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https://www.readbyqxmd.com/read/28187810/management-of-infections-associated-with-neurocritical-care
#1
L Rivera-Lara, W Ziai, P Nyquist
The reported incidence of hospital-acquired infections (HAIs) in the neurointensive care unit (NICU) ranges from 20% to 30%. HAIs in US hospitals cost between $28 and $45 billion per year in direct medical costs. These infections are associated with increased length of hospital stay and increased morbidity and mortality. Infection risk is increased in NICU patients due to medication side-effects, catheter and line placement, neurosurgical procedures, and acquired immune suppression secondary to steroid/barbiturate use and brain injury itself...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28186869/sedative-hypnotic-drug-withdrawal-syndrome-recognition-and-treatment
#2
Cynthia Santos, Ruben E Olmedo
Sedative-hypnotic drugs include gamma-Aminobutyric acid (GABA)ergic agents such as benzodiazepines, barbiturates, gamma-Hydroxybutyric acid [GHB], gamma-Butyrolactone [GBL], baclofen, and ethanol. Chronic use of these substances can cause tolerance, and abrupt cessation or a reduction in the quantity of the drug can precipitate a life-threatening withdrawal syndrome. Benzodiazepines, phenobarbital, propofol, and other GABA agonists or analogues can effectively control symptoms of withdrawal from GABAergic agents...
March 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28182406/spiro-cyclopropanes-from-intramolecular-cyclopropanation-of-pyranopyrazoles-and-pyranopyrimidine-diones-and-lewis-acid-mediated-3-2-cycloadditions-of-spirocyclopropylpyrazolones
#3
Prasun Mukherjee, Asish R Das
A robust intramolecular cyclopropanation reaction was first performed on pyrano-pyrazole and pyrano-pyrimidine dione derivatives to obtain spiro-cyclopropyl pyrazolones and barbiturates, using iodosylbenzene (PhIO) or the combination of iodobenzene diacetate (PIDA)/ molecular iodine (I2), under mild reaction conditions. Syntheses of functionally and stereochemically diversified, novel spiropyrazolone fused 2-iminothiophene and spiropyrazolone fused pyrroline scaffolds were also demonstrated via Lewis acid catalyzed highly diastereoselective (3+2) cycloaddition reactions of the synthesized spiro-cyclopropyl pyrazolones with phenyl isothiocyanate and benzonitrile respectively...
February 9, 2017: Journal of Organic Chemistry
https://www.readbyqxmd.com/read/28182114/evolution-of-cerebral-atrophy-in-a-patient-with-super-refractory-status-epilepticus-treated-with-barbiturate-coma
#4
Christopher R Newey, Pravin George, Premkumar Nattanmai, Christine Ahrens, Stephen Hantus, Aarti Sarwal
Introduction. Status epilepticus is associated with neuronal breakdown. Radiological sequelae of status epilepticus include diffusion weighted abnormalities and T2/FLAIR cortical hyperintensities corresponding to the epileptogenic cortex. However, progressive generalized cerebral atrophy from status epilepticus is underrecognized and may be related to neuronal death. We present here a case of diffuse cerebral atrophy that developed during the course of super refractory status epilepticus management despite prolonged barbiturate coma...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28128088/gestational-pityriasis-rosea-suggestions-for-approaching-affected-pregnant-women
#5
Alexandra Monastirli, Efstathia Pasmatzi, George Badavanis, Dionysios Tsambaos
Dear Editor, Pityriasis rosea is a common, acute, and self-limiting dermatosis, which is associated with the endogenous systemic reactivation of human herpesvirus (HHV)-6 and/or HHV-7 (1). It predominantly affects individuals of both sexes in their second or third decade of life and is clinically characterized by the occurrence of an initial erythematosquamous plaque followed by the appearance of disseminated similar but smaller lesions one or two weeks later. Several patients develop systemic symptoms such as nausea, anorexia, malaise, headache, fever, arthralgia, and lymphadenopathy that may precede or accompany the eruption; the latter follows the cleavage lines of the trunk creating the configuration of a Christmas tree and spontaneously resolves within 4 to 8 weeks...
December 2016: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/28120455/supramolecular-polymerization-of-supermacrocycles-effect-of-molecular-conformations-on-kinetics-and-morphology
#6
Mitsuaki Yamauchi, Bimalendu Adhikari, Deepak D Prabhu, Xu Lin, Takashi Karatsu, Tomonori Ohba, Nobutaka Shimizu, Hideaki Takagi, Rie Haruki, Shin-Ichi Adachi, Takashi Kajitani, Takanori Fukushima, Shiki Yagai
Intricately designed π-conjugated molecules containing interactive groups can be used to generate supramolecular polymers with outstanding structural and functional properties. To construct such supramolecular polymers, the noncovalent synthesis of supermacrocyclic monomers from relatively simple molecules represent attractive strategy, although this has been rarely exploited. Herein, we report the supramolecular polymerization of two barbiturated naphthalene derivatives that circularly hexamerize via hydrogen bonding...
January 25, 2017: Chemistry: a European Journal
https://www.readbyqxmd.com/read/28115043/-benzodiazepines-should-still-be-first-line-treatment-for-alcohol-withdrawal
#7
Gro Askgaard, Anton Pottegård, Anders Fink-Jensen
In this review, we summarize the evidence for benzodiazepines and barbiturates as alcohol withdrawal treatment and outline a treatment guideline. A number of randomized controlled trials (RCTs) indicate that benzodiazepine treatment decreases alcohol withdrawal seizures and is safe. For barbiturates, only a few RCTs have been undertaken, and barbiturates were not found to be superior to benzodiazepines. Consequently, we suggest that benzodiazepines should still be first-line treatment for alcohol withdrawal...
January 16, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28079248/inhibition-of-matrix-metalloproteinase-9-by-a-barbiturate-nitrate-hybrid-ameliorates-dextran-sulphate-sodium-induced-colitis-effect-on-inflammation-related-genes
#8
Shane O'Sullivan, Jun Wang, Maria T Pigott, Neil Docherty, Noreen Boyle, Samuel Kana Lis, John F Gilmer, Carlos Medina
BACKGROUND AND PURPOSE: Matrix metalloproteinase-9 (MMP-9) is up-regulated in ulcerative colitis and implicated in the pathology of the disease. In this study, we have examined the effects of a barbiturate-based MMP inhibitor incorporating a nitric oxide donor/mimetic group (dinitrate-barbiturate) on the intestinal injury induced by dextran sulphate sodium (DSS). EXPERIMENTAL APPROACH: In vivo experiments were carried out using male Wistar rats given 5% DSS ad libitum in drinking water...
January 12, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28029372/cajal-s-unbearable-cephalalgias-the-consequences-of-a-misdiagnosis
#9
REVIEW
S Giménez-Roldán
Around the age of 66 Cajal consulted neurologist Nicolas Achúcarro complaining of "unbearable cephalalgias". He had not ever suffered from headaches. The diagnosis of early arteriosclerosis that was considered at the time a physiological, irreversible ailment of ageing had a strong emotional impact on Cajal. Comorbid depression, insomnia and self-treatment with escalating doses of Veronal(®) (barbital), a short-acting barbiturate, presumably aggravated the situation. Exposure to warm environments and being involved in tense discussions were identified as triggering factors of the headaches...
October 28, 2016: Revue Neurologique
https://www.readbyqxmd.com/read/28007369/pentobarbital-in-the-context-of-possible-suicides-analysis-of-a-case
#10
Paula Melo, Pedro Costa, Maria José Quintas, André Castro, Sónia Tarelho, João Miguel Franco, Helena M Teixeira
Pentobarbital is a barbiturate, acting as a central nervous system depressant (CNS), being used for its anticonvulsant, sedative, hypnotic and anaesthetic properties. Barbiturates were replaced by benzodiazepines, leading to a decrease in poisoning cases with these compounds. However, pentobarbital is still used in many countries as an anaesthetic in veterinary medicine. Due to its properties, this compound is sought after by people who wish to commit suicide, acquiring it on the black market. The authors present an unusual fatal pentobarbital intoxication case, in a 37 years-old male salesperson, with no known connection with the veterinary field, being more difficult to obtain this compound...
December 8, 2016: Forensic Science International
https://www.readbyqxmd.com/read/27995785/dearomatizing-radical-cyclizations-and-cyclization-cascades-triggered-by-electron-transfer-reduction-of-amide-type-carbonyls
#11
Huan-Ming Huang, David J Procter
Highly selective dearomatizing radical cyclizations and cyclization cascades, triggered by single electron transfer to amide-type carbonyls by SmI2-H2O-LiBr, provide efficient access to unprecedented spirocyclic scaffolds containing up to five stereocenters with high diastereocontrol. The first dearomatizing radical cyclizations involving radicals derived from amide carbonyls by single electron transfer take place under mild conditions and engage a range of aromatic and heteroaromatic systems present in the barbiturate substrates...
February 1, 2017: Journal of the American Chemical Society
https://www.readbyqxmd.com/read/27992389/contrasting-effects-of-the-%C3%AE-aminobutyric-acid-type-a-receptor-%C3%AE-3-subunit-n265m-mutation-on-loss-of-righting-reflexes-induced-by-etomidate-and-the-novel-anesthetic-barbiturate-r-mtfd-mpab-erratum
#12
https://www.readbyqxmd.com/read/27986812/barbiturates-bind-in-the-glic-ion-channel-pore-and-cause-inhibition-by-stabilizing-a-closed-state
#13
Zaineb Fourati, Reinis Reinholds Ruza, Duncan Laverty, Emmanuelle Drège, Sandrine Delarue-Cochin, Delphine Joseph, Patrice Koehl, Trevor Smart, Marc Delarue
Barbiturates induce anesthesia by modulating the activity of anionic and cationic pentameric ligand-gated ion channels (pLGICs). Despite more than a century of use in clinical practice, the prototypic binding site for this class of drugs within pLGICs is yet to be described. In this study, we present the first X-ray structures of barbiturates bound to GLIC, a cationic prokaryotic pLGIC with excellent structural homology to other relevant channels sensitive to general anesthetics and, as shown here, to barbiturates, at clinically relevant concentrations...
February 3, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/27979642/severe-carisoprodol-withdrawal-after-a-14-year-addiction-and-acute-overdose
#14
Kathy T Vo, Howard Horng, Craig G Smollin, Neal L Benowitz
BACKGROUND: Carisoprodol, a centrally acting muscle relaxant with a high abuse potential, has barbiturate-like properties at the GABA-A receptor, leading to central nervous system depression and desired effects. Its tolerance and dependence has been previously demonstrated in an animal model, and withdrawal has been described in several recent case reports. Many cases can be effectively managed with a short course of benzodiazepines or antipsychotic agents. However, abrupt cessation in a patient with a history of long-term and high-dose carisoprodol abuse may result in symptoms that are more difficult for providers to treat...
December 12, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27974971/the-psychological-wellbeing-of-iranian-journalists-a-descriptive-study
#15
Anthony Feinstein, Saul Feinstein, Maziar Behari, Bennis Pavisian
OBJECTIVE: Iran ranks 173 out of 180 countries on an index of press freedom. The purpose of the study was to assess the psychological wellbeing of Iranian journalists and document the stressors encountered in their work. DESIGN: A secure website was established and participants were given their unique identifying number and password to access the site. SETTING: Newsrooms in Iran and the diaspora. PARTICIPANTS: Responses were received from 114 journalists (76%) of whom 65...
December 2016: JRSM Open
https://www.readbyqxmd.com/read/27935723/remote-photoregulated-ring-gliding-in-a-2-rotaxane-via-a-molecular-effector
#16
Arnaud Tron, Isabelle Pianet, Alberto Martinez-Cuezva, James H R Tucker, Luca Pisciottani, Mateo Alajarin, Jose Berna, Nathan D McClenaghan
A molecular barbiturate messenger, which is reversibly released/captured by a photoswitchable artificial molecular receptor, is shown to act as an effector to control ring gliding on a distant hydrogen-bonding [2]rotaxane. Thus, light-driven chemical communication governing the operation of a remote molecular machine is demonstrated using an information-rich neutral molecule.
December 9, 2016: Organic Letters
https://www.readbyqxmd.com/read/27922194/pharmacodynamic-response-profiles-of-anxiolytic-and-sedative-drugs
#17
Xia Chen, Freerk Broeyer, Marieke de Kam, Joke Baas, Adam Cohen, Joop van Gerven
INTRODUCTION: Centrally-acting acutely anxiolytic drugs, like benzodiazepines, barbiturates and gabapentinoids, affect various central nervous system (CNS) functions, which reflect not only their anxiolytic effects but also neuropsychological side-effects. To validate the pharmacodynamic biomarkers for GABA-ergic anxiolytics, this study determined the pharmacodynamics of two anxiolytics and a non-anxiolytic control and linked them to their anxiolytic and sedative effects, during an anxiety-challenge study day...
December 6, 2016: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27866392/drug-caused-deaths-in-australian-medical-practitioners-and-health-care-professionals
#18
Jennifer L Pilgrim, Rhyse Dorward, Olaf H Drummer
BACKGROUND AND AIMS: There are numerous factors putting health-care professionals (HCP) at a higher risk of substance abuse and premature death, including high-stress jobs, access to controlled substances, long hours of practice and constant contact with the critically ill. This study aimed to examine fatal drug toxicity in this high-risk cohort, in order to: (1) estimate the rate of drug-caused deaths of Australian HCPs; (2) describe the key characteristics of the cohort; and (3) examine the relationship between HCP occupation and drug type, or intent...
November 20, 2016: Addiction
https://www.readbyqxmd.com/read/27861834/an-algorithm-for-opioid-and-barbiturate-reduction-in-the-acute-management-of-headache-in-the-emergency-department
#19
Zubair A Ahmed, Dimitrios A Nacopoulos, Seby John, Nancy Papesh, David Levine, Cynthia C Bamford
OBJECTIVE: To develop and implement an algorithm for the management of headaches presenting to the emergency department (ED) in order to decrease the frequency of opioid and barbiturate treatment both acutely as well as on discharge. BACKGROUND: Headache is the fifth leading cause of ED visits in the United States. In the case of primary headache, particularly migraine, treatment in the ED can be highly variable. Patients with migraine continue to be treated with opioids more commonly than nonopioid, migraine specific medications...
January 2017: Headache
https://www.readbyqxmd.com/read/27857927/a-fatal-adverse-effect-of-barbiturate-coma-therapy-dyskalemia
#20
Hyun Mook Kwon, Jin Wook Baek, Sang Pyung Lee, Jae Ik Cho
The management guideline for traumatic brain injury (TBI) recommends high-dose barbiturate therapy to control increased intracranial pressure refractory to other therapeutic options. High-dose barbiturate therapy, however, may cause many severe side effects; the commonly recognized ones include hypotension, immunosuppression, hepatic dysfunction, renal dysfunction, and prolonged decrease of cortical activity. Meanwhile, dyskalemia remains relatively uncommon. In this study, we report the case of a hypokalemic patient with severe rebound hyperkalemia, which occurred as a result of barbiturate coma therapy administered for TBI treatment...
October 2016: Korean Journal of Neurotrauma
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