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Moderate sedation

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https://www.readbyqxmd.com/read/28104716/source-3-registry-design-and-30-day-results-of-the-european-post-approval-registry-of-the-latest-generation-of-the-sapien-3tm-transcatheter-heart-valve
#1
Olaf Wendler, Gerhard Schymik, Hendrik Treede, Helmut Baumgartner, Nicolas Dumonteil, Leo Ihlberg, Franz-Josef Neumann, Giuseppe Tarantini, José L Zamorano, Alec Vahanian
BACKGROUND: -The SOURCE 3 Registry is a European multicentre, observational registry of the latest generation of transcatheter heart valve, the SAPIEN 3(TM) (Edwards Lifesciences, Irvine, CA/USA). Its purpose is to document outcomes of clinical safety and performance after European approval was given. METHODS: -In this manuscript we present the 30-day outcome of the SOURCE 3 Registry. All data is self-reported and all participating centres have committed to support their consecutive experience with the SAPIEN 3(TM) transcatheter heart valve, dependent on patients consent, before the start of the study...
January 19, 2017: Circulation
https://www.readbyqxmd.com/read/28101764/diazepam-in-the-treatment-of-moderate-to-severe-alcohol-withdrawal
#2
Steven J Weintraub
Benzodiazepines ameliorate or prevent the symptoms and complications of moderate to severe alcohol withdrawal, which can include autonomic hyperactivity, agitation, combativeness, hallucinations, seizures, delirium, and death. The benzodiazepines most commonly used for this purpose are lorazepam, chlordiazepoxide, oxazepam, and diazepam. It is widely asserted that no member of this group is superior to the others for treatment of alcohol withdrawal. However, of these, diazepam has the shortest time to peak effect, which facilitates both rapid control of symptoms and accurate titration to avoid over-sedation...
January 18, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28099638/risk-factors-for-agitation-in-critically-ill-patients
#3
Thiago Miranda Lopes de Almeida, Luciano Cesar Pontes de Azevedo, Paulo Maurício Garcia Nosé, Flavio Geraldo Resende de Freitas, Flávia Ribeiro Machado
Objective: To evaluate the incidence of agitation in the first 7 days after intensive care unit admission, its risk factors and its associations with clinical outcomes. Methods: This single-center prospective cohort study included all patients older than 18 years with a predicted stay > 48 hours within the first 24 hours of intensive care unit admission. Agitation was defined as a Richmond Agitation Sedation Scale score ≥ +2, an episode of agitation or the use of a specific medication recorded in patient charts...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28041858/combining-clinical-and-angiographic-variables-for-estimating-risk-of-target-lesion-revascularization-after-drug-eluting-stent-placement
#4
Joshua M Stolker, David J Cohen, Kevin F Kennedy, Michael J Pencina, Suzanne V Arnold, Neal S Kleiman, John A Spertus
BACKGROUND: Drug-eluting stents (DES) reduce restenosis but require prolonged antiplatelet therapy, when compared with bare metal stents. Ideally, the patient should be involved in this risk:benefit assessment prior to selecting DES, to maximize the benefits and cost-effectiveness of care, and to improve medication adherence. However, accurate estimation of restenosis risk may require angiographic factors identified at cardiac catheterization. METHODS: In a large PCI registry, we used logistic regression to identify clinical and angiographic predictors of clinically-driven target lesion revascularization (TLR) over the first year after stent placement...
December 18, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28009665/capnography-compared-to-pulse-oximetry-for-early-detection-of-respiratory-compromise-in-non-intubated-patients-undergoing-gastrointestinal-endoscopy-procedures-a-systematic-review-protocol
#5
Jace Holton, Bryan Flattery
Does the use of capnography versus pulse oximetry increase the early detection of respiratory compromise and improve safety in non-intubated patients undergoing moderate sedation for gastrointestinal endoscopy procedures?Respiratory compromise will be detected by alveolar hypoventilation/hyperventilation (EtCO2 < 35 mmHg/EtCO2 > 50 mmHg), arterial oxygen desaturation (defined as a pulse oximetry reading of <95% for >5 s), visual assessments of abnormal ventilation including apnea detection and adverse respiratory events that involve the need for bag-mask ventilation...
December 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28005831/bronchoscopy-safety-in-patients-with-chronic-obstructive-lung-disease
#6
Christina R Bellinger, Irtaza Khan, Arjun B Chatterjee, Edward F Haponik
BACKGROUND: Flexible bronchoscopy is a safe and minimally invasive diagnostic tool used by pulmonologists, but few studies have prospectively compared outcomes in patients with objectively defined obstructive lung disease to those without obstruction. METHODS: We determined whether complications in patients undergoing moderate sedation bronchoscopy differ in those without obstruction compared with chronic obstructive pulmonary disease (COPD). We prospectively followed all patients undergoing moderate sedation bronchoscopy in an inpatient or outpatient setting...
December 21, 2016: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28004588/2015-annual-report-of-the-american-association-of-poison-control-centers-national-poison-data-system-npds-33rd-annual-report
#7
James B Mowry, Daniel A Spyker, Daniel E Brooks, Ashlea Zimmerman, Jay L Schauben
INTRODUCTION: This is the 33rd Annual Report of the American Association of Poison Control Centers' (AAPCC) National Poison Data System (NPDS). As of 1 January 2015, 55 of the nation's poison centers (PCs) uploaded case data automatically to NPDS. The upload interval was 9.52 [7.40, 13.6] (median [25%, 75%]) minutes, creating a near real-time national exposure and information database and surveillance system. METHODS: We analyzed the case data tabulating specific indices from NPDS...
December 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/28003245/impulsivity-moderates-subjective-responses-to-alcohol-in-alcohol-dependent-individuals
#8
Jonathan G Westman, Spencer Bujarski, Lara A Ray
AIMS: Studies of social drinkers indicate that subjective response (SR) to alcohol and impulsivity are risk factors for the development of alcohol use disorder which may be related. It is unclear, however, whether there are significant relationships between SR and impulsivity among individuals with alcohol dependence. Using data from an intravenous (IV) alcohol challenge study, the present study is the first to explore the relationship between impulsivity and SR during alcohol administration among alcohol-dependent individuals...
December 20, 2016: Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism
https://www.readbyqxmd.com/read/28000133/association-of-early-hemodynamic-profile-and-the-development-of-systolic-dysfunction-following-traumatic-brain-injury
#9
Vijay Krishnamoorthy, Ali Rowhani-Rahbar, Nophanan Chaikittisilpa, Edward F Gibbons, Frederick P Rivara, Nancy R Temkin, Alex Quistberg, Monica S Vavilala
BACKGROUND: While systolic dysfunction has been observed following traumatic brain injury (TBI), the relationship between early hemodynamics and the development of systolic dysfunction has not been investigated. Our study aimed to determine the early hemodynamic profile that is associated with the development of systolic dysfunction after TBI. METHODS: We conducted a prospective cohort study among patients under 65 years old without cardiac comorbidities who sustained moderate-severe TBI...
December 20, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27995433/direct-percutaneous-endoscopic-jejunostomy-dpej-tube-placement-a-single-institution-experience-and-outcomes-to-30-days-and-beyond
#10
Andrew T Strong, Gautam Sharma, Matthew Davis, Michael Mulcahy, Suriya Punchai, Colin P O'Rourke, Stacy A Brethauer, John Rodriguez, Jeffrey L Ponsky, Matthew D Kroh
INTRODUCTION: Patients with prior foregut surgery requiring long-term enteral access typically undergo operative jejunostomy tube placement; however, direct percutaneous endoscopic jejunostomy (DPEJ) is a viable alternative. METHODS: All de novo DPEJ procedures performed by surgical and advanced endoscopists from May 2003 to June 2015 were retrospectively reviewed following approval by the Institutional Review Board. There were 59 cases identified. RESULTS: Our cohort had a mean age of 50...
December 19, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27976370/droperidol-for-psychosis-induced-aggression-or-agitation
#11
REVIEW
Mariam A Khokhar, John Rathbone
BACKGROUND: People experiencing acute psychotic illnesses, especially those associated with agitated or violent behaviour, may require urgent pharmacological tranquillisation or sedation. Droperidol, a butyrophenone antipsychotic, has been used for this purpose in several countries. OBJECTIVES: To estimate the effects of droperidol, including its cost-effectiveness, when compared to placebo, other 'standard' or 'non-standard' treatments, or other forms of management of psychotic illness, in controlling acutely disturbed behaviour and reducing psychotic symptoms in people with schizophrenia-like illnesses...
December 15, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27918951/subjective-alcohol-responses-in-a-cross-sectional-field-based-study-of-adolescents-and-young-adults-effects-of-age-drinking-level-and-dependence-consequences
#12
Hayley Treloar, Mark A Celio, Stephen A Lisman, Robert Miranda, Linda P Spear
BACKGROUND: Adolescents are physically, cognitively, socially, and emotionally different than adults in ways that may partially explain why alcohol misuse typically develops during this period. Ample animal-science evidence and nascent ecological evidence points toward developmentally limited differences in sensitivity to alcohol's stimulatory and sedative effects. Field-based research methods were used to test for such age-related differences in a sample of adolescents through young adults...
January 1, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/27902493/intravenous-amisulpride-for-the-prevention-of-postoperative-nausea-and-vomiting-two-concurrent-randomized-double-blind-placebo-controlled-trials
#13
Tong J Gan, Peter Kranke, Harold S Minkowitz, Sergio D Bergese, Johann Motsch, Leopold Eberhart, David G Leiman, Timothy I Melson, Dominique Chassard, Anthony L Kovac, Keith A Candiotti, Gabriel Fox, Pierre Diemunsch
BACKGROUND: Two essentially identical, randomized, double-blind, placebo-controlled, parallel-group phase III studies evaluated the efficacy of intravenous amisulpride, a dopamine D2/D3 antagonist, in the prevention of postoperative nausea and vomiting in adult surgical patients. METHODS: Adult inpatients undergoing elective surgery during general anesthesia and having at least two of the four Apfel risk factors for postoperative nausea and vomiting were enrolled at 9 U...
February 2017: Anesthesiology
https://www.readbyqxmd.com/read/27898164/dexmedetomidine-reduces-catheter-related-bladder-discomfort-a-prospective-randomized-placebo-controlled-double-blind-study
#14
Yang Zhao Yun, Xu Jun Mei, Zhu Rong, Dai Ru Ping, Liu Lei
OBJECTIVE: To evaluate the efficacy of dexmedetomidine in preventing catheterrelated bladder discomfort (CRBD) in a postanesthesia care unit (PACU). METHODS: A total of 138 consecutive adult male patients, classified by the American Society of Anesthesiologists (ASA) as ASA class I and ASA class II, were scheduled for elective open upper-middle abdominal surgery. They were randomized into 2 groups, C and D, comprising 69 patients each. Group C was given a saline solution as placebo, and group D received dexmedetomidine...
December 2016: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/27889545/comparison-of-carbon-dioxide-and-air-insufflation-during-consecutive-esophagogastroduodenoscopy-and-colonoscopy-in-moderate-sedation-patients-a-prospective-double-blind-randomized-controlled-trial
#15
Su Young Kim, Jun-Won Chung, Dong Kyun Park, Kwang An Kwon, Kyoung Oh Kim, Yoon Jae Kim, Jung Ho Kim
BACKGROUND AND AIMS: Endoscopy is performed with air insufflation and is usually associated with abdominal pain. It is well recognized that carbon dioxide (CO2) is absorbed more quickly into the body than air; however, to date, few studies have investigated the use of CO2 insufflation during consecutive esophagogastroduodenoscopy and colonoscopy (CEC). Thus, this study evaluated the efficacy of CO2 insufflation compared with air insufflation in CEC. METHODS: From March 2014 to April 2016, a total of 215 consecutive patients were randomly assigned to receive CO2 insufflation (CO2 group, n=108) or air insufflation (air group, n=107)...
November 23, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27885664/haloperidol-plus-promethazine-for-psychosis-induced-aggression
#16
REVIEW
Gisele Huf, Jacob Alexander, Pinky Gandhi, Michael H Allen
BACKGROUND: Health services often manage agitated or violent people, and such behaviour is particularly prevalent in emergency psychiatric services (10%). The drugs used in such situations should ensure that the person becomes calm swiftly and safely. OBJECTIVES: To examine whether haloperidol plus promethazine is an effective treatment for psychosis-induced aggression. SEARCH METHODS: On 6 May 2015 we searched the Cochrane Schizophrenia Group's Register of Trials, which is compiled by systematic searches of major resources (including MEDLINE, EMBASE, AMED, BIOSIS, CINAHL, PsycINFO, PubMed, and registries of clinical trials) and their monthly updates, handsearches, grey literature, and conference proceedings...
25, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27884475/frailty-kidney-function-and-polypharmacy-the%C3%A2-atherosclerosis-risk-in-communities-aric-study
#17
Shoshana H Ballew, Yan Chen, Natalie R Daya, Job G Godino, B Gwen Windham, Mara McAdams-DeMarco, Josef Coresh, Elizabeth Selvin, Morgan E Grams
BACKGROUND: Frail individuals are at increased risk for poor outcomes, including adverse drug events. Kidney function is often compromised in frailty and is a key consideration in medication choice and dosing; however, creatinine-based measures of kidney function may be biased in frail individuals. STUDY DESIGN: Observational study. SETTING & PARTICIPANTS: 4,987 community-dwelling older men and women with complete data who participated in visit 5 of the Atherosclerosis Risk in Communities (ARIC) Study (2011-2013)...
November 21, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27878224/potential-drug-interactions-in-patients-given-antiretroviral-therapy
#18
Wendel Mombaque Dos Santos, Silvia Regina Secoli, Stela Maris de Mello Padoin
Objective: to investigate potential drug-drug interactions (PDDI) in patients with HIV infection on antiretroviral therapy. Methods: a cross-sectional study was conducted on 161 adults with HIV infection. Clinical, socio demographic, and antiretroviral treatment data were collected. To analyze the potential drug interactions, we used the software Micromedex(r). Statistical analysis was performed by binary logistic regression, with a p-value of ≤0.05 considered statistically significant...
November 21, 2016: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/27862901/does-minimalist-transfemoral-transcatheter-aortic-valve-replacement-produce-better-survival-in-patients-with-severe-chronic-obstructive-pulmonary-disease
#19
Jose F Condado, Moosa N Haider, Stamatios Lerakis, Patricia Keegan, Hope Caughron, Vinod H Thourani, Chandan Devireddy, Bradley Leshnower, Kreton Mavromatis, Eric L Sarin, James Stewart, Robert Guyton, Jessica Forcillo, Ateet Patel, Amy Simone, Peter C Block, Vasilis Babaliaros
OBJECTIVES: To compare outcomes after minimalist and standard transfemoral transcatheter aortic valve replacement (TF-TAVR) in patients with severe chronic obstructive pulmonary disease (COPD). BACKGROUND: TF-TAVR is increasingly performed with conscious sedation and transthoracic echocardiography guidance (minimalist). The safety/efficacy of this technique in patients with severe COPD is unknown. METHODS: We compared demographics, 30-day outcomes and 1-year survival of patients with severe COPD (FEV1% ≤50) who underwent minimalist vs...
November 12, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27862227/one-year-safety-and-efficacy-study-of-bilastine-treatment-in-japanese-patients-with-chronic-spontaneous-urticaria-or-pruritus-associated-with-skin-diseases
#20
Akiko Yagami, Masutaka Furue, Michinori Togawa, Akihiro Saito, Michihiro Hide
A number of second-generation non-sedating antihistamines are used in clinical practices over the world. However, long-term safety and efficacy have not been proved high level evidence based medicine. We have performed an open-label, multicenter, phase III study to evaluate the long-term safety and efficacy of bilastine, a novel non-sedating H1 -antihistamine for patients with chronic spontaneous urticaria (CSU) or pruritus associated with skin diseases (trial registration no. JapicCTI-142528). Patients aged 18-74 years were treated with bilastine 20 mg once daily for up to 52 weeks...
November 14, 2016: Journal of Dermatology
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