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https://www.readbyqxmd.com/read/28635347/ketamine-and-international-regulations
#1
Yanhui Liao, Yi-Lang Tang, Wei Hao
BACKGROUND: Ketamine is an anesthetic commonly used in low-income countries and has recently been shown to be effective for treatment-resistant depression. However, the illicit manufacturing, trafficking, and nonmedical use of ketamine are increasing globally, and its illicit use poses major public health challenges in many countries. OBJECTIVES: To review the nonmedical use of ketamine in selected countries and its regulatory control. METHODS: We conducted a review of literature identified from searches of the China National Knowledge Infrastructure (CNKI) (1979-2016) and PubMed databases, supplemented by additional references identified by the authors...
February 13, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28614863/-anesthetic-management-in-thoracic-trauma-patients
#2
Alf Kozian, Astrid Bergmann, Thomas Hachenberg, Thomas Schilling
In daily practice, management of patients with blunt thoracic trauma is challenging for the anesthetist. Injuries of airways, lungs, diaphragm, heart and large vessels are the main difficulties.Respiratory and circulatory physiology in general is affected by general anesthesia, which may result in an increased number of perioperative complications. Therefore, anesthetic management of patients with thoracic trauma needs to address different clinical topics: management of difficult airways, intrinsic effects of anesthetics and mechanical ventilation on respiratory and cardiac function, the adequate replacement of blood loss as well as type and extent of the surgical intervention...
June 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28608134/venoarterial-pco2-to-arteriovenous-oxygen-content-difference-ratio-is-a-poor-surrogate-for-anaerobic-metabolism-in-hemodilution-an-experimental-study
#3
Arnaldo Dubin, Gonzalo Ferrara, Vanina Siham Kanoore Edul, Enrique Martins, Héctor Saúl Canales, Carlos Canullán, Gastón Murias, Mario Omar Pozo, Elisa Estenssoro
BACKGROUND: The identification of anaerobic metabolism in critically ill patients is a challenging task. Observational studies have suggested that the ratio of venoarterial PCO2 (Pv-aCO2) to arteriovenous oxygen content difference (Ca-vO2) might be a good surrogate for respiratory quotient (RQ). Yet Pv-aCO2/Ca-vO2 might be increased by other factors, regardless of anaerobic metabolism. At present, comparisons between Pv-aCO2/Ca-vO2 and RQ have not been performed. We sought to compare these variables during stepwise hemorrhage and hemodilution...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28602010/closed-loop-regulation-of-arterial-pressure-after-acute-brain-death
#4
Kristian Soltesz, Trygve Sjöberg, Tomas Jansson, Rolf Johansson, Anders Robertsson, Audrius Paskevicius, Quiming Liao, Guangqi Qin, Stig Steen
The purpose of this concept study was to investigate the possibility of automatic mean arterial pressure (MAP) regulation in a porcine heart-beating brain death (BD) model. Hemodynamic stability of BD donors is necessary for maintaining acceptable quality of donated organs for transplantation. Manual stabilization is challenging, due to the lack of vasomotor function in BD donors. Closed-loop stabilization therefore has the potential of increasing availability of acceptable donor organs, and serves to indicate feasibility within less demanding patient groups...
June 10, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28598924/resuscitative-endovascular-balloon-occlusion-of-the-aorta-principles-initial-clinical-experience-and-considerations-for-the-anesthesiologist
#5
Srikanth Sridhar, Sam D Gumbert, Christopher Stephens, Laura J Moore, Evan G Pivalizza
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an endovascular technique that allows for temporary occlusion of the aorta in patients with severe, life-threatening, trauma-induced noncompressible hemorrhage arising below the diaphragm. REBOA utilizes a transfemoral balloon catheter inserted in a retrograde fashion into the aorta to provide inflow control and support blood pressure until definitive hemostasis can be achieved. Initial retrospective and registry clinical data in the trauma surgical literature demonstrate improvement in systolic blood pressure with balloon inflation and improved survival compared to open aortic cross-clamping via resuscitative thoracotomy...
June 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28597457/safeguarding-infant-brains-a-multidisciplinary-challenge-results-of-a-survey-update-on-current-scientific-evidence-and-recommendations-on-how-to-deal-with-possible-anesthetic-drug-neurotoxicity
#6
Frank Weber, John Vlot, Rene Wijnen
No abstract text is available yet for this article.
June 8, 2017: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28597281/gangrenous-cholecystitis-innovative-laparoscopic-techniques-to-facilitate-subtotal-fenestrating-cholecystectomy-when-a-critical-view-of-safety-cannot-be-achieved
#7
Rebekah Kirkwood, Lauren Damon, Jennifer Wang, Esther Hong, Kimberly Kirkwood
BACKGROUND: Gangrenous cholecystitis is associated with a higher conversion rate of conversion from laparoscopic to open than acute non-gangrenous cholecystitis. New strategies and techniques are needed to decrease conversion rates and improve outcomes. METHODS: In this article, we provide a richly detailed, illustrated description of a modified fundus-first technique that we have developed over the last 15 years and now use routinely with rare conversions. We also compared outcomes of laparoscopic (LC) and open (OC) approaches for pathologically confirmed gangrenous cholecystitis in 146 patients during 1995-2005, the first 10 years during which these two approaches were performed contemporaneously at our institution on comparable patients...
June 8, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28594690/anaesthesiology-for-children-with-arthrogryposis
#8
Artem N Savenkov, Giorgio E Pajardi, Olga E Agranovich, Dmitry Zabolskiy, Harold J P van Bosse
Patients with arthrogryposis often require anesthesia for surgical procedures. Intubation can be challenging due to lack of visualization. Anesthetic maintenance is fairly routine. Pheripheral blocks are an important adjunct to postoperative pain management.
July 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28590232/anesthesia-for-patients-with-mucopolysaccharidoses-comprehensive-review-of-the-literature-with-emphasis-on-airway-management
#9
REVIEW
Brittney M Clark, Juraj Sprung, Toby N Weingarten, Mary E Warner
Mucopolysaccharidoses (MPS) are rare, inherited, lysosomal storage diseases that cause accumulation of glycosaminoglycans, resulting in anatomic abnormalities and organ dysfunction that can increase the risk of anesthesia complications. We conducted a systematic review of the literature in order to describe the anesthetic management and perioperative outcomes in patients with MPS. We reviewed English-language literature search using an OVID-based search strategy of the following databases: 1) PubMed (1946-present), 2) Medline (1946-present), 3) EMBASE (1946-present), and 4) Web of Science (1946-present) using the following search terms: mucopolysaccharidosis, Hurler, Scheie, Sanfilippo, Morquio, Maroteaux, anesthesia, perioperative, intubation, respiratory insufficiency, and airway...
June 6, 2017: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/28588463/looking-for-the-self-phenomenology-neurophysiology-and-philosophical-significance-of-drug-induced-ego-dissolution
#10
Raphaël Millière
There is converging evidence that high doses of hallucinogenic drugs can produce significant alterations of self-experience, described as the dissolution of the sense of self and the loss of boundaries between self and world. This article discusses the relevance of this phenomenon, known as "drug-induced ego dissolution (DIED)", for cognitive neuroscience, psychology and philosophy of mind. Data from self-report questionnaires suggest that three neuropharmacological classes of drugs can induce ego dissolution: classical psychedelics, dissociative anesthetics and agonists of the kappa opioid receptor (KOR)...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28571661/-evaluation-and-perioperative-management-of-patients-with-diabetes-mellitus-a-challenge-for-the-anesthesiologist
#11
REVIEW
João Paulo Jordão Pontes, Florentino Fernandes Mendes, Mateus Meira Vasconcelos, Nubia Rodrigues Batista
Diabetes mellitus (DM) is characterized by alteration in carbohydrate metabolism, leading to hyperglycemia and increased perioperative morbidity and mortality. It evolves with diverse and progressive physiological changes, and the anesthetic management requires attention regarding this pathology interference in multiple organ systems and their respective complications. Patient's history, physical examination, and complementary exams are important in the preoperative management, particularly glycosylated hemoglobin (HbA1c), which has a strong predictive value for complications associated with diabetes...
May 29, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28558784/hesperetin-5-7-3-o-triacetate-suppresses-airway-hyperresponsiveness-in-ovalbumin-sensitized-and-challenged-mice-without-reversing-xylazine-ketamine-induced-anesthesia-in-normal-mice
#12
You-Lan Yang, Chi-Li Chen, Chi-Ming Chen, Wun-Chang Ko
BACKGROUND: We recently reported that hesperetin-5,7,3'-O-triacetate (HTA) dually inhibited phosphodiesterase (PDE)3/4 with a therapeutic ratio of 20.8. The application and development of PDE4 inhibitors for treating asthma or COPD are limited by their side effects, such as nausea, vomiting and gastric hypersecretion. PDE4 inhibitors were reported to reverse xylazine/ketamine-induced anesthesia in rats and triggered vomiting in ferrets. Thus the reversing effect of HTA on xylazine/ketamine-induced anesthesia in mice was studied to assess emetic effect of HTA...
May 30, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28555509/inhibitory-effects-of-propofol-on-th17-cell-differentiation
#13
Chi-Chien Lin, Der-Yuan Chen, Kuo-Tung Tang, Ya-Hsuan Chao, Ching-Hui Shen, Ping-Wing Lui
Propofol (2,6-diisopropylphenol) is probably the most widely used intravenous anesthetic agent in daily practice. It has been reported to show immunomodulatory activity. However, the effect of propofol on the differention of T cells remains unclear. In this study, we demonstrated for the first time that propofol inhibited both interleukin (IL)-6 plus transforming growth factor-β (TGF-β)-induced Th17 cell differentiation in vitro and in LPS-challenged mice. Propofol also suppressed the IL-6-induced phosphorylation of Janus kinase-2 (JAK2)/signal transducer and activator of transcription (STAT3) pathway, a cytokine-activated essential transcription factor in Th17 cell development, which occurred concomitantly with the enhancement of suppressor of cytokine signaling-3 (SOCS3) expression involved in the downregulation of STAT3 phosphorylation...
May 30, 2017: Immunopharmacology and Immunotoxicology
https://www.readbyqxmd.com/read/28553380/giant-occipital-meningoencephalocele-in-a-neonate-a-therapeutic-challenge
#14
Vikul Kumar, S Bhaikhel Kulwant, Suman Saurabh, S Chauhan Richa
Encephalocele is a rare lesion, being an embryological mesodermal anomaly which results in a defect in the cranium and dura, associated with herniation of meninges, cerebrospinal fluid, or brain tissues through a defect usually covered by scalp. Surgical management of children with giant occipital encephalocele requires careful attention to pediatric anesthetic and surgical principles. We present a case of a giant occipital encephalocele highlighting the problems encountered in its management.
January 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/28535941/-anesthetic-management-of-two-patients-with-alkaptonuric-ochronosis-for-total-knee-arthroplasty
#15
Betul Kozanhan
The current case report describes two cases of alkaptonuric ochronosis for anesthetic management. Alkaptonuria is a rare genetic orphan disease of tyrosine metabolism characterized by an accumulation of homogentisic acid in cartilage and connective tissues. Patients present most commonly for orthopedic joint surgery due to progressive arthropathy that can be misdiagnosed many a times. However respiratory, airway, cardiovascular and genitourinary systems complications can occur with age progressing. Restricted range of motion of cervical spine may lead to difficulty with airway management...
May 20, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28529059/a-review-of-human-neuroimaging-investigations-involved-with-central-autonomic-regulation-of-baroreflex-mediated-cardiovascular-control
#16
Derek S Kimmerly
Effective regulation of central blood volume and arterial pressure is critical for optimal cardiovascular homeostasis. Inadequate regulation of mean arterial pressure has important pathophysiological implications including syncope, end organ damage, and stroke. Such regulation requires appropriate central integration of barosensory afferents and reflex autonomic control of the heart and blood vessels. The neural pathways involved with the baroreflex include brainstem nuclei that receive modulatory input from higher brain centres...
May 15, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28526144/pulmonary-vasodilators-and-anesthesia-considerations
#17
REVIEW
Jeremy B Green, Brendon Hart, Elyse M Cornett, Alan D Kaye, Ali Salehi, Charles J Fox
Pulmonary hypertension (PH) is a complex disease process of the pulmonary vasculature system characterized by elevated pulmonary arterial pressures. Patients with PH are at increased risk for morbidity and mortality, including intraoperatively and postoperatively. Appreciation by the clinical anesthesiologist of the pathophysiology of PH is warranted. Careful and meticulous strategy using appropriate anesthetic medications, pulmonary vasodilator and inotropic agents, and careful fluid management all increase the likelihood of the best possible outcome in this challenging patient population...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28509777/ultrasound-guided-percutaneous-cryoneurolysis-for-acute-pain-management-a-case-report
#18
Rodney A Gabriel, John J Finneran, Deepa Asokan, Andrea M Trescot, NavParkash S Sandhu, Brian M Ilfeld
We report 3 different cases in which ultrasound-guided percutaneous cryoneurolysis was performed to treat acute pain: 1 patient with refractory incisional pain after percutaneous nephrolithotomy; 1 patient with burns to the foot; and 1 patient with pain from iliac crest grafting. Acute pain associated with surgery or injury is a challenge to treat with local anesthetic-based regional anesthesia techniques when the anticipated pain duration exceeds a few days. Cryoneurolysis is an alternative analgesic method that utilizes extremely cold temperatures to reversibly ablate peripheral nerves and is potentially a novel method for acute pain management...
May 12, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28506256/aav-vector-distribution-in-the-mouse-respiratory-tract-following-four-different-methods-of-administration
#19
Lisa A Santry, Joelle C Ingrao, Darrick L Yu, Jondavid G de Jong, Laura P van Lieshout, Geoffrey A Wood, Sarah K Wootton
BACKGROUND: Targeted delivery of gene therapy vectors to the mouse respiratory tract is often performed via intranasal or intratracheal administration; however, there can be a great deal of variability between these methods, which could potentially influence experimental results. Improving the accuracy and precision of lung delivery will not only reduce the number of animals required to detect statistically significant differences, but may reduce the variability of studies from different laboratories...
May 15, 2017: BMC Biotechnology
https://www.readbyqxmd.com/read/28484490/intraluminal-administration-of-resiniferatoxin-protects-against-clostridium-difficile-toxin-a-induced-colitis
#20
Steven R Vigna
Clostridium difficile toxin A is a colonic inflammatory agent that acts partially by activation of TRPV1 (transient receptor potential vanilloid type 1). Resiniferatoxin (RTX) is an excitotoxin that activates TRPV1 at low concentrations and defunctionalizes TRPV1 at high concentrations. RTX at various doses was injected intraluminally into isolated ileal segments in anesthetized rats. After 3 hours, the treated segments were removed and inflammation was assessed. This acute treatment with RTX resulted in biphasic responses: (1) an increase in inflammation similar to that caused by toxin A and capsaicin at low doses of up to 100 ng RTX and (2) no inflammatory effect of RTX at higher doses (1-100 μg), consistent with a defunctionalizing or neurotoxic effect of RTX at high doses...
2017: Gastroenterology Research and Practice
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