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https://www.readbyqxmd.com/read/29764554/-efficacy-and-safety-of-nalbuphine-on-analgesia-of-patients-in-intensive-care-unit
#1
Shaohua Liu, Youdong Wan, Yonggang Luo, Li Wan, Wenjing Yun, Haixu Wang, Zhenhua Wang, Xiaoguang Duan, Ruifang Zhang, Yingying Zhao, Hongwei Cui, Tongwen Sun
OBJECTIVE: To analyze the efficacy and safety of nalbuphine in patients with sedative analgesia in intensive care unit (ICU). METHODS: A prospective observation was conducted. The adult patients with mild and moderate analgesia in general ICU of the First Affiliated Hospital of Zhengzhou University from January to November in 2017 were enrolled, and they were divided into nalbuphine group and sufentanil group in proper order. The nabobrown group was given 40 mg nabobrown, the sufentanil group was given 0...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29745723/management-of-a-complex-patient-intravenous-olanzapine-use
#2
Phey Yee Goh, Beatrice Huang, Nancy Pehlivan
OBJECTIVE: This case report aims to highlight the challenges faced by mental health clinicians in managing complex medical and psychiatric presentation, with a particular interest in intravenous (IV) olanzapine use outside the emergency department (ED) and intensive care unit setting. CONCLUSION: There is no current prescribing guideline regarding the use of IV olanzapine for acute agitation associated with schizophrenia and bipolar disorder. Most of the literature available regarding the use of IV olanzapine has originated from studies performed in the ED setting, with the majority of studies reporting a favourable efficacy and safety profile for IV olanzapine...
May 1, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/29743653/long-term-outcome-of-recoverable-stents-for-budd-chiari-syndrome-complicated-with-inferior-vena-cava-thrombosis
#3
Yonghua Bi, Hongmei Chen, Penxu Ding, Jianzhuang Ren, Xinwei Han
This study aimed to present long-term results of a 12-year patient follow-up of recoverable stents for BCS complicated by inferior vena cava (IVC) thrombosis. Forty consecutive patients with BCS complicated by IVC thrombosis were treated with recoverable stents. The median duration of symptoms was 24 months. Recoverable stents was placed after predilation of the obstructed IVC, and then agitation thrombolysis or catheter-directed thrombolysis of IVC was performed. The recoverable stents was removed eventually after thrombus disappeared...
May 9, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29724638/placid-study-a-randomized-trial-comparing-the-efficacy-and-safety-of-inhaled-loxapine-versus-intramuscular-aripiprazole-in-acutely-agitated-patients-with-schizophrenia-or-bipolar-disorder
#4
Luis San, Gemma Estrada, Natalia Oudovenko, Francisco Montañés, Natalia Dobrovolskaya, Olga Bukhanovskaya, Mikhail Popov, Eduard Vieta
The aim of the study was to investigate the efficacy and safety of inhaled loxapine compared with the intramuscular (IM) antipsychotic aripiprazole in acutely agitated patients with schizophrenia or bipolar I disorder. PLACID was an assessor-blind, parallel-group trial conducted in 23 centres in the Czech Republic, Germany, Spain, and Russia. Patients (aged 18-65 years) diagnosed with schizophrenia or bipolar I disorder experiencing acute agitation (Clinical Global Impression [CGI]-Severity score ≥ 4) while hospitalized or attending an emergency room were randomized to receive up to two doses of inhaled loxapine 9...
May 1, 2018: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29719399/effectiveness-and-safety-of-oral-olanzapine-treatment-transitioned-from-rapid-acting-intramuscular-olanzapine-for-agitation-associated-with-schizophrenia
#5
Hideaki Katagiri, Masanori Taketsuna, Shinpei Kondo, Kenta Kajimoto, Etsuko Aoi, Yuka Tanji
Objective: To assess the effectiveness and safety of oral olanzapine treatment transitioned from rapid-acting intramuscular olanzapine (RAIM) in patients with acute agitation associated with schizophrenia in a real-world clinical setting. Methods: The postmarketing surveillance study with a 3-day observational period after the last RAIM administration was conducted (original study). Following this, an extended study was added for patients who received oral olanzapine after RAIM administration during the original study period, in order to additionally observe them for 7 days after initial RAIM administration...
2018: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/29680485/-seclusion-and-mechanical-restraints-in-psychiatric-care-prescriptions-procedures-pharmacological-management-and-monitoring
#6
Chloé Tezenas du Montcel, Célia Kowal, Audrey Leherle, Soraya Kabbaj, Ariel Frajerman, Emmanuel Le Guen, Nora Hamdani, Franck Schürhoff, Marion Leboyer, Antoine Pelissolo, Baptiste Pignon
We will briefly summarize the French recommendations concerning the use of seclusion and mechanical restraint. Acute agitation and aggression or self-injurious activity during psychotic and manic episodes are the main indication of prescription of the coercive measures. Their prescriptions respect specific modalities that will be explained. Although they proved to be efficient, seclusion and restrain need to stay a last resort option, considering the risk of physical complications and psychological consequences...
April 18, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29664808/trends-in-pharmacological-emergency-treatment-of-patients-suffering-from-schizophrenia-over-a-16-year-observation-period
#7
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/29661160/characterizing-the-experience-of-agitation-in-patients-with-bipolar-disorder-and-schizophrenia
#8
Jenna Roberts, Alfredo Gracia Canales, Sophee Blanthorn-Hazell, Anca Craciun Boldeanu, Davneet Judge
BACKGROUND: Agitation is a common manifestation of bipolar disorder and schizophrenia which includes symptoms ranging from inner tension and unease to violence and aggression. Much of the existing literature has focused on agitation in the acute setting, with the patient experience poorly defined. Thus, the aim of this study was to characterize agitation and its management from a patient perspective, with the focus on those who reside in the community. METHODS: Surveys were completed across Germany, Spain and the UK by 583 community dwelling patients with schizophrenia or bipolar disorder who experienced episodes of agitation...
April 16, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/29656154/acute-recanalization-of-a-partially-thrombosed-large-intracranial-aneurysm
#9
E Atallah, E Valle-Giler, T Elarjani, N Chalouhi, S Tjoumakaris, R H Rosenwasser, N Herial, M R Gooch, H Zarzour, P Jabbour
BACKGROUND: Thrombosed large intracranial aneurysms(TLIAs) are not continuously contemplated as stable lesions. Completely occluded large IAs' spontaneous recanalization has been previously described. CASE DESCRIPTION: We report the case of a middle-aged patient presenting with agitation, acute headache, visual field defects and left hemiparesis. A large thrombosed Posterior Communicating (PCom) artery aneurysm was identified with an infarct at the same arterial territory on neuroimaging studies...
April 12, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29629931/magnetic-resonance-imaging-in-neurocritically-ill-patients-who-fails-and-how
#10
Joong-Goo Kim, Myung-Ah Ko, Han-Bin Lee, Sang-Beom Jeon
OBJECTIVES: Performing magnetic resonance imaging (MRI) in neurocritically ill patients is challenging because it often requires sedation and withholding care in the neurological intensive care unit. This study investigated the incidence of and reasons for failed or complicated MRI (MRI-FC) in such patients. METHODS: A consecutive series of 218 neurocritically ill patients who underwent brain MRI were retrospectively evaluated. Failed or complicated MRI included failure to obtain all ordered sequences, unscheduled sedative administration, decrease in oxygen saturation to less than 90%, hypotension (≥40-mm Hg decrease and/or use of inotropic agents), and cardiac or respiratory arrest...
April 6, 2018: Journal of Patient Safety
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
#11
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/29610916/should-this-patient-receive-prophylactic-medication-to-prevent-delirium-grand-rounds-discussion-from-beth-israel-deaconess-medical-center
#12
Anjala V Tess, Melissa L P Mattison, Joshua R Leo, Eileen E Reynolds
In 2015, the American Geriatrics Society released recommendations for prevention and management of postoperative delirium, based on a systematic literature review and evaluation of nonpharmacologic and pharmacologic approaches by an expert panel. The guidelines recommend an interdisciplinary focus on nonpharmacologic measures (reorientation, medication management, early mobility, nutrition, and gastointestinal motility) for prevention and consideration of this strategy for acute management. They also recommend optimizing nonopioid medication as a means to manage pain and avoiding benzodiazepines other than to treat substance withdrawal...
April 3, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29609546/high-frequency-power-of-heart-rate-variability-can-predict-the-outcome-of-thoracic-surgical-patients-with-acute-respiratory-distress-syndrome-on-admission-to-the-intensive-care-unit-a-prospective-single-centric-case-controlled-study
#13
I-Chen Chen, Chew-Teng Kor, Ching-Hsiung Lin, Jane Kuo, Jang-Zern Tsai, Wen-Je Ko, Cheng-Deng Kuo
BACKGROUND: The morbidity and mortality of acute respiratory distress syndrome (ARDS) remains high, and the strategic focus of ARDS research has shifted toward identifying patients at high risk of mortality early in the course of illness. This study intended to identify the heart rate variability (HRV) measure that can predict the outcome of patients with ARDS on admission to the surgical intensive care unit (SICU). METHODS: Patients who had lung or esophageal cancer surgery were included either in the ARDS group (n = 21) if they developed ARDS after surgery or in the control group (n = 11) if they did not...
April 2, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29596102/clonidine-effect-on-pain-after-cesarean-delivery-a-randomized-controlled-trial-of-different-routes-of-administration
#14
Hermann S Fernandes, Fernando Bliacheriene, Thúlio M Vago, Gabriela T Corregliano, Marcelo L Torres, Rossana P Francisco, Hazem A Ashmawi
BACKGROUND: Intrathecal clonidine prolongs spinal anesthesia. We evaluated the effects of the addition of intrathecal or intravenous clonidine (75 µg) to standard cesarean delivery spinal anesthesia on postoperative pain and neonatal outcomes. METHODS: In a randomized, placebo-controlled, double-blind trial, 64 women scheduled for elective cesarean delivery under spinal anesthesia were randomly allocated and compared among 3 groups: intrathecal clonidine 75 µg, intravenous clonidine 75 µg, and placebo...
March 27, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29574851/dexmedetomidine-induced-fever-and-delirium-a-case-report
#15
L B Straw, C R Dodson, D S Schrift
WHAT IS KNOWN AND OBJECTIVE: Dexmedetomidine is a selective alpha-2 agonist used for sedation in the intensive care unit (ICU). CASE DESCRIPTION: A 41-year-old woman intubated in the ICU and being treated for acute respiratory distress syndrome (ARDS) received dexmedetomidine following successful extubation to treat increasing agitation thought to be secondary to a history of polysubstance abuse. Following initiation of the dexmedetomidine, the patient became febrile as well as increasingly more agitated and delirious...
March 25, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29567042/face-and-content-validity-of-variables-associated-with-the-difficult-to-sedate-child-in-the-paediatric-intensive-care-unit-a-survey-of-paediatric-critical-care-clinicians
#16
Ruth M Lebet, Lisa A Asaro, Athena F Zuppa, Martha A Q Curley
BACKGROUND: Clinicians recognise that some critically ill children are difficult-to-sedate. It may be possible to identify this clinical phenotype for sedation response using statistical modelling techniques adopted from machine learning. This requires identification of a finite number of variables to include in the statistical model. OBJECTIVE: To establish face and content validity for 17 candidate variables identified in the international literature as characteristic of the difficult-to-sedate child phenotype...
March 19, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29543606/ce-original-research-recognizing-delirium-in-hospitalized-children-a-systematic-review-of-the-evidence-on-risk-factors-and-characteristics
#17
Cheryl Holly, Sallie Porter, Mercedes Echevarria, Margaret Dreker, Sevara Ruzehaji
The findings can facilitate earlier recognition and prevention of pediatric delirium. ABSTRACT: Purpose: The purpose of this study was to examine the evidence regarding the risk factors for and characteristics of acute pediatric delirium in hospitalized children. METHODS: The systematic review method within an epidemiological framework of person, place, and time was used. Fifty-two studies were selected for initial retrieval. Of these, after assessment for methodological quality, 21 studies involving 2,616 subjects were included in the review...
March 14, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29534916/metoclopramide-induced-pheochromocytoma-crisis
#18
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/29533309/%C3%AE-pyrrolidinopentiophenone-flakka-catalyzing-catatonia-a-case-report-and-literature-review
#19
Elon Richman, Nathan J Skoller, Bernice Fokum, Brandi A Burke, Chelsea A Hickerson, Robert O Cotes
: Synthetic cathinones are a class of novel psychoactive substances. α-Pyrrolidinopentiophenone (α-PVP), or "Flakka", is one of these substances. Users often present acutely psychotic or agitated. We present the case of a 20-year-old male without prior psychiatric history who was brought to the hospital by his family because of increasingly bizarre and erratic behavior after reported ingestion of Flakka. What ensued was a prolonged course of psychosis and severe catatonia. Synthetic cathinones are thought to cause catatonia in approximately 1% of cases...
March 12, 2018: Journal of Addiction 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
#20
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
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