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https://www.readbyqxmd.com/read/29318022/clinical-trial-experience-with-ca4p-anticancer-therapy-focus-on-efficacy-cardiovascular-adverse-events-and-hypertension-management
#1
REVIEW
Rachel Grisham, Bonnie Ky, Krishnansu S Tewari, David J Chaplin, Joan Walker
Combretastatin A4-phosphate (CA4P) is a vascular-disrupting agent (VDA) in clinical development for the treatment of ovarian and other cancers. In contrast to antiangiogenic agents, such as bevacizumab, which suppress the development of new tumor vasculature, VDAs target established tumor vasculature. These differing but complementary mechanisms of action are currently being explored in clinical trials combining CA4P and bevacizumab. Clinical experience to date has highlighted an important need to better understand the cardiovascular adverse events of CA4P, both alone and in combination with antiangiogenic agents, which can also be associated with cardiovascular adverse events...
2018: Gynecologic Oncology Research and Practice
https://www.readbyqxmd.com/read/29317084/-reversal-of-neuromuscular-block-with-sugammadex-in-five-heart-transplant-pediatric-recipients
#2
Ricardo Vieira Carlos, Marcelo Luis Abramides Torres, Hans Donald de Boer
Heart transplantation is a frequent procedure in the treatment of end-stage cardiac dysfunction. Therefore, these patient populations will also be more frequent exposed to other more common surgical procedures after their transplantation. Anesthesiologist should be aware in their assessment of these patients, especially regarding some specific issues related to patients with a history of heart transplantation, like reversal of neuromuscular block. Several reports described that cholinesterase inhibitors drugs, like neostigmine, may produce a dose-dependent life-threatening bradycardia in heart transplant recipients while other publication described the safe use of neostigmine...
January 6, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29303138/is-age-a-determinant-for-nausea-and-vomiting-in-disabled-patients-after-dental-treatment-under-sedation
#3
Hüseyin Cihad Turgut, Metin Alkan, Gülay Kip, Mustafa Sancar Ataç, Sevil Kahraman Altundağ, Süleyman Bozkaya, Berrin Işik, Mustafa Arslan
BACKGROUND AND AIM: Postoperative nausea and vomiting (PONV) is one of most frequently encountered problems after dental treatment of mentally and/or motor disabled patients under sedation or general anesthesia. In this study, we aimed to investigate whether PONV incidence in disabled patients differs between adults (≥18 years) and children/teenage (<18 years). Also investigating complication rates related with anesthesia protocols were additional objectives of the study. MATERIALS AND METHODS: We retrospectively evaluated anesthesia reports of 664 cases undergone different dental treatment procedures under deep sedation with various anesthetic agents...
November 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29289914/incidence-outcomes-and-outcome-prediction-of-unplanned-extubation-in-critically-ill-children-an-11year-experience
#4
R Al-Abdwani, C B Williams, C Dunn, J Macartney, K Wollny, H Frndova, N Chin, D Stephens, C S Parshuram
PURPOSE: Unplanned extubation represents loss of control in the ICU, is associated with harm and is used as a measure of quality of care. We evaluated the rates and consequences of unplanned extubation. MATERIALS AND METHODS: Eligible patients were intubated, <18years, and in ICU. Patient, care-related and environmental characteristics were compared in patients who did and did not receive positive pressure ventilation in the 24h after events. Rates are expressed per 100 intubation-days...
December 24, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29287870/postoperative-bradycardia-following-adenotonsillectomy-in-children-does-intraoperative-administration-of-dexmedetomidine-play-a-role
#5
Benjamin Bush, Joseph D Tobias, Chen Lin, James Ruda, Kris R Jatana, Garth Essig, Jennifer Cooper, Dmitry Tumin, Charles A Elmaraghy
INTRODUCTION: Dexmedetomidine is a novel pharmacologic agent that has become a frequently used adjunct during care of pediatric patients with obstructive sleep apnea (OSA) undergoing tonsillectomy. While generally safe and effective, dexmedetomidine is associated with adverse effects of hypotension and bradycardia from its central sympatholytic effects. Due to safety concerns, our institution routinely admits patients with OSA for overnight cardiorespiratory monitoring following tonsillectomy...
January 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29279731/acupuncture-associated-vasovagal-response-revised-terminology-and-hospital-experience
#6
Kimberly A Christensen, Barbara J Gosse, Celia Hildebrand, Lynn A Gershan
Background: Vasovagal responses associated with acupuncture therapy are relatively uncommon adverse events, occurring in ∼0.02%-7% of treatments. The complex neurocardiovascular reflexes involved in vasovagal responses can induce a range of symptoms such as dizziness, nausea, sweating, bradycardia, hypotension, and, in some cases, syncope or convulsions. Although patients typically recover quickly with proper support, these events may be of concern and anxiety-producing for both patient and provider. Providers need to be well-versed in methods for prevention and treatment of acupuncture-associated vasovagal responses to promote safe practice environments, patient satisfaction and comfort, and cost-effectiveness...
December 1, 2017: Medical Acupuncture
https://www.readbyqxmd.com/read/29250229/leadless-pacemakers-implant-explant-and-long-term-safety-and-efficacy-data
#7
REVIEW
Krishna Kancharla, Abhishek J Deshmukh, Paul A Friedman
Implantable cardiac pacemakers have seen remarkable progress in the last sixty years and remained as cornerstone therapy for symptomatic bradycardia. Despite this progress the current day traditional transvenous implanted pacemaker systems are limited by the need for a surgically created pocket for the generator, indwelling leads in the vascular system and lastly passage through the tricuspid valve. A majority of the implant and explant related complications are due to the surgical pocket and indwelling leads...
August 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29246389/mitigating-passive-fatigue-during-monotonous-drives-with-thermal-stimuli-insights-into-the-effect-of-different-stimulation-durations
#8
Elisabeth Schmidt, Angelika C Bullinger
Driving on monotonous roads has been shown to cause passive fatigue as even non-sleep-deprived drivers suffer from the lack of stimuli. Consequently, alertness is reduced and the risk of accidents increases. To counteract this risk, measures need to be taken to mitigate driver fatigue. While in the past, some studies have been focused on the potential of thermal stimuli to reduce fatigue, their results seem inconclusive. Examining the study conditions in which the thermal stimuli were studied, it becomes obvious that the duration of the thermal stimulus strongly affects perceived fatigue...
December 12, 2017: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/29245361/effects-of-remifentanil-with-or-without-midazolam-pretreatment-on-the-95-effective-dose-of-propofol-for-loss-of-consciousness-during-induction-a-randomized-clinical-trial
#9
Jae Chul Koh, Juyeon Park, Na Young Kim, Ann Hee You, Seo Hee Ko, Dong Woo Han
BACKGROUND: Propofol is a rapid, efficient hypnotic agent with antiemetic effects. However, a high dosage is related to hemodynamic abnormalities such as hypotension and bradycardia. Pretreatment with remifentanil can decrease injection pain and stabilize hemodynamics during the induction period. Remifentanil or midazolam in combination with propofol can provide synergistic or additive effects during anesthesia induction. However, the hypnotic doses of propofol required in patients who receive pretreatment with remifentanil or midazolam remain unclear...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29239751/feasibility-of-single-vs-two-physician-procedural-sedation-in-a-small-community-emergency-department
#10
Clayton P Josephy, David R Vinson
OBJECTIVE: Sedation is commonly required for painful procedures in the emergency department (ED). Some facilities mandate two physicians be present for deep sedation cases. Evidence is lacking, however, that a two-physician approach improves safety outcomes. We report our experience on the feasibility of replacing a two-physician ED procedural sedation policy with a single-physician policy in a small, single-coverage community ED. METHODS: This is a retrospective, before/after, single-center observational study of prospectively collected data from January 2013 through December 2016...
November 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29238167/comparison-of-dexmedetomidine-and-fentanyl-as-local-anesthetic-adjuvants-in-spinal-anesthesia-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#11
REVIEW
ShuJun Sun, JiaMei Wang, NaRen Bao, Ying Chen, Jun Wang
Purpose: To compare the effects of dexmedetomidine (Dex) and fentanyl as adjuvants to local anesthetics in spinal anesthesia. Methods: Two researchers independently searched the PUBMED, EMBASE, Cochrane library, and CBM for randomized controlled trials comparing the effects of Dex and fentanyl as adjuvants to local anesthetics for intrathecal injection. Results: A total of 639 patients from nine studies were included in this meta-analysis...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29217577/paradoxical-escape-responses-by-narwhals-monodon-monoceros
#12
Terrie M Williams, Susanna B Blackwell, Beau Richter, Mikkel-Holger S Sinding, Mads Peter Heide-Jørgensen
Until recent declines in Arctic sea ice levels, narwhals (Monodon monoceros) have lived in relative isolation from human perturbation and sustained predation pressures. The resulting naïvety has made this cryptic, deep-diving cetacean highly susceptible to disturbance, although quantifiable effects have been lacking. We deployed a submersible, animal-borne electrocardiograph-accelerometer-depth recorder to monitor physiological and behavioral responses of East Greenland narwhals after release from net entanglement and stranding...
December 8, 2017: Science
https://www.readbyqxmd.com/read/29192954/is-heart-rate-recovery-index-a-predictive-factor-for-cardioinhibitory-syncope
#13
Volkan Emren, Uğur Kocabaş
BACKGROUND: Cardionhibitory syncope is related with excessive bradycardia or asystole due to parasympathetic response. AIM: We investigated whether patients with cardioinhibitory syncope have higher heart rate recovery index (HRRi) considered as an parasympathetic system activation in exercises stress testing (EST) than other those with other neurogenic syncope forms METHODS: A total of 262 patients who had neurogenic syncope documented by head-up tilt test (HUTT) and 199 healthy control individuals were examined...
December 1, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29189109/monocentric-experience-of-leadless-pacing-with-focus-on-challenging-cases-for-conventional-pacemaker
#14
Christophe Garweg, Joris Ector, Gabor Voros, Adèle Greyling, Bert Vandenberk, Stefaan Foulon, Rik Willems
AIM: Leadless cardiac pacemaker has been developed to reduce complications related to cardiac pacing and is considered as an alternative to conventional pacemaker although safety and efficacy data in clinical practice are limited. The purpose of this study was to investigate the safety and efficacy profile of Micra Transcatheter Pacing System (TPS) used in daily clinical activity with a focus on challenging cases for conventional pacing. METHODS: A total of 66 patients (46 men, 79...
November 30, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/29173417/the-subcutaneous-defibrillator
#15
REVIEW
Jonathan Weinstock, Christopher Madias
The transvenous implantable cardioverter-defibrillator (ICD) has been shown in multiple studies to be effective in the prevention of sudden cardiac death in select populations. The Achilles heel of traditional ICD technology has been the transvenous lead. The subcutaneous ICD provides effective sudden death protection while avoiding lead-related complications of traditional transvenous systems. The subcutaneous ICD is a reasonable option for patients with an ICD indication who do not need bradycardia pacing or cardiac resynchronization therapy...
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29170994/-no-go-donor-hepatectomy-in-living-donor-liver-transplantation
#16
Viniyendra Pamecha, Kishore G S Bharathy, Shyam S Mahansaria, Piyush K Sinha, Archana Rastogi, Shridhar V Sasturkar
BACKGROUND: Selection of appropriate donors after rigorous evaluation is of paramount importance in living-donor liver transplantation. Despite this, donor surgery may not proceed due to unforeseen reasons. The aim of this paper is to study reasons for "no go" donor hepatectomy in living liver donors. PATIENTS AND METHODS: Donor operations stopped after surgical start, directly due to donor safety-related reasons, qualified for inclusion as "no go" donor hepatectomy...
November 24, 2017: Hepatology International
https://www.readbyqxmd.com/read/29160143/some-autonomic-deficits-of-acute-or-chronic-cervical-spinal-contusion-reversed-by-interim-brainstem-stimulation
#17
Alberto A Vitores, Stephanie S Sloley, Catalina Martinez, Melissa M Carballosa-Gautam, Ian D Hentall
Prolonged electrical stimulation of the hindbrain's nucleus raphe magnus (NRM) or its major midbrain input region, the periaqueductal gray (PAG), was previously found in rats to promote recovery from sensory-motor and histological deficits of acute thoracic spinal cord injury (SCI). Here, some visceral deficits of acute and chronic midline cervical (C5) contusion are similarly examined. Cranially implanted wireless stimulators delivered intermittent 8 Hz, 30-70 µA cathodal pulse trains to a brainstem microelectrode...
November 21, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29154821/heterotaxy-syndrome-and-associated-arrhythmias-in-pediatric-patients
#18
Mary C Niu, Heather A Dickerson, Judson A Moore, Caridad de la Uz, Santiago O Valdés, Jeffrey J Kim, David E Bard, Shaine A Morris, Christina Y Miyake
BACKGROUND: Heterotaxy Syndrome (HS) is a rare disorder with complex anatomy involving misarrangements of the cardiac conduction system. Arrhythmias may be related to anatomic variations and contribute to morbidity. OBJECTIVE: This study investigated the associations between arrhythmias, anatomy, and outcomes in a large HS cohort. METHODS: A single center retrospective review of patients diagnosed with HS ≤ 21 years of age was performed...
November 14, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29153912/-acute-epiglottitis-due-to-haemophilus-influenzae-b-a-severe-consequence-of-increased-skepticism-about-vaccination
#19
J Doutau, C Bost-Bru, A Gayot, I Wroblewski, I Pelloux, T Debillon, A Millet
Acute epiglottis is a life-threatening disease in relation with the occurrence of an acute upper airway obstruction. Its incidence has fallen dramatically since the widespread introduction of Haemophilus influenzae type b (Hib) conjugate vaccine. We report the case of a 26-month-old child who was not fully immunized and presented acute upper airway respiratory distress with fever. The symptoms quickly evolved to a respiratory arrest condition with bradycardia, revealing epiglottitis due to Hib. Despite high immunization coverage with great efficacy and occurrence of herd immunity, this entity still exists because of the French population's skepticism of the routine vaccination schedule...
December 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29149140/optimization-of-postoperative-intravenous-patient-controlled-analgesia-with-opioid-dexmedetomidine-combinations-an-updated-meta-analysis-with-trial-sequential-analysis-of-randomized-controlled-trials
#20
Ke Peng, Juan Zhang, Xiao-Wen Meng, Hua-Yue Liu, Fu-Hai Ji
BACKGROUND: It is still a challenge to optimize postoperative pain management. The effects of adding dexmedetomidine (DEX) to opioid-based postoperative intravenous patient-controlled analgesia (PCA) are not fully understood. OBJECTIVES: The aim of this study is to assess the efficacy and safety of opioid-DEX combinations for postoperative PCA, and a trial sequential analysis (TSA) is utilized to evaluate the robustness of the current evidence. STUDY DESIGN: A systematic review and meta-analysis...
November 2017: Pain Physician
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