38,737 results match your criteria Sedation


What is the appropriate communication style for family members confronting difficult surrogate decision-making in palliative care?: A randomized video vignette study in medical staff with working experiences of clinical oncology.

Jpn J Clin Oncol 2018 Dec 1. Epub 2018 Dec 1.

Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, Japan.

Background: The family members of terminally ill patients are often requested to make difficult surrogate decisions during palliative care. This study sought to clarify the appropriate communication style for physicians as perceived by family members confronting difficult surrogate decision-making.

Methods: This experimental psychological study used scripted videos. Read More

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December 2018

Nonintubated surgical biopsy of undetermined interstitial lung disease: a multicentre outcome analysis.

Interact Cardiovasc Thorac Surg 2018 Dec 1. Epub 2018 Dec 1.

Section of Biostatistics, Tor Vergata University, Rome, Italy.

Objectives: Nonintubated surgical biopsy (NISB) of interstitial lung disease (ILD) has shown promise in unicentre reports as a reliable method to achieve pathological diagnosis with low morbidity. The aim of this study was to investigate for the first time early outcomes of NISB of ILD using a multicentre retrospective analysis.

Methods: Seven European and extra-European institutions participated in the study. Read More

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December 2018
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Anesthesia for endovascular treatment in anterior circulation stroke: A systematic review and meta-analysis.

Brain Behav 2018 Dec 3:e01178. Epub 2018 Dec 3.

Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Background: Endovascular treatment in patients with acute anterior circulation stroke could be performed under either conscious sedation (CS) or general anesthesia (GA). Although several studies have investigated the association between the clinical outcomes and the two anesthesia methods, consensus is lacking.

Methods: PubMed and EMBASE searches were used to select full-text articles comparing the effects of GA and CS on functional outcome and complications in patients with anterior circulation ischemic stroke. Read More

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December 2018

Dispersion in Scores on the Richmond Agitation and Sedation Scale as a Measure of Delirium in Patients with Subdural Hematomas.

Neurocrit Care 2018 Nov 30. Epub 2018 Nov 30.

Division of Critical Care Neurology, Department of Neurology, Columbia University Medical Center, Milstein Hospital Building, 177 Fort Washington Avenue, 8-300 Center, New York, NY, 10032, USA.

Background: Delirium is a frequent complication of critical illness, but its diagnosis is more difficult in brain-injured patients due to language impairment and disorders of consciousness. We conducted a prospective cohort study to determine whether Richmond Agitation and Sedation Scale (RASS) scores could be used to reliably diagnose delirium in the setting of brain injury. We also examined clinical factors associated with delirium in patients with subdural hematomas (SDH) and assessed its impact on functional outcome at discharge. Read More

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November 2018

Validation of ultrasound as a diagnostic tool to assess vocal cord motion in an animal feasibility study.

Gland Surg 2018 Oct;7(5):433-439

Department of Otolaryngology, Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.

Background: Post-thyroidectomy dysphonia can result from recurrent laryngeal nerve (RLN) injury. Confirmation of postoperative recurrent nerve function has prompted many surgeons to advocate laryngoscopic examination. Indirect and flexible laryngoscopy permit visualization of vocal cord motion, but not all thyroid surgeons are skilled in these techniques. Read More

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October 2018
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Sedation versus general anesthesia for transcatheter aortic valve replacement.

J Thorac Dis 2018 Nov;10(Suppl 30):S3588-S3594

Department of Anesthesia & Perioperative Medicine, University of Western Ontario, London, ON, Canada.

There is currently significant controversy regarding the best anesthesia management for patients undergoing transcatheter aortic valve replacement (TAVR). Some institutions primarily use general anesthesia (GA) but many institutions primarily use moderate sedation. Much of the controversy is due to the limited evidence base available to inform this decision and the strong feelings and pre-conceived notions about the optimal anesthesia technique which exist amongst anesthesiologists, cardiologists, and cardiac surgeons. Read More

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November 2018

Anterior mediastinal masses - A multidisciplinary pathway for safe diagnostic procedures.

J Pediatr Surg 2018 Nov 6. Epub 2018 Nov 6.

Department of Paediatric Surgery, St Georges Hospital NHS Trust, London, UK. Electronic address:

Objective: The objective of this study was to report our multidisciplinary diagnostic approach for patients with anterior mediastinal masses (AMM).

Methods: A retrospective review of patients with AMM at a tertiary pediatric surgical oncology centre (January 2011-December 2016) was performed. We analyzed data on clinical presentation, mode of tissue diagnosis, anesthetic techniques, and complications. Read More

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November 2018
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Safety of Conscious Sedation in Patients Undergoing Endoscopic Retrograde Cholangio Pancreatography.

J Coll Physicians Surg Pak 2018 Dec;28(12):950-952

Department of Physiology, Altibri Medical College, Karachi, Pakistan.

Objective: To assess the safety of conscious sedation in patients undergoing endoscopic retrograde cholangio pancreaticography (ERCP).

Study Design: An observational study.

Place And Duration Of Study: Department of Gastroenterology, Liaquat National Hospital, Karachi, from April 2010 to April 2015. Read More

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December 2018

Comparative study between Dexmedetomidine and Ondansteron for prevention of post spinal shivering. A randomized controlled trial.

BMC Anesthesiol 2018 Nov 30;18(1):179. Epub 2018 Nov 30.

Department of Anesthesia, Fayoum University, Fayoum, Egypt.

Background: Regional anesthesia could affect the homeostatic system functions resulting frequently in perioperative hypothermia and consequently shivering. The objective of this trial was to evaluate the efficacy of dexmedetomidine and ondansetron to reduce the incidence and severity of shivering after intrathecal blocks.

Methods: This randomized placebo-controlled trial included 120 patients allocated equally in three groups. Read More

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November 2018

Carpal Tunnel Syndrome: Retrospective Analysis of 60 Consecutive Cases of Ambulatory Surgical Treatment With Local Anesthesia.

Hand (N Y) 2018 Dec 2:1558944718813721. Epub 2018 Dec 2.

3 Centro Universitário Serra dos Órgãos, Teresópolis, Brazil.

Background: The purpose of this study was to evaluate the safety and efficacy of ambulatory open surgical treatment for carpal tunnel syndrome with local anesthesia and without tourniquet ischemia, sedation by an anesthesiologist, or hospitalization.

Methods: A retrospective analysis of 60 consecutive cases performed during 1 year was conducted, excluding other compressive or noncompressive neuropathies. The criteria for treatment efficacy were improvements in symptoms and recurrence rates, and the safety criterion was the presence of complications. Read More

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December 2018

Dexmedetomidine Use in a Tertiary Care NICU: A Descriptive Study.

Ann Pharmacother 2018 Dec 3:1060028018812089. Epub 2018 Dec 3.

2 Department of Peditrics, University of Calgary, Calgary, AB, Canada.

Background: Continuous infusions of dexmedetomidine are increasingly used for sedation in critically ill pediatric patients. Emerging data suggest potential benefits when used for sedation in neonates, including reduced sedative requirements and earlier enteral feeds.

Objective: To describe the use, adverse effects, and signs of withdrawal in a cohort of neonates receiving dexmedetomidine, the majority of whom were receiving concomitant opioids. Read More

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December 2018

Autistic Man Falling Through The Cracks. Advanced patient transport and the "pop-up" recovery ward.

Prehosp Emerg Care 2018 Dec 3:1-4. Epub 2018 Dec 3.

b University of Sydney, Faculty of Medicine and Health, School of Rural Health (Dubbo/Orange) , Dubbo , 2830 Australia.

The Royal Flying Doctor Service was tasked to relocate a 19 year-old autistic patient with severe social anxiety, agoraphobia and morbid obesity from one residential location to another. The retrieval team was confronted with two main challenges: 1. Continuous risk elevation in an elective patient transportation as distinct from other urgent prehospital transfers of mental health patients. Read More

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December 2018

Deep Brain Stimulation Surgery without Sedation.

Stereotact Funct Neurosurg 2018 Dec 5:1-9. Epub 2018 Dec 5.

Center for Deep Brain Stimulation, University Hospital Regensburg, Regensburg,

Background: Sedatives and opioids used during deep brain stimulation (DBS) surgery interfere with optimal target localization and add to side effects and risks, and thus should be minimized.

Objective: To retrospectively test the actual need for sedatives and opioids when cranial nerve blocks and specific therapeutic communication are applied.

Methods: In a case series, 64 consecutive patients treated with a strong rapport, constant contact, non-verbal communication and hypnotic suggestions, such as dissociation to a "safe place," reframing of disturbing noises and self-confirmation, were compared to 22 preceding patients under standard general anaesthesia or conscious sedation. Read More

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December 2018
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Mechanisms of Etomidate-Mediated Decrease of Spontaneous Spike Activity of Mouse Cerebellar Purkinje Cells in vivo.

Pharmacology 2018 Dec 5;103(1-2):82-92. Epub 2018 Dec 5.

Key Laboratory of Cellular Function and Pharmacology of Jilin Province, Yanbian University, Yanji,

Etomidate is an imidazole, nonbarbiturate hypnotic agent that is increasingly used in procedural sedation. However, the effects of etomidate on the spontaneous activity of cerebellar Purkinje cells (PCs) in living mouse have not been fully understood. In this study, we investigated the effects of etomidate on the spontaneous simple spike (SS) activity of PCs in urethane-anesthetized mice by cell-attached recording and pharmacological methods. Read More

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December 2018
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Percutaneous laser ablation of benign thyroid nodules: a one year follow-up study.

Einstein (Sao Paulo) 2018 Nov 29;16(4):eAO4279. Epub 2018 Nov 29.

Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

Objective: To evaluate safety and effectiveness of nodule volume reduction and thyroid function after percutaneous laser ablation treatment in patients with benign nonfunctioning thyroid nodules.

Methods: Prospective single-center study, from January 2011 to October 2012, which evaluated 30 euthyroid and thyroid antibodies negative patients with benign solitary or dominant nodule with indication of treatment due to compressive symptoms and aesthetic disturbances. The clinical and laboratory (thyroid ultrasound, TSH, FT4, TG, TG-Ab, TPO-Ab and TRAb levels) evaluations were performed before the procedure, and periodically 1 week, 3 months and 6 months after. Read More

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November 2018
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Opioid tapering and weaning protocols in pediatric critical care units: a systematic review.

Rev Assoc Med Bras (1992) 2018 Oct;64(10):909-915

Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da USP, São Paulo (SP), Brasil.

Objective: Opioid abstinence syndrome is common in the pediatric intensive care environment because sedation is often needed during the children's treatment. There is no specific guideline regarding the management of these patients; and lately, methadone is an important drug for the prevention of abstinence symptoms during the weaning of opioids. This study gathers the available research to establish the initial dose of methadone, the rate of taper and tools to recognize this syndrome and act promptly. Read More

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October 2018
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Critical Care of Neuromuscular Disorders.

Continuum (Minneap Minn) 2018 Dec;24(6):1753-1775

Purpose Of Review: Weakness is a common reason patients are seen in neurologic consultation. This article reviews the differential diagnosis of neuromuscular disorders in the intensive care unit (ICU), discusses the intensive care needs and evaluation of respiratory failure in patients with neuromuscular disorders, and provides a practical guide for management.

Recent Findings: Although primary neuromuscular disorders used to be the most common cause for weakness from peripheral nervous system disease in the ICU, a shift toward ICU-acquired weakness is observed in today's clinical practice. Read More

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December 2018
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Using sedative substances until death: A mortality follow-back study on the role of healthcare settings.

Palliat Med 2018 Dec 5:269216318815799. Epub 2018 Dec 5.

1 Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.

Background:: In the last decade, the use of sedative substances to keep a patient in deep sedation until death increased fourfold in German-speaking Switzerland, where every third patient admitted to hospital, palliative care unit or hospice died continuously deeply sedated.

Aim:: To investigate sedation practices across healthcare settings and to identify their associations with conventional symptom control.

Design:: National mortality follow-back study in Switzerland between 2013 and 2014. Read More

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December 2018
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A clinical trial on the acute effects of methadone and buprenorphine on actual driving and cognitive function of healthy volunteers.

Br J Clin Pharmacol 2018 Dec 4. Epub 2018 Dec 4.

Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, University of Maastricht, Maastricht, The Netherlands.

Aims: The present study assessed the acute effects of methadone and buprenorphine on actual on-road driving performance and neurocognitive function.

Methods: Methadone (5 and 10 mg per oral) and buprenorphine (0.2 and 0. Read More

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December 2018

Using the Model for Improvement to implement the Critical-Care Pain Observation Tool in an adult intensive care unit.

BMJ Open Qual 2018 9;7(4):e000304. Epub 2018 Oct 9.

Department of Anaesthesia and Pain, Raigmore Hospital, Inverness, UK.

Managing pain is challenging in the intensive care unit (ICU) as often patients are unable to self-report due to the effects of sedation required for mechanical ventilation. Minimal sedative use and the utilisation of analgesia-first approaches are advocated as best practice to reduce unwanted effects of oversedation and poorly managed pain. Despite evidence-based recommendations, behavioural pain assessment tools are not readily implemented in many critical care units. Read More

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October 2018
4 Reads

Preoperative fasting in the department of plastic surgery.

BMJ Open Qual 2018 10;7(4):e000161. Epub 2018 Nov 10.

Department of Plastic Surgery, North Bristol NHS Trust, Bristol, UK.

Preoperative fasting is necessary to reduce the risk of regurgitation of gastric contents and pulmonary aspiration in patients undergoing general anaesthetic and procedural sedation. Excessive fasting is associated with metabolic, cardiovascular and gastrointestinal complications and patient discomfort. We aimed to reduce the fasting time for patients on the plastic surgery trauma list. Read More

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November 2018

Surgery on cervical folds for transcervical intrauterine artificial insemination with frozen-thawed semen enhances pregnancy rates in the sheep.

Theriogenology 2018 Nov 22;126:28-35. Epub 2018 Nov 22.

Section of Obstetrics and Gynecology, Department of Veterinary Medicine, University of Sassari, Sassari, Italy.

In sheep industry, genetic progress rate achieved by artificial insemination (AI) is limited by the convoluted anatomy of the cervix, which does not allow the passage of an insemination catheter for uterine semen deposition. The aim of this study was to test, in 98 pregnant at term Sarda ewes, the effects of: Experiment 1) total or partial ablation of cervical folds and Experiment 2) 4 or 2 incisions of cervical folds, on the passage of an insemination catheter, deposition of frozen-thawed semen and pregnancy rates. Surgical procedures were performed within 24 h from parturition providing deep sedation and epidural anaesthesia. Read More

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November 2018

Effectiveness and safety of gastrointestinal endoscopy during a specific sedation training program for non-anesthesiologists.

Rev Esp Enferm Dig 2018 Dec 3;111. Epub 2018 Dec 3.

Anestesiología y Reanimación, Complejo Hospitalario Universitario de Santiago de Compostela. Universidad de Santiago de Compostela, España.

Introduction: sedation is a key component for the improvement of sedation quality. A correct administration requires appropriate training. We performed a study to compare sedation effectiveness, safety and patient satisfaction when administered by gastroenterologists, with and without specific training. Read More

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December 2018
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When and how to provide a palliative sedation in terminally ill patients?

Rev Prat 2017 12;67(10):1139-1143

Pôle recherche et enseignement universitaire, maison médicale Jeanne-Garnier, Paris, France.

When and how to provide a palliative sedation in terminally ill patients? With the introduction in the French law of sedatives practices, the professionals in palliative care are obliged to define the concepts, to name the difference kinds of sedations, to elaborate guidelines for good practice. French society of palliative care has worked to clarify the vocabulary, and to differentiate palliative sedations to their duration, their depth and the patient's consent (typology SEDAPALL). Its guidelines of 2010 have been updated in the form of three reference sheets in conjunction with a continuous deep sedation until death: how to estimate that the vital prognosis is short term? How to evaluate the refractory suffering? What are the guidelines for the pharmacological administration? The French National Authority for Health has produced a guide titled "How to realise a continuous deep sedation until death?" The present paper highlights some fundamental points of necessary steps: listening, understanding and analysing the suffering; the collegiate procedure - multi professional deliberative process, the pharmacological administration. Read More

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December 2017

Principles and challenges of law n° 2016-87 of 2 February 2016 creating new rights for the sick and the end-of-life

Authors:
Régis Aubry

Rev Prat 2017 12;67(10):1131-1133

Service de soins palliatifs, CHU de Besançon, Besançon, France.

Principles and challenges of law n° 2016-87 of 2 february 2016 creating new rights for the sick and the end-of-life. This law reinforces and modifies the rights of patient. Advance directives become binding but are not unenforceable. Read More

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December 2017
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Population Pharmacokinetic/Pharmacodynamic Model-Guided Dosing Optimization of a Novel Sedative HR7056 in Chinese Healthy Subjects.

Front Pharmacol 2018 19;9:1316. Epub 2018 Nov 19.

Clinical Pharmacology Research Center, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.

HR7056 is a new benzodiazepine, showing more faster acting onset and recovery than currently available short-acting sedatives. To avoid inadequate anesthesia and predict return of cognition, allowing for immediate neurological evaluation, HR7056 pharmacokinetics and pharmacodynamics were characterized in Chinese healthy subjects. We report on modeling of the data and simulations of dosage regimens for future study. Read More

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November 2018

Pharmacists' interventions to reduce sedative/hypnotic use for insomnia in hospitalized patients.

Saudi Pharm J 2018 Dec 20;26(8):1204-1207. Epub 2018 Jul 20.

University of Arizona College of Pharmacy, USA.

Background: Hospitalization can contribute to insomnia in many patients and is usually treated symptomatically. However, sedative/hypnotic misuse is associated with complications in this population, especially in the elderly. Such complications include dizziness, falls and over-sedation. Read More

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December 2018
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[Use of the autologous dorsal dermis in reconstruction of the posterior palpebral lamella in blepharopoiesis].

Ann Chir Plast Esthet 2018 Nov 30. Epub 2018 Nov 30.

Département de chirurgie plastique, reconstructrice, brûlés, plaies et cicatrisation, CHU Lapeyronie, 371, avenue de Doyen Gaston Giraud, 34295 Montpellier, France. Electronic address:

Objectives: Blepharopoiesis represents a double aesthetic and functional challenge. If anterior lamellar reconstruction is less discussed, the variety of posterior lamellar substitutes testifies that none is ideal. We report here our experience of the use of autologous dermal dermis as posterior lamellar substitutes in bilamellar blepharopoiesis. Read More

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November 2018

Test performance of point-of-care ultrasound for gastric content.

Am J Emerg Med 2019 Jan 24;37(1):123-126. Epub 2018 Oct 24.

Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, United States of America.

Objective: We sought to determine test performance characteristics of emergency physician ultrasound for the identification of gastric contents.

Methods: Subjects were randomized to fast for at least 10 h or to consume food and water. A sonologist blinded to the patient's status performed an ultrasound of the stomach 10 min after randomization and oral intake, if applicable. Read More

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January 2019
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Frequency and characteristics of drowsiness, somnolence, or daytime sleepiness in patients with advanced cancer.

Palliat Support Care 2018 Dec 4:1-5. Epub 2018 Dec 4.

Palliative Care and Rehabilitation Medicine,The University of Texas MD Anderson Cancer Center,Houston,TX.

IntroductionCancer-related drowsiness (CRD) is a distressing symptom in advanced cancer patients (ACP). The aim of this study was to determine the frequency and factors associated with severity of CRD. We also evaluated the screening performance of Edmonton Symptom Assessment Scale-drowsiness (ESAS-D) item against the Epworth Sedation Scale (ESS). Read More

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December 2018

Sleep and Intensive Care Unit-Acquired Weakness in Critically Ill Older Adults.

Dimens Crit Care Nurs 2019 Jan/Feb;38(1):20-28

Maya N. Elías, PhD, MA, RN, is a postdoctoral research fellow at the School of Nursing & Health Studies at the University of Miami, Coral Gables, Florida. Cindy L. Munro, PhD, ANP-BC, FAAAS, is dean and professor at the School of Nursing & Health Studies at the University of Miami, Coral Gables, Florida. Zhan Liang, PhD, RN, is an assistant professor at the School of Nursing & Health Studies at the University of Miami, Coral Gables, Florida. Karel Calero, MD, is an assistant professor at the College of Medicine, Department of Pulmonary, Critical Care, & Sleep Medicine at the University of South Florida, Tampa. Ming Ji, PhD, is a professor at the College of Nursing at the University of South Florida, Tampa.

Background: Older adults in the intensive care unit (ICU) often experience sleep disturbances, which may stem from life-threatening illness, the ICU environment, medications/sedation, or psychological stress. Two complementary endocrinological responses occur as a result of compromised sleep and consequently could exacerbate ICU-acquired weakness: a decrease in anabolic hormones leading to decreased protein synthesis and an increase in catabolic hormones leading to increased protein degradation. Age-associated decreases in anabolic hormones, such as insulin-like growth factor 1, testosterone, and growth hormone, may inhibit protein synthesis. Read More

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December 2018
2 Reads

Effects of oral trazodone on echocardiographic and hemodynamic variables in healthy cats.

J Feline Med Surg 2018 Nov 30:1098612X18814565. Epub 2018 Nov 30.

Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA.

Objectives: The purpose of this study was to evaluate the effects of oral trazodone on echocardiographic variables, heart rate (HR) and blood pressure (BP) in healthy cats.

Methods: Client-owned domestic cats between 2 and 8 years of age were recruited. Cats were considered healthy based on physical examination, complete blood count, blood chemistry profile, urinalysis, total thyroxine concentration, non-invasive BP measurement by Doppler method and a screening transthoracic echocardiogram with simultaneous electrocardiogram. Read More

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November 2018
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Clinical indications and scanning protocols for chest CT in children with cystic fibrosis: a survey of UK tertiary centres.

BMJ Paediatr Open 2018 27;2(1):e000367. Epub 2018 Oct 27.

Institute of Applied Clinical Science, Keele University, Keele, UK.

Objectives: Chest CT is increasingly used to monitor disease progression in children with cystic fibrosis (CF) but there is no national guideline regarding its use. Our objective was to assess the indications for undertaking chest CT and the protocols used to obtain scans.

Design Setting And Participants: An electronic questionnaire was developed to assess clinicians views on chest CT in children with CF. Read More

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October 2018
2 Reads

The α3β4 nicotinic acetylcholine receptor antagonist 18-Methoxycoronaridine decreases binge-like ethanol consumption in adult C57BL/6J mice.

Alcohol 2018 Nov 26. Epub 2018 Nov 26.

Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania, 16802, United States of America. Electronic address:

Binge alcohol drinking is a health burden in the United States which has an alarming economic impact. Unfortunately, medications available for alcohol abuse have low efficacy or adverse side effects creating a need to evaluate novel therapies. Growing research suggests that 18-Methoxycoronaridine (18-MC), an α3β4 nicotinic acetylcholine receptor (nAChR) antagonist, may be effective at reducing ethanol consumption. Read More

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November 2018
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Changes of diaphragmatic excursion and lung compliance during major laparoscopic pelvic surgery: A prospective observational study.

PLoS One 2018 29;13(11):e0207841. Epub 2018 Nov 29.

Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Major laparoscopic pelvic surgery requires steep Trendelenburg position with pneumoperitoneum for a long time. We investigated the effect of Trendelenburg position with pneumoperitoneum on diaphragmatic excursion and lung compliance during major laparoscopic pelvic surgery using M-mode sonography. Twenty patients undergoing elective pelviscopic radical hysterectomy were included in this study. Read More

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November 2018

Effect of Total Intravenous Anesthesia vs Volatile Induction With Maintenance Anesthesia on Emergence Agitation After Nasal Surgery: A Randomized Clinical Trial.

JAMA Otolaryngol Head Neck Surg 2018 Nov 29. Epub 2018 Nov 29.

Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Importance: Emergence agitation is common after nasal surgery under general anesthesia and may lead to serious consequences for the patient, including an increased risk of injury, pain, hemorrhage, and self-extubation. Despite decades of research, studies on the incidence, risk factors, and prevention of emergence agitation in adult patients are ongoing, and opinions differ on the different effects of inhalation and intravenous anesthesia.

Objective: To investigate the effect of anesthetic method on the occurrence of emergence agitation after nasal surgery. Read More

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November 2018

A Novel GABA Receptor Ligand MIDD0301 with Limited Blood-Brain Barrier Penetration Relaxes Airway Smooth Muscle Ex Vivo and In Vivo.

Am J Physiol Lung Cell Mol Physiol 2018 Nov 29. Epub 2018 Nov 29.

Anesthesiology, College of Physicians and Surgeons of Columbia University.

Airway smooth muscle cells express GABA receptors, and previous reports have demonstrated that GABA receptor activators relax airway smooth muscle. However, given the activity of GABA receptors in central nervous system inhibitory neurotransmission, concern exists that these activators may lead to undesirable sedation. MIDD0301 is a novel imidazobenzodiazepine and positive allosteric modulator of the GABA receptor with limited brain distribution, thus eliminating the potential for sedation. Read More

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November 2018

Polysomnographic assessment of respiratory disturbance during deep propofol sedation for endoscopic submucosal dissection of gastric tumors.

World J Gastrointest Endosc 2018 Nov;10(11):340-347

Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan.

Aim: To investigate that polysomnographic monitoring can accurately evaluate respiratory disturbance incidence during sedation for gastrointestinal endoscopy compare to pulse oximetry alone.

Methods: This prospective observational study included 10 elderly patients with early gastric cancer undergoing endoscopic submucosal dissection (ESD) under propofol sedation. Apart from routine cardiorespiratory monitoring, polysomnography measurements were acquired. Read More

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November 2018

Extended-release quetiapine overdose is associated with delayed onset of toxicity compared to immediate-release quetiapine overdose.

Emerg Med Australas 2018 Nov 28. Epub 2018 Nov 28.

Monash Emergency Research Collaborative, Department of Medicine, Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.

Objectives: There are currently no studies comparing toxicity after extended-release (XR) and immediate-release (IR) quetiapine overdose. To compare the time course of toxicity of XR and IR quetiapine overdose.

Methods: Retrospective analysis of toxicology unit consultations from July 2013 to April 2016. Read More

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November 2018

Sedative and antinociceptive effects of different detomidine constant rate infusions, with or without methadone in standing horses.

Equine Vet J 2018 Nov 28. Epub 2018 Nov 28.

São Paulo State University (UNESP), School of Veterinary Medicine and Animal Science, Botucatu, SP, Brazil.

Background: Standing surgery avoids the risks of general anaesthesia in horses.

Objectives: To assess sedation, antinociception and gastrointestinal motility in standing horses after a detomidine loading dose and 2-hours constant rate intravenous (i.v. Read More

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November 2018

Analysis of 17 948 pediatric patients undergoing procedural sedation with a combination of intranasal dexmedetomidine and ketamine.

Paediatr Anaesth 2018 Nov 28. Epub 2018 Nov 28.

Department of Anesthesiology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.

Background: Intranasal procedural sedation using dexmedetomidine is well described in the literature. The combination of intranasal dexmedetomidine and ketamine is a novel approach for which there are little data on the rate of successful sedation or adverse events.

Objectives: The aim of this study is to evaluate the rate of successful sedation and adverse events of intranasal procedural sedation using a combination of dexmedetomidine and ketamine for diagnostic examination in children. Read More

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November 2018
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Prolonged coma resulting from massive levothyroxine overdose and the utility of N-terminal prohormone brain natriuretic peptide (NT-proBNP).

Clin Toxicol (Phila) 2018 Nov 28:1-3. Epub 2018 Nov 28.

a Monash Clinical Toxicology Unit, Emergency Medicine Service, Monash Health , Melbourne , VIC , Australia.

Introduction: Levothyroxine overdose rarely results in systemic toxicity. We report a case of intentional levothyroxine overdose with a delayed onset coma and delirium lasting two weeks.

Case Summary: A 72-year-old female ingested 12 mg levothyroxine. Read More

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November 2018

Baclofen for alcohol use disorder.

Cochrane Database Syst Rev 2018 Nov 26;11:CD012557. Epub 2018 Nov 26.

Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, Rome, Italy, 00154.

Background: Alcohol use disorder (AUD) and alcohol-related impairments belong to the most widespread psychiatric disorders leading to specific psychophysical, affective and cognitive symptoms and consequences for psychosocial well-being and health. Alcohol consumption is increasingly becoming a problem in many developing regions and AUD prevalence is estimated at 4.1% worldwide, with highest prevalence in European countries (7. Read More

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November 2018

Interventions for preventing intensive care unit delirium in adults.

Cochrane Database Syst Rev 2018 Nov 23;11:CD009783. Epub 2018 Nov 23.

The Neuroscience Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, Denmark, 2100.

Background: Delirium is defined as a disturbance in attention, awareness and cognition with reduced ability to direct, focus, sustain and shift attention, and reduced orientation to the environment. Critically ill patients in the intensive care unit (ICU) frequently develop ICU delirium. It can profoundly affect both them and their families because it is associated with increased mortality, longer duration of mechanical ventilation, longer hospital and ICU stay and long-term cognitive impairment. Read More

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November 2018
4 Reads

Changes in thromboinflammatory profiles across the generations of transcatheter aortic heart valves.

J Thromb Thrombolysis 2018 Nov 27. Epub 2018 Nov 27.

Gill Heart and Vascular Institute, University of Kentucky, BBSRB B345, Lexington, KY, 40506, USA.

The transcatheter aortic valve replacement (TAVR) procedure was developed to provide patients with severe aortic stenosis an alternative to the surgical aortic valve replacement. Since the approval of the original SAPIEN the technology has rapidly evolved. While several approaches can be used for valve deployment, as delivery systems have become smaller and more flexible, the transfemoral approach has become the dominant technique for valve deployment. Read More

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November 2018

A Systematic Review Assessing the Current State of Automated Pupillometry in the NeuroICU.

Neurocrit Care 2018 Nov 27. Epub 2018 Nov 27.

Department of Ophthalmology, Emory University School of Medicine, 1648 Pierce Drive NE, Atlanta, GA, 30307, USA.

The aim of this study was to assess the current state of automated pupillometry technology and its application in the neurointensive care unit (neuroICU). We performed a literature search using the PubMed, MEDLINE, and EMBASE databases from database inception through a search end date of October 18, 2018, to identify studies reporting on the use of automated pupillometry in the care of critically ill patients with neurological impairment. Two independent reviewers reviewed all titles and abstracts in two filtering phases. Read More

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November 2018