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Critical care pharmacology

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https://www.readbyqxmd.com/read/28806860/patient-caregiver-and-provider-perceptions-of-pain-and-pain-management-in-adolescents-and-young-adults-with-bleeding-disorders
#1
Angela Lambing, Cynthia D Nichols, James E Munn, Terry L Anderson, Bartholomew J Tortella, Michelle L Witkop
INTRODUCTION: Recurrent bleeding and associated pain are critical components in the management of bleeding disorders, yet scant data describe perceptions of pain in this patient population. OBJECTIVE: This study assessed perceptions of pain and pain management in adolescents and young adults (AYAs) with haemophilia or von Willebrand disease (VWD) to determine agreement/disagreement between patients, caregivers and health care providers. METHODS: Using an online questionnaire, AYA patients (N=89), their caregivers (N=77), and providers (N=54) reported on pain perception, pain treatment and pain control...
August 14, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28803496/management-of-multidrug-resistant-pseudomonas-aeruginosa-in-the-intensive-care-unit-state-of-the-art
#2
Alberto Enrico Maraolo, Marco Cascella, Silvia Corcione, Arturo Cuomo, Salvatore Nappa, Guglielmo Borgia, Francesco Giuseppe De Rosa, Ivan Gentile
Pseudomonas aeruginosa (PA) is one of the most important causes of healthcare-related infections among Gram-negative bacteria. The best therapeutic approach is controversial, especially for multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains as well as in the setting of most severe patients, such as in the intensive care unit (ICU). Areas covered: This article addresses several points. First, the main microbiological aspects of PA, focusing on its wide array of resistance mechanisms. Second, risk factors and the worse outcome linked to MDR-PA infection...
August 14, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28791431/glycine-receptors-and-glycine-transporters-targets-for-novel-analgesics
#3
REVIEW
Hanns Ulrich Zeilhofer, Mario A Acuña, Jacinthe Gingras, Gonzalo E Yévenes
Glycinergic neurotransmission has long been known for its role in spinal motor control. During the last two decades, additional functions have become increasingly recognized-among them is a critical contribution to spinal pain processing. Studies in rodent pain models provide proof-of-concept evidence that enhancing inhibitory glycinergic neurotransmission reduces chronic pain symptoms. Apparent strategies for pharmacological intervention include positive allosteric modulators of glycine receptors and modulators or inhibitors of the glial and neuronal glycine transporters GlyT1 and GlyT2...
August 8, 2017: Cellular and Molecular Life Sciences: CMLS
https://www.readbyqxmd.com/read/28770341/prenatal-depression-screening-and-antidepressant-prescription-obstetrician-gynecologists-practices-opinions-and-interpretation-of-evidence
#4
Laura H Taouk, Kristen A Matteson, Lauren M Stark, Jay Schulkin
Obstetrician-gynecologists (ob-gyns) are well-positioned to detect symptoms of perinatal depression; however, little is known about how ob-gyns respond. The purpose of this study was to evaluate ob-gyns' beliefs and practices related to prenatal depression screening and antidepressant prescription during pregnancy. A larger survey on prenatal medication was developed at the American College of Obstetricians and Gynecologists (ACOG) and distributed to a sample of 1000 Fellows. The overall response rate was 37...
August 2, 2017: Archives of Women's Mental Health
https://www.readbyqxmd.com/read/28744243/the-odyssey-of-dental-anxiety-from-prehistory-to-the-present-a-narrative-review
#5
REVIEW
Enrico Facco, Gastone Zanette
Dental anxiety (DA) can be considered as a universal phenomenon with a high prevalence worldwide; DA and pain are also the main causes for medical emergencies in the dental office, so their prevention is an essential part of patient safety and overall quality of care. Being DA and its consequences closely related to the fight-or-flight reaction, it seems reasonable to argue that the odyssey of DA began way back in the distant past, and has since probably evolved in parallel with the development of fight-or-flight reactions, implicit memory and knowledge, and ultimately consciousness...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28743362/critical-revision-of-the-medical-treatment-of-gout-in-brazil
#6
Valderilio Feijó Azevedo, Maicon Piana Lopes, Nathan Marostica Catholino, Eduardo Dos Santos Paiva, Vitor Andrei Araújo, Geraldo da Rocha Castelar Pinheiro
Gout is considered the most common form of inflammatory arthritis in men over 40 years. The authors present a brief review of the current treatment of gout and discuss the existing pharmacological limitations in Brazil for the treatment of this disease. Although allopurinol is still the main drug administered for decreasing serum levels of uric acid in gout patients in this country, the authors also present data that show a great opportunity for the Brazilian drug market for the treatment of hyperuricemia and gout and especially for patients using private and public (SUS) health care systems...
July 2017: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/28742141/bruton-s-tyrosine-kinase-inhibitor-bms-986142-in-experimental-models-of-rheumatoid-arthritis-enhances-efficacy-of-agents-representing-clinical-standard-of-care
#7
Kathleen M Gillooly, Claudine Pulicicchio, Mark A Pattoli, Lihong Cheng, Stacey Skala, Elizabeth M Heimrich, Kim W McIntyre, Tracy L Taylor, Daniel W Kukral, Shailesh Dudhgaonkar, Jignesh Nagar, Dana Banas, Scott H Watterson, Joseph A Tino, Aberra Fura, James R Burke
Bruton's tyrosine kinase (BTK) regulates critical signal transduction pathways involved in the pathobiology of rheumatoid arthritis (RA) and other autoimmune disorders. BMS-986142 is a potent and highly selective reversible small molecule inhibitor of BTK currently being investigated in clinical trials for the treatment of both RA and primary Sjögren's syndrome. In the present report, we detail the in vitro and in vivo pharmacology of BMS-986142 and show this agent provides potent and selective inhibition of BTK (IC50 = 0...
2017: PloS One
https://www.readbyqxmd.com/read/28729228/tangled-history-of-the-european-uses-of-sphagnum-moss-and-sphagnol
#8
REVIEW
Jacek Drobnik, Adam Stebel
ETHNOPHARMACOLOGICAL RELEVANCE: Sphagnum mosses and peat could have been utilized as wound dressings for centuries, however reliable data on this subject are ambiguous; sometimes even no distinction between peat moss (Sphagnum spp.) and peat is made or these terms become confused. The first scientific account on surgical use of peat comes from 1882: a peat digger who successfully, by himself and in the way unknown to the then medicine, cured an open fracture of his forearm with peat. The peat, and very soon the peat moss itself (which is the major constituent of peat) drew attention of the 19th-century surgeons...
July 18, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28721340/post-intensive-care-syndrome-an-overview
#9
Gautam Rawal, Sankalp Yadav, Raj Kumar
Survival of critically unwell patients has improved in the last decade due to advances in critical care medicine. Some of these survivors develop cognitive, psychiatric and /or physical disability after treatment in intensive care unit (ICU), which is now recognized as post intensive care syndrome (PICS). Given the limited awareness about PICS in the medical faculty this aspect is often overlooked which may lead to reduced quality of life and cause a lot of suffering of these patients and their families. Efforts should be directed towards preventing PICS by minimizing sedation and early mobilization during ICU...
June 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28712906/a-comparison-of-pharmacologic-therapeutic-agents-used-for-the-reduction-of-intracranial-pressure-following-traumatic-brain-injury
#10
REVIEW
Ahmed M Alnemari, Brianna M Krafcik, Tarek R Mansour, Daniel Gaudin
OBJECTIVE: In neurotrauma care, a better understanding of treatments following traumatic brain injury (TBI) has led to a significant decrease in morbidity and mortality in this population. TBI represents a significant medical problem, and complications following TBI are associated with the initial injury and post-event intracranial processes such as elevated intracranial pressure (ICP) and brain edema. Consequently, appropriate therapeutic interventions are required to reduce brain tissue damage and improve cerebral perfusion...
July 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28707198/platelet-targeted-pharmacologic-treatments-as-anti-cancer-therapy
#11
REVIEW
P Gresele, S Momi, M Malvestiti, M Sebastiano
Platelets act as multifunctional cells participating in immune response, inflammation, allergy, tissue regeneration, and lymphoangiogenesis. Among the best-established aspects of a role of platelets in non-hemostatic or thrombotic disorders, there is their participation in cancer invasion and metastasis. The interaction of many different cancer cells with platelets leads to platelet activation, and on the other hand platelet activation is strongly instrumental to the pro-carcinogenic and pro-metastatic activities of platelets...
July 13, 2017: Cancer Metastasis Reviews
https://www.readbyqxmd.com/read/28698830/prevalence-and-predictors-of-home-use-of-glucometers-in-diabetic-patients
#12
Syed A Farhan, Ali T Shaikh, Maria Zia, Bilal R Kahara, Ramsha Muneer, Muzna Rehman, Ayesha Mubashir, Hassaan Sadiq, Durr-E-Amna Siddiqui, Syed M Haseeb, Hafsa Tanveer, Khadijah Siddiq, Saib B Mujtaba, Samir A Mirza, Hira Feroz, Kaneez Fatima
BACKGROUND: Self-monitoring of blood glucose (SMBG) is a critical component of diabetes care. However, it has been shown that use of glucometers in developing countries such as Pakistan is limited. The aim of this study was to determine the frequency of glucometer usage in the urban diabetic population of Karachi and to identify variables that influenced the likelihood of practice of SMBG. METHODS: A cross-sectional study was conducted among 567 adult diabetic patients selected at random from the out-patient departments of multiple healthcare institutions in Karachi categorized into two settings; Government and Private...
June 10, 2017: Curēus
https://www.readbyqxmd.com/read/28693463/descriptive-analysis-of-cochrane-child-relevant-systematic-reviews-an-update-and-comparison-between-2009-and-2013
#13
Katelynn Crick, Denise Thomson, Ricardo M Fernandes, Megan Nuspl, Dean T Eurich, Brian H Rowe, Lisa Hartling
BACKGROUND: Systematic reviews support health systems and clinical decision-making by identifying and summarizing all existing studies on a particular topic. In 2009, a comprehensive description of child-relevant systematic reviews published in the Cochrane Database of Systematic Reviews was compiled. This study aims to provide an update, and to describe these systematic reviews according to their content and methodological approaches. METHODS: All child-relevant systematic reviews published by the Cochrane Collaboration in the Cochrane Database of Systematic Reviews (CDSR) as of March, 2013 were identified and described in relation to their content and methodological approaches...
July 11, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28682317/a-management-strategy-that-reduces-nicu-admissions-and-decreases-charges-from-the-front-line-of-the-neonatal-abstinence-syndrome-epidemic
#14
S Loudin, J Werthammer, L Prunty, S Murray, J I Shapiro, T H Davies
OBJECTIVE: The purpose of this study was to test a specialized needs-based management model for a high volume of babies born with neonatal abstinence syndrome (NAS) while controlling costs and reducing neonatal intensive care unit (NICU) bed usage. STUDY DESIGN: Data were analyzed from inborn neonates >35 weeks' gestational age with the diagnosis of NAS (ICD9-CM 779.5), requiring pharmacologic treatment and discharged from 2010 through 2015. Significance was determined using Kruskal-Wallis and Mann-Whitney as well as χ(2) for trend...
July 6, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28671135/fifteen-years-of-clinical-trials-in%C3%A2-huntington-s-disease-a-very-low-clinical%C3%A2-drug-development-success-rate
#15
André M Travessa, Filipe B Rodrigues, Tiago A Mestre, Joaquim J Ferreira
BACKGROUND: Drug development in Huntington's disease (HD) is particularly challenging, and only two compounds are approved by the FDA. It is therefore essential to appraise drug development programs in order to understand the reasons for their failure during the early stages of development. OBJECTIVES: To describe the landscape of HD therapeutic development and critically explore the causes of compound attrition in the different stages of drug development, from phase 1 to phase 4...
2017: Journal of Huntington's Disease
https://www.readbyqxmd.com/read/28669553/expert-consensus-guidelines-for-stocking-of-antidotes-in-hospitals-that-provide-emergency-care
#16
Richard C Dart, Lewis R Goldfrank, Brian L Erstad, David T Huang, Knox H Todd, Jeffrey Weitz, Vikhyat S Bebarta, E Martin Caravati, Fred M Henretig, Theodore R Delbridge, William Banner, Sandra M Schneider, Victoria E Anderson
We provide recommendations for stocking of antidotes used in emergency departments (EDs). An expert panel representing diverse perspectives (clinical pharmacology, medical toxicology, critical care medicine, hematology/oncology, hospital pharmacy, emergency medicine, emergency medical services, pediatric emergency medicine, pediatric critical care medicine, poison centers, hospital administration, and public health) was formed to create recommendations for antidote stocking. Using a standardized summary of the medical literature, the primary reviewer for each antidote proposed guidelines for antidote stocking to the full panel...
June 29, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28656829/use-of-dexmedetomidine-infusion-as-a-sedative-drug-for-patients-in-the-intensive-care-unit
#17
Nelson Selvaraj
The administration of sedatives may present several challenges for critical care nurses. Evidence-based practice requires critical care nurses to remain up to date with developments in sedation management and ensure safe and effective use of sedative agents in their practice. Dexmedetomidine is a sedative drug that has been increasingly used in the intensive care setting in recent years. This article provides an overview of the pharmacological properties of dexmedetomidine and discusses nurses' responsibilities in caring for patients receiving dexmedetomidine infusion...
June 28, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28640822/effective-treatment-options-for-musculoskeletal-pain-in-primary-care-a-systematic-overview-of-current-evidence
#18
Opeyemi O Babatunde, Joanne L Jordan, Danielle A Van der Windt, Jonathan C Hill, Nadine E Foster, Joanne Protheroe
BACKGROUND & AIMS: Musculoskeletal pain, the most common cause of disability globally, is most frequently managed in primary care. People with musculoskeletal pain in different body regions share similar characteristics, prognosis, and may respond to similar treatments. This overview aims to summarise current best evidence on currently available treatment options for the five most common musculoskeletal pain presentations (back, neck, shoulder, knee and multi-site pain) in primary care...
2017: PloS One
https://www.readbyqxmd.com/read/28635354/the-effects-of-food-on-opioid-induced-nausea-and-vomiting-and-pharmacological-parameters-a-systematic-review
#19
Robert B Raffa, Robert Colucci, Joseph V Pergolizzi
Opioids remain the standard of care for treating moderate to severe pain resulting from surgery or injury in cases of acute pain, and are recommended for patients who have not responded to nonopioid analgesics. Effective management of pain has an impact on clinical course and often depends on achieving an acceptable balance between opioid efficacy, safety, and tolerability. Common opioid-related adverse events such as nausea and vomiting are associated with an overall lower achievement of effective pain management and patient satisfaction...
June 21, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28631765/-noninvasive-ventilation-and-sedation-evidence-and-practical-tools-for-its-utilization
#20
Ilaria Battistoni, Marco Marini, Giorgio Caretta, Fabio Vagnarelli, Fabiana Lucà, Emilia Biscottini, Alberto Lavorgna, Vincenza Procaccini, Letizia Riva, Gabriele Vianello, Nadia Aspromonte, Massimo Iacoviello, Renata De Maria, Serafina Valente, Michele Massimo Gulizia
Noninvasive ventilation (NIV) has gained increased acceptance inside the critical area, since it has been shown to be effective in reducing or avoiding the need for oro-tracheal intubation. NIV efficacy is dependent on the selection of the appropriate patients and on their compliance to therapy. Actually, full collaboration is not easily reached especially in agitated patients.Sedation during NIV is useful to reduce the rate of treatment failure, but robust data to guide the development of best practice are limited and sometimes local customs appear to exert a strong influence on patterns of care...
June 2017: Giornale Italiano di Cardiologia
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