ABSTRACT
Background: the co-administration of ketamine and propofol [CoKP] is thought to maximize the beneficial profile of each medication, while minimizing the respective adverse effects of each medication
Objective: our objective was to compare adverse events between ketamine monotherapy [KM] and CoKP for procedural sedation and analgesia [PSA] in a pediatric emergency department [ED]
Methods: this was a prospective, randomized, single-blinded, controlled trial of KM vs. CoKP in patients between 3 and 21 years of age. The attending physician administered either ketamine 1 mg/kg i.v. or ketamine 0.5 mg/kg and propofol 0.5 mg/kg i.v. The physician could administer up to three additional doses of ketamine [0.5 mg/kg/dose] or ketamine/propofol [0.25 mg/kg/dose of each]. Adverse events [e.g., respiratory events, cardiovascular events, unpleasant emergence reactions] were recorded. Secondary outcomes included efficacy, recovery time, and satisfaction scores
Results: thirty-two patients were randomized to KM and 29 patients were randomized to CoKP. There was no difference in adverse events or type of adverse event, except nausea was more common in the KM group. Efficacy of PSA was higher in the KM group [99%] compared to the CoKP group [90%]. Median recovery time was the same
Conclusions: we found no significant differences in adverse events between the KM and CoKP groups. While CoKP is a reasonable choice for pediatric PSA, our study did not demonstrate an advantage of this combination over KM
ABSTRACT
Elderly individuals are very vulnerable to influenza infection, and more prone to influenza-related morbidity and mortality. However, the prevalence of elderly persons receiving influenza vaccine remains low. Many factors have been proposed as the cause beyond this low prevalence, with knowledge and misconceptions about the vaccine on the top of the list
Objectives: the aim of this review is to assess the knowledge, attitude, and prevalence of flu vaccine and its effect among elderly
Methods: To achieve this aim, online database search was conducted to review articles stating knowledge, attitude, and incidence of flu vaccine and its effects among elderly. PubMed was searched for appropriately-related studies that address the studied parameters. PubMed search yielded 19 results, we quickly inspected the abstracts of these results to select those with most relevant data. Of 19 articles, 8 were chosen for review
Results: The prevalence of influenza vaccine ranged from 58% to 73%. Inadequate or lack of knowledge about the vaccine were common in over half of the elderly patients not receiving vaccine. The vast majority [>90%] of those received the vaccine did so after a clear recommendation by their physicians
Discussion: Inadequate knowledge and false beliefs about the influenza vaccines were the main cause of low vaccination rate among elderly. Physicians advice and health education were the most potent influencer on raising the prevalence of elderly immunization