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https://www.readbyqxmd.com/read/29779974/administration-of-rotaglide%C3%A2-solution-for-treating-refractory-severe-radial-artery-spasm-a-case-report
#1
Vikram Raje, Sanah Christopher, Dennis A Hopkinson, Danielle A Kania, Ion S Jovin
Severe radial artery spasm is a complication of transradial cardiac catheterization. We describe a case of severe radial artery spasm causing catheter entrapment. The spasm was refractory and resistant to intra-arterial vasodilators, systemic vasodilators, and moderate sedation. Rotaglide™ (Boston Scientific, Marlborough, MA) solution via continuous infusion was delivered through the catheter and then the sheath, resolving the spasm and allowing the removal of the catheter and sheath without injury to the radial artery...
May 5, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29772269/a-new-method-for-determining-levels-of-sedation-in-dogs-a-pilot-study-with-propofol-and-a-novel-neuroactive-steroid-anesthetic
#2
B L Youngblood, Y Ueyama, W W Muir, G M Belfort, R H Hammond, J Dai, F G Salituro, A J Robichaud, J J Doherty
BACKGROUND: Different levels of consciousness are required in order to perform different medical procedures. Sedation scales established to objectively define various levels of sedation in humans have not been thoroughly characterized in non-human species. Postural changes in rats or dogs are useful as gross measures of sedation but are inadequate for quantitative assessment since graded levels of sedation are difficult to delineate and obscured by movement abnormalities. NEW METHOD: A new canine sedation scoring (CSS) method was developed based on the modified observer's assessment of alertness and sedation score (MOAA/S) used in humans...
May 14, 2018: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/29764554/-efficacy-and-safety-of-nalbuphine-on-analgesia-of-patients-in-intensive-care-unit
#3
Shaohua Liu, Youdong Wan, Yonggang Luo, Li Wan, Wenjing Yun, Haixu Wang, Zhenhua Wang, Xiaoguang Duan, Ruifang Zhang, Yingying Zhao, Hongwei Cui, Tongwen Sun
OBJECTIVE: To analyze the efficacy and safety of nalbuphine in patients with sedative analgesia in intensive care unit (ICU). METHODS: A prospective observation was conducted. The adult patients with mild and moderate analgesia in general ICU of the First Affiliated Hospital of Zhengzhou University from January to November in 2017 were enrolled, and they were divided into nalbuphine group and sufentanil group in proper order. The nabobrown group was given 40 mg nabobrown, the sufentanil group was given 0...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29762764/insomnia-as-a-path-to-alcoholism-tolerance-development-and-dose-escalation
#4
Timothy Roehrs, Thomas Roth
Study Objectives: To assess the risks associated with the use of alcohol as a "sleep aid", we evaluated tolerance development to pre-sleep ethanol's sedative-hypnotic effects, subsequent ethanol dose escalation, and changes in mood and ethanol "liking". Methods: Volunteers, 21-55 yrs old, with insomnia in otherwise good medical and psychiatric health and no history of alcoholism or drug abuse participated. In experiment 1 (n=24) 0.0, 0.3, or 0...
May 12, 2018: Sleep
https://www.readbyqxmd.com/read/29743180/comparison-of-transesophageal-and-transthoracic-echocardiography-under-moderate-sedation-for-guiding-transcatheter-aortic-valve-replacement
#5
Ines Sherifi, Alaa Mabrouk Salem Omar, Mithun Varghese, Menachem Weiner, Ani Anyanwu, Jason C Kovacic, Samin Sharma, Annapoorna Kini, Partho Sengupta
The optimal periprocedural imaging strategy during transcathether aortic valve replacement (TAVR) performed under moderate sedation is debated. Transthoracic echocardiography (TTE) provides suboptimal views due to poorer resolution and patient positioning, whereas use of transesophageal echocardiography (TEE) under moderate sedation is not widely utilized. The aim of our study was to compare the value of TTE in comparison with TEE guidance under moderate sedation during TAVR. The study population included 144 consecutive patients (mean age 83±11 years, 78(54%) females) who had TAVR under moderate sedation using either a TTE (n=96) or TEE (n=48)...
May 9, 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/29742216/pain-assessment-of-traumatic-brain-injury-victims-using-the-brazilian-version-of-the-behavioral-pain-scale
#6
Caíque Jordan Nunes Ribeiro, Andra Carla Santos de Araújo, Saulo Barreto Brito, Daniele Vieira Dantas, Mariangela da Silva Nunes, José Antonio Barreto Alves, Maria do Carmo de Oliveira Ribeiro
OBJECTIVE: To evaluate the validity and reliability of the Brazilian version of the Behavioral Pain Scale (BPS-Br) in victims of traumatic brain injury. METHODS: Observational prospective study with paired and repeated measures conducted at two intensive care units (clinical and surgical) of a large general hospital. The convenience sample consisted of adult victims of moderate or severe penetrating or blunt craniocerebral trauma who were sedated and mechanically ventilated...
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29728704/the-novel-ghrelin-receptor-inverse-agonist-pf-5190457-administered-with-alcohol-preclinical-safety-experiments-and-a-phase-1b-human-laboratory-study
#7
Mary R Lee, Jenica D Tapocik, Mwlod Ghareeb, Melanie L Schwandt, Alexandra A Dias, April N Le, Enoch Cobbina, Lisa A Farinelli, Sofia Bouhlal, Mehdi Farokhnia, Markus Heilig, Fatemeh Akhlaghi, Lorenzo Leggio
Rodent studies indicate that ghrelin receptor blockade reduces alcohol consumption. However, no ghrelin receptor blockers have been administered to heavy alcohol drinking individuals. Therefore, we evaluated the safety, tolerability, pharmacokinetic (PK), pharmacodynamic (PD) and behavioral effects of a novel ghrelin receptor inverse agonist, PF-5190457, when co-administered with alcohol. We tested the effects of PF-5190457 combined with alcohol on locomotor activity, loss-of-righting reflex (a measure of alcohol sedative actions), and on blood PF-5190457 concentrations in rats...
May 4, 2018: Molecular Psychiatry
https://www.readbyqxmd.com/read/29723486/doppler-ultrasound-can-be-used-to-monitor-umbilical-arterial-blood-flow-in-lightly-sedated-pigs-at-multiple-gestational-ages
#8
Claire Stenhouse, Peter Tennant, W Colin Duncan, Cheryl J Ashworth
Doppler ultrasound was performed under moderate sedation (ketamine and azaperone) for 30min to monitor umbilical arterial (UA) blood flow in one uterine horn of Large White×Landrace gilts (n=23) at Gestational Days (GD) 30, 45, 60 and 90. Gilts were scanned before they were killed to examine relationships between litter size, sex ratio and five UA parameters (peak systolic velocity (PSV), end diastolic velocity (EDV), A/B (PSV to EDV) ratio, fetal heart rate (FHR) and resistance index (RI)). In gilts in which scans were obtained from all fetuses in the scanned horn, relationships between UA parameters, and fetal weight and sex were examined...
May 4, 2018: Reproduction, Fertility, and Development
https://www.readbyqxmd.com/read/29721773/prolonged-cecal-insertion-time-is-not-associated-with-decreased-adenoma-detection-when-a-longer-withdrawal-time-is-achieved
#9
Cassandra D L Fritz, Zachary L Smith, Jeffrey Elsner, Thomas Hollander, Dayna Early, Vladimir Kushnir
BACKGROUND: The association between withdrawal time and adenoma detection has been established; however, the effect of cecal insertion time on adenoma detection remains unclear. AIM: To determine the association between cecal insertion time and adenoma detection. METHODS: This study completed a retrospective analysis of data collected in 4 prospective randomized-controlled trials related to screening and surveillance colonoscopy at a single tertiary care from 2010 to 2016...
May 3, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29720564/evidence-that-sedative-effects-of-benzodiazepines-involve-unexpected-gaba-a-receptor-subtypes-quantitative-observation-studies-in-rhesus-monkeys
#10
Angela N Duke, Zhiqiang Meng, Donna M Platt, John R Atack, Gerard R Dawson, David S Reynolds, V V N Phani Babu Tiruveedhula, Guanguan Li, Michael Rajesh Stephen, Werner Sieghart, James M Cook, James K Rowlett
Using non-human primates, we introduced a new set of behavioral categories for observable sedative effects based on pediatric anesthesiology classifications. We examined the effects of alprazolam and diazepam (non-selective benzodiazepines), zolpidem (preferential binding to α1 subunit-containing GABAA receptors), HZ-166 (8-ethynyl-6-(2'-pyridine)-4H-2,5,10b-triaza-benzo[e]azulene-3-carboxylic acid ethyl ester; functionally selective for α2 and α3 subunit-containing GABAA receptors), MRK-696 (7-cyclobutyl-6-(2-methyl-2H-1,2,4-triazol-2-ylmethoxy)-3-(2-flurophenyl)-1,2,4-triazolo(4,3-b)pyridazine; no selectivity but partial intrinsic activity), and TPA023B (6,2'-difluro-5'-(3-(1-hydroxy-1-methylethyl)imidazo(1,2-b((1,2,4)triazin-7-yl)(1,1'-biphenyl)-2-carbonitrile; selectivity for α2, α3, α5 subunit-containing GABAA receptors) using quantitative behavioral observation techniques in rhesus monkeys...
May 2, 2018: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/29717414/primary-central-sleep-apnea-and-anesthesia-a-retrospective-case-series
#11
Alexandru Alexa, Meghna P Mansukhani, Bhargavi Gali, Atousa Deljou, Juraj Sprung, Toby N Weingarten
PURPOSE: Primary (idiopathic) central sleep apnea (PCSA) is a rare central sleep-related breathing disorder characterized by increased chemoreceptor sensitivity to partial pressure of carbon dioxide, which manifests as hyperventilation followed by apnea during non-rapid eye movement sleep. The purpose of this retrospective study was to describe the postoperative course of patients who had PCSA and underwent procedures requiring anesthetic management. METHODS: Patients who received a diagnosis of PCSA at our institution and required procedural anesthesia between 1 January 2010 and 1 June 2016 underwent a comprehensive review of their health records with a focus on identifying respiratory complications...
May 1, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29679692/impact-of-fellowship-training-level-on-colonoscopy-quality-and-efficiency-metrics
#12
Hussein Bitar, Hassaan Zia, Muhammad Bashir, Pratyusha Parava, Muhammad Hanafi, William Tierney, Mohammad Madhoun
BACKGROUND & AIMS: Previous studies have described variable effects of fellow involvement on the adenoma detection rate (ADR), but few have stratified this effect by level of training. We aimed to evaluate the "fellow effect" on multiple procedural metrics including a newly defined adenoma management efficiency index, which may have a role in documenting colonoscopy proficiency for trainees. We also describe the impact of level of training on moderate sedation use. METHODS: We performed a retrospective review of 2024 patients (mean age 60...
April 18, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29676338/psychoactive-substance-use-and-psychiatric-morbidity-among-pregnant-women-attending-an-ante-natal-clinic-in-benin-city-nigeria
#13
Oluyemisi O Adebowale, Bawo O James
Objective: This study sought to determine the prevalence, patterns and feasibility of screening for psychoactive substance use among pregnant women in an antenatal clinic in Nigeria. It also aimed to determine the relationship between psychoactive substance use risk severity and psychiatric morbidity. Methods: A cross-sectional study was undertaken among 395 pregnant women previously booked for ante-natal care. A sociodemographic questionnaire, the Alcohol Smoking and Substance Involvement Test (ASSIST) and the 20-item self-reporting questionnaire-20 were interviewer administered...
January 2018: Nigerian Postgraduate Medical Journal
https://www.readbyqxmd.com/read/29669351/bronchial-thermoplasty-in-severe-asthma-best-practice-recommendations-from-an-expert-panel
#14
Peter I Bonta, Pascal Chanez, Jouke T Annema, Pallav L Shah, Robert Niven
Bronchial thermoplasty (BT) is a bronchoscopic treatment for patients with severe asthma who remain symptomatic despite optimal medical therapy. In this "expert best practice" paper, the background and practical aspects of BT are highlighted. Randomized, controlled clinical trials have shown BT to be safe and effective in reducing severe exacerbations, improving quality of life, and decreasing emergency department visits. Five-year follow-up studies have provided evidence of the functional stability of BT-treated patients with persistence of a clinical benefit...
2018: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29665357/second-trimester-surgical-abortion-practices-in-the-united-states
#15
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/29659090/detection-of-intra-cardiac-thrombi-and-congestive-heart-failure-in-cats-using-computed-tomographic-angiography
#16
Kyle P Vititoe, Ryan C Fries, Stephen Joslyn, Laura E Selmic, Mark Howes, Jordan P Vitt, Robert T O'Brien
Arterial thromboembolism is a life-threatening condition in cats most commonly secondary to cardiac disease. Echocardiography is the reference standard to evaluate for presence of a thrombus. In humans, computed tomographic (CT) angiography is becoming widely used to detect left atrial thrombi precluding the use of sedation. The purpose of this prospective, controlled, methods comparison pilot study was threefold: (1) describe new CT angiography protocol used in awake cats with cardiac disease and congestive heart failure; (2) determine accuracy of continuous and dynamic acquisition CT angiography to identify and characterize cardiac thrombi from spontaneous echocardiographic contrast using transthoracic echocardiography as our reference standard; (3) identify known negative prognostic factors and comorbidities of the thorax that CT angiography may provide that complement or supersede echocardiographic examination...
April 16, 2018: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/29652275/dexmedetomidine-versus-ketofol-sedation-for-outpatient-diagnostic-transesophageal-echocardiography-a-randomized-controlled-study
#17
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/29649848/-palliative-sedation-despite-guidelines-a-difficult-process-of-decisions
#18
Martin Kamprad, Ute Helm
A distinction needs to be made between intermediate and continuous sedation as well as between minimal, moderate and deep sedation. To gain ethical acceptance it is crucial that for palliative sedation (PS) minimally required doses are administered to decrease suffering. Intermittent PS is used for decreasing physical symptoms, whereas deep continuous PS is used to minimize intolerable suffering or psychological symptoms. Precise medical indication and education of patient and relatives are pre-requirements to any PS...
April 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29648844/acceptability-of-nonabstinent-treatment-outcome-goals-among-addiction-treatment-providers-in-ukraine
#19
Alan K Davis, Tetiana Nickelsen, Robert A Zucker, Erin E Bonar, Maureen A Walton
We examined whether acceptability of nonabstinence treatment outcome goals varied as a function of a patient's severity of diagnosis (ICD-10 harmful use vs. dependence syndrome; World Health Organization, 1992), finality of outcome goal (intermediate vs. final), and type of substance (e.g., tobacco, alcohol, cannabis), among addiction treatment providers in Ukraine. We surveyed 44% of Ukrainian treatment providers (n = 446/1023; Mage = 40.4, SD = 8.6; Male = 67%; MYears Of Experience = 10.2, SD = 7.2). For tobacco use, most respondents (78%-93%) rated nonabstinence as acceptable, regardless of diagnostic severity or finality of outcome goal (i...
April 12, 2018: Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors
https://www.readbyqxmd.com/read/29587186/role-of-%C3%AE-2-3-specific-gaba-a-receptor-isoforms-in-the-development-of-hippocampus-kindling-epileptogenesis
#20
Doodipala Samba Reddy, Ryan F Yoshimura, Gunasekaran Ramanathan, Chase Carver, Timothy B Johnstone, Derk J Hogenkamp, Kelvin W Gee
OBJECTIVE: Subunit-specific positive allosteric modulators (PAMs) of gamma-aminobutyric acid-A (GABA-A) receptors are commonly used to uncover the role of GABA-A receptor isoforms in brain function. Recently, we have designed novel PAMs selective for β2/3 -subunit containing GABA-A receptors (β2/3 -selective PAMs) that are nonbenzodiazepine site-mediated and do not show an α-subunit isoform selectivity, yet exhibit anxiolytic efficacy with reduced potential for sedation, cognitive impairment, and tolerance...
March 24, 2018: Epilepsy & Behavior: E&B
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