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https://www.readbyqxmd.com/read/28735156/adaptive-periodic-paralysis-allows-weaning-deep-sedation-overcoming-the-drowning-syndrome-in-ecmo-patients-bridged-for-lung-transplantation-a-case-series
#1
Irina Timofte, Michael Terrin, Erik Barr, June Kim, Joseph Rinaldi, Nicholas Ladikos, Jay Menaker, Ali Tabatabai, Zachary Kon, Bartley Griffith, Richard Pierson, Si Pham, Aldo Iacono, Daniel Herr
PURPOSE: Sedation in extracorporeal membrane oxygenation (ECMO) is challenging. Patients require deep sedation because of extremely high respiratory rates and increased work of breathing ("Drowning Syndrome") resulting in altered intra-thoracic pressure and reduced pump flow associated with hemodynamic compromise and decreased oxygenation. However, deep sedation impedes essential active rehabilitation with physical therapy. METHODS: We reviewed data on 3 ECMO patients for whom we used a novel approach to replace continuous drips with periodic sedation/paralysis...
July 17, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28733841/analgosedation-of-adult-patients-with-elevated-intracranial-pressure-survey-of-current-clinical-practice-in-austria
#2
Guenther Herzer, Claudia Mirth, Udo M Illievich, Wolfgang G Voelckel, Helmut Trimmel
BACKGROUND: Analgesia and sedation are key items in intensive care. Recently published S3 guidelines specifically address treatment of patients with elevated intracranial pressure. METHODS: The Austrian Society of Anesthesiology, Resuscitation and Intensive Care Medicine carried out an online survey of neurointensive care units in Austria in order to evaluate the current state of practice in the areas of analgosedation and delirium management in this high-risk patient group...
July 21, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28725569/psychiatric-adult-onset-of-urea-cycle-disorders-a-case-series
#3
Adrien Bigot, Paul Brunault, Christian Lavigne, François Feillet, Sylvie Odent, Elsa Kaphan, Christel Thauvin, Vanessa Leguy, Pierre Broué, Michel C Tchan, François Maillot
Adult onset urea cycle disorders (UCD) may present with psychiatric symptoms, occasionally as the initial presentation. We aimed to describe the characteristics of patients presenting with a psychiatric adult-onset of UCDs, to discuss which signs could suggest this diagnosis in such a situation, and to determine which tests should be conducted. A survey of psychiatric symptoms occurring in teenagers or adults with UCD was conducted in 2010 among clinicians involved in the French society for the study of inborn errors of metabolism (SFEIM)...
September 2017: Molecular Genetics and Metabolism Reports
https://www.readbyqxmd.com/read/28721092/hemicrania-continua-clinical-review-diagnosis-and-management
#4
REVIEW
Sanjay Prakash, Payal Patel
Hemicrania continua (HC) is an indomethacin-responsive primary headache disorder which is currently classified under the heading of trigeminal autonomic cephalalgias (TACs). It is a highly misdiagnosed and underreported primary headache. The pooled mean delay of diagnosis of HC is 8.0 ± 7.2 years. It is not rare. We noted more than 1000 cases in the literature. It represents 1.7% of total headache patients attending headache or neurology clinic. Just like other TACs, it is characterized by strictly unilateral pain in the trigeminal distribution, cranial autonomic features in the same area and agitation during exacerbations/attacks...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28716269/dopamine-agonist-withdrawal-syndrome-daws-in-a-tertiary-parkinson-disease-treatment-center
#5
Shnehal Patel, Xiomara Garcia, Mohammad Edrees Mohammad, Xin Xin Yu, Katelyn Vlastaris, Kaley O'Donnell, Kathryn Sutton, Hubert H Fernandez
INTRODUCTION: Dopamine agonists are a mainstay of treatment for patients with Parkinson disease (PD). However, side effects limit their use, often necessitating dose change. Upon withdrawal, patients may experience dopamine agonist withdrawal syndrome (DAWS). To date, there is no established protocol for the prevention or treatment of DAWS. METHODS: We performed a retrospective chart review of PD patients who were taking a dopamine agonist. RESULTS: In our large cohort of 313 PD patients who were on a dopamine agonist, we found that 39...
August 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28715780/use-of-perampanel-in-children-and-adolescents-with-lennox-gastaut-syndrome
#6
Stéphane Auvin, Blandine Dozieres, Adina Ilea, Catherine Delanoë
AIM: Report the use of perampanel treatment in children with Lennox-Gastaut syndrome (LGS). METHOD: We conducted a prospective study of 13 LGS patients (seven male; mean age, 12.8years) treated with adjunctive perampanel therapy. Perampanel was initiated at 2mg/day and titrated to a median maximum dose of 6mg/day. RESULTS: After a mean follow-up duration of 10.8months (range, 1-24months), nine patients (69.2%) were responders (≥50% reduction in total seizure frequency) and nine (69...
July 14, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28710237/focal-neurological-presentation-in-hashimoto-s-encephalopathy-mimicking-a-vascular-occlusion-of-the-middle-cerebral-artery
#7
Ahmad Alazzeh, Sarah Jaroudi, Matthew Gooch, Alan N Peiris
Hashimoto's encephalopathy is a rare form of autoimmune encephalopathy. It is likely an underdiagnosed entity especially in the setting of focal neurological defects. We report a case of a 49-year-old man who presented with "strange behavior"of a day's duration. Examination was significant only for lethargy, poor attention span and agitation. Routine labs revealed leucocytosis. Head CT scan was unremarkable. Lumbar puncture showed high white blood cells with lymphocytosis and elevated protein level. The patient was empirically treated for meningitis without improvement...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28709012/de-escalation-of-aggressive-behaviour-in-healthcare-settings-concept-analysis
#8
REVIEW
Nutmeg Hallett, Geoffrey L Dickens
BACKGROUND: De-escalation is the recommended first-line response to potential violence and aggression in healthcare settings. Related scholarly activity has increased exponentially since the 1980s, but there is scant research about its efficacy and no guidance on what constitutes the gold standard for practice. OBJECTIVES: To clarify the concept of de-escalation of violence and aggression as described within the healthcare literature. DESIGN: Concept analysis guided by Rodgers' evolutionary approach...
July 4, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28708800/the-effects-of-white-noise-on-agitated-behaviors-mental-status-and-activities-of-daily-living-in-older-adults-with-dementia
#9
Li-Wei Lin, Shu-Chuan Weng, Hua-Shan Wu, Lu-Jen Tsai, Ya-Ling Lin, Shu-Hui Yeh
BACKGROUND: The aging of society is a global trend, and care of older adults with dementia is an urgent challenge. As dementia progresses, patients exhibit negative emotions, memory disorders, sleep disorders, and agitated behavior. Agitated behavior is one of the most difficult problems for family caregivers and healthcare providers to handle when caring for older adults with dementia. PURPOSE: The aim of this study was to investigate the effectiveness of white noise in improving agitated behavior, mental status, and activities of daily living in older adults with dementia...
July 13, 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/28708753/effectiveness-of-preoperative-intranasal-dexmedetomidine-compared-with-oral-midazolam-for-the-prevention-of-emergence-delirium-in-the-pediatric-patient-undergoing-general-anesthesia-a-systematic-review
#10
James FitzSimons, Laura S Bonanno, Stephanie Pierce, Jennifer Badeaux
BACKGROUND: Emergence delirium is defined as a cognitive disturbance during emergence from general anesthesia resulting in hallucinations, delusions and confusion manifested by agitation, restlessness, involuntary physical movement and extreme flailing in bed. Postoperative emergence delirium develops in 12% to 18% of all children undergoing general anesthesia for surgery. This post-anesthetic phenomenon changes cognitive and psychomotor behavior, and puts pediatric patients and health care personnel at risk of injury...
July 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28707325/effects-of-scalp-nerve-block-on-pain-and-emergence-agitation-after-paediatric-nevus-surgery-a-clinical-trial
#11
J-S Kim, G W Kim, D H Park, H E Ahn, M Y Chang, J Y Kim
BACKGROUND: Pain is considered as being one cause of post-operative emergence agitation (EA) from sevoflurane anaesthesia. The purpose of this study was to investigate the pure effect of post-operative pain on EA after sevoflurane anaesthesia in preschool children undergoing excision of scalp nevi. METHODS: Forty-four children, 1-7 years old, undergoing scalp nevus excision were enrolled. Patients were randomly assigned to two groups: the remifentanil group received single intravenous injection of short-acting synthetic opioid, remifentanil 1 μg/kg just before the scalp incision, and the block group received scalp nerve block with 0...
July 14, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28705297/the-diagnosis-and-treatment-of-behavioral-disorders-in-dementia
#12
Torsten Kratz
BACKGROUND: Behavioral disorders such as aggressiveness, agitation, delusions, disinhibition, affect lability, and apathy arise in more than 90% of patients with dementia. Behavioral disorders are a major challenge and the greatest stress factor in everyday life for nursing personnel and for family members caring for the patient. METHODS: This review is based on relevant publications retrieved by a selective literature search in the PubMed, Cochrane Library, and German S3 guideline databases with the search terms "behavioral disorders," "non-cognitive disorders," and "challenging behavior," in conjunction with "dementia" and "behavioral and psychological symptoms of dementia...
June 30, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28704833/pica-in-a-child-with-anterior-cingulate-gyrus-oligodendroglioma-case-report
#13
Shivani D Rangwala, Matthew K Tobin, Daniel M Birk, Jonathan T Butts, Dimitrios C Nikas, Yoon S Hahn
The anterior cingulate gyrus (ACG) is a continued focus of research as its exact role in brain function and vast connections with other anatomical locations is not fully understood. A review of the literature illustrates the role the ACG likely plays in cognitive and emotional processing, as well as a modulating role in motor function and goal-oriented behaviors. While lesions of the cingulate gyrus are rare, each new case broadens our understanding of its role in cognitive neuroscience and higher order processing...
July 14, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28699248/phenotypical-characteristics-of-postpartum-psychosis-a-clinical-cohort-study
#14
Astrid M Kamperman, Marian J Veldman-Hoek, Richard Wesseloo, Emma Robertson Blackmore, Veerle Bergink
OBJECTIVES: Postpartum psychosis (PP) is known for its clear onset but its phenotype has never been clearly described in a cohort. The aim of this study was to describe PP symptomatology, and to identify subgroups of patients based on symptom profiles. METHODS: We prospectively assessed a wide range of symptoms in cases of PP in a cohort of women (N=130) admitted to the Mother-Baby inpatient unit. Using a person-centered analytic approach, we distinguished mutually exclusive subgroups of women...
July 12, 2017: Bipolar Disorders
https://www.readbyqxmd.com/read/28698646/plasma-biomarkers-are-associated-with-agitation-and-regional-brain-atrophy-in-alzheimer-s-disease
#15
Jung-Lung Hsu, Wei-Ju Lee, Yi-Chu Liao, Jiing-Feng Lirng, Shuu-Jiun Wang, Jong-Ling Fuh
This study investigated the relationships among plasma biomarkers, regional brain atrophy, and clinical symptoms in patients with Alzheimer's disease (AD; n = 177), mild cognitive impairment (MCI; N = 60) and controls (n = 108). The Mini-Mental Status Examination (MMSE), Clinical Dementia Rating (CDR), and Neuropsychiatric Inventory (NPI) subscales were administered to subjects. Magnetic resonance imaging was performed and medial temporal atrophy (MTA) and posterior atrophy (PA) were assessed visually...
July 11, 2017: Scientific Reports
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
#16
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/28697572/delayed-recall-and-working-memory-mmse-domains-predict-delirium-following-cardiac-surgery
#17
Catherine C Price, Cynthia Garvan, Loren Hizel, Marcos G Lopez, Frederic T Billings
BACKGROUND: Reduced preoperative cognition is a risk factor for postoperative delirium. The significance for type of preoperative cognitive deficit, however, has yet to be explored and could provide important insights into mechanisms and prediction of delirium. OBJECTIVE: Our goal was to determine if certain cognitive domains from the general cognitive screener, the Mini-Mental State Exam (MMSE), predict delirium after cardiac surgery. METHODS: Patients completed a preoperative MMSE prior to undergoing elective cardiac surgery...
July 4, 2017: Journal of Alzheimer's Disease: JAD
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
#18
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/28691250/obesity-in-patients-with-major-depression-is-related-to-bipolarity-and-mixed-features-evidence-from-the-bridge-ii-mix-study
#19
Eleonora Petri, Olivia Bacci, Margherita Barbuti, Isabella Pacchiarotti, Jean-Michel Azorin, Jules Angst, Charles L Bowden, Sergey Mosolov, Eduard Vieta, Allan H Young, Giulio Perugi
OBJECTIVES: The Bipolar Disorders: Improving Diagnosis, Guidance and Education (BRIDGE)-II-Mix study aimed to estimate the frequency of mixed states in patients with a major depressive episode (MDE) according to different definitions. The present post-hoc analysis evaluated the association between obesity and the presence of mixed features and bipolarity. METHODS: A total of 2811 MDE subjects were enrolled in a multicenter cross-sectional study. In 2744 patients, the body mass index (BMI) was evaluated...
July 10, 2017: Bipolar Disorders
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
#20
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
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