China
Africa
Explore chapters and articles related to this topic
Communication Stations
Published in Adnan Darr, Karan Jolly, Jameel Muzaffar, ENT Vivas, 2023
Wai Sum Cho, Anna Slovick, Jameel Muzaffar, Adnan Darr
Part 3: During the operation, access was very difficult and you were unable to proceed with stapling of the pouch. You were worried about a perforation and decided to insert a nasogastric feeding tube and keep the patient nil by mouth for 5 days. Explain to the patient your operative findings and further management planDuring the consultation, you found that the patient is refusing to stay in hospital for 5 days as he is the main carer for his son who has learning disabilityPoints to cover: Explain about difficulty with access and concern about perforationAddress patient's concern: Explore if son is known to learning disability team/have any support packages at homeAllow opportunity for patient to arrange care at homeDiscuss potential alternatives such as a water-soluble contrast swallow or CT scan with oral contrast to assess for any leak of which, if clear, may be able to be discharged
Medicines management
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Kirsty Andrews, Martina O’Brien
There are two other forms of medicines, which, although taken into the mouth, are not swallowed: Sublingual medication. These are produced as sprays or tablets and are absorbed through the mucosa under the tongue. As the sublingual area is very vascular, absorption and effect of the drug occur rapidly.Buccal medication. These medicines are usually produced as tablets and are put on to the gum under the lip. Again, the effect of the drug is rapid.
Enteral Nutrition
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Stephanie G. Harshman, Lauren G. Fiechtner
Human milk and infant formula are the primary sources of nutrition during the first year of life (Chapter 5). When an infant is unable to meet his needs by mouth, these products can be provided through a feeding tube. For all infants, feeding (orally or enterally) should start on the first day of life if medically able. Initiation and advancement of EN is dependent on the individual including their age, weight, and medical stability.
Sublingual dexmedetomidine: repurposing an anesthetic as an anti-agitation agent
Published in Expert Review of Neurotherapeutics, 2023
Justin Faden, Meghan Musselman, Leslie Citrome
Sublingual dexmedetomidine allows for rapid, noninvasive treatment of agitation in patients with bipolar disorder or schizophrenia. The FDA-approved indication is inclusive of agitation associated with Bipolar II as well as with depressed states of bipolar disorder, unique for any agent FDA-approved for the acute treatment of agitation. A benefit of this medication is that the rapid, noninvasive formulation may improve patient experience and may therefore facilitate improved cooperation between patient and healthcare provider[19]. Disadvantages include that the medication must be taken as directed in the mouth and allowed to dissolve, which can take a few minutes, typically more time than it takes to administer an injection. The patient must be able to cooperate with medication administration which precludes patients actively refusing care. It is noteworthy that the vehicle is mucoadhesive and cannot be easily swallowed or spit out. Additionally, dexmedetomidine is microdeposited onto the film and absorption is therefore not directly dependent on film dissolution. A potential obstacle to use is that due to the safety and tolerability profile, patients taking CNS depressants and medications that prolong the QT interval as well as individuals with cardiovascular conditions may not be ideal candidates for sublingual dexmedetomidine [26]. Additional real-world studies will be needed before its place in the treatment landscape can be clearly delineated.
Assessment of biomarkers of exposure and potential harm, and physiological and subjective health measures in exclusive users of nicotine pouches and current, former and never smokers
Published in Biomarkers, 2023
David Azzopardi, Linsey E. Haswell, Justin Frosina, Michael McEwan, Nathan Gale, Jesse Thissen, Filimon Meichanetzidis, George Hardie
In this study, participants were asked to use the NPs in their usual way, allowing us to obtain use behaviour data for this relatively new type of nicotine product. The mean in-mouth time was 33.3 min, which is considerably shorter than the fixed duration of 60 min that has been used in several pharmacokinetic (PK) studies of NPs (Lunell et al. 2020, McEwan et al. 2022, Azzopardi et al. 2022c). This suggests that the PK parameters (e.g. Cmax, AUC) observed in those studies are likely to represent the higher end of nicotine exposure experienced by NP users. In addition, the usage times from this study are considerably lower than the 60–70 min previously reported for snus (Digard et al. 2013). The usage times recorded in the present study might be used to inform future PK studies to obtain more ‘real-world’ data. Interestingly, the Swedish participants used the NPs for much longer than the Danish participants (46.6 vs 19.1 min), which is likely to be the main driver for the higher TNeq results in the Swedish NP users compared with Danish NP users. This disparity in usage times may be influenced by the overall use of lower nicotine strengths by the Swedish participants as compared with the Danish participants. Alternatively, it may reflect the long tradition of snus use that is unique to Sweden.
Evaluation and clinical comparison studies on liposomal and non-liposomal ascorbic acid (vitamin C) and their enhanced bioavailability
Published in Journal of Liposome Research, 2021
Sreerag Gopi, Preetha Balakrishnan
Totally, 24 subjects were enrolled in the study. In regular intervals, subjects were housed in the clinical facility for at least 11 h pre-dose to 24 h post-dose and the washout period of at least 7 days from the successive dosing day. In every period, for an overnight fasting of at least 10 h, in the beginning of day, a single oral dose, 5 mL of either LVC or NLVC, was administered by using syringe (as per randomization schedule) that was cleaned using 240 mL of drinking water, at ambient temperature, after administration of investigational medicinal products, to the subjects in sitting posture, under the supervision of investigator and trained study personnel (Jain, n.d.) including quality assurance auditor. Mouth check with the help of tongue depressor to assess compliance to dosing was carried out.