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1.
medRxiv ; 2023 Aug 20.
Article in English | MEDLINE | ID: mdl-37645940

ABSTRACT

Opioid dependence is a national crisis, with 30 million patients annually at risk of becoming persistent opioid users after receiving opioids for post-surgical pain management. Translational Pain Services (TPS) demonstrate effectiveness for behavioral health improvements but its effectiveness in preventing persistent opioid use is less established, especially amongst opioid exposed patients. Prohibitive costs and accessibility challenges have hindered TPS program adoption. To address these limitations, we designed and implemented a remote telehealth TPS protocol focusing on preventing continued opioid use while improving behavioral health. Licensed therapists trained in the opioid-tapering CBT protocol delivered sessions reimbursed through standard payer reimbursement. Our prospective study evaluated the protocol's effectiveness on preventing persistent opioid use and behavioral health outcomes amongst both opioid naïve and exposed patients. In an opioid-naive patient cohort (n=67), 100% completely tapered off opioids, while in an opioid-exposed cohort (n =19) 52% completely tapered off opioids, demonstrating promising results. In both cohorts, we observed significant improvements in behavioral health scores, including pain. This opioid-tapering digital TPS is effective, adoptable, and incurs no out-of-pocket cost for healthcare systems. We provide the opioid-tapering CBT protocol in the supplement to facilitate adoption. Trial Registration Impact of Daily, Digital and Behavioral Tele-health Tapering Program for Perioperative Surgical Patients Exposed to Opioids and Benzodiazepines registered at clinicaltrials.gov, NCT04787692. https://clinicaltrials.gov/ct2/show/NCT04787692?term=NCT04787692&draw=2&rank=1.

2.
J Child Neurol ; 23(8): 922-5, 2008 Aug.
Article in English | MEDLINE | ID: mdl-18660475

ABSTRACT

Monosomy 1p36 is a newly delineated multiple congenital anomalies/mental retardation syndrome characterized by mental retardation, growth delay, epilepsy, congenital heart defects, characteristic facial appearance, and precocious puberty. It is now considered to be one of the most common subtelomeric micro-deletion syndromes. This article reports new findings of choroid plexus hyperplasia and dextrocardia with situs solitus in a patient who had deletion of chromosome 1p26.33 with a brief review of the literature.


Subject(s)
Abnormalities, Multiple/genetics , Choroid Plexus/abnormalities , Choroid Plexus/pathology , Chromosome Deletion , Craniofacial Abnormalities/genetics , Dextrocardia/genetics , Intellectual Disability/genetics , Monosomy/genetics , Abnormalities, Multiple/diagnosis , Child , Child Behavior Disorders/diagnosis , Child Behavior Disorders/genetics , Craniofacial Abnormalities/diagnosis , Developmental Disabilities/diagnosis , Developmental Disabilities/genetics , Dextrocardia/diagnosis , Female , Humans , Hyperplasia , Intellectual Disability/diagnosis , Magnetic Resonance Imaging , Papilloma, Choroid Plexus/diagnosis , Papilloma, Choroid Plexus/genetics , Self-Injurious Behavior/diagnosis , Self-Injurious Behavior/genetics , Tomography, X-Ray Computed
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