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https://www.readbyqxmd.com/read/28646600/intranasal-ketamine-proved-feasible-for-pain-control-in-paediatric-care-and-parental-support-was-high
#1
E Scheier, U Balla, A Siman
Venipuncture and intravenous placement are common causes of pain in children. The Pediatric Emergency Department at Kaplan Medical Center carried out a feasibility trial to look at whether nasal ketamine could provide pain control during these procedures. From June to December 2016, we enrolled 20 children aged 1-12 years who resisted venipuncture or intravenous placement. This article is protected by copyright. All rights reserved.
June 24, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28620730/advances-towards-painless-vaccination-and-newer-modes-of-vaccine-delivery
#2
Neha Garg, Anju Aggarwal
Vaccines have been successful in reducing the mortality and morbidity, but most of them are delivered by intramuscular or intravenous route. They are associated with pain to the baby and bring lot of anxiety for the parents. There has been a marked increase in the number of injections required in first two years of life for completing the vaccination schedule. Hence, there is a need to have a painless vaccine delivery system. Numerous new routes of vaccination like, oral, nasal and transdermal routes are being tried...
June 16, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28601750/sex-specific-effects-of-intranasal-oxytocin-on-thermal-pain-perception-a-randomised-double-blind-placebo-controlled-cross-over-study
#3
Lincoln M Tracy, Izelle Labuschagne, Nellie Georgiou-Karistianis, Stephen J Gibson, Melita J Giummarra
Chronic neck and shoulder pain (CNSP) is a common musculoskeletal disorder in adults, which is linked to hypersensitivity to noxious stimuli. The hormone oxytocin has been implicated as a potential therapeutic for the management of chronic pain disorders, and has been suggested to have sex-specific effects on the salience of threatening stimuli. This study investigated the influence of intranasal oxytocin on the perception of noxious thermal stimuli. Participants were 24 individuals with CNSP lasting >12months (eight women), and 24 age- and sex-matched healthy, pain-free controls...
June 3, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/28551041/emergency-departments-increasingly-administering-medications-through-the-nose
#4
REVIEW
Deborah L McBride
Administering medications through the nose as an alternative to intramuscular or intravenous injections is increasingly popular in emergency departments and out-of hospital settings because it is simple, fast, and can be used in situations where obtaining intravenous access is difficult or time intensive. This article examines the literature and indications for the out-of-hospital and emergency department administration of five commonly used intranasal medications: midazolam (used to sedate children and treat seizures), fentanyl (for pain relief), naloxone (for opioid overdoses), ketamine (to induce anesthesia) and dexmedetomidine (to sedate and relieve pain in children)...
May 24, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28504483/comparison-of-a-new-intranasal-naloxone-formulation-to-intramuscular-naloxone-results-from-hypothesis-generating-small-clinical-studies
#5
B T Gufford, G R Ainslie, J R White, M E Layton, J M Padowski, G M Pollack, M F Paine
Easy-to-use naloxone formulations are needed to help address the opioid overdose epidemic. The pharmacokinetics of i.v., i.m., and a new i.n. naloxone formulation (2 mg) were compared in six healthy volunteers. Relative to i.m. naloxone, geometric mean (90% confidence interval [CI]) absolute bioavailability of i.n. naloxone was modestly lower (55%; 90% CI, 43-70% vs. 41%; 90% CI, 27-62%), whereas average (±SE) mean absorption time was substantially shorter (74 ± 8.8 vs. 6.7 ± 4.9 min). The opioid-attenuating effects of i...
May 15, 2017: Clinical and Translational Science
https://www.readbyqxmd.com/read/28497569/early-onset-of-efficacy-and-consistency-of-response-across-multiple-migraine-attacks-from-the-randomized-compass-study-avp-825-breath-powered-%C3%A2-exhalation-delivery-system-sumatriptan-nasal-powder-vs-oral-sumatriptan
#6
Stephen Silberstein, Paul K Winner, Peter J McAllister, Stewart J Tepper, Rashmi Halker, Ramy A Mahmoud, Joao Siffert
OBJECTIVE: To further characterize the clinical utility of AVP-825 based on additional prespecified outcomes and post hoc analyses of COMPASS, a Phase 3 comparative efficacy trial of AVP-825 vs 100 mg oral sumatriptan (NCT01667679). AVP-825 was approved in January 2016 by the US Food and Drug Administration under the name ONZETRA(®) Xsail(®) (sumatriptan nasal powder) for the acute treatment of migraine with or without aura in adults. BACKGROUND: AVP-825 is a delivery system that uses a patient's own breath to deliver low-dose sumatriptan powder to the upper posterior regions of the nasal cavity beyond the narrow nasal valve, areas lined with vascular mucosa conducive to rapid drug absorption into the systemic circulation...
May 11, 2017: Headache
https://www.readbyqxmd.com/read/28485846/oxytocin-and-migraine-headache
#7
REVIEW
Alexander Tzabazis, Shashi Kori, Jordan Mechanic, James Miller, Conrado Pascual, Neil Manering, Dean Carson, Michael Klukinov, Egilius Spierings, Daniel Jacobs, Jason Cuellar, William H Frey, Leah Hanson, Martin Angst, David C Yeomans
This article reviews material presented at the 2016 Scottsdale Headache Symposium. This presentation provided scientific results and rationale for the use of intranasal oxytocin for the treatment of migraine headache. Results from preclinical experiments are reviewed, including in vitro experiments demonstrating that trigeminal ganglia neurons possess oxytocin receptors and are inhibited by oxytocin. Furthermore, most of these same neurons contain CGRP, the release of which is inhibited by oxytocin. Results are also presented which demonstrate that nasal oxytocin inhibits responses of trigeminal nucleus caudalis neurons to noxious stimulation using either noxious facial shock or nitroglycerin infusion...
May 2017: Headache
https://www.readbyqxmd.com/read/28465701/use-of-sedative-drugs-at-reducing-the-side-effects-of-voiding-cystourethrography-in-children
#8
REVIEW
Anahita Alizadeh, Maryam Naseri, Yalda Ravanshad, Shahabaddin Sorouri, Malihe Banihassan, Anoush Azarfar
BACKGROUND: Imaging of the kidneys and urinary tract has a significant and critical role for diagnosis of genitourinary system diseases. Although technological progress goes toward less invasive approaches, some of the current methods are still invasive and annoying. Voiding cystourethrography (VCUG) is the best and most accurate method for diagnosis and grading of vesicoureteral reflux. VCUG is a distressful procedure that gives serious anxiety and pain in a large proportion of children and fear for parents; therefore, using effective sedative drugs with the least side effects is necessary and should be considered...
2017: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/28459726/dexmedetomidine-as-a-supplement-to-spinal-anesthesia-block-a-case-report-of-three-infants
#9
Franklin Chiao, Karen Boretsky
We report a novel use for dexmedetomidine as a supplemental intravenous or intranasal sedative for spinal anesthesia in infants. The children were 1, 2, and 9 months old having either inguinal hernia repair or circumcision. None of them experienced clinically relevant hemodynamic changes or apnea. Pain scores were zero throughout the postoperative period.
April 28, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28444856/pharmacokinetics-after-a-single-dose-of-naloxone-administered-as-a-nasal-spray-in-healthy-volunteers
#10
E Vanky, L Hellmundt, U Bondesson, S Eksborg, S Lundeberg
BACKGROUND: There is increasing interest in the use of intranasal naloxone to reverse adverse opioid effects during management of procedural pain in children and in adults after overdose. There are limited data on the pharmacokinetics of intranasal naloxone so in this study we aimed to detail the pharmacokinetic profile of the commercially marketed injectable solution of naloxone 0.4 mg/ml when administered as an intranasal spray. METHODS: Twenty healthy volunteers received naloxone as an intranasal spray at a dose of 10 μg/kg...
July 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28442950/effect-of-intranasal-dexmedetomidine-on-emergence-agitation-after-sevoflurane-anesthesia-in-children-undergoing-tonsillectomy-and-or-adenoidectomy
#11
Ahmed Mostafa Abd El-Hamid, Hany Mahmoud Yassin
BACKGROUND: Emergence agitation (EA) after sevoflurane anesthesia is common in children during recovery from general anesthesia and may result in postoperative complications. This study investigated safety and effectiveness of intranasal dexmedetomidine in reducing the incidence and severity of EA. METHODS: This prospective, randomized double-blinded controlled trial included 86 patients scheduled for the tonsillectomy and/or adenoidectomy under general anesthesia with sevoflurane...
April 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28418398/intranasal-oxytocin-enhances-intrinsic-corticostriatal-functional-connectivity-in-women
#12
R A I Bethlehem, M V Lombardo, M-C Lai, B Auyeung, S K Crockford, J Deakin, S Soubramanian, A Sule, P Kundu, V Voon, S Baron-Cohen
Oxytocin may influence various human behaviors and the connectivity across subcortical and cortical networks. Previous oxytocin studies are male biased and often constrained by task-based inferences. Here, we investigate the impact of oxytocin on resting-state connectivity between subcortical and cortical networks in women. We collected resting-state functional magnetic resonance imaging (fMRI) data on 26 typically developing women 40 min following intranasal oxytocin administration using a double-blind placebo-controlled crossover design...
April 18, 2017: Translational Psychiatry
https://www.readbyqxmd.com/read/28416501/protocol-for-a-placebo-controlled-within-participants-crossover-trial-evaluating-the-efficacy-of-intranasal-oxytocin-to-improve-pain-and-function-among-women-with-chronic-pelvic-musculoskeletal-pain
#13
Joshua A Rash, Kirsti Toivonen, Magali Robert, Maryam Nasr-Esfahani, John F Jarrell, Tavis S Campbell
INTRODUCTION: This protocol presents the rationale and design for a trial evaluating the efficacy of intranasal oxytocin in improving pain and function among women with chronic pelvic musculoskeletal pain. Oxytocin is a neuropeptide traditionally recognised for involvement in labour, delivery and lactation. Novel evidence suggests that oxytocin decreases pain sensitivity in humans. While oxytocin administration has been reported to lower pain sensitivity among patients experiencing chronic back pain, headache, constipation and colon pain, no research has evaluated the association between intranasal oxytocin and chronic pelvic musculoskeletal pain...
April 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28411530/the-influence-of-intrapartum-opioid-use-on-breastfeeding-experience-at-6-weeks-post-partum-a-secondary-analysis
#14
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/28400322/bladder-involvement-in-stage-i-endometriosis
#15
Paula C Brady, Stacey A Missmer, Marc R Laufer
BACKGROUND: Endometriosis-the ectopic implantation of endometrial-like tissue-affects 10% of adolescent females and adults. Bladder involvement, causing dysuria and hematuria, occurs in a very small number of endometriosis patients. CASE: The patient presented at age 12 years with dysuria and pelvic pain. Laparoscopy revealed stage I endometriosis. Postoperatively, she reported persistent dysuria and passage of tissue in her urine. Cystoscopy showed diffuse erythema; urine cytology revealed glandular and spindle cells suggestive of endometriosis...
April 8, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/28399933/intranasal-sedation-using-ketamine-and-midazolam-for-pediatric-dental-treatment-naso-study-protocol-for-a-randomized-controlled-trial
#16
Heloisa Sousa Gomes, Analya Rodrigues Miranda, Karolline Alves Viana, Aline Carvalho Batista, Paulo Sucasas Costa, Anelise Daher, Geovanna de Castro Morais Machado, Joji Sado-Filho, Liliani Aires Candido Vieira, Patrícia Corrêa-Faria, Marie Therese Hosey, Luciane Rezende Costa
BACKGROUND: Uncooperative children may need to receive dental treatment under sedation, which is indicated when nonpharmacological behavior guidance is unsuccessful. There are randomized controlled trials (RCTs) comparing different sedative protocols for dental procedures; however, the evidence for superiority of one form over another is weak. The primary aim of this study is to investigate the efficacy of intranasally administered ketamine plus midazolam for the dental treatment of children...
April 11, 2017: Trials
https://www.readbyqxmd.com/read/28376637/correlation-of-symptoms-clinical-signs-and-biomarkers-of-inflammation-in-postsurgical-chronic-rhinosinusitis
#17
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
#18
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/28345745/in-vitro-and-in-vivo-assessment-of-the-abuse-potential-of-pf614-a-novel-bio-md%C3%A2-prodrug-of-oxycodone
#19
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/28275979/intranasal-dexmedetomidine-for-procedural-sedation-in-children-a-suitable-alternative-to-chloral-hydrate
#20
REVIEW
Giorgio Cozzi, Stefania Norbedo, Egidio Barbi
Sedation is often required for children undergoing diagnostic procedures. Chloral hydrate has been one of the sedative drugs most used in children over the last 3 decades, with supporting evidence for its efficacy and safety. Recently, chloral hydrate was banned in Italy and France, in consideration of evidence of its carcinogenicity and genotoxicity. Dexmedetomidine is a sedative with unique properties that has been increasingly used for procedural sedation in children. Several studies demonstrated its efficacy and safety for sedation in non-painful diagnostic procedures...
April 2017: Paediatric Drugs
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