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https://www.readbyqxmd.com/read/29223669/experimental-use-of-new-absorbable-tracheal-stent
#1
Luciano F Schopf, José Carlos Fraga, Rodrigo Porto, Luis A Santos, Douglas R Marques, Paulo R Sanchez, Fabíola S Meyer, Jane M Ulbrich
BACKGROUND/PURPOSE: Silicone and metallic stents are not effective in children with tracheobronchial stenosis or tracheomalacia. Herein, we aimed to evaluate the clinical manifestations and histological reaction of rabbit trachea to the presence of a new poly(lactic-co-glycolic acid) with polyisoprene (PLGA/PI) polymer absorbable stent. METHODS: Fourteen adult white rabbits (weight, 3.0-3.5kg) were randomly assigned to three groups: Group I (n=6): PLGA/PI spiral stent; Group II (n=6): PLGA/PI fragment; and Group III (n=2): controls...
November 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29181331/effect-of-intravenous-acetaminophen-on-postoperative-pain-in-vitrectomy-a-randomized-double-blind-clinical-trial
#2
Seyed Hossein Sadrolsadat, Fardin Yousefshahi, Abbas Ostadalipour, Fatemeh Zahra Mohammadi, Jalil Makarem
Background: Nowadays, pain, nausea, and vomiting are regarded as important complications of anesthesia and surgery. The current study aimed at assessing the effect of preemptive intravenous acetaminophen on control of pain, nausea, vomiting, shivering, and drowsiness following the general anesthesia for retina and/or vitrectomy surgeries. Methods: In a randomized, double-blind, clinical trial, 83 candidates for retina or vitrectomy eye surgery under general anesthesia were distributed into 3 groups: A) 41 patients in the control group who received 100 mL of normal saline just before the surgery and 100 mL of normal saline 20 minutes before the end of surgery; B) 21 patients in the preemptive group who received acetaminophen 15 mg/kg in 100 mL normal saline just before the surgery and 100 mL normal saline 20 minutes before the end of surgery; C) 21 patients in the preventive group who received 100 mL normal saline just before the surgery and acetaminophen 15 mg/kg in 100 mL normal saline 20 minutes before the end of surgery...
June 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29167217/5-fu-induced-leukoencephalopathy-with-reversible-lesion-of-splenium-of-corpus-callosum-in-a-patient-with-colorectal-cancer
#3
Gyanendra Acharya, Maria T Cruz Carreras, Terry Wynne Rice
5-Fluorouracil (5-FU), a commonly used antimetabolite and antineoplastic agent, has been approved for treatment of various cancers. Neurotoxicities are considered extremely rare side effects of 5-FU. We present a case of 5-FU-induced encephalopathy with diffusion-restricted reversible lesion of the splenium of the corpus callosum in a patient with colorectal cancer. The patient presented with confusion, dysarthria and agitation after 5-FU infusion. The prognosis of this toxic effects of 5-FU is usually good if recognised and treated in time...
November 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29166854/a-single-dose-of-dezocine-suppresses-emergence-agitation-in-preschool-children-anesthetized-with-sevoflurane-remifentanil
#4
Li-Jun An, Yang Zhang, Zheng Su, Xian-Long Zhang, Hai-Lin Liu, Zhi-Jie Zhang, Jian-Lin Hu, Shi-Tong Li
BACKGROUND: Emergence agitation (EA) is a common phenomenon in preschool children during emergence from general anesthesia. This study evaluated the safety and efficacy of dezocine for emergence agitation in preschool children anesthetized with sevoflurane-remifentanil. METHODS: A total of 100 preschool children, scheduled for elective laparoscopic repair of an inguinal hernia by high ligation of the hernia sac under sevoflurane-remifentanil anesthesia were randomized into two groups: Group C (n = 50) received Ringer's lactate 10 mL and Group D received Ringer's lactate 10 mL containing dezocine 0...
November 22, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29153907/-violent-outburst-from-teenagers-in-the-pediatric-emergency-room-complex-cases
#5
L Cohen, C Gras-Le Guenb, J Fleury, E Caldagues, L Dreno, G Picherot, N Vabres
INTRODUCTION: Teenagers admitted to the emergency room for a violent attacks episode are increasingly numerous. The source of agitation is multifactorial for these teenagers, often with a complex course. They jeopardize hospital wards, which are often ill-suited for and overwhelmed during these outbursts. This study aims to identify and describe all the teenagers admitted to the hospital over 1 year for a violent outburst and discuss their management. METHODS AND EQUIPMENT: Retrospective and descriptive study of teenagers admitted to the pediatric emergency department of the Nantes University Hospital for a violent outburst in 2015...
November 16, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29151095/violent-behavior
#6
Sophia Sopromadze, Alexander Tsiskaridze
Violence is a significant public health problem representing one of the leading causes of death worldwide for people aged 15-44 years. Although violence and aggression are more frequent in adolescence and early adult life and decline with advancing age, these conditions can still develop for the first time in old age especially in association with organic brain disorder. Rates of violent death vary according to country income levels and are twice as higher in low- to middle-income countries than in high-income countries...
2018: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/29136301/ketamine-for-the-acute-management-of-excited-delirium-and-agitation-in-the-prehospital-setting
#7
Kyle A Weant, Lauren M Linder, Clint A Ross
BACKGROUND: Traditional first-line therapy in the prehospital setting for the acutely agitated patient includes an antipsychotic in combination with a benzodiazepine. Recently, interest has grown regarding the use of ketamine in the prehospital setting as an attempt to overcome the limitations of the traditional medications and provide a more safe and effective therapy. This review provides an overview of the pharmacology of ketamine, evaluates the literature regarding ketamine use for prehospital agitation, and proposes an algorithm that may be used within the prehospital setting...
November 14, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29079068/safety-of-risperidone-for-acute-agitation-and-alcohol-intoxication-in-emergency-department-patients
#8
Patricia A Pepa, Kelly C Lee, Hien E Huynh, Michael P Wilson
BACKGROUND: Acute agitation in the setting of alcohol intoxication is commonly encountered in the Emergency Department (ED). In this setting, expert consensus guidelines recommend haloperidol over second-generation antipsychotics due to their limited safety data in alcohol intoxication. OBJECTIVE: The primary objective was to compare vital sign changes prior to and after risperidone administration between ED patients presenting with alcohol intoxication [ETOH (+)] and without alcohol intoxication [ETOH (-)]...
October 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29076979/the-impact-of-intraoperative-magnetic-resonance-imaging-on-patient-safety-management-during-awake-craniotomy
#9
Kotoe Kamata, Takashi Maruyama, Hiroshi Iseki, Minoru Nomura, Yoshihiro Muragaki, Makoto Ozaki
BACKGROUND: Awake craniotomy paired with intraoperative magnetic resonance imaging (iMRI) is now the established technique for maximizing surgical resection, while preserving neurological function. However, leaving an unsecured airway patient in the iMRI gantry represents considerable risk. Our study aimed at identifying the incidence of critical adverse events in unsecured airway patients during iMRI as part of awake craniotomy. MATERIALS AND METHODS: We conducted a clinical chart review of consecutive awake craniotomies performed between November 1999 and December 2015...
October 25, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29072524/acute-side-effects-after-consumption-of-the-new-synthetic-cannabinoids-ab-chminaca-and-mdmb-chmica
#10
Maren Hermanns-Clausen, Dieter Müller, Josephine Kithinji, Verena Angerer, Florian Franz, Florian Eyer, Hartmud Neurath, Gesine Liebetrau, Volker Auwärter
INTRODUCTION: In 2014, the "European Monitoring Centre for Drugs and Drug Addiction" (EMCDDA) reported on 30 novel synthetic cannabinoids (SCs). Among these were indole- and indazole-based valine derivatives with a cyclohexylmethyl side chain (e.g., AB-CHMINACA and MDMB-CHMICA), which represent a new class of SCs. METHODS: A prospective observational study of patients treated in emergency departments (EDs) after the intake of SCs was conducted. Clinical and laboratory data were combined and reported to a poison control centre...
October 26, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29065540/activation-of-alkaline-irrigation-fluids-in-endodontics
#11
REVIEW
Laurence J Walsh, Roy George
In conventional endodontic treatment, alkaline solutions of sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) are used in combination to disinfect the root canal system and to eliminate debris and smear layers. An important concept that has emerged over recent years is the use of active physical methods for agitating these fluids to improve their penetration within areas that are not reached by endodontic instruments and to accelerate the chemical actions of these alkaline fluids against planktonic microorganisms, biofilms, soft tissue remnants and smear layers...
October 23, 2017: Materials
https://www.readbyqxmd.com/read/29064946/synthetic-cannabinoids-a-review-of-the-clinical-implications-of-a-new-drug-of-choice
#12
Shaina A Freund, Adrian S Banning
Synthetic marijuana use is an emerging public health problem in the United States, and can cause agitation, severe psychosis, bizarre hallucinations, and possibly death. This article describes these products, which are unregulated and can vary widely in composition, and how clinicians can recognize patients with synthetic cannabinoid toxicity and treat them appropriately to minimize morbidity and mortality.
November 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/29063228/safety-and-feasibility-of-a-ketamine-package-to-support-emergency-and-essential-surgery-in-kenya-when-no-anesthetist-is-available-an-analysis-of-1216-consecutive-operative-procedures
#13
Thomas F Burke, Sebastian Suarez, Daniel I Sessler, Ayla Senay, Taha Yusufali, Charles Masaki, Moytrayee Guha, Debora Rogo, Pankaj Jani, Brett D Nelson, Khama Rogo
BACKGROUND: Lack of access to emergency and essential surgery is widespread in low- and middle-income countries. Scarce anesthesia services contribute to this unmet need. The aim of this study was to evaluate the safety and feasibility of the Every Second Matters for Emergency and Essential Surgery-Ketamine (ESM-Ketamine) package for emergency and essential procedures when no anesthetist was available. METHODS: From November 2013 to September 2017, the ESM-Ketamine package was used for patients requiring emergency or life-improving surgeries in fifteen selected facilities across Kenya when no anesthetist was available...
December 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29051871/bilateral-divergent-shoulder-s-fracture-dislocation-case-in-an-ischemic-stroke-patient
#14
Atchi Walla, Faré Gnandi-Piou, Pilakimwé Egbohou, Komi Assogba, Mawuko Quacoe
INTRODUCTION: The literature review revealed that nowadays only about 15 cases of bilateral shoulder dislocation associated with the fracture of the upper end of the humerus have been published. The triad of lesional mechanism designated by the triple syndrome E composed of epilepsy, electrocution, and external trauma was the circumstances noted in which these fractures dislocations occur with migration of the two humeral heads either forward or backward. CASE REPORT: An architect of 36-year-old, right-handed, was admitted in emergency department for loss of knowledge of progressive installation...
May 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29045249/inhaled-loxapine-for-agitation-in-intoxicated-patients-a-case-series
#15
Carlos Roncero, Elena Ros-Cucurull, Raúl Felipe Palma-Álvarez, Alfonso Carlos Abad, Christian Fadeuilhe, Miquel Casas, Lara Grau-López
OBJECTIVES: Episodes of agitation are frequent in intoxicated patients who have a substance use disorder, a psychiatric disorder or both (dual diagnosis). For managing the agitation, it is necessary to act promptly in a safe environment and addressing any underlying etiology. Inhaled loxapine improves symptoms of agitation in adults with psychiatric disorders (eg, schizophrenia) within 10 minutes of administration. Recently, some reports have documented the usefulness of loxapine in dual diagnoses patients with agitation...
November 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/29038156/human-toxicity-caused-by-indole-and-indazole-carboxylate-synthetic-cannabinoid-receptor-agonists-from-horizon-scanning-to-notification
#16
Simon L Hill, Michael Dunn, Céline Cano, Suzannah J Harnor, Ian R Hardcastle, Johann Grundlingh, Paul I Dargan, David M Wood, Simon Tucker, Thomas Bartram, Simon H L Thomas
BACKGROUND: The emergence of novel psychoactive substances (NPS), particularly synthetic cannabinoid receptor agonists (SCRA), has involved hundreds of potentially harmful chemicals in a highly dynamic international market challenging users', clinicians', and regulators' understanding of what circulating substances are causing harm. We describe a toxicovigilance system for NPS that predicted the UK emergence and identified the clinical toxicity caused by novel indole and indazole carboxylate SCRA...
October 16, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/29037744/intoxication-from-the-novel-synthetic-cannabinoids-ab-pinaca-and-adb-pinaca-a-case-series-and-review-of-the-literature
#17
REVIEW
Patil Armenian, Michael Darracq, Jirair Gevorkyan, Shane Clark, Bryan Kaye, Nicklaus P Brandehoff
Synthetic cannabinoids (SC), are a novel class of designer drugs which emerged as a drug of abuse in the late 2000's. We report a case series of 6 patients who may have smoked a synthetic cannabinoid product in a remote wilderness setting. They presented with varying degrees of altered mental status, agitation, and seizures. Two were confirmed to have AB-PINACA, ADB-PINACA and their respective pentanoic acid metabolites in biological specimens via liquid chromatography time-of-flight mass spectrometry (LC-TOF/MS)...
October 14, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/29033344/a-prospective-study-of-ketamine-as-primary-therapy-for-prehospital-profound-agitation
#18
Jon B Cole, Lauren R Klein, Paul C Nystrom, Johanna C Moore, Brian E Driver, Brandon J Fryza, Justin Harrington, Jeffrey D Ho
OBJECTIVE: We investigated the effectiveness of ketamine as a primary therapy for prehospital profound agitation. METHODS: This was a prospective observational study of patients receiving 5mg/kg of intramuscular ketamine for profound agitation, defined as a score of +4 on the Altered Mental Status Scale (AMSS), a validated ordinal scale of agitation from -4 (unresponsive) to +4 (most agitated). The primary outcome was time to adequate sedation (AMSS<+1). Secondary outcomes included need for additional sedatives, intubation frequency, complications associated with ketamine, and mortality...
October 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29020936/staggering-the-dose-of-sugammadex-lowers-risks-for-severe-emergence-cough-a-randomized-control-trial
#19
Loh P S, M M Miskan, Chin Y Z, R A Zaki
BACKGROUND: Cough on emergence has been reported as a common adverse reaction with sugammadex reversal. We investigated if staggering the dose of sugammadex will reduce emergence cough in a single-center, randomized, double-blinded study. METHODS: A hundred and twenty ASA 1-3 adults were randomly reversed with 1 mg/kg sugammadex prior to extubation followed by another 1 mg/kg immediately after extubation (staggered group), single dose of 2 mg/kg sugammadex (single bolus group) or neostigmine 0...
October 11, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28993347/interrupted-aortic-arch-complicated-with-takotsubo-cardiomyopathy-mimicking-aortic-dissection
#20
Farhala Mari Baloch, Javed Majid Tai, Aamir Hameed Khan, Abdul Baqi
A 50-year-old man presented to the emergency department with interscapular pain, diaphoresis and restlessness. Initial examination raised the possibility of aortic dissection; however, the CT scan did not concur with the diagnosis. An ECG showed ST segment elevation in leads V1-V6 and echocardiography showed severe left ventricular systolic dysfunction. Coronary angiography through the right femoral artery was attempted but the diagnostic catheter could not be advanced to the ascending aorta. Radiocontrast injection showed complete obstruction of the descending aorta...
October 9, 2017: BMJ Case Reports
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