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Delirium assessment

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https://www.readbyqxmd.com/read/28231030/safety-of-patient-mobilization-and-rehabilitation-in-the-icu-systematic-review-with-meta-analysis
#1
Peter Nydahl, Thiti Sricharoenchai, Saurabh Chandra, Firuzan Sari Kundt, Minxuan Huang, Magdalena Fischill, Dale M Needham
BACKGROUND: Early mobilization and rehabilitation of patients in intensive care units (ICU) may improve physical function, and reduce the duration of delirium, mechanical ventilation and ICU length of stay. However, safety concerns are an important barrier to widespread implementation. OBJECTIVE: To synthesize safety data regarding patient mobilization and rehabilitation in the ICU, including falls, removal of endotracheal tubes (ETT), removal or dysfunction of intravascular catheters, removal of other catheters/tubes, cardiac arrest, hemodynamic changes and desaturation...
February 23, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28226985/the-letter-and-shape-drawing-lsd-test-an-efficient-and-systematised-approach-to-testing-of-visuospatial-function
#2
Michael Tenorio, Olugbenga A Williams, Maeve Leonard, Debbie White, Frank McKenna, Colum P Dunne, David Meagher, Chris Exton, Michael Tenorio, Olugbenga A Williams, Maeve Leonard, Debbie White, Frank McKenna, Colum P Dunne, David Meagher, Chris Exton, Debbie White, Olugbenga A Williams, Colum P Dunne, David Meagher, Michael Tenorio, Frank McKenna, Chris Exton, Maeve Leonard
The automation and systemisation of the next generation of cognitive assessment approaches have the potential to change how clinicians assess and interact with patients. This may be especially pertinent in the case of delirium, as current methods often rely on the subjective opinion of clinicians and specialists, with potential for the condition to be overlooked or misdiagnosed. Currently, one of the most commonly used tests, is the clock-drawing test, which has relatively wide appeal as a cognitive screening instrument due to its clinical utility and psychometric properties...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28219810/continuous-electroencephalography-in-a-mixed-non-neurological-intensive-care-population-an-observational-study
#3
Patrick Schramm, Judyta Luczak, Kristin Engelhard, Jasmin El Shazly, Martin Juenemann, Marlene Tschernatsch
PURPOSE: Continuous electroencephalography (cEEG) improves monitoring of the brain in unconscious patients, but implementation at ICU is difficult. The present investigation shows a way to introduce cEEG at an anesthesiological ICU and discusses the first experiences. MATERIALS AND METHODS: The study analyzed the feasibility of cEEG, assessed the interpretable cEEG time, importance of automatic seizure detection, the incidence of seizures, the predominant background EEG activity, incidence of delirium and mortality...
February 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28214194/orthogeriatric-activity-in-a-general-hospital-of-castilla-la-mancha-spain
#4
J M Fernández-Ibáñez, M C Morales-Ballesteros, E Crespo-Romero, S Gómez-Gómez, M D Fraga-Fuentes, J Cruz-Tejado, P A Hernández-Zegarra, Á Arias-Arias, M M García-Baltasar
AIM: To describe the orthogeriatric activity in the elderly with hip fractures in the Hospital Mancha Centro, based on the recommendations of the main guidelines. MATERIAL AND METHOD: Observational prospective study, comprising all patients over 65 years of age admitted to the Traumatology Unit with a hip fracture between April 2015 and December 2015. Patients were admitted under the care of the Traumatology Unit with cross-consultation carried out with the Geriatrics Department, which then carried out a pre-operative geriatric assessment and the post-operative follow-ups...
February 14, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28214083/the-effect-of-nonpharmacological-training-on-delirium-identification-and-intervention-strategies-of-intensive-care-nurses
#5
Ayşegül Öztürk Birge, Hatice Tel Aydin
OBJECTIVE: This study aims to investigate the effect of nonpharmacological intervention training on delirium recognition and the intervention strategies of intensive care (ICU) nurses. METHOD: This is a quasi-experimental study conducted using a pretest-posttest design. The study sample included a total of 95 patients staying in the medical ICU of a university hospital and 19 nurses working in these units. The data were collected using the Patient and Nurse Introduction, Confusion Assessment Method for the ICU, and Delirium Risk Factors, and Non-pharmacological Interventions in Delirium Prevention Forms...
February 14, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28212172/cognitive-decline-associated-with-anesthesia-and-surgery-in-the-elderly-does-this-contribute-to-dementia-prevalence
#6
Lisbeth Evered, David A Scott, Brendan Silbert
PURPOSE OF REVIEW: To provide an update on the current state of research investigating the effects of anesthesia and surgery on cognition in the elderly, including consideration of overlap with cognitive disorders in the community. RECENT FINDINGS: The studies reviewed here identify detrimental effects of anesthesia and surgery on cognition in a proportion of elderly individuals. Animal models demonstrate an association between anesthetic agents and Alzheimer's disease pathology...
February 15, 2017: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/28210861/the-effects-of-alcoholism-and-smoking-on-advanced-cancer-patients-admitted-to-an-acute-supportive-palliative-care-unit
#7
Sebastiano Mercadante, Claudio Adile, Patrizia Ferrera, Alessandra Casuccio
AIM: The aim of this prospective study was to determine the characteristics and symptom burden of advanced cancer patients with alcoholism problems and smoking, who were referred to an acute palliative/supportive care unit (ASPCU) of a comprehensive cancer center. METHODS: Patients' characteristics, indications for admission, kind of admission, awareness of prognosis, and anticancer treatments were recorded. The Edmonton Symptom Assessment Scale (ESAS) was used to assess physical and psychological symptoms, and the CAGE questionnaire for the diagnosis of alcoholism...
February 16, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28210771/factors-influencing-physical-activity-and-rehabilitation-in-survivors-of-critical-illness-a-systematic-review-of-quantitative-and-qualitative-studies
#8
REVIEW
Selina M Parry, Laura D Knight, Bronwen Connolly, Claire Baldwin, Zudin Puthucheary, Peter Morris, Jessica Mortimore, Nicholas Hart, Linda Denehy, Catherine L Granger
PURPOSE: To identify, evaluate and synthesise studies examining the barriers and enablers for survivors of critical illness to participate in physical activity in the ICU and post-ICU settings from the perspective of patients, caregivers and healthcare providers. METHODS: Systematic review of articles using five electronic databases: MEDLINE, CINAHL, EMBASE, Cochrane Library, Scopus. Quantitative and qualitative studies that were published in English in a peer-reviewed journal and assessed barriers or enablers for survivors of critical illness to perform physical activity were included...
February 16, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28205243/the-effect-of-treatment-of-anemia-with-blood-transfusion-on-delirium-a-systematic-review
#9
Vera van der Zanden, Sara J Beishuizen, Lieke M Swart, Sophia E de Rooij, Barbara C van Munster
OBJECTIVES: Treating the precipitating factors of delirium is the mainstay of the prevention and treatment of delirium. We aim to investigate the role of anemia and blood transfusion within the multicomponent prevention and treatment strategy of delirium. DESIGN: Systematic review. SETTING: We included cohort studies or Randomized Controlled Trials (RCTs) that considered blood transfusion as treatment for delirium or risk factor, and had delirium as outcome...
February 15, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28198997/randomized-clinical-trial-of-comprehensive-geriatric-assessment-and-optimization-in-vascular-surgery
#10
J S L Partridge, D Harari, F C Martin, J L Peacock, R Bell, A Mohammed, J K Dhesi
BACKGROUND: Increasing numbers of older patients are undergoing vascular surgery. Inadequate preoperative assessment and optimization may contribute to increased postoperative morbidity and mortality. METHODS: Patients aged at least 65 years scheduled for elective aortic aneurysm repair or lower-limb arterial surgery were enrolled in an RCT of standard preoperative assessment or preoperative comprehensive geriatric assessment and optimization. Randomization was stratified by sex and surgical site (aorta/lower limb)...
February 15, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28182690/impact-of-dexmedetomidine-on-the-incidence-of-delirium-in-elderly-patients-after-cardiac-surgery-a-randomized-controlled-trial
#11
Xue Li, Jing Yang, Xiao-Lu Nie, Yan Zhang, Xue-Ying Li, Li-Huan Li, Dong-Xin Wang, Daqing Ma
BACKGROUND: Delirium is a frequent complication after cardiac surgery and its occurrence is associated with poor outcomes. The purpose of this study was to investigate the impact of perioperative dexmedetomidine administration on the incidence of delirium in elderly patients after cardiac surgery. METHODS: This randomized, double-blinded, and placebo-controlled trial was conducted in two tertiary hospitals in Beijing between December 1, 2014 and July 19, 2015. Eligible patients were randomized into two groups...
2017: PloS One
https://www.readbyqxmd.com/read/28173895/delirium-in-the-intensive-care-setting-a-reevaluation-of-the-validity-of-the-cam-icu-and-icdsc-versus-the-dsm-iv-tr-in-determining-a-diagnosis-of-delirium-as-part-of-the-daily-clinical-routine
#12
Soenke Boettger, David Garcia Nuñez, Rafael Meyer, André Richter, Susana Franco Fernandez, Alain Rudiger, Maria Schubert, Josef Jenewein
BACKGROUND: In the intensive care setting, delirium is a common occurrence that comes with subsequent adversities. Therefore, several instruments have been developed to screen for and detect delirium. Their validity and psychometric properties, however, remain controversial. METHOD: In this prospective cohort study, the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC) were evaluated versus the DSM-IV-TR in the diagnosis of delirium with respect to their validity and psychometric properties...
February 8, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28164113/nonpharmacological-interventions-targeted-at-delirium-risk-factors-delivered-by-trained-volunteers-medical-and-psychology-students-reduced-need-for-antipsychotic-medications-and-the-length-of-hospital-stay-in-aged-patients-admitted-to-an-acute-internal-medicine
#13
Stanislaw Gorski, Karolina Piotrowicz, Krzysztof Rewiuk, Monika Halicka, Weronika Kalwak, Paulina Rybak, Tomasz Grodzicki
Purpose. Effectiveness of nonpharmacological multicomponent prevention delivered by trained volunteers (medical and psychology students), targeted at delirium risk factors in geriatric inpatients, was assessed at an internal medicine ward in Poland. Patients and Methods. Participants were recruited to intervention and control groups at the internal medicine ward (inclusion criteria: age ≥ 75, acute medical condition, basic orientation, and logical contact on admission; exclusion criteria: life expectancy < 24 hours, surgical hospitalization, isolation due to infectious disease, and discharge to other medical wards)...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28163496/association-of-cognitive-and-noncognitive-symptoms-of-delirium-a-study-from-consultation-liaison-psychiatry-set-up
#14
Sandeep Grover, Aseem Mehra, Subho Chakrabarti, Ajit Avasthi
AIMS: This study aims to evaluate the cognitive functions of patients with delirium using Hindi Mental Status Examination (HMSE), to study the correlation of cognitive functions assessed by HMSE with noncognitive symptoms as assessed using Delirium Rating Scale-Revised 1998 (DRS-R-98) and to study the association of cognitive functions assessed using HMSE and DRS-R98. METHODS: A total of 76 consecutive patients fulfilling the diagnosis of delirium were evaluated on DRS-R-98, HMSE, and Short Informant Questionnaire on Cognitive Decline in the Elderly (retrospective IQCODE)...
December 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28160235/characteristics-of-patients-with-an-unplanned-admission-to-an-acute-palliative-care-unit
#15
Sebastiano Mercadante, Claudio Adile, Patrizia Ferrera, Alessandra Casuccio
The aim of this cohort study is to compare the symptom burden of patients who have an unplanned admission to an acute palliative care unit (APCU) with patients who have a regular planned admission. A consecutive sample of advanced cancer patients who were admitted to an APCU was prospectively assessed. The reasons and the kind of admission were recorded (unplanned, UP, or planned, P). Anticancer treatments, whether patients were on/off treatment or uncertain, previous care setting, and who referred the patient to the unit were also recorded...
February 3, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28157431/increased-symptom-expression-among-patients-with-delirium-admitted-to-an-acute-palliative-care-unit
#16
Maxine de la Cruz, Sriram Yennu, Diane Liu, Jimin Wu, Akhila Reddy, Eduardo Bruera
INTRODUCTION: Delirium is the most common neuropsychiatric condition in very ill patients and those at the end of life. Previous case reports found that delirium-induced disinhibition may lead to overexpression of symptoms. It negatively affects communication between patients, family members, and the medical team and can sometimes lead to inappropriate interventions. Better understanding would result in improved care. Our aim was to determine the effect of delirium on the reporting of symptom severity in patients with advanced cancer...
February 3, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28156478/using-touch-based-technology-to-screen-patients-in-the-icu
#17
Matthew J Loscalzo, Rupinder Sidhu, David Horak, Sorin Buga
: 76 Background: The intensive care unit (ICU) is associated with high mortality rates, significant costs, along with occasionally futile and non-indicated care. Surveys of patients indicate the majority wish to focus on comfort and being at home at the end of life as opposed to the aggressive interventions received in the hospital. Although a small percentage of patients may be awake, medical teams look to the families to provide the direction of care for a patient in the ICU. City of Hope National Medical Center has utilized tablet-based screening of caregivers for years, and now in conjunction with delirium screening has started to roll out tablet-based screening for patients who are awake and do not have delirium...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152732/reducing-pain-agitation-and-delirium-to-optimize-outcomes-in-mechanically-ventilated-critically-ill-oncology-patients
#18
Dana Bullick, Sharon Barniak, Joanne McGovern, Trisha Patel, Jeffrey Hoag
: 233 Background: Greater than 60% of cancer patients experience chronic pain which is heightened in critical illness. Optimal pain assessment is challenging in the critically ill leading to under treatment due to sedation during mechanical ventilation (MV). The Society of Critical Care Medicine (SCCM) favors treating pain with intermittent boluses rather than continuous infusions; however,appropriate analgesic doses and means of titration are elusive leading to over sedation, prolonged ventilation, and delirium...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28148613/delirium-in-trauma-patients-prevalence-and-predictors
#19
Kathryn T Von Rueden, Breighanna Wallizer, Paul Thurman, Karen McQuillan, Tiffany Andrews, Jennifer Merenda, Heesook Son
BACKGROUND: Delirium is associated with increased mortality, morbidity, hospital costs, and postdischarge cognitive dysfunction. Most research focuses on nontrauma patients receiving mechanical ventilation in the intensive care unit. OBJECTIVES: To determine the prevalence and predictors of delirium in trauma patients residing in intensive and intermediate care units of an academic medical center. METHODS: Trauma patients were screened for delirium by using the Confusion Assessment Method for the Intensive Care Unit...
February 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28144726/-delirium-in-stroke-patients-critical-analysis-of-statistical-procedures-for-the-identification-of-risk-factors
#20
P Nydahl, N G Margraf, A Ewers
BACKGROUND: Delirium is a relevant complication following an acute stroke. It is a multifactor occurrence with numerous interacting risk factors that alternately influence each other. PROBLEM: The risk factors of delirium in stroke patients are often based on limited clinical studies. The statistical procedures and clinical relevance of delirium related risk factors in adult stroke patients should therefore be questioned. METHOD: This secondary analysis includes clinically relevant studies that give evidence for the clinical relevance and statistical significance of delirium-associated risk factors in stroke patients...
January 31, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
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