poisoning Mortality, by State and Race and Ethnicity: United States, 2019. National Center for Health Statistics, March 2021. http://dx.doi.org/10.15620/cdc:103967.

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