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M Barburoglu, A Arat
BACKGROUND AND PURPOSE: There is very limited data concerning utilization of flow diverters in children. Our aim is to report results for the treatment of complex intracranial aneurysms and carotid cavernous fistulas by using flow diverters in children. MATERIALS AND METHODS: Retrospective review of children (17 years of age or younger) treated with flow diverters between May 2011 and July 2014 was performed. Clinical and laboratory data and angiographic findings were extracted...
October 20, 2016: AJNR. American Journal of Neuroradiology
Juan C Batlle
No abstract text is available yet for this article.
November 2016: Radiology
Ashkan Heshmatzadeh Behzadi, Martin R Prince
Although the low incidence of immediate-type gadolinium-based contrast agent (GBCA) allergic reactions is widely known, preventing these reactions and properly managing them to reduce their adverse sequel can improve the already exceedingly favorable GBCA safety profile. This review article should help those who order, supervise, or administer GBCA contrast agents, including recognizing and handling allergic reaction risks intrinsic to their use. Areas of focus include factors indicating increased allergic reaction risk, patient selection strategies, skin testing, premedication, and treatment of adverse events...
June 29, 2016: Topics in Magnetic Resonance Imaging: TMRI
Ali M Mokhtar, Ahmed I Elsakka, Hassan M Ali
BACKGROUND: Anxiety is a concern in obstetrics, especially in preeclamptic mothers. Sedation is not commonly used in parturients for fear of adverse neonatal effect. We investigated maternal and neonatal outcome of midazolam as an adjuvant to spinal anesthesia for elective cesarean delivery. METHODS: A prospective randomized controlled trial, in which eighty preeclamptic parturients received either an intravenous dose of 0.035 mg/kg of midazolam or an equal volume of normal saline, 30 min before spinal anesthesia...
September 2016: Anesthesia, Essays and Researches
Radhe Sharan, Brij Mohan, Harkomal Kaur, Anju Bala
BACKGROUND: Fiberoptic intubation is a technique commonly used for difficult airways. Conscious sedation is desirable to make this procedure tolerable, and it is essential that patients are cooperative, relaxed, and comfortable especially when difficult airway anatomy or pathology is encountered. OBJECTIVE: To compare the safety and efficacy of propofol versus midazolam in oral fiberoptic endotracheal intubation in terms of hemodynamic changes, level of sedation, ease of intubation, and patient comfort and complications...
September 2016: Anesthesia, Essays and Researches
Seokyung Shin, Chan Hyuk Park, Hyun Ju Kim, Sang Hun Park, Sang Kil Lee, Young Chul Yoo
BACKGROUND: Ideal sedation for endoscopic submucosal dissection (ESD) aims to satisfy both the endoscopist and patient. However, previous studies show that a satisfactory procedure for the endoscopist does not equal higher patient satisfaction. This study attempted to find a sedation protocol that is able to increase patient satisfaction during propofol-based sedation by adding low-dose midazolam as premedication. METHODS: Seventy-two adult patients were randomly allocated to receive either 0...
October 14, 2016: Surgical Endoscopy
Efrain Talamantes, Karla Gonzalez, Carol M Mangione, Gery Ryan, Alejandro Jimenez, Fabio Gonzalez, Seira Santizo Greenwood, David E Hayes-Bautista, Gerardo Moreno
BACKGROUND AND OBJECTIVES: One third of Latino medical students begin their premedical undergraduate education at a community college (CC) or 2-year college, compared to a 4-year university. This study explored the academic and personal experiences Latino premedical students commonly encounter at the CC. METHODS: In 2013, five focus groups with Latino premedical and medical students (n=45) were conducted in Los Angeles and San Jose, CA. All students were enrolled or attended a CC...
October 2016: Family Medicine
David Smith, High Cheek, Brenda Denson, Christopher M Pruitt
OBJECTIVE: Intranasal (IN) midazolam is a commonly prescribed medication for pediatric sedation and anxiolysis. One of its most frequently-encountered adverse effects is discomfort with administration. While it has been proposed that premedicating with lidocaine reduces this undesirable consequence, this combination has not been thoroughly researched. The objective of our study was to assess whether topical lidocaine lessens the discomfort associated with IN midazolam administration. METHODS: This was a double-blinded, randomized, placebo-controlled trial performed in an urban, academic pediatric emergency department...
October 14, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Sarah E Bigby, Jennifer E Carter, Sébastien Bauquier, Thierry Beths
Anesthesia protocols for patients with intracranial lesions need to provide hemodynamic stability, preserve cerebrovascular autoregulation, avoid increases in intracranial pressure, and facilitate a rapid recovery. Propofol total intravenous anesthesia (TIVA) maintains cerebral blood flow autoregulation and is considered superior to inhalant agents as an anesthetic protocol for patients with intracranial lesions. A propofol-based TIVA subsequent to premedication with medetomidine and diazepam was used in a king penguin ( Aptenodytes patagonicus ) undergoing magnetic resonance imaging of the brain after a new onset of seizures...
September 2016: Journal of Avian Medicine and Surgery
Babita Ghai, Kajal Jain, Akshay Kumar Saxena, Nidhi Bhatia, Kushaljit Singh Sodhi
BACKGROUND: Children undergoing computerized tomography (CT) frequently require sedation to allay their anxiety, and prevent motion artifacts and stress of intravenous (IV) cannulation. AIMS: The aim of this trial was to compare the effectiveness of oral midazolam and intranasal dexmedetomidine as sole premedicants in children for carrying out both IV cannulation as well as CT scanning, without the need for additional IV sedatives. METHODS: Fifty-nine children, aged 1-6 years, scheduled to undergo CT imaging under sedation were randomized to receive either 0...
October 13, 2016: Paediatric Anaesthesia
Selahattin Tugrul, Remzi Dogan, Erol Senturk, Ilker Kocak, Seda Sezen, Mefkur Bakan, Orhan Ozturan
: OBJECTıVE: The objective of this randomized double blind study was to evaluate effect of the premedication with oral clonidine on blood pressure, cleaning of surgical site and bleeding in the ESS performed due to advanced NP. METHODS: A total of 52 patients who underwent functional endoscopic sinus surgery (FESS) due to Kennedy grade 4 nasal polyposis (NP) were included. Patients were randomized into two groups. Group 1 (n=26) received 0.2mg oral clonodine one hour before the operation in addition to standard anesthesia procedure...
August 30, 2016: American Journal of Otolaryngology
Katherine N Cahill, Tanya M Laidlaw
The acute clinical symptoms that develop following the oral ingestion of aspirin, or any other inhibitor of cyclooxygenase-1, are well established in aspirin-exacerbated respiratory disease: nasal congestion, rhinorrhea, and bronchospasm. Less commonly, gastrointestinal distress, rash, angioedema, or urticaria also develops. However, the pathobiology that drives these clinical reactions is poorly understood. Use of an intranasal aspirin challenge protocol or administration of premedications inhibiting the leukotriene pathway decreases the severity of clinical reaction, which suggests the involvement of both local effector cells and cysteinyl leukotrienes in the pathogenesis of aspirin-induced reactions...
November 2016: Immunology and Allergy Clinics of North America
Florian C Roessler, Sabrina Schumacher, Andreas Sprenger, Ulrich Gärtner, Mohamed Al-Khaled, Jürgen Eggers
BACKGROUND: Patients with acute ischemic strokes frequently take an acetylsalicylic acid (ASA) premedication. We determined the impact of ASA on different thrombolysis strategies in vitro. METHODS: For two clot types made from platelet-rich plasma (one with and one without ASA) lysis rates were measured by weight loss after 1 h for five different groups: in control group A clots were solely placed in plasma; in groups B and C clots were treated with rt-PA (60 kU/ml), and in groups D and E clots were treated with desmoteplase (DSPA; 2 µg/ml)...
October 7, 2016: Journal of Vascular Research
Kyu Nam Kim, Dong Won Kim, Yeong Hun Sin, Soo Kyung Lee
Although anaphylactic shock during the perioperative period is rare, it can be lethal due to severe cardiovascular and respiratory collapse. Midazolam is generally used as premedication for relieving anxiety about the operation, and the danger of anaphylactic shock after intramuscular injection is not widely recognized. We report the first case of anaphylactic shock occurring during the perioperative period after intramuscular injection of midazolam. Since anaphylactic shock after intramuscular injection can be of slow onset, the operation should be delayed if an anaphylactic reaction is suspected, even if the symptoms are limited...
October 2016: Korean Journal of Anesthesiology
Masoud Ghorbanlo, Mahmoud Reza Mohaghegh, Forozan Yazdanian, Mehrdad Mesbah, Ziya Totonchi
BACKGROUND: The need for muscle relaxants in general anesthesia in different surgeries including cardiac surgeries, and the type of relaxant to be used considering its different hemodynamic effects on patients with heart disease can be of considerable importance. In this study, the hemodynamic effects of two muscle relaxants, Cisatracurium and Atracurium in patients whit low function of left ventricle who are candidate for open heart surgery have been considered. METHOD: This study has been designed as a randomized prospective double-blind clinical trial...
July 27, 2016: Medical Archives
Yoshitaka Saito, Masaki Kobayashi, Takehiro Yamada, Kumiko Kasashi, Rio Honma, Satoshi Takeuchi, Yasushi Shimizu, Ichiro Kinoshita, Hirotoshi Dosaka-Akita, Ken Iseki
PURPOSE: Magnesium supplementation is an effective protective method against cisplatin-induced nephrotoxicity (CIN); however, there are few reports regarding the mechanism of its nephroprotective effect. The aim of this study was to determine whether premedication with intravenous magnesium prevents CIN and to determine the relationship between its nephroprotective effect and serum magnesium level. METHODS: Fifty-eight patients with head and neck cancer who received cisplatin, docetaxel, and 5-fluorouracil (DCF) were retrospectively investigated...
October 3, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
L Dupree Hatch, Peter H Grubb, Amanda S Lea, William F Walsh, Melinda H Markham, Patrick O Maynord, Gina M Whitney, Ann R Stark, E Wesley Ely
OBJECTIVE: To improve patient safety in our NICU by decreasing the incidence of intubation-associated adverse events (AEs). METHODS: We sequentially implemented and tested 3 interventions: standardized checklist for intubation, premedication algorithm, and computerized provider order entry set for intubation. We compared baseline data collected over 10 months (period 1) with data collected over a 10-month intervention and sustainment period (period 2). Outcomes were the percentage of intubations containing any prospectively defined AE and intubations with bradycardia or hypoxemia...
October 2016: Pediatrics
Cameron Ratliff, Rebecca S Sayre, Mauricio Lepiz
A hand-reared, 53-kg, female, 30-day-old black rhinoceros ( Diceros bicornis ) calf presented for magnetic resonance imaging and computed tomography after demonstrating neurologic signs. The rhino was premedicated intramuscularly with butorphanol and midazolam, yielding satisfactory sedation. Induction was achieved using intravenous propofol until the trachea could be intubated. Anesthesia was maintained with sevoflurane in 100% oxygen (mean end-tidal concentration of 2 ± 0.5%). Mean values recorded during anesthesia included were heart rate, end-tidal carbon dioxide, respiratory rate, noninvasive blood pressure, and pulse oximetry...
September 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Rae Young Kang, Kyung Sook Yoo, Hyeon Ju Han, Ju-Yeun Lee, Se-Hoon Lee, Dong-Wan Kim, Yu Jeung Lee
PURPOSE: A weekly docetaxel regimen had comparable efficacy with a tri-weekly schedule and caused significantly less severe neutropenia and febrile neutropenia. Therefore, a weekly docetaxel regimen has become increasingly common in cancer treatment. Premedication with corticosteroids can effectively prevent or reduce the severity of hypersensitivity and fluid retention. However, no recommended steroid dosage for a weekly docetaxel regimen has been established to date. The aim of this study is to compare the efficacy and complications of two different weekly docetaxel premedication protocols...
September 30, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Manojkumar Bupathi, Joud Hajjar, Stacie Bean, Siqing Fu, David Hong, Daniel Karp, Bettzy Stephen, Kenneth Hess, Funda Meric-Bernstam, Aung Naing
Infusion reactions (IRs) to anti-neoplastic agents require prompt recognition and immediate treatment to avert significant complications. We conducted a retrospective review of the medical records of consecutive patients who received anti-neoplastic therapy in the outpatient treatment center of the Department of Investigational Cancer Therapeutics from January 1, 2013 to November 30, 2013. Of the 597 patients who received treatment, 9 (1.5 %) had IRs (all ≤ grade 2). The most common IRs observed on first occurrence were chills (n = 5), itching, rash, and facial flushing (n = 3 each)...
September 29, 2016: Investigational New Drugs
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