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https://www.readbyqxmd.com/read/28102628/transient-symptomatic-worsening-by-atropine-in-opsoclonus-myoclonus-syndrome
#1
Hirotsugu Miyoshi, Ryuji Nakamura, Ayano Yamaga, Toshiaki Haraki, Toshimichi Yasuda, Hiroshi Hamada, Masashi Kawamoto
Opsoclonus-myoclonus syndrome (OMS) is characterized by abnormal eye and systemic involuntary movements, as well as cerebellar ataxia. Some sedatives and anesthetics worsen movements associated with OMS, while there is no known report of a negative effect of atropine. We report on sedation in two patients with OMS. Involuntary movements were transiently worsened after using atropine with midazolam or thiamylal in both, but were not seen when atropine was not used. We speculated that atropine has the potential to exacerbate involuntary movements in OMS due to vulnerability to this agent via unknown mechanisms...
January 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28101764/diazepam-in-the-treatment-of-moderate-to-severe-alcohol-withdrawal
#2
Steven J Weintraub
Benzodiazepines ameliorate or prevent the symptoms and complications of moderate to severe alcohol withdrawal, which can include autonomic hyperactivity, agitation, combativeness, hallucinations, seizures, delirium, and death. The benzodiazepines most commonly used for this purpose are lorazepam, chlordiazepoxide, oxazepam, and diazepam. It is widely asserted that no member of this group is superior to the others for treatment of alcohol withdrawal. However, of these, diazepam has the shortest time to peak effect, which facilitates both rapid control of symptoms and accurate titration to avoid over-sedation...
January 18, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28100529/children-and-parental-anxiolysis-in-paediatric-ambulatory-surgery-a-randomized-controlled-study-comparing-0-3%C3%A2-mg-kg-1-midazolam-to-tablet-computer-based-interactive-distraction
#3
C Marechal, J Berthiller, S Tosetti, B Cogniat, H Desombres, L Bouvet, B Kassai, D Chassard, M de Queiroz Siqueira
BACKGROUND: The operating theatre, anaesthesia induction and separation from parents create fear and anxiety in children. Anxiety leads to adverse behavioral changes appearing and sometimes persisting during the postoperative period. Our aim was to compare the effects of midazolam (0.3 mg kg(-)(1): MDZ) for premedication with age-appropriate tablet game apps (TAB) on children anxiety during and after ambulatory surgery. METHODS: A randomized controlled trial was conducted from May 16th, 2013 to March 25th, 2014 at the Children Hospital of Lyon...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28100064/a-risk-stratifying-tool-to-facilitate-safe-late-stage-percutaneous-endoscopic-gastrostomy-in-als
#4
Alexander G Thompson, Victoria Blackwell, Rachael Marsden, Emma Millard, Clare Lawson, Annabel H Nickol, James E East, Kevin Talbot, Philip J Allan, Martin R Turner
BACKGROUND: The safety of percutaneous endoscopic gastrostomy (PEG) insertion in amyotrophic lateral sclerosis (ALS) patients with significant respiratory compromise has been questioned. OBJECTIVES: To review the characteristics of an ALS clinic patient cohort undergoing PEG, and the introduction of a risk stratification tool with procedural adaptations for higher-risk individuals. METHODS: Patients undergoing PEG insertion were analysed (n = 107)...
January 19, 2017: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
https://www.readbyqxmd.com/read/28097507/in-vitro-phase-i-and-phase-ii-drug-metabolism-in-the-liver-of-juvenile-and-adult-g%C3%A3-ttingen-minipigs
#5
Els Van Peer, Frank Jacobs, Jan Snoeys, Jos Van Houdt, Ils Pijpers, Christophe Casteleyn, Chris Van Ginneken, Steven Van Cruchten
PURPOSE: In view of pediatric drug development, juvenile animal studies are gaining importance. However, data on drug metabolizing capacities of juvenile animals are scarce, especially in non-rodent species. Therefore, we aimed to characterize the in vitro biotransformation of four human CYP450 substrates and one UGT substrate in the livers of developing Göttingen minipigs. METHODS: Liver microsomes from late fetal, Day 1, Day 3, Day 7, Day 28, and adult male and female Göttingen minipigs were incubated with a cocktail of CYP450 substrates, including phenacetin, tolbutamide, dextromethorphan, and midazolam...
January 17, 2017: Pharmaceutical Research
https://www.readbyqxmd.com/read/28097432/attitudes-of-palliative-home-care-physicians-towards-palliative-sedation-at-home-in-italy
#6
Sebastiano Mercadante, Francesco Masedu, Alessandro Mercadante, Franco Marinangeli, Federica Aielli
BACKGROUND: Information about the attitudes towards palliative sedation (PS) at home is limited. AIM: The aim of this survey was to assess the attitudes of palliative care physicians in Italy regarding PS at home. DESIGN: A questionnaire was submitted to a sample of palliative care physicians, asking information about their activity and attitudes towards PS at home. SETTING: This is a survey of home care physicians in Italy who were involved in end-of-life care decisions at home...
January 17, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28094153/development-and-validation-of-a-fast-ionic-liquid-based-dispersive-liquid-liquid-microextraction-procedure-combined-with-lc-ms-ms-analysis-for-the-quantification-of-benzodiazepines-and-benzodiazepine-like-hypnotics-in-whole-blood
#7
Marieke De Boeck, Sophie Missotten, Wim Dehaen, Jan Tytgat, Eva Cuypers
To date, thorough clean-up of complex biological samples remains an essential part of the analytical process. The solid phase extraction (SPE) technique is the well-known standard, however, its main weaknesses are the labor-intensive and time-consuming protocols. In this respect, dispersive liquid-liquid microextractions (DLLME) seem to offer less complex and more efficient extraction procedures. Furthermore, ionic liquids (ILs) - liquid salts - are emerging as new promising extraction solvents, thanks to their non-flammable nature, negligible vapor pressure and easily adaptable physiochemical properties...
December 26, 2016: Forensic Science International
https://www.readbyqxmd.com/read/28073611/propofol-versus-midazolam-for-procedural-sedation-in-the-emergency-department-a-study-on-efficacy-and-safety
#8
Heleen Lameijer, Ytje T Sikkema, Albert Pol, Maike G E Bosch, Femke Beije, Rieneke Feenstra, Bas W J Bens, Ewoud Ter Avest
BACKGROUND: Procedural sedation for painful procedures in the emergency department (ED) can be accomplished with various pharmacological agents. The choice of the sedative used is highly dependent on procedure- and patient characteristics and on personal- or local preferences. METHODS: We conducted a multicenter retrospective cohort study of procedural sedations performed in the EDs of 5 hospitals in the Netherlands over a 4year period to evaluate the efficacy- (success rate of the intended procedure) and safety (incidence of sedation (adverse) events) of propofol sedations compared to midazolam sedations...
January 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28073119/in-vitro-inhibition-of-human-cyp450s-1a2-2c9-3a4-5-2d6-and-2e1-by-grandisin
#9
Maísa Daniela Habenschus, Fernanda de Lima Moreira, Norberto Peporine Lopes, Anderson R M de Oliveira
Grandisin, a lignan isolated from many species of plants, such as Virola surinamensis, is a potential drug candidate due to its biological properties, highlighted by its antitumor and trypanocidal activities. In this study, the inhibitory effects of grandisin on the activities of human cytochrome P450 enzymes were investigated by using human liver microsomes. Results showed that grandisin is a competitive inhibitor of CYP2C9 and a competitive and mechanism-based inhibitor of CYP3A4/5. The apparent Ki value for CYP2C9 was 50...
January 10, 2017: Planta Medica
https://www.readbyqxmd.com/read/28072737/the-efficacy-of-dexmedetomidine-remifentanil-versus-dexmedetomidine-propofol-in-children-undergoing-flexible-bronchoscopy-a-retrospective-trial
#10
Hongquan Zhang, Baojun Fang, Wenjing Zhou
Flexible bronchoscopy has been more and more used for diagnosis and management diseases of respiratory system in pediatrics. Previous studies have reported that remifentanil (RF) and propofol are safe and effective for flexible bronchoscopy in adults, however, there have no trials evaluate the efficacy of DEX-RF versus dexmedetomidine-propofol in children undergoing flexible bronchoscopy.We divided 123 children undergoing flexible bronchoscopy with DEX-RF or dexmedetomidine-propofol into 2 groups: Group DR (n = 63, DEX infusion at 1...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28067704/intravenous-ketamine-infusions-for-neuropathic-pain-management-a-promising-therapy-in-need-of-optimization
#11
Dermot P Maher, Lucy Chen, Jianren Mao
Intravenous ketamine infusions have been used extensively to treat often-intractable neuropathic pain conditions. Because there are many widely divergent ketamine infusion protocols described in the literature, the variation in these protocols presents a challenge for direct comparison of one protocol with another and in discerning an optimal protocol. Careful examination of the published literature suggests that ketamine infusions can be useful to treat neuropathic pain and that certain characteristics of ketamine infusions may be associated with better clinical outcomes...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28062846/effects-of-morphine-alfaxalone-midazolam-premedication-alfaxalone-induction-and-sevoflurane-maintenance-on-intraocular-pressure-and-tear-production-in-dogs
#12
A Mayordomo-Febrer, M Rubio, M Martínez-Gassent, M M López-Murcia
Intraocular pressure (IOP) and tear production are commonly affected by general anaesthesia. It is necessary to have a good control of both to guarantee successful ophthalmic surgery. The purpose of this research was to evaluate if the protocol based on the administration of morphine-alfaxalone-midazolam as premedication, alfaxalone as induction and sevoflurane as maintenance, can induce changes on IOP and Schirmer's tear test (STT-1) in healthy dogs. Twenty-two adult mixed-breed dogs scheduled for an ovariohysterectomy were enrolled for the study...
January 6, 2017: Veterinary Record
https://www.readbyqxmd.com/read/28061836/end-tidal-capnographic-monitoring-to-detect-apnea-episodes-during-flexible-bronchoscopy-under-sedation
#13
Tsukasa Ishiwata, Kenji Tsushima, Mai Fujie, Kenichi Suzuki, Kosuke Hirota, Mitsuhiro Abe, Naoko Kawata, Jiro Terada, Koichiro Tatsumi
BACKGROUND: Apnea developing as a result of oversedation is a potential clinical problem in patients undergoing flexible bronchoscopy (FB) under sedation. However, there are no reports of evaluation using a standardized method of the frequency of occurrence of apnea episodes during FB under sedation. The aim of this study was to investigate the frequency of apnea episodes during FB under sedation in the clinical setting by end-tidal capnography. METHODS: This study was a single-institution retrospective review of a prospectively maintained database and medical records, including capnographic data, from April 2015 to March 2016...
January 7, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28059581/hot-and-cold-drugs-national-park-service-medication-stability-at-the-extremes-of-temperature
#14
Patil Armenian, Danielle Campagne, Geoff Stroh, Crystal Ives Tallman, William Z D Zeng, Thomas Lin, Roy R Gerona
STUDY OBJECTIVE: National Park Service (NPS) Parkmedics provide medical care in austere environments. The objective of this study was to evaluate the stability of specific medications used by Parkmedics at extremes of temperatures likely to be faced in the field. METHODS: This is a bench research study conducted in the laboratory setting over a 4-week period. Parenteral medications were separated into 4 temperature exposure groups: A) 45°C (hot); B) -20°C (cold); C) hot then cold temperatures alternating weekly; and D) cold then hot temperatures alternating weekly...
January 6, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28059034/midazolam-plus-haloperidol-as-adjuvant-analgesics-to-morphine-in-opium-dependent-patients-a-randomized-clinical-trial
#15
Mohammad Afzalimoghaddam, Maryam Edalatifard, Amir Nejati, Mehdi Momeni, Nader Isavi, Ehsan Karimialavijeh
BACKGROUND: Tolerance to opioids among opium-dependent patients creates obstacles for proper pain management of these patients in the emergency department (ED). The aim of the present study was to investigate the efficacy of intramuscular (IM) haloperidol plus midazolam on morphine analgesia among opium-dependent patients. METHODS: Opium-dependent adults who were admitted to the ED for new-onset severe pain in the limbs or abdomen (within 24 hours of admission and a pain score of over six, using a numerical rating scale [NRS]) were recruited...
January 6, 2017: Current Drug Abuse Reviews
https://www.readbyqxmd.com/read/28057897/review-and-update-of-the-hong-kong-epilepsy-guideline-on-status-epilepticus
#16
REVIEW
E Lw Fung, B Bh Fung
Convulsive status epilepticus is the most extreme form of seizure. It is a medical and neurological emergency that requires prompt and appropriate treatment. Treatment of convulsive status epilepticus is usually divided into stages/steps. The International League Against Epilepsy has released a new definition of status epilepticus that may help to unify the definition in future studies. Over the last few years new information has become available regarding its management. The Rapid Anticonvulsant Medication Prior to Arrival Trial demonstrated non-inferiority of intramuscular midazolam in early status epilepticus compared with intravenous lorazepam...
January 6, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28057557/anesthetics-inhibit-extracellular-signal-regulated-kinase1-2-phosphorylation-via-nmda-receptor-phospholipase-c-and-protein-kinase-c-in-mouse-hippocampal-slices
#17
Gao Haiying, Han Mingjie, Zhang Lingyu, Wang Qingxiang, Wang Haisong, Zhang Bingxi
BACKGROUND: Extracellular signal-regulated kinase 1/2 (ERK1/2) has been implicated in learning and memory; however, whether intravenous anesthetics modulate ERK1/2 remains unknown. The aim of this study was to examine the effect of several intravenous anesthetics on the phosphorylation of ERK1/2 in the hippocampus of adult mice. METHODS: Western blotting was used to examine cellular levels of phosphorylated and unphosphorylated ERK1/2 in mouse hippocampus slices, which were incubated with or without anesthetics including propofol, etomidate, ketamine and midazolam, a protein kinase C (PKC) activator or inhibitor, or phospholipase C (PLC) activator or inhibitor...
January 3, 2017: Neurochemistry International
https://www.readbyqxmd.com/read/28050719/sudden-benzodiazepine-induced-resolution-of-post-operative-pediatric-cerebellar-mutism-syndrome-a-clinical-spect-study
#18
Francesco Nicita, Milena Paiano, Mauro Liberatore, Alberto Spalice, Paola Papoff, Mariacristina Ullo, Manolo Piccirilli, Anna Clerico, Amalia Schiavetti
Post-operative pediatric cerebellar mutism syndrome (PPCMS) is a clinical syndrome arising from cerebellar injury and characterized by absence of speech and other possible symptoms and signs. Rare reports described some benefit after administration of dopamine agonist therapy, but no treatment has proven efficacy. In this paper, we report on the dramatic, sudden resolution of PPCMS induced by midazolam administration in a boy who underwent posterior fossa surgery for choroid plexus papilloma of the fourth ventricle...
January 3, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28049636/verification-of-a-maternal-fetal-physiologically-based-pharmacokinetic-model-for-passive-placental-permeability-drugs
#19
Zufei Zhang, Jashvant D Unadkat
Fetal exposure to drugs cannot be readily estimated from single time point cord blood sampling at the time of delivery. Therefore, we developed a physiologically-based pharmacokinetic (PBPK) model to estimate fetal drug exposure throughout pregnancy. Here we report verification of this novel maternal-fetal physiologically-based pharmacokinetic (m-f-PBPK) model for drugs that passively diffuse across the placenta and are not metabolized/transported there. Our recently built m-f-PBPK model was populated with gestational age-dependent changes in maternal drug disposition and maternal-fetal physiology...
January 3, 2017: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/28042634/anesthesia-methods-used-by-anesthetic-specialists-for-circumcision-cases-national-survey-study-for-turkey
#20
Cafer Altaş, Gamze Küçükosman, Bülent S Yurtlu, Rahşan D Okyay, Bengü G Aydın, Özcan Pişkin, Murat Çimencan, Hilal Ayoğlu, Volkan Hancı, Işıl Özkoçak-Turan
To examine the anesthesiologist's choice for anesthesia techniques and drugs in circumcision and determine the preoperative examination, intraoperative monitoring techniques, postoperative analgesia methods, and common complications among anesthesiologists working in Turkey. Methods: This cross-sectional study was conducted at Bulent Ecevit University Hospital, Zonguldak, Turkey, between May and July 2012. Survey data were obtained via survey forms through electronic data over the web. The questionnaire consists of 20 questions...
January 2017: Saudi Medical Journal
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