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Management of agitated

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https://www.readbyqxmd.com/read/28733841/analgosedation-of-adult-patients-with-elevated-intracranial-pressure-survey-of-current-clinical-practice-in-austria
#1
Guenther Herzer, Claudia Mirth, Udo M Illievich, Wolfgang G Voelckel, Helmut Trimmel
BACKGROUND: Analgesia and sedation are key items in intensive care. Recently published S3 guidelines specifically address treatment of patients with elevated intracranial pressure. METHODS: The Austrian Society of Anesthesiology, Resuscitation and Intensive Care Medicine carried out an online survey of neurointensive care units in Austria in order to evaluate the current state of practice in the areas of analgosedation and delirium management in this high-risk patient group...
July 21, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28721092/hemicrania-continua-clinical-review-diagnosis-and-management
#2
REVIEW
Sanjay Prakash, Payal Patel
Hemicrania continua (HC) is an indomethacin-responsive primary headache disorder which is currently classified under the heading of trigeminal autonomic cephalalgias (TACs). It is a highly misdiagnosed and underreported primary headache. The pooled mean delay of diagnosis of HC is 8.0 ± 7.2 years. It is not rare. We noted more than 1000 cases in the literature. It represents 1.7% of total headache patients attending headache or neurology clinic. Just like other TACs, it is characterized by strictly unilateral pain in the trigeminal distribution, cranial autonomic features in the same area and agitation during exacerbations/attacks...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28715780/use-of-perampanel-in-children-and-adolescents-with-lennox-gastaut-syndrome
#3
Stéphane Auvin, Blandine Dozieres, Adina Ilea, Catherine Delanoë
AIM: Report the use of perampanel treatment in children with Lennox-Gastaut syndrome (LGS). METHOD: We conducted a prospective study of 13 LGS patients (seven male; mean age, 12.8years) treated with adjunctive perampanel therapy. Perampanel was initiated at 2mg/day and titrated to a median maximum dose of 6mg/day. RESULTS: After a mean follow-up duration of 10.8months (range, 1-24months), nine patients (69.2%) were responders (≥50% reduction in total seizure frequency) and nine (69...
July 14, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28705298/methamphetamine-related-disorders
#4
Euphrosyne Gouzoulis-Mayfrank, Roland Härtel-Petri, Willem Hamdorf, Ursula Havemann-Reinecke, Stephan Mühlig, Norbert Wodarz
BACKGROUND: Methamphetamine is considered more dangerous than other stimulants because of its acute complications, long-term neurotoxicity, and potential for drug dependence. Until now, there have been no evidence-based guidelines for the treatment of methamphetamine-related disorders, either in Germany or abroad. METHODS: A systematic literature search was performed on the treatment of methamphetamine-related disorders. Based on this literature review, a multidisciplinary expert panel developed recommendations using the nominal group technique...
June 30, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28698031/comparable-impediment-of-cognitive-function-in-female-and-male-rats-subsequent-to-daily-administration-of-haloperidol-after-traumatic-brain-injury
#5
Kristin E Free, Anna M Greene, Corina O Bondi, Naima Lajud, Patricia B de la Tremblaye, Anthony E Kline
Antipsychotic drugs, such as haloperidol (HAL), are prescribed in the clinic to manage traumatic brain injury (TBI)-induced agitation. While preclinical studies have consistently shown that once-daily administration of HAL hinders functional recovery after TBI in male rats, its effects in females are unknown. Hence, the objective of this study was to directly compare neurobehavioral and histological outcomes in both sexes to determine whether the reported deleterious effects of HAL extend to females. Anesthetized adult female and male rats received either a controlled cortical impact (CCI) or sham injury and then were randomly assigned to a dosing regimen of HAL (0...
July 8, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28662911/what-is-the-efficacy-of-droperidol-for-the-management-of-acute-psychosis-induced-agitation
#6
EDITORIAL
Michael Gottlieb, Jessen Schiebout
No abstract text is available yet for this article.
June 26, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28658012/use-of-electroconvulsive-therapy-in-dementia-related-agitation-a-case-series
#7
M Caroline Burton, Sandra L Koeller, Frank M Brekke, Adonye T Afonya, Bruce Sutor, Maria I Lapid
OBJECTIVES: This naturalistic prospective observation study examines the efficacy of electroconvulsive therapy (ECT) in treating dementia-related agitation. METHODS: Patients with dementia-related agitation who received ECT were compared with patients with the same condition who did not receive ECT using Cohen-Mansfield Agitation Inventory (CMAI), Neuropsychiatric Inventory (NPI)-nursing home version, and Clinical Global Impression Scale (CGI). Outcomes were compared between ECT-treated and non-ECT-treated patients...
June 28, 2017: Journal of ECT
https://www.readbyqxmd.com/read/28646587/perioperative-pain-management-after-fibular-free-flap-harvesting-for-head-and-neck-reconstruction-using-mini-catheters-to-inject-local-anesthetic-a-pilot-study
#8
Andrea Ferri, Andrea Varazzani, Adriana Valente, Giuseppe Pedrazzi, Bernardo Bianchi, Silvano Ferrari, Enrico Sesenna
BACKGROUND: Fibular donor site pain management in the early postoperative period can help minimize complications, patient discomfort, and agitation. Traditional management of postoperative pain consists of systemic administration of opioids and NSAIDS. The use of local anesthetics in addition to systemic analgesics has the potential to improve pain control. Purpose of the study is to evaluate the efficacy of mini-catheters used to inject local anesthetic into the fibular donor site after flap harvesting for reconstruction of the head-and-neck area...
June 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28638198/efficacy-of-atypical-antipsychotics-in-the-management-of-acute-agitation-and-aggression-in-hospitalized-patients-with-schizophrenia-or-bipolar-disorder-results-from-a-systematic-review
#9
REVIEW
Xin Yu, Christoph U Correll, Yu-Tao Xiang, Yifeng Xu, Jizhong Huang, Fude Yang, Gang Wang, Tianmei Si, John M Kane, Prakash Masand
Acute agitation and aggression are common symptoms in patients with bipolar disorder and schizophrenia. In this review, we discuss the prevalence, clinical assessment strategies, treatment options, and current Western and Chinese guidelines for the management of acute agitation and aggression in patients with bipolar disorder or schizophrenia. Among available approaches, we discuss in detail recent evidence supporting the use of intramuscular (IM) antipsychotics and some recently approved oral atypical antipsychotics for the management of acute aggression and agitation in hospitalized patients with bipolar disorder or schizophrenia presenting with acute agitation or aggression, highlighting some differences between individual antipsychotic agents...
October 25, 2016: Shanghai Archives of Psychiatry
https://www.readbyqxmd.com/read/28623497/-psychiatric-emergencies
#10
F Schneider, S Weber-Papen
Psychiatric emergencies present a frequent and interdisciplinary challenge. Clinical diagnosis and management are complicated by the acuity, and the patient's compliance is often limited by the illness. Psychiatric emergencies include states of acute agitation, suicidality, delirium, stupor, and drug-induced emergencies. Sometimes interventions such as conversational contact, responding empathically to patients, or "talking down" are sufficient. If pharmacotherapy is necessary, benzodiazepines and antipsychotic drugs are the primary agents of choice...
June 16, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28614197/sedation-management-in-children-supported-on-extracorporeal-membrane-oxygenation-for-acute-respiratory-failure
#11
James B Schneider, Todd Sweberg, Lisa A Asaro, Aileen Kirby, David Wypij, Ravi R Thiagarajan, Martha A Q Curley
OBJECTIVES: To describe sedation management in children supported on extracorporeal membrane oxygenation for acute respiratory failure. DESIGN: Secondary analysis of prospectively collected data from a multicenter randomized trial of sedation (Randomized Evaluation of Sedation Titration for Respiratory Failure). SETTING: Twenty-one U.S. PICUs. PATIENTS: One thousand two hundred fifty-five children, 2 weeks to 17 years old, with moderate/severe pediatric acute respiratory distress syndrome...
June 13, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28613368/-rapid-tranquillisation-for-agitated-patients-with-psychostimulant-intoxication
#12
P Geerts, K Titeca, G M D Lemmens, J De Fruyt
Because psychostimulant intoxication can lead to serious health risks for the patient, it is often necessary to ensure that the patient receives both adequate medical surveillance and rapid tranquillisation.<br/> AIM: To find out whether there is scientific evidence that psychopharmacological intervention helps patients with psychostimulant intoxication to manage aggression and agitation.<br/> METHOD: We searched the literature systematically.<br/> RESULTS: Our study showed that intravenous droperidol worked faster and was more effective than intravenous lorazepam in inducing sedation in patients intoxicated with psychostimulants...
2017: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/28595662/behavior-and-evolution-of-young-onset-dementia-part-2-beyond-ii-study-an-intervention-study-aimed-at-improvement-in-the-management-of-neuropsychiatric-symptoms-in-institutionalized-people-with-young-onset-dementia
#13
J C L van Duinen-van den IJssel, B Appelhof, S A Zwijsen, M Smalbrugge, F R J Verhey, M E de Vugt, S U Zuidema, R T C M Koopmans, C Bakker
BACKGROUND: Both neuropsychiatric symptoms (NPS) and psychotropic drug use (PDU) are common in institutionalized People with Young Onset Dementia (PwYOD) and can produce negative outcomes such as reduced quality of life and high workload. In community-dwelling PwYOD, NPS are found to be associated with unmet care needs. This emphasizes the importance of a care program for the management of NPS in institutionalized PwYOD that also addresses unmet care needs and PDU. The objectives of the Behavior and Evolution of Young ONset Dementia part 2 (BEYOND-II) study are to develop a care program for the management of NPS in institutionalized PwYOD and to evaluate its effectiveness...
June 9, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28579785/dexmedetomidine-for-the-management-of-postictal-agitation-after-electroconvulsive-therapy-with-s-ketamine-anesthesia
#14
Suna Su Aksay, Jan Malte Bumb, Dmitry Remennik, Manfred Thiel, Laura Kranaster, Alexander Sartorius, Christoph Janke
OBJECTIVES: Postictal agitation (PIA) represents one of the most common complications during a modified electroconvulsive therapy (ECT) course. Its clinical management can be challenging especially in cases with poor response to benzodiazepines. Dexmedetomidine, a highly selective alpha-2 adrenoceptor agonist acting predominantly in the locus coeruleus, exerts sedative effects without causing relevant respiratory depression. To the best of our knowledge, this is the first study that aimed to assess the impact of dexmedetomidine use with S-ketamine anesthesia on PIA reduction in ECT...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28572112/delirium-in-children-identification-prevention-and-management
#15
Amanda Bettencourt, Jodi E Mullen
Delirium in children is an often underrecognized but serious complication of hospitalization. Delirium in this age group has been described as behaviors such as refractory agitation and restlessness, visual or auditory hallucinations, children being "not themselves," and a lethargic state. Often, children with delirium are at risk for harming themselves by dislodging tubes, falling, or refusing care. Pediatric nurses must recognize and intervene to prevent and treat delirium in hospitalized children because the delirium may be an indicator of worsening clinical status and is associated with high mortality and morbidity in children of all ages and with posttraumatic stress disorder...
June 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28572103/interprofessional-team-s-perception-of-care-delivery-after-implementation-of-a-pediatric-pain-and-sedation-protocol
#16
Sandra L Staveski, May Wu, Tiffany M Tesoro, Stephen J Roth, Michael J Cisco
BACKGROUND: Pain and agitation are common experiences of patients in pediatric cardiac intensive care units. Variability in assessments by health care providers, communication, and treatment of pain and agitation creates challenges in management of pain and sedation. OBJECTIVES: To develop guidelines for assessment and treatment of pain, agitation, and delirium in the pediatric cardiac intensive unit in an academic children's hospital and to document the effects of implementation of the guidelines on the interprofessional team's perception of care delivery and team function...
June 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28561954/evidence-for-the-presence-of-a-bacterial-endosymbiont-in-the-pecan-scab-pathogen-venturia-effusa-basyonym-fusicladium-effusum
#17
E G Medrano, L J Grauke, R L Stanford, T Thompson
AIMS: To determine whether Venturia effusa the causative fungal agent of pecan scab harbors a bacterial symbiont. METHODS AND RESULTS: Venturia effusa isolates were maintained on potato dextrose agar amended with antibiotics (chloramphenicol 100 μg ml(-1) , and tetracycline 100 μg ml(-1) ). Genomic DNA extracted from mycelia was used to target eubacterial 16S rDNA. A 1(.) 4 kbp PCR amplified product using 16S rDNA degenerate primers was cloned, sequenced and found to have 99% identities with Actinobacteria representatives...
May 31, 2017: Journal of Applied Microbiology
https://www.readbyqxmd.com/read/28547318/a-systematic-review-of-alpha-2-agonists-for-sedation-in-mechanically-ventilated-neurocritical-care-patients
#18
Alexandre Tran, Henrietta Blinder, Brian Hutton, Shane W English
The use of sedative medications is commonplace in intensive care units (ICUs) and an invaluable clinical tool for the intensive care physician. Sedation for critically ill, mechanically ventilated patients provides an opportunity to reduce anxiety, discomfort as well as ventilator intolerance and dyssynchrony. Alpha-2 agonists in particular have become increasingly popular for use in the neurocritical care population due to their proposed effectiveness in facilitating examinations and procedures as well as reducing the need for adjunctive agents...
May 25, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28523268/the-sedative-effect-of-propranolol-on-critically-ill-patients-a-case-series
#19
Junji Shiotsuka, Andrew Steel, James Downar
INTRODUCTION: Recent studies have examined the effectiveness of alpha-2 adrenergic agonists for controlling delirium and agitation. Propranolol, a non-selective beta-adrenergic antagonist with good penetration of the blood-brain barrier, has not been investigated for this purpose. MATERIALS AND METHODS: We retrospectively reviewed the medical records of all patients who were prescribed propranolol in our Medical Surgical ICU from January 1, 2010, to December 31, 2013...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28501048/systematic-review-of-evidence-underpinning-non-pharmacological-therapies-in-dementia
#20
Richard Olley, Andrea Morales
Objective Dementia is one of the most common illnesses worldwide, and is one of the most important causes of disability in older people. Currently, dementia affects over 35million people around the globe. It is expected that this number will increase to 65.7million by 2030. Early detection, diagnosis and treatment to control the principal behaviour symptoms may help reduce these numbers and delay the progression to more advanced and dangerous stages of this disorder with resultant increase quality of life for those affected...
May 15, 2017: Australian Health Review: a Publication of the Australian Hospital Association
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