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https://www.readbyqxmd.com/read/29147790/-etomidate-for-intravenous-induction-of-anaesthesia
#1
C Dumps, D Bolkenius, E Halbeck
The pharmacological and historical knowledge about the currently available intravenous induction hypnotics form the basis for the daily work of anesthetists. Side effects of using hypnotic induction agents must be anticipated and adequately treated. Decades of experience with using intravenous induction hypnotics have led to theoretical requirements for an ideal narcotic agent with a best possible side effect profile. In the absence of this optimal hypnotic induction agent, a careful selection of one or a combination of narcotic drugs is necessary to meet the needs of the respective risk constellation of the patient...
November 16, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29145989/pain-management-strategies-in-shoulder-arthroplasty
#2
REVIEW
Jason L Codding, Charles L Getz
Pain control in total shoulder arthroplasty demands a multidisciplinary approach with collaboration between patients, surgeon, and anesthetist. A multimodal approach with preemptive medication, regional blockade, local anesthetics, and a combination of acetaminophen, nonsteroidal antiinflammatory drugs, tramadol, and gabapentinoids postoperatively leads to pain control and patient satisfaction. Assessment of patients' expectations constitutes a vital aspect of the preoperative patient evaluation. Educating and psychologically preparing patients reduces postoperative pain...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145327/current-practice-and-usual-care-of-major-cervical-disorders-in-korea-a-cross-sectional-study-of-korean-health-insurance-review-and-assessment-service-national-patient-sample-data
#3
A Ryeon Choi, Joon-Shik Shin, Jinho Lee, Yoon Jae Lee, Me-Riong Kim, Min-Seok Oh, Eun-Jung Lee, Sungchul Kim, Mia Kim, In-Hyuk Ha
Neck pain is a highly common condition and is the 4th major cause of years lived with disability. Previous literature has focused on the effect of specific treatments, and observations of actual practice are lacking to date. This study examined Korean health insurance review and assessment service (HIRA) claims data to the aim of assessing prevalence and comparing current medical practice and costs of cervical disorders in Korea.Current practice trends were determined through assessment of prevalence, total expenses, per-patient expense, average days in care, average days of visits, sociodemographic characteristics, distribution of medical costs, and frequency of treatment types of high frequency cervical disorders (cervical sprain/strain, cervical intervertebral disc displacement [IDD], and cervicalgia)...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29139482/opioid-misuse-in-gastroenterology-and-non-opioid-management-of-abdominal-pain
#4
REVIEW
Eva Szigethy, Mitchell Knisely, Douglas Drossman
Opioids were one of the earliest classes of medications used for pain across a variety of conditions, but morbidity and mortality have been increasingly associated with their chronic use. Despite these negative consequences, chronic opioid use is increasing worldwide, with the USA and Canada having the highest rates. Chronic opioid use for noncancer pain can have particularly negative effects in the gastrointestinal and central nervous systems, including opioid-induced constipation, narcotic bowel syndrome, worsening psychopathology and addiction...
November 15, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29131328/headache-education-active-waiting-directive-a-program-to-enhance-well-being-during-long-referral-wait-times
#5
Ana Marissa Lagman-Bartolome, Valerie Lawler, Christine Lay
OBJECTIVE: The aim of this initiative was to evaluate the clinical impact, patient acceptability, and sustainability of implementing a newly developed evidence-guided migraine education program in an academic headache center. BACKGROUND: Headache is the fifth most common reason for emergency department (ED) visits and accounts for more than 10 million physician visits annually. Successful management of headaches presents a challenge to both primary care providers and neurologists...
November 12, 2017: Headache
https://www.readbyqxmd.com/read/29130600/opioid-dependence-and-pregnancy-in-early-twentieth-century-america
#6
Nathan Tauger
BACKGROUND AND AIMS: Research on Neonatal Abstinence Syndrome has prompted discussion over how to ensure best outcomes for pregnant women who use drugs and for drug-dependent newborns. Before Neonatal Abstinence Syndrome and the 1980s panic of "crack babies," turn-of-the-century American medical journals discussed infants born to drug-using mothers. This paper aimed to determine whether women who used drugs while pregnant in early twentieth-century America were subject to the stigma many face today...
November 11, 2017: Addiction
https://www.readbyqxmd.com/read/29127803/development-of-thresholds-of-excess-toxicity-for-environmental-species-and-their-application-to-identification-of-modes-of-acute-toxic-action
#7
Jin J Li, Xu J Zhang, Yi Yang, Tao Huang, Chao Li, Limin Su, Yuan H Zhao, Mark T D Cronin
The acute toxicity of organic pollutants to fish, Daphnia magna, Tetrahymena pyriformis, and Vibrio fischeri was investigated. The results indicated that the Toxicity Ratio (TR) threshold of log TR =1, which has been based on the distribution of toxicity data to fish, can also be used to discriminate reactive or specifically acting compounds from baseline narcotics for Daphnia magna and Vibrio fischeri. A log TR=0.84 is proposed for Tetrahymena pyriformis following investigation of the relationships between the species sensitivity and the absolute averaged residuals (AAR) between the predicted baseline toxicity and the experimental toxicity...
November 8, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/29124404/pediatric-patients-receiving-naloxone-within-48%C3%A2-h-of-anesthesia-a-case-control-study
#8
Vinay K Donempudi, Juraj Sprung, Toby N Weingarten
PURPOSE: Excessive narcotization in pediatric surgical patients has not been well characterized. This report describes the use of postoperative naloxone in pediatric patients. METHODS: Pediatric surgical patients from January 1, 2010, through June 30, 2016, who underwent general anesthesia and received naloxone within 48 h postoperatively were identified and matched 1:1 with controls by age, sex, and procedure. Cases and controls underwent retrospective chart review...
November 9, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/29122625/comparison-of-intraoperative-and-early-postoperative-outcomes-of-caudal-versus-dorsal-penile-nerve-blocks-for-outpatient-penile-surgeries
#9
Katherine H Chan, Aali Shah, Elizabeth A Moser, Konrad Szymanski, Benjamin M Whittam, Rosalia Misseri, Martin Kaefer, Richard Rink, Mark P Cain
OBJECTIVE: To compare intraoperative and 1-hour postoperative outcomes in caudal versus dorsal penile nerve block (DPNB) patients undergoing penile surgeries. MATERIAL AND METHODS: We performed a retrospective cohort study of males <10 years old undergoing penile procedures (2013-2015) using the Pediatric Regional Anesthesia Network, Pediatric Health Information System databases and our medical records. The primary outcome was a maximum Faces Limbs Activity Crying Consolability pain score > 3...
November 6, 2017: Urology
https://www.readbyqxmd.com/read/29121531/decreased-pain-tolerance-before-surgery-and-increased-postoperative-narcotic-requirements-in-abstinent-tobacco-smokers
#10
Ling Shen, Kai Wei, Qianbo Chen, Haibo Qiu, Yong Tao, Qiang Yao, Jinchao Song, Chengjian Li, Liang Zhao, Yantao Liu, Zhijie Lu
INTRODUCTION: The clinical influence of smoking cessation on pain tolerance before surgery and postoperative pain perception is not fully understood. This clinical study investigated the effect of smoking cessation on pain threshold during the perioperative period in patients undergoing hepatic resection. METHODS: We enrolled 148 male patients (68 non-smokers and 80 abstinent smokers) who underwent hepatic resection and received postoperative patient-controlled intravenous analgesia...
October 28, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/29121158/opioid-use-by-patients-after-rhinoplasty
#11
Sagar Patel, Angela Sturm, Michael Bobian, Peter F Svider, Giancarlo Zuliani, Russell Kridel
Importance: Given the increase in opioid addiction and overdose in the United States, reasoned opioid use after outpatient surgery may affect prescription medication abuse. Objectives: To examine patient use of opioids after rhinoplasty and establish an optimal postrhinoplasty pain management regimen. Design, Setting, and Participants: In this case series, opioid use was evaluated in 62 patients who underwent rhinoplasty performed by 3 fellowship-trained facial plastic surgeons, 2 in private practice in Texas and 1 in an academic setting in Michigan, from February 2016 to September 2016...
November 9, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/29120518/small-bowel-obstruction-after-transoral-robotic-surgery
#12
Joseph McClellan, Virginie Achim, Daniel Clayburgh
BACKGROUND: Head and neck surgery is not often considered a risk factor for intestinal ileus and small bowel obstruction. However, many of these patients may have had prior abdominal surgery, a known risk factor for small bowel obstruction, and may be at risk for bowel obstruction after a surgical procedure of the head and neck. METHODS: We present a case describing a patient who, after undergoing transoral robotic surgery, experienced delayed postoperative ileus and eventual small bowel obstruction requiring exploratory laparotomy and bowel resection...
November 9, 2017: Head & Neck
https://www.readbyqxmd.com/read/29119401/role-of-endogenous-agonists-of-opioid-receptors-in-the-regulation-of-heart-resistance-to-postischemic-reperfusion-injury
#13
A S Gorbunov, O E Vaizova, M V Belousov, S V Pozdnyakova, E A Nesterov, P G Madonov
Intravenous injection of nonselective antagonists of opioid receptors (OR) naltrexone (5 mg/kg) and naloxone methiodide (5 mg/kg), selective δ1-OR antagonist BNTX (0.7 mg/kg), selective δ2-OR blocker naltriben (0.3 mg/kg), selective κ-OR antagonist norbinaltorphimine (2 mg/kg), and selective blocker of ORL1 opioid receptors JTC-801 (0.1 mg/kg) produced no effect on reperfusion injury to the heart in rats narcotized with α-chloralose. In contrast, selective μ-OR antagonist CTAP (1 mg/kg) limited the infarct size, although this effect was not observed at a lower CTAP concentration of 0...
November 9, 2017: Bulletin of Experimental Biology and Medicine
https://www.readbyqxmd.com/read/29119398/myocardial-protection-against-ischemic-and-reperfusion-injuries-experimental-study
#14
I A Mandel', A Yu Podoksenov, I V Sukhodolo, Yu K Podoksenov, Yu S Svirko, N O Kamenshchikov, S L Mikheev, A S Sementsov, Yu V Rogovskaya, D A An, V M Shipulin, L N Maslov
The effects of hypoxic, hyperoxic, and hypoxic-hyperoxic preconditioning were examined in the prospective study on narcotized and artificially ventilated rabbits. Under artificial circulation, acute myocardial ischemia was modeled by ligation of anterior descending coronary artery, which was followed by reperfusion. The degree of ventricular arrhythmias was assessed, and the ischemic area was evaluated in percent of the area at risk. Microscopic characterization of the myocardium was employed to assess the cardioprotective effect of hypoxic and/or hyperoxic preconditioning...
November 9, 2017: Bulletin of Experimental Biology and Medicine
https://www.readbyqxmd.com/read/29117206/cannabis-alcohol-and-fatal-road-accidents
#15
Jean-Louis Martin, Blandine Gadegbeku, Dan Wu, Vivian Viallon, Bernard Laumon
INTRODUCTION: This research aims to estimate the relative risks of responsibility for a fatal accident linked to driving under the influence of cannabis or alcohol, the prevalence of these influences among drivers and the corresponding attributable risk ratios. A secondary goal is to estimate the same items for three other groups of illicit drugs (amphetamines, cocaine and opiates), and to compare the results to a similar study carried out in France between 2001 and 2003. METHODOLOGY: Police procedures for fatal accidents in Metropolitan France during 2011 were analyzed and 300 characteristics encoded to provide a database of 4,059 drivers...
2017: PloS One
https://www.readbyqxmd.com/read/29106940/sediment-associated-polycyclic-aromatic-hydrocarbons-and-potential-eco-hazards-in-chabahar-bay-iran
#16
Mehri Seyed Hashtroudi, Vahid Aghadadashi
The surface sediments (0-4cm, n=6) from Chabahar Bay were analyzed to assess the concentrations, composition, and potential eco-hazards of associated PAHs. The range of ∑16 PAHs' concentration was 25.75-312.38ngg(-1) dw, with mean and median levels of 126.7 and 55.12ngg(-1) dw, respectively. The bay was classified as a region with low to moderate PAH pollution. The sources of PAHs varied, and 2-3-ring compounds were dominant (37-90%). There was no significant correlation between TOC/grain size and levels of PAHs...
October 26, 2017: Marine Pollution Bulletin
https://www.readbyqxmd.com/read/29105821/accurate-prediction-of-acute-fish-toxicity-of-fragrance-chemicals-with-the-rtgill-w1-cell-assay
#17
Andreas Natsch, Heike Laue, Tina Haupt, Valentin von Niederhäusern, Gordon Sanders
Testing for acute fish toxicity is an integral part of the environmental safety assessment of chemicals. A true replacement of primary fish tissue was recently proposed using cell viability in a fish gill cell line (RTgill-W1) as a means of predicting acute toxicity, showing good predictivity on 35 chemicals. To promote regulatory acceptance, the predictivity and applicability domain of novel tests need to be carefully evaluated on chemicals with existing high quality in vivo data. We applied the RTgill-W1 cell assay to 38 fragrance chemicals with a wide range of physico-chemical properties, a broad range of LC50 values and representing a diverse range of chemistries...
November 4, 2017: Environmental Toxicology and Chemistry
https://www.readbyqxmd.com/read/29099540/depression-and-anxiety-in-patients-undergoing-left-ventricular-assist-device-implantation
#18
Scott Lundgren, Cecilia Y M Poon, Ahmed Selim, Brian D Lowes, Ronald Zolty, Adam Burdorf, Yael Potashnik-Peled, Michael J Moulton, John Y Um, Eugenia Raichlin
BACKGROUND: Depression and anxiety are associated with a worse prognosis in heart failure patients. The aim of this study was to identify the prevalence of depression and anxiety in left ventricular assist device (LVAD) candidates and assess their effect on post-LVAD outcomes. METHODS: Based on the pre-LVAD psychological assessment, the total cohort of 246 patients were divided into 4 groups: 1) no depression or anxiety (NDep&Anx group, n = 138); 2) isolated depression (Dep group, n = 42); 3) isolated anxiety (Anx group, n = 32), and 4) combined depression and anxiety (Dep&Anx group, n = 34)...
November 1, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29084006/review-and-update-on-postoperative-opioid-use-after-nasal-and-sinus-surgery
#19
Sophia D Becker, Daniel G Becker
PURPOSE OF REVIEW: We examine the current literature on pain management after sinus and nasal surgery. The goal after surgery is to provide effective pain management without having too many 'leftovers', as leftover medications are an important source of opioids that are fueling the current prescription narcotic epidemic in the United States. There are more than 250 000 sinus operations and 260 000 septoplasties performed annually, and surgeons commonly prescribe a narcotic pain medication for postoperative pain management...
October 27, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/29081434/entitled-to-addiction-pharmaceuticals-race-and-america-s-first-drug-war
#20
David Herzberg
This article rethinks the formative decades of American drug wars through a social history of addiction to pharmaceutical narcotics, sedatives, and stimulants in the first half of the twentieth century. It argues, first, that addiction to pharmaceutical drugs is no recent aberration; it has historically been more extensive than "street" or illicit drug use. Second, it argues that access to psychoactive pharmaceuticals was a problematic social entitlement constructed as distinctively medical amid the racialized reforms of the Progressive Era...
2017: Bulletin of the History of Medicine
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