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"Atropine" AND "Emergency"

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https://www.readbyqxmd.com/read/30514630/low-concentration-atropine-for-myopia-progression-lamp-study-a-randomized-double-blinded-placebo-controlled-trial-of-0-05-0-025-and-0-01-atropine-eye-drops-in-myopia-control
#1
Jason C Yam, Yuning Jiang, Shu Min Tang, Antony K P Law, Joyce J Chan, Emily Wong, Simon T Ko, Alvin L Young, Clement C Tham, Li Jia Chen, Chi Pui Pang
PURPOSE: Low-concentration atropine is an emerging therapy for myopia progression, but its efficacy and optimal concentration remain uncertain. Our study aimed to evaluate the efficacy and safety of low-concentration atropine eye drops at 0.05%, 0.025%, and 0.01% compared with placebo over a 1-year period. DESIGN: Randomized, placebo-controlled, double-masked trial. PARTICIPANTS: A total of 438 children aged 4 to 12 years with myopia of at least -1...
July 6, 2018: Ophthalmology
https://www.readbyqxmd.com/read/30505602/a-pilot-project-using-eye-tracking-technology-to-design-a-standardised-anaesthesia-workspace
#2
Jaber Hanhan, Roderick King, T Kyle Harrison, Alex Kou, Steven K Howard, Lindsay K Borg, Cynthia Shum, Ankeet D Udani, Edward R Mariano
Objective: Maximising safe handoff procedures ensures patient safety. Anaesthesiology practices have primarily focused on developing better communication tools. However, these tools tend to ignore the physical layout of the anaesthesia workspace itself. Standardising the anaesthesia workspace has the potential to improve patient safety. The design process should incorporate end user feedback and objective data. Methods: This pilot project aims to design a standardised anaesthesia workspace using eye-tracking technology at a single university-affiliated Veterans Affairs hospital...
December 2018: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/30456142/a-pilot-study-on-the-management-and-outcomes-of-self-poisoning-in-a-rural-ugandan-emergency-centre
#3
Vinodinee Dissanayake, Erin T Dalka, Cynthia Koh, Mark Bisanzo, Ryan S Brandt, Timothy B Erickson, Stacey Chamberlain
Introduction: The Global Emergency Care Collaborative and Nyakibale Hospital in Rukungiri opened the first functional emergency centre in rural Uganda. We investigated decontamination, management and outcomes of poisoned patients in the emergency centre. Methods: An electronic database started recording charts from 24 March 2012. A search for diagnoses concerning self-poisoning was performed from 24 March 2012 to 30 December 2013 and 192 charts were found and de-identified...
March 2018: African Journal of Emergency Medicine Revue Africaine de la Médecine D'urgence
https://www.readbyqxmd.com/read/30366034/acute-behavioral-effects-of-deliriant-hallucinogens-atropine-and-scopolamine-in-adult-zebrafish
#4
Andrey D Volgin, Oleg A Yakovlev, Konstantin A Demin, Polina A Alekseeva, Allan V Kalueff
Atropine and scopolamine are classical muscarinic cholinergic antagonists that exert multiple CNS effects. Belonging to a group of deliriant hallucinogens, these drugs induce delirium-like hallucinations, hyperactivity, altered affective states and amnesia. However, as deliriants remain the least studied group of hallucinogens, their complex and poorly understood profiles necessitate further clinical and preclinical studies. The zebrafish (Danio rerio) is rapidly emerging as a powerful model organism for translational neuropsychopharmacology research...
October 23, 2018: Behavioural Brain Research
https://www.readbyqxmd.com/read/30307341/effect-of-cholinergic-crisis-on-the-potency-of-different-emergency-anaesthesia-protocols-in-soman-poisoned-rats
#5
Katharina Marquart, Julia Herbert, Niko Amend, Horst Thiermann, Franz Worek, Timo Wille
BACKGROUND: In a military or terrorist scenario, combination of organophosphorus compounds (OP) poisoning with physical trauma requiring surgical treatment and thus general anaesthesia are possible. Previous in vitro studies showed an altered potency of relevant anaesthetics during cholinergic crisis. Hence, it is not clear, which anaesthetics are suitable to achieve the necessary stage of surgical anaesthesia in OP poisoning. METHODS: In the present study, different anaesthetic regimens (ketamine-midazolam, propofol-fentanyl, thiopental-fentanyl), relevant in military emergency medicine, were examined in soman-poisoned rats...
October 11, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/30269453/usefulness-of-serum-lactate-as-a-predictor-of-successful-discontinuation-of-continuous-atropine-infusion-in-patients-with-severe-acute-organophosphate-poisoning
#6
Ho Chul Kwon, Yong Sung Cha, Gyo Jin An, Yoonsuk Lee, Hyun Kim
OBJECTIVE: In severe organophosphate (OP) poisoning, administration of atropine via continuous intravenous infusion is typically considered. To date, there have been no studies on predicting successful atropine discontinuation through plasma cholinesterase (PChE) and serum lactate levels, which are monitored during critical care in severe acute OP poisoning. Therefore, we retrospectively evaluated the usefulness of serum lactate and PChE as predictors of successful discontinuation of atropine infusion...
September 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/30218682/superior-efficacy-of-hi-6-dimethanesulfonate-over-pralidoxime-methylsulfate-against-russian-vx-poisoning-in-cynomolgus-monkeys-macaca-fascicularis
#7
Chloé Reymond, Nina Jaffré, Nicolas Taudon, Mathilde Menneteau, Hervé Chaussard, Josiane Denis, Cédric Castellarin, Franck Dhote, Frédéric Dorandeu
Organophosphorus nerve agents still represent a serious risk to human health. In the French armed forces, the current emergency treatment against OP intoxications is a fully licensed wet-dry dual-chambered autoinjector (Ineurope ®), that contains pralidoxime methylsulfate (2-PAM) to reactivate inhibited acetylcholinesterase (AChE), atropine sulfate (AS) and avizafone chlorhydrate (AVZ). While this treatment is effective against several of the known nerve agents, it shows little efficacy against the Russian VX (VR), one of the most toxic compounds...
December 1, 2018: Toxicology
https://www.readbyqxmd.com/read/30111957/bradycardia-with-syncope-in-carotid-sinus-syndrome-a-rare-case-report-in-palliative-care
#8
Arunangshu Ghoshal, Shamali Poojary, Anuja Damani, Naveen S Salins, Jayita K Deodhar, Maryann Muckaden
Emergencies in palliative care need to be defined by the potential distress that a clinical issue raises for a person. A 58-year-old male with carcinoma vallecula referred for palliative care presented with recurrent syncopal attacks. On examination, a swelling at the left angle of mandible pressing on the carotid sinus was detected. A clinical diagnosis of carotid sinus syndrome was made, which is an exaggerated response to carotid sinus baroreceptor stimulation and results in dizziness or syncope from transient diminished cerebral perfusion...
July 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/30027605/the-pharmacokinetics-of-ketamine-following-intramuscular-injection-to-f344-rats
#9
Benjamin Moeller, Brenna Espelien, Waylon Weber, Philip Kuehl, Melanie Doyle-Eisele, C Edwin Garner, Jacob D McDonald, Efrain Garcia, Robert Raulli, Judith Laney
Ketamine is a glutamate N-methyl-D-aspartate receptor antagonist that is a rapid-acting dissociative anesthetic. It has been proposed as an adjuvant treatment along with other drugs (atropine, midazolam, pralidoxime) used in the current standard of care (SOC) for organophosphate and nerve agent exposures. Ketamine is a pharmaceutical agent that is readily available to most clinicians in emergency departments and possesses a broad therapeutic index with well-characterized effects in humans. The objective of this study was to determine the pharmacokinetic profile of ketamine and its active metabolite, norketamine, in F344 rats following single or repeated intramuscular administrations of subanesthetic levels (7...
July 20, 2018: Drug Testing and Analysis
https://www.readbyqxmd.com/read/30004324/prolonged-paralysis-in-a-child-with-organophosphate-pesticide-poisoning
#10
K Balme, M McCulloch, C Stephen
A 17-month-old boy presented to a local community health centre in Cape Town, South Africa, with severe organophosphate pesticide poisoning (OPP), necessitating the use of intravenous atropine to control cholinergic symptoms, as well as emergency intubation for ongoing respiratory distress. He required prolonged ventilatory support in the intensive care unit at his referral hospital and had subsequent delayed neurological recovery, spending 8 days in hospital.We present this case to emphasise the importance of adequate atropinisation in the management of severe OPP and to highlight the dangers of inappropriate use of suxamethonium for intubation in patients with OPP...
May 25, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29777043/new-advances-in-amblyopia-therapy-i-binocular-therapies-and-pharmacologic-augmentation
#11
Courtney L Kraus, Susan M Culican
Amblyopia therapy options have traditionally been limited to penalisation of the non-amblyopic eye with either patching or pharmaceutical penalisation. Solid evidence, mostly from the Pediatric Eye Disease Investigator Group, has validated both number of hours a day of patching and days per week of atropine use. The use of glasses alone has also been established as a good first-line therapy for both anisometropic and strabismic amblyopia. Unfortunately, visual acuity equalisation or even improvement is not always attainable with these methods...
November 2018: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/29760826/best-prophylactic-strategy-in-groups-at-risk-of-intraoperative-floppy-iris-syndrome-development-comparison-between-atropine-instillation-and-adrenaline-intracameral-injection
#12
Raffaele Nuzzi, Paolo Arnoffi, Federico Tridico
Background: Intraoperative Floppy Iris Syndrome (IFIS) is an important cause of surgical complications and iris defects in patients undergoing phacoemulsification that were treated with selective subtype α1A receptor antagonists for a long period of time. To date, no definitive preventive strategy has emerged, yet. The need of prophylaxis is dictated by the high prevalence of males affected by benign prostatic hyperplasia undergoing cataract surgery. Objective: To identify the best prophylactic strategy in groups at risk of IFIS development by comparing two mydriatic treatments in course of phacoemulsification surgery...
2018: Open Ophthalmology Journal
https://www.readbyqxmd.com/read/29760666/candyflipping-and-other-combinations-identifying-drug-drug-combinations-from-an-online-forum
#13
Michael Chary, David Yi, Alex F Manini
Novel psychoactive substances (NPS) refer to synthetic compounds or derivatives of more widely known substances of abuse that have emerged over the last two decades. Case reports suggest that users combine substances to achieve desired psychotropic experiences while reducing dysphoria and unpleasant somatic effects. However, the pattern of combining NPS has not been studied on a large scale. Here, we show that posts discussing NPS describe combining nootropics with sedative-hypnotics and stimulants with plant hallucinogens or psychiatric medications...
2018: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/29759676/outcomes-associated-with-electrical-cardioversion-for-atrial-fibrillation-when-performed-autonomously-by-an-advanced-practice-provider
#14
Theresa A Strzelczyk, Rachel M Kaplan, Meena Medler, Bradley P Knight
OBJECTIVES: This study sought to determine the feasibility, safety, and efficacy of elective electrical cardioversion (CV) for atrial fibrillation (AF) when performed autonomously by a trained advanced practice provider (APP) using a guideline-directed protocol. BACKGROUND: APPs have emerged as an integral part of the cardiovascular team. METHODS: A licensed advanced practice nurse-clinical nurse specialist was trained and obtained credentials to perform CVs...
December 11, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29681419/physostigmine-reversal-of-dysarthria-and-delirium-after-iatrogenic-atropine-overdose-from-a-dental-procedure
#15
Jon B Cole, Benjamin S Orozco, Ann M Arens
BACKGROUND: Sublingual atropine, dosed at 0.4-0.8 mg, is used by dentists as an antisialogogue to facilitate and increase the speed of procedures. Concentrated ophthalmic atropine drops (10 mg/mL) are commonly used off-label for this purpose. These highly concentrated drops may result in medication errors, atropine toxicity, and the antimuscarinic toxidrome. We report a case of a man who suffered acute delirium and dysarthria (from dry mouth) after an iatrogenic overdose from a dental procedure...
June 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29656945/ketamine-versus-ketamine-pluses-atropine-for-pediatric-sedation-a-meta-analysis
#16
REVIEW
Jiaxiao Shi, Ang Li, Zhijian Wei, Yang Liu, Cong Xing, Hongyu Shi, Han Ding, Dayu Pan, Guangzhi Ning, Shiqing Feng
OBJECTIVES: The application of atropine for pediatric sedation in the emergency department remains controversial. Our objective was to perform a comprehensive review of the literature and assess the clinical indexes in groups with and without atropine use. METHODS: PubMed, EMBASE, and the Cochrane Library were searched for randomized and non-randomized studies that compared ketamine and ketamine plus atropine for pediatric sedation. The risk ratio with 95% confidence interval was calculated using either a fixed- or random-effects model according to the value of I2 ...
July 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29626346/propofol-for-implantable-cardioverter-defibrillator-implantation-in-patients-with-brugada-syndrome
#17
Hye-Mee Kwon, Sung-Hoon Kim, Se-Ung Park, Jin-Ho Rhim, Hee-Sun Park, Wook-Jong Kim, Gi-Byoung Nam
AIMS: Avoiding propofol in patients with Brugada syndrome has been suggested because of the theoretical risk of provoking ventricular arrhythmias, although propofol may be selected for conscious sedation during electrophysiological procedures in catheterization laboratories. This study aimed to document periprocedural electrocardiographic changes and adverse events in patients with Brugada syndrome undergoing implantable cardioverter defibrillator (ICD) implantation using propofol sedation...
June 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29532502/administering-atropine-and-ketamine-before-less-invasive-surfactant-administration-resulted-in-low-pain-scores-in-a-prospective-study-of-premature-neonates
#18
L Bourgoin, L Caeymaex, F Decobert, C Jung, C Danan, X Durrmeyer
AIM: Less invasive surfactant administration (LISA) can avoid tracheal intubation for neonatal respiratory distress syndrome, but can be painful because it requires laryngoscopy. The aim of this study was to assess the efficacy and tolerance of intravenous atropine plus ketamine administration before LISA. METHODS: We conducted a prospective observational study of all premature infants hospitalised in our French neonatal intensive care unit treated with LISA between March 2015 and March 2016...
July 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29404375/use-of-selective-serotonin-reuptake-inhibitor-and-midodrine-in-a-patient-with-autonomic-instability-2-2-compressive-squamous-cell-carcinoma-and-pain
#19
Kyle Ball, Thomas P Vacek
A rare cause of reflex syncope is metastatic cancers involving the head and neck. These can irritate the glossopharyngeal nerve and lead to glossopharyngeal neuralgia with associated syncope. This type of syncope is difficult to treat since it commonly involves both a vasodepressor and cardioinhibitory response, and typically requires removal of the irritative focus. We report a case of a 52-year-old male who presented from home with syncope. He endorsed a 5-week history of progressively worsened positional headaches and dramatic 40-pound weight loss with night sweats over 6 months...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29363292/acute-intoxications-among-turkish-children
#20
Baran S Kizilyildiz, Kamuran Karaman, Selvi Özen, Abdurrahman Üner
BACKGROUND: The aim of this study was to investigate characteristics, outcomes and clinical features of acute intoxications among children in Van region of Turkey. METHODS: All cases with a diagnosis of acute intoxication admitted to the Pediatric Emergency Department of the Yüzüncü Yıl University of Van from June 1, 2010 to November 30, 2011 were evaluated. We retrospectively examined the medical records for demographical and etiological characteristics of patients below 17 years of age...
February 2018: Minerva Pediatrica
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