Background And Aims: Several drug combinations have been tried in patients with acyanotic congenital heart disease (ACHD) undergoing transcatheter device closure in the cardiac catheterisation laboratory (CCL). Adequate sedation, analgesia, akinesia, cardiorespiratory stability, and prompt recovery are key requirements. Ketamine with propofol is used for this purpose. Dexmedetomidine carries a shorter recovery time. This study compared dexmedetomidine-propofol (DP) with ketamine-propofol (KP) in patients in the CCL.
Methods: This was an open label randomised trial at a CCL over a 2-year period from August 2012 to August 2014. Fifty-six paediatric and 44 young adults with ACHD underwent device closure and were randomised to receive DP or KP. The primary outcome studied was time to regain full consciousness, airway and motor recovery.
Results: Baseline characteristics were similar in the study groups. In the DP arm as compared to the KP arm, the time to recovery of consciousness (mean ± SD) was significantly faster in both paediatric patients [30 ± 15 vs. 58 ± 13 min ( < 0.001)] and in young adult patients [22 ± 10 vs. 35 ± 12 min ( < 0.001)]. There was significantly faster motor recovery also (mean ± SD) [paediatric: 25 ± 05 vs. 40 ± 14 ( < 0.001); young adult: 10 ± 05 vs. 22 ± 10 min ( < 0.001)].
Conclusion: Procedural anaesthesia with DP in paediatric and young adult patients with ACHD undergoing device closure in the CCL resulted in faster recovery of consciousness and motor recovery compared to KP.
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http://dx.doi.org/10.4103/ija.IJA_692_17 | DOI Listing |
BMC Health Serv Res
January 2025
Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK.
Background: Given the increasing recognition of the value of greater integration of physical and mental health services for children and young people, we aimed to evaluate preferences among parents for the characteristics associated with integrated health service provision for two conditions (eating disorders, functional symptom disorders).
Methods: Two discrete choice experiments (DCEs) were conducted, using electronic surveys. Participants were adult parents of children and young people.
BMC Psychiatry
January 2025
MedaData, LLC, Rochester Hills, USA.
Background: Adults with ADHD benefit from treatment with extended-release (ER) formulations that provide symptom control for the entire day. Some patients are advised to supplement their extended-release medication with an immediate-release (IR) medication later in the day if they need to prolong its effects. Given that several FDA-approved ER formulations are available and many individual patient variables may affect efficacy, the purpose of this study was to identify reliable predictors of the tendency for patients to supplement their daily ER medication with an IR medication.
View Article and Find Full Text PDFImmun Ageing
January 2025
Institute for Behavioral Medicine Research, Ohio State University, 460 Medical Center Drive, Columbus, OH, 43210, USA.
Background: Obesity and metabolic syndrome are major public health concerns linked to cognitive decline with aging. Prior work from our lab has demonstrated that short-term high fat diet (HFD) rapidly impairs memory function via a neuroinflammatory mechanism. However, the degree to which these rapid inflammatory changes are unique to the brain is unknown.
View Article and Find Full Text PDFArch Bronconeumol
December 2024
State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; Guangzhou National Laboratory, Guangzhou, China. Electronic address:
Introduction: Previous studies have proposed forced expiratory volume in 0.5s (FEV) to determine health outcomes in infants and young children, but few studies exist in adults. This study aims to investigate the associations between FEV and all-cause mortality in adults.
View Article and Find Full Text PDFAlcohol Clin Exp Res (Hoboken)
January 2025
Department of Psychiatry, University of California San Diego Medical School, San Diego, California, USA.
Background: Preliminary evaluations of 212 drinking offspring from the San Diego Prospective Study (SDPD) indicated that over 50% developed alcohol use disorder (AUD) by their mid-20s. The present analysis evaluated if those findings remained robust when the group increased to 454 individuals, a sample size that facilitated a search for potential contributors to the high AUD prevalence.
Methods: Semistructured interviews were used to evaluate lifetime AUD diagnoses in 224 daughters and 230 sons from the SDPS (N = 454) by mean age 26.
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