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Acute agitation

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https://www.readbyqxmd.com/read/28507634/multi-system-complications-after-intravenous-cocaine-abuse
#1
Lidija Petkovska, Andon Chibishev, Aleksandra Stevcevska, Ivica Smokovski, Dusan Petkovski, Emilija Antova
BACKGROUND: Use and abuse of cocaine are associated with numerous adverse effects, independent of the route of administration. More severe conditions of poisoning, however, are observed after cocaine intravenous administration. AIM: We present a case of severe poisoning after violent intravenous injection of cocaine, but with a good outcome. CASE PRESENTATION: Cocaine was intravenously (i.v.) administered in 16-years old female patient as a homicide attempt...
April 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28500785/don-t-label-me-a-qualitative-study-of-patients-perceptions-and-experiences-of-sedation-during-behavioral-emergency-in-the-emergency-department
#2
Celene Y L Yap, Jonathan C Knott, David C M Kong, Marie Gerdtz, Kay Stewart, David McD Taylor
OBJECTIVES: Behavioral emergencies are commonly seen in emergency departments. Acutely agitated patients can be difficult to manage and sedation may be required to decrease dangerous behavior and to ensure the safety of both the patient and staff. While the experience of staff caring for this population has been reported, patients' experiences with their overall management remains unknown. We aimed to describe the perceptions and experiences of patients regarding the use of sedation during acute behavioral emergencies...
May 13, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28488989/spice-y-kidney-failure-a-case-report-and-systematic-review-of-acute-kidney-injury-attributable-to-the-use-of-synthetic-cannabis
#3
REVIEW
Ceyda Zarifi, Shuchi Vyas
INTRODUCTION: Spice is a synthetic cannabinoid that is readily available for purchase in smoke shops at relatively low cost. Spice is not detectable upon routine drug screening, making it an increasingly popular new street drug. CASE REPORT: A 21-year-old man presented with new-onset seizures. During the next 2 days, he developed uncontrollable hypertension, agitation, respiratory failure requiring intubation, pulmonary hypertension, and acute kidney injury (AKI) with a maximum blood urea nitrogen/creatinine level of 54/7...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28481672/prediction-of-behavioural-and-cognitive-deficits-in-patients-with-traumatic-brain-injury-at-an-acute-rehabilitation-setting
#4
E de Guise, J LeBlanc, M Feyz, J Lamoureux, S Greffou
OBJECTIVE: The goal of this study was to identify factors that would predict short-term neuropsychological outcome in patients with traumatic brain injury (TBI) hospitalized in an acute rehabilitation setting. METHODS: Data was collected in the context of an acute early rehabilitation setting of a trauma centre. A brief neuropsychological assessment was carried out for 348 patients within a month following their trauma. RESULTS: Length of post-traumatic amnesia (PTA) was the best predictor of behavioural, memory and executive function variables within a month post TBI...
May 8, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28475360/patient-preferences-for-medicine-administration-for-acute-agitation-results-from-an-internet-based-survey-of-patients-diagnosed-with-bipolar-disorder-or-schizophrenia-in-two-nordic-countries
#5
Tine Rikke Jørgensen, Charlotte Emborg, Karianne Dahlen, Mette Bøgelund, Andreas Carlborg
The objective was to elicit patient preferences for medicine administration method in the management of acute agitation episodes among patients diagnosed with bipolar disorder or schizophrenia. The patients' experiences of acute agitation episodes and their management of episodes were also explored. Data were collected via an anonymous, internet-based survey of residents in Denmark or Sweden with schizophrenia or bipolar disorder (October 2014 to December 2014). Inclusion criteria were having a diagnosis of schizophrenia or bipolar disorder, and being above 18 years of age...
May 5, 2017: Psychology, Health & Medicine
https://www.readbyqxmd.com/read/28463343/biological-treatment-of-acute-agitation-or-aggression-with-schizophrenia-or-bipolar-disorder-in-the-inpatient-setting
#6
Christoph U Correll, Xin Yu, Yutao Xiang, John M Kane, Prakash Masand
BACKGROUND: Schizophrenia and bipolar disorders are chronic illnesses that commonly present with symptoms of acute agitation and aggression. These symptoms must be managed rapidly to prevent potential harm to the patient and others, including their caregivers, peers, and health care workers. A number of treatment options are available to clinicians to manage acute agitation and aggression, including non-pharmacologic behavioral and environmental de-escalation strategies, as well as biological treatment options such as pharmacologic agents and electroconvulsive therapy...
May 2017: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
https://www.readbyqxmd.com/read/28452274/an-innovative-approach-to-hydration-for-a-patient-with-dementia
#7
Adam Beales
Nursing older people in acute settings involves the provision of complex care, including the maintenance of good hydration. Dehydration is a serious condition that may contribute to the development of pressure ulcers, urinary tract infections, acute kidney injury and venous thromboembolism. If oral hydration methods are not successful, the alternatives are intravenous (IV) or subcutaneous fluid hydration therapy. These are invasive methods and may not be tolerated by all patients. This article uses a case study to explore an innovative approach to oral hydration...
April 28, 2017: Nursing Older People
https://www.readbyqxmd.com/read/28450691/acute-encephalopathy-due-to-angel-s-trumpet-intoxication-a-case-report-and-literature-review
#8
Shinichi Takeshima, Shuichiro Neshige, Naoyuki Hara, Tomoshi Kubo, Takahiro Himeno, Masaru Kuriyama
We report two cases (a married couple) of intoxication due to angel's trumpet ingestion. Case 1: A 71-year-old woman was found lying unconscious on the sofa at home and was brought to our hospital by ambulance. She showed mydriatic anisocoria, and an intracerebral lesion was suspected. However, the brain magnetic resonance imaging showed no abnormal lesion and acute encephalopathy of unknown cause was diagnosed. Case 2: A 68-year-old man (husband of the patient of Case 1) showed alteration of consciousness with agitation and was admitted to our hospital on the next day...
April 27, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/28441236/the-new-mirus-system-for-short-term-sedation-in-postsurgical-icu-patients
#9
Stefano Romagnoli, Cosimo Chelazzi, Gianluca Villa, Giovanni Zagli, Francesco Benvenuti, Paola Mancinelli, Giulio Arcangeli, Stefano Dugheri, Alessandro Bonari, Lorenzo Tofani, Andrea Belardinelli, A Raffaele De Gaudio
OBJECTIVES: To evaluate the feasibility and safety of the MIRUS system (Pall International, Sarl, Fribourg, Switzerland) for sedation with sevoflurane for postsurgical ICU patients and to evaluate atmospheric pollution during sedation. DESIGN: Prospective interventional study. SETTING: Surgical ICU. February 2016 to December 2016. PATIENTS: Postsurgical patients requiring ICU admission, mechanical ventilation, and sedation...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28439690/association-of-endotracheal-tube-repositioning-and-acute-laryngeal-lesions-during-mechanical-ventilation-in-children
#10
Denise Manica, Catia de Souza Saleh Netto, Cláudia Schweiger, Leo Sekine, Larissa Valency Enéas, Denise Rotta Pereira, Gabriel Kuhl, Paulo Roberto Antonacci Carvalho, Paulo José Cauduro Marostica
The objective of this study is to determine the incidence of post-extubation acute laryngeal lesions in a pediatric intensive care unit (PICU) and potential risk factors. Children, aged 28 days to 5 years, admitted to the PICU who required endotracheal intubation for at least 24 h were enrolled. Exclusion criteria were a previous intubation, history of laryngeal disease, current or past tracheostomy, the presence of craniofacial malformations and patients considered on palliative care. All patients underwent flexible fiber-optic laryngoscopy (FFL) not later than 8 h after extubation...
April 24, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28433979/lethal-high-acute-disseminated-encephalomyelitis-adem-triggered-by-toxic-effect-of-synthetic-cannabinoid-black-mamba
#11
Kiran Samra, Ian S Boon, Gregory Packer, Saiju Jacob
A previously well 25-year-old man presented with agitation, double incontinence and left-sided incoordination. His symptoms started after smoking a synthetic cannabinoid (black mamba) 5 days earlier. Over 48 hours, he developed aphasia, generalised hypertonia, hyper-reflexia and dense left hemiparesis. This progressed to profuse diaphoresis, fever, tachycardia, hypertension and a possible seizure necessitating admission to the intensive care unit. CT head and cerebrospinal fluid analysis were unremarkable...
April 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28421836/analytical-confirmation-of-synthetic-cannabinoids-in-a-cohort-of-179-presentations-with-acute-recreational-drug-toxicity-to-an-emergency-department-in-london-uk-in-the-first-half-of-2015
#12
Rachelle Abouchedid, Simon Hudson, Natalie Thurtle, Takahiro Yamamoto, James H Ho, George Bailey, Michelle Wood, Nele Sadones, Christophe P Stove, Alison Dines, John R H Archer, David M Wood, Paul I Dargan
CONTEXT: Synthetic cannabinoid receptor agonists are the largest group of new psychoactive substances reported in the last decade; in this study we investigated how commonly these drugs are found in patients presenting to the Emergency Department with acute recreational drug toxicity. METHODS: We conducted an observational cohort study enrolling consecutive adult patients presenting to an Emergency Department (ED) in London (UK) January-July 2015 (6 months) with acute recreational drug toxicity...
June 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28420470/-explore-objective-clinical-variables-for-detecting-delirium-in-icu-patients-a-prospective-case-control-study
#13
Xiaojiang Liu, Jie Lyu, Youzhong An
OBJECTIVE: The aim of this case-control study is to explore clinical objective variables for diagnosing delirium of intensive care unit (ICU) patients. METHODS: According to the method of prospective case-control study, critical adult postoperative patients who were transferred to ICU of Peking University People's Hospital from October 2015 to May 2016 and needed mechanical ventilation were included. After evaluating the Richmond agitation sedation scale score (RASS), the patients whose score were -2 or greater were sorted into two groups, delirium and non-delirium, according to the confusion assessment method for the ICU (CAM-ICU)...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28401138/prevalence-of-symptoms-at-the-end-of-life-in-an-acute-care-hospital-a-retrospective-cohort-study
#14
Daniel Kobewka, Paul Ronksley, Dan McIsaac, Sunita Mulpuru, Alan Forster
BACKGROUND: There is currently debate over the benefits and harms of physician-assisted death. One of the factors influencing this debate is concern about symptoms in the days before death. The objective of this study was to describe the frequency of symptoms before death and determine patient characteristics associated with these symptoms. METHODS: We reviewed the medical record of every patient who died at a multisite academic teaching hospital over a 3-month period...
January 2017: CMAJ Open
https://www.readbyqxmd.com/read/28400941/abnormal-color-flow-signal-traversing-the-myocardial-wall-not-everything-is-what-it-appears-to-be
#15
Kathy Edelman, Angel López-Candales
A case of a patient presenting with an acute myocardial infarction is presented. A transthoracic echocardiographic examination revealed an abnormal color flow signal that traversed the myocardial wall from a large inferior aneurysm and initially considered to be a ventricular septal defect. However, further echocardiographic manipulation utilizing modified views along with sequential injections of both agitated saline and Definity(®) proved very useful to identify a pseudoaneurysm. There was no further need for any other diagnostic test, and the patient was treated surgically, undergoing successful repair of the pseudoaneurysm as well as coronary artery bypass grafting of the left coronary artery...
October 2016: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/28399317/patterns-of-new-physical-problems-emerging-in-long-term-care-residents-with-dementia
#16
Christine R Kovach, Julie Ellis, Crystal-Rae Evans
Individuals receiving skilled nursing care have multiple comorbid conditions that impact comfort and resource use. The current study describes variations in the trajectories of new physical problems emerging over 8 weeks and the predictive value for future health and behavior in a sample of 72 residents with dementia. Residents had two to 37 new physical problems occurring over 8 weeks. Sixty-five percent of the sample had five or more new problems and were identified by three unstable trajectories. Common problems, illnesses, and symptoms accounted for 28...
April 11, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/28393558/supraventricular-tachycardia-and-acute-confusion-following-ingestion-of-e-cigarette-fluid-containing-ab-fubinaca-and-adb-fubinaca-a-case-report-with-quantitative-analysis-of-serum-drug-concentrations
#17
Rex Pui Kin Lam, Magdalene Huen Yin Tang, Siu Chung Leung, Yeow Kuan Chong, Matthew Sik Hon Tsui, Tony Wing Lai Mak
BACKGROUND: AB-FUBINACA and ADB-FUBINACA are structurally similar synthetic cannabinoids with potent CB1 receptor agonistic effects. Very little is known about their pharmacology and toxicology. OBJECTIVE: To report a case of supraventricular tachycardia and acute confusion after ingestion of e-cigarette fluid containing AB-FUBINACA and ADB-FUBINACA, with quantitative analysis of the serum drug concentrations. CASE REPORT: A healthy 24-year-old man ingested two drops of e-cigarette fluid which were later found to contain AB-FUBINACA and ADB-FUBINACA...
April 10, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28388984/case-control-study-on-risk-factors-of-unplanned-extubation-based-on%C3%A2-patient-safety-model-in-critically-ill-patients-with-mechanical-ventilation
#18
EunOk Kwon, KyungSook Choi
PURPOSE: This study aimed to identify risk factors of unplanned extubation in intensive care unit (ICU) patients with mechanical ventilation using a patient safety model. METHODS: This study was designed to be a case-control study. Data collection sheets, including 29 risk factors of unplanned extubation in mechanically ventilation patients were retrospectively collected based on a patient safety model over 3 years. From 41,207 mechanically ventilated patients, 230 patients were identified to have unplanned extubation during their ICU stay...
March 2017: Asian Nursing Research
https://www.readbyqxmd.com/read/28383362/aripiprazole-once-monthly-in-the-treatment-of-acute-psychotic-episodes-in-schizophrenia-post-hoc-analysis-of-positive-and-negative-syndrome-scale-marder-factor-scores
#19
Zahinoor Ismail, Timothy Peters-Strickland, Maia Miguelez, Ross A Baker, Peter Hertel, Anna Eramo, Na Jin, Pamela Perry, Raymond Sanchez, Robert D McQuade, John M Kane
BACKGROUND: Long-acting injectable antipsychotics are treatment options for acute and long-term treatment of patients with schizophrenia. In a previously published 12-week randomized, double-blind, placebo-controlled clinical trial of patients with schizophrenia experiencing an acute psychotic episode, aripiprazole once-monthly 400 mg (AOM 400) produced significantly greater improvement than placebo on the primary endpoint, Positive and Negative Syndrome Scale (PANSS) total score at week 10...
June 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28376877/rationale-and-design-of-the-placid-study-a-randomised-trial-comparing-the-efficacy-and-safety-of-inhaled-loxapine-versus-im-aripiprazole-in-acutely-agitated-patients-with-schizophrenia-or-bipolar-disorder
#20
L San, G Estrada, N Oudovenko, E Vieta
BACKGROUND: The management of acute agitation manifesting in patients with schizophrenia or bipolar disorder requires swift pharmacological intervention to provide rapid symptomatic relief and prevent escalation to aggression and violence. Antipsychotic medications are widely used in this setting and the availability of an inhaled formulation with deep lung absorption of the antipsychotic loxapine has the potential to deliver a faster onset of therapeutic effect than the available intramuscular formulations of antipsychotics...
April 4, 2017: BMC Psychiatry
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