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Delirium , infection

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https://www.readbyqxmd.com/read/29755322/microglial-activation-after-systemic-stimulation-with-lipopolysaccharide-and-escherichia-coli
#1
Inge C M Hoogland, Dunja Westhoff, Joo-Yeon Engelen-Lee, Jeroen Melief, Mercedes Valls Serón, Judith H M P Houben-Weerts, Inge Huitinga, David J van Westerloo, Tom van der Poll, Willem A van Gool, Diederik van de Beek
Background: Microglial activation after systemic infection has been suggested to mediate sepsis-associated delirium. A systematic review of animal studies suggested distinct differences between microglial activation after systemic challenge with live bacteria and lipopolysaccharide (LPS). Here, we describe a mouse model of microglial activation after systemic challenge with live Escherichia coli ( E. coli ) and compare results with systemic challenge with LPS. Methods: Sixty mice were intraperitoneally injected with E...
2018: Frontiers in Cellular Neuroscience
https://www.readbyqxmd.com/read/29746650/age-dependent-morbidity-and-mortality-outcomes-after-surgical-aortic-valve-replacement
#2
Amjad I Hussain, Andreas Auensen, Cathrine Brunborg, Jan Otto Beitnes, Lars Gullestad, Kjell I Pettersen
OBJECTIVES: This study addressed the assumption of increased morbidity and mortality after surgical aortic valve replacement in patients older than 80 years with severe aortic stenosis. METHODS: This prospective study was performed in consecutive patients referred for aortic valve replacement. The age-dependent change in cognitive and physical function, quality of life and rehospitalization and complication rates during the following year and 5-year all-cause mortality were documented...
May 9, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29744126/htlv-1-atll-refractory-hypercalcaemia-and-hiv-1-co-infection
#3
Abdullah E Laher, Feroza Motara, Muhammed Moolla, Osman Ebrahim
Adult T-cell lymphoma/leukemia (ATLL) is a rare tumour of T-lymphocytes that is associated with human T-lymphotrophic virus type 1 (HTLV-1) infection as well as severe/refractory hypercalcaemia. Human immunodefficiency virus type 1 (HIV-1) infected individuals are at increased risk of acquiring co-infection with HTLV-1. We present the case of a 37 -year -old HIV-1 positive and antiretroviral therapy naive woman who was admitted to the ICU with delirium, a generalised maculopapular rash, severe hypercalcaemia of 4...
January 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29723848/risk-factors-and-outcomes-of-delirium-in-older-patients-admitted-to-postacute-care-with-and-without-dementia
#4
Neus Gual, Alessandro Morandi, Laura Monica Pérez, Laura Brítez, Pamela Burbano, Flor Man, Marco Inzitari
BACKGROUND: Delirium research is poorly studied in postacute care, a growing setting due to aging populations, as well as in dementia, a critical risk factor for delirium and particularly prevalent in postacute care. We investigated risk factors for delirium and its outcomes in older adults with and without dementia admitted to a subacute care unit (SCU) after exacerbated chronic conditions. METHODS: This is a prospective cohort study including patients ≥65 years old admitted to an SCU for 12 months...
May 3, 2018: Dementia and Geriatric Cognitive Disorders
https://www.readbyqxmd.com/read/29720578/targeting-inflammatory-monocytes-in-sepsis-associated-encephalopathy-and-long-term-cognitive-impairment
#5
Graciela Andonegui, Erin L Zelinski, Courtney L Schubert, Derrice Knight, Laura A Craig, Brent W Winston, Simon C Spanswick, Björn Petri, Craig N Jenne, Janice C Sutherland, Rita Nguyen, Natalie Jayawardena, Margaret M Kelly, Christopher J Doig, Robert J Sutherland, Paul Kubes
Sepsis-associated encephalopathy manifesting as delirium is a common problem in critical care medicine. In this study, patients that had delirium due to sepsis had significant cognitive impairments at 12-18 months after hospital discharge when compared with controls and Cambridge Neuropsychological Automated Test Battery-standardized scores in spatial recognition memory, pattern recognition memory, and delayed-matching-to-sample tests but not other cognitive functions. A mouse model of S. pneumoniae pneumonia-induced sepsis, which modeled numerous aspects of the human sepsis-associated multiorgan dysfunction, including encephalopathy, also revealed similar deficits in spatial memory but not new task learning...
May 3, 2018: JCI Insight
https://www.readbyqxmd.com/read/29694607/clinical-and-laboratory-characteristics-associated-with-referral-of-hospitalized-elderly-to-palliative-care
#6
Suelen Pereira Arcanjo, Luis Alberto Saporetti, José Antonio Esper Curiati, Wilson Jacob-Filho, Thiago Junqueira Avelino-Silva
Objective To investigate clinical and laboratory characteristics associated with referral of acutely ill older adults to exclusive palliative care. Methods A retrospective cohort study based on 572 admissions of acutely ill patients aged 60 years or over to a university hospital located in São Paulo, Brazil, from 2009 to 2013. The primary outcome was the clinical indication for exclusive palliative care. Comprehensive geriatric assessments were used to measure target predictors, such as sociodemographic, clinical, cognitive, functional and laboratory data...
2018: Einstein
https://www.readbyqxmd.com/read/29670988/reducing-complications-and-overall-healthcare-costs-of-hip-fracture-management-a-retrospective-study-on-the-application-of-a-diagnostic-therapeutic-pathway-in-the-cosenza-general-hospital
#7
M Loizzo, F Gallo, D Caruso
BACKGROUND: Diagnostic Therapeutic Pathways (DTPs) are multidisciplinary plans designed by each healthcare organization for a specific category of patients to reduce the variability of professional behaviors and to ensure greater safety and better overall healthcare outcomes. Hip fractures are a frequent traumatic injury, particularly in the elderly, and DTPs recommend early surgical intervention, often not done due to organizational challenges and bureaucracy. Medical conditions suggesting a delay are not frequent, however long waiting times not only increase the risk of complications and mortality, but also increase the number of diagnostic test and physician consultations...
May 2018: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/29669581/reduced-ex-vivo-release-of-pro-inflammatory-cytokines-and-elevated-plasma-interleukin-6-are-inflammatory-signatures-of-post-stroke-delirium
#8
Katarzyna Kowalska, Elzbieta Klimiec, Kazimierz Weglarczyk, Joanna Pera, Agnieszka Slowik, Maciej Siedlar, Tomasz Dziedzic
BACKGROUND: Experimental studies suggest that systemic inflammation contributes to the pathophysiology of delirium. The aim of our study was to determine blood-derived inflammatory signatures of post-stroke delirium. METHODS: We included 144 ischemic stroke patients. We assessed delirium on a daily basis during the first 7 days of hospitalization. Venous blood was collected at day 3 after the onset of stroke and stimulated ex vivo with lipopolysaccharide (LPS)...
April 18, 2018: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29628028/-disorders-associated-with-mild-cognitive-impairment-risk-factors-and-predictors
#9
Manuel Antón Jiménez, José Luis González Guerrero
Traditionally, cognitive impairment has been associated not only with ageing itself but also with concomitant comorbidities that interact in the disease continuum from the prodromic phases. Notable among these are delirium, nutritional alterations, balance and gait, infections and even a progressive incidence of neoplasms. However, with regard to diagnosis and staging, clinicians should perhaps remain especially alert to the possibility of pharmacological iatrogeny, which is not limited to psychopharmacological treatment...
June 2017: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/29609489/long-term-sequelae-of-acute-respiratory-distress-syndrome-caused-by-severe-community-acquired-pneumonia-delirium-associated-cognitive-impairment-and-post-traumatic-stress-disorder
#10
Claudia Denke, Felix Balzer, Mario Menk, Sebastian Szur, Georg Brosinsky, Sascha Tafelski, Klaus-Dieter Wernecke, Maria Deja
Objective Delirium in critically ill patients is considered a risk factor for various long-term consequences. We evaluated delirium and associated long-term outcomes in patients with acute respiratory distress syndrome with non-H1N1 and H1N1- associated severe community-acquired pneumonia (sCAP) who had been recommended to take antiviral drugs associated with delirious symptoms as adverse effects. Methods Of 64 patients, 42 survivors (H1N1, 15; non-H1N1, 27) were analyzed regarding the relationship between medication and the duration of delirium in the intensive care unit...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29570150/cost-effectiveness-research-in-anesthesiology
#11
Bijan J Teja, Tori N Sutherland, Sheila R Barnett, Daniel S Talmor
Perioperative interventions aimed at decreasing costs and improving outcomes have become increasingly popular in recent years. Anesthesiologists are often faced with a choice among different treatment strategies with little data available on the comparative cost-effectiveness. We performed a systematic review of the English language literature between 1980 and 2014 to identify cost-effectiveness analyses of anesthesiology and perioperative medicine interventions. We excluded interventions related to critical care or pediatric anesthesiology, and articles on interventions not normally ordered or performed by anesthesiologists...
March 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29567515/in-hospital-complication-rate-following-microendoscopic-versus-open-lumbar-laminectomy-a-propensity-score-matched-analysis
#12
Takeshi Oichi, Yasushi Oshima, Hirotaka Chikuda, Junichi Ohya, Hiroki Matsui, Kiyohide Fushimi, Sakae Tanaka, Hideo Yasunaga
BACKGROUND CONTEXT: The incidence of postoperative complications after microendoscopic laminectomy (MEL) has not been compared with that of open laminectomy in a large study, so it is not clear whether MEL is a safer procedure. PURPOSE: To compare postoperative morbidity and mortality following lumbar laminectomy between patients treated with MEL and open laminectomy. STUDY DESIGN: Retrospective cohort study with propensity score-matched analysis...
March 19, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29561424/nonopportunistic-infection-leading-to-rapidly-progressive-dementia-in-a-patient-with-hiv-aids-a-case-report
#13
Johannes Eimer, Jan Vesterbacka, Irina Savitcheva, Rayomand Press, Homayoun Roshanisefat, Piotr Nowak
RATIONALE: Cognitive dysfunction is a common presenting symptom in patients with HIV/AIDS. It is usually directly associated with HIV infection or due to opportunistic infection. Rapidly progressive dementia, however, is rarely observed in acute HIV infection or during immune reconstitution. Recently, a case of Creutzfeld-Jakob disease (CJD) has been reported in a patient with chronic HIV infection. The incidence of CJD is not known to be increased among immunocompromised patients. PATIENT CONCERNS: We here report the case of a 59-year-old male patient with a recent diagnosis of HIV/AIDS and Pneumocystis jiroveci pneumonia presenting with secondary behavioral changes and disorientation...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29474407/predicting-excess-cost-for-older-inpatients-with-clinical-complexity-a-retrospective-cohort-study-examining-cognition-comorbidities-and-complications
#14
Kasia Bail, Brian Draper, Helen Berry, Rosemary Karmel, John Goss
BACKGROUND: Hospital-acquired complications increase length of stay and contribute to poorer patient outcomes. Older adults are known to be at risk for four key hospital-acquired complications (pressure injuries, pneumonia, urinary tract infections and delirium). These complications have been identified as sensitive to nursing characteristics such as staffing levels and level of education. The cost of these complications compared to the cost of admission severity, dementia, other comorbidities or age has not been established...
2018: PloS One
https://www.readbyqxmd.com/read/29474380/predisposing-and-precipitating-factors-for-delirium-in-community-dwelling-older-adults-admitted-to-hospital-with-this-condition-a-prospective-case-series
#15
Emmanuelle Magny, Hélène Le Petitcorps, Maria Pociumban, Zineb Bouksani-Kacher, Éric Pautas, Joël Belmin, Sylvie Bastuji-Garin, Carmelo Lafuente-Lafuente
BACKGROUND: Factors associated with delirium among community-dwelling older adults have been poorly studied. Our aim was to describe the prevalence of predisposing and precipitating factors for delirium among patients admitted for delirium and to assess whether these factors were appropriately recognized at the first patient assessment at hospital. METHODS: Consecutive community-dwelling individuals admitted to three geriatric acute care units with a confirmed initial diagnosis of delirium were prospectively included...
2018: PloS One
https://www.readbyqxmd.com/read/29423616/frequency-and-predictors-of-post-stroke-delirium-in-prospective-observational-polish-study-propolis
#16
P Pasinska, K Kowalska, E Klimiec, A Szyper-Maciejowska, A Wilk, A Klimkowicz-Mrowiec
Delirium is the most common and serious neurobehavioral complication in acute hospital admissions. Some patients develop signs of delirium but do not meet all diagnostic criteria. Stroke is a major risk factor for delirium. The aim of this prospective study was to build a predictive model for delirium and subsyndromal post-stroke delirium. Patients with stroke were screened for delirium during the first 7 days after admission. Delirium was diagnosed according to DSM-V criteria. Baseline demographic, biochemical, stroke-related data, medications used, neurological deficit, and premorbid cognitive and functional impairment were assessed...
April 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29402715/does-parkinson-disease-increase-the-risk-of-perioperative-complications-after-total-hip-arthroplasty-a-nationwide-database-study
#17
Jared M Newman, Nipun Sodhi, Sarah E Dalton, Anton Khlopas, Richard P Newman, Carlos A Higuera, Michael A Mont
BACKGROUND: Parkinson disease (PD) is the second most common neurodegenerative disorder in the United States, affecting over 1 million people. As part of the disease process, PD can cause poor bone quality and other musculoskeletal problems that can affect a patient's quality of life. With advances in treatment, PD patients can be more active and may be candidates for total hip arthroplasty (THA). However, there is a paucity of literature on the outcomes of THA in PD patients. Therefore, the purpose of this study was to evaluate the perioperative outcomes of PD patients who underwent THA...
January 16, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29390969/hypertension-mitral-valve-disease-atrial-fibrillation-and-low-education-level-predict-delirium-and-worst-outcome-after-cardiac-surgery-in-older-adults
#18
Fátima R Oliveira, Victor H Oliveira, Ítalo M Oliveira, José W Lima, Daniela Calderaro, Danielle M Gualandro, Bruno Caramelli
BACKGROUND: Delirium is a common complication after cardiac surgery in older adult patients. However, risk factors and the influence of delirium on patient outcomes are not well established. We aimed to determine the incidence, predisposing and triggering factors of delirium following cardiac surgery. METHODS: One hundred seventy-three consecutive patients aged ≥60 years were studied. Patients' characteristics and two cognitive function assessment tests were recorded preoperatively...
February 1, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29378075/evidence-based-practice-guideline-delirium
#19
Patricia Finch Guthrie, Shelley Rayborn, Howard K Butcher
Delirium is a common cause of morbidity and mortality in hospitalized older adults often superimposed on dementia. Older patients with delirium are more likely than other populations to develop hospital-acquired infections, pressure ulcers, and immobility and nutritional issues, as well as to have increased health care costs, longer hospital stays, and long-term care following discharge. Interventions that prevent or mitigate the effects of delirium while promoting recovery are essential for caring for hospitalized older patients...
February 1, 2018: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/29362259/prognostic-factors-of-inhospital-death-in-elderly-patients-a-time-to-event-analysis-of-a-cohort-study-in-martinique-french-west-indies
#20
Lidvine Godaert, Seendy Bartholet, Fréderique Dorléans, Fatiha Najioullah, Sebastien Colas, Jean-Luc Fanon, André Cabié, Raymond Césaire, Moustapha Dramé
OBJECTIVE: The primary objective was to identify predictive factors of inhospital death in a population of patients aged 65 years or older hospitalised with Chikungunya virus (CHIKV) infection. The secondary aim was to develop and validate a predictive score for inhospital death based on the predictors identified. DESIGN: Longitudinal retrospective study from January to December 2014. SETTING: University Hospital of Martinique. PARTICIPANTS: Patients aged ≥65 years, admitted to any clinical ward and who underwent reverse transcription PCR testing for CHIKV infection...
January 23, 2018: BMJ Open
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