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https://www.readbyqxmd.com/read/28928558/oral-clonidine-premedication-attenuates-hemodynamic-responses-of-ketamine-during-total-intravenous-anesthesia
#1
Pulak Tosh, Sunil Rajan, Nitu Puthenveettil, Lakshmi Kumar
BACKGROUND: The most commonly used drug for total intravenous anesthesia (TIVA) is ketamine which results in cardiovascular stimulation. AIMS: The primary aim of this study was to assess the effect of oral clonidine premedication on attenuating the hemodynamic responses following ketamine administration. SETTINGS AND DESIGNS: This was a prospective, observational, comparative study conducted in a tertiary care institution. SUBJECTS AND METHODS: A total of 40 female patients aged 18-55 years who were posted for elective short gynecological procedures under TIVA were recruited for this study...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28927394/laboratory-markers-of-cardiac-and-metabolic-complications-after-generalized-tonic-clonic-seizures
#2
Robert D Nass, Sina Meiling, René P Andrié, Christian E Elger, Rainer Surges
BACKGROUND: Generalized tonic-clonic seizures (GTCS) frequently lead to emergency inpatient referrals. Laboratory blood values are routinely performed on admission to detect underlying causes and metabolic or cardiac complications. Our goal was to assess the nature and frequency of complications occurring in association with GTCS. METHODS: We retrospectively extracted data from emergency protocols and discharge letters of adult patients admitted to the Department of Epileptology between 01/2010 and 06/2015...
September 19, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28923236/emergency-nurses-knowledge-and-self-rated-practice-skills-when-caring-for-older-patients-in-the-emergency-department
#3
Helen Rawson, Paul N Bennett, Cherene Ockerby, Alison M Hutchinson, Julie Considine
BACKGROUND: Older adults are high users of emergency department services and their care requirements can present challenges for emergency nurses. Although clinical outcomes for older patients improve when they are cared for by nurses with specialist training, emergency nurses' knowledge and self-assessment of care for older patients is poorly understood. AIM: To assess emergency nurses' knowledge and self-rating of practice when caring for older patients. METHODS: A cross-sectional self-report survey of emergency nurses (n=101) in Melbourne, Australia...
September 8, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28915907/effect-of-a-mother-s-recorded-voice-on-emergence-from-general-anesthesia-in-pediatric-patients-study-protocol-for-a-randomized-controlled-trial
#4
Seok Young Song, Sang Gyu Kwak, Eugene Kim
BACKGROUND: Emergence delirium is a behavioral disturbance after general anesthesia in children and may distress both the patients and the primary caregivers, such as parents and medical staff, looking after the patients. Various medical and emotional interventions have been investigated to reduce emergence delirium; however, none are completely effective. This trial intends to assess whether the mother's recorded voice can reduce this adverse post-anesthesia event and facilitate arousal from general anesthesia...
September 15, 2017: Trials
https://www.readbyqxmd.com/read/28904966/the-effect-of-oral-dexmedetomidine-premedication-on-preoperative-cooperation-and-emergence-delirium-in-children-undergoing-dental-procedures
#5
Sultan Keles, Ozlem Kocaturk
INTRODUCTION: The aim of this study was to detect the effect of 1 μg/kg of oral dexmedetomidine (DEX) as premedication among children undergoing dental procedures. MATERIALS AND METHODS: The study involved 100 children between 2 and 6 years of age, ASA I, who underwent full-mouth dental rehabilitation. The DEX group (n = 50) received 1 μg/kg DEX in apple juice, and the control group (n = 50) received only apple juice. The patients' scores on the Ramsay Sedation Scale (RSS), parental separation anxiety scale, mask acceptance scale, and pediatric anesthesia emergence delirium scale (PAEDS) and hemodynamic parameters were recorded...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28895757/intoxications-in-the-strida-project-involving-a-panorama-of-psychostimulant-pyrovalerone-derivatives-mdpv-copycats
#6
Olof Beck, Matilda Bäckberg, Patrick Signell, Anders Helander
CONTEXT: An increasing number of new psychoactive substances (NPS) of different chemical classes have become available through marketing and sale over the Internet. This report from the Swedish STRIDA project presents the prevalence, laboratory results, and clinical features in intoxications involving 11 stimulant pyrovalerone NPS derivatives over a 5-year period. STUDY DESIGN: Case series of consecutive patients with admitted or suspected intake of NPS presenting to Swedish hospitals for emergency treatment from January 2011 to March 2016...
September 12, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28893727/development-of-a-virtual-reality-exposure-tool-as-psychological-preparation-for-elective-pediatric-day-care-surgery-methodological-approach-for-a-randomized-controlled-trial
#7
Robin Eijlers, Jeroen S Legerstee, Bram Dierckx, Lonneke M Staals, Johan Berghmans, Marc P van der Schroeff, Rene Mh Wijnen, Elisabeth Mwj Utens
BACKGROUND: Preoperative anxiety in children is highly prevalent and is associated with adverse outcomes. Existing psychosocial interventions to reduce preoperative anxiety are often aimed at distraction and are of limited efficacy. Gradual exposure is a far more effective way to reduce anxiety. Virtual reality (VR) provides a unique opportunity to gradually expose children to all aspects of the operating theater. OBJECTIVE: The aims of our study are (1) to develop a virtual reality exposure (VRE) tool to prepare children psychologically for surgery; and (2) to examine the efficacy of the VRE tool in a randomized controlled trial (RCT), in which VRE will be compared to care as usual (CAU)...
September 11, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28891828/poor-performance-on-a-preoperative-cognitive-screening-test-predicts-postoperative-complications-in-older-orthopedic-surgical-patients
#8
Deborah J Culley, Devon Flaherty, Margaret C Fahey, James L Rudolph, Houman Javedan, Chuan-Chin Huang, John Wright, Angela M Bader, Bradley T Hyman, Deborah Blacker, Gregory Crosby
BACKGROUND: The American College of Surgeons and the American Geriatrics Society have suggested that preoperative cognitive screening should be performed in older surgical patients. We hypothesized that unrecognized cognitive impairment in patients without a history of dementia is a risk factor for development of postoperative complications. METHODS: We enrolled 211 patients 65 yr of age or older without a diagnosis of dementia who were scheduled for an elective hip or knee replacement...
September 8, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28888918/effects-of-psychopharmacological-treatment-with-antipsychotic-drugs-on-the-vascular-system
#9
REVIEW
Kai G Kahl, Mechthild Westhoff-Bleck, Tillmann H C Krüger
Psychopharmacological treatment with antipsychotic drugs is an essential part of guideline-based treatment strategies in psychotic disorders, such as schizophrenia, schizoaffective disorders, and delusional disorders. Other mental disorders frequently treated with antipsychotic drugs are bipolar disorders, and major depressive disorder. Furthermore, antipsychotic drugs are often given in emergency and surgical units for the treatment of metabolic or postoperative delirium. Antipsychotic drugs can exert direct and indirect effects on the vascular system, potentially leading to severe complications such as thromboembolism...
September 6, 2017: Vascular Pharmacology
https://www.readbyqxmd.com/read/28887627/-sepsis-masquerading-as-delirium
#10
REVIEW
A Seifert, C S Hartog, J Zweigner, W Schummer, K Reinhart
A previously healthy 60-year-old patient presented to the emergency department with severe headache, altered personality and fever. He was treated for bacterial meningitis with delirium of unknown cause but presumed to be due to alcohol withdrawal. Despite receiving the antibiotic therapy regimen recommended for bacterial meningitis the patient's condition rapidly deteriorated with profound delirium and tachypnea. The intensivist who was consulted immediately suspected sepsis-associated organ failure and admitted the patient to the intensive care unit (ICU)...
September 8, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28876970/responding-to-ten-common-delirium-misconceptions-with-best-evidence-an-educational-review-for-clinicians
#11
Mark A Oldham, Nina M Flanagan, Ariba Khan, Olga Boukrina, Edward R Marcantonio
Delirium (acute confusion) is a serious, common health condition, and it predicts poor outcomes, including greater rates of mortality, institutionalization, prolonged hospitalization, and cognitive impairment. Expedient diagnosis and management are critical to address modifiable delirium causes and improve both quality of care and outcomes. Moreover, more than a third of delirium is preventable. Despite the clear significance of delirium and our increasingly sophisticated understanding of the condition, the gap between evidence and practice persists...
September 6, 2017: Journal of Neuropsychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/28862050/synthetic-cannabinoid-black-mamba-infidelity-in-patients-presenting-for-emergency-stabilization-in-colorado-a-p-scan-cohort
#12
Nicklaus Brandehoff, Axel Adams, Kyle McDaniel, Samuel D Banister, Roy Gerona, Andrew A Monte
BACKGROUND: Use of new psychoactive substances (NPS) has increased over the last decade. During this period, variability of both clinical presentations and chemical compositions of these compounds has increased. Synthetic cannabinoids (SCs) are the most commonly used NPS and there are more than 100 documented unique molecules in this class. "Black Mamba", often associated to ADB-FUBINACA, is the most commonly used SC in Colorado. It has been linked to kidney injury, myocardial toxicity, seizures, and death...
September 1, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28854540/electroencephalography-and-delirium-in-the-postoperative-period
#13
B J A Palanca, T S Wildes, Y S Ju, S Ching, M S Avidan
Delirium commonly manifests in the postoperative period as a clinical syndrome resulting from acute brain dysfunction or encephalopathy. Delirium is characterized by acute and often fluctuating changes in attention and cognition. Emergence delirium typically presents and resolves within minutes to hours after termination of general anaesthesia. Postoperative delirium hours to days after an invasive procedure can herald poor outcomes. Easily recognized when patients are hyperactive or agitated, delirium often evades diagnosis as it most frequently presents with hypoactivity and somnolence...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28834857/oral-agents-for-the-management-of-agitation-and-agitated-delirium-in-critically-ill-patients
#14
Qiu Min Yeo, Tessa L Wiley, Melanie N Smith, Drayton A Hammond
Agitation is one of the most common issues that critically ill patients experience. Medications used to manage agitation are often administered intravenously or intramuscularly in the acutely agitated, critically ill patient. However, a multimodal approach that utilizes multiple routes of administration may be appropriate. This review summarizes the available literature on oral antipsychotics, clonidine, and valproic acid to manage agitation in critically ill patients while also focusing on their pharmacology and appropriate monitoring...
October 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/28831910/delirium-in-advanced-cancer-may-have-link-to-lower-survival-rate
#15
(no author information available yet)
Patients with advanced cancer who present at emergency departments (EDs) with delirium are prone to an earlier death, a study has found.
August 23, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28822348/risk-factors-for-potential-drug-drug-interactions-in-intensive-care-unit-patients
#16
Slobodan M Janković, Ana V Pejčić, Miloš N Milosavljević, Valentina D Opančina, Nikola V Pešić, Tamara T Nedeljković, Goran M Babić
PURPOSE: To determine risk factors for each severity-based category of potential drug-drug interactions (DDIs) encountered at intensive care unit (ICU) patients. METHODS: This was a retrospective cohort analysis of patients treated at the ICU of the Clinical Center Kragujevac, a public tertiary care hospital in Kragujevac, Serbia. Three interaction checkers were used to reveal drug-drug interactions: Medscape, Epocrates and Micromedex. RESULTS: The study included 201 patients, 66...
August 14, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28817952/professional-socialization-a-grounded-theory-of-the-clinical-reasoning-processes-that-rns-and-lpns-use-to-recognize-delirium
#17
Mohamed El Hussein, Sandra Hirst, Joseph Osuji
Delirium is an acute disorder of attention and cognition. It affects half of older adults in acute care settings and is a cause of increasing mortality and costs. Registered nurses (RNs) and licensed practical nurses (LPNs) frequently fail to recognize delirium. The goals of this research were to identify the reasoning processes that RNs and LPNs use to recognize delirium, to compare their reasoning processes, and to generate a theory that explains their clinical reasoning processes. Theoretical sampling was employed to elicit data from 28 participants using grounded theory methodology...
August 1, 2017: Clinical Nursing Research
https://www.readbyqxmd.com/read/28810649/effect-of-dexmedetomidine-combined-with-sufentanil-on-preventing-emergence-agitation-in-children-receiving-sevoflurane-anesthesia-for-cleft-palate-repair-surgery
#18
Ke Luo, Jun-Mei Xu, Lin Cao, Ju Gao
The aim of the present study was to observe whether dexmedetomidine (DEX) combined with sufentanil decreased emergence agitation (EA) in children receiving sevoflurane anesthesia for cleft palate repair surgery. Children undergoing elective cleft palate repair surgery were randomly allocated into the DEX + sufentanil group (group DS; n=50) and the normal saline + fentanyl group (group SF; n=50). Patients in group DS were treated with 0.5 µg/kg DEX prior to induction of anesthesia, whereas patients in group SF received an equal volume of normal saline...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28802384/retrospective-study-of-intranasal-dexmedetomidine-as-a-prophylactic-against-emergence-delirium-in-pediatric-patients-undergoing-ear-tube-surgery
#19
Lisgelia Santana, Katherine Mills
OBJECTIVES: This study evaluated the effect of intranasal dexmedetomidine on emergence delirium (ED) in pediatric patients who underwent ear tube surgeries. Due to the brief nature of the surgery and low levels of pain experienced, an IV is rarely needed, limiting the medications available to anesthesiologists to manage postoperative delirium that may arise during recovery from inhalational anesthesia. Intravenous dexmedetomidine is an alpha-2 agonist anesthetic that is used in pediatric patients for the management of ED in various surgical procedures...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28800801/behavioral-emergencies-special-considerations-in-the-geriatric-psychiatric-patient
#20
REVIEW
Awais Aftab, Asim A Shah
This article reviews psychiatric considerations and common psychiatric emergencies in the elderly. The elderly are vulnerable to medication side-effects because of pharmacokinetic changes from aging, and require lower doses and slower titration. They are a high-risk group for suicide, with more serious intent, fewer warning signs, and more lethality. Prompt diagnosis and treatment of delirium in emergency settings is essential, given association with worse outcomes when undiagnosed. Pharmacologic options with demonstrable efficacy for agitation in dementia are limited to antipsychotics, which are, however, associated with an increased risk of mortality; behavioral interventions are universally recommended as first-line measures...
September 2017: Psychiatric Clinics of North America
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