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https://www.readbyqxmd.com/read/28435493/prehospital-care-for-the-adult-and-pediatric-seizure-patient-current-evidence-based-recommendations
#1
Eric C Silverman, Karl A Sporer, Justin M Lemieux, John F Brown, Kristi L Koenig, Marianne Gausche-Hill, Eric M Rudnick, Angelo A Salvucci, Greg H Gilbert
INTRODUCTION: We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of adult and pediatric patients with a seizure and to compare these recommendations against the current protocol used by the 33 emergency medical services (EMS) agencies in California. METHODS: We performed a review of the evidence in the prehospital treatment of patients with a seizure, and then compared the seizure protocols of each of the 33 EMS agencies for consistency with these recommendations...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28431278/intranasal-oxytocin-does-not-modulate-jumping-to-conclusions-in-schizophrenia-potential-interactions-with-caudate-volume-and-baseline-social-functioning
#2
Fernando Caravaggio, Philip Gerretsen, Wanna Mar, Jun Ku Chung, Eric Plitman, Shinichiro Nakajima, Julia Kim, Yusuke Iwata, Raihaan Patel, M Mallar Chakravarty, Gary Remington, Ariel Graff-Guerrero, Mahesh Menon
BACKGROUND: Patients with schizophrenia (SCZ) tend to sample less information when making a decision, jumping to conclusions (JTC) without sufficient evidence. This "JTC bias" may be a trait marker of the disease and may not improve with antipsychotic treatment. We conducted a double-blind, placebo-controlled trial to test whether intranasal oxytocin could reduce JTC in stable, medicated patients with SCZ and healthy controls (HCs). We also explored whether striatal volume, clinical symptoms, and baseline social functioning (SF) was related to JTC performance...
March 31, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/28424564/new-developments-in-the-management-of-narcolepsy
#3
REVIEW
Vivien C Abad, Christian Guilleminault
Narcolepsy is a life-long, underrecognized sleep disorder that affects 0.02%-0.18% of the US and Western European populations. Genetic predisposition is suspected because of narcolepsy's strong association with HLA DQB1*06-02, and genome-wide association studies have identified polymorphisms in T-cell receptor loci. Narcolepsy pathophysiology is linked to loss of signaling by hypocretin-producing neurons; an autoimmune etiology possibly triggered by some environmental agent may precipitate hypocretin neuronal loss...
2017: Nature and Science of Sleep
https://www.readbyqxmd.com/read/28423474/nasal-obstructive-disorders-impair-health-related-quality-of-life-in-adolescents-with-persistent-allergic-rhinitis-a-real-life-study
#4
Meritxell Valls-Mateus, Franklin Marino-Sanchez, Karen Ruiz-Echevarría, Paulina Cardenas-Escalante, Rosa Jiménez-Feijoo, Jaime Blasco-Lozano, María Teresa Giner-Muñoz, Oliver Haag, Isam Alobid, Ana María Plaza Martin, Joaquim Mullol
BACKGROUND: We previously reported a higher prevalence of nasal obstructive disorders (NOD) in pediatric patients with persistent allergic rhinitis (PER) not responding to medical treatment. The aim of this study was to determine the impact of NOD on quality of life (QoL) in this population. METHODS: Real-life prospective study including 142 patients (41 children, 6-11 yo and 101 adolescents, 12-17 yo) with moderate and severe PER. After two months of medical treatment (intranasal steroids and antihistamines) patients were asked if their symptoms had improved (yes/no) and classified accordingly in R, responders and NR, non-responders...
April 19, 2017: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/28411530/the-influence-of-intrapartum-opioid-use-on-breastfeeding-experience-at-6-weeks-post-partum-a-secondary-analysis
#5
Julie-Anne Fleet, Meril Jones, Ingrid Belan
OBJECTIVE: To examine breastfeeding experiences up to 6 weeks postpartum for mothers administered intranasal fentanyl, subcutaneous fentanyl or intramuscular pethidine for intrapartum analgesia. DESIGN: A secondary analysis was undertaken using the per-protocol dataset to examine the third phase of a larger randomised controlled trial. This phase of the study examined breastfeeding intention and experience from the first hour of birth to 6 weeks postpartum. Medical records were audited and women were contacted at 6 weeks postpartum to complete a telephone questionnaire...
April 3, 2017: Midwifery
https://www.readbyqxmd.com/read/28408985/new-drugs-in-psychiatry-focus-on-new-pharmacological-targets
#6
REVIEW
Filippo Caraci, Gian Marco Leggio, Salvatore Salomone, Filippo Drago
The approval of psychotropic drugs with novel mechanisms of action has been rare in recent years. To address this issue, further analysis of the pathophysiology of neuropsychiatric disorders is essential for identifying new pharmacological targets for psychotropic medications. In this report, we detail drug candidates being examined as treatments for psychiatric disorders. Particular emphasis is placed on agents with novel mechanisms of action that are being tested as therapies for depression, schizophrenia, or Alzheimer's disease...
2017: F1000Research
https://www.readbyqxmd.com/read/28403108/analyses-and-treatments-of-postoperative-nasal-complications-after-endonasal-transsphenoidal-resection-of-pituitary-neoplasms
#7
You Cheng, Fei Xue, Tian-You Wang, Jun-Feng Ji, Wei Chen, Zhi-Yi Wang, Li Xu, Chun-Hua Hang, Xin-Feng Liu
In this study, we analyze and discuss the treatments of postoperative nasal complications after endonasal transsphenoidal resection of pituitary neoplasms (PNs). We performed 129 endonasal transsphenoidal resections of PNs and analyzed and treated cases with nasal complications. After endonasal transsphenoidal resection of PNs, there were 26 cases of postoperative nasal complications (20.1%), including nasal hemorrhage (4.8%), cerebrospinal fluid rhinorrhea (6.9%), sphenoid sinusitis (2.3%), atrophic rhinitis (1...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28396435/intranasal-msc-derived-a1-exosomes-ease-inflammation-and-prevent-abnormal-neurogenesis-and-memory-dysfunction-after-status-epilepticus
#8
Qianfa Long, Dinesh Upadhya, Bharathi Hattiangady, Dong-Ki Kim, Su Yeon An, Bing Shuai, Darwin J Prockop, Ashok K Shetty
Status epilepticus (SE), a medical emergency that is typically terminated through antiepileptic drug treatment, leads to hippocampus dysfunction typified by neurodegeneration, inflammation, altered neurogenesis, as well as cognitive and memory deficits. Here, we examined the effects of intranasal (IN) administration of extracellular vesicles (EVs) secreted from human bone marrow-derived mesenchymal stem cells (MSCs) on SE-induced adverse changes. The EVs used in this study are referred to as A1-exosomes because of their robust antiinflammatory properties...
April 10, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28376637/correlation-of-symptoms-clinical-signs-and-biomarkers-of-inflammation-in-postsurgical-chronic-rhinosinusitis
#9
Samuel D Racette, Rohan C Wijewickrama, Vijayvel Jayaprakash, David A Sherris, Carlos Santos, Hirohito Kita, Frank E O'Donnell, Jens U Ponikau
OBJECTIVE: The study aimed to evaluate symptoms described by patients with chronic rhinosinusitis with polypoid changes/nasal polyps and their correlation with computed tomography (CT), nasal endoscopy, and intranasal biomarkers. STUDY DESIGN: Prospective multicenter study symptom data from postsurgical adult chronic rhinosinusitis study participants with recurrent disease refractory to medical therapy were analyzed in comparison with objective data. METHODS: Using logistic regression analysis, participant-rated 16-question surveys from 258 participants were assessed for correlation with nasal endoscopy scores, CT percentage of sinus occlusion, and intranasal biomarkers of fungal antigens (Alternaria and Aspergillus), eosinophilic inflammation (eosinophil-derived neurotoxin [EDN] and major basic protein [MBP]), and inflammatory cytokines (interleukins 5 and 13)...
June 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28366351/when-to-pick-the-nose-out-of-hospital-and-emergency-department-intranasal-administration-of-medications
#10
REVIEW
Megan A Rech, Brian Barbas, Whitney Chaney, Elizabeth Greenhalgh, Charles Turck
The intranasal route for medication administration is increasingly popular in the emergency department and out-of-hospital setting because such administration is simple and fast, and can be used for patients without intravenous access and in situations in which obtaining an intravenous line is difficult or time intensive (eg, for patients who are seizing or combative). Several small studies (mostly pediatric) have shown midazolam to be effective for procedural sedation, anxiolysis, and seizures. Intranasal fentanyl demonstrates both safety and efficacy for the management of acute pain...
March 25, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28347608/sedation-effects-of-intranasal-dexmedetomidine-delivered-as-sprays-versus-drops-on-pediatric-response-to-venous-cannulation
#11
Zhubin Xie, Weihua Shen, Jingyi Lin, Liwen Xiao, Minyan Liao, Xiaoliang Gan
OBJECTIVES: Mucosal atomization device (MAD) was designed to increase the bioavailability of intranasal medications by facilitating absorption, the present study aimed to evaluate and compare the sedation effects of intranasal dexmedetomidine delivered as drops versus sprays on pediatric responses to intravenous cannulation. METHODS: One hundred and six pediatric patients (aged from 2 to 5years) scheduled for elective ophthalmic surgery were intranasally received a dose of 2μg/kg in 20μl/kg of dexmedetomidine for sedation to reduce response to venous cannulation...
March 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28345745/in-vitro-and-in-vivo-assessment-of-the-abuse-potential-of-pf614-a-novel-bio-md%C3%A2-prodrug-of-oxycodone
#12
D Lynn Kirkpatrick, William K Schmidt, Ricardo Morales, John Cremin, Julie Seroogy, Craig Husfeld, Thomas Jenkins
OBJECTIVE: The need for pain medication which will not lead to abuse is well recognized. Ensysce has designed prodrug analogs of the commonly used pain medications including hydromorphone, oxycodone (OC), hydrocodone, and morphine that limit their use to oral delivery, two of which are in clinical development. This study was undertaken to demonstrate that PF614, an extended-release prodrug of OC, allows the release of OC as designed when delivered orally, yet it resists ex vivo extraction with household chemicals and is pharmacologically inactive when administered by nonoral routes (nasal and parenteral), thereby substantially reducing its intravenous (IV) and intranasal abuse potential...
January 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28337075/intranasal-dexmedetomidine-as-a-sedative-for-pediatric-procedural-sedation
#13
Natalie Behrle, Esma Birisci, Jordan Anderson, Sara Schroeder, Abdallah Dalabih
OBJECTIVE: This study seeks to evaluate the efficacy and safety of intranasal (IN) dexmedetomidine as a sedative medication for non-invasive procedural sedation. METHODS: Subjects 6 months to 18 years of age undergoing non-invasive elective procedures were included. Dexmedetomidine (3 mcg/kg) was administered IN 40 minutes before the scheduled procedure time. The IN dexmedetomidine cohort was matched and compared to a cohort of 690 subjects who underwent sedation for similar procedures without the use of dexmedetomidine to evaluate for observed events/interventions and procedural times...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28323986/chronic-intranasal-insulin-does-not-affect-hepatic-lipids-but-lowers-circulating-bcaas-in-healthy-male-subjects
#14
Thomas Scherer, Peter Wolf, Sabina Smajis, Melania Gaggini, Martina Hackl, Amalia Gastaldelli, Peter Klimek, Elisa Einwallner, Rodrig Marculescu, Anton Luger, Clemens Fürnsinn, Siegfried Trattnig, Christoph Buettner, Martin Krššák, Michael Krebs
Context: Nonalcoholic fatty liver disease and elevated circulating branched-chain amino acids (BCAAs) are common characteristics of obesity and type 2 diabetes. In rodents, brain insulin signaling controls both hepatic triglyceride secretion and BCAA catabolism. Whether brain insulin signaling controls similar metabolic pathways in humans is unknown. Objective: Here we assessed if intranasal insulin, a method to preferentially deliver insulin to the central nervous system, is able to modulate hepatic lipid content and plasma BCAAs in humans...
April 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28272019/geniposide-demonstrates-anti-inflammatory-and-antiviral-activity-against-pandemic-a-jiangsu-1-2009-h1n1-influenza-virus-infection-in-vitro-and-in-vivo
#15
Zhang Yunshi, Yao Jing, Qi Xian, Liu Xing, Lu Xieqin, Feng Ganzhu
BACKGROUND: Influenza A viruses (IAVs) remains to be a great threat to human health for centuries, without effective control. Geniposide, a main iridoid glycoside compound extracted from Gardenia jasminoides Ellis (GJ) fruit, possesses various biologic activities including anti-inflammation and anti-virus. METHODS: Madin-Darby Canine Kidney (MDCK) cells were infected with pandemic A/Jiangsu/1/2009 (H1N1) influenza virus in vitro. Cytotoxicity and antiviral activity of geniposide were estimated by MTT assay...
March 8, 2017: Antiviral Therapy
https://www.readbyqxmd.com/read/28271228/comparison-of-ease-of-administration-of-intranasal-midazolam-spray-and-oral-midazolam-syrup-by-parents-as-premedication-to-children-undergoing-elective-surgery
#16
Milthi Manoj, M V S Satya Prakash, Srinivasan Swaminathan, Rithu Krishna Kamaladevi
BACKGROUND: The efficacy of midazolam as premedication in children for providing pre-operative sedation and reducing parental separation anxiety has been well established. Many studies have compared the effectiveness and medication acceptance of midazolam via oral and intranasal routes. In this study, we have compared the ease of administration of oral midazolam syrup and intranasal midazolam spray as premedication, administered by parents to children. METHODS: Ninety children were randomly allocated into one of the two groups: group N received nasal midazolam spray 0...
March 7, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28259526/review-of-intranasally-administered-medications-for-use-in-the-emergency-department
#17
Abby M Bailey, Regan A Baum, Karolyn Horn, Tameka Lewis, Kate Morizio, Amy Schultz, Kyle Weant, Stephanie N Justice
BACKGROUND: Intranasal (IN) medication delivery is a viable alternative to other routes of administration, including intravenous (IV) and intramuscular (IM) administration. The IN route bypasses the risk of needle-stick injuries and alleviates the emotional trauma that may arise from the insertion of an IV catheter. OBJECTIVE: This review aims to evaluate published literature on medications administered via the IN route that are applicable to practice in emergency medicine...
March 1, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28251391/a-multicenter-open-label-long-term-safety-and-tolerability-study-of-dfn-02-an-intranasal-spray-of-sumatriptan-10%C3%A2-mg-plus-permeation-enhancer-ddm-for-the-acute-treatment-of-episodic-migraine
#18
Sagar Munjal, Elimor Brand-Schieber, Kent Allenby, Egilius L H Spierings, Roger K Cady, Alan M Rapoport
BACKGROUND: DFN-02 is a novel intranasal spray formulation composed of sumatriptan 10 mg and a permeation-enhancing excipient comprised of 0.2% 1-O-n-Dodecyl-β-D-Maltopyranoside (DDM). This composition of DFN-02 allows sumatriptan to be rapidly absorbed into the systemic circulation and exhibit pharmacokinetics comparable to subcutaneously administered sumatriptan. Rapid rate of absorption is suggested to be important for optimal efficacy. The objective of this study was to evaluate the safety and tolerability of DFN-02 (10 mg) in the acute treatment of episodic migraine with and without aura over a 6-month period based on the incidence of treatment-emergent adverse events and the evaluation of results of clinical laboratory tests, vital signs, physical examination, and electrocardiograms...
December 2017: Journal of Headache and Pain
https://www.readbyqxmd.com/read/28247440/clinical-features-imaging-characteristics-and-long-term-outcome-of-dogs-with-cranial-meningocele-or-meningoencephalocele
#19
K Lazzerini, R Gutierrez-Quintana, R José-López, F McConnell, R Gonçalves, J McMurrough, S De Decker, C Muir, S L Priestnall, L Mari, F Stabile, L De Risio, C Loeffler, A Tauro, C Rusbridge, S Rodenas, S Añor, C de la Fuente, A Fischer, A Bruehschwein, J Penderis, J Guevar
BACKGROUND: The term meningoencephalocele (MEC) describes a herniation of cerebral tissue and meninges through a defect in the cranium, whereas a meningocele (MC) is a herniation of the meninges alone. HYPOTHESIS/OBJECTIVES: To describe the clinical features, magnetic resonance imaging (MRI) characteristics, and outcomes of dogs with cranial MC and MEC. ANIMALS: Twenty-two client-owned dogs diagnosed with cranial MC or MEC. METHODS: Multicentric retrospective descriptive study...
March 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28242555/imaging-prevalence-of-nasal-septal-perforation-in-an-urban-population
#20
Menachem Gold, Issac Boyack, Nicholas Caputo, Aaron Pearlman
OBJECTIVE: To determine the prevalence of nasal septal perforation (NSP) on CT imaging in an urban hospital setting. METHODS: Facial bone CT scans from 3708 consecutive patients were reviewed for the presence of NSP. Size of the perforation was measured in two dimensions. Medical records were reviewed for possible risk factors. RESULTS: The prevalence of NSP was 2.05%. The most common risk factor was a history of drug abuse. Cocaine was the most prevalent drug used...
February 20, 2017: Clinical Imaging
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