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https://www.readbyqxmd.com/read/28429385/risk-factors-proximate-to-suicide-and-suicide-risk-assessment-in-the-context-of-denied-suicide-ideation
#1
Alan L Berman
Health care providers have significant opportunities to identify individuals at near-term risk for suicide, but lack empirical data on near-term risk factors. This study aimed to identify dynamic, state-related risk factors observed by clinical practitioners within the last 30 days of life of 157 patients who died by suicide and to compare these near-term risk factors among patients who denied versus responded positively to having suicide ideation (SI) when last asked by a clinical practitioner prior to their death...
April 21, 2017: Suicide & Life-threatening Behavior
https://www.readbyqxmd.com/read/28425829/effects-of-dexmedetomidine-versus-midazolam-for-premedication-in-paediatric-anaesthesia-with-sevoflurane-a-meta-analysis
#2
Ji-Feng Feng, Xiao-Xia Wang, Yan-Yan Lu, Deng-Ge Pang, Wei Peng, Jian-Lan Mo
Background Dexmedetomidine (DEX), an α2-adrenergic receptor agonist, produces ideal sedation and early postoperative recovery for premedication in paediatric surgery, reducing preoperative anxiety and facilitating smooth induction of anaesthesia. We performed a meta-analysis to compare the effects of DEX and midazolam (MDZ) in paediatric anaesthesia with sevoflurane. Methods PubMed, Ovid, Web of Science, and Public Health Management Corporation were searched through December 2016 for randomized controlled trials (RCTs) that compared DEX and MDZ in children undergoing sevoflurane anaesthesia...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28422874/consort-the-effect-of-intraoperative-dexmedetomidine-on-hemodynamic-responses-during-emergence-from-nasotracheal-intubation-after-oral-surgery
#3
Youn Yi Jo, Hong Soon Kim, Kyung Cheon Lee, Young Jin Chang, Youseok Shin, Hyun Jeong Kwak
BACKGROUND: Dexmedetomidine provides smooth emergence with reduced agitation. The authors hypothesized low-dose dexmedetomidine infusion might contribute to hemodynamic stability during and after nasotracheal tube extubation. METHODS: Ninety-three adult patients scheduled for oral and maxillofacial surgery were enrolled in this prospective study. Patients were randomly assigned to receive normal saline (control group, n = 31), dexmedetomidine at 0.2 μg/kg/h (DEX0...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28421896/anosognosia-and-its-relation-to-psychiatric-symptoms-in-early-onset-alzheimer-disease
#4
Bora Yoon, Yong S Shim, Yun Jeong Hong, Seong Hye Choi, Hee Kyung Park, Sun Ah Park, Jee Hyang Jeong, Soo Jin Yoon, Dong-Won Yang
BACKGROUND: We investigated differences in the prevalence of anosognosia and neuropsychiatric symptoms (NPSs) characteristics according to disease severity in patients with early-onset Alzheimer disease (EOAD). METHODS: We recruited 616 patients with EOAD. We subdivided participants into 2 groups based on the presence or absence of anosognosia and then again by Clinical Dementia Rating (CDR) scale. We compared the differences in the Neuropsychiatric Inventory (NPI) scores according to anosognosia and disease severity...
May 2017: Journal of Geriatric Psychiatry and Neurology
https://www.readbyqxmd.com/read/28421836/analytical-confirmation-of-synthetic-cannabinoids-in-a-cohort-of-179-presentations-with-acute-recreational-drug-toxicity-to-an-emergency-department-in-london-uk-in-the-first-half-of-2015
#5
Rachelle Abouchedid, Simon Hudson, Natalie Thurtle, Takahiro Yamamoto, James H Ho, George Bailey, Michelle Wood, Nele Sadones, Christophe P Stove, Alison Dines, John R H Archer, David M Wood, Paul I Dargan
CONTEXT: Synthetic cannabinoid receptor agonists are the largest group of new psychoactive substances reported in the last decade; in this study we investigated how commonly these drugs are found in patients presenting to the Emergency Department with acute recreational drug toxicity. METHODS: We conducted an observational cohort study enrolling consecutive adult patients presenting to an Emergency Department (ED) in London (UK) January-July 2015 (6 months) with acute recreational drug toxicity...
June 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28421731/intraoperative-dexmedetomidine-sedation-reduces-the-postoperative-agitated-behaviour-in-elderly-patients-undergoing-orthopaedic-surgery-compared-to-the-propofol-sedation-a-retrospective-analysis-of-855-patients
#6
Hyun-Jung Shin, Bon-Wook Koo, Seung-Uk Bang, Jin-Hee Kim, Jung-Won Hwang, Sang-Hwan DO, Hyo-Seok Na
BACKGROUND: Postoperative agitation or confusion is one of the symptoms of hyperactive delirium in elderly patients. We retrospectively evaluated the incidence of postoperative abnormal psychomotor behaviour in elderly surgical patients according to the use of different intraoperative sedative agents: dexmedetomidine vs. propofol. METHODS: The medical records of 855 elderly patients, who underwent orthopaedic surgery with regional anaesthesia between July 2012 and September 2015, were divided into two groups-the dexmedetomidine group (n=263) and the propofol group (n=592)-and evaluated...
April 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28421287/-age-89-years-depression-fall-with-pelvic-fracture-severe-confusion-serotonin-syndrome-differential-diagnosis-importance-of-cyp450-and-economic-considerations
#7
REVIEW
W Weinrebe, A Moutaouakil, K Risz, M Martin, K Jeckelmann, S Goetz
A case study of an 89-year-old patient is reported, who was admitted to hospital because of immobility due to pain. After the cause of the pain could initially be clarified and treated, the further clinical course in this very old woman showed an alarming symptom complex of agitation, confusion and cognitive deterioration, which took on grave forms. The work-up of this case showed a typical constellation of pain and depression in old age; however, the pharmaceutical treatment in this case is not atypical and could lead to a severe serotonin syndrome...
April 18, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28420470/-explore-objective-clinical-variables-for-detecting-delirium-in-icu-patients-a-prospective-case-control-study
#8
Xiaojiang Liu, Jie Lyu, Youzhong An
OBJECTIVE: The aim of this case-control study is to explore clinical objective variables for diagnosing delirium of intensive care unit (ICU) patients. METHODS: According to the method of prospective case-control study, critical adult postoperative patients who were transferred to ICU of Peking University People's Hospital from October 2015 to May 2016 and needed mechanical ventilation were included. After evaluating the Richmond agitation sedation scale score (RASS), the patients whose score were -2 or greater were sorted into two groups, delirium and non-delirium, according to the confusion assessment method for the ICU (CAM-ICU)...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28415099/p594contrast-transthoracic-echocardiography-as-a-gatekeeper-for-patent-foramen-ovale-closure
#9
M Muratori, G Italiano, E Innocenti, L Fusini, M Mapelli, G Tamborini, S Ghulam Ali, P Gripari, A Maltagliati, F Celeste, M Pepi
Background.: The presence of patent foramen ovale (PFO) has been linked to many illness, including cryptogenic stroke, transient ischemic attack, migraine, platypnea-orthodeoxia syndrome and decompression sickness in scuba divers. Transesophageal echocardiography is the gold standard technique for the visualization of atrial septal anatomy, but it is a secondary level exam, not always available, with additional associated costs and not completely free from procedural risks. Standard transthoracic echocardiography (TTE) has a too low sensitivity for PFO screening...
December 1, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28414666/just-a-puff-of-smoke
#10
A Leonard
CASE: A 44 year old woman with a history of stroke s/p aneurysm clipping, seizure, and substance abuse was brought to the hospital after a family member received a call from her friend saying she was acting unusual and may have had a seizure while hanging out on the street. At her baseline, she needed modest assistance in daily activities after her CVA and conversed without issue. Her mother died of a stroke. On exam the patient was afebrile, normotensive with mild tachycardia to 110...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28412050/-the-correlation-among-the-ramsay-sedation-scale-richmond-agitation-sedation-scale-and-riker-sedation-agitation-scale-during-midazolam-remifentanil-sedation
#11
Turgut Namigar, Karacalar Serap, Akdaş Tekin Esra, Odacılar Özgül, Öztürk Ali Can, Ak Aysel, Ali Achmet
BACKGROUND AND OBJECTIVES: Sedative and analgesic treatment administered to critically ill patients need to be regularly assessed to ensure that previously stated goals are well achieved as the risk of complications of oversedation is minimized. We revised and prospectively tested the Ramsay Sedation Scale (RSS) for interrater reliability and compared it with the Riker Sedation-Agitation Scale (RSAS) and the Richmond Agitation Sedation Scale (RASS) to test construct validity during midazolam-remifentanil sedation...
April 12, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28410258/behavioral-disturbance-causing-sudden-respiratory-distress-in-a-3-year-old-after-tracheocutaneous-fistula-closure-a-case-report
#12
Rhashedah A Ekeoduru, Hassan M Aijazi, Amy D Graham-Carlson
A 3-year-old boy underwent tracheostomy at age 5 months for respiratory failure. The tracheostomy tube was removed a year later but a tracheocutaneous fistula developed requiring fistulectomy and primary skin closure. After an initial uneventful course in the postanesthesia care unit, the patient became agitated, began to scream, and suddenly developed rapidly progressing subcutaneous emphysema over his chest, face, and abdomen. Orotracheal intubation was emergently performed and chest radiograph revealed pneumothorax and pneumomediastinum...
April 13, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28407198/chlorpromazine-dose-for-people-with-schizophrenia
#13
REVIEW
Katharine Dudley, Xiaomeng Liu, Saskia De Haan
BACKGROUND: The World Health Organization (WHO) Model Lists of Essential Medicines lists chlorpromazine as one of its five medicines used in psychotic disorders. OBJECTIVES: To determine chlorpromazine dose response and dose side-effect relationships for schizophrenia and schizophrenia-like psychoses. SEARCH METHODS: We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials (December 2008; 2 October 2014; 19 December 2016)...
April 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28401138/prevalence-of-symptoms-at-the-end-of-life-in-an-acute-care-hospital-a-retrospective-cohort-study
#14
Daniel Kobewka, Paul Ronksley, Dan McIsaac, Sunita Mulpuru, Alan Forster
BACKGROUND: There is currently debate over the benefits and harms of physician-assisted death. One of the factors influencing this debate is concern about symptoms in the days before death. The objective of this study was to describe the frequency of symptoms before death and determine patient characteristics associated with these symptoms. METHODS: We reviewed the medical record of every patient who died at a multisite academic teaching hospital over a 3-month period...
January 2017: CMAJ Open
https://www.readbyqxmd.com/read/28400941/abnormal-color-flow-signal-traversing-the-myocardial-wall-not-everything-is-what-it-appears-to-be
#15
Kathy Edelman, Angel López-Candales
A case of a patient presenting with an acute myocardial infarction is presented. A transthoracic echocardiographic examination revealed an abnormal color flow signal that traversed the myocardial wall from a large inferior aneurysm and initially considered to be a ventricular septal defect. However, further echocardiographic manipulation utilizing modified views along with sequential injections of both agitated saline and Definity(®) proved very useful to identify a pseudoaneurysm. There was no further need for any other diagnostic test, and the patient was treated surgically, undergoing successful repair of the pseudoaneurysm as well as coronary artery bypass grafting of the left coronary artery...
October 2016: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/28399647/%C3%AE-blockers-cocaine-and-the-unopposed-%C3%AE-stimulation-phenomenon
#16
John R Richards, Judd E Hollander, Edward A Ramoska, Fareed N Fareed, I Charles Sand, María Manuela Izquierdo Gómez, Richard A Lange
Cocaine abuse remains a significant worldwide health problem. Patients with cardiovascular toxicity from cocaine abuse frequently present to the emergency department for treatment. These patients may be tachycardic, hypertensive, agitated, and have chest pain. Several pharmacological options exist for treatment of cocaine-induced cardiovascular toxicity. For the past 3 decades, the phenomenon of unopposed α-stimulation after β-blocker use in cocaine-positive patients has been cited as an absolute contraindication, despite limited and inconsistent clinical evidence...
May 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28398818/neuroleptic-malignant-syndrome-malignant-catatonia-in-child-psychiatry-literature-review-and-a-case-series
#17
Neera Ghaziuddin, Melissa Hendriks, Paresh Patel, Lee E Wachtel, Dirk M Dhossche
OBJECTIVE: To describe the presentation of neuroleptic malignant syndrome (NMS) and malignant catatonia (MC) in children and adolescents. BACKGROUND: NMS and MC are life-threatening, neuropsychiatric syndromes, associated with considerable morbidity and mortality. NMS is diagnosed when there is a recent history of treatment with an antipsychotic (AP) medication, while MC is diagnosed when the symptoms resemble NMS but without a history of exposure to an AP agent...
February 23, 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28397128/characteristics-and-treatment-of-patients-with-clinical-illness-due-to-synthetic-cannabinoid-inhalation-reported-by-medical-toxicologists-a-toxic-database-study
#18
Andrew A Monte, Diane P Calello, Roy R Gerona, Eike Hamad, Sharan L Campleman, Jeffery Brent, Paul Wax, Robert G Carlson
INTRODUCTION: Synthetic cannabinoid (SC) abuse has resulted in numerous outbreaks of severe clinical illness across the United States over the past decade. The primary objective of this study was to determine the clinical characteristics of patients abusing SC requiring bedside consultation by medical toxicologists. METHODS: This was a multicenter analysis from a prospectively collected cohort of patients presenting to medical care after synthetic cannabinoid exposure, utilizing the ToxIC Registry...
April 10, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/28393558/supraventricular-tachycardia-and-acute-confusion-following-ingestion-of-e-cigarette-fluid-containing-ab-fubinaca-and-adb-fubinaca-a-case-report-with-quantitative-analysis-of-serum-drug-concentrations
#19
Rex Pui Kin Lam, Magdalene Huen Yin Tang, Siu Chung Leung, Yeow Kuan Chong, Matthew Sik Hon Tsui, Tony Wing Lai Mak
BACKGROUND: AB-FUBINACA and ADB-FUBINACA are structurally similar synthetic cannabinoids with potent CB1 receptor agonistic effects. Very little is known about their pharmacology and toxicology. OBJECTIVE: To report a case of supraventricular tachycardia and acute confusion after ingestion of e-cigarette fluid containing AB-FUBINACA and ADB-FUBINACA, with quantitative analysis of the serum drug concentrations. CASE REPORT: A healthy 24-year-old man ingested two drops of e-cigarette fluid which were later found to contain AB-FUBINACA and ADB-FUBINACA...
April 10, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28390512/management-of-medical-complications-during-the-rehabilitation-of-moderate-severe-traumatic-brain-injury
#20
REVIEW
Billie A Schultz, Erica Bellamkonda
Brain injury specialists are experienced providers able to identify and treat the unique medical complications after moderate-severe traumatic brain injury, including posttraumatic seizures, paroxysmal sympathetic hyperactivity, spasticity, hydrocephalus, agitation, neuroendocrine dysfunction, heterotopic ossification, venous thromboembolism, and cranial nerve dysfunction. Owing to the potential negative impact on outcome if left untreated, identification and appropriate treatment is essential. An additional role of the brain injury specialist is to educate family about potential medical complications and anticipated outcomes after brain injury...
May 2017: Physical Medicine and Rehabilitation Clinics of North America
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