Identifying Co-occurring Disorders Among Patients With an Opioid involved Hospital Encounter Using National Hospital Care Survey Data.

This report documents the development of the 2016 National Hospital Care Survey (NHCS) Co-occurring Disorders Algorithm, which can be used to identify patients with an opioid-involved hospital encounter who had lifetime diagnoses of both a substance use disorder and a selected mental health issue. Lifetime diagnoses are defined as diagnoses at any point in the past or during the current encounter. This algorithm was created to complement the earlier NHCS Enhanced Opioid Identification Algorithm designed to improve the classification of patients with opioid-involved hospital encounters.

Improvement in The Function of Isolated Rat Pancreatic Islets through Reduction of Oxidative Stress Using Traditional Iranian Medicine.

OBJECTIVE: Pancreatic islets have fewer antioxidant enzymes than other tissues and thus are vulnerable to oxidative stress. In the present study, the effects of nine specifically selected Iranian medical plants on the mitochondria function and survival of isolated rat islets were examined. MATERIALS AND METHODS: In this experimental study, following laparotomy, pancreases of rats were removed and the islets isolated and incubated in vitro for 24 hours. Logarithmic doses of plant materials were added to the islets and incubated for an additional 24 hours after which the viability of the cells and production of reactive oxygen species (ROS) were measured. Levels of insulin production in relation to static and stimulated glucose concen- trations were also determined. RESULTS: The tested compounds markedly increased survival of the islet cells, their mi- tochondrial activity, and insulin levels at the same time as reducing production of ROS. Greatest effects were observed in the following order: Peganum harmala, Glycyrrhiza glabra, Satureja hortensis, Rosmarinus officinalis, Teucrium scordium, Aloe vera, Zingiber officinale, Silybum marianum, and Hypericum perforatum at doses of 10, 10(3), 10(4), 10, 10(2), 10(2), 10(-1), 10 and 10(3)µgmL(-1), respectively. CONCLUSION: Based on these results, we suggest that pretreatment with these select- ed Iranian medical plants can improve the outcomes of pancreas transplants and grafts through the control of oxidative stress damage.

Breakthroughs in monogenic diabetes genetics: from pediatric forms to young adulthood diabetes.

Several monogenic forms of pancreatic beta-cell dysfunction leading to non-autoimmune diabetes have been diagnosed early in life, in neonates or during infancy, in childhood or even in young adulthood, with genetically heterogeneous aetiologies.They include neonatal diabetes mellitus, non auto-immune diabetes in infancy and childhood, dominantly inherited young-onset diabetes and very rare diabetes-associated syndromes. More than ten genes that are highly expressed in the pancreatic beta-cell have been identified in these monogenic subtypes of diabetes, and several aetiological mechanisms of beta-cell dysfunction are involved including reduced beta-cell number, failure of glucose sensing and increased destruction of the beta-cell, which result in inadequate insulin secretion despite a chronic hyperglycemia. There is rising evidence that common polymorphisms in the genes implicated in monogenic diabetes may also be involved in susceptibility to adulthood type 2 diabetes. This review describes the major advances arising from the identification of the genetic and molecular mechanisms underlying the clinical features of various conditions of diabetes in the young, and how these new genetic and biological insights led to novel pharmacogenomic approaches.

Antipsychotic Adherence Intervention for Veterans over 40 with Schizophrenia: Results of a Pilot Study.

This pilot study tested the feasibility, acceptability, and effect-sizes of a multimodal, individual intervention designed to optimize antipsychotic medication use in patients >/=40 years of age with schizophrenia or schizoaffective disorder. METHODS: We randomized 40 patients into two groups: usual care (UC) or a nine-session, manualized, antipsychotic adherence intervention (AAI). The AAI attempted to improve adherence by combining three psychosocial techniques: a) education, b) skills training, and c) alliance building. Sessions employed a semi-structured format to facilitate open communication. The primary outcome was antipsychotic adherence at study end. We obtained qualitative data regarding patient preferences for the duration and modality for receiving the adherence intervention. RESULTS: Compared to the UC group, a greater proportion of the AAI group was adherent post-intervention (65% vs. 55.6%; OR=1.49), a difference that was statistically not significant. The entire AAI group reported that they intended to take medications, and 75% were satisfied with the intervention. CONCLUSIONS: The AAI was feasible and acceptable. Preliminary data on its effectiveness warrant a larger study. Qualitative data shows that patients prefer brief adherence interventions and accept telephone strategies.