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Acute agitation

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https://www.readbyqxmd.com/read/28807142/efficacy-of-lurasidone-in-the-treatment-of-agitation-a-post-hoc-analysis-of-five-short-term-studies-in-acutely-ill-patients-with-schizophrenia
#1
Michael H Allen, Leslie Citrome, Andrei Pikalov, Jay Hsu, Antony Loebel
OBJECTIVE: This post hoc analysis evaluated the effect of lurasidone on agitation in acutely ill patients with schizophrenia. METHOD: Patient-level data were pooled from five 6-week, randomized, double-blind, placebo-controlled studies of fixed-dose, once-daily, oral lurasidone (40, 80, 120, or 160 mg/d). Agitation was assessed with the Positive and Negative Syndrome Scale-Excited Component (PANSS-EC) score, utilizing a mixed model for repeated measurement analysis...
July 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28800800/behavioral-emergencies-special-considerations-in-the-pregnant-patient
#2
REVIEW
Awais Aftab, Asim A Shah
This article describes psychiatric emergencies in pregnant women. The perinatal period is a time of psychiatric vulnerability. Up to 1 in 6 pregnant women experience major depressive disorder, and 1 in 4 pregnant women with bipolar disorder experience mood exacerbation. We discuss the management of severe mental illness in pregnancy, risk to mother and child of untreated psychiatric illness in pregnancy, risk of relapse of psychiatric disorders in pregnancy with medication discontinuation, psychopharmacologic considerations of teratogenicity and other fetal adverse effects, acute agitation in the pregnant patient, suicidality in pregnancy, and emergency considerations related to substance use disorders...
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28800797/a-modern-day-fight-club-the-stabilization-and-management-of-acutely-agitated-patients-in-the-emergency-department
#3
REVIEW
Andrew New, Veronica Theresa Tucci, Juan Rios
This article is an overview of the treatment and management of acutely agitated patients as they present in the emergency department or emergency psychiatric facility. This article focuses on how a patient encounter may unfold and what issues need to be considered along the way. Verbal de-escalation is emphasized as a standard of care, including the offering of environmental changes and medications when indicated. Approved medications are reviewed as well as the proper use of restraints.
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28758203/haloperidol-for-psychosis-induced-aggression-or-agitation-rapid-tranquillisation
#4
REVIEW
Edoardo G Ostinelli, Melanie J Brooke-Powney, Xue Li, Clive E Adams
BACKGROUND: Haloperidol used alone is recommended to help calm situations of aggression or agitation for people with psychosis. It is widely accessible and may be the only antipsychotic medication available in limited-resource areas. OBJECTIVES: To examine whether haloperidol alone is an effective treatment for psychosis-induced aggression or agitation, wherein clinicians are required to intervene to prevent harm to self and others. SEARCH METHODS: We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials (26th May 2016)...
July 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28754047/introducing-namaste-care-to-the-hospital-environment-a-pilot-study
#5
Kimberley St John, Jonathan Koffman
BACKGROUND: The rising prevalence of dementia is impacting on acute hospitals and placing increased expectations on health and social care professionals to improve the support and services they are delivering. It has been recommended that good practice in dementia care relies on adopting a palliative approach to care and meeting people's physical, psychological, social and spiritual needs. Increased dementia training for staff that includes initiatives that promote dignity; enhancing communication skills and recognizing that a person with dementia may be approaching the end of their lives are needed...
October 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28745784/clinical-research-of-different-analgesia-methods-on-perianesthetic-pain-of-patients-with-moderate-and-severe-craniocerebral-injury-who-have-emergency-operation
#6
Q Huang, H Xu, Q-S Xiao
OBJECTIVE: To compare the effects of two different analgesia methods on postoperative pain of patients with moderate and severe craniocerebral injury who had an emergency operation. PATIENTS AND METHODS: In this study, 64 patients who were treated in our hospital from January 2015 to January 2016 and diagnosed with acute craniocerebral injury, were consecutively selected. The patients were divided into the propofol total intravenous anesthesia group (the observation group) and the isoflurane intravenous-inhalation combined anesthesia group (the control group) randomly with 32 cases each...
July 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28739149/oral-medication-for-agitation-of-psychiatric-origin-a-scoping-review-of-randomized-controlled-trials
#7
Samuel Mullinax, Farhad Shokraneh, Michael P Wilson, Clive E Adams
BACKGROUND: Understanding more about the efficacy and safety of oral second-generation antipsychotic medications in reducing the symptoms of acute agitation could improve the treatment of psychiatric emergencies. OBJECTIVE: The objective of this scoping review was to examine the evidence base underlying expert consensus panel recommendations for the use of oral second-generation antipsychotics to treat acute agitation in mentally ill patients. METHODS: The Cochrane Schizophrenia Group's Study-Based Register was searched for randomized controlled trials comparing oral second-generation antipsychotics, benzodiazepines, or first-generation antipsychotics with or without adjunctive benzodiazepines, irrespective of route of administration of the drug being compared...
July 21, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28708877/median-raphe-region-stimulation-alone-generates-remote-but-not-recent-fear-memory-traces
#8
Diána G Balázsfi, Dóra Zelena, Lívia Farkas, Kornél Demeter, István Barna, Csaba Cserép, Virág T Takács, Gábor Nyíri, Flóra Gölöncsér, Beáta Sperlágh, Tamás F Freund, József Haller
The median raphe region (MRR) is believed to control the fear circuitry indirectly, by influencing the encoding and retrieval of fear memories by amygdala, hippocampus and prefrontal cortex. Here we show that in addition to this established role, MRR stimulation may alone elicit the emergence of remote but not recent fear memories. We substituted electric shocks with optic stimulation of MRR in C57BL/6N male mice in an optogenetic conditioning paradigm and found that stimulations produced agitation, but not fear, during the conditioning trial...
2017: PloS One
https://www.readbyqxmd.com/read/28705298/methamphetamine-related-disorders
#9
Euphrosyne Gouzoulis-Mayfrank, Roland Härtel-Petri, Willem Hamdorf, Ursula Havemann-Reinecke, Stephan Mühlig, Norbert Wodarz
BACKGROUND: Methamphetamine is considered more dangerous than other stimulants because of its acute complications, long-term neurotoxicity, and potential for drug dependence. Until now, there have been no evidence-based guidelines for the treatment of methamphetamine-related disorders, either in Germany or abroad. METHODS: A systematic literature search was performed on the treatment of methamphetamine-related disorders. Based on this literature review, a multidisciplinary expert panel developed recommendations using the nominal group technique...
June 30, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28698343/protocol-for-an-observational-study-of-delirium-in-the-post-anaesthesia-care-unit-pacu-as-a-potential-predictor-of-subsequent-postoperative-delirium
#10
Victoria Cui, Catherine M Tedeschi, Vanessa L Kronzer, Sherry L McKinnon, Michael S Avidan
INTRODUCTION: Postoperative delirium can be a serious consequence of major surgery, associated with longer hospital stays, readmission, cognitive and functional deterioration and mortality. Delirium is an acute, reversible disorder characterised by fluctuating course, inattention, disorganised thinking and altered level of consciousness. Delirium occurring in the hours immediately following anaesthesia and delirium occurring in the postoperative period of 1-5 days have been described as distinct clinical entities...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28697164/the-use-safety-and-efficacy-of-olanzapine-in-a-level-i-pediatric-trauma-center-emergency-department-over-a-10-year-period
#11
Jon B Cole, Lauren R Klein, Ashley M Strobel, Stephane R Blanchard, Rebecca Nahum, Marc L Martel
OBJECTIVES: Olanzapine is a second-generation antipsychotic increasingly used in emergency medicine for many indications. Literature on its use in children is sparse. Our objectives were to describe the use, safety, and efficacy of olanzapine in pediatric emergency patients. METHODS: A structured chart review was performed of patients 18 years old or younger receiving olanzapine from 2007 to 2016 in the emergency department of a pediatric level I trauma center. RESULTS: A total of 285 children received olanzapine...
July 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28689637/measurement-of-flow-of-thought-in-68-patients-monitored-in-post-emergency-outpatient-consultations-role-of-ideational-turmoil-in-the-anxiety-depressive-symptomatology
#12
J Vandevoorde, A Sanchez Valero, E Baudoin, S Kamar, B Chabert, T Baudoin
INTRODUCTION: Rumination, cognitive control deficits, cognitive saturation, and loss of inhibition are the major hypotheses used to explain depressive disorders. A few studies have nevertheless looked at the form of thought. In this study, we will test a double measurement of the number of thoughts and a double measurement of the flow of thought together with their correlation with well-being, mental pain, and depression. MATERIAL AND METHODS: Between May and September 2015, 68 subjects, initially admitted as emergencies for acute anxiety depressive disorders and/or suicide attempts and subsequently monitored as post-emergency outpatients in medico-psychological consultations agreed to complete a set of Visual Analogue Scales measuring their well-being, their mental pain, their estimated number of thoughts and the how agitated these thoughts are estimated to be...
July 6, 2017: L'Encéphale
https://www.readbyqxmd.com/read/28671972/diaphragm-a-mnemonic-to-describe-the-work-of-breathing-in-patients-with-respiratory-failure
#13
Aiman Tulaimat, William E Trick
BACKGROUND: The assessment of the work of breathing in the definitions of respiratory failure is vague and variable. OBJECTIVE: Identify a parsimonious set of signs to describe the work of breathing in hypoxemic, acutely ill patients. METHODS: We examined consecutive medical ICU patients receiving oxygen with a mask, non-invasive ventilation, or T-piece. A physician inspected each patient for 10 seconds, rated the level of respiratory distress, and then examined the patient for vital signs and 17 other physical signs...
2017: PloS One
https://www.readbyqxmd.com/read/28662911/what-is-the-efficacy-of-droperidol-for-the-management-of-acute-psychosis-induced-agitation
#14
EDITORIAL
Michael Gottlieb, Jessen Schiebout
No abstract text is available yet for this article.
June 26, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28650682/de-escalation-training-to-medical-surgical-nurses-in-the-acute-care-setting
#15
Kimberly Lynn Ferrara, Mary Lynn Davis-Ajami, Joan Insalaco Warren, Lyn Stankiewicz Murphy
Violence is increasing on medical-surgical units as a "silent epidemic." This quality improvement project employs a small non-experimental, single-group, pre- and post-test design (N = 11) to determine the effectiveness of de-escalation training on medical-surgical nurses' confidence levels when dealing with agitated patients. Regardless of age, education, or years of experience, scores improved for each question on Thackrey's (1987) Confidence in Coping with Patient Aggression Instrument after implementing Ten Domains of De-escalation by Richmond et al...
June 26, 2017: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/28638198/efficacy-of-atypical-antipsychotics-in-the-management-of-acute-agitation-and-aggression-in-hospitalized-patients-with-schizophrenia-or-bipolar-disorder-results-from-a-systematic-review
#16
REVIEW
Xin Yu, Christoph U Correll, Yu-Tao Xiang, Yifeng Xu, Jizhong Huang, Fude Yang, Gang Wang, Tianmei Si, John M Kane, Prakash Masand
Acute agitation and aggression are common symptoms in patients with bipolar disorder and schizophrenia. In this review, we discuss the prevalence, clinical assessment strategies, treatment options, and current Western and Chinese guidelines for the management of acute agitation and aggression in patients with bipolar disorder or schizophrenia. Among available approaches, we discuss in detail recent evidence supporting the use of intramuscular (IM) antipsychotics and some recently approved oral atypical antipsychotics for the management of acute aggression and agitation in hospitalized patients with bipolar disorder or schizophrenia presenting with acute agitation or aggression, highlighting some differences between individual antipsychotic agents...
October 25, 2016: Shanghai Archives of Psychiatry
https://www.readbyqxmd.com/read/28623497/-psychiatric-emergencies
#17
F Schneider, S Weber-Papen
Psychiatric emergencies present a frequent and interdisciplinary challenge. Clinical diagnosis and management are complicated by the acuity, and the patient's compliance is often limited by the illness. Psychiatric emergencies include states of acute agitation, suicidality, delirium, stupor, and drug-induced emergencies. Sometimes interventions such as conversational contact, responding empathically to patients, or "talking down" are sufficient. If pharmacotherapy is necessary, benzodiazepines and antipsychotic drugs are the primary agents of choice...
July 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28620429/novel-approaches-to-ultrasonography-of-the-lung-and-pleural-space-where-are-we-now
#18
REVIEW
Daniel Lichtenstein
This review article is an update of what should be known for practicing basic lung ultrasound in the critically ill (LUCI) and is also of interest for less critical disciplines (e.g. pulmonology). It pinpoints on the necessity of a professional machine (not necessarily a sophisticated one) and probe. It lists the 10 main signs of LUCI and some of the main protocols made possible using LUCI: the BLUE protocol for a respiratory failure, the FALLS protocol for a circulatory failure, the SESAME protocol for a cardiac arrest and the investigation of a ventilated acute respiratory distress syndrome patient, etc...
June 2017: Breathe
https://www.readbyqxmd.com/read/28614434/post-stroke-psychosis-how-long-should-we-treat
#19
Maria do Céu Ferreira, Célia Machado, Beatriz Santos, Álvaro Machado
Objective: To describe a rare case of a patient who developed psychotic symptoms after a right stroke that disappeared with antipsychotic treatment, but appears to need low-dose maintenance antipsychotic therapy. Case description: A 65-year-old man presented at the psychiatric emergency service with a history of persistent delusional jealousy, visual illusions and agitation with onset about 1 month after a right posterior cerebral artery ischemic stroke. These symptoms only disappeared with therapeutic dosages of an antipsychotic drug (3 mg/day of risperidone)...
June 12, 2017: Trends in Psychiatry and Psychotherapy
https://www.readbyqxmd.com/read/28614197/sedation-management-in-children-supported-on-extracorporeal-membrane-oxygenation-for-acute-respiratory-failure
#20
James B Schneider, Todd Sweberg, Lisa A Asaro, Aileen Kirby, David Wypij, Ravi R Thiagarajan, Martha A Q Curley
OBJECTIVES: To describe sedation management in children supported on extracorporeal membrane oxygenation for acute respiratory failure. DESIGN: Secondary analysis of prospectively collected data from a multicenter randomized trial of sedation (Randomized Evaluation of Sedation Titration for Respiratory Failure). SETTING: Twenty-one U.S. PICUs. PATIENTS: One thousand two hundred fifty-five children, 2 weeks to 17 years old, with moderate/severe pediatric acute respiratory distress syndrome...
June 13, 2017: Critical Care Medicine
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