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https://www.readbyqxmd.com/read/29045280/sedation-practice-in-extracorporeal-membrane-oxygenation-treated-patients-with-acute-respiratory-distress-syndrome-a-retrospective-study
#1
Julian deBacker, Erik Tamberg, Laveena Munshi, Lisa Burry, Eddy Fan, Sangeeta Mehta
Our objective was to characterize sedation management in adult patients with severe respiratory distress syndrome (ARDS) treated with venovenous extracorporeal membrane oxygenation (VV-ECMO). We conducted a retrospective chart review of these patients treated at Toronto General Hospital between January 2012 and October 2015. Medications administered (sedative, analgesic, paralytic, and antipsychotic), sedation depth (Sedation Agitation Scale [SAS] score) delirium assessments, and mobilization were recorded daily...
October 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29037336/neuropsychiatry-towards-a-philosophy-of-praxis
#2
Jesús Ramirez-Bermudez, Rodrigo Perez-Esparza, Luis Carlos Aguilar-Venegas, Perminder Sachdev
Neuropsychiatry is a specialized clinical, academic and scientific discipline with its field located in the borderland territory between neurology and psychiatry. In this article, we approach the theoretical definition of neuropsychiatry, and in order to address the practical aspects of the discipline, we describe the profile of a neuropsychiatric liaison service in the setting of a large hospital for neurological diseases in a middle-income country. An audit of consecutive in-patients requiring neuropsychiatric assessment at the National Institute of Neurology and Neurosurgery of Mexico is reported, comprising a total of 1212 patients...
October 2017: Revista Colombiana de Psiquiatría
https://www.readbyqxmd.com/read/28960161/geriatric-comanagement-reduces-perioperative-complications-and-shortens-duration-of-hospital-stay-after-lumbar-spine-surgery-a-prospective-single-institution-experience
#3
Owoicho Adogwa, Aladine A Elsamadicy, Victoria D Vuong, Jessica Moreno, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
OBJECTIVE Geriatric patients undergoing lumbar spine surgery have unique needs due to the physiological changes of aging. They are at risk for adverse outcomes such as delirium, infection, and iatrogenic complications, and these complications, in turn, contribute to the risk of functional decline, nursing home admission, and death. Whether preoperative and perioperative comanagement by a geriatrician reduces the incidence of in-hospital complications and length of in-hospital stay after elective lumbar spine surgery remains unknown...
September 29, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28939397/national-survey-of-emergency-physicians-concerning-home-based-care-options-as-alternatives-to-emergency-department-based-hospital-admissions
#4
Amy R Stuck, Christopher Crowley, James Killeen, Edward M Castillo
BACKGROUND: Emergency departments (EDs) in the United States play a prominent role in hospital admissions, especially for the growing population of older adults. Home-based care, rather than hospital admission from the ED, provides an important alternative, especially for older adults who have a greater risk of adverse events, such as hospital-acquired infections, falls, and delirium. OBJECTIVE: The objective of the survey was to understand emergency physicians' (EPs) perspectives on home-based care alternatives to hospitalization from the ED...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28894370/reversible-global-aphasia-as-a-side-effect-of-quetiapine-a-case-report-and-literature-review
#5
Ching-Fang Chien, Poyin Huang, Sun-Wung Hsieh
Quetiapine is an atypical antipsychotic agent which is also prescribed for delirium due to its anti-dopaminergic effects; aphasia is an unusual side effect associated with the drug. Here, we report the case of an 83-year-old woman who was prescribed quetiapine (50 mg per day) for delirium. Unexpected, global aphasia occurred 3 days after treatment began. Complete recovery occurred following discontinuation of the drug. A brain computed tomography scan excluded intracranial hemorrhage and the laboratory results confirmed that no exacerbation of infection or electrolyte imbalances were present...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28885286/predicting-perioperative-complications-in-adult-spinal-deformity-surgery-using-a-simple-sliding-scale
#6
Go Yoshida, Tomohiko Hasegawa, Yu Yamato, Sho Kobayashi, Shin Oe, Tomohiro Banno, Yuuki Mihara, Hideyuki Arima, Hiroki Ushirozako, Tatsuya Yasuda, Daisuke Togawa, Yukihiro Matsuyama
STUDY DESIGN: Retrospective database study OBJECTIVE.: To develop and validate a sliding scale for predicting perioperative complications associated with ASD surgery. SUMMARY OF BACKGROUND DATA: ASD surgery can have high perioperative complication rates, which is associated with increased morbidity and mortality. METHODS: Data on consecutive ASD patients undergoing posterior corrective surgery over a six-year interval were collected from a prospective database...
September 6, 2017: Spine
https://www.readbyqxmd.com/read/28874102/ertapenem-associated-neurotoxicity-in-the-spinal-cord-injury-sci-population-a-case-series
#7
Ursula C Patel, Mallory A Fowler
Context Ertapenem, a broad spectrum carbapenem antibiotic, is used often in Spinal Cord Injury (SCI) patients due to increased risk factors for multi-drug resistant (MDR) infections in this population. Neurotoxicity, specifically seizures, due to ertapenem is a known adverse effect and has been described previously. Other manifestations such as delirium and visual hallucinations have rarely been reported, and no literature, to the best of our knowledge, specifically describes these effects solely in the SCI population...
September 6, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28870776/consensus-report-by-the-pediatric-acute-lung-injury-and-sepsis-investigators-and-pediatric-blood-and-marrow-transplantation-consortium-joint-working-committees-on-supportive-care-guidelines-for-management-of-veno-occlusive-disease-in-children-and-adolescents
#8
Nadia Ovchinsky, Warren Frazier, Jeffery J Auletta, Christopher C Dvorak, Monica Ardura, Enkyung Song, Jennifer McArthur, Asumthia Jeyapalan, Robert Tamburro, Kris M Mahadeo, Chani Traube, Christine N Duncan, Rajinder P S Bajwa
Some patients with veno-occlusive disease (VOD) have multiorgan dysfunction, and multiple teams are involved in their daily care in the pediatric intensive care unit. Cardiorespiratory dysfunction is critical in these patients, requiring immediate action. The decision of whether to use a noninvasive or an invasive ventilation strategy may be difficult in the setting of mucositis or other comorbidities in patients with VOD. Similarly, monitoring of organ function may be very challenging in these patients, who may have fulminant hepatic failure with or without hepatic encephalopathy complicated by delirium and/or infections...
September 1, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28861418/incidence-of-postoperative-delirium-in-patients-undergoing-total-knee-arthroplasty-an-asian-perspective
#9
Juncheng Huang, Hamid Rahmatullah Bin Abd Razak, Seng Jin Yeo
BACKGROUND: Very little is known in the literature with regards to the incidence of postoperative delirium following total knee arthroplasty (TKA) in Asians and the associated surgical factors. We conducted a retrospective study on incidence of postoperative delirium following TKA in Asians. METHODS: One thousand sixteen knees of 954 consecutive patients who underwent TKA by the senior author of this study in the year 2006 were included in this review. All written and electronic medical records for patients were screened...
August 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28794518/pre-stroke-apathy-symptoms-are-associated-with-an-increased-risk-of-delirium-in-stroke-patients
#10
Elzbieta Klimiec, Katarzyna Kowalska, Paulina Pasinska, Aleksandra Klimkowicz-Mrowiec, Aleksandra Szyper, Joanna Pera, Agnieszka Slowik, Tomasz Dziedzic
Neuropsychiatric symptoms can be interrelated to delirium. We aimed to investigate an association between pre-stroke neuropsychiatric symptoms and the risk of delirium in stroke patients. We included 606 patients (median age: 73, 53% female) with stroke or transient ischemic attack admitted within 48 hours from symptoms onset. We assessed delirium on a daily basis during the first 7 days of hospitalization. To make diagnosis of delirium we used DSM-5 criteria. We used Neuropsychiatric Inventory to assess neuropsychiatric symptoms occurring within 4 weeks prior to stroke...
August 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28750010/intensive-care-discharge-delay-is-associated-with-increased-hospital-length-of-stay-a-multicentre-prospective-observational-study
#11
MULTICENTER STUDY
Ravindranath Tiruvoipati, John Botha, Jason Fletcher, Himangsu Gangopadhyay, Mainak Majumdar, Sanjiv Vij, Eldho Paul, David Pilcher
BACKGROUND: Some patients experience a delayed discharge from the intensive care unit (ICU) where the intended and actual discharge times do not coincide. The clinical implications of this remain unclear. OBJECTIVE: To determine the incidence and duration of delayed ICU discharge, identify the reasons for delay and evaluate the clinical consequences. METHODS: Prospective multi-centre observational study involving five ICUs over a 3-month period...
2017: PloS One
https://www.readbyqxmd.com/read/28741278/italian-intersociety-consensus-on-prevention-diagnosis-and-treatment-of-delirium-in-hospitalized-older-persons
#12
Giuseppe Bellelli, Alessandro Morandi, Marco Trabucchi, Guido Caironi, Daniele Coen, Carlo Fraticelli, Ciro Paolillo, Carolina Prevaldi, Angela Riccardi, Gianfranco Cervellin, Corrado Carabellese, Salvatore Putignano, Stefania Maggi, Antonio Cherubini, Paola Gnerre, Andrea Fontanella, Nicola Latronico, Concezione Tommasino, Antonio Corcione, Giovanni Ricevuti, Nicola Ferrara, Francesco De Filippi, Alberto Ferrari, Mario Guarino, Maria Pia Ruggieri, Pietro Amedeo Modesti, Carlo Locatelli, Patrizia Hrelia, Marco Otto Toscano, Emi Bondi, Antonio Tarasconi, Luca Ansaloni, Francesco Perticone
Delirium is a severe neuropsychiatric syndrome characterized by inattention and global cognitive dysfunction in the setting of an acute medical illness, medical complication, drug intoxication, or drug withdrawal. The most important risk factors are advanced age and dementia, whereas pain, dehydration, infections, stroke, metabolic disturbances, and surgery are the most common triggering factors. Although delirium is a common clinical syndrome in different settings of care (acute care hospitals, inpatient rehabilitation facilities, nursing homes, and hospices), it often remains under-recognized, poorly understood, and inadequately managed...
July 24, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28737064/the-effects-of-delirium-prevention-guidelines-on-elderly-stroke-patients
#13
Jihye Song, Minkyung Lee, Dukyoo Jung
This study aimed to evaluate the effectiveness of the delirium prevention interventions recommended by the Delirium Prevention Guidelines for Elderly Stroke Patients (DPGESP). The DPGESP comprises nine dimensions with 28 interventions, including risk factor assessment, orientation disorder prevention, sleeping pattern maintenance, sensory interventions, constipation, dehydration, hypoxia and infection prevention, pain management, and appropriate nutrition maintenance. This quasi-experimental study used a nonequivalent control group and a pretest-posttest design...
July 1, 2017: Clinical Nursing Research
https://www.readbyqxmd.com/read/28711217/psychosis-due-to-disseminated-cryptococcal-infection-and-delirium-in-an-immunocompetent-patient-a-case-report-and-review-of-the-literature
#14
Jungjin Kim, Georgina Hartzell, Neguine Rezaii, Lauren Gensler, Wendy Baer, Raymond Young, Ann C Schwartz
No abstract text is available yet for this article.
June 9, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28671901/effectiveness-and-safety-of-an-extended-icu-visitation-model-for-delirium-prevention-a-before-and-after-study
#15
Regis Goulart Rosa, Tulio Frederico Tonietto, Daiana Barbosa da Silva, Franciele Aparecida Gutierres, Aline Maria Ascoli, Laura Cordeiro Madeira, William Rutzen, Maicon Falavigna, Caroline Cabral Robinson, Jorge Ibrain Salluh, Alexandre Biasi Cavalcanti, Luciano Cesar Azevedo, Rafael Viegas Cremonese, Tarissa Ribeiro Haack, Cláudia Severgnini Eugênio, Aline Dornelles, Marina Bessel, José Mario Meira Teles, Yoanna Skrobik, Cassiano Teixeira
OBJECTIVES: To evaluate the effect of an extended visitation model compared with a restricted visitation model on the occurrence of delirium among ICU patients. DESIGN: Prospective single-center before and after study. SETTING: Thirty-one-bed medical-surgical ICU. PATIENTS: All patients greater than or equal to 18 years old with expected length of stay greater than or equal to 24 hours consecutively admitted to the ICU from May 2015 to November 2015...
October 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28664811/how-can-i-help-older-people-in-hospital-get-home-sooner-and-prevent-deconditioning
#16
Jo Jennings
Concerns about the complications of prolonged bed rest were raised as far back as 1947 ( Asher 1947 ). Hospital stays are associated with iatrogenic infections, medication errors, increased risk of delirium and side effects of prolonged bed rest ( Inouye and Charpentier 1996 , Covinsky et al 2011 ).
June 30, 2017: Nursing Older People
https://www.readbyqxmd.com/read/28625940/prodromal-stage-of-disease-dementia-with-lewy-bodies-how-to-diagnose-in-practice
#17
Frédéric Blanc, Marc Verny
Disease with Lewy bodies or dementia with Lewy bodies (DLB), particularly at the prodromal stage, is a complex disease to diagnose because of different clinical beginnings and variable paths in terms of clinical expression. Thus DLB can be entcountered in different input modes: mild cognitive impairment, depression, acute behavioral disorders, confusion and delirium, or sleep disorders. In the aim to better diagnose the disease, should be sought obviously to search for the key symptoms: fluctuations, hallucinations, extra-pyramidal syndrome, and REM sleep behavior disorder...
June 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28624753/treatment-of-asymptomatic-uti-in-older-delirious-medical-in-patients-a-prospective-cohort-study
#18
Monidipa Dasgupta, Chris Brymer, Sameer Elsayed
BACKGROUND: Despite clinical practice guidelines, asymptomatic bacteriuria (ASB) in older people is frequently treated. A common reason for treating ASB is a change in mental status. OBJECTIVE: To determine how often asymptomatic UTI is treated in older medically ill delirious individuals and its association with functional recovery. METHODS: Consecutive older medical in-patients were screened for delirium, and followed in hospital. Treatment for asymptomatic UTI was defined as documented treatment for a possible urinary tract infection with antibiotics, without concurrent infectious or urinary symptoms...
September 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28601141/neuropsychiatric-aspects-of-infectious-diseases-an-update
#19
REVIEW
Sahil Munjal, Stephen J Ferrando, Zachary Freyberg
Among the critically ill, infectious diseases can play a significant role in the etiology of neuropsychiatric disturbances. All critical care physicians are familiar with delirium as a secondary complication of systemic infection. This article focuses on key infectious diseases that commonly and directly produce neuropsychiatric symptoms, including direct infection of the central nervous system, human immunodeficiency virus infection, and AIDS.
July 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28592789/are-sutureless-aortic-valves-suitable-for-severe-high-risk-patients-suffering-from-active-infective-aortic-valve-endocarditis
#20
Alexander Weymann, Johanna Konertz, Michael Laule, Karl Stangl, Pascal M Dohmen
BACKGROUND Sutureless aortic valves were introduced to facilitate minimally invasive aortic valve surgery. Since sutureless aortic valves are a feasible procedure, we evaluated if any benefits could be identified in severe high-risk patients with active infective endocarditis of the aortic valve. MATERIAL AND METHODS Between April 2014 and April 2015, a total of 42 patients received a sutureless Perceval® aortic valve (Sorin Biomedica Cardio Srl, Saluggia, Italy) for different indications. Nine of these patients (median age 71 years, range 47-83 years) suffered from active infective endocarditis, including four patients with prosthetic aortic valve endocarditis...
June 8, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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