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https://www.readbyqxmd.com/read/28913501/acute-poisoning-due-to-ingestion-of-datura-stramonium-a-case-report
#1
Sebastian Daniel Trancă, Robert Szabo, Mihaela Cociş
Datura stramonium (DS) is a widespread annual plant, containing atropine, hyoscyamine, and scopolamine, which can produce poisoning with a severe anticholinergic syndrome. Teenagers ingest the roots, seeds or the entire plant to obtain its hallucinogenic and euphoric effects. We presented the case of a 22 year old male who was admitted to the Emergency Room in a coma after consuming Datura stramonium, 2 hours earlier. The patient presented with fever, tachycardia with right bundle branch block, and urinary retention...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28911287/effect-of-sugammadex-versus-neostigmine-atropine-combination-on-postoperative-cognitive-dysfunction-after-elective-surgery
#2
C Batistaki, M Riga, F Zafeiropoulou, G Lyrakos, G Kostopanagiotou, P Matsota
This study aimed to assess the effects of sugammadex and neostigmine/atropine on postoperative cognitive dysfunction (POCD) in adult patients after elective surgery. A randomised, double-blind controlled trial was carried out on 160 American Society of Anesthesiologists physical status I to III patients who were >40 years. The Mini-Mental State Evaluation, clock-drawing test and the Isaacs Set test were used to assess cognitive function at three timepoints: 1) preoperatively, 2) one hour postoperatively, and 3) at discharge...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28894751/peripheral-inhibitor-of-ache-neostigmine-prevents-the-inflammatory-dependent-suppression-of-gnrh-lh-secretion-during-the-follicular-phase-of-the-estrous-cycle
#3
Andrzej P Herman, Janina Skipor, Agata Krawczyńska, Joanna Bochenek, Karolina Wojtulewicz, Hanna Antushevich, Anna Herman, Kamila Paczesna, Katarzyna Romanowicz, Dorota Tomaszewska-Zaremba
The study was designed to test the hypothesis that the inhibition of acetylcholinesterase (AChE) activity at the periphery by Neostigmine (0.5 mg/animal) will be sufficient to prevent inflammatory dependent suppression of the gonadotropin-releasing hormone (GnRH)/luteinising hormone (LH) secretion in ewes in the follicular phase of the estrous cycle, and this effect will be comparable with the systemic AChE inhibitor, Donepezil (2.5 mg/animal). An immune/inflammatory challenge was induced by peripheral administration of lipopolysaccharide (LPS; 400 ng/kg)...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28893807/neostigmine-and-glycopyrronium-a-potential-safe-alternative-for-patients-with-pseudo-obstruction-without-access-to-conventional-methods-of-decompression
#4
Alfred Adiamah, Sarah Johnson, Adrian Ho, James Orbell
Intestinal pseudo-obstruction mimics bowel obstruction. However, on examination, no mechanical cause is identified. This condition will often resolve when managed conservatively, yet in some cases decompression is required to avoid the serious complications of bowel ischaemia and perforation. This is performed endoscopically, and due to the invasive nature and limited access to this service, an alternative treatment option is deemed appealing. Neostigmine has good efficacy in the decompression of pseudo-obstruction but is hindered by its wide side effect profile...
September 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28868303/adjuvants-to-local-anesthetics-current-understanding-and-future-trends
#5
EDITORIAL
Amlan Swain, Deb Sanjay Nag, Seelora Sahu, Devi Prasad Samaddar
Although beneficial in acute and chronic pain management, the use of local anaesthetics is limited by its duration of action and the dose dependent adverse effects on the cardiac and central nervous system. Adjuvants or additives are often used with local anaesthetics for its synergistic effect by prolonging the duration of sensory-motor block and limiting the cumulative dose requirement of local anaesthetics. The armamentarium of local anesthetic adjuvants have evolved over time from classical opioids to a wide array of drugs spanning several groups and varying mechanisms of action...
August 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28828195/critically-ill-patients-and-gut-motility-are-we-addressing-it
#6
REVIEW
Alfredo Vazquez-Sandoval, Shekhar Ghamande, Salim Surani
Gastrointestinal (GI) dysmotility is a common problem in the critically ill population. It can be a reflection and an early sign of patient deterioration or it can be an independent cause of morbidity and mortality. GI dysmotility can be divided for clinical purposes on upper GI dysmotility and lower GI dysmotility. Upper GI dysmotility manifests by nausea, feeding intolerance and vomiting; its implications include aspiration into the airway of abdominal contents and underfeeding. Several strategies to prevent and treat this condition can be tried and they include prokinetics and post-pyloric feeds...
August 6, 2017: World Journal of Gastrointestinal Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28806470/efficacy-and-safety-of-sugammadex-versus-neostigmine-in-reversing-neuromuscular-blockade-in-adults
#7
REVIEW
Ana-Marija Hristovska, Patricia Duch, Mikkel Allingstrup, Arash Afshari
BACKGROUND: Acetylcholinesterase inhibitors, such as neostigmine, have traditionally been used for reversal of non-depolarizing neuromuscular blocking agents. However, these drugs have significant limitations, such as indirect mechanisms of reversal, limited and unpredictable efficacy, and undesirable autonomic responses. Sugammadex is a selective relaxant-binding agent specifically developed for rapid reversal of non-depolarizing neuromuscular blockade induced by rocuronium. Its potential clinical benefits include fast and predictable reversal of any degree of block, increased patient safety, reduced incidence of residual block on recovery, and more efficient use of healthcare resources...
August 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28802619/sugammadex-efficacy-for-reversal-of-rocuronium-and-vecuronium-induced-neuromuscular-blockade-a-pooled-analysis-of-26-studies
#8
William Joseph Herring, Tiffany Woo, Christopher A Assaid, Robert J Lupinacci, Hendrikus J Lemmens, Manfred Blobner, Karin S Khuenl-Brady
STUDY OBJECTIVE: To summarize and compare efficacy of sugammadex with neostigmine or placebo for reversal of rocuronium- or vecuronium-induced neuromuscular blockade (NMB), and to demonstrate consistency of sugammadex results across various patient populations. DESIGN: Pooled analysis on data from 26 multicenter, randomized, Phase II and III studies. SETTING: Operating room. PATIENTS: 1855 adults undergoing surgery under general anesthesia and receiving rocuronium or vecuronium for NMB...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28763316/effects-of-calcium-chloride-coadministered-with-neostigmine-on-neuromuscular-blockade-recovery-a-double-blind-randomised-study
#9
Jae-Woo Ju, Hyun-Chang Kim, Sehee Yoon, Deok Man Hong, Hee-Pyoung Park
BACKGROUND: Ionised calcium plays an important role in neuromuscular transmission, but its effects on the reversal of nondepolarising neuromuscular blockade have not been fully evaluated. OBJECTIVE: We examined whether calcium chloride coadministered with neostigmine could enhance the rate of neuromuscular recovery. DESIGN: Randomised double-blind trial. SETTING: A tertiary teaching hospital. PATIENTS: In total, 53 patients undergoing elective surgery under general anaesthesia with neuromuscular monitoring by acceleromyography using a TOF-Watch SX monitor...
September 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28757832/sugammadex-versus-two-doses-of-neostigmine-for-reversal-of-rocuronium-in-gastric-sleeve-surgery
#10
Abdulhamid Alsaeed, Fahad Bamehriz, Sharaf Eldin, Tareq Alzahrani, Abdullah Alharbi, Abdelazeem Eldawlatly
BACKGROUND AND AIM: The aim of this prospective randomized trial is to compare the quality of reversal of rocuronium with either sugammadex (SUG) versus 2.5 mg or 5 mg neostigmine (NEO). PATIENTS AND METHODS: A total of 110 patients with body mass index >40 underwent elective gastric sleeve surgery were enrolled in this study. Exclusion criteria included patients with co-existing muscular and cardiovascular diseases. Patients were randomly allocated to one of the following groups: group A (SUG), Group B (NEO 2...
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28749013/physiological-versus-pharmacological-signalling-to-myosin-phosphorylation-in-airway-smooth-muscle
#11
Ning Gao, Ming-Ho Tsai, Audrey N Chang, Weiqi He, Cai-Ping Chen, Minsheng Zhu, Kristine E Kamm, James T Stull
Ca(2+) /calmodulin activation of myosin light chain kinase (MLCK) initiates myosin regulatory light chain (RLC) phosphorylation for smooth muscle contraction with subsequent dephosphorylation for relaxation by myosin light chain phosphatase (MLCP) containing regulatory (MYPT1) and catalytic (PP1cδ) subunits. RLC phosphorylation-dependent force development is regulated by distinct signalling modules involving protein phosphorylations. We investigated responses to cholinergic agonist treatment versus neurostimulation by electric field stimulation (EFS) in bovine tracheal smooth muscle...
July 27, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28731951/does-sugammadex-administration-affect-postoperative-nausea-and-vomiting-after-laparoscopic-cholecystectomy-a-prospective-double-blind-randomized-study
#12
Ayca Tas Tuna, Onur Palabiyik, Mustafa Orhan, Tugba Sonbahar, Havva Sayhan, Yakup Tomak
BACKGROUND: The aim of this study is to assess the effect of sugammadex on postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy. METHODS: Eighty patients who were scheduled for elective laparoscopic cholecystectomy surgery were enrolled in this prospective study. Patients were randomly assigned to neostigmine (group N) or sugammadex (group S) for neuromuscular antagonism at the end of anesthesia. The incidence of PONV and antiemetic consumption were recorded...
August 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28720838/the-efficacy-and-safety-of-sugammadex-for-reversing-postoperative-residual-neuromuscular-blockade-in-pediatric-patients-a-systematic-review
#13
Guangyu Liu, Rui Wang, Yanhong Yan, Long Fan, Jixiu Xue, Tianlong Wang
The aim of this study is to evaluate the efficacy and safety of sugammadex for reversing neuromuscular blockade in pediatric patients. MEDLINE and other three Databases were searched. Randomized clinical trials were included if they compared sugammadex with neostigmine or placebo in pediatric patients undergoing surgery involving the use of rocuronium or vecuronium. The primary outcome was the time interval from administration of reversal agents to train-of-four ratio (TOFr, T4/T1) > 0.9. Incidences of any drug-related adverse events were secondary outcomes...
July 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28701612/sugammadex-to-reverse-neuromuscular-blockade-in-a-child-with-a-past-history-of-cardiac-transplantation
#14
Karen Miller, Brian Hall, Joseph D Tobias
Sugammadex is a novel agent for the reversal of neuromuscular blockade. The speed and efficacy of reversal with sugammadex are significantly faster than acetylcholinesterase inhibitors, such as neostigmine. Sugammadex also has a limited adverse profile when compared with acetylcholinesterase inhibitors, specifically in regard to the incidence of bradycardia. This adverse effect may be particularly relevant in the setting of a heart transplant recipient with a denervated heart. The authors present a case of an 8-year-old child, status postcardiac transplantation, who required anesthetic care for laparoscopy and lysis of intra-abdominal adhesions...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28674252/the-long-lasting-enhancing-effect-of-distigmine-on-acetylcholine-induced-contraction-of-guinea-pig-detrusor-smooth-muscle-correlates-with-its-anticholinesterase-activity
#15
Keisuke Obara, Tsukasa Ogawa, Daisuke Chino, Yoshio Tanaka
Distigmine bromide (distigmine), a reversible, long-lasting cholinesterase (ChE) inhibitor, is used for the treatment of underactive bladder in Japan and has been shown to potentiate urinary bladder (UB) contractility. We studied the duration of distigmine's potentiating effects on acetylcholine (ACh)-induced UB contraction and its inhibitory effects on ChE activity, and compared that with those of other ChE inhibitors (neostigmine, pyridostigmine, and ambenonium). The duration of potentiating/inhibitory effects of ChE inhibitors, including distigmine, on ACh-induced guinea pig UB contraction/ChE activity was evaluated for 12 h following washout...
2017: Biological & Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/28664138/naringenin-inhibits-pacemaking-activity-in-interstitial-cells-of-cajal-from-murine-small-intestine
#16
Hyun Jung Kim, Byung Joo Kim
BACKGROUND: Naringenin (NRG) is a common dietary polyphenolic constituent of fruits. NRG has diverse pharmacological activities, and is used in traditional medicine to treat various diseases including gastrointestinal (GI) disorders. Interstitial cells of Cajal (ICCs) are pacemaker cells of the GI tract. In this study, the authors investigated the effects of NRG on ICCs and on GI motility in vitro and in vivo. METHODS: ICCs were dissociated from mouse small intestines by enzymatic digestion...
June 2017: Integrative medicine research
https://www.readbyqxmd.com/read/28663623/comparison-of-epidural-butorphanol-with-neostigmine-and-epidural-sufentanyl-with-neostigmine-for-first-stage-of-labor-analgesia-a-randomized-controlled-trial
#17
Manoj Chaurasia, Ashok Kumar Saxena, Geetanjali T Chilkoti
BACKGROUND: Epidural administration of neostigmine appears to be safe in the obstetric population. Recently, few studies have concluded 10 μg sufentanil to be an effective adjuvant with epidural neostigmine in providing labor analgesia. However, no study has evaluated the analgesic effect of epidural butorphanol with neostigmine for the same. MATERIALS AND METHODS: The parturients were randomly allocated to one of the three study groups - Group A (n = 30) received butorphanol 1 mg and neostigmine 7 μg/kg...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28658142/use-of-neuromuscular-blockers-and-neostigmine-for-general-anesthesia-and-its-association-with-neuraxial-blockade-a-retrospective-study
#18
Filipe Nadir Caparica Santos, Angélica de Fátima de Assunção Braga, Fernando Eduardo Feres Junqueira, Rafaela Menezes Bezerra, Felipe Ferreira de Almeida, Franklin Sarmento da Silva Braga, Vanessa Henriques Carvalho
This research aimed to assess the use of neuromuscular blockers (NMB) and its reversal, associated or not with neuraxial blockade, after general anesthesia.This retrospective study analyzed 1295 patients that underwent surgery with general anesthesia at Prof. Dr. José Aristodemo Pinotti Hospital in 2013. The study included patients aged >1 year, with complete, readable medical charts and anesthetic records.Rocuronium (ROC) was the most used NMB (96.7%), with an initial dose of 0.60 (0.52-0.74) mg/kg and total dose of 0...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28640017/reversal-of-vecuronium-induced-neuromuscular-blockade-with-low-dose-sugammadex-at-train-of-four-count-of-four-a-randomized-controlled-trial
#19
RANDOMIZED CONTROLLED TRIAL
László Asztalos, Zoltán Szabó-Maák, András Gajdos, Réka Nemes, Adrienn Pongrácz, Szabolcs Lengyel, Béla Fülesdi, Edömér Tassonyi
BACKGROUND: Rocuronium-induced neuromuscular block that spontaneously recovered to a train-of-four count of four can be reversed with sugammadex 0.5 or 1.0 mg/kg. We investigated whether these doses of sugammadex can also reverse vecuronium at a similar level of block. METHODS: Sixty-five patients were randomly assigned, and 64 were analyzed in this controlled, superiority study. Participants received general anesthesia with propofol, sevoflurane, fentanyl, and vecuronium...
September 2017: Anesthesiology
https://www.readbyqxmd.com/read/28620569/the-optimal-pain-management-approach-for-a-laboring-patient-a-review-of-current-literature
#20
REVIEW
Albert Kelly, Quang Tran
There is a general agreement that a patient in labor should be given the option to have an epidural block for pain management. Despite this consensus, there are differences in practice patterns as to when to initiate an epidural and how to minimize its impact on the duration and outcome of a patient's labor. A review of the literature suggests epidural analgesia does prolong stages one and two of labor, but not significantly. Cesarean delivery rates are not affected by the early initiation of epidural analgesia...
May 10, 2017: Curēus
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