Buprenorphine/naloxone maintenance therapy in patients with meperidine use disorder

Meperidine hydrochloride is a synthetic opioid and a weak µ receptor agonist. Meperidine use disorder is mostly iatrogenic and is common in health care workers. In addition, it is prescribed in acute and chronic pain complaints, and has a high potential for creating addiction. Treatment of meperidine use disorder is a challenging issue and there is no standardised treatment for meperidine addiction. Buprenorphine is a μ receptor partial agonist, a long-acting synthetic opioid for the treatment of opioid dependence and has a buprenorphine/naloxone (BN) form combined with naloxone. Buprenorphine maintenance therapy is one of the treatment options performed in opiate use disorder. But there is a paucity of data about treatment of meperidine use disorder. Here, a full remission case report is presented with BN maintenance treatment for a patient with meperidine use disorder diagnosis

Urinary extract profiles of illegal substances at psychiatry and dependency clinics: three years report

Background: Substance abuse is a serious problem all over the world. There are many studies report the illegal substance use profile but few studies present their toxicology laboratory analysis. This study reports a quantitative profile of (Urine Drug Screening)) for illegal substances in Sakarya-Turkey.Methods: This study presents the urine analysis of all illegal substances which were made in the laboratory of Sakarya Training Research Hospital between March 2012 and February 2015. The results obtained from socio-demographic data and urine tests of patients were analyzed by examining their hospital record files. Urine drug screening was conducted with immunoassay quantitative analysis.Results: People subjected to substance analysis (n=2948) ages vary between 12 and 76, their mean age was 28.30±9.46. 96.74% (n=2852) of them were males. Substance positivity was determined in 34.73% of all patients (n=1024/2948) and their ages varied between 14 and 70 and their mean age was 29.39±9.65. Distribution of the urine positivity of the substances contained: marijuana 79, 5% (n=814), amphetamine 30.17% (n=309), ecstasy 23.74% (n=199), benzodiazepine 9,1% (n=94), synthetic cannabinoid 4.9% (n=12/243); opioid 5.2% (n=54), cocaine 1.67% (n=14) and multiple substance 29.9% (n=308).Conclusions: According to this study, marijuana is the most frequently used substance and multiple substance use is common. Synthetic cannabinoid seems to take place rapidly among the users. Updating the kits is important to reach the correct information in drug screening tests

Cadastral valuation as instrument for strategic planning

The article analyzes issues modern state improving of cadastral valuation methods. In this case, the role of the land and property complex in strategic and territorial planning is analyzed. The necessity of forecasting changes in the lands cadastral value for achieving strategic goals and the choice of town-planning solutions is shown

Evaluation of the Relationship Between the Level of Vitamin D in Maternal Blood and Breast Milk and Postpartum Depression

Objective: This study aimed to evaluate the relationship between postpartum depression (PPD) and vitamin D levels in maternal blood and breast milk. Material and Methods: The study included women who presented to a polyclinic between December 2017 and_x000D_ August 2018, 4-6 weeks after having given live birth, who were aged between 18 and 40 years and married, gave birth after a planned single_x000D_ pregnancy, were feeding their baby with only breast milk and stated that they were taking vitamin D supplementation at the dose recommended by the Ministry of Health. The depression status of the women who agreed to participate in the study by signing the volunteer informed_x000D_ consent form was evaluated using the Edinburgh Postpartum Depression Scale (EPDS). Two groups were formed as Group 1: EPDS score_x000D_ <13 (n=44) (without PPD) and Group 2: EPDS score ≥13 (n=31) (with PPD). The vitamin D levels in breast milk and maternal blood in both_x000D_ groups were compared. Results: 75 female patients included in the study had a mean age of 29.80±4.54 years. The mean vitamin D levels in_x000D_ breast milk and maternal blood were found to be 13.26±5.39 ng/mL and 17.14±6.79 ng/mL, respectively. In terms of depression status, no_x000D_ statistically significant difference was found between the groups regarding the serum vitamin D levels and the mean level of vitamin D in breast_x000D_ milk (p=0.463, p=0.847). Conclusion: No significant correlation was determined between the vitamin D levels in maternal blood and breast_x000D_ milk and PPD, while vitamin D was found to be low both in maternal blood and breast milk

Evaluation of nutritional status in pediatric intensive care unit patients: the results of a multicenter, prospective study in Turkey

IntroductionMalnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies.Material and MethodIn this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined.ResultsOf the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% (n = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% (n = 533) of the patients achieved the target calorie intake, and 81.65% (n = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h (p = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week (p = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p = 0.024).ConclusionTimely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score

Delirium and High Creatine Kinase and Myoglobin Levels Related to Synthetic Cannabinoid Withdrawal

Synthetic cannabinoids (SCs) are included in a group of drugs called new psychoactive substances. Effects of SCs on the central nervous system are similar to other cannabinoids, but 2–100 times more potent than marijuana. Thus, addiction and withdrawal symptoms are more severe than natural cannabinoids. Withdrawal symptoms of SCs were reported in the literature previously. But there is no report about SC withdrawal delirium and its treatment. Several studies reported that agonists of CB1 receptors play a role in GABA and glutamatergic neurotransmission, which is similar to the effects of alcohol on GABA and glutamatergic receptors. Previous studies on alcohol delirium cases suggested that elevated creatine kinase (CK) can be a marker of progress. This study reports delirium and high serum CK levels related to SC withdrawal and offers a treatment with benzodiazepine for them. We described two cases treated in our inpatient clinic about SC withdrawal with increase of serum CK level and other laboratory parameters. One of them demonstrated delirium symptoms and the other did not with early rapid treatment

Development of stigma scale for women with mental illness in perinatal period, validity and reliability study

Abstract Aim Although there are many scales that measure stigma, there is no scale with the necessary adequacy to measure stigma in the perinatal period. The study aims to develop the stigma scale for women with mental illness in the perinatal period and test its validity and reliability. Materials and methods Participants were reached via patients, visitors, and hospital staff who applied to Sakarya Training and Research Hospital between 01/06/2022 and 01/12/2022. Two hundred people (female n = 134, male n = 66) aged 18–65 participated in the study and "Sociodemographic data form," "Perinatal Mental Illness Stigma Scale (PMISS)," "Social Distance Scale," and "Beliefs Towards Mental Illness Scale" were used to collect data. Data were analyzed using SPSS 22 and the AMOS 26 program. Results The Content Validity Index of the scale items was between 0.80–1. Cronbach's alpha coefficient score of the general scale was 0.94, the "Discrimination and Prejudice" sub-dimension was 0.93, and the "Labeling" sub-dimension was 0.88. It was determined that item-total score correlations varied between 0.410 and 0.799. P value calculated < 0.05 in Barlett's test and 0.94 in the Kaiser-Meyer Olkin test. These values show that factor analysis can be applied to the scale. According to the Exploratory Factor Analysis result, the scale has a 2-factor structure, explaining 60% of the total variance. The Guttman Split-Half coefficient of the scale was 0.882, and the Spearman-Brown coefficient was 0.883. The scale was reapplied to 30 participants with an interval of three weeks. The correlation coefficient between the two measurements was 0.91, indicating that the scale satisfies the invariance principle over time. Conclusion The PMISS is a reliable measurement tool that can be used to investigate stigma towards mental illness during the perinatal period in the Turkish population