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Severity delirium

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https://www.readbyqxmd.com/read/29776706/gaps-in-pain-agitation-and-delirium-management-in-intensive-care-outputs-from-a-nurse-workshop
#1
REVIEW
Carsten Hermes, Maria Acevedo-Nuevo, Andrea Berry, Thomas Kjellgren, Alessandra Negro, Paola Massarotto
Significant improvements in our understanding of pain, agitation, and delirium management within the Intensive Care Unit have been made in recent years. International guidelines and implementation bundles have become more evidence-based, patient-centred, and provide clear recommendations on the best-practice management of critically ill patients. However, the intensive care community has highlighted the need for higher-order evidence in several areas of pain, agitation and delirium research and studies suggest that a significant number of intensive care patients still receive outdated treatment as a consequence of inadequate guideline implementation...
May 15, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29765105/neural-predisposing-factors-of-postoperative-delirium-in-elderly-patients-with-femoral-neck-fracture
#2
Sunghyon Kyeong, Jung Eun Shin, Kyu Hyun Yang, Woo Suk Lee, Tae-Sub Chung, Jae-Jin Kim
Elderly adults are more likely to develop delirium after major surgery, but there is limited knowledge of the vulnerability for postoperative delirium. In this study, we aimed to identify neural predisposing factors for postoperative delirium and develop a prediction model for estimating an individual's probability of postoperative delirium. Among 57 elderly participants with femoral neck fracture, 25 patients developed postoperative delirium and 32 patients did not. We preoperatively obtained data for clinical assessments, anatomical MRI, and resting-state functional MRI...
May 15, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29762304/effectiveness-and-harms-of-pharmacological-interventions-in-the-treatment-of-delirium-in-adults-in-intensive-care-units-post-cardiac-surgery-a-systematic-review-protocol
#3
Vivienne Leigh, Catalin Tufanaru, Rosalind Elliott
The review objective is to synthesize the best available evidence on the effectiveness and harms of pharmacological interventions in the treatment of delirium in adults in intensive care units (ICU) after cardiac surgery.The specific review question is: What is the effectiveness and what are the harms of pharmacological interventions in relation to the duration and severity of delirium episodes, length of stay in ICU, length of stay in hospital, functional capacity and quality of life and mortality for critically ill adult patients treated in intensive care after cardiac surgery?...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29761891/processed-electroencephalogram-and-evoked-potential-techniques-for-amelioration-of-postoperative-delirium-and-cognitive-dysfunction-following-non-cardiac-and-non-neurosurgical-procedures-in-adults
#4
REVIEW
Yodying Punjasawadwong, Waraporn Chau-In, Malinee Laopaiboon, Sirivimol Punjasawadwong, Pathomporn Pin-On
BACKGROUND: Postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) may complicate a patient's postoperative recovery in several ways. Monitoring of processed electroencephalogram (EEG) or evoked potential (EP) indices may prevent or minimize POD and POCD, probably through optimization of anaesthetic doses. OBJECTIVES: To assess whether the use of processed EEG or auditory evoked potential (AEP) indices (bispectral index (BIS), narcotrend index, cerebral state index, state entropy and response entropy, patient state index, index of consciousness, A-line autoregressive index, and auditory evoked potentials (AEP index)) as guides to anaesthetic delivery can reduce the risk of POD and POCD in non-cardiac surgical or non-neurosurgical adult patients undergoing general anaesthesia compared with standard practice where only clinical signs are used...
May 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29752853/dexmedetomidine-for-the-reduction-of-emergence-delirium-in-children-undergoing-tonsillectomy-with-propofol-anesthesia-a-double-blind-randomized-study
#5
Adelais G Tsiotou, Anna Malisiova, Elena Kouptsova, Maria Mavri, Maria Anagnostopoulou, Evagelia Kalliardou
BACKGROUND: Postanesthesia emergence delirium is a motor agitation state complicating pediatric anesthesia. We investigated the efficacy of dexmedetomidine in reducing emergence delirium in children undergoing tonsillectomy with and without adenoidectomy using total intravenous anesthesia with propofol. METHODS: This was a prospective, single-center, double-blind, randomized study. The primary outcome was the presence or absence of emergence delirium with and without dexmedetomidine...
May 12, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29751986/delirium-after-cardiac-surgery-incidence-phenotypes-predisposing-and-precipitating-risk-factors-and-effects
#6
Gianfranco Sanson, Yuliya Khlopenyuk, Sara Milocco, Massimiliano Sartori, Lorella Dreas, Adam Fabiani
BACKGROUND: In cardiac surgical patients little is known about different phenotypes of delirium and how the symptoms fluctuate over time. OBJECTIVES: Evaluate risk factors, incidence, fluctuations, phenotypic characteristics and impact on patients' outcomes of delirium. METHODS: Prospective longitudinal study. In postoperative intensive care unit 199 patient were assessed three-times a day through an adapted versions of the Intensive Care Delirium Screening Checklist...
May 8, 2018: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/29746694/delirium-burden-in-patients-and-family-caregivers-development-and-testing-of-new-instruments
#7
Annie M Racine, Madeline D'Aquila, Eva M Schmitt, Jacqueline Gallagher, Edward R Marcantonio, Richard N Jones, Sharon K Inouye, Dena Schulman-Green
Background and Objectives: Delirium creates distinct emotional distress in patients and family caregivers, yet there are limited tools to assess the experience. Our objective was to develop separate patient and family caregiver delirium burden instruments and to test their content and construct validity. Research Design and Methods: Two hundred forty-seven patients and 213 family caregivers were selected from an ongoing prospective cohort of medical-surgical admissions aged ≥70 years old...
May 8, 2018: Gerontologist
https://www.readbyqxmd.com/read/29746650/age-dependent-morbidity-and-mortality-outcomes-after-surgical-aortic-valve-replacement
#8
Amjad I Hussain, Andreas Auensen, Cathrine Brunborg, Jan Otto Beitnes, Lars Gullestad, Kjell I Pettersen
OBJECTIVES: This study addressed the assumption of increased morbidity and mortality after surgical aortic valve replacement in patients older than 80 years with severe aortic stenosis. METHODS: This prospective study was performed in consecutive patients referred for aortic valve replacement. The age-dependent change in cognitive and physical function, quality of life and rehospitalization and complication rates during the following year and 5-year all-cause mortality were documented...
May 9, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29745516/-research-on-the-mechanism-of-delirium-based-on-related-serum-biomarkers-of-the-delirium
#9
REVIEW
Yanyan Wang, Yulin Liao, Jirong Yue
Delirium is an acute cognitive disorder caused by a variety of factors which lead to cerebral cortical dysfunction. At present the studies on the pathophysiology of delirium is still very few. But studies on serum biomarker of delirium can help to elucidate the pathophysiological mechanism of delirium, and the studies are significant for delirium diagnosis, severity classification and prediction of long-term outcome. This review examines three major groups of delirium related serum biomarkers: ① risk markers: those that are present or elevated prior to disease onset, including serum chemistries, genetic markers and so on; ② disease markers: those markers elevate with delirium onset and fall when delirium recovery, including acetylcholine and serum anticholinergic activity, serotonin, serum amino acids, and melatonin, interleukin, C-reactive protein; and ③ end products: those that rise in proportion to the consequences of disease, including S-100ß and neuron specific enolase...
June 1, 2017: Sheng Wu Yi Xue Gong Cheng Xue za Zhi, Journal of Biomedical Engineering, Shengwu Yixue Gongchengxue Zazhi
https://www.readbyqxmd.com/read/29744126/htlv-1-atll-refractory-hypercalcaemia-and-hiv-1-co-infection
#10
Abdullah E Laher, Feroza Motara, Muhammed Moolla, Osman Ebrahim
Adult T-cell lymphoma/leukemia (ATLL) is a rare tumour of T-lymphocytes that is associated with human T-lymphotrophic virus type 1 (HTLV-1) infection as well as severe/refractory hypercalcaemia. Human immunodefficiency virus type 1 (HIV-1) infected individuals are at increased risk of acquiring co-infection with HTLV-1. We present the case of a 37 -year -old HIV-1 positive and antiretroviral therapy naive woman who was admitted to the ICU with delirium, a generalised maculopapular rash, severe hypercalcaemia of 4...
January 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29743884/exploring-postoperative-cognitive-dysfunction-and-delirium-in-noncardiac-surgery-using-mri-a-systematic-review
#11
REVIEW
Chenxi Huang, Johan Mårtensson, Ismail Gögenur, Mohammad Sohail Asghar
Surgical patients are at high risk of developing postoperative cognitive dysfunction (POCD) and postoperative delirium (POD). POCD and POD are associated with increased morbidity and mortality and worsening functional outcomes leading to severe socioeconomic consequences for the patient and the society in general. Magnetic resonance imaging (MRI) offers a unique opportunity to study the anatomy and function of the brain. MRI thus plays an important role in elucidating the neuronal component of POCD and POD...
2018: Neural Plasticity
https://www.readbyqxmd.com/read/29742583/adjunct-ketamine-use-in-the-management-of-severe-ethanol-withdrawal
#12
Anthony F Pizon, Michael J Lynch, Neal J Benedict, Joseph H Yanta, Adam Frisch, Nathan B Menke, Greg S Swartzentruber, Andrew M King, Michael G Abesamis, Sandra L Kane-Gill
OBJECTIVES: Ketamine offers a plausible mechanism with favorable kinetics in treatment of severe ethanol withdrawal. The purpose of this study is to determine if a treatment guideline using an adjunctive ketamine infusion improves outcomes in patients suffering from severe ethanol withdrawal. DESIGN: Retrospective observational cohort study. SETTING: Academic tertiary care hospital. PATIENTS: Patients admitted to the ICU and diagnosed with delirium tremens by Diagnostic and Statistical Manual of Mental Disorders V criteria...
May 8, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29738102/validation-of-the-brief-confusion-assessment-method-for-screening-delirium-in-elderly-medical-patients-in-a-german-emergency-department
#13
Verena Baten, Hans-Jörg Busch, Caroline Busche, Bonaventura Schmid, Miriam Heupel-Reuter, Evgeniy Perlov, Jochen Brich, Stefan Klöppel
BACKGROUND: Delirium is frequent in elderly patients presenting in the emergency department (ED). Despite the severe prognosis, the majority of delirium cases remain undetected by emergency physicians (EPs). At the time of our study there was no valid delirium screening tool available for EDs in German-speaking regions. We aimed to evaluate the brief Confusion Assessment Method (bCAM) for a German ED during the daily work routine. METHODS: We implemented the bCAM into practice in a German interdisciplinary high volume ED, and evaluated the bCAM's validity in a convenience sample of medical patients aged ≥70 years...
May 8, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29730622/early-rehabilitation-to-prevent-postintensive-care-syndrome-in-patients-with-critical-illness-a-systematic-review-and-meta-analysis
#14
Ryota Fuke, Toru Hifumi, Yutaka Kondo, Junji Hatakeyama, Tetsuhiro Takei, Kazuma Yamakawa, Shigeaki Inoue, Osamu Nishida
INTRODUCTION: We examined the effectiveness of early rehabilitation for the prevention of postintensive care syndrome (PICS), characterised by an impaired physical, cognitive or mental health status, among survivors of critical illness. METHODS: We performed a systematic literature search of several databases (Medline, Embase and Cochrane Central Register of Controlled Trials) and a manual search to identify randomised controlled trials (RCTs) comparing the effectiveness of early rehabilitation versus no early rehabilitation or standard care for the prevention of PICS...
May 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29725829/involvement-of-acute-neuroinflammation-in-postoperative-delirium-like-cognitive-deficits-in-rats
#15
Takashi Kawano, Daiki Yamanaka, Bun Aoyama, Hiroki Tateiwa, Marie Shigematsu-Locatelli, Atsushi Nishigaki, Hideki Iwata, Fabricio M Locatelli, Masataka Yokoyama
PURPOSE: The purpose of this study was to investigate the age-, time-, and brain region-dependent postoperative neuroinflammatory trajectory, and its association with neurocognitive outcomes in rats. METHODS: Adult and aged rats were randomly assigned to one of three groups: control, isoflurane anesthesia alone, and isoflurane anesthesia with abdominal surgery. On either postoperative day 2 (early phase) or 7 (late phase), all rats were tested for trace and context fear memory retention after acquisition of trace fear conditioning...
May 3, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29720798/mercury-toxicity-following-unauthorized-siddha-medicine-intake-a-mimicker-of-acquired-neuromyotonia-report-of-32-cases
#16
G Gnanashanmugam, R Balakrishnan, S P Somasundaram, N Parimalam, P Rajmohan, M B Pranesh
Context: Mercury is used extensively in the preparation of Siddha medicines, after purification. In this study, we present 32 patients of mercury toxicity following unauthorized Siddha medicine intake who mimicked neuromyotonia clinically. We analyzed the clinical features of these patients, the role of autoimmunity in etiopathology, and compared it with acquired neuromyotonia. Subjects and Methods: This is a retrospective study to analyze inpatients in a tertiary care center, admitted with mercury toxicity following Siddha medicine intake from August 2012 to October 2016...
January 2018: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/29717845/assessment-and-management-of-older-patients-with-delirium-in-acute-settings
#17
Martha Dixon
This article aims to assist nurses and nursing students to consider the presentation of delirium in older patients and the resulting assessment and nursing interventions required. It considers the three types of delirium: hyperactive, hypoactive and mixed. It also discusses potential causes of delirium. Older patients are at increased risk of delirium due to factors such as cognitive impairment, co-morbidities and acute illness. Nurses should be confident in the use of the 4AT score to assess patients with delirium...
May 2, 2018: Nursing Older People
https://www.readbyqxmd.com/read/29706986/prevalence-of-mild-cognitive-impairment-and-dementia-in-saudi-arabia-a-community-based-study
#18
Muath Alkhunizan, Abdullah Alkhenizan, Loay Basudan
Introduction: The age of the population in Saudi Arabia is shifting toward elderly, which can lead to an increased risk of mild cognitive impairment (MCI) and dementia. Objective: The aim of this study is to determine the prevalence of cognitive impairment (MCI and dementia) among elderly patients in a community-based setting in Riyadh, Saudi Arabia. Methods: In this cross-sectional study, we included patients aged 60 years and above who were seen in the Family Medicine Clinics affiliated with King Faisal Specialist Hospital and Research Centre...
January 2018: Dementia and Geriatric Cognitive Disorders Extra
https://www.readbyqxmd.com/read/29699898/an-evaluation-of-single-question-delirium-screening-tools-in-older-emergency-department-patients
#19
Jin H Han, Amanda Wilson, John F Schnelle, Robert S Dittus, E Wesley Ely
OBJECTIVES: To determine the diagnostic performances of several single question delirium screens. To the patient we asked: "Have you had any difficulty thinking clearly lately?" To the patient's surrogate, we asked: "Is the patient at his or her baseline mental status?" and "Have you noticed the patient's mental status fluctuate throughout the course of the day?" METHODS: This was a prospective observational study that enrolled English speaking patients 65 years or older...
March 22, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29699467/nonpharmacologic-and-medication-minimization-strategies-for-the-prevention-and-treatment-of-icu-delirium-a-narrative-review
#20
Gregory J Blair, Talha Mehmood, Mona Rudnick, Ware G Kuschner, Juliana Barr
Delirium is a multifactorial entity, and its understanding continues to evolve. Delirium has been associated with increased morbidity, mortality, length of stay, and cost for hospitalized patients, especially for patients in the intensive care unit (ICU). Recent literature on delirium focuses on specific pharmacologic risk factors and pharmacologic interventions to minimize course and severity of delirium. While medication management clearly plays a role in delirium management, there are a variety of nonpharmacologic interventions, pharmacologic minimization strategies, and protocols that have been recently described...
January 1, 2018: Journal of Intensive Care Medicine
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