scholarly journals Antipsychotic Drugs or Benzodiazepines for Rapid Tranquilization in Mental Health Facilities or Emergency Department Settings

2021 ◽  
Vol 1 (8) ◽  
Author(s):  
Gabrielle Brankston ◽  
Lory Picheca
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Observational Studies ◽  
Antipsychotic Drugs ◽  
Alcohol Intoxication ◽  
Similar Efficacy ◽  
Efficacy And Safety ◽  
Comparative Efficacy ◽  
Randomized Controlled ◽  
Inpatient Settings

Evidence from 5 systematic reviews, 3 randomized controlled trials, and 4 observational studies provide inconsistent evidence regarding the comparative efficacy and safety of antipsychotic drugs and benzodiazepines for adults with acute aggression or agitation requiring rapid tranquilization in emergency department or mental health inpatient settings. Overall, the evidence came from low- to moderate-quality studies. Some studies suggested different antipsychotic drugs and benzodiazepines, alone or in combination, have similar efficacy, whereas others favoured one treatment over another. No studies differentiated between adults aged 18 to 64 years and those older than 65 years. Most studies included mixed ages or excluded patients older than 75 years. No studies differentiated between aggression or agitation associated with psychiatric illness and other etiologies such as alcohol intoxication. One guideline suggests initial treatment with intramuscular lorazepam, promethazine, or 1 of aripiprazole, droperidol, or olanzapine. If the desired outcome is not achieved with monotherapy, the guideline recommends an intramuscular combination of either promethazine plus haloperidol or lorazepam plus haloperidol.

scholarly journals Efficacy and safety of platinum chain and gold weight implants for paralytic lagophthalmos: a systematic review

2021 ◽  
Vol 30 (2) ◽  
pp. 106-15
Author(s):  
Yunia Irawati ◽  
Tjahjono Darminto Gondhowiardjo ◽  
Hardyanto Soebono
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Observational Studies ◽  
Similar Efficacy ◽  
Google Scholar ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Gold Weight ◽  
Platinum Chain

BACKGROUND Surgery has been proposed as a treatment of paralytic lagophthalmos. However, no consensus has been reached on the best treatment. This study was aimed to investigate the efficacy and safety between platinum chain and gold weight implants to treat paralytic lagophthalmos. METHODS This study used all randomized controlled trials or observational studies (prospective or retrospective) using platinum chain and gold weight implants for paralytic lagophthalmos surgery that were published from 1990 to 2020 in the PubMed, Cochrane, and Google Scholar databases. Efficacy was indicated by the reduction of ≥3 in lagophthalmos, and safety was measured based on complications after surgery. RESULTS The efficacy of platinum chain and gold weight implants were 60–100% and 10–93.6%, respectively. The complications of platinum chain implant were 0–2.9% of extrusion and 0–3.3% of migration. However, gold weight implant had 0–13.3% of migration. CONCLUSIONS Both platinum chain and gold weight implants have similar efficacy to treat paralytic lagophthalmos. However, gold weight implant has a higher rate of complication.

scholarly journals Lantox—The Chinese Botulinum Toxin Drug—Complete English Bibliography and Comprehensive Formalised Literature Review

Toxins ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 370
Author(s):  
Dirk Dressler ◽  
Lizhen Pan ◽  
Junhui Su ◽  
Fei Teng ◽  
Lingjing Jin
Keyword(s):  
Literature Review ◽  
Observational Studies ◽  
Similar Efficacy ◽  
Conversion Ratio ◽  
Brand Names ◽  
Efficacy And Safety ◽  
Paper Citation ◽  
Safety Features ◽  
Randomised Controlled ◽  
Nose And Throat

In 1997, lanbotulinumtoxinA (LAN) was introduced in China. It is now available in Asia, Latin America and Eastern Europe under various brand names including Hengli®, Lantox®, Prosigne®, Lanzox®, Redux®, Liftox®, HBTX-A and CBTX-A. The literature on LAN is mostly published in Chinese language, restricting its international accessibility. We, therefore, wanted to generate a complete English bibliography of all LAN publications and then use it for a comprehensive formalised literature review. Altogether, 379 LAN publications (322 in Chinese and 57 in English) were retrieved from PubMed and Science and Technology Paper Citation Database. Indications covered are motor (257), glandular (16), pain (32) and aesthetics (48). Topics are neurological (250), aesthetic (48), paediatric (38), ophthalmological (18), urological (9), methodological (6), gastroenterological (5), ear, nose and throat (4) and surgical (1). Seventy-one publications are randomised controlled trials, forty-one publications are interventional studies and observational studies, fifteen publications are case studies, eighteen publications are reviews, and two publications are guidelines. LAN publications cover all relevant topics of BT therapy throughout a period of more than 20 years. This constitutes a publication basis resembling those of other BT drugs. None of the LAN publications presents data contradictory to those generated with other BT type-A drugs. LAN seems to have a similar efficacy and safety features when compared to onabotulinumtoxinA using a 1:1 LAN– onabotulinumtoxinA conversion ratio. Large controlled multicentre studies will become necessary for LAN’s registrations in Europe and North America.

scholarly journals Oral dexamethasone for the prevention of acute migraine recurrence in pediatric patients presenting to the emergency department with migraine

2018 ◽  
Vol 1 ◽  
pp. 251581631880415
Author(s):  
Serena L Orr ◽  
Lawrence Richer ◽  
Nick Barrowman ◽  
Roger Zemek
Keyword(s):  
Emergency Department ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Recruitment Rate ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Oral Dexamethasone ◽  
Safety Outcomes

Objective: To assess the feasibility of a randomized controlled trial protocol that aims to determine the efficacy and safety of oral dexamethasone compared to placebo for the prevention of migraine recurrence in children and adolescents visiting the pediatric emergency department (ED) with migraine. Methods: This study was a two-arm, parallel-group, randomized, placebo-controlled, double-blind pilot trial of patients presenting to the pediatric ED with migraine. Eligible participants were randomized at 1:1 ratio to receive either oral dexamethasone 0.6 mg/kg (maximum 15 mg) or matched placebo as a single dose. Efficacy and safety outcomes were assessed at discharge, 48 h and 7 days after discharge. The primary outcome of the trial was feasibility and was assessed through participant recruitment rate, follow-up completion rates, participant satisfaction ratings and comparison of enrolled versus non-enrolled participants. Efficacy and safety outcomes were not analyzed given that this was a pilot study. Results: Twelve participants were enrolled over the 6-month recruitment period. This represents 60% of the planned sample size and a 10.5% recruitment rate. No other feasibility issues were identified and patients expressed high satisfaction rates with their treatment: 90.9% were satisfied with their treatment at discharge and at 48-h follow-up and 81.8% were satisfied with their treatment at 7-day follow-up (81.8%). There were no significant differences observed when comparing enrolled participants to those not enrolled. Conclusion: This pilot randomized controlled trial is the first to assess dexamethasone in the pediatric ED for the prevention of migraine recurrence. The protocol is feasible but recruitment in a single center was lower than expected. Future pediatric ED migraine studies may use innovative or pragmatic trial designs to maximize feasibility from a recruitment standpoint.

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