Comparison of Nasopharyngeal Airway with Endoscopic Respiratory Mask for Hypoxemia in Painless Gastrointestinal Endoscopy in Obese Outpatients: Study Protocol for a Randomized Controlled Trial DOI Creative Commons

Dongmei Xiang,

Lei Deng,

Rui Zhou

и другие.

Medical Devices Evidence and Research, Год журнала: 2025, Номер Volume 18, С. 97 - 106

Опубликована: Фев. 1, 2025

Sedatives and anesthetics can modify airway tone induce respiratory depression, exacerbating the gas exchange impairments associated with obesity. In obese patients undergoing gastrointestinal endoscopy, upper obstruction hypoventilation are prevalent, leading to frequent occurrences of hypoxemia during procedure. This study aims investigate effects nasopharyngeal in mitigating via alleviating outpatients painless endoscopy is a prospective single-center randomized controlled study. After signing written informed consent, eligible scheduled for will be randomly allocated into group (group N) control C), 88 each group. Patients N undergo intubation prior examination, whereas C receive oxygen therapy through an endoscopic mask at flow rate 10 L/min All two groups propofol opioids procedural sedation. The primary outcome incidence hypoxemia. secondary outcomes epistaxis, suspended examination due hypoxemia, manual ventilation, times attempt nasopharynx insertion, duration insertion airway, tracheal/laryngeal intubation, adverse cardiovascular events, complications, VAS score pain after removing satisfaction patients, endoscopist anesthesiologists. evaluates on caused by sedation endoscopy. results this expected provide evidence use outpatients. ChiCTR2300078892.

Язык: Английский

Breathing Rhythm and Pattern and Their Influence on Emotion DOI Open Access
Sufyan Ashhad, Kaiwen Kam, Christopher A. Del Negro

и другие.

Annual Review of Neuroscience, Год журнала: 2022, Номер 45(1), С. 223 - 247

Опубликована: Март 9, 2022

Breathing is a vital rhythmic motor behavior with surprisingly broad influence on the brain and body. The apparent simplicity of breathing belies complex neural control system, central pattern generator (bCPG), that exhibits diverse operational modes to regulate gas exchange coordinate an array behaviors. In this review, we focus selected advances in our understanding bCPG. At core bCPG preBötzinger (preBötC), which drives inspiratory rhythm via unexpectedly sophisticated emergent mechanism. Synchronization dynamics underlying preBötC rhythmogenesis imbue system robustness lability. These are modulated by inputs from throughout generate rhythmic, patterned activity widely distributed. connectivity emerging literature support link between breathing, emotion, cognition becoming experimentally tractable. bring great potential for elucidating function dysfunction other mammalian circuits.

Язык: Английский

Процитировано

91

Causal inference from cross-sectional earth system data with geographical convergent cross mapping DOI Creative Commons
Bingbo Gao, Jianyu Yang, Ziyue Chen

и другие.

Nature Communications, Год журнала: 2023, Номер 14(1)

Опубликована: Сен. 21, 2023

Causal inference in complex systems has been largely promoted by the proposal of some advanced temporal causation models. However, models have serious limitations when time series data are not available or present insignificant variations, which causes a common challenge for earth system science. Meanwhile, there few spatial fully exploring rich cross-sectional Earth systems. The generalized embedding theorem proves that observations can be combined together to construct state space dynamic system, and if two variables from same they causally linked. Inspired this, here we show Geographical Convergent Cross Mapping (GCCM) model causal with data-based cross-mapping prediction reconstructed space. Three typical cases, where clearly existing causations cannot measured through models, demonstrate GCCM could detect weak-moderate correlation is significant. When coupling between significant strong, advantageous identifying primary direction better revealing bidirectional asymmetric causation, overcoming mirroring effect.

Язык: Английский

Процитировано

60

Overdose mortality rates for opioids and stimulant drugs are substantially higher in men than in women: state-level analysis DOI Open Access
Eduardo R. Butelman, Yuefeng Huang, David H. Epstein

и другие.

Neuropsychopharmacology, Год журнала: 2023, Номер 48(11), С. 1639 - 1647

Опубликована: Июнь 15, 2023

Язык: Английский

Процитировано

49

Treatment of overdose in the synthetic opioid era DOI Creative Commons
Phil Skolnick

Pharmacology & Therapeutics, Год журнала: 2021, Номер 233, С. 108019 - 108019

Опубликована: Окт. 11, 2021

Overdose deaths are often viewed as the leading edge of opioid epidemic which has gripped United States over past two decades (Skolnick, 2018a). This emphasis is perhaps unsurprising because overdose both number-one cause death for individuals between 25 and 64 years old (Dezfulian et al., 2021) a significant contributor to decline in average lifespan (Dowell 2017). Exacerbated by COVID 19 pandemic, it was estimated there were 93,400 drug during 12 months ending December 2020, with more than 69,000 (that is, >74%) these fatalities attributed (Ahmad 2021). However, focus on mortality statistics 2021; Shover 2020) tends obscure broader medical impact nonfatal overdose. Analyses multiple databases indicate that each opioid-induced fatality, 6.4 8.4 non-fatal overdoses, exacting burden individual society. Over 7-8 years, been an alarming increase misuse synthetic opioids ("synthetics"), primarily fentanyl related piperidine-based analogs. Within 2-3 structurally unrelated class high potency synthetics, benzimidazoles exemplified etonitazene isotonitazene ("iso"), have also appeared illicit markets (Thompson, 2020; Ujvary al. In 80% fatal overdoses now involve synthetics The unique physicochemical pharmacological properties described this review responsible morbidity associated their well widespread availability. dramatic referred "3rd wave" (Pardo 2019; Volkow Blanco, epidemic. Among consequences resulting from potent need higher doses competitive antagonist, naloxone, reverse development effective reversal agents such those essential component tripartite strategy (Volkow Collins, 2017) reduce biopsychosocial "synthetic era".

Язык: Английский

Процитировано

87

Divergent brainstem opioidergic pathways that coordinate breathing with pain and emotions DOI Creative Commons
Shijia Liu, Mao Ye, Gerald M. Pao

и другие.

Neuron, Год журнала: 2021, Номер 110(5), С. 857 - 873.e9

Опубликована: Дек. 17, 2021

Язык: Английский

Процитировано

85

Transient cAMP production drives rapid and sustained spiking in brainstem parabrachial neurons to suppress feeding DOI
Jonnathan Singh Alvarado, Andrew Lutas,

Joseph C. Madara

и другие.

Neuron, Год журнала: 2024, Номер 112(9), С. 1416 - 1425.e5

Опубликована: Фев. 27, 2024

Язык: Английский

Процитировано

11

Dual mechanisms of opioid-induced respiratory depression in the inspiratory rhythm-generating network DOI Creative Commons
Nathan A. Baertsch, Nicholas E. Bush, Nicholas Burgraff

и другие.

eLife, Год журнала: 2021, Номер 10

Опубликована: Авг. 17, 2021

The analgesic utility of opioid-based drugs is limited by the life-threatening risk respiratory depression. Opioid-induced depression (OIRD), mediated μ-opioid receptor (MOR), characterized a pronounced decrease in frequency and regularity inspiratory rhythm, which originates from medullary preBötzinger Complex (preBötC). To unravel cellular- network-level consequences MOR activation preBötC, MOR-expressing neurons were optogenetically identified manipulated transgenic mice vitro vivo. Based on these results, model OIRD was developed silico. We conclude that hyperpolarization - expressing preBötC alone does not phenocopy OIRD. Instead, effects are twofold: (1) pre-inspiratory spiking reduced (2) excitatory synaptic transmission suppressed, thereby disrupting network-driven rhythmogenesis. These dual mechanisms opioid action act synergistically to make normally robust rhythm-generating network particularly prone collapse when challenged with exogenous opioids.

Язык: Английский

Процитировано

50

Mechanisms of opioid-induced respiratory depression DOI
Brian A. Baldo, Michael Rose

Archives of Toxicology, Год журнала: 2022, Номер 96(8), С. 2247 - 2260

Опубликована: Апрель 26, 2022

Язык: Английский

Процитировано

39

Molecular ontology of the parabrachial nucleus DOI
Samyukta Karthik, Dake Huang,

Yaritza Delgado

и другие.

The Journal of Comparative Neurology, Год журнала: 2022, Номер 530(10), С. 1658 - 1699

Опубликована: Фев. 8, 2022

Abstract Diverse neurons in the parabrachial nucleus (PB) communicate with widespread brain regions. Despite evidence linking them to a variety of homeostatic functions, it remains difficult determine which PB influence functions because their subpopulations intermingle extensively. An improved framework for identifying these intermingled would help advance our understanding neural circuit linked this region. Here, we present foundation developmental‐genetic ontology that classifies based on intrinsic, molecular features. By combining transcription factor labeling Cre fate‐mapping, find is blend two, developmentally distinct macropopulations glutamatergic neurons. Neurons first macropopulation express Lmx1b (and, lesser extent, Lmx1a ) and are mutually exclusive those second macropopulation, derive from precursors expressing Atoh1 . This second, ‐derived includes many Foxp2 ‐expressing neurons, but also identifies subset Kölliker–Fuse (KF) population GABAergic ventrolateral (“caudal KF”). Immediately ventral PB, Phox2b (some coexpressing occupy KF, supratrigeminal nucleus, reticular formation. We show organizes subsidiary patterns adult gene expression (including Satb2 , Calca Grp Pdyn predicts output projections amygdala ( ), hypothalamus hindbrain / ). Using organize, interpret, PB‐related information could accelerate translation experimental findings animal models human patients.

Язык: Английский

Процитировано

38

Parabrachial tachykinin1-expressing neurons involved in state-dependent breathing control DOI Creative Commons

Joseph W. Arthurs,

Anna J. Bowen, Richard D. Palmiter

и другие.

Nature Communications, Год журнала: 2023, Номер 14(1)

Опубликована: Фев. 21, 2023

Abstract Breathing is regulated automatically by neural circuits in the medulla to maintain homeostasis, but breathing also modified behavior and emotion. Mice have rapid patterns that are unique awake state distinct from those driven automatic reflexes. Activation of medullary neurons control does not reproduce these patterns. By manipulating transcriptionally defined parabrachial nucleus, we identify a subset express Tac1 , Calca gene exerts potent precise conditional awake, anesthetized, via projections ventral intermediate reticular zone medulla. Activating drives frequencies match physiological maximum through mechanisms differ underlie breathing. We postulate this circuit important for integration with state-dependent behaviors emotions.

Язык: Английский

Процитировано

22