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Delirium , infection, sepsis

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https://www.readbyqxmd.com/read/28335673/modifiable-risk-factors-for-delirium-in-critically-ill-trauma-patients
#1
Marc-Alexandre Duceppe, David R Williamson, Audrée Elliott, Mélissa Para, Marie-Christine Poirier, Marie-Soleil Delisle, Dan Deckelbaum, Tarek Razek, Monique Desjardins, Jean-Claude Bertrand, Francis Bernard, Philippe Rico, Lisa Burry, Anne Julie Frenette, Marc Perreault
OBJECTIVE: Intensive care unit (ICU)-acquired delirium has been associated with increased morbidity and mortality. Prevention strategies including modification of delirium risk factors are emphasized by practice guidelines. No study has specifically evaluated modifiable delirium risk factors in trauma ICU patients. Our goal was to evaluate modifiable risk factors for delirium among trauma patients admitted to the ICU. DESIGN: Prospective observational study. SETTING: Two level 1 trauma ICU centers...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28286656/are-you-ernest-shackleton-the-polar-explorer-refining-the-criteria-for-delirium-and-brain-dysfunction-in-sepsis
#2
EDITORIAL
Frank Anthony Rasulo, Giuseppe Bellelli, Eugene Wesley Ely, Alessandro Morandi, Pratik Pandharipande, Nicola Latronico
The Third International Consensus Definitions for Sepsis and Septic Shock has recently defined sepsis as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Organ dysfunctions in this consensus definition were identified as an organ-specific Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score ≥ 2 points. The quick SOFA (qSOFA) considers altered mentation indicating brain dysfunction when the Glasgow Coma Scale (GCS) score is ≤13 or ≤14. However, concern has been expressed that the revised criteria may lead to a failure in recognizing the signs of potentially lethal organ dysfunction and thus sepsis...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28156637/complications-of-intrathecal-pump-therapy-in-malignancy-related-pain
#3
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/27884743/mortality-and-morbidity-after-spinal-surgery-in-patients-with-parkinson-disease-a-retrospective-matched-pair-cohort-study
#4
Takeshi Oichi, Hirotaka Chikuda, Junichi Ohya, Ryo Ohtomo, Kojiro Morita, Hiroki Matsui, Kiyohide Fushimi, Sakae Tanaka, Hideo Yasunaga
BACKGROUND CONTEXT: There is a lack of information about postoperative outcomes and related risk factors associated with spinal surgery in patients with Parkinson disease (PD). PURPOSE: This study aimed to investigate the postoperative morbidity and mortality associated with spinal surgery for patients with PD, and the risk factors for poor outcomes. STUDY DESIGN: This is a retrospective matched-pair cohort study. PATIENT SAMPLE: Data of patients who underwent elective spinal surgery between July 2010 and March 2013 were extracted from the Diagnosis Procedure Combination database, a nationwide inpatient database in Japan...
November 21, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27781969/-a-blood-culture-containing-coagulase-negative-staphylococci-not-always-due-to-contamination
#5
E C F Wagenaar, P van Wijngaarden, C M Verduin, D Beelen, R W van Etten
Staphylococcus lugdunensis (SL) is a species belonging to the group of coagulase-negative staphylococci (CNS). It can cause severe infections such as endocarditis. Three cases of endocarditis caused by SL are presented. The first case describes a 71-year-old man with a fever and endogenous endophthalmitis. The second case describes delirium in an 87-year-old woman, thought to be due to pneumonia. The third case describes a 76-year-old man with an infection of unknown origin. In all cases, the first blood cultures drawn were positive for CNS and considered to be contaminated...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27436624/prognostic-value-of-acute-delirium-recovery-in-older-adults
#6
Carlos Jorge-Ripper, María-Remedios Alemán, Rosa Ros, Selena Aguilera, Emilio González-Reimers, Elisa Espelosín, Francisco Santolaria
AIM: To analyze the prognostic impact of short-term changes in the intensity of delirium in association or not with sepsis. We also aimed to analyze if s100B, a serum protein derived from astrocytes related to cerebral damage, could be a marker of delirium or sepsis. METHODS: We included 47 patients with acute delirium and sepsis, 36 with delirium and no evidence of infection, and 36 patients with sepsis without delirium. The diagnosis of delirium was established by the Confusion Assessment Method...
July 19, 2016: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/27105460/medical-complications-after-adult-spinal-deformity-surgery-incidence-risk-factors-and-clinical-impact
#7
Alex Soroceanu, Douglas C Burton, Jonathan Haim Oren, Justin S Smith, Richard Hostin, Christopher I Shaffrey, Behrooz A Akbarnia, Christopher P Ames, Thomas J Errico, Shay Bess, Munish C Gupta, Vedat Deviren, Frank J Schwab, Virginie Lafage
STUDY DESIGN: Retrospective review of a prospective multicenter database evaluating surgical adult spinal deformity (ASD) patients. OBJECTIVE: This study aims to identify risk factors for medical complications in ASD patients undergoing surgery. SUMMARY OF BACKGROUND DATA: ASD surgery is known for its high complication rate. This study examines baseline patient characteristics for predictors of medical complications in surgical ASD patients...
November 15, 2016: Spine
https://www.readbyqxmd.com/read/26916045/-urosepsis-in-geriatric-patients
#8
REVIEW
H J Heppner, F Yapan, A Wiedemann
Due to the demographic shift, increasing numbers of geriatric patients are admitted to acute care hospitals of all levels of care. This means that special challenges must be met in the medical care and management of these patients.Immunosenescence and multimorbidity make elderly patients vulnerable to infectious diseases. Urinary tract infections range from "simple" cystitis to pyelonephritis and urosepsis and, at 25%, are the second most common form of infection in geriatric patients. It is often difficult to make a diagnosis because typical symptoms do not always occur...
February 2016: Aktuelle Urologie
https://www.readbyqxmd.com/read/26852394/high-prolactin-levels-are-associated-with-more-delirium-in-septic-patients
#9
Duc Nam Nguyen, Luc Huyghens, Johan Schiettecatte, Johan Smitz, Jean-Louis Vincent
PURPOSES: We investigated whether high prolactin levels were associated with delirium in septic patients because neuropsychiatric disorders are frequently associated with hyperprolactinemia. MATERIALS AND METHODS: Prolactin levels were measured daily for 4 days in 101 patients with sepsis. Delirium was assessed using the Richmond Agitation Sedation Scale and the Confusion Assessment Method in the ICU. RESULTS: Delirium developed in 79 patients (78%) and was more common in patients older than 65 years...
June 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/26768428/biomarkers-of-delirium-in-a-low-risk-community-acquired-pneumonia-induced-sepsis
#10
Cristiane Damiani Tomasi, Francieli Vuolo, Jaqueline Generoso, Márcio Soares, Tatiana Barichello, João Quevedo, Cristiane Ritter, Felipe Dal-Pizzol
There are different theories about the pathophysiology of sepsis-associated encephalopathy (SAE), and the majority of our knowledge was derived from critically ill patients. 7In less severe sepsis, it is probable that neuroinflammation can be a major aspect of SAE development. We hypothesized that in non-severe septic patients, blood biomarkers of inflammation, endothelial activation, coagulation, and brain function would be different when compared to patients with and without brain dysfunction. A total of 30 patients presenting with community-acquired pneumonia (CAP)-induced sepsis were included of which 10 (33 %) developed SAE...
January 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/26556425/sepsis-associated-encephalopathy
#11
REVIEW
Neera Chaudhry, Ashish Kumar Duggal
Sepsis associated encephalopathy (SAE) is a common but poorly understood neurological complication of sepsis. It is characterized by diffuse brain dysfunction secondary to infection elsewhere in the body without overt CNS infection. The pathophysiology of SAE is complex and multifactorial including a number of intertwined mechanisms such as vascular damage, endothelial activation, breakdown of the blood brain barrier, altered brain signaling, brain inflammation, and apoptosis. Clinical presentation of SAE may range from mild symptoms such as malaise and concentration deficits to deep coma...
2014: Advances in Medicine
https://www.readbyqxmd.com/read/25722876/septic-encephalopathy-when-cytokines-interact-with-acetylcholine-in-the-brain
#12
REVIEW
Qing-Hong Zhang, Zhi-Yong Sheng, Yong-Ming Yao
Sepsis-associated encephalopathy (SAE) is a brain dysfunction that occurs secondary to infection in the body, characterized by alteration of consciousness, ranging from delirium to coma, seizure or focal neurological signs. SAE involves a number of mechanisms, including neuroinflammation, in which the interaction between cytokines and acetylcholine results in neuronal loss and alterations in cholinergic signaling. Moreover, the interaction also occurs in the periphery, accelerating a type of immunosuppressive state...
2014: Military Medical Research
https://www.readbyqxmd.com/read/25673978/urological-surgery-in-elderly-patients-results-and-complications
#13
Milos Brodak, Jan Tomasek, Jaroslav Pacovsky, Lukas Holub, Petr Husek
PURPOSE: Owing to the large aging population, a growing number of elderly patients are undergoing surgical treatment. Surgical procedures in elderly patients are associated with a higher risk of complications. The aim of this study was to evaluate the efficacy and safety of urological surgeries in old patients. METHODS: The authors carried out a retrospective study, evaluating results and early postoperative complications in patients aged 75 years and older. The cohort of patients included 221 patients who underwent surgical procedures in the department of urology between January 2011 and December 2012...
2015: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/25263474/-risks-and-complications-of-urological-surgical-procedures-in-elderly-patients
#14
J Tomášek, J Pacovský, M Broďák
INTRODUCTION: Surgical procedures in elderly patients are associated with a higher risk of complications. The main goal of this study was to evaluate the results and complications of urological surgeries in elderly patients. MATERIAL AND METHODS: A retrospective study was completed, evaluating the perioperative and early postoperative complications in patients over the age of 75. In total, 221 patients that underwent urological surgery between January 2011 and December 2012 were evaluated...
July 2014: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/25058261/complications-to-evaluate-adult-trauma-care-an-expert-consensus-study
#15
Lynne Moore, François Lauzier, Henry Thomas Stelfox, Natalie Le Sage, Gilles Bourgeois, Julien Clément, Michèle Shemilt, Alexis F Turgeon
BACKGROUND: Complications affect up to 37% of patients hospitalized for injury and increase mortality, morbidity, and costs. One of the keys to controlling complications for injury admissions is to monitor in-hospital complication rates. However, there is no consensus on which complications should be used to evaluate the quality of trauma care. The objective of this study was to develop a consensus-based list of complications that can be used to assess the acute phase of adult trauma care...
August 2014: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/25038834/a-very-unusual-organism-causing-stroke-like-symptoms
#16
Eve McCann, Mark Barber, Pamela Hunter, Donald Inverarity
A 78-year-old man presented to hospital with new onset confusion and fever. The working diagnosis was of delirium due to an infection of unknown source, and empirical i.v. antibiotic treatment was given. Two days later, he deteriorated and developed clinical features in keeping with a total anterior circulation stroke. Brain imaging was unremarkable. Blood cultures grew an organism subsequently identified as Facklamia languida. Following treatment with broad-spectrum antibiotics, his condition improved. A diagnosis of F...
September 2014: Age and Ageing
https://www.readbyqxmd.com/read/24382619/insights-and-advances-in-multidisciplinary-critical-care-a-review-of-recent-research
#17
REVIEW
Stijn Blot, Elsa Afonso, Sonia Labeau
The intensive care unit is a work environment where superior dedication is pivotal to optimize patients' outcomes. As this demanding commitment is multidisciplinary in nature, it requires special qualities of health care workers and organizations. Thus research in the field covers a broad spectrum of activities necessary to deliver cutting-edge care. However, given the abundance of research articles and education activities available, it is difficult for modern critical care clinicians to keep up with the latest progress and innovations in the field...
January 2014: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/24360244/the-management-of-community-acquired-pneumonia-in-the-elderly
#18
REVIEW
Paola Faverio, Stefano Aliberti, Giuseppe Bellelli, Giulia Suigo, Sara Lonni, Alberto Pesci, Marcos I Restrepo
Pneumonia is one of the main causes of morbidity and mortality in the elderly. The elderly population has exponentially increased in the last decades and the current epidemiological trends indicate that it is expected to further increase. Therefore, recognizing the special needs of older people is of paramount importance. In this review we address the main differences between elderly and adult patients with pneumonia. We focus on several aspects, including the atypical clinical presentation of pneumonia in the elderly, the methods to assess severity of illness, the appropriate setting of care, and the management of comorbidities...
April 2014: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/24084178/encephalopathy-of-infection-and-systemic-inflammation
#19
REVIEW
G Bryan Young
This review will discuss several intracranial infections and sepsis-associated encephalopathy. Intracranial infections and inflammation of interest to the neurologist and EEG technicians include viral and autoimmune encephalitides; bacterial, fungal, and other meningitides; cerebritis; and brain abscess and subdural empyema. Sepsis-associated encephalopathy refers to a diffuse brain dysfunction secondary to infection that is principally located outside of the central nervous system. It is much more common than all of the intracranial infections put together, at least for adults in Western society...
October 2013: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/23930244/alcoholic-leukopenic-pneumococcal-sepsis
#20
Abdul Hamid Alraiyes, Khaldoon Shaheen, M Chadi Alraies
Alcohol abuse has been associated with an increased mortality and morbidity due to increased aspiration, delirium tremens, and seizures. The association of pneumococcal lung infections and leukopenia in the setting of alcohol abuse are rarely reported; however, when present, severe lung infections can happen with severe lung injury and poor response to conventional therapy and ultimately, death. We are reporting a case of 55-year-old-man presented with shortness of breath, cough and altered mental status and eventually found with severe pneumococcal lung infection in the setting of leukopenia and long-term alcohol abuse representing alcoholic leukopenic pneumococcal sepsis syndrome...
April 2013: Avicenna Journal of Medicine
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