Contamination of surface water and drinking water with pharmaceuticals presents an environmental concern. It has been shown to affect aquatic organisms and have adverse health effects on humans. One of the most common pharmaceutical contaminants is the opioid analgesic tramadol. In this communication, we report on the first surface plasmon resonance biosensor-based detection of tramadol in water. The biosensor utilizes a binding inhibition format and enables detection of tramadol at a wide range of concentrations (5 orders of magnitude) with a limit of detection of 0.52 µg/L. The results of a small-scale environmental study are reported in which the biosensor was used to analyze river water samples. The results were found to agree well with those obtained using the liquid chromatography-tandem mass spectrometry (HPLC-MS/MS).

• Klíčová slova
• Biosensor, Surface plasmon resonance, Tramadol, Water quality monitoring,
• MeSH
• biosenzitivní techniky * metody   MeSH
• chemické látky znečišťující vodu * analýza   MeSH
• limita detekce MeSH
• monitorování životního prostředí * metody   MeSH
• opioidní analgetika * analýza   MeSH
• povrchová plasmonová rezonance * metody   MeSH
• řeky chemie   MeSH
• tandemová hmotnostní spektrometrie MeSH
• tramadol * analýza   MeSH
• vysokoúčinná kapalinová chromatografie MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• chemické látky znečišťující vodu * MeSH
• opioidní analgetika * MeSH
• tramadol * MeSH

A common opioid analgesic for cancer pain and, to a lesser extent, non-cancer pain, is hydromorphone (HM). Oral formulations as well as subcutaneous, intravenous, and other routes are frequently used for its administration. Its pharmacokinetics and pharmacodynamics have also been extensively researched. This article examines the pharmacological properties of hydromorphone and the development of its use both domestically and internationally with the goal of serving as a reference for the sensible clinical use of this medication. Key words Hydromorphone, Pharmacological action, Route of administration, Cancer pain, Adverse effects.

• MeSH
• hydromorfon * aplikace a dávkování   škodlivé účinky   terapeutické užití   farmakologie   farmakokinetika   MeSH
• lidé MeSH
• nádorová bolest * farmakoterapie   metabolismus   MeSH
• opioidní analgetika * aplikace a dávkování   škodlivé účinky   terapeutické užití   farmakologie   farmakokinetika   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• hydromorfon * MeSH
• opioidní analgetika * MeSH

Abuse of the highly toxic compound fentanyl and its analogues is increasing, raising serious public health concerns due to their potency and availability. Therefore, there is a need for decontamination methodologies to safely remove fentanyl to avoid harmful exposure. In this study, the efficacy of commercial and in-house synthesized decontamination agents (Dahlgren Decon, RSDL (Reactive Skin Decontamination Lotion), FAST-ACT (First applied sorbent treatment against chemical threats), GDS2000, alldecont MED, bleach, Domestos Spray Bleach, Effekt Klor, MgO, TiO2-nanodiamond, and CeO2) were evaluated for the degradation of fentanyl and carfentanil under controlled laboratory conditions and on wooden floor surfaces. Liquid chromatography/mass spectrometry analysis showed that oxidative decontamination agents were the most effective, with N-oxides identified as major degradation products. The physiological effects of these N-oxides were also investigated regarding their ability to activate the µ-opioid receptor and their metabolism in human liver microsomes. The results provide empirical evidence that complements prior research findings on the degradation of fentanyl and carfentanil using a variety of decontamination agents.

• MeSH
• dekontaminace * metody   MeSH
• fentanyl * analogy a deriváty   farmakologie   MeSH
• jaterní mikrozomy metabolismus   MeSH
• lidé MeSH
• opioidní analgetika farmakologie   MeSH
• receptory opiátové mu metabolismus   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• carfentanil MeSH Prohlížeč
• fentanyl * MeSH
• opioidní analgetika MeSH
• receptory opiátové mu MeSH

PURPOSE: Pain after open urological procedures is often intense. The aim of the study was to compare the efficacy of intrathecal morphine with systemic analgesia approaches. DESIGN: Prospective, randomized, single-blind controlled study. METHODS: Patients undergoing open prostatectomy or nephrectomy were randomly divided into the intervention group or the control group. Patients in the intervention group received morphine 250 mcg in 2.5 mL saline intrathecally. Anesthesia was identical in both groups. All patients were admitted to the intensive care unit (ICU) postoperative and received paracetamol 1 g intravenously every 6 hours and diclofenac 75 mg intramuscularly every 12 hours. If postoperative pain exceeded four on the numeric rating scale, morphine 10 mg was administered subcutaneously. Pain intensity, time to first dose of morphine, morphine doses, and side effects were recorded. FINDINGS: In total, 41 patients were assigned to the intervention group and 57 to the control group. The time to administration of the first dose of morphine was significantly (P < .001) longer in the intervention group when compared to controls. This observation was also noted individually for patients undergoing nephrectomy (36.86 hours vs 4.06 hours) and prostatectomy (33.13 hours vs 4.5 hours). Many patients did not need opioids after surgery in the intervention group (nephrectomy 72% vs 3%, prostatectomy 75% vs 4.5%, P < .001). There was no significant difference in the incidence of side effects. CONCLUSIONS: The results of our study confirmed that preoperative intrathecal morphine provides long-lasting analgesia and reduces the need for postoperative systemic administration of opioids. Adverse effects are minor and comparable between groups.

• Klíčová slova
• analgesia, intrathecal morphine, nephrectomy, postoperative pain, prostatectomy,
• MeSH
• anestetika lokální aplikace a dávkování   MeSH
• jednoduchá slepá metoda MeSH
• lidé středního věku MeSH
• lidé MeSH
• morfin * aplikace a dávkování   MeSH
• nefrektomie * metody   MeSH
• opioidní analgetika * aplikace a dávkování   MeSH
• pooperační bolest * farmakoterapie   prevence a kontrola   MeSH
• prospektivní studie MeSH
• prostatektomie * metody   MeSH
• senioři MeSH
• spinální injekce * metody   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• anestetika lokální MeSH
• morfin * MeSH
• opioidní analgetika * MeSH

BACKGROUND: Adequate postoperative pain treatment is important for quality of life, patient satisfaction, rehabilitation, function, and total opioid consumption, and might lower both the risk of chronic postoperative pain and the costs for society. Prolonged opioid consumption is a well-known risk factor for addiction. Previous studies in upper extremity surgery have shown that total opioid consumption is a third of the amount prescribed, which can be explained by package size. The aim of this study was to examine whether implementation of prepacked takehome analgesia bags reduced the quantity of prescribed and dispensed opioids. MATERIAL AND METHODS: We introduced prepacked take-home analgesia bags for postoperative pain treatment in outpatient surgery. The bags came in two sizes, each containing paracetamol, etoricoxib, and oxycodone. The first 147 patients who received the prepacked analgesia bags were included in the study, and received a questionnaire one month after surgery covering self-assessed pain (visual analog scale of 0-10) and satisfaction (0-5), as well as opioid consumption. Prescription data after introducing the analgesia bags were compared with data before the bags were introduced. RESULTS: Of the 147 patients included in the study, 58 responded. Compared to standard prescription (small bag group: 14 oxycodone immediate release capsules (5 mg), large bag group: additional 28 oxycodone extended release tablets (5 mg), based on the smallest available package), the patients in the small analgesia bag group received 50% less oxycodone and 67% less for the large bag group. Patients with small bags consumed a median of 0.0 mg oxycodone and those with large bags consumed a median of 25.0 mg oxycodone. The median satisfaction was 5.0 (range: 2-5) and the median pain score was acceptable at the first postoperative day. Prescription data showed a significant reduction of 60.0% in the total amount of prescribed opioids after the introduction of prepacked analgesia bags. CONCLUSIONS: The introduction of prepacked analgesia bags dramatically reduced the quantity of opioids prescribed after outpatient hand surgery. Patient satisfaction was high and the postoperative pain level was acceptable. KEY WORDS: analgesia, hand surgery, opioids, outpatint surgery, wrist surgery.

• MeSH
• ambulantní chirurgické výkony * metody   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• management bolesti metody   MeSH
• měření bolesti MeSH
• opioidní analgetika * aplikace a dávkování   MeSH
• oxykodon aplikace a dávkování   MeSH
• paracetamol aplikace a dávkování   terapeutické užití   MeSH
• pooperační bolest * prevence a kontrola   farmakoterapie   MeSH
• ruka chirurgie   MeSH
• spokojenost pacientů MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• opioidní analgetika * MeSH
• oxykodon MeSH
• paracetamol MeSH

BACKGROUND: Knowledge of co-occurring mental disorders (termed 'dual diagnosis') among patients receiving opioid agonist treatment (OAT) is scarce. This study aimed (1) to estimate the prevalence and structure of dual diagnoses in two national cohorts of OAT patients and (2) to compare mental disorders between OAT patients and the general populations stratified on sex and standardized by age. METHODS: A registry-linkage study of OAT patients from Czechia (N = 4,280) and Norway (N = 11,389) during 2010-2019 was conducted. Data on mental disorders (F00-F99; ICD-10) recorded in nationwide health registers were linked to the individuals registered in OAT. Dual diagnoses were defined as any mental disorder excluding substance use disorders (SUDs, F10-F19; ICD-10). Sex-specific age-standardized morbidity ratios (SMR) were calculated for 2019 to compare OAT patients and the general populations. RESULTS: The prevalence of dual diagnosis was 57.3% for Czechia and 78.3% for Norway. In Czechia, anxiety (31.1%) and personality disorders (25.7%) were the most prevalent, whereas anxiety (33.8%) and depression (20.8%) were the most prevalent in Norway. Large country-specific variations were observed, e.g., in ADHD (0.5% in Czechia, 15.8% in Norway), implying differences in screening and diagnostic practices. The SMR estimates for any mental disorders were 3.1 (females) and 5.1 (males) in Czechia and 5.6 (females) and 8.2 (males) in Norway. OAT females had a significantly higher prevalence of co-occurring mental disorders, whereas SMRs were higher in OAT males. In addition to opioid use disorder (OUD), other substance use disorders (SUDs) were frequently recorded in both countries. CONCLUSIONS: Results indicate an excess of mental health problems in OAT patients compared to the general population of the same sex and age in both countries, requiring appropriate clinical attention. Country-specific differences may stem from variations in diagnostics and care, reporting to registers, OAT provision, or substance use patterns.

• Klíčová slova
• Dual diagnosis, Opioid agonist treatment, Opioid use disorder, Psychiatric comorbidity, Registry-based study,
• MeSH
• diagnóza dvojí (psychiatrie) MeSH
• dospělí MeSH
• duševní poruchy * epidemiologie   farmakoterapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• opiátová substituční terapie * statistika a číselné údaje   MeSH
• opioidní analgetika terapeutické užití   MeSH
• poruchy osobnosti epidemiologie   MeSH
• poruchy spojené s užíváním opiátů * epidemiologie   farmakoterapie   MeSH
• prevalence MeSH
• registrace * MeSH
• senioři MeSH
• sexuální faktory MeSH
• úzkostné poruchy epidemiologie   farmakoterapie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Norsko epidemiologie   MeSH
• Názvy látek
• opioidní analgetika MeSH

BACKGROUND: Orofacial clefts are the most common congenital abnormalities. Cleft lip reconstruction is performed mostly in 3 months of life including the neonatal period. The consumption of opioids during anesthesia is one of the monitored parameters of anesthesia safety. We investigated the effect of using an infraorbital nerve block for reducing opioid consumption during cleft lip surgery in neonates. PATIENTS/METHODS: Overall, 100 patients who underwent primary cleft lip surgery in neonatal age between 2018 and 2021 were included in the study. The primary outcome was to compare opioid requirements during cleft lip surgery with and without using regional anesthesia. Secondary outcomes included a first oral intake from surgery between neonates with and without regional anesthesia and complications rate of infraorbital nerve block. RESULTS: Data from 100 patients (46 patients with and 64 without regional anesthesia) were retrospectively analyzed and classified into two groups according to whether regional anesthesia during neonatal cleft lip surgery had been performed or not. The use of infraorbital block was found to be positively correlated with lower doses of opioids used during the general anesthesia for the surgery (mean 0.48 μg/kg vs 0.29 μg/kg, p < 0.05). The postoperative course was evaluated based on the interval from surgery to first oral intake which was statistically insignificant shorter (p = 0.16) in the group of patients using regional anesthesia. No complications were recorded in the group of patients with regional anesthesia. CONCLUSIONS: Regional anesthesia is associated with reduced opioid consumption during anesthesia thereby increasing the safety of anesthesia in neonates. GOV IDENTIFIER: NCT06067854https://clinicaltrials.gov/study/NCT06067854?cond=NCT06067854&rank=1.

• Klíčová slova
• Cleft lip, Infraorbital nerve block, Neonatal cleft lip surgery, Opioids in neonates, Regional anesthesia,
• MeSH
• lidé MeSH
• nervová blokáda * metody   MeSH
• novorozenec MeSH
• opioidní analgetika * terapeutické užití   MeSH
• pooperační bolest farmakoterapie   prevence a kontrola   MeSH
• retrospektivní studie MeSH
• rozštěp patra * chirurgie   MeSH
• rozštěp rtu * chirurgie   MeSH
• svodná anestezie * metody   MeSH
• zákroky plastické chirurgie metody   škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• opioidní analgetika * MeSH

Endogenous opioid peptides serve as potent analgesics through the opioid receptor (OR) activation. However, they often suffer from poor metabolic stability, low lipophilicity, and low blood-brain barrier permeability. Researchers have developed many strategies to overcome the drawbacks of current pain medications and unwanted biological effects produced by the interaction with opioid receptors. Here, we tested multifunctional enkephalin analogs LYS739 (MOR/DOR agonist and KOR partial antagonist) and LYS744 (MOR/DOR agonist and KOR full antagonist) under in vivo conditions in comparison with MOR agonist, morphine. We applied 2D electrophoretic resolution to investigate differences in proteome profiles of crude membrane (CM) fractions isolated from the rat brain cortex and hippocampus exposed to the drugs (10 mg/kg, seven days). Our results have shown that treatment with analog LYS739 induced the most protein changes in cortical and hippocampal samples. The identified proteins were mainly associated with energy metabolism, cell shape and movement, apoptosis, protein folding, regulation of redox homeostasis, and signal transduction. Among these, the isoform of mitochondrial ATP synthase subunit beta (ATP5F1B) was the only protein upregulation in the hippocampus but not in the brain cortex. Contrarily, the administration of analog LYS744 caused a small number of protein alterations in both brain parts. Our results indicate that the KOR full antagonism, together with MOR/DOR agonism of multifunctional opioid ligands, can be beneficial in treating chronic pain states by reducing changes in protein expression levels but retaining analgesic efficacy.

• Klíčová slova
• Crude membrane fractions, KOR antagonism, Morphine, Multifunctional enkephalin analogs, Proteomic analysis, Rat brain,
• MeSH
• analgetika MeSH
• enkefaliny metabolismus   MeSH
• hipokampus metabolismus   MeSH
• krysa rodu Rattus MeSH
• morfin * farmakologie   MeSH
• mozek metabolismus   MeSH
• opioidní analgetika farmakologie   MeSH
• receptory opiátové mu * metabolismus   MeSH
• receptory opiátové metabolismus   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu Rattus MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• analgetika MeSH
• enkefaliny MeSH
• morfin * MeSH
• opioidní analgetika MeSH
• receptory opiátové mu * MeSH
• receptory opiátové MeSH

BACKGROUND: There is a lack of studies on methamphetamine (MA) exposure and morbidity in children beyond the perinatal period. OBJECTIVES: We compared morbidity in children (0-3 years) with prenatal MA exposure to opioid-exposed and to non-exposed children. METHODS: We used data from a Czech nationwide, registry-based cohort study (2000-2014). Children, who reached 3 years of age, of mothers hospitalized with (i) MA use disorder during pregnancy (MA; n = 194), (ii) opioid use disorder during pregnancy (opioids; n = 166), and (iii) general population (GP; n = 1,294,349) with no recorded history of substance use disorder (SUD). Information on inpatient contacts, length of stay, and diagnoses (International Statistical Classification of Diseases and Related Health Problems 10th Revision [ICD-10]) were assessed. Crude and adjusted odds ratios (aOR), 95% confidence interval (CI) for the risk of hospitalization, and for getting diagnosis from the ICD-10 diagnosis chapters were calculated using binary logistic regression. A stratified analysis on hospitalizations with SUD of mothers was performed. RESULTS: No significant differences were found in the measures of hospitalization between the MA and opioid groups. Children prenatally exposed to MA and opioids had higher numbers of hospitalizations and diagnoses and longer stays in hospital than children in the GP. Increased risks of certain infectious and parasitic diseases were found in both MA (aOR = 1.6; CI: 1.1-2.3) and opioid (aOR = 1.9; 1.3-2.8) groups as compared to the GP group. The most pronounced difference in stratified analysis on maternal hospitalizations related to SUD after birth was observed for injury, poisoning, and certain other consequences of external causes in the strata of the MA group who had hospitalized mothers (aOR 6.3, 1.6-24.6) compared to the strata without maternal hospitalizations (aOR 1.4, 0.9-2.3). CONCLUSION: This study suggests that children born to mothers using MA during pregnancy have similar morbidity during the first 3 years of life but higher than the GP. The excess of risk was primarily due to infections and injuries in the MA group.

• Klíčová slova
• Child morbidity, Health registries, Hospitalization, Long-term effects, Methamphetamine, Prenatal exposure,
• MeSH
• dítě MeSH
• kohortové studie MeSH
• lidé MeSH
• methamfetamin * škodlivé účinky   MeSH
• morbidita MeSH
• opioidní analgetika terapeutické užití   MeSH
• poruchy spojené s užíváním opiátů * epidemiologie   farmakoterapie   MeSH
• registrace MeSH
• těhotenství MeSH
• zpožděný efekt prenatální expozice * epidemiologie   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• methamfetamin * MeSH
• opioidní analgetika MeSH

The presence of pharmaceuticals (PHA) and narcotics (NAR) in wastewater (WW) has attracting growing interest due to concern for aquatic environment and the possibility to exploit their presence to estimate drug consumption by population. This work aims to (i) quantify PHA and NAR in the WW of the Brno metropolitan area, (ii) determine the effectiveness of the current conventional wastewater treatment plant (WWTP), and (iii) estimate the illicit drug (ID) consumption. 23 PHA and 9 NAR were frequently detected in the untreated WW and studied for their removal. One year monitoring was carried out to highlight a possible seasonal pattern with PHA and NAR load in WW, WWTP effectiveness, and illicit consumption. Results highlighted that the most abundant PHA and NAR were caffeine (73.9 ± 6.9 μg L-1) and methamphetamine (2.3 ± 0.1 μg L-1) while oxazepam (0.13 ± 0.05 μg L-1) and EDDP (0.02 ± 0.01 μg L-1) were the lowest ones, respectively. Only paracetamol, caffeine, atenolol, ciprofloxacin, amphetamine, cocaine, morphine, and benzoylecgonine exhibited a high biodegradability being removed almost completely (> 90 %). A predominant illicit use of methamphetamine was estimated (17 ± 0.6 doses 1000.inh-1 d-1) that might suggest a higher number of consumers than previous official estimation. A lower abuse of cocaine (2.7 ± 0.5 doses 1000.inh-1 d-1), amphetamine (2.2 ± 0.3 doses 1000.inh-1 d-1), methadone (1.1 ± 0.2 doses 1000.inh-1 d-1), heroin (0.9 ± 0.2 doses 1000.inh-1 d-1), and MDMA (0.7 ± 0.1 doses 1000.inh-1 d-1) was found. A seasonality pattern was highlighted for some PHA and NAR influent load and removal, and, about ID consumption, only for heroin and methadone. These results will be useful for water utilities, to enhance the knowledge about the presence and removal of PHA and NAR, and local and national authorities to evaluate and counteract the problem of ID abuse.

• Klíčová slova
• Emerging contaminants, Environmental surveillance, Pervitine, Pharmaceutical compounds removal, Public health, WBE,
• MeSH
• amfetamin MeSH
• chemické látky znečišťující vodu * analýza   MeSH
• epidemiologie odpadních vod MeSH
• heroin MeSH
• kofein MeSH
• kokain * analýza   MeSH
• lidé MeSH
• methadon MeSH
• methamfetamin * MeSH
• monitorování životního prostředí MeSH
• narkotika MeSH
• odhalování abúzu drog metody   MeSH
• odpadní voda MeSH
• poruchy spojené s užíváním psychoaktivních látek * epidemiologie   MeSH
• roční období MeSH
• zakázané drogy * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• amfetamin MeSH
• chemické látky znečišťující vodu * MeSH
• heroin MeSH
• kofein MeSH
• kokain * MeSH
• methadon MeSH
• methamfetamin * MeSH
• narkotika MeSH
• odpadní voda MeSH
• zakázané drogy * MeSH