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Acute agitation

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https://www.readbyqxmd.com/read/28933260/older-and-newer-strategies-for-the-pharmacological-treatment-of-agitation-in-schizophrenia-and-bipolar-disorder
#1
Giovanni Amodeo, Andrea Fagiolini, Gabriele Sachs, Andreas Erfurth
BACKGROUND: Treatment of acute agitation in patients with bipolar disorder and schizophrenia is a multifaceted and dynamic task, which presents unique and complex challenges to healthcare providers. OBJECTIVE: To ascertain and describe which medications are best to use in agitated patients with schizophrenia or bipolar disorder Method: Selective review of current guidelines and of the literature pertaining to the treatment of agitation in patients with schizophrenia or bipolar disorder Results: Pharmacologic treatment of agitation should be based on an assessment of the most likely cause of the agitation...
September 18, 2017: CNS & Neurological Disorders Drug Targets
https://www.readbyqxmd.com/read/28927394/laboratory-markers-of-cardiac-and-metabolic-complications-after-generalized-tonic-clonic-seizures
#2
Robert D Nass, Sina Meiling, René P Andrié, Christian E Elger, Rainer Surges
BACKGROUND: Generalized tonic-clonic seizures (GTCS) frequently lead to emergency inpatient referrals. Laboratory blood values are routinely performed on admission to detect underlying causes and metabolic or cardiac complications. Our goal was to assess the nature and frequency of complications occurring in association with GTCS. METHODS: We retrospectively extracted data from emergency protocols and discharge letters of adult patients admitted to the Department of Epileptology between 01/2010 and 06/2015...
September 19, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28922625/living-and-dying-with-advanced-dementia-a-prospective-cohort-study-of-symptoms-service-use-and-care-at-the-end-of-life
#3
Elizabeth L Sampson, Bridget Candy, Sarah Davis, Anna Buylova Gola, Jane Harrington, Michael King, Nuriye Kupeli, Gerry Leavey, Kirsten Moore, Irwin Nazareth, Rumana Z Omar, Victoria Vickerstaff, Louise Jones
BACKGROUND: Increasing number of people are dying with advanced dementia. Comfort and quality of life are key goals of care. AIMS: To describe (1) physical and psychological symptoms, (2) health and social care service utilisation and (3) care at end of life in people with advanced dementia. DESIGN: 9-month prospective cohort study. SETTING AND PARTICIPANTS: Greater London, England, people with advanced dementia (Functional Assessment Staging Scale 6e and above) from 14 nursing homes or their own homes...
August 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28876970/responding-to-ten-common-delirium-misconceptions-with-best-evidence-an-educational-review-for-clinicians
#4
Mark A Oldham, Nina M Flanagan, Ariba Khan, Olga Boukrina, Edward R Marcantonio
Delirium (acute confusion) is a serious, common health condition, and it predicts poor outcomes, including greater rates of mortality, institutionalization, prolonged hospitalization, and cognitive impairment. Expedient diagnosis and management are critical to address modifiable delirium causes and improve both quality of care and outcomes. Moreover, more than a third of delirium is preventable. Despite the clear significance of delirium and our increasingly sophisticated understanding of the condition, the gap between evidence and practice persists...
September 6, 2017: Journal of Neuropsychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/28869228/symptom-profile-as-assessed-on-delirium-rating-scale-revised-98-of-delirium-in-respiratory-intensive-care-unit-a-study-from-india
#5
Akhilesh Sharma, Savita Malhotra, Sandeep Grover, S K Jindal
AIM: This study aimed to evaluate the phenomenology of delirium in patients admitted in a Respiratory Intensive Care Unit (RICU). METHODS: Consecutive patients admitted to RICU were screened for delirium using Richmond Agitation-Sedation Scale (RASS), Confusion Assessment Method for ICU (CAM-ICU) assessment tool and those found positive for delirium were evaluated by a psychiatrist to confirm the diagnosis. Those with a diagnosis of delirium as per the psychiatrist were evaluated on Delirium Rating Scale-Revised-98 (DRS-R-98) to study phenomenology...
September 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28864877/clinical-assessment-and-management-of-delirium-in-the-palliative-care-setting
#6
Shirley Harvey Bush, Sallyanne Tierney, Peter Gerard Lawlor
Delirium is a neurocognitive syndrome arising from acute global brain dysfunction, and is prevalent in up to 42% of patients admitted to palliative care inpatient units. The symptoms of delirium and its associated communicative impediment invariably generate high levels of patient and family distress. Furthermore, delirium is associated with significant patient morbidity and increased mortality in many patient populations, especially palliative care where refractory delirium is common in the dying phase. As the clinical diagnosis of delirium is frequently missed by the healthcare team, the case for regular screening is arguably very compelling...
September 1, 2017: Drugs
https://www.readbyqxmd.com/read/28854540/electroencephalography-and-delirium-in-the-postoperative-period
#7
B J A Palanca, T S Wildes, Y S Ju, S Ching, M S Avidan
Delirium commonly manifests in the postoperative period as a clinical syndrome resulting from acute brain dysfunction or encephalopathy. Delirium is characterized by acute and often fluctuating changes in attention and cognition. Emergence delirium typically presents and resolves within minutes to hours after termination of general anaesthesia. Postoperative delirium hours to days after an invasive procedure can herald poor outcomes. Easily recognized when patients are hyperactive or agitated, delirium often evades diagnosis as it most frequently presents with hypoactivity and somnolence...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28851451/structured-physical-exercise-improves-neuropsychiatric-symptoms-in-acute-dementia-care-a-hospital-based-rct
#8
Tim Fleiner, Hannah Dauth, Marleen Gersie, Wiebren Zijlstra, Peter Haussermann
BACKGROUND: The primary objective of this trial is to investigate the effects of a short-term exercise program on neuropsychiatric signs and symptoms in acute hospital dementia care. METHODS: Within a hospital-based randomized controlled trial, the intervention group conducted a 2-week exercise program with four 20-min exercise sessions on 3 days per week. The control group conducted a social stimulation program. Effects on neuropsychiatric signs and symptoms were measured via the Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change, the Neuropsychiatric Inventory, and the Cohen-Mansfield Agitation Inventory...
August 29, 2017: Alzheimer's Research & Therapy
https://www.readbyqxmd.com/read/28834857/oral-agents-for-the-management-of-agitation-and-agitated-delirium-in-critically-ill-patients
#9
Qiu Min Yeo, Tessa L Wiley, Melanie N Smith, Drayton A Hammond
Agitation is one of the most common issues that critically ill patients experience. Medications used to manage agitation are often administered intravenously or intramuscularly in the acutely agitated, critically ill patient. However, a multimodal approach that utilizes multiple routes of administration may be appropriate. This review summarizes the available literature on oral antipsychotics, clonidine, and valproic acid to manage agitation in critically ill patients while also focusing on their pharmacology and appropriate monitoring...
October 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/28827932/comparison-of-neonatal-pain-agitation-and-sedation-scale-with-premature-infant-pain-profile-for-the-assessment-of-acute-prolonged-pain-in-neonates-on-assisted-ventilation-a-prospective-observational-study
#10
Saumil Ashvin Desai, Ruchi Nimish Nanavati, Bonny Bipin Jasani, Nandkishor Kabra
AIM: This study aimed to compare Neonatal Pain, Agitation, and Sedation Scale (N-PASS) with Premature Infant Pain Profile (PIPP) for the assessment of acute prolonged pain in ventilated neonates. METHODS: This study was conducted in two phases. In phase 1 of the study, we assessed whether neonates on assisted ventilation experienced acute prolonged pain. In phase 2, the aim was to compare N-PASS with PIPP for the assessment of acute prolonged pain in neonates on assisted ventilation...
July 2017: Indian Journal of Palliative Care
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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