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Delirium

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https://www.readbyqxmd.com/read/28918202/implementation-of-a-risk-stratified-opioid-weaning-protocol-in-a-pediatric-intensive-care-unit
#1
L Nelson Sanchez-Pinto, Lara P Nelson, Phuong Lieu, Joyce Y Koh, John W Rodgers, Krichelle A Larson, Jennifer M Huson, Rambod Amirnovin
PURPOSE: Opioids are important in the care of critically ill children. However, their use is associated with complications including delirium, dependence, withdrawal, and bowel dysfunction. Our aim was to implement a risk-stratified opioid weaning protocol to reduce the duration of opioids without increasing the incidence of withdrawal. METHODS: A pre- and post-interventional prospective study was undertaken in a large children's hospital pediatric ICU where we implemented a risk-stratified opioid weaning protocol...
September 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28918171/the-association-between-delirium-and-sarcopenia-in-older-adult-patients-admitted-to-acute-geriatrics-units-results-from-the-glisten-multicenter-observational-study
#2
Giuseppe Bellelli, Antonella Zambon, Stefano Volpato, Pasquale Abete, Lara Bianchi, Mario Bo, Antonio Cherubini, Francesco Corica, Mauro Di Bari, Marcello Maggio, Giovanna Maria Manca, Maria Rosaria Rizzo, Andrea Rossi, Francesco Landi
BACKGROUND & AIMS: To date, studies assessing the relationship between sarcopenia and delirium, two of the most common geriatric syndromes, are lacking. We sought to explore this association by investigating the co-occurrence of these two conditions and the independent association between them in a population of hospitalized older adults. METHODS: Cross-sectional multicenter analysis of older adults consecutively admitted to 12 acute geriatric units (AGUs). Sarcopenia was assessed upon admission by evaluating the presence of low skeletal mass index (kg/m(2)), and either low handgrip strength or low walking speed (European Working Group on Sarcopenia in Older People, EWGSOP criteria)...
September 5, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28918165/delirium-following-topical-application-of-compounded-creams-containing-multiple-analgesic-medications-in-geriatric-patients-two-new-cases
#3
Alyssa A Soumoff, David L Cook, Caroline C Clark
No abstract text is available yet for this article.
August 12, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28918164/telepsychiatry-consultation-for-medical-and-surgical-inpatient-units
#4
Julie A Graziane, Priya Gopalan, Jack Cahalane
BACKGROUND: Telepsychiatry is becoming more commonplace in the provision of psychiatric care. Most commonly used in the outpatient setting, there is little information available in the literature as to the use of telepsychiatry for inpatient medical/surgical consultation. OBJECTIVE: We review the University of Pittsburgh Medical Center's telepsychiatry consultation program that provides consultation to an outlying community-based rural hospital. METHODS: This article examines the 69 telepsychiatry consultations that were performed from November 2014 through February 2016, looking at the patients served, common consultation questions, and patterns of diagnoses and recommendations...
August 12, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28915907/effect-of-a-mother-s-recorded-voice-on-emergence-from-general-anesthesia-in-pediatric-patients-study-protocol-for-a-randomized-controlled-trial
#5
Seok Young Song, Sang Gyu Kwak, Eugene Kim
BACKGROUND: Emergence delirium is a behavioral disturbance after general anesthesia in children and may distress both the patients and the primary caregivers, such as parents and medical staff, looking after the patients. Various medical and emotional interventions have been investigated to reduce emergence delirium; however, none are completely effective. This trial intends to assess whether the mother's recorded voice can reduce this adverse post-anesthesia event and facilitate arousal from general anesthesia...
September 15, 2017: Trials
https://www.readbyqxmd.com/read/28915175/when-the-letter-f-meets-the-letter-d-beneficial-impact-of-open-visiting-and-family-presence-on-incidence-of-delirium-among-icu-patients
#6
Alberto Giannini
No abstract text is available yet for this article.
October 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28914375/central-nervous-system-involvement-in-patients-with-granulomatosis-with-polyangiitis-a-single-center-retrospective-study
#7
George E Fragoulis, Sophia Lionaki, Aliki Venetsanopoulou, Panayiotis G Vlachoyiannopoulos, Haralampos M Moutsopoulos, Athanasios G Tzioufas
The aims of this study were to estimate the frequency of central nervous system (CNS) involvement in Greek patients with granulomatosis with polyangiitis (GPA) and describe the related clinical characteristics and long-term outcomes of these patients. Medical charts of all ANCA-associated vasculitis patients were retrospectively reviewed, and GPA patients with CNS involvement were identified. Demographics, serological, and clinical features throughout the disease course were recorded. Comparisons of disease characteristics and long-term outcomes were performed between GPA patients with and without CNS involvement...
September 15, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28914332/-comment-on-ketamine-for-prevention-of-postoperative-delirium-and-pain
#8
S Ziemann, M Coburn
No abstract text is available yet for this article.
September 15, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28912778/neuroprotective-effects-of-annexin-a1-tripeptide-after-deep-hypothermic-circulatory-arrest-in-rats
#9
Zhiquan Zhang, Qing Ma, Bijal Shah, G Burkhard Mackensen, Donald C Lo, Joseph P Mathew, Mihai V Podgoreanu, Niccolò Terrando
Resolution agonists, including lipid mediators and peptides such as annexin A1 (ANXA1), are providing novel approaches to treat inflammatory conditions. Surgical trauma exerts a significant burden on the immune system that can affect and impair multiple organs. Perioperative cerebral injury after cardiac surgery is associated with significant adverse neurological outcomes such as delirium and postoperative cognitive dysfunction. Using a clinically relevant rat model of cardiopulmonary bypass (CPB) with deep hypothermic circulatory arrest (DHCA), we tested the pro-resolving effects of a novel bioactive ANXA1 tripeptide (ANXA1sp) on neuroinflammation and cognition...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28911284/effect-of-nicotine-replacement-therapy-on-mortality-delirium-and-duration-of-therapy-in-critically-ill-smokers-a-systematic-review-and-meta-analysis
#10
K T Ng, M Gillies, D M Griffith
Nicotine replacement therapy is widely used in critically ill smokers and its effect on delirium, mortality and duration of intensive care unit (ICU) admission is unknown. The aims of this review were to determine whether the management of nicotine withdrawal with nicotine replacement therapy reduces delirium, mortality or length of stay in critically ill smokers in ICU. The primary outcome was incidence of author-defined ICU delirium. Secondary outcomes were ICU or hospital mortality, ICU-free days at day 28, and ICU or hospital length of stay...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28910303/the-influence-of-analgesic-based-sedation-protocols-on-delirium-and-outcomes-in-critically-ill-patients-a-randomized-controlled-trial
#11
Dan Liu, Jie Lyu, Huiying Zhao, Youzhong An
OBJECTIVE: To investigate the influence of analgesic-based midazolam sedation on delirium and outcomes in critically ill patients and to analyze the risk factors of delirium. DESIGN: Single center, prospective randomized controlled trial. SETTING: A surgical intensive care unit (ICU) in a tertiary care hospital in China. PATIENTS: Mechanically ventilated patients requiring sedation. MEASUREMENTS AND MAIN RESULTS: Patients admitted to the surgical intensive care unit who required sedation and were undergoing mechanical ventilation for longer than 24 hours were randomly divided into three groups: 1) the remifentanil group received remifentanil and midazolam, 2) the fentanyl group received fentanyl and midazolam, and 3) the control group received only midazolam...
2017: PloS One
https://www.readbyqxmd.com/read/28906192/preoperative-risks-for-subsyndromal-delirium-in-older-adults-following-orthopedic-surgery
#12
Dawn L Denny, Glenda Lindseth
No abstract text is available yet for this article.
October 2017: Western Journal of Nursing Research
https://www.readbyqxmd.com/read/28905076/-life-after-ards
#13
REVIEW
B Sensen, S Braune, G de Heer, T Bein, S Kluge
Patients who survive acute respiratory distress syndrome (ARDS) often suffer from long-term physical and psychological sequelae. Lung function is commonly only mildly reduced, whereas general physical activity and walking distance are often compromised. Most markedly, these patients have a high incidence of depression, anxiety, and posttraumatic stress disorder. The rate of cognitive dysfunction is as high as 70-100% at the time of hospital discharge, and remains 46-80% and 20% one year and five years post discharge, respectively...
September 13, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28904966/the-effect-of-oral-dexmedetomidine-premedication-on-preoperative-cooperation-and-emergence-delirium-in-children-undergoing-dental-procedures
#14
Sultan Keles, Ozlem Kocaturk
INTRODUCTION: The aim of this study was to detect the effect of 1 μg/kg of oral dexmedetomidine (DEX) as premedication among children undergoing dental procedures. MATERIALS AND METHODS: The study involved 100 children between 2 and 6 years of age, ASA I, who underwent full-mouth dental rehabilitation. The DEX group (n = 50) received 1 μg/kg DEX in apple juice, and the control group (n = 50) received only apple juice. The patients' scores on the Ramsay Sedation Scale (RSS), parental separation anxiety scale, mask acceptance scale, and pediatric anesthesia emergence delirium scale (PAEDS) and hemodynamic parameters were recorded...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28904548/effect-of-family-patient-communication-on-the-incidence-of-delirium-in-hospitalized-patients-in-cardiovascular-surgery-icu
#15
Maryam Eghbali-Babadi, Nasrin Shokrollahi, Tayebe Mehrabi
BACKGROUND: Cardiovascular diseases are the most important causes of morbidity and mortality in the world, and cardiac surgery is one of the treatments that have complication for patients. One of the most important current psychological complications after cardiac surgery is delirium. For its prevention and treatment, considerable attention should be paid to the role of family. This study has been conducted for assessing the effect of the relationship between the family and patient on the incidence of delirium in hospitalized patients in cardiovascular surgery intensive care unit (ICU) of Isfahan Shahid Chamran hospital...
July 2017: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/28904515/psychogenic-polydipsia-management-challenges
#16
M S Bhatia, Aparna Goyal, Rashmita Saha, Nimisha Doval
Compulsive water drinking or psychogenic polydipsia is now increasingly seen in psychiatric populations. Effects of increased water intake can lead to hyponatremia causing symptoms of nausea, vomiting, seizures, delirium and can even be life threatening if not recognized and managed early. Here we present a 35-year old adult who was diagnosed with psychogenic polydipsia and was successfully managed with a combination of pharmacotherapy, fluid restriction and psychosocial management.
June 25, 2017: Shanghai Archives of Psychiatry
https://www.readbyqxmd.com/read/28903799/a-comparison-of-outcomes-according-to-different-diagnostic-systems-for-delirium-dsm-5-dsm-iv-cam-and-drs-r98
#17
Dimitrios Adamis, David Meagher, Siobhan Rooney, Owen Mulligan, Geraldine McCarthy
Studies indicate that DSM-5 criteria for delirium are relatively restrictive, and identify different cases of delirium compared with previous systems. We evaluate four outcomes of delirium (mortality, length of hospital stay, institutionalization, and cognitive improvement) in relation to delirium defined by different DSM classification systems. Prospective, longitudinal study of patients aged 70+ admitted to medical wards of a general hospital. Participants were assessed up to a maximum of four times during two weeks, using DSM-5 and DSM-IV criteria, DRS-R98 and CAM scales as proxies for DSM III-R and DSM III...
September 14, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28903083/delirium-characteristics-and-outcomes-in-medical-and-surgical-lnpatients-a-subgroup-analysis
#18
Sungmin Kim, Jae-Jin Kim, Jooyoung Oh, Jaesub Park, Jin Young Park
PURPOSE: Persistent delirium can negatively affect patients, increase healthcare costs, and extend the length of hospital stays. This investigation was undertaken to explore associations between patient characteristics and delirium outcomes. MATERIALS AND METHODS: Intensive care unit (ICU) and medical and surgical ward inpatients for whom psychiatric consultation was requested for delirium were included in this study. Delirium screening and ongoing assessments were conducted using the Confusion Assessment Method for ICU patients...
August 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28895757/intoxications-in-the-strida-project-involving-a-panorama-of-psychostimulant-pyrovalerone-derivatives-mdpv-copycats
#19
Olof Beck, Matilda Bäckberg, Patrick Signell, Anders Helander
CONTEXT: An increasing number of new psychoactive substances (NPS) of different chemical classes have become available through marketing and sale over the Internet. This report from the Swedish STRIDA project presents the prevalence, laboratory results, and clinical features in intoxications involving 11 stimulant pyrovalerone NPS derivatives over a 5-year period. STUDY DESIGN: Case series of consecutive patients with admitted or suspected intake of NPS presenting to Swedish hospitals for emergency treatment from January 2011 to March 2016...
September 12, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28894686/risk-factors-for-delirium-after-spine-surgery-in-extremely-elderly-patients-aged-80-years-or-older-and-review-of-the-literature-japan-association-of-spine-surgeons-with-ambition-multicenter-study
#20
Kazuyoshi Kobayashi, Shiro Imagama, Kei Ando, Naoki Ishiguro, Masaomi Yamashita, Yawara Eguchi, Morio Matsumoto, Ken Ishii, Tomohiro Hikata, Shoji Seki, Hidetomi Terai, Akinobu Suzuki, Koji Tamai, Masaaki Aramomi, Tetsuhiro Ishikawa, Atsushi Kimura, Hirokazu Inoue, Gen Inoue, Masayuki Miyagi, Wataru Saito, Kei Yamada, Michio Hongo, Yuji Matsuoka, Hidekazu Suzuki, Atsushi Nakano, Kazuyuki Watanabe, Hirotaka Chikuda, Junichi Ohya, Yasuchika Aoki, Masayuki Shimizu, Toshimasa Futatsugi, Keijiro Mukaiyama, Masaichi Hasegawa, Katsuhito Kiyasu, Haku Iizuka, Yoichi Iizuka, Ryoichi Kobayashi, Kotaro Nishida, Kenichiro Kakutani, Hideaki Nakajima, Hideki Murakami, Satoru Demura, Satoshi Kato, Katsuhito Yoshioka, Takashi Namikawa, Kei Watanabe, Kazuyoshi Nakanishi, Yukihiro Nakagawa, Mitsunori Yoshimoto, Hiroyasu Fujiwara, Norihiro Nishida, Yasuaki Imajo, Masashi Yamazaki, Masataka Sakane, Tetsuya Abe, Kengo Fujii, Takashi Kaito, Takeo Furuya, Sumihisa Orita, Seiji Ohtori
STUDY DESIGN: Retrospective database analysis. OBJECTIVE: Spine surgeries in elderly patients have increased in recent years due to aging of society and recent advances in surgical techniques, and postoperative complications have become more of a concern. Postoperative delirium is a common complication in elderly patients that impairs recovery and increases morbidity and mortality. The objective of the study was to analyze postoperative delirium associated with spine surgery in patients aged 80 years or older with cervical, thoracic, and lumbar lesions...
September 2017: Global Spine Journal
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