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https://www.readbyqxmd.com/read/28721340/post-intensive-care-syndrome-an-overview
#1
Gautam Rawal, Sankalp Yadav, Raj Kumar
Survival of critically unwell patients has improved in the last decade due to advances in critical care medicine. Some of these survivors develop cognitive, psychiatric and /or physical disability after treatment in intensive care unit (ICU), which is now recognized as post intensive care syndrome (PICS). Given the limited awareness about PICS in the medical faculty this aspect is often overlooked which may lead to reduced quality of life and cause a lot of suffering of these patients and their families. Efforts should be directed towards preventing PICS by minimizing sedation and early mobilization during ICU...
June 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28715040/-taste-dysfunction-dysgeusia-and-radioiodine-therapy-of-thyroid-cancer-be-aware-of-side-effects-by-antidepressants-and-sedatives
#2
Markus Dietlein, Alexander Drzezga
In addition to xerostomia, taste dysfunction (hypo-, dysgeusia) is an independent side effect of radioiodine therapy of thyroid cancer. Hypogeusia results from damage of the small mucous salivary glands in the vicinity of the taste buds. Particularly in those patients, who are treated with drugs such as antidepressants or sedatives, taste dysfunction becomes frequently clinically symptomatic. If feasible, therapy regimens bearing a potential risk for taste dysfunction should be switched. Additional damage to taste function should be minimalized, including cessation of smoking, change of agents for dental hygiene, and change of toothpaste...
July 17, 2017: Nuklearmedizin. Nuclear Medicine
https://www.readbyqxmd.com/read/28707846/palliative-sedation-ethical-aspects
#3
Guido Miccinesi, Augusto Caraceni, Marco Maltoni
Palliative sedation (PS), the medical act of decreasing a patient's awareness to relieve otherwise intractable suffering, is considered by some commentators to be controversial because of its consequences on residual survival and/or quality of life, and to be inappropriate for treating pure existential suffering. We will argue that PS must be always proportional, i.e. controlling refractory symptoms while keeping the loss of personal values (communication, affective relationships, care relationship) as low as possible, and that imminence of death is necessary too, from an ethical point of view, if a deep and continuous sedation (DCS) is proposed...
July 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28704639/a-sense-of-agency-an-ethnographic-exploration-of-being-awake-during-mechanical-ventilation-in-the-intensive-care-unit
#4
Eva Laerkner, Ingrid Egerod, Finn Olesen, Helle Ploug Hansen
BACKGROUND: There is a current trend towards lighter or no sedation of mechanically ventilated patients in the intensive care unit. The advantages of less sedation have been demonstrated as shorter duration of mechanical ventilation and reduced length of stay in the intensive care unit and hospital. Non-sedated patients are more awake during mechanical ventilation, but little is known about how this affects the intensive care patient. AIM: To explore patients' experiences of being awake during critical illness and mechanical ventilation in the intensive care unit...
June 30, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28662627/continuous-palliative-sedation-for-existential-distress-a-survey-of-canadian-palliative-care-physicians-views
#5
Anna Voeuk, Cheryl Nekolaichuk, Robin Fainsinger, Ann Huot
BACKGROUND: Palliative sedation can be used for refractory symptoms during end-of-life care. However, continuous palliative sedation (CPS) for existential distress remains controversial due to difficulty determining when this distress is refractory. OBJECTIVES: The aim was to determine the opinions and practices of Canadian palliative care physicians regarding CPS for existential distress. METHODS: A survey focusing on experience and views regarding CPS for existential distress was sent to 322 members of the Canadian Society of Palliative Care Physicians...
January 2017: Journal of Palliative Care
https://www.readbyqxmd.com/read/28554064/driving-under-the-influence-of-drugs-perceptions-and-attitudes-of-new-zealand-drivers
#6
Neha Malhotra, Nicola J Starkey, Samuel G Charlton
This study explored the patterns of drug driving in New Zealand by investigating 1) drivers' perceptions about impairment caused by legal and illegal drugs 2) countermeasures employed by drivers when under the influence of drugs (e.g., decisions not to drive) 3) drivers' attitudes about police enforcement of drug driving and 4) the factors that predict the likelihood of engaging in drug driving. Participants (n=434) were licensed drivers who completed an online questionnaire. Results of the questionnaire indicated that drivers rated hallucinogens and opiates as being the illegal drugs producing the highest level of driving impairment and cannabis the lowest...
May 26, 2017: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/28475406/a-survey-of-hospice-and-palliative-care-clinician-s-experiences-and-attitudes-regarding-the-use-of-palliative-sedation
#7
Samuel Maiser, Karen Estrada-Stephen, Natasha Sahr, Jonathan Gully, Sean Marks
BACKGROUND: A variety of terms and attitudes surround palliative sedation (PS) with little research devoted to hospice and palliative care (HPC) clinicians' perceptions and experiences with PS. These factors may contribute to the wide variability in the reported prevalence of PS. OBJECTIVE: This study was designed to better identify hospice and palliative care (HPC) clinician attitudes toward, and clinical experiences with palliative sedation (PS). METHODS: A 32-question survey was distributed to members of the American Academy of Hospice and Palliative Medicine (n = 4678)...
May 5, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28472777/anesthetic-dreaming-anesthesia-awareness-and-patient-satisfaction-after-deep-sedation-with-propofol-target-controlled-infusion-a-prospective-cohort-study-of-patients-undergoing-day-case-breast-surgery
#8
Marco Cascella, Roberta Fusco, Domenico Caliendo, Vincenza Granata, Domenico Carbone, Maria Rosaria Muzio, Giuseppe Laurelli, Stefano Greggi, Francesca Falcone, Cira Antonietta Forte, Arturo Cuomo
BACKGROUND: Anesthetic dreaming and anesthesia awareness are well distinct phenomena. Although the incidence of intraoperative awareness is more common among patients who reported a dream after surgery, the exact correlation between the two phenomena remains an unsolved rebus. The main purpose of this study was to investigate anesthetic dreaming, anesthesia awareness and psychological consequences eventually occurred under deep sedation. Intraoperative dreaming experiences were correlated with dream features in natural sleep...
April 19, 2017: Oncotarget
https://www.readbyqxmd.com/read/28458576/continuous-postoperative-infusion-of-remifentanil-inhibits-the-stress-responses-to-tracheal-extubation-of-patients-under-general-anesthesia
#9
Guoliang Zhao, Xiaoyue Yin, Ya Li, Jianlin Shao
PURPOSE: The study aimed to assess the combined effects of parecoxib with three different doses of remifentanil and its effect on the stress and cough responses following tracheal extubation under general anesthesia. METHODS: A total of 120 patients with American Society of Anesthesiologists (ASA) scores of I or II, undergoing selective thyroidectomy with total intravenous anesthesia (propofol-remifentanil) and tracheal intubation, were randomly allocated to be treated with an intravenous injection of parecoxib and a continuous infusion of remifentanil at 0...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28456907/bispectral-index-monitoring-in-cancer-patients-undergoing-palliative-sedation-a-preliminary-report
#10
Edith Monreal-Carrillo, Silvia Allende-Pérez, David Hui, Maria-Fernanda García-Salamanca, Eduardo Bruera, Emma Verástegui
INTRODUCTION: Continuous palliative sedation (PS) is currently titrated based on clinical observation; however, it is often unclear if patients are still aware of their suffering. The aim of this prospective study is to characterize the level of consciousness in patients undergoing PS using Bispectral Index (BIS) monitoring. PATIENTS AND METHODS: We enrolled consecutive patients with refractory symptoms requiring PS. We documented the level of sedation using Ramsay Sedation Scale (RSS) and BIS at 0, 2, 4, 6, 12, and 24 h during the first day of PS and examined their degree of association...
April 29, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28431636/systemic-air-embolism-after-endoscopy-without-vessel-injury-a-summary-of-reported-cases
#11
Peter Voigt, Stefan Schob, Sebastian Gottschling, Thomas Kahn, Alexey Surov
INTRODUCTION: Systemic air embolism (SAE) is a rare but serious complication following endoscopic procedures. It may occur with or without direct vessel injury. The aim of this work is to review cases of SAE following endoscopy without proven vessel injury. METHODS: In this systematic review PubMed database was screened for SAE following endoscopy from 1990 to 2015. Only cases without proven major vessel injury were included in the analysis. Including one case of SAE after colonoscopy from our hospital the analysis comprised 40 cases...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28342959/early-lance-adams-syndrome-after-cardiac-arrest-prevalence-time-to-return-to-awareness-and-outcome-in-a-large-cohort
#12
Irene Aicua Rapun, Jan Novy, Daria Solari, Mauro Oddo, Andrea O Rossetti
INTRODUCTION: Early myoclonus after cardiac arrest (CA) is traditionally viewed as a poor prognostic sign (status myoclonus). However, some patients may present early Lance-Adams syndrome (LAS): under appropriate treatment, they can reach a satisfactory functional outcome. Our aim was to describe their profile, focusing on pharmacologic management in the ICU, time to return of awareness, and long-term prognosis. METHODS: Adults with early LAS (defined as generalized myoclonus within 96h, with epileptiform EEG within 48h after CA) were retrospectively identified in our CA registry between 2006 and 2016...
June 2017: Resuscitation
https://www.readbyqxmd.com/read/28330787/acute-impact-of-caffeinated-alcoholic-beverages-on-cognition-a-systematic-review
#13
REVIEW
Laurence Lalanne, Pierre-Eric Lutz, François Paille
INTRODUCTION: Energy drinks are popular beverages that are supposed to counteract sleepiness, increase energy, maintain alertness and reduce symptoms of hangover. Cognitive enhancing seems to be related to many compounds such as caffeine, taurine and vitamins. Currently, users mostly combine psychostimulant effects of energy drinks to counteract sedative effects of alcohol. However, recent literature suggests that this combination conducts to feel less intoxicated but still impaired. The goal of the present article is to review cognitive impact and subjective awareness in case of caffeinated alcoholic beverage (CAB) intoxication...
March 19, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28325154/the-behavioral-profile-of-methylenedioxypyrovalerone-mdpv-and-%C3%AE-pyrrolidinopentiophenone-pvp-a-systematic-review
#14
Cornel N Stanciu, Thomas M Penders, Samantha A Gnanasegaram, Elvin Pirapakaran, Juvraj S Padda, Jeeven S Padda
BACKGROUND: New psychoactive substances are emerging at an alarming rate. With novel structures and properties they produce unique behavioral characteristics during intoxication. Synthetic cathinones are some of the most common. More and more are presenting to emergency departments due to consequences of use. Aside from isolated reports, little is known about these compounds. OBJECTIVE: Here we review literature pertaining to two common synthetic cathinones, MDPV and alphaPVP, and correlate clinically with guidance on management of intoxications...
March 21, 2017: Current Drug Abuse Reviews
https://www.readbyqxmd.com/read/28294420/chronic-urticaria-in-the-real-life-clinical-practice-setting-in-sweden-norway-and-denmark-baseline-results-from-the-non-interventional-multicentre-aware-study
#15
S F Thomsen, E C Pritzier, C D Anderson, N Vaugelade-Baust, R Dodge, A-K Dahlborn, C Vestergaard
BACKGROUND: Chronic urticaria (CU) is characterized by the recurrence of itchy hives and/or angioedema for more than 6 weeks. AWARE (A World-wide Antihistamine-Refractory Chronic Urticaria Patient Evaluation) is a multinational study designed to document the real-life treatment situation, burden of disease and clinical resource usage of H1-antihistamine-refractory CU patients. OBJECTIVE: To examine baseline data from Scandinavian AWARE patients. METHODS: AWARE is a prospective, non-interventional, multinational, umbrella design study, which includes adults (≥18 years) with a confirmed CU diagnosis (>2 months) that is refractory to H1-antihistamines...
March 10, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28260348/current-views-of-pediatric-intensive-care-unit-picu
#16
Conghai Fan, Boxiang Qi, Chao Chen
International best practice endorses the use of standardized approaches in the management of pediatric patients in the Pediatric Intensive Care Unit (PICU). There is increasing awareness of the risk of prolonged duration of mechanical ventilation as a consequence of morphine use leading to ventilator associated pneumonia (VAP), extended PICU and hospital length of stay and increased morbidity and mortality. Accordingly a fundamental outcome measure of this study was to determine whether raising awareness of these issues and the introduction of analgesia and sedation guidelines led to a reduction in the amount of analgesics and sedatives administered to PICU patients, while not exposing them to pain and distress...
March 3, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28250482/efficacy-of-intravenous-dexmedetomidine-on-patient-s-satisfaction-comfort-and-sedation-during-awake-fibre-optic-intubation-in-patients-with-cervical-spondylotic-myelopathy-posted-for-elective-cervical-fixation
#17
Saikat Niyogi, Samir Basak, Amita Acharjee, Indrani Chakraborty
BACKGROUND AND AIMS: Various anaesthetic drugs, in addition to airway block, are used for producing favourable intubation conditions during awake fibre-optic intubation (AFOI), but most of them cause respiratory depression and hypoxaemia. The aim of this study was to evaluate the efficacy of intravenous (IV) dexmedetomidine (DEX) on sedation, patient comfort and cardiovascular responses during AFOI in patients with cervical spondylotic myelopathy (CSM). METHODS: This randomised, placebo-controlled, double-blinded, prospective study was conducted on 56 adult patients with cervical spondylotic myelopathy (CSM) undergoing elective cervical fixation, who were randomly allocated into two groups - Group D and Group C...
February 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28245939/desaturation-in-procedural-sedation-for-children-with-long-bone-fractures-does-weight-status-matter
#18
Danielle G Hirsch, John Tyo, Brian H Wrotniak
INTRODUCTION: Childhood obesity remains a serious problem in the United States. Significant associated adverse incidents have been reported with sedation of children with obesity, namely hypoxemia. The objective of our study was to determine if overweight and obesity were associated with increased desaturations during procedural sedation compared with patients of healthy weight. METHODS: This was a single-center retrospective chart review of data from a three-year period of patient's age 2-17years...
February 20, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28243139/an-observational-feasibility-study-to-assess-the-safety-and-effectiveness-of-intranasal-fentanyl-for-radiofrequency-ablations-of-the-lumbar-facet-joints
#19
Michael W Bartoszek, Amy McCoart, Kyung-Soo Jason Hong, Chelsey Haley, Krista Beth Highland, Anthony R Plunkett
PURPOSE: The purpose of the present observational, feasibility study is to assess the preliminary safety and effectiveness of intranasal fentanyl for lumbar facet radiofrequency ablation procedures. PATIENTS AND METHODS: This cohort observational study included 23 adult patients. Systolic and diastolic blood pressures, heart rate, oxygen saturation percent, Pasero Opioid-Induced Sedation Scale score, and the Defense and Veterans Pain Rating Scale pain score were assessed prior to the procedure and intranasal fentanyl (100 μg) administration and every 15 minutes after administration, up to 60 minutes post administration...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28228343/ultrasound-guided-femoral-nerve-blockage-in-a-patellar-dislocation-an-effective-technique-for-emergency-physicians
#20
Sami Eksert, Sinan Akay, Murtaza Kaya, Ali Kantemir, Kenan Keklikci
BACKGROUND: Patellar dislocation is an orthopedic emergency and its reduction can be painful. The aim of this case is to show that the ultrasound-guided femoral nerve blockage can be effectively used in the pain management of patellar reduction in the emergency department (ED). CASE REPORT: A 21-year-old man was admitted to our ED after suffering a fall down a flight of stairs. The initial physical examination and plain radiography showed a patellar dislocation in the right knee...
February 19, 2017: Journal of Emergency Medicine
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