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https://www.readbyqxmd.com/read/29120894/advances-in-pharmacotherapies-for-movement-disorders-in-children-current-limitations-and-future-progress
#1
Jean-Pierre Lin
PURPOSE OF REVIEW: In childhood, movement disorders are generated by a very large number of disorders of the nervous system, and the very different developmental ages at which these occur make studies of pharmacotherapy efficacy extremely difficult. In most clinical practices, medication used in management is by trial and error, and limited by lack of efficacy and/or adverse drug reactions leading to drug intolerance. Nevertheless, symptom reduction using polypharmacy must be balanced against any accompanying comorbidities such as poor attention and concentration, constipation, ileus, urinary retention, blurred vision sedation and respiratory depression...
December 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28992737/asenapine-iloperidone-and-lurasidone-exposures-in-young-children-reported-to-u-s-poison-centers
#2
Gina Stassinos, Wendy Klein-Schwartz
CONTEXT: Asenapine, iloperidone and lurasidone are relatively new atypical antipsychotics. There is limited information on toxicity on pediatric exposures to these drugs. The objective of this study was to compare toxicity associated with asenapine, iloperidone and lurasidone exposures in young children. METHODS: A retrospective study of U.S. National Poison Data System from 2010 to 2015 of single substance exposures to asenapine, iloperidone or lurasidone in children <6 years of age that were followed to known outcome was performed...
October 10, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28952972/acute-opiate-overdose-an-update-on-management-strategies-in-emergency-department-and-critical-care-unit
#3
Rukma Parthvi, Abhinav Agrawal, Sameer Khanijo, Adey Tsegaye, Arunabh Talwar
BACKGROUND: Opioids are natural, semisynthetic, or synthetic substances that act on opioid receptors in the central nervous system. Clinically, they are prescribed for pain management. Opioid overdose (OOD) occurs when the central nervous system and respiratory drive are suppressed because of excessive consumption of the drug. Symptoms of OOD include drowsiness, slow breathing, pinpoint pupils, cyanosis, loss of consciousness, and death. Due to their addictive potential and easy accessibility opioid addiction is a growing problem worldwide...
September 13, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28943457/clinical-staging-of-fibrodysplasia-ossificans-progressiva-fop
#4
Robert J Pignolo, Frederick S Kaplan
Fibrodyplasia ossificans progressiva (FOP) is an ultra-rare genetic condition of heterotopic ossification (HO) that results in progressive loss of joint function, ultimately rendering movement impossible. Death is most commonly the result of thoracic insufficiency syndrome, or complications related to recurrent respiratory infections. There are no current treatments for FOP, but early and emerging clinical trials offer hope for this devastating disease. With the recent reporting of a comprehensive global natural history study, scales to assess joint dysfunction, and a more accurate prediction of joint survival, it is now possible to construct a conceptual framework for the clinical staging of FOP...
September 21, 2017: Bone
https://www.readbyqxmd.com/read/28932559/pupillary-abnormalities-in-non-selected-critically-ill-patients-an-observational-study
#5
Philippe Portran, Martin Cour, Romain Hernu, Sylvie de la Salle, Laurent Argaud
BACKGROUND: Repeated pupillary examination is a key element of neurologic surveillance in intensive care units (ICU). However, in non-selected critically ill patients, the clinical interest of monitoring pupillary diameter and light reflex is poorly documented. We aimed to determine the prevalence and the etiologies of pupillary abnormalities (PAs) in this ICU patient population. METHODS: We performed a prospective, observational study in a medical university affiliated ICU over a 6-month period...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28851379/prognosis-and-treatment-of-folfox-therapy-related-interstitial-pneumonia-a-plea-for-multimodal-immune-modulating-therapy-in-the-respiratory-insufficient-patient
#6
Annick De Weerdt, Amélie Dendooven, Annemie Snoeckx, Jan Pen, Martin Lammens, Philippe G Jorens
BACKGROUND: The FOLFOX regimen, i.e., folinic acid (FOL), fluorouracil (F) and oxaliplatin (OX), is a drug cocktail that is used to treat gastric and colorectal cancers. Despite the concomitant improvements in response rate, duration of response and patient survival, reports of serious toxic pulmonary side effects have progressively emerged. CASE PRESENTATION: We describe a patient who was treated with FOLFOX as an adjuvant to a rectosigmoidal resection of a rectosigmoidal carcinoma and who developed respiratory insufficiency requiring mechanical ventilation...
August 29, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28834562/potential-drug-drug-interactions-among-critically-ill-pediatric-patients-in-a-tertiary-pulmonary-center
#7
Maryam Hassanzad, Sara Arenas-Lopez, Shadi Baniasadi
Patients in the pediatric intensive care unit (PICU) are at increased risk of potential drug-drug interactions (pDDIs) because of the complexity of pharmacotherapy. The current study aimed to assess the rate, pattern, risk factors, and management of pDDIs in the PICU of an academic pulmonary hospital. A prospective observational study was conducted for 6 months. Pharmacotherapy data of PICU-admitted patients were evaluated by a clinical pharmacologist. Interacting drugs, reliability, mechanism, potential outcome, and clinical management of pDDIs were identified using the Lexi-Interact database...
August 23, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28798922/practical-approach-to-the-patient-with-acute-neuromuscular-weakness
#8
REVIEW
Rajeev Nayak
Acute neuromuscular paralysis (ANMP) is a clinical syndrome characterized by rapid onset muscle weakness progressing to maximum severity within several days to weeks (less than 4 wk). Bulbar and respiratory muscle weakness may or may not be present. It is a common neurological emergency which requires immediate and careful investigations to determine the etiology because accurate diagnosis has significant impact on therapy and prognosis. Respiratory failure caused by neuromuscular weakness is considered as more critical than lung disease because its development may be insidious or subtle until sudden decompensation leads to life threatening hypoxia...
July 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28791431/glycine-receptors-and-glycine-transporters-targets-for-novel-analgesics
#9
REVIEW
Hanns Ulrich Zeilhofer, Mario A Acuña, Jacinthe Gingras, Gonzalo E Yévenes
Glycinergic neurotransmission has long been known for its role in spinal motor control. During the last two decades, additional functions have become increasingly recognized-among them is a critical contribution to spinal pain processing. Studies in rodent pain models provide proof-of-concept evidence that enhancing inhibitory glycinergic neurotransmission reduces chronic pain symptoms. Apparent strategies for pharmacological intervention include positive allosteric modulators of glycine receptors and modulators or inhibitors of the glial and neuronal glycine transporters GlyT1 and GlyT2...
August 8, 2017: Cellular and Molecular Life Sciences: CMLS
https://www.readbyqxmd.com/read/28754148/nosocomial-bacterial-infections-and-their-antimicrobial-susceptibility-patterns-among-patients-in-ugandan-intensive-care-units-a-cross-sectional-study
#10
Peter Agaba, Janat Tumukunde, J V B Tindimwebwa, Arthur Kwizera
BACKGROUND: The intensive care unit (ICU) admits critically ill patients requiring advanced airway, respiratory, cardiac and renal support. Despite the highly-specialized interventions, the mortality and morbidity is still high due to a number of reasons including nosocomial infections, which are the most likely complications in hospitalized patients with the rates being highest among ICU patients. METHODS: In this cross-sectional study of 111 adult patients admitted to 2 of the ICUs in Uganda, we set out to describe the commonest bacterial infections, their antimicrobial susceptibility patterns and factors associated with development of a nosocomial infection...
July 28, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28748088/modeling-risk-for-developing-drug-resistant-bacterial-infections-in-an-mdr-naive-critically-ill-population
#11
Rajiv Sonti, Megan E Conroy, Elena M Welt, Yi Hu, George Luta, Daniel B Jamieson
PURPOSE: To create a model predictive of an individual's risk of developing a de novo multidrug-resistant (MDR) infection while in the intensive care unit (ICU). METHODS: This is a case-control study in which 189 ICU patients diagnosed with their first infection with an MDR organism were compared on the basis of demographic, past medical and clinical variables to randomly selected ICU patients without such an infection, era-matched in a 2:1 ratio. A prediction tool was derived using multivariate logistic regression...
July 2017: Therapeutic Advances in Infectious Disease
https://www.readbyqxmd.com/read/28657373/extended-infusion-of-beta-lactam-antibiotics-optimizing-therapy-in-critically-ill-patients-in-the-era-of-antimicrobial-resistance
#12
Nesrine A Rizk, Zeina A Kanafani, Hussam Z Tabaja, Souha S Kanj
Beta-lactams are at the cornerstone of therapy in critical care settings, but their clinical efficacy is challenged by the rise in bacterial resistance. Infections with multi-drug resistant organisms are frequent in intensive care units, posing significant therapeutic challenges. The problem is compounded by a dearth in the development of new antibiotics. In addition, critically-ill patients have unique physiologic characteristics that alter the drugs pharmacokinetics and pharmacodynamics. Areas covered: The prolonged infusion of antibiotics (extended infusion [EI] and continuous infusion [CI]) has been the focus of research in the last decade...
July 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28601441/evaluation-and-handling-of-constipation-in-critical-patients
#13
J Pérez-Sánchez, J Fernández-Boronat, E Martínez-Méndez, M L Marín-Cagigas, D Mota-Puerto, M C Pérez-Román, G Martínez-Estalella
OBJECTIVE: To evaluate the effectiveness of nursing care against constipation and to identify, analyze and evaluate causes and consequences. METHODOLOGY: Observational, descriptive and prospective study in polyvalent ICU tertiary hospital (2013-2015). INCLUSION CRITERIA: >18 years, stay >7 days, connected to respiratory support, with nasogastric tube and enteral or mixed nutrition. Patients with gastrointestinal pathology, encephalopathic and jejunostomy/ileostomy were excluded...
October 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28580101/highly-specific-and-rapid-glycan-based-amperometric-detection-of-influenza-viruses
#14
Xikai Cui, Amrita Das, Abasaheb N Dhawane, Joyce Sweeney, Xiaohu Zhang, Vasanta Chivukula, Suri S Iyer
Rapid and precise detection of influenza viruses in a point of care setting is critical for applying appropriate countermeasures. Current methods such as nucleic acid or antibody based techniques are expensive or suffer from low sensitivity, respectively. We have developed an assay that uses glucose test strips and a handheld potentiostat to detect the influenza virus with high specificity. Influenza surface glycoprotein neuraminidase (NA), but not bacterial NA, cleaved galactose bearing substrates, 4,7di-OMe N-acetylneuraminic acid attached to the 3 or 6 position of galactose, to release galactose...
May 1, 2017: Chemical Science
https://www.readbyqxmd.com/read/28553127/real-world-health-care-utilization-in-asthma-patients-using-albuterol-sulfate-inhalation-aerosol-proair-%C3%A2-hfa-with-and-without-integrated-dose-counters
#15
Edward M Kerwin, Thomas J Ferro, Rinat Ariely, Debra E Irwin, Ruchir Parikh
BACKGROUND: Accurate tracking of the administered dose of asthma rescue inhalers is critical for optimal disease management and is related to reductions in rates of unscheduled health care utilization in asthma patients. There are few published data on the real-world impact of rescue inhalers with integrated dose counters (IDCs) on health care resource utilization (HRU) for asthma patients. This study evaluates HRU among users of ProAir(®) hydrofluoroalkane (HFA) (albuterol sulfate inhalation aerosol), with IDC versus without IDC, in asthma patients...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28524035/-comparison-of-risk-of-death-between-older-and-non-older-critical-patients-in-icu-a-retrospective-cohort-study-of-consecutive-3-years
#16
Yeting Zhou, Daoming Tong, Shaodan Wang, Liansong Liu, Song Ye, Benwen Xu
OBJECTIVE: To investigate the risk of death between older and non-older critical patients in intensive care unit (ICU) in Shuyang People's Hospital. METHODS: A retrospective cohort study was conducted. The critical patients who aged 15 or above, and admitted to ICU of Shuyang People's Hospital from January 2014 to December 2016 were enrolled, and all the data was collected from the registration and electronic medical records in the ICU. The prevalence and causes of death in ICU critical patients during the study period were observed...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28355466/invasive-mould-infections-in-the-icu-setting-complexities-and-solutions
#17
REVIEW
Matteo Bassetti, Emilio Bouza
Infections caused by filamentous fungi represent a major burden in the ICU. Invasive aspergillosis is emerging in non-neutropenic individuals with predisposing conditions, e.g. corticosteroid treatment, chronic obstructive pulmonary disease, liver cirrhosis, solid organ cancer, HIV infection and transplantation. Diagnosis is challenging because the signs and symptoms are non-specific, and initiation of additional diagnostic examinations is often delayed because clinical suspicion is low. Isolation of an Aspergillus species from the respiratory tract in critically ill patients, and tests such as serum galactomannan, bronchoalveolar lavage 1-3-β-d-glucan and specific PCR should be interpreted with caution...
March 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28319467/effects-of-iv-acetaminophen-on-core-body-temperature-and-hemodynamic-responses-in-febrile-critically-ill-adults-a-randomized-controlled-trial
#18
RANDOMIZED CONTROLLED TRIAL
Hildy M Schell-Chaple, Kathleen D Liu, Michael A Matthay, Daniel I Sessler, Kathleen A Puntillo
OBJECTIVE: To determine the effects of IV acetaminophen on core body temperature, blood pressure, and heart rate in febrile critically ill patients. DESIGN: Randomized, double-blind, placebo-controlled clinical trial. SETTING: Three adult ICUs at a large, urban, academic medical center. PATIENTS: Forty critically ill adults with fever (core temperature, ≥ 38.3°C). INTERVENTION: An infusion of acetaminophen 1 g or saline placebo over 15 minutes...
July 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28298202/evaluation-of-sublingual-microcirculation-in-a-paediatric-intensive-care-unit-prospective-observational-study-about-its-feasibility-and-utility
#19
Rafael González, Jorge López, Javier Urbano, María José Solana, Sarah Nicole Fernández, María José Santiago, Jesús López-Herce
BACKGROUND: Evaluation of the microcirculation in critically ill patients is usually done by means of indirect parameters. The aim of our study was to evaluate the functional state of the microcirculation by direct visualization of sublingual microcirculation using Sidestream Dark Field Imaging, to determine the correlation between these findings and other parameters that are commonly used in the clinical practice and to assess the applicability of the systematic use of this technique in critically ill children...
March 15, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28297813/-clinical-application-and-evaluation-of-an-early-non-sedation-protocol-for-critically-ill-respiratory-patients
#20
RANDOMIZED CONTROLLED TRIAL
J B Huang, C Q Lan, H Y Li, L Chen, J G Pan, L L Chen, H Weng, Y M Zeng
Objective: To study the value of an early (mechanical ventilation after 24 h) non-sedation protocol for intubated, mechanically ventilated patients in the respiratory intensive care unit (RICU). Methods: Seventy intubated, mechanically ventilated patients were prospectively enrolled and randomly assigned to management with early non-sedation (intervention group; n=35) or with daily interruption of sedation (DIS) (control group; n=35). The duration of mechanical ventilation, length of the RICU and hospital stay, RICU and hospital mortality, drug consumption, RICU and hospitalization expenses, incidence of complications and adverse events and serum levels of vital organ damage and inflammatory markers after mechanical ventilation for 48 h were recorded and compared...
March 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
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