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Sedation awareness

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https://www.readbyqxmd.com/read/28913911/older-adults-awareness-of-deprescribing-a-population-based-survey
#1
Justin P Turner, Cara Tannenbaum
OBJECTIVES: To determine older adults' awareness of the concept of medication-induced harm and their familiarity with the term "deprescribing." Secondary objectives were to ascertain determinants of self-initiated deprescribing conversations and to identify how older adults seek information on medication harms. DESIGN: Cross-sectional population-based household telephone survey using random-digit dialling. SETTING: Canada. PARTICIPANTS: Community-dwelling adults aged 65 and older (N = 2,665; n = 898 men, n = 1,767 women, mean age 74...
September 15, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28879336/the-use-of-general-anesthesia-to-facilitate-dental-treatment-in-adult-patients-with-special-needs
#2
REVIEW
Mathew Albert Wei Ting Lim, Gelsomina Lucia Borromeo
General anesthesia is commonly used to facilitate dental treatment in patients with anxiety or challenging behavior, many of whom are children or patients with special needs. When performing procedures under general anesthesia, dental surgeons must perform a thorough pre-operative assessment, as well as ensure that the patients are aware of the potential risks and that informed consent has been obtained. Such precautions ensure optimal patient management and reduce the frequency of morbidities associated with this form of sedation...
June 2017: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28852812/pediatric-providers-and-radiology-examinations-knowledge-and-comfort-levels-regarding-ionizing-radiation-and-potential-complications-of-imaging
#3
Benjamin Wildman-Tobriner, Victoria M Parente, Charles M Maxfield
BACKGROUND: Pediatric providers should understand the basic risks of the diagnostic imaging tests they order and comfortably discuss those risks with parents. Appreciating providers' level of understanding is important to guide discussions and enhance relationships between radiologists and pediatric referrers. OBJECTIVE: To assess pediatric provider knowledge of diagnostic imaging modalities that use ionizing radiation and to understand provider concerns about risks of imaging...
August 29, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28845957/sleep-disorders-sleep-related-breathing-disorders
#4
Deepa Burman
Sleep-related breathing disorders or sleep-disordered breathing are characterized by abnormal respiration during sleep. They are grouped into obstructive sleep apnea (OSA), central sleep apnea, sleep-related hypoventilation, and sleep-related hypoxemia disorder. OSA is a common disorder encountered in the family medicine setting that is increasingly being recognized because of the obesity epidemic and greater public and physician awareness. OSA is characterized by recurrent episodes of partial or complete closure of the upper airway resulting in disturbed breathing during sleep...
September 2017: FP Essentials
https://www.readbyqxmd.com/read/28828366/sedation-and-neuromuscular-blocking-agents-in-acute-respiratory-distress-syndrome
#5
REVIEW
Jeremy Bourenne, Sami Hraiech, Antoine Roch, Marc Gainnier, Laurent Papazian, Jean-Marie Forel
Mechanical ventilation (MV) is the cornerstone of acute respiratory distress syndrome (ARDS) management. The use of protective ventilation is a priority in this acute phase of lung inflammation. Neuromuscular blocking agents (NMBAs) induce reversible muscle paralysis. Their use in patients with ARDS remains controversial but occurs frequently. NMBAs are used in 25-45% of ARDS patients for a mean period of 1±2 days. The main indications of NMBAs are hypoxemia and facilitation of MV. For ethical reasons, NMBA use is inseparable from sedation in the management of early ARDS...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28791566/effects-of-antidepressants-on-sleep
#6
REVIEW
Adam Wichniak, Aleksandra Wierzbicka, Małgorzata Walęcka, Wojciech Jernajczyk
PURPOSE OF REVIEW: The aim of this review article was to summarize recent publications on effects of antidepressants on sleep and to show that these effects not only depend on the kind of antidepressant drugs but are also related to the dose, the time of drug administration, and the duration of the treatment. RECENT FINDINGS: Complaints of disrupted sleep are very common in patients suffering from depression, and they are listed among diagnostic criteria for this disorder...
August 9, 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/28753704/-sleep-apnea-and-mechanical-ventilation-impact-on-clinical-course-and-perioperative-management
#7
S Keymel, S Krüger, S Steiner
There is a high prevalence of sleep related breathing disorders in critical ill patients and in perioperative settings. Nevertheless, less is known about their impact on clinical course and therapeutic strategies in this context. Intensive care physicians should be aware of difficult airway, weaning- and post-extubation failure and negative impact of SRBD on hemodynamics. Sedatives and analgetics might worsen SRBD and their use should be restricted as far as possible, furthermore the use of NIV might be beneficial...
July 28, 2017: Pneumologie
https://www.readbyqxmd.com/read/28748395/variation-in-caries-treatment-proposals-among-dentists-in-norway-the-best-interest-of-the-child
#8
A Rønneberg, A B Skaare, B Hofmann, I Espelid
AIM: To explore variation in treatment-related-decisions for severe caries in children among dentists in the Public Dental Service (PDS) in Norway. It was also to evaluate the treatment choices in relation to the best interest of children and a child's rights to enjoy the highest standard of health care. METHODS: A pre-coded questionnaire was sent electronically to all general dental practitioners (GDPs) working in the PDS in eight counties in Norway (n = 611)...
July 26, 2017: European Archives of Paediatric Dentistry: Official Journal of the European Academy of Paediatric Dentistry
https://www.readbyqxmd.com/read/28743752/thalamocortical-synchronization-during-induction-and-emergence-from-propofol-induced-unconsciousness
#9
Francisco J Flores, Katharine E Hartnack, Amanda B Fath, Seong-Eun Kim, Matthew A Wilson, Emery N Brown, Patrick L Purdon
General anesthesia (GA) is a reversible drug-induced state of altered arousal required for more than 60,000 surgical procedures each day in the United States alone. Sedation and unconsciousness under GA are associated with stereotyped electrophysiological oscillations that are thought to reflect profound disruptions of activity in neuronal circuits that mediate awareness and cognition. Computational models make specific predictions about the role of the cortex and thalamus in these oscillations. In this paper, we provide in vivo evidence in rats that alpha oscillations (10-15 Hz) induced by the commonly used anesthetic drug propofol are synchronized between the thalamus and the medial prefrontal cortex...
August 8, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28728537/super-selective-coil-embolization-of-a-basilar-perforator-artery-aneurysm-previously-treated-by-the-stent-in-stent-technique-using-an-extremely-soft-bare-coil-delivered-through-a-one-marker-microcatheter
#10
Yves Chau, Marina Sachet, Jacques Sédat
Background Aneurysms of the perforating arteries arising from the basilar artery trunk are rare and represent a therapeutic challenge. Methods A basilar perforator aneurysm was initially treated by the stent-in-stent technique. Enlargement of the aneurysm was seen on follow up and the sac was secondarily coiled using two extremely soft bare coils, delivered through a one-marker microcatheter. Results At 6 months, the patient had a modified Rankin Scale score of 0 and cerebral arteriography demonstrated complete occlusion of the lesion...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28721340/post-intensive-care-syndrome-an-overview
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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