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Saadatnia M, Norouzi R, Najafi MA, Gol Parvar S, Najafian A, Tabatabei A, Foroughi M, Esteki S, Khorvash F. Opioid Use Disorder and intracerebral hemorrhage in Isfahan, Iran: a case-control study. Front Neurol 2024; 15:1420675. [PMID: 39350972 PMCID: PMC11439711 DOI: 10.3389/fneur.2024.1420675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 08/30/2024] [Indexed: 10/04/2024] Open
Abstract
Background Opium use disorder is a significant health problem in our country, leading to a considerable number of health issues. Opium has several detrimental effects on its consumers. However, the effect of Opium use disorder on intracerebral hemorrhage (ICH) has not been evaluated. This study aims to evaluate the relationship between Opium use disorder and ICH. Methods In this case-control study, 402 patients with ICH and 404 patients without ICH enrolled. Opium use disorder, other vascular risk factors including diabetes mellitus, hypertension, hyperlipidemia, and tobacco smoking was compared between these groups. Patients with ICH were divided into two groups; first group are patients with history of Opioid Use Disorder and second group are those patients without Opioid Use Disorder. ICH features including clinical and imaging characteristics and prognostic findings were compared between patients with and without Opium use disorder. Results This case-control study of 806 participants found that hypertension (OR = 6.84, 95% CI: 5.03-9.34, p-value: <0.001), Opium use disorder (OR = 4.23, 95% CI: 2.42-7.35, p-value: <0.001) and tobacco smoking (OR = 1.47, 95% CI: 1.01-2.16, p-value: 0.049) had a higher risk of ICH. Opium-addicted subjects had higher ICH scores (2.61 ± 1.27 vs. 2.11 ± 1.29, p-value: 0.005), were more likely to have infratentorial hemorrhage (22% vs. 12%, OR = 2.13, 95% CI: 1.06-4.28, p-value: 0.038), more likely to be intubated (66% vs. 54%, OR = 1.79, 95% CI: 0.98-3.27, p-value = 0.041) and had lower GCS scores (9.58 ± 3.60 vs. 8.25 ± 3.88, p-value: 0.01). The effect of Opium use disorder independently on ICH was also shown in logistic regression (adjusted OR = 3.15, p-value = 0.001). Conclusion This study is the first to evaluate the effect of Opium use disorder on ICH, identifying Opium use disorder as a new potential risk factor for ICH.
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Affiliation(s)
- Mohammad Saadatnia
- Department of Neurology, Isfahan Neurosciences Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Razieh Norouzi
- Department of Neurology, Isfahan Neurosciences Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Amin Najafi
- Department of Neurology, Isfahan Neurosciences Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sahand Gol Parvar
- Department of Neurology, Isfahan Neurosciences Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arash Najafian
- Department of Medical Science, Islamic Azad University, Najafabad Branch, Isfahan, Iran
| | - Aryan Tabatabei
- Department of Medical Science, Islamic Azad University, Najafabad Branch, Isfahan, Iran
| | - Melika Foroughi
- Department of Neurology, Isfahan Neurosciences Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sadaf Esteki
- Department of Medical Science, Islamic Azad University, Najafabad Branch, Isfahan, Iran
| | - Fariborz Khorvash
- Department of Neurology, Isfahan Neurosciences Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
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Mehrpour O, Saeedi F, Vohra V, Hoyte C. Outcome prediction of methadone poisoning in the United States: implications of machine learning in the National Poison Data System (NPDS). Drug Chem Toxicol 2024; 47:556-563. [PMID: 37941394 DOI: 10.1080/01480545.2023.2277128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 10/10/2023] [Accepted: 10/18/2023] [Indexed: 11/10/2023]
Abstract
Methadone is an opioid receptor agonist with a high potential for abuse. The current study aimed to compare different machine learning models to predict the outcomes following methadone poisoning. This six-year retrospective longitudinal study utilizes National Poison Data System (NPDS) data. The severity of outcomes was derived from the NPDS Coding Manual. Our database was divided into training (70%) and test (30%) sets. We used a light gradient boosting machine (LGBM), extreme gradient boosting (XGBoost), random forest (RF), and logistic regression (LR) to predict the outcomes of methadone poisoning. A total of 3847 patients with methadone exposures were included. Our results demonstrated that machine learning models conferred high accuracy and reliability in determining the outcomes of methadone poisoning cases. The performance evaluation showed all models had high accuracy, precision, specificity, recall, and F1-score values. All models could reach high specificity (more than 96%) and high precision (80% or more) for predicting major outcomes. The models could also achieve a high sensitivity to predict minor outcomes. Finally, the accuracy of all models was about 75%. However, XGBoost and LGBM models achieved the best performance among all models. This study showcased the accuracy and reliability of machine learning models in the outcome prediction of methadone poisoning.
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Affiliation(s)
- Omid Mehrpour
- Michigan Poison & Drug Information Center, Wayne State University School of Medicine, Detroit, MI, USA
- Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, CO, USA
| | - Farhad Saeedi
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences (BUMS), Birjand, Iran
| | - Varun Vohra
- Department of Emergency Medicine, Michigan Poison & Drug Information Center, Wayne State University School of Medicine, Detroit, MI, USA
| | - Christopher Hoyte
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- University of Colorado Hospital, Aurora, CO, USA
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3
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Hu J, Song Y, Huang X, Li C, Jin X, Cen L, Zhang C, Ding B, Lian J. Opioids-Induced Long QT Syndrome: A Challenge to Cardiac Health. Cardiovasc Toxicol 2024; 24:472-480. [PMID: 38630336 PMCID: PMC11076354 DOI: 10.1007/s12012-024-09853-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/28/2024] [Indexed: 05/08/2024]
Abstract
The challenge posed by opioid overdose has become a significant concern for health systems due to the complexities associated with drug prohibition, widespread clinical use, and potential abuse. In response, healthcare professionals have primarily concentrated on mitigating the hallucinogenic and respiratory depressant consequences of opioid overdose to minimize associated risks. However, it is crucial to acknowledge that most opioids possess the capacity to prolong the QT interval, particularly in cases of overdose, thereby potentially resulting in severe ventricular arrhythmias and even sudden death if timely intervention is not implemented. Consequently, alongside addressing the typical adverse effects of opioids, it is imperative to consider their cardiotoxicity. To enhance comprehension of the correlation between opioids and arrhythmias, identify potential targets for prompt intervention, and mitigate the hazards associated with clinical utilization, an exploration of the interaction between drugs and ion channels, as well as their underlying mechanisms, becomes indispensable. This review primarily concentrates on elucidating the impact of opioid drugs on diverse ion channels, investigating recent advancements in this domain, and attaining a deeper understanding of the mechanisms underlying the prolongation of the QT interval by opioid drugs, along with potential interventions.
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Affiliation(s)
- Jiale Hu
- Department of Cardiology, Ningbo University Health Science Center Affiliated Lihuili Hospital, Ningbo University, Zhejiang, China
| | - Yongfei Song
- Department of Cardiology, Ningbo University Health Science Center Affiliated Lihuili Hospital, Ningbo University, Zhejiang, China
- Ningbo Institute of Innovation for Combined Medicine and Engineering, Ningbo Medical Center Lihuili Hospital, Ningbo University, No. 378 Dongqing Road, Yinzhou District, Ningbo, 315000, Zhejiang, China
| | - Xiaoyan Huang
- Department of Cardiology, Ningbo University Health Science Center Affiliated Lihuili Hospital, Ningbo University, Zhejiang, China
- Ningbo Institute of Innovation for Combined Medicine and Engineering, Ningbo Medical Center Lihuili Hospital, Ningbo University, No. 378 Dongqing Road, Yinzhou District, Ningbo, 315000, Zhejiang, China
| | - Chongrong Li
- Department of Cardiology, Ningbo University Health Science Center Affiliated Lihuili Hospital, Ningbo University, Zhejiang, China
| | - Xiaojun Jin
- Department of Cardiology, Ningbo University Health Science Center Affiliated Lihuili Hospital, Ningbo University, Zhejiang, China
| | - Lichao Cen
- Department of Cardiology, Ningbo University Health Science Center Affiliated Lihuili Hospital, Ningbo University, Zhejiang, China
| | - Chuanjin Zhang
- Department of Cardiology, Ningbo University Health Science Center Affiliated Lihuili Hospital, Ningbo University, Zhejiang, China
| | - Beilei Ding
- Department of Cardiology, Ningbo University Health Science Center Affiliated Lihuili Hospital, Ningbo University, Zhejiang, China
| | - Jiangfang Lian
- Department of Cardiology, Ningbo University Health Science Center Affiliated Lihuili Hospital, Ningbo University, Zhejiang, China.
- Ningbo Institute of Innovation for Combined Medicine and Engineering, Ningbo Medical Center Lihuili Hospital, Ningbo University, No. 378 Dongqing Road, Yinzhou District, Ningbo, 315000, Zhejiang, China.
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Masoudkabir F, Shafiee A, Heidari A, Mohammadi NSH, Tavakoli K, Jalali A, Nayebirad S, Alaeddini F, Saadat S, Vasheghani-Farahani A, Sadeghian S, Arita VA, Boroumand M, Karimi A. Epidemiology of substance and opium use among adult residents of Tehran; a comprehensive report from Tehran cohort study (TeCS). BMC Psychiatry 2024; 24:132. [PMID: 38365633 PMCID: PMC10870582 DOI: 10.1186/s12888-024-05561-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/26/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND The prevalence and burden of substance and opium use have increased worldwide over the past decades. In light of rapid population changes in Tehran, we aimed to evaluate the prevalence of opium and other substance use among adult residents in Tehran, Iran. METHOD From March 2016 to March 2019, we utilized data from 8 296 participants in the Tehran Cohort Study recruitment phase (TeCS). We calculated the age-sex-weighted prevalence of substance use and the geographic distribution of substance use in Tehran. We also used logistic regression analysis to determine possible determinants of opium use. RESULT We analyzed data from 8 259 eligible participants with complete substance use data and the average age of participants was 53.7 ± 12.75 years. The prevalence of substance use was 5.6% (95% confidence interval [CI]: 4.6- 7.1%). Substance use was more common in males than females (Prevalence: 10.5% [95% CI: 8.6- 12.6%] vs. 0.5% [95% CI: 0.2- 1.2%], respectively). The age-sex weighted prevalence of substance use was 5.4% (95% CI: 4.6-7.1%). Moreover, opium was the most frequently used substance by 95.8% of substance users. Additionally, we found that male gender (Odds ratio [OR]: 12.1, P < 0.001), alcohol intake (OR: 1.3, P = 0.016), and smoking (OR: 8.5, P < 0.001) were independently associated with opium use. CONCLUSIONS We found that the prevalence of substance use in Tehran was 5.6%, and opium was the most frequently used substance. In addition, male gender, lower levels of education, alcohol, and tobacco consumption are the main risk factors for substance use in Tehran. Healthcare providers and policymakers can utilize our results to implement preventive strategies to minimize substance use in Tehran.
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Affiliation(s)
- Farzad Masoudkabir
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Akbar Shafiee
- Tehran Heart Center , Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences , Tehran, Iran
| | - Amirhossein Heidari
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Negin Sadat Hosseini Mohammadi
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center (SSRC), Tehran University of Medical Science, Tehran, Iran
| | - Kiarash Tavakoli
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center (SSRC), Tehran University of Medical Science, Tehran, Iran
| | - Arash Jalali
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Cardiovascular Research, Tehran Heart Center, North Kargar Ave, 1411713138, Tehran, Iran.
| | - Sepehr Nayebirad
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshid Alaeddini
- Tehran Heart Center , Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences , Tehran, Iran
| | - Soheil Saadat
- Department of Emergency Medicine, University of California, Irvine, CA, USA
| | - Ali Vasheghani-Farahani
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Sadeghian
- Tehran Heart Center , Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences , Tehran, Iran
| | - Vicente Artola Arita
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Mohamamdali Boroumand
- Tehran Heart Center , Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences , Tehran, Iran
| | - Abbasali Karimi
- Tehran Heart Center , Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences , Tehran, Iran
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Rajabi R, Eslami Aliabadi H, Javad Mahdizadeh M, Azzizadeh Forouzi M. A comparative study of religious beliefs, spiritual intelligence and spiritual well-being in two therapies based on education (anonymous drug user) and methadone in drug user in Iran. BMC Res Notes 2023; 16:101. [PMID: 37308965 PMCID: PMC10262557 DOI: 10.1186/s13104-023-06377-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 06/05/2023] [Indexed: 06/14/2023] Open
Abstract
OBJECTIVE Prevention of high-risk behaviors has always been considered; According to the researches, a person's religious attitudes and beliefs and intelligence quotient are associated with the prevention of high-risk behaviors such as drug addiction, and religiosity and spirituality also reduce drug addiction; Therefore, this study was conducted to compare religious beliefs, intelligence and spiritual health in two methods of education-based treatment and methadone in people with addiction. RESULTS A comparative study was performed among 184 people on all drug users admitted to these wards that treated with methadone and participants of meetings of anonymous drug users. Four questionnaires were used to collect information. Mean, and standard deviation were used to describe the demographic characteristics of participants. Chi-square and fisher tests were used to compare demographic information in the two groups. The present study was performed following acquisition of the code of ethics (IR.BUMS.REC.1395.156) from Research Ethics Committee of Birjand University of Medical Sciences.
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Affiliation(s)
- Raheleh Rajabi
- Department of Nursing, Zarand School of Nursing, Kerman University of Medical Sciences, Kerman, Iran
| | - Hassan Eslami Aliabadi
- Nursing midwifery school, Assistant Professor of Nursing, Department of Nursing, Ferdows School of Health and Allied Medical Sciences, Birjand university of Medical Sciences, Birjand, Iran
| | - Mohammad Javad Mahdizadeh
- Instructor of Nursing, Nursing Department, Zarand School of Nursing, Kerman University of Medical Sciences, Kerman, Iran
| | - Mansooreh Azzizadeh Forouzi
- Medical surgical nursing, Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.
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Mokhtari M. Opioids ease my pain: Early-life malnutrition and elderly outcomes. Soc Sci Med 2023; 327:115940. [PMID: 37178551 DOI: 10.1016/j.socscimed.2023.115940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/08/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023]
Abstract
Despite a large body of evidence showing that early-life malnutrition influences adult outcomes, there is no evidence that early-life starvation causes use of opioids. Studying the long-term effects of a food shortage in Iran caused by WWII, we find that the rate of people who use drugs in this cohort increased significantly higher than in surrounding cohorts. Then, we examine a broad spectrum of outcomes for this cohort to shed light on potential causes of opioid use in the survivors of this cohort. Our findings suggest that pain contributes significantly to opioid use.
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Affiliation(s)
- MohammadAli Mokhtari
- Institute of Economics (IdEP), Università della Svizzera Italiana, Via Giuseppe Buffi 13, 6900, Lugano, Switzerland.
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Experiences and Perspectives of Patients Treated with Methadone on Mental Health Aspect of Lifestyle: A Qualitative Study. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2022. [DOI: 10.5812/ijpbs-128804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Drug abuse and its consequences place a considerable social and economic burden on society. Drug abuse has increased in Iran and reached three times the global average, indicating the need to develop innovative strategies to cope with this phenomenon. Objectives: Following a community-based participatory research approach, the aim was to identify the lived experience of drug users regarding the psychological aspect of their lifestyle. Methods: Narrative inquiry and phenomenological design were applied as the research framework. The use of in-depth interviewees and field notes guided the data collection and analysis. A total of 26 in-depth interviews were conducted with people who suffered from drug use (7 females and 19 males) in 2021. Interviewees ranging from 70 to 90 minutes were conducted in a quiet, private location chosen by the researcher. All interviews were audio-taped and transcribed, and analyzed using Colaizzi's method. Data analysis was administered using MAXQDA version 2020. Results: Most of the participants were educated Diploma and above. The participants' age ranged from 25 to 53 years old. During the interview, the subjects were in the following stages, methadone treatment time (n = 26). The analysis revealed four themes, and 11 sub-themes emerged. The themes were as follows: (1) negative emotions; (2) poor psychological capital; (3) poor support; and (4) psychological well-being. Conclusions: The most important problems of people with substance use, in the psychological dimension of lifestyle, include experiencing negative emotions, weak psychological capital, weak social support, unhealthy psychological well-being such as negative self-acceptance, reduced positive relations, not having a purposeful life, and inability to control environmental pressures. Hopefully, this study can help health policymakers develop more effective strategies against drug use.
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Rostam-Abadi Y, Gholami J, Noroozi A, Ansari M, Baheshmat S, Hamzehzadeh M, Ghadirzadeh MR, Vahdani B, Ekhtiari H, Mojtabai R, Rahimi-Movaghar A. Public health risks associated with methadone in Iran: A systematic review and meta-analysis. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 100:103529. [PMID: 34826790 DOI: 10.1016/j.drugpo.2021.103529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 09/25/2021] [Accepted: 10/30/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND There has been a marked growth in methadone maintenance treatment (MMT) in Iran in the past two decades with positive health outcomes. We conducted a systematic review of studies on the prevalence of non-prescribed methadone use, methadone use disorder, and methadone-related poisoning and mortality in Iran. METHODS We searched International and Iranian databases up to May 2020 and contacted relevant experts. The pooled proportions were estimated through random-effects model. Methadone-related adverse outcomes were evaluated over time. RESULTS Sixty-five studies were included. The pooled estimates of non-prescribed methadone use in the last 12-month were 2.7% (95%CI: 0.9-5.4) and 0.1% (95%CI: 0.03-0.2) in the male and female general population, respectively. Among people who use drugs, 8.4% reported daily non-prescribed use in 2018. Four heterogeneous studies in drug treatment centers reported the existence of treatment-seeking for methadone use disorder. Methadone was responsible for 10.4% (95%CI: 4.5-18.3) of cases of acute poisoning in adults and 16.0% (95%CI: 9.3-24.1) in children. Methadone was reported as a cause of death in 53.5% of substance-related deaths referred to the Legal Medicine Organization while being the only cause in 35.8% of all cases. CONCLUSION Non-prescribed use of methadone in the general population is much less than opiates and some other available prescription opioids, like tramadol. However, notwithstanding the large and successful MMT program in Iran, increasing trends in methadone-related poisoning and deaths pose serious public health concerns. There is an urgent need to explore these fatal and non-fatal poisoning cases and implement policies to curb the harms associated with methadone use.
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Affiliation(s)
- Yasna Rostam-Abadi
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Jaleh Gholami
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Noroozi
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Ansari
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Shahab Baheshmat
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran; Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine (SATiM), Tehran University of Medical Sciences, Tehran, Iran
| | - Marziyeh Hamzehzadeh
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran; Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine (SATiM), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Bita Vahdani
- Center for Disease Affairs and Transplant, Ministry of Health, Tehran, Iran
| | - Hamed Ekhtiari
- Laureate Institute for Brain Research, Tulsa, Oklahoma, USA
| | - Ramin Mojtabai
- Department of Mental Health, Bloomberg School of Public Health and Department of Psychiatry, Johns Hopkins University, Baltimore, Maryland, USA
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran.
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Abstract
This paper is the forty-second consecutive installment of the annual anthological review of research concerning the endogenous opioid system, summarizing articles published during 2019 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides and receptors as well as effects of opioid/opiate agonists and antagonists. The review is subdivided into the following specific topics: molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors (1), the roles of these opioid peptides and receptors in pain and analgesia in animals (2) and humans (3), opioid-sensitive and opioid-insensitive effects of nonopioid analgesics (4), opioid peptide and receptor involvement in tolerance and dependence (5), stress and social status (6), learning and memory (7), eating and drinking (8), drug abuse and alcohol (9), sexual activity and hormones, pregnancy, development and endocrinology (10), mental illness and mood (11), seizures and neurologic disorders (12), electrical-related activity and neurophysiology (13), general activity and locomotion (14), gastrointestinal, renal and hepatic functions (15), cardiovascular responses (16), respiration and thermoregulation (17), and immunological responses (18).
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, 65-30 Kissena Blvd., Flushing, NY, 11367, United States.
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Javadi HR, Mirakbari SM, Allami A, Yazdi Z, Katebi K. Opium-associated QT Interval Prolongation: A Cross-sectional Comparative Study. Indian J Crit Care Med 2021; 25:43-47. [PMID: 33603300 PMCID: PMC7874289 DOI: 10.5005/jp-journals-10071-23596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Toxicity and side effects of long-term use of opioids are well studied, but little information exists regarding electrophysiological disturbances of opium consumption. While natural opium has been regarded safe to a great extent among traditional communities, concerns are emerging owing to the available evidence of QT prolongation that have been exposed during recent outcome surveillance of patients under opioid use. Potential QT prolonging interactions would raise a higher level of such concern in opium users during COVID pandemic and warrant attention. Materials and methods This study was designed to detect the prevalence of QTc prolongation among opium users and nonusers. Two groups were compared with regard to gender, age, and median QTc interval. Normal and prolonged QTc intervals of user group were compared with respect to age, sex, dose of opium consumption, and duration of opium consumption. Results 123 opium users and 39 controls were investigated. Median QTc interval in opium user and non-user group was 460 vs 386 milliseconds, respectively (p value < 0.001). In all, 59.3%, (95% CI: 50.51–67.62%) of cases and none of non-user had prolonged QTc interval (p value < 0.001). There was no significance between normal and prolonged QTc intervals with respect to dose and duration of opium use. Conclusion This study indicated that opium consumption is associated with QTc prolongation. This prolongation does not relate to dose and duration of opium use. Further study is propounded to assess the clinical significance of these results and to determine risk rating of opium compared to other opioids in this regard. How to cite this article Javadi HR, Mirakbari SM, Allami A, Yazdi Z, Katebi K. Opium-associated QT Interval Prolongation: A Cross-sectional Comparative Study. Indian J Crit Care Med 2021;25(1):43–47.
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Affiliation(s)
- Hamid R Javadi
- Department of Cardiology, Bu Ali Hospital, Qazvin University of Medical Sciences, Qazvin, Islamic Republic of Iran
| | - Seyed M Mirakbari
- Department of Clinical Toxicology, Bu Ali Hospital, Qazvin University of Medical Sciences, Qazvin, Islamic Republic of Iran
| | - Abbas Allami
- Department of Infectious Disease, Bu Ali Hospital, Qazvin University of Medical Sciences, Qazvin, Islamic Republic of Iran
| | - Zohreh Yazdi
- Metabolic Disease Research Center, Bu Ali Hospital, Qazvin University of Medical Sciences, Qazvin, Islamic Republic of Iran
| | - Kimia Katebi
- Faculty of Medicine, Qazvin University of Medical Sciences, Islamic Republic of Iran
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11
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Sharma A. Opium-associated QT Interval Prolongation: A Cross-sectional Comparative Study. Indian J Crit Care Med 2021; 25:6-7. [PMID: 33603292 PMCID: PMC7874287 DOI: 10.5005/jp-journals-10071-23704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
How to cite this article: Sharma A. Opium-associated QT Interval Prolongation: A Cross-sectional Comparative Study. Indian J Crit Care Med 2021;25(1):6-7.
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Affiliation(s)
- Ankit Sharma
- Department of Anesthesia and Intensive Care, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
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12
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Demir B, Ozsoy F, Buyuk A, Altindag A. ECG changes in patients with opioid use disorder; P-QT wave dispersion: a retrospective study. J Addict Dis 2020; 39:234-240. [PMID: 33215556 DOI: 10.1080/10550887.2020.1848257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE We aimed to examine the electrocardiographic arrhythmia risk predictors in patients with opioid use disorder by P wave dispersion, QT dispersion, and by comparing Tp-e/QTc ratio with healthy controls. METHODS One hundred seventeen patients who were diagnosed with opioid use disorder according to DSM-5 criteria and who were hospitalized in 25 Aralık Gaziantep State Hospital AMATEM (Alcohol and substance addiction treatment center) service and a healthy control group consisting of 168 subjects were included in the study. Electrocardiography (ECG) scans of all participants were performed in the supine position and at rest. P wave dispersion, QT dispersion, and Tp-e/QTc ratio were calculated. RESULTS Of all the participants, 12 were women (4.21%), 273 (95.78%) were men. The mean age of all participants was 30.42 ± 9.36 years. No difference was found between the gender, mean age, marital status, educational level, and smoking status of the participants (p > 0.05). The entire patient group was using heroin. Heart rate of the patient group was calculated as 68.14 ± 13.26 beats per minute, being lower than healthy controls (p < 0.05). Although QT dispersion value was lower than healthy controls (p < 0.05); P wave dispersion did not differ between groups (p > 0.05). CONCLUSION It is thought that the patients with opioid use disorder are at risk for cardiac arrhythmia based on our findings. Therefore, physicians should be careful about cardiac rhythm and conduction problems while organizing any treatment of these patients.
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Affiliation(s)
- Bahadir Demir
- Department of Psychiatry, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Filiz Ozsoy
- Clinic of Psychiatry, Tokat State Hospital, Tokat, Turkey
| | - Ahmet Buyuk
- 25 December State Hospital, Clinic of Cardiology, Gaziantep, Turkey
| | - Abdurrahman Altindag
- Department of Psychiatry, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
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13
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Abbaszadeh-Mashkani S, Hoque SS, Banafshe HR, Ghaderi A. The effect of crocin (the main active saffron constituent) on the cognitive functions, craving, and withdrawal syndrome in opioid patients under methadone maintenance treatment. Phytother Res 2020; 35:1486-1494. [PMID: 33078480 DOI: 10.1002/ptr.6913] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 09/14/2020] [Accepted: 10/04/2020] [Indexed: 12/23/2022]
Abstract
Individuals under methadone maintenance treatment (MMT) programs are susceptible to several complications, including withdrawal syndrome, craving, and cognitive deficits. This study was designed to elevate the effect of crocin administration on withdrawal syndrome, craving, and cognitive function in subjects under MMT programs. It was a clinical trial that was conducted among 60 patients referred to Soltan Mirahmad Clinic for addict patients in Kashan, Iran. The patients were allocated to two groups including placebo and intervention groups. The intervention group received 30 mg/day crocin (n = 30) and placebo (n = 30) once a day, in 12 weeks. Withdrawal syndrome, craving, and cognitive function parameters were measured before and after the intervention in subjects under MMT programs. Compared with the placebo group, crocin resulted in a significant improvement in craving score (p = .03), and withdrawal symptoms score (p = .01) in the intervention group. In addition, crocin supplementation did not affect cognitive function parameters (e.g., TMT, FAS test, and DGSP score). Overall, crocin supplementation for 12 weeks to patients under MMT programs had beneficial effects on craving and withdrawal symptoms score, but did not affect the cognitive function parameters.
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Affiliation(s)
- Samira Abbaszadeh-Mashkani
- Trauma Nursing Research Center, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Hamid Reza Banafshe
- Physiology Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Amir Ghaderi
- Department of Addiction studies, School of Medical, Kashan University of Medical Sciences, Kashan, Iran.,Clinical Research Development Unit-Matini/Kargarnejad Hospital, Kashan University of Medical Sciences, Kashan, Iran
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14
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Moradinazar M, Najafi F, Jalilian F, Pasdar Y, Hamzeh B, Shakiba E, Hajizadeh M, Haghdoost AA, Malekzadeh R, Poustchi H, Nasiri M, Okati-Aliabad H, Saeedi M, Mansour-Ghanaei F, Farhang S, Safarpour AR, Maharlouei N, Farjam M, Amini S, Amini M, Mohammadi A, Mirzaei-Alavijeh M. Prevalence of drug use, alcohol consumption, cigarette smoking and measure of socioeconomic-related inequalities of drug use among Iranian people: findings from a national survey. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2020; 15:39. [PMID: 32503660 PMCID: PMC7275311 DOI: 10.1186/s13011-020-00279-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 05/28/2020] [Indexed: 02/06/2023]
Abstract
Background Drug use can lead to several psychological, medical and social complications. The current study aimed to measure and decomposes socioeconomic-related inequalities in drug use among adults in Iran. Methods This was a cross-sectional study The PERSIAN Cohort is the largest and most important cohort among 18 distinct areas of Iran. This study was conducted on 130,570 adults 35 years and older. A structured questionnaire was applied to collect data. The concentration index (C) was used to quantify and decompose socioeconomic inequalities in drug use. Results The prevalence experience of drug use was 11.9%. The estimated C for drug use was − 0.021. The corresponding value of the C for women and men were − 0.171 and − 0.134, respectively. The negative values of the C suggest that drug use is more concentrated among the population with low socioeconomic status in Iran (p < 0.001). For women, socioeconomic status (SES) (26.37%), province residence (− 22.38%) and age (9.76%) had the most significant contribution to socioeconomic inequality in drug use, respectively. For men, SES (80.04%), smoking (32.04%) and alcohol consumption (− 12.37%) were the main contributors to socioeconomic inequality in drug use. Conclusions Our study indicated that drug use prevention programs in Iran should focus on socioeconomically disadvantaged population. Our finding could be useful for health policy maker to design and implement effective preventative programs to protect Iranian population against the drug use.
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Affiliation(s)
- Mehdi Moradinazar
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farzad Jalilian
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behrooz Hamzeh
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ebraim Shakiba
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Hajizadeh
- School of Health Administration, Faculty of Health, Dalhousie University, Halifax, Canada
| | - Ali Akbar Haghdoost
- Modeling in Health Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Malekzadeh
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzeyeh Nasiri
- Modelling in health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Hassan Okati-Aliabad
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Majid Saeedi
- Department of Pharmaceutics, School of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Sara Farhang
- Liver and gastrointestinal Diseases Research center, Tabriz University of Medical sciences, Tabriz, Iran
| | - Ali Reza Safarpour
- Gastroenterohe Pathology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Najmeh Maharlouei
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojtaba Farjam
- Non-communicable diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Saeed Amini
- Health Services Management, Arak University of Medical Sciences, Arak, Iran
| | - Mahin Amini
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Mohammadi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Mirzaei-Alavijeh
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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15
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Sadeghi Bimorgh M, Omidi A, Ghoreishi FS, Rezaei Ardani A, Ghaderi A, Banafshe HR. The Effect of Transcranial Direct Current Stimulation on Relapse, Anxiety, and Depression in Patients With Opioid Dependence Under Methadone Maintenance Treatment: A Pilot Study. Front Pharmacol 2020; 11:401. [PMID: 32308624 PMCID: PMC7145941 DOI: 10.3389/fphar.2020.00401] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 03/17/2020] [Indexed: 11/13/2022] Open
Abstract
Background and Objective Patients under methadone maintenance therapy (MMT) are susceptible to several complications including mental disturbances and risk of relapse. The present study was designed to evaluate the effects of tDCS on relapse, depression, and anxiety of opioid-dependent patients under methadone maintenance treatment (MMT). Methods It was a randomized-clinical trial that conducted among 27 male patients referred to the outpatient addiction clinic of Ibn-e-Sina psychiatric hospital in Mashhad from July 2018 to May 2019. Participants were allocated to two treatment groups including intervention and sham groups. The intervention group received seven sessions of tDCS, in the F3 (cathode) and F4 (anode) areas of the brain, each one lasts 20 min, in two consecutive weeks. Depression, anxiety, and stress scale-21 (DASS-21) were measured before, during, and after the intervention in patients under MMT. Relapse on the morphine, cannabis, and methamphetamine was screened by urine dipstick tests of morphine, cannabis, and methamphetamine. Results Depression, anxiety, and stress of participants were significantly reduced in the intervention group compared with the control after the seventh session of tDCS (P < 0.001, P=0.01, and P=0.01, respectively). In addition, the relapse rate showed no significant changes between the two groups (P=0.33). Conclusion Overall, our study demonstrated that depression, anxiety, and stress of participants were significantly reduced after the seventh session of tDCS, but did not affect on the relapse rate. Therefore, it can be applied as a safe and effective technique to relieve mental disorder among receiving MMT. Clinical Trial Registration http://www.irct.ir, identifier IRCT20180604039979N1.
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Affiliation(s)
- Mohammad Sadeghi Bimorgh
- Department of Addiction Studies, School of Medical, Kashan University of Medical Sciences, Kashan, Iran
| | - Abdollah Omidi
- Department of Clinical Psychology, School of Medicine, Kashan University of Medical Science, Kashan, Iran
| | - Fatemeh Sadat Ghoreishi
- Clinical Research Development Unit, Matini/Kargarnejad Hospital, Kashan University of Medical Sciences, Kashan, Iran
| | - Amir Rezaei Ardani
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Ghaderi
- Department of Addiction Studies, School of Medical, Kashan University of Medical Sciences, Kashan, Iran.,Clinical Research Development Unit, Matini/Kargarnejad Hospital, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamid Reza Banafshe
- Physiology Research Center, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran.,Department of Pharmacology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
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16
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Nakhaee S, Ghasemi S, Karimzadeh K, Zamani N, Alinejad-Mofrad S, Mehrpour O. The effects of opium on the cardiovascular system: a review of side effects, uses, and potential mechanisms. Subst Abuse Treat Prev Policy 2020; 15:30. [PMID: 32303254 PMCID: PMC7164148 DOI: 10.1186/s13011-020-00272-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 04/08/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Iran, as in many other Asian and Middle Eastern countries, some believe that opium has beneficial effects on cardiovascular system. Dependent patients suppose that opium has positive effects on cardiovascular function and can prevent or improve cardiovascular diseases; however, only few comprehensive studies evaluating such effects have been performed. OBJECTIVES In this study, we sought to clarify the effect of opium on cardiovascular problems by incorporating the previous findings and the current information on the issue and to explain the possible mechanisms of this effect. METHODS The available human studies published up to October 30, 2019, were searched in different databases. Case-control, cohort, and cross-sectional studies were retrieved. Papers published in English or those with an English abstract were included. The risk of bias for each included study was assessed based on the Newcastle-Ottawa Scale (NOS). We then categorized the effects of opium on cardiovascular problems along with its probable underlying mechanisms of action. RESULTS In this study, most of the published articles suggested the adverse effects of opium on the cardiovascular system, including atherosclerosis, myocardial infarction, arrhythmia, low ejection fraction, and cardiovascular mortality; however, some articles reported the beneficial or impartial effects of opium on the cardiovascular system. In this article, we have categorized all the effects of opium on cardiovascular system; also, the proposed mechanisms of action of opium in each of the above-mentioned disorders are summarized. CONCLUSION Although the available evidences were incoherent, it was mostly suggested that opium use does not protect against or improve cardiovascular problems.
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Affiliation(s)
- Samaneh Nakhaee
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
| | - Saeedeh Ghasemi
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Kimiya Karimzadeh
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Nasim Zamani
- Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Omid Mehrpour
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran.
- Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, 1391 Speer Blvd, 777 Bannock St. MC 0180, Denver, CO, 80204, USA.
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17
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Thind M, Rodriguez I, Kosari S, Turner JR. How to Prescribe Drugs With an Identified Proarrhythmic Liability. J Clin Pharmacol 2019; 60:284-294. [DOI: 10.1002/jcph.1551] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 10/10/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Munveer Thind
- Lankenau Institute for Medical Research Philadelphia Pennsylvania USA
| | - Ignacio Rodriguez
- Novartis Pharmaceutical Corporation East Hanover New Jersey USA
- Cardiac Safety Research Consortium Duke Clinical Research Institute Durham North Carolina USA
| | - Sam Kosari
- Discipline of Pharmacy, Faculty of Health University of Canberra Bruce Australian Capital Territory Australia
| | - J. Rick Turner
- Cardiac Safety Research Consortium Duke Clinical Research Institute Durham North Carolina USA
- The American College of Clinical Pharmacology Rockville Maryland USA
- Department of Pharmacy Practice Campbell University College of Pharmacy & Health Sciences Buies Creek North Carolina USA
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