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https://www.readbyqxmd.com/read/27913280/neuropsychological-functioning-and-chronic-methadone-use-a-systematic-review-and-meta-analysis
#1
REVIEW
A Baldacchino, M Armanyous, D J K Balfour, G Humphris, K Matthews
INTRODUCTION: There is a presumption that neurocognition is commonly impaired in chronic methadone exposed individuals (CM) when compared with healthy controls (HP). Additionally, it remains unclear if short term (<1year) abstinence (AP) is associated with an altered cognitive profile when compared with CM. METHOD: A random effect model approach was used on data assembled into the Comprehensive Meta-Analysis programme. Cohen's d effect sizes and a significance levels of p<0...
November 29, 2016: Neuroscience and Biobehavioral Reviews
https://www.readbyqxmd.com/read/27912882/tenuifolin-a-saponin-derived-from-radix-polygalae-exhibits-sleep-enhancing-effects-in-mice
#2
Qing Cao, Yong Jiang, Su-Ying Cui, Peng-Fei Tu, Yue-Mei Chen, Xiao-Li Ma, Xiang-Yu Cui, Yuan-Li Huang, Hui Ding, Jin-Zhi Song, Bin Yu, Zhao-Fu Sheng, Zi-Jun Wang, Ya-Ping Xu, Guang Yang, Hui Ye, Xiao Hu, Yong-He Zhang
BACKGROUND: Radix Polygalae, the dried root of Polygala tenuifolia, has been extensively used as a traditional Chinese medicine for promoting intelligence and tranquilization. Polygalasaponins extracted from the root of P. tenuifolia possess evident anxiolytic and sedative-hypnotic activities. Previous studies have reported that tenuifolin was a major constituent of polygalasaponins. PURPOSE: The currently study aims to investigate the hypnotic effect and possible mechanism of tenuifolin in freely moving mice...
December 15, 2016: Phytomedicine: International Journal of Phytotherapy and Phytopharmacology
https://www.readbyqxmd.com/read/27911257/individualized-antibiotic-therapy-in-patients-with-ventilator-associated-pneumonia
#3
Gurdal Yilmaz, Sedat Saylan, Firdevs Aksoy, Iftihar Koksal
The optimal duration of treatment of ventilator-associated pneumonia (VAP) is still the subject of debate. While 1-week treatment has been reported as possibly sufficient, patients generally receive antibiotic therapy for 10-14 days. The purpose of our study was to investigate whether length of treatment in patients with VAP can be reduced with an individualized therapeutic strategy. The study was performed prospectively with patients diagnosed with VAP in our hospital's intensive care units between 1 January and 31 December, 2015...
December 1, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27909739/quantification-of-anticholinergic-and-sedative-drug-load-with-the-drug-burden-index-a-review-of-outcomes-and-methodological-quality-of-studies
#4
REVIEW
Hans Wouters, Helene van der Meer, Katja Taxis
PURPOSE: The Drug Burden Index (DBI) is a non-invasive method to quantify patients' anticholinergic and sedative drug burden from their prescriptions. This systematic review aimed to summarise the evidence on the associations between the DBI and clinical outcomes and methodological quality of studies. METHODS: A search in PubMed and Embase (search terms: 'drug', 'burden', and 'index') was performed and experts were contacted. We excluded publications that did not report empirical results or clinical outcomes...
December 1, 2016: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27909609/emergency-difficult-airway-management-in-a-patient-with-severe-epidermolysis-bullosa
#5
Ahmet Selim Özkan, Gülay Erdoğan Kayhan, Sedat Akbaş, Osman Kaçmaz, Mahmut Durmuş
Epidermolysis bullosa (EB) is a rare disease characterised by vesiculobullous lesions with minimal trauma to the skin and mucous membranes. Bleeding, scar tissue, contractures, oedema and lesions that can spread throughout the body can cause a difficult airway and vascular access in patients with EB. Therefore, anaesthetic management in patients with EB is a major problem even for experienced anaesthesiologists. Herein, we report a case of difficult airway management in a patient diagnosed with severe EB who presented for emergency tracheostomy because of respiratory failure under general anaesthesia...
October 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27909550/information-seeking-and-anxiety-among-colonoscopy-na%C3%A3-ve-adults-direct-to-colonoscopy-vs-traditional-consult-first-pathways
#6
Jocelyn A Silvester, Harmandeep Kalkat, Lesley A Graff, John R Walker, Harminder Singh, Donald R Duerksen
AIM: To investigate the effects of direct to colonoscopy pathways on information seeking behaviors and anxiety among colonoscopy-naïve patients. METHODS: Colonoscopy-naïve patients at two tertiary care hospitals completed a survey immediately prior to their scheduled outpatient procedure and before receiving sedation. Survey items included clinical pathway (direct or consult), procedure indication (cancer screening or symptom investigation), telephone and written contact from the physician endoscopist office, information sources, and pre-procedure anxiety...
November 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27908944/use-of-neuromuscular-blockers-during-therapeutic-hypothermia-after-cardiac-arrest-a-nursing-protocol
#7
Coraline Boulila, Samia Ben Abdallah, Aude Marincamp, Vincent Coic, Romuald Lauverjat, Nicole Ericher, Wulfran Bougouin, Jean-Paul Mira, Alain Cariou, Guillaume Geri
BACKGROUND: Neuromuscular blockers used to prevent shivering during therapeutic hypothermia in comatose patients after out-of-hospital cardiac arrest are associated with adverse events. OBJECTIVE: To assess the influence of a nurse-implemented protocol on use of neuromuscular blockers in patients treated with 24-hour therapeutic hypothermia after out-of-hospital cardiac arrest. METHODS: A before and after study was done in a 24-bed cardiac arrest center...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27908308/remarkable-damage-along-with-poor-quality-of-life-in-takayasu-arteritis-cross-sectional-results-of-a-long-term-followed-up-multicentre-cohort
#8
Ahmet Omma, Burak Erer, Omer Karadag, Neslihan Yilmaz, Fatma Alibaz-Oner, Fatih Yildiz, Melike Kalfa, Gezmis Kimyon, Sedat Kiraz, Haner Direskeneli, Eren Erken, Kenan Aksu, Ahmet Mesut Onat, Ahmet Gül, Lale Ocal, Murat Inanc, Sevil Kamali
OBJECTIVES: We aimed to assess the outcome of a large Takayasu arteritis (TAK) cohort using the vasculitis damage index (VDI) and quality of life (QoL) scale, tools which have been validated for vasculitis. METHODS: Disease activity, damage and QoL were cross-sectionally evaluated in 165 TAK patients from 6 centres. SF-36 were applied to 51 age-matched healthy controls (HC). Persistent activity for ≥6 months was considered as treatment resistance (r-TAK). The correlation between VDI, clinical characteristics and mental (MCS)/physical (PCS) component scores of SF-36 were analysed...
November 10, 2016: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/27907964/critical-care-neurology-perspective-on-delirium
#9
Matthew B Maas, Andrew M Naidech
The evidence linking delirium to poor outcomes after critical illness is compelling, including higher mortality, prolonged mechanical ventilation, longer length of intensive care unit stay, and long-term cognitive impairments. The attitude toward delirium in the neurologic community is shifting away from viewing it as an unmodifiable, inevitable consequence of severe illness to treating it is as a neurologic emergency, akin to seizures or encephalitis. Delirium, like other manifestations of critical illness encephalopathy, is an organ dysfunction syndrome...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907958/critical-care-management-after-cardiac-arrest
#10
Hans Friberg, Tobias Cronberg
Sudden cardiac arrest is a devastating event with high mortality and substantial morbidity among survivors. Early recognition and intervention to restore circulation is the primary goal; once that is achieved, the path toward a meaningful recovery starts. Initial in-hospital care is focused on emergency cardiac care, but soon there is a change to a more brain-oriented critical care including targeted temperature management, brain monitoring, sedation, and repeated neurologic assessments. In patients who show early signs of awakening from coma once sedation has been stopped, the prognosis is generally good...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907956/intensive-care-management-of-the-endovascular-stroke-patient
#11
Julian Bösel
Acute ischemic stroke caused by the occlusion of large brain vessels can be treated effectively by mechanical thrombectomy, as proved by recent strong and consistent evidence from high-quality randomized trials. This new era of endovascular stroke treatment, however, poses particular challenges that go far beyond the so far gold standard of intravenous thrombolysis alone. Because these stroke patients usually present with severe neurologic deficits, may be unstable from cardiac or pulmonary instability, have to endure an invasive intervention of sometimes long duration, may suffer complications and require close postinterventional follow-up, they often demand intensive care measures...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27906416/a-study-of-clozapine-induced-sedation
#12
Rosa B Sauras, Sonia Ramos, Louisa Mann, Emilio Fernandez-Egea
No abstract text is available yet for this article.
November 2016: Actas Españolas de Psiquiatría
https://www.readbyqxmd.com/read/27905940/drug-poisoning-deaths-in-the-united-states-1999-2012-a-statistical-adjustment-analysis
#13
Christopher J Ruhm
BACKGROUND: Drug poisoning mortality in the US has risen rapidly but the drugs involved are frequently unspecified on death certificates. METHODS: Reported and adjusted proportions of specific drug types involved in fatal drug poisonings were calculated using vital statistics mortality data from 1999 to 2012. The adjusted proportions were those predicted to occur if at least one specific type of drug had been identified on the death certificates of all poisoning fatalities...
January 15, 2016: Population Health Metrics
https://www.readbyqxmd.com/read/27904641/the-effect-of-daily-sedation-interruption-protocol-on-early-incidence-of-ventilator-associated-pneumonia-among-patients-hospitalized-in-critical-care-units-receiving-mechanical-ventilation
#14
Mehdi Shahabi, Hojatollah Yousefi, Ahmad Reza Yazdannik, Babak Alikiaii
BACKGROUND: Ventilator-associated pneumonia (VAP) is a common side effect in patients who receive intravenous sedation infusion. In routine care, after starting sedation infusion for patients who receive mechanical ventilation, interruption of sedation starts without protocol. This study aimed to evaluate the effect of daily sedation vacation protocol on the incidence of VAP in mechanically ventilated patients. MATERIALS AND METHODS: In this clinical trial study, 80 patients with intravenous sedation infusion were selected and randomly allocated to intervention and control groups...
September 2016: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/27904618/assessment-of-different-anesthesia-depth-under-total-intravenous-anesthesia-on-postoperative-cognitive-function-in-laparoscopic-patients
#15
Delin Zhang, Aiqing Nie
BACKGROUND: This study aimed to compare the effects of different depths of sedation during total intravenous anesthesia (TIVA) with remifentanil and propofol given by target-controlled infusion (TCI) on postoperative cognitive function in young and middle-aged patients undergoing gynecological laparoscopic surgery. MATERIALS AND METHODS: A total of 150 American Society of Anesthesiologists physical Status I/II patients scheduled for gynecological laparoscopic operation were randomly divided into three groups...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27904260/sonographic-identification-of-peripheral-nerves-in-the-forearm
#16
Saundra A Jackson, Charlotte Derr, Anthony De Lucia, Marvin Harris, Zuheily Closser, Branko Miladinovic, Rahul Mhaskar, Theresa Jorgensen, Lori Green
BACKGROUND: With the growing utilization of ultrasonography in emergency medicine combined with the concern over adequate pain management in the emergency department (ED), ultrasound guidance for peripheral nerve blockade in ED is an area of increasing interest. The medical literature has multiple reports supporting the use of ultrasound guidance in peripheral nerve blocks. However, to perform a peripheral nerve block, one must first be able to reliably identify the specific nerve before the procedure...
October 2016: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/27903341/-the-application-of-conscious-sedation-with-a-small-dose-of-dexmedetomidine-and-sufentanil-in-elderly-patients-undergoing-multiple-intestinal-polyps-resection
#17
C M Shi, Y D Zhou, M Xu, X D Wang, L M Meng, X J Liu, X Y Guo
Objective: To explore the effectiveness and feasibility of conscious sedation with a low dose of dexmedetomidine and sufentanil during multiple intestinal polyps resection in elderly patients. Methods: Sixty elderly patients who underwent multiple intestinal polyps resection in Peking University Third Hospital from Janurary to May 2016 were randomly divided into dexmedetomidine group (D group, n=30) and propofol group (P group, n=30). There were 28 males and 32 females with a mean age of (70.4±4.5) years old (range: 65-80 years old)...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27903013/isoflurane-associated-mydriasis-mimicking-blown-pupils-in-a-patient-treated-in-a-neurointensive-care-unit
#18
Eva Magdalena Korf, Volker Martin Tronnier, Jan Gliemroth, Jan Nils Küchler
We report a misinterpretation of bilateral mydriasis as blown pupils related to elevated intracranial pressure (ICP) under volatile sedation with isoflurane (Anesthetic Conserving Device [AnaConDa], Hudson RCI, Uppland Vasby, Sweden) in a 59-year-old patient with a severe traumatic brain injury with frontal contusion. The patient showed bilateral mydriasis and a missing light reflex 8 hours after changing sedation from intravenous treatment with midazolam and esketamine to volatile administration of isoflurane...
November 30, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/27902947/what-factors-affect-implementation-of-early-rehabilitation-into-intensive-care-unit-practice-a-qualitative-study-with-clinicians
#19
Selina M Parry, Louisa Remedios, Linda Denehy, Laura D Knight, Lisa Beach, Thomas C Rollinson, Sue Berney, Zudin A Puthucheary, Peter Morris, Catherine L Granger
PURPOSE: To identify the barriers and enablers that influence clinicians' implementation of early rehabilitation in critical care. MATERIALS AND METHODS: Qualitative study involving 26 multidisciplinary participants who were recruited using purposive sampling. Four focus groups were conducted using semistructured questions to explore attitudes, beliefs, and experiences. Data were transcribed verbatim and thematic analysis was performed. RESULTS: Six themes emerged, as follows: (1) the clinicians' expectations and knowledge (including rationale for rehabilitation, perceived benefits, and experience), (2) the evidence for and application of rehabilitation (including beliefs regarding when to intervene), (3) patient factors (including prognosis, sedation, delirium, cooperation, motivation, goals, and family), (4) safety considerations (including physiological stability and presence of devices or lines), (5) environmental influences (staffing, resources, equipment, time, and competing priorities), and (6) culture and teamwork...
November 12, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27902657/the-assessment-of-the-risk-of-unplanned-extubation-in-an-adult-intensive-care-unit
#20
Semine Aydoğan, Nurten Kaya
BACKGROUND: In order to plan and implement nursing intervention to reduce the incidence rate of unplanned extubation problem in the intensive care unit (ICU), it is necessary to determine the risk factors of unplanned extubation and the patients under risk. AIMS: This study was undertaken with the aim of evaluating the risk of unplanned extubation of endotracheal tube in adult ICU. DESIGN: This was a case-control study. METHODS: The population constituted patients hospitalized in the adult ICU during 1-year period in a university hospital...
January 2017: Dimensions of Critical Care Nursing: DCCN
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