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https://www.readbyqxmd.com/read/28300462/an-update-on-the-advancements-in-the-treatment-of-agitation-in-alzheimer-s-disease
#1
Anton P Porsteinsson, Inga M Antonsdottir
Neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD) are associated with significant negative outcomes for patients and their caregivers. Agitation, one of the most distressing NPS, lacks well-established long term interventions that are both effective and safe. While nonpharmacological interventions are suggested as first-line treatment, they aren't effective in managing symptoms for every patient, resulting in pharmacological interventions for some patients. Traditionally these interventions consist of off-label use of antipsychotics, sedative/hypnotics, anxiolytics, acetylcholinesterase inhibitors, memantine, and antidepressants; where the efficacy doesn't necessarily outweigh the associated risks...
March 16, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28275227/halogenated-volatile-anesthetics-in-the-intensive-care-unit-current-knowledge-on-an-upcoming-practice
#2
Pascal L Langlois, Frederick D'Aragon, William Manzanares
The aim of this narrative review was to highlight key points of volatile anesthetics administration in the intensive care unit (ICU), including AnaConDa® and Mirus® devices characteristics and the reported findings on clinical outcomes in critically ill patients. Intravenous sedation in the ICU is associated with issues, such as over- and under-sedation. Halogenated compounds, which can be safely administered by inserting a device in any ICU ventilation circuit, have interesting pharmacodynamic and pharmacokinetic profiles for patients with multi-organ failure...
March 8, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28267008/endoscopic-pilonidal-sinus-treatment-combined-with-crystalized-phenol-application-may-prevent-recurrence
#3
Ibrahim Ethem Gecim, Utku Ufuk Goktug, Haydar Celasin
BACKGROUND: No single treatment yet exists for pilonidal disease that has a short healing time, good cosmetic results, and a low rate of recurrence. Phenol crystal application and diathermy ablation through an endoscope have been used for the treatment of pilonidal disease, but this cohort is the first one to combine them. OBJECTIVE: The purpose of this study was to examine the safety, effectiveness, and short- and long-term outcomes of crystalized phenol treatment combined with endoscopic pilonidal sinus treatment for pilonidal disease...
April 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28262515/integrated-primary-care-insomnia-management-in-australia
#4
Fatema-Tun-Naher Sake, Keith Wong, Delwyn J Bartlett, Bandana Saini
BACKGROUND: There is growing support to expand the roles of pharmacists by recognizing their knowledge and skills beyond those around dispensing of medications. Introducing non-dispensing pharmacists at the premises of General Practitioners (GPs) for a collaborative service can potentially and significantly help to provide more effective and efficient health services, for example, in under-recognized or mismanaged conditions such as insomnia. Such a collaborative service could also reduce the costs and risks associated with long-term use of sedatives, besides improving patient's quality of life...
February 20, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28260438/results-of-biliary-reconstruction-using-a-polytetrafluoroethylene-graft-in-liver-transplant-patients
#5
Mehmet Haberal, Ebru H Ayvazoglu Soy, Gokhan Moray, Kenan Caliskan, Sedat Yildirim, Adnan Torgay
OBJECTIVES: Biliary complications after liver transplant are a major concern with their high incidence, the need for repeated and long-term treatment, and their potential effects on graft and patient survival. We report our experience with biliary anastomosis using a spiral polytetrafluoroethylene graft. MATERIALS AND METHODS: Between December 8, 1988, and July 2016, we performed 538 liver transplant procedures. We used a spiral polytetrafluoroethylene graft for biliary anastomosis in 10 patients: for biliary stricture reconstruction after liver transplant in 4 patients and during the primary liver transplant in 6 patients...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260190/general-anesthesia-improves-contact-force-and-reduces-gap-formation-in-pulmonary-vein-isolation-a-comparison-with-conscious-sedation
#6
Akio Chikata, Takeshi Kato, Takanori Yaegashi, Satoru Sakagami, Chieko Kato, Takahiro Saeki, Keiichi Kawai, Shin-Ichiro Takashima, Hisayoshi Murai, Soichiro Usui, Hiroshi Furusho, Shuichi Kaneko, Masayuki Takamura
Compared to conscious sedation (CS), the use of general anesthesia (GA) in pulmonary vein isolation (PVI) is associated with a lower recurrence rate of atrial fibrillation (AF). GA may improve catheter stability and mapping system accuracy compared to CS, but its influence on contact force (CF) parameters during ipsilateral PVI has not previously been investigated. The study population comprised 176 consecutive patients (107 in GA group and 69 in CS group) with AF who underwent their first PVI procedure. We retrospectively assessed CF parameters, force-time integral (FTI), FTI/wall thickness during anatomical ipsilateral PVI and long-term outcome after ablation...
March 4, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28246074/delirium-after-mechanical-ventilation-in-intensive-care-units-the-cognitive-and-psychosocial-assessment-capa-study-protocol
#7
Daniella Bulic, Michael Bennett, Helen Rodgers, Mary Nourse, Patrick Rubie, Jeffrey Cl Looi, Frank Van Haren
BACKGROUND: In the intensive care unit (ICU), critical illness delirium occurs in the context of multiple comorbidities, multi-organ failure, and invasive management techniques, such as mechanical ventilation, sedation, and lack of sleep. Delirium is characterized by an acute confusional state defined by fluctuating mental status, inattention, and either disorganized thinking or an altered level of consciousness. The long-term cognitive and psychosocial function of patients that experience delirium in the ICU is of crucial interest because preliminary data suggest a strong association between ICU-related delirium and long-term cognitive impairment...
February 28, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28240945/evaluation-of-contractile-phenotype-in-airway-smooth-muscle-cells-isolated-from-endobronchial-biopsy-and-tissue-specimens-from-horses
#8
Amandine Vargas, Aude Peltier, Jean Dubé, Josiane Lefebvre-Lavoie, Véronique Moulin, Francine Goulet, Jean-Pierre Lavoie
OBJECTIVE To develop a method to maintain the initial phenotype of airway smooth muscle (ASM) cells isolated from equine endobronchial biopsy specimens in long-term cell culture. SAMPLE Endobronchial tissue specimens (8 to 10/horse) collected from the lungs of previously healthy horses at necropsy (n = 12) and endobronchial biopsy specimens collected from standing, sedated, heaves-affected horses in clinical remission of the disease (5) and control horses (4). PROCEDURES A sampling protocol was developed to recover and maintain a contractile phenotype in ASM cells from endobronchial specimens from freshly harvested equine lungs and from healthy and heaves-affected horses...
March 2017: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/28236389/early-mobilization-of-mechanically-ventilated-patients
#9
REVIEW
Pam Hruska
Critically ill patients requiring mechanical ventilation are least likely to be mobilized and, as a result, are at-risk for prolonged complications from weakness. The use of bed rest and sedation when caring for mechanically ventilated patients is likely shaped by historical practice; however, this review demonstrates early mobilization, with little to no sedation, is possible and safe. Assessing readiness for mobilization in context of progressing patients from passive to active activities can lead to long-term benefits and has been achievable with resource-efficient implementations and team work...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28222534/a-meta-analysis-of-memantine-for%C3%A2-depression
#10
Taro Kishi, Shinji Matsunaga, Nakao Iwata
We conducted a systematic review and meta-analysis on whether memantine was beneficial for the treatment of depressive symptoms in major depressive disorder (MDD) and bipolar disorder (BD). The analysis included double-blind, randomized, placebo-controlled trials of memantine in MDD and BD. The primary outcome measures for efficacy and safety were response rate and all-cause discontinuation, respectively. Risk ratio (RR) and standardized mean difference with 95% confidence intervals (95% CI) were calculated...
2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28213776/the-importance-of-drug-induced-sedation-endoscopy-d-i-s-e-techniques-in-surgical-decision-making-conventional-versus-target-controlled-infusion-techniques-a-prospective-randomized-controlled-study-and-a-retrospective-surgical-outcomes-analysis
#11
Andrea De Vito, Vanni Agnoletti, Gianluca Zani, Ruggero Massimo Corso, Giovanni D'Agostino, Elisabetta Firinu, Chiara Marchi, Ying-Shuo Hsu, Stefano Maitan, Claudio Vicini
Drug-Induced Sedation Endoscopy (DISE) consists of the direct observation of the upper airways during sedative-induced sleep, allowing the identification of the sites of pharyngeal collapse, which is the main pathological event in Obstructive Sleep Apnea (OSA). The Authors have compared Target Controlled Infusion (TCI) sedation endoscopy (TCI-DISE) technique to conventional DISE (CDISE), performed by a manual bolus injection of sedative agent, to recreate accurately and safely snoring and apnea patterns comparable to natural sleep...
February 17, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28206874/a-quality-improvement-initiative-on-the-use-of-psychotropic-drugs-in-nursing-homes-in-flanders
#12
Majda Azermai, Maarten Wauters, Dirk De Meester, Lisa Renson, Danny Pauwels, Laurine Peeters, Hans Warie, Mirko Petrovic
INTRODUCTION: Government-funded quality improvement projects aimed to reduce the high psychotropic medication use in Belgian long-term care settings. DESIGN: A pilot project (2013-2014) with a pre-post and follow-up intervention design. METHODS: Two nursing homes received three educational courses. In the intervention nursing home (INH) additionally, a transition towards person-centred care through professional support was applied. Drug use was recorded at baseline, after 10 months (post) and after 22 months (follow-up), and coded into the Anatomical Therapeutic Chemical classification...
February 16, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28193181/persistent-use-of-psychotropic-drugs-in-nursing-home-residents-in-norway
#13
Anne-Sofie Helvik, Jūratė Šaltytė Benth, Bei Wu, Knut Engedal, Geir Selbæk
BACKGROUND: The prevalence of psychotropic drug (PTD) use in NH residents is high, but few have explored prevalence and persistency in PTD in NH residents and factors associated with persistency. This at the same time as we know that risk of side events may be higher with long- term use in older adults. Thus, the aim of this study was to describe the prevalence and persistence in use of PTD and to explore factors associated with persistence in use of PTD at two consecutive time points in nursing home (NH) residents...
February 13, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28143993/transcatheter-closure-of-patent-ductus-arteriosus-in-adolescents-and-adults-a-case-series
#14
Sukman Tulus Putra, Mulyadi M Djer, Nikmah S Idris, Sudigdo Sastroasmoro
During 11 years period from January 2005 to December 2015 there were 18 adolescent and adult patients  who underwent transcatheter closure of PDA using PDA Amplatzer Duct Occluder (ADO). There were 9 cases with age of 14 to 18 years and 9 cases with age of more than 18 years where the oldest case was 46 years old. Two cases were male and 16 cases were female. Prior to procedures, clinical assessment, ECG, chest x-ray and transthoracic echocardiography (TTE) were performed to confirm the diagnosis of PDA. The procedures of device implantation was performed under conscious sedation in adults and using general anesthesia in adolescents...
October 2016: Acta Medica Indonesiana
https://www.readbyqxmd.com/read/28141899/intravenous-midazolam-infusion-for-sedation-of-infants-in-the-neonatal-intensive-care-unit
#15
REVIEW
Eugene Ng, Anna Taddio, Arne Ohlsson
BACKGROUND: Proper sedation for neonates undergoing uncomfortable procedures may reduce stress and avoid complications. Midazolam is a short-acting benzodiazepine that is used increasingly in neonatal intensive care units (NICUs). However, its effectiveness as a sedative in neonates has not been systematically evaluated. OBJECTIVES: Primary objeciveTo assess the effectiveness of intravenous midazolam infusion for sedation, as evaluated by behavioural and/or physiological measurements of sedation levels, in critically ill neonates in the NICU...
January 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28116804/gabapentin-acutely-increases-the-apnea-hypopnea-index-in-older-men-data-from-a-randomized-double-blind-placebo-controlled-study
#16
Ronaldo D Piovezan, Camila Kase, Renato Moizinho, Sergio Tufik, Dalva Poyares
Although drugs with sedative properties may increase the risk of airway collapse during sleep, their acute effects on the apnea-hypopnea index in older adults are under-reported. We investigated the acute effects of gabapentin (GABA) on sleep breathing in older men without sleep apnea. A double-blind, randomized, placebo-controlled cross-over pilot study using a bedtime dose of gabapentin 300 mg was conducted in eight non-obese older men. Polysomnography measured the effects of the intervention. The apnea-hypopnea index was higher in the gabapentin arm than in the placebo arm (22...
January 24, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28112072/physicians-perceptions-of-suffering-in-people-with-dementia-at-the-end-of-life
#17
Jenny T van der Steen, Luc Deliens, Raymond T C M Koopmans, Bregje D Onwuteaka-Philipsen
OBJECTIVE: Our aim was to describe physicians' perceptions of the suffering of their patients who are dying with dementia, many of whom are incompetent with regard to decision making and have difficulty with communicating about the source of their distress and with identifying related factors. METHOD: We analyzed data from the nationally representative observational Dutch End-of-Life in Dementia (DEOLD) cohort study (2007-2011), which involved 34 long-term care facilities...
January 23, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28107122/evaluating-the-impact-of-pharmacists-on-reducing-use-of-sedative-hypnotics-for-treatment-of-insomnia-in-long-term-care-facility-residents
#18
Maria Grazia Gemelli, Katherine Yockel, Kenneth C Hohmeier
OBJECTIVE: To determine if pharmacist intervention can decrease the use of inappropriate sedative/hypnotics in the elderly population in the long-term care facility setting. DESIGN: A multicenter, prospective chart review of sedative/hypnotic use for insomnia among long-term care facility residents. SETTING: Eleven regional long-term care facilities in Northeastern Tennessee. PARTICIPANTS: Long-term care facility residents older than 65 years of age, with confirmed insomnia diagnoses and no history of seizure or recent psychotropic gradual-dose reduction attempts...
November 1, 2016: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28105858/hplc-ms-ms-method-for-dexmedetomidine-quantification-with-design-of-experiments-approach-application-to-pediatric-pharmacokinetic-study
#19
Oliwia Szerkus, Wiktoria Struck-Lewicka, Marta Kordalewska, Ewa Bartosińska, Renata Bujak, Agnieszka Borsuk, Agnieszka Bienert, Alicja Bartkowska-Śniatkowska, Justyna Warzybok, Paweł Wiczling, Antoni Nasal, Roman Kaliszan, Michał Jan Markuszewski, Danuta Siluk
AIM: The purpose of this work was to develop and validate a rapid and robust LC-MS/MS method for the determination of dexmedetomidine (DEX) in plasma, suitable for analysis of a large number of samples. METHOD: Systematic approach, Design of Experiments, was applied to optimize ESI source parameters and to evaluate method robustness, therefore, a rapid, stable and cost-effective assay was developed. The method was validated according to US FDA guidelines. LLOQ was determined at 5 pg/ml...
February 2017: Bioanalysis
https://www.readbyqxmd.com/read/28074297/-delirium-analgesia-and-sedation-in-intensive-care-medicine-development-of-a-protocol-based-management-approach
#20
A Wolf, R Mörgeli, A Müller, B Weiss, C Spies
Intensive care treatment has long-term consequences that are often not immediately apparent to the health care providers. The combination of muscle weakness, cognitive damage, and psychological disorders is comprised under the term post-intensive care syndrome (PICS). Analgesia and sedation protocols, as well as nonpharmacological preventive and therapeutic approaches, are effective tools for avoiding complications and improving long-term survival. The principle of "early goal-directed therapy" is fundamental...
February 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
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