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https://www.readbyqxmd.com/read/29792577/serious-consequences-of-malnutrition-and-delirium-in-frail-older-patients
#1
Elizabeth Rosted, Tatiana Prokofieva, Suzanne Sanders, Martin Schultz
Malnutrition is highly prevalent in geriatric patients and is associated with an increased risk of death. In addition, delirium is a common condition of the older hospitalized patients. As brain has a high nutritional requirement, malnutrition may play an important role in cognitive dysfunction including the development of delirium. This study investigated the association between delirium and malnutrition in frail older patients and the effects on adverse outcomes. It was found that 75% of the patients with delirium suffered from malnutrition indicating that malnutrition contributes to the development of delirium in older hospitalized patients...
May 24, 2018: Journal of Nutrition in Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29792239/screening-for-delirium-with-the-intensive-care-delirium-screening-checklist-icdsc-symptom-profile-and-utility-of-individual-items-in-the-identification-of-delirium-dependent-on-the-level-of-sedation
#2
Soenke Boettger, Rafael Meyer, André Richter, Susana Franco Fernandez, Alain Rudiger, Maria Schubert, Josef Jenewein, David Garcia Nuñez
OBJECTIVE: The importance of the proper identification of delirium, with its high incidence and adversities in the intensive care setting, has been widely recognized. One common screening instrument is the Intensive Care Delirium Screening Checklist (ICDSC); however, the symptom profile and key features of delirium dependent on the level of sedation have not yet been evaluated. METHOD: In this prospective cohort study, the ICDSC was evaluated versus the Diagnostic and Statistical Manual, 4th edition, text revision, diagnosis of delirium set as standard with respect to the symptom profile, and correct identification of delirium...
May 24, 2018: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29789139/medical-and-preoperative-evaluation-of-the-older-adult
#3
REVIEW
Audrey Chun
Because of age, increased rates of multimorbidity, polypharmacy, functional changes, and cognitive impairment, older adults are at higher risk for perioperative complications. Identifying modifiable risk factors and educating patients and families about what to expect can improve surgical outcomes and satisfaction. Comprehensive preoperative evaluation assesses these potential factors and should include recommendations for risk reduction. The optimal preoperative evaluation for older adults should address medical conditions and other areas pertinent to the care of older adults including assessments of cognition, capacity, delirium risk, function, frailty, nutrition, medications, and treatment preferences...
May 19, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29787821/slc25a13-c-1610_1612delinsat-mutation-in-an-indian-patient-and-literature-review-of-79-cases-of-citrin-deficiency-for-genotype-phenotype-associations
#4
A Radha Rama Devi, Shaik Mohammad Naushad
Here, we report SLC25A13 c.1610_1612delinsAT mutation from India in a 13-year old boy who presented with recurrent episodes of delirium and hyperammonemia. This is the second case with this mutation; the first case was of Pakistani origin. The boy responded to diet modification, sodium benzoate and arginine supplementation. Furthermore, we have aimed to establish genotype-phenotype correlation of 79 cases of citrin deficiency (46 males and 33 females) reported in 24 studies from all over the world. Inverse association was observed between age of onset and jaundice (r = -0...
May 19, 2018: Gene
https://www.readbyqxmd.com/read/29787415/cooccurrence-of-post-intensive-care-syndrome-problems-among-406-survivors-of-critical-illness
#5
Annachiara Marra, Pratik P Pandharipande, Timothy D Girard, Mayur B Patel, Christopher G Hughes, James C Jackson, Jennifer L Thompson, Rameela Chandrasekhar, Eugene Wesley Ely, Nathan E Brummel
OBJECTIVES: To describe the frequency of cooccurring newly acquired cognitive impairment, disability in activities of daily livings, and depression among survivors of a critical illness and to evaluate predictors of being free of post-intensive care syndrome problems. DESIGN: Prospective cohort study. SETTING: Medical and surgical ICUs from five U.S. centers. PATIENTS: Patients with respiratory failure or shock, excluding those with preexisting cognitive impairment or disability in activities of daily livings...
May 21, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29784546/complexity-of-the-medication-regimen-for-polypathological-patients
#6
L Bellostas-Muñoz, J Díez-Manglano
OBJECTIVE: To determine the complexity of the therapeutic regimen for polypathological patients hospitalised in internal medicine departments. METHODS: A multicentre observational study included polypathological patients hospitalised in internal medicine departments. Patients who were readmitted or died were excluded. Data were collected on age, sex, residence, disease, Charlson, Barthel and Lawton-Brody indices, Pfeiffer questionnaire, Gijón scale, number of hospitalisations in the previous year, delirium, need for and availability of caregivers and the PROFUND index score...
May 18, 2018: Revista Clínica Española
https://www.readbyqxmd.com/read/29784261/reduction-of-postanesthetic-pediatric-distress-a-coordinated-approach
#7
Simon Hayhoe, Scott Pallett, Juliet Zani, Joanne Trott
PURPOSE: Preoperative anxiety in children is associated with postoperative distress in recovery. Both are predictors of long-term maladaptive behavior. Remedies have been suggested to modify individual risk factors, but overall strategy is lacking. DESIGN: An approach to anxiety reduction coordinated throughout the hospital experience has been developed in our day-stay pediatric surgical unit. METHODS: There is a preadmission familiarization visit...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29784256/perioperative-delirium-protocol-for-the-older-patient
#8
Thomas J Pallaria, Casey Panebianco, Mary C Kamienski
PURPOSE: Delirium is an acute change in cognition and attention. It may affect any age group. It is most common in older patients and is associated with a significant increase in mortality. The purpose of this project was to implement an assessment protocol to identify patients at risk for postoperative delirium. DESIGN: A case study approach was used. METHODS: The Confusion Assessment Method (CAM) tool for screening and diagnostic purposes was used to train surgeons, anesthesia providers, and nurses...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29784254/evidence-based-practice-in-perianesthesia-nursing-application-of-the-american-geriatrics-society-clinical-practice-guideline-for-postoperative-delirium-in-older-adults
#9
Catherine Hebert
Delirium is a pervasive and dangerous syndrome for older adults in the perianesthesia setting, occurring in up to 60% of surgical cases. The American Geriatrics Society performed a systematic review to develop recommendations for the prevention and management of postoperative delirium in older adults. The recommendations emphasize nonpharmacologic interventions with a strong focus on reducing the use of psychoactive medication. Perianesthesia nurses can serve as leaders in translating these recommendations into evidence-based practice at the bedside for older adults...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29782389/development-of-a-novel-self-administered-cognitive-assessment-tool-and-normative-data-for-older-adults
#10
Raphael J Monsch, Amélie C Burckhardt, Manfred Berres, Alessandra E Thomann, Michael M Ehrensperger, Luzius A Steiner, Nicolai Goettel
BACKGROUND: Preexisting cognitive impairment in surgical patients is one of the leading risk factors for adverse cognitive outcomes such as postoperative delirium and postoperative cognitive dysfunction. We developed a self-administered tablet computer application intended to assess the individual risk for adverse postoperative cognitive outcomes. This cross-sectional study aimed to establish normative data for the tool. MATERIALS AND METHODS: Healthy volunteers aged 65 years and above were administered the Mini-Mental State Examination, Geriatric Depression Scale, and Consortium to Establish a Registry for Alzheimer's Disease-Neuropsychological Assessment Battery to assess cognitive health...
May 18, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29776706/gaps-in-pain-agitation-and-delirium-management-in-intensive-care-outputs-from-a-nurse-workshop
#11
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/29776669/-the-role-of-end-of-life-palliative-sedation-medical-and-ethical-aspects-review
#12
REVIEW
Miriam S Menezes, Maria das Graças Mota da Cruz de Assis Figueiredo
BACKGROUND AND OBJECTIVE: Palliative sedation is a medical procedure that has been used for more than 25 years to relieve refractory symptoms not responsive to any previous treatment in patients with no possibility of cure and near the end of life. Many uncertainties persist on the issue regarding definition, indications, decision making, most appropriate place to perform the procedure, most used drugs, need for monitoring, fluids and nutritional support, and possible ethical dilemmas...
May 15, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29775510/educational-intervention-on-delirium-assessment-using-confusion-assessment-method-icu-cam-icu-in-a-general-intensive-care-unit
#13
Vimala Ramoo, Harlinna Abu, Vineya Rai, Surindar Kaur Surat Singh, Ayuni Asma' Baharudin, Mahmoud Danaee, Raveena Rajalachimi R Thinagaran
AIMS AND OBJECTIVES: The primary objective was to assess intensive care unit nurses' knowledge of intensive care unit delirium and delirium assessment before and after an educational intervention. In addition, nurses' perception on the usefulness of a delirium assessment tool and barriers against delirium assessment were assessed as secondary objectives. BACKGROUND: Early identification of delirium in intensive care units is crucial for patient care. Hence, nurses require adequate knowledge to enable appropriate evaluation of delirium using standardised practice and assessment tools...
May 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29773957/perioperative-predictors-of-delirium-and-incidence-factors-in-adult-patients-post-cardiac-surgery
#14
Stavros Theologou, Konstantinos Giakoumidakis, Christos Charitos
Background: Delirium is a quite common complication in adult patients post-cardiac surgery. The purpose of our study was to identify perioperative characteristics and also focus on incidence factors that could predict delirium in the cardiac surgery intensive care unit (CICU) postoperatively. Methods: We conducted a prospective study of 179 consecutive patients, who underwent open-heart surgical operation and were admitted to the CICU of a general tertiary hospital in Athens, Greece...
2018: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/29771710/cognitive-decline-after-delirium-in-patients-undergoing-cardiac-surgery
#15
Charles H Brown, Julia Probert, Ryan Healy, Michelle Parish, Yohei Nomura, Atsushi Yamaguchi, Jing Tian, Kenton Zehr, Kaushik Mandal, Vidyulata Kamath, Karin J Neufeld, Charles W Hogue
BACKGROUND: Delirium is common after cardiac surgery and has been associated with morbidity, mortality, and cognitive decline. However, there are conflicting reports on the magnitude, trajectory, and domains of cognitive change that might be affected. The authors hypothesized that patients with delirium would experience greater cognitive decline at 1 month and 1 yr after cardiac surgery compared to those without delirium. METHODS: Patients who underwent coronary artery bypass and/or valve surgery with cardiopulmonary bypass were eligible for this cohort study...
May 16, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29769154/performance-of-the-french-version-of-the-4at-for-screening-the-elderly-for-delirium-in-the-emergency-department
#16
Anne-Julie Gagné, Philippe Voyer, Valérie Boucher, Alexandra Nadeau, Pierre-Hugues Carmichael, Mathieu Pelletier, Emilie Gouin, Simon Berthelot, Raoul Daoust, Machelle Wilchesky, Hélène Richard, Isabelle Pelletier, Stephanie Ballard, Antoine Laguë, Marcel Émond
CLINICIAN'S CAPSULE What is known about the topic? Delirium is frequent in older inpatients but often goes undetected. A short tool, the 4 A's Test (4AT), was created and validated for the detection of delirium. What did this study ask? This study compared the performance of the French version of the 4AT (4AT-F) with the Confusion Assessment Method (CAM) for the screening of delirium. What did this study find? The 4AT-F was a fast and reliable screening tool for delirium in the emergency department (ED). Why does this study matter to clinicians? Because of its quick administration time, it allows for systematic screening of patients at risk of delirium and cognitive impairment...
May 17, 2018: CJEM
https://www.readbyqxmd.com/read/29767323/prevalence-and-risk-factors-related-to-haloperidol-use-for-delirium-in-adult-intensive-care-patients-the-multinational-aid-icu-inception-cohort-study
#17
Marie O Collet, Jesús Caballero, Romain Sonneville, Fernando A Bozza, Peter Nydahl, Anna Schandl, Hilden Wøien, Giuseppe Citerio, Mark van den Boogaard, Johanna Hästbacka, Matthias Haenggi, Kirsten Colpaert, Louise Rose, Marija Barbateskovic, Theis Lange, Aksel Jensen, Martin B Krog, Ingrid Egerod, Helle L Nibro, Jørn Wetterslev, Anders Perner
PURPOSE: We assessed the prevalence and variables associated with haloperidol use for delirium in ICU patients and explored any associations of haloperidol use with 90-day mortality. METHODS: All acutely admitted, adult ICU patients were screened during a 2-week inception period. We followed the patient throughout their ICU stay and assessed 90-day mortality. We assessed patients and their variables in the first 24 and 72 h in ICU and studied their association together with that of ICU characteristics with haloperidol use...
May 16, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29766622/evaluating-the-implementation-of-confusion-assessment-method-intensive-care-unit-using-a-quality-improvement-approach
#18
C Stewart, S Bench
Quality improvement (QI) is a way through which health care delivery can be made safer and more effective. Various models of quality improvement methods exist in health care today. These models can help guide and manage the process of introducing changes into clinical practice. The aim of this project was to implement the use of a delirium assessment tool into three adult critical care units within the same hospital using a QI approach. The objective was to improve the identification and management of delirium...
May 15, 2018: Nursing in Critical Care
https://www.readbyqxmd.com/read/29765105/neural-predisposing-factors-of-postoperative-delirium-in-elderly-patients-with-femoral-neck-fracture
#19
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/29764723/frailty-assessment-to-help-predict-patients-at-risk-of-delirium-when-consulting-the-emergency-department
#20
Marianne Giroux, Marie-Josée Sirois, Valérie Boucher, Raoul Daoust, Émilie Gouin, Mathieu Pelletier, Simon Berthelot, Philippe Voyer, Marcel Émond
BACKGROUND: Delirium is underdiagnosed in seniors at emergency departments (EDs) even though it is a frequent complication and is associated with functional and cognitive decline. As frailty is an independent predictor of adverse events in seniors, screening for frailty in EDs may help identify those at risk of delirium. OBJECTIVES: To assess if screening older patients for frailty in EDs could help identify those at risk of delirium. METHODOLOGY: This study was part of the multicenter prospective cohort INDEED study...
May 12, 2018: Journal of Emergency Medicine
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