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https://www.readbyqxmd.com/read/29786898/adults-with-comorbid-posttraumatic-stress-disorder-alcohol-use-disorder-and-opioid-use-disorder-the-effectiveness-of-modified-prolonged-exposure
#1
Kelly R Peck, Julie A Schumacher, Paul R Stasiewicz, Scott F Coffey
Opioid use disorders (OUDs) are a growing problem in the United States. When OUDs co-occur with problematic drinking and posttraumatic stress disorder (PTSD), negative drug-related mental and physical health outcomes may be exacerbated. Thus, it is important to establish whether PTSD treatments with established efficacy for dually diagnosed individuals also demonstrate efficacy in individuals who engage in problematic drinking and concurrent opioid misuse. Adults who met DSM-IV-TR criteria for PTSD and alcohol dependence were recruited from a substance use treatment facility and were randomly assigned to receive either modified prolonged exposure (mPE) therapy for PTSD or a non-trauma-focused comparison treatment...
May 22, 2018: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/29779912/how-often-do-we-perform-painful-and-stressful-procedures-in-the-paediatric-intensive-care-unit-a-prospective-observational-study
#2
Manuel A Baarslag, Sharan Jhingoer, Erwin Ista, Karel Allegaert, Dick Tibboel, Monique van Dijk
BACKGROUND: Adequate analgesia and sedation is crucial in critical care. There is little knowledge on the extent of painful and stressful procedures on children admitted to a paediatric intensive care unit (PICU) and its analgesic and/or sedative management. OBJECTIVE: The primary objective was to determine the number of painful and stressful procedures per patient per day in our PICU patients, including the numbers of attempts. A secondary objective was to map PICU nurses' perceptions of the painfulness of the included procedures...
May 17, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29774961/influence-of-caudal-epidural-analgesia-on-cortisol-concentrations-and-pain-related-behavioral-responses-in-mares-during-and-after-ovariectomy-via-colpotomy
#3
Aileen L Rowland, Kati G Glass, Sicilia T Grady, Kevin J Cummings, Katrin Hinrichs, Ashlee E Watts
OBJECTIVE: To determine the influence of epidural detomidine and morphine on serum corticosteroid concentrations and pain-related behavioral responses in mares during and after ovariectomy via colpotomy. STUDY DESIGN: Blinded prospective study. ANIMALS: Nine university-owned mares. METHODS: Five of 9 horses received caudal epidural detomidine hydrochloride (0.01 mg/kg) and morphine sulfate (0.1 mg/kg) prior to surgery...
May 18, 2018: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29742583/adjunct-ketamine-use-in-the-management-of-severe-ethanol-withdrawal
#4
Anthony F Pizon, Michael J Lynch, Neal J Benedict, Joseph H Yanta, Adam Frisch, Nathan B Menke, Greg S Swartzentruber, Andrew M King, Michael G Abesamis, Sandra L Kane-Gill
OBJECTIVES: Ketamine offers a plausible mechanism with favorable kinetics in treatment of severe ethanol withdrawal. The purpose of this study is to determine if a treatment guideline using an adjunctive ketamine infusion improves outcomes in patients suffering from severe ethanol withdrawal. DESIGN: Retrospective observational cohort study. SETTING: Academic tertiary care hospital. PATIENTS: Patients admitted to the ICU and diagnosed with delirium tremens by Diagnostic and Statistical Manual of Mental Disorders V criteria...
May 8, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29733751/sacrospinous-ligament-fixation-under-local-anesthesia-in-elderly-patients-at-high-risk-of-general-anesthesia
#5
Mehmet Baki Senturk, Ozan Doğan
INTRODUCTION AND HYPOTHESIS: Sacrospinous ligament fixation(SSLF) is a commonly used surgical procedure in pelvic organ prolapse due to high treatment success rates. Many intraoperative and postoperative anesthesia-related obstacles may be encountered by the elderly population. Local anesthesia alone or with intravenous sedation may provide simple, cheap, and safe anesthesia. For elderly patients at high risk for general anesthesia according to the American Society of Anesthesiologists(ASA), it is better to operate through the vaginal route under local anesthesia...
May 7, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/29714431/emotion-regulation-and-premedication-success-relationship-in-children-who-underwent-general-anesthesia
#6
Aslıhan Aykut, Berrin Işık
Background/aim: This study aims to investigate the relationship between emotion regulation characteristics and the efficacy of midazolam premedication. Materials and methods: Sixty-three children, aged 3 to 8 years old, with tonsillectomy and/or adenoidectomy and taking premedication with midazolam (Group 2) or without premedication (Group 1), were included in this study. The behavioral and emotional status of the children was evaluated with the Conners Parent Rating Scale-48 (CPRS-48) and Emotion Regulation Checklist (ERC)...
April 30, 2018: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29706126/regional-anesthesia-for-arteriovenous-fistula-surgery-may-reduce-hospital-length-of-stay-and-reoperation-rates
#7
Naida M Cole, Kamen Vlassakov, Ethan Y Brovman, Mahyar Heydarpour, Richard D Urman
BACKGROUND AND OBJECTIVES: Regional anesthesia has been proposed as the preferred mode of anesthesia for arteriovenous fistula surgery due to its associated vasodilatory effects and fistula patency rates. We analyzed patient outcomes after arteriovenous fistula surgery for their association with the type of anesthesia received. METHODS: The National Surgical Quality Improvement Project database was accessed to identify a cohort of 3199 patients undergoing arteriovenous fistula surgery from 2007 to 2015...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29701428/anaesthetic-management-in-a-duchennne-muscle-dystrophy-patient-for-treatment-of-recurrent-pneumothorax
#8
Sara Mota, Liuba Germanova, Joana Cortesão, Teresa Paiva
INTRODUCTION: Duchenne muscular dystrophy (DMD) is an x linked recessive disorder. Long term prognosis is ominous, with development of respiratory distress and cardiomyopathy in advanced stage of the disease and expected death in the teens-to-mid 20s due to respiratory or cardiac failure. Peri-operative management of this patients is challenging due to difficult airway anatomy (macroglossia, limited neck and mandibular mobility). Additionally, they are at risk of developing malignant hyperthermia, rhabdomyolysis and hyperkalemic cardiac arrest when exposed to halogenated inhalational anaesthetics and depolarizing muscle relaxants...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29688789/comparison-of-angiographic-dyes-and-injection-techniques-for-ocular-anterior-segment-angiography-in-horses
#9
Chris G Pirie, Alexander J LoPinto, Wade A Tenney
OBJECTIVE To assess and compare 2 injection techniques for conducting ocular anterior segment indocyanine green angiography (ASICGA) and sodium fluorescein (SF) angiography in horses. ANIMALS 3 healthy adult female horses (age range, 19 to 25 years). PROCEDURES Horses were sedated, jugular catheters were placed, and manual restraint was used to ensure proper positioning for the angiography procedure. Two injection techniques (IV and intra-arterial) were performed for each horse 1 week apart. Intravenous injections of 0...
May 2018: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/29688787/comparison-of-desflurane-and-propofol-at-equipotent-doses-in-combination-with-a-constant-rate-infusion-of-dexmedetomidine-on-global-and-peripheral-perfusion-and-oxygenation-in-horses
#10
Stephan Neudeck, Sabine B R Kästner, Liza Wittenberg-Voges, Karl Rohn, Klaus Hopster
OBJECTIVE To determine global and peripheral perfusion and oxygenation during anesthesia with equipotent doses of desflurane and propofol combined with a constant rate infusion of dexmedetomidine in horses. ANIMALS 6 warmblood horses. PROCEDURES Horses were premedicated with dexmedetomidine (3.5 μg•kg-1 , IV). Anesthesia was induced with propofol or ketamine and maintained with desflurane or propofol (complete crossover design) combined with a constant rate infusion of dexmedetomidine (7 μg•kg-1 •h-1 )...
May 2018: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/29666901/subcutaneously-administered-dexmedetomidine-is-efficiently-absorbed-and-is-associated-with-attenuated-cardiovascular-effects-in-healthy-volunteers
#11
P Uusalo, D Al-Ramahi, I Tilli, R A Aantaa, M Scheinin, T I Saari
PURPOSE: Palliative care patients often need sedation to alleviate intractable anxiety, stress, and pain. Dexmedetomidine is used for sedation of intensive care patients, but there is no prior information on its subcutaneous (SC) administration, a route that would be favored in palliative care. We compared the pharmacokinetics and cardiovascular, sympatholytic, and sedative effects of SC and intravenously (IV) administered dexmedetomidine in healthy volunteers. METHODS: An open two-period, cross-over design with balanced randomization was used...
April 17, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29665357/second-trimester-surgical-abortion-practices-in-the-united-states
#12
Katharine O White, Heidi E Jones, Jade Shorter, Wendy V Norman, Edith Guilbert, E Steve Lichtenberg, Maureen Paul
OBJECTIVE: To assess whether second-trimester surgical abortion practices of U.S. providers agree with evidence-based policy guidelines. STUDY DESIGN: We conducted a cross-sectional survey of abortion facilities in the U.S. identified via publicly available resources and professional networks from June through December 2013. RESULTS: Of 703 identified facilities, 383 (54%) participated including 172 clinicians providing second-trimester surgical abortions (D&Es)...
April 14, 2018: Contraception
https://www.readbyqxmd.com/read/29652275/dexmedetomidine-versus-ketofol-sedation-for-outpatient-diagnostic-transesophageal-echocardiography-a-randomized-controlled-study
#13
S Sruthi, Banashree Mandal, Manoj K Rohit, Goverdhan Datt Puri
Background: Moderate sedation is required for out-patient transesophageal echocardiography (TEE). Our objective was to compare the effect of Ketofol and dexmedetomidine for outpatient procedural sedation in diagnostic TEE with a hypothesis that Ketofol would be as effective as dexmedetomidine. Patients and. Methods: Fifty adult patients of age group 18-60 years with atrial septal defect, rheumatic valvular heart disease undergoing diagnostic TEE in the outpatient echocardiography laboratory were randomized into two groups, group D and group KF...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29630034/effective-dose-of-intravenous-dexmedetomidine-to-prolong-the-analgesic-duration-of-interscalene-brachial-plexus-block-a-single-center-prospective-double-blind-randomized-controlled-trial
#14
RyungA Kang, Ji Seon Jeong, Jae Chul Yoo, Ju Hyun Lee, Soo Joo Choi, Mi Sook Gwak, Tae Soo Hahm, Jin Huh, Justin Sangwook Ko
BACKGROUND AND OBJECTIVES: Intravenous (IV) dexmedetomidine (DEX) is reported to prolong the analgesic duration after single-shot interscalene brachial plexus block (ISBPB). However, the effective analgesic dose of IV DEX remains undetermined. Therefore, we aimed to elucidate the clinically relevant dose of IV DEX to prolong the analgesic duration of ISBPB. METHODS: Seventy-two patients scheduled for arthroscopic shoulder surgery received ISBPB with 15 mL of 0.5% ropivacaine with 1:200,000 epinephrine and were randomly assigned to 1 of 4 groups (n = 18, each): (1) IV normal saline (control), (2) IV DEX 0...
April 6, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29628580/comparison-of-intravenous-bolus-and-infusion-of-dexmedetomidine-on-characteristics-of-subarachnoid-block
#15
Tripti Vatsalya, Chandrakant Waikar, Madhurima Singh
Aims: Dexmedetomidine is very dynamic drug, used for analgesia, sedation, blunting the laryngoscopic responses and as adjuvants in regional anesthesia. Studies have shown that intravenous (iv) dexmedetomidine given during spinal anesthesia increases the quality of subarachnoid block (SAB). In this study, we compare the two iv regimen of dexmedetomidine on analgesic effect of spinal anesthesia. One is bolus dose of dexmedetomidine and other is infusion during the surgery, both given after induction of spinal anesthesia...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29627630/awake-intradural-spinal-tumour-resection
#16
Anan Shtaya, Chan Bao Luong, Erlick Pereira
BACKGROUND: Meningioma is a common slow growing spinal tumour with a predilection for intradural occurrence. Patients usually present with pain followed by ataxia and sensory and sphincter problems. The gold standard treatment in these cases is gross total microsurgical resection under general anaesthesia. However, there exist high anaesthetic risk patients unsuitable for general anaesthesia. Performing spinal surgeries under local anaesthesia and sedation has been reported albeit rarely for mostly minimally invasive procedures but not for open intradural pathologies...
April 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29623221/efficacy-of-dexmedetomidine-versus-ketofol-for-sedation-of-postoperative-mechanically-ventilated-patients-with-obstructive-sleep-apnea
#17
Hatem Elmoutaz Mahmoud, Doaa Abou Elkassim Rashwan
Patients with sleep apnea are prone to postoperative respiratory complications, requiring restriction of sedatives during perioperative care. We performed a prospective randomized study on 24 patients with obstructive sleep apnea (OSA) who underwent elective surgery under general anesthesia. The patients were equally divided into two groups: Group Dex : received dexmedetomidine loading dose 1 mcg/kg IV over 10 min followed by infusion of 0.2-0.7 mcg/kg/hr; Group KFL : received ketofol as an initial bolus dose 500 mcg/kg IV (ketamine/propofol 1 : 1) and maintenance dose of 5-10 mcg/kg/min...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29602985/rendezvous-endoscopic-recanalization-for-complete-esophageal-obstruction
#18
Stefano Fusco, Thomas Kratt, Cihan Gani, Dietmar Stueker, Daniel Zips, Nisar P Malek, Martin Goetz
BACKGROUND AND STUDY AIM: Complete esophageal obstruction after (chemo)radiation for head and neck cancers is rare. However, inability to swallow one's own saliva strongly inflicts upon quality of life. Techniques for endoscopic recanalization in complete obstruction are not well established. We assessed the efficacy and safety of rendezvous recanalization. PATIENTS AND METHODS: We performed a retrospective review of all patients who underwent endoscopic recanalization of complete proximal esophageal obstruction after radiotherapy between January 2009 and June 2016...
March 30, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29587271/iterative-variance-stabilizing-transformation-denoising-of-spectral-domain-optical-coherence-tomography-images-applied-to-retinoblastoma
#19
Soumia Sid Ahmed, Zoubeida Messali, Florent Poyer, Livia Lumbroso-Le Rouic, Laurence Desjardins, Nathalie Cassoux, Carole D Thomas, Sergio Marco, Stéphanie Lemaitre
BACKGROUND: Due to the presence of speckle Poisson noise, the interpretation of spectral domain-optical coherence tomography (SD-OCT) images frequently requires the use of data averaging to improve the signal-to-noise ratio. This implies long acquisition times and requires patient sedation in some cases. Iterative variance stabilizing transformation (VST) is a possible approach by which to remove speckle Poisson noise on single images. METHODS: We used SD-OCT images of human and murine (LH Beta-Tag mouse model) retinas with and without retinoblastoma acquired with 2 different imaging devices (Bioptigen and Micron IV)...
March 26, 2018: Ophthalmic Research
https://www.readbyqxmd.com/read/29583040/effects-of-mk-467-hydrochloride-and-hyoscine-butylbromide-on-cardiorespiratory-and-gastrointestinal-changes-induced-by-detomidine-hydrochloride-in-horses
#20
Heidi A Tapio, Marja R Raekallio, Anna Mykkänen, Khursheed Mama, Jóse L Mendez-Angulo, Heidi Hautajärvi, Outi M Vainio
OBJECTIVE To compare the effects of MK-467 and hyoscine butylbromide on detomidine hydrochloride-induced cardiorespiratory and gastrointestinal changes in horses. ANIMALS 6 healthy adult horses. PROCEDURES Horses received detomidine hydrochloride (20 μg/kg, IV), followed 10 minutes later by MK-467 hydrochloride (150 μg/kg; DET-MK), hyoscine butylbromide (0.2 mg/kg; DET-HYO), or saline (0.9% NaCl) solution (DET-S), IV, in a Latin square design. Heart rate, respiratory rate, rectal temperature, arterial and venous blood pressures, and cardiac output were measured; blood gases and arterial plasma drug concentrations were analyzed; selected cardiopulmonary variables were calculated; and sedation and gastrointestinal borborygmi were scored at predetermined time points...
April 2018: American Journal of Veterinary Research
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