To see the other types of publications on this topic, follow the link: Onset and withdrawal.
Journal articles on the topic 'Onset and withdrawal'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Onset and withdrawal.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
A. K. KOTHARI, VIRENDRA KUMAR, P. M. JAIN, and R.C. PUROHIT. "A modified approach for determination of onset and withdrawal of monsoon." Journal of Agrometeorology 10, no. 2 (2008): 178–83. http://dx.doi.org/10.54386/jam.v10i2.1200.
Full textAbstract:
Onset of monsoon is an important rainfall characteristic for drought management and crop planning. Morris and Zandstra method for onset was compared with observed values for a period of 20 years, which revealed a mismatch in the Bhilwara region in 40 per cent of years. The criteria for rainfall accumulation for both onset and withdrawal was modified in such a way that the determined and observed onset of monsoon showed a significant match. For early and late onset of monsoon and intermittent low/nil rainfall weeks. Withdrawals were adjusted and length of growing period for Bhilwara region was determined.
2
Ilicic, Marina, Tamas Zakar, and Jonathan W. Paul. "Epigenetic regulation of progesterone receptors and the onset of labour." Reproduction, Fertility and Development 31, no. 6 (2019): 1035. http://dx.doi.org/10.1071/rd18392.
Full textAbstract:
Progesterone plays a crucial role in maintaining pregnancy by promoting myometrial quiescence. The withdrawal of progesterone action signals the end of pregnancy and, in most mammalian species, this is achieved by a rapid fall in progesterone concentrations. However, in humans circulating progesterone concentrations remain high up to and during labour. Efforts to understand this phenomenon led to the ‘functional progesterone withdrawal’ hypothesis, whereby the pro-gestation actions of progesterone are withdrawn, despite circulating concentrations remaining elevated. The exact mechanism of functional progesterone withdrawal is still unclear and in recent years has been the focus of intense research. Emerging evidence now indicates that epigenetic regulation of progesterone receptor isoform expression may be the crucial mechanism by which functional progesterone withdrawal is achieved, effectively precipitating human labour despite high concentrations of circulating progesterone. This review examines current evidence that epigenetic mechanisms play a role in determining whether the pro-gestation or pro-contractile isoform of the progesterone receptor is expressed in the pregnant human uterus. We explore the mechanism by which these epigenetic modifications are achieved and, importantly, how these underlying epigenetic mechanisms are influenced by known regulators of uterine physiology, such as prostaglandins and oestrogens, in order to phenotypically transform the pregnant uterus and initiate labour.
3
Koychev, Ivan, Savvas Hadjiphilippou, Joanna Lynch, Paul Whelan, and James MacCabe. "Sudden-Onset Catatonia Following Clozapine Withdrawal." Journal of Clinical Psychiatry 77, no. 07 (2016): e899-e899. http://dx.doi.org/10.4088/jcp.15cr10355.
Full text
4
Mayo-Smith, Michael F., and Donald Bernard. "Late-Onset Seizures in Alcohol Withdrawal." Alcoholism: Clinical and Experimental Research 19, no. 3 (1995): 656–59. http://dx.doi.org/10.1111/j.1530-0277.1995.tb01563.x.
Full text
5
Czyz, Craig N., Phelan G. Piehota, and Adam M. Strittmatter. "Acute onset esotropia after heroin withdrawal." American Journal of Emergency Medicine 33, no. 4 (2015): 598.e1–598.e2. http://dx.doi.org/10.1016/j.ajem.2014.08.063.
Full text
6
Nakaegawa, Tosiyuki, Osamu Arakawa, and Kenji Kamiguchi. "Investigation of Climatological Onset and Withdrawal of the Rainy Season in Panama Based on a Daily Gridded Precipitation Dataset with a High Horizontal Resolution." Journal of Climate 28, no. 7 (2015): 2745–63. http://dx.doi.org/10.1175/jcli-d-14-00243.1.
Full textAbstract:
Abstract The present study investigated the onset and withdrawal dates of the rainy season in Panama by using newly developed, gridded, daily precipitation datasets with a high horizontal resolution of 0.05° based on ground precipitation observations. The onset and withdrawal dates showed very complicated geographical features, although the country of Panama is oriented parallel to latitude lines, and the geographical patterns of the onset and withdrawal dates could simply reflect the latitudinal migration of the intertropical convergence zone, as seen in other regions and countries. An absolute threshold value of 3 mm day−1 (pentad mean precipitation) was used to determine the onset and withdrawal dates. The onset and withdrawal dates obtained from the gridded daily precipitation dataset clearly depicted the migration of the rainy season. The rainy season starts suddenly in pentad 21 (11–15 April) in most of eastern Panama and in pentad 22 (16–20 April) in most of western Panama. The termination of the rainy season begins in Los Santos Province during pentad 67 (27 November–1 December) and expands to both the eastern and western surrounding areas. There is no dry season in the western part of the Caribbean coastal zone. Water vapor fluxes and topography suggest dynamical causes, such as a topographically induced upward mass flux accompanied by high humidity, for the complicated geographical features of the onset and withdrawal dates. An assessment was made of uncertainties in the timing of the onset and withdrawal associated with the definition of these terms.
7
D. S., PAI, BANDGAR ARTI, DEVI SUNITHA, et al. "Normal dates of onset/progress and withdrawal of southwest monsoon over India." MAUSAM 71, no. 4 (2021): 553–70. http://dx.doi.org/10.54302/mausam.v71i4.33.
Full textAbstract:
The new normal dates of onset/progress and withdrawal of southwest monsoon over the country are computed based on the operationally declared dates of these events by India Meteorological Department (IMD) during recent years. The normal onset/progress dates were calculated based on 1961-2019 data and that of withdrawal were calculated based on 1971-2019 data. This study also suggests new objective rainfall criteria to define the monsoon onset/ progress over various parts of the country. The new objective criteria are based on the IMD daily rainfall data at 1° × 1° (latitude × longitude) spatial grids over the country. The new criteria were designed so as to closely simulate IMD’s operational declaration of onset/progress of monsoon. However, no new criteria are suggested for defining withdrawal dates. The dates of monsoon onset/progress derived in each of these 1° × 1° grids based on the new criteria for the period 1961-2019 were also used to compute normal onset/progress dates of monsoon over the country. The climatological normal dates of onset and withdrawal of monsoon over India currently used by IMD for operational services are based on old data period (1901-1940) obtained from the rainfall analysis of 149 stations. This study proposes the new normal dates of monsoon onset/progress (based on the new rainfall criteria) and withdrawal (based on the operational data) to replace the existing normal. On comparing the new normal dates of monsoon onset and withdrawal with the existing normal dates of these events, interesting difference were observed. The monsoon onset/progress is relatively delayed over most parts of the Indian monsoon region in the new normal compared to the existing normal. However, monsoon onset/ progress is relatively faster in the new normal than the existing normal over Lakshadweep Islands, a few grids from western part of northeast India and western parts of south Peninsula and some areas of north and extreme northwest India. As per the new normal, the monsoon sets over Kerala around 1st June, nearly same as the existing normal date and covers the entire country one week before the existing normal. However, monsoon withdrawal from northwest India is delayed by more than 2 weeks compared to the existing normal date (i.e., 1st September). Monsoon retreats from most parts of the country except south Peninsula and some parts of neighboring central India by 15th October coinciding with the existing normal and subsequently northeast monsoon gets established over south Peninsula.
8
Raj, Dr YEA. "A re -assessment study on the onset and withdrawal dates of Indian northeast monsoon for the decade 2011-20." MAUSAM 75, no. 3 (2024): 747–58. http://dx.doi.org/10.54302/mausam.v75i3.6159.
Full textAbstract:
Abstract: The onset and withdrawal dates of Indian North east monsoon (NEM) over the combined region of Coastal Tamil Nadu (CTN) and South coastal Andhra Pradesh (SCAP) for the 10 year period 2011 -20 have been re -determined based on daily rainfall data of 16 stations by following an objective criteria. The dates thus derived when appended with past set of dates fixed by following similar methodology has resulted in a homogenous set of onset and withdrawal dates of NEM for 150 years. The mean onset / withdrawal dates for 2011-20 has been obtained as 23 October and 31 December respectively. During 2011-20, the normal NEM withdrawal from the southern and northern coasts have taken place on 23 December and 5 January respectively. This characteristic of existence of differential withdrawal dates which was shown in an earlier study based on 50 year data of 1961-2010, has persisted in 2011-20 as well. The superposed epoch analysis conducted on the daily rainfall of the 16 stations has shown very sharp increase of rainfall at the time of onset and decrease after withdrawal. The daily rainfall has increased from 1-5 mm to 10-33 mm at onset and has decreased from 4-16 mm to 0-2 mm at withdrawal. The empirical orthogonal function analysis conducted on the pentad rainfall of October-January rainfall of 4 sub regions SCAP, North, Central and South CTN (NCTN, CCTN and SCTN) has revealed that the first principal component which could be associated with the overall strength of NEM, explains 78.3% of the variation and that the loadings which are positive for all the regions are higher in NCTN and CCTN. The second principal component which explains 12.7 % of variation has positive loadings in SCAP and NCTN and negative loadings in CCTN and SCTN associated with opposite type of rainfall anomalies in the two regions. The empirical orthogonal function analysis manifesting such a pattern could be partly associated with late withdrawal in the south coast compared to north coast. An analysis of the frequencies of heavy/very heavy /extremely heavy rainfall derived for several periods has revealed that there have been 429 heavy rainfall events over 16 stations and 10 years during October- December. By defining and computing a probability based heavy rainfall index, it has been shown that frequency of heavy rainfall occurrences commencing from onset date is 91 for 16 stations and 10 years, which is 19 time more in the onset phase compared to pre onset phase and that once withdrawal takes place heavy rainfall occurrence becomes very rare.
9
ALI, MEHFOOZ, D. JOARDAR, and B. R. LOE. "Variability of southwest monsoon over Rajasthan and Kerala." MAUSAM 56, no. 3 (2022): 593–600. http://dx.doi.org/10.54302/mausam.v56i3.989.
Full textAbstract:
The onset, withdrawal dates and rainfall of southwest monsoon corresponding to east and west Rajasthan sub-divisions have been examined statistically for the past 63 years (1941-2003) to bring out some major aspects of their variability and trend to predict these parameters of southwest monsoon over Rajasthan. Various correlation coefficients have been worked out. Study reveals, shift in monsoon activity, enhancement of monsoon duration, early onset and late withdrawal enhances monsoon duration and seasonal rainfall over Rajasthan. Early onset over east Rajasthan certainly brings early onset over west Rajasthan.
10
Douglas, Andrea F., Howard L. Weiner, and David R. Schwartz. "Prolonged intrathecal baclofen withdrawal syndrome." Journal of Neurosurgery 102, no. 6 (2005): 1133–36. http://dx.doi.org/10.3171/jns.2005.102.6.1133.
Full textAbstract:
✓ The authors describe a patient who experienced a prolonged course of intrathecal baclofen withdrawal syndrome after removal of an implantable baclofen pump for treatment of pump infection and meningitis. The current literature outlines management options for the acute management of this syndrome. In this report the authors discuss the long-term presentation of this syndrome and suggest a treatment strategy for management of the syndrome. A 37-year-old man who presented with a baclofen pump infection and meningitis experienced acute onset of intrathecal baclofen withdrawal syndrome 12 hours after the pump had been surgically removed. The patient's symptoms evolved into a severe, treatment-refractory withdrawal syndrome lasting longer than 1 month. Oral baclofen replacement with adjunctive administration of parenteral γ-aminobutyric acid agonists only served to stabilize the patient's critical condition throughout his hospital course. Replacement of the baclofen pump and restoration of intrathecal delivery of the medication was necessary to trigger the patient's dramatic recovery and complete reversal of the withdrawal syndrome within approximately 48 hours. These findings indicate that a more direct method of treating infected baclofen pumps than immediate surgical removal is necessary to prevent the onset of intrathecal baclofen withdrawal syndrome. Various options for preventing the onset of the syndrome while simultaneously treating the infection are discussed.
11
RAJ, Y. E. A. "Onset, withdrawal and intra-seasonal variation of northeast monsoon over coastal Tamil Nadu, 1901-2000." MAUSAM 54, no. 3 (2022): 605–14. http://dx.doi.org/10.54302/mausam.v54i3.1551.
Full textAbstract:
The onset and withdrawal dates of northeast monsoon over coastal Tamil Nadu have been objectively determined for the ten year period 1991-2000. The statistics of onset and withdrawal dates for the 100 year 20th century period 1901-2000 have been presented and discussed. It has been shown by employing techniques such as harmonic/spectral analysis and cross lag correlation over 100 year rainfall data, that the daily rainfall of coastal Tamil Nadu during September-February displays a prominent 40-days periodicity and that rainfall anomalies move from south to north taking nearly 2 days to traverse between Pamban and Chennai separated latitudinally by nearly 400 km. In 70% of the years the onset and withdrawal process of northeast monsoon gets excited by the 40-day periodicity.
12
Loeffler, Rodney A. "Alcohol consumption and withdrawal in new-onset seizures." Annals of Emergency Medicine 18, no. 1 (1989): 109. http://dx.doi.org/10.1016/s0196-0644(89)80332-4.
Full text
13
Stephen, K. C. Ng, W. Allen Hauser, John CM Brust, and Mervyn Susser. "Alcohol Consumption and Withdrawal in New-Onset Seizures." New England Journal of Medicine 319, no. 11 (1988): 666–73. http://dx.doi.org/10.1056/nejm198809153191102.
Full text
14
Singh, Arun, and George S. Alexopoulos. "Mania during antidepressant withdrawal in late-onset depression." International Journal of Geriatric Psychiatry 28, no. 6 (2013): 654–55. http://dx.doi.org/10.1002/gps.3894.
Full text
15
Gould, Shannon L., and Leon A. Hyer. "Dementia and Behavioral Disturbance: Does Premorbid Personality Really Matter?" Psychological Reports 95, no. 3_suppl (2004): 1072–78. http://dx.doi.org/10.2466/pr0.95.3f.1072-1078.
Full textAbstract:
This study considers the influence of premorbid personality on the expression of behavioral disturbances among individuals with dementia. A total of 68 outpatients with a diagnosis of dementia were assessed for current cognitive functioning, premorbid personality traits, and new behavioral disturbances since dementia onset. The results of this study show some evidence for the influence of personality on the expression of both irritability and withdrawal. Specifically, increased withdrawal and irritability after dementia onset were associated with an inhibited premorbid personality style. In addition, a premorbidly independent personality style was associated with less withdrawal. Further research is needed to clarify the role of premorbid personality on behaviors in this population.
16
Brandt, Jaclyn, Jonathan T. Evans, Taylor Mildenhall, et al. "Delaying the onset of treadmill exercise following peripheral nerve injury has different effects on axon regeneration and motoneuron synaptic plasticity." Journal of Neurophysiology 113, no. 7 (2015): 2390–99. http://dx.doi.org/10.1152/jn.00892.2014.
Full textAbstract:
Transection of a peripheral nerve results in withdrawal of synapses from motoneurons. Some of the withdrawn synapses are restored spontaneously, but those containing the vesicular glutamate transporter 1 (VGLUT1), and arising mainly from primary afferent neurons, are withdrawn permanently. If animals are exercised immediately after nerve injury, regeneration of the damaged axons is enhanced and no withdrawal of synapses from injured motoneurons can be detected. We investigated whether delaying the onset of exercise until after synapse withdrawal had occurred would yield similar results. In Lewis rats, the right sciatic nerve was cut and repaired. Reinnervation of the soleus muscle was monitored until a direct muscle (M) response was observed to stimulation of the tibial nerve. At that time, rats began 2 wk of daily treadmill exercise using an interval training protocol. Both M responses and electrically-evoked H reflexes were monitored weekly for an additional seven wk. Contacts made by structures containing VGLUT1 or glutamic acid decarboxylase (GAD67) with motoneurons were studied from confocal images of retrogradely labeled cells. Timing of full muscle reinnervation was similar in both delayed and immediately exercised rats. H reflex amplitude in delayed exercised rats was only half that found in immediately exercised animals. Unlike immediately exercised animals, motoneuron contacts containing VGLUT1 in delayed exercised rats were reduced significantly, relative to intact rats. The therapeutic window for application of exercise as a treatment to promote restoration of synaptic inputs onto motoneurons following peripheral nerve injury is different from that for promoting axon regeneration in the periphery.
17
Xiaofang, Zhao, and Wang Lijuan. "Characteristics of the South China Sea Monsoon from the Onset to Withdrawal before and after 1993/94." Advances in Meteorology 2020 (September 16, 2020): 1–13. http://dx.doi.org/10.1155/2020/8820460.
Full textAbstract:
The characteristics and possible impact factors of the South China Sea summer monsoon (SCSSM) evolution from onset to withdrawal before and after 1993/94 are investigated using ERA-Interim, CPC rainfall, and OLR data. During the late-onset period of 1979–1993, the SCSSM was characterized by stronger onset intensity and a gradual withdrawal, resulting in a continuous, strong preflood season in Southern China and a slower rain-belt retreat from north to south China in September. In addition, the rain-belt in the Yangtze River basin persisted much longer during summer. However, during the early-onset period in 1994–2016, the SCSSM is associated with a weaker onset intensity and comparatively faster retreat. The advanced preflood season lasted intermittently throughout May and the whole eastern China precipitation lasted until October when it retreated rapidly, making the rain-belt in Southern China persist for an extended duration. Further analysis indicates that a strong modulation of SCS intraseasonal oscillation (ISO) on the SCSSM evolution is observed. There are two active low-frequency oscillations over the SCS in summer during the late-onset period but three during the early-onset period. The wet ISO in the Northwest Pacific propagating northwestward into the SCS and enhanced SCSSM ISO activity may contribute to the early onset and faster withdrawal after 1993/94. The effect of warm western Pacific sea surface temperatures (SST) on the SCSSM evolution is also discussed.
18
Nakagawa, *Miyako, Kosuke Doki, Mana Obata-Yasuoka, et al. "EFFECTS OF MULTIPLE NEUROPSYCHIATRIC MEDICATIONS DURING PREGNANCY ON NEONATAL ABSTINENCE SYNDROME (SECOND REPORT)." International Journal of Neuropsychopharmacology 28, Supplement_1 (2025): i264—i265. https://doi.org/10.1093/ijnp/pyae059.467.
Full textAbstract:
Abstract Background Neonatal abstinence syndrome (NAS) is characterized by withdrawal symptoms in neonates because of the discontinuation of transplacental drug transfer after delivery. Although the use of neuropsychiatric drugs in pregnant women is associated with the onset of NAS (Kanemura, 2020), it remains unclear which types of and how many neuropsychiatric drugs are the risk for NAS. Aims & Objectives The aim of this study is to investigate the type and number of neuropsychiatric drugs in pregnant women in association with onset of NAS. Method Three hundred sixteen mothers who were receiving neuropsychiatric drugs (antipsychotics, antidepressants, antiepileptics, anxiolytics/sedatives) during the pregnancy and their 320 neonates were investigated in University of Tsukuba Hospital during January 2016 to December 2022. NAS was assessed by Isobe score using the checklist for 15 withdrawal symptoms (Kanemura, 2020). Multivariate logistic regression analysis was used to evaluate the relationship between maternal and neonatal background factors, and withdrawal symptoms. This study was approved by the Ethics Committee of the University of Tsukuba Hospital. Results The mothers were receiving one (n=169, 53%), two (n=86, 27%), and three or more neuropsychiatric drugs (n=65, 20%) (a maximum, seven drugs). One hundred sixty-three neonates developed withdrawal symptoms 1-10 days after delivery. The incidence of withdrawal symptoms depended on the number of neuropsychiatric drugs during the pregnancy. Significant difference was observed in the incidence of withdrawal symptoms between one or two drugs (45%) and three or more drugs (74%) (P<0.001). The mean Isobe scores also increased with the number of neuropsychiatric drugs: 1.0 in one drug, 1.4 in two drugs, 2.5 in three drugs, and 2.6 in four or more drugs. Multivariate logistic regression analysis revealed that the onset of withdrawal symptoms was associated with the use of three or more neuropsychiatric drugs during the pregnancy (adjusted odds ratio [95% confidence interval]: 2.40 [1.08-5.32], P=0.03) and primiparity (1.74 [1.08-2.80], P=0.02). In contrast, the type of neuropsychiatric drugs was not a significant risk factor for the onset of withdrawal symptoms: 1.64 [0.96-2.80] for antipsychotics, 1.59 [0.95-2.67] for antidepressants, and 0.93 [0.53-1.65] for anxiolytics/sedatives. Discussion & Conclusion The onset of neonatal withdrawal symptoms was associated with the use of three or more neuropsychiatric drugs, regardless the type of pharmacological effects, during the pregnancy. It is considered that concurrent use of multiple neuropsychiatric medications in pregnant women is a risk factor for NAS. References [1]Kanemura, A et al. (2020). Evaluation of neonatal withdrawal syndrome in neonates delivered by women taking psychotropic or anticonvulsant drugs: A retrospective chart review of the effects of multiple medications and breastfeeding. European Journal of obstetrics, gynecology, and reproductive biology, 254, 226–230.
19
Gossop, Michael, and John Strang. "A Comparison of the Withdrawal Responses of Heroin and Methadone Addicts during Detoxification." British Journal of Psychiatry 158, no. 5 (1991): 697–99. http://dx.doi.org/10.1192/bjp.158.5.697.
Full textAbstract:
This study compares the withdrawal responses of methadone and heroin addicts during a ten-day in-patient detoxification programme with methadone. Contrary to suggestions in the literature, the methadone group reported more severe withdrawal symptoms during both the acute withdrawal phase and the recovery phase. There were no differences between the two groups in onset or duration of symptoms. Whereas there may be reasons to favour methadone as a maintenance drug, its use may lead to difficulties during withdrawal.
20
Oo, Kyaw Than. "Climatology Definition of the Myanmar Southwest Monsoon (MSwM): Change Point Index (CPI)." Advances in Meteorology 2023 (January 25, 2023): 1–18. http://dx.doi.org/10.1155/2023/2346975.
Full textAbstract:
Myanmar’s climate is heavily influenced by its geographic location and relief. Located between the Indian summer monsoon (ISM) and the East Asian summer monsoon (EASM), Myanmar’s climate is distinguished by the alternation of seasons known as the monsoon. The north-south direction of peaks and valleys creates a pattern of alternate zones of heavy and scanty precipitation during both the northeast and southwest monsoons. The majority of the rainfall has come from Myanmar’s southwest monsoon (MSwM), which is Myanmar’s rainy season (summer in global terms, June–September). This study explained both threshold-based and nonthreshold-based objective definitions of the onset and withdrawal of large-scale MSwM. The seasonal transitions in MSwM circulation and precipitation are convincingly represented by the new index, which is based on change point detection of the atmospheric moisture flow converging in the MSwM region (10–28 N, 92–102 E). A transition in vertically integrated moisture transport (VIMT), the reversal of surface winds, and an increase in precipitation may also be considered when defining MSwM onset objectively. We also define a change point of the MSwM (CPI) index for MSwM onset and withdrawal dates. The climatological mean onset of MSwM is day 135 (May 14), withdrawal is day 278 (October 4), and the total season length is 144 days. We are investigating spatial patterns of rainfall progression at and after the start of the monsoon, rather than transitions within a single region of the MSwM. The local southwest monsoon duration is well correlated with the CPI duration on interannual timescales, particularly in the peak rainfall regions, with a delay (advance) in large-scale onset or withdrawal associated with a delay (advance) of onset or withdrawal by local index. Hence, the next phase of this research is to study the maintenance and break of the monsoon to understand the underlying physical processes governing the monsoon circulation. The results of this study provide a possibility to reconstruct Myanmar’s monsoon climate dynamics, and the findings of this study can help unravel many remaining questions regarding the greater Asian monsoon system’s variability.
21
Wojtowicz, Jeremy M., Mark C. Yarema, and Paul M. Wax. "Withdrawal from gamma-hydroxybutyrate, 1,4-butanediol and gamma-butyrolactone: a case report and systematic review." CJEM 10, no. 01 (2008): 69–74. http://dx.doi.org/10.1017/s1481803500010034.
Full textAbstract:
ABSTRACT1,4-Butanediol (1,4-BD) is an industrial solvent that is metabolized to gamma-hydroxybutyrate (GHB), a gamma-aminobutyric acid agonist and central nervous system depressant. GHB and its analogues are popular drugs of abuse. Withdrawal from these agents is characterized by autonomic instability and altered mental status. We report a case of withdrawal from 1,4-BD lasting 6 days and complicated by new onset of seizures and rhabdomyolysis. In addition, we conducted a systematic review of the English literature pertaining to withdrawal from GHB, 1,4-BD and gamma-butyrolactone (GBL). Data collected from source articles included last use prior to symptom onset, clinical features on presentation, duration of symptoms and outcome. Twenty-seven studies with 57 episodes of withdrawal were included. Thirty-six cases (63%) involved GHB, 3 cases (5%) involved 1,4-BD and 18 (32%) involved GBL. The most common patient symptoms were tremor (67%), hallucinations (63%), tachycardia (63%) and insomnia (58%). Seizures and rhabdomyolysis each occurred in 7% of cases, but only 1 death occurred. Emergency physicians must consider withdrawal from these agents when patients present with clinical features suggestive of a sedative-hypnotic withdrawal syndrome.
22
Sarker, Haripada, Abdul Mannan Chowdhury, and Samarendra Karmakar. "Variability of Some Meteorological Elements During the Southwest Monsoon Season in Bangladesh." Journal of Bangladesh Academy of Sciences 40, no. 2 (2016): 155–67. http://dx.doi.org/10.3329/jbas.v40i2.30771.
Full textAbstract:
Statistical computation and analysis of the co-efficient of variation of different meteorological parameter such as mean sea level pressure, rainfall, dew-point depression, minimum temperature and maximum temperature over Bangladesh during the onset, on-going and withdrawal phases of southwest monsoon, season of 1981- 2010 was dealt with. The study reveals that the coefficient of variation of the mean sea level (msl) pressure is practically small over Bangladesh during the onset and ongoing phases of southwest monsoon. During the onset phase, the CV of msl pressure is relatively higher and decreases during the on-going phase. The variation of msl pressure increases slightly in the withdrawal phase of monsoon. The ranges of CV of msl pressure are 0.064 - 0.197%, 0.079 - 0.809%, 0.091 - 0.793%, 0.069 - 0.272%, 0.0695 - 0.229% and 0.127 - 0.32% in May, June, July, August, September and October, respectively. The variation of dew-point depression decreases in the eastern part during the onset phase of southwest monsoon and becomes lower all over Bangladesh during the on-going phase of monsoon. It again increases during the withdrawal phase. The maximum co-efficient of variation of rainfall exists over the southeastern part of Bangladesh during the on-going phase of southwest monsoon and decreases in June and July over Bangladesh i.e. during the early on-going phase of monsoon. The co-efficient of variation of minimum and maximum temperatures is found to decrease during the onset and on-going phases of southwest monsoon and increases during the withdrawal of monsoon from Bangladesh.Journal of Bangladesh Academy of Sciences, Vol. 40, No. 2, 155-167, 2016
23
Regmi, B., S. Limbu, and S. Nepal. "Is There Possibility Of Withdrawal Seizure In Opioid Dependence Syndrome? A Case Report." Journal of Psychiatrists' Association of Nepal 9, no. 2 (2020): 82–84. http://dx.doi.org/10.3126/jpan.v9i2.36290.
Full textAbstract:
Opioids are commonly used and abused substance worldwide. Opioid withdrawal may manifest as severe muscle cramps, diarrhea, rhinorrhea, lacrimation, piloerection, yawning, and fever. Here, we report a 32 year old man with heroin dependence, presented with new onset generalized tonic-clonic seizure following heroin withdrawal. Seizure is a life-threating condition and rare phenomenon in opioid withdrawal therefore, reporting of this case is important. It may help clinician to be aware and consider seizure as a part of opioid withdrawal.
24
Kasula, Varun, Brody M. Fogleman, Maaya Dev, Tyler Rizzieri, Corinne O’Brien, and Rupa Shetty. "Opiate Withdrawal-Associated Esotropia: A Case Report and Systematic Review." Psychiatry International 5, no. 2 (2024): 231–40. http://dx.doi.org/10.3390/psychiatryint5020016.
Full textAbstract:
Esotropia, which is the medial deviation of one or both eyes, is a rare withdrawal symptom that has been associated with opiate addiction. We report a case of a 36-year-old female patient who developed acute-onset esotropia and diplopia after self-admission to a psychiatric facility for fentanyl addiction treatment and a systematic review of this rare presentation. A search of four databases (PubMed, Scopus, Embase, and Google Scholar) was conducted as of January 2024. We found 15 documented cases of opiate withdrawal-associated esotropia, with an average age of 27.2 years and an average time between last use and symptom onset of 5.61 days. The most common symptom was diplopia, especially binocular diplopia, and the majority of cases resolved without pharmacologic intervention. Considering the current opioid crisis, our systematic review and case report add valuable insight into the less-explored neurological and ophthalmological consequences of opiate withdrawal, a condition that should always be considered in cases of acute or chronic onset esotropia.
25
Fasullo, J., and P. J. Webster. "A Hydrological Definition of Indian Monsoon Onset and Withdrawal." Journal of Climate 16, no. 19 (2003): 3200–3211. http://dx.doi.org/10.1175/1520-0442(2003)016<3200a:ahdoim>2.0.co;2.
Full text
26
Marciani, M. G., and J. Gotman. "Effects of Drug Withdrawal on Location of Seizure Onset." Epilepsia 27, no. 4 (1986): 423–31. http://dx.doi.org/10.1111/j.1528-1157.1986.tb03562.x.
Full text
27
Young, Christopher C., and Brian S. Kaufman. "Neuroleptic malignant syndrome postoperative onset due to levodopa withdrawal." Journal of Clinical Anesthesia 7, no. 8 (1995): 652–56. http://dx.doi.org/10.1016/0952-8180(95)00097-6.
Full text
28
Yang, Yun-Han, Wen-Ching Hsieh, and Chia-Hsiang Chan. "Zolpidem dependence with delayed-onset opioid-like withdrawal symptoms." Indian Journal of Psychiatry 66, no. 5 (2024): 483–84. http://dx.doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_962_23.
Full text
29
Anderson, Kyle R., Ingrid A. Johanson, Matthew R. Patrick, et al. "Magma reservoir failure and the onset of caldera collapse at Kīlauea Volcano in 2018." Science 366, no. 6470 (2019): eaaz1822. http://dx.doi.org/10.1126/science.aaz1822.
Full textAbstract:
Caldera-forming eruptions are among Earth’s most hazardous natural phenomena, yet the architecture of subcaldera magma reservoirs and the conditions that trigger collapse are poorly understood. Observations from the formation of a 0.8–cubic kilometer basaltic caldera at Kīlauea Volcano in 2018 included the draining of an active lava lake, which provided a window into pressure decrease in the reservoir. We show that failure began after <4% of magma was withdrawn from a shallow reservoir beneath the volcano’s summit, reducing its internal pressure by ~17 megapascals. Several cubic kilometers of magma were stored in the reservoir, and only a fraction was withdrawn before the end of the eruption. Thus, caldera formation may begin after withdrawal of only small amounts of magma and may end before source reservoirs are completely evacuated.
30
Rauscher, Sara A., Anji Seth, Brant Liebmann, Jian-Hua Qian, and Suzana J. Camargo. "Regional Climate Model–Simulated Timing and Character of Seasonal Rains in South America." Monthly Weather Review 135, no. 7 (2007): 2642–57. http://dx.doi.org/10.1175/mwr3424.1.
Full textAbstract:
Abstract The potential of an experimental nested prediction system to improve the simulation of subseasonal rainfall statistics including daily precipitation intensity, rainy season onset and withdrawal, and the frequency and duration of dry spells is evaluated by examining a four-member ensemble of regional climate model simulations performed for the period 1982–2002 over South America. The study employs the International Centre for Theoretical Physics (ICTP) regional climate model, version 3 (RegCM3), driven with the NCEP–NCAR reanalysis and the European Centre–Hamburg GCM, version 4.5. Statistics were examined for five regions: the northern Amazon, southern Amazon, the monsoon region, Northeast Brazil, and southeastern South America. RegCM3 and the GCM are able to replicate the distribution of daily rainfall intensity in most regions. The analysis of the rainy season timing shows the observed onset occurring first over the monsoon region and then spreading northward into the southern Amazon, in contrast to some previous studies. Correlations between the onset and withdrawal date and SSTs reveal a strong relationship between the withdrawal date in the monsoon region and SSTs in the equatorial Pacific, with above-average SSTs associated with late withdrawal. Over Northeast Brazil, the regional model errors are smaller than those shown by the GCM, and the strong interannual variability in the timing of the rainy season is better simulated by RegCM3. However, the regional model displays an early bias in onset and withdrawal over the southern Amazon and the monsoon regions. Both RegCM3 and the GCM tend to underestimate (overestimate) the frequency of shorter (longer) dry spells, although the differences in dry spell frequency during warm and cold ENSO events are well simulated. The results presented here show that there is potential for added value from the regional model in simulating subseasonal statistics; however, improvements in the physical parameterizations are needed for this tropical region.
31
Sonawane, U. R., and A. M. Kamble. "Contingency Crop Planning for Parbhani Region of Marathwada Based on Rainfall Analysis." Journal of Agriculture and Ecology Research International 26, no. 3 (2025): 17–26. https://doi.org/10.9734/jaeri/2025/v26i3671.
Full textAbstract:
Climate change and variability pose significant challenges to global agriculture, particularly in regions reliant on rainfed farming systems. Erratic rainfall patterns, prolonged dry spells, and extreme weather events disrupt traditional cropping practices. Contingency crop planning is a crucial strategy for enhancing agricultural productivity, emerges as a proactive approach, allowing stakeholders to adjust crop choices and management practices in response to unexpected conditions. In the present study, the contingency crop planning was suggested on the basis of Markov chain probability model to determine the dry and wet week probabilities and onset and withdrawal of rainy season for Parbhani using 30 years (1991 to 2020) weekly rainfall data. The data on onset and withdrawal of rainy season indicated that the monsoon starts on the 23rd SMW (04th June – 10th June) and remains active up to the 42nd week (15th – 21st October). Based on the mean rainfall, onset and withdrawal of the effective monsoon, and the initial and conditional probability at various important growth phases of certain rabi and kharif crops. The suggested crop management plan has been created after contingency measures, such as standard meteorological week (SMW) for sowing, protective irrigation, and hoeing operations, were identified for the study area.
32
Matushansky, Igor, Farshid Radparvar, and Arthur I. Skoultchi. "Manipulating the onset of cell cycle withdrawal in differentiated erythroid cells with cyclin-dependent kinases and inhibitors." Blood 96, no. 8 (2000): 2755–64. http://dx.doi.org/10.1182/blood.v96.8.2755.
Full textAbstract:
Abstract Terminal differentiation of erythroid cells results in terminal cell divisions followed by irreversible cell cycle withdrawal of hemoglobinized cells. The mechanisms leading to cell cycle withdrawal were assessed in stable transfectants of murine erythroleukemia cells, in which the activities of cyclin-dependent kinases (CDKs) and CDK inhibitors (CDKIs) could be tightly regulated during differentiation. Cell cycle withdrawal of differentiating cells is mediated by induction of several CDKIs, thereby leading to inhibition of CDK2 and CDK4. Manipulation of CDK activity in differentiating cells demonstrates that the onset of cell cycle withdrawal can be either greatly accelerated or greatly delayed without affecting hemoglobin levels. Extending the proliferation of differentiating cells requires the synergistic action of CDK2 and CDK4. Importantly, CDK6 cannot substitute for CDK4 in this role, which demonstrates that the 2 cyclin D–dependent kinases are functionally different. The results show that differentiating hemoglobinized cells can be made to proliferate far beyond their normal capacity to divide.
33
Matushansky, Igor, Farshid Radparvar, and Arthur I. Skoultchi. "Manipulating the onset of cell cycle withdrawal in differentiated erythroid cells with cyclin-dependent kinases and inhibitors." Blood 96, no. 8 (2000): 2755–64. http://dx.doi.org/10.1182/blood.v96.8.2755.h8002755_2755_2764.
Full textAbstract:
Terminal differentiation of erythroid cells results in terminal cell divisions followed by irreversible cell cycle withdrawal of hemoglobinized cells. The mechanisms leading to cell cycle withdrawal were assessed in stable transfectants of murine erythroleukemia cells, in which the activities of cyclin-dependent kinases (CDKs) and CDK inhibitors (CDKIs) could be tightly regulated during differentiation. Cell cycle withdrawal of differentiating cells is mediated by induction of several CDKIs, thereby leading to inhibition of CDK2 and CDK4. Manipulation of CDK activity in differentiating cells demonstrates that the onset of cell cycle withdrawal can be either greatly accelerated or greatly delayed without affecting hemoglobin levels. Extending the proliferation of differentiating cells requires the synergistic action of CDK2 and CDK4. Importantly, CDK6 cannot substitute for CDK4 in this role, which demonstrates that the 2 cyclin D–dependent kinases are functionally different. The results show that differentiating hemoglobinized cells can be made to proliferate far beyond their normal capacity to divide.
34
OPERTO, Francesca Felicia, Grazia Maria Giovanna PASTORINO, and Giangennaro COPPOLA. "Parental Stress in New-Onset Epilepsy and After Therapy Withdrawal." BRAIN. BROAD RESEARCH IN ARTIFICIAL INTELLIGENCE AND NEUROSCIENCE 11, no. 1Sup2 (2020): 44–50. http://dx.doi.org/10.18662/brain/11.1sup2/37.
Full text
35
Geen, Ruth, F. Hugo Lambert, and Geoffrey K. Vallis. "Processes and Timescales in Onset and Withdrawal of “Aquaplanet Monsoons”." Journal of the Atmospheric Sciences 76, no. 8 (2019): 2357–73. http://dx.doi.org/10.1175/jas-d-18-0214.1.
Full textAbstract:
Abstract Aquaplanets with low-heat-capacity slab-ocean boundary conditions can exhibit rapid changes in the regime of the overturning circulation over the seasonal cycle, which have been connected to the onset of Earth’s monsoons. In spring, as the ITCZ migrates off the equator, it jumps poleward and a sudden transition occurs from an eddy-driven, equinoctial regime with two weak Hadley cells, to a near-angular-momentum-conserving, solstitial regime with a strong, cross-equatorial winter-hemisphere cell. Here, the controls on the transition latitude and rate are explored in idealized moist aquaplanet simulations. It is found that the transition remains rapid relative to the solar forcing when year length and slab-ocean heat capacity are varied, and, at Earth’s rotation rate, always occurs when the ITCZ reaches approximately 7°. This transition latitude is, however, found to scale inversely with rotation rate. Interestingly, the transition rate varies nonmonotonically with rotation, with a maximum at Earth’s rotation rate, suggesting that Earth may be particularly disposed to a fast monsoon onset. The fast transition relates to feedbacks in both the atmosphere and the slab ocean. In particular, an evaporative feedback between the lower-level branch of the overturning circulation and the surface temperature is identified. This accelerates monsoon onset and slows withdrawal. Last, comparing eddy-permitting and axisymmetric experiments shows that, in contrast with results from dry models, in this fully moist model the presence of eddies slows the migration of the ITCZ between hemispheres.
36
Chong, J., M. Cohen, and E. Waubant. "Multiple sclerosis onset after granulocyte macrophage colony-stimulating factor withdrawal." Multiple Sclerosis and Related Disorders 20 (February 2018): 178–80. http://dx.doi.org/10.1016/j.msard.2018.01.025.
Full text
37
Shiovitz, T. M., T. L. Welke, P. D. Tigel, et al. "Cholinergic Rebound and Rapid Onset Psychosis Following Abrupt Clozapine Withdrawal." Schizophrenia Bulletin 22, no. 4 (1996): 591–95. http://dx.doi.org/10.1093/schbul/22.4.591.
Full text
38
Sharma, Namita, Chandrima Naskar, Kiran Sharma, and Sandeep Grover. "Sudden onset catatonia following tricyclic antidepressant withdrawal - A case report." Indian Journal of Psychiatry 65, no. 11 (2023): 1202–3. http://dx.doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_679_23.
Full text
39
Francesca, Felicia Operto, Maria Giovanna Pastorino Grazia, and Coppola Giangennaro. "Parental Stress in New-Onset Epilepsy and After Therapy Withdrawal." BRAIN. Broad Research in Artificial Intelligence and Neuroscience 11, No 1 Sup2 (2020): 44–50. https://doi.org/10.18662/brain/11.1Sup2/37.
Full textAbstract:
Objective: To assess maternal and paternal stress inparents of children with epilepsy, at the time of diagnosis, after one year of follow-up and after therapy withdrawal. Methods: We investigated parental stress in a sample of 85 children aged 2-14 years, divided into two groups based on the diagnosis: Group 1 (50 patients) with Childhood Absence Epilepsy or Idiopathic Focal Epilepsy with Rolandic discharges; Group 2 (35 patients) with different forms of drug-resistant Epilepsy. Every parent completed the Parental Stress Index-Short Form at Time 0, when they received the diagnosis and patients started therapy, at Time 1, after 1 year of follow-up. Only parents of Group 1 completed the same questionnaire after 2 years therapy withdrawal. Results: We found high levels of stress in both mothers and fathers at Time 0, without statistically significant differences between the two groups.At Time 1, stress values were unchanged in Group 1 mothers; conversely, the levels of stress in Group 1 fathers were reduced, with average values that fell within the "normal range". In group 2, stress levels were reduced both in mothers and fathers at Time 1, compared to Time 0, but equally fell into the "clinical range", for both parents.In Group1, even one and two years after therapy withdrawal, parental stress did not normalizeand all scores persisted in the "clinical range" in both mothers and fathers. Conclusions: Our study revealed that, the diagnosis of epilepsy itself tended to increase parental stress, apparently regardless of the severity of the disorder; even after a period of follow-up, when epilepsy was better controlled, overall parental stress remained high. Parental stresslevels remained higher than expected, even 2 years after the suspension of therapy and the absence of seizures. This was probably due to concerns with the reappearance of new seizures or a more severe type of epilepsy with the suspension of drug(s), and feelings of inadequacy with their parental role(s).
40
AGNIHOTRI, CL. "Inference of the moisture field over Arabian Sea during the monsoon of 1984 using I NSAT-IB sea surface temperature data." MAUSAM 37, no. 4 (2022): 521–24. http://dx.doi.org/10.54302/mausam.v37i4.2590.
Full textAbstract:
In this study moisture incursion in the Arabian Sea has been monitored during the onset, active and withdrawal phase of the summer monsoon (May-Sept 1984) using sea surface temperature anomalies This study shows that tongue of moist air reached south. Peninsula about 20 days ahead of the normal onset of monsoon and continued to be ahead by 12-14 day even after Its setting. During the withdrawal phase it has been observed that moist air starts with drawing from north Arabian Sea by third week of September replaced by dry continental air mass which continued to move southward pushing further south the moist air and the monsoon.
41
Vega, Inmaculada, Pedro Ribera, and David Gallego. "Characteristics of the Onset, Withdrawal, and Breaks of the Western North Pacific Summer Monsoon in the 1949–2014 Period." Journal of Climate 33, no. 17 (2020): 7371–89. http://dx.doi.org/10.1175/jcli-d-19-0734.1.
Full textAbstract:
ABSTRACTThe western North Pacific summer monsoon (WNPSM) onset and withdrawal dates as well as its breaks have been determined throughout the 1949–2014 period by defining the monsoon daily directional index (MDDI). This index, developed exclusively with wind direction observations, is an upgrade of the monthly western North Pacific directional index. The onset date shows a high interannual variability, varying between early May and early August, whereas the WNPSM withdrawal shows a lower interannual variability, occurring between October and mid-November. The MDDI reflects the multibreak character of the WNPSM. Breaks, which tend to last a few weeks, are more likely to happen from mid-August to early September and from late June to mid-July. This bimodal distribution shows decadal variability. In addition, the monsoon dates determined by the MDDI show very good agreement with relationships previously described in literature, such as the influence of tropical Pacific SST on the monsoon onset/withdrawal and changes in tropical cyclone (TC) tracks related to monsoon breaks. The WNPSM tends to start earlier (later) and finish later (earlier) under eastern Pacific (EP) La Niña (El Niño) conditions, especially from the 1980s on. Central Pacific (CP) ENSO is also associated with the monsoon withdrawal, which is advanced (delayed) under CP El Niño (La Niña). TCs tend to move from the Philippine Sea to the South China Sea during active monsoon days whereas they tend to reach higher latitudes during inactive monsoon days, especially in August and July.
42
Desai, Vibha C. A., Yann Ferrand, Teresa M. Cavanaugh, et al. "Comparative Effectiveness of Tacrolimus-Based Steroid Sparing versus Steroid Maintenance Regimens in Kidney Transplantation: Results from Discrete Event Simulation." Medical Decision Making 37, no. 7 (2017): 827–43. http://dx.doi.org/10.1177/0272989x17700879.
Full textAbstract:
Background. Corticosteroids used as immunosuppressants to prevent acute rejection (AR) and graft loss (GL) following kidney transplantation are associated with serious cardiovascular and other adverse events. Evidence from short-term randomized controlled trials suggests that many patients on a tacrolimus-based immunosuppressant regimen can withdraw from steroids without increased AR or GL risk. Objectives. To measure the long-term tradeoff between GL and adverse events for a heterogeneous-risk population and determine the optimal timing of steroid withdrawal. Methods. A discrete event simulation was developed including, as events, AR, GL, myocardial infarction (MI), stroke, cytomegalovirus, and new onset diabetes mellitus (NODM), among others. Data from the United States Renal Data System were used to estimate event-specific parametric regressions, which accounted for steroid-sparing regimen (avoidance, early 7-d withdrawal, 6-mo withdrawal, 12-mo withdrawal, and maintenance) as well as patients’ demographics, immunologic risks, and comorbidities. Regression-equation results were used to derive individual time-to-event Weibull distributions, used, in turn, to simulate the course of patients over 20 y. Results. Patients on steroid avoidance or an early-withdrawal regimen were more likely to experience AR (45.9% to 55.0% v. 33.6%, P < 0.05) and GL (51.5% to 68.8% v. 37.8%, P < 0.05) compared to patients on steroid maintenance. Patients in 6-mo and 12-mo steroid withdrawal groups were less likely to experience MI (11.1% v. 13.3%, P < 0.05), NODM (30.7% to 34.4% v. 37.7%, P < 0.05), and cardiac death (29.9% to 30.5% v. 32.4%, P < 0.05), compared to steroid maintenance. Conclusions. Strategies of 6- and 12-mo steroid withdrawal post-kidney transplantation are expected to reduce the rates of adverse cardiovascular events and other outcomes with no worsening of AR or GL rates compared with steroid maintenance.
43
Zoran, Mark J., and Charles D. Drewes. "The Rapid Tail Withdrawal Reflex of the Tubificid Worm, Branchiura Sowerbyi." Journal of Experimental Biology 137, no. 1 (1988): 487–500. http://dx.doi.org/10.1242/jeb.137.1.487.
Full textAbstract:
The rapid tail withdrawal of the tubificid worm, Branchiura sowerbyi, was studied using correlated electrophysiological and behavioural analyses. The minimal response latency (i.e. time from onset of mechanical stimulus to onset of withdrawal) was approximately 7 ms, faster than the escape responses of any previously studied invertebrate. Factors contributing to the speed and efficacy of this response include: (1) a sensitive mechanosensory system for detecting potential prey, (2) a short latency for excitation along afferent and efferent pathways, (3) a rapid intersegmental conduction of lateral giant fibre spikes, (4) a short coupling time from muscle excitation to the onset of shortening, and (5) the requirement of only a single lateral giant fibre spike for a complete (all-or-none) response. Videotaped sequences of predator—prey interactions showed that such reflex speed permits effective escape from the strike of the bluegill (Lepomis macrochirus).
44
Bond, William S., Neil J. Berwish, and Brian Swift. "Severe Withdrawal Syndrome after Substitution of a Short-Acting Benzodiazepine for a Long-Acting Benzodiazepine." Drug Intelligence & Clinical Pharmacy 19, no. 10 (1985): 742–44. http://dx.doi.org/10.1177/106002808501901010.
Full textAbstract:
A severe withdrawal syndrome occurred in a patient after oxazepam 10 mg bid was substituted for diazepam 5 mg bid. The onset of symptoms was consistent with the rate of decline of diazepam and its active metabolite, desmethyldiazepam. Reintroduction of diazepam produced prompt symptom remission. This report and others suggest the need for caution when substituting a short-acting drug for a long-acting one, even when usual doses of each are used. The chronic use of benzodiazepines for eight months or longer prior to substitution or withdrawal appears to place the patient at a higher risk of incurring withdrawal phenomena. Slow and careful tapering of drug is required in such patients to reduce the risk of withdrawal symptoms.
45
Dominguez, Karen D., Dawn M. Lomako, Robert W. Katz, and H. William Kelly. "Opioid Withdrawal in Critically Ill Neonates." Annals of Pharmacotherapy 37, no. 4 (2003): 473–77. http://dx.doi.org/10.1345/aph.1c324.
Full textAbstract:
OBJECTIVE: To determine the occurrence of and risk factors for opioid withdrawal in critically ill neonates receiving continuous infusions of fentanyl. DESIGN: A prospective interventional cohort study was conducted in a university hospital neonatal intensive care unit with 19 neonates who received a minimum of 24 hours of fentanyl by continuous infusion. MEASUREMENTS: Fentanyl total dose, duration of infusion, and peak infusion rate were recorded. Patients were evaluated for withdrawal using the Neonatal Abstinence Scoring System of Finnegan. Patients with a score ≥8 were considered to have opioid withdrawal. MAIN RESULTS: Withdrawal was observed in 10 (53%) of 19 neonates. The fentanyl total dose (median 525 vs. 168 μg/kg, respectively; p = 0.03) and infusion duration (median 10 vs. 7 d, respectively; p = 0.04) were significantly greater in neonates with withdrawal compared to those without withdrawal. A fentanyl total dose ≥415 μg/kg predicted withdrawal with 70% sensitivity and 78% specificity. A fentanyl infusion duration ≥8 days predicted withdrawal with 90% sensitivity and 67% specificity. The most frequent symptoms of withdrawal were sleeping <3 hours after feeding (81%) and increased muscle tone (55%). In all neonates with withdrawal, onset occurred within 24 hours of fentanyl discontinuation. CONCLUSIONS: Opioid withdrawal occurs frequently in critically ill neonates who receive continuous infusions of fentanyl. Longer infusion duration and higher total dose were associated with withdrawal symptoms.
46
Bhanushali, Pranav. "PARASYMPATHETIC INFLUENCE ON THE MYOCARDIUM TO THE ONSET OF EXERCISE AND IMMEDIATE POST EXERCISE RECOVERY." International Journal of Advanced Research 10, no. 03 (2022): 262–82. http://dx.doi.org/10.21474/ijar01/14390.
Full textAbstract:
Background: The purpose of this study was to investigate the influence of parasympathetic nervous system on heart rate after the onset of exercise and immediate post exercise recovery. The heart rate is one of the most important cardiovascular parameter, which is very commonly used in sports to measure athletic performance. The parasympathetic nervous system is one of the major factors controlling the heart rate response due to exercise or any other stressful activity. It is also found that parasympathetic nervous system has a trainable characteristic. Hence the study focused on relating the heart rate response to the parasympathetic nervous system during the onset of exercise and immediate post exercise recovery. Methodology: This study followed an experimental approach to the problem through the analysis of archived data in the form of heart rate response to incremental workloads to volitional fatigue. The subjects in the archived data comprised of past research data measured during cycle ergometry testing to volitional fatigue. The demography of the subjects was determined via the archived data. The data consisted of 33 healthy male subjects between 19 and 47 years of age. The subjects were divided into two groups: very fit and moderately fit group, based on their VO2 max. The 50th percentile of the MaxVO2 was determined by using the median for the group. The median value obtained was 57.2 ml/kg/min. The subjects with the MaxVO2 above 57.2 ml/kg/min were grouped into a very fit category of the individuals, and the subjects with MaxVO2 below 57.2 ml/kg/min were grouped into moderately fit category. There were sixteen (n=16) subjects in the very fit group and seventeen (n=17) subjects in the moderately fit group. The outcome of the test was measured in heart rate. The parasympathetic withdrawal includes the heart rate data collected during the first three minutes of exercise. The parasympathetic reinfusion includes the heart rate data collected during the last three minutes of exercise. The statistical analysis comprised of correlation analysis and the t-test for independent samples. The results were: the correlation coefficient for very fit group parasympathetic withdrawal versus parasympathetic reinfusion is -0.81 at p < 0.05 and was found to be significant. The correlation coefficient for moderately fit group parasympathetic withdrawal versus parasympathetic reinfusion is 0.65 at p < 0.05 and was found to be non significant. A t-test for independent samples was used to determine the difference between the heart rate response due to parasympathetic withdrawal and heart rate response due to parasympathetic reinfusion for the very fit group of subjects, and the difference was found to be statistically significant at p value of 0.002. A t-test for independent samples was used to determine the difference between the heart rate response due to parasympathetic withdrawal and the heart rate response due to parasympathetic reinfusion for the moderately fit group of subjects, and the difference was found to be statistically significant at p value of 0.001. The conclusion is that there is significant association between heart rate response due parasympathetic withdrawal and heart rate response due to parasympathetic reinfusion for very fit group of subjects. But there is no significant association between heart rate response due to parasympathetic withdrawal and heart rate response due to parasympathetic reinfusion for moderately fit group of subjects. There exists a significant difference between the heart rate response due to parasympathetic withdrawal and heart rate response due to parasympathetic reinfusion in both very fit and moderately fit group of subjects.
47
Lipworth, BJ, JJ McMurray, RA Clark, and AD Struthers. "Development of persistent late onset asthma following treatment with captopril." European Respiratory Journal 2, no. 6 (1989): 586–88. http://dx.doi.org/10.1183/09031936.93.02060586.
Full textAbstract:
We describe the first case of de novo asthma following treatment with the angiotensin converting enzyme (ACE) inhibitor captopril. Despite drug withdrawal there was evidence of persistent airways obstruction and bronchial hyperreactivity. This suggests the possibility that ACE inhibitors may uncover an asthmatic tendency in patients with pre-existing bronchial hyperreactivity.
48
Solovyev, S., E. Aseeva, G. Koilubaeva, E. Nasonov, A. Lila, and N. Nikishina. "AB0389 GLUCOCORTICOID WITHDRAWAL IN SYSTEMIC LUPUS ERYTHEMATOSUS: ANALYSIS OF 750 SLE PATIENTS FROM THE RUSSIAN AND KYRGYZ COHORTS." Annals of the Rheumatic Diseases 79, Suppl 1 (2020): 1494.2–1495. http://dx.doi.org/10.1136/annrheumdis-2020-eular.3130.
Full textAbstract:
Background:Objectives:Glucocorticoids (GCs) have been the mainstream of systemic lupus erythematosus (SLE) treatment for the last 70 years. GCs allow to achieve effective control over SLE activity quite rapidly – both in mild and severe disease. The majority of SLE patients have received GC therapy; in some cohorts up to 80% - 100% of patients continue on low maintenance GCs doses < 7.5 mg/day for many years, perhaps some of them are treated indefinitely. It is clear that cumulative GCs dose is responsible for adverse effects. But it remains still unclear whether GCs should be continued indefinitely and, if not, when and how this treatment should be discontinued. On the other hand, treat-to-target SLE recommendations suggest GC withdrawal where possible as an important target of the treatment plan.Methods:Patients who attempted GCs withdrawal were included in the Eurasian SLE RENAISSANCE cohort. A retrospective analysis of 350 patients from Russia and 400 patients from Kyrgyzstan was conducted. The following information was assessed during withdrawal attempts: SLE duration, disease activity at the onset and initiation of GCs dose reduction, therapy at SLE onset, the duration of the last flare, activity and therapy at the end of FUP, and duration of remission after GCs withdrawal. Definitions of remission were applied to GCs withdrawal in line with European consensus criteria.Results:Out of 750 patients with a follow-up of about 6 years (IQR 1-23), GCs withdrawal due to persistent remission was documented in 15 patients (2.0%). In 14 out of these 15, SLE onset was associated with high disease activity based on SLEDAI 2K > 8. High level of anti-DNA and a decrease in C3 \ C4 complement were present in 12, 4 patients had nephritis with preserved renal function, 4 patients manifested signs of CNS damage (convulsions, headaches, sleep disturbances, memory issues, neuropathy, hallucinations), and another 5 had vasculitis. 10 patients were administered pulse therapy with 3 g methylprednisolone due to high disease activity. Initiation of GCs dose reduction with intent to discontinue in 7 patients was substantiated by prolonged clinical remission, meanwhile SLE duration in this group varied from 2 to 20 years, and duration of the last flare - from 6 to 165 months. Acute onset with high disease activity reaching 12-23 scores by SLEDAI 2 K was documented in 8 cases of early SLE with disease duration varying from 1.5 to 6 months. These patients were prescribed the most aggressive induction therapy, including cascade plasma filtration in combination with pulse therapy, cyclophosphamide and Rituximab at 1 g dose. Remission (SLEDAI2K 0-2 scores) was achieved 4-6-8 months later after termination of aggressive induction therapy. The duration of remission after GCs withdrawal in all 15 patients ranged from 3.5 to 240 months. In 8 patients with aggressive induction therapy, remission lasted from 18 to 240 months. In 2 remaining patients, remission lasted for 9 and 16 months after GCs withdrawal. Each flare required intake of low prednisolone doses for 3-4 weeks.Conclusion:GCs withdrawal is an achievable goal in SLE and may be attempted after a long-term remission, and possibly after aggressive intensive care in the early stages of SLE.Disclosure of Interests:None declared
49
Honeine, Jean-Louis, Oscar Crisafulli, and Marco Schieppati. "Body sway adaptation to addition but not withdrawal of stabilizing visual information is delayed by a concurrent cognitive task." Journal of Neurophysiology 117, no. 2 (2017): 777–85. http://dx.doi.org/10.1152/jn.00725.2016.
Full textAbstract:
The aim of this study was to test the effects of a concurrent cognitive task on the promptness of the sensorimotor integration and reweighting processes following addition and withdrawal of vision. Fourteen subjects stood in tandem while vision was passively added and removed. Subjects performed a cognitive task, consisting of counting backward in steps of three, or were “mentally idle.” We estimated the time intervals following addition and withdrawal of vision at which body sway began to change. We also estimated the time constant of the exponential change in body oscillation until the new level of sway was reached, consistent with the current visual state. Under the mentally idle condition, mean latency was 0.67 and 0.46 s and the mean time constant was 1.27 and 0.59 s for vision addition and withdrawal, respectively. Following addition of vision, counting backward delayed the latency by about 300 ms, without affecting the time constant. Following withdrawal, counting backward had no significant effect on either latency or time constant. The extension by counting backward of the time interval to stabilization onset on addition of vision suggests a competition for allocation of cortical resources. Conversely, the absence of cognitive task effect on the rapid onset of destabilization on vision withdrawal, and on the relevant reweighting time course, advocates the intervention of a subcortical process. Diverting attention from a challenging standing task discloses a cortical supervision on the process of sensorimotor integration of new balance-stabilizing information. A subcortical process would instead organize the response to removal of the stabilizing sensory input. NEW & NOTEWORTHY This study is the first to test the effect of an arithmetic task on the time course of balance readjustment following visual withdrawal or addition. Performing such a cognitive task increases the time delay following addition of vision but has no effect on withdrawal dynamics. This suggests that sensorimotor integration following addition of a stabilizing signal is performed at a cortical level, whereas the response to its withdrawal is “automatic” and accomplished at a subcortical level.
50
Shrivastava, Divya, and Shri JL Chaudhary. "Effect of monsoon onset and withdrawal on rice production in Chhattisgarh." International Journal of Chemical Studies 8, no. 6 (2020): 418–23. http://dx.doi.org/10.22271/chemi.2020.v8.i6f.10807.
Full text