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https://www.readbyqxmd.com/read/28522914/one-year-experience-with-computer-assisted-propofol-sedation-for-colonoscopy
#1
Otto S Lin, Danielle La Selva, Richard A Kozarek, Deborah Tombs, Wade Weigel, Ryan Beecher, Johannes Koch, Susan McCormick, Michael Chiorean, Fred Drennan, Michael Gluck, Nanda Venu, Michael Larsen, Andrew Ross
AIM: To report our one-year experience with computer assisted propofol sedation (CAPS) for colonoscopy as the first United States Medical Center to adopt CAPS technology for routine clinical use. METHODS: Between September 2014 and August 2015, 2677 patients underwent elective outpatient colonoscopy with CAPS at our center. All colonoscopies were performed by 1 of 17 gastroenterologists certified in the use of the CAPS system, with the assistance of a specially trained nurse...
April 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28521116/efficacy-of-anticonvulsant-substances-in-the-6hz-seizure-test-comparison-of-two-rodent-species
#2
Elise Esneault, Guillaume Peyon, Vincent Castagné
Usually performed in the mouse, the 6Hz seizure test is used for screening potential new anticonvulsant substances against complex partial seizures. Nevertheless, advanced models of temporal lobe epilepsy (TLE) are more often performed in rats, so that possible species-related differences may complicate the development of anticonvulsant substances. The aim of the present study was to evaluate the feasibility of adapting the 6Hz test in the rat. We first compared the effects of increasing current intensities for inducing seizures in the mouse and in the rat...
May 10, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28480864/-antiseizure-activity-of-c-ephalaria-gigantea-root-extract
#3
N Gogitidze, N Mushkiashvili, M Gedevanishvili, N Tabatadze, G Dekanosidze
Antiseizure activity of Cephalaria gigantea root extract was studied using PTZ- and/or audiogenic seizure models in outbred Wistar and inbred Krouchinsky- Molodkina rats respectively. In PTZ - model onset of tonic- clonic seizures, latencies to the beginning of the seizure activity, and mortality, and similarly in audiogenic seizures behavioral convulsive reactions , facial automatisms and latency to wild running were evaluated. The extract is used traditionally in Georgian folk medicine as anticonvulsant drug...
March 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28466184/thirty-day-emergency-room-visits-and-hospital-admissions-after-outpatient-non-vascular-image-guided-procedures
#4
Quang Nguyen, Sahil V Mehta, Jieming Fang, Robert Sheiman, Robert Kane, Muneeb Ahmed, Ammar Sarwar, Bettina Siewert, Olga R Brook
PURPOSE: To evaluate the rate of post-procedure emergency department (ED) visits and hospital admissions following outpatient non-vascular image-guided interventions performed under moderate sedation and to identify common and preventable causes of emergency department visits and hospital admissions. MATERIALS AND METHODS: Institutional review board approval was acquired for this HIPAA-compliant retrospective study with waiver of informed consent. 1426 consecutive patients undergoing 1512 outpatient image-guided procedures under moderate sedation from November 2012 to August 2014 were included...
May 2, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28465784/does-deep-sedation-with-propofol-affect-adenoma-detection-rates-in-average-risk-screening-colonoscopy-exams
#5
Selvi Thirumurthi, Gottumukkala S Raju, Mala Pande, Joseph Ruiz, Richard Carlson, Katherine B Hagan, Jeffrey H Lee, William A Ross
AIM: To determine the effect of sedation with propofol on adenoma detection rate (ADR) and cecal intubation rates (CIR) in average risk screening colonoscopies compared to moderate sedation. METHODS: We conducted a retrospective chart review of 2604 first-time average risk screening colonoscopies performed at MD Anderson Cancer Center from 2010-2013. ADR and CIR were calculated in each sedation group. Multivariable regression analysis was performed to adjust for potential confounders of age and body mass index (BMI)...
April 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28458576/continuous-postoperative-infusion-of-remifentanil-inhibits-the-stress-responses-to-tracheal-extubation-of-patients-under-general-anesthesia
#6
Guoliang Zhao, Xiaoyue Yin, Ya Li, Jianlin Shao
PURPOSE: The study aimed to assess the combined effects of parecoxib with three different doses of remifentanil and its effect on the stress and cough responses following tracheal extubation under general anesthesia. METHODS: A total of 120 patients with American Society of Anesthesiologists (ASA) scores of I or II, undergoing selective thyroidectomy with total intravenous anesthesia (propofol-remifentanil) and tracheal intubation, were randomly allocated to be treated with an intravenous injection of parecoxib and a continuous infusion of remifentanil at 0...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28456907/bispectral-index-monitoring-in-cancer-patients-undergoing-palliative-sedation-a-preliminary-report
#7
Edith Monreal-Carrillo, Silvia Allende-Pérez, David Hui, Maria-Fernanda García-Salamanca, Eduardo Bruera, Emma Verástegui
INTRODUCTION: Continuous palliative sedation (PS) is currently titrated based on clinical observation; however, it is often unclear if patients are still aware of their suffering. The aim of this prospective study is to characterize the level of consciousness in patients undergoing PS using Bispectral Index (BIS) monitoring. PATIENTS AND METHODS: We enrolled consecutive patients with refractory symptoms requiring PS. We documented the level of sedation using Ramsay Sedation Scale (RSS) and BIS at 0, 2, 4, 6, 12, and 24 h during the first day of PS and examined their degree of association...
April 29, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28443041/national-identification-counteracts-the-sedative-effect-of-positive-intergroup-contact-on-ethnic-activism
#8
Adrienne Pereira, Eva G T Green, Emilio Paolo Visintin
Positive intergroup contact with socially and economically advantaged national majorities has been shown to reduce ethnic identification among minorities, thereby undermining ethnic minority activism. This finding implies that ethnic identity is the relevant social identity driving ethnic minorities' struggle for equality. We argue that the study of the "sedating" effect of positive intergroup contact for minorities should be more nuanced. The existence of multiple and sometimes interplaying social identities can foster a reinterpretation of the meaning of "ethnic" activism...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28439690/association-of-endotracheal-tube-repositioning-and-acute-laryngeal-lesions-during-mechanical-ventilation-in-children
#9
Denise Manica, Catia de Souza Saleh Netto, Cláudia Schweiger, Leo Sekine, Larissa Valency Enéas, Denise Rotta Pereira, Gabriel Kuhl, Paulo Roberto Antonacci Carvalho, Paulo José Cauduro Marostica
The objective of this study is to determine the incidence of post-extubation acute laryngeal lesions in a pediatric intensive care unit (PICU) and potential risk factors. Children, aged 28 days to 5 years, admitted to the PICU who required endotracheal intubation for at least 24 h were enrolled. Exclusion criteria were a previous intubation, history of laryngeal disease, current or past tracheostomy, the presence of craniofacial malformations and patients considered on palliative care. All patients underwent flexible fiber-optic laryngoscopy (FFL) not later than 8 h after extubation...
April 24, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28438447/randomized-clinical-trial-of-propofol-versus-alfentanil-for-moderate-procedural-sedation-in-the-emergency-department
#10
James R Miner, Brian E Driver, Johanna C Moore, Erik Faegerstrom, Lauren Klein, Matthew Prekker, Jon B Cole
STUDY OBJECTIVE: To compare the frequency of airway and respiratory adverse events leading to an intervention between moderate sedation using alfentanil or propofol. METHODS: We performed a randomized clinical trial in which adults undergoing moderate sedation in the ED received either alfentanil or propofol. Our primary outcome was the frequency of airway and respiratory adverse events leading to an intervention. Other outcomes included sedation depth, efficacy, sedation time, patient satisfaction, pain, and satisfaction...
April 21, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28417889/monitoring-for-the-oral-and-maxillofacial-surgeon
#11
REVIEW
Robert C Bosack
Parenteral medications are titrated in the oral and maxillofacial surgery office to achieve moderate sedation, deep sedation, or general anesthesia while continuously maintaining spontaneous ventilation with an open airway. After initial drug administration, the provider assesses and interprets both the level of anesthesia and the presence/severity of adverse side effects, both of which guide further drug titration, cessation, reversal, or medical management. This assessment is called monitoring, which guides the conduct of anesthesia delivery and becomes the essence of this art...
May 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28416250/therapeutic-hypothermia-for-neonates-with-hypoxic-ischemic-encephalopathy
#12
REVIEW
Ming-Chou Chiang, Yuh-Jyh Jong, Chyi-Her Lin
Therapeutic hypothermia (TH) is a recommended regimen for newborn infants who are at or near term with evolving moderate-to-severe hypoxic ischemic encephalopathy (HIE). The Task Force of the Taiwan Child Neurology Society and the Taiwan Society of Neonatology held a joint meeting in 2015 to establish recommendations for using TH on newborn patients with HIE. Based on current evidence and experts' experiences, this review article summarizes the key points and recommendations regarding TH for newborns with HIE, including: (1) selection criteria for TH; (2) choices of method and equipment for TH; (3) TH prior to and during transport; (4) methods for temperature maintenance, monitoring, and rewarming; (5) systemic care of patients during TH, including the care of respiratory and cardiovascular systems, management of fluids, electrolytes, and nutrition, as well as sedation and drug metabolism; (6) monitoring and management of seizures; (7) neuroimaging, prognostic factors, and outcomes; and (8) adjuvant therapy for TH...
March 27, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28399379/physiology-of-arousal-in-osa-and-potential-impacts-for-sedative-treatment
#13
Amy S Jordan, Fergal J O'Donoghue, Jennifer M Cori, John Trinder
Treatment options for patients with obstructive sleep apnea (OSA) intolerant of continuous positive airway pressure (CPAP) are limited. Thus, new therapies are sought. Recently, there has been interest in using sedatives to delay arousal from sleep, allowing upper airway dilator muscle recruitment sufficient to re-open the airway while maintaining sleep. In this review the rationale for sedative use and prior sedative studies in OSA are presented, along with a description of six factors that may determine sedative treatment success...
April 11, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28398941/the-season-of-hoverboards-a-case-series-of-fractures
#14
Chester J Donnally, Charles M Lawrie, Augustus J Rush, Avi C Baitner
OBJECTIVE: The aim of this study was to identify the types of pediatric orthopedic extremity fractures that are sustained as a result of hoverboard (self-balancing, self-propelling, 2-wheeled boards) use. METHODS: We performed a retrospective review of all orthopedic consultations from the emergency department at our institution from December 1 to 31, 2015. Data was collected on the injury mechanism, fracture location, management, and patient characteristics including sex, age, and hand dominance...
May 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28386401/the-efficacy-and-safety-of-intravenous-lidocaine-for-analgesia-in-the-older-adult-a-literature-review
#15
REVIEW
Harriet Daykin
Opioids remain the mainstay of analgesia for the treatment of moderate to severe acute pain. Even in the young, the use of opioids can be associated with an increased incidence of post-operative complications such as respiratory depression, vomiting, pruritus, excessive sedation, slowing of gastrointestinal function, and urinary retention. The need to manage acute pain in the older patient is becoming more common as the population ages, and increasingly older patients are undergoing more major surgery. Medical conditions are more common in older people and can result in the requirement of systemic analgesia for fractures, malignancy, nociceptive or neuropathic pain and peripheral vascular disease...
February 2017: British Journal of Pain
https://www.readbyqxmd.com/read/28365484/bolus-administration-of-fentanyl-and-midazolam-for-colonoscopy-increases-endoscopy-unit-efficiency-and-safety-compared-with-titrated-sedation
#16
Raymond Finn, Amanda Boyd, Li Lin, Ziad F Gellad
BACKGROUND & AIMS: Guidelines recommend slow titration of sedatives for moderate sedation. Bolus sedation, in which a larger weight-based dose of medication is given upfront, has been shown in a single trial to be beneficial. We evaluated the effects of bolus sedation on procedural safety, efficiency and patient experience. METHODS: We performed a retrospective analysis of colonoscopies performed between April 2010 and April 2011 at Duke Medical Center. Colonoscopies prior to October 2010 were performed with nurse-directed titration of sedative (n=966); colonoscopies performed after October 2010 were performed with physician-directed administration of bolus sedative (n=699)...
March 29, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28363848/perioperative-use-of-gabapentinoids-in-france
#17
Valéria Martinez, Michel Carles, Emmanuel Marret, Hélène Beloeil
BACKGROUND: Gabapentinoids have governmental health agency approval for "chronic neuropathic pain." Over the last decade, however, the perioperative prescription of gabapentinoids has become more popular among anaesthesiologists due to their anxiolytic and antihyperalgesic proprieties, despite weak scientific evidence supporting the risk/benefit ratio for this indication. METHODS: Our aim was to extensively describe the use of perioperative gabapentinoids by French anaesthesiologists...
March 28, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28363200/evolution-of-right-ventricular-size-over-time-after-tetralogy-of-fallot-repair-a-longitudinal-cardiac-magnetic-resonance-study
#18
Tobias Rutz, Fransis Ghandour, Christian Meierhofer, Susanne Naumann, Stefan Martinoff, Rüdiger Lange, Peter Ewert, Heiko C Stern, Sohrab Fratz
Aims: It is commonly believed that pulmonary regurgitation (PR) after surgical repair of tetralogy of Fallot (TOF) leads to progressive right ventricular (RV) enlargement. However, progressive RV dilatation has never clearly been documented in this patient population. Therefore, we studied the size of the RV over time in patients after surgical TOF repair. Methods and results: Fifty-one consecutive patients after surgical TOF repair underwent at least two cardiovascular magnetic resonance (CMR) exams using a single CMR scanner...
March 1, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28362678/the-behavior-pain-assessment-tool-for-critically-ill-adults-a-validation-study-in-28-countries
#19
Céline Gélinas, Kathleen A Puntillo, Pavel Levin, Elie Azoulay
Many critically ill adults are unable to communicate their pain through self-report. The study purpose was to validate the use of the 8-item Behavior Pain Assessment Tool (BPAT) in patients hospitalized in 192 intensive care units from 28 countries. A total of 4812 procedures in 3851 patients were included in data analysis. Patients were assessed with the BPAT before and during procedures by 2 different raters (mostly nurses and physicians). Those who were able to self-report were asked to rate their pain intensity and pain distress on 0 to 10 numeric rating scales...
May 2017: Pain
https://www.readbyqxmd.com/read/28355345/chronic-dosing-with-mirtazapine-does-not-produce-sedation-in-rats
#20
Alberto Salazar-Juárez, Susana Barbosa-Méndez, Paola Merino-Reyes, Maura Matus-Ortega, Jorge A Hernández-Calderón, Benito Antón
OBJECTIVE: Sedation/somnolence are major side effects of pharmacotherapies for depression, and negatively affect long-term treatment compliance in depressed patients. Use of mirtazapine (MIR), an atypical antidepressant approved for the treatment of moderate to severe depression with comorbid anxiety disorders, is associated with significant sedation/somnolence, especially in short-term therapy. Nonetheless, studies with human subjects suggest that MIR-induced sedation is transient, especially when high and repeated doses are used...
March 23, 2017: Revista Brasileira de Psiquiatria
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