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[PMID]:28988529
[Au] Autor:Silachev DN; Usatikova EA; Pevzner IB; Zorova LD; Babenko VA; Gulyaev MV; Pirogov YA; Plotnikov EY; Zorov DB
[Ad] Endereço:Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, 119992, Russia. zorov@genebee.msu.ru.
[Ti] Título:Effect of Anesthetics on Efficiency of Remote Ischemic Preconditioning.
[So] Source:Biochemistry (Mosc);82(9):1006-1016, 2017 Sep.
[Is] ISSN:1608-3040
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Remote ischemic preconditioning of hind limbs (RIPC) is an effective method for preventing brain injury resulting from ischemia. However, in numerous studies RIPC has been used on the background of administered anesthetics, which also could exhibit neuroprotective properties. Therefore, investigation of the signaling pathways triggered by RIPC and the effect of anesthetics is important. In this study, we explored the effect of anesthetics (chloral hydrate and Zoletil) on the ability of RIPC to protect the brain from injury caused by ischemia and reperfusion. We found that RIPC without anesthesia resulted in statistically significant decrease in neurological deficit 24 h after ischemia, but did not affect the volume of brain injury. Administration of chloral hydrate or Zoletil one day prior to brain ischemia produced a preconditioning effect by their own, decreasing the degree of neurological deficit and lowering the volume of infarct with the use of Zoletil. The protective effects observed after RIPC with chloral hydrate or Zoletil were similar to those observed when only the respective anesthetic was used. RIPC was accompanied by significant increase in the level of brain proteins associated with the induction of ischemic tolerance such as pGSK-3ß, BDNF, and HSP70. However, Zoletil did not affect the level of these proteins 24 h after injection, and chloral hydrate caused increase of only pGSK-3ß. We conclude that RIPC, chloral hydrate, and Zoletil produce a significant neuroprotective effect, but the simultaneous use of anesthetics with RIPC does not enhance the degree of neuroprotection.
[Mh] Termos MeSH primário: Anestésicos/uso terapêutico
Lesões Encefálicas/etiologia
Isquemia Encefálica/complicações
Precondicionamento Isquêmico
Fármacos Neuroprotetores/uso terapêutico
[Mh] Termos MeSH secundário: Anestésicos/farmacologia
Animais
Lesões Encefálicas/prevenção & controle
Isquemia Encefálica/tratamento farmacológico
Isquemia Encefálica/terapia
Hidrato de Cloral/farmacologia
Hidrato de Cloral/uso terapêutico
Combinação de Medicamentos
Masculino
Fármacos Neuroprotetores/farmacologia
Ratos
Tiletamina/farmacologia
Tiletamina/uso terapêutico
Resultado do Tratamento
Zolazepam/farmacologia
Zolazepam/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anesthetics); 0 (Drug Combinations); 0 (Neuroprotective Agents); 0 (tiletamine, zolazepam drug combination); 2YFC543249 (Tiletamine); 418M5916WG (Chloral Hydrate); G1R474U58U (Zolazepam)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171010
[St] Status:MEDLINE
[do] DOI:10.1134/S0006297917090036


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[PMID]:28407198
[Au] Autor:Dudley K; Liu X; De Haan S
[Ad] Endereço:Institute of Mental Health, University of Nottingham, Nottingham, UK.
[Ti] Título:Chlorpromazine dose for people with schizophrenia.
[So] Source:Cochrane Database Syst Rev;4:CD007778, 2017 04 13.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The World Health Organization (WHO) Model Lists of Essential Medicines lists chlorpromazine as one of its five medicines used in psychotic disorders. OBJECTIVES: To determine chlorpromazine dose response and dose side-effect relationships for schizophrenia and schizophrenia-like psychoses. SEARCH METHODS: We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials (December 2008; 2 October 2014; 19 December 2016). SELECTION CRITERIA: All relevant randomised controlled trials (RCTs) comparing low doses of chlorpromazine (≤ 400 mg/day), medium dose (401 mg/day to 800 mg/day) or higher doses (> 800 mg/day) for people with schizophrenia, and which reported clinical outcomes. DATA COLLECTION AND ANALYSIS: We included studies meeting review criteria and providing useable data. Review authors extracted data independently. For dichotomous data, we calculated fixed-effect risk ratios (RR) and their 95% confidence intervals (CIs). For continuous data, we calculated mean differences (MD) and their 95% CIs based on a fixed-effect model. We assessed risk of bias for included studies and graded trial quality using GRADE (Grading of Recommendations Assessment, Development and Evaluation). MAIN RESULTS: As a result of searches undertaken in 2014, we found one new study and in 2016 more data for already included studies. Five relevant studies with 1132 participants (585 are relevant to this review) are now included. All are hospital-based trials and, despite over 60 years of chlorpromazine use, have durations of less than six months and all are at least at moderate risk of bias. We found only data on low-dose (≤ 400 mg/day) versus medium-dose chlorpromazine (401 mg/day to 800 mg/day) and low-dose versus high-dose chlorpromazine (> 800 mg/day).When low-dose chlorpromazine (≤ 400 mg/day) was compared to medium-dose chlorpromazine (401 mg/day to 800 mg/day), there was no clear benefit of one dose over the other for both global and mental state outcomes (low-quality and very low-quality evidence). There was also no clear evidence for people in one dosage group being more likely to leave the study early, over the other dosage group (moderate-quality evidence). Similar numbers of participants from each group experienced agitation and restlessness (very low-quality evidence). However, significantly more people in the medium-dose group (401 mg/day to 800 mg/day) experienced extrapyramidal symptoms in the short term (2 RCTS, n = 108, RR 0.47, 95% CI 0.30 to 0.74, moderate-quality evidence). No data for death were available.When low-dose chlorpromazine (≤ 400 mg/day) was compared to high-dose chlorpromazine (> 800 mg/day), data from one study with 416 patients were available. Clear evidence of a benefit of the high dose was found with regards to global state. The low-dose group had significantly fewer people improving (RR 1.13, 95% CI 1.01 to 1.25, moderate-quality evidence). There was also a marked difference between the number of people leaving the study from each group for any reason, with significantly more people leaving from the high-dose group (RR 0.60, 95% CI 0.40 to 0.89, moderate-quality evidence). More people in the low-dose group had to leave the study due to deterioration in behaviour (RR 2.70, 95% CI 1.34 to 5.44, low-quality evidence). There was clear evidence of a greater risk of people experiencing extrapyramidal symptoms in general in the high-dose group (RR 0.43, 95% CI 0.32 to 0.59, moderate-quality evidence). One death was reported in the high-dose group yet no effect was shown between the two dosage groups (RR 0.33, 95% CI 0.01 to 8.14, moderate-quality evidence). No data for mental state were available. AUTHORS' CONCLUSIONS: The dosage of chlorpromazine has changed drastically over the past 50 years with lower doses now being the preferred of choice. However, this change was gradual and arose not due to trial-based evidence, but due to clinical experience and consensus. Chlorpromazine is one of the most widely used antipsychotic drugs yet appropriate use of lower levels has come about after many years of trial and error with much higher doses. In the absence of high-grade evaluative studies, clinicians have had no alternative but to learn from experience. However, such an approach can lack scientific rigor and does not allow for proper dissemination of information that would assist clinicians find the optimum treatment dosage for their patients. In the future, data for recently released medication should be available from high-quality trials and studies to provide optimum treatment to patients in the shortest amount of time.
[Mh] Termos MeSH primário: Antipsicóticos/administração & dosagem
Clorpromazina/administração & dosagem
Esquizofrenia/tratamento farmacológico
[Mh] Termos MeSH secundário: Antipsicóticos/efeitos adversos
Barbitúricos/administração & dosagem
Hidrato de Cloral/administração & dosagem
Clorpromazina/efeitos adversos
Esquema de Medicação
Seres Humanos
Hipnóticos e Sedativos/administração & dosagem
Pacientes Desistentes do Tratamento/estatística & dados numéricos
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Antipsychotic Agents); 0 (Barbiturates); 0 (Hypnotics and Sedatives); 418M5916WG (Chloral Hydrate); U42B7VYA4P (Chlorpromazine)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170802
[Lr] Data última revisão:
170802
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170414
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD007778.pub2


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[PMID]:28275979
[Au] Autor:Cozzi G; Norbedo S; Barbi E
[Ad] Endereço:Emergency Department, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", via dell'Istria 65/1, 34132, Trieste, Italy. giorgiocozzi@gmail.com.
[Ti] Título:Intranasal Dexmedetomidine for Procedural Sedation in Children, a Suitable Alternative to Chloral Hydrate.
[So] Source:Paediatr Drugs;19(2):107-111, 2017 Apr.
[Is] ISSN:1179-2019
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:Sedation is often required for children undergoing diagnostic procedures. Chloral hydrate has been one of the sedative drugs most used in children over the last 3 decades, with supporting evidence for its efficacy and safety. Recently, chloral hydrate was banned in Italy and France, in consideration of evidence of its carcinogenicity and genotoxicity. Dexmedetomidine is a sedative with unique properties that has been increasingly used for procedural sedation in children. Several studies demonstrated its efficacy and safety for sedation in non-painful diagnostic procedures. Dexmedetomidine's impact on respiratory drive and airway patency and tone is much less when compared to the majority of other sedative agents. Administration via the intranasal route allows satisfactory procedural success rates. Studies that specifically compared intranasal dexmedetomidine and chloral hydrate for children undergoing non-painful procedures showed that dexmedetomidine was as effective as and safer than chloral hydrate. For these reasons, we suggest that intranasal dexmedetomidine could be a suitable alternative to chloral hydrate.
[Mh] Termos MeSH primário: Hidrato de Cloral/administração & dosagem
Dexmedetomidina/administração & dosagem
Hipnóticos e Sedativos/administração & dosagem
[Mh] Termos MeSH secundário: Administração Intranasal
Criança
Hidrato de Cloral/efeitos adversos
Dexmedetomidina/efeitos adversos
Seres Humanos
Hipnóticos e Sedativos/efeitos adversos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Hypnotics and Sedatives); 418M5916WG (Chloral Hydrate); 67VB76HONO (Dexmedetomidine)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:171114
[Lr] Data última revisão:
171114
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170310
[St] Status:MEDLINE
[do] DOI:10.1007/s40272-017-0217-5


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[PMID]:28242616
[Au] Autor:Mataftsi A; Malamaki P; Prousali E; Riga P; Lathyris D; Chalvatzis NT; Haidich AB
[Ad] Endereço:2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
[Ti] Título:Safety and efficacy of chloral hydrate for procedural sedation in paediatric ophthalmology: a systematic review and meta-analysis.
[So] Source:Br J Ophthalmol;101(10):1423-1430, 2017 Oct.
[Is] ISSN:1468-2079
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Although chloral hydrate (CH) has been used as a sedative for decades, it is not widely accepted as a valid choice for ophthalmic examinations in uncooperative children. This study aimed to systematically review the literature on the drug's safety and efficacy. METHODS: We searched PubMed, EMBASE, ISI Web of Science, Scopus, CENTRAL, Google Scholar and Trip database to 1 October 2015, using the keywords 'chloral hydrate', 'paediatric' and 'procedural sedation OR diagnostic sedation'. A meta-analysis of randomised controlled trials (RCTs) was performed. RESULTS: A total of 6961 articles were screened and 104 were included in the review. Thirteen of these concerned paediatric ophthalmic examination, while 13 others were RCTs and were meta-analysed. CH was reported to have been administered in a total of 24 265 sedation episodes in children aged from <1 month to 18 years. The meta-analysis showed CH had a higher OR (2.95, 95% CI 1.09 to 7.99) for successful sedation compared to other sedatives, but significant limitations apply. The commonest reported adverse events (AE) were not serious (eg, paradoxical reaction or transient vomiting) and required no intervention. Severe AE, including two deaths, were related to comorbidity, overdose or aspiration. CONCLUSIONS: Despite the paucity of high quality evidence, the existing literature suggests that the use of CH for procedural sedation in children appears to be an effective alternative to general anaesthesia, and it can be safe when administered in the hospital setting with appropriate monitoring and vigilance for intervention.
[Mh] Termos MeSH primário: Hidrato de Cloral/uso terapêutico
Sedação Consciente/métodos
Hipnóticos e Sedativos/uso terapêutico
Oftalmologia/métodos
Pediatria/métodos
[Mh] Termos MeSH secundário: Criança
Hidrato de Cloral/efeitos adversos
Sedação Consciente/efeitos adversos
Seres Humanos
Hipnóticos e Sedativos/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Hypnotics and Sedatives); 418M5916WG (Chloral Hydrate)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170301
[St] Status:MEDLINE
[do] DOI:10.1136/bjophthalmol-2016-309449


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[PMID]:28072745
[Au] Autor:Chen ML; Chen Q; Xu F; Zhang JX; Su XY; Tu XZ
[Ad] Endereço:Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China.
[Ti] Título:Safety and efficacy of chloral hydrate for conscious sedation of infants in the pediatric cardiovascular intensive care unit.
[So] Source:Medicine (Baltimore);96(1):e5842, 2017 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study evaluates the safety and efficacy of chloral hydrate administration for the conscious sedation of infants in the pediatric cardiovascular intensive care unit (PCICU).We conducted a retrospective review of the charts of 165 infants with congenital heart disease who received chloral hydrate in our PCICU between January 2014 and December 2014. Chloral hydrate was administered orally or rectally to infants using doses of 50 mg/kg. We collected and analyzed relevant clinical parameters.The overall length of time to achieve sedation was ranged from 5 to 35 min (10.8 ±â€Š6.2 min); the overall mean duration of sedation was ranged from 15 to 60 min (33.5 ±â€Š11.3 min); and the overall mean length of time to return to normal activity was 10 min to 6 h (34.3 ±â€Š16.2 min). The length of the PCICU stay was ranged from 3 to 30 days (8.2 ±â€Š7.1 days). Physiologically, there were no clinically significant changes in heart rate, mean arterial pressure, respiratory rate, or peripheral oxygen saturation before, during, or after use of the chloral hydrate. There were no significant differences regarding sedative effects in the subgroups (cyanotic vs acyanotic group, with pulmonary infection vs without pulmonary infection group, and with pulmonary hypertension vs without pulmonary hypertension group).Our experience suggests that chloral hydrate is a safe and efficacious agent for conscious sedation of infants in the PCICU.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Cardiovasculares
Hidrato de Cloral
Cardiopatias Congênitas/cirurgia
[Mh] Termos MeSH secundário: Período de Recuperação da Anestesia
Procedimentos Cirúrgicos Cardiovasculares/efeitos adversos
Procedimentos Cirúrgicos Cardiovasculares/métodos
China
Hidrato de Cloral/administração & dosagem
Hidrato de Cloral/efeitos adversos
Sedação Consciente/métodos
Feminino
Seres Humanos
Hipnóticos e Sedativos/administração & dosagem
Hipnóticos e Sedativos/efeitos adversos
Lactente
Unidades de Terapia Intensiva Pediátrica/estatística & dados numéricos
Masculino
Monitorização Intraoperatória/métodos
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Hypnotics and Sedatives); 418M5916WG (Chloral Hydrate)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170224
[Lr] Data última revisão:
170224
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170111
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000005842


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[PMID]:28010927
[Au] Autor:Manasfi T; De Méo M; Di Giorgio C; Coulomb B; Boudenne JL
[Ad] Endereço:Aix Marseille Université, CNRS, LCE UMR 7376, 13331 Marseille, France. Electronic address: tarek.manasfi@univ-amu.fr.
[Ti] Título:Assessing the genotoxicity of two commonly occurring byproducts of water disinfection: Chloral hydrate and bromal hydrate.
[So] Source:Mutat Res;813:37-44, 2017 Jan.
[Is] ISSN:1873-135X
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Water disinfection treatments result in the formation of disinfection byproducts (DBPs) that have been linked to adverse human health outcomes including higher incidence of bladder and colorectal cancer. However, data about the genotoxicity of DBPs is limited to only a small fraction of compounds. Chloral hydrate (CH) and bromal hydrate (BH) are two trihaloacetaldehydes commonly detected in disinfected waters, but little is known about their genotoxicity, especially BH. We investigated the genotoxicity of CH and BH using a test battery that includes three in vitro genotoxicity assays. We conducted the Ames test using Salmonella bacterial strains TA97a, TA98, TA100 and TA102, and the alkaline comet assay and the micronucleus test both using Chinese hamster ovary cells. We carried out the tests in the absence and presence of the metabolic fraction S9 mix. CH did not exhibit statistically significant genotoxic effects in any of the three assays. In contrast, BH exhibited mutagenic activity in the Salmonella strain TA100 and induced statistically significant DNA lesions in CHO cells as appeared in the comet assay. The genotoxic potential of BH in both assays decreased in the presence of the metabolic fraction S9 mix. BH did not induce chromosomal damage in CHO cells. Our results show that BH exhibited genotoxic activity by causing mutations and primary DNA damage while CH did not induce genotoxic effects. Our findings highlight concerns about the higher genotoxicity of brominated DBPs in comparison to their chlorinated analogues.
[Mh] Termos MeSH primário: Bromo/química
Hidrato de Cloral/química
Desinfecção/métodos
Purificação da Água/métodos
[Mh] Termos MeSH secundário: Animais
Células CHO
Cricetinae
Cricetulus
Masculino
Testes de Mutagenicidade
Ratos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
418M5916WG (Chloral Hydrate); SBV4XY874G (Bromine)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170523
[Lr] Data última revisão:
170523
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161225
[St] Status:MEDLINE


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[PMID]:27981385
[Au] Autor:Wohlrab J; Gilbrich F; Wolff L; Fischer M; Philipp S
[Ad] Endereço:Universitätsklinik und Poliklinik für Dermatologie und Venerologie, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06097, Halle (Saale), Deutschland. johannes.wohlrab@medizin.uni-halle.de.
[Ti] Título:[Preclinical safety evaluation of chloral hydrate after topical application using the example of psoriatic itch].
[Ti] Título:Präklinische Validierung der Sicherheit von Chloralhydrat zur topischen Applikation am Beispiel des psoriatischen Pruritus..
[So] Source:Hautarzt;68(3):217-223, 2017 Mar.
[Is] ISSN:1432-1173
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:BACKGROUND: Psoriasis is known today as a T­cell-mediated autoimmunological systemic disease. The chronic inflammatory processes involve neuroimmunological factors that are held responsible not only for various aspects of psychiatric-neurological comorbidities but also for neurosensory problems, primarily itching. Amongst other things, the significance of GABA receptors are often discussed in this context. The topical use of chloral hydrate in semisolid preparations for antipruritic therapy goes back to Neisser and is currently experiencing a revival in individually manufactured formulations. However, it is currently unknown whether the unwanted side effects that are described for systemic use of chloral hydrate are also relevant for topical application. OBJECTIVES: For lack of clinical safety data, preclinical tests for cutaneous cytotoxicity and calculations for systemic bioavailability after topical application have been performed. CONCLUSION: The present data cannot fully remove safety concerns for topical application of chloral hydrate in the formulation favoured by the NRF (Neues Rezepturformularium)-the so-called 1­2-3-cream. A twice daily use of the 1­2-3-cream on a maximum of 10% of the body surface can be regarded as safe. For a better assessment of harmlessness, tests for cutaneous bioavailability (concentration-time profile) on human skin and clinical studies would be necessary.
[Mh] Termos MeSH primário: Hidrato de Cloral/administração & dosagem
Erupção por Droga/diagnóstico
Queratinócitos/efeitos dos fármacos
Queratinócitos/metabolismo
Modelos Biológicos
Prurido/tratamento farmacológico
Psoríase/tratamento farmacológico
[Mh] Termos MeSH secundário: Administração Cutânea
Administração Tópica
Linhagem Celular
Hidrato de Cloral/efeitos adversos
Simulação por Computador
Relação Dose-Resposta a Droga
Erupção por Droga/etiologia
Erupção por Droga/metabolismo
Avaliação Pré-Clínica de Medicamentos/métodos
Seres Humanos
Queratinócitos/patologia
Taxa de Depuração Metabólica
Prurido/metabolismo
Prurido/patologia
Psoríase/metabolismo
Psoríase/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
418M5916WG (Chloral Hydrate)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171108
[Lr] Data última revisão:
171108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161217
[St] Status:MEDLINE
[do] DOI:10.1007/s00105-016-3909-9


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[PMID]:26755506
[Au] Autor:Dirani M; Nasreddine W; Melhem J; Arabi M; Beydoun A
[Ad] Endereço:Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon.
[Ti] Título:Efficacy of the Sequential Administration of Melatonin, Hydroxyzine, and Chloral Hydrate for Recording Sleep EEGs in Children.
[So] Source:Clin EEG Neurosci;48(1):41-47, 2017 Jan.
[Is] ISSN:2169-5202
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Sedation of children for electroencephalography (EEG) recordings is often required. Chloral hydrate (CH) requires medical clearance and continuous monitoring. To try to reduce personnel and time resources associated with CH administration, a new sedation policy was formulated. This study included all children who underwent an EEG during a consecutive 3-month period following the implementation of the new sedation policy, which consists of the sequential administration of melatonin, hydroxyzine (if needed), and CH (if needed). The comparator group included all children with a recorded EEG during a consecutive 3-month period when the sedation policy consisted of the sole administration of CH. A total of 803 children with a mean age of 7.9 years (SD = 5.1, range = 0.5-17.7 years) were included. Sleep EEG recordings were obtained in 364 of 385 children (94.6%) using the old sedation policy and in 409 of 418 children (97.9%) using the new one. With the new sedation policy, the percentage of children requiring CH dropped from 37.1% to 6.7% (P < .001). Time to sleep onset and duration of sleep were not significantly different between the 2 policies. The new sedation policy was very well tolerated. The new sedation policy is very safe, is highly efficacious in obtaining sleep EEG recordings, and will result in substantial saving of time and personnel resources.
[Mh] Termos MeSH primário: Hidrato de Cloral/administração & dosagem
Eletroencefalografia/efeitos dos fármacos
Hidroxizina/administração & dosagem
Melatonina/administração & dosagem
Sono/efeitos dos fármacos
Sono/fisiologia
[Mh] Termos MeSH secundário: Depressores do Sistema Nervoso Central
Criança
Pré-Escolar
Sedação Consciente/métodos
Esquema de Medicação
Quimioterapia Combinada/métodos
Eletroencefalografia/métodos
Feminino
Seres Humanos
Hipnóticos e Sedativos
Lactente
Masculino
Polissonografia/métodos
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
Resultado do Tratamento
[Pt] Tipo de publicação:CONTROLLED CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Central Nervous System Depressants); 0 (Hypnotics and Sedatives); 30S50YM8OG (Hydroxyzine); 418M5916WG (Chloral Hydrate); JL5DK93RCL (Melatonin)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170227
[Lr] Data última revisão:
170227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160113
[St] Status:MEDLINE


  9 / 1684 MEDLINE  
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[PMID]:27941708
[Au] Autor:Cai J; Peng Y; Chen T; Liao H; Zhang L; Chen Q; He Y; Wu P; Xie T; Pan Q
[Ad] Endereço:Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China (mainland).
[Ti] Título:Chloral Hydrate Treatment Induced Apoptosis of Macrophages via Fas Signaling Pathway.
[So] Source:Med Sci Monit;22:4836-4843, 2016 Dec 10.
[Is] ISSN:1643-3750
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND There are recent reports on several anesthetics that have anti-inflammatory and anti-infective effects apart from their uses for pain relief and muscle relaxation. Chloral hydrate is a clinical anesthetic drug and sedative that has also been reported to attenuate inflammatory response, but the mechanisms are not clearly understood. MATERIAL AND METHODS This study investigated the effect of chloral hydrate treatment on the apoptosis of macrophages and explored the underlying mechanisms. RAW264.7 macrophages were treated with various concentrations of chloral hydrate for various lengths of time. Morphological changes were observed under a light microscope and apoptosis was detected with annexin-V-FITC/PI double-staining assay, Hochest 33258 and DNA ladder assay, the expression of Fas/FasL was detected with a flow cytometer, and the Fas signaling pathway was assessed by Western blotting. RESULTS The results showed that chloral hydrate treatment induced the morphology of RAW264.7 macrophages to change shape from typical fusiform to round in a concentration- and time-dependent manner, and was finally suspended in the supernatant. For the induction of apoptosis, chloral hydrate treatment induced the apoptosis of RAW264.7 macrophages from early-to-late stage apoptosis in a concentration- and time-dependent manner. For the mechanism, chloral hydrate treatment induced higher expression of Fas on RAW264.7 macrophages, and was also associated with changes in the expression of proteins involved in Fas signaling pathways. CONCLUSIONS Chloral hydrate treatment can induce the apoptosis of RAW264.7 macrophages through the Fas signaling pathway, which may provide new options for adjunctive treatment of acute inflammation.
[Mh] Termos MeSH primário: Apoptose/efeitos dos fármacos
Hidrato de Cloral/farmacologia
Proteína Ligante Fas/metabolismo
Macrófagos/efeitos dos fármacos
Receptor fas/metabolismo
[Mh] Termos MeSH secundário: Animais
Células Cultivadas
Relação Dose-Resposta a Droga
Macrófagos/citologia
Macrófagos/metabolismo
Camundongos
Células RAW 264.7
Transdução de Sinais/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Fas Ligand Protein); 0 (Fas protein, mouse); 0 (Fasl protein, mouse); 0 (fas Receptor); 418M5916WG (Chloral Hydrate)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161213
[St] Status:MEDLINE


  10 / 1684 MEDLINE  
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[PMID]:27788823
[Au] Autor:Cao D; Liu Y; Li J; Gong J
[Ad] Endereço:Chongqing Key Laboratory of Hepatobiliary Surgery and the Department of Hepatobiliary Surgery, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
[Ti] Título:Isoflurane: An Ideal Anesthetic for Rodent Orthotopic Liver Transplantation Surgery?
[So] Source:Transplant Proc;48(8):2815-2820, 2016 Oct.
[Is] ISSN:1873-2623
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Because the choice of anesthetic affects the rodent orthotopic liver transplantation (OLT) model, we compared the effects of isoflurane, ketamine, chloral hydrate, and pentobarbital on the OLT model. BASIC PROCEDURES: OLT was performed using the two-cuff technique. Two hundred male rats were randomly divided into five groups: control, isoflurane, ketamine, chloral hydrate, and pentobarbital groups. Rectal temperatures, respiratory rates, arterial blood values (pH, PaCO , PaO , and SatO ), liver function tests and histopathology, recovery times, and anhepatic stage mortality rates were assessed. MAIN FINDINGS: Compared with controls, respiratory rates decreased by 20% in the isoflurane group, and decreased by 40%-50% in the ketamine, chloral hydrate, and pentobarbital groups. The PaO , SatO , and pH levels in the ketamine, chloral hydrate, and pentobarbital groups were significantly lower than those in the isoflurane and control groups (P < .05). Only the pentobarbital group displayed significant liver histopathologic changes along with significantly higher levels of serum alanine aminotransferase and total bilirubin, but a significantly lower level of serum albumin, compared with the control group (P < .05). The isoflurane group had a 0% anhepatic stage mortality rate compared with rates of 30%-40% in the other anesthetic groups. PRINCIPAL CONCLUSIONS: Isoflurane should be the preferred anesthetic for rodent OLT surgery due to its minimal respiratory and hepatic physiological effects as well as its low anhepatic phase mortality rate. Secondary to isoflurane, ketamine and chloral hydrate may be administered as donor anesthetics. Pentobarbital use should be avoided entirely in rodent OLT surgery due to its significant hepatotoxic effects.
[Mh] Termos MeSH primário: Anestésicos
Isoflurano
Transplante de Fígado/métodos
[Mh] Termos MeSH secundário: Animais
Hidrato de Cloral
Ketamina
Fígado/efeitos dos fármacos
Masculino
Modelos Animais
Monitorização Fisiológica
Pentobarbital
Distribuição Aleatória
Ratos Sprague-Dawley
Respiração/efeitos dos fármacos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anesthetics); 418M5916WG (Chloral Hydrate); 690G0D6V8H (Ketamine); CYS9AKD70P (Isoflurane); I4744080IR (Pentobarbital)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161030
[St] Status:MEDLINE



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