bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hallucinogens: Spiritual and Therapeutic Use, Overuse, and Complications
Authors: Grob Charles S. 
Published: October 2018

Abstract
A fascinating class of psychoactive substances possessing a long and mysterious history of human use are the classic hallucinogens. Forming a vital component of prehistorical and aboriginal culture and belief systems, hallucinogens were ultimately condemned and repressed by evolving civilizations, only to the “rediscovered” in the 20th century. Of compelling interest to anthropologists, ethnobotanists, pharmacologists, medical scientists, and mental health clinicians, their use was diverted to the general culture, particularly among youth during the politically tumultuous 1960s: it was determined to be the cause of a period of cultural upheaval associated with a perceived public health crisis. After decades of quiescence, however, the careful examination of hallucinogens under rigorous and approved research conditions has resumed. This chapter will explore the historical background, neuropharmacology, cultural use, risks of adverse events/addiction, recent renaissance of controlled research, and models for optimal use and implications for the future.
Ayurvedic Approach to Addiction
Authors: Modir Shahla J. 
Published: October 2018

Abstract
Ayurveda is one of the oldest systems of natural medicine in the world. Originating over 4,000 years ago, it is the root of several other branches of traditional medicine including the Chinese and Greek medical systems. The word “veda” means knowledge or science and the term “ayus” means life in Sanskrit. Thus, the term “ayurveda” means the knowledge or “science of life.” In this chapter, we review the basic principles and pathophysiology of illness from an Ayurvedic medicine perspective. We also discuss in depth the disease treatment model from an Ayurvedic perspective. Additionally, we explore the Ayurvedic view of addiction and discuss treatment approaches. Included is the use of the Ayurvedic model to describe and treat three different types of alcoholism as an illustration of varying doshic imbalances.
Traditional Chinese Medicine (TCM) and Acupuncture Approach to Addiction
Authors: Modir Shahla J. , Morris Joel 
Published: October 2018

Abstract
The first half of this chapter paints a broad overview of TCM (traditional Chinese medicine) with a focus on addiction. The second half details the Western studies, which address specific addictive substances. A glimpse of TCM’s history in the context of the medical models is discussed. The Western medical model is compared to and differentiated from TCM. Yin-yang and 5-element theory are detailed. The Zang Fu patterns are examined along with the principles of treatment and recognition of patterns. The 3 treasures (jing, qi, and shen) are discussed. Acupuncture was serendipitously found to be an addiction treatment with EA (electro acupuncture) and auricular points in 1972, which suggested a neuroendocrinological basis. Animal studies pointed toward involvement of different neurotransmitters in the basic mechanism of acupuncture, which are: the dopamine, GABAeric, and serotonergic systems. Most of the quality Western studies use the NADA (National Acupuncture Detoxification Association) protocols, which use 5 auricular points: shen men, kidney, liver, and lung. This protocol treats opiates, cocaine, nicotine, and AUDs. Regarding opiate detoxification, addicts assigned to the treatment groups were more consistent and more frequently attended treatment. Regarding alcohol, female participants (N = 185) who received acupuncture reported a decrease in cravings, depression, and anxiety with an increase in problem solving, when compared to controls (N = 101). There is less evidence that acupuncture is helpful for cocaine and nicotine. Acupuncture appears most helpful as an adjunct therapy, which keeps people more engaged in therapy longer, resulting in better outcomes.
Ibogaine: History, Pharmacology, Spirituality, & Clinical Data
Authors: Shapiro Benjamin 
Published: October 2018

Abstract
Ibogaine is an indole alkaloid derived from the African shrub Tabernathe iboga with broad anti-addictive, anti-depressant, and central nervous system stimulating effects. It is categorized as an oneriogen (or atypical hallucinogen) and has been used in West African tribal rituals for centuries. It was identified by French explorers in the early 1900s, came to the United States in the 1960s, and became marginalized in the mid-1990s after adverse outcomes halted federally funded human trials. Since then legal ibogaine treatment clinics have been established in countries without use restrictions. Ibogaine is a σ1 and σ2 receptor and μ and κ opioid receptor agonist and a α3β4 nicotinic and NMDA receptor antagonist. Decades of trials have demonstrated ibogaine’s potential. Human trials of ibogaine consistently demonstrate rapid remission of acute withdrawal symptoms but differ in their findings with regard to abstinence and toxicity. While ibogaine is not a “magic bullet,” considerable abstinence may result after multiple treatments, however QT prolongation can produce lethal ventricular tachyarrhythmias.18 MC is in pre-clinical investigation.
Integrative Approaches to Healing
Authors: Scott E. Hitchcock , Muñoz George E. 
Published: October 2018

Abstract
Emotional balance and stability are important aspects of long-term abstinence from non-prescribed mood altering chemicals. Labiality (extreme mood swings) can contribute to relapse. This chapter challenges the traditional concept of healing, defined as a return to prior levels of functioning. Adverse childhood experiences, with their long-term contribution to adolescent and adult mood problems are noted. Interventions for adverse childhood experiences are recommended as part of the healing journey for emotional wellness. The limitations of traditional addiction treatment are discussed, as well as various possible detractors to good emotional health and sobriety. Interventions, processes, and various counseling theoretical practices are suggested for improving mood, emotional well-being, and sobriety. Ongoing assessment and monitoring of emotional well-being and relapse risk are critical. The quality of the relationship between the practitioner and patient is crucial in order to co-create a viable, individualized, holistic treatment plan.
Integrative Approaches to the Management of Chronic Pain and Substance Abuse
Authors: Pujol Lynette M. , Herbert Bettina , Geppert Cynthia M. A. , Cardon Karen E. 
Published: October 2018

Abstract
The complexity of pain and addiction is a challenging clinical problem to address. Approaching the treatment of addiction and pain requires a holistic interpretation of a patient, understanding the psychological as well as biological mechanisms involved in both conditions. Given these facts, an interface has been created in this chapter of 2 phenomenal approaches to pain focused in both the psychiatric and mechanistic pain models. The result is a well-rounded and comprehensive view on how to approach pain in the integrative format for patients with addiction. When to consider different conventional and integrative modalities is reviewed including their evidence base. The role of personality, pain perception, and cognitions are all examined. The full array of integrative approaches including mind-body interventions, guided imagery, CBT, hypnosis, spirituality, mindfulness and postural techniques, manipulation, yoga, Tai chi and TCM are all discussed.
The Future of Addiction and Recovery Healing Arts
Authors: Modir Shahla J. , Muñoz George E. 
Published: October 2018

Abstract
This chapter peers into the future of addiction treatment. It begins with an exploration of repetitive transcranial magnetic brain stimulation or rTMS as a treatment for SUD. The evidence and clinical data is reviewed. Findings include outcome data on the use of rTMS. Furthermore, important brain regions central to the development of SUD are examined: the ventral tegmental area and ventral striatum appear to play a central role in the binge/intoxication stage, the extended amygdala in the withdrawal/negative affect stage, and the orbitofrontal cortex-dorsal striatum, prefrontal cortex, basolateral amygdala, hippocampus, and insula in craving. The role of genomics and gene-wide associations to deliver future personalized addiction treatments is discussed as is advanced functional neural imaging. Technology for patients and consumers, including relapse prevention apps and bidirectional biometric reading is mentioned. Breakthroughs in addiction immunology, both generalized and substance specific, are discussed as potential points of future study and interventions.
Challenges of Anesthesia Outside of the Operating Room
Authors: Gross Wendy L. , Urman Richard D. 
Published: October 2018

Abstract
As health care bears the simultaneous burdens of rapid technological development and increasing financial constraints, there has been significant increase in the number and types of procedures performed outside of the operating room. The broadening scope and complexity of noninvasive procedures, along with increasing acuity of patients, often make deeper sedation, general anesthesia, and robust hemodynamic monitoring both necessary and challenging. Anesthesiologists are more frequently called upon to provide care for medically complex patients undergoing novel, unfamiliar procedures in nontraditional locations. As technology advances, the number of procedure areas and the need for anesthesia services proliferates. The landscape of anesthesiology, therefore, is changing; new challenges and opportunities have emerged. This chapter provides an overview of these challenges, including assessing locations, equipment considerations, integrating care teams, safety guidelines, preprocedural patient evaluation and postprocedure care, commonly encountered problems, and financial considerations.
Anesthetic Techniques
Authors: Grech Dennis , Hausman Laurence M. 
Published: October 2018

Abstract
Anesthetic techniques for procedures performed outside the traditional operating room are varied. General anesthesia, sedation, and regional anesthesia can all be delivered in this venue. The choice of technique is based on safety considerations and patient comorbidities. Perioperative monitoring such as pulse oximetry, end-tidal carbon dioxide monitoring, and electrocardiography and blood pressure monitoring protocols must be consistent with American Society of Anesthesiologists guidelines. Common procedures include elective office-based anesthetics, emergency room sedations, endoscopic retrograde cholangiopancreatographies in the gastroenterology suite, and minimally invasive interventions in the radiology department. Because most of these locations have limited postanesthesia care unit capabilities, the patient’s rapid return to baseline functioning and the ability to be discharged quickly, safely, and comfortably are important goals. Thus, anesthetic technique and the pharmacokinetics and pharmacodynamics of the anesthetics, analgesics, antiemetics, and local anesthetics are of utmost importance.
Anesthesia Information Management Systems (AIMS) for the OOOR Setting
Authors: Ruskin Keith J. , Gottlieb Ori 
Published: October 2018

Abstract
Anesthesia information management systems (AIMS) offer significant benefits to an anesthesiologist who practices beyond the operating room. AIMS systems have the potential to improve patient care because they deliver a customized, legible anesthesia record while storing the patient’s physiologic data in an easily searchable database. An electronic workflow allows the anesthesiologist to focus on patient care while facilitating tasks such as quality assurance, compliance, research, and billing.
Outcomes, Regulation, and Quality Improvement
Authors: Metzner Julia , Domino Karen B. 
Published: October 2018

Abstract
To improve the safety of patients undergoing procedures in remote locations, practitioners should be familiar with rigorous continuous quality improvement systems, national and regulatory patient safety efforts, as well as complications related to anesthesia/sedation in out of the operating room (OOOR) settings. This chapter discusses severe outcomes and mechanisms of injury in OOOR locations, national patient safety and regulatory efforts that may be adapted to the OOOR setting, and quality improvement efforts essential to track outcomes and improve patient safety. Patient safety can be improved by adherence to respiratory monitoring (e.g., pulse oximetry and capnography), sedation standards/guidelines and national patient safety and regulatory efforts, and development of vigorous quality improvement systems to measure outcomes and make changes.
Gastrointestinal Endoscopy Procedures
Authors: Gromski Mark A. , Matthes Kai 
Published: October 2018

Abstract
A vast array of gastrointestinal endoscopic procedures are performed routinely that vary from the very common screening colonoscopy to such highly specialized procedures as endoscopic submucosal dissection or per oral endoscopic myotomy. Gastrointestinal endoscopic procedures may be performed in various settings, including outpatient endoscopy/surgery centers, the emergency room, intensive care units, or hospital operating rooms. It is essential to be aware of the components of each procedure, the stimulating components of each procedure (which will interplay with the need for a plan for sedation), and the potential complications of each procedure. This chapter provides essential background information for most of the routinely encountered endoscopic procedures that may be useful to help plan for safe care of the patient during and after the procedure.
Anesthesia for Gastrointestinal Endoscopic Procedures
Authors: Barton Lori Kral , Fragneto Regina Y. 
Published: October 2018

Abstract
As the population ages, patients presenting for endoscopic procedures are more likely to have significant comorbidities. In addition, endoscopic procedures of increasing complexity are being performed. While there are significant differences among geographic regions in the United States, anesthesia care providers are providing sedation or general anesthesia for a greater proportion of procedures performed in the endoscopy suite. A variety of drugs and anesthetic techniques have been used successfully. Propofol remains the most commonly used drug when sedation is provided by an anesthesia professional, sometimes as a sole agent and sometimes in combination with other medications. Dexmedetomine and ketamine have also been used successfully. Patient characteristics and the specific needs of the endoscopist based on the procedure being performed will determine the most appropriate anesthetic regimen for each patient. For more complex endoscopic techniques, general anesthesia may be preferred, with some data indicating improved success of the procedure.
Anesthetic Implications of Natural Orifice Translumenal Endoscopic Surgery (NOTES) and Single-Incision Laparoscopic Surgery (SILS)
Authors: Gromski Mark A. , Matthes Kai 
Published: October 2018

Abstract
This chapter introduces the concepts of natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopic surgery (SILS). The field of NOTES has evolved over the past decade, and this developmental framework is also outlined to help better understand the current state of the field. NOTES describes a minimally invasive approach to surgical diseases in which instruments are passed transluminally to achieve access to the desired body. SILS is a minimally invasive approach carried out as an extension of traditional laparoscopic surgery. The anesthetic implications of NOTES and SILS are explained, including potential complications that are unique to each. Finally, future directions in developmental endoscopy are discussed to give a sense of what types of procedures may become available or commonplace in the coming decade.
Electroconvulsive Therapy
Authors: Ross Lisa 
Published: October 2018

Abstract
The anesthetic management of patients who receive electroconvulsive therapy (ECT) for various psychiatric conditions in both the inpatient and the outpatient settings must take into account a number factors, such as its associated physiologic responses, existing comorbidities, medication management, monitoring, complications, and contraindications in order for it to remain a safe procedure. This chapter reviews the indications for ECT, the preprocedure anesthetic evaluation; theories regarding the therapeutic mechanism of action leading to the efficacy of ECT; cerebrovascular, cardiovascular, and neuroendocrine responses and monitoring standards. Furthermore, it discusses the selection of medications for induction, inhalational agents, and muscle relaxants as well as common drug interactions and premedication practices. The chapter culminates with an assessment of the morbidity and mortality associated with ECT both anesthetic and nonanesthetic related.
Anesthetic Considerations in Homeland Disasters
Authors: Perelmut Robert , Pretto Ernesto A. 
Published: October 2018

Abstract
This chapter will primarily focus on anesthetic considerations in homeland disasters likely to require the presence of the anesthesiologist in the out-of-hospital or prehospital environment. In order to understand the context within which anesthesiologists might be asked to function in the out-of-operating room setting during disaster response, we will provide a brief review of the disaster management functions of prehospital emergency medical services (EMS)/trauma systems. We will also describe the reorganization of hospital and intensive care services necessary to handle a surge of incoming critically injured or ill casualties. Our focus will be the role of the anesthesiologist, working in partnership with community or local EMS/trauma system and its network of hospitals, since the local EMS/ambulance system constitutes the basic functional unit of disaster medical response in the United States. We will end with a brief description of the major challenges we face in the delivery of intensive care services in mass and catastrophic casualty disasters.
Anesthesia Considerations in Dental Practice
Authors: Townsend Janice A. , Hernandez Gabriel , Harhad Lynda 
Published: October 2018

Abstract
Demand for anesthesia personnel outside of the operating room is increasing in dentistry. Anesthesia for dentistry is unique due to the shared airway and the limitations of the dental office environment. Knowledge of local anesthesia in dentistry is necessary as profound anesthesia is essential for sedation and may be indicated as an adjunct for general anesthesia. Nitrous oxide is also utilized alone or in conjunction with oral or parenteral sedation, and the anesthesia staff must be familiar with its use in dentistry. Stringent protocols for patient selection and monitoring are essential for safe administration of anesthesia in the dental setting.
Ultrarapid Opiate Detoxification
Authors: Gevirtz Clifford M. , Frost Elizabeth , Kaye Alan D. 
Published: October 2018

Abstract
Extended opioid use results in physical dependence and neural adaptation. Opioid dependence treatment can be carried out with opioid receptor agonists, partial agonists, and antagonists. Conventional treatments have low success rates. Methadone and buprenorphine treatments involve substituting long-duration agonists for the opiate of abuse, essentially substituting one opiate for another. Rapid opiate detoxification is a 3-day process involving large amounts of an opiate antagonist. Both treatments have associated problems. Ultrarapid opiate detoxification (UROD) anesthetizes a patient and precipitates withdrawal while unconscious. It shortens withdrawal, avoiding much of the subjective withdrawal discomfort. Clonidine is critical to reduce catecholamine levels and mitigate central nervous system hyperarousal in acute withdrawal. A UROD advantage is that the withdrawal period is markedly shortened to 8 hours or less versus up to several months for conventional treatments. The patient is anesthetized during the acute withdrawal period and does not experience the unpleasant consequences of acute detoxification.
Nonelective Care On Board an Aircraft
Authors: Connor Christopher , O’Brien Ben 
Published: October 2018

Abstract
The International Air Transport Association recognizes that “the airline is responsible for carrying its passengers safely and efficiently to the destination,” yet “the airline has no real means of ensuring that all passengers are fit to begin their journey.”1 There exists an extensive body of work, including textbooks and guidelines,2–4 to support prehospital in-flight care. These references deal with the challenges of emergent and elective aeromedical transport and repatriation, as would be confronted by a flight physician or flight nurse. This chapter, on the other hand, aims to support the anesthesia practitioner with a clinic or hospital-based practice, highlighting important factors to consider should he or she be called on to provide medical care and advice incidentally while on an aircraft as a passenger.
The Future of NORA
Authors: Matthews Donald M. 
Published: October 2018

Abstract
NORA is a very young field of anesthesia practice. The idea of a text concerning NORA would have seemed unlikely as recently as five years ago, so prognosticating about the future of NORA has potential pitfalls. Most particularly, the pace of change in medical practice can be very rapid, especially if a disruptive or innovative technology is introduced. None-the-less, certain predications can be made based on the rapid evolution of NORA. It will be interesting to look back in thirty years and to see what percentage of these predications prove to be accurate. This chapter discusses and predicts the future of NORA, its expected growth, and how facilities and practices will need to evolve to accommodate it.
Left Pan-Hippocampal Low Grade Glioma—2-Stage Transsylvian Transventricular and Paramedian Supracerebellar Transtentorial Approaches: 2-Dimensional Operative Video
Authors: Fernandez-Miranda Juan C 
Published: October 2018

Abstract
The surgical goal for low-grade gliomas (LGGs) is to maximize resection while minimizing morbidity. Pan-hippocampal LGGs extend from the hippocampal head to the hippocampal tail, and involve the parahippocampal gyrus and uncus. Given their anteroposterior extension, they cannot be completely removed with 1 single approach, requiring a 2-stage front-to-back operation.
In this video, we present the case of a 52-yr-old man with new onset of generalized seizures and a dominant-side, nonenhancing, pan-hippocampal infiltrative lesion compatible with a low-grade glioma. Preoperative high-definition fiber tractography (HDFT) showed the spatial relationship of the tumor with surrounding fiber tracts, such as the arcuate, inferior fronto-occipital, and middle longitudinal fascicles, and optic radiations.
Surgical resection was planned in 2 separate stages. The first stage consisted of a transsylvian transinferior insular sulcus approach to the extra- and intraventricular aspects of the uncohippocampal region. The entire anterior and middle portions of the tumor were successfully removed with minimal morbidity, including transient naming difficulties and permanent superior quadrantanopia. Postoperative HDFT showed preservation of all fiber tracts, except for a portion of Meyer's loop and the inferior-most aspect of the inferior fronto-occipital fascicle. The second stage was completed 8 wk later and consisted of a paramedian supracerebellar-transtentorial approach on sitting position. The posterior portion of the tumor was entirely removed to achieve a complete macroscopic tumor resection. The final diagnosis was IDH1-positive LGG.
Pan-hippocampal tumors remain a surgical challenge but accurate knowledge of surgical neuroanatomy and surgical approaches facilitates their safe and effective treatment.
The patient signed an informed consent including the use of photographic and video material for educational or academic purposes.