Clinical neuropharmacology
Wei Xie, Le Wang, Zhe Peng et al.
6 citations
Preoperative nasal administration of low-dose esketamine or dexmedetomidine reduces emergence delirium after pediatric fiberoptic bronchoscopy. In a randomized trial of 126 children aged 1–6 years, emergence delirium occurred in 7.14% of those given 1.0 mg/kg esketamine and 18.6% of those given 1.0 μg/kg dexmedetomidine, compared with 48.78% in the saline control group. Both drugs also lowered postoperative pain intensity. Dexmedetomidine prolonged the time to awaken and open eyes in the recovery unit, while hemodynamics, oral secretions, and recovery-stay duration did not differ among groups.
Psychiatry and clinical neurosciences
April 1, 2024
Ting Xue, Jialing Sheng, Hui Gao et al.
5 citations
An 8-month daily guided intensive meditation-based intervention (iMI) added to a general rehabilitation program reduced persistent hallucinations and delusions and improved health-related quality of life in male inpatients with treatment-refractory schizophrenia. In a randomized trial of 64 participants, those receiving iMI showed significantly greater reductions in Positive and Negative Syndrome Scale total scores, positive symptoms, and hallucination/delusion items at both 3 and 8 months compared with rehabilitation alone. Treatment response rates (at least 25% reduction) for these measures were higher in the iMI group at 8 months. The iMI group also reported better physical activity and mindfulness skills. Longer iMI duration produced stronger benefits.
Journal of affective disorders
May 1, 2025
Xiaohui Zhou, Li Zhang, Weiwei Gao et al.
4 citations
In a rat model of depression, modified electroconvulsive therapy (MECT) effectively reduced depressive symptoms but worsened cognitive impairments, increased hippocampal neuronal death, and triggered neuroinflammation. Adding esketamine, an FDA-approved antidepressant, reversed those cognitive deficits, reduced cell death and inflammation, and improved synaptic plasticity. Esketamine worked by increasing levels of the protein KLF4, which in turn blocked the p38 MAPK signaling pathway. When KLF4 was experimentally reduced, esketamine's protective effects disappeared, confirming its essential role. The findings suggest that combining esketamine with electroconvulsive therapy could protect against memory and thinking problems in patients.
medRxiv : the preprint server for health sciences
January 18, 2025
Stephanie C. DeMasi, Brant Imhoff, Ariel A. Lewis et al.
preprint
Among critically ill adults undergoing emergency tracheal intubation, it is uncertain whether the choice of ketamine or etomidate for induction of anesthesia affects patient outcomes. The Randomized trial of Sedative choice for Intubation (RSI) is a pragmatic, multicenter trial enrolling 2,364 patients across 14 U.S. sites to compare ketamine versus etomidate. The primary outcome is all-cause, 28-day in-hospital mortality; a secondary outcome is cardiovascular collapse during intubation. Enrollment began in April 2022 and is expected to conclude in 2025. Prespecifying the protocol and statistical analysis plan before enrollment ends increases the trial's rigor, reproducibility, and transparency.