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Delirium assessment

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https://www.readbyqxmd.com/read/28936959/-correlation-between-apache-ii-scores-and-delirium-probability-of-senile-severe-pneumonia-patients-undergoing-invasive-mechanical-ventilation
#1
Xinghua Pei, Haiming Yu, Yanhong Wu, Xu Zhou
OBJECTIVE: To investigate the correlation between acute physiology and chronic health evaluation II (APACHE II) scores and delirium probability of senile severe pneumonia patients undergoing invasive mechanical ventilation (MV). METHODS: A retrospective study was conducted. Eighty-nine senile severe pneumonia patients undergoing invasive MV admitted to intensive care unit (ICU) of Hunan Provincial People's Hospital from January 2015 to March 2017 were enrolled. APACHE II scores were collected 24 hours before invasive MV...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28933260/older-and-newer-strategies-for-the-pharmacological-treatment-of-agitation-in-schizophrenia-and-bipolar-disorder
#2
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/28928558/oral-clonidine-premedication-attenuates-hemodynamic-responses-of-ketamine-during-total-intravenous-anesthesia
#3
Pulak Tosh, Sunil Rajan, Nitu Puthenveettil, Lakshmi Kumar
BACKGROUND: The most commonly used drug for total intravenous anesthesia (TIVA) is ketamine which results in cardiovascular stimulation. AIMS: The primary aim of this study was to assess the effect of oral clonidine premedication on attenuating the hemodynamic responses following ketamine administration. SETTINGS AND DESIGNS: This was a prospective, observational, comparative study conducted in a tertiary care institution. SUBJECTS AND METHODS: A total of 40 female patients aged 18-55 years who were posted for elective short gynecological procedures under TIVA were recruited for this study...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28927394/laboratory-markers-of-cardiac-and-metabolic-complications-after-generalized-tonic-clonic-seizures
#4
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/28923236/emergency-nurses-knowledge-and-self-rated-practice-skills-when-caring-for-older-patients-in-the-emergency-department
#5
Helen Rawson, Paul N Bennett, Cherene Ockerby, Alison M Hutchinson, Julie Considine
BACKGROUND: Older adults are high users of emergency department services and their care requirements can present challenges for emergency nurses. Although clinical outcomes for older patients improve when they are cared for by nurses with specialist training, emergency nurses' knowledge and self-assessment of care for older patients is poorly understood. AIM: To assess emergency nurses' knowledge and self-rating of practice when caring for older patients. METHODS: A cross-sectional self-report survey of emergency nurses (n=101) in Melbourne, Australia...
September 8, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28918171/the-association-between-delirium-and-sarcopenia-in-older-adult-patients-admitted-to-acute-geriatrics-units-results-from-the-glisten-multicenter-observational-study
#6
Giuseppe Bellelli, Antonella Zambon, Stefano Volpato, Pasquale Abete, Lara Bianchi, Mario Bo, Antonio Cherubini, Francesco Corica, Mauro Di Bari, Marcello Maggio, Giovanna Maria Manca, Maria Rosaria Rizzo, Andrea Rossi, Francesco Landi
BACKGROUND & AIMS: To date, studies assessing the relationship between sarcopenia and delirium, two of the most common geriatric syndromes, are lacking. We sought to explore this association by investigating the co-occurrence of these two conditions and the independent association between them in a population of hospitalized older adults. METHODS: Cross-sectional multicenter analysis of older adults consecutively admitted to 12 acute geriatric units (AGUs). Sarcopenia was assessed upon admission by evaluating the presence of low skeletal mass index (kg/m(2)), and either low handgrip strength or low walking speed (European Working Group on Sarcopenia in Older People, EWGSOP criteria)...
September 5, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28915907/effect-of-a-mother-s-recorded-voice-on-emergence-from-general-anesthesia-in-pediatric-patients-study-protocol-for-a-randomized-controlled-trial
#7
Seok Young Song, Sang Gyu Kwak, Eugene Kim
BACKGROUND: Emergence delirium is a behavioral disturbance after general anesthesia in children and may distress both the patients and the primary caregivers, such as parents and medical staff, looking after the patients. Various medical and emotional interventions have been investigated to reduce emergence delirium; however, none are completely effective. This trial intends to assess whether the mother's recorded voice can reduce this adverse post-anesthesia event and facilitate arousal from general anesthesia...
September 15, 2017: Trials
https://www.readbyqxmd.com/read/28912778/neuroprotective-effects-of-annexin-a1-tripeptide-after-deep-hypothermic-circulatory-arrest-in-rats
#8
Zhiquan Zhang, Qing Ma, Bijal Shah, G Burkhard Mackensen, Donald C Lo, Joseph P Mathew, Mihai V Podgoreanu, Niccolò Terrando
Resolution agonists, including lipid mediators and peptides such as annexin A1 (ANXA1), are providing novel approaches to treat inflammatory conditions. Surgical trauma exerts a significant burden on the immune system that can affect and impair multiple organs. Perioperative cerebral injury after cardiac surgery is associated with significant adverse neurological outcomes such as delirium and postoperative cognitive dysfunction. Using a clinically relevant rat model of cardiopulmonary bypass (CPB) with deep hypothermic circulatory arrest (DHCA), we tested the pro-resolving effects of a novel bioactive ANXA1 tripeptide (ANXA1sp) on neuroinflammation and cognition...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28904548/effect-of-family-patient-communication-on-the-incidence-of-delirium-in-hospitalized-patients-in-cardiovascular-surgery-icu
#9
Maryam Eghbali-Babadi, Nasrin Shokrollahi, Tayebe Mehrabi
BACKGROUND: Cardiovascular diseases are the most important causes of morbidity and mortality in the world, and cardiac surgery is one of the treatments that have complication for patients. One of the most important current psychological complications after cardiac surgery is delirium. For its prevention and treatment, considerable attention should be paid to the role of family. This study has been conducted for assessing the effect of the relationship between the family and patient on the incidence of delirium in hospitalized patients in cardiovascular surgery intensive care unit (ICU) of Isfahan Shahid Chamran hospital...
July 2017: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/28903799/a-comparison-of-outcomes-according-to-different-diagnostic-systems-for-delirium-dsm-5-dsm-iv-cam-and-drs-r98
#10
Dimitrios Adamis, David Meagher, Siobhan Rooney, Owen Mulligan, Geraldine McCarthy
Studies indicate that DSM-5 criteria for delirium are relatively restrictive, and identify different cases of delirium compared with previous systems. We evaluate four outcomes of delirium (mortality, length of hospital stay, institutionalization, and cognitive improvement) in relation to delirium defined by different DSM classification systems. Prospective, longitudinal study of patients aged 70+ admitted to medical wards of a general hospital. Participants were assessed up to a maximum of four times during two weeks, using DSM-5 and DSM-IV criteria, DRS-R98 and CAM scales as proxies for DSM III-R and DSM III...
September 14, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28903083/delirium-characteristics-and-outcomes-in-medical-and-surgical-lnpatients-a-subgroup-analysis
#11
Sungmin Kim, Jae-Jin Kim, Jooyoung Oh, Jaesub Park, Jin Young Park
PURPOSE: Persistent delirium can negatively affect patients, increase healthcare costs, and extend the length of hospital stays. This investigation was undertaken to explore associations between patient characteristics and delirium outcomes. MATERIALS AND METHODS: Intensive care unit (ICU) and medical and surgical ward inpatients for whom psychiatric consultation was requested for delirium were included in this study. Delirium screening and ongoing assessments were conducted using the Confusion Assessment Method for ICU patients...
August 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28894370/reversible-global-aphasia-as-a-side-effect-of-quetiapine-a-case-report-and-literature-review
#12
Ching-Fang Chien, Poyin Huang, Sun-Wung Hsieh
Quetiapine is an atypical antipsychotic agent which is also prescribed for delirium due to its anti-dopaminergic effects; aphasia is an unusual side effect associated with the drug. Here, we report the case of an 83-year-old woman who was prescribed quetiapine (50 mg per day) for delirium. Unexpected, global aphasia occurred 3 days after treatment began. Complete recovery occurred following discontinuation of the drug. A brain computed tomography scan excluded intracranial hemorrhage and the laboratory results confirmed that no exacerbation of infection or electrolyte imbalances were present...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28891911/delineating-the-trajectory-of-cognitive-recovery-from-general-anesthesia-in-older-adults-design-and-rationale-of-the-torie-trajectory-of-recovery-in-the-elderly-project
#13
Joshua S Mincer, Mark G Baxter, Patrick J McCormick, Mary Sano, Arthur E Schwartz, Jess W Brallier, Heather G Allore, Bradley N Delman, Margaret C Sewell, Prantik Kundu, Cheuk Ying Tang, Angela Sanchez, Stacie G Deiner
BACKGROUND: Mechanistic aspects of cognitive recovery after anesthesia and surgery are not yet well characterized, but may be vital to distinguishing the contributions of anesthesia and surgery in cognitive complications common in the elderly such as delirium and postoperative cognitive dysfunction. This article describes the aims and methodological approach to the ongoing study, Trajectory of Recovery in the Elderly (TORIE), which focuses on the trajectory of cognitive recovery from general anesthesia...
September 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28869952/risk-factors-for-delirium-in-older-medical-inpatients-in-tanzania
#14
Emma Grace Lewis, Jessica Banks, Stella-Maria Paddick, Ashanti Duinmaijer, Laura Tucker, Aloyce Kisoli, Jane Cletus, Carolyn Lissu, Kajiru Kilonzo, Glynis Cosker, Elizabeta Blagoja Mukaetova-Ladinska, Catherine Dotchin, William Gray, Richard Walker, Sarah Urasa
BACKGROUND: The risk factors for prevalent delirium in older hospitalised adults in Sub-Saharan Africa (SSA) remain poorly characterised. METHODS: A total of 510 consecutive admissions of adults aged ≥60 years to acute medical wards of Kilimanjaro Christian Medical Centre in northern Tanzania were recruited. Patients were assessed within 24 h of admission with a risk factor questionnaire, physiological observations, neurocognitive assessment, and informant interview...
September 5, 2017: Dementia and Geriatric Cognitive Disorders
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
#15
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/28868067/cerebrospinal-fluid-apolipoprotein-e-levels-in-delirium
#16
Gideon A Caplan, JIan Tai, Fazrul Mohd Hanizan, Catherine L McVeigh, Mark A Hill, Anne Poljak
BACKGROUND/AIMS: Delirium and the apolipoprotein E ε4 allele are risk factors for late-onset Alzheimer disease (LOAD), but the connection is unclear. We looked for an association. METHODS: Inpatients with delirium (n = 18) were compared with LOAD outpatients (n = 19), assaying blood and cerebrospinal fluid (CSF) using multiplex ELISA. RESULTS: The patients with delirium had a higher Confusion Assessment Method (CAM) score (5.6 ± 1.2 vs. 0...
May 2017: Dementia and Geriatric Cognitive Disorders Extra
https://www.readbyqxmd.com/read/28868035/a-novel-stress-diathesis-model-to-predict-risk-of-post-operative-delirium-implications-for-intra-operative-management
#17
Renée El-Gabalawy, Ronak Patel, Kayla Kilborn, Caitlin Blaney, Christopher Hoban, Lawrence Ryner, Duane Funk, Regina Legaspi, Joseph A Fisher, James Duffin, David J Mikulis, W Alan C Mutch
Introduction: Risk assessment for post-operative delirium (POD) is poorly developed. Improved metrics could greatly facilitate peri-operative care as costs associated with POD are staggering. In this preliminary study, we develop a novel stress-diathesis model based on comprehensive pre-operative psychiatric and neuropsychological testing, a blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) carbon dioxide (CO2) stress test, and high fidelity measures of intra-operative parameters that may interact facilitating POD...
2017: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/28865447/multicenter-assessment-of-sedation-and-delirium-practices-in-the-intensive-care-units-in-poland-is-this-common-practice-in-eastern-europe
#18
Katarzyna Kotfis, Małgorzata Zegan-Barańska, Maciej Żukowski, Krzysztof Kusza, Mariusz Kaczmarczyk, E Wesley Ely
BACKGROUND: The majority of critically ill patients experience distress during their stay in the Intensive Care Unit (ICU), resulting from systemic illness, multiple interventions and environmental factors. Providing humane care should address concomitant treatment of pain, agitation and delirium. The use of sedation and approaches to ICU delirium should be monitored according to structured guidelines. However, it is unknown to what extent these concepts are followed in Eastern European countries like Poland...
September 2, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28865338/impact-of-restarting-home-neuropsychiatric-medications-on-sedation-outcomes-in-medical-intensive-care-unit-patients
#19
Mary K La, Melissa L Thompson Bastin, Jenee T Gisewhite, Carrie A Johnson, Alexander H Flannery
PURPOSE: This single-center, retrospective cohort study investigated the effects of timing of initiating home neuropsychiatric medications (NPMs) on sedation-related outcomes. MATERIALS AND METHODS: Subjects included adult medical intensive care unit (MICU) patients who had an NPM on their admission medication list; intubated before or on arrival to the intensive care unit (ICU); and were on benzodiazepine-based sedation. The intervention assessed was the timing of the initiation of home NPMs: early (≤5days) vs...
July 29, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28864877/clinical-assessment-and-management-of-delirium-in-the-palliative-care-setting
#20
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
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