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Delirium

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https://www.readbyqxmd.com/read/28431424/sleep-disordered-breathing-postoperative-delirium-and-cognitive-impairment
#1
Enoch W K Lam, Frances Chung, Jean Wong
Sleep-disordered breathing (SDB) is highly prevalent in the general population and has been associated with cognitive impairment in older individuals. Delirium is an acute decline in cognitive function and attention that often occurs after surgery, especially in older individuals. Several recent studies suggest an association between SDB and postoperative delirium. The aim of this systematic review is to examine the current literature on SDB, postoperative delirium, and cognitive impairment and to discuss the pathophysiology and perioperative considerations...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28430755/differentiating-delirium-from-sedative-hypnotic-related-iatrogenic-withdrawal-syndrome-lack-of-specificity-in-pediatric-critical-care-assessment-tools
#2
Kate Madden, Michele M Burns, Robert C Tasker
OBJECTIVES: To identify available assessment tools for sedative/hypnotic iatrogenic withdrawal syndrome and delirium in PICU patients, the evidence supporting their use, and describe areas of overlap between the components of these tools and the symptoms of anticholinergic burden in children. DATA SOURCES: Studies were identified using PubMed and EMBASE from the earliest available date until July 3, 2016, using a combination of MeSH terms "delirium," "substance withdrawal syndrome," and key words "opioids," "benzodiazepines," "critical illness," "ICU," and "intensive care...
April 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28421731/intraoperative-dexmedetomidine-sedation-reduces-the-postoperative-agitated-behaviour-in-elderly-patients-undergoing-orthopaedic-surgery-compared-to-the-propofol-sedation-a-retrospective-analysis-of-855-patients
#3
Hyun-Jung Shin, Bon-Wook Koo, Seung-Uk Bang, Jin-Hee Kim, Jung-Won Hwang, Sang-Hwan DO, Hyo-Seok Na
BACKGROUND: Postoperative agitation or confusion is one of the symptoms of hyperactive delirium in elderly patients. We retrospectively evaluated the incidence of postoperative abnormal psychomotor behaviour in elderly surgical patients according to the use of different intraoperative sedative agents: dexmedetomidine vs. propofol. METHODS: The medical records of 855 elderly patients, who underwent orthopaedic surgery with regional anaesthesia between July 2012 and September 2015, were divided into two groups-the dexmedetomidine group (n=263) and the propofol group (n=592)-and evaluated...
April 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28420470/-explore-objective-clinical-variables-for-detecting-delirium-in-icu-patients-a-prospective-case-control-study
#4
Xiaojiang Liu, Jie Lyu, Youzhong An
OBJECTIVE: The aim of this case-control study is to explore clinical objective variables for diagnosing delirium of intensive care unit (ICU) patients. METHODS: According to the method of prospective case-control study, critical adult postoperative patients who were transferred to ICU of Peking University People's Hospital from October 2015 to May 2016 and needed mechanical ventilation were included. After evaluating the Richmond agitation sedation scale score (RASS), the patients whose score were -2 or greater were sorted into two groups, delirium and non-delirium, according to the confusion assessment method for the ICU (CAM-ICU)...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28413088/a-retrospective-analysis-of-neurocognitive-impairment-in-older-patients-with-burn-injuries
#5
Emily G Holmes, Samuel W Jones, Sarah L Laughon
BACKGROUND: Older adults comprise a growing proportion of the United States population that is at risk for burns. However, few studies have examined cognitive function in this patient population. OBJECTIVE: The purpose of this study was to measure the prevalence and incidence of dementia and delirium in older adults admitted for burn injuries. METHODS: This was an Institutional Review Board-approved, retrospective study of all patients 65 years and older admitted to the University of North Carolina Jaycee Burn Center from 2005-2015...
March 6, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28412481/environmental-and-clinical-risk-factors-for-delirium-in-a-neurosurgical-center-a-prospective-study
#6
Fumihiro Matano, Takayuki Mizunari, Keiko Yamada, Shiro Kobayashi, Yasuo Murai, Akio Morita
INTRODUCTION: Few reports of delirium-related risk factors have focused on environmental risk factors and clinical risk factors, such as white matter signal abnormalities on magnetic resonance imaging (MRI) FLAIR images. MATERIAL & METHODS: We prospectively enrolled 253 patients admitted to our neurosurgical center between December 2014 and June 2015 and analyzed a total of 220 patients (100 males; mean age, 64.1 years; age range, 17-92 years). The upper 4 points of the Intensive Care Delirium Screening Checklist (ICDSC) indicated delirium...
April 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28411290/prognosticating-with-the-hospitalized-patient-1-year-mortality-risk-score-using-information-abstracted-from-the-medical-record
#7
Genevieve Casey, Carl van Walraven
BACKGROUND: Predicting death risk in patients with diverse conditions is difficult. The Hospitalized-patient One-year Mortality Risk (HOMR) score accurately determines death risk in adults admitted to hospital using health administrative data unavailable to clinicians and most researchers. OBJECTIVE: Determine if HOMR is valid when calculated using data abstracted directly from the medical record. DESIGN: Medical record review linked to population-based administrative data...
April 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28410450/delirium-use-antipsychotics-when-appropriate-and-appropriately
#8
Jeremy M Hirst, Christina L Vaughan, Scott A Irwin
No abstract text is available yet for this article.
April 14, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28410314/times-are-changing-in-pediatric-delirium
#9
Laura A Watkins
No abstract text is available yet for this article.
May 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28410275/implementation-of-an-icu-bundle-an-interprofessional-quality-improvement-project-to-enhance-delirium-management-and-monitor-delirium-prevalence-in-a-single-picu
#10
Shari Simone, Sarah Edwards, Allison Lardieri, L Kyle Walker, Ana Lia Graciano, Omayma A Kishk, Jason W Custer
OBJECTIVES: To examine the impact of an ICU bundle on delirium screening and prevalence and describe characteristics of delirium cases. DESIGN: Quality improvement project with prospective observational analysis. SETTING: Nineteen-bed PICU in an urban academic medical center. PATIENTS: All consecutive patients admitted from December 1, 2013, to September 30, 2015. INTERVENTIONS: A multidisciplinary team implemented an ICU bundle consisting of three clinical protocols: delirium, sedation, and early mobilization using the Plan-Do-Study-Act cycles as part of a quality improvement project...
April 13, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28410038/critical-care-nurses-knowledge-and-practice-of-delirium-assessment
#11
Gabby Rowley-Conwy
AIMS: The aim of this study was to examine perceived barriers to assessment of delirium for critical care nurses, and the impact of education on their knowledge and practice. BACKGROUND: Delirium is a significant problem in critical care, leading to increased morbidity and mortality. Many authors have found variations in assessment by critical care nurses, but there has been limited analysis of the reasons for this. Education on the topic improves knowledge and practice, but the best approach has not been examined...
April 13, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28407199/comprehensive-geriatric-assessment-for-prevention-of-delirium-after-hip-fracture-a-systematic-review-of-randomized-controlled-trials
#12
Lynn Shields, Victoria Henderson, Robert Caslake
OBJECTIVES: To assess the efficacy of comprehensive geriatric assessment (CGA) in prevention of delirium after hip fracture. DESIGN: Systematic review and metaanalysis. SETTING: Ward based models on geriatrics wards and visiting team based models on orthopaedics wards were included. PARTICIPANTS: Four trials (three European, one U.S.; 973 participants) were identified. Two assessed ward-based, and two assessed team-based interventions...
April 13, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28406727/the-experience-of-patients-with-alcohol-misuse-after-surviving-a-critical-illness-a-qualitative-study
#13
Brendan J Clark, Jacqueline Jones, K Diandra Reed, Rachel Marie Hodapp, Ivor S Douglas, David Van Pelt, Ellen L Burnham, Marc Moss
RATIONALE: Alcohol misuse is common in patients admitted to the intensive care unit (ICU) but there is currently no evidence-based approach to address drinking in ICU survivors. OBJECTIVES: We sought to describe the experience of ICU survivors with alcohol misuse during their hospitalization and the 3 months following hospital discharge in order to inform an alcohol specific intervention for this unique population. METHODS: We conducted a descriptive qualitative study of ICU survivors from medical ICUs in three separate hospitals with a positive screening result on the Alcohol Use Disorders Identification Test...
April 13, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28405945/the-comparative-risk-of-delirium-with-different-opioids-a-systematic-review
#14
REVIEW
Lieke M Swart, Vera van der Zanden, Petra E Spies, Sophia E de Rooij, Barbara C van Munster
OBJECTIVE: There is substantial evidence that the use of opioids increases the risk of adverse outcomes such as delirium, but whether this risk differs between the various opioids remains controversial. In this systematic review, we evaluate and discuss possible differences in the risk of delirium from the use of various types of opioids in older patients. METHODS: We performed a search in MEDLINE by combining search terms on delirium and opioids. A specific search filter for use in geriatric medicine was used...
April 12, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28402867/functional-connectivity-and-network-analysis-during-hypoactive-delirium-and-recovery-from-anesthesia
#15
Tianne Numan, Arjen J C Slooter, Arendina W van der Kooi, Annemieke M L Hoekman, Willem J L Suyker, Cornelis J Stam, Edwin van Dellen
OBJECTIVE: To gain insight in the underlying mechanism of reduced levels of consciousness due to hypoactive delirium versus recovery from anesthesia, we studied functional connectivity and network topology using electroencephalography (EEG). METHODS: EEG recordings were performed in age and sex-matched patients with hypoactive delirium (n=18), patients recovering from anesthesia (n=20), and non-delirious control patients (n=20), all after cardiac surgery. Functional and directed connectivity were studied with phase lag index and directed phase transfer entropy...
March 6, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28401613/implementing-augmentative-and-alternative-communication-in-critical-care-settings-perspectives-of-healthcare-professionals
#16
Charlotte Handberg, Anna Katarina Voss
AIM: The aim of the current study was to describe the perspectives of healthcare professionals caring for intubated patients on implementing Augmentative and Alternative Communication (AAC) in critical care settings. BACKGROUND: Patients in critical care settings subjected to endotracheal intubation suffer from a temporary functional speech disorder and can also experience anxiety, stress and delirium, leading to longer and more complicated hospitalization and rehabilitation...
April 12, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28400963/psychiatry-and-the-geriatric-syndromes-creating-constructive-interfaces
#17
EDITORIAL
Simon Thacker, Mike Skelton, Rowan Harwood
Integrating mental and physical healthcare is difficult to achieve because of professional and organisational barriers. Psychiatrists recognise the problems resulting from fragmentation of services and want continuity of care for patients, but commissioning and service structures perpetuate these problems. One way forward may be to follow the syndromic model employed by geriatricians as a means of avoiding over-emphasis on diagnosis above the pragmatics of implementing multi-component, coordinated care. Commissioners need to be made aware of the overlap and complementarity of skills possessed by old age psychiatry and geriatric medicine to create joint services for people vulnerable to dementia and delirium...
April 2017: BJPsych Bulletin
https://www.readbyqxmd.com/read/28399089/-the-topical-problems-of-the-application-of-the-taser-electroshock-devices
#18
I V Kondratova, K Yu Kulinkovich
The objective of the present study was the analysis of publications in the foreign medical literature concerning the problems of safety, clinical diagnostics, pathological morphology, and treatment of the patients subjected to the impact by various models of the TASER electroshock devices. The materials for this article were borrowed from the available Internet resources and libraries. The methods of scientific analysis were employed to follow up the dynamics of publication and to determine the number of publications on the issues of interest...
2017: Sudebno-meditsinskaia Ekspertiza
https://www.readbyqxmd.com/read/28397128/characteristics-and-treatment-of-patients-with-clinical-illness-due-to-synthetic-cannabinoid-inhalation-reported-by-medical-toxicologists-a-toxic-database-study
#19
Andrew A Monte, Diane P Calello, Roy R Gerona, Eike Hamad, Sharan L Campleman, Jeffery Brent, Paul Wax, Robert G Carlson
INTRODUCTION: Synthetic cannabinoid (SC) abuse has resulted in numerous outbreaks of severe clinical illness across the United States over the past decade. The primary objective of this study was to determine the clinical characteristics of patients abusing SC requiring bedside consultation by medical toxicologists. METHODS: This was a multicenter analysis from a prospectively collected cohort of patients presenting to medical care after synthetic cannabinoid exposure, utilizing the ToxIC Registry...
April 10, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/28396704/emergency-department-stay-associated-delirium-in-older-patients
#20
Marcel Émond, David Grenier, Jacques Morin, Debra Eagles, Valérie Boucher, Natalie Le Sage, Éric Mercier, Philippe Voyer, Jacques S Lee
BACKGROUND: Caring for older patients can be challenging in the Emergency Department (ED). A > 12 hr ED stay could lead to incident episodes of delirium in those patients. The aim of this study was to assess the incidence and impacts of ED-stay associated delirium. METHODS: A historical cohort of patients who presented to a Canadian ED in 2009 and 2011 was randomly constituted. Included patients were aged ≥ 65 years old, admitted to any hospital ward, non-delirious upon arrival and had at least a 12-hour ED stay...
March 2017: Canadian Geriatrics Journal: CGJ
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