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https://www.readbyqxmd.com/read/28226082/stroke-occurring-in-patients-with-cognitive-impairment-or-dementia
#1
Solène Moulin, Didier Leys
Objective: To determine how pre-stroke cognitive impairment can be detected, its mechanism, and influence on outcome and management. Methods: Literature search. Results: (i) A systematic approach with the Informant Questionnaire of Cognitive Decline in the Elderly is recommended; (ii) Pre-stroke cognitive impairment may be due to brain lesions of vascular, degenerative, or mixed origin; (iii) Patients with pre-stroke dementia, have worse outcomes, more seizures, delirium, and depression, and higher mortality rates; they often need to be institutionalised after their stroke; (iv) Although the safety profile of treatment is not as good as that of cognitively normal patients, the risk:benefit ratio is in favour of treating these patients like others...
February 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28215925/-elderly-patients-and-intensive-care-systematic-review-and-geriatrician-s-point-of-view
#2
H Vallet, B Riou, J Boddaert
The global population is aging and intensive care unit admission rate of elderly patients is dramatically increasing. The objective of this review is to provide an overview of the literature about the management of elderly patients in intensive care unit and more specifically about epidemiology, admission criteria, mortality, functional prognosis and ethical aspects. We also discuss the data on cardiorespiratory arrest, shock, acute respiratory failure and delirium. The mortality rate of patients over 80 years old in intensive care unit can reach up to 70% at 1year, but is dependent on many factors, such as comorbidities or frailty...
February 16, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28214194/orthogeriatric-activity-in-a-general-hospital-of-castilla-la-mancha-spain
#3
J M Fernández-Ibáñez, M C Morales-Ballesteros, E Crespo-Romero, S Gómez-Gómez, M D Fraga-Fuentes, J Cruz-Tejado, P A Hernández-Zegarra, Á Arias-Arias, M M García-Baltasar
AIM: To describe the orthogeriatric activity in the elderly with hip fractures in the Hospital Mancha Centro, based on the recommendations of the main guidelines. MATERIAL AND METHOD: Observational prospective study, comprising all patients over 65 years of age admitted to the Traumatology Unit with a hip fracture between April 2015 and December 2015. Patients were admitted under the care of the Traumatology Unit with cross-consultation carried out with the Geriatrics Department, which then carried out a pre-operative geriatric assessment and the post-operative follow-ups...
February 14, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28212172/cognitive-decline-associated-with-anesthesia-and-surgery-in-the-elderly-does-this-contribute-to-dementia-prevalence
#4
Lisbeth Evered, David A Scott, Brendan Silbert
PURPOSE OF REVIEW: To provide an update on the current state of research investigating the effects of anesthesia and surgery on cognition in the elderly, including consideration of overlap with cognitive disorders in the community. RECENT FINDINGS: The studies reviewed here identify detrimental effects of anesthesia and surgery on cognition in a proportion of elderly individuals. Animal models demonstrate an association between anesthetic agents and Alzheimer's disease pathology...
February 15, 2017: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/28190430/delirium-in-critically-ill-patients
#5
A J C Slooter, R R Van De Leur, I J Zaal
Delirium is common in critically ill patients and associated with increased length of stay in the intensive care unit (ICU) and long-term cognitive impairment. The pathophysiology of delirium has been explained by neuroinflammation, an aberrant stress response, neurotransmitter imbalances, and neuronal network alterations. Delirium develops mostly in vulnerable patients (e.g., elderly and cognitively impaired) in the throes of a critical illness. Delirium is by definition due to an underlying condition and can be identified at ICU admission using prediction models...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28184314/-doc-can-i-fly-to-australia-a-case-report-and-review-of-delirium-following-long-haul-flight
#6
Thomas McCabe
Air travel is now a common feature of most of our elderly population's lives. There is little by way of warnings, rules or recommendations for our patients with psychiatric diagnoses, in particular dementia, who intend to travel by plane, in contrast to other specialties. In this article I highlight an adverse outcome of long-haul air travel as a result of delirium and resulting accelerated decline in overall cognitive function. I review literature related to the topic and suggest ways to minimise precipitating factors for stressors prior to and during flights...
February 2017: BJPsych Bulletin
https://www.readbyqxmd.com/read/28182690/impact-of-dexmedetomidine-on-the-incidence-of-delirium-in-elderly-patients-after-cardiac-surgery-a-randomized-controlled-trial
#7
Xue Li, Jing Yang, Xiao-Lu Nie, Yan Zhang, Xue-Ying Li, Li-Huan Li, Dong-Xin Wang, Daqing Ma
BACKGROUND: Delirium is a frequent complication after cardiac surgery and its occurrence is associated with poor outcomes. The purpose of this study was to investigate the impact of perioperative dexmedetomidine administration on the incidence of delirium in elderly patients after cardiac surgery. METHODS: This randomized, double-blinded, and placebo-controlled trial was conducted in two tertiary hospitals in Beijing between December 1, 2014 and July 19, 2015. Eligible patients were randomized into two groups...
2017: PloS One
https://www.readbyqxmd.com/read/28180239/preoperative-serum-metabolites-are-associated-with-postoperative-delirium-in-elderly-hip-fracture-patients
#8
Yong Guo, Yinan Zhang, Peiyu Jia, Wenying Wang, Quanhong Zhou, Lulu Sun, Aihua Zhao, Xin Zhang, Xuemin Wang, Yingchuan Li, Junfeng Zhang, Wei Jiang
No abstract text is available yet for this article.
February 9, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28178019/effectiveness-of-multi-component-interventions-on-incidence-of-delirium-in-hospitalized-older-patients-with-hip-fracture-a-systematic-review-protocol
#9
Tarandeep Oberai, Lucylynn Lizarondo, Jaarsma Ruurd
The objective of this systematic review is to identify, evaluate and synthesize evidence on the effectiveness of multi-component interventions on the incidence of delirium in hospitalized elderly patients with hip fracture.Specifically, the review question is: In hospitalized older patients with hip fracture, what is the effectiveness of multi-component interventions on the incidence of delirium?
February 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28169890/dementia-and-delirium-in-the-elderly-hospitalized-patient-delirium-is-a-medical-emergency
#10
Michele Paulo, Elizabeth Ann Scruth, Sonya R Jacoby
No abstract text is available yet for this article.
March 2017: Clinical Nurse Specialist CNS
https://www.readbyqxmd.com/read/28164113/nonpharmacological-interventions-targeted-at-delirium-risk-factors-delivered-by-trained-volunteers-medical-and-psychology-students-reduced-need-for-antipsychotic-medications-and-the-length-of-hospital-stay-in-aged-patients-admitted-to-an-acute-internal-medicine
#11
Stanislaw Gorski, Karolina Piotrowicz, Krzysztof Rewiuk, Monika Halicka, Weronika Kalwak, Paulina Rybak, Tomasz Grodzicki
Purpose. Effectiveness of nonpharmacological multicomponent prevention delivered by trained volunteers (medical and psychology students), targeted at delirium risk factors in geriatric inpatients, was assessed at an internal medicine ward in Poland. Patients and Methods. Participants were recruited to intervention and control groups at the internal medicine ward (inclusion criteria: age ≥ 75, acute medical condition, basic orientation, and logical contact on admission; exclusion criteria: life expectancy < 24 hours, surgical hospitalization, isolation due to infectious disease, and discharge to other medical wards)...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28163496/association-of-cognitive-and-noncognitive-symptoms-of-delirium-a-study-from-consultation-liaison-psychiatry-set-up
#12
Sandeep Grover, Aseem Mehra, Subho Chakrabarti, Ajit Avasthi
AIMS: This study aims to evaluate the cognitive functions of patients with delirium using Hindi Mental Status Examination (HMSE), to study the correlation of cognitive functions assessed by HMSE with noncognitive symptoms as assessed using Delirium Rating Scale-Revised 1998 (DRS-R-98) and to study the association of cognitive functions assessed using HMSE and DRS-R98. METHODS: A total of 76 consecutive patients fulfilling the diagnosis of delirium were evaluated on DRS-R-98, HMSE, and Short Informant Questionnaire on Cognitive Decline in the Elderly (retrospective IQCODE)...
December 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28149635/dexmedetomidine-for-prevention-of-delirium-in-elderly-patients-after-non-cardiac-surgery
#13
COMMENT
Elliott A Karren, Adam B King, Christopher G Hughes
No abstract text is available yet for this article.
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28141603/prevention-and-management-of-postoperative-delirium-in-elderly-patients-following-elective-spinal-surgery
#14
Alireza K Nazemi, Anirudh K Gowd, Jonathan J Carmouche, Stephen L Kates, Todd J Albert, Caleb J Behrend
STUDY DESIGN: This study is a systematic review. OBJECTIVE: Propose an evidence-based algorithm for prevention, diagnosis, and management of postoperative delirium in geriatric patients undergoing elective spine surgery. SUMMARY OF BACKGROUND DATA: Delirium is associated with longer stays after elective surgery, increased risk of readmission, and $6.9 billion annually in medical costs. Early diagnosis and treatment of delirium can reduce length of stay (LOS), in-hospital morbidity, and health care costs...
January 30, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28133043/-safety-and-feasibility-of-pancreatic-surgery-for-pancreatic-cancer-in-elderly-patients
#15
Toru Aoyama, Masaaki Murakawa, Keisuke Kazama, Amane Kanazawa, Tetsuta Satoyoshi, Yosuke Atsumi, Yusuke Katayama, Koichiro Yamaoku, Satoshi Kobayashi, Makoto Ueno, Manabu Morimoto, Akio Higuchi, Manabu Shiozawa, Naoto Yamamoto, Takashi Oshima, Norio Yukawa, Takaki Yoshikawa, Yasushi Rino, Munetaka Masuda, Soichiro Morinaga
PURPOSE: This study aimed to evaluate the safety and feasibility of pancreatic surgery for pancreatic cancer in elderly patients. PATIENTS AND METHODS: In total, 9 patients underwent pancreatic surgery for pancreatic cancer between April 2005 and March 2014. The surgical complications were evaluated by Clavien-Dindo classification. RESULTS: The median operating time was 420(range: 354-503)min and the median blood loss was 640(range: 350-1,170)mL...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28120023/-help-hospital-elder-life-program-multimodal-delirium-prevention-in-elderly-patients
#16
K Singler, C Thomas
Delirium in older adults is associated with an increased risk for cognitive and functional decline. Multiple risk factors, such as underlying dementia, multiple comorbidities, anticholinergic medication or visual and hearing impairment foster the incidence of delirium. By identification of patients at risk and the initiation of a multiple component delirium prevention program delirium is preventable in 30-40% of all cases. There is broad evidence for comprehensive multicomponent delirium prevention strategies in patient care, but their implementation is still lacking in many hospitals...
February 2017: Der Internist
https://www.readbyqxmd.com/read/28116342/subsyndromal-delirium-compared-with-delirium-dementia-and-subjects-without-delirium-or-dementia-in-elderly-general-hospital-admissions-and-nursing-home-residents
#17
Esteban Sepulveda, Maeve Leonard, Jose G Franco, Dimitrios Adamis, Geraldine McCarthy, Colum Dunne, Paula T Trzepacz, Ana M Gaviria, Joan de Pablo, Elisabet Vilella, David J Meagher
INTRODUCTION: Subsyndromal delirium (SSD) complicates diagnosis of delirium and dementia, although there is little research comparing their symptom profiles. METHODS: Cross-sectional study of 400 elderly patients' admission to a general hospital or nursing home diagnosed with delirium, SSD, dementia, or no-delirium/no-dementia (NDND). Symptom profiles were assessed using the Delirium Rating Scale-Revised-98 (DRS-R98). RESULTS: Twenty percent patients had delirium, 19...
2017: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring
https://www.readbyqxmd.com/read/28110901/-gastrointestinal-bleeding-and-delirium-challenges-in-the-diagnosis-of-gallstone-ileus-a-case-report-and-review-of-literature
#18
Francisco Aguilar-Espinosa, José Luis Gálvez-Romero, Jesús Falfán-Moreno, Gustavo Adolfo Guerrero-Martínez, Facundo Vargas-Solís
BACKGROUND: Gallstone ileus is a non-strangulated mechanical obstruction of the small bowel or colon as a result of the passage of gallstones through a biliary enteric fistula. It is a rare complication of cholelithiasis, affects patients over 65 years, and the disease occurs predominantly in females. Preoperative diagnosis is difficult due to the lack of specific signs and symptoms in elderly patients with multiple comorbidities. CLINICAL CASE: A 93-year-old female presenting with a one-week history of upper gastrointestinal bleeding, electrolyte imbalance and community- acquired pneumonia pneumonia...
January 19, 2017: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/28101764/diazepam-in-the-treatment-of-moderate-to-severe-alcohol-withdrawal
#19
Steven J Weintraub
Benzodiazepines ameliorate or prevent the symptoms and complications of moderate to severe alcohol withdrawal, which can include autonomic hyperactivity, agitation, combativeness, hallucinations, seizures, delirium, and death. The benzodiazepines most commonly used for this purpose are lorazepam, chlordiazepoxide, oxazepam, and diazepam. It is widely asserted that no member of this group is superior to the others for treatment of alcohol withdrawal. However, of these, diazepam has the shortest time to peak effect, which facilitates both rapid control of symptoms and accurate titration to avoid over-sedation...
January 18, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28096832/perioperative-care-in-elderly-cardiac-surgery-patients
#20
Ewa Kucewicz-Czech, Katarzyna Kiecak, Ewa Urbańska, Tomasz Maciejewski, Robert Kaliś, Waldemar Pakosiewicz, Tadeusz Kołodziej, Piotr Knapik, Roman Przybylski, Marian Zembala
INTRODUCTION: Surgery is an extreme physiological stress for the elderly. Aging is inevitably associated with irreversible and progressive cellular degeneration. Patients above 75 years of age are characterized by impaired responses to operative stress and a very narrow safety margin. AIM: To evaluate perioperative complications in patients aged ≥ 75 years who underwent cardiac surgery in comparison to outcomes in younger patients. MATERIAL AND METHODS: The study was conducted at the Silesian Centre for Heart Diseases in Zabrze in 2009-2014 after a standard of perioperative care in seniors was implemented to reduce complications, in particular to decrease the duration of mechanical ventilation and reduce postoperative delirium...
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
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