Reversal of sedation and respiratory depression after anaesthesia by the combined use of physostigmine and naloxone in neurosurgical patients

1986 ◽  
Vol 30 (5) ◽  
pp. 374-377 ◽  
Author(s):  
L. Wiklund
Keyword(s):  
Respiratory Depression ◽  
Combined Use ◽  
Neurosurgical Patients

scholarly journals Neurorehabilitation in cognitive disorders in patients with neurosurgical brain pathology

2020 ◽  
Vol 7 (3) ◽  
pp. 5-13
Author(s):  
N. E. Ivanova ◽  
M. Y. Efimova ◽  
T. M. Alekseeva ◽  
M. L. Pospelova ◽  
A. S. Lepekhina
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Rehabilitation ◽  
Nervous Activity ◽  
Cognitive Disorders ◽  
Modern Medicine ◽  
Brain Pathology ◽  
Combined Use ◽  
Neurosurgical Patients ◽  
Design And Methods ◽  
Cortical Functions

Background. Neurosurgical pathology of the brain is an urgent problem of modern medicine. Existing models of cognitive rehabilitation are based on neuropsychological correction. The literature does not contain enough information about the effect of medical and physiotherapeutic techniques on higher nervous activity.Objective. To assess the effect of neurorehabilitation in cognitive impairment in patients with neurosurgical brain pathology.Design and methods. The dynamics of cognitive impairment was studied in 165 neurosurgical patients (72 men, 93 women, average age 52.82 ± 14.79 years) at the second stage of rehabilitation. The severity of the deficit of higher cortical functions was assessed upon admission and after 30 days in the rehabilitation department. Roschina test, MMSE, FAB, HDRS were used to detect depression.Results. When analyzing the dynamics of indicators for scoring higher cortical functions, it was found that in all groups of patients, cognitive rehabilitation led to positive results.Conclusion. The combined use of neuropsychological, medical and physiotherapeutic techniques can significantly improve the results of rehabilitation treatment.

scholarly journals Opioid toxicity due to CNS depressant polypharmacy: A case report

2021 ◽  
Vol 11 (2) ◽  
pp. 70-74
Author(s):  
Christine Lee ◽  
Annabelle Wanson ◽  
Sarah Frangou ◽  
David Chong ◽  
Katelyn Halpape
Keyword(s):  
Respiratory Depression ◽  
Opioid Use Disorder ◽  
Careful Consideration ◽  
Patient Specific ◽  
Chronic Obstructive ◽  
Opioid Use ◽  
Obstructive Pulmonary Disease ◽  
Cns Depressant ◽  
Combined Use ◽  
Specific Factors

Abstract The interaction between methadone and central nervous system depressants can cause serious adverse effects, including profound sedation, respiratory depression, coma, and death. This poses a challenge in the treatment of patients with concurrent psychiatric and substance use disorders as the combined use is often unavoidable. We report a case of a patient with opioid use disorder, mood disorder unspecified, chronic pain, and chronic obstructive pulmonary disease who experienced 2 serious episodes of CNS and respiratory depression due to polypharmacy-induced opioid toxicity. Careful consideration of pharmacokinetics, pharmacodynamics, and patient-specific factors was imperative to identify the suspected contributing medications: methadone, lorazepam, divalproex, gabapentin, and cyclobenzaprine. Cognitive and system factors that contributed to these adverse events and strategies to mitigate risk of recurrence were also identified.

scholarly journals Medical case management after laminectomy or craniotomy: do all patients benefit from admission to the intensive care unit?

1998 ◽  
Vol 5 (2) ◽  
pp. E6 ◽  
Author(s):  
James A. Nitahara ◽  
Malou Valencia ◽  
Michael A. Bronstein
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Care ◽  
Severity Of Illness ◽  
Prognostic System ◽  
Effectiveness Analysis ◽  
Combined Use ◽  
Neurosurgical Patients ◽  
Spinal Cord Surgery ◽  
Step Down

To define severity of illness to identify most effectively patients for whom admission to the intensive care unit (ICU) is unnecessary, the authors performed a retrospective cost-effectiveness analysis. The authors studied the records of 113 patients who were admitted to the ICU after undergoing laminectomy (or other spinal cord surgery) or craniotomy for removal of neoplasm; the Acute Physiology and Chronic Health Evaluation III prognostic system had identified these patients as having a 10% or less risk of requiring intervention while in the ICU. No patient required active intervention during a mean stay of 3.26 days in the ICU. Combined use of a “step-down” postoperative care unit and ICU can optimize allocation of medical resources while providing high-quality care for some neurosurgical patients who are at low risk of requiring postoperative intervention.

TRACHEOSTOMY IN CRITICALLY ILL NEUROSURGICAL PATIENTS

2001 ◽  
Vol 5 (1) ◽  
pp. A5-A5
Author(s):  
Keith Y.C. Goh ◽  
Wendy Teoh ◽  
Chumpon Chan
Keyword(s):  
Critically Ill ◽  
Neurosurgical Patients

Platelet monitoring for PCI

2009 ◽  
Vol 29 (04) ◽  
pp. 376-380 ◽  
Author(s):  
D. Capodanno ◽  
D. J. Angiolillo
Keyword(s):  
Interindividual Variability ◽  
State Of The Art ◽  
Coronary Intervention ◽  
Functional Tests ◽  
Treatment Regimens ◽  
Advantages And Disadvantages ◽  
Coronary Syndrome ◽  
Combined Use ◽  
Increased Risk ◽  
Percutaneous Coronary

SummaryDespite the clinical benefit associated with the combined use of aspirin and clopidogrel in patients with acute coronary syndrome or those undergoing percutaneous coronary intervention, a considerable interindividual variability in response to these drugs have been consistently reported. There is a growing interest on applying platelet functional tests with the goal of identifying patients at increased risk of recurrent ischaemic events and potentially tailoring antiplatelet treatment regimens.This manuscript will review the state of the art on the most commonly available platelet functional tests, describing their advantages and disadvantages and exploring their applicability in clinical practice.

201Tl Scintigraphy in the Evaluation of Palpable and Nonpalpable Breast Lesions: Correlation with Mammography and Ultrasonography

1997 ◽  
Vol 36 (08) ◽  
pp. 282-288 ◽  
Author(s):  
T. Atasever ◽  
A. Özdemir ◽  
I. Öznur ◽  
N. I. Karabacak ◽  
N. Gökçora ◽  
...  
Keyword(s):  
Final Diagnosis ◽  
Lower Sensitivity ◽  
Breast Lesions ◽  
Breast Cancers ◽  
Combined Use ◽  
Malignant Breast ◽  
Malignant Lesions ◽  
Benign Breast Lesions ◽  
Palpable Breast ◽  
Metastatic Sites

Summary Aim: Our goal was to determine the clinical usefulness of TI-201 to identify breast cancer in patients with suspicious breast lesions on clinical examination, and/or abnormal radiologic (mammography and/or ultrasonography) findings. Methods: TI-201 scintigraphy were performed in sixty-eight patients with 70 breast abnormalities (51 palpable, 19 nonpalpable) and compared with mammography and ultrasonography (US). Early (15 min) and late (3 h) images of the breasts were obtained following the injection of 111 MBq (3 mCi) of TI-201. Visual and semiquantitative interpretation was performed. Results: Final diagnosis confirmed 52 malignant breast lesions and 18 benign conditions. TI-201 visualized 47 of 52 (90%) overall malignant lesions. Thirty-eight of 40 (95%) palpable and 9 of 12 (75%) nonpalpable breast cancers were detected by TI-201 scintigraphy. The smallest mass lesion detected by TI-201 measured 1.5x1.0 cm. Eleven breast lesions were interpreted as indeterminate by mammography and/or sonography. TI-201 scintigraphy excluded malignancy in 7 of 8 (88%) patients with benign breast lesions interpreted as indeterminate. Five of the 18 (28%) benign breast lesions showed TI-201 uptake. None of the fibroadenoma and fibrocystic changes accumulated TI-201. TI-201 scintigraphy, mammography and ultrasonography showed 90%, 92%, 85% overall sensitivity and 72%, 56%, 61% overall specificity respectively. Twenty-one of the 28 (75%) axillary nodal metastatic sites were also detected by TI-201. In malignant and benign lesions, early and late lesion/contralateral normal side (L/N) ratios were 1.58 ± 0.38 (mean ± SD) and 1.48 ± 0.32 (p >0.05), 1.87 ± 0.65 and 1.34 ± 0.20 (p<0.05) respectively. The mean early and late L/N ratios of malignant and benign groups did not show statistical difference (p>0.05). Conclusion: Overall, TI-201 scintigraphy was the most specific of the three methods and yielded favourable results in palpable breast cancers, while it showed lower sensitivity in nonpalpable cancers and axillary metastases. Combined use of TI-201 scintigraphy with mammography and US seems to be useful in difficult cases, such as dense breasts and indeterminate breast lesions.

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