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https://www.readbyqxmd.com/read/27918326/anesthetic-considerations-for-patients-with-congenital-central-hypoventilation-syndrome-a-systematic-review-of-the-literature
#1
Saptashree M Basu, Frances F Chung, Shireen F AbdelHakim, Jean Wong
Congenital central hypoventilation syndrome (CCHS) is a form of sleep-disordered breathing characterized by a diminished drive to breathe during sleep, despite progressive hypercapnia and hypoxia. The condition results from mutations in the paired-like homeobox 2B (PHOX2B) gene. The aim of this review was to conduct a systematic search of the current data on CCHS as it relates to perioperative considerations and to discuss the classification, prevalence, pathophysiology, presentation, genetics, and management of the condition...
December 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27911257/individualized-antibiotic-therapy-in-patients-with-ventilator-associated-pneumonia
#2
Gurdal Yilmaz, Sedat Saylan, Firdevs Aksoy, Iftihar Koksal
The optimal duration of treatment of ventilator-associated pneumonia (VAP) is still the subject of debate. While 1-week treatment has been reported as possibly sufficient, patients generally receive antibiotic therapy for 10-14 days. The purpose of our study was to investigate whether length of treatment in patients with VAP can be reduced with an individualized therapeutic strategy. The study was performed prospectively with patients diagnosed with VAP in our hospital's intensive care units between 1 January and 31 December, 2015...
December 1, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27908308/remarkable-damage-along-with-poor-quality-of-life-in-takayasu-arteritis-cross-sectional-results-of-a-long-term-followed-up-multicentre-cohort
#3
Ahmet Omma, Burak Erer, Omer Karadag, Neslihan Yilmaz, Fatma Alibaz-Oner, Fatih Yildiz, Melike Kalfa, Gezmis Kimyon, Sedat Kiraz, Haner Direskeneli, Eren Erken, Kenan Aksu, Ahmet Mesut Onat, Ahmet Gül, Lale Ocal, Murat Inanc, Sevil Kamali
OBJECTIVES: We aimed to assess the outcome of a large Takayasu arteritis (TAK) cohort using the vasculitis damage index (VDI) and quality of life (QoL) scale, tools which have been validated for vasculitis. METHODS: Disease activity, damage and QoL were cross-sectionally evaluated in 165 TAK patients from 6 centres. SF-36 were applied to 51 age-matched healthy controls (HC). Persistent activity for ≥6 months was considered as treatment resistance (r-TAK). The correlation between VDI, clinical characteristics and mental (MCS)/physical (PCS) component scores of SF-36 were analysed...
November 10, 2016: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/27907964/critical-care-neurology-perspective-on-delirium
#4
Matthew B Maas, Andrew M Naidech
The evidence linking delirium to poor outcomes after critical illness is compelling, including higher mortality, prolonged mechanical ventilation, longer length of intensive care unit stay, and long-term cognitive impairments. The attitude toward delirium in the neurologic community is shifting away from viewing it as an unmodifiable, inevitable consequence of severe illness to treating it is as a neurologic emergency, akin to seizures or encephalitis. Delirium, like other manifestations of critical illness encephalopathy, is an organ dysfunction syndrome...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27885664/haloperidol-plus-promethazine-for-psychosis-induced-aggression
#5
REVIEW
Gisele Huf, Jacob Alexander, Pinky Gandhi, Michael H Allen
BACKGROUND: Health services often manage agitated or violent people, and such behaviour is particularly prevalent in emergency psychiatric services (10%). The drugs used in such situations should ensure that the person becomes calm swiftly and safely. OBJECTIVES: To examine whether haloperidol plus promethazine is an effective treatment for psychosis-induced aggression. SEARCH METHODS: On 6 May 2015 we searched the Cochrane Schizophrenia Group's Register of Trials, which is compiled by systematic searches of major resources (including MEDLINE, EMBASE, AMED, BIOSIS, CINAHL, PsycINFO, PubMed, and registries of clinical trials) and their monthly updates, handsearches, grey literature, and conference proceedings...
November 25, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27881185/melatonin-and-melatonin-agonists-to-prevent-and-treat-delirium-in-critical-illness-a-systematic-review-protocol
#6
Jennifer Foster, Lisa D Burry, Lehana Thabane, Karen Choong, Kusum Menon, Mark Duffett, Alexandra Cheung, Melanie Guenette, Timothy Chimunda, Louise Rose
BACKGROUND: Delirium is a syndrome characterized by acute fluctuations and alterations in attention and arousal. Critically ill patients are at particularly high risk, and those that develop delirium are more likely to experience poor clinical outcomes such as prolonged duration of ICU and hospital length of stay, and increased mortality. Melatonin and melatonin agonists (MMA) have the potential to decrease the incidence and severity of delirium through their hypnotic and sedative-sparing effects, thus improving health-related outcomes...
November 24, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27862227/one-year-safety-and-efficacy-study-of-bilastine-treatment-in-japanese-patients-with-chronic-spontaneous-urticaria-or-pruritus-associated-with-skin-diseases
#7
Akiko Yagami, Masutaka Furue, Michinori Togawa, Akihiro Saito, Michihiro Hide
A number of second-generation non-sedating antihistamines are used in clinical practices over the world. However, long-term safety and efficacy have not been proved high level evidence based medicine. We have performed an open-label, multicenter, phase III study to evaluate the long-term safety and efficacy of bilastine, a novel non-sedating H1 -antihistamine for patients with chronic spontaneous urticaria (CSU) or pruritus associated with skin diseases (trial registration no. JapicCTI-142528). Patients aged 18-74 years were treated with bilastine 20 mg once daily for up to 52 weeks...
November 14, 2016: Journal of Dermatology
https://www.readbyqxmd.com/read/27861433/understanding-phenotypes-of-obstructive-sleep-apnea-applications-in-anesthesia-surgery-and-perioperative-medicine
#8
Yamini Subramani, Mandeep Singh, Jean Wong, Clete A Kushida, Atul Malhotra, Frances Chung
Obstructive sleep apnea (OSA) is a prevalent sleep-disordered breathing with potential long-term major neurocognitive and cardiovascular sequelae. The pathophysiology of OSA varies between individuals and is composed of different underlying mechanisms. Several components including the upper airway anatomy, effectiveness of the upper airway dilator muscles such as the genioglossus, arousal threshold of the individual, and inherent stability of the respiratory control system determine the pathogenesis of OSA...
November 17, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27856146/early-neurological-wake-up-test-in-intubated-brain-injured-patients-a-long-term-single-centre-experience
#9
Pierre Esnault, Ambroise Montcriol, Erwan D'Aranda, Julien Bordes, Philippe Goutorbe, Henry Boret, Eric Meaudre
BACKGROUND: In prehospital setting, a severe traumatic brain injury (TBI) requires tracheal intubation, sedation and mechanical ventilation pending the initial imagery. An early neurological wake-up test (ENWT), soon after the initial imaging assessment, allows a rapid neurological reassessment. This strategy authorises an initial clinical examination of reference with which will be compared the later examinations. The main objective of this study was to describe the characteristics of the patients who underwent an ENWT, and to determine its causes of failure...
November 14, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27856137/therapeutic-hypothermia-and-inhalation-anesthesia-in-a-patient-with-severe-pneumococcal-meningitis-and-secondary-cardiac-arrest
#10
Nejc Bukovnik, Andrej Markota, Tomaž Velnar, Janez Rebol, Andreja Sinkovič
Therapeutic hypothermia was associated with increased mortality in patients with severe bacterial meningitis in a large randomized trial. It still remains a treatment strategy for comatose survivors of cardiac arrest. There are several potential advantages of inhalational anesthetics as long-term sedation agents compared to intravenous sedation, however, uncontrollable increases of intracranial pressure were observed in neurocritical patients. Here we present a patient with severe bacterial meningitis and secondary cardiac arrest where therapeutic hypothermia and inhalational anesthesia were successfully used...
November 2, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27846922/brexpiprazole-in-patients-with-schizophrenia-overview-of-short-and-long-term-phase-3-controlled-studies
#11
Stephen R Marder, Mika Juhani Hakala, Mette Krog Josiassen, Peter Zhang, John Ouyang, Emmanuelle Weiller, Catherine Weiss, Mary Hobart
OBJECTIVE: Review efficacy, safety, and tolerability of brexpiprazole in patients with schizophrenia in short- and long-term phase 3 studies. METHODS: Patients experiencing a current exacerbation of schizophrenia received brexpiprazole in two fixed-dose (2 and 4 mg), 6-week, placebo-controlled studies, one flexible-dose (2-4 mg), 6-week, placebo-control and active reference study, and one fixed-dose (1-4 mg), 52-week, placebo-controlled maintenance study. RESULTS: The efficacy of brexpiprazole was demonstrated in the two short-term fixed-dose studies with statistically significant improvements from baseline in Positive and Negative Syndrome Scale (PANSS) total score compared with placebo...
November 16, 2016: Acta Neuropsychiatrica
https://www.readbyqxmd.com/read/27811558/renal-protection-in-the-21st-century
#12
Melanie Meersch, Alexander Zarbock
PURPOSE OF REVIEW: Among critically ill patients, acute kidney injury (AKI) is still a common and serious complication with a tremendous impact on short-term and long-term outcomes. The objective of this review is to discuss strategies for renal protection and prevention of AKI in ICU patients. RECENT FINDINGS: It is fundamental to identify patients at risk for AKI as soon as possible and as accurately as possible. In order to achieve these goals, translational approaches implementing new biomarkers have shown promising results...
December 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27785583/short-and-long-term-use-of-medication-for-psychological-distress-after-the-diagnosis-of-cancer
#13
Cheng-Hsu Wang, Lynn Chu Huang, Chen-Chang Yang, Chi-Liang Chen, Yiing-Jenq Chou, Yen-Yuan Chen, Wei-Chih Yang, Likwang Chen
PURPOSE: This study investigated the short- and long-term use of medication for psychological distress after the diagnosis of cancer. METHODS: Longitudinal data from the Taiwan National Health Insurance database were used to follow 35,137 cancer patients for 2.5 years after being diagnosed in 2006 and 2007. RESULTS: Among those patients who survived for at least 180 days, 20.9 % had used psychotropic medications; sedatives were the most frequently prescribed (14...
October 26, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27783767/moderate-sedation-helps-improve-future-behavior-in-pediatric-dental-patients-a-prospective-study
#14
Denise Espíndola Antunes, Karolline Alves Viana, Paulo Sucasas Costa, Luciane Rezende Costa
There is little evidence on the long-term effects of pharmacological management in children undergoing dental treatment. This study aimed to assess children's behavior in consecutive dental sessions following oral rehabilitation using different pharmacological regimens for behavioral control. Participants were preschoolers who were previously treated for caries under one of the following: no sedative, oral sedation with midazolam, oral sedation with midazolam/ketamine, or general anesthesia. The children's behavior in the follow-up sessions was assessed using the Ohio State University Behavioral Rating Scale (OSUBRS); higher scores represented less cooperative behavior (range 5-20)...
October 24, 2016: Brazilian Oral Research
https://www.readbyqxmd.com/read/27782948/sevoflurane-abolishes-oxygenation-impairment-in-a-long-term-rat-model-of-acute-lung-injury
#15
Patrick Kellner, Mattia Müller, Tobias Piegeler, Philipp Eugster, Christa Booy, Martin Schläpfer, Beatrice Beck-Schimmer
BACKGROUND: Patients experiencing acute lung injury (ALI) often need mechanical ventilation for which sedation may be required. In such patients, usually the first choice an intravenously administered drug. However, growing evidence suggests that volatile anesthetics such as sevoflurane are a valuable alternative. In this study, we evaluate pulmonary and systemic effects of long-term (24-hour) sedation with sevoflurane compared with propofol in an in vivo animal model of ALI. METHODS: Adult male Wistar rats were subjected to ALI by intratracheal lipopolysaccharide (LPS) application, mechanically ventilated and sedated for varying intervals up to 24 hours with either sevoflurane or propofol...
October 24, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27767401/-awake-clipping-of-cerebral-aneurysms-report-of-initial-series
#16
Saleem I Abdulrauf, Peter Vuong, Ritesh Patel, Raghu Sampath, Ahmed M Ashour, Lauren M Germany, Jonathon Lebovitz, Colt Brunson, Yuvraj Nijjar, J Kyle Dryden, Maheen Q Khan, Mihaela G Stefan, Evan Wiley, Ryan T Cleary, Connor Reis, Jodi Walsh, Paula Buchanan
OBJECTIVE Risk of ischemia during aneurysm surgery is significantly related to temporary clipping time and final clipping that might incorporate a perforator. In this study, the authors attempted to assess the potential added benefit to patient outcomes of "awake" neurological testing when compared with standard neurophysiological testing performed under general anesthesia. The procedure is performed after the induction of conscious sedation, and for the neurological testing, the patient is fully awake. METHODS The authors conducted an institutional review board-approved prospective study of clipping unruptured intracranial aneurysms (UIAs) in 30 consecutive adult patients who underwent awake clipping...
October 21, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27763767/drug-burden-index-and-change-in-cognition-over-time-in-community-dwelling-older-men-the-champ-study
#17
Kris M Jamsen, Danijela Gnjidic, Sarah N Hilmer, Jenni Ilomäki, David G Le Couteur, Fiona M Blyth, David J Handelsman, Vasi Naganathan, Louise M Waite, Robert G Cumming, J Simon Bell
OBJECTIVE: Anticholinergic and sedative medications are associated with acute cognitive impairment but the long-term impact on change in cognition is unclear. This study investigated the effect of anticholinergic and sedative medications, quantified using the Drug Burden Index (DBI), on change in cognition over time in community-dwelling older men. METHODS: This was a prospective cohort study of men aged ≥70 years in Sydney, Australia. DBI was assessed at baseline, two and five years...
October 20, 2016: Annals of Medicine
https://www.readbyqxmd.com/read/27761920/isoflurane-prevents-acquired-epilepsy-in-rat-models-of-temporal-lobe-epilepsy
#18
Guy Bar-Klein, Rebecca Klee, Claudia Brandt, Marion Bankstahl, Pablo Bascuñana, Kathrin Töllner, Hotjensa Dalipaj, Jens P Bankstahl, Alon Friedman, Wolfgang Löscher
OBJECTIVE: Acquired epilepsy is a devastating long-term risk of various brain insults, including trauma, stroke, infections, and status epilepticus (SE). There is no preventive treatment for patients at risk. Due to the complex alterations involved in epileptogenesis, it is likely that multi-targeted approaches are required for epilepsy prevention. We report novel preclinical findings with isoflurane, which exerts various non-anesthetic effects that may be relevant for anti-epileptogenesis...
October 19, 2016: Annals of Neurology
https://www.readbyqxmd.com/read/27759849/long-term-results-after-ct-guided-percutaneous-ethanol-ablation-for-the-treatment-of-hyperfunctioning-adrenal-disorders
#19
Nathan Elie Frenk, Fernando Sebastianes, Antonio Marcondes Lerario, Maria Candida Barisson Villares Fragoso, Berenice Bilharinho Mendonca, Marcos Roberto de Menezes
OBJECTIVES: To evaluate the safety and long-term efficacy of computed tomography-guided percutaneous ethanol ablation for benign primary and secondary hyperfunctioning adrenal disorders. METHOD: We retrospectively evaluated the long-term results of nine patients treated with computed tomography-guided percutaneous ethanol ablation: eight subjects who presented with primary adrenal disorders, such as pheochromocytoma, primary macronodular adrenal hyperplasia and aldosterone-producing adenoma, and one subject with Cushing disease refractory to conventional treatment...
October 1, 2016: Clinics
https://www.readbyqxmd.com/read/27759568/survey-of-neonatal-intensive-care-unit-nurse-attitudes-toward-therapeutic-hypothermia-treatment
#20
Alexa Craig, Christine James, Janelle Bainter, Francis L Lucas, Scott Evans, John Glazer, Donna Dowling
BACKGROUND: The traumatic experiences of parents of babies treated with therapeutic hypothermia (TH) have been described. No research has assessed neonatal intensive care unit (NICU) nurse experience in providing care to hypothermic babies and emotional support to their parents. PURPOSE: To assess NICU nurse attitudes to the provision of TH with respect to perceptions about baby pain/sedation, need for nurse and parent education, decision making about initiation of TH, and barriers to best care...
October 18, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
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