keyword
https://read.qxmd.com/read/38487325/case-report-acute-hhv6b-encephalitis-myelitis-post-car-t-cell-therapy-in-patients-with-relapsed-refractory-aggressive-b-cell-lymphoma
#1
Ningwen Li, Ruoxuan Zhang, Jue Wang, Xiaojian Zhu, Fankai Meng, Yang Cao, Gaoxiang Wang, Yang Yang
BACKGROUND: The development of chimeric antigen receptor (CAR)-T cell therapy has revolutionized treatment outcomes in patients with lymphoid malignancies. However, several studies have reported a relatively high rate of infection in adult patients following CD19-targeting CAR T-cell therapy, particularly in the first 28 days. Notably, acute human herpesvirus 6 B (HHV6B) reactivation occurs in up to two-thirds of allogeneic hematopoietic stem cell transplantation patients. CASE PRESENTATIONS: Herein, we describe a report of HHV6B encephalitis/myelitis in three patients with relapsed/refractory diffuse large B-cell lymphoma post CAR T-cell therapy...
2024: Frontiers in Neurology
https://read.qxmd.com/read/38481336/cognitive-disorders-in-advanced-parkinson-s-disease-challenges-in-the-diagnosis-of-delirium
#2
REVIEW
Christine Daniels, Jon Rodríguez-Antigüedad, Elisabeth Jentschke, Jaime Kulisevsky, Jens Volkmann
Parkinson's disease (PD) is a neurodegenerative condition that is frequently associated with cognitive disorders. These can arise directly from the primary disease, or be triggered by external factors in susceptible individuals due to PD or other predisposing factors. The cognitive disorders encompass PD-associated cognitive impairment (PD-CI), delirium, PD treatment-associated cognitive side effects, cognitive non-motor fluctuations, and PD-associated psychosis. Accurate diagnosis of delirium is crucial because it often stems from an underlying disease that may be severe and require specific treatment...
March 14, 2024: Neurological research and practice
https://read.qxmd.com/read/38472124/immunological-analysis-of-postoperative-delirium-after-thoracic-aortic-surgery
#3
JOURNAL ARTICLE
Haein Ko, Mukhammad Kayumov, Kyo Seon Lee, Sang Gi Oh, Kook Joo Na, In Seok Jeong
BACKGROUND: Delirium is a recognized neurological complication following cardiac surgery and is associated with adverse clinical outcomes, including elevated mortality and prolonged hospitalization. While several clinical risk factors for post-cardiac surgery delirium have been identified, the pathophysiology related to the immune response remains unexamined. This study was conducted to investigate the immunological factors contributing to delirium in patients after thoracic aortic surgery...
March 13, 2024: Journal of chest surgery
https://read.qxmd.com/read/38467994/cumulative-anticholinergic-burden-and-its-predictors-among-older-adults-with-alzheimer-s-disease-initiating-cholinesterase-inhibitors
#4
JOURNAL ARTICLE
Ashna Talwar, Satabdi Chatterjee, Jeffrey Sherer, Susan Abughosh, Michael Johnson, Rajender R Aparasu
BACKGROUND: Cumulative anticholinergic burden refers to the cumulative effect of multiple medications with anticholinergic properties. However, concomitant use of cholinesterase inhibitors (ChEIs) and anticholinergic burden can nullify the benefit of the treatment and worsen Alzheimer's disease (AD). A literature gap exists regarding the extent of the cumulative anticholinergic burden and associated risk factors in AD. Therefore, this study evaluated the prevalence and predictors of cumulative anticholinergic burden among patients with AD initiating ChEIs...
March 11, 2024: Drugs & Aging
https://read.qxmd.com/read/38465631/rivastigmine-for-the-management-of-anticholinergic-delirium
#5
JOURNAL ARTICLE
Angela L Chiew, Amanda G Holford, Betty S H Chan, Katherine Z Isoardi
INTRODUCTION: Anticholinergic agents are commonly taken in overdose, often causing delirium. The spectrum of anticholinergic delirium ranges from mild agitation to severe behavioural disturbance. Physostigmine is an effective treatment for anticholinergic delirium, but its availability is limited. As rivastigmine is readily available, it has been used to manage anticholinergic delirium; however, there is limited research investigating its use. METHOD: This was a retrospective review of patients with anticholinergic delirium treated in two toxicology units with rivastigmine (oral capsule or transdermal patch) from January 2019 to June 2023...
March 11, 2024: Clinical Toxicology
https://read.qxmd.com/read/38445262/improved-prediction-of-sepsis-associated-encephalopathy-in-intensive-care-unit-sepsis-patients-with-an-innovative-nomogram-tool
#6
JOURNAL ARTICLE
Jun Jin, Lei Yu, Qingshan Zhou, Mian Zeng
BACKGROUND: Sepsis-associated encephalopathy (SAE) occurs as a result of systemic inflammation caused by sepsis. It has been observed that the majority of sepsis patients experience SAE while being treated in the intensive care unit (ICU), and a significant number of survivors continue suffering from cognitive impairment even after recovering from the illness. The objective of this study was to create a predictive nomogram that could be used to identify SAE risk factors in patients with ICU sepsis...
2024: Frontiers in Neurology
https://read.qxmd.com/read/38441156/acute-encephalopathy-in-the-icu-a-practical-approach
#7
JOURNAL ARTICLE
Pedro Kurtz, Mark van den Boogaard, Timothy D Girard, Bertrand Hermann
PURPOSE OF REVIEW: Acute encephalopathy (AE) - which frequently develops in critically ill patients with and without primary brain injury - is defined as an acute process that evolves rapidly and leads to changes in baseline cognitive status, ranging from delirium to coma. The diagnosis, monitoring, and management of AE is challenging. Here, we discuss advances in definitions, diagnostic approaches, therapeutic options, and implications to outcomes of the clinical spectrum of AE in ICU patients without primary brain injury...
February 12, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38438300/insulin-resistance-and-osteocalcin-associate-with-the-incidence-and-severity-of-postoperative-delirium-in-elderly-patients-undergoing-joint-replacement
#8
JOURNAL ARTICLE
Yang Mi, Ouyang Wen, Zhou Lei, Long Ge, Liu Xing, He Xi
AIM: While insulin sensitivity plays an important role in maintaining glucose metabolic homeostasis and cognitive function, its impact on postoperative delirium (POD) remains unclear. This study aimed to investigate the association between POD and indicators of insulin sensitivity, including insulin resistance and osteocalcin. METHODS: A total of 120 elderly patients undergoing joint replacement were recruited and divided into delirium and non-delirium groups. Plasma and cerebrospinal fluid (CSF) samples were collected for the analysis of biomarkers, including insulin, uncarboxylated osteocalcin (ucOC), total osteocalcin (tOC), and glucose...
March 4, 2024: Geriatrics & Gerontology International
https://read.qxmd.com/read/38438279/melatonin-does-not-reduce-delirium-severity-in-hospitalized-older-adults-results-of-a-randomized-placebo-controlled-trial
#9
JOURNAL ARTICLE
Peter W Lange, Alisa Turbić, Cheng Hwee Soh, Daniel Clayton-Chubb, Wen Kwang Lim, Rachel Conyers, Rosie Watson, Andrea B Maier
BACKGROUND: Delirium is common in older inpatients, causing distress, cognitive decline, and death. Current therapies are unsatisfactory, limited by lack of efficacy and adverse effects. There is an urgent need for effective delirium treatment. Sleep wake cycle is disturbed in delirium; endogenous Melatonin is perturbed, and exogenous Melatonin is a safe and effective medication for sleep disorders. This study aims to determine the effect of oral Melatonin 5 mg immediate release (IR) nightly for five nights on the severity of delirium in older (≥65 years) medical inpatients...
March 4, 2024: Journal of the American Geriatrics Society
https://read.qxmd.com/read/38436682/outcome-predictors-of-post-covid-conditions-in-the-european-academy-of-neurology-covid-19-registry
#10
JOURNAL ARTICLE
Maurizio Angelo Leone, Raimund Helbok, Elisa Bianchi, Clarissa Lin Yasuda, Maria Konti, Dauren Ramankulov, Maria Lolich, Arijana Lovrencic-Huzjan, Tibor Kovács, Carmel Armon, Maria Sofia Cotelli, Francesco Cavallieri, Oxana Grosu, Gordana Kiteva-Trenchevska, Ildefonso Rodriguez-Leyva, Marion Boldingh, Waldemar Brola, Luís F Maia, Mafalda Maria Laracho de Seabra, Eugenia Irene Davidescu, Bogdan Ovidiu Popescu, Svetlana Kopishinskaia, Claudio L A Bassetti, Elena Moro
Several neurological manifestations are part of the post-COVID condition. We aimed to: (1) evaluate the 6-month outcome in the cohort of patients with neurological manifestations during the COVID-19 acute phase and surviving the infection, and find outcome predictors; (2) define the prevalence and type of neurological symptoms persistent at six months after the infection. Data source was an international registry of patients with COVID-19 infection and neurological symptoms, signs or diagnoses established by the European Academy of Neurology...
March 4, 2024: Journal of Neurology
https://read.qxmd.com/read/38428834/impact-of-prefracture-cognitive-impairment-and-postoperative-delirium-on-recovery-after-hip-fracture-surgery
#11
JOURNAL ARTICLE
Tomoko Kamimura, Yuya Kobayashi, Satoshi Tamaki, Masayoshi Koinuma
OBJECTIVES: This study aimed to examine the impact of prefracture cognitive impairment (CI) severity and postoperative delirium on recovery after hip fracture surgery in older patients. DESIGN: Prospective study with a 1-year follow-up. SETTING AND PARTICIPANTS: We included 355 patients aged ≥80 years from 2 acute hospitals in Japan. METHODS: Barthel Index (BI) ambulation scores were assessed prefracture and at 1, 3, 6, and 12 months postoperatively...
February 27, 2024: Journal of the American Medical Directors Association
https://read.qxmd.com/read/38426709/feasibility-of-goal-directed-fluid-therapy-in-patients-with-transcatheter-aortic-valve-replacement-an-ambispective-analysis
#12
JOURNAL ARTICLE
Ralf Felix Trauzeddel, Michael Nordine, Giovanni B Fucini, Michael Sander, Henryk Dreger, Karl Stangl, Sascha Treskatsch, Marit Habicher
INTRODUCTION: Goal-directed fluid therapy (GDFT) has been shown to reduce postoperative complications. The feasibility of GDFT in transcatheter aortic valve replacement (TAVR) patients under general anesthesia has not yet been demonstrated. We examined whether GDFT could be applied in patients undergoing TAVR in general anesthesia and its impact on outcomes. METHODS: Forty consecutive TAVR patients in the prospective intervention group with GDFT were compared to 40 retrospective TAVR patients without GDFT...
March 1, 2024: Brazilian Journal of Cardiovascular Surgery
https://read.qxmd.com/read/38424490/butyrylcholinesterase-activity-in-patients-with-postoperative-delirium-after-cardiothoracic-surgery-or-percutaneous-valve-replacement-an-observational-interdisciplinary-cohort-study
#13
JOURNAL ARTICLE
Konstantin Schlake, Johannes Teller, Lukas Hinken, Hans Laser, Ralf Lichtinghagen, Andreas Schäfer, Christine Fegbeutel, Karin Weissenborn, Carolin Jung, Hans Worthmann, Maria Magdalena Gabriel
BACKGROUND AND OBJECTIVES: Postoperative delirium is a frequent and severe complication after cardiac surgery. Activity of butyrylcholinesterase (BChE) has been discussed controversially regarding a possible role in its development. This study aimed to investigate the relevance of BChE activity as a biomarker for postoperative delirium after cardiac surgery or percutaneous valve replacement. METHODS: A total of 237 patients who received elective cardiothoracic surgery or percutaneous valve replacement at a tertiary care centre were admitted preoperatively...
March 1, 2024: BMC Neurology
https://read.qxmd.com/read/38420358/association-between-preoperative-albumin-levels-and-postoperative-delirium-in-geriatric-hip-fracture-patients
#14
JOURNAL ARTICLE
Wei Wang, Wei Yao, Wanyun Tang, Yuhao Li, Qiaomei Lv, Wenbo Ding
OBJECTIVE: This study aims to examine the association between preoperative serum albumin levels and postoperative delirium (POD) in geriatric patients who have undergone hip fracture surgery, with the goal of offering novel insights for clinical interventions targeting POD. METHODS: A retrospective analysis was conducted on the medical records of patients who underwent hip fracture surgery in a tertiary medical institution from January 2013 to November 2023. The patients were classified based on hypoalbuminemia (defined as a serum albumin level < 35 g/L) and clinical threshold...
2024: Frontiers in Medicine
https://read.qxmd.com/read/38388111/variation-in-care-and-outcomes-for-people-after-hip-fracture-with-and-without-cognitive-impairment-results-from-the-australian-and-new-zealand-hip-fracture-registry
#15
JOURNAL ARTICLE
Morag E Taylor, Lara A Harvey, Maria Crotty, Ian A Harris, Catherine Sherrington, Jacqueline C T Close
BACKGROUND: People with dementia have poorer outcomes after hip fracture and this may be due in part to variation in care. We aimed to compare care and outcomes for people with and without cognitive impairment after hip fracture. METHODS: Retrospective cohort study using Australian and New Zealand Hip Fracture Registry data for people ≥50 years of age who underwent hip fracture surgery (n = 49,063). Cognitive impairment or known dementia and cognitively healthy groups were defined using preadmission cognitive status...
February 2024: Journal of Nutrition, Health & Aging
https://read.qxmd.com/read/38384616/a-case-of-ertapenem-induced-delirium
#16
Maria Aquilina, Nicole Galdes, Neville Spiteri
Ertapenem is a carbapenem antibiotic that is typically prescribed in cases of moderate-to-severe infections, especially ones involving abscess formation. We describe the case of an 82-year-old gentleman who presented with osteomyelitis and abscess formation who developed delirium after 15 days of ertapenem treatment. The patient experienced delusions, insomnia, agitation, and disorientation. The patient's mental status improved and returned to his baseline within 48 hours of halting ertapenem treatment. A high index of suspicion is required to identify and treat ertapenem-induced delirium...
January 2024: Curēus
https://read.qxmd.com/read/38381393/post-sepsis-psychiatric-disorder-pathophysiology-prevention-and-treatment
#17
REVIEW
Dayong Li, Xujie Zhang, Yuru Lu, Liang Jing, Hongjie Hu, Yaqin Song, Shuhui Wu, Wei Zhu
Post-sepsis psychiatric disorder, encompassing anxiety, depression, post-traumatic stress disorder and delirium, is a highly prevalent complication secondary to sepsis, resulting in a marked increase in long-term mortality among affected patients. Regrettably, psychiatric impairment associated with sepsis is frequently disregarded by clinicians. This review aims to summarize recent advancements in the understanding of the pathophysiology, prevention, and treatment of post-sepsis mental disorder, including coronavirus disease 2019-related psychiatric impairment...
February 21, 2024: Neurological Sciences
https://read.qxmd.com/read/38380761/association-between-perioperative-self-reported-sleep-disturbances-and-delirium-risk-in-elderly-patients-following-total-joint-arthroplasty-a-cohort-study
#18
JOURNAL ARTICLE
Hao Chen, Zheng Fang, Yang-Yang Wu, Cheng-Hui Zhao, Yu-Jie Wang, Xiao-He Zhu, Xin-Qi Cheng
Perioperative sleep disturbance may increase delirium risk. However, the role of perioperative sleep disturbance in delirium following total joint arthroplasty remains unclear. This prospective cohort study aimed to observe the delirium risk in patients with sleep disturbances. After excluding pre-existing sleep disturbances, older patients scheduled for total joint arthroplasty from July 17, 2022, to January 12, 2023, were recruited. Preoperative sleep disturbance or postoperative sleep disturbance was defined as a Chinese version of the Richards-Campbell Sleep Questionnaire (RCSQ) score of <50 during hospitalisation...
February 21, 2024: Journal of Sleep Research
https://read.qxmd.com/read/38379517/an-exploratory-research-report-on-brain-mineralization-in-postoperative-delirium-and-cognitive-decline
#19
JOURNAL ARTICLE
Florian Lammers-Lietz, Friedrich Borchers, Insa Feinkohl, Stefan Hetzer, Cicek Kanar, Frank Konietschke, Gunnar Lachmann, Claudia Chien, Claudia Spies, Georg Winterer, Laszlo Zaborszky, Norman Zacharias, Friedemann Paul
Delirium is a severe postoperative complication associated with poor overall and especially neurocognitive prognosis. Altered brain mineralization is found in neurodegenerative disorders but has not been studied in postoperative delirium and postoperative cognitive decline. We hypothesized that mineralization-related hypointensity in susceptibility-weighted magnetic resonance imaging (SWI) is associated with postoperative delirium and cognitive decline. In an exploratory, hypothesis-generating study, we analysed a subsample of cognitively healthy patients ≥65 years who underwent SWI before (N = 65) and 3 months after surgery (N = 33)...
February 21, 2024: European Journal of Neuroscience
https://read.qxmd.com/read/38375685/a-real-world-pharmacovigilance-study-of-ceftazidime-avibactam-data-mining-of-the-food-and-drug-administration-adverse-event-reporting-system-database
#20
JOURNAL ARTICLE
Haiping Yao, Yanyan Wang, Yan Peng, Zhixiong Huang, Guoping Gan, Zhu Wang
Ceftazidime/avibactam (CAZ/AVI) is a combination of a well-known third-generation, broad-spectrum cephalosporin with a new beta-lactamase inhibitor that has been approved for the treatment of various infectious diseases (especially multidrug-resistant Gram-negative bacterial infections) by the Food and Drug Administration (FDA). The current study extensively assessed CAZ/AVI-related adverse events (AEs) in the real world through data mining of the FDA Adverse Event Reporting System (FAERS) database to better understand toxicities...
February 20, 2024: Journal of Clinical Pharmacology
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