[The use of dexmedetomidine in extreme agitation].

BACKGROUND: In clinical practice antipsychotics, benzodiazepines and/or antihistamines are used to calm agitated patients. If agitation persists and patients have contraindications for these substances, then anesthetics, such as propofol, can also be used as well, to serve as a sedative. Our attention was drawn to a particular case in which dexmedetomidine was used as a sedative. AIM: To study the literature on the use of α2-agonists, such as dexmedetomidine, in the treatment of extreme agitation. METHOD: We reviewed the relevant scientific literature. RESULTS: α2-agonists, such as dexmedetomidine, are new anesthetic agents that have analgetic and sympatholytic effects without suppressing respiration. These agents are used frequently in intensive care because their sedative effect are short-lived and do not cause amnesia, sleep deprivation or cognitive disturbance. Excited delirium syndrome (eds) is a type of extreme agitation for which dexmedetomidine can be used. CONCLUSION: There may well be a place for dexmedetomidine in the treatment of extreme agitation when standard treatments have failed. Further research is needed in order to ascertain whether dexmedetomidine should play a role in such treatment.status: publishe

Prevalence and demography of transsexualism in Belgium

International audienceAim : The Belgian medical world has acknowledged the diagnosis of transsexualism and accepted Sex Reassignment Surgery (SRS) as oneof the steps in the treatment of choice since 1985. This prevalence and demographic study analyses data on all Belgian individuals who haveundergone SRS since that year.Methods : All (188) plastic surgeons as well as all gender teams (Antwerp, Bruges, Ghent, and Lie`ge) in Belgium were sent demographicquestionnaires to be completed for each of their transsexual patients.Results : The results show an overall prevalence of 1:12,900 for male-to-female and 1:33,800 for female-to-male transsexuals in Belgium.In Wallonia (the French-speaking region of Belgium) the prevalence is significantly lower than in Flanders (the Dutch-speaking region) and inBrussels (the bilingual capital region). In the total Belgian population the male/female sex ratio is 2.43:1, again with a substantial differencebetween Wallonia on the one hand and Flanders on the other.Discussion and Conclusion. e While in Flanders and in Brussels the prevalence is comparable to that in other Western European countries,in Wallonia it is markedly lower. Transsexualism in Wallonia appears to be socially less acceptable: persons suffering from gender dysphoria inthat part of Belgium encounter more problems accessing gender clinics and receiving treatment