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Delirium , infection

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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/28332157/systematic-overdosing-of-oxa-and-cloxacillin-in-severe-infections-treated-in-icu-risk-factors-and-side-effects
#2
Mathilde Neuville, Najoua El-Helali, Eric Magalhaes, Aguila Radjou, Roland Smonig, Jean-François Soubirou, Guillaume Voiriot, Alban Le Monnier, Stéphane Ruckly, Lila Bouadma, Romain Sonneville, Jean-François Timsit, Bruno Mourvillier
BACKGROUND: Oxacillin and cloxacillin are the most frequently used penicillins for the treatment of severe methicillin-susceptible Staphylococcus aureus infections in intensive care units (ICUs), especially endocarditis. International recommendations do not suggest any adaptation of the dosage in case of renal impairment. We wanted to assess the risk factors for overdosing in ICU and the related observed side effects. METHODS: All patients with a therapeutic drug monitoring of oxa- or cloxacillin between 2008 and 2014 were included...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28286656/are-you-ernest-shackleton-the-polar-explorer-refining-the-criteria-for-delirium-and-brain-dysfunction-in-sepsis
#3
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/28262398/post-operative-delirium-is-an-independent-predictor-of-30-day-hospital-readmission-after-spine-surgery-in-the-elderly-%C3%A2-65years-old-a-study-of-453-consecutive-elderly-spine-surgery-patients
#4
Aladine A Elsamadicy, Timothy Y Wang, Adam G Back, Emily Lydon, Gireesh B Reddy, Isaac O Karikari, Oren N Gottfried
In the last decade, costs of U.S. healthcare expenditures have been soaring, with billions of dollars spent on hospital readmissions. Identifying causes and risk factors can reduce soaring readmission rates and help lower healthcare costs. The aim of this is to determine if post-operative delirium in the elderly is an independent risk factor for 30-day hospital readmission after spine surgery. The medical records of 453 consecutive elderly (≥65years old) patients undergoing spine surgery at Duke University Medical Center from 2008 to 2010 were reviewed...
March 2, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28255510/risk-factors-for-urinary-retention-following-surgical-repair-of-hip-fracture-in-female-patients
#5
Ron Cialic, Victor Shvedov, Yaffa Lerman
BACKGROUND/OBJECTIVES: Postoperative urinary retention (POUR) is a common event following surgical procedures. An increase in the number of elderly individuals who undergo hip fracture repair procedures is inevitable due to the aging of population. Postoperative urinary retention is associated with both early (infections, delirium) and late complications (urinary incontinence) of surgery. The objective of the current study is to direct attention to the less studied population of patients admitted to a geriatric rehabilitation ward following hip fracture repair who are at risk of POUR...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28208916/delirium-in-parkinson-s-disease-a-cocktail-diagnosis
#6
Robin George Manappallil
Mental disturbances have been described in patients with Parkinson's Disease (PD). Of these, the common conditions are delirium and psychosis. Delirium has been attributed to change of environment, especially hospital stay and infections; while psychosis is due to drugs like dopamine agonists. This is a case of a 75-year-old male, on levodopa therapy for PD, who presented with delirium and ended up with a cocktail diagnosis: Cryptococcal meningitis, Hashimoto's Encephalopathy (HE), Urinary tract infection with acute renal failure, Uremic encephalopathy and Levodopa induced psychosis...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28190439/neurologic-complications-of-polytrauma
#7
R M Jha, L Shutter
Neurologic complications in polytrauma can be classified by etiology and clinical manifestations: neurovascular, delirium, and spinal or neuromuscular problems. Neurovascular complications include ischemic strokes, intracranial hemorrhage, or the development of traumatic arteriovenous fistulae. Delirium and encephalopathy have a reported incidence of 67-92% in mechanically ventilated polytrauma patients. Causes include sedation, analgesia/pain, medications, sleep deprivation, postoperative state, toxic ingestions, withdrawal syndromes, organ system dysfunction, electrolyte/metabolic abnormalities, and infections...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28156637/complications-of-intrathecal-pump-therapy-in-malignancy-related-pain
#8
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/28144726/-delirium-in-stroke-patients-critical-analysis-of-statistical-procedures-for-the-identification-of-risk-factors
#9
P Nydahl, N G Margraf, A Ewers
BACKGROUND: Delirium is a relevant complication following an acute stroke. It is a multifactor occurrence with numerous interacting risk factors that alternately influence each other. PROBLEM: The risk factors of delirium in stroke patients are often based on limited clinical studies. The statistical procedures and clinical relevance of delirium related risk factors in adult stroke patients should therefore be questioned. METHOD: This secondary analysis includes clinically relevant studies that give evidence for the clinical relevance and statistical significance of delirium-associated risk factors in stroke patients...
January 31, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28093812/factors-predicting-incidence-of-post-operative-delirium-in-older-people-following-hip-fracture-surgery-a-systematic-review-and-meta-analysis
#10
REVIEW
T O Smith, A Cooper, G Peryer, R Griffiths, C Fox, J Cross
OBJECTIVE: Delirium is one of the most common complications following hip fracture surgery in older people. This study identified pre- and peri-operative factors associated with the development of post-operative delirium following hip fracture surgery. METHODS: Published and unpublished literature were searched to identify all evidence reporting variables on patient characteristics, on-admission, intra-operative and post-operative management assessing incident delirium in older people following hip fracture surgery...
January 17, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28088641/pathophysiological-and-behavioral-effects-of-systemic-inflammation-in-aged-and-diseased-rodents-with-relevance-to-delirium-a-systematic-review
#11
REVIEW
Leroy Schreuder, B J Eggen, Knut Biber, Regien G Schoemaker, Jon D Laman, Sophia E de Rooij
Delirium is a frequent outcome for aged and demented patients that suffer a systemic inflammatory insult. Animal models that reconstruct these etiological processes have potential to provide a better understanding of the pathophysiology of delirium. Therefore, we systematically reviewed animal studies in which systemic inflammation was superimposed on aged or diseased animal models. In total, 77 studies were identified. Aged animals were challenged with a bacterial endotoxin in 29 studies, 25 studies superimposed surgery on aged animals, and in 6 studies a bacterial infection, Escherichia coli (E...
January 11, 2017: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/28072724/fatal-antiphospholipid-syndrome-following-endoscopic-transnasal-transsphenoidal-surgery-for-a-pituitary-tumor-a-case-report
#12
Chiao-Zhu Li, Chiao-Ching Li, Chih-Chuan Hsieh, Meng-Chi Lin, Dueng-Yuan Hueng, Feng-Chen Liu, Yuan-Hao Chen
INTRODUCTION: The fatal type of antiphospholipid syndrome is a rare but life-threating condition. It may be triggered by surgery or infection. Endoscopic transnasal-transsphenoidal surgery is a common procedure for pituitary tumor. We report a catastrophic case of a young woman died of fatal antiphospholipid syndrome following endoscopic transnasal-transsphenoidal surgery. METHODS AND RESULT: A 31-year-old woman of a history of stroke received endoscopic transnasal-transsphenoidal surgery for a pituitary tumor...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28072642/acute-neuropsychiatric-symptoms-associated-with-antibiotic-treatment-of-helicobacter-pylori-infections-a-review
#13
Nicholas H Neufeld, Nourhan S Mohamed, Nikola Grujich, Kenneth Shulman
Helicobacter pylori infects half the global population. Because serious complications can result from this infection, a so-called "triple therapy" is recommended: treatment with a proton-pump inhibitor and clarithromycin, along with amoxicillin or metronidazole. Although these antibiotics have been associated with neuropsychiatric symptoms, it is difficult to disentangle the effects of antibiotics from the effects of acute infections that may precipitate acute neuropsychiatric symptoms. Study of patients with chronic H...
January 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/28042169/the-problem-of-polypharmacy-in-female-patients-with-overactive-bladders-cross-sectional-study-in-a-specialist-outpatient-department
#14
C S Schneidinger, W Umek, B Böhmdorfer
Background: The consumption of certain drugs can cause urinary incontinence. The aim of this study is to determine the frequency of consumption of drugs that can favour incontinence, the incidence of polypharmacy and the incidence of potentially dangerous drug-drug interactions in female patients suffering from overactive bladder (OAB) who presented to a urogynaecological outpatient department. Methods: We undertook a retrospective case series study. The data from 100 female patients who attended the urogynaecological outpatient department of the Vienna General Hospital [VGH; Allgemeinen Krankenhauses Wien (AKH)] in the period from 20...
December 2016: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/27997467/functional-outcomes-of-operative-management-of-scapula-fractures-in-a-geriatric-cohort
#15
Peter A Cole, Jeffrey A Gilbertson, Peter A Cole
OBJECTIVES: To analyze functional outcomes, motion, and strength in patients 65 years of age and older who underwent operative management of a scapula fracture. DESIGN: Retrospective review of prospective database. SETTING: A single level-1 teaching trauma center. PATIENTS/PARTICIPANTS: Two hundred fifty patients with scapula fractures were operated between January 2002 and March 2014. A review identified 16 geriatric patients 65 years of age and older...
January 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27984255/knowns-and-unknowns-about-delirium-in-stroke-a-review
#16
REVIEW
Elzbieta Klimiec, Tomasz Dziedzic, Katarzyna Kowalska, Agnieszka Slowik, Aleksandra Klimkowicz-Mrowiec
Delirium is a transient condition characterized by sudden and fluctuating disturbances in cognitive function. The condition can be considered a sign of the brain's vulnerability and diminished resilience to insult. Among the many clinical manifestations are cognitive, psychomotor, and sleep disturbances. Delirium is associated with longer hospital stays, worse functional outcomes, and higher mortality. Although up to 48% of patients who have had a stroke develop delirium, the condition has been studied much less in these patients than in general medicine, surgical, and intensive care patients...
2016: Cognitive and Behavioral Neurology: Official Journal of the Society for Behavioral and Cognitive Neurology
https://www.readbyqxmd.com/read/27979481/postoperative-delirium-is-associated-with-increased-intensive-care-unit-and-hospital-length-of-stays-after-liver-transplantation
#17
Bishwajit Bhattacharya, Adrian Maung, Kimberly Barre, Linda Maerz, Manuel I Rodriguez-Davalos, Michael Schilsky, David C Mulligan, Kimberly A Davis
BACKGROUND: Delirium is increasingly recognized as a common and important postoperative complication that significantly hinders surgical recovery. However, there is a paucity of data examining the incidence and impact of delirium after liver transplantation. METHODS: Retrospective case series in a tertiary care center examining all (n = 144) adult patients who underwent liver transplantation during a 6-y period. RESULTS: Delirium occurred in 25% of the patients with an average duration of 4...
January 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27887978/mild-encephalitis-encephalopathy-with-reversible-splenial-lesion-mers-due-to-dengue-virus
#18
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...
February 2017: 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-disease-a-retrospective-matched-pair-cohort-study
#19
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/27836006/mycoplasma-pneumoniae-associated-mild-encephalitis-encephalopathy-with-a-reversible-splenial-lesion-report-of-two-pediatric-cases-and-a-comprehensive-literature-review
#20
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
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