keyword
https://read.qxmd.com/read/38357643/evaluating-early-lymphocyte-to-monocyte-ratio-as-a-predictive-biomarker-for-delirium-in-older-adult-patients-with-sepsis-insights-from-a-retrospective-cohort-analysis
#21
JOURNAL ARTICLE
Xiaopeng Shi, Lei Yang, Weimin Bai, Lijuan Jing, Lijie Qin
BACKGROUND: This study aims to explore the value of the Lymphocyte-to-Monocyte Ratio (LMR) in predicting delirium among older adult patients with sepsis. METHODS: Retrospective data were obtained from the MIMIC-IV database in accordance with the STROBE guidelines. Patients aged 65 and above, meeting the Sepsis 3.0 criteria, were selected for this study. Delirium was assessed using the Confusion Assessment Method for the ICU (CAM-ICU). Demographic information, comorbid conditions, severity of illness scores, vital sign measurements, and laboratory test results were meticulously extracted...
2024: Frontiers in Medicine
https://read.qxmd.com/read/38355071/comparison-of-pharmacological-treatments-for-agitated-delirium-in-the-last-days-of-life
#22
JOURNAL ARTICLE
Natsuki Kawashima, Naosuke Yokomichi, Tatsuya Morita, Ritsuko Yabuki, Takayuki Hisanaga, Kengo Imai, Yumi Hirose, Miho Shimokawa, Satoru Miwa, Toshihiro Yamauchi, Soichiro Okamoto, Eriko Satomi
CONTEXT: Antipsychotics are often used in managing symptoms of terminal delirium, but evidence is limited. OBJECTIVES: To explore the comparative effectiveness of haloperidol with as-needed benzodiazepines (HPD) vs. chlorpromazine (CPZ) vs. levomepromazine (LPZ) for agitated delirium in the last days. METHODS: A prospective observational study was conducted in two palliative care units in Japan. Adult cancer patients who developed agitated delirium with a modified Richmond Agitation-Sedation Scale (RASS-PAL) of one or more were included; palliative care specialist physicians determined that the etiology was irreversible; and estimated survival was 3 weeks or less...
February 12, 2024: Journal of Pain and Symptom Management
https://read.qxmd.com/read/38353680/valve-unit-instead-of-intensive-or-intermediate-care-unit-admission-following-transcatheter-edge-to-edge-mitral-valve-repair-is-safe-and-reduces-postprocedural-complications
#23
JOURNAL ARTICLE
Matthias Gröger, Dominik Felbel, Michael Paukovitsch, Leonhard Moritz Schneider, Sinisa Markovic, Wolfgang Rottbauer, Mirjam Keßler
BACKGROUND: Transcatheter edge-to-edge mitral valve repair (M-TEER) is often performed in general anesthesia, and postprocedural monitoring is usually warranted on an intensive or intermediate care unit (ICU/IMC). We evaluated the implications of a dedicated valve unit (VU) instead of an ICU/IMC for monitoring after M-TEER. METHODS AND RESULTS: In total, 624 patients were retrospectively analyzed. A total of 312 patients were primarily transferred to either ICU or IMC following M-TEER, and 312 patients were scheduled for the VU in the absence of indications for ICU/IMC treatment...
February 14, 2024: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://read.qxmd.com/read/38350730/intensive-care-unit-interventions-to-promote-sleep-and-circadian-biology-in-reducing-incident-delirium-a-scoping-review
#24
REVIEW
M Elizabeth Wilcox, Lisa Burry, Marina Englesakis, Briar Coman, Marietou Daou, Frank Mp van Haren, E Wes Ely, Karen J Bosma, Melissa P Knauert
RATIONALE/OBJECTIVES: Despite plausible pathophysiological mechanisms, research is needed to confirm the relationship between sleep, circadian rhythm and delirium in patients admitted to the intensive care unit (ICU). The objective of this review is to summarise existing studies promoting, in whole or in part, the normalisation of sleep and circadian biology and their impact on the incidence, prevalence, duration and/or severity of delirium in ICU. METHODS: A sensitive search of electronic databases and conference proceedings was completed in March 2023...
February 13, 2024: Thorax
https://read.qxmd.com/read/38348284/the-delphi-delirium-management-algorithms-a-practical-tool-for-clinicians-the-result-of-a-modified-delphi-expert-consensus-approach
#25
JOURNAL ARTICLE
Thomas H Ottens, Carsten Hermes, Valerie Page, Mark Oldham, Rakesh Arora, O Joseph Bienvenu, Mark van den Boogaard, Gideon Caplan, John W Devlin, Michaela-Elena Friedrich, Willem A van Gool, James Hanison, Hans-Christian Hansen, Sharon K Inouye, Barbara Kamholz, Katarzyna Kotfis, Matthew B Maas, Alasdair M J MacLullich, Edward R Marcantonio, Alessandro Morandi, Barbara C van Munster, Ursula Müller-Werdan, Alessandra Negro, Karin J Neufeld, Peter Nydahl, Esther S Oh, Pratik Pandharipande, Finn M Radtke, Sylvie De Raedt, Lisa J Rosenthal, Robert Sanders, Claudia D Spies, Emma R L C Vardy, Eelco F Wijdicks, Arjen J C Slooter
Delirium is common in hospitalised patients, and there is currently no specific treatment. Identifying and treating underlying somatic causes of delirium is the first priority once delirium is diagnosed. Several international guidelines provide clinicians with an evidence-based approach to screening, diagnosis and symptomatic treatment. However, current guidelines do not offer a structured approach to identification of underlying causes. A panel of 37 internationally recognised delirium experts from diverse medical backgrounds worked together in a modified Delphi approach via an online platform...
2024: Delirium (Bielef)
https://read.qxmd.com/read/38342753/delirium-is-frequently-underdiagnosed-among-older-hospitalised-patients-despite-available-information-in-hospital-medical-records
#26
JOURNAL ARTICLE
Irit Titlestad, Kristoffer Haugarvoll, Stein-Erik H Solvang, Tone Merete Norekvål, Ragnhild E Skogseth, Ole A Andreassen, Dag Årsland, Bjørn Erik Neerland, Jan Erik Nordrehaug, Grethe S Tell, Lasse M Giil
BACKGROUND: In-hospital delirium is associated with adverse outcomes and is underdiagnosed, limiting research and clinical follow-up. OBJECTIVE: To compare the incidence of in-hospital delirium determined by chart-based review of electronic medical records (D-CBR) with delirium discharge diagnoses (D-DD). Furthermore, to identify differences in symptoms, treatments and delirium triggers between D-CBR and D-DD. METHOD: The community-based cohort included 2,115 participants in the Hordaland Health Study born between 1925 and 1927...
February 1, 2024: Age and Ageing
https://read.qxmd.com/read/38335445/successful-management-of-terminal-delirium-with-transdermal-blonanserin-patch-in-a-terminally-ill-cancer-patient
#27
JOURNAL ARTICLE
Hideyuki Nishiofuku, Masanori Mori, Naosuke Yokomichi, Yumi Sakuma, Koichi Sugiyama, Yoshiaki Takashina, Akemi Miyagi, Masato Ishizuka, Kengo Imai, Tatsuya Morita
Delirium is a distressing condition in terminally ill cancer patients, often treated with antipsychotics. Administering them orally, subcutaneously, or intravenously can be challenging in severely agitated patients. Transdermal antipsychotic patches offer an alternative, but their use for terminal delirium remains underexplored. We present the case of a 73-year-old man with advanced diffuse large B cell lymphoma who developed severe mixed delirium during third-line chemotherapy. Nonpharmacological interventions and oral risperidone plus intravenous haloperidol failed to improve his condition...
February 9, 2024: Journal of Palliative Medicine
https://read.qxmd.com/read/38335150/the-association-of-preoperative-diabetes-with-postoperative-delirium-in-older-patients-undergoing-major-orthopedic-surgery-a-prospective-matched-cohort-study
#28
JOURNAL ARTICLE
Zixiang Shang, Yu Jiang, Panpan Fang, Wenjie Zhu, Jiaxin Guo, Lili Li, Yongjie Liang, Sichen Zhang, Shenglan Ma, Bin Mei, Yinguang Fan, Zhongcong Xie, Qiying Shen, Xuesheng Liu
BACKGROUND: Postoperative delirium (POD) is a common form of postoperative brain dysfunction, especially in the elderly. However, its risk factors remain largely to be determined. This study aimed to investigate whether (1) preoperative diabetes is associated with POD after elective orthopedic surgery and (2) intraoperative frontal alpha power is a mediator of the association between preoperative diabetes and POD. METHODS: This was a prospective matched cohort study of patients aged 60 years or more, with a preoperative diabetes who underwent elective orthopedic surgery...
February 9, 2024: Anesthesia and Analgesia
https://read.qxmd.com/read/38321514/spanish-transcultural-adaptation-of-the-4at-score-for-the-evaluation-of-delirium-in-the-emergency-department-a-prospective-diagnostic-test-accuracy-study
#29
JOURNAL ARTICLE
Marta Morales-Puerto, María Ruiz-Díaz, Silvia García-Mayor, Álvaro León-Campos, José Miguel Morales-Asencio, José Carlos Canca-Sánchez, Sonia Gavira-Guerra, Cecilia Toledo-Fernandez, Marta Aranda-Gallardo
BACKGROUND: Delirium is one of the most common adverse events in older people during hospitalization, especially in the emergency department. Reliable, easy-to-use instruments are necessary to properly manage delirium in this setting. This study aims to evaluate the diagnostic validity of the Spanish version of the 4 'A's Test (4AT) in the ED. METHODS: A diagnostic accuracy study was conducted in patients over 65 years old admitted to the Emergency Department who did not have a formal diagnosis of dementia or a severe mental health disorder...
February 6, 2024: BMC Nursing
https://read.qxmd.com/read/38321383/perioperative-point-of-care-testing-of-plasmacholinesterases-identifies-older-patients-at-risk-for-postoperative-delirium-an-observational-prospective-cohort-study
#30
JOURNAL ARTICLE
Matthias S Gruendel, Wibke Brenneisen, Jakob Wollborn, Gerrit Haaker, Melanie Meersch, Simone Gurlit, Ulrich Goebel
BACKGROUND: Postoperative delirium (POD) is a severe perioperative complication that may increase mortality and length-of-stay in older patients. Moreover, POD is a major economic burden to any healthcare system. An altered expression of Acetylcholine- and Butyrylcholinesterases (AChE, BuChE) due to an unbalanced neuroinflammatory response to trauma or an operative stimulus has been reported to play an essential role in the development of POD. We investigated if perioperative measurement of cholinesterases (ChEs) can help identifying patients at risk for the occurrence of POD in both, scheduled and emergency surgery patients...
February 6, 2024: BMC Geriatrics
https://read.qxmd.com/read/38316720/delirium-is-not-dementia-delirium-awareness-day-related-event-at-the-university-hospital-in-krakow
#31
JOURNAL ARTICLE
Wiktoria Wieczorek-Stawińska, Monika Ryś, Ian Perera, Anna Rudzińska, Barbara Gryglewska, Jerzy Gąsowski, Karolina Piotrowicz
PURPOSE: To present the two-day Delirium Awareness Day-related event held at the University Hospital, Kraków, Poland. METHODS: Activities included a lecture, a multimedia presentation, meetings with healthcare workers at their respective wards, and distribution of information posters about delirium. Local news outlets were also engaged. RESULTS: We reached out to approximately 300 persons in the hospital itself and several thousand via TV and radio broadcasts...
February 6, 2024: European Geriatric Medicine
https://read.qxmd.com/read/38314872/poor-olfaction-prior-to-cardiac-surgery-association-with-cognition-plasma-neurofilament-light-and-post-operative-delirium
#32
JOURNAL ARTICLE
Vidyulata Kamath, Lisa R Yanek, Karin J Neufeld, Alexandria Lewis, Hamza Aziz, Lan M Le, Jing Tian, Abhay Moghekar, Charles W Hogue, Charles H Brown
OBJECTIVES: Post-operative delirium (POD) affects up to 50% of cardiac surgery patients, with higher incidence in older adults. There is increasing need for screening tools that identify individuals most vulnerable to POD. Here, we examined the relationship between pre-operative olfaction and both incident POD and POD severity in patients undergoing cardiac surgery. We also examined cross-sectional relationships between baseline olfaction, cognition, and plasma neurofilament light (NfL)...
February 2024: International Journal of Geriatric Psychiatry
https://read.qxmd.com/read/38314508/hemichorea-hemiballismus-associated-with-a-case-of-cerebral-toxoplasmosis-in-a-hematopoietic-stem-cell-transplant-recipient
#33
JOURNAL ARTICLE
Xiomara Rocha-Cadman, Amanda R Revilla, Karla Cadman, James C Root
Due to their immunocompromised state, recipients of hematopoietic stem cell transplants (HSCTs) are at a higher risk of opportunistic infections, such as that of toxoplasmosis. Toxoplasmosis is a rare but mortal infection that can cause severe neurological symptoms, including confusion. In immunosuppressed individuals, such as those with acquired immunodeficiency syndrome (AIDS), toxoplasmosis can cause movement disorders, including hemichorea-hemiballismus. We present the case of a 54-year-old Caucasian male with a history of hypertension and JAK-2-negative primary myelofibrosis who underwent an allogeneic peripheral blood stem cell transplant from a related donor...
February 5, 2024: Palliative & Supportive Care
https://read.qxmd.com/read/38313939/patients-dreams-and-unreal-experiences-during-intensive-care-unit-icu-hospitalization
#34
REVIEW
Konstantina Dimou, Agapi L Batiridou, Fotios Tatsis, Spiros Georgakis, Zoe Konstanti, Georgios Papathanakos, Stefanos Mantzoukas, Elena Dragioti, Mary Gouva, Vasilios Koulouras
In the intensive care unit (ICU), patients often experience fragmented memories, primarily comprising dreams and illusions. These experiences can impact psychosocial well-being, correlating with post-traumatic stress symptoms and heightened anxiety. Understanding these phenomena is crucial for holistic care. To systematically explore patients' perspectives concerning the recollection of dreams and unreal encounters during their stay in the ICU, considering pertinent clinical conditions and potential influencing factors, we conducted a comprehensive search in the PubMed/MEDLINE, Web of Science, and Scopus databases until November 20, 2023, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
January 2024: Curēus
https://read.qxmd.com/read/38310893/infection-delirium-and-risk-of-dementia-in-patients-with-and-without-white-matter-disease-on-previous-brain-imaging-a-population-based-study
#35
JOURNAL ARTICLE
Sarah T Pendlebury, Ramon Luengo-Fernandez, Anna Seeley, Matthew B Downer, Aubretia McColl, Peter M Rothwell
BACKGROUND: The increased risk of dementia after delirium and infection might be influenced by cerebral white matter disease (WMD). In patients with transient ischaemic attack (TIA) and minor stroke, we assessed associations between hospital admissions with delirium and 5-year dementia risk and between admissions with infection and dementia risk, stratified by WMD severity (moderate or severe vs absent or mild) on baseline brain imaging. METHODS: We included patients with TIA and minor stroke (National Institutes of Health Stroke Score <3) from the Oxford Vascular Study (OXVASC), a longitudinal population-based study of the incidence and outcomes of acute vascular events in a population of 94 567 individuals, with no age restrictions, attending eight general practices in Oxfordshire, UK...
February 2024: The Lancet. Healthy longevity
https://read.qxmd.com/read/38306585/mixed-methods-study-of-end-of-life-experiences-of-patients-with-hematologic-malignancies-in-social-hospice-residential-home-care-settings
#36
JOURNAL ARTICLE
Carol S Weisse, Kelly Melekis, Alice Cheng, Anuja Keerthi Konda, Ajay Major
PURPOSE: Hospice is underutilized by patients with hematologic malignancies (HM), and when patients are referred, they are typically more ill, hospitalized, and with shorter length of stay (LOS) than patients with solid tumors (ST), limiting research about home hospice care experiences of patients with HM. In this mixed-methods study, we examined the hospice experiences of patients with HM who died at residential care homes (RCHs), home-based settings in which volunteer caregivers and hospice staff provide end-of-life (EOL) care under the social hospice model...
February 2, 2024: JCO oncology practice
https://read.qxmd.com/read/38304570/decreasing-the-incidence-of-delirium-via-multi-sensory-stimulation-in-patients-receiving-mechanical-ventilation-in-the-intensive-care-unit-a-protocol-for-a-randomized-feasibility-study
#37
JOURNAL ARTICLE
Bin He, Bei-Rong Mo, Si-Ya Meng, Zheng Yang, Wen-Ting Liu, Yu-Ying Wang, Xiao-Ling Mou, Yu-Qi Chen, Yu Chen
INTRODUCTION: Delirium is a common acute brain dysfunction syndrome in patients admitted to intensive care units (ICUs). Family engagement strategies, based on the theory of multi-sensory stimulation to ameliorate sensory deprivation in patients, may be an effective and scalable method to reduce the burden of delirium. METHODS: /design: This is a assessor-blinded, randomised controlled trial of the feasibility of multi-sensory stimulation (MS) in patients with delirium...
April 2024: Contemporary Clinical Trials Communications
https://read.qxmd.com/read/38302876/case-report-a-unique-presentation-of-memantine-overdose-causing-echolalia-and-hypertension
#38
JOURNAL ARTICLE
Sana Durrani, Shaista Ahmed
BACKGROUND: Since 2003 when memantine was first approved for use in the management of moderate-severe Alzheimer's dementia, its use has become more widespread and is being explored in other diseases like neuropathic pain, epilepsy, and mood disorders. Our case uniquely highlights two important adverse effects in a patient who overdosed on memantine. One is hypertension, which is easy to overlook as a medication side effect. The other is echolalia which is the repetition of words and phrases spoken by another person...
February 1, 2024: BMC Geriatrics
https://read.qxmd.com/read/38301387/performance-and-validation-of-two-icu-delirium-assessment-and-severity-tools-a-prospective-observational-study
#39
JOURNAL ARTICLE
Mark van den Boogaard, Margot Leenders, Monica Pop-Purceleanu, Bram Tilburgs
BACKGROUND: The clinical statistical performance of the Confusion Assessment Method Intensive Care Unit (CAM-ICU, including CAM-ICU-7) and Intensive Care Delirium Screening Checklist (ICDSC) have rarely been studied. Additionally, delirium severity is often not measured due to a lack of validation of delirium assessment tools. OBJECTIVE: The aim was to determine the statistical performance of both delirium assessment tools in daily practice, and the correlation with the gold standard Delirium Rating Scale (DRS)-R98, for delirium severity...
January 31, 2024: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://read.qxmd.com/read/38300249/successful-treatment-of-severe-alcohol-withdrawal-delirium-with-very-high-dose-diazepam-260-480%C3%A2-mg-administration
#40
JOURNAL ARTICLE
Şükrü Alperen Korkmaz, Ebru Aldemir, Demet Güleç Öyekçin
Introduction: Alcohol withdrawal delirium, commonly known as "delirium tremens (DT)", is the most severe clinical condition of alcohol withdrawal syndrome (AWS). Symptoms of DT include changes in consciousness and cognitive and perceptual impairments that fluctuate during the day. Treatment includes general support, such as helping the patient to re-orientate, close monitoring of vital signs and adequate hydration, and symptomatic treatment for agitation, autonomic instability, and hallucinations. In symptomatic treatment of DT, benzodiazepines are most commonly preferred due to their GABA-ergic effects...
February 1, 2024: Current Medical Research and Opinion
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