ABSTRACT
Most research describing ketamine as a treatment for depression has relied on intravenous dosing. There remains a need for more research to support this treatment with other routes of administration. This was a retrospective chart review of 30 patients hospitalized with unipolar or bipolar treatment-resistant depression who were treated with up to four doses of compounded intranasal racemic ketamine (50 mg or 75 mg). Treatment courses lasted up to 7 days. Symptom improvement was measured with either the Hamilton Depression Rating Scale or the Montgomery-Åsberg Depression Rating Scale. Ketamine was well tolerated with no severe adverse events or treatment discontinuations due to adverse effects. Blood pressures increased by 4-6 mmHg on average with no patients requiring medication to lower blood pressure. Twenty patients (66.7%) were classified as treatment responders based on depression scores decreasing by more than 50%. Among the 27 patients with moderate to severe suicidal ideation scores at baseline, these decreased by 68.5% on average. Overall, the results suggest that compounded intranasal racemic ketamine was safe and effective in the treatment of depressive symptoms and suicidal ideation in a real-world sample of patients hospitalized with treatment-resistant depression. Additional research comparing intranasal ketamine to esketamine and intravenous racemic ketamine is warranted. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Subject(s)
Depressive Disorder, Major , Ketamine , Humans , Ketamine/adverse effects , Antidepressive Agents/therapeutic use , Antidepressive Agents/adverse effects , Depression/drug therapy , Retrospective Studies , Depressive Disorder, Major/drug therapy , Depressive Disorder, Major/chemically induced , Depressive Disorder, Major/diagnosis , Analgesics , Administration, IntranasalABSTRACT
The use of personal protective equipment by veterinary workers during radiographic imaging is inconsistent. While the self-reported use of leaded aprons and thyroid shields approaches 100% in some studies, the use of leaded gloves and eyeglasses is much lower. Previous studies describing personal protective equipment use are based on self-reporting. Objectives of this prospective, observational study were to describe use of leaded personal protective equipment during radiographic imaging by veterinary workers, and to compare observed use with self-reported use. Use of leaded personal protective equipment during radiographic imaging by veterinary workers was observed over a 10 week period using two motion-triggered video cameras, and a questionnaire was then completed by workers on their use of personal protective equipment. Workers restrained the animal during 91.8% (753/820) of exposures. An apron and a securely closed thyroid shield were worn for >99% of studies. Gloves were used correctly for 43.6% (156/358) of radiographic studies. Leaded eyeglasses were worn for 1.7% (6/358) of studies. Correct glove use was more frequent during regular working hours than after-hours for both veterinarians (odds ratio 32.7, P = 0.001) and veterinary students (odds ratio 75.1, P < 0.001). The number of workers in the room was lower when animals were sedated (P = 0.002) or anesthetized (P = 0.017). Workers overestimated their frequency of glove use (P <0.001). In conclusion, workers use personal protective equipment less frequently in an unsupervised environment, and overestimate their use of personal protective equipment. Use of sedation or anesthesia decreases worker exposure to ionizing radiation.
