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https://www.readbyqxmd.com/read/28521032/a-neglected-cause-of-iatrogenic-brachial-plexus-injuries-in-psychiatric-patients
#1
José Fernando Guedes-Corrêa, Maristella Reis da Costa Pereira, Francisco José Lourenço Torrão-Junior, José Vicente Martins, Daniel Alves Neiva Barbosa
BACKGROUND: Psychiatric patients are often kept immobilized during hospitalization to avoid self-inflicted injuries and danger to third parties. Inadequate positioning can lead to brachial plexus injuries (BPI). OBJECTIVE: To present a series of 5 psychiatric patients with BPI after being left sedated and restrained for prolonged periods of time during hospitalization. METHODS: We retrospectively reviewed the charts of 5 psychiatric patients with iatrogenic BPI referred by other institutions to our service...
May 18, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28510664/trends-in-use-of-sedation-for-low-risk-endoscopy-looking-beyond-monitored-anesthesia-care
#2
Felix W Leung
No abstract text is available yet for this article.
May 16, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28509772/safety-of-deep-sedation-in-the-endoscopy-suite
#3
Megan L Allen
PURPOSE OF REVIEW: As the complexity of endoscopic procedures increases, the use of propofol and the desire for deep sedation are becoming more common in the endoscopy suite. This review explores sedation depth, agents used for sedation, recommended monitoring, and adverse event risks that occur during sedation for endoscopy. RECENT FINDINGS: The sedation provider for endoscopy varies by practice location and with regulatory requirements. As increasingly deep levels of sedation are used in this setting, the need for all providers to have training in the ability to rescue patients from sedation-related side effects is paramount...
May 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28506550/cardioprotective-efficacy-of-sevoflurane-vs-propofol-during-induction-and-or-maintenance-in-patients-undergoing-coronary-artery-revascularization-surgery-without-pump-a-randomized-trial
#4
J L Guerrero Orriach, M Galán Ortega, A Ramirez Fernandez, M Ramirez Aliaga, M I Moreno Cortes, D Ariza Villanueva, A Florez Vela, J Alcaide Torres, C Santiago Fernandez, E Matute Gonzalez, E Alsina Marcos, J J Escalona Belmonte, M Rubio Navarro, L Garrido Sanchez, J Cruz Mañas
PURPOSE: Pre and post-operative administration of sevoflurane in myocardial revascularization surgery provides enhanced cardioprotective effects exerted by pharmacologic pre- and post-conditioning, as compared to propofol. The identification of the enzymes involved in conditioning mechanisms is crucial to the understanding of the effects of sevoflurane in cardiac surgery patients. The impact of sevoflurane on another crucial target organ-the kidney-was also assessed. METHODS: Ninety patients undergoing off-pump myocardial revascularization surgery were allocated to receive either intra- and postoperative sevoflurane (SS), intraoperative sevoflurane and postoperative propofol (SP), or intra- and postoperative propofol (PP))...
May 3, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28505050/unsedated-in-office-transgastrostomy-esophagoscopy-tge-to-monitor-therapy-in-pediatric-esophageal-disease
#5
Caroline H T Hall, Nathalie Nguyen, Glenn T Furuta, Jeremy Prager, Emily Deboer, Robin Deterding, Calies Menard-Katcher, Kelley E Capocelli, Robert E Kramer, Joel A Friedlander
Monitoring therapy in esophageal inflammatory disorders such as eosinophilic esophagitis (EoE) and reflux esophagitis often requires frequent endoscopic evaluation. We recently reported the effective use of unsedated in office Transnasal Esophagoscopy (TNE) that significantly decreased costs and anaesthetic exposure associated with pediatric esophagoscopy in EoE. Here we report a series of pediatric patients with esophagitis with gastrostomy tubes who underwent unsedated transgastrostomy esophagoscopy (TGE) in an office setting...
May 12, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28501797/predictors-of-procedural-complications-in-adult-fontan-patients-undergoing-non-cardiac-procedures
#6
Alexander C Egbe, Arooj R Khan, Naser M Ammash, David W Barbara, William C Oliver, Sameh M Said, Emmanuel Akintoye, Carole A Warnes, Heidi M Connolly
OBJECTIVE: Limited data exist regarding the outcomes of non-cardiac procedures (NCPs) in adult patients after Fontan operations (Fontan patients). METHODS: To compare procedural outcomes after NCPs in Fontan patients with outcomes for two matched control groups: patients with repaired congenital heart disease and biventricular circulation (CHD-BiV) and patients with no heart disease (NHD). We defined cyanosis as oxygen saturation <90% and procedural hypoxia as saturation <80% or a decrease in saturation >10% from baseline...
May 13, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28501533/promising-modalities-to-identify-and-monitor-eosinophilic-esophagitis
#7
Girish Hiremath, Sandeep K Gupta
Eosinophilic esophagitis (EoE) is an allergen-mediated condition characterized by symptoms of esophageal dysfunction and histological evidence of intense eosinophilic inflammation involving the esophagus in absence of overlapping conditions such as gastroesophageal reflux disease. Since the initial description as a distinct entity about two decades ago, there has been a remarkable rise in the recognition of this clinico-pathologic entity. Current approach to diagnose and monitor EoE requires repeated esophagogastroduodenoscopies (EGDs), with associated sedation/anesthesia, to visualize mucosal abnormalities, and to obtain multiple biopsies for histologic assessment and to evaluate treatment response...
May 10, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28497615/quantification-of-rat-supraglottic-laryngeal-sensation-threshold
#8
Derrick C Gale, Neel K Bhatt, Randal C Paniello
OBJECTIVE: Laryngeal adductor response (LAR) to air puff is used as a reliable method in evaluating sensation thresholds (ST) in human laryngeal sensory disorders. This method has been difficult to perform in small subjects such as rodents. The aims of this study were to 1) evaluate ST to air puff under binocular microlaryngoscopy in rats to evaluate laryngeal sensory disorders, 2) determine sensory thresholds at varying target locations, and 3) determine the ideal depth of anesthesia...
May 11, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28489649/a-novel-computerized-test-for-detecting-and-monitoring-visual-attentional-deficits-and-delirium-in-the-icu
#9
Cameron Green, Kirsty Hendry, Elizabeth S Wilson, Timothy Walsh, Mike Allerhand, Alasdair M J MacLullich, Zoë Tieges
OBJECTIVES: Delirium in the ICU is associated with poor outcomes but is under-detected. Here we evaluated performance of a novel, graded test for objectively detecting inattention in delirium, implemented on a custom-built computerized device (Edinburgh Delirium Test Box-ICU). DESIGN: A pilot study was conducted, followed by a prospective case-control study. SETTING: Royal Infirmary of Edinburgh General ICU. PATIENTS: A pilot study was conducted in an opportunistic sample of 20 patients...
May 9, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28489614/validation-of-innovative-techniques-for-monitoring-nociception-during-general-anesthesia-a-clinical-study-using-tetanic-and-intracutaneous-electrical-stimulation
#10
Sandra Funcke, Sven Sauerlaender, Hans O Pinnschmidt, Bernd C Saugel, Kai Bremer, Daniel A Reuter, Rainer Nitzschke
BACKGROUND: This study compares the analgesic indices Analgesia Nociception Index (heart rate variability), Surgical Pleth Index (photoplethysmography), and pupillary dilatation, to heart rate, mean arterial pressure, and bispectral index, with regard to diagnostic accuracy and prediction probability for nociceptive response. The primary endpoint was the correlation between Δ values and the remifentanil dose administered. METHODS: We anesthetized 38 patients with propofol and increasing doses of remifentanil and applied standardized tetanic and intracutaneous electrical painful stimulations on each analgesic level...
May 10, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28469334/clinical-profile-of-pediatric-oncology-patients-treated-by-external-beam-radiotherapy-an-institutional-experience
#11
Virender Suhag, B S Sunita, Pankaj Vats, Arti Sarin, A K Singh, Mayuri Jain
INTRODUCTION: Pediatric tumors are a heterogeneous group of malignant conditions requiring multimodal treatment, and management of such cases is at time challenging. We present the clinical profile of pediatric cancer patients who received radiation, either alone or as adjuvant to surgery and chemotherapy; in prophylactic, radical or palliative clinical setting. AIM: This study was envisaged to review our experience of pediatric oncology cases, their clinical and morphological profile, dosage schedule of radiotherapy, and the therapy induced complications...
January 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/28459733/a-phase-1-single-center-double-blind-placebo-controlled-study-in-healthy-subjects-to-assess-the-safety-tolerability-clinical-effects-and-pharmacokinetics-pharmacodynamics-of-intravenous-cyclopropyl-methoxycarbonylmetomidate-abp-700-after-a-single-ascending
#12
Michel M R F Struys, Beatrijs I Valk, Douglas J Eleveld, Anthony R Absalom, Peter Meyer, Sascha Meier, Izaak den Daas, Thomas Chou, Kai van Amsterdam, Jason A Campagna, Steven P Sweeney
BACKGROUND: Cyclopropyl-methoxycarbonylmetomidate (ABP-700) is a new "soft" etomidate analog. The primary objectives of this first-in-human study were to describe the safety and efficacy of ABP-700 and to determine its maximum tolerated dose. Secondary objectives were to characterize the pharmacokinetics of ABP-700 and its primary metabolite (cyclopropyl-methoxycarbonyl acid), to assess the clinical effects of ABP-700, and to investigate the dose-response and pharmacokinetic/pharmacodynamic relationships...
May 1, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28458027/applicability-of-neurotrend-as-a-bedside-monitor-in-the-neuro-icu
#13
J Herta, J Koren, F Fürbass, A Zöchmeister, M Hartmann, A Hosmann, C Baumgartner, A Gruber
OBJECTIVE: To assess whether ICU caregivers can correctly read and interpret continuous EEG (cEEG) data displayed with the computer algorithm NeuroTrend (NT) with the main attention on seizure detection and determination of sedation depth. METHODS: 120 screenshots of NT (480h of cEEG) were rated by 18 briefly trained nurses and biomedical analysts. Multirater agreements (MRA) as well as interrater agreements (IRA) compared to an expert opinion (EXO) were calculated for items such as pattern type, pattern location, interruption of recording, seizure suspicion, consistency of frequency, seizure tendency and level of sedation...
June 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28456907/bispectral-index-monitoring-in-cancer-patients-undergoing-palliative-sedation-a-preliminary-report
#14
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/28452908/measurement-of-oxygen-consumption-variations-in-critically-ill-burns-patients-are-the-fick-method-and-indirect-calorimetry-interchangeable
#15
Sabri Soussi, Fabrice Vallée, Florian Roquet, Vincent Bevilacqua, Mourad Benyamina, Axelle Ferry, Alexandru Cupaciu, Maïté Chaussard, Christian De Tymowski, David Boccara, Maurice Mimoun, Marc Chaouat, James Anstey, Alexandre Mebazaa, Matthieu Legrand
OBJECTIVES: To evaluate the interchangeability of oxygen consumption variations measured with the Fick equation (ΔVO2Fick) and indirect calorimetry (ΔVO2Haldane) in critically-ill burns patients. METHODS: Prospective observational single-center study conducted in a university hospital. Twenty-two consecutive burns patients with circulatory insufficiency and hyperlactatemia (>2 mmol/l) who required a fluid challenge (FC) were included. All patients had cardiac output (CO) monitoring (transpulmonary thermodilution technique) and were ventilated and sedated...
April 27, 2017: Shock
https://www.readbyqxmd.com/read/28447490/risks-and-benefits-of-pre-operative-dexmedetomidine-in-oral-and-maxillofacial-surgeries-a-systematic-review
#16
Amin Davoudi, Bijan Movahedian Attar, Elham Shadmehr
Oral and maxillofacial surgeries might induce anxiety and pain to the patients. Sedative agents are one of the best ways for eliminating such consequences. Dexmedetomidine (DEX) is a recent sedative agent which presents higher sedative quality with greater specificity than other drugs. The aim of present paper is to evaluate the risks and benefits of administrating DEX during oral and maxillofacial surgeries by reviewing high quality released articles. Areas covered: Searches on PubMed, Scopus and Web of Science databases were completed with focus on randomized controlled trials (RCT)...
April 27, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28446017/dexmedetomidine-oral-mucosa-patch-for-sedation-suppresses-apoptosis-in-hippocampus-of-normal-rats
#17
Je Hoon Park, Il Gyu Ko, Sung Eun Kim, Jun Jang Jin, Lakkyong Hwang, Chang Ju Kim, Soo Hwan Yoon, Jongki Hong, Jun Young Chung, Deok Won Lee
PURPOSE: Dexmedetomidine, an α2-adrenergic agonist, provides sedative and analgesic effects without significant respiratory depression. Dexmedetomidine has been suggested to have an antiapoptotic effect in response to various brain insults. We developed an oral mucosa patch using dexmedetomidine for sedation. The effects of the dexmedetomidine oral mucosa patch on cell proliferation and apoptosis in the hippocampus were evaluated. METHODS: A hydrogel oral mucosa patch was adhered onto the oral cavity of physiologically normal rats, and was attached for 2 hours, 6 hours, 12 hours, or 24 hours...
April 2017: International Neurourology Journal
https://www.readbyqxmd.com/read/28441273/case-report-of-physiologic-phenibut-dependence-treated-with-a-phenobarbital-taper-in-a-patient-being-treated-with-buprenorphine
#18
Emily Brunner, Robert Levy
: This case report describes the development of dependence to phenibut, a gamma-aminobutyric acid-receptor type B agonist, in a patient concurrently being treated with buprenorphine. The patient experienced withdrawal symptoms which were successfully treated with a phenobarbital taper based on a protocol to treat sedative use disorder. This case report provided an example of the development of a phenibut use disorder and also brought up a public health question of whether phenibut should therefore be officially classified and monitored...
April 24, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28441236/the-new-mirus-system-for-short-term-sedation-in-postsurgical-icu-patients
#19
Stefano Romagnoli, Cosimo Chelazzi, Gianluca Villa, Giovanni Zagli, Francesco Benvenuti, Paola Mancinelli, Giulio Arcangeli, Stefano Dugheri, Alessandro Bonari, Lorenzo Tofani, Andrea Belardinelli, A Raffaele De Gaudio
OBJECTIVES: To evaluate the feasibility and safety of the MIRUS system (Pall International, Sarl, Fribourg, Switzerland) for sedation with sevoflurane for postsurgical ICU patients and to evaluate atmospheric pollution during sedation. DESIGN: Prospective interventional study. SETTING: Surgical ICU. February 2016 to December 2016. PATIENTS: Postsurgical patients requiring ICU admission, mechanical ventilation, and sedation...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28441231/patient-specific-classification-of-icu-sedation-levels-from-heart-rate-variability
#20
Sunil B Nagaraj, Siddharth Biswal, Emily J Boyle, David W Zhou, Lauren M McClain, Ednan K Bajwa, Sadeq A Quraishi, Akeju Oluwaseun, Riccardo Barbieri, Patrick L Purdon, M Brandon Westover
OBJECTIVE: To develop a personalizable algorithm to discriminate between sedation levels in ICU patients based on heart rate variability. DESIGN: Multicenter, pilot study. SETTING: Several ICUs at Massachusetts General Hospital, Boston, MA. PATIENTS: We gathered 21,912 hours of routine electrocardiogram recordings from a heterogenous group of 70 adult ICU patients. All patients included in the study were mechanically ventilated and were receiving sedatives...
April 22, 2017: Critical Care Medicine
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