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https://www.readbyqxmd.com/read/28110410/neurophysiological-assessment-of-brain-dysfunction-in-critically-ill-patients-an-update
#1
REVIEW
Eric Azabou, Catherine Fischer, Jean Michel Guerit, Djillali Annane, François Mauguiere, Fréderic Lofaso, Tarek Sharshar
The aim of this review was to provide up-to-date information about the usefulness of clinical neurophysiology testing in the management of critically ill patients. Evoked potentials (EPs) and electroencephalogram (EEG) are non-invasive clinical neurophysiology tools that allow an objective assessment of the central nervous system's function at the bedside in intensive care unit (ICU). These tests are quite useful in diagnosing cerebral complications, and establishing the vital and functional prognosis in ICU...
January 21, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28109383/portico-sheathless-transcatheter-aortic-valve-implantation-via-distal-axillary-artery
#2
Giuseppe Bruschi, Paola Colombo, Luca Botta, Stefano Nava, Bruno Merlanti, Oriana Belli, Francesco Musca, Francesco Soriano, Claudio F Russo, Fabrizio Oliva
Transcatheter aortic valve implantation has been designed to treat older patients affected by severe aortic stenosis who are considered high-risk surgical candidates because of multiple comorbidities. The least invasive approach for transcatheter aortic valves implantation should be considered the transfemoral retrograde route, because it is minimally invasive and is feasible with local anesthesia and mild sedation. Despite significant technical improvements in recent years, the transfemoral approach is contraindicated in cases of severe peripheral artery disease...
February 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28109272/opinions-about-the-new-law-on-end-of-life-issues-in-a-sample-of-french-patients-receiving-palliative-care
#3
Augustin Boulanger, Théo Chabal, Marie Fichaux, Mireille Destandau, Jean Marc La Piana, Pascal Auquier, Karine Baumstarck, Sébastien Salas
BACKGROUND: In February 2nd 2016, the French government enacted the Claeys-Leonetti law that forbade euthanasia and established the right to deep and continuous sedation for end-of-life patients. Moreover, the law also obliges clinicians to abide by any advance directives regarding treatment and investigation, except in cases where they are "obviously inappropriate" in a given medical situation, or in cases of emergency, in order to allow medical staff to take time to assess the patient's situation...
January 21, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28109052/the-use-of-methadone-to-facilitate-opioid-weaning-in-pediatric-critical-care-patients-a-systematic-review-of-the-literature-and-meta-analysis
#4
REVIEW
Leslie A Dervan, Beryl Yaghmai, Robert Scott Watson, Fredric M Wolf
BACKGROUND: Continuous opioid infusion therapy is commonly utilized in the pediatric intensive care setting to treat pain and facilitate tolerance of invasive therapies. Transitioning to methadone is one common strategy for weaning from continuous opioid infusions, but in practice this transition can be challenging, and many children still experience iatrogenic withdrawal. AIM: We reviewed the literature to evaluate the best available evidence to guide methadone therapy in this setting, and to summarize associated adverse events...
January 20, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28108773/effects-of-caffeine-on-alcohol-reinforcement-beverage-choice-self-administration-and-subjective-ratings
#5
Mary M Sweeney, Steven E Meredith, Daniel P Evatt, Roland R Griffiths
RATIONALE: Combining alcohol and caffeine is associated with increased alcohol consumption, but no prospective experimental studies have examined whether added caffeine increases alcohol consumption. OBJECTIVES: This study examined how caffeine alters alcohol self-administration and subjective reinforcing effects in healthy adults. METHODS: Thirty-one participants completed six double-blind alcohol self-administration sessions: three sessions with alcohol only (e...
January 20, 2017: Psychopharmacology
https://www.readbyqxmd.com/read/28107654/examining-the-link-between-nonmedical-use-of-sedatives-tranquilizers-and-pain-relievers-with-dispositions-toward-impulsivity-among-college-students
#6
Brittany E Blanchard, Angela K Stevens, Andrew K Littlefield, Amelia E Talley, Jennifer L Brown
BACKGROUND: The association between impulsive dispositions and the use of the central nervous system (CNS) depressant alcohol has been examined extensively; however, the links between other depressant use (sedatives, tranquilizers, and pain relievers) and impulsivity have been less studied, and findings have been equivocal. This may be due, in part, to varying operationalizations of "impulsivity," as well as issues related to the lumping versus splitting of various depressant substances when assessing use...
January 6, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28107373/dexmedetomidine-versus-midazolam-in-procedural-sedation-a-systematic-review-of-efficacy-and-safety
#7
Clemens R M Barends, Anthony Absalom, Baucke van Minnen, Arjan Vissink, Anita Visser
OBJECTIVES: To systematically review the literature comparing the efficacy and safety of dexmedetomidine and midazolam when used for procedural sedation. MATERIALS AND METHODS: We searched MEDLINE, EMBASE and COCHRANE for clinical trials comparing dexmedetomidine and midazolam for procedural sedation up to June 20, 2016. Inclusion criteria: clinical trial, human subjects, adult subjects (≥18 years), article written in English, German, French or Dutch, use of study medication for conscious sedation and at least one group receiving dexmedetomidine and one group receiving midazolam...
2017: PloS One
https://www.readbyqxmd.com/read/28107122/evaluating-the-impact-of-pharmacists-on-reducing-use-of-sedative-hypnotics-for-treatment-of-insomnia-in-long-term-care-facility-residents
#8
Maria Grazia Gemelli, Katherine Yockel, Kenneth C Hohmeier
OBJECTIVE: To determine if pharmacist intervention can decrease the use of inappropriate sedative/hypnotics in the elderly population in the long-term care facility setting. DESIGN: A multicenter, prospective chart review of sedative/hypnotic use for insomnia among long-term care facility residents. SETTING: Eleven regional long-term care facilities in Northeastern Tennessee. PARTICIPANTS: Long-term care facility residents older than 65 years of age, with confirmed insomnia diagnoses and no history of seizure or recent psychotropic gradual-dose reduction attempts...
November 1, 2016: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28106925/clinical-study-evaluating-the-accuracy-of-injecting-the-distal-tarsal-joints-in-the-horse
#9
K A Seabaugh, K T Selberg, P O E Mueller, R B Eggleston, J F Peroni, K M Claunch, H J Markwell, G M Baxter
BACKGROUND: Osteoarthritis (OA) of the centrodistal (CD) and tarsometatarsal (TMT) joints is a common cause of lameness in horses. Intra-articular diagnostic anaesthesia and/or therapeutic injection are relied upon to help diagnose and treat many horses with OA of these joints. OBJECTIVES: The objective of this study was to determine the accuracy of arthrocentesis of the CD and TMT joints using a sample population of equine surgeons and surgery residents. STUDY DESIGN: Randomised experimental study...
January 20, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28106690/saccular-aneurysm-of-internal-jugular-vein-in-a-young-patient
#10
Korhan Kilic, Ugur Kaya, Muhammed Sedat Sakat, Recai Mazlumoglu, Harun Ucuncu
No abstract text is available yet for this article.
January 18, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28106673/outcomes-of-pediatric-fractures-managed-with-closed-reduction-by-orthopaedic-residents-in-the-emergency-department
#11
Vivek Natarajan, Ermias Abebe, James Dunlap, Patrick Bosch, Ozgur Dede, W Timothy Ward, James Roach
BACKGROUND: Closed reduction of pediatric fractures is commonly performed by orthopaedic residents using conscious sedation in the emergency department (ED). The purpose of this study was to determine the rate of satisfactory reductions as performed by residents, and to determine the outcomes of these procedures. METHODS: A retrospective review was performed of all fractures that underwent closed reduction under conscious sedation in the ED of a level 1 pediatric trauma center between January 1, 2010 and November 30, 2014...
January 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28105858/hplc-ms-ms-method-for-dexmedetomidine-quantification-with-design-of-experiments-approach-application-to-pediatric-pharmacokinetic-study
#12
Oliwia Szerkus, Wiktoria Struck-Lewicka, Marta Kordalewska, Ewa Bartosińska, Renata Bujak, Agnieszka Borsuk, Agnieszk Bienert, Alicja Bartkowska-Śniatkowska, Justyna Warzybok, Paweł Wiczling, Antoni Nasal, Roman Kaliszan, Mchał Jan Markuszewski, Danuta Siluk
AIM: The purpose of this work was to develop and validate a rapid and robust LC-MS/MS method for the determination of dexmedetomidine (DEX) in plasma, suitable for analysis of a large number of samples. METHOD: Systematic approach, Design of Experiments, was applied to optimize ESI source parameters and to evaluate method robustness, therefore, a rapid, stable and cost-effective assay was developed. The method was validated according to US FDA guidelines. LLOQ was determined at 5 pg/ml...
January 20, 2017: Bioanalysis
https://www.readbyqxmd.com/read/28105667/palatoglossus-coupling-in-selective-upper-airway-stimulation
#13
Clemens Heiser, Günther Edenharter, Murat Bas, Markus Wirth, Benedikt Hofauer
OBJECTIVES/HYPOTHESIS: Selective upper airway stimulation (sUAS) of the hypoglossal nerve is a useful therapy to treat patients with obstructive sleep apnea. Is it known that multiple obstructions can be solved by this stimulation technique, even at the retropalatal region. The aim of this study was to verify the palatoglossus coupling at the soft palate during stimulation. STUDY DESIGN: Single-center, prospective clinical trail. METHODS: Twenty patients who received an sUAS implant from April 2015 to April 2016 were included...
January 20, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28105598/clinical-pharmacokinetics-and-pharmacodynamics-of-dexmedetomidine
#14
REVIEW
Maud A S Weerink, Michel M R F Struys, Laura N Hannivoort, Clemens R M Barends, Anthony R Absalom, Pieter Colin
Dexmedetomidine is an α2-adrenoceptor agonist with sedative, anxiolytic, sympatholytic, and analgesic-sparing effects, and minimal depression of respiratory function. It is potent and highly selective for α2-receptors with an α2:α1 ratio of 1620:1. Hemodynamic effects, which include transient hypertension, bradycardia, and hypotension, result from the drug's peripheral vasoconstrictive and sympatholytic properties. Dexmedetomidine exerts its hypnotic action through activation of central pre- and postsynaptic α2-receptors in the locus coeruleus, thereby inducting a state of unconsciousness similar to natural sleep, with the unique aspect that patients remain easily rousable and cooperative...
January 19, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28105111/effect-of-rocuronium-on-the-bispectral-index-under-anesthesia-and-tracheal-intubation
#15
Hui Yue, Jinyu Han, Ling Liu, Kaiyuan Wang, Jincheng Li
The aim of the present study was to investigate the effect of various doses of rocuronium on bispectral index (BIS) responses to propofol induction and tracheal intubation, as well as the role of the non-depolarization muscle relaxant rocuronium on the depth of sedation. A total of 72 patients (American Society of Anesthesiologists physical status I-II) were anaesthetized with propofol using a target-controlled infusion, and randomly divided into two sedation level groups (n=36). The patients were divided into 2 groups according to the BIS value: A normal sedation group (group 1), with a stable BIS value at 40-60, and a deep sedation group (group 2), with a BIS value <20 or with burst suppression...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28104716/source-3-registry-design-and-30-day-results-of-the-european-post-approval-registry-of-the-latest-generation-of-the-sapien-3tm-transcatheter-heart-valve
#16
Olaf Wendler, Gerhard Schymik, Hendrik Treede, Helmut Baumgartner, Nicolas Dumonteil, Leo Ihlberg, Franz-Josef Neumann, Giuseppe Tarantini, José L Zamorano, Alec Vahanian
BACKGROUND: -The SOURCE 3 Registry is a European multicentre, observational registry of the latest generation of transcatheter heart valve, the SAPIEN 3(TM) (Edwards Lifesciences, Irvine, CA/USA). Its purpose is to document outcomes of clinical safety and performance after European approval was given. METHODS: -In this manuscript we present the 30-day outcome of the SOURCE 3 Registry. All data is self-reported and all participating centres have committed to support their consecutive experience with the SAPIEN 3(TM) transcatheter heart valve, dependent on patients consent, before the start of the study...
January 19, 2017: Circulation
https://www.readbyqxmd.com/read/28104560/metabolite-characterization-of-a-novel-sedative-drug-remimazolam-in-human-plasma-and-urine-using-ultra-high-performance-liquid-chromatography-coupled-with-synapt-high-definition-mass-spectrometry
#17
Ying Zhou, Pei Hu, Ji Jiang
Remimazolam is a new chemical entity belonging to the benzodiazepine class of sedative drugs, which shows faster-acting onset and recovery than currently available short-acting sedatives. In the present study, ultra high performance liquid chromatography with synapt high-definition mass spectrometry method combined with MassLynx software was established to characterize metabolites of remimazolam in human plasma and urine. In total, 5 human metabolites were detected, including 3 phase I and 2 phase II metabolites...
January 12, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28103816/use-of-a-self-rating-scale-to-monitor-depression-severity-in-recurrent-gp-consultations-in-primary-care-does-it-really-make-a-difference-a-randomised-controlled-study
#18
C Wikberg, J Westman, E-L Petersson, M E H Larsson, M André, R Eggertsen, J Thorn, H Ågren, C Björkelund
BACKGROUND: Little information is available about whether the use of self-assessment instruments in primary care affects depression course and outcome. The purpose was to evaluate whether using a depression self-rating scale in recurrent person-centred GP consultations affected depression severity, quality of life, medication use, and sick leave frequency. METHODS: Patients in the intervention group met their GP regularly at least 4 times during the 3 months intervention...
January 19, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28103503/sedative-hypnotic-like-effect-and-molecular-docking-of-di-naphthodiospyrol-from-diospyros-lotus-in-an-animal-model
#19
Abdur Rauf, Taibi Ben Hadda, Ghias Uddin, José P Cerón-Carrasco, Jorge Peña-García, Horacio Pérez-Sánchez, Haroon Khan, Saud Bawazeer, Seema Patel, Mohammad S Mubarak, Tareq Abu-Izneid, Yahia Nasser Mabkhot
BACKGROUND: Diospyros lotus Linn commonly known as date-plum, or Caucasian persimmon has multiple uses in folk medicine. Various parts of this plant is used for alleviating lumbago, dysponea, hemorrhage, insomnia, and hiccup. The plant extracts possess a variety of biological activities, such as anti-inflammatory, sedative, febrifuge, anti-microbial, vermifuge, and anti-hypertensive. AIM/HYPOTHESIS: The aim of the present work is to investigate the sedative-hypnotic effect of a rare dimeric napthoquione 1 obtained from the chloroform soluble fraction of D...
January 16, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28102628/transient-symptomatic-worsening-by-atropine-in-opsoclonus-myoclonus-syndrome
#20
Hirotsugu Miyoshi, Ryuji Nakamura, Ayano Yamaga, Toshiaki Haraki, Toshimichi Yasuda, Hiroshi Hamada, Masashi Kawamoto
Opsoclonus-myoclonus syndrome (OMS) is characterized by abnormal eye and systemic involuntary movements, as well as cerebellar ataxia. Some sedatives and anesthetics worsen movements associated with OMS, while there is no known report of a negative effect of atropine. We report on sedation in two patients with OMS. Involuntary movements were transiently worsened after using atropine with midazolam or thiamylal in both, but were not seen when atropine was not used. We speculated that atropine has the potential to exacerbate involuntary movements in OMS due to vulnerability to this agent via unknown mechanisms...
January 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
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