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https://www.readbyqxmd.com/read/27925849/development-and-prospective-federal-state-wide-evaluation-of-a-device-for-height-based-dose-recommendations-in-prehospital-pediatric-emergencies-a-simple-tool-to-prevent-most-severe-drug-errors
#1
Jost Kaufmann, Bernhard Roth, Thomas Engelhardt, Alex Lechleuthner, Michael Laschat, Christoph Hadamitzky, Frank Wappler, Martin Hellmich
OBJECTIVE: Drug dosing errors pose a particular threat to children in prehospital emergency care. With the Pediatric emergency ruler (PaedER), we developed a simple height-based dose recommendation system and evaluated its effectiveness in a pre-post interventional trial as the Ethics Committee disapproved randomization due to the expected positive effect of the PaedER on outcome. METHODS: Pre-interventional data were retrospectively retrieved from the electronic records and medical protocols of the Cologne Emergency Medical Service over a two-year period prior to the introduction of the PaedER...
December 7, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27923692/a-hemodynamic-directed-approach-to-pediatric-cardiopulmonary-resuscitation-hd-cpr-improves-survival
#2
Ryan W Morgan, Todd J Kilbaugh, Wesley Shoap, George Bratinov, Yuxi Lin, Ting-Chang Hsieh, Vinay M Nadkarni, Robert A Berg, Robert M Sutton
AIM: Most pediatric in-hospital cardiac arrests (IHCAs) occur in ICUs where invasive hemodynamic monitoring is frequently available. Titrating cardiopulmonary resuscitation (CPR) to the hemodynamic response of the individual improves survival in preclinical models of adult cardiac arrest. The objective of this study was to determine if titrating CPR to systolic blood pressure (SBP) and coronary perfusion pressure (CoPP) in a pediatric porcine model of asphyxia-associated ventricular fibrillation (VF) IHCA would improve survival as compared to traditional CPR...
December 3, 2016: Resuscitation
https://www.readbyqxmd.com/read/27923649/food-allergy-trends-and-epinephrine-autoinjector-presence-in-summer-camps
#3
Natalie R Schellpfeffer, Harvey L Leo, Michael Ambrose, Andrew N Hashikawa
BACKGROUND: Pediatric campers with food allergies are at greater risk for exposure and anaphylaxis. A diagnosis of asthma increases risk for anaphylaxis. Epidemiological investigations of food-allergic children at high risk for allergic reactions requiring intervention in camp settings are lacking. OBJECTIVE: The objectives of this study were to estimate the prevalence of food allergies among otherwise healthy campers in summer camps throughout the United States and Canada, and to assess asthma comorbidity and determine rates of epinephrine autoinjector prescriptions present in this population...
December 3, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27922561/a-pharmacologic-review-of-anaphylaxis
#4
Nancy S Yunker, Bradley J Wagner
Anaphylaxis occurs in the surgical population and may have devastating consequences. Anaphylaxis and anaphylactoid reactions are immediate hypersensitivity reactions that are most commonly precipitated by medications, insect stings, and foods. In the surgical population, 47.4% of immediate hypersensitivity reactions were precipitated by neuromuscular blocking agents, followed by latex and antibiotics in 20% and 18.1% of cases, respectively. Initial treatment consists of removing the precipitating trigger, administering epinephrine, and correct patient positioning...
October 2016: Plastic Surgical Nursing
https://www.readbyqxmd.com/read/27913744/effects-of-atorvastatin-on-adp-arachidonic-acid-collagen-and-epinephrine-induced-platelet-aggregation
#5
Lei Zhao, Demin Liu, Bin Liu, Haijuan Hu, Wei Cui
OBJECTIVE: Atorvastatin reduces the incidence of cardiovascular events. However, the effects of atorvastatin on platelet aggregation are unknown. METHODS: Blood samples were obtained from 126 healthy volunteers. Prepared isolated platelet suspensions were adjusted with saline to three different concentrations of 100 × 10(9), 300 × 10(9), and 600 × 10(9) platelets/L. Platelet samples were incubated with atorvastatin (10(-7 )mol/L, 10(-6 )mol/L or 10(-5 )mol/L), and stimulated with ADP (10 µmol/L), arachidonic acid (0...
December 2, 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/27913306/effect-of-bradykinin-receptor-antagonism-on-ace-inhibitor-associated-angioedema
#6
Brittany T Straka, Claudia E Ramirez, James B Byrd, Elizabeth Stone, Alencia Woodard-Grice, Hui Nian, Chang Yu, Aleena Banerji, Nancy J Brown
BACKGROUND: The B2 receptor antagonist icatibant is approved for treatment of attacks of hereditary angioedema. Icatibant has been reported to decrease time-to-resolution of angiotensin-converting enzyme (ACE) inhibitor-associated angioedema in one study of European patients. METHODS: Patients with ACE inhibitor-associated angioedema (defined as swelling of lips, tongue, pharynx or face during ACE inhibitor use and no swelling in the absence of ACE inhibitor use) were enrolled at Vanderbilt University Medical Center from October 2007 through September 2015 and at Massachusetts General Hospital in 2012...
November 29, 2016: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27912253/sex-and-age-differences-in-epinephrine-mechanisms-and-outcomes-after-brain-injury
#7
William M Armstead, John Riley, Monica S Vavilala
Traumatic brain injury (TBI) is the leading cause of injury related death in children, with boys and children under 4 years having particularly poor outcomes. Cerebral autoregulation is often impaired after TBI, contributing to poor outcome. Cerebral perfusion pressure can be normalized by use of vasoactive agents. The c-Jun-terminal kinase (JNK) isoform of mitogen activated protein kinase (MAPK) produces hemodynamic impairment after TBI, but less is known about its role in histopathology. We investigated whether epinephrine (EPI) age and sex dependently protected cerebral autoregulation and limited histopathology after TBI and the role of JNK in that outcome...
December 2, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27909508/arguments-to-apply-epinephrine-for-pocket-hematoma-reduction-the-maitre-study
#8
REVIEW
Nikolay Ilov Md, Nikolay Ilov Md, Anatoly Nechepurenko Md, Albert Abdulkadyrov, Damir Paskeev, Elena Damrina, Elena Kulikova, Marina Terent'eva, Dinara Stompel, Dmitry Tarasov Md
Pocket hematoma (PH) is a common complication of implantations of cardiac electrophysiological devices with occurring at a particularly high rate in patients on oral anticoagulation or antiplatelet treatment. Different pharmacological agents with hemostatic effect are used to avoid PH. We supposed that the vasoconstrictor effects of epinephrine may reduce bleeding extent and be effective in prevention of PH. Maitre is the first clinical trial conducted with an aim to show the safety and efficacy of epinephrine in PH prophylaxis...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27908910/hospital-variation-in-time-to-epinephrine-for-non-shockable-in-hospital-cardiac-arrest
#9
Rohan Khera, Paul S Chan, Michael W Donnino, Saket Girotra
BACKGROUND: -For patients with in-hospital cardiac arrests due to non-shockable rhythms, delays in epinephrine administration beyond 5 minutes is associated with worse survival. However, the extent of hospital variation in delayed epinephrine administration and its impact on hospital-level outcomes is unknown. METHODS: -Within Get with the Guidelines-Resuscitation, we identified 103,932 adult patients (≥18 years) at 548 hospitals with an in-hospital cardiac arrest due to a non-shockable rhythm who received at least 1 dose of epinephrine between 2000 to 2014...
December 1, 2016: Circulation
https://www.readbyqxmd.com/read/27905308/a-case-of-extreme-hypokalaemia
#10
L M Ten Bos, T C Veenstra, B D Westerhof, F H Bosch
Hypokalaemia is a common clinical problem. It can lead to severe disturbances in cardiac, neurological and muscle function. We present the case of a 45-year-old woman who was transported to our hospital with cardiac arrest following ventricular fibrillation. Blood sampling revealed severe acidosis (pH 7.02) and extreme hypokalaemia (0.9 mmol/l). The low serum potassium level was most likely caused by the combination of a very deficient diet and use of a thiazide diuretic. She never reported any symptoms. An acute intracellular shift of potassium due to epinephrine and perhaps also the cathecholamines in Red Bull may have further decreased the serum potassium concentration...
November 2016: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/27904951/pre-emptive-injection-of-peri-articular-multimodal-drug-for-post-operative-pain-management-in-total-knee-arthroplasty-a-double-blind-randomized-clinical-trial
#11
Mahdi Motififard, Ali Omidian, Sajad Badiei
PURPOSE: Severe post-operative pain is one of the main problems after total knee arthroplasty. In this study, we investigated the effect of a peri-articular multimodal drugs injections pre-emptively on post-operative pain control and knee functions following total knee arthroplasty. METHODS AND MATERIALS: This study was a double-blind randomized clinical trial. Eligible cases including 137 patients-aged 30 to 80 years old-were randomly divided into one of two groups: the drug group received a cocktail consisting of bupivacaine hydrochloride, morphine sulphate, epinephrine, and ketorolac...
November 30, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27904529/anti-aggregatory-effect-of-boswellic-acid-in-high-fat-fed-rats-involvement-of-redox-and-inflammatory-cascades
#12
Mona Kamal Tawfik
INTRODUCTION: A high-fat diet is one of the main dietary factors promoting platelet aggregation. The present study was conducted to elucidate the involvement of boswellic acid (BA) on the platelet hyperaggregability in HFD-fed rats. As platelet hyperaggregability in HFD rats is closely linked to inflammation and enhanced free radical production, the present study was extended to evaluate the anti-inflammatory and anti-oxidative effect of BA on HFD-promoted platelet aggregation. MATERIAL AND METHODS: Rats were assigned to normal, HFD-fed, aspirin-treated (30 mg/kg), and BA-treated (250 and 500 mg/kg) groups...
December 1, 2016: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/27896318/insulin-elevates-leptin-secretion-and-mrna-levels-via-cyclic-amp-in-3t3-l1-adipocytes-deprived-of-glucose
#13
Tomomi Tsubai, Yukihiro Noda, Kazuma Ito, Makoto Nakao, Yusuke Seino, Yutaka Oiso, Yoji Hamada
AIMS: Leptin plays an important role in the pathogenesis of obesity and diabetes, yet the regulatory mechanisms of this hormone have not been fully elucidated. In this study, we aimed to clarify the roles of insulin and glucose in leptin secretion and mRNA production using inhibitors of insulin signal transduction in adipocytes cultured under glucose-free or normal conditions. METHODS: Differentiated 3T3-L1 adipocytes were stimulated with insulin in combination with inhibitors for phosphoinositide 3-kinase (PI3K), Akt, and phosphodiesterase 3B (PDE3B), as well as epinephrine and a cyclic AMP (cAMP) analog under glucose-free or normal conditions...
November 2016: Heliyon
https://www.readbyqxmd.com/read/27893492/safety-of-local-intracutaneous-lidocaine-anesthesia-used-by-dermatologic-surgeons-for-skin-cancer-excision-and-postcancer-reconstruction-quantification-of-standard-injection-volumes-and-adverse-event-rates
#14
Murad Alam, Matthew R Schaeffer, Amelia Geisler, Emily Poon, Scott W Fosko, Divya Srivastava
BACKGROUND: Intracutaneous lidocaine is used for anesthesia in dermatologic surgery for skin cancer excision and repair with exceedingly low incidence of reported adverse events. OBJECTIVE: To measure (1) the quantity of lidocaine typically used for facial skin cancer excision and reconstruction; and (2) the frequency and character of associated adverse events. METHODS: Survey study of dermatologic surgeons with longitudinal reporting. Reported practice during 10 business days: (1) mean volume of 1% lidocaine per skin cancer excision; (2) maximum per excision; (3) mean per reconstruction; and (4) maximum per reconstruction...
December 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/27892597/a-multi-center-study-on-anaphylaxis-caused-by-peanut-tree-nuts-and-seeds-in-children-and-adolescents
#15
Kyunguk Jeong, So-Yeon Lee, Kangmo Ahn, Jihyun Kim, Hae-Ran Lee, Dong In Suh, Bok-Yang Pyun, Taek Ki Min, Ji-Won Kwon, Kyu-Earn Kim, Kyung Won Kim, Myung Hyun Sohn, Yoon Hee Kim, Tae Won Song, Jung Hyun Kwon, You Hoon Jeon, Hyung Young Kim, Jeong Hee Kim, Young Min Ahn, Sooyoung Lee
Peanut (PN) and tree nuts (TNs) are common causes of anaphylaxis in Western countries but no information is available in Korea. To feature clinical characteristics of anaphylaxis caused by PN, TNs, and seeds, a retrospective medical record review was performed in 14 university hospitals in Korea (2009-2013).One hundred and twenty-six cases were identified, with the mean age of 4.9 years. PN, walnut (WN), and pine nut accounted for 32.5%, 41.3%, and 7.1%, respectively. The median values of specific IgE (sIgE) to PN, WN and pine nut were 10...
November 28, 2016: Allergy
https://www.readbyqxmd.com/read/27891453/efficacy-of-ketamine-as-an-adjunct-to-local-anesthesia-in-the-surgical-removal-of-impacted-mandibular-third-molars-a-split-mouth-prospective-controlled-clinical-study
#16
Anand Shah, Rajshekhar Halli, Yash Merchant, Rajesh Kshirsagar, Jyotsana Khurana
INTRODUCTION: The removal of impacted teeth is one of the most common procedures performed by oral and maxillofacial surgeons. Reduction of discomfort post-operatively and efficient local anesthesia are imperative for success in surgical practice. At sub-anesthetic doses, ketamine has a noticeable analgesic action, which can be used to supplement local anesthesia with minimal side effects. AIM: To assess the efficacy of low-dose ketamine as an adjunct to local anesthesia in the management of pain, swelling and trismus after surgical removal of impacted mandibular third molars...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27890557/anaphylaxis-in-a-health-maintenance-organization-international-classification-of-diseases-coding-and-epinephrine-auto-injector-prescribing
#17
Deena Pourang, Michael Batech, Javed Sheikh, Shefali Samant, Michael Kaplan
BACKGROUND: Accurate estimates of the incidence of anaphylaxis are limited. Current International Classification of Diseases, Ninth Revision (ICD-9) codes complicate accurate diagnosis of anaphylaxis and assessment of appropriate epinephrine prescribing. OBJECTIVE: To quantify the incidence and demographic character of patients with anaphylaxis-related ICD-9 codes in a large health maintenance organization and analyze epinephrine prescribing and dispensing rates...
November 24, 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27889211/takotsubo-cardiomyopathy-associated-with-epinephrine-use-a-systematic-review-and-meta-analysis
#18
Salik Nazir, Saroj Lohani, Niranjan Tachamo, Sushil Ghimire, Dilli Ram Poudel, Anthony Donato
BACKGROUND: Takotsubo cardiomyopathy is a syndrome of transient cardiac dysfunction that is frequently associated with sudden emotional or physical stress. Epinephrine use has been implicated in precipitating Takotsubo cardiomyopathy in multiple case reports and case series. We sought to systematically review the current English literature on this association. METHODS: We searched relevant articles on Takotsubo cardiomyopathy associated with epinephrine administration and extracted data on demographic characteristics, clinical features, investigations and clinical outcomes...
November 22, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27886390/green-yellow-and-red-risk-perception-in-everyday-life-a-communication-tool
#19
A Stensgaard, A DunnGalvin, D Nielsen, M Munch, C Bindslev-Jensen
BACKGROUND: Adolescents have the highest risk for food allergy-related fatalities. Our main aim was to investigate the level of risk in everyday social situations as perceived by adolescents/young adults with peanut allergy, their families and their friends. METHODS: The web-based 'Colours Of Risks' (COR) questionnaire was completed by 70 patients (aged 12-23 years), 103 mothers and fathers, 31 siblings (aged 12-26 years), and 42 friends (aged 12-24 years). COR deals with six main contexts (home, school/university, work, visiting/social activities, special occasions/parties, and vacations), each with 1-12 items...
November 25, 2016: Allergy
https://www.readbyqxmd.com/read/27882094/the-protective-and-hemodynamic-effects-of-dexmedetomidine-on-hypertensive-cerebral-hemorrhage-patients-in-the-perioperative-period
#20
Junhui Zhao, Chuixian Zhou
The aim of the present study was to analyze the protective and hemodynamic effects of dexmedetomidine in hypertensive cerebral hemorrhage (HCH) patients during perioperative period. In total, 50 HCH patients were selected and randomly divided into two groups, one group was administered with dexmedetomidine and the other groups with midazolam. The mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO2) were monitored in the two groups of patients before and during the operation. The MAP, HR, SpO2 and PETCO2 recorded 5 min after admission into the operation room was considered T1, the same parameters recorded 10 min after drug administration were considered T2, just after starting the operation were considered T3 and 30 min after start of operation were considered T4...
November 2016: Experimental and Therapeutic Medicine
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