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Delirium and cancer

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https://www.readbyqxmd.com/read/28515935/methotrexate-encephalopathy-two-cases-in-adult-cancer-patients-who-recovered-with-pathophysiologically-based-therapy
#1
Shodeinde A Coker, David A Pastel, Melissa C Davis, Elizabeth M Bengtson, Camilo E Fadul, Lionel D Lewis
BACKGROUND/OBJECTIVES: Neurotoxicity is a serious and sometimes fatal adverse effect that can occur following methotrexate treatment. We describe two adult patients with hematological malignancies with methotrexate encephalopathy who recovered with dextromethorphan therapy. RESULTS: Case 1: A 24-year-old male with acute lymphoblastic leukemia developed the acute onset of bilateral facial weakness and slurred speech after his first treatment with high-dose intravenous methotrexate...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28504118/direct-evidence-of-central-nervous-system-axonal-damage-in-patients-with-postoperative-delirium-a-preliminary-study-of-pnf-h-as-a-promising-serum-biomarker
#2
Reo Inoue, Masahiko Sumitani, Toru Ogata, Hirotaka Chikuda, Takehiro Matsubara, So Kato, Nobutake Shimojo, Kanji Uchida, Yoshitsugu Yamada
INTRODUCTION: Approximately 50%-80% patients experience postoperative delirium, an acute cognitive dysfunction associated with prolonged hospitalization, increased mortality, excess healthcare costs, and persistent cognitive impairment. Elucidation of the mechanism of delirium and associated diagnostic and therapeutic measures are urgently required. Here we investigated the role of phosphorylated neurofilament heavy subunit (pNF-H), a major structural protein in axons, as a predictive maker of postoperative delirium...
May 11, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28479415/off-label-medication-use-in-the-inpatient-palliative-care-unit
#3
Jung Hye Kwon, Min Ji Kim, Sebastian Bruera, Minjeong Park, Eduardo Bruera, David Hui
CONTEXT: Although off-label medications are frequently prescribed in palliative care, there are no published studies examining their use in the United States. OBJECTIVES: We examined the frequency of off-label medication use in cancer patients admitted to an acute palliative care unit (APCU). METHODS: This prospective observational study enrolled consecutive patients with advanced cancer admitted to the APCU of a tertiary care cancer center...
May 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28464966/accuracy-of-oncologist-assessments-of-psychiatric-problems-in-cancer-inpatients
#4
Daisuke Yasugi, Hidetaka Tamune, Jitsuki Sawamura, Katsuji Nishimura
OBJECTIVE: Our objective was to examine the accuracy of non-psychiatrist assessments of psychiatric problems in cancer patients. METHOD: We conducted a retrospective chart review of cancer patients who were admitted and referred to the consultation-liaison (C-L) team between January of 2011 and December of 2012. The agreement between non-psychiatrist assessments and final diagnoses by attending C-L psychiatrists was estimated for every category of referral assessment using codes from the International Classification of Mental and Behavioral Disorders (10th revision)...
May 3, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28464962/wernicke-encephalopathy-without-delirium-in-patients-with-cancer
#5
Hideki Onishi, Mayumi Ishida, Iori Tanahashi, Takao Takahashi, Yoshitada Taji, Kenji Ikebuchi, Daisuke Furuya, Tatsuo Akechi
OBJECTIVE: Wernicke encephalopathy (WE) is a neuropsychiatric disorder caused by thiamine deficiency. Several reports of WE in cancer patients are known. WE is sometimes overlooked because most patients do not exhibit its typical symptoms (e.g., delirium, ataxia, ocular palsy). If delirium is not present, a diagnosis of WE is difficult because delirium is the hallmark symptom of WE. METHOD: Taken from a series on WE in cancer, we report two patients who developed WE without delirium during periodic psycho-oncology outpatient visits...
May 3, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28456907/bispectral-index-monitoring-in-cancer-patients-undergoing-palliative-sedation-a-preliminary-report
#6
Edith Monreal-Carrillo, Silvia Allende-Pérez, David Hui, Maria-Fernanda García-Salamanca, Eduardo Bruera, Emma Verástegui
INTRODUCTION: Continuous palliative sedation (PS) is currently titrated based on clinical observation; however, it is often unclear if patients are still aware of their suffering. The aim of this prospective study is to characterize the level of consciousness in patients undergoing PS using Bispectral Index (BIS) monitoring. PATIENTS AND METHODS: We enrolled consecutive patients with refractory symptoms requiring PS. We documented the level of sedation using Ramsay Sedation Scale (RSS) and BIS at 0, 2, 4, 6, 12, and 24 h during the first day of PS and examined their degree of association...
April 29, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28447103/comparison-of-clinical-outcomes-following-head-and-neck-surgery-among-patients-who-contract-to-abstain-from-alcohol-vs-patients-who-abuse-alcohol
#7
Azeem S Kaka, Songzhu Zhao, Enver Ozer, Amit Agrawal, Stephen Kang, James Rocco, Ricardo Carrau, Theodoros Teknos, John D Clapp, Harrison Weed, Matthew O Old
Importance: Alcohol abuse is highly prevalent in the population of patients with head and neck cancer, and active abuse at the time of surgery results in poor postoperative outcomes. Objective: To determine the association of alcohol abstinence with postoperative outcome in alcohol misusers undergoing major surgical procedures of the head and neck. Design, Setting, and Participants: As a case-control study, from July 2013 to August 2015, outcomes were collected in patients at an academic tertiary referral center requiring free flap reconstruction who had undergone an abstinence contract (n = 15) and compared with those who were abusers of alcohol prior to the inception of the protocol (n = 30)...
April 26, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28382266/impact-of-lifestyle-diseases-on-postoperative-complications-and-survival-in-elderly-patients-with-stage-i-non-small-cell-lung-cancer
#8
Sang Seok Jeong, Pil Jo Choi, Jung Hoon Yi, Sung Sil Yoon
BACKGROUND: The influence of lifestyle diseases on postoperative complications and long-term survival in patients with non-small cell lung cancer (NSCLC) is unclear. The aim of this study was to determine whether lifestyle diseases were significant risk factors of perioperative and long-term surgical outcomes in elderly patients with stage I NSCLC. METHODS: Between December 1995 and November 2013, 110 patients aged 65 years or older who underwent surgical resection of stage I NSCLC at Dong-A University Hospital were retrospectively studied...
April 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28379811/predictors-of-delirium-in-corticosteroid-treated-patients-with-advanced-cancer-an-exploratory-multicenter-prospective-observational-study
#9
Naoki Matsuo, Tatsuya Morita, Yoshinobu Matsuda, Kenichiro Okamoto, Yoshihisa Matsumoto, Keisuke Kaneishi, Takuya Odagiri, Hiroki Sakurai, Hideki Katayama, Ichiro Mori, Hirohide Yamada, Hiroaki Watanabe, Taro Yokoyama, Takashi Yamaguchi, Tomohiro Nishi, Akemi Shirado, Shuji Hiramoto, Toshio Watanabe, Hiroyuki Kohara, Satofumi Shimoyama, Etsuko Aruga, Mika Baba, Koki Sumita, Satoru Iwase
BACKGROUND: Corticosteroids are often used to treat fatigue and anorexia, but occasionally produce delirium. Information on the predictors of delirium in corticosteroid-treated cancer patients remains limited. OBJECTIVE: To identify potential factors predicting the development of delirium in corticosteroid-treated cancer patients. DESIGN: An exploratory, multicenter, prospective, observational study. SETTING/SUBJECTS: Inclusion criteria for this study were patients who had metastatic or locally advanced cancer and a fatigue or anorexia intensity score of 4 or more on a 0-10 Numerical Rating Scale...
April 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28379128/-associated-factors-with-the-presence-of-secondary-neoplastic-cells-in-the-cerebrospinal-fluid-of-patients-with-suspected-carcinomatous-meningitis
#10
Fernando Warley, María Belén Binella, Diego Hernan Giunta, Cristina M Elizondo, Bruno Leonel Ferreyro, Lucia Caraballo
BACKGROUND: Improvement in oncologic therapy has increased survival in oncologic patients. There has been a concomitant increase in the incidence of secondary meningeal involvement. Early diagnosis is mandatory. OBJECTIVE: To identify factors associated with the presence of secondary neoplastic cells in cerebrospinal fluid of patients with suspected carcinomatous meningitis (CM) Methods: Cross-sectional study involving adult patients with solid cancer diagnosis and suspected CM between 2004 and 2014 at Hospital Italiano de Buenos Aires...
2017: Revista de la Facultad de Ciencias Médicas
https://www.readbyqxmd.com/read/28378081/laparoscopy-assisted-distal-gastrectomy-is-feasible-also-for-elderly-patients-aged-80-years-and-over-effectiveness-and-long-term-prognosis
#11
Motohira Yoshida, Shigehiro Koga, Kei Ishimaru, Yuji Yamamoto, Yusuke Matsuno, Satoshi Akita, Jun Kuwabara, Kazufumi Tanigawa, Yuji Watanabe
BACKGROUND: Elderly patients usually have concurrent ailments, and the safety and effectiveness of laparoscopy-assisted distal gastrectomy (LADG) for these patients have been controversial. This study aimed to evaluate whether laparoscopy-assisted distal gastrectomy is safe and effective for elderly patients aged 80 years and over, as well as to clarify their long-term prognosis. METHODS: A total of 31 patients aged 80 years and over who underwent LADG in our hospital were retrospectively reviewed...
April 4, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28375046/delirium-assessed-by-memorial-delirium-assessment-scale-in-advanced-cancer-patients-admitted-to-an-acute-palliative-supportive-care-unit
#12
Sebastiano Mercadante, Claudio Adile, Patrizia Ferrera, Andrea Cortegiani, Alessandra Casuccio
BACKGROUND: Delirium is often unrecognized in cancer patients. The aim of this study was to investigate the prevalence of delirium assessed by the Memorial Delirium Assessment Scale (MDAS) and possible associated factors on admission to an acute palliative/supportive care unit (APSCU). The secondary outcome was to assess changes in MDAS and symptom burden at time of discharge. METHODS: A consecutive sample of advanced cancer patients who were admitted to an APSCU was prospectively assessed for a period of 10 months...
May 5, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28334798/risk-factors-for-postoperative-delirium-in-patients-undergoing-major-head-and-neck-cancer-surgery-a-meta-analysis
#13
Yun Zhu, Gangpu Wang, Shengwen Liu, Shanghui Zhou, Ying Lian, Chenping Zhang, Wenjun Yang
Objective: Postoperative delirium is common after extensive surgery. This study aimed to collate and synthesize published literature on risk factors for delirium in patients with head and neck cancer surgery. Methods: Three databases were searched (MEDLINE, Embase, and Cochrane Library) between January 1987 and July 2016. The Newcastle Ottawa Scale (NOS) was adopted to evaluate the study quality. Pooled odds ratios or mean differences for individual risk factors were estimated using the Mantel-Haenszel and inverse-variance methods...
February 24, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28210861/the-effects-of-alcoholism-and-smoking-on-advanced-cancer-patients-admitted-to-an-acute-supportive-palliative-care-unit
#14
Sebastiano Mercadante, Claudio Adile, Patrizia Ferrera, Alessandra Casuccio
AIM: The aim of this prospective study was to determine the characteristics and symptom burden of advanced cancer patients with alcoholism problems and smoking, who were referred to an acute palliative/supportive care unit (ASPCU) of a comprehensive cancer center. METHODS: Patients' characteristics, indications for admission, kind of admission, awareness of prognosis, and anticancer treatments were recorded. The Edmonton Symptom Assessment Scale (ESAS) was used to assess physical and psychological symptoms, and the CAGE questionnaire for the diagnosis of alcoholism...
February 16, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28160834/-observational-study-of-delirium-in-palliative-care
#15
REVIEW
Maryse Mailly, Jean-Pierre Bénézech, Josyane Chevallier-Michaud
Caregivers know that the agitation and movements to reject sheets and clothes is found in some patients with cancer in the palliative phase. An observational study was carried out with the aim of refining the short-term prognosis clinical approach and to organise more suitably adapted care.
February 2017: Revue de L'infirmière
https://www.readbyqxmd.com/read/28160235/characteristics-of-patients-with-an-unplanned-admission-to-an-acute-palliative-care-unit
#16
Sebastiano Mercadante, Claudio Adile, Patrizia Ferrera, Alessandra Casuccio
The aim of this cohort study is to compare the symptom burden of patients who have an unplanned admission to an acute palliative care unit (APCU) with patients who have a regular planned admission. A consecutive sample of advanced cancer patients who were admitted to an APCU was prospectively assessed. The reasons and the kind of admission were recorded (unplanned, UP, or planned, P). Anticancer treatments, whether patients were on/off treatment or uncertain, previous care setting, and who referred the patient to the unit were also recorded...
February 3, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28157431/increased-symptom-expression-among-patients-with-delirium-admitted-to-an-acute-palliative-care-unit
#17
Maxine de la Cruz, Sriram Yennu, Diane Liu, Jimin Wu, Akhila Reddy, Eduardo Bruera
INTRODUCTION: Delirium is the most common neuropsychiatric condition in very ill patients and those at the end of life. Previous case reports found that delirium-induced disinhibition may lead to overexpression of symptoms. It negatively affects communication between patients, family members, and the medical team and can sometimes lead to inappropriate interventions. Better understanding would result in improved care. Our aim was to determine the effect of delirium on the reporting of symptom severity in patients with advanced cancer...
February 3, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28156664/association-between-anti-cholinergic-burden-and-delirium-among-patients-with-advanced-cancer-referred-to-a-palliative-care-consult-service
#18
Joseph Baidoo, Vishidha Reddy Balankari, Jessica Marie Waletich-Flemming, Marvin Delgado-Guay, Jimin Wu, Diane D Liu, Eduardo Bruera
213 Background: Delirium occurs in about 45-60% hospitalized patients and 80-85% at the end of life. Predisposing factors include anti-cholinergic medications as is often cited in the geriatric literature. Our study aimed to demonstrate the association of anti-cholinergic burden and delirium in patients with advanced cancer. METHODS: Retrospective review of 775 consecutive patients seen by the palliative care inpatient consult team. Demographic data, MDAS, ECOG, and anti-cholinergic drugs were determined...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156637/complications-of-intrathecal-pump-therapy-in-malignancy-related-pain
#19
Egidio Del Fabbro
102 Background: Intrathecal pumps (ITP) are used to manage severe malignancy related pain by delivering analgesics directly into the cerebrospinal fluid, in theory allowing for a reduced opioid dose and fewer complications. Although there is literature to support efficacy in patients with cancer, including improved survival, this mode of drug delivery also carries a risk of serious complications. Reports of complications in non-malignant pain suggest the risks and mortality related to ITP may be under-appreciated and that injury and liability occur with both ITP placement and ITP maintenance...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156465/experience-with-palliative-sedation-ps-in-an-inpatient-oncology-setting
#20
Diogo Bugano Diniz Gomes, Pedro Luiz Serrano Uson Junior, Patricia Taranto, Monique Sedlmaier Franca, Daniel Eiger, Rodrigo Coutinho Mariano, David Hui, Auro Del Giglio
63 Background: Palliative sedation (PS) is an intervention to treat refractory symptoms and to relieve suffering at the end of life. Its prevalence and practice patterns vary widely. METHODS: This is a retrospective study of the use of PS in cancer patients who died at our comprehensive cancer center between March 1, 2012 and December 31, 2014. PS was defined as the use of continuous infusion of midazolam or neuroleptics for refractory symptoms as stated in the progress notes. Patients who died in the ICU were excluded...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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