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https://www.readbyqxmd.com/read/28810649/effect-of-dexmedetomidine-combined-with-sufentanil-on-preventing-emergence-agitation-in-children-receiving-sevoflurane-anesthesia-for-cleft-palate-repair-surgery
#1
Ke Luo, Jun-Mei Xu, Lin Cao, Ju Gao
The aim of the present study was to observe whether dexmedetomidine (DEX) combined with sufentanil decreased emergence agitation (EA) in children receiving sevoflurane anesthesia for cleft palate repair surgery. Children undergoing elective cleft palate repair surgery were randomly allocated into the DEX + sufentanil group (group DS; n=50) and the normal saline + fentanyl group (group SF; n=50). Patients in group DS were treated with 0.5 µg/kg DEX prior to induction of anesthesia, whereas patients in group SF received an equal volume of normal saline...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28810087/multiple-pulmonary-arteriovenous-malformations-an-unusual-cause-of-shortness-of-breath-and-recurrent-strokes
#2
Kalyan C Potu, Shenjing Li, Shawn C Kelly, Julia A Prescott-Focht, Scott Pham
OBJECTIVE: To discuss an uncommon case of a patient with multiple pulmonary arteriovenous malformations (PAVMs) presenting with dyspnea on exertion and recurrent strokes. BACKGROUND: A 79-year-old woman with recent onset recurrent cerebrovascular accidents (CVAs) was referred to cardiology for evaluation of dyspnea on exertion. Clinical examination was unrevealing. METHODS: A transthoracic echocardiogram (TTE) with agitated saline was suggestive of an extra-cardiac shunt...
February 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28808477/effect-of-lamotrigine-in-the-treatment-of-bipolar-depression-with-psychotic-features-a-case-report
#3
Tomoko Kajiya, Hiroko Sugawara, Yusuke Kajio, Satoru Morieda, Hibiki Tanaka, Tadashi Jono, Noboru Fujise, Mamoru Hashimoto
BACKGROUND: Major depressive episodes with psychotic features are more common in bipolar disorder than in major depressive disorder; however, there is little information on the optimal treatment for bipolar depression with psychotic features. CASE PRESENTATION: The patient was a 69-year-old man. At the age of 66, he was admitted to the hospital for the treatment of bipolar depression with psychotic features. He was treated with a combination therapy of antipsychotics and antidepressants during long-term hospitalization...
2017: Annals of General Psychiatry
https://www.readbyqxmd.com/read/28807142/efficacy-of-lurasidone-in-the-treatment-of-agitation-a-post-hoc-analysis-of-five-short-term-studies-in-acutely-ill-patients-with-schizophrenia
#4
Michael H Allen, Leslie Citrome, Andrei Pikalov, Jay Hsu, Antony Loebel
OBJECTIVE: This post hoc analysis evaluated the effect of lurasidone on agitation in acutely ill patients with schizophrenia. METHOD: Patient-level data were pooled from five 6-week, randomized, double-blind, placebo-controlled studies of fixed-dose, once-daily, oral lurasidone (40, 80, 120, or 160 mg/d). Agitation was assessed with the Positive and Negative Syndrome Scale-Excited Component (PANSS-EC) score, utilizing a mixed model for repeated measurement analysis...
July 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28800982/pain-measurement-in-mechanically-ventilated-patients-after-cardiac-surgery-comparison-of-the-behavioral-pain-scale-bps-and-the-critical-care-pain-observation-tool-cpot
#5
Saskia Rijkenberg, Willemke Stilma, Robert J Bosman, Nardo J van der Meer, Peter H J van der Voort
OBJECTIVES: The Behavioral Pain Scale (BPS) and Critical-Care Pain Observation Tool (CPOT) are behavioral pain assessment tools for sedated and unconscious critically ill patients. The aim of this study was to compare the reliability, internal consistency, and discriminant validation of the BPS and the CPOT simultaneously in mechanically ventilated patients after cardiac surgery. DESIGN: A prospective, observational cohort study. SETTING: A 20-bed closed-format intensive care unit with mixed medical, surgical, and cardiac surgery patients in a teaching hospital in Amsterdam, The Netherlands...
August 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28800811/violence-in-the-emergency-department-a-global-problem
#6
REVIEW
Allison Tadros, Christopher Kiefer
Violence against health care workers is an unfortunately common event. Because of several inherent factors, emergency departments are particularly vulnerable. Once an incident occurs, it often goes unreported and leads to both physical and mental trauma. Health care workers should learn to recognize the cues that patients are escalating toward violence and be familiar with various options for sedating agitated patients. If sedation is not successful, physical restraint may become necessary. There are measures that can be taken that may help minimize the likelihood of violence toward health care workers...
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28800801/behavioral-emergencies-special-considerations-in-the-geriatric-psychiatric-patient
#7
REVIEW
Awais Aftab, Asim A Shah
This article reviews psychiatric considerations and common psychiatric emergencies in the elderly. The elderly are vulnerable to medication side-effects because of pharmacokinetic changes from aging, and require lower doses and slower titration. They are a high-risk group for suicide, with more serious intent, fewer warning signs, and more lethality. Prompt diagnosis and treatment of delirium in emergency settings is essential, given association with worse outcomes when undiagnosed. Pharmacologic options with demonstrable efficacy for agitation in dementia are limited to antipsychotics, which are, however, associated with an increased risk of mortality; behavioral interventions are universally recommended as first-line measures...
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28800800/behavioral-emergencies-special-considerations-in-the-pregnant-patient
#8
REVIEW
Awais Aftab, Asim A Shah
This article describes psychiatric emergencies in pregnant women. The perinatal period is a time of psychiatric vulnerability. Up to 1 in 6 pregnant women experience major depressive disorder, and 1 in 4 pregnant women with bipolar disorder experience mood exacerbation. We discuss the management of severe mental illness in pregnancy, risk to mother and child of untreated psychiatric illness in pregnancy, risk of relapse of psychiatric disorders in pregnancy with medication discontinuation, psychopharmacologic considerations of teratogenicity and other fetal adverse effects, acute agitation in the pregnant patient, suicidality in pregnancy, and emergency considerations related to substance use disorders...
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28800797/a-modern-day-fight-club-the-stabilization-and-management-of-acutely-agitated-patients-in-the-emergency-department
#9
REVIEW
Andrew New, Veronica Theresa Tucci, Juan Rios
This article is an overview of the treatment and management of acutely agitated patients as they present in the emergency department or emergency psychiatric facility. This article focuses on how a patient encounter may unfold and what issues need to be considered along the way. Verbal de-escalation is emphasized as a standard of care, including the offering of environmental changes and medications when indicated. Approved medications are reviewed as well as the proper use of restraints.
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28796120/synthetic-cannabis-analogues-and-suicidal-behavior-case-report
#10
Pedro Miguel Dos Santos Oliveira, Ana Sofia Félix Morais, Nuno Gonçalo Gomes Fernandes Madeira
INTRODUCTION: Despite growing legal control, a wide range of synthetic cannabis analogues is currently used for recreational purposes, notwithstanding their well adverse outcomes, which appear to be more frequent and more serious than those associated with cannabis use. We present the case report of a patient with paranoid schizophrenia, who attempted suicide by serious bodily harm after a single use of "Shiva Ultra Strong," a compound of several synthetic cannabis analogues. CASE SUMMARY: A 32-year-old male patient with paranoid schizophrenia was brought to the emergency department presenting with a severe self-inflicted wound to the neck which lacerated the right jugular vein and ipsilateral airway, and narrowly missed the carotid bifurcation...
August 8, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28790827/the-effects-of-memantine-on-behavioral-disturbances-in-patients-with-alzheimer-s-disease-a-meta-analysis
#11
Taro Kishi, Shinji Matsunaga, Nakao Iwata
BACKGROUND: Memantine is effective in the treatment of behavioral disturbances in patients with Alzheimer's disease. It has not yet been fully determined which behavioral disturbances respond best to memantine. METHODS: We conducted a meta-analysis of memantine vs control (placebo or usual care) for the treatment of individual behavioral disturbances (delusion, hallucination, agitation/aggression, dysphoria, anxiety/phobia, euphoria, apathy, disinhibition, irritability/lability, aberrant motor activity/activity disturbances, nighttime disturbance/diurnal rhythm disturbances, and eating disturbances)...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28782308/a-prospective-observational-study-to-determine-the-prevalence-and-clinical-profile-of-patients-of-hypertensive-crisis-in-a-tertiary-care-hospital
#12
Santosh B Salagre, Shobha M Itolikar, Kapil Gedam
BACKGROUND: Hypertension can present in crisis form as 'hypertensive urgency'(HU) or as 'hypertensive emergency' (HE). Both the conditions are associated with significant morbidity and mortality. AIM: To evaluate the clinical characteristics, course of illness, end-organ damage and survival outcome in patients with hypertensive crisis. METHODOLOGY: This prospective observational year-long study was conducted after due ethical considerations on 120 adult non-pregnant patients who presented with blood pressure of >180/120 mm Hg in the emergency medical services of a tertiary care hospital...
June 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28777752/urine-ad7c-ntp-predicts-amyloid-deposition-and-symptom-of-agitation-in-patients-with-alzheimer-s-disease-and-mild-cognitive-impairment
#13
Nan Zhang, Liling Zhang, Yan Li, Marc L Gordon, Li Cai, Ying Wang, Mengya Xing, Yan Cheng
BACKGROUND: Expression of neuronal thread protein (NTP), which is considered to be related to neuritic sprouting and neuronal death, may be elevated in brain tissue, cerebrospinal fluid, and even urine in patients with Alzheimer's disease (AD). OBJECTIVE: In this study, we analyzed the correlation between urine AD-associated NTP (AD7c-NTP) level, and amyloid-β (Aβ) deposition, and clinical symptoms in AD and mild cognitive impairment (MCI). METHODS: Twenty-two patients with mild to moderate AD and 8 subjects with MCI were recruited...
July 29, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28774327/could-remifentanil-reduce-duration-of-mechanical-ventilation-in-comparison-with-other-opioids-for-mechanically-ventilated-patients-a-systematic-review-and-meta-analysis
#14
Yibing Zhu, Yinhua Wang, Bin Du, Xiuming Xi
BACKGROUND: Sedation and analgesia are commonly required to relieve anxiety and pain in mechanically ventilated patients. Fentanyl and morphine are the most frequently used opioids. Remifentanil is a selective μ-opioid receptor that is metabolized by unspecific esterases and eliminated independently of liver or renal function. Remifentanil has a rapid onset and offset and a short context-sensitive half-life regardless of the duration of infusion, which may lead to reductions in weaning and extubation...
August 3, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28772221/perioperative-prediction-of-agitated-hyperactive-delirium-after-cardiac-surgery-in-adults-the-development-of-a-practical-scorecard
#15
Hani N Mufti, Gregory M Hirsch
BACKGROUND: Delirium is a temporary mental disorder that occurs frequently among hospitalized patients. In this study we sought to develop a user-friendly scorecard based on perioperative features to identify patients at risk of developing agitated delirium after cardiac surgery. METHODS: Retrospective analysis was performed on adult patients undergoing cardiac surgery in a single center. A parsimonious predictive model was created, with subsequent internal validation...
July 27, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28769540/electroconvulsive-therapy-for-agitation-in-schizophrenia-metaanalysis-of-randomized-controlled-trials
#16
Xiaojing Gu, Wei Zheng, Tong Guo, Gabor S Ungvari, Helen F K Chiu, Xiaolan Cao, Carl D'Arcy, Xiangfei Meng, Yuping Ning, Yutao Xiang
BACKGROUND: Agitation poses a significant challenge in the treatment of schizophrenia. Electroconvulsive therapy (ECT) is a fast, effective and safe treatment for a variety of psychiatric disorders, but no meta-analysis of ECT treatment for agitation in schizophrenia has yet been reported. AIMS: To systematically evaluate the efficacy and safety of ECT alone or ECT-antipsychotics (APs) combination for agitation in schizophrenia. METHODS: Systematic literature search of randomized controlled trials (RCTs) was performed...
February 25, 2017: Shanghai Archives of Psychiatry
https://www.readbyqxmd.com/read/28763881/-efficacy-and-tolerance-of-memantine-monotherapy-and-combination-therapy-with-reinhartdt-and-sea-cucumber-capsule-on-agitation-in-moderate-to-severe-alzheimer-disease
#17
E Y Yu, Z L Liao, Y F Tan, Y J Qiu, J P Zhu, Y Chen, S S Lin, M H Wu
Objective: To explore the efficacy and tolerance of Memantine combined Reinhartdt And Sea Cucumber Capsule (R.S.C) on treating agitation in patients with moderate-severe Alzheimer disease (AD). Methods: One hundred and fifty-eight moderate-sever AD patients from Sep.2013 to Sep.2014 in Zhejiang Provincial People's Hospital were randomly divided into two groups: group of Memantine combined R. S.C and group of single Memantine. Then Mini-Mental Sate Examination (MMSE) and Neuropsychiatric Inventory (NPI) were used to evaluate cognition symptom, behavioral and psychological symptoms of dementia (BPSD) and agitation symptom at the baseline and the end of 24 weeks...
July 18, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28754047/introducing-namaste-care-to-the-hospital-environment-a-pilot-study
#18
Kimberley St John, Jonathan Koffman
BACKGROUND: The rising prevalence of dementia is impacting on acute hospitals and placing increased expectations on health and social care professionals to improve the support and services they are delivering. It has been recommended that good practice in dementia care relies on adopting a palliative approach to care and meeting people's physical, psychological, social and spiritual needs. Increased dementia training for staff that includes initiatives that promote dignity; enhancing communication skills and recognizing that a person with dementia may be approaching the end of their lives are needed...
October 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28748895/a-case-of-severe-carbamazepine-overdose-treated-successfully-with-combined-hemoperfusion-and-hemodialysis-technique
#19
Natalia Vallianou, Myrto Giannopoulou, Kyriakos Trigkidis, Elefteria Bei, Evangelia Margellou, Theofanis Apostolou
Carbamazepine intoxication manifests as altered mental status ranging from drowsiness to a coma and/or cardiac abnormalities such as sinus tachycardia, prolongation of the QRS interval, ventricular tachycardia, and hypotension. The patient may be agitated, but central nervous system (CNS) depression and presentation with coma is more common and could be lethal. Serious CNS toxicity often requires hemoperfusion and/or hemodialysis (HD). Herein, we present a case of a comatose patient, who was treated with a combination of hemoperfusion and HD in series...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28745784/clinical-research-of-different-analgesia-methods-on-perianesthetic-pain-of-patients-with-moderate-and-severe-craniocerebral-injury-who-have-emergency-operation
#20
Q Huang, H Xu, Q-S Xiao
OBJECTIVE: To compare the effects of two different analgesia methods on postoperative pain of patients with moderate and severe craniocerebral injury who had an emergency operation. PATIENTS AND METHODS: In this study, 64 patients who were treated in our hospital from January 2015 to January 2016 and diagnosed with acute craniocerebral injury, were consecutively selected. The patients were divided into the propofol total intravenous anesthesia group (the observation group) and the isoflurane intravenous-inhalation combined anesthesia group (the control group) randomly with 32 cases each...
July 2017: European Review for Medical and Pharmacological Sciences
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