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Terminal sedation

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https://www.readbyqxmd.com/read/29649029/dexmedetomidine-sedation-for-paroxysmal-supraventricular-tachycardia-ablation-is-not-associated-with-alteration-of-arrhythmia-inducibility
#1
Andrew M Slupe, Jessica Minnier, Merritt H Raitt, Ignatius Gerardo E Zarraga, Karen S MacMurdy, Peter M Jessel
BACKGROUND: Dexmedetomidine (Dex) is an attractive agent for procedural sedation due to its unique pharmacodynamic profile, specifically affording predictable sedation without concurrent respiratory depression. However, Dex has previously been reported to prevent or terminate arrhythmias. The purpose of this study was to investigate paroxysmal supraventricular tachycardia (PSVT) inducibility and homeostatic stability during electrophysiology studies (EPSs) and ablation when a standardized Dex protocol was used as the primary sedation agent...
April 11, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29642519/beneficial-effects-of-bioactive-compounds-in-mulberry-fruits-against-cisplatin-induced-nephrotoxicity
#2
Dahae Lee, Jae Sik Yu, Seoung Rak Lee, Gwi Seo Hwang, Ki Sung Kang, Jae Gyu Park, Hyun Young Kim, Ki Hyun Kim, Noriko Yamabe
Mulberry, the fruit of white mulberry tree ( Morus alba L., Moraceae), is commonly used in traditional Chinese medicines as a sedative, tonic, laxative, and emetic. In our continuing research of the bioactive metabolites from mulberry, chemical analysis of the fruits led to the isolation of five compounds, 1 - 5 . The compounds were identified as butyl pyroglutamate ( 1 ), quercetin 3- O -β-d-glucoside ( 2 ), kaempferol 3- O -β-d-rutinoside ( 3 ), rutin ( 4 ), and 2-phenylethyl d-rutinoside ( 5 ) by spectroscopic data analysis, comparing their nuclear magnetic resonance (NMR) data with those in published literature, and liquid chromatography-mass spectrometry analysis...
April 9, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29628954/the-effect-of-acupressure-at-spleen-6-acupuncture-point-on-the-anxiety-level-and-sedative-and-analgesics-consumption-of-women-during-labor-a-randomized-single-blind-clinical-trial
#3
Parisa Samadi, Zahra Alipour, Minoor Lamyian
Background: Labor pain is the most severe pain women would experience, which could lead to loss of emotional control that plays a key role in creating a traumatic delivery experience and psychological disorders. The goal of this study was to evaluate the effect of acupressure on anxiety level and sedative and analgesics consumption in women during labor. Materials and Methods: This study was a randomized, single-blind clinical trial performed at Maryam Hospital in Tehran, Iran...
March 2018: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/29583048/pharmacokinetics-and-pharmacodynamics-after-oral-administration-of-tapentadol-hydrochloride-in-dogs
#4
James Howard, Turi K Aarnes, Jonathan Dyce, Phillip Lerche, Larry W Wulf, Johann F Coetzee, Jeffrey Lakritz
OBJECTIVE To evaluate pharmacokinetic and pharmacodynamic characteristics of 3 doses of tapentadol hydrochloride orally administered in dogs. ANIMALS 6 healthy adult mixed-breed dogs. PROCEDURES In a prospective, randomized crossover study, dogs were assigned to receive each of 3 doses of tapentadol (10, 20, and 30 mg/kg, PO); there was a 1-week washout period between subsequent administrations. Plasma concentrations and physiologic variables were measured for 24 hours. Samples were analyzed by use of high-performance liquid chromatography-tandem mass spectrometry...
April 2018: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/29566706/dexmedetomidine-attenuates-lung-apoptosis-induced-by-renal-ischemia-reperfusion-injury-through-%C3%AE-2-ar-pi3k-akt-pathway
#5
Juanjuan Li, Qian Chen, Xinhai He, Azeem Alam, Jiaolin Ning, Bin Yi, Kaizhi Lu, Jianteng Gu
BACKGROUND: Acute lung injury caused by renal ischemia-reperfusion is one of the leading causes of acute kidney injury-related death. Dexmedetomidine, an α2 -adrenergic agonist sedative, has been found to have protective effects against acute kidney injury and remote lung injury. We sought to determine whether dexmedetomidine can exert its anti-apoptotic effects in acute lung injury after acute kidney injury, in addition to its common anti-inflammatory effects, and to determine the underlying mechanisms...
March 23, 2018: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29548893/palliative-sedation-in-terminal-cancer-patients-admitted-to-hospice-or-home-care-programs-does-the-setting-matter-results-from-a-national-multicenter-observational-study
#6
Augusto Caraceni, Raffaella Speranza, Elio Spoldi, Cristina Sonia Ambroset, Stefano Canestrari, Mauro Marinari, Anna Maria Marzi, Luciano Orsi, Laura Piva, Mirta Rocchi, Danila Valenti, Gianluigi Zeppetella, Furio Zucco, Alessandra Raimondi, Leonor Vasconcelos Matos, Cinzia Brunelli
CONTEXT: Few studies regarding palliative sedation (PS) have been carried out in home care (HC) setting. A comparison of PS rate and practices between hospice (HS) and HC is also lacking. OBJECTIVES: Comparing HC and HS settings for PS rate, patient clinical characteristics before and during PS, decision-making process and clinical aspects of PS. METHODS: 38 HC/HS services in Italy participated in a multicenter observational longitudinal study...
March 13, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29526984/nationwide-survey-of-palliative-care-for-patients-with-heart-failure-in-japan
#7
Takashi Kuragaichi, Yuma Kurozumi, Shogo Ohishi, Yasuo Sugano, Akihiro Sakashita, Norihiko Kotooka, Makoto Suzuki, Taiki Higo, Dai Yumino, Yasuko Takada, Seiko Maeda, Saori Yamabe, Koichi Washida, Tomonori Takahashi, Tomohito Ohtani, Yasushi Sakata, Yukihito Sato
BACKGROUND: Palliative care for heart failure (HF) patients is recommended in Western guidelines, so this study aimed to clarify the current status of palliative care for HF patients in Japan.Methods and Results:A survey was sent to all Japanese Circulation Society-authorized cardiology training hospitals (n=1,004) in August 2016. A total of 544 institutions (54%) returned the questionnaire. Of them, 527 (98%) answered that palliative care is necessary for patients with HF. A total of 227 (42%) institutions held a palliative care conference for patients with HF, and 79% of the institutions had <10 cases per year...
March 10, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29521421/the-pharmacokinetics-and-analgesic-effects-of-extended-release-buprenorphine-administered-subcutaneously-in-healthy-dogs
#8
M Barletta, S M Ostenkamp, A C Taylor, J Quandt, B D X Lascelles, K M Messenger
Buprenorphine is a partial μ agonist opioid used for analgesia in dogs. An extended-release formulation (ER-buprenorphine) has been shown to provide effective analgesia for 72 hr in rats and mice. Six healthy mongrel dogs were enrolled in a randomized, blinded crossover design to describe and compare the pharmacokinetics and pharmacodynamics of ER-buprenorphine administered subcutaneous at 0.2 mg/kg (ER-B) and commercially available buprenorphine for injection intravenously at 0.02 mg/kg (IV-B). After drug administration, serial blood samples were collected to measure plasma buprenorphine concentrations using liquid chromatography/mass spectrometry detection...
March 9, 2018: Journal of Veterinary Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29482491/hispanic-hospice-patients-experiences-of-end-stage-restlessness
#9
Susanny J Beltran
End-stage restlessness, or terminal agitation, is experienced by some patients during their final days and is characterized by physical, emotional, or spiritual distress, agitation or anxiety. End-stage restlessness negatively affects the patient's death experience and can be distressing to the family and care team. Using the 2007 National Home and Hospice Care survey, this study examined factors associated with experiencing end-stage restlessness among non-Hispanic white and Hispanic hospice patients deceased at time of discharge...
February 26, 2018: Journal of Social Work in End-of-life & Palliative Care
https://www.readbyqxmd.com/read/29474938/differential-family-experience-of-palliative-sedation-therapy-in-specialised-palliative-or-critical-care-units
#10
Hui-Shan Shen, Szu-Yin Chen, Denise Shuk Ting Cheung, Shu-Yi Wang, Lee Jung Jae, Chia-Chin Lin
CONTEXT: No study has examined the varying family experience of palliative sedation therapy (PST) for terminally ill patients in different settings. OBJECTIVES: To examine and compare family concerns about PST use and its effect on the grief suffered by terminally ill patients' families in palliative care units (PCU) or intensive care units (ICU). METHODS: A total of 154 family members of such patients were recruited in Taiwan, of whom 143 completed the study, with 81 from the PCU and 62 from the ICU...
February 20, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29468519/effect-of-pressure-support-ventilation-on-carboxyhemoglobin-toxicokinetic-after-acute-carbon-monoxide-intoxication-a-swine-model
#11
N Delvau, A Penaloza, G Liistro, F Thys, I K Delattre, Philippe Hantson, P Gianello, P M Roy
INTRODUCTION: In an experimental study on carbon monoxide (CO) exposure in swine, we aimed to compare the influence of oxygen therapy using a non-rebreathing mask (NRM) to continuous positive airway pressure (CPAP) and two pressure support ventilation (PSV) devices on the decrease of the terminal elimination half-life of carboxyhemoglobin (COHb t1/2 ). This was the primary outcome. METHODS: Eight spontaneously breathing pigs were sedated by propofol and exposed to 940 ppm CO several times (n = 25) to obtain COHb levels of 30%...
February 21, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29466036/pharmacokinetics-of-buprenorphine-after-intravenous-and-oral-transmucosal-administration-in-guinea-pigs-cavia-porcellus
#12
Miranda J Sadar, Heather K Knych, Tracy L Drazenovich, Joanne R Paul-Murphy
OBJECTIVE To determine pharmacokinetics and sedative effects of buprenorphine after IV and oral transmucosal (OTM) administration in guinea pigs. ANIMALS 14 male guinea pigs (6 adults for preliminary experiment; eight 8 to 11-week-old animals for primary study). PROCEDURES A preliminary experiment was conducted to determine an appropriate buprenorphine dose. In the primary study, buprenorphine (0.2 mg/kg) was administered IV or OTM, and blood samples were obtained. The pH of the oral cavity was measured before OTM administration...
March 2018: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/29402365/-effect-and-mechanism-of-dexmedetomidine-on-lungs-in-patients-of-sepsis-complicated-with-acute-respiratory-distress-syndrome
#13
Xianfeng Chen, Juntao Hu, Chi Zhang, Yiping Pan, Diansheng Tian, Fafa Kuang, Zhanhong Tang
OBJECTIVE: To investigate the mechanisms of protective effects of dexmedetomidine on lungs in patients of sepsis complicated with acute respiratory distress syndrome (ARDS). METHODS: The adult patients with sepsis complicated with ARDS, the oxygenation index (PaO2/FiO2) was 150-200 mmHg (1 mmHg = 0.133 kPa), acute physiology and chronic health evaluation II (APACHE II) score was 10-20, need mechanical ventilation (MV) treatment > 72 hours, and admitted to intensive care unit (ICU) of the First Affiliated Hospital of Guangxi Medical University from September 2013 to June 2017 were enrolled...
February 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29382541/palliative-sedation-for-existential-suffering-a-systematic-review-of-argument-based-ethics-literature
#14
REVIEW
Paulo Rodrigues, Jasper Crokaert, Chris Gastmans
CONTEXT: Although unanimity exists on using palliative sedation (PS) for controlling refractory physical suffering in end-of-life situations, using it for controlling refractory existential suffering (PS-ES) is controversial. Complicating the debate is that definitions and terminology for existential suffering are unclear, ambiguous, and imprecise, leading to a lack of consensus for clinical practice. OBJECTIVES: To systematically identify, describe, analyze, and discuss ethical arguments and concepts underpinning the argument-based bioethics literature on PS-ES...
January 31, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29333613/pharmacokinetics-pharmacodynamics-and-clinical-use-of-trazodone-and-its-active-metabolite-m-chlorophenylpiperazine-in-the-horse
#15
J L Davis, J Schirmer, E Medlin
Trazodone is a serotonin receptor antagonist and reuptake inhibitor used extensively as an anxiolytic in human and small animal veterinary medicine. The aims of this study were to determine the pharmacokinetics of oral trazodone in experimental horses and to evaluate the effect of oral trazodone in clinical horses. Six experimental horses were administered trazodone at 7.5 or 10 mg/kg. Plasma concentrations of trazodone and its metabolite (m-CPP) were determined via UPLC-MS/MS. Noncompartmental pharmacokinetic analysis, sedation and ataxia scores were determined...
January 14, 2018: Journal of Veterinary Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29321000/care-quality-following-intrauterine-death-in-spanish-hospitals-results-from-an-online-survey
#16
Paul Richard Cassidy
BACKGROUND: The objective of the study was to evaluate practices in Spanish hospitals after intrauterine death in terms of medical/ technical care and bereavement support care. METHODS: A cross-sectional descriptive study using an online self-completion questionnaire. The population was defined as women who had experienced an intrauterine fetal death between sixteen weeks and birth, either through spontaneous late miscarriage/stillbirth or termination of pregnancy for medical reasons...
January 10, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29320823/first-blindness-cases-of-horses-infected-with-setaria-digitata-nematoda-filarioidea-in-the-republic-of-korea
#17
Jihun Shin, Kyu-Sung Ahn, Guk-Hyun Suh, Ha-Jung Kim, Hak-Sub Jeong, Byung-Su Kim, Eunsang Choi, Sung-Shik Shin
Ocular setariases of cattle were reported but those of equine hosts have never been reported in the Republic of Korea (Korea). We found motile worms in the aqueous humor of 15 horses (Equus spp.) from 12 localities in southern parts of Korea between January 2004 and November 2017. After the affected animals were properly restrained under sedation and local anesthesia, 10 ml disposable syringe with a 16-gauge needle was inserted into the anterior chamber of the affected eye to successfully remove the parasites...
December 2017: Korean Journal of Parasitology
https://www.readbyqxmd.com/read/29317119/noninvasive-ventilation-during-endoscopic-procedures-rationale-clinical-use-and-devices
#18
REVIEW
Marina Pieri, Giovanni Landoni, Luca Cabrini
Endoscopic procedures, such as transesophageal echocardiography, gastroscopy, and airway fibroscopy, routinely are performed in a heterogenous population of patients for diagnostic/interventional purposes (eg, transfemoral aortic valve replacement, airway fibroscopies, and intubation). Sedation frequently is administered to achieve an appropriate degree of patient compliance and procedure success. Patients with reduced respiratory reserve or those who are overly sedated, however, may develop hypoxia and respiratory failure during endoscopies, necessitating premature termination of the examination itself...
April 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29305500/euthanasia-and-palliative-sedation-in-belgium
#19
Raphael Cohen-Almagor, E Wesley Ely
The aim of this article is to use data from Belgium to analyse distinctions between palliative sedation and euthanasia. There is a need to reduce confusion and improve communication related to patient management at the end of life specifically regarding the rapidly expanding area of patient care that incorporates a spectrum of nuanced yet overlapping terms such as palliative care, sedation, palliative sedation, continued sedation, continued sedation until death, terminal sedation, voluntary euthanasia and involuntary euthanasia...
January 4, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29236646/evaluation-of-bone-mineral-density-bmd-and-indicators-of-bone-turnover-in-patients-with-hemophilia
#20
Mehmet Dagli, Ali Kutlucan, Sedat Abusoglu, Abdulkadir Basturk, Mehmet Sozen, Leyla Kutlucan, Ali Unlu, Farise Yilmaz
A decrease in bone mass is observed in hemophilic patients. The aim of this study was to evaluate bone mineral density (BMD), parathyroid hormone (PTH), 25-hydroxy vitamin D (vitamin D), and a bone formation and resorption marker, procollagen type I N-terminal propeptide (PINP) and urinary N-terminal telopeptide (uNTX) respectively, in hemophilic patients and healthy controls. Laboratory parameters related to the pathogenesis of bone loss such as neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were also evaluated...
December 13, 2017: Bosnian Journal of Basic Medical Sciences
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