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emergency agitation

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https://www.readbyqxmd.com/read/29451111/-in-and-out-of-hospital-emergency-psychiatry-what-is-the-best-approach
#1
J J Luykx, J K Tijdink, W Tempelaar, C H Vinkers, L de Witte
A range of clinical syndromes may present with psychiatric symptoms, both in and out of hospital settings. In such situations agitation, suicidality, communication difficulties and legal aspects often play a role, making diagnosis and treatment a challenge. Based on several case studies, we illustrate how the recently-published Dutch open access source 'Acute Psychiatry' (www.acutepsychiatrie.com) can be of help in acute psychiatric presentations both within and outside psychiatric hospitals.
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29433934/evidence-based-review-of-pharmacotherapy-for-acute-agitation-part-2-safety
#2
Leslie S Zun
BACKGROUND: The management of acute agitation in the emergency department often requires the administration of rapid-acting antipsychotic agents. However, there are few comparative studies and little guidance regarding the risks associated with use of such drugs in the acute setting. OBJECTIVE: This structured evidence-based review compared the safety of antipsychotic pharmacotherapies for acute agitation using data from randomized controlled trials identified by a literature search of the PubMed database...
February 9, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29416458/randomized-comparison-between-dexmedetomidine-and-midazolam-for-prevention-of-emergence-agitation-after-nasal-surgeries
#3
Pranjali Kurhekar, Krishnagopal Vinod, Buddhan Rajarathinam, J Shesha Dhiviya Krishna, M S Raghuraman
Background: Emergence agitation (EA) in nasal surgeries is seen in around 22% of patients, which can go to dangerous levels. Dexmedetomidine is effective in prevention of EA in such patients. Midazolam given as premedication fails to prevent EA due to its short half-life. In this study, we compared efficacy of dexmedetomidine and midazolam by intravenous infusion for prevention of EA in adult nasal surgeries. Materials and Methods: Seventy patients belonging to American society of anesthesiologist Status I and II, between 18 and 60 years of age posted for elective nasal surgeries were randomly divided into two groups...
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29416453/effect-of-dexmedetomidine-on-emergence-agitation-using-desflurane-in-pediatric-cataract-surgery
#4
Shikha Jain, Sameer Sethi, Babita Ghai, Jagat Ram
Background: In this study, we compared effectiveness of two doses of dexmedetomidine (0.15 μg/kg and 0.3 μg/kg) in preventing desflurane-induced emergence agitation (EA) in pediatric patients undergoing elective cataract surgery. Methods: It is a prospective double-blinded randomized study conducted on 65 American Society of Anesthesiologists 1 children (2-10 years) who underwent elective cataract surgery at our institute. They were randomized into two equal groups, who received either dexmedetomidine 0...
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29416346/prediction-of-emergence-agitation-using-withdrawal-reaction-following-rocuronium-injection-in-preschool-aged-patients-undergoing-inguinal-herniorrhaphy-a-preliminary-exploratory-observational-trial
#5
Dae Hee Kim, Go Un Roh, Young Bok Lee, Chang Ik Choi, Jae Moon Lee, Yun Jeong Chae
Purpose: The development of emergence agitation (EA) is associated with several factors including age, preoperative anxiety, postoperative pain, anesthesia method, and surgery type. No studies have investigated whether the withdrawal reaction following rocuronium injection can predict the occurrence of EA. Therefore, we investigated this relationship in preschool-aged children undergoing inguinal herniorrhaphy, and which grade of withdrawal reaction is appropriate for identifying patients at risk of experiencing EA...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29416244/comparison-of-maintenance-emergence-and-recovery-characteristics-of-sevoflurane-and-desflurane-in-pediatric-ambulatory-surgery
#6
Manish B Kotwani, Anila D Malde
Background and Aims: Increasing number of pediatric ambulatory surgeries are being carried out in general anesthesia using supraglottic airways (SGAs). Literature comparing sevoflurane and desflurane for the maintenance of SGA-based anesthesia is limited. Hence, we planned this prospective randomized study to compare the maintenance, emergence and recovery characteristics of sevoflurane and desflurane for pediatric ambulatory surgery. Material and Methods: Sixty children aged 6 months to 6 years posted for short surgical procedures were enrolled into the study...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29415258/a-long-term-open-label-study-to-evaluate-the-safety-and-tolerability-of-brexpiprazole-as-maintenance-treatment-in-adults-with-schizophrenia
#7
Andy Forbes, Mary Hobart, John Ouyang, Lily Shi, Stephanie Pfister, Mika Hakala
Background: Brexpiprazole is a serotonin-dopamine activity modulator with efficacy in acute schizophrenia and relapse prevention. The aim of this Phase 3, multicenter study was to assess the long-term safety, tolerability, and efficacy of treatment with brexpiprazole flexible-dose 1-4 mg/day. Methods: Patients rolled over into this 52-week open-label study (amended to 26 weeks towards the end) from three randomized, double-blind, placebo-controlled Phase 3 studies...
February 3, 2018: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29395692/approach-to-the-agitated-emergency-department-patient
#8
Michael Gottlieb, Brit Long, Alex Koyfman
BACKGROUND: Acute agitation is a common occurrence in the emergency department (ED) that requires rapid assessment and management. OBJECTIVE: This review provides an evidence-based summary of the current ED evaluation and management of acute agitation. DISCUSSION: Acute agitation is an increasingly common presentation to the ED and has a broad differential diagnosis including metabolic, neurologic, infectious, toxicologic, and psychiatric etiologies...
January 29, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29392356/efficacy-of-external-nasal-nerve-block-following-nasal-surgery-a%C3%A2-randomized-controlled-trial
#9
M Ibrahim, A M Elnabtity, A Keera
BACKGROUND: Pain is the major determinant factor which affects the quality of recovery and postoperative agitation following nasal surgery with the patient under general anesthesia. Our objectives were to test the hypothesis that an external nasal nerve block will decrease pain intensity, decrease drug consumption, decrease the incidence of postoperative emergence agitation and improve quality of recovery. MATERIAL AND METHODS: In this study 100 adult patients who were scheduled for elective external nasal surgery with the patient under general anesthesia and nasal packing on each side, received external nasal nerve blocks postoperatively for 24 h with saline (group I) or 2% xylocaine (group II) with 1:200,000 epinephrine...
February 1, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29391799/safety-and-effectiveness-of-rapid-acting-intra-muscular-olanzapine-for-agitation-associated-with-schizophrenia-japan-postmarketing-surveillance-study
#10
Hideaki Katagiri, Masanori Taketsuna, Shinpei Kondo, Kenta Kajimoto, Etsuko Aoi, Yuka Tanji
Objective: The objective of this study was to evaluate the safety and effectiveness of rapid-acting intramuscular (IM) olanzapine in the treatment of acute agitation associated with schizophrenia in real-world clinical settings in Japan. Methods: In this multicenter, postmarketing surveillance (PMS) study, patients with acute agitation associated with schizophrenia were treated with IM olanzapine daily in a daily clinical setting. The observational period ranged from 1 to 7 days, including the day of initial administration...
2018: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/29381993/effects-of-nefopam-on-emergence-agitation-after-general-anesthesia-for-nasal-surgery-a-prospective-randomized-and-controlled-trial
#11
Young Seok Jee, Hwang-Ju You, Tae-Yun Sung, Choon-Kyu Cho
BACKGROUND: Emergence agitation (EA) occurs frequently after nasal surgery. N-methyl-D-aspartate (NMDA) receptor antagonists and analgesics, such as fentanyl, have been shown to prevent EA. Nefopam inhibits the NMDA receptor and shows a potent analgesic effect. We investigated the effects of nefopam on EA in patients undergoing nasal surgery. METHODS: In this prospective, double-blind study, 100 adult patients were allocated randomly to 1 of 2 groups (each n = 50)...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29376861/the-progression-of-neuropsychiatric-symptoms-in-alzheimer-s-disease-during-a-five-year-follow-up-kuopio-alsova-study
#12
Ilona Hallikainen, Kristiina Hongisto, Tarja Välimäki, Tuomo Hänninen, Janne Martikainen, Anne M Koivisto
BACKGROUND: An improved understanding of the role of neuropsychiatric symptoms (NPS) in the course of Alzheimer's disease (AD) has recently emerged. NPS lead to hospitalization and caregiver stress, but are more variable during the course of the disease than other symptoms. Knowledge about the role of specific NPS in disease progression and prognosis is especially limited. OBJECTIVES: To examine the relationship between specific NPS and AD severity during a 5-year follow-up period, and to determine which baseline NPS predict AD progression...
2018: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29366893/molecular-characterization-of-cry1d-133-toxin-from-bacillus-thuringiensis-strain-hd133-and-its-toxicity-against-spodoptera-littoralis
#13
Dalel BenFarhat-Touzri, Fatma Driss, Sonia Jemli, Slim Tounsi
Bacillus thuringiensis subsp. aizawai strain HD133, known by its effectiveness against Spodoptera species, produces bipyramidal crystals encompassing the insecticidal proteins Cry1Ab, Cry1Ca and Cry1D-133 in the proportions 60:37:3, respectively. In this study, we dealt with the relevance of the low rate of Cry1D-133. The cry1D-133 gene from HD133 was cloned and sequenced. Both nucleotide and amino acid sequence similarity analyses with the cry1D genes available in the GenBank database revealed that cry1D-133 is a new variant of cry1Da-type genes with 99% identity with cry1Da1...
January 20, 2018: International Journal of Biological Macromolecules
https://www.readbyqxmd.com/read/29363929/best-practices-in-managing-child-and-adolescent-behavioral-health-emergencies-digest
#14
Vera Feuer, Joshua Rocker, Babar M Saggu, Jason M Andrus, Molly Wormley
Behavioral health emergencies most commonly present as depression, suicidal behavior, aggression, and severe disorganization. Emergency clinicians should avoid relying solely on past medical history or previous psychiatric diagnoses that might prematurely rule out medical pathologies. Treatments for behavioral health emergencies consist of de-escalation interventions aimed at preventing agitation, aggression, and harm. This issue reviews medical pathologies and underlying causes that can result in psychiatric presentations and summarizes evidence-based practices to evaluate, manage, and refer patients with behavioral health emergencies...
January 22, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29362047/impact-of-dexmedetomidine-on-pediatric-agitation-in-the-postanesthesia-care-unit
#15
Hongyan Li, Longming Zhang, Min Shi, Shengqiang Yang, Shengde Li, Shenqiang Gao
PURPOSE: This study aims to investigate the impacts of dexmedetomidine (DEX) on agitation in the postanesthesia care unit (PACU) for pediatric patients undergoing tonsillectomy. DESIGN: Eighty-two pediatric patients with elective tonsillectomy were randomly divided into the DEX group (group D) and the control group (group C). All patients' surgery in the two study groups were completed under tracheal cannula-based general anesthesia. Group D was infused 0.2 mcg/kg/hour DEX...
February 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29362046/the-efficacy-of-intraoperative-eeg-to-predict-the-occurrence-of-emergence-agitation-in-the-postanesthetic-room-after-sevoflurane-anesthesia-in-children
#16
Young-Eun Jang, Sung-Ae Jeong, Sun-Young Kim, In-Kyung Song, Ji-Hyun Lee, Jin-Tae Kim, Hee-Soo Kim
PURPOSE: Emergence agitation (EA) is common after sevoflurane anesthesia, but there are no definite predictors. This study investigated whether intraoperative electroencephalography (EEG) can indicate the occurrence of EA in children. DESIGN: A prospective predictive study design was used. METHODS: EEG-derived parameters (spectral edge frequency 95, beta, alpha, theta, and delta power) were measured at 1.0 minimum alveolar concentration (MAC) and 0...
February 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29361326/evidence-based-review-of-pharmacotherapy-for-acute-agitation-part-1-onset-of-efficacy
#17
Leslie S Zun
BACKGROUND: The main goal of antipsychotic medication in the management of acute agitation in the emergency department is to rapidly induce calm without oversedation, enabling patients to participate in their own care. However, there is a paucity of comparative studies, particularly with newer fast-acting second-generation antipsychotic agents. OBJECTIVE OF THE REVIEW: This structured evidence-based review compared the onset of efficacy of antipsychotic treatments for acute agitation using data from randomized controlled trials identified by a literature search of the PubMed database...
January 17, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29333775/-effect-of-dexmedetomidine-on-emergence-agitation-after-general-anesthesia-in-children-undergoing-odontotherapy-in-day-surgery-operating-room
#18
Luo Lin, Zhang Yueming, Li Meisheng, Wang Jiexue, Ji Yang
OBJECTIVE: To study the effectiveness of dexmedetomidine used for general anesthesia maintenance in children undergoing odontotherapy in day-surgery operating room in reducing the incidence of emergence agitation (EA). METHODS: Eighty children undergoing odontotherapy and under general anesthesia in day-surgery operating room were randomized into two groups, group A (n=40) and group B (n=40). Each patient in group A was administered with a bolus dose of dexmedetomidine (1...
December 1, 2017: Hua Xi Kou Qiang Yi Xue za Zhi, Huaxi Kouqiang Yixue Zazhi, West China Journal of Stomatology
https://www.readbyqxmd.com/read/29303801/intravenous-valproic-acid-add-on-therapy-in-acute-agitation-adolescents-with-suspected-substance-abuse-a-report-of-six-cases
#19
Claudia Battaglia, Roberto Averna, Milena Labonia, Assia Riccioni, Stefano Vicari
The aim of this study was to test efficacy and safety of intravenous (IV) valproate for aggression in children and adolescents with mood or conduct disorder and concomitant substance abuse. Six patients received a 20 mg/kg dose of IV valproic acid as an add-on therapy to their standard therapy with second-generation antipsychotics and benzodiazepines. Agitation and general psychopathology were measured at baseline and after the first injection using the Modified Overt Aggression Scale, the Brief Psychiatric Rating Scale, and the Children's Global Assessment Scale...
January 2018: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/29287876/effect-of-preoperative-visiting-operation-room-on-emergence-agitation-in-preschool-children-under-sevoflurane-anesthesia
#20
RANDOMIZED CONTROLLED TRIAL
Qiaosheng Zhong, Xianfeng Qu, Chuanhua Xu
BACKGROUND: Emergence agitation (EA) is a common complication in children during recovery from sevoflurane anesthesia with an high incidence. The main objective of this study was to compare the effects of preoperative visiting operation room (PVOR) to administration of propofol at the end of anesthesia on EA in preschool children under sevoflurane anesthesia. METHODS: Sixty-nine preschool children aged from 3 to 6 years scheduled for tonsillectomy under sevoflurane anesthesia were randomly allocated to one of the three groups to receive either PVOR (Group PV), routine preoperative visit (Group RV) or routine preoperative visit plus propofol (Group RP), 23 patients were included in each group...
January 2018: International Journal of Pediatric Otorhinolaryngology
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