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https://www.readbyqxmd.com/read/28860857/preventing-nausea-and-vomiting-in-women-undergoing-regional-anesthesia-for-cesarean-section-challenges-and-solutions
#1
REVIEW
Yvonne Jelting, Christian Klein, Thomas Harlander, Leopold Eberhart, Norbert Roewer, Peter Kranke
BACKGROUND: Intraoperative nausea and vomiting (IONV) or postoperative nausea and vomiting (PONV) affecting women undergoing regional anesthesia for cesarean section is an important clinical problem since these techniques are used widely. There are burdens of literature about IONV/PONV and several in parturient and cesarean. However, it needs more attention. The underlying mechanisms of IONV and PONV in the obstetrical setting mainly include hypotension due to sympathicolysis during neuraxial anesthesia, bradycardia owing to an increased vagal tone, the visceral stimulation via the surgical procedure and intravenously administered opioids...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28859790/ivabradine-in-children-with-dilated-cardiomyopathy-and-symptomatic-chronic-heart-failure
#2
RANDOMIZED CONTROLLED TRIAL
Damien Bonnet, Felix Berger, Eero Jokinen, Paul F Kantor, Piers E F Daubeney
BACKGROUND: Heart rate reduction as a therapeutic target has been investigated in adults with heart failure (HF). Ivabradine has shown promising efficacy, but has not been evaluated in children. Currently, treatment recommendations for chronic pediatric HF are based mainly on chronic HF guidelines for adults. OBJECTIVES: The authors explored the dose-response relationship of ivabradine in children with dilated cardiomyopathy and symptomatic chronic HF. The primary endpoint was ≥20% reduction in heart rate from baseline without inducing bradycardia or symptoms...
September 5, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28846146/paroxysmal-atrioventricular-block-electrophysiological-mechanism-of-phase-4-conduction-block-in-the-his-purkinje-system-a-comparison-with-phase-3-block
#3
Mohammad Shenasa, Mark E Josephson, Andrew L Wit
BACKGROUND: Paroxysmal atrioventricular (A-V) block is relatively rare, and due to its transient nature, it is often under recognized. It is often triggered by atrial, junctional or ventricular premature beats, and occurs in the presence of a diseased His-Purkinje system (HPS). Here we present a 45-year-old white male who was admitted for observation due to recurrent syncope and near-syncope, who had paroxysmal A-V block. The likely cellular electrophysiological mechanisms(s) of paroxysmal A-V block and its differential diagnosis and management are discussed...
August 28, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28741365/in-response-to-the-letter-by-cabadas-r-and-%C3%A3-lvarez-escudero-j-about-the-editorial-will-societies-of-anesthesiologists-partake-in-the-take-off-of-non-anesthesiologist-administration-of-propofol
#4
Jean-Marc Dumonceau
I thank R. Cabadas and J. Álvarez-Escudero (1). 1. Apologies accepted. 2. The statistical significance of the difference in proportions seems doubtful. 3. Although these small studies do not allow us to confirm the safety of endoscopist-directed propofol sedation, they deserve a short comment as they represent the best available level of evidence (RCTs) and are also informative. 4. Hypoxemia, hypotension and bradycardia are frequent and have no clinical consequences in most cases. 5. The authors started this chapter by stating "scientific opinions must be carefully based" (3); 6...
July 25, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28667190/3-lead-electrocardiogram-is-more-reliable-than-pulse-oximetry-to-detect-bradycardia-during-stabilisation-at-birth-of-very-preterm-infants
#5
Beatriz Iglesias, Marí­a José Rodríguez, Esther Aleo, Enrique Criado, Jose Martínez-Orgado, Luis Arruza
OBJECTIVES: Current neonatal resuscitation guidelines suggest the use of ECG in the delivery room (DR) to assess heart rate (HR). However, reliability of ECG compared with pulse oximetry (PO) in a situation of bradycardia has not been specifically investigated. The objective of the present study was to compare HR monitoring using ECG or PO in a situation of bradycardia (HR <100 beats per minute (bpm)) during preterm stabilisation in the DR. STUDY DESIGN: Video recordings of resuscitations of infants <32 weeks of gestation were reviewed...
June 30, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28590987/-chaotic-arrhythmia-during-successful-resuscitation-after-ingestion-of-yew-taxus-baccata-needles
#6
Andreas Zutter, Kathrin Hauri, Katrina S Evers, Sabine Uhde, Jens Fassl, Oliver Tobias Reuthebuch, Andreas Berset, Michael Kühne, Birgit C Donner
OBJECTIVE: The study aims to describe the management of a case of life-threatening yew (Taxus baccata) intoxication. BACKGROUND: The needles of the yew tree contain highly cardiotoxic taxines. Intoxication with taxines, typically as part of suicide attempts, may lead to potentially lethal arrhythmias which often require prolonged cardiopulmonary resuscitation and other supportive measures. No specific therapy has been described. In some cases, extracorporeal life support has been used...
June 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28550929/arrhythmia-and-clinical-cardiac-findings-in-children-with-anderson-fabry-disease
#7
Hunter C Wilson, Robert J Hopkin, Peace C Madueme, Richard J Czosek, Laurie A Bailey, Michael D Taylor, John L Jefferies
Anderson-Fabry Disease (AFD) is a lysosomal storage disorder that results in progressive cardiovascular hypertrophy, scarring, and arrhythmia burden; yet, the early cardiac phenotype of AFD is still poorly defined. To further characterize early cardiac features in AFD, we evaluated electrocardiographic and clinical findings contained in a local cohort of pediatric AFD patients and arrhythmia data in children enrolled in the Fabry Registry. Twenty-six local patients aged <18 years were identified (average age 9...
July 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28525411/beta-blockers-and-traumatic-brain-injury-a-systematic-review-meta-analysis-and-eastern-association-for-the-surgery-of-trauma-guideline
#8
Aziz S Alali, Kaushik Mukherjee, Victoria A McCredie, Eyal Golan, Prakesh S Shah, James M Bardes, Susan E Hamblin, Elliott R Haut, James C Jackson, Kosar Khwaja, Nimitt J Patel, Satish R Raj, Laura D Wilson, Avery B Nathens, Mayur B Patel
OBJECTIVE: To determine if beta-(β)-blockers improve outcomes after acute traumatic brain injury (TBI). BACKGROUND: There have been no new inpatient pharmacologic therapies to improve TBI outcomes in a half-century. Treatment of TBI patients with β-blockers offers a potentially beneficial approach. METHODS: Using MEDLINE, EMBASE, and CENTRAL databases, eligible articles for our systematic review and meta-analysis (PROSPERO CRD42016048547) included adult (age ≥ 16 years) blunt trauma patients admitted with TBI...
May 18, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28452098/impact-of-bradycardia-or-asystole-on-neonatal-cardiopulmonary-resuscitation-at-birth
#9
Vasantha Hs Kumar, Annie Skrobacz, Changxing Ma
BACKGROUND: Fetal hypoxia from intrapartum events can lead to absent heart rate (HR) or bradycardia at birth requiring aggressive neonatal resuscitation. Neonatal resuscitation guidelines do not differentiate bradycardia (HR <100 beats/min) from absent HR at birth. Given that HR is the primary determinant of resuscitation, we hypothesize that infants with no HR at 1 min would require more extensive resuscitation with worse clinical outcome than infants with bradycardia at 1 min. METHODS: A retrospective analysis was performed in infants born between 1 January 2000 and 31 December 2015 with no HR at 1 min (defined as Apgar score [AS] = 0 at 1 min; absent HR [AHR] group) or bradycardia at 1 min (AS = 1 at 1 min)...
April 28, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28377295/frequency-of-medical-emergency-team-activation-prior-to-pediatric-cardiopulmonary-resuscitation
#10
Natalie Jayaram, Maya L Chan, Fengming Tang, Christopher S Parshuram, Paul S Chan
BACKGROUND: Medical Emergency Teams (METs) are designed to respond to signs of clinical decline in order to prevent cardiopulmonary arrest and reduce mortality. The frequency of MET activation prior to pediatric cardiopulmonary resuscitation (CPR) is unknown. METHODS: Within the Get With The Guidelines-Resuscitation Registry (GWTG-R), we identified children with bradycardia or cardiac arrest requiring CPR on the general inpatient or telemetry floors from 2007 to 2013...
June 2017: Resuscitation
https://www.readbyqxmd.com/read/28345212/cardiac-iodine-123-metaiodobenzylguanidine-scintigraphy-may-be-useful-to-identify-pathologic-from-physiologic-sinus-bradycardia
#11
Akihiro Sunaga, Masaharu Masuda, Masashi Fujita, Osamu Iida, Takashi Kanda, Yasuhiro Matsuda, Takakazu Morozumi, Toshiaki Mano, Masaaki Uematsu
BACKGROUND: Sinus bradycardia includes pathologic sick sinus syndrome (SSS) and physiologic bradycardia such as athletes' heart. Pacemaker implantation is indicated for patients with symptomatic SSS; however, the indication remains difficult to determine in those with mild and/or unspecific symptoms. The sympathetic tone is increased in response to reduced cardiac output in SSS, whereas excessive vagal tone has been seen in physiological bradycardia. We sought to determine if cardiac iodine-123-metaiodobenzylguanidine scintigraphy ((123) I-MIBG) was useful in differentiating pathologic from physiologic sinus bradycardia...
March 27, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28315642/comparison-of-atipamezole-with-yohimbine-for-antagonism-of-xylazine-in-mice-anesthetized-with-ketamine-and-xylazine
#12
Christopher F Janssen, Pauline Maiello, M Jerry Wright, Kara B Kracinovsky, Joseph T Newsome
The α2 adrenergic agonist xylazine produces a sedative effect and is typically combined with ketamine and used for anesthesia or chemical restraint of laboratory mice. Xylazine's sedative effect-and its undesirable side effects of bradycardia, hypotension, and poor tissue perfusion-can be reversed by administration of α2 antagonists, such as atipamezole or yohimbine. Although atipamezole and yohimbine dosing guidelines are available for mice, no controlled comparison has been performed to guide the lab animal community in the selection of one over the other...
March 1, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28287212/-the-pacemaker-and-implantable-cardioverter-defibrillator-registry-of-the-italian-association-of-arrhythmology-and-cardiac-pacing-annual-report-2015
#13
MULTICENTER STUDY
Alessandro Proclemer, Massimo Zecchin, Antonio D'Onofrio, Giuseppe Boriani, Giovanni Luca Botto, Domenico Facchin, Luca Rebellato, Marco Ghidina, Giulia Bianco, Emanuela Bernardelli, Elsa Pucher, Dario Gregori
BACKGROUND: The pacemaker (PM) and implantable cardioverter-defibrillator (ICD) Registry of the Italian Association of Arrhythmology and Cardiac Pacing (AIAC) monitors the main epidemiological data in real-world practice. The survey for the 2015 activity collects information about demographics, clinical characteristics, main indications for PM/ICD therapy and device types from the Italian collaborating centers. METHODS: The Registry collects prospectively national PM and ICD implantation activity on the basis of European cards...
January 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28225377/inappropriate-shocks-and-power-delivery-using-adult-automatic-external-defibrillator-pads-in-a-pediatric-patient
#14
Shai Tejman-Yarden, Uriel Katz, Marina Rubinstein, Yehuda Attias, Reem Yahia, David Mishali, Michael Glikson
The use of automatic external defibrillators (AEDs) during pulseless resuscitations is considered safe and reliable, and was established as part of the guidelines in out-of-hospital events. Based on extensive studies, the use of the standard AED is now indicated in every age group with a preference of pediatric pad application for small children and babies. If unavailable, adult pads are recommended. We report a case of 2 inappropriate AED shocks that were delivered to a neonate during a pulseless resuscitation after application of adult pads...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28188706/comparison-of-atipamezole-with-yohimbine-for-antagonism-of-xylazine-in-mice-anesthetized-with-ketamine-and-xylazine
#15
Christopher Janssen, Pauline Maiello, M Jerry Wright, Kara Kracinovsky, Joseph Newsome
The α2 adrenergic agonist xylazine produces a sedative effect and is typically combined with ketamine and used for anesthesia or chemical restraint of laboratory mice. Xylazine's sedative effect-and its undesirable side effects of bradycardia, hypotension, and poor tissue perfusion-can be reversed by administration of α2 antagonists, such as atipamezole or yohimbine. Although atipamezole and yohimbine dosing guidelines are available for mice, no controlled comparison has been performed to guide the lab animal community in the selection of one over the other...
February 10, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28178172/effects-of-combined-oral-sucrose-and-nonnutritive-sucking-nns-on-procedural-pain-of-nicu-newborns-2001-to-2016-a-prisma-compliant-systematic-review-and-meta-analysis
#16
REVIEW
Yi Liu, Xinchun Huang, Biru Luo, Wentao Peng
BACKGROUND: Both oral sucrose (OS) and nonnutritive sucking (NNS) are effective nonpharmacological methods to alleviate procedures pain in neonatal intensive care unit (NICU) newborns when they were used alone, but the combined effect of OS+NNS remains controversial. So, we conducted this study to evaluate the efficiency of NNS combined with oral sucrose on pain relief in NICU newborns undergoing painful procedures. METHODS: We searched PubMed, Ovid (Medline), Embase (Medline), Cochrane Central Library, and other resources such as Google Scholar, bibliographies of included literatures for all available articles...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28122680/the-society-of-thoracic-surgeons-expert-consensus-for-the-resuscitation-of-patients-who-arrest-after-cardiac-surgery
#17
(no author information available yet)
The Society of Thoracic Surgeons Task Force on Resuscitation After Cardiac Surgery provides this professional society perspective on resuscitation in patients who arrest after cardiac surgery. This document was created using a multimodal methodology for evidence generation and includes information from existing guidelines, from the International Liaison Committee on Resuscitation, from our own structured literature reviews on issues particular to cardiac surgery, and from an international survey on resuscitation hosted by CTSNet...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27903390/-current-status-of-antiarrhythmic-drug-use-and-safety-assessment-in-chinese-patients-with-atrial-fibrillation
#18
R He, X Du, S W Liu, L J Sun, Y Li, H Zeng, Y Y Li, C Sun, Y Zhang, C S Ma, W Gao
Objective: To investigate the current status of antiarrhythmic drugs (AADs) use in Chinese patients with atrial fibrillation(AF) and assess the safety of AADs in this patient cohort. Methods: From January 2011 to December 2013, a total of 4 008 AF patients treated with AADs was enrolled in this study and patients were followed up for 24 months. Detailed information of prescribed drug, the causes of drug discontinuation and side effects were recorded. Results: Amiodarone was prescribed to 64.3%(2 579 cases) and propafenone to 31...
November 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/27903028/-cardiovascular-morbidity-and-mortality-in-patients-with-kidney-disease
#19
REVIEW
Ivo Quack, Ralf Westenfeld
Patients with kidney disease have a significantly increased cardiovascular morbidity and mortality. Especially diabetics have an increased risk to develop renal insufficiency and cardiovascular events. Two recent studies show that the SGLT2 inhibitor Empagliflozin and the GLP1 agonist Liraglutid are able to lower the cardiovascular risk of type2 diabetics with renal insufficiency. Recent observations suggest that bradycardia and asystole are main triggers for sudden cardiac death in patients with chronic kidney disease...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27799257/defibrillators-selecting-the-right-device-for-the-right-patient
#20
REVIEW
Sana M Al-Khatib, Paul Friedman, Kenneth A Ellenbogen
Advances in the field of defibrillation have brought to practice different types of devices that include the transvenous implantable cardioverter-defibrillator (ICD) with or without cardiac resynchronization therapy, the subcutaneous ICD (S-ICD), and the wearable cardioverter-defibrillator. To ensure optimal use of these devices and to achieve best patient outcomes, clinicians need to understand how these devices work, learn the characteristics of patients who qualify them for one type of device versus another, and recognize the remaining gaps in knowledge surrounding these devices...
November 1, 2016: Circulation
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