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Long term sedation

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https://www.readbyqxmd.com/read/29782388/glasgow-coma-scale-score-fluctuations-are-inversely-associated-with-a-nirs-based-index-of-cerebral-autoregulation-in-acutely-comatose-patients
#1
Ryan J Healy, Andres Zorrilla-Vaca, Wendy Ziai, Marek A Mirski, Charles W Hogue, Romergryko Geocadin, Batya Radzik, Caitlin Palmisano, Lucia Rivera-Lara
BACKGROUND: The Glasgow Coma Scale (GCS) is an essential coma scale in critical care for determining the neurological status of patients and for estimating their long-term prognosis. Similarly, cerebral autoregulation (CA) monitoring has shown to be an accurate technique for predicting clinical outcomes. However, little is known about the relationship between CA measurements and GCS scores among neurological critically ill patients. This study aimed to explore the association between noninvasive CA multimodal monitoring measurements and GCS scores...
May 18, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29762314/effectiveness-of-dexmedetomidine-versus-propofol-on-extubation-times-length-of-stay-and-mortality-rates-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#2
John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29757346/effectiveness-of-a-multifaceted-intervention-to-reduce-night-time-sedative-use-in-a-rehabilitation-unit-a-pre-post-intervention-study
#3
Juliana Delos Reyes, Anthony T Sharkey, Laura Morrison, Maria Costello, Cate Crowe, Robert Murphy, Shaun T O'Keeffe, Eamon C Mulkerrin
Background: night-time sedation prescribed during a hospital stay can result in long-term use of such medications in older people. We examined the effectiveness of a multifaceted intervention to reduce night time sedation in an inpatient rehabilitation unit. Methods: an initial retrospective survey of night-time sedative use was followed by prospective re-evaluation after a number of changes were made including education of staff and of patients regarding the potential hazards of sedative medications, measures to promote sleep hygiene and facilitate a 'quiet time' after 10 pm and development of a withdrawal protocol for patients on long-term night sedation...
May 11, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29755713/a-mobile-multimedia-reminiscence-therapy-application-to-reduce-behavioral-and-psychological-symptoms-in-persons-with-alzheimer-s
#4
Danish Imtiaz, Arshia Khan, Adriana Seelye
The goal of this project is to develop a novel and innovative mobile solution to address behavioral and psychological symptoms of dementia (BPSD) that occur in individuals with Alzheimer's. BPSD can include agitation, restlessness, aggression, apathy, obsessive-compulsive and repetitive behaviors, hallucinations, delusions, paranoia, and wandering. Alzheimer's currently affects 5.4 million adults in the United States and that number is projected to increase to 14 million by 2050. Almost 90% of all affected with AD experience BPSD, resulting in increased healthcare costs, heavier burden on caregivers, poor patient outcomes, early nursing home placement, long-term hospitalizations, and misuse of medications...
2018: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29720440/association-of-blood-pressure-with-short-and-long-term-functional-outcome-after-stroke-thrombectomy-post-hoc-analysis-of-the-siesta-trial
#5
Silvia Schönenberger, Lorenz Uhlmann, Matthias Ungerer, Johannes Pfaff, Simon Nagel, Christina Klose, Martin Bendszus, Wolfgang Wick, Peter A Ringleb, Meinhard Kieser, Markus A Möhlenbruch, Julian Bösel
BACKGROUND AND PURPOSE: Outcome after mechanical thrombectomy for ischemic stroke may be influenced by blood pressure (BP). This study aims to assess the association of BP changes during general anesthesia versus conscious sedation with functional outcome after mechanical thrombectomy. METHODS: SIESTA (Sedation vs Intubation for Endovascular Stroke Treatment) was a monocentric randomized trial of general anesthesia versus conscious sedation during mechanical thrombectomy involving BP target protocols...
May 2, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29713452/challenges-of-the-pharmacological-management-of-benzodiazepine-withdrawal-dependence-and-discontinuation
#6
REVIEW
Dimy Fluyau, Neelambika Revadigar, Brittany E Manobianco
Background: Benzodiazepines (BZDs) are among the most prescribed sedative hypnotics and among the most misused and abused medications by patients, in parallel with opioids. It is estimated that more than 100 million Benzodiazepine (BZD) prescriptions were written in the United States in 2009. While medically useful, BZDs are potentially dangerous. The co-occurring abuse of opioids and BZD, as well as increases in BZD abuse, tolerance, dependence, and short- and long-term side effects, have prompted a worldwide discussion about the challenging aspects of medically managing the discontinuation of BZDs...
May 2018: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/29701428/anaesthetic-management-in-a-duchennne-muscle-dystrophy-patient-for-treatment-of-recurrent-pneumothorax
#7
Sara Mota, Liuba Germanova, Joana Cortesão, Teresa Paiva
INTRODUCTION: Duchenne muscular dystrophy (DMD) is an x linked recessive disorder. Long term prognosis is ominous, with development of respiratory distress and cardiomyopathy in advanced stage of the disease and expected death in the teens-to-mid 20s due to respiratory or cardiac failure. Peri-operative management of this patients is challenging due to difficult airway anatomy (macroglossia, limited neck and mandibular mobility). Additionally, they are at risk of developing malignant hyperthermia, rhabdomyolysis and hyperkalemic cardiac arrest when exposed to halogenated inhalational anaesthetics and depolarizing muscle relaxants...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29673408/long-term-scar-quality-after-hydrosurgical-versus-conventional-debridement-of-deep-dermal-burns-hycon-trial-study-protocol-for-a-randomized-controlled-trial
#8
Catherine M Legemate, Harold Goei, Esther Middelkoop, Irma M M H Oen, Tim H J Nijhuis, Kelly A A Kwa, Paul P M van Zuijlen, Gerard I J M Beerthuizen, Marianne K Nieuwenhuis, Margriet E van Baar, Cornelis H van der Vlies
BACKGROUND: Deep dermal burns require tangential excision of non-viable tissue and skin grafting to improve wound healing and burn-scar quality. Tangential excision is conventionally performed with a knife, but during the last decade hydrosurgery has become popular as a new tool for tangential excision. Hydrosurgery is generally thought to be a more precise and controlled manner of burn debridement leading to preservation of viable tissue and, therefore, better scar quality. Although scar quality is considered to be one of the most important outcomes in burn surgery today, no randomized controlled study has compared the effect of these two common treatment modalities with scar quality as a primary outcome...
April 19, 2018: Trials
https://www.readbyqxmd.com/read/29669351/bronchial-thermoplasty-in-severe-asthma-best-practice-recommendations-from-an-expert-panel
#9
Peter I Bonta, Pascal Chanez, Jouke T Annema, Pallav L Shah, Robert Niven
Bronchial thermoplasty (BT) is a bronchoscopic treatment for patients with severe asthma who remain symptomatic despite optimal medical therapy. In this "expert best practice" paper, the background and practical aspects of BT are highlighted. Randomized, controlled clinical trials have shown BT to be safe and effective in reducing severe exacerbations, improving quality of life, and decreasing emergency department visits. Five-year follow-up studies have provided evidence of the functional stability of BT-treated patients with persistence of a clinical benefit...
2018: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29663328/gamma-aminobutyric-acid-agonists-for-antipsychotic-induced-tardive-dyskinesia
#10
REVIEW
Samer Alabed, Youssef Latifeh, Husam Aldeen Mohammad, Hanna Bergman
BACKGROUND: Chronic antipsychotic drug treatment may cause tardive dyskinesia (TD), a long-term movement disorder. Gamma-aminobutyric acid (GABA) agonist drugs, which have intense sedative properties and may exacerbate psychotic symptoms, have been used to treat TD. OBJECTIVES: 1. Primary objectiveThe primary objective was to determine whether using non-benzodiazepine GABA agonist drugs for at least six weeks was clinically effective for the treatment of antipsychotic-induced TD in people with schizophrenia, schizoaffective disorder or other chronic mental illnesses...
April 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29663283/eeg-artifact-versus-subclinical-status-epilepticus-in-a-patient-following-cardiac-arrest
#11
Jean E Cibula, Daniel S Demos, Brenda G Fahy
BACKGROUND: A challenge in ICU EEG interpretation is identifying subclinical status epilepticus versus patterns on the ictal-interictal continuum versus other repetitive patterns. In the electrically noisy intensive care unit, identifying and eliminating interference and artifact allow accurate diagnoses from the EEG, avoiding unnecessary treatment or sedation. METHODS: We present a case during Impella (Abiomed Inc, Danvers, MA) continuous flow left ventricular assist device use where the EEG artifact was initially misinterpreted as seizure by the resident and treated as status epilepticus because of the "focal" sharply contoured repetitive pattern...
April 16, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29652686/massive-macroglossia-after-posterior-cranial-fossa-surgery-a-case-report
#12
Jennifer F Ha, Lisa N Vitale, Marie A Pfarr, Yu Kawai, David A Zopf
A 16-year-old boy with Chiari 1 malformation presented for an elective suboccipital craniectomy and C1 laminectomy. His intraoperative course was uneventful. At the conclusion of the procedure, he met extubation criteria and followed commands. After extubation, he developed progressive upper airway obstruction and became obtunded. He was reintubated via videolaryngoscopy, which showed edema not only to the tongue, but also to the posterior pharynx and blisters over the vocal folds and epiglottis. The patient was transferred to the pediatric intensive care unit intubated and sedated...
April 15, 2018: A&A practice
https://www.readbyqxmd.com/read/29651507/efficacy-and-side-effects-of-baclofen-and-the-novel-gaba-b-receptor-positive-allosteric-modulator-cmppe-in-animal-models-for-alcohol-and-cocaine-addiction
#13
Valentina Vengeliene, Tatiane T Takahashi, Olga A Dravolina, Irina Belozertseva, Edwin Zvartau, Anton Y Bespalov, Rainer Spanagel
RATIONALE: Preclinical studies suggest that the GABAB receptor is a potential target for treatment of substance use disorders. However, recent clinical trials report adverse effects in patients treated with the GABAB receptor agonist baclofen and even question efficacy. How can the discrepancy between preclinical and clinical findings be explained? OBJECTIVE: To test efficacy and adverse effects of baclofen and the novel GABAB positive allosteric modulator (PAM) CMPPE in rat addiction models, which were developed in accordance with DSM...
April 12, 2018: Psychopharmacology
https://www.readbyqxmd.com/read/29650783/percutaneous-ct-guided-biopsies-of-the-cervical-spine-technique-histopathologic-and-microbiologic-yield-and-safety-at-a-single-academic-institution
#14
E L Wiesner, T J Hillen, J Long, J W Jennings
BACKGROUND AND PURPOSE: Cervical spine biopsies can be challenging due to the anatomy and the adjacent critical structures. Percutaneous image-guided biopsies can obviate the need for an open biopsy, however there have been few studies looking at the approaches, safety, and efficacy of percutaneous cervical spine biopsies. This retrospective study evaluated technical considerations, histopathologic and microbiologic yield, and safety in CT-guided cervical bone biopsies. MATERIALS AND METHODS: A retrospective review of cervical bone and/or bone/disc biopsies performed from January 2010 to January 2017 was included in this study...
April 12, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29643163/effect-of-intratracheal-dexmedetomidine-administration-on-recovery-from-general-anaesthesia-after-gynaecological-laparoscopic-surgery-a-randomised-double-blinded-study
#15
Fei Wang, Haoxiang Zhong, Xiaoyan Xie, Weiping Sha, Caili Li, Zhenping Li, Zhuomei Huang, Chaojin Chen
OBJECTIVES: To examine the efficacy of intratracheal dexmedetomidine (Dex) injection for the prevention of the laryngeal response on emergence from general anaesthesia following gynaecological laparoscopic surgery. DESIGN: Prospective, randomised, double-blinded, controlled trial. SETTING: A general hospital, Guangdong Province, China. PARTICIPANTS: All patients who underwent elective laparoscopic gynaecological surgery, aged 18-60 years old, 40-80 kg in weight, American Society of Anesthesiologists class I-II were eligible...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29627276/a-review-on-drug-induced-sedation-endoscopy-technique-grading-systems-and-controversies
#16
REVIEW
Matt Lechner, Dominic Wilkins, Bhik Kotecha
Sleep disordered breathing (SDB) comprises a spectrum of disorders, ranging from simple snoring to severe obstructive sleep apnoea (OSA), with a significant burden to health care systems in high income countries. If left untreated, OSA has significant cumulative, long-term health consequences. In the 1990s drug induced sedation endoscopy (DISE) has been developed to become a primary tool in the diagnosis and management of OSA. It allows meticulous endoscopic evaluation of the airway and identifies areas of collapse, thereby informing both on the selection of surgical techniques, where efficacy depends entirely on success at relieving obstruction at a certain level and on the usefulness of conservative measures, such as mandibular advancement splints...
February 24, 2018: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/29624189/improving-the-safety-of-opioid-use-for-acute-noncancer-pain-in-hospitalized-adults-a-consensus-statement-from-the-society-of-hospital-medicine
#17
Shoshana J Herzig, Hilary J Mosher, Susan L Calcaterra, Anupam B Jena, Teryl K Nuckols
Hospital-based clinicians frequently treat acute, noncancer pain. Although opioids may be beneficial in this setting, the benefits must be balanced with the risks of adverse events, including inadvertent overdose and prolonged opioid use, physical dependence, or development of opioid use disorder. In an era of epidemic opioid use and related harms, the Society of Hospital Medicine (SHM) convened a working group to develop a consensus statement on opioid use for adults hospitalized with acute, noncancer pain, outside of the palliative, end-of-life, and intensive care settings...
April 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29614295/methodology-and-effects-of-repeated-intranasal-delivery-of-dnsp-11-in-awake-rhesus-macaques
#18
M J Stenslik, A Evans, F Pomerleau, R Weeks, P Huettl, E Foreman, J Turchan-Cholewo, A Andersen, W A Cass, Z Zhang, R C Grondin, D M Gash, G A Gerhardt, L H Bradley
BACKGROUND: To determine if the intranasal delivery of neuroactive compounds is a viable, long-term treatment strategy for progressive, chronic neurodegenerative disorders, such as Parkinson's disease (PD), intranasal methodologies in preclinical models comparable to humans are needed. NEW METHOD: We developed a methodology to evaluate the repeated intranasal delivery of neuroactive compounds on the non-human primate (NHP) brain, without the need for sedation. We evaluated the effects of the neuroactive peptide, DNSP-11 following repeated intranasal delivery and dose-escalation over the course of 10-weeks in Rhesus macaques...
March 31, 2018: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/29607519/long-term-effects-of-tibial-plateau-leveling-osteotomy-and-tibial-tuberosity-advancement-on-tibial-plateau-subchondral-bone-density-in-dogs
#19
Elizabeth S Leach, Ursula Krotscheck, Kelsey J Goode, Galina M Hayes, Peter Böttcher
OBJECTIVE: To evaluate long-term loading patterns using subchondral bone density (SBD) distribution of the tibial plateau after tibial plateau leveling osteotomy (TPLO) and tibial tuberosity advancement (TTA). STUDY DESIGN: Cross-sectional study. ANIMALS: Adult (> 2 years), medium to large breed dogs (>20 kg) that had been treated with TPLO or TTA at least 1 year prior to the study were recruited. A normal cohort of similar age and weight dogs with normal physical and orthopedic examinations served as control...
April 1, 2018: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29607394/diagnostic-adequacy-and-safety-of-endoscopic-ultrasound-guided-fine-needle-aspiration-in-patients-with-lymphadenopathy-in-a-large-cohort
#20
Rinkesh K Bansal, Narendra S Choudhary, Saurabh K Patle, Mahesh K Gupta, Chitranshu Vashishtha, Gagandeep Kaur, Haimanti Sarin, Rajesh Puri
Background and study aims : The role of endoscopic-ultrasound (EUS) guided fine-needle aspiration (FNA) in patients with lymphadenopathy in terms of diagnostic adequacy and safety in large population is not well defined. The aim of this study was to evaluate diagnostic adequacy and safety of EUS-FNA in patients with lymphadenopathy. Patients and methods:  Retrospective study from October 2010 to September 2015 at tertiary care center in Delhi-NCR. We analyzed data from 1005 EUS- FNAs of lymph nodes...
April 2018: Endoscopy International Open
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