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https://www.readbyqxmd.com/read/29664808/trends-in-pharmacological-emergency-treatment-of-patients-suffering-from-schizophrenia-over-a-16-year-observation-period
#1
Monika Edlinger, Anna-Sophia Welte, Nursen Yalcin-Siedentopf, Georg Kemmler, Felix Neymeyer, W Wolfgang Fleischhacker, Alex Hofer
Patients suffering from schizophrenia are often treated in locked psychiatric units because of psychomotor agitation, hostility and aggressive behavior, or suicidality. Because of legal conditions, investigations on these acutely ill patients are difficult, and many studies do not represent 'real-life psychiatry'. This retrospective survey was conducted at the Department of Psychiatry, Psychotherapy and Psychosomatics of the Medical University, Innsbruck, Austria. Data were collected from the records of all adult inpatients suffering from a schizophrenia spectrum disorder according to the International Classification of Diseases, 10th ed...
April 16, 2018: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29656945/ketamine-versus-ketamine-pluses-atropine-for-pediatric-sedation-a-meta-analysis
#2
REVIEW
Jiaxiao Shi, Ang Li, Zhijian Wei, Yang Liu, Cong Xing, Hongyu Shi, Han Ding, Dayu Pan, Guangzhi Ning, Shiqing Feng
OBJECTIVES: The application of atropine for pediatric sedation in the emergency department remains controversial. Our objective was to perform a comprehensive review of the literature and assess the clinical indexes in groups with and without atropine use. METHODS: PubMed, EMBASE, and the Cochrane Library were searched for randomized and non-randomized studies that compared ketamine and ketamine plus atropine for pediatric sedation. The risk ratio with 95% confidence interval was calculated using either a fixed- or random-effects model according to the value of I2 ...
April 5, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29651740/the-expanding-role-of-ketamine-in-the-emergency-department
#3
Sophia Sheikh, Phyllis Hendry
Patients frequently come to the emergency department for pain. For decades, ketamine has been used in the emergency department for procedural sedation but is now receiving attention as a potential alternative to opioids because of its unique analgesic effects. Additionally, ketamine's dissociative properties have made it a popular choice for sedating profoundly agitated patients. In this narrative review, these new roles for ketamine in the emergency department are discussed.
April 12, 2018: Drugs
https://www.readbyqxmd.com/read/29628550/effect-of-pregabalin-premedication-on-emergence-agitation-in-children-after-sevoflurane-anesthesia-a-randomized-controlled-study
#4
Hesham Mohamed Marouf
Background: Emergence agitation (EA) is common in pediatrics after sevoflurane anesthesia. Aims: We intended to study the effect of preoperative pregabalin on EA in pediatrics after sevoflurane anesthesia. Settings and Design: This study design was a prospective randomized controlled double-blinded study. Patients and Methods: Sixty children with American Society of Anesthesiologists physical status Classes I-II, aged 4-10 years, prepared for adenotonsillectomy under sevoflurane anesthesia were randomized to two equal groups (control Group C and pregabalin Group P)...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29623620/economic-evaluation-of-midazolam-droperidol-combination-versus-droperidol-or-olanzapine-for-the-management-of-acute-agitation-in-the-emergency-department-a-within-trial-analysis
#5
Celene Y L Yap, Ya-Seng Arthur Hsueh, Jonathan C Knott, David McD Taylor, Esther W Chan, David C M Kong
BACKGROUND: The combination of midazolam and droperidol has proven superior to droperidol or olanzapine monotherapy in the management of acute agitation in emergency departments (EDs). OBJECTIVE: This is the first economic analysis to evaluate the cost-benefit and cost effectiveness of the midazolam-droperidol combination compared with droperidol or olanzapine for the management of acute agitation in EDs. METHODS: This analysis used data derived from a randomised, controlled, double-blind clinical trial conducted in two metropolitan Australian EDs between October 2014 and August 2015...
July 24, 2017: PharmacoEconomics Open
https://www.readbyqxmd.com/read/29616702/identifying-better-outcome-measures-to-improve-treatment-of-agitation-in-dementia-a-report-from-the-eu-us-ctad-task-force
#6
M Sano, M Soto, M Carrillo, J Cummings, S Hendrix, J Mintzer, A Porsteinsson, P Rosenberg, L Schneider, J Touchon, P Aisen, B Vellas, C Lyketsos
For the second time in the past 3 years, the EU-US CTAD Task Force addressed challenges related to designing clinical trials for agitation in dementia, which is one of the most disruptive aspects of the condition for both patients and caregivers. Six recommendations emerged from the Task Force meeting: 1 - Operationalizing agitation criteria established by the IPA; 2 - Combining clinician- and caregiver-derived outcomes as primary outcome measures; 3 - Using global ratings to define clinically meaningful effects and power studies; 4 - Improving the accuracy of caregiver reports by better training and education of caregivers; 5 - Employing emerging technologies to collect near real-time behavioral data; and 6 - Utilizing innovative trial designs and increasing the use of biomarkers to maximize the productivity of clinical trials for neuropsychiatric symptoms...
2018: Journal of Prevention of Alzheimer's Disease
https://www.readbyqxmd.com/read/29613919/addressing-dual-patient-and-staff-safety-through-a-team-based-standardized-patient-simulation-for-agitation-management-in-the-emergency-department
#7
Ambrose H Wong, Marc A Auerbach, Halley Ruppel, Lauren J Crispino, Alana Rosenberg, Joanne D Iennaco, Federico E Vaca
INTRODUCTION: Emergency departments (EDs) have seen harm rise for both patients and health workers from an increasing rate of agitation events. Team effectiveness during care of this population is particularly challenging because fear of physical harm leads to competing interests. Simulation is frequently employed to improve teamwork in medical resuscitations but has not yet been reported to address team-based behavioral emergency care. As part of a larger investigation of agitated patient care, we designed this secondary study to examine the impact of an interprofessional standardized patient simulation for ED agitation management...
April 3, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29608114/prolonged-toxicity-from-kambo-cleansing-ritual
#8
Kai Li, Howard Horng, Kara Lynch, Craig G Smollin
CONTEXT: Kambo cleanse is a purification, cleansing ritual traditionally performed by South American shaman to confer luck and health to hunters. CASE DETAILS: We report a patient who presented to the emergency department with prolonged symptoms of vomiting, flushing, facial swelling, altered mental status, and agitation requiring chemical restraints, 22 h after a Kambo cleanse. The patient was found with four small, circular, superficial burns to the ankle at the site where the resin was introduced...
April 2, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/29606317/behavioral-disorders-the-blind-spot-of-neurology-and-psychiatry
#9
REVIEW
C Azuar, R Levy
Behavioral disorders occupy the crossroads between neurology and psychiatry, and emerging disorders, such as frontotemporal lobar degeneration of genetic origin and autoimmune encephalitis, can present with both neurological and psychiatric signs. Thus, the primary aim of this introductory article is to review frequently encountered behavioral clinical features, such as apathy and agitation, and their related syndromes, including frontal and anterior temporal syndromes. These behavioral states and their underlying etiologies are also here illustrated with clinical case reports...
March 29, 2018: Revue Neurologique
https://www.readbyqxmd.com/read/29605483/severe-opioid-withdrawal-precipitated-by-vivitrol%C3%A2
#10
R S Wightman, L S Nelson, J D Lee, L M Fox, S W Smith
The risk of severe precipitated opioid withdrawal (POW) is amplified when precipitated by a long-acting opioid antagonist. IM extended release naltrexone (XRNTX;Vivitrol®) is an FDA approved therapy to prevent relapse of opioid and alcohol abuse. Two cases of precipitated opioid withdrawal from XRNTX are presented that illustrate different patient reactions to POW. A 56-year-old woman developed a hypertensive emergency and required continuous intravenous vasodilator, clonidine, and intensive care monitoring after re-initiation of XRNTX following opioid relapse...
March 21, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29576825/comparison-of-sedative-effectiveness-of-thiopental-versus-midazolam-in-reduction-of-shoulder-dislocation
#11
Elnaz Vahidi, Rezvan Hemati, Mehdi Momeni, Amirhossein Jahanshir, Morteza Saeedi
BACKGROUND: Various sedative drugs have been proposed to control anxiety and agitation in shoulder dislocation, but none of them has been diagnosed as the best sedative and relaxant agent. The study aimed to compare the sedative effectiveness of thiopental versus midazolam in reduction of shoulder dislocation. METHODS: A randomized double-blind controlled trail was performed in 80 patients with shoulder dislocation recruited from the emergency department. Ten patients were excluded and 70 patients were enrolled in the study...
2018: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29559022/post-flood-rapid-needs-assessment-in-srinagar-city-jammu-and-kashmir-state-india-september-2014
#12
Rajesh Yadav, Dundaiah Somashekar, Samir V Sodha, Kayla F Laserson, Srinivasa Venkatesh, Himanshu Chauhan
OBJECTIVES: Torrential rainfall and flooding from September 2-6, 2014 submerged >350 villages in Jammu and Kashmir state. We conducted rapid needs assessment in capital Srinagar from 27 September to 1 October to assess population health and safety needs. METHODS: Based on Community Assessment for Public Health Emergency Response (CASPER) methodology, we selected 7 households each from 30 census blocks using 2-stage cluster sampling. We collected information on demographics, needs, and illnesses using structured questionnaire...
March 21, 2018: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/29551622/treatment-of-behavior-disturbances-with-ketamine-in-a-patient-diagnosed-with-major-neurocognitive-disorder
#13
Douglas Steenblock
A 77-year-old woman who had been previously diagnosed with a major neurocognitive disorder became highly agitated and aggressive in a long-term care facility. She did not respond to intramuscular (IM) haloperidol plus lorazepam and had to be transported to the local emergency department (ED). In the ambulance, she remained highly agitated and was given 200 mg IM ketamine. Within minutes of receiving this, she de-escalated dramatically with no apparent adverse effects and remained stable for several days. Although ketamine has been used recently in pre-hospital settings and EDs to reduce agitated behavior, there has been little if any investigation of its potential for reducing behavior disturbances in patients who suffer from major neurocognitive disorders...
February 26, 2018: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/29534916/metoclopramide-induced-pheochromocytoma-crisis
#14
James B Leonard, Kashif M Munir, Hong K Kim
Metoclopramide (MCP) is a commonly used anti-emetic in the emergency department (ED). Its use is generally well tolerated; although infrequent adverse reactions such as extrapyramidal reactions or tardive dyskinesia are reported. However, many ED providers are not familiar with the potentially life-threatening hypertensive emergency that can be precipitated by MCP administration in patients with pheochromocytoma. A previously healthy 36-year-old woman presented to the ED with headache and nausea. She developed acute hypertensive emergency (acute agitation, worsening headache, chest pain and wide complex tachycardia) when her blood pressure (BP) increased to 223/102mmHg (initial BP, 134/86mmHg) after receiving intravenous MCP...
March 5, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29526946/a-retrospective-study-on-the-epidemiological-and-clinical-features-of-emergency-patients-with-large-or-massive-consumption-of-caffeinated-supplements-or-energy-drinks-in-japan
#15
Yoshito Kamijo, Michiko Takai, Yuji Fujita, Kiyotaka Usui
Objective We conducted a retrospective study on the epidemiological and clinical features of patients with acute caffeine poisoning in Japan. Methods Letters requesting participation were sent to 264 emergency departments of hospitals, and questionnaires were mailed to those that agreed to participate. Patients Participants were patients transported to emergency departments of hospitals between April 2011 and March 2016 after consuming large or massive amounts of caffeinated supplements and/or energy drinks (caffeine dose ≥1...
March 9, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29516771/activities-of-daily-living-retraining-and-goal-attainment-during-posttraumatic-amnesia
#16
Jessica Trevena-Peters, Adam McKay, Jennie Ponsford
It is uncertain whether therapy delivered during posttraumatic amnesia (PTA) following traumatic brain injury can be effective due to risk of agitation and poor learning capacity. This study used goal attainment scaling (GAS) to assess gains in activities of daily living (ADL) retraining during PTA. Occupational therapists' perspectives on goal setting and therapy delivery were also explored qualitatively. Forty-nine rehabilitation inpatients were provided with manualised ADL retraining following errorless and procedural learning principles during PTA...
March 8, 2018: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/29508484/a-psychometric-evaluation-of-the-pediatric-anesthesia-emergence-delirium-scale
#17
Jenny Ringblom, Ingrid Wåhlin, Marie Proczkowska
BACKGROUND: Emergence delirium and emergence agitation have been a subject of interest since the early 1960s. This behavior has been associated with increased risk of injury in children and dissatisfaction with anesthesia care in their parents. The Pediatric Anesthesia Emergence Delirium Scale is a commonly used instrument for codifying and recording this behavior. AIMS: The aim of this study was to psychometrically evaluate the Pediatric Anesthesia Emergence Delirium scale, focusing on the factor structure, in a sample of children recovering from anesthesia after surgery or diagnostic procedures...
March 6, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29508167/inhalative-sedation-with-small-tidal-volumes-under-venovenous-ecmo
#18
Axel Rand, Peter K Zahn, Thomas A Schildhauer, Christian Waydhas, Uwe Hamsen
BACKGROUND: Inhalative sedation is an emerging method for long-term sedation in intensive care therapy. There is evidence that it is easy to control and may be beneficial compared to intravenous sedation. Yet little is known about the use in patients with compromised lung function. In this retrospective analysis, we searched files of patients receiving inhalative sedation under venovenous extracorporeal membrane oxygenator (vv-ECMO) support due to lung failure. METHODS: After ethical approval, we performed a retrospective analysis of patients receiving vv-ECMO support and inhalative sedation in the surgical ICU in 2015...
March 5, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29504986/impending-thyroid-storm-in-a-pregnant-woman-with-undiagnosed-hyperthyroidism-a-case-report-and-literature-review
#19
REVIEW
Yushan Ma, Hao Li, Jin Liu, Xuemei Lin, Hui Liu
RATIONALE: Thyroid storm is a rare complication during caesarean section of patients with hyperthyroidism. It occurs abruptly, with a high mortality rate if not recognized immediately and aggressively treated. Herein, we reported a case of impending thyroid storm during a caesarean section. PATIENT CONCERNS: A healthy 23-year-old woman with undiagnosed hyperthyroidism underwent an emergency caesarean section under general anesthesia. After tracheal extubation, the patient exhibited abnormal tachycardia, agitation, sweating, and hyperpyrexia...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29503826/predictive-factors-of-mortality-in-acute-amphetamine-type-stimulants-poisoning-a-review-of-226-cases
#20
Mitra Rahimi, Somaieh Lookzadeh, Roxana Sadeghi, Kambiz Soltaninejad, Shahin Shadnia, Abdolkarim Pajoumand, Hossein Hassanian-Moghaddam, Nasim Zamani, Masoud Latifi-Pour
Introduction: Amphetamine type stimulants (ATS) such as amphetamine and methamphetamine (MA) are one of the most important causes of poisoning in the world. In this study we aimed to define the predictive factors of mortality in acute ATS poisoning patients. Methods: This is a retrospective cross-sectional study on all cases with acute ATS poisoning who were referred to a referral center for poisoning, Tehran, Iran, from April 2011 to March 2014. Using patients' medical records, demographic data, route of exposure, type and amount of ATS, the cause of poisoning, clinical presentations, and electrocardiogram (ECG) and laboratory findings, as well as patient's outcomes were collected and analyzed regarding the independent predictive factors of mortality...
2018: Emergency (Tehran, Iran)
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