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https://www.readbyqxmd.com/read/29782356/acute-neurologic-complications-during-extracorporeal-membrane-oxygenation-a-systematic-review
#1
Raoul Sutter, Kai Tisljar, Stephan Marsch
OBJECTIVES: We determine the frequency, risk factors, and mortality of neurologic complications in adults on extracorporeal membrane oxygenation and propose an algorithm for preventive strategies. DATA SOURCES: PubMed, Embase, and Cochrane databases. STUDY SELECTION: Screening was performed using predefined search terms to identify cohort studies reporting neurologic complications in adults during extracorporeal membrane oxygenation from 1990 to 2017...
May 18, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29728755/ed50-of-remifentanil-for-providing-excellent-intubating-conditions-when-co-administered-with-a-single-standard-dose-of-propofol-without-the-use-of-muscle-relaxants-in-children-dose-finding-clinical-trial
#2
Andre Hideo Ono, Thiago Rocha Moura, Cátia Sousa Govêia, Gabriel Magalhães Nunes Guimarães, Luís Cláudio de Araújo Ladeira, Helga Bezerra Gomes da Silva
PURPOSE: Previous studies evidenced that orotracheal intubation without neuromuscular blockers is feasible in children and has some potential advantages. Remifentanil has favorable pharmacodynamic and pharmacokinetic properties as an opioid for orotracheal intubation, but its dose for excellent intubation conditions when co-administered with propofol has not been established. This study was designed to find the minimum effective dose of remifentanil for excellent intubation conditions of children when co-administered with propofol, without neuromuscular relaxant drugs...
May 4, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29701428/anaesthetic-management-in-a-duchennne-muscle-dystrophy-patient-for-treatment-of-recurrent-pneumothorax
#3
Sara Mota, Liuba Germanova, Joana Cortesão, Teresa Paiva
INTRODUCTION: Duchenne muscular dystrophy (DMD) is an x linked recessive disorder. Long term prognosis is ominous, with development of respiratory distress and cardiomyopathy in advanced stage of the disease and expected death in the teens-to-mid 20s due to respiratory or cardiac failure. Peri-operative management of this patients is challenging due to difficult airway anatomy (macroglossia, limited neck and mandibular mobility). Additionally, they are at risk of developing malignant hyperthermia, rhabdomyolysis and hyperkalemic cardiac arrest when exposed to halogenated inhalational anaesthetics and depolarizing muscle relaxants...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29557685/magnesium-sulfate-and-calcium-channel-blocking-drugs-as-antidotes-for-acute-organophosphorus-insecticide-poisoning-a-systematic-review-and-meta-analysis
#4
Miran Brvar, Ming Yin Chan, Andrew H Dawson, Richard R Ribchester, Michael Eddleston
INTRODUCTION: Treatment of acute organophosphorus or carbamate insecticide self-poisoning is often ineffective, with tens of thousands of deaths occurring every year. Researchers have recommended the addition of magnesium sulfate or calcium channel blocking drugs to standard care to reduce acetylcholine release at cholinergic synapses. OBJECTIVE: We aimed to review systematically the evidence from preclinical studies in animals exposed to organophosphorus or carbamate insecticides concerning the efficacy of magnesium sulfate and calcium channel blocking drugs as therapy compared with placebo in reducing mortality or clinical features of poisoning...
March 20, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/29555261/comparison-of-two-sedation-regimens-during-targeted-temperature-management-after-cardiac-arrest
#5
Marine Paul, Wulfran Bougouin, Florence Dumas, Guillaume Geri, Benoit Champigneulle, Lucie Guillemet, Omar Ben Hadj Salem, Stéphane Legriel, Jean-Daniel Chiche, Julien Charpentier, Jean-Paul Mira, Claudio Sandroni, Alain Cariou
PURPOSE: Although guidelines on post-resuscitation care recommend the use of short-acting agents for sedation during targeted temperature management (TTM) after cardiac arrest (CA), the potential advantages of this strategy have not been clinically demonstrated. METHODS: We compared two sedation regimens (propofol-remifentanil, period P2, vs midazolam-fentanyl, period P1) among comatose TTM-treated CA survivors. Management protocol, apart from sedation and neuromuscular blockers use, did not change between the two periods...
March 16, 2018: Resuscitation
https://www.readbyqxmd.com/read/29505006/clinically-suspected-anaphylaxis-induced-by-sugammadex-in-a-patient-with-weaver-syndrome-undergoing-restrictive-mammoplasty-surgery-a-case-report-with-the-literature-review
#6
REVIEW
Nurdan Bedirli, Berrin Işık, Mehrnoosh Bashiri, Kutluk Pampal, Ömer Kurtipek
RATIONALE: Sugammadex is a cylodextrin derivate that encapsulates steroidal neuromuscular blocker agents and is reported as a safe and well-tolerated drug. In this case report, we present a patient who developed grade 3 anaphylaxis just after sugammadex administration. PATIENT CONCERNS: A 22-year-old woman with diagnosis of Weaver syndrome was scheduled for bilateral mammoplasty and resection of unilateral accessory breast tissue resection. Anesthesia was induced and maintained by propofol, rocuronium, and remifentanil...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29491750/sedation-protocol-during-bevacizumab-intravitreal-injection-in-preterm-infants-with-retinopathy-of-prematurity
#7
Jamie L Miller, Peter N Johnson, Kari Harkey, R Michael Siatkowski
OBJECTIVES: This study describes outcomes of intravenous (IV) analgesics and sedatives for bedside intravitreal bevacizumab injections for retinopathy of prematurity. METHODS: This retrospective study included infants receiving intravitreal bevacizumab injections between January 2012 and May 2016. Infants were excluded if bevacizumab was administered under general anesthesia or for incomplete records. Data collection included demographics, sedation and analgesia regimen, and cardiopulmonary adverse events (AEs)...
January 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29474819/direct-evidence-for-high-affinity-blockade-of-na-v-1-6-channel-subtype-by-huwentoxin-iv-spider-peptide-using-multiscale-functional-approaches
#8
Tânia C Gonçalves, Rachid Boukaiba, Jordi Molgó, Muriel Amar, Michel Partiseti, Denis Servent, Evelyne Benoit
The Chinese bird spider huwentoxin-IV (HwTx-IV) is well-known to be a highly potent blocker of NaV 1.7 subtype of voltage-gated sodium (NaV ) channels, a genetically validated analgesic target, and thus promising as a potential lead molecule for the development of novel pain therapeutics. In the present study, the interaction between HwTx-IV and NaV 1.6 channel subtype was investigated using multiscale (from in vivo to individual cell) functional approaches. HwTx-IV was approximatively 2 times more efficient than tetrodotoxin (TTX) to inhibit the compound muscle action potential recorded from the mouse skeletal neuromuscular system in vivo, and 30 times more effective to inhibit nerve-evoked than directly-elicited muscle contractile force of isolated mouse hemidiaphragms...
May 1, 2018: Neuropharmacology
https://www.readbyqxmd.com/read/29411605/investigation-of-agonist-recognition-and-channel-properties-in-a-flatworm-glutamate-gated-chloride-channel
#9
Daniel Callau-Vázquez, Stephan A Pless, Timothy Lynagh
Glutamate-gated chloride channels (GluCls) are neurotransmitter receptors that mediate crucial inhibitory signaling in invertebrate neuromuscular systems. Their role in invertebrate physiology and their absence from vertebrates make GluCls a prime target for antiparasitic drugs. GluCls from flatworm parasites are substantially different from and are much less understood than those from roundworm and insect parasites, hindering the development of potential therapeutics targeting GluCls in flatworm-related diseases such as schistosomiasis...
February 27, 2018: Biochemistry
https://www.readbyqxmd.com/read/29394509/increase-of-hyperpolarization-activated-cyclic-nucleotide-gated-current-in-the-aberrant-excitability-of-spinal-muscular-atrophy
#10
Hsing-Jung Lai, Chien-Lin Chen, Li-Kai Tsai
OBJECTIVE: The pathophysiology of spinal muscular atrophy (SMA) is still unclear. METHODS: The nerve excitability test in SMA patients and a mouse model of SMA was carried out to explore the pathophysiology of nodal and internodal currents, and quantitative PCR, western blotting, and whole-cell patch-clamp recording were used for the identified hypothesis. RESULTS: The nerve excitability test in SMA patients showed increased inward rectification in the current-threshold relationship and increased overshoot after hyperpolarizing threshold electrotonus, which indicates increased hyperpolarization-activated cyclic nucleotide-gated (HCN) current; these findings correlated with disease severity...
March 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29351759/tracheal-intubation-in-critically-ill-patients-a-comprehensive-systematic-review-of-randomized-trials
#11
Luca Cabrini, Giovanni Landoni, Martina Baiardo Radaelli, Omar Saleh, Carmine D Votta, Evgeny Fominskiy, Alessandro Putzu, Cézar Daniel Snak de Souza, Massimo Antonelli, Rinaldo Bellomo, Paolo Pelosi, Alberto Zangrillo
BACKGROUND: We performed a systematic review of randomized controlled studies evaluating any drug, technique or device aimed at improving the success rate or safety of tracheal intubation in the critically ill. METHODS: We searched PubMed, BioMed Central, Embase and the Cochrane Central Register of Clinical Trials and references of retrieved articles. Finally, pertinent reviews were also scanned to detect further studies until May 2017. The following inclusion criteria were considered: tracheal intubation in adult critically ill patients; randomized controlled trial; study performed in Intensive Care Unit, Emergency Department or ordinary ward; and work published in the last 20 years...
January 20, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29332117/pseudocholinesterase-levels-in-patients-under-electroconvulsive-therapy
#12
Gamze Küçükosman, Özcan Pişkin, Volkan Hancı, Rahşan D Okyay, Hilal Ayoğlu, Bülent S Yurtlu, Mehmet Akın, Işıl Ö Turan
In this study, we aimed to retrospectively assess the correlation of pseudocholinesterase (PChE) levels with age, gender, body weight and diagnosed psychiatric diseases in electroconvulsive therapy (ECT) cases. Methods: This retrospective study was conducted at Bülent Ecevit University Hospital, Zonguldak, Turkey, between 2007 and 2011. In the study, 193 ECT case files were retrospectively scanned to evaluate PChE values before ECT and other file information.  Results: There was no difference between gender in terms of PChE levels...
January 2018: Saudi Medical Journal
https://www.readbyqxmd.com/read/29278784/elucidating-the-biogeographical-variation-of-the-venom-of-naja-naja-spectacled-cobra-from-pakistan-through-a-venom-decomplexing-proteomic-study
#13
Kin Ying Wong, Choo Hock Tan, Kae Yi Tan, Naeem H Quraishi, Nget Hong Tan
Naja naja is a medically important species that is distributed widely in South Asia. Its venom lethality and neutralization profile have been reported to vary markedly, but the understanding of this phenomenon has been limited without a comprehensive venom profile for the Pakistani N. naja. This study set to investigate the venom proteome of Pakistani N. naja applying reverse-phase HPLC, SDS-PAGE, mass spectrometry and data-mining approaches. The venom enzymatics and antigen binding activities were also studied...
March 20, 2018: Journal of Proteomics
https://www.readbyqxmd.com/read/29200077/consensus-statement-on-perioperative-use-of-neuromuscular-monitoring
#14
Mohamed Naguib, Sorin J Brull, Aaron F Kopman, Jennifer M Hunter, Béla Fülesdi, Hal R Arkes, Arthur Elstein, Michael M Todd, Ken B Johnson
A panel of clinician scientists with expertise in neuromuscular blockade (NMB) monitoring was convened with a charge to prepare a consensus statement on indications for and proper use of such monitors. The aims of this article are to: (a) provide the rationale and scientific basis for the use of quantitative NMB monitoring; (b) offer a set of recommendations for quantitative NMB monitoring standards; (c) specify educational goals; and (d) propose training recommendations to ensure proper neuromuscular monitoring and management...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29153297/pain-management-practice-and-guidelines-in-jordanian-pediatric-intensive-care-units
#15
Ahmad Ismail, Paula Forgeron, Viola Polomeno, Huda Gharaibeh, Denise Harrison
Limited knowledge exists of current pain management practices and supporting guidelines in Jordanian pediatric intensive care units. To determine the current pain management practices and the availability and content of practice guidelines in Jordanian pediatric intensive care units, we conducted a cross-sectional and multisite survey of four pediatric intensive care units in Jordan. A questionnaire was developed and orally administered over the phone or in person to head nurses or their nominees to capture pain management practices and the existence and content of guidelines...
November 15, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29125190/lambert-eaton-myasthenic-syndrome-mouse-passive-transfer-model-illuminates-disease-pathology-and-facilitates-testing-therapeutic-leads
#16
REVIEW
Stephen D Meriney, Tyler B Tarr, Kristine S Ojala, Man Wu, Yizhi Li, David Lacomis, Adolfo Garcia-Ocaña, Mary Liang, Guillermo Valdomir, Peter Wipf
Lambert-Eaton myasthenic syndrome (LEMS) is an autoimmune disorder caused by antibodies directed against the voltage-gated calcium channels that provide the calcium ion flux that triggers acetylcholine release at the neuromuscular junction. To study the pathophysiology of LEMS and test candidate therapeutic strategies, a passive-transfer animal model has been developed in mice, which can be created by daily intraperitoneal injections of LEMS patient serum or IgG into mice for 2-4 weeks. Results from studies of the mouse neuromuscular junction have revealed that each synapse has hundreds of transmitter release sites but that the probability for release at each one is likely to be low...
January 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29095176/sugammadex-for-neuromuscular-blockade-reversal
#17
Michelle R Papathanas, Alley Killian
Postoperative residual neuromuscular blockade is associated with an increased risk of respiratory insufficiency, aspiration, and potential pulmonary complications. The standard of care for reversal of residual block centers on anticholinesterases such as neostigmine. However, these medications provide inconsistent or inadequate effect while being associated with potentially severe adverse effects. Sugammadex, a modified γ-cyclodextrine compound, is a recently approved agent for the reversal of blockade with aminosterodial neuromuscular blockers...
October 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29079016/the-8-year-experience-of-the-florence-referral-ecmo-center-and-retrieval-team-for-acute-respiratory-failure
#18
Giovanni Cianchi, Chiara Lazzeri, Manuela Bonizzoli, Stefano Batacchi, Morena Cozzolino, Marco Ciapetti, Pasquale Bernardo, Andrea Franci, Marco Chiostri, Adriano Peris
OBJECTIVE: Many extracorporeal membrane oxygenation (ECMO) centers for respiratory failure and ECMO mobile teams were instituted during the H1N1 pandemic. Data on transportation are scarce and heterogeneous. The authors therefore described the experience of their referral ECMO center for severe respiratory failure from 2009 to 2016 and gave a comprehensive report of transfers performed by their mobile ECMO team. DESIGN: Observational retrospective study. SETTING: An intensive care unit (ECMO referral center) in a teaching hospital...
June 8, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29050397/the-antimyotonic-effect-of-lamotrigine-in-non-dystrophic-myotonias-a-double-blind-randomized-study
#19
RANDOMIZED CONTROLLED TRIAL
Grete Andersen, Gitte Hedermann, Nanna Witting, Morten Duno, Henning Andersen, John Vissing
Mexiletine is the only drug with proven effect for treatment of non-dystrophic myotonia, but mexiletine is expensive, has limited availability and several side effects. There is therefore a need to identify other pharmacological compounds that can alleviate myotonia in non-dystrophic myotonias. Like mexiletine, lamotrigine is a sodium channel blocker, but unlike mexiletine, lamotrigine is available, inexpensive, and well tolerated. We investigated the potential of using lamotrigine for treatment of myotonia in patients with non-dystrophic myotonias...
September 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28987399/review-of-difficult-airway-management-in-thoracic-surgery
#20
M Granell, M J Parra, M J Jiménez, L Gallart, A Villalonga, O Valencia, M C Unzueta, A Planas, J M Calvo
The management of difficult airway (DA) in thoracic surgery is more difficult due to the need for lung separation or isolation and frequent presence of associated upper and lower airway problems. We performed an article review analysing 818 papers published with clinical evidence indexed in Pubmed that allowed us to develop an algorithm. The best airway management in predicted DA is tracheal intubation and independent bronchial blockers guided by fibroscopy maintaining spontaneous ventilation. For unpredicted DA, the use of videolaryngoscopes is recommended initially, and adequate neuromuscular relaxation (rocuronium/sugammadex), among other maneuvers...
January 2018: Revista Española de Anestesiología y Reanimación
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