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https://www.readbyqxmd.com/read/27887978/mild-encephalitis-encephalopathy-with-reversible-splenial-lesion-mers-due-to-dengue-virus
#1
Choong Yi Fong, Mi Mi Ko Khine, Alan Basil Peter, Wei Kang Lim, Faizatul Izza Rozalli, Kartini Rahmat
A 14-year-old girl presented with encephalopathy, delirium and ophthalmoplegia following a 3day history of high-grade fever. Brain MRI on day 6 of illness showed diffusion restricted ovoid lesion in the splenium of corpus callosum. Dengue virus encephalitis was diagnosed with positive PCR for dengue virus type-2 in both serum and cerebrospinal fluid. She made a complete recovery from day 10 of illness. Repeat brain MRI on day 12 of illness showed resolution of the splenial lesion. Serial diffusion tensor imaging (DTI) showed normal fractional anisotropy values on resolution of splenial lesion indicating that MERS was likely due to transient interstitial oedema with preservation of white matter tracts...
November 23, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27884743/mortality-and-morbidity-after-spinal-surgery-in-patients-with-parkinson-s-disease-a-retrospective-matched-pair-cohort-study
#2
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's disease (PD). PURPOSE: To investigate the postoperative morbidity and mortality associated with spinal surgery for patients with PD, and the risk factors for poor outcomes. STUDY DESIGN: 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/27836006/mycoplasma-pneumoniae-associated-mild-encephalitis-encephalopathy-with-a-reversible-splenial-lesion-report-of-two-pediatric-cases-and-a-comprehensive-literature-review
#3
Norishi Ueda, Satoshi Minami, Manabu Akimoto
BACKGROUND: No literature review exists on Mycoplasma pneumoniae-associated mild encephalitis/encepharopathy with a reversible splenial lesion (MERS). METHODS: M.pneumoniae-associated MERS cases were searched till August 2016 using PubMed/Google for English/other-language publications and Ichushi ( http://www.jamas.or.jp/ ) for Japanese-language publications. Inclusion criteria were children fulfilling definition for encephalitis, M.pneumoniae infection, and neuroimaging showing hyperintensity in the splenium of the corpus callosum (SCC) alone (type I) or SCC/other brain areas (type II)...
November 11, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27816908/delirium-risk-stratification-in-consecutive-unselected-admissions-to-acute-medicine-validation-of-a-susceptibility-score-based-on-factors-identified-externally-in-pooled-data-for-use-at-entry-to-the-acute-care-pathway
#4
Sarah T Pendlebury, Nicola G Lovett, Sarah C Smith, Rose Wharton, Peter M Rothwell
BACKGROUND: recognition of prevalent delirium and prediction of incident delirium may be difficult at first assessment. We therefore aimed to validate a pragmatic delirium susceptibility (for any, prevalent and incident delirium) score for use in front-line clinical practice in a consecutive cohort of older acute medicine patients. METHODS: consecutive patients aged ≥65 years over two 8-week periods (2010-12) were screened prospectively for delirium using the Confusion Assessment Method (CAM), and delirium was diagnosed using the DSM IV criteria...
November 5, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27797086/risk-factors-for-new-onset-delirium-in-patients-with-bloodstream-infections-independent-and-quantitative-effect-of-catheters-and-drainages-a-four-year-cohort-study
#5
Tolga Dittrich, Sarah Tschudin-Sutter, Andreas F Widmer, Stephan Rüegg, Stephan Marsch, Raoul Sutter
BACKGROUND: Bloodstream infections (BSI) and delirium are frequent in critically ill patients. During systemic inflammatory response to BSI, cytokines may interact with neurotransmitters and neuronal receptors driving acute brain dysfunction. However, prospectively collected data on incidence, prediction and impact of delirium in association with BSI are lacking. This study aimed to determine the incidence and predictors of new-onset delirium and its impact on outcome in critically ill adult patients with BSI...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27781969/-a-blood-culture-containing-coagulase-negative-staphylococci-not-always-due-to-contamination
#6
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/27765479/etiologies-and-delirium-rates-of-elderly-ed-patients-with-acutely-altered-mental-status-a-multicenter-prospective-study
#7
Mehmet Ali Aslaner, Mustafa Boz, Ali Çelik, Asliddin Ahmedali, Sercan Eroğlu, Nalan Metin Aksu, Serkan Emre Eroğlu
OBJECTIVES: Altered mental status (AMS) is a challenging diagnosis in older patients and has a large range of etiologies. The aim of this study was to investigate the nature of such etiologies for physicians to be better aware of AMS backgrounds and hence improve outcomes and mortality rates. METHODS: This prospective observational study was conducted at 4 emergency departments. Patients 65 years and older who presented to the emergency department with acute AMS (≤1 week), with symptoms ranging from comas and combativeness, were eligible for inclusion in this study...
October 5, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27759751/fever-delirium-and-incontinence-not-always-a-uti
#8
Emily McNicholas, Ahmed H Abdelhafiz
Unexplained fever and confusion is a common reason for emergency medical admission. When this occurs in the context of new urinary incontinence, a urinary tract infection may be considered to be the most likely cause. However it is also important to consider spinal pathology when this combination of symptoms arises. We present a case of a retropharygeal collection presenting in a patient with this combination of symptoms.
2016: Acute Medicine
https://www.readbyqxmd.com/read/27753184/spinal-infections-in-older-people-an-analysis-of-demographics-presenting-features-microbiology-and-outcomes
#9
Sanka Amadoru, Kwang Lim, Mark Tacey, Craig Aboltins
AIMS: To explore differences in presentation and outcomes between younger and older patients with bacterial spinal infections. METHODS: Clinical, microbiological and radiological information was collected for patients at a single metropolitan hospital with spinal infections (spondylodiscitis, vertebral osteomyelitis, septic discitis, facet joint septic arthritis, and spinal epidural abscess) between January 2008 and January 2015. Patients were excluded if under 18 years of age, or if clinical and imaging findings were inconsistent with the diagnosis...
October 18, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27747731/status-epilepticus-and-delirium-associated-with-ertapenem-in-a-very-elderly-patient-with-chronic-kidney-disease-and-silent-ischaemic-cerebrovascular-disease
#10
Huimin Lin, Samuel T H Chew
An 85-year-old female with chronic kidney disease and newly acquired seizures on oral phenytoin received intravenous ertapenem 500 mg once daily for a urinary tract infection and bacteraemia involving extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli. After three ertapenem doses, she developed seizures which self-aborted. Corrected phenytoin level was sub-therapeutic initially, but became therapeutic following a phenytoin dose increase. On Day 14 of ertapenem, the patient suffered another episode of seizure...
December 2015: Drug Saf Case Rep
https://www.readbyqxmd.com/read/27744500/some-unusual-forms-of-early-onset-postpartum-psychosis
#11
Ian Brockington
In addition to bipolar cycloid episodes, infective delirium and eclamptic psychosis, each of which has characteristic clinical features and course, brief episodes of delirium and stupor are also seen in the immediate aftermath of parturition. Several mothers have had similar episodes developing later in the first 10 days, and some have cyclical disorders with an unusual time base. Bipolar/cycloid disorders can start on day 1 or even earlier.
October 16, 2016: Archives of Women's Mental Health
https://www.readbyqxmd.com/read/27687901/evidence-based-interventions-to-reduce-adverse-events-in-hospitals-a-systematic-review-of-systematic-reviews
#12
Marieke Zegers, Gijs Hesselink, Wytske Geense, Charles Vincent, Hub Wollersheim
OBJECTIVE: To provide an overview of effective interventions aimed at reducing rates of adverse events in hospitals. DESIGN: Systematic review of systematic reviews. DATA SOURCES: PubMed, CINAHL, PsycINFO, the Cochrane Library and EMBASE were searched for systematic reviews published until October 2015. STUDY SELECTION: English-language systematic reviews of interventions aimed at reducing adverse events in hospitals, including studies with an experimental design and reporting adverse event rates, were included...
2016: BMJ Open
https://www.readbyqxmd.com/read/27687720/prevention-of-critical-care-complications-in-the-coronary-intensive-care-unit-protocols-bundles-and-insights-from-intensive-care-studies
#13
Sean van Diepen, Wendy I Sligl, Jeffrey B Washam, Ian C Gilchrist, Rakesh C Arora, Jason N Katz
Over the past half century, coronary care units have expanded from specialized ischemia arrhythmia monitoring units into intensive care units (ICUs) for acutely ill and medically complex patients with a primary cardiac diagnosis. Patients admitted to contemporary coronary intensive care units (CICUs) are at risk for common and preventable critical care complications, yet many CICUs have not adopted standard-of-care prevention protocols and practices from general ICUs. In this article, we (1) review evidence-based interventions and care bundles that reduce the incidence of ventilator-associated pneumonia, excess sedation during mechanical ventilation, central line infections, stress ulcers, malnutrition, delirium, and medication errors and (2) recommend pragmatic adaptations for common conditions in critically ill patients with cardiac disease, and (3) provide example order sets and practical CICU protocol implementation strategies...
July 1, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27687177/safety-of-simultaneous-bilateral-total-knee-arthroplasty-using-an-extramedullary-referencing-system-results-from-2098-consecutive-patients
#14
Jai Gon Seo, Sang Min Kim, Jung Min Shin, Youngjun Kim, Byung Hoon Lee
INTRODUCTION: Simultaneous bilateral total knee arthroplasty (TKA) has been associated with a high risk of morbidity and mortality. The orthopedic surgeon must, therefore, decide whether bilateral simultaneous TKA is a safe operation to perform and endeavor to decrease the risk of serious complications or even death. METHODS: This retrospective review included 2098 consecutive patients who underwent bilateral simultaneous TKAs by the protocol used in our institution, including the use of extramedullary instruments to minimize medullary canal invasion and overlapping procedures for both knees to decrease operation time...
November 2016: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/27665997/agitation-delirium-and-cognitive-outcomes-in-intracerebral-hemorrhage
#15
Lisa J Rosenthal, Brandon A Francis, Jennifer L Beaumont, David Cella, Michael D Berman, Matthew B Maas, Eric M Liotta, Robert Askew, Andrew M Naidech
BACKGROUND: Delirium predicts higher long-term cognitive morbidity. We previously identified a cohort of patients with spontaneous intracerebral hemorrhage and delirium and found worse outcomes in health-related quality of life (HRQoL) in the domain of cognitive function. OBJECTIVE: We tested the hypothesis that agitation would have additional prognostic significance on later cognitive function HRQoL. METHODS: Prospective identification of 174 patients with acute intracerebral hemorrhage, measuring stroke severity, agitation, and delirium, with a standardized protocol and measures...
August 5, 2016: Psychosomatics
https://www.readbyqxmd.com/read/27641367/unraveling-the-relationship-between-delirium-brain-damage-and-subsequent-cognitive-decline-in-a-cohort-of-individuals-undergoing-surgery-for-hip-fracture
#16
Sara J E Beishuizen, Rikie M Scholtens, Barbara C van Munster, Sophia E de Rooij
OBJECTIVES: To assess the association between serum S100B levels (a marker of brain damage), delirium, and subsequent cognitive decline. DESIGN: Substudy of a multicenter randomized controlled trial. SETTING: Surgical, orthopedic, and trauma surgery wards of two teaching hospitals. PARTICIPANTS: Individuals aged 65 and older (range 65-102) admitted for hip fracture surgery (N = 385). MEASUREMENTS: During hospitalization, presence of delirium was assessed daily...
September 19, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27633985/systemic-tnf-%C3%AE-produces-acute-cognitive-dysfunction-and-exaggerated-sickness-behavior-when-superimposed-upon-progressive-neurodegeneration
#17
Edel Hennessy, Shane Gormley, Ana Belen Lopez-Rodriguez, Caoimhe Murray, Carol Murray, Colm Cunningham
Inflammation influences chronic neurodegeneration but its precise roles are not yet clear. Systemic inflammation caused by infection, trauma or co-morbidity can alter the brain's inflammatory status, produce acute cognitive impairments, such as delirium, and drive new pathology and accelerated decline. Consistent with this, elevated systemic TNF-α is associated with more rapid cognitive decline over 6 months in Alzheimer's disease patients. In the current study we challenged normal animals and those with existing progressive neurodegeneration (ME7 prion disease) with TNF-α (i...
September 12, 2016: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/27516915/west-nile-virus-encephalitis-in-a-patient-with-neuroendocrine-carcinoma
#18
Romina Deldar, Derek Thomas, Anna Maria Storniolo
Importance. Oftentimes, when patients with metastatic cancer present with acute encephalopathy, it is suspected to be secondary to their underlying malignancy. However, there are multiple causes of delirium such as central nervous system (CNS) infections, electrolyte abnormalities, and drug adverse reactions. Because West Nile Virus (WNV) neuroinvasive disease has a high mortality rate in immunosuppressed patients, a high index of suspicion is required in patients who present with fever, altered mental status, and other neurological symptoms...
2016: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/27436624/prognostic-value-of-acute-delirium-recovery-in-older-adults
#19
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/27362971/outcomes-of-dementia-systematic-review-and-meta-analysis-of-hospital-administrative-database-studies
#20
Ahsan Rao, Amna Suliman, Sabine Vuik, Paul Aylin, Ara Darzi
INTRODUCTION: Aim of the study was to compare various outcomes of dementia patients with elderly patients without dementia by conducting a systematic review of previous population-based studies. METHODS: The relevant studies were retrieved from search of electronic databases. RESULTS: The pooled data from included 11 studies consisted of outcomes of 1,044,131 dementia patients compared to 9,639,027 elderly patients without dementia. Meta-analysis showed that the mortality in dementia patients was 15...
September 2016: Archives of Gerontology and Geriatrics
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