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https://www.readbyqxmd.com/read/28650904/pediatric-procedural-sedation-using-the-combination-of-ketamine-and-propofol-outside-of-the-emergency-department-a-report-from-the-pediatric-sedation-research-consortium
#1
Jocelyn R Grunwell, Curtis Travers, Anne G Stormorken, Patricia D Scherrer, Corrie E Chumpitazi, Jana A Stockwell, Mark G Roback, Joseph Cravero, Pradip P Kamat
OBJECTIVES: Outcomes associated with a sedative regimen comprised ketamine + propofol for pediatric procedural sedation outside of both the pediatric emergency department and operating room are underreported. We used the Pediatric Sedation Research Consortium database to describe a multicenter experience with ketamine + propofol by pediatric sedation providers. DESIGN: Prospective observational study of children receiving IV ketamine + propofol for procedural sedation outside of the operating room and emergency department using data abstracted from the Pediatric Sedation Research Consortium during 2007-2015...
June 23, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28640169/the-use-of-lorazepam-and-electroconvulsive-therapy-in-the-treatment-of-catatonia-treatment-characteristics-and-outcomes-in-60-patients
#2
Ahmet Unal, Abdurrahman Altindag, Bahadir Demir, Ihsan Aksoy
OBJECTIVES: Lorazepam and electroconvulsive therapy (ECT) are effective treatments for catatonia. However, systematic data on these treatments in catatonia are limited. In the present study, we aimed to investigate the clinical and treatment-related characteristics of patients with catatonia who underwent lorazepam and/or ECT. METHODS: Between January 2012 and December 2016, we received 60 patients with catatonia hospitalized in the Gaziantep University Faculty of Medicine Clinic of Psychiatry...
June 20, 2017: Journal of ECT
https://www.readbyqxmd.com/read/28629738/nitrous-oxide-versus-oral-sedation-for-pain-management-of-first-trimester-surgical-abortion-a-randomized-study
#3
Rameet H Singh, Maria Montoya, Eve Espey, Lawrence Leeman
OBJECTIVE: The objective of the study was to compare nitrous oxide with oxygen (N2O/O2) to oral hydrocodone/acetaminophen and lorazepam for analgesia during first-trimester surgical abortion. STUDY DESIGN: This double-blind randomized trial assigned women undergoing first-trimester surgical abortion at<11 weeks' gestation to inhaled N2O/O2 vs. oral sedation for pain management. The N2O/O2 group received up to 70:30 ratio during the procedure and placebo pills preprocedure; the oral group received inhaled oxygen during the procedure and oral hydrocodone/acetaminophen 5 mg/325 mg and lorazepam 1 mg preprocedure...
June 16, 2017: Contraception
https://www.readbyqxmd.com/read/28620949/nonintravenous-rescue-medications-for-pediatric-status-epilepticus-a-cost-effectiveness-analysis
#4
Iván Sánchez Fernández, Marina Gaínza-Lein, Tobias Loddenkemper
OBJECTIVE: To quantify the cost-effectiveness of rescue medications for pediatric status epilepticus: rectal diazepam, nasal midazolam, buccal midazolam, intramuscular midazolam, and nasal lorazepam. METHODS: Decision analysis model populated with effectiveness data from the literature and cost data from publicly available market prices. The primary outcome was cost per seizure stopped ($/SS). One-way sensitivity analyses and second-order Monte Carlo simulations evaluated the robustness of the results across wide variations of the input parameters...
June 16, 2017: Epilepsia
https://www.readbyqxmd.com/read/28615768/the-phenomenology-and-treatment-response-in-catatonia-a-hospital-based-descriptive-study
#5
Sarada Prasanna Swain, Sushree Sangita Behura, Manoj Kumar Dash
BACKGROUND: Literatures regarding clinical symptomatology and treatment response of catatonia are very few. OBJECTIVE: To assess onset, clinical profile, diagnostic break up, treatment response and outcome in patients diagnosed as Catatonia, reported to a tertiary care hospital. METHODS: The present study was a cross-sectional descriptive study conducted in indoor of Mental Health Institute (Centre of Excellence), S.C.B. Medical College, between March 2015 to March 2016...
May 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/28613368/-rapid-tranquillisation-for-agitated-patients-with-psychostimulant-intoxication
#6
P Geerts, K Titeca, G M D Lemmens, J De Fruyt
Because psychostimulant intoxication can lead to serious health risks for the patient, it is often necessary to ensure that the patient receives both adequate medical surveillance and rapid tranquillisation.<br/> AIM: To find out whether there is scientific evidence that psychopharmacological intervention helps patients with psychostimulant intoxication to manage aggression and agitation.<br/> METHOD: We searched the literature systematically.<br/> RESULTS: Our study showed that intravenous droperidol worked faster and was more effective than intravenous lorazepam in inducing sedation in patients intoxicated with psychostimulants...
2017: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/28610803/catatonia-is-not-schizophrenia-and-it-is-treatable
#7
Francisco J Appiani, Gonzalo S Castro
Catatonia is a cluster of motor features that appears in many recognized psychiatric illnesses, that according to the DSM-5 it is not linked as a subtype to schizophrenia anymore. The classic signs are mutism, a rigid posture, fixed staring, stereotypic movements, and stupor, which are all part of a broad psychopathology that may be found in affective, thought, neurological, toxic, metabolic and immunological disorders. Despite the many etiologies, catatonia may be a life-threatening condition with a specific treatment...
June 10, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28595243/determinants-and-timeline-of-perioperative-anxiety-in-mohs-surgery
#8
Irèn Kossintseva, David Zloty
BACKGROUND: Patients undergoing Mohs micrographic surgery (MMS) exhibit anxiety relating to cancer cure or the expected cosmetic outcome. OBJECTIVE: To obtain quantitative measurements of perioperative cancer and cosmetic anxiety levels in first-time MMS patients. Parameters influencing anxiety and its natural course were assessed. METHODS: Prospective, single-blinded, questionnaire study of 173 patients undergoing MMS of the face. Anxiety levels were assessed using a visual analog scale preoperatively and postoperatively over 6 months...
June 6, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28582280/lorazepam-challenge-for-individuals-at-varying-genetic-risk-for-alzheimer-disease
#9
Cynthia M Stonnington, Brian Harel, Dona E C Locke, Joseph G Hentz, Nan Zhang, Paul Maruff, Richard J Caselli
INTRODUCTION: This study set out to clarify the differential acute cognitive impact of lorazepam based on varying genetic risk for Alzheimer disease. METHODS: Fifty-seven cognitively unimpaired individuals aged 51 to 88, genotyped according to apolipoprotein E (APOE) and translocase of outer mitochondrial membrane (40 homolog) poly-T lengths, completed cognitive testing before, 2.5 and 5 hours after receiving a 1 mg dose of lorazepam. RESULTS: Post-lorazepam, there were significant (P<0...
June 2, 2017: Alzheimer Disease and Associated Disorders
https://www.readbyqxmd.com/read/28574532/association-between-opioid-and-benzodiazepine-use-and-clinical-deterioration-in-ward-patients
#10
Patrick G Lyons, Ashley Snyder, Sarah Sokol, Dana P Edelson, Babak Mokhlesi, Matthew M Churpek
BACKGROUND: Opioids and benzodiazepines are frequently used in hospitals, but little is known about outcomes among ward patients receiving these medications. OBJECTIVE: To determine the association between opioid and benzodiazepine administration and clinical deterioration. DESIGN: Observational cohort study. SETTING: 500-bed academic urban tertiary-care hospital. PATIENTS: All adults hospitalized on the wards from November 2008 to January 2016 were included...
June 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28571548/intermittent-transient-motor-aphasia-in-acute-lithium-toxicity-a-case-report-and-brief-review
#11
S Madhusoodanan, Varudhini Reddy, Sonya Mohan
INTRODUCTION: Lithium is known to cause certain neurological deficits. However, reports of aphasia secondary to lithium toxicity are scant. We report the case of a 70 year old African American woman with a history of schizoaffective disorder and mild dementia who developed transient intermittent aphasia secondary to lithium toxicity. METHODS: Patient was admitted because of agitation, delusional behavior, and loud and pressured speech. Her previous medications included divalproex sodium 500mg po bid, valproic acid 250mg po qd, risperidone 3...
May 31, 2017: Current Drug Safety
https://www.readbyqxmd.com/read/28559636/treating-an-adolescent-with-long-qt-syndrome-for-bipolar-disorder-a-case-presentation
#12
Özlem Önen, Ayşe Kutlu, Handan Özek Erkuran
OBJECTIVES: Long QT syndrome (LQTS) is described as the development of sudden syncope attacks or death as a result of ventricular tachycardia (VT) episodes that might be observed as elongated QT interval in electrocardiography (ECG). Implantable Cardioverter Defibrillator (ICD) is recommended as first-line treatment for the condition in guidelines. We aimed to present an adolescent recently diagnosed with Bipolar Disorder (BD) who had LQTS that was treated with ICD, discussing her follow up and treatment along with relevant literature...
January 26, 2017: Psychopharmacology Bulletin
https://www.readbyqxmd.com/read/28543168/a-new-tool-to-tackle-the-opioid-epidemic-description-utility-and-results-from-the-maine-diversion-alert-program
#13
Brian J Piper, Clare E Desrosiers, Harriet C Fisher, Kenneth L McCall, Stephanie D Nichols
STUDY OBJECTIVE: The opioid epidemic continues to impact the United States, and new strategies are needed to combat this epidemic. The objective of this study was to analyze 2015 drug arrest data from Maine's Diversion Alert program (diversionalert. org), compare arrest data between the first quarters of 2015 and 2016, and provide an analysis of the sex differences in the arrests as well as information about DA use. STUDY DESIGN: A population-based, descriptive study using data from the Maine Diversion Alert Program...
May 19, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28540039/successful-withdrawal-from-high-dose-benzodiazepine-in-a-young-patient-through-electronic-monitoring-of-polypharmacy-a-case-report-in-an-ambulatory-setting
#14
REVIEW
Hèctor R Loscertales, Valerie Wentzky, Kenneth Dürsteler, Johannes Strasser, Kurt E Hersberger, Isabelle Arnet
BACKGROUND: Dependence on high-dose benzodiazepines (BZDs) is well known and discontinuation attempts are generally unsuccessful. A well established protocol for high-dose BZD withdrawal management is lacking. We present the case of withdrawal from high-dose lorazepam (>20 mg daily) in an unemployed 35-year-old male outpatient through agonist substitution with long-acting clonazepam and electronic monitoring over 28 weeks. METHODS: All medicines were repacked into weekly 7 × 4 cavity multidose punch cards with an electronic monitoring system...
May 2017: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/28535979/mirtazapine-fatal-poisoning
#15
Claudia Vignali, Angelo Groppi, Francesca Brandolini, Francesco Maria Avato, Anna Talarico, Rosa Maria Gaudio, Luca Morini
Mirtazapine is a noradrenergic and specific serotoninergic antidepressant agent that stimulates norepinephrine and serotonin release while also blocking serotonin receptors (5-HT2 and 5-HT3). Although the drug is used extensively, at present we do not know of any fatal cases due to mirtazapine alone. On the contrary, the published literature describes several fatal poisoning cases related to the intake of mirtazapine together with other drugs. Here we describe a fatal case of mirtazapine self-poisoning, since the other drug detected (lorazepam), was within the therapeutic range...
May 8, 2017: Forensic Science International
https://www.readbyqxmd.com/read/28515558/a-rare-case-of-complicated-opioid-withdrawal-in-delirium-without-convulsions
#16
B Neeraj Raj, N Manamohan, Divya Hegde, Chandrashekar B Huded, Johnson Pradeep
Opioids are one of the commonly abused substances in India. Opioid withdrawal symptoms classically include severe muscle cramps, bone aches, autonomic symptoms, anxiety, restlessness, insomnia, and temperature dysregulation. However, reports of cases with delirium during withdrawal are few. A 25-year-old male with severe opioid withdrawal symptoms developed delirium. Investigations were normal. There were no comorbidities, no significant past history and family history. Patient treated for opioid dependence with tapering doses of lorazepam and clonidine...
March 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/28511598/silexan-in-anxiety-disorders-clinical-data-and-pharmacological-background
#17
Siegfried Kasper, Walter E Müller, Hans-Peter Volz, Hans-Jürgen Möller, Egon Koch, Angelika Dienel
OBJECTIVES: Silexan is a lavender oil preparation available in 80-mg capsules. Here we review clinical trials investigating its anxiolytic efficacy, safety and tolerability in humans, as well as preclinical investigations supporting this therapeutic use. METHODS: Besides three selected publications reporting preclinical investigations, seven clinical trials are included, of which five had a treatment duration of 6 or 10 weeks. Primary outcome measure was the HAM-A total score reduction, while single items were assessed with regard to effects on concomitant depressive symptoms and on quality of sleep...
June 19, 2017: World Journal of Biological Psychiatry
https://www.readbyqxmd.com/read/28492463/impact-of-an-alcohol-withdrawal-treatment-pathway-on-hospital-length-of-stay-a-retrospective-observational-study-comparing-pre-and-post-pathway-implementation
#18
Andrew J Muzyk, Rachel E Rogers, Gary Dighe, Jessica Hartung, Robert C Musser, Mary J Stillwagon, Sarah Rivelli
OBJECTIVE: To determine if the implementation of a hospital-specific alcohol withdrawal treatment pathway used in a medical-surgical patient population decreased hospital length of stay (LOS) compared with the standard of care. METHODS: This retrospective observational study, conducted in a large academic tertiary care hospital, involved 582 subjects who met criteria for study inclusion, with 275 subjects in the 2010 cohort and 307 in the 2012 cohort. The Alcohol Withdrawal Project Team was formed with the goal of creating a standardized approach to the recognition and treatment of alcohol withdrawal at Duke University Hospital...
May 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/28491312/neuroleptic-malignant-syndrome-following-catatonia-vigilance-is-the-price-of-antipsychotic-prescription
#19
Thomas J Reilly, Sean Cross, David M Taylor, Richard Haslam, Sophie C Tomlin, Benjamin Gaastra
OBJECTIVES: To describe a case of neuroleptic malignant syndrome following antipsychotic treatment of catatonia, highlighting the potentially serious complications of this rare adverse drug reaction. METHODS: We present a case report of a patient who developed this syndrome with various sequelae. RESULTS: The patient developed neuroleptic after being treated with lorazepam and olanzapine for catatonia. He subsequently developed the complications of rhabdomyolysis, acute kidney injury, pulmonary embolism, urinary retention and ileus...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28487010/benzodiazepine-prescribing-in-the-elderly-in%C3%A2-germany-and-korea-a-comparison-of-two%C3%A2-observational-studies%C3%A2
#20
Barry Woodcock, Karel Kostev, Ju-Young Shin
OBJECTIVES: To identify differences and similarities in benzodiazepine (BZD) prescribing patterns in elderly patients reported in two separate and independent investigations, one from Germany for the year 2014 and the other from Korea for the year 2013. METHODS: Data on patients over 65 years, who were prescribed at least one BZD, were obtained from population databases. The design and characteristics of the two studies were similar. RESULTS: The use of BZDs in the elderly in Korea was several-fold higher than in Germany depending on the age stratification...
May 10, 2017: International Journal of Clinical Pharmacology and Therapeutics
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