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Acute agitation

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https://www.readbyqxmd.com/read/28708877/median-raphe-region-stimulation-alone-generates-remote-but-not-recent-fear-memory-traces
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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...
June 16, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28620429/novel-approaches-to-ultrasonography-of-the-lung-and-pleural-space-where-are-we-now
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/28601627/effects-of-small-dose-dexmedetomidine-on-hyperdynamic-responses-to-electroconvulsive-therapy
#14
Xiang Li, Fang Tan, Chao-Jun Jian, Na Guo, Zhi-Yong Zhong, Zi-Qing Hei, Shao-Li Zhou
BACKGROUND: Acute hemodynamic responses to electroconvulsive therapy (ECT) may increase the risk of cardiovascular complications in vulnerable patients. The aim of the current study was to assess the effect of small-dose dexmedetomidine on hyperdynamic responses to ECT. METHODS: Seventy-eight patients were enrolled and randomly allocated to receive either 0.2 μg/kg dexmedetomidine (Dex group, n = 39) or saline (Control group, n = 39) prior to ECT. Heart rate (HR) and mean arterial pressure (MAP) were recorded immediately after the administration of dexmedetomidine (T1), and 0, 1, 3, 5 and 10 min after the electrical stimuli ended (T2, T3, T4, T5 and T6)...
June 7, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28598043/clinical-profile-of-hypertensive-emergencies-in-an-intensive-care-unit
#15
Shubhangi V Dhadke, Vithal N Dhadke, Dhruv S Batra
AIMS AND OBJECTIVE: To study the prevalence of hypertensive emergencies in an ICU set up and to study the clinical presentation of hypertensive emergencies related to cardiovascular, neurological and renovascular system. METHODS: Type of Study: Cross-sectional, descriptive study. DURATION OF STUDY: Two years from 1st December 2011 till 30th November 2013. SAMPLE SIZE: 50 patients of hypertensive emergencies admitted to the intensive care unit of Dr...
May 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28597920/a-case-of-nonfatal-intoxication-associated-with-the-recreational-use-of-diphenidine
#16
Enrico Gerace, Elena Bovetto, Daniele Di Corcia, Marco Vincenti, Alberto Salomone
Diphenidine is a dissociative drug that shows several psychotropic effects including euphoria, shifts in perception of reality, hallucinations, and transient anterograde amnesia. In this study, a case of acute intoxication occurring after diphenidine intake is reported. A 30-year-old Caucasian male was hospitalized after he was found in a confused and agitated state and unable to communicate. The physical examination displayed tachycardia, miotic pupils, and increased both body temperature and respiratory rate...
June 9, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28594246/a-review-of-vilazodone-exposures-with-focus-on-serotonin-syndrome-effects
#17
C William Heise, Hannah Malashock, Daniel E Brooks
BACKGROUND: Vilazodone is an antidepressant with selective serotonin reuptake inhibition and partial 5HT1A agonism. Serotonin syndrome is believed to be due to excessive stimulation of 5-HT2A and 5-HT1A receptors, resulting in the clinical triad of altered mentation, autonomic instability and neuromuscular abnormalities. The goal of this study is to define serotonergic effects after vilazodone exposure. METHODS: A retrospective review of two databases: the American Association of Poison Controls Centers' National Poison Data System (NPDS) and the American College of Medical Toxicology's Toxicology Investigators Consortium (ToxIC Registry)...
June 8, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28583103/in-patient-costs-of-agitation-and-containment-in-a-mental-health-catchment-area
#18
Antoni Serrano-Blanco, Maria Rubio-Valera, Ignacio Aznar-Lou, Luisa Baladón Higuera, Karina Gibert, Alfredo Gracia Canales, Lisette Kaskens, José Miguel Ortiz, Luis Salvador-Carulla
BACKGROUND: There is a scarce number of studies on the cost of agitation and containment interventions and their results are still inconclusive. We aimed to calculate the economic consequences of agitation events in an in-patient psychiatric facility providing care for an urban catchment area. METHODS: A mixed approach combining secondary analysis of clinical databases, surveys and expert knowledge was used to model the 2013 direct costs of agitation and containment events for adult inpatients with mental disorders in an area of 640,572 adult inhabitants in South Barcelona (Spain)...
June 6, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28571548/intermittent-transient-motor-aphasia-in-acute-lithium-toxicity-a-case-report-and-brief-review
#19
S Madhusoodanan, Varudhini Reddy, Sonya Mohan
INTRODUCTION: Lithium is known to cause certain neurological deficits. However, reports of aphasia secondary to lithium toxicity are scant. We report the case of a 70 year old African American woman with a history of schizoaffective disorder and mild dementia who developed transient intermittent aphasia secondary to lithium toxicity. METHODS: Patient was admitted because of agitation, delusional behavior, and loud and pressured speech. Her previous medications included divalproex sodium 500mg po bid, valproic acid 250mg po qd, risperidone 3...
May 31, 2017: Current Drug Safety
https://www.readbyqxmd.com/read/28560807/psychometric-evaluation-of-the-cohen-mansfield-agitation-inventory-in-an-acute-general-hospital-setting
#20
Nuriye Kupeli, Victoria Vickerstaff, Nicola White, Kathryn Lord, Sharon Scott, Louise Jones, Elizabeth L Sampson
OBJECTIVES: The Cohen-Mansfield Agitation Inventory (CMAI; (Cohen-Mansfield and Kerin, 1986)) is a well-known tool for assessing agitated behaviours in people with dementia who reside in long-term care. No studies have evaluated the psychometric qualities and factor structure of the CMAI in acute general hospitals, a setting where people with demand may become agitated. METHOD: Longitudinal study investigating pain, agitation and behavioural problems in 230 people with dementia admitted to acute general hospitals in 2011-2012...
May 31, 2017: International Journal of Geriatric Psychiatry
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