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Severity delirium

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https://www.readbyqxmd.com/read/29353441/pre-and-postoperative-management-of-risk-factors-for-postoperative-delirium-who-is-in-charge-and-what-is-its-essence
#1
Bruno Neuner, Daniel Hadzidiakos, Gabriella Bettelli
Postoperative delirium (POD) is an adverse clinical outcome characterized by cognitive, affective and behavioral symptoms with typically an acute onset and a fluctuating course. POD is attributed to certain patients' predisposing factors as well as to treatment-related precipitating factors. While there are several single-component interventions for the prevention of POD, evolving evidence suggests the importance of a system approach in the prevention of POD. This involves strategies by multidisciplinary teams with additional geriatric consultation services to identify risk factors for POD and to modify their impact on the perioperative course...
January 20, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29351772/effect-of-an-interactive-e-learning-tool-for-delirium-on-patient-and-nursing-outcomes-in-a-geriatric-hospital-setting-findings-of-a-before-after-study
#2
Elke Detroyer, Fabienne Dobbels, Andrew Teodorczuk, Mieke Deschodt, Yves Depaifve, Etienne Joosten, Koen Milisen
BACKGROUND: Education of healthcare workers is a core element of multicomponent delirium strategies to improve delirium care and, consequently, patient outcomes. However, traditional educational strategies are notoriously difficult to implement. E-learning is hypothesised to be easier and more cost effective, but research evaluating effectiveness of delirium education through e-learning is scarce at present. Aim is to determine the effect of a nursing e-learning tool for delirium on: (1) in-hospital prevalence, duration and severity of delirium or mortality in hospitalized geriatric patients, and (2) geriatric nurses' knowledge and recognition regarding delirium...
January 19, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29351571/the-barriers-and-facilitators-for-recognising-distress-in-people-with-severe-dementia-on-general-hospital-wards
#3
G J E Crowther, C A Brennan, M I Bennett
Introduction: psychological symptoms and delirium are common, but underreported in people with dementia on hospital wards. Unrecognised and untreated symptoms can manifest as distress. Identifying distress accurately therefore could act as a trigger for better investigation and treatment of the underlying causes. The challenges faced by healthcare professionals to recognise and report distress are poorly understood. Methods: semi-structured interviews with a purposive sample of 25 healthcare professionals working with older people in general hospitals were conducted...
January 17, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29349349/a-retrospective-analysis-of-outpatient-anesthesia-management-for-dental-treatment-of-patients-with-severe-alzheimer-s-disease
#4
Eunsun So, Hyun Jeong Kim, Myong-Hwan Karm, Kwang-Suk Seo, Juhea Chang, Joo Hyung Lee
Background: The number of patients with Alzheimer's disease is growing worldwide, and the proportion of patients requiring dental treatment under general anesthesia increases with increasing severity of the disease. However, outpatient anesthesia management for these patients involves great risks, as most patients with Alzheimer's disease are old and may show reduced cardiopulmonary functions and have cognitive disorders. Methods: This study retrospectively investigated 43 patients with Alzheimer's disease who received outpatient anesthesia for dental treatment between 2012-2017...
December 2017: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29340154/the-impact-of-sepsis-delirium-and-psychological-distress-on-self-rated-cognitive-function-in-icu-survivors-a-prospective-cohort-study
#5
Emily Brück, Anna Schandl, Matteo Bottai, Peter Sackey
Background: Many intensive care unit (ICU) survivors develop psychological problems and cognitive impairment. The relation between sepsis, delirium, and later cognitive problems is not fully elucidated, and the impact of psychological symptoms on cognitive function is poorly studied in ICU survivors. The primary aim of this study was to examine the relationship between sepsis, ICU delirium, and later self-rated cognitive function. A second aim was to investigate the association between psychological problems and self-rated cognitive function 3 months after the ICU stay...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29325983/a-case-of-delirium-and-rhabdomyolysis-in-severe-iatrogenic-opioid-withdrawal
#6
Jessie Hanna, Samantha Swetter
No abstract text is available yet for this article.
December 14, 2017: Psychosomatics
https://www.readbyqxmd.com/read/29321714/cavum-vergae-liability-and-steroid-treatment-manic-episode-brain-imaging-findings-and-clinical-follow-up-of-a-systemic-lupus-erythematosus-case
#7
Emre Misir, İbrahim Tolga Binbay, Bilge Targitay, Hidayet Ece Arat, Gerçek Can, Köksal Alptekin
Systemic lupus erythematosus (SLE) or Lupus is a chronic and idiopathic autoimmune connective tissue disease that involves several organs and organ systems. SLE may lead to a group of psychiatric manifestations, including delirium, anxiety disorders, cognitive dysfunction, mood disorders, and psychosis, which are caused by organic or non-organic factors. In addition, it is thought that the most common cause of neuropsychiatric lupus is corticosteroid use; central nervous system involvement and inflammatory processes also have an important role in the development of psychiatric manifestations...
December 2017: Noro Psikiyatri Arsivi
https://www.readbyqxmd.com/read/29314374/falls-and-delirium-in-an-acute-care-setting-a-retrospective-chart-review-before-and-after-an-organization-wide-interprofessional-education
#8
Rhonda L Babine, Kristiina E Hyrkäs, Sarah Hallen, Heidi R Wierman, Deborah A Bachand, Joanne L Chapman, Valerie J Fuller
AIM AND OBJECTIVES: To describe and compare identification of delirium, length of stay, and discharge locations in two patient samples of falls, before and after an organization wide interprofessional delirium education and practice change along with implementation of a policy. BACKGROUND: Delirium is a common and severe problem for hospitalized patients, with occurrence ranging from 14-56%, morbidity and mortality from 25-33%. Recent studies report that 73-96% of patients who fell during a hospital stay had symptoms of delirium; however the delirium went undiagnosed and untreated in 75% of the cases...
January 4, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29295719/effectiveness-of-multicomponent-interventions-on-incidence-of-delirium-in-hospitalized-older-patients-with-hip-fracture-a-systematic-review
#9
Tarandeep Oberai, Kate Laver, Maria Crotty, Maggie Killington, Ruurd Jaarsma
BACKGROUND: Delirium is the most frequent complication among the hospitalized elderly with hip fracture. Although, delirium is associated with longer hospital stay, higher mortality rates, worse functional outcomes, and higher institutionalization rates yet health service planners have hugely ignored its existence. This review aims to identify the effectiveness of multicomponent interventions to prevent delirium in hospitalized elderly patients with hip fracture. METHODS: This review includes experimental, non-experimental, and observational studies...
January 3, 2018: International Psychogeriatrics
https://www.readbyqxmd.com/read/29276990/bright-light-and-oxygen-therapies-decrease-delirium-risk-in-critically-ill-surgical-patients-by-targeting-sleep-and-acid-base-disturbances
#10
Sirimas Potharajaroen, Sookjaroen Tangwongchai, Thavatchai Tayjasanant, Thammasak Thawitsri, George Anderson, Michael Maes
This study examined the effects of bright light therapy (BLT) on the incidence of delirium in post-operative patients admitted to a surgical intensive care unit (SICU) and delineates risk and protective factors. We included 62 patients in a single-blind, randomized controlled study. The intervention group was treated with care as usual plus BLT for three consecutive days. Delirium was diagnosed by DSM-5 criteria with the Confusion Assessment Method-Intensive Care Unit (CAM-ICU). Risk factors for delirium were measured, including the APACHE II score, Insomnia Severity Index (ISI), as well as hematocrit and bicarbonate levels...
December 18, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/29276297/patient-outcomes-associated-with-phenobarbital-use-with-or-without-benzodiazepines-for-alcohol-withdrawal-syndrome-a-systematic-review
#11
Drayton A Hammond, Jordan M Rowe, Adrian Wong, Tessa L Wiley, Kristen C Lee, Sandra L Kane-Gill
Purpose: Benzodiazepines are the drug of choice for alcohol withdrawal syndrome (AWS); however, phenobarbital is an alternative agent used with or without concomitant benzodiazepine therapy. In this systematic review, we evaluate patient outcomes with phenobarbital for AWS. Methods: Medline, Cochrane Library, and Scopus were searched from 1950 through February 2017 for controlled trials and observational studies using ["phenobarbital" or "barbiturate"] and ["alcohol withdrawal" or "delirium tremens."] Risk of bias was assessed using tools recommended by National Heart, Lung, and Blood Institute...
October 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29248434/does-my-older-cancer-patient-have-cognitive-impairment
#12
Jon Snaedal
Cancer and impaired cognition are both frequent conditions in old age and consequently coexist to certain degree. The prevalence of impaired cognition increases sharply after the age of 65 and the more advanced form of cognitive impairment; dementia, is exceeding 30% by the age of 85years. Adequate cognition is crucial for understanding important facts and for giving consent for intervention. There are many different stages of cognitive impairment, ranging from subjective cognitive impairment to severe dementia...
December 13, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/29247265/end-of-life-care-pathway-of-head-and-neck-cancer-patients-single-institution-experience
#13
T Heinonen, V Loimu, K Saarilahti, T Saarto, A Mäkitie
BACKGROUND: Studies on palliative care of head and neck cancer (HNC) patients are scarce although the affected patient population is quite large. OBJECTIVE: To evaluate the role of a specialised palliative-care pathway of HNC patients. PATIENTS AND METHODS: Data on all HNC patients who were treated at the Helsinki University Hospital Palliative Care Center during 1 year were retrospectively reviewed. The analysis comprised 60 patients (49 males; mean age 67 years; range 28-88)...
December 15, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29246814/neuroborreliosis-and-acute-encephalopathy-the-use-of-cxcl13-as-a-biomarker-in-cns-manifestations-of-lyme-borreliosis
#14
Matthias Karrasch, Volker Fingerle, Katharina Boden, Andreas Darr, Michael Baier, Eberhard Straube, Igor Nenadic
We report the case of an 80-year-old patient with acute onset confusion initially suspected to reflect delirium in incipient Alzheimer's disease. Cerebrospinal fluid tests revealed an unusually severe form of neuroborreliosis, which resolved following antibiotic treatment. This was mirrored in the measurement of CXCL13, which is suggested as a complementary biomarker. Clinical implications for screening, differential diagnosis and treatment are discussed.
December 11, 2017: Ticks and Tick-borne Diseases
https://www.readbyqxmd.com/read/29234918/patients-with-dementia-in-acute-care-hospitals-a%C3%A2-cross-sectional-study-of-physicians-experiences-and-attitudes
#15
Lena Helm, Katrin Balzer, Anja Behncke, Nora Eisemann, Sascha Köpke
BACKGROUND: Patients with dementia (PwD) are a vulnerable group and caring for these patients in acute care hospitals is challenging. Structural conditions and standardized treatment procedures in hospitals often do not correspond to the needs of this patient group. Physicians may not be well prepared for caring for PwD. OBJECTIVE: This study aimed to ascertain physicians' experiences and attitudes in caring for PwD or cognitive disorders and their subjective workload...
December 12, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/29230342/the-treatment-of-clozapine-withdrawal-delirium-with-electroconvulsive-therapy
#16
Anish Modak, Arne Åhlin
Clozapine, a commonly used atypical antipsychotic, can precipitate a severe withdrawal syndrome. In this report, we describe a case of delirium with catatonic features emerging after the immediate cessation of clozapine subsequent to concerns of developing neuroleptic malignant syndrome. After multiple treatments were found to be inefficacious, electroconvulsive therapy (ECT) was initiated, resulting in significant improvement. A literature search revealed six previous cases of clozapine-withdrawal syndromes of varied symptomatology treated with ECT...
2017: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/29222181/fifteen-minute-consultation-an-approach-to-a-child-presenting-to-the-emergency-department-with-acute-psychotic-symptoms
#17
Anil Vasudev Israni, Sumant Kumar, Nahin Hussain
Presentation of a child in the A&E with altered behaviour including psychotic features is not unusual. New-onset psychotic symptoms in children pose a significant diagnostic challenge due to several reasons. First, primary psychotic conditions are uncommon in pre-pubertal children. Second, differentiating between delirium and psychosis can be difficult in children, more so in infants, toddlers and young children. Third, intervening and managing a secondary cause of psychosis can significantly optimise outcome...
December 8, 2017: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/29221884/-efficacy-and-tolerance-of-tocilizumab-for-corticosteroid-sparing-in-giant-cell-arteritis-and-aortitis-experience-of-nimes-university-hospital-about-eleven-patients
#18
J Broner, E Arnaud
INTRODUCTION: Giant cell arteritis is a large-vessels vasculitis, which treatment consists in a slowly-tappered steroid-therapy. Immunosuppressive agents are sometimes used in case of steroid-dependance. We have conducted an observationnal retrospective study including patients treated with tocilizumab for a giant cell arteritis or an aortitis in the internal medicine department at the Nîmes University Hospital. RESULTS: Eleven patients were included between 2011 and 2016, who had been treated only with prednisone...
December 5, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29216606/first-and-second-line-pharmacological-treatment-for-delirium-in-general-hospital-setting-retrospective-analysis
#19
Ken Wada, Yukitaka Morita, Takashi Iwamoto, Yoshihiro Mifune, Shinji Nojima
AIM: We examined the first- and second-line pharmacological treatment for delirium to determine which drugs were chosen, how and when second-line drugs were started, and the effectiveness and tolerability of those treatments. METHODS: A retrospective medical chart review was performed for delirium inpatients referred to the Department of Psychiatry, Hiroshima Citizens Hospital, from October 2011 to September 2012. Clinical diagnoses were based on ICD-10. We compared the baseline severity of delirium, duration needed for improvement, and rescue with antipsychotics between subjects given only first-line drugs and those switched to second-line drugs...
December 4, 2017: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/29214512/anticholinergic-prescribing-in-medicare-part-d-beneficiaries-residing-in-nursing-homes-results-from-a-retrospective-cross-sectional-analysis-of-medicare-data
#20
Joshua Niznik, Xinhua Zhao, Tao Jiang, Joseph T Hanlon, Sherrie L Aspinall, Joshua Thorpe, Carolyn Thorpe
BACKGROUND: Prescribing of medications with anticholinergic properties in older nursing home residents is relatively common, despite an association with an increased risk for falls, delirium, and other outcomes. Few studies have investigated what factors influence different levels of prescribing of these agents. OBJECTIVES: The primary objective was to identify factors associated with low- and high-level anticholinergic burden in nursing home residents. A secondary objective was to examine in detail the contribution of different medications to low versus high burden to aid in determining which drugs to target in interventions...
December 6, 2017: Drugs & Aging
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