16,150 results match your criteria Delirium


Clinically significant drug-drug interactions involving medications used for symptom control in patients with advanced malignant disease. A systematic review.

J Pain Symptom Manage 2019 Feb 15. Epub 2019 Feb 15.

Regional Centre of Excellence for Palliative Care, Western Norway, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine K1, University of Bergen, Bergen, Norway.

Context: Most patients with advanced malignant disease need to take several drugs to control symptoms. This treatment raises risks of serious adverse effects and drug-drug interactions (DDIs).

Objectives: To identify studies reporting clinically significant DDIs involving medications used for symptom control, other than opioids used for pain management, in adult patients with advanced malignant disease. Read More

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http://dx.doi.org/10.1016/j.jpainsymman.2019.02.006DOI Listing
February 2019

Factors Associated with Length of Stay in Hospital Patients with and Without Dementia.

J Alzheimers Dis 2019 ;67(3):1055-1065

Network Aging Research, University of Heidelberg, Heidelberg, Baden-Wuerttemberg, Germany.

Background: Hospital care of older adults, especially of those with dementia, is associated with a high risk of complications and increased mortality. Adverse events are often triggered by hospital-related factors, hence the time spent in hospitals should be limited. There is little knowledge of the specific factors influencing hospitalizations of older persons. Read More

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http://dx.doi.org/10.3233/JAD-180593DOI Listing
January 2019

Bizarre behavior and decreased level of consciousness in an adult patient.

Neth J Med 2019 Jan;77(1):25-28

Red Cross Hospital, Beverwijk, the Netherlands.

This case report presents an adult patient with decreased levels of consciousness and bizarre behavior. A silent delirium was first suspected however, symptoms did not improve and further examination revealed elevated ammonia levels. A hepatic cause and portosystemic shunting were excluded and eventually a diagnosis of ornithine transcarbamylase deficiency was made. Read More

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January 2019

Delirium and Alzheimer's Disease: A Proposed Model for Shared Pathophysiology.

Int J Geriatr Psychiatry 2019 Feb 17. Epub 2019 Feb 17.

Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife, Boston, MA.

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http://dx.doi.org/10.1002/gps.5088DOI Listing
February 2019

Clusters of non-adherence to medication in neurological patients.

Res Social Adm Pharm 2019 Feb 11. Epub 2019 Feb 11.

Department of Neurology, Jena University Hospital, Jena, Germany.

Background: Non-adherence to medication is a common and serious problem in health care. To develop more effective interventions to improve adherence, there is a need for a better understanding of the individual types of non-adherence.

Objective: To determine clusters of non-adherence in neurological patients using a complex adherence questionnaire. Read More

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http://dx.doi.org/10.1016/j.sapharm.2019.01.001DOI Listing
February 2019

Vitamin D: A novel protective factor for delirium?

Neurology 2019 Feb 15. Epub 2019 Feb 15.

From the Unit of Cardiovascular and Nutritional Epidemiology (S.C.L.), Institute of Environmental Medicine, Karolinska Institutet, Stockholm; Department of Surgical Sciences (S.C.L.), Uppsala University, Sweden; and Medical School (L.F.), University of Western Australia, Perth.

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http://dx.doi.org/10.1212/WNL.0000000000007121DOI Listing
February 2019

Vitamin D levels and risk of delirium: A mendelian randomization study in the UK Biobank.

Neurology 2019 Feb 15. Epub 2019 Feb 15.

From the Epidemiology and Public Health Group (K.B., L.J., L.C.P., J.D., D.M.), University of Exeter Medical School, Royal Devon & Exeter Hospital, Exeter, UK; UConn Center on Aging (G.A.K., R.H.F., D.M.), University of Connecticut, Farmington, CT; and National Institute on Aging (L.F.), Baltimore, MD.

Objective: To estimate effects of vitamin D levels on incident delirium hospital admissions using inherited genetic variants in mendelian randomization models, which minimize confounding and exclude reverse causation.

Methods: Longitudinal analysis using the UK Biobank, community-based, volunteer cohort (2006-2010) with incident hospital-diagnosed delirium (ICD-10 F05) ascertained during ≤9.9 years of follow-up of hospitalization records (to early 2016). Read More

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http://dx.doi.org/10.1212/WNL.0000000000007136DOI Listing
February 2019

Predicting the Unpredictable-How to Score the Risk of Delirium in Critically Ill Patients.

Authors:
Raoul Sutter

Crit Care Med 2019 Mar;47(3):484-486

Intensive Care Units and Department of Neurology, University Hospital Basel; and Medical Faculty, University of Basel, Basel, Switzerland.

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http://dx.doi.org/10.1097/CCM.0000000000003602DOI Listing
March 2019
6.312 Impact Factor

Perioperative Epidural Use and Risk of Delirium in Surgical Patients: A Secondary Analysis of the PODCAST Trial.

Anesth Analg 2019 Feb 12. Epub 2019 Feb 12.

From the Department of Anesthesiology.

Background: Postoperative delirium is an important public health concern without effective prevention strategies. This study tested the hypothesis that perioperative epidural use would be associated with decreased risk of delirium through postoperative day 3.

Methods: This was a secondary, observational, nonrandomized analysis of data from The Prevention of Delirium and Complications Associated With Surgical Treatments Trial (PODCAST; NCT01690988). Read More

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http://dx.doi.org/10.1213/ANE.0000000000004038DOI Listing
February 2019
1 Read

Can acute stress be fatal? A systematic cross-disciplinary review.

Stress 2019 Feb 15:1-9. Epub 2019 Feb 15.

b Psychiatric Centre Copenhagen, Department O, Rigshospitalet , Copenhagen University Hospital ,  Copenhagen , Denmark.

In this review it is discussed if acute stress can be fatal. The review is based on literature searches on PubMed, PsycINFO as well as Web of Science. Literature concerning the conditions excited delirium syndrome (ExDS), malignant catatonia, takotsubo cardiomyopathy (TCM), and capture myopathy (CM) is reviewed and compared. Read More

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https://www.tandfonline.com/doi/full/10.1080/10253890.2018.1
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http://dx.doi.org/10.1080/10253890.2018.1561847DOI Listing
February 2019
1 Read

Intra-operative Blood Transfusion Predicts Post-Operative Delirium among Older Patients Undergoing Elective Orthopedic Surgery: a Prospective Cohort Study.

Int J Geriatr Psychiatry 2019 Feb 13. Epub 2019 Feb 13.

Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan.

Objectives: To evaluate the roles of preoperative anemia and intra-operative blood transfusion in the development of post-operative delirium among older patients undergoing elective orthopedic surgery.

Methods: This prospective cohort study recruited subjects aged 60 years and over who were admitted for elective orthopedic surgery in a tertiary medical center during April 2011 to December 2013. Demographic data (age, gender, BMI, educational level), surgery-related factors (ASA class, type of anesthesia and surgery, intra-operative blood transfusion), results of geriatric assessment (hearing/visual impairment, cognition, depressive mood, comorbidity, malnutrition, polypharmacy, ADL, and IADL), laboratory data, length of hospital stay and the development of post-operative delirium were collected for analysis. Read More

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http://dx.doi.org/10.1002/gps.5086DOI Listing
February 2019

The effect of SENATOR (Software ENgine for the Assessment and optimisation of drug and non-drug Therapy in Older peRsons) on incident adverse drug reactions (ADRs) in an older hospital cohort - Trial Protocol.

BMC Geriatr 2019 Feb 13;19(1):40. Epub 2019 Feb 13.

Health Research Board Clinical Research Facility-Cork, University College Cork, Cork University Hospital, Wilton, Cork, Ireland, T12 DC4A.

Background: The aim of this trial is to evaluate the effect of SENATOR software on incident, adverse drug reactions (ADRs) in older, multimorbid, hospitalized patients. The SENATOR software produces a report designed to optimize older patients' current prescriptions by applying the published STOPP and START criteria, highlighting drug-drug and drug-disease interactions and providing non-pharmacological recommendations aimed at reducing the risk of incident delirium.

Methods: We will conduct a multinational, pragmatic, parallel arm Prospective Randomized Open-label, Blinded Endpoint (PROBE) controlled trial. Read More

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http://dx.doi.org/10.1186/s12877-019-1047-9DOI Listing
February 2019

Patient Safety Incidents Describing Patient Falls in Critical Care in North West England Between 2009 and 2017.

J Patient Saf 2019 Feb 9. Epub 2019 Feb 9.

University of Manchester Medical School, Manchester, United Kingdom.

Aim: The aim of the study was to review reported falls in critical care units to see whether the causes and results were different from those described in a general hospital population.

Methods: We reviewed and classified patient safety incidents describing falls from critical care units in the North West of England between 2009 and 2017. The classification reviewed patient and staff factors contributing to the fall, the environment of the fall, and the reported consequences. Read More

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http://dx.doi.org/10.1097/PTS.0000000000000574DOI Listing
February 2019
1 Read

Postinjection Delirium/Sedation Syndrome After 31st Long-Acting Olanzapine Depot Injection.

Clin Neuropharmacol 2019 Feb 8. Epub 2019 Feb 8.

Department of Psychiatry, Central Institute of Psychiatry, Ranchi, India.

Objective: Long-acting depot preparations of antipsychotics are the mainstay of treatment for patients with schizophrenia who show nonadherence to their medications. Olanzapine pamoate is one of the recently approved long-acting depot psychotropic preparations that have shown its efficacy both in clinical trials and in clinical uses against the illness. However, emerging literature indicates toward a cluster of adverse effects known as postinjection delirium/sedation syndrome (PDSS). Read More

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http://dx.doi.org/10.1097/WNF.0000000000000329DOI Listing
February 2019
2 Reads
1.836 Impact Factor

Adverse Effects of Physostigmine.

J Med Toxicol 2019 Feb 11. Epub 2019 Feb 11.

California Poison Control System, San Francisco Division, San Francisco, CA, USA.

Introduction: Physostigmine is a tertiary amine carbamate acetylcholinesterase inhibitor. Its ability to cross the blood-brain barrier makes it an effective antidote to reverse anticholinergic delirium. Physostigmine is underutilized following the publication of patients with sudden cardiac arrest after physostigmine administration in patients with tricyclic antidepressant (TCA) overdoses. Read More

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http://dx.doi.org/10.1007/s13181-019-00697-zDOI Listing
February 2019
1 Read

Continuous Infusion Ketamine for Adjunctive Analgosedation in Mechanically Ventilated, Critically Ill Patients.

Pharmacotherapy 2019 Feb 11. Epub 2019 Feb 11.

Adjunct Assistant Professor of Pharmacy Practice and Administrative Sciences, James L. Winkle College of Pharmacy, University of Cincinnati, 234 Goodman Street, Cincinnati, OH, 45219.

Objective: Ketamine is an N-methyl-D-aspartate (NMDA) antagonist with emerging evidence assessing its use as a continuous infusion agent to provide concomitant analgesia and sedation. The role of ketamine as adjunctive therapy in mechanically ventilated patients is unclear. This study sought to investigate the impact of adjunctive continuous infusion ketamine on concomitant analgesic and sedative dosing while providing goal comfort in mechanically ventilated patients. Read More

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http://dx.doi.org/10.1002/phar.2223DOI Listing
February 2019
2 Reads

Low-Dose Ketamine Infusion to Decrease Postoperative Delirium for Spinal Fusion Patients.

J Perianesth Nurs 2019 Feb 8. Epub 2019 Feb 8.

Purpose: The primary aim of this project was to decrease the incidence of postoperative delirium after spine surgery.

Design: A prospective preimplementation and postimplementation design was used.

Methods: A reduced dose ketamine protocol was implemented for adult patients undergoing elective spinal fusion surgery. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10899472183041
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http://dx.doi.org/10.1016/j.jopan.2018.11.009DOI Listing
February 2019
1 Read

Single dose phenobarbital in addition to symptom-triggered lorazepam in alcohol withdrawal.

Authors:
Francisco Ibarra

Am J Emerg Med 2019 Jan 30. Epub 2019 Jan 30.

Community Regional Medical Center, P.O. Box 1232, Fresno, CA 93715, United States of America. Electronic address:

Objective: The purpose of this study was to evaluate the safety and efficacy of a single parenteral dose of phenobarbital in addition to symptom-triggered lorazepam for the acute management of alcohol withdrawal syndrome (AWS).

Methods: This was a retrospective chart review of adult patients who presented to the Emergency Department with moderate or severe symptoms of alcohol withdrawal. Patients were included if they received at least 4 mg of lorazepam through the hospital's Alcohol Withdrawal Order Set on hospital day one. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.01.053DOI Listing
January 2019
2 Reads

Evaluation of the Brief Alcohol Withdrawal Scale Protocol at an Academic Medical Center.

J Addict Med 2019 Feb 6. Epub 2019 Feb 6.

Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD (BKL, VTG, RMK, ASJ); Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (AAHA, TN); Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (ESC); Department of Medicine, The Johns Hopkins Hospital, Baltimore, MD (PM, KP); Center for Chemical Dependence, Johns Hopkins Bayview Medical Center, Baltimore, MD (DAR); Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD (SY).

Objectives: The standard of care for treatment of alcohol withdrawal is symptom-triggered dosing of benzodiazepines using a withdrawal scale. Abbreviated scales are desired for clinician efficiency. The objective of this study was to evaluate the use of the 5-item Brief Alcohol Withdrawal Scale (BAWS) protocol. Read More

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http://dx.doi.org/10.1097/ADM.0000000000000510DOI Listing
February 2019
3 Reads

CE: Original Research: New Acute Symptoms in Older Adults with Cognitive Impairment: What Should Family Caregivers Do?

Am J Nurs 2019 Feb 7. Epub 2019 Feb 7.

Melinda R. Steis is a nurse manager at the Viera Outpatient Clinic, Orlando Veterans Affairs Medical Center (VAMC), Melbourne, FL. Lynn Unruh is a professor and Varadraj Prabhu Gurupur is an assistant professor in the Department of Health Management and Informatics, College of Community Innovation and Education, University of Central Florida, Orlando. Emilia Shettian is a cofounder of Enigma Health and is based in Leesburg, FL. Meredeth Rowe is a professor in the College of Nursing, University of South Florida, Tampa. Adam Golden is associate chief of staff of research at Orlando VAMC and a professor in the Department of Internal Medicine, College of Medicine, University of Central Florida. The authors acknowledge Nadia Telemaque-Brathwaite, MBA, health care administrator and team leader at the Viera Outpatient Clinic, for her assistance with data collection. Contact author: Melinda R. Steis, The authors and planners have disclosed no potential conflicts of interest, financial or otherwise.

Study findings support targeted interventions that facilitate early recognition and appropriate action.

Abstract: Background: When older adults with cognitive impairment develop new physical or behavioral symptoms, their family caregivers face a difficult decision: whether and when to seek professional medical care. Most family caregivers lack formal training in assessment and may have difficulty making such decisions. Read More

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http://dx.doi.org/10.1097/01.NAJ.0000554006.31272.d1DOI Listing
February 2019
2 Reads

New Approaches for Delirium: A Case for Robotic Pets.

Am J Med 2019 Feb 7. Epub 2019 Feb 7.

Division of Cardiology, Albany Medical Center, Albany, New York.

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http://dx.doi.org/10.1016/j.amjmed.2018.12.039DOI Listing
February 2019

Yokukansan for perioperative psychiatric symptoms in cancer patients undergoing high invasive surgery. J-SUPPORT 1605 (ProD Study): study protocol for a randomized controlled trial.

Trials 2019 Feb 8;20(1):110. Epub 2019 Feb 8.

Department of Psycho-Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, Japan.

Background: Preoperative anxiety and postoperative delirium affect both short- and long-term prognoses in patients with cancer; therefore, these conditions require early prevention and treatment. However, no standard preventive or therapeutic methods have been established for them. Yokukansan, a Japanese herbal medicine for the treatment of insomnia and anxiety, causes relatively few adverse drug reactions and effectively improves the behavioral and psychological symptoms of dementia. Read More

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https://trialsjournal.biomedcentral.com/articles/10.1186/s13
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http://dx.doi.org/10.1186/s13063-019-3202-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6368807PMC
February 2019
2 Reads

Psychiatric Care in Hematopoietic Stem Cell Transplantation.

Psychosomatics 2019 Jan 19. Epub 2019 Jan 19.

Department of Psychiatry, University of North Carolina - Chapel Hill, Chapel Hill, NC; Lineberger Comprehensive Cancer Center, University of North Carolina - Chapel Hill, Chapel Hill, NC; Department of Medicine, University of North Carolina - Chapel Hill, Chapel Hill, NC.

Background: Patients with cancer frequently experience neuropsychiatric symptoms due to their medical illness or its treatment. In recent decades, psychiatrists have become increasingly involved in the care of patients with cancer. However, psychiatrists may be less familiar with hematopoietic stem cell transplantation (HSCT), a distinct cancer treatment modality associated with multiple neuropsychiatric sequelae. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00333182193002
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http://dx.doi.org/10.1016/j.psym.2019.01.005DOI Listing
January 2019
2 Reads

Sharing Frailty-related information in perioperative care: an analysis from a temporal perspective.

BMC Health Serv Res 2019 Feb 7;19(1):105. Epub 2019 Feb 7.

Department of Anesthesiology and Operative Intensive Care Medicine, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.

Background: Especially patients older than 65 years undergoing surgery are prone to develop frailty-related complications that may go far beyond the index hospitalization (e.g., cognitive impairment following postoperative delirium). Read More

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http://dx.doi.org/10.1186/s12913-019-3890-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6367783PMC
February 2019

Determining Interrater Reliability of the Cornell Assessment of Pediatric Delirium Screening Tool Among PICU Nurses.

Pediatr Crit Care Med 2019 Feb 5. Epub 2019 Feb 5.

Children's Core for Biomedical Statistics, Center for Clinical and Translational Research Seattle Children's Research Institute, Seattle, WA.

Objectives: To determine the interrater reliability of the Cornell Assessment of Pediatric Delirium Screening Tool amount PICU nurses.

Design: The design was setup as a cross-sectional study and conducted over the course of a year.

Setting: This study setting was a PICU and a pediatric cardiac ICU at Seattle Children's Hospital, a tertiary freestanding university-affiliated hospital in Seattle, Washington. Read More

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http://dx.doi.org/10.1097/PCC.0000000000001896DOI Listing
February 2019
1 Read

Effect of early and focused benzodiazepine therapy on length of stay in severe alcohol withdrawal syndrome.

Clin Toxicol (Phila) 2019 Feb 7:1-4. Epub 2019 Feb 7.

b Department of Surgery , University of California, Davis Medical Center , Sacramento , CA, USA.

Objective: Current evidence supports symptom-triggered therapy for alcohol withdrawal syndrome (AWS). Early, escalating therapy with benzodiazepines (BZD) appears to decrease ICU length of stay (LOS); however, the effect on hospital LOS remains unknown. The hypothesis of this study is that focused BZD treatment in the first 24 h will decrease hospital LOS. Read More

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http://dx.doi.org/10.1080/15563650.2018.1542701DOI Listing
February 2019
1 Read

Reflections on palliative sedation.

Authors:
Robert Twycross

Palliat Care 2019 27;12:1178224218823511. Epub 2019 Jan 27.

'Palliation sedation' is a widely used term to describe the intentional administration of sedatives to reduce a dying person's consciousness to relieve intolerable suffering from refractory symptoms. Research studies generally focus on either 'continuous sedation until death' or 'continuous deep sedation'. It is not always clear whether instances of secondary sedation (i. Read More

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http://dx.doi.org/10.1177/1178224218823511DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350160PMC
January 2019
1 Read

Post-Operative Delirium.

J Maxillofac Oral Surg 2019 Mar 10;18(1):157-158. Epub 2018 Oct 10.

GMC Rajnandgaon, Shri Ram Kripa, H.No. 82-83, Janta Bhawan Lane, Choubey Colony, Raipur, CG 492001 India.

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http://dx.doi.org/10.1007/s12663-018-1165-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6328838PMC

Management of delirium in Parkinson's disease.

J Neural Transm (Vienna) 2019 Feb 6. Epub 2019 Feb 6.

Department of Neurology, Charité-Universitätsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Germany.

Delirium is an acute and fluctuating disturbance of attention and awareness. Pre-existing cognitive disturbances or dementia are the most significant risk factors for developing delirium and precipitating factors such as drug treatment, infections, trauma, or surgery may trigger delirium. Patients with Parkinson's disease (PD) are at an increased risk for delirium which may be underdiagnosed due to phenomenological overlap between delirium and chronic neuropsychiatric features of PD or side effects of dopaminergic medication. Read More

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http://dx.doi.org/10.1007/s00702-019-01980-7DOI Listing
February 2019
6 Reads

Autoimmune glial fibrillary acidic protein astrocytopathy.

Curr Opin Neurol 2019 Feb 4. Epub 2019 Feb 4.

Department of Neurology.

Purpose Of Review: To describe a recently characterized autoimmune, inflammatory central nervous system (CNS) disorder known as autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy.

Recent Findings: Affected patients present with symptoms of one or more of meningitis (headache and neck ache), encephalitis (delirium, tremor, seizures, or psychiatric symptoms), and myelitis (sensory symptoms and weakness). Optic disc papillitis (blurred vision) is common. Read More

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http://dx.doi.org/10.1097/WCO.0000000000000676DOI Listing
February 2019
3 Reads

Intravenous perfusion of tiapride in a case of treatment-resistant delirium.

Actas Esp Psiquiatr 2019 Jan 1;47(1):33-6. Epub 2019 Jan 1.

Facultativo especialista en Psiquiatría. Hospital General de Villarrobledo.

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January 2019
5 Reads

The transition from vivid dreams over floccillations and visual hallucinations to complete delirium in a geriatric patient at the dawn of Alzheimer's dementia: beneficial role of rivastigmine.

Psychogeriatrics 2019 Feb 5. Epub 2019 Feb 5.

Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Evangelisches Krankenhaus Castrop-Rauxel, Academic Teaching Hospital of the University of Duisburg/Essen, Castrop-Rauxel, Germany.

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http://dx.doi.org/10.1111/psyg.12412DOI Listing
February 2019
3 Reads

Geriatric Consultation Reduces High-risk Medication Usage at Discharge in Elderly Trauma Patients.

Cureus 2018 Nov 28;10(11):e3649. Epub 2018 Nov 28.

Internal Medicine, Hackensack University Medical Center, Hackensack, USA.

Background Traumatic injury in a growing geriatric population is associated with higher mortality and complication rates. Geriatric consultation (GC) is vital in reducing risk factors that contribute to adverse outcomes. This study aims to determine if receiving a GC had an impact on high-risk medication usage. Read More

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http://dx.doi.org/10.7759/cureus.3649DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351116PMC
November 2018
1 Read

Baclofen and the Alcohol Withdrawal Syndrome-A Short Review.

Front Psychiatry 2018 22;9:773. Epub 2019 Jan 22.

Kershaw Unit, Gartnavel Royal Hospital, Glasgow, United Kingdom.

The Alcohol Withdrawal Syndrome (AWS), which may occur with or without delirium, is a frequent consequence of sudden alcohol cessation in patients with moderate to severe Alcohol Dependence Syndrome (ADS). Withdrawal as a result of habituation to alcohol is part of the definition of the Alcohol Dependence Syndrome (ICD10). Since the recognition of Delirium Tremens, in the early nineteenth century, the management of the syndrome, an acute medical emergency, has proven controversial. Read More

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http://dx.doi.org/10.3389/fpsyt.2018.00773DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6349735PMC
January 2019
3 Reads

Pellagra and Alcohol Dependence Syndrome: Findings From a Tertiary Care Addiction Treatment Centre in India.

Alcohol Alcohol 2019 Feb 5. Epub 2019 Feb 5.

Centre for Addiction Medicine, Department of Psychiatry National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, India.

Aim: To define the prevalence and clinical presentation of pellagra, a multi-systemic disease caused by the deficiency of niacin, in patients admitted to a tertiary addiction treatment centre in southern India, with alcohol dependence syndrome (ADS)-(ICD10).

Methods: Review of the health records of 2947 patients who received inpatient care for ADS between 2015 and 2017.

Results: Out of 2947, 31 (1%) were diagnosed with pellagra. Read More

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http://dx.doi.org/10.1093/alcalc/agz004DOI Listing
February 2019
3 Reads

[Assessment of mental symptoms in intensive care unit patients : Suggestion for a German version of the Intensive Care Psychological Assessment Tool].

Med Klin Intensivmed Notfmed 2019 Feb 5. Epub 2019 Feb 5.

Institut für Psychologie, Arbeitsbereich Differentielle Psychologie, Friedrich-Schiller-Universität Jena, Jena, Deutschland.

Background: Intensive care unit (ICU) treatment may be associated with mental symptoms such as anxiety, depressed mood, hopelessness and nightmares in critically ill patients. While many physical symptoms can be detected via standardized measures, an instrument to assess mental symptoms is actually missing.

Objectives: An existing validated screening tool to detect mental symptoms in critically ill patients, the Intensive Care Psychological Assessment Tool (IPAT), has been translated into German and tested in two surgical ICUs and an intermediate care unit. Read More

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http://dx.doi.org/10.1007/s00063-019-0537-zDOI Listing
February 2019
2 Reads

Effect of Electroencephalography-Guided Anesthetic Administration on Postoperative Delirium Among Older Adults Undergoing Major Surgery: The ENGAGES Randomized Clinical Trial.

JAMA 2019 02;321(5):473-483

Department of Anesthesiology, Washington University School of Medicine, St Louis, Missouri.

Importance: Intraoperative electroencephalogram (EEG) waveform suppression, often suggesting excessive general anesthesia, has been associated with postoperative delirium.

Objective: To assess whether EEG-guided anesthetic administration decreases the incidence of postoperative delirium.

Design, Setting, And Participants: Randomized clinical trial of 1232 adults aged 60 years and older undergoing major surgery and receiving general anesthesia at Barnes-Jewish Hospital in St Louis. Read More

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http://dx.doi.org/10.1001/jama.2018.22005DOI Listing
February 2019
2 Reads

Depth of Anesthesia and Postoperative Delirium.

JAMA 2019 02;321(5):459-460

Queen Mary University of London, London, United Kingdom.

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http://dx.doi.org/10.1001/jama.2019.0164DOI Listing
February 2019
4 Reads

Evaluating the Impact of the Dementia Care in Hospitals Program (DCHP) on Hospital-Acquired Complications: Study Protocol.

Int J Environ Res Public Health 2018 Aug 30;15(9). Epub 2018 Aug 30.

Centre for Healthy Brain Ageing, Dementia Collaborative Research Centre, University of New South Wales, Sydney, NSW 2052, Australia.

Despite the increasing number of older people, many with cognitive impairment (CI), in hospitals, there is yet to be an evaluation of hospital-wide interventions improving the management of those with CI. In hospitalized patients with CI, there are likely to be associations between increased complications that impact on outcomes, length of stay, and costs. This prospective study will evaluate the effectiveness of an established hospital CI support program on patient outcomes, patient quality of life, staff awareness of CI, and carer satisfaction. Read More

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http://dx.doi.org/10.3390/ijerph15091878DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165270PMC
August 2018
3 Reads

Major depressive disorder in medical illness: A review of assessment, prevalence, and treatment options.

Psychosom Med 2019 Feb 1. Epub 2019 Feb 1.

Department of Psychiatry, Brigham and Women's Hospital, Boston MA.

Major Depression, as well as other depressive disorders, are commonly comorbid with other medical illnesses, particularly chronic and systemic medical illnesses. The cooccurrence of the disorders is so common that it challenges our notions of the meaning of comorbidity and our desire to neatly separate psychiatric and medical illnesses. The overlap between symptoms of physical illness and the neurovegetative symptoms of major depression and the initial normative emotional response to physical illness add to the challenge of accurate diagnosis and timely treatment of depression in the medically ill. Read More

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http://dx.doi.org/10.1097/PSY.0000000000000678DOI Listing
February 2019
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The scientific evidence for a potential link between confusion and urinary tract infection in the elderly is still confusing - a systematic literature review.

BMC Geriatr 2019 Feb 4;19(1):32. Epub 2019 Feb 4.

Research and Development Unit, Primary Health Care in Southern Älvsborg County, Sven Eriksonsplatsen 4, SE-503 38, Borås, Sweden.

Background: Non-specific symptoms, such as confusion, are often suspected to be caused by urinary tract infection (UTI) and continues to be the most common reason for suspecting a UTI despite many other potential causes. This leads to significant overdiagnosis of UTI, inappropriate antibiotic use and potential harmful outcomes. This problem is particularly prevalent in nursing home settings. Read More

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http://dx.doi.org/10.1186/s12877-019-1049-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360770PMC
February 2019
3 Reads

Evaluation of Changes in Functional Status in the Year After Aortic Valve Replacement.

JAMA Intern Med 2019 Feb 4. Epub 2019 Feb 4.

Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

Importance: Functional status is a patient-centered outcome that is important for a meaningful gain in health-related quality of life after aortic valve replacement.

Objective: To determine functional status trajectories in the year after transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR).

Design, Setting, And Participants: A prospective cohort study with a 12-month follow-up was conducted at a single academic center in 246 patients undergoing TAVR or SAVR for severe aortic stenosis. Read More

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http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jam
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http://dx.doi.org/10.1001/jamainternmed.2018.6738DOI Listing
February 2019
4 Reads

Intraoperative dexmedetomidine to prevent postoperative delirium: in search of the magic bullet.

Can J Anaesth 2019 Jan 28. Epub 2019 Jan 28.

Department of Anesthesia and Perioperative Care, University of California, 500 Parnassus Avenue, Box 0648, San Francisco, CA, 94143, USA.

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http://link.springer.com/10.1007/s12630-019-01300-3
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http://dx.doi.org/10.1007/s12630-019-01300-3DOI Listing
January 2019
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Intraoperative use of dexmedetomidine for the prevention of emergence agitation and postoperative delirium in thoracic surgery: a randomized-controlled trial.

Can J Anaesth 2019 Jan 24. Epub 2019 Jan 24.

Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Gangnam-Gu, Seoul, 135-710, South Korea.

Purpose: We investigated whether preventive use of dexmedetomidine during surgery was effective for reducing emergence agitation and postoperative delirium.

Methods: In this double-blind randomized-controlled trial, 143 patients undergoing thoracoscopic lung resection surgery were randomly assigned to the dexmedetomidine-sevoflurane (DEX-Sevo, n = 73) or sevoflurane (Sevo, n = 70) groups. Dexmedetomidine or saline administration was started after inducing anesthesia and continued until the end of surgery at a fixed dose (0. Read More

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http://link.springer.com/10.1007/s12630-019-01299-7
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http://dx.doi.org/10.1007/s12630-019-01299-7DOI Listing
January 2019
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Common Challenges to Effective ABCDEF Bundle Implementation: The ICU Liberation Campaign Experience.

Crit Care Nurse 2019 Feb;39(1):46-60

Michele Balas is an associate professor, Center of Excellence in Critical and Complex Care, College of Nursing, and a nurse scientist, Wexner Medical Center, The Ohio State University, Columbus.

Although growing evidence supports the safety and effectiveness of the ABCDEF bundle (A, assess, prevent, and manage pain; B, both spontaneous awakening and spontaneous breathing trials; C, choice of analgesic and sedation; D, delirium: assess, prevent, and manage; E, early mobility and exercise; and F, family engagement and empowerment), intensive care unit providers often struggle with how to reliably and consistently incorporate this interprofessional, evidence-based intervention into everyday clinical practice. Recently, the Society of Critical Care Medicine completed the ICU Liberation ABCDEF Bundle Improvement Collaborative, a 20-month, nationwide, multicenter quality improvement initiative that formalized dissemination and implementation strategies and tracked key performance metrics to overcome barriers to ABCDEF bundle adoption. The purpose of this article is to discuss some of the most challenging implementation issues that Collaborative teams experienced, and to provide some practical advice from leading experts on ways to overcome these barriers. Read More

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http://dx.doi.org/10.4037/ccn2019927DOI Listing
February 2019
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Implementing the ABCDEF Bundle: Top 8 Questions Asked During the ICU Liberation ABCDEF Bundle Improvement Collaborative.

Crit Care Nurse 2019 Feb;39(1):36-45

Joanna Stollings is a clinical pharmacist, Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, Tennessee.

The ABCDEF bundle (A, assess, prevent, and manage pain; B, both spontaneous awakening and spontaneous breathing trials; C, choice of analgesic and sedation; D, delirium: assess, prevent, and manage; E, early mobility and exercise; and F, family engagement and empowerment) improves intensive care unit patient-centered outcomes and promotes interprofessional teamwork and collaboration. The Society of Critical Care Medicine recently completed the ICU Liberation ABCDEF Bundle Improvement Collaborative, a 20-month, multicenter, national quality improvement initiative that formalized dissemination and implementation strategies to promote effective adoption of the ABCDEF bundle. The purpose of this article is to describe 8 of the most frequently asked questions during the Collaborative and to provide practical advice from leading experts to other institutions implementing the ABCDEF bundle. Read More

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http://dx.doi.org/10.4037/ccn2019981DOI Listing
February 2019
9 Reads

Depression Predicts Delirium After Coronary Artery Bypass Graft Surgery Independent of Cognitive Impairment and Cerebrovascular Disease: An Analysis of the Neuropsychiatric Outcomes After Heart Surgery Study.

Am J Geriatr Psychiatry 2018 Dec 25. Epub 2018 Dec 25.

Department of Psychiatry (MAO, HBL), University of Rochester Medical Center, Rochester, NY.

Objective: Although depression is a known risk factor for delirium after coronary artery bypass graft (CABG) surgery, it is unclear whether this risk is independent of delirium risk attributable to cognitive impairment or cerebrovascular disease. This study examines depression, mild cognitive impairment (MCI), and cerebrovascular disease as post-CABG delirium risk factors.

Methods: This prospective observational cohort study was performed in a tertiary-care academic hospital. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10647481183062
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http://dx.doi.org/10.1016/j.jagp.2018.12.025DOI Listing
December 2018
5 Reads