bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychedelics as Psychiatric Medications
Authors: Nutt David , Castle David 
Published: March 2023

Abstract
There is substantial contemporary interest in psychedelic agents as medicines for maladies of the mind. This follows research in the 1950s and 1960s exploring the use of LSD and other psychedelics to treat a range of psychiatric illnesses as well as addictions. This research was shut down after prohibition of these drugs; however, the last decade has seen a major renewal of interest in the therapeutic use of psychedelics and related drugs in psychiatry. Part of the Oxford Psychiatry Library series, this book provides an overview of this hugely exciting field, covering the history of psychedelics, clinical aspects, risks and side effects, precautions, and processes. Psilocybin (found in ‘magic mushrooms’) has been used effectively for amelioration of distress in people with depression and anxiety in the context of potentially life-ending cancers. MDMA (‘ecstasy’) has shown efficacy for severe posttraumatic stress disorder, with enduring benefit. Other psychedelics, both plant-derived (e.g. ayahuasca) and synthetically produced (e.g. LSD) are also being investigated for their potential therapeutic value. These agents not only herald a new neurobiology but also allow an integration of psychotherapy with biological compounds that is truly novel and that challenges established psychiatric practice. Further, the action of these agents on the brain allows an exploration of how the brain works to ‘open up’ to psychotherapeutic healing. This book will appeal to clinicians in mental health and addictions, policy makers and neuroscientists; to pharmacists and pharmacologists; and to the general public.
MDMA
Authors: Mithoefer Michael C. , Presti David E. 
Published: March 2023

Abstract
MDMA (3,4-methylenedioxymethamphetamine) was originally synthesized and patented by the Merck chemical company in 1914. It was not explored for human use until the 1970–80s when there were published reports that it could be a useful catalyst to psychotherapy, in part because it often produced reduced anxiety and increased emotional openness. In 1985, in response to media attention to the recreational use of MDMA in the dance scene, the United States government placed MDMA in Schedule 1, making it illegal and declared unavailable for medical use. MDMA has complex pharmacological effects, including synaptic release of serotonin and other monoamines and triggering increased levels of oxytocin and other hormones. Research into the effects of MDMA is a rapidly evolving field, and the relationship between the physiological effects of MDMA and the range of experiences reported during MDMA sessions remains speculative. Controlled clinical trials of MDMA as a catalyst to psychotherapy have been under way since 2004, and most have been focused on posttraumatic stress disorder as a possible indication. After a series of international Phase 2 trials, results of the first Phase 3 trial were published in 2021 showing very robust improvements in posttraumatic stress disorder symptoms (measured by CAPS 5, the primary outcome measure), improvements in disability and depression scores, and a good safety record. A relatively nondirective method of therapy has been used in clinical trials that allows for each person’s unique therapeutic process to unfold in its own way without a pre-existing agenda.
Ayahuasca
Authors: Perkins Daniel , Ruffell Simon G. D. , Sarris Jerome 
Published: March 2023

Abstract
Ayahuasca is a psychedelic plant brew originating in the Amazon basin. It is typically made from two basic components: the ayahuasca vine (Banisteriopsis caapi), containing various harmala alkaloids, and the leaves of a plant containing the potent psychedelic dimethyltryptamine (DMT), such as the chacruna plant (Psychotria viridis). Evidence suggests the brew has been used for at least hundreds of years, primarily by indigenous tribes for a range of purposes including psychological and physical healing. The components of the brew exert a range of neurochemical effects, with recent research suggesting it may be effective in treating depression, anxiety, and addiction. The harmala alkaloids found in the vine are monoamine oxidase-A enzyme inhibitors (MAOIs). These compounds prevent the deamination of DMT as well as exerting their own psychotropic effects. DMT is known to modulate the signalling of serotonin and dopamine via serotonin and dopamine receptor agonism, as well as sigma-1 agonism. Interest in the plant brew has increased dramatically in recent years, with large numbers of ‘ayahuasca tourists’ visiting the Amazon basin to partake in ceremonies with the intention of treating a range of different conditions. Similarly, research into ayahuasca has increased, both in naturalistic and clinical settings, with potential medicalization giving rise to complex ethical issues that must be carefully considered.
Ketamine
Authors: Di Vincenzo Joshua D. , Rosenblat Joshua D. , McIntyre Roger S. 
Published: March 2023

Abstract
Chapter 9 examines the history, clinical evidence, and proposed mechanisms of action of ketamine formulations as treatments for mood disorders such as treatment-resistant depression (TRD) and suicidality associated with major depressive disorder (MDD) and/or bipolar disorder (BD). It reviews ketamine’s history as a drug originally developed for anaesthesia, to its subsequent repurposing and approval for psychiatric indications. Additionally, it reviews mechanisms of action by which ketamine is hypothesized to ameliorate depressive and suicidal symptoms, as well as some of the neurological processes thought to underlie mood disorders like MDD and BD. It also discusses some of the most commonly observed treatment-emergent adverse events (TEAEs) associated with ketamine in psychiatry, including tips for clinicians and prescribers on how to mitigate these TEAEs and optimize outcomes.
Independent Living With(out) Privacy
Authors: Ho Anita 
Published: March 2023

Abstract
This chapter highlights various socio-contextual factors that frame people’s practical identity around aging and “independent living,” their available options for health monitoring, and their decisional motivations regarding the use of artificial intelligence (AI) home health monitoring. Section 1 details the perceived need for alternatives to traditional in-person home health monitoring. Section 2 investigates the common claim that AI home health monitoring can promote users’ autonomy and well-being. Section 3 utilizes a relational lens to contextualize AI health monitoring against the backdrop of an aging population, changing family patterns, and inadequate social or system support. It cautions that uncritical promotion of AI health monitoring without systemic improvement in the care environment may paradoxically exacerbate caregiver burden and isolation of those being remotely monitored.
Introduction and Overview
Authors: Galynker Igor 
Published: March 2023

Abstract
This chapter provides an overview of the enduring suicide epidemic in the United States and critically examines the limitations inherent in conventional suicide prevention and risk assessment strategies. To illustrate the challenges, the chapter reviews the current lack of reliable tests for suicide prediction, the problem with relying on patient disclosure of suicidal ideation, and the important distinction between long-term and short-term risk factors for predicting imminent suicide risk. While the field of suicide research has provided a strong empirical basis for understanding who is at risk for suicide, determining when someone may attempt suicide remains an enduring challenge for clinicians and researchers alike. In response to an urgent need to better understand when individuals are at imminent risk for suicide, this chapter introduces a proposed suicide-specific diagnosis, suicide crisis syndrome (SCS), an acute pre-suicidal state that can be identified, treated, and implemented as a clinical tool to save the lives of those in suicidal despair. This chapter also briefly introduces a novel framework, the narrative-crisis model of suicide, which includes SCS as a central feature. The latter half of the chapter examines contemporary practices in suicide risk assessment, including comparisons of clinical judgment and risk stratification systems, and concludes by offering readers suggestions for how to best use this book as a comprehensive roadmap for assessing imminent suicide risk.
Conducting Short-Term Risk Assessment Interviews
Authors: Galynker Igor 
Published: March 2023

Abstract
Chapter 9 describes several ways to integrate the previously discussed constructs (trait vulnerability, stressful life events, suicidal narrative, suicide crisis syndrome, and clinician’s emotional response to suicidal patients) into suicide risk assessment interviews in different clinical settings. The first section of the chapter combines all the core constructs into one comprehensive risk assessment outline. The second section discusses the real-world challenges of suicide risk assessment, emphasizing the limitations of self-disclosed suicidal ideation and intent and highlighting strategies to minimize the suicide risk interview bias. The third section outlines the potential advantages and shortcomings of the existing short-term suicide risk assessment scales. The fourth section describes three risk assessment interview strategies, illustrated by clinically relevant examples. The final section provides a striking clinical case example that underscores the importance of incorporating clinicians’ emotional responses into the suicide risk assessment.
Autonomic Nerve Blocks
Authors: Ethier Steven , Pride Keth 
Published: March 2023

Abstract
Chronic pain disorders present with different etiologies and consequently their signals are carried by different classifications of nerve fibers. Syndromes and disorders that present with sympathetically based pain are therefore treated differently than those with more musculoskeletal based etiologies. Autonomic nerve blockade primarily targeting sympathetic nerve ganglia can be used to provide significant pain relief in certain chronic pain disorders, most notably complex regional pain syndrome. Commonly targeted sympathetic ganglia include the stellate, celiac, and lumbar sympathetic chains. The purpose of this chapter is to provide recommendations on how to best perform these blocks as well as describe their indications, possible complications, and relevant surrounding anatomy.
Peripheral Nerve Blocks (Neck)
Authors: Blaine Scott , Pride Keth 
Published: March 2023

Abstract
To facilitate awake endotracheal intubation, a blockade of the glossopharyngeal, superior laryngeal, and recurrent laryngeal nerves can be utilized. The peripheral blockade of nerves in the neck is most often used to facilitate awake endotracheal intubation for the patient with a difficult airway. Although topicalization with minimal-to-moderate sedation is often sufficient to perform an awake intubation, one should be knowledgeable of all the alternative methods should the need arise. This chapter focuses on the indications, relevant anatomy, and complications of these blocks. Also described is blockade of the cervical plexus, which is useful in facilitating surgery on more superficial neck structures.
Butyrylcholinesterase (Pseudocholinesterase) Deficiency
Authors: Harris Brian , Ferguson Kris 
Published: March 2023

Abstract
Pseudocholinesterase is a plasma enzyme that functions to hydrolyze esters in succinylcholine, mivacurium, and ester-type local anesthetic. Pseudocholinesterase is produced in the liver and exists as an α2-globulin. Pseudocholinesterase deficiency is a rare disorder that can be acquired or inherited. Patients are asymptomatic unless given a medication that requires hydrolysis for termination of action. Pseudocholinesterase deficiency can cause delayed awakening due to prolonged action of succinylcholine. The metabolism of chloroprocaine is significantly prolonged, leading to an extended duration of nerve blockade. Cocaine’s effects can be exaggerated as cocaine is an ester-linked local anesthetic. The dibucaine number can be used to quantify pseudocholinesterase activity. Treatment is typically supportive if pseudocholinesterase deficiency is undiagnosed.
Tranquilizers
Authors: Aiyer Rohit , Money Sarah 
Published: March 2023

Abstract
Tranquilizers over the years have provided physicians a means to help control patients’ anxiety, agitation, and aggression. The major groups of tranquilizers are antipsychotics, specifically butyrophenones, and benzodiazepines. The butyrophenones, such as haloperidol, block dopamine D2 receptors, which clinically results in a reduction in agitation and psychosis. This can be a very effective medication for the treatment of acute delirium, particularly in an inpatient hospital setting. Benzodiazepines are also widely prescribed by clinicians, particularly due to their multipurpose uses, which include alleviation of tension, anxiety, muscle tensions, and spasticity. This class of medications interacts with γ-aminobutyric acid (GABA) A receptor, which opens the channel and allows for chloride ions to travel into the cell, resultingin hyperpolarization. Clinically, benzodiazepines can be grouped based on several factors, such as lipid solubility, half-life, and receptor binding affinity.
Neurological Disorders
Authors: Jowza Maryam , James Dominika 
Published: March 2023

Abstract
Neurological diseases are a heterogeneous group of disorders with varying etiologies. Neurologic conditions affecting the brain can be related to trauma, tumor, vascular malformations, congenital anomalies, or degenerative diseases. Congenital neurological conditions are often hereditary and may affect brain structure and physiology (tuberous sclerosis, neurofibromatosis). Degenerative neurological conditions often are associated with aging and involve central nervous system (CNS) malfunction at both anatomic and molecular levels (Parkinson disease, Alzheimer disease). Presence of these underlying disease processes should be taken under consideration to ensure appropriate anesthetic management. This chapter focuses on specific congenital and degenerative neurologic disorders and explores their anesthetic implications.
Epilepsy
Authors: Jowza Maryam , James Dominika 
Published: March 2023

Abstract
Seizures are among the most common neurological disorders encountered by anesthesiologists. Prevention and treatment of perioperative seizure is of utmost importance during neurosurgical procedures as uncontrolled seizures increase brain tissue metabolic demand and lead to poor operative outcomes. Perioperative use of antiepileptic drugs (AEDs) effectively decreases risk of intraoperative seizure events. AEDs, although very effective, are associated with many adverse effects and can interact with anesthetic agents. Phenytoin, phenobarbital, and carbamazepine induce hepatic microsomal enzymes (CYP3A4, CYP2C19), which can lead to accelerated metabolism of benzodiazepines, certain opioids, and resistance to neuromuscular blockers (NMBDs). Conversely, valproic acid inhibits certain enzymes (CYP2D6), leading to a decrease in methadone elimination. Sedative effects of AEDs impact anesthetic management by enhancing effects of anesthetic volatiles and sedatives. Intraoperative seizures should be treated immediately with securing the airway, performing ventilation, and ensuring hemodynamic stability, followed by intravenous administration of fast-acting benzodiazepines and phenytoin/fosphenytoin. For anesthesia induction, one should consider agents with antiepileptic properties, such as propofol, thiopental, or phenobarbital, but avoid ketamine and methohexital. Regarding the nondepolarizing muscle relaxants, atracurium and cisatracurium should be avoided as their metabolite laudanosine may have central nervous system–activating, epileptogenic properties. Anesthesia may be maintained with desflurane or isoflurane due to anticonvulsant properties. If possible, one should avoid long-acting neuromuscular blockers in an effort to monitor for seizure recurrence. AEDs should be continued throughout the entire perioperative period.
Therapeutic Barbiturate Coma
Authors: Rahman Syed A. 
Published: March 2023

Abstract
Pharmacological neuroprotection in patients with cerebral injury has been an area of interest for decades. Therapeutic barbiturate coma is initiated for neuroprotective benefit in focal cerebral ischemia and treatment of intractable intracranial hypertension and refractory status epilepticus. Brain protection is believed to be from depression of cerebral metabolic rate and cerebral blood flow, antiseizure effects, hypnotic properties, and inverse steal. Barbiturates and propofol are the drugs frequently used for this purpose. However, the doses and dosing regimens employed to achieve barbiturate coma often result in significant and severe side effects, like hemodynamic instability, cardiac arrhythmias, and difficulty in assessing neurological status. Therefore, close monitoring for adverse effects and judicious use of therapeutic coma in clinical circumstances with clear potential benefit is imperative.
Positioning and Anesthesia in Sitting Position
Authors: Mahboobi Sohail K. , Rothkrug Alexander 
Published: March 2023

Abstract
Positioning is an important aspect of any surgical procedure. Anesthetized patients cannot reliably express discomfort; thus, the burden of ensuring safe positioning falls on the provider. Assigning roles to staff is important to efficiently and smoothly achieve proper positioning for any case. Potential harm that may befall a patient as a result of poor positioning includes but is not limited to pressure injuries, peripheral nerve injuries, and complications related to unfavorable hemodynamics. The American Society of Anesthesiologists Closed Claims Project identifies perioperative nerve injury as the second most common injury (16%). Nerve injuries may be a result of stretching, compression, ischemia, or metabolic derangements. General anesthesia has been shown not to be a risk factor for peripheral nerve injury as compared to cases under regional anesthesia and/or varying levels of sedation. Risk factors that contribute to nerve injuries include advanced age, history of peripheral neuropathy, and diabetes. Eye injuries (&lt;0.1% of all anesthetics) range from mild discomfort to permanent vision loss. For instance, the prone position risks excessive pressure placed on the eyes. If that pressure exceeds arterial pressure, a patient may experience retinal ischemia. If the eyes are left open, corneal drying can occur in 10 minutes. Corneal abrasions, the most common eye injury, are usually secondary to foreign objects, such as masks and drapes, causing direct trauma. This chapter discusses the different positions seen in surgery and special considerations for each one.
Monitored Anesthesia Care and Sedation
Authors: Eden Nikki , Rajan Shobana 
Published: March 2023

Abstract
Any anesthesia service provided exclusively by a qualified anesthesia provider for a specific procedure defines monitored anesthesia care (MAC), regardless of level of sedation achieved. MAC dictates that an anesthesiologist will provide a preoperative assessment, intraoperative management, and postoperative follow-up care for every patient. In contrast, conscious sedation can be performed by certified non–anesthesia providers during specific procedures; however, the anesthesiologist and non–anesthesia provider must both perform the procedure and monitor the patient under sedation. Having an anesthesiologist who is strictly focused on the anesthetic permits the highest level of patient safety and care throughout the entire procedure.
Divisions of Bronchoscopic Anatomy
Authors: Gunst Matthew , Giordano Christopher 
Published: March 2023

Abstract
The lower airway anatomy should be as familiar to the anesthesiologist as the upper airway anatomy as both are pivotal to adequately and efficiently instrument the airway. Alterations in bronchial segments and their anatomic differences can affect anesthetic delivery, airway management, management of patients with chronic pulmonary conditions, and alterations in pulmonary mechanics following lung surgery. Recognizing the changing structures in the respiratory tree as it pertains to entering different segments will equip physicians in ideally instrumenting the airway as well as maximizing ventilation and perfusion exchange. This chapter focuses on conductive airway anatomy, which is vital for anesthesiologists managing thoracic and non-thoracic surgical and critical care patients.
Temperature Effect on Blood Gases
Authors: Mahboobi Sohail K. , Mahmood Faraz 
Published: March 2023

Abstract
The solubility of gases increases in blood with decreasing temperature and consequently a decrease in partial pressures. In certain clinical conditions, a patient’s body temperature is lower than normal (e.g., ventilated patients in critical care units and floors, after cardiac arrest when return of spontaneous circulation has been achieved, and during surgery, particularly on bypass in cardiac surgical procedures). The management of acid-base balance in the hypothermic state is a topic of discussion as with decreasing temperature, PaO2 and PaCO2 also decrease, causing a lower PaCO2 and a rise in pH and an alkalotic picture at that temperature if nothing is added to the blood. When the blood gases are sent to the laboratory, the sample is warmed to 37°C and measurements performed are then corrected to the patient’s actual current body temperature. The two major schools of thought are alpha-stat and pH-stat management of blood gases in hypothermic patients. In alpha-stat, if at 37°C blood gases are in normal range, then nothing is required with an assumption that a decrease in pH on both sides of the cell membrane is in the same direction that keeps electrical neutrality in normal functioning range without causing disruption of cell function. In pH-stat, the aim is to keep blood gas values in normal range at the patient’s actual temperature by adding CO2 to raise PaCO2 and decrease pH to a normal level. Both methods have benefits and drawbacks, and no one method is considered superior to the other.
Lung Volume
Authors: Helwege Sarah , Sharma Archit 
Published: March 2023

Abstract
Formally evaluating the pulmonary function testing of patients is not a standard of care; however, in patients with life-impacting or long-standing pulmonary disease, pulmonary function testing the different volumes and capacities can be quite beneficial to the anesthesia provider. For most patients, a detailed history and physical examination is sufficient for managing patients with common pulmonary diseases. Even though preoperative testing of volumes and capacities does not give an exact picture of postoperative pulmonary performance, understanding the dynamics and sequelae associated with deficiencies in pulmonary function is vital as it lends guidance on ventilatory settings, medication administration, and postoperative care.
Nonpulmonary Surgery, Including Mediastinoscopy and Bronchoscopy
Authors: Fadumiye Christopher O. 
Published: March 2023

Abstract
This chapter focuses on nonpulmonary surgeries of the thoracic cavity, with the exception of pulmonary surgeries like thoracotomy and surgical resections of the lungs. Its emphasis is on mediastinal surgeries and bronchoscopy under general anesthesia. Specific focus is on how to approach these procedures from a perioperative perspective; the chapter also discuss adverse effects and complications. The chapter further explores ultrasound use in bronchoscopy, lung lavage with bronchoscopy, and the various anesthetic options available for these procedures, either in the operating room or in an outpatient or minor procedural area. The target audience is anesthesia residents in the United States and around the world. The chapter’s overall intention is to provide a quick broad overview of nonpulmonary surgery and bronchoscopy, making it a handy and quick review for board examination preparation.