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https://www.readbyqxmd.com/read/29051871/bilateral-divergent-shoulder-s-fracture-dislocation-case-in-an-ischemic-stroke-patient
#1
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
#2
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...
October 18, 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
#3
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
#4
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 13, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/29033344/a-prospective-study-of-ketamine-as-primary-therapy-for-prehospital-profound-agitation
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/28987309/risperidone-in-the-emergency-setting-is-associated-with-more-hypotension-in-elderly-patients
#8
Michael P Wilson, Kimberly Nordstrom, Austin Hopper, Austin Porter, Edward M Castillo, Gary M Vilke
BACKGROUND: Expert consensus panels have recommended risperidone as first-line treatment for agitation of psychiatric origin. However, there are few if any studies on this medication in the emergency setting. OBJECTIVES: To assess the hemodynamic effects of risperidone in an emergency department (ED) setting, stratified by age. METHODS: This is a structured chart review of all patients who received oral risperidone over a 6-year period in an ED setting, excluding patients who received this medication as a prescription refill...
October 5, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28987298/palliative-care-symptom-management-in-the-emergency-department-the-abc-s-of-symptom-management-for-the-emergency-physician
#9
Mari Siegel, Suzanne Bigelow
BACKGROUND: Palliative care is a rapidly evolving area of emergency medicine. With an estimated 5,000 to 10,000 baby boomers per day reaching retirement age, emergency departments (EDs) are treating more patients with chronic and serious disease. Palliative care offers comprehensive care for patients with advanced medical illness, aims to alleviate suffering and improve quality of life, and plays an important role in caring for these patients in the ED. OBJECTIVES: We sought to increase the emergency physician's knowledge of and comfort with symptom control in palliative and hospice patients...
October 5, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28949804/can-dexmedetomidine-influence-recovery-profiles-from-general-anesthesia-in-nasal-surgery
#10
Ho Seok Lee, Ho Young Yoon, Ho Jun Jin, Se Hwan Hwang
Objectives Dexmedetomidine has sympatholytic, sedative, anesthetic, and analgesic effects, as well as vasoconstrictive effects, which may help prevent hypotension under general anesthesia. This meta-analysis aimed to perform a systematic review of the literature and investigate the effect of dexmedetomidine on perioperative morbidity following nasal surgery and its adverse effects. Data Sources MEDLINE, SCOPUS, and the Cochrane database. Review Methods Two authors independently searched the databases from their inception to March 2017...
September 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28947165/efficacy-of-activities-of-daily-living-retraining-during-posttraumatic-amnesia-a-randomised-controlled-trial
#11
Jessica Trevena-Peters, Adam McKay, Gershon Spitz, Rachel Suda, Belinda Renison, Jennie Ponsford
OBJECTIVE: To assess the efficacy of Activities of Daily Living (ADL) retraining during posttraumatic amnesia (PTA), compared with ADL retraining commencing after emergence from PTA. DESIGN: Randomised controlled trial. SETTING: Inpatient rehabilitation centre. PARTICIPANTS: 104 participants with severe TBI, admitted to rehabilitation and remaining in PTA for > 7 days, were randomised to receive either treatment as usual (TAU) with daily ADL retraining (Treatment), or TAU alone (physiotherapy, necessary speech therapy), during PTA...
September 22, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28944102/sex-differences-in-suicide-related-symptoms-in-a-large-military-sample
#12
Megan L Rogers, Fallon B Ringer, Matthew S Michaels, Bruno Chiurliza, Christopher R Hagan, Carol Chu, Matthew E Schneider, Ingrid C Lim, Thomas E Joiner
Little research has focused on suicide-related symptoms in female servicemembers, despite high rates of suicidal behaviors. This study examined sex differences in suicide-related risk factors in 3,374 U.S. Army Recruiters (91.9% male). Female servicemembers had a greater number of past major depressive and suicidal ideation episodes than males; there were no differences in suicide attempt histories or mental health visits. Females reported significantly fewer symptoms of current suicidal ideation, perceived burdensomeness, and acquired capability...
2017: Military Behavioral Health
https://www.readbyqxmd.com/read/28942181/novel-adverse-events-of-vortioxetine-a-disproportionality-analysis-in-usfda-adverse-event-reporting-system-database
#13
Viswam Subeesh, Hemendra Singh, Eswaran Maheswari, Elsa Beulah
BACKGROUND: Signal detection is one of the most advanced and emerging field in pharmacovigilance. It is a modern method of detecting new reaction (which can be desired or undesired) of a drug. It facilitates early adverse drug reaction detection which enables health professionals to identify adverse events that may not have been identified in pre-marketing clinical trials. Vortioxetine, the first mixed serotonergic antidepressant was initially approved by the US Food and Drug Administration (USFDA) on September 30, 2013 for the treatment of adults with Major Depressive Disorder (MDD)...
September 14, 2017: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/28927394/laboratory-markers-of-cardiac-and-metabolic-complications-after-generalized-tonic-clonic-seizures
#14
Robert D Nass, Sina Meiling, René P Andrié, Christian E Elger, Rainer Surges
BACKGROUND: Generalized tonic-clonic seizures (GTCS) frequently lead to emergency inpatient referrals. Laboratory blood values are routinely performed on admission to detect underlying causes and metabolic or cardiac complications. Our goal was to assess the nature and frequency of complications occurring in association with GTCS. METHODS: We retrospectively extracted data from emergency protocols and discharge letters of adult patients admitted to the Department of Epileptology between 01/2010 and 06/2015...
September 19, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28922625/living-and-dying-with-advanced-dementia-a-prospective-cohort-study-of-symptoms-service-use-and-care-at-the-end-of-life
#15
Elizabeth L Sampson, Bridget Candy, Sarah Davis, Anna Buylova Gola, Jane Harrington, Michael King, Nuriye Kupeli, Gerry Leavey, Kirsten Moore, Irwin Nazareth, Rumana Z Omar, Victoria Vickerstaff, Louise Jones
BACKGROUND: Increasing number of people are dying with advanced dementia. Comfort and quality of life are key goals of care. AIMS: To describe (1) physical and psychological symptoms, (2) health and social care service utilisation and (3) care at end of life in people with advanced dementia. DESIGN: 9-month prospective cohort study. SETTING AND PARTICIPANTS: Greater London, England, people with advanced dementia (Functional Assessment Staging Scale 6e and above) from 14 nursing homes or their own homes...
August 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28911339/emerging-treatments-for-the-behavioral-and-psychological-symptoms-of-dementia
#16
Abhinav Anand, Puneet Khurana, Jasneet Chawla, Neha Sharma, Navneet Khurana
Dementia is referred to a loss of memory and decline in other mental abilities at levels critical enough to hinder performance of daily activities. It can be of several types, depending on the underlying pathophysiology. The behavioral and psychological symptoms of dementia (BPSD) are various, but the most clinically significant are depression, apathy, and anxiety. Other BPSD include agitation, aberrant motor behavior, elation, hallucinations, and alterations in sleep and appetite. About 90% of sufferers of dementia are affected by BPSD during the course of the illness...
September 15, 2017: CNS Spectrums
https://www.readbyqxmd.com/read/28895757/intoxications-in-the-strida-project-involving-a-panorama-of-psychostimulant-pyrovalerone-derivatives-mdpv-copycats
#17
Olof Beck, Matilda Bäckberg, Patrick Signell, Anders Helander
CONTEXT: An increasing number of new psychoactive substances (NPS) of different chemical classes have become available through marketing and sale over the Internet. This report from the Swedish STRIDA project presents the prevalence, laboratory results, and clinical features in intoxications involving 11 stimulant pyrovalerone NPS derivatives over a 5-year period. STUDY DESIGN: Case series of consecutive patients with admitted or suspected intake of NPS presenting to Swedish hospitals for emergency treatment from January 2011 to March 2016...
September 12, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28895149/efficacy-of-dexmedetomidine-for-perioperative-morbidities-in-pediatric-tonsillectomy-a-metaanalysis
#18
REVIEW
Hye Kyung Cho, Ho Young Yoon, Ho Jun Jin, Se Hwan Hwang
OBJECTIVES: This study aimed to assess the effects of perioperative dexmedetomidine as an adjuvant to tonsillectomy compared with opioid or sham in children. DATA SOURCE: Five databases (PubMed, SCOPUS, Embase, Web of Science, and Cochrane Central Register of Controlled Trials) were searched from inception of article collections to April 2017. REVIEW METHODS: Prospective, randomized controlled studies that compared outcomes between children who underwent tonsillectomy plus dexmedetomidine administration (intervention) and children who underwent tonsillectomy with placebo or opioid (control) were systemically and independently reviewed by two researchers...
September 12, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28879324/cause-analysis-prevention-and-treatment-of-postoperative-restlessness-after-general-anesthesia-in-children-with-cleft-palate
#19
REVIEW
Hao Xu, Xiao-Peng Mei, Li-Xian Xu
Cleft palate is one of the most common congenital malformations of the oral and maxillofacial region, with an incidence rate of around 0.1%. Early surgical repair is the only method for treatment of a cleft lip and palate. However, because of the use of inhalation anesthesia in children and the physiological characteristics of the cleft palate itself combined with the particularities of cleft palate surgery, the incidence rate of postoperative emergence agitation (EA) in cleft palate surgery is significantly higher than in other types of interventions...
March 2017: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28876970/responding-to-ten-common-delirium-misconceptions-with-best-evidence-an-educational-review-for-clinicians
#20
Mark A Oldham, Nina M Flanagan, Ariba Khan, Olga Boukrina, Edward R Marcantonio
Delirium (acute confusion) is a serious, common health condition, and it predicts poor outcomes, including greater rates of mortality, institutionalization, prolonged hospitalization, and cognitive impairment. Expedient diagnosis and management are critical to address modifiable delirium causes and improve both quality of care and outcomes. Moreover, more than a third of delirium is preventable. Despite the clear significance of delirium and our increasingly sophisticated understanding of the condition, the gap between evidence and practice persists...
September 6, 2017: Journal of Neuropsychiatry and Clinical Neurosciences
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