The Kinetic and Dynamic Characteristics of Benzodiazepines in the Treatment of Anxiety

1988 ◽  
Vol 3 (S2) ◽  
pp. 175s-182s
Author(s):  
L.F. Fabre
Keyword(s):  
General Hospital ◽  
Dynamic Characteristics ◽  
Plasma Levels ◽  
Rating Scales ◽  
Active Drug ◽  
Massachusetts General Hospital ◽  
The Other ◽  
Sedation Scale ◽  
Drug Induced ◽  
Treatment Groups

SummaryBenzodiazepines are assumed to cause drowsiness and sedation. Rating scales such as the Massachusetts General Hospital Sedation Scale and the Morning Evaluation of Drug Induced Sedation Scale allow testing of this hypothesis and assessment of the effects of benzodiazepines. We performed a five-week study of prazepam in 63 anxious outpatients. Plasma levels of desmethyldiazepam were assessed weekly. Placebo was given the first week, followed by active drug for three weeks, and placebo the final week. One group received prazepam 30 mg/h, the other received prazepam 10 mg three times per day. Drowsiness-sedation and anxiolytic efficacy were assessed at baseline and weekly. Plasma desmethyldiazepam levels were similar in both treatment groups. Efficacy was profound in both groups. Drowsiness-sedation measured high at baseline and decreased significantly (P=0.05) over the 3 weeks when active drug was administered. Sedation decreased by as much as 40%. Sleep was improved with prazepam, and this may have resulted in decreased drowsiness. We conclude that anxious outpatients have significant levels of drowsiness-sedation and that treatment with benzodiazepines reduces the occurrence of this symptom.

scholarly journals Night Call in a Teaching Hospital: 1979 and 2019

2019 ◽  
Vol 14 (12) ◽  
pp. 782-784
Author(s):  
Shaurya Taran ◽  
Benjamin Chin-Yee ◽  
Allan S Detsky
Keyword(s):  
General Hospital ◽  
Teaching Hospital ◽  
Massachusetts General Hospital ◽  
The Other ◽  
University Of Toronto ◽  
Night Call ◽  
The University

No matter the era, few aspects of residency are more defining or memorable than overnight call. Nights can be a time of growth and learning but also of fear and uncertainty, as residents take on the responsibility of managing sick patients on their own. One of us (ASD) started his residency in 1978 at the Massachusetts General Hospital in Boston; the other two (ST and BCY) started theirs in 2016 and 2017, respectively, at the University of Toronto. In this essay, we reflect on our experiences of night call separated by 40 years, highlighting what has changed and what has stayed the same.

scholarly journals Regional Cerebral Blood Flow after Marijuana Smoking

1992 ◽  
Vol 12 (5) ◽  
pp. 750-758 ◽  
Author(s):  
Roy J. Mathew ◽  
William H. Wilson ◽  
Diane F. Humphreys ◽  
Joe V. Lowe ◽  
Kathryn E. Wiethe
Keyword(s):  
Carbon Monoxide ◽  
Pulse Rate ◽  
Plasma Levels ◽  
Rating Scales ◽  
Right Hemisphere ◽  
Previous History ◽  
Inhalation Technique ◽  
Drug Induced ◽  
End Tidal ◽  
Smoking Marijuana

Regional CBF was measured with the 133Xe inhalation technique before and thrice after smoking marijuana of two strengths and placebo in 20 physically and mentally healthy male volunteers with a previous history of exposure to marijuana. They were drug-free at the time of the study. Blood pressure, pulse rate, end-tidal carbon dioxide, end-tidal carbon monoxide, and forehead skin perfusion were quantified during the CBF measurements. Blood samples were drawn for quantification of plasma levels of Δ9-tetrahydrocannabinol (THC) before and during the 2 h after smoking marijuana or placebo. Drug-induced intoxication and changes in mood were quantified with rating scales. Marijuana smoking was associated with bilateral CBF increase, which was maximal 30 min later. Greater CBF increases were seen in the frontal region and right hemisphere. No significant CBF changes were seen after placebo. Pulse rate and respiration increased significantly after marijuana but not placebo. Both marijuana and placebo smoking were associated with increased end-tidal carbon monoxide. CBF increase in both hemispheres correlated significantly with degree of intoxication, plasma levels of THC, and pulse rate.

Heat-Etching with a Bullivant Type II Simple Freeze-Cleave Device

1970 ◽  
Vol 28 ◽  
pp. 106-107 ◽  
Author(s):  
Ronald S. Weinstein ◽  
N. Scott McNutt
Keyword(s):  
New Zealand ◽  
General Hospital ◽  
Massachusetts General Hospital ◽  
Type I ◽  
Type Ii ◽  
Collaborative Effort ◽  
Temperature And Pressure ◽  
The University

The Type I simple cold block device was described by Bullivant and Ames in 1966 and represented the product of the first successful effort to simplify the equipment required to do sophisticated freeze-cleave techniques. Bullivant, Weinstein and Someda described the Type II device which is a modification of the Type I device and was developed as a collaborative effort at the Massachusetts General Hospital and the University of Auckland, New Zealand. The modifications reduced specimen contamination and provided controlled specimen warming for heat-etching of fracture faces. We have now tested the Mass. General Hospital version of the Type II device (called the “Type II-MGH device”) on a wide variety of biological specimens and have established temperature and pressure curves for routine heat-etching with the device.

scholarly journals Implementing ERAS: how we achieved success within an anesthesia department

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dan B. Ellis ◽  
Aalok Agarwala ◽  
Elena Cavallo ◽  
Pam Linov ◽  
Michael K. Hidrue ◽  
...  
Keyword(s):  
General Hospital ◽  
Residency Program ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Massachusetts General Hospital ◽  
Educational Interventions ◽  
Nurse Anesthetists ◽  
Intervention Period ◽  
Post Intervention ◽  
Anesthesia Group

Abstract Background The Massachusetts General Hospital is a large, quaternary care institution with 58 operating rooms, 164 anesthesiologists, 76 certified nurse anesthetists (CRNAs), an anesthesiology residency program that admits 25 residents annually, and 35 surgeons who perform laparoscopic, vaginal, and open hysterectomies. In March of 2018, our institution launched an Enhanced Recovery After Surgery (ERAS) pathway for patients undergoing hysterectomy. To implement the anesthesia bundle of this pathway, an intensive 14-month educational endeavor was created and put into effect. There were no subsequent additional educational interventions. Methods We retrospectively reviewed records of 2570 patients who underwent hysterectomy between October 2016 and March 2020 to determine adherence to the anesthesia bundle of the ERAS Hysterectomy pathway. RESULTS: Increased adherence to the four elements of the anesthesia bundle (p < 0.001) was achieved during the intervention period. Compliance with the pathway was sustained in the post-intervention period despite no additional actions. Conclusions Implementing the anesthesia bundle of an ERAS pathway in a large anesthesia group with diverse providers successfully occurred using implementation science-based approach of intense interventions, and these results were maintained after the intervention ceased.

scholarly journals Dental pulp stem cells overexpressing hepatocyte growth factor facilitate the repair of DSS-induced ulcerative colitis

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Ning Li ◽  
Yichi Zhang ◽  
Narayan Nepal ◽  
Guoqing Li ◽  
Ningning Yang ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Ulcerative Colitis ◽  
Body Weight ◽  
Stem Cell ◽  
Dental Pulp ◽  
The Other ◽  
Therapeutic Effects ◽  
Colon Injury ◽  
Treatment Groups ◽  
Hepatocyte Growth

Abstract Background Ulcerative colitis (UC) is a chronic and recurrent disease without satisfactory treatment strategies. Dental pulp stem cell (DPSC) transplantation has been proposed as a potential therapy for UC. This study aimed to investigate the therapeutic effects of the rat hepatocyte growth factor (HGF) gene transduced into DPSCs for UC. Methods The therapeutic effects of HGF-DPSCs transplanted intravenously into a rat model of UC induced by 5% dextran sulphate sodium (DSS) were compared with the other treatment groups (LV-HGF group, DPSCs group and GFP-DPSCs group). Immunofluorescence and immunohistochemistry were used to observe the localization and proliferation of HGF-DPSCs at the site of colon injury. The expression levels of inflammatory factors were detected by real-time quantitative PCR (RT-PCR) and western blotting. The oxidative stress markers were detected by ELISA. DAI scores and body weight changes were used to macroscopically evaluate the treatment of rats in each group. Results Immunofluorescence and immunohistochemistry assays showed that HGF-DPSCs homed to colon injury sites and colocalized with intestinal stem cell (ISC) markers (Bmi1, Musashi1 and Sox9) and significantly promoted protein expression (Bmi1, Musashi1, Sox9 and PCNA). Anti-inflammatory cytokine (TGF-β and IL-10) expression was the highest in the HGF-DPSCs group compared with the other treatment groups, while the expression of pro-inflammatory cytokines (TNF-α and INF-γ) was the lowest. Additionally, the oxidative stress response results showed that malondialdehyde (MDA) and myeloperoxidase (MPO) expression decreased while superoxide dismutase (SOD) expression increased, especially in the HGF-DPSCs group. The DAI scores showed a downward trend with time in the five treatment groups, whereas body weight increased, and the changes were most prominent in the HGF-DPSCs group. Conclusions The study indicated that HGF-DPSCs can alleviate injuries to the intestinal mucosa by transdifferentiating into ISC-like cells, promoting ISC-like cell proliferation, suppressing inflammatory responses and reducing oxidative stress damage, which provides new ideas for the clinical treatment of UC.

scholarly journals Prevalencia y factores asociados al deseo sexual hipoactivo en hombres del Quindío

2020 ◽  
Author(s):  
Franklin José Espitia De La Hoz
Keyword(s):  
General Hospital ◽  
Sexual Functioning ◽  
Massachusetts General Hospital ◽  
Vitamina D

Resumen Introducción El deseo sexual hipoactivo describe el bajo interés hacia la actividad sexual en general, caracterizando la escasa o nula motivación para tener relaciones eróticas, con disminución o ausencia de pensamientos o fantasías sexuales. Objetivo Evaluar la prevalencia y factores asociados, al deseo sexual hipoactivo en hombres del Quindío, así como estimar las demás disfunciones sexuales. Métodos Estudio observacional. La población estuvo constituida por 171 hombres que asistieron a consulta externa en una clínica universitaria de la ciudad de Armenia, Colombia, en el 2019. Se excluyeron los hombres menores de 18 años, residentes fuera del Quindío, situación psicopatológica o social que dificultara la comprensión del instrumento y los que no consintieron participar en el estudio. Se aplicó como instrumento el “Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ)”. Se evaluaron las características socio-demográficas, estilos de vida, salud sexual y reproductiva, antecedentes y comportamiento sexual. Se hizo análisis descriptivo. Resultados La edad promedio fue de 41,79 ± 11,46 años (rango 18–81). La prevalencia de disfunciones sexuales en el grupo estudiado fue de 21,63%. La puntuación del MGH-SFQ fue de 14,61 ± 4,23 puntos (variación: 7,26 - 19,26). Se presentaron dificultades con el interés sexual (15,78%), excitación sexual (6,43%), orgasmo (8,77%), erección (21,63%) y satisfacción sexual global (12,28%). La mediana de disfunciones sexuales por hombre fue de 2, que se hizo presente en el 27,48% %. El análisis multivariado (regresión logística) mostró que los factores asociados al deseo sexual hipoactivo fueron testosterona baja (OR: 5,59; IC95% 1,82–18,37), ansiedad / depresión (OR: 5,53; IC95% 1,72–18,43), convivencia en pareja mayor a 10 años (OR: 5,19; IC95%: 2,71–11,71), ansiedad de desempeño (OR: 4,62; IC95% 1,95–10,56), incremento de la edad (OR: 3,42; IC95%: 1,26–9,36), cansancio / estrés (OR: 2,58; IC95%: 1,08–3,28), trastornos del sueño (OR: 1,89; IC95%: 1,35–2,58), conflictos de pareja (OR: 1,53; IC95%: 1,02–2,37) y antecedente de disfunciones sexuales (OR: 1,47; IC95%: 0,99–2,22); mientras que, el uso de juguetes sexuales (OR: 0,78; IC95%: 0,72–0,96; p = 0,021), consumo de vitamina D (2000 UI / diarias) (OR: 0,64; IC95%: 0,42–0,96) o de Inhibidores de fosfodiesterasa-5 (OR: 0,78; IC95%: 0,63–0,93) constituyeron factores protectores. Conclusiones En el presente estudio, el 21,63% de los hombres presentaron disfunciones sexuales. Los trastornos de la erección (21,63%) y el interés sexual (15,78%), fueron los más afectados. La testosterona baja, ansiedad / depresión y convivencia en pareja mayor a 10 años, encabezan los principales factores asociados al deseo sexual hipoactivo. El hacer actividades juntos (OR: 0,44; IC95%: 0,34–0,68), el respeto a ser personas diferentes (OR: 0,53; IC95%: 0,41–0,71), mantener la armonía en la pareja (OR: 0,61; IC95%: 0,47–0,79) y la expresión de sentimientos a la pareja (OR: 0,68; IC95%: 0,46–0,95) constituyen una línea de protección para mejorar las estrategias de prevención de los trastornos sexuales en esa población.

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