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Delirium , infection

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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
#1
REVIEW
Leroy Schreuder, Bart J L Eggen, Knut P H 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
#2
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
#3
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
#4
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
#5
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
#6
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...
December 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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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...
January 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27759751/fever-delirium-and-incontinence-not-always-a-uti
#15
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
#16
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
#17
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
#18
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
#19
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
#20
REVIEW
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...
January 2017: Canadian Journal of Cardiology
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