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Delirium tremens

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https://www.readbyqxmd.com/read/27922474/embracing-a-nurse-driven-alcohol-withdrawal-protocol-through-quality-improvement
#1
John Barrett, Maria Jansen, April Cooper, Matthew Felbinger, Faith Waters
BACKGROUND: Alcohol withdrawal can lead to severe complications including seizures, delirium tremens, and death if not treated appropriately. Nurses are critical to the safety and outcomes of these patients. OBJECTIVE: The objective of this retrospective study was to determine if nursing education on a community hospital's alcohol withdrawal protocol led to improved nursing compliance. METHODS: This is a quality improvement project involving a two-part retrospective review-an initial needs assessment followed by nursing education and a subsequent posteducation retrospective review...
October 2016: Journal of Addictions Nursing
https://www.readbyqxmd.com/read/27851231/1596-mortality-length-of-stay-and-charges-associated-with-delirium-tremens-in-the-surgical-population
#2
Mohammad Mahbub Jamil, Sohaib Khan, Marcel Tafen-Wandji, Jorge Ortiz
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27803505/outcomes-after-implementation-of-an-alcohol-withdrawal-protocol-at-a-single-institution
#3
Mary E Eberly, Anna G Lockwood, Sean Lockwood, Kelly W Davis
Background: There are varying dosing strategies for the administration of benzodiazepines in the setting of alcohol withdrawal. In October 2014, a symptom-based alcohol withdrawal protocol (AWP) using the Clinical Institute Withdrawal Assessment of Alcohol, Revised (CIWA-Ar) scale was implemented at one institution. Objective: To evaluate the safety and efficacy of the AWP. Methods: Retrospective chart review was completed, including patients receiving at least one dose of diazepam for alcohol withdrawal pre- and post-protocol...
October 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/27797817/self-disembowelment-during-delirium-tremens-why-early-diagnosis-is-vital
#4
Rachel Thomasson, Vanessa Craig, Elspeth Guthrie
Delirium tremens is a serious yet treatable complication of alcohol withdrawal. Timely diagnosis is critical as there are well-established treatment regimens that provide symptomatic relief within hours to days. We report the case of a 34-year-old man with an undisclosed history of alcohol dependency. He presented with paranoid beliefs and was transferred to a psychiatric inpatient unit with suspected schizophrenia. Classic features of delirium tremens such as sympathetic overdrive and visual hallucinations were not salient features of his presentation...
October 24, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27542731/baclofen-to-prevent-agitation-in-alcohol-addicted-patients-in-the-icu-study-protocol-for-a-randomised-controlled-trial
#5
Mickael Vourc'h, Fanny Feuillet, Pierre-Joachim Mahe, Véronique Sebille, Karim Asehnoune
BACKGROUND: Alcohol is the leading psychoactive substance consumed in France, with about 15 million regular consumers. The National institute on Alcohol Abuse and Alcoholism (NIAAA) considers alcohol abuse to be more than 14 units of alcohol a week for men and 7 units for women. The specific complication of alcoholism is the alcohol withdrawal syndrome. Its incidence reaches up to 30 % and its main complications are delirium tremens, restlessness, extended hospital stay, higher morbidity, and psychiatric and cognitive impairment...
August 19, 2016: Trials
https://www.readbyqxmd.com/read/27219321/meta-analysis-reveals-significant-association-of-the-3-utr-vntr-in-slc6a3-with-alcohol-dependence
#6
Yunlong Ma, Rongli Fan, Ming D Li
BACKGROUND: Although many studies have analyzed the association of 3'-untranslated region variable-number tandem repeat (VNTR) polymorphism in SLC6A3 with alcohol dependence (AD), the results remain controversial. This study aimed to determine whether this variant indeed has any genetic effect on AD by integrating 17 reported studies with 5,929 participants included. METHODS: The A9-dominant genetic model that considers A9-repeat and non-A9 repeat as 2 genotypes and compared their frequencies in alcoholics with that in controls was adopted...
July 2016: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/27212829/central-pontine-myelinolysis-in-a-case-of-alcohol-dependence-syndrome
#7
Kaushik Chatterjee, Austin B Fernandes, Sunil Goyal, Sunitha Shanker
Osmotic Demyelination Syndrome includes Central Pontine Myelinolysis and Extrapontine Myelinolysis. This condition has been described in cases of chronic Alcohol Dependence Syndrome and in rapid correction of hyponatremia. Though we frequently see patients with Alcohol Dependence Syndrome presenting with complicated withdrawal, Central Pontine Myelinolysis remains largely undetected and under-reported in literature. We present here a case of protracted Delirium Tremens where MRI brain revealed Central Pontine Myelinolysis...
July 2015: Industrial Psychiatry Journal
https://www.readbyqxmd.com/read/27196747/management-of-acute-alcohol-withdrawal-syndrome-in-critically-ill-patients
#8
REVIEW
Deepali Dixit, Jeffrey Endicott, Lisa Burry, Liz Ramos, Siu Yan Amy Yeung, Sandeep Devabhakthuni, Claire Chan, Anthony Tobia, Marilyn N Bulloch
Approximately 16-31% of patients in the intensive care unit (ICU) have an alcohol use disorder and are at risk for developing alcohol withdrawal syndrome (AWS). Patients admitted to the ICU with AWS have an increased hospital and ICU length of stay, longer duration of mechanical ventilation, higher costs, and increased mortality compared with those admitted without an alcohol-related disorder. Despite the high prevalence of AWS among ICU patients, no guidelines for the recognition or management of AWS or delirium tremens in the critically ill currently exist, leading to tremendous variability in clinical practice...
July 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27086324/involuntary-psychiatric-holds-the-structure-of-admissions-on-the-example-of-institute-of-psychiatry-and-neurology-in-warsaw
#9
Inga Markiewicz, Janusz Heitzman, Ewa Gardyńska-Ziemba
OBJECTIVES: The aim of the study was to analyse the structure of involuntary psychiatric holds in Institute of Psychiatry and Neurology in Warsaw, throughout the year. Our research interests included socio-demographic profiles of the patients, time of admissions (time of a day/night/ season), type of diagnoses at admission and suicide attempts preceding the admission. We also analysed the normative aspect of involuntary admissions, i.e. which Articles of the Polish Mental Health Act constituted the basis for these patients admission, and if the choice of articles was justifiable by a diagnosis of the mental disorder...
2016: Psychiatria Polska
https://www.readbyqxmd.com/read/27057302/letter-to-the-editor-alcohol-associated-atrial-fibrillation-delirium-tremens-cordis-revisited
#10
LETTER
Tsung O Cheng
No abstract text is available yet for this article.
October 2015: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/26893017/propofol-for-treatment-of-refractory-alcohol-withdrawal-syndrome-a-review-of-the-literature
#11
REVIEW
Amy L Brotherton, Eric P Hamilton, H Grace Kloss, Drayton A Hammond
The authors evaluated all available evidence on the use of propofol as an adjuvant for the treatment of resistant alcohol withdrawal syndrome (AWS) in comparison to other therapies. A comprehensive PubMed search (1966-December 2015) was conducted using the search terms propofol, alcohol withdrawal, and drug therapy. Articles were cross-referenced for other citations. Clinical studies, case series, and case reports published in the English language assessing the use of propofol in adult patients for treatment of AWS were reviewed for inclusion...
April 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/26861990/treatment-of-severe-alcohol-withdrawal
#12
REVIEW
Kyle J Schmidt, Mitesh R Doshi, Jenna M Holzhausen, Allycia Natavio, Megan Cadiz, Jim E Winegardner
OBJECTIVE: Approximately 50% of patients with alcohol dependence experience alcohol withdrawal. Severe alcohol withdrawal is characterized by seizures and/or delirium tremens, often refractory to standard doses of benzodiazepines, and requires aggressive treatment. This review aims to summarize the literature pertaining to the pharmacotherapy of severe alcohol withdrawal. DATA SOURCES: PubMed (January 1960 to October 2015) was searched using the search termsalcohol withdrawal, delirium tremens, intensive care, andrefractory Supplemental references were generated through review of identified literature citations...
May 2016: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/26830178/alcohol-withdrawal-syndrome-in-critically-ill-patients-identification-assessment-and-management
#13
Lynsey J Sutton, Annemarie Jutel
Management of alcohol withdrawal in critically ill patients is a challenge. The alcohol consumption histories of intensive care patients are often incomplete, limiting identification of patients with alcohol use disorders. Abrupt cessation of alcohol places these patients at risk for alcohol withdrawal syndrome. Typically benzodiazepines are used as first-line therapy to manage alcohol withdrawal. However, if patients progress to more severe withdrawal or delirium tremens, extra adjunctive medications in addition to benzodiazepines may be required...
February 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/26768685/pharmacotherapy-for-alcohol-dependence-the-2015-recommendations-of-the-french-alcohol-society-issued-in-partnership-with-the-european-federation-of-addiction-societies
#14
Benjamin Rolland, François Paille, Claudine Gillet, Alain Rigaud, Romain Moirand, Corine Dano, Maurice Dematteis, Karl Mann, Henri-Jean Aubin
BACKGROUND: The latest French good practice recommendations (GPRs) for the screening, prevention, and treatment of alcohol misuse were recently published in partnership with the European Federation of Addiction Societies (EUFAS). This article aims to synthesize the GPRs focused on the pharmacotherapy of alcohol dependence. METHODS: A four-member European steering committee defined the questions that were addressed to an 18-member multiprofessional working group (WG)...
January 2016: CNS Neuroscience & Therapeutics
https://www.readbyqxmd.com/read/26653700/takotsubo-cardiomyopathy-precipitated-by-delirium-tremens
#15
Chidozie Charles Agu, Ahmed Bakhit, Md Basunia, Bikash Bhattarai, Vikram Oke, Divya Salhan, Frances Schmidt
A 57-year-old woman presented with alcohol withdrawal symptoms, which later progressed to delirium tremens. During hospitalization, she developed respiratory distress with acute pulmonary edema. Electrocardiogram (ECG) showed diffuse ST elevation with elevated cardiac enzymes. Echocardiogram showed estimated ejection fraction of 20-25% with characteristic apical ballooning. After several days of supportive care, the patient showed significant clinical improvement with normalization of ECG, cardiac enzymes, and echocardiographic findings...
2015: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/26523695/delirium-tremens-is-associated-with-increased-mortality-in-acute-coronary-syndrome
#16
LETTER
Gurkan Acar, Yasin Turker
No abstract text is available yet for this article.
2016: Cardiology
https://www.readbyqxmd.com/read/26512587/morphine-for-intravenous-patient-controlled-analgesia-may-inhibit-delirium-tremens-a-case-report-and-literature-review
#17
REVIEW
Chia-Ta Chan, Wen-Wei Liao, William Huang
Alcoholism is common among trauma patients and often lacks the appropriate monitoring. Alcohol withdrawal syndrome (AWS), including delirium tremens (DT), can be associated with significant postoperative morbidity and mortality. However, appropriate acute pain management may protect against delirium; the administration of intravenous patient-controlled analgesia (IV - PCA) may not only alleviate pain, but also reduce the incidence of post-operative delirium. IV-PCA is widely used today; however, little attention has been paid to its influence on the development of AWS or DT post-surgery...
October 2015: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26444921/from-antiquity-to-the-n-methyl-d-aspartate-receptor-a-history-of-delirium-tremens
#18
F J Rodriguez Porcel, H S Schutta
Delirium associated with excessive alcohol consumption has been known since antiquity. This condition became more common as the supply of distilled fermented liquors increased. Delirium, including delirium associated with excessive alcohol consumption, was for many centuries regarded as a form of brain inflammation - "phrenitis" - and was treated with depletion. At the end of the eighteenth century treatment by depletion of alcohol-related delirium began to be replaced by sedation and led to significantly better outcomes...
2015: Journal of the History of the Neurosciences
https://www.readbyqxmd.com/read/26337198/review-of-adjunctive-dexmedetomidine-in-the-management-of-severe-acute-alcohol-withdrawal-syndrome
#19
REVIEW
Adrian Wong, Pamela L Smithburger, Sandra L Kane-Gill
BACKGROUND: The primary management of alcohol withdrawal involves the administration of a γ-aminobutyric acid agonist, such as benzodiazepines, for management of symptoms and to prevent further progression to seizure or delirium tremens. Despite escalating doses of benzodiazepines, published literature indicates that some patient's alcohol withdrawal syndrome symptoms do not respond, and that the use of adjunctive agents may be beneficial in these patients. Dexmedetomidine, an α2-agonist, serves as a potential adjunctive agent through management of associated autonomic symptoms...
2015: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/26288296/-laboratory-predictors-of-delirium-tremens-severity
#20
D B Vinogradov, A I Sinitskiĭ
AIM: To identify the most informative predictors of delirium tremens severity. MATERIAL AND METHODS: A total of 105 patients from a department of urgent drug addiction help of the Chelyabinsk regional addiction hospital were examined. To find the most informative predictors of delirium tremens severity, we studied a relationship between biogenic amine metabolism and changes in cortisol levels in dependence of patients' condition. The level of catecholamines (adrenaline, noradrenaline, dopamine) and their precursor 3'4-dioxyphenylalanine in blood and daily urine, serotonin and histamine content, thrombocyte monoamine oxidase B activity, urinary tribulin activity, and serum cortisol levels of the patients with different severity of delirium tremens were assessed...
2015: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
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