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  1 / 15919 MEDLINE  
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[PMID]:28460124
[Au] Autor:Mantua J; Henry OS; Garskovas NF; Spencer RMC
[Ad] Endereço:Department of Psychological and Brain Sciences, Neuroscienceand Behavior Program, Amherst, MA.
[Ti] Título:Mild Traumatic Brain Injury Chronically Impairs Sleep- and Wake-Dependent Emotional Processing.
[So] Source:Sleep;40(6), 2017 Jun 01.
[Is] ISSN:1550-9109
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Study Objectives : A single traumatic brain injury (TBI), even when mild (ie, concussion), can cause lasting consequences. Individuals with a history of chronic (>1-year prior) mild TBI have an increased risk of mood disturbances (eg, depression, suicide). This population also has lingering sleep alterations, including poor sleep quality and changes in sleep stage proportions. Given these sleep deficits, we aimed to test whether sleep-dependent emotional memory consolidation is reduced in this population. We utilized a mild TBI group (3.7 ± 2.9 years post injury) and an uninjured (non-TBI) population. Methods : Participants viewed negative and neutral images both before and after a 12-hour period containing sleep ("Sleep" group) or an equivalent period of time spent awake ("Wake" group). Participants rated images for valence/arousal at both sessions, and memory recognition was tested at session two. Results : The TBI group had less rapid eye movement (REM), longer REM latency, and more sleep complaints. Sleep-dependent memory consolidation of nonemotional images was present in all participants. However, consolidation of negative images was only present in the non-TBI group. A lack of differentiation between the TBI Sleep and Wake groups was due to poor performance in the sleep group and, unexpectedly, enhanced performance in the wake group. Additionally, although the non-TBI participants habituated to negative images over a waking period, the TBI participants did not. Conclusions : We propose disrupted sleep- and wake-dependent emotional processing contributes to poor emotional outcomes following chronic, mild TBI. This work has broad implications, as roughly one-third of the US population will sustain a mild TBI during their lifetime.
[Mh] Termos MeSH primário: Lesões Encefálicas Traumáticas/fisiopatologia
Lesões Encefálicas Traumáticas/psicologia
Emoções
Sono
Vigília
[Mh] Termos MeSH secundário: Adolescente
Adulto
Estudos de Casos e Controles
Doença Crônica/psicologia
Feminino
Seres Humanos
Masculino
Consolidação da Memória
Distúrbios do Início e da Manutenção do Sono
Sono REM
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.1093/sleep/zsx062


  2 / 15919 MEDLINE  
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[PMID]:28453783
[Au] Autor:Ferré Á; Poca MA; de la Calzada MD; Moncho D; Romero O; Sampol G; Sahuquillo J
[Ad] Endereço:Clinical Neurophysiology Department, Barcelona, Spain.
[Ti] Título:Sleep-Related Breathing Disorders in Chiari Malformation Type 1: A Prospective Study of 90 Patients.
[So] Source:Sleep;40(6), 2017 Jun 01.
[Is] ISSN:1550-9109
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Study objective: The aim of the present study is to describe the prevalence of sleep disorders in a large group of patients with Chiari malformation type 1 (CM-1) and determine the presence of risk factors associated with these abnormalities. Methods: Prospective study with consecutive patient selection. We included 90 adult patients with CM-1, defined by the presence of a cerebellar tonsillar descent (TD) ≥3 mm. Clinical, neuroradiological studies, and nocturnal polysomnography (PSG) was carried out. In addition, patients were also subclassified into 2 CM subtypes: CM-1, with the obex above the foramen magnum (FM) and CM-1.5, in which along with a TD ≥3 mm, the obex was located below the FM. Results: We observed a high prevalence (50%) of sleep-related breathing disorders (SRBDs) with predominant hypopnea. Only six patients showed a central apnea index of ≥5. Hypoventilation was observed in only three patients. SRBD severity was associated with male sex, older age, excess weight, and the presence of hydrocephalus. No differences in clinical or PSG parameters were found when comparing CM subtypes (CM-1 and CM-1.5). Sleep architecture study showed decreased sleep efficiency with an increase in arousal and waking after sleep onset. The presence of SRBDs was found to be associated with poorer sleep architecture parameters. Conclusions: This study confirms a high prevalence of SRBDs in patients with CM-1 and CM-1.5, with a predominant obstructive component. Nocturnal PSG recordings should be systematically conducted in these patients, especially those who are male, older, or overweight or those who present hydrocephalus.
[Mh] Termos MeSH primário: Malformação de Arnold-Chiari/epidemiologia
Dissonias/epidemiologia
Dissonias/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Distribuição por Idade
Malformação de Arnold-Chiari/classificação
Nível de Alerta
Feminino
Seres Humanos
Hidrocefalia/epidemiologia
Hipoventilação/epidemiologia
Masculino
Sobrepeso/epidemiologia
Polissonografia
Prevalência
Estudos Prospectivos
Fatores de Risco
Caracteres Sexuais
Síndromes da Apneia do Sono/epidemiologia
Síndromes da Apneia do Sono/fisiopatologia
Vigília
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/sleep/zsx069


  3 / 15919 MEDLINE  
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[PMID]:29386444
[Au] Autor:Mori Y; Kinoshita F; Takada H
[Ad] Endereço:Department of Human and Artificial Intelligent Systems, Graduate School of Engineering, University of Fukui.
[Ti] Título:[Study of Equilibrium Control System during a Lowering at Arousal Level].
[So] Source:Nihon Eiseigaku Zasshi;73(1):34-38, 2018.
[Is] ISSN:1882-6482
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:OBJECTIVES: Contingent negative variation (CNV) is an event-related potential proportional to vigilance degree. A CNV graph shows an inverted U-shape, and this bioreaction disappears after falling below a threshold of vigilance degree. Previous studies have shown that the event-related potential gained with time decreases with sleep deprivation, and a decrease in the vigilance degree has been confirmed using Flicker values (FV) and the Stanford Sleepiness Scale (SSS) score. The minimum integrated value was recorded 24 h after the onset of sleep deprivation. In a present study, we used 36-h sleep deprivation. The FVs, SSS scores, and stabilograms were obtained every 90 min for 52 h, except for the 12 h of sleep. We herein examine whether the biocontrol system is changed by sleep deprivation. RESULTS: The time sequences in FV and SSS score showed that the degree of vigilance markedly decreased 22.5 h after the onset of this experiment, which supported CNV disappearance with sleep deprivation. The sway value with subjects' eyes closed was greatest 22.5 h after the onset of this experiment. Furthermore, there were no significant differences between the sway value during the above-mentioned sleep deprivation and that after 12 h of sleep. We considered that the equilibrium function and vigilance after 36-h sleep deprivation did not recover markedly well with sleep of sufficient duration. That is, the biocontrol process in the subconscious still proceeds after awakening. CONCLUSIONS: In this study, we focused on bioprocessing, especially the equilibrium function, during sleep deprivation and investigated the relationship between the equilibrium function and sleep deprivation. We obtained evidence supporting CNV disappearance after sleep deprivation for 36 h. The equilibrium control system without CNV was compared with that with CNV.
[Mh] Termos MeSH primário: Nível de Alerta/fisiologia
Variação Contingente Negativa/fisiologia
Equilíbrio Postural/fisiologia
Privação do Sono/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Fusão Flicker/fisiologia
Seres Humanos
Masculino
Vigília/fisiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180202
[St] Status:MEDLINE
[do] DOI:10.1265/jjh.73.34


  4 / 15919 MEDLINE  
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[PMID]:28468274
[Au] Autor:Charrier A; Olliac B; Roubertoux P; Tordjman S
[Ad] Endereço:Pôle Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent (PHUPEA), Université de Rennes 1, Centre Hospitalier Guillaume-Régnier, 154 Rue de Châtillon, Rennes 35000, France. a.charrier@ch-guillaumeregnier.fr.
[Ti] Título:Clock Genes and Altered Sleep-Wake Rhythms: Their Role in the Development of Psychiatric Disorders.
[So] Source:Int J Mol Sci;18(5), 2017 Apr 29.
[Is] ISSN:1422-0067
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:In mammals, the circadian clocks network (central and peripheral oscillators) controls circadian rhythms and orchestrates the expression of a range of downstream genes, allowing the organism to anticipate and adapt to environmental changes. Beyond their role in circadian rhythms, several studies have highlighted that circadian clock genes may have a more widespread physiological effect on cognition, mood, and reward-related behaviors. Furthermore, single nucleotide polymorphisms in core circadian clock genes have been associated with psychiatric disorders (such as autism spectrum disorder, schizophrenia, anxiety disorders, major depressive disorder, bipolar disorder, and attention deficit hyperactivity disorder). However, the underlying mechanisms of these associations remain to be ascertained and the cause-effect relationships are not clearly established. The objective of this article is to clarify the role of clock genes and altered sleep-wake rhythms in the development of psychiatric disorders (sleep problems are often observed at early onset of psychiatric disorders). First, the molecular mechanisms of circadian rhythms are described. Then, the relationships between disrupted circadian rhythms, including sleep-wake rhythms, and psychiatric disorders are discussed. Further research may open interesting perspectives with promising avenues for early detection and therapeutic intervention in psychiatric disorders.
[Mh] Termos MeSH primário: Relógios Circadianos
Peptídeos e Proteínas de Sinalização do Ritmo Circadiano/genética
Ritmo Circadiano
Transtornos Mentais/genética
Transtornos do Sono-Vigília/genética
Sono
Vigília
[Mh] Termos MeSH secundário: Animais
Transtorno do Espectro Autista/etiologia
Transtorno do Espectro Autista/genética
Transtorno Bipolar/etiologia
Transtorno Bipolar/genética
Transtorno Depressivo Maior/etiologia
Transtorno Depressivo Maior/genética
Seres Humanos
Transtornos Mentais/etiologia
Esquizofrenia/etiologia
Esquizofrenia/genética
Transtornos do Sono-Vigília/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Circadian Rhythm Signaling Peptides and Proteins)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE


  5 / 15919 MEDLINE  
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[PMID]:28449906
[Au] Autor:Lancien M; Inocente CO; Dauvilliers Y; Kugener B; Scholz S; Raverot V; Lin JS; Guyon A; Gustin MP; Franco P
[Ad] Endereço:Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, CNRS UMR5292, University Lyon 1, Lyon, France.
[Ti] Título:Low cerebrospinal fluid hypocretin levels during sudden infant death syndrome (SIDS) risk period.
[So] Source:Sleep Med;33:57-60, 2017 May.
[Is] ISSN:1878-5506
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The temporal association between sudden infant death syndrome (SIDS) and sleep suggests that the arousability from sleep provides a protective mechanism for survival. Recently, the hypocretin system, which promotes wakefulness, has been implicated in SIDS, since it has been reported that SIDS victims have fewer hypocretin neurons than infants who have died from other causes. To understand the role of hypocretin in SIDS, it is essential to better understand how this system matures. The present study compared cerebrospinal fluid (CSF) hypocretin in children aged 2-6 months, which is the age of peak incidence for SIDS, to both younger and older children. METHOD: Hypocretin levels were measured in CSF samples from 101 children who underwent a clinically relevant lumbar puncture. Children were separated into five age groups: 0-2 months, 2-6 months, 1-5 years, 5-10 years, and 10-18 years. RESULTS: Hypocretin levels were not significantly different between 1-5 years, 5-10 years, and 10-18 years. Therefore, these three groups were pooled into a single one (1-18 years) for further analysis. Between the 0-2 month, 2-6 month, and 1-18 year groups, a significant difference in CSF hypocretin levels existed (p = 0.001). Simple comparisons showed that CSF hypocretin levels in the 2-6 month age group were significantly lower than hypocretin levels in both the 0-2 month and 1-18 year group (p < 0.001 and p = 0.008, respectively), but not significantly between 0-2 month and 1-18 year children. CONCLUSIONS: The CSF hypocretin levels were lower at the age of peak incidence for SIDS. This could underlie an increased vulnerability to SIDS at this specific age.
[Mh] Termos MeSH primário: Orexinas/análise
Sono/fisiologia
Morte Súbita do Lactente/líquido cefalorraquidiano
Vigília/fisiologia
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Feminino
Seres Humanos
Incidência
Lactente
Recém-Nascido
Masculino
Punção Espinal/métodos
Morte Súbita do Lactente/epidemiologia
Morte Súbita do Lactente/etiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (HCRT protein, human); 0 (Orexins)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


  6 / 15919 MEDLINE  
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[PMID]:28449905
[Au] Autor:Xu X; Wu H; Zhuang J; Chen K; Huang B; Zhao Z; Zhao Z
[Ad] Endereço:Department of Neurology, Changzheng Hospital, Second Military Medical University of PLA, Shanghai, PR China.
[Ti] Título:Sleep-wake patterns, non-rapid eye movement, and rapid eye movement sleep cycles in teenage narcolepsy.
[So] Source:Sleep Med;33:47-56, 2017 May.
[Is] ISSN:1878-5506
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To further characterize sleep disorders associated with narcolepsy, we assessed the sleep-wake patterns, rapid eye movement (REM), and non-REM (NREM) sleep cycles in Chinese teenagers with narcolepsy. METHODS: A total of 14 Chinese type 1 narcoleptic patients (13.4 ± 2.6 years of age) and 14 healthy age- and sex-matched control subjects (13.6 ± 1.8 years of age) were recruited. Ambulatory 24-h polysomnography was recorded for two days, with test subjects adapting to the instruments on day one and the study data collection performed on day two. RESULTS: Compared with the controls, the narcoleptic patients showed a 1.5-fold increase in total sleep time over 24 h, characterized by enhanced slow-wave sleep and REM sleep. Frequent sleep-wake transitions were identified in nocturnal sleep with all sleep stages switching to wakefulness, with more awakenings and time spent in wakefulness after sleep onset. Despite eight cases of narcolepsy with sleep onset REM periods at night, the mean duration of NREM-REM sleep cycle episode and the ratio of REM/NREM sleep between patients and controls were not significantly different. CONCLUSION: Our study identified hypersomnia in teenage narcolepsy despite excessive daytime sleepiness. Sleep fragmentation extended to all sleep stages, indicating impaired sleep-wake cycles and instability of sleep stages. The limited effects on NREM-REM sleep cycles suggest the relative conservation of ultradian regulation of sleep.
[Mh] Termos MeSH primário: Narcolepsia/diagnóstico
Narcolepsia/fisiopatologia
Fases do Sono/fisiologia
Sono REM/fisiologia
[Mh] Termos MeSH secundário: Adolescente
Estudos de Casos e Controles
Criança
China/epidemiologia
Ritmo Circadiano/fisiologia
Distúrbios do Sono por Sonolência Excessiva/complicações
Distúrbios do Sono por Sonolência Excessiva/epidemiologia
Distúrbios do Sono por Sonolência Excessiva/etiologia
Feminino
Seres Humanos
Masculino
Narcolepsia/epidemiologia
Polissonografia/métodos
Privação do Sono/diagnóstico
Privação do Sono/fisiopatologia
Ritmo Ultradiano/fisiologia
Vigília/fisiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


  7 / 15919 MEDLINE  
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[PMID]:29304108
[Au] Autor:Perez-Atencio L; Garcia-Aracil N; Fernandez E; Barrio LC; Barios JA
[Ad] Endereço:Unit of Experimental Neurology, "Ramón y Cajal" Hospital-IRYCIS, Carretera de Colmenar km 9, 28034 Madrid, Spain.
[Ti] Título:A four-state Markov model of sleep-wakefulness dynamics along light/dark cycle in mice.
[So] Source:PLoS One;13(1):e0189931, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Behavioral states alternate between wakefulness (wk), rapid eye movement (rem) and non-rem (nrem) sleep at time scale of hours i.e., light and dark cycle rhythms and from several tens of minutes to seconds (i.e., brief awakenings during sleep). Using statistical analysis of bout duration, Markov chains of sleep-wk dynamics and quantitative EEG analysis, we evaluated the influence of light/dark (ld) changes on brain function along the sleep-wk cycle. Bout duration (bd) histograms and Kaplan-Meier (km) survival curves of wk showed a bimodal statistical distribution, suggesting that two types of wk do exist: brief-wk (wkb) and long-wk (wkl). Light changes modulated specifically wkl bouts, increasing its duration during active/dark period. In contrast, wkb, nrem and rem bd histograms and km curves did not change significantly along ld cycle. Hippocampal eeg of both types of wk were different: in comparison wkb showed a lower spectral power in fast gamma and fast theta bands and less emg tone. After fitting a four-states Markov chain to mice hypnograms, moreover in states transition probabilities matrix was found that: in dark/active period, state-maintenance probability of wkl increased, and probability of wkl to nrem transition decreased; the opposite was found in light period, favoring the hypothesis of the participation of brief wk into nrem-rem intrinsic sleep cycle, and the role of wkl in SWS homeostasis. In conclusion, we propose an extended Markov model of sleep using four stages (wkl, nrem, rem, wkb) as a fully adequate model accounting for both modulation of sleep-wake dynamics based on the differential regulation of long-wk (high gamma/theta) epochs during dark and light phases.
[Mh] Termos MeSH primário: Escuridão
Luz
Sono/fisiologia
Vigília/fisiologia
[Mh] Termos MeSH secundário: Animais
Eletroencefalografia
Masculino
Cadeias de Markov
Camundongos
Camundongos Endogâmicos C57BL
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180106
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189931


  8 / 15919 MEDLINE  
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[PMID]:29253029
[Au] Autor:Bargiotas P; Eugster L; Oberholzer M; Debove I; Lachenmayer ML; Mathis J; Pollo C; Schüpbach WMM; Bassetti CL
[Ad] Endereço:Department of Neurology, University Hospital (Inselspital) and University of Bern, Bern, Switzerland.
[Ti] Título:Sleep-wake functions and quality of life in patients with subthalamic deep brain stimulation for Parkinson's disease.
[So] Source:PLoS One;12(12):e0190027, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Sleep-wake disturbances (SWD) are frequent in Parkinson's disease (PD). The effect of deep brain stimulation (DBS) on SWD is poorly known. In this study we examined the subjective and objective sleep-wake profile and the quality of life (QoL) of PD patients in the context of subthalamic DBS. PATIENTS AND METHODS: We retrospectively analyzed data from PD patients and candidates for DBS in the nucleus suthalamicus (STN). Pre-DBS, sleep-wake assessments included subjective and objective (polysomnography, vigilance tests and actigraphy) measures. Post-DBS, subjective measures were collected. QoL was assessed using the Parkinson's Disease Questionnaire (PDQ-39) and the RAND SF-36-item Health Survey (RAND SF-36). RESULTS: Data from 74 PD patients (62% male, mean age 62.2 years, SD = 8.9) with a mean UPDRS-III (OFF) of 34.2 (SD = 14.8) and 11.8 (SD = 4.5) years under PD treatment were analyzed. Pre-DBS, daytime sleepiness, apathy, fatigue and depressive symptoms were present in 49%, 34%, 38% and 25% of patients respectively but not always as co-occurring symptoms. Sleep-wake disturbances were significantly correlated with QoL scores. One year after STN DBS, motor signs, QoL and sleepiness improved but apathy worsened. Changes in QoL were associated with changes in sleepiness and apathy but baseline sleep-wake functions were not predictive of STN DBS outcome. CONCLUSION: In PD patients presenting for STN DBS, subjective and objective sleep-wake disturbances are common and have a negative impact on QoL before and after neurosurgery. Given the current preliminary evidence, prospective observational studies assessing subjective and objective sleep-wake variables prior to and after DBS are needed.
[Mh] Termos MeSH primário: Estimulação Encefálica Profunda/métodos
Doença de Parkinson/fisiopatologia
Qualidade de Vida
Transtornos do Sono-Vigília/fisiopatologia
Sono
[Mh] Termos MeSH secundário: Actigrafia
Idoso
Estudos de Coortes
Feminino
Seguimentos
Inquéritos Epidemiológicos
Seres Humanos
Masculino
Meia-Idade
Doença de Parkinson/complicações
Doença de Parkinson/terapia
Polissonografia
Estudos Retrospectivos
Transtornos do Sono-Vigília/etiologia
Núcleo Subtalâmico/fisiologia
Inquéritos e Questionários
Vigília
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180112
[Lr] Data última revisão:
180112
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171219
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190027


  9 / 15919 MEDLINE  
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[PMID]:28742772
[Au] Autor:Lobaugh LMY; Martin LD; Schleelein LE; Tyler DC; Litman RS
[Ad] Endereço:From the *Department of Anesthesiology, Perioperative, and Pain Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas; †Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, Seattle, Washington; ‡Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Washington; §Department of Anesthesiology & Critical Care, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; ‖Department of Anesthesiology & Critical Care, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; ¶Wake Up Safe, Cincinnati, Ohio.
[Ti] Título:Medication Errors in Pediatric Anesthesia: A Report From the Wake Up Safe Quality Improvement Initiative.
[So] Source:Anesth Analg;125(3):936-942, 2017 09.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Wake Up Safe is a quality improvement initiative of the Society for Pediatric Anesthesia that contains a deidentified registry of serious adverse events occurring in pediatric anesthesia. The aim of this study was to describe and characterize reported medication errors to find common patterns amenable to preventative strategies. METHODS: In September 2016, we analyzed approximately 6 years' worth of medication error events reported to Wake Up Safe. Medication errors were classified by: (1) medication category; (2) error type by phase of administration: prescribing, preparation, or administration; (3) bolus or infusion error; (4) provider type and level of training; (5) harm as defined by the National Coordinating Council for Medication Error Reporting and Prevention; and (6) perceived preventability. RESULTS: From 2010 to the time of our data analysis in September 2016, 32 institutions had joined and submitted data on 2087 adverse events during 2,316,635 anesthetics. These reports contained details of 276 medication errors, which comprised the third highest category of events behind cardiac and respiratory related events. Medication errors most commonly involved opioids and sedative/hypnotics. When categorized by phase of handling, 30 events occurred during preparation, 67 during prescribing, and 179 during administration. The most common error type was accidental administration of the wrong dose (N = 84), followed by syringe swap (accidental administration of the wrong syringe, N = 49). Fifty-seven (21%) reported medication errors involved medications prepared as infusions as opposed to 1 time bolus administrations. Medication errors were committed by all types of anesthesia providers, most commonly by attendings. Over 80% of reported medication errors reached the patient and more than half of these events caused patient harm. Fifteen events (5%) required a life sustaining intervention. Nearly all cases (97%) were judged to be either likely or certainly preventable. CONCLUSIONS: Our findings characterize the most common types of medication errors in pediatric anesthesia practice and provide guidance on future preventative strategies. Many of these errors will be almost entirely preventable with the use of prefilled medication syringes to avoid accidental ampule swap, bar-coding at the point of medication administration to prevent syringe swap and to confirm the proper dose, and 2-person checking of medication infusions for accuracy.
[Mh] Termos MeSH primário: Anestesia/normas
Bases de Dados Factuais/normas
Erros de Medicação/prevenção & controle
Pediatria/normas
Melhoria de Qualidade/normas
Relatório de Pesquisa/normas
Vigília
[Mh] Termos MeSH secundário: Sistemas de Notificação de Reações Adversas a Medicamentos/normas
Sistemas de Notificação de Reações Adversas a Medicamentos/tendências
Anestesia/efeitos adversos
Anestesia/tendências
Bases de Dados Factuais/tendências
Seres Humanos
Erros de Medicação/tendências
Pediatria/tendências
Melhoria de Qualidade/tendências
Relatório de Pesquisa/tendências
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000002279


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[PMID]:27772564
[Au] Autor:Leonard M; O'Connell H; Williams O; Awan F; Exton C; O'Connor M; Adamis D; Dunne C; Cullen W; Meagher DJ
[Ad] Endereço:Graduate Entry Medical School, University of Limerick, Ireland; Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland; Department of Psychiatry, University Hospital Limerick, Irelan
[Ti] Título:Attention, vigilance and visuospatial function in hospitalized elderly medical patients: Relationship to neurocognitive diagnosis.
[So] Source:J Psychosom Res;90:84-90, 2016 11.
[Is] ISSN:1879-1360
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Efficient detection of neurocognitive disorders is a key diagnostic challenge. We explored how simple bedside tests of attention, vigilance and visuospatial function might assist in identifying delirium in hospitalized patients. METHODS: Performance on a battery of bedside cognitive tests was compared in elderly medical inpatients with DSM-IV delirium, dementia, comorbid delirium-dementia, and no neurocognitive disorder. RESULTS: 193 patients [mean age 79.9±7.3; 97 male] were assessed with delirium (n=45), dementia (n=33), comorbid delirium-dementia (n=65) and no neurocognitive disorder (NNCD) (n=50). The ability to meaningfully engage with the tests varied from 84% (Spatial Span Forwards) to 57% (Vigilance B test), and was especially problematic among the comorbid delirium-dementia group. The NNCD was distinguished from the delirium groups for most tests, and from the dementia group for the Vigilance B test and the Clock Drawing Test. The dementia group differed from delirium groups in respect of the Months Backward Test, Vigilance A and B tests, Global assessment of visuospatial ability and the Interlocking Pentagons Test. Overall, patients with delirium were best identified by three tests - the Months Backward Test, Vigilance A test and the Global Assessment of visuospatial function with failure to correctly complete any two of these predicting delirium status in 80% of cases. CONCLUSION: Simple bedside tests of attention, vigilance and visuospatial ability can help to distinguish neurocognitive disorders, including delirium, from other presentations. There is a need to develop more accurate methods specifically designed to assess patients with neurocognitive disorder who are unable to engage with conventional tests.
[Mh] Termos MeSH primário: Nível de Alerta
Atenção
Transtornos Cognitivos/psicologia
Hospitalização
Desempenho Psicomotor
Comportamento Espacial
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Nível de Alerta/fisiologia
Atenção/fisiologia
Transtornos Cognitivos/diagnóstico
Transtornos Cognitivos/epidemiologia
Comorbidade
Delírio/diagnóstico
Delírio/epidemiologia
Delírio/psicologia
Demência/diagnóstico
Demência/epidemiologia
Demência/psicologia
Manual Diagnóstico e Estatístico de Transtornos Mentais
Feminino
Seres Humanos
Masculino
Testes Neuropsicológicos/normas
Desempenho Psicomotor/fisiologia
Comportamento Espacial/fisiologia
Vigília
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171229
[Lr] Data última revisão:
171229
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE



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