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  1. Article ; Online: Response to the letter: "Utility of electroencephalography in toxin-induced seizure".

    Sidlak, Alexander M / Dibble, Brent / Schultz, Brian

    Academic emergency medicine : official journal of the Society for Academic Emergency Medicine

    2024  

    Language English
    Publishing date 2024-04-12
    Publishing country United States
    Document type Letter
    ZDB-ID 1329813-6
    ISSN 1553-2712 ; 1069-6563
    ISSN (online) 1553-2712
    ISSN 1069-6563
    DOI 10.1111/acem.14918
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Utility of electroencephalography in toxin-induced seizures.

    Sidlak, Alexander M / Dibble, Brent / Schultz, Brian

    Academic emergency medicine : official journal of the Society for Academic Emergency Medicine

    2024  Volume 31, Issue 3, Page(s) 249–255

    Abstract: Introduction: Toxin-induced seizures differ from seizures occurring in epilepsy and have a high rate of complications. Electroencephalography (EEG) is routinely obtained when there is concern for nonconvulsive status epilepticus (NCSE). The purpose of ... ...

    Abstract Introduction: Toxin-induced seizures differ from seizures occurring in epilepsy and have a high rate of complications. Electroencephalography (EEG) is routinely obtained when there is concern for nonconvulsive status epilepticus (NCSE). The purpose of this study was to characterize the typical findings after toxin-induced seizures, assess the rate of epileptiform discharges and NCSE, and identify any changes in management resulting from EEG.
    Methods: Patients older than 16 years who had an EEG during hospitalization for drug-induced seizure or seizure-like activity were included. We reviewed 10 years of data (2013-2022) across our hospital system (four community hospitals and one academic center). Patients with a history of seizures and those with cardiac arrest prior to EEG were excluded. The primary outcome was incidence of epileptiform discharges on EEG. The secondary outcome was number of antiseizure medications (ASM) added after EEG.
    Results: A total of 256 encounters were screened with 83 patient encounters included. A total of 53% (44/83) of EEGs showed some degree of generalized slowing. A total of 2.4% (2/83) of cases had epileptiform activity on EEG. No cases of nonconvulsive status were identified. No ASM was started in the two cases where epileptiform discharges were identified.
    Conclusions: During usual care of toxin-induced seizures, epileptiform discharges are uncommon.
    MeSH term(s) Humans ; Seizures/drug therapy ; Electroencephalography/methods ; Status Epilepticus/drug therapy ; Status Epilepticus/epidemiology ; Incidence ; Retrospective Studies
    Language English
    Publishing date 2024-02-22
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 1329813-6
    ISSN 1553-2712 ; 1069-6563
    ISSN (online) 1553-2712
    ISSN 1069-6563
    DOI 10.1111/acem.14834
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Analysis of rising cases of adolescent opioid use presentations to the emergency department and their management.

    Sidlak, Alexander / Dibble, Brent / Dhaliwal, Mannet / Bottone, Paul / Marino, Ryan / Henry, Linda / Howell, John

    Drug and alcohol dependence

    2024  Volume 258, Page(s) 111136

    Abstract: Objective: We sought to answer the question of how adolescents (ages 12-17 years old) with opioid-related presentations are currently managed in the ED. The two main outcomes were the proportion of visits where naloxone and buprenorphine were both used ... ...

    Abstract Objective: We sought to answer the question of how adolescents (ages 12-17 years old) with opioid-related presentations are currently managed in the ED. The two main outcomes were the proportion of visits where naloxone and buprenorphine were both used and prescribed, and the rate of revisits to the emergency department in the six months following ED presentation.
    Methods: This was a multi-center retrospective cross-sectional study. We studied patients presenting to the ED who were 12-17 years old with an opioid-related presentation.
    Results: Two-hundred and thirty-one patients were identified out of 571 encounters screened. Of these presentations, 77/231 (33%) were girls and 154/231 (67%) were boys. The majority of patients were Latino (64%; n=147); 26% were white (n=59), 6% were middle eastern or Arab (14), and 4% were black (10). Incidence of opioid use disorder per 100,000 presentations increased by 2800% from 2014 to 2022 (21/100,000 +/- 10 [2014] to 600/100,000 +/- 50 [2022]). A plurality of cases was related to opioid withdrawal (42%; 97). On discharge from the ED, 29% of patients received naloxone. For patients in withdrawal, 4% received a prescription for buprenorphine. Twenty-nine percent of patients had a return to the ED in the six months following initial visit.
    Conclusions: Adolescent opioid-related presentations to the ED are rapidly increasing. Increasing ED presentations, compounded by a high 6-month revisit rate, pose a management challenge amid limited outpatient resources for this population. Opioid agonist therapy and naloxone are not routinely provided. Increasing the use of both are two ways to improve the quality of care for this population.
    MeSH term(s) Humans ; Male ; Adolescent ; Female ; Emergency Service, Hospital ; Cross-Sectional Studies ; Opioid-Related Disorders/epidemiology ; Opioid-Related Disorders/drug therapy ; Child ; Retrospective Studies ; Naloxone/therapeutic use ; Buprenorphine/therapeutic use ; Narcotic Antagonists/therapeutic use
    Chemical Substances Naloxone (36B82AMQ7N) ; Buprenorphine (40D3SCR4GZ) ; Narcotic Antagonists
    Language English
    Publishing date 2024-02-29
    Publishing country Ireland
    Document type Journal Article ; Multicenter Study ; Research Support, N.I.H., Extramural
    ZDB-ID 519918-9
    ISSN 1879-0046 ; 0376-8716
    ISSN (online) 1879-0046
    ISSN 0376-8716
    DOI 10.1016/j.drugalcdep.2024.111136
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Increasing number and shifting demographics of adolescent opioid use disorder presentations to the emergency department.

    Sidlak, Alexander M / Howell, John M / Henry, Linda / Dibble, Brent

    The American journal of emergency medicine

    2023  Volume 73, Page(s) 79–82

    Abstract: Introduction: Opioid use has been increasing in adolescents; however, lacking are data describing sex, ethnicity, and age groups most affected. We identified and characterized the trend in the adolescent population who presented to the emergency ... ...

    Abstract Introduction: Opioid use has been increasing in adolescents; however, lacking are data describing sex, ethnicity, and age groups most affected. We identified and characterized the trend in the adolescent population who presented to the emergency departments (ED) of a large hospital system.
    Methods: We obtained data directly from the electronic medical record for patients aged 12-21 years from January 2014 to December 2022. We identified opioid-related visits by primary diagnosis. Trends were compared amongst age groups and by sex and reported ethnicity.
    Results: Opioid-related presentations increased in all age groups and were significantly increased in adolescents aged 13-17 years compared to patients aged 18-21 years (1700% [range: 1000-3300%] v 400% [200-800%]; p = 0.02). Adolescents presenting to the ED with opioid-related primary diagnoses were more likely to be Hispanic and male in our region.
    Discussion: Over the last two years (2021-22) there was a significant increase in opioid-related presentations to our hospital system amongst adolescents and an acceleration post-COVID. In 2022, emergency department presentations shifted to younger teenagers and from white young adults to Hispanic adolescents. The increased number of cases posed management problems in the ED given the lack of outpatient treatment options.
    Conclusion: Opioid-related ED presentations are increasing in adolescents with post-COVID increases in male, Hispanic, and younger patients in our region. Pathways for outpatient treatment need to be developed for adolescents with OUD.
    Language English
    Publishing date 2023-08-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605890-5
    ISSN 1532-8171 ; 0735-6757
    ISSN (online) 1532-8171
    ISSN 0735-6757
    DOI 10.1016/j.ajem.2023.08.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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