Superiority of split dose midazolam as conscious sedation for outpatient colonoscopy.

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Lee, Hyuk; Kim, Jeong Hwan

2009-08-14

To elucidate the efficacy and safety of a split dose of midazolam in combination with meperidine for colonoscopy. Eighty subjects undergoing outpatient colonoscopy were randomly assigned to group A or B. Group A (n = 40) received a split dose of midazolam in combination with meperidine. Group B (n = 40) received a single dose of midazolam in combination with meperidine. Outcome measurements were level of sedation, duration of sedation and recovery, degree of pain and satisfaction, procedure-related memory, controllability, and adverse events. Group A had a lower frequency of significant hypoxemia (P = 0.043) and a higher sedation score on withdrawal of the endoscope from the descending colon than group B (P = 0.043). Group B recovered from sedation slightly sooner than group A (P memory, except insertion-related memory, were lower in group A one week after colonoscopic examination (P = 0.018 and P sedation status during colonoscopic examination and a reduction in procedure-related pain and memory, but resulted in longer recovery time.

[No inhibition of intestinal motility following ketamine-midazolam anesthesia. A comparison of anesthesia with enflurane and fentanyl/midazolam].

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Freye, E; Knüfermann, V

1994-02-01

Postoperative intestinal atonia is a complication which is likely to occur in patients predisposed for constipation and in patients after intra-abdominal operations. The postoperative delay of bowel movement, however, is often also related to the type of anaesthesia being used. In order to evaluate the magnitude of an anaesthetic-induced postoperative delay of bowel movement, two types of intravenous-based anaesthesia using fentanyl/midazolam (1 mg/25 mg; dosage 0.1 ml/kg/h), and ketamine/midazolam (250 mg/25 mg; dosage 0.1 ml/kg/h) respectively were compared with a volatile anaesthetic technique (enflurane; mean concentration 1.5 vol%). METHODS. In three groups of patients (each n = 15) undergoing elective surgery of the lower extremities, induction of anaesthesia was accomplished with methohexital (1-1.5 mg/kg) to facilitate intubation. For the maintenance of muscle relaxation vecuronium bromide was used. All patients were given droperidol to prevent postoperative emesis, and they were artificially ventilated with N2O/O2 (60:40) to normal end-expiratory CO2 concentrations. No anticholinergic agents were used at the end of operation since they are known to interfere with bowel motility. In order to determine gastro-intestinal motility, the H2 exhalation test was used. For this purpose 40 g lactulose in 100 ml of water was given to all patients via a gastral tube shortly before extubation. Lactulose is broken down by bacteria once it enters the colon, and H2 is released, taken up by the vascular system and exhaled. Postoperatively, patients were asked to exhale into a 20-ml syringe every 10 min. The content was analysed for hydrogen (ppm), using an electrochemical sensor (GMI exhaled hydrogen monitor). From the time of lactulose instillation to a threefold increase in end-expiratory hydrogen concentration (compared to the preoperative value), gastro-coecal transit time was computed. RESULTS. All three groups of patients were comparable in age, height and body

Comparison of oral midazolam with a combination of oral midazolam and nitrous oxide-oxygen inhalation in the effectiveness of dental sedation for young children

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Al-Zahrani A

2009-03-01

Full Text Available Aim: To compare the effectiveness of 0.6 mg/kg oral midazolam sedation alone and a combination of 0.6 mg/kg oral midazolam plus nitrous oxide-oxygen inhalation sedation, in controlling the behavior of uncooperative children during dental treatment. Study Design: The study had a crossover design where the same patient received two different sedation regimens, that is, oral midazolam 0.6 mg/kg and oral midazolam 0.6 mg/kg with nitrous oxide-oxygen inhalation during two dental treatment visits. Materials and Methods: Thirty children (17 males and 13 females were randomly selected for the study, with a mean age of 55.07 (± 9.29 months, ranging from 48 - 72 months. A scoring system suggested by Houpt et al. (1985 was utilized for assessment of the children′s behavior. Results : There was no significant (p > 0.05 difference in the overall behavior assessment between the two sedation regimens, that is, oral midazolam alone and oral midazolam plus nitrous oxide-oxygen. However, the combination of midazolam and nitrous oxide-oxygen showed significantly (p < 0.05 superior results as compared to midazolam alone, in terms of controlling movement and crying during local anesthesia administration and restorative procedures. Conclusion: Compared to oral midazolam alone, a combination of oral midazolam and nitrous oxide inhalation sedation appears to provide more comfort to pediatric dental patients and operators during critical stages of dental treatment.

Allosteric activation of cytochrome P450 3A4 by efavirenz facilitates midazolam binding.

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Ichikawa, Tomohiko; Tsujino, Hirofumi; Miki, Takahiro; Kobayashi, Masaya; Matsubara, Chiaki; Miyata, Sara; Yamashita, Taku; Takeshita, Kohei; Yonezawa, Yasushige; Uno, Tadayuki

2017-12-18

1. The purpose of this study is to investigate the heteroactivation mechanism of CYP3A4 by efavirenz, which enhances metabolism of midazolam in vivo, in terms of its binding to CYP3A4 with in vitro spectroscopic methods. 2. Efavirenz exhibited a type II spectral change with binding to CYP3A4 indicating a possible inhibitor. Although dissociation constant (K d ) was approximated as 520 μM, efavirenz enhanced binding affinity of midazolam as a co-existing drug with an estimated iK d value of 5.6 µM which is comparable to a clinical concentration. 3. Efavirenz stimulated the formation of 1'-hydroxymidazolam, and the product formation rate (V max ) concentration-dependently increased without changing the K m . Besides, an efavirenz analogue, [6-chloro-1,4-dihydro-4-(1-pentynyl)-4-(trifluoromethyl)-2H-3,1-benzoxazin-2-one] (efavirenz impurity) slightly facilitated the binding affinity of midazolam in a concentration-dependent manner. These results propose that efavirenz affects midazolam-binding via binding to the peripheral site which is apart from the active site of CYP3A4. 4. A molecular dynamics simulation also suggested the bound-efavirenz was repositioned to effector-binding site. As a consequence, our spectroscopic studies clarified the heteroactivation of CYP3A4 caused by efavirenz with a proper affinity to the peripheral site, and we concluded the method can be a useful tool for characterising the potential for drug-drug interactions.

Intra-operative Patient-Controlled Sedation (PCS:Propofol versus Midazolam Supplementation During Epidural Analgesia (Clinical and Hormonal Study

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Hassan S Al-khayat

2008-01-01

Full Text Available This study was done on sixty adult males scheduled to have an epidural analgesia for elective inguinal hernia repair. The study was designed to compare propofol and midazolam with regard to their suitability for the patient-controlled sedation (PCS technique during epidural analgesia. Patients were divided into three equal groups and premedicated with 0.2mg.kg -1 oral midazolam. Group I (G1 served as control. Using PCS technique, the pump was programmed to deliver on demand a bolus dose of 0.5 mg.kg- 1 of propofol in Group II (G2 or 0.1mg.kg -1 midazolam in Group III(G3. Patient′s sedation status was assessed by sedation score, comfort scale and by psychometric testing. The total delivered dose of each tested drug was calculated. Serum concentrations of propfol and midazolam, plasma cortisol and free fatty acids were measured. Propofol and midazolam PCS technique produced excellent and easily controllable sedation. The dose needed to produce steady state sedation was 2.8±1.42 and 0.11±0.6 mg.kg -1 .h- 1 for propofol and midazolam respectively. Propofol was more suitable than midazolam for PCS because of its rapid onset, favorable recovery profile and low side effects. PCS proved to be a stress-free and acceptable technique.

Interaction between repeated restraint stress and concomitant midazolam administration on sweet food ingestion in rats

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Silveira P.P.

2000-01-01

Full Text Available Emotional changes can influence feeding behavior. Previous studies have shown that chronically stressed animals present increased ingestion of sweet food, an effect reversed by a single dose of diazepam administered before testing the animals. The aim of the present study was to evaluate the response of animals chronically treated with midazolam and/or submitted to repeated restraint stress upon the ingestion of sweet food. Male adult Wistar rats were divided into two groups: controls and exposed to restraint 1 h/day, 5 days/week for 40 days. Both groups were subdivided into two other groups treated or not with midazolam (0.06 mg/ml in their drinking water during the 40-day treatment. The animals were placed in a lighted area in the presence of 10 pellets of sweet food (Froot loops®. The number of ingested pellets was measured during a period of 3 min, in the presence or absence of fasting. The group chronically treated with midazolam alone presented increased ingestion when compared to control animals (control group: 2.0 ± 0.44 pellets and midazolam group: 3.60 ± 0.57 pellets. The group submitted to restraint stress presented an increased ingestion compared to controls (control group: 2.0 ± 0.44 pellets and stressed group: 4.18 ± 0.58 pellets. Chronically administered midazolam reduced the ingestion in stressed animals (stressed/water group: 4.18 ± 0.58 pellets; stressed/midazolam group: 3.2 ± 0.49 pellets. Thus, repeated stress increases appetite for sweet food independently of hunger and chronic administration of midazolam can decrease this behavioral effect.

Administration order of midazolam/fentanyl for moderate dental sedation.

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Lobb, Douglas; Clarke, Alix; Lai, Hollis

2018-02-01

The purpose of this study is to investigate the effects of administration order when a sedative drug (midazolam) and an opioid analgesic drug (fentanyl) is applied for moderate intravenous (IV) sedation in dentistry. A retrospective chart review was conducted in one dental clinic during its transition from a midazolam-first to a fentanyl-first protocol for dental procedures requiring moderate IV sedation. Physiological parameters, drug administration times, patient recovery times, drug dosages, and patient recall and satisfaction were investigated for differences. A total of 76 charts (40 midazolam-first and 36 fentanyl-first administrations), were used in the analysis. Administering midazolam first resulted in an average 4.38 min (52%) decrease in administration times (P 0.05). Oxygen saturation levels did not drop below 90% for either group; however, 5 cases in the fentanyl-first group fell to between 90% and 92%, compared with 0 cases in the midazolam-first group. The administration order of fentanyl and midazolam may have different effects on patients and the sedation procedure. Findings from this study should be used to facilitate discussion among dental practitioners and to guide additional research investigating this topic.

Effect of midazolam versus propofol sedation on markers of neurological injury and outcome after isolated severe head injury: a pilot study.

LENUS (Irish Health Repository)

Ghori, Kamran A

2012-02-03

BACKGROUND: Midazolam and propofol are sedative agents commonly administered to patients with brain injury. We compared plasma concentrations of glial cell S100beta protein and nitric oxide (NO) between patients who received midazolam and those who received propofol sedation after severe brain injury, and investigated the association between S100beta and NO concentrations and neurological outcome. DESIGN: 28 patients with severe head injury (Glasgow Coma Score <9) who required sedation and ventilation were randomly assigned to receive midazolam (n =15) or propofol (n = 13) based sedation. Blood samples were drawn daily for 5 days for estimation of S100beta and NO concentrations. Neurological outcome was assessed 3 months later as good (Glasgow Outcome Score [GOS], 4-5) or poor (GOS, 1-3). RESULTS: A good neurological outcome was observed in 8\\/15 patients (53%) in the midazolam group and 7\\/13 patients (54%) in the propofol group. Patients with a poor outcome had higher serum S100beta concentrations on ICU admission and on Days 1-4 in the ICU than those with a good outcome (mean [SD] on Day 1, 0.99 [0.81] v 0.41 [0.4] microg\\/L; Day 2, 0.80 [0.81] v 0.41 [0.24] microg\\/L; Day 3, 0.52 [0.55] v 0.24 [0.25] microg\\/L; and Day 4, 0.54 [0.43] v 0.24 [0.35] microg\\/L; P<0.05). There was no significant difference on Day 5. Plasma NO concentrations were not associated with outcome. In subgroup analysis, there was no difference in S100beta and NO concentrations between patients with a good outcome versus those with a poor outcome in either the midazolam or propofol group. CONCLUSIONS: Plasma concentrations of markers of neurological injury in patients with severe head injury were similar in those who received midazolam sedation and those who received propofol. Patients who had a poor neurological outcome at 3 months had consistently higher serum S100beta concentrations during the initial 4 days after injury than patients who had a good outcome.

Role of neurosteroids in the anticonvulsant activity of midazolam.

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Dhir, Ashish; Rogawski, Michael A

2012-04-01

Midazolam is a short-acting benzodiazepine that is widely used as an i.v. sedative and anticonvulsant. Besides interacting with the benzodiazepine site associated with GABA(A) receptors, some benzodiazepines act as agonists of translocator protein (18 kDa) (TSPO) to enhance the synthesis of steroids, including neurosteroids with positive modulatory actions on GABA(A) receptors. We sought to determine if neurosteroidogenesis induced by midazolam contributes to its anticonvulsant action. Mice were pretreated with neurosteroid synthesis inhibitors and potentiators followed by midazolam or clonazepam, a weak TSPO ligand. Anticonvulsant activity was assessed with the i.v. pentylenetetrazol (PTZ) threshold test. Midazolam (500-5000 µg·kg(-1) , i.p.) caused a dose-dependent increase in seizure threshold. Pretreatment with the neurosteroid synthesis inhibitors finasteride, a 5α-reductase inhibitor, and a functional TSPO antagonist PK 11195, reduced the anticonvulsant action of midazolam. The anticonvulsant action of midazolam was enhanced by the neurosteroidogenic drug metyrapone, an 11β-hydroxylase inhibitor. In contrast, the anticonvulsant action of clonazepam (100 µg·kg(-1) ) was reduced by finasteride but not by PK 11195, indicating a possible contribution of neurosteroids unrelated to TSPO. Enhanced endogenous neurosteroid synthesis, possibly mediated by an interaction with TSPO, contributed to the anticonvulsant action of midazolam. Enhanced neurosteroidogenesis may also be a factor in the actions of other benzodiazepines, even those that only weakly interact with TSPO. © 2011 The Authors. British Journal of Pharmacology © 2011 The British Pharmacological Society.

Effect of midazolam on memory during fiberoptic gastroscopy under conscious sedation.

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Hong, Yun Jeong; Jang, Eun Hye; Hwang, Jihye; Roh, Jee Hoon; Kwon, Miseon; Lee, Don; Lee, Jae-Hong

2015-01-01

As the fiberoptic gastroscopy using midazolam is being in widespread use, the exact nature of midazolam on memory should be clarified. We intended to examine whether midazolam causes selective anterograde amnesia and what impact it has on other aspects of memory and general cognitive function. We recruited healthy subjects undergoing fiberoptic gastroscopy under conscious sedation. At baseline, history taking for retrograde amnesia and the Korean version of the Montreal Cognitive Assessment were performed. A man's name and address were given immediately after intravenous midazolam administration. After gastroscopy, the subjects were asked to recall those items. By the time they had fully recovered consciousness, the same test was repeated along with the Korean version of the Montreal Cognitive Assessment and a test for retrograde amnesia. A total of 30 subjects were enrolled in this study. Subjects with high-dose midazolam showed lower scores in the immediate and delayed recall of "a man's name and address" compared with those with low-dose midazolam. The midazolam dose was inversely correlated with the delayed recall scores of "a man's name and address." On full recovery of consciousness, the subjects did not exhibit any of anterograde or retrograde amnesia. These findings suggest that midazolam causes transient selective anterograde amnesia in a dose-dependent manner.

Midazolam inhibits chondrogenesis via peripheral benzodiazepine receptor in human mesenchymal stem cells.

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Chen, Yung-Ching; Wu, King-Chuen; Huang, Bu-Miin; So, Edmund Cheung; Wang, Yang-Kao

2018-05-01

Midazolam, a benzodiazepine derivative, is widely used for sedation and surgery. However, previous studies have demonstrated that Midazolam is associated with increased risks of congenital malformations, such as dwarfism, when used during early pregnancy. Recent studies have also demonstrated that Midazolam suppresses osteogenesis of mesenchymal stem cells (MSCs). Given that hypertrophic chondrocytes can differentiate into osteoblast and osteocytes and contribute to endochondral bone formation, the effect of Midazolam on chondrogenesis remains unclear. In this study, we applied a human MSC line, the KP cell, to serve as an in vitro model to study the effect of Midazolam on chondrogenesis. We first successfully established an in vitro chondrogenic model in a micromass culture or a 2D high-density culture performed with TGF-β-driven chondrogenic induction medium. Treatment of the Midazolam dose-dependently inhibited chondrogenesis, examined using Alcian blue-stained glycosaminoglycans and the expression of chondrogenic markers, such as SOX9 and type II collagen. Inhibition of Midazolam by peripheral benzodiazepine receptor (PBR) antagonist PK11195 or small interfering RNA rescued the inhibitory effects of Midazolam on chondrogenesis. In addition, Midazolam suppressed transforming growth factor-β-induced Smad3 phosphorylation, and this inhibitory effect could be rescued using PBR antagonist PK11195. This study provides a possible explanation for Midazolam-induced congenital malformations of the musculoskeletal system through PBR. © 2018 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

Rectal premedication in pediatric anesthesia: midazolam versus ketamine

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Moshirian N

2008-06-01

Full Text Available Background: Premedication is widely used in pediatric anesthesia to reduce emotional trauma and ensure smooth induction. The rectal route is one of the most commonly accepted means of drug administration. The aim of our study was to investigate and compare the efficacy of rectally administered midazolam versus that of ketamine as a premedication in pediatric patients.Methods: We performed a prospective randomized double-blinded clinical trial in 64 children, 1 to 10 years of age, randomly allocated into two groups. The midazolam group received 0.5 mg/kg rectal midazolam and the ketamine group received 5 mg/kg rectal ketamine. The preoperative sedation scores were evaluated on a three-point scale. The anxiolysis and mask acceptance scores were evaluated separately on a four-point scale, with ease of parental separation, based on the presence or lack of crying, evaluated on a two-point scale. Results: Neither medication showed acceptable sedation (>75%, with no significant difference in sedation score between the two groups (P=0.725. Anxiolysis and mask acceptance using either midazolam or ketamine were acceptable, with  midazolam performing significantly better than ketamine (P=0.00 and P=0.042, respectively. Ease of parental separation was seen in both groups without significant difference (P=0.288 and no major adverse effects, such as apnea, occurred in either group.Conclusions: Rectal midazolam is more effective than ketamine in anxiolysis and mask acceptance. Although they both can ease separation anxiety in children before surgery, we found neither drug to be acceptable for sedation.

A comparison of the effects of propofol and midazolam on memory during two levels of sedation by using target-controlled infusion.

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de Roode, A; van Gerven, J M; Schoemaker, R C; Engbers, F H; Olieman, W; Kroon, J R; Cohen, A F; Bovill, J G

2000-11-01

We examined memory during sedation with target-controlled infusions of propofol and midazolam in a double-blinded five-way, cross-over study in 10 volunteers. Each active drug infusion was targeted to sedation level 1 (asleep) and level 4 (lethargic) as determined with the Observer Assessment of Alertness/Sedation scale. At the target level of sedation, drug concentration was clamped for 30 min, during which time neutral words were presented. After 2 h, explicit memory was assessed by recall, and implicit memory by using a wordstem completion test. Venous drug concentrations (mean +/- SD) were 1350 ng/mL (+/-332 ng/mL) for propofol and 208 ng/mL (+/-112 ng/mL) for midazolam during Observer Assessment of Alertness/Sedation scale level 4; and 1620 ng/mL (+/-357 ng/mL) and 249 ng/mL (+/-82 ng/mL) respectively during level 1. The wordstem completion test frequencies at low level sedation were significantly higher than spontaneous frequencies (8.7% + 2.4%; P: sedation were accompanied by small differences in venous propofol or midazolam concentrations. This indicates steep concentration-effect relationships. Neutral information is still memorized during low-level sedation with both drugs. The memory effect of propofol and midazolam did not differ significantly. Implicit memory can occur during different states of consciousness and might lead to psychological damage. In 10 volunteers, implicit memory was investigated during sedation with propofol and midazolam in a double-blinded, placebo-controlled study. To compare the effects of both drugs, they were titrated using a computer-controlled infusion system to produce similar high and low levels of sedation.

Development of midazolam sublingual tablets: in vitro study.

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Odou, P; Barthelemy, C; Robert, H

1998-01-01

Midazolam is a benzodiazepine with short elimination half-life, used as induction or continuous agent for general anesthesia. At present, only injectable solution is available from French hospital pharmacies. The aim of the study is the development of 5 mg midazolam sublingual tablets to realize a short general anesthesia without intravenous or intramuscular injection. Incorporation of citric acid in the tablet formulation leads to an increase of dissolution rates of active drug, but a decrease of diffusion through lipid membranes is observed with 10 mg of citric acid when using the Dibbern's Resomat three phases apparatus. One explanation of this result is that midazolam (pKa = 6.1) in presence of 10 mg of citric acid is ionised. The ionised form, more hydrophilic, cannot cross the artificial lipid membrane and therefore the diffusion decreases. On the other hand, the decrease of diffusion's rate, when pH increases, is explained by the precipitation of midazolam at pH higher than 6. A compromise between dissolution and diffusion results leads us to choose the sublingual formulation containing 5 mg of citric acid per tablet.

Effect of methamphetamine on the pharmacokinetics of dextromethorphan and midazolam in rats.

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Dostalek, M; Hadasova, E; Hanesova, M; Pistovcakova, J; Sulcova, A; Jurica, J; Tomandl, J; Linhart, I

2005-01-01

Methamphetamine is the fourth most frequently reported compound associated with drug abuse on admission of patients to treatment centres after cocaine, heroin and marijuana. It is metabolized in the organism with a reaction that is catalyzed by cytochrome P450, mainly by the CYP2D and CYP3A subfamily, 4-hydroxyamphetamine and amphetamine being dominant metabolites. The present pharmacokinetic study was undertaken to investigate the possible influence of methamphetamine (10 mg/kg, i.p., once daily for six days) on the pharmacokinetics of dextromethorphane as a model substrate for rat cytochrome P-4502D2 and midazolam as a model substrate for CYP3A1/2. Animals received a single injection of dextromethorphane (10 mg/kg) or midazolam (5 mg/kg) in the tail vein 24 h after the last dose of methamphetamine or administration of placebo. The results of pharmacokinetic analysis showed a significantly increased rate of dextrorphane and 3-hydroxymorphinan formation, and a marked stimulatory effect of methamphetamine on CYP2D2 metabolic activity. Similarly, the kinetics of midazolam's metabolic conversion to hydroxy derivates of midazolam indicated a significant increase in CYP3A1/2 activity. The results showed that the administration of methamphetamine significantly stimulated the metabolic activity of CYP2D2 as well as that of CYP3A1/2. With regard to the high level of homology between human and rat CYP isoforms studied, the results may have a clinical impact on future pharmacotherapy for methamphetamine abuse.

Preemptive analgesic effects of midazolam and diclofenac in rat model

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Antigona Hasani

2011-05-01

Full Text Available The aim of the present study was to investigate the preemptive analgesic effects of intraperitoneally administrated midazolam and diclofenac, before acute and inflammatory induced pain in rat model.One hundred twenty-eight (n=8 in each group male Sprague Dawley rats were included in the study. Paw movements in response to thermal stimulation or paw flinching in response to formalin injection were compared after midazolam (0.1, 1, 5 and 10 mg/kg and diclofenac (10 mg/kg, intraperitoneal administration. Saline was used as a control.Preemptive analgesic effect was significant in both tests when diclofenac and midazolam was administrated before the pain stimuli (p<0.01 and p<0.001. Intraperitoneal injection of midazolam in doses 5 and 10 mg/kg, increase the response time in hot plate test and decrease the number of flinches in formalin test (p<0.01 vs. p<0.001. ED50 of midazolam (with diclofenac in hot plate test was 2.02 mg/kg (CI95% =-3.47-5.03 mg; and, 0.9 mg/kg (CI95% =-0.87-4.09 mg in phase I and 0.7 mg/kg (CI95% = 0.48-6.63 mg in phase II, in formalin test.Intraperitoneally administered midazolam and diclofenac had preemptive analgesic effects on acute thermal, and inflammatory induced pain in rats.

Changes to the bispectral index and regional cerebral blood flow in a sedative state, caused by midazolam administration

International Nuclear Information System (INIS)

Ikeda, Junko

2006-01-01

Psychosedation, as used in the field of dentistry, is intended to provide trouble-free dental care while maintaining a proper level of sedation. One drug used in psychosedation is midazolam, which is known to have a strong amnestic effect. In the current research, I sought to clarify whether the bispectral index (BIS) using electroencephalogram (EEG) analysis can be used for assessment of optimal sedation in psychosedation, and what effects midazolam has on the cerebrum's mechanism of memory. The subjects were 17 healthy adult volunteers. Intravenous sedation involved a single administration of 0.06 mg/kg midazolam, or 6 mg/kg/h propofol, administered for 5 minutes and then continuously administered for 25 minutes at 3 mg/kg/h. For nitrous oxide inhalation sedation, 10-30% nitrous oxide was used. Clinical sedation and the BIS were measured in a variety of circumstances. To examine the effects of midazolam on the central nervous system, changes in brain oxygen consumption in visual memory tasks were assessed through observing changes in areas of brain activation using 3T fMRI. With intravenous sedation using midazolam or propofol, the BIS decreased immediately after drug administration, and the BIS at which optimal sedation was clinically determined was about 65. In contrast, no decrease in the BIS was noted with nitrous oxide inhalation sedation. In observing areas of brain activation by fMRI, the oxygen consumption mainly of visual cortices in the occipital lobe increased as a result of stimulation by visual memory tasks. Regardless of the amnestic effect midazolam produced in subjects, it did not suppress activation of the visual cortices in the occipital lobe. In intravenous sedation using midazolam or propofol, the BIS is effective in determining optimal sedation, and appropriate perioperative management can be performed using the BIS. However, in nitrous oxide inhalation sedation it appears that the BIS cannot be used to monitor levels of sedation. Amnestic

Effects of midazolam and morphine on cerebral oxygenation and hemodynamics in ventilated premature infants.

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van Alfen-van der Velden, A A E M; Hopman, J C W; Klaessens, J H G M; Feuth, T; Sengers, R C A; Liem, K D

2006-01-01

Midazolam sedation and morphine analgesia are commonly used in ventilated premature infants. To evaluate the effects of midazolam versus morphine infusion on cerebral oxygenation and hemodynamics in ventilated premature infants. 11 patients (GA 26.6-33.0 weeks, BW 780-2,335 g) were sedated with midazolam (loading dose 0.2 mg/kg, maintenance 0.2 mg/kg/h) and 10 patients (GA 26.4-33.3 weeks, BW 842-1,955 g) were sedated with morphine (loading dose 0.05 mg/kg, maintenance 0.01 mg/kg/h). Changes in oxyhemoglobin (Delta cO2Hb) and deoxyhemoglobin (Delta cHHb) were assessed using near infrared spectrophotometry. Changes in cHbD (= Delta cO(2)Hb - Delta cHHb) reflect changes in cerebral blood oxygenation and changes in concentration of total hemoglobin (Delta ctHb = Delta cO2Hb + Delta cHHb) represent changes in cerebral blood volume (DeltaCBV). Changes in cerebral blood flow velocity (DeltaCBFV) were intermittently measured using Doppler ultrasound. Heart rate (HR), mean arterial blood pressure (MABP), arterial oxygen saturation (saO2) and transcutaneous measured pO2 (tcpO2) and pCO2 (tcpCO2) were continuously registered. Statistical analyses were carried out using linear mixed models to account for the longitudinal character study design. Within 15 min after the loading dose of midazolam, a decrease in saO2, tcpO2 and cHbD was observed in 5/11 infants. In addition, a fall in MABP and CBFV was observed 15 min after midazolam administration. Immediately after morphine infusion a decrease in saO2, tcpO2 and cHbD was observed in 6/10 infants. Furthermore, morphine infusion resulted in a persistent increase in CBV. Administration of midazolam and morphine in ventilated premature infants causes significant changes in cerebral oxygenation and hemodynamics, which might be harmful. Copyright 2006 S. Karger AG, Basel.

Two Oral Midazolam Preparations in Pediatric Dental Patients: A Prospective Randomised Clinical Trial

OpenAIRE

Katayoun Salem; Shaqayegh Kamranzadeh; Maryam Kousha; Shahnaz Shaeghi; Fatemeh AbdollahGorgi

2015-01-01

Pharmacological sedation is an alternative behavior management strategy in pediatric dentistry. The aim of this study was to compare the behavioral and physiologic effects of “commercially midazolam syrup” versus “orally administered IV midazolam dosage form (extemporaneous midazolam (EF))” in uncooperative pediatric dental patients. Eighty-eight children between 4 to 7 years of age received 0.2–0.5 mg/kg midazolam in this parallel trial. Physiologic parameters were recorded at baseline and e...

Can intravenous conscious sedation with midazolam be effective at facilitating surgical dentistry in adolescent orthodontic patients? A service evaluation.

Science.gov (United States)

Stamp, A J; Dorman, M L; Vernazza, C R; Deeming, G; Reid, C; Wilson, K E; Girdler, N M

2017-01-27

Background Surgical dentistry during orthodontic care often occurs in adolescence and may involve surgical removal or exposure of teeth. The invasive nature of treatment, combined with dental anxiety, means care can often be provided under general anaesthesia (GA). Best-practice guidelines however endorse conscious sedation as an alternative, where appropriate. Although a limited number of studies have shown safe and effective use of intravenous conscious sedation (IVCS) with midazolam in this cohort, robust evidence to support routine use is lacking. Aim To assess whether IVCS with midazolam can effectively facilitate surgical dentistry in adolescent orthodontic patients in primary care.Method A retrospective service evaluation was undertaken reviewing clinical records of adolescents (aged 12-15 years) undergoing surgical exposure and/or surgical removal of teeth under IVCS with midazolam.Results A total of 174 adolescents (mean age 14.2 years) attended for treatment between 2009 and 2015. Of these adolescents, 98.9% (N = 172) allowed cannulation, with all surgical dentistry completed during a single visit. Midazolam dose ranged from 2-7 mg with 79.1% of patients having good or excellent cooperation and three minor adverse events occurring.Conclusion This service evaluation shows IVCS with midazolam can effectively facilitate surgical orthodontics in carefully selected adolescents. There is however a distinct need to further explore potential for this technique to provide a viable alternative to GA.

Comparison of subcutaneous dexmedetomidine-midazolam versus alfaxalone-midazolam sedation in leopard geckos (Eublepharis macularius).

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Doss, Grayson A; Fink, Dustin M; Sladky, Kurt K; Mans, Christoph

2017-09-01

To compare dexmedetomidine-midazolam with alfaxalone-midazolam for sedation in leopard geckos (Eublepharis macularius). Prospective, randomized, blinded, complete crossover study. Nine healthy adult leopard geckos. Geckos were administered a combination of dexmedetomidine (0.1 mg kg -1 ) and midazolam (1.0 mg kg -1 ; treatment D-M) or alfaxalone (15 mg kg -1 ) and midazolam (1.0 mg kg -1 ; treatment A-M) subcutaneously craniodorsal to a thoracic limb. Heart rate (HR), respiratory rate (f R ), righting reflex, palpebral reflex, superficial and deep pain reflexes, jaw tone and escape response were assessed every 5 minutes until reversal. Conditions for intubation and response to needle prick were evaluated. Antagonist drugs [flumazenil (0.05 mg kg -1 ) ± atipamezole (1.0 mg kg -1 )] were administered subcutaneously, craniodorsal to the contralateral thoracic limb, 45 minutes after initial injection, and animals were monitored until recovery. HR, but not f R , decreased significantly over time in both treatments. HR was significantly lower than baseline at all time points in D-M and for all but the 5 and 10 minute time points in A-M. HR was significantly higher in A-M at all time points after drug administration when compared with D-M. Sedation scores between protocols were similar for most time points. All animals in A-M lost righting reflex compared with seven out of nine (78%) geckos in D-M. Geckos in A-M lost righting reflex for significantly longer time. Mean ± standard deviation time to recovery after antagonist administration was 6.1 ± 2.2 minutes for D-M and 56 ± 29 minutes for A-M, and these times were significantly different. Combination D-M or A-M provided sedation of a level expected to allow physical examinations and venipuncture in leopard geckos. A-M provided a faster onset of sedation compared with D-M. Recovery was significantly faster following antagonist reversal of D-M, compared with A-M. Copyright © 2017 Association of

Two Oral Midazolam Preparations in Pediatric Dental Patients: A Prospective Randomised Clinical Trial

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Katayoun Salem

2015-01-01

Full Text Available Pharmacological sedation is an alternative behavior management strategy in pediatric dentistry. The aim of this study was to compare the behavioral and physiologic effects of “commercially midazolam syrup” versus “orally administered IV midazolam dosage form (extemporaneous midazolam (EF” in uncooperative pediatric dental patients. Eighty-eight children between 4 to 7 years of age received 0.2–0.5 mg/kg midazolam in this parallel trial. Physiologic parameters were recorded at baseline and every 15 minutes. Behavior assessment was conducted objectively by Houpt scale throughout the sedation and North Carolina at baseline and during injection and cavity preparation. No significant difference in behavior was noted by Houpt or North Carolina scale. Acceptable behavior (excellent, very good, and good was observed in 90.9% of syrup and 79.5% of EF subjects, respectively. Physiological parameters remained in normal range without significant difference between groups and no adverse effect was observed. It is concluded that EF midazolam preparation can be used as an acceptable alternative to midazolam syrup.

Stability of Fentanyl Citrate, Hydromorphone Hydrochloride, Ketamine Hydrochloride, Midazolam, Morphine Sulfate, and Pentobarbital Sodium in Polypropylene Syringes

OpenAIRE

Anderson, Collin; MacKay, Mark

2015-01-01

Purpose: Determine the stability of fentanyl 10 mcg/mL in 0.9% sodium chloride, fentanyl 10 mcg/mL in 5% dextrose, fentanyl 50 mcg/mL, hydromorphone 100 mcg/mL in 0.9% sodium chloride, ketamine 10 mg/mL, midazolam 0.4 mg/mL in 5% dextrose, midazolam 5 mg/mL, morphine 1 mg/mL in 0.9% sodium chloride, morphine 1 mg/mL in 5% dextrose, and pentobarbital 50 mg/mL when stored as single drug entities at room temperature in polypropylene syringes. Methods: Four 5 mL samples of each drug and concentra...

Effect of midazolam on memory: a study of process dissociation procedure and functional magnetic resonance imaging.

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Tian, S Y; Zou, L; Quan, X; Zhang, Y; Xue, F S; Ye, T H

2010-06-01

To assess the effects of midazolam on explicit and implicit memories, 12 volunteers were randomly divided into the two groups: one with an Observer's Assessment of Alertness/Sedation score of 3 (mild sedation) and one with a score of 1 (deep sedation). Blood oxygen-level-dependent functional magnetic resonance imaging was measured before and during an auditory stimulus, then with midazolam sedation, and then during a second auditory stimulus with continuous midazolam sedation. After 4 h, explicit and implicit memories were assessed. There was no evidence of explicit memory at the two levels of midazolam sedation. Implicit memory was retained at a mild level of midazolam sedation but absent at a deep level of midazolam sedation. At a mild level of midazolam sedation, activation of all brain areas by auditory stimulus (as measured by functional magnetic resonance imaging) was uninhibited. However, a deep level of midazolam sedation depressed activation of the superior temporal gyrus by auditory stimulus. We conclude that midazolam does not abolish implicit memory at a mild sedation level, but can abolish both explicit and implicit memories at a deep sedation level. The superior temporal gyrus may be one of the target areas.

Epileptic manifestations induced by midazolam in the neonatal period Manifestações epilépticas induzidas por midazolam no período neonatal

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Maria Augusta Montenegro

2001-06-01

Full Text Available Antiepileptic drugs may cause worsening of epilepsy by aggravating pre-existing seizures or by triggering new seizure types. There are several reports of adverse effects related to midazolam, but only a few authors reported epileptic manifestations. We report four newborns seen at the Neonatal Intensive Care Unit of our University Hospital, who developed seizures a few seconds after the administration of midazolam. It is difficult to identify the patients at risk, but it is important to be aware and recognize this situation.Drogas antiepilépticas podem piorar o controle da epilepsia por agravar crises epilépticas pre-existentes ou por desencadear novos tipos de crises. Existem vários relatos de eventos adversos relacionados ao midazolam; entretanto, poucos autores referem manifestações epilépticas. Neste estudo relatamos a ocorrência de crises epilépticas poucos segundos após a administração de midazolam, em quatro neonatos atendidos na Unidade de Terapia Intensiva do nosso hospital universitário. É difícil determinar quais pacientes estão em risco, mas é importante estar atento e reconhecer esta situação.

A short-term high fat diet increases exposure to midazolam and omeprazole in healthy subjects

NARCIS (Netherlands)

Achterbergh, Roos; Lammers, Laureen A.; van Nierop, Samuel; Klümpen, Heinz-Josef; Soeters, Maarten R.; Mathôt, Ron A. A.; Romijn, Johannes A.

2016-01-01

Knowledge of factors contributing to variation in drug metabolism is of vital importance to optimize drug treatment. This study assesses the effects of a short-term hypercaloric high fat diet on metabolism of five oral drugs, which are each specific for a single P450 isoform: midazolam (CYP3A4),

Mechanism-based pharmacodynamic modeling of the interaction of midazolam, bretazenil, and zolpidem with ethanol.

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Tuk, Bert; van Gool, Toon; Danhof, Meindert

2002-06-01

The pharmacokinetic and pharmacodynamic interactions of ethanol with the full benzodiazepine agonist midazolam, the partial agonist bretazenil and the benzodiazepine BZ1 receptor subtype selective agonist zolpidem have been determined in the rat in vivo, using an integrated pharmacokinetic-pharmacodynamic approach. Ethanol was administered as a constant rate infusion resulting in constant plasma concentrations of 0.5 g/l. The pharmacokinetics and pharmacodynamics of midazolam, bretazenil, and zolpidem were determined following an intravenous infusion of 5.0, 2.5, and 18 mg/kg respectively. The amplitude in the 11.5-30 Hz frequency band of the EEG was used as measure of the pharmacological effect. For each of the benzodiazepines the concentration-EEG effect relationship could be described by the sigmoid Emax pharmacodynamic model. Significant differences in both EC50 and Emax were observed. The values of the EC50 were 76 +/- 11, 12 +/- 3, and 512 +/- 116 ng/ml for midazolam, bretazenil, and zolpidem respectively. The values of the Emax were 113 +/- 9, 44 +/- 3, and 175 +/- 10 microV/s. In the presence of ethanol the values of the EC50 of midazolam and zolpidem were reduced to approximately 50% of the original value. The values for Emax and Hill-factor were unchanged Due to a large interindividual variability no significant change in EC50 was observed for bretazenil. Analysis of the data on basis of a mechanism-based model showed only a decrease in the apparent affinity constant KPD for all three drugs, indicating that changes in EC50 can be explained entirely by a change in the apparent affinity constant KPD without concomitant changes in the efficacy parameter ePD and the stimulus-effect relationship. The findings of this study show that the pharmacodynamic interactions with a low dose of ethanol in vivo are qualitatively and quantitatively similar for benzodiazepine receptor full agonists, partial agonists, and benzodiazepine BZ1 receptor subtype selective

Sedation with midazolam for voiding cystourethrography in children: a randomised double-blind study

International Nuclear Information System (INIS)

Stokland, E.; Jacobsson, B.; Ljung, B.; Andreasson, S.; Jodal, U.

2003-01-01

Background: Sedation with midazolam facilitates the performance of diagnostic procedures in children, including voiding cystourethrography (VCUG). However, the influence of sedation on voiding and imaging results have not been adequately evaluated. Objective: Midazolam and placebo were compared to assess discomfort during VCUG and to evaluate if sedation influenced the outcome of the examination. Materials and methods: The study was prospective, randomized and double-blind, and included 95 children, 48 in the midazolam group (median age 2.2 years) and 47 in the placebo group (median age 3.2 years). The evaluation included the child's/parent's experience of the VCUG, as well as the examination results. Results: The children/parents in the midazolam group experienced the VCUG as less distressing compared to those in the placebo group (P < 0.001). Forty-six of 48 children sedated with midazolam could void during the imaging procedure compared to 38 of 47 children given placebo (NS). There was no difference in frequency or grade of vesicoureteric reflux or bladder emptying between the groups. Conclusions: When sedation is required to perform VCUG in children, midazolam can be used without negative effect on the outcome of the examination. (orig.)

The effects of concurrent atorvastatin therapy on the pharmacokinetics of intravenous midazolam.

LENUS (Irish Health Repository)

Mc Donnell, C G

2012-02-03

Midazolam is a commonly used anaesthetic agent and is metabolised by the 3A4 isoform of the cytochrome P450 enzyme system. Atorvastatin is also metabolised by cytochrome P450 3A4 and, in vitro, atorvastatin inhibits the cytochrome P450 3A4-mediated metabolism of mexazolam. We hypothesised that concurrent administration of atorvastatin and midazolam would result in altered midazolam pharmacokinetics. Fourteen patients scheduled to undergo general anaesthesia for elective surgery were recruited in a matched pair design to receive intravenous midazolam (0.15 mg.kg-1). Of these patients, seven were taking long-term atorvastatin. Atorvastatin patients demonstrated a greater area under the curve (889.4 (standard deviation 388.6) ng-h.ml-1) vs. control patients (629.1 (standard deviation 197.2) ng-h.ml-1) (p < 0.05). Patients taking atorvastatin also demonstrated a decreased clearance (0.18 (standard deviation 0.08) l-kg. h-1) vs. control patients (0.27 (standard deviation 0.08) l-kg.h-1) (p < 0.05). This study suggests that chronically administered atorvastatin decreases the clearance of intravenously administered midazolam.

INTRANASAL DEXMEDETOMIDINE VS. INTRANASAL MIDAZOLAM FOR PREMEDICATION OF PAEDIATRIC SURGERY PATIENTS

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Revi N

2016-06-01

Full Text Available AIM Preoperative anxiety is one of the most common problems faced by anyone practising paediatric anaesthesia. Various drugs have been used in various routes to get a calm but cooperative child before induction of anaesthesia. Midazolam and dexmedetomidine have already proved their value in paediatric premedication. This study was conducted to compare the effects of these two drugs given intranasally. MATERIALS AND METHODS 100 children falling under the inclusion criteria were assigned to groups of 50 each. They received either intranasal midazolam 0.2 mg/kg (group M or intranasal dexmedetomidine 2 mcg/kg (Group D as premedication. They were compared with regards to the sedation status, anxiety levels and cardiovascular status every 10 minutes, at parental separation and at face mask application. RESULTS The mean sedation score obtained at all-time intervals, at parental separation and more importantly at mask induction were much lower for the midazolam group compared to the dexmedetomidine group. The mean anxiety levels, in general, were lower in the midazolam group, but they attained statistical significance only at 10 minutes and at mask induction. The heart rate measured up to 20 minutes after drug administration did not show much difference between both groups, but at 30 minutes, 40 minutes and at parental separation, heart rate was found to be lower in the dexmedetomidine group. CONCLUSION Intranasal dexmedetomidine and intranasal midazolam are equally effective in providing satisfactory parental separation, but intranasal midazolam produced superior conditions for mask acceptance than intranasal dexmedetomidine.

Effect of a herbal extract containing curcumin and piperine on midazolam, flurbiprofen and paracetamol (acetaminophen) pharmacokinetics in healthy volunteers

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Volak, Laurie P; Hanley, Michael J; Masse, Gina; Hazarika, Suwagmani; Harmatz, Jerold S; Badmaev, Vladimir; Majeed, Muhammed; Greenblatt, David J; Court, Michael H

2013-01-01

Aims Turmeric extract derived curcuminoids (curcumin, demethoxycurcumin and bisdemethoxycurcumin) are currently being evaluated for the treatment of cancer and Alzheimer's dementia. Previous in vitro studies indicate that curcuminoids and piperine (a black pepper derivative that enhances curcuminoid bioavailability) could inhibit human CYP3A, CYP2C9, UGT and SULT dependent drug metabolism. The aim of this study was to determine whether a commercially available curcuminoid/piperine extract alters the pharmacokinetic disposition of probe drugs for these enzymes in human volunteers. Methods A randomized placebo-controlled six way crossover study was conducted in eight healthy volunteers. A standardized curcuminoid/piperine preparation (4 g curcuminoids plus 24 mg piperine) or matched placebo was given orally four times over 2 days before oral administration of midazolam (CYP3A probe), flurbiprofen (CYP2C9 probe) or paracetamol (acetaminophen) (dual UGT and SULT probe). Plasma and urine concentrations of drugs, metabolites and herbals were measured by HPLC. Subject sedation and electroencephalograph effects were also measured following midazolam dosing. Results Compared with placebo, the curcuminoid/piperine treatment produced no meaningful changes in plasma Cmax, AUC, clearance, elimination half-life or metabolite levels of midazolam, flurbiprofen or paracetamol (α = 0.05, paired t-tests). There was also no effect of curcuminoid/piperine treatment on the pharmacodynamics of midazolam. Although curcuminoid and piperine concentrations were readily measured in plasma following glucuronidase/sulfatase treatment, unconjugated concentrations were consistently below the assay thresholds (0.05–0.08 μm and 0.6 μm, respectively). Conclusion The results indicate that short term use of this piperine-enhanced curcuminoid preparation is unlikely to result in a clinically significant interaction involving CYP3A, CYP2C9 or the paracetamol conjugation enzymes. PMID:22725836

Dreaming in sedation during spinal anesthesia: a comparison of propofol and midazolam infusion.

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Kim, Duk-Kyung; Joo, Young; Sung, Tae-Yun; Kim, Sung-Yun; Shin, Hwa-Yong

2011-05-01

Although sedation is often performed during spinal anesthesia, the details of intraoperative dreaming have not been reported. We designed this prospective study to compare 2 different IV sedation protocols (propofol and midazolam infusion) with respect to dreaming during sedation. Two hundred twenty adult patients were randomly assigned to 2 groups and received IV infusion of propofol or midazolam for deep sedation during spinal anesthesia. Patients were interviewed on emergence and 30 minutes later to determine the incidence, content, and nature of their dreams. Postoperatively, patient satisfaction with the sedation was also evaluated. Two hundred fifteen patients (108 and 107 in the propofol and midazolam groups, respectively) were included in the final analysis. The proportion of dreamers was 39.8% (43/108) in the propofol group and 12.1% (13/107) in the midazolam group (odds ratio=4.78; 95% confidence interval: 2.38 to 9.60). Dreams of the patients receiving propofol were more memorable and visually vivid than were those of the patients receiving midazolam infusion. The majority of dreams (36 of 56 dreamers, 64.3%) were simple, pleasant ruminations about everyday life. A similarly high level of satisfaction with the sedation was observed in both groups. In cases of spinal anesthesia with deep sedation, dreaming was almost 5 times more common in patients receiving propofol infusion than in those receiving midazolam, although this did not influence satisfaction with the sedation. Thus, one does not need to consider intraoperative dreaming when choosing propofol or midazolam as a sedative drug in patients undergoing spinal anesthesia. © 2011 International Anesthesia Research Society

Conscious sedation by oral administration of midazolam in paediatric dental treatment.

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Erlandsson, A L; Bäckman, B; Stenström, A; Stecksén-Blicks, C

2001-01-01

Midazolam is a short-acting benzodiazepine with rapid onset, short duration of action and minimal side effects. The aim of this study was to evaluate the oral administration of midazolam as pre-operative sedation in the dental treatment of uncooperative pediatric patients. Included in the study were 160 children with a mean age of 6.7 +/- 2.6 years (1-14 years), 83 boys and 77 girls. All the patients had been referred for specialist treatment due to behavioral management problems. Treatment was performed in 250 sessions. All the children received an oral dose of 0.2 mg/kg body weight of midazolam. Acceptance of treatment was evaluated according to Rud & Kisling. Local anesthesia followed by restorative treatment and/or extractions constituted more than 90% of the performed treatments. Of the 250 sessions, 63% were performed with total acceptance and 30% with doubtful acceptance. In 7%, no treatment could be performed. No serious complications were registered during or after treatment. All the children were able to leave the clinic one hour after treatment. In conclusion, we consider oral administration of midazolam a safe form of premedication. The route of administration, the short waiting-time and half-life, in combination with a level of sedation that allows treatment to be performed, are the principal advantages of conscious sedation with orally administered midazolam.

Effects of midazolam on cerebral blood flow in human volunteers

International Nuclear Information System (INIS)

Forster, A.; Juge, O.; Morel, D.

1982-01-01

The effects of intravenously administered midazolam on cerebral blood flow were evaluated in eight healthy volunteers using the 133 Xe inhalation technique. Six minutes after an intravenous dose of 0.15 mg/kg midazolam, the cerebral blood flow decreased significantly (P less than 0.001) from a value of 40.6 +/- 3.3 to a value of 27.0 +/- 5.0 ml . 100 g-1 . min-1. Cerebrovascular resistance (CVR) increased from 2.8 +/- 0.2 to 3.9 to 0.6 mmHg/(ml . 100 g-1 . min-1)(P less than 0.001). Mean arterial blood pressure decreased significantly (P less than 0.05) from 117 +/- 8 to 109 +/- 9 mmHg and arterial carbon dioxide tension increased from 33.9 +/- 2.3 to 38.6 +/- 3.2 mmHg (P less than 0.05). Arterial oxygen tension remained stable throughout the study, 484 +/- 95 mmHg before the administration of midazolam and 453 +/- 76 mmHg after. All the subjects slept after the injection of the drug and had anterograde amnesia of 24.5 +/- 5 min. The decrease in mean arterial blood pressure was probably not important since it remained in the physiologic range for cerebral blood flow autoregulation. The increase in arterial carbon dioxide tension observed after the midazolam injection may have partially counteracted the effect of this new benzodiazepine on cerebral blood flow. Our data suggest that midazolam might be a safe agent to use for the induction of anethesia in neurosurgical patients with intracranial hypertension

Effects of midazolam on explicit vs implicit memory in a pediatric surgery setting.

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Stewart, Sherry H; Buffett-Jerrott, Susan E; Finley, G Allen; Wright, Kristi D; Valois Gomez, Teresa

2006-11-01

Placebo-controlled studies show that midazolam impairs explicit memory in children undergoing surgery (Buffett-Jerrott et al., Psychopharmacology 168:377-386, 2003; Kain et al., Anesthesiology 93:676-684, 2000). A recent within-subjects study showed that midazolam impaired explicit memory while leaving implicit memory intact in a sample of older children undergoing painful medical procedures (Pringle et al., Health Psychol 22:263-269, 2003). We attempted to replicate and extend these findings in a randomized, placebo-controlled design with younger children undergoing surgery. Children aged 3-6 years who were undergoing ear tube (myringotomy) surgery were randomly assigned to receive midazolam (n = 12) or placebo (n = 11). After surgery, they were tested on explicit (recognition) and implicit (priming) memory for pictures encoded before surgery. Relative to placebo, the midazolam-treated children showed poorer recognition memory on the explicit task but equivalent priming on the implicit task. Overall, it appears that midazolam induces a dissociation between explicit and implicit memory in young children in the pediatric surgery setting. Theoretical and clinical implications of the findings are discussed along with directions for future research.

Predicting the Best Fit: A Comparison of Response Surface Models for Midazolam and Alfentanil Sedation in Procedures With Varying Stimulation.

Science.gov (United States)

Liou, Jing-Yang; Ting, Chien-Kun; Mandell, M Susan; Chang, Kuang-Yi; Teng, Wei-Nung; Huang, Yu-Yin; Tsou, Mei-Yung

2016-08-01

Selecting an effective dose of sedative drugs in combined upper and lower gastrointestinal endoscopy is complicated by varying degrees of pain stimulation. We tested the ability of 5 response surface models to predict depth of sedation after administration of midazolam and alfentanil in this complex model. The procedure was divided into 3 phases: esophagogastroduodenoscopy (EGD), colonoscopy, and the time interval between the 2 (intersession). The depth of sedation in 33 adult patients was monitored by Observer Assessment of Alertness/Scores. A total of 218 combinations of midazolam and alfentanil effect-site concentrations derived from pharmacokinetic models were used to test 5 response surface models in each of the 3 phases of endoscopy. Model fit was evaluated with objective function value, corrected Akaike Information Criterion (AICc), and Spearman ranked correlation. A model was arbitrarily defined as accurate if the predicted probability is effect-site concentrations tested ranged from 1 to 76 ng/mL and from 5 to 80 ng/mL for midazolam and alfentanil, respectively. Midazolam and alfentanil had synergistic effects in colonoscopy and EGD, but additivity was observed in the intersession group. Adequate prediction rates were 84% to 85% in the intersession group, 84% to 88% during colonoscopy, and 82% to 87% during EGD. The reduced Greco and Fixed alfentanil concentration required for 50% of the patients to achieve targeted response Hierarchy models performed better with comparable predictive strength. The reduced Greco model had the lowest AICc with strong correlation in all 3 phases of endoscopy. Dynamic, rather than fixed, γ and γalf in the Hierarchy model improved model fit. The reduced Greco model had the lowest objective function value and AICc and thus the best fit. This model was reliable with acceptable predictive ability based on adequate clinical correlation. We suggest that this model has practical clinical value for patients undergoing procedures

Comparative evaluation of midazolam and butorphanol as oral premedication in pediatric patients

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Chandni Sinha

2012-01-01

Full Text Available Background: To compare oral midazolam (0.5 mg/kg with oral butorphanol (0.2 mg/kg as a premedication in 60 pediatric patients with regards to sedation, anxiolysis, rescue analgesic requirement, and recovery profile. Materials and Methods: In a double blinded study design, 60 pediatric patients belonging to ASA class I and II between the age group of 2-12 years scheduled for elective surgery were randomized to receive either oral midazolam (group I or oral butorphanol (group II 30 min before induction of anesthesia. The children were evaluated for levels of sedation and anxiety at the time of separation from the parents, venepuncture, and at the time of facemask application for induction of anesthesia. Rescue analgesic requirement, postoperative recovery, and complications were also recorded. Results: Butorphanol had better sedation potential than oral midazolam with comparable anxiolysis at the time of separation of children from their parents. Midazolam proved to be a better anxiolytic during venepuncture and facemask application. Butorphanol reduced need for supplemental analgesics perioperatively without an increase in side effects such as nausea, vomiting, or unpleasant postoperative recovery. Conclusion: Oral butorphanol is a better premedication than midazolam in children in view of its excellent sedative and analgesic properties. It does not increase side effects significantly.

Administration of midazolam in infancy does not affect learning and memory of adult mice.

Science.gov (United States)

Xu, Hua; Liu, Zhi-Qiang; Liu, Yi; Zhang, Wei-Shi; Xu, Bo; Xiong, Yuan-Chang; Deng, Xiao-Ming

2009-12-01

1. Midazolam is a common fast-acting GABA(A) receptor agonist. Recent data suggest that exposure to midazolam in early life may cause long-term effects on brain function through stable epigenetic reprogramming. The aim of the present study was to determine whether the administration of midazolam to infant mice would affect their learning and memory in adulthood. 2. An open-field test was conducted before and then 3, 24, 48 and 72 h after administration of midazolam (50 mg/kg, i.p.) to infant mice. Saline control mice received an equal volume of saline i.p. 3 h before the open-field test. Total movements, total movement time, total movement distance and velocity were analysed. Novel object recognition (NOR), Morris water-maze and passive avoidance tests were performed when the treated mice grew to adulthood (105 days of age). 3. The results of open-field test showed that midazolam significantly reduced locomotor activity (total movements, total movement time, total movement distance and velocity) in infant mice 3 and 24 h after drug administration and that these effects had disappeared by 72 h after drug administration. The results of the water-maze, NOR and passive avoidance tests in adulthood (at 105 days of age) indicated that administration of midazolam in infancy had no long-term effects on the learning and memory behaviours of adult mice compared with the saline control. 4. Acute midazolam administration to infant mice affected spontaneous locomotor activity for approximately 2 days, but did not seem to have any significant impact on cognitive functioning that lasted into adulthood.

Acid-base status and cardiovascular function in mink (Mustela vison) anaesthetized with ketamine/midazolam.

Science.gov (United States)

Wamberg, S; Svendsen, P; Johansen, B

1996-01-01

Heart rate, arterial blood pressure and blood acid-base status were determined in 18 adult female mink (mean (+/- SEM) body weight 1052 +/- 34 g) during long-term anaesthesia with either controlled ventilation (n=12) or spontaneous respiration (n=6). Surgical anaesthesia was induced by intramuscular injection of ketamine hydrochloride (Ketaminol Vet, 40.0 +/- 1.7 mg/kg) and midazolam hydrochloride (Dormicum 2.8 +/- 0.1 mg/kg) and maintained for at least 5 h by continuous intravenous infusion of this drug combination in 0.9% saline. For all animals, the mean rates of infusion of ketamine and midazolam were 48.4 +/- 1.6 and 1.61 +/- 0.12 mg/h, respectively. Following continuous infusion of the anaesthetics in isotonic saline, at a rate of 20 ml/h, a moderate 'dilution acidosis' developed, which could be corrected by replacement of part of the saline with sodium bicarbonate to a final concentration of approximately 25 mmol NaHCO3 per litre. However, when the animals were allowed to breathe spontaneously, an increase in heart rate and a combined respiratory and metabolic acidosis occurred, due to severe respiratory depression. Apart from these effects and a few cases of increased salivation, no adverse effects over time were observed on the arterial blood acid-base status and cardiovascular function of the animals during ketamine/midazolam anaesthesia. It is concluded that the procedure described for long-term anaesthesia in mink is convenient and safe for acute physiological experiments in this species, provided normal body temperature and pulmonary gas exchange is sufficiently maintained. Thus, the need for an adequately controlled artificial ventilation is strongly emphasized. Finally, a proposal for the composition of an intravenous solution, containing ketamine and midazolam hydrochloride, and sodium bicarbonate in saline, suitable for long-term anaesthesia in adult mink is presented.

The Effects of Single-Dose Rectal Midazolam Application on Postoperative Recovery, Sedation, and Analgesia in Children Given Caudal Anesthesia Plus Bupivacaine

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Sedat Saylan

2014-01-01

Full Text Available Background. This study aimed to compare the effects of rectal midazolam addition after applying bupivacaine and caudal anesthesia on postoperative analgesia time, the need for additional analgesics, postoperative recovery, and sedation and to find out its adverse effects in children having lower abdominal surgery. Methods. 40 children between 2 and 10 years of ASA I-II were randomized, and they received caudal anesthesia under general anesthesia. Patients underwent the application of caudal block in addition to saline and 1 mL/kg bupivacaine 0.25%. In the postoperative period, Group C (n = 20 was given 5 mL saline, and Group M (n = 20 was given 0.30 mg/kg rectal midazolam diluted with 5 mL saline. Sedation scale and postoperative pain scale (CHIPPS of the patients were evaluated. The patients were observed for their analgesic need, first analgesic time, and adverse effects for 24 hours. Results. Demographic and hemodynamic data of the two groups did not differ. Postoperative sedation scores in both groups were significantly lower compared with the preoperative period. There was no significant difference between the groups in terms of sedation and sufficient analgesia. Conclusions. We conclude that caudal anesthesia provided sufficient analgesia in peroperative and postoperative periods, and rectal midazolam addition did not create any differences. This trial is registered with ClinicalTrials.gov NCT02127489.

Stability of midazolam in syrspend SF and syrspend SF cherry.

Science.gov (United States)

Geiger, Christine M; Sorenson, Bridget; Whaley, Paul A

2013-01-01

Midazolam is a short-acting benzodiazepine central nervous system depressant available as an injection, tablet, or oral syrup. The need for alternative dosage form options for patients unable to take tablets and shortages of other forms of the drug have led compounding pharmacies to seek alternatives, mainly solutions and suspensions. Additionally, some patients are unable to use suspending agents containing alcohol or sorbitol. The objective of this study was to determine the stability of midazolam in sorbitol-free, alcohol-free SyrSpend SF and SyrSpend SF Cherry suspending agents. The studied samples were compounded into a 1-mg/mL suspension and stored in low-actinic plastic bottles at temperatures between 2 degrees C to 8 degrees C and at room temperature conditions. Six samples were assayed at each time point out to 58 days by a stability-indicating high-performance liquid chromatography method. The method was validated for its specificity through forced-degradation studies. The samples remained within 90% to 110% of the initial concentration throughout the course of the study. Based on the data collected, the beyond-use date of these preparations is at least 58 days when protected from light at both refrigerated and room temperature storage conditions.

Evident cognitive impairments in seemingly recovered patients after midazolam-based light sedation during diagnostic endoscopy

OpenAIRE

Yen-Hsuan Hsu; Feng-Sheng Lin; Chi-Cheng Yang; Chih-Peng Lin; Mau-Sun Hua; Wei-Zen Sun

2015-01-01

Midazolam is a widely used sedative agent during colonoscopy, with cognitive toxicity. However, the potential cognitive hazard of midazolam-based light sedation has not been sufficiently examined. We aimed to examine the cognitive safety and vulnerability profile under midazolam light sedation, with a particular focus on individual variations. Methods: We conducted a prospective case-controlled study in an academic hospital. In total, 30 patients undergoing sedative colonoscopy as part of ...

[Sedation with intravenous midazolam during upper gastrointestinal endoscopy--changes in hemodynamics, oxygen saturation and memory].

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Mizuno, Ju; Matsuki, Michiko; Gouda, Yoshinori; Nishiyama, Tomoki; Hanaoka, Kazuo

2003-09-01

Cardiorespiratory adverse effects are often observed in patients undergoing upper gastrointestinal endoscopy with sedation. In this study, we examined hemodynamics, oxygen saturation and memory during upper gastrointestinal endoscopy under sedation with intravenous midazolam. Eight healthy outpatients without any obvious complications received intravenous midazolam 5 mg for sedation for upper gastrointestinal endoscopy. Blood pressure, heart rate and percutaneous arterial oxygen saturation (SpO2) were measured before, during and after endoscopy. After the arousal by intravenous flumazenil, we inquired the patients about the level of memory during the endoscopy. Blood pressure decreased significantly two minutes after midazolam administration, but increased significantly after the insertion of an endoscope which was not different from the control value. Heart rate increased significantly one and three minutes after the insertion of the endoscope. SpO2 decreased significantly after midazolam administration and stayed at around 95%. No patients remembered the procedure. Sedation with intravenous midazolam during upper gastrointestinal endoscopy is useful to control the cardiovascular responses, and to obtain amnesia. However, a decrease in SpO2 should be watched carefully.

Sedation and physiologic response to manual restraint after intranasal administration of midazolam in Hispaniolan Amazon parrots (Amazona ventralis).

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Mans, Christoph; Guzman, David Sanchez-Migallon; Lahner, Lesanna L; Paul-Murphy, Joanne; Sladky, Kurt K

2012-09-01

Administration of intranasal midazolam (2 mg/kg) was evaluated for sedation and effects on cloacal temperature, respiratory rate, and heart rate in manually restrained Hispaniolan Amazon parrots (Amazona ventralis). Adult parrots (n=9) were administered either midazolam (2 mg/kg) or an equal volume of saline solution intranasally before a 15-minute manual restraint in a complete crossover study. Respiratory rate and sedation scores were recorded before and during capture and during and after 15 minutes of manual restraint. Heart rate and cloacal temperature were recorded during manual restraint. After restraint, the parrots received intranasal flumazenil (0.05 mg/kg) or an equal volume of saline solution, and the recovery time was recorded. In those birds that received midazolam, sedation was observed within 3 minutes of administration, and vocalization, flight, and defense responses were significantly reduced during capture. During manual restraint, the mean rate of cloacal temperature increase was significantly slower and remained significantly lower in birds that received midazolam compared with controls. Mean respiratory rates were significantly lower for up to 12 minutes in parrots that received midazolam compared with those receiving saline solution. Flumazenil antagonized the effects of midazolam within 10 minutes. No overt clinical adverse effects to intranasal midazolam and flumazenil administration were observed. Further studies on the safety of intranasal midazolam and flumazenil in this species are warranted.

Low-dose intranasal versus oral midazolam for routine body MRI of claustrophobic patients

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Tschirch, Frank T.C.; Goepfert, Kerstin; Brunner, Genevieve; Weishaupt, Dominik [University Hospital Zuerich, Institute of Diagnostic Radiology, Zuerich (Switzerland); Froehlich, Johannes M. [Klus-Apotheke, Zuerich (Switzerland)

2007-06-15

The purpose of this study was to assess prospectively the potential of low-dose intranasal midazolam compared to oral midazolam in claustrophobic patients undergoing routine body magnetic resonance imaging (MRI). Seventy-two adult claustrophobic patients referred for body MRI were randomly assigned to one of two treatment groups (TG1 and TG2). The 36 patients of TG1 received 7.5 mg midazolam orally 15 min before MRI, whereas the 36 patients of TG2 received one (or, if necessary, two) pumps of a midazolam nasal spray into each nostril immediately prior to MRI (in total, 1 or 2 mg). Patients' tolerance, anxiety and sedation were assessed using a questionnaire and a visual analogue scale immediately before and after MRI. Image quality was evaluated using a five-point-scale. In TG1, 18/36 MRI examinations (50%) had to be cancelled, the reduction of anxiety was insufficient in 12/18 remaining patients (67%). In TG2, 35/36 MRI examinations (97%) were completed successfully, without relevant adverse effects. MRI image quality was rated higher among patients of TG2 compared to TG1 (p<0.001). Low-dose intranasal midazolam is an effective and patient-friendly solution to overcome anxiety in claustrophobic patients in a broad spectrum of body MRI. Its anxiolytic effect is superior to that of the orally administrated form. (orig.)

Efficacy of midazolam as oral premedication in children in comparison to triclofos sodium

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Kolathu Parambil Radhika

2016-01-01

Full Text Available Background and Aims: The perioperative behavioural studies demonstrate that children are at greater risk of experiencing turbulent anaesthetic induction and adverse behavioural sequelae. We aimed to compare the efficacy of midazolam 0.5 mg/kg with triclofos sodium 100 mg/kg as oral premedication in children undergoing elective surgery. Methods: In this prospective, randomised and double-blind study, sixty children posted for elective lower abdominal surgery were enrolled. The patients were randomly divided into midazolam group (Group M and triclofos sodium group (Group T of thirty each. Group M received oral midazolam 0.5 mg/kg 30 min before induction, and Group T received oral triclofos sodium 100 mg/kg 60 min before induction. All children were evaluated for level of sedation after premedication, behaviour at the time of separation from parents and at the time of mask placement for induction of anaesthesia. Mann–Whitney U-test was used for comparing the grade of sedation, ease of separation and acceptance of face mask. Results: Oral midazolam produced adequate sedation in children after premedication in comparison to oral triclofos (P = 0.002. Both drugs produced successful separation from parents, and the children were very cooperative during induction. No adverse effects attributable to the premedicants were seen. Conclusions: Oral midazolam is superior to triclofos sodium as a sedative anxiolytic in paediatric population.

Evident cognitive impairments in seemingly recovered patients after midazolam-based light sedation during diagnostic endoscopy.

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Hsu, Yen-Hsuan; Lin, Feng-Sheng; Yang, Chi-Cheng; Lin, Chih-Peng; Hua, Mau-Sun; Sun, Wei-Zen

2015-06-01

Midazolam is a widely used sedative agent during colonoscopy, with cognitive toxicity. However, the potential cognitive hazard of midazolam-based light sedation has not been sufficiently examined. We aimed to examine the cognitive safety and vulnerability profile under midazolam light sedation, with a particular focus on individual variations. We conducted a prospective case-controlled study in an academic hospital. In total, 30 patients undergoing sedative colonoscopy as part of a health check-up were recruited. Neuropsychological testing on the full cognitive spectrum was evaluated at 15 minutes and 120 minutes after low-dose midazolam administration. The modified reliable change index (RCI) was used for intrapersonal comparisons and controlling for practice effects. Midazolam affected psychomotor speed (48%), memory (40%), learning (32%), working memory (17%), and sustained attention (11%), while sparing orientation and the fluency aspect of executive function at the acute stage. Residual memory (10%) and learning (10%) impairments at 2 hours after administration were evidenced in some patients. The three object recall and digit symbol coding tests can serve as useful screening tools. Midazolam-based light sedation induced selective cognitive impairments and prolonged cognitive impairments occurred in patients with advanced age. A longer observation time and further screening were recommended for patients due to their at risk state. Copyright © 2013. Published by Elsevier B.V.

Effects of midazolam and morphine on cerebral oxygenation and hemodynamics in ventilated premature infants.

NARCIS (Netherlands)

Velden, A.A.E.M. van der; Hopman, J.C.W.; Klaessens, J.H.G.M.; Feuth, A.B.; Sengers, R.C.A.; Liem, K.D.

2006-01-01

BACKGROUND: Midazolam sedation and morphine analgesia are commonly used in ventilated premature infants. OBJECTIVES: To evaluate the effects of midazolam versus morphine infusion on cerebral oxygenation and hemodynamics in ventilated premature infants. METHODS: 11 patients (GA 26.6-33.0 weeks, BW

Intravenous ketamine is as effective as midazolam/fentanyl for procedural sedation and analgesia in the emergency department.

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Jamal, S M; Fathil, S M; Nidzwani, M M; Ismail, A K; Yatim, F M

2011-08-01

The study compared the effectiveness of ketamine and midazolam/fentanyl as procedural sedation and analgesia agents for reduction of fractures and dislocated joints. Forty-one adult patients were enrolled by convenience sampling. They were randomized to receive ketamine or midazolam/fentanyl. Depth of sedation, pain score, procedural outcome and memory of the procedure were documented. The ketamine group had deeper sedation, but there was no statistical difference in other variables between the two groups. Three patients in the midazolam/fentanyl group had oxygen desaturation. More adverse effects were associated with ketamine. Intravenous ketamine is as effective as midazolam/fentanyl for procedural sedation.

The use of temazepam elixir in surgical dental sedation: a comparison with intravenous midazolam.

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Skelly, A M; Girdler, N M; File, S E

1992-02-22

Out-patients attending for removal of at least one lower third molar were randomly allocated to treatment with temazepam elixir (n = 7) or intravenous midazolam (n = 8), as well as local analgesia. Patients were tested prior to drug administration and at the end of surgery. Both drugs increased heart rate and midazolam also decreased diastolic blood pressure. The two drugs caused significant, equal increases in ratings of sedation, but the reduction of anxiety was significant only for midazolam. There was significant amnesia for material presented after drug administration, as well as for dental events and this was significantly greater for midazolam. The effects of these drugs in dental patients were compared with those in normal volunteers treated in an identical manner, but without oral surgery. The drugs had similar significant cardiovascular and amnesic effects in the volunteers and the same effects on mood ratings, even though volunteers and patients differed in their pretreatment levels of anxiety and discontent. The dentist's ratings of the sedation and operating conditions were excellent in both cases. Thus temazepam elixir provided a useful sedative for oral surgery, avoiding the complications of intravenous administration. However, for equivalent levels of sedation, midazolam had greater anxiolytic and amnesic effects than temazepam.

Síndrome de abstinência associada à interrupção da infusão de fentanil e midazolam em pediatria Withdrawal syndrome associated with cessation of fentanyl and midazolam in pediatrics

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J.N. Bicudo

1999-03-01

Full Text Available OBJETIVO: Determinar a ocorrência de síndrome de abstinência em crianças internadas em UCI Pediátrica em uso de fentanil e midazolam. MÉTODOS: Avaliadas 36 crianças internadas na UCI Pediátrica do Hospital São Paulo - Universidade Federal de São Paulo, no período de março a setembro de 1997, com idade variando de 5 dias a 22 meses (22 masc : 14 fem que fizeram uso de fentanil e midazolam por mais de 24 horas. Utilizado o Escore Neonatal de Abstinência adaptado por Finnegan que determina a ocorrência de síndrome de abstinência em crianças menores de 2 anos. Escore maior ou igual a 8 é considerado como síndrome de abstinência. Correlacionados a síndrome de abstinência com a dose total acumulada, velocidade de infusão, dose diária e tempo de utilização do fentanil e do midazolam. RESULTADOS: Determinada síndrome de abstinência em 18 (50% das 36 crianças. Aplicado o teste estatístico de Mann Whitney para comparar os grupos com e sem síndrome de abstinência. Dose total acumulada de fentanil (5732.7 ± 5114.91 vs. 624.2 ± 591.2mcg, pPURPOSE: To determine the incidence of abstinence syndrome in children interned in the Pediatric Intensive Care Unit (PICU in fentanyl use and midazolam METHODS: Evaluation of 36 children interned in PICU of the Hospital São Paulo - Federal University of São Paulo, in the period from March to September 1997, with age varying from 5 days to 22 months (22 masc: 14 fem who used fentanyl use and midazolam for more than 24 hours. Used the Escore Neonatal of Abstinence adapted by Finnegan determines the occurrence of abstinence syndrome in was used to children 2 years old or less. Sustain larger or equal for 8 is considered as abstinence syndrome. Correlated the abstinence syndrome with the accumulated total dose, infusion velocity, daily dose and time of use of the fentanyl and midazolam. RESULTS: Certain abstinence syndrome in 18 (50% of the 36 children. Applied Mann Whitney's statistical

[Examination of the optimal midazolam dose required for loss of puncture memory at the time of spinal anesthesia].

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Boku, Aiji; Koyama, Shinichi; Kishimoto, Naotaka; Nakatani, Keiji; Kurita, Satoshi; Nagata, Noboru; Niwa, Hitoshi

2011-08-01

We examined midazolam ED50 according to age that was necessary for loss of puncture memory at the time of spinal anesthesia and determined whether we could estimate the presence of puncture memory from the degree of sedation after midazolam administration. We enrolled patients with ASA PS 1 or 2 and patients from 50 to 80 years of age who had been planned for surgery with spinal anesthesia. We divided the patients into groups according to their age--50s, 60s, and 70s as L, M, and H groups, respectively. We evaluated the degree of sedation with six phases of scores after intravenous administration of midazolam and spinal anesthesia was performed. The midazolam dose was based on the ups and downs method. The midazolam ED50s required for the loss of puncture memory in groups L, M, and H were 0.043, 0.035, and 0.026 mg x kg(-1), respectively. We estimated the association between the sedation degree score after midazolam administration and the puncture memory from ROC curve, but AUC was 0.56 for all cases. The midazolam ED50 required for the loss of puncture memory decreased with age but it was difficult to estimate puncture memory from the degree of sedation.

Effective Dosage of Midazolam to Erase the Memory of Vascular Pain During Propofol Administration.

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Boku, Aiji; Inoue, Mika; Hanamoto, Hiroshi; Oyamaguchi, Aiko; Kudo, Chiho; Sugimura, Mitsutaka; Niwa, Hitoshi

Intravenous sedation with propofol is often administered to anxious patients in dental practice. Pain on injection of propofol is a common adverse effect. This study aimed to determine the age-adjusted doses of midazolam required to erase memory of vascular pain of propofol administration and assess whether the Ramsay Sedation Scale (RSS) after the pretreatment of midazolam was useful to predict amnesia of the vascular pain of propofol administration. A total of 246 patients with dental phobia requiring dental treatment under intravenous sedation were included. Patients were classified according to their age: 30s, 40s, 50s, and 60s. Three minutes after administration of a predetermined dose of midazolam, propofol was infused continuously. After completion of the dental procedure, patients were interviewed about the memory of any pain or discomfort in the injection site or forearm. The dosage of midazolam was determined using the Dixon up-down method. The first patient was administered 0.03 mg/kg, and if memory of vascular pain remained, the dosage was increased by 0.01 mg/kg for the next patient, and then if the memory was erased, the dosage was decreased by 0.01 mg/kg. The effective dosage of midazolam in 95% of each age group for erasing the memory of propofol vascular pain (ED95) was determined using logistic analysis. The accuracy of RSS to predict the amnesia of injection pain was assessed by receiver operating characteristic (ROC) analysis. The ED95 of midazolam to erase the memory of propofol vascular pain was 0.061 mg/kg in patients in their 30s, 0.049 mg/kg in patients in their 40s, 0.033 mg/kg in patients in their 50s, and 0.033 mg/kg in patients in their 60s. The area under the ROC curve was 0.31. The ED95 of midazolam required to erase the memory of propofol vascular pain demonstrated a downward trend with age. On the other hand, it was impossible to predict the amnesia of propofol vascular pain using the RSS.

Prophylactic antiemetic effects of midazolam, dexamethasone, and its combination after middle ear surgery

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Makhdoom, Naeem K; Farid, Magdy F

2009-01-01

To evaluate and compare the efficacy of the combination of midazolam and dexamethasone, with midazolam and dexamethasone alone, for the prevention of postoperative nausea and vomiting (PONV) in female patients undergoing middle ear surgery. A prospective, randomized, double-blind, placebo-controlled study in 80 female patients (mean age 32.6 years), undergoing middle ear surgery with general anesthesia at Ohud Hospital, Madina, Kingdom of Saudi Arabia from May 2007 to May 2008. Patients were classified into 4 groups. They received intravenous normal saline (S group), midazolam 0.075 mg/kg (M group), or dexamethasone 10 mg (D group), or a combination of midazolam and dexamethasone (MD group), before the induction of anesthesia. Postoperatively for 24 hours observation and assessment of nausea, vomiting, rescue anti-emetics, and side effects of the study drugs such as headache and drowsiness were carried out. There was a significant difference between the 4 groups. The MD group was the least to develop PONV compared to other groups (p<0.01). Regarding nausea, there was a non-significant difference between the 4 groups, although the MD group developed the least symptoms among the 4 groups, there were no significant differences in pain intensity and side effects such as, headache, dizziness, and drowsiness between the 4 groups. The combination of midazolam 0.075 mg/kg and dexamethasone 10 mg intravenously is better than either drug alone in reducing the incidence of PONV in female patients after middle ear surgery. (author)

A comparison of midazolam and clonidine as an oral premedication in pediatric patients

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Sequeira Trevor

2012-01-01

Full Text Available Background: To compare oral midazolam (0.5 mg/kg versus oral clonidine (4 μg/kg as a premedication in pediatric patients aged between 2-12 years with regard to sedation and anxiolysis. Methods: Sixty pediatric patients belonging to the American Society of Anesthesiologists class I and II between the age group of 2-12 years scheduled for elective surgery were randomly allocated to receive either oral midazolam (group I 30 min before induction or oral clonidine (group II 90 min before induction of anesthesia. The children were evaluated for levels of sedation and anxiety at the time of separation from the parents, venepuncture, and at the time of mask application for induction of anesthesia. Results: After premedication, the percentage of children who were sedated and calm increased in both the groups. The overall level of sedation was better in the children in the clonidine group, but children in the midazolam group had a greater degree of anxiolysis at times of venepuncture and mask application. In addition, midazolam did not cause significant changes in hemodynamics unlike clonidine where a significant fall in blood pressure was noted, after premedication, but preinduction. Conclusion: We conclude that under the conditions of the study, oral midazolam is superior to clonidine as an anxiolytic in pediatric population. Clonidine with its sedative action especially at the time of separation from parents along with its other perioperative benefits cannot be discounted.

Withdrawal syndrome associated with cessation of fentanyl and midazolam in pediatrics

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Bicudo, J.n. [UNIFESP; Souza, N. de [UNIFESP; Mângia, C.m.f. [UNIFESP; Carvalho, Werther Brunow de [UNIFESP

1999-01-01

PURPOSE: To determine the incidence of abstinence syndrome in children interned in the Pediatric Intensive Care Unit (PICU) in fentanyl use and midazolam METHODS: Evaluation of 36 children interned in PICU of the Hospital São Paulo - Federal University of São Paulo, in the period from March to September 1997, with age varying from 5 days to 22 months (22 masc: 14 fem) who used fentanyl use and midazolam for more than 24 hours. Used the Escore Neonatal of Abstinence adapted by Finnegan determi...

Sedation with midazolam in flexible bronchoscopy – A prospective study

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R. Rolo

2012-09-01

Full Text Available Introduction: Sedatives have been increasingly used to improve patient comfort during flexible bronchoscopy (FOB. Due to its rapid-onset, anxiolytic and amnestic properties, midazolam is one of the most commonly used sedatives. Objectives: To evaluate the effect of sedation with midazolam, including patient tolerance, complications and its potential use on a daily routine basis. Methods: A multi-centre, prospective, randomized, placebo-controlled study was made on 100 patients submitted to FOB in two Pulmonology Departments. Midazolam (0.05 mg/kg was administered to patients in Group 1 and saline solution (0.9% NaCl to patients in Group 2, 5 min before the procedure. The Hospital Anxiety and Depression Scale (HADS-A was used to determine patient anxiety level. Subjective questionnaires concerning main fears and complaints were answered before and after FOB. Results: Mean age was 56.0 ± 14.1 years; 66% were male. Most (65% patients had low score ( 0.05 and pain (4% vs 12%; p > 0.05 were not statistically different.Willingness to repeat the exam was reported in all patients in Group 1 and in 82% in Group 2 (p = 0.003. Conclusion: Sedation with midazolam in FOB improved patient's comfort and decreased complaints, without significant haemodynamic changes. It should be offered to the patient on a routine basis. Resumo: Introdução: Os agentes sedativos têm vindo a ser cada vez mais utilizados na broncofibroscopia (BF para melhorar o conforto do doente. Devido à sua rápida ação, propriedades ansiolíticas e amnésicas, o midazolam é um dos sedativos mais frequentemente usados. Objetivos: Avaliar o efeito da sedação com midazolam na BF, incluindo a tolerância do doente, complicações e a sua potencial aplicação na prática clínica diária. Material e Métodos: Estudo multicêntrico, prospetivo, randomizado, controlado com placebo, com inclusão de 100 indiv

Injection anaesthesia with fentanyl-midazolam-medetomidine in adult female mice: importance of antagonization and perioperative care.

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Fleischmann, Thea; Jirkof, Paulin; Henke, Julia; Arras, Margarete; Cesarovic, Nikola

2016-08-01

Injection anaesthesia is commonly used in laboratory mice; however, a disadvantage is that post-anaesthesia recovery phases are long. Here, we investigated the potential for shortening the recovery phase after injection anaesthesia with fentanyl-midazolam-medetomidine by antagonization with naloxone-flumazenil-atipamezole. In order to monitor side-effects, the depth of anaesthesia, heart rate (HR), core body temperature (BT) and concentration of blood gases, as well as reflex responses, were assessed during a 50 min anaesthesia. Mice were allowed to recover from the anaesthesia in their home cages either with or without antagonization, while HR, core BT and spontaneous home cage behaviours were recorded for 24 h. Mice lost righting reflex at 330 ± 47 s after intraperitoneal injection of fentanyl-midazolam-medetomidine. During anaesthesia, HR averaged 225 ± 23 beats/min, respiratory rate and core BT reached steady state at 131 ± 15 breaths/min and 34.3 ± 0.25℃, respectively. Positive pedal withdrawal reflex, movement triggered by tail pinch and by toe pinch, still occurred in 25%, 31.2% and 100% of animals, respectively. Arterial blood gas analysis revealed acidosis, hypoxia, hypercapnia and a marked increase in glucose concentration. After anaesthesia reversal by injection with naloxone-flumazenil-atipamezole, animals regained consciousness after 110 ± 18 s and swiftly returned to physiological baseline values, yet they displayed diminished levels of locomotion and disrupted circadian rhythm. Without antagonization, mice showed marked hypothermia (22 ± 1.9℃) and bradycardia (119 ± 69 beats/min) for several hours. Fentanyl-midazolam-medetomidine provided reliable anaesthesia in mice with reasonable intra-anaesthetic side-effects. Post-anaesthetic period and related adverse effects were both reduced substantially by antagonization with naloxone-flumazenil-atipamezole. © The Author(s) 2016.

Randomized Clinical Trial of Sedation With Oral Midazolam For Voiding Cystourethrography in Children

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Haji Ghorbann Nooreddini

2010-08-01

Full Text Available Background:Voiding Cystourethrography (VCUG is a distressing procedure for children.Conscious sedation with any drug that its dose would not influences the procedure is preferred. The aim of this study was to assess the effectiveness of conscious sedation using oral midazolam in children undergoing VCUG.Methods: From November 2008 to October 2009 period, 93 Patients (68 girls and 25 boys, age ranging from 24 months to 11 years old (mean, 5.8 yearswere double blindly randomized to receive a placebo (water or oral midazolam before the examination. The primary outcome measures were patients' cooperation, facility of the procedure, 48 hours post procedure memory of children, bladder urine residue and detection of Vesocoureteral reflex. The data were analysed by SPSS and categorical variables compared using t-test and continuous variables compared using Chi. Square and Fisher’s exact tests.Results: 93 children were randomizly divided in two groups. In midazolam   group, 44(93.6% patients had good cooperation but in the control group 26(56.5%had bad cooperation and 19 patients (41.3% very bad cooperation (P=0.000. In midazolam group, 36 children (76.6% had easy separation from their parents but in   control group 20 children (43.5% had moderate resistant and 21(45.7% severe resistant. (P=0.000. Eighteen (38 % patients of the study group and twenty patients(43 % of control group had VUR respectively (P=0.65.   Conclusion:According to this study, midazolam is a useful sedation in children undergoing VCUG.  

Midazolam administration at a department of pediatric radiology: Conscious sedation for diagnostic imaging studies

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Madzik, J.; Marcinski, A.; Brzewski, M.; Jakubowska, A.; Roik, D.; Majkowska, Z.; Biejat, A.; Krzemien, G.

2006-01-01

The aims of the study were to evaluate the usefulness of midazolam administration for sedation prior to some diagnostic examinations in children and to present the requirements and rules for sedation in departments of pediatric radiology. From Oct. 2001 to Aug. 2005, two hundred children were investigated after conscious sedation with midazolam. The examinations were: voiding cystourethrography (129), voiding sonocystography (64), barium enema (3), ultrasonography (1), urography (1), X-ray of facial bone (1), and brain CT (1). The children's age-range was 4 months to 13 years 9 months. The decision for sedation was based on conversation with the child and/or parents, their experience with previous examinations, emotional status of the child, and exclusion of contraindications (renal insufficiency, hepatic failure, respiratory/circulatory insufficiency, allergy to benzodiazepines in anamnesis). Midazolam was given orally in a dose of 0.5 mg/kg body weight, 15-20 minutes before examination (already at the department of pediatric radiology). The parents were informed of the possible side effects and what to do after the procedure. All diagnostic procedures with conscious sedation were well tolerated by the children and accepted by the parents. The parents with experience from previous diagnostic procedures indicated that they would want their child to have midazolam again if the examination needed to be repeated. No significant complications were observed in the children receiving midazolam and few adverse effect on voiding during cystourethrography. In three children (2.5, 3, and 5 years old), paradoxical reactions occurred (psychomotor agitation) which disappeared spontaneously after some minutes and had no influence on the procedure. Application of midazolam for conscious sedation diminished anxiety and discomfort from diagnostic procedures and short anterograde amnesia protected the child's mind from painful experience. Conscious sedation should be widely used in

Population pharmacodynamic modelling of midazolam induced sedation in terminally ill adult patients

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de Winter, Brenda C. M.; Masman, Anniek D.; van Dijk, Monique; Baar, Frans P. M.; Tibboel, Dick; Koch, Birgit C. P.; van Gelder, Teun; Mathot, Ron A. A.

2017-01-01

Aims Midazolam is the drug of choice for palliative sedation and is titrated to achieve the desired level of sedation. A previous pharmacokinetic (PK) study showed that variability between patients could be partly explained by renal function and inflammatory status. The goal of this study was to combine this PK information with pharmacodynamic (PD) data, to evaluate the variability in response to midazolam and to find clinically relevant covariates that may predict PD response. Method A population PD analysis using nonlinear mixed effect models was performed with data from 43 terminally ill patients. PK profiles were predicted by a previously described PK model and depth of sedation was measured using the Ramsay sedation score. Patient and disease characteristics were evaluated as possible covariates. The final model was evaluated using a visual predictive check. Results The effect of midazolam on the sedation level was best described by a differential odds model including a baseline probability, Emax model and interindividual variability on the overall effect. The EC50 value was 68.7 μg l–1 for a Ramsay score of 3–5 and 117.1 μg l–1 for a Ramsay score of 6. Comedication with haloperidol was the only significant covariate. The visual predictive check of the final model showed good model predictability. Conclusion We were able to describe the clinical response to midazolam accurately. As expected, there was large variability in response to midazolam. The use of haloperidol was associated with a lower probability of sedation. This may be a result of confounding by indication, as haloperidol was used to treat delirium, and deliria has been linked to a more difficult sedation procedure. PMID:28960387

Comparison of Preanesthetic Sedation after Intranasal Administration of Fentanyle, Ketamin and Midazolam

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F Javaherforoosh

2006-07-01

Full Text Available Introduction & Objective: Induction of anesthesia in children can be a challenge for anesthetist. A stormy induction may increase the personality & behavioral changes. Therefore, it is desirable that they enter the operating room sedated. Many drugs are used for preanesthetic medication and there are many routes for administration. One route of administration is nasal mucous. In this study we compared the effect and side effect of three drugs (midazolam, ketamin and fentanyle after intra nasal administration. Materials & Methods: This is a double blind clinical trial. In this study we selected 60 patients (20 patients for every group A, B or C. We used 3 mg/kg ketamin or 3µg/kg fentanyle or 0.3 mg/kg midazolam by intranasal spray. After administration and in 5, 10 and 15 minutes, we observed the SPO2, PR and RR. After 15 min’s we separated children from parents and brought them to the operating room and controlled the acceptance of separation, depth of sedation with Ramsay score, acceptance of mask and tolerance of IV canulation. The data were then analyzed using K2 and kruskal-wallis test. Results: In our study we found that in SPO2 fentanyle had the highest rate of reduction even though none of the children had SPO2 lower than 90%. There were no differences between drugs in RR. In fentanyle group, we had the lowest rate and in ketamin group the highest rate. Midazolam had the medium rate. The rate of sedation for acceptance of separation from parents had no difference between the groups and all drugs with this dosage were effective for this aim. However, in Ramsay score, acceptance of mask and tolerance of IV canulation, the midazolam was more effective than the others. Conclusion: Intranasal administration of midazolam is a safe route for sedation in children in the pre-anesthetic time.

Evaluation of the safety and efficacy of a nursing-driven midazolam protocol for the management of procedural pain associated with burn injuries.

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Bidwell, Katherine L; Miller, Sidney F; Coffey, Rebecca; Calvitti, Kristin; Porter, Kyle; Murphy, Claire V

2013-01-01

Burn pain is one of the most excruciating types of pain and can be difficult to manage. Benzodiazepines may be effective in reducing pain by minimizing anxiety associated with dressing changes. This study aimed to evaluate the safety and efficacy of adjunctive midazolam during dressing changes in patients with uncontrolled pain using opioid monotherapy or significant anxiety associated with dressing changes. A retrospective cohort analysis comparing patients who received midazolam during dressing changes with control patients was performed. Each midazolam patient was matched with up to two control patients who did not receive midazolam on the basis of age, sex, TBSA burned, and grafting requirement. The primary endpoint was the oral morphine equivalents required during admission after initiation of midazolam. Thirty-six patients were included for evaluation (14 midazolam and 22 control patients). Baseline characteristics were similar between the two groups, although patients in the midazolam group had higher pain scores and oral morphine equivalent requirements at baseline. When adjusted for baseline pain, day postburn, age, sex, and grafting status, total oral morphine equivalents and mean pain scores during admission were similar between the groups. One midazolam patient experienced oxygen desaturation with midazolam, but did not require flumazenil for reversal. The use of midazolam during burn dressing changes in patients with poorly controlled pain and/or anxiety was not associated with reduced requirements for oral morphine equivalents or lower pain scores during admission. Further research into the role of benzodiazepines in burn pain management is warranted.

Premedication with benzodiazepines for upper gastrointestinal endoscopy: Comparison between oral midazolam and sublingual alprazolam

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Vahid Sebghatollahi

2017-01-01

Full Text Available Background: Premedication with orally administered benzodiazepines is effective in reducing anxiety and discomfort related to endoscopic procedures. We evaluated the efficacy and safety of oral midazolam in comparison to sublingual alprazolam as premedication for esophagogastroduodenoscopy (EGD. Materials and Methods: Adult candidates for diagnostic EGD received either oral midazolam (7.5 mg in 15 cc apple juice or sublingual alprazolam (0.5 mg 30 min before EGD. Procedural anxiety and pain/discomfort were assessed using 11-point numerical rating scales. Patients' overall tolerance (using a four-point Likert scale and willingness to repeat the EGD, if necessary, were also assessed. Blood pressure, heart rate, and arterial oxygen saturation were monitored from medication to 30 min after the procedure. Results: Patients experienced a similar reduction in procedural anxiety after medication with oral midazolam and sublingual alprazolam; mean (standard deviation [SD] of 1.86 [1.63] and 2.02 [1.99] points, respectively, P = 0.91. Compared to oral midazolam, pain/discomfort scores were lower with sublingual alprazolam; mean (SD of 4.80 (3.01 versus 3.68 (3.28, P = 0.024. There was no significant difference between the two groups in patients' tolerance, willingness to repeat the procedure, or hemodynamic events. Conclusion: Oral midazolam and sublingual alprazolam are equally effective in reducing EGD-related anxiety; however, EGD-related pain/discomfort is lower with alprazolam. Both benzodiazepines are equally safe and can be used as premedication for patients undergoing diagnostic EGD.

Midazolam: uma nova alternativa para sedação em odontopediatria = Midazolam: a new alternative to sedation in pediatric dentistry

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Duque, Cristiane

2005-01-01

Full Text Available Na prática clínica, existem muitas crianças imaturas e ansiosas ou pacientes com comprometimento físico e/ou mental que não cooperam durante o tratamento odontológico. A sedação pré-operatória é uma das alternativas que facilitam o manejo desses pacientes. O midazolam é um benzodiazepínico que pode ser indicado para crianças, como pré-medicação em procedimentos de curta duração. Isso porque apresenta propriedades hipnóticas e sedativas, além de ser absorvido e eliminado rapidamente pelo organismo. Dessa forma, o objetivo deste estudo é avaliar, por meio de uma revisão de literatura, a efetividade do midazolam, administrado por via oral e intranasal, como agente sedativo para crianças não cooperadoras submetidas a tratamento odontológico

Efficacy of intrathecal midazolam versus fentanyl for endoscopic

African Journals Online (AJOL)

intrathecal midazolam versus fentanyl as an adjunct to bupivacaine for endoscopic urology surgery. Methods: Sixty adult ASA grade I–II patients undergoing transurethral resection of prostate or bladder tumor under spinal block. Postoperative analgesia was provided with intravenous diclofenac. The onset and duration of ...

Anticonvulsant treatment of sarin-induced seizures with nasal midazolam: An electrographic, behavioral, and histological study in freely moving rats

International Nuclear Information System (INIS)

Gilat, E.; Kadar, T.; Levy, A.; Rabinovitz, I.; Cohen, G.; Kapon, Y.; Sahar, R.; Brandeis, R.

2005-01-01

Centrally mediated seizures and convulsions are common consequences of exposure to organophosphates (OPs). These seizures rapidly progress to status epilepticus (SE) and contribute to profound brain injury. Effective management of these seizures is critical for minimization of brain damage. Nasal application of midazolam (1.5 mg/kg) after 5 min of sarin-induced electrographic seizure activity (EGSA) ameliorated EGSA and convulsive behavior (238 ± 90 s). Identical treatment after 30 min was not sufficient to ameliorate ECoG paradoxical activity and convulsive behavior. Nasal midazolam (1.5 mg/kg), together with scopolamine (1 mg/kg, im) after 5 min of EGSA, exerted a powerful and rapid anticonvulsant effect (53 ± 10 s). Delaying the same treatment to 30 min of EGSA leads to attenuation of paroxysmal ECoG activity in all cases but total cessation of paroxysmal activity was not observed in most animals tested. Cognitive tests utilizing the Morris Water Maze demonstrated that nasal midazolam alone or together with scopolamine (im), administered after 5 min of convulsions, abolished the effect of sarin on learning. Both these treatments, when given after 30 min of convulsions, only decreased the sarin-induced learning impairments. Whereas rats which were not subject to the anticonvulsant agents did not show any memory for the platform location, both treatments (at 5 min as well as at 30 min) completely abolished the memory deficits. Both treatments equally blocked the impairment of reversal learning when given at 5 min. However, when administered after 30 min, midazolam alone reversed the impairments in reversal learning, while midazolam with scopolamine did not. Rats exposed to sarin and treated with the therapeutic regimen with the exclusion of midazolam exhibited severe brain lesions that encountered the hippocampus, pyriform cortex, and thalamus. Nasal midazolam at 5 min prevented brain damage, while delaying the midazolam treatment to 30 min of EGSA resulted in

Anticonvulsant treatment of sarin-induced seizures with nasal midazolam: An electrographic, behavioral, and histological study in freely moving rats

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Gilat, E [Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona, 74100 (Israel); Kadar, T [Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona, 74100 (Israel); Levy, A [Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona, 74100 (Israel); Rabinovitz, I [Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona, 74100 (Israel); Cohen, G [Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona, 74100 (Israel); Kapon, Y [Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona, 74100 (Israel); Sahar, R [Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona, 74100 (Israel); Brandeis, R [Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona, 74100 (Israel)

2005-11-15

Centrally mediated seizures and convulsions are common consequences of exposure to organophosphates (OPs). These seizures rapidly progress to status epilepticus (SE) and contribute to profound brain injury. Effective management of these seizures is critical for minimization of brain damage. Nasal application of midazolam (1.5 mg/kg) after 5 min of sarin-induced electrographic seizure activity (EGSA) ameliorated EGSA and convulsive behavior (238 {+-} 90 s). Identical treatment after 30 min was not sufficient to ameliorate ECoG paradoxical activity and convulsive behavior. Nasal midazolam (1.5 mg/kg), together with scopolamine (1 mg/kg, im) after 5 min of EGSA, exerted a powerful and rapid anticonvulsant effect (53 {+-} 10 s). Delaying the same treatment to 30 min of EGSA leads to attenuation of paroxysmal ECoG activity in all cases but total cessation of paroxysmal activity was not observed in most animals tested. Cognitive tests utilizing the Morris Water Maze demonstrated that nasal midazolam alone or together with scopolamine (im), administered after 5 min of convulsions, abolished the effect of sarin on learning. Both these treatments, when given after 30 min of convulsions, only decreased the sarin-induced learning impairments. Whereas rats which were not subject to the anticonvulsant agents did not show any memory for the platform location, both treatments (at 5 min as well as at 30 min) completely abolished the memory deficits. Both treatments equally blocked the impairment of reversal learning when given at 5 min. However, when administered after 30 min, midazolam alone reversed the impairments in reversal learning, while midazolam with scopolamine did not. Rats exposed to sarin and treated with the therapeutic regimen with the exclusion of midazolam exhibited severe brain lesions that encountered the hippocampus, pyriform cortex, and thalamus. Nasal midazolam at 5 min prevented brain damage, while delaying the midazolam treatment to 30 min of EGSA resulted

Could conscious sedation with midazolam for dental procedures be ...

African Journals Online (AJOL)

CS) with intravenous midazolam could become an alternative modality to general anesthesia (GA) for dental procedures. Materials and Methods: In our study, 58 and 47 American Society of Anesthesiologists (ASA).1 pediatric patients, aged ...

Cognitive properties of sedation agents: comparison of the effects of nitrous oxide and midazolam on memory and mood.

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Thompson, J M; Neave, N; Moss, M C; Scholey, A B; Wesnes, K; Girdler, N M

1999-11-27

To compare the effects of nitrous oxide and midazolam on cognition and mood. A three-way, counterbalanced, cross-over study, using patients receiving conscious sedation for routine dental treatment. On each of three separate visits, patients performed a computerised test battery to determine baseline cognitive performance. Then, following administration of either midazolam, nitrous oxide, or no drug, patients re-performed the test battery. Finally, patients completed visual analogue scales assessing their subjective mood state. Relative to baseline performance, midazolam administration produced significantly slower reaction times compared with nitrous oxide and no-drug conditions. Furthermore, patients receiving midazolam were impaired in accuracy relative to the other conditions on many of the cognitive tasks, particularly those assessing the recall of information. Patient performance in nitrous oxide and control conditions did not significantly differ. These results could not be explained by differences in mood between the conditions, as subjective mood ratings during midazolam or nitrous oxide administration were very similar. It is important for clinicians to be aware that peri-operative recall of information is reduced in patients who have undergone midazolam sedation. This is an advantage for patients who are anxious, and do not wish to be aware of the operative treatment being performed. However, as the cognitive impairment is enduring, an adult escort and written post-operative instructions should be mandatory for midazolam sedation patients. In contrast, the use of nitrous oxide sedation does not significantly impair higher cognitive tasks and thus patients receiving nitrous oxide sedation can resume normal activities in the post-operative period.

Efficacy and safety of non-intravenous midazolam for the treatment of status epilepticus in children: a Meta-analysis

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Yan LIN

2016-02-01

Full Text Available Objective To evaluate the clinical efficacy and safety of non-intravenous midazolam for treating status epilepticus (SE in children.  Methods Taking midazolam, status epilepticus and children both in Chinese and English as search terms, retrieve in databases such as PubMed, ScienceDirect, China National Knowledge Infrastructure (CNKI, VIP and Wanfang Data, assisted by manual searching and Google Scholar, in order to collect randomized controlled trials (RCTs about non-intravenous midazolam for treating SE in children from January 2000 to January 2015. Jadad Scale was used to evaluate the quality of literatures. Meta-analysis was performed by using RevMan 5.3 software. Results There were a total of 258 records after preliminary searching, and 6 RCTs involving 766 episodes were finally included after excluding duplicate ones and those which did not meet the inclusion criteria. The results were as follows: 1 midazolam via intranasal administration was as effective as intravenous diazepam in achieving seizure control in children (RD = -0.070, 95%CI: -0.200—0.060, P = 0.290. However, non-intravenous (intranasal or buccal midazolam showed better effects on seizure control than rectal diazepam (RD = 0.170, 95% CI: 0.030—0.320; P = 0.020. 2 The mean time from arrival at hospital to cessation was not significantly different between intranasal midazolam and intravenous diazepam (SMD = -1.570, 95%CI: -3.280—0.140; P = 0.070. 3 There was no statistical difference between intranasal midazolam and intravenous diazepam for the time from giving drug to cessation (SMD = 0.240, 95%CI: -0.110—0.590; P = 0.170. 4 There was no statistical difference on the occurrence rate of adverse drug reactions between non-intravenous midazolam and intravenous or non-intravenous diazepam (RD = -0.010, 95% CI: -0.030—0.200; P = 0.500.  Conclusions Non-intravenous midazolam is safe and effective in the treatment for status epilepticus in children. However, the

Voltammetric behavior of sedative drug midazolam at glassy carbon electrode in solubilized systems

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Jain, Rajeev; Yadav, Rajeev Kumar

2012-01-01

Redox behavior of midazolam was studied at a glassy carbon electrode in various buffer systems, supporting electrolytes and pH using differential pulse, square-wave and cyclic voltammetry. Based on its reduction behavior, a direct differential pulse voltammetric method has been developed and validated for the determination of midazolam in parenteral dosage. Three well-defined peaks were observed in 0.1% SLS, BrittonâRobinson (BR) buffer of pH 2.5. The effect of surfactants like sodium lauryl ...

Voltammetric behavior of sedative drug midazolam at glassy carbon electrode in solubilized systems

OpenAIRE

Jain, Rajeev; Yadav, Rajeev Kumar

2011-01-01

Redox behavior of midazolam was studied at a glassy carbon electrode in various buffer systems, supporting electrolytes and pH using differential pulse, square-wave and cyclic voltammetry. Based on its reduction behavior, a direct differential pulse voltammetric method has been developed and validated for the determination of midazolam in parenteral dosage. Three well-defined peaks were observed in 0.1% SLS, Britton–Robinson (BR) buffer of pH 2.5. The effect of surfactants like sodium lauryl ...

Disruption of cortical integration during midazolam-induced light sedation.

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Liang, Peipeng; Zhang, Han; Xu, Yachao; Jia, Wenbin; Zang, Yufeng; Li, Kuncheng

2015-11-01

This work examines the effect of midazolam-induced light sedation on intrinsic functional connectivity of human brain, using a randomized, double-blind, placebo-controlled, cross-over, within-subject design. Fourteen healthy young subjects were enrolled and midazolam (0.03 mg/kg of the participant's body mass, to a maximum of 2.5 mg) or saline were administrated with an interval of one week. Resting-state fMRI was conducted before and after administration for each subject. We focus on two types of networks: sensory related lower-level functional networks and higher-order functions related ones. Independent component analysis (ICA) was used to identify these resting-state functional networks. We hypothesize that the sensory (visual, auditory, and sensorimotor) related networks will be intact under midazolam-induced light sedation while the higher-order (default mode, executive control, salience networks, etc.) networks will be functionally disconnected. It was found that the functional integrity of the lower-level networks was maintained, while that of the higher-level networks was significantly disrupted by light sedation. The within-network connectivity of the two types of networks was differently affected in terms of direction and extent. These findings provide direct evidence that higher-order cognitive functions including memory, attention, executive function, and language were impaired prior to lower-level sensory responses during sedation. Our result also lends support to the information integration model of consciousness. © 2015 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.

Hemodynamics and bispectral index (BIS of dogs anesthetized with midazolam and ketamine associated with medetomidine or dexmedetomidine and submitted to ovariohysterectomy Avaliação hemodinâmica e do índice bispectral (BIS de cadelas anestesiadas com midazolam e cetamina associados à medetomidina ou dexmedetomidina e submetidas a ovário-salpingo-histerectomia

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Fernando do Carmo Silva

2010-04-01

Full Text Available PURPOSE: To evaluate hemodynamics and bispectral index (BIS in bitches anesthetized with ketamine and midazolam in combination with dexmedetomidine or medetomidine and submitted to ovariohysterectomy. METHODS: Twenty bitches pretreated with levomedetomidine and buprenorphine were anesthetized with 5 mg.kg-1 ketamine and 0.2 mg.kg-1 midazolam i.v. Continuous infusion of 0.4 mg.kg-1.h-1 midazolam and 20 mg.kg-1.h-1 ketamine was initiated in combination with DEX (n=10: 20 µg.kg-1.h-1 dexmedetomidine or MED (n=10: 30 µg.kg-1.h-1 medetomidine over 30 minutes. A pharmacokinetic study provided dexmedetomidine plasma concentration, set to be 3.0 ng.mL-1. RESULTS: BIS decreased in both groups (P0.05, but heart rate decreased in both groups, as compared to control values (POBJETIVO: Verificar o comportamento hemodinâmico e o índice bispectral de cadelas anestesiadas com cetamina e midazolam associados à dexmedetomidina ou medetomidina. MÉTODOS: Vinte cadelas receberam pré-tratamento com levomepromazina e buprenorfina e foram anestesiadas com cetamina, 5 mg.kg-1 i.v., e midazolam, 0,2 mg.kg-1 i.v., seguidos da administração contínua de midazolam, 0,4 mg.kg-1.h-1, e cetamina, 20 mg.kg-1.h-1, associados, conforme o grupo, à: DEX (n=10: dexmedetomidina 20 µg.kg-1.h-1 ou MED (n=10: medetomidina 30 µg.kg-1.h-1, mantidos por 30 minutos. A dose de dexmedetomidina foi obtida por meio de estudo farmacocinético planejando-se concentração plasmática de 3,0 ng.mL-1. RESULTADOS: Os valores do BIS diminuíram em ambos os grupos (P0,05, sem a presença de efeitos adversos. CONCLUSÃO: A administração contínua de dexmedetomidina em concentração plasmática calculada de 3 ng.mL-1, em combinação com midazolam e cetamina, resulta em plano anestésico adequado para castração de cadelas, estabilidade hemodinâmica e despertar tranquilo, sem efeitos adversos.

Impact of Solutol HS 15 on the pharmacokinetic behavior of midazolam upon intravenous administration to male Wistar rats.

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Bittner, Beate; González, Roberto Carlos Bravo; Isel, Hughes; Flament, Christophe

2003-07-01

The pharmacokinetic profile of midazolam (MDZ) and its major metabolites 1'-OH-midazolam (1'OH-MDZ) and 4-OH-midazolam (4OH-MDZ) was investigated in rats. MDZ was administered intravenously at 5 mg/kg either in the absence (NaCl 0.9%, control group) or in the presence of the surfactant Solutol HS 15, a weak inhibitor of cytochrome P450 3A (CYP3A) activity in vitro (Solutol HS 15-treated group). It was found that the pharmacokinetic profiles of MDZ, 1'OH-MDZ and 4OH MDZ did not differ significantly in the two dosing vehicles (P values above 0.2). MDZ exhibited a high plasma clearance (Cl) of 79 and 92 ml/min/kg (corresponding to a blood Cl of 64 and 75 ml/min/kg), a high volume of distribution (V(d)) of 4.0 and 3.6 l/kg, and an area under the plasma concentration-time curve (AUC(t0-tinf)) of 1062 and 932 h.ng/ml in the control group and in the Solutol HS 15-treated group, respectively. The amount of MDZ excreted unchanged into urine was below 0.01% with both dosing vehicles. AUC(t0-tinf) in the control group was 12.3 h.ng/ml for 1'OH-MDZ and 38.8 h.ng/ml 4OH-MDZ. In the Solutol HS 15-treated group, AUC(t0-tinf) was 14 h.ng/ml for 1'OH-MDZ and 35.4 h.ng/ml for 4OH-MDZ. The metabolite concentrations excreted into urine were below the limit of quantification. In the rat, MDZ has a high blood clearance that is limited by liver blood flow. Therefore, weak CYP3A inhibitors like Solutol HS 15 are not likely to affect the hepatic blood clearance of MDZ in vivo.

A randomized, controlled, crossover trial of oral midazolam and hydroxyzine for pediatric dental sedation Sedação com midazolam e hidroxizina por via oral em Odontopediatria: ensaio clínico randomizado, controlado e cruzado

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Alessandra Rodrigues de Almeida Lima

2003-09-01

Full Text Available The effectiveness of oral midazolam in pediatric dentistry is controversial. This randomized, controlled, crossover, double blind clinical trial was conducted in order to study the effect of midazolam, used either alone or in association with hydroxyzine, during child dental treatment. Thirty seven dental sedation sessions were carried out on 11 ASA I uncooperative children less than five years-old. In each appointment children were randomly assigned to groups: P - placebo, M - midazolam (1.0 mg/kg, or MH - midazolam (0.75 mg/kg plus hydroxyzine (2.0 mg/kg. Vital signs (blood pressure, breathing rate, pulse and oxygen saturation and behavior parameters (consciousness, crying, movement, overall behavior were evaluated every 15 minutes. Friedman and Wilcoxon statistical tests were used to compare groups and different moments in the same group. Normal values of vital signs were usually registered. Heart rate increased in groups P and M as the session went on. Group M presented less crying and movement at the first 15 minutes of treatment. Group MH caused more drowsiness at the beginning of the session. Overall behavior was better in group M than in groups P or MH. Group M produced effective sedation in 77% of the cases, and group MH did so in 30.8%. It was concluded that midazolam was effective and safe, and its association with hydroxyzine did not lead to additional advantages in pediatric dental sedation.Há controvérsias quanto aos benefícios do midazolam na sedação de crianças durante a atenção odontológica. Conduziu-se um ensaio clínico controlado, cruzado e duplo-cego para comparar o efeito sedativo em Odontopediatria da administração oral do midazolam, associado ou não à hidroxizina. Trinta e sete sessões foram realizadas em 11 crianças menores de cinco anos, ASA I. Em cada atendimento, os pacientes receberam aleatoriamente o medicamento conforme os grupos: P - placebo, M - midazolam (1,0 mg/kg; MH - midazolam (0,75 mg

Efecto sedante del midazolam genérico versus innovador en ratas Wistar

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Radamés Alemón-Medina

2015-11-01

Full Text Available Antecedentes: ocho de cada diez pacientes en Terapia Intensiva del Instituto Nacional de Pediatría no obtienen el mismo efecto ansiolítico y sedante con midazolam genérico (PiSA®, que con el innovador (Dormicum, Roche® a pesar de que su biodisponibilidad es de 100%.  Objetivo: determinar diferencias significativas en el efecto sedante del midazolam genérico y del innovador administrados parenteralmente.  Material y métodos: estudio aleatorizado cruzado en 24 ratas Wistar macho distribuidas en 4 grupos (n=6. A cada individuo se le administró una dosis de 0.5 mg/kg de peso vía intraperitoneal. Se determinaron los grados de sedación mediante la escala de Salamone. Se midió la concentración del fármaco en las ampolletas de ambas marcas por cromatografía líquida de alta resolución. Resultados: el efecto sedante del midazolam apareció al mismo tiempo y tuvo la misma duración, ndependientemente de la marca. El efecto tiende a ser más duradero con el innovador pero sin ser estadísticamente significativo (ANOVA, p ≤ 0.05. Asimismo, la mayoría de los animales llegaron al nivel 3 de sedación con ambas marcas.   Conclusión: tanto el midazolam innovador como el genérico tienen el mismo efecto sedante: aparece al mismo tiempo y tiene la misma duración.

Midazolam induces apoptosis in MA-10 mouse Leydig tumor cells through caspase activation and the involvement of MAPK signaling pathway

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So EC

2014-02-01

Full Text Available Edmund Cheung So,1,2 Yu-Xuan Lin,3 Chi Hao Tseng,1 Bo-Syong Pan,3 Ka-Shun Cheng,2 Kar-Lok Wong,2 Lyh-Jyh Hao,4 Yang-Kao Wang,5 Bu-Miin Huang2 1Department of Anesthesia, Tainan Municipal An Nan Hospital, China Medical University, Tainan, Taiwan; 2Department of Anesthesia, China Medical University, Taichung, Taiwan; 3Department of Cell Biology and Anatomy, National Cheng Kung University, Tainan, Taiwan; 4Department of Internal Medicine, Division of Endocrinology and Metabolism, Kaohsiung Veteran General Hospital Tainan Branch Tainan, Taiwan; 5Graduate Institute of Biomedical Materials and Tissue Engineering, Taipei Medical University, Taipei, Taiwan Purpose: The present study aims to investigate how midazolam, a sedative drug for clinical use with cytotoxicity on neuronal and peripheral tissues, induced apoptosis in MA-10 mouse Leydig tumor cells. Methods: The apoptotic effect and underlying mechanism of midazolam to MA-10 cells were investigated by flow cytometry assay and Western blotting methods. Results: Data showed that midazolam induced the accumulation of the MA-10 cell population in the sub-G1 phase and a reduction in the G2/M phase in a time- and dose-dependent manner, suggesting an apoptotic phenomenon. Midazolam could also induce the activation of caspase-8, -9, and -3 and poly (ADP-ribose polymerase proteins. There were no changes in the levels of Bax and cytochrome-c, whereas Bid was significantly decreased after midazolam treatment. Moreover, midazolam decreased both pAkt and Akt expression. In addition, midazolam stimulated the phosphorylation of p38 and c-Jun NH2-terminal kinase but not extracellular signal-regulated kinase. Conclusion: Midazolam could induce MA-10 cell apoptosis through the activation of caspase cascade, the inhibition of pAkt pathway, and the induction of p38 and c-Jun NH2-terminal kinase pathways. Keywords: midazolam, apoptosis, MA-10 cell, caspase, Akt, MAPKs

Estudo comparativo de midazolam com cetamina S(+ versus midazolam com bloqueio paracervical uterino para aspiração manual intra-uterina Estudio comparativo de midazolam con cetamina S(+ versus midazolam con bloqueo paracervical uterino para aspiración manual intrauterina Comparative study of midazolam with ketamine S(+ versus midazolam with uterine paracervical block for manual intrauterine aspiration

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Vonaldo Torres de Almeida

2006-10-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: Avaliar a efetividade, a analgesia pós-operatória e o grau de satisfação e recomendação das pacientes submetidas à aspiração manual intra-uterina por meio da comparação de duas técnicas anestésicas. MÉTODO: Foram estudadas, prospectivamente, 80 pacientes distribuídas aleatoriamente em dois grupos. Todas receberam midazolam, por via venosa. Em seguida, o Grupo MC recebeu cetamina S(+ por via venosa e o Grupo MP, bloqueio paracervical uterino. Na sala de cirurgia a eficácia da técnica foi avaliada por três observadores (o pesquisador, o obstetra e o residente de obstetrícia e, após uma hora, foi avaliada por um observador que desconhecia a técnica realizada, a analgesia pós-operatória, os graus de satisfação de recomendação da paciente mediante escala verbal. RESULTADOS: As técnicas mostraram-se eficientes em 95% das pacientes do Grupo MC e 76,7% das pacientes do Grupo MP (p = 0,04. Entre as pacientes do Grupo MC, 67% não apresentaram dor após uma hora, enquanto no grupo MP a porcentagem de pacientes sem dor foi de 33,3% (p JUSTIFICATIVA Y OBJETIVOS: Evaluar la efectividad, la analgesia postoperatoria y el grado de satisfacción y recomendación de las pacientes sometidas a la aspiración manual intrauterina a través de la comparación de las técnicas anestésicas. MÉTODO: Formando parte de un estudio de prospección, se estudiaron 80 pacientes distribuidas aleatoriamente en 2 grupos. Todas recibieron midazolam por vía venosa. En seguida, el Grupo MC, recibió cetamina S(+ por vía venosa y el Grupo MP bloqueo paracervical uterino. En la sala de cirugía la eficacia de la técnica fue evaluada por tres observadores (el investigador, el obstetra y el residente de obstetricia y después de una hora, fue evaluada por un observador que desconocía la técnica realizada, la analgesia postoperatoria y los grados de satisfacción de recomendación de la paciente mediante escala verbal

Evaluation of Intranasal Midazolam as an Anesthetic Premedication in Preschool Children

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Sh Behdad

2005-10-01

Full Text Available Introduction: Preoperative psycho emotional preparation of patients is one of the principle purposes of anesthesia which can be achieved by administration of premedications. Children should receive premedication before entering the operating room due to their dependence on parents and the fear and anxiety of separation from parents. Different drugs are administered for this purpose, but considering children's sensitivity, it is wise to use the most effective and comfortable medication with least side effects. Midazolam is a rapid onset, short acting and water soluble benzodiazapine which can be administered by oral, intravenous, intramuscular, rectal or intranasal routes. The purpose of this study was to evaluate the result of intranasal midazolam administration (0.2 mg/kg as a premedication in children aged 2-6 years.( Min dose and enough time Methods: In this randomized prospective study, 100 children aged between 2-6 years old in class ASA 1 and candidates of surgery were divided into two groups; case and control. The control group received several nasal drops of normal saline, while the case group received 0.2 mg/kg nasal midazolam 20 minutes before anesthesia induction. Results: Twenty minutes after administration of the nasal drops, 14% in the control group and 68% in the case group were alert and calm. (P value=0.0 . Mask acceptance during induction of anesthesia in control and case group was 14%and 72%, respectively (P value >0.00 The recovery time in the case group was longer (P value >0.5, but no complications (nausea, vomiting, respiratory and cardiovascular problems were seen in either group. Conclusion: Nasal midazolam with its anxiolytic, tranquilizing effects and no respiratory or cardiovascular complications is a safe drug and being better than parenteral drugs is acceptable by children.

IS ATOMIZED INTRANASAL MIDAZOLAM A NOVEL SEDATIVE PREMEDICATION IN PAEDIATRIC PATIENTS?

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Savitri D. Kabade

2017-06-01

Full Text Available BACKGROUND The successful conduct of anaesthesia in children depends on adequate premedication, which not only comforts the anxious child but also comforts the parents or guardians. Atomized Intranasal Midazolam is quickly absorbed through the nasal mucosa, resulting in a rapid and reliable onset of action. Clonidine has several applications in paediatric anaesthesia as a premedication and as an adjuvant in general as well as regional anaesthesia. Thus, in search of a novel premedication technique, we conducted a study to compare the effectiveness of atomized intranasal midazolam with intranasal clonidine for preoperative sedation in paediatric patients undergoing elective surgery. MATERIALS AND METHODS After obtaining Institutional Ethical Committee clearance and parent’s consent, a prospective, randomised, double-blinded clinical study was conducted in 78 children of ASA I and II, belonging to 2 - 10 years age, posted for various elective surgery. Group M (n= 39 received atomized intranasal midazolam (0.3 mg/kg and Group C (n= 39 received clonidine (4 mcg/kg instilled into both the nostrils. Sedation score (Ramsay, separation score, mask acceptance, recovery and vital parameters were recorded. Statistical analysis of data was done using IBM-SPSS version 21.0. RESULTS Mean sedation scores (± SD were higher in Group M than in Group C (at 5th minute 1.58 ± 0.55 in Group M and 1.15 ± 0.36 in Group C with P= 0.002, at 10th minute 2.34 ± 0.97 in Group M and 1.75 ± 0.71 in Group C with P= 0.008. Separation scores and mask acceptance were better with Group M than Group C. Haemodynamic parameters were similar in both the groups and no major adverse effects were noted. CONCLUSION Atomized intranasal midazolam produces superior sedation levels, child-parent separation and mask acceptance compared to intranasal clonidine in children.

Comparing the Effect of Intravenous Midazolam with Rectal Sodium Valproate in Controlling of Children with Refractory Status Epilepticus

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T Mahmoudian

2006-01-01

Full Text Available Background: Refractory status epilepticus usually defined as a seizure lasting at least 60 minutes which is uncontrollable by Diazepam, Phenytoin, or Phenobarbital. The aim of this study was to compare the effect of interavenous Midazolam and rectal Sodium valproate in controlling refractory status epilepticus. Methods: In this case-control study; 76 children with (mean age of 37± 20 months with refractory status epilepticus were randomly divided into two groups to receive IV Midazolam and rectal Sodium Valproate. The effect of the two drugs were compared in control of seizure during first 20 minutes of treatment. Results: In 84.2 percent of children treated with IV Midazolam, the seizure was under control within 4.5 ± 0.5 minutes, while in 63 percent of those receiving Sodium Valproate, the seizure was completely controlled within 16.5 ± 0.8 minutes (P < 0.00001. Conclusion: The IV Midazolam was more effective than Sodium valproate, but the latter can be used in hospitals or pediatric emergency wards without ICU for controlling of refractory status epilepticus. Key words: refractory status epilepticus, midazolam, sodium valproate

Implicit transitive inference and the human hippocampus: does intravenous midazolam function as a reversible hippocampal lesion?

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Greene Anthony J

2007-09-01

Full Text Available Abstract Recent advances have led to an understanding that the hippocampus is involved more broadly than explicit or declarative memory alone. Tasks which involve the acquisition of complex associations involve the hippocampus whether the learning is explicit or implicit. One hippocampal-dependent implicit task is transitive inference (TI. Recently it was suggested that implicit transitive inference does not depend upon the hippocampus (Frank, M. J., O'Reilly, R. C., & Curran, T. 2006. When memory fails, intuition reigns: midazolam enhances implicit inference in humans. Psychological Science, 17, 700–707. The authors demonstrated that intravenous midazolam, which is thought to inactivate the hippocampus, may enhance TI performance. Three critical assumptions are required but not met: 1 that deactivations of other regions could not account for the effect 2 that intravenous midazolam does indeed deactivate the hippocampus and 3 that midazolam influences explicit but not implicit memory. Each of these assumptions is seriously flawed. Consequently, the suggestion that implicit TI does not depend upon the hippocampus is unfounded.

Bronchoscopic diagnosis of peripheral pulmonary lung cancer employing sedation with fentanyl and midazolam.

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Minami, Daisuke; Nakasuka, Takamasa; Ando, Chihiro; Iwamoto Md, Yoshitaka; Sato, Ken; Fujiwara, Keiichi; Shibayama, Takuo; Yonei Md PhD, Toshirou; Sato, Toshio

2017-09-01

Sedation with fentanyl and midazolam during bronchoscopic examination is commonly employed by pulmonary physicians in the USA and Europe. We assessed the efficacy of such sedation in the bronchoscopic diagnosis of peripheral lung cancer. We retrospectively evaluated data from 102 patients who underwent transbronchial biopsies (TBB) for diagnosis of peripheral lung cancer. Bronchoscopies with and without fentanyl were performed in 61 (group A) and 41 (group B) patients, respectively. Midazolam was administered to all patients. Medical records were retrieved, and between-group comparisons were made using unpaired Student's t-tests. The mean fentanyl dose was 49.5 μg (range: 10-100 μg), and midazolam doses in groups A and B were 4.29mg (range: 1-14mg) and 5.54mg (range: 1-12mg), respectively. Diagnostic histological specimens were obtained from 75.4% and 65.8% of group A and B patients, respectively (P = 0.30). The diagnostic sensitivities for lung cancer, via at least one of TBB, cytological brushing, or bronchial washing, in groups A and B were 88.5% and 70.4%, respectively (P = 0.035). Moreover, lesion diagnostic sensitivities, via at least one of TBB, cytological brushing, and bronchial washing, in groups A and B were 98.1% and 68.0%, respectively (P = 0.01). Fentanyl and midazolam sedation during bronchoscopy facilitated the diagnosis of peripheral pulmonary lung cancers. Copyright © 2017 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

Comparison of oral ketamine and oral midazolam as sedative agents in pediatric dentistry

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Damle S

2008-09-01

Full Text Available The safe and effective treatment of uncooperative or combative preschool children with extensive dental needs is one of pediatric dentist′s ongoing challenges. The traditional methods of behavior management are no longer acceptable to parents as they are not ready to spare more time for dental treatment of their children. Keeping this in mind, the present study was designed and carried out to evaluate the sedative effects of oral ketamine and oral midazolam prior to general anesthesia. Twenty uncooperative children in the age-group of 2-6 years were selected after thorough medical examination and investigations. Informed consent was obtained from the parent. This was a randomized double-blind study. An anesthesiologist administered either 0.5 mg/kg midazolam or 5 mg/kg ketamine orally. The heart rate, respiratory rate, and oxygen saturation were recorded at regular intervals. The sedation and anxiolysis scores were also recorded. The parents were asked to answer a questionnaire at the follow-up session the next day on the surgical experience of the parent and the child and side effects experienced, if any. When the data was subjected to statistical analysis, it was observed that both drugs resulted in adequate sedation at the end of 30 min, with oral midazolam providing significantly better anxiolysis. The heart rate and respiratory rate were marginally higher with oral ketamine. The questionnaire revealed a better response with oral midazolam; side effects were more prominent with oral ketamine.

Studies on thiopentone and midazolam hemodynamic response during induction of anesthesia in patients with coronary artery disease

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mohammad Sofiabadi

2005-08-01

Conclusions: Hemodynamic effects of midazolam is similar to thiopentone. Midazolam is a water-soluble, safe and effective inductive anesthetic with short- term effects, much lesser venous irritation, and it can be used instead of thiopentone in patients with cardiac diseases or those patients which thiopentone is contraindicated for whom.

Premedication with melatonin vs midazolam: efficacy on anxiety and compliance in paediatric surgical patients.

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Impellizzeri, Pietro; Vinci, Enrica; Gugliandolo, Maria Cristina; Cuzzocrea, Francesca; Larcan, Rosalba; Russo, Tiziana; Gravina, Maria Rosaria; Arena, Salvatore; D'Angelo, Gabriella; Gitto, Eloisa; Montalto, Angela Simona; Alibrandi, Angela; Marseglia, Lucia; Romeo, Carmelo

2017-07-01

Preoperative anxiety is a major problem in paediatric surgical patients. Melatonin has been used as a premedicant agent and data regarding effectiveness are controversial. The primary outcome of this randomized clinical trial was to evaluate the effectiveness of oral melatonin premedication, in comparison to midazolam, in reducing preoperative anxiety in children undergoing elective surgery. As secondary outcome, compliance to intravenous induction anaesthesia was assessed. There were 80 children undergoing surgery randomly assigned, 40 per group, to receive oral midazolam (0.5 mg/kg, max 20 mg) or oral melatonin (0.5 mg/kg, max 20 mg). Trait anxiety of children and their mothers (State-Trait Anxiety Inventory) at admission, preoperative anxiety and during anaesthesia induction (Modified Yale Pre-operative Anxiety Scale), and children's compliance with anaesthesia induction (Induction Compliance Checklist) were all assessed. Children premedicated with melatonin and midazolam did not show significant differences in preoperative anxiety levels, either in the preoperative room or during anaesthesia induction. Moreover, compliance during anaesthesia induction was similar in both groups. This study adds new encouraging data, further supporting the potential use of melatonin premedication in reducing anxiety and improving compliance to induction of anaesthesia in children undergoing surgery. Nevertheless, further larger controlled clinical trials are needed to confirm the real effectiveness of melatonin as a premedicant agent in paediatric population. What is Known: • Although midazolam represents the preferred treatment as a premedication for children before induction of anaesthesia, it has several side effects. • Melatonin has been successfully used as a premedicant agent in adults, while data regarding effectiveness in children are controversial. What is New: • In this study, melatonin was as effective as midazolam in reducing children's anxiety in both

Intestinal first pass metabolism of midazolam in liver cirrhosis --effect of grapefruit juice

DEFF Research Database (Denmark)

Andersen, Vibeke; Pedersen, Natalie; Larsen, Niels-Erik

2002-01-01

Grapefruit juice inhibits CYP3A4 in the intestinal wall leading to a reduced intestinal first pass metabolism and thereby an increased oral bioavailability of certain drugs. For example, it has been shown that the oral bioavailability of midazolam, a CYP3A4 substrate, increased by 52% in healthy...... subjects after ingestion of grapefruit juice. However, this interaction has not been studied in patients with impaired liver function. Accordingly, the effect of grapefruit juice on the AUC of midazolam and the metabolite alpha-hydroxymidazolam was studied in patients with cirrhosis of the liver....

Dexmedetomidine, ketamine, and midazolam for oral rehabilitation: a case report.

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Kim, Bill W S; Peskin, Robert M

2015-01-01

Intravenous sedation is frequently provided by anesthesiologists for phobic patients undergoing elective dental treatment in outpatient settings. Propofol is one of the most commonly used anesthetic agents that can result in apnea and respiratory depression, thereby posing potential difficulties with perioperative airway management. Dexmedetomidine has been utilized successfully in intravenous sedation for a wide variety of procedures and holds potential as an alternative to propofol in outpatient dental settings. However, as a single agent, it may not provide adequate depth of sedation and analgesia for oral rehabilitation. In this case report we demonstrate an effective alternative intravenous deep-sedation technique for an adult phobic patient undergoing oral rehabilitation utilizing 3 agents in combination: dexmedetomidine, ketamine, and midazolam. This combination of agents may be especially useful for those patients with a history of substance abuse, where administration of opioids may be undesirable or contraindicated.

The effect of midazolam on implicit and explicit memory in category exemplar production and category cued recall.

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Arndt, Jason; Passannante, Anthony; Hirshman, Elliot

2004-03-01

Transfer-appropriate processing theory (Roediger, Weldon, & Challis, 1989) proposes that dissociations between performance on explicit and implicit memory tests arise because these tests often rely on different types of information processing (e.g., perceptual processing vs conceptual processing). This perspective predicts that implicit and explicit memory tasks that rely primarily on conceptual processing should show comparable results, not dissociations. Numerous studies have demonstrated such similarities. It is, however, possible that these results arise from explicit memory contamination of performance on implicit memory tasks. To address this issue, an experiment was conducted in which participants were administered the sedative midazolam prior to study. Midazolam is known to create a temporary, but dense, period of anterograde amnesia. The effects of blocking stimulus materials by semantic category at study and generation at study were investigated on category exemplar production and category-cued recall. The results of this study demonstrated a dissociation of the effects of midazolam on category exemplar production and category-cued recall. Specifically, midazolam reduced the effect of blocking stimulus materials in category-cued recall, but not in category exemplar production. The differential effect of midazolam on explicit and implicit memory is at odds with transfer-appropriate processing theory and suggests that theories of memory must distinguish the roles of different types of conceptual processing on implicit and explicit memory tests.

Oral ketamine/midazolam is superior to intramuscular meperidine, promethazine, and chlorpromazine for pediatric cardiac catheterization.

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Auden, S M; Sobczyk, W L; Solinger, R E; Goldsmith, L J

2000-02-01

An IM combination of meperidine, promethazine, and chlorpromazine (DPT) has been given as sedation for pediatric procedures for more than 40 years. We compared this IM combination to oral (PO) ketamine/midazolam in children having cardiac catheterization. A total of 51 children, ages 9 mo to 10 yr, were enrolled and randomized in this double-blinded study. All children received an IM injection at time zero and PO fluid 15 minutes later. We observed acceptance of medication, onset of sedation and sleep, and sedative efficacy. The cardiorespiratory changes were evaluated. Sedation was supplemented with IV propofol as required. Recovery time, parental satisfaction, and patient amnesia were assessed. Ketamine/midazolam given PO was better tolerated (P < 0.0005), had more rapid onset (P < 0.001), and provided superior sedation (P < 0.005). Respiratory rate decreased after IM DPT only. Heart rate and shortening fraction were stable. Oxygen saturation and mean blood pressure decreased minimally in both groups. Supplemental propofol was more frequently required (P < or = 0.02) and in larger doses (P < 0.05) after IM DPT. Parental satisfaction ratings were higher (P < 0.005) and amnesia was more reliably obtained (P = 0.007) with PO ketamine/midazolam. Two patients needed airway support after the PO medication, as did two other patients when PO ketamine/midazolam was supplemented with IV propofol. Although PO ketamine/midazolam provided superior sedation and amnesia compared to IM DPT, this regimen may require the supervision of an anesthesiologist for safe use. Oral medication can be superior to IM injections for sedating children with congenital heart disease; however, the safety of all medications remains an issue.

A Comparative Study between Intramuscular Midazolam and Oral Clonidine As A Premedication For General Anesthesia

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Jignasa J Patel; Kalpana A Desai

2015-01-01

Background: Most anesthesiologists agree on the need for efficient pre-medication. The pattern of desired effects of a pre-medication is however, complex and includes relief of anxiety, sedation and relaxation of the patient. The present study was undertaken to compare the effects of Midazolam and clonidine as premedication. Methodology: A comparative study between midazolam and clonidine as a premedication for general anesthesia was conducted. Patients were divided in two groups: Group I: In...

The effect of intrathecal midazolam on the characteristics of ...

African Journals Online (AJOL)

Objectives: The present study was undertaken to determine the onset of sensory block, the time to achieve the maximum level of sensory block and the analgesic efficacy of intrathecal midazolam when given in combination with bupivacaine, and also to observe any undesirable side-effects produced by the ...

Complete recovery from intractable complex regional pain syndrome, CRPS-type I, following anesthetic ketamine and midazolam.

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Kiefer, Ralph-Thomas; Rohr, Peter; Ploppa, Annette; Altemeyer, Karl-Heinz; Schwartzman, Robert Jay

2007-06-01

To describe the treatment of an intractable complex regional pain syndrome I (CRPS-I) patient with anesthetic doses of ketamine supplemented with midazolam. A patient presented with a rapidly progressing contiguous spread of CRPS from a severe ligamentous wrist injury. Standard pharmacological and interventional therapy successively failed to halt the spread of CRPS from the wrist to the entire right arm. Her pain was unmanageable with all standard therapy. As a last treatment option, the patient was transferred to the intensive care unit and treated on a compassionate care basis with anesthetic doses of ketamine in gradually increasing (3-5 mg/kg/h) doses in conjunction with midazolam over a period of 5 days. On the second day of the ketamine and midazolam infusion, edema, and discoloration began to resolve and increased spontaneous movement was noted. On day 6, symptoms completely resolved and infusions were tapered. The patient emerged from anesthesia completely free of pain and associated CRPS signs and symptoms. The patient has maintained this complete remission from CRPS for 8 years now. In a patient with severe spreading and refractory CRPS, a complete and long-term remission from CRPS has been obtained utilizing ketamine and midazolam in anesthetic doses. This intensive care procedure has very serious risks but no severe complications occurred. The psychiatric side effects of ketamine were successfully managed with the concomitant use of midazolam and resolved within 1 month of treatment. This case report illustrates the effectiveness and safety of high-dose ketamine in a patient with generalized, refractory CRPS.

Sedative effects of midazolam and xylazine with or without ketamine and detomidine alone following intranasal administration in Ring-necked Parakeets.

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Vesal, Nasser; Eskandari, Mohammad H

2006-02-01

To evaluate the effects of intranasal administration of midazolam and xylazine (with or without ketamine) and detomidine and their specific antagonists in parakeets. Prospective study. 17 healthy adult Ring-necked Parakeets (Psittacula krameri) of both sexes (mean weight, 128.83+/-10.46 g [0.28+/-0.02 lb]). The dose of each drug or ketamine-drug combination administered intranasally that resulted in adequate sedation (ie, unrestrained dorsal recumbency maintained for >or=5 minutes) was determined; the onset of action, duration of dorsal recumbency, and duration of sedation associated with these treatments were evaluated. The efficacy of the reversal agents flumazenil, yohimbine, and atipamezole was also evaluated. In parakeets, intranasal administration of midazolam (7.3 mg/kg [3.32 mg/lb]) or detomidine (12 mg/kg [5.45 mg/lb]) caused adequate sedation within 2.7 and 3.5 minutes, respectively. Combinations of midazolam (3.65 mg/kg [1.66 mg/lb]) and xylazine (10 mg/kg [4.55 mg/lb]) with ketamine (40 to 50 mg/kg [18.2 to 22.7 mg/lb]) also achieved adequate sedation. Compared with detomidine, duration of dorsal recumbency was significantly longer with midazolam. Intranasal administration of flumazenil (0.13 mg/kg [0.06 mg/lb]) significantly decreased midazolam-associated recumbency time. Compared with the xylazineketamine combination, duration of dorsal recumbency was longer after midazolam-ketamine administration. Intranasal administration of flumazenil, yohimbine, or atipamezole significantly decreased the duration of sedation induced by midazolam, xylazine, or detomidine, respectively. Intranasal administration of sedative drugs appears to be an acceptable method of drug delivery in Ring-necked Parakeets. Reversal agents are also effective when administered via this route.

Propofol or midazolam infusion associated with subarachnoid anaesthesia in sheep submitted to bilateral tibial osteotomy

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Marcos Paulo Antunes de Lima

2016-09-01

Full Text Available ABSTRACT. de Lima M.P.A., Comassetto F., Regalin D., Dallabrida A.L., Ronchi S.J. & Oleskovicz N. [Propofol or midazolam infusion associated with subarachnoid anaesthesia in sheep submitted to bilateral tibial osteotomy.] Infusão contínua de propofol ou midazolam associado à anestesia subaracnóidea em ovinos submetidos a osteotomia bilateral de tíbia. Revista Brasileira de Medicina Veterinária, 38(3:250-256, 2016. Departamento de Medicina Veteriná- ria, Centro de Ciências Agroveterinárias, Universidade do Estado de Santa Catarina, Av. Luís de Camões, 2090, Conta Dinheiro, Lages, SC 88520-000, Brasil. E-mail: noleskovicz@yahoo.com.br The sheep stands out for being a great experimental model in the orthopedic area. Thus, the aim of this study was to evaluate the safety and efficacy of the anesthetic maintenance by continuous infusion of propofol or midazolam associated with spinal anesthesia with morphine and ropivacaine in sheep underwent bilateral tibial osteotomy. Twelve healthy sheep, with an average weight of 30.5±2.7 kg were used. The animals were sedated with 0.3 mg.Kg-1 of morphine IM associated with 20 mcg.Kg-1 of detomidine IV. Then they were allocated into two groups: Midazolam group (GMID, which were induced with ketamine 5 mg.Kg-1 and midazolam 0.5 mg.Kg-1 IV, and anesthetic maintenance being performed by continuous infusion of 0 7 mg.Kg-1.h-1 of midazolam; Propofol group (GPRO, which were induced to anesthesia with 4 mg.Kg-1 propofol and maintained with its own infusion at a rate of 0.25 mg.Kg-1.min-1. The animals were intubated and maintained on spontaneous ventilation with 100% oxygen. Spinal anesthesia was performed with 0.5 mg.Kg-1 of 0.75% ropivacaine combined with 0.1 mg.Kg-1 of morphine, diluted with NaCl 0.9% solution to total volume of 1mL/7.5Kg. Significant respiratory depression after anesthesia induction was characterized by significantly increased levels of CO2 and reduced pH in both groups. A significant

Avaliação da associação midazolam/droperidol na tranqüilização de suínos Evaluation of midazolam/droperidol association for tranquilization of swines

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José Antonio Marques

1995-01-01

Full Text Available Na presente pesquisa, avaliou-se a associação midazolam/droperidol na tranqüilização de 11 suínos da raça Landrace. Foram analisadas as frequências cardíaca, respiratória, temperatura retal e hemogasimetria arterial antes e após a administração do midazolam (0,4mg/kg IM associado ao droperidol (0,4mg/kg IM. As anotações paramétricas e análises hemogasimétricas foram realizadas a intervalos de 10 minutos, durante uma hora após a administração das drogas. Concomitantemente efetuaram-se observações clínicas a respeito da eficácia da tranqüilização. Não ocorreram alterações significativas nos parâmetros de frequência cardíaca e equilíbrio ácido-base. A frequência respiratória diminuiu significativamente, quando comparada aos valores basais. O tempo médio de ação das drogas foi de 60 minutos, com período de latência de 3 minutos. Durante a tranqüilização houve relaxamento muscular, perda dos reflexos posturais, indiferença ao meio ambiente e manutenção dos reflexos protetores. A análise dos resultados permite indicar a associação midazolam/droperidol para a tranqüilização/sedação de suínos.The association midazolam/droperidol was evaluated in the chemical restraint of 11 Landrace swines. Cardiac and respiratory rates were studied as well as rectal temperature and blood gas analisis after and before the midazolam (0.4mg/kg/droperidol (0.4mg/kg injection. The parametrical values and the blood gas analisis were performed during an hour period after drug administration, at 10 minutes intervals. At the same time, clinical trials were performed about the effectiveness of the tranquilization. Significant changes did not occur in the heart rate and acid-basic equilibrium. The respiratory rate decreased significantly, when compared to basal measurements. The set time of the drug action was that of 60 minutes, with an onset period of 3 minutes. During the tranquilization it was observed muscle relief

Safety, tolerability and pharmacokinetics of doravirine, a novel HIV non-nucleoside reverse transcriptase inhibitor, after single and multiple doses in healthy subjects.

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Anderson, Matt S; Gilmartin, Jocelyn; Cilissen, Caroline; De Lepeleire, Inge; Van Bortel, Luc; Dockendorf, Marissa F; Tetteh, Ernestina; Ancona, June K; Liu, Rachael; Guo, Ying; Wagner, John A; Butterton, Joan R

2015-01-01

Doravirine is a novel non-nucleoside inhibitor of HIV-1 reverse transcriptase with potent activity against wild-type virus (95% inhibitory concentration 19 nM, 50% human serum). Doravirine has low potential to cause drug-drug interactions since it is primarily eliminated by oxidative metabolism and does not inhibit or significantly induce drug-metabolizing enzymes. The pharmacokinetics and safety of doravirine were investigated in two double-blind, dose-escalation studies in healthy males. Thirty-two subjects received single doses of doravirine (6-1,200 mg) or matching placebo tablets; 40 subjects received doravirine (30-750 mg) or matching placebo tablets once daily for 10 days. In addition, the effect of doravirine (120 mg for 14 days) on single-dose pharmacokinetics of the CYP3A substrate midazolam was evaluated (10 subjects). The maximum plasma concentration (Cmax) of doravirine was achieved within 1-5 h with an apparent terminal half-life of 12-21 h. Consistent with single-dose pharmacokinetics, steady state was achieved after approximately 7 days of once daily administration, with accumulation ratios (day 10/day 1) of 1.1-1.5 in the area under the plasma concentration-time curve during the dosing interval (AUC0-24 h), Cmax and trough plasma concentration (C24 h). All dose levels produced C24 h>19 nM. Administration of 50 mg doravirine with a high-fat meal was associated with slight elevations in AUC time zero to infinity (AUC0-∞) and C24 h with no change in Cmax. Midazolam AUC0-∞ was slightly reduced by coadministration of doravirine (geometric mean ratio 0.82, 90% CI 0.70, 0.97). There was no apparent relationship between adverse event frequency or intensity and doravirine dose. No rash or significant central nervous system events other than headache were reported. Doravirine is generally well tolerated in single doses up to 1,200 mg and multiple doses up to 750 mg once daily for up to 10 days, with a pharmacokinetic profile supportive of once

The effect of auricular acupuncture on pain during colonoscopy with midazolam and pethidine

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Kusumastuti, R.; Srilestari, A.; Abdurrohim, K.; Abdullah, M.

2017-08-01

Colonoscopy is the standard procedure for colorectal cancer screening. One of its common complications is abdominal pain. Analgesia has not provided favorable outcomes so various complementary practices have been developed, including auricular acupuncture. In this study, a randomized controlled trial of 56 patients who underwent colonoscopy was conducted to determine the effect of acupuncture on the pain experienced during colonoscopy. Subjects were divided into two groups: The first received acupuncture combined with midazolam and pethidine, while the second were administered placebo puncture in addition to midazolam and pethidine. The median Critical Care Pain Observation Tool (CPOT) score was lower in the auricular acupuncture group than in the placebo puncture group(0.7 [0-4.83] vs. 1.9 [0-6.20] p = 0.010), while there were no significant differences to median Visual Analog Scale (VAS) scores (29 [0-100] vs. 44.5 [0-100] p = 0.147), heart rate changes (-2.58 [14.31] vs.-2.43 [12.28]; p = 0.970), or the mean time to the cecum (16 [8-51] vs. 22 [5-63] p = 0.206). Auricular acupuncture combined with midazolam and pethidine was found to be effective at reducing pain during colonoscopy.

[Evaluation of N2O inhalation and oral midazolam conscious sedation in pediatric dentistry of children with intellectual disability].

Science.gov (United States)

Tian, Xiao-hua; Yang, Yan-zhong; Li, Xiao-feng

2015-06-01

To evaluate the effect of N2O inhalation and oral midazolam sedation on uncooperative patients with intellectual disability in pediatric dentistry. N2O inhalation (35%-50%) and oral midazolam conscious sedation (dosages range: 0.50-0.75 mg/kg) were applied to 67 uncooperative pediatric patients with intellectual disability in outpatient department. The patients were divided into 2 groups: group A (N2O inhalation conscious sedation) and group B(oral midazolam conscious sedation).Treatment results and safety were statistically analyzed by Chi-square test with SPSSl3.0 software package. The mean success rate was 70%. The success rate in group B (75%) was higher than group A (67%). The overall incidence of adverse reactions was 13%(9/67). The adverse reaction rate in group B (25%) was significantly higher than group A (5%, P<0.05). N2O inhalation and oral midazolam conscious sedation are effective and safe in pediatric dental uncooperative patients with intellectual disability.

Study of Preinduction Sedation with Intranasal Midazolam in Children

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A. Rostaminejad

2010-04-01

Full Text Available Introduction & Objectives: Surgical procedures are the most stressful expreiences in life, specially in children. Different methods are used before operation to decrease the stress. Intranasal midazolam is an effective way of preparing before operation and to prevent the separation irritability.Materials & Methods: In a double blind experimental trial study , 60 patients aged 2-6 years with ASAI who had no elective surgery in the past were randomly chosen and divided into two groups.For the patients in group I intranasal midazolam 0.2 mg/kg was administerated and for the patients in group II the equal volume of normal saline was used. The patients’ crying was considered as mild, moderate, and severe. The irritability of their hands shaking during IV canula insertion,consciousness before the induction of anesthesia and cooperation during the mask ventilation were also evaluated.Results: The result of our study determined that 93.3% of the children in group I didn’t cry or they did mildly when separated from their parents but 90% of the children of group II cried moderately and some severely and 90% of the patients in group I cooperated well when separated from their parents. The resistance in group II was moderate or severe in 76.6%. Before induction of anesthesia 73.4% of group I were asleep but woke up with stimulation. 93.3% of the patients in group II were awake and irritated.90% of group I shook their hands steadily during iv cannula insertion but their hands shaking increased in 83.3% of group II..100% of group I cooperated well during face mask ventilation but 76.6% of group II did not. Conclusion: The above mentioned experiences showed that the intranasal midazolam is an effective way of preinduction sedation in children.

Comparison of haloperidol and midazolam in restless management of patients referred to the Emergency Department: A double-blinded, randomized clinical trial

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Mehrdad Esmailian

2015-01-01

Full Text Available Background: Restless and violent behaviors are common in Emergency Departments (EDs, which need therapeutic interventions in most of the times. The first-generation anti-psychotic drugs are one of the most applicable therapeutic agents in the management of such patients, but their use has some limitations. Some studies suggest midazolam as an alternative medicine. Therefore, this study was performed with the aim of comparison of the efficacy and safety of haloperidol and midazolam in the restless management of referring patients to EDs. Materials and Methods: The present double-blinded trial was done on patients needed sedation and referred to the ED of Alzahra Hospital, Isfahan, Iran, in 2014. The patients were categorized into two random groups of haloperidol (5 mg and midazolam receivers (2.5 mg for those weighing 50 kg, as intramuscular administration. The time to achieve sedation, need for rescue dose, need to resedation within the first 60 min, and adverse effects of drugs were compared among the groups. Results: Forty-eight patients were entered to the study. The mean age in the haloperidol and midazolam groups was 44.8 ± 4.1 years and 45.5 ± 4.7 years, respectively (P = 0.91. The mean time of sedation in the haloperidol and midazolam groups was 5.6 ± 0.3 min and 5.2 ± 0.1 min, respectively (P = 0.31. The mean time of full consciousness after sedation was 36.2 ± 4.5 min and 38.2 ± 3.4 min in the haloperidol and midazolam groups, respectively (P = 0.72. On average, time to arousal in the midazolam group was 10.33 min more than the haloperidol group, but it was not statistically significant. Conclusion: The results of the present study show that administration of midazolam and haloperidol have similar efficacy in the treatment of restless symptoms with the same recovery time from drug effects for referring patients to the ED. In addition, none of the adverse effects were observed in this study.

Midazolam inhibits hippocampal long-term potentiation and learning through dual central and peripheral benzodiazepine receptor activation and neurosteroidogenesis.

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Tokuda, Kazuhiro; O'Dell, Kazuko A; Izumi, Yukitoshi; Zorumski, Charles F

2010-12-15

Benzodiazepines (BDZs) enhance GABA(A) receptor inhibition by direct actions on central BDZ receptors (CBRs). Although some BDZs also bind mitochondrial receptors [translocator protein (18 kDa) (TSPO)] and promote the synthesis of GABA-enhancing neurosteroids, the role of neurosteroids in the clinical effects of BDZs is unknown. In rat hippocampal slices, we compared midazolam, an anesthetic BDZ, with clonazepam, an anticonvulsant/anxiolytic BDZ that activates CBRs selectively. Midazolam, but not clonazepam, increased neurosteroid levels in CA1 pyramidal neurons without changing TSPO immunostaining. Midazolam, but not clonazepam, also augmented a form of spike inhibition after stimulation adjacent to the pyramidal cell layer and inhibited induction of long-term potentiation. These effects were prevented by finasteride, an inhibitor of neurosteroid synthesis, or 17PA [17-phenyl-(3α,5α)-androst-16-en-3-ol], a blocker of neurosteroid effects on GABA(A) receptors. Moreover, the synaptic effects were mimicked by a combination of clonazepam with FGIN (2-[2-(4-fluorophenyl)-1H-indol-3-yl]-N,N-dihexylacetamide), a selective TSPO agonist, or a combination of clonazepam with exogenous allopregnanolone. Consistent with these in vitro results, finasteride abolished the effects of midazolam on contextual fear learning when administrated 1 d before midazolam injection. Thus, dual activation of CBRs and TSPO appears to result in unique actions of clinically important BDZs. Furthermore, endogenous neurosteroids are shown to be important regulators of pyramidal neuron function and synaptic plasticity.

Systemic or Intra-Amygdala Injection of a Benzodiazepine (Midazolam) Impairs Extinction but Spares Re-Extinction of Conditioned Fear Responses

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Hart, Genevra; Harris, Justin A.; Westbrook, R. Frederick

2009-01-01

Rats were subjected to one or two cycles of fear conditioning and extinction, injected with a benzodiazepine, midazolam, before the first or second extinction, and tested for long-term inhibition of fear responses (freezing). In Experiment 1, inhibition of context-conditioned fear was spared when midazolam was injected before the second…

[Pre-anesthetic medication with intranasal dexmedetomidine and oral midazolam as an anxiolytic. A clinical trial].

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Linares Segovia, B; García Cuevas, M A; Ramírez Casillas, I L; Guerrero Romero, J F; Botello Buenrostro, I; Monroy Torres, R; Ramírez Gómez, X S

2014-10-01

Dexmedetomidine is a pharmacological option for sedation in children. In this study, the efficacy of intranasal dexmedetomidine to reduce preoperative anxiety in pediatric patients is compared with that of oral midazolam. A prospective, randomized, double-blind, controlled trial was conducted on children 2-12 years of age, randomly assigned to one of the following two groups: group A received premedication with oral midazolam and intranasal placebo, group B received intranasal dexmedetomidine and oral placebo. Anxiety was assessed with the modified Yale scale, and a risk analysis and number needed to treat was performed. A total of 108 patients were included, 52 (48.1%) treated with dexmedetomidine, and 56 (51.9%) with midazolam. Anxiety was less frequent in the dexmedetomidine group at 60minutes (P=.001), induction (p=.04), and recovery (P=.0001). Risk analysis showed that dexmedetomidine reduced the risk of anxiety by 28% (RAR=0.28, 95% CI; 0.12 to 0.43) and to prevent one case of anxiety, four patients need to be treated with intranasal dexmedetomidine (NNT=4, 95% CI: 3-9).Changes in heart rate, mean arterial pressure, and oxygen saturation, were statistically significant in the dexmedetomidine group, with no clinical consequences. There were no cases of bradycardia, hypotension or oxygen desaturation. Intranasal dexmedetomidine premedication is more effective than oral midazolam to reduce preoperative anxiety in pediatric patients. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Toediening van intraveneuze sedatie met midazolam door tandarts is onveilig

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Broers, D L M; Plat, J; de Jongh, A; Zuidgeest, T G M; Blom, H C C M; Kraaijenhagen, A E; Pieterse, C M; Bildt, M M

2015-01-01

In the December issue of the Nederlands Tijdschrift voor Tandheelkunde (Dutch Journal of Dentistry) in 2014, an article was devoted to the use of light sedation with midazolam by dentists. A number of dentists who are active in the area of Special Dentistry (anxiety management, care of the disabled)

Anestesia com cetamina, midazolam e óxido nitroso em cães submetidos à esofagoplastia cervical Ketamine, midazolam and nitrous oxide anesthesia in dogs submitted to cervical esophagoplasty

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Juliana Tabarelli Brondani

2003-12-01

Full Text Available Este estudo foi realizado para avaliar a anestesia intravenosa com cetamina e midazolam (K-M em cães ventilados mecanicamente com 66% de óxido nitroso e 33% de oxigênio ou 100% de oxigênio. Foram utilizados 16 cães sem raça definida, hígidos, com peso médio de 14,2 ± 3,78kg, submetidos a jejum sólido de 12 horas prévio ao procedimento. A anestesia foi induzida com a associação de cetamina (10mg.kg-1 e midazolam (0,5mg.kg-1 administrados na mesma seringa por via intravenosa (IV. Para manutenção anestésica, foi utilizada cetamina (5mg.kg-1 e midazolam (0,25mg.kg-1 administrados por via IV em intervalos de 10 minutos. Os animais foram distribuídos em dois grupos: N2O e O2. No grupo N2O, os cães foram ventilados mecanicamente com 66% de óxido nitroso e 33% de oxigênio. No grupo O2, somente o oxigênio foi utilizado para ventilação artificial. Em ambos os grupos, os animais foram submetidos à esofagoplastia cervical. As variáveis fisiológicas utilizadas para comparação entre os grupos foram: freqüência cardíaca, pressões arteriais sistólica, média e diastólica, saturação de oxigênio da hemoglobina e temperatura corporal. A necessidade ou não de doses adicionais da associação cetamina e midazolam também foi registrada para comparação. A análise estatística dos resultados não demonstrou diferenças significativas nas variáveis fisiológicas entre os grupos. No grupo O2, foram necessárias doses maiores da associação K-M para manutenção anestésica nos 30 minutos iniciais (pThis study was conducted to evaluate the effects of ketamine, midazolam, and nitrous oxide anesthesia (K-M in dogs artificially ventilated with 66% nitrous oxide and 33% oxygen or 100% oxygen. These dogs were submitted to experimental cervical esophagoplasty. Sixteen clinically healtly mixed breed dogs with mean body weight of 14.2 ± 3.78kg were studied. A 12-hour fasting period was established for each dog. Anesthesia was produced

Discomfort during bronchoscopy performed after endobronchial intubation with fentanyl and midazolam: a prospective study.

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Minami, Daisuke; Takigawa, Nagio; Kano, Hirohisa; Ninomiya, Takashi; Kubo, Toshio; Ichihara, Eiki; Ohashi, Kadoaki; Sato, Akiko; Hotta, Katsuyuki; Tabata, Masahiro; Tanimoto, Mitsune; Kiura, Katsuyuki

2017-05-01

Although endobronchial intubation during a bronchoscopic examination is useful for invasive procedures, it is not routine practice in Japan. The present study evaluated discomfort due to endobronchial intubation using fentanyl and midazolam sedation during bronchoscopy. Thirty-nine patients were enrolled prospectively from November 2014 to September 2015 at Okayama University Hospital. Fentanyl (20 µg) was administered to the patients just before endobronchial intubation, and fentanyl (10 µg) and midazolam (1 mg) were added as needed during the procedure. A questionnaire survey was administered 2 h after the examination. In the questionnaire, patient satisfaction was scored using a visual analog scale as follows: excellent (1 point), good (2 points), normal (3 points), uncomfortable (4 points) and very uncomfortable (5 points). An additional question ('Do you remember the bronchoscopic examination?') was also asked. Predefined parameters (blood pressure, heart rate, oxygen saturation and complications) were recorded. The enrolled patients included 22 males and 17 females; their median age was 70 (range: 28-88) years. The patients received a mean dose of 47.9 µg of fentanyl (range: 30-90 µg) and 2.79 mg of midazolam (range: 1-7 mg). In total, 28 patients (71.7%) agreed to undergo a second bronchoscopic examination; the mean levels of discomfort and for the re-examination were 2.07 points each. About 41% of the patients remembered the bronchoscopic examination. No severe complications were reported. Endobronchial intubation using fentanyl and midazolam sedation during an invasive bronchoscopic procedure might be recommended. UMIN000015578 in the UMIN Clinical Trials Registry. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

The effects of intrathecal midazolam on the duration of analgesia in ...

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This study was designed to evaluate the effect of 2 mg preservative-free intrathecal midazolam added to spinal bupivacaine during postoperative analgesia, and the incidence of adverse effects, if any, in patients undergoing knee arthroscopies. Method: Fifty consenting American Society of Anesthesiologists (ASA) physical ...

Perioperative effects of oral midazolam premedication in children undergoing skin laser treatment: a double-blinded randomized placebo-controlled trial Efeitos peroperatórios da premedicação oral de midazolam em crianças submetidas a tratamento de pele por laser: estudo duplo-cego randomizado e controlado

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Mehrdad Shoroghi

2011-08-01

Full Text Available PURPOSE: To investigate and compare the efficacy of oral midazolam with two different dosages in orange juice on perioperative hemodynamics and behavioral changes in children who underwent skin laser treatment in an academic educational Hospital. METHODS: Ninety children, candidates for skin laser treatment were randomly assigned to 1 of 3 groups of 30 each: the placebo group received 0.1 ml/kg orange flavored juice, group 2 and 3 receiving 0.5 and 1 mg/kg of injectable midazolam mixed with an equal volume of orange juice, respectively. The main outcome measures included the mask acceptance, patients' behavioral scales and postoperative events. RESULTS: There were no significant differences in heart rate, respiratory rate, and systolic blood pressure among the three groups. However, arterial oxygen saturation was significantly reduced in those given 1 mg.kg-1 midazolam. The median scores of anxiety, separation from parent, preparing an intravenous line, acceptance of the oxygen mask, good sedation, crying reduction and consciousness level were better in midazolam group. Postoperative agitation and re-crying were also more frequent in placebo receivers. Those given 1 mg.kg-1 midazolam were significantly more optimal for sedation, crying, consciousness, preparing an intravenous line, and postoperative re-crying compared with 0.5 mg.kg-1 midazolam receivers. CONCLUSION: As a preanaesthetic medication, the 1 mg.kg-1 dose of orally given midazolam especially in a volume of orange juice and can optimize the children's behavior during skin laser treatment with no serious adverse effects, enhancing their parents' satisfactions about the sedative protocol.OBJETIVO:Investigar e comparar a eficácia do uso oral de midazolam com duas diferentes doses de suco de laranja na hemodinâmica peropeatória e mudanças de desempenho em crianças submetidas tratamento de pele por laser em Hospital educacional e acadêmico. MÉTODOS:Noventa crianças candidatas a

Comparison of the Effects of Fentanyl and Midazolam as a Premedication in Children Undergoing Inguinal Hernial Surgery

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MH Abdollahi

2011-04-01

Full Text Available Introduction: Premedication with midazolam can occasionally result in increased pediatric anxiety. In this study, we compared the effects of intravenous midazolam and fentanyl as pediatric premedication in children posted for inguinal hernia surgery. Methods: In this double blind randomized clinical trial study, sixty pediatric patients were randomly allocated to two study groups. Anesthesia was similar in both groups. Sedation score by Richmond agitation sedation scale was repeatedly measured on arrival to the preoperative part of the operating room, during drug administration, separation of the child from parent for transfer to the operating room, induction of anesthesia, time of transfer to the recovery room and discharge from the recovery room. Post-operative nausea and vomiting was also recorded. The collected data was analyzed with SPSS 15 and P value<0.05 was considered meaningful. Results: Baseline characteristics of the two study groups were similar. Mean RASS at separation of patients from parents; the time between the study drug administrations till separation from parents, induction of anesthesia and end of operation and need for additional drug during separation was significantly lower in the midazolam group. Opioid need in the fentanyl group was higher. Other findings were similar in the two groups. Conclusion: Use of fentanyl instead of midazolam as a premedication is not a priority in children posted for surgery.

Conscious Sedation Efficacy of 0.3 and 0.5 mg/kg Oral Midazolam for Three to Six Year-Old Uncooperative Children Undergoing Dental Treatment: A Clinical Trial

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Masoud Fallahinejad Ghajari

2016-10-01

Full Text Available Objectives: Midazolam with variable dosages has been used to induce sedation in pediatric dentistry. The aim of this study was to compare the efficacy of two dosages of oral midazolam for conscious sedation of children undergoing dental treatment.Materials and Methods: In this randomized crossover double blind clinical trial, 20 healthy children (ASA I aged three to six years with negative or definitely negative Frankl behavioral rating scale were evaluated. Half of the children received 0.5mg/kg oral midazolam plus 1mg/kg hydroxyzine (A orally in the first session and 0.3mg/kg oral midazolam plus 1mg/kg hydroxyzine (B in the next session. The other half received the drugs on a reverse order. Sedation degree by Houpt sedation rating scale, heart rate and level of SpO2 were assessed at the beginning and after 15 and 30 minutes. The data were analyzed using SPSS 19 and Wilcoxon Signed Rank and McNemar’s tests.Results: The results showed that although administration of 0.5mg/kg oral midazolam was slightly superior to 0.3mg/kg oral midazolam in terms of sedation efficacy, the differences were not significant (P>0.05. The difference in treatment success was not significant either (P>0.05. Heart rate, oxygen saturation (SpO2 and respiratory rate were within the normal range and did not show a significant change (P>0.05.Conclusions: The overall success rate of the two drug combinations namely 0.5mg/kg oral midazolam plus hydroxyzine and 0.3mg/kg oral midazolam plus hydroxyzine was not significantly different for management of pediatric patients.Keywords: Conscious Sedation; Pediatric Dentistry; Midazolam; Hydroxyzine

Midazolam conscious sedation in a large Danish municipal dental service for children and adolescents.

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Uldum, Birgitte; Hallonsten, Anna-Lena; Poulsen, Sven

2008-07-01

The aim of this study was to describe the introduction and the first six years use of midazolam for conscious sedation in a municipal dental service in Denmark. In 1998, all dentists were introduced to midazolam conscious sedation. A sedation chart was filled in for each session, and parents' assessment was obtained. In 2004, all clinical materials were collected. Six hundred and eighty sessions were performed; 63.7% of the children were between 2 and 6 years of age; 88.5% belonged to American Society of Anesthesiologists grade 1; 74.8% of the sedations performed used the oral route of administration. Restorations were performed during 60.3% of the sessions, and extractions during 38.4%. Complications during the sessions were rare, the most frequent being double vision (6.1%), hiccups (2.7%), and paradoxical reaction (2.0%). Using Wilton's sedation scale, 42.9% were calm and 27.7% were agitated during treatment, whereas after treatment 61.7% were calm; 80.4% of the parents were very positive towards this sedation method. Sedation with midazolam for dental treatment of children with dental fear and anxiety is a feasible and an efficient method with a low rate of complications. It can probably reduce the need for dental treatment under general anaesthesia.

[Conscious sedation and amnesic effect of intravenous low-dose midazolam prior to spinal anesthesia].

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Koyama, Shinichi; Ohashi, Naotsugu; Kurita, Satoshi; Nakatani, Keiji; Nagata, Noboru; Toyoda, Yoshiroh

2008-06-01

The pain associated with spinal puncture is severe, and the memory of this uncomfortable procedure often deters patients from undergoing the procedure again. Therefore, it is important to make the patient as comfortable as possible when this procedure is performed. We administrated a low-dose (1-2.5 mg) of midazolam intravenously several minutes before conducting a spinal-tap in 200 patients undergoing elective surgery of the lower limb. The dose of midazolam used was based on the patient's age and weight, and we investigated remaining of a memory concerning the spinal-tap procedure and side effects of midazolam at the end of surgery. Memory of the spinal-tap procedure remained in 14.0%, 1.9%, and 32.7% of the patients who had received benzodiazepine preoperatively and in 25.0%, 40.0%, and 60.9% of the patients who hadn't received benzodiazepine preoperatively in the age group or =70 years, respectively. No patient experienced severe respiratory depression, but an excessive sedation or restlessness was experienced in 1.6%, 4.8%, and 5.2% of the patients. In the patients aged memory concerning the spinal-tap procedure; however, it is important to note that the number of side effects associated with this procedure increases in patients aged > or =60 years.

Associação entre midazolam e detomidina na medicação pré-anestésica para indução da anestesia geral com cetamina em potros A combination study of midazolam and detomidine in the premedication anesthesia for the induction of general anesthesia with ketamine in foals

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J.A. Marques

2009-12-01

Full Text Available Empregou-se a associação midazolam e detomidina para indução de anestesia com cetamina em 16 potros, machos e fêmeas, entre três e seis meses de idade, distribuídos aleatória e equitativamente em dois grupos (GI e GII. A todos os animais foram administrados midazolam, via intramuscular, na dose de 0,2mg/kg, e após 15 minutos, detomidina, via intravenosa, na dose de 0,02mg/kg. Os animais do GII receberam cetamina pela via intravenosa, dose 2,0mg/kg, três minutos após a administração de detomidina. Quinze minutos após o midazolam, ocorreram sedação e ligeira ataxia, e dois minutos após a administração da detomidina, decúbito lateral em todos os potros, com miorrelaxamento e presença dos reflexos de deglutição e miorrelaxamento, anal e oculo-palpebral. A associação midazolam/detomidina e cetamina provocou ausência dos reflexos de deglutição. Para todos os animais, o tempo de recuperação foi de 45-60 minutos, e temperatura retal e frequência respiratória permaneceram estáveis. Ocorreram bradicardia, bloqueio atrioventricular de segundo grau e aumento das pressões arteriais sistólica, diastólica e média após dois minutos da administração da detomidina. A associação midazolam/detomidina e cetamina demonstrou ser um método eficiente e seguro para a anestesia de potros hígidos.A combination of midazolam, 0.2mg/kg body weight given via intramuscular, and detomidine, 0.02mg/kg body weight given via intravenous (IV, was evaluated as a method for induction of anesthesia with ketamine, 2.0mg/kg body weight given via IV in foals. Sixteen male and female foals aging from three to six-month old were distributed into two groups. Both groups were first injected with midazolam and with detomidine 15 minutes later. Three minutes later, ketamine was injected in the foals. Sedation and light ataxia were observed 15 minutes after midazolam administration. Bradycardia, atrioventricular block, increased blood pressure, lateral

Hyperalgesic effect induced by barbiturates, midazolam and ethanol: pharmacological evidence for GABA-A receptor involvement

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M.A.K.F. Tatsuo

1997-02-01

Full Text Available The involvement of GABA-A receptors in the control of nociception was studied using the tail-flick test in rats. Non-hypnotic doses of the barbiturates phenobarbital (5-50 mg/kg, pentobarbital (17-33 mg/kg, and thiopental (7.5-30 mg/kg, of the benzodiazepine midazolam (10 mg/kg or of ethanol (0.4-1.6 g/kg administered by the systemic route reduced the latency for the tail-flick response, thus inducing a 'hyperalgesic' state in the animals. In contrast, non-convulsant doses of the GABA-A antagonist picrotoxin (0.12-1.0 mg/kg administered systemically induced an increase in the latency for the tail-flick response, therefore characterizing an 'antinociceptive' state. Previous picrotoxin (0.12 mg/kg treatment abolished the hyperalgesic state induced by effective doses of the barbiturates, midazolam or ethanol. Since phenobarbital, midazolam and ethanol reproduced the described hyperalgesic effect of GABA-A-specific agonists (muscimol, THIP, which is specifically antagonized by the GABA-A antagonist picrotoxin, our results suggest that GABA-A receptors are tonically involved in the modulation of nociception in the rat central nervous system

Midazolam por via oral como medicação pré-anestésica em crianças e adolescentes com paralisia cerebral: estudo comparativo das variações do índice bispectral Midazolam por vía oral como medicación preanestésica en niños y adolescentes con parálisis cerebral: estudio comparativo de las variaciones del índice bispectral Oral midazolam as pre-anesthetic medication in children and teenagers with cerebral palsy: a comparative study on the variations of the bispectral index

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Verônica Vieira da Costa

2009-02-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: O midazolam é um derivado benzodiazepínico com ação hipnótica e muito utilizado como medicação pré-anestésica em anestesia pediátrica. As crianças com paralisia cerebral (PC também se beneficiam do uso do midazolam, mas seus efeitos são ainda desconhecidos sobre esse grupo de pacientes que apresentam uma série de particularidades, com alterações inclusive no local de ação do midazolam. O objetivo do estudo foi avaliar a ação do midazolam utilizado como medicação pré-anestésica sobre o índice bispectral (EEG-BIS dos pacientes com paralisia cerebral. MÉTODO: Foram avaliados dois grupos de pacientes: um com diagnóstico de PC e outro sem doença do sistema nervoso central (SNC e periférico. Foram registrados valores de EEG-BIS na enfermaria na véspera da operação e no dia da operação, 40 minutos depois da administração de 0,6 mg.kg-1 de midazolam via oral. Foram excluídos pacientes com história de reação paradoxal ao midazolam e pacientes do grupo-controle que estivessem em uso de outra medicação. RESULTADOS: Foram estudados 77 pacientes de ambos os sexos, entre 4 e 18 anos de idade. Não houve diferença entre os valores de EEG-BIS basal entre os grupos estudados. Após o uso do midazolam houve diminuição dos valores do EEG-BIS nos dois grupos estudados, com diferença estatística significativa em cada grupo. Na comparação entre grupos não houve diferença estatística. CONCLUSÕES: O midazolam administrado como medicação pré-anestésica na dose de 0,6 mg.kg-1 diminui os valores basais do EEG-BIS sem caracterizar hipnose e sem diferença estatística nos grupos estudados.JUSTIFICATIVA Y OBJETIVOS: El midazolam es un derivado benzodiazepínico con acción hipnótica y muy utilizado como medicación preanestésica en anestesia pediátrica. Los niños con parálisis cerebral (PC también se benefician del uso del midazolam, pero sus efectos todavía se desconocen sobre ese

Intranasal sedation using ketamine and midazolam for pediatric dental treatment (NASO): study protocol for a randomized controlled trial.

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Gomes, Heloisa Sousa; Miranda, Analya Rodrigues; Viana, Karolline Alves; Batista, Aline Carvalho; Costa, Paulo Sucasas; Daher, Anelise; Machado, Geovanna de Castro Morais; Sado-Filho, Joji; Vieira, Liliani Aires Candido; Corrêa-Faria, Patrícia; Hosey, Marie Therese; Costa, Luciane Rezende

2017-04-11

Uncooperative children may need to receive dental treatment under sedation, which is indicated when nonpharmacological behavior guidance is unsuccessful. There are randomized controlled trials (RCTs) comparing different sedative protocols for dental procedures; however, the evidence for superiority of one form over another is weak. The primary aim of this study is to investigate the efficacy of intranasally administered ketamine plus midazolam for the dental treatment of children. We have designed a three-armed, parallel RCT to assess intranasal sedation using ketamine/midazolam in terms of the following measures: efficacy, safety, and cost-effectiveness. Two- to 6-year-old healthy children, referred for dental treatment in a dental sedation center in Brazil due to uncooperative behavior and requiring restorative dental procedures, will be recruited. Each child will be randomly assigned to one of the three groups: A - Intranasal administration of ketamine (4.0 mg/kg, maximum 100 mg) and midazolam (0.2 mg/kg, maximum 5.0 mg); B - Oral administration of ketamine (4.0 mg/kg, maximum 100 mg) and midazolam (0.5 mg/kg, maximum 20 mg); and C - Oral administration of midazolam (1.0 mg/kg, maximum 20 mg). The primary outcome is the child's behavior assessed through an observational scale using digital videos of the restorative dental treatment under sedation. The secondary outcomes are as follows: acceptance of sedative administration; memory of intraoperative events; the child's stress; adverse events; the child's pain during the procedure; the parent's, dentists', and child's perceptions of sedation; and economic analysis. Measures will be taken at baseline and drug administration and during and after the dental procedure. The necessary sample size was estimated to be 84 children after a blinded interim analysis of the first 30 cases. This study will provide data that can substantially add to science and pediatric dentistry as it examines the effect of sedative

The role of a low-dose ketamine-midazolam regimen in the management of severe painful crisis in patients with sickle cell disease.

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Tawfic, Qutaiba A; Faris, Ali S; Kausalya, Rajini

2014-02-01

Acute pain is one of the main causes of hospital admission in sickle cell disease, with variable intensity and unpredictable onset and duration. We studied the role of a low-dose intravenous (IV) ketamine-midazolam combination in the management of severe painful sickle cell crisis. A retrospective analysis was performed with data from nine adult patients who were admitted to the intensive care unit with severe painful sickle cell crises not responding to high doses of IV morphine and other adjuvant analgesics. A ketamine-midazolam regimen was added to the ongoing opioids as an initial bolus of ketamine 0.25mg/kg, followed by infusion of 0.2-0.25mg/kg/h. A midazolam bolus of 1mg followed by infusion of 0.5-1mg/h was added to reduce ketamine emergence reactions. Reduction in morphine daily requirements and improvement in pain scores were the determinants of ketamine-midazolam effect. The t-tests were used for statistical analysis. Nine patients were assessed, with mean age of 27±11 years. Morphine requirement was significantly lower after adding the IV ketamine-midazolam regimen. The mean±SD IV morphine requirement (milligram/day) in the pre-ketamine day (D0) was 145.6±16.5, and it was 112±12.2 on Day 1 (D1) of ketamine treatment (P=0.007). The Numeric Rating Scale scores on D0 ranged from eight to ten (mean 9.1), but improved to range from five to seven (mean 5.7) on D1. There was a significant improvement in pain scores after adding ketamine-midazolam regimen (P=0.01). Low-dose ketamine-midazolam IV infusion might be effective in reducing pain and opioid requirements in patients with sickle cell disease with severe painful crisis. Further controlled studies are required to prove this effect. Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Changes to the bispectral index and regional cerebral blood flow in a sedative state, caused by midazolam administration

OpenAIRE

池田, 淳子; イケダ, ジュンコ; Junko, IKEDA

2006-01-01

Psychosedation, as used in the field of dentistry, is intended to provide trouble-free dental care while maintaining a proper level of sedation. One drug used in psychosedation is midazolam, which is known to have a strong amnestic effect. In the current research, I sought to clarify whether the bispectral index (BIS) using EEC analysis can be used for assessment of optimal sedation in psychosedation, and what effects midazolam has on the cerebrum's mechanism of memory. The subjects were 17 h...

Oral Midazolam Premedication for Children Undergoing General Anaesthesia for Dental Care

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Saad A. Sheta

2009-01-01

Full Text Available Objectives. To assess the efficacy and safety of injectable midazolam administered orally in 3 different doses in children undergoing complete dental rehabilitation under GA. Subjects and Methods. 60 children aged 2–6 years were enrolled in the study. The children were randomly assigned to one of 3 groups and received orally 0.5, 0.75, or 1.0 mg/kg of injectable midazolam mixed with apple juice 30 minutes before separation from parents. The following measurements were assessed: patient's acceptance of the medication, reaction to separation from parents, sedation scores, and recovery conditions. Results. More children were comfortable with parent separation in the group that received the 1.0 mg/kg dose (90% compared to the group that received the 0.75 mg/kg dose (75% and the group that received the 0.5 mg/kg dose (55%. The number of children who had desirable sedation was similar in the 0.75 mg/kg and 1.0 mg/kg dose groups. Twenty five percent of the children in the group that received the 0.5 mg/kg dose did not allow venepuncture before induction of GA, and induction of GA was poor for 20% of the children in this group. An increasing number of children scored excellent in terms of ease of venepuncture in 0.75 mg/kg dose group (10% and in the 1.0 mg/kg dose group (20% and in terms of induction of GA, 25% and 35%, respectively. Recovery of spontaneous ventilation and extubation was delayed by over 15 minutes in 2 children in the 1.0 mg/kg dose group. Conclusion. The dose of 0.75 mg/kg of injectable midazolam given orally as premedication is acceptable, effective, and safe.

Effects of ketamine and midazolam on emergence agitation after sevoflurane anaesthesia in children receiving caudal block: a randomized trial

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Ayse Ozcan

2014-11-01

Full Text Available Background and objectives: Emergence agitation is a common postanaesthetic problem in children after sevoflurane anaesthesia. We aimed to compare the effects of ketamine and midazolam administered intravenously, before the end of surgery, for prevention of emergence agitation in children who received caudal block for pain relief under sevoflurane anaesthesia. Methods: 62 American Society of Anesthesiologists patient classification status I children, aged 2–7 years, scheduled for inguinal hernia repair, circumcision or orchidopexy were enrolled to the study. Anaesthesia was induced with sevoflurane 8% in a mixture of 50% oxygen and nitrous oxide. After achieving adequate depth of anaesthesia, a laryngeal mask was placed and then caudal block was performed with 0.75 mL kg−1, 0.25% bupivacaine. At the end of the surgery, ketamine 0.25 mg kg−1, midazolam 0.03 mg kg−1 and saline were given to ketamine, midazolam and control groups, respectively. Agitation was assessed using Paediatric Anaesthesia Emergence Delirium scale and postoperative pain was evaluated with modified Children's Hospital of Eastern Ontario Pain Scale. Results and conclusions: Modified Children's Hospital of Eastern Ontario Pain Scale scores were found higher in control group than in ketamine and midazolam groups. Paediatric Anaesthesia Emergence Delirium scores were similar between groups. Modified Children's Hospital of Eastern Ontario Pain Scale and Paediatric Anaesthesia Emergence Delirium scores showed a significant decrease by time in all groups during follow-up in postanaesthesia care unit. The present study resulted in satisfactory Paediatric Anaesthesia Emergence Delirium scores which are below 10 in all groups. As a conclusion, neither ketamine nor midazolam added to caudal block under sevoflurane anaesthesia did show further effect on emergence agitation. In addition, pain relief still seems to be the major factor in preventing emergence agitation after

The role of midazolam-induced sedation in bone marrow aspiration/trephine biopsies.

Science.gov (United States)

Mainwaring, C J; Wong, C; Lush, R J; Smith, J G; Singer, C R

1996-12-01

This study was undertaken in 102 adult patients to evaluate the safety and efficacy of intravenous (i.v.) midazolam in the setting of bone marrow aspiration and trephine biopsy (BMAT). Combined local anaesthetic (LA) and sedation was used in 87% of patients and 13% received LA alone. Amnesia occurred in all sedated patients with only 9% experiencing a mild degree of post-procedure pain. This contrasted sharply with the non-sedated group, in whom 85% had intense pain during the biopsy followed by protracted local discomfort in approximately 54%. Drowsiness and some psychomotor impairment were the only notable sedation-related side-effects in approximately 20%. None required assisted ventilation. There was a resounding patient preference for BMAT with sedation. Considering the ease of use, safety and efficacy of i.v. midazolam, the availability of flumazenil as a reversal agent and the undoubted positive effects on quality of life, we would advocate using it in BMAT provided that there were no contraindications.

Efficacy and safety of flumazenil injection for the reversal of midazolam sedation after elective outpatient endoscopy.

Science.gov (United States)

Lee, Sang Pyo; Sung, In-Kyung; Kim, Jeong Hwan; Lee, Sun-Young; Park, Hyung Seok; Shim, Chan Sup

2018-02-01

Midazolam sedation during elective endoscopy is widely performed and flumazenil is frequently administered after endoscopy to reverse sedation in clinical practice. This study aimed to investigate the safety and efficacy of flumazenil injections after elective endoscopy under midazolam sedation. Participants who underwent an upper endoscopy under midazolam sedation were randomly divided into two groups. In group I, flumazenil was administered i.v. 10 min after the patient's transfer to the recovery room, and no antidote was injected in group II. The time of stay in the recovery room and adverse events were reviewed through the nursing records. We asked the patients about their pain and degree of satisfaction according to a visual analogue scale (VAS), their memory of the procedure, mental status and the presence of uncomfortable symptoms on the day of the procedure and the day afterwards. The length of stay in recovery was significantly shorter in group I than in group II. No significant differences were found in the number of patients with pain (VAS ≥1), adverse events and discomfort between the two groups. Additionally, there were no differences in the patients' memory of the procedure, satisfaction with sedation, willingness to repeat the endoscopy and mental status. The time in the recovery room after flumazenil administration was significantly shortened, and the use of the drug did not increase the risk of adverse events or discomfort. The use of flumazenil for reversing midazolam sedation seems to be safe and effective. © 2018 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

Effects of Propofol and Midazolam on Newborns’ Apgar Scores and Mothers’ Hemodynamic under Spinal Anesthesia

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Navid Kalani

2016-05-01

Full Text Available At present, cesarean section is the most prevalent surgical procedure in women and the anesthesia performed for it has turned into a selective technique. This study compared the effects of midazolam and propofol on newborns’ Apgar scores and on the hemodynamic status of the mothers undergoing cesarean sections. This research, in the form of a double-blind clinical trial, was carried out on forty-two15 - 35 year-old of class ASAI and II pregnant women who underwent cesarean section. Using the simple random method, they were divided into two groups of equal members: 21 in the Propofol and 21 in the midazolam groups. The newborns’ Apgar scores were recorded 1 and 5 minutes after birth and the mothers’ hemodynamic status 3, 5, 10, 15, 30, 60 minutes into the surgical procedure. The data was analyzed using SPSS, the repeated measurement test, and the independent t-test. One and five minutes after birth, there were no significant differences between the newborns’ Apgar scores in the two groups (p=0.08, or between the two groups (p=0.33. Results showed there were no statistically significant differences between the Apgar scores of the newborns at low doses of midazolam and propofol.

Characterization of mucoadhesive nasal gels containing midazolam hydrochloride prepared from Linum usitatissimum L. mucilage

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Shyamoshree Basu

2011-12-01

Full Text Available Nasal drug delivery systems prepared from natural materials are gaining importance in the field of pharmaceutical technology. Mucilage isolated from Linum usitatissimum L. (LUM seeds was reported to be an effective natural mucoadhesive agent. The present study deals with a comparison of various characteristics of nasal gels containing midazolam hydrochloride (HCl prepared from mucoadhesive agent extracted from Linum usitatissimum L. seeds and synthetic polymers like HPMC and Carbopol 934P in terms of texture profile analysis, mucoadhesive strength, and in vivo drug absorption profiles. It was observed that gels formulated with the natural mucilage showed better results than the synthetic gels in all aspects like hardness, adhesiveness, cohesiveness and mucoadhesive strength. The absolute bioavailability of midazolam hydrochloride from the natural gel was 97.55% whereas that of synthetic gels was 57.33% and 76.81% respectively.Sistemas de liberação nasal preparados com produtos naturais estão ganhando importância no campo da tecnologia farmacêutica. A mucilagem isolada de sementes de Linum usitatissimum L. (LUM mostrou-se agente mucoadesivo eficaz. O presente estudo trata da comparação de várias características de géis nasais contendo cloridrato de midazolam preparados com agente mucoadesivo extraído das sementes de Linum usitatissimum L. e com polímeros sintéticos, como HPMC e Carbopol 943P, com relação ao perfil de textura, força mucoadesiva e perfis de absorção do fármaco in vivo. Observou-se que os géis formulados com mucilagem natural apresentam melhores resultados do que os sintéticos em todos os aspectos, como dureza, adesão, coesão e força mucoadesiva. A biodisponibilidade absoluta do cloridrato de midazolam a partir do gel natural foi de 97,55%, enquanto que nos géis sintéticos foi de 57,33% e 76,81%, respectivamente.

Conscious sedation procedures using intravenous midazolam for dental care in patients with different cognitive profiles: a prospective study of effectiveness and safety.

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Valérie Collado

Full Text Available The use of midazolam for dental care in patients with intellectual disability is poorly documented. This study aimed to evaluate the effectiveness and safety of conscious sedation procedures using intravenous midazolam in adults and children with intellectual disability (ID compared to dentally anxious patients (DA. Ninety-eight patients with ID and 44 patients with DA programmed for intravenous midazolam participated in the study over 187 and 133 sessions, respectively. Evaluation criteria were success of dental treatment, cooperation level (modified Venham scale, and occurrence of adverse effects. The mean intravenous dose administered was 8.8±4.9 mg and 9.8±4.1 mg in ID and DA sessions respectively (t-test, NS. 50% N₂O/O₂ was administered during cannulation in 51% of ID sessions and 61% of DA sessions (NS, Fisher exact test. Oral or rectal midazolam premedication was administered for cannulation in 31% of ID sessions and 3% of DA sessions (p<0,001, Fisher exact test. Dental treatment was successful in 9 out of 10 sessions for both groups. Minor adverse effects occurred in 16.6% and 6.8% of ID and DA sessions respectively (p = 0.01, Fisher exact test. Patients with ID were more often very disturbed during cannulation (25.4% ID vs. 3.9% DA sessions and were less often relaxed after induction (58.9% ID vs. 90.3% DA and during dental treatment (39.5% ID vs. 59.7% DA (p<0.001, Fisher exact test than patients with DA. When midazolam sedation was repeated, cooperation improved for both groups. Conscious sedation procedures using intravenous midazolam, with or without premedication and/or inhalation sedation (50% N₂O/O₂, were shown to be safe and effective in patients with intellectual disability when administered by dentists.

Effects of ketamine and midazolam on emergence agitation after sevoflurane anaesthesia in children receiving caudal block: a randomized trial

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Ayse Ozcan

2014-12-01

Full Text Available Background and objectives: Emergence agitation is a common postanaesthetic problem in children after sevoflurane anaesthesia. We aimed to compare the effects of ketamine and midazolam administered intravenously, before the end of surgery, for prevention of emergence agitation in children who received caudal block for pain relief under sevoflurane anaesthesia. Methods: 62 American Society of Anesthesiologists patient classification status I children, aged 2–7 years, scheduled for inguinal hernia repair, circumcision or orchidopexy were enrolled to the study. Anaesthesia was induced with sevoflurane 8% in a mixture of 50% oxygen and nitrous oxide. After achieving adequate depth of anaesthesia, a laryngeal mask was placed and then caudal block was performed with 0.75 mL kg−1, 0.25% bupivacaine. At the end of the surgery, ketamine 0.25 mg kg−1, midazolam 0.03 mg kg−1 and saline were given to ketamine, midazolam and control groups, respectively. Agitation was assessed using Paediatric Anaesthesia Emergence Delirium scale and postoperative pain was evaluated with modified Children's Hospital of Eastern Ontario Pain Scale. Results and conclusions: Modified Children's Hospital of Eastern Ontario Pain Scale scores were found higher in control group than in ketamine and midazolam groups. Paediatric Anaesthesia Emergence Delirium scores were similar between groups. Modified Children's Hospital of Eastern Ontario Pain Scale and Paediatric Anaesthesia Emergence Delirium scores showed a significant decrease by time in all groups during follow-up in postanaesthesia care unit. The present study resulted in satisfactory Paediatric Anaesthesia Emergence Delirium scores which are below 10 in all groups. As a conclusion, neither ketamine nor midazolam added to caudal block under sevoflurane anaesthesia did show further effect on emergence agitation. In addition, pain relief still seems to be the major factor in preventing emergence agitation after

Effect of Intranasal Sedation Using Ketamine and Midazolam on Behavior of 3-6 Year-Old Uncooperative Children in Dental Office: A Clinical Trial

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Majid Mehran

2017-02-01

Full Text Available Objectives: The aim of the present study was to compare the effects of intranasal ketamine and midazolam on behavior of 3-6 year-old children during dental treatments.  Materials and Methods: In this randomized cross-over clinical trial, 17 uncooperative children requiring at least two dental treatments were selected and randomly received ketamine (0.5mg/kg or midazolam (0.2mg/kg prior to treatment. The other medication was used in the next visit. The children’s behavioral pattern was determined according to the Houpt's scale regarding sleep, movement, crying and overall behavior. Physiological parameters were also measured at different time intervals. The data were subjected to Wilcoxon Signed Rank test and two-way repeated measures ANOVA.Results: The frequency of crying decreased significantly following ketamine administration compared to midazolam (P=0.002; movement of children decreased with fewer incidence of treatment interruption (P=0.001 while their sleepiness increased (P=0.003. Despite higher success of sedation with ketamine compared to midazolam, no significant differences were found between the two regarding patients’ overall behavior (P>0.05. The patients had higher heart rate and blood pressure with ketamine; however, no significant difference was found regarding respiratory rate and oxygen saturation (P>0.05.  Conclusions: Ketamine (0.5mg/kg led to fewer movements, less crying and more sleepiness compared to midazolam (0.2mg/kg. No significant differences were found between the two drugs regarding children’s overall behavior and sedation efficiency. Both drugs demonstrated positive efficacy for sedation of children during dental treatments.Keywords: Conscious Sedation; Ketamine; Midazolam; Administration, Intranasal

Exacerbation of benign familial neonatal epilepsy induced by massive doses of phenobarbital and midazolam.

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Maeda, Tomoki; Shimizu, Miki; Sekiguchi, Kazuhito; Ishii, Atsushi; Ihara, Yukiko; Hirose, Shinichi; Izumi, Tatsuro

2014-08-01

Barbiturates and benzodiazepines are the first-line anticonvulsants for neonatal seizures. However, in immature brains, those drugs may lead to paradoxical neuronal excitation. A patient with benign familial neonatal epilepsy developed epileptic encephalopathy after massive doses of phenobarbital that were followed by a continuous infusion of midazolam on postnatal day 3. Electroencephalography revealed rhythmic delta activity in clusters with migrating epileptic foci. After discontinuation of both drugs, the patient's consciousness promptly improved and her electroencephalography normalized on postnatal day 5. This baby developed persistent electroencephalographic seizures due to massive doses of phenobarbital and midazolam. Clinicians should be aware of this anticonvulsant-induced paradoxical neuronal excitation and the uncoupling phenomenon, especially in individuals with benign familial neonatal epilepsy, who have low seizure thresholds. Copyright © 2014 Elsevier Inc. All rights reserved.

Ação do anticonvulsivante isolado e associado ao midazolam como medicação pré-anestésica sobre o índice bispectral (BIS em pacientes com paralisa cerebral Acción del antiepiléptico aislado y asociado al midazolam como medicación preanestésica sobre el índice bispectral (BIS en pacientes con parálisis cerebral Effect of isolated anticonvulsant drug use and associated to midazolam as pre-anesthetic medication on the bispectral index (BIS in patients with cerebral palsy

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Verônica Vieira da Costa

2010-06-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: Os pacientes com paralisia cerebral (PC frequentemente usam fármacos para tratamento de doenças concomitantes, como convulsões. O midazolam é o hipnótico mais utilizado como medicação pré-anestésica e suas interações medicamentosas nos pacientes com PC são desconhecidas. O objetivo deste estudo foi avaliar o midazolam como medicação pré-anestésica no BIS dos pacientes com PC em uso crônico de anticonvulsivantes. MÉTODO: Foram avaliados três grupos de pacientes: PC sem uso de anticonvulsivantes, PC em uso de anticonvulsivante e outro grupo sem doença e sem uso de medicações (Grupo Controle. Na véspera da cirurgia, com os pacientes despertos e em decúbito dorsal, foi colocado o monitor do BIS e foram registrados os valores basais do BIS. No dia seguinte, 40 minutos antes da cirurgia, os pacientes receberam 0,6 mg.kg-1 de midazolam por via oral. Antes do início da anestesia, foi realizado o mesmo procedimento para registro do BIS, após o uso do midazolam. RESULTADOS: Foram estudados 107 pacientes - 39 pacientes do Grupo Controle e 68 com diagnóstico de PC. Desses, 17 faziam uso de anticonvulsivante. Com relação ao valor médio de BIS após o uso do midazolam, não houve diferença entres os pacientes do Grupo Controle e do Grupo PC que não tomavam anticonvulsivante, enquanto entre os pacientes que faziam uso de anticonvulsivantes houve diferença (p = 0,003. A possibilidade de diminuição do BIS após o uso do midazolam aumenta de acordo com o número de anticonvulsivantes usados pelo paciente. CONCLUSÕES: O uso crônico de anticonvulsivante associado ao midazolam via oral como medicação pré-anestésica pode levar à diminuição dos valores de BIS, configurando níveis profundos de hipnose.JUSTIFICATIVA Y OBJETIVOS: Los pacientes con parálisis cerebral (PC, a menudo usan fármacos para el tratamiento de enfermedades concomitantes, como las convulsiones. El midazolam es el hipnótico m

Midazolam with Bupivacaine for Improving Analgesia Quality in Brachial Plexus Block for Upper Limb Surgeries

International Nuclear Information System (INIS)

Laiq, N.; Khan, M.N.; Khan, S.

2008-01-01

To compare the onset, duration and postoperative pain scores of supraclavicular block with bupivacaine alone and bupivacaine-midazolam combination. A randomized controlled clinical trial was conducted on 50 ASA-I or II adult patients undergoing upper limb surgeries under supraclavicular brachial plexus block. Patients were randomly allocated into two groups of 25 each. Patients in group A were administered 30 ml of 0.5% bupivacaine with midazolam 50 micro g kg/sup -1/. Hemodynamic variables (heart rate, noninvasive blood pressure, oxygen saturation), pain scores, rescue analgesic requirements and sedation score were recorded for 24 hours postoperatively, and compared using ANOVA with significance at p <0.05. The onset and duration of sensory and motor block was significantly faster and longer in group B compared to group A (p < 0.001). Pain scores were significantly lower in group B for 24 hours postoperatively (p < 0.001). Demand for rescue analgesic were significantly less in group B. Hemodynamics and sedation scores did not differ between the groups in the studied period. Bupivacaine (0.5%) in combination with Midazolam (50 micro g kg/sup -1/) quickened the onset as well as prolonged the duration of sensory and motor blockade of the brachial plexus for upper limb surgery. It improved postoperative analgesia without producing any adverse events compared to plain bupivacaine (0.5%) in equal volume. (author)

Effect of Oral Midazolam Premedication on Children's Co-operation Before General Anesthesia in Pediatric Dentistry.

Science.gov (United States)

Kaviani, Nasser; Shahtusi, Mina; Haj Norousali Tehrani, Maryam; Nazari, Sara

2014-09-01

Premedication is expedient in reducing the psychological trauma from recalling the unpleasant pre-anesthetic phases, hence, inducing a trouble-free anesthesia. This study aimed to determine the effectiveness of oral midazolam in co-operation of the subjects before general anesthesia and in recalling the pre-anesthetic phases, performed on children candidate for dental treatment under general anesthesia. In this prospective clinical trial study, 62 healthy non-cooperative children, candidate for dental treatment under general anesthesia, were randomly divided into study and control groups. The children received 20ml orange juice, 20 minutes before starting the anesthesia. The juice of the test group contained 0.5mg/kg of midazolam and that of the control group included no medication. The induction and the maintenance process of anesthesia were similar in both groups. The manner of subjects when separated from parents, their cooperation during intravenous catheterization, and recalling the pre-anesthetic events were recorded. Data were analyzed by adopting chi-square and Mann-Whitney tests. Most of the children in the test group had a comfortable separation from parents, restful IV catheterization and 90% of the subjects did not recall the pre-anesthetic events. Under the circumstances of this study, it could be concluded that 0.5mg/kg oral midazolam premedication is effective for comfortable separation of children from parents and restful IV catheterization and also forgetting the pre-anesthetic events.

Hypoalbuminaemia and decreased midazolam clearance in terminally ill adult patients, an inflammatory effect?

NARCIS (Netherlands)

Franken, Linda G.; Masman, Anniek D.; de Winter, Brenda C. M.; Baar, Frans P. M.; Tibboel, Dick; van Gelder, Teun; Koch, Birgit C. P.; Mathot, Ron A. A.

2017-01-01

AimsMidazolam is the drug of choice for palliative sedation and is titrated to achieve the desired level of sedation. Because of large inter-individual variability (IIV), however, the time it takes to achieve adequate sedation varies widely. It would therefore greatly improve clinical care if an

Evaluation of 6 years use of sedation with midazolam for dental treatment

DEFF Research Database (Denmark)

Østergaard, Birthe; Haukali, Gro; Poulsen, Sven

  Abstract: Titel: Evaluering af seks års brug af midazolam til sedering ved tandbehandling. B. Høgsbro Østergaard 1,2 , G. Haukali 1,2, S. Poulsen 2 . 1 Tandplejen Århus, 2 Afd. for Samfundsodontologi og Pædodonti, Århus Tandlægeskole, Århus Universitet. Mål: At evaluere midazolamsedering til...

The influence of midazolam on heart rate arises from cardiac autonomic tones alterations in Burmese pythons, Python molurus.

Science.gov (United States)

Lopes, Ivã Guidini; Armelin, Vinicius Araújo; Braga, Victor Hugo da Silva; Florindo, Luiz Henrique

2017-12-01

The GABA A receptor agonist midazolam is a compound widely used as a tranquilizer and sedative in mammals and reptiles. It is already known that this benzodiazepine produces small to intermediate heart rate (HR) alterations in mammals, however, its influence on reptiles' HR remains unexplored. Thus, the present study sought to verify the effects of midazolam on HR and cardiac modulation in the snake Python molurus. To do so, the snakes' HR, cardiac autonomic tones, and HR variability were evaluated during four different experimental stages. The first stage consisted on the data acquisition of animals under untreated conditions, in which were then administered atropine (2.5mgkg -1 ; intraperitoneal), followed later by propranolol (3.5mgkg -1 ; intraperitoneal) (cardiac double autonomic blockade). The second stage focused on the data acquisition of animals under midazolam effect (1.0mgkg -1 ; intramuscular), which passed through the same autonomic blockade protocol of the first stage. The third and fourth stages consisted of the same protocol of stages one and two, respectively, with the exception that atropine and propranolol injections were reversed. By comparing the HR of animals that received midazolam (second and fourth stages) with those that did not (first and third stages), it could be observed that this benzodiazepine reduced the snakes' HR by ~60%. The calculated autonomic tones showed that such cardiac depression was elicited by an ~80% decrease in cardiac adrenergic tone and an ~620% increase in cardiac cholinergic tone - a finding that was further supported by the results of HR variability analysis. Copyright © 2017 Elsevier B.V. All rights reserved.

HYPOTHERMIC CARDIOPULMONARY BYPASS INFLUENCES THE CONCENTRATION-RESPONSE RELATIONSHIP AND THE BIODISPOSITION OF ROCURONIUM

NARCIS (Netherlands)

SMEULERS, NJ; WIERDA, JMKH; VANDENBROEK, L; HUET, RCGG; HENNIS, PJ

In 10 patients scheduled for elective coronary artery bypass grafting under midazolam-sufentanil anaesthesia, the influence of hypothermia on the plasma concentration-response and biodisposition of rocuronium were investigated. Neuromuscular function was monitored mechanomyographically. plasma and

Midazolam microdose to determine systemic and pre-systemic metabolic CYP3A activity in humans.

Science.gov (United States)

Hohmann, Nicolas; Kocheise, Franziska; Carls, Alexandra; Burhenne, Jürgen; Haefeli, Walter E; Mikus, Gerd

2015-02-01

We aimed to establish a method to assess systemic and pre-systemic cytochrome P450 (CYP) 3A activity using ineffective microgram doses of midazolam. In an open, one sequence, crossover study, 16 healthy participants received intravenous and oral midazolam at microgram (0.001 mg intravenous and 0.003 mg oral) and regular milligram (1 mg intravenous and 3 mg oral) doses to assess the linearity of plasma and urine pharmacokinetics. Dose-normalized AUC and Cmax were 37.1 ng ml(-1 ) h [95% CI 35.5, 40.6] and 39.1 ng ml(-1) [95% CI 30.4, 50.2] for the microdose and 39.0 ng ml(-1 ) h [95% CI 36.1, 42.1] and 37.1 ng ml(-1) [95% CI 26.9, 51.3] for the milligram dose. CLmet was 253 ml min(-1) [95% CI 201, 318] vs. 278 ml min(-1) [95% CI 248, 311] for intravenous doses and 1880 ml min(-1) [95% CI 1590, 2230] vs. 2050 ml min(-1) [95% CI 1720, 2450] for oral doses. Oral bioavailability of a midazolam microdose was 23.4% [95% CI 20.0, 27.3] vs. 20.9% [95% CI 17.1, 25.5] after the regular dose. Hepatic and gut extraction ratios for microgram doses were 0.44 [95% CI 0.39, 0.49] and 0.53 [95% CI 0.45, 0.63] and compared well with those for milligram doses (0.43 [95% CI 0.37, 0.49] and 0.61 [95% CI 0.53, 0.70]). The pharmacokinetics of an intravenous midazolam microdose is linear to the applied regular doses and can be used to assess safely systemic CYP3A activity and, in combination with oral microdoses, pre-systemic CYP3A activity. © 2014 The British Pharmacological Society.

Allosteric activation of midazolam CYP3A5 hydroxylase activity by icotinib - Enhancement by ketoconazole.

Science.gov (United States)

Zhuang, XiaoMei; Zhang, TianHong; Yue, SiJia; Wang, Juan; Luo, Huan; Zhang, YunXia; Li, Zheng; Che, JinJing; Yang, HaiYing; Li, Hua; Zhu, MingShe; Lu, Chuang

2016-12-01

Icotinib (ICO), a novel small molecule and a tyrosine kinase inhibitor, was developed and approved recently in China for non-small cell lung cancer. During screening for CYP inhibition potential in human liver microsomes (HLM), heterotropic activation toward CYP3A5 was revealed. Activation by icotinib was observed with CYP3A-mediated midazolam hydroxylase activity in HLM (∼40% over the baseline) or recombinant human CYP3A5 (rhCYP3A5) (∼70% over the baseline), but not in the other major CYPs including rhCYP3A4. When co-incubated with selective CYP3A4 inhibitor CYP3cide or monoclonal human CYP3A4 inhibitory antibody in HLM, the activation was extended to ∼60%, suggesting CYP3A5 might be the isozyme involved. Further, the relative activation was enhanced to ∼270% in rhCYP3A5 in the presence of ketoconazole. The activation was substrate and pathway dependent and observed only in the formation of 1'-OH-midazolam, and not 4-OH-midazolam, 6β-OH-testosterone, or oxidized nifedipine. The activation requires the presence of cytochrome b5 and it is only observed in the liver microsomes of dogs, monkeys, and humans, but not in rats and mice. Kinetic analyses of 1'-OH-midazolam formation showed that ICO increased the V max values in HLM and rhCYP3A5 with no significant changes in K m values. By adding CYP3cide with ICO to the incubation, the V max values increased 2-fold over the CYP3cide control. Addition of ketoconazole with ICO alone or ICO plus CYP3cide resulted in an increase in V max values and decrease in K m values compared to their controls. This phenomenon may be attributed to a new mechanism of CYP3A5 heterotropic activation, which warrants further investigation. Copyright © 2016 Elsevier Inc. All rights reserved.

Evaluation of the use of midazolam as a co-induction agent with ketamine for anaesthesia in sedated ponies undergoing field castration.

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Allison, A; Robinson, R; Jolliffe, C; Taylor, P M

2018-05-01

There are limited investigations comparing ketamine to a ketamine-midazolam co-induction. To compare quality and safety of general anaesthesia induced using ketamine alone with anaesthesia co-induced using ketamine and midazolam. Randomised, double blinded, placebo controlled trial. After i.v. detomidine (20 μg/kg) thirty-eight ponies undergoing field castration received either 0.06 mg/kg (0.6 mL/50 kg) midazolam (group M) or 0.6 mL/50 kg placebo (group P) with 2.2 mg/kg ketamine i.v. for anaesthetic induction. Quality of anaesthetic induction, endotracheal intubation, surgical relaxation and recovery were scored using combinations of simple descriptive and visual analogue scales. Time of sedation, induction, start of endotracheal intubation, first movement, sternal recumbency and standing were recorded, as were time, number and total quantity of additional i.v. detomidine and ketamine injections. Cardiorespiratory variables were assessed every 5 min. Adverse effects were documented. Data were tested for normality and analysed with a mixed model ANOVA, Fisher's exact test, unpaired Students' t test and Wilcoxon Rank-sum as appropriate; Pketamine (P = 0.04). Time (minutes) from induction to first movement (PKetamine-midazolam co-induction compared to ketamine alone improved quality of induction, ease of intubation and muscle relaxation without impacting recovery quality. © 2017 EVJ Ltd.

Reducing risk of overdose with midazolam injection in adults: an evaluation of change in clinical practice to improve patient safety in England.

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Flood, Chris; Matthew, Linda; Marsh, Rachel; Patel, Bhavesh; Mansaray, Mariama; Lamont, Tara

2015-02-01

This study sought to evaluate potential reductions in risk associated with midazolam injection, a sedating medication, following a UK National Patient Safety Alert. This alert, 'Reducing risk of overdose with midazolam injection in adults', was sent to all National Health Service organizations as a Rapid Response Report detailing actions services should take to minimize risks. To evaluate any potential changes arising from this alert, a number of data sources were explored including reported incidents to a national reporting system for health care error, clinician survey and audit data, pharmaceutical purchasing patterns and feedback from National Health Service managers. Prior to the Rapid Response Report, 498 incidents were received by the National Patient Safety Agency including three deaths. Post-implementation of the Rapid Response Report (June 2009), no incidents resulting in death or severe harm had been received. All organizations reported having completed the Rapid Response Report actions. Purchase and use of risk-prone, high-strength sedating midazolam by health care organizations decreased significantly as did the increased use of safer, lower strength doses (as recommended in the Rapid Response Report). Organizations can achieve safer medication practices, better knowledge, awareness and implementation of national safer practice recommendations. Risks from inadvertent overdose of midazolam injection were reduced post-implementation of national recommendations. Ongoing monitoring of this particular adverse event will be required with a sustained patient safety message to health services to maintain awareness of the issue and reduction in the number of midazolam-related errors. © 2014 John Wiley & Sons, Ltd.

The effect of midazolam on neutrophil mitogen-activated protein kinase.

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Ghori, Kamran

2010-06-01

Neutrophil p38 mitogen-activated protein kinase (MAPK) is a key enzyme in the intracellular signalling pathway that is responsible for many neutrophil functions, which are important in neutrophil-endothelial interaction. The imidazole compounds are inhibitors of this enzyme system. The objectives of this in-vitro investigation were to examine the effect of midazolam on neutrophil p38 MAPK activation (phosphorylation) following in-vitro ischaemia-reperfusion injury, and the expression of adhesion molecule CD11b\\/CD18.

Evident cognitive impairments in seemingly recovered patients after midazolam-based light sedation during diagnostic endoscopy

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Yen-Hsuan Hsu

2015-06-01

Conclusion: Midazolam-based light sedation induced selective cognitive impairments and prolonged cognitive impairments occurred in patients with advanced age. A longer observation time and further screening were recommended for patients due to their at risk state.

Midazolam and propofol used alone or sequentially for long-term sedation in critically ill, mechanically ventilated patients: a prospective, randomized study.

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Zhou, Yongfang; Jin, Xiaodong; Kang, Yan; Liang, Guopeng; Liu, Tingting; Deng, Ni

2014-06-16

Midazolam and propofol used alone for long-term sedation are associated with adverse effects. Sequential use may reduce the adverse effects, and lead to faster recovery, earlier extubation and lower costs. This study evaluates the effects, safety, and cost of midazolam, propofol, and their sequential use for long-term sedation in critically ill mechanically ventilated patients. A total of 135 patients who required mechanical ventilation for >3 days were randomly assigned to receive midazolam (group M), propofol (group P), or sequential use of both (group M-P). In group M-P, midazolam was switched to propofol until the patients passed the spontaneous breathing trial (SBT) safety screen. The primary endpoints included recovery time, extubation time and mechanical ventilation time. The secondary endpoints were pharmaceutical cost, total cost of ICU stay, and recollection to mechanical ventilation-related events. The incidence of agitation following cessation of sedation in group M-P was lower than group M (19.4% versus 48.7%, P = 0.01). The mean percentage of adequate sedation and duration of sedation were similar in the three groups. The recovery time, extubation time and mechanical ventilation time of group M were 58.0 (interquartile range (IQR), 39.0) hours, 45.0 (IQR, 24.5) hours, and 192.0 (IQR, 124.0) hours, respectively; these were significantly longer than the other groups, while they were similar between the other two groups. In the treatment-received analysis, ICU duration was longer in group M than group M-P (P = 0.016). Using an intention-to-treat analysis and a treatment-received analysis, respectively, the pharmaceutical cost of group M-P was lower than group P (P memory of the uncomfortable events was lower than in group M (11.7% versus 25.0%, P memory was similar (P >0.05). The incidence of hypotension in group M-P was lower than group (P = 0.01). Sequential use of midazolam and propofol was a safe and effective sedation protocol, with higher clinical

The efficacy of adding dexamethasone, midazolam, or epinephrine to 0.5% bupivacaine in supraclavicular brachial plexus block.

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El-Baradey, Ghada F; Elshmaa, Nagat S

2014-11-01

The aim was to assess the effectiveness of adding either dexamethasone or midazolam in comparison with epinephrine addition to 0.5% bupivacaine in supraclavicular brachial plexus block. This is a prospective randomized controlled observer-blinded study. This study was carried out in Tanta University Hospital on 60 patients of both sexes; American Society of Anesthesiologists physical Status I and II, age range from 18 to 45 years undergo elective surgery to upper limb. All patients were anesthetized with ultrasound guided supraclavicular brachial plexus block and randomly divided into three groups (each group 20 patients) Group E (epinephrine): 30 mL bupivacaine 0.5%with 1:200,000 epinephrine (5 μg/mL). Group D (dexamethasone): 30 mL bupivacaine 0.5% and dexamethasone 8 mg. Group M (midazolam): 30 ml bupivacaine 0.5% and midazolam 50 μg/kg. The primary outcome measures were onset and duration of sensory and motor block and time to first analgesic request. The windows version of SPSS 11.0.1 (SPSS Inc., Chicago, IL, USA) was used for statistical analysis. Data were presented in form of mean ± standard deviation multiple analysis of variance (ANOVA) was used to compare the three groups and Scheffe test was used after ANOVA. Power of significance P < 0.05 was considered to be statistically significant. Onset of sensory and motor block was significantly rapid (P < 0.05) in Groups D and M in comparison with Group E. Time of administration of rescue analgesic, duration of sensory and motor block showed significant increase (P < 0.05) in Group D in comparison with Group M which showed significant increase (P < 0.05) in comparison with Group E. In comparison with epinephrine and midazolam addition of dexamethasone to bupivacaine had rapid onset of block and longer time to first analgesic request with fewer side-effects.

Pre-anesthetic Anxiety Level in Children with Congenital Heart Disease: Comparison between Maternal Presence during Anesthetic Induction and Midazolam Premedication

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Ratna F Soenarto

2016-09-01

Full Text Available General anesthesia was needed by children with congenital heart disease (CHD who underwent cardiaccatheterization procedure and surgery. Pre-anesthetic anxiety in children with CHD can cause significantproblems during induction of anesthesia which leads to negative postoperative outcomes. This studycompared the role of maternal presence during anesthesia induction with midazolam premedication onpre-anesthetic anxiety level in children with CHD. Dr. Cipto Mangunkusumo National Hospital on April toSeptember 2014. Forty-five CHD patients aged 2-5 years old who underwent cardiac invasive procedurewere divided into P group (received midazolam premedication and M group (had maternal presence duringanesthesia induction. Modified Yale Pre-anxiety Scale (MYPAS was used for measuring anxiety level ineach patient during preoperative visit, on the time patient entered the procedure room and during induction ofanesthesia. There was no significant difference of MYPAS scores between the two groups in all measurementtimes. The MYPAS score results were non-anxious (median score 23.4 and the highest was at induction ofanesthesia. Inter-rater agreement test between 2 observers was good (k>0.5. In conclusion, there was nosignificant difference between the effect of maternal presence during induction of anesthesia and midazolampremedication on pre-anesthetic anxiety level in children with CHD. Keywords: pre-anesthetic anxiety, congenital heart disease, maternal presence, midazolam.   Peran Kehadiran Ibu selama Induksi Anestesia dengan PremedikasiMidazolam terhadap Tingkat Kecemasan Pra-anestesia Anak denganPenyakit Jantung Bawan Abstrak Pembiusan umum diperlukan oleh pasien dengan penyakit jantung bawaan (PJB pada saat kateterisasiatau pembedahan jantung. Kecemasan pra-anestesia dapat menimbulkan masalah saat induksi anestesiayang berdampak negatif pascapembedahan. Penelitian ini bertujuan untuk membandingkan efek premedikasimidazolam dan kehadiran ibu selama

Factors predisposing to coma and delirium: fentanyl and midazolam exposure; CYP3A5, ABCB1, and ABCG2 genetic polymorphisms; and inflammatory factors.

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Skrobik, Yoanna; Leger, Caroline; Cossette, Mariève; Michaud, Veronique; Turgeon, Jacques

2013-04-01

Delirium and sedative-induced coma are described as incremental manifestations of cerebral dysfunction. Both may be associated with sedative or opiate doses and pharmacokinetic or pharmacogenetic variables, such as drug plasma levels (exposure), drug metabolism, and/or their transport across the blood-brain barrier. To compare biological and drug treatment characteristics in patients with coma and/or delirium while in the ICU. In 99 patients receiving IV fentanyl, midazolam, or both, we evaluated drug doses, covariates likely to influence drug effects (age, body mass index, and renal and hepatic dysfunction); delirium risk factors; concomitant administration of CYP3A and P-glycoprotein substrates/inhibitors; ABCB1, ABCG2, and CYP3A5 genetic polymorphisms; and fentanyl and midazolam plasma levels. Delirium and coma were evaluated daily. In patients with only coma (n=15), only delirium (n=7), and neither ever (n=14), we measured plasma levels of tumor necrosis factor-α, interleukin (IL)-1β, IL-1RA, IL-6, IL-8, IL-10, IL-17,macrophage inflammatory protein-1β, and monocyte chemotactic protein-1. Time to first coma was associated with fentanyl and midazolam doses (p=0.03 and p=0.01, respectively). The number of days in coma was associated with the number of days of coadministration of CYP3A inhibitors (r=0.30; p=0.006). Plasma levels of fentanyl were higher in patients with clinical coma (3.7±4.7 vs. 2.0±1.8 ng/mL, p=0.0001) as were midazolam plasma levels (1050±2232 vs. 168±249 ng/mL, p=0.0001). Delirium occurrence was unrelated to midazolam administration, cumulative doses, or serum levels. Days with delirium were associated with days of coadministration of P-glycoprotein inhibitor (r=0.35; p=0.0004). Delirious patients had higher levels of the inflammatory mediator IL-6 than comatose patients (129.3 vs. 35.0 pg/mL, p=0.05). Coma is associated with fentanyl and midazolam exposure; delirium is unrelated to midazolam and may be linked to inflammatory status

Comparative study between dexmedetomidine/nalbuphine and midazolam/nalbuphine in monitored anesthesia care during ear surgery

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Mahmoud Hassan Mohamed

2014-01-01

Conclusion: We concluded that the combination of dexmedetomidine/nalbuphine is a better alternative to midazolam/nalbuphine in MAC since it provides analgesia, amnesia and sedation with better intraoperative and postoperative patient satisfaction with better surgical field exposure.

Cardiovascular effects of midazolam in levomepromazine premedicated dogs

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Gladys Bastos de Castro

1992-12-01

Full Text Available Experiments were performed on ten mongrel dogs with 10-18 kg body weight. They received levomepromazine 1.0 mg/kg body weight, I.V. as premedication, and 15 minutes later, midazolam was given in dosage of 2.0 mg/kg body weight intravenously. The result showed moderat increase on respiratory rate and decrease heart rate after 15 minutes and increase heart rate after 30 minutes. Mean and sistolic arterial pressure decreased significantly (p<0.05 but without clinical importance, remained in the physiologic range. Hipnosis duration was less than 20 minutes and at 30 minutes the dogs awaked and they tried to walk.

Comparison of the changes in blood glucose level during sedation with midazolam and propofol in implant surgery: a prospective randomized clinical trial.

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Kaviani, Nasser; Koosha, Farzad; Shahtusi, Mina

2014-09-01

Reducing the patients' stress can prevent, or at least, limit the increase in blood glucose level. The study compares the effect of propofol and midazolam on blood glucose level in the patients undergoing dental implant surgery. The effect of pre-operational stress on blood glucose level during the surgery is also evaluated. This prospective randomized clinical trial recruited 33 patients undergoing dental implant surgery and divided into two groups. Conscious sedation was performed by midazolam in one group and with propofol in another group. The pre-operational stress was scored and the blood glucose level was measured in 4 different stages; before the operation, two minutes after the local anesthetic injection; thirty minutes after the onset of operation and at the end of the operation. The results were analyzed by employing ANOVA and Pearson test. The p Value was adopted 0.05 and the confidence coefficient was assumed 95%. The average levels of the blood glucose in midazolam and propofol group were 93.82 mg/dl and 94 mg/dl before the operation which displayed a meaningful increase of blood glucose level in both groups as the operation went on. The values were 103.76 mg/dl for midazolam and 108.56 mg/dl for the propofol group (pblood glucose level between two groups in the different stages of the operation (p= 0.466). The Pearson correlation coefficient test revealed a higher increase in the blood glucose level in the patients with a higher pre-operational stress score (r= 0.756, pblood glucose level while undergoing an operation. No statistically significant difference was detected between midazolam and propofol.

Effect of preoperative oral midazolam sedation on separation anxiety and emergence delirium among children undergoing dental treatment under general anesthesia

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El Batawi, Hisham Yehia

2015-01-01

Aim: To investigate the possible effects of preoperative oral Midazolam on parental separation anxiety, emergence delirium, and post-anesthesia care unit time on children undergoing dental rehabilitation under general anesthesia. Methods: Randomized, prospective, double-blind study. Seventy-eight American Society of Anesthesiology (ASA) I children were divided into two groups of 39 each. Children of the first group were premedicated with oral Midazolam 0.5 mg/kg, while children of the control group were premedicated with a placebo. Scores for parental separation, mask acceptance, postoperative emergence delirium, and time spent in the post-anesthesia care unit were compared statistically. Results: The test group showed significantly lower parental separation scores and high acceptance rate for anesthetic mask. There was no significant difference between the two groups regarding emergence delirium and time spent in post-anesthesia care unit. Conclusions: Preoperative oral Midazolam could be a useful adjunct in anxiety management for children suffering dental anxiety. The drug may not reduce the incidence of postoperative emergence delirium. The suggested dose does not seem to affect the post-anesthesia care unit time. PMID:25992332

Effect of preoperative oral midazolam sedation on separation anxiety and emergence delirium among children undergoing dental treatment under general anesthesia.

Science.gov (United States)

El Batawi, Hisham Yehia

2015-01-01

To investigate the possible effects of preoperative oral Midazolam on parental separation anxiety, emergence delirium, and post-anesthesia care unit time on children undergoing dental rehabilitation under general anesthesia. Randomized, prospective, double-blind study. Seventy-eight American Society of Anesthesiology (ASA) I children were divided into two groups of 39 each. Children of the first group were premedicated with oral Midazolam 0.5 mg/kg, while children of the control group were premedicated with a placebo. Scores for parental separation, mask acceptance, postoperative emergence delirium, and time spent in the post-anesthesia care unit were compared statistically. The test group showed significantly lower parental separation scores and high acceptance rate for anesthetic mask. There was no significant difference between the two groups regarding emergence delirium and time spent in post-anesthesia care unit. Preoperative oral Midazolam could be a useful adjunct in anxiety management for children suffering dental anxiety. The drug may not reduce the incidence of postoperative emergence delirium. The suggested dose does not seem to affect the post-anesthesia care unit time.

Rapid tranquilization for agitated patients in emergency psychiatric rooms: a randomized trial of olanzapine, ziprasidone, haloperidol plus promethazine, haloperidol plus midazolam and haloperidol alone

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Baldaçara,Leonardo; Sanches,Marsal; Cordeiro,Daniel Cruz; Jackowski,Andrea Parolin

2011-01-01

OBJECTIVE: To compare the effectiveness of intramuscular olanzapine, ziprasidone, haloperidol plus promethazine, haloperidol plus midazolam and haloperidol alone as the first medication(s) used to treat patients with agitation and aggressive behavior. METHOD: One hundred fifty patients with agitation caused by psychotic or bipolar disorder were randomly assigned under double-blind conditions to receive olanzapine, ziprasidone, haloperidol plus midazolam, haloperidol plus promethazine or halop...

Relationships between Endogenous Plasma Biomarkers of Constitutive Cytochrome P450 3A Activity and Single-Time-Point Oral Midazolam Microdose Phenotype in Healthy Subjects.

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Woolsey, Sarah J; Beaton, Melanie D; Choi, Yun-Hee; Dresser, George K; Gryn, Steven E; Kim, Richard B; Tirona, Rommel G

2016-04-01

Due to high basal interindividual variation in cytochrome P450 3A (CYP3A) activity and susceptibility to drug interactions, there has been interest in the application of efficient probe drug phenotyping strategies, as well as endogenous biomarkers for assessment of in vivo CYP3A activity. The biomarkers 4β-hydroxycholesterol (4βHC) and 6β-hydroxycortisol (6βHCL) are sensitive to CYP3A induction and inhibition. However, their utility for the assessment of constitutive CYP3A activity remains uncertain. We investigated whether endogenous plasma biomarkers (4βHC and 6βHCL) are associated with basal CYP3A metabolic activity in healthy subjects assessed by a convenient single-time-point oral midazolam (MDZ) phenotyping strategy. Plasma 4βHC and 6βHCL metabolic ratios (MRs) were analysed in 51 healthy adult participants. CYP3A activity was determined after administration of an oral MDZ microdose (100 μg). Simple linear and multiple linear regression analyses were performed to assess relationships between MDZ oral clearance, biomarkers and subject covariates. Among study subjects, basal MDZ oral clearance, 4βHC and 6βHCL MRs ranged 6.5-, 10- and 13-fold, respectively. Participant age and alcohol consumption were negatively associated with MDZ oral clearance (p = 0.03 and p = 0.045, respectively), while weight and female sex were associated with lower plasma 4βHC MR (p = 0.0003 and p = 0.032, respectively). Neither 4βHC nor 6βHCL MRs were associated with MDZ oral clearance. Plasma 4βHC and 6βHCL MRs do not relate to MDZ single-time-point metabolic phenotype in the assessment of constitutive CYP3A activity among healthy individuals. © 2015 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

COMPARATIVE STUDY TO EVALUATE ANALGESIC EFFICACY OF CAUDAL MIDAZOLAM AND CLONIDINE POSTOPERATIVE ANALGESIA IN CHILDREN

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Ramalinga Raju A.V.S

2017-03-01

Full Text Available BACKGROUND Caudal epidural analgesia is one of the most popular regional techniques used in paediatric patients undergoing lower limb, anoperineal and abdominal surgical procedures for postoperative pain relief. The aim of postoperative pain relief is to provide subjective comfort and inhibit trauma-induced nociceptive impulses to blunt autonomic and reflex responses to pain and subsequently to enhance the restoration of function. Caudal epidural analgesia though practiced widely is of short duration even when used with long-acting local anaesthetics. MATERIALS AND METHODS Children of either sex undergoing elective hernia or hydrocele surgery within in the age group of 2-8 years belonging to ASA I and II were included in the study. Informed consent was obtained from the parents before procedure. RESULTS The duration of analgesia in the study group was 10.14 ± 4.69 hrs. and 6.83 ± 0.79 hrs. in the clonidine group and midazolam group. Duration of analgesia in clonidine group was significantly longer when compared to with midazolam group with a p value of <0.05. Sedation Score- There was decrease in heart rate and mean arterial pressure from baseline, but these were under allowable limits of 20%. The patient had pain scores of less than 8 for first 6-8 hrs. The patients were well sedated and were easily arousable. CONCLUSION We conclude that in our study we found that clonidine 8 μg/kg provided good analgesia for a longer duration when compared with midazolam. Clonidine also provided good sedation with minimal haemodynamic variations. This is in agreement with studies conducted to know haemodynamic stability with higher doses of clonidine.

Síndrome de abstinência associada à interrupção da infusão de fentanil e midazolam em pediatria

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Bicudo,J.N.; Souza,N. de; Mângia,C.M.F.; Carvalho,W.B. de

1999-01-01

OBJETIVO: Determinar a ocorrência de síndrome de abstinência em crianças internadas em UCI Pediátrica em uso de fentanil e midazolam. MÉTODOS: Avaliadas 36 crianças internadas na UCI Pediátrica do Hospital São Paulo - Universidade Federal de São Paulo, no período de março a setembro de 1997, com idade variando de 5 dias a 22 meses (22 masc : 14 fem) que fizeram uso de fentanil e midazolam por mais de 24 horas. Utilizado o Escore Neonatal de Abstinência adaptado por Finnegan que determina a oc...

Efeitos anestésicos da administração intranasal ou intramuscular de cetamina S+ e midazolam em pomba-rola (Streptotelia sp. Anesthetic effects of intranasal or intramuscular administration of S+ Ketamine and Midazolam in ring necked dove (Streptotelia sp.

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Suzane L. Beier

2013-04-01

Full Text Available A via intranasal é uma boa alternativa por ser indolor e de fácil aplicação em aves. O objetivo deste estudo foi avaliar os efeitos anestésicos da associação de cetamina S+ e midazolam pela via intranasal (IN em comparação com a via intramuscular (IM em pombos. Foram utilizados 12 pombos alocados em dois grupos com 15 dias de intervalo, os quais receberam: grupo IM: 20 mg/kg de cetamina S+ associada a 3,5 mg/kg de midazolam pela via intramuscular (musculatura do peito; e grupo IN, mesmo protocolo, porém, pela via intranasal. Os parâmetros avaliados foram: período de latência, tempo de duração em decúbito dorsal, tempo total de anestesia, tempo de recuperação e efeitos adversos. Para a análise estatística, empregou-se o teste de Wilcoxon, com as diferenças consideradas significativas quando PThe intranasal route is a good alternative because is painless and easy to perform in birds. The objective of this study was to evaluate the anesthetic effects of S+ ketamine and midazolam administered by intranasal or intramuscular route in pigeons. Twelve animals were used in a randomized and crossover design. Animals received two treatments with 2-weeks interval. IM group: animals received 20mg/kg of S+ ketamine and 3.5mg/kg of midazolam by intramuscular route (pectoral muscles; IN group: animals received the same protocol by intranasal route. Parameters evaluated were: onset of action, time of duration in dorsal recumbency; total time of anesthesia and side effects. Statistical analysis was performed using Wilcoxon test and the differences were considered significant when P<0.05. Onset of action was 30 [30-47.5] and 40 [30-50] seconds for IM and IN respectively. Time of duration in dorsal recumbency was 59 [53.25-65] and 63 [37-71.25] minutes for IM and IN respectively, without significant differences between treatments. Total time of anesthesia was 88 [86.25-94.5] and 68 [53.5-93] minutes for IM and IN, respectively, with significant

Decreased absorption of midazolam in the stomach due to low pH induced by co-administration of Banha-sasim-tang

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Jun Hyeon Jo

2016-08-01

Full Text Available Objectives Banha-sasim-tang (BST, which consists of seven different herbs, is one of the most popular herbal formulae for treating gastrointestinal disorders in Eastern Asia. The commonly used herbal medicine is often co-administered with other therapeutic drugs, which raises the possibility of herb–drug interactions and may modify the clinical safety profile of therapeutic drugs. Methods We investigated the potential herb–drug interactions between BST extract and midazolam (MDZ in mice. The area under the plasma concentration-time curve (AUC of MDZ and 1ʹ-hydroxymidazolam (1ʹ-OH-MDZ was evaluated for both oral and intraperitoneal administration of MDZ, following oral administration of BST (0.5 and 1 g/kg. Results It was found that the AUC of MDZ and 1ʹ-OH-MDZ was lower in case of oral administration of MDZ. Administration of BST extract was not associated with hepatic cytochrome P450 activity. BST extract induced a strong reduction in pH and it has been reported that oral mucosal absorption of MDZ is lower at low pH. The decreased absorption rate of MDZ might be caused by the ingredients of BST and may not be related to other factors such as increased excretion of MDZ by P-glycoprotein. Conclusions The altered pharmacokinetics of midazolam caused by co-administration with BST in vivo could be attributed to a decrease in pH and subsequent reduction of MDZ absorption rate.

Evaluation of a combination of low-dose ketamine and low-dose midazolam in terminal dyspnea-attenuation of "double-effect"

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Abhijit Kanti Dam

2008-01-01

Full Text Available Aim: Of all symptoms in palliative medicine those concerning respiration are most excruciating and difficult to treat. Reticence about the use of morphine for palliation of dyspnea is common, especially in nonmalignant diseases, as there is a fear of causing respiratory depression, particularly where Chronic Obstructive Pulmonary Disease (COPD exists. This factor is also compounded by the lack of availability of morphine in parts of developing countries. Ketamine has excellent anesthetic and analgesic effects in addition to being easily available. It produces bronchodilatation and does not produce respiratory or cardiovascular depression. The author seeks to evaluate the role of low-dose (0.2 mg/kg ketamine and midazolam (0.02 mg/kg in the attenuation of terminal dyspnea. Methods: Sixteen patients with terminal dyspnea, admitted to the Critical Care Unit (CCU with cancer and other noncancer diagnoses were recruited. The subjective component of dyspnea was assessed using the Graphic Rating Scale (GRS, which has values from 0 - 10, 10 being maximum dyspnea. Each patient received a low-dose of ketamine and midazolam for relief of dyspnea. All the patients received low-flow (2 L/min. oxygen therapy via nasal cannula. Immediately after admission, all the patients were reassured and nursed in a decubitus position of their choice. The GRS was recorded at the point of admission, 10 minutes after starting oxygen therapy, and ten minutes after administration of low-dose ketamine and midazolam. Hemodynamic parameters were also recorded at these three points. Result: All the patients who enrolled in our study had significant dyspnea at admission, as was evident from the GRS scores of 8.250 (SD 0.91, respiratory rate of 28.56 (SD 5.0, mean arterial blood pressure (MABP of 102.7 (SD 14.63, pulse rate of 115.62 (SD 23.3, and SpO2 of 92.43 (SD 2.38. All the patients benefited from the combination of ketamine and midazolam, as evidenced by the statistically

Cardiovascular effects of a continuous rate infusion of lidocaine in calves anesthetized with xylazine, midazolam, ketamine and isoflurane.

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Araújo, Marcelo A; Dias, Bianca P; Bovino, Fernanda; Deschk, Maurício; Abimussi, Caio Jx; Oliva, Valéria Nls; Rodrigues, Celso A; Santos, Paulo Sp

2014-03-01

To assess the cardiovascular changes of a continuous rate infusion of lidocaine in calves anesthetized with xylazine, midazolam, ketamine and isoflurane during mechanical ventilation. Prospective, randomized, cross-over, experimental trial. A total of eight, healthy, male Holstein calves, aged 10 ± 1 months and weighing 114 ± 11 kg were included in the study. Calves were administered xylazine followed by ketamine and midazolam, orotracheal intubation and maintenance on isoflurane (1.3%) using mechanical ventilation. Forty minutes after induction, lidocaine (2 mg kg⁻¹ bolus) or an equivalent volume of saline (0.9%) was administered IV followed by a continuous rate infusion (100 μg kg⁻¹ minute⁻¹) of lidocaine (treatment L) or saline (treatment C). Heart rate (HR), systolic, diastolic and mean arterial pressures (SAP, DAP and MAP), central venous pressure (CVP), mean pulmonary arterial pressure (mPAP), pulmonary arterial occlusion pressure (PAOP), cardiac output, end-tidal carbon dioxide (Pe'CO2 ) and core temperature (CT) were recorded before lidocaine or saline administration (Baseline) and at 20-minute intervals (T20-T80). Plasma concentrations of lidocaine were measured in treatment L. The HR was significantly lower in treatment L compared with treatment C. There was no difference between the treatments with regards to SAP, DAP, MAP and SVRI. CI was significantly lower at T60 in treatment L when compared with treatment C. PAOP and CVP increased significantly at all times compared with Baseline in treatment L. There was no significant difference between times within each treatment and between treatments with regards to other measured variables. Plasma concentrations of lidocaine ranged from 1.85 to 2.06 μg mL⁻¹ during the CRI. At the studied rate, lidocaine causes a decrease in heart rate which is unlikely to be of clinical significance in healthy animals, but could be a concern in compromised animals. © 2013 Association of Veterinary Anaesthetists

Midazolam intravenous conscious sedation in oral surgery. A retrospective study of 372 cases.

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Runes, J; Ström, C

1996-01-01

In 1987 the Swedish Dental Act was amended to allow Swedish dentists who have undergone a specific accreditation course to administer intra-venous sedation. Midazolam is a benzodiazepin derivate with express sedative and hypnotic qualities, powerful amnesia, a short half-life time and few secondary effects. From 1989-1994 midazolam intravenous conscious sedation (ICS) was administered in 372 cases in the Department of Oral and Maxillofacial Surgery, County Hospital, Falun. This study presents data on the 298 patients. Although surgical removal of impacted wisdom teeth predominated, implant surgery, reduction of fractures and correction of anomalies were also carried out. Supplementary sedative premedication was rarely used. Most patients were treated under local anaesthesia. The mean dosage was 10.45 mg (range 1.25-40 mg). Mean dosage/kg was 0.15 mg (range 0.03-0.50 mg). The average duration of anaesthesia was 50 minutes. The average recovery time was 94 minutes. Three hundred and sixty-nine of 372 planned treatments were completed. No serious complications occurred. The patients were co-operative during surgery and were satisfied with the treatment. Compared with full anaesthesia this method required less resources and is a valuable complement in management of anxious patients undergoing oral surgery.

Midazolam Plus Haloperidol as Adjuvant Analgesics to Morphine in Opium Dependent Patients: A Randomized Clinical Trial.

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Afzalimoghaddam, Mohammad; Edalatifard, Maryam; Nejati, Amir; Momeni, Mehdi; Isavi, Nader; Karimialavijeh, Ehsan

2016-01-01

Tolerance to opioids among opium-dependent patients creates obstacles for proper pain management of these patients in the emergency department (ED). The aim of the present study was to investigate the efficacy of intramuscular (IM) haloperidol plus midazolam on morphine analgesia among opium-dependent patients. Opium-dependent adults who were admitted to the ED for new-onset severe pain in the limbs or abdomen (within 24 hours of admission and a pain score of over six, using a numerical rating scale [NRS]) were recruited. Participants were randomly assigned into two groups. Group A received morphine 0.05 mg/kg intravenously (IV) and a mixture of midazolam 2.5 mg and haloperidol 2.5 mg (diluted in 5 cc of distilled water, IM); group B received morphine 0.05 mg/kg IV and distilled water 5 cc, IM. Measured outcomes were related to: 1) pain intensity; 2) total doses of morphine; 3) changes in hemodynamic status and level of consciousness of patients. NRS scores (zero to 10) before and one, three and six hours following intervention, as well as total doses of morphine, were recorded. We recruited 68 males (78.16%) and 19 females (21.83%). The mean age was 38.28±6.59 years. The pain score in group A declined more rapidly over six hours than that in group B. Moreover, as compared to group B, the amount of morphine use decreased significantly in group A. Based on the present data, adding haloperidol plus midazolam to morphine for pain management improved pain scores and lowered morphine consumption among opium-dependent patients. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Success rate of IR midazolam sedation in combination with C-CLAD in pediatric dental patients—a prospective observational study

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Malka Ashkenazi

2014-03-01

Full Text Available Objective. To evaluate the success rate of intra-rectal (IR midazolam in combination with nitrous oxide/oxygen (N2O sedation in young uncooperative dental patients when the local anesthesia is delivered by a computerized controlled local anesthetic delivery (C-CLAD.Study Design. This observational study consisted of 219 uncooperative children (age: 4.3 ± 1.69 y who received IR midazolam (0.4 mg/kg and N2O to complete their dental treatment. Measured variables included: child’s pain disruptive behavior during delivery of anesthesia by C-CLAD (CHEOP Scale, child behavior during treatment (Houpt scale, dental procedure performed, and side effects that appeared during treatment.Results. There was a high level of cooperation (mean score: 6.69 ± 2.1 during administration of local anesthesia. Good-to-excellent behavior was shown by 87% of the children during treatment. Planned treatment was completed by 184 (92% patients. No statistically significant changes were noticed in the oxygen saturation levels before and after treatment. Children with side effects included 3 (1.3% with nistagmus, 5 (2.3% with diplopia, and 18 (8.2% with hiccups. Three consecutive sedations decreased the overall behavior score by 5.7% compared to the first appointment (p < .05.Conclusions. IR midazolam-N2O sedation in combination with C-CLAD is very effective for delivery of dental treatment to young uncooperative children.

[Sedation with midazolam for ambulatory pediatric dentistry].

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Shavlokhova, E A; Ostreĭkov, I F; Korolenkova, M V

2014-01-01

To improve the quality of dental treatment in children by using combined anaesthesia technique including local anaesthesia and conscious sedation, and to assess the effectiveness of conscious sedation for younger children undergoing dental treatment. The study included 208 children aged 14-88 months who received dental treatment for tooth decay and its complication under combined anaesthesia. Midazolam was used as sedative medication. Sedation level was assessed by visual scale and BIS-monitoring. ANI-monitoring was also used for pain sensitiveness evaluation. Results All 208 children were successfully treated under combined anaesthesia which showed satisfactory sedation rates both by visual scale and and BIS-monitoring values. While mean patient age was 39 months 20.6% were younger than 24 months. These data are extremely valuable as according to literature review conscious sedation in early infancy remains controversial. Our results proved conscious sedation to be effective in younger children undergoing dental treatment thus representing important alternative for general anaesthesia and providing a basis for later behavior management.

Assessment of Pharmacokinetic Interactions Between Obeticholic Acid and Caffeine, Midazolam, Warfarin, Dextromethorphan, Omeprazole, Rosuvastatin, and Digoxin in Phase 1 Studies in Healthy Subjects.

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Edwards, Jeffrey E; Eliot, Lise; Parkinson, Andrew; Karan, Sharon; MacConell, Leigh

2017-09-01

Obeticholic acid (OCA), a potent and selective farnesoid X receptor agonist, is indicated for the treatment of primary biliary cholangitis (PBC). We investigated the potential drug-drug interaction effect of OCA on metabolic CYP450 enzymes and drug transporters. Five phase 1 single-center, open-label, fixed-sequence, inpatient studies were conducted in healthy adult subjects to evaluate the effect of oral daily doses of 10 or 25 mg OCA on single-dose plasma pharmacokinetics of specific probe substrates for enzymes CYP1A2 (caffeine, R-warfarin), CYP3A (midazolam, R-warfarin), CYP2C9 (S-warfarin), CYP2D6 (dextromethorphan), CYP2C19 (omeprazole), and drug transporters, BCRP/OATP1B1/OATP1B3 (rosuvastatin), and P-gp (digoxin). OCA showed no substantial suppression/inhibition of S-warfarin, digoxin, and dextromethorphan and weak interactions with caffeine, omeprazole, rosuvastatin, and midazolam. The maximal pharmacodynamic responses (E max ) to warfarin-based INR, PT, and aPTT were reduced by 11%, 11%, and 1%, respectively, for the 10-mg dose group and by 7%, 7% and 0%, respectively, for the 25-mg dose group. Overall, drugs dosed in combination with OCA were well tolerated, and most adverse events were mild in severity. No clinically important trends were noted in laboratory evaluations, vital signs, or 12-lead ECGs. In these studies, OCA showed weak to no suppression/inhibition of metabolic enzymes and drug transporters at the highest recommended therapeutic dose in patients with PBC. On the basis on these analyses, monitoring and maintenance of target INR range are required during coadministration of OCA with drugs that are metabolized by CYP1A2 (R-warfarin). Intercept Pharmaceuticals, Inc.

Optimal and safe standard doses of midazolam and propofol to achieve patient and doctor satisfaction with dental treatment: A prospective cohort study

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Nonaka, Mutsumi; Nishimura, Akiko; Gotoh, Kinuko; Oka, Shuichirou; Iijima, Takehiko

2017-01-01

Background The incidences of morbidity and mortality caused by pharmacosedation for dental treatment have not yet reached zero. Adverse events are related to inappropriate respiratory management, mostly originating from an overdose of sedatives. Since sedation is utilized for the satisfaction of both the dentist and the patient, the optimal dose should be minimized to prevent adverse events. We attempted to define the optimal doses of midazolam and propofol required to achieve high levels of patient and dentist satisfaction. Methods One thousand dental patients, including those undergoing third molar extractions, were enrolled in this study. A dose of 1 mg of midazolam was administered at 1-minute intervals until adequate sedation was achieved. Propofol was then infused continuously to maintain the sedation level. Both the patients and the dentists were subsequently interviewed and asked to complete a questionnaire. A multivariate logistic regression analysis was used to examine the factors that contributed to patient and dentist satisfaction. Results The peak midazolam dose resulting in the highest percentage of patient satisfaction was 3 mg. Both a lower dose and a higher dose reduced patient satisfaction. Patient satisfaction increased with an increasing dosage of propofol up until 4 mg/kg/hr, reaching a peak of 78.6%. The peak midazolam dose resulting in the highest percentage of dentist satisfaction (78.8%) was 2 mg. Incremental propofol doses reduced dentist satisfaction, in contrast to their effect on patient satisfaction. The strongest independent predictors of patient satisfaction and dentist satisfaction were no intraoperative memory (OR, 5.073; 95% CI, 3.532–7.287; Psedation is relatively light, memory loss and an absence of unintentional patient movements can be expected without adverse events. PMID:28182732

Phenobarbital and midazolam increase neonatal seizure-associated neuronal injury.

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Torolira, Daniel; Suchomelova, Lucie; Wasterlain, Claude G; Niquet, Jerome

2017-07-01

Status epilepticus is common in neonates and infants, and is associated with neuronal injury and adverse developmental outcomes. γ-Aminobutyric acidergic (GABAergic) drugs, the standard treatment for neonatal seizures, can have excitatory effects in the neonatal brain, which may worsen the seizures and their effects. Using a recently developed model of status epilepticus in postnatal day 7 rat pups that results in widespread neuronal injury, we found that the GABA A agonists phenobarbital and midazolam significantly increased status epilepticus-associated neuronal injury in various brain regions. Our results suggest that more research is needed into the possible deleterious effects of GABAergic drugs on neonatal seizures and on excitotoxic neuronal injury in the immature brain. Ann Neurol 2017;82:115-120. © 2017 American Neurological Association.

Prehospital Agitation and Sedation Trial (PhAST): A Randomized Control Trial of Intramuscular Haloperidol versus Intramuscular Midazolam for the Sedation of the Agitated or Violent Patient in the Prehospital Environment.

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Isenberg, Derek L; Jacobs, Dorian

2015-10-01

Violent patients in the prehospital environment pose a threat to health care workers tasked with managing their medical conditions. While research has focused on methods to control the agitated patient in the emergency department (ED), there is a paucity of data looking at the optimal approach to subdue these patients safely in the prehospital setting. Hypothesis This study evaluated the efficacy of two different intramuscular medications, midazolam and haloperidol, to determine their efficacy in sedating agitated patients in the prehospital setting. This was a prospective, randomized, observational trial wherein agitated patients were administered intramuscular haloperidol or intramuscular midazolam to control agitation. Agitation was quantified by the Richmond Agitation and Sedation Scale (RASS). Paramedics recorded the RASS and vital signs every five minutes during transport and again upon arrival to the ED. The primary outcome was mean time to achieve a RASS less than +1. Secondary outcomes included mean time for patients to return to baseline mental status and adverse events. Five patients were enrolled in each study group. In the haloperidol group, the mean time to achieve a RASS score of less than +1 was 24.8 minutes (95% CI, 8-49 minutes), and the mean time for the return of a normal mental status was 84 minutes (95% CI, 0-202 minutes). Two patients required additional prehospital doses for adequate sedation. There were no adverse events recorded in the patients administered haloperidol. In the midazolam group, the mean time to achieve a RASS score of less than +1 was 13.5 minutes (95% CI, 8-19 minutes) and the mean time for the return of normal mental status was 105 minutes (95% CI, 0-178 minutes). One patient required additional sedation in the ED. There were no adverse events recorded among the patients administered midazolam. Midazolam and haloperidol administered intramuscularly appear equally effective for sedating an agitated patient in the

Differential effects of midazolam and zolpidem on sleep-wake states and epileptic activity in WAG/Rij rats

NARCIS (Netherlands)

Depoortere, H.; Francon, D.; Luijtelaar, E.L.J.M. van; Drinkenburg, W.H.I.M.; Coenen, A.M.L.

1995-01-01

Hypnotic drugs are known to possess antiepileptic activity. Therefore, the effects of the benzodiazepine hypnotic midazolam (10 mg/kg) and the novel imidazopyridine hypnotic zolpidem (10 mg/kg) on sleep-wake states and on the number of spike-wave discharges were evaluated in WAG/Rij rats. Rats of

The cost effectiveness of licensed oromucosal midazolam (Buccolam(®)) for the treatment of children experiencing acute epileptic seizures: an approach when trial evidence is limited.

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Lee, Dawn; Gladwell, Daniel; Batty, Anthony J; Brereton, Nic; Tate, Elaine

2013-04-01

In the UK, two treatment options are used for acute epileptic seizures in the community-rectal diazepam and unlicensed buccal midazolam. In practice, the former is rarely used, with unlicensed buccal midazolam being widely recommended and prescribed by physicians. In September 2011, Buccolam(®) (licensed midazolam oromucosal solution) became the first medicine to receive a Paediatric-Use Marketing Authorization (PUMA) and it is indicated for the treatment of prolonged, acute, convulsive seizures by caregivers in the community for children (aged 6 months to marketing authorization processes and may be based upon small population subsets and may not, in some cases, require new safety or efficacy data to be generated; a similar situation to that seen for orphan drugs. This can lead to challenges when conducting economic evaluations. The aim of this study was to assess the cost effectiveness of Buccolam(®) for children with a diagnosis of epilepsy suffering prolonged, acute, convulsive seizures occurring in the UK community setting. DESIGN AND PERSPECTIVE: A hybrid model was developed according to a UK payer perspective. The model included a time-to-event simulation for the frequency and location of occurrence of seizures, along with a decision-tree model that assessed the treatment pathway when a seizure occured. The model compared treatment with Buccolam(®) with standard care in the community (95 % unlicensed buccal midazolam and 5 % rectal diazepam) or either treatment alone. The model was informed by data from a variety of sources, including clinical effectiveness estimates, and costs based on published UK data, using 2012-13 prices, where possible. To determine current practice and real-world effectiveness, a Delphi panel and a survey of parents of children with epilepsy were conducted. Buccolam(®) showed a reduction in costs of £2,939 compared with standard care, £14,269 compared with rectal diazepam alone and £886 compared with unlicensed buccal midazolam

A pré-medicação com midazolam antes de secção cesariana não tem efeitos adversos no neonato

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Ahmet Can Senel

2014-01-01

Full Text Available Como todos os pacientes cirúrgicos, pacientes obstétricas também sentem estresse e ansieda de operatórios. Isso pode ser prevenido se forem passadas à paciente informações detalhadas sobre sua operação e se forem administrados medicamentos farmacológicos pré-operatórios. Devido aos efeitos depressivos dos sedativos nos neonatos, os medicamentos farmacológicos são omitidos, especialmente em pacientes obstétricas. A literatura contém poucos estudos concernentes ao uso de midazolam no pré-operatório em pacientes de secção cesariana (C/S. Nosso objetivo nesse estudo foi ajudar nossas pacientes passando por cirurgia C/S. Um grupo agendado para C/S eletiva recebeu midazolam 0,025 mg kg−1 por via intraveno sa; o outro grupo recebeu salina. A ansiedade materna foi avaliada com o uso dos escores da Amsterdam Preoperative Anxiety and Information Scale (APAIS (Escala de Ansiedade e Informação Pré-operatória de Amsterdam, e os neonatos foram avaliados por Apgar e pelo instrumento Neonatal Neurologic and Adaptive Capacity Score (NACS (Escore Neurológico e de Capacidade Adaptativa do Neonato. Em conclusão, os pacientes pré-medicados com midazolam 0,025 mg kg−1 medicação tiveram escores de ansiedade significativamente baixos, sem qualquer efeito adverso nos neonatos. Portanto, midazolam pode, com segurança, ser utilizado como agente de pré-medicação na cirurgia C/S.

Short- and long-term follow-up of intensive care unit patients after sedation with isoflurane and midazolam--a pilot study.

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Sackey, Peter V; Martling, Claes-Roland; Carlswärd, Christine; Sundin, Orjan; Radell, Peter J

2008-03-01

To compare memories from the intensive care unit (ICU) and short- and long-term psychological morbidity in patients after sedation with intravenous midazolam or inhaled isoflurane. Prospective long-term follow-up after randomized controlled trial. General ICU at Karolinska University Hospital, Solna, Stockholm. Forty patients in need of sedation during ventilator treatment. Patients were randomized to receive isoflurane or midazolam for goal-directed sedation until extubation or for a maximum of 96 hrs. For short-term follow-up, doctors', nurses', and physiotherapists' notes from the 4 days following exposure to the study drugs were reviewed for words indicating adequate or pathologic cognitive and psychological recovery. For long-term follow-up, all 6-month survivors received questionnaires including the ICU Memory Tool (ICU-MT), Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale (IES), and Well-Being Index. Additionally, several screening questions for previous posttraumatic stress symptoms were included. In the short term follow-up, no significant differences were found between groups. In the long-term follow-up, a trend toward fewer hallucinations/delusions after isoflurane sedation than after midazolam (two of ten isoflurane patients vs. five of seven midazolam patients) was found (p = .06). None of the five solely isoflurane-sedated patients reported hallucinations/delusions from the ICU. There was no difference in groups in long-term psychological morbidity as measured with HADS and IES. Memories of negative feelings in the ICU (ICU-MT) were associated with high HADS and IES scores (Fisher's exact test, p = .02 and p = .01, respectively). Sedation of ICU patients with isoflurane may result in fewer delusional memories or hallucinations from the ICU compared with more commonly used intravenous sedation. Memories of negative feelings from the ICU were associated with symptoms of depression or anxiety or symptoms indicating posttraumatic stress

Preliminary investigation into the ventilatory effects of midazolam in isoflurane-anaesthetised goats

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George F. Stegmann

2012-05-01

Full Text Available The ventilatory effects of intravenous midazolam (MDZ were evaluated in isoflurane- anaesthetised goats. Eight female goats aged 2–3 years were fasted from food and water for 12 h. Anaesthesia was then induced using a face mask with isoflurane in oxygen, whilst the trachea was intubated with a cuffed tracheal tube and anaesthesia maintained with isoflurane at 1.5% end-tidal concentration. Ventilation was spontaneous. The goats were treated with either a saline placebo (PLC or MDZ intravenously at 0.2 mg/kg. Analysis of variance for repeated measures was used for the analysis of data. Significance was taken at the 0.05 level. Differences between treatments were not statistically significant (p > 0.05 for tidal volume, ventilation rate, tidal volume/kg (VT/kg and end-tidal carbon dioxide partial pressure. Within treatments, VT and VT/kg differed 5 min after MDZ administration; this was statistically significant (p < 0.05. The occurrence of apnoea in the MDZ-treated goats was statistically significant (p = 0.04 compared with the PLC treated goats. Intravenous MDZ at 0.2 mg/kg administered to isoflurane-anaesthetised goats may result in transient apnoea and a mild decrease in VT and VT/kg.

Preliminary investigation into the ventilatory effects of midazolam in isoflurane-anaesthetised goats

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George F. Stegmann

2012-04-01

Full Text Available The ventilatory effects of intravenous midazolam (MDZ were evaluated in isoflurane- anaesthetised goats. Eight female goats aged 2–3 years were fasted from food and water for 12 h. Anaesthesia was then induced using a face mask with isoflurane in oxygen, whilst the trachea was intubated with a cuffed tracheal tube and anaesthesia maintained with isoflurane at 1.5% end-tidal concentration. Ventilation was spontaneous. The goats were treated with either a saline placebo (PLC or MDZ intravenously at 0.2 mg/kg. Analysis of variance for repeated measures was used for the analysis of data. Significance was taken at the 0.05 level. Differences between treatments were not statistically significant (p > 0.05 for tidal volume, ventilation rate, tidal volume/kg (VT/kg and end-tidal carbon dioxide partial pressure. Within treatments, VT and VT/kg differed 5 min after MDZ administration; this was statistically significant (p < 0.05. The occurrence of apnoea in the MDZ-treated goats was statistically significant (p = 0.04 compared with the PLC treated goats. Intravenous MDZ at 0.2 mg/kg administered to isoflurane-anaesthetised goats may result in transient apnoea and a mild decrease in VT and VT/kg.

Aerosolized intranasal midazolam for safe and effective sedation for quality computed tomography imaging in infants and children.

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Mekitarian Filho, Eduardo; de Carvalho, Werther Brunow; Gilio, Alfredo Elias; Robinson, Fay; Mason, Keira P

2013-10-01

This pilot study introduces the aerosolized route for midazolam as an option for infant and pediatric sedation for computed tomography imaging. This technique produced predictable and effective sedation for quality computed tomography imaging studies with minimal artifact and no significant adverse events. Copyright © 2013 Mosby, Inc. All rights reserved.

Addition of low-dose ketamine to midazolam and low-dose bupivacaine improves hemodynamics and postoperative analgesia during spinal anesthesia for cesarean section

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Ahmed Sobhy Basuni

2016-01-01

Conclusion: Intrathecal low-dose ketamine combined with midazolam and low-dose bupivacaine stabilizes hemodynamics and prolongs postoperative analgesia without significant side-effects in parturients undergoing CS.

A gradient of mercury concentrations in Scottish single malt whiskies.

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Rose, Neil L; Yang, Handong; Turner, Simon D

2016-02-01

Mercury (Hg) concentrations were measured in 26 Scottish single malt whiskies, and all found to be very low (mercury emissions and deposition over the last 200 years affecting concentrations in local waters used in whisky production. As UK atmospheric emissions of mercury have declined by 90 % since the 1970s, we suggest that whisky being produced today should have even lower Hg concentrations when consumed in 10- to 15-years time. This reduction may be compromised by the remobilisation of contaminants stored in catchment soils being transferred to source waters, but is very unlikely to raise the negligible health risk due to Hg from Scottish single malt whisky consumption.

Perioperative effects of oral midazolam premedication in children undergoing skin laser treatment. A double-blinded randomized placebo-controlled trial

NARCIS (Netherlands)

Shoroghi, Mehrdad; Arbabi, Shahriyar; Farahbakhsh, Farshid; Sheikhvatan, Mehrdad; Abbasi, Ali

2011-01-01

Purpose: To investigate and compare the efficacy of oral midazolam with two different dosages in orange juice on perioperative hemodynamics and behavioral changes in children who underwent skin laser treatment in an academic educational Hospital. Methods: Ninety children, candidates for skin laser

Comparison of Dexmedetomidine and Midazolam in Sedation for Percutaneous Drainage of Hepatic Hydatid Cysts.

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Bavullu, Emine Nilgün; Aksoy, Esra; Abdullayev, Ruslan; Göğüş, Nermin; Dede, Doğan

2013-12-01

Hydatid cyst still continues to be a public health problem. The basic treatment for the disease is surgery, but ultrasound-guided percutaneous drainage has become an important treatment alternative. Agents preferred for sedation during drainage performed under local anaesthesia must also preserve respiration and hemodynamic stability while providing adequate sedation. We compared the sedative properties of midazolam, which has a short duration of action, and a selective α2 adrenergic receptor agonist, dexmedetomidine, and the intraoperative complications. After approval by the clinical trials ethics committee, 40 patients with similar demographic data were randomized into two groups. All patients received 10 mg metoclopramide and 45.5 mg pheniramine before the procedure. Then, midazolam (0.07 mg kg(-1) IV bolus followed by 0.01 mg kg(-1) h(-1) infusion) was administered to Group 1, and dexmedetomidine (1 μg kg(-1) loading dose in 10 minutes, followed by 0.2 μg kg(-1) h(-1) continuous infusion) was administered to Group 2 for sedation. Just before the surgical procedure, all patients received IV propofol in a subhypnotic dose of 0.5 mg kg(-1); the dose was repeated if adequate sedation could not be achieved. Observer's assessment of alertness/sedation (OAA/S) scale and Bispectral index (BIS) were used to evaluate the sedation level during the procedure. Heart rate (HR), mean arterial pressure (MAP), respiratory rate (RR), peripheral oxygen saturation (SpO2) and end-tidal carbon dioxide pressure (ETCO2) were monitored before and after induction and every 5 minutes thereafter. Propofol requirement was noted for each group. Sedation in the dexmedetomidine group was as effective and adequate as that observed in the midazolam group. BIS values were significantly lower in the dexmedetomidine group, especially after 10 minutes and thereafter. RR, SpO2, and ETCO2 were similar in both groups, whereas clinically insignificant decreases in HR and MAP were observed in the

Computerized electrocardiogram in agoutis (Dasyprocta prymnolopha Wagler, 1831 anesthetized with ketamine and midazolam

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Anaemilia N. Diniz

Full Text Available ABSTRACT: An electrocardiogram is a test that assesses heart electrical activity and is applied more frequently in the veterinary care of wild animals. The present study aimed to define the electrocardiogram pattern of agoutis (Dasyprocta prymnolopha Wagler, 1831 anesthetized with ketamine and midazolam. Eighteen clinically healthy agoutis (D. prymnolopha were used from the Nucleus for Wild Animal Studies and Conservation (NEPAS of the Federal University of Piauí, Brazil. The animals were chemically restrained with 5% ketamine hydrochloride at a dose of 15mg/kg and midazolam at a dose of 1mg/kg by intramuscular injection. Electrocardiogram tests were carried out by a computerized method with the veterinary electrocardiogram [Acquisition Model for Computer (ECG - PC version Windows 95 Brazilian Electronic Technology (TEB consisting of an electronic circuit externally connected to a notebook computer with ECGPC-VET (TEB software installed on the hard disc. In analysing the EKG results, significant differences were observed for QRS complex duration, PR and QT intervals and for R wave millivoltage between the genders; but we observed a significant influence of weight despite the gender. In the present experiment, the anaesthetic protocol was shown to be well tolerated by the agoutis, and no arrhythmias occurred during the time the animals were monitored. The reference values obtained should be used to better understand the cardiac electrophysiology of the species and for its clinical and surgical management.

Pharmacokinetic considerations and recommendations in palliative care, with focus on morphine, midazolam and haloperidol.

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Franken, L G; de Winter, B C M; van Esch, H J; van Zuylen, L; Baar, F P M; Tibboel, D; Mathôt, R A A; van Gelder, T; Koch, B C P

2016-06-01

A variety of medications are used for symptom control in palliative care, such as morphine, midazolam and haloperidol. The pharmacokinetics of these drugs may be altered in these patients as a result of physiological changes that occur at the end stage of life. This review gives an overview of how the pharmacokinetics in terminally ill patients may differ from the average population and discusses the effect of terminal illness on each of the four pharmacokinetic processes absorption, distribution, metabolism, and elimination. Specific considerations are also given for three commonly prescribed drugs in palliative care: morphine, midazolam and haloperidol). The pharmacokinetics of drugs in terminally ill patients can be complex and limited evidence exists on guided drug use in this population. To improve the quality of life of these patients, more knowledge and more pharmacokinetic/pharmacodynamics studies in terminally ill patients are needed to develop individualised dosing guidelines. Until then knowledge of pharmacokinetics and the physiological changes that occur in the final days of life can provide a base for dosing adjustments that will improve the quality of life of terminally ill patients. As the interaction of drugs with the physiology of dying is complex, pharmacological treatment is probably best assessed in a multi-disciplinary setting and the advice of a pharmacist, or clinical pharmacologist, is highly recommended.

Evaluation of single and double centrifugation tube methods for concentrating equine platelets.

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Argüelles, D; Carmona, J U; Pastor, J; Iborra, A; Viñals, L; Martínez, P; Bach, E; Prades, M

2006-10-01

The aim of this study was to evaluate single and double centrifugation tube methods for concentrating equine platelets. Whole blood samples were collected from clinically normal horses and processed by use of single and double centrifugation tube methods to obtain four platelet concentrates (PCs): PC-A, PC-B, PC-C, and PC-D, which were analyzed using a flow cytometry hematology system for hemogram and additional platelet parameters (mean platelet volume, platelet distribution width, mean platelet component concentration, mean platelet component distribution width). Concentrations of transforming growth factor beta 1 (TGF-beta(1)) were determined in all the samples. Platelet concentrations for PC-A, PC-B, PC-C, and PC-D were 45%, 44%, 71%, and 21% higher, respectively, compared to the same values for citrated whole blood samples. TGF-beta(1) concentrations for PC-A, PC-B, PC-C, and PC-D were 38%, 44%, 44%, and 37% higher, respectively, compared to citrated whole blood sample values. In conclusion, the single and double centrifugation tube methods are reliable methods for concentrating equine platelets and for obtaining potentially therapeutic TGF-beta(1) levels.

Effects of Rolapitant Administered Intravenously on the Pharmacokinetics of a Modified Cooperstown Cocktail (Midazolam, Omeprazole, Warfarin, Caffeine, and Dextromethorphan) in Healthy Subjects.

Science.gov (United States)

Wang, Xiaodong; Zhang, Zhi-Yi; Arora, Sujata; Wang, Jing; Lu, Sharon; Powers, Dan; Kansra, Vikram

2018-04-25

Rolapitant is a selective, long-acting neurokinin-1 receptor antagonist, approved in the United States and Europe for prevention of delayed chemotherapy-induced nausea and vomiting in adults. This open-label study evaluated the effects of a new intravenous formulation of rolapitant on cytochrome P450 (CYP) enzyme (CYP3A, CYP1A2, CYP2C9, CYP2C19, and CYP2D6) activity. On days 1 and 14, 36 healthy volunteers received a modified Cooperstown cocktail (midazolam 3 mg [CYP3A substrate], caffeine 200 mg [CYP1A2 substrate], S-warfarin 10 mg [CYP2C9 substrate] + vitamin K 10 mg, omeprazole 40 mg [CYP2C19 substrate], and dextromethorphan 30 mg [CYP2D6 substrate]). On day 7, subjects received the modified Cooperstown cocktail after 166.5-mg rolapitant infusion. On days 21, 28, and 35, subjects received oral dextromethorphan. Maximum plasma concentration (C max ) and area under the plasma concentration-time curve (AUC 0-last ) of probe drugs post- vs pre-rolapitant administration were assessed using geometric least-squares mean ratios (GMRs) with 90%CIs. The 90%CIs of the GMRs were within the 0.80-1.25 no-effect limits for caffeine and S-warfarin C max and AUC 0-last . For midazolam C max and AUC 0-last and omeprazole C max , the 90%CIs of the GMRs were marginally outside these limits. Intravenous rolapitant coadministration increased dextromethorphan exposure, peaking 14 days post-rolapitant administration (GMRs: C max , 2.74, 90%CI 2.21-3.40; AUC 0-last , 3.36, 90%CI 2.74-4.13). Intravenous rolapitant 166.5 mg and probe drugs were well tolerated when coadministered. These data suggest that intravenous rolapitant is not an inhibitor of CYP3A, CYP2C9, CYP2C19, or CYP1A2 but is a moderate inhibitor of CYP2D6. © 2018, The American College of Clinical Pharmacology.

Simultaneous determination of midazolam and 1'-hydroxymidazolam in human plasma by liquid chromatography with tandem mass spectrometry.

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Li, Wenkui; Luo, Suyi; Smith, Harold T; Tse, Francis L S

2007-08-01

A sensitive and simple liquid chromatography-tandem mass spectrometry method for the determination of midazolam and 1'-hydroxymidazolam in human plasma has been developed and validated with a dynamic range of 0.1-250 ng/mL. The analysis was based on semi-automated liquid-liquid extraction followed by evaporation of the extraction solvent, reconstitution and chromatography on a reversed-phase C(18) column. The mobile phase consists of 5 mm ammonium acetate and methanol and runs in gradient at a flow rate of 0.25 mL/min with column temperature of approximately 20 degrees C. The entire column effluent was transferred into the LC-MS/MS interface operated in positive electrospray ionization mode. The chromatographic run time was 4.3 min per injection, with retention times for midazolam, 1'-hydroxymidazolaml and the internal standard, triazolam, of 2.5, 2.3 and 2.1 min, respectively. The intra-day and inter-day precision (RSD %) and accuracy (bias %) of the quality control samples were <15.0% and within +/-13%, respectively. The current method has been applied to a clinical drug-drug interaction study in human. Copyright (c) 2007 John Wiley & Sons, Ltd.

[Effect of dexmedetomidine and midazolam on respiration and circulation functions in patients undergoing open heart surgery under acupuncture-assisted general anesthesia].

Science.gov (United States)

Tang, Wei; Wang, Jian; Fu, Guo-Qiang; Yuan, Lan

2014-06-01

To evaluate the effect of Dexmedetomidine and Midazolam on respiratory and circulation in patients experiencing open heart surgery under acupuncture-assisted general anesthesia. Sixty patients undergoing open heart surgery (cardiac valve replacement surgery and aortic valve replacement surgery) were randomly and equally divided into Dexmedetomidine (D) and Midazolam (M) groups. Electroacupuncture (EA) was applied to bilateral Yunmen (LU 2), Zhongfu (LU1), Lieque (LU7) and Neiguan (PC6). For patients of group D, Dexmedetomidine (i.v., loading dose: 1 microg/kg, and succedent dose: 0.2-1 microg x kg(-1) x h(-1)) was given. For patients of group M, Midazolam (i.v., loading dose: 0.05 mg/kg, succedent dose: 0.01-0.03 mg x kg(-1) x h(-1)) was given. Arterial oxygen pressure (PaO2), arterial carbondioxide tension (PaCO2), O2 saturation (SPO2), mean arterial pressure (MAP), heart rate (HR), anesthetic effect, time of spontaneous breathing recovery, and time of resuscitation were recorded before operation (T0), immediately after skin incision (T1), immediately after sternotomy (T2), before suspension of cardiopulmonary bypass (CPB, T3), immediately after cardiac re-beating (T4), immediately after CPB cessation (T5), and at the end of surgery (T6). Before operation, no significant differences were found between the group D and M in the levels of PaO2, PaCO2 and SPO2 (P > 0.05). The PaO2 and SPO2 levels after skin incision, sternotomy, before suspension of CPB and at the end of surgery were significantly lower in group M than in group D (P heart re-beating,after CPB cessation and at the end of surgery in group M were considerably higher than those in group D (P 0.05). It suggested that the respiration and circulation states in group D were more smoothly than those in group M. There was no significant difference between the two groups in the time of resuscitation (P > 0.05). Dexmedetomidine is superior to Midazolam in analgesia, and improving respiration and circulation

Sedative Effects of Intranasal Midazolam Administration in Wild Caught Blue-fronted Amazon (Amazona aestiva) and Orange-winged Amazon (Amazona amazonica) Parrots.

Science.gov (United States)

Schaffer, Débora P H; de Araújo, Nayone L L C; Raposo, Ana Cláudia S; Filho, Emanoel F Martins; Vieira, João Victor R; Oriá, Arianne P

2017-09-01

Safe and effective sedation protocols are important for chemical restraint of birds in clinical and diagnostic procedures, such as clinical evaluations, radiographic positioning, and blood collection. These protocols may reduce stress and ease the management of wild-caught birds, which are susceptible to injury or death when exposed to stressful situations. We compare the sedative effect of intranasal midazolam in wild-caught blue-fronted (Amazona aestiva) and orange-winged (Amazona amazonica) Amazon parrots. Ten adult parrots of each species (n = 20), of unknown sex, weighing 0.337 ± 0.04 (blue-fronted) and 0.390 ± 0.03 kg (orange-winged), kg were used. Midazolam (2 mg/kg) was administered intranasally and the total volume of the drug was divided equally between the 2 nostrils. Onset time and total sedation time were assessed. Satisfactory sedation for clinical evaluation was induced in all birds. Onset time and total sedation times were similar in both species: 5.36 ± 1.16 and 25.40 ± 5.72 minutes, respectively, for blue-fronted Amazons and 5.09 ± 0.89 and 27.10 ± 3.73 minutes, respectively, for orange-winged Amazons. A total of 15 animals showed absence of vocalization, with moderate muscle relaxation and wing movement upon handling, and 2 animals presented with lateral recumbence, with intense muscle relaxation and no wing movement, requiring no restraint. Three blue-fronted Amazons had no effective sedation. Intranasally administered midazolam at a dose of 2 mg/kg effectively promoted sedative effects with a short latency time and fast recovery in wild-caught parrots.

Liquid chromatography-tandem mass spectrometry method for simultaneous quantification of bisoprolol, ramiprilat, propranolol and midazolam in rat dried blood spots.

Science.gov (United States)

Cvan Trobec, Katja; Trontelj, Jurij; Springer, Jochen; Lainscak, Mitja; Kerec Kos, Mojca

2014-05-01

Dried blood spot (DBS) sampling represents a suitable method for pharmacokinetic studies in rats, particularly if serial sampling is needed. To study the pharmacokinetics of drugs in a rat heart failure (HF) model, we developed and validated a method for the simultaneous determination of bisoprolol, ramiprilat, propranolol and midazolam in DBS samples. Bisoprolol and ramipril are widely used in the treatment of HF, and midazolam and propranolol are markers of hepatic metabolism, which can be altered in HF. A 20μL sample of rat blood was pipetted onto Whatman 903 Protein Saver Card and allowed to dry. The whole spot was excised and 300μL of solvent (methanol with 10% ultrapure water and 0.1% formic acid) was added. After mixing and incubating the sample in an ultrasonic bath, a mixture of isotopically labeled internal standards was added. After centrifugation, the extracts were cleaned on an Ostro™ plate and analyzed using liquid chromatography-tandem mass spectroscopy. The method was successfully validated. No significant interference was observed in the retention times of analytes or internal standards. The intraday and interday accuracy and precision were within a ±15% interval. The method was linear in the range 5-250μg/L and the lower limit of quantification was 5μg/L for all four analytes. The absolute matrix effect ranged from 98.7% for midazolam to 121% for ramiprilat. The recovery was lowest for ramiprilat and highest for propranolol. Samples were stable at all tested temperatures. The method has been used successfully in a real-time pharmacokinetic study in rats. Copyright © 2014 Elsevier B.V. All rights reserved.

Hybrid entanglement concentration assisted with single coherent state

International Nuclear Information System (INIS)

Guo Rui; Zhou Lan; Sheng Yu-Bo; Gu Shi-Pu; Wang Xing-Fu

2016-01-01

Hybrid entangled state (HES) is a new type of entanglement, which combines the advantages of an entangled polarization state and an entangled coherent state. HES is widely discussed in the applications of quantum communication and computation. In this paper, we propose three entanglement concentration protocols (ECPs) for Bell-type HES, W-type HES, and cluster-type HES, respectively. After performing these ECPs, we can obtain the maximally entangled HES with some success probability. All the ECPs exploit the single coherent state to complete the concentration. These protocols are based on the linear optics, which are feasible in future experiments. (paper)

Comparison of Haloperidol Alone and in Combination with Midazolam for the Treatment of Acute Agitation in an Inpatient Palliative Care Service.

Science.gov (United States)

Ferraz Gonçalves, José António; Almeida, Ana; Costa, Isabel; Silva, Paula; Carneiro, Rui

2016-12-01

Agitation is a very distressing problem that must be controlled as quickly as possible, but using a safe method. The authors conducted a comparison of two protocols: a combination of haloperidol and midazolam and haloperidol alone. The combination drug protocol controlled 101 out of 121 (84%) episodes of agitation with only the first dose, whereas the haloperidol alone protocol controlled 47 out of 74 (64%) episodes. This difference is statistically significant (P =.002), with a post hoc analyzed power of 0.88. The median time from the first dose to the control of agitation was 15 minutes (range: 5-210) with the combination and 60 minutes (range: 10-430) with the other protocol, P haloperidol and midazolam is effective and safe for the control of agitation in palliative care and it is more effective than haloperidol alone. Therefore, the combination should be adopted as the preferred protocol. It would be helpful if the usefulness of this protocol is confirmed by others.

Continuous infusion in adult females dogs submitted to ovariohysterectomy with midazolam-xylazine and/or medetomidine pre-treated with methotrimeprazine and buprenorphine Infusão continua em cães fêmeas submetidas à ovariohisterectomia com midazolam/cetamina/xilazina e/ou medetomidina pré-tratadas com levomepromazina e buprenorfina

Directory of Open Access Journals (Sweden)

Fernando do Carmo Silva

2007-08-01

Full Text Available PURPOSE: To compare, by continuous infusion of ketamine or medetomidine combined to methotrimeprazine and buprenorphine, ketamine and midazolam, the degree of hypnosis, myorelaxation, anesthetic quality and surgical feasibility through evaluation of possible parametric alterations and recovery quality. METHODS: 20 healthy adult females dogs, aged 3 to 5 years, body weight between 7 and 15 kg, were assigned randomly and homogenously to 2 groups of 10 animals each (n=10, group 1 (G1 and group 2 (G2, respectively. Animals of G1 were subjected to a pre-treatment with intravenous 1.0 mg/kg methotrimeprazine and or 3ì/kg. After 15 minutes, a 5.0 mg/kg ketamine and 0.2 mg/kg midazolam were intravenously injected. Immediately after induction, an anesthetic combination of 0.4 mg/kg/h midazolam, 20 mg/kg/h ketamine and 1.0 mg/kg/h xylazine, was continuously and intravenously administered for 30 minutes. The same techniques were used in G2 except for the substitution of xylazine for 30ìg/kg/h medetomidine. RESULTS: In G1 there was a 1st and 2nd degree atrioventricular heart block, a longer recovery period and lower quality. In G2 a 1st degree atrioventricular heart block occurred but isolated and ephemeral. CONCLUSIONS: The continuous infusion method, besides reducing drugs utilization, prevented collateral effects allowing a more tranquil recovery with no excitations, both protocols permitted the surgical procedure (ovary-hysterectomy bringing about a reduction in hypnosis and an accentuated myorelaxation. Xylazine and medetomidine showed a similar pharmacodynamic behavior but with different clinical aspects. The electrocardiographic alterations observed in G2 and in a lower degree in G1 must be well studied. Describers: dogs, ketamine, methotrimeprazine, medetomidine, midazolam and xylazine.OBJETIVO: Comparar através de infusão contínua de xilazina ou medetomidina associada à metotrimeprazina e buprenorfina, cetamina e midazolam, o grau de hipnose

Midazolam inhibits hippocampal long-term potentiation and learning through dual central and peripheral benzodiazepine receptor activation and neurosteroidogenesis

OpenAIRE

Tokuda, Kazuhiro; O’Dell, Kazuko A.; Izumi, Yukitoshi; Zorumski, Charles F.

2010-01-01

Benzodiazepines (BDZs) enhance γ-aminobutyric acid-A (GABAA) receptor inhibition by direct actions on central BDZ receptors (CBRs). Although some BDZs also bind mitochondrial receptors (translocator protein 18kDa, TSPO) and promote the synthesis of GABA-enhancing neurosteroids, the role of neurosteroids in the clinical effects of BDZs is unknown. In rat hippocampal slices, we compared midazolam, an anesthetic BDZ with clonazepam, an anticonvulsant/anxiolytic BDZ that activates CBRs selectivel...

Analgesia after feline ovariohysterectomy under midazolam-medetomidine-ketamine anaesthesia with buprenorphine or butorphanol, and carprofen or meloxicam: a prospective, randomised clinical trial.

Science.gov (United States)

Polson, Sally; Taylor, Polly M; Yates, David

2012-08-01

One hundred female cats undergoing routine ovariohysterectomy under midazolam-medetomidine-ketamine anaesthesia were included in a blinded, randomised, prospective clinical study to compare postoperative analgesia produced by four analgesic drug combinations given preoperatively (n = 25 per group). A secondary aim was to assess the effects in kittens and pregnant animals. Buprenorphine 180 µg/m(2) or butorphanol 6 mg/m(2) were given with either carprofen 4 mg/kg (groups BUPC and BUTC, respectively) or meloxicam 0.3 mg/kg (groups BUPM or BUTM, respectively). Medetomidine was not antagonised. A simple, descriptive scale (SDS; 0-4), a dynamic and interactive visual analogue scale (DIVAS; 0-100 mm) and mechanical nociceptive thresholds (MT; 2.5-mm diameter probe) were used to evaluate postoperative pain. All pain scores were low (DIVAS 10 N) and there were no significant differences between the groups. It was concluded that all protocols provided adequate analgesia and when used with midazolam-medetomidine-ketamine are effective for routine feline ovariohysterectomy.

Changes in blood glucose level during and after light sedations using propofol-fentanyl and midazolam-fentanyl in diabetic patients who underwent cataract surgery.

Science.gov (United States)

Khalighinejad, Pooyan; Rahimi, Mojtaba; Naghibi, Khosro; Niknam, Negar

2015-01-01

Surgeries may trigger the stress response which leads to changes in blood glucose level, and studies suggest that different sedation and anesthesia methods have different effects on blood glucose level. The aim of this study was to investigate changes of blood glucose levels in diabetic patients and compare them in two sedation methods of propofol + fentanyl and midazolam + fentanyl. Totally, 80 diabetic candidates for cataract surgery who had all the inclusion criteria, underwent cataract surgery using two methods of propofol (1 mg/kg/h) + fentanyl (2 μg/kg) (Group P) and midazolam (0.03 mg/kg) + fentanyl (2 μg/kg) (Group M) for light sedation. In the end, 70 patients (Group P n = 35 and Group M n = 35) remained in the study. Patients' blood glucose levels, vital signs, and hemodynamic data were assessed 30 min prior to the surgery, each 15 min during surgery and at the end of surgery. Hemodynamic parameters did not have a statistically significant difference between the two groups mean blood glucose level in Group M was 149.15 mg/dl and in Group P was 149.2 mg/dl, and based on repeated measures analysis of variance test, significant differences were not observed between the two groups (P = 0.99). T-test showed no significant differences in the blood glucose level at any time of the study between the two groups. Light sedation methods of propofol + fentanyl and midazolam + fentanyl did not have any differences in alteration of blood glucose level.

Systemic or Intra-Amygdala Infusion of the Benzodiazepine, Midazolam, Impairs Learning, but Facilitates Re-Learning to Inhibit Fear Responses in Extinction

Science.gov (United States)

Hart, Genevra; Harris, Justin A.; Westbrook, R. Frederick

2010-01-01

A series of experiments used rats to study the effect of a systemic or intra-amygdala infusion of the benzodiazepine, midazolam, on learning and re-learning to inhibit context conditioned fear (freezing) responses. Rats were subjected to two context-conditioning episodes followed by extinction under drug or vehicle, or to two cycles of context…

Variation in caffeine concentration in single coffee beans.

Science.gov (United States)

Fox, Glen P; Wu, Alex; Yiran, Liang; Force, Lesleigh

2013-11-13

Twenty-eight coffee samples from around the world were tested for caffeine levels to develop near-infrared reflectance spectroscopy (NIRS) calibrations for whole and ground coffee. Twenty-five individual beans from five of those coffees were used to develop a NIRS calibration for caffeine concentration in single beans. An international standard high-performance liquid chromatography method was used to analyze for caffeine content. Coffee is a legal stimulant and possesses a number of heath properties. However, there is variation in the level of caffeine in brewed coffee and other caffeinated beverages. Being able to sort beans on the basis of caffeine concentration will improve quality control in the level of caffeine in those beverages. The range in caffeine concentration was from 0.01 mg/g (decaffeinated coffee) to 19.9 mg/g (Italian coffee). The majority of coffees were around 10.0-12.0 mg/g. The NIRS results showed r(2) values for bulk unground and ground coffees were >0.90 with standard errors coffee beans. One application of this calibration could be sorting beans on caffeine concentration to provide greater quality control for high-end markets. Furthermore, bean sorting may open new markets for novel coffee products.

Tranquilização rápida para pacientes agitados nos serviços de emergência psiquiátrica: um ensaio clínico randomisado de olanzapina, ziprasidona, haloperidol mais prometazina, haloperidol mais midazolam e haloperidol em monoterapia

OpenAIRE

Baldaçara, Leonardo; Sanches, Marsal; Cordeiro, Daniel Cruz; Jackowski, Andrea Parolin

2011-01-01

OBJECTIVE: To compare the effectiveness of intramuscular olanzapine, ziprasidone, haloperidol plus promethazine, haloperidol plus midazolam and haloperidol alone as the first medication(s) used to treat patients with agitation and aggressive behavior. METHOD: One hundred fifty patients with agitation caused by psychotic or bipolar disorder were randomly assigned under double-blind conditions to receive olanzapine, ziprasidone, haloperidol plus midazolam, haloperidol plus promethazine or halop...

Turning up the Noise or Turning Down the Volume? On the Nature of the Impairment of Episodic Recognition Memory by Midazolam

Science.gov (United States)

Malmberg, Kenneth J.; Zeelenberg, Rene; Shiffrin, Richard M.

2004-01-01

E. Hirshman, J. Fisher, T. Henthom, J. Amdt, and A. Passanname (2002) found that Midazolam disrupts the mirror-patterned word-frequency effect for recognition memory by reversing the typical hit-rate advantage for low-frequency words. They noted that this result is consistent with dual-process accounts (e.g., R. C. Atkinson & J. F. Juola, 1974; G.…

Concentrations of amoxicillin and clindamycin in teeth following a single dose of oral medication.

Science.gov (United States)

Schüssl, Yvonne; Pelz, Klaus; Kempf, Jürgen; Otten, Jörg-Elard

2014-01-01

The main purpose of this study is the detection of amoxicillin and clindamycin concentrations in teeth. Eleven patients received 2 g of amoxicillin, and 11 patients received 600 mg of clindamycin in a single dose of oral medication at least 60 min prior to tooth extraction due to systemic diseases. The concentrations were determined in crowns and roots separately using liquid chromatography-tandem mass spectrometry (LC-MS-MS). Amoxicillin (13 samples) and clindamycin (12 samples) were detected in the samples of the root and crown preparations of the extracted teeth. The mean concentration of amoxicillin was 0.502 μg/g in the roots and 0.171 μg/g in the crowns. The mean concentration of clindamycin was 0.270 μg/g in the roots and 0.064 μg/g in the crowns. A single dose of oral amoxicillin and clindamycin leads to concentrations of both antibiotics in teeth which exceed the minimal inhibition concentration of some oral bacteria. The proof of antibacterial activity in dental hard tissue after oral single-dose application is new. The antimicrobial effect of amoxicillin and clindamycin concentrations in roots of teeth may be of clinical relevance to bacterial reinfection from dentinal tubules.

GRIN planar waveguide concentrator used with a single axis tracker.

Science.gov (United States)

Bouchard, Sébastien; Thibault, Simon

2014-03-10

It is generally accepted that small to medium level concentrators could be used as cost-competitive replacements for tracked solar panels. The objective is to design a system that can reach a good level of sun concentration with only one sun-tracking axis and is cheap to fabricate. As the most critical parameter for all concentrator designs, optical efficiency needed improvement to reduce the cost of power produced by our system. By using a graded-index planar waveguide with an index profile similar to SELFOC fiber, the ray's path can be controlled. Also, the concentrator can be fabricated in a single block, which reduces Fresnel reflections. Overall, the optical efficiency can be improved by as much as 33% compared to the same system made with a homogeneous waveguide. Furthermore, the ability to cost-effectively fabricate the concentrator by molding can be preserved, making it possible to reduce the cost of the solar power produced.

The CLOSED trial; CLOnidine compared with midazolam for SEDation of paediatric patients in the intensive care unit : Study protocol for a multicentre randomised controlled trial

NARCIS (Netherlands)

A. Neubert (Antje); M.A. Baarslag (Manuel A.); M. van Dijk (Monique); J.M. van Rosmalen (Joost); J.F. Standing (Joseph); Y. Sheng (Yucheng); W. Rascher; D. Roberts (Deborah); J. Winslade (Jackie); L. Rawcliffe (Louise); S.M. Hanning (Sara M.); T. Metsvaht (Tuuli); V. Giannuzzi (Viviana); P. Larsson (Peter); P. Pokorna (Pavla); A. Simonetti (Alessandra); D. Tibboel (Dick)

2017-01-01

markdownabstract__Introduction__ Sedation is an essential part of paediatric critical care. Midazolam, often in combination with opioids, is the current gold standard drug. However, as it is a far-from-ideal agent, clonidine is increasingly being used in children. This drug is prescribed off-label

Análise comparativa dos efeitos do diazepam, midazolam, propofol e etomidato na contratilidade miocárdica e no fluxo coronariano: estudo em corações isolados de ratos Effects of diazepam, midazolam, propofol and etomidate in myocardial contractility and coronary blood flow: comparative analysis in isolated rat's hearts

Directory of Open Access Journals (Sweden)

Carlos Geraldo Sobral de Medeiros

2004-06-01

stable at 90 cm H2O and temperature at 37.0+0.5 °C. With the exception of the Group I (control, they were submitted to single one-minute infusions of diazepam (50 micrograms - Group II; midazolam (25 micrograms - Group III; propofol (25 and 50 micrograms - Group IV and etomidate (25 micrograms - Group V. The drugs were diluted in 0.1 mL of K-H solution and the CBF rate and the perfusion pressure controlled during their infusion.The heart rate (beats per minute, myocardial tension (grams and coronary blood flow (millimeters per minute were measure at 1, 3, 5, 10, 15, 20, 25 and 30 minutes. The myocardial contractility was obtained by calculating the first derived tension/time (dT/dt max, at each time interval. RESULTS: The heart rate showed variations in Groups I, III and IV. A variation in the myocardial tension was seen in all groups except Group I and alterations in the CBF were seen in all groups, except in Group IV during the experiment. The myocardial contractility decreased in all groups, except for Group I. CONCLUSION: The assayed drugs diminished the myocardial contractility (p<0.05; the variations of the coronary blood flow were not directly correlated to those that occurred with the myocardial contractility.

A prospective, randomized, double blind and placebo-control study comparing the additive effect of oral midazolam and clonidine for postoperative nausea and vomiting prophylaxis in granisetron premedicated patients undergoing laparoscopic cholecystecomy

Directory of Open Access Journals (Sweden)

Ghanshyam Yadav

2013-01-01

Full Text Available Background: Reduction of postoperative nausea and vomiting (PONV continues to be a major challenge in perioperative care in spite of introduction of newer antiemetics with better efficacy and safety profiles. Therefore, we evaluated the additive effect of oral midazolam and clonidine for PONV prophylaxis in granisetron premedicated patients undergoing laparoscopic cholecystectomy. Materials and Methods: In a prospective, randomized fashion, 120 selected cases were randomized into three groups: I, II or III to receive a tablet of midazolam (15 mg, n = 36, clonidine (150 mcg, n = 40, or glucose as placebo (5 g, n = 44 orally, 1 h before anesthesia. Occurrence of PONV along with need for rescue antiemetic during the first postoperative day was compared between groups as a primary outcome. Results: Episodes of PONV reduced significantly in Group II (15% as compared to group I and III (22.2%, 59% at various time points during the period of observation (P = 0.002. Need for rescue antiemetic was significantly lower in group I (13.88% and II (5% as compared to group III (52.27%, P < 0.001. Conclusion: Oral clonidine is better adjuvant for PONV prophylaxis, as compared to midazolam, in granisetron premedicated patients undergoing laparoscopic cholecystectomy.

Intentional intra-arterial injection of midazolam in a patient with status epilepticus in the intensive care unit

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Muhammad Asghar Ali

2017-01-01

Full Text Available Fundamental medical care includes intravenous (IV access which provides prompt resuscitation and reliable delivery of analgesics, antibiotics, and vasoactive medication. Difficult access populations, especially in critical area, continue to challenge providers to consider and utilize alternative means to provide IV access. Potential options under such circumstances include intramuscular, intraosseous, and intratracheal drug administration, but in extreme cases where no other options are available, intra-arterial route might be considered. We present a case where midazolam was intentionally injected intra-arterially to abort seizure activity in a patient with status epilepticus in the Intensive Care Unit.

A general approach to break the concentration barrier in single-molecule imaging

KAUST Repository

Loveland, Anna B.; Habuchi, Satoshi; Walter, Johannes C.; van Oijen, Antoine M.

2012-01-01

Single-molecule fluorescence imaging is often incompatible with physiological protein concentrations, as fluorescence background overwhelms an individual molecule's signal. We solve this problem with a new imaging approach called PhADE (Photo

A general approach to break the concentration barrier in single-molecule imaging

KAUST Repository

Loveland, Anna B.

2012-09-09

Single-molecule fluorescence imaging is often incompatible with physiological protein concentrations, as fluorescence background overwhelms an individual molecule\\'s signal. We solve this problem with a new imaging approach called PhADE (PhotoActivation, Diffusion and Excitation). A protein of interest is fused to a photoactivatable protein (mKikGR) and introduced to its surface-immobilized substrate. After photoactivation of mKikGR near the surface, rapid diffusion of the unbound mKikGR fusion out of the detection volume eliminates background fluorescence, whereupon the bound molecules are imaged. We labeled the eukaryotic DNA replication protein flap endonuclease 1 with mKikGR and added it to replication-competent Xenopus laevis egg extracts. PhADE imaging of high concentrations of the fusion construct revealed its dynamics and micrometer-scale movements on individual, replicating DNA molecules. Because PhADE imaging is in principle compatible with any photoactivatable fluorophore, it should have broad applicability in revealing single-molecule dynamics and stoichiometry of macromolecular protein complexes at previously inaccessible fluorophore concentrations. © 2012 Nature America, Inc. All rights reserved.

Genotype-phenotype associations for common CYP3A4 and CYP3A5 variants in the basal and induced metabolism of midazolam in European- and African-American men and women.

Science.gov (United States)

Floyd, Michael D; Gervasini, Guillermo; Masica, Andrew L; Mayo, Gail; George, Alfred L; Bhat, Kolari; Kim, Richard B; Wilkinson, Grant R

2003-10-01

CYP3A activity in adults varies between individuals and it has been suggested that this has a genetic basis, possibly related to variant alleles in CYP3A4 and CYP3A5 genes. Accordingly, genotype-phenotype associations were investigated under constitutive and induced conditions. Midazolam's systemic and oral clearances, and the erythromycin breath test (ERBT) were determined in 57 healthy subjects: 23 (11 men, 12 women) European- and 34 (14 men, 20 women) African-Americans. Studies were undertaken in the basal state and after 14-15 days pretreatment with rifampin. DNA was characterized for the common polymorphisms CYP3A4*1B, CYP3A5*3, CYP3A5*6 and CYP3A5*7 by direct sequencing, and for exon 21 and exon 26 variants of MDR1 by allele-specific, real-time polymerase chain reaction. In 95% of subjects, the basal systemic clearance of midazolam was unimodally distributed and variability was less than four-fold whereas, in 98% of the study population, oral clearance varied five-fold. No population or sex-related differences were apparent. Similar findings were observed with the ERBT. Rifampin pretreatment markedly increased the systemic (two-fold) and oral clearance (16-fold) of midazolam, and the ERBT (two-fold) but the variabilities were unchanged. No associations were noted between these phenotypic measures and any of the studied genotypes, except for oral clearance and its fold-increase after rifampin. These were related to the presence of CYP3A4*1B and the inversely linked CYP3A5*3 polymorphism, with the extent of induction being approximately 50% greater in CYP3A5*3 homozygotes compared to wild-type subjects. In most healthy subjects, variability in intestinal and hepatic CYP3A activity, using midazolam as an in-vivo probe, is modest and common polymorphisms in CYP3A4 and CYP3A5 do not appear to have important functional significance.

Midazolam intranasal para la sedación preanestésica pediátrica

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Joaquín L. de la Lastra Rodríguez

1995-12-01

Full Text Available El ingreso hospitalario y un tratamiento quirúrgico pueden crear en los niños temor, ansiedad y trastornos emocionales al abandonar la atmósfera de seguridad y confianza del hogar y estar en el ambiente desconocido del hospital. La medicación preanestésica logra la reducción de la ansiedad y disminuye su respuesta. En el presente trabajo se utilizó con este fin el midazolam al 0,5 % (dormicum en dosis de 0,2 a 0,3 mg por kg de peso corporal administrado por vía intranasal, con la finalidad de observar las ventajas de este método en 30 niños menores de 5 años de edad. Se logró una sedación rápida y de corta duración y no se observó ninguna complicación.

Propofol and midazolam inhibit conscious memory processes very soon after encoding: an event-related potential study of familiarity and recollection in volunteers.

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Veselis, Robert A; Pryor, Kane O; Reinsel, Ruth A; Li, Yuelin; Mehta, Meghana; Johnson, Ray

2009-02-01

Intravenous drugs active via gamma-aminobutyric acid receptors to produce memory impairment during conscious sedation. Memory function was assessed using event-related potentials (ERPs) while drug was present. The continuous recognition task measured recognition of photographs from working (6 s) and long-term (27 s) memory while ERPs were recorded from Cz (familiarity recognition) and Pz electrodes (recollection recognition). Volunteer participants received sequential doses of one of placebo (n = 11), 0.45 and 0.9 microg/ml propofol (n = 10), 20 and 40 ng/ml midazolam (n = 12), 1.5 and 3 microg/ml thiopental (n = 11), or 0.25 and 0.4 ng/ml dexmedetomidine (n = 11). End-of-day yes/no recognition 225 min after the end of drug infusion tested memory retention of pictures encoded on the continuous recognition tasks. Active drugs increased reaction times and impaired memory on the continuous recognition task equally, except for a greater effect of midazolam (P memory for familiarity (P = 0.03) and possibly for recollection processes (P = 0.12). Propofol shifted ERP amplitudes to smaller voltages (P memory but not working memory. ERP measures of memory revealed different pathways to end-of-day memory loss as early as 27 s after encoding.

Single photon counting fluorescence lifetime detection of pericellular oxygen concentrations.

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Hosny, Neveen A; Lee, David A; Knight, Martin M

2012-01-01

Fluorescence lifetime imaging microscopy offers a non-invasive method for quantifying local oxygen concentrations. However, existing methods are either invasive, require custom-made systems, or show limited spatial resolution. Therefore, these methods are unsuitable for investigation of pericellular oxygen concentrations. This study describes an adaptation of commercially available equipment which has been optimized for quantitative extracellular oxygen detection with high lifetime accuracy and spatial resolution while avoiding systematic photon pile-up. The oxygen sensitive fluorescent dye, tris(2,2'-bipyridyl)ruthenium(II) chloride hexahydrate [Ru(bipy)(3)](2+), was excited using a two-photon excitation laser. Lifetime was measured using a Becker & Hickl time-correlated single photon counting, which will be referred to as a TCSPC card. [Ru(bipy)(3)](2+) characterization studies quantified the influences of temperature, pH, cellular culture media and oxygen on the fluorescence lifetime measurements. This provided a precisely calibrated and accurate system for quantification of pericellular oxygen concentration based on measured lifetimes. Using this technique, quantification of oxygen concentrations around isolated viable chondrocytes, seeded in three-dimensional agarose gel, revealed a subpopulation of cells that exhibited significant spatial oxygen gradients such that oxygen concentration reduced with increasing proximity to the cell. This technique provides a powerful tool for quantifying spatial oxygen gradients within three-dimensional cellular models.

Efficient electronic entanglement concentration assisted by single mobile electrons

International Nuclear Information System (INIS)

Sheng Yu-Bo; Zhou Lan

2013-01-01

We present an efficient entanglement concentration protocol (ECP) for mobile electrons with charge detection. This protocol is quite different from other ECPs for one can obtain a maximally entangled pair from a pair of less-entangled state and a single mobile electron with a certain probability. With the help of charge detection, it can be repeated to reach a higher success probability. It also does not need to know the coefficient of the original less-entangled states. All these advantages may make this protocol useful in current distributed quantum information processing

Induction of anaesthesia with remifentanil after bolus midazolam administration in Landrace/Large White swine

DEFF Research Database (Denmark)

Zacharioudaki, Argyro; Lelovas, Pavlos; Sergentanis, Theodoros N.

2017-01-01

relaxation, resistance to the laryngoscope, vocal cord position, vocal cord movement and response to intubation. The time required to intubate and necessity for an additional midazolam dose were recorded. Baseline and post-intubation variables were compared with paired t tests, whereas for differences......Objective To investigate an alternative combination for anaesthesia induction in swine. Study design Randomized, ‘blinded’ experimental study. Animals Forty-five Landrace/Large White swine weighing 20.0 ± 1.5 kg. Methods Pulse oximetry, heart rate (HR) and blood pressure were measured after...... = 0.008 and p = 0.032, respectively) between baseline and post-intubation phase; in groups R3 and R4, there were decreases in systolic blood pressure (p = 0.040 and p = 0.019, respectively). In the multivariate analysis, remifentanil dose was not associated with the observed changes in haemodynamic...

Study of carrier concentration in single InP nanowires by luminescence and Hall measurements

International Nuclear Information System (INIS)

Lindgren, David; Hultin, Olof; Heurlin, Magnus; Storm, Kristian; Borgström, Magnus T; Samuelson, Lars; Gustafsson, Anders

2015-01-01

The free electron carrier concentrations in single InP core–shell nanowires are determined by micro-photoluminescence, cathodoluminescence (CL) and Hall effect measurements. The results from luminescence measurements were obtained by solving the Fermi–Dirac integral, as well as by analyzing the peak full width at half maximum (FWHM). Furthermore, the platform used for Hall effect measurements, combined with spot mode CL spectroscopy, is used to determine the carrier concentrations at specific positions along single nanowires. The results obtained via luminescence measurements provide an accurate and rapid feedback technique for the epitaxial development of doping incorporation in nanowires. The technique has been employed on several series of samples in which growth parameters, such as V/III-ratio, temperature and dopant flows, were investigated in an optimization procedure. The correlation between the Hall effect and luminescence measurements for extracting the carrier concentration of different samples were in excellent agreement. (paper)

Efficacy of antidotes (midazolam, atropine and HI-6) on nerve agent induced molecular and neuropathological changes.

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RamaRao, Golime; Afley, Prachiti; Acharya, Jyothiranjan; Bhattacharya, Bijoy Krishna

2014-04-04

Recent alleged attacks with nerve agent sarin on civilians in Syria indicate their potential threat to both civilian and military population. Acute nerve agent exposure can cause rapid death or leads to multiple and long term neurological effects. The biochemical changes that occur following nerve agent exposure needs to be elucidated to understand the mechanisms behind their long term neurological effects and to design better therapeutic drugs to block their multiple neurotoxic effects. In the present study, we intend to study the efficacy of antidotes comprising of HI-6 (1-[[[4-(aminocarbonyl)-pyridinio]-methoxy]-methyl]-2-[(hydroxyimino) methyl] pyridinium dichloride), atropine and midazolam on soman induced neurodegeneration and the expression of c-Fos, Calpain, and Bax levels in discrete rat brain areas. Therapeutic regime consisting of HI-6 (50 mg/kg, i.m), atropine (10 mg/kg, i.m) and midazolam (5 mg/kg, i.m) protected animals against soman (2×LD50, s.c) lethality completely at 2 h and 80% at 24 h. HI-6 treatment reactivated soman inhibited plasma and RBC cholinesterase up to 40%. Fluoro-Jade B (FJ-B) staining of neurodegenerative neurons showed that soman induced significant necrotic neuronal cell death, which was reduced by this antidotal treatment. Soman increased the expression of neuronal proteins including c-Fos, Bax and Calpain levels in the hippocampus, cerebral cortex and cerebellum regions of the brain. This therapeutic regime also reduced the soman induced Bax, Calpain expression levels to near control levels in the different brain regions studied, except a mild induction of c-Fos expression in the hippocampus. Rats that received antidotal treatment after soman exposure were protected from mortality and showed reduction in the soman induced expression of c-Fos, Bax and Calpain and necrosis. Results highlight the need for timely administration of better antidotes than standard therapy in order to prevent the molecular and biochemical changes and

INTUBATIONS CONDITIONS AND HOMODYNAMIC RESPONSES UNDER ANESTHESIA INDUCTION WITH THREE COMBINATION DRUGS: ALFENTANIL- MIDAZOLAM, ALFENTANIL- THIOPENTAL AND ALFENTANIL- KETAMINE

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H SOLTANI NEZHAD

2000-03-01

Full Text Available Background. Administration of alfentanil followed by propofol intravenously (IV without neuromuscular blockage for induction of anesthesia provides adaquate conditions for tracheal intubation. Other hypnotic drugs have not been thoroughly investigated in this regard. The aim of the present study was comparison of intubation conditions and hemodynamic responses of anesthesia induction with alfentanil/midazolam, alfentanil/Na thiopental and alfentanil/ ketamine. Methods. In a clinical trial study one hundred and twenty children were randomly allocated to four groups. Medication in these groups were alfentanil 40 µg/kg+ midazolam 200 µg/kg,alfentanil 40 µg/kg+Na thiopental 6 µg/kg, alfentanil 40 µg/kg+ketamin 2 mg/kg & Na thipental 6 mg/kg+suxamethonium 2 mg/kg (as control group. In all patients the ease of ventilation via face mask, jaw mobility, degree of exposure and position of vocal cords, patient's response to tracheal intubation, duration of time was needed for intubation and hemodynamic changes after intubation were assessed and recorded. Findings. There are significant differences between first three groups (interventional groups for jaw mebility, ventilation, vocal cord visuality, vocal cord position, patient movement during laryngoscopy and mean laryngoscopy time, (P < 0.05. There is significant difference between all groups of nesdonal+alfentanil except for patient movement. There is significant difference between mean SBP and PR before and after intubation in first and third group. Conclusion. Results represent that the group of Alfentanil plus Nesdonal had a better quality of ventilation rather than two other groups. It is recommended that administration of alfentanil plus thiopental combination is preferred in cases that using muscle relaxant is contraindicated.

Comparison of the Effects of Oral Midazolam, Ketamine and Tramadol on Postoperative Agitation Related to Sevoflurane in Children

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Rahşan Karayazılı

2010-12-01

Full Text Available Aim: The aim of our study was to investigate the effects of oral midazolam, ketamine and tramadol, which have been administered as premedication in pediatric patients, on sedation quality, postoperative agitation and pain. Methods: Sixty pediatric patients (aged 2-12 years with American Society of Anesthesiology (ASA classifications I and II were included in the study. Group M was administered 0.5 mg kg-1 midazolam, Group K 6 mg kg-1 ketamine and Group T 2 mg kg-1 tramadol orally. The mean arterial blood pressure (MAP, heart rates (HR, Ramsey sedation scores (Rss and sedation agitation scores (Sas were recorded before and at 10 and 30 min after drug administration, before induction and 5,10, 15, 30, 45, 60, and 90 minutes after operation in all patients. Anesthesia induction was performed with lidocaine, propofol and rocuronium. Maintenance of anaesthesia was provided with sevoflurane, N2O and O2. Recovery times, Alderete scores and facial pain scores (FPS were recorded. Results: There were no differences between the groups according to demographic data. HR was significantly lower in Group T. Group M was determined to be more agitated 30 and 45 min after the operation. Also, Alderete scores were lower in Goup K. The FPS scores of Group T were lower (p<0.05. There was no statistically significant difference between the groups according to frequency of postoperative agitation and delirium. Conclusion: Although ketamine may reduce the postoperative sedation-agitation scores, it also may reduce the recovery scores in pediatric patients. Tramadol does not provide adequate sedation in premedication, but it reduces postoperative pain scores. However, the frequency of postoperative agitation-delirium is not different among these three agents. (The Medical Bulletin of Haseki 2010; 48: 146-52

In vitro investigation on the impact of the surface-active excipients Cremophor EL, Tween 80 and Solutol HS 15 on the metabolism of midazolam.

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Bravo González, Roberto C; Huwyler, Jörg; Boess, Franziska; Walter, Isabelle; Bittner, Beate

2004-01-01

The impact of the surface-active formulation ingredients Cremophor EL, Tween 80 and Solutol HS 15 on the intrinsic clearance (Clint) of midazolam (MDZ) was investigated in rat hepatocytes and microsomes. In rat hepatocytes with 0.003%, 0.03% and 0.3% (w/v) Solutol HS 15 already present in the incubation medium, the Clint was significantly reduced in a dose-dependent manner by about 25%, 30% and 50%, respectively. In the presence of Cremophor EL and Tween 80 a significant reduction in Clint by about 30% and 25%, respectively, was observed at 0.03% surfactant concentration. At 0.3% of Cremophor EL and Tween 80, Clint was reduced by about 50% and 20%, respectively. A reduction in Clint was also observed in experiments with rat liver microsomes. At surfactant concentrations up to 0.03%, cytotoxicity assays (lactate dehydrogenase release, adenosine triphosphate content) as well as light microscope investigations did not reveal any cytotoxic impact of the surfactants on the hepatocyte monolayer. A potential interaction of the surfactants with biological membranes was determined using phosphatidylcholine-cholesterol liposomes loaded with self-quenching concentrations of carboxyfluorescein. No marked release of carboxyfluorescein from the liposomes (that would be an indication for a surfactant-dependent disruption of membrane integrity) was observed up to concentrations of 0.03% of the different surfactants. It is concluded that cytochrome P450 3A mediated metabolism of MDZ seems to be prevented by all surfactants at concentrations above 0.03%. In our experiments the surfactants did not show toxic effects at concentrations that resulted in a decreased Clint of MDZ. Thus, a direct inhibition of the metabolizing enzymes, a molecular interaction with the microsomes as well as an alteration of membrane properties that did not yet result in a release of LDH have to be taken into consideration as reasons for the observed changes in the metabolism of MDZ. Copyright 2004 John

Evaluation of a butorphanol, detomidine, and midazolam combination for immobilization of captive Nile lechwe antelopes (Kobus magaceros).

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Laricchiuta, Pietro; De Monte, Valentina; Campolo, Marco; Grano, Fabio; Iarussi, Fabrizio; Crovace, Antonio; Staffieri, Francesco

2012-07-01

Field immobilization of captive antelope may be required for medical examination, blood sample collection, and animal identification. The aim of this study was to evaluate the effects of a combination of butorphanol, detomidine, and midazolam (BDM) and its partial reversibility in Nile lechwe antelope (Kobus megaceros). Nine captive lechwes, weighing 28-64 kg, were immobilized, in February 2011, with butorphanol 0.20 ± 0.05 (mean ± SD) mg/kg, detomidine 0.20 ± 0.05 mg/kg, and midazolam 0.31 ± 0.08 mg/kg administered intramuscularly (IM) with a blowpipe. Physiologic parameters and depth of anesthesia were recorded when the animals became recumbent at 19.55 ± 8.36 min after darting (T0) and after 10 (T10), 20 (T20), and 30 (T30) min. An arterial blood sample was collected at T20. At the end of the procedures, immobilization was partially reversed with atipamezole 0.25 mg/kg IM. Quality of induction, immobilization, and recovery was scored. The BDM combination induced immobilization and lateral recumbency in 13.44 ± 5.61 min. Median induction score (scored 1 [excellent] to 4 [poor]) was 1 (range 1-2). Heart rate varied 40-104 beats/min, respiratory rate 16-108 breaths/min, and rectal temperature 36.5-40.3 C. Hyperthermia was observed and rapidly treated in three animals that demonstrated insufficient immobilization after darting. Arterial blood gas analyses revealed a mean pH of 7.43 ± 0.07, partial arterial pressure of CO(2) of 44.1 ± 6.0 mmHg, partial arterial pressure of O(2) of 74.0 ± 13.5 mmHg, and an arterial O(2) saturation of 94.77 ± 3.96%. Recovery was smooth and animals were walking in 13.44 ± 7.85 min. Median recovery score (1 = excellent to 4 = poor) was 1 (range 1-2). The BDM was effective in immobilizing captive healthy lechwes with minimal cardiorespiratory changes.

A numerical analysis on forming limits during spiral and concentric single point incremental forming

Science.gov (United States)

Gipiela, M. L.; Amauri, V.; Nikhare, C.; Marcondes, P. V. P.

2017-01-01

Sheet metal forming is one of the major manufacturing industries, which are building numerous parts for aerospace, automotive and medical industry. Due to the high demand in vehicle industry and environmental regulations on less fuel consumption on other hand, researchers are innovating new methods to build these parts with energy efficient sheet metal forming process instead of conventionally used punch and die to form the parts to achieve the lightweight parts. One of the most recognized manufacturing process in this category is Single Point Incremental Forming (SPIF). SPIF is the die-less sheet metal forming process in which the single point tool incrementally forces any single point of sheet metal at any process time to plastic deformation zone. In the present work, finite element method (FEM) is applied to analyze the forming limits of high strength low alloy steel formed by single point incremental forming (SPIF) by spiral and concentric tool path. SPIF numerical simulations were model with 24 and 29 mm cup depth, and the results were compare with Nakajima results obtained by experiments and FEM. It was found that the cup formed with Nakajima tool failed at 24 mm while cups formed by SPIF surpassed the limit for both depths with both profiles. It was also notice that the strain achieved in concentric profile are lower than that in spiral profile.

The safety and efficacy of intranasal midazolam sedation combined with inhalation sedation with nitrous oxide and oxygen in paediatric dental patients as an alternative to general anaesthesia.

Science.gov (United States)

Wood, Michael

2010-01-01

Conscious Decision' was published in 2000 by the Department of Health, effectively ending the provision of dental general anaesthesia (DGA) outside the hospital environment. Other aspects of dental anxiety and behavioural management and sedation techniques were encouraged before the decision to refer for a DGA was reached. Although some anxious children may be managed with relative analgesia (RA), some may require different sedation techniques for dentists to accomplish dental treatment. Little evidence has been published in the UK to support the use of alternative sedation techniques in children. This paper presents another option using an alternative conscious sedation technique. to determine whether a combination of intranasal midazolam (IN) and inhalation sedation with nitrous oxide and oxygen is a safe and practical alternative to DGA. A prospective clinical audit of 100 cases was carried out on children referred to a centre for DGA. 100 children between 3 and 13 years of age who were referred for DGA were treated using this technique. Sedation was performed by intranasal midazolam followed by titrating a mixture of nitrous oxide and oxygen. A range of dental procedures was carried out while the children were sedated. Parents were present during the dental treatment. Data related to the patient, dentistry and treatment as well as sedation variables were collected at the treatment visit and a telephonic post-operative assessment from the parents was completed a week later. It was found that 96% of the required dental treatment was completed successfully using this technique, with parents finding this technique acceptable in 93% of cases. 50% of children found the intranasal administration of the midazolam acceptable. There was no clinically relevant oxygen desaturation during the procedure. Patients were haemodynamically stable and verbal contact was maintained throughout the procedure. In selected cases this technique provides a safe and effective alternative

Single Enteral Loading Dose of Phenobarbital for Achieving Its Therapeutic Serum Levels in Neonates

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Turhan, Ali H.; Atici, Aytug; Okuyaz, Cetin; Uysal, Sercan

2010-01-01

Aim To investigate whether therapeutic serum drug levels may be achieved with a single enteral loading dose of phenobarbital. Methods The study was performed at the Mersin University Hospital in Turkey between April 2004 and August 2006, and included 29 newborn babies with seizure. After the acute treatment of the seizure with midazolam at a dose of 0.1 mg/kg, phenobarbital was administered by orogastric route at a loading dose of 20 mg/kg. Serum phenobarbital concentrations were measured at 0.5, 3, 6, and 12 hours after the loading. Serum phenobarbital levels between 10-30 μg/mL were considered as the therapeutic range. Results The serum phenobarbital levels reached therapeutic values in 9 (31%), 19 (66%), 21 (72%), and 23 (79%) patients at 0.5, 3, 6, and 12 hours after loading, respectively, while they did not reach therapeutic values in 6 patients (21%) after 12 hours. Four of the patients in whom there was no increase in serum phenobarbital levels had hypoxic-ischemic encephalopathy. Conclusion Enteral loading of phenobarbital can achieve therapeutic serum levels in the large majority of newborn babies with seizure and may be safely used in babies with the intact gastrointestinal tract. PMID:20564764

A comparison of the effect of two doses of oral melatonin with oral midazolam and placebo on pre-operative anxiety, cognition and psychomotor function in children: A randomised double-blind study

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Madhuri S Kurdi

2016-01-01

Full Text Available Background and Aims: Melatonin (MT, a naturally occurring pituitary hormone has a sleep promoting effect. There are very few studies on pre-operative oral MT (0.2-0.5 mg/kg in children. We planned a study to assess the efficacy of oral MT in two doses and compare it with oral midazolam and placebo for pre-operative anxiolysis, sedation, maintenance of cognition and psychomotor skills, parental separation behaviour and venepuncture compliance. Methods: This prospective double-blind randomised study was conducted after ethical committee approval on 100 children aged 5-15 years, American Society of Anaesthesiologists physical status I and II undergoing elective surgery at our hospital from January 1, 2014, to December 31, 2014. Mentally disordered children were excluded from the study. They were randomised into four groups of 25 each (A, B, C, D to receive either oral MT 0.5 mg/kg or 0.75 mg/kg or oral midazolam 0.5 mg/kg or placebo 45-60 min, respectively, before induction. The child′s anxiety, cognition and psychomotor function before and after pre-medication, behaviour during the parental separation and venepuncture were appropriately scored. Kruskal-Wallis analysis of variance for intergroup and Wilcoxon matched pairs tests for intragroup comparisons of data were applied. Results: The four groups were comparable regarding mean age, weight and sex. The anxiety score reductions in the three groups when compared to placebo were statistically significant. Children receiving MT 0.75 mg/kg had maximum anxiolysis and venepuncture compliance (P < 0.05. Cognition was decreased with maximum sedation, successful parental separation and psychomotor impairment in the midazolam group (P < 0.05. Conclusion: Oral MT (0.5 mg/kg and 0.75 mg/kg in children decreases pre-operative anxiety without impairing cognitive and psychomotor functions, the 0.75 mg/kg dose being most effective.

Distributions and concentrations of thallium in Korean soils determined by single and sequential extraction procedures.

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Lee, Jin-Ho; Kim, Dong-Jin; Ahn, Byung-Koo

2015-06-01

The objectives of this study were to investigate the distribution of thallium in soils collected near suspected areas such as cement plants, active and closed mines, and smelters and to examine the extraction of thallium in the soils using 19 single chemical and sequential chemical extraction procedures. Thallium concentrations in soils near cement plants were distributed between 1.20 and 12.91 mg kg(-1). However, soils near mines and smelters contained relatively low thallium concentrations ranging from 0.18 to 1.09 mg kg(-1). Thallium extractability with 19 single chemical extractants from selected soils near cement plants ranged from 0.10% to 8.20% of the total thallium concentration. In particular, 1.0 M NH4Cl, 1.0 M (NH4)2SO4, and 1.0 M CH3COONH4 extracted more thallium than other extractants. Sequential fractionation results of thallium from different soils such as industrially and artificially contaminated soils varied with the soil properties, especially soil pH and the duration of thallium contamination.

Activity concentrations of 137Cs in meat of broiler chicken after single and continuous application

International Nuclear Information System (INIS)

Poeschl, M.; Balas, J.

1998-01-01

Previously we examined the transfer, distribution and half-live of radiocaesium in broiler chicken after the application of artificially contaminated feed mixture or wheat wheat contaminated from the Chernobyl accident. Our results pointed to a different dynamics of radiocaesium in breast meat compared to leg meat in the chicken after short-time application (3 oral applications in 1 day). The aim of the present study was to find if the results are similar also after single and repeated (long-time) applications of an artificially contaminated feed mixture. Two experiments were carried out with broiler chickens (White Leghorn hybrid, race ISA VEDETTE). In experiment 1, one artificially contaminated oral dose of 5160 Bq of 137 Cs (activity concentration 1664 Bq/g) was administered to 18-day-old chickens. In experiment 2, artificially contaminated oral doses of 500 Bq of 137 Cs (activity concentration 161.3 Bq/g) were administered to 14-day-old chickens twice a day (at 8:00 and 20:00 h.) for 10 days. In either experiment, four chickens were slaughtered for activity determination in meat (breast and leg muscles) 6, 12, 24, 48 and 96 hours and 2, 4, 8, 10 days, respectively, after the first application of 137 Cs. The uptake of the single oral 137 Cs was rapid and the maximum 137 Cs activity concentrations were found in breast meat (0.783 Bq/g) 24 hours and in leg meat (1.005 Bq/g) 6 hours after 137 Cs application. From the 24th hour of the experiment, radiocaesium activity concentrations in breast and leg meat decreased with the biological half-life (T 1/2b ) of 84 and 66 hours, respectively. During a 10-day application of continuous doses of 137 Cs, the Cs activity concentrations increased and were 3.988 Bq/g in breast meat and 5.610 Bq/g in leg meat on day 2, and 7.427 Bq/g and 7.698 Bq/g, respectively, on day 10. Immediately after the administration of radiocaesium was stopped, the 137 Cs activity concentrations decreased rapidly with T 1/2b = 4.5 and 3.8 days in

A pré-medicação com midazolam antes de secção cesariana não tem efeitos adversos no neonato

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Senel, Ahmet Can; Mergan, Fatih

2014-01-01

Como todos os pacientes cirúrgicos, pacientes obstétricas também sentem estresse e ansieda de operatórios. Isso pode ser prevenido se forem passadas à paciente informações detalhadas sobre sua operação e se forem administrados medicamentos farmacológicos pré-operatórios. Devido aos efeitos depressivos dos sedativos nos neonatos, os medicamentos farmacológicos são omitidos, especialmente em pacientes obstétricas. A literatura contém poucos estudos concernentes ao uso de midazolam no pré-operat...

Changes in the biogenic amine content of the prefrontal cortex, amygdala, dorsal hippocampus, and nucleus accumbens of rats submitted to single and repeated sessions of the elevated plus-maze test

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Carvalho M.C.

2005-01-01

Full Text Available It has been demonstrated that exposure to a variety of stressful experiences enhances fearful reactions when behavior is tested in current animal models of anxiety. Until now, no study has examined the neurochemical changes during the test and retest sessions of rats submitted to the elevated plus maze (EPM. The present study uses a new approach (HPLC by looking at the changes in dopamine and serotonin levels in the prefrontal cortex, amygdala, dorsal hippocampus, and nucleus accumbens in animals upon single or double exposure to the EPM (one-trial tolerance. The study involved two experiments: i saline or midazolam (0.5 mg/kg before the first trial, and ii saline or midazolam before the second trial. For the biochemical analysis a control group injected with saline and not tested in the EPM was included. Stressful stimuli in the EPM were able to elicit one-trial tolerance to midazolam on re-exposure (61.01%. Significant decreases in serotonin contents occurred in the prefrontal cortex (38.74%, amygdala (78.96%, dorsal hippocampus (70.33%, and nucleus accumbens (73.58% of the animals tested in the EPM (P < 0.05 in all cases in relation to controls not exposed to the EPM. A significant decrease in dopamine content was also observed in the amygdala (54.74%, P < 0.05. These changes were maintained across trials. There was no change in the turnover rates of these monoamines. We suggest that exposure to the EPM causes reduced monoaminergic neurotransmission activity in limbic structures, which appears to underlie the "one-trial tolerance" phenomenon.

Repeated anaesthesia with isoflurane and medetomidine-midazolam-fentanyl in guinea pigs and its influence on physiological parameters.

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Sabrina Schmitz

Full Text Available Repeated anaesthesia may be required in experimental protocols and in daily veterinary practice, but anaesthesia is known to alter physiological parameters in GPs (Cavia porcellus, GPs. This study investigated the effects of repeated anaesthesia with either medetomidine-midazolam-fentanyl (MMF or isoflurane (Iso on physiological parameters in the GP. Twelve GPs were repeatedly administered with MMF or Iso in two anaesthesia sets. One set consisted of six 40-min anaesthesias, performed over 3 weeks (2 per week; the anaesthetic used first was randomized. Prior to Iso anaesthesia, atropine was injected. MMF anaesthesia was antagonized with AFN (atipamezole-flumazenil-naloxone. Abdominally implanted radio-telemetry devices recorded the mean arterial blood pressure (MAP, heart rate (HR and core body temperature continuously. Additionally, respiratory rate, blood glucose and body weight were assessed. An operable state could be achieved and maintained for 40 min in all GPs. During the surgical tolerance with MMF, the GPs showed a large MAP range between the individuals. In the MMF wake- up phase, the time was shortened until the righting reflex (RR returned and that occurred at lower MAP and HR values. Repeated Iso anaesthesia led to an increasing HR during induction (anaesthesias 2-6, non-surgical tolerance (anaesthesias 3-6 and surgical tolerance (anaesthesias 4, 6. Both anaesthetics may be used repeatedly, as repeating the anaesthesias resulted in only slightly different physiological parameters, compared to those seen with single anaesthesias. The regular atropine premedication induced HR increases and repeated MMF anaesthesia resulted in a metabolism increase which led to the faster return of RR. Nevertheless, Iso's anaesthesia effects of strong respiratory depression and severe hypotension remained. Based on this increased anaesthesia risk with Iso, MMF anaesthesia is preferable for repeated use in GPs.

Degradation of benzodiazepines after 120 days of EMS deployment.

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McMullan, Jason T; Jones, Elizabeth; Barnhart, Bruce; Denninghoff, Kurt; Spaite, Daniel; Zaleski, Erin; Silbergleit, Robert

2014-01-01

EMS treatment of status epilepticus improves outcomes, but the benzodiazepine best suited for EMS use is unclear, given potential high environmental temperature exposures. To describe the degradation of diazepam, lorazepam, and midazolam as a function of temperature exposure and time over 120 days of storage on active EMS units. Study boxes containing vials of diazepam, lorazepam, and midazolam were distributed to 4 active EMS units in each of 2 EMS systems in the southwestern United States during May-August 2011. The boxes logged temperature every minute and were stored in EMS units per local agency policy. Two vials of each drug were removed from each box at 30-day intervals and underwent high-performance liquid chromatography to determine drug concentration. Concentration was analyzed as mean (and 95%CI) percent of initial labeled concentration as a function of time and mean kinetic temperature (MKT). 192 samples were collected (2 samples of each drug from each of 4 units per city at 4 time-points). After 120 days, the mean relative concentration (95%CI) of diazepam was 97.0% (95.7-98.2%) and of midazolam was 99.0% (97.7-100.2%). Lorazepam experienced modest degradation by 60 days (95.6% [91.6-99.5%]) and substantial degradation at 90 days (90.3% [85.2-95.4%]) and 120 days (86.5% [80.7-92.3%]). Mean MKT was 31.6°C (95%CI 27.1-36.1). Increasing MKT was associated with greater degradation of lorazepam, but not midazolam or diazepam. Midazolam and diazepam experienced minimal degradation throughout 120 days of EMS deployment in high-heat environments. Lorazepam experienced significant degradation over 120 days and appeared especially sensitive to higher MKT exposure.

Cowpea viruses: Effect of single and mixed infections on symptomatology and virus concentration

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Nsa Imade Y

2007-09-01

Full Text Available Abstract Natural multiple viral infections of cultivated cowpeas have been reported in Nigeria. In this study, three Nigerian commercial cowpea cultivars ("Olo 11", "Oloyin" and "White" and two lines from the IITA (IT86D- 719 and TVU 76 were mechanically inoculated with Cowpea aphid-borne mosaic virus (CABMV, Bean southern mosaic virus (SBMV and Cowpea mottle virus (CMeV singly, as well as in all possible combinations at 10, 20 and 30 days after planting (DAP. Samples of leaves or stems were collected at 10, 20 and 30 days after inoculation (DAI and analyzed for relative virus concentration by Enzyme-Linked Immunosrbent Assay. All the cultivars and lines {CVS/L} were susceptible to the viruses but the commercial CVS showed more severe symptoms and had relatively higher viral concentration. In single virus infections, CABMV which induced the most severe symptoms had absorbance values (at 405 nm of 0.11 to 0.46 while SBMV and CMeV which induced moderate symptoms had virus titre of 0.74 to 1.99 and 0.11 to 0.90 respectively. Plants inoculated 10 DAP had significantly higher virus concentration than those inoculated 30 DAP. In mixed infections involving CABMV (10 DAP apical necrosis and death were observed in commercial cultivars "Olo 11" and "White". Enhancement of CMeV titers were observed in plants infected with CMeV + CABMV. Multiple viral infections of cowpeas may result in complete yield loss, hence, the availability of seeds of cultivars with a high level of multiple virus resistance is recommended as a means of control.

Eficacia del midazolam contra la ansiedad en niños de 1-3 años sometidos a cirugía

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Rosaevelyn Oriolo Estrada

2014-06-01

Full Text Available Introducción: cualquier acto quirúrgico crea ansiedad, sobre todo en niños, a lo que se añade la ansiedad parental por separación a la entrada al salón de operaciones. Objetivo: demostrar la eficacia del midazolam jarabe para controlar la ansiedad en niños de 1-3 años que fueron sometidos a cirugía que requería anestesia general en el Hospital Provincial Pediátrico Docente "Pepe Portilla" de Pinar del Río, en el período 2008-2009. Material y método: se realizó estudio de cohorte, longitudinal y prospectivo de casos y controles en niños. Treinta recibieron dosis de 0.5 mg/kg de peso, y 60 controles que no lo recibieron, previo consentimiento informado de los padres. Se midió tiempo de sedación, signos vitales, reacciones adversas y grado de satisfacción de padres y personal del salón de operaciones. Se calcularon frecuencias que fueron comparadas mediante X². Resultados: la muestra resultó homogénea por sexo, edades y el tipo de cirugía a realizarse (p> 0,05. La sedación se obtuvo desde los 10 minutos en (24 niños/30. La bradipnea fue el único efecto adverso observado en 7 niños. Los controles (100% taquipneicos y llorosos. El 76.7 % de los padres y el 100% del personal estuvo satisfecho con los efecto sedativos del midazolam. Conclusiones: es la primera vez que se usa esta droga como premedicación anestésica en niños 1-3 años, y se demuestra la eficacia y efectiva, con escasas reacciones adversas y gran aceptabilidad y satisfacción por padres y personal de salud.

Comparison of alfaxalone, ketamine and thiopental for anaesthetic induction and recovery in Thoroughbred horses premedicated with medetomidine and midazolam.

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Wakuno, A; Aoki, M; Kushiro, A; Mae, N; Kodaira, K; Maeda, T; Yamazaki, Y; Ohta, M

2017-01-01

There is limited information on clinical use of the new injectable anaesthetic agent alfaxalone in Thoroughbred horses. To compare anaesthetic induction and recovery characteristics and cardiopulmonary responses between alfaxalone, ketamine and thiopental in Thoroughbred horses premedicated with medetomidine and midazolam. Randomised blinded experimental cross-over study. Six Thoroughbred horses were anaesthetised 3 times with alfaxalone 1 mg/kg bwt, ketamine 2.5 mg/kg bwt or thiopental 4 mg/kg bwt after premedication with medetomidine 6 μg/kg bwt and midazolam 20 μg/kg bwt. Qualities of anaesthetic induction and recovery were scored on a scale of 1 (poor) to 5 (excellent). Induction time and recovery time were recorded. Cardiopulmonary values (heart rate, respiratory rate, arterial blood pressures, and arterial blood gases) were recorded throughout anaesthesia. Data were analysed with nonparametric methods. The anaesthetic induction (P = 0.2) and recovery (P = 0.1) quality scores (median, range) were not different amongst protocols and were 4.0, 3-5; 5.0, 4-5; 4.5, 3-5; and 4.5, 3-5; 3.5, 2-5; 4.0, 2-5 for alfaxalone, ketamine and thiopental, respectively. Induction time for ketamine (67, 53-89 s) was significantly longer than that for alfaxalone (49, 40-51 s, P = 0.01) and thiopental (48, 43-50 s, P = 0.01). Time to standing for alfaxalone (44, 40-63 min, P = 0.01) and thiopental (39, 30-58 min, P = 0.01) was significantly longer than that for ketamine (25, 18-26 min). Cardiovascular values were maintained within the clinically acceptable level throughout anaesthesia. Respiratory rate significantly decreased during anaesthesia for all 3 drugs; however, spontaneous breathing did not disappear, and PaCO 2 values were maintained at approximately 50 mmHg. All 3 drugs showed similar effects in relation to anaesthetic induction and recovery qualities and cardiopulmonary responses. However, alfaxalone and thiopental prolonged recovery time

Effectiveness of preoperative intranasal dexmedetomidine, compared with oral midazolam, for the prevention of emergence delirium in the pediatric patient undergoing general anesthesia: a systematic review.

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FitzSimons, James; Bonanno, Laura S; Pierce, Stephanie; Badeaux, Jennifer

2017-07-01

Emergence delirium is defined as a cognitive disturbance during emergence from general anesthesia resulting in hallucinations, delusions and confusion manifested by agitation, restlessness, involuntary physical movement and extreme flailing in bed. Postoperative emergence delirium develops in 12% to 18% of all children undergoing general anesthesia for surgery. This post-anesthetic phenomenon changes cognitive and psychomotor behavior, and puts pediatric patients and health care personnel at risk of injury. A newer drug, dexmedetomidine, is a selective alpha-2 agonist, which works in the brain and spinal cord that has sedative, analgesic and anxiolytic properties. Dexmedetomidine also has the ability to lower the overall anesthetic requirements by reducing sympathetic outflow in response to painful surgical stimulation. In current literature, there is not a systematic review that compares the effectiveness of preoperative intranasal dexmedetomidine administration against oral midazolam for the prevention of emergence delirium. The objective of this review was to identify the effectiveness of preoperative intranasal dexmedetomidine compared to oral midazolam for the prevention of emergence delirium in the pediatric patient undergoing general anesthesia. This review considered studies that included pediatric patients aged three to seven years, with an American Society of Anesthesiologists (ASA) classification of I or II, and undergoing general anesthesia for elective/ambulatory surgery. This review excluded studies that included patients who had special needs including: developmental delay, chronic pain issues, and/or any preexisting mental or physical health disorders which categorized them above an ASA II. This review considered studies that compared preoperative intranasal administration of dexmedetomidine with preoperative oral administration of midazolam for the prevention of emergence delirium. This review considered both experimental and non-experimental study

Fluidized bed combustion of single coal char particles at high CO{sub 2} concentration

Energy Technology Data Exchange (ETDEWEB)

Scala, F.; Chirone, R. [CNR, Naples (Italy)

2010-12-15

Combustion of single coal char particles was studied at 850{sup o}C in a lab-scale fluidized bed at high CO{sub 2} concentration, typical of oxyfiring conditions. The burning rate of the particles was followed as a function of time by continuously measuring the outlet CO and O{sub 2} concentrations. Some preliminary evaluations on the significance of homogeneous CO oxidation in the reactor and of carbon gasification by CO{sub 2} in the char were also carried out. Results showed that the carbon burning rate increases with oxygen concentration and char particle size. The particle temperature is approximately equal to that of the bed up to an oxygen concentration of 2%, but it is considerably higher for larger oxygen concentrations. Both CO{sub 2} gasification of char and homogeneous CO oxidation are not negligible. The gasification reaction rate is slow and it is likely to be controlled by intrinsic kinetics. During purely gasification conditions the extent of carbon loss due to particle attrition by abrasion (estimated from the carbon mass balance) appears to be much more important than under combustion conditions.

Evaluation of butorphanol, medetomidine and midazolam as a reversible narcotic combination in free-ranging African lions (Panthera leo).

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Wenger, Sandra; Buss, Peter; Joubert, Jenny; Steenkamp, Johan; Shikwambana, Purvance; Hatt, Jean-Michel

2010-11-01

To evaluate the effects of the combination butorphanol, medetomidine and midazolam (BMM) and its reversibility in lions. Prospective clinical trial. Thirty free-ranging lions, 10 male and 20 female, weighing 81-210 kg. Lions were immobilised with butorphanol mean 0.31 ± SD 0.034 mg kg(-1), medetomidine 0.052 ± 0.006 mg kg(-1), midazolam 0.21 ± 0.024 mg kg(-1) and hyaluronidase 1250 IU administered intramuscularly with a dart gun. Upon recumbency, physiological parameters and anaesthetic depth were monitored 10-15 minutes after darting (T1) and repeated every 10 minutes for a further 30 minutes (T2, T3, T4). Arterial blood gas analyses were performed at T1 and T4. At the end of the procedure, 45-60 minutes after initial darting, immobilisation was reversed with naltrexone 0.68 ± 0.082 mg kg(-1), atipamezole 0.26 ± 0.031 mg kg(-1), and flumazenil 0.0032 ± 0.0007 mg kg(-1) administered intravenously and subcutaneously. The BMM combination rapidly induced immobilisation and lateral recumbency was reached within 7.25 ± 2.3 minutes. Median induction score [scored 1 (excellent) to 4 (poor)] was 1.4 (range 1-2). Cardio-respiratory parameters were stable. Heart rate varied from 32 to 72 beats per minute, respiratory rate from 14 to 32 breaths minute(-1) and rectal temperature from 36.6 to 40.3 °C. No sudden arousals were observed. Arterial blood gas analyses revealed a mean pH of 7.33, PaCO(2) of 33 mmHg and PaO(2) of 87 mmHg. Mild to moderate hypoxemia was seen in four lions. Recovery was smooth and lions were walking within 4.4 ± 4.25 minutes. Median recovery score [scored 1 (excellent) to 4 (poor)] was 1.3 (range 1-2). The drug combination proved to be effective in immobilising free-ranging healthy lions of both sexes with minimal cardio-respiratory changes. © 2010 The Authors. Veterinary Anaesthesia and Analgesia © 2010 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.

Distribution of Exogenous and Endogenous CYP3A Markers and Related Factors in Healthy Males and Females.

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Lee, Jieon; Kim, Andrew HyoungJin; Yi, SoJeong; Lee, SeungHwan; Yoon, Seo Hyun; Yu, Kyung-Sang; Jang, In-Jin; Cho, Joo-Youn

2017-07-01

Cytochrome P450 (CYP) 3A is an important drug-metabolizing enzyme in humans. Assessing CYP3A activity is necessary for predicting therapeutic outcomes or the potential adverse events of various therapeutics. This study sought to evaluate the distribution of endogenous and exogenous markers reflecting hepatic CYP3A activity and related factors affecting its activity in healthy male and female. Each subject was given a single 1 mg dose of midazolam intravenously. Pharmacokinetics, pharmacometabolomics, and pharmacogenomics analyses were performed to evaluate CYP3A activity. Urinary and plasma steroids were quantified with gas chromatography coupled with triple-quadrupole mass spectrometry (GC-MS), and the concentrations of midazolam and its metabolites were quantified with liquid chromatography coupled with electrospray tandem mass spectrometry (LC-MS/MS). A total of 100 subjects completed this study. Midazolam clearance (MDZ CL) and the metabolic ratio (MDZ MR) were significantly correlated with 6β-OH-cortisol/cortisol and 6β-OH-cortisone/cortisone. MDZ CL, 6β-OH-cortisol/cortisol, and 6β-OH-cortisone/cortisone decreased with increasing age (Pearson r = -0.333, -0.329, and -0.528, respectively; P exogenous and endogenous markers showed decreased CYP3A activity with increasing age, which suggested that age could be a factor that significantly influences CYP3A activity.

Predictive Modelling of Concentration of Dispersed Natural Gas in a Single Room

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Abdulfatai JIMOH

2009-07-01

Full Text Available This paper aimed at developing a mathematical model equation to predict the concentration of natural gas in a single room. The model equation was developed by using theoretical method of predictive modelling. The model equation developed is as given in equation 28. The validity of the developed expression was tested through the simulation of experimental results using computer software called MathCAD Professional. Both experimental and simulated results were found to be in close agreement. The statistical analysis carried out through the correlation coefficients for the results of experiment 1, 2, 3 and 4 were found to be 0.9986, 1.0000, 0.9981 and 0.9999 respectively, which imply reasonable close fittings between the experimental and simulated concentrations of dispersed natural gas within the room. Thus, the model equation developed can be considered a good representation of the phenomena that occurred when there is a leakage or accidental release of such gas within the room.

Single Oral Dose Toxicity Test of Blue Honeysuckle Concentrate in Mice

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Park, Sang-In; Choi, Seung-Hoon; Song, Chang-Hyun; Park, Soo-Jin; Shin, Yong-Kook; Han, Chang-Hyun; Lee, Young Joon; Ku, Sae-Kwang

2015-01-01

The objective of this study was to obtain single oral dose toxicity information for concentrated and lyophilized powder of blue honeysuckle (Lonicera caerulea L., Caprifoliaceae; BHcL) in female and male ICR mice to aid in the process of developing natural origin medicinal ingredients or foods following proximate analysis and phytochemical profile measurement. The proximate analysis revealed that BHcL had an energy value of 3.80 kcal/g and contained 0.93 g/g of carbohydrate, 0.41 g/g of sugar, 0.02 g/g of protein, and 0.20 mg/g of sodium. BHcL did not contain lipids, including saturated lipids, trans fats, or cholesterols. Further, BHcL contained 4.54% of betaine, 210.63 mg/g of total phenols, 159.30 mg/g of total flavonoids, and 133.57 mg/g of total anthocyanins. Following administration of a single oral BHcL treatment, there were no treatment-related mortalities, changes in body weight (bw) or organ weight, clinical signs, necropsy or histopathological findings up to 2,000 mg/kg bw, the limited dosage for rodents of both sexes. We concluded that BHcL is a practically non-toxic material in toxicity potency. PMID:25874034

Iron concentration in breast milk normalised within one week of a single high-dose infusion of iron isomaltoside in randomised controlled trial

DEFF Research Database (Denmark)

Holm, Charlotte; Thomsen, Lars Lykke; Nørgaard, Astrid

2017-01-01

AIM: We compared the iron concentration in breast milk after a single high-dose of intravenous iron isomaltoside or daily oral iron for postpartum haemorrhage. METHODS: In this randomised controlled trial, the women were allocated a single dose of intravenous 1,200mg iron isomaltoside or oral iron...... deviation) iron concentration in breast milk in the intravenous and oral groups were 0.72 ± 0.27 mg/L and 0.40 ± 0.18 mg/L at three days (p birth. CONCLUSION: A single high...

Process design and simulation for optimizing the oxygen concentration in Czochralski-grown single-crystal silicon

International Nuclear Information System (INIS)

Jung, Y. J.; Kim, W. K.; Jung, J. H.

2014-01-01

The highest-concentration impurity in a single-crystal silicon ingot is oxygen, which infiltrates the ingot during growth stage. This oxygen adversely affects the wafer is quality. This study was aimed at finding an optimal design for the Czochralski (Cz) process to enable high-quality and low cost (by reducing power consumption) wafer production by controlling the oxygen concentration in the silicon ingots. In the Cz process, the characteristics of silicon ingots during crystallization are greatly influenced by the design and the configuration of the hot zone, and by crystallization rate. In order to identify process conditions for obtaining an optimal oxygen concentration of 11 - 13 ppma (required for industrial-grade ingots), designed two shield shapes for the hot zone. Furthermore, oxygen concentrations corresponding to these two shapes were compared by evaluating each shape at five different production speeds. In addition, simulations were performed to identify the optimal shield design for industrial applications.

Process design and simulation for optimizing the oxygen concentration in Czochralski-grown single-crystal silicon

Energy Technology Data Exchange (ETDEWEB)

Jung, Y. J.; Kim, W. K.; Jung, J. H. [Yeungnam University, Gyeongsan (Korea, Republic of)

2014-08-15

The highest-concentration impurity in a single-crystal silicon ingot is oxygen, which infiltrates the ingot during growth stage. This oxygen adversely affects the wafer is quality. This study was aimed at finding an optimal design for the Czochralski (Cz) process to enable high-quality and low cost (by reducing power consumption) wafer production by controlling the oxygen concentration in the silicon ingots. In the Cz process, the characteristics of silicon ingots during crystallization are greatly influenced by the design and the configuration of the hot zone, and by crystallization rate. In order to identify process conditions for obtaining an optimal oxygen concentration of 11 - 13 ppma (required for industrial-grade ingots), designed two shield shapes for the hot zone. Furthermore, oxygen concentrations corresponding to these two shapes were compared by evaluating each shape at five different production speeds. In addition, simulations were performed to identify the optimal shield design for industrial applications.

[Concentration of glutathione (GSH), ascorbic acid (vitamin C) and substances reacting with thiobarbituric acid (TBA-rs) in single human brain metastases].

Science.gov (United States)

Dudek, Henryk; Farbiszewski, Ryszard; Rydzewska, Maria; Michno, Tadeusz; Kozłowski, Andrzej

2005-01-01

The aim of the study was to estimate the concentration of glutathione (GSH), ascorbic acid (vitamin C) and thiobarbituric acid (TBA-rs) in single human brain metastases and histologically unchanged nerve tissue. The research was conducted on fragments of neoplasmatic tissue collected from 45 patients undergoing surgery in the Department of Neurosurgery, Medical University of Białystok in years 1996-2002. Concentration of GSH was evaluated using the GSH-400 method, vitamin C using the method of Kyaw and TBA-rs using the method of Salaris and Babs. It has been found that there is a decrease of concentration of GSH and vitamin C and a considerable increase (p TBA-rs in investigated single brain human metastasis in correlation to the concentration of the mentioned above substances in unchanged nerve tissue.

Detection of ultra-low oxygen concentration based on the fluorescence blinking dynamics of single molecules

Science.gov (United States)

Wu, Ruixiang; Chen, Ruiyun; Zhou, Haitao; Qin, Yaqiang; Zhang, Guofeng; Qin, Chengbing; Gao, Yan; Gao, Yajun; Xiao, Liantuan; Jia, Suotang

2018-01-01

We present a sensitive method for detection of ultra-low oxygen concentrations based on the fluorescence blinking dynamics of single molecules. The relationship between the oxygen concentration and the fraction of time spent in the off-state, stemming from the population and depopulation of triplet states and radical cationic states, can be fitted with a two-site quenching model in the Stern-Volmer plot. The oxygen sensitivity is up to 43.42 kPa-1 in the oxygen partial pressure region as low as 0.01-0.25 kPa, which is seven times higher than that of the fluorescence intensity indicator. This method avoids the limitation of the sharp and non-ignorable fluctuations that occur during the measurement of fluorescence intensity, providing potential applications in the field of low oxygen-concentration monitoring in life science and industry.

Seasonal variations of radon concentrations in single-family houses with different sub-structures

DEFF Research Database (Denmark)

Majborn, B.

1992-01-01

Seasonal variations of indoor radon concentrations have been studied in 70 single-family houses selected according to the type of sub-structure and the type of soil underneath the house. Five categories of sub-structure were included - slab-on-grade, crawl space, basement, and combinations...... of basement with slab-on-grade or crawl space. Half of the houses are located on clayey till and the other half on glaciofluvial gravel. In each house radon was measured in a living room and a bedroom, in the basement if present, and in the crawl space if present and accessible. The measurements were made...... with track detectors on a quarterly basis throughout a year. For living rooms and bedrooms the seasonal variations range from being highly significant for the slab-on-grade houses to being insignificant for the crawl space houses. For basements and crawl spaces the geometric mean radon concentrations do...

COMBINE MIDAZOLAM-FENTANYL-KETAMIN FOR EVISERATION SURGERY IN PATIENT WITH MULTIDRUG ALERGY IN ACUTE ON CHRONIC EXCACERBATION OF HIPERSENSITIVITY REACTION

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Putu Agus Surya Panji

2018-06-01

Full Text Available ABSTRACT Multidrug Alergy is a relatively rare imunology abnormality. Generally, it caused by congenital genotype and influence with environment. After treated the acute on chronic exacerbation of hypersensivity tipe 1, and the inflamation can alleviate, the patient schedule of eviseration oculi dextra with general anesthesia. And the opthamologist curious about the proceddure because eviseration need antibiotic to wash the oculi, but there are no antibiotic saved for the patient. For general anesthesia, the patient has no history so we can’t predicted about the anesthetic drug’s allergy. We choose combine ketamine-midazolamadn fentanyl to facilitate the anesthesia. Ketamine significantly reduces the production of inflammatory cytokines without affecting the production of anti-inflammatory cytokines. Fentanyl is the opioid which is the most rarely caused allergy and have strong potential. Midazolam can help the sedation

Novel concept of nonimaging single reflection solar energy concentrator

Energy Technology Data Exchange (ETDEWEB)

Gasparovsky, D.

2004-07-01

Many solar applications require temperatures higher than those that can be achieved by common flat-plate collectors. Temperatures over 100 C are necessary e.g. for industrial process heat. Such temperatures can be obtained by means of solar energy concentrators. Advantages of concentrating the solar radiation can bring in addition to higher temperatures also decrease in heat losses and material savings due to smaller size of absorber, if taking into account that costs for material absorber per square meter can be possibly higher than costs for e.g. concentrating mirrors. On the other hand, using the concentration, two other kinds of losses will raise: losses of diffuse radiation and optical losses. There exist a variety of solar energy concentrators for different purposes. For lowtemperature applications, inexpensive concentrators of diffuse radiation can be used. For these concentrators, acceptance angle A defines the ability to concentrate the diffuse radiation and also its concentration factor C. To this class of concentrators belongs e.g. nonimaging types like CPC (Compound Parabolic Concentrator), V-trough types, cylindrical concentrators etc. This paper deals with development of a new type of concentrator, novel concept of which is based on functionality of CPC by means of flat mirrors, primarily designed for needs of SME's (Small and Medium Enterprises). The CLON project is being ellaborated under the 5th Framework Programme of the EU. (orig.)

The CLOSED trial; CLOnidine compared with midazolam for SEDation of paediatric patients in the intensive care unit: study protocol for a multicentre randomised controlled trial.

Science.gov (United States)

Neubert, Antje; Baarslag, Manuel Alberto; Dijk, Monique van; Rosmalen, Joost van; Standing, Joseph F; Sheng, Yucheng; Rascher, Wolfgang; Roberts, Deborah; Winslade, Jackie; Rawcliffe, Louise; Hanning, Sara M; Metsvaht, Tuuli; Giannuzzi, Viviana; Larsson, Peter; Pokorná, Pavla; Simonetti, Alessandra; Tibboel, Dick

2017-06-21

Sedation is an essential part of paediatric critical care. Midazolam, often in combination with opioids, is the current gold standard drug. However, as it is a far-from-ideal agent, clonidine is increasingly being used in children. This drug is prescribed off-label for this indication, as many drugs in paediatrics are. Therefore, the CLOSED trial aims to provide data on the pharmacokinetics, safety and efficacy of clonidine for the sedation of mechanically ventilated patients in order to obtain a paediatric-use marketing authorisation. The CLOSED study is a multicentre, double-blind, randomised, active-controlled non-inferiority trial with a 1:1 randomisation between clonidine and midazolam. Both treatment groups are stratified according to age in three groups with the same size: <28 days (n=100), 28 days to <2 years (n=100) and 2-18 years (n=100). The primary end point is defined as the occurrence of sedation failure within the study period. Secondary end points include a pharmacokinetic/pharmacodynamic relationship, pharmacogenetics, occurrence of delirium and withdrawal syndrome, opioid consumption and neurodevelopment in the neonatal age group. Logistic regression will be used for the primary end point, appropriate statistics will be used for the secondary end points. Written informed consent will be obtained from the parents/caregivers. Verbal or deferred consent will be used in the sites where national legislation allows. The study has institutional review board approval at recruiting sites. The results will be published in a peer-reviewed journal and shared with the worldwide medical community. EudraCT: 2014-003582-24; Clinicaltrials.gov: NCT02509273; pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Prevention of organophosphate-induced chronic epilepsy by early benzodiazepine treatment.

Science.gov (United States)

Shrot, Shai; Ramaty, Erez; Biala, Yoav; Bar-Klein, Guy; Daninos, Moshe; Kamintsky, Lyn; Makarovsky, Igor; Statlender, Liran; Rosman, Yossi; Krivoy, Amir; Lavon, Ophir; Kassirer, Michael; Friedman, Alon; Yaari, Yoel

2014-09-02

Poisoning with organophosphates (OPs) may induce status epilepticus (SE), leading to severe brain damage. Our objectives were to investigate whether OP-induced SE leads to the emergence of spontaneous recurrent seizures (SRSs), the hallmark of chronic epilepsy, and if so, to assess the efficacy of benzodiazepine therapy following SE onset in preventing the epileptogenesis. We also explored early changes in hippocampal pyramidal cells excitability in this model. Adult rats were poisoned with the paraoxon (450μg/kg) and immediately treated with atropine (3mg/kg) and obidoxime (20mg/kg) to reduce acute mortality due to peripheral acetylcholinesterase inhibition. Electrical brain activity was assessed for two weeks during weeks 4-6 after poisoning using telemetric electrocorticographic intracranial recordings. All OP-poisoned animals developed SE, which could be suppressed by midazolam. Most (88%) rats which were not treated with midazolam developed SRSs, indicating that they have become chronically epileptic. Application of midazolam 1min following SE onset had a significant antiepileptogenic effect (only 11% of the rats became epileptic; p=0.001 compared to non-midazolam-treated rats). Applying midazolam 30min after SE onset did not significantly prevent chronic epilepsy. The electrophysiological properties of CA1 pyramidal cells, assessed electrophysiologically in hippocampal slices, were not altered by OP-induced SE. Thus we show for the first time that a single episode of OP-induced SE in rats leads to the acquisition of chronic epilepsy, and that this epileptogenic outcome can be largely prevented by immediate, but not delayed, administration of midazolam. Extrapolating these results to humans would suggest that midazolam should be provided together with atropine and an oxime in the immediate pharmacological treatment of OP poisoning. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Performance of single-junction and dual-junction InGaP/GaAs solar cells under low concentration ratios

International Nuclear Information System (INIS)

Khan, Aurangzeb; Yamaguchi, Masafumi; Takamoto, Tatsuya

2004-01-01

A study of the performance of single-junction InGaP/GaAs and dual-junction InGaP/GaAs tandem cells under low concentration ratios (up to 15 suns), before and after 1 MeV electron irradiation is presented. Analysis of the tunnel junction parameters under different concentrated light illuminations reveals that the peak current (J P ) and valley current (J V ) densities should be greater than the short-circuit current density (J sc ) for better performance. The tunnel junction behavior against light intensity improved after irradiation. This led to the suggestion that the peak current density (J P ) and valley current density (J V ) of the tunnel junction were enhanced after irradiation or the peak current was shifted to higher concentration. The recovery of the radiation damage under concentrated light illumination conditions suggests that the performance of the InGaP/GaAs tandem solar cell can be enhanced even under low concentration ratios

Peculiar behavior of magnetoresistance in HgSe single crystal with low electron concentration

Science.gov (United States)

Lonchakov, A. T.; Bobin, S. B.; Deryushkin, V. V.; Okulov, V. I.; Govorkova, T. E.; Neverov, V. N.

2018-02-01

Magnetoresistive properties of the single crystal of HgSe with a low electron concentration were studied in a wide range of temperatures and magnetic fields. Some fundamental parameters of the spectrum and scattering of electrons were experimentally determined. Two important features of magnetic transport were found—strong transverse magnetoresistance (MR) and negative longitudinal MR, which can indicate the existence of the topological phase of the Weyl semimetal (WSM) in HgSe. Taking this hypothesis into account, we suggest a modified band diagram of mercury selenide at low electron energies. The obtained results are essential for the deeper understanding of both physics of gapless semiconductors and WSMs—promising materials for various applications in electronics, spintronics, computer, and laser technologies.

AMS measurement of C-14 concentration in a single-year ring of a 2500-yr-old tree

International Nuclear Information System (INIS)

Sakurai, H.; Gandou, T.; Kato, W.; Sawaki, Y.; Matsumoto, T.; Aoki, T.; Matsuzaki, H.; Gunji, S.; Tokanai, F.

2004-01-01

The 14 C concentration in rings of an old tree that date back approximately 2500 yr has been measured at single-year intervals with a highly accurate liquid scintillation counter (LSC) (0.2%) to investigate the 11-yr periodicity of solar activity. To investigate the applicability of AMS to accurate 14 C measurement, 16 graphite samples produced from the cellulose of a single-year tree ring of a 2500-yr-old cedar were measured with the micro analysis laboratory tandem (MALT) accelerator, at The University of Tokyo, and the results were compared with the 14 C age determined using LSC. The average 14 C age of the single-year tree ring calculated from 16 measurements was 2496 ± 23 yr BP, corresponding to the statistical accuracy of 0.26%. This was consistent with the age of 2514 ± 23 yr BP determined using LSC within the acceptable error range, which indicates that accelerator mass spectrometry (AMS) is applicable for accurate 14 C measurement using multi-graphite for the same single-year tree ring

Efeitos da associação de tiletamina/zolazepam ou cetamina S(+)/midazolam/tramadol para contenção química em bugios-ruivos (Allouatta guariba clamitans)

OpenAIRE

Spolti,Pâmela; Moraes,Aury N. de; Tamanho,Renato B.; Gehrcke,Martielo I.; Souza Júnior,Júlio C.; Oleskovicz,Nilson

2013-01-01

Avaliaram-se dois protocolos para contenção química em bugios-ruivos. Para tal, foram utilizados 12 macacos bugios, hígidos, com peso médio de 6,4±0,4 kg, os quais foram submetidos a jejum alimentar e hídrico de seis e duas horas, respectivamente. Os animais foram alocados em dois grupos que receberam injeção via intramuscular: TZ (n=6), os quais receberam uma associação de tiletamina e zolazepam (Zoletil®) na dose de 3,6mg/kg e CEMTRA (n=6), que receberam cetamina S(+), midazolam e tramadol ...

Effects of MicroRNA-34a on the Pharmacokinetics of Cytochrome P450 Probe Drugs in Mice.

Science.gov (United States)

Jilek, Joseph L; Tian, Ye; Yu, Ai-Ming

2017-05-01

MicroRNAs (miRNAs or miRs), including miR-34a, have been shown to regulate nuclear receptor, drug-metabolizing enzyme, and transporter gene expression in various cell model systems. However, to what degree miRNAs affect pharmacokinetics (PK) at the systemic level remains unknown. In addition, miR-34a replacement therapy represents a new cancer treatment strategy, although it is unknown whether miR-34a therapeutic agents could elicit any drug-drug interactions. To address this question, we refined a practical single-mouse PK approach and investigated the effects of a bioengineered miR-34a agent on the PK of several cytochrome P450 probe drugs (midazolam, dextromethorphan, phenacetin, diclofenac, and chlorzoxazone) administered as a cocktail. This approach involves manual serial blood microsampling from a single mouse and requires a sensitive liquid chromatography-tandem mass spectrometry assay, which was able to illustrate the sharp changes in midazolam PK by ketoconazole and pregnenolone 16 α -carbonitrile as well as phenacetin PK by α -naphthoflavone and 3-methylcholanthrene. Surprisingly, 3-methylcholanthrene also decreased systemic exposure to midazolam, whereas both pregnenolone 16 α -carbonitrile and 3-methylcholanthrene largely reduced the exposure to dextromethorphan, diclofenac, and chlorzoxazone. Finally, the biologic miR-34a agent had no significant effects on the PK of cocktail drugs but caused a marginal (45%-48%) increase in systemic exposure to midazolam, phenacetin, and dextromethorphan in mice. In vitro validation of these data suggested that miR-34a slightly attenuated intrinsic clearance of dextromethorphan. These findings from single-mouse PK and corresponding mouse liver microsome models suggest that miR-34a might have minor or no effects on the PK of coadministered cytochrome P450-metabolized drugs. Copyright © 2017 by The American Society for Pharmacology and Experimental Therapeutics.

Comparison of oral dexmedetomidine and midazolam for premedication and emergence delirium in children after dental procedures under general anesthesia: a retrospective study

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Keles S

2018-03-01

Full Text Available Sultan Keles,1 Ozlem Kocaturk2 1Department of Pediatric Dentistry, Faculty of Dentistry, Adnan Menderes University, Aydin, Turkey; 2Department of Oral and Maxillofacial Surgery, Division of Anesthesiology, Faculty of Dentistry, Adnan Menderes University, Aydin, Turkey Background: Premedication is the most common way to minimize distress in children entering the operating room and to facilitate the smooth induction of anesthesia and is accomplished using various sedative drugs before the children are being transferred to the operating room. The aim of this study was to compare the effect of oral dexmedetomidine (DEX and oral midazolam (MID on preoperative cooperation and emergence delirium (ED among children who underwent dental procedures at our hospital between 2016 and 2017.Patients and methods: The medical records of 52 children, who were American Society of Anesthesiologists I, aged between 3 and 7 years, and who underwent full-mouth dental rehabilitation under general anesthesia (GA, were evaluated. Twenty-six patients were given 2 µg/kg of DEX, while another 26 patients were given 0.5 mg/kg of MID in apple juice as premedication agents. The patients’ scores on the Ramsay Sedation Scale (RSS, Parental Separation Anxiety Scale (PSAS, Mask Acceptance Scale, Pediatric Anesthesia Emergence Delirium Scale (PAEDS, and hemodynamic parameters were recorded from patients’ files. The level of sedation of children had been observed just before premedication and at 15, 30, and 45 min after premedication. The data were analyzed using a chi-square test, Fisher’s exact test, Student’s t-test, and analysis of variance in SPSS.Results: The Mask Acceptance Scale and PSAS scores and RSS scores at 15, 30, and 45 min after premedication were not statistically different (p>0.05 in both groups, whereas the PAEDS scores were significantly lower in the DEX group (p<0.05.Conclusion: Oral DEX provided satisfactory sedation levels, ease of parental

Concentration risk

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Matić Vesna

2016-01-01

Full Text Available Concentration risk has been gaining a special dimension in the contemporary financial and economic environment. Financial institutions are exposed to this risk mainly in the field of lending, mostly through their credit activities and concentration of credit portfolios. This refers to the concentration of different exposures within a single risk category (credit risk, market risk, operational risk, liquidity risk.

Thin films of single-walled carbon nanotubes promote human osteoblastic cells (Saos-2) proliferation in low serum concentrations

International Nuclear Information System (INIS)

Akasaka, Tsukasa; Yokoyama, Atsuro; Matsuoka, Makoto; Hashimoto, Takeshi; Watari, Fumio

2010-01-01

One strategy used for the regeneration of bone is the development of cell culture substrates and scaffolds that can control osteoblast proliferation and differentiation. In recent investigations, carbon nanotubes (CNTs) have been utilized as scaffolds for osteoblastic cell cultures; however, there are only a few reports describing the proliferation of osteoblastic cells on thin CNT films; in particular, the effects of serum concentration on cell proliferation have not been studied. In the present study, we prepared culture dishes with homogeneous thin or thick films of non-modified CNTs and examined the effect of serum concentrations on human osteoblastic cells (Saos-2) proliferation in these culture dishes. We demonstrated that the ratio of cell proliferation was strongly affected by the concentration of serum. Interestingly, single-walled carbon nanotube (SWNT) thin films were found to be the most effective substrate for the proliferation of Saos-2 cells in low concentrations of serum. Thus, thin SWNT films may be used as an effective biomaterial for the culture of Saos-2 cells in low serum concentrations.

Efeitos hemodinâmicos da combinação de dexmedetomidina-fentanil versus midazolam-fentanil em crianças submetidas à cirurgia cardíaca com circulação extracorpórea Efectos hemodinámicos de la combinación de dexmedetomidina-fentanil versus midazolam-fentanil en ninõs sometidos a la cirugía cardíaca con circulación extracorpórea Hemodynamic effects of the combination of dexmedetomidine-fentanyl versus midazolam-fentanyl in children undergoing cardiac surgery with cardiopulmonary bypass

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Jyrson Guilherme Klamt

2010-08-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: Avaliar a eficácia da infusão combinada de dexmedetomidina e fentanil na resposta hemodinâmica durante cirurgia cardíaca com circulação extracorpórea (CEC em crianças. MÉTODO: Trinta e duas crianças com idade entre 1 mês e 10 anos, agendadas para cirurgia cardíaca com circulação extracorpórea, foram distribuídas de modo aleatório em dois grupos: o Grupo MDZ recebeu midazolam 0,2 mg.kg-1.h-1, enquanto o Grupo DEX recebeu dexmedetomidina 1 µg.kg-1.h-1 durante uma hora e, em seguida, o ritmo de infusão foi reduzido à metade em ambos os grupos. Ambos os grupos receberam fentanil 10 µg.kg-1, midazolam 0,2 mg.h-1 e vecurônio 0,2 mg.kg-1 para indução da anestesia. As mesmas doses de fentanil com vecurônio da indução foram infundidas durante a primeira hora após a indução e, em seguida, reduzidas à metade. As infusões foram iniciadas imediatamente após a indução e mantidas até o final da cirurgia. O isoflurano foi administrado por curto tempo para controle da resposta hiperdinâmica à incisão e esternotomia. RESULTADOS: Em ambos os grupos, a pressão arterial sistólica e a frequência cardíaca reduziram de modo significativo após uma hora de infusão anestésica, porém o aumento da pressão arterial sistólica e diastólica e da frequência cardíaca à incisão da pele foram significantemente menores no Grupo DEX. Um número significativamente menor de pacientes demandaram suplementação com isoflurano no Grupo DEX. Após a CEC, os pacientes de ambos os grupos tiveram respostas hemodinâmicas similares. CONCLUSÕES: A infusão sem bolus de dexmedetomidina parece ser um adjuvante efetivo do fentanil na promoção de sedação e controle das respostas hemodinâmicas durante cirurgia para cardiopatias congênitas em crianças.JUSTIFICATIVA Y OBJETIVOS: Evaluar la eficacia de la infusión combinada de dexmedetomidina y fentanil en la respuesta hedominámica durante la cirugía card

A new single-moment microphysics scheme for cloud-resolving models using observed dependence of ice concentration on temperature.

Science.gov (United States)

Khairoutdinov, M.

2015-12-01

The representation of microphysics, especially ice microphysics, remains one of the major uncertainties in cloud-resolving models (CRMs). Most of the cloud schemes use the so-called bulk microphysics approach, in which a few moments of such distributions are used as the prognostic variables. The System for Atmospheric Modeling (SAM) is the CRM that employs two such schemes. The single-moment scheme, which uses only mass for each of the water phases, and the two-moment scheme, which adds the particle concentration for each of the hydrometeor category. Of the two, the single-moment scheme is much more computationally efficient as it uses only two prognostic microphysics variables compared to ten variables used by the two-moment scheme. The efficiency comes from a rather considerable oversimplification of the microphysical processes. For instance, only a sum of the liquid and icy cloud water is predicted with the temperature used to diagnose the mixing ratios of different hydrometeors. The main motivation for using such simplified microphysics has been computational efficiency, especially in the applications of SAM as the super-parameterization in global climate models. Recently, we have extended the single-moment microphysics by adding only one additional prognostic variable, which has, nevertheless, allowed us to separate the cloud ice from liquid water. We made use of some of the recent observations of ice microphysics collected at various parts of the world to parameterize several aspects of ice microphysics that have not been explicitly represented before in our sing-moment scheme. For example, we use the observed broad dependence of ice concentration on temperature to diagnose the ice concentration in addition to prognostic mass. Also, there is no artificial separation between the pristine ice and snow, often used by bulk models. Instead we prescribed the ice size spectrum as the gamma distribution, with the distribution shape parameter controlled by the

Spatio-temporal dynamics of multimodal EEG-fNIRS signals in the loss and recovery of consciousness under sedation using midazolam and propofol.

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Seul-Ki Yeom

Full Text Available On sedation motivated by the clinical needs for safety and reliability, recent studies have attempted to identify brain-specific signatures for tracking patient transition into and out of consciousness, but the differences in neurophysiological effects between 1 the sedative types and 2 the presence/absence of surgical stimulations still remain unclear. Here we used multimodal electroencephalography-functional near-infrared spectroscopy (EEG-fNIRS measurements to observe electrical and hemodynamic responses during sedation simultaneously. Forty healthy volunteers were instructed to push the button to administer sedatives in response to auditory stimuli every 9-11 s. To generally illustrate brain activity at repetitive transition points at the loss of consciousness (LOC and the recovery of consciousness (ROC, patient-controlled sedation was performed using two different sedatives (midazolam (MDZ and propofol (PPF under two surgical conditions. Once consciousness was lost via sedatives, we observed gradually increasing EEG power at lower frequencies (15 Hz, as well as spatially increased EEG powers in the delta and lower alpha bands, and particularly also in the upper alpha rhythm, at the frontal and parieto-occipital areas over time. During ROC from unconsciousness, these spatio-temporal changes were reversed. Interestingly, the level of consciousness was switched on/off at significantly higher effect-site concentrations of sedatives in the brain according to the use of surgical stimuli, but the spatio-temporal EEG patterns were similar, regardless of the sedative used. We also observed sudden phase shifts in fronto-parietal connectivity at the LOC and the ROC as critical points. fNIRS measurement also revealed mild hemodynamic fluctuations. Compared with general anesthesia, our results provide insights into critical hallmarks of sedative-induced (unconsciousness, which have similar spatio-temporal EEG-fNIRS patterns regardless of the stage and

Crystal Growth of Ca3Nb(Ga1−xAlx3Si2O14 Piezoelectric Single Crystals with Various Al Concentrations

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Yuui Yokota

2015-08-01

Full Text Available Ca3Nb(Ga1−xAlx3Si2O14 (CNGAS single crystals with various Al concentrations were grown by a micro-pulling-down (µ-PD method and their crystal structures, chemical compositions, crystallinities were investigated. CNGAS crystals with x = 0.2, 0.4 and 0.6 indicated a single phase of langasite-type structure without any secondary phases. In contrast, the crystals with x = 0.8 and 1 included some secondary phases in addition to the langasite-type phase. Lattice parameters, a- and c-axes lengths, of the langasite-type phase systematically decreased with an increase of Al concentration. The results of chemical composition analysis revealed that the actual Al concentrations in as-grown crystals were almost consistent with the nominal compositions. In addition, there was no large segregation of each cation along the growth direction.

Drug-induced amnesia is a separate phenomenon from sedation: electrophysiologic evidence.

Science.gov (United States)

Veselis, R A; Reinsel, R A; Feshchenko, V A

2001-10-01

Sedative-hypnotic drugs not only increase sedation, but also impair memory as serum concentration increases. These drugs also produce profound changes in the auditory event-related potential (ERP). The ability of various ERP components to predict changes in sedation and memory produced by various drugs was tested. Sixty-five healthy volunteers randomly received intravenous placebo, midazolam, propofol, thiopental, fentanyl with ondansetron, or ondansetron alone at five different stable target concentrations (three increasing, two decreasing) using a computer-controlled infusion pump to produce varying degrees of sedation without loss of consciousness. ERPs were recorded while volunteer participants detected a deviant auditory stimulus and made a button-press response to a target tone (standard oddball paradigm, 80:20 ratio, to elicit a P3 response). At each target concentration, volunteers learned a list of 16 words. The predictive probabilities (Pk) of various ERP components were determined for word recognition at the end of the day (memory) and log reaction time to the deviant stimulus (sedation). The N2 latency of the ERP consistently predicted log reaction time in all groups (Pk +/- SE from 0.58 +/- 0.04 to 0.71 +/- 0.04). The N2P3 amplitude of the ERP was the best predictor of memory performance for midazolam (Pk, 0.63 +/- 0.04), propofol (Pk, 0.62 +/- 0.05), and thiopental (Pk, 0.66 +/- 0.04). There was a differential ability to predict memory performance from sedation for midazolam and propofol. Midazolam and propofol affect memory differentially from their sedative effects, and these are indexed by specific components of the auditory ERP. These components of the ERP are associated with specific, but not necessarily unique, neuroanatomic structures. Thus, these drugs act by additional mechanisms beyond general central nervous system depression to produce the effects of sedation and memory impairment.

Spectral filtering modulation method for estimation of hemoglobin concentration and oxygenation based on a single fluorescence emission spectrum in tissue phantoms.

Science.gov (United States)

Liu, Quan; Vo-Dinh, Tuan

2009-10-01

Hemoglobin concentration and oxygenation in tissue are important biomarkers that are useful in both research and clinical diagnostics of a wide variety of diseases such as cancer. The authors aim to develop simple ratiometric method based on the spectral filtering modulation (SFM) of fluorescence spectra to estimate the total hemoglobin concentration and oxygenation in tissue using only a single fluorescence emission spectrum, which will eliminate the need of diffuse reflectance measurements and prolonged data processing as required by most current methods, thus enabling rapid clinical measurements. The proposed method consists of two steps. In the first step, the total hemoglobin concentration is determined by comparing a ratio of fluorescence intensities at two emission wavelengths to a calibration curve. The second step is to estimate oxygen saturation by comparing a double ratio that involves three emission wavelengths to another calibration curve that is a function of oxygen saturation for known total hemoglobin concentration. Theoretical derivation shows that the ratio in the first step is linearly proportional to the total hemoglobin concentrations and the double ratio in the second step is related to both total hemoglobin concentration and hemoglobin oxygenation for the chosen fiber-optic probe geometry. Experiments on synthetic fluorescent tissue phantoms, which included hemoglobin with both constant and varying oxygenation as the absorber, polystyrene spheres as scatterers, and flavin adenine dinucleotide as the fluorophore, were carried out to validate the theoretical prediction. Tissue phantom experiments confirm that the ratio in the first step is linearly proportional to the total hemoglobin concentration and the double ratio in the second step is related to both total hemoglobin concentrations and hemoglobin oxygenation. Furthermore, the relations between the two ratios and the total hemoglobin concentration and hemoglobin oxygenation are insensitive

A single sip of a strong alcoholic beverage causes exposure to carcinogenic concentrations of acetaldehyde in the oral cavity.

Science.gov (United States)

Linderborg, Klas; Salaspuro, Mikko; Väkeväinen, Satu

2011-09-01

The aim of this study was to explore oral exposure to carcinogenic (group 1) acetaldehyde after single sips of strong alcoholic beverages containing no or high concentrations of acetaldehyde. Eight volunteers tasted 5 ml of ethanol diluted to 40 vol.% with no acetaldehyde and 40 vol.% calvados containing 2400 μM acetaldehyde. Salivary acetaldehyde and ethanol concentrations were measured by gas chromatography. The protocol was repeated after ingestion of ethanol (0.5 g/kg body weight). Salivary acetaldehyde concentration was significantly higher after sipping calvados than after sipping ethanol at 30s both with (215 vs. 128 μmol/l, psipping of the alcoholic beverages. Carcinogenic concentrations of acetaldehyde are produced from ethanol in the oral cavity instantly after a small sip of strong alcoholic beverage, and the exposure continues for at least 10 min. Acetaldehyde present in the beverage has a short-term effect on total acetaldehyde exposure. Copyright © 2011 Elsevier Ltd. All rights reserved.

Sedation using 5% lidocaine patches, midazolam and propofol in a combative, obese adolescent with severe autistic disorder undergoing brain magnetic resonance imaging: a case report.

Science.gov (United States)

Seo, Kwon Hui; Jung, Hong Soo; Kang, Eu Gene; Kim, Change Jae; Rhee, Ho Young; Jeon, Yeon Soo

2014-12-01

We present a 17-year-old man who underwent brain magnetic resonance imaging and laboratory exams for uncontrolled seizure. Patients with an autistic disorder require deep sedation or, occasionally, general anesthesia even for radiologic exams or simple procedures. The anesthetic management of an obese, violent patient with a severe autistic disorder and mental retardation can be challenging to anesthesiologists and requires a more careful approach in selecting adequate anesthetics and doses. This case emphasizes the importance of having a detailed plan to ensure the smooth process of premedication, anesthetic induction, maintenance, emergence and safe discharge of incorporated patients in the event of unexpected situations. A 5% lidocaine patch to relieve the pain from the intramuscular injection and intravenous cannulation, intramuscular midazolam as premedication, and propofol for the maintenance of sedation can be a good sedation protocol in incorporated patients.

Functional and morphological effects of diazepam and midazolam on tumor vasculature in the 9L gliosarcoma brain tumor model using dynamic susceptibility contrast MRI: a comparative study

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Yan N

2017-10-01

Full Text Available Nuo Yan,1 Yuzhen Zheng,2 Cheng Yang1 1Second Department of Anesthesiology, The Affiliated Hospital to Logistics University of PAP, Tianjin, 2Department of Anesthesiology, Tianjin Huanhu Hospital, Tianjin, China Abstract: Antiangiogenic therapy attenuates tumor growth by reducing vascularization. Diazepam (DZP and midazolam (MZL have antiangiogenic properties in human umbilical vein endothelial cells. Thus, we investigated the antiangiogenic activity of DZP and MZL in the rat 9L gliosarcoma brain tumor model. The effect on tumor vasculature was evaluated using dynamic susceptibility contrast magnetic resonance imaging with gradient-echo (GE and spin-echo (SE to assess perfusion parameters, including cerebral blood volume (CBV, cerebral blood flow (CBF, mean transit time (MTT, and mean vessel diameter. The GE-normalized CBF (nCBF in the tumors of untreated controls was significantly lower than that in normal brain tissue, whereas the CBV and MTT were higher. DZP- and MZL-treated rats had higher CBF and lower CBV and MTT values than did untreated controls. The tumor size decreased significantly to 33.5% in DZP-treated rats (P<0.001 and 22.5% in MZL-treated rats (P<0.01 relative to controls. The SE-normalized CBV was lower in DZP-treated (32.9% and MZL-treated (10.6% rats compared with controls. The mean vessel diameter decreased significantly by 32.5% in DPZ-treated and by 24.9% in MZL-treated rats compared with controls (P<0.01. The GE and SE nCBF values were higher in DZP-treated (49.9% and 40.1%, respectively and MZL-treated (41.2% and 32.1%, respectively rats than in controls. The GE- and SE-normalized MTTs were lower in DZP-treated (48.2% and 59.8%, respectively and MZL-treated (40.5% and 51.2%, respectively rats than in controls. Both DZP and MZL had antiangiogenic effects on tumor perfusion and vasculature; however, the antiangiogenic activity of DZP is more promising than that of MZL. Keywords: diazepam, midazolam, 9L gliosarcoma

Nonintravenous rescue medications for pediatric status epilepticus: A cost-effectiveness analysis.

Science.gov (United States)

Sánchez Fernández, Iván; Gaínza-Lein, Marina; Loddenkemper, Tobias

2017-08-01

To quantify the cost-effectiveness of rescue medications for pediatric status epilepticus: rectal diazepam, nasal midazolam, buccal midazolam, intramuscular midazolam, and nasal lorazepam. Decision analysis model populated with effectiveness data from the literature and cost data from publicly available market prices. The primary outcome was cost per seizure stopped ($/SS). One-way sensitivity analyses and second-order Monte Carlo simulations evaluated the robustness of the results across wide variations of the input parameters. The most cost-effective rescue medication was buccal midazolam (incremental cost-effectiveness ratio ([ICER]: $13.16/SS) followed by nasal midazolam (ICER: $38.19/SS). Nasal lorazepam (ICER: -$3.8/SS), intramuscular midazolam (ICER: -$64/SS), and rectal diazepam (ICER: -$2,246.21/SS) are never more cost-effective than the other options at any willingness to pay. One-way sensitivity analysis showed the following: (1) at its current effectiveness, rectal diazepam would become the most cost-effective option only if its cost was $6 or less, and (2) at its current cost, rectal diazepam would become the most cost-effective option only if effectiveness was higher than 0.89 (and only with very high willingness to pay of $2,859/SS to $31,447/SS). Second-order Monte Carlo simulations showed the following: (1) nasal midazolam and intramuscular midazolam were the more effective options; (2) the more cost-effective option was buccal midazolam for a willingness to pay from $14/SS to $41/SS and nasal midazolam for a willingness to pay above $41/SS; (3) cost-effectiveness overlapped for buccal midazolam, nasal lorazepam, intramuscular midazolam, and nasal midazolam; and (4) rectal diazepam was not cost-effective at any willingness to pay, and this conclusion remained extremely robust to wide variations of the input parameters. For pediatric status epilepticus, buccal midazolam and nasal midazolam are the most cost-effective nonintravenous rescue

Millisecond single-molecule localization microscopy combined with convolution analysis and automated image segmentation to determine protein concentrations in complexly structured, functional cells, one cell at a time.

Science.gov (United States)

Wollman, Adam J M; Leake, Mark C

2015-01-01

We present a single-molecule tool called the CoPro (concentration of proteins) method that uses millisecond imaging with convolution analysis, automated image segmentation and super-resolution localization microscopy to generate robust estimates for protein concentration in different compartments of single living cells, validated using realistic simulations of complex multiple compartment cell types. We demonstrate its utility experimentally on model Escherichia coli bacteria and Saccharomyces cerevisiae budding yeast cells, and use it to address the biological question of how signals are transduced in cells. Cells in all domains of life dynamically sense their environment through signal transduction mechanisms, many involving gene regulation. The glucose sensing mechanism of S. cerevisiae is a model system for studying gene regulatory signal transduction. It uses the multi-copy expression inhibitor of the GAL gene family, Mig1, to repress unwanted genes in the presence of elevated extracellular glucose concentrations. We fluorescently labelled Mig1 molecules with green fluorescent protein (GFP) via chromosomal integration at physiological expression levels in living S. cerevisiae cells, in addition to the RNA polymerase protein Nrd1 with the fluorescent protein reporter mCherry. Using CoPro we make quantitative estimates of Mig1 and Nrd1 protein concentrations in the cytoplasm and nucleus compartments on a cell-by-cell basis under physiological conditions. These estimates indicate a ∼4-fold shift towards higher values in the concentration of diffusive Mig1 in the nucleus if the external glucose concentration is raised, whereas equivalent levels in the cytoplasm shift to smaller values with a relative change an order of magnitude smaller. This compares with Nrd1 which is not involved directly in glucose sensing, and which is almost exclusively localized in the nucleus under high and low external glucose levels. CoPro facilitates time-resolved quantification of

Nonimaging concentrators for solar thermal energy

Science.gov (United States)

Winston, R.; Gallagher, J. J.

1980-03-01

A small experimental solar collector test facility was used to explore applications of nonimaging optics for solar thermal concentration in three substantially different configurations: a single stage system with moderate concentration on an evacuated absorber (a 5.25X evacuated tube Compound Parabolic Concentrator or CPC), a two stage system with high concentration and a non-evacuated absorber (a 16X Fresnel lens/CPC type mirror) and moderate concentration single stage systems with non-evacuated absorbers for lower temperature (a 3X and a 6.5X CPC). Prototypes of each of these systems were designed, built and tested. The performance characteristics are presented.

Ultra flat ideal concentrators of high concentration

Energy Technology Data Exchange (ETDEWEB)

Chaves, Julio [IST, Physics Dept., Lisboa (Portugal); INETI-DER, Lisboa (Portugal); Collares-Pereira, Manuel [INETI-DER, Lisboa (Portugal)

2000-07-01

A new method for the design of nonimaging devices is presented. Its application to the design of ultra flat compact concentrators is analysed. These new concentrators are based on a combination of two stages: the first one is composed of a large number of small structures placed side by side and the second one is a very compact single device concentrating the radiation to the limit. These devices are ideal for 2D. These compact designs are much more compact than the traditional ones like lens-mirror combinations or parabolic primaries with nonimaging secondaries. Besides, they can be designed for any acceptance angle, while the traditional ones are limited to small acceptance angles. (Author)

Simulation and development of a multi-leg homogeniser concentrating assembly for concentrated photovoltaic (CPV) system with electrical rating analysis

International Nuclear Information System (INIS)

Burhan, Muhammad; Chua, Kian Jon Ernest; Ng, Kim Choon

2016-01-01

Highlights: • Novel multi-leg homogeniser concentrating assembly is developed for CPV system. • Single set of concentrator, concentrates sunlight on 4 MJCs with 1° acceptance angle. • The system performance is analyzed through experiment and ray tracing simulation. • Mini two axis solar tracker, with high tracking accuracy, is developed and tested. • Electrical rating analysis accurately estimates CPV system performance in any region. - Abstract: Concentrated photovoltaic (CPV) system utilizing multi-junction solar cells, is the main focus for current research, offering highest efficiency among all photovoltaic systems. The main aspect of CPV system is the design and performance of concentrating assembly, as it determines the performance of whole CPV system. However, the conventional design of CPV concentrating assembly dedicates one concentrator for each solar cell, in which single concentrator is capable to concentrate solar radiation onto single solar cell. This paper proposes a novel concentrating assembly for CPV system, which is designed to concentrate solar radiation onto four multi-junction solar cells with a single set of concentrators. The proposed design not only can reduce the number of concentrators and assembly efforts for CPV systems, but also achieved an acceptance angle of 1°. In this paper, the proposed multi-leg homogeniser CPV concentrating assembly is designed, developed, experimentally tested and verified through ray tracing simulation. The paper also discuss the development of mini, precise and accurate but cost effective two axis solar tracker for CPV system, which can be installed at any location even at rooftop of residential buildings, unlike conventional large scale CPV systems. Moreover, through the electrical rating analysis of the developed CPV system, its performance can be accurately estimated in any region.

Single-side renal sympathetic denervation to treat malignant refractory hypertension in a solitary kidney patient.

Science.gov (United States)

Ribichini, Flavio; Ferrara, Angela; Pighi, Michele; Pesarini, Gabriele; Gambaro, Alessia; Valvo, Enrico; Lupo, Antonio; Vassanelli, Corrado

2014-12-01

Renal sympathetic denervation (RSD) is emerging as a new therapeutic option for patients with severe hypertension refractory to medical therapy. Patients affected by renovascular or anatomical abnormalities have hitherto been systematically excluded from clinical trials with RSD because of concern about safety and the unknown efficacy of the procedure in this subgroup of patients. We describe the management of a case of RSD in a single-kidney patient with refractory hypertension; the patient had had a previous surgical right nephrectomy for renal cell carcinoma that subsequently required no other oncologic treatment. After multidisciplinary assessment, the patient underwent RSD. The procedure was performed through a 6F femoral access using the Symplicity™ RSD system (Medtronic, Mountain View, CA, USA). Radiofrequency was applied to the renal artery wall in 6 different points under general sedation with midazolam to control back pain caused by the procedure, that was performed without periprocedural complications. The patient was discharged 2 days later after a control of the vascular access site and routine biochemical examinations. The following 9-month follow up showed a significant reduction in blood pressure and stable renal function, without signs of renal damage. Our report confirms the feasibility of RSD in this delicate context, without evident negative effects on kidney function and with a significant reduction in blood pressure. Future studies are needed to fully clarify the value of RSD in single-kidney patients.

Identification of benign and malignant thyroid nodules by in vivo iodine concentration measurement using single-source dual energy CT

Science.gov (United States)

Gao, Shun-Yu; Zhang, Xiao-Yan; Wei, Wei; Li, Xiao-Ting; Li, Yan-Ling; Xu, Min; Sun, Ying-Shi; Zhang, Xiao-Peng

2016-01-01

Abstract This study proposed to determine whether in vivo iodine concentration measurement by single-source dual energy (SSDE) CT can improve differentiation between benign and malignant thyroid nodules. In total, 53 patients presenting with thyroid nodules underwent SSDE CT scanning. Iodine concentrations were measured for each nodule and normal thyroid tissue using the GSI-viewer image analysis software. A total of 26 thyroid nodules were malignant in 26 patients and confirmed by surgery; 33 nodules from 27 patients were benign, with 10 confirmed by surgery and others after follow-up. Iodine concentrations with plain CT were significantly lower in malignant than benign nodules (0.47 ± 0.20 vs 1.17 ± 0.38 mg/mL, P = 0.00). Receiver operating characteristic (ROC) curve showed an area under the curve (AUC) of 0.93; with a cutoff of 0.67, iodine concentration showed 92.3% sensitivity and 88.5% specificity in diagnosing malignancy. Iodine concentration obtained by enhanced and plain CT were significantly higher in malignant than benign nodules (9.05 ± 3.35 vs 3.46 ± 2.24 mg/mL, P = 0.00). ROC curve analysis showed an AUC of 0.93; with a cutoff value of 3.37, iodine concentration displayed 78% sensitivity, 95% specificity in diagnosing malignancy. Combining unenhanced with enhanced iodine concentrations, the diagnostic equation was: Y = –8.641 × unenhanced iodine concentration + 0.663 × iodine concentration. ROC curve showed an AUC of 0.98 (95% CI, 0.94, 1.00). With Y ≥ –2 considered malignancy, diagnostic sensitivity and specificity were 96%, 96.3%, respectively. This study concluded that SSDE CT can detect the differences in iodine uptake and blood supply between benign and malignant thyroid lesions. PMID:27684811

Single Sodium Pyruvate Ingestion Modifies Blood Acid-Base Status and Post-Exercise Lactate Concentration in Humans

Directory of Open Access Journals (Sweden)

Robert A. Olek

2014-05-01

Full Text Available This study examined the effect of a single sodium pyruvate ingestion on a blood acid-base status and exercise metabolism markers. Nine active, but non-specifically trained, male subjects participated in the double-blind, placebo-controlled, crossover study. One hour prior to the exercise, subjects ingested either 0.1 g·kg−1 of body mass of a sodium pyruvate or placebo. The capillary blood samples were obtained at rest, 60 min after ingestion, and then three and 15 min after completing the workout protocol to analyze acid-base status and lactate, pyruvate, alanine, glucose concentrations. The pulmonary gas exchange, minute ventilation and the heart rate were measured during the exercise at a constant power output, corresponding to ~90% O2max. The blood pH, bicarbonate and the base excess were significantly higher after sodium pyruvate ingestion than in the placebo trial. The blood lactate concentration was not different after the ingestion, but the post-exercise was significantly higher in the pyruvate trial (12.9 ± 0.9 mM than in the placebo trial (10.6 ± 0.3 mM, p < 0.05 and remained elevated (nonsignificant after 15 min of recovery. The blood pyruvate, alanine and glucose concentrations, as well as the overall pulmonary gas exchange during the exercise were not affected by the pyruvate ingestion. In conclusion, the sodium pyruvate ingestion one hour before workout modified the blood acid-base status and the lactate production during the exercise.

Anestesia epidural com associação medetomidina e lidocaína, em gatos pré-medicados com acepromazina e midazolam

Directory of Open Access Journals (Sweden)

D.A.S.D. Lima

2011-04-01

Full Text Available Avaliaram-se os efeitos anestésicos promovidos pela associação medetomidina e lidocaína por via epidural, em gatos pré-tratados com acepromazina e midazolam. Foram utilizados 10 gatos adultos, machos e fêmeas, hígidos e com média de peso de 2,5±0,6kg, distribuídos em dois grupos (GM e GL de igual número (n=5. Administraram-se, como medicação pré-anestésica, acepromazina, 0,2mg/kg, e midazolam, 0,5mg/kg, via intramuscular, e 20 minutos depois, nos animais do GM, por via epidural, lidocaína, 4,4mg/kg, associada à medetomidina, 0,02mg/kg. Os gatos do GL receberam lidocaína, 4,4mg/kg, associada à solução de NaCl a 0,9%. As avaliações ocorreram antes da pré-anestesia (MPA, 20 minutos após a MPA e antes da anestesia epidural, e aos 10, 20, 30 e 40 minutos após a anestesia epidural, respectivamente, T-20, T0, T10, T20, T30 e T40. Foram avaliados: frequência cardíaca (FC e respiratória (FR, temperatura do corpo, saturação de oxiemoglobina, analgesia, miorrelaxamento e período de recuperação. No GM, a FC diminuiu em T20, T30 e T40 em relação ao T-20 e T10 e foi mais baixa que a FC do GL em T20, T30 e T40, respectivamente, 86, 91 e 88 bat/min e 194, 205 e 177 bat/min. A FR variou entre o T-20 e os outros momentos de avaliação nos animais do GL. Nas variáveis eletrocardiográficas, houve diferenças entre T20, T30 e T40 e T-20 e T0, valores de 235, 238 e 240ms e 156 e 161ms, respectivamente, somente no GM. Este grupo diferiu do GL nas avaliações em T20, T30 e T40, valores de 147, 132 e 150ms para os gatos do GL. Oitenta por cento dos gatos tiveram analgesia intensa, e em todos os animais ocorreu relaxamento da mandíbula e da língua. O tempo de recuperação foi de 40 e 15min no GM e no GL, respectivamente. Concluiu-se que a associação lidocaína com medetomidina promoveu plano anestésico estável com grau de anestesia e recuperação anestésica de boa qualidade.

Simulation and development of a multi-leg homogeniser concentrating assembly for concentrated photovoltaic (CPV) system with electrical rating analysis

KAUST Repository

Burhan, Muhammad

2016-03-09

Concentrated photovoltaic (CPV) system utilizing multi-junction solar cells, is the main focus for current research, offering highest efficiency among all photovoltaic systems. The main aspect of CPV system is the design and performance of concentrating assembly, as it determines the performance of whole CPV system. However, the conventional design of CPV concentrating assembly dedicates one concentrator for each solar cell, in which single concentrator is capable to concentrate solar radiation onto single solar cell. This paper proposes a novel concentrating assembly for CPV system, which is designed to concentrate solar radiation onto four multi-junction solar cells with a single set of concentrators. The proposed design not only can reduce the number of concentrators and assembly efforts for CPV systems, but also achieved an acceptance angle of 1°. In this paper, the proposed multi-leg homogeniser CPV concentrating assembly is designed, developed, experimentally tested and verified through ray tracing simulation. The paper also discuss the development of mini, precise and accurate but cost effective two axis solar tracker for CPV system, which can be installed at any location even at rooftop of residential buildings, unlike conventional large scale CPV systems. Moreover, through the electrical rating analysis of the developed CPV system, its performance can be accurately estimated in any region. © 2016 Elsevier Ltd. All rights reserved.

Simulation and development of a multi-leg homogeniser concentrating assembly for concentrated photovoltaic (CPV) system with electrical rating analysis

KAUST Repository

Burhan, Muhammad; Chua, Kian Jon Ernest; Ng, Kim Choon

2016-01-01

Concentrated photovoltaic (CPV) system utilizing multi-junction solar cells, is the main focus for current research, offering highest efficiency among all photovoltaic systems. The main aspect of CPV system is the design and performance of concentrating assembly, as it determines the performance of whole CPV system. However, the conventional design of CPV concentrating assembly dedicates one concentrator for each solar cell, in which single concentrator is capable to concentrate solar radiation onto single solar cell. This paper proposes a novel concentrating assembly for CPV system, which is designed to concentrate solar radiation onto four multi-junction solar cells with a single set of concentrators. The proposed design not only can reduce the number of concentrators and assembly efforts for CPV systems, but also achieved an acceptance angle of 1°. In this paper, the proposed multi-leg homogeniser CPV concentrating assembly is designed, developed, experimentally tested and verified through ray tracing simulation. The paper also discuss the development of mini, precise and accurate but cost effective two axis solar tracker for CPV system, which can be installed at any location even at rooftop of residential buildings, unlike conventional large scale CPV systems. Moreover, through the electrical rating analysis of the developed CPV system, its performance can be accurately estimated in any region. © 2016 Elsevier Ltd. All rights reserved.

Horizontally staggered lightguide solar concentrator with lateral displacement tracking for high concentration applications.

Science.gov (United States)

Ma, Hongcai; Wu, Lin

2015-07-10

We present the design of a horizontally staggered lightguide solar concentrator with lateral displacement tracking for high concentration applications. This solar concentrator consists of an array of telecentric primary concentrators, a horizontally staggered lightguide layer, and a vertically tapered lightguide layer. The primary concentrator is realized by two plano-aspheric lenses with lateral movement and maintains a high F-number over an angle range of ±23.5°. The results of the simulations show that the solar concentrator achieves a high concentration ratio of 500× with ±0.5° of acceptance angle by a single-axis tracker and dual lateral translation stages.

Concentrations of levofloxacin (HR 355) in the respiratory tract following a single oral dose in patients undergoing fibre-optic bronchoscopy.

Science.gov (United States)

Andrews, J M; Honeybourne, D; Jevons, G; Brenwald, N P; Cunningham, B; Wise, R

1997-10-01

Concentrations of levofloxacin were measured in bronchial biopsies, alveolar macrophages (AM), epithelial lining fluid (ELF) and serum following a single oral dose. Concentrations were measured by a microbiological assay method. A total of 35 patients undergoing fibre-optic bronchoscopy were studied. Mean serum, AM, ELF and biopsy concentrations were as follows. 0.5 h: 4.73 mg/L, 19.1 mg/L, 4.74 mg/L and 4.3 mg/kg; 1 h: 6.6 mg/L, 32.5 mg/L, 10.8 mg/L and 8.3 mg/kg; 2 h: 4.9 mg/L, 41.9 mg/L, 9.0 mg/L and 6.5 mg/kg; 4 h: 4.1 mg/L, 27.7 mg/L, 10.9 mg/L and 6.0 mg/kg; and 6-8 h: 4.0 mg/L, 38.4 mg/L, 9.6 mg/L and 4.0 mg/kg respectively. Mean serum and AM concentrations at 12-24 h were 1.2 and 13.9 mg/L respectively (concentrations in biopsy and ELF were only measurable in three of the six patients). These concentrations exceed the MIC90s of the common respiratory pathogens, Haemophilus influenzae (0.015 mg/L), Moraxella catarrhalis (0.06 mg/L) and Streptococcus pneumoniae (1 mg/L) and suggest that levofloxacin should be efficacious in the treatment of community- and hospital-acquired respiratory infection.

Facilitating influence of stress on the consolidation of fear memory induced by a weak training: reversal by midazolam pretreatment.

Science.gov (United States)

Maldonado, Noelia Martina; Martijena, Irene Delia; Molina, Víctor Alejandro

2011-11-20

It is well known that an emotionally arousing experience usually results in a robust and persistent memory trace. The present study explored the potential mechanisms involved in the influence of stress on the consolidation of a contextual fear memory in animals subjected to a weak fear training protocol, and whether pretreatment with intra-basolateral amygdala or systemic administration of midazolam (MDZ) prevents the potential stress-induced influence on fear memory formation. A previous restraint session facilitated fear retention, this effect was not due to a sensitized effect of restraint on the footshock experience. MDZ, both systemically or intra-basolateral amygdala infusion prior to the restraint, attenuated the stress-induced promoting influence on fear memory formation. In addition, stress exposure activated the ERK1/2 pathway in basolateral amygdala (BLA) after the weak training procedure but not after the immediate footshock protocol. Similar to our behavioral findings, MDZ attenuated stress-induced elevation of phospho-ERK2 (p-ERK2) in BLA following the acquisition session. Given that the activation of ERK1/2 pathway is essential for associative learning, we propose that stress-induced facilitation of p-ERK2 in BLA is an important mechanism for the promoting influence of stress on the consolidation of contextual fear memory. Copyright © 2011 Elsevier B.V. All rights reserved.

Evaluation of injectable anaesthesia with five medetomidine-midazolam based combinations in Egyptian fruit bats ( Rousettus aegyptiacus).

Science.gov (United States)

Tuval, Avishag; Las, Liora; Shilo-Benjamini, Yael

2018-01-01

Egyptian fruit bats are increasingly used as model animals in neuroscience research. Our aim was to characterize suitable injectable anaesthesia for this species, possibly replacing inhalant anaesthesia, thus minimizing occupational health hazards. Eight bats were randomly assigned by a crossover design for subcutaneously administered combinations of medetomidine-midazolam with: saline (MM-Sal), ketamine (MM-Ket), fentanyl (MM-Fen), morphine (MM-Mor), or butorphanol (MM-But). The anaesthetic depth and vital signs were monitored at baseline and every 10 min until bats recovered. If after 180 min the bats did not recover, atipamezole was administered. Mean induction times were 7-11.5 min with all combinations. Twitching during induction was common. All combinations produced anaesthesia, with significantly decreased heart rate (from 400 to 200 bpm) and respiratory rate (from 120-140 to 36-65 rpm). Arrhythmia and irregular breathing patterns occurred. MM-Fen, MM-Mor, and MM-But depressed respiration significantly more than MM-Sal. Time to first movement with MM-Ket and MM-But lasted significantly longer than with MM-Sal. Recovery time was significantly shorter in the MM-Sal (88 min) in comparison to all other treatments, and it was significantly longer in the MM-But (159 min), with atipamezole administered to four of the eight bats. In conclusion, all five anaesthetic protocols are suitable for Egyptian fruit bats; MM-Ket produces long anaesthesia and minimal respiratory depression, but cannot be antagonized completely. MM-Fen, MM-Mor, and MM-But depress respiration, but are known to produce good analgesia, and can be fully antagonized. Administration of atipamezole following the use of MM-But in Egyptian fruit bats is recommended.

PIXE channeling for concentration and location measurements of Zn- and Cd-dopants in InP single crystals

International Nuclear Information System (INIS)

Vogt, J.; Krause, H.; Flagmeyer, R.; Otto, G.; Lux, M.

1993-01-01

We present results of the determination of Cd- and Zn-dopants in InP single crystals using the PIXE and RBS spectrometry at our 2 MeV Van de Graaff accelerator. The (100) oriented crystals were doped by thermodiffusion of Cd and Zn atoms. For concentration and localization measurements we used the ion-channeling technique and energy dispersive spectrometry of proton induced X-ray emission (PIXE). Angular scans of the K-lines of In, Cd and Zn were obtained. The strong In X-rays were attenuated by a rhodium foil in front of the low energy Ge detector. The PIXE-channeling results were compared with SIMS and Hall-effect measurements. (orig.)

The effect of single low-dose dexamethasone on blood glucose concentrations in the perioperative period: a randomized, placebo-controlled investigation in gynecologic surgical patients.

Science.gov (United States)

Murphy, Glenn S; Szokol, Joseph W; Avram, Michael J; Greenberg, Steven B; Shear, Torin; Vender, Jeffery S; Gray, Jayla; Landry, Elizabeth

2014-06-01

The effect of single low-dose dexamethasone therapy on perioperative blood glucose concentrations has not been well characterized. In this investigation, we examined the effect of 2 commonly used doses of dexamethasone (4 and 8 mg at induction of anesthesia) on blood glucose concentrations during the first 24 hours after administration. Two hundred women patients were randomized to 1 of 6 groups: Early-control (saline); Early-4 mg (4 mg dexamethasone); Early-8 mg (8 mg dexamethasone); Late-control (saline); Late-4 mg (4 mg dexamethasone); and Late-8 mg (8 mg dexamethasone). Blood glucose concentrations were measured at baseline and 1, 2, 3, and 4 hours after administration in the early groups and at baseline and 8 and 24 hours after administration in the late groups. The incidence of hyperglycemic events (the number of patients with at least 1 blood glucose concentration >180 mg/dL) was determined. Blood glucose concentrations increased significantly over time in all control and dexamethasone groups (from median baselines of 94 to 102 mg/dL to maximum medians ranging from 141 to 161.5 mg/dL, all P < 0.001). Blood glucose concentrations did not differ significantly between the groups receiving dexamethasone (either 4 or 8 mg) and those receiving saline at any measurement time. The incidence of hyperglycemic events did not differ in any of the early (21%-28%, P = 0.807) or late (13%-24%, P = 0.552) groups. Because blood glucose concentrations during the first 24 hours after administration of single low-dose dexamethasone did not differ from those observed after saline administrations, these results suggest clinicians need not avoid using dexamethasone for nausea and vomiting prophylaxis out of concerns related to hyperglycemia.

Nanotip analysis for dielectrophoretic concentration of nanosized viral particles.

Science.gov (United States)

Yeo, Woon-Hong; Lee, Hyun-Boo; Kim, Jong-Hoon; Lee, Kyong-Hoon; Chung, Jae-Hyun

2013-05-10

Rapid and sensitive detection of low-abundance viral particles is strongly demanded in health care, environmental control, military defense, and homeland security. Current detection methods, however, lack either assay speed or sensitivity, mainly due to the nanosized viral particles. In this paper, we compare a dendritic, multi-terminal nanotip ('dendritic nanotip') with a single terminal nanotip ('single nanotip') for dielectrophoretic (DEP) concentration of viral particles. The numerical computation studies the concentration efficiency of viral particles ranging from 25 to 100 nm in radius for both nanotips. With DEP and Brownian motion considered, when the particle radius decreases by two times, the concentration time for both nanotips increases by 4-5 times. In the computational study, a dendritic nanotip shows about 1.5 times faster concentration than a single nanotip for the viral particles because the dendritic structure increases the DEP-effective area to overcome the Brownian motion. For the qualitative support of the numerical results, the comparison experiment of a dendritic nanotip and a single nanotip is conducted. Under 1 min of concentration time, a dendritic nanotip shows a higher sensitivity than a single nanotip. When the concentration time is 5 min, the sensitivity of a dendritic nanotip for T7 phage is 10(4) particles ml(-1). The dendritic nanotip-based concentrator has the potential for rapid identification of viral particles.

Nanotip analysis for dielectrophoretic concentration of nanosized viral particles

International Nuclear Information System (INIS)

Yeo, Woon-Hong; Lee, Hyun-Boo; Kim, Jong-Hoon; Chung, Jae-Hyun; Lee, Kyong-Hoon

2013-01-01

Rapid and sensitive detection of low-abundance viral particles is strongly demanded in health care, environmental control, military defense, and homeland security. Current detection methods, however, lack either assay speed or sensitivity, mainly due to the nanosized viral particles. In this paper, we compare a dendritic, multi-terminal nanotip (‘dendritic nanotip’) with a single terminal nanotip (‘single nanotip’) for dielectrophoretic (DEP) concentration of viral particles. The numerical computation studies the concentration efficiency of viral particles ranging from 25 to 100 nm in radius for both nanotips. With DEP and Brownian motion considered, when the particle radius decreases by two times, the concentration time for both nanotips increases by 4–5 times. In the computational study, a dendritic nanotip shows about 1.5 times faster concentration than a single nanotip for the viral particles because the dendritic structure increases the DEP-effective area to overcome the Brownian motion. For the qualitative support of the numerical results, the comparison experiment of a dendritic nanotip and a single nanotip is conducted. Under 1 min of concentration time, a dendritic nanotip shows a higher sensitivity than a single nanotip. When the concentration time is 5 min, the sensitivity of a dendritic nanotip for T7 phage is 10 4 particles ml −1 . The dendritic nanotip-based concentrator has the potential for rapid identification of viral particles. (paper)

Effects of concentrate replacement by feed blocks on ruminal fermentation and microbial growth in goats and single-flow continuous-culture fermenters.

Science.gov (United States)

Molina-Alcaide, E; Pascual, M R; Cantalapiedra-Hijar, G; Morales-García, E Y; Martín-García, A I

2009-04-01

The effect of replacing concentrate with 2 different feed blocks (FB) on ruminal fermentation and microbial growth was evaluated in goats and in single-flow continuous-culture fermenters. Diets consisted of alfalfa hay plus concentrate and alfalfa hay plus concentrate with 1 of the 2 studied FB. Three trials were carried out with 6 rumen-fistulated Granadina goats and 3 incubation runs in 6 single-flow continuous-culture fermenters. Experimental treatments were assigned randomly within each run, with 2 repetitions for each diet. At the end of each in vivo trial, the rumen contents were obtained for inoculating the fermenters. For each incubation run, the fermenters were inoculated with ruminal fluid from goats fed the same diet supplied to the corresponding fermenter flask. The average pH values, total and individual VFA, and NH(3)-N concentrations, and acetate:propionate ratios in the rumen of goats were not affected (P >or= 0.10) by diet, whereas the microbial N flow (MNF) and efficiency were affected (P fermenters, the diet affected pH (Por= 0.05), and total (P=0.02), NH(3) (P=0.005), and non-NH(3) (P=0.02) N flows, whereas the efficiency of VFA production was not affected (P=0.75). The effect of diet on MNF and efficiency depended on the bacterial pellet used as a reference. An effect (Pfermenter contents and effluent were similar (P=0.05). Differences (Pfermentation variables and bacterial pellet compositions were found. Partial replacement of the concentrate with FB did not greatly compromise carbohydrate fermentation in unproductive goats. However, this was not the case for MNF and efficiency. Differences between the results obtained in vivo and in vitro indicate a need to identify conditions in fermenters that allow better simulation of fermentation, microbial growth, and bacterial pellet composition in vivo. Reduced feeding cost could be achieved with the inclusion of FB in the diets of unproductive goats without altering rumen fermentation.

Concentrations of moxifloxacin in serum and pulmonary compartments following a single 400 mg oral dose in patients undergoing fibre-optic bronchoscopy.

Science.gov (United States)

Soman, A; Honeybourne, D; Andrews, J; Jevons, G; Wise, R

1999-12-01

The concentrations of moxifloxacin achieved after a single 400 mg dose were measured in serum, epithelial lining fluid (ELF), alveolar macrophages (AM) and bronchial mucosa (BM). Concentrations were determined using a microbiological assay. Nineteen patients undergoing fibre-optic bronchoscopy were studied. Mean serum, ELF, AM and BM concentrations at 2.2, 12 and 24 h were as follows: 2.2 h: 3.2 mg/L, 20.7 mg/L, 56.7 mg/L, 5.4 mg/kg; 12 h: 1.1 mg/L, 5.9 mg/L, 54.1 mg/L, 2.0 mg/kg; 24 h: 0.5 mg/L, 3.6 mg/L, 35.9 mg/L, 1.1 mg/kg, respectively. These concentrations exceed the MIC(90)s for common respiratory pathogens such as Streptococcus pneumoniae (0.25 mg/L), Haemophilus influenzae (0.03 mg/L), Moraxella catarrhalis (0.12 mg/L), Chlamydia pneumoniae (0.12 mg/L) and Mycoplasma pneumoniae (0. 12 mg/L) and indicate that moxifloxacin should be effective in the treatment of community-acquired, lower respiratory tract infections.

Tomographic Reconstruction of Tracer Gas Concentration Profiles in a Room with the Use of a Single OP-FTIR and Two Iterative Algorithms: ART and PWLS.

Science.gov (United States)

Park, Doo Y; Fessier, Jeffrey A; Yost, Michael G; Levine, Steven P

2000-03-01

Computed tomographic (CT) reconstructions of air contaminant concentration fields were conducted in a room-sized chamber employing a single open-path Fourier transform infrared (OP-FTIR) instrument and a combination of 52 flat mirrors and 4 retroreflectors. A total of 56 beam path data were repeatedly collected for around 1 hr while maintaining a stable concentration gradient. The plane of the room was divided into 195 pixels (13 × 15) for reconstruction. The algebraic reconstruction technique (ART) failed to reconstruct the original concentration gradient patterns for most cases. These poor results were caused by the "highly underdetermined condition" in which the number of unknown values (156 pixels) exceeds that of known data (56 path integral concentrations) in the experimental setting. A new CT algorithm, called the penalized weighted least-squares (PWLS), was applied to remedy this condition. The peak locations were correctly positioned in the PWLS-CT reconstructions. A notable feature of the PWLS-CT reconstructions was a significant reduction of highly irregular noise peaks found in the ART-CT reconstructions. However, the peak heights were slightly reduced in the PWLS-CT reconstructions due to the nature of the PWLS algorithm. PWLS could converge on the original concentration gradient even when a fairly high error was embedded into some experimentally measured path integral concentrations. It was also found in the simulation tests that the PWLS algorithm was very robust with respect to random errors in the path integral concentrations. This beam geometry and the use of a single OP-FTIR scanning system, in combination with the PWLS algorithm, is a system applicable to both environmental and industrial settings.

Endogenous concentrations, pharmacokinetics, and selected pharmacodynamic effects of a single dose of exogenous GABA in horses.

Science.gov (United States)

Knych, H K; Steinmetz, S J; McKemie, D S

2015-04-01

The anti-anxiety and calming effects following activation of the GABA receptor have been exploited in performance horses by administering products containing GABA. The primary goal of the study reported here was to describe endogenous concentrations of GABA in horses and the pharmacokinetics, selected pharmacodynamic effects, and CSF concentrations following administration of a GABA-containing product. The mean (±SD) endogenous GABA level was 36.4 ± 12.5 ng/mL (n = 147). Sixteen of these horses received a single intravenous and oral dose of GABA (1650 mg). Blood, urine, and cerebrospinal fluid (n = 2) samples were collected at time 0 and at various times for up to 48 h and analyzed using LC-MS. Plasma clearance and volume of distribution was 155.6 and 147.6 L/h and 0.154 and 7.39 L for the central and peripheral compartments, respectively. Terminal elimination half-life was 22.1 (intravenous) and 25.1 (oral) min. Oral bioavailability was 9.81%. Urine GABA concentrations peaked rapidly returning to baseline levels by 3 h. Horses appeared behaviorally unaffected following oral administration, while sedative-like changes following intravenous administration were transient. Heart rate was increased for 1 h postintravenous administration, and gastrointestinal sounds decreased for approximately 30 min following both intravenous and oral administration. Based on a limited number of horses and time points, exogenously administered GABA does not appear to enter the CSF to an appreciable extent. © 2014 John Wiley & Sons Ltd.

Organic Isothiocyanates: Dietary Modulators of Doxorubicin Resistance in Breast Cancer

Science.gov (United States)

2004-06-01

activation (16). In addition, ITCs can study, the compounds were ineffective at a concentration of induce phase II enzymes responsible for the...over 50% of drugs in clinical use including erythromycin, been reported in women as a result of higher alcohol lidocaine , and midazolam and is also

Applicability of a Single Time Point Strategy for the Prediction of Area Under the Concentration Curve of Linezolid in Patients

DEFF Research Database (Denmark)

Srinivas, Nuggehally R; Syed, Muzeeb

2016-01-01

Background and Objectives: Linezolid, a oxazolidinone, was the first in class to be approved for the treatment of bacterial infections arising from both susceptible and resistant strains of Gram-positive bacteria. Since overt exposure of linezolid may precipitate serious toxicity issues......, therapeutic drug monitoring (TDM) may be required in certain situations, especially in patients who are prescribed other co-medications. Methods: Using appropriate oral pharmacokinetic data (single dose and steady state) for linezolid, both maximum plasma drug concentration (Cmax) versus area under the plasma...... concentration–time curve (AUC) and minimum plasma drug concentration (Cmin) versus AUC relationship was established by linear regression models. The predictions of the AUC values were performed using published mean/median Cmax or Cmin data and appropriate regression lines. The quotient of observed and predicted...

Exfoliation in ecstasy: liquid crystal formation and concentration-dependent debundling observed for single-wall nanotubes dispersed in the liquid drug γ-butyrolactone

Science.gov (United States)

Bergin, Shane D.; Nicolosi, Valeria; Giordani, Silvia; de Gromard, Antoine; Carpenter, Leslie; Blau, Werner J.; Coleman, Jonathan N.

2007-11-01

Large-scale debundling of single-walled nanotubes has been demonstrated by dilution of nanotube dispersions in the solvent γ-butyrolactone. This liquid, sometimes referred to as 'liquid ecstasy', is well known for its narcotic properties. At high concentrations the dispersions form an anisotropic, liquid crystalline phase which can be removed by mild centrifugation. At lower concentrations an isotropic phase is observed with a biphasic region at intermediate concentrations. By measuring the absorbance before and after centrifugation, as a function of concentration, the relative anisotropic and isotropic nanotube concentrations can be monitored. The upper limit of the pure isotropic phase was CNT~0.004 mg ml-1, suggesting that this can be considered the nanotube dispersion limit in γ-butyrolactone. After centrifugation, the dispersions are stable against sedimentation and further aggregation for a period of 8 weeks at least. Atomic-force-microscopy studies on films deposited from the isotropic phase reveal that the bundle diameter distribution decreases dramatically as concentration is decreased. Detailed data analysis suggests the presence of an equilibrium bundle number density. A population of individual nanotubes is always observed which increases with decreasing concentration until almost 40% of all dispersed objects are individual nanotubes at a concentration of 6 × 10-4 mg ml-1. The number density of individual nanotubes peaks at a concentration of ~6 × 10-3 mg ml-1 where almost 10% of the nanotubes by mass are individualized.

Exfoliation in ecstasy: liquid crystal formation and concentration-dependent debundling observed for single-wall nanotubes dispersed in the liquid drug {gamma}-butyrolactone

Energy Technology Data Exchange (ETDEWEB)

Bergin, Shane D [School of Physics, Trinity College Dublin, University of Dublin, Dublin 2 (Ireland); Nicolosi, Valeria [School of Physics, Trinity College Dublin, University of Dublin, Dublin 2 (Ireland); Giordani, Silvia [School of Physics, Trinity College Dublin, University of Dublin, Dublin 2 (Ireland); Gromard, Antoine de [School of Physics, Trinity College Dublin, University of Dublin, Dublin 2 (Ireland); Carpenter, Leslie [School of Physics, Trinity College Dublin, University of Dublin, Dublin 2 (Ireland); Blau, Werner J [School of Physics, Trinity College Dublin, University of Dublin, Dublin 2 (Ireland); Coleman, Jonathan N [School of Physics, Trinity College Dublin, University of Dublin, Dublin 2 (Ireland)

2007-11-14

Large-scale debundling of single-walled nanotubes has been demonstrated by dilution of nanotube dispersions in the solvent {gamma}-butyrolactone. This liquid, sometimes referred to as 'liquid ecstasy', is well known for its narcotic properties. At high concentrations the dispersions form an anisotropic, liquid crystalline phase which can be removed by mild centrifugation. At lower concentrations an isotropic phase is observed with a biphasic region at intermediate concentrations. By measuring the absorbance before and after centrifugation, as a function of concentration, the relative anisotropic and isotropic nanotube concentrations can be monitored. The upper limit of the pure isotropic phase was C{sub NT}{approx}0.004 mg ml{sup -1}, suggesting that this can be considered the nanotube dispersion limit in {gamma}-butyrolactone. After centrifugation, the dispersions are stable against sedimentation and further aggregation for a period of 8 weeks at least. Atomic-force-microscopy studies on films deposited from the isotropic phase reveal that the bundle diameter distribution decreases dramatically as concentration is decreased. Detailed data analysis suggests the presence of an equilibrium bundle number density. A population of individual nanotubes is always observed which increases with decreasing concentration until almost 40% of all dispersed objects are individual nanotubes at a concentration of 6 x 10{sup -4} mg ml{sup -1}. The number density of individual nanotubes peaks at a concentration of {approx}6 x 10{sup -3} mg ml{sup -1} where almost 10% of the nanotubes by mass are individualized.

Exfoliation in ecstasy: liquid crystal formation and concentration-dependent debundling observed for single-wall nanotubes dispersed in the liquid drug γ-butyrolactone

International Nuclear Information System (INIS)

Bergin, Shane D; Nicolosi, Valeria; Giordani, Silvia; Gromard, Antoine de; Carpenter, Leslie; Blau, Werner J; Coleman, Jonathan N

2007-01-01

Large-scale debundling of single-walled nanotubes has been demonstrated by dilution of nanotube dispersions in the solvent γ-butyrolactone. This liquid, sometimes referred to as 'liquid ecstasy', is well known for its narcotic properties. At high concentrations the dispersions form an anisotropic, liquid crystalline phase which can be removed by mild centrifugation. At lower concentrations an isotropic phase is observed with a biphasic region at intermediate concentrations. By measuring the absorbance before and after centrifugation, as a function of concentration, the relative anisotropic and isotropic nanotube concentrations can be monitored. The upper limit of the pure isotropic phase was C NT ∼0.004 mg ml -1 , suggesting that this can be considered the nanotube dispersion limit in γ-butyrolactone. After centrifugation, the dispersions are stable against sedimentation and further aggregation for a period of 8 weeks at least. Atomic-force-microscopy studies on films deposited from the isotropic phase reveal that the bundle diameter distribution decreases dramatically as concentration is decreased. Detailed data analysis suggests the presence of an equilibrium bundle number density. A population of individual nanotubes is always observed which increases with decreasing concentration until almost 40% of all dispersed objects are individual nanotubes at a concentration of 6 x 10 -4 mg ml -1 . The number density of individual nanotubes peaks at a concentration of ∼6 x 10 -3 mg ml -1 where almost 10% of the nanotubes by mass are individualized

Total intravenous anesthesia with midazolam, ketamine, and xylazine or detomidine following induction with tiletamine, zolazepam, and xylazine in red deer (Cervus elaphus hippelaphus) undergoing surgery.

Science.gov (United States)

Auer, Ulrike; Wenger, Sandra; Beigelböck, Christoph; Zenker, Wolfgang; Mosing, Martina

2010-10-01

Sixteen captive female red deer were successfully anesthetized to surgically implant a telemetry system. The deer were immobilized with (mean±SD) 1.79±0.29 mg/kg xylazine and 1.79±0.29 mg/kg tiletamine/zolazepam given intramuscularly with a dart gun. Anesthesia was maintained for 69±2 min using a total intravenous protocol with a catheter placed in the jugular vein. Group X received xylazine (0.5±0.055 mg/kg/hr) and group D, detomidine (2±0.22 μg/kg/hr), both in combination with ketamine (2±0.02 mg/kg/hr) and midazolam (0.03±0.0033 mg/kg/hr), as a constant rate infusion. Anesthesia was reversed with 0.09±0.01 mg/kg atipamezole and 8.7±1.21 μg/kg sarmazenil given intravenously in both groups. These drug combinations provided smooth induction, stable anesthesia for surgery, and rapid recovery. Respiratory depression and mild hypoxemia were seen, and we, therefore, recommend using supplemental intranasal oxygen.

A single exposure of sediment sulphate-reducing bacteria to oxytetracycline concentrations relevant to aquaculture enduringly disturbed their activity, abundance and community structure.

Science.gov (United States)

Fernández, M L; Granados-Chinchilla, F; Rodríguez, C

2015-08-01

Although feed medicated with antibiotics is widely used in animal production to prevent and treat bacterial infections, the effect of these drugs on nontarget anaerobic bacteria is unknown. We aimed to clarify whether a single exposure of sulphate-reducing bacteria (SRB) from a tilapia pond to oxytetracycline (OTC) concentrations relevant to aquaculture impacts their function, abundance and community structure. To demonstrate changes in SO4(2-) content, SRB abundance, dsrB copy number and SRB diversity, sediment mesocosms were spiked with 5, 25, 50 and 75 mg OTC kg(-1) and examined for 30 days by means of ion chromatography, qPCR, cultivation and fluorescent in situ hybridization (FISH). On day 3, we measured higher SO4(2-) concentrations (ca. two-fold) and a reduction in dsrB copy numbers of approximately 50% in the treatments compared to the controls. After 30 days, a subtle yet measurable enrichment of bacteria from the order Desulfovibrionales occurred in mesocosms receiving ≥ 50 mg OTC kg(-1), notwithstanding that SRB counts decreased two orders of magnitude. OTC was dynamically and reversibly converted into 4-epioxytetracycline and other related compounds in a dose-dependent manner during the experiment. A single exposure to rather high OTC concentrations triggered functional and structural changes in a SRB community that manifested quickly and persisted for a month. This study improves our limited knowledge on the ecotoxicology of antibiotics in anaerobic environments. © 2015 The Society for Applied Microbiology.

Case study of a grid connected with a battery photovoltaic system: V-trough concentration vs. single-axis tracking

International Nuclear Information System (INIS)

Tina, G.M.; Scandura, P.F.

2012-01-01

Highlights: ► PV systems with sun tracking and concentrators (CPVS) can reduce the cost of energy per kWh produced. ► The V-trough low-concentration system solution is compatible with flat PV module technologies. ► Optical, thermal and electrical models are needed to forecast real power production. ► The description of a PV grid connected system with batteries, a one-axis tracker and CPV photovoltaic system is presented. ► Outdoor measurements of the generating system are provided and discussed. - Abstract: Photovoltaic systems (PVSs) combined with either some form of storage, such as a battery energy storage system (BESS), or direct load control, can play a crucial role in achieving a more economical operation of the electric utility system while enhancing its reliability with additional energy sources. At the same time, it is also important to use cost-effective PV solutions. In this context, a low-concentration PVS (CPVS) is analysed as a feasible alternative. This paper, present a case study of a complex PVS, composed of two PVSs, a storage system (BEES) and an inverter that allows the system to operate in both the island and grid-connected modes. The first PVS, is a 2.76-kWp single-axis tracking system (azimuth) with modules facing south and tilted 30°, while the second PVS is a dual-axis tracking system, rated 860 Wp, consisting of a concentrator at the flat mirrors (DoubleSun® Four). The system is installed on the roof of the main building of the “ITIS Marconi” school (Italy). A detailed description of the system is provided, and preliminary operating data are presented and discussed. The efficiencies of the PV systems are calculated and measured to evaluate the cost effectiveness of a low-concentration system.

Propofol for procedural sedation and analgesia reduced dedicated emergency nursing time while maintaining safety in a community emergency department.

Science.gov (United States)

Reynolds, Joshua C; Abraham, Michael K; Barrueto, Fermin F; Lemkin, Daniel L; Hirshon, Jon M

2013-09-01

Procedural sedation and analgesia is a core competency in emergency medicine. Propofol is replacing midazolam in many emergency departments. Barriers to performing procedural sedation include resource utilization. We hypothesized that emergency nursing time is shorter with propofol than midazolam, without increasing complications. Retrospective analysis of a procedural sedation registry for two community emergency departments with combined census of 100,000 patients/year. Demographics, procedure, and ASA physical classification status of adult patients receiving procedural sedation between 2007-2010 with midazolam or propofol were analyzed. Primary outcome was dedicated emergency nursing time. Secondary outcomes were procedural success, ED length of stay, and complication rate. Comparative statistics were performed with Mann-Whitney, Kruskal-Wallis, chi-square, or Fisher's exact test. Linear regression was performed with log-transformed procedural sedation time to define predictors. Of 328 procedural sedation and analgesia, 316 met inclusion criteria, of which 60 received midazolam and 256 propofol. Sex distribution varied between groups (midazolam 3% male; propofol 55% male; P = 0.04). Age, procedure, and ASA status were not significantly different. Propofol had shorter procedural sedation time (propofol 32.5 ± 24.2 minutes; midazolam 78.7 ± 51.5 minutes; P differences between complication rates (propofol 14%; midazolam 13%; P = 0.88) or emergency department length of stay (propofol 262.5 ± 132.8 minutes; midazolam 288.6 ± 130.6 minutes; P = 0.09). Use of propofol resulted in shorter emergency nursing time and higher procedural success rate than midazolam with a comparable safety profile. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

Development of a single-meal fish consumption advisory for methyl mercury

Energy Technology Data Exchange (ETDEWEB)

Ginsberg, G.L.; Toal, B.F.

2000-02-01

Methyl mercury (meHg) contamination of fish is the leading cause of fish consumption advisories in the US. These advisories have focused upon repeated or chronic exposure, whereas risks during pregnancy may also exist from a single-meal exposure if the fish tissue concentration is high enough. In this study, acute exposure to meHg from a single fish meal was analyzed by using the one-compartment meHg biokinetic model to predict maternal hair concentrations. These concentrations were evaluated against the mercury hair concentration corresponding to the US Environmental Protection Agency's reference dose (RfD), which is intended to protect against neurodevelopmental effects. The one-compartment model was validated against blood concentrations from three datasets in which human subjects ingested meHg in fish, either as a single meal or multiple meals. Model simulations of the single-meal scenario at different fish meHg concentrations found that concentrations of 2.0 ppm or higher can be associated with maternal hair concentrations elevated above the RfD level for days to weeks during gestation. A single-meal fish concentration cutoff of {ge} 2.0 ppm is an important consideration, especially because this single high exposure event might be in addition to a baseline meHg body burden from other types of fish consumption. This type of single-meal advisory requires that fish sampling programs provide data for individual rather than composited fish, and take into account seasonal differences that may exist in fish concentrations.

A generalized model for site percolation with two independent concentrations

International Nuclear Information System (INIS)

Lin Jiancheng.

1987-05-01

In this paper the usual site percolation problem with single concentration is generalized to the one that contains two independent concentrations. Using the real space renormalization technique we derive an exact transformation for the one dimensional lattice and a cluster transformation for triangle lattice in two dimensions. The critical exponents and the percolation threshold concentrations obtained are the same as those of the usual single concentration percolation problem. Critical line and flow diagram in the two concentration parameters space are also given. (author). 10 refs, 6 figs

Cardiopulmonary effects of medetomidine or midazolam in combination with ketamine or tiletamine / zolazepam for the immobilisation of captive cheetahs (Acinonyx jubatus

Directory of Open Access Journals (Sweden)

G.F. Stegmann

2006-06-01

Full Text Available Captive cheetah (Acinonyx jubatus scheduled for either general health examination or dental surgery were immobilised with combinations of medetomidine-ketamine (K/DET, n = 19, midazolam-ketamine (K/MID, n = 4 or medetomidine-tiletamine-zolazepam (Z/DET, n=5. Induction time and arterial blood pressure was not statistically significantly (P > 0.05 different between treatment groups. Transient seizures were observed in the K/DET treated animals during induction. Hypertension was present in all groups during anaesthesia with mean(+SD systolic pressure of 30.7+5.0 kPa for the K/DET group, 27.7+ 2.7 kPa for the K/MID group, and 33.1+4.6 kPa for the Z/DET group. Heart rate was statistically significantly (P < 0.05 lower in the K/DET group (69 + 13.2 beats/min compared to the K/MID group (97 + 22.6 beats/min, and ventilation rate was statistically significantly (P < 0.05 lower in the K/MID group (15 + 0.0 breaths/min compared with the K/DET group (21+4.6. A metabolic acidosis and hypoxia were observed during anaesthesia when breathing air. Oxygen (O2 administration resulted in a statistically significant (P < 0.05 increase in the arterial partial pressure of carbon dioxide (hypercapnoea, arterial partial pressure of O2, and % oxyhaemoglobin saturation.

Effectiveness of flumazenil on return of cognitive functions after a general anesthetic.

Science.gov (United States)

Pregler, J L; Mok, M S; Steen, S N

1994-09-01

Benzodiazepines used intra-operatively can occasionally cause prolonged sedation. Flumazenil (Romazicon) is an imidazobenzodiazepine that functions as a benzodiazepine receptor antagonist. This clinical investigation was designed to evaluate the efficacy and of intravenous flumazenil in reversing the central effects of midazolam after a general anesthetic using midazolam for maintenance. 30 ASA I-III inpatients entered and completed this study. All were interviewed preoperatively and baseline performance on a battery of psychomotor tests was obtained. Parameters measured included an assessment of sleep status, vital signs, responsiveness to verbal stimuli, quality of speech, facial expression, eye coordination, recognition of a picture card, finger-finger-to-nose (FFN) coordination and overall discharge readiness. General anesthesia was induced with midazolam. Midazolam and fentanyl were the primary maintenance agents combined with N2O and O2 (70:30) and a limited concentration of isoflurane. In the recovery room the test drug was administered in a double-blinded, randomized manner. 20 patients received flumazenil (F), the rest placebo (P). Testing was done at times 0, 5, 15, 30, 60, 120, and 180 min in the PACU. Memory testing consisted of recall of study pictures at 180 min and recognition on the first postoperative day. Demographic data were similar for both groups with the exception of age. The F group had a higher mean composite score (comprising responsiveness to verbal stimuli, speech, facial expression and eye coordination) and better FFN scores at 5, 15, and 30 min (p pictures better at 5 and 15 min (p WORDS)

KETAMINE-MEDETOMIDINE AND KETAMINE-MEDETOMIDINE-MIDAZOLAM ANESTHESIA IN CAPTIVE CHEETAHS (ACINONYX JUBATUS)-COMPARISON OF BLOOD PRESSURE AND KIDNEY BLOOD FLOW.

Science.gov (United States)

Stagegaard, Julia; Hørlyck, Arne; Hydeskov, Helle B; Bertelsen, Mads F

2017-06-01

Six clinically healthy captive cheetahs ( Acinonyx jubatus ) were anesthetized twice using two different drug combinations to investigate if blood pressure and kidney blood flow are affected by medetomidine dosage. Protocol KM (2.0 mg/kg ketamine and 0.05 mg/kg medetomidine) was compared with protocol KMM (2.0 mg/kg ketamine, 0.02 mg/kg medetomidine, and 0.1 mg/kg midazolam). Heart rate (HR), respiratory rate (RR), body temperature, end-tidal carbon dioxide pressure (ETCO 2 ), and anesthetic depth were monitored every 10 min. Noninvasive mean (MAP), systolic (SAP), and diastolic (DAP) arterial blood pressure were measured, and Duplex Doppler ultrasonography was performed on the kidneys. The mean arterial resistive index (RI) was determined and the pulse pressure index (PPI) was calculated, as indicators for kidney blood flow. There were no significant differences in induction and recovery times. MAP was significantly higher with KM than KMM at 35 min, and in both protocols decreased significantly after atipamezole administration. DAP was significantly higher at 25 and 35 min in animals anesthetized with KM; it also decreased significantly with both protocols after atipamezole administration. The PPI was significantly lower throughout the procedure with KM, and with both protocols increased significantly after atipamezole administration. Both the higher blood pressure and the reduced PPI with KM were likely a direct effect of the higher medetomidine dosage, and these findings indicate that lower medetomidine dosages might reduce hypertension and lead to a better PPI in cheetah immobilization.

Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection. Vol. 47/No. RR-4.

Science.gov (United States)

1998-04-17

suppression. • The following drugs may increase ZDV concentration (and therefore potential toxicity): probenecid, atovaquone, methadone , valproic acid...antihistamines (e.g., astemizole orterfenadine); certain cardiac drugs (e.g., amiodarone, bepridil hydrochloride , encainide hydrochlo- ride, flecainide...flurazepam hydrochloride , midazolam, triazolam, or zolpidem tartrate); certain psychotropic drugs (e.g., bupropion hydrochloride , clozapine, or pimoz

Efeitos da associação de tiletamina/zolazepam ou cetamina S(+/midazolam/tramadol para contenção química em bugios-ruivos (Allouatta guariba clamitans Effects of tiletamine/zolazepam or S(+ ketamine/midazolam/tramadol for chemical contention in red howler monkeys (Allouatta guariba clamitans

Directory of Open Access Journals (Sweden)

Pâmela Spolti

2013-02-01

Full Text Available Avaliaram-se dois protocolos para contenção química em bugios-ruivos. Para tal, foram utilizados 12 macacos bugios, hígidos, com peso médio de 6,4±0,4 kg, os quais foram submetidos a jejum alimentar e hídrico de seis e duas horas, respectivamente. Os animais foram alocados em dois grupos que receberam injeção via intramuscular: TZ (n=6, os quais receberam uma associação de tiletamina e zolazepam (Zoletil® na dose de 3,6mg/kg e CEMTRA (n=6, que receberam cetamina S(+, midazolam e tramadol (Cemtra ®, lote piloto 001/10, Ouro Fino Saúde Animal Ltda., Cravinhos, SP-Brasil, constituído por 100mg/ml de cetamina S+, 20mg/ml de tramadol e 10mg/ml de midazolam na dose de 1ml da associação para cada 10kg de peso corporal, correspondendo às doses de 10mg/kg, 1mg/kg e 2mg/kg, respectivamente. Anteriormente a administração dos fármacos (M0 foram avaliadas: frequência cardíaca (FC e respiratória (f, temperatura retal (TR, tempo de preenchimento capilar (TPC, pressão arterial sistólica (PAS, saturação de oxigênio na hemoglobina (SpO2, presença de salivação, grau de miorrelaxamento e sedação, índice Bispectral (BIS e Sinal de Qualidade do BIS (SQI, resposta ao pinçamento interdigital e tempos de latência, deambulação e de recuperação total (TRT. Os parâmetros foram reavaliados em M5, M10, M20, M30, M40 e M50 (5, 10, 20, 30, 40 e 50 minutos após a administração dos fármacos. No TZ os animais foram mais responsivos ao pinçamento interdigital ao longo dos tempos. Os animais do CEMTRA apresentaram maior grau de miorrelaxamento e de sedação. A f do CEMTRA foi menor após a administração do tratamento em todos os momentos em relação ao M0. Entre grupos a f do CEMTRA foi menor em relação ao TZ em M2 e M4. Os tempos totais de sedação e de recuperação foram de 48±4 e 150,1±42,1 min para o CEMTRA e de 38±7 e 73,1±20,6 para o TZ. Conclui-se que ambas as formulações são seguras para contenção química de

Intranasal sedatives in pediatric dentistry

Science.gov (United States)

AlSarheed, Maha A.

2016-01-01

Objectives: To identify the intranasal (IN) sedatives used to achieve conscious sedation during dental procedures amongst children. Methods: A literature review was conducted by identifying relevant studies through searches on Medline. Search included IN of midazolam, ketamine, sufentanil, dexmedetomidine, clonidine, haloperidol and loranzepam. Studies included were conducted amongst individuals below 18 years, published in English, and were not restricted by year. Exclusion criteria were articles that did not focus on pediatric dentistry. Results: Twenty studies were included. The most commonly used sedatives were midazolam, followed by ketamine and sufentanil. Onset of action for IN midazolam was 5-15 minutes (min), however, IN ketamine was faster (mean 5.74 min), while both IN sufentanil (mean 20 min) and IN dexmedetomidine (mean 25 min) were slow in comparison. Midazolam was effective for modifying behavior in mild to moderately anxious children, however, for more invasive or prolonged procedures, stronger sedatives, such as IN ketamine, IN sufentanil were recommended. In addition, ketamine fared better in overall success rate (89%) when compared with IN midazolam (69%). Intranasal dexmedetomidine was only used as pre-medication amongst children. While its’ onset of action is longer when compared with IN midazolam, it produced deeper sedation at the time of separation from the parent and at the time of anesthesia induction. Conclusion: Intranasal midazolam, ketamine and sufentanil are effective and safe for conscious sedation, while intranasal midazolam, dexmedetomidine and sufentanil have proven to be effective premedications. PMID:27570849

The concentrations of clinafloxacin in alveolar macrophages, epithelial lining fluid, bronchial mucosa and serum after administration of single 200 mg oral doses to patients undergoing fibre-optic bronchoscopy.

Science.gov (United States)

Honeybourne, D; Andrews, J M; Cunningham, B; Jevons, G; Wise, R

1999-01-01

The concentrations of clinafloxacin were measured in serum, bronchial mucosa, alveolar macrophages and epithelial lining fluid after single 200 mg oral doses of clinafloxacin had been administered to 15 subjects who were undergoing bronchoscopy. Concentrations were measured using a microbiological assay method. Mean concentrations in serum, bronchial mucosa, alveolar macrophages and epithelial lining fluid at a mean of 1.27 h post-dose were 1.54, 2.65, 15.60 and 2.71 mg/L respectively. These site concentrations exceeded the MIC90 for common respiratory pathogens and indicate that clinafloxacin is likely to be effective in the treatment of a wide range of respiratory tract infections.

Rapid concentration and dialysis of proteins with single hollow fibers: possible applications in analysis of protein secretion by isolated cells and steroid radioimmunoassays

International Nuclear Information System (INIS)

Rommerts, F.F.G.; Clotscher, W.F.; Van der Molen, H.J.

1977-01-01

Single hollow fibers were used in specially made cells for fast concentration and dialysis of solutions containing macromolecules. Volumes on the order of 5 ml of diluted protein solutions could be concentrated to 50--100 μl or less within 7 min with a protein recovery of 60--80%. More than 99% of the molecules with a molecular weight less than 500 could be removed in less than 1 hr. A possible application of the rapid dialysis method for the mechanization of radioimmunoassays is indicated. It was shown that in the radioimmunoassay of steriods the unbound steroids could be removed after incubation with antiserum, within 10 min and without a change in volume

Determination of blood leukocyte concentration with constant volume acquisition on a flow cytometer is comparable to individualized single platform testing with beads as internal reference standard

DEFF Research Database (Denmark)

Hansen, Susan; Dahl, Ronald; Hoffmann, Hans Jürgen

2008-01-01

at a high rate has a median of 163 microl (IQR 156-170) with TruCount tubes. Leukocyte concentrations of 26 healthy volunteers were measured twice on up to four occasions with a Bürker-Türk chamber, by single platform technology (SPT) with TruCount tubes and on the same data set using CVA. Total leukocyte...... concentrations determined by CVA correlated better with measurements in a Bürker-Türk (BT) chamber than with SPT. Concentrations determined with CVA were 1.86% higher than with BT whereas SPT data were 5.35% higher than BT (p...LeukoGating can be established using microscopy as a reference, and is comparable to BT chamber and SPT determination. Leukocyte concentrations can be measured with CVA on flow cytometers in research and clinical settings....

Radiation-induced segregation on defect clusters in single-phase concentrated solid-solution alloys

International Nuclear Information System (INIS)

Lu, Chenyang; Yang, Taini; Jin, Ke; Gao, Ning; Xiu, Pengyuan; Zhang, Yanwen; Gao, Fei; Bei, Hongbin; Weber, William J.; Sun, Kai; Dong, Yan; Wang, Lumin

2017-01-01

A group of single-phase concentrated solid-solution alloys (SP-CSAs), including NiFe, NiCoFe, NiCoFeCr, as well as a high entropy alloy NiCoFeCrMn, was irradiated with 3 MeV Ni"2"+ ions at 773 K to a fluence of 5 × 10"1"6 ions/cm"2 for the study of radiation response with increasing compositional complexity. Advanced transmission electron microscopy (TEM) with electron energy loss spectroscopy (EELS) was used to characterize the dislocation loop distribution and radiation-induced segregation (RIS) on defect clusters in the SP-CSAs. The results show that a higher fraction of faulted loops exists in the more compositionally complex alloys, which indicate that increasing compositional complexity can extend the incubation period and delay loop growth. The RIS behaviors of each element in the SP-CSAs were observed as follows: Ni and Co tend to enrich, but Cr, Fe and Mn prefer to deplete near the defect clusters. RIS level can be significantly suppressed by increasing compositional complexity due to the sluggish atom diffusion. According to molecular static (MS) simulations, “disk” like segregations may form near the faulted dislocation loops in the SP-CSAs. Segregated elements tend to distribute around the whole faulted loop as a disk rather than only around the edge of the loop.

Single Molecule Nano-Metronome

OpenAIRE

Buranachai, Chittanon; McKinney, Sean A.; Ha, Taekjip

2006-01-01

We constructed a DNA-based nano-mechanical device called the nano-metronome. Our device is made by introducing complementary single stranded overhangs at the two arms of the DNA four-way junction. The ticking rates of this stochastic metronome depend on ion concentrations and can be changed by a set of DNA-based switches to deactivate/reactivate the sticky end. Since the device displays clearly distinguishable responses even with a single basepair difference, it may lead to a single molecule ...

Prehospital Care for the Adult and Pediatric Seizure Patient: Current Evidence Based Recommendations

Directory of Open Access Journals (Sweden)

Eric C. Silverman

2017-04-01

Full Text Available Introduction: We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of adult and pediatric patients with a seizure and to compare these recommendations against the current protocol used by the 33 emergency medical services (EMS agencies in California. Methods: We performed a review of the evidence in the prehospital treatment of patients with a seizure, and then compared the seizure protocols of each of the 33 EMS agencies for consistency with these recommendations. We analyzed the type and route of medication administered, number of additional rescue doses permitted, and requirements for glucose testing prior to medication. The treatment for eclampsia and seizures in pediatric patients were analyzed separately. Results: Protocols across EMS Agencies in California varied widely. We identified multiple drugs, dosages, routes of administration, re-dosing instructions, and requirement for blood glucose testing prior to medication delivery. Blood glucose testing prior to benzodiazepine administration is required by 61% (20/33 of agencies for adult patients and 76% (25/33 for pediatric patients. All agencies have protocols for giving intramuscular benzodiazepines and 76% (25/33 have protocols for intranasal benzodiazepines. Intramuscular midazolam dosages ranged from 2 to 10 mg per single adult dose, 2 to 8 mg per single pediatric dose, and 0.1 to 0.2 mg/kg as a weight-based dose. Intranasal midazolam dosages ranged from 2 to 10 mg per single adult or pediatric dose, and 0.1 to 0.2 mg/kg as a weight-based dose. Intravenous/intrasosseous midazolam dosages ranged from 1 to 6 mg per single adult dose, 1 to 5 mg per single pediatric dose, and 0.05 to 0.1 mg/kg as a weight-based dose. Eclampsia is specifically addressed by 85% (28/33 of agencies. Forty-two percent (14/33 have a protocol for administering magnesium sulfate, with intravenous dosages ranging from 2 to 6 mg, and 58% (19/33 allow benzodiazepines to be

Unpredictable drug reaction in a child with Cornelia de Lange syndrome.

Science.gov (United States)

Stevic, Marija; Milojevic, Irina; Bokun, Zlatko; Simic, Dusica

2015-02-01

Preoperative use of midazolam sedation is mandatory during induction of anesthesia in noncooperative and hyperactive children to prevent possible obstacles. Unusual drug reactions rarely occur in patients undergoing anesthesia or in intensive care unit. This report describes an unpredictable drug reaction after a routine midazolam premedication in a patient with no history of allergy. There has been no literature data yet to show that midazolam can provoke respiratory problems in patients with Cornelia de Lange Syndrome. In our opinion midazolam should be avoided in patients with Cornelia de Lange Syndrome, which we enforced after first unpredictable reaction.

Single gold nanoparticle plasmonic spectroscopy for study of chemical-dependent efflux function of single ABC transporters of single live Bacillus subtilis cells.

Science.gov (United States)

Browning, Lauren M; Lee, Kerry J; Cherukuri, Pavan K; Huang, Tao; Songkiatisak, Preeyaporn; Warren, Seth; Xu, Xiao-Hong Nancy

2018-03-26

ATP-binding cassette (ABC) membrane transporters serve as self-defense transport apparatus in many living organisms and they can selectively extrude a wide variety of substrates, leading to multidrug resistance (MDR). The detailed molecular mechanisms remain elusive. Single nanoparticle plasmonic spectroscopy highly depends upon their sizes, shapes, chemical and surface properties. In our previous studies, we have used the size-dependent plasmonic spectra of single silver nanoparticles (Ag NPs) to study the real-time efflux kinetics of the ABC (BmrA) transporter and MexAB-OprM transporter in single live cells (Gram-positive and Gram-negative bacterium), respectively. In this study, we prepared and used purified, biocompatible and stable (non-aggregated) gold nanoparticles (Au NPs) (12.4 ± 0.9 nm) to study the efflux kinetics of single BmrA membrane transporters of single live Bacillus subtillis cells, aiming to probe chemical dependent efflux functions of BmrA transporters and their potential chemical sensing capability. Similar to those observed using Ag NPs, accumulation of the intracellular Au NPs in single live cells (WT and ΔBmrA) highly depends upon the cellular expression of BmrA and the NP concentration (0.7 and 1.4 nM). The lower accumulation of intracellular Au NPs in WT (normal expression of BmrA) than ΔBmrA (deletion of bmrA) indicates that BmrA extrudes the Au NPs out of the WT cells. The accumulation of Au NPs in the cells increases with NP concentration, suggesting that the Au NPs most likely passively diffuse into the cells, similar to antibiotics. The result demonstrates that such small Au NPs can serve as imaging probes to study the efflux function of the BmrA membrane transporter in single live cells. Furthermore, the dependence of the accumulation rate of intracellular Au NPs in single live cells upon the expression of BmrA and the concentration of the NPs is about twice higher than that of the same sized Ag NPs. This interesting finding

Effect of fertilizer type on cadmium and fluorine concentrations in clover herbage

International Nuclear Information System (INIS)

McLaughlin, M.J.

2002-01-01

This study investigated whether changing phosphatic fertilizer type affects the accumulation of cadmium (Cd) and fluorine (F) in pasture herbage. North Carolina phosphate rock and partially acidulated fertilizers derived from this rock generally have higher Cd and F concentrations compared to single superphosphate currently manufactured in Australia. Clover herbage from sites of the National Reactive Phosphate Rock (RPR) trial was collected and analysed for concentrations of Cd (11 sites) and F (4 sites). A comparison was made between pastures fertilized with 4 rates of single superphosphate, North Carolina phosphate rock, and partially acidulated phosphate rock having Cd concentrations of 283, 481, and 420 mg Cd/kg P respectively, and 170, 271, and 274 g F/kg P respectively. One site used Hemrawein (Egypt) phosphate rock (HRP) having a Cd and F concentration of 78 mg Cd/kg P and 256 g F/kg P respectively. To help identify differences in herbage Cd concentrations between sites, unfertilised soils from each site were analyzed for total and extractable Cd contents. At one site Cd concentrations in bulk herbage (clover, grasses and weeds) were related to infestation of the pasture by capeweed (Arctotheca calendula L. Levyns). There were no significant differences between F in herbage from plots fertilized with single superphosphate, partially acidulated phosphate rock or North Carolina phosphate rock, or between sites. Concentrations of F in herbage were low, generally less than 10 mg F /kg. However, there were large differences in Cd concentrations in herbage between sites, while differences between fertilizer treatments were small in comparison. The site differences were only weakly related to total or extractable (0.01 mol/L CaCl 2 ) Cd concentrations in soil. Significant differences in Cd concentrations in clover due to fertilizer type were found at 5 sites. North Carolina phosphate rock treatments had significantly higher Cd concentrations in clover compared to

Intranasal Midazolam versus Rectal Diazepam for the Management of Canine Status Epilepticus: A Multicenter Randomized Parallel-Group Clinical Trial.

Science.gov (United States)

Charalambous, M; Bhatti, S F M; Van Ham, L; Platt, S; Jeffery, N D; Tipold, A; Siedenburg, J; Volk, H A; Hasegawa, D; Gallucci, A; Gandini, G; Musteata, M; Ives, E; Vanhaesebrouck, A E

2017-07-01

Intranasal administration of benzodiazepines has shown superiority over rectal administration for terminating emergency epileptic seizures in human trials. No such clinical trials have been performed in dogs. To evaluate the clinical efficacy of intranasal midazolam (IN-MDZ), via a mucosal atomization device, as a first-line management option for canine status epilepticus and compare it to rectal administration of diazepam (R-DZP) for controlling status epilepticus before intravenous access is available. Client-owned dogs with idiopathic or structural epilepsy manifesting status epilepticus within a hospital environment were used. Dogs were randomly allocated to treatment with IN-MDZ (n = 20) or R-DZP (n = 15). Randomized parallel-group clinical trial. Seizure cessation time and adverse effects were recorded. For each dog, treatment was considered successful if the seizure ceased within 5 minutes and did not recur within 10 minutes after administration. The 95% confidence interval was used to detect the true population of dogs that were successfully treated. The Fisher's 2-tailed exact test was used to compare the 2 groups, and the results were considered statistically significant if P status epilepticus in 70% (14/20) and 20% (3/15) of cases, respectively (P = .0059). All dogs showed sedation and ataxia. IN-MDZ is a quick, safe and effective first-line medication for controlling status epilepticus in dogs and appears superior to R-DZP. IN-MDZ might be a valuable treatment option when intravenous access is not available and for treatment of status epilepticus in dogs at home. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Single Molecule Nano-Metronome

Science.gov (United States)

Buranachai, Chittanon; McKinney, Sean A.; Ha, Taekjip

2008-01-01

We constructed a DNA-based nano-mechanical device called the nano-metronome. Our device is made by introducing complementary single stranded overhangs at the two arms of the DNA four-way junction. The ticking rates of this stochastic metronome depend on ion concentrations and can be changed by a set of DNA-based switches to deactivate/reactivate the sticky end. Since the device displays clearly distinguishable responses even with a single basepair difference, it may lead to a single molecule sensor of minute sequence differences of a target DNA. PMID:16522050

Associação de cetamina S(+ e midazolam pelo método convencional de cálculo e pela extrapolação alométrica em bugios-ruivo (Alouatta guariba clamitans: resposta clínica e cardiorrespiratória S(+ ketamine and midazolam association by the conventional method of calculation and allometric extrapolation in red howler monkeys (Alouatta guariba clamitans: clinical and cardiopulmonary response

Directory of Open Access Journals (Sweden)

Joana Aurora Braun Chagas

2010-02-01

Full Text Available O objetivo deste estudo foi avaliar o protocolo de contenção química com cetamina S(+ e midazolam em bugios-ruivos, comparando o cálculo de doses pelo método convencional e o método de extrapolação alométrica. Foram utilizados 12 macacos bugios (Alouatta guariba clamitans hígidos, com peso médio de 4,84±0,97kg, de ambos os sexos. Após jejum alimentar de 12 horas e hídrico de seis horas, realizou-se contenção física manual e aferiram-se os seguintes parâmetros: frequência cardíaca (FC, frequência respiratória (f, tempo de preenchimento capilar (TPC, temperatura retal (TR, pressão arterial sistólica não invasiva (PANI e valores de hemogasometria arterial. Posteriormente, os animais foram alocados em dois grupos: GC (Grupo Convencional, n=06, os quais receberam cetamina S(+ (5mg kg-1 e midazolam (0,5mg kg-1, pela via intramuscular, com doses calculadas pelo método convencional; e GA (Grupo Alometria, n=06, os quais receberam o mesmo protocolo, pela mesma via, utilizando-se as doses calculadas pelo método de extrapolação alométrica. Os parâmetros descritos foram mensurados novamente nos seguintes momentos: M5, M10, M20 e M30 (cinco, 10, 20 e 30 minutos após a administração dos fármacos, respectivamente. Também foram avaliados: qualidade de miorrelaxamento, reflexo podal e caudal, pinçamento interdigital, tempo para indução de decúbito, tempo hábil de sedação, qualidade de sedação, e tempo e qualidade de recuperação. O GA apresentou menor tempo para indução ao decúbito, maior grau e tempo de sedação, bem como redução significativa da FC e PANI de M5 até M30, quando comparado ao GC. Conclui-se que o grupo no qual o cálculo de dose foi realizado por meio da alometria (GA apresentou melhor grau de relaxamento muscular e sedação, sem produzir depressão cardiorrespiratória significativa.The aim of this study was to evaluate a protocol of chemical restraint comparing the conventional method of

Nonimaging polygonal mirrors achieving uniform irradiance distributions on concentrating photovoltaic cells.

Science.gov (United States)

Schmitz, Max; Dähler, Fabian; Elvinger, François; Pedretti, Andrea; Steinfeld, Aldo

2017-04-10

We introduce a design methodology for nonimaging, single-reflection mirrors with polygonal inlet apertures that generate a uniform irradiance distribution on a polygonal outlet aperture, enabling a multitude of applications within the domain of concentrated photovoltaics. Notably, we present single-mirror concentrators of square and hexagonal perimeter that achieve very high irradiance uniformity on a square receiver at concentrations ranging from 100 to 1000 suns. These optical designs can be assembled in compound concentrators with maximized active area fraction by leveraging tessellation. More advanced multi-mirror concentrators, where each mirror individually illuminates the whole area of the receiver, allow for improved performance while permitting greater flexibility for the concentrator shape and robustness against partial shading of the inlet aperture.

Efeitos sedativos da associação de Cetamina e Midazolam administrados pela via intranasal ou intramuscular em papagaio (Amazona aestiva e Amazona vinacea

Directory of Open Access Journals (Sweden)

Eduarda H. Bitencourt

2013-09-01

Full Text Available A falta de protocolos de sedação seguros para uso em papagaios na literatura demonstra a necessidade de conhecer os anestésicos que são eficazes nestes animais. Devido a pouca massa muscular desta espécie, notou-se a necessidade de estudar outra via de administração, menos invasiva e dolorosa ao animal, como a via intranasal. O objetivo deste estudo foi avaliar os efeitos sedativos e a viabilidade da administração intranasal, em comparação à via intramuscular, de 15mg/kg de Cetamina e 1mg/kg de Midazolam. Foram utilizados 14 papagaios das espécies Amazona aestiva e Amazona vinacea, de ambos os sexos, adultos, peso médio de 388,5±29,1g. Os animais foram distribuídos aleatoriamente em dois grupos: intramuscular (IM, n=7 e intranasal (IN, n=7. No grupo intramuscular, a administração dos anestésicos foi realizada nos músculos peitorais, utilizando seringas de insulina e no grupo intranasal, com auxílio de uma micropipeta. Avaliou-se o período de latência, tempo de duração, qualidade de sedação, e o tempo de recuperação total. A média para o período de latência no grupo IM foi de 6,13±2,02 minutos e no grupo IN de 4,84±2,37 minutos. Já para o tempo de duração da sedação no grupo IM a média foi de 35,81±29,56 e no grupo IN de 24,52±14,83 minutos. Ambas as vias promoveram sedação adequada, pois a média do escore da qualidade de sedação obtida pelo grupo IM foi 2±1,5 e pelo grupo IN 1,28±1,1. O tempo de recuperação total no grupo IM foi de 27,04±11,69 e no grupo IN de 17,67±11,64 minutos. Apesar do grupo IN ter apresentado os menores tempos de período de latência, duração e de recuperação total e ter obtido melhor escore na qualidade de sedação, não houve diferença estatística significativa entre os grupos. Os resultados obtidos neste estudo indicam que a administração de 15 mg/kg de cetamina e 1mg/kg de midazolam pela via intranasal ou intramuscular em papagaios (Amazona aestiva e

Alcohol sensor based on single-mode-multimode-single-mode fiber structure

Science.gov (United States)

Mefina Yulias, R.; Hatta, A. M.; Sekartedjo, Sekartedjo

2016-11-01

Alcohol sensor based on Single-mode -Multimode-Single-mode (SMS) fiber structure is being proposed to sense alcohol concentration in alcohol-water mixtures. This proposed sensor uses refractive index sensing as its sensing principle. Fabricated SMS fiber structure had 40 m of multimode length. With power input -6 dBm and wavelength 1550 nm, the proposed sensor showed good response with sensitivity 1,983 dB per % v/v with measurement range 05 % v/v and measurement span 0,5% v/v.

Concentrated Solutions of Single-Chain Nanoparticles: A Simple Model for Intrinsically Disordered Proteins under Crowding Conditions.

Science.gov (United States)

Moreno, Angel J; Lo Verso, Federica; Arbe, Arantxa; Pomposo, José A; Colmenero, Juan

2016-03-03

By means of large-scale computer simulations and small-angle neutron scattering (SANS), we investigate solutions of single-chain nanoparticles (SCNPs), covering the whole concentration range from infinite dilution to melt density. The analysis of the conformational properties of the SCNPs reveals that these synthetic nano-objects share basic ingredients with intrinsically disordered proteins (IDPs), as topological polydispersity, generally sparse conformations, and locally compact domains. We investigate the role of the architecture of the SCNPs in their collapse behavior under macromolecular crowding. Unlike in the case of linear macromolecules, which experience the usual transition from self-avoiding to Gaussian random-walk conformations, crowding leads to collapsed conformations of SCNPs resembling those of crumpled globules. This behavior is already found at volume fractions (about 30%) that are characteristic of crowding in cellular environments. The simulation results are confirmed by the SANS experiments. Our results for SCNPs--a model system free of specific interactions--propose a general scenario for the effect of steric crowding on IDPs: collapse from sparse conformations at high dilution to crumpled globular conformations in cell environments.

Short- and long-term temporal changes in soil concentrations of selected endocrine disrupting compounds (EDCs) following single or multiple applications of sewage sludge to pastures

International Nuclear Information System (INIS)

Rhind, S.M.; Kyle, C.E.; Ruffie, H.; Calmettes, E.; Osprey, M.; Zhang, Z.L.; Hamilton, D.; McKenzie, C.

2013-01-01

Temporal changes in soil burdens of selected endocrine disrupting compounds were determined following application to pasture of either sewage sludge or inorganic fertilizer. Soil polycyclic aromatic hydrocarbon and polychlorinated biphenyl concentrations were not altered. Changes in concentrations of diethylhexyl phthalate (DEHP) and PBDEs 47 and 99 differed with season but concentrations remained elevated for more than three weeks after application, when grazing animals are normally excluded from pasture. It is concluded that single applications of sewage sludge can increase soil concentrations of some, but not all classes of EDCs, possibly to concentrations sufficient to exert biological effects when different chemicals act in combination, but patterns of change depend on season and soil temperature. Analysis of soil from pasture subjected to repeated sludge applications, over 13 years, provided preliminary evidence of greater increases in soil burdens of all of the EDC groups measured, including all of the PBDE congeners measured. -- Highlights: •Sewage sludge or inorganic fertilizer was applied to pasture. •Soil PAH and PCB concentrations were not altered by sludge treatment. •Temporal changes in soil phthalate and PBDE differed with season. •Some soil EDC levels were elevated for more than three weeks after application. -- Effects of sewage sludge application to pastures on temporal changes in soil concentrations of endocrine disrupting compounds differ with chemical class and season

Salt Concentration Differences Alter Membrane Resistance in Reverse Electrodialysis Stacks

KAUST Repository

Geise, Geoffrey M.; Curtis, Andrew J.; Hatzell, Marta C.; Hickner, Michael A.; Logan, Bruce E.

2014-01-01

Membrane ionic resistance is usually measured by immersing the membrane in a salt solution at a single, fixed concentration. While salt concentration is known to affect membrane resistance when the same concentration is used on both sides

Effectiveness of Sedoanalgesia in Percutaneous Liver Biopsy Premedication

Science.gov (United States)

Sezgin, Orhan; Ates, Fehmi; Altintas, Engin; Saritas, Bunyamin

2017-01-01

Aim: Percutaneous needle liver biopsy (PLB) is frequently associated with pain and anxiety. This may discourage the patients for biopsy, and rebiopsies, if needed. We planned a study to investigate the efficacy of additional analgesia or sedation for PLB. Materials and methods: The study has been designed as a single-center, prospective study. The PLB was planned for 18- to 65-year-old consecutive patients who were included in the study. The patients were divided into three premedication groups as control, Meperidine, and Midazolam. Hospital Anxiety and Depression Scale (HADS) was used to measure each subject’s anxiety level. Fifteen minutes before the biopsy, 1 mL 0.9% NaCl subcutaneously (sc), 1 mg/kg (max 100 mg) Meperidine sc, or 0.1 mg/kg (max 5 mg) Midazolam intravenously was administered to patients respectively. Then PLB was done with 16 G Menghini needle. The day after, the patients were asked about feelings regarding biopsy. Results: Groups were similar by gender and age. The HADS scores prior to PLB and on visual analog scale (VAS, 1-10 points) score during PLB were similar. In the three groups, 7, 12, and 7 patients, respectively, experienced no pain. Other patients explained pain as mild or moderate or severe. The number of patients who agreed for possible rebiopsy was higher in Meperidine and Midazolam groups than in the control group. Conclusion: Premedication with Meperidine or Midazolam in PLB would improve patients’ tolerance, comfort, and attitude against a possible repeat PLB. How to cite this article: Sezgin O, Yaras S, Ates F, Altintas E, Saritas B. Effectiveness of Sedoanalgesia in Percutaneous Liver Biopsy Premedication. Euroasian J Hepato-Gastroenterol 2017;7(2):146-149. PMID:29201797

A Comparison of Intramuscular Anesthetic Techniques in Chickens

Directory of Open Access Journals (Sweden)

Shahin Hajighahramani

2017-02-01

Full Text Available Background & Objective: Administration of anesthetic substances to chickens requires careful consideration for the safe delivery of the agent to the bird. The research objective was to evaluate several drug combinations for intramuscular anesthesia in chickens for physiologic, nutritional, pharmacological and other investigations. Meterial & Methods: Sixty healthy chickens were randomly assigned in six treatment groups and received Ketamine in combination with Xylazine, Midazolam or Acepromazine. Heart and respiratory rate, induction time, duration of surgical anesthesia and light anesthesia were measured. Results: Induction of anesthesia was significantly longer following Acepromazine- Ketamine and Midazolam- Ketamine compared to other groups (P<0.05. Duration of surgical anesthesia was longest with Xylazine- Midazolam- Ketamine and shortest with Midazolam-Ketamine and Acepromazine- Ketamine (P<0.05. Conclusion: In conclusion, the most effective drug combinations resulting in longer duration of surgical anesthesia, were Xylazine- Acepromazine- Ketamine and Xylazine- Midazolam- Ketamine. Other combinations did not produce appropriate surgical anesthesia, but they make slight changes in physiological data.

Fundamental limits to position determination by concentration gradients.

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Filipe Tostevin

2007-04-01

Full Text Available Position determination in biological systems is often achieved through protein concentration gradients. Measuring the local concentration of such a protein with a spatially varying distribution allows the measurement of position within the system. For these systems to work effectively, position determination must be robust to noise. Here, we calculate fundamental limits to the precision of position determination by concentration gradients due to unavoidable biochemical noise perturbing the gradients. We focus on gradient proteins with first-order reaction kinetics. Systems of this type have been experimentally characterised in both developmental and cell biology settings. For a single gradient we show that, through time-averaging, great precision potentially can be achieved even with very low protein copy numbers. As a second example, we investigate the ability of a system with oppositely directed gradients to find its centre. With this mechanism, positional precision close to the centre improves more slowly with increasing averaging time, and so longer averaging times or higher copy numbers are required for high precision. For both single and double gradients, we demonstrate the existence of optimal length scales for the gradients for which precision is maximized, as well as analyze how precision depends on the size of the concentration-measuring apparatus. These results provide fundamental constraints on the positional precision supplied by concentration gradients in various contexts, including both in developmental biology and also within a single cell.

Development of a novel method for simultaneous concentration of viruses and protozoa from a single water sample.

Science.gov (United States)

Haramoto, Eiji; Katayama, Hiroyuki; Asami, Mari; Akiba, Michihiro

2012-06-01

A novel method, electronegative membrane-vortex (EMV) method, was developed for simultaneous concentration of viruses and protozoa from a single water sample. Viruses and protozoa in a water sample were mixed with a cation solution and adsorbed on an electronegative membrane. Concentrated virus and protozoa samples were obtained as supernatant and pellet fractions, respectively, by vigorous vortex mixing of the membrane and centrifugation of the eluted material. The highest recovery efficiencies of model microbes from river water and tap water by this EMV method were obtained using a mixed cellulose ester membrane with a pore size of 0.45 μm (Millipore) as the electronegative membrane and MgCl(2) as the cation solution. The recovery was 27.7-86.5% for poliovirus, 25.7-68.3% for coliphage Qβ, 28.0-60.0% for Cryptosporidium oocysts, and 35.0-53.0% for Giardia cysts. The EMV method detected successfully indigenous viruses and protozoa in wastewater and river water samples from the Kofu basin, Japan, showing an overall positive rate of 100% (43/43) for human adenovirus, 79% (34/43) for norovirus GI, 65% (28/43) for norovirus GII, 23% (10/43) for Cryptosporidium oocysts, and 60% (26/43) for Giardia cysts. By direct DNA sequencing, a total of four genotypes (AI, AII, B, and G) of Giardia intestinalis were identified in the water samples, indicating that the river water was contaminated with feces from various mammals, including humans. Copyright © 2012 Elsevier B.V. All rights reserved.

The effect of ethanol concentration on the direct ethanol fuel cell performance and products distribution: A study using a single fuel cell/attenuated total reflectance - Fourier transform infrared spectroscopy

Science.gov (United States)

Assumpção, M. H. M. T.; Nandenha, J.; Buzzo, G. S.; Silva, J. C. M.; Spinacé, E. V.; Neto, A. O.; De Souza, R. F. B.

2014-05-01

The effect of ethanol concentration on the direct ethanol fuel cell (DEFC) performance and products distribution were studied in situ using a single fuel cell/ATR-FTIR setup. The experiments were performed at 80 °C using commercial Pt3Sn/C as anodic catalyst and the concentrations of ethanol solution were varied from 0.1 to 2.0 mol L-1. An increase in power density was observed with the increase of ethanol concentration to 1.0 mol L-1, while the band intensities analysis in the FTIR spectra revealed an increase of acetic acid/acetaldehyde ratio with the increase of ethanol concentration. Also, from FTIR spectra results, it could be concluded that the acetic acid production follow parallel mechanisms; that is, it does not require the presence of acetaldehyde as an intermediate.

Refractive Secondary Solar Concentrator Being Designed and Developed

Science.gov (United States)

Macosko, Robert P.; Donovan, Richard M.

1998-01-01

As the need for achieving super high temperatures (2000 K and above) in solar heat receivers has developed so has the need for secondary concentrators. These concentrators refocus the already highly concentrated solar energy provided by a primary solar collector, thereby significantly reducing the light entrance aperture of the heat receiver and the resulting infrared radiation heat loss from the receiver cavity. Although a significant amount of research and development has been done on nonimaging hollow reflective concentrators, there has been no other research or development to date on solid, single crystal, refractive concentrators that can operate at temperatures above 2000 K. The NASA Lewis Research Center recently initiated the development of single-crystal, optically clear, refractive secondary concentrators that, combined with a flux extractor, offer a number of significant advantages over the more conventional, hollow, reflective concentrators at elevated temperatures. Such concentrators could potentially provide higher throughput (efficiency), require no special cooling device, block heat receiver material boiloff from the receiver cavity, provide for flux tailoring in the cavity via the extractor, and potentially reduce infrared heat loss via an infrared block coating.The many technical challenges of designing and fabricating high-temperature refractive secondary concentrators and flux extractors include identifying optical materials that can survive the environment (high-temperature, vacuum and/or hydrogen atmosphere), developing coatings for enhanced optical and thermal performance, and developing crystal joining techniques and hardware that can survive launch loads.

Effective viscous flow properties for fiber suspensions under concentrated conditions

International Nuclear Information System (INIS)

Christensen, R.M.

1993-01-01

The effective longitudinal and transverse shear viscosities are derived for an aligned fiber suspension. The solutions are valid under very concentrated conditions for a hexagonal arrangement of the single size fibers. The results compliment the classical dilute suspension forms at the other extreme of concentration. Empirical forms are constructed to cover the full range of volume fraction of the fiber phase. Also, single size spherical particle suspensions are given a similar treatment to that of the fiber case

Steady-State Serum T3 Concentrations for 48 Hours Following the Oral Administration of a Single Dose of 3,5,3'-Triiodothyronine Sulfate (T3S).

Science.gov (United States)

Santini, Ferruccio; Giannetti, Monica; Ricco, Ilaria; Querci, Giorgia; Saponati, Giorgio; Bokor, Daniela; Rivolta, Giovanni; Bussi, Simona; Braverman, Lewis E; Vitti, Paolo; Pinchera, Aldo

2014-07-01

Sulfate conjugation of thyroid hormones is an alternate metabolic pathway that facilitates the biliary and urinary excretion of iodothyronines and enhances their deiodination rate, leading to the generation of inactive metabolites. A desulfating pathway reverses this process, and thyromimetic effects have been observed following the parenteral administration of 3,5,3'-triiodothyronine (T3) sulfate (T3S) in rats. The present study investigated whether T3S is absorbed after oral administration in humans and if it represents a source of T3. Twenty-eight hypothyroid patients (7 men and 21 women; mean age, 44 ± 11 years) who had a thyroidectomy for thyroid carcinoma were enrolled. Replacement thyroid hormone therapy was withdrawn (42 days for thyroxine, 14 days for T3) prior to 131I remnant ablation. A single oral dose of 20, 40, 80 (4 patients/group), or 160 μg (16 patients/group) of T3S was administered 3 days before the planned administration of 131I. Blood samples for serum T3S and total T3 (TT3) concentrations were obtained at various times up to 48 hours after T3S administration. At all T3S doses, serum T3S concentrations increased, reaching a peak at 2 to 4 hours and progressively returning to basal levels within 8 to 24 hours. The T3S maximum concentration (Cmax) and area under the 0- to 48-hour concentration-time curve (AUC0-48h) were directly and significantly related to the administered dose. An increase in serum TT3 concentration was observed (significant after 1 hour), and the concentration increased further at 2 and 4 hours and then remained steady up to 48 hours after T3S administration. There was a significant direct correlation between the TT3 AUC0-48h and the administered dose of T3S. No changes in serum free thyroxine (T4) concentrations during the entire study period were observed, whereas serum thyroid-stimulating hormone levels increased slightly at 48 hours, but this was not related to the dose of T3S. No adverse events were reported. (1) T3S is

Physiological Responses and Gene Expression in Ultrasound-Guided Supraclavicular Brachial Plexus Block: a Comparative Study

Directory of Open Access Journals (Sweden)

Hayam G Sayyed

2018-05-01

Full Text Available Background/Aims: Ultrasound-guided supraclavicular brachial plexus block (BPB has come into wider use as a regional anesthetic during upper limb operations. This study assessed the neurological and hemodynamic changes and gene expression after co-administration of midazolam or neostigmine with bupivacaine during supraclavicular BPB. Methods: The study involved 90 adults divided into three groups: control (bupivacaine, midazolam (bupivacaine plus midazolam, and neostigmine (bupivacaine plus neostigmine. Blood samples were taken and interleukin-6 (IL-6 and tumor necrosis factor-alpha (TNF-α mRNA levels were measured by real-time PCR, and oxidative stress markers were identified. In addition to the hemodynamic variables, the onset and duration of sensory and motor blockades, duration of analgesia, pain scores, time of first request for an analgesic, and amounts of analgesics ingested were evaluated. Results: Compared with the control and neostigmine groups, the midazolam group experienced longer sensory and motor blockades, prolonged analgesia, lower pain scores at 12 h and 24 h, and lower need for postoperative analgesics. Moreover, the midazolam group exhibited lower oxidative stress markers with a higher fold change in IL-6 and TNF-α mRNA levels. Conclusion: Midazolam co-administered with bupivacaine provided better analgesic quality than did neostigmine with bupivacaine. This might be due to its superior antioxidant and anti-inflammatory effects.

Mechanics of single-walled carbon nanotubes inside open single-walled carbon nanocones

International Nuclear Information System (INIS)

Ansari, R.; Hosseinzadeh, M.

2013-01-01

This study investigates the mechanical characteristics of single-walled carbon nanotubes (CNTs) inside open single-walled carbon nanocones (CNCs). New semi-analytical expressions are presented to evaluate van der Waals (vdW) interactions between CNTs and open CNCs. Continuum approximation, along with the the Lennard-Jones (LJ) potential function, is used in this study. The effects of geometrical parameters on alterations in vdW potential energy and the interaction force are extensively examined for the concentric CNT-open CNC configuration. The CNT is assumed to enter the nanocone either through the small end or the wide end of the cone. The preferred position of the CNT with respect to the nanocone axis is fully investigated for various geometrical parameters. The optimum nanotube radius minimizing the total potential energy of the concentric configuration is determined for different radii of the small end of the cone. The examined configuration generates asymmetric oscillation; thus, the system constitutes a nano-oscillator.

Concentration polarization in nanochannel DNA electrophoresis

NARCIS (Netherlands)

Dubsky, P.; Das, Siddhartha; van den Berg, Albert; Eijkel, Jan C.T.

2011-01-01

We demonstrate that the large field electrophoresis of a single DNA molecule in nanofluidic systems is accompanied by concentration polarization. We illustrate this phenomena by utilizing our electrophoretic simulation tool SIMUL. First we in-vestigate a simple system with univalent strong

Studies on the concentration dependence of specific rotation of Alpha lactose monohydrate (α-LM) aqueous solutions and growth of α-LM single crystals

Science.gov (United States)

Vinodhini, K.; Divya Bharathi, R.; Srinivasan, K.

2018-02-01

Lactose is an optically active substance. As it is one of the reducing sugars, exhibits mutarotation in solution when it dissolves in any solvent. In solution, lactose exists in two isomeric forms, alpha-Lactose (α-L) and beta-lactose (β-L) through the mutarotation reaction. Mutarotation produces a dynamic equilibrium between two isomers in a solution and kinetics of this process determines the growth rate of alpha lactose monohydrate (α-LM) crystals. Since no data were available on the specific rotation of aqueous α-LM solutions at different concentrations at 33 °C, the initial experiments were carried out on the specific rotation of aqueous α-LM solutions at different concentrations at 33 °C. The specific rotations of the solutions were decreased with increasing time through the mutarotation reaction. The initial and final (equilibrium) specific rotations of the solutions were determined by using automatic digital polarimeter. The compositions of α and β-L in all prepared solutions were calculated from initial and final optical rotations by the method of Sharp and Doob. The composition of α-L decreased whereas, the composition of β-L increased in solutions with increasing concentration of α-LM at 33 °C. Experimental results revealed that this method could be easily and safely employed to study the dependence of specific rotation of solutions on their concentration. The effect of β-lactose on the morphology of nucleated α-LM single crystals has been studied at different experimental conditions.

Pressure drop in T's in concentric ducts

International Nuclear Information System (INIS)

Shock, R.A.W.

1983-02-01

A set of experiments has been carried out to measure the pressure drop characteristics of single-phase flow in dividing and joining right-angled T's in a concentric ducting system. These have been compared with measured pressure drops in a simple round tube system. In most tests with the concentric system the number of velocity heads lost is either similar to, or more than, the value for the round tubes. (author)

Locomotor differences in Mongolian gerbils with the effects of ...

African Journals Online (AJOL)

Locomotor differences in Mongolian gerbils with the effects of midazolam ... African Health Sciences ... We subjected the gerbils to an adapted “Open Field” to determine the possible effects on central nervous system of midazolam. Gerbils ...

A single exposure to a sublethal pediocin concentration initiates a resistance-associated temporal cell envelope and general stress response in Listeria monocytogenes

DEFF Research Database (Denmark)

Laursen, Martin Frederik; Bahl, Martin Iain; Licht, Tine Rask

2015-01-01

was to determine if exposure to sublethal concentrations of pediocin-containing Lactobacillus plantarum WHE 92 supernatant could prime L. monocytogenes for resistance. By transcriptomic analysis, we found two, 55 and 539 genes differentially expressed after 10, 60 and 180 min of exposure to L. plantarum WHE 92...... resistant than wild types to L. plantarum WHE 92 supernatant. LisRK, SigB and SigL regulation and genes associated with resistance are involved in the temporal adaptive response to pediocin and all three regulatory systems affect pediocin resistance. Thus, a single exposure to a sublethal pediocin...

A compact spectrum splitting concentrator for high concentration photovoltaics based on the dispersion of a lens

Science.gov (United States)

He, J.; Flowers, C. A.; Yao, Y.; Atwater, H. A.; Rockett, A. A.; Nuzzo, R. G.

2018-06-01

Photovoltaic devices used in conjunction with functional optical elements for light concentration and spectrum splitting are known to be a viable approach for highly efficient photovoltaics. Conventional designs employ discrete optical elements, each with the task of either performing optical concentration or separating the solar spectrum. In the present work, we examine the performance of a compact photovoltaic architecture in which a single lens plays a dual role as both a concentrator and a spectrum splitter, the latter made possible by exploiting its intrinsic dispersion. A four-terminal two-junction InGaP/GaAs device is prepared to validate the concept and illustrates pathways for improvements. A spectral separation in the visible range is demonstrated at the focal point of a plano-convex lens with a geometric concentration ratio of 1104X with respect to the InGaP subcell.

Single-cell measurement of red blood cell oxygen affinity.

Science.gov (United States)

Di Caprio, Giuseppe; Stokes, Chris; Higgins, John M; Schonbrun, Ethan

2015-08-11

Oxygen is transported throughout the body by hemoglobin (Hb) in red blood cells (RBCs). Although the oxygen affinity of blood is well-understood and routinely assessed in patients by pulse oximetry, variability at the single-cell level has not been previously measured. In contrast, single-cell measurements of RBC volume and Hb concentration are taken millions of times per day by clinical hematology analyzers, and they are important factors in determining the health of the hematologic system. To better understand the variability and determinants of oxygen affinity on a cellular level, we have developed a system that quantifies the oxygen saturation, cell volume, and Hb concentration for individual RBCs in high throughput. We find that the variability in single-cell saturation peaks at an oxygen partial pressure of 2.9%, which corresponds to the maximum slope of the oxygen-Hb dissociation curve. In addition, single-cell oxygen affinity is positively correlated with Hb concentration but independent of osmolarity, which suggests variation in the Hb to 2,3-diphosphoglycerate (2-3 DPG) ratio on a cellular level. By quantifying the functional behavior of a cellular population, our system adds a dimension to blood cell analysis and other measurements of single-cell variability.

A portable concentrator for processing plutonium

International Nuclear Information System (INIS)

Chamberlain, D.B.; Conner, C.; Chen, L.

1995-01-01

A horizontal, agitated film concentrator designed to concentrate liquid streams to a high solid content slurry is briefly described. The Rototherm unit is being studied for use at US Department of Energy facilities to handle large quantities of aqueous plutonium solutions. Capabilities for evaporating more than 98% of the water present in a single pass have been demonstrated. Decontamination factors of 10 6 to 10 7 are expected. The unit may also be useful for recycling aqueous waste treatment reagents from the decontamination of gaseous diffusion plants

Simultaneous determination of zolazepam and tiletamine in dog plasma by liquid chromatography coupled to a tandem mass spectrometry.

Science.gov (United States)

Noh, Kyeumhan; Kim, Kil-Soo; Ahn, Byoungki; Archimbault, Pillippe; Oh, Tae-Ho; Kang, Wonku

2012-10-01

A mixture of tiletamine, a dissociative anesthetic, and zolazepam, a minor tranquilizer, has been widely used as an anesthetic or an immobilizing agent in a variety of animal species. However, interestingly, their pharmacokinetic behaviors have been published only in polar bears and pigs. In this study, we introduce a sensitive liquid chromatography/tandem mass spectrometry (LC/MS/MS) method for determining the two drugs in dog plasma. After simple protein precipitation with acetonitrile including midazolam (internal standard), the analytes were chromatographed on a reversed-phase column with a mobile phase of 10 m m ammonium acetate aqueous solution and acetonitrile (1:4, v/v). The accuracy and precision of the assay were in accordance with FDA regulations for the validation of bioanalytical methods. This method was used to measure the concentrations of zolazepam and tiletamine in plasma after a single intramuscular 10 mg dose of each in beagle dogs. Copyright © 2012 John Wiley & Sons, Ltd.

A high-gain, compact, nonimaging concentrator: RXI.

Science.gov (United States)

Miñano, J C; Gonźlez, J C; Benítez, P

1995-12-01

The design procedure of a new nonimaging concentrator (called an RXI) is explained. Rays that impinge on the concentrator aperture, within the acceptance angle, are directed to the receiver by means of one refraction, one reflection, and one total internal reflection. The concentrator can be made as a single dielectric piece (in which the receiver is immersed) whose aspect ratio (thickness/aperture diameter) is close to 1/3. Ray-tracing analysis of a rotational symmetric RXI shows total transmissions of greater than 94.5% (no absorption or reflection losses are considered) when the acceptance angle of the incoming rays is small (<3°) and when the receiver area is the smallest possible (maximal concentration.).

Tracking integration in concentrating photovoltaics using laterally moving optics.

Science.gov (United States)

Duerr, Fabian; Meuret, Youri; Thienpont, Hugo

2011-05-09

In this work the concept of tracking-integrated concentrating photovoltaics is studied and its capabilities are quantitatively analyzed. The design strategy desists from ideal concentration performance to reduce the external mechanical solar tracking effort in favor of a compact installation, possibly resulting in lower overall cost. The proposed optical design is based on an extended Simultaneous Multiple Surface (SMS) algorithm and uses two laterally moving plano-convex lenses to achieve high concentration over a wide angular range of ±24°. It achieves 500× concentration, outperforming its conventional concentrating photovoltaic counterparts on a polar aligned single axis tracker.

Activation of ERK2 in basolateral amygdala underlies the promoting influence of stress on fear memory and anxiety: influence of midazolam pretreatment.

Science.gov (United States)

Maldonado, N M; Espejo, P J; Martijena, I D; Molina, V A

2014-02-01

Exposure to emotionally arousing experiences elicits a robust and persistent memory and enhances anxiety. The amygdala complex plays a key role in stress-induced emotional processing and in the fear memory formation. It is well known that ERK activation in the amygdala is a prerequisite for fear memory consolidation. Moreover, stress elevates p-ERK2 levels in several areas of the brain stress circuitry. Therefore, given that the ERK1/2 cascade is activated following stress and that the role of this cascade is critical in the formation of fear memory, the present study investigated the potential involvement of p-ERK2 in amygdala subnuclei in the promoting influence of stress on fear memory formation and on anxiety-like behavior. A robust and persistent ERK2 activation was noted in the Basolateral amygdala (BLA), which was evident at 5min after restraint and lasted at least one day after the stressful experience. Midazolam, a short-acting benzodiazepine ligand, administered prior to stress prevented the increase in the p-ERK2 level in the BLA. Pretreatment with intra-BLA infusion of U0126 (MEK inhibitor), but not into the adjacent central nucleus of the amygdala, attenuated the stress-induced promoting influence on fear memory formation. Finally, U0126 intra-BLA infusion prevented the enhancement of anxiety-like behavior in stressed animals. These findings suggest that the selective ERK2 activation in BLA following stress exposure is an important mechanism for the occurrence of the promoting influence of stress on fear memory and on anxiety-like behavior. © 2013 Published by Elsevier B.V. and ECNP.

Pollutant threshold concentration determination in marine ecosystems using an ecological interaction endpoint

International Nuclear Information System (INIS)

Wang, Changyou; Liang, Shengkang; Guo, Wenting; Yu, Hua; Xing, Wenhui

2015-01-01

The threshold concentrations of pollutants are determined by extrapolating single-species effect data to community-level effects. This assumes the most sensitive endpoint of the life cycle of individuals and the species sensitivity distribution from single-species toxic effect tests, thus, ignoring the ecological interactions. The uncertainties due to this extrapolation can be partially overcome using the equilibrium point of a customized ecosystem. This method incorporates ecological interactions and integrates the effects on growth, survival, and ingestion into a single effect measure, the equilibrium point excursion in the customized ecosystem, in order to describe the toxic effects on plankton. A case study showed that the threshold concentration of copper calculated with the endpoint of the equilibrium point was 10 μg L −1 , which is significantly different from the threshold calculated with a single-species endpoint. The endpoint calculated using this method provides a more relevant measure of the ecological impact than any single individual-level endpoint. - Highlights: • Ecotoxicological effect of exposure to copper was tested on a customized ecosystem. • Equilibrium point of biomasses in the customized ecosystem was used as an endpoint. • Exposure–response relationship in a community level was built on equilibrium point. • A threshold concentration incorporating ecological interactions was derived. - The equilibrium biomass incorporating ecological interactions in a customized ecosystem was used as an endpoint to calculate the threshold concentration at a community level

Nonimaging optics in luminescent solar concentration.

Science.gov (United States)

Markman, B D; Ranade, R R; Giebink, N C

2012-09-10

Light trapped within luminescent solar concentrators (LSCs) is naturally limited in angular extent by the total internal reflection critical angle, θcrit, and hence the principles of nonimaging optics can be leveraged to increase LSC concentration ratio by appropriately reshaping the edges. Here, we use rigorous ray-tracing simulations to explore the potential of this concept for realistic LSCs with compound parabolic concentrator (CPC)-tapered edges and show that, when applied to a single edge, the concentration ratio is increased by 23% while maintaining >90% of the original LSC optical efficiency. Importantly, we find that CPC-tapering all of the edges enables a significantly greater intensity enhancement up to 35% at >90% of the original optical efficiency, effectively enabling two-dimensional concentration through a cooperative, ray-recycling effect in which rays rejected by one CPC are accepted by another. These results open up a significant opportunity to improve LSC performance at virtually no added manufacturing cost by incorporating nonimaging optics into their design.

White butterflies as solar photovoltaic concentrators

Science.gov (United States)

Shanks, Katie; Senthilarasu, S.; Ffrench-Constant, Richard H.; Mallick, Tapas K.

2015-07-01

Man’s harvesting of photovoltaic energy requires the deployment of extensive arrays of solar panels. To improve both the gathering of thermal and photovoltaic energy from the sun we have examined the concept of biomimicry in white butterflies of the family Pieridae. We tested the hypothesis that the V-shaped posture of basking white butterflies mimics the V-trough concentrator which is designed to increase solar input to photovoltaic cells. These solar concentrators improve harvesting efficiency but are both heavy and bulky, severely limiting their deployment. Here, we show that the attachment of butterfly wings to a solar cell increases its output power by 42.3%, proving that the wings are indeed highly reflective. Importantly, and relative to current concentrators, the wings improve the power to weight ratio of the overall structure 17-fold, vastly expanding their potential application. Moreover, a single mono-layer of scale cells removed from the butterflies’ wings maintained this high reflectivity showing that a single layer of scale cell-like structures can also form a useful coating. As predicted, the wings increased the temperature of the butterflies’ thorax dramatically, showing that the V-shaped basking posture of white butterflies has indeed evolved to increase the temperature of their flight muscles prior to take-off.

White butterflies as solar photovoltaic concentrators.

Science.gov (United States)

Shanks, Katie; Senthilarasu, S; Ffrench-Constant, Richard H; Mallick, Tapas K

2015-07-31

Man's harvesting of photovoltaic energy requires the deployment of extensive arrays of solar panels. To improve both the gathering of thermal and photovoltaic energy from the sun we have examined the concept of biomimicry in white butterflies of the family Pieridae. We tested the hypothesis that the V-shaped posture of basking white butterflies mimics the V-trough concentrator which is designed to increase solar input to photovoltaic cells. These solar concentrators improve harvesting efficiency but are both heavy and bulky, severely limiting their deployment. Here, we show that the attachment of butterfly wings to a solar cell increases its output power by 42.3%, proving that the wings are indeed highly reflective. Importantly, and relative to current concentrators, the wings improve the power to weight ratio of the overall structure 17-fold, vastly expanding their potential application. Moreover, a single mono-layer of scale cells removed from the butterflies' wings maintained this high reflectivity showing that a single layer of scale cell-like structures can also form a useful coating. As predicted, the wings increased the temperature of the butterflies' thorax dramatically, showing that the V-shaped basking posture of white butterflies has indeed evolved to increase the temperature of their flight muscles prior to take-off.

Applicability of a Single Time Point Strategy for the Prediction of Area Under the Concentration Curve of Linezolid in Patients: Superiority of Ctrough- over Cmax-Derived Linear Regression Models.

Science.gov (United States)

Srinivas, Nuggehally R; Syed, Muzeeb

2016-03-01

Linezolid, a oxazolidinone, was the first in class to be approved for the treatment of bacterial infections arising from both susceptible and resistant strains of Gram-positive bacteria. Since overt exposure of linezolid may precipitate serious toxicity issues, therapeutic drug monitoring (TDM) may be required in certain situations, especially in patients who are prescribed other co-medications. Using appropriate oral pharmacokinetic data (single dose and steady state) for linezolid, both maximum plasma drug concentration (Cmax) versus area under the plasma concentration-time curve (AUC) and minimum plasma drug concentration (Cmin) versus AUC relationship was established by linear regression models. The predictions of the AUC values were performed using published mean/median Cmax or Cmin data and appropriate regression lines. The quotient of observed and predicted values rendered fold difference calculation. The mean absolute error (MAE), root mean square error (RMSE), correlation coefficient (r), and the goodness of the AUC fold prediction were used to evaluate the two models. The Cmax versus AUC and trough plasma concentration (Ctrough) versus AUC models displayed excellent correlation, with r values of >0.9760. However, linezolid AUC values were predicted to be within the narrower boundary of 0.76 to 1.5-fold by a higher percentage by the Ctrough (78.3%) versus Cmax model (48.2%). The Ctrough model showed superior correlation of predicted versus observed values and RMSE (r = 0.9031; 28.54%, respectively) compared with the Cmax model (r = 0.5824; 61.34%, respectively). A single time point strategy of using Ctrough level is possible as a prospective tool to measure the AUC of linezolid in the patient population.

Temporal Variability of Microplastic Concentrations in Freshwater Streams

Science.gov (United States)

Watkins, L.; Walter, M. T.

2016-12-01

Plastic pollution, specifically the size fraction less than 5mm known as microplastics, is an emerging contaminant in waterways worldwide. The ability of microplastics to adsorb and transport contaminants and microbes, as well as be ingested by organisms, makes them a concern in both freshwater and marine ecosystems. Recent efforts to determine the extent of microplastic pollution are increasingly focused on freshwater systems, but most studies have reported concentrations at a single time-point; few have begun to uncover how plastic concentrations in riverine systems may change through time. We hypothesize the time of day and season of sampling influences the concentrations of microplastics in water samples and more specifically, that daytime stormflow samples contain the highest microplastic concentrations due to maximized runoff and wastewater discharge. In order to test this hypothesis, we sampled in two similar streams in Ithaca, New York using a 333µm mesh net deployed within the thalweg. Repeat samples were collected to identify diurnal patterns as well as monthly variation. Samples were processed in the laboratory following the NOAA wet peroxide oxidation protocol. This work improves our ability to interpret existing single-time-point survey results by providing information on how microplastic concentrations change over time and whether concentrations in existing stream studies are likely representative of their location. Additionally, these results will inform future studies by providing insight into representative sample timing and capturing temporal trends for the purposes of modeling and of developing regulations for microplastic pollution.

Single-crystal growth of ceria-based materials

International Nuclear Information System (INIS)

Ulbrich, Gregor

2015-01-01

In this work it could be shown that Skull-Melting is a suitable method for growing ceria single crystals. Twenty different ceria-based single crystals could be manufactured. It was possible to dope ceria single crystals with Gd, Sm, Y, Zr, Ti, Ta, and Pr in different concentrations. Also co-doping with the named metals was realized. However, there remain some problems for growing ceria-based single crystals by Skull-Melting. As ignition metal zirconium was used because no ceria-based material works well. For that reason all single crystals show small zirconium contamination. Another problem is the formation of oxygen by the heat-induced reduction of ceria during the melting process. Because of that the skull of sintered material is often destroyed by gas pressure. This problem had to be solved individually for every single crystal. The obtained single crystals were characterized using different methods. To ensure the single crystal character the y were examined by Laue diffraction. All manufactured crystals are single crystals. Also powder diffraction patterns of the milled and oxidized samples were measured. For the determination of symmetry and metric the structural parameters were analyzed by the Rietveld method. All synthesized materials crystallize in space group Fm-3m known from calcium fluoride. The cubic lattice parameter a was determined for all crystals. In the case of series with different cerium and zirconium concentrations a linear correlation between cerium content and cubic lattice parameter was detected. The elemental composition was determined by WDX. All crystals show a homogeneous elemental distribution. The oxygen content was calculated because the WDX method isn't useful for determination.

[Comparison of two methods for conscious sedation in maxillofacial surgery with local anesthesia].

Science.gov (United States)

Zöller, J; Zöller, B; Hassfeld, S; Köhler, J

1992-01-01

A randomised, prospective study was conducted to compare the efficiency and safety of methods for intravenous conscious sedation in patients undergoing oral surgery under local analgesia. 150 systemically healthy patients (ASA Class I and II) participated. Three groups were formed: group 1 received 0.05 mg/kg midazolam; group 2 0.05 mg/kg midazolam, 1.5 mg/kg tramadol, 50 mg alizaprid; group 3 0.05 mg/kg midazolam, 0.2 mg/kg nalbuphine, 50 mg alizaprid. Blood pressure, heart rate and oxygen saturation were measured throughout the procedure. The results confirmed that the use of nalbuphine (group 3) allows a reduction in the mean dosage of midazolam required to produce satisfactory sedation and effected a more rapid recovery time compared to group 12 and 2. With the combination nalbuphine and alizaprid nausea and vomiting could be reduced for the most part compared to group 2.

Efeitos da associação de tiletamina/zolazepam ou cetamina S(+/midazolam/tramadol para contenção química em bugios-ruivos (Allouatta guariba clamitans

Directory of Open Access Journals (Sweden)

Pâmela Spolti

2013-02-01

Full Text Available Avaliaram-se dois protocolos para contenção química em bugios-ruivos. Para tal, foram utilizados 12 macacos bugios, hígidos, com peso médio de 6,4±0,4 kg, os quais foram submetidos a jejum alimentar e hídrico de seis e duas horas, respectivamente. Os animais foram alocados em dois grupos que receberam injeção via intramuscular: TZ (n=6, os quais receberam uma associação de tiletamina e zolazepam (Zoletil® na dose de 3,6mg/kg e CEMTRA (n=6, que receberam cetamina S(+, midazolam e tramadol (Cemtra ®, lote piloto 001/10, Ouro Fino Saúde Animal Ltda., Cravinhos, SP-Brasil, constituído por 100mg/ml de cetamina S+, 20mg/ml de tramadol e 10mg/ml de midazolam na dose de 1ml da associação para cada 10kg de peso corporal, correspondendo às doses de 10mg/kg, 1mg/kg e 2mg/kg, respectivamente. Anteriormente a administração dos fármacos (M0 foram avaliadas: frequência cardíaca (FC e respiratória (f, temperatura retal (TR, tempo de preenchimento capilar (TPC, pressão arterial sistólica (PAS, saturação de oxigênio na hemoglobina (SpO2, presença de salivação, grau de miorrelaxamento e sedação, índice Bispectral (BIS e Sinal de Qualidade do BIS (SQI, resposta ao pinçamento interdigital e tempos de latência, deambulação e de recuperação total (TRT. Os parâmetros foram reavaliados em M5, M10, M20, M30, M40 e M50 (5, 10, 20, 30, 40 e 50 minutos após a administração dos fármacos. No TZ os animais foram mais responsivos ao pinçamento interdigital ao longo dos tempos. Os animais do CEMTRA apresentaram maior grau de miorrelaxamento e de sedação. A f do CEMTRA foi menor após a administração do tratamento em todos os momentos em relação ao M0. Entre grupos a f do CEMTRA foi menor em relação ao TZ em M2 e M4. Os tempos totais de sedação e de recuperação foram de 48±4 e 150,1±42,1 min para o CEMTRA e de 38±7 e 73,1±20,6 para o TZ. Conclui-se que ambas as formulações são seguras para contenção química de

Midazolam Injection

Science.gov (United States)

... the effects of exposure to anesthesia on brain development in young children. Parents and caregivers of children younger than 3 years of age and pregnant women should talk to their doctors about the risks of anesthesia on brain development and appropriate timing of procedures that require general ...

Growth and study of some gel grown group II single crystals of iodate

Indian Academy of Sciences (India)

Unknown

Abstract. Single crystals of calcium iodate and barium iodate were grown by simple gel technique by single diffusion method. The optimum conditions were established by varying various parameters such as pH of gel solution, gel concentration, gel setting time, concentration of the reactants etc. Crystals having different.

Concentration Polarization to Measure Nano-pore Accessibility

NARCIS (Netherlands)

Solsona, Miguel; Eijkel, Jan C.T.; Olthuis, Wouter; Papadimitriou, Vasileios; van den Berg, Albert; Abelmann, Leon; Weckhuysen, Bert M.; Nieuwelink, A. E.

2017-01-01

Understanding the deactivation process in porous catalysts is of tremendous economic significance. We demonstrate the feasibility of using the concentration polarization method to obtain the pore accessibility distribution at single particle level for the first time. By using this technique we could

Evaluation of single-stage adjustable strabismus surgery under conscious sedation

Directory of Open Access Journals (Sweden)

Sharma Pradeep

2009-01-01

Full Text Available Purpose: To evaluate the feasibility and stability of ocular alignment after single-stage adjustable strabismus surgery (SSASS performed under topical anesthesia. Materials and Methods: Forty-five patients of concomitant exodeviations were randomized into three groups of 15 cases each and were operated with three different techniques: Group I - conventional surgery, Group II - two-stage adjustable suture technique with suture adjustment performed 6h postoperatively and Group III- SSASS under topical anesthesia and intravenous conscious sedation with midazolam and fentanyl. Intraoperative suture adjustment was done by giving a cross target to the patient on the ceiling at the end of the procedure. Surgical results were compared among the three groups at three months follow-up. Intraoperative hemodynamic parameters and patients′ experience of the surgery (by questionnaire were also compared. Results: Mean preoperative deviation for distance in Groups I, II, III was -41.67 prism diopter (pd ±9.0, -38.93 pd ±11.05 and -41.87 pd ±8.91 ( P =0.6 respectively. At three months, mean correction achieved for distance was +31.87 pd ±11.71, +35.47 pd ±10.86 and +42.80 pd ±10.71 respectively which was significantly different between Group III and Group I ( P =0.03. Intraoperatively all hemodynamic parameters remained stable and comparable ( P =0. 5 in all groups. Intraoperative pain ( P < 0.001 and time taken for surgery ( P < 0.001 was more in the SSASS group. Amount of exodrift was 10-12 pd, comparable in all three groups ( P = 0.5. Conclusions: SSASS, performed under topical anesthesia, is safe and has better outcomes than conventional recession-resection surgery for concomitant exodeviation. An overcorrection of about 10-12 pd is recommended to check the exodrift and achieve stable alignment.

A Concentrator Photovoltaic System Based on a Combination of Prism-Compound Parabolic Concentrators

Directory of Open Access Journals (Sweden)

Ngoc Hai Vu

2016-08-01

Full Text Available We present a cost-effective concentrating photovoltaic system composed of a prism and a compound parabolic concentrator (P-CPC. In this approach, the primary collector consists of a prism, a solid compound parabolic concentrator (CPC, and a slab waveguide. The prism, which is placed on the input aperture of CPC, directs the incoming sunlight beam to be parallel with the main axes of parabolic rims of CPC. Then, the sunlight is reflected at the parabolic rims and concentrated at the focal point of these parabolas. A slab waveguide is coupled at the output aperture of the CPC to collect focused sunlight beams and to guide them to the solar cell. The optical system was modeled and simulated with commercial ray tracing software (LightTools™. Simulation results show that the optical efficiency of a P-CPC can achieve up to 89%. when the concentration ratio of the P-CPC is fixed at 50. We also determine an optimal geometric structure of P-CPC based on simulation. Because of the simplicity of the P-CPC structure, a lower-cost mass production process is possible. A simulation based on optimal structure of P-CPC was performed and the results also shown that P-CPC has high angular tolerance for input sunlight. The high tolerance of the input angle of sunlight allows P-CPC solar concentrator utilize a single sun tracking system instead of a highly precise dual suntracking system as cost effective solution.

Single-Event Transgene Product Levels Predict Levels in Genetically Modified Breeding Stacks.

Science.gov (United States)

Gampala, Satyalinga Srinivas; Fast, Brandon J; Richey, Kimberly A; Gao, Zhifang; Hill, Ryan; Wulfkuhle, Bryant; Shan, Guomin; Bradfisch, Greg A; Herman, Rod A

2017-09-13

The concentration of transgene products (proteins and double-stranded RNA) in genetically modified (GM) crop tissues is measured to support food, feed, and environmental risk assessments. Measurement of transgene product concentrations in breeding stacks of previously assessed and approved GM events is required by many regulatory authorities to evaluate unexpected transgene interactions that might affect expression. Research was conducted to determine how well concentrations of transgene products in single GM events predict levels in breeding stacks composed of these events. The concentrations of transgene products were compared between GM maize, soybean, and cotton breeding stacks (MON-87427 × MON-89034 × DAS-Ø15Ø7-1 × MON-87411 × DAS-59122-7 × DAS-40278-9 corn, DAS-81419-2 × DAS-44406-6 soybean, and DAS-21023-5 × DAS-24236-5 × SYN-IR102-7 × MON-88913-8 × DAS-81910-7 cotton) and their component single events (MON-87427, MON-89034, DAS-Ø15Ø7-1, MON-87411, DAS-59122-7, and DAS-40278-9 corn, DAS-81419-2, and DAS-44406-6 soybean, and DAS-21023-5, DAS-24236-5, SYN-IR102-7, MON-88913-8, and DAS-81910-7 cotton). Comparisons were made within a crop and transgene product across plant tissue types and were also made across transgene products in each breeding stack for grain/seed. Scatter plots were generated comparing expression in the stacks to their component events, and the percent of variability accounted for by the line of identity (y = x) was calculated (coefficient of identity, I 2 ). Results support transgene concentrations in single events predicting similar concentrations in breeding stacks containing the single events. Therefore, food, feed, and environmental risk assessments based on concentrations of transgene products in single GM events are generally applicable to breeding stacks composed of these events.

A new plastic scintillation resin for single-step separation, concentration and measurement of technetium-99.

Science.gov (United States)

Barrera, J; Tarancón, A; Bagán, H; García, J F

2016-09-14

Technetium is a synthetic element with no stable isotopes, produced as waste in nuclear power plants and in cyclotrons used for nuclear medicine. The element has high mobility, in the form of TcO4(-); its determination is therefore important for environmental protection. Technetium is found in low concentrations and therefore common methods for its analysis include long treatments in several steps and require large amounts of reagents for its purification and preconcentration. Plastic scintillation resins (PSresin) are novel materials used to separate, preconcentrate and measure radionuclides in a single step. The objective of this study is to prepare and characterise a PSresin for the preconcentration and measurement of (99)Tc. The study first evaluates the reproducibility of the production of PSresins between batches and over time; showing good reproducibility and storage stability. Next, we studied the effect of some common non-radioactive interferences, showing small influences on measurement, and radioactive interferences ((36)Cl and (238)U/(234)U). (36)Cl can be removed by a simple treatment with 0.5 M HCl and (238)U/(234)U can be removed from the column by cleaning with a mixture of 0.1 M HNO3 and 0.1 M HF. In the latter case, a slight change in the morphology of the PSresin caused an increase in detection efficiency. Finally, the PSresin was applied to the measurement of real spiked samples (sea water and urine) with deviations lower than 10% in all cases. Copyright © 2016 Elsevier B.V. All rights reserved.

A reliable method for the counting and control of single ions for single-dopant controlled devices

International Nuclear Information System (INIS)

Shinada, T; Kurosawa, T; Nakayama, H; Zhu, Y; Hori, M; Ohdomari, I

2008-01-01

By 2016, transistor device size will be just 10 nm. However, a transistor that is doped at a typical concentration of 10 18 atoms cm -3 has only one dopant atom in the active channel region. Therefore, it can be predicted that conventional doping methods such as ion implantation and thermal diffusion will not be available ten years from now. We have been developing a single-ion implantation (SII) method that enables us to implant dopant ions one-by-one into semiconductors until the desired number is reached. Here we report a simple but reliable method to control the number of single-dopant atoms by detecting the change in drain current induced by single-ion implantation. The drain current decreases in a stepwise fashion as a result of the clusters of displaced Si atoms created by every single-ion incidence. This result indicates that the single-ion detection method we have developed is capable of detecting single-ion incidence with 100% efficiency. Our method potentially could pave the way to future single-atom devices, including a solid-state quantum computer

Amphetamine concentrations in human urine following single-dose administration of the calcium antagonist prenylamine-studies using fluorescence polarization immunoassay (FPIA) and GC-MS.

Science.gov (United States)

Kraemer, Thomas; Roditis, Susanne K; Peters, Frank T; Maurer, Hans H

2003-03-01

Prenylamine (R,S-N-(3,3-diphenylpropyl-methyl-2-phenethylamine), a World Health Organization class V calcium antagonist, is known to be metabolized to amphetamine. In this study, amphetamine concentrations after a single-dose administration of prenylamine were determined to check if they reached values that could be of analytical and/or pharmacological importance in clinical and forensic toxicology. Enantiomeric composition of amphetamine was also studied. Five volunteers received a single 120-mg oral dose of prenylamine. Urine samples were analyzed using the Abbott TDx immunoassay Amphetamine/Methamphetamine II and using our routine systematic toxicological analysis (STA) gas chromatography-mass spectrometry (GC-MS) procedure. For quantitation purposes, GC-MS was used in the selected-ion monitoring (SIM) mode (ions m/z 118, 122, 240, 244) after solid-phase extraction (Isolute Confirm HCX) and derivatization (heptafluorobutyric anhydride). Amphetamine-d5 was used as internal standard (IS). Chiral separation of the heptafluorobutyrated amphetamine enantiomers was achieved using an Astec Chiraldex G-PN column. The TDx results showed a great variability for the different volunteers. A urine sample of one volunteer showed results as high as 3200 ng/mL, whereas the urine samples of another volunteer never gave results greater than the TDx detection limit (100 ng/mL). Using the STA procedure, the presence of amphetamine could be confirmed in all urine samples with TDx results greater than the cutoff value (300 ng/mL). Using the GC-MS SIM method, amphetamine concentrations up to 1280 ng/mL were determined. Chiral analysis revealed that both enantiomers of amphetamine were present in the samples with a surplus of the S(+)-enantiomer in the early phase of excretion. Forensic implications are discussed.

Nonimaging achromatic shaped Fresnel lenses for ultrahigh solar concentration.

Science.gov (United States)

Languy, Fabian; Habraken, Serge

2013-05-15

The maximum concentration ratio achievable with a solar concentrator made of a single refractive primary optics is much more limited by the chromatic aberration than by any other aberration. Therefore achromatic doublets made with poly(methyl methacrylate) and polycarbonate are of great interest to enhance the concentration ratio and to achieve a spectrally uniform flux on the receiver. In this Letter, shaped achromatic Fresnel lenses are investigated. One lossless design is of high interest since it provides spectrally and spatially uniform flux without being affected by soiling problems. With this design an optical concentration ratio of about 8500× can be achieved.

Pollutant threshold concentration determination in marine ecosystems using an ecological interaction endpoint.

Science.gov (United States)

Wang, Changyou; Liang, Shengkang; Guo, Wenting; Yu, Hua; Xing, Wenhui

2015-09-01

The threshold concentrations of pollutants are determined by extrapolating single-species effect data to community-level effects. This assumes the most sensitive endpoint of the life cycle of individuals and the species sensitivity distribution from single-species toxic effect tests, thus, ignoring the ecological interactions. The uncertainties due to this extrapolation can be partially overcome using the equilibrium point of a customized ecosystem. This method incorporates ecological interactions and integrates the effects on growth, survival, and ingestion into a single effect measure, the equilibrium point excursion in the customized ecosystem, in order to describe the toxic effects on plankton. A case study showed that the threshold concentration of copper calculated with the endpoint of the equilibrium point was 10 μg L(-1), which is significantly different from the threshold calculated with a single-species endpoint. The endpoint calculated using this method provides a more relevant measure of the ecological impact than any single individual-level endpoint. Copyright © 2015 Elsevier Ltd. All rights reserved.

Vertical variability of aerosol single-scattering albedo and equivalent black carbon concentration based on in-situ and remote sensing techniques during the iAREA campaigns in Ny-Ålesund

Science.gov (United States)

Markowicz, K. M.; Ritter, C.; Lisok, J.; Makuch, P.; Stachlewska, I. S.; Cappelletti, D.; Mazzola, M.; Chilinski, M. T.

2017-09-01

This work presents a methodology for obtaining vertical profiles of aerosol single scattering properties based on a combination of different measurement techniques. The presented data were obtained under the iAREA (Impact of absorbing aerosols on radiative forcing in the European Arctic) campaigns conducted in Ny-Ålesund (Spitsbergen) during the spring seasons of 2015-2017. The retrieval uses in-situ observations of black carbon concentration and absorption coefficient measured by a micro-aethalometer AE-51 mounted onboard a tethered balloon, as well as remote sensing data obtained from sun photometer and lidar measurements. From a combination of the balloon-borne in-situ and the lidar data, we derived profiles of single scattering albedo (SSA) as well as absorption, extinction, and aerosol number concentration. Results have been obtained in an altitude range from about 400 m up to 1600 m a.s.l. and for cases with increased aerosol load during the Arctic haze seasons of 2015 and 2016. The main results consist of the observation of increasing values of equivalent black carbon (EBC) and absorption coefficient with altitude, and the opposite trend for aerosol concentration for particles larger than 0.3 μm. SSA was retrieved with the use of lidar Raman and Klett algorithms for both 532 and 880 nm wavelengths. In most profiles, SSA shows relatively high temporal and altitude variability. Vertical variability of SSA computed from both methods is consistent; however, some discrepancy is related to Raman retrieval uncertainty and absorption coefficient estimation from AE-51. Typically, very low EBC concentration in Ny-Ålesund leads to large error in the absorbing coefficient. However, SSA uncertainty for both Raman and Klett algorithms seems to be reasonable, e.g. SSA of 0.98 and 0.95 relate to an error of ±0.01 and ± 0.025, respectively.

Genome-wide association study of serum selenium concentrations

DEFF Research Database (Denmark)

Gong, Jian; Hsu, Li; Harrison, Tabitha

2013-01-01

Selenium is an essential trace element and circulating selenium concentrations have been associated with a wide range of diseases. Candidate gene studies suggest that circulating selenium concentrations may be impacted by genetic variation; however, no study has comprehensively investigated...... this hypothesis. Therefore, we conducted a two-stage genome-wide association study to identify genetic variants associated with serum selenium concentrations in 1203 European descents from two cohorts: the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening and the Women’s Health Initiative (WHI). We...... tested association between 2,474,333 single nucleotide polymorphisms (SNPs) and serum selenium concentrations using linear regression models. In the first stage (PLCO) 41 SNPs clustered in 15 regions had p

Single-Molecule Flow Platform for the Quantification of Biomolecules Attached to Single Nanoparticles.

Science.gov (United States)

Jung, Seung-Ryoung; Han, Rui; Sun, Wei; Jiang, Yifei; Fujimoto, Bryant S; Yu, Jiangbo; Kuo, Chun-Ting; Rong, Yu; Zhou, Xing-Hua; Chiu, Daniel T

2018-05-15

We describe here a flow platform for quantifying the number of biomolecules on individual fluorescent nanoparticles. The platform combines line-confocal fluorescence detection with near nanoscale channels (1-2 μm in width and height) to achieve high single-molecule detection sensitivity and throughput. The number of biomolecules present on each nanoparticle was determined by deconvolving the fluorescence intensity distribution of single-nanoparticle-biomolecule complexes with the intensity distribution of single biomolecules. We demonstrate this approach by quantifying the number of streptavidins on individual semiconducting polymer dots (Pdots); streptavidin was rendered fluorescent using biotin-Alexa647. This flow platform has high-throughput (hundreds to thousands of nanoparticles detected per second) and requires minute amounts of sample (∼5 μL at a dilute concentration of 10 pM). This measurement method is an additional tool for characterizing synthetic or biological nanoparticles.

Towards single molecule biosensors using super-resolution fluorescence microscopy.

Science.gov (United States)

Lu, Xun; Nicovich, Philip R; Gaus, Katharina; Gooding, J Justin

2017-07-15

Conventional immunosensors require many binding events to give a single transducer output which represents the concentration of the analyte in the sample. Because of the requirements to selectively detect species in complex samples, immunosensing interfaces must allow immobilisation of antibodies while repelling nonspecific adsorption of other species. These requirements lead to quite sophisticated interfacial design, often with molecular level control, but we have no tools to characterise how well these interfaces work at the molecular level. The work reported herein is an initial feasibility study to show that antibody-antigen binding events can be monitored at the single molecule level using single molecule localisation microscopy (SMLM). The steps to achieve this first requires showing that indium tin oxide surfaces can be used for SMLM, then that these surfaces can be modified with self-assembled monolayers using organophosphonic acid derivatives, that the amount of antigens and antibodies on the surface can be controlled and monitored at the single molecule level and finally antibody binding to antigen modified surfaces can be monitored. The results show the amount of antibody that binds to an antigen modified surface is dependent on both the concentration of antigen on the surface and the concentration of antibody in solution. This study demonstrates the potential of SMLM for characterising biosensing interfaces and as the transducer in a massively parallel, wide field, single molecule detection scheme for quantitative analysis. Copyright © 2016 Elsevier B.V. All rights reserved.

Stimulus-response functions of single avian olfactory bulb neurones.

Science.gov (United States)

McKeegan, Dorothy E F; Demmers, Theodorus G M; Wathes, Christopher M; Jones, R Bryan; Gentle, Michael J

2002-10-25

This study investigated olfactory processing in a functional context by examining the responses of single avian olfactory bulb neurones to two biologically important gases over relevant concentration ranges. Recordings of extracellular spike activity were made from 80 single units in the left olfactory bulb of 11 anaesthetised, freely breathing adult hens (Gallus domesticus). The units were spontaneously active, exhibiting widely variable firing rates (0.07-47.28 spikes/s) and variable temporal firing patterns. Single units were tested for their response to an ascending concentration series of either ammonia (2.5-100 ppm) or hydrogen sulphide (1-50 ppm), delivered directly to the olfactory epithelium. Stimulation with a calibrated gas delivery system resulted in modification of spontaneous activity causing either inhibition (47% of units) or excitation (53%) of firing. For ammonia, 20 of the 35 units tested exhibited a response, while for hydrogen sulphide, 25 of the 45 units tested were responsive. Approximate response thresholds for ammonia (median threshold 3.75 ppm (range 2.5-60 ppm, n=20)) and hydrogen sulphide (median threshold 1 ppm (range 1-10 ppm, n=25)) were determined with most units exhibiting thresholds near the lower end of these ranges. Stimulus response curves were constructed for 23 units; 16 (the most complete) were subjected to a linear regression analysis to determine whether they were best fitted by a linear, log or power function. No single function provided the best fit for all the curves (seven were linear, eight were log, one was power). These findings show that avian units respond to changes in stimulus concentration in a manner generally consistent with reported responses in mammalian olfactory bulb neurones. However, this study illustrates a level of fine-tuning to small step changes in concentration (<5 ppm) not previously demonstrated in vertebrate single olfactory bulb neurones.

Emergency transfusion of patients with unknown blood type with blood group O Rhesus D positive red blood cell concentrates: a prospective, single-centre, observational study.

Science.gov (United States)

Selleng, Kathleen; Jenichen, Gregor; Denker, Kathrin; Selleng, Sixten; Müllejans, Bernd; Greinacher, Andreas

2017-05-01

Emergency patients with unknown blood type usually receive O Rhesus D negative (RhD-) red blood cell concentrates until their blood group is determined to prevent RhD+ related adverse transfusion reactions. As 85% of individuals are RhD+, this consumption of O RhD- red blood cell concentrates contributes to shortages of O RhD- red blood cell concentrates, sometimes forcing transfusion of known RhD- patients with RhD+ red blood cell concentrates. Here we report the outcome of this transfusion policy transfusing all emergency patients with unknown blood type with O RhD+ red blood cell concentrates. In this prospective single-centre observational study done between Jan 1, 2001, and Dec 31, 2015, we assessed all consecutive RhD- patients at the University Medicine Greifswald who received RhD+ red blood cell concentrates (emergency patients with unknown blood type; and RhD- patients receiving RhD+ red blood cell concentrates during RhD- red blood cell concentrate shortages). No patients were excluded. The primary endpoint was anti-D allo-immunisation at 2 months follow-up or later. Patients were followed up and tested for immunisation against red blood cell antigens using the direct antiglobulin test and an antibody screen every 3-5 days for 4 weeks or until death, or hospital discharge. Surviving patients were screened for development of anti-D antibodies for up to 12 months (at the predefined timepoints 2, 3, 6, and 12 months) after RhD+ red blood cell transfusion. 437 emergency patients, of whom 85 (20%) were RhD-, received 2836 RhD+ red blood cell concentrates. The overall risk of inducing anti-D antibodies (in all 437 recipients) was 17 (4%, 95% CI 2·44-6·14) of 437 (assuming all patients lost to follow-up developed anti-D allo-immunisation). During this period, 110 known RhD- patients received RhD+ red blood cell concentrates during RhD- red blood cell concentrate shortages. Of these, 29 (26%; 95% CI 19·0-35·3) developed anti-D allo-immunisation (assuming all

Conduta anestésica em balneoterapia de pacientes queimados: avaliação prospectiva de 2852 procedimentos Conducta anestésica en balneoterapia de pacientes quemados: evaluación prospectiva de 2852 procedimientos Anesthetic procedure for balneotherapy of burned patients: prospective evaluation of 2852 cases

Directory of Open Access Journals (Sweden)

Fernando Antônio de Freitas Cantinho

2004-04-01

usada en más 142 casos. El alfentanil, como algunos otros agentes, fue poco usado. La duración de los procedimientos fue de 29,3 ± 10,6 minutos; mayor peso y SCQ se correlacionaron con el aumento significante de la duración. Hubo 30 casos de disminución de la SpO2 abajo de 90%, siendo 3 casos (0,59% en el subgrupo que recibió S(+-cetamina y midazolam por vía venosa, y 24 casos (1,93% en el que recibió S(+-cetamina, midazolam y fentanil por la misma vía (p = 0,039. Hubo un caso de parada cardíaca en paciente moribundo, que fue recuperado, prosiguiéndose el baño hasta el final. CONCLUSIONES: La S(+-cetamina, el midazolam y el fentanil fueron los agentes más utilizados, siendo la S(+-cetamina el principal agente. Las técnicas anestésicas utilizadas se mostraron seguras y eficaces.BACKGROUND AND OBJECTIVES: Deep analgesia of burned patients needing daily care of their injuries is a field where references are very scarce in the literature. This study aimed at evaluating balneotherapy anesthetic technique in 2852 procedures. METHODS: A one-year period prospective evaluation was performed on sedative and analgesic alternatives adopted by anesthesiologists. Age, weight, gender, burned surface area (BSA, drugs and doses used, duration, monitoring, number of sessions by patient, and complications were recorded. Samples was divided in four groups according to age: group A, 65 years, and the results were compared. RESULTS: There have been 2852 balneotherapy sessions performed in 134 patients: Group A = 743 sessions in 42 patients; Group B = 354 sessions in 16 patients; Group C = 1573 sessions in 68 patients; Group D = 182 sessions in 8 patients. Throughout the study, the intravenous S(+-ketamine as single agent was used in 116 sessions. The intravenous S(+-ketamine with midazolam was used in 631 sessions. The intravenous S(+-ketamine with midazolam and fentanyl was used in 1562 sessions. The muscular S(+-ketamine as single agent was used in 188 sessions, being 173 in

Hemoglobin concentration determination based on near infrared spatially resolved transmission spectra

Science.gov (United States)

Zhang, Linna; Li, Gang; Lin, Ling

2016-10-01

Spatially resolved diffuse reflectance spectroscopy method has been proved to be more effective than single point spectroscopy method in the experiment to predict the concentration of the Intralipid diluted solutions. However, Intralipid diluted solution is simple, cannot be the representative of turbid liquids. Blood is a natural and meaningful turbid liquid, more complicate. Hemoglobin is the major constituent of the whole blood. And hemoglobin concentration is commonly used in clinical medicine to diagnose many diseases. In this paper, near infrared spatially resolved transmission spectra (NIRSRTS) and Partial Least Square Regression (PLSR) were used to predict the hemoglobin concentration of human blood. The results showed the prediction ability for hemoglobin concentration of the proposed method is better than single point transmission spectroscopy method. This paper demonstrated the feasibility of the spatially resolved diffuse reflectance spectroscopy method for practical liquid composition analysis. This research provided a new thinking of practical turbid liquid composition analysis.

Increase in tiagabine serum concentration with coadministration of gemfibrozil.

Science.gov (United States)

Burstein, Aaron H; Boudreau, Eilis A; Theodore, William H

2009-02-01

To report a case of possible acute tiagabine toxicity secondary to administration of gemfibrozil. A 39-year-old male was taking tiagabine 16 mg orally 3 times per day and carbamazepine 500 mg orally twice per day for complex partial seizures secondary to mesial temporal sclerosis. He was found to have type IV hypertriglyceridemia and was prescribed gemfibrozil. Because he reported severe confusion and altered consciousness shortly after a single 600-mg dose of gemfibrozil, he was admitted for controlled challenge with that drug. A single 300-mg dose of gemfibrozil resulted in lightheadedness and led to a 59% and 75% increase in total tiagabine serum concentrations at 2 and 5 hours, respectively, without significant change in baseline carbamazepine concentrations. This is the first report of an interaction between the widely used antihyperlipidemic drug gemfibrozil and tiagabine. Since tiagabine, which was originally developed as an antiepileptic medication, is now being used widely for a variety of other indications such as anxiety and depression, there is an increased risk for clinically significant interactions with gemfibrozil. Increased total and unbound tiagabine concentrations following a single 300-mg dose of gemfibrozil and reproduction of clinical symptoms with gemfibrozil rechallenge suggests the toxicity our patient experienced was due to a pharmacokinetic drug interaction. Use of the Horn Drug Interaction Probability Scale showed a probable interaction between gemfibrozil and tiagabine.

Protein determination in single corns

International Nuclear Information System (INIS)

Knorr, J.; Schiekel, M.; Franke, W.; Focke, F.

1994-01-01

Determination of protein content in food materials is usually done by analyzing the nitrogen amount by wet chemical Kjeldahl method. An improved accuracy accompanied by smaller analyzing intervals can be achieved using nondestructive neutron activation. Analyses have been performed using 14 MeV neutrons to determine the content of N and P in single wheat corns. Irradiation parameters have been optimized to prevent serious radiation damage in grains. About 200 single corns have been investigated with total net weights ranging from 30 to 70 mg. The tested arrangement allows determination of nitrogen amount in a single corn down to 0.3 mg with an accuracy of better than 4 %. Mean nitrogen concentrations in the range from 9 to 19% per corn have been detected. (author) 5 refs.; 6 figs

Design of a Modular E-Core Flux Concentrating Axial Flux Machine: Preprint

Energy Technology Data Exchange (ETDEWEB)

Husain, Tausif; Sozer, Yilmaz; Husain, Iqbal; Muljadi, Eduard

2015-08-24

In this paper a novel E-Core axial flux machine is proposed. The machine has a double-stator, single-rotor configuration with flux-concentrating ferrite magnets and pole windings across each leg of an E-Core stator. E-Core stators with the proposed flux-concentrating rotor arrangement result in better magnet utilization and higher torque density. The machine also has a modular structure facilitating simpler construction. This paper presents a single-phase and a three-phase version of the E-Core machine. Case studies for a 1.1-kW, 400-rpm machine for both the single-phase and three-phase axial flux machines are presented. The results are verified through 3D finite element analysis. facilitating simpler construction. This paper presents a single-phase and a three-phase version of the E-Core machine. Case studies for a 1.1-kW, 400-rpm machine for both the single-phase and three-phase axial flux machines are presented. The results are verified through 3D finite element analysis.

Intrapulmonary concentration of enrofloxacin in healthy calves

Science.gov (United States)

OTOMARU, Konosuke; HIRATA, Masaya; IKEDO, Tomonobu; HORINOUCHI, Chie; NOGUCHI, Michiko; ISHIKAWA, Shingo; NAGATA, Shun-ichi; HOBO, Seiji

2015-01-01

To determine the intrapulmonary concentration of enrofloxacin (ERFX) in calves, plasma, bronchoalveolar lavage fluid (BALF) and alveolar cells samples were obtained from clinically healthy calves. Four clinically healthy calves were administered a single dose of ERFX (5 mg/kg) by subcutaneous injection. Samples of plasma were obtained for each subjects at 0 (before administration), 1 and 2 hr after administration of ERFX. Samples of BALF were obtained from each subject at 0, 1 and 2 hr after administration of ERFX. This examination was conducted two times, one week apart. The mean EFRX concentrations in plasma at 1 and 2 hr after administration were l.23 and 1.29 µg/ml, respectively. The mean EFRX concentrations in pulmonary epithelial lining fluid (ELF) at 1 and 2 hr after administration 8.53 µg/ml and 9.42 µg/ml, respectively. The mean ERFX concentrations of alveolar cells in BALF at 1 and 2 hr after administration were 4.04 µg/ml and 5.19 µg/ml, respectively. These results suggest that the ERFX concentrations in ELF and alveolar cells concentrations in BALF at 1 and 2 hr after administration were higher than the plasma concentrations. PMID:26668174

Sonochemical optimization of the conductivity of single wall nanotube networks

NARCIS (Netherlands)

Kaempgen, M.; Lebert, M.; Haluska, M.; Nicoloso, N.; Roth, S.

2008-01-01

Networks of single-wall carbon nanotubes (SWCNTs) are covalently functionalized with oxygen-containing groups. In lower concentration, these functional groups act as stable dopands improving the conductivity of the SWCNT material. In higher concentration however, their role as defects with a certain

Blue luminescence in Tm3+-doped KGd(WO4)2 single crystals

International Nuclear Information System (INIS)

Gueell, F.; Mateos, X.; Gavalda, Jna.; Sole, R.; Aguilo, M.; Diaz, F.; Massons, J.

2004-01-01

Up-conversion blue emissions of trivalent thulium ions in monoclinic KGd(WO 4 ) 2 single crystals at 454 and 479 nm are reported for a single pump laser source at 688 nm. We grew thulium-doped KGd(WO 4 ) 2 single crystals at several concentrations from 0.1% to 10%. We recorded a polarized optical absorption spectrum for the 3 F 2 + 3 F 3 energy levels of thulium at room temperature and low temperature (6 K). From the low temperature emission spectra we determined the splitting of the 3 H 6 ground state. The blue emissions are characterized as a function of the dopant concentration and temperature from 10 K to room temperature. To our knowledge, this is the first time that sequential two-photon excitation process (STEP) generated blue emissions in thulium-doped single crystals with a single excitation wavelength

Concentration addition, independent action and generalized concentration addition models for mixture effect prediction of sex hormone synthesis in vitro.

Directory of Open Access Journals (Sweden)

Niels Hadrup

Full Text Available Humans are concomitantly exposed to numerous chemicals. An infinite number of combinations and doses thereof can be imagined. For toxicological risk assessment the mathematical prediction of mixture effects, using knowledge on single chemicals, is therefore desirable. We investigated pros and cons of the concentration addition (CA, independent action (IA and generalized concentration addition (GCA models. First we measured effects of single chemicals and mixtures thereof on steroid synthesis in H295R cells. Then single chemical data were applied to the models; predictions of mixture effects were calculated and compared to the experimental mixture data. Mixture 1 contained environmental chemicals adjusted in ratio according to human exposure levels. Mixture 2 was a potency adjusted mixture containing five pesticides. Prediction of testosterone effects coincided with the experimental Mixture 1 data. In contrast, antagonism was observed for effects of Mixture 2 on this hormone. The mixtures contained chemicals exerting only limited maximal effects. This hampered prediction by the CA and IA models, whereas the GCA model could be used to predict a full dose response curve. Regarding effects on progesterone and estradiol, some chemicals were having stimulatory effects whereas others had inhibitory effects. The three models were not applicable in this situation and no predictions could be performed. Finally, the expected contributions of single chemicals to the mixture effects were calculated. Prochloraz was the predominant but not sole driver of the mixtures, suggesting that one chemical alone was not responsible for the mixture effects. In conclusion, the GCA model seemed to be superior to the CA and IA models for the prediction of testosterone effects. A situation with chemicals exerting opposing effects, for which the models could not be applied, was identified. In addition, the data indicate that in non-potency adjusted mixtures the effects cannot

Radon concentrations in different types of dwellings in Israel

International Nuclear Information System (INIS)

Epstein, L.; Koch, J.; Riemer, T.; Haquin, G.; Orion, I.

2014-01-01

The average radon concentration in Israeli dwellings was assessed by combining the results of a 2006 radon survey in single family houses with the results of a 2011 radon survey in apartments of multi-storey buildings. Both surveys were based on long-term measurements using CR-39 detectors. The survey in multi-storey buildings was intended to assess the influence of recent practices in the local building industry on the radon concentrations. These practices include the use of building materials with higher concentrations of the natural radionuclides in the last 20 y than before, as well as the improvement in sealing techniques over that period. Another practice in place since the early 1990's is the building of a shielded area in every apartment that is known as an RSS (residential secure space). The RSS is a room built from massive concrete walls, floor and ceiling that can be hermetically sealed and is intended to protect its residents from a missile attack. The influence of the above-mentioned features on radon concentrations was estimated by dividing the participating apartments into two groups: apartments in buildings >20 y, built using building materials with low concentrations of the natural radionuclides, regular sealing and without an RSS and apartments in buildings newer than 10 y, built using building materials with higher concentrations of the natural radionuclides, improved sealing and including an RSS. It was found that the average radon concentration in apartments in new buildings was significantly higher than in old buildings and the average radon concentration in single-family houses was significantly higher than in apartments in multi-storey buildings. Doses due to indoor radon were estimated on the basis of the updated information included in the 2009 International Commission on Radiological Protection statement on radon. (authors)

Composition of single-step media used for human embryo culture.

Science.gov (United States)

Morbeck, Dean E; Baumann, Nikola A; Oglesbee, Devin

2017-04-01

To determine compositions of commercial single-step culture media and test with a murine model whether differences in composition are biologically relevant. Experimental laboratory study. University-based laboratory. Inbred female mice were superovulated and mated with outbred male mice. Amino acid, organic acid, and ions content were determined for single-step culture media: CSC, Global, G-TL, and 1-Step. To determine whether differences in composition of these media are biologically relevant, mouse one-cell embryos were cultured for 96 hours in each culture media at 5% and 20% oxygen in a time-lapse incubator. Compositions of four culture media were analyzed for concentrations of 30 amino acids, organic acids, and ions. Blastocysts at 96 hours of culture and cell cycle timings were calculated, and experiments were repeated in triplicate. Of the more than 30 analytes, concentrations of glucose, lactate, pyruvate, amino acids, phosphate, calcium, and magnesium varied in concentrations. Mouse embryos were differentially affected by oxygen in G-TL and 1-Step. Four single-step culture media have compositions that vary notably in pyruvate, lactate, and amino acids. Blastocyst development was affected by culture media and its interaction with oxygen concentration. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

A discussion about maximum uranium concentration in digestion solution of U3O8 type uranium ore concentrate

International Nuclear Information System (INIS)

Xia Dechang; Liu Chao

2012-01-01

On the basis of discussing the influence of single factor on maximum uranium concentration in digestion solution,the influence degree of some factors such as U content, H 2 O content, mass ratio of P and U was compared and analyzed. The results indicate that the relationship between U content and maximum uranium concentration in digestion solution was direct ratio, while the U content increases by 1%, the maximum uranium concentration in digestion solution increases by 4.8%-5.7%. The relationship between H 2 O content and maximum uranium concentration in digestion solution was inverse ratio, the maximum uranium concentration in digestion solution decreases by 46.1-55.2 g/L while H 2 O content increases by 1%. The relationship between mass ratio of P and U and maximum uranium concentration in digestion solution was inverse ratio, the maximum uranium concentration in digestion solution decreases by 116.0-181.0 g/L while the mass ratio of P and U increase 0.1%. When U content equals 62.5% and the influence of mass ratio of P and U is no considered, the maximum uranium concentration in digestion solution equals 1 578 g/L; while mass ratio of P and U equals 0.35%, the maximum uranium concentration decreases to 716 g/L, the decreased rate is 54.6%, so the mass ratio of P and U in U 3 O 8 type uranium ore concentrate is the main controlling factor. (authors)

Radon concentration in dwellings of Lanzarote (Canary Islands)

Energy Technology Data Exchange (ETDEWEB)

Pinza, C.; Armas, J.H. [La Laguna Univ., Tenerife (Spain). Faculty of Medicine; Poffijn, A. [Ghent Rijksuniversiteit (Belgium). Lab. voor Kernfysica

1997-07-01

A total of 126 radon passive dosemeters were distributed in 63 dwellings on the island of Lanzarote (Canary Islands) to measure the indoor radon concentration in the period April-June 1994. The mean overall indoor concentration was 50 Bq.m{sup -3} with a standard deviation of 17 Bq.m{sup -3}. Applying the conversion factor for the effective dose, recommended by ICRP 65, this results in a mean effective dose of 0.75 mSv.y{sup -1}. The mean radon concentration in single-family houses proves to be higher at the ground floor than in upper levels. The mean radon concentration obtained in bedrooms is higher than in living-rooms, independently of the floor they are located at. Statistically significant differences in the mean radon concentration have been found depending on the soil permeability (P = 0.001) and building materials used (P 0.0006). (author).

Radon concentration in dwellings of Lanzarote (Canary Islands)

International Nuclear Information System (INIS)

Pinza, C.; Armas, J.H.; Poffijn, A.

1997-01-01

A total of 126 radon passive dosemeters were distributed in 63 dwellings on the island of Lanzarote (Canary Islands) to measure the indoor radon concentration in the period April-June 1994. The mean overall indoor concentration was 50 Bq.m -3 with a standard deviation of 17 Bq.m -3 . Applying the conversion factor for the effective dose, recommended by ICRP 65, this results in a mean effective dose of 0.75 mSv.y -1 . The mean radon concentration in single-family houses proves to be higher at the ground floor than in upper levels. The mean radon concentration obtained in bedrooms is higher than in living-rooms, independently of the floor they are located at. Statistically significant differences in the mean radon concentration have been found depending on the soil permeability (P = 0.001) and building materials used (P 0.0006). (author)

A Critical Analysis of Concentration and Competition in the Indian Pharmaceutical Market.

Science.gov (United States)

Mehta, Aashna; Hasan Farooqui, Habib; Selvaraj, Sakthivel

2016-01-01

It can be argued that with several players marketing a large number of brands, the pharmaceutical market in India is competitive. However, the pharmaceutical market should not be studied as a single market but, as a sum total of a large number of individual sub-markets. This paper examines the methodological issues with respect to defining the relevant market involved in studying concentration in the pharmaceutical market in India. Further, we have examined whether the Indian pharmaceutical market is competitive. Indian pharmaceutical market was studied using PharmaTrac, the sales audit data from AIOCD-AWACS, that organises formulations into 5 levels of therapeutic classification based on the EphMRA system. The Herfindahl-Hirschman Index (HHI) was used as the indicator of market concentration. We calculated HHI for the entire pharmaceutical market studied as a single market as well as at the five different levels of therapeutic classification. Whereas the entire pharmaceutical market taken together as a single market displayed low concentration (HHI = 226.63), it was observed that if each formulation is defined as an individual sub-market, about 69 percent of the total market in terms of market value displayed at least moderate concentration. Market should be defined taking into account the ease of substitutability. Since, patients cannot themselves substitute the formulation prescribed by the doctor with another formulation with the same indication and therapeutic effect, owing to information asymmetry, it is appropriate to study market concentration at the narrower levels of therapeutic classification.

Propofol dose and incidence of dreaming during sedation.

Science.gov (United States)

Eer, Audrey Singyi; Padmanabhan, Usha; Leslie, Kate

2009-10-01

Dreaming is commonly reported after propofol-based sedation. We measured the incidence of dreaming and bispectral index (BIS) values in colonoscopy patients sedated with combinations of propofol, midazolam and fentanyl. Two hundred patients presenting for elective outpatient colonoscopy were sedated with combinations of propofol, midazolam and fentanyl. BIS was monitored throughout the procedure. Patients were interviewed immediately after they emerged from sedation. The primary end point was a report of dreaming during sedation. Ninety-seven patients were administered propofol alone, 44 were administered propofol and fentanyl, 16 were administered propofol and midazolam and 43 were administered propofol, midazolam and fentanyl. Dreaming was reported by 19% of patients. Dreamers received higher doses of propofol and had lower BIS values during sedation. Age of 50 years or less, preoperative quality of recovery score of less than 14, higher home dream recall, propofol dose of more than 300 mg and time to Observers' Assessment of Alertness/Sedation score equalling 5 of 8 min or less were independent predictors of dreaming. Dreaming during sedation is associated with higher propofol dose and lower BIS values.

Zero-mode waveguide nanophotonic structures for single molecule characterization

Science.gov (United States)

Crouch, Garrison M.; Han, Donghoon; Bohn, Paul W.

2018-05-01

Single-molecule characterization has become a crucial research tool in the chemical and life sciences, but limitations, such as limited concentration range, inability to control molecular distributions in space, and intrinsic phenomena, such as photobleaching, present significant challenges. Recent developments in non-classical optics and nanophotonics offer promising routes to mitigating these restrictions, such that even low affinity (K D ~ mM) biomolecular interactions can be studied. Here we introduce and review specific nanophotonic devices used to support single molecule studies. Optical nanostructures, such as zero-mode waveguides (ZMWs), are usually fabricated in thin gold or aluminum films and serve to confine the observation volume of optical microspectroscopy to attoliter to zeptoliter volumes. These simple nanostructures allow individual molecules to be isolated for optical and electrochemical analysis, even when the molecules of interest are present at high concentration (µM–mM) in bulk solution. Arrays of ZMWs may be combined with optical probes such as single molecule fluorescence, single molecule fluorescence resonance energy transfer, and fluorescence correlation spectroscopy for distributed analysis of large numbers of single-molecule reactions or binding events in parallel. Furthermore, ZMWs may be used as multifunctional devices, for example by combining optical and electrochemical functions in a single discrete architecture to achieve electrochemical ZMWs. In this review, we will describe the optical properties, fabrication, and applications of ZMWs for single-molecule studies, as well as the integration of ZMWs into systems for chemical and biochemical analysis.

Single molecule transcription factor dynamics in the syncytial Drosophila embryo

Science.gov (United States)

Darzacq, Xavier

During early development in the Drosophila embryo, cell fates are determined over the course of just 2 hours with exquisite spatio-temoral precision. One of the key regulators of this process is the transcription factor Bicoid which forms a concentration gradient across the long axis of the embryo. Although Bicoids' primary role is activation at the anterior, where concentrations are highest, it is also known to play a role in the posterior where there are only 100s of molecules per nucleus. Understanding how Bicoid can find its target at such low concentrations has remained intractable, largely due to the inability to perform single molecule imaging in the context of the developing embryo. Here we use lattice light sheet microscopy to overcome the technical barriers of sample thickness and auto-fluorescence to characterize the single molecule dynamics of Bicoid. We find that off-rates do not vary across the embryo and that instead the on-rates are modulated through the formation of clusters that enrich local concentration. This data is contrary to the current concentration dependent model of Bicoid function since local concentration within the nucleus is now a regulated parameter and suggests a previously unknown mechanism for regulation at extremely low concentrations.

Radon concentration distribution mapping in a small detached house

International Nuclear Information System (INIS)

Muellerova, Monika; Moravcsik, Attila; Holy, Karol; Hutka, Miroslav; Hola, Olga

2013-01-01

Radon activity concentration was investigated in an older, single storey detached house. The rooms of the house are in contact with the bedrock. The house is fitted with plastic windows and populated mostly during the summer. Integral (Raduet) and continuous (AlphaGUARD) methods were used to measure the radon activity concentration. Average radon and thoron activity concentrations in the house were 150 Bq/m 3 and 40 Bq/m 3 , respectively. The impact of the house occupancy on radon activity concentration was significant only during the summer months when a decrease of radon activity concentration was recorded due to an increased ventilation rate. In the autumn and winter months, the impact of the house occupancy on radon activity concentration was relatively small - up to 20 %. The increases in radon activity concentration after the room had been thoroughly ventilated were analysed in order to estimate the ventilation rate and the rate of radon supply into the house. (orig.)

Feasibility of Single Scan for Simultaneous Evaluation of Regional Krypton and Iodine Concentrations with Dual-Energy CT: An Experimental Study.

Science.gov (United States)

Hong, Sae Rom; Chang, Suyon; Im, Dong Jin; Suh, Young Joo; Hong, Yoo Jin; Hur, Jin; Kim, Young Jin; Choi, Byoung Wook; Lee, Hye-Jeong

2016-11-01

Purpose To evaluate the feasibility of a simultaneous single scan of regional krypton and iodine concentrations by using dual-energy computed tomography (CT). Materials and Methods The study was approved by the institutional animal experimental committee. An airway obstruction model was first made in 10 beagle dogs, and a pulmonary arterial occlusion was induced in each animal after 1 week. For each model, three sessions of dual-energy CT (80% krypton ventilation [krypton CT], 80% krypton ventilation with iodine enhancement [mixed-contrast agent CT], and iodine enhancement [iodine CT]) were performed. Krypton maps were made from krypton and mixed-contrast agent CT, and iodine maps were made from iodine and mixed-contrast agent CT. Observers measured overlay Hounsfield units of the diseased and contralateral segments on each map. Values were compared by using the Wilcoxon signed-rank test. Results In krypton maps of airway obstruction, overlay Hounsfield units of diseased segments were significantly decreased compared with those of contralateral segments in both krypton and mixed-contrast agent CT (P = .005 for both). However, the values of mixed-contrast agent CT were significantly higher than those of krypton CT for both segments (P = .005 and .007, respectively). In iodine maps of pulmonary arterial occlusion, values were significantly lower in diseased segments than in contralateral segments for both iodine and mixed-contrast agent CT (P = .005 for both), without significant difference between iodine and mixed-contrast agent CT for both segments (P = .126 and .307, respectively). Conclusion Although some limitations may exist, it might be feasible to analyze regional krypton and iodine concentrations simultaneously by using dual-energy CT. © RSNA, 2016.

Simple schemes for generation of W-type multipartite entangled states and realization of quantum-information concentration

International Nuclear Information System (INIS)

Deng-Yu, Zhang; Shi-Qing, Tang; Li-Jun, Xie; Xiao-Gui, Zhan; Yin-Hua, Chen; Feng, Gao

2010-01-01

We propose simple schemes for generating W-type multipartite entangled states in cavity quantum electrodynamics (CQED). Our schemes involve a largely detuned interaction of Λ-type three-level atoms with a single-mode cavity field and a classical laser, and both the symmetric and asymmetric W states can be created in a single step. Our schemes are insensitive to both the cavity decay and atomic spontaneous emission. With the above system, we also propose a scheme for realizing quantum-information concentration which is the reverse process of quantum cloning. In this scheme, quantum-information originally coming from a single qubit, but now distributed into many qubits, is concentrated back to a single qubit in only one step. (general)

Hemodialysis does not alter in vitro hepatic CYP3A4 and CYP2D6 metabolic activity in uremic serum

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Decker BS

2013-12-01

Full Text Available Brian S Decker,1,2 Kalisha D O'Neill,1,2 Mary A Chambers,1,2 James E Slaven,3 Zhangsheng Yu,3 David R Jones,2,4 Sharon M Moe1,21Division of Nephrology, 2Department of Medicine, 3Department of Biostatistics, 4Division of Clinical Pharmacology, Department of Medicine, School of Medicine, Indiana University, Indianapolis, IN, USAAbstract: There is a paucity of studies evaluating the change in liver metabolism in subjects receiving hemodialysis. The purpose of this study was to compare the effect of uremic toxins on hepatic cytochrome P450 (CYP3A4 and CYP2D6 metabolism before and after a 4-hour hemodialysis session. Midazolam and dextromethorphan were incubated with uremic serum collected from subjects before and after the 4-hour hemodialysis session. Analysis and quantification of the 1'-OH-midazolam and 4-OH-midazolam and dextrorphan metabolites were performed by high-pressure liquid chromatography/mass spectrometry. Statistical analysis using the Student's t-test (paired was used to compare the amount of metabolite formed. The mean amount of 1'-OH-midazolam, 4-OH-midazolam, and dextrorphan metabolites formed before and after hemodialysis did not significantly differ. There was no significant difference in CYP3A4 and CYP2D6 metabolic activity in uremic serum before and after hemodialysis.Keywords: hemodialysis, uremia, CYP3A4, CYP2D6, metabolism

Sedations and analgesia in patients undergoing percutaneous transhepatic biliary drainage

Energy Technology Data Exchange (ETDEWEB)

Hatzidakis, A.A.; Charonitakis, E.; Athanasiou, A.; Tsetis, D.; Chlouverakis, G.; Papamastorakis, G.; Roussopoulou, G.; Gourtsoyiannis, N.C

2003-02-01

AIM: To present our experience using intravenous sedoanalgesia for percutaneous biliary drainage. MATERIALS AND METHODS: This study comprised 100 patients, all of whom were continuously monitored [electrocardiogram (ECG), blood pressure, pulse oxymetry] and received an initial dose of 2 mg midazolam followed by 0.02 mg fentanyl. Before every anticipated painful procedure, a maintenance dose of 0.01 mg fentanyl was administered. If the procedure continued and the patient became aware, another 1 mg midazolam was given. This was repeated if patients felt pain. A total dose of 0.08 mg fentanyl and 7 mg midazolam was never exceeded. Immediately after the procedure, the nurse was asked to evaluate patients' pain score. The patients were asked 3 h later to complete a visual 10-degree pain score scale. RESULTS: The average dose of fentanyl and midazolam was 0.042 mg (0.03-0.08 mg) and 4.28 mg (2-7 mg), respectively. Only one patient recorded the procedure as painful. The scores given by the attending nurse (1-7 points, mean 2.9) correlated well with those given by the patients (1-6 points, mean 2.72). No complications were noted. CONCLUSION: According to our experience, interventional radiologists practising biliary procedures can administer low doses of midazolam and minimize the doses of fentanyl, without loss of adequate sedation and analgesia. Hatzidakis, A. A. et al. (2003). Clinical Radiology58, 121-127.

Sedations and analgesia in patients undergoing percutaneous transhepatic biliary drainage

International Nuclear Information System (INIS)

Hatzidakis, A.A.; Charonitakis, E.; Athanasiou, A.; Tsetis, D.; Chlouverakis, G.; Papamastorakis, G.; Roussopoulou, G.; Gourtsoyiannis, N.C.

2003-01-01

AIM: To present our experience using intravenous sedoanalgesia for percutaneous biliary drainage. MATERIALS AND METHODS: This study comprised 100 patients, all of whom were continuously monitored [electrocardiogram (ECG), blood pressure, pulse oxymetry] and received an initial dose of 2 mg midazolam followed by 0.02 mg fentanyl. Before every anticipated painful procedure, a maintenance dose of 0.01 mg fentanyl was administered. If the procedure continued and the patient became aware, another 1 mg midazolam was given. This was repeated if patients felt pain. A total dose of 0.08 mg fentanyl and 7 mg midazolam was never exceeded. Immediately after the procedure, the nurse was asked to evaluate patients' pain score. The patients were asked 3 h later to complete a visual 10-degree pain score scale. RESULTS: The average dose of fentanyl and midazolam was 0.042 mg (0.03-0.08 mg) and 4.28 mg (2-7 mg), respectively. Only one patient recorded the procedure as painful. The scores given by the attending nurse (1-7 points, mean 2.9) correlated well with those given by the patients (1-6 points, mean 2.72). No complications were noted. CONCLUSION: According to our experience, interventional radiologists practising biliary procedures can administer low doses of midazolam and minimize the doses of fentanyl, without loss of adequate sedation and analgesia. Hatzidakis, A. A. et al. (2003). Clinical Radiology58, 121-127

Sedative choice in drug-induced sleep endoscopy: A neuropharmacology-based review.

Science.gov (United States)

Shteamer, Jack W; Dedhia, Raj C

2017-01-01

To examine the suitability of commonly used agents for drug-induced sleep endoscopy (DISE) based on agent-specific neuropharmacology. PubMed. A literature search of the PubMed database was performed on January 1, 2016. A two-layered search strategy was performed to identify relevant pharmacologic agents and articles related to neuropharmacology for these agents. The first search identified relevant pharmacologic agents; the second search examined agents with greater than five results from search 1, along with medical subject headings "respiration," "sleep," "pharmacology," and/or "[respective agent] (e.g., propofol)." Articles not in English were excluded. Bibliographies of pertinent articles were hand-searched for additional articles. Three agents were commonly identified from search 1: propofol, midazolam, and dexmedetomidine with 44, 13, and 6 results, respectively. Of note, 11 results utilized coinduction with midazolam and propofol. Search 2 for propofol, midazolam, and dexmedetomidine retrieved 219, 220, and 26 results, respectively. Eleven results for propofol, 4 for midazolam, and 9 for dexmedetomidine were found to be related to their neuropharmacology. The current review demonstrates relatively few investigations seeking to characterize the neuropharmacologic suitability of DISE agents. Compared to propofol and midazolam, dexmedetomidine's mechanism of action appears most likely to induce natural sleep pathways. Further study of its effect on upper airway collapsibility (critical closing pressure) and pharyngeal muscle tone (genioglossus electrode electromyography) are needed. Laryngoscope, 2016 Laryngoscope, 127:273-279, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

A Compound Detection System Based on Ultrasonic Flow Rate and Concentration

Directory of Open Access Journals (Sweden)

Qing-Hui WANG

2014-02-01

Full Text Available This paper proposes a new detection system for monitoring gas concentration and flow rate. Velocity difference of ultrasonic wave in bi-directional propagation in measured gas is recorded and utilized for computing the online gas concentration and flow rate. Meanwhile, the temperature compensation, return signal processing and error analysis algorithms are applied to improve the accuracy. The experimental results show that, compared with the single sensor measurement of gas flow rate or concentration, the proposed detection system with lower cost and higher accuracy can be applied in the occasion which needs simultaneous monitoring of gas concentration and flow rate.

Flux Concentration and Pole Shaping in a Single Phase Hybrid Switched Reluctance Motor Drive

DEFF Research Database (Denmark)

Jakobsen, Uffe; Lu, Kaiyuan

2010-01-01

The single phase hybrid switched reluctance motor (HSRM) may be a good candidate for low-cost drives used for pump applications. This paper presents a new design of the HSRM with improved starting torque achieved by stator pole shaping, and a better arrangement of the embedded stator permanent...

Salt Concentration Differences Alter Membrane Resistance in Reverse Electrodialysis Stacks

KAUST Repository

Geise, Geoffrey M.

2014-01-14

Membrane ionic resistance is usually measured by immersing the membrane in a salt solution at a single, fixed concentration. While salt concentration is known to affect membrane resistance when the same concentration is used on both sides of the membrane, little is known about membrane resistance when the membrane is placed between solutions of different concentrations, such as in a reverse electrodialysis (RED) stack. Ionic resistance measurements obtained using Selemion CMV and AMV that separated sodium chloride and ammonium bicarbonate solutions of different concentrations were greater than those measured using only the high-concentration solution. Measured RED stack resistances showed good agreement with resistances calculated using an equivalent series resistance model, where the membranes accounted for 46% of the total stack resistance. The high area resistance of the membranes separating different salt concentration solutions has implications for modeling and optimizing membranes used in RED systems.

Planar-integrated single-crystalline perovskite photodetectors

KAUST Repository

Saidaminov, Makhsud I.

2015-11-09

Hybrid perovskites are promising semiconductors for optoelectronic applications. However, they suffer from morphological disorder that limits their optoelectronic properties and, ultimately, device performance. Recently, perovskite single crystals have been shown to overcome this problem and exhibit impressive improvements: low trap density, low intrinsic carrier concentration, high mobility, and long diffusion length that outperform perovskite-based thin films. These characteristics make the material ideal for realizing photodetection that is simultaneously fast and sensitive; unfortunately, these macroscopic single crystals cannot be grown on a planar substrate, curtailing their potential for optoelectronic integration. Here we produce large-area planar-integrated films made up of large perovskite single crystals. These crystalline films exhibit mobility and diffusion length comparable with those of single crystals. Using this technique, we produced a high-performance light detector showing high gain (above 104 electrons per photon) and high gain-bandwidth product (above 108 Hz) relative to other perovskite-based optical sensors.

Effects of laparoscopy on the cardiorespiratory system of brown brocket deer (Mazama gouazoubira anesthetized with ketamine/ xylazine/ midazolam combination and isoflurane Efeitos da laparoscopia sobre o sistema cardiorrespiratório de veados-catingueiro (Mazama gouazoubira anestesiados com a associação cetamina/xilazina/midazolam e isofluorano

Directory of Open Access Journals (Sweden)

Marina Salles Munerato

2008-11-01

Full Text Available Laparoscopy is not widely used as a tool to perform assisted reproduction techniques in South American cervids; thus, scarce information in literature is available regarding its effects and appropriate anesthetic protocols to perform it. This study evaluated the effect of laparoscopy on heart rate (HR, respiration rate (RR, saturation of oxyhemoglobin (SpO2 and rectal temperature (RT of six female brown brocket deer (Mazama gouazoubira anesthetized with ketamine (5mg/kg, xylazine (0.3mg/kg, midazolam (0.5mg/kg combination i.v. and isoflurane. Twelve laparoscopies were performed and each animal was used twice with a 40-day interval. After anesthetized, the animals were placed in dorsal recumbency to perform laparoscopy procedure using abdominal CO2 insufflations (14.2 ± 2.39mmHg; M ± SE. The main events of the laparoscopy procedure were divided into three periods: animal without (P1 and with abdominal insufflation (P2 and abdominal insufflation with the hips raised at 45º (P3. As a control, the animals were anesthetized again 40 days after the last laparoscopy, and were maintained in a dorsal recumbency for the same average duration of the previous anesthesia and no laparoscopy procedure was conducted. The period of anesthesia for the controls was also divided into P1, P2, and P3 considering the average duration of these periods in previous laparoscopies performed. Data were analyzed through the (ANOVA variance analysis followed by Tukey test and values at PA laparoscopia ainda é pouco utilizada como ferramenta para técnicas de reprodução assistida em cervídeos sul-americanos, não havendo informações sobre seus efeitos e protocolos anestésicos seguros para sua realização. Objetivaramse avaliar as possíveis alterações na freqüência cardíaca (FC, respiratória (FR, saturação de oxihemoglobina (SpO2 e temperatura retal (TR durante a laparoscopia para visualização dos órgãos reprodutivos de seis fêmeas de veado

Variability of Urinary Phthalate Metabolite and Bisphenol A Concentrations before and during Pregnancy

Science.gov (United States)

Braun, Joe M.; Smith, Kristen W.; Williams, Paige L.; Calafat, Antonia M.; Berry, Katharine; Ehrlich, Shelley

2012-01-01

Background: Gestational phthalate and bisphenol A (BPA) exposure may increase the risk of adverse maternal/child health outcomes, but there are few data on the variability of urinary biomarkers before and during pregnancy. Objective: We characterized the variability of urinary phthalate metabolite and BPA concentrations before and during pregnancy and the ability of a single spot urine sample to classify average gestational exposure. Methods: We collected 1,001 urine samples before and during pregnancy from 137 women who were partners in couples attending a Boston fertility clinic and who had a live birth. Women provided spot urine samples before (n ≥ 2) and during (n ≥ 2) pregnancy. We measured urinary concentrations of monoethyl phthalate (MEP), mono-n-butyl phthalate (MBP), mono-iso-butyl phthalate, monobenzyl phthalate (MBzP), four metabolites of di-(2-ethylhexyl) phthalate (DEHP), and BPA. After adjusting for specific gravity, we characterized biomarker variability using intraclass correlation coefficients (ICCs) and conducted several surrogate category analyses to determine whether a single spot urine sample could adequately classify average gestational exposure. Results: Absolute concentrations of phthalate metabolites and BPA were similar before and during pregnancy. Variability was higher during pregnancy than before pregnancy for BPA and MBzP, but similar during and before pregnancy for MBP, MEP, and ΣDEHP. During pregnancy, MEP (ICC = 0.50) and MBP (ICC = 0.45) were less variable than BPA (ICC = 0.12), MBzP (ICC = 0.25), and ΣDEHP metabolites (ICC = 0.08). Surrogate analyses suggested that a single spot urine sample may reasonably classify MEP and MBP concentrations during pregnancy, but more than one sample may be necessary for MBzP, DEHP, and BPA. Conclusions: Urinary phthalate metabolites and BPA concentrations were variable before and during pregnancy, but the magnitude of variability was biomarker specific. A single spot urine sample

Development of two dimensional electrophoresis method using single chain DNA

International Nuclear Information System (INIS)

Ikeda, Junichi; Hidaka, So

1998-01-01

By combining a separation method due to molecular weight and a method to distinguish difference of mono-bases, it was aimed to develop a two dimensional single chain DNA labeled with Radioisotope (RI). From electrophoretic pattern difference of parent and variant strands, it was investigated to isolate the root module implantation control gene. At first, a Single Strand Conformation Polymorphism (SSCP) method using concentration gradient gel was investigated. As a result, it was formed that intervals between double chain and single chain DNAs expanded, but intervals of both single chain DNAs did not expand. On next, combination of non-modified acrylic amide electrophoresis method and Denaturing Gradient-Gel Electrophoresis (DGGE) method was examined. As a result, hybrid DNA developed by two dimensional electrophoresis arranged on two lines. But, among them a band of DNA modified by high concentration of urea could not be found. Therefore, in this fiscal year's experiments, no preferable result could be obtained. By the used method, it was thought to be impossible to detect the differences. (G.K.)

In vitro reduction of dental erosion by low-concentration TiF4 solutions

NARCIS (Netherlands)

Vieira, A.M.; Ruben, J.L.; Bronkhorst, E.M.; Huysmans, M.C.D.N.J.M.

2011-01-01

The aims of this study were to compare daily versus single applications of low-concentration TiF(4) solutions for reduction of enamel erosion and to evaluate the enamel surface loss due to application of these solutions. Sixty bovine enamel samples were randomly divided into 2 groups: single versus

In vitro Reduction of Dental Erosion by Low-Concentration TiF4 Solutions

NARCIS (Netherlands)

Vieira, A. M.; Ruben, J. L.; Bronkhorst, E. M.; Huysmans, M. C. D. N. J. M.

2011-01-01

The aims of this study were to compare daily versus single applications of low-concentration TiF4 solutions for reduction of enamel erosion and to evaluate the enamel surface loss due to application of these solutions. Sixty bovine enamel samples were randomly divided into 2 groups: single versus

Chemical restraint of captive Kinkajous Potos flavus (Schreber, 1774 (Carnivora: Procyonidae using a ketamine, xylazine and midazolam combination and reversal with yohimbine

Directory of Open Access Journals (Sweden)

Jesús Lescano

2016-12-01

Full Text Available Detailed information on the anaesthetic and cardiorespiratory effects of drug combinations used for the chemical immobilization of Kinkajous (Potos flavus is scarce.  This study assessed the effects of ketamine (2.5mg/kg, xylazine (1mg/kg and midazolam (0.5mg/kg combination in P. flavus.  Five clinically healthy adult Kinkajous of both sexes were included.  Heart rate, respiratory rate, oxygen saturation, blood pressure and body temperature were recorded at five-minute intervals for 25 minutes.  Then, animals received 0.125mg/kg of yohimbine by intramuscular injection.  Anaesthetic depth was assessed based on stimulus response and muscle tone.  Induction, immobilization, and recovery periods were recorded and qualitatively assessed based on the absence of adverse effects.  The durations of the induction, immobilization, and recovery periods were 9.42±1.73, 33.33±2.16, and 31.37±5.82 minutes.  All periods showed good quality and adequate anaesthetic depth was achieved.  Mean heart and respiratory rates were 99±20 beats/minute and 44±9 breaths/minute.  Both parameters decreased over the duration of the anaesthesia but they did not reach levels suggesting either bradycardia or bradypnea.  Mean body temperature was 37.1±1.5 0C and it also showed a decreasing trend over the duration of the anaesthesia.  Mean oxygen saturation was 92±6% and it showed a mildly increasing trend over the duration of the anesthesia.  Mean blood pressure was 129±23 mmHg and mild to moderate hypertension was observed.  No mortality occurred and no adverse effects were observed in any of the individuals during the three months following immobilization.  The assessed anaesthetic combination effectively immobilized the P. flavus individuals, provided good quality and acceptable duration of both induction and recovery periods.  It should, however, not be used in Kinkajous with either known hypertension record or pre-existing target organ disease (e

Pharmacokinetic properties of methadone hydrochloride after single intramuscular administration in adult dairy goats.

Science.gov (United States)

Kock, M; Thompson, E; Vulliet, P R; Brooks, D L

1994-10-01

Pharmacokinetic parameters of methadone were studied in adult dairy goats. Five goats were each given methadone hydrochloride as a single 0.2 mg/kg of body weight dosage by intramuscular (IM) administration. Plasma methadone concentrations were determined for 96 h after dosing. Plasma methadone concentrations after IM administration were best described by an open one-compartment model. Overall elimination half-life (t1/2) was 1.38 h. Peak plasma concentrations were reached 0.25 h after dosing, and the actual plasma concentration averaged 37.8 ng/ml (SD = 12.76) at that time. The data obtained from this study suggest that plasma concentrations, similar to those that are analgesic in humans, can be achieved after IM administration of methadone at a dose rate of 0.2 mg/kg of body weight. In addition, these plasma concentrations can be maintained for up to 3 h after a single injection and, therefore, may provide satisfactory analgesia for such period.

Supra-recommendation Treatment of Super-refractory Status Epilepticus.

Science.gov (United States)

Vyas, Devashish Dhiren; Dash, Gopal Krishna

2016-06-01

A 28-year old female was admitted with recurrent seizures following 2 days of febrile illness, after which she developed status epilepticus. Midazolam and later thiopentone infusions were started after failure of regular intravenous antiepileptics. Burst suppression was achieved at doses of 3 mg/kg/hr for midazolam and 6 mg/kg/hr of thiopentone. Adjunctive medications included methylprednisolone, intravenous immunoglobulin and acyclovir. Imaging and biochemical parameters were normal. She required 3 cycles of midazolam and 2 cycles of thiopentone for complete cessation of seizures. She recovered with mild attentional and recent memory deficits on follow up. Treatment of super-refractory status epilepticus requires individualized regimens and may need doses beyond conventional limits. To the best of our knowledge, there is no such reported case from India.

Monocrystalline silicon photovoltaic luminescent solar concentrator with 4.2% power conversion efficiency

NARCIS (Netherlands)

Desmet, L.; Ras, A.J.M.; Boer, de D.K.G.; Debije, M.G.

2012-01-01

We report conversion efficiencies of experimental single and dual light guide luminescent solar concentrators. We have built several 5¿¿cm×5¿¿cm and 10¿¿cm×10¿¿cm luminescent solar concentrator (LSC) demonstrators consisting of c-Si photovoltaic cells attached to luminescent light guides of Lumogen

Direct quantification of rare earth element concentrations in natural waters by ICP-MS

International Nuclear Information System (INIS)

Lawrence, Michael G.; Greig, Alan; Collerson, Kenneth D.; Kamber, Balz S.

2006-01-01

A direct quadrupole ICP-MS technique has been developed for the analysis of the rare earth elements and yttrium in natural waters. The method has been validated by comparison of the results obtained for the river water reference material SLRS-4 with literature values. The detection limit of the technique was investigated by analysis of serial dilutions of SLRS-4 and revealed that single elements can be quantified at single-digit fg/g concentrations. A coherent normalised rare earth pattern was retained at concentrations two orders of magnitude below natural concentrations for SLRS-4, demonstrating the excellent inter-element accuracy and precision of the method. The technique was applied to the analysis of a diluted mid-salinity estuarine sample, which also displayed a coherent normalised rare earth element pattern, yielding the expected distinctive marine characteristics

Single-step transesterification with simultaneous concentration and stable isotope analysis of fatty acid methyl esters by gas chromatography-combustion-isotope ratio mass spectrometry.

Science.gov (United States)

Panetta, Robert J; Jahren, A Hope

2011-05-30

Gas chromatography-combustion-isotope ratio mass spectrometry (GC-C-IRMS) is increasingly applied to food and metabolic studies for stable isotope analysis (δ(13) C), with the quantification of analyte concentration often obtained via a second alternative method. We describe a rapid direct transesterification of triacylglycerides (TAGs) for fatty acid methyl ester (FAME) analysis by GC-C-IRMS demonstrating robust simultaneous quantification of amount of analyte (mean r(2) =0.99, accuracy ±2% for 37 FAMEs) and δ(13) C (±0.13‰) in a single analytical run. The maximum FAME yield and optimal δ(13) C values are obtained by derivatizing with 10% (v/v) acetyl chloride in methanol for 1 h, while lower levels of acetyl chloride and shorter reaction times skewed the δ(13) C values by as much as 0.80‰. A Bland-Altman evaluation of the GC-C-IRMS measurements resulted in excellent agreement for pure oils (±0.08‰) and oils extracted from French fries (±0.49‰), demonstrating reliable simultaneous quantification of FAME concentration and δ(13) C values. Thus, we conclude that for studies requiring both the quantification of analyte and δ(13) C data, such as authentication or metabolic flux studies, GC-C-IRMS can be used as the sole analytical method. Copyright © 2011 John Wiley & Sons, Ltd.

Single-cell Analysis of Lambda Immunity Regulation

DEFF Research Database (Denmark)

Bæk, Kristoffer Torbjørn; Svenningsen, Sine Lo; Eisen, Harvey

2003-01-01

We have examined expression of the ¿cI operon in single cells via a rexgfp substitution. Although average fluorescence agreed with expectations for expression of ¿-repressor, fluorescence fluctuated greatly from cell-to-cell. Fluctuations in repressor concentration are not predicted by previous m...

Reduction of oxygen concentration by heater design during Czochralski Si growth

Science.gov (United States)

Zhou, Bing; Chen, Wenliang; Li, Zhihui; Yue, Ruicun; Liu, Guowei; Huang, Xinming

2018-02-01

Oxygen is one of the highest-concentration impurities in single crystals grown by the Czochralski (CZ) process, and seriously impairs the quality of the Si wafer. In this study, computer simulations were applied to design a new CZ system. A more appropriate thermal field was acquired by optimization of the heater structure. The simulation results showed that, compared with the conventional system, the oxygen concentration in the newly designed CZ system was reduced significantly throughout the entire CZ process because of the lower crucible wall temperature and optimized convection. To verify the simulation results, experiments were conducted on an industrial single-crystal furnace. The experimental results showed that the oxygen concentration was reduced significantly, especially at the top of the CZ-Si ingot. Specifically, the oxygen concentration was 6.19 × 1017 atom/cm3 at the top of the CZ-Si ingot with the newly designed CZ system, compared with 9.22 × 1017 atom/cm3 with the conventional system. Corresponding light-induced degradation of solar cells based on the top of crystals from the newly designed CZ system was 1.62%, a reduction of 0.64% compared with crystals from the conventional system (2.26%).

Fiber Bragg Grating Sensor for Detection of Nitrate Concentration in Water

Directory of Open Access Journals (Sweden)

A. S. LALASANGI

2011-02-01

Full Text Available The concentrations of chemical species in drinking water are of great interest. We demonstrated etched fiber Bragg grating (FBG as a concentration sensor for nitrate by analyzing the Bragg wavelength shift with concentration of chemical solution. The FBG is fabricated by phase mask technique on single mode Ge-B co-doped photosensitive fiber. Sensitivity of FBGs to the surrounding solution concentration can be enhanced by reducing diameter of the cladding with 40 % HF solution. The maximum sensitivity achieved is 1.322 ´ 10-3 nm/ppm. The overall shift of Bragg wavelength is of the order of 6.611 ´ 10-2 nm for 10 to 50 ppm concentration.

Investigation of Stress Concentration and Casing Strength Degradation Caused by Corrosion Pits

Directory of Open Access Journals (Sweden)

Wei Yan

2016-01-01

Full Text Available Downhole casing and tubing are subjected to corrosion in many cases because of the exposure to corrosive environment. A more serious problem is that pitting corrosion occurs in the casing inner surface. Meanwhile, downhole strings are subjected to various forms of mechanical loads, for example, internal pressure load, external collapse load, or both. These loads acting on the corrosion pits will cause stress concentration and degrade the casing strength. Thus, it is essential to evaluate the stress concentration degree reasonably. The SCF (stress concentration factor is usually used to characterize the degree of stress concentration induced by corrosion pits. This paper presented a comparison on the SCFs regarding the analytical method for a single pit and experimental method for double pits. The results show that the SCF of a single pit depends mainly on the depth of the corrosion pit; however, the SCF of the double pits strongly depends on the pits distance. A correction factor of 1.3 was recommended in the double pits SCF prediction model.

An investigation of factors influencing indoor radon concentrations

International Nuclear Information System (INIS)

Majborn, B.; Soerensen, A.; Nielsen, S.P.; Boetter-Jensen, L.

1988-05-01

Variations in indoor radon concentrations and some influencing factors have been studied during a two-year period (1986-1987) in 16 almost identical single-family houses.The annual average radon concentration in the houses varied from about 50 to about 400 Bq/m 3 . Variations in soil characteristics and radon concentration in soil gas could not be directly related to the variations of the average indoor radon concentrations. Most of the houses showed a ''normal'' seasonal variation of the radon concentration with a maximum in the winter and minimum in the summer. A deviating seasonal variation was found in three of the houses. Hourly data obtained in one unoccupied house during a period of 2-1/2 months showed no or only weak correlations between the indoor radon concentration and meteorological factors. However, for most of the houses, the seasonal variation of the indoor radon concentration was well correlated with the average indoor-outdoor temperature difference on a 2-month basis. It was demonstrated that the radon concentration can be strongly reduced in the Risoe houses if a district-heating duct, which is connected to all the houses, is ventilated, so that a slightly lowered pressure is maintained in the duct. 5 taps., 24 ill. (author)

Hybrid Perovskites: Prospects for Concentrator Solar Cells.

Science.gov (United States)

Lin, Qianqian; Wang, Zhiping; Snaith, Henry J; Johnston, Michael B; Herz, Laura M

2018-04-01

Perovskite solar cells have shown a meteoric rise of power conversion efficiency and a steady pace of improvements in their stability of operation. Such rapid progress has triggered research into approaches that can boost efficiencies beyond the Shockley-Queisser limit stipulated for a single-junction cell under normal solar illumination conditions. The tandem solar cell architecture is one concept here that has recently been successfully implemented. However, the approach of solar concentration has not been sufficiently explored so far for perovskite photovoltaics, despite its frequent use in the area of inorganic semiconductor solar cells. Here, the prospects of hybrid perovskites are assessed for use in concentrator solar cells. Solar cell performance parameters are theoretically predicted as a function of solar concentration levels, based on representative assumptions of charge-carrier recombination and extraction rates in the device. It is demonstrated that perovskite solar cells can fundamentally exhibit appreciably higher energy-conversion efficiencies under solar concentration, where they are able to exceed the Shockley-Queisser limit and exhibit strongly elevated open-circuit voltages. It is therefore concluded that sufficient material and device stability under increased illumination levels will be the only significant challenge to perovskite concentrator solar cell applications.

single dose pharmacokinetics of mefloquine in healthy nigerian

African Journals Online (AJOL)

BSN

Mefloquine 500mg single dose was administered and blood samples were collected ... particle size ODS Hypersil (HETP, Macclesfield, UK) at a pressure of 55 Mpa .... dose to area under the plasma drug concentration - time curve, assuming ...

Effects of ambient temperature and oxygen concentration on diesel spray combustion using a single-nozzle injector in a constant volume combustion chamber

KAUST Repository

Jing, Wei

2013-09-02

This work investigates the effects of ambient conditions on diesel spray combustion in an optically accessible, constant volume chamber using a single-nozzle fuel injector. The ambient O2 concentration was varied between five discrete values from 10% to 21% and three different ambient temperatures (800 K, 1000 K, and 1200 K). These conditions simulate different exhaust gas recirculation (EGR) levels and ambient temperatures in diesel engines. Both conventional diesel combustion and low temperature combustion (LTC) modes were observed under these conditions. A transient analysis and a quasi-steady state analysis are employed in this article. The transient analysis focuses on the flame development from beginning to the end, illustrating how the flame structure changes during this process; the quasi-steady state analysis focuses on the stable flame structure. The transient analysis was conducted using high-speed imaging of both OH* chemiluminescence and natural luminosity (NL). In addition, three different images were acquired using an ICCD camera, corresponding to OH* chemiluminescence, narrow-band flame emission at 430 nm (Band A) and at 470 nm (Band B), and were used to investigate the quasi-steady state combustion process. From the transient analysis, it was found that the NL signal becomes stronger and confined to narrow regions when the temperature and O2 concentration increase during the development of flame. The OH* intensity is much lower for the 10% ambient O2 and 800 K conditions compared to the higher temperatures and O2 levels. This implies the occurrence of LTC under these conditions. Results from the quasi-steady combustion stage indicate that high-temperature reactions effectively oxidize the soot in the downstream locations where only OH* signal is observed. In addition, an area was calculated for each spectral region, and results show that the area of Band A and Band B emissions in these images is larger than the area of OH* emissions at the lower O2

Effects of ambient temperature and oxygen concentration on diesel spray combustion using a single-nozzle injector in a constant volume combustion chamber

KAUST Repository

Jing, Wei; Roberts, William L.; Fang, Tiegang

2013-01-01

This work investigates the effects of ambient conditions on diesel spray combustion in an optically accessible, constant volume chamber using a single-nozzle fuel injector. The ambient O2 concentration was varied between five discrete values from 10% to 21% and three different ambient temperatures (800 K, 1000 K, and 1200 K). These conditions simulate different exhaust gas recirculation (EGR) levels and ambient temperatures in diesel engines. Both conventional diesel combustion and low temperature combustion (LTC) modes were observed under these conditions. A transient analysis and a quasi-steady state analysis are employed in this article. The transient analysis focuses on the flame development from beginning to the end, illustrating how the flame structure changes during this process; the quasi-steady state analysis focuses on the stable flame structure. The transient analysis was conducted using high-speed imaging of both OH* chemiluminescence and natural luminosity (NL). In addition, three different images were acquired using an ICCD camera, corresponding to OH* chemiluminescence, narrow-band flame emission at 430 nm (Band A) and at 470 nm (Band B), and were used to investigate the quasi-steady state combustion process. From the transient analysis, it was found that the NL signal becomes stronger and confined to narrow regions when the temperature and O2 concentration increase during the development of flame. The OH* intensity is much lower for the 10% ambient O2 and 800 K conditions compared to the higher temperatures and O2 levels. This implies the occurrence of LTC under these conditions. Results from the quasi-steady combustion stage indicate that high-temperature reactions effectively oxidize the soot in the downstream locations where only OH* signal is observed. In addition, an area was calculated for each spectral region, and results show that the area of Band A and Band B emissions in these images is larger than the area of OH* emissions at the lower O2

Number of core samples: Mean concentrations and confidence intervals

International Nuclear Information System (INIS)

Jensen, L.; Cromar, R.D.; Wilmarth, S.R.; Heasler, P.G.

1995-01-01

This document provides estimates of how well the mean concentration of analytes are known as a function of the number of core samples, composite samples, and replicate analyses. The estimates are based upon core composite data from nine recently sampled single-shell tanks. The results can be used when determining the number of core samples needed to ''characterize'' the waste from similar single-shell tanks. A standard way of expressing uncertainty in the estimate of a mean is with a 95% confidence interval (CI). The authors investigate how the width of a 95% CI on the mean concentration decreases as the number of observations increase. Specifically, the tables and figures show how the relative half-width (RHW) of a 95% CI decreases as the number of core samples increases. The RHW of a CI is a unit-less measure of uncertainty. The general conclusions are as follows: (1) the RHW decreases dramatically as the number of core samples is increased, the decrease is much smaller when the number of composited samples or the number of replicate analyses are increase; (2) if the mean concentration of an analyte needs to be estimated with a small RHW, then a large number of core samples is required. The estimated number of core samples given in the tables and figures were determined by specifying different sizes of the RHW. Four nominal sizes were examined: 10%, 25%, 50%, and 100% of the observed mean concentration. For a majority of analytes the number of core samples required to achieve an accuracy within 10% of the mean concentration is extremely large. In many cases, however, two or three core samples is sufficient to achieve a RHW of approximately 50 to 100%. Because many of the analytes in the data have small concentrations, this level of accuracy may be satisfactory for some applications

Defect spectroscopy of single ZnO microwires

Science.gov (United States)

Villafuerte, M.; Ferreyra, J. M.; Zapata, C.; Barzola-Quiquia, J.; Iikawa, F.; Esquinazi, P.; Heluani, S. P.; de Lima, M. M.; Cantarero, A.

2014-04-01

The point defects of single ZnO microwires grown by carbothermal reduction were studied by microphotoluminescence, photoresistance excitation spectra, and resistance as a function of the temperature. We found the deep level defect density profile along the microwire showing that the concentration of defects decreases from the base to the tip of the microwires and this effect correlates with a band gap narrowing. The results show a characteristic deep defect levels inside the gap at 0.88 eV from the top of the VB. The resistance as a function of the temperature shows defect levels next to the bottom of the CB at 110 meV and a mean defect concentration of 4 × 1018 cm-3. This combination of techniques allows us to study the band gap values and defects states inside the gap in single ZnO microwires and opens the possibility to be used as a defect spectroscopy method.

A new plastic scintillation resin for single-step separation, concentration and measurement of technetium-99

Energy Technology Data Exchange (ETDEWEB)

Barrera, J. [Department of Analytical Chemistry, Universitat de Barcelona, Martí i Franqués, 1-11, E-08028, Barcelona (Spain); Tarancón, A., E-mail: alex.tarancon@ub.edu [Department of Analytical Chemistry, Universitat de Barcelona, Martí i Franqués, 1-11, E-08028, Barcelona (Spain); Bagán, H. [Department of Pure and Applied Biochemistry, Lund University, Getingevägen 60, hus II, 22100 SE, Lund (Sweden); García, J.F. [Department of Analytical Chemistry, Universitat de Barcelona, Martí i Franqués, 1-11, E-08028, Barcelona (Spain)

2016-09-14

Technetium is a synthetic element with no stable isotopes, produced as waste in nuclear power plants and in cyclotrons used for nuclear medicine. The element has high mobility, in the form of TcO{sub 4}{sup −}; its determination is therefore important for environmental protection. Technetium is found in low concentrations and therefore common methods for its analysis include long treatments in several steps and require large amounts of reagents for its purification and preconcentration. Plastic scintillation resins (PSresin) are novel materials used to separate, preconcentrate and measure radionuclides in a single step. The objective of this study is to prepare and characterise a PSresin for the preconcentration and measurement of {sup 99}Tc. The study first evaluates the reproducibility of the production of PSresins between batches and over time; showing good reproducibility and storage stability. Next, we studied the effect of some common non-radioactive interferences, showing small influences on measurement, and radioactive interferences ({sup 36}Cl and {sup 238}U/{sup 234}U). {sup 36}Cl can be removed by a simple treatment with 0.5 M HCl and {sup 238}U/{sup 234}U can be removed from the column by cleaning with a mixture of 0.1 M HNO{sub 3} and 0.1 M HF. In the latter case, a slight change in the morphology of the PSresin caused an increase in detection efficiency. Finally, the PSresin was applied to the measurement of real spiked samples (sea water and urine) with deviations lower than 10% in all cases. - Highlights: • A plastic scintillation resin for selective analysis of {sup 99}Tc has been developed. • The method is valid for analysis of {sup 99}Tc in seawater and urine samples. • Presence of Cl{sup −}, NO{sub 3}{sup −}, SO{sub 4}{sup 2−}, {sup 36}Cl, U and Th not affect retention of {sup 99}Tc.

A new plastic scintillation resin for single-step separation, concentration and measurement of technetium-99

International Nuclear Information System (INIS)

Barrera, J.; Tarancón, A.; Bagán, H.; García, J.F.

2016-01-01

Technetium is a synthetic element with no stable isotopes, produced as waste in nuclear power plants and in cyclotrons used for nuclear medicine. The element has high mobility, in the form of TcO_4"−; its determination is therefore important for environmental protection. Technetium is found in low concentrations and therefore common methods for its analysis include long treatments in several steps and require large amounts of reagents for its purification and preconcentration. Plastic scintillation resins (PSresin) are novel materials used to separate, preconcentrate and measure radionuclides in a single step. The objective of this study is to prepare and characterise a PSresin for the preconcentration and measurement of "9"9Tc. The study first evaluates the reproducibility of the production of PSresins between batches and over time; showing good reproducibility and storage stability. Next, we studied the effect of some common non-radioactive interferences, showing small influences on measurement, and radioactive interferences ("3"6Cl and "2"3"8U/"2"3"4U). "3"6Cl can be removed by a simple treatment with 0.5 M HCl and "2"3"8U/"2"3"4U can be removed from the column by cleaning with a mixture of 0.1 M HNO_3 and 0.1 M HF. In the latter case, a slight change in the morphology of the PSresin caused an increase in detection efficiency. Finally, the PSresin was applied to the measurement of real spiked samples (sea water and urine) with deviations lower than 10% in all cases. - Highlights: • A plastic scintillation resin for selective analysis of "9"9Tc has been developed. • The method is valid for analysis of "9"9Tc in seawater and urine samples. • Presence of Cl"−, NO_3"−, SO_4"2"−, "3"6Cl, U and Th not affect retention of "9"9Tc.

Concentrations of trimethoprim and sulphadoxine in tissues from goats and a cow

Energy Technology Data Exchange (ETDEWEB)

Nielsen, P; Rasmussen, F [Kongelige Veterinaer- og Landbohoejskole, Copenhagen (Denmark)

1975-01-01

The concentration of trimethoprim and sulphadoxine in plasma and tissue from goats and a cow have been determined after a single intravenous injection. Furthermore, the concentration of the two drugs and their metabolites in plasma and tissues have been determined after continuous intravenous infusion for 2 1/2 - 3 hrs. Trimethoprim was present in all tissues but brain at higher concentrations than in plasma while the concentration of sulphadoxine in the different tissues were lower than in plasma. The highest concentration of the 2 drugs and their metabolites was found in the kidney. The distribution pattern of trimethoprim and sulphadoxine was similar in cow and goats.

Concentrations of trimethoprim and sulphadoxine in tissues from goats and a cow

International Nuclear Information System (INIS)

Nielsen, P.; Rasmussen, F.

1975-01-01

The concentration of trimethoprim and sulphadoxine in plasma and tissue from goats and a cow have been determined after a single intravenous injection. Furthermore, the concentration of the two drugs and their metabolites in plasma and tissues have been determined after continuous intravenous infusion for 2 1/2 - 3 hrs. Trimethoprim was present in all tissues but brain at higher concentrations than in plasma while the concentration of sulphadoxine in the different tissues were lower than in plasma. The highest concentration of the 2 drugs and their metabolites was found in the kidney. The distribution pattern of trimethoprim and sulphadoxine was similar in cow and goats. (author)

Limited sampling strategy for determining metformin area under the plasma concentration-time curve

DEFF Research Database (Denmark)

Santoro, Ana Beatriz; Stage, Tore Bjerregaard; Struchiner, Claudio José

2016-01-01

AIM: The aim was to develop and validate limited sampling strategy (LSS) models to predict the area under the plasma concentration-time curve (AUC) for metformin. METHODS: Metformin plasma concentrations (n = 627) at 0-24 h after a single 500 mg dose were used for LSS development, based on all su...

in upper gastrointestinal endoscopy

Directory of Open Access Journals (Sweden)

Sinan Uzman

2016-07-01

Full Text Available Introduction : There is increasing interest in sedation for upper gastrointestinal endoscopy (UGE. Prospective randomized studies comparing sedation properties and complications of propofol and midazolam/meperidine in upper gastrointestinal endoscopy (UGE are few. Aim: To compare propofol and midazolam/meperidine sedation for UGE in terms of cardiopulmonary side effects, patient and endoscopist satisfaction and procedure-related times. Material and methods: This was a prospective, randomized, double-blind study of propofol versus midazolam and meperidine in 100 patients scheduled for diagnostic upper gastrointestinal endoscopy. The patients were divided into propofol and midazolam/meperidine groups. Randomization was generated by a computer. Cardiopulmonary side effects (hypotension, bradycardia, hypoxemia, procedure-related times (endoscopy time, awake time, time to hospital discharge, and patient and endoscopist satisfaction were compared between groups. Results: There was no significant difference between the groups with respect to the cost, endoscopy time, or demographic and clinical characteristics of the patients. Awake time and time to hospital discharge were significantly shorter in the propofol group (6.58 ±4.72 vs. 9.32 ±4.26 min, p = 0.030 and 27.60 ±7.88 vs. 32.00 ±10.54 min, p = 0.019. Hypotension incidence was significantly higher in the propofol group (12% vs. 0%, p = 0.027. The patient and endoscopist satisfaction was better with propofol. Conclusions : Propofol may be preferred to midazolam/meperidine sedation, with a shorter awake and hospital discharge time and better patient and endoscopist satisfaction. However, hypotension risk should be considered with propofol, and careful evaluation is needed, particularly in cardiopulmonary disorders.

Low-to-moderate nitrogen and phosphorus concentrations accelerate microbially driven litter breakdown rates

Science.gov (United States)

John S. Kominoski; Amy D. Rosemond; Jonathan P. Benstead; Vladislav Gulis; John C. Maerz; David Manning

2015-01-01

Particulate organic matter (POM) processing is an important driver of aquatic ecosystem productivity that is sensitive to nutrient enrichment and drives ecosystem carbon (C) loss. Although studies of single concentrations of nitrogen (N) or phosphorus (P) have shown effects at relatively low concentrations, responses of litter breakdown rates along gradients of low-to-...

FROG INTESTINAL PERFUSION TO EVALUATE DRUG PERMEABILITY: APPLICATION TO P-gp AND CYP3A4 SUBSTRATES

Directory of Open Access Journals (Sweden)

Neelima eYerasi

2015-07-01

Full Text Available AbstractTo evaluate the reliability of using in situ frog intestinal perfusion technique for permeability assessment of carrier transported drugs which are also substrates for CYP enzymes. Single Pass Intestinal Perfusion (SPIP studies were performed in frogs of the species Rana tigrina using established method for rats with some modifications after inducing anesthesia. Effective permeability coefficient (Peff of losartan and midazolam was calculated in the presence and absence of inhibitors using the parallel-tube model. Peff of losartan when perfused alone was found to be 0.427 ± 0.27×10-4cm/s and when it was co-perfused with inhibitors, significant change in Peff was observed. Peff of midazolam when perfused alone was found to be 2.03 ± 0.07 × 10-4cm/s and when it was co-perfused with inhibitors, no significant change in Peff was observed. Comparison of Peff calculated in frog with that of other available models and also humans suggested that the Peff values are comparable and reflected well with human intestinal permeability. It is possible to determine the Peff value for compounds which are dual substrates of P-gp and CYP3A4 using in situ frog intestinal perfusion technique. The calculated Peff values correlated well with reported Peff values of probe drugs. comparison of the Peff value of losartan obtained with that of reported human’s Peff and Caco 2 cell data, and comparison of the Peff value of midazolam with that of reported rat’s Peff, we could conclude that SPIP from model can be reliably used in preclinical studies for permeability estimation. This model may represent a valuable alternative to the low speed and high cost of conventional animal models (typically rodents for the assessment of intestinal permeability.

Influence of alloy elements on physical and mechanical properties of single crystalline austenitic stainless steels

International Nuclear Information System (INIS)

Okamoto, Kazutaka; Kaneda, Junya; Yoshinari, Akira; Aono, Yasuhisa

2000-01-01

The single crystalline austenitic stainless steels based on 316 L were developed to improve their resistance to intergranular corrosion and stress corrosion cracking. However the mechanical properties of the single crystals were lower than those of polycrystalline. The precipitation hardening methods were applied to the single crystal for the increase of their mechanical strength by addition of niobium and heat treatments. In this paper, the influences of niobium concentration on the several physical and mechanical properties of these single crystalline austenitic stainless steels were studied. The thermal conductivity, coefficients of thermal expansion and elastic constants of the single crystals were almost the same as those of polycrystalline independently of the niobium concentration. The mechanical properties of the single crystals strongly depended on the niobium concentration and the orientation. In the specimen which contains 1.0 mass% niobium, 0.2% proof stress were remarkably improved; 370 MPa, 337 MPa and 403 MPa were obtained in , and orientations at the room temperature. The creep rupture strength and the high cycle fatigue strength were also improved by addition of niobium. In the -orientated specimen which contains 1.0 mass% niobium, the creep rupture strength at 873 K for 103 hours, 245 MPa and the high cycle fatigue strength at 773 K for 107 cycles, 220 MPa were obtained. Furthermore, the single crystalline pipe, bolts and nuts were successfully manufactured for the application of these single crystals. (author)

Detection of Respiratory Adverse Events in Pediatric Dental Patients Sedated With 0.75mg/Kg of Midazolam and Oxygen by Continuous Pretracheal Auscultation: A Prospective Randomized Controlled Trial.

Science.gov (United States)

Somri, Mostafa; Matter, Ibrahim; Hadjittofi, Christopher; Hoash, Naser; Moaddi, Bian; Kharouba, Johnny; Parisinos, Constantinos A; Peretz, Benjamin

Sedation is becoming more commonplace for pediatric patients undergoing minor procedures. Fortunately, electronic monitors have contributed to a reduction in the associated respiratory adverse events (RAEs). To test the hypothesis that adding the pretracheal stethoscope (PTS) to standard monitoring methods (SMMs) may improve RAE detection in sedated pediatric dental patients, the frequency of RAEs detected by SMMs (i.e. visual observation, capnography, and pulse oximetry) was compared to that detected by SMMs alongside continuous PTS auscultation. A prospective, randomised, controlled trial was performed with 100 pediatric patient participants of ASA≤2, who were scheduled to receive dental treatment under 0.75 mg/kg and oxygen. Patients were randomised into Groups A (n=50; SMMs) and B (n=50; SMMs+PTS). Inclusion criteria were behavioral management problems and intolerance to dental treatment despite behavioral management techniques or nitrous oxide administration. Exclusion criteria were high-risk conditions for RAEs, altered mental status, gastrointestinal disorders, parental refusal of conscious sedation and failure of previous conscious sedation. An anesthesist was present throughout the dental treatments. RAEs were detected in 10 (20%) and 22(44%) Group A and B patients respectively (p=0.01). The majority of RAEs within Group B were detected by PTS auscultation (n=19). Capnography produced 13 and 15 false-positive results in Groups A and B respectively, whereas the PTS produced 4(8%) false-positive results in Group B (p=0.009). PTS was found to be useful for detecting RAEs during pediatric dental sedation with 0.75mg/kg midazolam and oxygen, in the presence of an anesthesist.

Alfaxalone anesthesia in the bengalese finch (Lonchura domestica)

DEFF Research Database (Denmark)

Perrin, Kathryn L.; Nielsen, Jesper B.; Thomsen, Anders F.

2017-01-01

design. Subsequently, a similar protocol was used to compare 30 mg/kg alfaxalone alone or combined with either 0.7 mg/kg midazolam or 1 mg/kg butorphanol SC. Induction and recovery times were recorded and depth of anesthesia monitored at 5-min intervals throughout each procedure. Functional oxygen...... inductions, and the addition of both midazolam and butorphanol resulted in longer durations of anesthesia than alfaxalone alone. The addition of midazolam significantly decreased the pulse rate at 15 min compared with alfaxalone alone. Alfaxalone was found to be an effective agent for inducing anesthesia...... when administered subcutaneously, and no complications were observed. Increasing the dose, and combining with a benzodiazepine or opioid increased the duration of anesthesia with minimal or no effects on respiratory or pulse rates, within the dose range investigated....

Use of anesthesia dramatically alters the oral glucose tolerance and insulin secretion in C57Bl/6 mice

DEFF Research Database (Denmark)

Windeløv, Johanne A; Pedersen, Jens; Holst, Jens J

2016-01-01

Evaluation of the impact of anesthesia on oral glucose tolerance in mice. Anesthesia is often used when performing OGTT in mice to avoid the stress of gavage and blood sampling, although anesthesia may influence gastrointestinal motility, blood glucose, and plasma insulin dynamics. C57Bl/6 mice...... in the time frame -15 to +150 min. Plasma insulin concentration was measured at time 0 and 20 min. All four anesthetic regimens resulted in impaired glucose tolerance compared to saline/no anesthesia. (1) hypnorm/midazolam increased insulin concentrations and caused an altered glucose tolerance; (2) ketamine...... regimens altered the oral glucose tolerance, and we conclude that anesthesia should not be used when performing metabolic studies in mice....

Concentration and saturation effects of tethered polymer chains on adsorbing surfaces

Science.gov (United States)

Descas, Radu; Sommer, Jens-Uwe; Blumen, Alexander

2006-12-01

We consider end-grafted chains at an adsorbing surface under good solvent conditions using Monte Carlo simulations and scaling arguments. Grafting of chains allows us to fix the surface concentration and to study a wide range of surface concentrations from the undersaturated state of the surface up to the brushlike regime. The average extension of single chains in the direction parallel and perpendicular to the surface is analyzed using scaling arguments for the two-dimensional semidilute surface state according to Bouchaud and Daoud [J. Phys. (Paris) 48, 1991 (1987)]. We find good agreement with the scaling predictions for the scaling in the direction parallel to the surface and for surface concentrations much below the saturation concentration (dense packing of adsorption blobs). Increasing the grafting density we study the saturation effects and the oversaturation of the adsorption layer. In order to account for the effect of excluded volume on the adsorption free energy we introduce a new scaling variable related with the saturation concentration of the adsorption layer (saturation scaling). We show that the decrease of the single chain order parameter (the fraction of adsorbed monomers on the surface) with increasing concentration, being constant in the ideal semidilute surface state, is properly described by saturation scaling only. Furthermore, the simulation results for the chains' extension from higher surface concentrations up to the oversaturated state support the new scaling approach. The oversaturated state can be understood using a geometrical model which assumes a brushlike layer on top of a saturated adsorption layer. We provide evidence that adsorbed polymer layers are very sensitive to saturation effects, which start to influence the semidilute surface scaling even much below the saturation threshold.

Tube collector with integrated tracking parabolic concentrator

Energy Technology Data Exchange (ETDEWEB)

Grass, C.; Benz, N.; Hacker, Z.; Timinger, A. [ZAE Bayern, Bavarian Centre for Applied Energy Research, Muenchen (Germany)

2000-07-01

Low concentrating CPC collectors usually do not track the sun and are mounted in east-west direction with a latitude dependent slope angle. They are most suitable for maximum working temperatures up to 200 250 deg. C. We present a novel evacuated tube-collector with a trough-like concentrating mirror. Single-axis tracking of the mirror is realized with a magnetic mechanism. The mirror is mounted inside the evacuated tube and hence protected from environmental influences. One axis tracking in combination with a small acceptance angle allows for higher concentration as compared to non-tracking concentrating collectors. Ray-tracing analysis shows a half acceptance angle of about 5 deg. at a geometrical concentration ratio of 3.2. The losses of evacuated tube collectors are dominated by the radiation losses of the absorber. Hence, reducing the absorber size can lead to higher efficiencies at high operating temperature levels. With the presented collector we aim for operating temperatures up to 400 deg. C. At temperatures of 300 deg. C we expect efficiencies of 65 %. This allows for application in industrial process heat generation, high efficient solar cooling and power generation. A first prototype was tested at the ZAE Bayern. The optical efficiency was measured to be 75 %. (au)

Integration of Multiplexed Microfluidic Electrokinetic Concentrators with a Morpholino Microarray via Reversible Surface Bonding for Enhanced DNA Hybridization.

Science.gov (United States)

Martins, Diogo; Wei, Xi; Levicky, Rastislav; Song, Yong-Ak

2016-04-05

We describe a microfluidic concentration device to accelerate the surface hybridization reaction between DNA and morpholinos (MOs) for enhanced detection. The microfluidic concentrator comprises a single polydimethylsiloxane (PDMS) microchannel onto which an ion-selective layer of conductive polymer poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate) ( PSS) was directly printed and then reversibly surface bonded onto a morpholino microarray for hybridization. Using this electrokinetic trapping concentrator, we could achieve a maximum concentration factor of ∼800 for DNA and a limit of detection of 10 nM within 15 min. In terms of the detection speed, it enabled faster hybridization by around 10-fold when compared to conventional diffusion-based hybridization. A significant advantage of our approach is that the fabrication of the microfluidic concentrator is completely decoupled from the microarray; by eliminating the need to deposit an ion-selective layer on the microarray surface prior to device integration, interfacing between both modules, the PDMS chip for electrokinetic concentration and the substrate for DNA sensing are easier and applicable to any microarray platform. Furthermore, this fabrication strategy facilitates a multiplexing of concentrators. We have demonstrated the proof-of-concept for multiplexing by building a device with 5 parallel concentrators connected to a single inlet/outlet and applying it to parallel concentration and hybridization. Such device yielded similar concentration and hybridization efficiency compared to that of a single-channel device without adding any complexity to the fabrication and setup. These results demonstrate that our concentrator concept can be applied to the development of a highly multiplexed concentrator-enhanced microarray detection system for either genetic analysis or other diagnostic assays.

Corneal pharmacokinetics of the 2% diacerein eye drops between multiple administration and single administration

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Ke Yang

2018-04-01

Full Text Available AIM: To compare the pharmacokinetic differences of the 2% diacerein eye drops between conjunctival sac multiple administration and single administration in the cornea, and to provide the experimental basis for clinicians to use the conjunctival sac multiple administration.METHODS: Male Kunming mice were randomly divided into the multiple administration group and the single administration group. The multiple administration group were given diacerein eye drop every 2min(3 times in total. The concentrations of the metabolites of diacerein in the cornea were measured by high performance liquid chromatography after given eye drop 5, 15, 30, 60, 120, and 180min. The pharmacokinetic parameters were calculated by pharmacokinetic software(DAS2.1.1. RESULTS: The metabolites of diacerein, rhein, was detected in the cornea at each time point. The concentration of the metabolite of diacerein in the cornea was 318.678±40.88, 210.02±25.66, 188.83±31.74, 112.24±11.70, 90.28±22.01 and 57.67±13.71μg/g after given eye drop 5, 15, 30, 60, 120, and 180min in the multiple administration group. The concentration in the single administration group was 145.17±19.29, 97.95±10.49, 71.18±18.70, 39.11±2.44, 18.10±2.34 and 9.08±2.04μg/g respectively. The concentration of rhein in the cornea was the highest at 5min after the administration in the two groups. The concentration of the multiple administration group was higher than that in the single administration group at 5, 15, 30, 60, 120, and 180min(PCONCLUSION: Compared with the single administration, the conjunctival sac multiple administration has the advantages of high drug concentration and long duration. Therefor the conjunctival sac multiple administration is a more effective method to treat acute infectious corneal diseases.

A novel self-micro-emulsifying delivery system (SMEDS) formulation significantly improves the fasting absorption of EPA and DHA from a single dose of an omega-3 ethyl ester concentrate.

Science.gov (United States)

Qin, Yan; Nyheim, Hilde; Haram, Else Marie; Moritz, Joseph M; Hustvedt, Svein Olaf

2017-10-16

Absorption of EPA and DHA from Omega-3-acid ethyl ester (EE) concentrate supplements occurs most efficiently when taken in context of a fatty meal; adequate fat intake is required to release bile salts that emulsify and pancreatic enzymes that digest omega-3-containing lipids in the intestine. Current guidelines recommend reduction in fat intake and therefore there is a need to optimize the absorption of Omega-3 in those consuming low-fat or no-fat meals. To this end, BASF has developed an Absorption Acceleration Technology, a novel self-micro-emulsifying delivery system (SMEDS) formulation of highly concentrated Omega-3-acid EE which enables rapid emulsification and microdroplet formation upon entering the aqueous environment of the gut therefore enhances the absorption. Two separate single dose, crossover studies were conducted to determine the relative bioavailability of omega-3-acid EE concentrate, either as a novel SMEDS formulation (PRF-021) or as control, in healthy fasted male and female adults at two dose levels (Study 1 "low dose": 630 mg EPA + DHA in PRF-021 vs. 840 mg EPA + DHA in control; Study 2 "high dose": 1680 mg EPA + DHA in PRF-021 vs. 3360 mg EPA + DHA in control). Blood samples were collected immediately before supplementation and at defined time intervals for 48 h. Plasma concentration of total EPA and DHA were determined for pharmacokinetic analysis, area under the curve (AUC) and maximum observed concentration (C max ) was determined. Total EPA plus DHA absorption from SMEDS formulation PRF-021 were 6.4 and 11.5 times higher compared to control in low- and high-dose studies respectively, determined as the ratio of baseline corrected, dose normalized AUC 0-24h of PRF-021 over that of control. EPA and DHA individually showed differing levels of enhancement: the AUC 0-24h ratio for EPA was 23.8 and 25.7 in low and high dose studies, respectively, and the AUC 0-24h ratio for DHA was 3.6 and 5.6 in low and high dose studies

A Compound Detection System Based on Ultrasonic Flow Rate and Concentration

OpenAIRE

Qing-Hui WANG; Fang MU; Li-Feng WEI

2014-01-01

This paper proposes a new detection system for monitoring gas concentration and flow rate. Velocity difference of ultrasonic wave in bi-directional propagation in measured gas is recorded and utilized for computing the online gas concentration and flow rate. Meanwhile, the temperature compensation, return signal processing and error analysis algorithms are applied to improve the accuracy. The experimental results show that, compared with the single sensor measurement of gas flow rate or conce...

Mechanical properties of pure and doped InP single crystals under concentrated loading

International Nuclear Information System (INIS)

Boyarskaya, Yu.S.; Grabko, D.Z.; Medinskaya, M.I.; Palistrant, N.A.

1997-01-01

The mechanical properties of pure and doped (Fe, Zn, Sn) InP single crystals were investigated in the temperature interval from 293 to 600 K. It was shown that impurity hardening (the microhardness increase) was more pronounced at elevated temperatures than at 293 K. This is conditioned by braking of the moving dislocations with impurities which is more observed in the the high temperature region. The obvious anisotropy of the scratch hardness was revealed at room temperature for the (001) face of crystals under investigation. This anisotropy decreased sharply in increasing the temperature from 293 to 600 K

Effect of indium and antimony doping in SnS single crystals

Energy Technology Data Exchange (ETDEWEB)

Chaki, Sunil H., E-mail: sunilchaki@yahoo.co.in; Chaudhary, Mahesh D.; Deshpande, M.P.

2015-03-15

Highlights: • Single crystals growth of pure SnS, indium doped SnS and antimony doped SnS by direct vapour transport (DVT) technique. • Doping of In and Sb occurred in SnS single crystals by cation replacement. • The replacement mechanism ascertained by EDAX, XRD and substantiated by Raman spectra analysis. • Dopants concentration affects the optical energy bandgap. • Doping influences electrical transport properties. - Abstract: Single crystals of pure SnS, indium (In) doped SnS and antimony (Sb) doped SnS were grown by direct vapour transport (DVT) technique. Two doping concentrations of 5% and 15% each were employed for both In and Sb dopants. Thus in total five samples were studied viz., pure SnS (S1), 5% In doped SnS (S2), 15% In doped SnS (S3), 5% Sb doped SnS (S4) and 15% Sb doped SnS (S5). The grown single crystal samples were characterized by evaluating their surface microstructure, stoichiometric composition, crystal structure, Raman spectroscopy, optical and electrical transport properties using appropriate techniques. The d.c. electrical resistivity and thermoelectric power variations with temperature showed semiconducting and p-type nature of the as-grown single crystal samples. The room temperature Hall Effect measurements further substantiated the semiconducting and p-type nature of the as-grown single crystal samples. The obtained results are deliberated in detail.

Study on the determination of permissible concentration in sea food

International Nuclear Information System (INIS)

Lee, C.M.; Lee, K.J.; Lee, W.K.

2002-01-01

Radioactive permissible concentration limit using the data which is suitable for Koreans is not established. In this paper, concentration limit is determined by using Korean food intake. Ministry of science of technology will adopt the new recommendation soon, so at this paper, dose limit of new value in ICRP 60 is used. Experts who have studied on this area worry about over-exposure by estimation of the case that intake contaminated a food by one radionuclide, therefore, complex intake limit is determined about all kinds of fishery products to solve this problem. Derived Food Concentration in single food divided by S(number of samples) and N(number of radionuclides) gives Complex intake limit (Derived Food Concentration in plural food). The value of N and S in this study is 3 and 12 respectively

Concentrations of garenoxacin in plasma, bronchial mucosa, alveolar macrophages and epithelial lining fluid following a single oral 600 mg dose in healthy adult subjects.

Science.gov (United States)

Andrews, J; Honeybourne, D; Jevons, G; Boyce, M; Wise, R; Bello, A; Gajjar, D

2003-03-01

A microbiological assay was used to measure concentrations of garenoxacin (BMS-284756) in plasma, bronchial mucosa (BM), alveolar macrophages (AM) and epithelial lining fluid (ELF), following a single 600 mg oral dose. Twenty-four healthy subjects were allocated into four nominal time intervals after the dose, 2.5-3.5, 4.5-5.5, 10.5-11.5 and 23.5-24.5 h. Mean concentrations in plasma, BM, AM and ELF, respectively, for the four nominal time windows were for 2.5-3.5 h 10.0 mg/L (S.D. 2.8), 7.0 mg/kg (S.D. 1.3), 106.1 mg/L (S.D. 60.3) and 9.2 mg/L (S.D. 3.6); 4.5-5.5 h 8.7 mg/L (S.D. 2.2), 6.0 mg/kg (S.D. 1.9), 158.6 mg/L (S.D. 137.4) and 14.3 mg/L (S.D. 8.2); 10.5-11.5 h 6.1 mg/L (S.D. 1.9), 4.0 mg/kg (S.D. 1.4), 76.0 mg/L (S.D. 47.7) and 7.9 mg/L (S.D. 4.6); and 23.5-24.5 h 2.1 mg/L (S.D. 0.5), 1.7 mg/kg (S.D. 0.7), 30.7 mg/L (S.D. 12.9) and 3.3 mg/L (S.D. 2.3). Concentrations at all sites exceeded MIC(90)s for the common respiratory pathogens Haemophilus influenzae (0.03 mg/L), Moraxella catarrhalis (0.015 mg/L) and Streptococcus pneumoniae (0.06 mg/L). These data suggest that garenoxacin should be effective in the treatment of community-acquired pneumonia and chronic obstructive pulmonary disease.

Performance study of solar cell arrays based on a Trough Concentrating Photovoltaic/Thermal system

International Nuclear Information System (INIS)

Li, Ming; Ji, Xu; Li, Guoliang; Wei, Shengxian; Li, YingFeng; Shi, Feng

2011-01-01

Highlights: → The performances of solar cell arrays based on a Trough Concentrating Photovoltaic/Thermal (TCPV/T) system have been studied. → The optimum concentration ratios for the single crystalline silicon cell, the Super cells and the GaAs cells were studied by experiments. → The influences between the solar cell's performance and the series resistances, the working temperature, solar irradiation intensity were explored. - Abstract: The performances of solar cell arrays based on a Trough Concentrating Photovoltaic/Thermal (TCPV/T) system have been studied via both experiment and theoretical calculation. The I-V characteristics of the solar cell arrays and the output performances of the TCPV/T system demonstrated that among the investigated four types of solar cell arrays, the triple junction GaAs cells possessed good performance characteristics and the polysilicon cells exhibited poor performance characteristics under concentrating conditions. The optimum concentration ratios for the single crystalline silicon cell, the Super cells and the GaAs cells were also studied by experiments. The optimum concentration ratios for the single crystalline silicon cells and Super cells were 4.23 and 8.46 respectively, and the triple junction GaAs cells could work well at higher concentration ratio. Besides, some theoretical calculations and experiments were performed to explore the influences of the series resistances and the working temperature. When the series resistances R s changed from 0 Ω to 1 Ω, the maximum power P m of the single crystalline silicon, the polycrystalline silicon, the Super cell and the GaAs cell arrays decreased by 67.78%, 74.93%, 77.30% and 58.07% respectively. When the cell temperature increased by 1 K, the short circuit current of the four types of solar cell arrays decreased by 0.11818 A, 0.05364 A, 0.01387 A and 0.00215 A respectively. The research results demonstrated that the output performance of the solar cell arrays with lower

Electrical and photoelectric properties of PbGa2Se4 single crystals

International Nuclear Information System (INIS)

Tagiev, B.G.; Tagiev, O.B.; Dzhabbarov, R.B.; Musaeva, N.N.

1999-01-01

Thermal dependence of dark current spectral distribution of photocurrent and temperature quenching of photocurrent of PbGa 2 Se 4 single crystals are investigated. Concentrations and mobilities of free charge carriers, concentrations and activation energies of gaps, values of Fermi level and forbidden zone width are calculated [ru

Single-cell measurement of red blood cell oxygen affinity

OpenAIRE

Caprio, Di; Stokes, Chris; Higgins, John M.; Schonbrun, Ethan

2015-01-01

Oxygen is transported throughout the body by hemoglobin in red blood cells. While the oxygen affinity of blood is well understood and is routinely assessed in patients by pulse oximetry, variability at the single-cell level has not been previously measured. In contrast, single-cell measurements of red blood cell volume and hemoglobin concentration are taken millions of times per day by clinical hematology analyzers and are important factors in determining the health of the hematologic system....

Charge transfer effects, thermo and photochromism in single crystal CVD synthetic diamond.

Science.gov (United States)

Khan, R U A; Martineau, P M; Cann, B L; Newton, M E; Twitchen, D J

2009-09-09

We report on the effects of thermal treatment and ultraviolet irradiation on the point defect concentrations and optical absorption profiles of single crystal CVD synthetic diamond. All thermal treatments were below 850 K, which is lower than the growth temperature and unlikely to result in any structural change. UV-visible absorption spectroscopy measurements showed that upon thermal treatment (823 K), various broad absorption features diminished: an absorption band at 270 nm (used to deduce neutral single substitutional nitrogen (N(S)(0)) concentrations) and also two broad features centred at approximately 360 and 520 nm. Point defect centre concentrations as a function of temperature were also deduced using electron paramagnetic resonance (EPR) spectroscopy. Above ∼500 K, we observed a decrease in the concentration of N(S)(0) centres and a concomitant increase in the negatively charged nitrogen-vacancy-hydrogen (NVH) complex (NVH(-)) concentration. Both transitions exhibited an activation energy between 0.6 and 1.2 eV, which is lower than that for the N(S)(0) donor (∼1.7 eV). Finally, it was found that illuminating samples with intense short-wave ultraviolet light recovered the N(S)(0) concentration and also the 270, 360 and 520 nm absorption features. From these results, we postulate a valence band mediated charge transfer process between NVH and single nitrogen centres with an acceptor trap depth for NVH of 0.6-1.2 eV. Because the loss of N(S)(0) concentration is greater than the increase in NVH(-) concentration we also suggest the presence of another unknown acceptor existing at a similar energy to NVH. The extent to which the colour in CVD synthetic diamond is dependent on prior history is discussed.